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Lenge M, Balestrini S, Mei D, Macconi L, Caligiuri ME, Cuccarini V, Aquino D, Mazzi F, d’Incerti L, Darra F, Bernardina BD, Guerrini R. Morphometry and network-based atrophy patterns in SCN1A-related Dravet syndrome. Cereb Cortex 2023; 33:9532-9541. [PMID: 37344172 PMCID: PMC10431750 DOI: 10.1093/cercor/bhad224] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 06/23/2023] Open
Abstract
Mutations of the voltage-gated sodium channel SCN1A gene (MIM#182389) are among the most clinically relevant epilepsy-related genetic mutations and present variable phenotypes, from the milder genetic epilepsy with febrile seizures plus to Dravet syndrome, a severe developmental and epileptic encephalopathy. Qualitative neuroimaging studies have identified malformations of cortical development in some patients and mild atrophic changes, partially confirmed by quantitative studies. Precise correlations between MRI findings and clinical variables have not been addressed. We used morphometric methods and network-based models to detect abnormal brain structural patterns in 34 patients with SCN1A-related epilepsy, including 22 with Dravet syndrome. By measuring the morphometric characteristics of the cortical mantle and volume of subcortical structures, we found bilateral atrophic changes in the hippocampus, amygdala, and the temporo-limbic cortex (P-value < 0.05). By correlating atrophic patterns with brain connectivity profiles, we found the region of the hippocampal formation as the epicenter of the structural changes. We also observed that Dravet syndrome was associated with more severe atrophy patterns with respect to the genetic epilepsy with febrile seizures plus phenotype (r = -0.0613, P-value = 0.03), thus suggesting that both the underlying mutation and seizure severity contribute to determine atrophic changes.
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Affiliation(s)
- Matteo Lenge
- Neuroscience Department, Meyer Children’s Hospital IRCCS, 50139, Florence, Italy
| | - Simona Balestrini
- Neuroscience Department, Meyer Children’s Hospital IRCCS, 50139, Florence, Italy
| | - Davide Mei
- Neuroscience Department, Meyer Children’s Hospital IRCCS, 50139, Florence, Italy
| | - Letizia Macconi
- Neuroradiology Unit, Meyer Children’s Hospital IRCCS, 50139, Florence, Italy
| | - Maria Eugenia Caligiuri
- Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Grecia University, 88100, Catanzaro, Italy
| | - Valeria Cuccarini
- Neuroradiology Unit, Fondazione IRCCS Neurologico Carlo Besta, 20100, Milan, Italy
| | - Domenico Aquino
- Neuroradiology Unit, Fondazione IRCCS Neurologico Carlo Besta, 20100, Milan, Italy
| | - Federica Mazzi
- Neuroradiology Unit, Fondazione IRCCS Neurologico Carlo Besta, 20100, Milan, Italy
| | - Ludovico d’Incerti
- Neuroradiology Unit, Meyer Children’s Hospital IRCCS, 50139, Florence, Italy
| | - Francesca Darra
- Child Neuropsychiatry Unit, Department of Engineering for Innovation Medicine University of Verona, 37100, Verona, Italy
| | - Bernardo Dalla Bernardina
- Child Neuropsychiatry Unit, Department of Engineering for Innovation Medicine University of Verona, 37100, Verona, Italy
- Pediatric Epilepsy Research Center (CREP), Azienda Ospedaliera Universitaria Integrata, 37100, Verona, Italy
| | - Renzo Guerrini
- Neuroscience Department, Meyer Children’s Hospital IRCCS, 50139, Florence, Italy
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