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1.
Acta Paediatr ; 113(2): 191-198, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37874257

RESUMO

AIM: To determine the apparent diffusion coefficient (ADC) in brain structures during the first 2 weeks of life and its relation with neurological outcome for hypoxic-ischaemic encephalopathy (HIE) in term neonates. METHODS: We retrospectively evaluated 56 term-born neonates. The ADC values were measured for 11 brain regions. The clinical outcomes at least 2 years of age were defined as normal outcome, mild disability and severe disability. The area under curves (AUCs) by ROC analysis were performed to predict the neurodevelopmental outcomes. The clinical outcomes were compared between favourable outcome and adverse outcome and also between normal outcome and unfavourable outcome. RESULTS: Thirty-four patients were judged as normal outcome, 10 as mild disability and 12 as severe disability. When the clinical outcomes were compared between favourable outcome and adverse outcome, the AUC on the 1st week was highest value at the thalamus. When the clinical outcomes were compared between normal outcome and unfavourable outcome, the AUC on the 1st week was highest at the thalamus. CONCLUSION: The ADC values in the thalamus in the 1st week can predict the neurological outcome. The ADC values in centrum semiovale on the 2nd week can be used to predict neurodevelopmental outcomes.


Assuntos
Hipóxia-Isquemia Encefálica , Recém-Nascido , Humanos , Estudos Retrospectivos , Hipóxia-Isquemia Encefálica/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética , Encéfalo , Curva ROC , Imageamento por Ressonância Magnética
2.
Neuropediatrics ; 54(3): 217-221, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-35642300

RESUMO

Joubert syndrome (JS) is a genetic neurodevelopmental disorder characterized by lower brainstem dysplasia and cerebellar vermis agenesis termed molar tooth sign (MTS), psychomotor retardation, abnormal respiratory pattern in infancy, and oculomotor abnormalities. Arima syndrome (AS), which is a severe form of JS, is characterized by severe psychomotor retardation, congenital visual impairment, progressive renal dysfunction, and lower brainstem dysplasia from early infancy. Numerous patients with AS expire in early childhood. Recently, c.6012-12T> A in the CEP290 gene was reported as a specific variant of AS. Herein, we report the cases of two siblings showing a phenotype of JS with compound heterozygous mutations (c.6012-12T > A / c.5924delT) in the CEP290 gene. The older sister (aged 19 years) had hypotonia, hypertelorism, and anteverted nares since birth. As a neonate, she developed a transient abnormal respiratory pattern and nystagmus, and brain magnetic resonance imaging (MRI) showed MTS. The younger sister (aged 13 years) exhibited mild hypotonia and pendular nystagmus as a neonate; MRI revealed MTS. Both sisters had psychomotor retardation, oculomotor dysfunction, and bilateral renal cysts with normal renal function. They can walk and have simple conversation. They do not meet the diagnostic criteria for AS, and their symptoms were milder than those of previously reported cases with this specific mutation. This report indicates the expanding spectrum of the CEP290 variant.


Assuntos
Anormalidades Múltiplas , Anormalidades do Olho , Doenças Renais Policísticas , Pré-Escolar , Feminino , Humanos , Anormalidades Múltiplas/diagnóstico por imagem , Anormalidades Múltiplas/genética , Antígenos de Neoplasias/genética , Proteínas de Ciclo Celular/genética , Cerebelo/patologia , Proteínas do Citoesqueleto/genética , Anormalidades do Olho/diagnóstico por imagem , Anormalidades do Olho/genética , Hipotonia Muscular , Fenótipo , Doenças Renais Policísticas/patologia , Retina/anormalidades , Irmãos
3.
Brain Dev ; 44(9): 605-611, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35798636

