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Zhang W, Si Q, Guan Z, Cao L, Wang M, Zhao C, Sun L, Zhang X, Zhang Z, Li C, Song W. Improved whole-brain reconfiguration efficiency reveals mechanisms of speech rehabilitation in cleft lip and palate patients: an fMRI study. Front Aging Neurosci 2025; 17:1536658. [PMID: 40103926 PMCID: PMC11913808 DOI: 10.3389/fnagi.2025.1536658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2024] [Accepted: 02/13/2025] [Indexed: 03/20/2025] Open
Abstract
Introduction Cleft lip and/or palate (CLP) patients still have severe speech disorder requiring speech rehabilitation after surgical repair. The clarity of language rehabilitation is evaluated clinically by the Language Rehabilitation Scale. However, the pattern and underlying mechanisms of functional changes in the brain are not yet clear. Recent studies suggest that the brain's reconfiguration efficiency appears to be a key feature of its network dynamics and general cognitive abilities. In this study, we compared the association between rehabilitation effects and reconfiguration efficiency. Methods We evaluated CLP patients with speech rehabilitation (n = 23) and without speech rehabilitation (n = 23) and normal controls (n = 25). Assessed CLP patients on the Chinese Speech Intelligibility Test Word Lists and collected fMRI data and behavioral data for all participants. We compared behavioral data and task activation levels between participants for between-group differences and calculated reconfiguration efficiencies for each task based on each participant. In patients, we correlated reconfiguration efficiency with task performance and measured the correlation between them. Results Behaviorally, CLP patients with rehabilitation scored significantly higher than those without rehabilitation on the Chinese Speech Intelligibility Test Word Lists. Rehabilitation caused local brain activation levels of CLP patients to converge toward those of controls, indicating rehabilitative effects on brain function. Analysis of reconfiguration efficiency across tasks at the local and whole-brain levels identified underlying recovery mechanisms. Whole-brain reconfiguration efficiency was significantly and positively correlated with task performance. Conclusion Our results suggest that speech rehabilitation can improve the level of language-related brain activity in CLP patients, and that reconfiguration efficiency can be used as an assessment index of language clarity to evaluate the effectiveness of brain rehabilitation in CLP patients, a finding that can provide a better understanding of the degree of brain function recovery in patients.
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Affiliation(s)
- Wenjing Zhang
- Department of Rehabilitation Medicine, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Qian Si
- School of Cyber Science and Technology, Beihang University, Beijing, China
| | - Zhongtian Guan
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Lei Cao
- Department of Rehabilitation Medicine, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Mengyue Wang
- School of Life Sciences, Beijing Institute of Technology, Beijing, China
| | - Cui Zhao
- School of Communication Sciences, Beijing Language and Culture University, Beijing, China
| | - Liwei Sun
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Xu Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Zhixi Zhang
- Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing, China
| | - Chunlin Li
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Weiqun Song
- Department of Rehabilitation Medicine, Xuanwu Hospital Capital Medical University, Beijing, China
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Hsu CC, Wu YH, Lee KS, Shih PC, Liu TY, Wei JCC, Chu WM, Nakai T, Yang FPG. Verbal training can improve neurocognitive and reading performance by increasing white matter integrity and grey matter volume. Exp Gerontol 2024; 198:112625. [PMID: 39490557 DOI: 10.1016/j.exger.2024.112625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 10/16/2024] [Accepted: 10/25/2024] [Indexed: 11/05/2024]
Abstract
INTRODUCTION Dementia and mild cognitive impairment (MCI) present both health and economic challenges on a global scale, thus affecting millions of people, and is projected to increase significantly by the year 2050. Early language processing deficits are evident in those diagnosed with Alzheimer's disease and MCI. Recent advances in pharmacologic and non-pharmacologic interventions, including cognitive rehabilitation and training, show promising effects on cognitive functions. Articulation training, particularly, is highlighted for its potential in addressing the communication difficulties which those experiencing dementia and MCI face, based on the transmission deficit hypothesis. This study aimed to perform a voxel-wise comparison of morphological changes in grey matter volume as well as white matter integrity to represent the plastic changes in response to articulation training among older, healthy Japanese adults. METHODS Forty older, healthy Japanese adults were randomized into either a cognitive training group or a control group. The study involved comprehensive behavioral assessments, neuroimaging (including 3D anatomy, fMRI and Diffusion Tensor Imaging), and a structured verbal articulation training regimen. The training included reading tasks which focused on enhancing both articulation and phonological skills. Neuroimaging data were acquired using a 3 Tesla Siemens MR scanner, with the FSL tool being used for white matter analysis and the CAT12 toolbox for grey matter analysis. RESULTS Significant increases in grey matter volume were observed in certain regions, including the left Supplementary motor area, Postcentral gyrus, and bilateral Superior frontal gyrus among those in the training group. Correlations were noted between reading abilities and cortical volume in areas such as the left Middle temporal gyrus, pulvinar, and Middle occipital gyrus. White matter integrity also improved, as evidenced by increased fractional anisotropy in tracts such as the superior longitudinal fasciculus, corona radiata, and internal capsule. These findings suggest a link between articulation training and enhanced neuroplasticity in both grey and white matter regions related to language processing. CONCLUSION The study demonstrates that a 4-week verbal articulation training intervention period can lead to significant improvements in grey matter volume in the left Supplementary motor area, the left Postcentral gyrus, and the bilateral Superior frontal gyrus, as well as the integrity of white matter tracts associated with language processing among older adults. These results suggest that such training could be a valuable tool in enhancing cognitive functions related to language in older populations.
