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Hofer-Martini S, Hofer M, Hemprich A, Berger T, Fuchs M, Meuret S. [Auditory processing in children and adolescents with cleft palate]. Laryngorhinootologie 2020; 100:30-37. [PMID: 33022738 DOI: 10.1055/a-1250-8639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Patients with cleft palate often suffer from recurrent otitis media chronica with effusion during infancy. The consecutive binaural conductive hearing loss is seen as a risk factor for developing auditory processing disease. Since there are just a few studies examining auditory processing in this population this study aimed to investigate on an own patient cohort with different cleft manifestations in terms of auditory processing disorders in context to given studies. MATERIAL AND METHODS This study included 48 patients (5-16 years): all patients had a non-syndromic cleft palate and normal peripheral hearing at the time of examination. The protocol included otoscopy, pure tone audiogram, speech intelligibility in noise, dichotic speech discrimination, auditory short-term memory and a parental questionnaire. RESULTS The majority of the parents did not indicate problems in the parental questionnaire. 69 % of the participants showed conspicuous results in the speech intelligibility in noise, whereas the dichotic speech discrimination and the auditory short-term memory were suspicious in 16.7 % only. The results in both tests proved mainly a problem in younger children. Noticeable results in speech intelligibility in noise were found in all age groups. CONCLUSION Children and adolescents with cleft palate are at risk to develop auditory processing disorders. In this study population speech intelligibility in noise was the most common problem. 90 % of the children had received a speech therapy which could have already compensated problems concerning dichotic speech discrimination and the auditory short-term memory but not problems in speech intelligibility in noise.
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Affiliation(s)
| | - Mathias Hofer
- HNO-Praxis Lindenauer Markt, Leipzig, Germany.,Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Leipzig AöR, Leipzig, Germany
| | - Alexander Hemprich
- Klinik und Poliklinik für Mund-, Kiefer- und Plastische Gesichtschirurgie, Universitätsklinikum Leipzig AöR, Leipzig, Germany
| | - Thomas Berger
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Leipzig AöR, Leipzig, Germany.,Sektion Phoniatrie und Audiologie der Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Leipzig, Germany
| | - Michael Fuchs
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Leipzig AöR, Leipzig, Germany.,Sektion Phoniatrie und Audiologie der Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Leipzig, Germany
| | - Sylvia Meuret
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Leipzig AöR, Leipzig, Germany.,Sektion Phoniatrie und Audiologie der Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Leipzig, Germany
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Preliminary evaluation of pre-speech and neurodevelopmental measures in 7-11-week-old infants with isolated oral clefts. Pediatr Res 2020; 89:85-90. [PMID: 32279071 PMCID: PMC7554202 DOI: 10.1038/s41390-020-0887-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this research study was to evaluate the earliest markers of vocal functioning and neurological development in infants with isolated oral cleft of the lip and/or palate (iCL/P). METHODS Participants were recruited through advertisements and clinic visits at a local mid-western university. A total of eight participants (four unaffected and four with iCL/P), ranging in age from 7.29 to 11.57 weeks, were enrolled and completed demographic and pre-speech measures. A subset of six males (four unaffected and two with iCL/P) successfully completed a structural magnetic resonance imaging scan. RESULTS Patterns of disrupted vocal control and reduced myelinated white matter were found in participants with iCL/P. CONCLUSIONS The findings of this study provide a foundation from which to build further research on the neuronal development of infants with oral clefts: the need to evaluate measures of cortical development, inclusion of information on anesthesia exposure and airway obstruction, and suggestions for avoiding identified pitfalls/blocks to obtaining data are discussed. IMPACT Research in children with isolated oral clefts has demonstrated higher rates of learning disorders connected to subtle differences in brain structure. There is no work evaluating the potential impact of exposure to anesthesia on development. This is the first known attempt to evaluate brain structure and function in infants with isolated oral clefts before exposure to anesthesia. Potential trends of early vocal issues and structural brain differences (less myelinated white matter) were identified in infants with isolated oral clefts compared to unaffected controls. Differences in brain structure and function in infants with isolated oral clefts may be present before surgery.
