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
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Research in children with isolated oral clefts has demonstrated higher rates of learning disorders connected to subtle differences in brain structure.
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There is no work evaluating the potential impact of exposure to anesthesia on development.
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This is the first known attempt to evaluate brain structure and function in infants with isolated oral clefts before exposure to anesthesia.
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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.
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Differences in brain structure and function in infants with isolated oral clefts may be present before surgery.
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Acknowledgements
We thank the Cleft Palate Foundation and Dr. Deborah Kacmarynski who provided financial support to this project. We would also like to thank Joel Bruss who went above and beyond to process the youngest brain images our lab has obtained. Finally, we would like to extend our sincerest gratitude to the families who allowed their infants to participate in this study.
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A.L.C.: Contributed to design of the work; acquisition, analysis, and interpretation of data; and revision and final approval of the manuscript. K.W.: Contributed to design of the work; acquisition, analysis, and interpretation of data; and revision and final approval of the manuscript. M.E.: Contributed to acquisition and analysis of data, and final approval of the manuscript. E.K.: Contributed to acquisition and analysis of data, and final approval of the manuscript. A.B.: Contributed to analysis and interpretation of data, and revision and final approval of the manuscript. T.K.: Contributed to analysis and interpretation of data, and revision and final approval of the manuscript. V.M.: Contributed to design of the work, and revision and final approval of the manuscript. This study was funded by grants through the Cleft Palate Foundation (PI: A.L.C., Ph.D.) and a University of Iowa Foundation Fund through the Department of Otolaryngology (Director: Deborah Kacmarynski, M.D.).
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Conrad, A.L., Wermke, K., Eisenmann, M. et al. Preliminary evaluation of pre-speech and neurodevelopmental measures in 7–11-week-old infants with isolated oral clefts. Pediatr Res 89, 85–90 (2021). https://doi.org/10.1038/s41390-020-0887-5
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DOI: https://doi.org/10.1038/s41390-020-0887-5
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