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Mason KN, Black J. Incorporating Velopharyngeal MRI into the Clinical Decision-Making Process for a Patient Presenting with Velopharyngeal Dysfunction Following a Failed Palatoplasty. Cleft Palate Craniofac J 2023:10556656231173500. [PMID: 37143294 PMCID: PMC10624648 DOI: 10.1177/10556656231173500] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
This clinical report describes the implementation of magnetic resonance imaging (MRI) to evaluate a patient with long-standing velopharyngeal dysfunction. She was referred to the craniofacial clinic at age 10 with no prior surgical history and subsequently completed a Furlow palatoplasty due to a suspected submucous cleft palate. However, results were unfavorable with minimal improvement in speech or resonance. The clinical presentation, treatment, outcomes, and contributions from MRI for secondary surgical planning are described. Addition of MRI into the clinical workflow provided insights into the anatomy and physiology of the velopharyngeal mechanism that were unable to be obtained from nasendoscopy and speech evaluation alone.
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Affiliation(s)
- Kazlin N. Mason
- Department of Human Services, University of Virginia, Charlottesville, VA, 22903
| | - Jonathan Black
- University of Virginia Health System, Division of Plastic Surgery, Charlottesville, VA, 22903
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2
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Blagowidow N, Nowakowska B, Schindewolf E, Grati FR, Putotto C, Breckpot J, Swillen A, Crowley TB, Loo JCY, Lairson LA, Óskarsdóttir S, Boot E, Garcia-Minaur S, Cristina Digilio M, Marino B, Coleman B, Moldenhauer JS, Bassett AS, McDonald-McGinn DM. Prenatal Screening and Diagnostic Considerations for 22q11.2 Microdeletions. Genes (Basel) 2023; 14. [PMID: 36672900 DOI: 10.3390/genes14010160] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/23/2022] [Accepted: 12/24/2022] [Indexed: 01/11/2023] Open
Abstract
Diagnosis of a chromosome 22q11.2 microdeletion and its associated deletion syndrome (22q11.2DS) is optimally made early. We reviewed the available literature to provide contemporary guidance and recommendations related to the prenatal period. Indications for prenatal diagnostic testing include a parent or child with the 22q11.2 microdeletion or suggestive prenatal screening results. Definitive diagnosis by genetic testing of chorionic villi or amniocytes using a chromosomal microarray will detect clinically relevant microdeletions. Screening options include noninvasive prenatal screening (NIPS) and imaging. The potential benefits and limitations of each screening method should be clearly conveyed. NIPS, a genetic option available from 10 weeks gestational age, has a 70-83% detection rate and a 40-50% PPV for most associated 22q11.2 microdeletions. Prenatal imaging, usually by ultrasound, can detect several physical features associated with 22q11.2DS. Findings vary, related to detection methods, gestational age, and relative specificity. Conotruncal cardiac anomalies are more strongly associated than skeletal, urinary tract, or other congenital anomalies such as thymic hypoplasia or cavum septi pellucidi dilatation. Among others, intrauterine growth restriction and polyhydramnios are additional associated, prenatally detectable signs. Preconception genetic counselling should be offered to males and females with 22q11.2DS, as there is a 50% risk of transmission in each pregnancy. A previous history of a de novo 22q11.2 microdeletion conveys a low risk of recurrence. Prenatal genetic counselling includes an offer of screening or diagnostic testing and discussion of results. The goal is to facilitate optimal perinatal care.
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3
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Schmitt JE, DeBevits JJ, Roalf DR, Ruparel K, Gallagher RS, Gur RC, Alexander-Bloch A, Eom TY, Alam S, Steinberg J, Akers W, Khairy K, Crowley TB, Emanuel B, Zakharenko SS, McDonald-McGinn DM, Gur RE. A Comprehensive Analysis of Cerebellar Volumes in the 22q11.2 Deletion Syndrome. Biol Psychiatry Cogn Neurosci Neuroimaging 2023; 8:79-90. [PMID: 34848384 PMCID: PMC9162086 DOI: 10.1016/j.bpsc.2021.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 10/12/2021] [Accepted: 11/08/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND The presence of a 22q11.2 microdeletion (22q11.2 deletion syndrome [22q11DS]) ranks among the greatest known genetic risk factors for the development of psychotic disorders. There is emerging evidence that the cerebellum is important in the pathophysiology of psychosis. However, there is currently limited information on cerebellar neuroanatomy in 22q11DS specifically. METHODS High-resolution 3T magnetic resonance imaging was acquired in 79 individuals with 22q11DS and 70 typically developing control subjects (N = 149). Lobar and lobule-level cerebellar volumes were estimated using validated automated segmentation algorithms, and subsequently group differences were compared. Hierarchical clustering, principal component analysis, and graph theoretical models were used to explore intercerebellar relationships. Cerebrocerebellar structural connectivity with cortical thickness was examined via linear regression models. RESULTS Individuals with 22q11DS had, on average, 17.3% smaller total cerebellar volumes relative to typically developing subjects (p < .0001). The lobules of the superior posterior cerebellum (e.g., VII and VIII) were particularly affected in 22q11DS. However, all cerebellar lobules were significantly smaller, even after adjusting for total brain volumes (all cerebellar lobules p < .0002). The superior posterior lobule was disproportionately associated with cortical thickness in the frontal lobes and cingulate cortex, brain regions known be affected in 22q11DS. Exploratory analyses suggested that the superior posterior lobule, particularly Crus I, may be associated with psychotic symptoms in 22q11DS. CONCLUSIONS The cerebellum is a critical but understudied component of the 22q11DS neuroendophenotype.