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3
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Increased activation of the hippocampus during a Chinese character subvocalization task in adults with cleft lip and palate palatoplasty and speech therapy. Neuroreport 2017; 28:739-744. [DOI: 10.1097/wnr.0000000000000832] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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4
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Ma X, McPherson B, Ma L. Electrophysiological assessment of auditory processing disorder in children with non-syndromic cleft lip and/or palate. PeerJ 2016; 4:e2383. [PMID: 27635347 PMCID: PMC5012300 DOI: 10.7717/peerj.2383] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 07/30/2016] [Indexed: 12/02/2022] Open
Abstract
Objectives Cleft lip and/or palate is a common congenital craniofacial malformation found worldwide. A frequently associated disorder is conductive hearing loss, and this disorder has been thoroughly investigated in children with non-syndromic cleft lip and/or palate (NSCL/P). However, analysis of auditory processing function is rarely reported for this population, although this issue should not be ignored since abnormal auditory cortical structures have been found in populations with cleft disorders. The present study utilized electrophysiological tests to assess the auditory status of a large group of children with NSCL/P, and investigated whether this group had less robust central auditory processing abilities compared to craniofacially normal children. Methods 146 children with NSCL/P who had normal peripheral hearing thresholds, and 60 craniofacially normal children aged from 6 to 15 years, were recruited. Electrophysiological tests, including auditory brainstem response (ABR), P1-N1-P2 complex, and P300 component recording, were conducted. Results ABR and N1 wave latencies were significantly prolonged in children with NSCL/P. An atypical developmental trend was found for long latency potentials in children with cleft compared to control group children. Children with unilateral cleft lip and palate showed a greater level of abnormal results compared with other cleft subgroups, whereas the cleft lip subgroup had the most robust responses for all tests. Conclusion Children with NSCL/P may have slower than normal neural transmission times between the peripheral auditory nerve and brainstem. Possible delayed development of myelination and synaptogenesis may also influence auditory processing function in this population. Present research outcomes were consistent with previous, smaller sample size, electrophysiological studies on infants and children with cleft lip/palate disorders. In view of the these findings, and reports of educational disadvantage associated with cleft disorders, further research that focuses on the auditory processing abilities of children with cleft lip/palate disorder is warranted.
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Affiliation(s)
- Xiaoran Ma
- Division of Speech and Hearing Sciences, University of Hong Kong , Hong Kong , China
| | - Bradley McPherson
- Division of Speech and Hearing Sciences, University of Hong Kong , Hong Kong , China
| | - Lian Ma
- School of Stomatology, Peking University , Beijing , China
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5
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Adamson CL, Anderson VA, Nopoulos P, Seal ML, Da Costa AC. Regional brain morphometric characteristics of nonsyndromic cleft lip and palate. Dev Neurosci 2014; 36:490-8. [PMID: 25171633 DOI: 10.1159/000365389] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 06/19/2014] [Indexed: 11/19/2022] Open
Abstract
Nonsyndromic cleft lip and palate (NSCLP) encompasses a group of orofacial abnormalities. Emerging evidence has revealed the presence of structural brain abnormalities in affected individuals. Previous studies have performed structure-based volumetric analysis of the brain assessing gross lobular subdivisions of the cerebral cortex and white matter which may have only vague relationships to the functional subregions implicated in behavioral and cognitive deficits observed in NSCLP patients. High-resolution magnetic resonance imaging structural data were acquired to provide a detailed characterization of the brain with respect to both regional cortical volume and thickness in 26 children with NSCLP and 26 age- and demographically matched typically developing children. Children with NSCLP exhibited abnormally large cerebral cortex grey matter volumes with decreased volumes of subcortical grey matter and cerebral white matter structures. Hemisphere-specific patterns of cortical volume and thickness abnormalities were identified. This study is the first to examine cortical thickness abnormalities in NSCLP. Overall, these findings suggest that the brains of children with NSCLP are less mature than those of their age-matched peers. Gender-specific comparisons reveal that NSCLP females were more immature compared to their typically developing peers compared to NSCLP males.
