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Functional Network Development in Sagittal Craniosynostosis Treated With Whole Vault Cranioplasty
Raysa Cabrejo1, Cheryl Lacadie2, Alexander Sun1
1Department of Surgery, Division of Plastic Surgery, Yale Medical School.
The Journal of Craniofacial Surgery
|February 3, 2021
Summary
Whole vault cranioplasty (WVC) in infants with sagittal craniosynostosis alters brain network connectivity. Post-surgery, improved connectivity is seen in visual and frontoparietal networks, though some deficits may persist.
Area of Science:
- Neuroscience
- Pediatric Neurosurgery
- Medical Imaging
Background:
- Sagittal craniosynostosis is a congenital condition where the sagittal suture fuses prematurely.
- This fusion impacts skull development and may affect underlying brain structures and function.
- Understanding neurological changes associated with whole vault cranioplasty (WVC) is crucial for patient outcomes.
Purpose of the Study:
- To investigate neurological alterations before and after whole vault cranioplasty (WVC) in patients with sagittal craniosynostosis.
- To analyze changes in functional brain network connectivity using advanced neuroimaging techniques.
Main Methods:
- A case-control study involving 25 patients with 30 functional MRI scans.
- Analysis of functional MRI and diffusion tensor imaging data using BioImageSuite.
- Examination of 9 functional brain networks and their correlated regions.
Main Results:
- Infants post-WVC showed increased connectivity in left frontoparietal, V2, and V3 visual networks (P < 0.001).
- Decreased connectivity was observed in the right frontoparietal network (RFPN) (P < 0.001).
- Adolescents treated with WVC exhibited increased salience network connectivity and decreased RFPN connectivity compared to controls.
Conclusions:
- Patients with sagittal craniosynostosis exhibit distinct cerebral network connections in infancy.
- WVC surgery leads to specific connectivity changes in networks crucial for executive function and emotional control.
- While some network abnormalities correct post-surgery, persistent alterations in salience and RFPN may impact executive functioning.
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