Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA.
Department of Diagnostic Radiology, Yale School of Medicine, New Haven, CT, USA.
Childs Nerv Syst. 2024 May;40(5):1477-1487. doi: 10.1007/s00381-023-06262-y. Epub 2024 Jan 4.
Nonsyndromic craniosynostosis (NSC) is associated with neurocognitive deficits, and intervention at infancy is standard of care to limit the negative effects of NSC on brain development. In this study, diffusion tensor imaging (DTI) was implemented to investigate white matter microstructure in infants with NSC undergoing cranial vault remodeling, and a comparison was made with white matter development in neurotypical controls.
Infants presenting with NSC (n = 12) underwent DTI scans before and after cranial vault remodeling. Neurotypical infants (n = 5), age matched to NSC patients at preoperative scans, were compared to preoperative DTI scans. Pre- and postoperative NSC scans were compared in aggregate, and the sagittal synostosis (n = 8) patients were evaluated separately. Finally, neurotypical infants from the University of North Carolina/University of New Mexico Baby Connectome Project (BCP), who underwent DTI scans at timepoints matching the NSC pre- and postoperative DTI scans, were analyzed (n = 9). Trends over the same time period were compared between NSC and BCP scans.
No significant differences were found between preoperative NSC scans and controls. White matter development was more limited in NSC patients than in BCP patients, with microstructural parameters of the corpus body and genu and inferior and superior longitudinal fasciculi consistently lagging behind developmental changes observed in healthy patients.
Infant white matter development appears more limited in NSC patients undergoing cranial vault remodeling relative to that in neurotypical controls. Further investigation is needed to explore these differences and the specific effects of early surgical intervention.
非综合征性颅缝早闭（NSC）与神经认知缺陷有关，婴儿期的干预是标准的护理措施，以限制 NSC 对大脑发育的负面影响。在这项研究中，采用弥散张量成像（DTI）来研究接受颅盖重塑的 NSC 婴儿的白质微观结构，并与神经典型对照组的白质发育进行比较。
患有 NSC 的婴儿（n=12）在颅盖重塑前后接受 DTI 扫描。将神经典型的婴儿（n=5）与 NSC 患者的术前扫描年龄匹配，并与术前 DTI 扫描进行比较。对术前和术后的 NSC 扫描进行汇总比较，并对矢状缝早闭（n=8）患者进行单独评估。最后，分析了来自北卡罗来纳大学/新墨西哥大学婴儿连接组计划（BCP）的神经典型婴儿（n=9），他们在与 NSC 术前和术后 DTI 扫描时间匹配的时间点接受了 DTI 扫描。比较了 NSC 和 BCP 扫描之间同一时间段的趋势。
术前 NSC 扫描与对照组之间无显著差异。与 BCP 患者相比，NSC 患者的白质发育更为受限，胼胝体和膝状体以及下和上纵束的微观结构参数始终落后于健康患者的发育变化。
与神经典型对照组相比，接受颅盖重塑的 NSC 患者的婴儿白质发育似乎更为受限。需要进一步研究以探索这些差异以及早期手术干预的具体影响。
