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Ma Q, Chen G, Li Y, Guo Z, Zhang X. The molecular genetics of PI3K/PTEN/AKT/mTOR pathway in the malformations of cortical development. Genes Dis 2024; 11:101021. [PMID: 39006182 PMCID: PMC11245990 DOI: 10.1016/j.gendis.2023.04.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/07/2023] [Accepted: 04/30/2023] [Indexed: 07/16/2024] Open
Abstract
Malformations of cortical development (MCD) are a group of developmental disorders characterized by abnormal cortical structures caused by genetic or harmful environmental factors. Many kinds of MCD are caused by genetic variation. MCD is the common cause of intellectual disability and intractable epilepsy. With rapid advances in imaging and sequencing technologies, the diagnostic rate of MCD has been increasing, and many potential genes causing MCD have been successively identified. However, the high genetic heterogeneity of MCD makes it challenging to understand the molecular pathogenesis of MCD and to identify effective targeted drugs. Thus, in this review, we outline important events of cortical development. Then we illustrate the progress of molecular genetic studies about MCD focusing on the PI3K/PTEN/AKT/mTOR pathway. Finally, we briefly discuss the diagnostic methods, disease models, and therapeutic strategies for MCD. The information will facilitate further research on MCD. Understanding the role of the PI3K/PTEN/AKT/mTOR pathway in MCD could lead to a novel strategy for treating MCD-related diseases.
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Affiliation(s)
- Qing Ma
- NHC and CAMS Key Laboratory of Molecular Probe and Targeted Theranostics, Harbin Medical University, Harbin, Heilongjiang 150000, China
| | - Guang Chen
- Department of Urology, The Fourth Hospital of Harbin Medical University, Harbin, Heilongjiang 150000, China
| | - Ying Li
- NHC and CAMS Key Laboratory of Molecular Probe and Targeted Theranostics, Harbin Medical University, Harbin, Heilongjiang 150000, China
- Department of Child and Adolescent Health, School of Public Health, Harbin Medical University, Harbin, Heilongjiang 150000, China
| | - Zhenming Guo
- Institute for Regenerative Medicine, Shanghai East Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai 200120, China
| | - Xue Zhang
- NHC and CAMS Key Laboratory of Molecular Probe and Targeted Theranostics, Harbin Medical University, Harbin, Heilongjiang 150000, China
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2
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Vermeulen I, Rodriguez-Alvarez N, François L, Viot D, Poosti F, Aronica E, Dedeurwaerdere S, Barton P, Cillero-Pastor B, Heeren RMA. Spatial omics reveals molecular changes in focal cortical dysplasia type II. Neurobiol Dis 2024; 195:106491. [PMID: 38575092 DOI: 10.1016/j.nbd.2024.106491] [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: 11/14/2023] [Revised: 03/14/2024] [Accepted: 04/01/2024] [Indexed: 04/06/2024] Open
Abstract
Focal cortical dysplasia (FCD) represents a group of diverse localized cortical lesions that are highly epileptogenic and occur due to abnormal brain development caused by genetic mutations, involving the mammalian target of rapamycin (mTOR). These somatic mutations lead to mosaicism in the affected brain, posing challenges to unravel the direct and indirect functional consequences of these mutations. To comprehensively characterize the impact of mTOR mutations on the brain, we employed here a multimodal approach in a preclinical mouse model of FCD type II (Rheb), focusing on spatial omics techniques to define the proteomic and lipidomic changes. Mass Spectrometry Imaging (MSI) combined with fluorescence imaging and label free proteomics, revealed insight into the brain's lipidome and proteome within the FCD type II affected region in the mouse model. MSI visualized disrupted neuronal migration and differential lipid distribution including a reduction in sulfatides in the FCD type II-affected region, which play a role in brain myelination. MSI-guided laser capture microdissection (LMD) was conducted on FCD type II and control regions, followed by label free proteomics, revealing changes in myelination pathways by oligodendrocytes. Surgical resections of FCD type IIb and postmortem human cortex were analyzed by bulk transcriptomics to unravel the interplay between genetic mutations and molecular changes in FCD type II. Our comparative analysis of protein pathways and enriched Gene Ontology pathways related to myelination in the FCD type II-affected mouse model and human FCD type IIb transcriptomics highlights the animal model's translational value. This dual approach, including mouse model proteomics and human transcriptomics strengthens our understanding of the functional consequences arising from somatic mutations in FCD type II, as well as the identification of pathways that may be used as therapeutic strategies in the future.
