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Elsayed MEA, Lander B, Senthil S, Edward DP, Malik R. The secondary childhood glaucomas. Surv Ophthalmol 2025; 70:544-562. [PMID: 39486644 DOI: 10.1016/j.survophthal.2024.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 10/18/2024] [Accepted: 10/28/2024] [Indexed: 11/04/2024]
Abstract
The secondary childhood glaucomas are a heterogenous group, often associated with other ocular or systemic abnormalities. These childhood glaucomas are distinct from primary childhood glaucomas, both in terms of their clinical features and their response to conventional treatment. Surgical management can be challenging in children with secondary glaucoma. On average, this group undergo more surgical procedures and revisions than those with primary congenital glaucoma. We provide a synopsis of secondary childhood glaucomas in terms of classification, clinical features, and management strategies, with emphasis on recent developments.
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Affiliation(s)
| | | | | | - Deepak P Edward
- Glaucoma Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; Dept of Ophthalmology and Visual Sciences, University of Illinois Eye and Ear Infirmary, Chicago, USA
| | - Rizwan Malik
- Glaucoma Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
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Lins MGDS, Morais PDJ, Martinho JDO, do Nascimento MCA, Vila APS, Castanhole-Nunes MMU, Pavarino ÉC, Goloni-Bertollo EM. Clinical and epidemiological characterisation of neurofibromatosis type 1: Combined analysis of a reference hospital in Brazil and DataSUS. Genet Mol Biol 2025; 48:e20240144. [PMID: 40402550 PMCID: PMC12100465 DOI: 10.1590/1678-4685-gmb-2024-0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Accepted: 01/30/2025] [Indexed: 05/23/2025] Open
Abstract
Neurofibromatosis type 1 (NF1) is a syndrome triggered by mutations in the NF1 gene, which alter the neurofibromin protein, a negative regulator of the RAS oncogenic pathway. Due to underreporting, the scarcity of studies on NF1 in Brazil and its importance in public health. This study aimed to assess the clinical and epidemiological characterisation of NF1 in a Reference Hospital in the country and DataSUS. The study analysed the electronic medical records of patients with NF1 and the DataSUS databases. The medical records showed a greater number of female, white and adult patients. There was a high frequency of clinical features adopted by the NIH consensus for the clinical diagnosis of the disease, such as CALMs, dermal neurofibromas and axillary/inguinal ephelides, bone and ophthalmological changes, in addition malignant and benign neoplasms and neurodevelopmental disorders. On the other hand, the data provided by DataSUS shows a disproportionate concentration of NF1 consultations between the country's regions, with a low level of diagnoses of newborn with NF1 and a NF1 mortality rate of 3.06% in the population. There is therefore a need for new public policies on access to diagnosis, treatment and information about the disease for the Brazilian population.
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Affiliation(s)
- Marina Gabriela da Silva Lins
- Faculdade de Medicina de São José do Rio Preto (FAMERP), Departamento de Biologia Molecular, Unidade de Pesquisa em Genética e Biologia Molecular (UPGEM), São José do Rio Preto, SP, Brazil
| | - Peterson de Jesus Morais
- Faculdade de Medicina de São José do Rio Preto (FAMERP), Departamento de Biologia Molecular, Unidade de Pesquisa em Genética e Biologia Molecular (UPGEM), São José do Rio Preto, SP, Brazil
- Universidade Estadual Paulista (UNESP), Instituto de Biociências, Letras e Ciências Exatas (IBILCE), Departamento de Biologia, São José do Rio Preto, SP, Brazil
| | - Júlia de Oliveira Martinho
- Faculdade de Medicina de São José do Rio Preto (FAMERP), Departamento de Biologia Molecular, Unidade de Pesquisa em Genética e Biologia Molecular (UPGEM), São José do Rio Preto, SP, Brazil
- Universidade Estadual Paulista (UNESP), Instituto de Biociências, Letras e Ciências Exatas (IBILCE), Departamento de Biologia, São José do Rio Preto, SP, Brazil
| | - Mariah Cristina Antunes do Nascimento
- Faculdade de Medicina de São José do Rio Preto (FAMERP), Departamento de Biologia Molecular, Unidade de Pesquisa em Genética e Biologia Molecular (UPGEM), São José do Rio Preto, SP, Brazil
- Universidade Estadual Paulista (UNESP), Instituto de Biociências, Letras e Ciências Exatas (IBILCE), Departamento de Biologia, São José do Rio Preto, SP, Brazil
| | - Ana Paula Simedan Vila
- Faculdade de Medicina de São José do Rio Preto (FAMERP), Departamento de Biologia Molecular, Unidade de Pesquisa em Genética e Biologia Molecular (UPGEM), São José do Rio Preto, SP, Brazil
| | - Márcia Maria Urbanin Castanhole-Nunes
- Faculdade de Medicina de São José do Rio Preto (FAMERP), Departamento de Biologia Molecular, Unidade de Pesquisa em Genética e Biologia Molecular (UPGEM), São José do Rio Preto, SP, Brazil
| | - Érika Cristina Pavarino
- Faculdade de Medicina de São José do Rio Preto (FAMERP), Departamento de Biologia Molecular, Unidade de Pesquisa em Genética e Biologia Molecular (UPGEM), São José do Rio Preto, SP, Brazil
| | - Eny Maria Goloni-Bertollo
- Faculdade de Medicina de São José do Rio Preto (FAMERP), Departamento de Biologia Molecular, Unidade de Pesquisa em Genética e Biologia Molecular (UPGEM), São José do Rio Preto, SP, Brazil
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Wu F, Ji X, Shen M, Cheng P, Gao Y, Liu W, Chen J, Feng S, Wu H, Di F, Li Y, Wang J, Zhang X, Chen Q. Prevalence, clinical characteristics and outcomes of seizures in neurofibromatosis type 1: A systematic review and single arm meta-analysis. Epilepsy Res 2024; 208:107476. [PMID: 39532017 DOI: 10.1016/j.eplepsyres.2024.107476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 11/06/2024] [Indexed: 11/16/2024]
Abstract
