Abstract
Speech therapy has been widely used as an essential therapy for compensatory articulation errors in nonsyndromic cleft lip and palate patients. We sought to identify potential biomarkers of nonsyndromic cleft lip and palate children after speech rehabilitation based on resting-state fMRI and graph theory techniques. We scanned 28 nonsyndromic cleft lip and palate and 28 typically developing children for resting-state fMRI on a 3T MRI scanner. Functional networks were constructed, and their topological properties were obtained for assessing between-group differences (two-sample t-tests). Also, language clear degree scale scores were obtained for correlation analysis with the topological features in nonsyndromic cleft lip and palate patients. Significant between-group differences of local properties were detected in brain regions involved in higher-order language and social cognition. There were no significant correlations between topological feature differences and language clear degree scale scores in nonsyndromic cleft lip and palate patients. Graph theory provided valuable insight into the neurobiological mechanisms of speech rehabilitation in nonsyndromic cleft lip and palate patients. The global network features, small-world index, nodal clustering coefficient, and nodal shortest path length may represent potential imaging biomarkers for the estimation of effective speech rehabilitation.
Highlights
Cleft lip and palate (CLP) can be divided into two types, syndromic CLP and nonsyndromic CLP (NSCLP), according to whether it is part of a well-known syndrome
Based on using the between-group differences, topological parameters of the nodes showed no statistical relationship with Chinese language clear degree scale (CLCDS) scores (FDR correction P < 0.02)
The significant findings can be generalized as follows: (i) the differences of local node metrics were mostly affected in brain regions associated with higher-order language and social cognition; (ii) for the global network metrics, there were no significant between-group differences among Cp, Lp, Eg, and Eloc; (iii) brain networks of the speech rehabilitated NSCLP group exhibited different small-world topology and higher σ and γ values compared with healthy controls
Summary
Cleft lip and palate (CLP) can be divided into two types, syndromic CLP and nonsyndromic CLP (NSCLP), according to whether it is part of a well-known syndrome. NSCLP accounts for 70% of CLP with unknown etiology. Speech and resonance disorders due to velopharyngeal insufficiency (VPI), including hypernasality, nasal emission, and compensatory articulation errors, are the most common complications of NSCLP, with incidence rates ranging from 22% to 92% (Ruiter et al, 2009). Even following the physical management of VPI through surgery, 5%50% of patients with CLP still suffer from compensatory articulation errors (Priester and Goorhuis-Brouwer, 2008; Taib et al, 2015). Speech therapy is often needed to correct abnormal placement that develops to compensate for VPI. The neuroplastic mechanisms stimulated by speech therapy in children with NSCLP are still unknown
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