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Glad DM, Pardej SK, Olszewski E, Klein-Tasman BP. Feasibility and acceptability of a telehealth intervention for improving peer relationships for adolescents with neurofibromatosis type 1: a single-arm pilot study. J Pediatr Psychol 2024:jsae050. [PMID: 38908005 DOI: 10.1093/jpepsy/jsae050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/24/2024] Open
Abstract
OBJECTIVE Elevated rates of social difficulties are evident for children and adolescents with neurofibromatosis type 1 (NF1) but the effects of social skills interventions have not been investigated for this population. The Program for the Education and Enrichment of Relational Skills (PEERS®), a widely established social skills intervention in autism spectrum disorders with expansion to other conditions, was recently modified to be offered virtually. This study examined the feasibility and acceptability of this telehealth intervention. METHODS 27 adolescents with NF1 with social skills difficulties and at least 1 caregiver enrolled in the study. 19 of those participants (Mage = 14.21 years, SD = 1.63; 7 females; 79% White) completed PEERS® via telehealth in a single-arm pilot study. Dropout rates, attendance records, helpfulness of the curriculum topics and caregiver-reported acceptability, including ratings on the Treatment Acceptability Questionnaire, were examined. RESULTS Low study drop out (30% of enrolled participants; 14% of participants who began the intervention) and high attendance rates were observed. Caregivers found sessions related to common, everyday interactions most helpful. Adolescents indicated sessions related to having get-togethers and social nuances (e.g., humor) as most helpful. Caregiver ratings indicated acceptability of the intervention. CONCLUSIONS This investigation supported the feasibility and acceptability of telehealth PEERS®, a social skills intervention program, among adolescents with NF1 and their caregivers based on attendance patterns as well as appraisal of the curriculum and telehealth modality.
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Affiliation(s)
- Danielle M Glad
- Department of Psychology, University of Wisconsin, Milwaukee, WI, United States
| | - Sara K Pardej
- Department of Psychology, University of Wisconsin, Milwaukee, WI, United States
| | - Ellen Olszewski
- Department of Psychology, University of Wisconsin, Milwaukee, WI, United States
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2
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McGhee CA, Honari H, Siqueiros-Sanchez M, Serur Y, van Staalduinen EK, Stevenson D, Bruno JL, Raman MM, Green T. Influences of RASopathies on Neuroanatomical Variation in Children. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00103-4. [PMID: 38621478 DOI: 10.1016/j.bpsc.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 03/09/2024] [Accepted: 04/04/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND RASopathies are a group of disorders characterized by pathogenic mutations in the Ras/mitogen-activated protein kinase (Ras/MAPK) signaling pathway. Distinct pathogenic variants in genes encoding proteins in the Ras/MAPK pathway cause Noonan syndrome (NS) and neurofibromatosis type 1 (NF1), which are associated with increased risk for autism spectrum disorder and attention-deficit/hyperactivity disorder. METHODS This study examined the effect of RASopathies (NS and NF1) on human neuroanatomy, specifically on surface area (SA), cortical thickness (CT), and subcortical volumes. Using vertex-based analysis for cortical measures and Desikan region of interest parcellation for subcortical volumes, we compared structural T1-weighted images of children with RASopathies (n = 91, mean age = 8.81 years, SD = 2.12) to those of sex- and age-matched typically developing children (n = 74, mean age = 9.07 years, SD = 1.77). RESULTS Compared with typically developing children, RASopathies had convergent effects on SA and CT, exhibiting increased SA in the precentral gyrus, decreased SA in occipital regions, and thinner CT in the precentral gyrus. RASopathies exhibited divergent effects on subcortical volumes, with syndrome-specific influences from NS and NF1. Overall, children with NS showed decreased volumes in striatal and thalamic structures, and children with NF1 displayed increased volumes in the hippocampus, amygdala, and thalamus. CONCLUSIONS Our study reveals the converging and diverging neuroanatomical effects of RASopathies on human neurodevelopment. The convergence of cortical effects on SA and CT indicates a shared influence of Ras/MAPK hyperactivation on the human brain. Therefore, considering these measures as objective outcome indicators for targeted treatments is imperative.
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Affiliation(s)
- Chloe Alexa McGhee
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, California.
| | - Hamed Honari
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, California
| | | | - Yaffa Serur
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, California
| | - Eric K van Staalduinen
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, California
| | - David Stevenson
- Division of Medical Genetics, Stanford University, Stanford, California
| | - Jennifer L Bruno
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, California
| | - Mira Michelle Raman
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, California
| | - Tamar Green
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, California
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3
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Glad DM, Pardej SK, Olszewski E, Klein-Tasman BP. Pilot study of the effectiveness of a telehealth group for improving peer relationships for adolescents with neurofibromatosis type 1. Orphanet J Rare Dis 2024; 19:115. [PMID: 38475852 DOI: 10.1186/s13023-024-03093-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Interventions for social difficulties have not been investigated in the neurofibromatosis type 1 (NF1) population despite observations of elevated rates of social difficulties. In this pilot study, the effectiveness of a 14-week telehealth PEERS® intervention with nineteen adolescents with NF1 (Mage=13.79 years, SD = 1.32) with social skills difficulties was examined. Measures of social outcomes were completed at three timepoints (before, immediately after, and at 14-week follow-up). RESULTS Caregiver-reported social-emotional skills, social impairment, caregiver-reported number of adolescent get-togethers, and teen social knowledge showed significant improvement following the intervention. CONCLUSIONS The PEERS® intervention is promising to support the social and friendship skills of adolescents with NF1 who have social difficulties.
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Affiliation(s)
- Danielle M Glad
- Department of Psychology, University of Wisconsin- Milwaukee, 2441 E Hartford Ave, Wisconsin, 53211, Milwaukee, USA.
| | - Sara K Pardej
- Department of Psychology, University of Wisconsin- Milwaukee, 2441 E Hartford Ave, Wisconsin, 53211, Milwaukee, USA
| | - Ellen Olszewski
- Department of Psychology, University of Wisconsin- Milwaukee, 2441 E Hartford Ave, Wisconsin, 53211, Milwaukee, USA
| | - Bonita P Klein-Tasman
- Department of Psychology, University of Wisconsin- Milwaukee, 2441 E Hartford Ave, Wisconsin, 53211, Milwaukee, USA
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Di Stasi M, Cocozza S, Buccino S, Paolella C, Di Napoli L, D'Amico A, Melis D, Ugga L, Villano G, Ruocco M, Scala I, Brunetti A, Elefante A. The role of unidentified bright objects in the neurocognitive profile of neurofibromatosis type 1 children: a volumetric MRI analysis. Acta Neurol Belg 2024; 124:223-230. [PMID: 37733157 PMCID: PMC10874314 DOI: 10.1007/s13760-023-02381-0] [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: 05/25/2023] [Accepted: 09/07/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE Cognitive impairment is described in 80% of Neurofibromatosis type 1 (NF1) patients. Brain focal areas of T2w increased signal intensity on MRI, the so-called Unidentified Bright Objects (UBOs) have been hypothesized to be related to cognitive dysfunction, although conflicting results are available in literature. Here, we investigated the possible relation between UBOs' volume, cognitive impairment, and language disability in NF1 patients. MATERIAL AND METHODS In this retrospective study, clinical and MRI data of 21 NF1 patients (M/F = 12/9; mean age 10.1 ± 4.5) were evaluated. Brain intellectual functioning and language abilities were assessed with specific scales, while the analyzed MRI sequences included axial 2D-T2-weighted and FLAIR sequences. These images were used independently for UBOs segmentation with a semiautomatic approach and obtained volumes were normalized for biparietal diameters to take into account for brain volume. Possible differences in terms of normalized UBOs volumes were probed between cognitively affected and preserved patients, as well as between subjects with or without language impairment. RESULTS Patients cognitively affected were not different in terms of UBOs volume compared to those preserved (p = 0.35 and p = 0.30, for T2-weighted and FLAIR images, respectively). Similarly, no differences were found between patients with and without language impairment (p = 0.47 and p = 0.40, for the two sequences). CONCLUSIONS The relation between UBOs and cognition in children with NF1 has been already investigated in literature, although leading to conflicting results. Our study expands the current knowledge, showing a lack of correlation between UBOs volume and both cognitive impairment and language disability in NF1 patients.
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Affiliation(s)
- Martina Di Stasi
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy
- Department of Diagnostic and Interventional Neuroradiology, University Hospital "San Giovanni di Dio e Ruggi di Aragona", Salerno, Italy
| | - Sirio Cocozza
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy.
| | - Sara Buccino
- Department of Maternal and Child Health, Federico II University Hospital, Naples, Italy
| | - Chiara Paolella
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy
| | - Linda Di Napoli
- Department of Maternal and Child Health, Federico II University Hospital, Naples, Italy
| | | | - Daniela Melis
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy
| | - Gianmichele Villano
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy
| | - Manuel Ruocco
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Iris Scala
- Department of Maternal and Child Health, Federico II University Hospital, Naples, Italy
| | - Arturo Brunetti
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy
| | - Andrea Elefante
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy
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Hernandez DP, Cruz DM, Martinez CS, Garcia LM, Figueroa A, Villarreal M, Manoj LM, Lopez S, López-Lorenzo KD, López-Juárez A. Gender-Specific Fine Motor Skill Learning Is Impaired by Myelin-Targeted Neurofibromatosis Type 1 Gene Mutation. Cancers (Basel) 2024; 16:477. [PMID: 38339230 PMCID: PMC10854893 DOI: 10.3390/cancers16030477] [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: 01/04/2024] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 02/12/2024] Open
Abstract
Neurofibromatosis type 1 (NF1) is caused by mutations in the NF1 gene. The clinical presentation of NF1 includes diverse neurological issues in pediatric and adult patients, ranging from learning disabilities, motor skill issues, and attention deficit disorder, to increased risk of depression and dementia. Preclinical research suggests that abnormal neuronal signaling mediates spatial learning and attention issues in NF1; however, drugs that improve phenotypes in models show inconclusive results in clinical trials, highlighting the need for a better understanding of NF1 pathophysiology and broader therapeutic options. Most NF1 patients show abnormalities in their brain white matter (WM) and myelin, and links with NF1 neuropathophysiology have been suggested; however, no current data can clearly support or refute this idea. We reported that myelin-targeted Nf1 mutation impacts oligodendrocyte signaling, myelin ultrastructure, WM connectivity, and sensory-motor behaviors in mice; however, any impact on learning and memory remains unknown. Here, we adapted a voluntary running test-the complex wheel (CW; a wheel with unevenly spaced rungs)-to delineate fine motor skill learning curves following induction of an Nf1 mutation in pre-existing myelinating cells (pNf1 mice). We found that pNf1 mutant females experience delayed or impaired learning in the CW, while proper learning in pNf1 males is predominantly disrupted; these phenotypes add complexity to the gender-dependent learning differences in the mouse strain used. No broad differences in memory of acquired CW skills were detected in any gender, but gene-dose effects were observed at the studied time points. Finally, nitric oxide signaling regulation differentially impacted learning in wild type (WT)/pNf1, male/female mice. Our results provide evidence for fine motor skill learning issues upon induction of an Nf1 mutation in mature myelinating cells. Together with previous connectivity, cellular, and molecular analyses, these results diversify the potential treatments for neurological issues in NF1.
