1
|
Wright JN, Feyma TJ, Ishak GE, Abeshaus S, Metz JB, Brown ECB, Friedman SD, Browd SR, Feldman KW. Correction to: Subdural hemorrhage rebleeding in abused children: frequency, associations and clinical presentation. Pediatr Radiol 2020; 50:1161. [PMID: 32444953 DOI: 10.1007/s00247-020-04687-0] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The original article included a statement which is not fully accurate. This correction clarifies the original statement.
Collapse
Affiliation(s)
- Jason N Wright
- Department of Radiology, Seattle Children's Hospital, Harborview Medical Center, Seattle, WA, USA.,University of Washington, Seattle, WA, USA
| | - Timothy J Feyma
- Department of Neurology, Gillette Children's Specialty Health Care, St. Paul, MN, USA
| | - Gisele E Ishak
- Department of Radiology, Seattle Children's Hospital, Harborview Medical Center, Seattle, WA, USA.,University of Washington, Seattle, WA, USA
| | - Sergey Abeshaus
- Department of Neurosurgery, Rambam Health Care Campus, Haifa, Israel
| | - James B Metz
- Department of Pediatrics, University of Vermont School of Medicine, Burlington, VT, USA
| | - Emily C B Brown
- University of Washington, Seattle, WA, USA.,Department of Pediatrics, Children's Protection Program, M/S SB-250, Seattle Children's Hospital, Harborview Medical Center, 4800 Sand Point Way NE, Seattle, WA, 98105, USA
| | - Seth D Friedman
- Department of Radiology, Seattle Children's Hospital, Harborview Medical Center, Seattle, WA, USA.,University of Washington, Seattle, WA, USA
| | - Samuel R Browd
- University of Washington, Seattle, WA, USA.,Department of Neurological Surgery, Seattle Children's Hospital, Harborview Medical Center, Seattle, WA, USA
| | - Kenneth W Feldman
- University of Washington, Seattle, WA, USA. .,Department of Pediatrics, Children's Protection Program, M/S SB-250, Seattle Children's Hospital, Harborview Medical Center, 4800 Sand Point Way NE, Seattle, WA, 98105, USA.
| |
Collapse
|
2
|
Merbler AM, Byiers BJ, Hoch J, Dimian AC, Barney CC, Feyma TJ, Beisang AA, Bartolomucci A, Symons FJ. Preliminary Evidence That Resting State Heart Rate Variability Predicts Reactivity to Tactile Stimuli in Rett Syndrome. J Child Neurol 2020; 35:42-48. [PMID: 31552776 PMCID: PMC7098209 DOI: 10.1177/0883073819875915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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] [Indexed: 11/16/2022]
Abstract
Patients with Rett syndrome may manifest altered pain perception/experience and are vulnerable to conditions associated with chronic pain. Pain response is difficult to measure, however, because of severe communicative impairment. There is also documented autonomic dysfunction, including decreased heart rate variability. Given the relation between pain and the autonomic nervous system, we tested the feasibility of using resting heart rate variability to predict nonverbal pain/discomfort behavior during a standardized modified quantitative sensory test in Rett syndrome. All stimulus applications resulted in increased behavioral reactivity compared to baseline, with repeated von Frey significantly greater than all other stimuli. Resting heart rate variability predicted behavioral reactivity to repeated von Frey. These preliminary findings provide feasibility evidence for an integrated autonomic-sensory measurement approach and are consistent at a construct level with preclinical evidence in Rett syndrome. Further work is needed to determine how heart rate variability changes during stimulus application.
