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Slavova N, Muenger R, Sanchez-Albisua I, Regényi M, Oesch G, Fluss J, Hackenberg A, Lebon S, Maier O, Datta AN, Bigi S, Grunt S, Steinlin M. Inflammatory Type Focal Cerebral Arteriopathy of the Posterior Circulation in Children: A Comparative Cohort Study. Stroke 2024; 55:1006-1014. [PMID: 38445467 PMCID: PMC10962439 DOI: 10.1161/strokeaha.123.043562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 01/08/2024] [Accepted: 01/18/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Inflammatory type focal cerebral arteriopathy (FCA-i) in the anterior circulation (AC) is well characterized, and the focal cerebral arteriopathy severity score (FCASS) reflects the severity of the disease. We identified cases of FCA-i in the posterior circulation (PC) and adapted the FCASS to describe these cases. METHODS In this comparative cohort study, patients from the Swiss NeuroPaediatric Stroke Registry with ischemic stroke due to FCA-i between January 2000 and December 2018 were analyzed. A comparison between PC and AC cases regarding pediatric National Institutes of Health Stroke Scale score and pediatric stroke outcome measure and FCASS was performed. We estimated infarct size by the modified pediatric Alberta Stroke Program Early Computed Tomography Score in children with AC stroke and the adapted Bernese posterior diffusion-weighted imaging score in the PC. RESULTS Thirty-five children with a median age of 6.3 (interquartile range, 2.7-8.2 [95% CI, 0.9-15.6]; 20 male; 57.1%) years with FCA-i were identified. The total incidence rate was 0.15/100 000/year (95% CI, 0.11-0.21). Six had PC-FCA-i. Time to final FCASS was longer in the PC compared with AC; the evolution of FCASS did not differ. Initial pediatric National Institutes of Health Stroke Scale score was higher in children with FCA-i in the PC with a median of 10.0 (interquartile range, 5.75-21.0) compared with 4.5 (interquartile range, 2.0-8.0) in those with AC-FCA-i. Different from the anterior cases, PC infarct volume did not correlate with higher discharge, maximum, or final FCASS scores (Pearson correlation coefficient [r], 0.25, 0.35, and 0.54). CONCLUSIONS FCA-i also affects the PC. These cases should be included in future investigations into FCA-i. Although it did not correlate with clinical outcomes in our cohort, the modified FCASS may well serve as a marker for the evolution of the arteriopathy in posterior FCA-i.
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Affiliation(s)
- Nedelina Slavova
- Support Center for Advanced Neuroimaging, Institute of Diagnostic and Interventional Neuroradiology (N.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland
- Pediatric Radiology, University of Basel Children’s Hospital and University of Basel, Switzerland (N.S.)
- Department of Neurology, University Hospital Bern (N.S.), University of Bern, Switzerland
| | - Robin Muenger
- Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics (R.M., I.S.-A., M.R., G.O., S.G., M.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Iciar Sanchez-Albisua
- Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics (R.M., I.S.-A., M.R., G.O., S.G., M.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Maria Regényi
- Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics (R.M., I.S.-A., M.R., G.O., S.G., M.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Gabriela Oesch
- Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics (R.M., I.S.-A., M.R., G.O., S.G., M.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Joël Fluss
- Department of Pediatrics, Gynecology and Obstetrics, Pediatric Neurology Unit, University Hospitals of Geneva, Switzerland (J.F.)
| | - Annette Hackenberg
- Department of Pediatric Neurology, University Children’s Hospital, Zürich, Switzerland (A.H.)
| | - Sébastien Lebon
- Pediatric Neurology and Neurorehabilitation Unit, Lausanne University Hospital, Switzerland (S.L.)
| | - Oliver Maier
- Division of Child Neurology, Department of Pediatrics, Children’s Hospital, St. Gallen, Switzerland (O.M.)
| | - Alexandre N. Datta
- Department of Pediatric Neurology and Developmental Medicine, University of Basel Children’s Hospital, Switzerland (A.D.)
| | - Sandra Bigi
- Institute of Social and Preventive Medicine (S.B.), University of Bern, Switzerland
- Division of Pediatric Neurology, Department of Pediatrics, Children’s Hospital Lucerne, Switzerland (S.B.)
| | - Sebastian Grunt
- Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics (R.M., I.S.-A., M.R., G.O., S.G., M.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Maja Steinlin
- Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics (R.M., I.S.-A., M.R., G.O., S.G., M.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland
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Ji H, Payette K, Speckert A, Tuura R, Grehten P, Kottke R, Ochseinbein-Kölble N, Hagmann C, Mazzone L, Meuli M, Padden B, Hackenberg A, Wille DA, Moehrlen U, Latal B, SPINA BIFIDA STUDY GROUP ZURICH, Jakab A. Thalamic connectivity topography in newborns with spina bifida: association with neurological functional level but not developmental outcome at 2 years. Cereb Cortex 2024; 34:bhad438. [PMID: 37991274 PMCID: PMC10793566 DOI: 10.1093/cercor/bhad438] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 07/20/2023] [Revised: 10/11/2023] [Accepted: 10/11/2023] [Indexed: 11/23/2023] Open
Abstract
Spina bifida affects spinal cord and cerebral development, leading to motor and cognitive delay. We investigated whether there are associations between thalamocortical connectivity topography, neurological function, and developmental outcomes in open spina bifida. Diffusion tensor MRI was used to assess thalamocortical connectivity in 44 newborns with open spina bifida who underwent prenatal surgical repair. We quantified the volume of clusters formed based on the strongest probabilistic connectivity to the frontal, parietal, and temporal cortex. Developmental outcomes were assessed using the Bayley III Scales, while the functional level of the lesion was assessed by neurological examination at 2 years of age. Higher functional level was associated with smaller thalamo-parietal, while lower functional level was associated with smaller thalamo-temporal connectivity clusters (Bonferroni-corrected P < 0.05). Lower functional levels were associated with weaker thalamic temporal connectivity, particularly in the ventrolateral and ventral anterior nuclei. No associations were found between thalamocortical connectivity and developmental outcomes. Our findings suggest that altered thalamocortical circuitry development in open spina bifida may contribute to impaired lower extremity function, impacting motor function and independent ambulation. We hypothesize that the neurologic function might not merely be caused by the spinal cord lesion, but further impacted by the disruption of cerebral neuronal circuitry.
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Affiliation(s)
- Hui Ji
- Center for MR Research, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- Neuroscience Center Zurich, University of Zurich, Zurich 8006, Switzerland
- Children’s Research Center, University Children’s Hospital Zurich, Zurich 8032, Switzerland
| | - Kelly Payette
- Center for MR Research, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- Neuroscience Center Zurich, University of Zurich, Zurich 8006, Switzerland
- Children’s Research Center, University Children’s Hospital Zurich, Zurich 8032, Switzerland
| | - Anna Speckert
- Center for MR Research, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- Neuroscience Center Zurich, University of Zurich, Zurich 8006, Switzerland
- Children’s Research Center, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- University Research Priority Program (URPP), Adaptive Brain Circuits in Development and Learning (AdaBD), University of Zurich, Zurich 8006, Switzerland
| | - Ruth Tuura
- Center for MR Research, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- Children’s Research Center, University Children’s Hospital Zurich, Zurich 8032, Switzerland
| | - Patrice Grehten
- Children’s Research Center, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- Department of Diagnostic Imaging, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- Zurich Center for Fetal Diagnosis and Therapy, Zurich 8032, Switzerland
- Zurich Center for Spina Bifida, University Children’s Hospital Zurich, Zurich 8032, Switzerland
| | - Raimund Kottke
- Children’s Research Center, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- Department of Diagnostic Imaging, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- Zurich Center for Fetal Diagnosis and Therapy, Zurich 8032, Switzerland
- Zurich Center for Spina Bifida, University Children’s Hospital Zurich, Zurich 8032, Switzerland
| | - Nicole Ochseinbein-Kölble
- Zurich Center for Fetal Diagnosis and Therapy, Zurich 8032, Switzerland
- Department of Obstetrics, University Hospital of Zurich, Zurich 8032, Switzerland
- University of Zurich, Zurich 8006, Switzerland
| | - Cornelia Hagmann
- Children’s Research Center, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- Zurich Center for Spina Bifida, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- Department of Neonatology, University Children's Hospital Zurich, Zurich 8032, Switzerland
| | - Luca Mazzone
- Children’s Research Center, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- Zurich Center for Fetal Diagnosis and Therapy, Zurich 8032, Switzerland
- Zurich Center for Spina Bifida, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich 8032, Switzerland
| | - Martin Meuli
- Zurich Center for Spina Bifida, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- University of Zurich, Zurich 8006, Switzerland
| | - Beth Padden
- Children’s Research Center, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- Zurich Center for Spina Bifida, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- Division of Pediatric Rehabilitation, University Children’s Hospital Zurich, Zurich 8032, Switzerland
| | - Annette Hackenberg
- Children’s Research Center, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- Zurich Center for Spina Bifida, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- University of Zurich, Zurich 8006, Switzerland
- Department of Pediatric Neurology, University Children’s Hospital Zurich, Zurich 8032, Switzerland
| | - David-Alexander Wille
- Department of Pediatric Neurology, Cantonal Hospital of Baden, Baden 5404, Switzerland
| | - Ueli Moehrlen
- Zurich Center for Fetal Diagnosis and Therapy, Zurich 8032, Switzerland
- Zurich Center for Spina Bifida, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- University of Zurich, Zurich 8006, Switzerland
- Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich 8032, Switzerland
| | - Beatrice Latal
- Children’s Research Center, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- University Research Priority Program (URPP), Adaptive Brain Circuits in Development and Learning (AdaBD), University of Zurich, Zurich 8006, Switzerland
- University of Zurich, Zurich 8006, Switzerland
- Child Development Center, University Children’s Hospital Zurich, Zurich 8032, Switzerland
| | | | - Andras Jakab
- Center for MR Research, University Children’s Hospital Zurich, Zurich 8032, Switzerland
- Neuroscience Center Zurich, University of Zurich, Zurich 8006, Switzerland
- University Research Priority Program (URPP), Adaptive Brain Circuits in Development and Learning (AdaBD), University of Zurich, Zurich 8006, Switzerland
- University of Zurich, Zurich 8006, Switzerland
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3
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Gericke FC, Hanson JVM, Hackenberg A, Gerth-Kahlert C. Visual outcome measures in pediatric myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Eur J Paediatr Neurol 2024; 48:113-120. [PMID: 38217965 DOI: 10.1016/j.ejpn.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/08/2023] [Accepted: 12/27/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) comprises various age-dependent clinical phenotypes and may be monophasic, multiphasic, or chronic. Optic neuritis (ON) is a common manifestation and frequently appears in combination with other MOGAD phenotypes, particularly in young children. Despite permanent structural damage to the retinal nerve fiber layer (RNFL), children often experience complete visual recovery. AIMS To analyze the progression and impact of MOGAD on the visual system of pediatric patients independently of the history of ON. METHODS This retrospective study included children who met specific criteria: myelin oligodendrocyte glycoprotein (MOG) immunoglobulin G (IgG) seropositivity, acute presentation of MOGAD, and written general consent. Main outcome measures were global peripapillary retinal nerve fiber layer (pRNFL) thickness, and near and distance visual acuity, analyzed using descriptive statistics. RESULTS We identified 10 patients with median age of 7.7 years at first event: 7 patients manifested with acute disseminated encephalomyelitis (ADEM) (with ON 5/7, ADEM only 1/7, with transverse myelitis (TM) 1/7), 2 with isolated ON, and 1 patient with neuromyelitis optica spectrum disorder (NMOSD)-like phenotype with ON. Among ON patients, 5/8 were affected bilaterally, with 3 initially diagnosed with unilateral ON but experiencing subsequent involvement of the fellow eye. None of the patients without previous ON showed a deterioration of visual acuity and, if evaluated, a reduction of the pRNFL. CONCLUSION Most pediatric MOGAD-ON patients in our cohort presented with acute vison loss and optic disc edema. All patients achieved complete visual recovery, independent of number of relapses or initial visual loss. The pRNFL thickness decreased for several months and stabilized at reduced levels after 12 months in the absence of further relapses. MOGAD may not have subclinical/'silent' effects on the visual system, as visual acuity and pRNFL were not affected in patients without ON.
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Affiliation(s)
| | - James V M Hanson
- Department of Ophthalmology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Annette Hackenberg
- Department of Neuropediatrics, University Children's Hospital Zurich, Switzerland
| | - Christina Gerth-Kahlert
- Department of Ophthalmology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
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4
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Maroofian R, Kaiyrzhanov R, Cali E, Zamani M, Zaki MS, Ferla M, Tortora D, Sadeghian S, Saadi SM, Abdullah U, Karimiani EG, Efthymiou S, Yeşil G, Alavi S, Al Shamsi AM, Tajsharghi H, Abdel-Hamid MS, Saadi NW, Al Mutairi F, Alabdi L, Beetz C, Ali Z, Toosi MB, Rudnik-Schöneborn S, Babaei M, Isohanni P, Muhammad J, Khan S, Al Shalan M, Hickey SE, Marom D, Elhanan E, Kurian MA, Marafi D, Saberi A, Hamid M, Spaull R, Meng L, Lalani S, Maqbool S, Rahman F, Seeger J, Palculict TB, Lau T, Murphy D, Mencacci NE, Steindl K, Begemann A, Rauch A, Akbas S, Aslanger AD, Salpietro V, Yousaf H, Ben-Shachar S, Ejeskär K, Al Aqeel AI, High FA, Armstrong-Javors AE, Zahraei SM, Seifi T, Zeighami J, Shariati G, Sedaghat A, Asl SN, Shahrooei M, Zifarelli G, Burglen L, Ravelli C, Zschocke J, Schatz UA, Ghavideldarestani M, Kamel WA, Van Esch H, Hackenberg A, Taylor JC, Al-Gazali L, Bauer P, Gleeson JJ, Alkuraya FS, Lupski JR, Galehdari H, Azizimalamiri R, Chung WK, Baig SM, Houlden H, Severino M. Biallelic MED27 variants lead to variable ponto-cerebello-lental degeneration with movement disorders. Brain 2023; 146:5031-5043. [PMID: 37517035 PMCID: PMC10690011 DOI: 10.1093/brain/awad257] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 01/27/2023] [Revised: 06/29/2023] [Accepted: 07/11/2023] [Indexed: 08/01/2023] Open
Abstract
MED27 is a subunit of the Mediator multiprotein complex, which is involved in transcriptional regulation. Biallelic MED27 variants have recently been suggested to be responsible for an autosomal recessive neurodevelopmental disorder with spasticity, cataracts and cerebellar hypoplasia. We further delineate the clinical phenotype of MED27-related disease by characterizing the clinical and radiological features of 57 affected individuals from 30 unrelated families with biallelic MED27 variants. Using exome sequencing and extensive international genetic data sharing, 39 unpublished affected individuals from 18 independent families with biallelic missense variants in MED27 have been identified (29 females, mean age at last follow-up 17 ± 12.4 years, range 0.1-45). Follow-up and hitherto unreported clinical features were obtained from the published 12 families. Brain MRI scans from 34 cases were reviewed. MED27-related disease manifests as a broad phenotypic continuum ranging from developmental and epileptic-dyskinetic encephalopathy to variable neurodevelopmental disorder with movement abnormalities. It is characterized by mild to profound global developmental delay/intellectual disability (100%), bilateral cataracts (89%), infantile hypotonia (74%), microcephaly (62%), gait ataxia (63%), dystonia (61%), variably combined with epilepsy (50%), limb spasticity (51%), facial dysmorphism (38%) and death before reaching adulthood (16%). Brain MRI revealed cerebellar atrophy (100%), white matter volume loss (76.4%), pontine hypoplasia (47.2%) and basal ganglia atrophy with signal alterations (44.4%). Previously unreported 39 affected individuals had seven homozygous pathogenic missense MED27 variants, five of which were recurrent. An emerging genotype-phenotype correlation was observed. This study provides a comprehensive clinical-radiological description of MED27-related disease, establishes genotype-phenotype and clinical-radiological correlations and suggests a differential diagnosis with syndromes of cerebello-lental neurodegeneration and other subtypes of 'neuro-MEDopathies'.
