1
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Pontell ME, Barrero CE, Naidu K, Hitchner M, Wagner CS, Salinero LK, Swanson JW, Bartlett SP, Taylor JA. Changes in Ventricular Volume After Posterior Vault Distraction Osteogenesis in Patients With Syndromic and Nonsyndromic Craniosynostosis. J Craniofac Surg 2024; 35:1967-1971. [PMID: 39194194 DOI: 10.1097/scs.0000000000010405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 05/18/2024] [Indexed: 08/29/2024] Open
Abstract
OBJECTIVE Little is known about the response of the ventricular system to cranial vault surgery in patients with craniosynostosis. This study aims to evaluate the changes in the cerebral ventricular system in response to posterior vault distraction osteogenesis (PVDO) in patients with syndromic and nonsyndromic craniosynostosis. METHODS A single-institution retrospective review of all patients with craniosynostosis undergoing PVDO from 2000 to 2022 was completed. Patients were included for analysis if they had pre and postoperative cranial computed tomography scans. Ventricular volume (VV) and intracranial volume (ICV) were calculated using segmentation software. RESULTS Both patients with syndromic synostosis and nonsyndromic synostosis (NSS) experienced a significant increase in ICV after PVDO, but only patients with NSS experienced a significant VV change ( P = 0.004). After normalization by ICV, total, lateral, and third VV changes retained significance with percentage increases of 114%, 117%, and 89%, respectively ( P < 0.05 for all). CONCLUSION The differing results between cohorts reinforce the concept that the intracranial milieu is different between patients with syndromic synostosis and NSS. The results of the NSS cohort suggest that these patients may exist in a compensated state in which a reduction in cerebral blood flow and VV allows for the maintenance of parenchymal health to prevent the development of intracranial hypertension. Further studies may explore VV as a surrogate marker of ICP elevation, and the utility of cranial vault remodeling on nonsynostotic pathologies with cephalocranial disproportion.
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Affiliation(s)
- Matthew E Pontell
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Carlos E Barrero
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Kirin Naidu
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Michaela Hitchner
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Connor S Wagner
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Lauren K Salinero
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Jordan W Swanson
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Scott P Bartlett
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Jesse A Taylor
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
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2
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Kim HY, Lee YA, Shin CH, Cho TJ, Ko JM. Clinical Manifestations and Outcomes of 20 Korean Hypochondroplasia Patients with the FGFR3 N540K variant. Exp Clin Endocrinol Diabetes 2023; 131:123-131. [PMID: 36442838 DOI: 10.1055/a-1988-9734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hypochondroplasia is a skeletal dysplasia caused by activating pathologic variants of FGFR3. The N540K variant accounts for 60-70% of reported cases and is associated with severe manifestations. Here, we analyze the clinical manifestations and outcomes of Korean patients with hypochondroplasia harboring the FGFR3 N540K variant. METHODS Medical records of 20 unrelated patients with genetically confirmed N540K-related hypochondroplasia were retrospectively reviewed. All individuals were diagnosed with hypochondroplasia by Sanger sequencing for FGFR3, or target-panel sequencing for skeletal dysplasia. The effectiveness of growth hormone therapy was analyzed in 16 patients treated with growth hormones. RESULTS Among 20 patients (7 men, 13 women), the mean age at first visit was 3.5±1.0 years, and the mean follow-up duration was 6.8±0.6 years. The patients presented with a short stature and/or short limbs. Genu varum, macrocephaly, and developmental delay were observed in 11 (55.0%), 9 (45.0%), and 5 (25.0%) patients, respectively. Of the 12 patients who underwent neuroimaging, five (41.7%) showed abnormal findings (one required operation for obstructive hydrocephalus). Among 16 growth-hormone-treated patients (two were growth-hormone deficient), the increase in height standard deviation scores was significant after a mean 5.4±0.7 years of treatment (+0.6 and+1.8 using growth references for healthy controls and achondroplasia children, respectively). Four patients underwent surgical limb lengthening at a mean age of 8.8±3.3 years. CONCLUSIONS Neurodevelopmental abnormalities are frequently observed in patients with N540K-related hypochondroplasia. Close monitoring of skeletal manifestations and neurodevelopmental status is necessary for hypochondroplasia.
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Affiliation(s)
- Hwa Young Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Young Ah Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Choong Ho Shin
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Tae-Joon Cho
- Department of Orthopaedics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Min Ko
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.,Rare Disease Center, Seoul National University Hospital, Seoul, Korea
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3
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Ahmadi M, Herting A, Mueffelmann B, Woermann FG, Abou Jamra R, Bien CG, Polster T, Brandt C. Hypochondroplasia and temporal lobe epilepsy - A series of 4 cases. Epilepsy Behav 2022; 126:108479. [PMID: 34922328 DOI: 10.1016/j.yebeh.2021.108479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/26/2021] [Accepted: 11/27/2021] [Indexed: 11/03/2022]
Abstract
Hypochondroplasia is a skeletal dysplasia syndrome with an autosomal dominant inheritance. It may be associated with temporal lobe epilepsy. We present a series of four patients (two female, two male) with hypochondroplasia who presented at our center with drug refractory epilepsy. Clinical details and EEG and MRI findings led to a diagnosis of temporal lobe epilepsy in all four cases. The MRI findings indicate the epilepsy in hypochondroplasia may be associated with bilateral temporal lobe dysgenesis.
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Affiliation(s)
- Mehdi Ahmadi
- Dept. of Epileptology (Krankenhaus Mara), Bielefeld University, Medical School, Campus Bielefeld-Bethel, Maraweg 21, 33617 Bielefeld, Germany.
| | - Arne Herting
- Dept. of Epileptology (Krankenhaus Mara), Bielefeld University, Medical School, Campus Bielefeld-Bethel, Maraweg 21, 33617 Bielefeld, Germany.
| | - Birgitt Mueffelmann
- Dept. of Epileptology (Krankenhaus Mara), Bielefeld University, Medical School, Campus Bielefeld-Bethel, Maraweg 21, 33617 Bielefeld, Germany.
| | | | - Rami Abou Jamra
- Institute of Human Genetics, University Medical Center Leipzig, Leipzig, Germany.
| | - Christian G Bien
- Dept. of Epileptology (Krankenhaus Mara), Bielefeld University, Medical School, Campus Bielefeld-Bethel, Maraweg 21, 33617 Bielefeld, Germany.
| | - Tilman Polster
- Dept. of Epileptology (Krankenhaus Mara), Bielefeld University, Medical School, Campus Bielefeld-Bethel, Maraweg 21, 33617 Bielefeld, Germany.
| | - Christian Brandt
- Dept. of Epileptology (Krankenhaus Mara), Bielefeld University, Medical School, Campus Bielefeld-Bethel, Maraweg 21, 33617 Bielefeld, Germany.
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4
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Bernardo P, Budetta M, Aliberti F, Carpentieri ML, De Brasi D, Sorrentino L, Russo C, D'amico A, Cinalli G, Santoro C, Coppola A. Temporal lobe malformations, focal epilepsy, and FGFR3 mutations: a non-causal association? Neurol Sci 2021; 42:2063-2067. [PMID: 33389251 DOI: 10.1007/s10072-020-04923-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 11/19/2020] [Indexed: 12/01/2022]
Abstract
Temporal lobe abnormalities and focal epilepsy have been documented in FGFR3-related clinical condition, including hypochondroplasia and Muenke syndrome. FGFR3 is expressed in the brain during development and could play a role in nervous system development and hippocampal formation. These observations suggest a non-casual association between temporal malformation, epilepsy, and FGFR3 mutations. Herein, we report clinical, electroclinical, and neuroimaging findings of three additional cases of focal epilepsy and temporal lobe malformations occurring in children with FGFR3 gene mutations.
