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Slušná D, Kohli JS, Hau J, Álvarez-Linera Prado J, Linke AC, Hinzen W. Functional dysregulation of the auditory cortex in bilateral perisylvian polymicrogyria: Multiparametric case analysis of the absent speech phenotype. Cortex 2024; 171:423-434. [PMID: 38109835 DOI: 10.1016/j.cortex.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/23/2023] [Accepted: 11/02/2023] [Indexed: 12/20/2023]
Abstract
The absence of speech is a clinical phenotype seen across neurodevelopmental syndromes, offering insights for neural language models. We present a case of bilateral perisylvian polymicrogyria (BPP) and complete absence of speech with considerable language comprehension and production difficulties. We extensively characterized the auditory speech perception and production circuitry by employing a multimodal neuroimaging approach. Results showed extensive cortical thickening in motor and auditory-language regions. The auditory cortex lacked sensitivity to speech stimuli despite relatively preserved thalamic projections yet had no intrinsic functional organization. Subcortical structures implicated in early stages of processing exhibited heightened sensitivity to speech. The arcuate fasciculus, a suggested marker of language in BPP, showed similar volume and integrity to a healthy control. The frontal aslant tract, linked to oromotor function, was partially reconstructed. These findings highlight the importance of assessing the auditory cortex beyond speech production structures to understand absent speech in BPP. Despite profound cortical alterations, the intrinsic motor network and motor-speech pathways remained largely intact. This case underscores the need for comprehensive phenotyping using multiple MRI modalities to uncover causes of severe disruption in language development.
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Affiliation(s)
- Dominika Slušná
- Department of Translation and Language Sciences, Campus Poblenou, Pompeu Fabra University, Barcelona, Spain.
| | - Jiwandeep S Kohli
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Janice Hau
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, USA
| | | | - Annika C Linke
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Wolfram Hinzen
- Department of Translation and Language Sciences, Campus Poblenou, Pompeu Fabra University, Barcelona, Spain; Institució Catalana de Recerca I Estudis Avancats, ICREA, Barcelona, Spain
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Costanzo F, Zanni G, Fucà E, Di Paola M, Barresi S, Travaglini L, Colafati GS, Gambardella A, Bellacchio E, Bertini E, Menghini D, Vicari S. Cerebellar Agenesis and Bilateral Polimicrogyria Associated with Rare Variants of CUB and Sushi Multiple Domains 1 Gene (CSMD1): A Longitudinal Neuropsychological and Neuroradiological Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031224. [PMID: 35162247 PMCID: PMC8835405 DOI: 10.3390/ijerph19031224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/12/2022] [Accepted: 01/17/2022] [Indexed: 12/04/2022]
Abstract
Cerebellar agenesis is an extremely rare condition characterized by a near complete absence of the cerebellum. The pathogenesis and molecular basis remain mostly unknown. We report the neuroradiological, molecular, neuropsychological and behavioral characterization of a 5-year-old girl, with cerebellar agenesis associated with parietal and peri-Sylvian polymicrogyria, followed-up for 10 years at four time points. Whole exome sequencing identified two rare variants in CSMD1, a gene associated with neurocognitive and psychiatric alterations. Mild intellectual impairment, cerebellar ataxia and deficits in language, memory and executive functions, with relatively preserved adaptive and psychopathological domains, were initially showed. Phonological awareness and verbal memory declined at 11 years of age, and social and anxiety problems emerged. Adaptive and psychopathological characteristics dramatically worsened at 15 years. In summary, the developmental clinical outcome showed impairment in multiple cognitive functions in childhood, with a progressive decline in cognitive and adaptive abilities and the emergence of psychopathological symptoms in adolescence. The observed phenotype could be the result of a complex interplay between cerebellar abnormality, brain malformation and the relations with CSMD1 variants. These findings may provide insights into the developmental clinical outcomes of a co-occurrence between rare brain malformation and rare genetic variants associated to neurodevelopmental disorders.