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Affiliation(s)
- Reza Maroofian
- Department of Neuromuscular Diseases, University College London, Queen Square, Institute of Neurology, London WC1N 3BG, UK
| | - Rauan Kaiyrzhanov
- Department of Neuromuscular Diseases, University College London, Queen Square, Institute of Neurology, London WC1N 3BG, UK
| | - Elisa Cali
- Department of Neuromuscular Diseases, University College London, Queen Square, Institute of Neurology, London WC1N 3BG, UK
| | - Mina Zamani
- Department of Biology, Faculty of Science, Shahid Chamran University of Ahvaz, Ahvaz, Iran
- Narges Medical Genetics and Prenatal Diagnosis Laboratory, Kianpars, Ahvaz, Iran
- Ati Mehr Kasra Genetics Institute, Kianpars, Ahvaz, Iran
| | - Maha S Zaki
- Clinical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo 12622, Egypt
| | - Matteo Ferla
- Wellcome Centre for Human Genetics, University of Oxford and Oxford NIHR Biomedical Research Centre, Oxford, OX3 7BN UK
| | - Domenico Tortora
- Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Saeid Sadeghian
- Department of Pediatric Neurology, Golestan Medical, Educational, and Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saadia Maryam Saadi
- Human Molecular Genetics Laboratory, Health Biotechnology Division, National Institute for Biotechnology and Genetic Engineering (NIBGE) College, PIEAS, 44000 Faisalabad, Pakistan
| | - Uzma Abdullah
- University Institute of Biochemistry and Biotechnology, PMAS Arid Agriculture University, 46300 Rawalpindi, Pakistan
| | - Ehsan Ghayoor Karimiani
- Department of Medical Genetics, Next Generation Genetic Polyclinic, Mashhad, Iran
- Molecular and Clinical Sciences Institute, St. George’s, University of London, London SW17 0RE, UK
- Innovative Medical Research Center, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Stephanie Efthymiou
- Department of Neuromuscular Diseases, University College London, Queen Square, Institute of Neurology, London WC1N 3BG, UK
| | - Gözde Yeşil
- Department of Medical Genetics, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey
| | - Shahryar Alavi
- Department of Neuromuscular Diseases, University College London, Queen Square, Institute of Neurology, London WC1N 3BG, UK
| | - Aisha M Al Shamsi
- Genetic Division, Pediatrics Department, Tawam Hospital, Al Ain, UAE
| | - Homa Tajsharghi
- School of Health Science, Division Biomedicine and Translational Medicine, University of Skovde, SE-541 28 Skovde, Sweden
| | - Mohamed S Abdel-Hamid
- Medical Molecular Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, 12622 Cairo, Egypt
| | - Nebal Waill Saadi
- College of Medicine, University of Baghdad, 10071 Baghdad, Iraq
- Children Welfare Teaching Hospital, 10071 Baghdad, Iraq
| | - Fuad Al Mutairi
- Genetics and Precision Medicine department, King Abdullah Specialized Children’s Hospital, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, 22384 Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, 22384 Riyadh, Saudi Arabia
| | - Lama Alabdi
- Department of Zoology, College of Science, King Saud University, 11421 Riyadh, Saudi Arabia
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, 12713 Riyadh, Saudi Arabia
| | | | - Zafar Ali
- Department of Cellular and Molecular Medicine, WJC PANUM, University of Copenhagen, DK-1165 Copenhagen, Denmark
- Centre for Biotechnology and Microbiology, University of Swat, Swat 19120, Pakistan
| | - Mehran Beiraghi Toosi
- Pediatric Neurology Department Pediatric Ward Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Meisam Babaei
- Department of Pediatrics, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Pirjo Isohanni
- Research Programs Unit, Stem Cells and Metabolism, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
- Department of Child Neurology, Children’s Hospital, Paediatric Research Center, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
| | - Jameel Muhammad
- Human Molecular Genetics Laboratory, Health Biotechnology Division, National Institute for Biotechnology and Genetic Engineering (NIBGE) College, PIEAS, 44000 Faisalabad, Pakistan
- Centre for Regenerative Medicine and Stem Cell Research, Juma Building, Aga Khan University, Karachi 74800, Pakistan
| | - Sheraz Khan
- Human Molecular Genetics Laboratory, Health Biotechnology Division, National Institute for Biotechnology and Genetic Engineering (NIBGE) College, PIEAS, 44000 Faisalabad, Pakistan
| | - Maha Al Shalan
- Genetics and Precision Medicine department, King Abdullah Specialized Children’s Hospital, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, 22384 Riyadh, Saudi Arabia
| | - Scott E Hickey
- Division of Genetic & Genomic Medicine, Nationwide Children’s Hospital, Columbus, OH 43205, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Daphna Marom
- Genetics Institute and Genomic Center, Tel Aviv Sourasky Medical Center, and Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Emil Elhanan
- Nephro-Genetic Clinic, Nephrology Department and Genetics Institute, Tel Aviv Medical Center, Tel Aviv 64239, Israel
| | - Manju A Kurian
- Molecular Neurosciences, Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
- Department of Neurology, Great Ormond Street Hospital, London WC1N 1EH, UK
| | - Dana Marafi
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Pediatrics, Faculty of Medicine, Kuwait University, Safat 13110, Kuwait
| | - Alihossein Saberi
- Narges Medical Genetics and Prenatal Diagnosis Laboratory, Kianpars, Ahvaz, Iran
- Department of Medical Genetics, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Hamid
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Robert Spaull
- Nephro-Genetic Clinic, Nephrology Department and Genetics Institute, Tel Aviv Medical Center, Tel Aviv 64239, Israel
- Molecular Neurosciences, Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
| | - Linyan Meng
- Department of Neurology, Great Ormond Street Hospital, London WC1N 1EH, UK
| | - Seema Lalani
- Department of Neurology, Great Ormond Street Hospital, London WC1N 1EH, UK
| | - Shazia Maqbool
- Developmental-Behavioural Paediatrics Department, University of Child Health Sciences & The Children’s Hospital, 54000 Lahore, Pakistan
| | - Fatima Rahman
- Developmental-Behavioural Paediatrics Department, University of Child Health Sciences & The Children’s Hospital, 54000 Lahore, Pakistan
| | - Jürgen Seeger
- Center for Social Pediatrics and Epilepsy Outpatient Clinic Frankfurt Mitte, 60316 Frankfurt am Main, Germany
| | | | - Tracy Lau
- Department of Neuromuscular Diseases, University College London, Queen Square, Institute of Neurology, London WC1N 3BG, UK
| | - David Murphy
- Department of Neuromuscular Diseases, University College London, Queen Square, Institute of Neurology, London WC1N 3BG, UK
| | - Niccolo Emanuele Mencacci
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Katharina Steindl
- Institute of Medical Genetics, University of Zurich, 8952 Schlieren, Switzerland
| | - Anais Begemann
- Institute of Medical Genetics, University of Zurich, 8952 Schlieren, Switzerland
| | - Anita Rauch
- Institute of Medical Genetics, University of Zurich, 8952 Schlieren, Switzerland
| | - Sinan Akbas
- Department of Medical Genetics, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey
| | - Ayça Dilruba Aslanger
- Department of Medical Genetics, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey
| | - Vincenzo Salpietro
- Department of Neuromuscular Diseases, University College London, Queen Square, Institute of Neurology, London WC1N 3BG, UK
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L’Aquila, 67100 L’Aquila, Italy
| | - Hammad Yousaf
- Human Molecular Genetics Laboratory, Health Biotechnology Division, National Institute for Biotechnology and Genetic Engineering (NIBGE) College, PIEAS, 44000 Faisalabad, Pakistan
| | - Shay Ben-Shachar
- Clalit Research Institute, Clalit Health Services, 6578898 Ramat Gan, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Katarina Ejeskär
- School of Health Science, Division Biomedicine and Translational Medicine, University of Skovde, SE-541 28 Skovde, Sweden
| | - Aida I Al Aqeel
- Department of Pediatrics, Prince Sultan Military Medical City, 12233 Riyadh, Saudi Arabia
- American University of Beirut, 1107 2020 Beirut, Lebanon
- Alfaisal University, 11533 Riyadh, Saudi Arabia
| | - Frances A High
- Division of Medical Genetics, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Amy E Armstrong-Javors
- Harvard Medical School, Boston, MA 02115, USA
- Department of Pediatric Neurology, Massachusetts General Hospital, Boston, MA 02114, USA
| | | | - Tahereh Seifi
- Department of Biology, Faculty of Science, Shahid Chamran University of Ahvaz, Ahvaz, Iran
- Narges Medical Genetics and Prenatal Diagnosis Laboratory, Kianpars, Ahvaz, Iran
| | - Jawaher Zeighami
- Narges Medical Genetics and Prenatal Diagnosis Laboratory, Kianpars, Ahvaz, Iran
- Ati Mehr Kasra Genetics Institute, Kianpars, Ahvaz, Iran
| | - Gholamreza Shariati
- Narges Medical Genetics and Prenatal Diagnosis Laboratory, Kianpars, Ahvaz, Iran
- Department of Medical Genetics, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Alireza Sedaghat
- Narges Medical Genetics and Prenatal Diagnosis Laboratory, Kianpars, Ahvaz, Iran
- Diabetes Research center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Samaneh Noroozi Asl
- Department of Pediatrics Endocrinology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohmmad Shahrooei
- Specialized Immunology Laboratory of Dr Shahrooei, Sina Medical Complex, Ahvaz, Iran
- Department of Microbiology and Immunology, Clinical and Diagnostic Immunology, KU Leuven, 3000 Leuven, Belgium
| | | | - Lydie Burglen
- Cerebellar Malformations and Congenital diseases Reference Center and Neurogenetics Lab, Department of Genetics, Armand Trousseau Hospital, AP-HP Sorbonne Université, 75006 Paris, France
- Developmental Brain Disorders Laboratory, Imagine Institute, INSERM UMR 1163, 75015 Paris, France
| | - Claudia Ravelli
- Pediatric Neurology Department, Movement Disorders Center, Armand Trousseau Hospital, AP-HP Sorbonne Université, 75006 Paris, France
| | - Johannes Zschocke
- Institute of Human Genetics, Medical University Innsbruck, 6020 Innsbruck, Austria
| | - Ulrich A Schatz
- Institute of Human Genetics, Medical University Innsbruck, 6020 Innsbruck, Austria
- Institute of Human Genetics, Klinikum rechts der Isar, Technische Universität Munich, 81675 Munich, Germany
| | | | - Walaa A Kamel
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Department of Neurology, Faculty of Medicine, Beni-Suef University, 62521 Beni Suef, Egypt
| | - Hilde Van Esch
- Center for Human Genetics, University Hospitals Leuven, 3000 Leuven, Belgium
- Laboratory for the Genetics of Cognition, Department of Human Genetics, KU Leuven–University of Leuven, 3000 Leuven, Belgium
| | - Annette Hackenberg
- Department of Pediatric Neurology, University Children's Hospital Zürich, University of Zürich, 8032 Zürich, Switzerland
| | - Jenny C Taylor
- Wellcome Centre for Human Genetics, University of Oxford and Oxford NIHR Biomedical Research Centre, Oxford, OX3 7BN UK
| | - Lihadh Al-Gazali
- Departments of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | | | - Joseph J Gleeson
- Department of Neurosciences, University of California, San Diego, La Jolla, CA 92093, USA
- Rady Children’s Institute for Genomic Medicine, San Diego, CA 92025, USA
| | - Fowzan Sami Alkuraya
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - James R Lupski
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
- Texas Children’s Hospital, Houston, TX 77030, USA
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Hamid Galehdari
- Department of Biology, Faculty of Science, Shahid Chamran University of Ahvaz, Ahvaz, Iran
- Ati Mehr Kasra Genetics Institute, Kianpars, Ahvaz, Iran
| | - Reza Azizimalamiri
- Department of Pediatric Neurology, Golestan Medical, Educational, and Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Wendy K Chung
- Boston Children’s Hospital and Harvard Medical School Boston, MA 02115, USA
| | - Shahid Mahmood Baig
- Human Molecular Genetics Laboratory, Health Biotechnology Division, National Institute for Biotechnology and Genetic Engineering (NIBGE) College, PIEAS, 44000 Faisalabad, Pakistan
- Department of Biological and Biomedical Sciences, Aga Khan University, 74800 Karachi, Pakistan
| | - Henry Houlden
- Department of Neuromuscular Diseases, University College London, Queen Square, Institute of Neurology, London WC1N 3BG, UK
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Wendel EM, Thonke HS, Bertolini A, Baumann M, Blaschek A, Merkenschlager A, Karenfort M, Kornek B, Lechner C, Pohl D, Pritsch M, Schanda K, Schimmel M, Thiels C, Waltz S, Wiegand G, Anlar B, Barisic N, Blank C, Breu M, Broser P, Della Marina A, Diepold K, Eckenweiler M, Eisenkölbl A, Freilinger M, Gruber-Sedlmayr U, Hackenberg A, Iff T, Knierim E, Koch J, Kutschke G, Leiz S, Lischetzki G, Nosadini M, Pschibul A, Reiter-Fink E, Rohrbach D, Salandin M, Sartori S, Schlump JU, Stoffels J, Strautmanis J, Tibussek D, Tüngler V, Utzig N, Reindl M, Rostásy K. Temporal Dynamics of MOG Antibodies in Children With Acquired Demyelinating Syndrome. Neurol Neuroimmunol Neuroinflamm 2022; 9:9/6/e200035. [PMID: 36229191 PMCID: PMC9562044 DOI: 10.1212/nxi.0000000000200035] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 08/04/2022] [Indexed: 11/06/2022]
Abstract
Background and Objective The spectrum of myelin oligodendrocyte glycoprotein (MOG) antibody–associated disorder (MOGAD) comprises monophasic diseases such as acute disseminated encephalomyelitis (ADEM), optic neuritis (ON), and transverse myelitis and relapsing courses of these presentations. Persistently high MOG antibodies (MOG immunoglobulin G [IgG]) are found in patients with a relapsing disease course. Prognostic factors to determine the clinical course of children with a first MOGAD are still lacking. The objective of the study is to assess the clinical and laboratory prognostic parameters for a risk of relapse and the temporal dynamics of MOG‐IgG titers in children with MOGAD in correlation with clinical presentation and disease course. Methods In this prospective multicenter hospital-based study, children with a first demyelinating attack and complete data set comprising clinical and radiologic findings, MOG-IgG titer at onset, and clinical and serologic follow-up data were included. Serum samples were analyzed by live cell-based assay, and a titer level of ≥1:160 was classified as MOG-IgG–positive. Results One hundred sixteen children (f:m = 57:59) with MOGAD were included and initially diagnosed with ADEM (n = 59), unilateral ON (n = 12), bilateral ON (n = 16), myelitis (n = 6), neuromyelitis optica spectrum disorder (n = 8) or encephalitis (n = 6). The median follow-up time was 3 years in monophasic and 5 years in relapsing patients. There was no significant association between disease course and MOG-IgG titers at onset, sex, age at presentation, or clinical phenotype. Seroconversion to MOG-IgG–negative within 2 years of the initial event showed a significant risk reduction for a relapsing disease course. Forty-two/one hundred sixteen patients (monophasic n = 26, relapsing n = 16) had serial MOG-IgG testing in years 1 and 2 after the initial event. In contrast to relapsing patients, monophasic patients showed a significant decrease of MOG-IgG titers during the first and second years, often with seroconversion to negative titers. During the follow-up, MOG-IgG titers were persistently higher in relapsing than in monophasic patients. Decrease in MOG-IgG of ≥3 dilution steps after the first and second years was shown to be associated with a decreased risk of relapses. In our cohort, no patient experienced a relapse after seroconversion to MOG-IgG–negative. Discussion In this study, patients with declining MOG-IgG titers, particularly those with seroconversion to MOG-IgG–negative, are shown to have a significantly reduced relapse risk.
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Kivrak Pfiffner F, Koller S, Ménétrey A, Graf U, Bähr L, Maspoli A, Hackenberg A, Kottke R, Gerth-Kahlert C, Berger W. Homozygosity for a Novel DOCK7 Variant Due to Segmental Uniparental Isodisomy of Chromosome 1 Associated with Early Infantile Epileptic Encephalopathy (EIEE) and Cortical Visual Impairment. Int J Mol Sci 2022; 23:ijms23137382. [PMID: 35806387 PMCID: PMC9266905 DOI: 10.3390/ijms23137382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 06/19/2022] [Accepted: 06/29/2022] [Indexed: 11/16/2022] Open
Abstract
Early infantile epileptic encephalopathy (EIEE) is a severe neurologic and neurodevelopmental disease that manifests in the first year of life. It shows a high degree of genetic heterogeneity, but the genetic origin is only identified in half of the cases. We report the case of a female child initially diagnosed with Leber congenital amaurosis (LCA), an early-onset retinal dystrophy due to photoreceptor cell degeneration in the retina. The first examination at 9 months of age revealed no reaction to light or objects and showed wandering eye movements. Ophthalmological examination did not show any ocular abnormalities. The patient displayed mildly dysmorphic features and a global developmental delay. Brain MRI demonstrated pontine hypo-/dysplasia. The patient developed myoclonic epileptic seizures and epileptic spasms with focal and generalized epileptiform discharges on electroencephalogram (EEG) at the age of 16 months. Genetic screening for a potentially pathogenic DNA sequence variant by whole-exome sequencing (WES) revealed a novel, conserved, homozygous frameshift variant (c.5391delA, p.(Ala1798LeufsTer59)) in exon 42 of the DOCK7 gene (NM_001271999.1). Further analysis by SNP array (Karyomapping) showed loss of heterozygosity (LOH) in four segments of chromosome 1. WES data of the parents and the index patient (trio analysis) demonstrated that chromosome 1 was exclusively inherited from the mother. Four LOH segments of chromosome 1 alternately showed isodisomy (UPiD) and heterodisomy (UPhD). In WES data, the father was a noncarrier, and the mother was heterozygous for this DOCK7 variant. The DOCK7 gene is located in 1p31.3, a region situated in one of the four isodisomic segments of chromosome 1, explaining the homozygosity seen in the affected child. Finally, Sanger sequencing confirmed maternal UPiD for the DOCK7 variant. Homozygous or compound heterozygous pathogenic variants in the DOCK7 (dedicator of cytokinesis 7) gene are associated with autosomal recessive, early infantile epileptic encephalopathy 23 (EIEE23; OMIM #615,859), a rare and heterogeneous group of neurodevelopmental disorders diagnosed during early childhood. To our knowledge, this is the first report of segmental uniparental iso- and heterodisomy of chromosome 1, leading to homozygosity of the DOCK7 frameshift variant in the affected patient.
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Affiliation(s)
- Fatma Kivrak Pfiffner
- Institute of Medical Molecular Genetics, University of Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland; (F.K.P.); (S.K.); (U.G.); (L.B.); (A.M.)
| | - Samuel Koller
- Institute of Medical Molecular Genetics, University of Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland; (F.K.P.); (S.K.); (U.G.); (L.B.); (A.M.)
| | - Anika Ménétrey
- Department of Pediatric Neurology, University Children’s Hospital, University of Zurich, 8032 Zurich, Switzerland; (A.M.); (A.H.)
| | - Urs Graf
- Institute of Medical Molecular Genetics, University of Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland; (F.K.P.); (S.K.); (U.G.); (L.B.); (A.M.)
| | - Luzy Bähr
- Institute of Medical Molecular Genetics, University of Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland; (F.K.P.); (S.K.); (U.G.); (L.B.); (A.M.)
| | - Alessandro Maspoli
- Institute of Medical Molecular Genetics, University of Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland; (F.K.P.); (S.K.); (U.G.); (L.B.); (A.M.)
| | - Annette Hackenberg
- Department of Pediatric Neurology, University Children’s Hospital, University of Zurich, 8032 Zurich, Switzerland; (A.M.); (A.H.)
| | - Raimund Kottke
- Department of Diagnostic Imaging, University Children’s Hospital, University of Zurich, 8032 Zurich, Switzerland;
| | | | - Wolfgang Berger
- Institute of Medical Molecular Genetics, University of Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland; (F.K.P.); (S.K.); (U.G.); (L.B.); (A.M.)
- Neuroscience Center Zurich, University and ETH Zurich, 8057 Zurich, Switzerland
- Center for Integrative Human Physiology, University of Zurich, 8057 Zurich, Switzerland
- Correspondence:
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Serrallach BL, Orman G, Boltshauser E, Hackenberg A, Desai NK, Kralik SF, Huisman TAGM. Neuroimaging in cerebellar ataxia in childhood: A review. J Neuroimaging 2022; 32:825-851. [PMID: 35749078 DOI: 10.1111/jon.13017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/27/2022] [Accepted: 06/05/2022] [Indexed: 11/28/2022] Open
Abstract
Ataxia is one of the most common pediatric movement disorders and can be caused by a large number of congenital and acquired diseases affecting the cerebellum or the vestibular or sensory system. It is mainly characterized by gait abnormalities, dysmetria, intention tremor, dysdiadochokinesia, dysarthria, and nystagmus. In young children, ataxia may manifest as the inability or refusal to walk. The diagnostic approach begins with a careful clinical history including the temporal evolution of ataxia and the inquiry of additional symptoms, is followed by a meticulous physical examination, and, depending on the results, is complemented by laboratory assays, electroencephalography, nerve conduction velocity, lumbar puncture, toxicology screening, genetic testing, and neuroimaging. Neuroimaging plays a pivotal role in either providing the final diagnosis, narrowing the differential diagnosis, or planning targeted further workup. In this review, we will focus on the most common form of ataxia in childhood, cerebellar ataxia (CA). We will discuss and summarize the neuroimaging findings of either the most common or the most important causes of CA in childhood or present causes of pediatric CA with pathognomonic findings on MRI. The various pediatric CAs will be categorized and presented according to (a) the cause of ataxia (acquired/disruptive vs. inherited/genetic) and (b) the temporal evolution of symptoms (acute/subacute, chronic, progressive, nonprogressive, and recurrent). In addition, several illustrative cases with their key imaging findings will be presented.
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Affiliation(s)
- Bettina L Serrallach
- Edward B. Singleton Department of Radiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Gunes Orman
- Edward B. Singleton Department of Radiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Eugen Boltshauser
- Department of Pediatric Neurology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Annette Hackenberg
- Department of Pediatric Neurology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Nilesh K Desai
- Edward B. Singleton Department of Radiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Stephen F Kralik
- Edward B. Singleton Department of Radiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Thierry A G M Huisman
- Edward B. Singleton Department of Radiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
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van Geest FS, Groeneweg S, van den Akker ELT, Bacos I, Barca D, van den Berg SAA, Bertini E, Brunner D, Brunetti-Pierri N, Cappa M, Cappuccio G, Chatterjee K, Chesover AD, Christian P, Coutant R, Craiu D, Crock P, Dewey C, Dica A, Dimitri P, Dubey R, Enderli A, Fairchild J, Gallichan J, Garibaldi LR, George B, Hackenberg A, Heinrich B, Huynh T, Kłosowska A, Lawson-Yuen A, Linder-Lucht M, Lyons G, Monti Lora F, Moran C, Müller KE, Paone L, Paul PG, Polak M, Porta F, Reinauer C, de Rijke YB, Seckold R, Menevşe TS, Simm P, Simon A, Spada M, Stoupa A, Szeifert L, Tonduti D, van Toor H, Turan S, Vanderniet J, de Waart M, van der Wal R, van der Walt A, van Wermeskerken AM, Wierzba J, Zibordi F, Zung A, Peeters RP, Visser WE. Long-Term Efficacy of T3 Analogue Triac in Children and Adults With MCT8 Deficiency: A Real-Life Retrospective Cohort Study. J Clin Endocrinol Metab 2022; 107:e1136-e1147. [PMID: 34679181 PMCID: PMC8852204 DOI: 10.1210/clinem/dgab750] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Patients with mutations in thyroid hormone transporter MCT8 have developmental delay and chronic thyrotoxicosis associated with being underweight and having cardiovascular dysfunction. OBJECTIVE Our previous trial showed improvement of key clinical and biochemical features during 1-year treatment with the T3 analogue Triac, but long-term follow-up data are needed. METHODS In this real-life retrospective cohort study, we investigated the efficacy of Triac in MCT8-deficient patients in 33 sites. The primary endpoint was change in serum T3 concentrations from baseline to last available measurement. Secondary endpoints were changes in other thyroid parameters, anthropometric parameters, heart rate, and biochemical markers of thyroid hormone action. RESULTS From October 15, 2014 to January 1, 2021, 67 patients (median baseline age 4.6 years; range, 0.5-66) were treated up to 6 years (median 2.2 years; range, 0.2-6.2). Mean T3 concentrations decreased from 4.58 (SD 1.11) to 1.66 (0.69) nmol/L (mean decrease 2.92 nmol/L; 95% CI, 2.61-3.23; P < 0.0001; target 1.4-2.5 nmol/L). Body-weight-for-age exceeded that of untreated historical controls (mean difference 0.72 SD; 95% CI, 0.36-1.09; P = 0.0002). Heart-rate-for-age decreased (mean difference 0.64 SD; 95% CI, 0.29-0.98; P = 0.0005). SHBG concentrations decreased from 245 (99) to 209 (92) nmol/L (mean decrease 36 nmol/L; 95% CI, 16-57; P = 0.0008). Mean creatinine concentrations increased from 32 (11) to 39 (13) µmol/L (mean increase 7 µmol/L; 95% CI, 6-9; P < 0.0001). Mean creatine kinase concentrations did not significantly change. No drug-related severe adverse events were reported. CONCLUSIONS Key features were sustainably alleviated in patients with MCT8 deficiency across all ages, highlighting the real-life potential of Triac for MCT8 deficiency.