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Affiliation(s)
- Pia Bernardo
- Department of Neurosciences and Neurosurgery, Santobono-Pausilipon Children's Hospital, Naples, Italy. .,Department of Translational Medical Science, Pediatric Section, University of Naples Federico II, Naples, Italy. .,Department of Neurosciences, Pediatric Psychiatry and Neurology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy.
| | - Mauro Budetta
- Paediatric and Child Neurology Unit, Cava de' Tirreni AOU S. Giovanni di Dio e Ruggiero d'Aragona Hospital, Salerno, Italy
| | - Ferdinando Aliberti
- Department of Neurosciences and Neurosurgery, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Maria Luisa Carpentieri
- Paediatric and Child Neurology Unit, Cava de' Tirreni AOU S. Giovanni di Dio e Ruggiero d'Aragona Hospital, Salerno, Italy
| | - Daniele De Brasi
- Department of Pediatrics, AORN Santobono Pausilipon, Naples, Italy
| | - Livio Sorrentino
- Paediatric and Child Neurology Unit, Cava de' Tirreni AOU S. Giovanni di Dio e Ruggiero d'Aragona Hospital, Salerno, Italy
| | - Carmela Russo
- Department of Neurosciences, Department of Neuroradiology, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Alessandra D'amico
- Department of Advanced Biomedical Sciences, University "Federico II", Naples, Italy
| | - Giuseppe Cinalli
- Department of Neurosciences and Neurosurgery, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Claudia Santoro
- Referral Centre of Neurofibromatosis, Department of Woman and Child, "Luigi Vanvitelli" University of Campania, Naples, Italy.,Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonietta Coppola
- Epilepsy Centre, Department of Neuroscience, Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
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5
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Mutti C, Riccò M, Bartolini Y, Bernabè G, Trippi I, Melpignano A, Ciliento R, Zinno L, Florindo I, Sasso E, Odone A, Parrino L, Vaudano AE. Incomplete hippocampal inversion and epilepsy: A systematic review and meta-analysis. Epilepsia 2020; 62:383-396. [PMID: 33325054 DOI: 10.1111/epi.16787] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 11/20/2020] [Accepted: 11/20/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Incomplete hippocampal inversion (IHI) is a relatively frequent radiological finding at visual inspection in both epilepsy and healthy controls, but its clinical significance is unclear. Here, we systematically retrieve and assess the association between epilepsy and IHI using a meta-analytic approach. Additionally, we estimate the prevalence of IHI in patients with malformation of cortical development (MCD). METHODS We systematically searched two databases (Embase and PubMed) to identify potentially eligible studies from their inception to December 2019. For inclusion, studies were population-based, case-control, observational studies reporting on epilepsy and IHI. The risk of developing epilepsy in IHI (estimated with odds ratio [ORs]) and the frequency of IHI among patients with MCD are provided. RESULTS We screened 3601 records and assessed eligibility of 2812 full-text articles. The final material included 13 studies involving 1630 subjects. Seven studies (1329 subjects: 952 epileptic and 377 nonepileptic) were included for the estimation of the risk of developing epilepsy in the presence of IHI. The estimated OR of active epilepsy in IHI was 1.699 (95% confidence interval = 0.880-3.281), with moderate heterogeneity across studies (I2 = 71%). Seven studies (591 patients) provided information about the frequency of IHI in MCD. Up to one third of patients with MCD (27.9%) presented coexistent IHI. SIGNIFICANCE The present findings confirm that IHI is commonly observed in patients with MCD especially in periventricular nodular heterotopia or polymicrogyria. However, the estimated OR indicates overall weak increased odds of epilepsy in people with IHI, suggesting that the presence of isolated IHI cannot be considered a strong independent predictor for epilepsy development. Clear-cut neuroradiological criteria for IHI and advanced postprocessing analyses on structural magnetic resonance imaging scans are recommended to highlight differences between epileptogenic and nonepileptogenic IHI.
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Affiliation(s)
- Carlotta Mutti
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Matteo Riccò
- AUSL-IRCCS of Reggio Emilia, Occupational Health and Safety Service, Reggio Emilia, Italy
| | - Yerma Bartolini
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Giorgia Bernabè
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Irene Trippi
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Andrea Melpignano
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Rosario Ciliento
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Lucia Zinno
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Irene Florindo
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Enrico Sasso
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Anna Odone
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - Liborio Parrino
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Anna Elisabetta Vaudano
- Neurology Unit, Baggiovara Hospital, University Hospital of Modena, Modena, Italy.,Department of Biomedical, Metabolic, and Neural Science, and Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
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6
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O'Hara J, Ruggiero F, Wilson L, James G, Glass G, Jeelani O, Ong J, Bowman R, Wyatt M, Evans R, Samuels M, Hayward R, Dunaway DJ. Syndromic Craniosynostosis: Complexities of Clinical Care. Mol Syndromol 2019; 10:83-97. [PMID: 30976282 DOI: 10.1159/000495739] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Patients with syndromic craniosynostosis have a molecularly identified genetic cause for the premature closure of their cranial sutures and associated facial and extra-cranial features. Their clinical complexity demands comprehensive management by an extensive multidisciplinary team. This review aims to marry genotypic and phenotypic knowledge with clinical presentation and management of the craniofacial syndromes presenting most frequently to the craniofacial unit at Great Ormond Street Hospital for Children NHS Foundation Trust.
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Affiliation(s)
- Justine O'Hara
- Great Ormond Street Craniofacial Unit, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Federica Ruggiero
- Great Ormond Street Craniofacial Unit, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Louise Wilson
- Great Ormond Street Craniofacial Unit, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Greg James
- Great Ormond Street Craniofacial Unit, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Graeme Glass
- Great Ormond Street Craniofacial Unit, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Owase Jeelani
- Great Ormond Street Craniofacial Unit, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Juling Ong
- Great Ormond Street Craniofacial Unit, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Richard Bowman
- Great Ormond Street Craniofacial Unit, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Michelle Wyatt
- Great Ormond Street Craniofacial Unit, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Robert Evans
- Great Ormond Street Craniofacial Unit, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Martin Samuels
- Great Ormond Street Craniofacial Unit, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Richard Hayward
- Great Ormond Street Craniofacial Unit, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - David J Dunaway
- Great Ormond Street Craniofacial Unit, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children NHS Trust, London, UK
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7
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Manikkam SA, Chetcuti K, Howell KB, Savarirayan R, Fink AM, Mandelstam SA. Temporal Lobe Malformations in Achondroplasia: Expanding the Brain Imaging Phenotype Associated with FGFR3-Related Skeletal Dysplasias. AJNR Am J Neuroradiol 2017; 39:380-384. [PMID: 29170271 DOI: 10.3174/ajnr.a5468] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 09/13/2017] [Indexed: 11/07/2022]
Abstract
Thanatophoric dysplasia, achondroplasia, and hypochondroplasia belong to the fibroblast growth factor receptor 3 (FGFR3) group of genetic skeletal disorders. Temporal lobe abnormalities have been documented in thanatophoric dysplasia and hypochondroplasia, and in 1 case of achondroplasia. We retrospectively identified 13 children with achondroplasia who underwent MR imaging of the brain between 2002 and 2015. All children demonstrated a deep transverse temporal sulcus on MR imaging. Further common neuroimaging findings were incomplete hippocampal rotation (12 children), oversulcation of the mesial temporal lobe (11 children), loss of gray-white matter differentiation of the mesial temporal lobe (5 children), and a triangular shape of the temporal horn (6 children). These appearances are very similar to those described in hypochondroplasia, strengthening the association of temporal lobe malformations in FGFR3-associated skeletal dysplasias.
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Affiliation(s)
- S A Manikkam
- From the Departments of Medical Imaging (S.A. Manikkam, A.M.F., S.A. Mandelstam)
| | - K Chetcuti
- Department of Radiology (K.C.), Alder Hey Children's Hospital, Liverpool, UK
| | - K B Howell
- Neurology (K.B.H.), Royal Children's Hospital, Melbourne, Australia.,Departments of Paediatrics (K.B.H., S.A. Mandelstam).,Murdoch Children's Research Institute (K.B.H., R.S., A.M.F., S.A. Mandelstam), Melbourne, Australia
| | - R Savarirayan
- Murdoch Children's Research Institute (K.B.H., R.S., A.M.F., S.A. Mandelstam), Melbourne, Australia.,Victorian Clinical Genetics Services (R.S.), Melbourne, Australia
| | - A M Fink
- From the Departments of Medical Imaging (S.A. Manikkam, A.M.F., S.A. Mandelstam).,Radiology (A.M.F., S.A. Mandelstam), University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute (K.B.H., R.S., A.M.F., S.A. Mandelstam), Melbourne, Australia
| | - S A Mandelstam
- From the Departments of Medical Imaging (S.A. Manikkam, A.M.F., S.A. Mandelstam).,Departments of Paediatrics (K.B.H., S.A. Mandelstam).,Radiology (A.M.F., S.A. Mandelstam), University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute (K.B.H., R.S., A.M.F., S.A. Mandelstam), Melbourne, Australia.,Florey Institute of Neuroscience and Mental Health (S.A. Mandelstam), Melbourne, Australia
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8
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Okubo Y, Kitamura T, Anzai M, Endo W, Inui T, Takezawa Y, Suzuki-Muromoto S, Miyabayashi T, Togashi N, Oba H, Saitsu H, Matsumoto N, Haginoya K. A patient with Muenke syndrome manifesting migrating neonatal seizures. Brain Dev 2017; 39:873-876. [PMID: 28551036 DOI: 10.1016/j.braindev.2017.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/08/2017] [Accepted: 05/10/2017] [Indexed: 01/05/2023]
Abstract
We report a patient with Muenke syndrome who had repetitive apneic spell followed by focal status epilepticus in the early infancy. Ictal EEG showed focal spikes bursts originated from the left hemisphere and sifted to the right hemisphere, during which he had migrating tonic seizures from right side of the body to the left side of the body. Brain MRI showed abnormal development of bilateral hippocampus, which was characterized as abnormal folding of hippocampal gyri. However, the long-term seizure prognosis was favorable. Results from this and previous studies failed to support the notion that FGFR3 (P250) mutation results in epileptic encephalopathy.
