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De Keersmaecker B, Jansen K, Aertsen M, Naulaers G, De Catte L. Outcome of partial agenesis of corpus callosum. Am J Obstet Gynecol 2024; 230:456.e1-456.e9. [PMID: 37816486 DOI: 10.1016/j.ajog.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND The diagnosis of corpus callosum anomalies by prenatal ultrasound has improved over the last decade because of improved imaging techniques, scanning skills, and the routine implementation of transvaginal neurosonography. OBJECTIVE Our aim was to investigate all cases of incomplete agenesis of the corpus callosum and to report the sonographic characteristics, the associated anomalies, and the perinatal outcomes. STUDY DESIGN We performed a retrospective analysis of cases from January 2007 to December 2017 with corpus callosum anomalies, either referred for a second opinion or derived from the prenatal ultrasound screening program in a single tertiary referral center. Cases with complete agenesis were excluded from the analysis. Standardized investigation included a detailed fetal ultrasound including neurosonogram, fetal karyotyping (standard karyotype or array comparative genomic hybridization) and fetal magnetic resonance imaging. The pregnancy outcome was collected, and pathologic investigation in case of termination of the pregnancy or fetal or neonatal loss was compared with the prenatal findings. The pregnancy and fetal or neonatal outcomes were reported. The neurologic assessment was conducted by a pediatric neurologist using the Bayley Scales of Infant Development-II and the standardized Child Development Inventory when the Bayley investigation was unavailable. RESULTS Corpus callosum anomalies were diagnosed in 148 cases during the study period, 62 (41.9%) of which were excluded because of complete agenesis, and 86 fetuses had partial agenesis (58.1%). In 20 cases, partial agenesis (23.2%) was isolated, whereas 66 (76.7%) presented with different malformations among which 29 cases (43.9%) were only central nervous system lesions, 21 cases (31.8%) were non-central nervous system lesions, and 16 cases (24.3%) had a combination of central nervous system and non-central nervous system lesions. The mean gestational age at diagnosis for isolated and non-isolated cases was comparable (24.29 [standard deviation, 5.05] weeks and 24.71 [standard deviation, 5.35] weeks, respectively). Of the 86 pregnancies with partial agenesis, 46 patients opted for termination of the pregnancy. Neurologic follow-up data were available for 35 children. The overall neurologic outcome was normal in 21 of 35 children (60%); 3 of 35 (8.6%) showed mild impairment and 6 of 35 (17.1%) showed moderate impairment. The remaining 5 of 35 (14.3%) had severe impairment. The median duration of follow-up for the isolated form was 45.6 months (range, 36-52 months) and 73.3 months (range, 2-138 months) for the nonisolated form. CONCLUSION Partial corpus callosum agenesis should be accurately investigated by neurosonography and fetal magnetic resonance imaging to describe its morphology and the associated anomalies. Genetic anomalies are frequently present in nonisolated cases. Efforts must be taken to improve ultrasound diagnosis of partial agenesis and to confirm its isolated nature to enhance parental counseling. Although 60% of children with prenatal diagnosis of isolated agenesis have a favorable prognosis later in life, they often have mild to severe disabilities including speech disorders at school age and behavior and motor deficit disorders that can emerge at a later age.
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Affiliation(s)
- Bart De Keersmaecker
- Fetal-Maternal Medicine Unit, Department of Obstetrics and Gynecology, University Hospital Leuven, Leuven, Belgium; Department of Obstetrics and Gynecology, AZ Groeninge, Kortrijk, Belgium; Department of Development and Regeneration, University Hospital Leuven, Leuven, Belgium
| | - Katrien Jansen
- Department of Development and Regeneration, University Hospital Leuven, Leuven, Belgium; Department of Pediatrics, Pediatric Neurology Unit, University Hospital Leuven, Leuven, Belgium
| | - Michael Aertsen
- Department of Development and Regeneration, University Hospital Leuven, Leuven, Belgium; Department of Radiology, University Hospital Leuven, Leuven, Belgium
| | - Gunner Naulaers
- Department of Development and Regeneration, University Hospital Leuven, Leuven, Belgium; Department of Pediatrics, Neonatal Unit, University Hospital Leuven, Leuven, Belgium
| | - Luc De Catte
- Fetal-Maternal Medicine Unit, Department of Obstetrics and Gynecology, University Hospital Leuven, Leuven, Belgium; Department of Development and Regeneration, University Hospital Leuven, Leuven, Belgium.
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Delafontaine S, Iannuzzo A, Bigley TM, Mylemans B, Rana R, Baatsen P, Poli MC, Rymen D, Jansen K, Mekahli D, Casteels I, Cassiman C, Demaerel P, Lepelley A, Frémond ML, Schrijvers R, Bossuyt X, Vints K, Huybrechts W, Tacine R, Willekens K, Corveleyn A, Boeckx B, Baggio M, Ehlers L, Munck S, Lambrechts D, Voet A, Moens L, Bucciol G, Cooper MA, Davis CM, Delon J, Meyts I. Heterozygous mutations in the C-terminal domain of COPA underlie a complex autoinflammatory syndrome. J Clin Invest 2024; 134:e163604. [PMID: 38175705 PMCID: PMC10866661 DOI: 10.1172/jci163604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
Mutations in the N-terminal WD40 domain of coatomer protein complex subunit α (COPA) cause a type I interferonopathy, typically characterized by alveolar hemorrhage, arthritis, and nephritis. We described 3 heterozygous mutations in the C-terminal domain (CTD) of COPA (p.C1013S, p.R1058C, and p.R1142X) in 6 children from 3 unrelated families with a similar syndrome of autoinflammation and autoimmunity. We showed that these CTD COPA mutations disrupt the integrity and the function of coat protein complex I (COPI). In COPAR1142X and COPAR1058C fibroblasts, we demonstrated that COPI dysfunction causes both an anterograde ER-to-Golgi and a retrograde Golgi-to-ER trafficking defect. The disturbed intracellular trafficking resulted in a cGAS/STING-dependent upregulation of the type I IFN signaling in patients and patient-derived cell lines, albeit through a distinct molecular mechanism in comparison with mutations in the WD40 domain of COPA. We showed that CTD COPA mutations induce an activation of ER stress and NF-κB signaling in patient-derived primary cell lines. These results demonstrate the importance of the integrity of the CTD of COPA for COPI function and homeostatic intracellular trafficking, essential to ER homeostasis. CTD COPA mutations result in disease by increased ER stress, disturbed intracellular transport, and increased proinflammatory signaling.
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Affiliation(s)
- Selket Delafontaine
- Laboratory for Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Alberto Iannuzzo
- Université Paris Cité, CNRS, INSERM, Institut Cochin, Paris, France
| | - Tarin M. Bigley
- Department of Pediatrics, Division of Rheumatology/Immunology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Bram Mylemans
- Laboratory of Biomolecular Modelling and Design, Department of Chemistry, KU Leuven, Leuven, Belgium
| | - Ruchit Rana
- Division of Immunology, Allergy and Retrovirology, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - Pieter Baatsen
- Electron Microscopy Platform of VIB Bio Imaging Core, KU Leuven, Leuven, Belgium
| | - Maria Cecilia Poli
- Department of Pediatrics, Clínica Alemana de Santiago, Universidad del Desarollo, Santiago, Chile
- Immunology and Rheumatology Unit, Hospital de Niños Dr. Roberto del Rio, Santiago, Chile
| | - Daisy Rymen
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Katrien Jansen
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Djalila Mekahli
- PKD Research Group, Laboratory of Ion Channel Research, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
- Department of Pediatric Nephrology
| | | | | | - Philippe Demaerel
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Alice Lepelley
- Université Paris Cité, Imagine Institute, Laboratory of Neurogenetics and Neuroinflammation, INSERM UMR 1163, Paris, France
| | - Marie-Louise Frémond
- Université Paris Cité, Imagine Institute, Laboratory of Neurogenetics and Neuroinflammation, INSERM UMR 1163, Paris, France
- Paediatric Haematology-Immunology and Rheumatology Unit, Necker Hospital, AP-HP.Centre - Université Paris Cité, Paris, France
| | - Rik Schrijvers
- Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology and Transplantation, and
| | - Xavier Bossuyt
- Clinical and Diagnostic Immunology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Katlijn Vints
- Electron Microscopy Platform of VIB Bio Imaging Core, KU Leuven, Leuven, Belgium
| | - Wim Huybrechts
- Center for Human Genetics, Leuven University Hospitals, Leuven, Belgium
| | - Rachida Tacine
- Université Paris Cité, CNRS, INSERM, Institut Cochin, Paris, France
| | - Karen Willekens
- Center for Human Genetics, Leuven University Hospitals, Leuven, Belgium
| | - Anniek Corveleyn
- Center for Human Genetics, Leuven University Hospitals, Leuven, Belgium
| | - Bram Boeckx
- Laboratory for Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium
- VIB Center for Cancer Biology, Leuven, Belgium
| | - Marco Baggio
- Laboratory for Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Lisa Ehlers
- Laboratory for Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Sebastian Munck
- VIB Bio Imaging Core and VIB–KU Leuven Center for Brain & Disease Research, KU Leuven Department of Neurosciences, Leuven, Belgium
| | - Diether Lambrechts
- Laboratory for Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium
- VIB Center for Cancer Biology, Leuven, Belgium
| | - Arnout Voet
- Laboratory of Biomolecular Modelling and Design, Department of Chemistry, KU Leuven, Leuven, Belgium
| | - Leen Moens
- Laboratory for Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Giorgia Bucciol
- Laboratory for Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Megan A. Cooper
- Department of Pediatrics, Division of Rheumatology/Immunology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Carla M. Davis
- Division of Immunology, Allergy and Retrovirology, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - Jérôme Delon
- Université Paris Cité, CNRS, INSERM, Institut Cochin, Paris, France
| | - Isabelle Meyts
- Laboratory for Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
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Guimarães GO, D'Angelo F, Brouillette K, Souza LDM, da Silva RA, Mondin TC, Pedrotti Moreira F, Kapczinski F, de Azevedo Cardoso T, Jansen K. Incidence and risk factors for anxiety disorders in young adults: A population-based prospective cohort study. Encephale 2023; 49:572-576. [PMID: 36253174 DOI: 10.1016/j.encep.2022.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 07/18/2022] [Accepted: 08/04/2022] [Indexed: 11/06/2022]
Abstract
Anxiety disorders are among the most common psychiatric disorders in the general population. Our objective was to describe the cumulative incidence and risk factors of anxiety disorders, including obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD), in a follow-up of young adults over a five-year period. This is a prospective cohort conducted in two waves. The first took place from 2007 to 2009, in which 1,560 young adults aged between 18 and 24 years were evaluated using the Mini-International Neuropsychiatric Interview (MINI). Subjects were invited to participate in the second wave, which wave took place from 2012 to 2014, where 1,244 young adults were evaluated using the MINI-Plus. Our findings showed a cumulative incidence of 10.9% for any anxiety disorder, 6.5% for generalized anxiety disorder, 6.0% for agoraphobia, 2.0% for OCD, 1.6% for panic disorder, 1.1% for social anxiety and 0.7% for PTSD. Being female and having had a depressive episode were risk factors to develop any anxiety disorder. We observed a high cumulative incidence of anxiety disorders in a population-based sample of young adults. Our data highlights the importance of the early identification of these disorders as this could lead to early illness detection, early illness management and a reduced burden of disease.
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Affiliation(s)
- G O Guimarães
- Department of Health and Behavior, Catholic University of Pelotas - Universidade Católica de Pelotas, Rua Gonçalves Chaves, 373, Sala 424C, 96015-560 Pelotas, RS, Brazil
| | - F D'Angelo
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - K Brouillette
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; School of Interdisciplinary Science, Life Sciences Program, McMaster University, Hamilton, ON, Canada
| | - L D M Souza
- Department of Health and Behavior, Catholic University of Pelotas - Universidade Católica de Pelotas, Rua Gonçalves Chaves, 373, Sala 424C, 96015-560 Pelotas, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - R A da Silva
- Department of Health and Behavior, Catholic University of Pelotas - Universidade Católica de Pelotas, Rua Gonçalves Chaves, 373, Sala 424C, 96015-560 Pelotas, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - T C Mondin
- Department of Health and Behavior, Catholic University of Pelotas - Universidade Católica de Pelotas, Rua Gonçalves Chaves, 373, Sala 424C, 96015-560 Pelotas, RS, Brazil; Pró-Reitoria de Assuntos Estudantis (PRAE), Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - F Pedrotti Moreira
- Department of Health and Behavior, Catholic University of Pelotas - Universidade Católica de Pelotas, Rua Gonçalves Chaves, 373, Sala 424C, 96015-560 Pelotas, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - F Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil; Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada; Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - T de Azevedo Cardoso
- Department of Health and Behavior, Catholic University of Pelotas - Universidade Católica de Pelotas, Rua Gonçalves Chaves, 373, Sala 424C, 96015-560 Pelotas, RS, Brazil; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; School of Interdisciplinary Science, Life Sciences Program, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - K Jansen
- Department of Health and Behavior, Catholic University of Pelotas - Universidade Católica de Pelotas, Rua Gonçalves Chaves, 373, Sala 424C, 96015-560 Pelotas, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil.
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Sourbron J, Proost R, Jansen K, Riva A, Eschermann K, Barnett JR, Lagae L. A novel GABRG2 variant in Sunflower syndrome: A case report and video EEG monitoring. Epileptic Disord 2023; 25:815-822. [PMID: 37632399 DOI: 10.1002/epd2.20154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/20/2023] [Accepted: 08/21/2023] [Indexed: 08/28/2023]
Abstract
OBJECTIVE Sunflower syndrome is a unique photosensitive epilepsy, characterized by heliotropism and stereotyped seizures associated with handwaving. These handwaving events (HWE) are thought to be an ictal phenomenon, although current data are contrasting. Photosensitive epilepsy occurs in 2%-5% of the epilepsy forms and several pathogenic gene variants have been associated with photosensitive epilepsy. However, the genetic etiology of Sunflower syndrome remains unknown. Antiseizure medications (ASM) efficacious in treating photosensitive epilepsy are valproic acid (VPA) and levetiracetam (LEV) although some forms, such as Sunflower syndrome, can be drug-resistant. METHODS AND RESULTS Here, we report an 8-year-old boy with an early onset of episodes of HWE that was initially categorized as behavioral problems for which risperidone was started. However, the medical history was suggestive of Sunflower syndrome, and subsequent video EEG showed focal mostly temporal and frontotemporal (right and left) epileptiform activity and confirmed the epileptic nature of the HWE. Thus, VPA was started and initially led to seizure frequency reduction. Molecular analyses showed a pathogenic variant in GABRG2 (c.1287G>A p.(Trp429Ter)), which has been associated with photosensitive and generalized epilepsy. SIGNIFICANCE Overall, clinicians worldwide should be cautious by interpreting HWE and/or other tic-like movements, since an epileptic origin cannot be ruled out. A prompt and correct diagnosis can be made by performing a video EEG early on in the diagnostic process when epileptic seizures are part of the differential diagnosis. Even though the genetic etiology of Sunflower syndrome remains poorly understood, this constellation supports further genetic testing since the detection of a pathogenic variant can help in making correct decisions regarding ASM management.
