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Research ArticlePediatric Neuroimaging

Brain Abnormalities in Patients with Germline Variants in H3F3: Novel Imaging Findings and Neurologic Symptoms Beyond Somatic Variants and Brain Tumors

C.A.P.F. Alves, O. Sherbini, F. D’Arco, D. Steel, M.A. Kurian, F.C. Radio, G.B. Ferrero, D. Carli, M. Tartaglia, T.B. Balci, N.N. Powell-Hamilton, S.A. Schrier Vergano, H. Reutter, J. Hoefele, R. Günthner, E.R. Roeder, R.O. Littlejohn, D. Lessel, S. Lüttgen, C. Kentros, K. Anyane-Yeboa, C.B. Catarino, S. Mercimek-Andrews, J. Denecke, M.J. Lyons, T. Klopstock, E.J. Bhoj, L. Bryant and A. Vanderver
American Journal of Neuroradiology June 2022, DOI: https://doi.org/10.3174/ajnr.A7555
C.A.P.F. Alves
aFrom the Division of Neuroradiology (C.A.P.F.A.)
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O. Sherbini
aaDepartment of Neurology (O.S., A.V.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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F. D’Arco
dDepartments of Radiology (F.D.)
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D. Steel
eNeurology (D.S., M.A.K.), Great Ormond Street Hospital for Children, London, UK
fMolecular Neurosciences (D.S., M.A.K.), Zayed Centre for Research into Rare Diseases in Children, UCL GOS-Institute of Child Health, London, UK
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M.A. Kurian
eNeurology (D.S., M.A.K.), Great Ormond Street Hospital for Children, London, UK
fMolecular Neurosciences (D.S., M.A.K.), Zayed Centre for Research into Rare Diseases in Children, UCL GOS-Institute of Child Health, London, UK
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F.C. Radio
gGenetics and Rare Diseases Research Division (F.C.R., M.T.), Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
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G.B. Ferrero
hDepartment of Public Health and Pediatrics (G.B.F., D.C.), University of Torino, Turin, Italy
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D. Carli
hDepartment of Public Health and Pediatrics (G.B.F., D.C.), University of Torino, Turin, Italy
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M. Tartaglia
gGenetics and Rare Diseases Research Division (F.C.R., M.T.), Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
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T.B. Balci
iMedical Genetics Programof Southwestern Ontario (T.B.B.), London Health Sciences Centre, London, Ontario, Canada
jDepartment of Paediatrics (T.B.B.), Western University, London, Ontario, Canada
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N.N. Powell-Hamilton
kDivision of Medical Genetics (N.N.P.-H.), Nemours Children’s Hospital, Wilmington, Delaware
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S.A. Schrier Vergano
lDivision of Medical Genetics and Metabolism (S.A.S.V.), Children’s Hospital of The King’s Daughters, Norfolk, Virginia
mDepartment of Pediatrics (S.A.S.V.), Eastern Virginia Medical School, Norfolk, Virginia
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H. Reutter
nDivision of Neonatology and Pediatric Intensive Care (H.R.), Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander University Nürnberg-Erlangen, Erlangen, Germany
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J. Hoefele
oInstitute of Human Genetics (J.H., R.G.)
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R. Günthner
oInstitute of Human Genetics (J.H., R.G.)
pDepartment of Nephrology (R.G.), Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
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E.R. Roeder
qDepartment of Pediatrics and Molecular and Human Genetics (E.R.R., R.O.L.), Baylor College of Medicine, San Antonio, Texas
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R.O. Littlejohn
qDepartment of Pediatrics and Molecular and Human Genetics (E.R.R., R.O.L.), Baylor College of Medicine, San Antonio, Texas
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D. Lessel
rInstitute of Human Genetics (D.L., S.L.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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S. Lüttgen
rInstitute of Human Genetics (D.L., S.L.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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C. Kentros
sDivision of Clinical Genetics (C.K., K.A.-Y.), Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, New York
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K. Anyane-Yeboa
sDivision of Clinical Genetics (C.K., K.A.-Y.), Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, New York
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C.B. Catarino
tFriedrich-Baur-Institute (C.B.C., T.K.), Department of Neurology, University Hospital, Ludwig-Maximilian University Munich, Munich, Germany
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S. Mercimek-Andrews
wDepartment of Medical Genetics (S.M.-A.), Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
xDepartment of Medical Genetics (S.M.-A.), The Hospital for Sick Children, Toronto, Ontario, Canada
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J. Denecke
yDepartment of Pediatrics (J.D.), University Medical Center Eppendorf, Hamburg, Germany
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M.J. Lyons
zGreenwood Genetic Center (M.J.L.), Greenwood, South Carolina
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T. Klopstock
tFriedrich-Baur-Institute (C.B.C., T.K.), Department of Neurology, University Hospital, Ludwig-Maximilian University Munich, Munich, Germany
uGerman Center for Neurodegenerative Diseases (T.K.), Munich, Germany
vMunich Cluster for Systems Neurology (T.K.), Munich, Germany
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E.J. Bhoj
bDepartment of Radiology, Division of Human Genetics (E.J.B., L.B.)
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L. Bryant
bDepartment of Radiology, Division of Human Genetics (E.J.B., L.B.)
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A. Vanderver
cDepartment of Pediatrics, and Division of Neurology (A.V.), Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
aaDepartment of Neurology (O.S., A.V.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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  • FIG 1.
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    FIG 1.

