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Mertiri L, Boltshauser E, Kralik SF, Desai NK, Lequin MH, Huisman TAGM. Incidence and Characteristics of Cerebellar Atrophy/Volume Loss in Children with Confirmed Diagnosis of Tuberous Sclerosis Complex. CHILDREN (BASEL, SWITZERLAND) 2024; 11:627. [PMID: 38929207 PMCID: PMC11201845 DOI: 10.3390/children11060627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 05/14/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024]
Abstract
Objectives: The goal of our study was to determine the incidence of cerebellar atrophy, assess the imaging findings in the posterior fossa and determine the incidence of hippocampal sclerosis in a cohort of pediatric patients with confirmed tuberous sclerosis complex (TSC). Material and methods: MRI studies of 98 TSC pediatric patients (mean age 7.67 years) were evaluated for cerebellar atrophy, cerebral/cerebellar tubers, white matter lesions, subependymal nodules, subependymal giant cell astrocytomas, ventriculomegaly, and hippocampal sclerosis. Clinical charts were revisited for clinical symptoms suggesting cerebellar involvement, for seizures and treatment for seizures, behavioral disorders and autism. Results: Cerebral tubers were present in 97/98 cases. In total, 97/98 had subependymal nodules, 15/98 had SEGA, 8/98 had ventriculomegaly and 4/98 had hippocampal sclerosis. Cerebellar tubers were found in 8/98 patients (8.2%), whereas cerebellar atrophy was described in 38/98 cases (38.8%). In 37/38 patients, cerebellar volume loss was mild and diffuse, and only one case presented with left hemi-atrophy. Briefly, 32/38 presented with seizures and were treated with anti-seizure drugs. In total, 8/38 (21%) presented with behavioral disorders, 10/38 had autism and 2/38 presented with seizures and behavioral disorders and autism. Conclusions: Several studies have demonstrated cerebellar involvement in patients with TSC. Cerebellar tubers differ in shape compared with cerebral tubers and are associated with cerebellar volume loss. Cerebellar atrophy may be focal and diffuse and one of the primary cerebellar manifestations of TSC, especially if a TSC2 mutation is present. Cerebellar degeneration may, however, also be secondary/acquired due to cellular damage resulting from seizure activity, the effects of anti-seizure drugs and anoxic-ischemic injury from severe seizure activity/status epilepticus. Further, prospective studies are required to identify and establish the pathogenic mechanism of cerebellar atrophy in patients with TSC.
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Affiliation(s)
- Livja Mertiri
- Edward B. Singleton Department of Radiology, Texas Children’s Hospital and Baylor College of Medicine, Houston, TX 77030, USA; (S.F.K.); (N.K.D.); (M.H.L.); (T.A.G.M.H.)
| | - Eugen Boltshauser
- Division of Pediatric Neurology, University Children’s Hospital Zurich, 8032 Zurich, Switzerland;
| | - Stephen F. Kralik
- Edward B. Singleton Department of Radiology, Texas Children’s Hospital and Baylor College of Medicine, Houston, TX 77030, USA; (S.F.K.); (N.K.D.); (M.H.L.); (T.A.G.M.H.)
| | - Nilesh K. Desai
- Edward B. Singleton Department of Radiology, Texas Children’s Hospital and Baylor College of Medicine, Houston, TX 77030, USA; (S.F.K.); (N.K.D.); (M.H.L.); (T.A.G.M.H.)
| | - Maarten H. Lequin
- Edward B. Singleton Department of Radiology, Texas Children’s Hospital and Baylor College of Medicine, Houston, TX 77030, USA; (S.F.K.); (N.K.D.); (M.H.L.); (T.A.G.M.H.)
| | - Thierry A. G. M. Huisman
- Edward B. Singleton Department of Radiology, Texas Children’s Hospital and Baylor College of Medicine, Houston, TX 77030, USA; (S.F.K.); (N.K.D.); (M.H.L.); (T.A.G.M.H.)
