1
|
Vermoyal JC, Hardy D, Goirand-Lopez L, Vinck A, Silvagnoli L, Fortoul A, Francis F, Cappello S, Bureau I, Represa A, Cardoso C, Watrin F, Marissal T, Manent JB. Grey matter heterotopia subtypes show specific morpho-electric signatures and network dynamics. Brain 2024; 147:996-1010. [PMID: 37724593 DOI: 10.1093/brain/awad318] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/04/2023] [Accepted: 09/07/2023] [Indexed: 09/21/2023] Open
Abstract
Grey matter heterotopia (GMH) are neurodevelopmental disorders associated with abnormal cortical function and epilepsy. Subcortical band heterotopia (SBH) and periventricular nodular heterotopia (PVNH) are two well-recognized GMH subtypes in which neurons are misplaced, either forming nodules lining the ventricles in PVNH, or forming bands in the white matter in SBH. Although both PVNH and SBH are commonly associated with epilepsy, it is unclear whether these two GMH subtypes differ in terms of pathological consequences or, on the contrary, share common altered mechanisms. Here, we studied two robust preclinical models of SBH and PVNH, and performed a systematic comparative assessment of the physiological and morphological diversity of heterotopia neurons, as well as the dynamics of epileptiform activity and input connectivity. We uncovered a complex set of altered properties, including both common and distinct physiological and morphological features across heterotopia subtypes, and associated with specific dynamics of epileptiform activity. Taken together, these results suggest that pro-epileptic circuits in GMH are, at least in part, composed of neurons with distinct, subtype-specific, physiological and morphological properties depending on the heterotopia subtype. Our work supports the notion that GMH represent a complex set of disorders, associating both shared and diverging pathological consequences, and contributing to forming epileptogenic networks with specific properties. A deeper understanding of these properties may help to refine current GMH classification schemes by identifying morpho-electric signatures of GMH subtypes, to potentially inform new treatment strategies.
Collapse
Affiliation(s)
- Jean-Christophe Vermoyal
- INMED, INSERM, Aix-Marseille University, Turing Centre for Living Systems, Marseille 13009, France
| | - Delphine Hardy
- INMED, INSERM, Aix-Marseille University, Turing Centre for Living Systems, Marseille 13009, France
| | - Lucas Goirand-Lopez
- INMED, INSERM, Aix-Marseille University, Turing Centre for Living Systems, Marseille 13009, France
| | - Antonin Vinck
- INMED, INSERM, Aix-Marseille University, Turing Centre for Living Systems, Marseille 13009, France
| | - Lucas Silvagnoli
- INMED, INSERM, Aix-Marseille University, Turing Centre for Living Systems, Marseille 13009, France
| | - Aurélien Fortoul
- INMED, INSERM, Aix-Marseille University, Turing Centre for Living Systems, Marseille 13009, France
| | - Fiona Francis
- INSERM, Sorbonne University, Institut du Fer à Moulin, Paris 75005, France
| | - Silvia Cappello
- Department of Physiological Genomics, Biomedical Center, LMU Munich, Planegg-Martinsried 82152, Germany
| | - Ingrid Bureau
- INMED, INSERM, Aix-Marseille University, Turing Centre for Living Systems, Marseille 13009, France
| | - Alfonso Represa
- INMED, INSERM, Aix-Marseille University, Turing Centre for Living Systems, Marseille 13009, France
| | - Carlos Cardoso
- INMED, INSERM, Aix-Marseille University, Turing Centre for Living Systems, Marseille 13009, France
| | - Françoise Watrin
- INMED, INSERM, Aix-Marseille University, Turing Centre for Living Systems, Marseille 13009, France
| | - Thomas Marissal
- INMED, INSERM, Aix-Marseille University, Turing Centre for Living Systems, Marseille 13009, France
| | - Jean-Bernard Manent
- INMED, INSERM, Aix-Marseille University, Turing Centre for Living Systems, Marseille 13009, France
| |
Collapse
|
2
|
Nguyen LH, Xu Y, Nair M, Bordey A. The mTOR pathway genes MTOR, Rheb, Depdc5, Pten, and Tsc1 have convergent and divergent impacts on cortical neuron development and function. eLife 2024; 12:RP91010. [PMID: 38411613 PMCID: PMC10942629 DOI: 10.7554/elife.91010] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Abstract
Brain somatic mutations in various components of the mTOR complex 1 (mTORC1) pathway have emerged as major causes of focal malformations of cortical development and intractable epilepsy. While these distinct gene mutations converge on excessive mTORC1 signaling and lead to common clinical manifestations, it remains unclear whether they cause similar cellular and synaptic disruptions underlying cortical network hyperexcitability. Here, we show that in utero activation of the mTORC1 activator genes, Rheb or MTOR, or biallelic inactivation of the mTORC1 repressor genes, Depdc5, Tsc1, or Pten in the mouse medial prefrontal cortex leads to shared alterations in pyramidal neuron morphology, positioning, and membrane excitability but different changes in excitatory synaptic transmission. Our findings suggest that, despite converging on mTORC1 signaling, mutations in different mTORC1 pathway genes differentially impact cortical excitatory synaptic activity, which may confer gene-specific mechanisms of hyperexcitability and responses to therapeutic intervention.
Collapse
Affiliation(s)
- Lena H Nguyen
- Department of Neuroscience, School of Behavioral and Brain Sciences, University of Texas at DallasRichardsonUnited States
- Departments of Neurosurgery and Cellular & Molecular Physiology, Wu Tsai Institute, Yale University School of MedicineNew HavenUnited States
| | - Youfen Xu
- Departments of Neurosurgery and Cellular & Molecular Physiology, Wu Tsai Institute, Yale University School of MedicineNew HavenUnited States
| | - Maanasi Nair
- Departments of Neurosurgery and Cellular & Molecular Physiology, Wu Tsai Institute, Yale University School of MedicineNew HavenUnited States
| | - Angelique Bordey
- Departments of Neurosurgery and Cellular & Molecular Physiology, Wu Tsai Institute, Yale University School of MedicineNew HavenUnited States
| |
Collapse
|
3
|
Nguyen LH, Xu Y, Nair M, Bordey A. The mTOR pathway genes mTOR, Rheb, Depdc5, Pten, and Tsc1 have convergent and divergent impacts on cortical neuron development and function. bioRxiv 2024:2023.08.11.553034. [PMID: 37609221 PMCID: PMC10441381 DOI: 10.1101/2023.08.11.553034] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Brain somatic mutations in various components of the mTOR complex 1 (mTORC1) pathway have emerged as major causes of focal malformations of cortical development and intractable epilepsy. While these distinct gene mutations converge on excessive mTORC1 signaling and lead to common clinical manifestations, it remains unclear whether they cause similar cellular and synaptic disruptions underlying cortical network hyperexcitability. Here, we show that in utero activation of the mTORC1 activators, Rheb or mTOR, or biallelic inactivation of the mTORC1 repressors, Depdc5, Tsc1, or Pten in mouse medial prefrontal cortex leads to shared alterations in pyramidal neuron morphology, positioning, and membrane excitability but different changes in excitatory synaptic transmission. Our findings suggest that, despite converging on mTORC1 signaling, mutations in different mTORC1 pathway genes differentially impact cortical excitatory synaptic activity, which may confer gene-specific mechanisms of hyperexcitability and responses to therapeutic intervention.
Collapse
Affiliation(s)
- Lena H. Nguyen
- Department Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX 75080, USA
- Departments of Neurosurgery and Cellular & Molecular Physiology, Wu Tsai Institute, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Youfen Xu
- Departments of Neurosurgery and Cellular & Molecular Physiology, Wu Tsai Institute, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Maanasi Nair
- Departments of Neurosurgery and Cellular & Molecular Physiology, Wu Tsai Institute, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Angelique Bordey
- Departments of Neurosurgery and Cellular & Molecular Physiology, Wu Tsai Institute, Yale University School of Medicine, New Haven, CT 06510, USA
| |
Collapse
|
4
|
Goel K, Phillips HW, Chen JS, Ngo J, Edmonds B, Ha PX, Wang A, Weil A, Russell BE, Salamon N, Nariai H, Fallah A. Hemispheric epilepsy surgery for hemimegalencephaly: The UCLA experience. Epilepsia 2024; 65:57-72. [PMID: 37873610 DOI: 10.1111/epi.17807] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVES Hemimegalencephaly (HME) is a rare congenital brain malformation presenting predominantly with drug-resistant epilepsy. Hemispheric disconnective surgery is the mainstay of treatment; however, little is known about how postoperative outcomes compare across techniques. Thus we present the largest single-center cohort of patients with HME who underwent epilepsy surgery and characterize outcomes. METHODS This observational study included patients with HME at University of California Los Angeles (UCLA) from 1984 to 2021. Patients were stratified by surgical intervention: anatomic hemispherectomy (AH), functional hemispherectomy (FH), or less-than-hemispheric resection (LTH). Seizure freedom, functional outcomes, and operative complications were compared across surgical approaches. Regression analysis identified clinical and intraoperative variables that predict seizure outcomes. RESULTS Of 56 patients, 43 (77%) underwent FH, 8 (14%) underwent AH, 2 (4%) underwent LTH, 1 (2%) underwent unknown hemispherectomy type, and 2 (4%) were managed non-operatively. At median last follow-up of 55 months (interquartile range [IQR] 20-92 months), 24 patients (49%) were seizure-free, 17 (30%) required cerebrospinal fluid (CSF) shunting for hydrocephalus, 9 of 43 (21%) had severe developmental delay, 8 of 38 (21%) were non-verbal, and 15 of 38 (39%) were non-ambulatory. There was one (2%) intraoperative mortality due to exsanguination earlier in this cohort. Of 12 patients (29%) requiring revision surgery, 6 (50%) were seizure-free postoperatively. AH, compared to FH, was not associated with statistically significant improved seizure freedom (hazard ratio [HR] = .48, p = .328), although initial AH trended toward greater odds of seizure freedom (75% vs 46%, p = .272). Younger age at seizure onset (HR = .29, p = .029), lack of epilepsia partialis continua (EPC) (HR = .30, p = .022), and no contralateral seizures on electroencephalography (EEG) (HR = .33, p = .039) independently predicted longer duration of seizure freedom. SIGNIFICANCE This study helps inform physicians and parents of children who are undergoing surgery for HME by demonstrating that earlier age at seizure onset, absence of EPC, and no contralateral EEG seizures were associated with longer postoperative seizure freedom. At our center, initial AH for HME may provide greater odds of seizure freedom with complications and functional outcomes comparable to those of FH.
Collapse
Affiliation(s)
- Keshav Goel
- David Geffen School of Medicine at the University of California, Los Angeles, California, USA
| | - H Westley Phillips
- Department of Neurosurgery, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jia-Shu Chen
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Jacqueline Ngo
- Department of Pediatrics, Division of Pediatric Neurology, David Geffen School of Medicine at the University of California, Los Angeles, California, USA
| | - Benjamin Edmonds
- Department of Pediatrics, Division of Pediatric Neurology, David Geffen School of Medicine at the University of California, Los Angeles, California, USA
| | - Phong X Ha
- Department of Radiology, David Geffen School of Medicine at the University of California, Los Angeles, California, USA
| | - Andrew Wang
- David Geffen School of Medicine at the University of California, Los Angeles, California, USA
- College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
| | - Alexander Weil
- Brain and Development Research Axis, Sainte-Justine Research Center, Montréal, Québec, Canada
- Department of Surgery, Division of Neurosurgery, Sainte-Justine University Hospital Centre, Montréal, Québec, Canada
- Department of Surgery, Division of Neurosurgery, University of Montreal Hospital Centre (CHUM), Montréal, Québec, Canada
- Department of Neuroscience, University of Montreal, Montréal, Québec, Canada
| | - Bianca E Russell
- Department of Human Genetics, Division of Clinical Genetics, David Geffen School of Medicine at University of California, Los Angeles, California, USA
| | - Noriko Salamon
- Department of Radiology, David Geffen School of Medicine at the University of California, Los Angeles, California, USA
| | - Hiroki Nariai
- Department of Pediatrics, Division of Pediatric Neurology, David Geffen School of Medicine at the University of California, Los Angeles, California, USA
| | - Aria Fallah
- David Geffen School of Medicine at the University of California, Los Angeles, California, USA
- Department of Neurosurgery, David Geffen School of Medicine at University of California, Los Angeles, California, USA
- Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, California, USA
| |
Collapse
|
5
|
Liu X, Zhu Y, Liu Q, Zhang S, Wu P, Sun Y, Zhang J, Wang R, Ji T, Wang S, Liu X, Jiang Y, Cai L, Wu Y. Clinical characteristics and surgical outcomes in children with mild malformation of cortical development and oligodendroglial hyperplasia in epilepsy. Epilepsia Open 2023; 8:898-911. [PMID: 37144544 PMCID: PMC10472402 DOI: 10.1002/epi4.12755] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 05/01/2023] [Indexed: 05/06/2023] Open
Abstract
OBJECTIVE Mild malformation of cortical development with oligodendroglial hyperplasia in epilepsy (MOGHE) is a new and rare histopathological entity of cortical developmental malformations. The clinical characteristics of MOGHE remain challenging. METHODS Children with histologically confirmed MOGHE were retrospectively studied. The clinical findings, electroclinical and imaging features, and postoperative outcomes were analyzed, and previously published studies were reviewed up to June 2022. RESULTS Thirty-seven children were included in our cohort. Clinical characteristics included early onset in infancy (94.6% before 3 years), multiple seizure types, and moderate or severe delay. Epileptic spasm is the most common seizure type and initial manifestation. The lesions were mainly multilobar (59.5% multiple lobes and 8.1% hemispheres), and predominance in the frontal lobe was observed. The interictal EEG pattern was circumscribed or widespread. The prominent MRI characteristics were cortical thickening, cortical/subcortical hyperintense T2/FLAIR signal, and blurring at the GM and WM transition. Among the 21 children followed up for more than 1 year after surgery, 76.2% were seizure-free. Preoperative interictal circumscribed discharges and larger resections were significantly associated with a good postoperative outcome. The clinical features of 113 patients in the reviewed studies were similar to those we reported, but the lesions were mainly unilobar (73.5%) and Engel I was achieved in only 54.2% after surgery. SIGNIFICANCE Distinct clinical characteristics in MOGHE, especially age at onset, epileptic spasm, and age-related MRI characteristics, can help in early diagnosis. Preoperative interictal discharge and surgical strategy may be predictors of postoperative outcomes.
