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Rabanaque D, Regalado M, Benítez R, Rabanaque S, Agut T, Carreras N, Mata C. Semi-Automatic GUI Platform to Characterize Brain Development in Preterm Children Using Ultrasound Images. J Imaging 2023; 9:145. [PMID: 37504822 PMCID: PMC10381479 DOI: 10.3390/jimaging9070145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/06/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023] Open
Abstract
The third trimester of pregnancy is the most critical period for human brain development, during which significant changes occur in the morphology of the brain. The development of sulci and gyri allows for a considerable increase in the brain surface. In preterm newborns, these changes occur in an extrauterine environment that may cause a disruption of the normal brain maturation process. We hypothesize that a normalized atlas of brain maturation with cerebral ultrasound images from birth to term equivalent age will help clinicians assess these changes. This work proposes a semi-automatic Graphical User Interface (GUI) platform for segmenting the main cerebral sulci in the clinical setting from ultrasound images. This platform has been obtained from images of a cerebral ultrasound neonatal database images provided by two clinical researchers from the Hospital Sant Joan de Déu in Barcelona, Spain. The primary objective is to provide a user-friendly design platform for clinicians for running and visualizing an atlas of images validated by medical experts. This GUI offers different segmentation approaches and pre-processing tools and is user-friendly and designed for running, visualizing images, and segmenting the principal sulci. The presented results are discussed in detail in this paper, providing an exhaustive analysis of the proposed approach's effectiveness.
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Affiliation(s)
- David Rabanaque
- Barcelona East School of Engineering, Universitat Politècnica de Catalunya, 08019 Barcelona, Spain
| | - Maria Regalado
- Barcelona East School of Engineering, Universitat Politècnica de Catalunya, 08019 Barcelona, Spain
| | - Raul Benítez
- Barcelona East School of Engineering, Universitat Politècnica de Catalunya, 08019 Barcelona, Spain
- Research Centre for Biomedical Engineering (CREB), Barcelona East School of Engineering, Universitat Politècnica de Catalunya, 08028 Barcelona, Spain
- Pediatric Computational Imaging Research Group, Hospital Sant Joan de Déu Barcelona, 08950 Esplugues de Llobregat, Spain
| | - Sonia Rabanaque
- Barcelona East School of Engineering, Universitat Politècnica de Catalunya, 08019 Barcelona, Spain
| | - Thais Agut
- Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu Barcelona, 08950 Esplugues de Llobregat, Spain
- Neonatal Department, Hospital Sant Joan de Déu Barcelona, 08950 Esplugues de Llobregat, Spain
- Fundación NeNe, 28010 Madrid, Spain
| | - Nuria Carreras
- Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu Barcelona, 08950 Esplugues de Llobregat, Spain
- Neonatal Department, Hospital Sant Joan de Déu Barcelona, 08950 Esplugues de Llobregat, Spain
| | - Christian Mata
- Barcelona East School of Engineering, Universitat Politècnica de Catalunya, 08019 Barcelona, Spain
- Research Centre for Biomedical Engineering (CREB), Barcelona East School of Engineering, Universitat Politècnica de Catalunya, 08028 Barcelona, Spain
- Pediatric Computational Imaging Research Group, Hospital Sant Joan de Déu Barcelona, 08950 Esplugues de Llobregat, Spain
- Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu Barcelona, 08950 Esplugues de Llobregat, Spain
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Kozłowska Z, Komasińska P, Steinborn B, Toboła-Wróbel K, Pietryga M, Szymankiewicz-Breborowicz M, Szczapa T, Bekiesińska-Figatowska M. Spontaneous Resolution of Congenital Dural Venous Sinus Ectasia Associated With Polymicrogyria-Case Report. Front Pediatr 2022; 10:822551. [PMID: 35295696 PMCID: PMC8918672 DOI: 10.3389/fped.2022.822551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
Dural venous sinus ectasia belongs to a rare group of venous sinus malformations of unknown origin and uncertain prognosis. We report the first patient with idiopathic congenital ectasia of the confluence of sinuses with thrombosis associated with bilateral polymicrogyria. It may highlight the causative relation between ischemia within the central nervous system due to torcular herophili ectasia with thrombosis in early pregnancy and the development of cortical malformations in neonates. We also highlight the role of MR neuroimaging in the diagnosis of these entities.