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Affiliation(s)
- Daniella P. Hernandez
- Department of Health and Biomedical Sciences, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA
| | - Daniela M. Cruz
- Department of Health and Biomedical Sciences, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA
| | - Celeste S. Martinez
- Department of Health and Biomedical Sciences, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA
| | - Larisa M. Garcia
- Department of Health and Biomedical Sciences, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA
| | - Ashley Figueroa
- Department of Health and Biomedical Sciences, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA
| | - Marisol Villarreal
- Department of Health and Biomedical Sciences, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA
| | - Liya M. Manoj
- Department of Health and Biomedical Sciences, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA
| | - Saul Lopez
- Department of Health and Biomedical Sciences, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA
| | | | - Alejandro López-Juárez
- Department of Health and Biomedical Sciences, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA
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Pardej SK, Casnar CL, Yund BD, Klein-Tasman BP. An evaluation of computerized attention and executive function measures for use with school age children with neurofibromatosis type 1. Child Neuropsychol 2024:1-16. [PMID: 38214530 DOI: 10.1080/09297049.2024.2302634] [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: 10/07/2021] [Accepted: 12/21/2023] [Indexed: 01/13/2024]
Abstract
The present study investigated the performance of children with neurofibromatosis type 1 on computerized assessments of attention and executive function. Relations to ADHD symptomatology were also examined. Participants included 37 children (20 male) with NF1 (9-13 years; Mage = 11.02). Participants completed the NIH Toolbox Dimensional Change Card Sort, List Sort Working Memory (LSWM), and Flanker tasks, as well as Cogstate Identification and One Back tests. ADHD symptomatology was assessed using the K-SADS. Average performance was significantly different from the normative mean on every measure, except LSWM. The NIH Toolbox Flanker and Cogstate Identification tasks detected the highest proportion of participants with at least mild difficulty, and the Cogstate Identification task detected the highest proportion of participants with severe difficulty. Analyses revealed significant relations with ADHD symptomatology for two NIH toolbox tasks. The various computerized measures of attention and executive function offer different information when working with school age children with NF1. The NIH Flanker may offer the most room for change and offers face validity, which may be beneficial for clinical trials research. However, the LSWM shows most support for relations with behavioral indicators of attention and executive challenges.
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Affiliation(s)
- Sara K Pardej
- Department of Psychology, University of Wisconsin - Milwaukee, Milwaukee, WI, USA
| | | | - Brianna D Yund
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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de Blank P, Nishiyama A, López-Juárez A. A new era for myelin research in Neurofibromatosis type 1. Glia 2023; 71:2701-2719. [PMID: 37382486 PMCID: PMC10592420 DOI: 10.1002/glia.24432] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 06/12/2023] [Accepted: 06/12/2023] [Indexed: 06/30/2023]
Abstract
Evidence for myelin regulating higher-order brain function and disease is rapidly accumulating; however, defining cellular/molecular mechanisms remains challenging partially due to the dynamic brain physiology involving deep changes during development, aging, and in response to learning and disease. Furthermore, as the etiology of most neurological conditions remains obscure, most research models focus on mimicking symptoms, which limits understanding of their molecular onset and progression. Studying diseases caused by single gene mutations represents an opportunity to understand brain dys/function, including those regulated by myelin. Here, we discuss known and potential repercussions of abnormal central myelin on the neuropathophysiology of Neurofibromatosis Type 1 (NF1). Most patients with this monogenic disease present with neurological symptoms diverse in kind, severity, and onset/decline, including learning disabilities, autism spectrum disorders, attention deficit and hyperactivity disorder, motor coordination issues, and increased risk for depression and dementia. Coincidentally, most NF1 patients show diverse white matter/myelin abnormalities. Although myelin-behavior links were proposed decades ago, no solid data can prove or refute this idea yet. A recent upsurge in myelin biology understanding and research/therapeutic tools provides opportunities to address this debate. As precision medicine moves forward, an integrative understanding of all cell types disrupted in neurological conditions becomes a priority. Hence, this review aims to serve as a bridge between fundamental cellular/molecular myelin biology and clinical research in NF1.
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Affiliation(s)
- Peter de Blank
- Department of Pediatrics, The Cure Starts Now Brain Tumor Center, University of Cincinnati and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Akiko Nishiyama
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, Connecticut, USA
| | - Alejandro López-Juárez
- Department of Health and Biomedical Sciences, University of Texas Rio Grande Valley, Brownsville, Texas, USA
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Rai B, Naylor P, Sanchez MS, Wintermark M, Raman M, Jo B, Reiss A, Green T. Novel effects of Ras-MAPK pathogenic variants on the developing human brain and their link to gene expression and inhibition abilities. RESEARCH SQUARE 2023:rs.3.rs-2580911. [PMID: 36865206 PMCID: PMC9980214 DOI: 10.21203/rs.3.rs-2580911/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
The RASopathies are genetic syndromes associated with pathogenic variants causing dysregulation of the Ras/mitogen-activated protein kinase (Ras-MAPK) pathway, essential for brain development, and increased risk for neurodevelopmental disorders. Yet, the effects of most pathogenic variants on the human brain are unknown. We examined: 1. How Ras-MAPK activating variants of PTPN11 / SOS1 protein-coding genes affect brain anatomy. 2. The relationship between PTPN11 gene expression levels and brain anatomy, and 3. The relevance of subcortical anatomy to attention and memory skills affected in the RASopathies. We collected structural brain MRI and cognitive-behavioral data from 40 pre-pubertal children with Noonan syndrome (NS), caused by PTPN11 ( n = 30) or SOS1 ( n = 10) variants (age 8.53 ± 2.15, 25 females), and compared them to 40 age- and sex-matched typically developing controls (9.24 ± 1.62, 27 females). We identified widespread effects of NS on cortical and subcortical volumes and on determinants of cortical gray matter volume, surface area (SA) and cortical thickness (CT). In NS, we observed smaller volumes of bilateral striatum, precentral gyri, and primary visual area ( d 's<-0.8), and extensive effects on SA ( d 's>|0.8|) and CT ( d 's>|0.5|) relative to controls. Further, SA effects were associated with increasing PTPN11 gene expression, most prominently in the temporal lobe. Lastly, PTPN11 variants disrupted normative relationships between the striatum and inhibition functioning. We provide evidence for effects of Ras-MAPK pathogenic variants on striatal and cortical anatomy as well as links between PTPN11 gene expression and cortical SA increases, and striatal volume and inhibition skills. These findings provide essential translational information on the Ras-MAPK pathway's effect on human brain development and function.
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Sawyer C, Green J, Lim B, Pobric G, Jung J, Vassallo G, Evans DG, Stagg CJ, Parkes LM, Stivaros S, Muhlert N, Garg S. Neuroanatomical correlates of working memory performance in Neurofibromatosis 1. Cereb Cortex Commun 2022; 3:tgac021. [PMID: 35673329 PMCID: PMC9169056 DOI: 10.1093/texcom/tgac021] [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: 04/08/2022] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Neurofibromatosis 1 (NF1) is a single-gene disorder associated with cognitive impairments, particularly with deficits in working memory. Prior research indicates that brain structure is affected in NF1, but it is unclear how these changes relate to aspects of cognition. Methods 29 adolescents aged 11-17 years were compared to age and sex-matched controls. NF1 subjects were assessed using detailed multimodal measurements of working memory at baseline followed by a 3T MR scan. A voxel-based morphometry approach was used to estimate the total and regional gray matter(GM) volumetric differences between the NF1 and control groups. The working memory metrics were subjected to a principal component analysis (PCA) approach. Results The NF1 groups showed increased gray matter volumes in the thalamus, corpus striatum, dorsal midbrain and cerebellum bilaterally in the NF1 group as compared to controls. Principal component analysis on the working memory metrics in the NF1 group yielded three independent factors reflecting high memory load, low memory load and auditory working memory. Correlation analyses revealed that increased volume of posterior cingulate cortex, a key component of the default mode network (DMN) was significantly associated with poorer performance on low working memory load tasks. Conclusion These results are consistent with prior work showing larger subcortical brain volumes in the NF1 cohort. The strong association between posterior cingulate cortex volume and performance on low memory load conditions supports hypotheses of deficient DMN structural development, which in turn may contribute to the cognitive impairments in NF1.
