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Ge WR, Fu PP, Zhang WN, Zhang B, Ding YX, Yang G. Case report: Genotype and phenotype of DYNC1H1-related malformations of cortical development: a case report and literature review. Front Neurol 2023; 14:1163803. [PMID: 37181555 PMCID: PMC10167015 DOI: 10.3389/fneur.2023.1163803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 04/11/2023] [Indexed: 05/16/2023] Open
Abstract
Background Mutations in the dynein cytoplasmic 1 heavy chain 1 (DYNC1H1) gene are linked to malformations of cortical development (MCD), which may be accompanied by central nervous system (CNS) manifestations. Here, we present the case of a patient with MCD harboring a variant of DYNC1H1 and review the relevant literature to explore genotype-phenotype relationships. Case presentation A girl having infantile spasms, was unsuccessfully administered multiple antiseizure medications and developed drug-resistant epilepsy. Brain magnetic resonance imaging (MRI) at 14 months-of-age revealed pachygyria. At 4 years-of-age, the patient exhibited severe developmental delay and mental retardation. A de novo heterozygous mutation (p.Arg292Trp) in the DYNC1H1 gene was identified. A search of multiple databases, including PubMed and Embase, using the search strategy DYNC1H1 AND [malformations of cortical development OR seizure OR intellectual OR clinical symptoms] up to June 2022, identified 129 patients from 43 studies (including the case presented herein). A review of these cases showed that patients with DYNC1H1-related MCD had higher risks of epilepsy (odds ratio [OR] = 33.67, 95% confidence interval [CI] = 11.59, 97.84) and intellectual disability/developmental delay (OR = 52.64, 95% CI = 16.27, 170.38). Patients with the variants in the regions encoding the protein stalk or microtubule-binding domain had the most prevalence of MCD (95%). Conclusion MCD, particularly pachygyria, is a common neurodevelopmental disorder in patients with DYNC1H1 mutations. Literature searches reveales that most (95%) patients who carried mutations in the protein stalk or microtubule binding domains exhibited DYNC1H1-related MCD, whereas almost two-thirds of patients (63%) who carried mutations in the tail domain did not display MCD. Patients with DYNC1H1 mutations may experience central nervous system (CNS) manifestations due to MCD.
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Affiliation(s)
- Wen-Rong Ge
- Department of Pediatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Pei-Pei Fu
- Department of Pediatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wei-Na Zhang
- Department of Pediatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Bo Zhang
- Department of Neurology and ICCTR Biostatistics and Research Design Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Ying-Xue Ding
- Department of Pediatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Guang Yang
- Senior Department of Pediatrics, The Seventh Medical Center of People's Liberation Army General Hospital, Beijing, China
- Department of Pediatrics, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
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Khandelwal A, Aggarwal A, Sharma A, Malik A, Bose A. MRI of Malformations of Cortical Development- A Comprehensive Review. World Neurosurg 2021; 159:70-79. [PMID: 34896352 DOI: 10.1016/j.wneu.2021.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 11/29/2022]
Abstract
MCDs (malformations of cortical development) are structural anomalies that disrupt the normal process of the cortical development. These include microcephaly with simplified gyral pattern/microlissencephaly, hemimegalencephaly, focal cortical dysplasia, lissencephaly, heterotopia, polymicrogyria and schizencephaly. They can present with intractable epilepsy, developmental delay, neurological deficits or cognitive impairment. Though the definitive diagnosis of MCD depends on histopathology, the pathological tissue is rarely available hence diagnosis begins with neuroimaging. This article shall briefly review the embryology followed by specific MRI imaging features of MCD in an attempt to simplify the process of diagnosing these disorders with clinical and genetic correlation.A table has been included to highlight the embryological, clinical and genetic findings associated with various MCDs.
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Affiliation(s)
- Ayush Khandelwal
- Senior Resident, Department of Radiology, VMMC and Safdarjung Hospital, New Delhi
| | - Ankita Aggarwal
- Assistant Professor, Department of Radiology, VMMC and Safdarjung Hospital, New Delhi.