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Affiliation(s)
- Chris L Adamson
- Developmental Imaging, Murdoch Childrens Research Institute, Parkville, Vic., Australia
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6
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Genetics of cleft lip and/or cleft palate: Association with other common anomalies. Eur J Med Genet 2014; 57:381-93. [DOI: 10.1016/j.ejmg.2014.04.003] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 04/03/2014] [Indexed: 12/16/2022]
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Lipinski RJ, Holloway HT, O'Leary-Moore SK, Ament JJ, Pecevich SJ, Cofer GP, Budin F, Everson JL, Johnson GA, Sulik KK. Characterization of subtle brain abnormalities in a mouse model of Hedgehog pathway antagonist-induced cleft lip and palate. PLoS One 2014; 9:e102603. [PMID: 25047453 PMCID: PMC4105496 DOI: 10.1371/journal.pone.0102603] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 06/20/2014] [Indexed: 11/19/2022] Open
Abstract
Subtle behavioral and cognitive deficits have been documented in patient cohorts with orofacial clefts (OFCs). Recent neuroimaging studies argue that these traits are associated with structural brain abnormalities but have been limited to adolescent and adult populations where brain plasticity during infancy and childhood may be a confounding factor. Here, we employed high resolution magnetic resonance microscopy to examine primary brain morphology in a mouse model of OFCs. Transient in utero exposure to the Hedgehog (Hh) signaling pathway antagonist cyclopamine resulted in a spectrum of facial dysmorphology, including unilateral and bilateral cleft lip and palate, cleft of the secondary palate only, and a non-cleft phenotype marked by midfacial hypoplasia. Relative to controls, cyclopamine-exposed fetuses exhibited volumetric differences in several brain regions, including hypoplasia of the pituitary gland and olfactory bulbs, hyperplasia of the forebrain septal region, and expansion of the third ventricle. However, in affected fetuses the corpus callosum was intact and normal division of the forebrain was observed. This argues that temporally-specific Hh signaling perturbation can result in typical appearing OFCs in the absence of holoprosencephaly--a condition classically associated with Hh pathway inhibition and frequently co-occurring with OFCs. Supporting the premise that some forms of OFCs co-occur with subtle brain malformations, these results provide a possible ontological basis for traits identified in clinical populations. They also argue in favor of future investigations into genetic and/or environmental modulation of the Hh pathway in the etiopathogenesis of orofacial clefting.
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Affiliation(s)
- Robert J. Lipinski
- The Bowles Center for Alcohol Studies, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- * E-mail:
| | - Hunter T. Holloway
- The Bowles Center for Alcohol Studies, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Shonagh K. O'Leary-Moore
- The Bowles Center for Alcohol Studies, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Jacob J. Ament
- The Bowles Center for Alcohol Studies, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Stephen J. Pecevich
- The Bowles Center for Alcohol Studies, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Gary P. Cofer
- Center for In Vivo Microscopy, Duke University, Durham, North Carolina, United States of America
| | - Francois Budin
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Joshua L. Everson
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - G. Allan Johnson
- Center for In Vivo Microscopy, Duke University, Durham, North Carolina, United States of America
| | - Kathleen K. Sulik
- The Bowles Center for Alcohol Studies, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina, United States of America
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Aerts A, DeVolder I, Weinberg SM, Thedens D, Dunnwald M, Schutte BC, Nopoulos P. Haploinsufficiency of interferon regulatory factor 6 alters brain morphology in the mouse. Am J Med Genet A 2013; 164A:655-60. [PMID: 24357509 DOI: 10.1002/ajmg.a.36333] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 10/12/2013] [Indexed: 12/22/2022]
Abstract
Orofacial clefts are among the commonest birth defects. Among many genetic contributors to orofacial clefting, Interferon Regulatory Factor 6 (IRF6) is unique since mutations in this gene cause Van der Woude (VWS), the most common clefting syndrome. Furthermore, variants in IRF6 contribute to increased risk for non-syndromic cleft lip and/or palate (NSCL/P). Our previous work shows that individuals with either VWS or NSCL/P may have cerebral anomalies (larger anterior, smaller posterior regions), and a smaller cerebellum. The objective of this study was to test the hypothesis that disrupting Irf6 in the mouse will result in quantitative brain changes similar to those reported for humans with VWS and NSCL/P. Male mice heterozygous for Irf6 (Irf6(gt1/+); n = 9) and wild-type (Irf6(+/+) ; n = 6) mice at comparable age underwent a 4.7-T MRI scan to obtain quantitative measures of cortical and subcortical brain structures. There was no difference in total brain volume between groups. However, the frontal cortex was enlarged in the Irf6(gt1/+) mice compared to that of wild types (P = 0.028) while the posterior cortex did not differ. In addition, the volume of the cerebellum of Irf6(gt1/+) mice was decreased (P = 0.004). Mice that were heterozygous for Irf6 showed a similar pattern of brain anomalies previously reported in humans with VWS and NSCL/P. These structural differences were present in the absence of overt oral clefts. These results support a role for IRF6 in brain morphometry and provide evidence for a potential genetic link to abnormal brain development in orofacial clefting.