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Affiliation(s)
- J Eric Schmitt
- Brain Behavior Laboratory, Neurodevelopment and Psychosis Section, Department of Psychiatry, Philadelphia, Pennsylvania; Division of Neuroradiology, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
| | - John J DeBevits
- Division of Neuroradiology, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - David R Roalf
- Brain Behavior Laboratory, Neurodevelopment and Psychosis Section, Department of Psychiatry, Philadelphia, Pennsylvania
| | - Kosha Ruparel
- Brain Behavior Laboratory, Neurodevelopment and Psychosis Section, Department of Psychiatry, Philadelphia, Pennsylvania
| | - R Sean Gallagher
- Brain Behavior Laboratory, Neurodevelopment and Psychosis Section, Department of Psychiatry, Philadelphia, Pennsylvania
| | - Ruben C Gur
- Brain Behavior Laboratory, Neurodevelopment and Psychosis Section, Department of Psychiatry, Philadelphia, Pennsylvania
| | - Aaron Alexander-Bloch
- Brain Behavior Laboratory, Neurodevelopment and Psychosis Section, Department of Psychiatry, Philadelphia, Pennsylvania
| | - Tae-Yeon Eom
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Shahinur Alam
- Center for Bioimage Informatics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Jeffrey Steinberg
- Center for Bioimage Informatics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Walter Akers
- Center for Bioimage Informatics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Khaled Khairy
- Center for In Vivo Imaging and Therapeutics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - T Blaine Crowley
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Beverly Emanuel
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Stanislav S Zakharenko
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Donna M McDonald-McGinn
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Raquel E Gur
- Brain Behavior Laboratory, Neurodevelopment and Psychosis Section, Department of Psychiatry, Philadelphia, Pennsylvania; Division of Neuroradiology, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Korann V, Suhas S, Appaji A, Nagendra B, Padmanabha A, Jacob A, Devi P, Bharath RD, Kumar V, Varambally S, Venkatasubramanian G, Rao SV, Webers CA, Berendschot TT, Rao NP. Association between retinal vascular measures and brain white matter lesions in schizophrenia. Asian J Psychiatr 2022; 70:103042. [PMID: 35219980 DOI: 10.1016/j.ajp.2022.103042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/28/2022] [Accepted: 02/17/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Recent studies have examined retinal vascular abnormalities in schizophrenia as retinal vascular imaging is a non-invasive proxy to cerebral microvasculature. However, relation between retinal vascular abnormalities and brain structure is not well examined in schizophrenia. Hence in this study, for the first time, we examined the relationship between retinal vascular measures and brain white matter lesions in schizophrenia. We examined brain white matter lesions as they are considered a predictive marker for future adverse cerebrovascular event. METHODS We acquired retinal vascular images of both eyes using a non-mydriatic camera and calculated retinal vascular diameter, tortuosity, trajectory and fractal dimension using validated methods. All patients underwent Magnetic Resonance Imaging of bran and we computed white matter hypo-intensities using Freesurfer software. We performed a linear regression analysis to examine the relationship between white matter hypo-intensities and retinal vascular measures controlling for age, sex, fasting blood sugar, creatinine, whole-brain volume, and antipsychotic dose. RESULTS The regression model was significant in Schizophrenia patients (R=0.983;R2 =0.966;-F=10.849;p = 0.008) but not in healthy volunteers (R=0.828;R2 =0.686;F=0.182; p = 0.963). Among the retinal vascular measures, arterial tortuosity (β = 0.963;p-0.002), tortuosity (β = -1.002;p = 0.001) and fractal dimension (β = -0.688;p = 0.014) were significant predictors of white matter lesions. DISCUSSION The current study's findings support the conclusion that retinal vascular fractal dimension and tortuosity are associated with changes in cerebral white matter and may be considered proxy markers for cerebral microvasculature in schizophrenia. Considering the relationship between white matter lesions and stroke, these observations could have important clinical implications to screen schizophrenia patients for risk of adverse cerebrovascular event.
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Neuhaus E, Hattingen E, Breuer S, Steidl E, Polomac N, Rosenow F, Rüber T, Herrmann E, Ecker C, Kushan L, Lin A, Vajdi A, Bearden CE, Jurcoane A. Heterotopia in Individuals with 22q11.2 Deletion Syndrome. AJNR Am J Neuroradiol 2021; 42:2070-2076. [PMID: 34620586 PMCID: PMC8583271 DOI: 10.3174/ajnr.a7283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/19/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE MR imaging studies and neuropathologic findings in individuals with 22q11.2 deletion syndrome show anomalous early brain development. We aimed to retrospectively evaluate cerebral abnormalities, focusing on gray matter heterotopia, and to correlate these with subjects' neuropsychiatric impairments. MATERIALS AND METHODS Three raters assessed gray matter heterotopia and other morphologic brain abnormalities on 3D T1WI and T2*WI in 75 individuals with 22q11.2 deletion syndrome (27 females, 15.5 [SD, 7.4] years of age) and 53 controls (24 females, 12.6 [SD, 4.7] years of age). We examined the association among the groups' most frequent morphologic findings, general cognitive performance, and comorbid neuropsychiatric conditions. RESULTS Heterotopia in the white matter were the most frequent finding in individuals with 22q11.2 deletion syndrome (n = 29; controls, n = 0; between-group difference, P < .001), followed by cavum septi pellucidi and/or vergae (n = 20; controls, n = 0; P < .001), periventricular cysts (n = 10; controls, n = 0; P = .007), periventricular nodular heterotopia (n = 10; controls, n = 0; P = .007), and polymicrogyria (n = 3; controls, n = 0; P = .3). However, individuals with these morphologic brain abnormalities did not differ significantly from those without them in terms of general cognitive functioning and psychiatric comorbidities. CONCLUSIONS Taken together, our findings, periventricular nodular heterotopia or heterotopia in the white matter (possibly related to interrupted Arc cells migration), persistent cavum septi pellucidi and/or vergae, and formation of periventricular cysts, give clues to the brain development disorder induced by the 22q11.2 deletion syndrome. There was no evidence that these morphologic findings were associated with differences in psychiatric or cognitive presentation of the 22q11.2 deletion syndrome.
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Affiliation(s)
- E Neuhaus
- From the Institute of Neuroradiology (E.N., E. Hattingen, S.B., E.S., N.P., A.J.)
- Department of Neurology and Epilepsy Center Frankfurt Rhine-Main (E.N., F.R., T.R.)
- LOEWE Center for Personalized Translational Epilepsy Research (E.N., F.R., T.R.)
| | - E Hattingen
- From the Institute of Neuroradiology (E.N., E. Hattingen, S.B., E.S., N.P., A.J.)
| | - S Breuer
- From the Institute of Neuroradiology (E.N., E. Hattingen, S.B., E.S., N.P., A.J.)
| | - E Steidl
- From the Institute of Neuroradiology (E.N., E. Hattingen, S.B., E.S., N.P., A.J.)
| | - N Polomac
- From the Institute of Neuroradiology (E.N., E. Hattingen, S.B., E.S., N.P., A.J.)
| | - F Rosenow
- Department of Neurology and Epilepsy Center Frankfurt Rhine-Main (E.N., F.R., T.R.)
- LOEWE Center for Personalized Translational Epilepsy Research (E.N., F.R., T.R.)
| | - T Rüber
- Department of Neurology and Epilepsy Center Frankfurt Rhine-Main (E.N., F.R., T.R.)
- LOEWE Center for Personalized Translational Epilepsy Research (E.N., F.R., T.R.)