Collapse
Affiliation(s)
- Xianyu Liu
- Department of PediatricsPeking University First HospitalBeijingChina
| | - Ying Zhu
- Department of RadiologyPeking University First HospitalBeijingChina
| | - Qingzhu Liu
- Pediatric Epilepsy CenterPeking University First HospitalBeijingChina
| | - Shuang Zhang
- Department of PathologyPeking University First HospitalBeijingChina
| | - Pengxia Wu
- Department of PediatricsPeking University First HospitalBeijingChina
| | - Yu Sun
- Pediatric Epilepsy CenterPeking University First HospitalBeijingChina
| | - Jie Zhang
- Department of PediatricsPeking University First HospitalBeijingChina
| | - Ruofan Wang
- Pediatric Epilepsy CenterPeking University First HospitalBeijingChina
| | - Taoyun Ji
- Department of PediatricsPeking University First HospitalBeijingChina
- Pediatric Epilepsy CenterPeking University First HospitalBeijingChina
| | - Shuang Wang
- Department of PediatricsPeking University First HospitalBeijingChina
- Pediatric Epilepsy CenterPeking University First HospitalBeijingChina
| | - Xiaoyan Liu
- Department of PediatricsPeking University First HospitalBeijingChina
- Pediatric Epilepsy CenterPeking University First HospitalBeijingChina
| | - Yuwu Jiang
- Department of PediatricsPeking University First HospitalBeijingChina
- Pediatric Epilepsy CenterPeking University First HospitalBeijingChina
| | - Lixin Cai
- Pediatric Epilepsy CenterPeking University First HospitalBeijingChina
| | - Ye Wu
- Department of PediatricsPeking University First HospitalBeijingChina
- Pediatric Epilepsy CenterPeking University First HospitalBeijingChina
| |
Collapse
|
6
|
Contro E, Volpe N, Larcher L, Dall'Asta A, Penas Da Costa MA, Vairo G, Di Pasquo E, Giorgini I, Ghi T. Normal and abnormal appearance of fetal ganglionic eminence on second-trimester three-dimensional ultrasound. Ultrasound Obstet Gynecol 2023; 62:398-404. [PMID: 37099497 DOI: 10.1002/uog.26229] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 04/07/2023] [Accepted: 04/13/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVES To describe the appearance and size of the ganglionic eminence (GE) in normal fetuses on midtrimester three-dimensional (3D) neurosonography and to report on the association between GE alterations (cavitation or enlargement) and malformation of cortical development (MCD). METHODS This was a prospective multicenter cohort study of normal fetuses and a retrospective analysis of pathological cases with MCD. From January 2022 to June 2022, patients attending our tertiary centers for an expert fetal brain scan were recruited for the purpose of the study. A 3D volume of the fetal head, starting from the sagittal plane, was acquired in apparently normal fetuses using a transabdominal or transvaginal approach. Stored volume datasets were then evaluated independently by two expert operators. Two measurements (longitudinal diameter and transverse diameter) of the GE in the coronal view were obtained twice by each operator. Intra- and interobserver measurement variation was calculated. Reference ranges for GE measurements were calculated in the normal population. A previously stored volume dataset of 60 cases with MCD was also analyzed independently by the two operators using the same method in order to assess if GE abnormalities (cavitation or enlargement) were present. Postnatal follow-up was obtained in all cases. RESULTS In the study period, 160 normal fetuses between 19 and 22 weeks of gestation were included in the study. The GE was visible in the coronal plane on 3D neurosonography in 144 (90%) cases and was not clearly visible in the remaining 16 (10%) cases. The intra- and interobserver agreement was almost perfect for the longitudinal diameter, with an intraclass correlation coefficient (ICC) of 0.90 (95% CI, 0.83-0.93) and 0.90 (95% CI, 0.86-0.92), respectively, and substantial for the transverse diameter, with an ICC of 0.80 (95% CI, 0.70-0.87) and 0.64 (95% CI, 0.53-0.72), respectively. A retrospective analysis of 50 cases with MCD in the second trimester showed that GE enlargement was present in 12 cases and GE cavitation was present in four cases. CONCLUSIONS Systematic assessment of the GE in fetuses at 19-22 weeks of gestation is feasible on 3D neurosonography, with good reproducibility in normal cases. Cavitation or enlargement of the GE can be demonstrated in fetuses with MCD. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Collapse
Affiliation(s)
- E Contro
- Unit of Obstetrics and Gynecology, Department of Medicine and Surgery, S. Orsola University Hospital of Bologna, IRCCS AOUB, Bologna, Italy
| | - N Volpe
- Unit of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - L Larcher
- Unit of Obstetrics and Gynecology, Department of Medicine and Surgery, S. Orsola University Hospital of Bologna, IRCCS AOUB, Bologna, Italy
| | - A Dall'Asta
- Unit of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - M A Penas Da Costa
- Unit of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - G Vairo
- Unit of Obstetrics and Gynecology, Department of Medicine and Surgery, S. Orsola University Hospital of Bologna, IRCCS AOUB, Bologna, Italy
| | - E Di Pasquo
- Unit of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - I Giorgini
- Unit of Obstetrics and Gynecology, Department of Medicine and Surgery, S. Orsola University Hospital of Bologna, IRCCS AOUB, Bologna, Italy
| | - T Ghi
- Unit of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| |
Collapse
|
7
|
Nguyen LH, Sharma M, Bordey A. 4E-BP1 expression in embryonic postmitotic neurons mitigates mTORC1-induced cortical malformations and behavioral seizure severity but does not prevent epilepsy in mice. Front Neurosci 2023; 17:1257056. [PMID: 37680968 PMCID: PMC10480503 DOI: 10.3389/fnins.2023.1257056] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 07/31/2023] [Indexed: 09/09/2023] Open
Abstract
Hyperactivation of the mechanistic target of rapamycin complex 1 (mTORC1) pathway during neurodevelopment leads to focal cortical malformations associated with intractable seizures. Recent evidence suggests that dysregulated cap-dependent translation downstream of mTORC1 contributes to cytoarchitectural abnormalities and seizure activity. Here, we examined whether reducing cap-dependent translation by expressing a constitutively active form of the translational repressor, 4E-BP1, downstream of mTORC1 would prevent the development of cortical malformations and seizures. 4E-BP1CA was expressed embryonically either in radial glia (neural progenitor cells) that generate cortical layer 2/3 pyramidal neurons or in migrating neurons destined to layer 2/3 using a conditional expression system. In both conditions, 4E-BP1CA expression reduced mTORC1-induced neuronal hypertrophy and alleviated cortical mislamination, but a subset of ectopic neurons persisted in the deep layers and the white matter. Despite the above improvements, 4E-BP1CA expression in radial glia had no effects on seizure frequency and further exacerbated behavioral seizure severity associated with mTORC1 hyperactivation. In contrast, conditional 4E-BP1CA expression in migratory neurons mitigated the severity of behavioral seizures but the seizure frequency remained unchanged. These findings advise against targeting 4E-BPs by 4E-BP1CA expression during embryonic development for seizure prevention and suggest the presence of a development-dependent role for 4E-BPs in mTORC1-induced epilepsy.
Collapse
Affiliation(s)
- Lena H. Nguyen
- Department of Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, United States
- Departments of Neurosurgery and Cellular & Molecular Physiology, Wu Tsai Institute, Yale University School of Medicine, New Haven, CT, United States
| | - Manas Sharma
- Departments of Neurosurgery and Cellular & Molecular Physiology, Wu Tsai Institute, Yale University School of Medicine, New Haven, CT, United States
| | - Angelique Bordey
- Departments of Neurosurgery and Cellular & Molecular Physiology, Wu Tsai Institute, Yale University School of Medicine, New Haven, CT, United States
| |
Collapse
|
8
|
Kolbjer S, Martín Muñoz DA, Örtqvist AK, Pettersson M, Hammarsjö A, Anderlid BM, Dahlin M. Polymicrogyria: epidemiology, imaging, and clinical aspects in a population-based cohort. Brain Commun 2023; 5:fcad213. [PMID: 37614989 PMCID: PMC10443657 DOI: 10.1093/braincomms/fcad213] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/04/2023] [Accepted: 08/09/2023] [Indexed: 08/25/2023] Open
Abstract
Polymicrogyria is estimated to be one of the most common brain malformations, accounting for ∼16% of malformations of cortical development. However, the prevalence and incidence of polymicrogyria is unknown. Our aim was to estimate the prevalence, incidence rate, neuroimaging diversity, aetiology, and clinical phenotype of polymicrogyria in a population-based paediatric cohort. We performed a systematic search of MRI scans at neuroradiology department databases in Stockholm using the keyword polymicrogyria. The study population included all children living in the Stockholm region born from January 2004 to June 2021 with polymicrogyria. Information on the number of children living in the region during 2004-21 was collected from records from Statistics Sweden, whereas the number of births for each year during the study period was collected from the Swedish Medical Birth Register. All MRI scans were re-evaluated, and malformations were classified by a senior paediatric neuroradiologist. The prevalence and yearly incidence were estimated. Clinical data were collected from medical records. A total of 109 patients with polymicrogyria were included in the study. The overall polymicrogyria prevalence in Stockholm was 2.3 per 10 000 children, and the overall estimated yearly incidence between 2004 and 2020 was 1.9 per 10 000 person-years. The most common polymicrogyria distribution was in the frontal lobe (71%), followed by the parietal lobe (37%). Polymicrogyria in the peri-sylvian region was observed in 53%. Genetic testing was performed in 90 patients revealing pathogenic variants in 32%. Additionally, 12% had variants of uncertain significance. Five patients had a confirmed congenital infection, and in six individuals, the cause of polymicrogyria was assumed to be vascular. Epilepsy was diagnosed in 54%. Seizure onset during the first year of life was observed in 44%. The most common seizure types were focal seizures with impaired awareness, followed by epileptic spasms. Thirty-three of 59 patients with epilepsy (56%) were treated with more than two anti-seizure medications, indicating that pharmacoresistant epilepsy is common in polymicrogyria patients. Neurodevelopmental symptoms were observed in 94% of the individuals. This is the first population-based study on polymicrogyria prevalence and incidence. Confirmed genetic aetiology was present in one-third of individuals with polymicrogyria. Epilepsy was common in this patient group, and the majority had pharmacoresistant epilepsy. These findings increase our knowledge about polymicrogyria and will help in counselling patients and their families.
