Neurodevelopment Among Infants with Deformational Plagiocephaly

畸形斜头畸形婴儿的神经发育

• 批准号: 7122510
• 负责人: MATTHEW Louis SPELTZ
• 金额: $ 48.23万
• 依托单位: SEATTLE CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-14 至 2010-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7122510
• 关键词: age difference; behavior test; brain morphology; cephalometry; clinical research; computed axial tomography; congenital oral /facial /cranial defect; developmental neurobiology; disease /disorder etiology; family structure /dynamics; gender difference; human subject; infant human (0-1 year); intelligence tests; longitudinal human study; magnetic resonance imaging; micrencephaly; neuropsychological tests; postnatal growth disorder; preschool child (1-5); prognosis; socioeconomics

DESCRIPTION (provided by applicant): Deformational plagiocephaly (DP) refers to cranial asymmetry believed to be attributable to external forces molding the malleable infant skull. Suspected casual factors include pre-natal factors (e.g., intrauterine constraint), post-natal events (e.g., invariant positioning during sleep) and/or underlying neuropathology. Initial studies of the neurodevelopment of children with DP have found evidence for significant deficits, but methodological problems limit the interpretation of these studies; potential explanations for such findings are unclear. Further investigation is necessary to refine etiological hypotheses and to provide clinicians and parents with accurate information regarding the neurodevelopmental correlates of DP. Several factors indicate the need for rather immediate study of these issues: the rapidly increasing rate of DP (and/or increasing awareness of and parental worry about the condition), the proliferation of associated medical treatments (helmets and craniofacial surgery), the possibility of preventable developmental problems, and the implication of causal association with the American Academy of Pediatrics "Back to Sleep" campaign. In this 5-year longitudinal study, we would like to investigate these issues by recruiting 300 infants with DP and 325 matched controls, following them from age 6 to 36 months. A subgroup of DP cases will be imaged using MRI (n= 46) and compared to controls by sharing data with another NIH-funded study of normal brain development. Specific aims are: (1) Compare the neurodevelopment of infants/toddlers with and without DP using a multi-domain model of neuropsychological development; (2) Among infants with DP, determine the association between neurodevelopmental status and severity of cranial asymmetry (assessed by both clinical judgment and skull imaging); (3) Develop and test a predictive model of 36-month neurodevelopmental outcomes for infants with DP; (4) Evaluate the perceived facial appearance of infants with and without DP (does the condition produce noticeable effects on facial appearance, as many parents fear?); (5) Develop and test a predictive model of parent participation in elective treatments (i.e., what parent/family and infant medical factors best predict treatment participation?) and (6) Using MRI, compare the brain structure and volume of infants with and without DP; among cases, examine relations among brain structure/volume, skull asymmetry, and neuropsychological status.

描述（由申请人提供）：变形型损伤（DP）是指被认为归因于外力塑造可延展的婴儿头骨的颅骨不对称性。怀疑的休闲因素包括产前因素（例如，宫内约束），产后事件（例如，睡眠期间的不变定位）和/或基本的神经病理学。 DP儿童神经发育的初步研究发现了明显缺陷的证据，但是方法论问题限制了这些研究的解释。这些发现的潜在解释尚不清楚。需要进一步研究以完善病因学假设，并为临床医生和父母提供有关DP神经发育相关性的准确信息。几个因素表明需要立即研究这些问题：DP的速度迅速增加（和/或对父母对疾病的认识和父母的担忧），相关药物治疗的繁殖（头盔和颅面手术）的繁殖，可能预防与美国佩德迪亚的Causal Access of American Access of Pediatemy segale tackips campaign overaight overady''在这项为期5年的纵向研究中，我们想通过招募300名具有DP和325个匹配对照的婴儿来调查这些问题，从6岁到36个月之后。 DP病例的亚组将使用MRI（n = 46）成像，并通过与NIH资助的另一项对正常脑发育的研究共享数据，并将其与对照组进行比较。具体目的是：（1）使用神经心理学发展的多域模型比较有或没有DP的婴儿/幼儿的神经发育； （2）在患有DP的婴儿中，确定神经发育状态与颅不对称性的严重程度之间的关联（通过临床判断和颅骨成像进行评估）； （3）为患有DP的婴儿开发和测试36个月神经发育结局的预测模型； （4）评估有或没有DP的婴儿的感知面部外观（这种情况是否会像许多父母所害怕的那样对面部外观产生明显的影响？）； （5）开发和测试父母参与选修治疗的预测模型（即，哪些父母/家庭和婴儿医疗因素可以最好地预测治疗参与？）和（6）使用MRI，比较有和没有DP的婴儿的大脑结构和婴儿的体积；在案例中，检查大脑结构/体积，颅骨不对称和神经心理学状态之间的关系。