Clinical and pathological correlations in Charcot-Marie-Tooth neuropathy type 1A with the 17p11.2p12 duplication: a cross-sectional morphometric and immunohistochemical study in twenty cases

In a cross-sectional, clinical, and morphometric analysis we assessed the correlation between the clinical and pathological evolution of disease in 20 unrelated patients of various ages affected by Charcot-Marie-Tooth neuropathy type 1A (CMT1A) with the 17p11.2p12 (peripheral myelin protein 22, PMP22) duplication. The severity of neurologic deficits and slowing of motor conduction velocity at the median nerve did not vary significantly with the patients' age. The amount of demyelination was significantly higher below 15 years than in older age groups; in contrast, myelinated fiber and onion bulb densities were similar at all ages. The results indicate that in duplicated CMT1A, the pathological process develops early in life and progresses little during the course of the disease. Younger patients had lower g-ratio values, suggesting that the trigger of demyelination in early years could be a hypermyelination, resulting from PMP22 overexpression. Yet none of the 20 patients examined had immunohistochemical evidence of altered PMP22 expression. The early onset and development of the disorder make it difficult to detect PMP22 overdosage in nerve biopsies.

Short term prognosis of stroke in a clinical series of 94 patients

We conducted a study on the factors predictive of early mortality (within 30 days of onset of symptoms) in a clinical series of 94 patients at their first stroke. Irrespective of the type of stroke, ischemic or hemorrhagic, early mortality proved to correlate with clinical parameters, such as coma at onset, presence of paralysis, changes in ocular motility, and neuroradiological parameters (lesion size on the CT scan) indicative of stroke severity.

Cytoskeletal changes induced by 2,5-hexanedione on developing human neurons in vitro

Dissociated dorsal root ganglion cells from human fetuses were exposed to 2,5-hexanedione (2,5-HD) for 2 weeks. Morphological changes induced by 2,5-HD consisted in focal neurofilament (NF)-containing enlargements preferentially located in distal, preterminal regions of unmyelinated fibers. Tangles of NF were also observed in the perikarya of nerve cells. Morphometric analysis disclosed that the cross-sectional areas of the 2,5-HD treated axons were 30% smaller than those of control axons. This alteration was associated with reduction of number of NF per unit area. These findings demonstrate that 2,5-HD treatment induces a generalized disorganization of neuronal and axonal NF responsible for focal enlargements as well as atrophic changes of unmyelinated fibers.

Multifactorial etiological aspects of epilepsy

The results of a computerized analysis of 555 newly recognized idiopathic epilepsy patients (301 males and 254 females) are presented. All patients were under 30 years over the period 1980-1985. The possible prenatal and perinatal risk factors (RFs) for epilepsy were investigated. The data showed that 307 patients (55.5%) had possible RFs; 162 had one possible RF, 145 two or more. The association of two or more RFs had a high frequency in secondary generalized epilepsy (66.6%) and in partial epilepsy. A multifactorial etiology of epilepsy is suggested, hypothesizing a connection either between prenatal and perinatal RFs or between multiple perinatal RFs.