| | - Anuradha Sharma
- Assistant Professor, Department of Radiology, VMMC and Safdarjung Hospital, New Delhi
| | - Amita Malik
- Professor, Department of Radiology, VMMC and Safdarjung Hospital, New Delhi
| | - Anindita Bose
- Senior Resident, Department of Radiology, UCMS and GTB Hospital,Delhi
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Christodoulou JA, Barnard ME, Del Tufo SN, Katzir T, Whitfield-Gabrieli S, Gabrieli JD, Chang BS. Integration of gray matter nodules into functional cortical circuits in periventricular heterotopia. Epilepsy Behav 2013; 29:400-6. [PMID: 24090774 PMCID: PMC3844926 DOI: 10.1016/j.yebeh.2013.08.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 08/27/2013] [Indexed: 11/18/2022]
Abstract
Alterations in neuronal circuitry are recognized as an important substrate of many neurological disorders, including epilepsy. Patients with the developmental brain malformation of periventricular nodular heterotopia (PNH) often have both seizures and dyslexia, and there is evidence to suggest that aberrant neuronal connectivity underlies both of these clinical features. We used task-based functional MRI (fMRI) to determine whether heterotopic nodules of gray matter in this condition are integrated into functional cortical circuits. Blood oxygenation level-dependent (BOLD) fMRI was acquired in eight participants with PNH during the performance of reading-related tasks. Evidence of neural activation within heterotopic gray matter was identified, and regions of cortical coactivation were then mapped systematically. Findings were correlated with resting-state functional connectivity results and with performance on the fMRI reading-related tasks. Six participants (75%) demonstrated activation within at least one region of gray matter heterotopia. Cortical areas directly overlying the heterotopia were usually coactivated (60%), as were areas known to have functional connectivity to the heterotopia in the task-free resting state (73%). Six of seven (86%) primary task contrasts resulted in heterotopia activation in at least one participant. Activation was most commonly seen during rapid naming of visual stimuli, a characteristic impairment in this patient population. Our findings represent a systematic demonstration that heterotopic gray matter can be metabolically coactivated in a neuronal migration disorder associated with epilepsy and dyslexia. Gray matter nodules were most commonly coactivated with the anatomically overlying cortex and other regions with resting-state connectivity to heterotopia. These results have broader implications for understanding the network pathogenesis of both seizures and reading disabilities.
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Affiliation(s)
- Joanna A. Christodoulou
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Mollie E. Barnard
- Comprehensive Epilepsy Center, Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Stephanie N. Del Tufo
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Tami Katzir
- Department of Learning Disabilities, University of Haifa, Haifa, Israel
| | - Susan Whitfield-Gabrieli
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - John D.E. Gabrieli
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Bernard S. Chang
- Comprehensive Epilepsy Center, Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
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Tripathi M, Tripathi M, Kumar G, Malhotra A, Bal C. ′Double cortex′ sign on FDG-PET/CT in diffuse band heterotopia. Indian J Nucl Med 2013; 28:249-50. [PMID: 24379541 PMCID: PMC3866676 DOI: 10.4103/0972-3919.121979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Walker LM, Katzir T, Liu T, Ly J, Corriveau K, Barzillai M, Chu F, O'Connor MG, Hackney DB, Chang BS. Gray matter volumes and cognitive ability in the epileptogenic brain malformation of periventricular nodular heterotopia. Epilepsy Behav 2009; 15:456-60. [PMID: 19541546 PMCID: PMC2721909 DOI: 10.1016/j.yebeh.2009.05.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Revised: 05/12/2009] [Accepted: 05/16/2009] [Indexed: 02/02/2023]
Abstract
Periventricular nodular heterotopia (PNH) is a brain malformation clinically characterized by the triad of epilepsy, normal intelligence, and dyslexia. We investigated the structure-function relationship between cerebral volumes and cognitive ability in this disorder by studying 12 subjects with PNH and 6 controls using volumetric analysis of high-resolution anatomical MRI and neuropsychological testing. Total cerebral volumes and specific brain compartment volumes (gray matter, white matter, and cerebrospinal fluid) in subjects with PNH were comparable to those in controls. There was a negative correlation between heterotopic gray matter volume and cortical gray matter volume. Cerebral and cortical volumes in PNH did not correlate with Full Scale IQ, unlike in normal individuals. Our findings support the idea that heterotopic nodules contain misplaced neurons that would normally have migrated to the cortex, and suggest that structural correlates of normal cognitive ability may be different in the setting of neuronal migration failure.