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Affiliation(s)
- Andrea Aerts
- Department of Psychiatry, University of Iowa, Iowa City, Iowa
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9
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Abstract
Orofacial clefts (OFCs)--primarily cleft lip and cleft palate--are among the most common birth defects in all populations worldwide, and have notable population, ethnicity, and gender differences in birth prevalence. Interest in these birth defects goes back centuries, as does formal scientific interest; scientists often used OFCs as examples or evidence during paradigm shifts in human genetics, and have also used virtually every new method of human genetic analysis to deepen our understanding of OFC. This review traces the evolution of human genetic investigations of OFC, highlights the specific insights gained about OFC through the years, and culminates in a review of recent key OFC genetic findings resulting from the powerful tools of the genomics era. Notably, OFC represents a major success for genome-wide approaches, and the field is poised for further breakthroughs in the near future.
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Affiliation(s)
- Mary L Marazita
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA.
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10
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Conrad AL, Richman L, Nopoulos P, Dailey S. Neuropsychological functioning in children with non-syndromic cleft of the lip and/or palate. Child Neuropsychol 2012; 15:471-84. [PMID: 19184778 DOI: 10.1080/09297040802691120] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Evaluate neuropsychological functioning in children with non-syndromic cleft of the lip and/or palate (NSCL/P) through profile variance within type of cleft and comparisons to controls. METHODS Children ages 7 to 17 years participated; 66 had a diagnosis of NSCL/P and 87 were healthy controls. Neuropsychological tests of language, visual-perceptual, executive functioning, and memory skills were administered. Between- and within-group differences were assessed. RESULTS Within cleft types, children with NSCLP had an even profile with equal Verbal and Performance IQ (VIQ and PIQ, respectively). Children with non-syndromic cleft palate only (NSCP) had significantly lower VIQ than PIQ, while children with non-syndromic cleft lip only (NSCL) showed a nonsignificant trend for higher VIQ than PIQ. Overall, subjects with NSCL/P performed lower on measures of expressive language and verbal memory than controls. CONCLUSIONS While deficits in verbal and memory skills for children with NSCL/P remain apparent, there is still uncertainty around the possible influence of cleft type on the pattern of deficits.
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Affiliation(s)
- Amy Lynn Conrad
- The University of Iowa College of Medicine, Psychiatry Research, and University of Iowa Hospitals and Clinics, Otolaryngology, Iowa City, IA 52242, USA.
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Demir T, Karacetin G, Baghaki S, Aydin Y. Psychiatric assessment of children with nonsyndromic cleft lip and palate. Gen Hosp Psychiatry 2011; 33:594-603. [PMID: 21816483 DOI: 10.1016/j.genhosppsych.2011.06.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Revised: 06/20/2011] [Accepted: 06/21/2011] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of the study was to determine whether children with nonsyndromic cleft lip and palate (NSCLP) are more likely to be diagnosed with psychiatric disorders and whether cleft-related factors are related to psychopathology. METHOD Twenty children from 6 to 16 years of age with NSCLP, attending the Plastic, Reconstructive and Aesthetic Surgery Department of Cerrahpasa Medical Faculty between January and October 2010, were included as the case group. Forty healthy children who were matched on age and sex with the case group served as controls. Children were assessed by psychiatric interviews and scales. RESULTS Social anxiety disorder (SAD) (P=.003) and major depressive disorder (MDD) (P=.010) were more prevalent in children with NSCLP. The severity of dentofacial (P=.035) and cleft lip nose deformities (P=.002), appearance and competence of the lip (P=.008), dental alignment (P=.002), feeding (P=.044) and articulation problems (P<.001) were associated with clinical global functioning. CONCLUSIONS Children with NSCLP are at risk of developing psychopathology, especially SAD and MDD. The above cleft-related factors and articulation problems may be the target of interventions to prevent and treat psychiatric disorders in these children.