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Affiliation(s)
- Zuzanna Kozłowska
- Department of Neonatology, Neonatal Biophysical Monitoring and Cardiopulmonary Therapies Research Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Paulina Komasińska
- Department of Developmental Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Barbara Steinborn
- Department of Developmental Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Kinga Toboła-Wróbel
- Department of Obstetrics and Women's Health, Poznan University of Medical Sciences, Poznan, Poland
| | - Marek Pietryga
- Department of Obstetrics and Women's Health, Poznan University of Medical Sciences, Poznan, Poland
| | - Marta Szymankiewicz-Breborowicz
- Department of Neonatology, Neonatal Biophysical Monitoring and Cardiopulmonary Therapies Research Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Tomasz Szczapa
- Department of Newborns' Infectious Diseases, Chair of Neonatology, Poznan University of Medical Sciences, Poznan, Poland
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Kobow K, Jabari S, Pieper T, Kudernatsch M, Polster T, Woermann FG, Kalbhenn T, Hamer H, Rössler K, Mühlebner A, Spliet WGM, Feucht M, Hou Y, Stichel D, Korshunov A, Sahm F, Coras R, Blümcke I, von Deimling A. Mosaic trisomy of chromosome 1q in human brain tissue associates with unilateral polymicrogyria, very early-onset focal epilepsy, and severe developmental delay. Acta Neuropathol 2020; 140:881-891. [PMID: 32979071 PMCID: PMC7666281 DOI: 10.1007/s00401-020-02228-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 02/06/2023]
Abstract
Polymicrogyria (PMG) is a developmental cortical malformation characterized by an excess of small and frustrane gyration and abnormal cortical lamination. PMG frequently associates with seizures. The molecular pathomechanisms underlying PMG development are not yet understood. About 40 genes have been associated with PMG, and small copy number variations have also been described in selected patients. We recently provided evidence that epilepsy-associated structural brain lesions can be classified based on genomic DNA methylation patterns. Here, we analyzed 26 PMG patients employing array-based DNA methylation profiling on formalin-fixed paraffin-embedded material. A series of 62 well-characterized non-PMG cortical malformations (focal cortical dysplasia type 2a/b and hemimegalencephaly), temporal lobe epilepsy, and non-epilepsy autopsy controls was used as reference cohort. Unsupervised dimensionality reduction and hierarchical cluster analysis of DNA methylation profiles showed that PMG formed a distinct DNA methylation class. Copy number profiling from DNA methylation data identified a uniform duplication spanning the entire long arm of chromosome 1 in 7 out of 26 PMG patients, which was verified by additional fluorescence in situ hybridization analysis. In respective cases, about 50% of nuclei in the center of the PMG lesion were 1q triploid. No chromosomal imbalance was seen in adjacent, architecturally normal-appearing tissue indicating mosaicism. Clinically, PMG 1q patients presented with a unilateral frontal or hemispheric PMG without hemimegalencephaly, a severe form of intractable epilepsy with seizure onset in the first months of life, and severe developmental delay. Our results show that PMG can be classified among other structural brain lesions according to their DNA methylation profile. One subset of PMG with distinct clinical features exhibits a duplication of chromosomal arm 1q.
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Affiliation(s)
- Katja Kobow
- Department of Neuropathology, Institute of Neuropathology, Affiliated Partner of the ERN EpiCARE, Universitätsklinikum Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.
| | - Samir Jabari
- Department of Neuropathology, Institute of Neuropathology, Affiliated Partner of the ERN EpiCARE, Universitätsklinikum Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Tom Pieper
- Department of Neurology, Schön Klinik Vogtareuth, Vogtareuth, Germany
| | - Manfred Kudernatsch
- Department of Neurosurgery and Epilepsy Surgery, Schön Klinik Vogtareuth, Vogtareuth, Germany
- Research Institute "Rehabilitation, Transition, Palliation", PMU Salzburg, Salzburg, Austria
| | - Tilman Polster
- Epilepsy Center Bethel, Krankenhaus Mara, Bielefeld, Germany
| | | | - Thilo Kalbhenn
- Department of Neurosurgery, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Hajo Hamer
- Department of Neurology, Epilepsy Center, Universitätsklinikum Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Karl Rössler
- Department of Neurosurgery, Universitätsklinikum Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Erlangen, Germany
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Angelika Mühlebner
- Department of (Neuro)Pathology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Wim G M Spliet
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martha Feucht
- Department of Pediatrics and Adolescent Medicine, Affiliated Partner of the ERN EpiCARE, Medical University Vienna, Vienna, Austria
| | - Yanghao Hou
- Department of Neuropathology, Universitätsklinikum Heidelberg, and, CCU Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Damian Stichel
- Department of Neuropathology, Universitätsklinikum Heidelberg, and, CCU Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andrey Korshunov
- Department of Neuropathology, Universitätsklinikum Heidelberg, and, CCU Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Felix Sahm
- Department of Neuropathology, Universitätsklinikum Heidelberg, and, CCU Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Roland Coras
- Department of Neuropathology, Institute of Neuropathology, Affiliated Partner of the ERN EpiCARE, Universitätsklinikum Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Ingmar Blümcke
- Department of Neuropathology, Institute of Neuropathology, Affiliated Partner of the ERN EpiCARE, Universitätsklinikum Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Andreas von Deimling
- Department of Neuropathology, Universitätsklinikum Heidelberg, and, CCU Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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MTOR pathway in focal cortical dysplasia type 2: What do we know? Epilepsy Behav 2018; 85:157-163. [PMID: 29945038 DOI: 10.1016/j.yebeh.2018.05.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 01/15/2023]
Abstract
Focal cortical dysplasia (FCD) is the most commonly encountered developmental malformation that causes refractory epilepsy. Focal cortical dysplasia type 2 is one of the most usual neuropathological findings in tissues resected therapeutically from patients with drug-resistant epilepsy. Unlike other types of FCD, it is characterized by laminar disorganization and dysplastic neurons, which compromise the organization of the six histologically known layers in the cortex; the morphology and/or cell location can also be altered. A comprehensive review about the pathogenesis of this disease is important because of the necessity to update the results reported over the past years. Here, we present an updated review through Pubmed about the mammalian target of rapamycin (MTOR) pathway in FCD type 2. A wide variety of aspects was covered in 44 articles related to molecular and cellular biology, including experiments in animal and human models. The first publications appeared in 2004, but there is still a lack of studies specifically for one type of FCD. With the advancement of techniques and greater access to molecular and cellular experiments, such as induced pluripotent stem cells (iPSCs) and organoids, it is believed that the trend is increasing the number of publications contributing to the achievement of new discoveries.
