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Fukami-Gartner A, Baburamani AA, Dimitrova R, Patkee PA, Ojinaga-Alfageme O, Bonthrone AF, Cromb D, Uus AU, Counsell SJ, Hajnal JV, O’Muircheartaigh J, Rutherford MA. Comprehensive volumetric phenotyping of the neonatal brain in Down syndrome. Cereb Cortex 2023; 33:8921-8941. [PMID: 37254801 PMCID: PMC10350827 DOI: 10.1093/cercor/bhad171] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/28/2023] [Accepted: 04/29/2023] [Indexed: 06/01/2023] Open
Abstract
Down syndrome (DS) is the most common genetic cause of intellectual disability with a wide range of neurodevelopmental outcomes. To date, there have been very few in vivo neuroimaging studies of the neonatal brain in DS. In this study we used a cross-sectional sample of 493 preterm- to term-born control neonates from the developing Human Connectome Project to perform normative modeling of regional brain tissue volumes from 32 to 46 weeks postmenstrual age, accounting for sex and age variables. Deviation from the normative mean was quantified in 25 neonates with DS with postnatally confirmed karyotypes from the Early Brain Imaging in DS study. Here, we provide the first comprehensive volumetric phenotyping of the neonatal brain in DS, which is characterized by significantly reduced whole brain, cerebral white matter, and cerebellar volumes; reduced relative frontal and occipital lobar volumes, in contrast with enlarged relative temporal and parietal lobar volumes; enlarged relative deep gray matter volume (particularly the lentiform nuclei); and enlargement of the lateral ventricles, amongst other features. In future, the ability to assess phenotypic severity at the neonatal stage may help guide early interventions and, ultimately, help improve neurodevelopmental outcomes in children with DS.
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Affiliation(s)
- Abi Fukami-Gartner
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, St. Thomas’ Hospital, London SE1 7EH, United Kingdom
- MRC Centre for Neurodevelopmental Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE1 1UL, United Kingdom
| | - Ana A Baburamani
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, St. Thomas’ Hospital, London SE1 7EH, United Kingdom
| | - Ralica Dimitrova
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, St. Thomas’ Hospital, London SE1 7EH, United Kingdom
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, United Kingdom
| | - Prachi A Patkee
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, St. Thomas’ Hospital, London SE1 7EH, United Kingdom
| | - Olatz Ojinaga-Alfageme
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, St. Thomas’ Hospital, London SE1 7EH, United Kingdom
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London WC1E 7HX, United Kingdom
| | - Alexandra F Bonthrone
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, St. Thomas’ Hospital, London SE1 7EH, United Kingdom
| | - Daniel Cromb
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, St. Thomas’ Hospital, London SE1 7EH, United Kingdom
| | - Alena U Uus
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, St. Thomas’ Hospital, London SE1 7EH, United Kingdom
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, United Kingdom
| | - Serena J Counsell
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, St. Thomas’ Hospital, London SE1 7EH, United Kingdom
| | - Joseph V Hajnal
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, St. Thomas’ Hospital, London SE1 7EH, United Kingdom
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, United Kingdom
| | - Jonathan O’Muircheartaigh
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, St. Thomas’ Hospital, London SE1 7EH, United Kingdom
- MRC Centre for Neurodevelopmental Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE1 1UL, United Kingdom
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, United Kingdom
| | - Mary A Rutherford
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, St. Thomas’ Hospital, London SE1 7EH, United Kingdom
- MRC Centre for Neurodevelopmental Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE1 1UL, United Kingdom
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Abstract
Hydrocephalus, the abnormal accumulation and impaired circulation/clearance of cerebrospinal fluid, occurs as a common phenotypic feature of a diverse group of genetic syndromes. In this review, we outline the genetic mutations, pathogenesis, and accompanying symptoms underlying syndromic hydrocephalus in the context of: L1 syndrome, syndromic craniosynostoses, achondroplasia, NF 1/2, Down's syndrome, tuberous sclerosis, Walker-Warburg syndrome, primary ciliary dyskinesia, and osteogenesis imperfecta. Further, we discuss emerging genetic variants associated with syndromic hydrocephalus.
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Affiliation(s)
- Kaamya Varagur
- Department of Neurosurgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Sai Anusha Sanka
- Department of Neurosurgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Jennifer M. Strahle
- Department of Neurosurgery, Washington University School of Medicine, St Louis, Missouri, USA
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Leary OP, Svokos KA, Klinge PM. Reappraisal of Pediatric Normal-Pressure Hydrocephalus. J Clin Med 2021; 10:jcm10092026. [PMID: 34065105 PMCID: PMC8125971 DOI: 10.3390/jcm10092026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 12/13/2022] Open
Abstract
While normal-pressure hydrocephalus (NPH) is most commonly diagnosed in older adulthood, a significant body of literature has accumulated over half a century documenting the clinical phenomenon of an NPH-like syndrome in pediatric patients. As in adult NPH, it is likely that pediatric NPH occurs due to a heterogeneous array of developmental, structural, and neurodegenerative pathologies, ultimately resulting in aberrant cerebrospinal fluid (CSF) flow and distribution within and around the brain. In this review, we aimed to systematically survey the existing clinical evidence supporting the existence of a pediatric form of NPH, dating back to the original recognition of NPH as a clinically significant subtype of communicating hydrocephalus. Leveraging emergent trends from the old and more recent published literature, we then present a modern characterization of pediatric NPH as a disorder firmly within the same disease spectrum as adult NPH, likely with overlapping etiology and pathophysiological mechanisms. Exemplary cases consistent with the diagnosis of pediatric NPH selected from the senior author’s neurosurgical practice are then presented alongside the systematic review to aid in discussion of the typical clinical and radiographic manifestations of pediatric NPH. Common co-morbidities and modern surgical treatment options are also described.
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Affiliation(s)
- Owen P. Leary
- Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA; (O.P.L.); (K.A.S.)
| | - Konstantina A. Svokos
- Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA; (O.P.L.); (K.A.S.)
| | - Petra M. Klinge
- Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA; (O.P.L.); (K.A.S.)
- Rhode Island Hospital, APC Building 6th Floor, 593 Eddy Street, Providence, RI 02903, USA
- Correspondence:
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