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Affiliation(s)
- Isabeau Vermeulen
- Maastricht MultiModal Molecular Imaging Institute (M4i), Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands
| | | | - Liesbeth François
- UCB Pharma, Chemin du Foriest 1, 1420 Braine-l'Alleud, Walloon Region, Belgium
| | - Delphine Viot
- UCB Pharma, Chemin du Foriest 1, 1420 Braine-l'Alleud, Walloon Region, Belgium
| | - Fariba Poosti
- UCB Pharma, Chemin du Foriest 1, 1420 Braine-l'Alleud, Walloon Region, Belgium
| | - Eleonora Aronica
- Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Department of (Neuro)Pathology, De Boelelaan 1108, 1081 HV Amsterdam, the Netherlands; Stichting Epilepsie Instellingen Nederland (SEIN), Achterweg 3, 2103 SW Heemstede, the Netherlands
| | | | - Patrick Barton
- UCB Pharma, 216 Bath Rd, Slough, SL1 3WE Berkshire, United Kingdom
| | - Berta Cillero-Pastor
- Maastricht MultiModal Molecular Imaging Institute (M4i), Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands; Cell Biology-Inspired Tissue Engineering (cBITE), MERLN, Maastricht University, Universiteitssingel 40, 6229 ET Maastricht, Netherlands
| | - Ron M A Heeren
- Maastricht MultiModal Molecular Imaging Institute (M4i), Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands.
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Ding Z, Hu S, Su TY, Choi JY, Morris S, Wang X, Sakaie K, Murakami H, Huppertz HJ, Blümcke I, Jones S, Najm I, Ma D, Wang ZI. Combining magnetic resonance fingerprinting with voxel-based morphometric analysis to reduce false positives for focal cortical dysplasia detection. Epilepsia 2024; 65:1631-1643. [PMID: 38511905 PMCID: PMC11166521 DOI: 10.1111/epi.17951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/09/2024] [Accepted: 03/04/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVE We aim to improve focal cortical dysplasia (FCD) detection by combining high-resolution, three-dimensional (3D) magnetic resonance fingerprinting (MRF) with voxel-based morphometric magnetic resonance imaging (MRI) analysis. METHODS We included 37 patients with pharmacoresistant focal epilepsy and FCD (10 IIa, 15 IIb, 10 mild Malformation of Cortical Development [mMCD], and 2 mMCD with oligodendroglial hyperplasia and epilepsy [MOGHE]). Fifty-nine healthy controls (HCs) were also included. 3D lesion labels were manually created. Whole-brain MRF scans were obtained with 1 mm3 isotropic resolution, from which quantitative T1 and T2 maps were reconstructed. Voxel-based MRI postprocessing, implemented with the morphometric analysis program (MAP18), was performed for FCD detection using clinical T1w images, outputting clusters with voxel-wise lesion probabilities. Average MRF T1 and T2 were calculated in each cluster from MAP18 output for gray matter (GM) and white matter (WM) separately. Normalized MRF T1 and T2 were calculated by z-scores using HCs. Clusters that overlapped with the lesion labels were considered true positives (TPs); clusters with no overlap were considered false positives (FPs). Two-sample t-tests were performed to compare MRF measures between TP/FP clusters. A neural network model was trained using MRF values and cluster volume to distinguish TP/FP clusters. Ten-fold cross-validation was used to evaluate model performance at the cluster level. Leave-one-patient-out cross-validation was used to evaluate performance at the patient level. RESULTS MRF metrics were significantly higher in TP than FP clusters, including GM T1, normalized WM T1, and normalized WM T2. The neural network model with normalized MRF measures and cluster volume as input achieved mean area under the curve (AUC) of .83, sensitivity of 82.1%, and specificity of 71.7%. This model showed superior performance over direct thresholding of MAP18 FCD probability map at both the cluster and patient levels, eliminating ≥75% FP clusters in 30% of patients and ≥50% of FP clusters in 91% of patients. SIGNIFICANCE This pilot study suggests the efficacy of MRF for reducing FPs in FCD detection, due to its quantitative values reflecting in vivo pathological changes. © 2024 International League Against Epilepsy.