BACKGROUND Neurofibromatosis type 1 (NF1) is a common neurocutaneous syndrome that predisposes patients to seizures. We aimed to estimate the prevalence, clinical characteristics and outcomes of seizures in NF1 patients, and analyze prognostic factors of seizures. METHODS Systematic searches were conducted in the PubMed, EMBASE, Web of Science, Scopus, Cochrane Library, and grey literature databases from inception to April 2024. We identified observational studies that included NF1 patients with seizures. Clinical characteristics of seizures were summarized and meta-analyses of prevalence and outcomes were conducted. We assessed publication bias using funnel plots and conducted sensitivity analysis to assess stability and reliability. Individual patient data were analyzed to evaluate prognostic factors. RESULTS Fourteen studies were identified from 1021 records. A total of 337 patients with seizures from 4946 NF1 patients were included. Meta-analysis indicated the overall prevalence of seizures in NF1 patients was 8.1 % (95 % CI= 5.9-10.3 %). The first seizure usually occurs in childhood, with a median age range of 3.5-12.0 years. Focal seizures (54.2 %) and generalized tonic-clonic seizures (16.8 %) were the most common types. The seizure freedom rate was 68.5 % (95 % CI= 57.5-79.5 %), mostly with one or two antiseizure medications. Cortical malformation/hippocampus sclerosis emerged as an independent risk factor for persistent seizures (OR=5.19, 95 %CI=1.27-21.18, P=0.02). CONCLUSION Though NF1 patients face a higher risk of seizures than the general population, the majority achieve seizure freedom. Patients with cortical malformation or hippocampus sclerosis were at a higher risk of persistent seizures.
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Affiliation(s)
- Fan Wu
- Department of Neurology, Children's Hospital Capital Institute of Pediatrics, Beijing, China; Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xinna Ji
- Department of Neurology, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Mengxiao Shen
- Department of Neurology, Children's Hospital Capital Institute of Pediatrics, Beijing, China; Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Peidi Cheng
- Department of Neurology, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Yanyan Gao
- Department of Neurology, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Wanting Liu
- Department of Neurology, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Jinxiao Chen
- Department of Neurology, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Shuo Feng
- Department of Neurology, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Huanhuan Wu
- Department of Neurology, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Fei Di
- Department of Neurosurgery, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Yunlin Li
- Department of Neurosurgery, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Jianhua Wang
- Translational Medicine Laboratory, Beijing Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, China
| | - Xue Zhang
- State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qian Chen
- Department of Neurology, Children's Hospital Capital Institute of Pediatrics, Beijing, China.
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Lalvani S, Brown RM. Neurofibromatosis Type 1: Optimizing Management with a Multidisciplinary Approach. J Multidiscip Healthc 2024; 17:1803-1817. [PMID: 38680880 PMCID: PMC11055545 DOI: 10.2147/jmdh.s362791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 04/09/2024] [Indexed: 05/01/2024] Open
Abstract
Neurofibromatosis Type I (NF1) is a complex genetic condition that affects multiple organ systems and presents a unique set of challenges for clinicians in its management. NF1 is a tumor predisposition syndrome that primarily affect the peripheral and central nervous systems via the impact of haploinsufficiency upon neural crest lineage cells including Schwann cells, melanocytes, fibroblasts, etc. NF1 can further lead to pathology of the skin, bones, visual system, and cardiovascular system, all of which can drastically reduce a patient's quality of life (QOL). This review provides a comprehensive examination of the many specialties required for the care of patients with Neurofibromatosis Type 1 (NF1). We delve into the pathogenesis and clinical presentation of NF1, highlighting its diverse manifestations and the challenges they pose in management. The review underscores the importance of a multidisciplinary approach to NF1, emphasizing how such an approach can significantly improve patient outcomes and overall QOL. Central to this approach is the role of the NF expert, who guides a multidisciplinary team (MDT) comprising healthcare professionals from many areas of expertise. The MDT collaboratively addresses the multifaceted needs of NF1 patients, ensuring comprehensive and personalized care. This review highlights the need for further investigation to optimize the workflow for NF1 patients in an MDT setting, and to improve implementation and efficacy.
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Affiliation(s)
- Shaan Lalvani
- Department of Neurology, The Mount Sinai Hospital, New York, NY, USA
| | - Rebecca M Brown
- Department of Neurology, The Mount Sinai Hospital, New York, NY, USA
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Rodríguez-Martín M, Báez-Flores J, Ribes V, Isidoro-García M, Lacal J, Prieto-Matos P. Non-Mammalian Models for Understanding Neurological Defects in RASopathies. Biomedicines 2024; 12:841. [PMID: 38672195 PMCID: PMC11048513 DOI: 10.3390/biomedicines12040841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/27/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
RASopathies, a group of neurodevelopmental congenital disorders stemming from mutations in the RAS/MAPK pathway, present a unique opportunity to delve into the intricacies of complex neurological disorders. Afflicting approximately one in a thousand newborns, RASopathies manifest as abnormalities across multiple organ systems, with a pronounced impact on the central and peripheral nervous system. In the pursuit of understanding RASopathies' neurobiology and establishing phenotype-genotype relationships, in vivo non-mammalian models have emerged as indispensable tools. Species such as Danio rerio, Drosophila melanogaster, Caenorhabditis elegans, Xenopus species and Gallus gallus embryos have proven to be invaluable in shedding light on the intricate pathways implicated in RASopathies. Despite some inherent weaknesses, these genetic models offer distinct advantages over traditional rodent models, providing a holistic perspective on complex genetics, multi-organ involvement, and the interplay among various pathway components, offering insights into the pathophysiological aspects of mutations-driven symptoms. This review underscores the value of investigating the genetic basis of RASopathies for unraveling the underlying mechanisms contributing to broader neurological complexities. It also emphasizes the pivotal role of non-mammalian models in serving as a crucial preliminary step for the development of innovative therapeutic strategies.