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Affiliation(s)
- Cameron Sawyer
- Division of Neuroscience & Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
| | - Jonathan Green
- Division of Neuroscience & Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
| | - Ben Lim
- Child & Adolescent Mental Health Department, Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, Oxford Road, M13 9WL, United Kingdom
| | - Gorana Pobric
- Division of Neuroscience & Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
| | - JeYoung Jung
- School of Psychology, Precision Imaging Beacon, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom
| | - Grace Vassallo
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, United Kingdom
| | - D Gareth Evans
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, United Kingdom
| | - Charlotte J Stagg
- Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences & MRC Brain Network Dynamics Unit, University of Oxford, OX3 9DU, United Kingdom
| | - Laura M Parkes
- Division of Neuroscience & Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
| | - Stavros Stivaros
- Geoffrey Jefferson Brain Research Centre, Northern care Alliance NHS Foundation Trust, Stott Lane, Manchester M6 8HD, United Kingdom
| | - Nils Muhlert
- Division of Neuroscience & Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
| | - Shruti Garg
- Division of Neuroscience & Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
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Sánchez Marco SB, López Pisón J, Calvo Escribano C, González Viejo I, Miramar Gallart MD, Samper Villagrasa P. Neurological manifestations of neurofibromatosis type 1: our experience. Neurologia 2022; 37:325-333. [PMID: 31326214 DOI: 10.1016/j.nrl.2019.05.003] [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: 03/14/2019] [Revised: 04/29/2019] [Accepted: 05/20/2019] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION Neurofibromatosis type 1 (NF1) is a progressive multisystem disorder following an autosomal dominant inheritance pattern that presents with multiple neurological manifestations. METHODS We reviewed medical histories of patients with NF1 followed up at our hospital's paediatric neurology department from May 1990 to 31 December 2018. We collected data on neurological symptoms. RESULTS A total of 128 patients with NF1 were identified. Mean age (SD) at NF1 diagnosis was 4.43 (3.38) years (range, 0.5-14.5 years). There was a slight female predominance (53.1%). Macrocephaly (head circumference over 2 SDs above average for age) was present in 37.5% of cases. Attention-deficit/hyperactivity disorder was recorded in 28.9% of patients (37): combined type in 20 patients, predominantly inattentive in 15, and predominantly impulsive/hyperactive in 2. Other manifestations included headache (18.6%), cognitive impairment (7.8%), motor deficit (6.2%), and epilepsy (4.68%). Brain MRI was performed in 85 patients, revealing T2-weighted hyperintensities in the basal ganglia and/or cerebellum in 60 patients (70.5%), Chiari malformation type 1 in 4 cases, and arachnoid cysts in 3. Optic nerve gliomas were identified by MRI in 22 patients (25.8%). Other MRI findings included plexiform neurofibromas (9.3%) and central nervous system gliomas (3.1%). CONCLUSIONS The neurological manifestations identified in our sample are consistent with those reported in the literature. Effective transfer strategies from paediatric neurology departments and subsequent clinical follow-up by adult neurology departments are needed to prevent loss to follow-up in adulthood.
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Affiliation(s)
- S B Sánchez Marco
- Unidad de Neurología Pediátrica, Servicio de Pediatría, Hospital Infantil Universitario Miguel Servet, Zaragoza, España.
| | - J López Pisón
- Unidad de Neurología Pediátrica, Servicio de Pediatría, Hospital Infantil Universitario Miguel Servet, Zaragoza, España
| | - C Calvo Escribano
- Unidad de Oncohematología Pediátrica, Servicio de Pediatría, Hospital Infantil Universitario Miguel Servet, Zaragoza, España
| | - I González Viejo
- Servicio de Oftalmología, Hospital Infantil Universitario Miguel Servet, Hospital Infantil Universitario Miguel Servet, Zaragoza, España
| | - M D Miramar Gallart
- Servicio de Genética Clínica, Hospital Universitario Miguel Servet, Zaragoza, España
| | - P Samper Villagrasa
- Departamento de Pediatría, Radiología y Medicina Física, Facultad de Medicina de Zaragoza, Universidad de Zaragoza, Zaragoza, España
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Wang S, Friedman JM, Suppa P, Buchert R, Mautner VF. White matter is increased in the brains of adults with neurofibromatosis 1. Orphanet J Rare Dis 2022; 17:115. [PMID: 35248131 PMCID: PMC8898512 DOI: 10.1186/s13023-022-02273-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 02/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Neurofibromatosis 1 (NF1) is a rare autosomal dominant disease characterized by increased Schwann cell proliferation in peripheral nerves. Several small studies of brain morphology in children with NF1 have found increased total brain volume, total white matter volume and/or corpus callosum area. Some studies (mostly in children with NF1) also attempted to correlate changes in brain morphology and volume with cognitive or behavioural abnormalities, although the findings were inconsistent. We aimed to characterize alterations in brain volumes by three-dimensional (3D) MRI in adults with NF1 in major intracranial sub-regions. We also aimed to assess the effect of age on these volumes and correlated brain white matter and grey matter volumes with neuropsychometric findings in adults with NF1. Methods We obtained brain volume measurements using 3D magnetic resonance imaging for 351 adults with NF1 and, as a comparison group, 43 adults with neurofibromatosis 2 (NF2) or Schwannomatosis. We assessed a subset of 19 adults with NF1 for clinical severity of NF1 features and neurological problems and conducted psychometric testing for attention deficiencies and intelligence quotient. We compared brain volumes between NF1 patients and controls and correlated volumetric measurements to clinical and psychometric features in the NF1 patients. Results Total brain volume and total and regional white matter volumes were all significantly increased in adults with NF1. Grey matter volume decreased faster with age in adults with NF1 than in controls. Greater total brain volume and white matter volume were correlated with lower attention deficits and higher intelligence quotients in adults with NF1. Conclusion Our findings are consistent with the hypothesis that dysregulation of brain myelin production is a cardinal manifestation of NF1 and that these white matter changes may be functionally important in affected adults. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02273-1.
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Glad DM, Casnar CL, Yund BD, Lee K, Klein-Tasman BP. Parent-Reported Social Skills in Children with Neurofibromatosis Type 1: Longitudinal Patterns and Relations with Attention and Cognitive Functioning. J Dev Behav Pediatr 2021; 42:656-665. [PMID: 34618723 PMCID: PMC8944791 DOI: 10.1097/dbp.0000000000000939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 01/27/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Social skills difficulties are commonly reported by parents and teachers of school age (SA) children with neurofibromatosis type 1 (NF1). Investigations of social skills of young children with NF1 are scarce. This study aimed to characterize the emergence of social skills challenges beginning in early childhood, examine social skills longitudinally into SA, and explore interrelations with attention-deficit hyperactivity disorder (ADHD) symptomatology and cognitive functioning among children with NF1 cross-sectionally and longitudinally. METHOD Three samples of children with NF1 and their parents participated: (1) early childhood (n = 50; ages 3-6; mean [M] = 3.96, SD = 1.05), (2) SA (n = 40; ages 9-13; [M] = 10.90, SD = 1.59), and (3) both early childhood and SA (n = 25). Parent-reported social skills (Social Skills Rating System and Social Skills Improvement System), ADHD symptomatology (Conners Parent Rating Scales - Revised and Conners - Third Edition), and parent-reported cognitive abilities (Differential Ability Scales - Second Edition) were evaluated. RESULTS Parental ratings of social skills were relatively stable throughout childhood. Ratings of social skills at the end of early childhood significantly predicted school-age social skills. Parental ratings of ADHD symptomatology showed significant negative relations with social skills. Early childhood inattentive symptoms predicted school-age social skills ratings. Cognitive functioning was not significantly related to social skills. CONCLUSION Parent-reported social skills difficulties are evident during early childhood. This work adds to the literature by describing the frequency and stability of social skills challenges in early childhood and in the school-age period in NF1. Research about interventions to support social skills when difficulties are present is needed.
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Affiliation(s)
- Danielle M. Glad
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI
| | - Christina L. Casnar
- Department of Neurology, Division of Neuropsychology, Medical College of Wisconsin, Wauwatosa, WI
| | - Brianna D. Yund
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, Minneapolis, MN
| | - Kristin Lee
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI
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Haebich KM, Dao DP, Pride NA, Barton B, Walsh KS, Maier A, Chisholm AK, Darke H, Catroppa C, Malarbi S, Wilkinson JC, Anderson VA, North KN, Payne JM. The mediating role of ADHD symptoms between executive function and social skills in children with neurofibromatosis type 1. Child Neuropsychol 2021; 28:318-336. [PMID: 34587865 DOI: 10.1080/09297049.2021.1976129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Children with neurofibromatosis type 1 (NF1) often experience executive dysfunction, attention deficit/hyperactivity disorder (ADHD) symptoms and poor social skills, however, the nature of the relationships between these domains in children with NF1 is unclear. This study investigated these relationships using primary caregiver ratings of executive functions, ADHD symptoms and social skills in children with NF1. Participants were 136 children with NF1 and 93 typically developing (TD) controls aged 3-15 years recruited from 3 multidisciplinary neurofibromatosis clinics in Melbourne and Sydney, Australia, and Washington DC, USA. Mediation analysis was performed on primary outcome variables: parent ratings of executive functions (Behavior Rating Inventory of Executive Function, Metacognition Index), ADHD symptoms (Conners-3/Conners ADHD Diagnostic and Statistical Manual for Mental Disorders Scales) and social skills (Social Skills Improvement System-Rating Scale), adjusting for potential confounders (full scale IQ, sex, and social risk). Results revealed significantly poorer executive functions, elevated ADHD symptoms and reduced social skills in children with NF1 compared to controls. Poorer executive functions significantly predicted elevated ADHD symptoms and poorer social skills. Elevated ADHD symptoms significantly mediated the relationship between executive functions and social skills problems although did not fully account for social dysfunction. This study provides evidence for the importance of targeting ADHD symptoms as part of future interventions aimed at promoting prosocial behaviors in children with NF1.