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Affiliation(s)
- Zheng Ding
- Epilepsy Center, Neurological Institute - Cleveland Clinic, Cleveland, Ohio
- Biomedical Engineering - Case Western Reserve University, Cleveland, Ohio
| | - Siyuan Hu
- Biomedical Engineering - Case Western Reserve University, Cleveland, Ohio
| | - Ting-Yu Su
- Epilepsy Center, Neurological Institute - Cleveland Clinic, Cleveland, Ohio
- Biomedical Engineering - Case Western Reserve University, Cleveland, Ohio
| | - Joon Yul Choi
- Epilepsy Center, Neurological Institute - Cleveland Clinic, Cleveland, Ohio
- Biomedical Engineering - Yonsei University, Wonju, Republic of Korea
| | - Spencer Morris
- Epilepsy Center, Neurological Institute - Cleveland Clinic, Cleveland, Ohio
- Biomedical Engineering - Case Western Reserve University, Cleveland, Ohio
| | - Xiaofeng Wang
- Quantitative Health Science - Cleveland Clinic, Cleveland, Ohio
| | - Ken Sakaie
- Imaging Institute - Cleveland Clinic, Cleveland, Ohio
| | - Hiroatsu Murakami
- Epilepsy Center, Neurological Institute - Cleveland Clinic, Cleveland, Ohio
| | | | - Ingmar Blümcke
- Epilepsy Center, Neurological Institute - Cleveland Clinic, Cleveland, Ohio
- Neuropathology - University Hospital Erlangen, Erlangen, Germany
| | - Stephen Jones
- Imaging Institute - Cleveland Clinic, Cleveland, Ohio
| | - Imad Najm
- Epilepsy Center, Neurological Institute - Cleveland Clinic, Cleveland, Ohio
| | - Dan Ma
- Biomedical Engineering - Case Western Reserve University, Cleveland, Ohio
| | - Zhong Irene Wang
- Epilepsy Center, Neurological Institute - Cleveland Clinic, Cleveland, Ohio
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Zhang S, Luo Y, Zhao Y, Zhu F, Jiang X, Wang X, Mo T, Zeng H. Prognostic analysis in children with focal cortical dysplasia II undergoing epilepsy surgery: Clinical and radiological factors. Front Neurol 2023; 14:1123429. [PMID: 36949857 PMCID: PMC10025379 DOI: 10.3389/fneur.2023.1123429] [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: 12/14/2022] [Accepted: 02/06/2023] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate the value of clinical profiles and radiological findings in assessing postsurgical outcomes in children with focal cortical dysplasia (FCD) II while exploring prognostic predictors of this disease. METHODS We retrospectively reviewed 50 patients with postoperative pathologically confirmed FCD II from January 2016 to June 2021. The clinical profiles and preoperative radiological findings were measured and analyzed. The patients were classified into four classes based on the Engel Class Outcome System at the last follow-up. For the analysis, the patients were divided into two categories based on Engel I and Engel II-IV, namely, seizure-free and non-seizure-free groups. Qualitative and quantitative factors were subsequently compared by groups using comparative statistics. Receiver operating characteristic (ROC) curves were used to identify the predictors of prognosis in children with FCD II. RESULTS Thirty-seven patients (74%) had Engel class I outcomes. The minimum postsurgical follow-up was 1 year. At the epilepsy onset, patients who attained seizure freedom were older and less likely to have no apparent lesions on the preoperative MRI ("MRI-negative"). The non-seizure-free group exhibited a higher gray matter signal intensity ratio (GR) on 3D T1-MPRAGE images (p = 0.006), with a lower GR on T2WI images (p = 0.003) and FLAIR images (p = 0.032). The ROC curve indicated that the model that combined the GR value of all MRI sequences (AUC, 0.87; 95% CI, 0.77-0.97; p < 0.001; 86% sensitivity, 85% specificity) was able to predict prognosis accurately. CONCLUSION A lower age at the onset or the MRI-negative finding of FCD lesions suggests a poor prognosis for children with FCD II. The model consisting of GR values from three MRI sequences facilitates the prognostic assessment of FCD II patients with subtle MRI abnormalities to prevent worse outcomes.