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Affiliation(s)
- Floriana Costanzo
- Child and Adolescent Neuropsychiatry Unit, Department of Neurosciences, Bambino Gesù Children’s Hospital IRCCS, Via Ferdinando Baldelli 41, I-00146 Rome, Italy; (F.C.); (E.F.); (S.V.)
| | - Ginevra Zanni
- Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children’s Hospital, IRCCS, Viale di San Paolo 15, I-00146 Rome, Italy; (G.Z.); (L.T.); (E.B.)
| | - Elisa Fucà
- Child and Adolescent Neuropsychiatry Unit, Department of Neurosciences, Bambino Gesù Children’s Hospital IRCCS, Via Ferdinando Baldelli 41, I-00146 Rome, Italy; (F.C.); (E.F.); (S.V.)
| | - Margherita Di Paola
- Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306, I-00179 Rome, Italy;
- Department of Mental Health, King Faisal Specialist Hospital & Research Center, Riyadh 12713, Saudi Arabia
| | - Sabina Barresi
- Pathology Unit, Department of Laboratories, Bambino Gesù Children’s Hospital, IRCCS, Viale di San Paolo 15, I-00146 Rome, Italy;
| | - Lorena Travaglini
- Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children’s Hospital, IRCCS, Viale di San Paolo 15, I-00146 Rome, Italy; (G.Z.); (L.T.); (E.B.)
| | - Giovanna Stefania Colafati
- Oncological Neuroradiology Unit, Department of Imaging, Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, I-00100 Rome, Italy;
| | - Antonio Gambardella
- Institute of Neurology, University Magna Græcia, I-88100 Catanzaro, Italy;
- Institute of Molecular Bioimaging and Physiology, National Research Council, I-88100 Catanzaro, Italy
| | - Emanuele Bellacchio
- Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, Viale di San Paolo 15, I-00146 Rome, Italy;
| | - Enrico Bertini
- Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children’s Hospital, IRCCS, Viale di San Paolo 15, I-00146 Rome, Italy; (G.Z.); (L.T.); (E.B.)
| | - Deny Menghini
- Child and Adolescent Neuropsychiatry Unit, Department of Neurosciences, Bambino Gesù Children’s Hospital IRCCS, Via Ferdinando Baldelli 41, I-00146 Rome, Italy; (F.C.); (E.F.); (S.V.)
- Correspondence: ; Tel.: +39-0668597091
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Department of Neurosciences, Bambino Gesù Children’s Hospital IRCCS, Via Ferdinando Baldelli 41, I-00146 Rome, Italy; (F.C.); (E.F.); (S.V.)
- Department of Life Science and Public Health, Catholic University of the Sacred Heart, Largo Agostino Gemelli 1, I-00168 Rome, Italy
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Morozova E, Morozov D, Belousova M, Utkuzova M, Madiakina A. Uncommon variants of speech disorder in children: congenital bilateral perisylvian syndrome. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:21-26. [DOI: 10.17116/jnevro202212209221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Braden RO, Boyce JO, Stutterd CA, Pope K, Goel H, Leventer RJ, Scheffer IE, Morgan AT. Speech, Language, and Oromotor Skills in Patients With Polymicrogyria. Neurology 2021; 96:e1898-e1912. [PMID: 33589534 DOI: 10.1212/wnl.0000000000011698] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 01/06/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether specific speech, language, and oromotor profiles are associated with different patterns of polymicrogyria, we assessed 52 patients with polymicrogyria using a battery of standardized tests and correlated findings with topography and severity of polymicrogyria. METHODS Patients were identified via clinical research databases and invited to participate, irrespective of cognitive and verbal language abilities. We conducted standardized assessments of speech, oromotor structure and function, language, and nonverbal IQ. Data were analyzed according to normative assessment data and descriptive statistics. We conducted a correlation analysis between topographic pattern and speech and language findings. RESULTS Fifty-two patients (33 male, 63%) were studied at an average age of 12.7 years (range 2.5-36 years). All patients had dysarthria, which ranged from mild impairment to anarthria. Developmental speech errors (articulation and phonology), oral motor structure and function deficits, and language disorder were frequent. A total of 23/29 (79%) had cognitive abilities in the low average to extremely low range. In the perisylvian polymicrogyria group (36/52), speech, everyday language, and oral motor impairments were more severe, compared to generalized (1 patient), frontal (3), polymicrogyria with periventricular nodular heterotopia (3), parasagittal parieto-occipital (1), mesial occipital (1), and other (7) patterns. CONCLUSIONS Dysarthria is a core feature of polymicrogyria, often accompanied by receptive and expressive language impairments. These features are associated with all polymicrogyria distribution patterns and more severe in individuals with bilateral polymicrogyria, particularly in the perisylvian region.