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Affiliation(s)
- Kristina M Haebich
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences,University of Melbourne, Melbourne, Australia
| | - Duy P Dao
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia
| | - Natalie A Pride
- Kids Ne Uroscience Centre, the Children's Hospital at Westmead, Sydney, Australia.,Discipline of Paediatrics & Child Health, University of Sydney, Sydney, Australia
| | - Belinda Barton
- Kids Ne Uroscience Centre, the Children's Hospital at Westmead, Sydney, Australia.,Discipline of Paediatrics & Child Health, University of Sydney, Sydney, Australia.,Children's Hospital Education Research Institute, the Children's Hospital at Westmead, Sydney, Australia
| | - Karin S Walsh
- Center for Neuroscience and Behavioral Medicine, Children's National Hospital, Washington, DC, USA.,Departments of Pediatrics and Psychiatry, The George Washington University School of Medicine, Washington, DC, USA
| | - Alice Maier
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia
| | - Anita K Chisholm
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences,University of Melbourne, Melbourne, Australia
| | - Hayley Darke
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia
| | - Cathy Catroppa
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences,University of Melbourne, Melbourne, Australia
| | - Stephanie Malarbi
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences,University of Melbourne, Melbourne, Australia
| | - Jake C Wilkinson
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia.,School of Psychology, Cardiff University, Cardiff, UK
| | - Vicki A Anderson
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences,University of Melbourne, Melbourne, Australia
| | - Kathryn N North
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences,University of Melbourne, Melbourne, Australia
| | - Jonathan M Payne
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences,University of Melbourne, Melbourne, Australia
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Tam LT, Ng NN, McKenna ES, Bruckert L, Yeom KW, Campen CJ. Effects of Age on White Matter Microstructure in Children With Neurofibromatosis Type 1. J Child Neurol 2021; 36:894-900. [PMID: 34048307 DOI: 10.1177/08830738211008736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Children with neurofibromatosis type 1 (NF1) often report cognitive challenges, though the etiology of such remains an area of active investigation. With the advent of treatments that may affect white matter microstructure, understanding the effects of age on white matter aberrancies in NF1 becomes crucial in determining the timing of such therapeutic interventions. A cross-sectional study was performed with diffusion tensor imaging from 18 NF1 children and 26 age-matched controls. Fractional anisotropy was determined by region of interest analyses for both groups over the corpus callosum, cingulate, and bilateral frontal and temporal white matter regions. Two-way analyses of variance were done with both ages combined and age-stratified into early childhood, middle childhood, and adolescence. Significant differences in fractional anisotropy between NF1 and controls were seen in the corpus callosum and frontal white matter regions when ages were combined. When stratified by age, we found that this difference was largely driven by the early childhood (1-5.9 years) and middle childhood (6-11.9 years) age groups, whereas no significant differences were appreciable in the adolescence age group (12-18 years). This study demonstrates age-related effects on white matter microstructure disorganization in NF1, suggesting that the appropriate timing of therapeutic intervention may be in early childhood.
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Affiliation(s)
- Lydia T Tam
- Neurology, 10623Stanford Hospital and Clinics, Palo Alto, CA, USA
| | - Nathan N Ng
- Neurology, 10623Stanford Hospital and Clinics, Palo Alto, CA, USA
| | - Emily S McKenna
- Neurology, 10623Stanford Hospital and Clinics, Palo Alto, CA, USA
| | - Lisa Bruckert
- Neonatal and Developmental Medicine, 10624Stanford University School of Medicine, Stanford, CA, USA
| | - Kristen W Yeom
- Radiology, 10623Stanford Hospital and Clinics, Stanford, CA, USA
- Co-senior authors
| | - Cynthia J Campen
- Neurology, 10623Stanford Hospital and Clinics, Palo Alto, CA, USA
- Co-senior authors
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15
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Janusz JA, Klein-Tasman BP, Payne JM, Wolters PL, Thompson HL, Martin S, de Blank P, Ullrich N, Del Castillo A, Hussey M, Hardy KK, Haebich K, Rosser T, Toledo-Tamula MA, Walsh KS. Recommendations for Social Skills End Points for Clinical Trials in Neurofibromatosis Type 1. Neurology 2021; 97:S73-S80. [PMID: 34230205 PMCID: PMC8594002 DOI: 10.1212/wnl.0000000000012422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 06/07/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To review parent-report social skills measures to identify and recommend consensus outcomes for use in clinical trials of social deficit in children and adolescents (ages 6-18 years) with neurofibromatosis type 1 (NF1). METHODS Searches were conducted via PubMed and ClinicalTrials.gov to identity social skills outcome measures with English language versions used in clinical trials in the past 5 years with populations with known social skills deficits, including attention-deficit/hyperactivity disorder and autism spectrum disorder (ASD). Measures were rated by the Response Evaluation in Neurofibromatosis and Schwannomatosis (REiNS) Neurocognitive Committee on patient characteristics, use in published studies, domains assessed, availability of standard scores, psychometric properties, and feasibility to determine their appropriateness for use in NF1 clinical trials. RESULTS Two measures were ultimately recommended by the committee: the Social Responsiveness Scale-2 (SRS-2) and the Social Skills Improvement System-Rating Scale (SSIS-RS). CONCLUSIONS Each of the 2 measures assesses different aspects of social functioning. The SSIS-RS is appropriate for studies focused on broader social functioning; the SRS-2 is best for studies targeting problematic social behaviors associated with ASD. Researchers will need to consider the goals of their study when choosing a measure, and specific recommendations for their use are provided.
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Affiliation(s)
- Jennifer A Janusz
- From the Children's Hospital Colorado and University of Colorado School of Medicine (J.A.J.), Aurora; Department of Psychology (B.P.K.-T.), University of Wisconsin-Milwaukee; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P., K.H.), University of Melbourne, Australia; Pediatric Oncology Branch (P.L.W., S.M., M.A.T.-T.), National Cancer Institute, Bethesda, MD; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Cincinnati Medical Center (P.d.B.), OH; Boston Children's Hospital (N.U.), MA; Children's National Hospital, Gilbert NF Institute (A.d.C., K.K.H., K.S.W.), Washington, DC; Children's Tumor Foundation (M.H.), New York, NY; The George Washington School of Medicine (K.K.H., K.S.W.), Washington, DC; Children's Hospital Los Angeles (T.R.), CA; and Leidos Biomedical Research, Inc. (M.A.T.-T.), Frederick, MD.
| | - Bonita P Klein-Tasman
- From the Children's Hospital Colorado and University of Colorado School of Medicine (J.A.J.), Aurora; Department of Psychology (B.P.K.-T.), University of Wisconsin-Milwaukee; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P., K.H.), University of Melbourne, Australia; Pediatric Oncology Branch (P.L.W., S.M., M.A.T.-T.), National Cancer Institute, Bethesda, MD; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Cincinnati Medical Center (P.d.B.), OH; Boston Children's Hospital (N.U.), MA; Children's National Hospital, Gilbert NF Institute (A.d.C., K.K.H., K.S.W.), Washington, DC; Children's Tumor Foundation (M.H.), New York, NY; The George Washington School of Medicine (K.K.H., K.S.W.), Washington, DC; Children's Hospital Los Angeles (T.R.), CA; and Leidos Biomedical Research, Inc. (M.A.T.-T.), Frederick, MD
| | - Jonathan M Payne
- From the Children's Hospital Colorado and University of Colorado School of Medicine (J.A.J.), Aurora; Department of Psychology (B.P.K.-T.), University of Wisconsin-Milwaukee; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P., K.H.), University of Melbourne, Australia; Pediatric Oncology Branch (P.L.W., S.M., M.A.T.-T.), National Cancer Institute, Bethesda, MD; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Cincinnati Medical Center (P.d.B.), OH; Boston Children's Hospital (N.U.), MA; Children's National Hospital, Gilbert NF Institute (A.d.C., K.K.H., K.S.W.), Washington, DC; Children's Tumor Foundation (M.H.), New York, NY; The George Washington School of Medicine (K.K.H., K.S.W.), Washington, DC; Children's Hospital Los Angeles (T.R.), CA; and Leidos Biomedical Research, Inc. (M.A.T.-T.), Frederick, MD
| | - Pamela L Wolters
- From the Children's Hospital Colorado and University of Colorado School of Medicine (J.A.J.), Aurora; Department of Psychology (B.P.K.-T.), University of Wisconsin-Milwaukee; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P., K.H.), University of Melbourne, Australia; Pediatric Oncology Branch (P.L.W., S.M., M.A.T.-T.), National Cancer Institute, Bethesda, MD; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Cincinnati Medical Center (P.d.B.), OH; Boston Children's Hospital (N.U.), MA; Children's National Hospital, Gilbert NF Institute (A.d.C., K.K.H., K.S.W.), Washington, DC; Children's Tumor Foundation (M.H.), New York, NY; The George Washington School of Medicine (K.K.H., K.S.W.), Washington, DC; Children's Hospital Los Angeles (T.R.), CA; and Leidos Biomedical Research, Inc. (M.A.T.-T.), Frederick, MD
| | - Heather L Thompson
- From the Children's Hospital Colorado and University of Colorado School of Medicine (J.A.J.), Aurora; Department of Psychology (B.P.K.-T.), University of Wisconsin-Milwaukee; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P., K.H.), University of Melbourne, Australia; Pediatric Oncology Branch (P.L.W., S.M., M.A.T.-T.), National Cancer Institute, Bethesda, MD; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Cincinnati Medical Center (P.d.B.), OH; Boston Children's Hospital (N.U.), MA; Children's National Hospital, Gilbert NF Institute (A.d.C., K.K.H., K.S.W.), Washington, DC; Children's Tumor Foundation (M.H.), New York, NY; The George Washington School of Medicine (K.K.H., K.S.W.), Washington, DC; Children's Hospital Los Angeles (T.R.), CA; and Leidos Biomedical Research, Inc. (M.A.T.-T.), Frederick, MD
| | - Staci Martin
- From the Children's Hospital Colorado and University of Colorado School of Medicine (J.A.J.), Aurora; Department of Psychology (B.P.K.-T.), University of Wisconsin-Milwaukee; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P., K.H.), University of Melbourne, Australia; Pediatric Oncology Branch (P.L.W., S.M., M.A.T.-T.), National Cancer Institute, Bethesda, MD; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Cincinnati Medical Center (P.d.B.), OH; Boston Children's Hospital (N.U.), MA; Children's National Hospital, Gilbert NF Institute (A.d.C., K.K.H., K.S.W.), Washington, DC; Children's Tumor Foundation (M.H.), New York, NY; The George Washington School of Medicine (K.K.H., K.S.W.), Washington, DC; Children's Hospital Los Angeles (T.R.), CA; and Leidos Biomedical Research, Inc. (M.A.T.-T.), Frederick, MD
| | - Peter de Blank
- From the Children's Hospital Colorado and University of Colorado School of Medicine (J.A.J.), Aurora; Department of Psychology (B.P.K.-T.), University of Wisconsin-Milwaukee; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P., K.H.), University of Melbourne, Australia; Pediatric Oncology Branch (P.L.W., S.M., M.A.T.-T.), National Cancer Institute, Bethesda, MD; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Cincinnati Medical Center (P.d.B.), OH; Boston Children's Hospital (N.U.), MA; Children's National Hospital, Gilbert NF Institute (A.d.C., K.K.H., K.S.W.), Washington, DC; Children's Tumor Foundation (M.H.), New York, NY; The George Washington School of Medicine (K.K.H., K.S.W.), Washington, DC; Children's Hospital Los Angeles (T.R.), CA; and Leidos Biomedical Research, Inc. (M.A.T.-T.), Frederick, MD