- Department of Epileptology (T.R.), University Hospital Bonn, Bonn, Germany
| | - E Herrmann
- Institute of Biostatistics and Mathematical Modelling (E. Herrmann)
| | - C Ecker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (C.E.), Goethe University Frankfurt, Frankfurt am Main, Germany
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience (C.E.), King's College, London, UK
| | - L Kushan
- Department of Psychiatry and Biobehavioral Sciences (L.K., A.L., A.V., C.E.B.), Semel Institute for Neuroscience and Human Behavior
| | - A Lin
- Department of Psychiatry and Biobehavioral Sciences (L.K., A.L., A.V., C.E.B.), Semel Institute for Neuroscience and Human Behavior
| | - A Vajdi
- Department of Psychiatry and Biobehavioral Sciences (L.K., A.L., A.V., C.E.B.), Semel Institute for Neuroscience and Human Behavior
| | - C E Bearden
- Department of Psychiatry and Biobehavioral Sciences (L.K., A.L., A.V., C.E.B.), Semel Institute for Neuroscience and Human Behavior
- Department of Psychology (C.E.B.), University of California, Los Angeles, Los Angeles, California
| | - A Jurcoane
- From the Institute of Neuroradiology (E.N., E. Hattingen, S.B., E.S., N.P., A.J.)
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6
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AlKalaf HY, AlHashem AM, AlSaleh NS, AlJohar NM, Abo Thneen AM, ElGhezal HM, Bouhjar IB, Tlili-Graiess K, Sahari AH, Tabarki BM. Epilepsy, neuropsychiatric phenotypes, neuroimaging findings, and genotype-neurophenotype correlation in 22q11.2 deletion syndrome. ACTA ACUST UNITED AC 2021; 25:287-291. [PMID: 33130809 PMCID: PMC8015611 DOI: 10.17712/nsj.2020.4.20200045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objectives: To describe the epilepsy, neuropsychiatric manifestations, and neuroimaging findings in a group of patients with 22q11.2 DS, and to correlate the size of the deleted genetic material with the severity of the phenotype. Methods: We retrospectively analyzed the medical records of 28 patients (21 pediatric patients and 7 adults) with a genetically confirmed diagnosis of 22q11.2 DS. Clinical data (epilepsy, neurological exam, neuropsychological and developmental assessment, and psychiatric disorders), neuroimaging, and cytogenetic tests were analyzed. Results: Of the 28 patients with 22q11.2 DS, 6 (21.4%) had epileptic seizures, 2 had symptomatic hypocalcemic seizures, 4 (14.2%) had a psychiatric disorder, which comprised of attention deficit hyperactivity disorder, autism spectrum disorder, psychosis, and mood disorder, and 17 (60.7%) had developmental delay. All patients with epilepsy had a developmental delay. Twelve patients underwent a neuropsychology assessment. Intellectual levels ranged from moderate intellectual disability (7/12, 58%) to average (5/12, 41.6%). Of the 16 patients, 6 (37.5%) had a normal brain, while 10 (62.5%) had abnormal neuroimaging findings. No significant correlation was found between the size of the deleted genetic material and the severity of the phenotype. Conclusion: 22q11.2DS patients are at high risk to develop epilepsy, neuropsychiatric manifestations, and structural brain abnormalities. This indicates that this defined genetic locus is crucial for the development of the nervous system, and patients with 22q11.2 DS have genetic susceptibility to develop epilepsy.
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Affiliation(s)
- Heeba Y AlKalaf
- Division of Pediatric Neurology, Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
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7
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Kasereka MC, Hawkes MT. Neuroinvasive potential of human coronavirus OC43: case report of fatal encephalitis in an immunocompromised host. J Neurovirol 2021; 27:340-4. [PMID: 33405204 DOI: 10.1007/s13365-020-00926-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/25/2020] [Accepted: 11/08/2020] [Indexed: 12/04/2022]
Abstract
Neurologic manifestations of COVID-19 include anosmia, ageusia, encephalopathy, agitation, confusion, ischemic strokes, Guillain–Barré syndrome, seizures, and hemorrhagic encephalitis. Although mechanisms of central nervous system (CNS) injury are likely diverse, direct viral invasion of the CNS has been demonstrated in case reports. Neurotropism of human coronaviruses (HCoVs) is therefore of great interest in the context of the COVID-19 pandemic. Here we present an autopsy-proven case of fatal human coronavirus (HCoV)-OC43 encephalitis in an infant with aplastic thymus and chronic T-cell lymphopenia. Clinicians should remain alert to the possibility of direct CNS invasion by human coronaviruses, including the novel pandemic SARS-CoV-2.
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8
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Sudhir BJ, Honavalli Murali S, Gohil J, Poyuran R, Sethuraman M, Harihara Venkat E. Cyanosis and Clipping: Noninfectious Aneurysm in a Patient with 22q11.2 Deletion Syndrome. Pediatr Neurosurg 2021; 56:45-49. [PMID: 33550290 DOI: 10.1159/000512581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/27/2020] [Indexed: 11/19/2022]
Abstract
Noninfectious cerebral aneurysms are rare in patients with congenital cyanotic heart disease. We present a patient with DiGeorge/velocardiofacial syndrome with a complex congenital cyanotic heart disease with a ruptured anterior communicating artery aneurysm. The 10-year-old child was managed by surgical clipping of the aneurysm. Surgical challenges included prominent veins in the Sylvian fissure, difficulty in differentiating arterial and venous bleed, and anesthetic risks. The patient recovered without any neurological deficits. This is the first report of a patient with 22q11.2 deletion syndrome, with a noninfectious cerebral aneurysm.
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Affiliation(s)
- Bhanu Jayanand Sudhir
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India,
| | - Sanjay Honavalli Murali
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Jaypalsinh Gohil
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Rajalakshmi Poyuran
- Department of Neuro-Pathology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Manikantan Sethuraman
- Department of Neuro-Anesthesia, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Easwer Harihara Venkat
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
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9
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Jalbrzikowski M. Neuroimaging Phenotypes Associated With Risk and Resilience for Psychosis and Autism Spectrum Disorders in 22q11.2 Microdeletion Syndrome. Biol Psychiatry Cogn Neurosci Neuroimaging 2020; 6:211-224. [PMID: 33218931 DOI: 10.1016/j.bpsc.2020.08.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 01/17/2023]
Abstract
Identification of biological risk factors that contribute to the development of complex neuropsychiatric disorders such as psychosis and autism spectrum disorder (ASD) is key for early intervention and detection. Furthermore, parsing the biological heterogeneity associated with these neuropsychiatric syndromes will help us understand the neural mechanisms underlying psychiatric symptom development. The 22q11.2 microdeletion syndrome (22q11DS) is caused by a recurrent genetic mutation that carries significantly increased risk for developing psychosis and/or ASD. In this review, I provide an brief introduction to 22q11DS and discuss common phenotyping strategies that are used to assess psychosis and ASD in this population. I then summarize neuroimaging phenotypes associated with psychosis and ASD in 22q11.DS. Next, I discuss challenges within the field and provide practical suggestions to overcome these obstacles. Finally, I discuss future directions for moving 22q11DS risk and resilience research forward.