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Affiliation(s)
- Ching-Chi Hsu
- Board of Directors, Wizcare Medical Corporation Aggregate, Taichung, Taiwan; International Intercollegiate Ph.D. Program, National Tsing Hua University, Hsinchu, Taiwan
| | - Yun-Hsiang Wu
- Department of Foreign Languages and Literature, National Tsing Hua University, Hsinchu, Taiwan; Center for Cognition and Mind Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | - Kang-Shuo Lee
- Department of Foreign Languages and Literature, National Tsing Hua University, Hsinchu, Taiwan; Center for Cognition and Mind Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | - Po-Cheng Shih
- Division of Allergy, Immunology, Rheumatology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Tzu-Yu Liu
- Department of Foreign Languages and Literature, National Tsing Hua University, Hsinchu, Taiwan; Center for Cognition and Mind Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Wei-Min Chu
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; Geriatrics and Gerontology Research Center, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
| | - Toshiharu Nakai
- Department of Radiology, Graduate School of Dentistry, Osaka University, Suita, Japan; Institute of Neuroimaging and Informatics, Obu, Japan.
| | - Fan-Pei Gloria Yang
- Department of Foreign Languages and Literature, National Tsing Hua University, Hsinchu, Taiwan; Center for Cognition and Mind Sciences, National Tsing Hua University, Hsinchu, Taiwan; Department of Radiology, Graduate School of Dentistry, Osaka University, Suita, Japan.
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Bai Y, Liu S, Zhu M, Wang B, Li S, Meng L, Shi X, Chen F, Jiang H, Jiang C. Perceptual Pattern of Cleft-Related Speech: A Task-fMRI Study on Typical Mandarin-Speaking Adults. Brain Sci 2023; 13:1506. [PMID: 38002467 PMCID: PMC10669275 DOI: 10.3390/brainsci13111506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/30/2023] [Accepted: 10/17/2023] [Indexed: 11/26/2023] Open
Abstract
Congenital cleft lip and palate is one of the common deformities in the craniomaxillofacial region. The current study aimed to explore the perceptual pattern of cleft-related speech produced by Mandarin-speaking patients with repaired cleft palate using the task-based functional magnetic resonance imaging (task-fMRI) technique. Three blocks of speech stimuli, including hypernasal speech, the glottal stop, and typical speech, were played to 30 typical adult listeners with no history of cleft palate speech exploration. Using a randomized block design paradigm, the participants were instructed to assess the intelligibility of the stimuli. Simultaneously, fMRI data were collected. Brain activation was compared among the three types of speech stimuli. Results revealed that greater blood-oxygen-level-dependent (BOLD) responses to the cleft-related glottal stop than to typical speech were localized in the right fusiform gyrus and the left inferior occipital gyrus. The regions responding to the contrast between the glottal stop and cleft-related hypernasal speech were located in the right fusiform gyrus. More significant BOLD responses to hypernasal speech than to the glottal stop were localized in the left orbital part of the inferior frontal gyrus and middle temporal gyrus. More significant BOLD responses to typical speech than to the glottal stop were localized in the left inferior temporal gyrus, left superior temporal gyrus, left medial superior frontal gyrus, and right angular gyrus. Furthermore, there was no significant difference between hypernasal speech and typical speech. In conclusion, the typical listener would initiate different neural processes to perceive cleft-related speech. Our findings lay a foundation for exploring the perceptual pattern of patients with repaired cleft palate.
