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Fetta A, Toni F, Pettenuzzo I, Ricci E, Rocca A, Gambi C, Soliani L, Di Pisa V, Martini S, Sperti G, Cagnazzo V, Accorsi P, Bartolini E, Battaglia D, Bernardo P, Canevini MP, Ferrari AR, Giordano L, Locatelli C, Mancardi M, Orsini A, Pippucci T, Pruna D, Rosati A, Suppiej A, Tagliani S, Vaisfeld A, Vignoli A, Izumi K, Krantz I, Cordelli DM. Structural brain abnormalities in Pallister-Killian syndrome: a neuroimaging study of 31 children. Orphanet J Rare Dis 2024; 19:107. [PMID: 38459574 PMCID: PMC10921669 DOI: 10.1186/s13023-024-03065-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/03/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Pallister-Killian syndrome (PKS) is a rare genetic disorder caused by mosaic tetrasomy of 12p with wide neurological involvement. Intellectual disability, developmental delay, behavioral problems, epilepsy, sleep disturbances, and brain malformations have been described in most individuals, with a broad phenotypic spectrum. This observational study, conducted through brain MRI scan analysis on a cohort of patients with genetically confirmed PKS, aims to systematically investigate the neuroradiological features of this syndrome and identify the possible existence of a typical pattern. Moreover, a literature review differentiating the different types of neuroimaging data was conducted for comparison with our population. RESULTS Thirty-one individuals were enrolled (17 females/14 males; age range 0.1-17.5 years old at first MRI). An experienced pediatric neuroradiologist reviewed brain MRIs, blindly to clinical data. Brain abnormalities were observed in all but one individual (compared to the 34% frequency found in the literature review). Corpus callosum abnormalities were found in 20/30 (67%) patients: 6 had callosal hypoplasia; 8 had global hypoplasia with hypoplastic splenium; 4 had only hypoplastic splenium; and 2 had a thin corpus callosum. Cerebral hypoplasia/atrophy was found in 23/31 (74%) and ventriculomegaly in 20/31 (65%). Other frequent features were the enlargement of the cisterna magna in 15/30 (50%) and polymicrogyria in 14/29 (48%). Conversely, the frequency of the latter was found to be 4% from the literature review. Notably, in our population, polymicrogyria was in the perisylvian area in all 14 cases, and it was bilateral in 10/14. CONCLUSIONS Brain abnormalities are very common in PKS and occur much more frequently than previously reported. Bilateral perisylvian polymicrogyria was a main aspect of our population. Our findings provide an additional tool for early diagnosis.Further studies to investigate the possible correlations with both genotype and phenotype may help to define the etiopathogenesis of the neurologic phenotype of this syndrome.
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Affiliation(s)
- Anna Fetta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell'Età Pediatrica, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, Bologna, Italy
| | - Francesco Toni
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neuroradiologia con Tecniche ad elevata complessità- PNTEC, Bologna, Italy
| | - Ilaria Pettenuzzo
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell'Età Pediatrica, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, Bologna, Italy
| | - Emilia Ricci
- Epilepsy Center, Childhood and Adolescence Neuropsychiatry Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, 20142, Milan, Italy.
| | - Alessandro Rocca
- UO di Pediatria d'Urgenza, IRCCS Policlinico Sant'Orsola, Bologna, Italy
| | - Caterina Gambi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell'Età Pediatrica, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, Bologna, Italy
| | - Luca Soliani
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell'Età Pediatrica, Bologna, Italy
| | - Veronica Di Pisa
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell'Età Pediatrica, Bologna, Italy
| | - Silvia Martini
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, Bologna, Italy
- Neonatal Intensive Care Unit, IRCCS AOUBO, Bologna, Italy
| | - Giacomo Sperti
- Scuola di Specializzazione in Pediatria - Alma Mater Studiorum, Università di Bologna, Bologna, Italy
| | - Valeria Cagnazzo
- Scuola di Specializzazione in Pediatria - Alma Mater Studiorum, Università di Bologna, Bologna, Italy
| | | | - Emanuele Bartolini
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, 56128, Pisa, Italy
