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Lenge M, Balestrini S, Napolitano A, Mei D, Conti V, Baldassarri G, Trivisano M, Pellacani S, Macconi L, Longo D, Rossi Espagnet MC, Cappelletti S, D'Incerti L, Barba C, Specchio N, Guerrini R. Morphometric network-based abnormalities correlate with psychiatric comorbidities and gene expression in PCDH19-related developmental and epileptic encephalopathy. Transl Psychiatry 2024; 14:35. [PMID: 38238304 PMCID: PMC10796344 DOI: 10.1038/s41398-024-02753-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/03/2024] [Accepted: 01/08/2024] [Indexed: 01/22/2024] Open
Abstract
Protocadherin-19 (PCDH19) developmental and epileptic encephalopathy causes an early-onset epilepsy syndrome with limbic seizures, typically occurring in clusters and variably associated with intellectual disability and a range of psychiatric disorders including hyperactive, obsessive-compulsive and autistic features. Previous quantitative neuroimaging studies revealed abnormal cortical areas in the limbic formation (parahippocampal and fusiform gyri) and underlying white-matter fibers. In this study, we adopted morphometric, network-based and multivariate statistical methods to examine the cortex and substructure of the hippocampus and amygdala in a cohort of 20 PCDH19-mutated patients and evaluated the relation between structural patterns and clinical variables at individual level. We also correlated morphometric alterations with known patterns of PCDH19 expression levels. We found patients to exhibit high-significant reductions of cortical surface area at a whole-brain level (left/right pvalue = 0.045/0.084), and particularly in the regions of the limbic network (left/right parahippocampal gyri pvalue = 0.230/0.016; left/right entorhinal gyri pvalue = 0.002/0.327), and bilateral atrophy of several subunits of the amygdala and hippocampus, particularly in the CA regions (head of the left CA3 pvalue = 0.002; body of the right CA3 pvalue = 0.004), and differences in the shape of hippocampal structures. More severe psychiatric comorbidities correlated with more significant altered patterns, with the entorhinal gyrus (pvalue = 0.013) and body of hippocampus (pvalue = 0.048) being more severely affected. Morphometric alterations correlated significantly with the known expression patterns of PCDH19 (rvalue = -0.26, pspin = 0.092). PCDH19 encephalopathy represents a model of genetically determined neural network based neuropsychiatric disease in which quantitative MRI-based findings correlate with the severity of clinical manifestations and had have a potential predictive value if analyzed early.
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Affiliation(s)
- Matteo Lenge
- Child Neurology Unit and Laboratories, Neuroscience Department, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
| | - Simona Balestrini
- Child Neurology Unit and Laboratories, Neuroscience Department, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
| | - Antonio Napolitano
- Medical Physics Department, Bambino Gesù Children's Hospital, IRCCS, 00100, Rome, Italy
| | - Davide Mei
- Child Neurology Unit and Laboratories, Neuroscience Department, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
| | - Valerio Conti
- Child Neurology Unit and Laboratories, Neuroscience Department, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
| | - Giulia Baldassarri
- Medical Physics Department, Bambino Gesù Children's Hospital, IRCCS, 00100, Rome, Italy
| | - Marina Trivisano
- Neurology, Epilepsy and Movement Disorders, Bambino Gesù Children's Hospital, IRCCS, Full Member of European Reference Network EpiCARE, 00165, Rome, Italy
| | - Simona Pellacani
- Child Neurology Unit and Laboratories, Neuroscience Department, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
| | - Letizia Macconi
- Pediatric Radiology Unit, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
| | - Daniela Longo
- Functional and Interventional Neuroimaging Unit, Bambino Gesù Children's Hospital, IRCCS, 00165, Rome, Italy
| | | | - Simona Cappelletti
- Neurology, Epilepsy and Movement Disorders, Bambino Gesù Children's Hospital, IRCCS, Full Member of European Reference Network EpiCARE, 00165, Rome, Italy
| | - Ludovico D'Incerti
- Pediatric Radiology Unit, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
| | - Carmen Barba
- Child Neurology Unit and Laboratories, Neuroscience Department, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
| | - Nicola Specchio
- Neurology, Epilepsy and Movement Disorders, Bambino Gesù Children's Hospital, IRCCS, Full Member of European Reference Network EpiCARE, 00165, Rome, Italy
| | - Renzo Guerrini
- Child Neurology Unit and Laboratories, Neuroscience Department, Meyer Children's Hospital IRCCS, 50139, Florence, Italy.