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Affiliation(s)
- Siqi Zhang
- Shantou University Medical College, Shantou University, Shantou, China
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China
| | - Yi Luo
- Shantou University Medical College, Shantou University, Shantou, China
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China
| | - Yilin Zhao
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China
| | - Fengjun Zhu
- Department of Epilepsy Surgical Department, Shenzhen Children's Hospital, Shenzhen, China
| | - Xianping Jiang
- Department of Pathology, Shenzhen Children's Hospital, Shenzhen, China
| | - Xiaoyu Wang
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China
| | - Tong Mo
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China
| | - Hongwu Zeng
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China
- *Correspondence: Hongwu Zeng
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Foit NA, Yung S, Lee HM, Bernasconi A, Bernasconi N, Hong SJ. A whole-brain 3D myeloarchitectonic atlas: Mapping the Vogt-Vogt legacy to the cortical surface. Neuroimage 2022; 263:119617. [PMID: 36084859 DOI: 10.1016/j.neuroimage.2022.119617] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 09/03/2022] [Accepted: 09/05/2022] [Indexed: 11/18/2022] Open
Abstract
Building precise and detailed parcellations of anatomically and functionally distinct brain areas has been a major focus in Neuroscience. Pioneer anatomists parcellated the cortical manifold based on extensive histological studies of post-mortem brain, harnessing local variations in cortical cyto- and myeloarchitecture to define areal boundaries. Compared to the cytoarchitectonic field, where multiple neuroimaging studies have recently translated this old legacy data into useful analytical resources, myeloarchitectonics, which parcellate the cortex based on the organization of myelinated fibers, has received less attention. Here, we present the neocortical surface-based myeloarchitectonic atlas based on the histology-derived maps of the Vogt-Vogt school and its 2D translation by Nieuwenhuys. In addition to a myeloarchitectonic parcellation, our package includes intracortical laminar profiles of myelin content based on Vogt-Vogt-Hopf original publications. Histology-derived myelin density mapped on our atlas demonstrated a close overlap with in vivo quantitative MRI markers for myelin and relates to cytoarchitectural features. Complementing the existing battery of approaches for digital cartography, the whole-brain myeloarchitectonic atlas offers an opportunity to validate imaging surrogate markers of myelin in both health and disease.
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Affiliation(s)
- Niels A Foit
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, QC, Canada; Department of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany
| | - Seles Yung
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, QC, Canada
| | - Hyo Min Lee
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, QC, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, QC, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, QC, Canada
| | - Seok-Jun Hong
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, QC, Canada; Center for the Developing Brain, Child Mind Institute, NY, USA; Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea; Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea.
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6
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Zaidan BC, Cardoso ICDS, de Campos BM, da Silva LRP, Coelho VCM, Silveira KAA, Amorim BJ, Alvim MKM, Tedeschi H, Yasuda CL, Ghizoni E, Cendes F, Rogerio F. Histopathological Correlations of Qualitative and Quantitative Temporopolar MRI Analyses in Patients With Hippocampal Sclerosis. Front Neurol 2022; 12:801195. [PMID: 35002940 PMCID: PMC8739995 DOI: 10.3389/fneur.2021.801195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 11/29/2021] [Indexed: 11/28/2022] Open
Abstract
Hippocampal sclerosis (HS) is a common cause of pharmacoresistant focal epilepsy. Here, we (1) performed a histological approach to the anterior temporal pole of patients with HS to evaluate cortical and white matter (WM) cell populations, alteration of myelin integrity and markers of neuronal activity, and (2) correlated microscopic data with magnetic resonance imaging (MRI) findings. Our aim was to contribute with the understanding of neuroimaging and pathophysiological mechanisms of temporal lobe epilepsy (TLE) associated with HS. We examined MRIs and surgical specimens from the anterior temporal pole from TLE-HS patients (n = 9) and compared them with 10 autopsy controls. MRIs from healthy volunteers (n = 13) were used as neuroimaging controls. Histological techniques were performed to assess oligodendrocytes, heterotopic neurons, cellular proliferative index, and myeloarchitecture integrity of the WM, as well as markers of acute (c-fos) and chronic (ΔFosB) activities of neocortical neurons. Microscopic data were compared with neuroimaging findings, including T2-weighted/FLAIR MRI temporopolar blurring and values of fractional anisotropy (FA) from diffusion-weighed imaging (DWI). We found a significant increase in WM oligodendrocyte number, both in hematoxylin and eosin, and in Olig2-stained sections. The frequencies of oligodendrocytes in perivascular spaces and around heterotopic neurons were significantly higher in patients with TLE–HS compared with controls. The percentage of 2',3'-cyclic-nucleotide 3'-phosphodiesterase (CNPase; a marker of myeloarchitecture integrity) immunopositive area in the WM was significantly higher in TLE-HS, as well as the numbers of c-fos- and ΔFosB-immunostained neocortical neurons. Additionally, we demonstrated a decrease in axonal bundle integrity on neuroimaging, with a significant reduction in the FA in the anterior temporal pole. No differences were detected between individuals with and without temporopolar blurring on visual MRI analysis, considering the number of oligodendroglial cells and percentage of WM CNPase-positive areas. Also, there was no relationship between T2 relaxometry and oligodendrocyte count. In conclusion, our histopathological data support the following: (1) the hypothesis that repetitive neocortical neuronal activity could induce changes in the WM cellular constitution and myelin remodeling in the anterior temporal pole from patients with TLE-HS, (2) that oligodendroglial hyperplasia is not related to temporal blurring or T2 signal intensity on MRI, and (3) that reduced FA is a marker of increase in Olig2-immunopositive cells in superficial temporopolar WM from patients with TLE-HS.
