Validation of the finding of hypertrophy of the clava in infantile neuroaxonal dystrophy/PLA2G6 by biometric analysis

A. Al-Maawali, G. Yoon, A. S. Feigenbaum, W. C. Halliday, J. T.R. Clarke, H. M. Branson, B. L. Banwell, D. Chitayat, Susan I. Blaser

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: Infantile neuroaxonal dystrophy (INAD), an autosomal recessive neurodegenerative disorder due to PLA2G6 mutation, is classified both as a PLA2G6-associated neurodegeneration (PLAN) disorder and as one of the neurodegeneration with brain iron accumulation (NBIA) disorders. Age of onset and clinical presentation in INAD is variable. Typically described imaging features of cerebellar atrophy, cerebellar cortex bright FLAIR signal, and globus pallidus iron deposition are variable or late findings. We characterize clinical and neuroimaging phenotypes in nine children with confirmed PLA2G6 mutations and show a useful imaging feature, clava hypertrophy, which may aid in earlier identification of patients. Measurements of the clava confirm actual enlargement, rather than apparent enlargement due to volume loss of the other brain stem structures. Methods: A retrospective clinical and MRI review was performed. Brain stem measurements were performed and compared with age-matched controls. Results: We identified nine patients, all with novel PLA2G6 gene mutations. MRI, available in eight, showed clava hypertrophy, regardless of age or the absence of other more typically described neuroimaging findings. Brain autopsy in our cohort confirmed prominent spheroid bodies in the clava nuclei. Conclusion: Clava hypertrophy is an important early imaging feature which may aid in indentification of children who would benefit from specific testing for PLA2G6 mutations.

Original languageEnglish
Pages (from-to)1035-1042
Number of pages8
JournalNeuroradiology
Volume58
Issue number10
DOIs
Publication statusPublished - Oct 1 2016

Fingerprint

Neuroaxonal Dystrophies
Hypertrophy
Mutation
Neuroimaging
Brain Stem
Cerebellar Cortex
Globus Pallidus
Age of Onset
Neurodegenerative Diseases
Atrophy
Autopsy
Iron
Phenotype
Brain
Genes

Keywords

  • Atypical INAD (NBIA2B)
  • Clava
  • INAD (NBIA2A)
  • PLAN/PLA2G6
  • Seitelberger’s disease

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Al-Maawali, A., Yoon, G., Feigenbaum, A. S., Halliday, W. C., Clarke, J. T. R., Branson, H. M., ... Blaser, S. I. (2016). Validation of the finding of hypertrophy of the clava in infantile neuroaxonal dystrophy/PLA2G6 by biometric analysis. Neuroradiology, 58(10), 1035-1042. https://doi.org/10.1007/s00234-016-1726-6

Validation of the finding of hypertrophy of the clava in infantile neuroaxonal dystrophy/PLA2G6 by biometric analysis. / Al-Maawali, A.; Yoon, G.; Feigenbaum, A. S.; Halliday, W. C.; Clarke, J. T.R.; Branson, H. M.; Banwell, B. L.; Chitayat, D.; Blaser, Susan I.

In: Neuroradiology, Vol. 58, No. 10, 01.10.2016, p. 1035-1042.

Research output: Contribution to journalArticle

Al-Maawali, A, Yoon, G, Feigenbaum, AS, Halliday, WC, Clarke, JTR, Branson, HM, Banwell, BL, Chitayat, D & Blaser, SI 2016, 'Validation of the finding of hypertrophy of the clava in infantile neuroaxonal dystrophy/PLA2G6 by biometric analysis', Neuroradiology, vol. 58, no. 10, pp. 1035-1042. https://doi.org/10.1007/s00234-016-1726-6
Al-Maawali, A. ; Yoon, G. ; Feigenbaum, A. S. ; Halliday, W. C. ; Clarke, J. T.R. ; Branson, H. M. ; Banwell, B. L. ; Chitayat, D. ; Blaser, Susan I. / Validation of the finding of hypertrophy of the clava in infantile neuroaxonal dystrophy/PLA2G6 by biometric analysis. In: Neuroradiology. 2016 ; Vol. 58, No. 10. pp. 1035-1042.
@article{758899a4e6444c8d968496dec7946fe4,
title = "Validation of the finding of hypertrophy of the clava in infantile neuroaxonal dystrophy/PLA2G6 by biometric analysis",
abstract = "Introduction: Infantile neuroaxonal dystrophy (INAD), an autosomal recessive neurodegenerative disorder due to PLA2G6 mutation, is classified both as a PLA2G6-associated neurodegeneration (PLAN) disorder and as one of the neurodegeneration with brain iron accumulation (NBIA) disorders. Age of onset and clinical presentation in INAD is variable. Typically described imaging features of cerebellar atrophy, cerebellar cortex bright FLAIR signal, and globus pallidus iron deposition are variable or late findings. We characterize clinical and neuroimaging phenotypes in nine children with confirmed PLA2G6 mutations and show a useful imaging feature, clava hypertrophy, which may aid in earlier identification of patients. Measurements of the clava confirm actual enlargement, rather than apparent enlargement due to volume loss of the other brain stem structures. Methods: A retrospective clinical and MRI review was performed. Brain stem measurements were performed and compared with age-matched controls. Results: We identified nine patients, all with novel PLA2G6 gene mutations. MRI, available in eight, showed clava hypertrophy, regardless of age or the absence of other more typically described neuroimaging findings. Brain autopsy in our cohort confirmed prominent spheroid bodies in the clava nuclei. Conclusion: Clava hypertrophy is an important early imaging feature which may aid in indentification of children who would benefit from specific testing for PLA2G6 mutations.",
keywords = "Atypical INAD (NBIA2B), Clava, INAD (NBIA2A), PLAN/PLA2G6, Seitelberger’s disease",
author = "A. Al-Maawali and G. Yoon and Feigenbaum, {A. S.} and Halliday, {W. C.} and Clarke, {J. T.R.} and Branson, {H. M.} and Banwell, {B. L.} and D. Chitayat and Blaser, {Susan I.}",
year = "2016",
month = "10",
day = "1",
doi = "10.1007/s00234-016-1726-6",
language = "English",
volume = "58",
pages = "1035--1042",
journal = "Neuroradiology",
issn = "0028-3940",
publisher = "Springer Verlag",
number = "10",