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Affiliation(s)
- Jo Sourbron
- Section Pediatric Neurology, Department of Development and Regeneration, University Hospital KU Leuven, Leuven, Belgium
- Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Renee Proost
- Section Pediatric Neurology, Department of Development and Regeneration, University Hospital KU Leuven, Leuven, Belgium
| | - Katrien Jansen
- Section Pediatric Neurology, Department of Development and Regeneration, University Hospital KU Leuven, Leuven, Belgium
| | - Antonella Riva
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, Italy
- IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Kirsten Eschermann
- Research Institute for Rehabilitation, Transition and Palliation, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital of the Paracelsus Medical University, Salzburg, Austria
- Clinic for Neuropediatrics and Neurological Rehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik Vogtareuth, Vogtareuth, Germany
| | - James Richard Barnett
- Pediatric Epilepsy, Program Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Lieven Lagae
- Section Pediatric Neurology, Department of Development and Regeneration, University Hospital KU Leuven, Leuven, Belgium
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Japaridze G, Loeckx D, Buckinx T, Armand Larsen S, Proost R, Jansen K, MacMullin P, Paiva N, Kasradze S, Rotenberg A, Lagae L, Beniczky S. Automated detection of absence seizures using a wearable electroencephalographic device: a phase 3 validation study and feasibility of automated behavioral testing. Epilepsia 2023; 64 Suppl 4:S40-S46. [PMID: 35176173 DOI: 10.1111/epi.17200] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/01/2022] [Accepted: 02/14/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Our primary goal was to measure the accuracy of fully automated absence seizure detection, using a wearable electroencephalographic (EEG) device. As a secondary goal, we also tested the feasibility of automated behavioral testing triggered by the automated detection. METHODS We conducted a phase 3 clinical trial (NCT04615442), with a prospective, multicenter, blinded study design. The input was the one-channel EEG recorded with dry electrodes embedded into a wearable headband device connected to a smartphone. The seizure detection algorithm was developed using artificial intelligence (convolutional neural networks). During the study, the predefined algorithm, with predefined cutoff value, analyzed the EEG in real time. The gold standard was derived from expert evaluation of simultaneously recorded full-array video-EEGs. In addition, we evaluated the patients' responsiveness to the automated alarms on the smartphone, and we compared it with the behavioral changes observed in the clinical video-EEGs. RESULTS We recorded 102 consecutive patients (57 female, median age = 10 years) on suspicion of absence seizures. We recorded 364 absence seizures in 39 patients. Device deficiency was 4.67%, with a total recording time of 309 h. Average sensitivity per patient was 78.83% (95% confidence interval [CI] = 69.56%-88.11%), and median sensitivity was 92.90% (interquartile range [IQR] = 66.7%-100%). The average false detection rate was .53/h (95% CI = .32-.74). Most patients (n = 66, 64.71%) did not have any false alarms. The median F1 score per patient was .823 (IQR = .57-1). For the total recording duration, F1 score was .74. We assessed the feasibility of automated behavioral testing in 36 seizures; it correctly documented nonresponsiveness in 30 absence seizures, and responsiveness in six electrographic seizures. SIGNIFICANCE Automated detection of absence seizures with a wearable device will improve seizure quantification and will promote assessment of patients in their home environment. Linking automated seizure detection to automated behavioral testing will provide valuable information from wearable devices.
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Affiliation(s)
| | | | | | - Sidsel Armand Larsen
- Department of Clinical Neurophysiology, Danish Epilepsy Center Filadelfia, Dianalund, Denmark
| | | | | | - Paul MacMullin
- Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Natalia Paiva
- Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sofia Kasradze
- Institute of Neurology and Neuropsychology, Tbilisi, Georgia
| | - Alexander Rotenberg
- Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Sándor Beniczky
- Department of Clinical Neurophysiology, Danish Epilepsy Center Filadelfia, Dianalund, Denmark
- Department of Clinical Neurophysiology, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Dzhus M, Ehlers L, Wouters M, Jansen K, Schrijvers R, De Somer L, Vanderschueren S, Baggio M, Moens L, Verhaaren B, Lories R, Bucciol G, Meyts I. A Narrative Review of the Neurological Manifestations of Human Adenosine Deaminase 2 Deficiency. J Clin Immunol 2023; 43:1916-1926. [PMID: 37548813 PMCID: PMC10661818 DOI: 10.1007/s10875-023-01555-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 07/14/2023] [Indexed: 08/08/2023]
Abstract
Deficiency of human adenosine deaminase type 2 (DADA2) is a complex systemic autoinflammatory disorder characterized by vasculopathy, immune dysregulation, and hematologic abnormalities. The most notable neurological manifestations of DADA2 are strokes that can manifest with various neurological symptoms and are potentially fatal. However, neurological presentations can be diverse. We here present a review of the neurological manifestations of DADA2 to increase clinical awareness of DADA2 as the underlying diagnosis. We reviewed all published cases of DADA2 from 1 January 2014 until 19 July 2022 found via PubMed. A total of 129 articles describing the clinical features of DADA2 were included in the analysis. Six hundred twenty-eight patients diagnosed with DADA2 were included in the review. 50.3% of patients had at least signs of one reported neurological event, which was the initial or sole manifestation in 5.7% and 0.6%, respectively. 77.5% of patients with neurological manifestations had at least signs of one cerebrovascular accident, with lacunar strokes being the most common and 35.9% of them having multiple stroke episodes. There is a remarkable predilection for the brain stem and deep gray matter, with 37.3% and 41.6% of ischemic strokes, respectively. Other neurological involvement included neuropathies, focal neurological deficits, ophthalmological findings, convulsions, and headaches. In summary, neurological manifestations affect a significant proportion of patients with DADA2, and the phenotype is broad. Neurological manifestations can be the first and single manifestation of DADA2. Therefore, stroke, encephalitis, posterior reversible encephalopathy syndrome, mononeuropathy and polyneuropathy, and Behçet's disease-like presentations should prompt the neurologist to exclude DADA2, especially but not only in childhood.
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Affiliation(s)
- Mariia Dzhus
- Department of Microbiology, Immunology and Transplantation, Inborn Errors of Immunity, KU Leuven, Leuven, Belgium
| | - Lisa Ehlers
- Department of Microbiology, Immunology and Transplantation, Inborn Errors of Immunity, KU Leuven, Leuven, Belgium
| | - Marjon Wouters
- Department of Microbiology, Immunology and Transplantation, Inborn Errors of Immunity, KU Leuven, Leuven, Belgium
| | - Katrien Jansen
- Department of Development and Regeneration, Department of Pediatrics, University Hospitals Leuven and KU Leuven, Leuven, Belgium
| | - Rik Schrijvers
- Department of General Internal Medicine-Allergy and Clinical Immunology, Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology and Transplantation, University Hospitals Leuven and KU Leuven, Leuven, Belgium
| | - Lien De Somer
- Department of Pediatric Rheumatology, Laboratory of Immunobiology, Rega Institute, European Reference Network for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases, University Hospital Leuven and KU Leuven, Leuven, Belgium
| | - Steven Vanderschueren
- Department of General Internal Medicine, European Reference Network for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases, Department of Microbiology, Immunology and Transplantation, University Hospitals Leuven and KU Leuven, Leuven, Belgium
| | - Marco Baggio
- Department of Microbiology, Immunology and Transplantation, Inborn Errors of Immunity, KU Leuven, Leuven, Belgium
| | - Leen Moens
- Department of Microbiology, Immunology and Transplantation, Inborn Errors of Immunity, KU Leuven, Leuven, Belgium
| | | | - Rik Lories
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Centre, Division of Rheumatology, University Hospitals Leuven and KU Leuven, Leuven, Belgium
| | - Giorgia Bucciol
- Department of Microbiology, Immunology and Transplantation, Inborn Errors of Immunity, Department of Pediatrics, University Hospitals Leuven and KU Leuven, Leuven, Belgium
| | - Isabelle Meyts
- Department of Microbiology, Immunology and Transplantation, Inborn Errors of Immunity, Department of Pediatrics, European Reference Network for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases, University Hospitals Leuven and KU Leuven, Leuven, Belgium.
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7
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Proost R, Macea J, Lagae L, Van Paesschen W, Jansen K. Wearable detection of tonic seizures in childhood epilepsy: An exploratory cohort study. Epilepsia 2023; 64:3013-3024. [PMID: 37602476 DOI: 10.1111/epi.17756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/18/2023] [Accepted: 08/18/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVE To investigate the performance of a multimodal wearable device for the offline detection of tonic seizures (TS) in a pediatric childhood epilepsy cohort, with a focus on patients with Lennox-Gastaut syndrome. METHODS Parallel with prolonged video-electroencephalography (EEG), the Plug 'n Patch system, a multimodal wearable device using the Sensor Dot and replaceable electrode adhesives, was used to detect TS. Multiple biosignals were recorded: behind-the-ear EEG, surface electromyography, electrocardiography, and accelerometer/gyroscope. Biosignals were annotated blindly by a neurologist. Seizure characteristics were described, and performance was assessed by sensitivity, positive predictive value (PPV), F1 score, and false alarm rate (FAR) per hour. Performance was compared to seizure diaries kept by the caretaker. RESULTS Ninety-nine TS were detected in 13 patients. Seven patients (54%) had Lennox-Gastaut syndrome and six patients (46%) had other forms of (developmental) epileptic encephalopathies or drug-resistant epilepsy. All but one patient had intellectual disability. Overall sensitivity was 41%, with a PPV of 9%, an F1 score of 14%, and a median FAR per hour of 0.75. Performance increased to an F1 score of 66% for nightly seizures lasting at least 10 s (sensitivity 66%, PPV 66%) and 71% for nightly seizures lasting at least 20 s (sensitivity 62%, PPV 82%). For these seizures there were no false alarms in 10 of 13 patients. Sensitivity of seizure diaries reached a maximum of 52% for prolonged (≥20 s) nightly seizures, even though caretakers slept in the same room. SIGNIFICANCE We showed that it is feasible to use a multimodal wearable device with multiple adhesive sites in children with epilepsy and intellectual disability. For prolonged nightly seizures, offline manual detection of TS outperformed seizure diaries. The recognition of seizure-specific signatures using multiple modalities can help in the development of automated TS detection algorithms.
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Affiliation(s)
- Renee Proost
- Paediatric Neurology Department, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Jaiver Macea
- Neurology Department, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Lieven Lagae
- Paediatric Neurology Department, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Wim Van Paesschen
- Neurology Department, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Katrien Jansen
- Paediatric Neurology Department, University Hospitals Leuven, KU Leuven, Leuven, Belgium
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8
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Devos J, Devriendt K, Richter J, Jansen K, Baldewijns M, Thal DR, Aertsen M. Fetal-onset Alexander disease with radiological-neuropathological correlation. Pediatr Radiol 2023; 53:2149-2153. [PMID: 37455276 DOI: 10.1007/s00247-023-05710-w] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/16/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023]
Abstract
Alexander disease is a leukodystrophy caused by mutations in the GFAP gene, primarily affecting the astrocytes. This report describes the prenatal and post-mortem neuroimaging findings in a case of genetically confirmed, fetal-onset Alexander disease with pathological correlation after termination of pregnancy. The additional value of fetal brain magnetic resonance imaging in the third trimester as a complementary evaluation tool to neurosonography is shown for suspected cases of fetal-onset Alexander disease. Diffuse signal abnormalities of the periventricular white matter in association with thickening of the fornix and optic chiasm can point towards the diagnosis. Furthermore, the presence of atypical imaging findings such as microcephaly and cortical folding abnormalities in this case broadens our understanding of the phenotypic variability of Alexander disease.
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Affiliation(s)
- Johannes Devos
- Department of Radiology, University Hospitals Leuven (UZ), Herestraat 49, Louvain, 3000, Belgium.
| | - Koenraad Devriendt
- Center for Human Genetics, University of Leuven (KU) and University Hospitals Leuven (UZ), Louvain, Belgium
| | - Jute Richter
- Department of Gynecology and Obstetrics, University Hospitals Leuven (UZ), Louvain, Belgium
| | - Katrien Jansen
- Department of Development and Regeneration, University Hospitals Leuven (UZ), Louvain, Belgium
| | | | - Dietmar R Thal
- Laboratory for Neuropathology, Department of Imaging and Pathology and Leuven Brain Institute, University of Leuven (KU) and Department of Pathology, University Hospitals Leuven (UZ), Louvain, Belgium
| | - Michael Aertsen
- Department of Radiology, University Hospitals Leuven (UZ), Herestraat 49, Louvain, 3000, Belgium
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Meyts I, Bucciol G, Jansen K, Wollants E, Breuer J. Aichivirus: an Emerging Pathogen in Patients with Primary and Secondary B-Cell Deficiency. J Clin Immunol 2023; 43:532-535. [PMID: 36449139 DOI: 10.1007/s10875-022-01410-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/16/2022] [Indexed: 12/05/2022]
Affiliation(s)
- Isabelle Meyts
- Department of Pediatrics, Laboratory for Inborn Errors of Immunity, University Hospitals, KU Leuven, Herestraat 49, 3000, Leuven, EU, Belgium.
| | - Giorgia Bucciol
- Department of Pediatrics, Laboratory for Inborn Errors of Immunity, University Hospitals, KU Leuven, Herestraat 49, 3000, Leuven, EU, Belgium
| | - Katrien Jansen
- Department of Pediatrics, University Hospitals, KU Leuven, Herestraat 49, 3000, Leuven, EU, Belgium
| | - Elke Wollants
- Laboratory of Clinical and Epidemiological Virology (Rega Institute), KU Leuven, Herestraat 49, 3000, Leuven, EU, Belgium
| | - Judith Breuer
- Microbiology, Virology and Infection Prevention and Control, Great Ormond Street Hospital for Children, NHS Foundation Trust, Division of Infection and Immunity, University College London, London, UK
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10
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Rochtus A, Lagae L, Jansen K, De Somer L, Vermeulen F, de Zegher F. Reversible Hypothalamic Obesity in a Girl with Suprasellar Tuberculoma. Horm Res Paediatr 2023; 97:165-171. [PMID: 36977392 DOI: 10.1159/000530384] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
INTRODUCTION Suprasellar tuberculoma are extremely rare in children and most of those patients present with headache, vomiting, visual disturbances, and hypofunction of the pituitary gland. In this case report, we present a girl with tuberculosis, who developed significant weight gain in combination with pituitary dysfunction, which recovered after antituberculosis treatment. CASE PRESENTATION An 11-year old girl presented with headache, fever and anorexia that progressively evolved into an encephalopathic status with cranial nerves III and VI paresis. Brain MRI showed meningeal contrast capture along cranial nerves II (including optic chiasm), III, V and VI bilaterally and multiple contrast enhancing brain parenchyma lesions. Tuberculin skin test was negative but interferon-gamma release assay was positive. The clinical and radiological working diagnosis was consistent with tuberculous meningoencephalitis. Pulse corticosteroids for 3 days and quadruple antituberculosis therapy were started and the girl demonstrated obvious improvement of her neurological symptoms. However, after a few months of therapy she developed remarkable weight gain (+20 kg in 1 year) and growth arrest. Her hormone profile revealed insulin resistance (homeostasis model assessment-estimated insulin resistance [HOMA-IR] 6.8) despite putative growth hormone deficiency (circulating insulin-like growth factor-I [IGF-I] 104 μg/L [-2.4 SD]). Follow-up brain MRI showed a decrease in basal meningitis, but increased parenchymal lesions in the suprasellar region extending medially into the nucleus lentiformis, with now a voluminous tuberculoma at this site. Antituberculosis treatment was continued for a total of 18 months. The patient improved clinically, she regained her pre-illness Body Mass Index (BMI) SDS and her growth rate increased slightly. On the hormonal side, disappearance of insulin resistance (HOMA-IR 2.5) and an increase in IGF-I (175 μg/L, -1.4 SD) was noted, and her last brain MRI showed a remarkable volume reduction of the suprasellar tuberculoma. CONCLUSION Suprasellar tuberculoma can have a very dynamic presentation during the active stage of the disease, which can be reversed by prolonged antituberculosis treatment. Previous studies showed that the tuberculous process can also cause long term and irreversible changes in the hypothalamic-pituitary axis. Prospective studies are however needed in the pediatric population to know the exact incidence and type of pituitary dysfunction.