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Affiliation(s)
- Bruna Cunha Zaidan
- Department of Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Brunno Machado de Campos
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Vanessa C Mendes Coelho
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Bárbara Juarez Amorim
- Department of Anesthesiology, Oncology and Radiology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Helder Tedeschi
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Clarissa Lin Yasuda
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Enrico Ghizoni
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Fernando Cendes
- Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Fabio Rogerio
- Department of Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
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Gruber V, Lang J, Endmayr V, Diehm R, Pimpel B, Glatter S, Anink JJ, Bongaarts A, Luinenburg MJ, Reinten RJ, van der Wel N, Larsen P, Hainfellner JA, Rössler K, Aronica E, Scholl T, Mühlebner A, Feucht M. Impaired myelin production due to an intrinsic failure of oligodendrocytes in mTORpathies. Neuropathol Appl Neurobiol 2021; 47:812-825. [PMID: 34173252 PMCID: PMC8518586 DOI: 10.1111/nan.12744] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/24/2021] [Indexed: 12/22/2022]
Abstract
AIMS We aim to evaluate if the myelin pathology observed in epilepsy-associated focal cortical dysplasia type 2B (FCD2B) and-histologically indistinguishable-cortical tubers of tuberous sclerosis complex (TSC) is primarily related to the underlying malformation or constitutes a secondary phenomenon due to the toxic microenvironment created by epileptic seizures. We also aim to investigate the possible beneficial effect of the mTOR pathway regulator everolimus on white matter pathology. METHODS Primary mixed glial cell cultures derived from epilepsy surgery specimens of one TSC and seven FCD2B patients were grown on polycaprolactone fibre matrices and analysed using immunofluorescence and electron microscopy. Unaffected white matter from three age-matched epilepsy patients with mild malformations of cortical development (mMCD) and one with FCD3D served as controls. Additionally, TSC2 knock-out was performed using an oligodendroglial cell line. Myelination capacities of nanofibre grown cells in an inflammatory environment after mTOR-inhibitor treatment with everolimus were further investigated. RESULTS Reduced oligodendroglial turnover, directly related to a lower myelin content was found in the patients' primary cells. In our culture model of myelination dynamics, primary cells grown under 'inflammatory condition' showed decreased myelination, that was repaired by treatment with everolimus. CONCLUSIONS Results obtained in patient-derived primary oligodendroglial and TSC2 knock-out cells suggest that maturation of oligodendroglia and production of a proper myelin sheath seem to be impaired as a result of mTOR pathway disturbance. Hence, oligodendroglial pathology may reflect a more direct effect of the abnormal genetic programme rather than to be an inactive bystander of chronic epilepsy.
