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Ronconi L, Casartelli L, Carna S, Molteni M, Arrigoni F, Borgatti R. When one is Enough: Impaired Multisensory Integration in Cerebellar Agenesis. Cereb Cortex 2017; 27:2041-2051. [PMID: 26946125 DOI: 10.1093/cercor/bhw049] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
In the last two decades, an intriguing shift in the understanding of the cerebellum has led to consider the nonmotor functions of this structure. Although various aspects of perceptual and sensory processing have been linked to the cerebellar activity, whether the cerebellum is essential for binding information from different sensory modalities remains uninvestigated. Multisensory integration (MSI) appears very early in the ontogenesis and is critical in several perceptual, cognitive, and social domains. For the first time, we investigated MSI in a rare case of cerebellar agenesis without any other associated brain malformations. To this aim, we measured reaction times (RTs) after the presentation of visual, auditory, and audiovisual stimuli. A group of neurotypical age-matched individuals was used as controls. Although we observed the typical advantage of the auditory modality relative to the visual modality in our patient, a clear impairment in MSI was found. Beyond the obvious prudence necessary for inferring definitive conclusions from this single-case picture, this finding is of interest in the light of reduced MSI abilities reported in several neurodevelopmental and psychiatric disorders-such as autism, dyslexia, and schizophrenia-in which the cerebellum has been implicated.
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Affiliation(s)
- L Ronconi
- Developmental and Cognitive Neuroscience Laboratory, Department of General Psychology, University of Padova, 35122 Padova, Italy.,Child Psychopathology Unit, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, 23842 Lecco, Italy
| | - L Casartelli
- Child Psychopathology Unit, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, 23842 Lecco, Italy.,Developmental Psychopathology Unit, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - S Carna
- Child Psychopathology Unit, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, 23842 Lecco, Italy.,Developmental Psychopathology Unit, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - M Molteni
- Child Psychopathology Unit, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, 23842 Lecco, Italy
| | | | - R Borgatti
- Neuropsychiatry and Neurorehabilitation Unit, Scientific Institute, IRCCSEugenio Medea, Bosisio Parini, 23842 Lecco, Italy
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Fiori S, Poretti A, Pannek K, Del Punta R, Pasquariello R, Tosetti M, Guzzetta A, Rose S, Cioni G, Battini R. Diffusion Tractography Biomarkers of Pediatric Cerebellar Hypoplasia/Atrophy: Preliminary Results Using Constrained Spherical Deconvolution. AJNR Am J Neuroradiol 2016; 37:917-23. [PMID: 26659337 DOI: 10.3174/ajnr.a4607] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 09/29/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND PURPOSE Advances in MR imaging modeling have improved the feasibility of reconstructing crossing fibers, with increasing benefits in delineating angulated tracts such as cerebellar tracts by using tractography. We hypothesized that constrained spherical deconvolution-based probabilistic tractography could successfully reconstruct cerebellar tracts in children with cerebellar hypoplasia/atrophy and that diffusion scalars of the reconstructed tracts could differentiate pontocerebellar hypoplasia, nonprogressive cerebellar hypoplasia, and progressive cerebellar atrophy. MATERIALS AND METHODS Fifteen children with cerebellar ataxia and pontocerebellar hypoplasia, nonprogressive cerebellar hypoplasia or progressive cerebellar atrophy and 7 controls were included in this study. Cerebellar and corticospinal tracts were reconstructed by using constrained spherical deconvolution. Scalar measures (fractional anisotropy and mean, axial and radial diffusivity) were calculated. A general linear model was used to determine differences among groups for diffusion MR imaging scalar measures, and post hoc pair-wise comparisons were performed. RESULTS Cerebellar and corticospinal tracts were successfully reconstructed in all subjects. Significant differences in diffusion MR imaging scalars were found among groups, with fractional anisotropy explaining the highest variability. All groups with cerebellar pathologies showed lower fractional anisotropy compared with controls, with the exception of cerebellar hypoplasia. CONCLUSIONS This study shows the feasibility of constrained spherical deconvolution to reconstruct cerebellar and corticospinal tracts in children with morphologic cerebellar pathologies. In addition, the preliminary results show the potential utility of quantitative analysis of scalars of the cerebellar white matter tracts in children with cerebellar pathologies such as cerebellar hypoplasia and atrophy. Further studies with larger cohorts of patients are needed to validate the clinical significance of our preliminary results.