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Clinical Profile of Children with Malformations of Cortical Development. Indian J Pediatr 2015; 82:591-4. [PMID: 25708062 DOI: 10.1007/s12098-015-1723-5] [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] [Received: 10/08/2014] [Accepted: 02/04/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To elucidate the clinical-radiological profile of children with malformations of cortical development. METHODS This observational study was conducted at a tertiary care child hospital of north India. Clinical-radiological data records were reviewed and assessment of children's functioning in five key areas of physical, adaptive behavior, social emotional, cognitive and communication was performed using Developmental Profile-3. RESULTS Sixty-four cases of "Malformations of cortical development" were studied. The commonest malformations were lissencephaly (14/64), agyria-pachygyria (14/64) and schizencephaly (14/64). Focal cortical dysplasia (n = 12), hemimegalencephaly (n = 4), polymicrogyria (n = 3) and heterotopias (n = 3) were the other malformations seen. On Developmental Profile-3, 90 % children had developmental delay. CONCLUSIONS The present study provides important data on the pattern of malformations of cortical development seen in a tertiary care hospital. It emphasizes that all children with developmental delay and seizures should be evaluated with magnetic resonance imaging.
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Marchi N, Granata T, Janigro D. Inflammatory pathways of seizure disorders. Trends Neurosci 2014; 37:55-65. [PMID: 24355813 PMCID: PMC3977596 DOI: 10.1016/j.tins.2013.11.002] [Citation(s) in RCA: 165] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 11/17/2013] [Accepted: 11/18/2013] [Indexed: 12/17/2022]
Abstract
Epilepsy refers to a cluster of neurological diseases characterized by seizures. Although many forms of epilepsy have a well-defined immune etiology, in other forms of epilepsy an altered immune response is only suspected. In general, the hypothesis that inflammation contributes to seizures is supported by experimental results. Additionally, antiepileptic maneuvers may act as immunomodulators and anti-inflammatory therapies can treat seizures. Triggers of seizure include a bidirectional communication between the nervous system and organs of immunity. Thus, a crucial cellular interface protecting from immunological seizures is the blood-brain barrier (BBB). Here, we summarize recent advances in the understanding and treatment of epileptic seizures that derive from a non-neurocentric viewpoint and suggest key avenues for future research.
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Affiliation(s)
- Nicola Marchi
- Department of Molecular Medicine, Cerebrovascular Research, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA; Department of Neurobiology, Institute of Functional Genomics, Centre National de la Recherche Scientifique, Montpellier, France
| | | | - Damir Janigro
- Department of Molecular Medicine, Cerebrovascular Research, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA; Department of Neurological Surgery, Cerebrovascular Research, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.
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Lee SK, Kim DW. Focal cortical dysplasia and epilepsy surgery. J Epilepsy Res 2013; 3:43-7. [PMID: 24649472 PMCID: PMC3952251 DOI: 10.14581/jer.13009] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 12/07/2011] [Indexed: 02/01/2023] Open
Abstract
Focal cortical dysplasia (FCD) is the most commonly encountered developmental malformation that causes refractory epilepsy. With advances in neuroimaging techniques, in particular MRI, recent studies have revealed a higher prevalence of FCD than previously estimated and have improved the preoperative identification and classification of these abnormalities. However, MRI frequently does not show any abnormalities in patients with pathologically proven FCD. In this situation, functional neuroimaing such as FDG-PET and ictal SPECT can be helpful. FCD is thought to be intrinsically epileptogenic, because the dysplastic tissues contain aberrant neural networks that are highly susceptible to abnormal excitation. The response to the medical treatment of epilepsy has been documented as consistently poor. Therefore, surgical resection has been an important alternative treatment for patients with intractable epilepsy related to FCD. Incomplete resection of FCD has been consistently known to be a poor prognostic factor. However, the complete removal of FCD is often difficult because the demarcation of the lesion is frequently poor, and dysplastic tissues tend to be more extensive than is apparent on MRI. Evidence indicates that even patients with MRI abnormalities who have resective epilepsy surgery for FCD have worse surgical outcomes than those of patients who have surgery for other focal lesional epilepsy syndromes. Careful planning of evelauation using intracranial electrodes is necessary for successful epilepsy surgery.
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Affiliation(s)
- Sang Kun Lee
- Department of Neurology, Seoul National University College of Medicine, Seoul
| | - Dong-Wook Kim
- Department of Neurology, Konkuk University College of Medicine, Seoul,
Korea
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