| | - Nicole Ullrich
- From the Children's Hospital Colorado and University of Colorado School of Medicine (J.A.J.), Aurora; Department of Psychology (B.P.K.-T.), University of Wisconsin-Milwaukee; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P., K.H.), University of Melbourne, Australia; Pediatric Oncology Branch (P.L.W., S.M., M.A.T.-T.), National Cancer Institute, Bethesda, MD; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Cincinnati Medical Center (P.d.B.), OH; Boston Children's Hospital (N.U.), MA; Children's National Hospital, Gilbert NF Institute (A.d.C., K.K.H., K.S.W.), Washington, DC; Children's Tumor Foundation (M.H.), New York, NY; The George Washington School of Medicine (K.K.H., K.S.W.), Washington, DC; Children's Hospital Los Angeles (T.R.), CA; and Leidos Biomedical Research, Inc. (M.A.T.-T.), Frederick, MD
| | - Allison Del Castillo
- From the Children's Hospital Colorado and University of Colorado School of Medicine (J.A.J.), Aurora; Department of Psychology (B.P.K.-T.), University of Wisconsin-Milwaukee; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P., K.H.), University of Melbourne, Australia; Pediatric Oncology Branch (P.L.W., S.M., M.A.T.-T.), National Cancer Institute, Bethesda, MD; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Cincinnati Medical Center (P.d.B.), OH; Boston Children's Hospital (N.U.), MA; Children's National Hospital, Gilbert NF Institute (A.d.C., K.K.H., K.S.W.), Washington, DC; Children's Tumor Foundation (M.H.), New York, NY; The George Washington School of Medicine (K.K.H., K.S.W.), Washington, DC; Children's Hospital Los Angeles (T.R.), CA; and Leidos Biomedical Research, Inc. (M.A.T.-T.), Frederick, MD
| | - Maureen Hussey
- From the Children's Hospital Colorado and University of Colorado School of Medicine (J.A.J.), Aurora; Department of Psychology (B.P.K.-T.), University of Wisconsin-Milwaukee; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P., K.H.), University of Melbourne, Australia; Pediatric Oncology Branch (P.L.W., S.M., M.A.T.-T.), National Cancer Institute, Bethesda, MD; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Cincinnati Medical Center (P.d.B.), OH; Boston Children's Hospital (N.U.), MA; Children's National Hospital, Gilbert NF Institute (A.d.C., K.K.H., K.S.W.), Washington, DC; Children's Tumor Foundation (M.H.), New York, NY; The George Washington School of Medicine (K.K.H., K.S.W.), Washington, DC; Children's Hospital Los Angeles (T.R.), CA; and Leidos Biomedical Research, Inc. (M.A.T.-T.), Frederick, MD
| | - Kristina K Hardy
- From the Children's Hospital Colorado and University of Colorado School of Medicine (J.A.J.), Aurora; Department of Psychology (B.P.K.-T.), University of Wisconsin-Milwaukee; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P., K.H.), University of Melbourne, Australia; Pediatric Oncology Branch (P.L.W., S.M., M.A.T.-T.), National Cancer Institute, Bethesda, MD; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Cincinnati Medical Center (P.d.B.), OH; Boston Children's Hospital (N.U.), MA; Children's National Hospital, Gilbert NF Institute (A.d.C., K.K.H., K.S.W.), Washington, DC; Children's Tumor Foundation (M.H.), New York, NY; The George Washington School of Medicine (K.K.H., K.S.W.), Washington, DC; Children's Hospital Los Angeles (T.R.), CA; and Leidos Biomedical Research, Inc. (M.A.T.-T.), Frederick, MD
| | - Kristina Haebich
- From the Children's Hospital Colorado and University of Colorado School of Medicine (J.A.J.), Aurora; Department of Psychology (B.P.K.-T.), University of Wisconsin-Milwaukee; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P., K.H.), University of Melbourne, Australia; Pediatric Oncology Branch (P.L.W., S.M., M.A.T.-T.), National Cancer Institute, Bethesda, MD; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Cincinnati Medical Center (P.d.B.), OH; Boston Children's Hospital (N.U.), MA; Children's National Hospital, Gilbert NF Institute (A.d.C., K.K.H., K.S.W.), Washington, DC; Children's Tumor Foundation (M.H.), New York, NY; The George Washington School of Medicine (K.K.H., K.S.W.), Washington, DC; Children's Hospital Los Angeles (T.R.), CA; and Leidos Biomedical Research, Inc. (M.A.T.-T.), Frederick, MD
| | - Tena Rosser
- From the Children's Hospital Colorado and University of Colorado School of Medicine (J.A.J.), Aurora; Department of Psychology (B.P.K.-T.), University of Wisconsin-Milwaukee; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P., K.H.), University of Melbourne, Australia; Pediatric Oncology Branch (P.L.W., S.M., M.A.T.-T.), National Cancer Institute, Bethesda, MD; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Cincinnati Medical Center (P.d.B.), OH; Boston Children's Hospital (N.U.), MA; Children's National Hospital, Gilbert NF Institute (A.d.C., K.K.H., K.S.W.), Washington, DC; Children's Tumor Foundation (M.H.), New York, NY; The George Washington School of Medicine (K.K.H., K.S.W.), Washington, DC; Children's Hospital Los Angeles (T.R.), CA; and Leidos Biomedical Research, Inc. (M.A.T.-T.), Frederick, MD
| | - Mary Anne Toledo-Tamula
- From the Children's Hospital Colorado and University of Colorado School of Medicine (J.A.J.), Aurora; Department of Psychology (B.P.K.-T.), University of Wisconsin-Milwaukee; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P., K.H.), University of Melbourne, Australia; Pediatric Oncology Branch (P.L.W., S.M., M.A.T.-T.), National Cancer Institute, Bethesda, MD; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Cincinnati Medical Center (P.d.B.), OH; Boston Children's Hospital (N.U.), MA; Children's National Hospital, Gilbert NF Institute (A.d.C., K.K.H., K.S.W.), Washington, DC; Children's Tumor Foundation (M.H.), New York, NY; The George Washington School of Medicine (K.K.H., K.S.W.), Washington, DC; Children's Hospital Los Angeles (T.R.), CA; and Leidos Biomedical Research, Inc. (M.A.T.-T.), Frederick, MD
| | - Karin S Walsh
- From the Children's Hospital Colorado and University of Colorado School of Medicine (J.A.J.), Aurora; Department of Psychology (B.P.K.-T.), University of Wisconsin-Milwaukee; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P., K.H.), University of Melbourne, Australia; Pediatric Oncology Branch (P.L.W., S.M., M.A.T.-T.), National Cancer Institute, Bethesda, MD; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Cincinnati Medical Center (P.d.B.), OH; Boston Children's Hospital (N.U.), MA; Children's National Hospital, Gilbert NF Institute (A.d.C., K.K.H., K.S.W.), Washington, DC; Children's Tumor Foundation (M.H.), New York, NY; The George Washington School of Medicine (K.K.H., K.S.W.), Washington, DC; Children's Hospital Los Angeles (T.R.), CA; and Leidos Biomedical Research, Inc. (M.A.T.-T.), Frederick, MD
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Neurological manifestations of neurofibromatosis type 1: our experience. NEUROLOGÍA (ENGLISH EDITION) 2021; 37:325-333. [DOI: 10.1016/j.nrleng.2019.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 05/20/2019] [Indexed: 11/23/2022] Open
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Russo C, Russo C, Cascone D, Mazio F, Santoro C, Covelli EM, Cinalli G. Non-Oncological Neuroradiological Manifestations in NF1 and Their Clinical Implications. Cancers (Basel) 2021; 13:cancers13081831. [PMID: 33921292 PMCID: PMC8070534 DOI: 10.3390/cancers13081831] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Central nervous system involvement (CNS) is a common finding in Neurofibromatosis type 1 (NF1). Beside tumor-related manifestations, NF1 is also characterized by a wide spectrum of CNS alterations with variable impacts on functioning and life quality. Here, we propose an overview of non-oncological neuroradiological findings in NF1, with an insight on pathophysiological and embryological clues for a better understanding of the development of these specific alterations. Abstract Neurofibromatosis type 1 (NF1), the most frequent phakomatosis and one of the most common inherited tumor predisposition syndromes, is characterized by several manifestations that pervasively involve central and peripheral nervous system structures. The disorder is due to mutations in the NF1 gene, which encodes for the ubiquitous tumor suppressor protein neurofibromin; neurofibromin is highly expressed in neural crest derived tissues, where it plays a crucial role in regulating cell proliferation, differentiation, and structural organization. This review article aims to provide an overview on NF1 non-neoplastic manifestations of neuroradiological interest, involving both the central nervous system and spine. We also briefly review the most recent MRI functional findings in NF1.
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Affiliation(s)
- Camilla Russo
- Department of Electrical Engineering and Information Technology (DIETI), University of Naples “Federico II”, 80125 Naples, Italy
- Correspondence: ; Tel.: +39-333-7050711
| | - Carmela Russo
- Pediatric Neuroradiology Unit, Department of Pediatric Neurosciences, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy; (C.R.); (D.C.); (F.M.); (E.M.C.)
| | - Daniele Cascone
- Pediatric Neuroradiology Unit, Department of Pediatric Neurosciences, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy; (C.R.); (D.C.); (F.M.); (E.M.C.)
| | - Federica Mazio
- Pediatric Neuroradiology Unit, Department of Pediatric Neurosciences, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy; (C.R.); (D.C.); (F.M.); (E.M.C.)
| | - Claudia Santoro
- Neurofibromatosis Referral Center, Department of Woman, Child, General and Specialized Surgery, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Eugenio Maria Covelli
- Pediatric Neuroradiology Unit, Department of Pediatric Neurosciences, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy; (C.R.); (D.C.); (F.M.); (E.M.C.)
| | - Giuseppe Cinalli
- Pediatric Neurosurgery Unit, Department of Pediatric Neurosciences, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy;
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18
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Beaussart-Corbat ML, Barbarot S, Farges D, Martin L, Roy A. Executive functions in preschool-aged children with neurofibromatosis type 1: Value for early assessment. J Clin Exp Neuropsychol 2021; 43:163-175. [PMID: 33685350 DOI: 10.1080/13803395.2021.1893277] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction: Executive functions (EFs) impairment is common in children with neurofibromatosis type 1 (NF1), and could be a significant vulnerability associated with this medical disorder. However, we still know little about EFs in preschool NF1. Our study assessed EFs in NF1 children using performance-based tests and daily life questionnaires, which combined the views of parents and teachers.Method: Seven classic experimental tasks were used to evaluate EFs in 33 NF1 children aged 3 to 5 years old, and BRIEF-P questionnaires were completed by their parents and teachers. These children's performance was compared with a control group of 52 healthy children matched in age, gender and socio-cultural status.Results: NF1 children have significantly lower scores for 5 out of 7 executive tasks than control children and significantly higher levels of EF concerns in the parent and teacher BRIEF-P ratings. The correlations between performance-based tests and questionnaires are weak.Conclusions: Our results support an early executive dysfunction in NF1 children and call for early and systematic assessment of EFs. Both performance-based tests and questionnaires are complementary tools to investigate early EFs dysfunction in children with NF1.