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Affiliation(s)
- Ferdy S van Geest
- Academic Center for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Stefan Groeneweg
- Academic Center for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Erica L T van den Akker
- Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Iuliu Bacos
- Centrul Medical Dr. Bacos Cosma, Timisoara 307200, Romania
| | - Diana Barca
- Carol Davila University of Medicine, Department of Clinical Neurosciences, Paediatric Neurology Discipline II, Bucharest 050474, Romania
- Paediatric Neurology Clinic, Reference Center for Rare Paediatric Neurological Disorders, ENDO-ERN member, Alexandru Obregia Hospital, Bucharest 041914, Romania
| | - Sjoerd A A van den Berg
- Diagnostic Laboratory for Endocrinology, Department of Internal Medicine, Erasmus Medical Center , 3015 GD Rotterdam, The Netherlands
- Department of Clinical chemistry, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Enrico Bertini
- Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesu' Children's Research Hospital IRCCS, 00165 Rome, Italy
| | - Doris Brunner
- Gottfried Preyer's Children Hospital, 1100 Vienna, Austria
| | - Nicola Brunetti-Pierri
- Department of Translational Medicine, Federico II University, 80131 Naples, Italy
- Telethon Institute of Genetics and Medicine, Pozzuoli, 80078 Naples, Italy
| | - Marco Cappa
- Division of Endocrinology, Bambino Gesu' Children's Research Hospital IRCCS, 00165 Rome, Italy
| | - Gerarda Cappuccio
- Department of Translational Medicine, Federico II University, 80131 Naples, Italy
- Telethon Institute of Genetics and Medicine, Pozzuoli, 80078 Naples, Italy
| | - Krishna Chatterjee
- Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Alexander D Chesover
- Division of Endocrinology, The Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto, M5G 1X8, Canada
| | - Peter Christian
- East Kent Hospitals University NHS Foundation Trust, Ashford TN24 0LZ, UK
| | - Régis Coutant
- Department of Pediatric Endocrinology and Diabetology, University Hospital, 49100 Angers, France
| | - Dana Craiu
- Carol Davila University of Medicine, Department of Clinical Neurosciences, Paediatric Neurology Discipline II, Bucharest 050474, Romania
- Paediatric Neurology Clinic, Reference Center for Rare Paediatric Neurological Disorders, ENDO-ERN member, Alexandru Obregia Hospital, Bucharest 041914, Romania
| | - Patricia Crock
- John Hunter Children's Hospital, New Lambton Heights, NSW 2305, Australia
- Hunter Medical Research Institute, University of Newcastle Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Cheyenne Dewey
- Genomics Institute Mary Bridge Children's Hospital, MultiCare Health System Tacoma, WA 98403, USA
| | - Alice Dica
- Carol Davila University of Medicine, Department of Clinical Neurosciences, Paediatric Neurology Discipline II, Bucharest 050474, Romania
- Paediatric Neurology Clinic, Reference Center for Rare Paediatric Neurological Disorders, ENDO-ERN member, Alexandru Obregia Hospital, Bucharest 041914, Romania
| | - Paul Dimitri
- Sheffield Children's NHS Foundation Trust, Sheffield Hallam University and University of Sheffield, Sheffield, S10 2TH, UK
| | - Rachana Dubey
- Medanta Superspeciality Hospital, Indore 800020, India
| | - Anina Enderli
- Department of Neuropediatrics, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zürich, Switzerland
- Neurology Department, Children's Hospital, St. Gallen, 9000, Switzerland
| | - Jan Fairchild
- Department of Diabetes and Endocrinology, Women's and Children's Hospital, North Adelaide 5066 SouthAustralia
| | | | | | - Belinda George
- Department of Endocrinology, St. John's Medical College Hospital, Bengaluru 560034, India
| | - Annette Hackenberg
- Department of Neuropediatrics, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zürich, Switzerland
| | - Bianka Heinrich
- Department of Neuropediatrics, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zürich, Switzerland
| | - Tony Huynh
- Department of Endocrinology & Diabetes, Queensland Children's Hospital, South Brisbane Queensland 4101, Australia
- Department of Chemical Pathology, Mater Pathology, South Brisbane, Queensland 4101, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland 4072, Australia
| | - Anna Kłosowska
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Amy Lawson-Yuen
- Genomics Institute Mary Bridge Children's Hospital, MultiCare Health System Tacoma, WA 98403, USA
| | - Michaela Linder-Lucht
- Division of Neuropediatrics and Muscular Disorders, Department of Pediatrics and Adolescent Medicine, University Hospital Freiburg, 79106 Freiburg, Germany
| | - Greta Lyons
- Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Felipe Monti Lora
- Pediatric Endocrinology Group, Santa Catarina Hospital, São Paulo, 01310-000, Brazil
| | - Carla Moran
- Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Katalin E Müller
- Heim Pal National Institute of Pediatrics, Budapest, 1089, Hungary
- Institute of Translational Medicine, University of Pécs, Pécs, 7622, Hungary
| | - Laura Paone
- Division of Endocrinology, Bambino Gesu' Children's Research Hospital IRCCS, 00165 Rome, Italy
| | - Praveen G Paul
- Department of Paediatrics, Christian Medical College, Vellore 632004, India
| | - Michel Polak
- Paediatric Endocrinology, Diabetology and Gynaecology Department, Necker Children's University Hospital, Imagine Institute, Université de Paris, Paris 75015, France
| | - Francesco Porta
- Department of Paediatrics, AOU Città della Salute e della Scienza di Torino, University of Torino, Torino 10126,Italy
| | - Christina Reinauer
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Medical Faculty, Duesseldorf 40225, Germany
| | - Yolanda B de Rijke
- Department of Clinical chemistry, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Rowen Seckold
- John Hunter Children's Hospital, New Lambton Heights, NSW 2305, Australia
- Hunter Medical Research Institute, University of Newcastle Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Tuba Seven Menevşe
- Marmara University School of Medicine Department of Pediatric Endocrinology, Istanbul 34854, Turkey
| | - Peter Simm
- Royal Children's Hospital/University of Melbourne, Parkville 3052,Australia
| | - Anna Simon
- Department of Paediatrics, Christian Medical College, Vellore 632004, India
| | - Marco Spada
- Department of Paediatrics, AOU Città della Salute e della Scienza di Torino, University of Torino, Torino 10126,Italy
| | - Athanasia Stoupa
- Paediatric Endocrinology, Diabetology and Gynaecology Department, Necker Children's University Hospital, Imagine Institute, Université de Paris, Paris 75015, France
| | - Lilla Szeifert
- 1st Department of Pediatrics, Semmelweis University, Budapest, 1083, Hungary
| | - Davide Tonduti
- Child Neurology Unit - C.O.A.L.A. (Center for Diagnosis and Treatment of Leukodystrophies), V. Buzzi Children's Hospital, Milano 20154, Italy
| | - Hans van Toor
- Diagnostic Laboratory for Endocrinology, Department of Internal Medicine, Erasmus Medical Center , 3015 GD Rotterdam, The Netherlands
| | - Serap Turan
- Marmara University School of Medicine Department of Pediatric Endocrinology, Istanbul 34854, Turkey
| | - Joel Vanderniet
- John Hunter Children's Hospital, New Lambton Heights, NSW 2305, Australia
- Hunter Medical Research Institute, University of Newcastle Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Monique de Waart
- Department of Clinical chemistry, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Ronald van der Wal
- Diagnostic Laboratory for Endocrinology, Department of Internal Medicine, Erasmus Medical Center , 3015 GD Rotterdam, The Netherlands
| | - Adri van der Walt
- Private Paediatric Neurology Practice of Dr A van der Walt, Durbanville, South Africa
| | | | - Jolanta Wierzba
- Department of Internal and Pediatric Nursing, Institute of Nursing and Midwifery, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Federica Zibordi
- Child Neurology Unit, Fondazione IRCCS, Istituto Neurologico Carlo Besta, Milan 20133, Italy
| | - Amnon Zung
- Pediatric Endocrinology Unit, Kaplan Medical Center, University of Jerusalem, Rehovot 76100, Israel
| | - Robin P Peeters
- Academic Center for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
| | - W Edward Visser
- Academic Center for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
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Hackenberg A, Battilana B, Hebeisen M, Steinfeld R, Khan N. Preoperative clinical symptomatology and stroke burden in pediatric moyamoya angiopathy: Defining associated risk variables. Eur J Paediatr Neurol 2021; 35:130-136. [PMID: 34715507 DOI: 10.1016/j.ejpn.2021.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To evaluate the preoperative clinical and magnetic resonance imaging and angiography (MRI-MRA) characteristics in pediatric moyamoya patients. METHODS Analysis included 100 children with moyamoya angiopathy referred to our moyamoya center for preoperative evaluation. Clinical symptoms, neurological status using Pediatric Stroke Outcome Measurement (PSOM) and degree of disability on modified Rankin scale score (mRS) were evaluated. MRI-MRA evaluation included the assessment of ischemic lesions and involvement of posterior circulation. Data were analyzed for moyamoya disease (MMD), moyamoya syndrome (MMS) and age at disease onset. RESULTS Stroke was a common presentation in both MMD and MMS patients. TIAs and headaches/migraine were more frequent in MMD. There was no evidence of a difference in stroke burden on MRI as well as in PCA involvement between the two subgroups. Children <2 years had higher odds of having a stroke (OR 15.5, 95% CI 3.8-62.4, p < 0.001), recurrent stroke (OR 11.8, 95%CI 2.9-46.7, p < 0.001) and unfavorable mRS (≥2) (OR 4.2, 95% CI 1.3-13.7, p = 0.01) when compared to those >5 years of age. There was some evidence of association of PCA involvement with recurrent strokes (OR 3.1, CI 1.0-9.6, p = 0.05), a poor PSOM (OR 3.0, 95% CI 1.1-8.2, p = 0.04) and mRS (OR 3.1, 95% CI 1.2-8.3, p = 0.02). CONCLUSION Stroke seems to be a common presentation in both MMD and MMS patients. Early age at symptom onset and involvement of posterior circulation seem to be important risk factors for a high stroke burden and an unfavorable PSOM and mRS.
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Affiliation(s)
- Annette Hackenberg
- Department of Pediatric Neurology, University Children's Hospital, University of Zurich, Switzerland; Moyamoya Center, University Children's Hospital, University of Zurich, Switzerland.
| | - Bianca Battilana
- Moyamoya Center, University Children's Hospital, University of Zurich, Switzerland
| | - Monika Hebeisen
- Moyamoya Center, University Children's Hospital, University of Zurich, Switzerland; Department of Biostatistics, Institute of Epidemiology, Biostatistics and Prevention, University of Zurich, Switzerland
| | - Robert Steinfeld
- Department of Pediatric Neurology, University Children's Hospital, University of Zurich, Switzerland
| | - Nadia Khan
- Moyamoya Center, University Children's Hospital, University of Zurich, Switzerland
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10
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Mirza-Schreiber N, Zech M, Wilson R, Brunet T, Wagner M, Jech R, Boesch S, Škorvánek M, Necpál J, Weise D, Weber S, Mollenhauer B, Trenkwalder C, Maier EM, Borggraefe I, Vill K, Hackenberg A, Pilshofer V, Kotzaeridou U, Schwaibold EMC, Hoefele J, Waldenberger M, Gieger C, Peters A, Meitinger T, Schormair B, Winkelmann J, Oexle K. Blood DNA methylation provides an accurate biomarker of KMT2B-related dystonia and predicts onset. Brain 2021; 145:644-654. [PMID: 34590685 DOI: 10.1093/brain/awab360] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/26/2021] [Accepted: 08/15/2021] [Indexed: 11/13/2022] Open
Abstract
Dystonia is a prevalent, heterogeneous movement disorder characterized by involuntarily abnormal postures. Biomarkers of dystonia are notoriously lacking. Here, a biomarker is reported for histone lysine methyltransferase (KMT2B)-deficient dystonia, a leading subtype among the individually rare monogenic dystonias. It was derived by applying a support vector machine to an episignature of 113 DNA CpG sites which, in blood cells, showed significant epigenome-wide association with KMT2B deficiency and at least 1x log-fold change of methylation. This classifier was accurate both when tested on the general population and on samples with various other deficiencies of the epigenetic machinery, thus allowing for definitive evaluation of variants of uncertain significance and identifying patients who may profit from deep brain stimulation, a highly successful treatment in KMT2B-deficient dystonia. Methylation was increased in KMT2B deficiency at all 113 CpG sites. The coefficients of variation of the normalized methylation levels at these sites also perfectly classified the samples with KMT2B-deficient dystonia. Moreover, the mean of the normalized methylation levels correlated well with the age at onset of dystonia (p = 0.003) - being lower in samples with late or incomplete penetrance-thus serving as a predictor of disease onset and severity. Similarly, it may also function in monitoring the recently envisioned treatment of KMT2B deficiency by inhibition of DNA methylation.
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Affiliation(s)
- Nazanin Mirza-Schreiber
- Institute of Neurogenomics (ING), Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany.,Neurogenetic Systems Analysis Group, Institute of Neurogenomics (ING), Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Michael Zech
- Institute of Neurogenomics (ING), Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany.,Institute of Human Genetics, Technical University of Munich, School of Medicine, 81675 Munich, Germany
| | - Rory Wilson
- Research Unit Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Theresa Brunet
- Institute of Neurogenomics (ING), Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany.,Institute of Human Genetics, Technical University of Munich, School of Medicine, 81675 Munich, Germany
| | - Matias Wagner
- Institute of Neurogenomics (ING), Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany.,Institute of Human Genetics, Technical University of Munich, School of Medicine, 81675 Munich, Germany
| | - Robert Jech
- Department of Neurology, Charles University, 1st Faculty of Medicine and General University Hospital in Prague, 121 08 Prague, Czech Republic
| | - Sylvia Boesch
- Department of Neurology, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Matej Škorvánek
- Department of Neurology, P. J. Safarik University, 04011 Kosice, Slovakia.,Department of Neurology, University Hospital L. Pasteur, 04011 Kosice, Slovakia
| | - Ján Necpál
- Department of Neurology, Zvolen Hospital, 96001 Zvolen, Slovakia
| | - David Weise
- Department of Neurology, Asklepios Fachklinikum Stadtroda, 07646 Stadtroda, Germany.,Department of Neurology, University of Leipzig, 04103 Leipzig, Germany
| | - Sandrina Weber
- Institute of Neurogenomics (ING), Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany.,University Medical Center Goettingen, Department of Neurology and Paracelsus-Elena-Klinik, 34128 Kassel, Germany
| | - Brit Mollenhauer
- University Medical Center Goettingen, Department of Neurology and Paracelsus-Elena-Klinik, 34128 Kassel, Germany
| | - Claudia Trenkwalder
- University Medical Center Goettingen, Department of Neurology and Paracelsus-Elena-Klinik, 34128 Kassel, Germany
| | - Esther M Maier
- Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, 80337 Munich, Germany
| | - Ingo Borggraefe
- Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, 80337 Munich, Germany
| | - Katharina Vill
- Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, 80337 Munich, Germany
| | - Annette Hackenberg
- Department of Pediatric Neurology, University Children's Hospital, 8032 Zürich, Switzerland
| | | | - Urania Kotzaeridou
- Department of Child Neurology and Metabolic Medicine, Center for Pediatric and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | | | - Julia Hoefele
- Institute of Human Genetics, Technical University of Munich, School of Medicine, 81675 Munich, Germany
| | - Melanie Waldenberger
- Research Unit Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Christian Gieger
- Research Unit Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany.,German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Annette Peters
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany.,Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany.,Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München, 81377 Munich, Germany
| | - Thomas Meitinger
- Institute of Human Genetics, Technical University of Munich, School of Medicine, 81675 Munich, Germany
| | - Barbara Schormair
- Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, 80337 Munich, Germany
| | - Juliane Winkelmann
- Institute of Neurogenomics (ING), Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany.,Institute of Human Genetics, Technical University of Munich, School of Medicine, 81675 Munich, Germany.,Chair of Neurogenetics, Technical University of Munich, School of Medicine, 81675 Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), 81377 Munich, Germany
| | - Konrad Oexle
- Institute of Neurogenomics (ING), Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany.,Neurogenetic Systems Analysis Group, Institute of Neurogenomics (ING), Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany.,Institute of Human Genetics, Technical University of Munich, School of Medicine, 81675 Munich, Germany
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11
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Meng L, Isohanni P, Shao Y, Graham BH, Hickey SE, Brooks S, Suomalainen A, Joset P, Steindl K, Rauch A, Hackenberg A, High FA, Armstrong-Javors A, Mencacci NE, Gonzàlez-Latapi P, Kamel WA, Al-Hashel JY, Bustos BI, Hernandez AV, Krainc D, Lubbe SJ, Van Esch H, De Luca C, Ballon K, Ravelli C, Burglen L, Qebibo L, Calame DG, Mitani T, Marafi D, Pehlivan D, Saadi NW, Sahin Y, Maroofian R, Efthymiou S, Houlden H, Maqbool S, Rahman F, Gu S, Posey JE, Lupski JR, Hunter JV, Wangler MF, Carroll CJ, Yang Y. MED27 Variants Cause Developmental Delay, Dystonia, and Cerebellar Hypoplasia. Ann Neurol 2021; 89:828-833. [PMID: 33443317 DOI: 10.1002/ana.26019] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 12/30/2022]
Abstract
The Mediator multiprotein complex functions as a regulator of RNA polymerase II-catalyzed gene transcription. In this study, exome sequencing detected biallelic putative disease-causing variants in MED27, encoding Mediator complex subunit 27, in 16 patients from 11 families with a novel neurodevelopmental syndrome. Patient phenotypes are highly homogeneous, including global developmental delay, intellectual disability, axial hypotonia with distal spasticity, dystonic movements, and cerebellar hypoplasia. Seizures and cataracts were noted in severely affected individuals. Identification of multiple patients with biallelic MED27 variants supports the critical role of MED27 in normal human neural development, particularly for the cerebellum. ANN NEUROL 2021;89:828-833.
