Sex differences in the neurodevelopment of school-age children with and without single-suture craniosynostosis

Abstract

Sex differences in neurodevelopmental abilities among children with SSC are substantial, but not a unique correlate of this disorder as similar differences were observed among controls. Girls and those with sagittal synostosis have the lowest risk for academic problems. Boys with unicoronal synostosis warrant close developmental surveillance.

Language, learning, and memory in children with and without single-suture craniosynostosis

“…For example, Fernald et al 16 found that by age 5 years the language skills of children from lower socioeconomic backgrounds were delayed by approximately 2 years in comparison with more socially advantaged peers. Similarly we have previously reported sex differences on the neurocognitive measures used in this test battery, 13 with males in both the case and control groups scoring lower than females from both groups on most measures. Thus, failing to adjust for sex, SES, and other demographic confounding variables may yield misleading results and variation across studies, depending on the population sampled.…”

“…Given the mixed findings from previous studies, 4,6,9,12,13,15,23,34,41,48 the primary aim of this investigation was to determine whether school-age children with SSC, all of whom underwent cranioplasty, have deficits in language and memory skills in relation to demographically similar children without a craniofacial disorder. Use of a control group for such comparisons is critical but has been rarely undertaken in previous research on this topic.…”

“…We have previously reported on differences in performance by suture group, identifying children with unilateral coronal and unilateral lambdoid synostosis as at greatest risk. 13,43 A report by Chieffo et al 9 is the only other study to date that has directly assessed and compared the performance of school-aged children with different suture involvement in the same study, although these authors only included children with sagittal and unilateral coronal synostosis. 9 Similar to our findings, Chieffo et al 9 reported poorer verbal fluency and working memory for children with unilateral coronal synostosis compared with children with sagittal SSC and the control participants.…”

“…As such, the study's design is limited in its ability to elucidate the mechanisms by which SSC or factors associated with SSC (e.g., surgery and anesthesia exposure 35 ) have led to the group differences observed here and elsewhere. 4,6,9,13,15,23,34,41,48 The etiology of the neurodevelopmental consequences and correlates of SSC remains unclear, with some hypotheses focusing on the effects of the fused suture on brain development [1][2][3]47,49 and others emphasizing preexisting neuropathology that may affect both brain and cranium. 5,19 These studies provide some evidence that changes in brain morphology present prior to surgery persist after surgery.…”

Cognitive Development of Children with Craniosynostosis

“…Developmental delays are generally mild and vary significantly, those with unicoronal or lambdoid synostosis being most vulnerable, whereas sagittal synostosis cases, the most common variety of synostosis, are spared. Boys with single-suture craniosynostosis score lower on academic and IQ tests than girls; and males are more likely than females to have learning problems (50 vs 30%); males with unicoronal synostosis have a 86% risk of learning disorder [ 2 ].…”