}

TY - JOUR

T1 - Validation of the finding of hypertrophy of the clava in infantile neuroaxonal dystrophy/PLA2G6 by biometric analysis

AU - Al-Maawali, A.

AU - Yoon, G.

AU - Feigenbaum, A. S.

AU - Halliday, W. C.

AU - Clarke, J. T.R.

AU - Branson, H. M.

AU - Banwell, B. L.

AU - Chitayat, D.

AU - Blaser, Susan I.

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Introduction: Infantile neuroaxonal dystrophy (INAD), an autosomal recessive neurodegenerative disorder due to PLA2G6 mutation, is classified both as a PLA2G6-associated neurodegeneration (PLAN) disorder and as one of the neurodegeneration with brain iron accumulation (NBIA) disorders. Age of onset and clinical presentation in INAD is variable. Typically described imaging features of cerebellar atrophy, cerebellar cortex bright FLAIR signal, and globus pallidus iron deposition are variable or late findings. We characterize clinical and neuroimaging phenotypes in nine children with confirmed PLA2G6 mutations and show a useful imaging feature, clava hypertrophy, which may aid in earlier identification of patients. Measurements of the clava confirm actual enlargement, rather than apparent enlargement due to volume loss of the other brain stem structures. Methods: A retrospective clinical and MRI review was performed. Brain stem measurements were performed and compared with age-matched controls. Results: We identified nine patients, all with novel PLA2G6 gene mutations. MRI, available in eight, showed clava hypertrophy, regardless of age or the absence of other more typically described neuroimaging findings. Brain autopsy in our cohort confirmed prominent spheroid bodies in the clava nuclei. Conclusion: Clava hypertrophy is an important early imaging feature which may aid in indentification of children who would benefit from specific testing for PLA2G6 mutations.

AB - Introduction: Infantile neuroaxonal dystrophy (INAD), an autosomal recessive neurodegenerative disorder due to PLA2G6 mutation, is classified both as a PLA2G6-associated neurodegeneration (PLAN) disorder and as one of the neurodegeneration with brain iron accumulation (NBIA) disorders. Age of onset and clinical presentation in INAD is variable. Typically described imaging features of cerebellar atrophy, cerebellar cortex bright FLAIR signal, and globus pallidus iron deposition are variable or late findings. We characterize clinical and neuroimaging phenotypes in nine children with confirmed PLA2G6 mutations and show a useful imaging feature, clava hypertrophy, which may aid in earlier identification of patients. Measurements of the clava confirm actual enlargement, rather than apparent enlargement due to volume loss of the other brain stem structures. Methods: A retrospective clinical and MRI review was performed. Brain stem measurements were performed and compared with age-matched controls. Results: We identified nine patients, all with novel PLA2G6 gene mutations. MRI, available in eight, showed clava hypertrophy, regardless of age or the absence of other more typically described neuroimaging findings. Brain autopsy in our cohort confirmed prominent spheroid bodies in the clava nuclei. Conclusion: Clava hypertrophy is an important early imaging feature which may aid in indentification of children who would benefit from specific testing for PLA2G6 mutations.

KW - Atypical INAD (NBIA2B)

KW - Clava

KW - INAD (NBIA2A)

KW - PLAN/PLA2G6

KW - Seitelberger’s disease

UR - http://www.scopus.com/inward/record.url?scp=84981507190&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84981507190&partnerID=8YFLogxK

U2 - 10.1007/s00234-016-1726-6

DO - 10.1007/s00234-016-1726-6

M3 - Article

VL - 58

SP - 1035

EP - 1042

JO - Neuroradiology

JF - Neuroradiology

SN - 0028-3940

IS - 10

ER -