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Affiliation(s)
- Anne Rochtus
- Department of Development and Regeneration, Section Pediatric Endocrinology, University Hospital Leuven, Leuven, Belgium
- Department of Development and Regeneration, Section Pediatric Neurology, University Hospital Leuven, Leuven, Belgium
| | - Lieven Lagae
- Department of Development and Regeneration, Section Pediatric Neurology, University Hospital Leuven, Leuven, Belgium
| | - Katrien Jansen
- Department of Development and Regeneration, Section Pediatric Neurology, University Hospital Leuven, Leuven, Belgium
| | - Lien De Somer
- Department of Microbiology, Immunology and Transplantation, Section Pediatric Rheumatology, University Hospital Leuven, Leuven, Belgium
| | - François Vermeulen
- Department of Development and Regeneration, Section Pediatric Infectiology, University Hospital Leuven, Leuven, Belgium
| | - Francis de Zegher
- Department of Development and Regeneration, Section Pediatric Endocrinology, University Hospital Leuven, Leuven, Belgium
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11
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Hermans T, Smets L, Lemmens K, Dereymaeker A, Jansen K, Naulaers G, Zappasodi F, Van Huffel S, Comani S, De Vos M. A multi-task and multi-channel convolutional neural network for semi-supervised neonatal artefact detection. J Neural Eng 2023; 20. [PMID: 36791462 DOI: 10.1088/1741-2552/acbc4b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/15/2023] [Indexed: 02/17/2023]
Abstract
Objective. Automated artefact detection in the neonatal electroencephalogram (EEG) is crucial for reliable automated EEG analysis, but limited availability of expert artefact annotations challenges the development of deep learning models for artefact detection. This paper proposes a semi-supervised deep learning approach for artefact detection in neonatal EEG that requires few labelled data by training a multi-task convolutional neural network (CNN).Approach. An unsupervised and a supervised objective were jointly optimised by combining an autoencoder and an artefact classifier in one multi-output model that processes multi-channel EEG inputs. The proposed semi-supervised multi-task training strategy was compared to a classical supervised strategy and other existing state-of-the-art models. The models were trained and tested separately on two different datasets, which contained partially annotated multi-channel neonatal EEG. Models were evaluated using the F1-statistic and the relevance of the method was investigated in the context of a functional brain age (FBA) prediction model.Main results. The proposed multi-task and multi-channel CNN methods outperformed state-of-the-art methods, reaching F1 scores of 86.2% and 95.7% on two separate datasets. The proposed semi-supervised multi-task training strategy was shown to be superior to a classical supervised training strategy when the amount of labels in the dataset was artificially reduced. Finally, we found that the error of a brain age prediction model correlated with the amount of automatically detected artefacts in the EEG segment.Significance. Our results show that the proposed semi-supervised multi-task training strategy can train CNNs successfully even when the amount of labels in the dataset is limited. Therefore, this method is a promising semi-supervised technique for developing deep learning models with scarcely labelled data. Moreover, a correlation between the error of FBA estimates and the amount of detected artefacts in the corresponding EEG segments indicates the relevance of artefact detection for robust automated EEG analysis.
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Affiliation(s)
- Tim Hermans
- Department of Electrical Engineering (ESAT), STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, KU Leuven, Leuven, Belgium
| | - Laura Smets
- Department of Electrical Engineering (ESAT), STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, KU Leuven, Leuven, Belgium.,Department of Neuroscience, Imaging and Clinical Sciences, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Katrien Lemmens
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Neonatal Intensive Care Unit, UZ Leuven, Leuven, Belgium
| | - Anneleen Dereymaeker
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Neonatal Intensive Care Unit, UZ Leuven, Leuven, Belgium
| | - Katrien Jansen
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Child Neurology, UZ Leuven, Leuven, Belgium
| | - Gunnar Naulaers
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Neonatal Intensive Care Unit, UZ Leuven, Leuven, Belgium
| | - Filippo Zappasodi
- Department of Neuroscience, Imaging and Clinical Sciences, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy.,Behavioral Imaging and Neural Dynamics Center, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy.,Institute for Advanced Biomedical Technologies, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Sabine Van Huffel
- Department of Electrical Engineering (ESAT), STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, KU Leuven, Leuven, Belgium
| | - Silvia Comani
- Department of Neuroscience, Imaging and Clinical Sciences, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy.,Behavioral Imaging and Neural Dynamics Center, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Maarten De Vos
- Department of Electrical Engineering (ESAT), STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, KU Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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12
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Hermans T, Carkeek K, Dereymaeker A, Jansen K, Naulaers G, Van Huffel S, De Vos M. Partial wavelet coherence as a robust method for assessment of neurovascular coupling in neonates with hypoxic ischemic encephalopathy. Sci Rep 2023; 13:457. [PMID: 36627381 PMCID: PMC9832127 DOI: 10.1038/s41598-022-27275-8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 12/29/2022] [Indexed: 01/12/2023] Open
Abstract
In neonates with hypoxic ischemic encephalopathy, the computation of wavelet coherence between electroencephalogram (EEG) power and regional cerebral oxygen saturation (rSO2) is a promising method for the assessment of neurovascular coupling (NVC), which in turn is a promising marker for brain injury. However, instabilities in arterial oxygen saturation (SpO2) limit the robustness of previously proposed methods. Therefore, we propose the use of partial wavelet coherence, which can eliminate the influence of SpO2. Furthermore, we study the added value of the novel NVC biomarkers for identification of brain injury compared to traditional EEG and NIRS biomarkers. 18 neonates with HIE were monitored for 72 h and classified into three groups based on short-term MRI outcome. Partial wavelet coherence was used to quantify the coupling between C3-C4 EEG bandpower (2-16 Hz) and rSO2, eliminating confounding effects of SpO2. NVC was defined as the amount of significant coherence in a frequency range of 0.25-1 mHz. Partial wavelet coherence successfully removed confounding influences of SpO2 when studying the coupling between EEG and rSO2. Decreased NVC was related to worse MRI outcome. Furthermore, the combination of NVC and EEG spectral edge frequency (SEF) improved the identification of neonates with mild vs moderate and severe MRI outcome compared to using EEG SEF alone. Partial wavelet coherence is an effective method for removing confounding effects of SpO2, improving the robustness of automated assessment of NVC in long-term EEG-NIRS recordings. The obtained NVC biomarkers are more sensitive to MRI outcome than traditional rSO2 biomarkers and provide complementary information to EEG biomarkers.
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Affiliation(s)
- Tim Hermans
- Department of Electrical Engineering (ESAT), STADIUS, KU Leuven, Leuven, Belgium.
| | - Katherine Carkeek
- grid.5596.f0000 0001 0668 7884Department of Development and Regeneration, KU Leuven, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Neonatal Intensive Care Unit, UZ Leuven, Leuven, Belgium ,grid.48769.340000 0004 0461 6320Neonatal Intensive Care Unit, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - Anneleen Dereymaeker
- grid.5596.f0000 0001 0668 7884Department of Development and Regeneration, KU Leuven, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Neonatal Intensive Care Unit, UZ Leuven, Leuven, Belgium
| | - Katrien Jansen
- grid.5596.f0000 0001 0668 7884Department of Development and Regeneration, KU Leuven, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Child Neurology, UZ Leuven, Leuven, Belgium
| | - Gunnar Naulaers
- grid.5596.f0000 0001 0668 7884Department of Development and Regeneration, KU Leuven, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Neonatal Intensive Care Unit, UZ Leuven, Leuven, Belgium
| | - Sabine Van Huffel
- grid.5596.f0000 0001 0668 7884Department of Electrical Engineering (ESAT), STADIUS, KU Leuven, Leuven, Belgium
| | - Maarten De Vos
- grid.5596.f0000 0001 0668 7884Department of Electrical Engineering (ESAT), STADIUS, KU Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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Maes E, Cools F, Dereymaeker A, Jansen K, Naulaers G, Thewissen L. Cerebral oxygenation and body position in the preterm infant: A systematic review and meta-analysis. Acta Paediatr 2023; 112:42-52. [PMID: 36177661 DOI: 10.1111/apa.16558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/20/2022] [Accepted: 09/28/2022] [Indexed: 12/13/2022]
Abstract
AIM After preterm birth, supine head midline position is supported for stable cerebral blood flow (CBF) and prevention of intraventricular haemorrhage (IVH), while prone position supports respiratory function and enables skin-to-skin care. The prone compared to supine position could lead to a change in near-infrared derived cerebral tissue oxygen saturation (rScO2), which is a surrogate for cerebral blood flow (CBF). By monitoring rScO2 neonatologists aim to stabilise CBF during intensive care and prevent brain injury. In this systematic review and meta-analysis, we investigate the effect of the body position on rScO2. METHODS A comprehensive literature search was performed to identify all trials that included preterm infants in the first 2 weeks after birth and compared rScO2 in the prone versus supine head in midline position of the infant. A meta-analysis, including two subgroup analyses based on postnatal age (PNA) and gestational age (GA), was performed. RESULTS Six observational cohort studies were included. In the second, but not the first week after birth, a significant higher rScO2 in the prone position was found with a mean difference of 1.97% (95% CI 0.87-3.07). No rScO2 difference was observed between positions in the extremely preterm nor the preterm group. CONCLUSION No consistent evidence was found that body position influences rScO2 in the first 2 weeks after preterm birth. Subgroup analysis suggests that in the second week after birth, the prone position might result in higher cerebral rScO2 than the supine position with head in midline. Multiple factors determine the best body position in preterms.
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Affiliation(s)
- Eva Maes
- Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Filip Cools
- Neonatal Intensive Care Unit, University Hospital Brussels, Brussels, Belgium
| | - Anneleen Dereymaeker
- Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Katrien Jansen
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Pediatric Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Gunnar Naulaers
- Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Liesbeth Thewissen
- Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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14
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Jansen K, Michiels A, Voordeckers W, Steijvers T. Financing decisions in private family firms: a family firm pecking order. Small Bus Econ (Dordr) 2022; 61:1-21. [PMID: 38625293 PMCID: PMC9713752 DOI: 10.1007/s11187-022-00711-9] [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] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/18/2022] [Indexed: 04/17/2024]
Abstract
Abstract Family firms are one of the most ubiquitous forms of business organizations worldwide. Their survival and growth are thus not only crucial for the firms themselves but also for the overall economy. One of the factors that influence their survival and development are their financing decisions. These decisions are generally described through the pecking order theory. However, not much is known about the applicability of this theory in private family firms. Given the shortcomings (both theoretically and empirically) of the current literature, we analyze 1087 incremental financing decisions from 277 family firms to develop and test a specific family firm pecking order. We integrate the elements of the socioemotional wealth perspective to theoretically explain the preferred order and introduce family capital into the pecking order model. Our findings indicate that family firms first prefer internal financing, next debt financing, followed by family capital, and last external capital. We also find that SEW considerations play a role in this financing decision. Especially the retention of control over the firm and the aim to pass the firm to the next generation appear to play an important role in determining this order. These dimensions ensure that family firms try to avoid extra capital. However, when it is needed, they will opt for family capital over external capital. This paper thus provides more insight into the reasoning behind financing decisions in private family firms. Plain English Summary How do family firms finance their investments? When looking for ways to finance their investments, firms have several options. According to traditional finance theories, they generally follow a so-called pecking order: they prefer to first use their internal funds, before turning to external financing. For family firms, the most ubiquitous form of business organization worldwide, two important aspects have been ignored in this research until now. First, socioemotional aspects influence decision-making in family firms and thus probably also financing decisions. Next, the business family itself can act as an external source of finance, which is not yet accounted for in the current pecking order model. In this research, we take these issues into account in order to develop-theoretically and empirically-a family firm pecking order. We investigate over a thousand financing decisions of 277 privately held family firms. Our results show that they prefer internal financing, followed by bank debt, family capital, and external capital. Especially the retention of control over the firm and the aim to pass the firm to the next generation appear to play an important role in determining this order. Our research thus indicates that future research should pay attention to the peculiarities of family firms when investigating their financing decision.
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Affiliation(s)
- Katrien Jansen
- RCEF - Research Center for Entrepreneurship and Family Firms, Hasselt University, Agoralaan Building D, B-3590 Diepenbeek, Belgium
- Department of Accounting and Finance, University of Antwerp, Prinsstraat 13, 2000, Antwerpen, Belgium
| | - Anneleen Michiels
- RCEF - Research Center for Entrepreneurship and Family Firms, Hasselt University, Agoralaan Building D, B-3590 Diepenbeek, Belgium
| | - Wim Voordeckers
- RCEF - Research Center for Entrepreneurship and Family Firms, Hasselt University, Agoralaan Building D, B-3590 Diepenbeek, Belgium
| | - Tensie Steijvers
- RCEF - Research Center for Entrepreneurship and Family Firms, Hasselt University, Agoralaan Building D, B-3590 Diepenbeek, Belgium
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Constantine A, Condliffe R, Clift P, Jansen K, Wort SJ, Moledina S, Dimopoulos K. Macitentan for pulmonary arterial hypertension related to repaired congenital heart disease: real-world UK experience. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Patients with pulmonary arterial hypertension (PAH) following congenital heart disease (CHD) repair are an emerging population at increased risk of complications. Small numbers of such patients have been included in studies evaluating the efficacy of macitentan, but since obtaining a license for use in this population, limited real-world data have been published.
Purpose
To describe the safety and efficacy of macitentan therapy in a population of adults with repaired PAH-CHD.
Methods
We conducted a retrospective observational study of patients with repaired PAH-CHD newly started on macitentan in 2 UK specialist centres between 2014 and 2020. Clinical variables, including WHO functional class (FC), 6-minute walk (6MW) or incremental shuttle walk (ISW) distance, and EMPHASIS-10 score were recorded prior to and after initiation of macitentan therapy.
Results
Overall, 49 patients were included, 63.3% female, median age 40.8 [26.7–53.7] years at initiation of macitentan therapy. Macitentan was started as part of the initial PAH therapeutic regimen in 18 (36.7%) and was an add-on to existing therapy in 31 (63.3%) patients, of whom over a third (35.5%) were switched from another endothelin receptor antagonist. At the time of therapy initiation, most patients (68.4%) were in WHO functional class (FC) III, while 26.3% were in FC II and 5.3% in FC I. Baseline 6-minute walk distance (n=31, 72.1%) was 355.0 [263.5–461.2] m and incremental shuttle walk distance (n=12, 27.9%) was 220.0 [175.0–302.5] m. EMPHASIS-10 score (n=39) was 24 [10–36]. After 12.7 [9.8–16.1] months of macitentan therapy, objective exercise capacity improved by 11.8 [−4.3–36.9]% (p=0.01). Health-related quality of life improved by at least 5 points in 41.9% of patients, but there was no significant change in quality of life score in the overall group (0.0 [−20.3–18.1]% change, p=0.78). Macitentan therapy was stopped in 4 (8.2%) patients due to an adverse event or patient choice, and 5 (10.2%) due to clinical worsening or absence of clinical improvement. At 1 year following macitentan initiation, 6 (12.2%) patients had been further escalated to triple therapy and 5 (10.2%) had died.
Conclusions
Patients with repaired PAH-CHD treated with macitentan in the UK are a highly symptomatic group with limited exercise tolerance. Macitentan was well-tolerated overall and led to a significant improvement in objective exercise capacity.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship.
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Affiliation(s)
| | - R Condliffe
- Sheffield Teaching Hospitals NHS Trust, Pulmonary Vascular Disease Unit , Sheffield , United Kingdom
| | - P Clift
- Queen Elizabeth Hospital Birmingham, Department of Cardiology , Birmingham , United Kingdom
| | - K Jansen
- Freeman Hospital, Adult Congenital and Paediatric Heart Unit , Newcastle-Upon-Tyne , United Kingdom
| | - S J Wort
- Royal Brompton Hospital , London , United Kingdom
| | - S Moledina
- Great Ormond Street Hospital for Children, National Paediatric Pulmonary Hypertension Service UK , London , United Kingdom
| | - K Dimopoulos
- Royal Brompton Hospital , London , United Kingdom
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Constantine A, Dimopoulos K, Condliffe R, Clift P, Jansen K, Dhillon R, Chaplin G, Muthurangu V, Moledina S. Paediatric pulmonary arterial hypertension following congenital heart defect repair: enhanced risk stratification and outcomes in a national cohort. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction
Pulmonary arterial hypertension (PAH) is a common complication of congenital heart disease (CHD). PAH following CHD repair (repaired PAH-CHD) is an emerging population with increased morbidity and mortality [1–3]. Risk scores that are widely used in the adult PAH population have not been validated and may not be applicable in young children with repaired PAH-CHD.