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Affiliation(s)
- Linyan Meng
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX
- Baylor Genetics, Houston, TX
| | - Pirjo Isohanni
- Research Programs Unit, Stem Cells and Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Child Neurology, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Yunru Shao
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX
- Department of Pediatrics, Baylor College of Medicine, Houston, TX
- Texas Children's Hospital, Houston, TX
| | - Brett H Graham
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Scott E Hickey
- Department of Pediatrics, Ohio State University College of Medicine, Division of Genetic and Genomic Medicine, Nationwide Children's Hospital, Columbus, OH
| | - Stephanie Brooks
- Department of Pediatrics, Ohio State University College of Medicine, Division of Genetic and Genomic Medicine, Nationwide Children's Hospital, Columbus, OH
| | - Anu Suomalainen
- Research Programs Unit, Stem Cells and Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Pascal Joset
- Institute of Medical Genetics, University of Zürich, Schlieren-Zürich, Switzerland
| | - Katharina Steindl
- Institute of Medical Genetics, University of Zürich, Schlieren-Zürich, Switzerland
| | - Anita Rauch
- Institute of Medical Genetics, University of Zürich, Schlieren-Zürich, Switzerland
| | - Annette Hackenberg
- Department of Pediatric Neurology, University Children's Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Frances A High
- Division of Medical Genetics, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Amy Armstrong-Javors
- Harvard Medical School, Boston, MA
- Department of Pediatric Neurology, Massachusetts General Hospital, Boston, MA
| | - Niccolò E Mencacci
- Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Simpson Querrey Center for Neurogenetics, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Paulina Gonzàlez-Latapi
- Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Walaa A Kamel
- Department of Neurology, Ibn Sina Hospital, Kuwait City, Kuwait
- Department of Neurology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Jasem Y Al-Hashel
- Department of Neurology, Ibn Sina Hospital, Kuwait City, Kuwait
- Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Bernabé I Bustos
- Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Simpson Querrey Center for Neurogenetics, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Alejandro V Hernandez
- Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Dimitri Krainc
- Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Simpson Querrey Center for Neurogenetics, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Steven J Lubbe
- Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Simpson Querrey Center for Neurogenetics, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Hilde Van Esch
- Center for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Chiara De Luca
- Center for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Katleen Ballon
- Centre for Developmental Disabilities, University Hospitals Leuven, Leuven, Belgium
| | - Claudia Ravelli
- Pediatric Neurology Department, Neurogenetics Reference Center, I-motion Institute, Public Hospital Network of Paris, Sorbonne University, Armand Trousseau Hospital, Paris, France
| | - Lydie Burglen
- Cerebellar Malformations and Congenital Diseases Reference Center and Neurogenetics Lab, Department of Genetics, Public Hospital Network of Paris, Sorbonne University, Armand Trousseau Hospital, Paris, France
- Developmental Brain Disorders Laboratory, Imagine Institute, Paris, France
| | - Leila Qebibo
- Cerebellar Malformations and Congenital Diseases Reference Center and Neurogenetics Lab, Department of Genetics, Public Hospital Network of Paris, Sorbonne University, Armand Trousseau Hospital, Paris, France
| | - Daniel G Calame
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX
- Texas Children's Hospital, Houston, TX
- Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Tadahiro Mitani
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX
| | - Dana Marafi
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX
- Department of Pediatrics, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Davut Pehlivan
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX
- Texas Children's Hospital, Houston, TX
- Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Nebal W Saadi
- College of Medicine, Baghdad University, Baghdad, Iraq
- Children Welfare Teaching Hospital, Baghdad, Iraq
| | - Yavuz Sahin
- Department of Medical Genetics, Genoks Genetic Center, Ankara, Turkey
| | - Reza Maroofian
- Department of Neuromuscular Disorders, University College London Institute of Neurology, London, UK
| | - Stephanie Efthymiou
- Department of Neuromuscular Disorders, University College London Institute of Neurology, London, UK
| | - Henry Houlden
- Department of Neuromuscular Disorders, University College London Institute of Neurology, London, UK
| | - Shazia Maqbool
- Development and Behavioral Pediatrics Department, Institute of Child Health and Children Hospital, Lahore, Pakistan
| | - Fatima Rahman
- Development and Behavioral Pediatrics Department, Institute of Child Health and Children Hospital, Lahore, Pakistan
| | - Shen Gu
- School of Biomedical Sciences, Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Jennifer E Posey
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX
| | - James R Lupski
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX
- Department of Pediatrics, Baylor College of Medicine, Houston, TX
- Texas Children's Hospital, Houston, TX
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX
| | - Jill V Hunter
- Edward B. Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX
- Department of Radiology, Baylor College of Medicine, Houston, TX
| | - Michael F Wangler
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX
- Department of Child Neurology, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Jan and Dan Neurological Research Institute, Texas Children's Hospital, Houston, TX
| | - Christopher J Carroll
- Research Programs Unit, Stem Cells and Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Molecular and Clinical Sciences Research Institute, St George's, University of London, London, United Kingdom
| | - Yaping Yang
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX
- Baylor Genetics, Houston, TX
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12
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Serra S, Kugler J, Hug M, Hackenberg A, Latal B, Khan N. Preoperative neurodevelopment of children with moyamoya angiopathy. Dev Med Child Neurol 2021; 63:218-225. [PMID: 33098576 DOI: 10.1111/dmcn.14708] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 11/26/2022]
Abstract
AIM To preoperatively assess the neurodevelopment of a predominantly white population of children with moyamoya angiopathy (MMA). METHOD Assessments of 40 children with MMA (24 females, 16 males; mean age 6y 11mo, range 20mo-16y) included tests for non-verbal IQ and fine motor skills, and questionnaires on quality of life, behaviour, and executive functions. The Paediatric Stroke Outcome Measure (PSOM) score was evaluated by a paediatric neurologist. RESULTS Children with MMA had significantly lower non-verbal IQ scores (mean IQ 92.1, SD 19.6, p=0.015) and fine motor skills (z-score -1.84, p=0.004) than population norms. Patients with posterior cerebral artery (PCA) involvement had poorer non-verbal IQ scores than those without (79.6, SD 24.6 vs 95.2, SD 17.2, p=0.042). Higher PSOM scores were related to lower non-verbal IQ scores (Spearman's rank correlation coefficient -0.43, p=0.006), while the presence of stroke, bilaterality, disease versus syndrome, and age at diagnosis had no significant effect on non-verbal IQ. Quality of life, behaviour, and executive functions were in the typically developing range. INTERPRETATION Children with MMA are more likely to manifest intellectual and fine motor skill impairment before surgical intervention. PCA involvement is an additional risk factor for lower non-verbal IQ. WHAT THIS PAPER ADDS Children with moyamoya angiopathy have intellectual and fine motor skill impairment before surgical intervention. Posterior cerebral artery involvement and higher Paediatric Stroke Outcome Measure scores may predict poorer performance.
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Affiliation(s)
- Sabina Serra
- Child Development Centre, University Children's Hospital, Zurich, Switzerland
| | - Julietta Kugler
- Child Development Centre, University Children's Hospital, Zurich, Switzerland
| | - Martina Hug
- Child Development Centre, University Children's Hospital, Zurich, Switzerland.,Moyamoya Centre, Department of Surgery, University Children's Hospital, Zurich, Switzerland
| | - Annette Hackenberg
- Moyamoya Centre, Department of Surgery, University Children's Hospital, Zurich, Switzerland.,Department of Paediatric Neurology, University Children's Hospital, Zurich, Switzerland
| | - Beatrice Latal
- Child Development Centre, University Children's Hospital, Zurich, Switzerland.,Moyamoya Centre, Department of Surgery, University Children's Hospital, Zurich, Switzerland
| | - Nadia Khan
- Moyamoya Centre, Department of Surgery, University Children's Hospital, Zurich, Switzerland
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13
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Zech M, Jech R, Boesch S, Škorvánek M, Weber S, Wagner M, Zhao C, Jochim A, Necpál J, Dincer Y, Vill K, Distelmaier F, Stoklosa M, Krenn M, Grunwald S, Bock-Bierbaum T, Fečíková A, Havránková P, Roth J, Příhodová I, Adamovičová M, Ulmanová O, Bechyně K, Danhofer P, Veselý B, Haň V, Pavelekova P, Gdovinová Z, Mantel T, Meindl T, Sitzberger A, Schröder S, Blaschek A, Roser T, Bonfert MV, Haberlandt E, Plecko B, Leineweber B, Berweck S, Herberhold T, Langguth B, Švantnerová J, Minár M, Ramos-Rivera GA, Wojcik MH, Pajusalu S, Õunap K, Schatz UA, Pölsler L, Milenkovic I, Laccone F, Pilshofer V, Colombo R, Patzer S, Iuso A, Vera J, Troncoso M, Fang F, Prokisch H, Wilbert F, Eckenweiler M, Graf E, Westphal DS, Riedhammer KM, Brunet T, Alhaddad B, Berutti R, Strom TM, Hecht M, Baumann M, Wolf M, Telegrafi A, Person RE, Zamora FM, Henderson LB, Weise D, Musacchio T, Volkmann J, Szuto A, Becker J, Cremer K, Sycha T, Zimprich F, Kraus V, Makowski C, Gonzalez-Alegre P, Bardakjian TM, Ozelius LJ, Vetro A, Guerrini R, Maier E, Borggraefe I, Kuster A, Wortmann SB, Hackenberg A, Steinfeld R, Assmann B, Staufner C, Opladen T, Růžička E, Cohn RD, Dyment D, Chung WK, Engels H, Ceballos-Baumann A, Ploski R, Daumke O, Haslinger B, Mall V, Oexle K, Winkelmann J. Monogenic variants in dystonia: an exome-wide sequencing study. Lancet Neurol 2020; 19:908-918. [PMID: 33098801 DOI: 10.1016/s1474-4422(20)30312-4] [Citation(s) in RCA: 127] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 07/30/2020] [Accepted: 08/10/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Dystonia is a clinically and genetically heterogeneous condition that occurs in isolation (isolated dystonia), in combination with other movement disorders (combined dystonia), or in the context of multisymptomatic phenotypes (isolated or combined dystonia with other neurological involvement). However, our understanding of its aetiology is still incomplete. We aimed to elucidate the monogenic causes for the major clinical categories of dystonia. METHODS For this exome-wide sequencing study, study participants were identified at 33 movement-disorder and neuropaediatric specialty centres in Austria, Czech Republic, France, Germany, Poland, Slovakia, and Switzerland. Each individual with dystonia was diagnosed in accordance with the dystonia consensus definition. Index cases were eligible for this study if they had no previous genetic diagnosis and no indication of an acquired cause of their illness. The second criterion was not applied to a subset of participants with a working clinical diagnosis of dystonic cerebral palsy. Genomic DNA was extracted from blood of participants and whole-exome sequenced. To find causative variants in known disorder-associated genes, all variants were filtered, and unreported variants were classified according to American College of Medical Genetics and Genomics guidelines. All considered variants were reviewed in expert round-table sessions to validate their clinical significance. Variants that survived filtering and interpretation procedures were defined as diagnostic variants. In the cases that went undiagnosed, candidate dystonia-causing genes were prioritised in a stepwise workflow. FINDINGS We sequenced the exomes of 764 individuals with dystonia and 346 healthy parents who were recruited between June 1, 2015, and July 31, 2019. We identified causative or probable causative variants in 135 (19%) of 728 families, involving 78 distinct monogenic disorders. We observed a larger proportion of individuals with diagnostic variants in those with dystonia (either isolated or combined) with coexisting non-movement disorder-related neurological symptoms (100 [45%] of 222; excepting cases with evidence of perinatal brain injury) than in those with combined (19 [19%] of 98) or isolated (16 [4%] of 388) dystonia. Across all categories of dystonia, 104 (65%) of the 160 detected variants affected genes which are associated with neurodevelopmental disorders. We found diagnostic variants in 11 genes not previously linked to dystonia, and propose a predictive clinical score that could guide the implementation of exome sequencing in routine diagnostics. In cases without perinatal sentinel events, genomic alterations contributed substantively to the diagnosis of dystonic cerebral palsy. In 15 families, we delineated 12 candidate genes. These include IMPDH2, encoding a key purine biosynthetic enzyme, for which robust evidence existed for its involvement in a neurodevelopmental disorder with dystonia. We identified six variants in IMPDH2, collected from four independent cohorts, that were predicted to be deleterious de-novo variants and expected to result in deregulation of purine metabolism. INTERPRETATION In this study, we have determined the role of monogenic variants across the range of dystonic disorders, providing guidance for the introduction of personalised care strategies and fostering follow-up pathophysiological explorations. FUNDING Else Kröner-Fresenius-Stiftung, Technische Universität München, Helmholtz Zentrum München, Medizinische Universität Innsbruck, Charles University in Prague, Czech Ministry of Education, the Slovak Grant and Development Agency, the Slovak Research and Grant Agency.
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Affiliation(s)
- Michael Zech
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany; Institute of Human Genetics, Technical University of Munich, Munich, Germany
| | - Robert Jech
- Department of Neurology, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Sylvia Boesch
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Matej Škorvánek
- Department of Neurology, Pavol Jozef Šafárik University, Košice, Slovakia; Department of Neurology, University Hospital of Louis Pasteur, Košice, Slovakia
| | - Sandrina Weber
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany; Institute of Human Genetics, Technical University of Munich, Munich, Germany
| | - Matias Wagner
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany; Institute of Human Genetics, Technical University of Munich, Munich, Germany
| | - Chen Zhao
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany
| | - Angela Jochim
- Klinik und Poliklinik für Neurologie, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Ján Necpál
- Department of Neurology, Zvolen Hospital, Zvolen, Slovakia
| | - Yasemin Dincer
- Lehrstuhl für Sozialpädiatrie, Technical University of Munich, Munich, Germany; Zentrum für Humangenetik und Laboratoriumsdiagnostik, Martinsried, Germany
| | - Katharina Vill
- Dr von Haunersches Kinderspital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Felix Distelmaier
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Heinrich-Heine-University, Düsseldorf, Germany
| | | | - Martin Krenn
- Institute of Human Genetics, Technical University of Munich, Munich, Germany; Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Stephan Grunwald
- Crystallography, Max Delbrück Center for Molecular Medicine, Berlin, Germany; Institute of Chemistry and Biochemistry, Free University of Berlin, Berlin, Germany
| | - Tobias Bock-Bierbaum
- Crystallography, Max Delbrück Center for Molecular Medicine, Berlin, Germany; Institute of Chemistry and Biochemistry, Free University of Berlin, Berlin, Germany
| | - Anna Fečíková
- Department of Neurology, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Petra Havránková
- Department of Neurology, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jan Roth
- Department of Neurology, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Iva Příhodová
- Department of Neurology, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Miriam Adamovičová
- Department of Paediatric Neurology, Thomayer Hospital, Prague, Czech Republic
| | - Olga Ulmanová
- Department of Neurology, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Karel Bechyně
- Department of Neurology, Hospital Písek, Pisek, Czech Republic
| | - Pavlína Danhofer
- Department of Child Neurology, Faculty of Medicine of Masaryk University Brno and University Hospital, Brno, Czech Republic
| | - Branislav Veselý
- Department of Neurology, Faculty Hospital, Constantine the Philosopher University, Nitra, Slovakia
| | - Vladimír Haň
- Department of Neurology, Pavol Jozef Šafárik University, Košice, Slovakia; Department of Neurology, University Hospital of Louis Pasteur, Košice, Slovakia
| | - Petra Pavelekova
- Department of Neurology, Pavol Jozef Šafárik University, Košice, Slovakia; Department of Neurology, University Hospital of Louis Pasteur, Košice, Slovakia
| | - Zuzana Gdovinová
- Department of Neurology, Pavol Jozef Šafárik University, Košice, Slovakia; Department of Neurology, University Hospital of Louis Pasteur, Košice, Slovakia
| | - Tobias Mantel
- Klinik und Poliklinik für Neurologie, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Tobias Meindl
- Klinik und Poliklinik für Neurologie, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Alexandra Sitzberger
- Dr von Haunersches Kinderspital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Sebastian Schröder
- Dr von Haunersches Kinderspital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Astrid Blaschek
- Dr von Haunersches Kinderspital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Timo Roser
- Dr von Haunersches Kinderspital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Michaela V Bonfert
- Dr von Haunersches Kinderspital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Edda Haberlandt
- Clinic for Pediatrics, Krankenhaus Stadt Dornbirn, Dornbirn, Austria
| | - Barbara Plecko
- Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, Graz, Austria
| | - Birgit Leineweber
- Sozialpädiatrisches Zentrum, Klinikum Dritter Orden, Munich, Germany
| | - Steffen Berweck
- Ludwig-Maximilians-Universität München, Munich, Germany; Hospital for Neuropediatrics and Neurological Rehabilitation, Centre of Epilepsy for Children and Adolescents, Schoen Klinik Vogtareuth, Vogtareuth, Germany
| | - Thomas Herberhold
- Hospital for Neuropediatrics and Neurological Rehabilitation, Centre of Epilepsy for Children and Adolescents, Schoen Klinik Vogtareuth, Vogtareuth, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Jana Švantnerová
- Second Department of Neurology, Faculty of Medicine, Comenius University, University Hospital Bratislava, Bratislava, Slovakia
| | - Michal Minár
- Second Department of Neurology, Faculty of Medicine, Comenius University, University Hospital Bratislava, Bratislava, Slovakia
| | | | - Monica H Wojcik
- Divisions of Newborn Medicine and Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA; Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Sander Pajusalu
- Department of Clinical Genetics, Tartu University Hospital, Tartu, Estonia; Department of Clinical Genetics, University of Tartu, Tartu, Estonia; Department of Genetics, Yale School of Medicine, New Haven, CT, USA
| | - Katrin Õunap
- Department of Clinical Genetics, Tartu University Hospital, Tartu, Estonia; Department of Clinical Genetics, University of Tartu, Tartu, Estonia
| | - Ulrich A Schatz
- Institute of Human Genetics, Technical University of Munich, Munich, Germany; Institute of Human Genetics, Medical University Innsbruck, Innsbruck, Austria
| | - Laura Pölsler
- Institute of Human Genetics, Medical University Innsbruck, Innsbruck, Austria
| | - Ivan Milenkovic
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Franco Laccone
- Institute of Medical Genetics, Medical University of Vienna, Vienna, Austria
| | | | - Roberto Colombo
- Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Steffi Patzer
- Klinik für Kinder-und Jugendmedizin St Elisabeth und St Barbara, Halle, Germany
| | - Arcangela Iuso
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany; Institute of Human Genetics, Technical University of Munich, Munich, Germany
| | - Julia Vera
- Child Neurology Service, Hospital San Borja Arriarán, University of Chile, Santiago, Chile
| | - Monica Troncoso
- Child Neurology Service, Hospital San Borja Arriarán, University of Chile, Santiago, Chile
| | - Fang Fang
- Department of Neurology, National Center for Children's Health, Beijing Children's Hospital and Capital Medical University, Beijing, China
| | - Holger Prokisch
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany; Institute of Human Genetics, Technical University of Munich, Munich, Germany
| | - Friederike Wilbert
- Department of Neuropediatrics and Muscle Disorders, University Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Matthias Eckenweiler
- Department of Neuropediatrics and Muscle Disorders, University Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Elisabeth Graf
- Institute of Human Genetics, Technical University of Munich, Munich, Germany
| | - Dominik S Westphal
- Institute of Human Genetics, Technical University of Munich, Munich, Germany
| | - Korbinian M Riedhammer
- Institute of Human Genetics, Technical University of Munich, Munich, Germany; Department of Nephrology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Theresa Brunet
- Institute of Human Genetics, Technical University of Munich, Munich, Germany
| | - Bader Alhaddad
- Institute of Human Genetics, Technical University of Munich, Munich, Germany
| | - Riccardo Berutti
- Institute of Human Genetics, Technical University of Munich, Munich, Germany
| | - Tim M Strom
- Institute of Human Genetics, Technical University of Munich, Munich, Germany
| | - Martin Hecht
- Neurologische Klinik am Klinikum Kaufbeuren, Bezirkskliniken Schwaben, Kaufbeuren, Germany
| | - Matthias Baumann
- Department of Pediatrics, Medical University Innsbruck, Innsbruck, Austria
| | - Marc Wolf
- Neurologische Klinik, Klinikum Stuttgart, Stuttgart, Germany; Neurologische Klinik, Universitätsmedizin Mannheim, Mannheim, University of Heidelberg, Mannheim, Germany
| | | | | | | | | | - David Weise
- Klinik für Neurologie, Asklepios Fachklinikum Stadtroda, Stadtroda, Germany
| | - Thomas Musacchio
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Jens Volkmann
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Anna Szuto
- Division of Clinical and Metabolic Genetics, Hospital for Sick Children and University of Toronto, Toronto, ON, Canada; Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
| | - Jessica Becker
- Institute of Human Genetics, University of Bonn and University Hospital Bonn, Bonn, Germany
| | - Kirsten Cremer
- Institute of Human Genetics, University of Bonn and University Hospital Bonn, Bonn, Germany
| | - Thomas Sycha
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Fritz Zimprich
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Verena Kraus
- Department of Paediatrics, School of Medicine, Technical University of Munich, Munich, Germany
| | - Christine Makowski
- Department of Paediatrics, School of Medicine, Technical University of Munich, Munich, Germany
| | - Pedro Gonzalez-Alegre
- Department of Neurology, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | - Tanya M Bardakjian
- Department of Neurology, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | - Laurie J Ozelius
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Annalisa Vetro
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Renzo Guerrini
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Esther Maier
- Dr von Haunersches Kinderspital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Ingo Borggraefe
- Dr von Haunersches Kinderspital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Alice Kuster
- Inborn Errors of Metabolism, Pediatric Intensive Care Unit, University Hospital of Nantes, Nantes, France
| | - Saskia B Wortmann
- Institute of Human Genetics, Technical University of Munich, Munich, Germany; University Children's Hospital, Salzburger Landeskliniken and Paracelsus Medical University, Salzburg, Austria; Radboud Center for Mitochondrial Medicine, Department of Pediatrics, Amalia Children's Hospital, Radboudumc, Nijmegen, Netherlands
| | - Annette Hackenberg
- Department of Pediatric Neurology, University Children's Hospital, Zürich, Switzerland
| | - Robert Steinfeld
- Department of Pediatric Neurology, University Children's Hospital, Zürich, Switzerland
| | - Birgit Assmann
- Division of Neuropediatrics and Metabolic Medicine, Department of General Pediatrics, University Hospital Heidelberg, Heidelberg, Germany
| | - Christian Staufner
- Division of Neuropediatrics and Metabolic Medicine, Department of General Pediatrics, University Hospital Heidelberg, Heidelberg, Germany
| | - Thomas Opladen
- Division of Neuropediatrics and Metabolic Medicine, Department of General Pediatrics, University Hospital Heidelberg, Heidelberg, Germany
| | - Evžen Růžička
- Department of Neurology, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Ronald D Cohn
- Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, ON, Canada; Hospital for Sick Children Research Institute, Hospital for Sick Children and University of Toronto, Toronto, ON, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - David Dyment
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Wendy K Chung
- Department of Pediatrics and Department of Medicine, Columbia University, New York, NY, USA
| | - Hartmut Engels
- Institute of Human Genetics, University of Bonn and University Hospital Bonn, Bonn, Germany
| | | | - Rafal Ploski
- Department of Medical Genetics, Medical University of Warsaw, Warsaw, Poland
| | - Oliver Daumke
- Crystallography, Max Delbrück Center for Molecular Medicine, Berlin, Germany; Institute of Chemistry and Biochemistry, Free University of Berlin, Berlin, Germany
| | - Bernhard Haslinger
- Klinik und Poliklinik für Neurologie, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Volker Mall
- Lehrstuhl für Sozialpädiatrie, Technical University of Munich, Munich, Germany; kbo-Kinderzentrum München, Munich, Germany
| | - Konrad Oexle
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany
| | - Juliane Winkelmann
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany; Institute of Human Genetics, Technical University of Munich, Munich, Germany; Lehrstuhl für Neurogenetik, Technical University of Munich, Munich, Germany; Munich Cluster for Systems Neurology, SyNergy, Munich, Germany.
