1
|
Marathu KK, Vahedifard F, Kocak M, Liu X, Adepoju JO, Bowker RM, Supanich M, Cosme-Cruz RM, Byrd S. Fetal MRI Analysis of Corpus Callosal Abnormalities: Classification, and Associated Anomalies. Diagnostics (Basel) 2024; 14:430. [PMID: 38396468 PMCID: PMC10887608 DOI: 10.3390/diagnostics14040430] [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: 01/08/2024] [Revised: 02/09/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Corpus callosal abnormalities (CCA) are midline developmental brain malformations and are usually associated with a wide spectrum of other neurological and non-neurological abnormalities. The study aims to highlight the diagnostic role of fetal MRI to characterize heterogeneous corpus callosal abnormalities using the latest classification system. It also helps to identify associated anomalies, which have prognostic implications for the postnatal outcome. METHODS In this study, retrospective data from antenatal women who underwent fetal MRI between January 2014 and July 2023 at Rush University Medical Center were evaluated for CCA and classified based on structural morphology. Patients were further assessed for associated neurological and non-neurological anomalies. RESULTS The most frequent class of CCA was complete agenesis (79.1%), followed by hypoplasia (12.5%), dysplasia (4.2%), and hypoplasia with dysplasia (4.2%). Among them, 17% had isolated CCA, while the majority (83%) had complex forms of CCA associated with other CNS and non-CNS anomalies. Out of the complex CCA cases, 58% were associated with other CNS anomalies, while 8% were associated with non-CNS anomalies. 17% of cases had both. CONCLUSION The use of fetal MRI is valuable in the classification of abnormalities of the corpus callosum after the confirmation of a suspected diagnosis on prenatal ultrasound. This technique is an invaluable method for distinguishing between isolated and complex forms of CCA, especially in cases of apparent isolated CCA. The use of diffusion-weighted imaging or diffusion tensor imaging in fetal neuroimaging is expected to provide further insights into white matter abnormalities in fetuses diagnosed with CCA in the future.
Collapse
Affiliation(s)
- Kranthi K. Marathu
- Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Chicago, IL 60612, USA; (F.V.); (M.K.); (X.L.); (J.O.A.); (S.B.)
| | - Farzan Vahedifard
- Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Chicago, IL 60612, USA; (F.V.); (M.K.); (X.L.); (J.O.A.); (S.B.)
| | - Mehmet Kocak
- Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Chicago, IL 60612, USA; (F.V.); (M.K.); (X.L.); (J.O.A.); (S.B.)
| | - Xuchu Liu
- Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Chicago, IL 60612, USA; (F.V.); (M.K.); (X.L.); (J.O.A.); (S.B.)
| | - Jubril O. Adepoju
- Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Chicago, IL 60612, USA; (F.V.); (M.K.); (X.L.); (J.O.A.); (S.B.)
| | - Rakhee M. Bowker
- Department of Pediatrics, Division of Neonatology, Rush Medical College, Chicago, IL 60612, USA;
| | - Mark Supanich
- Department of Radiology and Nuclear Medicine, Division for Diagnostic Medical Physics, Rush University Medical Center, Chicago, IL 60612, USA;
| | - Rosario M. Cosme-Cruz
- Department of Psychiatry and Behavioral Sciences, Rush Medical College, Chicago, IL 60612, USA;
| | - Sharon Byrd
- Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Chicago, IL 60612, USA; (F.V.); (M.K.); (X.L.); (J.O.A.); (S.B.)
| |
Collapse
|
2
|
Lubinsky M, Encha-Razavi F. Delineating septo-optic dysplasia. Birth Defects Res 2022; 114:1343-1353. [PMID: 36200678 DOI: 10.1002/bdr2.2095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/05/2022] [Accepted: 09/08/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Septo-optic dysplasia (SOD), once a variable triad of septum pellucidum defects (SPDs), optic nerve hypoplasia (ONH), and hypopituitarism, has had multiple findings added, with uncertain causes, definitions, and limits. METHOD Literature review. RESULTS SOD is a complex vascular sequence with confounders. CONCLUSIONS Proximal anterior cerebral artery trunk disruptions cause overlapping primary effects, giving ONH alone most often, and isolated SPD less. ONH disruptions can spread to pituitary, SPD disruptions to the cerebral cortex, causing schizencephaly and related anomalies. Pituitary defects are rare without ONH, and cortical findings are rare without SPD. Extensions are unidirectional, so isolated pituitary or cortical defects are separate from SOD. Micro- an- ophthalmia, a suggested ONH variant, is not part of SOD. Disruption by-products can affect development, causing cognitive and endocrine issues, and structural anomalies such as corpus callosum thinning, ventriculomegaly, and hippocampal and olfactory findings. Limbic extensions may also contribute to the same structural defects as by-products. Midline CNS developmental anomalies can act as disruptive foci, most likely through vascular variants, but have separate pathogenesis. Relative frequencies of specific pituitary hormone defects change as SOD rates increase. Increasing relative rates of midline CNS developmental defects and cortical anomalies are consistent with rising levels of exogenous exposures sensitizing to midline predispositions.