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Affiliation(s)
- Mario Rodríguez-Martín
- Laboratory of Functional Genetics of Rare Diseases, Department of Microbiology and Genetics, University of Salamanca, 37007 Salamanca, Spain; (M.R.-M.); (J.B.-F.)
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (M.I.-G.); (P.P.-M.)
| | - Juan Báez-Flores
- Laboratory of Functional Genetics of Rare Diseases, Department of Microbiology and Genetics, University of Salamanca, 37007 Salamanca, Spain; (M.R.-M.); (J.B.-F.)
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (M.I.-G.); (P.P.-M.)
| | - Vanessa Ribes
- Institut Jacques Monod, Université Paris Cité, CNRS, F-75013 Paris, France;
| | - María Isidoro-García
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (M.I.-G.); (P.P.-M.)
- Clinical Biochemistry Department, Hospital Universitario de Salamanca, 37007 Salamanca, Spain
- Clinical Rare Diseases Reference Unit DiERCyL, 37007 Castilla y León, Spain
- Department of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Jesus Lacal
- Laboratory of Functional Genetics of Rare Diseases, Department of Microbiology and Genetics, University of Salamanca, 37007 Salamanca, Spain; (M.R.-M.); (J.B.-F.)
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (M.I.-G.); (P.P.-M.)
| | - Pablo Prieto-Matos
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (M.I.-G.); (P.P.-M.)
- Clinical Rare Diseases Reference Unit DiERCyL, 37007 Castilla y León, Spain
- Department of Pediatrics, Hospital Universitario de Salamanca, 37007 Salamanca, Spain
- Department of Biomedical and Diagnostics Science, University of Salamanca, 37007 Salamanca, Spain
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Role of nerves in neurofibromatosis type 1-related nervous system tumors. Cell Oncol (Dordr) 2022; 45:1137-1153. [PMID: 36327093 DOI: 10.1007/s13402-022-00723-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder that affects nearly 1 in 3000 infants. Neurofibromin inactivation and NF1 gene mutations are involved in various aspects of neuronal function regulation, including neuronal development induction, electrophysiological activity elevation, growth factor expression, and neurotransmitter release. NF1 patients often exhibit a predisposition to tumor development, especially in the nervous system, resulting in the frequent occurrence of peripheral nerve sheath tumors and gliomas. Recent evidence suggests that nerves play a role in the development of multiple tumor types, prompting researchers to investigate the nerve as a vital component in and regulator of the initiation and progression of NF1-related nervous system tumors. CONCLUSION In this review, we summarize existing evidence about the specific effects of NF1 mutation on neurons and emerging research on the role of nerves in neurological tumor development, promising a new set of selective and targeted therapies for NF1-related tumors.
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Kang YR, Hong SM, Choi JH, Lee SJ, Kim JM, Wook Kang K, Nam TS. Sensory neuronopathy in a patient with neurofibromatosis type 1: A case report. Medicine (Baltimore) 2022; 101:e31718. [PMID: 36397418 PMCID: PMC9666172 DOI: 10.1097/md.0000000000031718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
RATIONALE Neurofibromatosis type 1 (NF-1) can manifest with various neurological symptoms. However, sensory ataxia has not been reported. PATIENT CONCERNS A 44-year-old man with NF-1 presented with several weeks of unsteady gait. He was diagnosed with gastric neuroendocrine tumor with multiple hepatic metastases 6 years ago and received palliative chemotherapy. Neurological examination revealed ataxia veering to the right side with no motor weakness. DIAGNOSES Clinical manifestations and electrodiagnostic studies suggested the dysfunction of the thoracic dorsal column (DC). Initial magnetic resonance imaging showed a lateral thoracic meningocele (LTM) located in the right paravertebral area at the T3-T4 vertebral level, but the spinal cord was unremarkable. Gait disturbance worsened after 9 months, and follow-up magnetic resonance imaging showed high signal intensity involving the right DC at the level adjacent to the LTM and spinal cord atrophy distal to the DC lesion. Tests for well-characterized paraneoplastic antibodies were negative. Ultimately, the patient was assumed to have sensory neuronopathy due to compressive damage to the dorsal root ganglia within the intervertebral foramina by LTM. INTERVENTIONS Empirical treatment with vitamin B12 supplementation and corticosteroids failed to improve his condition. The patient underwent decompressive laminectomy and excision of the meningocele with dura repair. OUTCOMES The patient temporarily improved to walk with assistance postoperatively. However, he developed dyspnea and hypotension 5 weeks later. Carcinoid heart disease confined the patient to the bed. The patient died of pneumonia 3 months after the operation. LESSONS This case with NF-1 shows asymmetric sensory ataxia of subacute progression. LTM may contribute to the development of sensory neuronopathy by damaging sensory neurons of the dorsal root ganglia. The comorbidities of the patient, including gastric neuroendocrine tumor and LTM, made it challenging to investigate the pathomechanism.