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Affiliation(s)
| | - Sébastien Barbarot
- Department of Dermatology, Nantes University, CHU Nantes, Nantes, France.,Neurofibromatosis Clinic, Nantes University Hospital, Nantes, France
| | - Denis Farges
- Pediatrics Department, Angers University Hospital, France
| | - Ludovic Martin
- Department of Dermatology, Angers University Hospital, France.,Reference Center for Inherited Skin Disorders (MAGEC Nord), Angers University Hospital, France
| | - Arnaud Roy
- Laboratory of Psychology, LPPL EA4638, University of Angers, Angers, France.,Neurofibromatosis Clinic, Nantes University Hospital, Nantes, France.,Reference Center for Learning Disabilities, Nantes University Hospital, Nantes, France
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19
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Johnson EM, Ishak AD, Naylor PE, Stevenson DA, Reiss AL, Green T. PTPN11 Gain-of-Function Mutations Affect the Developing Human Brain, Memory, and Attention. Cereb Cortex 2020; 29:2915-2923. [PMID: 30059958 DOI: 10.1093/cercor/bhy158] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 05/21/2018] [Accepted: 06/15/2018] [Indexed: 01/28/2023] Open
Abstract
The Ras-MAPK pathway has an established role in neural development and synaptic signaling. Mutations in this pathway are associated with a collection of neurodevelopmental syndromes, Rasopathies; among these, Noonan syndrome (NS) is the most common (1:2000). Prior research has focused on identifying genetic mutations and cellular mechanisms of the disorder, however, effects of NS on the human brain remain unknown. Here, imaging and cognitive data were collected from 12 children with PTPN11-related NS, ages 4.0-11.0 years (8.98 ± 2.33) and 12 age- and sex-matched typically developing controls (8.79 ± 2.17). We observe reduced gray matter volume in bilateral corpus striatum (Cohen's d = -1.0:-1.3), reduced surface area in temporal regions (d = -1.8:-2.2), increased cortical thickness in frontal regions (d = 1.2-1.3), and reduced cortical thickness in limbic regions (d = -1.6), including limbic structures integral to the circuitry of the hippocampus. Further, we find high levels of inattention, hyperactivity, and memory deficits in children with NS. Taken together, these results identify effects of NS on specific brain regions associated with ADHD and learning in children. While our research lays the groundwork for elucidating the neural and behavioral mechanisms of NS, it also adds an essential tier to understanding the Ras-MAPK pathway's role in human brain development.
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Affiliation(s)
- Emily M Johnson
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.,Department of Radiology/Molecular Imaging Program, Stanford University, Stanford, CA, USA
| | - Alexandra D Ishak
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Paige E Naylor
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - David A Stevenson
- Department of Pediatrics-Medical Genetics, Stanford University, Stanford, CA, USA
| | - Allan L Reiss
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.,Department of Radiology and Pediatrics, Stanford University, Stanford, CA, USA
| | - Tamar Green
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
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20
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Neurofibromatosis type 1: New developments in genetics and treatment. J Am Acad Dermatol 2020; 84:1667-1676. [PMID: 32771543 DOI: 10.1016/j.jaad.2020.07.105] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 07/26/2020] [Accepted: 07/28/2020] [Indexed: 12/12/2022]
Abstract
Neurofibromatosis type 1 is the most common neurocutaneous syndrome, with a frequency of 1 in 2500 persons. Diagnosis is paramount in the pretumor stage to provide proper anticipatory guidance for a number of neoplasms, both benign and malignant. Loss-of-function mutations in the NF1 gene result in truncated and nonfunctional production of neurofibromin, a tumor suppressor protein involved in downregulating the RAS signaling pathway. New therapeutic and preventive options include tyrosine kinase inhibitors, mTOR inhibitors, interferons, and radiofrequency therapy. This review summarizes recent updates in genetics, mutation analysis assays, and treatment options targeting aberrant genetic pathways. We also propose modified diagnostic criteria and provide an algorithm for surveillance of patients with neurofibromatosis type 1.
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21
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Walsh KS, del Castillo A, Kennedy T, Karim AI, Semerjian C. A Review of Psychological, Social, and Behavioral Functions in the RASopathies. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2020. [DOI: 10.1007/s40817-020-00088-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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22
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Baudou E, Nemmi F, Biotteau M, Maziero S, Peran P, Chaix Y. Can the Cognitive Phenotype in Neurofibromatosis Type 1 (NF1) Be Explained by Neuroimaging? A Review. Front Neurol 2020; 10:1373. [PMID: 31993017 PMCID: PMC6971173 DOI: 10.3389/fneur.2019.01373] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 12/11/2019] [Indexed: 12/29/2022] Open
Abstract
Neurofibromatosis type 1 (NF1) is one of the most frequent monogenetic disorders. It can be associated with cognitive dysfunctions in several domains such as executive functioning, language, visual perception, motor skills, social skills, memory and/or attention. Neuroimaging is becoming more and more important for a clearer understanding of the neural basis of these deficits. In recent years, several studies have used different imaging techniques to examine structural, morphological and functional alterations in NF1 disease. They have shown that NF1 patients have specific brain characteristics such as Unidentified Bright Objects (UBOs), macrocephaly, a higher volume of subcortical structures, microstructure integrity alterations, or connectivity alterations. In this review, which focuses on the studies published after the last 2 reviews of this topic (in 2010 and 2011), we report on recent structural, morphological and functional neuroimaging studies in NF1 subjects, with special focus on those that examine the neural basis of the NF1 cognitive phenotype. Although UBOs are one of the most obvious and visible elements in brain imaging, correlation studies have failed to establish a robust and reproducible link between major cognitive deficits in NF1 and their presence, number or localization. In the same vein, the results among structural studies are not consistent. Functional magnetic resonance imaging (fMRI) studies appear to be more sensitive, especially for understanding the executive function deficit that seems to be associated with a dysfunction in the right inferior frontal areas and the middle frontal areas. Similarly, fMRI studies have found that visuospatial deficits could be associated with a dysfunction in the visual cortex and especially in the magnocellular pathway involved in the processing of low spatial frequency and high temporal frequency. Connectivity studies have shown a reduction in anterior-posterior “long-range” connectivity and a deficit in deactivation in default mode network (DMN) during cognitive tasks. In conclusion, despite the contribution of new imaging techniques and despite relative advancement, the cognitive phenotype of NF1 patients is not totally understood.
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Affiliation(s)
- Eloïse Baudou
- Children's Hospital, Purpan University Hospital, Toulouse, France.,ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France
| | - Federico Nemmi
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France
| | - Maëlle Biotteau
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France
| | - Stéphanie Maziero
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France.,Octogone-Lordat, University of Toulouse, Toulouse, France
| | - Patrice Peran
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France
| | - Yves Chaix
- Children's Hospital, Purpan University Hospital, Toulouse, France.,ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France
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23
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Nemmi F, Cignetti F, Assaiante C, Maziero S, Audic F, Péran P, Chaix Y. Discriminating between neurofibromatosis-1 and typically developing children by means of multimodal MRI and multivariate analyses. Hum Brain Mapp 2019; 40:3508-3521. [PMID: 31077476 DOI: 10.1002/hbm.24612] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 04/08/2019] [Accepted: 04/17/2019] [Indexed: 11/08/2022] Open
Abstract
Neurofibromatosis Type 1 leads to brain anomalies involving both gray and white matter. The extent and granularity of these anomalies, together with their possible impact on brain activity, is still unknown. In this multicentric cross-sectional study we submitted a sample of 42 typically developing and 38 neurofibromatosis-1 children to a multimodal MRI assessment including T1, diffusion weighted and resting state functional sequences. We used a pipeline involving several features selection steps coupled with multivariate statistical analysis (supporting vector machine) to discriminate between the two groups while having interpretable models. We used MRI indexes measuring macro (gray matter volume) and microstructural (fractional anisotropy, mean diffusivity) characteristics of the brain, as well as indexes of brain activity (fractional amplitude of low frequency fluctuations) and connectivity (local and global correlation) at rest. We found that structural indexes could discriminate between the two groups, with the mean diffusivity leading to performance as high as the combination of all structural indexes combined (accuracy = 0.86), while functional indexes had worse performances. The MRI signature of NF1 brain pathology is a combination of gray and white matter abnormalities, as measured with gray matter volume, fractional anisotropy, and mean diffusivity.
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Affiliation(s)
- Federico Nemmi
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Fabien Cignetti
- CNRS, LNC, Aix Marseille Université, Marseille, France.,CNRS, Fédération 3C, Aix Marseille Université, Marseille, France.,CNRS, TIMC-IMAG, Université Grenoble Alpes, Grenoble, France
| | - Christine Assaiante
- CNRS, LNC, Aix Marseille Université, Marseille, France.,CNRS, Fédération 3C, Aix Marseille Université, Marseille, France
| | - Stephanie Maziero
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France.,URI Octogone-Lordat (EA 4156), Université de Toulouse, Toulouse, France
| | - Fredrique Audic
- Service de Neurologie Pédiatrique, CHU Timone-Enfants, Marseille, France
| | - Patrice Péran
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Yves Chaix
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
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24
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Measurement considerations in pediatric research on autism spectrum disorders. PROGRESS IN BRAIN RESEARCH 2018. [PMID: 30447755 DOI: 10.1016/bs.pbr.2018.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register]
Abstract
Studying Autism Spectrum Disorders (ASD) in genetic syndromes has gained interest in the scientific community as a way to elucidate mechanisms and symptom profiles to understand ASD more broadly. Appropriate and adequate measurement of constructs, symptomatology, and outcomes in clinical research is of vital importance in establishing the prevalence of such symptoms and measuring change in symptoms in the context of clinical trials. As such, we provide an overview of the prevalence of ASD, present current diagnostic guidelines, discuss important comorbidities to consider, describe current assessment strategies in assessing ASD, and discuss these within the context of a specific genetic condition to highlight how ASD can be best evaluated.