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Affiliation(s)
- Ruth O Braden
- From Murdoch Children's Research Institute (R.O.B., J.O.B., C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Departments of Audiology and Speech Pathology (R.O.B., J.O.B., A.T.M.) and Paediatrics (C.A.S., R.J.L., I.E.S.), University of Melbourne; The Royal Children's Hospital (C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Victorian Clinical Genetics Service (C.A.S., K.P.), Parkville, Victoria; Hunter Genetics (H.G.), John Hunter Hospital, New Lambton Heights, New South Wales; Austin Health (I.E.S.), Heidelberg, Victoria; and Florey Institute of Neuroscience and Mental Health (I.E.S.), Parkville, Victoria, Australia
| | - Jessica O Boyce
- From Murdoch Children's Research Institute (R.O.B., J.O.B., C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Departments of Audiology and Speech Pathology (R.O.B., J.O.B., A.T.M.) and Paediatrics (C.A.S., R.J.L., I.E.S.), University of Melbourne; The Royal Children's Hospital (C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Victorian Clinical Genetics Service (C.A.S., K.P.), Parkville, Victoria; Hunter Genetics (H.G.), John Hunter Hospital, New Lambton Heights, New South Wales; Austin Health (I.E.S.), Heidelberg, Victoria; and Florey Institute of Neuroscience and Mental Health (I.E.S.), Parkville, Victoria, Australia
| | - Chloe A Stutterd
- From Murdoch Children's Research Institute (R.O.B., J.O.B., C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Departments of Audiology and Speech Pathology (R.O.B., J.O.B., A.T.M.) and Paediatrics (C.A.S., R.J.L., I.E.S.), University of Melbourne; The Royal Children's Hospital (C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Victorian Clinical Genetics Service (C.A.S., K.P.), Parkville, Victoria; Hunter Genetics (H.G.), John Hunter Hospital, New Lambton Heights, New South Wales; Austin Health (I.E.S.), Heidelberg, Victoria; and Florey Institute of Neuroscience and Mental Health (I.E.S.), Parkville, Victoria, Australia
| | - Kate Pope
- From Murdoch Children's Research Institute (R.O.B., J.O.B., C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Departments of Audiology and Speech Pathology (R.O.B., J.O.B., A.T.M.) and Paediatrics (C.A.S., R.J.L., I.E.S.), University of Melbourne; The Royal Children's Hospital (C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Victorian Clinical Genetics Service (C.A.S., K.P.), Parkville, Victoria; Hunter Genetics (H.G.), John Hunter Hospital, New Lambton Heights, New South Wales; Austin Health (I.E.S.), Heidelberg, Victoria; and Florey Institute of Neuroscience and Mental Health (I.E.S.), Parkville, Victoria, Australia
| | - Himanshu Goel
- From Murdoch Children's Research Institute (R.O.B., J.O.B., C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Departments of Audiology and Speech Pathology (R.O.B., J.O.B., A.T.M.) and Paediatrics (C.A.S., R.J.L., I.E.S.), University of Melbourne; The Royal Children's Hospital (C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Victorian Clinical Genetics Service (C.A.S., K.P.), Parkville, Victoria; Hunter Genetics (H.G.), John Hunter Hospital, New Lambton Heights, New South Wales; Austin Health (I.E.S.), Heidelberg, Victoria; and Florey Institute of Neuroscience and Mental Health (I.E.S.), Parkville, Victoria, Australia
| | - Richard J Leventer
- From Murdoch Children's Research Institute (R.O.B., J.O.B., C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Departments of Audiology and Speech Pathology (R.O.B., J.O.B., A.T.M.) and Paediatrics (C.A.S., R.J.L., I.E.S.), University of Melbourne; The Royal Children's Hospital (C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Victorian Clinical Genetics Service (C.A.S., K.P.), Parkville, Victoria; Hunter Genetics (H.G.), John Hunter Hospital, New Lambton Heights, New South Wales; Austin Health (I.E.S.), Heidelberg, Victoria; and Florey Institute of Neuroscience and Mental Health (I.E.S.), Parkville, Victoria, Australia
| | - Ingrid E Scheffer
- From Murdoch Children's Research Institute (R.O.B., J.O.B., C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Departments of Audiology and Speech Pathology (R.O.B., J.O.B., A.T.M.) and Paediatrics (C.A.S., R.J.L., I.E.S.), University of Melbourne; The Royal Children's Hospital (C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Victorian Clinical Genetics Service (C.A.S., K.P.), Parkville, Victoria; Hunter Genetics (H.G.), John Hunter Hospital, New Lambton Heights, New South Wales; Austin Health (I.E.S.), Heidelberg, Victoria; and Florey Institute of Neuroscience and Mental Health (I.E.S.), Parkville, Victoria, Australia