Purpose
To characterize the 20-year cohort of the UK National Paediatric PH Service, focusing on peri-operative characteristics and outcomes of children with repaired PAH-CHD, and develop a tailored risk stratification tool.
Methods
We included consecutive children presenting to our specialist service between 2001 and 2021 with a diagnosis of repaired PAH-CHD. Patients with univentricular physiology, segmental pulmonary hypertension (PH), and PH primarily due to abnormal development of the pulmonary vasculature were excluded. Univariable Cox regression analysis was performed in children with PAH present ≥3 months after CHD repair, with an outcome of death or transplantation. Time-dependent ROC analysis was used to evaluate the risk model.
Results
Overall, 178 patients were included (age 3.2 [1.3–7.9] years, 58.4% female). Most children (73.0%) were referred following CHD repair. Complex CHD was present in 61.2%, and 48.9% had combined pre- and post-tricuspid shunts. Down syndrome was present in 33.1%. At the first post-operative PH assessment, 53.1% of patients had symptoms, mainly breathlessness. On echocardiographic evaluation, 30.9% had moderate-severe right ventricular dilatation and 23.7% had right ventricular systolic impairment. Over a median follow-up of 6.0 [2.4–11.0] years, 30 (19.2%) patients died and 5 (3.2%) patients underwent lung transplantation. Transpant-free survival at 1, 5, and 10 years was 94.7% (95% CI: 91.2–98.3%), 85.9% (95% CI: 80.3–91.9%), and 80.1% (95% CI: 73.1–87.7%), respectively. Cox analysis identified several clinical variables associated with death or transplantation, of which the following variables assessed post-repair were used to develop the risk score: absence of pre-operative PH, breathlessness, right ventricular dysfunction, and pulmonary vascular resistance index >14 WU m2 or lesion at high risk of causing PH (Figure 1). This novel, simple risk score performed well (AUC >80% at 1, 3, 5 and 10 years) and was well-calibrated in our cohort (Figure 2, D'Agostino-Nam p=0.76).
Conclusions
In this national cohort of children with repaired PAH-CHD, mortality is significant. This novel, simple risk score performed well in our population and could be used in clinical practice at the time of post-operative assessment to predict outcome and direct management but requires further validation.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - K Dimopoulos
- Royal Brompton Hospital , London , United Kingdom
| | - R Condliffe
- Sheffield Teaching Hospitals NHS Trust, Pulmonary Vascular Disease Unit , Sheffield , United Kingdom
| | - P Clift
- Queen Elizabeth Hospital Birmingham, Department of Cardiology , Birmingham , United Kingdom
| | - K Jansen
- Freeman Hospital, Adult Congenital and Paediatric Heart Unit , Newcastle-Upon-Tyne , United Kingdom
| | - R Dhillon
- Birmingham Children's Hospital, Heart Unit , Birmingham , United Kingdom
| | - G Chaplin
- University College London, UCL Institute of Cardiovascular Science , London , United Kingdom
| | - V Muthurangu
- University College London, UCL Institute of Cardiovascular Science , London , United Kingdom
| | - S Moledina
- Great Ormond Street Hospital for Children, National Paediatric Pulmonary Hypertension Service UK , London , United Kingdom
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Bucciol G, Willemyns N, Verhaaren B, Bossuyt X, Lagrou K, Corveleyn A, Moshous D, Jansen K, De Waele L, Meyts I. Child Neurology: Familial Hemophagocytic Lymphohistiocytosis Underlying Isolated Central Nervous System Inflammation. Neurology 2022; 99:660-664. [PMID: 36216522 DOI: 10.1212/wnl.0000000000201124] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/01/2022] [Indexed: 11/15/2022] Open
Abstract
Encephalitis and encephalopathy in children represent a diagnostic challenge. We describe a patient with relapsing encephalitis in whom the differential diagnosis included acute disseminated encephalomyelitis (ADEM), human herpesvirus 6 (HHV-6) encephalitis, and hemophagocytic lymphohistiocytosis (HLH). Because of its rarity, HLH is often overlooked as a differential diagnosis in encephalitis, especially in the isolated central nervous system (CNS) forms. As this case illustrates, inborn errors of immunity (IEIs) can underlie isolated encephalitis and should be included in the differential diagnosis of these presentations.
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Affiliation(s)
- Giorgia Bucciol
- Department of Pediatrics, Leuven University Hospitals, Leuven, Belgium .,Laboratory of Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Nele Willemyns
- Department of Pediatrics, Leuven University Hospitals, Leuven, Belgium
| | | | - Xavier Bossuyt
- Department of Laboratory Medicine, Leuven University Hospitals, Leuven, Belgium
| | - Katrien Lagrou
- Department of Laboratory Medicine, Leuven University Hospitals, Leuven, Belgium.,Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Anniek Corveleyn
- Center for Human Genetics, Leuven University Hospitals, Leuven, Belgium
| | - Despina Moshous
- Department of Pediatric Immunology, Hematology and Rheumatology, Necker-Enfants Malades Hospital, APHP, and Imagine Institute, Inserm U1163, Université Paris Cité, Paris, France
| | - Katrien Jansen
- Department of Pediatrics, Leuven University Hospitals, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Liesbeth De Waele
- Department of Pediatrics, Leuven University Hospitals, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Isabelle Meyts
- Department of Pediatrics, Leuven University Hospitals, Leuven, Belgium.,Laboratory of Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
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18
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Tamburro G, Jansen K, Lemmens K, Dereymaeker A, Naulaers G, De Vos M, Comani S. Automated detection and removal of flat line segments and large amplitude fluctuations in neonatal electroencephalography. PeerJ 2022; 10:e13734. [PMID: 35846889 PMCID: PMC9285485 DOI: 10.7717/peerj.13734] [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: 02/21/2022] [Accepted: 06/24/2022] [Indexed: 01/17/2023] Open
Abstract
Background Artefact removal in neonatal electroencephalography (EEG) by visual inspection generally depends on the expertise of the operator, is time consuming and is not a consistent pre-processing step to the pipeline for the automated EEG analysis. Therefore, there is the need for the automated detection and removal of artefacts in neonatal EEG, especially of distinct and predominant artefacts such as flat line segments (mainly caused by instrumental error where contact between electrodes and head box is lost) and large amplitude fluctuations (related to neonatal movements). Method A threshold-based algorithm for the automated detection and removal of flat line segments and large amplitude fluctuations in neonatal EEG of infants at term-equivalent age is developed. The algorithm applies thresholds to the absolute second difference, absolute amplitude, absolute first difference and the ratio between the frequency content above 50 Hz and the frequency content across all frequencies. Results The algorithm reaches a median accuracy of 0.91, a median hit rate of 0.91 and a median false discovery rate of 0.37. Also, a significant improvement (≈10%) in the performance of a four-stage sleep classifier is observed after artefact removal with the proposed algorithm as compared to before its application. Significance An automated artefact removal method contributes to the pipeline of automated EEG analysis. The proposed algorithm has shown to have good performance and to be effective in neonatal EEG applications.
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Affiliation(s)
- Gabriella Tamburro
- Department of Neuroscience, Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy,BIND – Behavioral Imaging and Neural Dynamics Center, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Katrien Jansen
- Department of Development and Regeneration, UZ Leuven, Leuven, Belgium
| | - Katrien Lemmens
- Department of Development and Regeneration, UZ Leuven, Leuven, Belgium
| | | | - Gunnar Naulaers
- Department of Development and Regeneration, UZ Leuven, Leuven, Belgium
| | - Maarten De Vos
- Department of Development and Regeneration, UZ Leuven, Leuven, Belgium,Department of Electrical Engineering (ESAT), STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, KU Leuven, Leuven, Belgium
| | - Silvia Comani
- Department of Neuroscience, Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy,BIND – Behavioral Imaging and Neural Dynamics Center, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
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19
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Generali T, Jansen K, Rybicka J, Nassar M, Hasan A, De Rita F. Collateral damage in single ventricle circulation: the unresolved challenge of heart transplantation for adult congenital heart disease. J Heart Lung Transplant 2022; 41:1530-1533. [DOI: 10.1016/j.healun.2022.06.014] [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] [Received: 03/24/2022] [Revised: 06/03/2022] [Accepted: 06/16/2022] [Indexed: 11/16/2022] Open
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20
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Deleu T, Jansen K, Calenbergh FV. Brain overgrowth associated with megalencephaly-capillary malformation syndrome causing progressive Chiari and syringomyelia. Surg Neurol Int 2022; 13:211. [PMID: 35673641 PMCID: PMC9168292 DOI: 10.25259/sni_1016_2021] [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: 10/06/2021] [Accepted: 04/29/2022] [Indexed: 12/02/2022] Open
Abstract
Background Megalencephaly-capillary malformation (M-CM) syndrome is a rare overgrowth syndrome characterized by macrocephaly, port-wine stains, asymmetric brain growth, hydrocephalus, and developmental delay. Cerebellar tonsil herniation is often seen, but rarely with syringomyelia. Case Description A newborn with M-CM syndrome developed a progressive Chiari malformation type I (CM-I) with syringomyelia. At 4 months, he was treated for subdural hematomas, while at 10 months, he required a shunt for hydrocephalus. At 16 years of age, he newly presented a left hemiparesis and ataxia. Notably, successive volumetric measurements of the posterior fossa/cerebellum showed disproportionate cerebellar growth over time that correlated with the appearance of a CM-I. Following a suboccipital craniectomy with C1-laminectomy and duraplasty, he neurologically improved. Conclusion M-CM with CM-I and syringomyelia rarely present together. Here, we treated an infant with M-CM who developed a progressive CM-I malformation and syringomyelia reflecting disproportionate growth of the cerebellum/posterior fossa over a 16-year period.
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Affiliation(s)
- Tom Deleu
- Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium
| | - Katrien Jansen
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
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21
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Jansen K, Leunisse M, Linssen MLE. [Reduction of trigeminal neuralgia complaints after recovery of the vertical dimension]. Ned Tijdschr Tandheelkd 2022; 129:225-229. [PMID: 35537089 DOI: 10.5177/ntvt.2022.05.17214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A 56-year-old man was referred by his dentist to an orthodontist as part of an interdisciplinary treatment plan for a complete dental rehabilitation. The patient presented with a mutilated dentition with a restricted envelope of function and generalized severe tooth wear with loss of vertical dimension. The patient showed a history of multiple endodontically treated and subsequently extracted elements associated with unexplained symptoms until a neurologist diagnosed trigeminal neuralgia. The orthodontic treatment in which the restricted envelope of function was eliminated and the vertical dimension was reestablished resulted in a significant reduction of the number of triggers experienced by the patient.
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22
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Proost R, Lagae L, Van Paesschen W, Jansen K. Sleep in children with refractory epilepsy and epileptic encephalopathies: A systematic review of literature. Eur J Paediatr Neurol 2022; 38:53-61. [PMID: 35395626 DOI: 10.1016/j.ejpn.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/14/2022] [Accepted: 03/25/2022] [Indexed: 10/18/2022]
Abstract
Children with epilepsy have more sleep disorders compared to healthy children. The bidirectional interaction between epilepsy and sleep is not completely understood. However, disruption of sleep architecture during childhood may have consequences for cognitive development. As children with drug-refractory epilepsy often have intellectual disability, sleep disruption could be an important contributing factor in severity of their cognitive impairment. To better understand these interactions, sleep architecture in children with drug-refractory epilepsy and epileptic encephalopathies should be investigated. In this review, we conducted a systematic literature search on this topic. Articles that investigated sleep macro- and/or microstructure by means of electroencephalogram/polysomnography were included, as well as articles that used validated questionnaires. Sixteen articles were reviewed, eight of which used polysomnography. Only 2 articles examined sleep in children with epileptic encephalopathies. Consistent findings on measures of sleep architecture were a reduction in REM percentage and an increase in sleep fragmentation when comparing drug-refractory patients with non-refractory and healthy subjects. The findings on slow wave sleep were less clear. Studies with questionnaires unambiguously confirmed subjectively more sleep problems in children with drug-refractory epilepsy. This is the first review of literature in this patient population. More good quality sleep studies in children with drug-refractory epilepsy are warranted. The use of wearables in the home setting together with automatic sleep staging could provide more insights.
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Affiliation(s)
- R Proost
- Department of Pediatric Neurology, University Hospital Leuven, Leuven, Belgium.
| | - L Lagae
- Department of Pediatric Neurology, University Hospital Leuven, Leuven, Belgium
| | - W Van Paesschen
- Department of Neurology, University Hospital Leuven, Leuven, Belgium
| | - K Jansen
- Department of Pediatric Neurology, University Hospital Leuven, Leuven, Belgium.
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23
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Funke H, Bernhard G, Claussner J, Jansen K, Matz W, Nitsche H, Oehme W, Reich T, Röllig D. Technical description of the radiological safety system for X-ray absorption spectroscopy experiments on radioactive samples at the Rossendorf Beamline. KERNTECHNIK 2022. [DOI: 10.1515/kern-2001-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
The Rossendorf Beamline at the European Synchrotron Radiation Facility is equipped with a unique radiochemistry experimental station. This dedicated station has been designed to perform environmentally relevant experiments on radionuclides, in particular actinides, using synchrotron based X-ray absorption fine structure spectroscopy. The technical concepts and the layout of this experimental station, where radioactive solids and liquids with activities of up to 185 MBq can be studied, are presented. The radiological safety of experimenters, equipment, and of the environment are ensured by the specially developed radiochemistry safety system. The multibarrier concept, the ventilation and air monitoring systems, the radiological protection system, and special software components for recording and visualisation of the safety status are described in detail.
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24
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Johannesen KM, Iqbal S, Guazzi M, Mohammadi NA, Pérez-Palma E, Schaefer E, De Saint Martin A, Abiwarde MT, McTague A, Pons R, Piton A, Kurian MA, Ambegaonkar G, Firth H, Sanchis-Juan A, Deprez M, Jansen K, De Waele L, Briltra EH, Verbeek NE, van Kempen M, Fazeli W, Striano P, Zara F, Visser G, Braakman HMH, Haeusler M, Elbracht M, Vaher U, Smol T, Lemke JR, Platzer K, Kennedy J, Klein KM, Au PYB, Smyth K, Kaplan J, Thomas M, Dewenter MK, Dinopoulos A, Campbell AJ, Lal D, Lederer D, Liao VWY, Ahring PK, Møller RS, Gardella E. Structural mapping of GABRB3 variants reveals genotype-phenotype correlations. Genet Med 2022; 24:681-693. [PMID: 34906499 DOI: 10.1016/j.gim.2021.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 11/05/2021] [Revised: 09/30/2021] [Accepted: 11/05/2021] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Pathogenic variants in GABRB3 have been associated with a spectrum of phenotypes from severe developmental disorders and epileptic encephalopathies to milder epilepsy syndromes and mild intellectual disability (ID). In this study, we analyzed a large cohort of individuals with GABRB3 variants to deepen the phenotypic understanding and investigate genotype-phenotype correlations. METHODS Through an international collaboration, we analyzed electro-clinical data of unpublished individuals with variants in GABRB3, and we reviewed previously published cases. All missense variants were mapped onto the 3-dimensional structure of the GABRB3 subunit, and clinical phenotypes associated with the different key structural domains were investigated. RESULTS We characterized 71 individuals with GABRB3 variants, including 22 novel subjects, expressing a wide spectrum of phenotypes. Interestingly, phenotypes correlated with structural locations of the variants. Generalized epilepsy, with a median age at onset of 12 months, and mild-to-moderate ID were associated with variants in the extracellular domain. Focal epilepsy with earlier onset (median: age 4 months) and severe ID were associated with variants in both the pore-lining helical transmembrane domain and the extracellular domain. CONCLUSION These genotype-phenotype correlations will aid the genetic counseling and treatment of individuals affected by GABRB3-related disorders. Future studies may reveal whether functional differences underlie the phenotypic differences.