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Affiliation(s)
- You-Ri Kang
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea
| | - Seong-Min Hong
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea
| | - Jong-Hee Choi
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea
| | - Seung-Jin Lee
- Department of Radiology, Chonnam National University Bitgoeul Hospital, Gwangju, Korea
| | - Jae-Myung Kim
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea
| | - Kyung Wook Kang
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea
- Department of Neurology, Chonnam National University Medical School, Gwangju, Korea
| | - Tai-Seung Nam
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea
- Department of Neurology, Chonnam National University Medical School, Gwangju, Korea
- *Correspondence: Tai-Seung Nam, Department of Neurology, Chonnam National University Medical School, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea (e-mail: )
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8
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Ardizzone A, Capra AP, Campolo M, Filippone A, Esposito E, Briuglia S. Neurofibromatosis: New Clinical Challenges in the Era of COVID-19. Biomedicines 2022; 10:biomedicines10050940. [PMID: 35625677 PMCID: PMC9138859 DOI: 10.3390/biomedicines10050940] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 02/01/2023] Open
Abstract
Rare diseases constitute a wide range of disorders thus defined for their low prevalence. However, taken together, rare diseases impact a considerable percentage of the world population, thus representing a public healthcare problem. In particular, neurofibromatoses are autosomal-dominant genetic disorders that include type 1 neurofibromatosis (NF1), type 2 neurofibromatosis (NF2) and schwannomatosis. Each of the three types is a genetically distinct disease with an unpredictable clinical course and for which there is still no resolutive cure. Therefore, a personalized therapeutic approach directed at improving the symptomatology as well as the search for new pharmacological strategies for the management of neurofibromatosis represents a priority for positive outcomes for affected patients. The coronavirus disease 2019 (COVID-19) pandemic has severely affected health systems around the world, impacting the provision of medical care and modifying clinical surveillance along with scientific research procedures. COVID-19 significantly worsened exchanges between healthcare personnel and neurofibromatosis patients, precluding continuous clinical monitoring in specialized clinic centers. In this new scenario, our article presents, for the first time, a comprehensive literature review on the clinical challenges for neurofibromatosis clinical care and research during the COVID-19 pandemic health emergency. The review was performed through PubMed (Medline) and Google Scholar databases until December 2021.
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Affiliation(s)
- Alessio Ardizzone
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Viale Ferdinando Stagno D’Alcontres 31, 98166 Messina, Italy; (A.A.); (A.P.C.); (M.C.); (A.F.)
| | - Anna Paola Capra
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Viale Ferdinando Stagno D’Alcontres 31, 98166 Messina, Italy; (A.A.); (A.P.C.); (M.C.); (A.F.)
| | - Michela Campolo
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Viale Ferdinando Stagno D’Alcontres 31, 98166 Messina, Italy; (A.A.); (A.P.C.); (M.C.); (A.F.)
| | - Alessia Filippone
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Viale Ferdinando Stagno D’Alcontres 31, 98166 Messina, Italy; (A.A.); (A.P.C.); (M.C.); (A.F.)
| | - Emanuela Esposito
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Viale Ferdinando Stagno D’Alcontres 31, 98166 Messina, Italy; (A.A.); (A.P.C.); (M.C.); (A.F.)
- Correspondence: ; Tel.: +39-090-676-5208
| | - Silvana Briuglia
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy;
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9
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Managing Headache Disorders Associated with Tuberous Sclerosis and Neurofibromatosis. Curr Pain Headache Rep 2022; 26:281-288. [PMID: 35179724 DOI: 10.1007/s11916-022-01032-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW Tuberous sclerosis complex (TSC) and neurofibromatosis (NF) are neurocutaneous disorders often encountered by neurologists in clinical practice. This article aims to familiarize adult and pediatric neurologists with common features of these disorders and headache specific evaluation and management. RECENT FINDINGS Non-malignant intracranial tumors in TSC include cortical tubers (glioneuronal hamartomas), subependymal nodules or subependymal giant-cell astrocytomas (SEGA). Headache disorders in TSC are largely secondary and can cause headaches due to increased intracranial pressure, mass effect, obstructive hydrocephalus, or hemorrhage. Neurosurgical intervention is typically required for management of large SEGAs; however, in patients with increased surgical risk, newer treatment modalities may be offered such as neoadjuvant therapy with an mTOR inhibitor (mTORi). Newer studies indicate headache disorders are more prevalent in neurofibromatosis type 1 (NF1). Primary headache disorders can include migraine and tension-type headache, while secondary headache disorders can be due to associated neoplasms such as optic pathway gliomas or brainstem gliomas, or less commonly vasculopathies such as moyamoya syndrome. Selumetinib is an oral, small molecule mitogen-activated protein kinase (MEK) agent with antineoplastic activity which is in ongoing trials for treatment of NF1-associated pediatric low-grade gliomas. NF1 stands out as having a higher association with primary headache disorders such as migraine. This association may be related to effects of mutation of the neurofibromin gene on pathways involved in pain and migraine genesis, however, warrants future study. Care should be taken when formulating a headache treatment plan to address comorbidities and avoid medications that may be contraindicated.
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10
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Bannon SM, Hopkins SW, Grunberg VA, Vranceanu AM. Psychosocial profiles of risk and resiliency in neurofibromatoses: a person-centered analysis of illness adaptation. J Neurooncol 2022; 156:519-527. [PMID: 35064449 DOI: 10.1007/s11060-021-03928-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/11/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES We sought to characterize psychosocial profiles of adaptation to neurofibromatosis (NF). METHODS Participants (N = 224) completed self-report measures of psychosocial functioning, including risk (i.e., perceived stress, depression, anxiety) and resiliency (i.e., gratitude, optimism, coping, social support, mindfulness, empathy). We used a TwoStep hierarchical cluster analysis to determine clusters reflecting adaptation to NF. RESULTS The analysis revealed two distinct groups, with the "Low Adaptation" group defined by high emotional distress and low resiliency (n = 130; 57% of participants), and the "High Adaptation" group defined by low emotional distress and high resiliency (n = 85; 37% of participants). Clusters differed significantly across nearly all criterion variables, as well as quality of life and pain interference. CONCLUSION Both risk and resiliency factors are important for understanding psychosocial adaptation to NF. Findings suggest that clinical providers should prioritize screening and intervention methods targeting these variables to promote positive adaptation to NF. TRIAL REGISTRATION ClinicalTrials.gov NCT03406208; https://clinicaltrials.gov/ct2/show/NCT03406208 (Archived by WebCite at http://www.webcitation.org/72ZoTDQ6h ).
