INTRODUCTION: Recent studies have begun to elucidate the long-term neurocognitive and behavioral sequelae of nonsyndromic craniosynostosis (NSC).1,2 With advances in functional MRI (fMRI) techniques with improved statistical rigor, this study seeks to determine if there is neurologic evidence of altered brain connectivity in NSC, and to investigate if these aberrations vary by form of synostosis. METHODS. Twenty participants (average age 11.6 ± 2.27 years, 15 males) with surgically-treated NSC (10 sagittal (SSO), 5 right unilateral coronal (UCS), 5 metopic (MSO)) were individually matched to controls by age, gender, and handedness. Resting-state fMRI was acquired in a 3T Siemens TIM Trio scanner (Erlangen, Germany). Data was motion-corrected with SPM (University College London) and underwent CSF and WM signal regression. BioImage Suite (Yale School of Medicine) was then used to analyze whole-brain intrinsic connectivity as well as seed-based connectivity for Brodmann Areas (BA) 7, 39 and 40, which are areas of language and visuospatial integration that have been previously implicated.3 Resulting group-level t-maps were cluster-corrected using nonparametric permutation tests with 5000 permutations in FSL (FMRIB, Oxford, UK).4 RESULTS: SSO demonstrated decreased whole-brain intrinsic connectivity compared to controls in left BA-39 and bilateral BA-7’s (p=0.071), which are the superior parietal lobules and the angular gyrus. UCS had significantly decreased intrinsic connectivity throughout the prefrontal cortex (PFC, p=0.031). On seed-based analysis, UCS had significantly increased connectivity between left BA-40 and bilateral BA-6, BA-8, and BA-9, and left BA-32 (p=0.050), between left BA-7 and the anterior PFC (p=0.065), and between left BA-7 and right BA-7 and BA-9 (p=0.077). MSO demonstrated increased connectivity between the left BA-7 seed and the right inferior frontal gyrus and right insula (p=0.090). CONCLUSION: NSC is associated with altered brain connectivity that varies by type of synostosis. SSO had decreased connectivity in regions of the parietal cortex associated with spatial cognition, visuomotor integration, and attention. UCS demonstrated significantly decreased intrinsic connectivity in the PFC, which plays a crucial role in executive function, as well as increased connectivity between the PFC and the right parietal cortex. Finally, MSO was the only group to demonstrate aberrations in the right insula and right inferior frontal gyrus. This study provides neurologic evidence of long-term sequelae of NSC that varies by suture type, which may underlie different phenotypes of neuropsychiatric impairment. Reference Citations: 1. Hashim PW, Patel A, Yang JF, et al. The effects of whole-vault cranioplasty versus strip craniectomy on long-term neuropsychological outcomes in sagittal craniosynostosis. Plast Reconstr Surg. 2014;134(3):491–501. 2. Kapp-Simon KA, Wallace E, Collett BR, Cradock MM, Crerand CE, Speltz ML. Language, learning, and memory in children with and without single-suture craniosynostosis. J Neurosurg Pediatr. 2016;17(5):578–588. 3. Beckett JS, Brooks ED, Lacadie C, et al. Altered brain connectivity in sagittal craniosynostosis. J Neurosurg Pediatr. 2014;13(6):690–698. 4. Eklund A, Nichols TE, Knutsson H. Cluster failure: Why fMRI inferences for spatial extent have inflated false-positive rates. Proc Natl Acad Sci U S A. 2016;113(28):7900–7905.