Collapse
|
3
|
Corpus Callosum Agenesis: An Insight into the Etiology and Spectrum of Symptoms. Brain Sci 2020; 10:brainsci10090625. [PMID: 32916978 PMCID: PMC7565833 DOI: 10.3390/brainsci10090625] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/06/2020] [Accepted: 09/07/2020] [Indexed: 12/22/2022] Open
Abstract
Brain hemispheres are connected by commissural structures, which consist of white matter fiber tracts that spread excitatory stimuli to various regions of the cortex. This allows an interaction between the two cerebral halves. The largest commissure is the corpus callosum (CC) which is located inferior to the longitudinal fissure, serving as its lower border. Sometimes this structure is not completely developed, which results in the condition known as agenesis of the corpus callosum (ACC). The aim of this paper was to review the latest discoveries related to the genetic and metabolic background of ACC, including the genotype/phenotype correlations as well as the clinical and imaging symptomatology. Due to various factors, including genetic defects and metabolic diseases, the development of CC may be impaired in many ways, which results in complete or partial ACC. This creates several clinical implications, depending on the specificity of the malformation and other defects in patients. Epilepsy, motor impairment and intellectual disability are the most prevalent. However, an asymptomatic course of the disease is even more common. ACC presents with characteristic images on ultrasound and magnetic resonance imaging (MRI).
Collapse
|
4
|
Simpson SJ, Ratnappuli A, Porte ME, McGann H, Lacey CJ. Hypothermia - an unusual initial presentation of human immunodeficiency virus infection. Int J STD AIDS 2020; 31:1219-1221. [PMID: 32757714 PMCID: PMC7549277 DOI: 10.1177/0956462420939409] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report an unusual case of human immunodeficiency virus (HIV) infection initially presenting with hypothermia and bradycardia associated with an HIV encephalitis. Searches reveal only five reported cases of spontaneous episodic hypothermia in the context of HIV infection. In our case, magnetic resonance imaging revealed the presence of a persistent cavum septum pellucidum (CSP), an anatomical and functional neuro-developmental abnormality, as well as changes compatible with an HIV encephalitis. Episodic hypothermia can occur in association with agenesis of the corpus callosum, known as Shapiro’s syndrome, and the presence of a persistent CSP in our case suggests it may have contributed to the clinical presentation.
Collapse
Affiliation(s)
- S J Simpson
- Hull York Medical School, University of York, York, UK
| | - A Ratnappuli
- Hull York Medical School, University of York, York, UK
| | - M E Porte
- Radiology, York Teaching Hospital, York, UK
| | - H McGann
- Infectious Diseases, St James University Hospital, Leeds, UK
| | - C J Lacey
- Hull York Medical School, University of York, York, UK
| |
Collapse
|
5
|
Masmejan S, Blaser S, Keunen J, Seaward G, Windrim R, Kelly E, Ryan G, Baud D, Van Mieghem T. Natural History of Ventriculomegaly in Fetal Agenesis of the Corpus Callosum. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:483-488. [PMID: 31502300 DOI: 10.1002/jum.15124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 07/26/2019] [Accepted: 08/04/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To assess the natural evolution of the size of the fetal lateral ventricles throughout pregnancy in fetuses with callosal anomalies. METHODS Cases of fetal callosal anomalies were retrospectively classified as isolated or complex based on the presence of other structural or genetic anomalies. Longitudinal ultrasound studies were reviewed, and postnatal outcomes were retrieved for isolated cases. RESULTS In 135 fetuses, those who first presented after 24 weeks' gestation were more likely to have ventriculomegaly (n = 58 of 68 [85%]) than those who presented before 24 weeks (n = 39 of 67 [58%]; P < .001). In 79 cases that had longitudinal follow-up, the mean increase in ventricular width was 0.6 mm/wk, without a significant difference between isolated and complex cases (mean ± SD, 0.6 ± 1.5 versus 0.6 ± 1.1 mm; P = .45). CONCLUSIONS Callosal anomalies are associated with progressive ventriculomegaly on prenatal ultrasound imaging, without a difference between isolated and complex anomalies. This feature should be considered part of the disease spectrum. The consequence of progressive ventriculomegaly on the long-term neurodevelopmental outcome is still unknown, and further studies should be aimed at obtaining long-term follow-up of these cases.