Collapse
Affiliation(s)
- Sintia Kolbjer
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm 17177, Sweden
- Department of Paediatric Neurology, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm 17176, Sweden
| | - Daniel A Martín Muñoz
- Department of Neuroradiology and Paediatric Radiology, Karolinska University Hospital, Stockholm 17176, Sweden
| | - Anne K Örtqvist
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm 17177, Sweden
- Department of Obstetrics and Gynaecology, Visby County Hospital, Visby 62155, Sweden
| | - Maria Pettersson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm 17177, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm 17176, Sweden
| | - Anna Hammarsjö
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm 17177, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm 17176, Sweden
| | - Britt-Marie Anderlid
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm 17177, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm 17176, Sweden
| | - Maria Dahlin
- Department of Paediatric Neurology, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm 17176, Sweden
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm 17177, Sweden
| |
Collapse
|
9
|
Krajden Haratz K, Birnbaum R, Kidron D, Har-Toov J, Salemnick Y, Brusilov M, Malinger G. Malformation of cortical development with abnormal cortex: early ultrasound diagnosis between 14 and 24 weeks of gestation. Ultrasound Obstet Gynecol 2023; 61:559-565. [PMID: 36484522 DOI: 10.1002/uog.26139] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/09/2022] [Accepted: 11/14/2022] [Indexed: 05/04/2023]
Abstract
OBJECTIVE To describe neurosonographic findings diagnostic or highly suggestive of the presence of malformations of cortical development involving the cortex that may be identified before 24 weeks of gestation. METHODS This was a retrospective single-center study of fetuses referred for neurosonography, during 2012-2019, with an abnormal cortical or sulcation pattern diagnosed early in the mid trimester. Stored files were analyzed for demographic data, abnormal brain findings, non-central nervous system abnormalities, final diagnosis and postnatal outcome. RESULTS The study cohort included 20 fetuses, with a mean gestational age at diagnosis of 18.7 (range, 14.4-23.6) weeks, in 11 of which the diagnosis was made before 20 weeks of gestation. Reasons for referral were: midline anomaly (n = 7), ventriculomegaly (n = 4), infratentorial findings (n = 3), suspected malformation of cortical development (n = 3), 'abnormal brain' (n = 2) and skeletal dysplasia (n = 1). On neurosonography, both the sulcation pattern and the cortical layer were abnormal in four cases, only the sulcation pattern was considered abnormal in seven and only the cortical layer was abnormal in nine. Nineteen fetuses presented with associated central nervous system anomalies and six also had non-central nervous system malformations. One case was recurrent. Eighteen parents opted for termination of pregnancy, including one selective termination in a twin pregnancy, and two fetuses were liveborn. CONCLUSIONS Familiarity with fetal brain anatomy and its early sonographic landmarks allowed early diagnosis of malformations involving cortical development. These patients are likely to represent the most severe cases and all had associated malformations. The presence of an abnormal cortical layer and/or abnormal overdeveloped sulci appear to be early signs of malformation of cortical development. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Collapse
Affiliation(s)
- K Krajden Haratz
- Fetal Neurology Clinic, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Birnbaum
- Fetal Neurology Clinic, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - D Kidron
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Pathology, Meir Hospital, Kfar Saba, Israel
| | - J Har-Toov
- Fetal Neurology Clinic, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Y Salemnick
- Fetal Neurology Clinic, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M Brusilov
- Fetal Neurology Clinic, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - G Malinger
- Fetal Neurology Clinic, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
10
|
Straka B, Vlčková M, Libá Z, Heřmanovská B, Kynčl M, Dorňáková J, Táborský J, Kršek P, Musilová A, Janota J, Balaščaková M. COL4A1 mutation-related disorder presenting as fetal intracranial bleeding, hydrocephalus, and polymicrogyria. Epilepsia Open 2023; 8:211-216. [PMID: 36504316 PMCID: PMC9977753 DOI: 10.1002/epi4.12681] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022] Open
Abstract
Fetal intracranial hemorrhage represents a rare event with an estimated prevalence of 1:10 000 pregnancies. We report a patient diagnosed prenatally with intracranial hemorrhage and ventriculomegaly carrying a novel, previously unreported, likely pathogenic variant in COL4A1. At the gestational age of 27 weeks, dilation of lateral ventricles was detected during a routine prenatal ultrasound scan, confirmed by prenatal MRI at 30 + 3 weeks of gestation. Prenatal examinations included amniocentesis with conventional G-band karyotyping and arrayCGH, and maternal testing for TORCH and parvovirus B19 infections. Virtual gene panel based on whole-exome sequencing data was performed postnatally. At the age of 2.5 months, the patient manifested epileptic seizures that remain difficult to control. Postnatal MRI showed partial thalamic fusion and polymicrogyria, in addition to severe enlargement of lateral ventricles, multiple deposits of hemosiderin in cerebral and cerebellar hemispheres, and thin optic nerve and chiasma. Virtual gene panel based on whole-exome sequencing data led to a detection of a de novo previously unreported in-frame deletion NM_001845.5:c.4688_4711del in COL4A1 located in the highly conserved NC1 domain initiating collagen helix assembly. The presented case lies one a more severe end of the COL4A1 mutation-related disease spectrum, manifesting as fetal intracranial bleeding, malformation of cortical development, drug-resistant epilepsy, and developmental delay.
Collapse
Affiliation(s)
- Barbora Straka
- Department of Paediatric Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Full Member of the ERN EpiCARE, Prague, Czech Republic
| | - Markéta Vlčková
- Department of Biology and Medical Genetics, Second Faculty of Medicine, Charles University and Motol University Hospital, Full Member of the ERN EpiCARE, Prague, Czech Republic
| | - Zuzana Libá
- Department of Paediatric Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Full Member of the ERN EpiCARE, Prague, Czech Republic
| | - Barbora Heřmanovská
- Department of Paediatric Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Full Member of the ERN EpiCARE, Prague, Czech Republic
| | - Martin Kynčl
- Department of Radiology, Second Faculty of Medicine, Charles University and Motol University Hospital, Full Member of the ERN EpiCARE, Prague, Czech Republic
| | - Jana Dorňáková
- Department of Obstetrics and Gynaecology, Neonatal Unit, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Jakub Táborský
- Department of Neurosurgery, Second Faculty of Medicine, Charles University and Motol University Hospital, Full Member of the ERN EpiCARE, Prague, Czech Republic
| | - Pavel Kršek
- Department of Paediatric Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Full Member of the ERN EpiCARE, Prague, Czech Republic
| | - Alena Musilová
- Department of Paediatric Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Full Member of the ERN EpiCARE, Prague, Czech Republic
| | - Jan Janota
- Department of Obstetrics and Gynaecology, Neonatal Unit, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.,Department of Pathological Physiology, First Faculty of Medicine, Charles University Prague, Czech Republic.,Department of Neonatology, Thomayer University Hospital, Prague, Czech Republic
| | - Miroslava Balaščaková
- Department of Biology and Medical Genetics, Second Faculty of Medicine, Charles University and Motol University Hospital, Full Member of the ERN EpiCARE, Prague, Czech Republic
| |
Collapse
|
11
|
López-Rivera JA, Leu C, Macnee M, Khoury J, Hoffmann L, Coras R, Kobow K, Bhattarai N, Pérez-Palma E, Hamer H, Brandner S, Rössler K, Bien CG, Kalbhenn T, Pieper T, Hartlieb T, Butler E, Genovese G, Becker K, Altmüller J, Niestroj LM, Ferguson L, Busch RM, Nürnberg P, Najm I, Blümcke I, Lal D. The genomic landscape across 474 surgically accessible epileptogenic human brain lesions. Brain 2022; 146:1342-1356. [PMID: 36226386 PMCID: PMC10115236 DOI: 10.1093/brain/awac376] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [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: 02/16/2022] [Revised: 08/11/2022] [Accepted: 10/12/2022] [Indexed: 11/12/2022] Open
Abstract
Understanding the exact molecular mechanisms involved in the etiology of epileptogenic pathologies with or without tumor activity is essential for improving treatment of drug-resistant focal epilepsy. Here, we characterize the landscape of somatic genetic variants in resected brain specimens from 474 individuals with drug-resistant focal epilepsy using deep whole-exome sequencing (>350×) and whole-genome genotyping. Across the exome, we observe a greater number of somatic single-nucleotide variants (SNV) in low-grade epilepsy-associated tumors (LEAT; 7.92 ± 5.65 SNV) than in brain tissue from malformations of cortical development (MCD; 6.11 ± 4 SNV) or hippocampal sclerosis (HS; 5.1 ± 3.04 SNV). Tumor tissues also had the largest number of likely pathogenic variant carrying cells. LEAT had the highest proportion of samples with one or more somatic copy number variants (CNV; 24.7%), followed by MCD (5.4%) and HS (4.1%). Recurring somatic whole chromosome duplications affecting Chromosome 7 (16.8%), chromosome 5 (10.9%), and chromosome 20 (9.9%) were observed among LEAT. For germline variant-associated MCD genes such as TSC2, DEPDC5, and PTEN, germline SNV were frequently identified within large loss of heterozygosity regions, supporting the recently proposed 'second hit' disease mechanism in these genes. We detect somatic variants in twelve established lesional epilepsy genes and demonstrate exome-wide statistical support for three of these in the etiology of LEAT (e.g., BRAF) and MCD (e.g., SLC35A2 and MTOR). We also identify novel significant associations for PTPN11 with LEAT and NRAS Q61 mutated protein with a complex MCD characterized by polymicrogyria and nodular heterotopia. The variants identified in NRAS are known from cancer studies to lead to hyperactivation of NRAS, which can be targeted pharmacologically. We identify large recurrent 1q21-q44 duplication including AKT3 in association with focal cortical dysplasia type 2a with hyaline astrocytic inclusions, another rare and possibly under-recognized brain lesion. The clinical genetic analyses showed that the numbers of somatic SNV across the exome and the fraction of affected cells were positively correlated with the age at seizure onset and surgery in individuals with LEAT. In summary, our comprehensive genetic screen sheds light on the genome-scale landscape of genetic variants in epileptic brain lesions, informs the design of gene panels for clinical diagnostic screening, and guides future directions for clinical implementation of epilepsy surgery genetics.
Collapse
Affiliation(s)
- Javier A López-Rivera
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, USA.,Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.,Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
| | - Costin Leu
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.,Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA.,Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T, Cambridge, MA 02142, USA.,Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK
| | - Marie Macnee
- Cologne Center for Genomics (CCG), University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931 Cologne, Germany
| | - Jean Khoury
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
| | - Lucas Hoffmann
- Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany, and partner of the European Reference Network (ERN) EpiCARE
| | - Roland Coras
- Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany, and partner of the European Reference Network (ERN) EpiCARE
| | - Katja Kobow
- Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany, and partner of the European Reference Network (ERN) EpiCARE
| | - Nisha Bhattarai
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.,Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
| | - Eduardo Pérez-Palma
- Universidad del Desarrollo, Centro de Genética y Genómica, Facultad de Medicina Clínica Alemana. Santiago 7610658, Chile
| | - Hajo Hamer
- Epilepsy Center, University Hospital Erlangen, Erlangen, Germany, and EpiCARE partner
| | - Sebastian Brandner
- Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany, and EpiCARE partner
| | - Karl Rössler
- Department of Neurosurgery, Medical University Vienna, Vienna, Austria, and EpiCARE partner
| | - Christian G Bien
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, Germany
| | - Thilo Kalbhenn
- Department of Neurosurgery - Epilepsy surgery, Evangelisches Klinikum Bethel, Universitätsklinikum OWL, Bielefeld University, Bielefeld, Germany
| | - Tom Pieper
- Center for Pediatric Neurology, Neurorehabilitation, and Epileptology, Schoen-Clinic, Vogtareuth, Germany
| | - Till Hartlieb
- Center for Pediatric Neurology, Neurorehabilitation, and Epileptology, Schoen-Clinic, Vogtareuth, Germany.,Research Institute "Rehabilitation, Transition, Palliation", PMU Salzburg, Salzburg, Austria
| | - Elizabeth Butler
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
| | - Giulio Genovese
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T, Cambridge, MA 02142, USA
| | - Kerstin Becker
- Cologne Center for Genomics (CCG), University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931 Cologne, Germany
| | - Janine Altmüller
- Cologne Center for Genomics (CCG), University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931 Cologne, Germany.,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Core Facility Genomics, Charitéplatz 1, 10117 Berlin, Germany.,Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Lisa Marie Niestroj
- Cologne Center for Genomics (CCG), University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931 Cologne, Germany
| | - Lisa Ferguson
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
| | - Robyn M Busch
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.,Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
| | - Peter Nürnberg
- Cologne Center for Genomics (CCG), University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931 Cologne, Germany.,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931 Cologne, Germany
| | - Imad Najm
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
| | - Ingmar Blümcke
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA.,Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany, and partner of the European Reference Network (ERN) EpiCARE
| | - Dennis Lal
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.,Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA.,Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T, Cambridge, MA 02142, USA.,Cologne Center for Genomics (CCG), University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931 Cologne, Germany
| |
Collapse
|
12
|
Nguyen LH, Xu Y, Mahadeo T, Zhang L, Lin TV, Born HA, Anderson AE, Bordey A. Expression of 4E-BP1 in juvenile mice alleviates mTOR-induced neuronal dysfunction and epilepsy. Brain 2021; 145:1310-1325. [PMID: 34849602 DOI: 10.1093/brain/awab390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 07/07/2021] [Revised: 09/01/2021] [Accepted: 09/22/2021] [Indexed: 11/13/2022] Open
Abstract
Hyperactivation of the mechanistic target of rapamycin (mTOR) pathway during fetal neurodevelopment alters neuron structure and function, leading to focal malformation of cortical development (FMCD) and intractable epilepsy. Recent evidence suggests a role for dysregulated cap-dependent translation downstream of mTOR in the formation of FMCD and seizures. However, it is unknown whether modifying translation once the developmental pathologies are established can reverse neuronal abnormalities and seizures. Addressing these issues is crucial with regards to therapeutics since these neurodevelopmental disorders are predominantly diagnosed during childhood, when patients present with symptoms. Here, we report increased phosphorylation of the mTOR effector and translational repressor, 4E-BP1, in patient FMCD tissue and in a mouse model of FMCD. Using temporally regulated conditional gene expression systems, we found that expression of a constitutively active form of 4E-BP1 that resists phosphorylation by mTOR in juvenile mice reduced neuronal cytomegaly and corrected several neuronal electrophysiological alterations, including depolarized resting membrane potential, irregular firing pattern, and aberrant expression of HCN4 channels. Further, 4E-BP1 expression in juvenile FMCD mice after epilepsy onset resulted in improved cortical spectral activity and decreased spontaneous seizure frequency in adults. Overall, our study uncovered a remarkable plasticity of the juvenile brain that facilitates novel therapeutic opportunities to treat FMCD-related epilepsy during childhood with potentially long-lasting effects in adults.