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Meyer JA, Graydon A, Muthukumaraswamy C, Jones HF. Brachial artery aneurysm and bilateral posterior circulation strokes in a young child with tuberous sclerosis complex. BMJ Case Rep 2023; 16:e255694. [PMID: 37963668 PMCID: PMC10649671 DOI: 10.1136/bcr-2023-255694] [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] [Indexed: 11/16/2023] Open
Abstract
Although tuberous sclerosis (TS) may affect many organs, vascular manifestations involving medium- and large-size vessels are rare. We present a young child with known TS who presented with bilateral posterior circulation infarcts and subsequently was found to have right-hand ischaemia secondary to a thrombosed brachial artery aneurysm. A wound on his right middle finger failed to heal with conservative management, and digital subtraction angiography and MR angiogram demonstrated a lack of bypass target with microcollateral supply of the forearm only. The right middle digit ischaemia was initially managed with right middle finger disarticulation at the metacarpophalangeal joint, but the wound failed to heal and the patient proceeded to a thumb-sparing carpo-metacarpal amputation. Aneurysms, stenotic-occlusive disease and embolic stroke are rare but important complications of TS.
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Affiliation(s)
- Juliette A Meyer
- Department of Paediatrics, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
- Paediatric Neuroservices, Starship Children's Health, Auckland, New Zealand
| | - Andrew Graydon
- Paediatric Orthopaedic Department, Starship Children's Health, Auckland, New Zealand
| | | | - Hannah F Jones
- Department of Paediatrics, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
- Paediatric Neuroservices, Starship Children's Health, Auckland, New Zealand
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Fidalgo da Silva E, Abu Khatir B, Drouillard C, Hinch I, Davis GO, Sameem M, Patel R, Fong J, Lubanska D, Porter LA. Tuberin levels during cellular differentiation in brain development. Differentiation 2023; 130:43-50. [PMID: 36608575 DOI: 10.1016/j.diff.2022.12.004] [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: 10/18/2021] [Revised: 12/13/2022] [Accepted: 12/21/2022] [Indexed: 12/26/2022]
Abstract
Tuberin is a member of a large protein complex, Tuberous Sclerosis Complex (TSC), and acts as a sensor for nutrient status regulating protein synthesis and cell cycle progression. Mutations in the Tuberin gene, TSC2, permits the formation of tumors that can lead to developmental defects in many organ systems, including the central nervous system. Tuberin is expressed in the brain throughout development and levels of Tuberin have been found to decrease during neuronal differentiation in cell lines in vitro. Our current work investigates the levels of Tuberin at two stages of embryonic development in vivo, and we study the mRNA and protein levels during a time course using immortalized cell lines in vitro. Our results show that total Tuberin levels are tightly regulated through developmental stages in the embryonic brain. At a cell biology level, we show that Tuberin levels are higher when cells are cultured as neurospheres, and knockdown of Tuberin results in a reduction in the number of neurospheres. This functional data supports the hypothesis that Tuberin is an important regulator of stemness and the reduction of Tuberin levels might support functional differentiation in the central nervous system. Understanding how Tuberin expression is regulated throughout neural development is essential to fully comprehend the role of this protein in several developmental and neural pathologies.