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Affiliation(s)
- Yukimune Okubo
- Department of Pediatric Neurology, Miyagi Children's Hospital, Miyagi, Japan.
| | - Taro Kitamura
- Department of Pediatrics, Sendai City Hospital, Sendai, Japan
| | - Mai Anzai
- Department of Pediatric Neurology, Miyagi Children's Hospital, Miyagi, Japan
| | - Wakaba Endo
- Department of Pediatric Neurology, Miyagi Children's Hospital, Miyagi, Japan
| | - Takehiko Inui
- Department of Pediatric Neurology, Miyagi Children's Hospital, Miyagi, Japan
| | - Yusuke Takezawa
- Department of Pediatric Neurology, Miyagi Children's Hospital, Miyagi, Japan; Department of Pediatrics, Sendai City Hospital, Sendai, Japan
| | | | - Takuya Miyabayashi
- Department of Pediatric Neurology, Miyagi Children's Hospital, Miyagi, Japan
| | - Noriko Togashi
- Department of Pediatric Neurology, Miyagi Children's Hospital, Miyagi, Japan
| | - Hiroshi Oba
- Department of Radiology, Teikyo University Hospital, Tokyo, Japan
| | - Hirotomo Saitsu
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan; Department of Biochemistry, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kazuhiro Haginoya
- Department of Pediatric Neurology, Miyagi Children's Hospital, Miyagi, Japan
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9
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González-Del Angel A, Estandía-Ortega B, Alcántara-Ortigoza MA, Martínez-Cruz V, Gutiérrez-Tinajero DJ, Rasmussen A, Gómez-González CS. Expansion of the variable expression of Muenke syndrome: Hydrocephalus without craniosynostosis. Am J Med Genet A 2016; 170:3189-3196. [PMID: 27568649 DOI: 10.1002/ajmg.a.37951] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 08/11/2016] [Indexed: 11/07/2022]
Abstract
Muenke syndrome (MS) is an autosomal dominant coronal craniosynostosis syndrome with variable extracranial anomalies. We studied 56 unrelated patients with non-syndromic uni- or bicoronal craniosynostosi to identify the frequency and clinical characteristics of MS in a cohort of Mexican childrens. The FGFR3 pathogenic variation p.Pro250Arg responsible for MS was characterized in all probands by PCR-restriction assay; available first-degree relatives (15 parents, 5 siblings) of the confirmed p.Pro250Arg carriers were also tested. All heterozygotes for p.Pro250Arg underwent clinical and audiologic assessment, as well as X-ray evaluations of hands and feet. Eight of 56 probands (14%) were found to carry the p.Pro250Arg variant and half of them were familial cases. Four p.Pro250Arg heterozygous familial members had been considered unaffected before the molecular testing. In one MS family, hydrocephalus without craniosynostosis, was documented as the only clinical manifestation in a previously undetected heterozygous male sibling. Hydrocephalus without craniosynostosis in a patient with the p.Pro250Arg variant suggests that some patients with MS might present only this manifestation; to our knowledge, hydrocephalus has not been described as isolated feature in MS, so we propose to consider this feature as an expansion of the MS phenotype rather than an unrelated finding. Our data also reinforce the notion that molecular testing of FGFR3 must be included in the diagnostic approach of coronal craniosynostosis. This will allow accurate genetic counseling and optimal management of MS, which might otherwise go undiagnosed because of mild manifestations and wide variability of expression. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Ariadna González-Del Angel
- Laboratorio de Biología Molecular, Departamento de Genética, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Bernardette Estandía-Ortega
- Laboratorio de Biología Molecular, Departamento de Genética, Instituto Nacional de Pediatría, Mexico City, Mexico
| | | | - Víctor Martínez-Cruz
- Laboratorio de Biología Molecular, Departamento de Genética, Instituto Nacional de Pediatría, Mexico City, Mexico
| | | | - Astrid Rasmussen
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma
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10
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Colle R, Cury C, Chupin M, Deflesselle E, Hardy P, Nasser G, Falissard B, Ducreux D, Colliot O, Corruble E. Hippocampal volume predicts antidepressant efficacy in depressed patients without incomplete hippocampal inversion. NEUROIMAGE-CLINICAL 2016; 12:949-955. [PMID: 27995060 PMCID: PMC5153557 DOI: 10.1016/j.nicl.2016.04.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/15/2016] [Accepted: 04/26/2016] [Indexed: 12/16/2022]
Abstract
Background Incomplete hippocampal inversion (IHI), also called malrotation, is a frequent atypical anatomical pattern of the hippocampus. Because of the crucial implication of the hippocampus in Major Depressive Disorder (MDD) and the neurodevelopmental hypothesis of MDD, we aimed to assess the prevalence of IHI in patients with MDD, the link of IHI with hippocampal volume (HV) and the impact of IHI on the predictive value of HV for response and remission after antidepressant treatment. Methods IHI (right and left, partial and total and IHI scores) and HV were assessed in 60 patients with a current Major Depressive Episode (MDE) in a context of MDD and 60 matched controls. Patients were prospectively assessed at baseline and after one, three and six months of antidepressant treatment for response and remission. Results The prevalence of IHI did not significantly differ between MDD patients (right = 23.3%; left = 38.3%) and controls (right = 16.7%; left = 33.3%). IHI was not significantly associated with MDD clinical characteristics. IHI alone did not predict response and remission after antidepressant treatment. However, an interaction between left HV and left IHI predicted six-month response (p = 0.04), HDRS score decrease (p = 0.02) and both three-month (p = 0.04) and six-month (p = 0.03) remission. A case-control design in 30 matched patients with or without left IHI confirmed that interaction. In patients without left IHI, left HV at baseline were smaller in six-month non-remitters as compared to remitters (2.2(± 0.43) cm3 vs 2.97(± 0.5) cm3 p = 0.02), and in six-month non-responders as compared to responders (2.18(± 0.42) cm3 vs 2.86(± 0.54) cm3, p = 0.03). In patients with left IHI, no association was found between left HV at baseline and antidepressant response and remission. Conclusion IHI is not more frequent in MDD patients than in controls, is not associated with HV, but is a confounder that decreases the predictive value of hippocampal volume to predict response or remission after antidepressant treatment. IHI should be systematically assessed in future research studies assessing hippocampal volume in MDD. Incomplete hippocampal inversion (IHI) is not significantly more frequent in MDD than in controls. IHI is not significantly associated with MDD clinical characteristics. Hippocampal volume predicts antidepressant efficacy in MDD patients without IHI. Hippocampal volume does not predict antidepressant efficacy in patients with IHI.
