Atypical cortical thickness and folding of language regions in Chinese nonsyndromic cleft lip and palate children after speech rehabilitation

Shi Wang; Lei Fang; Guofu Miao; Zhichao Li; Bo Rao; Hua Cheng

doi:10.3389/fneur.2022.996459

Atypical cortical thickness and folding of language regions in Chinese nonsyndromic cleft lip and palate children after speech rehabilitation

Front Neurol. 2022 Sep 20:13:996459. doi: 10.3389/fneur.2022.996459. eCollection 2022.

Authors

Shi Wang¹, Lei Fang², Guofu Miao³, Zhichao Li⁴, Bo Rao⁵, Hua Cheng⁶

Affiliations

¹ Department of Neonatology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² 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.
³ Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China.
⁴ 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.
⁵ Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China.
⁶ Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

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.

Keywords: cortical thickness; gyrification index; nonsyndromic cleft lip and palate; speech therapy; surface-based morphometry.