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Affiliation(s)
- Maria Jalbrzikowski
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
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10
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Solot CB, Moore TM, Crowley TB, Gerdes M, Moss E, McGinn DE, Emanuel BS, Zackai EH, Gallagher S, Calkins ME, Ruparel K, Gur RC, McDonald-McGinn D, Gur RE. Early language measures associated with later psychosis features in 22q11.2 deletion syndrome. Am J Med Genet B Neuropsychiatr Genet 2020; 183:392-400. [PMID: 32715620 PMCID: PMC8050829 DOI: 10.1002/ajmg.b.32812] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 02/18/2020] [Accepted: 06/01/2020] [Indexed: 12/18/2022]
Abstract
The 22q11.2 deletion syndrome (22q11DS) is associated with impaired cognitive functions and increased risk for schizophrenia spectrum disorders. Speech and language deficits are prominent, with evidence of decline anteceding emergence of psychosis. There is paucity of data examining language function in children with 22q11DS with follow-up assessment of psychosis spectrum (PS) symptoms. We examined the association between early language measures, obtained clinically, and PS status, obtained on average 10.1 years later, in 166 youths with 22q11DS, with repeated language testing in 48. Participants were administered the Preschool Language Scale (receptive/expressive), and/or, for school aged children, the Clinical Evaluation of Language Fundamentals (receptive/expressive), and age appropriate IQ tests. The structured interview for prodromal syndromes (SIPS) assessed PS symptoms. We found that performance on all preschool measures showed age associated decline, and males performed more poorly on core composite (receptive/expressive) and receptive language measures. For language assessment later in childhood, poorer performance was consistently associated with subsequent PS status. Furthermore, steeper age-related decline was seen in the PS group across language measures and marginally for full-scale IQ. These findings suggest that while preschool language testing is useful in characterizing performance decline in individuals with 22q11DS, it does not robustly differentiate those with subsequent PS from those without. However, language testing in the school age population can help identify individuals with 22q11DS who are at risk for psychosis. Such data are needed for elucidating a lifespan trajectory for affected individuals and may help understand pathways to psychosis applicable to the general population.
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Affiliation(s)
- Cynthia B. Solot
- Department of Speech-Language Pathology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Tyler M. Moore
- Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - T. Blaine Crowley
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Marsha Gerdes
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Edward Moss
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Daniel E. McGinn
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Beverly S. Emanuel
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Elaine H. Zackai
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sean Gallagher
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Monica E. Calkins
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kosha Ruparel
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ruben C. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Donna McDonald-McGinn
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Raquel E. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia
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11
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Hopkins SE, Chadehumbe M, Blaine Crowley T, Zackai EH, Bilaniuk LT, McDonald-McGinn DM. Neurologic challenges in 22q11.2 deletion syndrome. Am J Med Genet A 2018; 176:2140-2145. [PMID: 30365873 DOI: 10.1002/ajmg.a.38614] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 09/10/2015] [Accepted: 01/11/2016] [Indexed: 01/30/2023]
Abstract
Children with 22q11.2 deletion syndrome often come to medical attention due to signs and symptoms of neurologic dysfunction. It is imperative to understand the expected neurologic development of patients with this diagnosis in order to be alert for the potential neurologic complications, including cortical malformations, tethered cord, epilepsy, and movement disorders. We present an update of brain imaging findings from the CHOP 22q and You Center, a review of the current literature, and our current management practices for neurological issues.
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Affiliation(s)
- Sarah E Hopkins
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Madeline Chadehumbe
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Elaine H Zackai
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Larissa T Bilaniuk
- Division of Neuroradiology, Children's Hospital of Philadelphia, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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12
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Saadeh M, Zhao Y, Galadima H, Chaoui R, Sinkovskaya E, Abuhamad A. Relationship Between Cavum Septi Pellucidi Measurements and Fetal Hypoplastic Left Heart Syndrome or Dextro-Transposition of the Great Arteries. J Ultrasound Med 2018; 37:1673-1680. [PMID: 29280178 DOI: 10.1002/jum.14515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 09/09/2017] [Accepted: 09/27/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The aim of this study was to compare the size and position of the cavum septi pellucidi (CSP) in fetuses with hypoplastic left heart syndrome (HLHS) or dextro-transposition of the great arteries (d-TGA) with healthy fetuses. METHODS The CSP length, CSP width, and frontal lobe length were measured in 185 healthy fetuses (404 scans), 11 fetuses with HLHS (16 scans), and 11 fetuses with d-TGA (12 scans) between January 2005 and April 2016. Each measurement was compared between healthy fetuses and those with HLHS or d-TGA, controlling for the biparietal diameter. RESULTS Positive correlations were noted between biparietal diameter and CSP length, CSP width, and frontal lobe length (adjusted R2 = 0.811, 0.821, and 0.878, respectively). An increased CSP length was found in both fetuses with HLHS and those with d-TGA (P < .0001). The CSP width was only increased in fetuses with d-TGA (P = .0466). No difference in the frontal lobe length was noted. CONCLUSIONS In fetuses with HLHS, the CSP is increased in length. In fetuses with d-TGA, the CSP is increased in both length and width.
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Affiliation(s)
- Michael Saadeh
- Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Yili Zhao
- Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Hadiza Galadima
- Center for Health Analytics and Discovery, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Rabih Chaoui
- Center for Prenatal Diagnosis and Human Genetics, Berlin, Germany
| | - Elena Sinkovskaya
- Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Alfred Abuhamad
- Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia, USA
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13
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Roalf DR, Eric Schmitt J, Vandekar SN, Satterthwaite TD, Shinohara RT, Ruparel K, Elliott MA, Prabhakaran K, McDonald-McGinn DM, Zackai EH, Gur RC, Emanuel BS, Gur RE. White matter microstructural deficits in 22q11.2 deletion syndrome. Psychiatry Res 2017; 268:35-44. [PMID: 28865345 PMCID: PMC5814141 DOI: 10.1016/j.pscychresns.2017.08.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 08/02/2017] [Accepted: 08/06/2017] [Indexed: 02/06/2023]
Abstract
Diffusion tensor imaging (DTI) studies in 22q11.2 deletion syndrome (22q11DS), a neurogenetic condition associated with psychosis, report brain white matter (WM) microstructure aberrations. Several studies report that WM disruptions in 22q11DS are similar to deficits in idiopathic schizophrenia. Yet, DTI results in 22q11DS are inconsistent. We used DTI to compare WM structure in 22q11DS individuals to healthy controls (HC) and explored WM differences in 22q11DS with (+) and without (-) psychosis spectrum symptoms. We examined 39 22q11DS individuals and 39 age, sex and race equivalent HC. DTI was performed at 3T using a 64-direction protocol. Fractional anisotropy (FA) was lower, while radial diffusivity was higher in 22q11DS within the cingulum bundle. Mean diffusivity was lower in the inferior longitudinal fasciculus, while axial diffusivity (AD) was lower in the cingulum bundle, forceps major, and several posterior to anterior fasciculi. 22q11DS+ had lower FA in the cingulum bundle and lower AD in the uncinate fasciculus compared to 22q11DS-. Overall, we found aberrant WM microstructure in individuals with 22q11DS compared to age and sex matched HC and exploratory analysis indicated subtle WM deficits associated with psychosis. The findings highlight the dysfunction of WM microstructure in 22q11DS and its potential importance in elucidating WM abnormalities in psychosis.
