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Research ArticlePediatric Neuroimaging
Open Access

Brain Region–Specific Degeneration with Disease Progression in Late Infantile Neuronal Ceroid Lipofuscinosis (CLN2 Disease)

J.P. Dyke, D. Sondhi, H.U. Voss, K. Yohay, C. Hollmann, D. Mancenido, S.M. Kaminsky, L.A. Heier, K.D. Rudser, B. Kosofsky, B.J. Casey, R.G. Crystal and D. Ballon
American Journal of Neuroradiology June 2016, 37 (6) 1160-1169; DOI: https://doi.org/10.3174/ajnr.A4669
J.P. Dyke
aFrom the Departments of Radiology (J.P.D., H.U.V., L.A.H., D.B.)
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  • ORCID record for J.P. Dyke
D. Sondhi
bGenetic Medicine (D.S., C.H., D.M., S.M.K., R.G.C., D.B.)
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  • ORCID record for D. Sondhi
H.U. Voss
aFrom the Departments of Radiology (J.P.D., H.U.V., L.A.H., D.B.)
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  • ORCID record for H.U. Voss
K. Yohay
cPediatrics (K.Y., B.K.)
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  • ORCID record for K. Yohay
C. Hollmann
bGenetic Medicine (D.S., C.H., D.M., S.M.K., R.G.C., D.B.)
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D. Mancenido
bGenetic Medicine (D.S., C.H., D.M., S.M.K., R.G.C., D.B.)
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S.M. Kaminsky
bGenetic Medicine (D.S., C.H., D.M., S.M.K., R.G.C., D.B.)
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  • ORCID record for S.M. Kaminsky
L.A. Heier
aFrom the Departments of Radiology (J.P.D., H.U.V., L.A.H., D.B.)
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K.D. Rudser
eDivision of Biostatistics (K.D.R.), Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minnesota.
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B. Kosofsky
cPediatrics (K.Y., B.K.)
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B.J. Casey
dPsychiatry (B.J.C.), Weill Cornell Medical College, New York, New York
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R.G. Crystal
bGenetic Medicine (D.S., C.H., D.M., S.M.K., R.G.C., D.B.)
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D. Ballon
aFrom the Departments of Radiology (J.P.D., H.U.V., L.A.H., D.B.)
bGenetic Medicine (D.S., C.H., D.M., S.M.K., R.G.C., D.B.)
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    Fig 1.

    Surface representation of the FreeSurfer-based cortical parcellation for a control subject (A, 6.1 years of age) compared with that of an age-matched subject with CLN2 (B, 5.9 years of age; clinical CLN2 score = 1.5). Note the atrophy as evidenced by deeper sulci and less prominent gyri in the subject with more advanced disease.

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    Fig 2.

    The mean cerebral cortical gray matter thickness as a function of subject age (A) and clinical score (B) for CLN2 (solid diamond) and control (large filled square) groups. Subjects with CLN2 older than 72 months of age (open diamond) are not included in the linear fit.

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    Fig 3.

    The rate of decline of cortical thickness with age for cerebral lobes in CLN2 (n = 42, blue) versus control (n = 52, red) groups. The 95% confidence interval of the slope is plotted as the error bar. Differences between CLN2 and control population of P < .05 are marked with an asterisk.

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    Fig 4.
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    Fig 4.

    Regional changes in cortical thickness of the left hemisphere are plotted as a function of subject age for CLN2 (solid diamond) and control (large filled square) groups. Subjects with CLN2 older than 72 months of age (open diamond) are not included in the linear fit.

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    Fig 5.
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    Fig 5.

    Regional changes in cortical thickness of the right hemisphere are plotted as a function of subject age for CLN2 (solid diamond) and control (large filled square) groups. Subjects with CLN2 older than 72 months of age (open diamond) are not included in the linear fit.

Tables

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    Table 1:

    Cortical regions grouped by lobe as defined by the Desikan-Killiany atlas in FreeSurfer

    Temporal LobeParietal LobeOccipital LobeCingulate LobeFrontal Lobe
    BanksstsInferior parietalCuneusCaudal anterior cingulateCaudal middle frontal
    EntorhinalPostcentralLateral occipitalIsthmus cingulateFrontal pole
    FusiformPrecuneusLingualPosterior cingulateLateral orbitofrontal
    Inferior temporalSuperior parietalPericalcarineRostral anterior cingulateMedial orbitofrontal
    Middle temporalSupramarginalParacentral
    ParahippocampalPars opercularis
    Superior temporalPars orbitalis
    Temporal polePars triangularis
    Transverse temporalPrecentral
    Rostral middle frontal
    Superior frontal
    • Note:—Bankssts indicates banks of the superior temporal sulcus.

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    Table 2:

    The rate of decline (millimeters/month) and mean cortical thickness between CLN2 and healthy control populations in whole brain, hemispheres, and cerebral lobes

    CLN2 SlopeControl SlopeP ValueCLN2 MeanControl MeanP Value
    Whole brain−0.018(5)−0.002(1)<.0012.26(23)2.79(10)<.001
    LH−0.016(5)−0.002(1)<.0012.23(22)2.78(10)<.001
    RH−0.020(6)−0.002(1)<.0012.29(24)2.79(11)<.001
    LH cingulate−0.018(8)−0.003(2).0022.69(32)2.92(22)<.001
    LH frontal−0.005(5)−0.002(2).2652.33(17)2.87(12)<.001
    LH occipital−0.026(10)−0.004(3)<.0011.66(26)2.16(19)<.001
    LH parietal−0.021(5)−0.002(1)<.0012.10(26)2.71(13)<.001
    LH temporal−0.023(4)−0.002(3)<.0012.51(30)2.99(19)<.001
    RH cingulate−0.021(8)−0.003(3)<.0012.69(40)2.85(18)<.001
    RH frontal−0.014(4)−0.002(2)<.0012.41(21)2.87(14)<.001
    RH occipital−0.024(7)−0.004(2)<.0011.68(24)2.22(20)<.001
    RH parietal−0.023(7)−0.002(2)<.0012.16(27)2.71(13)<.001
    RH temporal−0.020(5)−0.002(3)<.0012.61(28)3.05(22)<.001
    • Note:—LH indicates left hemisphere; RH, right hemisphere.

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American Journal of Neuroradiology: 37 (6)
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J.P. Dyke, D. Sondhi, H.U. Voss, K. Yohay, C. Hollmann, D. Mancenido, S.M. Kaminsky, L.A. Heier, K.D. Rudser, B. Kosofsky, B.J. Casey, R.G. Crystal, D. Ballon
Brain Region–Specific Degeneration with Disease Progression in Late Infantile Neuronal Ceroid Lipofuscinosis (CLN2 Disease)
American Journal of Neuroradiology Jun 2016, 37 (6) 1160-1169; DOI: 10.3174/ajnr.A4669

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Brain Region–Specific Degeneration with Disease Progression in Late Infantile Neuronal Ceroid Lipofuscinosis (CLN2 Disease)
J.P. Dyke, D. Sondhi, H.U. Voss, K. Yohay, C. Hollmann, D. Mancenido, S.M. Kaminsky, L.A. Heier, K.D. Rudser, B. Kosofsky, B.J. Casey, R.G. Crystal, D. Ballon
American Journal of Neuroradiology Jun 2016, 37 (6) 1160-1169; DOI: 10.3174/ajnr.A4669
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