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Affiliation(s)
- Victoria‐Elisabeth Gruber
- Department of Pediatrics and Adolescent MedicineMedical University of Vienna – Affiliated Partner of the ERN EpiCAREViennaAustria
| | - Judith Lang
- Department of Pediatrics and Adolescent MedicineMedical University of Vienna – Affiliated Partner of the ERN EpiCAREViennaAustria
| | - Verena Endmayr
- Division of Neuropathology and Neurochemistry, Department of NeurologyMedical University of ViennaViennaAustria
| | - Robert Diehm
- Department of Pediatrics and Adolescent MedicineMedical University of Vienna – Affiliated Partner of the ERN EpiCAREViennaAustria
| | - Birgit Pimpel
- Department of Pediatrics and Adolescent MedicineMedical University of Vienna – Affiliated Partner of the ERN EpiCAREViennaAustria
| | - Sarah Glatter
- Department of Pediatrics and Adolescent MedicineMedical University of Vienna – Affiliated Partner of the ERN EpiCAREViennaAustria
| | - Jasper J. Anink
- Department of (Neuro)Pathology, Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
| | - Anika Bongaarts
- Department of (Neuro)Pathology, Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
| | - Mark J. Luinenburg
- Department of (Neuro)Pathology, Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
| | - Roy J. Reinten
- Department of (Neuro)Pathology, Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
| | - Nicole van der Wel
- Department of (Neuro)Pathology, Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
| | - Per Larsen
- Department of (Neuro)Pathology, Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
| | - Johannes A. Hainfellner
- Division of Neuropathology and Neurochemistry, Department of NeurologyMedical University of ViennaViennaAustria
| | - Karl Rössler
- Department of NeurosurgeryMedical University of ViennaViennaAustria
| | - Eleonora Aronica
- Department of (Neuro)Pathology, Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
- Stichting Epilepsie Instellingen Nederland (SEIN)HeemstedeThe Netherlands
| | - Theresa Scholl
- Department of Pediatrics and Adolescent MedicineMedical University of Vienna – Affiliated Partner of the ERN EpiCAREViennaAustria
| | - Angelika Mühlebner
- Department of PathologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Martha Feucht
- Department of Pediatrics and Adolescent MedicineMedical University of Vienna – Affiliated Partner of the ERN EpiCAREViennaAustria
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8
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Demerath T, Donkels C, Reisert M, Heers M, Rau A, Schröter N, Schulze-Bonhage A, Reinacher P, Scheiwe C, Shah MJ, Beck J, Vlachos A, Haas CA, Urbach H. Gray-White Matter Blurring of the Temporal Pole Associated With Hippocampal Sclerosis: A Microstructural Study Involving 3 T MRI and Ultrastructural Histopathology. Cereb Cortex 2021; 32:1882-1893. [PMID: 34515307 DOI: 10.1093/cercor/bhab320] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Hippocampal sclerosis (HS) is often associated with gray-white matter blurring (GMB) of the anterior temporal lobe. In this study, twenty patients with unilateral temporal lobe epilepsy and HS were studied with 3 T MRI including T1 MP2RAGE and DTI/DMI sequences. Anterior temporal lobe white matter T1 relaxation times and diffusion measures were analyzed on the HS side, on the contralateral side, and in 10 normal controls. Resected brain tissue of three patients without GMB and four patients with GMB was evaluated ultrastructurally regarding axon density and diameter, the relation of the axon diameter to the total fiber diameter (G-ratio), and the thickness of the myelin sheath. Hippocampal sclerosis GMB of the anterior temporal lobe was related to prolonged T1 relaxation and axonal loss. A less pronounced reduction in axonal fraction was also found on imaging in GMB-negative temporal poles compared with normal controls. Contralateral values did not differ significantly between patients and normal controls. Reduced axonal density and axonal diameter were histopathologically confirmed in the temporopolar white matter with GMB compared to temporal poles without. These results confirm that GMB can be considered an imaging correlate for disturbed axonal maturation that can be quantified with advanced diffusion imaging.
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Affiliation(s)
- T Demerath
- Department of Neuroradiology, Medical Center-University of Freiburg, Faculty of Medicine, 79106 Freiburg, Germany
| | - C Donkels
- Department of Neurosurgery, Experimental Epilepsy Research, Medical Center-University of Freiburg, Faculty of Medicine, 79106 Freiburg, Germany
| | - M Reisert