| | - Angela T Morgan
- From Murdoch Children's Research Institute (R.O.B., J.O.B., C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Departments of Audiology and Speech Pathology (R.O.B., J.O.B., A.T.M.) and Paediatrics (C.A.S., R.J.L., I.E.S.), University of Melbourne; The Royal Children's Hospital (C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Victorian Clinical Genetics Service (C.A.S., K.P.), Parkville, Victoria; Hunter Genetics (H.G.), John Hunter Hospital, New Lambton Heights, New South Wales; Austin Health (I.E.S.), Heidelberg, Victoria; and Florey Institute of Neuroscience and Mental Health (I.E.S.), Parkville, Victoria, Australia.
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Walker GM, Rollo PS, Tandon N, Hickok G. Effect of Bilateral Opercular Syndrome on Speech Perception. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2021; 2:335-353. [PMID: 37213256 PMCID: PMC10158595 DOI: 10.1162/nol_a_00037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 03/23/2021] [Indexed: 05/23/2023]
Abstract
Speech perception ability and structural neuroimaging were investigated in two cases of bilateral opercular syndrome. Due to bilateral ablation of the motor control center for the lower face and surrounds, these rare cases provide an opportunity to evaluate the necessity of cortical motor representations for speech perception, a cornerstone of some neurocomputational theories of language processing. Speech perception, including audiovisual integration (i.e., the McGurk effect), was mostly unaffected in these cases, although verbal short-term memory impairment hindered performance on several tasks that are traditionally used to evaluate speech perception. The results suggest that the role of the cortical motor system in speech perception is context-dependent and supplementary, not inherent or necessary.
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Affiliation(s)
- Grant M. Walker
- Department of Cognitive Sciences, University of California, Irvine
- * Corresponding Author:
| | | | - Nitin Tandon
- Department of Neurosurgery, University of Texas Medical School at Houston
| | - Gregory Hickok
- Department of Cognitive Sciences, University of California, Irvine
- Department of Language Science, University of California, Irvine
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Andelman-Gur MM, Leventer RJ, Hujirat M, Ganos C, Yosovich K, Carmi N, Lev D, Nissenkorn A, Dobyns WB, Bhatia K, Lerman-Sagie T, Blumkin L. Bilateral polymicrogyria associated with dystonia: A new neurogenetic syndrome? Am J Med Genet A 2020; 182:2207-2213. [PMID: 33001581 DOI: 10.1002/ajmg.a.61795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 04/15/2020] [Accepted: 06/23/2020] [Indexed: 11/07/2022]
Abstract
The clinical presentation of bilateral perisylvian polymicrogyria (PMG) is highly variable, including oromotor dysfunction, epilepsy, intellectual disability, and pyramidal signs. Extrapyramidal features are extremely rare. We present four apparently unrelated patients with a unique association of PMG with dystonia. The clinical, genetic, and radiologic features are described and possible mechanisms of dystonia are discussed. All patients were female and two were born to consanguineous families. All presented with early childhood onset dystonia. Other neurologic symptoms and signs classically seen in bilateral perisylvian PMG were observed, including oromotor dysfunction and speech abnormalities ranging from dysarthria to anarthria (4/4), pyramidal signs (3/4), hypotonia (3/4), postnatal microcephaly (1/4), and seizures (1/4). Neuroimaging showed a unique pattern of bilateral PMG with an infolded cortex originating primarily from the perisylvian region in three out of four patients. Whole exome sequencing was performed in two out of four patients and did not reveal pathogenic variants in known genes for cortical malformations or movement disorders. The dystonia seen in our patients is not described in bilateral PMG and suggests an underlying mechanism of impaired connectivity within the motor network or compromised cortical inhibition. The association of bilateral PMG with dystonia in our patients may represent a new neurogenetic disorder.