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Affiliation(s)
- David R Roalf
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
| | - J Eric Schmitt
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Simon N Vandekar
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Biostatistics and Epidemiology, Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Theodore D Satterthwaite
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Russell T Shinohara
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Kosha Ruparel
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Mark A Elliott
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Karthik Prabhakaran
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Donna M McDonald-McGinn
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Elaine H Zackai
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ruben C Gur
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA; Lifespan Brain Institute (LiBI) at the University of Pennsylvania and Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Beverly S Emanuel
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Raquel E Gur
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA; Lifespan Brain Institute (LiBI) at the University of Pennsylvania and Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA; Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
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14
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Zhan L, Jenkins LM, Zhang A, Conte G, Forbes A, Harvey D, Angkustsiri K, Goodrich-Hunsaker NJ, Durdle C, Lee A, Schumann C, Carmichael O, Kalish K, Leow AD, Simon TJ. Baseline connectome modular abnormalities in the childhood phase of a longitudinal study on individuals with chromosome 22q11.2 deletion syndrome. Hum Brain Mapp 2017; 39:232-248. [PMID: 28990258 DOI: 10.1002/hbm.23838] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 09/20/2017] [Accepted: 09/27/2017] [Indexed: 01/09/2023] Open
Abstract
Occurring in at least 1 in 3,000 live births, chromosome 22q11.2 deletion syndrome (22q11DS) produces a complex phenotype that includes a constellation of medical complications such as congenital cardiac defects, immune deficiency, velopharyngeal dysfunction, and characteristic facial dysmorphic features. There is also an increased incidence of psychiatric diagnosis, especially intellectual disability and ADHD in childhood, lifelong anxiety, and a strikingly high rate of schizophrenia spectrum disorders, which occur in around 30% of adults with 22q11DS. Using innovative computational connectomics, we studied how 22q11DS affects high-level network signatures of hierarchical modularity and its intrinsic geometry in 55 children with confirmed 22q11DS and 27 Typically Developing (TD) children. Results identified 3 subgroups within our 22q11DS sample using a K-means clustering approach based on several midline structural measures-of-interests. Each subgroup exhibited distinct patterns of connectome abnormalities. Subtype 1, containing individuals with generally healthy-looking brains, exhibited no significant differences in either modularity or intrinsic geometry when compared with TD. By contrast, the more anomalous 22q11DS Subtypes 2 and 3 brains revealed significant modular differences in the right hemisphere, while Subtype 3 (the most anomalous anatomy) further exhibited significantly abnormal connectome intrinsic geometry in the form of left-right temporal disintegration. Taken together, our findings supported an overall picture of (a) anterior-posteriorly differential interlobar frontotemporal/frontoparietal dysconnectivity in Subtypes 2 and 3 and (b) differential intralobar dysconnectivity in Subtype 3. Our ongoing studies are focusing on whether these subtypes and their connnectome signatures might be valid biomarkers for predicting the degree of psychosis-proneness risk found in 22q11DS. Hum Brain Mapp 39:232-248, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Liang Zhan
- Computer Engineering Program, University of Wisconsin-Stout, Wisconsin
| | | | - Aifeng Zhang
- Department of Psychiatry, University of Illinois, Chicago, Illinois
| | - Giorgio Conte
- Department of Computer Science, University of Illinois, Chicago, Illinois
| | - Angus Forbes
- Department of Computer Science, University of Illinois, Chicago, Illinois
| | - Danielle Harvey
- Division of Biostatistics, Department of Public Health Sciences, School of Medicine, University of California, Davis, California
| | | | - Naomi J Goodrich-Hunsaker
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, California.,Department of Psychology, Brigham Young University, Provo, Utah
| | - Courtney Durdle
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, California
| | - Aaron Lee
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, California
| | - Cyndi Schumann
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, California
| | - Owen Carmichael
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Kristopher Kalish
- Department of Neurology, University of California, Davis, California
| | - Alex D Leow
- Department of Psychiatry, University of Illinois, Chicago, Illinois.,Department of Bioengineering, University of Illinois, Chicago, Illinois
| | - Tony J Simon
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, California
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15
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Owen JP, Bukshpun P, Pojman N, Thieu T, Chen Q, Lee J, D'Angelo D, Glenn OA, Hunter JV, Berman JI, Roberts TP, Buckner R, Nagarajan SS, Mukherjee P, Sherr EH. Brain MR Imaging Findings and Associated Outcomes in Carriers of the Reciprocal Copy Number Variation at 16p11.2. Radiology 2017; 286:217-226. [PMID: 28786752 DOI: 10.1148/radiol.2017162934] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To identify developmental neuroradiologic findings in a large cohort of carriers who have deletion and duplication at 16p11.2 (one of the most common genetic causes of autism spectrum disorder [ASD]) and assess how these features are associated with behavioral and cognitive outcomes. Materials and Methods Seventy-nine carriers of a deletion at 16p11.2 (referred to as deletion carriers; age range, 1-48 years; mean age, 12.3 years; 42 male patients), 79 carriers of a duplication at 16p11.2 (referred to as duplication carriers; age range, 1-63 years; mean age, 24.8 years; 43 male patients), 64 unaffected family members (referred to as familial noncarriers; age range, 1-46 years; mean age, 11.7 years; 31 male participants), and 109 population control participants (age range, 6-64 years; mean age, 25.5 years; 64 male participants) were enrolled in this cross-sectional study. Participants underwent structural magnetic resonance (MR) imaging and completed cognitive and behavioral tests. MR images were reviewed for development-related abnormalities by neuroradiologists. Differences in frequency were assessed with a Fisher exact test corrected for multiple comparisons. Unsupervised machine learning was used to cluster radiologic features and an association between clusters and cognitive and behavioral scores from IQ testing, and parental measures of development were tested by using analysis of covariance. Volumetric analysis with automated segmentation was used to confirm radiologic interpretation. Results For deletion carriers, the most prominent features were dysmorphic and thicker corpora callosa compared with familial noncarriers and population control participants (16%; P < .001 and P < .001, respectively) and a greater likelihood of cerebellar tonsillar ectopia (30.7%; P < .002 and P < .001, respectively) and Chiari I malformations (9.3%; P < .299 and P < .002, respectively). For duplication carriers, the most salient findings compared with familial noncarriers and population control participants were reciprocally thinner corpora callosa (18.6%; P < .003 and P < .001, respectively), decreased white matter volume (22.9%; P < .001, and P < .001, respectively), and increased ventricular volume (24.3%; P < .001 and P < .001, respectively). By comparing cognitive assessments to imaging findings, the presence of any imaging feature associated with deletion carriers indicated worse daily living, communication, and social skills compared with deletion carriers without any radiologic abnormalities (P < .005, P < .002, and P < .004, respectively). For the duplication carriers, presence of decreased white matter, callosal volume, and/or increased ventricle size was associated with decreased full-scale and verbal IQ scores compared with duplication carriers without these findings (P < .007 and P < .004, respectively). Conclusion In two genetically related cohorts at high risk for ASD, reciprocal neuroanatomic abnormalities were found and determined to be associated with cognitive and behavioral impairments. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Julia P Owen
- From the Departments of Radiology (J.P.O., O.A.G., S.S.N., P.M.) and Neurology (P.B., N.P., T.T., E.H.S.), University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158; Department of Biostatistics, Columbia University, New York, NY (Q.C., J.L., D.D.); Department of Medicine and Pediatrics, Baylor School of Medicine, Houston, Tex (J.V.H.); Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (J.I.B., T.P.R.); and Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Mass (R.B.)