RESUMO

BACKGROUND: Very low-birth-weight infants (VLBWI) are at high risk for adverse neurodevelopmental outcomes. A new, feasible and practical classification system for white matter injury has been reported by Martinez-Biarge et al. Therefore, we investigated the relationship between white matter injury and neurodevelopmental outcomes using this system. MATERIALS AND METHODS: We enrolled a consecutive series of VLBWI birth weights <1500 g between 2012 and 2015. Two radiologists evaluated the brain MRI obtained in the VLBWI at term-equivalent age. MRI findings were classified into six Grades (Grade 0, Ia, Ib, II, III, IV). The frequency of abnormalities in each Grade was examined. The neurodevelopmental outcome of the VLBWI was assessed at two years or older, and we investigated the presence of cerebral palsy (CP) and intellectual disability (ID), and other serious outcomes. We also calculated the simple kappa value before the raters were matched. RESULTS: Among 167 VLBWI, 131 met the eligibility criteria. 114 was Grade 0 (87%), 11 was Grade I (8.4%), 3 was Grade II (2.3%), 1 was Grade III (0.8%), and 2 was Grade IV (1.5%). The frequency of any abnormalities of intelligence in Grade 0 was 24%. The frequency of CP in Grade I was 18%. All Grade III and Grade IV cases had mild CP and an ID. The simple kappa value was 0.95. CONCLUSION: The prognostic value of the MRI scoring tool was limited. However, all Grade III and Grade IV cases had mild CP and ID. The results demonstrated an excellent inter-rater correlation.


Assuntos
Lesões Encefálicas , Paralisia Cerebral , Deficiência Intelectual , Paralisia Cerebral/diagnóstico por imagem , Humanos , Lactente , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Inteligência , Imageamento por Ressonância Magnética/métodos
4.
Neuropediatrics ; 53(4): 246-250, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35843217

RESUMO

PURPOSE: Intraventricular hemorrhage (IVH) is common in infants with a low-birth-weight (LBW) and has been suggested to cause major impairment not only of future motor development but also of cognitive function and learning ability. The purpose of the present study is to assess the frequency of IVH using magnetic resonance imaging (MRI) in LBW infants and its clinical neurodevelopmental outcomes. METHODS: We enrolled a consecutive series of 247 neonates with an LBW of < 1,500 g hospitalized in the newborn intensive care unit between 2010 and 2015. The presence of IVH was examined using T2* MRI at term-equivalent age (TEA). We then investigated the clinical outcome at ≥3 years of age and its correlation with the IVH grade. RESULTS: The overall incidence of IVH among LBW infants was 16.2%. The proportion of infants with IVH showing a favorable outcome did not differ significantly from that of infants without IVH. The proportion of neonates showing a poor outcome was 6.7% for those with IVH and 1.9% for those without IVH and 2.7% for those with and without IVH combined. CONCLUSION: We were able to clarify the frequency of IVH in LBW infants using MRI at TEA. We demonstrated the lower incidence of mortality and IVH, the higher incidence of a favorable outcome, and the lower incidence of poor outcome.


Assuntos
Doenças do Prematuro , Hemorragia Cerebral/diagnóstico por imagem , Hemorragia Cerebral/epidemiologia , Humanos , Incidência , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , Imageamento por Ressonância Magnética
5.
J Neurochem ; 161(2): 129-145, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35233765

RESUMO

Increasing evidence suggests the involvement of peripheral amino acid metabolism in the pathophysiology of neuropsychiatric disorders, whereas the molecular mechanisms are largely unknown. Tetrahydrobiopterin (BH4) is a cofactor for enzymes that catalyze phenylalanine metabolism, monoamine synthesis, nitric oxide production, and lipid metabolism. BH4 is synthesized from guanosine triphosphate and regenerated by quinonoid dihydropteridine reductase (QDPR), which catalyzes the reduction of quinonoid dihydrobiopterin. We analyzed Qdpr-/- mice to elucidate the physiological significance of the regeneration of BH4. We found that the Qdpr-/- mice exhibited mild hyperphenylalaninemia and monoamine deficiency in the brain, despite the presence of substantial amounts of BH4 in the liver and brain. Hyperphenylalaninemia was ameliorated by exogenously administered BH4, and dietary phenylalanine restriction was effective for restoring the decreased monoamine contents in the brain of the Qdpr-/- mice, suggesting that monoamine deficiency was caused by the secondary effect of hyperphenylalaninemia. Immunohistochemical analysis showed that QDPR was primarily distributed in oligodendrocytes but hardly detectable in monoaminergic neurons in the brain. Finally, we performed a behavioral assessment using a test battery. The Qdpr-/- mice exhibited enhanced fear responses after electrical foot shock. Taken together, our data suggest that the perturbation of BH4 metabolism should affect brain monoamine levels through alterations in peripheral amino acid metabolism, and might contribute to the development of anxiety-related psychiatric disorders. Cover Image for this issue: https://doi.org/10.1111/jnc.15398.