- Department of Medical Physics, Medical Center-University of Freiburg, Faculty of Medicine, 79106 Freiburg, Germany.,Deparment of Stereotactic and Functional Neurosurgery, Medical Center-University of Freiburg, 79106 Freiburg, Germany
| | - M Heers
- Epilepsy Center, Medical Center-University of Freiburg, 79106 Freiburg, Germany
| | - A Rau
- Department of Neuroradiology, Medical Center-University of Freiburg, Faculty of Medicine, 79106 Freiburg, Germany
| | - N Schröter
- Department of Neurology, Medical Center-University of Freiburg, 79106 Freiburg, Germany
| | - A Schulze-Bonhage
- Epilepsy Center, Medical Center-University of Freiburg, 79106 Freiburg, Germany
| | - P Reinacher
- Deparment of Stereotactic and Functional Neurosurgery, Medical Center-University of Freiburg, 79106 Freiburg, Germany.,Fraunhofer Institute for Laser Fraunhofer Institute for Laser Technology (ILT), Aachen, Germany
| | - C Scheiwe
- Department of Neurosurgery, Medical Center-University of Freiburg, 79106 Freiburg, Germany
| | - M J Shah
- Department of Neurosurgery, Medical Center-University of Freiburg, 79106 Freiburg, Germany
| | - J Beck
- Department of Neurosurgery, Medical Center-University of Freiburg, 79106 Freiburg, Germany.,Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - A Vlachos
- Department of Neuroanatomy, Institute of Anatomy and Cell Biology, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany.,Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - C A Haas
- Department of Neurosurgery, Experimental Epilepsy Research, Medical Center-University of Freiburg, Faculty of Medicine, 79106 Freiburg, Germany.,Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - H Urbach
- Department of Neuroradiology, Medical Center-University of Freiburg, Faculty of Medicine, 79106 Freiburg, Germany
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9
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Srivastava A, Kumar K, Banerjee J, Tripathi M, Dubey V, Sharma D, Yadav N, Sharma MC, Lalwani S, Doddamani R, Chandra PS, Dixit AB. Transcriptomic profiling of high- and low-spiking regions reveals novel epileptogenic mechanisms in focal cortical dysplasia type II patients. Mol Brain 2021; 14:120. [PMID: 34301297 PMCID: PMC8305866 DOI: 10.1186/s13041-021-00832-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/14/2021] [Indexed: 11/15/2022] Open
Abstract
Focal cortical dysplasia (FCD) is a malformation of the cerebral cortex with poorly-defined epileptogenic zones (EZs), and poor surgical outcome in FCD is associated with inaccurate localization of the EZ. Hence, identifying novel epileptogenic markers to aid in the localization of EZ in patients with FCD is very much needed. High-throughput gene expression studies of FCD samples have the potential to uncover molecular changes underlying the epileptogenic process and identify novel markers for delineating the EZ. For this purpose, we, for the first time performed RNA sequencing of surgically resected paired tissue samples obtained from electrocorticographically graded high (MAX) and low spiking (MIN) regions of FCD type II patients and autopsy controls. We identified significant changes in the MAX samples of the FCD type II patients when compared to non-epileptic controls, but not in the case of MIN samples. We found significant enrichment for myelination, oligodendrocyte development and differentiation, neuronal and axon ensheathment, phospholipid metabolism, cell adhesion and cytoskeleton, semaphorins, and ion channels in the MAX region. Through the integration of both MAX vs non-epileptic control and MAX vs MIN RNA sequencing (RNA Seq) data, PLP1, PLLP, UGT8, KLK6, SOX10, MOG, MAG, MOBP, ANLN, ERMN, SPP1, CLDN11, TNC, GPR37, SLC12A2, ABCA2, ABCA8, ASPA, P2RX7, CERS2, MAP4K4, TF, CTGF, Semaphorins, Opalin, FGFs, CALB2, and TNC were identified as potential key regulators of multiple pathways related to FCD type II pathology. We have identified novel epileptogenic marker elements that may contribute to epileptogenicity in patients with FCD and could be possible markers for the localization of EZ.
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Affiliation(s)
| | - Krishan Kumar
- Dr B R Ambedkar Centre for Biomedical Research, University of Delhi, Delhi, 110007, India
| | | | | | - Vivek Dubey
- Department of Biophysics, AIIMS, New Delhi, India
| | - Devina Sharma
- Department of Neurosurgery, AIIMS, New Delhi, 110029, India
| | - Nitin Yadav
- Dr B R Ambedkar Centre for Biomedical Research, University of Delhi, Delhi, 110007, India
| | - M C Sharma
- Department of Pathology, AIIMS, New Delhi, India
| | - Sanjeev Lalwani
- Department of Forensic Medicine and Toxicology, AIIMS, New Delhi, India
| | | | - P Sarat Chandra
- Department of Neurosurgery, AIIMS, New Delhi, 110029, India.
| | - Aparna Banerjee Dixit
- Dr B R Ambedkar Centre for Biomedical Research, University of Delhi, Delhi, 110007, India.
