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Serpieri V, D’Abrusco F, Dempsey JC, Cheng YHH, Arrigoni F, Baker J, Battini R, Bertini ES, Borgatti R, Christman AK, Curry C, D'Arrigo S, Fluss J, Freilinger M, Gana S, Ishak GE, Leuzzi V, Loucks H, Manti F, Mendelsohn N, Merlini L, Miller CV, Muhammad A, Nuovo S, Romaniello R, Schmidt W, Signorini S, Siliquini S, Szczałuba K, Vasco G, Wilson M, Zanni G, Boltshauser E, Doherty D, Valente EM. SUFU haploinsufficiency causes a recognisable neurodevelopmental phenotype at the mild end of the Joubert syndrome spectrum. J Med Genet 2022; 59:888-894. [PMID: 34675124 PMCID: PMC9411896 DOI: 10.1136/jmedgenet-2021-108114] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/29/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND Joubert syndrome (JS) is a recessively inherited ciliopathy characterised by congenital ocular motor apraxia (COMA), developmental delay (DD), intellectual disability, ataxia, multiorgan involvement, and a unique cerebellar and brainstem malformation. Over 40 JS-associated genes are known with a diagnostic yield of 60%-75%.In 2018, we reported homozygous hypomorphic missense variants of the SUFU gene in two families with mild JS. Recently, heterozygous truncating SUFU variants were identified in families with dominantly inherited COMA, occasionally associated with mild DD and subtle cerebellar anomalies. METHODS We reanalysed next generation sequencing (NGS) data in two cohorts comprising 1097 probands referred for genetic testing of JS genes. RESULTS Heterozygous truncating and splice-site SUFU variants were detected in 22 patients from 17 families (1.5%) with strong male prevalence (86%), and in 8 asymptomatic parents. Patients presented with COMA, hypotonia, ataxia and mild DD, and only a third manifested intellectual disability of variable severity. Brain MRI showed consistent findings characterised by vermis hypoplasia, superior cerebellar dysplasia and subtle-to-mild abnormalities of the superior cerebellar peduncles. The same pattern was observed in two out of three tested asymptomatic parents. CONCLUSION Heterozygous truncating or splice-site SUFU variants cause a novel neurodevelopmental syndrome encompassing COMA and mild JS, which likely represent overlapping entities. Variants can arise de novo or be inherited from a healthy parent, representing the first cause of JS with dominant inheritance and reduced penetrance. Awareness of this condition will increase the diagnostic yield of JS genetic testing, and allow appropriate counselling about prognosis, medical monitoring and recurrence risk.
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Affiliation(s)
| | - Fulvio D’Abrusco
- Department of Molecular Medicine, University of Pavia, Pavia, Lombardia, Italy
| | - Jennifer C Dempsey
- Department of Pediatrics, University of Washington Center for Mendelian Genomics, WashingtonUSA
| | - Yong-Han Hank Cheng
- Department of Pediatrics, University of Washington Center for Mendelian Genomics, WashingtonUSA
| | - Filippo Arrigoni
- Neuroimaging Lab, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Janice Baker
- Genomics and Genetic Medicine Department, Children's Minnesota, Minneapolis, Minnesota, USA
| | - Roberta Battini
- Unit of Child Neuropsychiatry, IRCCS Foundation Stella Maris, Calambrone, Toscana, Italy,Department of Clinical ad Experimental Medicine, University of Pisa, Pisa, Italy
| | - Enrico Silvio Bertini
- Laboratory of Molecular Medicine, Unit of Muscular and Neurodegenerative Diseases, Department of Neuroscience, Bambino Gesu Children's Hospital, IRCCS, Rome, Italy
| | - Renato Borgatti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy,Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Angela K Christman
- Department of Pediatrics, University of Washington Center for Mendelian Genomics, WashingtonUSA
| | - Cynthia Curry
- Department of Pediatrics, Stanford University, Stanford, California, USA,Division of Medical Genetics, Department of Pediatrics, University of California San Francisco, Fresno, California, USA,University Pediatric Specialists, Fresno, California, USA
| | - Stefano D'Arrigo
- Department of Developmental Neurology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Joel Fluss
- Department of Women, Children and Adolescents, Geneva University Hospitals, Geneva, Switzerland
| | - Michael Freilinger
- Department of Paediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Simone Gana
- Neurogenetics Research Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Gisele E Ishak
- Department of Neuroradiology, University of Washington School of Medicine, Seattle, Washington, USA,Pediatric Radiology, Seattle Children’s Hospital, Seattle, Washington, USA
| | - Vincenzo Leuzzi