Collapse
Affiliation(s)
- Alyssa M. Merbler
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Breanne J. Byiers
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - John Hoch
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Adele C Dimian
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Chantel C. Barney
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA,Gillette Children’s Specialty Healthcare, St. Paul, MN, USA
| | | | | | - Alessandro Bartolomucci
- Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN, USA
| | - Frank J. Symons
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
3
|
Byiers BJ, Merbler AM, Barney CC, Frenn KA, Panoskaltsis-Mortari A, Ehrhardt MJ, Feyma TJ, Beisang AA, Symons F. Evidence of altered salivary cytokine concentrations in Rett syndrome and associations with clinical severity. Brain Behav Immun Health 2020; 1:100008. [PMID: 38377412 PMCID: PMC8474566 DOI: 10.1016/j.bbih.2019.100008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/11/2019] [Accepted: 10/13/2019] [Indexed: 11/17/2022] Open
Abstract
Background Immune dysregulation may play a role in the development of Rett syndrome (RTT), a neurodevelopmental disorder caused by mutations of the MECP2 gene. Abnormal cytokine concentrations have been documented in the serum of individuals with RTT. Measurement of salivary cytokines has been investigated as a potential alternative approach to measurement in blood and serum, but it is unclear whether salivary cytokine concentrations can provide valid information about systemic immune function in neurodevelopmental disorders. The goal of this study was to evaluate the potential validity of salivary cytokines as biomarkers of immune dysregulation in RTT. Methods Saliva samples from 16 individuals with RTT (all female; age range 2-40 years) and 16 healthy control females (age range 2-40 years) were analyzed for concentrations of 12 cytokines. Between-group differences in concentrations, and correlations with clinical severity in the RTT group were evaluated. Results Concentrations of several salivary cytokines (IL-1β, IL-6, IL-8, IL-10, GM-CSF, TNF-α, and VEGF) were increased in RTT compared to controls. The same cytokines showed significant positive correlations with clinical severity scores. There were no differences in concentrations of IL-2, IL-4, IL-5, IL-12p70, and IFN-γ. Conclusion The results suggest that salivary cytokines may be a possible indicator of immune dysregulation in RTT. Future research should investigate whether these results can be applied to other neurodevelopmental disorders.
Collapse
Affiliation(s)
- Breanne J. Byiers
- Department of Educational Psychology, 56 E River Rd, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Alyssa M. Merbler
- Department of Educational Psychology, 56 E River Rd, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Chantel C. Barney
- Gillette Children’s Specialty Healthcare, 200 University Ave E, St. Paul, Minnesota, 55101, USA
| | - Kristin A. Frenn
- Gillette Children’s Specialty Healthcare, 200 University Ave E, St. Paul, Minnesota, 55101, USA
| | - Angela Panoskaltsis-Mortari
- Cancer Center and Department of Pediatrics, Division of Blood and Marrow Transplantation, 2450 Riverside Ave, University of Minnesota, Minneapolis, MN, 55454, USA
| | - Michael J. Ehrhardt
- Cancer Center and Department of Pediatrics, Division of Blood and Marrow Transplantation, 2450 Riverside Ave, University of Minnesota, Minneapolis, MN, 55454, USA
| | - Timothy J. Feyma
- Gillette Children’s Specialty Healthcare, 200 University Ave E, St. Paul, Minnesota, 55101, USA
| | - Arthur A. Beisang
- Gillette Children’s Specialty Healthcare, 200 University Ave E, St. Paul, Minnesota, 55101, USA
| | - Frank Symons
- Department of Educational Psychology, 56 E River Rd, University of Minnesota, Minneapolis, MN, 55455, USA
| |
Collapse
|
4
|
Powis Z, Towne MC, Hagman KDF, Blanco K, Palmaer E, Castro A, Sajan SA, Radtke K, Feyma TJ, Juliette K, Tang S, Sidiropoulos C. Clinical diagnostic exome sequencing in dystonia: Genetic testing challenges for complex conditions. Clin Genet 2019; 97:305-311. [PMID: 31628766 DOI: 10.1111/cge.13657] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 05/23/2019] [Revised: 10/10/2019] [Accepted: 10/13/2019] [Indexed: 01/01/2023]
Abstract
Patients with dystonia are particularly appropriate for diagnostic exome sequencing (DES), due to the complex, diverse features and genetic heterogeneity. Personal and family history data were collected from test requisition forms and medical records from 189 patients with reported dystonia and available family members received for clinical DES. Of them, 20.2% patients had a positive genetic finding associated with dystonia. Detection rates for cases with isolated and combined dystonia were 22.4% and 25.0%, respectively. 71.4% of the cohort had co-occurring non-movement-related findings and a detection rate of 24.4%. Patients with childhood-onset dystonia trended toward higher detection rates (31.8%) compared to infancy (23.6%), adolescence (12.5%), and early-adulthood onset (16%). Uncharacterized gene findings were found in 6.7% (8/119) of cases that underwent analysis for genes without an established disease relationship. Patients with intellectual disability/developmental delay, seizures/epilepsy and/or multifocal dystonia were more likely to have positive findings (P = .0093, .0397, .0006). Four (2.1%) patients had findings in two genes, and seven (3.7%) had reclassification after the original report due to new literature, new clinical information or reanalysis request. Pediatric patients were more likely to have positive findings (P = .0180). Our observations show utility of family-based DES in patients with dystonia and illustrate the complexity of testing.