    Brain MR images. A and D, Variable degrees of corpus callosum deformities, particularly involving the body and splenium, noting partial agenesis in D. Deformed morphology of the posterior fossa, with variable degrees of low insertion of the torcula and size reduction of the supraoccipital line (SOL). Note the crowded appearance of the structures in the posterior fossa along with low disposition of the cerebellar tonsils, fitting in the Chiari I deformity criteria in C and D. E–H, Variable degrees of reduced size and/or internal rotational appearance of the head of the caudate nuclei, resulting in an enlarged and squared appearance of the frontal horns.

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    FIG 2.

    Brain MR images. Axial T2WI (A–C) and axial T1WI (D) showing 4 different patients with variable degrees of diffuse abnormal orientation and morphology of the gyri and sulci. Note particular abnormal morphology involving both frontal lobes (open arrows, A), a deformed perirolandic region (asterisks, B), and abnormal gyration of the medial frontal lobes in C and D (open arrowheads, C and D). Axial T2WI (E–H) shows 4 different patients with temporal pole hypoplasia.

Tables

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    Table 1:

    Demographic, genetic, and clinical information of individuals with disease-causing missense variantsa

    CharacteristicsIndividuals
    (n = 18)
    Age at last evaluation (yr)4.46 (1.9–12.1)
    Sex: female/male(8:10)
    H3F3 variant
     H3F3A11 (61)
     H3F3B7 (39)
    Microcephaly8 (44)
    Seizures10 (56)
     Febrile5 (50)
     Nonfebrile5 (50)
    Sitting (n = 17)
     Normal1 (6)
     Delayed12 (71)
     Not achieved4 (23)
    Walking
     Normal2 (11)
     Delayed10 (56)
     Not achieved6 (33)
    Speaking
     Normal1 (6)
     Delayed7 (38)
     Not achieved10 (56)
    • ↵a Categoric variables are described as number (percentage). Continuous variables are described as median (1Q–3Q).

    • View popup
    Table 2:

    Abnormal imaging information of individuals with disease-causing H3F3 missense variantsa

    Imaging FeaturesIndividuals(n = 18)
    Small posterior fossa13 (72)
    Cerebellum2 (11)
    Brainstem2 (11)
    Thalamus0
    Caudate8 (44)
    Putamen0
    Globus pallidum0
    Corpus callosum5 (28)
    Fourth ventricle6 (33)
    Lateral ventricle7 (38)
    White matter2
    Cortex8 (44)
    Optic nerves and chiasm1 (6)
    Temporal lobes/hippocampus8 (44)
    Clivus/sella4 (22)
    • ↵a Categoric variables are described as number (percentage).

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Cite this article
C.A.P.F. Alves, O. Sherbini, F. D’Arco, D. Steel, M.A. Kurian, F.C. Radio, G.B. Ferrero, D. Carli, M. Tartaglia, T.B. Balci, N.N. Powell-Hamilton, S.A. Schrier Vergano, H. Reutter, J. Hoefele, R. Günthner, E.R. Roeder, R.O. Littlejohn, D. Lessel, S. Lüttgen, C. Kentros, K. Anyane-Yeboa, C.B. Catarino, S. Mercimek-Andrews, J. Denecke, M.J. Lyons, T. Klopstock, E.J. Bhoj, L. Bryant, A. Vanderver
Brain Abnormalities in Patients with Germline Variants in H3F3: Novel Imaging Findings and Neurologic Symptoms Beyond Somatic Variants and Brain Tumors
American Journal of Neuroradiology Jun 2022, DOI: 10.3174/ajnr.A7555

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Brain Abnormalities in Patients with Germline Variants in H3F3: Novel Imaging Findings and Neurologic Symptoms Beyond Somatic Variants and Brain Tumors
C.A.P.F. Alves, O. Sherbini, F. D’Arco, D. Steel, M.A. Kurian, F.C. Radio, G.B. Ferrero, D. Carli, M. Tartaglia, T.B. Balci, N.N. Powell-Hamilton, S.A. Schrier Vergano, H. Reutter, J. Hoefele, R. Günthner, E.R. Roeder, R.O. Littlejohn, D. Lessel, S. Lüttgen, C. Kentros, K. Anyane-Yeboa, C.B. Catarino, S. Mercimek-Andrews, J. Denecke, M.J. Lyons, T. Klopstock, E.J. Bhoj, L. Bryant, A. Vanderver
American Journal of Neuroradiology Jun 2022, DOI: 10.3174/ajnr.A7555
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