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Affiliation(s)
- Turkay Demir
- Department of Child and Adolescent Psychiatry, Cerrahpasa Medical Faculty, University of Istanbul, 34098 Istanbul, Turkey.
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Collett BR, Stott-Miller M, Kapp-Simon KA, Cunningham ML, Speltz ML. Reading in children with orofacial clefts versus controls. J Pediatr Psychol 2010; 35:199-208. [PMID: 19509183 PMCID: PMC2902832 DOI: 10.1093/jpepsy/jsp047] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To examine reading and related skills in children with and without orofacial clefts. METHODS Forty-two children with orofacial clefts were recruited from an urban craniofacial center. A demographically similar sample of 43 children without clefts was recruited using community advertisements and a research registry. Participants completed assessments of basic reading, phonological awareness, phonological memory, reading fluency, and rapid naming. Parents completed a semi-structured interview regarding educational and medical history. RESULTS Children with clefts scored significantly lower than controls on measures of basic reading, phonological memory, and reading fluency. CONCLUSIONS This is one of the first studies of reading in children with orofacial clefts to include a control sample. The findings suggest that children with clefts are less adept readers than demographically matched peers without clefts, supporting the need to monitor academic achievement in this population.
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Affiliation(s)
- Brent R Collett
- University of Washington, Seattle Children's Hospital, WA, USA.
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Yang FF, McPherson B. Assessment and Management of Hearing Loss in Children with Cleft Lip and/or Palate: a Review. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/s0915-6992(07)80021-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Boes AD, Murko V, Wood JL, Langbehn DR, Canady J, Richman L, Nopoulos P. Social function in boys with cleft lip and palate: relationship to ventral frontal cortex morphology. Behav Brain Res 2007; 181:224-31. [PMID: 17537526 PMCID: PMC1976412 DOI: 10.1016/j.bbr.2007.04.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2006] [Revised: 04/13/2007] [Accepted: 04/17/2007] [Indexed: 11/23/2022]
Abstract
Isolated clefts of the lip and/or palate (ICLP) are developmental craniofacial abnormalities that have consistently been linked to increased social inhibition or shyness. Two explanations have been proposed: (1) psychosocial factors related to differences in facial appearance may lead to low self-concept and subsequent shyness, or (2) abnormal development of brain structures involved in social function, such as the ventral frontal cortex (VFC), may underlie the difference. To investigate these two possibilities this study was designed to evaluate measures of social function in relation to measures of self-concept and VFC morphology. Subjects included 30 boys (age 7-12) with ICLP and a comparison group of 43 boys without cleft in the same age category. Social function and self-concept were assessed using questionnaires with standardized scoring filled out by subjects and one of their parents. The cortical volume and surface area of the VFC, composed of the orbitofrontal cortex (OFC) and straight gyrus (SG), were evaluated using structural magnetic resonance imaging. The ICLP subjects had significantly impaired social function relative to the comparison group. No difference in self-concept was identified. VFC morphology revealed significant differences between groups, particularly decreased volume and surface area in the left SG of the ICLP group. Moreover, abnormal VFC measures were correlated with social dysfunction but measures of self-concept were not. These results are consistent with the possibility that aberrant VFC development may partially underlie social dysfunction in boys with ICLP.
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Affiliation(s)
- Aaron D Boes
- University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA.