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Affiliation(s)
| | - Richard J Leventer
- Department of Neurology, Royal Children's Hospital, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | | | - Christos Ganos
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, UK
- Department of Neurology, Charité University Hospital Berlin, Berlin, Germany
| | - Keren Yosovich
- Metabolic-Neurogenetic Clinic, Wolfson Medical Center, Holon, Israel
- Rina Mor Institute of Medical Genetics, Wolfson Medical Center, Holon, Israel
- Molecular Genetics Laboratory, Wolfson Medical Center, Holon, Israel
| | - Nirit Carmi
- Child Development Center, Maccabi Health Services, Bnei Brak, Israel
| | - Dorit Lev
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Metabolic-Neurogenetic Clinic, Wolfson Medical Center, Holon, Israel
- Rina Mor Institute of Medical Genetics, Wolfson Medical Center, Holon, Israel
| | - Andreea Nissenkorn
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel
| | - William B Dobyns
- Departments of Pediatrics and Neurology, University of Washington, Seattle, Washington, USA
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Kailash Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, UK
| | - Tally Lerman-Sagie
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Metabolic-Neurogenetic Clinic, Wolfson Medical Center, Holon, Israel
- Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel
| | - Lubov Blumkin
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Metabolic-Neurogenetic Clinic, Wolfson Medical Center, Holon, Israel
- Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel
- Pediatric Movement Disorders Service, Wolfson Medical Center, Holon, Israel
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Braden RO, Leventer RJ, Jansen A, Scheffer IE, Morgan AT. Speech and language in bilateral perisylvian polymicrogyria: a systematic review. Dev Med Child Neurol 2019; 61:1145-1152. [PMID: 30680716 DOI: 10.1111/dmcn.14153] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2018] [Indexed: 01/23/2023]
Abstract
AIM We aimed to systematically review the speech production, language, and oral function phenotype of bilateral perisylvian polymicrogyria (BPP), and examine the correlation between the topography of polymicrogyria and the severity of speech, language, and oral functional impairment. METHOD A systematic search of MEDLINE, Embase, and PubMed databases was completed on 26th October 2017 using Medical Subject Heading terms synonymous with BPP and speech, language, or oral motor impairment. In total, 2411 papers were identified and 48 met inclusion criteria. RESULTS Expressive and receptive language impairment and oral structural and functional deficits are frequent in BPP. Expressive deficits are frequently more severe than receptive. Only one study used formal assessments to demonstrate the presence of speech disorder, namely dysarthria. Seven studies reported an association between diffuse BPP and more severe language impairment. INTERPRETATION Findings confirmed that language deficits are common in BPP, though assessment of the specific speech phenotype is limited. The paucity of high quality studies detailing the specific communication phenotype of BPP highlights the need for further investigation. Improving understanding of this phenotype will inform the development of targeted therapies and lead to better long-term outcomes. WHAT THIS PAPER ADDS Speech, language, and oral functional impairments are common in individuals with bilateral perisylvian polymicrogyria. Posterior polymicrogyria is associated with a less severe language impairment than anterior polymicrogyria. Deeper investigation of speech is needed to understand implicated networks in this malformation.
