The sulcal pits as neurodevelopmental markers: A systematic review about their potential use in clinical practice

Sulcal pits, defined as the deepest points of the cortical surface and identified as stable landmarks, exhibit a consistent emergence sequence that aligns with established gyrification patterns, underscoring their potential as markers for early neurodevelopmental trajectories. Here, we investigate the potential of sulcal pits in characterizing the etiological roots of neurodevelopmental traits and disorders. This systematic review (PROSPERO register: CRD42022347303) was conducted according to PRISMA guidelines. Searches were performed in PubMed, Web of Science (WOS), and Scopus, initially identifying 102 articles, from which 53 were screened and 19 finally included. The articles were categorized into two main groups: those exploring the ontogenetic processes of sulcal pits and those investigating their relationship with neurodevelopmental phenotypes in health and disease. The review findings indicate that individuals with congenital conditions or neurodevelopmental disorders exhibit distinct patterns of sulcal pits that correlate with cognitive traits. Additionally, graph analyses consistently show lower mean similarity within individuals from affected groups, suggesting that variations in sulcal pit patterns reflect the impact of neurodevelopmental disturbances. These results highlight the potential of sulcal pits to capture instabilities in early brain development. However, they also point to a lack of comprehensive biological interpretation in the current literature. Further research is needed to enhance our understanding of the significance of sulcal pits in neurodevelopmental outcomes and to advance their use as diagnostic tools.