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Affiliation(s)
- Elizabeth Fidalgo da Silva
- Department of Biomedical Sciences, University of Windsor, 401 Sunset Ave. Windsor, Ontario, N9B 3P4, Canada
| | - Bashaer Abu Khatir
- Department of Biomedical Sciences, University of Windsor, 401 Sunset Ave. Windsor, Ontario, N9B 3P4, Canada
| | - Christopher Drouillard
- Department of Biomedical Sciences, University of Windsor, 401 Sunset Ave. Windsor, Ontario, N9B 3P4, Canada
| | - Isabelle Hinch
- Department of Biomedical Sciences, University of Windsor, 401 Sunset Ave. Windsor, Ontario, N9B 3P4, Canada
| | - Gordon Omar Davis
- Department of Biomedical Sciences, University of Windsor, 401 Sunset Ave. Windsor, Ontario, N9B 3P4, Canada
| | - Mariam Sameem
- Department of Biomedical Sciences, University of Windsor, 401 Sunset Ave. Windsor, Ontario, N9B 3P4, Canada
| | - Rutu Patel
- Department of Biomedical Sciences, University of Windsor, 401 Sunset Ave. Windsor, Ontario, N9B 3P4, Canada
| | - Jackie Fong
- Department of Biomedical Sciences, University of Windsor, 401 Sunset Ave. Windsor, Ontario, N9B 3P4, Canada
| | - Dorota Lubanska
- Department of Biomedical Sciences, University of Windsor, 401 Sunset Ave. Windsor, Ontario, N9B 3P4, Canada
| | - Lisa A Porter
- Department of Biomedical Sciences, University of Windsor, 401 Sunset Ave. Windsor, Ontario, N9B 3P4, Canada.
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Pereira CCDS, Dantas FDG, Manreza MLGD. Clinical profile of tuberous sclerosis complex patients with and without epilepsy: a need for awareness for early diagnosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:1004-1010. [PMID: 36535284 PMCID: PMC9770081 DOI: 10.1055/s-0042-1758456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Tuberous sclerosis complex (TSC) is a multisystemic disorder. Its clinical features manifest differently in several organs, prompting the need for better knowledge. OBJECTIVE The goal of the present study is to evaluate the neurological findings of TSC, such as cerebral lesions and epilepsy, and to raise awareness of non-neurological findings that could contribute to an earlier diagnosis and treatment. METHODS This was a natural history study of patients with a definitive diagnosis of TSC who were referred to a specialized outpatient clinic and followed-up for 2 years with clinical and radiological exams. RESULTS A total of 130 TSC patients (59 males [45.4%], mean age 20.4 years old [1 to 56 years old]); 107 patients (82.3%) were diagnosed with epilepsy. Seizures predominantly began at < 1 year old (72.8%); focal seizures predominated (86.9%); epileptic spasms occurred in 34.5% of patients, and refractory epilepsy was present in 55.1%. Neuropsychiatric disorders, cortical tubers and cerebellar tubers were significantly more frequent in the epilepsy group. Moreover, rhabdomyomas were significantly more frequent in the epilepsy group (p = 0.044), while lymphangioleiomyomatosis was significantly less frequent in the epilepsy group (p = 0.009). Other non-neurological findings did not differ significantly between the groups with and without epilepsy. CONCLUSIONS The present study of TSC patients demonstrated the predominantly neurological involvement and significantly higher proportion of TSC-associated neuropsychiatric disorders in the epilepsy group. Higher proportions of cortical and cerebellar tubers may be a risk factor for epilepsy and neurodevelopmental disorders.
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Affiliation(s)
- Conceição Campanario da Silva Pereira
- Universidade de São Paulo, Hospital das Clinicas de São Paulo, Departamento de Neurologia Infantil, São Paulo SP, Brazil.,Address for correspondence Conceição Campanario da Silva Pereira
| | - Felipe Diego Gomes Dantas
- Universidade de São Paulo, Hospital das Clínicas de São Paulo, Departamento de Neurorradiologia, São Paulo SP, Brazil.
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Yogi A, Hirata Y, Linetsky M, Ellingson BM, Salamon N. Cerebellar Tubers in Tuberous Sclerosis Complex Patients: New Imaging Characteristics and the Relationship with Cerebral Tubers. JOURNAL OF PEDIATRIC EPILEPSY 2022. [DOI: 10.1055/s-0042-1756717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Objective The imaging characteristics, evolution, and clinical features of cerebellar tubers in tuberous sclerosis complex (TSC) patients have not been well described. The purpose of this study is to investigate the imaging characteristics of cerebellar tubers, including their dynamic changes, and to evaluate the relationship with cerebral tubers in TSC patients.