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Affiliation(s)
- Katrine M Johannesen
- Department of Epilepsy Genetics and Personalized Treatment, The Danish Epilepsy Centre "Filadelfia", Dianalund, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Sumaiya Iqbal
- The Center for the Development of Therapeutics (CDOT), Broad Institute of MIT and Harvard, Cambridge, MA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA; Analytic & Translational Genetics Unit (ATGU), Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Milena Guazzi
- Department of Medicine, University of Genoa, Genoa, Italy; Department of Clinical Neurophysiology, The Danish Epilepsy Centre "Filadelfia", Dianalund, Denmark
| | - Nazanin A Mohammadi
- Department of Epilepsy Genetics and Personalized Treatment, The Danish Epilepsy Centre "Filadelfia", Dianalund, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Eduardo Pérez-Palma
- Centro de Genética y Genómica, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Elise Schaefer
- Service de Génétique Médicale, Institut de Génétique Médicale d'Alsace, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Anne De Saint Martin
- Department of Pediatric Neurology, Strasbourg University Hospital, Strasbourg, France
| | | | - Amy McTague
- Molecular Neurosciences, Developmental Neurosciences Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom; Department of Neurology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Roser Pons
- First Department of Pediatrics, "I Agia Sofia" Children Hospital, National & Kapodistrian University of Athens, Athens, Greece
| | - Amelie Piton
- Laboratoire de diagnostic génétique, Hôpital Civil, CHRU de Strasburg, Strasbourg, France
| | - Manju A Kurian
- Molecular Neurosciences, Developmental Neurosciences Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom; Department of Neurology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Gautam Ambegaonkar
- Department of Paediatric Neurology, Child Development Centre, Addenbrookes Hospital, Cambridge, United Kingdom
| | - Helen Firth
- Department of Clinical Genetics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Alba Sanchis-Juan
- NIHR BioResource, Department of Haematology, University of Cambridge, United Kingdom
| | - Marie Deprez
- CNRS, IPMC, Université Côte d'Azur, Sophia-Antipolis, France
| | - Katrien Jansen
- Department of Pediatric Neurology, University Hospitals KU Leuven, Leuven, Belgium
| | - Liesbeth De Waele
- Department of Pediatric Neurology, University Hospitals KU Leuven, Leuven, Belgium; Department of Development and Regeneration, Kulak Kortrijk Campus, Kortrijk, Belgium
| | - Eva H Briltra
- Department of Genetics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Nienke E Verbeek
- Department of Genetics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Marjan van Kempen
- Department of Genetics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Walid Fazeli
- Department of Pediatric Neurology, University Hospital Bonn, Bonn, Germany
| | - Pasquale Striano
- IRCCS Giannina Gaslini Institute, Genova, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Federico Zara
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy; Laboratory of Neurogenetics and Neuroscience, IRCCS Giannina Gaslini Institute, Genova, Italy
| | - Gerhard Visser
- Stichting Epilepsie Instellingen Nederland (SEIN), Hoofddorp, The Netherlands
| | - Hilde M H Braakman
- Department of Pediatric Neurology, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Neurology, Academic Center for Epileptology Kempenhaeghe & Maastricht University Medical Center, Heeze, The Netherlands
| | - Martin Haeusler
- Division of Neuropediatrics and Social Pediatrics, Department of Pediatrics, University Hospital RWTH Aachen, Aachen, Germany
| | - Miriam Elbracht
- Institute of Human Genetics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Ulvi Vaher
- Children's Clinic of Tartu University Hospital, Tartu, Estonia; ERN EpiCARE, Tartu, Estonia
| | - Thomas Smol
- Institut de Genetique Medicale, CHU Lille, Universite de Lille, Lille, France
| | - Johannes R Lemke
- Institute of Human Genetics, University of Leipzig Medical Center, Leipzig, Germany
| | - Konrad Platzer
- Institute of Human Genetics, University of Leipzig Medical Center, Leipzig, Germany
| | - Joanna Kennedy
- Clinical Genetics Service, University Hospitals Bristol NHS Foundation Trust, St Michael's Hospital, Bristol, United Kingdom
| | - Karl Martin Klein
- Department of Clinical Neurosciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medical Genetics, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Center of Neurology and Neurosurgery, University Hospital, Goethe-University Frankfurt, Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), Goethe University Frankfurt, Frankfurt, Germany
| | - Ping Yee Billie Au
- Department of Medical Genetics, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kimberly Smyth
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Julie Kaplan
- Division of Medical Genetics, Nemours A.I. duPont Hospital for Children, Wilmington, DE
| | - Morgan Thomas
- Precision Medicine/Genetic Testing Stewardship Program, Nemours A.I. duPont Hospital for Children, Wilmington, DE
| | - Malin K Dewenter
- Institute of Human Genetics, Universitätsmedizin, Johannes Gutenberg-University, Mainz Institut für Humangenetik, Mainz, Germany
| | - Argirios Dinopoulos
- Third Department of Pediatrics, Attiko University Hospital, University of Athens, Haidari, Greece
| | - Arthur J Campbell
- The Center for the Development of Therapeutics (CDOT), Broad Institute of MIT and Harvard, Cambridge, MA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Dennis Lal
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA; Genomic Medicine Institute, Cleveland Clinic Lerner Research Institute, Cleveland, OH; Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH; Cologne Center for Genomics (CCG), University of Cologne, Cologne, Germany
| | - Damien Lederer
- Centre de Génétique Humaine, Institut de Pathologie et de Génétique, Charleroi, Belgium
| | - Vivian W Y Liao
- Brain and Mind Centre, Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Philip K Ahring
- Brain and Mind Centre, Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Rikke S Møller
- Department of Epilepsy Genetics and Personalized Treatment, The Danish Epilepsy Centre "Filadelfia", Dianalund, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Elena Gardella
- Department of Epilepsy Genetics and Personalized Treatment, The Danish Epilepsy Centre "Filadelfia", Dianalund, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Department of Medicine, University of Genoa, Genoa, Italy; Department of Clinical Neurophysiology, The Danish Epilepsy Centre "Filadelfia", Dianalund, Denmark.
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25
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Funcke L, Hartung T, Jansen K, Kühn S, Schneider M, Stornati P, Wang X. Towards quantum simulations in particle physics and beyond on noisy intermediate-scale quantum devices. Philos Trans A Math Phys Eng Sci 2022; 380:20210062. [PMID: 34923847 DOI: 10.1098/rsta.2021.0062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/04/2021] [Indexed: 06/14/2023]
Abstract
We review two algorithmic advances that bring us closer to reliable quantum simulations of model systems in high-energy physics and beyond on noisy intermediate-scale quantum (NISQ) devices. The first method is the dimensional expressivity analysis of quantum circuits, which allows for constructing minimal but maximally expressive quantum circuits. The second method is an efficient mitigation of readout errors on quantum devices. Both methods can lead to significant improvements in quantum simulations, e.g. when variational quantum eigensolvers are used. This article is part of the theme issue 'Quantum technologies in particle physics'.
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Affiliation(s)
- L Funcke
- Center for Theoretical Physics, Co-Design Center for Quantum Advantage, and NSF AI Institute for Artificial Intelligence and Fundamental Interactions, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
- Perimeter Institute for Theoretical Physics, 31 Caroline Street North, Waterloo, Ontario, Canada N2L 2Y5
| | - T Hartung
- Department of Mathematical Sciences, University of Bath, 4 West, Claverton Down, Bath BA2 7AY, UK
- Computation-based Science and Technology Research Center, The Cyprus Institute, 20 Kavafi Street, 2121 Nicosia, Cyprus
| | - K Jansen
- NIC, DESY Zeuthen, Platanenallee 6, 15738 Zeuthen, Germany
| | - S Kühn
- Computation-based Science and Technology Research Center, The Cyprus Institute, 20 Kavafi Street, 2121 Nicosia, Cyprus
| | - M Schneider
- NIC, DESY Zeuthen, Platanenallee 6, 15738 Zeuthen, Germany
- Institut für Physik, Humboldt-Universität zu Berlin, Zum Großen Windkanal 6, 12489 Berlin, Germany
| | - P Stornati
- NIC, DESY Zeuthen, Platanenallee 6, 15738 Zeuthen, Germany
- Institut für Physik, Humboldt-Universität zu Berlin, Zum Großen Windkanal 6, 12489 Berlin, Germany
| | - X Wang
- School of Physics, Peking University, 5 Yiheyuan Rd, Haidian District, Beijing 100871, People's Republic of China
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Sourbron J, Jansen K, Mei D, Hammer TB, Møller RS, Gold NB, O'Grady L, Guerrini R, Lagae L. SLC7A3: In Silico Prediction of a Potential New Cause of Childhood Epilepsy. Neuropediatrics 2022; 53:46-51. [PMID: 34872132 DOI: 10.1055/s-0041-1739133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We report an in-depth genetic analysis in an 11-year-old boy with drug-resistant, generalized seizures and developmental disability. Three distinct variants of unknown clinical significance (VUS) were detected by whole exome sequencing (WES) but not by initial genetic analyses (microarray and epilepsy gene panel). These variants involve the SLC7A3, CACNA1H, and IGLON5 genes, which were subsequently evaluated by computational analyses using the InterVar tool and MutationTaster. While future functional studies are necessary to prove the pathogenicity of a certain VUS, segregation analyses over three generations and in silico predictions suggest the X-linked gene SLC7A3 (transmembrane solute carrier transporter) as the likely culprit gene in this patient. In addition, a search via GeneMatcher unveiled two additional patients with a VUS in SLC7A3. We propose SLC7A3 as a likely candidate gene for epilepsy and/or developmental/cognitive delay and provide an overview of the 27 SLC genes related to epilepsy by other preclinical and/or clinical studies.
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Affiliation(s)
- Jo Sourbron
- Department of Development and Regeneration, Section Pediatric Neurology, University Hospital KU Leuven, Leuven, Belgium.,Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Katrien Jansen
- Department of Development and Regeneration, Section Pediatric Neurology, University Hospital KU Leuven, Leuven, Belgium
| | - Davide Mei
- Neuroscience Department, Meyer Children's Hospital, European Reference Network ERN EpiCARE, University of Florence, Florence, Italy
| | - Trine Bjørg Hammer
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Epilepsy Genetics and Personalized Medicine, Danish Epilepsy Centre, Denmark and Clinical Genetic Department, Rigshospitalet, Copenhagen, Denmark
| | - Rikke S Møller
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Epilepsy Genetics and Personalized Medicine, Danish Epilepsy Center Dianalund, Denmark
| | - Nina B Gold
- Medical Genetics and Metabolism, Massachusetts General Hospital for Children, Boston, Massachusetts, United States.,Harvard Medical School, Department of Pediatrics, Boston, MA, USA
| | - Lauren O'Grady
- Medical Genetics and Metabolism, Massachusetts General Hospital for Children, Boston, Massachusetts, United States
| | - Renzo Guerrini
- Neuroscience Department, Meyer Children's Hospital, European Reference Network ERN EpiCARE, University of Florence, Florence, Italy.,IRCCS Stella Maris Foundation, Pisa, Italy
| | - Lieven Lagae
- Department of Development and Regeneration, Section Pediatric Neurology, University Hospital KU Leuven, Leuven, Belgium
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Hermans T, Carkeek K, Dereymaeker A, Jansen K, Naulaers G, Van Huffel S, De Vos M. Assessing Neurovascular Coupling Using Wavelet Coherence in Neonates with Asphyxia. Advances in Experimental Medicine and Biology 2022; 1395:183-187. [PMID: 36527635 DOI: 10.1007/978-3-031-14190-4_31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Brain monitoring is important in neonates with asphyxia in order to assess the severity of hypoxic ischaemic encephalopathy (HIE) and identify neonates at risk of adverse neurodevelopmental outcome. Previous studies suggest that neurovascular coupling (NVC), quantified as the interaction between electroencephalography (EEG) and near-infrared spectroscopy (NIRS)-derived regional cerebral oxygen saturation (rSO2) is a promising biomarker for HIE severity and outcome. In this study, we explore how wavelet coherence can be used to assess NVC. Wavelet coherence was computed in 18 neonates undergoing therapeutic hypothermia in the first 3 days of life, with varying HIE severities (mild, moderate, severe). We compared two pre-processing methods of the EEG prior to wavelet computation: amplitude integrated EEG (aEEG) and EEG bandpower. Furthermore, we proposed average real coherence as a biomarker for NVC. Our results indicate that NVC as assessed by wavelet coherence between EEG bandpower and rSO2 can be a valuable biomarker for HIE severity in neonates with peripartal asphyxia. More specifically, average real coherence in a very low frequency range (0.21-0.83 mHz) tends to be high (positive) in neonates with mild HIE, low (positive) in neonates with moderate HIE, and negative in neonates with severe HIE. Further investigation in a larger patient cohort is needed to validate our findings.
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Hermans T, Thewissen L, Gewillig M, Cools B, Jansen K, Pillay K, De Vos M, Van Huffel S, Naulaers G, Dereymaeker A. Functional brain maturation and sleep organisation in neonates with congenital heart disease. Eur J Paediatr Neurol 2022; 36:115-122. [PMID: 34954621 DOI: 10.1016/j.ejpn.2021.12.008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 11/23/2021] [Accepted: 12/11/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Neonates with Congenital Heart Disease (CHD) have structural delays in brain development. To evaluate whether functional brain maturation and sleep-wake physiology is also disturbed, the Functional Brain Age (FBA) and sleep organisation on EEG during the neonatal period is investigated. METHODS We compared 15 neonates with CHD who underwent multichannel EEG with healthy term newborns of the same postmenstrual age, including subgroup analysis for d-Transposition of the Great Arteries (d-TGA) (n = 8). To estimate FBA, a prediction tool using quantitative EEG features as input, was applied. Second, the EEG was automatically classified into the 4 neonatal sleep stages. Neonates with CHD underwent neurodevelopmental testing using the Bayley Scale of Infant Development-III at 24 months. RESULTS Preoperatively, the FBA was delayed in CHD infants and more so in d-TGA infants. The FBA was positively correlated with motor scores. Sleep organisation was significantly altered in neonates with CHD. The duration of the sleep cycle and the proportion of Active Sleep Stage 1 was decreased, again more marked in the d-TGA infants. Neonates with d-TGA spent less time in High Voltage Slow Wave Sleep and more in Tracé Alternant compared to healthy terms. Both FBA and sleep organisation normalised postoperatively. The duration of High Voltage Slow Wave Sleep remained positively correlated with motor scores in d-TGA infants. INTERPRETATION Altered early brain function and sleep is present in neonates with CHD. These results are intruiging, as inefficient neonatal sleep has been linked with adverse long-term outcome. Identifying how these rapid alterations in brain function are mitigated through improvements in cerebral oxygenation, surgery, drugs and nutrition may have relevance for clinical practice and outcome.