Collapse
Affiliation(s)
- Sophie Masmejan
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
- Obstetrics Unit, Department of Mother and Child, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Susan Blaser
- Division of Neuroradiology, Department of Diagnostic Imaging, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Johannes Keunen
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Gareth Seaward
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Rory Windrim
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Edmond Kelly
- Department of Pediatrics, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Greg Ryan
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
| | - David Baud
- Obstetrics Unit, Department of Mother and Child, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Tim Van Mieghem
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
6
|
Tarui T, Madan N, Farhat N, Kitano R, Ceren Tanritanir A, Graham G, Gagoski B, Craig A, Rollins CK, Ortinau C, Iyer V, Pienaar R, Bianchi DW, Grant PE, Im K. Disorganized Patterns of Sulcal Position in Fetal Brains with Agenesis of Corpus Callosum. Cereb Cortex 2019; 28:3192-3203. [PMID: 30124828 DOI: 10.1093/cercor/bhx191] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 07/11/2017] [Indexed: 12/22/2022] Open
Abstract
Fetuses with isolated agenesis of the corpus callosum (ACC) are associated with a broad spectrum of neurodevelopmental disability that cannot be specifically predicted in prenatal neuroimaging. We hypothesized that ACC may be associated with aberrant cortical folding. In this study, we determined altered patterning of early primary sulci development in fetuses with isolated ACC using novel quantitative sulcal pattern analysis which measures deviations of regional sulcal features (position, depth, and area) and their intersulcal relationships in 7 fetuses with isolated ACC (27.1 ± 3.8 weeks of gestation, mean ± SD) and 17 typically developing (TD) fetuses (25.7 ± 2.0 weeks) from normal templates. Fetuses with ACC showed significant alterations in absolute sulcal positions and relative intersulcal positional relationship compared to TD fetuses, which were not detected by traditional gyrification index. Our results reveal altered sulcal positional development even in isolated ACC that is present as early as the second trimester and continues throughout the fetal period. It might originate from altered white matter connections and portend functional variances in later life.
Collapse
Affiliation(s)
- Tomo Tarui
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Division of Newborn Medicine, Boston Children's Hospital,Harvard Medical School, Boston, MA, USA.,Mother Infant Research Institute, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA.,Department of Pediatrics, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Neel Madan
- Department of Radiology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Nabgha Farhat
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Division of Newborn Medicine, Boston Children's Hospital,Harvard Medical School, Boston, MA, USA
| | - Rie Kitano
- Mother Infant Research Institute, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Asye Ceren Tanritanir
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Division of Newborn Medicine, Boston Children's Hospital,Harvard Medical School, Boston, MA, USA
| | - George Graham
- Department of Obstetrics and Gynecology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Borjan Gagoski
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Alexa Craig
- Department of Pediatrics, Maine Medical Center, ME, USA
| | - Caitlin K Rollins
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Cynthia Ortinau
- Department of Pediatrics Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Vidya Iyer
- Mother Infant Research Institute, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Rudolph Pienaar
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Diana W Bianchi
- Medical Genetics Branch, National Human Genome Research Institute, Bethesda, MD, USA
| | - P Ellen Grant
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Division of Newborn Medicine, Boston Children's Hospital,Harvard Medical School, Boston, MA, USA.,Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kiho Im
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Division of Newborn Medicine, Boston Children's Hospital,Harvard Medical School, Boston, MA, USA
| |
Collapse
|
7
|
Huras H, Nowak M, Herman-Sucharska I, Radon-Pokracka M, Nocun A, Wiechec M. Screening performance for callosal agenesis in prenatal life. Single center study. Clin Imaging 2017; 46:116-120. [DOI: 10.1016/j.clinimag.2017.07.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 07/12/2017] [Accepted: 07/27/2017] [Indexed: 11/25/2022]