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25
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Systematic Review and Meta-analysis of Executive Functions in Preschool and School-Age Children With Neurofibromatosis Type 1. J Int Neuropsychol Soc 2018; 24:977-994. [PMID: 30375317 DOI: 10.1017/s1355617718000383] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Neurofibromatosis type 1 (NF1) is a genetic disorder in which the most frequent complication in children is learning disabilities. Over the past decade, growing arguments support the idea that executive dysfunction is a core deficit in children with NF1. However, some data remain inconsistent. The aim of this study was to determine the magnitude of impairment for each executive function (EF) and clarify the impact of methodological choices and participant's characteristics on EFs. METHODS In this meta-analysis, 19 studies met the selection criteria and were included with data from a total of 805 children with NF1 and 667 controls. Based on the Diamond's model (2013), EF measures were coded separately according to the following EF components: working memory, inhibitory control, cognitive flexibility, planning/problem solving. The review protocol was registered with PROSPERO (International prospective register of systematic reviews; CRD42017068808). RESULTS A significant executive dysfunction in children with NF1 is demonstrated. Subgroup analysis showed that the impairment varied as a function of the specific component of executive functioning. The effect size for working memory and planning/problem solving was moderate whereas it was small for inhibitory control and cognitive flexibility. Executive dysfunction seems to be greater with increasing age whereas assessment tool type, intellectual performance, attention deficit hyperactivity disorder and control group composition did not seem to affect EF results. CONCLUSIONS EF deficits are a core feature in children with NF1 and an early identification of executive dysfunctions is essential to limit their impact on the quality of life. (JINS, 2018, 24, 977-994).
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26
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Schütze M, de Souza Costa D, de Paula JJ, Malloy-Diniz LF, Malamut C, Mamede M, de Miranda DM, Brammer M, Romano-Silva MA. Use of machine learning to predict cognitive performance based on brain metabolism in Neurofibromatosis type 1. PLoS One 2018; 13:e0203520. [PMID: 30192842 PMCID: PMC6128556 DOI: 10.1371/journal.pone.0203520] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 08/22/2018] [Indexed: 12/12/2022] Open
Abstract
Neurofibromatosis Type 1 (NF1) can cause a wide range of cognitive deficits, but its underlying nature is still unknown. We investigated the correlation between cognitive performance and specific patterns of resting-state brain metabolism in a NF1 sample. Sixteen individuals diagnosed with NF1 underwent 18F-FDG PET/CT brain imaging followed by a neuropsychological assessment. Principal component analysis was performed on 17 measures of cognitive function and a machine learning approach based on Gaussian Process Regression was used to individually predict the components that represented most of the variance in the neuropsychological data. The accuracy of the method was estimated using leave-one-out cross-validation and its significance through permutation testing. We found that only the first component could be accurately predicted from resting state metabolism (r = 0.926, p<0.001). Multiple and heterogeneous measures contribute to the first component, mainly WISC/WAIS Procedure and Verbal IQ, verbal memory and fluency. Considering the accurate prediction of measures of neuropsychological performance based on brain metabolism in NF1 patients, this suggests an underlying metabolic pattern that relates to cognitive performance in this group.
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Affiliation(s)
- Manuel Schütze
- Instituto Nacional de Ciência e Tecnologia de Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- * E-mail:
| | - Danielle de Souza Costa
- Instituto Nacional de Ciência e Tecnologia de Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Jonas Jardim de Paula
- Instituto Nacional de Ciência e Tecnologia de Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Leandro Fernandes Malloy-Diniz
- Instituto Nacional de Ciência e Tecnologia de Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Carlos Malamut
- Instituto Nacional de Ciência e Tecnologia de Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Centro de Desenvolvimento da Tecnologia Nuclear, Comissão Nacional de Energia Nuclear, Belo Horizonte, Brazil
| | - Marcelo Mamede
- Instituto Nacional de Ciência e Tecnologia de Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Departamento de Anatomia e Imagem, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Débora Marques de Miranda
- Instituto Nacional de Ciência e Tecnologia de Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Departamento de Pediatria, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Michael Brammer
- Instituto Nacional de Ciência e Tecnologia de Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Department of Neuroimaging, Institute of Psychiatry, London, United Kingdom
| | - Marco Aurélio Romano-Silva
- Instituto Nacional de Ciência e Tecnologia de Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Departamento de Saúde Mental, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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27
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Barkovich MJ, Tan CH, Nillo RM, Li Y, Xu D, Glastonbury CM, Glenn OA, Dillon WP, Hess CP, Mueller S, Kline C, Dale AM, Jernigan TL, Sugrue LP, Barkovich AJ, Desikan RS. Abnormal Morphology of Select Cortical and Subcortical Regions in Neurofibromatosis Type 1. Radiology 2018; 289:499-508. [PMID: 30179114 DOI: 10.1148/radiol.2018172863] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To evaluate whether patients with neurofibromatosis type 1 (NF1)-a multisystem neurodevelopmental disorder with myriad imaging manifestations, including focal transient myelin vacuolization within the deep gray nuclei, brainstem, and cerebellum-exhibit differences in cortical and subcortical structures, particularly in subcortical regions where these abnormalities manifest. Materials and Methods In this retrospective study, by using clinically obtained three-dimensional T1-weighted MR images and established image analysis methods, 10 intracranial volume-corrected subcortical and 34 cortical regions of interest (ROIs) were quantitatively assessed in 32 patients with NF1 and 245 age- and sex-matched healthy control subjects. By using linear models, ROI cortical thicknesses and volumes were compared between patients with NF1 and control subjects, as a function of age. With hierarchic cluster analysis and partial correlations, differences in the pattern of association between cortical and subcortical ROI volumes in patients with NF1 and control subjects were also evaluated. Results Patients with NF1 exhibited larger subcortical volumes and thicker cortices of select regions, particularly the hippocampi, amygdalae, cerebellar white matter, ventral diencephalon, thalami, and occipital cortices. For the thalami and pallida and 22 cortical ROIs in patients with NF1, a significant inverse association between volume and age was found, suggesting that volumes decrease with increasing age. Moreover, compared with those in control subjects, ROIs in patients with NF1 exhibited a distinct pattern of clustering and partial correlations. Discussion Neurofibromatosis type 1 is characterized by larger subcortical volumes and thicker cortices of select structures. Most apparent within the hippocampi, amygdalae, cerebellar white matter, ventral diencephalon, thalami and occipital cortices, these neurofibromatosis type 1-associated volumetric changes may, in part, be age dependent. © RSNA, 2018 Online supplemental material is available for this article.
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Affiliation(s)
- Matthew J Barkovich
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Chin Hong Tan
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Ryan M Nillo
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Yi Li
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Duan Xu
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Christine M Glastonbury
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Orit A Glenn
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - William P Dillon
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Christopher P Hess
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Sabine Mueller
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Cassie Kline
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Anders M Dale
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Terry L Jernigan
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Leo P Sugrue
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - A James Barkovich
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Rahul S Desikan
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
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Social Function and Autism Spectrum Disorder in Children and Adults with Neurofibromatosis Type 1: a Systematic Review and Meta-Analysis. Neuropsychol Rev 2018; 28:317-340. [DOI: 10.1007/s11065-018-9380-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 07/10/2018] [Indexed: 12/27/2022]
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Koini M, Rombouts SARB, Veer IM, Van Buchem MA, Huijbregts SCJ. White matter microstructure of patients with neurofibromatosis type 1 and its relation to inhibitory control. Brain Imaging Behav 2017; 11:1731-1740. [PMID: 27796732 PMCID: PMC5707233 DOI: 10.1007/s11682-016-9641-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Neurofibromatosis Type 1 (NF1) is commonly associated with deficits in executive functions such as working memory and inhibitory control. A valid biomarker to describe the pathological basis of these deficits in NF1 is not available. The aim of this study was to investigate whether any abnormalities in white matter integrity of the executive function related anterior thalamic radiation (ATR), cingulate bundle (CB), and superior longitudinal fasciculus (SLF) may be regarded as a pathological basis for inhibitory control deficits in adolescents with NF1. Sixteen NF1 patients and 32 healthy controls underwent 3 T DTI MRI scanning. Whole brain-, ATR-, CB-, and SLF-white matter integrity were studied using fractional anisotropy, mean (MD), radial, and axial (DA) diffusivity. Correlation analyses between white matter metrics and inhibitory control (as measured with a computerized task) were performed. Also, verbal and performance abilities (IQ-estimates) were assessed and correlated with white matter metrics. Patients showed significant whole brain- and local microstructural pathology when compared to healthy controls in all measures. In NF1-patients, whole-brain (MD: r = .646 and DA: r = .673) and ATR- (r-range: -.405-.771), but not the CB- (r-range: -.307-.472) and SLF- (r-range: -.187-.406) white matter integrity, were correlated with inhibitory control. Verbal and performance abilities were not associated with white matter pathology. In NF1, white matter abnormalities are observed throughout the brain, but damage to the ATR seems specifically, or at least most strongly related to inhibitory control. Future studies should examine whether reduced white matter integrity in other brain regions or tracts is (more strongly) associated with different aspects of the cognitive-behavioral phenotype associated with NF1.
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Affiliation(s)
- M Koini
- Institute of Psychology, Leiden University, Leiden, The Netherlands.
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands.