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Affiliation(s)
- Romain Colle
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Claire Cury
- INSERM U1127, F-75013 Paris, France; CNRS, UMR 7225, 75013 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMRS 1127, F-75013 Paris, France; Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; Inria, Aramis project-team, Centre de Recherche de Paris, France; AP-HP, Hôpital de la Pitié-Salpêtrière, Departments of Neuroradiology and Neurology, F-75013 Paris, France
| | - Marie Chupin
- INSERM U1127, F-75013 Paris, France; CNRS, UMR 7225, 75013 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMRS 1127, F-75013 Paris, France; Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; Inria, Aramis project-team, Centre de Recherche de Paris, France; AP-HP, Hôpital de la Pitié-Salpêtrière, Departments of Neuroradiology and Neurology, F-75013 Paris, France
| | - Eric Deflesselle
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Patrick Hardy
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Ghaidaa Nasser
- Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; CNRS IR4M, UMR 8081, 94275 Le Kremlin Bicêtre, France; Service de Neuroradiologie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Bruno Falissard
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - Denis Ducreux
- Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; CNRS IR4M, UMR 8081, 94275 Le Kremlin Bicêtre, France; Service de Neuroradiologie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Olivier Colliot
- INSERM U1127, F-75013 Paris, France; CNRS, UMR 7225, 75013 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMRS 1127, F-75013 Paris, France; Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; Inria, Aramis project-team, Centre de Recherche de Paris, France; AP-HP, Hôpital de la Pitié-Salpêtrière, Departments of Neuroradiology and Neurology, F-75013 Paris, France
| | - Emmanuelle Corruble
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
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Cury C, Toro R, Cohen F, Fischer C, Mhaya A, Samper-González J, Hasboun D, Mangin JF, Banaschewski T, Bokde ALW, Bromberg U, Buechel C, Cattrell A, Conrod P, Flor H, Gallinat J, Garavan H, Gowland P, Heinz A, Ittermann B, Lemaitre H, Martinot JL, Nees F, Paillère Martinot ML, Orfanos DP, Paus T, Poustka L, Smolka MN, Walter H, Whelan R, Frouin V, Schumann G, Glaunès JA, Colliot O. Incomplete Hippocampal Inversion: A Comprehensive MRI Study of Over 2000 Subjects. Front Neuroanat 2015; 9:160. [PMID: 26733822 PMCID: PMC4686650 DOI: 10.3389/fnana.2015.00160] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 11/30/2015] [Indexed: 11/13/2022] Open
Abstract
The incomplete-hippocampal-inversion (IHI), also known as malrotation, is an atypical anatomical pattern of the hippocampus, which has been reported in healthy subjects in different studies. However, extensive characterization of IHI in a large sample has not yet been performed. Furthermore, it is unclear whether IHI are restricted to the medial-temporal lobe or are associated with more extensive anatomical changes. Here, we studied the characteristics of IHI in a community-based sample of 2008 subjects of the IMAGEN database and their association with extra-hippocampal anatomical variations. The presence of IHI was assessed on T1-weighted anatomical magnetic resonance imaging (MRI) using visual criteria. We assessed the association of IHI with other anatomical changes throughout the brain using automatic morphometry of cortical sulci. We found that IHI were much more frequent in the left hippocampus (left: 17%, right: 6%, χ(2)-test, p < 10(-28)). Compared to subjects without IHI, subjects with IHI displayed morphological changes in several sulci located mainly in the limbic lobe. Our results demonstrate that IHI are a common left-sided phenomenon in normal subjects and that they are associated with morphological changes outside the medial temporal lobe.
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Affiliation(s)
- Claire Cury
- Institut national de la santé et de la recherche médicale, U1127Paris, France; Centre National de la Recherche Scientifique, UMR 7225 Institut du Cerveau et de la Moelle épinièreParis, France; Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, UMR S 1127Paris, France; Institut du Cerveau et de la Moelle épinière, Institut du Cerveau et de la Moelle épinièreParis, France; Inria, Aramis Team, Centre de Recherche Paris-RocquencourtParis, France; Centre d'Acquisition et de Traitement des ImagesParis, France
| | - Roberto Toro
- Centre National de la Recherche Scientifique, Genes, Synapses and Cognition, URA 2182, Institut PasteurParis, France; Human Genetics and Cognitive Functions, Institut PasteurParis, France
| | - Fanny Cohen
- Institut national de la santé et de la recherche médicale, U1127Paris, France; Centre National de la Recherche Scientifique, UMR 7225 Institut du Cerveau et de la Moelle épinièreParis, France; Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, UMR S 1127Paris, France; Institut du Cerveau et de la Moelle épinière, Institut du Cerveau et de la Moelle épinièreParis, France; Inria, Aramis Team, Centre de Recherche Paris-RocquencourtParis, France
| | - Clara Fischer
- Centre d'Acquisition et de Traitement des ImagesParis, France; Institut d'Imagerie Biomédicale; Commissariat à l'énergie atomique et aux énergies alternatives; Direction des Sciences du VivantGif-Sur-Yvette, France
| | - Amel Mhaya
- Institut national de la santé et de la recherche médicale, U1127Paris, France; Centre National de la Recherche Scientifique, UMR 7225 Institut du Cerveau et de la Moelle épinièreParis, France; Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, UMR S 1127Paris, France; Institut du Cerveau et de la Moelle épinière, Institut du Cerveau et de la Moelle épinièreParis, France; Inria, Aramis Team, Centre de Recherche Paris-RocquencourtParis, France
| | - Jorge Samper-González
- Institut national de la santé et de la recherche médicale, U1127Paris, France; Centre National de la Recherche Scientifique, UMR 7225 Institut du Cerveau et de la Moelle épinièreParis, France; Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, UMR S 1127Paris, France; Institut du Cerveau et de la Moelle épinière, Institut du Cerveau et de la Moelle épinièreParis, France; Inria, Aramis Team, Centre de Recherche Paris-RocquencourtParis, France
| | - Dominique Hasboun
- Institut national de la santé et de la recherche médicale, U1127Paris, France; Centre National de la Recherche Scientifique, UMR 7225 Institut du Cerveau et de la Moelle épinièreParis, France; Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, UMR S 1127Paris, France; Institut du Cerveau et de la Moelle épinière, Institut du Cerveau et de la Moelle épinièreParis, France; Inria, Aramis Team, Centre de Recherche Paris-RocquencourtParis, France; Departments of Neuroradiology and Neurology, AP-HP, Hôpital de la Pitié-SalpétrièreParis, France
| | - Jean-François Mangin
- Centre d'Acquisition et de Traitement des ImagesParis, France; Institut d'Imagerie Biomédicale; Commissariat à l'énergie atomique et aux énergies alternatives; Direction des Sciences du VivantGif-Sur-Yvette, France
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Clinical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg Mannheim, Germany
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine, Trinity College DublinDublin, Ireland; Institute of Neuroscience, Trinity College DublinDublin, Ireland
| | - Uli Bromberg
- Department of Systems Neuroscience, Universitätsklinikum Hamburg Eppendorf Hamburg, Germany
| | - Christian Buechel
- Department of Systems Neuroscience, Universitätsklinikum Hamburg EppendorfHamburg, Germany; Department of Psychology, Stanford UniversityStanford, CA, USA
| | - Anna Cattrell
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK; MRC Social, Genetic and Developmental Psychiatry CentreLondon, UK
| | - Patricia Conrod
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK; Département de Psychiatrie, Centre Hospitalier Universitaire Sainte-Justine, Université de MontrealMontreal, QC, Canada
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University Mannheim, Germany
| | - Juergen Gallinat
- Department of Systems Neuroscience, Universitätsklinikum Hamburg EppendorfHamburg, Germany; Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité-Universitätsmedizin BerlinGermany
| | - Hugh Garavan
- Discipline of Psychiatry, School of Medicine, Trinity College Dublin Dublin, Ireland
| | - Penny Gowland
- School of Physics and Astronomy, University of Nottingham Nottingham, UK
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité-Universitätsmedizin Berlin Germany
| | | | - Hervé Lemaitre
- Institut national de la santé et de la recherche médicale U1000, Neuroimagerie en Psychiatrie, Université Paris-Sud, Université Paris Descartes Paris, France
| | - Jean-Luc Martinot
- Institut national de la santé et de la recherche médicale U1000, Neuroimagerie en Psychiatrie, Université Paris-Sud, Université Paris Descartes Paris, France
| | - Frauke Nees
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University Mannheim, Germany
| | - Marie-Laure Paillère Martinot