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14
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Jarius S, Lechner C, Wendel EM, Baumann M, Breu M, Schimmel M, Karenfort M, Marina AD, Merkenschlager A, Thiels C, Blaschek A, Salandin M, Leiz S, Leypoldt F, Pschibul A, Hackenberg A, Hahn A, Syrbe S, Strautmanis J, Häusler M, Krieg P, Eisenkölbl A, Stoffels J, Eckenweiler M, Ayzenberg I, Haas J, Höftberger R, Kleiter I, Korporal-Kuhnke M, Ringelstein M, Ruprecht K, Siebert N, Schanda K, Aktas O, Paul F, Reindl M, Wildemann B, Rostásy K. Cerebrospinal fluid findings in patients with myelin oligodendrocyte glycoprotein (MOG) antibodies. Part 2: Results from 108 lumbar punctures in 80 pediatric patients. J Neuroinflammation 2020; 17:262. [PMID: 32883358 PMCID: PMC7470445 DOI: 10.1186/s12974-020-01825-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 04/23/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND New-generation, cell-based assays have demonstrated a robust association of serum autoantibodies to full-length human myelin oligodendrocyte glycoprotein (MOG-IgG) with (mostly recurrent) optic neuritis, myelitis, and brainstem encephalitis, as well as with neuromyelitis optica (NMO)-like or acute-disseminated encephalomyelitis (ADEM)-like presentations. However, only limited data are yet available on cerebrospinal fluid (CSF) findings in MOG-IgG-associated encephalomyelitis (MOG-EM; also termed MOG antibody-associated disease, MOGAD). OBJECTIVE To describe systematically the CSF profile in children with MOG-EM. MATERIAL AND METHODS Cytological and biochemical findings (including white cell counts [WCC] and differentiation; frequency and patterns of oligoclonal bands; IgG/IgM/IgA and albumin concentrations and CSF/serum ratios; intrathecal IgG/IgM/IgA fractions; locally produced IgG/IgM/IgA concentrations; immunoglobulin class patterns; IgG/IgA/IgM reibergrams; Link index; measles/rubella/zoster [MRZ] reaction; other anti-viral and anti-bacterial antibody indices; CSF total protein; CSF L-lactate) from 108 lumbar punctures in 80 pediatric patients of mainly Caucasian descent with MOG-EM were analyzed retrospectively. RESULTS Most strikingly, CSF-restricted oligoclonal IgG bands, a hallmark of multiple sclerosis (MS), were absent in 89% of samples (N = 96), and the MRZ reaction, the most specific laboratory marker of MS known so far, in 100% (N = 29). If present at all, intrathecal IgG synthesis was low, often transient and mostly restricted to acute attacks. Intrathecal IgM synthesis was present in 21% and exclusively detectable during acute attacks. CSF WCC were elevated in 54% of samples (median 40 cells/μl; range 6-256; mostly lymphocytes and monocytes; > 100/μl in 11%). Neutrophils were present in 71% of samples; eosinophils, activated lymphocytes, and plasma cells were seen only rarely (all < 7%). Blood-CSF barrier dysfunction (as indicated by an elevated albumin CSF/serum ratio) was present in 46% of all samples (N = 79) and at least once in 48% of all patients (N = 67) tested. CSF alterations were significantly more frequent and/or more pronounced in patients with acute spinal cord or brain disease than in patients with acute ON and varied strongly depending on attack severity. CSF L-lactate levels correlated significantly with the spinal cord lesions load (measured in vertebral segments) in patients with acute myelitis (p = 0.0099). An analysis of pooled data from the pediatric and the adult cohort showed a significant relationship of QAlb (p < 0.0005), CST TP (p < 0.0001), and CSF L-lactate (p < 0.0003) during acute attacks with age. CONCLUSION MOG-IgG-associated EM in children is characterized by CSF features that are distinct from those in MS. With regard to most parameters, no marked differences between the pediatric cohort and the adult cohort analyzed in Part 1 were noted. Our findings are important for the differential diagnosis of pediatric MS and MOG-EM and add to the understanding of the immunopathogenesis of this newly described autoimmune disease.
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Affiliation(s)
- Sven Jarius
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany.
| | - Christian Lechner
- Division of Pediatric Neurology, Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Eva M Wendel
- Department of Pediatrics, Olgahospital, Klinikum Stuttgart, Stuttgart, Germany
| | - Matthias Baumann
- Division of Pediatric Neurology, Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Markus Breu
- Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Mareike Schimmel
- Division of Pediatric Neurology, Children's Hospital, Medical University of Augsburg, Augsburg, Germany
| | - Michael Karenfort
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Heinrich-Heine-University, Düsseldorf, Germany
| | - Adela Della Marina
- Department of Neuropediatrics, Developmental Neurology and Social Pediatrics, Children's Hospital, University of Duisburg-Essen, Duisburg, Germany
| | - Andreas Merkenschlager
- Division of Pediatric Neurology, University Hospital for Children and Adolescents, Leipzig, Germany
| | - Charlotte Thiels
- Department of Neuropediatrics, University Children's Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Astrid Blaschek
- Department of Pediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, University of Munich, Munich, Germany
| | | | - Steffen Leiz
- Department of Pediatrics, Division of Pediatric Neurology, Klinikum Dritter Orden, Munich, Germany
| | - Frank Leypoldt
- Neuroimmunology, Institute of Clinical Chemistry and Department of Neurology, Christian-Albrechts-University Kiel and Medical University Hospital Schleswig-Holstein, Kiel, Germany
| | - Alexander Pschibul
- Department of Neuropediatrics and Muscle Disorders, University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Annette Hackenberg
- Division of Pediatric Neurology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Andreas Hahn
- Department of Pediatric Neurology, University Children's Hospital Giessen, Giessen, Germany
| | - Steffen Syrbe
- Division of Child Neurology and Inherited Metabolic Diseases, Department of General Pediatrics, Center for Child and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Jurgis Strautmanis
- Department of Neurology, Children's Clinical University Hospital, Riga, Latvia
| | - Martin Häusler
- Department of Pediatrics, Division of Neuropediatrics and Social Pediatrics, Medical University RWTH Aachen, Aachen, Germany
| | - Peter Krieg
- Department of Pediatrics, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | - Astrid Eisenkölbl
- Department of Pediatrics, Women's and Children's Hospital, Linz, Austria
| | - Johannes Stoffels
- Department of Pediatric Neurology, Children's Hospital Neuburg, Neuburg, Germany
| | - Matthias Eckenweiler
- Department of Neuropediatrics and Muscle Disorders, University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ilya Ayzenberg
- Department of Neurology, St Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Jürgen Haas
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | - Romana Höftberger
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - Ingo Kleiter
- Department of Neurology, St Josef Hospital, Ruhr-University Bochum, Bochum, Germany
- Marianne-Strauß-Klinik, Behandlungszentrum Kempfenhausen für Multiple Sklerose Kranke gGmbH, Berg, Germany
| | - Mirjam Korporal-Kuhnke
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | - Marius Ringelstein
- Department of Neurology, Medical Faculty, Heinrich Heine University Dusseldorf, Düsseldorf, Germany
- Department of Neurology, Center for Neurology and Neuropsychiatry, LVR-Klinikum, Heinrich Heine University Dusseldorf, Düsseldorf, Germany
| | - Klemens Ruprecht
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nadja Siebert
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine, and Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Kathrin Schanda
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Orhan Aktas
- Department of Pediatric Neurology, Children's Hospital Neuburg, Neuburg, Germany
| | - Friedemann Paul
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine, and Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Markus Reindl
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Brigitte Wildemann
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | - Kevin Rostásy
- Department of Pediatric Neurology, Children's Hospital Datteln, University Witten/Herdecke, Datteln, Germany.
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15
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Henzi BC, Brotschi B, Balmer C, Hennig B, Rimensberger P, Perez MH, Pfammatter JP, Beghetti M, Sekarski N, Datta AN, Fluss J, Faignart N, Hackenberg A, Regényi M, Steinlin M, Hug MI. Risk Factors for Postprocedural Arterial Ischemic Stroke in Children With Cardiac Disease. Stroke 2020; 51:e242-e245. [PMID: 32811375 DOI: 10.1161/strokeaha.120.029447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Cardiac pathologies are the second most frequent risk factor (RF) in children with arterial ischemic stroke (AIS). This study aimed to analyze RFs for AIS in children with cardiac disease and cardiac intervention. METHODS Data were drawn from the Swiss Neuropediatric Stroke Registry. Patients with cardiac disease and postprocedural AIS registered from 2000 until 2015 were analyzed for the cause of cardiac disease and for potential RFs. RESULTS Forty-seven out of 78 children with cardiac disease had a cardiac intervention. Of these, 36 presented a postprocedural AIS. Median time from cardiac intervention to symptom onset was 4 days (interquartile range, 2-8.5); time to diagnosis of AIS was 2 days (interquartile range, 0-5.8). Main RFs for postprocedural AIS were hypotension, prosthetic cardiac material, right-to-left shunt, arrhythmias, low cardiac output, and infections. CONCLUSIONS In children with postprocedural AIS, time to diagnosis was delayed. Most patients presented multiple potentially modifiable RFs as hemodynamic alterations and infections.
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Affiliation(s)
- Bettina C Henzi
- Division of Child Neurology, Department of Pediatrics, University Children's Hospital Bern, University of Bern, Switzerland (B.C.H., M.R., M.S.).,Department of Pediatric Neurology and Developmental Medicine, University of Basel, Children's Hospital Basel, Switzerland (B.C.H., A.N.D.)
| | - Barbara Brotschi
- Department of Pediatric and Neonatal Intensive Care, University Children's Hospital Zurich, Switzerland (B.B.)
| | - Christian Balmer
- Department of Pediatric Cardiology, University Children's Hospital Zurich, Switzerland (C.B.)
| | - Bert Hennig
- Division of Pediatric Intensive Care, University Children's Hospital Bern, University of Bern, Switzerland (B.H.)
| | - Peter Rimensberger
- Division of Neonatology and Pediatric Intensive Care, Department of Pediatrics, University
Hospital of Geneva, Switzerland (P.R.)
| | - Marie-Hélène Perez
- Pediatric Intensive Care Unit, Department of Pediatrics, University Hospital of Lausanne, Switzerland (M.-H.P.)
| | - Jean-Pierre Pfammatter
- Center for Congenital Heart Disease, Departments of Cardiology and Cardiac Surgery, University Hospital of Bern, Switzerland (J.-P.P.)
| | - Maurice Beghetti
- Pediatric Cardiology Unit, University Children's Hospital HUG, Pulmonary Hypertension Program HUG, Centre Universitaire Romand de Cardiologie et Chirurgie Cardiaque Pédiatrique (CURCCCP), University of Geneva, Switzerland (M.B.)
| | - Nicole Sekarski
- Pediatric Cardiology Unit, Department of Pediatrics, Centre Universitaire Romand de Cardiologie et Chirurgie Cardiaque Pediatrique (CURCCCP), Lausanne University Hospital, Switzerland (N.S.)
| | - Alexandre N Datta
- Department of Pediatric Neurology and Developmental Medicine, University of Basel, Children's Hospital Basel, Switzerland (B.C.H., A.N.D.)
| | - Joel Fluss
- Pediatric Neurology Unit, Geneva Children's Hospital, Switzerland (J.F.)
| | - Nicole Faignart
- Pediatric Neurology, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital, Switzerland (N.F.)
| | - Annette Hackenberg
- Department of Pediatric Neurology, University Children's Hospital Zurich, Switzerland (A.H.)
| | - Mária Regényi
- Division of Child Neurology, Department of Pediatrics, University Children's Hospital Bern, University of Bern, Switzerland (B.C.H., M.R., M.S.)
| | - Maja Steinlin
- Division of Child Neurology, Department of Pediatrics, University Children's Hospital Bern, University of Bern, Switzerland (B.C.H., M.R., M.S.)
| | - Maja I Hug
- Department of Neonatology, University of Basel Children's Hospital (UKBB), Switzerland (M.I.H.)
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16
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Wendel EM, Baumann M, Barisic N, Blaschek A, Coelho de Oliveira Koch E, Della Marina A, Diepold K, Hackenberg A, Hahn A, von Kalle T, Karenfort M, Kornek B, Lechner C, Leiz S, Merkenschlager A, Nosadini M, Sartori S, Schanda K, Schimmel M, Seemann L, Tüngler V, Waltz S, Wegener-Panzer A, Wiegand G, Reindl M, Rostásy K. High association of MOG-IgG antibodies in children with bilateral optic neuritis. Eur J Paediatr Neurol 2020; 27:86-93. [PMID: 32327391 DOI: 10.1016/j.ejpn.2020.04.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/22/2020] [Accepted: 04/07/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Bilateral optic neuritis (bilON) is a rare clinical presentation often thought to be associated with relapsing disorders such as neuromyelitis optica spectrum disorders (NMOSD) or multiple sclerosis (MS). OBJECTIVE To characterize the clinical, radiological phenotype and antibody status of children presenting with bilON. MATERIAL AND METHODS Retrospective multicenter study on children with bilON age <18 years with a first episode aquired demyelinating syndrome (ADS), cMRI, AQP4- and serum MOG-antibody status and follow-up data were collected. RESULTS 30 patients (f:m = 15:15, median age 8.0y) with bilON met the inclusion criteria. 22/30 (73%) were MOG-positive (median: 1:1280, range: 1:160-1:1520). No patient showed AQP4-abs. 4/30 patients (13%), all with high MOG-abs titers, had recurrent episodes. No patient developed MS. Improvement after IVMP was observed in most patients (26/30; 87%). Outcome was favorable with no sequelae in 22/30 patients. Serial MOG-abs titers tested in 15/22 patients decreased to a median of 1:160 (range: 0-1:640) over a period of 31 months (range: 2-141 months) in 14/15 (93%) patients. MR imaging showed a predominantly anterior affection of the visual system in seropositive patients with bilateral intraorbital lesions in 68% (15/22), compared to 25% in MOG-negative patients (2/8). CONCLUSION Pediatric bilON is associated with high MOG-abs titers in combination with anterior involvement of the visual system. Despite severe loss of vision, the majority of patients shows distinct recovery after IVMP.
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Affiliation(s)
- Eva-Maria Wendel
- Department of Pediatrics, Olgahospital, Klinikum, Stuttgart, Germany
| | - Matthias Baumann
- Division of Pediatric Neurology, Department of Pediatrics I, Medical University of Innsbruck, Austria
| | - Nina Barisic
- Department of Pediatrics, Clinical Medical Center Zagreb, University of Zagreb Medical School, Croatia
| | - Astrid Blaschek
- Department of Pediatric Neurology, Dr. von Hauner Children's Hospital, Ludwig-Maximillian-Universität Munich, Germany
| | | | - Adela Della Marina
- Department of Neuropediatrics, Developmental Neurology and Social Pediatrics, Children's Hospital, University of Duisburg-Essen, Germany
| | - Katharina Diepold
- Division of Pediatric Neurology, Department of Pediatrics, Hospital Kassel, Germany
| | - Annette Hackenberg
- Department of Pediatric Neurology, University Children's Hospital, Zürich, Switzerland
| | - Andreas Hahn
- Division of Pediatric Neurology, Department of Pediatrics, Medical University Giessen, Germany
| | - Thekla von Kalle
- Department of Pediatric Radiology, Olgahospital, Klinikum Stuttgart, Germany
| | - Michael Karenfort
- Department of Pediatrics, Neonatology and Pediatric Cardiology, Children's Hospital, Heinrich-Heine-University, Düsseldorf, Germany
| | - Barbara Kornek
- Department of Neurology, Medical University Vienna, Austria
| | - Christian Lechner
- Division of Pediatric Neurology, Department of Pediatrics I, Medical University of Innsbruck, Austria
| | - Steffen Leiz
- Division of Pediatric Neurology, Department of Pediatrics, Klinikum Dritter Orden, Munich, Germany
| | - Andreas Merkenschlager
- Division of Pediatric Neurology, Department of Pediatrics, Medical University of Leipzig, Germany
| | - Margherita Nosadini
- Paediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padua, Italy
| | - Stefano Sartori
- Paediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padua, Italy
| | - Kathrin Schanda
- Clinical Department of Neurology, Medical University of Innsbruck, Austria
| | - Mareike Schimmel
- Division of Pediatric Neurology, Children's Hospital, Medical University of Augsburg, Germany
| | - Larissa Seemann
- Department of Pediatric Neurology, Children's Hospital DRK Siegen, Germany
| | - Victoria Tüngler
- Division of Pediatric Neurology, Department of Pediatrics, Medical University Carl Gustav Carus, Dresden, Germany
| | - Stephan Waltz
- Department of Pediatric Neurology, Children's Hospital Amsterdamer Straße, Cologne, Germany
| | - Andreas Wegener-Panzer
- Department of Pediatric Radiology, Children's Hospital Datteln, University Witten/Herdecke, Germany
| | - Gert Wiegand
- Division of Pediatric Neurology, Department of Pediatrics, Asklepios Klinik Nord, Heidberg/Hamburg, Germany
| | - Markus Reindl
- Clinical Department of Neurology, Medical University of Innsbruck, Austria
| | - Kevin Rostásy
- Department of Pediatric Neurology, Children's Hospital Datteln, University Witten/Herdecke, Germany.
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17
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Groeneweg S, van Geest FS, Abacı A, Alcantud A, Ambegaonkar GP, Armour CM, Bakhtiani P, Barca D, Bertini ES, van Beynum IM, Brunetti-Pierri N, Bugiani M, Cappa M, Cappuccio G, Castellotti B, Castiglioni C, Chatterjee K, de Coo IFM, Coutant R, Craiu D, Crock P, DeGoede C, Demir K, Dica A, Dimitri P, Dolcetta-Capuzzo A, Dremmen MHG, Dubey R, Enderli A, Fairchild J, Gallichan J, George B, Gevers EF, Hackenberg A, Halász Z, Heinrich B, Huynh T, Kłosowska A, van der Knaap MS, van der Knoop MM, Konrad D, Koolen DA, Krude H, Lawson-Yuen A, Lebl J, Linder-Lucht M, Lorea CF, Lourenço CM, Lunsing RJ, Lyons G, Malikova J, Mancilla EE, McGowan A, Mericq V, Lora FM, Moran C, Müller KE, Oliver-Petit I, Paone L, Paul PG, Polak M, Porta F, Poswar FO, Reinauer C, Rozenkova K, Menevse TS, Simm P, Simon A, Singh Y, Spada M, van der Spek J, Stals MAM, Stoupa A, Subramanian GM, Tonduti D, Turan S, den Uil CA, Vanderniet J, van der Walt A, Wémeau JL, Wierzba J, de Wit MCY, Wolf NI, Wurm M, Zibordi F, Zung A, Zwaveling-Soonawala N, Visser WE. Disease characteristics of MCT8 deficiency: an international, retrospective, multicentre cohort study. Lancet Diabetes Endocrinol 2020; 8:594-605. [PMID: 32559475 PMCID: PMC7611932 DOI: 10.1016/s2213-8587(20)30153-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/14/2020] [Accepted: 04/19/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Disordered thyroid hormone transport, due to mutations in the SLC16A2 gene encoding monocarboxylate transporter 8 (MCT8), is characterised by intellectual and motor disability resulting from cerebral hypothyroidism and chronic peripheral thyrotoxicosis. We sought to systematically assess the phenotypic characteristics and natural history of patients with MCT8 deficiency. METHODS We did an international, multicentre, cohort study, analysing retrospective data from Jan 1, 2003, to Dec 31, 2019, from patients with MCT8 deficiency followed up in 47 hospitals in 22 countries globally. The key inclusion criterion was genetically confirmed MCT8 deficiency. There were no exclusion criteria. Our primary objective was to analyse the overall survival of patients with MCT8 deficiency and document causes of death. We also compared survival between patients who did or did not attain full head control by age 1·5 years and between patients who were or were not underweight by age 1-3 years (defined as a bodyweight-for-age Z score <-2 SDs or <5th percentile according to WHO definition). Other objectives were to assess neurocognitive function and outcomes, and clinical parameters including anthropometric characteristics, biochemical markers, and neuroimaging findings. FINDINGS Between Oct 14, 2014, and Jan 17, 2020, we enrolled 151 patients with 73 different MCT8 (SLC16A2) mutations. Median age at diagnosis was 24·0 months (IQR 12·0-60·0, range 0·0-744·0). 32 (21%) of 151 patients died; the main causes of mortality in these patients were pulmonary infection (six [19%]) and sudden death (six [19%]). Median overall survival was 35·0 years (95% CI 8·3-61·7). Individuals who did not attain head control by age 1·5 years had an increased risk of death compared with patients who did attain head control (hazard ratio [HR] 3·46, 95% CI 1·76-8·34; log-rank test p=0·0041). Patients who were underweight during age 1-3 years had an increased risk for death compared with patients who were of normal bodyweight at this age (HR 4·71, 95% CI 1·26-17·58, p=0·021). The few motor and cognitive abilities of patients did not improve with age, as evidenced by the absence of significant correlations between biological age and scores on the Gross Motor Function Measure-88 and Bayley Scales of Infant Development III. Tri-iodothyronine concentrations were above the age-specific upper limit in 96 (95%) of 101 patients and free thyroxine concentrations were below the age-specific lower limit in 94 (89%) of 106 patients. 59 (71%) of 83 patients were underweight. 25 (53%) of 47 patients had elevated systolic blood pressure above the 90th percentile, 34 (76%) of 45 patients had premature atrial contractions, and 20 (31%) of 64 had resting tachycardia. The most consistent MRI finding was a global delay in myelination, which occurred in 13 (100%) of 13 patients. INTERPRETATION Our description of characteristics of MCT8 deficiency in a large patient cohort reveals poor survival with a high prevalence of treatable underlying risk factors, and provides knowledge that might inform clinical management and future evaluation of therapies. FUNDING Netherlands Organisation for Health Research and Development, and the Sherman Foundation.