Assuntos
Biopterinas , Fenilcetonúrias , Animais , Biopterinas/análogos & derivados , Biopterinas/metabolismo , Di-Hidropteridina Redutase , Medo , Humanos , Camundongos , Fenilalanina , Fenilcetonúrias/genética , Fenilcetonúrias/metabolismo
6.
Pediatr Radiol ; 52(7): 1356-1369, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35294621

RESUMO

BACKGROUND: Diffusion-weighted imaging performed shortly after brain injury has been shown to facilitate visualization of acute corticospinal tract injury known as "pre-Wallerian degeneration." OBJECTIVE: The aim of this study was to determine whether diffusion restriction in the corticospinal tract and corpus callosum occurs within the first 2 weeks after birth in neonates with neonatal hypoxic-ischemic encephalopathy. MATERIALS AND METHODS: We enrolled a consecutive series of 66 infants diagnosed with hypoxic-ischemic encephalopathy who underwent MRI. We evaluated diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values to assess the presence of restricted diffusion in the corticospinal tract and corpus callosum. Next, we compared ADC values in the corticospinal tract and in the splenium and genu of the corpus callosum of infants with abnormal pattern on MRI with those of control infants, who showed a normal pattern on MRI. We attempted to follow all infants with hypoxic-ischemic encephalopathy until 18 months of age and assess them using a standardized neurologic examination. RESULTS: After exclusions, we recruited 25 infants with abnormal MRI and 20 with normal MRI (controls). Among these 45 neonates, pre-Wallerian degeneration was visualized in the corticospinal tract in 10 neonates and in the corpus callosum in 12. The ADC values in the corticospinal tract in the first week were significantly lower than they were in the second week. Infants with pre-Wallerian degeneration in the corticospinal tract showed an unfavorable outcome. CONCLUSION: Pre-Wallerian degeneration was visualized in the corticospinal tract and corpus callosum and was associated with extensive brain injury caused by hypoxic-ischemic encephalopathy. The changes in signal were observed to evolve over time within the first 2 weeks. The clinical outcome of infants having pre-Wallerian degeneration in the corticospinal tract was unfavorable.


Assuntos
Lesões Encefálicas , Hipóxia-Isquemia Encefálica , Corpo Caloso/diagnóstico por imagem , Corpo Caloso/patologia , Imagem de Difusão por Ressonância Magnética/métodos , Humanos , Hipóxia-Isquemia Encefálica/diagnóstico por imagem , Hipóxia-Isquemia Encefálica/patologia , Lactente , Recém-Nascido , Tratos Piramidais/diagnóstico por imagem , Degeneração Walleriana/complicações , Degeneração Walleriana/patologia
7.
Acta Radiol ; 63(8): 1110-1117, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34259022

RESUMO

BACKGROUND: The morphological changes in the pons and cerebellum of neonates experiencing profound asphyxia in the early period of life remain to be clarified. PURPOSE: To assess the changes in the size of the pons and cerebellum during the first two weeks of life in term neonates with pontine and cerebellar injury caused by hypoxic-ischemic encephalopathy in comparison with a control group. MATERIAL AND METHODS: Two groups were investigated: a group with pontine/cerebellar injury (PCI) (n = 10) demonstrated by magnetic resonance imaging (MRI) diffusion-weighted imaging; and a control group without PCI - focal-multifocal white matter injury and a normal pattern (n = 24). The anteroposterior diameter (APD) and height of the pons and cerebellar vermis, and the transverse width of the cerebellum were measured twice in the first and second weeks of life. Differences between the groups were analyzed statistically using paired and unpaired Student's t-test at a significance level of P < 0.05. RESULTS: In the PCI group, the pontine APD and cerebellar vermian height were significantly decreased in the second week. An increase of pons and cerebellar size was evident during the first two weeks of life in the control groups. CONCLUSION: Infants with PCI and profound asphyxia show rapid decreases in pontine APD and cerebellar vermian height within the first two weeks of life.


Assuntos
Asfixia , Ponte , Asfixia/patologia , Cerebelo/diagnóstico por imagem , Cerebelo/patologia , Imagem de Difusão por Ressonância Magnética , Humanos , Lactente , Recém-Nascido , Imageamento por Ressonância Magnética , Ponte/diagnóstico por imagem , Ponte/patologia
8.
J Child Neurol ; 36(11): 950-957, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34547931