- Institut national de la santé et de la recherche médicale U1000, Neuroimagerie en Psychiatrie, Université Paris-Sud, Université Paris DescartesParis, France; AP-HP, Department of Adolescent Psychopathology and Medicine, Maison de Solenn, Cochin Hospital, University Paris Descartes, Sorbonne Paris CitéParis, France
| | - Dimitri P Orfanos
- Institut d'Imagerie Biomédicale; Commissariat à l'énergie atomique et aux énergies alternatives; Direction des Sciences du Vivant Gif-Sur-Yvette, France
| | - Tomas Paus
- Rotman Research Institute, BaycrestToronto, ON, Canada; Departments of Psychology and Psychiatry, University of TorontoToronto, Canada; Center for Developing Brain, Child Mind InstituteNew York, NY, USA
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, Clinical Faculty Mannheim, Central Institute of Mental Health, University of HeidelbergMannheim, Germany; Department of Child and Adolescent Psychiatry, Medical University of ViennaVienna, Austria
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden Dresden, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité-Universitätsmedizin BerlinGermany; Berlin School of Mind and Brain, Humboldt University BerlinBerlin, Germany
| | - Robert Whelan
- Department of Psychology, University College Dublin Dublin, Ireland
| | - Vincent Frouin
- Institut d'Imagerie Biomédicale; Commissariat à l'énergie atomique et aux énergies alternatives; Direction des Sciences du Vivant Gif-Sur-Yvette, France
| | - Gunter Schumann
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK; MRC Social, Genetic and Developmental Psychiatry CentreLondon, UK
| | - Joan A Glaunès
- MAP5, Université Paris Descartes, Sorbonne Paris Cité Paris, France
| | - Olivier Colliot
- Institut national de la santé et de la recherche médicale, U1127Paris, France; Centre National de la Recherche Scientifique, UMR 7225 Institut du Cerveau et de la Moelle épinièreParis, France; Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, UMR S 1127Paris, France; Institut du Cerveau et de la Moelle épinière, Institut du Cerveau et de la Moelle épinièreParis, France; Inria, Aramis Team, Centre de Recherche Paris-RocquencourtParis, France; Centre d'Acquisition et de Traitement des ImagesParis, France; Departments of Neuroradiology and Neurology, AP-HP, Hôpital de la Pitié-SalpétrièreParis, France
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12
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Cesaretti C, Spaccini L, Rustico M, Parazzini C, Doneda C, Re TJ, Righini A. Prenatal magnetic resonance imaging detection of temporal lobes and hippocampal anomalies in hypochondroplasia. Prenat Diagn 2014; 34:1015-7. [DOI: 10.1002/pd.4415] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 05/14/2014] [Accepted: 05/14/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Claudia Cesaretti
- Radiology and Neuroradiology Department; Children's Hospital V. Buzzi; Milan Italy
- Medical Genetics Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico; Milan Italy
| | - Luigina Spaccini
- Obstetrics and Gynecology Department; Children's Hospital V. Buzzi; Milan Italy
| | - Mariangela Rustico
- Obstetrics and Gynecology Department; Children's Hospital V. Buzzi; Milan Italy
| | - Cecilia Parazzini
- Radiology and Neuroradiology Department; Children's Hospital V. Buzzi; Milan Italy
| | - Chiara Doneda
- Radiology and Neuroradiology Department; Children's Hospital V. Buzzi; Milan Italy
| | - Thomas J. Re
- Radiology Institute; University of Milan; Milan Italy
| | - Andrea Righini
- Radiology and Neuroradiology Department; Children's Hospital V. Buzzi; Milan Italy
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Does the co-occurrence of FGFR3 gene mutation in hypochondroplasia, medial temporal lobe dysgenesis, and focal epilepsy suggest a syndrome? Pediatr Neurol 2014; 50:427-30. [PMID: 24630288 DOI: 10.1016/j.pediatrneurol.2014.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 12/23/2013] [Accepted: 01/01/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND Hypochondroplasia is a rare skeletal dysplasia characterized by disproportionately short stature, lumbar lordosis, and limited extension of the elbow caused by mutations in the fibroblast growth factor receptor 3 (FGFR3) gene that plays a role in controlling nervous system development. Hypochondroplasia with FGFR3 mutation associated with bilateral medial temporal lobe anomalies and focal epilepsy was previously reported in several patients. PATIENT We report clinical, electroclinical, and neuroradiological findings of one patient affected by hypochondroplasia. RESULTS Clinical diagnosis was confirmed by molecular analysis of the FGFR3 gene, which showed a N540 K mutation. The patient had normal psychomotor development and showed early-onset focal seizures with left temporal localization on interictal and ictal electroencephalograph. The seizures were well controlled, and the patient has been seizure-free since infancy. Magnetic resonance imaging showed abnormal anteriorly posteriorly infolding in the hippocampus and abnormally oriented parahippocampus sulci, and additional cortical rim dysplasia with gray-white matter junction blurring in the hippocampus. CONCLUSIONS The present case of hypochondroplasia and FGFR3 mutation in Asn540Lys associated with characteristic abnormalities involving bilaterally medial temporal lobe structures, probable hippocampal cortex focal dysplasia, and early onset of focal epilepsy underscores the possibility of a rare syndrome.
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Aravidis C, Konialis CP, Pangalos CG, Kosmaidou Z. A familial case of Muenke syndrome. Diverse expressivity of the FGFR3 Pro252Arg mutation--case report and review of the literature. J Matern Fetal Neonatal Med 2013; 27:1502-6. [PMID: 24168007 DOI: 10.3109/14767058.2013.860520] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Muenke is a fibroblast growth factor receptor 3 (FGFR-3)-associated syndrome, which was first described in late 1990 s. Muenke syndrome is an autosomal dominant disorder characterized mainly by coronal suture craniosynostosis, hearing impairment and intellectual disability. The syndrome is defined molecularly by a unique point mutation c.749C > G in exon 7 of the FGFR3 gene which results to an amino acid substitution p.Pro250Arg of the protein product. Despite the fact that the mutation rate at this nucleotide is one of the most frequently described in human genome, few Muenke familial case reports are published in current literature. We describe individuals among three generations of a Greek family who are carriers of the same mutation. Medical record and physical examination of family members present a wide spectrum of clinical manifestations. In particular, a 38-year-old woman and her father appear milder clinical findings regarding craniofacial characteristics compared to her uncle and newborn female child. This familial case illustrates the variable expressivity of Muenke syndrome in association with an identical gene mutation.
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Affiliation(s)
- Christos Aravidis
- Critical Care Department, Cytogenetics Unit, Evangelismos Hospital, Medical School of Athens University , Athens , Greece
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15
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Philpott CM, Widjaja E, Raybaud C, Branson HM, Kannu P, Blaser S. Temporal and occipital lobe features in children with hypochondroplasia/FGFR3 gene mutation. Pediatr Radiol 2013; 43:1190-5. [PMID: 23649205 DOI: 10.1007/s00247-013-2684-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 01/14/2013] [Accepted: 01/30/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND Thanatophoric dysplasia (TD) and hypochondroplasia are both caused by FGFR3 (fibroblast growth factor receptor 3) gene mutations. Temporal lobe dysplasia has been well described in thanatophoric dysplasia; however, only a couple of anecdotal cases of temporal lobe dysplasia in hypochondroplasia have been described. OBJECTIVE To define temporal lobe abnormalities in patients with hypochondroplasia, given that they share the same genetic mutation. MATERIALS AND METHODS We identified brain imaging studies of nine children with hypochondroplasia. The temporal lobes were assessed on CT and MRI for size and configuration of the temporal horn and aberrant sulcation of the inferior surface of the temporal lobe. RESULTS All children had a triangular-shape temporal horn and deep transverse fissures of the inferior temporal lobe surface. Neuroimaging in our cohort revealed enlarged temporal lobes and oversulcation of the mesial temporal and occipital lobes, with abnormal inferomedial orientation of these redundant gyri. Hippocampal dysplasia was also universal. CONCLUSION We confirmed frequent inferomesial temporal and occipital lobe abnormalities in our cohort of children with hypochondroplasia. Murine models with mutant fgfr3 display increased neuroprogenitor proliferation, cortical thickness and surface area in the temporo-occipital cortex. This is thought to result in excessive convolution and likely explains the imaging findings in this patient cohort. (Note that fgfr3 is the same genetic mutation in mice as FGFR3 is in humans.).
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Affiliation(s)
- Cristina M Philpott
- Department of Neuroradiology, The Hospital for Sick Children, Toronto, ON, Canada.