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Affiliation(s)
- S Fiori
- From Istituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (S.F., R.D.P., R.P., M.T., A.G., G.C., R.B.), Pisa, Italy
| | - A Poretti
- Section of Pediatric Neuroradiology (A.P.), Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, Maryland
| | - K Pannek
- Commonwealth Scientific and Industrial Research Organization (K.P., S.R.), Centre for Computational Informatics, Brisbane, Australia Department of Computing (K.P.), Imperial College London, London, United Kingdom
| | - R Del Punta
- From Istituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (S.F., R.D.P., R.P., M.T., A.G., G.C., R.B.), Pisa, Italy
| | - R Pasquariello
- From Istituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (S.F., R.D.P., R.P., M.T., A.G., G.C., R.B.), Pisa, Italy
| | - M Tosetti
- From Istituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (S.F., R.D.P., R.P., M.T., A.G., G.C., R.B.), Pisa, Italy
| | - A Guzzetta
- From Istituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (S.F., R.D.P., R.P., M.T., A.G., G.C., R.B.), Pisa, Italy Department of Clinical and Experimental Medicine (A.G., G.C.), University of Pisa, Pisa, Italy
| | - S Rose
- Commonwealth Scientific and Industrial Research Organization (K.P., S.R.), Centre for Computational Informatics, Brisbane, Australia
| | - G Cioni
- From Istituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (S.F., R.D.P., R.P., M.T., A.G., G.C., R.B.), Pisa, Italy Department of Clinical and Experimental Medicine (A.G., G.C.), University of Pisa, Pisa, Italy
| | - R Battini
- From Istituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (S.F., R.D.P., R.P., M.T., A.G., G.C., R.B.), Pisa, Italy
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Terracciano A, Renaldo F, Zanni G, D'Amico A, Pastore A, Barresi S, Valente EM, Piemonte F, Tozzi G, Carrozzo R, Valeriani M, Boldrini R, Mercuri E, Santorelli FM, Bertini E. The use of muscle biopsy in the diagnosis of undefined ataxia with cerebellar atrophy in children. Eur J Paediatr Neurol 2012; 16:248-56. [PMID: 21873089 PMCID: PMC3341568 DOI: 10.1016/j.ejpn.2011.07.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 07/21/2011] [Accepted: 07/24/2011] [Indexed: 01/07/2023]
Abstract
Childhood cerebellar ataxias, and particularly congenital ataxias, are heterogeneous disorders and several remain undefined. We performed a muscle biopsy in patients with congenital ataxia and children with later onset undefined ataxia having neuroimaging evidence of cerebellar atrophy. Significant reduced levels of Coenzyme Q10 (COQ10) were found in the skeletal muscle of 9 out of 34 patients that were consecutively screened. A mutation in the ADCK3/Coq8 gene (R347X) was identified in a female patient with ataxia, seizures and markedly reduced COQ10 levels. In a 2.5-years-old male patient with non syndromic congenital ataxia and autophagic vacuoles in the muscle biopsy we identified a homozygous nonsense mutation R111X mutation in SIL1 gene, leading to early diagnosis of Marinesco-Sjogren syndrome. We think that muscle biopsy is a valuable procedure to improve diagnostic assesement in children with congenital ataxia or other undefined forms of later onset childhood ataxia associated to cerebellar atrophy at MRI.
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Affiliation(s)
- Alessandra Terracciano
- Unit of Neuromuscular and Neurodegenerative Disorders, Lab of Molecular Medicine, Dept of Neuroscience, Bambino Gesù Childrens Hospital, Rome, Italy
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