| | - Polina Bukshpun
- From the Departments of Radiology (J.P.O., O.A.G., S.S.N., P.M.) and Neurology (P.B., N.P., T.T., E.H.S.), University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158; Department of Biostatistics, Columbia University, New York, NY (Q.C., J.L., D.D.); Department of Medicine and Pediatrics, Baylor School of Medicine, Houston, Tex (J.V.H.); Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (J.I.B., T.P.R.); and Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Mass (R.B.)
| | - Nicholas Pojman
- From the Departments of Radiology (J.P.O., O.A.G., S.S.N., P.M.) and Neurology (P.B., N.P., T.T., E.H.S.), University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158; Department of Biostatistics, Columbia University, New York, NY (Q.C., J.L., D.D.); Department of Medicine and Pediatrics, Baylor School of Medicine, Houston, Tex (J.V.H.); Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (J.I.B., T.P.R.); and Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Mass (R.B.)
| | - Tony Thieu
- From the Departments of Radiology (J.P.O., O.A.G., S.S.N., P.M.) and Neurology (P.B., N.P., T.T., E.H.S.), University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158; Department of Biostatistics, Columbia University, New York, NY (Q.C., J.L., D.D.); Department of Medicine and Pediatrics, Baylor School of Medicine, Houston, Tex (J.V.H.); Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (J.I.B., T.P.R.); and Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Mass (R.B.)
| | - Qixuan Chen
- From the Departments of Radiology (J.P.O., O.A.G., S.S.N., P.M.) and Neurology (P.B., N.P., T.T., E.H.S.), University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158; Department of Biostatistics, Columbia University, New York, NY (Q.C., J.L., D.D.); Department of Medicine and Pediatrics, Baylor School of Medicine, Houston, Tex (J.V.H.); Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (J.I.B., T.P.R.); and Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Mass (R.B.)
| | - Jihui Lee
- From the Departments of Radiology (J.P.O., O.A.G., S.S.N., P.M.) and Neurology (P.B., N.P., T.T., E.H.S.), University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158; Department of Biostatistics, Columbia University, New York, NY (Q.C., J.L., D.D.); Department of Medicine and Pediatrics, Baylor School of Medicine, Houston, Tex (J.V.H.); Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (J.I.B., T.P.R.); and Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Mass (R.B.)
| | - Debra D'Angelo
- From the Departments of Radiology (J.P.O., O.A.G., S.S.N., P.M.) and Neurology (P.B., N.P., T.T., E.H.S.), University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158; Department of Biostatistics, Columbia University, New York, NY (Q.C., J.L., D.D.); Department of Medicine and Pediatrics, Baylor School of Medicine, Houston, Tex (J.V.H.); Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (J.I.B., T.P.R.); and Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Mass (R.B.)
| | - Orit A Glenn
- From the Departments of Radiology (J.P.O., O.A.G., S.S.N., P.M.) and Neurology (P.B., N.P., T.T., E.H.S.), University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158; Department of Biostatistics, Columbia University, New York, NY (Q.C., J.L., D.D.); Department of Medicine and Pediatrics, Baylor School of Medicine, Houston, Tex (J.V.H.); Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (J.I.B., T.P.R.); and Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Mass (R.B.)
| | - Jill V Hunter
- From the Departments of Radiology (J.P.O., O.A.G., S.S.N., P.M.) and Neurology (P.B., N.P., T.T., E.H.S.), University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158; Department of Biostatistics, Columbia University, New York, NY (Q.C., J.L., D.D.); Department of Medicine and Pediatrics, Baylor School of Medicine, Houston, Tex (J.V.H.); Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (J.I.B., T.P.R.); and Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Mass (R.B.)
| | - Jeffrey I Berman
- From the Departments of Radiology (J.P.O., O.A.G., S.S.N., P.M.) and Neurology (P.B., N.P., T.T., E.H.S.), University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158; Department of Biostatistics, Columbia University, New York, NY (Q.C., J.L., D.D.); Department of Medicine and Pediatrics, Baylor School of Medicine, Houston, Tex (J.V.H.); Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (J.I.B., T.P.R.); and Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Mass (R.B.)
| | - Timothy P Roberts
- From the Departments of Radiology (J.P.O., O.A.G., S.S.N., P.M.) and Neurology (P.B., N.P., T.T., E.H.S.), University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158; Department of Biostatistics, Columbia University, New York, NY (Q.C., J.L., D.D.); Department of Medicine and Pediatrics, Baylor School of Medicine, Houston, Tex (J.V.H.); Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (J.I.B., T.P.R.); and Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Mass (R.B.)
| | - Randy Buckner
- From the Departments of Radiology (J.P.O., O.A.G., S.S.N., P.M.) and Neurology (P.B., N.P., T.T., E.H.S.), University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158; Department of Biostatistics, Columbia University, New York, NY (Q.C., J.L., D.D.); Department of Medicine and Pediatrics, Baylor School of Medicine, Houston, Tex (J.V.H.); Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (J.I.B., T.P.R.); and Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Mass (R.B.)