| | - Domenica Battaglia
- Pediatric Neurology, Department of Woman and Child Health and Public Health, Child Health Area, Catholic University UCSC, Rome, Italy
| | - Pia Bernardo
- Department of Neurosciences, Pediatric Psychiatry and Neurology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Maria Paola Canevini
- Epilepsy Center, Childhood and Adolescence Neuropsychiatry Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, 20142, Milan, Italy
| | - Anna Rita Ferrari
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, 56128, Pisa, Italy
| | - Lucio Giordano
- Child Neuropsychiatric Division, Spedali Civili, Brescia, Italy
| | | | - Margherita Mancardi
- Unit of Child Neuropsychiatry, IRCCS Istituto Giannina Gaslini, Epicare Network for Rare Disease, Genoa, Italy
| | - Alessandro Orsini
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Tommaso Pippucci
- U.O. Genetica Medica, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Emilia- Romagna, Italy
| | - Dario Pruna
- Department of Pediatric Neurology and Epileptology, Pediatric Depatment, ARNAS Brotzu, Cagliari, Italy
| | - Anna Rosati
- Neuroscience Department, Children's Hospital Anna Meyer, University of Florence, Viale Gaetano Pieraccini, 24, 50139, Firenze, Italy
| | - Agnese Suppiej
- Department of Medical Sciences, Pediatric Section, University Hospital of Ferrara, Ferrara, Italy
| | - Sara Tagliani
- Department of Medical Sciences, Pediatric Section, University Hospital of Ferrara, Ferrara, Italy
| | - Alessandro Vaisfeld
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, Bologna, Italy
- U.O. Genetica Medica, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Emilia- Romagna, Italy
| | - Aglaia Vignoli
- Child Neuropsychiatry Unit, Department of Health Sciences, ASSTGrande Ospedale Metropolitano, Niguarda, Milano, Italy
| | - Kosuke Izumi
- Division of Genetics and Metabolism, Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., 75390, Dallas, TX, USA
| | - Ian Krantz
- Divisions of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Duccio Maria Cordelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell'Età Pediatrica, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, Bologna, Italy
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Jaatela J, Nurmi T, Vallinoja J, Mäenpää H, Sairanen V, Piitulainen H. Altered corpus callosum structure in adolescents with cerebral palsy: connection to gait and balance. Brain Struct Funct 2023; 228:1901-1915. [PMID: 37615759 PMCID: PMC10516810 DOI: 10.1007/s00429-023-02692-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 07/24/2023] [Indexed: 08/25/2023]
Abstract
Cerebral palsy (CP) is the most common motor disorder in childhood. Recent studies in children with CP have associated weakened sensorimotor performance with impairments in the major brain white-matter (WM) structure, corpus callosum (CC). However, the relationship between CC structure and lower extremity performance, specifically gait and balance, remains unknown. This study investigated the transcallosal WM structure and lower limb motor stability performance in adolescents aged 10-18 years with spastic hemiplegic (n = 18) or diplegic (n = 13) CP and in their age-matched controls (n = 34). The modern diffusion-weighted MRI analysis included the diffusivity properties of seven CC subparts and the transcallosal lower limb sensorimotor tract of the dominant hemisphere. Children with CP had comprehensive impairments in the cross-sectional area, fractional anisotropy, and mean diffusivity of the CC and sensorimotor tract. Additionally, the extent of WM alterations varied between hemiplegic and diplegic subgroups, which was seen especially in the fractional anisotropy values along the sensorimotor tract. The diffusion properties of transcallosal WM were further associated with static stability in all groups, and with dynamic stability in healthy controls. Our novel results clarify the mechanistic role of the corpus callosum in adolescents with and without CP offering valuable insight into the complex interplay between the brain's WM organization and motor performance. A better understanding of the brain basis of weakened stability performance could, in addition, improve the specificity of clinical diagnosis and targeted rehabilitation in CP.
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Affiliation(s)
- Julia Jaatela
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, 02150, Espoo, Finland.