- Department of Neurology, Medical University of Graz, Auenbruggerplatz 22, A-8036, Graz, Austria.
| | - S A R B Rombouts
- Institute of Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - I M Veer
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands
- Department of Psychiatry and Psychotherapy, Division of Mind and Brain Research, Charité Universitaetsmedizin Berlin, Berlin, Germany
| | - M A Van Buchem
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - S C J Huijbregts
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands
- Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, The Netherlands
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30
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Green T, Naylor PE, Davies W. Attention deficit hyperactivity disorder (ADHD) in phenotypically similar neurogenetic conditions: Turner syndrome and the RASopathies. J Neurodev Disord 2017; 9:25. [PMID: 28694877 PMCID: PMC5502326 DOI: 10.1186/s11689-017-9205-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 05/18/2017] [Indexed: 11/17/2022] Open
Abstract
Background ADHD (attention deficit hyperactivity disorder) is a common neurodevelopmental disorder. There has been extensive clinical and basic research in the field of ADHD over the past 20 years, but the mechanisms underlying ADHD risk are multifactorial, complex and heterogeneous and, as yet, are poorly defined. In this review, we argue that one approach to address this challenge is to study well-defined disorders to provide insights into potential biological pathways that may be involved in idiopathic ADHD. Main body To address this premise, we selected two neurogenetic conditions that are associated with significantly increased ADHD risk: Turner syndrome and the RASopathies (of which Noonan syndrome and neurofibromatosis type 1 are the best-defined with regard to ADHD-related phenotypes). These syndromes were chosen for two main reasons: first, because intellectual functioning is relatively preserved, and second, because they are strikingly phenotypically similar but are etiologically distinct. We review the cognitive, behavioural, neural and cellular phenotypes associated with these conditions and examine their relevance as a model for idiopathic ADHD. Conclusion We conclude by discussing current and future opportunities in the clinical and basic research of these conditions, which, in turn, may shed light upon the biological pathways underlying idiopathic ADHD.
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Affiliation(s)
- Tamar Green
- Center for Interdisciplinary Brain Sciences Research, Stanford University School of Medicine, Stanford, USA
| | - Paige E Naylor
- Department of Clinical Psychology, Palo Alto University, Palo Alto, CA USA
| | - William Davies
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics and Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK.,School of Psychology, Cardiff University, Tower Building, 70, Park Place, Cardiff, CF10 3AT UK.,Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
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31
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Magdalon J, Sánchez-Sánchez SM, Griesi-Oliveira K, Sertié AL. Dysfunctional mTORC1 Signaling: A Convergent Mechanism between Syndromic and Nonsyndromic Forms of Autism Spectrum Disorder? Int J Mol Sci 2017; 18:ijms18030659. [PMID: 28335463 PMCID: PMC5372671 DOI: 10.3390/ijms18030659] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 03/13/2017] [Accepted: 03/14/2017] [Indexed: 12/28/2022] Open
Abstract
Whereas autism spectrum disorder (ASD) exhibits striking heterogeneity in genetics and clinical presentation, dysfunction of mechanistic target of rapamycin complex 1 (mTORC1) signaling pathway has been identified as a molecular feature common to several well-characterized syndromes with high prevalence of ASD. Additionally, recent findings have also implicated mTORC1 signaling abnormalities in a subset of nonsyndromic ASD, suggesting that defective mTORC1 pathway may be a potential converging mechanism in ASD pathology across different etiologies. However, the mechanistic evidence for a causal link between aberrant mTORC1 pathway activity and ASD neurobehavioral features varies depending on the ASD form involved. In this review, we first discuss six monogenic ASD-related syndromes, including both classical and potentially novel mTORopathies, highlighting their contribution to our understanding of the neurobiological mechanisms underlying ASD, and then we discuss existing evidence suggesting that aberrant mTORC1 signaling may also play a role in nonsyndromic ASD.
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Affiliation(s)
- Juliana Magdalon
- Hospital Israelita Albert Einstein, Centro de Pesquisa Experimental, São Paulo 05652-900, Brazil.
| | - Sandra M Sánchez-Sánchez
- Hospital Israelita Albert Einstein, Centro de Pesquisa Experimental, São Paulo 05652-900, Brazil.
- Departamento de Genética e Biologia Evolutiva, Instituto de Biociências, Universidade de São Paulo, São Paulo 05508-090, Brazil.
| | - Karina Griesi-Oliveira
- Hospital Israelita Albert Einstein, Centro de Pesquisa Experimental, São Paulo 05652-900, Brazil.
| | - Andréa L Sertié
- Hospital Israelita Albert Einstein, Centro de Pesquisa Experimental, São Paulo 05652-900, Brazil.
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32
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Torres Nupan MM, Velez Van Meerbeke A, López Cabra CA, Herrera Gomez PM. Cognitive and Behavioral Disorders in Children with Neurofibromatosis Type 1. Front Pediatr 2017; 5:227. [PMID: 29164079 PMCID: PMC5670111 DOI: 10.3389/fped.2017.00227] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/05/2017] [Indexed: 11/13/2022] Open
Abstract
AIM The last systematic review of research on the behavior of children with neurofibromatosis type 1 (NF1) was in 2012. Since then, several important findings have been published. Therefore, the study aim was to synthesize recent relevant work related to this issue. METHOD We conducted a systematic review of the literature. Relevant articles were identified using the electronic databases PubMed, PsycINFO, and Scopus and a manual search of references lists. Thirty of 156 articles identified met the inclusion criteria. A quality evaluation of the articles was performed and the information was synthesized using a narrative approach. RESULTS Compared with controls, children and adolescents with NF1 present significant alterations in language, reading, visuospatial skills, motor function, executive function, attention, behavior, emotion, and social skills. The prevalence of attention-deficit/hyperactivity disorder (ADHD) is important and can affect cognition and executive function variables. A high prevalence of autistic traits and autistic spectrum disorder were reported. The benefits of using statins to treat cognitive deficits are unclear. However, children with NF1 and ADHD seem to benefit from methylphenidate treatment. The presence of hyperintensities in brain magnetic resonance imaging data seem to be related to poor cognitive performance. Analysis of these lesions could help to predict cognitive alterations in children with NF1. INTERPRETATION There has been important progress to evaluate cognitive characteristics of children with NF1 and to determine the physiological mechanisms of the concomitant disorders. However, discrepancies in relation to intelligence, learning disabilities, attention deficits, and treatment remain. Further investigations on this topic are recommended.
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Affiliation(s)
- Martha Milade Torres Nupan
- Neurosciences Research Group, Medicine and Health Sciences School, Universidad del Rosario, Bogota, Colombia
| | - Alberto Velez Van Meerbeke
- Neurosciences Research Group, Medicine and Health Sciences School, Universidad del Rosario, Bogota, Colombia
| | | | - Paula Marcela Herrera Gomez
- Neurosciences Research Group, Medicine and Health Sciences School, Universidad del Rosario, Bogota, Colombia
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33
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Morris SM, Monroe CL, Gutmann DH. Macrocephaly Is Not a Predictor of Optic Pathway Glioma Development or Treatment in Neurofibromatosis Type 1. J Child Neurol 2016; 31:1540-1545. [PMID: 27581847 DOI: 10.1177/0883073816664659] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 07/08/2016] [Accepted: 07/22/2016] [Indexed: 12/26/2022]
Abstract
Neurofibromatosis type 1 is a common neurogenetic disorder characterized by significant clinical variability. As such, numerous studies have focused on identifying clinical, radiographic, or molecular biomarkers that predict the occurrence or progression of specific clinical features in individuals with neurofibromatosis type 1. One of these clinical biomarkers, macrocephaly, has been proposed as a prognostic factor for optic pathway glioma development. In the current study, the authors demonstrate that macrocephaly is not associated with the development of these brain tumors or the need to institute treatment for clinical progression. These findings suggest that macrocephaly is not a robust biomarker of optic pathway glioma formation or progression in children with neurofibromatosis type 1.
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Affiliation(s)
- Stephanie M Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Courtney L Monroe
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - David H Gutmann
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
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34
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Ornoy A, Weinstein-Fudim L, Ergaz Z. Genetic Syndromes, Maternal Diseases and Antenatal Factors Associated with Autism Spectrum Disorders (ASD). Front Neurosci 2016; 10:316. [PMID: 27458336 PMCID: PMC4933715 DOI: 10.3389/fnins.2016.00316] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 06/22/2016] [Indexed: 01/29/2023] Open
Abstract
Autism spectrum disorder (ASD) affecting about 1% of all children is associated, in addition to complex genetic factors, with a variety of prenatal, perinatal, and postnatal etiologies. In addition, ASD is often an important clinical presentation of some well-known genetic syndromes in human. We discuss these syndromes as well as the role of the more important prenatal factors affecting the fetus throughout pregnancy which may also be associated with ASD. Among the genetic disorders we find Fragile X, Rett syndrome, tuberous sclerosis, Timothy syndrome, Phelan-McDermid syndrome, Hamartoma tumor syndrome, Prader-Willi and Angelman syndromes, and a few others. Among the maternal diseases in pregnancy associated with ASD are diabetes mellitus (PGDM and/or GDM), some maternal autoimmune diseases like antiphospholipid syndrome (APLS) with anti-β2GP1 IgG antibodies and thyroid disease with anti-thyroid peroxidase (TPO) antibodies, preeclampsia and some other autoimmune diseases with IgG antibodies that might affect fetal brain development. Other related factors are maternal infections (rubella and CMV with fetal brain injuries, and possibly Influenza with fever), prolonged fever and maternal inflammation, especially with changes in a variety of inflammatory cytokines and antibodies that cross the placenta and affect the fetal brain. Among the drugs are valproic acid, thalidomide, misoprostol, and possibly SSRIs. β2-adrenergic receptor agonists and paracetamol have also lately been associated with increased rate of ASD but the data is too preliminary and inconclusive. Associations were also described with ethanol, cocaine, and possibly heavy metals, heavy smoking, and folic acid deficiency. Recent studies show that heavy exposure to pesticides and air pollution, especially particulate matter < 2.5 and 10 μm in diameter (PM2.5 and PM10) during pregnancy is also associated with ASD. Finally, we have to remember that many of the associations mentioned in this review are only partially proven, and not all are "clean" of different confounding factors. The associations described in this review emphasize again how little we know about the etiology and pathogenesis of ASD. It is obvious that we need more epidemiologic data to establish many of these associations, but if proven, they might be promising avenues for prevention.
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Affiliation(s)
- Asher Ornoy
- Laboratory of Teratology, Department of Medical Neurobiology, Hadassah Medical School, Hebrew University Jerusalem, Israel
| | - Liza Weinstein-Fudim
- Laboratory of Teratology, Department of Medical Neurobiology, Hadassah Medical School, Hebrew University Jerusalem, Israel
| | - Zivanit Ergaz
- Laboratory of Teratology, Department of Medical Neurobiology, Hadassah Medical School, Hebrew UniversityJerusalem, Israel; Department of Neonatology, Hadassah-Hebrew University Medical CenterJerusalem, Israel
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