Cognitive and neuropsychomotor development in craniosynostosis: an evaluation of the most affected functions

• Ano de defesa: 2025
• Autor(a) principal: Ferreira, Jéssica Luchi
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: eng
• Instituição de defesa: Biblioteca Digitais de Teses e Dissertações da USP
• Palavras-chave em Português: Cognição; Cognition; Craniossinostose; Craniosynostoses; Neuropsicologia; Neuropsychology
• Link de acesso: https://www.teses.usp.br/teses/disponiveis/61/61132/tde-22042025-112324/

Purpose: Craniosynostosis\'s physical manifestations are well known, while its impact on neurodevelopment and cognitive functions is still under-researched. Evaluating neurodevelopment and cognition helps define cognitive functions\' baseline in surgical procedures, aiding in therapeutic and rehabilitation approaches post-discharge. This study aims to characterise the cognitive profile and neuropsychomotor development to identify the most affected functions in this group. Methods: This retrospective cross-sectional study analysed 65 individuals with craniosynostosis (syndromic=39; isolated=26) who underwent neuropsychological assessments and used social-demographic data obtained from medical records in a specialised hospital of craniofacial anomalies. The study employed five instruments to assess neuropsychomotor development - Dimensional Inventory of Child Development Assessment; Behaviour Developmental Scale of Gesell and Amatruda and cognitive function - Wechsler Abbreviated Scale of Intelligence; Wechsler Intelligence Scale for Children; Raven Progressive Matrices; and SON-R 2 ½ -7 based on age groups. Results: There are significant differences between the two groups in Neuropsychological assessment outcomes (p=0.026), with 68.4% of syndromic patients showing altered neuropsychological results, compared to 40.7% in the isolated group. Language skills were the most frequently altered cognitive domain across all tests, followed by motor skills. Among the other cognitive domains, fluid intelligence showed deficits in 7.7% of patients, and motor skills were affected in 9.2%, predominantly in the isolated group (p=0.0047). Although a weak negative correlation was found between the age at surgery and cognitive improvement (r=-0.32), it shows an impact on cognitive outcomes: early surgery (0-1 year) showed mixed results, while later surgery (3+ years) generally resulted in poorer cognitive outcomes. Conclusion: The study highlights that early interventions are crucial for reducing developmental delays, though individual variability and syndromic conditions affect their effectiveness. Focusing on early intervention, targeted rehabilitation, and a smooth transition back to school can optimize cognitive development and manage delays. The differences in the tests used for comparison may affect the relevance of some findings.