- Department of Human Neuroscience, University of Rome La Sapienza, Roma, Lazio, Italy
| | - Hailey Loucks
- Department of Pediatrics, University of Washington Center for Mendelian Genomics, WashingtonUSA
| | - Filippo Manti
- Department of Human Neuroscience, University of Rome La Sapienza, Roma, Lazio, Italy
| | - Nancy Mendelsohn
- Complex Health Solutions, United Healthcare, Minneapolis, Minnesota, USA
| | - Laura Merlini
- Department of Pediatric Radiology, Geneva University Hospitals Children's Hospital, Geneva, Switzerland
| | - Caitlin V Miller
- Department of Pediatrics, University of Washington Center for Mendelian Genomics, WashingtonUSA
| | - Ansar Muhammad
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland,Depatment of Ophtalmology, University of Lausanne, Jules Gonin Eye Hospital, Lausanne, Switzerland,Department of Genetic Medicine and Development, University of Geneva, Geneva, Switzerland
| | - Sara Nuovo
- Department of Experimental Medicine, University of Rome La Sapienza, Rome, Lazio, Italy
| | - Romina Romaniello
- Neuropsychiatry and Neurorehabilitation Unit, Scientific Institute, IRCCS Eugenio Medea, Lecco, Italy
| | - Wolfgang Schmidt
- Center for Anatomy and Cell Biology, Neuromuscular Research Department, Medical University of Vienna, Vienna, Austria
| | - Sabrina Signorini
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Sabrina Siliquini
- Child Neuropsychiatry Unit, Paediatric Hospital G Salesi, Ancona, Italy
| | - Krzysztof Szczałuba
- Department of Medical Genetics, Warszawski Uniwersytet Medyczny, Warszawa, Poland
| | - Gessica Vasco
- Unit of Neurorehabilitation, Department of Neurosciences, IRCCS Bambino Gesù Children's Hospital, Roma, Italy
| | - Meredith Wilson
- Department of Clinical Genetics, Children’s Hospital at Westmead, Sydney, New South Wales, Australia,Discipline of Genomic Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Ginevra Zanni
- Laboratory of Molecular Medicine, Unit of Muscular and Neurodegenerative Diseases, Department of Neuroscience, Bambino Gesu Children's Hospital, IRCCS, Rome, Italy
| | - Eugen Boltshauser
- Department of Pediatric Neurology (Emeritus), University Children's Hospital Zürich, Zurich, Zürich, Switzerland
| | - Dan Doherty
- Department of Pediatrics, University of Washington Center for Mendelian Genomics, WashingtonUSA,Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Enza Maria Valente
- Neurogenetics Research Centre, IRCCS Mondino Foundation, Pavia, Italy,Department of Molecular Medicine, University of Pavia, Pavia, Lombardia, Italy
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Haghshomar M, Shobeiri P, Seyedi SA, Abbasi-Feijani F, Poopak A, Sotoudeh H, Kamali A, Aarabi MH. Cerebellar Microstructural Abnormalities in Parkinson's Disease: a Systematic Review of Diffusion Tensor Imaging Studies. CEREBELLUM (LONDON, ENGLAND) 2022; 21:545-571. [PMID: 35001330 DOI: 10.1007/s12311-021-01355-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/01/2021] [Indexed: 06/14/2023]
Abstract
Diffusion tensor imaging (DTI) is now having a strong momentum in research to evaluate the neural fibers of the CNS. This technique can study white matter (WM) microstructure in neurodegenerative disorders, including Parkinson's disease (PD). Previous neuroimaging studies have suggested cerebellar involvement in the pathogenesis of PD, and these cerebellum alterations can correlate with PD symptoms and stages. Using the PRISMA 2020 framework, PubMed and EMBASE were searched to retrieve relevant articles. Our search revealed 472 articles. After screening titles and abstracts, and full-text review, and implementing the inclusion criteria, 68 papers were selected for synthesis. Reviewing the selected studies revealed that the patterns of reduction in cerebellum WM integrity, assessed by fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity measures can differ symptoms and stages of PD. Cerebellar diffusion tensor imaging (DTI) changes in PD patients with "postural instability and gait difficulty" are significantly different from "tremor dominant" PD patients. Freezing of the gate is strongly related to cerebellar involvement depicted by DTI. The "reduced cognition," "visual disturbances," "sleep disorders," "depression," and "olfactory dysfunction" are not related to cerebellum microstructural changes on DTI, while "impulsive-compulsive behavior" can be linked to cerebellar WM alteration. Finally, higher PD stages and longer disease duration are associated with cerebellum white matter alteration depicted by DTI. Depiction of cerebellar white matter involvement in PD is feasible by DTI. There is an association with disease duration and severity and several clinical presentations with DTI findings. This clinical-imaging association may eventually improve disease management.
