Date of Award

January 2018

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

John Persing

Abstract

This study uses functional MRI (fMRI) to study long-term neurocognitive sequelae of nonsyndromic craniosynostosis (NSC), and understand if these aberrations vary by form of synostosis. Twenty adolescent participants with treated NSC (10 sagittal (SSO), 5 right unilateral coronal (UCS), 5 metopic (MSO)) were matched to controls by age, gender, and handedness. A subgroup of MSO was classified as severe metopic synostosis (SMS) based on the endocranial bifrontal angle. Resting-state fMRI was acquired in a 3T Siemens TIM Trio scanner, and data was motion- corrected, cluster-corrected with nonparametric permutation tests, and analyzed with BioImage Suite. SSO had decreased intrinsic connectivity compared to controls in the superior parietal lobules and the angular gyrus (p=0.071). UCS had decreased intrinsic connectivity throughout the prefrontal cortex (p=0.031). The SMS subgroup had significantly decreased connectivity among multiple subcortical structures. SSO had changes in regions associated with visuomotor integration and attention, while UCS had changes in circuits crucial in executive function. Finally, severity of metopic synostosis may influence the degree of neurocognitive aberration. This study provides neurologic evidence of long-term sequelae of NSC that varies by suture type, which may underlie different phenotypes of neurocognitive impairment.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 06/27/2020

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