Collapse
Affiliation(s)
- Lena H Nguyen
- Department of Neurosurgery, Yale University School of Medicine; New Haven, CT 06510, USA.,Department of Cellular and Molecular Physiology, Yale University School of Medicine; New Haven, CT 06510, USA
| | - Youfen Xu
- Department of Neurosurgery, Yale University School of Medicine; New Haven, CT 06510, USA
| | - Travorn Mahadeo
- Department of Neurosurgery, Yale University School of Medicine; New Haven, CT 06510, USA
| | - Longbo Zhang
- Department of Neurosurgery, Yale University School of Medicine; New Haven, CT 06510, USA
| | - Tiffany V Lin
- Department of Neurosurgery, Yale University School of Medicine; New Haven, CT 06510, USA
| | - Heather A Born
- Cain Foundation Laboratories, Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital; Houston, TX 77030, USA.,Department of Pediatrics, Baylor College of Medicine; Houston, TX 77030, USA
| | - Anne E Anderson
- Cain Foundation Laboratories, Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital; Houston, TX 77030, USA.,Department of Pediatrics, Baylor College of Medicine; Houston, TX 77030, USA
| | - Angélique Bordey
- Department of Neurosurgery, Yale University School of Medicine; New Haven, CT 06510, USA.,Department of Cellular and Molecular Physiology, Yale University School of Medicine; New Haven, CT 06510, USA
| |
Collapse
|
13
|
Chen W, Jin B, Aung T, He C, Chen C, Wang S, Ding Y, Ding F, Wang C, Li H, Jiang B, Zheng Z, Dai H, Zhu J, Geng Y, Ding M, Wang S. Response to antiseizure medications in epileptic patients with malformation of cortical development. Ther Adv Neurol Disord 2021; 14:17562864211050027. [PMID: 34671424 PMCID: PMC8521419 DOI: 10.1177/17562864211050027] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/12/2021] [Indexed: 11/16/2022] Open
Abstract
Background Malformation of cortical development (MCD) is one of the most common causes of pharmacoresistant epilepsy. Improving the knowledge of antiseizure medications (ASMs) treatment response in epileptic patients with MCD is crucial for optimal treatment options, either pharmacological therapy or non-pharmacological intervention. Aim To investigate the patterns of medical treatment outcome and the predictors for seizure freedom (SF) with ASM regimens in epilepsy caused by MCD. Methods The epileptic patients with MCD were consecutively enrolled from March 2013 to June 2019. SF was defined as no seizures for at least 12 months or three times the longest pretreatment inter-seizure interval, whichever was longer. Outcomes were classified into three patterns: pattern A: patients achieved SF at one point and remained so throughout follow-up; pattern B: patients' seizures fluctuated between periods of SF and relapse; pattern C: SF never attained. The terminal SF was defined if the patients remained SF at the last follow-up visit. Results A total of 164 epileptic patients with MCD were included. Pattern A was observed in 22, pattern B in 42, and pattern C in 100 patients. SF was ever achieved in 64 (pattern A and B) patients. Twenty-nine patients had terminal SF after a median follow-up time of 4.3 years. With continuing ASM treatment, seizure relapse risk was very low after a 5-year seizure-free period. The pretreatment seizure frequency was the only independent predictor for pattern A and seizure relapse. Sodium channel blockers monotherapy (33.8%) was more effective than levetiracetam (4.5%) in rendering SF in the initial ASM regimen. Conclusion Medical treatment can be successful in a minority of epileptic patients with MCD, and pretreatment seizure frequency helps to predict the treatment outcome. An unequal efficacy of ASMs in epilepsy caused by MCD suggests etiological evaluation is vital in the management of focal epilepsy.
Collapse
Affiliation(s)
- Wei Chen
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China Department of Neurology, Linhai Second People's Hospital, Taizhou, China
| | - Bo Jin
- Department of Neurology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Thandar Aung
- Epilepsy Center, Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Chenmin He
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Cong Chen
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shan Wang
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yao Ding
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Fang Ding
- Department of Neurology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, China
| | - Chao Wang
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hong Li
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Biao Jiang
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhe Zheng
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Haibin Dai
- Department of Pharmacy, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Junming Zhu
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yu Geng
- Department of Neurology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Meiping Ding
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shuang Wang
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| |
Collapse
|
14
|
Iwasaki M, Iijima K, Kawashima T, Tachimori H, Takayama Y, Kimura Y, Kaneko Y, Ikegaya N, Sumitomo N, Saito T, Nakagawa E, Takahashi A, Sugai K, Otsuki T. Epilepsy surgery in children under 3 years of age: surgical and developmental outcomes. J Neurosurg Pediatr 2021; 28:395-403. [PMID: 34388720 DOI: 10.3171/2021.4.peds21123] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Received: 03/02/2021] [Accepted: 04/13/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Pediatric epilepsy surgery is known to be effective, but early surgery in infancy is not well characterized. Extensive cortical dysplasia, such as hemimegalencephaly, can cause refractory epilepsy shortly after birth, and early surgical intervention is indicated. However, the complication rate of early pediatric surgery is significant. In this study, the authors assessed the risk-benefit balance of early pediatric epilepsy surgery as relates to developmental outcomes. METHODS This is a retrospective descriptive study of 75 patients who underwent their first curative epilepsy surgery at an age under 3 years at the authors' institution between 2006 and 2019 and had a minimum 1-year follow-up of seizure and developmental outcomes. Clinical information including surgical complications, seizure outcomes, and developmental quotient (DQ) was collected from medical records. The effects of clinical factors on DQ at 1 year after surgery were evaluated. RESULTS The median age at surgery was 6 months, peaking at between 3 and 4 months. Operative procedures included 27 cases of hemispherotomy, 19 cases of multilobar surgery, and 29 cases of unilobar surgery. Seizure freedom was achieved in 82.7% of patients at 1 year and in 71.0% of patients at a mean follow-up of 62.8 months. The number of antiseizure medications (ASMs) decreased significantly after surgery, and 19 patients (30.6%) had discontinued their ASMs by the last follow-up. Postoperative complications requiring cerebrospinal fluid (CSF) diversion surgery, such as hydrocephalus and cyst formation, were observed in 13 patients (17.3%). The mean DQ values were 74.2 ± 34.3 preoperatively, 60.3 ± 23.3 at 1 year after surgery, and 53.4 ± 25.1 at the last follow-up. Multiple regression analysis revealed that the 1-year postoperative DQ was significantly influenced by preoperative DQ and postoperative seizure freedom but not by the occurrence of any surgical complication requiring CSF diversion surgery. CONCLUSIONS Early pediatric epilepsy surgery has an acceptable risk-benefit balance. Seizure control after surgery is important for postoperative development.
Collapse
Affiliation(s)
- Masaki Iwasaki
- 1Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo
| | - Keiya Iijima
- 1Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo
| | - Takahiro Kawashima
- 2Department of Clinical Epidemiology, Translational Medical Center, NCNP, Kodaira, Tokyo
| | - Hisateru Tachimori
- 2Department of Clinical Epidemiology, Translational Medical Center, NCNP, Kodaira, Tokyo
| | - Yutaro Takayama
- 1Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo
| | - Yuiko Kimura
- 1Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo
| | - Yuu Kaneko
- 1Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo
| | - Naoki Ikegaya
- 3Department of Neurosurgery, Yokohama City University Hospital, Yokohama, Kanagawa
| | - Noriko Sumitomo
- 4Department of Child Neurology, National Center Hospital, NCNP, Kodaira, Tokyo
| | - Takashi Saito
- 4Department of Child Neurology, National Center Hospital, NCNP, Kodaira, Tokyo
| | - Eiji Nakagawa
- 4Department of Child Neurology, National Center Hospital, NCNP, Kodaira, Tokyo
| | - Akio Takahashi
- 5Department of Neurosurgery, Shibukawa Medical Center, Shibukawa, Gunma; and
| | - Kenji Sugai
- 4Department of Child Neurology, National Center Hospital, NCNP, Kodaira, Tokyo
| | | |
Collapse
|
15
|
Lau EOC, Damiani D, Chehade G, Ruiz-Reig N, Saade R, Jossin Y, Aittaleb M, Schakman O, Tajeddine N, Gailly P, Tissir F. DIAPH3 deficiency links microtubules to mitotic errors, defective neurogenesis, and brain dysfunction. eLife 2021; 10:e61974. [PMID: 33899739 PMCID: PMC8102060 DOI: 10.7554/elife.61974] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 08/10/2020] [Accepted: 04/23/2021] [Indexed: 12/13/2022] Open
Abstract
Diaphanous (DIAPH) three (DIAPH3) is a member of the formin proteins that have the capacity to nucleate and elongate actin filaments and, therefore, to remodel the cytoskeleton. DIAPH3 is essential for cytokinesis as its dysfunction impairs the contractile ring and produces multinucleated cells. Here, we report that DIAPH3 localizes at the centrosome during mitosis and regulates the assembly and bipolarity of the mitotic spindle. DIAPH3-deficient cells display disorganized cytoskeleton and multipolar spindles. DIAPH3 deficiency disrupts the expression and/or stability of several proteins including the kinetochore-associated protein SPAG5. DIAPH3 and SPAG5 have similar expression patterns in the developing brain and overlapping subcellular localization during mitosis. Knockdown of SPAG5 phenocopies DIAPH3 deficiency, whereas its overexpression rescues the DIAHP3 knockdown phenotype. Conditional inactivation of Diaph3 in mouse cerebral cortex profoundly disrupts neurogenesis, depleting cortical progenitors and neurons, leading to cortical malformation and autistic-like behavior. Our data uncover the uncharacterized functions of DIAPH3 and provide evidence that this protein belongs to a molecular toolbox that links microtubule dynamics during mitosis to aneuploidy, cell death, fate determination defects, and cortical malformation.
Collapse
Affiliation(s)
- Eva On-Chai Lau
- Université catholique de Louvain, Institute of Neuroscience, Developmental NeurobiologyBrusselsBelgium
| | - Devid Damiani
- Université catholique de Louvain, Institute of Neuroscience, Developmental NeurobiologyBrusselsBelgium
| | - Georges Chehade
- Université catholique de Louvain, Institute of Neuroscience, Developmental NeurobiologyBrusselsBelgium
| | - Nuria Ruiz-Reig
- Université catholique de Louvain, Institute of Neuroscience, Developmental NeurobiologyBrusselsBelgium
| | - Rana Saade
- Université catholique de Louvain, Institute of Neuroscience, Developmental NeurobiologyBrusselsBelgium
| | - Yves Jossin
- Université catholique de Louvain, Institute of Neuroscience, Mammalian Development and Cell BiologyBrusselsBelgium
| | | | - Olivier Schakman
- Université catholique de Louvain, Institute of Neuroscience, Cell PhysiologyBrusselsBelgium
| | - Nicolas Tajeddine
- Université catholique de Louvain, Institute of Neuroscience, Cell PhysiologyBrusselsBelgium
| | - Philippe Gailly
- Université catholique de Louvain, Institute of Neuroscience, Cell PhysiologyBrusselsBelgium
| | - Fadel Tissir
- Université catholique de Louvain, Institute of Neuroscience, Developmental NeurobiologyBrusselsBelgium
- College of Health and Life Sciences, HBKUDohaQatar
| |
Collapse
|
16
|
Mendes Coelho VC, Morita-Sherman M, Yasuda CL, Alvim MMK, Amorim BJ, Tedeschi H, Ghizoni E, Rogerio F, Cendes F. Magnetic resonance imaging findings and clinical characteristics in mild malformation of cortical development with oligodendroglial hyperplasia and epilepsy in a predominantly adult cohort. Epilepsia 2021; 62:1429-1441. [PMID: 33884614 DOI: 10.1111/epi.16907] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 12/26/2020] [Revised: 03/28/2021] [Accepted: 04/02/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We aimed to better characterize the magnetic resonance imaging (MRI) findings of mild malformation of cortical development with oligodendroglial hyperplasia (MOGHE), a rare clinicopathological entity associated with pharmacoresistance recently described in patients with frontal lobe epilepsy. METHODS We studied 12 patients who underwent epilepsy surgery and whose surgical specimens showed histopathological findings of MOGHE, characterized by preserved cortical lamination, blurred gray-white matter interface due to increased number of oligodendrocytes, and heterotopic neurons in the white matter. The age at MRI evaluation ranged from 11 to 58 years, except for one 4.5-year-old patient. RESULTS Following a detailed MRI analysis using an in-house protocol, we found abnormalities in all cases. The lesion was circumscribed in the frontal lobe in six (50%) and in the temporal lobe in three (25%) patients. In the remaining three patients (25%), the lesion was multilobar (frontotemporal and temporoparieto-occipital). Cortical thickening was mild in all patients, except in the 4.5-year-old patient, who had pronounced cortical thickening and white matter blurring. We also identified cortical/subcortical hyperintense T2/fluid-attenuated inversion recovery signal associated with gray/white matter blurring in all but one patient. When present, cleft cortical dimple, and deep sulci aided in localizing the lesion. Overall, the MRI findings were like those in focal cortical dysplasia (FCD) Type IIa. Surgical outcome was excellent in five patients (Engel Class I in 25% and II in 17%). The remaining seven patients (58%) had worthwhile seizure reduction (Engle Class III). Incomplete lesion resection was significantly associated with worse outcomes. SIGNIFICANCE MRI findings associated with MOGHE are similar to those described in FCD Type IIa. Although more frequent in the frontal lobe, MOGHE also occurred in the temporal lobe or involved multiple lobes. Multilobar or extensive MOGHE MRI lesions are associated with less favorable surgical outcomes. Because this is a rare condition, multicenter studies are necessary to characterize MOGHE further.
Collapse
Affiliation(s)
| | - Marcia Morita-Sherman
- Department of Neurology, University of Campinas, Campinas, São Paulo, Brazil.,Epilepsy Center, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Clarissa L Yasuda
- Department of Neurology, University of Campinas, Campinas, São Paulo, Brazil
| | - Marina M K Alvim
- Department of Neurology, University of Campinas, Campinas, São Paulo, Brazil
| | - Barbara Juarez Amorim
- Division of Nuclear Medicine, Department of Radiology, University of Campinas, Campinas, São Paulo, Brazil
| | - Helder Tedeschi
- Department of Neurology, University of Campinas, Campinas, São Paulo, Brazil
| | - Enrico Ghizoni
- Department of Neurology, University of Campinas, Campinas, São Paulo, Brazil
| | - Fabio Rogerio
- Department of Pathology, University of Campinas, Campinas, São Paulo, Brazil
| | - Fernando Cendes
- Department of Neurology, University of Campinas, Campinas, São Paulo, Brazil
| |
Collapse
|
17
|
Brock S, Cools F, Jansen AC. Neuropathology of genetically defined malformations of cortical development-A systematic literature review. Neuropathol Appl Neurobiol 2021; 47:585-602. [PMID: 33480109 PMCID: PMC8359484 DOI: 10.1111/nan.12696] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 08/03/2020] [Revised: 12/31/2020] [Accepted: 01/15/2021] [Indexed: 12/23/2022]
Abstract
AIMS Malformations of cortical development (MCD) include a heterogeneous spectrum of clinical, imaging, molecular and histopathological entities. While the understanding of genetic causes of MCD has improved with the availability of next-generation sequencing modalities, genotype-histopathological correlations remain limited. This is the first systematic review of molecular and neuropathological findings in patients with MCD to provide a comprehensive overview of the literature. METHODS A systematic review was performed between November 2019 and February 2020. A MEDLINE search was conducted for 132 genes previously linked to MCD in order to identify studies reporting macroscopic and/or microscopic findings in patients with a confirmed genetic cause. RESULTS Eighty-one studies were included in this review reporting neuropathological features associated with pathogenic variants in 46 genes (46/132 genes, 34.8%). Four groups emerged, consisting of (1) 13 genes with well-defined histological-genotype correlations, (2) 27 genes for which neuropathological reports were limited, (3) 5 genes with conflicting neuropathological features, and (4) 87 genes for which no histological data were available. Lissencephaly and polymicrogyria were reported most frequently. Associated brain malformations were variably present, with abnormalities of the corpus callosum as most common associated feature. CONCLUSIONS Neuropathological data in patients with MCD with a defined genetic cause are available only for a small number of genes. As each genetic cause might lead to unique histopathological features of MCD, standardised thorough neuropathological assessment and reporting should be encouraged. Histological features can help improve the understanding of the pathogenesis of MCD and generate hypotheses with impact on further research directions.
Collapse
Affiliation(s)
- Stefanie Brock
- Department of Pathology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.,Neurogenetics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Filip Cools
- Department of Neonatology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Anna C Jansen
- Neurogenetics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Pediatric Neurology Unit, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| |
Collapse
|
18
|
Ikawa A, Fujimoto A, Arai Y, Otsuki Y, Nozaki T, Baba S, Sato K, Enoki H. Case Report: Late-Onset Temporal Lobe Epilepsy Following Subarachnoid Hemorrhage: An Interplay Between Pre-existing Cortical Development Abnormality and Tissue Damage. Front Neurol 2021; 12:599130. [PMID: 33633663 PMCID: PMC7901922 DOI: 10.3389/fneur.2021.599130] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 01/19/2021] [Indexed: 12/26/2022] Open
Abstract
Epileptogenicity following brain insult depends on various factors including severity of the resulting lesion and extent of brain damage. We report a 54-year-old female patient who developed medically refractory epilepsy resulting from the interplay of pre-existing and post-insult pathologies. She presented with subarachnoid hemorrhage (SAH) due to a ruptured aneurysm and underwent clipping surgery. Seizures started 3 months post-operatively. MRI revealed cerebral ischemia and hemosiderin deposits in the left temporal lobes, and left hippocampal atrophy was suspected. As anti-seizure medications and vagus nerve stimulation failed to control her seizures, she underwent left temporal lobe resection and placement of a ventriculoperitoneal shunt for the post-operative complication of hydrocephalus. She remains seizure-free to date. Neuropathology revealed a previously undiagnosed focal cortical dysplasia (FCD) type 1a. Brain insult likely had a second hit effect in the late onset of epilepsy in this patient with pre-existing mild MCD, in whom secondary epilepsy can be attributed to the interplay of multiple underlying pathologies.
Collapse
Affiliation(s)
- Anna Ikawa
- Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.,Department of Neurosurgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Ayataka Fujimoto
- Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.,Department of Neurosurgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Yoshifumi Arai
- Department of Pathology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Yoshiro Otsuki
- Department of Pathology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Toshiki Nozaki
- Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Shimpei Baba
- Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Keishiro Sato
- Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Hideo Enoki
- Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| |
Collapse
|
19
|
Mutti C, Riccò M, Bartolini Y, Bernabè G, Trippi I, Melpignano A, Ciliento R, Zinno L, Florindo I, Sasso E, Odone A, Parrino L, Vaudano AE. Incomplete hippocampal inversion and epilepsy: A systematic review and meta-analysis. Epilepsia 2020; 62:383-396. [PMID: 33325054 DOI: 10.1111/epi.16787] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 09/06/2020] [Revised: 11/20/2020] [Accepted: 11/20/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Incomplete hippocampal inversion (IHI) is a relatively frequent radiological finding at visual inspection in both epilepsy and healthy controls, but its clinical significance is unclear. Here, we systematically retrieve and assess the association between epilepsy and IHI using a meta-analytic approach. Additionally, we estimate the prevalence of IHI in patients with malformation of cortical development (MCD). METHODS We systematically searched two databases (Embase and PubMed) to identify potentially eligible studies from their inception to December 2019. For inclusion, studies were population-based, case-control, observational studies reporting on epilepsy and IHI. The risk of developing epilepsy in IHI (estimated with odds ratio [ORs]) and the frequency of IHI among patients with MCD are provided. RESULTS We screened 3601 records and assessed eligibility of 2812 full-text articles. The final material included 13 studies involving 1630 subjects. Seven studies (1329 subjects: 952 epileptic and 377 nonepileptic) were included for the estimation of the risk of developing epilepsy in the presence of IHI. The estimated OR of active epilepsy in IHI was 1.699 (95% confidence interval = 0.880-3.281), with moderate heterogeneity across studies (I2 = 71%). Seven studies (591 patients) provided information about the frequency of IHI in MCD. Up to one third of patients with MCD (27.9%) presented coexistent IHI. SIGNIFICANCE The present findings confirm that IHI is commonly observed in patients with MCD especially in periventricular nodular heterotopia or polymicrogyria. However, the estimated OR indicates overall weak increased odds of epilepsy in people with IHI, suggesting that the presence of isolated IHI cannot be considered a strong independent predictor for epilepsy development. Clear-cut neuroradiological criteria for IHI and advanced postprocessing analyses on structural magnetic resonance imaging scans are recommended to highlight differences between epileptogenic and nonepileptogenic IHI.
Collapse
Affiliation(s)
- Carlotta Mutti
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Matteo Riccò
- AUSL-IRCCS of Reggio Emilia, Occupational Health and Safety Service, Reggio Emilia, Italy
| | - Yerma Bartolini
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Giorgia Bernabè
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Irene Trippi
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Andrea Melpignano
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Rosario Ciliento
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Lucia Zinno
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Irene Florindo
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Enrico Sasso
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Anna Odone
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - Liborio Parrino
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Anna Elisabetta Vaudano
- Neurology Unit, Baggiovara Hospital, University Hospital of Modena, Modena, Italy.,Department of Biomedical, Metabolic, and Neural Science, and Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| |
Collapse
|
20
|
Specchio N, Pietrafusa N, Ferretti A, De Palma L, Santarone ME, Pepi C, Trivisano M, Vigevano F, Curatolo P. Treatment of infantile spasms: why do we know so little? Expert Rev Neurother 2020; 20:551-566. [PMID: 32316776 DOI: 10.1080/14737175.2020.1759423] [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] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Infantile spasm (IS) is an epileptic syndrome with typical onset within the first 2 years of life. This condition might be caused by several etiologies. IS is associated with pathological neuronal networks; however, definite hypotheses on neurobiological processes are awaited. AREAS COVERED Changes in NMDA and GABAB receptors and increase of Ca2+ conductance are some of the possible pathophysiological mechanisms. Animal models can help, but most have only some features of IS. Outcome is strongly affected by etiology and the timing of treatment, which relies still on ACTH, oral steroids, and vigabatrin. No significant differences in terms of efficacy have been documented, though a combination of ACTH and vigabatrin seems to be associated with better long-term outcomes. Despite the increasing knowledge about the etiology and pathophysiology of IS, in the last years, no new treatment approaches have been recognized to be able to modify the neurobiological process underlying IS. Precision medicine has far to come in IS. EXPERT OPINION Recently, no new therapeutic options for IS have emerged, probably due to the lack of reliable animal models and to the extreme variability in etiologies. Consequently, the outlook for patients and families is poor and early recognition and intervention remain research priorities.
Collapse
Affiliation(s)
- Nicola Specchio
- Rare and Complex Epilepsy Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS , Rome, 00165, Italy.,Member of European Reference Network EpiCARE
| | - Nicola Pietrafusa
- Rare and Complex Epilepsy Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS , Rome, 00165, Italy
| | - Alessandro Ferretti
- Rare and Complex Epilepsy Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS , Rome, 00165, Italy
| | - Luca De Palma
- Rare and Complex Epilepsy Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS , Rome, 00165, Italy
| | - Marta Elena Santarone
- Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS , 00165, Rome, Italy
| | - Chiara Pepi
- Rare and Complex Epilepsy Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS , Rome, 00165, Italy.,Child Neurology and Psychiatry Unit, Systems Medicine Department, Tor Vergata University , 00133, Rome, Italy
| | - Marina Trivisano
- Rare and Complex Epilepsy Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS , Rome, 00165, Italy
| | - Federico Vigevano
- Member of European Reference Network EpiCARE.,Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS , 00165, Rome, Italy
| | - Paolo Curatolo
- Child Neurology and Psychiatry Unit, Systems Medicine Department, Tor Vergata University , 00133, Rome, Italy
| |
Collapse
|
21
|
Stouffs K, Verloo P, Brock S, Régal L, Beysen D, Ceulemans B, Jansen AC, Meuwissen MEC. Recurrent NEDD4L Variant in Periventricular Nodular Heterotopia, Polymicrogyria and Syndactyly. Front Genet 2020; 11:26. [PMID: 32117442 PMCID: PMC7013364 DOI: 10.3389/fgene.2020.00026] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 01/08/2020] [Indexed: 12/14/2022] Open
Abstract
NEDD4L encodes an ubiquitin ligase which is expressed in the cortex and ventricular zone of the fetal brain. Missense variants in NEDD4L have been reported in nine patients with periventricular nodular heterotopia (PNH), polymicrogyria, cleft palate, and syndactyly. All reported variants are located in the HECT domain, causing deregulation of signaling pathways, including the AKT/mTOR pathway. Here we describe a first familial case with four affected members with a high degree of intra-familial phenotypic variability. Phenotypic features in the proband consisted of severe neurodevelopmental delay, refractory seizures, bilateral PNH, and perisylvian polymicrogyria. The other family members were less severely affected with mild developmental delay and isolated bilateral PNH. All family members had syndactyly. An unrelated patient presented with severe neurodevelopmental delay, seizures, and hypospadias, expanding the phenotypic spectrum. MRI revealed bilateral PNH and perisylvian polymicrogyria. All tested patients carry the recurrent variant c.623G > A, p.(Arg208Gln) in the WW domain of NEDD4L. The variant in the unrelated patient occurred de novo. This is the first report of a NEDD4L variant located in the WW domain which is probably involved in the recognition of substrates for ligation suggesting a loss of function variant.
Collapse
Affiliation(s)
- Katrien Stouffs
- Center for Medical Genetics, UZ Brussel, Brussels, Belgium.,Neurogenetics Research Group, Reproduction Genetics and Regenerative Medicine Research Cluster, Vrije Universiteit Brussel, Brussels, Belgium
| | - Patrick Verloo
- Department of Pediatric Neurology, Ghent University Hospital, Ghent, Belgium
| | - Stefanie Brock
- Neurogenetics Research Group, Reproduction Genetics and Regenerative Medicine Research Cluster, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Pathology, UZ Brussel, Brussels, Belgium
| | - Luc Régal
- Pediatric Neurology Unit, Department of Pediatrics, UZ Brussel, Brussels, Belgium
| | - Diane Beysen
- Department of Pediatric Neurology, Antwerp University Hospital, Edegem, Belgium
| | - Berten Ceulemans
- Department of Pediatric Neurology, Antwerp University Hospital, Edegem, Belgium
| | - Anna C Jansen
- Neurogenetics Research Group, Reproduction Genetics and Regenerative Medicine Research Cluster, Vrije Universiteit Brussel, Brussels, Belgium.,Pediatric Neurology Unit, Department of Pediatrics, UZ Brussel, Brussels, Belgium
| | - Marije E C Meuwissen
- Center of Medical Genetics, Antwerp University Hospital, Edegem, Belgium.,Center of Medical Genetics, University of Antwerp, Edegem, Belgium
| |
Collapse
|
22
|
Moustaki K, Buhler E, Martinez R, Watrin F, Represa A, Manent JB. Size of Subcortical Band Heterotopia Influences the Susceptibility to Hyperthermia-Induced Seizures in a Rat Model. Front Cell Neurosci 2019; 13:473. [PMID: 31680876 PMCID: PMC6813413 DOI: 10.3389/fncel.2019.00473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 10/04/2019] [Indexed: 11/13/2022] Open
Abstract
Studies conducted in human and rodent models have suggested that preexisting neurodevelopmental defects could predispose immature brains to febrile seizures (FS). However, the impact of the anatomical extent of preexisting cortical malformations on FS susceptibility was never assessed. Here, we induced hyperthermic seizures (HS) in rats with bilateral subcortical band heterotopia (SBH) and found variable degrees of HS susceptibility depending on inter-individual anatomical differences in size and extent of SBH. This indicates that an association exists between the overall extent or location of a cortical malformation, and the predisposition to FS. This also suggests that various predisposing factors and underlying causes may contribute to the etiology of complex FS.
Collapse
Affiliation(s)
- Kalliopi Moustaki
- Institut de Neurobiologie de la Méditerranée INMED, INSERM UMR 1249, Aix-Marseille University, Marseille, France
| | - Emmanuelle Buhler
- Institut de Neurobiologie de la Méditerranée INMED, INSERM UMR 1249, Aix-Marseille University, Marseille, France
| | - Robert Martinez
- Institut de Neurobiologie de la Méditerranée INMED, INSERM UMR 1249, Aix-Marseille University, Marseille, France
| | - Françoise Watrin
- Institut de Neurobiologie de la Méditerranée INMED, INSERM UMR 1249, Aix-Marseille University, Marseille, France
| | - Alfonso Represa
- Institut de Neurobiologie de la Méditerranée INMED, INSERM UMR 1249, Aix-Marseille University, Marseille, France
| | - Jean-Bernard Manent
- Institut de Neurobiologie de la Méditerranée INMED, INSERM UMR 1249, Aix-Marseille University, Marseille, France
| |
Collapse
|
23
|
Lee M, Kim MJ, Kim EJ, Woo DC, Yum MS, Ko TS. How can methylprednisolone work on epileptic spasms with malformation of cortical development? Eur J Neurosci 2019; 50:4018-4027. [PMID: 31397941 DOI: 10.1111/ejn.14539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 04/19/2019] [Revised: 07/04/2019] [Accepted: 07/25/2019] [Indexed: 12/15/2022]
Abstract
Although steroids are suggested as the treatment of choice for infantile spasms, the mechanism of action is still unclear. Using a rat model of malformation of cortical development with refractory infantile spasms, we evaluated the efficacy of methylprednisolone on spasms susceptibility and behaviors. Additionally, we investigated the in vivo electrophysiological and neurochemical changes of the brain after methylprednisolone treatment. Infant rats with prenatal exposure of methylazoxymethanol at gestational day 15 were used. After a single dose of methylprednisolone or three different doses of methylprednisolone for 3 days, spasms were triggered by intraperitoneal injection of N-methyl-d-aspartic acid. In rats with 3 days of methylprednisolone pretreatment and their controls, behavioral testing was performed at postnatal day 15. In vivo magnetic resonance imaging was conducted at postnatal day 15 after 3 days of methylprednisolone treatment. The rats with single methylprednisolone pretreatment showed significantly delayed onset of spasms and multiple doses of methylprednisolone significantly suppressed the development of spasms in a dose-dependent manner. After multiple methylprednisolone pretreatment and a cluster of N-methyl-d-aspartic acid-induced spasms, the rats showed significantly increased freezing behaviors to conditioned stimuli. Glutamate-weighted chemical exchange saturation transfer revealed significant elevation of glutamate concentration in the cortices of the rats with multiple methylprednisolone pretreatments. Methylprednisolone pretreatment could attenuate N-methyl-d-aspartic acid-induced spasms with in vivo neurochemical and electrophysiological changes, which indicates this steroid's action on the brain and in epilepsy.
Collapse
Affiliation(s)
- Minyoung Lee
- Department of Pediatrics, Asan Medical Center Children's Hospital, Ulsan University College of Medicine, Seoul, Korea
| | - Min-Jee Kim
- Department of Pediatrics, Eulji University Hospital, Eulji University College of Medicine, Daejeon, Korea
| | - Eun-Jin Kim
- Department of Pediatrics, Asan Medical Center Children's Hospital, Ulsan University College of Medicine, Seoul, Korea
| | - Dong-Cheol Woo
- Department of Pediatrics, Asan Medical Center Children's Hospital, Ulsan University College of Medicine, Seoul, Korea
| | - Mi-Sun Yum
- Department of Pediatrics, Asan Medical Center Children's Hospital, Ulsan University College of Medicine, Seoul, Korea
| | - Tae-Sung Ko
- Department of Pediatrics, Asan Medical Center Children's Hospital, Ulsan University College of Medicine, Seoul, Korea
| |
Collapse
|
24
|
Bhoopathy RM, Arthy B, Vignesh SS, Srinivasan AV. Prevalence and clinical characteristics of malformations of cortical development and incomplete hippocampal inversion with medically intractable seizures in Chennai - A prospective study. Neurol India 2019; 67:442-447. [PMID: 31085857 DOI: 10.4103/0028-3886.258046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objective To study the prevalence and clinical characteristics of malformation of cortical development (MCD) and incomplete hippocampal inversion (IHI) in adults with intractable seizures. Materials and Methods In this prospective study of 3220 epileptic patients in our epilepsy clinic between 2012 and 2014, 416 had intractable seizures. In all patients, a detailed clinical history, neurological examination, electroencephalography (EEG), computed tomography (CT) scan, magnetic resonance imaging (MRI) brain, and neuropsychological assessment was conducted to identify MCD and IHI. Results Out of 416 patients with intractable seizures, MCD and IHI were confirmed in 85 patients (48 males, 37 females). MCD was observed in 46 (11.05%) patients and IHI were observed in 39 (9.37%) patients. Chi square test revealed no signi cant difference between the MCD and IHI groups across the patients in different age groups, gender, type of seizure, duration and onset of seizure, seizure frequency, clustering, status epilepticus, EEG, febrile seizures, and family history. Statistically significant differences (P < 0.05) were observed between the MCD and IHI groups for change in seizure semiology and in intelligence quotient (IQ) and memory quotient (MQ) scores obtained using Wechsler's adult intelligence scale III and Wechsler's memory scale. The IHI group showed higher IQ and MQ scores when compared to the MCD group. Furthermore, IHI occurred along with MCD in 6.52% (N = 3) of the population. Conclusion MCD and IHI patients are often associated with intractable complex partial seizures. Intractable epilepsy patients with normal intelligence and normal MRI should be investigated with hippocampal volumetric studies to identify the presence of IHI. Isolated IHI can be considered as a form of MCD because it mimics the clinical features of MCDs.
Collapse
Affiliation(s)
- R M Bhoopathy
- Institute of Neurology, Madras Medical College, Chennai, Tamil Nadu, India
| | - B Arthy
- Institute of Neurology, Madras Medical College, Chennai, Tamil Nadu, India
| | - S S Vignesh
- Institute of Neurology, Madras Medical College, Chennai, Tamil Nadu, India
| | - A V Srinivasan
- Institute of Neurology, Madras Medical College, Chennai, Tamil Nadu, India
| |
Collapse
|
25
|
García-Rincón D, Díaz-Alonso J, Paraíso-Luna J, Ortega Z, Aguareles J, de Salas-Quiroga A, Jou C, de Prada I, Martínez-Cerdeño V, Aronica E, Guzmán M, Pérez-Jiménez MÁ, Galve-Roperh I. Contribution of Altered Endocannabinoid System to Overactive mTORC1 Signaling in Focal Cortical Dysplasia. Front Pharmacol 2019; 9:1508. [PMID: 30687088 PMCID: PMC6334222 DOI: 10.3389/fphar.2018.01508] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 09/18/2018] [Accepted: 12/10/2018] [Indexed: 02/05/2023] Open
Abstract
Alterations of the PI3K/Akt/mammalian target of rapamycin complex 1 (mTORC1) signaling pathway are causally involved in a subset of malformations of cortical development (MCDs) ranging from focal cortical dysplasia (FCD) to hemimegalencephaly and megalencephaly. These MCDs represent a frequent cause of refractory pediatric epilepsy. The endocannabinoid system -especially cannabinoid CB1 receptor- exerts a neurodevelopmental regulatory role at least in part via activation of mTORC1 signaling. Therefore, we sought to characterize the possible contribution of endocannabinoid system signaling to FCD. Confocal microscopy characterization of the CB1 receptor expression and mTORC1 activation was conducted in FCD Type II resection samples. FCD samples were subjected to single nucleotide polymorphism screening for endocannabinoid system elements, as well as CB1 receptor gene sequencing. Cannabinoid CB1 receptor levels were increased in FCD with overactive mTORC1 signaling. CB1 receptors were enriched in phospho-S6-positive cells including balloon cells (BCs) that co-express aberrant markers of undifferentiated cells and dysplastic neurons. Pharmacological regulation of CB1 receptors and the mTORC1 pathway was performed in fresh FCD-derived organotypic cultures. HU-210-evoked activation of CB1 receptors was unable to further activate mTORC1 signaling, whereas CB1 receptor blockade with rimonabant attenuated mTORC1 overactivation. Alterations of the endocannabinoid system may thus contribute to FCD pathological features, and blockade of cannabinoid signaling might be a new therapeutic intervention in FCD.