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Affiliation(s)
- Maryam Haghshomar
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Parnian Shobeiri
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713137, Iran.
| | | | | | - Amirhossein Poopak
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Houman Sotoudeh
- Department of Radiology and Neurology, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Arash Kamali
- Department of Diagnostic and Interventional Radiology, University of Texas McGovern Medical School, Houston, TX, USA
| | - Mohammad Hadi Aarabi
- Department of Neuroscience (DNS), Padova Neuroscience Center-PNC, University of Padova, Padua, Italy
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Zhang Y, Furst AJ. Brainstem Diffusion Tensor Tractography and Clinical Applications in Pain. FRONTIERS IN PAIN RESEARCH (LAUSANNE, SWITZERLAND) 2022; 3:840328. [PMID: 35399154 PMCID: PMC8989264 DOI: 10.3389/fpain.2022.840328] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/15/2022] [Indexed: 11/13/2022]
Abstract
The brainstem is one of the most vulnerable brain structures in many neurological conditions, such as pain, sleep problems, autonomic dysfunctions, and neurodegenerative disorders. Diffusion tensor imaging and tractography provide structural details and quantitative measures of brainstem fiber pathways. Until recently, diffusion tensor tractographic studies have mainly focused on whole-brain MRI acquisition. Due to the brainstem's spatial localization, size, and tissue characteristics, and limits of imaging techniques, brainstem diffusion MRI poses particular challenges in tractography. We provide a brief overview on recent advances in diffusion tensor tractography in revealing human pathways connecting the brainstem to the subcortical regions (e.g., basal ganglia, mesolimbic, basal forebrain), and cortical regions. Each of these pathways contains different distributions of fiber tracts from known neurotransmitter-specific nuclei in the brainstem. We compare the brainstem tractographic approaches in literature and our in-lab developed automated brainstem tractography in terms of atlas building, technical advantages, and neuroanatomical implications on neurotransmitter systems. Lastly, we summarize recent investigations of using brainstem tractography as a promising tool in association with pain.
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Affiliation(s)
- Yu Zhang
- War Related Illness and Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, CA, United States,*Correspondence: Yu Zhang ;
| | - Ansgar J. Furst
- War Related Illness and Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, CA, United States,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States,Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Palo Alto, CA, United States,Polytrauma System of Care (PSC), VA Palo Alto Health Care System, Palo Alto, CA, United States
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Cohen M, Zesiger P, Merlini L, de Haller R, Fluss J. Modalities of reading acquisition in three siblings with infantile-onset saccade initiation delay (Cogan congenital ocular motor apraxia): A longitudinal study. Eur J Paediatr Neurol 2019; 23:517-524. [PMID: 30782493 DOI: 10.1016/j.ejpn.2019.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 01/23/2019] [Accepted: 01/31/2019] [Indexed: 11/29/2022]
Abstract
This study aims to ascertain the impact of congenital ocular motor apraxia (COMA), alternatively called infantile-onset saccade initiation delay (ISID), on reading acquisition. More specifically, the consequence of defective initiation of horizontal saccades during reading acquisition was investigated. Three siblings (A: male, 11y3m at the first time-point of testing (i.e. T1 hereafter); B: female, 7y3m at T1 and C: male, 5y9m at T1) suffering from ISID were assessed longitudinally over 3 years in various reading tests and their eye movements simultaneously registered. At each time-point, they were compared to control participants matched on reading level. Eye movements during reading tasks were markedly abnormal in children with ISID at the beginning of reading acquisition and their reading scores were poor. With time, the number of fixations, small amplitude saccades and their reading abilities became comparable to those of control children. Despite the abnormal eye movements and difficulties in specifically directing the eyes to the appropriate position, children with ISID do not seem to encounter major difficulties during reading acquisition, although mild delays might be observed during the early stages.
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Affiliation(s)
- Marjolaine Cohen
- Faculty of Psychology and Educational Science, University of Geneva, 28 Bd Pont d'Arve, CH-1211, Genève 4, Switzerland.
| | - Pascal Zesiger
- Faculty of Psychology and Educational Science, University of Geneva, 28 Bd Pont d'Arve, CH-1211, Genève 4, Switzerland
| | - Laura Merlini
- Pediatric Radiology, Children's Hospital of Geneva, Switzerland
| | - Raoul de Haller
- Pediatric Ophthalmology, La Tour Hospital, Geneva, Switzerland
| | - Joel Fluss
- Pediatric Neurology Unit, Pediatric Subspecialties Service, Children's Hospital of Geneva, Switzerland
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