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Agochukwu NB, Solomon BD, Benson LJ, Muenke M. Talocalcaneal coalition in Muenke syndrome: report of a patient, review of the literature in FGFR-related craniosynostoses, and consideration of mechanism. Am J Med Genet A 2013; 161A:453-60. [PMID: 23378035 PMCID: PMC3581720 DOI: 10.1002/ajmg.a.35233] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Accepted: 01/04/2012] [Indexed: 01/08/2023]
Abstract
Muenke syndrome is an autosomal dominant craniosynostosis syndrome resulting from a defining point mutation in the Fibroblast Growth Factor Receptor3 (FGFR3) gene. Muenke syndrome is characterized by coronal craniosynostosis (bilateral more often than unilateral), hearing loss, developmental delay, and carpal and/or tarsal bone coalition. Tarsal coalition is a distinct feature of Muenke syndrome and has been reported since the initial description of the disorder in the 1990s. Although talocalcaneal coalition is the most common tarsal coalition in the general population, it has never previously been reported in a patient with Muenke syndrome. We present a 7-year-old female patient with Muenke syndrome and symptomatic talocalcaneal coalition. She presented at the age of 7 with limping, tenderness and pain in her right foot following a fall and strain of her right foot. She was treated with ibuprofen, shoe inserts, a CAM walker boot, and stretching exercises without much improvement in symptoms. A computed tomography (CT) scan revealed bilateral talocalcaneal coalitions involving the middle facet. She underwent resection of the talocalcaneal coalitions, remaining pain-free post-operatively with an improvement in her range of motion, gait, and mobility. This report expands the phenotype of tarsal coalition in Muenke syndrome to include talocalcaneal coalition. A literature review revealed a high incidence of tarsal coalition in all FGFR related craniosynostosis syndromes when compared to the general population, a difference that is statistically significant. The most common articulation involved in all syndromic craniosynostoses associated with FGFR mutations is the calcaneocuboid articulation.
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Affiliation(s)
- Nneamaka B. Agochukwu
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health
- Clinical Research Training Program, National Institutes of Health, Bethesda, MD, USA
| | - Benjamin D. Solomon
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health
| | | | - Maximilian Muenke
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health
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Linnankivi T, Mäkitie O, Valanne L, Toiviainen-Salo S. Neuroimaging and neurological findings in patients with hypochondroplasia and FGFR3 N540K mutation. Am J Med Genet A 2012; 158A:3119-25. [PMID: 23165795 DOI: 10.1002/ajmg.a.35642] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2012] [Accepted: 08/02/2012] [Indexed: 11/07/2022]
Abstract
Hypochondroplasia (HCH), an autosomal dominant skeletal dysplasia caused by mutations in the FGFR3 gene, has not been commonly associated with neurological problems. Temporal lobe dysgenesis associated with epilepsy was recently described in single patients. In this retrospective study, we assessed neurological and neuroimaging aspects of 13 FGFR3 (N540K) mutation verified HCH patients in Finland. Eight patients had neurocognitive difficulties, ranging from specific learning disorder (2/13) to mild intellectual disability (5/13) or global developmental delay (1/13). Six of 13 patients had a history of seizures or epilepsy. Eight patients had undergone MRI. They all had structural abnormalities consistent with temporal lobe dysgenesis. Six patients had peritrigonal white matter reduction, and 4 had abnormally shaped lateral ventricles. We recommend a close follow-up of development in patients with HCH and a low threshold for neuroimaging.
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Affiliation(s)
- Tarja Linnankivi
- Department of Pediatric Neurology, Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.
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Agochukwu NB, Solomon BD, Gropman AL, Muenke M. Epilepsy in Muenke syndrome: FGFR3-related craniosynostosis. Pediatr Neurol 2012; 47:355-61. [PMID: 23044018 PMCID: PMC4133743 DOI: 10.1016/j.pediatrneurol.2012.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Accepted: 07/18/2012] [Indexed: 12/21/2022]
Abstract
Epilepsy, a neurologic disorder characterized by the predisposition to recurrent unprovoked seizures, is reported in more than 300 genetic syndromes. Muenke syndrome is an autosomal-dominant craniosynostosis syndrome characterized by unilateral or bilateral coronal craniosynostosis, hearing loss, intellectual disability, and relatively subtle limb findings such as carpal bone fusion and tarsal bone fusion. Muenke syndrome is caused by a single defining point mutation in the fibroblast growth factor receptor 3 (FGFR3) gene. Epilepsy rarely occurs in individuals with Muenke syndrome, and little detail is reported on types of epilepsy, patient characteristics, and long-term outcomes. We present seven patients with Muenke syndrome and seizures. A review of 789 published cases of Muenke syndrome, with a focus on epilepsy and intracranial anomalies in Muenke syndrome, revealed epilepsy in six patients, with intracranial anomalies in five. The occurrence of epilepsy in Muenke syndrome within our cohort of 58 patients, of whom seven manifested epilepsy, and the intracranial anomalies and epilepsy reported in the literature, suggest that patients with Muenke syndrome may be at risk for epilepsy and intracranial anomalies. Furthermore, the impact of Muenke syndrome on the central nervous system may be greater than previously thought.
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Affiliation(s)
- Nneamaka B. Agochukwu
- Clinical Research Training Program, National Institutes of Health, Bethesda, Maryland,Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Benjamin D. Solomon
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Andrea L. Gropman
- Department of Neurology, Children’s National Medical Center, Washington, DC,Department of Neurology, George Washington University of the Health Sciences, Washington, DC
| | - Maximilian Muenke
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland,Communications should be addressed to: Dr. Muenke; Medical, Genetics Branch; National Human Genome Research Institute; National, Institutes of Health; Building 35, Room 1B-203, MSC 3717; Bethesda, MD 20892.
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de Jong T, Rijken BFM, Lequin MH, van Veelen MLC, Mathijssen IMJ. Brain and ventricular volume in patients with syndromic and complex craniosynostosis. Childs Nerv Syst 2012; 28:137-40. [PMID: 22011964 PMCID: PMC3252498 DOI: 10.1007/s00381-011-1614-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Accepted: 10/10/2011] [Indexed: 11/16/2022]
Abstract
PURPOSE Brain abnormalities in patients with syndromic craniosynostosis can either be a direct result of the genetic defect or develop secondary to compression due to craniosynostosis, raised ICP or hydrocephalus. Today it is unknown whether children with syndromic craniosynostosis have normal brain volumes. The purpose of this study was to evaluate brain and ventricular volume measurements in patients with syndromic and complex craniosynostosis. This knowledge will improve our understanding of brain development and the origin of raised intracranial pressure in syndromic craniosynostosis. METHODS Brain and ventricular volumes were calculated from MRI scans of patients with craniosynostosis, 0.3 to 18.3 years of age. Brain volume was compared to age matched controls from the literature. All patient charts were reviewed to look for possible predictors of brain and ventricular volume. RESULTS Total brain volume in syndromic craniosynostosis equals that of normal controls, in the age range of 1 to 12 years. Brain growth occurred particularly in the first 5 years of age, after which it stabilized. Within the studied population, ventricular volume was significantly larger in Apert syndrome compared to all other syndromes and in patients with a Chiari I malformation. CONCLUSIONS Patients with syndromic craniosynostosis have a normal total brain volume compared to normal controls. Increased ventricular volume is associated with Apert syndrome and Chiari I malformations, which is most commonly found in Crouzon syndrome. We advice screening of all patients with Apert and Crouzon syndrome for the development of enlarged ventricle volume and the presence of a Chiari I malformation.
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Affiliation(s)
- T. de Jong
- Department of Plastic and Reconstructive Surgery, and Hand Surgery, Sophia Children’s Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - B. F. M. Rijken
- Department of Plastic and Reconstructive Surgery, and Hand Surgery, Sophia Children’s Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M. H. Lequin
- Department of Radiology, Sophia Children’s Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M. L. C. van Veelen
- Department of Neurosurgery, Sophia Children’s Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - I. M. J. Mathijssen
- Department of Plastic and Reconstructive Surgery, and Hand Surgery, Sophia Children’s Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
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Coronal synostosis syndrome (Muenke syndrome): the value of genetic testing versus clinical diagnosis. J Craniofac Surg 2011; 22:187-90. [PMID: 21233754 DOI: 10.1097/scs.0b013e3181f75412] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Muenke syndrome is a fibroblast growth factor receptor 3 (FGFR-3)-associated coronal craniosynostosis syndrome, which was first described in 1997. CASE We report an infant girl who was born to a 29-year-old primapara at 38 weeks' gestation. When evaluated at 3 days old, physical examination revealed a high forehead with frontal bossing, upturned nose, arched palate, shallow midface structures, and heavily ridged coronal sutures bilaterally. Clinically, the infant seemed to be neurologically normal. Skull radiographs and computed tomography confirmed the presence of bilateral coronal synostosis, with patency of all other sutures. Family history was remarkable, in that the infant's father, paternal grandmother, and a paternal cousin demonstrated subtle craniofacial features, which had not been previously identified. Mutation analysis of FGFR-3 revealed a missense mutation in exon 6, c.749 C>G, with a resultant amino acid change from proline to arginine at codon 250 (P250R), in keeping with Muenke syndrome (Am J Hum Genet 1997;60:555-564). The mutation was subsequently identified in her father, suggesting variable expression in this family, as he had only mild midfacial flattening. At 9 months of age, our patient underwent anterior cranial expansion, correction of orbital hypertelorism, intracranial orbital osteotomies, and advancement of the frontal bandeau. She tolerated the procedure well and has done well postoperatively. CONCLUSIONS We report the case of an infant with Muenke syndrome, with evidence of variable expressivity within the paternal family. The pertinent literature, in which only 2 prior Canadian cases were identified, is reviewed.
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Abdel-Salam GMH, Flores-Sarnat L, El-Ruby MO, Parboosingh J, Bridge P, Eid MM, El-Badry TH, Effat L, Curatolo P, Temtamy SA. Muenke syndrome with pigmentary disorder and probable hemimegalencephaly: An expansion of the phenotype. Am J Med Genet A 2010; 155A:207-14. [DOI: 10.1002/ajmg.a.33777] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Abstract
The Muenke syndrome (MS) is characterized by unicoronal or bicoronal craniosynostosis, midfacial hypoplasia, ocular hypertelorism, and a variety of minor abnormalities associated with a mutation in the fibroblast growth factor receptor 3 (FGFR3) gene. The birth prevalence is approximately one in 10,000 live births, accounting for 8-10% of patients with coronal synostosis. Although MS is a relatively common diagnosis in patients with craniosynostosis syndromes, with autosomal dominant inheritance, there has been no report of MS, in an affected Korean family with typical cephalo-facial morphology that has been confirmed by molecular studies. Here, we report a familial case of MS in a female patient with a Pro250Arg mutation in exon 7 (IgII-IGIII linker domain) of the FGFR3 gene. This patient had mild midfacial hypoplasia, hypertelorism, downslanting palpebral fissures, a beak shaped nose, plagio-brachycephaly, and mild neurodevelopmental delay. The same mutation was confirmed in the patient's mother, two of the mother's sisters and the maternal grandfather. The severity of the cephalo-facial anomalies was variable among these family members.
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Affiliation(s)
- Jae Eun Yu
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Dong Ha Park
- Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Soo Han Yoon
- Department of Neurosurgery, Ajou University School of Medicine, Suwon, Korea
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23
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Agostini G, Mancini J, Chabrol B, Villeneuve N, Milh M, George F, Maurel B, Girard N. [Language disorders in children with morphologic abnormalities of the hippocampus]. Arch Pediatr 2010; 17:1008-16. [PMID: 20409697 DOI: 10.1016/j.arcped.2010.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Revised: 02/11/2010] [Accepted: 03/14/2010] [Indexed: 11/29/2022]
Abstract
PURPOSE Morphologic abnormalities of the hippocampal formations (MAHF) are more frequently observed in magnetic resonance imaging (MRI). We wished to specify the types of disorders associated with these malformations based on a retrospective case series by studying the language of the children presenting these abnormalities. PATIENTS AND METHODS From the data of all the MRIs taken in the neuroradiology ward of our center over 16 months in patients under 18 years of age, we retrospectively selected the children with an MAHF, isolated or associated with other malformations. The MAHFs were defined and described according to criteria of shape or orientation defects of the hippocampal formations. We studied the files of the patients with isolated MAHF again. Those whose clinical presentation was compatible with language assessment were tested in a prospective approach. RESULTS Out of 2208 MRIs from 1 January 2007 to 30 April 2008, 96 (4.3%) showed an MAHF, including 61 (64%) boys and 35 (36%) girls, aged from 2 months to 17 years. Eighty-two (85%) had associated abnormalities, mainly including cerebral atrophy, corpus callosum agenesis or defect, and abnormal ventricular frontal horns. Fourteen (15%) had an isolated MAHF: 2 on the left hemisphere, 2 on the right hemisphere, and 10 on both. Of these 14, 9 were compatible with language assessment. From the test results, we divided these children into 2 groups, depending on the type and severity of the impairment. Four had very serious language disorders as part of mental retardation or autistic disorders; 4 others had language disorders predominantly in expression and phonology, with weak to pathological visual memory. This study showed no potential relation between the lateralization of MAHF and language disorders, nor between the existence of epilepsy and the severity of the language disorders. Of these 14 children, 9 had behavior and autism spectrum disorders and 7 were epileptic. CONCLUSION Even though language disorders are often part of a larger deficiency presentation, the results we obtained suggest that isolated MAHFs are not only causes of amnestic disorders, but they could also directly underlie language disorders, particularly in expression.
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Affiliation(s)
- G Agostini
- Service de neurologie pédiatrique, CHU La-Timone, Assistance publique-Hôpitaux de Marseille, 264 rue Saint-Pierre, Marseille, France.
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Escobar LF, Hiett AK, Marnocha A. Significant phenotypic variability of Muenke syndrome in identical twins. Am J Med Genet A 2009; 149A:1273-6. [PMID: 19449410 DOI: 10.1002/ajmg.a.32841] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Muenke syndrome (MS), also known as Muenke nonsyndromic coronal craniosynostosis, is an autosomal dominant condition which can be distinguished from the more common forms of acrocephalosyndactyly but presents a significant variable phenotype. We report on a set of identical twins with a de novo C749G mutation in the FGFR3 gene codon 250 after a pregnancy complicated by prenatal exposure to Nortriptyline. These patients illustrate the variable expressivity of MS in association with an identical gene mutation.
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Affiliation(s)
- Luis F Escobar
- Medical Genetics and Neurodevelopmental Center, St. Vincent Children's Hospital, Indianapolis, Indiana, USA.
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25
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Doherty ES, Lacbawan F, Hadley DW, Brewer C, Zalewski C, Kim HJ, Solomon B, Rosenbaum K, Domingo DL, Hart TC, Brooks BP, Immken L, Lowry RB, Kimonis V, Shanske AL, Jehee FS, Bueno MRP, Knightly C, McDonald-McGinn D, Zackai EH, Muenke M. Muenke syndrome (FGFR3-related craniosynostosis): expansion of the phenotype and review of the literature. Am J Med Genet A 2008; 143A:3204-15. [PMID: 18000976 DOI: 10.1002/ajmg.a.32078] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Muenke syndrome is an autosomal dominant disorder characterized by coronal suture craniosynostosis, hearing loss, developmental delay, carpal and tarsal fusions, and the presence of the Pro250Arg mutation in the FGFR3 gene. Reduced penetrance and variable expressivity contribute to the wide spectrum of clinical findings in Muenke syndrome. To better define the clinical features of this syndrome, we initiated a study of the natural history of Muenke syndrome. To date, we have conducted a standardized evaluation of nine patients with a confirmed Pro250Arg mutation in FGFR3. We reviewed audiograms from an additional 13 patients with Muenke syndrome. A majority of the patients (95%) demonstrated a mild-to-moderate, low frequency sensorineural hearing loss. This pattern of hearing loss was not previously recognized as characteristic of Muenke syndrome. We also report on feeding and swallowing difficulties in children with Muenke syndrome. Combining 312 reported cases of Muenke syndrome with data from the nine NIH patients, we found that females with the Pro250Arg mutation were significantly more likely to be reported with craniosynostosis than males (P < 0.01). Based on our findings, we propose that the clinical management should include audiometric and developmental assessment in addition to standard clinical care and appropriate genetic counseling.
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Affiliation(s)
- Emily S Doherty
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
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Keller MK, Hermann NV, Darvann TA, Larsen P, Hove HD, Christensen L, Schwartz M, Marsh JL, Kreiborg S. Craniofacial morphology in Muenke syndrome. J Craniofac Surg 2007; 18:374-86. [PMID: 17414289 DOI: 10.1097/scs.0b013e31803ffa63] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The purpose of this study was to test whether the severity of the cranial phenotype in Muenke syndrome infants with unicoronal synostosis is greater than in infants with nonsyndromic unicoronal synostosis. A total of 23 infants were included in the study. All infants included in the study had a computed tomography (CT)-verified synostosis of the coronal suture. The patients were either placed into the "Muenke" group (n=11) or the "non-Muenke" control group (n=12) on the basis of a test for the P250R mutation in the FGFR3 gene. On the basis of CT scans, a three-dimensional surface model corresponding to bone was created for each individual. The sutures were inspected for synostosis, and the degree of synostosis was assessed. Increased digital markings were recorded for both groups. Craniofacial morphology was assessed quantitatively using bony landmarks and recording of the midsagittal surface of the calvaria, cranial base, and maxillary complex. Increased digital markings were more severe posteriorly in Muenke patients than in non-Muenke patients. The Muenke patients with unilateral coronal synostosis showed a somewhat more severe asymmetry in the anterior part of the skull than the non-Muenke patients. The study indicates differences with regard to severity of increased digital markings and craniofacial asymmetry between the infants with Muenke syndrome and the infants with nonsyndromic unilateral coronal synostosis.
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Affiliation(s)
- Mette K Keller
- Department of Pediatric Dentistry and Clinical Genetics, School of Dentistry, 3D Laboratory, Faculty of Health Sciences, University of Copenhagen, and the Department of Clinical Genetics, The Juliane Marie Centre, Copenhagen University Hospital, Denmark
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Kinney HC, Armstrong DL, Chadwick AE, Crandall LA, Hilbert C, Belliveau RA, Kupsky WJ, Krous HF. Sudden death in toddlers associated with developmental abnormalities of the hippocampus: a report of five cases. Pediatr Dev Pathol 2007; 10:208-23. [PMID: 17535090 DOI: 10.2350/06-08-0144.1] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2006] [Accepted: 11/27/2006] [Indexed: 12/24/2022]
Abstract
Sudden unexplained death in childhood (SUDC) is the sudden death of a child older than 1 year of age that remains unexplained after review of the clinical history, circumstances of death, and autopsy with appropriate ancillary testing. We report here 5 cases of SUDC in toddlers that we believe define a new entity associated with hippocampal anomalies at autopsy. All of the toddlers died unexpectedly during the night, apparently during sleep. Within 48 hours before death, 2 toddlers had fever, 3 had a minor upper respiratory tract infection, and 3 experienced minor head trauma. There was a history of febrile seizures in 2 (40%) and a family history of febrile seizures in 2 (40%). Hippocampal findings included external asymmetry and 2 or more microdysgenetic features. The incidence of certain microdysgenetic features was substantially increased in the temporal lobes of these 5 cases compared with the temporal lobes of 39 (control) toddlers with the causes of death established at autopsy (P < 0.01). We propose that these 5 cases define a potential subset of SUDC whose sudden death is caused by an unwitnessed seizure arising during sleep in the anomalous hippocampus and producing cardiopulmonary arrest. Precipitating factors may be fever, infection, and/or minor head trauma. Suggested risk factors are a history of febrile seizures and/or a family history of febrile seizures. Future studies are needed to confirm these initial findings and to define the putative links between sudden death, hippocampal anomalies, and febrile seizures in toddlers.
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Affiliation(s)
- Hannah C Kinney
- Department of Pathology, Children's Hospital and Harvard Medical School, Boston, MA, USA.
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Abstract
The authors describe a child who has hypochondroplasia due to an N540K mutation and who has medial temporal lobe dysgenesis. This association has been reported only twice before. FGFR3 is expressed in the brain during development and plays a role in hippocampal formation, and FGFR3 mutations could cause cerebral malformations in hypochondroplasia. Further neuroimaging studies of patients with hypochondroplasia and epilepsy or developmental delay may clarify the proportion of patients with hypochondroplasia with this pattern of central nervous system abnormalities.
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Affiliation(s)
- Peter Kannu
- Genetic Health Services Victoria, Royal Children's Hospital, Melbourne, Australia
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Bernasconi N, Kinay D, Andermann F, Antel S, Bernasconi A. Analysis of shape and positioning of the hippocampal formation: an MRI study in patients with partial epilepsy and healthy controls. ACTA ACUST UNITED AC 2005; 128:2442-52. [PMID: 16014649 DOI: 10.1093/brain/awh599] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of this study was to evaluate systematically shape and positioning of the hippocampal formation (HF) in patients with partial epilepsy related to malformations of cortical development (MCD) and those with temporal lobe epilepsy (TLE). We studied 76 patients with MCD, including focal cortical dysplasia (n = 29; lesions located outside the temporal lobe in all), heterotopia (lesions outside of the temporal lobe, n = 14; lesions extending into the temporal lobe, n = 16), polymicrogyria (bilateral perisylvian, n = 14; unilateral perisylvian, n = 3) and 30 patients with TLE (hippocampal atrophy, n = 15; normal hippocampal volumes, n = 15). Shape and positioning of the HF were evaluated using a set of eight predefined morphological characteristics. In addition, the degree of hippocampal vertical orientation and medial positioning were assessed quantitatively. Patients were compared with 50 healthy controls. At least three criteria describing abnormal HF shape and positioning were found in 5/50 (10%) healthy controls, 37/76 (49%) MCD and 13/30 (43%) TLE patients. An association with all criteria was found in MCD and TLE, but not in healthy controls. In MCD there was no association between the side of HF shape abnormalities and the side of the cortical malformation or the EEG focus. Likewise, in TLE, HF abnormalities were not related to the side of the EEG focus. In both MCD and TLE patients who had hippocampal atrophy, no association was found between the side of HF shape abnormalities and the side of atrophy. Abnormal HF shape and positioning are found in a similar proportion in MCD and TLE. In TLE, they may be a marker of a more extensive disorder of brain development and may participate in the development of this condition.
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Affiliation(s)
- N Bernasconi
- Department of Neurology and Brain Imaging Center, McGill University, Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada
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Kannu P, Hayes IM, Mandelstam S, Donnan L, Savarirayan R. Medial temporal lobe dysgenesis in hypochondroplasia. Am J Med Genet A 2005; 138:389-91. [PMID: 16222682 DOI: 10.1002/ajmg.a.30974] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We describe two patients who have hypochondroplasia with medial temporal lobe dysgenesis. This association has only been reported once before. Both patients had an FGFR3 mutation: 1620C --> A, resulting in Asn540Lys. FGFR3 is expressed in the brain during development and plays a role in hippocampal formation. We suggest FGFR3 mutations might cause cerebral malformations in hypochondroplasia as well as in thanatophoric dysplasia. Further neuroimaging studies of patients with hypochondroplasia and epilepsy or developmental delay may clarify the proportion of patients with hypochondroplasia who have this pattern of central nervous system abnormalities.
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Affiliation(s)
- Peter Kannu
- Genetic Health Services, Victoria, Australia
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Sabatino G, Di Rocco F, Zampino G, Tamburrini G, Caldarelli M, Di Rocco C. Muenke syndrome. Childs Nerv Syst 2004; 20:297-301. [PMID: 14963686 DOI: 10.1007/s00381-003-0906-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2003] [Indexed: 11/26/2022]
Abstract
BACKGROUND Muenke syndrome is a genetically determined craniosynostosis that involves one or both coronal sutures. In some patients it is associated with skeletal abnormalities such as thimble-like middle phalanges, coned epiphysis, and/or neurological impairment, namely sensorineural hearing loss or mental retardation. In spite of a variable phenotype, Muenke syndrome has been related to a unique mutation on the FGFR3 gene, Pro 250 to Arg, which is characteristic of this disease. Because of the incomplete penetrance of this anomaly, the suspicion of Muenke syndrome must be raised in any child with uni- or bilateral coronal craniosynostosis, and the genetic analysis propounded even in the absence of extracranial features. ILLUSTRATIVE CASES We report the cases of two sisters who presented with Muenke syndrome and whose affected mother did not have any form of craniosynostosis.
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Affiliation(s)
- G Sabatino
- Section of Pediatric Neurosurgery, Institute of Neurosurgery, Catholic University Medical School, Largo A. Gemelli 8, 00168 Rome, Italy.
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