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Affiliation(s)
- Ruth O Braden
- Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia.,Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Melbourne, Victoria, Australia
| | - Richard J Leventer
- Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia.,Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Melbourne, Victoria, Australia.,Royal Children's Hospital, Parkville, Melbourne, Victoria, Australia
| | - Anna Jansen
- Neurogenetics Research Group, Reproduction Genetics and Regenerative Medicine Research Cluster, Vrije Universiteit Brussel, Brussels, Belgium.,Pediatric Neurology Unit, Department of Pediatrics, University Hospital Brussels, Brussels, Belgium
| | - Ingrid E Scheffer
- Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia.,Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Melbourne, Victoria, Australia.,Royal Children's Hospital, Parkville, Melbourne, Victoria, Australia.,Austin Health, Heidelberg, Melbourne, Victoria, Australia.,The Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Angela T Morgan
- Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia.,Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Melbourne, Victoria, Australia.,Royal Children's Hospital, Parkville, Melbourne, Victoria, Australia
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Smith RS, Kenny CJ, Ganesh V, Jang A, Borges-Monroy R, Partlow JN, Hill RS, Shin T, Chen AY, Doan RN, Anttonen AK, Ignatius J, Medne L, Bönnemann CG, Hecht JL, Salonen O, Barkovich AJ, Poduri A, Wilke M, de Wit MCY, Mancini GMS, Sztriha L, Im K, Amrom D, Andermann E, Paetau R, Lehesjoki AE, Walsh CA, Lehtinen MK. Sodium Channel SCN3A (Na V1.3) Regulation of Human Cerebral Cortical Folding and Oral Motor Development. Neuron 2018; 99:905-913.e7. [PMID: 30146301 DOI: 10.1016/j.neuron.2018.07.052] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 06/05/2018] [Accepted: 07/30/2018] [Indexed: 12/29/2022]
Abstract
Channelopathies are disorders caused by abnormal ion channel function in differentiated excitable tissues. We discovered a unique neurodevelopmental channelopathy resulting from pathogenic variants in SCN3A, a gene encoding the voltage-gated sodium channel NaV1.3. Pathogenic NaV1.3 channels showed altered biophysical properties including increased persistent current. Remarkably, affected individuals showed disrupted folding (polymicrogyria) of the perisylvian cortex of the brain but did not typically exhibit epilepsy; they presented with prominent speech and oral motor dysfunction, implicating SCN3A in prenatal development of human cortical language areas. The development of this disorder parallels SCN3A expression, which we observed to be highest early in fetal cortical development in progenitor cells of the outer subventricular zone and cortical plate neurons and decreased postnatally, when SCN1A (NaV1.1) expression increased. Disrupted cerebral cortical folding and neuronal migration were recapitulated in ferrets expressing the mutant channel, underscoring the unexpected role of SCN3A in progenitor cells and migrating neurons.
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Affiliation(s)
- Richard S Smith
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, and Howard Hughes Medical Institute, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Connor J Kenny
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, and Howard Hughes Medical Institute, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Vijay Ganesh
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, and Howard Hughes Medical Institute, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Ahram Jang
- Department of Pathology, Boston Children's Hospital, Boston, MA 02115, USA
| | - Rebeca Borges-Monroy
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, and Howard Hughes Medical Institute, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Jennifer N Partlow
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, and Howard Hughes Medical Institute, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - R Sean Hill
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, and Howard Hughes Medical Institute, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Taehwan Shin
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, and Howard Hughes Medical Institute, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Allen Y Chen
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, and Howard Hughes Medical Institute, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Ryan N Doan
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, and Howard Hughes Medical Institute, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Anna-Kaisa Anttonen
- The Folkhälsan Institute of Genetics, 00290 Helsinki, Finland; Medical and Clinical Genetics, Neuroscience Center and Research Programs Unit, Molecular Neurology, 00014, University of Helsinki, Helsinki, Finland
| | - Jaakko Ignatius
- Department of Clinical Genetics, Turku University Hospital, Turku, 20521, Finland
| | - Livija Medne
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Carsten G Bönnemann
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Jonathan L Hecht
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Oili Salonen
- Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, 00029 HUS, Helsinki, Finland
| | - A James Barkovich
- Benioff Children's Hospital, Departments of Radiology, Pediatrics, Neurology, and Neurological Surgery, University of California San Francisco, San Francisco, CA 94117, USA
| | - Annapurna Poduri
- Department of Neurology, Boston Children's Hospital and Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Martina Wilke
- Department of Clinical Genetics, Erasmus MC Rotterdam 3015CN, Netherlands
| | - Marie Claire Y de Wit
- Neurogenetics Joint Clinic in Sophia Children's Hospital, Erasmus MC Rotterdam 3015CN, Netherlands
| | - Grazia M S Mancini
- Department of Clinical Genetics, Erasmus MC Rotterdam 3015CN, Netherlands
| | - Laszlo Sztriha
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Kiho Im
- Division of Newborn Medicine, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Dina Amrom
- Neurogenetics Unit and Epilepsy Research Group, Montreal Neurological Institute and Hospital; and the Departments of Neurology & Neurosurgery and Human Genetics, McGill University, Montreal, QC H3A 2B4, Canada
| | - Eva Andermann
- Neurogenetics Unit and Epilepsy Research Group, Montreal Neurological Institute and Hospital; and the Departments of Neurology & Neurosurgery and Human Genetics, McGill University, Montreal, QC H3A 2B4, Canada
| | - Ritva Paetau
- Children's Hospital, University of Helsinki and Helsinki University Hospital, 00029 HUS, Helsinki, Finland
| | - Anna-Elina Lehesjoki
- The Folkhälsan Institute of Genetics, 00290 Helsinki, Finland; Medical and Clinical Genetics, Neuroscience Center and Research Programs Unit, Molecular Neurology, 00014, University of Helsinki, Helsinki, Finland
| | - Christopher A Walsh
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, and Howard Hughes Medical Institute, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
| | - Maria K Lehtinen
- Department of Pathology, Boston Children's Hospital, Boston, MA 02115, USA.
