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Published in: Journal of Inherited Metabolic Disease 2/2013

01-03-2013 | Original Article

Brain magnetic resonance imaging findings in patients with mucopolysaccharidosis VI

Authors: Ana C. M. Azevedo, Osvaldo Artigalás, Leonardo Vedolin, Márcia Komlós, Adriana Pires, Roberto Giugliani, Ida Vanessa D. Schwartz

Published in: Journal of Inherited Metabolic Disease | Issue 2/2013

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Abstract

Introduction

Mucopolysaccharidosis type VI (MPS VI) is a rare lysosomal storage disorder caused by the deficient activity of N-acetylgalactosamine 4-sulfatase. MPS VI is usually considered as not being associated with mental retardation.

Aims/methods

The main objective of the present study was to describe brain magnetic resonance imaging (MRI) findings and their correlation with clinical and biochemical findings in MPS VI patients. The study was conducted at Hospital de Clínicas de Porto Alegre, Brazil with 25 MPS VI patients. All patients were evaluated through clinical evaluation, IQ tests, urinary glycosaminoglycans (GAG) analysis, and brain MRI.

Results

Mean age at evaluation was 10.6 ± 4.52 years. Five of 16 patients presented total IQ below the normal range. Brain MRI was abnormal in the majority of patients (n = 19/21), and the most frequent abnormalities found were the presence of dilated perivascular spaces and white matter lesions. Correlations were found between age and normalized white matter lesion load (NLL) (r = 0.46; p = 0.04) and normalized cerebral volume (NCV) (r = −0.56; p = 0.01), between NLL and height deficit (r = 0.48; p = 0.04), and between NCV and weight deficit (r = −0.58; p = 0.01) and height deficit (r = −0.55; p = 0.01). A correlation between urinary GAG levels and quantitative brain MRI findings was not found, neither between qualitative and quantitative brain MRI findings and IQ scores.

Conclusions

MPS VI patients may present abnormal IQ scores without correlation with brain abnormalities on the MRI, a finding which was found to be very frequent in MPS VI. Additional studies are required to confirm our findings.
Literature
go back to reference Azevedo AC, Schwartz IV, Kalakun L et al (2004) Clinical and biochemical study of 28 patients with mucopolysaccharidosis type VI. Clin Genet 66:208–213PubMedCrossRef Azevedo AC, Schwartz IV, Kalakun L et al (2004) Clinical and biochemical study of 28 patients with mucopolysaccharidosis type VI. Clin Genet 66:208–213PubMedCrossRef
go back to reference Baehner F, Schmiedeskamp C, Krummenauer F et al (2005) Cumulative incidence rates of the mucopolysaccharidoses in Germany. J Inherit Metab Dis 28:1011–1017PubMedCrossRef Baehner F, Schmiedeskamp C, Krummenauer F et al (2005) Cumulative incidence rates of the mucopolysaccharidoses in Germany. J Inherit Metab Dis 28:1011–1017PubMedCrossRef
go back to reference Calleja Gero ML, González Gutiérrez-Solana L, López Marín L et al (2012) Neuroimaging findings in patient series with mucopolysaccharidosis. Neurologia 27:407–413PubMedCrossRef Calleja Gero ML, González Gutiérrez-Solana L, López Marín L et al (2012) Neuroimaging findings in patient series with mucopolysaccharidosis. Neurologia 27:407–413PubMedCrossRef
go back to reference Castro S, Ayres-Basto M, Rodrigues E et al (2008) Cerebral imaging findings in mucopolysaccharidosis types II and VI. J Inherit Metab Dis 31(Suppl 1):110 Castro S, Ayres-Basto M, Rodrigues E et al (2008) