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Tartuci IT, Junior NADS, Rogerio F, Dal Fabbro M, Garmes HM, Reis F. Intrasellar xanthogranuloma mimicking macroadenoma. Neuroradiol J 2024; 37:123-125. [PMID: 36951613 PMCID: PMC10863574 DOI: 10.1177/19714009231166075] [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] [Indexed: 03/24/2023] Open
Abstract
Intracranial xanthogranulomas (XGs) have been found at various sites, but xanthogranuloma of the sellar region is extremely rare. We report about a case of sellar XG in a 34-year-old female. Magnetic resonance imaging showed a solid-cystic mass located at the sella turcica. The cystic component was hyperintense on the T1-weighted image (WI) and T2WI. The solid component was hyperintense on T1WI and hypointense on T2WI. There was peripheral enhancement after gadolinium administration. The diagnosis of cystic macroadenoma was considered before surgery. Final diagnosis of XG was confirmed by histopathological examination after surgical resection. Gross total resection of the lesion was achieved using the microscope through endoscopic endonasal transsphenoidal approach. The patient had a good outcome and no symptom of diabetes insipidus, hormonal evaluation did not show any alterations compatible with hypopituitarism and prolactin levels were normal XG should receive diagnostic consideration for the sellar mass lesions with cystic components hyperintense on T1WI and T2WI, solid components hyperintense on T1WI and hypointense on T2WI, and CT without evidence of calcifications. It is important to consider the possibility of XG when pertinent, as it facilitates a proper surgical approach strategy.
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Affiliation(s)
- Iago Toledo Tartuci
- Department of Anesthesiology, Oncology and Radiology, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Nivaldo Adolfo da Silva Junior
- Department of Anesthesiology, Oncology and Radiology, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Fabio Rogerio
- Department of Pathology, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Mateus Dal Fabbro
- Department of Neurology, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Heraldo Mendes Garmes
- Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Fabiano Reis
- Department of Anesthesiology, Oncology and Radiology, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
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2
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Galvão IC, Kandratavicius L, Messias LA, Athié MCP, Assis-Mendonça GR, Alvim MKM, Ghizoni E, Tedeschi H, Yasuda CL, Cendes F, Vieira AS, Rogerio F, Lopes-Cendes I, Veiga DFT. Identifying cellular markers of focal cortical dysplasia type II with cell-type deconvolution and single-cell signatures. Sci Rep 2023; 13:13321. [PMID: 37587190 PMCID: PMC10432381 DOI: 10.1038/s41598-023-40240-3] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/07/2023] [Indexed: 08/18/2023] Open
Abstract
Focal cortical dysplasia (FCD) is a brain malformation that causes medically refractory epilepsy. FCD is classified into three categories based on structural and cellular abnormalities, with FCD type II being the most common and characterized by disrupted organization of the cortex and abnormal neuronal development. In this study, we employed cell-type deconvolution and single-cell signatures to analyze bulk RNA-seq from multiple transcriptomic studies, aiming to characterize the cellular composition of brain lesions in patients with FCD IIa and IIb subtypes. Our deconvolution analyses revealed specific cellular changes in FCD IIb, including neuronal loss and an increase in reactive astrocytes (astrogliosis) when compared to FCD IIa. Astrogliosis in FCD IIb was further supported by a gene signature analysis and histologically confirmed by glial fibrillary acidic protein (GFAP) immunostaining. Overall, our findings demonstrate that FCD II subtypes exhibit differential neuronal and glial compositions, with astrogliosis emerging as a hallmark of FCD IIb. These observations, validated in independent patient cohorts and confirmed using immunohistochemistry, offer novel insights into the involvement of glial cells in FCD type II pathophysiology and may contribute to the development of targeted therapies for this condition.
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Affiliation(s)
- Isabella C Galvão
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
| | - Ludmyla Kandratavicius
- Department of Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
| | - Lauana A Messias
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
| | - Maria C P Athié
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
| | - Guilherme R Assis-Mendonça
- Department of Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
| | - Marina K M Alvim
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
| | - Enrico Ghizoni
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
| | - Helder Tedeschi
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
| | - Clarissa L Yasuda
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
| | - Fernando Cendes
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
| | - André S Vieira
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
| | - Fabio Rogerio
- Department of Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
| | - Iscia Lopes-Cendes
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
| | - Diogo F T Veiga
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil.
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil.
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3
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Assis-Mendonça GR, Athié MCP, Tamanini JVG, de Souza A, Zanetti GG, Araújo PAORDA, Ghizoni E, Tedeschi H, Alvim MKM, de Almeida VS, de Souza W, Coras R, Yasuda CL, Blümcke I, Vieira AS, Cendes F, Lopes-Cendes I, Rogerio F. Transcriptome analyses of the cortex and white matter of focal cortical dysplasia type II: Insights into pathophysiology and tissue characterization. Front Neurol 2023; 14:1023950. [PMID: 37006485 PMCID: PMC10050872 DOI: 10.3389/fneur.2023.1023950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 01/26/2023] [Indexed: 03/17/2023] Open
Abstract
IntroductionFocal cortical dysplasia (FCD) is a common cause of pharmacoresistant epilepsy. According to the 2022 International League Against Epilepsy classification, FCD type II is characterized by dysmorphic neurons (IIa and IIb) and may be associated with balloon cells (IIb). We present a multicentric study to evaluate the transcriptomes of the gray and white matters of surgical FCD type II specimens. We aimed to contribute to pathophysiology and tissue characterization.MethodsWe investigated FCD II (a and b) and control samples by performing RNA-sequencing followed by immunohistochemical validation employing digital analyses.ResultsWe found 342 and 399 transcripts differentially expressed in the gray matter of IIa and IIb lesions compared to controls, respectively. Cholesterol biosynthesis was among the main enriched cellular pathways in both IIa and IIb gray matter. Particularly, the genes HMGCS1, HMGCR, and SQLE were upregulated in both type II groups. We also found 12 differentially expressed genes when comparing transcriptomes of IIa and IIb lesions. Only 1 transcript (MTRNR2L12) was significantly upregulated in FCD IIa. The white matter in IIa and IIb lesions showed 2 and 24 transcripts differentially expressed, respectively, compared to controls. No enriched cellular pathways were detected. GPNMB, not previously described in FCD samples, was upregulated in IIb compared to IIa and control groups. Upregulations of cholesterol biosynthesis enzymes and GPNMB genes in FCD groups were immunohistochemically validated. Such enzymes were mainly detected in both dysmorphic and normal neurons, whereas GPNMB was observed only in balloon cells.DiscussionOverall, our study contributed to identifying cortical enrichment of cholesterol biosynthesis in FCD type II, which may correspond to a neuroprotective response to seizures. Moreover, specific analyses in either the gray or the white matter revealed upregulations of MTRNR2L12 and GPNMB, which might be potential neuropathological biomarkers of a cortex chronically exposed to seizures and of balloon cells, respectively.
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Affiliation(s)
- Guilherme Rossi Assis-Mendonça
- Department of Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
| | - Maria Carolina Pedro Athié
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - João Vitor Gerdulli Tamanini
- Department of Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
| | - Arethusa de Souza
- Department of Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
| | - Gabriel Gerardini Zanetti
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Patrícia Aline Oliveira Ribeiro de Aguiar Araújo
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Enrico Ghizoni
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Helder Tedeschi
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Marina Koutsodontis Machado Alvim
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Vanessa Simão de Almeida
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Welliton de Souza
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Roland Coras
- Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany
| | - Clarissa Lin Yasuda
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Ingmar Blümcke
- Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany
| | - André Schwambach Vieira
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Fernando Cendes
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Iscia Lopes-Cendes
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Fabio Rogerio
- Department of Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
- The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
- *Correspondence: Fabio Rogerio
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4
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Reinhardt A, Pfister K, Schrimpf D, Stichel D, Sahm F, Reuss DE, Capper D, Wefers AK, Ebrahimi A, Sill M, Felsberg J, Reifenberger G, Becker A, Prinz M, Staszewski O, Hartmann C, Schittenhelm J, Gramatzki D, Weller M, Olar A, Rushing EJ, Bergmann M, Farrell MA, Blümcke I, Coras R, Beckervordersandforth J, Kim SH, Rogerio F, Dimova PS, Niehusmann P, Unterberg A, Platten M, Pfister SM, Wick W, Herold-Mende C, von Deimling A. Anaplastic ganglioglioma - a diagnosis comprising several distinct tumour types. Neuropathol Appl Neurobiol 2022; 48:e12847. [PMID: 35977725 DOI: 10.1111/nan.12847] [Citation(s) in RCA: 5] [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: 03/12/2022] [Revised: 07/20/2022] [Accepted: 08/05/2022] [Indexed: 11/29/2022]
Abstract
Anaplastic ganglioglioma is a rare tumour and diagnosis has been based on histological criteria. The 5th edition of the World Health Organization Classification of Tumours of the Central Nervous System (CNS WHO) does not list anaplastic ganglioglioma as a distinct diagnosis due to lack of molecular data in previous publications AIM: We retrospectively compiled a cohort of 54 histologically diagnosed anaplastic gangliogliomas to explore whether the molecular profiles of these tumours represent a separate type or resolve into other entities METHODS: Samples were subjected to histological review, DNA methylation profiling and next generation sequencing. Morphologic and molecular data were summarised to an integrated diagnosis RESULTS: The majority of histologically diagnosed anaplastic gangliogliomas resolved into CNS WHO diagnoses of glial tumours, most commonly pleomorphic xanthoastrocytoma (16/54), glioblastoma, IDH wildtype and diffuse paediatric-type high-grade glioma, H3 wildtype and IDH wildtype (11 and 2/54) followed by low-grade glial or glioneuronal tumours including pilocytic astrocytoma, dysembryoplastic neuroepithelial tumour and diffuse leptomeningeal glioneuronal tumour (5/54), IDH mutant astrocytoma (4/54) and others (6/54). A subset of tumours (10/54) was not assignable to a CNS WHO diagnosis and common molecular profiles pointing to a separate entity were not evident CONCLUSION: In summary, we show that tumours histologically diagnosed as anaplastic ganglioglioma comprise a wide spectrum of CNS WHO tumour types with different prognostic and therapeutic implications. We therefore suggest assigning this designation with caution and recommend comprehensive molecular workup.
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Affiliation(s)
- Annekathrin Reinhardt
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Current address: Centre for Human Genetics Tübingen, Tübingen, Germany
| | - Kristin Pfister
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Institute of Pathology, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Daniel Schrimpf
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Damian Stichel
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Felix Sahm
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - David E Reuss
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - David Capper
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Neuropathology, Berlin, Germany.,German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Annika K Wefers
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Azadeh Ebrahimi
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Neuropathology, University of Bonn, Bonn, Germany
| | - Martin Sill
- German Cancer Consortium (DKTK), Core Center Heidelberg, Germany.,Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
| | - Joerg Felsberg
- Institute of Neuropathology, Heinrich Heine University, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Guido Reifenberger
- Institute of Neuropathology, Heinrich Heine University, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany.,German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Albert Becker
- Department of Neuropathology, University of Bonn, Bonn, Germany
| | - Marco Prinz
- Institute of Neuropathology, Medical Faculty, University of Freiburg, Freiburg, Germany.,Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Signalling Research Centres BIOSS and CIBSS, University of Freiburg, Freiburg, Germany
| | - Ori Staszewski
- Institute of Neuropathology, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Christian Hartmann
- Department of Neuropathology, Hannover Medical School, Hannover, Germany
| | - Jens Schittenhelm
- Institute of Pathology and Neuropathology, University Tübingen, Comprehensive Cancer Center Tübingen, Tübingen, Germany
| | - Dorothee Gramatzki
- Department of Neurology, University Hospital and University Zurich, Zurich, Switzerland
| | - Michael Weller
- Department of Neurology, University Hospital and University Zurich, Zurich, Switzerland
| | | | | | - Markus Bergmann
- Institute of Neuropathology, Center for Pathology, Klinikum Bremen Mitte, Bremen, Germany
| | | | - Ingmar Blümcke
- Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany
| | - Roland Coras
- Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany
| | - Jan Beckervordersandforth
- Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Se Hoon Kim
- Department of Pathology, Yonsei University, College of Medicine, Seoul, South Korea
| | - Fabio Rogerio
- Department of Pathology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Petia S Dimova
- Epilepsy Surgery Center, Department of Neurosurgery, St. Ivan Rilski University Hospital, Sofia, Bulgaria
| | - Pitt Niehusmann
- Section of Neuropathology, Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - Andreas Unterberg
- Clinic for Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Michael Platten
- Department of Neurology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Clinical Cooperation Unit Neuroimmunology and Brain Tumour Immunology, German Cancer Research Center (DKFZ), Heidelberg
| | - Stefan M Pfister
- German Cancer Consortium (DKTK), Core Center Heidelberg, Germany.,Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany.,Division of Paediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Paediatric Oncology and Hematology, University Hospital Heidelberg, Heidelberg, Germany
| | - Wolfgang Wick
- German Cancer Consortium (DKTK), Core Center Heidelberg, Germany.,Neurology Clinic, University Hospital Heidelberg, Heidelberg, Germany
| | - Christel Herold-Mende
- Division of Experimental Neurosurgery, Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Andreas von Deimling
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,German Cancer Consortium (DKTK), Core Center Heidelberg, Germany
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5
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Avansini SH, Puppo F, Adams JW, Vieira AS, Coan AC, Rogerio F, Torres FR, Araújo PAOR, Martin M, Montenegro MA, Yasuda CL, Tedeschi H, Ghizoni E, França AFEC, Alvim MKM, Athié MC, Rocha CS, Almeida VS, Dias EV, Delay L, Molina E, Yaksh TL, Cendes F, Lopes Cendes I, Muotri AR. Junctional instability in neuroepithelium and network hyperexcitability in a focal cortical dysplasia human model. Brain 2022; 145:1962-1977. [PMID: 34957478 PMCID: PMC9336577 DOI: 10.1093/brain/awab479] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 07/30/2021] [Revised: 10/15/2021] [Accepted: 11/19/2021] [Indexed: 11/14/2022] Open
Abstract
Focal cortical dysplasia is a highly epileptogenic cortical malformation with few treatment options. Here, we generated human cortical organoids from patients with focal cortical dysplasia type II. Using this human model, we mimicked some focal cortical dysplasia hallmarks, such as impaired cell proliferation, the presence of dysmorphic neurons and balloon cells, and neuronal network hyperexcitability. Furthermore, we observed alterations in the adherens junctions zonula occludens-1 and partitioning defective 3, reduced polarization of the actin cytoskeleton, and fewer synaptic puncta. Focal cortical dysplasia cortical organoids showed downregulation of the small GTPase RHOA, a finding that was confirmed in brain tissue resected from these patients. Functionally, both spontaneous and optogenetically-evoked electrical activity revealed hyperexcitability and enhanced network connectivity in focal cortical dysplasia organoids. Taken together, our findings suggest a ventricular zone instability in tissue cohesion of neuroepithelial cells, leading to a maturational arrest of progenitors or newborn neurons, which may predispose to cellular and functional immaturity and compromise the formation of neural networks in focal cortical dysplasia.
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Affiliation(s)
- Simoni H Avansini
- Department of Pediatrics/Rady Children’s Hospital-San Diego, Department of Cellular & Molecular Medicine, School of Medicine, University of California San Diego, La Jolla, CA 92037, USA
- Department of Translational Medicine, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo 13083-887, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Sao Paulo 13083-888, Brazil
| | - Francesca Puppo
- Department of Pediatrics/Rady Children’s Hospital-San Diego, Department of Cellular & Molecular Medicine, School of Medicine, University of California San Diego, La Jolla, CA 92037, USA
| | - Jason W Adams
- Department of Pediatrics/Rady Children’s Hospital-San Diego, Department of Cellular & Molecular Medicine, School of Medicine, University of California San Diego, La Jolla, CA 92037, USA
| | - Andre S Vieira
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Sao Paulo 13083-888, Brazil
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Campinas Sao Paulo 13083-887, Brazil
| | - Ana C Coan
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Sao Paulo 13083-888, Brazil
- Department of Neurology, School of Medical Sciences, University of Campinas, Campinas Sao Paulo 13083-887, Brazil
| | - Fabio Rogerio
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Sao Paulo 13083-888, Brazil
- Department of Pathology, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo 13083-887, Brazil
| | - Fabio R Torres
- Department of Translational Medicine, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo 13083-887, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Sao Paulo 13083-888, Brazil
| | - Patricia A O R Araújo
- Department of Translational Medicine, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo 13083-887, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Sao Paulo 13083-888, Brazil
| | - Mariana Martin
- Department of Translational Medicine, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo 13083-887, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Sao Paulo 13083-888, Brazil
| | - Maria A Montenegro
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Sao Paulo 13083-888, Brazil
- Department of Neurology, School of Medical Sciences, University of Campinas, Campinas Sao Paulo 13083-887, Brazil
| | - Clarissa L Yasuda
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Sao Paulo 13083-888, Brazil
- Department of Neurology, School of Medical Sciences, University of Campinas, Campinas Sao Paulo 13083-887, Brazil
| | - Helder Tedeschi
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Sao Paulo 13083-888, Brazil
- Department of Neurology, School of Medical Sciences, University of Campinas, Campinas Sao Paulo 13083-887, Brazil
| | - Enrico Ghizoni
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Sao Paulo 13083-888, Brazil
- Department of Neurology, School of Medical Sciences, University of Campinas, Campinas Sao Paulo 13083-887, Brazil
| | - Andréa F E C França
- Department of Clinical Medicine, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo 13083-887, Brazil
| | - Marina K M Alvim
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Sao Paulo 13083-888, Brazil
- Department of Neurology, School of Medical Sciences, University of Campinas, Campinas Sao Paulo 13083-887, Brazil
| | - Maria C Athié
- Department of Translational Medicine, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo 13083-887, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Sao Paulo 13083-888, Brazil
| | - Cristiane S Rocha
- Department of Translational Medicine, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo 13083-887, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Sao Paulo 13083-888, Brazil
| | - Vanessa S Almeida
- Department of Translational Medicine, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo 13083-887, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Sao Paulo 13083-888, Brazil
| | - Elayne V Dias
- Department of Anesthesiology/Medical Center Hillcrest, School of Medicine, University of California San Diego, Hillcrest, CA 92103, USA
| | - Lauriane Delay
- Department of Anesthesiology/Medical Center Hillcrest, School of Medicine, University of California San Diego, Hillcrest, CA 92103, USA
| | - Elsa Molina
- Stem Cell Genomics and Microscopy Core, Sanford Consortium for Regenerative Medicine, University of California San Diego, La Jolla, CA 92037, USA
| | - Tony L Yaksh
- Department of Anesthesiology/Medical Center Hillcrest, School of Medicine, University of California San Diego, Hillcrest, CA 92103, USA
| | - Fernando Cendes
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Sao Paulo 13083-888, Brazil
- Department of Neurology, School of Medical Sciences, University of Campinas, Campinas Sao Paulo 13083-887, Brazil
| | - Iscia Lopes Cendes
- Department of Translational Medicine, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo 13083-887, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Sao Paulo 13083-888, Brazil
| | - Alysson R Muotri
- Department of Pediatrics/Rady Children’s Hospital-San Diego, Department of Cellular & Molecular Medicine, School of Medicine, University of California San Diego, La Jolla, CA 92037, USA
- Kavli Institute for Brain and Mind, Archealization Center (ArchC), Center for Academic Research and Training in Anthropogeny (CARTA), University of California San Diego, La Jolla, CA 92093, USA
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6
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Canto AM, Godoi AB, Matos AHB, Geraldis JC, Rogerio F, Alvim MKM, Yasuda CL, Ghizoni E, Tedeschi H, Veiga DFT, Henning B, Souza W, Rocha CS, Vieira AS, Dias EV, Carvalho BS, Gilioli R, Arul AB, Robinson RAS, Cendes F, Lopes-Cendes I. Benchmarking the proteomic profile of animal models of mesial temporal epilepsy. Ann Clin Transl Neurol 2022; 9:454-467. [PMID: 35238489 PMCID: PMC8994989 DOI: 10.1002/acn3.51533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 02/21/2022] [Accepted: 02/23/2022] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES We compared the proteomic signatures of the hippocampal lesion induced in three different animal models of mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE+HS): the systemic pilocarpine model (PILO), the intracerebroventricular kainic acid model (KA), and the perforant pathway stimulation model (PPS). METHODS We used shotgun proteomics to analyze the proteomes and find enriched biological pathways of the dorsal and ventral dentate gyrus (DG) isolated from the hippocampi of the three animal models. We also compared the proteomes obtained in the animal models to that from the DG of patients with pharmacoresistant MTLE+HS. RESULTS We found that each animal model presents specific profiles of proteomic changes. The PILO model showed responses predominantly related to neuronal excitatory imbalance. The KA model revealed alterations mainly in synaptic activity. The PPS model displayed abnormalities in metabolism and oxidative stress. We also identified common biological pathways enriched in all three models, such as inflammation and immune response, which were also observed in tissue from patients. However, none of the models could recapitulate the profile of molecular changes observed in tissue from patients. SIGNIFICANCE Our results indicate that each model has its own set of biological responses leading to epilepsy. Thus, it seems that only using a combination of the three models may one replicate more closely the mechanisms underlying MTLE+HS as seen in patients.
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Affiliation(s)
- Amanda M Canto
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
| | - Alexandre B Godoi
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
| | - Alexandre H B Matos
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
| | - Jaqueline C Geraldis
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
| | - Fabio Rogerio
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil.,Department of Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Marina K M Alvim
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil.,Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Clarissa L Yasuda
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil.,Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Enrico Ghizoni
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil.,Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Helder Tedeschi
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil.,Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Diogo F T Veiga
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
| | - Barbara Henning
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
| | - Welliton Souza
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
| | - Cristiane S Rocha
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
| | - André S Vieira
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil.,Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Elayne V Dias
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil.,Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Benilton S Carvalho
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil.,Department of Statistics, Institute of Mathematics, Statistics and Scientific Computing, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Rovilson Gilioli
- Laboratory of Animal Quality Control, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Albert B Arul
- Department of Chemistry, Vanderbilt University, Nashville, Tennessee, 37235, USA
| | - Renã A S Robinson
- Department of Chemistry, Vanderbilt University, Nashville, Tennessee, 37235, USA
| | - Fernando Cendes
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil.,Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Iscia Lopes-Cendes
- Department of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, SP, Brazil
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7
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Zaidan BC, Cardoso ICDS, de Campos BM, da Silva LRP, Coelho VCM, Silveira KAA, Amorim BJ, Alvim MKM, Tedeschi H, Yasuda CL, Ghizoni E, Cendes F, Rogerio F. Histopathological Correlations of Qualitative and Quantitative Temporopolar MRI Analyses in Patients With Hippocampal Sclerosis. Front Neurol 2022; 12:801195. [PMID: 35002940 PMCID: PMC8739995 DOI: 10.3389/fneur.2021.801195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 11/29/2021] [Indexed: 11/28/2022] Open
Abstract
Hippocampal sclerosis (HS) is a common cause of pharmacoresistant focal epilepsy. Here, we (1) performed a histological approach to the anterior temporal pole of patients with HS to evaluate cortical and white matter (WM) cell populations, alteration of myelin integrity and markers of neuronal activity, and (2) correlated microscopic data with magnetic resonance imaging (MRI) findings. Our aim was to contribute with the understanding of neuroimaging and pathophysiological mechanisms of temporal lobe epilepsy (TLE) associated with HS. We examined MRIs and surgical specimens from the anterior temporal pole from TLE-HS patients (n = 9) and compared them with 10 autopsy controls. MRIs from healthy volunteers (n = 13) were used as neuroimaging controls. Histological techniques were performed to assess oligodendrocytes, heterotopic neurons, cellular proliferative index, and myeloarchitecture integrity of the WM, as well as markers of acute (c-fos) and chronic (ΔFosB) activities of neocortical neurons. Microscopic data were compared with neuroimaging findings, including T2-weighted/FLAIR MRI temporopolar blurring and values of fractional anisotropy (FA) from diffusion-weighed imaging (DWI). We found a significant increase in WM oligodendrocyte number, both in hematoxylin and eosin, and in Olig2-stained sections. The frequencies of oligodendrocytes in perivascular spaces and around heterotopic neurons were significantly higher in patients with TLE–HS compared with controls. The percentage of 2',3'-cyclic-nucleotide 3'-phosphodiesterase (CNPase; a marker of myeloarchitecture integrity) immunopositive area in the WM was significantly higher in TLE-HS, as well as the numbers of c-fos- and ΔFosB-immunostained neocortical neurons. Additionally, we demonstrated a decrease in axonal bundle integrity on neuroimaging, with a significant reduction in the FA in the anterior temporal pole. No differences were detected between individuals with and without temporopolar blurring on visual MRI analysis, considering the number of oligodendroglial cells and percentage of WM CNPase-positive areas. Also, there was no relationship between T2 relaxometry and oligodendrocyte count. In conclusion, our histopathological data support the following: (1) the hypothesis that repetitive neocortical neuronal activity could induce changes in the WM cellular constitution and myelin remodeling in the anterior temporal pole from patients with TLE-HS, (2) that oligodendroglial hyperplasia is not related to temporal blurring or T2 signal intensity on MRI, and (3) that reduced FA is a marker of increase in Olig2-immunopositive cells in superficial temporopolar WM from patients with TLE-HS.
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Affiliation(s)
- Bruna Cunha Zaidan
- Department of Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Brunno Machado de Campos
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Vanessa C Mendes Coelho
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Bárbara Juarez Amorim
- Department of Anesthesiology, Oncology and Radiology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Helder Tedeschi
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Clarissa Lin Yasuda
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Enrico Ghizoni
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Fernando Cendes
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Fabio Rogerio
- Department of Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
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8
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Tamanini JVG, Dal Fabbro M, de Freitas LLL, Vassallo J, de Souza Queiroz L, Rogerio F. Digital analysis of hormonal immunostaining in pituitary adenomas classified according to WHO 2017 criteria and correlation with preoperative laboratory findings. Neurosurg Focus 2021; 48:E12. [PMID: 32480373 DOI: 10.3171/2020.3.focus2039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/03/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The authors sought to evaluate clinical and laboratory data from pituitary adenoma (PA) patients with functioning PA (associated with acromegaly [n = 10] or Cushing disease [n = 10]) or nonfunctioning PA (NFPA; n = 10) that were classified according to 2017 WHO criteria (based on the expression of the transcription factors pituitary-specific positive transcription factor 1 [Pit-1], a transcription factor member of the T-box family [Tpit], and steroidogenic factor 1 [SF-1]) and to assess the immunostaining results for growth hormone (GH) and adrenocorticotropic hormone (ACTH) in the corresponding tumors. METHODS Clinical and laboratory data were collected retrospectively. The percentage of tumoral cells positive for Pit-1, Tpit, or SF-1 was assessed and ImageJ software was used to evaluate immunopositivity in PAs with 2 different antibodies against GH (primary antibody 1 [AbGH-1] and primary antibody 2 [AbGH-2]) and 2 different antibodies against ACTH (primary antibody 1 [AbACTH-1] and primary antibody 2 [AbACTH-2]). RESULTS Cells with positive Pit-1 staining were more frequently observed in lesions from patients with acromegaly (acromegaly group) than in lesions from patients with Cushing disease (Cushing group; p < 0.001) and those from patients with NFPA (NFPA group; p < 0.001). The percentage of Tpit-positive cells was higher in the Cushing group than in the acromegaly (p < 0.001) and NFPA (p < 0.001) groups. No difference was detected regarding SF-1 frequency among all groups (p = 0.855). In acromegalic individuals, GH immunostaining levels varied depending on the antibody employed, and only one of the antibodies (AbGH-2) yielded higher values in comparison with the values for NFPA patients (p < 0.001). For all of the antibodies employed, no significant correlations were detected between GH tissue expression and the laboratory data (serum GH vs AbGH-1, p = 0.933; serum GH vs AbGH-2, p = 0.853; serum insulin-like growth factor-1 [IGF-1] vs AbGH-1, p = 0.407; serum IGF-1 vs AbGH-2, p = 0.881). In the Cushing group data, both antibodies showed similar ACTH tissue expression, which was higher than that obtained in the NFPA group (p < 0.001). There were no significant associations between ACTH immunohistochemical findings and ACTH serum levels (serum ACTH vs AbACTH-1, p = 0.651; serum ACTH vs AbACTH-2, p = 0.987). However, ACTH immunostaining evaluated with AbACTH-1 showed a significant correlation with 24-hour urinary cortisol (24-hour cortisol vs AbACTH-1, p = 0.047; 24-hour cortisol vs AbACTH-2, p = 0.071). CONCLUSIONS Immunostaining for Pit-1 and Tpit accurately identified lesions associated with acromegaly and Cushing disease, respectively. Conversely, SF-1 did not differentiate NFPA from lesions of the other two groups. Regarding hormonal tissue detection, results of the current investigation indicate that different antibodies may lead not only to divergent immunohistochemical results but also to lack of correlation with laboratory findings. Finally, PA classification based on transcription factor expression (Pit-1, Tpit, and SF-1), as proposed by the 2017 WHO classification of pituitary tumors, may avoid the limitations of PA classification based solely on digital immunohistochemical detection of hormones.
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Affiliation(s)
| | - Mateus Dal Fabbro
- 2Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
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9
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Blümcke I, Coras R, Busch RM, Morita-Sherman M, Lal D, Prayson R, Cendes F, Lopes-Cendes I, Rogerio F, Almeida VS, Rocha CS, Sim NS, Lee JH, Kim SH, Baulac S, Baldassari S, Adle-Biassette H, Walsh CA, Bizzotto S, Doan RN, Morillo KS, Aronica E, Mühlebner A, Becker A, Cienfuegos J, Garbelli R, Giannini C, Honavar M, Jacques TS, Thom M, Mahadevan A, Miyata H, Niehusmann P, Sarnat HB, Söylemezoglu F, Najm I. Toward a better definition of focal cortical dysplasia: An iterative histopathological and genetic agreement trial. Epilepsia 2021; 62:1416-1428. [PMID: 33949696 DOI: 10.1111/epi.16899] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [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: 10/23/2020] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Focal cortical dysplasia (FCD) is a major cause of difficult-to-treat epilepsy in children and young adults, and the diagnosis is currently based on microscopic review of surgical brain tissue using the International League Against Epilepsy classification scheme of 2011. We developed an iterative histopathological agreement trial with genetic testing to identify areas of diagnostic challenges in this widely used classification scheme. METHODS Four web-based digital pathology trials were completed by 20 neuropathologists from 15 countries using a consecutive series of 196 surgical tissue blocks obtained from 22 epilepsy patients at a single center. Five independent genetic laboratories performed screening or validation sequencing of FCD-relevant genes in paired brain and blood samples from the same 22 epilepsy patients. RESULTS Histopathology agreement based solely on hematoxylin and eosin stainings was low in Round 1, and gradually increased by adding a panel of immunostainings in Round 2 and the Delphi consensus method in Round 3. Interobserver agreement was good in Round 4 (kappa = .65), when the results of genetic tests were disclosed, namely, MTOR, AKT3, and SLC35A2 brain somatic mutations in five cases and germline mutations in DEPDC5 and NPRL3 in two cases. SIGNIFICANCE The diagnoses of FCD 1 and 3 subtypes remained most challenging and were often difficult to differentiate from a normal homotypic or heterotypic cortical architecture. Immunohistochemistry was helpful, however, to confirm the diagnosis of FCD or no lesion. We observed a genotype-phenotype association for brain somatic mutations in SLC35A2 in two cases with mild malformation of cortical development with oligodendroglial hyperplasia in epilepsy. Our results suggest that the current FCD classification should recognize a panel of immunohistochemical stainings for a better histopathological workup and definition of FCD subtypes. We also propose adding the level of genetic findings to obtain a comprehensive, reliable, and integrative genotype-phenotype diagnosis in the near future.
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Affiliation(s)
- Ingmar Blümcke
- Department of Neuropathology, University Hospital, Erlangen, Germany.,Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA
| | - Roland Coras
- Department of Neuropathology, University Hospital, Erlangen, Germany
| | - Robyn M Busch
- Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA.,Department of Neurology, Cleveland Clinic, Cleveland, OH, USA.,Genomic Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | | | - Dennis Lal
- Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA.,Genomic Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Richard Prayson
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Fernando Cendes
- Department of Neurology, University of Campinas, Sao Paulo, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology, Sao Paulo, Brazil
| | - Iscia Lopes-Cendes
- Brazilian Institute of Neuroscience and Neurotechnology, Sao Paulo, Brazil.,Department of Medical Genetics and Genomic Medicine, University of Campinas, Sao Paulo, Brazil
| | - Fabio Rogerio
- Brazilian Institute of Neuroscience and Neurotechnology, Sao Paulo, Brazil.,Department of Pathology, University of Campinas, Sao Paulo, Brazil
| | - Vanessa S Almeida
- Brazilian Institute of Neuroscience and Neurotechnology, Sao Paulo, Brazil.,Department of Medical Genetics and Genomic Medicine, University of Campinas, Sao Paulo, Brazil
| | - Cristiane S Rocha
- Brazilian Institute of Neuroscience and Neurotechnology, Sao Paulo, Brazil.,Department of Medical Genetics and Genomic Medicine, University of Campinas, Sao Paulo, Brazil
| | - Nam Suk Sim
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Jeong Ho Lee
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea.,SoVarGen, Inc., Daejeon, Korea
| | - Se Hoon Kim
- Department of Pathology, College of Medicine, Yonsei University, Seoul, South Korea
| | - Stephanie Baulac
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France
| | - Sara Baldassari
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France
| | - Homa Adle-Biassette
- Pathological Anatomy Service, Public Hospital Network of Paris, Paris, France.,NeuroDiderot, Inserm U1141, University of Paris, Paris, France
| | - Christopher A Walsh
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children's Hospital, Boston, MA, USA.,Departments of Pediatrics and Neurology, Harvard Medical School, Boston, MA, USA
| | - Sara Bizzotto
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children's Hospital, Boston, MA, USA.,Departments of Pediatrics and Neurology, Harvard Medical School, Boston, MA, USA
| | - Ryan N Doan
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children's Hospital, Boston, MA, USA.,Departments of Pediatrics and Neurology, Harvard Medical School, Boston, MA, USA
| | - Katherine S Morillo
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children's Hospital, Boston, MA, USA.,Departments of Pediatrics and Neurology, Harvard Medical School, Boston, MA, USA
| | - Eleonora Aronica
- Department of (Neuro)Pathology, Amsterdam UMC, location Academic Medical Center, Amsterdam, the Netherlands.,Epilepsy Institutes of the Netherlands Foundation, Heemstede, the Netherlands
| | - Angelika Mühlebner
- Department of (Neuro)Pathology, Amsterdam UMC, location Academic Medical Center, Amsterdam, the Netherlands.,Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Albert Becker
- Department of Neuropathology, University of Bonn Medical Center, Bonn, Germany
| | - Jesus Cienfuegos
- Department of Anatomic Pathology, International Center for Epilepsy Surgery, Humanitas Medical Group Hospital, Mexico City, Mexico.,Department of Anatomic Pathology, Angels Mexico Hospital, Mexico City, Mexico
| | - Rita Garbelli
- Epilepsy Unit, Carlo Besta Neurological Institute, Scientific Institute for Research and Health Care Foundation, Milan, Italy
| | - Caterina Giannini
- Anatomic Pathology, Mayo Clinic, Rochester, Minnesota, USA.,Department of Biomedical and Neuromotor Science,, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Mrinalini Honavar
- Department of Anatomic Pathology, Pedro Hispano Hospital, Matosinhos, Portugal
| | - Thomas S Jacques
- Developmental Biology and Cancer Research and Teaching Programme, University College London Great Ormond Street Institute of Child Health, London, UK.,Department of Histopathology, Great Ormond Street Hospital for Children, National Health Service Foundation Trust, London, UK
| | - Maria Thom
- Department of Neuropathology, Institute of Neurology, University College London, London, UK
| | - Anita Mahadevan
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Hajime Miyata
- Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan
| | - Pitt Niehusmann
- Department of Neuro-/Pathology, Translational Neurodegeneration Research and Neuropathology Lab, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Harvey B Sarnat
- Department of Paediatrics, University of Calgary Faculty of Medicine, Alberta Children's Hospital Research Institute, Calgary, AB, Canada.,Department of Pathology (Neuropathology),, University of Calgary Faculty of Medicine, Alberta Children's Hospital Research Institute, Calgary, AB, Canada.,Department of Clinical Neurosciences, University of Calgary Faculty of Medicine, Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Figen Söylemezoglu
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Imad Najm
- Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA.,Department of Neurology, Cleveland Clinic, Cleveland, OH, USA
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10
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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.
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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
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11
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de Souza JPSAS, Pimentel-Silva LR, Ayub G, Nogueira MH, Zanao T, Yasuda CL, Campos BM, Rogerio F, Tedeschi H, Cendes F, Ghizoni E. Transsylvian amygdalohippocampectomy for mesial temporal lobe epilepsy: Comparison of three different approaches. Epilepsia 2021; 62:439-449. [PMID: 33449366 DOI: 10.1111/epi.16816] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study's objective was to compare the transinsular (TI-AH), transuncus (TU-AH), and temporopolar (TP-AH) amygdalohippocampectomy approaches regarding seizure control, temporal stem (TS) damage, and neurocognitive decline. METHODS We included 114 consecutive patients with unilateral hippocampal sclerosis (HS) who underwent TI-AH, TU-AH, or TP-AH between 2002 and 2017. We evaluated seizure control using Engel classification. We used diffusion tensor imaging and postoperative Humphrey perimetry to assess the damage of the TS. We also performed pre- and postoperative memory performance and intelligence quotient (IQ). RESULTS There were no significant differences in the proportion of patients free of disabling seizures (Engel IA+IB) among the three surgical approaches in the survival analysis. However, more patients were free of disabling seizures (Engel IA+IB) at 2 years of postsurgical follow-up with TP-AH (69.5%) and TI-AH (76.7%) as compared to the TU-AH (43.5%) approach (p = .03). The number of fibers of the inferior fronto-occipital fasciculus postoperatively was reduced in the TI-AH group compared with the TU-AH and TP-AH groups (p = .001). The rate of visual field defects was significantly higher with TI-AH (14/19, 74%) in comparison to the TU-AH (5/15, 33%) and TP-AH (13/40, 32.5%) approaches (p = .008). Finally, there was a significant postoperative decline in verbal memory in left-sided surgeries (p = .019) and delayed recall for both sides (p < .001) regardless of the surgical approach. However, TP-AH was the only group that showed a significant improvement in visual memory (p < .001) and IQ (p < .001) for both right- and left-sided surgeries. SIGNIFICANCE The TP-AH group had better short-term seizure control than TU-AH, a lower rate of visual field defects than TI-AH, and improved visual memory and IQ compared to the other groups. Our findings suggest that TP-AH is a better surgical approach for temporal lobe epilepsy with HS than TI-AH and TU-AH.
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Affiliation(s)
| | | | - Gabriel Ayub
- Department of Ophthalmology, University of Campinas, Campinas, Brazil
| | | | - Tamires Zanao
- Neuroimaging Laboratory, University of Campinas, Campinas, Brazil
| | - Clarissa L Yasuda
- Neuroimaging Laboratory, University of Campinas, Campinas, Brazil.,Department of Neurology, University of Campinas, Campinas, Brazil
| | - Brunno M Campos
- Neuroimaging Laboratory, University of Campinas, Campinas, Brazil
| | - Fabio Rogerio
- Department of Neuropathology, University of Campinas, Campinas, Brazil
| | - Helder Tedeschi
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Fernando Cendes
- Neuroimaging Laboratory, University of Campinas, Campinas, Brazil.,Department of Neurology, University of Campinas, Campinas, Brazil
| | - Enrico Ghizoni
- Neuroimaging Laboratory, University of Campinas, Campinas, Brazil.,Department of Neurology, University of Campinas, Campinas, Brazil
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12
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Rogerio F, Tamanini JVG, Gerson G, Costa Haiter T, de Souza Queiroz L, Dal Fabbro M. A 79-Year-Old Woman With Headache and Acromegaly. Brain Pathol 2021; 30:407-408. [PMID: 32100431 DOI: 10.1111/bpa.12815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Fabio Rogerio
- Department of Pathology, State University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Gunter Gerson
- Department of Pathology and Forensic Medicine, Federal University of Ceará (UFC), Fortaleza, Brazil
| | - Thiago Costa Haiter
- Department of Pathology, State University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Mateus Dal Fabbro
- Department of Neurology, State University of Campinas (UNICAMP), Campinas, Brazil
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13
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de Souza JPSAS, Ayub G, Nogueira M, Zanao T, Lopes TM, Pimentel-Silva LR, Domene V, Marquez G, Yasuda CL, Ribeiro LF, Campos BM, Vasconcellos J, Rogerio F, Joaquim AF, Cendes F, Tedeschi H, Ghizoni E. Temporopolar amygdalohippocampectomy: seizure control and postoperative outcomes. J Neurosurg 2020; 134:1044-1053. [PMID: 32413857 DOI: 10.3171/2020.3.jns192624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 09/27/2019] [Accepted: 03/10/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the efficacy and safety of a modified surgical approach for the treatment of temporal lobe epilepsy secondary to hippocampal sclerosis (HS). This modified approach, called temporopolar amygdalohippocampectomy (TP-AH), includes a transsylvian resection of the temporal pole and subsequent amygdalohippocampectomy utilizing the limen insula as an anatomical landmark. METHODS A total of 61 patients who were diagnosed with HS and underwent TP-AH between 2013 and 2017 were enrolled. Patients performed pre- and postoperative diffusion tensor imaging and were classified according to Engel's scale for seizure control. To evaluate the functional preservation of the temporal stem white-matter fiber tracts, the authors analyzed postoperative Humphrey perimetries and pre- and postoperative neurocognitive performance (Rey Auditory Verbal Learning Test [RAVLT], Weschler Memory Scale-Revised [WMS-R], intelligence quotient [IQ], Boston Naming Test [BNT], and semantic and phonemic fluency). Demographic data and surgical complications were also recorded and described. RESULTS After a median follow-up of 36 ± 16 months, 46 patients (75.4%) achieved Engel class I, of whom 37 (60.6%) were Engel class IA. No significant changes in either the inferior frontooccipital fasciculus and optic radiation tractography were observed postoperatively for both left- and right-side surgeries. Reliable perimetry was obtained in 40 patients (65.6%), of whom 27 (67.5%) did not present any visual field defects (VFDs) attributable to surgery, while 12 patients (30%) presented with quadrant VFD, and 1 patient (2.5%) presented with hemifield VFD. Despite a significant decline in verbal memory (p = 0.007 for WMS-R, p = 0.02 for RAVLT recognition), there were significant improvements in both IQ (p < 0.001) and visual memory (p = 0.007). Semantic and phonemic fluency, and scores on the BNT, did not change postoperatively. CONCLUSIONS TP-AH provided seizure control similar to historical temporal lobe approaches, with a tendency to preserve the temporal stem and a satisfactory incidence of VFD. Despite a significant decline in verbal memory, there were significant improvements in both IQ and visual memory, along with preservation of executive function. This approach can be considered a natural evolution of the selective transsylvian approach.
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Affiliation(s)
| | | | | | - Tamires Zanao
- 1Neuroimaging Laboratory (LNI), Department of Neurology
| | | | | | | | | | - Clarissa Lin Yasuda
- 1Neuroimaging Laboratory (LNI), Department of Neurology.,3Clinical Neurology
| | | | | | | | - Fabio Rogerio
- 5Department of Anatomical Pathology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | | | - Fernando Cendes
- 1Neuroimaging Laboratory (LNI), Department of Neurology.,3Clinical Neurology
| | | | - Enrico Ghizoni
- 1Neuroimaging Laboratory (LNI), Department of Neurology.,Divisions of2Neurosurgery and
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14
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Kubach J, Muhlebner-Fahrngruber A, Soylemezoglu F, Miyata H, Niehusmann P, Honavar M, Rogerio F, Kim SH, Aronica E, Garbelli R, Vilz S, Popp A, Walcher S, Neuner C, Scholz M, Kuerten S, Schropp V, Roeder S, Eichhorn P, Eckstein M, Brehmer A, Kobow K, Coras R, Blumcke I, Jabari S. Same same but different: A Web-based deep learning application revealed classifying features for the histopathologic distinction of cortical malformations. Epilepsia 2020; 61:421-432. [PMID: 32080846 DOI: 10.1111/epi.16447] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/23/2020] [Accepted: 01/23/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The microscopic review of hematoxylin-eosin-stained images of focal cortical dysplasia type IIb and cortical tuber of tuberous sclerosis complex remains challenging. Both entities are distinct subtypes of human malformations of cortical development that share histopathological features consisting of neuronal dyslamination with dysmorphic neurons and balloon cells. We trained a convolutional neural network (CNN) to classify both entities and visualize the results. Additionally, we propose a new Web-based deep learning application as proof of concept of how deep learning could enter the pathologic routine. METHODS A digital processing pipeline was developed for a series of 56 cases of focal cortical dysplasia type IIb and cortical tuber of tuberous sclerosis complex to obtain 4000 regions of interest and 200 000 subsamples with different zoom and rotation angles to train a neural network. Guided gradient-weighted class activation maps (Guided Grad-CAMs) were generated to visualize morphological features used by the CNN to distinguish both entities. RESULTS Our best-performing network achieved 91% accuracy and 0.88 area under the receiver operating characteristic curve at the tile level for an unseen test set. Novel histopathologic patterns were found through the visualized Guided Grad-CAMs. These patterns were assembled into a classification score to augment decision-making in routine histopathology workup. This score was successfully validated by 11 expert neuropathologists and 12 nonexperts, boosting nonexperts to expert level performance. SIGNIFICANCE Our newly developed Web application combines the visualization of whole slide images with the possibility of deep learning-aided classification between focal cortical dysplasia IIb and tuberous sclerosis complex. This approach will help to introduce deep learning applications and visualization for the histopathologic diagnosis of rare and difficult-to-classify brain lesions.
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Affiliation(s)
- Joshua Kubach
- Institute of Neuropathology, University Hospitals, Erlangen, Germany
| | - Angelika Muhlebner-Fahrngruber
- Department of (Neuro)Pathology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Figen Soylemezoglu
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Hajime Miyata
- Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan
| | - Pitt Niehusmann
- Department of Neurology/Pathology, Oslo University Hospital, Oslo, Norway
| | - Mrinalini Honavar
- Department of Anatomic Pathology, Pedro Hispano Hospital, Matosinhos, Portugal
| | - Fabio Rogerio
- Department of Pathology, State University of Campinas, Campinas, Brazil
| | - Se-Hoon Kim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Eleonora Aronica
- Department of (Neuro)Pathology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands.,Stichting Epilepsie Instellingen Nederland, Zwolle, the Netherlands
| | | | - Samuel Vilz
- Institute of Neuropathology, University Hospitals, Erlangen, Germany
| | - Alexander Popp
- Institute of Neuropathology, University Hospitals, Erlangen, Germany
| | - Stefan Walcher
- Institute of Neuropathology, University Hospitals, Erlangen, Germany
| | - Christoph Neuner
- Institute of Neuropathology, University Hospitals, Erlangen, Germany
| | - Michael Scholz
- Institute of Anatomy, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Stefanie Kuerten
- Institute of Anatomy, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Verena Schropp
- Institute of Anatomy, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Sebastian Roeder
- Department of Neurology, University Hospitals Erlangen, Erlangen, Germany
| | - Philip Eichhorn
- Institute of Pathology, University Hospitals Erlangen, Erlangen, Germany
| | - Markus Eckstein
- Institute of Pathology, University Hospitals Erlangen, Erlangen, Germany
| | - Axel Brehmer
- Institute of Anatomy, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Katja Kobow
- Institute of Neuropathology, University Hospitals, Erlangen, Germany
| | - Roland Coras
- Institute of Neuropathology, University Hospitals, Erlangen, Germany
| | - Ingmar Blumcke
- Institute of Neuropathology, University Hospitals, Erlangen, Germany
| | - Samir Jabari
- Institute of Neuropathology, University Hospitals, Erlangen, Germany
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15
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Tamanini JVG, Rogerio F, Feitoza LDM, Caricati TA, Queiroz LS, Reis F. Primary sarcoma of the leptomeninges: unusual presentation and previously undescribed neuroimaging features. Arq Neuro-Psiquiatr 2019; 77:675-676. [DOI: 10.1590/0004-282x20190095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 04/07/2019] [Indexed: 11/21/2022]
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16
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Mota MVB, Zaidan BC, do Canto AM, Ghizoni E, Tedeschi H, de Souza Queiroz L, Alvim MKM, Cendes F, Lopes-Cendes I, Schenka AA, Vieira AS, Rogerio F. ATP Synthase Subunit Beta Immunostaining is Reduced in the Sclerotic Hippocampus of Epilepsy Patients. Cell Mol Neurobiol 2018; 39:149-160. [DOI: 10.1007/s10571-018-0641-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 12/06/2018] [Indexed: 01/30/2023]
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17
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Reis F, Fukuda A, Bonfitto JFL, Schwingel R, Queiroz LS, Rogerio F, Delamain MT. Primary central nervous system post-transplant lymphoproliferative disorder mimicking toxoplasmosis. Arq Neuropsiquiatr 2018; 76:566-567. [PMID: 30231131 DOI: 10.1590/0004-282x20180049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 03/05/2018] [Indexed: 11/22/2022]
Affiliation(s)
- Fabiano Reis
- Universidade Estadual de Campinas, Hospital das Clínicas, Campinas SP, Brasil
| | - Aya Fukuda
- Universidade Estadual de Campinas, Hospital das Clínicas, Campinas SP, Brasil
| | | | - Ricardo Schwingel
- Universidade Estadual de Campinas, Departamento de Radiologia, Campinas SP, Brasil
| | | | - Fabio Rogerio
- Universidade Estadual de Campinas, Departamento de Patologia, Campinas SP, Brasil
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18
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Avansini SH, Torres FR, Vieira AS, Dogini DB, Rogerio F, Coan AC, Morita ME, Guerreiro MM, Yasuda CL, Secolin R, Carvalho BS, Borges MG, Almeida VS, Araújo PAOR, Queiroz L, Cendes F, Lopes-Cendes I. Dysregulation of NEUROG2 plays a key role in focal cortical dysplasia. Ann Neurol 2018; 83:623-635. [PMID: 29461643 PMCID: PMC5901021 DOI: 10.1002/ana.25187] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 02/16/2018] [Accepted: 02/16/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Focal cortical dysplasias (FCDs) are an important cause of drug-resistant epilepsy. In this work, we aimed to investigate whether abnormal gene regulation, mediated by microRNA, could be involved in FCD type II. METHODS We used total RNA from the brain tissue of 16 patients with FCD type II and 28 controls. MicroRNA expression was initially assessed by microarray. Quantitative polymerase chain reaction, in situ hybridization, luciferase reporter assays, and deep sequencing for genes in the mTOR pathway were performed to validate and further explore our initial study. RESULTS hsa-let-7f (p = 0.039), hsa-miR-31 (p = 0.0078), and hsa-miR34a (p = 0.021) were downregulated in FCD type II, whereas a transcription factor involved in neuronal and glial fate specification, NEUROG2 (p < 0.05), was upregulated. We also found that the RND2 gene, a NEUROG2-target, is upregulated (p < 0.001). In vitro experiments showed that hsa-miR-34a downregulates NEUROG2 by binding to its 5'-untranslated region. Moreover, we observed strong nuclear expression of NEUROG2 in balloon cells and dysmorphic neurons and found that 28.5% of our patients presented brain somatic mutations in genes of the mTOR pathway. INTERPRETATION Our findings suggest a new molecular mechanism, in which NEUROG2 has a pivotal and central role in the pathogenesis of FCD type II. In this way, we found that the downregulation of hsa-miR-34a leads to upregulation of NEUROG2, and consequently to overexpression of the RND2 gene. These findings indicate that a faulty coupling in neuronal differentiation and migration mechanisms may explain the presence of aberrant cells and complete dyslamination in FCD type II. Ann Neurol 2018;83:623-635.
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Affiliation(s)
- Simoni H Avansini
- Department of Medical Genetics, University of Campinas and Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Fábio R Torres
- Department of Medical Genetics, University of Campinas and Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - André S Vieira
- Department of Medical Genetics, University of Campinas and Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Danyella B Dogini
- Department of Medical Genetics, University of Campinas and Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Fabio Rogerio
- Department of Anatomical Pathology, University of Campinas and Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Ana C Coan
- Department of Neurology, University of Campinas and Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Marcia E Morita
- Department of Neurology, University of Campinas and Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Marilisa M Guerreiro
- Department of Neurology, University of Campinas and Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Clarissa L Yasuda
- Department of Neurology, University of Campinas and Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Rodrigo Secolin
- Department of Medical Genetics, University of Campinas and Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Benilton S Carvalho
- Department of Medical Genetics, University of Campinas and Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Murilo G Borges
- Department of Medical Genetics, University of Campinas and Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Vanessa S Almeida
- Department of Medical Genetics, University of Campinas and Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Patrícia A O R Araújo
- Department of Medical Genetics, University of Campinas and Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Luciano Queiroz
- Department of Anatomical Pathology, University of Campinas and Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Fernando Cendes
- Department of Neurology, University of Campinas and Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Iscia Lopes-Cendes
- Department of Medical Genetics, University of Campinas and Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
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Rogerio F, de Souza Queiroz L, Reis F, Fukuda A, Silva NA, Joaquim AF. A 32-Year-Old Man with Headache and Visual Loss. Brain Pathol 2017; 27:559-560. [PMID: 28585388 DOI: 10.1111/bpa.12530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Fabio Rogerio
- Departments of Pathology, State University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Fabiano Reis
- Departments of Radiology, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Aya Fukuda
- Departments of Radiology, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Nivaldo Adolfo Silva
- Departments of Radiology, State University of Campinas (UNICAMP), Campinas, Brazil
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20
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Tani VM, Assis-Mendonça GR, da Silva TB, Rogerio F, De Paula EV. Microvascular thrombosis in sepsis: An autopsy study. Thromb Res 2017; 156:23-25. [PMID: 28578247 DOI: 10.1016/j.thromres.2017.05.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 04/25/2017] [Accepted: 05/27/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Vanessa M Tani
- Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | | | | | - Fabio Rogerio
- Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Erich V De Paula
- Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
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21
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Avansini SH, de Sousa Lima BP, Secolin R, Santos ML, Coan AC, Vieira AS, Torres FR, Carvalho BS, Alvim MKM, Morita ME, Yasuda CL, Pimentel-Silva LR, Dogini DB, Rogerio F, Cendes F, Lopes-Cendes I. MicroRNA hsa-miR-134 is a circulating biomarker for mesial temporal lobe epilepsy. PLoS One 2017; 12:e0173060. [PMID: 28384161 PMCID: PMC5383023 DOI: 10.1371/journal.pone.0173060] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 02/14/2017] [Indexed: 01/03/2023] Open
Abstract
Epilepsy is misdiagnosed in up to 25% of patients, leading to serious and long-lasting consequences. Recently, circulating microRNAs have emerged as potential biomarkers in a number of clinical scenarios. The purpose of this study was to identify and to validate circulating microRNAs that could be used as biomarkers in the diagnosis of epilepsy. Quantitative real-time PCR was used to measure plasma levels of three candidate microRNAs in two phases of study: an initial discovery phase with 14 patients with mesial temporal lobe epilepsy (MTLE), 13 with focal cortical dysplasia (FCD) and 16 controls; and a validation cohort constituted of an independent cohort of 65 patients with MTLE and 83 controls. We found hsa-miR-134 downregulated in patients with MTLE (p = 0.018) but not in patients with FCD, when compared to controls. Furthermore, hsa-miR-134 expression could be used to discriminate MTLE patients with an area under the curve (AUC) of 0.75. To further assess the robustness of hsa-miR-134 as a biomarker for MTLE, we studied an independent cohort of 65 patients with MTLE, 27 of whom MTLE patients were responsive to pharmacotherapy, and 38 patients were pharmacoresistant and 83 controls. We confirmed that hsa-miR-134 was significantly downregulated in the plasma of patients with MTLE when compared with controls (p < 0.001). In addition, hsa-miR-134 identified patients with MTLE regardless of their response to pharmacotherapy or the presence of MRI signs of hippocampal sclerosis. We revealed that decreased expression of hsa-miR-134 could be a potential non-invasive biomarker to support the diagnosis of patients with MTLE.
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Affiliation(s)
- Simoni H. Avansini
- Department of Medical Genetics, University of Campinas - UNICAMP, and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, São Paulo, Brazil
| | - Beatriz Pereira de Sousa Lima
- Department of Medical Genetics, University of Campinas - UNICAMP, and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, São Paulo, Brazil
| | - Rodrigo Secolin
- Department of Medical Genetics, University of Campinas - UNICAMP, and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, São Paulo, Brazil
| | - Marilza L. Santos
- Department of Medical Genetics, University of Campinas - UNICAMP, and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, São Paulo, Brazil
| | - Ana Carolina Coan
- Department of Neurology, University of Campinas - UNICAMP, and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, São Paulo, Brazil
| | - André S. Vieira
- Department of Medical Genetics, University of Campinas - UNICAMP, and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, São Paulo, Brazil
| | - Fábio R. Torres
- Department of Medical Genetics, University of Campinas - UNICAMP, and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, São Paulo, Brazil
| | - Benilton S. Carvalho
- Department of Statistics, Institute of Mathematics, Statistics and Scientific Computing, University of Campinas - UNICAMP, and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, São Paulo, Brazil
| | - Marina K. M. Alvim
- Department of Neurology, University of Campinas - UNICAMP, and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, São Paulo, Brazil
| | - Márcia E. Morita
- Department of Neurology, University of Campinas - UNICAMP, and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, São Paulo, Brazil
| | - Clarissa L. Yasuda
- Department of Neurology, University of Campinas - UNICAMP, and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, São Paulo, Brazil
| | - Luciana R. Pimentel-Silva
- Department of Neurology, University of Campinas - UNICAMP, and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, São Paulo, Brazil
| | - Danyella B. Dogini
- Department of Medical Genetics, University of Campinas - UNICAMP, and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, São Paulo, Brazil
| | - Fabio Rogerio
- Department of Anatomical Pathology, University of Campinas - UNICAMP, and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, São Paulo, Brazil
| | - Fernando Cendes
- Department of Neurology, University of Campinas - UNICAMP, and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, São Paulo, Brazil
| | - Iscia Lopes-Cendes
- Department of Medical Genetics, University of Campinas - UNICAMP, and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, São Paulo, Brazil
- * E-mail:
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Ignarro RS, Facchini G, de Melo DR, Pelizzaro-Rocha KJ, Ferreira CV, Castilho RF, Rogerio F. Characteristics of sulfasalazine-induced cytotoxicity in C6 rat glioma cells. Neurosci Lett 2017; 638:189-195. [DOI: 10.1016/j.neulet.2016.12.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 12/14/2016] [Accepted: 12/15/2016] [Indexed: 12/12/2022]
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Montgomery RM, Queiroz LDS, Rogerio F. EGFR, p53, IDH-1 and MDM2 immunohistochemical analysis in glioblastoma: therapeutic and prognostic correlation. Arq Neuropsiquiatr 2015. [PMID: 26200049 DOI: 10.1590/0004-282x20150059] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We studied 36 glioblastoma cases at HC-UNICAMP from 2008 to 2012 and classified the immunohistochemical distribution of the wild-type epidermal growth factor receptor (EGFR), mutated forms of p53 protein and isocitrate dehydrogenase-1 (IDH-1) and murine double protein 2 (MDM2). Immunostaining findings were correlated with clinical data and response to treatment (surgery, chemotherapy and radiotherapy). About 97% of the tumors were primary, most of them localized in the frontal lobe. Mean time free of clinical or symptomatic disease and free time of radiological disease were 7.56 and 7.14 months, respectively. We observed a significant positive correlation between expressions of p53 and MDM2, EGFR and MDM2. Clinical, radiological and overall survivals also showed a significant positive correlation. p53 staining and clinical survival showed a significant negative correlation. The current series provides clinical and histopathological data that contribute to knowledge on glioblastoma in Brazilians.