RESUMO

OBJECTIVE: There has been no previous report of diffusion restriction in the optic radiation of term neonates with hypoxic-ischemic encephalopathy. Here, using diffusion-weighted magnetic resonance imaging (MRI), we assessed diffusion restriction in the optic radiation within the first 2 weeks of life and estimated signal changes and the apparent diffusion coefficient in the optic radiation and lateral geniculate body using T1-weighted MRI. MATERIALS AND METHODS: Forty-five term neonates with hypoxic-ischemic encephalopathy underwent MRI twice during the first 2 weeks of life. Diffusion-weighted imaging and apparent diffusion coefficient were used to evaluate the presence of diffusion restriction in the optic radiation and lateral geniculate body. Apparent diffusion coefficient and T1 signal changes in the optic radiation and lateral geniculate body were also compared with those in 11 control neonates showing a normal pattern on MRI. RESULTS: Diffusion restriction in the optic radiation was observed in 29% (13/45) of the hypoxic-ischemic encephalopathy neonates at a median age of 3.5 days (range: 1-9 days). The apparent diffusion coefficient in the optic radiation of affected neonates was significantly reduced in comparison with the controls. In all neonates with optic radiation involvement, increased T1 signal intensity was observed in the optic radiation in the second week, and was also evident in in lateral geniculate body in 8 of those neonates. CONCLUSION: Diffusion restriction in the optic radiation is not rare among term neonates with hypoxic-ischemic encephalopathy, being visualized by diffusion-weighted imaging in the first week of life and also high-intensity T1 signal changes in the second week. This diffusion restriction in the optic radiation might be due to transsynaptic neuronal degeneration.


Assuntos
Hipóxia-Isquemia Encefálica/diagnóstico por imagem , Hipóxia-Isquemia Encefálica/patologia , Imageamento por Ressonância Magnética/métodos , Vias Visuais/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Imagem de Difusão por Ressonância Magnética/métodos , Feminino , Humanos , Recém-Nascido , Masculino , Estudos Retrospectivos
9.
Brain Dev ; 43(4): 505-514, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33436160

RESUMO

OBJECTIVE: Patients with pathogenic cyclin-dependent kinase-like-5 gene (CDKL5) variants are designated CDKL5 deficiency disorder (CDD). This study aimed to delineate the clinical characteristics of Japanese patients with CDD and elucidate possible appropriate treatments. METHODS: We recruited patients with pathogenic or likely pathogenic CDKL5 variants from a cohort of approximately 1,100 Japanese patients with developmental and epileptic encephalopathies, who underwent genetic analysis. We retrospectively reviewed clinical, electroencephalogram, neuroimaging, and genetic information. RESULTS: We identified 29 patients (21 females, eight males). All patients showed severe developmental delay, especially in males. Involuntary movements were observed in 15 patients. No antiepileptic drugs (AEDs) achieved seizure freedom by monotherapy. AEDs achieving ≥ 50% reduction in seizure frequency were sodium valproate in two patients, vigabatrin in one, and lamotrigine in one. Seizure aggravation was observed during the use of lamotrigine, potassium bromide, and levetiracetam. Adrenocorticotrophic hormone (ACTH) was the most effective treatment. The ketogenic diet (KD), corpus callosotomy and vagus nerve stimulation did not improve seizure frequency in most patients, but KD was remarkably effective in one. The degree of brain atrophy on magnetic resonance imaging (MRI) reflected disease severity. Compared with females, males had lower levels of attained motor development and more severe cerebral atrophy on MRI. CONCLUSION: Our patients showed more severe global developmental delay than those in previous studies and had intractable epilepsy, likely because previous studies had lower numbers of males. Further studies are needed to investigate appropriate therapy for CDD, such as AED polytherapy or combination treatment involving ACTH, KD, and AEDs.


Assuntos
Anticonvulsivantes/uso terapêutico , Epilepsia/genética , Síndromes Epilépticas/genética , Proteínas Serina-Treonina Quinases/genética , Espasmos Infantis/genética , Adolescente , Adulto , Criança , Pré-Escolar , Dieta Cetogênica , Eletroencefalografia , Epilepsia/tratamento farmacológico , Epilepsia/terapia , Síndromes Epilépticas/tratamento farmacológico , Síndromes Epilépticas/terapia , Feminino , Humanos , Lactente , Japão , Masculino , Estudos Retrospectivos , Espasmos Infantis/tratamento farmacológico , Espasmos Infantis/terapia , Resultado do Tratamento , Estimulação do Nervo Vago , Adulto Jovem
10.
Hum Mutat ; 42(1): 50-65, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33131168