| | - Srikantan S Nagarajan
- From the Departments of Radiology (J.P.O., O.A.G., S.S.N., P.M.) and Neurology (P.B., N.P., T.T., E.H.S.), University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158; Department of Biostatistics, Columbia University, New York, NY (Q.C., J.L., D.D.); Department of Medicine and Pediatrics, Baylor School of Medicine, Houston, Tex (J.V.H.); Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (J.I.B., T.P.R.); and Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Mass (R.B.)
| | - Pratik Mukherjee
- From the Departments of Radiology (J.P.O., O.A.G., S.S.N., P.M.) and Neurology (P.B., N.P., T.T., E.H.S.), University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158; Department of Biostatistics, Columbia University, New York, NY (Q.C., J.L., D.D.); Department of Medicine and Pediatrics, Baylor School of Medicine, Houston, Tex (J.V.H.); Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (J.I.B., T.P.R.); and Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Mass (R.B.)
| | - Elliott H Sherr
- From the Departments of Radiology (J.P.O., O.A.G., S.S.N., P.M.) and Neurology (P.B., N.P., T.T., E.H.S.), University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158; Department of Biostatistics, Columbia University, New York, NY (Q.C., J.L., D.D.); Department of Medicine and Pediatrics, Baylor School of Medicine, Houston, Tex (J.V.H.); Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (J.I.B., T.P.R.); and Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Mass (R.B.)
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16
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Bohm LA, Zhou TC, Mingo TJ, Dugan SL, Patterson RJ, Sidman JD, Roby BB. Neuroradiographic findings in 22q11.2 deletion syndrome. Am J Med Genet A 2017; 173:2158-2165. [PMID: 28577347 DOI: 10.1002/ajmg.a.38304] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/20/2017] [Accepted: 05/10/2017] [Indexed: 10/19/2022]
Abstract
22q11.2 deletion syndrome (22q11.2DS) is a common genetic disorder with enormous phenotypic heterogeneity. Despite the established prevalence of developmental and neuropsychiatric issues in this syndrome, its neuroanatomical correlates are not as well understood. A retrospective chart review was performed on 111 patients diagnosed with 22q11.2DS. Of the 111 patients, 24 with genetically confirmed 22q11.2 deletion and brain MRI or MRA were included in this study. The most common indications for imaging were unexplained developmental delay (6/24), seizures of unknown etiology (5/24), and unilateral weakness (3/24). More than half (13/24) of the patients had significant radiographic findings, including persistent cavum septi pellucidi and/or cavum vergae (8/24), aberrant cortical veins (6/24), polymicrogyria or cortical dysplasia (4/24), inner ear deformities (3/24), hypoplastic internal carotid artery (2/24), and hypoplastic cerebellum (1/24). These findings reveal the types and frequencies of brain malformations in this case series, and suggest that the prevalence of neuroanatomical abnormalities in 22q11.2DS may be underestimated. Understanding indications for imaging and frequently encountered brain malformations will result in early diagnosis and intervention in an effort to optimize patient outcomes.
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Affiliation(s)
- Lauren A Bohm
- University of Minnesota, Minneapolis, Minnesota.,ENT and Facial Plastic Surgery, Children's Minnesota, Children's Specialty Center, Minneapolis, Minnesota.,Division of Pediatric Otolaryngology, University of Michigan, Ann Arbor, Michigan
| | - Tom C Zhou
- University of Minnesota, Minneapolis, Minnesota
| | | | - Sarah L Dugan
- Medical Genetics, Children's Minnesota, Minneapolis, Minnesota.,Division of Pediatric Genetics, University of Utah, Salt Lake City, Utah
| | | | - James D Sidman
- University of Minnesota, Minneapolis, Minnesota.,ENT and Facial Plastic Surgery, Children's Minnesota, Children's Specialty Center, Minneapolis, Minnesota
| | - Brianne B Roby
- University of Minnesota, Minneapolis, Minnesota.,ENT and Facial Plastic Surgery, Children's Minnesota, Children's Specialty Center, Minneapolis, Minnesota
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17
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Bassett AS, Costain G, Marshall CR. Neuropsychiatric aspects of 22q11.2 deletion syndrome: considerations in the prenatal setting. Prenat Diagn 2016; 37:61-69. [PMID: 27718271 DOI: 10.1002/pd.4935] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 09/21/2016] [Accepted: 10/03/2016] [Indexed: 12/20/2022]
Abstract
Most major neuropsychiatric outcomes of concern to families are not detectable by prenatal ultrasound. The introduction of genome-wide chromosomal microarray analysis to prenatal clinical diagnostic testing has increased the detection of pathogenic 22q11.2 deletions, which cause the most common genomic disorder. The recent addition of this and other microdeletions to non-invasive prenatal screening methods using cell-free fetal DNA has further propelled interest in outcomes. Conditions associated with 22q11.2 deletions include intellect ranging from intellectual disability to average, schizophrenia and other treatable psychiatric conditions, epilepsy, and early-onset Parkinson's disease. However, there is currently no way to predict how severe the lifetime expression will be. Available evidence suggests no major role in these neuropsychiatric outcomes for the congenital cardiac or most other structural anomalies that may be detectable on ultrasound. This article provides an outline of the lifetime neuropsychiatric phenotype of 22q11.2 deletion syndrome that will be useful to clinicians involved in prenatal diagnosis and related genetic counselling. The focus is on information that will be most relevant to two common situations: detection of a 22q11.2 deletion in a fetus or newborn, and new diagnosis of 22q11.2 deletion syndrome in a parent without a previous molecular diagnosis. © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Anne S Bassett
- The Dalglish Family 22q Clinic, University Health Network, Toronto, Ontario, Canada.,Department of Mental Health, Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada.,Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Gregory Costain
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Medical Genetics Residency Training Program, University of Toronto, Toronto, Ontario, Canada
| | - Christian R Marshall
- The Centre for Applied Genomics and Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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18
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Kaltenboeck A, Friedrich F, Hinterbuchinger B, Litvan Z, Mossaheb N. [Diagnosis of 22q11.2 deletion syndrome in the context of newly developed psychosis]. Neuropsychiatr 2016; 30:223-6. [PMID: 27822729 DOI: 10.1007/s40211-016-0203-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 10/20/2016] [Indexed: 12/17/2022]
Abstract
22q11.2 deletion syndrome (clinically also known as velocardiofacial or DiGeorge syndrome) is the most common human microdeletion syndrome and can be associated with a multitude of clinical features. In this article we report the case of a 22-year-old patient from Austria who was diagnosed with previously unknown 22q11.2 deletion syndrome in the context of newly developed psychosis. Using this case as an example, we then discuss the implications of 22q11.2 deletion syndrome for clinical psychiatric practice.