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Affiliation(s)
- Stefan Groeneweg
- Academic Center For Thyroid Disease, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, Netherlands
| | - Ferdy S van Geest
- Academic Center For Thyroid Disease, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, Netherlands
| | - Ayhan Abacı
- Division of Pediatric Endocrinology, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey
| | - Alberto Alcantud
- Pediatric Neurology Section, Hospital Francesc de Borja de Gandia, Valencia, Spain
| | - Gautem P Ambegaonkar
- Department of Paediatric Neurology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Christine M Armour
- Regional Genetics Program, Children's Hospital of Eastern Ontario, and Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON, Canada
| | | | - Diana Barca
- Paediatric Neurology Clinic, Alexandru Obregia Hospital, Bucharest, Romania; Department of Neurosciences, Paediatric Neurology Discipline II, Carol Davila University of Medicine, Bucharest, Romania
| | - Enrico S Bertini
- Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesu' Children's Research Hospital IRCCS, Rome, Italy
| | - Ingrid M van Beynum
- Sophia Children's Hospital, Division of Paediatric Cardiology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Nicola Brunetti-Pierri
- Department of Translational Medicine, Federico II University, Naples, Italy; Telethon Institute of Genetics and Medicine, Pozzuoli, Naples, Italy
| | - Marianna Bugiani
- Department of Child Neurology, Center for Childhood White Matter Diseases, Emma Children's Hospital, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, and Amsterdam Neuroscience, Amsterdam, Netherlands; Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Marco Cappa
- Division of Endocrinology, Bambino Gesu' Children's Research Hospital IRCCS, Rome, Italy
| | - Gerarda Cappuccio
- Department of Translational Medicine, Federico II University, Naples, Italy; Telethon Institute of Genetics and Medicine, Pozzuoli, Naples, Italy
| | - Barbara Castellotti
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Krishna Chatterjee
- Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Irenaeus F M de Coo
- Department of Paediatric Neurology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Régis Coutant
- Department of Pediatric Endocrinology and Diabetology, University Hospital, Angers, France
| | - Dana Craiu
- Paediatric Neurology Clinic, Alexandru Obregia Hospital, Bucharest, Romania; Department of Neurosciences, Paediatric Neurology Discipline II, Carol Davila University of Medicine, Bucharest, Romania
| | - Patricia Crock
- John Hunter Children's Hospital and University of Newcastle, Newcastle, NSW, Australia
| | | | - Korcan Demir
- Division of Pediatric Endocrinology, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey
| | - Alice Dica
- Paediatric Neurology Clinic, Alexandru Obregia Hospital, Bucharest, Romania; Department of Neurosciences, Paediatric Neurology Discipline II, Carol Davila University of Medicine, Bucharest, Romania
| | - Paul Dimitri
- Sheffield Children's NHS Foundation Trust, Sheffield Hallam University and University of Sheffield, Sheffield, UK
| | - Anna Dolcetta-Capuzzo
- Academic Center For Thyroid Disease, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, Netherlands; Università Vita-Salute San Raffaele, Milan, Italy
| | | | | | - Anina Enderli
- Department of Neuropediatrics, University Children's Hospital Zurich, Zürich, Switzerland
| | - Jan Fairchild
- Department of Diabetes and Endocrinology, Women's and Children's Hospital, North Adelaide, SA, Australia
| | | | - Belinda George
- Department of Endocrinology, St. John's Medical College Hospital, Bengaluru, Karnataka, India
| | - Evelien F Gevers
- Centre for Endocrinology, William Harvey Research institute, Queen Mary University London, London, UK; Dept of Paediatric Endocrinology, Barts Health NHS Trust, London, UK
| | - Annette Hackenberg
- Department of Neuropediatrics, University Children's Hospital Zurich, Zürich, Switzerland
| | - Zita Halász
- Department of Paediatrics, Semmelweis University, Budapest, Hungary
| | - Bianka Heinrich
- Department of Neuropediatrics, University Children's Hospital Zurich, Zürich, Switzerland
| | - Tony Huynh
- Department of Endocrinology & Diabetes, Queensland Children's Hospital, South Brisbane, QLD, Australia; Department of Chemical Pathology, Mater Pathology, South Brisbane, QLD, Australia; Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Anna Kłosowska
- Medical University of Gdańsk, Department of Paediatrics, Haematology & Oncology, Department of General Nursery, Gdańsk, Poland
| | - Marjo S van der Knaap
- Department of Child Neurology, Center for Childhood White Matter Diseases, Emma Children's Hospital, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, and Amsterdam Neuroscience, Amsterdam, Netherlands
| | | | - Daniel Konrad
- Division of Pediatric Endocrinology and Diabetology and Children's Research Center, University Children's Hospital, Zurich, Switzerland
| | - David A Koolen
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center (Radboudumc), Nijmegen, Netherlands
| | - Heiko Krude
- Department of Paediatric Endocrinology and Diabetology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Amy Lawson-Yuen
- Genomics Institute Mary Bridge Children's Hospital, MultiCare Health System Tacoma, WA, USA
| | - Jan Lebl
- Department of Paediatrics, Second Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - Michaela Linder-Lucht
- Division of Neuropediatrics and Muscular Disorders, Department of Pediatrics and Adolescent Medicine, University Hospital Freiburg, Freiburg, Germany
| | - Cláudia F Lorea
- Teaching Hospital of Universidade Federal de Pelotas, Pelotas, Brazil
| | - Charles M Lourenço
- Faculdade de Medicina, Centro Universitario Estácio de Ribeirão Preto, Ribeirão Preto, Brazil
| | - Roelineke J Lunsing
- Department of Child Neurology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Greta Lyons
- Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Jana Malikova
- Department of Paediatrics, Second Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - Edna E Mancilla
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, PA, USA
| | - Anne McGowan
- Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Veronica Mericq
- Institute of Maternal and Child Research, University of Chile, Santiago, Chile; Department of Pediatrics, Clinica Las Condes, Santiago, Chile
| | - Felipe M Lora
- Pediatric Endocrinology Group, Santa Catarina Hospital, São Paulo, Brazil
| | - Carla Moran
- Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | | | - Isabelle Oliver-Petit
- Department of Paediatric Endocrinology and Genetics, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Laura Paone
- Division of Endocrinology, Bambino Gesu' Children's Research Hospital IRCCS, Rome, Italy
| | - Praveen G Paul
- Department of Paediatrics, Christian Medical College, Vellore, India
| | - Michel Polak
- Paediatric Endocrinology, Diabetology and Gynaecology Department, Necker Children's University Hospital, Imagine Institute, Paris, France
| | - Francesco Porta
- Department of Paediatrics, AOU Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - Fabiano O Poswar
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Christina Reinauer
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Medical Faculty, Duesseldorf, Germany
| | - Klara Rozenkova
- Department of Paediatrics, Second Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - Tuba S Menevse
- Marmara University School of Medicine Department of Pediatric Endocrinology, Istanbul, Turkey
| | - Peter Simm
- Royal Children's Hospital, Parkville, Melbourne, VIC, Australia
| | - Anna Simon
- Department of Paediatrics, Christian Medical College, Vellore, India
| | - Yogen Singh
- Department of Paediatric Cardiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Marco Spada
- Department of Paediatrics, AOU Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - Jet van der Spek
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center (Radboudumc), Nijmegen, Netherlands
| | - Milou A M Stals
- Academic Center For Thyroid Disease, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, Netherlands
| | - Athanasia Stoupa
- Paediatric Endocrinology, Diabetology and Gynaecology Department, Necker Children's University Hospital, Imagine Institute, Paris, France
| | | | - Davide Tonduti
- Child Neurology Unit, Fondazione IRCCS, Istituto Neurologico Carlo Besta, Milan, Italy
| | - Serap Turan
- Marmara University School of Medicine Department of Pediatric Endocrinology, Istanbul, Turkey
| | - Corstiaan A den Uil
- Department of Cardiology and Intensive Care Medicine, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Joel Vanderniet
- John Hunter Children's Hospital and University of Newcastle, Newcastle, NSW, Australia
| | | | | | - Jolante Wierzba
- Medical University of Gdańsk, Department of Paediatrics, Haematology & Oncology, Department of General Nursery, Gdańsk, Poland
| | | | - Nicole I Wolf
- Department of Child Neurology, Center for Childhood White Matter Diseases, Emma Children's Hospital, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, and Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Michael Wurm
- Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany; KUNO Children's University Hospital, Campus St. Hedwig, University of Regensburg, Regensburg, Germany
| | - Federica Zibordi
- Child Neurology Unit, Fondazione IRCCS, Istituto Neurologico Carlo Besta, Milan, Italy
| | - Amnon Zung
- Paediatric Endocrinology Unit, Kaplan Medical Center, Rehovot, Israel; Hebrew University of Jerusalem, Jerusalem, Israel
| | - Nitash Zwaveling-Soonawala
- Emma Children's Hospital, Department of Paediatric Endocrinology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - W Edward Visser
- Academic Center For Thyroid Disease, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, Netherlands.
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18
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Wiedemann A, Pastore-Wapp M, Slavova N, Steiner L, Weisstanner C, Regényi M, Steinlin M, Grunt S, Bigi S, Datta A, Fluss J, Hackenberg A, Keller E, MacKay MT, Maier O, Mercati D, Marcoz JP, Poloni C, Ramelli GP, Regényi M, Schmid R, Schmitt-Mechelke T. Impact of stroke volume on motor outcome in neonatal arterial ischemic stroke. Eur J Paediatr Neurol 2020; 25:97-105. [PMID: 31740218 DOI: 10.1016/j.ejpn.2019.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/22/2019] [Accepted: 10/29/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Neonatal arterial ischemic stroke (NAIS) can lead to long-term neurological consequences such as cerebral palsy (CP). The aim of this study was to evaluate the predictive value of acute diffusion-weighted imaging (DWI) for CP by analyzing stroke volume next to brain structure involvement. METHODS We included 37 term-born infants with NAIS prospectively registered in a nationwide pediatric stroke registry. DWI was performed between 0 and 8 days (mean 3 days) after stroke manifestation. Participants were neurologically assessed at the age of 2 years. We calculated the stroke volume (in mm3) and the ratio of the stroke volume to the volume of the entire brain (relative stroke volume). The predictive value of the relative stroke volume was analyzed and an optimal threshold for classification of children with high- and low-rates of CP was calculated. Predictive value of brain structure involvements and the prevalence of CP in combinations of different brain structures was also assessed. RESULTS Sixteen children (43.2%) developed CP. Relative stroke volume significantly predicted CP (p < .001). Its optimal threshold for division into high- and low-rate of CP was 3.3%. The basal ganglia (OR 8.3, 95% CI 1.2-60.0) and basis pontis (OR 18.5, 95% CI 1.8-194.8) were independently associated with CP. CONCLUSION In addition to determining the involvement of affected brain areas, the volumetric quantification of stroke volume allows accurate prediction of cerebral palsy in newborns with NAIS.
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Affiliation(s)
- Andreas Wiedemann
- Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern, Switzerland
| | - Manuela Pastore-Wapp
- Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern, Switzerland; Support Center of Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Nedelina Slavova
- Support Center of Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Leonie Steiner
- Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern, Switzerland
| | - Christian Weisstanner
- Support Center of Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Mária Regényi
- Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern, Switzerland
| | - Maja Steinlin
- Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern, Switzerland
| | - Sebastian Grunt
- Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern, Switzerland.
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19
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Korinthenberg R, Trollmann R, Felderhoff-Müser U, Bernert G, Hackenberg A, Hufnagel M, Pohl M, Hahn G, Mentzel HJ, Sommer C, Lambeck J, Mecher F, Hessenauer M, Winterholler C, Kempf U, Jacobs BC, Rostasy K, Müller-Felber W. Diagnosis and treatment of Guillain-Barré Syndrome in childhood and adolescence: An evidence- and consensus-based guideline. Eur J Paediatr Neurol 2020; 25:5-16. [PMID: 31941581 DOI: 10.1016/j.ejpn.2020.01.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 12/27/2019] [Accepted: 01/03/2020] [Indexed: 12/22/2022]
Abstract
This evidence- and consensus-based practical guideline for the diagnosis and treatment of Guillain-Barré Syndrome (GBS) in childhood and adolescence has been developed by a group of delegates from relevant specialist societies and organisations; it is the result of an initiative by the German-Speaking Society of Neuropediatrics (GNP), and is supported by the Association of Scientific Medical Societies (AWMF, Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften). A systematic analysis of the literature revealed that only a few adequately-controlled studies exist for this particular age group, while none carries a low risk of bias. For this reason, the diagnostic and therapeutic recommendations largely rely on findings in adult patients with GBS, for which there are a higher number of suitable studies available. Consensus was established using a written, multi-step Delphi process. A high level of consensus could be reached for the crucial steps in diagnosis and treatment. We recommend basing the diagnostic approach on the clinical criteria of GBS and deriving support from CSF and electrophysiological findings. Repetition of invasive procedures that yield ambiguous results is only recommended if the diagnosis cannot be ascertained from the other criteria. For severe or persistently-progressive GBS treatment with intravenous immunoglobulin (IVIG) is recommended, whereas in cases of IVIG intolerance or inefficacy we recommended treatment with plasmapheresis. Corticosteroids are ineffective for GBS but can be considered when acute onset chronic inflammatory demyelinating polyneuropathy (A-CIDP) is suspected due to a prolonged disease course. The full German version of the Guideline is available on the AWMF website (https://www.awmf.org/leitlinien/detail/ll/022-008.html).
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Affiliation(s)
- R Korinthenberg
- Division of Neuropediatrics and Muscular Disorders, Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, University Medical Center (UMC), University of Freiburg, Germany.
| | - R Trollmann
- Department of Neuropediatrics, UMC, Friedrich- Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | | | - G Bernert
- Department of Pediatrics, Kaiser-Franz-Joseph-Hospital with Preyer's Childrens Hospital, Vienna, Austria
| | - A Hackenberg
- Department of Pediatric Neurology, University Children's Hospital, Zürich, Switzerland
| | - M Hufnagel
- Division of Pediatric Infectious Diseases and Rheumatology, Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, UMC, University of Freiburg, Germany
| | - M Pohl
- Section Pediatric Nephrology, Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, UMC, University of Freiburg, Germany
| | - G Hahn
- Department of Radiological Diagnostics, UMC, University of Dresden, Germany
| | - H J Mentzel
- Section Pediatric Radiology, Institute of Diagnostic and Interventional Radiology, Universitätsklinikum Jena, Germany
| | - C Sommer
- Department of Neurology, UMC, University of Wuerzburg, Germany
| | - J Lambeck
- Department of Neurology and Neurophysiology, UMC, University of Freiburg, Germany
| | - F Mecher
- Physio Deutschland, German Federal Association for Physiotherapy, Germany
| | - M Hessenauer
- Centre for Pediatric Neurology, Neurorehabilitation and Epileptology, Schoen Clinic Vogtareuth, Germany
| | - C Winterholler
- German Federal Association of Logopedics (dbl e.V. Deutscher Bundesverband für Logopädie e.v), Germany
| | - U Kempf
- Mother of a GBS PPatient, Kraichtal-Neuenbürg, Germany
| | - B C Jacobs
- Departments of Neurology and Immunology, Erasmus MC, UMC Rotterdam, the Netherlands
| | - K Rostasy
- Department of Neuropediatrics, Children´s Hospital Datteln, University Witten/Herdecke, Germany
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20
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Begemann A, Acuña MA, Zweier M, Vincent M, Steindl K, Bachmann-Gagescu R, Hackenberg A, Abela L, Plecko B, Kroell-Seger J, Baumer A, Yamakawa K, Inoue Y, Asadollahi R, Sticht H, Zeilhofer HU, Rauch A. Further corroboration of distinct functional features in SCN2A variants causing intellectual disability or epileptic phenotypes. Mol Med 2019; 25:6. [PMID: 30813884 PMCID: PMC6391808 DOI: 10.1186/s10020-019-0073-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 02/05/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Deleterious variants in the voltage-gated sodium channel type 2 (Nav1.2) lead to a broad spectrum of phenotypes ranging from benign familial neonatal-infantile epilepsy (BFNIE), severe developmental and epileptic encephalopathy (DEE) and intellectual disability (ID) to autism spectrum disorders (ASD). Yet, the underlying mechanisms are still incompletely understood. METHODS To further elucidate the genotype-phenotype correlation of SCN2A variants we investigated the functional effects of six variants representing the phenotypic spectrum by whole-cell patch-clamp studies in transfected HEK293T cells and in-silico structural modeling. RESULTS The two variants p.L1342P and p.E1803G detected in patients with early onset epileptic encephalopathy (EE) showed profound and complex changes in channel gating, whereas the BFNIE variant p.L1563V exhibited only a small gain of channel function. The three variants identified in ID patients without seizures, p.R937C, p.L611Vfs*35 and p.W1716*, did not produce measurable currents. Homology modeling of the missense variants predicted structural impairments consistent with the electrophysiological findings. CONCLUSIONS Our findings support the hypothesis that complete loss-of-function variants lead to ID without seizures, small gain-of-function variants cause BFNIE and EE variants exhibit variable but profound Nav1.2 gating changes. Moreover, structural modeling was able to predict the severity of the variant impact, supporting a potential role of structural modeling as a prognostic tool. Our study on the functional consequences of SCN2A variants causing the distinct phenotypes of EE, BFNIE and ID contributes to the elucidation of mechanisms underlying the broad phenotypic variability reported for SCN2A variants.
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Affiliation(s)
- Anaïs Begemann
- Institute of Medical Genetics, University of Zurich, 8952, Schlieren, Zurich, Switzerland.,radiz-Rare Disease Initiative Zürich, Clinical Research Priority Program for Rare Diseases, University of Zurich, 8006, Zurich, Switzerland
| | - Mario A Acuña
- radiz-Rare Disease Initiative Zürich, Clinical Research Priority Program for Rare Diseases, University of Zurich, 8006, Zurich, Switzerland.,Institute of Pharmacology and Toxicology, University of Zurich, 8057, Zurich, Switzerland
| | - Markus Zweier
- Institute of Medical Genetics, University of Zurich, 8952, Schlieren, Zurich, Switzerland.,radiz-Rare Disease Initiative Zürich, Clinical Research Priority Program for Rare Diseases, University of Zurich, 8006, Zurich, Switzerland
| | - Marie Vincent
- Service de génétique médicale, CHU Nantes, 44093, Nantes, France
| | - Katharina Steindl
- Institute of Medical Genetics, University of Zurich, 8952, Schlieren, Zurich, Switzerland.,radiz-Rare Disease Initiative Zürich, Clinical Research Priority Program for Rare Diseases, University of Zurich, 8006, Zurich, Switzerland
| | | | - Annette Hackenberg
- Division of Child Neurology, University Children's Hospital Zurich, 8032, Zurich, Switzerland
| | - Lucia Abela
- radiz-Rare Disease Initiative Zürich, Clinical Research Priority Program for Rare Diseases, University of Zurich, 8006, Zurich, Switzerland.,Division of Child Neurology, University Children's Hospital Zurich, 8032, Zurich, Switzerland
| | - Barbara Plecko
- radiz-Rare Disease Initiative Zürich, Clinical Research Priority Program for Rare Diseases, University of Zurich, 8006, Zurich, Switzerland.,Division of Child Neurology, University Children's Hospital Zurich, 8032, Zurich, Switzerland.,Division of General Pediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, 8036, Graz, Austria
| | - Judith Kroell-Seger
- Children's department, Swiss Epilepsy Centre, Clinic Lengg, 8008, Zurich, Switzerland
| | - Alessandra Baumer
- Institute of Medical Genetics, University of Zurich, 8952, Schlieren, Zurich, Switzerland
| | - Kazuhiro Yamakawa
- Laboratory for Neurogenetics, RIKEN Center for Brain Science, Wako-shi, Saitama, 351-0198, Japan
| | - Yushi Inoue
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, 420-8688, Japan
| | - Reza Asadollahi
- Institute of Medical Genetics, University of Zurich, 8952, Schlieren, Zurich, Switzerland.,radiz-Rare Disease Initiative Zürich, Clinical Research Priority Program for Rare Diseases, University of Zurich, 8006, Zurich, Switzerland
| | - Heinrich Sticht
- Institute of Biochemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
| | - Hanns Ulrich Zeilhofer
- radiz-Rare Disease Initiative Zürich, Clinical Research Priority Program for Rare Diseases, University of Zurich, 8006, Zurich, Switzerland.,Institute of Pharmacology and Toxicology, University of Zurich, 8057, Zurich, Switzerland.,Institute of Pharmaceutical Sciences, ETH Zurich, 8093, Zürich, Switzerland.,Neuroscience Center Zurich, University of Zurich and ETH Zurich, 8057, Zurich, Switzerland
| | - Anita Rauch
- Institute of Medical Genetics, University of Zurich, 8952, Schlieren, Zurich, Switzerland. .,radiz-Rare Disease Initiative Zürich, Clinical Research Priority Program for Rare Diseases, University of Zurich, 8006, Zurich, Switzerland. .,Neuroscience Center Zurich, University of Zurich and ETH Zurich, 8057, Zurich, Switzerland. .,Zurich Center for Integrative Human Physiology, University of Zurich, 8057, Zurich, Switzerland.