Collapse
Affiliation(s)
- Daniel García-Rincón
- Instituto Ramón y Cajal de Investigación Sanitaria, Department of Biochemistry and Molecular Biology and Instituto Universitario de Investigación Neuroquímica, Complutense University, Madrid, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain
| | - Javier Díaz-Alonso
- Instituto Ramón y Cajal de Investigación Sanitaria, Department of Biochemistry and Molecular Biology and Instituto Universitario de Investigación Neuroquímica, Complutense University, Madrid, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain
| | - Juan Paraíso-Luna
- Instituto Ramón y Cajal de Investigación Sanitaria, Department of Biochemistry and Molecular Biology and Instituto Universitario de Investigación Neuroquímica, Complutense University, Madrid, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain
| | - Zaira Ortega
- Instituto Ramón y Cajal de Investigación Sanitaria, Department of Biochemistry and Molecular Biology and Instituto Universitario de Investigación Neuroquímica, Complutense University, Madrid, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain
| | - José Aguareles
- Instituto Ramón y Cajal de Investigación Sanitaria, Department of Biochemistry and Molecular Biology and Instituto Universitario de Investigación Neuroquímica, Complutense University, Madrid, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain
| | - Adán de Salas-Quiroga
- Instituto Ramón y Cajal de Investigación Sanitaria, Department of Biochemistry and Molecular Biology and Instituto Universitario de Investigación Neuroquímica, Complutense University, Madrid, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain
| | - Cristina Jou
- Departamento de Anatomía Patológica, Hospital Sant Joan de Déu, Barcelona, Spain
| | | | - Verónica Martínez-Cerdeño
- Institute for Pediatric Regenerative Medicine, Shriners Hospital for Children of Northern California and Department of Pathology and Laboratory Medicine, School of Medicine, University of California, Davis, Sacramento, CA, United States
| | - Eleonora Aronica
- Amsterdam UMC, Department of (Neuro)Pathology, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, Netherlands.,Stichting Epilepsie Instellingen Nederland, Heemstede, Netherlands
| | - Manuel Guzmán
- Instituto Ramón y Cajal de Investigación Sanitaria, Department of Biochemistry and Molecular Biology and Instituto Universitario de Investigación Neuroquímica, Complutense University, Madrid, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain
| | | | - Ismael Galve-Roperh
- Instituto Ramón y Cajal de Investigación Sanitaria, Department of Biochemistry and Molecular Biology and Instituto Universitario de Investigación Neuroquímica, Complutense University, Madrid, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain
| |
Collapse
|
26
|
Sahu S, Buhler E, Vermoyal JC, Watrin F, Represa A, Manent JB. Spontaneous epileptiform activity in a rat model of bilateral subcortical band heterotopia. Epilepsia 2018; 60:337-348. [PMID: 30597542 PMCID: PMC7027481 DOI: 10.1111/epi.14633] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 11/20/2018] [Accepted: 12/07/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Malformations of cortical development are common causes of intellectual disability and epilepsy, yet there is a crucial lack of relevant preclinical models associating seizures and cortical malformations. Here, we describe a novel rat model with bilateral subcortical band heterotopia (SBH) and examine whether this model develops spontaneous epileptic seizures. METHODS To generate bilateral SBH in rats, we combined RNAi-mediated knockdown of Dcx and in utero electroporation with a tripolar electrode configuration enabling simultaneous transfection of the two brain hemispheres. To determine whether bilateral SBH leads to epileptiform activity, rats of various ages were implanted for telemetric electrocorticographic recordings and histopathological examination was carried out at the end of the recording sessions. RESULTS By 2 months, rats with bilateral SBH showed nonconvulsive spontaneous seizures consisting of spike-and-wave discharges (SWDs) with dominant frequencies in the alpha and theta bands and secondarily in higher-frequency bands. SWDs occurred during both the dark and the light period, but were more frequent during quiet awake state than during sleep. Also, SWDs were more frequent and lasted longer at older ages. No sex differences were found. Although frequencies and durations of SWDs were found to be uncorrelated with the size of SBH, SWDs were initiated in some occasions from brain hemispheres comprising a larger SBH. Lastly, SWDs exhibited absence-like pharmacological properties, being temporarily alleviated by ethosuximide administration. SIGNIFICANCE This novel model of bilateral SBH with spontaneous epilepsy may potentially provide valuable new insights into causality between cortical malformations and seizures, and help translational research aiming at designing novel treatment strategies for epilepsy.
Collapse
Affiliation(s)
- Surajit Sahu
- Neurobiology Institute of the Mediterranean (INMED), Aix-Marseille University, French National Institute of Health and Medical Research (INSERM) UMR1249, Marseille, France
| | - Emmanuelle Buhler
- Neurobiology Institute of the Mediterranean (INMED), Aix-Marseille University, French National Institute of Health and Medical Research (INSERM) UMR1249, Marseille, France
| | - Jean-Christophe Vermoyal
- Neurobiology Institute of the Mediterranean (INMED), Aix-Marseille University, French National Institute of Health and Medical Research (INSERM) UMR1249, Marseille, France
| | - Françoise Watrin
- Neurobiology Institute of the Mediterranean (INMED), Aix-Marseille University, French National Institute of Health and Medical Research (INSERM) UMR1249, Marseille, France
| | - Alfonso Represa
- Neurobiology Institute of the Mediterranean (INMED), Aix-Marseille University, French National Institute of Health and Medical Research (INSERM) UMR1249, Marseille, France
| | - Jean-Bernard Manent
- Neurobiology Institute of the Mediterranean (INMED), Aix-Marseille University, French National Institute of Health and Medical Research (INSERM) UMR1249, Marseille, France
| |
Collapse
|
27
|
Abstract
Malformations of cortical development represent a common cause of epileptic encephalopathies and drug-resistant epilepsy in children. As current treatments are often ineffective, new therapeutic targets are needed for epileptic encephalopathies associated with cortical malformations. The mechanistic/mammalian target of rapamycin (mTOR) pathway constitutes a signaling pathway that drives cellular and molecular mechanisms of epileptogenesis in a variety of focal cortical malformations. mTOR inhibitors prevent epilepsy and associated pathogenic mechanisms of epileptogenesis in mouse models of tuberous sclerosis complex and are currently in clinical trials for drug-resistant seizures in these patients. A recent explosion of genetic studies has linked mutations in various genes regulating the mTOR pathway to other cortical malformations, such as focal cortical dysplasia and hemimegalencephaly. Thus, mTOR inhibitors represent promising candidates as novel antiseizure and antiepileptogenic therapies for epilepsy associated with a spectrum of cortical malformations.
Collapse
Affiliation(s)
- Anna Jeong
- Department of Neurology and the Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| | - Michael Wong
- Department of Neurology and the Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| |
Collapse
|
28
|
Sone D, Ikemura M, Saito Y, Taniguchi G, Kunii N. Marked accumulation of oligodendroglia-like cells in temporal lobe epilepsy with amygdala enlargement and hippocampal sclerosis. Neuropathology 2017; 38:154-158. [PMID: 28841245 DOI: 10.1111/neup.12410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 04/11/2017] [Revised: 07/24/2017] [Accepted: 07/24/2017] [Indexed: 11/28/2022]
Abstract
Although an increasing number of cases of temporal lobe epilepsy (TLE) with ipsilateral amygdala enlargement (AE) have been reported, there are few pathological reports, and no clear consensus has been established. Oligodendroglia or oligodendroglia-like cells (OLCs) have recently attracted attention in epilepsy studies. Here, we report the clinical and pathological findings of a 40-year-old male TLE patient with AE and hippocampal sclerosis, in whom histopathological study demonstrated remarkable clustering of OLCs around the uncus. The patient began to have refractory seizures at the age of 14, and preoperative MRI revealed left amygdala enlargement and left hippocampal atrophy. Other examinations were consistent with left mesial temporal epileptogenicity. He underwent surgical resection and achieved seizure freedom. Histopathological study of the amygdala showed swollen neurons with relatively large bodies and thick neurites, accompanied by vacuolar degeneration in the background. Additionally, there were marked clusters of OLCs with round nuclei and densely stained chromatin around the uncus. The OLCs were Olig2-positive. In the hippocampus, severe cell loss in CA1 and granule cell dispersion in the dentate gyrus were found. These findings may provide some insights for further pathological investigations of TLE with non-neoplastic AE.
Collapse
Affiliation(s)
- Daichi Sone
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masako Ikemura
- Department of Pathology, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuko Saito
- Department of Pathology and Laboratory Medicine, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Go Taniguchi
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Naoto Kunii
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan
| |
Collapse
|
29
|
Di Donato N, Jean YY, Maga AM, Krewson BD, Shupp AB, Avrutsky MI, Roy A, Collins S, Olds C, Willert RA, Czaja AM, Johnson R, Stover JA, Gottlieb S, Bartholdi D, Rauch A, Goldstein A, Boyd-Kyle V, Aldinger KA, Mirzaa GM, Nissen A, Brigatti KW, Puffenberger EG, Millen KJ, Strauss KA, Dobyns WB, Troy CM, Jinks RN. Mutations in CRADD Result in Reduced Caspase-2-Mediated Neuronal Apoptosis and Cause Megalencephaly with a Rare Lissencephaly Variant. Am J Hum Genet 2016; 99:1117-29. [PMID: 27773430 DOI: 10.1016/j.ajhg.2016.09.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 09/19/2016] [Indexed: 12/02/2022] Open
Abstract
Lissencephaly is a malformation of cortical development typically caused by deficient neuronal migration resulting in cortical thickening and reduced gyration. Here we describe a “thin” lissencephaly (TLIS) variant characterized by megalencephaly, frontal predominant pachygyria, intellectual disability, and seizures. Trio-based whole-exome sequencing and targeted re-sequencing identified recessive mutations of CRADD in six individuals with TLIS from four unrelated families of diverse ethnic backgrounds. CRADD (also known as RAIDD) is a death-domain-containing adaptor protein that oligomerizes with PIDD and caspase-2 to initiate apoptosis. TLIS variants cluster in the CRADD death domain, a platform for interaction with other death-domain-containing proteins including PIDD. Although caspase-2 is expressed in the developing mammalian brain, little is known about its role in cortical development. CRADD/caspase-2 signaling is implicated in neurotrophic factor withdrawal- and amyloid-β-induced dendritic spine collapse and neuronal apoptosis, suggesting a role in cortical sculpting and plasticity. TLIS-associated CRADD variants do not disrupt interactions with caspase-2 or PIDD in co-immunoprecipitation assays, but still abolish CRADD’s ability to activate caspase-2, resulting in reduced neuronal apoptosis in vitro. Homozygous Cradd knockout mice display megalencephaly and seizures without obvious defects in cortical lamination, supporting a role for CRADD/caspase-2 signaling in mammalian brain development. Megalencephaly and lissencephaly associated with defective programmed cell death from loss of CRADD function in humans implicate reduced apoptosis as an important pathophysiological mechanism of cortical malformation. Our data suggest that CRADD/caspase-2 signaling is critical for normal gyration of the developing human neocortex and for normal cognitive ability.
