Understanding The Learning Disabilities Linked To Sagittal Craniosynostosis
Raysa Cabrejo1, Cheryl Lacadie, BS1, Eric Brooks, MD, MHS1, Joel Beckett, MD1, Alex Sun, MD1, Jenny Yang, MD1, Carolyn Chuang, MD1, Jeffrey Eilbott, PhD1, Charles Duncan, MD1, Derek Steinbacher, DMD, MD1, Michael Alperovich, MD1, Pamela Ventola, PhD1, Kevin Pelphrey, PhD2, Todd Constable, PhD1, John Persing, MD1.
1Yale School of Medicine, New Haven, CT, USA, 2George Washington University, Washington, DC, USA.
Purpose: The purpose of this study is to investigate further findings that corroborate similarities between corrected sagittal craniosynostosis and ADHD. The ultimate aim is understanding if treatment of ADHD was appropriate for patients with corrected craniosynostosis or if different treatment and strategies were needed compared to ADHD patients. Methods: We studied a total of 30 functional magnetic resonance imaging (MRI) of 10 sagittal nonsyndromic craniosynostosis (sNSC), 10 Attention Deficit Hyperactivity Disorder (ADHD)-Combined, and 10 control adolescents. The fMRI scans were analyzed utilizing Statistical Parametric Mapping (SPM, University College London, UK) and analyzed with BioImageSuite (Yale University, USA). Results: ADHD has lower connectivity to BA11 (MNI: -12,26,-21), BA20 (MNI: 62,-24,-25), and BA21 (MNI: 62,-32,-23) compared to sNSC and controls (p<0.001). sNSC has a unique visuospatial defect, compared to ADHD, created by decreased connectivity to BA31 (MNI: -3,-68,37), BA7 (MNI: -4,-68,41), BA19 (MNI: 0,-83,31), visual association cortex (MNI: -4,-78,22), and primary visual cortex (MNI: 7,-74,21) (p<0.001). Conclusion: Patients born with sagittal nonsyndromic craniosynostosis have different neural connections than children born with ADHD. Patients born with sagittal nonsyndromic craniosynostosis have decreased connections in areas of visual processing and increased connections in areas of attention and auditory processing than patients with ADHD. Therefore, children with sagittal craniosynsotosis may have learning difficulties that, similar, yet different from ADHD.
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