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Affiliation(s)
- Sarah M Bannon
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 1 Bowdoin Square Suite 100, Boston, MA, USA
| | - Sarah W Hopkins
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 1 Bowdoin Square Suite 100, Boston, MA, USA
| | - Victoria A Grunberg
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 1 Bowdoin Square Suite 100, Boston, MA, USA
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 1 Bowdoin Square Suite 100, Boston, MA, USA.
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11
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Sorrentino U, Bellonzi S, Mozzato C, Brasson V, Toldo I, Parrozzani R, Clementi M, Cassina M, Trevisson E. Epilepsy in NF1: Epidemiologic, Genetic, and Clinical Features. A Monocentric Retrospective Study in a Cohort of 784 Patients. Cancers (Basel) 2021; 13:cancers13246336. [PMID: 34944956 PMCID: PMC8699608 DOI: 10.3390/cancers13246336] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/07/2021] [Accepted: 12/14/2021] [Indexed: 11/16/2022] Open
Abstract
An increased lifetime risk of epilepsy has been reported in neurofibromatosis type 1 (NF1) patients, ranging between 4% and 14%. To further analyze the correlation between NF1 and epilepsy, we retrospectively reviewed the epidemiologic, clinical, radiological, and molecular data of 784 unselected patients diagnosed with NF1 and referred to the neurofibromatosis outpatient clinics at the University Hospital of Padua. A crude prevalence of epilepsy of 4.7% was observed. In about 70% of cases, seizures arose in the context of neuroradiological findings, with the main predisposing factors being cerebral vasculopathies and hydrocephalus. In the absence of structural abnormalities, the prevalence of epilepsy was found to be 1.27%, which is approximately equal to the total prevalence in the general population. NF1 patients with seizures exhibit a higher incidence of intellectual disability and/or developmental delay, as well as of isolated learning disabilities. The comparison of causative NF1 mutations between the two groups did not reveal a specific genotype-phenotype correlation. Our data refine the current knowledge on epileptological manifestations in NF1 patients, arguing against the hypothesis that specific mechanisms, inherent to neurofibromin cellular function, might determine an increased risk of epilepsy in this condition.
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Affiliation(s)
- Ugo Sorrentino
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, 35128 Padua, Italy; (C.M.); (V.B.); (M.C.); (M.C.)
- Correspondence: (U.S.); (E.T.); Tel.: +39-049-8215444 (U.S.); +39-049-8211402 (E.T.)
| | - Silvia Bellonzi
- Pediatrics Complex Care Unit, Santa Maria della Misericordia Hospital, 45100 Rovigo, Italy;
| | - Chiara Mozzato
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, 35128 Padua, Italy; (C.M.); (V.B.); (M.C.); (M.C.)
| | - Valeria Brasson
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, 35128 Padua, Italy; (C.M.); (V.B.); (M.C.); (M.C.)
| | - Irene Toldo
- Pediatric Neurology Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padua, Italy;
| | - Raffaele Parrozzani
- Department of Neuroscience-Ophthalmology, University of Padova, 35128 Padua, Italy;
| | - Maurizio Clementi
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, 35128 Padua, Italy; (C.M.); (V.B.); (M.C.); (M.C.)
| | - Matteo Cassina
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, 35128 Padua, Italy; (C.M.); (V.B.); (M.C.); (M.C.)
| | - Eva Trevisson
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, 35128 Padua, Italy; (C.M.); (V.B.); (M.C.); (M.C.)
- Institute of Pediatric Research IRP, “Fondazione Città della Speranza”, 35127 Padua, Italy
- Correspondence: (U.S.); (E.T.); Tel.: +39-049-8215444 (U.S.); +39-049-8211402 (E.T.)
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12
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Pacot L, Vidaud D, Sabbagh A, Laurendeau I, Briand-Suleau A, Coustier A, Maillard T, Barbance C, Morice-Picard F, Sigaudy S, Glazunova OO, Damaj L, Layet V, Quelin C, Gilbert-Dussardier B, Audic F, Dollfus H, Guerrot AM, Lespinasse J, Julia S, Vantyghem MC, Drouard M, Lackmy M, Leheup B, Alembik Y, Lemaire A, Nitschké P, Petit F, Dieux Coeslier A, Mutez E, Taieb A, Fradin M, Capri Y, Nasser H, Ruaud L, Dauriat B, Bourthoumieu S, Geneviève D, Audebert-Bellanger S, Nizon M, Stoeva R, Hickman G, Nicolas G, Mazereeuw-Hautier J, Jannic A, Ferkal S, Parfait B, Vidaud M, members of the NF France Network, Wolkenstein P, Pasmant E. Severe Phenotype in Patients with Large Deletions of NF1. Cancers (Basel) 2021; 13:2963. [PMID: 34199217 PMCID: PMC8231977 DOI: 10.3390/cancers13122963] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 06/11/2021] [Indexed: 12/18/2022] Open
Abstract
Complete deletion of the NF1 gene is identified in 5-10% of patients with neurofibromatosis type 1 (NF1). Several studies have previously described particularly severe forms of the disease in NF1 patients with deletion of the NF1 locus, but comprehensive descriptions of large cohorts are still missing to fully characterize this contiguous gene syndrome. NF1-deleted patients were enrolled and phenotypically characterized with a standardized questionnaire between 2005 and 2020 from a large French NF1 cohort. Statistical analyses for main NF1-associated symptoms were performed versus an NF1 reference population. A deletion of the NF1 gene was detected in 4% (139/3479) of molecularly confirmed NF1 index cases. The median age of the group at clinical investigations was 21 years old. A comprehensive clinical assessment showed that 93% (116/126) of NF1-deleted patients fulfilled the NIH criteria for NF1. More than half had café-au-lait spots, skinfold freckling, Lisch nodules, neurofibromas, neurological abnormalities, and cognitive impairment or learning disabilities. Comparison with previously described "classic" NF1 cohorts showed a significantly higher proportion of symptomatic spinal neurofibromas, dysmorphism, learning disabilities, malignancies, and skeletal and cardiovascular abnormalities in the NF1-deleted group. We described the largest NF1-deleted cohort to date and clarified the more severe phenotype observed in these patients.