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Affiliation(s)
- Richard Murdoch Montgomery
- Departamento de Anatomia Patológica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Luciano de Souza Queiroz
- Departamento de Anatomia Patológica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Fabio Rogerio
- Departamento de Anatomia Patológica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Virginio VW, Nunes VS, Moura FA, Menezes FH, Andreollo NA, Rogerio F, Quintao EC, Scherrer DZ, Petrucci O, Faria EC, Sposito AC. Arterial tissue and plasma concentration of enzymatic-derived oxysterols are associated with atherosclerotic disease and systemic inflammatory activity. BBA Clinical 2015. [DOI: 10.1016/j.bbacli.2015.05.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Rogerio F, de Souza Queiroz L. 37-year-old female with intraventricular mass. Brain Pathol 2015; 25:227-8. [PMID: 25677065 DOI: 10.1111/bpa.12243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Fabio Rogerio
- Department of Pathology, State University of Campinas-Unicamp, Brazil
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Virginio VWM, Nunes VS, Moura FA, Menezes FH, Andreollo NA, Rogerio F, Scherrer DZ, Quintão ECR, Nakandakare E, Petrucci O, Nadruz-Junior W, de Faria EC, Sposito AC. Arterial tissue and plasma concentration of enzymatic-driven oxysterols are associated with severe peripheral atherosclerotic disease and systemic inflammatory activity. Free Radic Res 2014; 49:199-203. [PMID: 25465091 DOI: 10.3109/10715762.2014.992894] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Cholesterol undergoes oxidation via both enzymatic stress- and free radical-mediated mechanisms, generating a wide range of oxysterols. In contrast to oxidative stress-driven metabolites, enzymatic stress-derived oxysterols are scarcely studied in their association with atherosclerotic disease in humans. METHODS 24S-hydroxycholesterol (24S-HC), 25-hydroxycholesterol (25-HC), and 27-hydroxycholesterol (27-HC) were assessed in plasma and arteries with atherosclerotic plaques from 10 patients (54-84 years) with severe peripheral artery disease (PAD) as well as arteries free of atherosclerotic plaques from 13 individuals (45-78 years, controls). RESULTS Plasma 25-HC was higher in PAD individuals than in controls (6.3[2] vs. 3.9[1.9] ng/mgCol; p = 0.004). 24S-HC and 27-HC levels were, respectively, five- and 20-fold higher in the arterial tissue of PAD individuals than in those of the controls (p = 0.016 and p = 0.001). Plasma C-reactive protein correlated with plasma 24-HC (r = 0.51; p = 0.010), 25-HC (r = 0.75; p < 0.001), 27-HC (r = 0.48; p = 0.015), and with tissue 24S-HC (r = 0.4; p = 0.041) and 27-HC (r = 0.46; p = 0.023). CONCLUSION Arterial intima accumulation of 27-HC and 24S-HC is associated with advanced atherosclerotic disease and systemic inflammatory activity in individuals with severe PAD.
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Affiliation(s)
- V W M Virginio
- Lipid Laboratory and Center for Medicine and Experimental Surgery, Faculty of Medical Sciences, University of Campinas , Campinas, SP , Brazil
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Rogerio F, Morita ME, Coan AC, Guerreiro CAM, Tedeschi H, Coras R, de Souza Queiroz L, Blümcke I, Cendes F. Hippocampal dysplasia with balloon cells: case report and discussion on classification. J Neurol 2014; 261:2022-4. [DOI: 10.1007/s00415-014-7486-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 08/29/2014] [Accepted: 08/30/2014] [Indexed: 12/19/2022]
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Coras R, de Boer OJ, Armstrong D, Becker A, Jacques TS, Miyata H, Thom M, Vinters HV, Spreafico R, Oz B, Marucci G, Pimentel J, Mühlebner A, Zamecnik J, Buccoliero AM, Rogerio F, Streichenberger N, Arai N, Bugiani M, Vogelgesang S, Macaulay R, Salon C, Hans V, Polivka M, Giangaspero F, Fauziah D, Kim JH, Liu L, Dandan W, Gao J, Lindeboom B, Blümcke I, Aronica E. Good interobserver and intraobserver agreement in the evaluation of the new ILAE classification of focal cortical dysplasias. Epilepsia 2012; 53:1341-8. [PMID: 22642611 DOI: 10.1111/j.1528-1167.2012.03508.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE An International League Against Epilepsy (ILAE) consensus classification system for focal cortical dysplasias (FCDs) has been published in 2011 specifying clinicopathologic FCD variants. The aim of the present work was to microscopically assess interobserver agreement and intraobserver reproducibility for FCD categories among an international group of neuropathologists with different levels of experience and access to epilepsy surgery tissue. METHODS Surgical FCD specimens covering a broad histopathology spectrum were retrieved from 22 patients with epilepsy. Three surgical nonepilepsy specimens served as controls. A total of 188 slides with routine or immunohistochemical stainings were digitalized with a slide scanner to allow Internet-based microscopy review. Nine experienced neuropathologists were invited to review these cases twice at a time gap of 3 months and different orders of case presentation. The 2011 ILAE FCD consensus classification served as instruction. Kappa analysis was calculated to estimate interobserver and intraobserver agreement levels. In a third evaluation round, 21 additional neuropathologists with different experience and access to epilepsy surgery reviewed the same case series. KEY FINDINGS Interobserver agreement was good (κ = 0.6360), with 84% consensus of diagnoses during the first evaluation (21 of 25 cases). Kappa values increased to 0.6532 after reevaluation, and consensus was obtained in 24 (96%) of 25 cases. Overall intraobserver reproducibility was also good (κ = 0.7824, ranging from 0.4991 to 1.000). Fewest changes in the classification were made in the FCD type II group (2.2% of 225 original diagnoses), whereas the majority of changes occurred in FCD type III (13.7% of 225 original diagnoses). In the third evaluation round, interobserver agreement was reflected by the level of experience of each neuropathologist, with κ values ranging from moderate (0.5056; high level of experience >40 cases/year) to low (0.3265; low level of experience <10 cases/year). SIGNIFICANCE Our study achieved a good and reliable interobserver agreement among the group of expert neuropathologists originally involved in the ILAE FCD consensus classification system. Intraobserver reproducibility in this group was even more robust. These results showed considerable improvement compared to a previous study evaluating the 2004 Palmini FCD classification. Agreement levels were lower in our second group of neuropathologists and were related to their level of access and experience with epilepsy surgery specimens. These results suggested that the more precise ILAE definition of FCD histopathology patterns improves operational procedures in the diagnosis of FCDs. On the other hand, microscopic assessment of FCD is a challenge and requires sustained experience and teaching. The virtual slide review system allowed testing of this hypothesis and reached a widespread group of participating colleagues from different centers all over the world. We propose to further use this tool as a teaching device and also to address other epilepsy-associated entities still difficult to classify such as hippocampal sclerosis, long-term epilepsy-associated tumors, or mild malformations of cortical development (mMCDs), which were not yet covered by current ILAE classification systems.
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Affiliation(s)
- Roland Coras
- Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany.
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Avansini S, Torres F, Rogerio F, Dogini D, Coan A, Secolin R, Rocha C, Costa A, Costa A, Piaza A, Reis L, Oliveira E, Tedeschi H, Queiroz L, Cendes F, Lopes-Cendes I. Investigating the Role of microRNAs Regulation in the Development of Focal Cortical Dysplasia (P05.081). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Reis F, Vieira GHA, Rogerio F, Guerreiro MM, Queiroz LDS, Zanardi VDA. Supratentorial primitive neuroectodermal tumor (PNET): an uncommon location. Arq Neuropsiquiatr 2012; 69:997. [PMID: 22297899 DOI: 10.1590/s0004-282x2011000700033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Fabiano Reis
- Department of Radiology, Clinics Hospital, Faculty of Medical Sciences, State University of Campinas, SP, Brazil.
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Abstract
Neonatal sciatic nerve lesion is a useful experimental model for the study of neuronal cell death. Sciatic nerve transection or crush is the most frequently used approach to evaluate motoneuron loss in the lumbar enlargement of the spinal cord. Here we describe and illustrate the surgical procedures performed in our laboratory to assess motoneuron cell death and the related cellular mechanisms.
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Affiliation(s)
- Andre Schwambach Vieira
- Department of Anatomy, Cellular Biology, Physiology and Biophysics, State University of Campinas, Campinas, SP, Brazil
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Macedo LT, Rogerio F, Pereira EB, de Souza Queiroz L, Carvalheira JBC. Cerebrospinal tumor dissemination in a patient with myxopapillary ependymoma. J Clin Oncol 2011; 29:e795-8. [PMID: 21990418 DOI: 10.1200/jco.2011.36.6625] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Affiliation(s)
- A K Taneja
- Department of Radiology of the Clinics Hospital of the State University of Campinas, Faculty of Medical Sciences, Campinas, Sao Paulo, Brazil.
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Rezende AC, Peroni D, Vieira AS, Rogerio F, Talaisys RL, Costa FTM, Langone F, Skaper SD, Negro A. Ciliary neurotrophic factor fused to a protein transduction domain retains full neuroprotective activity in the absence of cytokine-like side effects. J Neurochem 2009; 109:1680-90. [DOI: 10.1111/j.1471-4159.2009.06091.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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