RESUMO

Many algorithms to detect copy number variations (CNVs) using exome sequencing (ES) data have been reported and evaluated on their sensitivity and specificity, reproducibility, and precision. However, operational optimization of such algorithms for a better performance has not been fully addressed. ES of 1199 samples including 763 patients with different disease profiles was performed. ES data were analyzed to detect CNVs by both the eXome Hidden Markov Model (XHMM) and modified Nord's method. To efficiently detect rare CNVs, we aimed to decrease sequencing biases by analyzing, at the same time, the data of all unrelated samples sequenced in the same flow cell as a batch, and to eliminate sex effects of X-linked CNVs by analyzing female and male sequences separately. We also applied several filtering steps for more efficient CNV selection. The average number of CNVs detected in one sample was <5. This optimization together with targeted CNV analysis by Nord's method identified pathogenic/likely pathogenic CNVs in 34 patients (4.5%, 34/763). In particular, among 142 patients with epilepsy, the current protocol detected clinically relevant CNVs in 19 (13.4%) patients, whereas the previous protocol identified them in only 14 (9.9%) patients. Thus, this batch-based XHMM analysis efficiently selected rare pathogenic CNVs in genetic diseases.


Assuntos
Variações do Número de Cópias de DNA , Exoma , Algoritmos , Exoma/genética , Feminino , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Humanos , Masculino , Reprodutibilidade dos Testes , Sequenciamento do Exoma
11.
J Med Genet ; 58(8): 505-513, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-32732225

RESUMO

BACKGROUND: Variants in the type IV collagen gene (COL4A1/2) cause early-onset cerebrovascular diseases. Most individuals are diagnosed postnatally, and the prenatal features of individuals with COL4A1/2 variants remain unclear. METHODS: We examined COL4A1/2 in 218 individuals with suspected COL4A1/2-related brain defects. Among those arising from COL4A1/2 variants, we focused on individuals showing prenatal abnormal ultrasound findings and validated their prenatal and postnatal clinical features in detail. RESULTS: Pathogenic COL4A1/2 variants were detected in 56 individuals (n=56/218, 25.7%) showing porencephaly (n=29), schizencephaly (n=12) and others (n=15). Thirty-four variants occurred de novo (n=34/56, 60.7%). Foetal information was available in 47 of 56 individuals, 32 of whom (n=32/47, 68.1%) had one or more foetal abnormalities. The median gestational age at the detection of initial prenatal abnormal features was 31 weeks of gestation. Only 14 individuals had specific prenatal findings that were strongly suggestive of features associated with COL4A1/2 variants. Foetal ventriculomegaly was the most common initial feature (n=20/32, 62.5%). Posterior fossa abnormalities, including Dandy-Walker malformation, were observed prenatally in four individuals. Regarding extrabrain features, foetal growth restriction was present in 16 individuals, including eight individuals with comorbid ventriculomegaly. CONCLUSIONS: Prenatal observation of ventriculomegaly with comorbid foetal growth restriction should prompt a thorough ultrasound examination and COL4A1/2 gene testing should be considered when pathogenic variants are strongly suspected.


Assuntos
Colágeno Tipo IV/genética , Mutação/genética , Síndrome de Dandy-Walker/genética , Feminino , Humanos , Masculino , Gravidez , Ultrassonografia Pré-Natal/métodos
12.
Acta Radiol ; 61(10): 1398-1405, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31979976

RESUMO

BACKGROUND: Perinatal hypoxic-ischemic encephalopathy (HIE) is a major cause of death and disability in infants. Magnetic resonance imaging (MRI) is valuable for predicting the outcome in high-risk neonates. The relationship of pontine and cerebellar injury to outcome has not been explored sufficiently. PURPOSE: To characterize MRI features of pontine and cerebellar injury and to assess the clinical outcomes of these neonates. MATERIAL AND METHODS: The retrospective study included 59 term neonates (25 girls) examined by MRI using 1.5-T scanner in the first two weeks of life between 2008 and 2017. Involvement of the pons and cerebellum was judged as a high signal intensity on diffusion-weighted image (DWI) and a restricted diffusion on an apparent diffusion coefficient (ADC) map. RESULTS: Pontine involvement was observed in the dorsal portion of pons in eight neonates and cerebellar involvement was observed in dentate nucleus (n = 8), cerebellar vermis (n = 3), and hemisphere (n = 1) in 11 neonates. Combined pontine and cerebellar involvement was observed in eight neonates and only cerebellar involvement in three. The pontine and cerebellar injuries were always associated with very severe brain injury including a basal ganglia/thalamus injury pattern and a total brain injury pattern. In terms of clinical outcome, all but four lost to follow-up, had severe cerebral palsy. CONCLUSION: Pontine and cerebellar involvement occurred in the dorsal portion of pons and mostly dentate nucleus and was always associated with a more severe brain injury pattern as well as being predictive of major disability.