|
8
|
Ingram DG, Churchill SS. Sleep Problems in Children With Agenesis of the Corpus Callosum. Pediatr Neurol 2017; 67:85-90. [PMID: 28089768 DOI: 10.1016/j.pediatrneurol.2016.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/21/2016] [Accepted: 10/01/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND Very little is known about sleep habits in children with agenesis of the corpus callosum (ACC). The purpose of this investigation was to evaluate sleep problems in children with ACC and examine the association with quality of life. METHODS We performed a cross-sectional, anonymous, internet-based survey offered to parents of children with ACC, aged five to 18 years. The Children's Sleep Habits Questionnaire (CSHQ) and pediatric quality of life (PedsQL) were used to assess sleep habits and quality of life, respectively. Associations between the total and all subdomains of CSHQ and PedsQL were tested. RESULTS The final sample included 66 parents of children with ACC. Overall, 78% of the children had clinically significant sleep problems, using a cutoff score of 41 on the CSHQ. Compared with a prior national sample of typically developing children, children with ACC scored significantly higher overall and in all subdomains of the CSHQ. The overall CSHQ and PedsQL were moderately correlated (r = -0.485, P < 0.001), indicating that children with more sleep problems had worse quality of life. In addition, the total CSHQ correlated with all subdomains of the pediatric quality of life, including emotional (r = -0.515, P < 0.01), social (r = -0.394, P < 0.01), physical (r = -0.263, P < 0.01), and school (r = -0.362, P < 0.01). These associations remained statistically significant in multivariable regression models controlling for age and gender. CONCLUSIONS Sleep problems are common and associated with lower quality of life in children with ACC.
Collapse
Affiliation(s)
- David G Ingram
- Division of Pulmonary and Sleep Medicine, Children's Mercy Hospital, Kansas City, Missouri.
| | - Shervin S Churchill
- Department of Family and Child Nursing, University of Washington, Seattle, Washington
| |
Collapse
|
9
|
Margari L, Palumbi R, Campa MG, Operto FF, Buttiglione M, Craig F, Matricardi S, Verrotti A. Clinical manifestations in children and adolescents with corpus callosum abnormalities. J Neurol 2016; 263:1939-45. [PMID: 27383641 DOI: 10.1007/s00415-016-8225-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 06/29/2016] [Accepted: 06/30/2016] [Indexed: 12/16/2022]
Abstract
Corpus callosum abnormality (CCA) outcomes are quite unpredictable and variable, from asymptomatic forms to mild or severe neurodevelopment disorders. The aim of this study was to examine clinical outcomes in CCA patients. The study included 61 children and adolescents in whom brain magnetic resonance imaging (MRI) scans showed CCA, isolated or associated to other central nervous system lesions. All patients underwent anamnesis, physical and neurological examination, routine laboratory tests, electroencephalogram (EEG), and MRI scans. In all participants, the intelligence quotient (IQ) was determined. We divided the participants into two subgroups: the first subgroup included patients with an isolated CCA, and the second subgroup included patients with CCA associated with extra-callosal brain lesions (complex CCA). We found that CCA were associated with elevated frequency to intellectual disability (ID), other neurodevelopment disorders, epilepsy, and isolated EEG anomalies. Mild ID (p = 0.003) was more frequent in the isolated subgroup, while epilepsy (p = 0.036) and pre-perinatal risk factors (p = 0.023) were more frequent in the complex CCA subgroup. Although the role of the CC in the interhemispheric communication is known, neurological and neurodevelopment outcomes of CCA are extremely variable and unpredictable. The presence of extra-callosal brain anomalies is one of the major prognostic factor, and probably, they have an important impact on the clinical outcome.
Collapse
Affiliation(s)
- Lucia Margari
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, Italy.
| | - Roberto Palumbi
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, Italy
| | - Maria Gloria Campa
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, Italy
| | - Francesca Felicia Operto
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, Italy
| | - Maura Buttiglione
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, Italy
| | - Francesco Craig
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, Italy
| | - Sara Matricardi
- Department of Pediatrics, University of Chieti, Chieti, Italy
| | - Alberto Verrotti
- Department of Pediatrics, University of L'Aquila, L'Aquila, Italy
| |
Collapse
|