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Affiliation(s)
- Linsey M. Walker
- Comprehensive Epilepsy Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Tami Katzir
- Department of Learning Disabilities, Faculty of Education, University of Haifa, Haifa, Israel
| | - Tianming Liu
- Department of Computer Science, University of Georgia, Athens, GA
| | - Jenny Ly
- Behavioral Neurology Unit, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | | | - Mirit Barzillai
- Center for Reading and Language Research, Tufts University, Medford, MA
| | - Felicia Chu
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Margaret G. O'Connor
- Behavioral Neurology Unit, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - David B. Hackney
- Division of Neuroradiology, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Bernard S. Chang
- Comprehensive Epilepsy Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
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Querne L, Berquin P, Vernier-Hauvette MP, Fall S, Deltour L, Meyer ME, de Marco G. Dysfunction of the attentional brain network in children with Developmental Coordination Disorder: a fMRI study. Brain Res 2008; 1244:89-102. [PMID: 18718456 DOI: 10.1016/j.brainres.2008.07.066] [Citation(s) in RCA: 107] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2007] [Revised: 07/08/2008] [Accepted: 07/10/2008] [Indexed: 11/30/2022]
Abstract
Children with Developmental Coordination Disorder (DCD) present impaired motor skills, frequently associated with impaired attentional and executive functions. The objective of this study was to assess the impact of DCD on effective connectivity applied to a putative model of inhibition. fMRI was performed in 9 children with DCD and 10 control children (8-13 years old) performing a go-nogo task. As previously reported, children with DCD obtained a similar score for correct inhibitions as controls, but responses were slower and more variable than in controls. Compared to controls, Structural Equation Modeling indicated that: (1) path coefficients from both middle frontal cortex (MFC) and anterior cingulate cortex (ACC) to inferior parietal cortex (IPC) increased in children with DCD particularly in the left hemisphere; (2) path coefficients between striatum and parietal cortex decreased in children with DCD in the right hemisphere. Results suggest that DCD could be characterized by abnormal brain hemispheric specialization during development. Furthermore, connectivity in the MFC-ACC-IPC network could indicate that children with DCD are less able than healthy children to easily and/or promptly switch between go and nogo motor responses. However, children with DCD seem to compensate for this poor efficiency by more actively engaging the ACC to prevent commissions allowing maintenance of a good level of inhibition.
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Affiliation(s)
- Laurent Querne
- Laboratoire de Neurosciences Fonctionnelles et Pathologies-UMR CNRS 8160, Département de pédiatrie-CHU d'Amiens, Place Victor Pauchet, 80054 Amiens Cédex, France
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Donders J, Mullarkey SK, Allchin J. Congenital bilateral perisylvian syndrome: a case study. Clin Neuropsychol 2008; 23:276-85. [PMID: 18618376 DOI: 10.1080/13854040802220042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We report the case of a 14-year-old boy with bilateral congenital perisylvian syndrome as evidenced by polymicrogyria in the left and right frontotemporal regions, pseudobulbar paresis, seizures, and spastic diplegia. This is the first description of comprehensive neuropsychological assessment in a child with this syndrome. The results reflect significant impairments in auditory processing and independent learning and retention, but relatively preserved cognitive performance on interactive tasks involving frequent feedback and redirection. The findings are interpreted in the context of the neuropathology of this syndrome, with an emphasis on pragmatic implications for rehabilitation.
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Affiliation(s)
- Jacobus Donders
- 1Psychology Service and 2Rehabilitation Technology Center, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI 49503, USA.
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Vitali P, Minati L, D'Incerti L, Maccagnano E, Mavilio N, Capello D, Dylgjeri S, Rodriguez G, Franceschetti S, Spreafico R, Villani F. Functional MRI in Malformations of Cortical Development: Activation of Dysplastic Tissue and Functional Reorganization. J Neuroimaging 2008; 18:296-305. [DOI: 10.1111/j.1552-6569.2007.00164.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Poduri A, Golja A, Takeoka M, Bourgeois BFD, Connolly L, Riviello JJ. Focal cortical malformations can show asymmetrically higher uptake on interictal fluorine-18 fluorodeoxyglucose positron emission tomography (PET). J Child Neurol 2007; 22:232-7. [PMID: 17621491 DOI: 10.1177/0883073807300305] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Interictal fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) is a component of the presurgical evaluation of patients with medically intractable epilepsy, including patients with malformations of cortical development. The authors describe 3 cases of focal cortical malformations that displayed asymmetrically higher uptake on FDG-PET performed in the interictal state in patients undergoing evaluation for possible focal resection for refractory localization-related epilepsy. The evaluation included routine and prolonged video electroencephalography (EEG), magnetic resonance imaging (MRI), interictal FDG-PET with concurrent EEG, and single-photon emission computed tomography (SPECT). All 3 patients had focal cortical malformations on MRI corresponding to regions of asymmetrically higher uptake on FDG-PET. EEG confirmed that the FDG-PET studies were performed in the interictal state. The lesions included a large region of subcortical heterotopia in the right frontal lobe, a left temporal lobe dysplasia, and a region of subcortical heterotopia in the right occipital lobe. In both patients with subcortical heterotopia, there were other focal regions of cortical malformation that were not associated with abnormal or asymmetric uptake on FDG-PET. Previous reports describe decreased uptake on interictal PET in most cases of focal cortical malformations. Normal to increased uptake has been reported with band heterotopia. The authors demonstrate that other types of focal malformations of cortical development, including focal subcortical heterotopia and lobar dysplasia, can be associated with asymmetrically higher uptake on interictal FDG-PET.
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Affiliation(s)
- Annapurna Poduri
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Children's Hospital Boston, Boston, Massachusetts 02115, USA. annapurna.poduri@ childrens.harvard.edu
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