Assuntos
Cerebelo/diagnóstico por imagem , Hipóxia-Isquemia Encefálica/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Ponte/diagnóstico por imagem , Cerebelo/patologia , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Hipóxia-Isquemia Encefálica/patologia , Recém-Nascido , Masculino , Ponte/patologia
13.
Childs Nerv Syst ; 36(6): 1223-1229, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31865401

RESUMO

PURPOSE: The most severe form of profound asphyxia in neonates is now known as "total brain injury," which forms part of the clinical spectrum of hypoxic-ischemic encephalopathy (HIE). Although the magnetic resonance (MR) imaging features of total brain injury remain to be determined, a widespread hyperintensity of the supratentorial brain, known as the "white cerebrum sign," has been reported in diffusion-weighted images (DWI). METHODS: We examined four neonates who developed severe profound asphyxia. RESULTS: In the first week of life, all neonates showed the white cerebrum sign on DWI. A follow-up of these cases over a period of 1 month revealed diffuse bilateral multicystic encephalomalacia (MCE) as well as shrinkage of the basal ganglia and thalami (BG/T). These MR findings were common to all neonates, and all the neonates had severe adverse clinical outcomes. CONCLUSION: Neonates, who exhibit the white cerebrum sign on MR imaging due to profound asphyxia, develop major disabilities, and MCE with shrinkage of the BG/T suggests miserable outcomes.


Assuntos
Lesões Encefálicas , Hipóxia-Isquemia Encefálica , Encéfalo/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética , Humanos , Hipóxia-Isquemia Encefálica/diagnóstico por imagem , Recém-Nascido , Imageamento por Ressonância Magnética
14.
J Med Genet ; 56(6): 396-407, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30842224

RESUMO

BACKGROUND: Rett syndrome (RTT) is a characteristic neurological disease presenting with regressive loss of neurodevelopmental milestones. Typical RTT is generally caused by abnormality of methyl-CpG binding protein 2 (MECP2). Our objective to investigate the genetic landscape of MECP2-negative typical/atypical RTT and RTT-like phenotypes using whole exome sequencing (WES). METHODS: We performed WES on 77 MECP2-negative patients either with typical RTT (n=11), atypical RTT (n=22) or RTT-like phenotypes (n=44) incompatible with the RTT criteria. RESULTS: Pathogenic or likely pathogenic single-nucleotide variants in 28 known genes were found in 39 of 77 (50.6%) patients. WES-based CNV analysis revealed pathogenic deletions involving six known genes (including MECP2) in 8 of 77 (10.4%) patients. Overall, diagnostic yield was 47 of 77 (61.0 %). Furthermore, strong candidate variants were found in four novel genes: a de novo variant in each of ATPase H+ transporting V0 subunit A1 (ATP6V0A1), ubiquitin-specific peptidase 8 (USP8) and microtubule-associated serine/threonine kinase 3 (MAST3), as well as biallelic variants in nuclear receptor corepressor 2 (NCOR2). CONCLUSIONS: Our study provides a new landscape including additional genetic variants contributing to RTT-like phenotypes, highlighting the importance of comprehensive genetic analysis.


Assuntos
Sequenciamento do Exoma , Estudos de Associação Genética , Predisposição Genética para Doença , Variação Genética , Fenótipo , Síndrome de Rett/diagnóstico , Síndrome de Rett/genética , Biologia Computacional/métodos , Variações do Número de Cópias de DNA , Ontologia Genética , Redes Reguladoras de Genes , Estudos de Associação Genética/métodos , Humanos , Proteína 2 de Ligação a Metil-CpG/genética , Polimorfismo de Nucleotídeo Único
15.
Pediatr Radiol ; 48(6): 865-874, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29417166