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21
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Papuc SM, Abela L, Steindl K, Begemann A, Simmons TL, Schmitt B, Zweier M, Oneda B, Socher E, Crowther LM, Wohlrab G, Gogoll L, Poms M, Seiler M, Papik M, Baldinger R, Baumer A, Asadollahi R, Kroell-Seger J, Schmid R, Iff T, Schmitt-Mechelke T, Otten K, Hackenberg A, Addor MC, Klein A, Azzarello-Burri S, Sticht H, Joset P, Plecko B, Rauch A. The role of recessive inheritance in early-onset epileptic encephalopathies: a combined whole-exome sequencing and copy number study. Eur J Hum Genet 2018; 27:408-421. [PMID: 30552426 PMCID: PMC6460568 DOI: 10.1038/s41431-018-0299-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 10/05/2018] [Accepted: 10/25/2018] [Indexed: 11/16/2022] Open
Abstract
Early-onset epileptic encephalopathy (EE) and combined developmental and epileptic encephalopathies (DEE) are clinically and genetically heterogeneous severely devastating conditions. Recent studies emphasized de novo variants as major underlying cause suggesting a generally low-recurrence risk. In order to better understand the full genetic landscape of EE and DEE, we performed high-resolution chromosomal microarray analysis in combination with whole-exome sequencing in 63 deeply phenotyped independent patients. After bioinformatic filtering for rare variants, diagnostic yield was improved for recessive disorders by manual data curation as well as molecular modeling of missense variants and untargeted plasma-metabolomics in selected patients. In total, we yielded a diagnosis in ∼42% of cases with causative copy number variants in 6 patients (∼10%) and causative sequence variants in 16 established disease genes in 20 patients (∼32%), including compound heterozygosity for causative sequence and copy number variants in one patient. In total, 38% of diagnosed cases were caused by recessive genes, of which two cases escaped automatic calling due to one allele occurring de novo. Notably, we found the recessive gene SPATA5 causative in as much as 3% of our cohort, indicating that it may have been underdiagnosed in previous studies. We further support candidacy for neurodevelopmental disorders of four previously described genes (PIK3AP1, GTF3C3, UFC1, and WRAP53), three of which also followed a recessive inheritance pattern. Our results therefore confirm the importance of de novo causative gene variants in EE/DEE, but additionally illustrate the major role of mostly compound heterozygous or hemizygous recessive inheritance and consequently high-recurrence risk.
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Affiliation(s)
- Sorina M Papuc
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland.,Victor Babes National Institute of Pathology, Bucharest, 050096, Romania
| | - Lucia Abela
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, 8032, Switzerland.,CRC Clinical Research Center University, Children's Hospital Zurich, Zurich, 8032, Switzerland.,radiz-Rare Disease Initiative Zürich, Clinical Research Priority Program for Rare Diseases University of Zurich, Zurich, 8032, Switzerland
| | - Katharina Steindl
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Anaïs Begemann
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Thomas L Simmons
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, 8032, Switzerland
| | - Bernhard Schmitt
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, 8032, Switzerland.,CRC Clinical Research Center University, Children's Hospital Zurich, Zurich, 8032, Switzerland
| | - Markus Zweier
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Beatrice Oneda
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Eileen Socher
- Institute of Biochemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, 91054, Germany
| | - Lisa M Crowther
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, 8032, Switzerland
| | - Gabriele Wohlrab
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, 8032, Switzerland
| | - Laura Gogoll
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Martin Poms
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, 8032, Switzerland
| | - Michelle Seiler
- Pediatric Emergency Department, University Children's Hospital Zurich, Zurich, 8032, Switzerland
| | - Michael Papik
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Rosa Baldinger
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Alessandra Baumer
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Reza Asadollahi
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Judith Kroell-Seger
- Children's department, Swiss Epilepsy Centre, Clinic Lengg, Zurich, 8000, Switzerland
| | - Regula Schmid
- Division of Child Neurology, Kantonsspital Winterthur, Winterthur, 8401, Switzerland
| | - Tobias Iff
- Municipal Hospital of Zurich Triemli, Zurich, 8063, Switzerland
| | | | - Karoline Otten
- Children's department, Swiss Epilepsy Centre, Clinic Lengg, Zurich, 8000, Switzerland
| | - Annette Hackenberg
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, 8032, Switzerland
| | - Marie-Claude Addor
- Department of Woman-Mother-Child, University Medical Center CHUV, Lausanne, 1015, Switzerland
| | - Andrea Klein
- Division of Paediatric Neurology, University Childerns Hospital Basel, UKBB, 4031, Basel, Switzerland.,Division of Paediatric Neurology, Development and Rehabilitation, University Children's Hospital, 3010, Bern, Switzerland
| | - Silvia Azzarello-Burri
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Heinrich Sticht
- Institute of Biochemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, 91054, Germany
| | - Pascal Joset
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Barbara Plecko
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, 8032, Switzerland.,CRC Clinical Research Center University, Children's Hospital Zurich, Zurich, 8032, Switzerland.,radiz-Rare Disease Initiative Zürich, Clinical Research Priority Program for Rare Diseases University of Zurich, Zurich, 8032, Switzerland.,Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, 8057, Switzerland.,Division of General Pediatrics, Department of Pediatrics, Medical University of Graz, 8036, Graz, Austria
| | - Anita Rauch
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland. .,radiz-Rare Disease Initiative Zürich, Clinical Research Priority Program for Rare Diseases University of Zurich, Zurich, 8032, Switzerland. .,Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, 8057, Switzerland. .,Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, 8057, Switzerland.
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22
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Hackenberg A, Wagner M, Pahnke J, Zeitler P, Boltshauser E. Low Voice, Spasmodic Dysphonia, and Hand Dystonia as Clinical Clues for KMT2B-Associated Early-Onset Dystonia. Neuropediatrics 2018; 49:356. [PMID: 29913530 DOI: 10.1055/s-0038-1661343] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Annette Hackenberg
- Department of Pediatric Neurology, University Children's Hospital, Zürich, Switzerland
| | - Matias Wagner
- Institute of Human Genetics, Technical University of Munich, Munich, Germany
| | - Jan Pahnke
- ENT Practice, Rigi Health Center, Küssnacht, Switzerland
| | - Petra Zeitler
- Pediatric Practice, Rigi Health Center, Küssnacht, Switzerland
| | - Eugen Boltshauser
- Department of Pediatric Neurology, University Children's Hospital, Zürich, Switzerland
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23
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Toelle SP, Avetisyan T, Kuyumjyan N, Sukhudyan B, Boltshauser E, Hackenberg A. Infantile Basal Ganglia Stroke after Mild Head Trauma Associated with Mineralizing Angiopathy of Lenticulostriate Arteries: An Under Recognized Entity. Neuropediatrics 2018; 49:262-268. [PMID: 29791933 DOI: 10.1055/s-0038-1649501] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Basal ganglia infarction in young children, mostly after mild head trauma, has been repeatedly reported. The pathogenesis and the risk factors are not fully understood. Lenticulostriate vasculopathy, usually referred to as basal ganglia calcification, is discussed as one of them. We describe five young (7-13 months old on presentation) male children who suffered from hemiparesis due to ischemic stroke of the basal ganglia, four of them after minor head trauma. All of them had calcification in the basal ganglia visible on computed tomography or cranial ultrasound but not on magnetic resonance imaging. Follow-up care was remarkable for recurrent infarction in three patients. One patient had a second symptomatic stroke on the contralateral side, and two patients showed new asymptomatic infarctions in the contralateral basal ganglia on imaging. In view of the scant literature, this clinic-radiologic entity seems under recognized. We review the published cases and hypothesize that male sex and iron deficiency anemia are risk factors for basal ganglia stroke after minor trauma in the context of basal ganglia calcification in infants. We suggest to perform appropriate targeted neuroimaging in case of infantile basal ganglia stroke, and to consider prophylactic medical treatment, although its value in this context is not proven.
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Affiliation(s)
- Sandra P Toelle
- Department of Pediatric Neurology, University Children's Hospital, Zürich, Switzerland
| | - Tamara Avetisyan
- Department of Pediatric Neurology, Yerevan State Medical University After Mkhitar Heratsi, "Muratsan" University Outpatient Clinic, Yerevan, Armenia
| | - Nune Kuyumjyan
- Department of Pediatric Neurology, "Sourb Astvatsamayr" Medical Center, Yerevan, Armenia
| | - Biayna Sukhudyan
- Department of Pediatric Neurology, Arabkir Medical Center, Yerevan, Armenia
| | - Eugen Boltshauser
- Department of Pediatric Neurology, University Children's Hospital, Zürich, Switzerland
| | - Annette Hackenberg
- Department of Pediatric Neurology, University Children's Hospital, Zürich, Switzerland
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24
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Bigi S, Dulcey A, Gralla J, Bernasconi C, Melliger A, Datta AN, Arnold M, Kaesmacher J, Fluss J, Hackenberg A, Maier O, Weber J, Poloni C, Fischer U, Steinlin M. Feasibility, safety, and outcome of recanalization treatment in childhood stroke. Ann Neurol 2018; 83:1125-1132. [DOI: 10.1002/ana.25242] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 04/18/2018] [Accepted: 04/18/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Sandra Bigi
- Department of Pediatrics, Division of Child Neurology, University Children's Hospital BernUniversity of Bern Bern
| | - Andrea Dulcey
- Department of Pediatrics, Division of Child Neurology, University Children's Hospital BernUniversity of Bern Bern
| | - Jan Gralla
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital BernUniversity of Bern Bern
| | - Corrado Bernasconi
- Department of Neurology, Inselspital, University Hospital BernUniversity of Bern Bern
| | - Amber Melliger
- Department of Pediatrics, Division of Child Neurology, University Children's Hospital BernUniversity of Bern Bern
| | - Alexandre N. Datta
- Department of Pediatric Neurology and Developmental MedicineUniversity of Basel Children's Hospital Basel
| | - Marcel Arnold
- Department of Neurology, Inselspital, University Hospital BernUniversity of Bern Bern
| | - Johannes Kaesmacher
- Department of Neurology, Inselspital, University Hospital BernUniversity of Bern Bern
| | - Joel Fluss
- Department of Pediatrics, Division of Child Neurology, University Children's Hospital GenevaUniversity of Geneva Geneva
| | - Annette Hackenberg
- Department of Pediatrics, Division of Child Neurology, University Children's Hospital ZurichUniversity of Zurich Zurich
| | - Oliver Maier
- Department of Pediatrics, Division of Child NeurologyChildren's Hospital St Gallen
| | - Johannes Weber
- Department of RadiologyCantonal Hospital St Gallen St Gallen
| | - Claudia Poloni
- Department of Pediatrics, Division of Child Neurology, University Children's Hospital LausanneUniversity of LausanneLausanne Switzerland
| | - Urs Fischer
- Department of Neurology, Inselspital, University Hospital BernUniversity of Bern Bern
| | - Maja Steinlin
- Department of Pediatrics, Division of Child Neurology, University Children's Hospital BernUniversity of Bern Bern
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25
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Scherrer KS, Relly C, Hackenberg A, Berger C, Paioni P. Case report: narcolepsy type 1 in an adolescent with HIV infection-coincidence or potential trigger? Medicine (Baltimore) 2018; 97:e11490. [PMID: 30045272 PMCID: PMC6078734 DOI: 10.1097/md.0000000000011490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
RATIONALE Despite the acknowledged importance of environmental risk factors in the etiology of narcolepsy, there is little research on this topic. HIV as a trigger for narcolepsy has not been systematically investigated. PATIENT CONCERNS We describe a case of narcolepsy type 1 (NT1) in an adolescent with HIV infection presenting with increased daytime sleepiness and excessive weight gain. DIAGNOSES NT1 was diagnosed according to the criteria of the third edition of the International Classification of Sleep Disorders (ICSD-3). INTERVENTIONS Pharmacological treatment with methylphenidate. OUTCOMES Four months after initiation of methylphenidate therapy the increased daytime sleepiness improved and excessive weight gain stopped. LESSONS Diagnosis of NT1 can be challenging at disease onset and is often delayed, especially in the pediatric population, because symptoms usually evolve gradually. The case presented here raises the possibility that the HIV infection may play a role in the pathogenesis of NT1 serving as trigger for autoimmune-mediated destruction of hypocretin-secreting neurons.
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Affiliation(s)
- Karin Sofia Scherrer
- Division of Infectious Diseases and Hospital Epidemiology and Children's Research Center University Children's Hospital Zurich, Zürich, Switzerland
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Churchill Hospital, Oxford, UK
| | - Christa Relly
- Division of Infectious Diseases and Hospital Epidemiology and Children's Research Center University Children's Hospital Zurich, Zürich, Switzerland
| | - Annette Hackenberg
- Department of Pediatric Neurology, University Children's Hospital Zürich, Zürich, Switzerland
| | - Christoph Berger
- Division of Infectious Diseases and Hospital Epidemiology and Children's Research Center University Children's Hospital Zurich, Zürich, Switzerland
| | - Paolo Paioni
- Division of Infectious Diseases and Hospital Epidemiology and Children's Research Center University Children's Hospital Zurich, Zürich, Switzerland
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26
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Affiliation(s)
- Eugen Boltshauser
- Department of Pediatric Neurology, University Children's Hospital, Zürich, Switzerland
| | - Sandra P Toelle
- Department of Pediatric Neurology, University Children's Hospital, Zürich, Switzerland
| | - Ianina Scheer
- Department of Diagnostic Imaging, University Children's Hospital, Zürich, Switzerland
| | - Annette Hackenberg
- Department of Pediatric Neurology, University Children's Hospital, Zürich, Switzerland
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27
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Stellacci E, Steindl K, Joset P, Mercurio L, Anselmi M, Cecchetti S, Gogoll L, Zweier M, Hackenberg A, Bocchinfuso G, Stella L, Tartaglia M, Rauch A. Clinical and functional characterization of two novel ZBTB20
mutations causing Primrose syndrome. Hum Mutat 2018; 39:959-964. [DOI: 10.1002/humu.23546] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/23/2018] [Accepted: 04/26/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Emilia Stellacci
- Dipartimento di Oncologia e Medicina Molecolare; Istituto Superiore di Sanità; Rome Italy
| | - Katharina Steindl
- Institute of Medical Genetics; University of Zurich; Schlieren-Zurich; Switzerland
| | - Pascal Joset
- Institute of Medical Genetics; University of Zurich; Schlieren-Zurich; Switzerland
| | - Laura Mercurio
- Dipartimento di Oncologia e Medicina Molecolare; Istituto Superiore di Sanità; Rome Italy
| | - Massimiliano Anselmi
- Dipartimento di Scienze e Tecnologie Chimiche; Università di Roma ‘‘Tor Vergata,’’ Rome; Italy
| | - Serena Cecchetti
- Servizio grandi strumentazioni e core facilities; Istituto Superiore di Sanità; Rome Italy
| | - Laura Gogoll
- Institute of Medical Genetics; University of Zurich; Schlieren-Zurich; Switzerland
| | - Markus Zweier
- Institute of Medical Genetics; University of Zurich; Schlieren-Zurich; Switzerland
| | - Annette Hackenberg
- Division of Paediatric Neurology; University Children's Hospital Zurich; Zürich Switzerland
| | - Gianfranco Bocchinfuso
- Dipartimento di Scienze e Tecnologie Chimiche; Università di Roma ‘‘Tor Vergata,’’ Rome; Italy
| | - Lorenzo Stella
- Dipartimento di Scienze e Tecnologie Chimiche; Università di Roma ‘‘Tor Vergata,’’ Rome; Italy
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division; Ospedale Pediatrico Bambino Gesù; Rome Italy
| | - Anita Rauch
- Institute of Medical Genetics; University of Zurich; Schlieren-Zurich; Switzerland
- radiz-Rare Disease Initiative Zürich; Clinical Research Priority Program for Rare Diseases University of Zurich; Zurich Switzerland
- Neuroscience Center Zurich; University of Zurich and ETH Zurich; Zurich Switzerland
- Zurich Center for Integrative Human Physiology; University of Zurich; Zurich Switzerland
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28
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Dimitrov B, Himmelreich N, Hipgrave Ederveen AL, Lüchtenborg C, Okun JG, Breuer M, Hutter AM, Carl M, Guglielmi L, Hellwig A, Thiemann KC, Jost M, Peters V, Staufner C, Hoffmann GF, Hackenberg A, Paramasivam N, Wiemann S, Eils R, Schlesner M, Strahl S, Brügger B, Wuhrer M, Christoph Korenke G, Thiel C. Cutis laxa, exocrine pancreatic insufficiency and altered cellular metabolomics as additional symptoms in a new patient with ATP6AP1-CDG. Mol Genet Metab 2018; 123:364-374. [PMID: 29396028 DOI: 10.1016/j.ymgme.2018.01.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 01/18/2018] [Accepted: 01/18/2018] [Indexed: 02/07/2023]
Abstract
Congenital disorders of glycosylation (CDG) are genetic defects in the glycoconjugate biosynthesis. >100 types of CDG are known, most of them cause multi-organ diseases. Here we describe a boy whose leading symptoms comprise cutis laxa, pancreatic insufficiency and hepatosplenomegaly. Whole exome sequencing identified the novel hemizygous mutation c.542T>G (p.L181R) in the X-linked ATP6AP1, an accessory protein of the mammalian vacuolar H+-ATPase, which led to a general N-glycosylation deficiency. Studies of serum N-glycans revealed reduction of complex sialylated and appearance of truncated diantennary structures. Proliferation of the patient's fibroblasts was significantly reduced and doubling time prolonged. Additionally, there were alterations in the fibroblasts' amino acid levels and the acylcarnitine composition. Especially, short-chain species were reduced, whereas several medium- to long-chain acylcarnitines (C14-OH to C18) were elevated. Investigation of the main lipid classes revealed that total cholesterol was significantly enriched in the patient's fibroblasts at the expense of phophatidylcholine and phosphatidylethanolamine. Within the minor lipid species, hexosylceramide was reduced, while its immediate precursor ceramide was increased. Since catalase activity and ACOX3 expression in peroxisomes were reduced, we assume an ATP6AP1-dependent impact on the β-oxidation of fatty acids. These results help to understand the complex clinical characteristics of this new patient.