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Affiliation(s)
- Tim Hermans
- Division STADIUS, Department of Electrical Engineering (ESAT), KU Leuven (University of Leuven), Leuven, Belgium
| | - Liesbeth Thewissen
- Department of Development and Regeneration, Neonatal Intensive Care Unit, University Hospitals Leuven, KU Leuven (University of Leuven), Leuven, Belgium
| | - Marc Gewillig
- Department of Cardiovascular Science, Paediatric Cardiology, University Hospitals Leuven, KU Leuven (University of Leuven), Leuven, Belgium
| | - Bjorn Cools
- Department of Cardiovascular Science, Paediatric Cardiology, University Hospitals Leuven, KU Leuven (University of Leuven), Leuven, Belgium
| | - Katrien Jansen
- Department of Development and Regeneration, Child Neurology, University Hospitals Leuven, KU Leuven (University of Leuven), Leuven, Belgium
| | - Kirubin Pillay
- Department of Paediatrics, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Maarten De Vos
- Division STADIUS, Department of Electrical Engineering (ESAT), KU Leuven (University of Leuven), Leuven, Belgium
| | - Sabine Van Huffel
- Division STADIUS, Department of Electrical Engineering (ESAT), KU Leuven (University of Leuven), Leuven, Belgium
| | - Gunnar Naulaers
- Department of Development and Regeneration, Neonatal Intensive Care Unit, University Hospitals Leuven, KU Leuven (University of Leuven), Leuven, Belgium
| | - Anneleen Dereymaeker
- Department of Development and Regeneration, Neonatal Intensive Care Unit, University Hospitals Leuven, KU Leuven (University of Leuven), Leuven, Belgium.
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Abdi K, Abramsky R, Andescavage N, Bambi J, Basu S, Bearer C, Benner EJ, Biselele T, Bliznyuk N, Breckpot J, Carey G, Chao A, Christiansen LI, Comani S, Croce P, De Vos M, Dereymaeker A, Dubois L, Eisch AJ, Epstein A, Geva N, Geva Y, Gewillig M, Gillis S, Goldberg RN, Gram M, Gregory S, Guez-Barber D, Hayakawa M, Henriksen NL, Hermans T, Hershkovitz R, Holgersen K, Holmqvist B, Jain V, Jansen K, Kandula V, Kapse K, Kawaguchi M, Khair A, Khazaei M, Kidokoro H, Kiffer FC, Kisilewicz K, Kumai S, Lacaille H, Ley D, Limperopoulos C, Lindholm SEH, Lukusa P, Lundberg R, MacFarlane P, Matak P, Mavinga L, Mayer C, Mbayabo G, Mitsumatsu T, Mubungu G, Murnick J, Nakata T, Narita H, Nataraj P, Natsume J, Naulaers G, Nikam R, Ortenlöf N, Ottolini K, Pan X, Pankratova S, Pegram K, Penn AA, Pradhan S, Raeisi K, Rickman N, Rikard B, Rotem R, Sangild PT, Sato Y, Sawamura F, Shany E, Shelef I, Shiraki A, Smets L, Sura L, Suzui R, Suzuki T, Tady BP, Taga G, Tamburro G, Thewissen L, Thompson JW, Thymann T, Tokat C, Vacher CM, Valdes C, Vallius S, Vatolin S, Watanabe H, Weintraub AY, Weiss M, Yamamoto H, Yaniv SS, Younge N, Yun S, Zappasodi F. Proceedings of the 13th International Newborn Brain Conference: Fetal and/or neonatal brain development, both normal and abnormal. J Neonatal Perinatal Med 2022; 15:411-426. [PMID: 35431185 DOI: 10.3233/npm-229002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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Abou Mehrem A, Al Awad E, Anninck K, Au-Young S, Aydinol N, Bartmann P, Benders M, Benlamri A, Bolderheij L, Celik Y, Chan N, Chau C, Chau V, Chen X, Chetcuti Ganado C, Coetser A, Cools F, Da Rocha G, Deigner HP, Dereymaeker A, Deshmukh L, Domonoske R, Dossani S, Dsouza JM, El Gamal M, Eshemokhai P, Esser M, Fiedrich E, Franz A, Ghosh A, Groenendaal F, Grunau RE, Venkata SKRG, Hamitoglu S, Hellström-Westas L, Irvine L, Jansen K, Javadyan A, Jenkin G, Kamanga N, Kaur N, Keles E, Keller M, Kelly E, Kesting SJ, Kgwadi D, Kim B, Kohl M, Kowal D, Kricitober JD, Leijser L, LePine M, Lim YP, Lodha A, Londhe A, Ly L, Maes E, Malhotra A, Marlow N, Mathew JL, McDonald C, McLean M, Metcalfe C, Meyer R, Miller SP, Miller S, Mogajane T, Mohammad K, Momin S, Montpetit J, Mukiza N, Murthy P, Scott JN, Nakibuuka V, Nakwa F, Naulaers G, Noort J, Ntuli N, Ondongo-Ezhet C, Paul R, Pepper M, Plum A, Rombough B, Saugstad O, Scotland J, Scott J, Seake K, Sebunya R, Selvanathan T, Sepeng L, Simsek H, Steins-Rang C, Stonestreet B, Tang S, Taskin E, Thewissen L, Thomas S, Thomas R, van Kwawegen A, van Rensburg J, Velaphi S, Wu Y, Yaman A, Yapicioglu-Yildizdas H, Yawno T, Zaki P, Zein H, Zhou L. Proceedings of the 13th International Newborn Brain Conference: Neuroprotection strategies in the neonate. J Neonatal Perinatal Med 2022; 15:427-439. [PMID: 35431186 DOI: 10.3233/npm-229003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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Kalhoff H, Kersting M, Jansen K, Lücke T. Application of the German food based dietary guidelines for infants, children and adolescents to estimate the consequences of vegetarian and vegan dietary restrictions on vitamin b12 intake. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.539] [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: 10/19/2022]
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Rochtus AM, Herijgers D, Jansen K, Decallonne B. Antiseizure medications and thyroid hormone homeostasis: Literature review and practical guideline. Epilepsia 2021; 63:259-270. [PMID: 34750814 DOI: 10.1111/epi.17117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/21/2021] [Accepted: 10/21/2021] [Indexed: 12/11/2022]
Abstract
Thyroid hormones play an essential role in central nervous system development, normal physiological brain function, and repair mechanisms. On one hand, thyroid hormone alterations influence cortical excitability, and on the other hand antiseizure medications (ASMs) are associated with alterations in thyroid hormone metabolism. Although this interaction has long been described, and epilepsy is a common and chronic neurological disease, studies describing the interplay are often small and retrospective. We performed a systematic review of the current literature on epilepsy, ASMs, and thyroid hormone metabolism. Forty-seven studies were included. Most studies were retrospective cross-sectional studies (n = 25) and investigated thyroid function alterations in patients on older ASMs such as phenobarbital, phenytoin, carbamazepine, and valproate. Overall, almost one third of patients with epilepsy had thyroid hormone alterations, especially patients on valproate (25%) and carbamazepine (10%-25%). Studies with patients receiving polytherapy are scarce, but reported a higher risk for hypothyroidism in patients with older age (p = .004), female sex (p = .014), longer duration of epilepsy (p = .001), intractable epilepsy (p = .009), and polytherapy. Studies on newer ASMs are also limited, and further studies on an interplay with thyroid hormone homeostasis are essential to improve the care for epilepsy patients. ASMs are associated with alterations in thyroid hormone metabolism. Thyroid function monitoring is indicated in patients on ASMs, especially those with refractory epilepsy and those on polytherapy. We provide a practical guideline for thyroid function monitoring for the clinician taking care of patients on ASMs.
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Affiliation(s)
- Anne Maria Rochtus
- Department of Pediatric Endocrinology, University Hospitals Leuven, Leuven, Belgium.,Department of Pediatric Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Dorien Herijgers
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
| | - Katrien Jansen
- Department of Pediatric Neurology, University Hospitals Leuven, Leuven, Belgium
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Wolters BA, Aartsma Y, Jansen K, van Hest R. Travel history and challenges of screening for latent TB infection in child asylum seekers. Int J Tuberc Lung Dis 2021; 25:945-947. [PMID: 34686238 DOI: 10.5588/ijtld.21.0223] [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: 11/10/2022] Open
Affiliation(s)
- B A Wolters
- Public Health TB Clinic, Regional Public Health Service Groningen, Groningen, The Netherlands, Department of Pulmonology and Tuberculosis, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands, Public Health TB Clinic, Regional Public Health Service Fryslân, Leeuwarden, The Netherlands
| | - Y Aartsma
- Public Health TB Clinic, Regional Public Health Service Groningen, Groningen, The Netherlands
| | - K Jansen
- Public Health TB Clinic, Regional Public Health Service Groningen, Groningen, The Netherlands
| | - R van Hest
- Public Health TB Clinic, Regional Public Health Service Groningen, Groningen, The Netherlands, Department of Pulmonology and Tuberculosis, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands, Public Health TB Clinic, Regional Public Health Service Drenthe, Assen, The Netherlands
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Jansen K, Steurer S. DOG1 expression is in common human tumors: A tissue microarray study on more than 15,000 tissue samples. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction/Objective
Introduction: DOG1 (Discovered on GIST1) is a voltage-gated calcium-activated chloride and bicarbonate channel that is highly expressed in interstitial cells of Cajal and in gastrointestinal stromal tumors (GIST) derived from Cajal cells.
Methods/Case Report
Methods: To systematically determine in what tumor entities and normal tissue types DOG1 may be further expressed, a tissue microarray (TMA) containing 15,965 samples from 121 different tumor types and subtypes as well as 608 samples of 76 different normal tissue types was analyzed by immunohistochemistry.
Results (if a Case Study enter NA)
Results: DOG1 immunostaining was found in 67 tumor types including GIST (95.7%), esophageal squamous cell carcinoma (31.9%), pancreatic ductal adenocarcinoma (33.6%), adenocarcinoma of the Papilla Vateri (20%), squamous cell carcinoma of the vulva (15.8%) and the oral cavity (15.3%), mucinous ovarian cancer (15.3%), esophageal adenocarcinoma (12.5%), endometrioid endometrial cancer (12.1%), neuroendocrine carcinoma of the colon (11.1%) and diffuse gastric adenocarcinoma (11%). Low level-DOG1 immunostaining was seen in 17 additional tumor entities. DOG1 expression was unrelated to histopathological parameters of tumor aggressiveness and/or patient prognosis in cancers of the breast (n=1,002), urinary bladder (975), ovary (469), endometrium (173), stomach (233), and thyroid gland (512).
Conclusion
High DOG1 expression was linked to estrogen receptor expression in breast cancer (p<0.0001) and absence of HPV infection in squamous cell carcinomas (p=0.0008). In conclusion, our data identify several tumor entities that can show DOG1 expression levels at similar levels as in GIST. Although DOG1 is tightly linked to a diagnosis of GIST in spindle cell tumors, the differential diagnosis is much broader in DOG1 positive epithelioid neoplasms.
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Affiliation(s)
- K Jansen
- Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Hamburg, GERMANY
| | - S Steurer
- University Medical Center Hamburg-Eppendorf, Hamburg, Hamburg, GERMANY
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Alexandrou C, Bacchio S, Bergner G, Constantinou M, Di Carlo M, Dimopoulos P, Finkenrath J, Fiorenza E, Frezzotti R, Garofalo M, Hadjiyiannakou K, Kostrzewa B, Koutsou G, Jansen K, Lubicz V, Mangin-Brinet M, Manigrasso F, Martinelli G, Papadiofantous E, Pittler F, Rossi G, Sanfilippo F, Simula S, Tarantino C, Todaro A, Urbach C, Wenger U. Quark masses using twisted-mass fermion gauge ensembles. Int J Clin Exp Med 2021. [DOI: 10.1103/physrevd.104.074515] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Swinnen L, Chatzichristos C, Jansen K, Lagae L, Depondt C, Seynaeve L, Vancaester E, Van Dycke A, Macea J, Vandecasteele K, Broux V, De Vos M, Van Paesschen W. Accurate detection of typical absence seizures in adults and children using a two-channel electroencephalographic wearable behind the ears. Epilepsia 2021; 62:2741-2752. [PMID: 34490891 PMCID: PMC9292701 DOI: 10.1111/epi.17061] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/09/2021] [Accepted: 08/23/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Patients with absence epilepsy sensitivity <10% of their absences. The clinical gold standard to assess absence epilepsy is a 24-h electroencephalographic (EEG) recording, which is expensive, obtrusive, and time-consuming to review. We aimed to (1) investigate the performance of an unobtrusive, two-channel behind-the-ear EEG-based wearable, the Sensor Dot (SD), to detect typical absences in adults and children; and (2) develop a sensitive patient-specific absence seizure detection algorithm to reduce the review time of the recordings. METHODS We recruited 12 patients (median age = 21 years, range = 8-50; seven female) who were admitted to the epilepsy monitoring units of University Hospitals Leuven for a 24-h 25-channel video-EEG recording to assess their refractory typical absences. Four additional behind-the-ear electrodes were attached for concomitant recording with the SD. Typical absences were defined as 3-Hz spike-and-wave discharges on EEG, lasting 3 s or longer. Seizures on SD were blindly annotated on the full recording and on the algorithm-labeled file and consequently compared to 25-channel EEG annotations. Patients or caregivers were asked to keep a seizure diary. Performance of the SD and seizure diary were measured using the F1 score. RESULTS We concomitantly recorded 284 absences on video-EEG and SD. Our absence detection algorithm had a sensitivity of .983 and false positives per hour rate of .9138. Blind reading of full SD data resulted in sensitivity of .81, precision of .89, and F1 score of .73, whereas review of the algorithm-labeled files resulted in scores of .83, .89, and .87, respectively. Patient self-reporting gave sensitivity of .08, precision of 1.00, and F1 score of .15. SIGNIFICANCE Using the wearable SD, epileptologists were able to reliably detect typical absence seizures. Our automated absence detection algorithm reduced the review time of a 24-h recording from 1-2 h to around 5-10 min.
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Affiliation(s)
- Lauren Swinnen
- Laboratory for Epilepsy Research, KU Leuven and Department of Neurology, University Hospitals, Leuven, Belgium
| | - Christos Chatzichristos
- Department of Electrical Engineering, STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, KU Leuven, Leuven, Belgium
| | - Katrien Jansen
- Department Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Lieven Lagae
- Department Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Laura Seynaeve
- Department of Neurology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.,Neuroprotection and Neuromodulation, Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | | | | | - Jaiver Macea
- Laboratory for Epilepsy Research, KU Leuven and Department of Neurology, University Hospitals, Leuven, Belgium
| | - Kaat Vandecasteele
- Department of Electrical Engineering, STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, KU Leuven, Leuven, Belgium
| | - Victoria Broux
- Laboratory for Epilepsy Research, KU Leuven and Department of Neurology, University Hospitals, Leuven, Belgium
| | - Maarten De Vos
- Department of Electrical Engineering, STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, KU Leuven, Leuven, Belgium.,Department Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Wim Van Paesschen
- Laboratory for Epilepsy Research, KU Leuven and Department of Neurology, University Hospitals, Leuven, Belgium
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Ansari AH, Pillay K, Dereymaeker A, Jansen K, Van Huffel S, Naulaers G, De Vos M. A Deep Shared Multi-Scale Inception Network Enables Accurate Neonatal Quiet Sleep Detection with Limited EEG Channels. IEEE J Biomed Health Inform 2021; 26:1023-1033. [PMID: 34329177 DOI: 10.1109/jbhi.2021.3101117] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In this paper, we introduce a new variation of the Convolutional Neural Network Inception block, called Sinc, for sleep stage classification in premature newborn babies using electroencephalogram (EEG). In practice, there are many medical centres where only a limited number of EEG channels are recorded. Existing automated algorithms mainly use multi-channel EEGs which perform poorly when fewer numbers of channels are available. The proposed Sinc utilizes multi-scale analysis to place emphasis on the temporal EEG information to be less dependent on the number of EEG channels. In Sinc, we increase the receptive fields through Inception while by additionally sharing the filters that have similar receptive fields, overfitting is controlled and the number of trainable parameters dramatically reduced. To train and test this model, 96 longitudinal EEG recordings from 26 premature infants are used. The Sinc-based model significantly outperforms state-of-the-art neonatal quiet sleep detection algorithms, with mean Kappa 0.77 0.01 (with 8-channel EEG) and 0.75 0.01 (with a single bipolar channel EEG). This is the first study using Inception-based networks for EEG analysis that utilizes filter sharing to improve efficiency and trainability. The suggested network can successfully detect quiet sleep stages with even a single EEG channel making it more practical especially in the hospital setting where cerebral function monitoring is predominantly used.