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Affiliation(s)
- Yun Bai
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China; (Y.B.)
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210029, China
| | - Shaowei Liu
- Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210004, China
| | - Mengxian Zhu
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China; (Y.B.)
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210029, China
| | - Binbing Wang
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China; (Y.B.)
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210029, China
| | - Sheng Li
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China; (Y.B.)
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210029, China
| | - Liping Meng
- Department of Children’s Healthcare, Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - Xinghui Shi
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China; (Y.B.)
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210029, China
| | - Fei Chen
- Department of Electrical and Electronic Engineering, Southern University of Science and Technology, Shenzhen 518055, China
| | - Hongbing Jiang
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China; (Y.B.)
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210029, China
| | - Chenghui Jiang
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China; (Y.B.)
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210029, China
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Zhang W, Zhao C, Sun L, Yang X, Yang L, Liang Y, Zhang X, Du X, Chen R, Li C. Articulation-Function-Associated Cortical Developmental Changes in Patients with Cleft Lip and Palate. Brain Sci 2023; 13:brainsci13040550. [PMID: 37190514 DOI: 10.3390/brainsci13040550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/17/2023] [Accepted: 03/22/2023] [Indexed: 03/29/2023] Open
Abstract
Cleft lip and palate (CLP) is one of the most common craniofacial malformations. Overall, 40–80% of CLP patients have varying degrees of articulation problems after palatoplasty. Previous studies revealed abnormal articulation-related brain function in CLP patients. However, the association between articulation disorders and cortical structure development in CLP patients remains unclear. Twenty-six CLP adolescents (aged 5–14 years; mean 8.88 years; female/male 8/18), twenty-three CLP adults (aged 18–35 years; mean 23.35 years; female/male 6/17), thirty-seven healthy adolescents (aged 5–16 years; mean 9.89 years; female/male 5/16), and twenty-two healthy adults (aged 19–37 years; mean 24.41 years; female/male 19/37) took part in the experiment. The current study aims to investigate developmental changes in cortical structures in CLP patients with articulation disorders using both structural and functional magnetic resonance imaging (MRI). Our results reveal the distinct distribution of abnormal cortical structures in adolescent and adult CLP patients. We also found that the developmental pattern of cortical structures in CLP patients differed from the pattern in healthy controls (delayed cortical development in the left lingual gyrus (t = 4.02, cluster-wise p < 0.05), inferior temporal cortex (z = −4.36, cluster-wise p < 0.05) and right precentral cortex (t = 4.19, cluster-wise p < 0.05)). Mediation analysis identified the cortical thickness of the left pericalcarine cortex as the mediator between age and articulation function (partial mediation effect (a*b = −0.48), 95% confident interval (−0.75, −0.26)). In conclusion, our results demonstrate an abnormal developmental pattern of cortical structures in CLP patients, which is directly related to their articulation disorders.
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Wang S, Fang L, Miao G, Li Z, Rao B, Cheng H. Atypical cortical thickness and folding of language regions in Chinese nonsyndromic cleft lip and palate children after speech rehabilitation. Front Neurol 2022; 13:996459. [PMID: 36203989 PMCID: PMC9531957 DOI: 10.3389/fneur.2022.996459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 08/24/2022] [Indexed: 11/28/2022] Open
Abstract
Objective Even after palatoplasty and speech rehabilitation, patients with cleft lip and palate (CLP) remain to produce pronunciation errors. We hypothesized that nonsyndromic CLP (NSCLP) after speech rehabilitation had structural abnormalities in language-related brain regions. This study investigates structural patterns in NSCLP children after speech rehabilitation using surface-based morphometry (SBM) analysis. Methods Forty-two children with NSCLP and 42 age- and gender-matched healthy controls were scanned for 3D T1-weighted images on a 3T MRI scanner. After reconstructing each brain surface, we computed SBM parameters and assessed between-group differences using two-sample t-tests and permutation tests (5,000 times). Then, we assessed the relationship between the SBM parameters and the Chinese language clear degree scale (CLCDS) using Pearson's correlation analysis. Result The speech-rehabilitated children with NSCLP showed lower cortical thickness and higher gyrification index mainly involving left language-related brain regions (permutation tests, p < 0.05). Furthermore, the lower cortical thickness of the left parahippocampal gyrus was positively correlated with CLCDS scores (r = 0.370, p = 0.017) in patients with NSCLP. Conclusion The SBM analysis showed that the structural abnormalities of speech-rehabilitated children with NSCLP mainly involved language-related brain regions, especially the dominant cerebral hemisphere. The structural abnormalities of the cortical thickness and folding in the language-related brain regions might be the neural mechanisms of speech errors in NSCLP children after speech rehabilitation. The cortical thickness of the parahippocampal gyrus may be a biomarker to evaluate pronunciation function.