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Affiliation(s)
- Bianca Dimitrov
- Center for Child and Adolescent Medicine, Department I, Im Neuenheimer Feld 669, 69120 Heidelberg, Germany
| | - Nastassja Himmelreich
- Center for Child and Adolescent Medicine, Department I, Im Neuenheimer Feld 669, 69120 Heidelberg, Germany
| | - Agnes L Hipgrave Ederveen
- Leiden University Medical Center, Center for Proteomics and Metabolomics, Albinusdreef 2, 2333 ZA Leiden, Netherlands
| | - Christian Lüchtenborg
- Heidelberg University Biochemistry Center (BZH), Im Neuenheimer Feld 328, 69120 Heidelberg, Germany
| | - Jürgen G Okun
- Center for Child and Adolescent Medicine, Department I, Im Neuenheimer Feld 669, 69120 Heidelberg, Germany
| | - Maximilian Breuer
- Center for Child and Adolescent Medicine, Department I, Im Neuenheimer Feld 669, 69120 Heidelberg, Germany
| | - Anna-Marlen Hutter
- Center for Child and Adolescent Medicine, Department I, Im Neuenheimer Feld 669, 69120 Heidelberg, Germany
| | - Matthias Carl
- Department of Cell and Molecular Biology, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany; Laboratory of Translational Neurogenetics, Center for Integrative Biology, University of Trento, 39123 Trento, Italy
| | - Luca Guglielmi
- Department of Cell and Molecular Biology, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany; Laboratory of Translational Neurogenetics, Center for Integrative Biology, University of Trento, 39123 Trento, Italy
| | - Andrea Hellwig
- Department of Neurobiology, Interdisciplinary Center for Neurosciences, Heidelberg University, Im Neuenheimer Feld 364, 69120 Heidelberg, Germany
| | - Kai Christian Thiemann
- Center for Child and Adolescent Medicine, Department I, Im Neuenheimer Feld 669, 69120 Heidelberg, Germany
| | - Markus Jost
- Center for Child and Adolescent Medicine, Department I, Im Neuenheimer Feld 669, 69120 Heidelberg, Germany
| | - Verena Peters
- Center for Child and Adolescent Medicine, Department I, Im Neuenheimer Feld 669, 69120 Heidelberg, Germany
| | - Christian Staufner
- Center for Child and Adolescent Medicine, Department I, Im Neuenheimer Feld 669, 69120 Heidelberg, Germany
| | - Georg F Hoffmann
- Center for Child and Adolescent Medicine, Department I, Im Neuenheimer Feld 669, 69120 Heidelberg, Germany
| | - Annette Hackenberg
- Division of Pediatric Neurology, University Children's Hospital Zürich, Steinwiesstrasse 75, 8032 Zürich, Switzerland
| | - Nagarajan Paramasivam
- Medical Faculty Heidelberg, Heidelberg University, 69120 Heidelberg, Germany; Division of Theoretical Bioinformatics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Bioinformatics and Omics Data Analytics (B240), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Stefan Wiemann
- Genomics & Proteomics Core Facility, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120 Heidelberg, Germany; Division of Molecular Genome Analysis, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120 Heidelberg, Germany
| | - Roland Eils
- Division of Theoretical Bioinformatics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Department for Bioinformatics and Functional Genomics, Institute for Pharmacy and Molecular Biotechnology (IPMB), BioQuant, Heidelberg University, 69120 Heidelberg, Germany; Bioinformatics and Omics Data Analytics (B240), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Matthias Schlesner
- Division of Theoretical Bioinformatics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Bioinformatics and Omics Data Analytics (B240), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Sabine Strahl
- Centre for Organismal Studies (COS), Glycobiology, Heidelberg University, Im Neuenheimer Feld 360, 69120 Heidelberg, Germany
| | - Britta Brügger
- Heidelberg University Biochemistry Center (BZH), Im Neuenheimer Feld 328, 69120 Heidelberg, Germany
| | - Manfred Wuhrer
- Leiden University Medical Center, Center for Proteomics and Metabolomics, Albinusdreef 2, 2333 ZA Leiden, Netherlands
| | - G Christoph Korenke
- Klinikum Oldenburg, Zentrum für Kinder-und Jugendmedizin, Klinik für Neuropädiatrie u. angeborene Stoffwechselerkrankungen, Rahel-Straus-Straße 10, 26133 Oldenburg, Germany
| | - Christian Thiel
- Center for Child and Adolescent Medicine, Department I, Im Neuenheimer Feld 669, 69120 Heidelberg, Germany.
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Lekaditi D, Hackenberg A, Scheer I, Ramantani G, Keller E, Meyer-Heim A. Kleinkind mit Chiari-Malformation Typ I, globalem Entwicklungsrückstand, Dysmorphiezeichen und atonischen Ereignissen mit Apnoen. Monatsschr Kinderheilkd 2017. [DOI: 10.1007/s00112-017-0396-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Romaniello R, Arrigoni F, Panzeri E, Poretti A, Micalizzi A, Citterio A, Bedeschi MF, Berardinelli A, Cusmai R, D’Arrigo S, Ferraris A, Hackenberg A, Kuechler A, Mancardi M, Nuovo S, Oehl-Jaschkowitz B, Rossi A, Signorini S, Tüttelmann F, Wahl D, Hehr U, Boltshauser E, Bassi MT, Valente EM, Borgatti R. Erratum to: Tubulin-related cerebellar dysplasia: definition of a distinct pattern of cerebellar malformation. Eur Radiol 2017; 27:5093. [DOI: 10.1007/s00330-017-4986-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Walker JH, Hackenberg A, Bozinov O, Berger C, Scheer I, Grotzer MA, Gerber NU. Ommaya reservoir "off-duty" causing major late-onset complications in a child with medulloblastoma. Pediatr Blood Cancer 2017; 64. [PMID: 27905687 DOI: 10.1002/pbc.26384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 10/20/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Janina H Walker
- Department of Oncology, University Children's Hospital, Zurich, Switzerland.,Children's Research Centre, University Children's Hospital, Zurich, Switzerland
| | - Annette Hackenberg
- Department of Neurology, University Children's Hospital, Zurich, Switzerland
| | - Oliver Bozinov
- Department of Neurosurgery, University Hospital, Zurich, Switzerland
| | - Christoph Berger
- Children's Research Centre, University Children's Hospital, Zurich, Switzerland.,Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital, Zurich, Switzerland
| | - Ianina Scheer
- Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland
| | - Michael A Grotzer
- Department of Oncology, University Children's Hospital, Zurich, Switzerland.,Children's Research Centre, University Children's Hospital, Zurich, Switzerland
| | - Nicolas U Gerber
- Department of Oncology, University Children's Hospital, Zurich, Switzerland.,Children's Research Centre, University Children's Hospital, Zurich, Switzerland
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32
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Hackenberg A, Boltshauser E, Gerth-Kahlert C, Stahr N, Azzarello-Burri S, Plecko B. Horizontal Gaze Palsy in Two Brothers with Compound Heterozygous ROBO3 Gene Mutations. Neuropediatrics 2017; 48:57-58. [PMID: 28024310 DOI: 10.1055/s-0036-1597610] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Annette Hackenberg
- Division of Pediatric Neurology, University Children's Hospital Zürich, Zürich, Switzerland
| | - Eugen Boltshauser
- Division of Pediatric Neurology, University Children's Hospital Zürich, Zürich, Switzerland
| | | | - Nikolai Stahr
- Division of Diagnostic Imaging, University Children's Hospital, Zürich, Switzerland
| | | | - Barbara Plecko
- Division of Pediatric Neurology, University Children's Hospital Zürich, Zürich, Switzerland
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33
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Meyer Sauteur PM, Roodbol J, Hackenberg A, de Wit MCY, Vink C, Berger C, Jacobs E, van Rossum AMC, Jacobs BC. Severe childhood Guillain-Barré syndrome associated with Mycoplasma pneumoniae infection: a case series. J Peripher Nerv Syst 2016; 20:72-8. [PMID: 26115201 DOI: 10.1111/jns.12121] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 04/28/2015] [Accepted: 06/10/2015] [Indexed: 01/09/2023]
Abstract
We report seven children with recent Mycoplasma pneumoniae infection and severe Guillain-Barré syndrome (GBS) that presented to two European medical centres from 1992 to 2012. Severe GBS was defined as the occurrence of respiratory failure, central nervous system (CNS) involvement, or death. Five children had GBS, one Bickerstaff brain stem encephalitis (BBE), and one acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP). The five patients with severe GBS were derived from an original cohort of 66 children with GBS. In this cohort, 17 children (26%) had a severe form of GBS and 47% of patients with M. pneumoniae infection presented with severe GBS. Of the seven patients in this case series, five were mechanically ventilated and four had CNS involvement (two were comatose). Most patients presented with non-specific clinical symptoms (nuchal rigidity and ataxia) and showed a rapidly progressive disease course (71%). Antibodies against M. pneumoniae were detected in all patients and were found to be intrathecally synthesised in two cases (GBS and BBE), which proves intrathecal infection. One patient died and only two patients recovered completely. These cases illustrate that M. pneumoniae infection in children can be followed by severe and complicated forms of GBS. Non-specific clinical features of GBS in such patients may predispose a potentially life-threatening delay in diagnosis.
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Affiliation(s)
- Patrick M Meyer Sauteur
- Department of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.,Laboratory of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center, Rotterdam, The Netherlands.,Division of Infectious Diseases and Hospital Epidemiology, and Children's Research Center (CRC), University Children's Hospital of Zurich, Zurich, Switzerland
| | - Joyce Roodbol
- Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Pediatric Neurology, Erasmus MC-Sophia Children's Hospital, University Medical Center, Rotterdam, The Netherlands
| | - Annette Hackenberg
- Division of Neurology, and Children's Research Center (CRC), University Children's Hospital of Zurich, Zurich, Switzerland
| | - Marie-Claire Y de Wit
- Department of Pediatrics, Division of Pediatric Neurology, Erasmus MC-Sophia Children's Hospital, University Medical Center, Rotterdam, The Netherlands
| | - Cornelis Vink
- Laboratory of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center, Rotterdam, The Netherlands.,Erasmus University College, Erasmus University, Rotterdam, The Netherlands
| | - Christoph Berger
- Division of Infectious Diseases and Hospital Epidemiology, and Children's Research Center (CRC), University Children's Hospital of Zurich, Zurich, Switzerland
| | - Enno Jacobs
- TU Dresden, Medical Faculty Carl Gustav Carus, Institute of Medical Microbiology and Hygiene, Dresden, Germany
| | - Annemarie M C van Rossum
- Department of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Bart C Jacobs
- Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Buerki SE, Grandgirard D, Datta AN, Hackenberg A, Martin F, Schmitt-Mechelke T, Leib SL, Steinlin M. Inflammatory markers in pediatric stroke: An attempt to better understanding the pathophysiology. Eur J Paediatr Neurol 2016; 20:252-260. [PMID: 26778232 DOI: 10.1016/j.ejpn.2015.12.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 11/11/2015] [Accepted: 12/06/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND The mechanisms of childhood and perinatal arterial ischemic stroke (AIS) are poorly understood. Multiple risk factors include cerebral arteriopathy, congenital cardiac disease, infection, sickle cell disease, and maternal-fetal conditions in neonates. For infections and parainfectious conditions being the most important a possible inflammatory pathophysiology has long been suspected. This pilot study aims to detect, whether there are any abnormalities of inflammatory markers associated with childhood and neonatal stroke. METHODS The concentration of 23 different metalloproteinases (MMPs), tissue inhibitors of MMPs (TIMPs), endothelial factors, vascular cell adhesion proteins, and cytokines in plasma were measured in 12 children with AIS, 7 healthy age matched controls and 6 full term neonates with perinatal AIS. RESULTS At the time of the acute event children with AIS had significantly elevated levels of MMP-9, TIMP4, IL-6, IL-8 and CRP compared to controls (p < 0.05). Except for lower IL-6 and CRP levels the pattern of children with a history of varizella-zoster virus (VZV) and other viral infections did not differ to the non-infectious group. Median levels of MMP-1, MMP-2, TIMP-1, TIMP-2, sE-selectin, sICAM-1, sVCAM-1, IL-8, IL-10, TNF-alpha, VEGF, Fetuin A were found to be higher in the neonatal group when compared with older children. CONCLUSION This pilot study supports the assumption of an inflammatory process and up-regulation of metalloproteinases and their inhibitors, and altered pattern of circulating pro-inflammatory cytokines, CRP and vWF levels in pediatric and neonatal AIS. It highlights the feasibility but also difficulties for similar larger future studies that should aim to clarify childhood stroke etiopathogenesis and consecutive further therapeutic options.
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Affiliation(s)
- Sarah E Buerki
- Division of Neurology, Department of Pediatrics, Children's Hospital and University of British Columbia, Canada; Department of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Berne, Switzerland.
| | - Denis Grandgirard
- Institute for Infectious Diseases, University of Bern, Neuroinfectiology Laboratory, Institute for Infectious Diseases, Postfach 8571, CH-3001 Bern, Switzerland
| | - Alexandre N Datta
- University Children's Hospital Basel, Universitäts-Kinderspital beider Basel, Spitalstrasse 33, CH-4056 Basel, Switzerland
| | - Annette Hackenberg
- University Children's Hospital Zürich, Kinderspital Zürich, University Children's Hospital Zürich, Steinwiesstrasse 75, CH-8032 Zürich, Switzerland
| | - Florence Martin
- Children's Hospital Winterthur, Kantonsspital Winterthur, Brauerstrasse 15, Postfach 834, CH-8401 Winterthur, Switzerland
| | - Thomas Schmitt-Mechelke
- Children's Hospital Lucerne, Luzerner Kantonsspital, Kinderspital Luzern, CH-6000 Luzern 16, Switzerland
| | - Stephen L Leib
- Institute for Infectious Diseases, University of Bern, Neuroinfectiology Laboratory, Institute for Infectious Diseases, Postfach 8571, CH-3001 Bern, Switzerland; Biology Division, Spiez Laboratory, Swiss Federal Office for Civil Protection, Spiez, Switzerland
| | - Maja Steinlin
- Department of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Berne, Switzerland
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Sauteur PMM, Hackenberg A, Tio-Gillen AP, van Rossum AMC, Berger C, Jacobs BC. Intrathecal Anti-GalC Antibodies in Bickerstaff Brain Stem Encephalitis. Neuropediatrics 2015; 46:428-30. [PMID: 26535876 DOI: 10.1055/s-0035-1566730] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Patrick M Meyer Sauteur
- Division of Pediatric Infectious Diseases and Immunology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center, Rotterdam, The Netherlands
| | - Annette Hackenberg
- Division of Neurology, and Children's Research Center (CRC), University Children's Hospital of Zurich, Zurich, Switzerland
| | - Anne P Tio-Gillen
- Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Annemarie M C van Rossum
- Division of Pediatric Infectious Diseases and Immunology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center, Rotterdam, The Netherlands
| | - Christoph Berger
- Division of Infectious Diseases and Hospital Epidemiology, and Children's Research Center (CRC), University Children's Hospital of Zurich, Zurich, Switzerland
| | - Bart C Jacobs
- Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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36
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Goeggel Simonetti B, Cavelti A, Arnold M, Bigi S, Regenyi M, Mattle HP, Gralla J, Fluss J, Weber P, Hackenberg A, Steinlin M, Fischer U. Long-term outcome after arterial ischemic stroke in children and young adults. Neurology 2015; 84:1941-7. [DOI: 10.1212/wnl.0000000000001555] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 12/18/2014] [Indexed: 11/15/2022] Open
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37
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Hackenberg A, Baumer A, Sticht H, Schmitt B, Kroell-Seger J, Wille D, Joset P, Papuc S, Rauch A, Plecko B. Infantile epileptic encephalopathy, transient choreoathetotic movements, and hypersomnia due to a De Novo missense mutation in the SCN2A gene. Neuropediatrics 2014; 45:261-4. [PMID: 24710820 DOI: 10.1055/s-0034-1372302] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Mutations of the SCN2A gene have originally been described in association with benign familial neonatal-infantile seizures (BFNIS). Recently, single patients with more severe phenotypes and persisting epileptic encephalopathies have been recognized. We report the case of a girl with severe infantile onset epileptic encephalopathy and a de novo missense mutation in the SCN2A gene (c.4025T > C/ = ; p.L1342P/ = ), who presented with a transient choreatic movement disorder, hypersomnia, and progressive brain atrophy. Whole exome sequencing did not reveal any other disease causing mutation. Our patient contributes to the expanding phenotypic spectrum of SCN2A-related disorders and underlines the importance of genetic workup in epileptic encephalopathies.
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Affiliation(s)
- Annette Hackenberg
- Division of Neurology, Department of Pediatrics, University Children's Hospital Zurich, Zurich, Switzerland
| | - Alessandra Baumer
- Institute of Medical Genetics, University of Zurich, Zurich, Switzerland
| | - Heinrich Sticht
- Institute of Biochemistry, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Bernhard Schmitt
- Division of Neurology, Department of Pediatrics, University Children's Hospital Zurich, Zurich, Switzerland
| | | | - David Wille
- Division of Neurology, Department of Pediatrics, University Children's Hospital Zurich, Zurich, Switzerland
| | - Pascal Joset
- Institute of Medical Genetics, University of Zurich, Zurich, Switzerland
| | - Sorina Papuc
- Institute of Medical Genetics, University of Zurich, Zurich, Switzerland
| | - Anita Rauch
- Institute of Medical Genetics, University of Zurich, Zurich, Switzerland
| | - Barbara Plecko
- Division of Neurology, Department of Pediatrics, University Children's Hospital Zurich, Zurich, Switzerland
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38
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Meyer Sauteur PM, Relly C, Hackenberg A, Stahr N, Berger C, Bloemberg GV, Jacobs E, Nadal D. Mycoplasma pneumoniae intrathecal antibody responses in Bickerstaff brain stem encephalitis. Neuropediatrics 2014; 45:61-3. [PMID: 23794446 DOI: 10.1055/s-0033-1348150] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The pathogenesis of Mycoplasma pneumoniae encephalitis is not established. We report, for the first time, the case of a patient with severe Bickerstaff brain stem encephalitis in whom we detected intrathecal production of M. pneumoniae-specific antibodies, contrasting the findings in another patient with less severe encephalitis in whom we detected intrathecal M. pneumoniae DNA but no specific antibodies. Our observations suggest that intrathecal M. pneumoniae-specific antibody responses may contribute to a more severe course of M. pneumoniae encephalitis.
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Affiliation(s)
- Patrick M Meyer Sauteur
- Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital of Zurich, Zurich, Switzerland
| | - Christa Relly
- Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital of Zurich, Zurich, Switzerland
| | - Annette Hackenberg
- Division of Neurology, University Children's Hospital of Zurich, Zurich, Switzerland
| | - Nikolai Stahr
- Division of Radiology, University Children's Hospital of Zurich, Zurich, Switzerland
| | - Christoph Berger
- Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital of Zurich, Zurich, Switzerland
| | - Guido V Bloemberg
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Enno Jacobs
- Institute of Medical Microbiology and Hygiene, Medical Faculty Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - David Nadal
- Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital of Zurich, Zurich, Switzerland
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Studer M, Boltshauser E, Capone Mori A, Datta A, Fluss J, Mercati D, Hackenberg A, Keller E, Maier O, Marcoz JP, Ramelli GP, Poloni C, Schmid R, Schmitt-Mechelke T, Wehrli E, Heinks T, Steinlin M. Factors affecting cognitive outcome in early pediatric stroke. Neurology 2014; 82:784-92. [DOI: 10.1212/wnl.0000000000000162] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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40
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Hackenberg A, Poggenburg I, Titgemeyer C, Hagendorff A. Rhombenzephalosynapsis, biparietale Alopezie und Hornhauttrübung. Monatsschr Kinderheilkd 2011. [DOI: 10.1007/s00112-011-2468-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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41
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Neilson DE, Adams MD, Orr CMD, Schelling DK, Eiben RM, Kerr DS, Anderson J, Bassuk AG, Bye AM, Childs AM, Clarke A, Crow YJ, Di Rocco M, Dohna-Schwake C, Dueckers G, Fasano AE, Gika AD, Gionnis D, Gorman MP, Grattan-Smith PJ, Hackenberg A, Kuster A, Lentschig MG, Lopez-Laso E, Marco EJ, Mastroyianni S, Perrier J, Schmitt-Mechelke T, Servidei S, Skardoutsou A, Uldall P, van der Knaap MS, Goglin KC, Tefft DL, Aubin C, de Jager P, Hafler D, Warman ML. Infection-triggered familial or recurrent cases of acute necrotizing encephalopathy caused by mutations in a component of the nuclear pore, RANBP2. Am J Hum Genet 2009; 84:44-51. [PMID: 19118815 DOI: 10.1016/j.ajhg.2008.12.009] [Citation(s) in RCA: 234] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Revised: 12/09/2008] [Accepted: 12/12/2008] [Indexed: 01/05/2023] Open
Abstract
Acute necrotizing encephalopathy (ANE) is a rapidly progressive encephalopathy that can occur in otherwise healthy children after common viral infections such as influenza and parainfluenza. Most ANE is sporadic and nonrecurrent (isolated ANE). However, we identified a 7 Mb interval containing a susceptibility locus (ANE1) in a family segregating recurrent ANE as an incompletely penetrant, autosomal-dominant trait. We now report that all affected individuals and obligate carriers in this family are heterozygous for a missense mutation (c.1880C-->T, p.Thr585Met) in the gene encoding the nuclear pore protein Ran Binding Protein 2 (RANBP2). To determine whether this mutation is the susceptibility allele, we screened controls and other patients with ANE who are unrelated to the index family. Patients from 9 of 15 additional kindreds with familial or recurrent ANE had the identical mutation. It arose de novo in two families and independently in several other families. Two other patients with familial ANE had different RANBP2 missense mutations that altered conserved residues. None of the three RANBP2 missense mutations were found in 19 patients with isolated ANE or in unaffected controls. We conclude that missense mutations in RANBP2 are susceptibility alleles for familial and recurrent cases of ANE.
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Affiliation(s)
- Derek E Neilson
- Department of Genetics, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, Cleveland, OH 44106, USA.
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Wagner J, Hackenberg A. Highlights of the 41st Institute on Hospital and Community Psychiatry. Hosp Community Psychiatry 1990; 41:19-24. [PMID: 2295477 DOI: 10.1176/ps.41.1.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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