Materials and Methods Two observers retrospectively reviewed 75 consecutive TSC patients to identify cerebellar tubers and to evaluate their imaging characteristics, including location, presence of retraction change, calcification, contrast enhancement, and the presence of an associated vascular anomaly, as well as dynamic changes in these characteristics. The number of cerebral tubers was compared between TSC patients with and without cerebellar tubers.
Results Twenty-five TSC patients with 28 cerebellar tubers were identified. All cerebellar tubers occurred within the lateral portions of the cerebellar hemispheres. Thirteen cerebellar tubers demonstrated calcification. Ten cerebellar tubers showed contrast enhancement, half of which demonstrated a zebra-like appearance. A vascular anomaly was associated with 12 tubers, one of which subsequently developed parenchymal hemorrhage. Fifteen cerebellar tubers demonstrated complex dynamic changes in size and contrast enhancement. Patients with cerebellar tubers had more cerebral tubers (p = 0.001).
Conclusion Cerebellar tubers demonstrate a specific distribution, suggesting a possible influence on higher brain function. The presence of an associated vascular anomaly may be an important imaging characteristic. Cerebellar tubers may be associated with a more severe manifestation of TSC, given their association with increased numbers of cerebral tubers. These findings may provide insights into the pathogenesis and clinical manifestations of cerebellar tubers in TSC patients.
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Affiliation(s)
- Akira Yogi
- Department of Radiology, University of the Ryukyus Hospital, Okinawa, Japan
- Department of Radiological Science, David Geffen School of Medicine, University of California, Los Angeles, California, United States
| | - Yoko Hirata
- Department of Radiological Science, David Geffen School of Medicine, University of California, Los Angeles, California, United States
- Department of Neurosurgery, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Michael Linetsky
- Department of Radiological Science, David Geffen School of Medicine, University of California, Los Angeles, California, United States
| | - Benjamin M Ellingson
- Department of Radiological Science, David Geffen School of Medicine, University of California, Los Angeles, California, United States
| | - Noriko Salamon
- Department of Radiological Science, David Geffen School of Medicine, University of California, Los Angeles, California, United States
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Sidira C, Vargiami E, Anastasiou A, Talimtzi P, Kyriazi M, Dragoumi P, Spanou M, Ntinopoulos A, Dalpa E, Evangeliou A, Zafeiriou DI. The Complex Interplay of Cortex, Cerebellum, and Age in a Cohort of Pediatric Patients With Tuberous Sclerosis Complex. Pediatr Neurol 2021; 123:43-49. [PMID: 34399109 DOI: 10.1016/j.pediatrneurol.2021.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/09/2021] [Accepted: 06/22/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND The neurodevelopmental impairment in tuberous sclerosis complex (TSC) has a multifactorial origin. Various factors have been proposed as predictors of neurological outcome such as tuber load, seizure onset, and TSC2 mutation. Cerebellar lesions have been associated with worse neuroradiological phenotype, but their contribution is not well understood. METHODS A partly retrospective and partly prospective pediatric cohort study was conducted at three hospitals in Greece between 2015 and 2020. Patients aged ≤ 18 years with a confirmed TSC daignosis were included and underwent brain imaging, a semistructured interview (authorized Greek version of the tuberous sclerosis-associated neuropsychiatric disorders, or TAND, checklist), and intellectual ability assessment. RESULTS The study populations consisted of 45 patients with TSC (22 females, 23 males; mean age 9.53 years). Twenty patients (44.4%) had cerebellar lesions. Cerebellar involvement was the most powerful predictor of tuber load (P = 0.03). Cerebellar lesions were associated with giant cell astrocytomas (SEGAs) (P = 0.01) and severe neurological outcome (P = 0.01). Even though in the univariate analysis early seizure onset, tuber load, and cerebellar involvement were associated with intellectual impairment and neurological severity, none of them was an independent predictor of cognitive outcome and neurological severity. CONCLUSIONS Cerebellar lesions are common among individuals with TSC. Cerebellar involvement correlates with supratentorial derangement and the development of SEGAs, which is suggestive of a more severe clinical and neuroradiological phenotype. Cerebellar involvement and early seizure onset were not independent predictors of either neurological severity or intellectual disability or neurobehavioral outcome; their role in TSC clinical phenotype should be further investigated.