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Affiliation(s)
- Shi Wang
- Department of Neonatology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Fang
- Department of Nuclear Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guofu Miao
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Zhichao Li
- Department of Rheumatism Immunology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Zhichao Li
| | - Bo Rao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
- Bo Rao
| | - Hua Cheng
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- Hua Cheng
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Li Z, Li C, Liang Y, Wang K, Wang L, Zhang X, Wu Q. Anomalous cerebral morphology of pregnant women with cleft fetuses. Front Hum Neurosci 2022; 16:959710. [PMID: 36158614 PMCID: PMC9491019 DOI: 10.3389/fnhum.2022.959710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivePregnancy leads to long-lasting changes in brain structure for healthy women; however, little is known regarding alterations in the cortical features of pregnant women with malformed fetuses. Isolated clefts of the lip and/or palate (ICL/P) are the most common congenital anomaly in the craniofacial region, which is highly gene-associated. We speculated that pregnant women carrying fetuses with ICL/P may have associated risk genes and specific brain changes during pregnancy.MethodsIn this study, we investigated T1-weighted brain magnetic resonance imaging data from 48 pregnant women: 24 women carrying fetuses with ICL/P (ICL/P group) and 24 women carrying normal fetuses (normal controls), then explored intergroup differences in gray matter volume (GMV), cortical thickness (CT) and cortical complexity (gyrification).ResultsCompared with controls, the ICL/P group had decreased total intracranial volume (TIV) than normal controls; besides, they exhibited increased GMV in the left cuneus, decreased GMV in the right superior temporal gyrus; increased CT in the left precuneus and left superior parietal gyrus, decreased CT involving parsopercularis, fusiform, middle temporal in the left hemisphere and supramarginal, precentral gyrus (PreCG) in the right hemisphere; increased gyrification in the left insula and PreCG, the left middle temporal, and the right supratemporal gyrus.ConclusionPregnant women with ICL/P fetuses had brain morphology changes involving language, auditory, vision, and sensory cortex, which may be their special brain changes compared to normal pregnant women. This study may provide clues for the early detection of fetuses with ICL/P, and be vital for preconception and prenatal counseling with non-invasive methods.
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Affiliation(s)
- Zhen Li
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Chunlin Li
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University, Beijing, China
- School of Biomedical Engineering, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
| | - Yuting Liang
- Department of Radiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Keyang Wang
- Department of Radiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Li Wang
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Xu Zhang
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University, Beijing, China
- School of Biomedical Engineering, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
- *Correspondence: Xu Zhang,
| | - Qingqing Wu
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
- Qingqing Wu,
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Sándor-Bajusz KA, Sadi A, Varga E, Csábi G, Antonoglou GN, Lohner S. The Brain in Oral Clefting: A Systematic Review With Meta-Analyses. Front Neuroanat 2022; 16:863900. [PMID: 35756498 PMCID: PMC9226441 DOI: 10.3389/fnana.2022.863900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
Background Neuroimaging of individuals with non-syndromic oral clefts have revealed subtle brain structural differences compared to matched controls. Previous studies strongly suggest a unified primary dysfunction of normal brain and face development which could explain these neuroanatomical differences and the neuropsychiatric issues frequently observed in these individuals. Currently there are no studies that have assessed the overall empirical evidence of the association between oral clefts and brain structure. Our aim was to summarize the available evidence on potential brain structural differences in individuals with non-syndromic oral clefts and their matched controls. Methods MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, Web of Science and Embase were systematically searched in September 2020 for case-control studies that reported structural brain MRI in individuals with non-syndromic oral clefts and healthy controls. Studies of syndromic oral clefts were excluded. Two review authors independently screened studies for eligibility, extracted data and assessed risk of bias with the Newcastle-Ottawa Scale. Random effects meta-analyses of mean differences (MDs) and their 95% confidence intervals (95% CI) were performed in order to compare global and regional brain MRI volumes. Results Ten studies from 18 records were included in the review. A total of 741 participants were analyzed. A moderate to high risk of bias was determined for the included studies. The cerebellum (MD: -12.46 cm3, 95% CI: -18.26, -6.67, n = 3 studies, 354 participants), occipital lobes (MD: -7.39, 95% CI: -12.80, -1.99, n = 2 studies, 120 participants), temporal lobes (MD: -10.53 cm3, 95% CI: -18.23, -2.82, n = 2 studies, 120 participants) and total gray matter (MD: -41.14 cm3; 95% CI: -57.36 to -24.92, n = 2 studies, 172 participants) were significantly smaller in the cleft group compared to controls. Discussion There may be structural brain differences between individuals with non-syndromic oral clefts and controls based on the available evidence. Improvement in study design, size, methodology and participant selection could allow a more thorough analysis and decrease study heterogeneity.