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19
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Schmitt JE, Yi J, Calkins ME, Ruparel K, Roalf DR, Cassidy A, Souders MC, Satterthwaite TD, McDonald-McGinn DM, Zackai EH, Gur RC, Emanuel BS, Gur RE. Disrupted anatomic networks in the 22q11.2 deletion syndrome. Neuroimage Clin 2016; 12:420-8. [PMID: 27622139 PMCID: PMC5008050 DOI: 10.1016/j.nicl.2016.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 07/06/2016] [Accepted: 08/23/2016] [Indexed: 11/16/2022]
Abstract
The 22q11.2 deletion syndrome (22q11DS) is an uncommon genetic disorder with an increased risk of psychosis. Although the neural substrates of psychosis and schizophrenia are not well understood, aberrations in cortical networks represent intriguing potential mechanisms. Investigations of anatomic networks within 22q11DS are sparse. We investigated group differences in anatomic network structure in 48 individuals with 22q11DS and 370 typically developing controls by analyzing covariance patterns in cortical thickness among 68 regions of interest using graph theoretical models. Subjects with 22q11DS had less robust geographic organization relative to the control group, particularly in the occipital and parietal lobes. Multiple global graph theoretical statistics were decreased in 22q11DS. These results are consistent with prior studies demonstrating decreased connectivity in 22q11DS using other neuroimaging methodologies.
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Affiliation(s)
- J. Eric Schmitt
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Radiology, Division of Neuroradiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - James Yi
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Monica E. Calkins
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kosha Ruparel
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David R. Roalf
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Amy Cassidy
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Margaret C. Souders
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Theodore D. Satterthwaite
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Donna M. McDonald-McGinn
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Elaine H. Zackai
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ruben C. Gur
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Radiology, Division of Neuroradiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Beverly S. Emanuel
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Raquel E. Gur
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Radiology, Division of Neuroradiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
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20
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Yi JJ, Weinberger R, Moore TM, Calkins ME, Guri Y, McDonald-McGinn DM, Zackai EH, Emanuel BS, Gur RE, Gothelf D, Gur RC. Performance on a computerized neurocognitive battery in 22q11.2 deletion syndrome: A comparison between US and Israeli cohorts. Brain Cogn 2016; 106:33-41. [PMID: 27200494 DOI: 10.1016/j.bandc.2016.02.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 02/07/2016] [Accepted: 02/08/2016] [Indexed: 02/02/2023]
Abstract
Increasingly, the effects of copy number variation (CNV) in the genome on brain function and behaviors are recognized as means to elucidate pathophysiology of psychiatric disorders. Such studies require large samples and we characterized the neurocognitive profile of two cohorts of individuals with 22q11.2 deletion syndrome (22q11DS), the most common CNV associated with schizophrenia, in an effort to harmonize phenotyping in multi-site global collaborations. The Penn Computerized Neurocognitive Battery (PCNB) was administered to individuals with 22q11DS in Philadelphia (PHL; n=155, aged 12-40) and Tel Aviv (TLV; n=59, aged 12-36). We examined effect sizes of performance differences between the cohorts and confirmed the factor structure of PCNB performance efficiency in the combined sample based on data from a large comparison community sample. The cohorts performed comparably with notable deficits in executive function, episodic memory and social cognition domains that were previously associated with abnormal neuroimaging findings in 22q11DS. In mixed model analysis, while there was a main effect for site for accuracy (number of correct response) and speed (time to correct response) independently, there were no main site effects for standardized efficiency (average of accuracy and speed). The fit of a structural model was excellent indicating that PCNB tests were related to the targeted cognitive domains. Thus, our results provide preliminary support for the use of the PCNB as an efficient tool for neurocognitive assessment in international 22q11DS collaborations.
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Affiliation(s)
- James J Yi
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Ronnie Weinberger
- The Behavioral Neurogenetics Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Tyler M Moore
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Monica E Calkins
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Yael Guri
- The Behavioral Neurogenetics Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Donna M McDonald-McGinn
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Elaine H Zackai
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Beverly S Emanuel
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Raquel E Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Doron Gothelf
- The Behavioral Neurogenetics Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Ruben C Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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21
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Scott JA, Goodrich-Hunsaker N, Kalish K, Lee A, Hunsaker MR, Schumann CM, Carmichael OT, Simon TJ. The hippocampi of children with chromosome 22q11.2 deletion syndrome have localized anterior alterations that predict severity of anxiety. J Psychiatry Neurosci 2016; 41:203-13. [PMID: 26599134 PMCID: PMC4853211 DOI: 10.1503/jpn.140299] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Individuals with 22q11.2 deletion syndrome (22q11.2DS) have an elevated risk for schizophrenia, which increases with history of childhood anxiety. Altered hippocampal morphology is a common neuroanatomical feature of 22q11.2DS and idiopathic schizophrenia. Relating hippocampal structure in children with 22q11.2DS to anxiety and impaired cognitive ability could lead to hippocampus-based characterization of psychosis-proneness in this at-risk population. METHODS We measured hippocampal volume using a semiautomated approach on MRIs collected from typically developing children and children with 22q11.2DS. We then analyzed hippocampal morphology with Localized Components Analysis. We tested the modulating roles of diagnostic group, hippocampal volume, sex and age on local hippocampal shape components. Lastly, volume and shape components were tested as covariates of IQ and anxiety. RESULTS We included 48 typically developing children and 69 children with 22q11.2DS in our study. Hippocampal volume was reduced bilaterally in children with 22q11.2DS, and these children showed greater variation in the shape of the anterior hippocampus than typically developing children. Children with 22q11.2DS had greater inward deformation of the anterior hippocampus than typically developing children. Greater inward deformation of the anterior hippocampus was associated with greater severity of anxiety, specifically fear of physical injury, within the 22q11.2DS group. LIMITATIONS Shape alterations are not specific to hippocampal subfields. CONCLUSION Alterations in the structure of the anterior hippocampus likely affect function and may impact limbic circuitry. We suggest these alterations potentially contribute to anxiety symptoms in individuals with 22q11.2DS through modulatory pathways. Altered hippocampal morphology may be uniquely linked to anxiety risk factors for schizophrenia, which could be a powerful neuroanatomical marker of schizophrenia risk and hence protection.
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Affiliation(s)
- Julia A. Scott
- Correspondence to: J.A. Scott, Center for Neuroscience, 1544 Newton Court, University of California, Davis CA, United States;
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