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Affiliation(s)
- Christina Sidira
- 1st Paediatric Department, Developmental Centre "A. Fokas", Aristotle University of Thessaloniki, "Hippokration" General Hospital, Thessaloniki, Greece
| | - Efthymia Vargiami
- 1st Paediatric Department, Developmental Centre "A. Fokas", Aristotle University of Thessaloniki, "Hippokration" General Hospital, Thessaloniki, Greece
| | | | - Persefoni Talimtzi
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Kyriazi
- 1st Paediatric Department, Developmental Centre "A. Fokas", Aristotle University of Thessaloniki, "Hippokration" General Hospital, Thessaloniki, Greece
| | - Pinelopi Dragoumi
- 1st Paediatric Department, Developmental Centre "A. Fokas", Aristotle University of Thessaloniki, "Hippokration" General Hospital, Thessaloniki, Greece
| | - Maria Spanou
- 3(rd)Pediatric Department, National and Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece
| | - Argirios Ntinopoulos
- 3(rd)Pediatric Department, National and Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece
| | - Efterpi Dalpa
- 4(th) Pediatric Department, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Athanasios Evangeliou
- 4(th) Pediatric Department, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Dimitrios I Zafeiriou
- 1st Paediatric Department, Developmental Centre "A. Fokas", Aristotle University of Thessaloniki, "Hippokration" General Hospital, Thessaloniki, Greece.
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Prediction of tuberous sclerosis-associated neurocognitive disorders and seizures via machine learning of structural magnetic resonance imaging. Neuroradiology 2021; 64:611-620. [PMID: 34532765 DOI: 10.1007/s00234-021-02789-6] [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: 04/26/2021] [Accepted: 08/06/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Tuberous sclerosis complex (TSC) is a genetic disorder characterized by multiorgan hamartomas, including cerebral lesions, with seizures as a common presentation. Most TSC patients will also experience neurocognitive comorbidities. Our objective was to use machine learning techniques incorporating clinical and imaging data to predict the occurrence of major neurocognitive disorders and seizures in TSC patients. METHODS A cohort of TSC patients were enrolled in this retrospective study. Clinical data included genetic, demographic, and seizure characteristics. Imaging parameters included the number, characteristics, and location of cortical tubers and the presence of subependymal nodules, SEGAs, and cerebellar tubers. A random forest machine learning scheme was used to predict seizures and neurodevelopmental delay or intellectual developmental disability. Prediction ability was assessed by the area-under-the-curve of receiver-operating-characteristics (AUC-ROC) of ten-fold cross-validation training set and an independent validation set. RESULTS The study population included 77 patients, 55% male (17.1 ± 11.7 years old). The model achieved AUC-ROC of 0.72 ± 0.1 and 0.68 in the training and internal validation datasets, respectively, for predicting neurocognitive comorbidity. Performance was limited in predicting seizures (AUC-ROC of 0.54 ± 0.19 and 0.71 in the training and internal validation datasets, respectively). The integration of seizure characteristics into the model improved the prediction of neurocognitive comorbidity with AUC-ROC of 0.84 ± 0.07 and 0.75 in the training and internal validation datasets, respectively. CONCLUSIONS This proof of concept study shows that it is possible to achieve a reasonable prediction of major neurocognitive morbidity in TSC patients using structural brain imaging and machine learning techniques. These tools can help clinicians identify subgroups of TSC patients with an increased risk of developing neurocognitive comorbidities.