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10
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Mühlebner A, van Scheppingen J, de Neef A, Bongaarts A, Zimmer TS, Mills JD, Jansen FE, Spliet WGM, Krsek P, Zamecnik J, Coras R, Blumcke I, Feucht M, Scholl T, Gruber VE, Hainfellner JA, Söylemezoğlu F, Kotulska K, Lagae L, Jansen AC, Kwiatkowski DJ, Jozwiak S, Curatolo P, Aronica E. Myelin Pathology Beyond White Matter in Tuberous Sclerosis Complex (TSC) Cortical Tubers. J Neuropathol Exp Neurol 2021; 79:1054-1064. [PMID: 32954437 PMCID: PMC7559237 DOI: 10.1093/jnen/nlaa090] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Tuberous sclerosis complex (TSC) is a monogenetic disease that arises due to mutations in either the TSC1 or TSC2 gene and affects multiple organ systems. One of the hallmark manifestations of TSC are cortical malformations referred to as cortical tubers. These tubers are frequently associated with treatment-resistant epilepsy. Some of these patients are candidates for epilepsy surgery. White matter abnormalities, such as loss of myelin and oligodendroglia, have been described in a small subset of resected tubers but mechanisms underlying this phenomenon are unclear. Herein, we analyzed a variety of neuropathologic and immunohistochemical features in gray and white matter areas of resected cortical tubers from 46 TSC patients using semi-automated quantitative image analysis. We observed divergent amounts of myelin basic protein as well as numbers of oligodendroglia in both gray and white matter when compared with matched controls. Analyses of clinical data indicated that reduced numbers of oligodendroglia were associated with lower numbers on the intelligence quotient scale and that lower amounts of myelin-associated oligodendrocyte basic protein were associated with the presence of autism-spectrum disorder. In conclusion, myelin pathology in cortical tubers extends beyond the white matter and may be linked to cognitive dysfunction in TSC patients.
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Affiliation(s)
- Angelika Mühlebner
- Department of (Neuro)Pathology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jackelien van Scheppingen
- Department of (Neuro)Pathology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Andrew de Neef
- Department of (Neuro)Pathology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Anika Bongaarts
- Department of (Neuro)Pathology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Till S Zimmer
- Department of (Neuro)Pathology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - James D Mills
- Department of (Neuro)Pathology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Floor E Jansen
- Department of Pediatric Neurology, Brain Center University Medical Center
| | - Wim G M Spliet
- Department of Pathology, University Medical Center Utrecht (WGMS) Utrecht, The Netherlands
| | | | | | - Roland Coras
- Second Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic; Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany
| | - Ingmar Blumcke
- Second Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic; Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany
| | | | | | | | | | - Figen Söylemezoğlu
- Medical University of Vienna, Vienna, Austria; Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Katarzyna Kotulska
- Department of Neurology and Epileptology, The Children's Memorial Health Institute, Warsaw, Poland
| | - Lieven Lagae
- Department of Development and Regeneration-Section Pediatric Neurology, University Hospitals KU Leuven, Leuven
| | - Anna C Jansen
- Pediatric Neurology Unit-UZ Brussel, Brussels Belgium
| | | | - Sergiusz Jozwiak
- Department of Neurology and Epileptology, The Children's Memorial Health Institute.,Department of Child Neurology, Medical University of Warsaw Warsaw, Poland
| | - Paolo Curatolo
- Child Neurology and Psychiatry Unit, Systems Medicine Department, Tor Vergata University, Rome, Italy
| | - Eleonora Aronica
- Department of (Neuro)Pathology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands
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11
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de Curtis M, Garbelli R, Uva L. A hypothesis for the role of axon demyelination in seizure generation. Epilepsia 2021; 62:583-595. [PMID: 33493363 DOI: 10.1111/epi.16824] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 01/06/2023]
Abstract
Loss of myelin and altered oligodendrocyte distribution in the cerebral cortex are commonly observed both in postsurgical tissue derived from different focal epilepsies (such as focal cortical dysplasias and tuberous sclerosis) and in animal models of focal epilepsy. Moreover, seizures are a frequent symptom in demyelinating diseases, such as multiple sclerosis, and in animal models of demyelination and oligodendrocyte dysfunction. Finally, the excessive activity reported in demyelinated axons may promote hyperexcitability. We hypothesize that the extracellular potassium rise generated during epileptiform activity may be amplified by the presence of axons without appropriate myelin coating and by alterations in oligodendrocyte function. This process could facilitate the triggering of recurrent spontaneous seizures in areas of altered myelination and could result in further demyelination, thus promoting epileptogenesis.
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Affiliation(s)
- Marco de Curtis
- Epilepsy Unit, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Rita Garbelli
- Epilepsy Unit, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Laura Uva
- Epilepsy Unit, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
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