| | - Timo Nurmi
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, 02150, Espoo, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014, Jyväskylä, Finland
| | - Jaakko Vallinoja
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, 02150, Espoo, Finland
| | - Helena Mäenpää
- Department of Neurology, New Children's Hospital, Helsinki University Central Hospital, 00029, Helsinki, Finland
| | - Viljami Sairanen
- Department of Clinical Neurophysiology, BABA Center, Pediatric Research Center, Children's Hospital and HUS Imaging, Helsinki University Central Hospital, 00029, Helsinki, Finland
- Department of Radiology, Kanta-Häme Central Hospital, 13530, Hämeenlinna, Finland
| | - Harri Piitulainen
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, 02150, Espoo, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014, Jyväskylä, Finland
- Department of Neurology, New Children's Hospital, Helsinki University Central Hospital, 00029, Helsinki, Finland
- Aalto NeuroImaging, Aalto University, 02150, Espoo, Finland
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Blumen HM, Jayakody O, Verghese J. Gait in cerebral small vessel disease, pre-dementia, and dementia: A systematic review. Int J Stroke 2023; 18:53-61. [PMID: 35797006 PMCID: PMC9841467 DOI: 10.1177/17474930221114562] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND The interrelationships between gait, cerebral small vessel disease (CSVD), and cognitive impairments in aging are not well-understood-despite their common co-occurrence. OBJECTIVE To systematically review studies of gait impairment in CSVD, pre-dementia, and dementia, and to identify key gaps for future research and novel pathways toward intervention. METHODS A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided search strategy was implemented in PubMed to identify relevant studies. Potential articles (n = 263) published prior to 1 December 2021 were screened by two reviewers. Studies with sample sizes >20 and including some adults over > 65 years (n = 202) were included. RESULTS The key findings were that (1) adverse gait and cognitive outcomes were associated with several (rather than select) CSVD pathologies distributed across the brain, and (2) poor gait and CSVD pathologies were more strongly associated with dementia with a vascular, rather than an Alzheimer's disease-related, cause. DISCUSSION A better understanding of the interrelationships between gait performance in CSVD, pre-dementia, and dementia requires studies examining (1) comprehensive patterns in the clinical manifestations of CSVD, (2) racially/ethnically diverse samples, (3) samples followed for extended periods of time or across the adult life span, (4) non-traditional CSVD neuroimaging markers (e.g. resting-state functional magnetic resonance imaging (fMRI)), and (5) continuous (e.g. wearable sensors) and complex (e.g. dual-task) walking performance.
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Affiliation(s)
- Helena M Blumen
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA,Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Oshadi Jayakody
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Joe Verghese
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA,Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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Khalaveh F, Seidl R, Czech T, Reinprecht A, Gruber GM, Berger A, Kiss H, Prayer D, Kasprian G. Myelomeningocele-Chiari II malformation-Neurological predictability based on fetal and postnatal magnetic resonance imaging. Prenat Diagn 2021; 41:922-932. [PMID: 34124788 PMCID: PMC8361919 DOI: 10.1002/pd.5987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/18/2021] [Accepted: 05/30/2021] [Indexed: 12/13/2022]
Abstract
Objective This systematic comparison between pre‐ and postnatal imaging findings and postnatal motor outcome assesses the reliability of MRI accuracy in the prognostication of the future long‐term (mean, 11.4 years) ambulatory status in a historic group of postnatally repaired myelomeningocele (MMC) cases. Methods A retrospective, single‐center study of 34 postnatally repaired MMC patients was performed. We used fetal and postnatal magnetic resonance imaging (MRI) to compare the fetal and postnatal radiological lesion level to each other and to the postnatal ambulatory level as a standard of reference and analyzed Chiari II malformation characteristics. Results In 13/15 (87%) and 29/31 (94%) cases, the functional level was equal to or better than the prenatal and postnatal radiological lesion level. A radiological lesion level agreement within two segments could be achieved in 13/15 (87%) patients. A worse than expected functional level occurred in cases with Myelocele (2/3 patients), coexistent crowding of the posterior fossa (2/3 patients) and/or abnormal white matter architecture, represented by callosal dysgenesis (1/3 patients). In all patients (2/2) with a radiological disagreement of more than two segments, segmentation disorders and scoliosis were observed. Conclusion Fetal and postnatal MRI are predictive of the long‐term ambulatory status in postnatally repaired MMC patients.
What's already known about this topic?
Fetal and postnatal magnetic resonance imaging (MRI) show a good correlation in identifying the level of the myelomeningocele (MMC) lesion. Prenatal ultrasound (US) and fetal MRI show a comparable agreement, within two segments, in predicting the short‐term ambulatory status.
What does this study add?
Fetal and postnatal MRI have a good predictive value for the long‐term ambulatory status in patients with postnatal MMC closure. MMC patients with worse than expected ambulatory status showed signs of vermian displacement and corpus callosum dysgenesis. In MMC patients with spinal segmentation disorders and scoliosis, there was a major disagreement between fetal and postnatal MRI, specifically with regard to the MMC lesion level.