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Seizure outcome after epilepsy surgery in tuberous sclerosis complex: Results and analysis of predictors from a multicenter study. J Neurol Sci 2021; 427:117506. [PMID: 34087568 DOI: 10.1016/j.jns.2021.117506] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 04/22/2021] [Accepted: 05/18/2021] [Indexed: 12/30/2022]
Abstract
Epilepsy surgery is recommended in selected patients with Tuberous Sclerosis Complex (TSC). However, reports on predictive factors of seizure outcome are variable. Here we report on seizure and cognitive outcome of 35 TSC patients who received surgery for refractory epilepsy in 7 Italian centers over a period of 22 years (1997-2019). The rate of seizure-free individuals at last follow-up (mean 7.5 years, range 1-21 years) was 51%. Patients with longer follow-up (≥10 years) had a lower rate of Engel I outcome (11.1%) than those who received surgery in the last 10 years (65.4%, p = 0.003). Factors associated with Engel II, III, IV outcome in our cohort included: high number of cortical tubers (≥5); presence of subependymal nodules (SENs); seizure onset before age 1 year; and multifocal interictal epileptic discharges (IEDs) on electroencephalogram (EEG). A subset of patients evaluated with Vineland Adaptive Behaviour Scales (VABS) showed developmental gains, in line with their developmental trajectories, but no improvement in standard scores after surgery was noted. Our study demonstrates that the rates of successful seizure outcome of epilepsy surgery in TSC have improved in the last 10 years. More than half of the patients achieved seizure freedom, and a high proportion of affected individuals experienced a reduction in seizure burden and in antiseizure medications. A comprehensive assessment after surgery should be performed in TSC patients to evaluate the overall neurodevelopmental outcome, as measures that are based only on seizure control do not adequately identify the benefits of surgery on global functioning in these patients.
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Russo C, Nastro A, Cicala D, De Liso M, Covelli EM, Cinalli G. Neuroimaging in tuberous sclerosis complex. Childs Nerv Syst 2020; 36:2497-2509. [PMID: 32519125 DOI: 10.1007/s00381-020-04705-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 05/25/2020] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Tuberous sclerosis complex (TSC) is a rare autosomal dominant disorder affecting multiple systems, due to inactivating mutations of TSC1 or TSC2 mTOR pathway genes. Neurological manifestations are observed in about 95% cases, representing the most frequent cause of morbidity and one of the most common causes of mortality. BACKGROUND Neuroimaging is crucial for early diagnosis, monitoring, and management of these patients. While computed tomography is generally used as first-line investigation at emergency department, magnetic resonance imaging is the reference method to define central nervous system involvement and investigate subtle pathophysiological alterations in TSC patients. PURPOSE Here, we review the state-of-the-art knowledge in TSC brain imaging, describing conventional findings and depicting the role of advanced techniques in providing new insights on the disease, also offering an overview on future perspectives of neuroimaging applications for a better understanding of disease pathophysiology.
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Affiliation(s)
- Camilla Russo
- Department of Pediatric Neurosciences, Pediatric Neuroradiology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy.,Department of Electrical Engineering and Information Technology (DIETI), University of Naples "Federico II", Naples, Italy
| | - Anna Nastro
- Department of Pediatric Neurosciences, Pediatric Neuroradiology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Domenico Cicala
- Department of Pediatric Neurosciences, Pediatric Neuroradiology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Maria De Liso
- Department of Pediatric Neurosciences, Pediatric Neuroradiology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Eugenio Maria Covelli
- Department of Pediatric Neurosciences, Pediatric Neuroradiology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Giuseppe Cinalli
- Department of Pediatric Neurosciences, Pediatric Neurosurgery Unit, Santobono-Pausilipon Children's Hospital, Via Mario Fiore n. 6, 80129, Naples, Italy.
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