RESUMO

BACKGROUND: Pseudonormalization of diffusion-weighted magnetic resonance imaging (MRI) can lead to underestimation of brain injury in newborns with hypoxic-ischemic encephalopathy (HIE), posing a significant problem. We have noticed that some neonates show pseudonormalization negativity on diffusion-weighted imaging. OBJECTIVE: To compare pseudonormalization negativity with clinical outcomes. MATERIALS AND METHODS: Seventeen term neonates with moderate or severe HIE underwent therapeutic hypothermia. They were examined by MRI twice at mean ages of 3 days and 10 days. We evaluated the presence of restricted diffusion, and also the presence or absence of pseudonormalization, by diffusion-weighted imaging at the time of the second MRI, and correlated the results with clinical outcome. RESULTS: DWI demonstrated no abnormality in seven neonates. Among the 10 neonates with abnormal diffusion-weighted imaging findings, 2 were positive for pseudonormalization and 8 were negative. Among neonates with normal diffusion-weighted imaging findings and with positivity for pseudonormalization, none had major disability. Among the eight neonates with pseudonormalization negativity, all but one, who was lost to follow-up, had major disability. CONCLUSION: Abnormal diffusion-weighted imaging with pseudonormalization negativity might be predictive of severe brain injury and major disability. The second-week MRI is important for the judgment of pseudonormalization.


Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Hipóxia-Isquemia Encefálica/diagnóstico por imagem , Feminino , Humanos , Hipotermia Induzida , Hipóxia-Isquemia Encefálica/terapia , Recém-Nascido , Masculino , Estudos Retrospectivos
16.
Mol Brain ; 7: 44, 2014 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-24893573

RESUMO

BACKGROUND: Voltage-dependent block of the NMDA receptor by Mg2+ is thought to be central to the unique involvement of this receptor in higher brain functions. However, the in vivo role of the Mg2+ block in the mammalian brain has not yet been investigated, because brain-wide loss of the Mg2+ block causes perinatal lethality. In this study, we used a brain-region specific knock-in mouse expressing an NMDA receptor that is defective for the Mg2+ block in order to test its role in neural information processing. RESULTS: We devised a method to induce a single amino acid substitution (N595Q) in the GluN2A subunit of the NMDA receptor, specifically in the hippocampal dentate gyrus in mice. This mutation reduced the Mg2+ block at the medial perforant path-granule cell synapse and facilitated synaptic potentiation induced by high-frequency stimulation. The mutants had more stable hippocampal place fields in the CA1 than the controls did, and place representation showed lower sensitivity to visual differences. In addition, behavioral tests revealed that the mutants had a spatial working memory deficit. CONCLUSIONS: These results suggest that the Mg2+ block in the dentate gyrus regulates hippocampal spatial information processing by attenuating activity-dependent synaptic potentiation in the dentate gyrus.


Assuntos
Giro Denteado/metabolismo , Magnésio/farmacologia , Receptores de N-Metil-D-Aspartato/antagonistas & inibidores , Envelhecimento/fisiologia , Animais , Sequência de Bases , Giro Denteado/efeitos dos fármacos , Giro Denteado/patologia , Giro Denteado/fisiopatologia , Potenciais Pós-Sinápticos Excitadores/efeitos dos fármacos , Marcação de Genes , Integrases/metabolismo , Camundongos , Camundongos Mutantes Neurológicos , Dados de Sequência Molecular , Proteínas Mutantes/metabolismo , Neurogênese/efeitos dos fármacos , Plasticidade Neuronal/efeitos dos fármacos , Especificidade de Órgãos/efeitos dos fármacos , Subunidades Proteicas/metabolismo , Receptores de N-Metil-D-Aspartato/metabolismo
17.
Brain Dev ; 36(8): 730-3, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24113355

RESUMO

We report the first case of Leigh syndrome (LS) with Fukuyama congenital muscular dystrophy (FCMD). A neonate suffered from lactic acidosis and subsequently presented with poor feeding, muscle weakness, hypotonia, cardiopulmonary dysfunction, and hydrocephalus. He died at 17 months. The findings of brain magnetic resonance imaging indicated some specific features of both LS and FCMD, and FCMD gene mutation was detected. Decreased mitochondrial respiratory complex I and II activity was noted. Mitochondrial DNA sequencing showed no pathogenic mutation. A case with complex I+II deficiency has rarely been reported, suggesting a nuclear gene mutation.