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Affiliation(s)
- Laurence Pacot
- Service de Génétique et Biologie Moléculaires, Hôpital Cochin, DMU BioPhyGen, Assistance Publique-Hôpitaux de Paris, AP-HP, Centre-Université de Paris, F-75014 Paris, France; (L.P.); (D.V.); (A.B.-S.); (A.C.); (T.M.); (C.B.); (B.P.); (M.V.)
- Inserm U1016—CNRS UMR8104, Institut Cochin, Université de Paris, CARPEM, F-75014 Paris, France;
| | - Dominique Vidaud
- Service de Génétique et Biologie Moléculaires, Hôpital Cochin, DMU BioPhyGen, Assistance Publique-Hôpitaux de Paris, AP-HP, Centre-Université de Paris, F-75014 Paris, France; (L.P.); (D.V.); (A.B.-S.); (A.C.); (T.M.); (C.B.); (B.P.); (M.V.)
- Inserm U1016—CNRS UMR8104, Institut Cochin, Université de Paris, CARPEM, F-75014 Paris, France;
| | - Audrey Sabbagh
- UMR 261, Laboratoire MERIT, IRD, Faculté de Pharmacie de Paris, Université de Paris, F-75006 Paris, France;
| | - Ingrid Laurendeau
- Inserm U1016—CNRS UMR8104, Institut Cochin, Université de Paris, CARPEM, F-75014 Paris, France;
| | - Audrey Briand-Suleau
- Service de Génétique et Biologie Moléculaires, Hôpital Cochin, DMU BioPhyGen, Assistance Publique-Hôpitaux de Paris, AP-HP, Centre-Université de Paris, F-75014 Paris, France; (L.P.); (D.V.); (A.B.-S.); (A.C.); (T.M.); (C.B.); (B.P.); (M.V.)
- Inserm U1016—CNRS UMR8104, Institut Cochin, Université de Paris, CARPEM, F-75014 Paris, France;
| | - Audrey Coustier
- Service de Génétique et Biologie Moléculaires, Hôpital Cochin, DMU BioPhyGen, Assistance Publique-Hôpitaux de Paris, AP-HP, Centre-Université de Paris, F-75014 Paris, France; (L.P.); (D.V.); (A.B.-S.); (A.C.); (T.M.); (C.B.); (B.P.); (M.V.)
| | - Théodora Maillard
- Service de Génétique et Biologie Moléculaires, Hôpital Cochin, DMU BioPhyGen, Assistance Publique-Hôpitaux de Paris, AP-HP, Centre-Université de Paris, F-75014 Paris, France; (L.P.); (D.V.); (A.B.-S.); (A.C.); (T.M.); (C.B.); (B.P.); (M.V.)
| | - Cécile Barbance
- Service de Génétique et Biologie Moléculaires, Hôpital Cochin, DMU BioPhyGen, Assistance Publique-Hôpitaux de Paris, AP-HP, Centre-Université de Paris, F-75014 Paris, France; (L.P.); (D.V.); (A.B.-S.); (A.C.); (T.M.); (C.B.); (B.P.); (M.V.)
| | - Fanny Morice-Picard
- Inserm U1211, Service de Génétique Médicale, CHU de Bordeaux, F-33000 Bordeaux, France;
| | - Sabine Sigaudy
- Department of Medical Genetics, Children’s Hospital La Timone, Assistance Publique des Hôpitaux de Marseille, F-13000 Marseille, France;
| | - Olga O. Glazunova
- Centre de Référence des Anomalies du Développement et Syndromes Malformatifs (UF 2970), CHU Timone, Assistance Publique des Hôpitaux de Marseille, F-13000 Marseille, France;
| | - Lena Damaj
- Department of Pediatrics, Competence Center of Inherited Metabolic Disorders, Rennes Hospital, F-35000 Rennes, France;
| | - Valérie Layet
- Consultations de Génétique, Groupe Hospitalier du Havre, F-76600 Le Havre, France;
| | - Chloé Quelin
- Service de Génétique Clinique, CLAD Ouest, CHU Rennes, Hôpital Sud, F-35000 Rennes, France; (C.Q.); (M.F.)
| | | | - Frédérique Audic
- Service de Neurologie Pédiatrique, CHU Timone Enfants, F-13000 Marseille, France;
| | - Hélène Dollfus
- Centre de Référence Pour les Affections Rares en Génétique Ophtalmologique, CARGO, Filière SENSGENE, Hôpitaux Universitaires de Strasbourg, F-67000 Strasbourg, France;
- Medical Genetics Laboratory, INSERM U1112, Institute of Medical Genetics of Alsace, Strasbourg Medical School, University of Strasbourg, F-67000 Strasbourg, France
| | | | - James Lespinasse
- Service de Génétique Clinique, CH de Chambéry, F-73000 Chambéry, France;
| | - Sophie Julia
- Service de Génétique Médicale, CHU de Toulouse, Hôpital Purpan, F-31000 Toulouse, France;
| | - Marie-Christine Vantyghem
- Endocrinology, Diabetology, Metabolism and Nutrition Department, Inserm 1190, Lille University Hospital EGID, F-59000 Lille, France;
| | - Magali Drouard
- Dermatology Department, CHU Lille, University of Lille, F-59000 Lille, France;
| | - Marilyn Lackmy
- Unité de Génétique Clinique, Centre de Compétences Maladies Rares Anomalies du Développement, CHRU de Pointe à Pitre, F-97110 Guadeloupe, France;
| | - Bruno Leheup
- Service de Génétique Médicale, Hôpitaux de Brabois, CHRU de Nancy, F-54500 Vandoeuvre-lès-Nancy, France;
| | - Yves Alembik
- Department of Medical Genetics, Strasbourg-Hautepierre Hospital, F-67000 Strasbourg, France; (Y.A.); (A.L.)