Collapse
Affiliation(s)
- Zöe Powis
- Department of Clinical Research Affairs, Ambry Genetics, Aliso Viejo, California
| | - Meghan C Towne
- Department of Clinical Research Affairs, Ambry Genetics, Aliso Viejo, California
| | - Kelly D F Hagman
- Department of Clinical Genomics, Ambry Genetics, Aliso Viejo, California
| | - Kirsten Blanco
- Department of Clinical Research Affairs, Ambry Genetics, Aliso Viejo, California
| | - Erika Palmaer
- Department of Clinical Genomics, Ambry Genetics, Aliso Viejo, California
| | - Andrew Castro
- Department of Genetic Specialists, Ambry Genetics, Aliso Viejo, California
| | - Samin A Sajan
- Department of Clinical Genomics, Ambry Genetics, Aliso Viejo, California
| | - Kelly Radtke
- Department of Clinical Genomics, Ambry Genetics, Aliso Viejo, California
| | - Timothy J Feyma
- Department of Neurology, Gillette Children's Specialty Healthcare, St Paul, Minnesota
| | - Kali Juliette
- Department of Neurology, Gillette Children's Specialty Healthcare, St Paul, Minnesota
| | - Sha Tang
- Department of Clinical Genomics, Ambry Genetics, Aliso Viejo, California
| | - Christos Sidiropoulos
- Department of Neurology and Ophthalmology, Michigan State University, East Lansing, Michigan
| |
Collapse
|
5
|
Symons FJ, Barney CC, Byiers BJ, McAdams BD, Foster SXYL, Feyma TJ, Wendelschafer-Crabb G, Kennedy WR. A clinical case-control comparison of epidermal innervation density in Rett syndrome. Brain Behav 2019; 9:e01285. [PMID: 30980517 PMCID: PMC6520294 DOI: 10.1002/brb3.1285] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 03/04/2019] [Accepted: 03/14/2019] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Rett syndrome (RTT), a rare neurodevelopmental disorder occurring primarily in females (1:10-15,000 female live births), is most often caused by loss-of-function mutations in the X-linked methyl-CpG-binding protein 2 gene (MECP2). Clinical observations and preclinical findings indicate apparent abnormal sensory and nociceptive function. There have been no direct investigations of epidermal sensory innervation in patients with RTT. METHODS We compared 3 mm epidermal punch biopsy specimens from adolescent female RTT patients (N = 4, aged 12-19 years) against an archived approximate age-, sex-, body-site matched comparison sample of healthy adolescent females (N = 8, ages 11-17). RESULTS Confocal imaging revealed, on average, statistically significant increased epidermal nerve fiber (ENF) peptidergic (co-stained calcitonin gene-related protein [CGRP]) innervation density compared with healthy female control individuals. CONCLUSIONS Given the clinical phenotype of disrupted sensory function along with diagnostic criteria specific to cold hands/feet and insensitivity to pain, our preliminary observations of ENF peptidergic fiber density differences warrants further investigation of the peripheral neurobiology in RTT.