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Mulc D, Smilović D, Krsnik Ž, Junaković-Munjas A, Kopić J, Kostović I, Šimić G, Vukšić M. Fetal development of the human amygdala. J Comp Neurol 2024; 532:e25580. [PMID: 38289194 DOI: 10.1002/cne.25580] [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: 04/30/2023] [Revised: 11/03/2023] [Accepted: 12/31/2023] [Indexed: 02/01/2024]
Abstract
The intricate development of the human amygdala involves a complex interplay of diverse processes, varying in speed and duration. In humans, transient cytoarchitectural structures deliquesce, leading to the formation of functionally distinct nuclei as a result of multiple interdependent developmental events. This study compares the amygdala's cytoarchitectural development in conjunction with specific antibody reactivity for neuronal, glial, neuropil, and radial glial fibers, synaptic, extracellular matrix, and myelin components in 39 fetal human brains. We recognized that the early fetal period, as a continuation of the embryonic period, is still dominated by relatively uniform histogenetic processes. The typical appearance of ovoid cell clusters in the lateral nucleus during midfetal period is most likely associated with the cell migration and axonal growth processes in the developing human brain. Notably, synaptic markers are firstly detected in the corticomedial group of nuclei, while immunoreactivity for the panaxonal neurofilament marker SMI 312 is found dorsally. The late fetal period is characterized by a protracted migration process evidenced by the presence of doublecortin and SOX-2 immunoreactivity ventrally, in the prospective paralaminar nucleus, reinforced by vimentin immunoreactivity in the last remaining radial glial fibers. Nearing the term period, SMI 99 immunoreactivity indicates that perinatal myelination becomes prominent primarily along major axonal pathways, laying the foundation for more pronounced functional maturation. This study comprehensively elucidates the rate and sequence of maturational events in the amygdala, highlighting the key role of prenatal development in its behavioral, autonomic, and endocrine regulation, with subsequent implications for both normal functioning and psychiatric disorders.
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Affiliation(s)
- Damir Mulc
- Croatian Institute for Brain Research, School of Medicine, Scientific Centre of Excellence for Basic, Clinical and Translational Neuroscience, University of Zagreb, Zagreb, Croatia
- Psychiatric Hospital Vrapče, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Dinko Smilović
- Croatian Institute for Brain Research, School of Medicine, Scientific Centre of Excellence for Basic, Clinical and Translational Neuroscience, University of Zagreb, Zagreb, Croatia
| | - Željka Krsnik
- Croatian Institute for Brain Research, School of Medicine, Scientific Centre of Excellence for Basic, Clinical and Translational Neuroscience, University of Zagreb, Zagreb, Croatia
| | - Alisa Junaković-Munjas
- Croatian Institute for Brain Research, School of Medicine, Scientific Centre of Excellence for Basic, Clinical and Translational Neuroscience, University of Zagreb, Zagreb, Croatia
| | - Janja Kopić
- Croatian Institute for Brain Research, School of Medicine, Scientific Centre of Excellence for Basic, Clinical and Translational Neuroscience, University of Zagreb, Zagreb, Croatia
| | - Ivica Kostović
- Croatian Institute for Brain Research, School of Medicine, Scientific Centre of Excellence for Basic, Clinical and Translational Neuroscience, University of Zagreb, Zagreb, Croatia
| | - Goran Šimić
- Croatian Institute for Brain Research, School of Medicine, Scientific Centre of Excellence for Basic, Clinical and Translational Neuroscience, University of Zagreb, Zagreb, Croatia
| | - Mario Vukšić
- Croatian Institute for Brain Research, School of Medicine, Scientific Centre of Excellence for Basic, Clinical and Translational Neuroscience, University of Zagreb, Zagreb, Croatia
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