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Abdulmajid L, Bosisio FM, Brems H, De Vlieger G, Garmyn M, Segers H, Demaerel P, Segers K, Jansen K, Lagae L, Verheecke M. An update on congenital melanocytic nevus syndrome: A case report and literature review. J Cutan Pathol 2021; 48:1497-1503. [PMID: 34255877 DOI: 10.1111/cup.14097] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 06/12/2021] [Accepted: 07/06/2021] [Indexed: 11/30/2022]
Abstract
Congenital melanocytic nevus syndrome (CMNS) is a rare condition characterized by pigmented skin lesions that are usually present at birth and are associated with an increased risk of neurological abnormalities and malignant melanoma. It mostly results from a post-zygotic NRAS mutation of neural-derived crest cells, leading to uncontrolled cell growth. Because of the increased knowledge of the genetics underlying CMNS, targeted therapy becomes a promising treatment option. We present a case of CMNS in a newborn. Physical examination at birth showed a giant congenital melanocytic nevus, extending from the occipital to the lower lumbar region. A magnetic resonance imaging scan revealed multiple cerebral and cerebellar parenchymal lesions. Genetic analysis of the cutaneous lesions showed the presence of an NRAS Q61R mutation. The patient was treated with dermabrasion to reduce the color intensity of the nevus. However, this was complicated by recurrent wound infections and laborious wound healing. At the age of 1 year, the patient had an age-appropriate psychomotor development, without neurological deficits.
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Affiliation(s)
- Lilaf Abdulmajid
- Faculty of Medicine and Health Sciences, University Antwerp, Wilrijk, Belgium
| | | | - Hilde Brems
- Department of Human Genetics, University Hospitals Leuven, UZ/KU Leuven, Leuven, Belgium
| | - Greet De Vlieger
- Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Marjan Garmyn
- Department of Dermatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Heidi Segers
- Department of Pediatric Hemato-Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Philippe Demaerel
- Department of Radiology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Katarina Segers
- Department of Plastic and Reconstructive surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Katrien Jansen
- Department of Development and Regeneration, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Lieven Lagae
- Department of Development and Regeneration, Section Pediatric Neurology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Magali Verheecke
- Department of Obstetrics and Gynecology, AZ Turnhout, Turnhout, Belgium
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39
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Kunpalin Y, Deprest J, Papastefanou I, Bredaki E, Sacco A, Russo F, Richter J, Jansen K, Ourselin S, De Coppi P, David AL, Ushakov F, De Catte L. Incidence and patterns of abnormal corpus callosum in fetuses with isolated spina bifida aperta. Prenat Diagn 2021; 41:957-964. [PMID: 33834531 PMCID: PMC7613455 DOI: 10.1002/pd.5945] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine the incidence and characterise corpus callosum (CC) abnormalities in fetuses with spina bifida aperta (SBA) between 18 and 26 weeks of gestation. METHODS This was a retrospective study on fetuses with isolated SBA and who were assessed for fetal surgery. Digitally stored ultrasound images of the brain were reviewed for the presence/absence of the CC, and the length and diameter of its constituent parts (rostrum, genu, body and splenium). We used regression analysis to determine the relationship between CC abnormalities and gestational age, head circumference, ventricle size, lesion level and lesion type. RESULTS Nearly three-quarters of fetuses with isolated SBA had an abnormal CC (71.7%, 76/106). Partial agenesis was most common in the splenium (18.9%, 20/106) and the rostrum (13.2%, 14/106). The most common abnormal pattern was of a short CC with normal diameter throughout. Of note, 20.8% (22/106) had a hypoplastic genu and 28.3% (30/106) had a thick body part. Larger lateral ventricle size was associated with partial agenesis of the CC (odds ratio [OR]: 0.14, p < 0.001) and inversely associated with a shorter CC (OR: 2.60, p < 0.01). CONCLUSION An abnormal CC is common in fetuses with isolated SBA who are referred for fetal surgery.
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Affiliation(s)
- Yada Kunpalin
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
- Department of Development and Regeneration, Cluster Woman and Child, Biomedical Sciences, KU Leuven, Leuven, Belgium
| | - Jan Deprest
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
- Department of Development and Regeneration, Cluster Woman and Child, Biomedical Sciences, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
| | | | - Emma Bredaki
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Adalina Sacco
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Francesca Russo
- Department of Development and Regeneration, Cluster Woman and Child, Biomedical Sciences, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
| | - Jute Richter
- Department of Development and Regeneration, Cluster Woman and Child, Biomedical Sciences, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
| | - Katrien Jansen
- Department of Development and Regeneration, Cluster Woman and Child, Biomedical Sciences, KU Leuven, Leuven, Belgium
- Department of Paediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Paolo De Coppi
- Department of Development and Regeneration, Cluster Woman and Child, Biomedical Sciences, KU Leuven, Leuven, Belgium
- Great Ormond Street Institute of Child's Health, University College London, London, UK
| | - Anna L. David
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
- Department of Development and Regeneration, Cluster Woman and Child, Biomedical Sciences, KU Leuven, Leuven, Belgium
| | - Fred Ushakov
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Luc De Catte
- Department of Development and Regeneration, Cluster Woman and Child, Biomedical Sciences, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
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40
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Ferguson RR, Dellantonio L, Balushi AA, Jansen K, Dür W, Muschik CA. Measurement-Based Variational Quantum Eigensolver. Phys Rev Lett 2021; 126:220501. [PMID: 34152185 DOI: 10.1103/physrevlett.126.220501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 06/13/2023]
Abstract
Variational quantum eigensolvers (VQEs) combine classical optimization with efficient cost function evaluations on quantum computers. We propose a new approach to VQEs using the principles of measurement-based quantum computation. This strategy uses entangled resource states and local measurements. We present two measurement-based VQE schemes. The first introduces a new approach for constructing variational families. The second provides a translation of circuit- to measurement-based schemes. Both schemes offer problem-specific advantages in terms of the required resources and coherence times.
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Affiliation(s)
- R R Ferguson
- Institute for Quantum Computing and Department of Physics and Astronomy, University of Waterloo, Waterloo N2L 3G1, Canada
| | - L Dellantonio
- Institute for Quantum Computing and Department of Physics and Astronomy, University of Waterloo, Waterloo N2L 3G1, Canada
| | - A Al Balushi
- Institute for Quantum Computing and Department of Physics and Astronomy, University of Waterloo, Waterloo N2L 3G1, Canada
| | - K Jansen
- NIC, DESY Zeuthen, Platanenallee 6, 15738 Zeuthen, Germany
| | - W Dür
- Institut für Theoretische Physik, Universität Innsbruck, Technikerstraße 21a, 6020 Innsbruck, Austria
| | - C A Muschik
- Institute for Quantum Computing and Department of Physics and Astronomy, University of Waterloo, Waterloo N2L 3G1, Canada
- Perimeter Institute for Theoretical Physics, Waterloo, Ontario N2L 2Y5, Canada
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41
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Generali T, Jansen K, Steedman R, De Rita F, Viganò G, McParlin D, Hermuzi A, Crossland D, O'Sullivan J, Coats L, Hasan A, Nassar MS. Contemporary Ross procedure outcomes: medium- to long-term results in 214 patients. Eur J Cardiothorac Surg 2021; 60:1112-1121. [PMID: 33969415 DOI: 10.1093/ejcts/ezab193] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 01/18/2021] [Accepted: 02/22/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Our goal was to present 2 decades of our experience with the Ross procedure and its sequential modifications, adopted since 2010, to improve the reoperation rate. METHODS We performed a single-centre, retrospective review of database information and medical notes about the implantation technique: the freestanding root. We compared era 1 (1997-2009) and era 2 (2010-2019). RESULTS Between 1997 and 2019, a total of 214 Ross procedures were performed (71% men, median age 24 years) [interquartile range (IQR) 15-38]. Of these, 87% had various forms of congenital-dysplastic aortic valves. The median cross-clamping and bypass times were 173 (IQR 148-202) and 202 (IQR 182-244) min. The median postoperative stay was 6 days (2-77). Thirty-day mortality was 0.5%. The median follow-up time was 8.2 years (IQR 3.9-13.2). Survival at 10 and 20 years was 97% and 95%; freedom from greater than moderate aortic regurgitation or aortic valve intervention was 91% and 80%; and 93% of the patients were in New York Heart Association functional class I. Twenty (21%) patients operated on during era 1 and 6 (9%) during era 2 underwent autograft reoperations. The median follow-up time was 14.3 (IQR 11.5-17.4) and 4.8 (IQR 2.5-7) years. Freedom from autograft reoperation was 87% and 69% at 10 and 20 years, with no significant difference between eras. Freedom from homograft reoperation was 96% and 76% at 10 and 20 years. The presence of aortic regurgitation, infective endocarditis and era 1 were predictors of autograft reoperation. Male gender and era 1 were predictors of neoaortic root dilatation. CONCLUSIONS The contemporary modified Ross procedure continues to deliver excellent results and should remain part of the strategy to treat children and young adults requiring aortic valve replacement.
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Affiliation(s)
- T Generali
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - K Jansen
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Congenital Heart Disease Research Group, Population Health Science Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - R Steedman
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - F De Rita
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - G Viganò
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - D McParlin
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - A Hermuzi
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - D Crossland
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Congenital Heart Disease Research Group, Population Health Science Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - J O'Sullivan
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Congenital Heart Disease Research Group, Population Health Science Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - L Coats
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Congenital Heart Disease Research Group, Population Health Science Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - A Hasan
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - M S Nassar
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Congenital Heart Disease Research Group, Population Health Science Institute, Newcastle University, Newcastle Upon Tyne, UK
- Cardiothoracic Unit, Alexandria University, Alexandria, Egypt
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42
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Bucciol G, Tousseyn T, Jansen K, Casteels I, Tangye SG, Breuer J, Brown JR, Wollants E, Van Ranst M, Moens L, Mekahli D, Meyts I. Hematopoietic Stem Cell Transplantation Cures Chronic Aichi Virus Infection in a Patient with X-linked Agammaglobulinemia. J Clin Immunol 2021; 41:1403-1405. [PMID: 33948812 DOI: 10.1007/s10875-021-01056-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/27/2021] [Indexed: 01/08/2023]
Affiliation(s)
- Giorgia Bucciol
- Department of Pediatrics, University Hospital Leuven, Herestraat 49, 3000, Leuven, Belgium.,Laboratory of Inborn Errors of Immunity, Department of Immunology, Microbiology and Transplantation, KU Leuven, Leuven, Belgium
| | - Thomas Tousseyn
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Katrien Jansen
- Department of Pediatrics, University Hospital Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Ingele Casteels
- Department of Ophthalmology, University Hospital Leuven, Leuven, Belgium
| | - Stuart G Tangye
- Immunity & Inflammation Theme, Garvan Institute of Medical Research, Sydney, NSW, Australia.,Faculty of Medicine, St Vincent's Clinical School, UNSW Sydney, Sydney, NSW, Australia
| | - Judy Breuer
- Department of Microbiology, Virology and Infection Prevention and Control, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Julianne R Brown
- Department of Microbiology, Virology and Infection Prevention and Control, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Elke Wollants
- Laboratory of Clinical and Epidemiological Virology (Rega Institute), KU Leuven, Leuven, Belgium
| | - Marc Van Ranst
- Laboratory of Clinical and Epidemiological Virology (Rega Institute), KU Leuven, Leuven, Belgium.,Department of Immunology, Microbiology and Transplantation, KU Leuven, Leuven, Belgium
| | - Leen Moens
- Laboratory of Inborn Errors of Immunity, Department of Immunology, Microbiology and Transplantation, KU Leuven, Leuven, Belgium
| | - Djalila Mekahli
- Department of Pediatric Nephrology, University Hospital Leuven, Leuven, Belgium.,PKD Research Group, Pediatric Laboratory, Department of Development and Regeneration, GPURE, KU Leuven, Leuven, Belgium
| | - Isabelle Meyts
- Department of Pediatrics, University Hospital Leuven, Herestraat 49, 3000, Leuven, Belgium. .,Laboratory of Inborn Errors of Immunity, Department of Immunology, Microbiology and Transplantation, KU Leuven, Leuven, Belgium.
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43
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Rochtus AM, Herijgers D, Jansen K, Decallonne B. Antiepileptic Drugs and Thyroid Hormone Homeostasis: Literature Review and Practical Guideline. J Endocr Soc 2021. [PMCID: PMC8090243 DOI: 10.1210/jendso/bvab048.1679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Thyroid hormones play an essential role in central nervous system development, normal physiological brain function and repairing mechanisms. On one hand, thyroid hormone alterations influence cortical excitability and on the other hand anti-epileptic drugs (AEDs) are associated with alterations in thyroid hormone metabolism. Although this interaction has long been described, and epilepsy is a common and chronic neurological disease, studies describing the interplay are often small and retrospective. We performed a systematic review of the current literature on epilepsy, AED therapy and thyroid hormone metabolism. Forty-seven studies were included. Most studies were retrospective cross-sectional studies (n=25) and investigated thyroid function alterations in patients on older AEDs such as phenobarbital, phenytoin, carbamazepine and valproic acid. Overall, almost one third of patients with epilepsy had subclinical hypothyroidism, especially patients on valproate and carbamazepine. Studies with patients receiving polytherapy are scarce, but reported a higher risk for hypothyroidism in patients with older age, female sex, longer duration of epilepsy, intractable epilepsy and polytherapy. Studies on newer AEDs are also scarce and further studies essential to improve the care for epilepsy patients. AEDs are associated with alterations in thyroid hormone metabolism. Thyroid function monitoring is indicated in patients on AEDs, especially those with refractory chronic epilepsy and those on polytherapy. We provide a practical guideline for thyroid function monitoring for the clinician taking care of patients on AEDs.
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44
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Lavanga M, Bollen B, Caicedo A, Dereymaeker A, Jansen K, Ortibus E, Van Huffel S, Naulaers G. The effect of early procedural pain in preterm infants on the maturation of electroencephalogram and heart rate variability. Pain 2021; 162:1556-1566. [PMID: 33110029 PMCID: PMC8054544 DOI: 10.1097/j.pain.0000000000002125] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 01/18/2023]
Abstract
ABSTRACT Preterm infants show a higher incidence of cognitive, social, and behavioral problems, even in the absence of major medical complications during their stay in the neonatal intensive care unit (NICU). Several authors suggest that early-life experience of stress and procedural pain could impact cerebral development and maturation resulting in an altered development of cognition, behavior, or motor patterns in later life. However, it remains very difficult to assess this impact of procedural pain on physiological development. This study describes the maturation of electroencephalogram (EEG) signals and heart rate variability in a prospective cohort of 92 preterm infants (<34 weeks gestational age) during their NICU stay. We took into account the number of noxious, ie, skin-breaking, procedures they were subjected in the first 5 days of life, which corresponded to a median age of 31 weeks and 4 days. Using physiological signal modelling, this study shows that a high exposure to early procedural pain, measured as skin-breaking procedures, increased the level of discontinuity in both EEG and heart rate variability in preterm infants. These findings have also been confirmed in a subset of the most vulnerable preterm infants with a gestational age lower than 29 weeks. We conclude that a high level of early pain exposure in the NICU increases the level of functional dysmaturity, which can ultimately impact preterm infants' future developmental outcome.