Collapse
|
30
|
Di Donato N, Kuechler A, Vergano S, Heinritz W, Bodurtha J, Merchant SR, Breningstall G, Ladda R, Sell S, Altmüller J, Bögershausen N, Timms AE, Hackmann K, Schrock E, Collins S, Olds C, Rump A, Dobyns WB. Update on the ACTG1-associated Baraitser-Winter cerebrofrontofacial syndrome. Am J Med Genet A 2016; 170:2644-51. [PMID: 27240540 DOI: 10.1002/ajmg.a.37771] [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: 04/28/2016] [Accepted: 05/17/2016] [Indexed: 11/08/2022]
Abstract
Baraitser-Winter cerebrofrontofacial syndrome is caused by heterozygous missense mutations in one of the two ubiquitous cytoplasmic actin-encoding genes ACTB and ACTG1. Recently, we characterized the large cohort of 41 patients presenting with this condition. Our series contained 34 patients with mutations in ACTB and only nine with ACTG1 mutations. Here, we report on seven unrelated patients with six mutations in ACTG1-four novel and two previously reported. Only one of seven patients was clinically diagnosed with this disorder and underwent ACTB/ACTG1 targeted sequencing, four patients were screened as a part of the large lissencephaly cohort and two were tested with exome sequencing. Retrospectively, facial features were compatible with the diagnosis but significantly milder than previously reported in four patients, and non-specific in one. The pattern of malformations of cortical development was highly similar in four of six patients with available MRI images and encompassed frontal predominant pachygyria merging with the posterior predominant band heterotopia. Two remaining patients showed mild involvement consistent with bilaterally simplified gyration over the frontal lobes. Taken together, we expand the clinical spectrum of the ACTG1-associated Baraitser-Winter cerebrofrontofacial syndrome demonstrating the mild end of the facial and brain manifestations. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Nataliya Di Donato
- Institute for Clinical Genetics, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany.
| | - Alma Kuechler
- Institut für Humangenetik, Universitätsklinikum Essen, Essen, Germany
| | - Samantha Vergano
- Division of Medical Genetics and Metabolism, Children's Hospital of The King's Daughters, Norfolk, Virginia
| | | | - Joann Bodurtha
- Medical College of Virginia, Department of Human and Molecular Genetics, Richmond, Virginia
| | - Sabiha R Merchant
- Department of Pediatric Neurology, New York Presbyterian Hospital and Weill Cornell Medical College, New York, New York
| | - Galen Breningstall
- Department of Pediatric Neurology, Gillette Children's Specialty Healthcare, St. Paul, Minnesota
| | - Roger Ladda
- Penn State Hershey Children's Hospital, Hershey, Pennsylvania
| | - Susan Sell
- Penn State Hershey Children's Hospital, Hershey, Pennsylvania
| | | | - Nina Bögershausen
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
| | - Andrew E Timms
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington
| | - Karl Hackmann
- Institute for Clinical Genetics, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Evelin Schrock
- Institute for Clinical Genetics, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Sarah Collins
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, Washington
| | - Carissa Olds
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, Washington
| | - Andreas Rump
- Institute for Clinical Genetics, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - William B Dobyns
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, Washington.,Department of Pediatrics, University of Washington, Seattle, Washington.,Department of Neurology, University of Washington, Seattle, Washington
| |
Collapse
|
31
|
Pinto ALR, Lohani S, Bergin AMR, Bourgeois BFD, Black PM, Prabhu SP, Madsen JR, Takeoka M, Poduri A. Surgery for intractable epilepsy due to unilateral brain disease: a retrospective study comparing hemispherectomy techniques. Pediatr Neurol 2014; 51:336-43. [PMID: 25160539 DOI: 10.1016/j.pediatrneurol.2014.05.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [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: 02/14/2014] [Revised: 05/14/2014] [Accepted: 05/17/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hemispherectomy is a surgical procedure used to treat medically intractable epilepsy in children with severe unilateral cortical disease secondary to acquired brain or congenital lesions. The major surgical approaches for hemispherectomy are anatomic hemispherectomy, traditional functional hemispherectomy, and peri-insular hemispherotomy. We describe the epilepsy outcome, including the need for reoperation, after hemispherectomy in patients with brain malformations or acquired brain lesions who underwent hemispherectomy for refractory epilepsy. METHODS We conducted a retrospective observational study at Children's Hospital Boston. Cases were ascertained from a research database of patients who underwent epilepsy surgery from 1997 to 2011. Data were obtained from electronic medical records and office charts. Outcome after surgery was defined as improvement in seizures (quantity and severity) represented by the Engel classification score measured at last follow-up, with a minimum of 12 months of follow-up. The need for reoperation for completion of hemispheric disconnection. We also examined whether placement of ventriculoperitoneal shunt was required after hemispherectomy was a secondary outcome. RESULTS We identified 36 patients who underwent hemispherectomy for severe, medically intractable epilepsy. Group 1 (n = 14) had static acquired lesions, and group 2 (n = 22) had malformations of cortical development. Mean age at surgery for group 1 was 9 years (S.D. 5.5) and 2.77 years for group 2 (S.D. 4.01; P < 0.001). The seizure outcome was good in both groups (Engel score I for 25, II for three, III for six, and IV for two patients) and did not differ between the two groups. In group 1, five patients underwent anatomic hemispherectomy (one had prior focal resection), four underwent functional hemispherectomy, and five underwent peri-insular hemispherotomy; none required a second procedure. In group 2, a total of 14 patients had anatomic hemispherectomy (of these, three had had limited prior focal resection), five had functional hemispherectomy, and three had peri-insular hemispherotomy. Among the patients in group 2 who had had functional hemispherectomy, one required reoperation to complete the disconnection and one required peri-insular hemispherotomy because of persistent seizures. In group 1, three patients underwent a ventriculoperitoneal shunt, and from these patients two underwent anatomic hemispherectomy and one had functional hemispherectomy. In group 2, 12 patients had ventriculoperitoneal shunt, and all of them had anatomic hemispherectomy as a first or second procedure. CONCLUSION Seizure outcome after hemispherectomy is good in patients with acquired lesions and with developmental malformations. Although the seizure outcome was similar in the three procedures, the complication rate was higher with anatomic hemispherectomy than with the more recent functional hemispherectomy and peri-insular hemispherotomy. The group with cortical malformations generally had surgery at a younger age; two patients with malformations of cortical development who underwent functional hemispherectomy required second surgeries. The need for reoperation in these cases may reflect the anatomic complexity of developmental hemispheric malformations, which may lead to incomplete disconnection.
Collapse
Affiliation(s)
- Anna L R Pinto
- Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Boston, Massachusetts
| | - Subash Lohani
- Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts
| | - Ann M R Bergin
- Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Boston, Massachusetts
| | - Blaise F D Bourgeois
- Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Boston, Massachusetts
| | - Peter M Black
- Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts
| | - Sanjay P Prabhu
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts
| | - Joseph R Madsen
- Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts
| | - Masanori Takeoka
- Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Boston, Massachusetts
| | - Annapurna Poduri
- Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Boston, Massachusetts.
| |
Collapse
|
32
|
Stutterd CA, Leventer RJ. Polymicrogyria: a common and heterogeneous malformation of cortical development. Am J Med Genet C Semin Med Genet 2014; 166C:227-39. [PMID: 24888723 DOI: 10.1002/ajmg.c.31399] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Polymicrogyria (PMG) is one of the most common malformations of cortical development. It is characterized by overfolding of the cerebral cortex and abnormal cortical layering. It is a highly heterogeneous malformation with variable clinical and imaging features, pathological findings, and etiologies. It may occur as an isolated cortical malformation, or in association with other malformations within the brain or body as part of a multiple congenital anomaly syndrome. Polymicrogyria shows variable topographic patterns with the bilateral perisylvian pattern being most common. Schizencephaly is a subtype of PMG in which the overfolded cortex lines full-thickness clefts connecting the subarachnoid space with the cerebral ventricles. Both genetic and non-genetic causes of PMG have been identified. Non-genetic causes include congenital cytomegalovirus infection and in utero ischemia. Genetic causes include metabolic conditions such as peroxisomal disorders and the 22q11.2 and 1p36 continguous gene deletion syndromes. Mutations in over 30 genes have been found in association with PMG, especially mutations in the tubulin family of genes. Mutations in the (PI3K)-AKT pathway have been found in association PMG and megalencephaly. Despite recent genetic advances, the mechanisms by which polymicrogyric cortex forms and causes of the majority of cases remain unknown, making diagnostic and prenatal testing and genetic counseling challenging. This review summarizes the clinical, imaging, pathologic, and etiologic features of PMG, highlighting recent genetic advances.
Collapse
|
33
|
Abstract
Malformations of cerebral cortical development include a wide range of developmental disorders that are common causes of neurodevelopmental delay and epilepsy. In addition, study of these disorders contributes greatly to the understanding of normal brain development and its perturbations. The rapid recent evolution of molecular biology, genetics and imaging has resulted in an explosive increase in our knowledge of cerebral cortex development and in the number and types of malformations of cortical development that have been reported. These advances continue to modify our perception of these malformations. This review addresses recent changes in our perception of these disorders and proposes a modified classification based upon updates in our knowledge of cerebral cortical development.
Collapse
Affiliation(s)
- A James Barkovich
- Neuroradiology, University of California at San Francisco, 505 Parnassus Avenue, San Francisco, CA 94913-0628, USA.
| | | | | | | | | |
Collapse
|
34
|
Felker MV, Walker LM, Sokol DK, Edwards-Brown M, Chang BS. Early cognitive and behavioral problems in children with nodular heterotopia. Epilepsy Behav 2011; 22:523-6. [PMID: 21908237 PMCID: PMC3206142 DOI: 10.1016/j.yebeh.2011.08.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [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: 06/30/2011] [Revised: 08/09/2011] [Accepted: 08/10/2011] [Indexed: 10/17/2022]
Abstract
Adults with periventricular nodular heterotopia (PNH) have epilepsy and dyslexia, but most have normal intelligence. It is not known whether PNH-related reading difficulty can be detected earlier in childhood or whether associated behavioral problems are present. We studied 10 children with PNH, 3 of whom did not have seizures, and 10 matched controls with neuropsychological testing and parental rating instruments at two time points separated by about 1 year. Children with PNH performed significantly worse than controls on a task related to reading fluency. In addition, those with PNH showed significantly worse adaptive skills, and a measure of conduct problems significantly worsened over time. Mood and behavioral problems were reported more commonly, though not significantly so, in children with PNH. These findings demonstrate that reading dysfluency can be evident in children with nodular heterotopia, even in the absence of epilepsy, but also highlight difficulties with behavior in this population.
Collapse
Affiliation(s)
- Marcia V. Felker
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN
| | - Linsey M. Walker
- Comprehensive Epilepsy Center, Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Deborah K. Sokol
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN
| | - Mary Edwards-Brown
- Department of Neuroradiology, Indiana University School of Medicine, Indianapolis, IN
| | - Bernard S. Chang
- Comprehensive Epilepsy Center, Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
35
|
Walker LM, Katzir T, Liu T, Ly J, Corriveau K, Barzillai M, Chu F, O'Connor MG, Hackney DB, Chang BS. Gray matter volumes and cognitive ability in the epileptogenic brain malformation of periventricular nodular heterotopia. Epilepsy Behav 2009; 15:456-60. [PMID: 19541546 PMCID: PMC2721909 DOI: 10.1016/j.yebeh.2009.05.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [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: 04/02/2009] [Revised: 05/12/2009] [Accepted: 05/16/2009] [Indexed: 02/02/2023]
Abstract
Periventricular nodular heterotopia (PNH) is a brain malformation clinically characterized by the triad of epilepsy, normal intelligence, and dyslexia. We investigated the structure-function relationship between cerebral volumes and cognitive ability in this disorder by studying 12 subjects with PNH and 6 controls using volumetric analysis of high-resolution anatomical MRI and neuropsychological testing. Total cerebral volumes and specific brain compartment volumes (gray matter, white matter, and cerebrospinal fluid) in subjects with PNH were comparable to those in controls. There was a negative correlation between heterotopic gray matter volume and cortical gray matter volume. Cerebral and cortical volumes in PNH did not correlate with Full Scale IQ, unlike in normal individuals. Our findings support the idea that heterotopic nodules contain misplaced neurons that would normally have migrated to the cortex, and suggest that structural correlates of normal cognitive ability may be different in the setting of neuronal migration failure.
Collapse
Affiliation(s)
- Linsey M. Walker
- Comprehensive Epilepsy Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Tami Katzir
- Department of Learning Disabilities, Faculty of Education, University of Haifa, Haifa, Israel
| | - Tianming Liu
- Department of Computer Science, University of Georgia, Athens, GA
| | - Jenny Ly
- Behavioral Neurology Unit, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | | | - Mirit Barzillai
- Center for Reading and Language Research, Tufts University, Medford, MA
| | - Felicia Chu
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Margaret G. O'Connor
- Behavioral Neurology Unit, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - David B. Hackney
- Division of Neuroradiology, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Bernard S. Chang
- Comprehensive Epilepsy Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| |
Collapse
|