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9
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Hong SJ, Bernhardt BC, Gill RS, Bernasconi N, Bernasconi A. The spectrum of structural and functional network alterations in malformations of cortical development. Brain 2017; 140:2133-2143. [DOI: 10.1093/brain/awx145] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 05/07/2017] [Indexed: 12/28/2022] Open
Affiliation(s)
- Seok-Jun Hong
- Neuroimaging of Epilepsy Laboratory, Department of Neurology and McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Boris C Bernhardt
- Neuroimaging of Epilepsy Laboratory, Department of Neurology and McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Ravnoor S Gill
- Neuroimaging of Epilepsy Laboratory, Department of Neurology and McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, Department of Neurology and McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, Department of Neurology and McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
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10
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Takahashi E, Folkerth RD, Galaburda AM, Grant PE. Emerging cerebral connectivity in the human fetal brain: an MR tractography study. Cereb Cortex 2011; 22:455-64. [PMID: 21670100 DOI: 10.1093/cercor/bhr126] [Citation(s) in RCA: 173] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Cerebral axonal connections begin to develop before birth during radial migration in each brain area. A number of theories are still actively debated regarding the link between neuronal migration, developing connectivity, and gyrification. Here, we used high angular resolution diffusion tractography on postmortem fetal human brains (postconception week (W) 17-40) to document the regression of radial and tangential organization likely to represent migration pathways and the emergence of corticocortical organization and gyrification. The dominant radial organization at W17 gradually diminished first in dorsal parieto-occipital and later in ventral frontotemporal regions with regional variation: radial organization persisted longer in the crests of gyri than at the depths of sulci. The dominant tangential organization of the ganglionic eminence at W17 also gradually disappeared by term, together with the disappearance of the ganglionic eminence. A few immature long-range association pathways were visible at W17, gradually became evident by term. Short-range corticocortical tracts emerged prior to gyrification in regions where sulci later developed. Our results suggest that the regional regression of radial organization and regional emergence of fetal brain connectivity proceeds in general from posterodorsal to anteroventral with local variations.
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Affiliation(s)
- Emi Takahashi
- Division of Newborn Medicine, Department of Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.
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11
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Toldo I, Calderone M, Sartori S, Mardari R, Gatta M, Boniver C, Guerrini R, Battistella PA. Bilateral perisylvian polymicrogyria with cerebellar dysplasia and ectopic neurohypophysis. J Child Neurol 2011; 26:361-5. [PMID: 21273507 DOI: 10.1177/0883073810381447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Polymicrogyria (involving or not the sylvian scissure) with cerebellar cortical dysplasia or vermis hypoplasia has been reported in few cases. In addition, the association between ectopic neurohypophysis and other cortical malformations, including bilateral perisylvian polymicrogyria, has been documented. We describe a girl affected by focal epilepsy since the age of 2 years. Magnetic resonance imaging (MRI) at 11 and 22 years of age showed bilateral perisylvian polymicrogyria, dysplasia of the left cerebellar hemisphere, and ectopic neurohypophysis. Genetic tests, including fluorescent in situ hybridization 22q11.2 and array-comparative genomic hybridization, and pituitary hormones (at the age of 20 years) were normal. The patient is now 22 years old, and she is seizure free under therapy with lamotrigine and levetiracetam. To the best of our knowledge, this is the first description of this complex cerebral malformation. This finding confirms that bilateral perisylvian polymicrogyria can be associated with other cerebral malformations; cerebellum and neurohypophysis must be carefully evaluated in patients with polymicrogyria.