| | - Alexia Lemaire
- Department of Medical Genetics, Strasbourg-Hautepierre Hospital, F-67000 Strasbourg, France; (Y.A.); (A.L.)
| | - Patrick Nitschké
- Bioinformatics Platform, Imagine Institute, INSERM UMR 1163, Université de Paris, F-75015 Paris, France;
| | - Florence Petit
- CHU Lille, Clinique de Génétique, Centre de Référence Anomalies du Développement, F-59000 Lille, France; (F.P.); (A.D.C.)
| | - Anne Dieux Coeslier
- CHU Lille, Clinique de Génétique, Centre de Référence Anomalies du Développement, F-59000 Lille, France; (F.P.); (A.D.C.)
| | - Eugénie Mutez
- Lille University, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, F-59000 Lille, France;
| | - Alain Taieb
- Department of Dermatology and Pediatric Dermatology, Bordeaux University Hospital, F-33000 Bordeaux, France;
| | - Mélanie Fradin
- Service de Génétique Clinique, CLAD Ouest, CHU Rennes, Hôpital Sud, F-35000 Rennes, France; (C.Q.); (M.F.)
| | - Yline Capri
- Département de Génétique, APHP Nord, Hôpital Robert Debré, F-75019 Paris, France; (Y.C.); (H.N.); (L.R.)
| | - Hala Nasser
- Département de Génétique, APHP Nord, Hôpital Robert Debré, F-75019 Paris, France; (Y.C.); (H.N.); (L.R.)
| | - Lyse Ruaud
- Département de Génétique, APHP Nord, Hôpital Robert Debré, F-75019 Paris, France; (Y.C.); (H.N.); (L.R.)
- UMR 1141, NEURODIDEROT, INSERM, Université de Paris, F-75019 Paris, France
| | - Benjamin Dauriat
- Department of Cytogenetics and Clinical Genetics, Limoges University Hospital, F-87000 Limoges, France;
| | - Sylvie Bourthoumieu
- Service de Cytogénétique et Génétique Médicale, CHU Limoges, F-87000 Limoges, France;
| | - David Geneviève
- Department of Genetics, Arnaud de Villeneuve University Hospital, F-34000 Montpellier, France;
| | - Séverine Audebert-Bellanger
- Département de Génétique Médicale et Biologie de la Reproduction, CHU Brest, Hôpital Morvan, F-29200 Brest, France;
| | - Mathilde Nizon
- Genetic Medical Department, CHU Nantes, F-44000 Nantes, France;
| | - Radka Stoeva
- Service de Cytogénétique, Centre Hospitalier Universitaire du Mans, F-72000 Le Mans, France;
| | - Geoffroy Hickman
- Department of Dermatology, Reference Center for Rare Skin Diseases MAGEC, Saint Louis Hospital AP-HP, F-75010 Paris, France;
| | - Gaël Nicolas
- Department of Genetics, FHU G4 Génomique, Normandie University, UNIROUEN, CHU Rouen, Inserm U1245, F-76000 Rouen, France;
| | - Juliette Mazereeuw-Hautier
- Département de Dermatologie, Centre de Référence des Maladies Rares de la Peau, CHU de Toulouse, F-31000 Toulouse, France;
| | - Arnaud Jannic
- Département de Dermatologie, AP-HP and UPEC, Hôpital Henri-Mondor, F-94000 Créteil, France; (A.J.); (S.F.); (P.W.)
| | - Salah Ferkal
- Département de Dermatologie, AP-HP and UPEC, Hôpital Henri-Mondor, F-94000 Créteil, France; (A.J.); (S.F.); (P.W.)
- INSERM, Centre d’Investigation Clinique 1430, F-94000 Créteil, France
| | - Béatrice Parfait
- Service de Génétique et Biologie Moléculaires, Hôpital Cochin, DMU BioPhyGen, Assistance Publique-Hôpitaux de Paris, AP-HP, Centre-Université de Paris, F-75014 Paris, France; (L.P.); (D.V.); (A.B.-S.); (A.C.); (T.M.); (C.B.); (B.P.); (M.V.)
- Inserm U1016—CNRS UMR8104, Institut Cochin, Université de Paris, CARPEM, F-75014 Paris, France;
| | - Michel Vidaud
- Service de Génétique et Biologie Moléculaires, Hôpital Cochin, DMU BioPhyGen, Assistance Publique-Hôpitaux de Paris, AP-HP, Centre-Université de Paris, F-75014 Paris, France; (L.P.); (D.V.); (A.B.-S.); (A.C.); (T.M.); (C.B.); (B.P.); (M.V.)
- Inserm U1016—CNRS UMR8104, Institut Cochin, Université de Paris, CARPEM, F-75014 Paris, France;
| | | | - Pierre Wolkenstein
- Département de Dermatologie, AP-HP and UPEC, Hôpital Henri-Mondor, F-94000 Créteil, France; (A.J.); (S.F.); (P.W.)
| | - Eric Pasmant
- Service de Génétique et Biologie Moléculaires, Hôpital Cochin, DMU BioPhyGen, Assistance Publique-Hôpitaux de Paris, AP-HP, Centre-Université de Paris, F-75014 Paris, France; (L.P.); (D.V.); (A.B.-S.); (A.C.); (T.M.); (C.B.); (B.P.); (M.V.)