Assuntos
Doença de Leigh/complicações , Doença de Leigh/diagnóstico , Síndrome de Walker-Warburg/complicações , Síndrome de Walker-Warburg/diagnóstico , Encéfalo/patologia , Humanos , Recém-Nascido , Doença de Leigh/patologia , Imageamento por Ressonância Magnética , Masculino , Síndrome de Walker-Warburg/metabolismo , Síndrome de Walker-Warburg/patologia
18.
Front Behav Neurosci ; 6: 58, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23060763

RESUMO

Pituitary adenylate cyclase-activating polypeptide (PACAP) is a neuropeptide acting as a neurotransmitter, neuromodulator, or neurotrophic factor. PACAP is widely expressed throughout the brain and exerts its functions through the PACAP-specific receptor (PAC(1)). Recent studies reveal that genetic variants of the PACAP and PAC(1) genes are associated with mental disorders, and several behavioral abnormalities of PACAP knockout (KO) mice are reported. However, an insufficient number of backcrosses was made using PACAP KO mice on the C57BL/6J background due to their postnatal mortality. To elucidate the effects of PACAP on neuropsychiatric function, the PACAP gene was knocked out in F1 hybrid mice (C57BL/6J × 129SvEv) for appropriate control of the genetic background. The PACAP KO mice were then subjected to a behavioral test battery. PACAP deficiency had no significant effects on neurological screen. As shown previously, the mice exhibited significantly increased locomotor activity in a novel environment and abnormal anxiety-like behavior, while no obvious differences between genotypes were shown in home cage (HC) activity. In contrast to previous reports, the PACAP KO mice showed normal prepulse inhibition (PPI) and slightly decreased depression-like behavior. Previous study demonstrates that the social interaction (SI) in a resident-intruder test was decreased in PACAP KO mice. On the other hand, we showed that PACAP KO mice exhibited increased SI in Crawley's three-chamber social approach test, although PACAP KO had no significant impact on SI in a HC. PACAP KO mice also exhibited mild performance deficit in working memory in an eight-arm radial maze (RM) and the T-maze (TM), while they did not show any significant abnormalities in the left-right discrimination task in the TM. These results suggest that PACAP has an important role in the regulation of locomotor activity, social behavior, anxiety-like behavior and, potentially, working memory.

19.
Front Behav Neurosci ; 5: 85, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22347851

RESUMO

A tumor suppressor gene, Adenomatous polyposis coli (Apc), is expressed in the nervous system from embryonic to adulthood stages, and transmits the Wnt signaling pathway in which schizophrenia susceptibility genes, including T-cell factor 4 (TCF4) and calcineurin (CN), are involved. However, the functions of Apc in the nervous system are largely unknown. In this study, as the first evaluation of Apc function in the nervous system, we have investigated the behavioral significance of the Apc gene, applying a battery of behavioral tests to Apc heterozygous knockout (Apc(+/-)) mice. Apc(+/-) mice showed no significant impairment in neurological reflexes or sensory and motor abilities. In various tests, including light/dark transition, open-field, social interaction, eight-arm radial maze, and fear conditioning tests, Apc(+/-) mice exhibited hypoactivity. In the eight-arm radial maze, Apc(+/-) mice 6-7 weeks of age displayed almost normal performance, whereas those 11-12 weeks of age showed a severe performance deficit in working memory, suggesting that Apc is involved in working memory performance in an age-dependent manner. The possibility that anemia, which Apc(+/-) mice develop by 17 weeks of age, impairs working memory performance, however, cannot be excluded. Our results suggest that Apc plays a role in the regulation of locomotor activity and presumably working memory performance.

20.
Front Behav Neurosci ; 4: 29, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20676234

RESUMO

C57BL/6 inbred strains of mice are widely used in knockout and transgenic research. To evaluate the loss-of-function and gain-of-function effects of the gene of interest, animal behaviors are often examined. However, an issue of C57BL/6 substrains that is not always appreciated is that behaviors are known to be strongly influenced by genetic background. To investigate the behavioral characteristics of C57BL/6 substrains, we subjected C57BL/6J, C57BL/6N, and C57BL/6C mice to a behavior test battery. We performed both a regular scale analysis, in which experimental conditions were tightly controlled, and large-scale analysis from large number of behavioral data that we have collected so far through the comprehensive behavioral test battery applied to 700-2,200 mice in total. Significant differences among the substrains were found in the results of various behavioral tests, including the open field, rotarod, elevated plus maze, prepulse inhibition, Porsolt forced swim, and spatial working memory version of the eight-arm radial maze. Our results show a divergence of behavioral performance in C57BL/6 substrains, which suggest that small genetic differences may have a great influence on behavioral phenotypes. Thus, the genetic background of different substrains should be carefully chosen, equated, and considered in the interpretation of mutant behavioral phenotypes.

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