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Affiliation(s)
- Kinga A. Sándor-Bajusz
- Department of Pediatrics, University of Pécs, Pécs, Hungary
- Doctoral School of Clinical Neurosciences, University of Pécs, Pécs, Hungary
| | - Asaad Sadi
- Adult Psychiatric Division, Borlänge Specialist Clinic, Borlänge, Sweden
| | - Eszter Varga
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | - Györgyi Csábi
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | - Georgios N. Antonoglou
- Periodontology Unit, Faculty of Dentistry, Centre for Host Microbiome Interactions, Oral and Craniofacial Sciences, King’s College London, London, United Kingdom
| | - Szimonetta Lohner
- Cochrane Hungary, Clinical Centre of the University of Pécs, Medical School, University of Pécs, Pécs, Hungary
- Department of Public Health Medicine, Medical School, University of Pécs, Pécs, Hungary
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Meregalli V, Alberti F, Madan CR, Meneguzzo P, Miola A, Trevisan N, Sambataro F, Favaro A, Collantoni E. Cortical Complexity Estimation Using Fractal Dimension: A Systematic Review of the Literature on Clinical and Nonclinical Samples. Eur J Neurosci 2022; 55:1547-1583. [PMID: 35229388 PMCID: PMC9313853 DOI: 10.1111/ejn.15631] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/27/2022] [Accepted: 02/20/2022] [Indexed: 12/04/2022]
Abstract
Fractal geometry has recently been proposed as a useful tool for characterizing the complexity of the brain cortex, which is likely to derive from the recurrence of sulci–gyri convolution patterns. The index used to describe the cortical complexity is called fractal dimensional (FD) and was employed by different research exploring the neurobiological correlates of distinct pathological and nonpathological conditions. This review aims to describe the literature on the application of this index, summarize the heterogeneities between studies and inform future research on this topic. Sixty‐two studies were included in the systematic review. The main research lines concern neurodevelopment, aging and the neurobiology of specific psychiatric and neurological disorders. Overall, the included papers indicate that cortical complexity is likely to reduce during aging and in various pathological processes affecting the brain. Nevertheless, the high heterogeneity between studies strongly prevents the possibility of drawing conclusions. Further research considering this index besides other morphological values is needed to better clarify the role of FD in characterizing the cortical structure. Fractal dimension (FD) is a useful tool for the assessment of cortical complexity. In healthy controls, FD is associated with development, aging and cognition. Alterations in FD have been observed in different neurological and psychiatric disorders.
