A Systematic review and Meta-Analysis on altered brain structure in patients born with non-syndromic cleft lip and/or palate.

  • Nadine N Homoud

Student thesis: Doctoral ThesisDoctor of Dental Surgery (DDS)

Abstract

Title: A Systematic review and meta-analysis on altered brain structure in patients born with non-syndromic cleft lip and/or palate.
Objective: To determine if there is evidence for a relationship between the presence of a non-syndromic cleft lip and/or palate (NSCLP) and altered brain structure in cleft affected individuals.
Design: Electronic database (MEDLINE; EMBASE; Cochrane library) and manual searches were performed and were limited to English language texts published between1st January 1969 until February 2020. Data extraction and risk of bias assessment were done independently by two reviewers. A meta-analysis on seven publications was performed using a random effects model.
Main outcome Measure: Comparison of brain structure between patients born with cleft lip and/or palate and unaffected healthy individuals.
Results: The systematic review comprised 9 studies of which seven were included in the meta-analysis. The latter comprised 360 individuals with NSCLP compared to unaffected controls. There was a statistically significant reduction in the overall intracranial volume and the total cerebellar volume in the cleft group compared to controls (Hedges g and 95% confidence intervals -0.38 (CI -0.71, -0.06) and -0.77 (CI -0.94, -0.60) respectively. For the frontal cortex and straight gyrus; total cerebral volume; and cortical grey matter there was no statistically significant difference between the cleft affected and unaffected individuals.
Conclusion: In individuals with non-syndromic cleft lip and/or palate, the overall intracranial volume and the total cerebellar volume are both statistically significantly smaller than in unaffected controls.
Date of Award26 Nov 2020
Original languageEnglish
Awarding Institution
  • The University of Bristol
SupervisorJulie C Williams (Supervisor), Jonathan Sandy (Supervisor) & Anthony J Ireland (Supervisor)

Keywords

  • cleft
  • brain
  • cleftlip
  • clefts
  • cleftpalate
  • nonsyndromic

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