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Affiliation(s)
- Irene Toldo
- Department of Pediatrics, University Hospital of Padua, Padua, Italy.
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12
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Jansen AC. Cognitive deficits and developmental language disorders in patients with malformations of cortical development. Epilepsia 2010; 51 Suppl 1:70-1. [PMID: 20331722 DOI: 10.1111/j.1528-1167.2009.02452.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Anna C Jansen
- Department of Pediatric Neurology, UZ Brussel, Brussels, Belgium.
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13
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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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14
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Abstract
The field of epilepsy has contributed significantly to localization of neurologic function, particularly in the neocortex. Methodologies such as cortical stimulation, positron emission tomography, functional MRI, trans-cranial magnetic stimulation, surgical resection, and magnetoencephalography have been used successfully in patients with epilepsy to locate specific functions, primarily for the purpose of defining eloquent cortex before surgical resections. The left hemisphere serves language-related functions and verbal memory in most people, whereas the right hemisphere serves some language function in addition to perceiving most components of music and other forms of nonverbal material. Both hemispheres cooperate in understanding spatial relationships. Studies in patients with developmental abnormalities have enriched our understanding of localization of function within the cortex. Future studies may help us understand the sequence in which specific regions are activated during specific tasks and determine which regions are necessary for tasks and which are supplementary. The ability to predict preoperatively the effect of removal of specific tissues would benefit surgical planning for all patients who undergo cortical resections, including those with epilepsy.
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15
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Morrison CE, Nakhutina L. Neuropsychological features of lesion-related epilepsy in adults: an overview. Neuropsychol Rev 2007; 17:385-403. [PMID: 17952606 DOI: 10.1007/s11065-007-9044-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2007] [Accepted: 10/03/2007] [Indexed: 11/26/2022]
Abstract
Lesional epilepsy is thought to be a direct consequence of focal brain lesions of dysgenetic, neoplastic, vascular, or traumatic origin. It has been estimated that at least half of all epilepsies are the result of such lesions. The current discussion includes an overview of the cognitive and behavioral presentations in adults with epilepsy secondary to focal pathology. The neuropsychological presentation in this population is influenced by many factors, including the location and nature of the underlying lesion, seizure characteristics, the effects of treatment, and patient variables. Few studies attempt to disentangle the specific contributions of these variables to cognitive performance. However, where available studies examining the separable effects of seizure-related variables on cognitive functioning in individuals with lesional epilepsy are also reviewed. This overview includes a discussion of focal malformations of cortical and vascular development and select foreign tissue and acquired lesions.
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Affiliation(s)
- Chris E Morrison
- Department of Neurology, Comprehensive Epilepsy Center, New York University Medical Center, 403 E 34th St., 4th Floor, New York, NY, 10016, USA.
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16
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Saletti V, Bulgheroni S, D'Incerti L, Franceschetti S, Molteni B, Airaghi G, Pantaleoni C, D'Arrigo S, Riva D. Verbal and gestural communication in children with bilateral perisylvian polymicrogyria. J Child Neurol 2007; 22:1090-8. [PMID: 17890406 DOI: 10.1177/0883073807306247] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We assessed intelligence and receptive and expressive language skills in 6 children, ages 7 years 9 months to 12 years 4 months, with bilateral perisylvian polymicrogyria of variable extent and with dysarthria of different severity. In view of the recent findings of a close relationship between word and gesture, we also examined the communicative use of gesture. We found that mental retardation was related to the extent of cortical malformation; lexical comprehension, but not morphosyntactic comprehension, and verbal production were more compromised than expected from nonverbal intellectual abilities; lack of verbal language was not compensated by the use of referential gestures. Results are discussed suggesting that compromised verbal and gestural communication in bilateral perisylvian polymicrogyria are not due simply to mental retardation and/or dysarthria but also to dysfunction of Sylvian fissure areas concerned with the totality of language processing.
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Affiliation(s)
- Veronica Saletti
- Developmental Neurology Division, Istituto Nazionale Neurologico, Besta, Milano, Italy
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