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Affiliation(s)
- Valentina Meregalli
- Department of Neurosciences, University of Padua, Padova, Italy.,Padua Neuroscience Center, University of Padua, Padova, Italy
| | | | | | - Paolo Meneguzzo
- Department of Neurosciences, University of Padua, Padova, Italy
| | - Alessandro Miola
- Department of Neurosciences, University of Padua, Padova, Italy.,Padua Neuroscience Center, University of Padua, Padova, Italy
| | - Nicolò Trevisan
- Department of Neurosciences, University of Padua, Padova, Italy.,Padua Neuroscience Center, University of Padua, Padova, Italy
| | - Fabio Sambataro
- Department of Neurosciences, University of Padua, Padova, Italy.,Padua Neuroscience Center, University of Padua, Padova, Italy
| | - Angela Favaro
- Department of Neurosciences, University of Padua, Padova, Italy.,Padua Neuroscience Center, University of Padua, Padova, Italy
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Rao B, Cheng H, Xu H, Peng Y. Random Network and Non-rich-club Organization Tendency in Children With Non-syndromic Cleft Lip and Palate After Articulation Rehabilitation: A Diffusion Study. Front Neurol 2022; 13:790607. [PMID: 35185761 PMCID: PMC8847279 DOI: 10.3389/fneur.2022.790607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/03/2022] [Indexed: 11/30/2022] Open
Abstract
Objective The neuroimaging pattern in brain networks after articulation rehabilitation can be detected using graph theory and multivariate pattern analysis (MVPA). In this study, we hypothesized that the characteristics of the topology pattern of brain structural network in articulation-rehabilitated children with non-syndromic cleft lip and palate (NSCLP) were similar to that in healthy comparisons. Methods A total of 28 children with NSCLP and 28 controls with typical development were scanned for diffusion tensor imaging on a 3T MRI scanner. Structural networks were constructed, and their topological properties were obtained. Besides, the Chinese language clear degree scale (CLCDS) scores were used for correlation analysis with topological features in patients with NSCLP. Results The NSCLP group showed a similar rich-club connection pattern, but decreased small-world index, normalized rich-club coefficient, and increased connectivity strength of connections compared to controls. The univariate and multivariate patterns of the structural network in articulation-rehabilitated children were primarily in the feeder and local connections, covering sensorimotor, visual, frontoparietal, default mode, salience, and language networks, and orbitofrontal cortex. In addition, the connections that were significantly correlated with the CLCDS scores, as well as the weighted regions for classification, were chiefly distributed in the dorsal and ventral stream associated with the language networks of the non-dominant hemisphere. Conclusion The average level rich-club connection pattern and the compensatory of the feeder and local connections mainly covering language networks may be related to the CLCDS in articulation-rehabilitated children with NSCLP. However, the patterns of small-world and rich-club structural organization in the articulation-rehabilitated children exhibited a random network and non-rich-club organization tendency. These findings enhanced the understanding of neuroimaging patterns in children with NSCLP after articulation rehabilitation.
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Affiliation(s)
- Bo Rao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Hua Cheng
- Department of Radiology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
- *Correspondence: Haibo Xu
| | - Yun Peng
- Department of Radiology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
- Yun Peng
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Cheng H, Rao B, Zhang W, Chen R, Peng Y. Increased modularity of the resting-state network in children with nonsyndromic cleft lip and palate after speech rehabilitation. Brain Behav 2021; 11:e02094. [PMID: 34343416 PMCID: PMC8413807 DOI: 10.1002/brb3.2094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Speech therapy is the primary management followed the physical management through surgery for children with nonsyndromic cleft lip and palate (NSCLP). However, the topological pattern of the resting-state network after rehabilitation remains poorly understood. We aimed to explore the functional topological pattern of children with NSCLP after speech rehabilitation compared with healthy controls. METHODS We examined 28 children with NSCLP after speech rehabilitation (age = 10.0 ± 2.3 years) and 28 healthy controls for resting-state functional MRI. We calculated functional connections and the degree strength, betweenness centrality, network clustering coefficient (Cp), characteristic path length (Lp), global network efficiency (Eg), local network efficiency (Eloc), modularity index (Q), module number, and participation coefficient for the between-group differences using two-sample t tests (corrected p < .05). Additionally, we performed a correlation analysis between the Chinese language clear degree scale (CLCDS) scores and topological properties in children with NSCLP. RESULTS We detected significant between-group differences in the areas under the curve (AUCs) of degree strength and betweenness centrality in language-related brain regions. There were no significant between-group differences in module number, participation coefficient, Cp, Lp, Eg, or Eloc. However, the Q (density: 0.05-0.30) and QAUC (t = 2.46, p = .02) showed significant between-group differences. Additionally, there was no significant correlation between topological properties of statistical between-group differences and CLCDS scores. CONCLUSIONS Although nodal metric differences existed in the language-related brain regions, the children with NSCLP after speech rehabilitation had similar global network properties, module numbers, and participation coefficient, but increased modularity. Our results suggested that children with NSCLP achieved speech rehabilitation through function specialization in the language-related brain regions. The resting-state topology pattern could be of substantive neurobiological importance and potential imaging biomarkers for speech rehabilitation.
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Affiliation(s)
- Hua Cheng
- Department of Radiology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Bo Rao
- Departments of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wenjing Zhang
- Department of Oral and Maxillofacial Plastic and Trauma Surgery, Center of Cleft Lip and Palate Treatment, Beijing Stomatological Hospital, Beijing, China
| | - Renji Chen
- Department of Oral and Maxillofacial Plastic and Trauma Surgery, Center of Cleft Lip and Palate Treatment, Beijing Stomatological Hospital, Beijing, China
| | - Yun Peng
- Department of Radiology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
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