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15
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Nopoulos P, Richman L, Andreasen N, Murray JC, Schutte B. Cognitive dysfunction in adults with Van der Woude syndrome. Genet Med 2007; 9:213-8. [PMID: 17438385 DOI: 10.1097/gim.0b013e3180335abd] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Van der Woude syndrome is an autosomal dominant disorder manifested in clefts of the lip and/or palate and lip pits. There is phenotypic and genotypic overlap between Van der Woude syndrome and isolated cleft of the lip and/or palate. Subjects with isolated cleft of the lip and/or palate have been shown to have cognitive dysfunction. Given the similarities between Van der Woude syndrome and isolated cleft of the lip and/or palate, the current study was designed to evaluate the pattern of cognitive function in adults with Van der Woude syndrome. METHODS Fourteen adults with Van der Woude syndrome were compared with age- and gender-matched controls. A battery of cognitive tests was administered to determine general IQ as well as more specific cognitive performance measures. RESULTS All subjects with Van der Woude syndrome showed deficits in performance on an executive function task. In addition, males with Van der Woude syndrome had significantly lower scores on intelligence measures and on a verbal fluency task compared with controls. CONCLUSION The pattern of cognitive function in Van der Woude syndrome is very similar to that seen in isolated cleft of the lip and/or palate. In addition, the findings have a significant gender effect in which males are more severely affected than females. This pattern is common to other conditions with a neurodevelopmental etiology, supporting the notion that the cognitive deficits of Van der Woude syndrome and isolated cleft of the lip and/or palate are due to abnormal brain development.
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Affiliation(s)
- Peg Nopoulos
- Department of Psychiatry, University of Iowa College of Medicine, Iowa City, Iowa 52242, USA.
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Richman LC, Ryan SM. Do the Reading Disabilities of Children With Cleft Fit Into Current Models of Developmental Dyslexia? Cleft Palate Craniofac J 2003. [DOI: 10.1597/1545-1569(2003)040<0154:dtrdoc>2.0.co;2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Nopoulos P, Berg S, VanDemark D, Richman L, Canady J, Andreasen NC. Cognitive dysfunction in adult males with non-syndromic clefts of the lip and/or palate. Neuropsychologia 2002; 40:2178-84. [PMID: 12208013 DOI: 10.1016/s0028-3932(02)00043-x] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Cognitive deficits have been well-documented in children with non-syndromic clefts of the lip and/or palate. However, no study to date has formally assessed cognition in adults with oral clefts. This study was designed to evaluate neuropsychological functioning in adult males with non-syndromic clefts of the lip and/or palate (n=50) compared to age and sex-matched controls. Subjects with oral clefts were found to have significantly lower full scale IQ, performance IQ and verbal IQ scores compared to their matched controls. After controlling for IQ, patients showed specific deficits in verbal fluency. Adult males with oral clefts manifest a specific pattern of cognitive deficits. As the development of the face is highly interdependent with the development of the brain, it is theorized that the etiology of these cognitive deficits is a primary problem with abnormal brain development.
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Affiliation(s)
- Peg Nopoulos
- Psychiatry Research, University of Iowa College of Medicine, 1-180 MEB, 500 Newton Road, Iowa City 52242, USA.
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Nopoulos P, Berg S, Canady J, Richman L, Van Demark D, Andreasen NC. Structural brain abnormalities in adult males with clefts of the lip and/or palate. Genet Med 2002; 4:1-9. [PMID: 11839951 DOI: 10.1097/00125817-200201000-00001] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To evaluate brain morphology of adult males with nonsyndromic clefts of the lip and/or palate (NSCLP) in comparison to a matched healthy control group. METHODS Brain structure was measured using quantitative analysis of magnetic resonance images. RESULTS Subjects with NSCLP had significant abnormalities in brain morphology consisting of abnormally enlarged anterior regions of the cerebrum, and decreased volumes of the posterior cerebrum and cerebellum. Overall, the most severely affected region was the left temporal lobe. Furthermore, these structural abnormalities were directly related to cognitive dysfunction. CONCLUSIONS These findings highlight the important relationship and interplay between face and brain development.
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Affiliation(s)
- Peg Nopoulos
- Department of Psychiatry, University of Iowa Hospital, Iowa City, Iowa 52242, USA
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Imaging of Craniofacial Disorders. Oral Maxillofac Surg Clin North Am 2001. [DOI: 10.1016/s1042-3699(20)30118-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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