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Affiliation(s)
- Mario Lavanga
- Department of Electrical Engineering (ESAT), Division STADIUS, KU Leuven, Leuven, Belgium
| | - Bieke Bollen
- Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Alexander Caicedo
- Department of Applied Mathematics and Computer Science, School of Engineering, Science and Technology, Universidad Del Rosario, Bogota', Colombia
| | - Anneleen Dereymaeker
- Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Katrien Jansen
- Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Els Ortibus
- Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Sabine Van Huffel
- Department of Electrical Engineering (ESAT), Division STADIUS, KU Leuven, Leuven, Belgium
| | - Gunnar Naulaers
- Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium
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45
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Hofmeister B, von Stülpnagel C, Betzler C, Mari F, Renieri A, Baldassarri M, Haberlandt E, Jansen K, Schilling S, Weber P, Ahlbory K, Tang S, Berweck S, Kluger G. Epilepsy in Nicolaides-Baraitser Syndrome: Review of Literature and Report of 25 Patients Focusing on Treatment Aspects. Neuropediatrics 2021; 52:109-122. [PMID: 33578439 DOI: 10.1055/s-0041-1722878] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Nicolaides-Baraitser syndrome (NCBRS), caused by a mutation in the SMARCA2 gene, which goes along with intellectual disability, congenital malformations, especially of face and limbs, and often difficult-to-treat epilepsy, is surveyed focusing on epilepsy and its treatment. Patients were recruited via "Network Therapy of Rare Epilepsies (NETRE)" and an international NCBRS parent support group. Inclusion criterion is NCBRS-defining SMARCA2 mutation. Clinical findings including epilepsy classification, anticonvulsive treatment, electroencephalogram (EEG) findings, and neurodevelopmental outcome were collected with an electronic questionnaire. Inclusion of 25 NCBRS patients with epilepsy in 23 of 25. Overall, 85% of the participants (17/20) reported generalized seizures, the semiology varied widely. EEG showed generalized epileptogenic abnormalities in 53% (9/17), cranial magnetic resonance imaging (cMRI) was mainly inconspicuous. The five most frequently used anticonvulsive drugs were valproic acid (VPA [12/20]), levetiracetam (LEV [12/20]), phenobarbital (PB [8/20]), topiramate (TPM [5/20]), and carbamazepine (CBZ [5/20]). LEV (9/12), PB (6/8), TPM (4/5), and VPA (9/12) reduced the seizures' frequency in more than 50%. Temporary freedom of seizures (>6 months) was reached with LEV (4/12), PB (3/8), TPM (1/5, only combined with PB and nitrazepam [NZP]), and VPA (4/12). Seizures aggravation was observed under lamotrigine (LTG [2/4]), LEV (1/12), PB (1/8), and VPA (1/12). Ketogenic diet (KD) and vagal nerve stimulation (VNS) reduced seizures' frequency in one of two each. This first worldwide retrospective analysis of anticonvulsive therapy in NCBRS helps to treat epilepsy in NCBRS that mostly shows only initial response to anticonvulsive therapy, especially with LEV and VPA, but very rarely shows complete freedom of seizures in this, rather genetic than structural epilepsy.
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Affiliation(s)
- Benedikt Hofmeister
- Department of Gastroenterology, Hepatology and Gastrointestinal Oncology, Technical University of Munich, Bogenhausen Academic Teaching Hospital, Munich, Germany
| | - Celina von Stülpnagel
- Institute for Transition, Rehabilitation and Palliation, Paracelsus Private Medical University of Salzburg, Salzburg, Austria.,Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Department of Pediatrics, Comprehensive Epilepsy Program for Children, University Hospital Munich, Munich, Germany
| | - Cornelia Betzler
- Institute for Transition, Rehabilitation and Palliation, Paracelsus Private Medical University of Salzburg, Salzburg, Austria.,Clinic for Neuropediatrics and Neurological Rehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik Vogtareuth, Vogtareuth, Germany
| | - Francesca Mari
- Department of Medical Genetics, University of Siena, Sienna, Italy
| | | | | | - Edda Haberlandt
- Department of Pediatrics, Krankenhaus der Stadt Dornbirn, Dornbirn, Austria
| | - Katrien Jansen
- Department of Development and Regeneration, University Hospitals of Leuven, Leuven, Belgium
| | - Stefan Schilling
- Department of Neuropediatrics, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Germany
| | - Peter Weber
- Department of Neuro- and Developmental Pediatrics, University Children's Hospital Basel, Basel, Switzerland
| | - Katja Ahlbory
- Department of Neuropediatrics, Children's Hospital Amsterdamer Straße, Kliniken Köln, Cologne, Germany
| | - Shan Tang
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, United Kingdom
| | - Steffen Berweck
- Clinic for Neuropediatrics and Neurological Rehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik Vogtareuth, Vogtareuth, Germany.,Department of Pediatrics, Ludwig Maximilian University of Munich, Munich, Germany
| | - Gerhard Kluger
- Institute for Transition, Rehabilitation and Palliation, Paracelsus Private Medical University of Salzburg, Salzburg, Austria.,Clinic for Neuropediatrics and Neurological Rehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik Vogtareuth, Vogtareuth, Germany
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46
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Gonzalez Fernandez O, De Rita F, Coats L, Crossland D, Nassar M, Hermuzi A, Santos Lopez B, Woods A, Robinson-Smith N, Petit T, Seller N, O´Sullivan J, McDiarmid A, Schueler S, Hasan A, MacGowan G, Jansen K. Ventricular Assist Devices in Adults with Failing Systemic Right Ventricle: The Importance of Concomitant Tricuspid Valve Replacement. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.321] [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: 10/21/2022] Open
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47
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Fernandez OG, De Rita F, Hasan A, Schueler S, MacGowan G, Jansen K. HVAD Decommission in a Failing Mustard: Making Virtue out of Necessity. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2110] [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: 11/30/2022] Open
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48
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Schöfer H, Enders M, Esser S, Feiterna-Sperling C, Hagedorn HJ, Magistro G, Mayr C, Münstermann D, Hahn K, Jansen K, Klein M, Krause W, Maschke M, Ochsendorf FR, Osowski S, Petry KU, Potthoff A, Rieg S, Sing A, Stücker M, Weberschock T, Werner RN, Brockmeyer NH. [Diagnosis and treatment of syphilis : Update of the S2k guidelines 2020 of the German STI Society (DSTIG) in cooperation with the following specialist societies: DAIG, dagnä, DDG, DGA, DGGG, DGHM, DGI, DGN, DGPI, DGU, RKI]. Hautarzt 2021; 71:969-999. [PMID: 32940778 DOI: 10.1007/s00105-020-04672-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- H Schöfer
- Helios Dr. Horst Schmidt Kliniken, Deutsche Klinik für Diagnostik, Aukamm-Allee 33, 65191, Wiesbaden, Deutschland.
| | - M Enders
- Labor Prof. Gisela Enders & Kollegen MVZ Stuttgart, Stuttgart, Deutschland
| | - S Esser
- Leiter der HIV/STD-Ambulanz, Klinik für Dermatologie und Venerologie, Universitätsklinikum Essen, Essen, Deutschland
| | - C Feiterna-Sperling
- Klinik für Pädiatrie m. S. Pneumologie, Immunologie und Intensivmedizin, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | | | - G Magistro
- Urologische Klinik, Ludwig-Maximilians-Universität München, München, Deutschland
| | - C Mayr
- Facharzt für Innere Medizin/Infektiologie, Hausärztliche Betreuung, Zentrum für Infektiologie Berlin, Prenzlauer Berg (ZIBP), MVZ, Berlin, Deutschland
| | | | - K Hahn
- Klinik für Neurologie, Universitätsmedizin Charité, Campus Charité Mitte, Berlin, Deutschland
| | - K Jansen
- Abteilung für Infektionsepidemiologie, Fachgebiet für HIV/AIDS und andere sexuell oder durch Blut übertragbare Infektionen, Robert Koch-Institut, Berlin, Deutschland
| | - M Klein
- Abteilung: Neurologische Klinik, Ludwig-Maximilians-Universität München, Klinikum Großhadern, München, Deutschland
| | - W Krause
- Hautklinik der Philipps-Universität, Marburg, Deutschland
| | - M Maschke
- Abteilung: Neurologie, Neurophysiologie und neurologische Frührehabilitation, MVZ der Barmherzigen Brüder Trier, Sektion Neurologie, Psychiatrie, Trier, Deutschland
| | - F R Ochsendorf
- Klinik für Dermatologie, Venerologie und Allergologie (KDVA), Universitätsklinikum Frankfurt, Frankfurt, Deutschland
| | - S Osowski
- Klinik f. Dermatologie, Venerologie und Allergologie (KDVA) und Evidenzbasierte Medizin, Institut für Allgemeinmedizin, Goethe-Universität Frankfurt, Frankfurt, Deutschland
| | - K U Petry
- Frauenklinik, Klinikum der Stadt Wolfsburg, Wolfsburg, Deutschland
| | - A Potthoff
- WIR "Walk In Ruhr" im St. Elisabeth-Hospital, Bochum, Deutschland
| | - S Rieg
- Abteilung Infektiologie, Klinik für Innere Medizin II, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - A Sing
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Oberschleißheim, Deutschland
| | - M Stücker
- Klinik für Dermatologie, Venerologie und Allergologie, Ruhr-Universität Bochum, Bochum, Deutschland
| | - T Weberschock
- Klinik f. Dermatologie, Venerologie und Allergologie (KDVA) und Evidenzbasierte Medizin, Institut für Allgemeinmedizin, Goethe-Universität Frankfurt, Frankfurt, Deutschland
| | - R N Werner
- Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence-Based Medicine (dEBM), Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - N H Brockmeyer
- WIR "Walk In Ruhr" im St. Elisabeth-Hospital, Bochum, Deutschland
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49
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Lavanga M, Heremans E, Moeyersons J, Bollen B, Jansen K, Ortibus E, Naulaers G, Van Huffel S, Caicedo A. Maturation of the Autonomic Nervous System in Premature Infants: Estimating Development Based on Heart-Rate Variability Analysis. Front Physiol 2021; 11:581250. [PMID: 33584326 PMCID: PMC7873975 DOI: 10.3389/fphys.2020.581250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 12/02/2020] [Indexed: 11/13/2022] Open
Abstract
This study aims at investigating the development of premature infants' autonomic nervous system (ANS) based on a quantitative analysis of the heart-rate variability (HRV) with a variety of novel features. Additionally, the role of heart-rate drops, known as bradycardias, has been studied in relation to both clinical and novel sympathovagal indices. ECG data were measured for at least 3 h in 25 preterm infants (gestational age ≤32 weeks) for a total number of 74 recordings. The post-menstrual age (PMA) of each patient was estimated from the RR interval time-series by means of multivariate linear-mixed effects regression. The tachograms were segmented based on bradycardias in periods after, between and during bradycardias. For each of those epochs, a set of temporal, spectral and fractal indices were included in the regression model. The best performing model has R 2 = 0.75 and mean absolute error MAE = 1.56 weeks. Three main novelties can be reported. First, the obtained maturation models based on HRV have comparable performance to other development models. Second, the selected features for age estimation show a predominance of power and fractal features in the very-low- and low-frequency bands in explaining the infants' sympathovagal development from 27 PMA weeks until 40 PMA weeks. Third, bradycardias might disrupt the relationship between common temporal indices of the tachogram and the age of the infant and the interpretation of sympathovagal indices. This approach might provide a novel overview of post-natal autonomic maturation and an alternative development index to other electrophysiological data analysis.
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Affiliation(s)
- Mario Lavanga
- Division STADIUS, Department of Electrical Engineering (ESAT), Katholieke Universiteit Leuven, Leuven, Belgium
| | - Elisabeth Heremans
- Division STADIUS, Department of Electrical Engineering (ESAT), Katholieke Universiteit Leuven, Leuven, Belgium
| | - Jonathan Moeyersons
- Division STADIUS, Department of Electrical Engineering (ESAT), Katholieke Universiteit Leuven, Leuven, Belgium
| | - Bieke Bollen
- Department of Development and Regeneration, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Katrien Jansen
- Department of Development and Regeneration, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Els Ortibus
- Department of Development and Regeneration, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Gunnar Naulaers
- Department of Development and Regeneration, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Sabine Van Huffel
- Division STADIUS, Department of Electrical Engineering (ESAT), Katholieke Universiteit Leuven, Leuven, Belgium
| | - Alexander Caicedo
- Applied Mathematics and Computer Science, School of Engineering, Science and Technology, Universidad del Rosario, Bogotá, Colombia
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50
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Constantine A, Jenkins P, Oliver J, Chung N, Jansen K, Fitzsimmons S, Walker N, Papaioannou V, Parry H, Condliffe R, Tulloh R, Dimopoulos K, Clift P. Multicentre study on pulmonary arterial hypertension therapies in fontan patients: underutilised or of limited use? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The Fontan circulation is successful in abolishing cyanosis and chronic volume overload in congenital heart disease (CHD) patients with single ventricle physiology. “Fontan failure” is a major cause of poor quality of life and mortality in these patients. Recently, pulmonary arterial hypertension (PAH) therapies have been used in Fontan patients with variable success, even though patients included in these studies are generally at the best end of the spectrum.
Aim
To assess contemporary patterns of PAH therapy in Fontan patients in large specialist CHD centres.
Methods
We identified all adult patients with a Fontan-type circulation under active follow-up in 8 specialist CHD centres between 2009 and 2019. Patients on PAH therapies were matched by age and gender to untreated patients (1:1 or 1:2). Baseline data were collated immediately prior to initiation of therapy (treated group) or from a synchronous routine clinical assessment (untreated group).
Results
During the study period, 70 Fontan patients were started on PAH therapy (6.5% of those under follow-up). The majority 63 (90.0%) were started on monotherapy with a phosphodiesterase-5 (PDE5) inhibitor, 6 (8.6%) patients were started on an endothelin receptor antagonist (ERA) and 1 (1.4%) received early sequential therapy with a PDE5 inhibitor and ERA. Prostacyclin analogues were not used, and no patients received triple therapy. Overall, 51 (72.9%) patients started therapy electively (49% in outpatient clinic, 51% as day case admission), while 18 (25.7%) were treated following urgent hospital admission with fluid overload +/− acute kidney injury. The remainder (2,2.9%) started therapy following cardiac surgery. Adverse events during treatment were rare. Patients starting PAH therapy were matched to 112 untreated patients (table 1). Patients were well matched between groups for age (p=0.52) and sex (p=0.27). Treated patients were more likely to be significantly impaired than matched patients (56.7% vs. 8.6% in NYHA class III/IV, p<0.0001) and were more likely to have ascites (16.2% vs. 0.9%, p=0.0002). Treated patients were also more likely to have a lower albumin level (43 [14–56] vs. 45 [29–54], p=0.01) or to be on a loop diuretic e.g. furosemide (p<0.0001), at a higher daily dose (p<0.0001) than matched patients. Only a quarter of patients on therapies had no high-risk features (24.2%), 80% of whom were from a single centre.
Conclusion
A small minority of Fontan patients followed in specialist centres receive PAH therapies. PAH therapy was reserved in most centres for patients with more advanced disease, targeting predominantly those with a “failing Fontan” in an individualised approach, in line with the recent adult CHD American Heart Association (AHA) guidelines. Further studied are needed to establish the role of PAH therapies in Fontan patients, provided that adult patients with advanced disease who are at increased risk of adverse outcome are included.
Figure 1
Funding Acknowledgement
Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Dr Constantine received an educational grant from Actelion Pharmaceuticals, a Janssen company of Johnson & Johnson, which helped to pay for travel for data collection.
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Affiliation(s)
| | - P Jenkins
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - J Oliver
- Leeds General Infirmary, Leeds, United Kingdom
| | - N Chung
- St Thomas' Hospital, London, United Kingdom
| | - K Jansen
- Freeman Hospital, Newcastle-Upon-Tyne, United Kingdom
| | - S Fitzsimmons
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - N Walker
- Golden Jubilee National Hospital, Glasgow, United Kingdom
| | - V Papaioannou
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - H Parry
- Leeds General Infirmary, Leeds, United Kingdom
| | - R Condliffe
- Royal Hallamshire Hospital, Sheffield, United Kingdom
| | - R Tulloh
- Bristol Heart Institute, Bristol, United Kingdom
| | | | - P Clift
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
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