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Affiliation(s)
- Farjad Khalaveh
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Rainer Seidl
- Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria
| | - Thomas Czech
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Andrea Reinprecht
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Gerlinde Maria Gruber
- Division of Anatomy and Developmental Biology, Department of Anatomy und Biomechanics, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
| | - Angelika Berger
- Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria.,Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Division of Neonatology, Pediatric Intensive Care & Neuropediatrics, Medical University of Vienna, Vienna, Austria
| | - Herbert Kiss
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Vienna, Austria
| | - Daniela Prayer
- Department of Radiology, Division of Neuro- and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria
| | - Gregor Kasprian
- Department of Radiology, Division of Neuro- and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria
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Lilja-Lund O, Kockum K, Hellström P, Söderström L, Nyberg L, Laurell K. Wide temporal horns are associated with cognitive dysfunction, as well as impaired gait and incontinence. Sci Rep 2020; 10:18203. [PMID: 33097796 PMCID: PMC7584644 DOI: 10.1038/s41598-020-75381-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 10/13/2020] [Indexed: 11/09/2022] Open
Abstract
The association between morphology of the brain and symptoms of suspected idiopathic normal pressure hydrocephalus (iNPH) is largely unknown. We investigated how ventricular expansion (width of the temporal horns [TH], callosal angle [CA], and Evans' index [EI]) related to symptom severity in suspected iNPH. Participants (n = 168; 74.9 years ± SD 6.7; 55% females) from the general population underwent neurological examination, computed tomography, and neuropsychological testing. Multiple linear regression analysis revealed that wide TH was independently associated with all examined iNPH symptoms (p < 0.01) except for fine-motor performance, whereas a narrow CA only was associated to specific motor and cognitive functions (p < 0.05). TH and EI correlated significantly with incontinence (rs 0.17 and rs 0.16; p < 0.05). In conclusion, wide TH was significantly associated with most iNPH-symptoms. This finding potentially reflects the complex nature of the hippocampus, however further studies are needed to demonstrate functional connectivity.
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Affiliation(s)
- Otto Lilja-Lund
- Department of Clinical Science, Neuroscience, Umeå University, Östersunds sjukhus, 831 83, Östersund, Sweden.
| | - Karin Kockum
- Department of Clinical Science, Neuroscience, Umeå University, Östersunds sjukhus, 831 83, Östersund, Sweden
| | - Per Hellström
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Lars Söderström
- Unit of Research, Education and Development, Östersund Hospital, Region Jämtland Härjedalen, Östersund, Sweden
| | - Lars Nyberg
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
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Cabibel V, Héraud N, Perrey S, Oliver N, Alexandre F, Varray A. Is bilateral corticospinal connectivity impaired in patients with chronic obstructive pulmonary disease? J Physiol 2020; 598:4591-4602. [PMID: 32697330 DOI: 10.1113/jp279560] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 07/01/2020] [Indexed: 12/30/2022] Open
Abstract
KEY POINTS During moderate and high levels of quadriceps force production, the ipsilateral motor cortex is concomitantly activated with the contralateral motor cortex throughout the corpus callosum to generate the motor command. Chronic obstructive pulmonary disease (COPD) patients display a structurally impaired corpus callosum that may explain the reduced motor command in this population, which in turn contributes to COPD-related muscle weakness of the knee extensors. The study aimed to determine whether bilateral connectivity was impaired and ipsilateral activation was lowered during unilateral strength production of the knee extensors. Our results indicate impaired bilateral connectivity but preserved ipsilateral activation in patients during unilateral isometric contractions of 50% of maximum voluntary strength. The preservation of ipsilateral activation during force production despite impaired bilateral connectivity is consistent with a reorganization of bilateral motor network function that drives unilateral strength production. ABSTRACT The contralateral primary motor cortex (M1) is not the only brain area implicated in motor command generation. During moderate and high levels of quadriceps force production, the ipsilateral M1 is concomitantly activated. Such activation is mediated by the corpus callosum, the main component of bilateral connectivity. Structural damage to the corpus callosum has been observed in chronic obstructive pulmonary disease (COPD) patients, which might reduce ipsilateral activation and contribute to the lower motor command associated with COPD muscle weakness. We thus aimed to determine whether bilateral connectivity and ipsilateral activation were impaired in COPD. Twenty-two COPD patients and 21 healthy age-matched controls were evaluated by transcranial magnetic stimulation, at rest and during 50% of maximal voluntary isometric contraction (MVIC) of the dominant vastus lateralis muscle. Bilateral connectivity was determined by the ipsilateral silent period (iSP) during 50% MVIC. Ipsilateral activation was determined as the increase in ipsilateral excitability from rest to 50% MVIC. As expected, COPD patients had significantly lower MVIC (-25%, p = 0.03). These patients also showed a significantly lower iSP (-53%, p < 0.001) compared to controls. The ipsilateral excitability was increased in patients and controls (×2.5 and ×3.5, respectively, p < 0.001) but not differently between groups (p = 0.84). Despite impaired bilateral connectivity in COPD, ipsilateral activation was not increased. Reorganization in the patients' interhemispheric pathways could explain the preserved ipsilateral activation.
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Affiliation(s)
- Vincent Cabibel
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France.,Les Cliniques du Souffle, Groupe 5 Santé, France
| | - Nelly Héraud
- Les Cliniques du Souffle, Groupe 5 Santé, France
| | - Stéphane Perrey
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France
| | | | | | - Alain Varray
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France
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