Collapse
Affiliation(s)
- Frank J Symons
- Department of Educational Psychology, Center for Neurobehavioral Development, University of Minnesota, Minneapolis, MN
| | - Chantel C Barney
- Gillette Children's Specialty Healthcare, Research Administration, St. Paul, MN
| | - Breanne J Byiers
- Department of Educational Psychology, Center for Neurobehavioral Development, University of Minnesota, Minneapolis, MN
| | - Brian D McAdams
- Department of Neurology, Peripheral Nerve Laboratory, University of Minnesota, Minneapolis, MN
| | - Shawn X Y L Foster
- Department of Neurology, Peripheral Nerve Laboratory, University of Minnesota, Minneapolis, MN
| | - Timothy J Feyma
- Department of Pediatric Neurology, Gillette Children's Specialty Healthcare, St. Paul, MN
| | | | - William R Kennedy
- Department of Neurology, Peripheral Nerve Laboratory, University of Minnesota, Minneapolis, MN
| |
Collapse
|
6
|
Abstract
BACKGROUND Rett syndrome (RTT) is a neurodevelopmental disorder primarily caused by mutations in the MECP2 gene. Sleep problems are reported by the majority of caregivers of individuals with RTT. METHODS The present study aimed to replicate and extend previous work about the feasibility of measuring sleep with an actigraph device in a sample of girls with clinically diagnosed RTT (N = 13, mean age = 9 years, 5 months). Participants wore an actigraph device day and night for seven consecutive days. Materials also included a parent-completed sleep diary to measure bedtime, duration of nighttime sleep, and daytime sleep, and the Child Sleep Habit's Questionnaire (CSHQ). RESULTS The means for the sample as measured by actigraphy were 492.3 min (SD = 47.3) of total night sleep (TNS), 76.0% (SD = 6.7) sleep efficiency, 86.0 min (SD = 34.2) of wake after sleep onset, and 46.1 min (50.8) of sleep when parents reported a nap occurring. Parents reported 589.7 min (SD = 53.6) of TNS, 15.9 min (SD = 12.0) of WASO, and 93.6 min (SD = 66.8) of daytime sleep according to sleep diaries, with all parents reporting at least one nap during the week. Relations were found between sleep characteristics and seizure status and CSHQ total scores. No age-related changes were observed for any sleep characteristic, regardless of collection method. Five of nine participants above the cutoff score on the CSHQ indicate the need for further evaluation for a sleep disorder. CONCLUSIONS Overall, actigraphy was feasible in this community-based sample of girls with RTT. The results replicated some aspects of previous studies of sleep in RTT (e.g., no age-related changes in total nighttime sleep or efficiency). Some participants met the American Academy of Sleep Medicine guidelines for recommended total sleep time, with others showing too much or too little sleep. Each of the three methods for describing sleep presented its own advantages and challenges. Future work should be prospectively designed, validate the use of actigraphy in this population, and include a typically developing comparison sample to improve the precision of our understanding of sleep in RTT.
Collapse
Affiliation(s)
- Alyssa M Merbler
- Department of Education Psychology, University of Minnesota, 250 Education Sciences, 56 E River Rd, Minneapolis, MN, 55455, USA.
| | - Breanne J Byiers
- Department of Education Psychology, University of Minnesota, 250 Education Sciences, 56 E River Rd, Minneapolis, MN, 55455, USA
| | - John J Garcia
- Sleep Health, Gillette Children's Specialty Healthcare, 200 University Ave E, Saint Paul, MN, 55101, USA
| | - Timothy J Feyma
- Pediatric Neurology, Gillette Children's Specialty Healthcare, 200 University Ave E, Saint Paul, MN, 55101, USA
| | - Frank J Symons
- Department of Education Psychology, University of Minnesota, 250 Education Sciences, 56 E River Rd, Minneapolis, MN, 55455, USA
| |
Collapse
|
7
|
Abstract
Data were collected parenting stress, adaptive behavior, pain, and health issues from the caregivers of 35 girls and women with Rett syndrome (mean age = 20.3). A majority (60%) of parents reported stress in the clinical range on at least 1 subscale of the Parenting Stress Index-Short Form. Seizures and uncertainty about their daughter's gastrointestinal pain experience were significantly associated with higher levels of parenting stress. No other child factors (adaptive behavior, age, residential status) were significantly related to parenting stress. Factors related to chronic health concerns (seizures, ambiguous pain presentation) may be important when considering family stress issues in relation to general outcomes for girls with Rett syndrome and related developmental disorders.
Collapse
Affiliation(s)
- Breanne J Byiers
- 1Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | | | | | | |
Collapse
|