- Inserm U1016—CNRS UMR8104, Institut Cochin, Université de Paris, CARPEM, F-75014 Paris, France;
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13
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Type-1 neurofibromatosis mimicking multiple mononeuropathy: the help of nerve ultrasound. Neurol Sci 2021; 42:3007-3009. [PMID: 33646440 DOI: 10.1007/s10072-021-05140-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/22/2021] [Indexed: 10/22/2022]
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Evaluation of clinical findings and neurofibromatosis type 1 bright objects on brain magnetic resonance images of 60 Turkish patients with NF1 gene variants. Neurol Sci 2021; 42:2045-2057. [PMID: 33443663 DOI: 10.1007/s10072-020-04988-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 12/11/2020] [Indexed: 12/13/2022]
Abstract
Neurofibromatosis type 1 (NF1) is caused by mutations in the NF1 gene. This retrospective study aims to evaluate the clinical manifestations and brain magnetic resonance images (MRI) analysis in 60 genetically confirmed NF1 patients. The results of next-generation sequencing (NGS), Sanger sequencing, and MLPA of NF1 gene were evaluated. A total of 54 different variants were identified. Fourteen out of them were novel variants (25.9%). Patients who complied with NIH criteria had most frequently frameshift variants (11/32 patients), and those with only CALMs had missense variants (9/28 patients). Neurofibromatosis type 1 bright objects (NBOs) on T2-weighted MRI were detected in 42 patients (42/56; 75%). These brain lesions were detected mostly in basal ganglia and in cerebellar vermis. NBOs were detected more in the patients who complied with NIH criteria (80.6%) compared to those who were only CALMs (68%). While frameshift variants (33.3%) were the most common type variants in the patients who had NBOs, the most common variants were splicing (35.7%) and missense (35.7%) variants in the patients whose MRIs were normal. Frameshift variants (11/28 patients; 39.3%) were the most common in the patients with more than one brain locus involvement. Therefore, we consider that frameshift variants may be associated with increased incidence of NBOs and involvement of more than one brain locus. In addition, NBOs may occur less frequently in the patients with splicing variants. To our knowledge, this is the first study evaluated the relationship between NF1 gene variants and NBOs. Future studies may help us understand the etiology of NBOs.
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Riccardi C, Perrone L, Napolitano F, Sampaolo S, Melone MAB. Understanding the Biological Activities of Vitamin D in Type 1 Neurofibromatosis: New Insights into Disease Pathogenesis and Therapeutic Design. Cancers (Basel) 2020; 12:E2965. [PMID: 33066259 PMCID: PMC7602022 DOI: 10.3390/cancers12102965] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/18/2020] [Accepted: 10/08/2020] [Indexed: 02/07/2023] Open
Abstract
Vitamin D is a fat-soluble steroid hormone playing a pivotal role in calcium and phosphate homeostasis as well as in bone health. Vitamin D levels are not exclusively dependent on food intake. Indeed, the endogenous production-occurring in the skin and dependent on sun exposure-contributes to the majority amount of vitamin D present in the body. Since vitamin D receptors (VDRs) are ubiquitous and drive the expression of hundreds of genes, the interest in vitamin D has tremendously grown and its role in different diseases has been extensively studied. Several investigations indicated that vitamin D action extends far beyond bone health and calcium metabolism, showing broad effects on a variety of critical illnesses, including cancer, infections, cardiovascular and autoimmune diseases. Epidemiological studies indicated that low circulating vitamin D levels inversely correlate with cutaneous manifestations and bone abnormalities, clinical hallmarks of neurofibromatosis type 1 (NF1). NF1 is an autosomal dominant tumour predisposition syndrome causing significant pain and morbidity, for which limited treatment options are available. In this context, vitamin D or its analogues have been used to treat both skin and bone lesions in NF1 patients, alone or combined with other therapeutic agents. Here we provide an overview of vitamin D, its characteristic nutritional properties relevant for health benefits and its role in NF1 disorder. We focus on preclinical and clinical studies that demonstrated the clinical correlation between vitamin D status and NF1 disease, thus providing important insights into disease pathogenesis and new opportunities for targeted therapy.
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Affiliation(s)
- Claudia Riccardi
- Department of Chemical Sciences, University of Naples Federico II, via Cintia 21, I-80126 Naples, Italy;
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and InterUniversity Center for Research in Neurosciences, University of Campania Luigi Vanvitelli, via Sergio Pansini 5, I-80131 Naples, Italy; (L.P.); (F.N.); (S.S.)
| | - Lorena Perrone
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and InterUniversity Center for Research in Neurosciences, University of Campania Luigi Vanvitelli, via Sergio Pansini 5, I-80131 Naples, Italy; (L.P.); (F.N.); (S.S.)
| | - Filomena Napolitano
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and InterUniversity Center for Research in Neurosciences, University of Campania Luigi Vanvitelli, via Sergio Pansini 5, I-80131 Naples, Italy; (L.P.); (F.N.); (S.S.)
| | - Simone Sampaolo
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and InterUniversity Center for Research in Neurosciences, University of Campania Luigi Vanvitelli, via Sergio Pansini 5, I-80131 Naples, Italy; (L.P.); (F.N.); (S.S.)
| | - Mariarosa Anna Beatrice Melone
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and InterUniversity Center for Research in Neurosciences, University of Campania Luigi Vanvitelli, via Sergio Pansini 5, I-80131 Naples, Italy; (L.P.); (F.N.); (S.S.)
- Sbarro Institute for Cancer Research and Molecular Medicine, Department of Biology, Temple University, BioLife Building (015-00), 1900 North 12th Street, Philadelphia, PA 19122-6078, USA
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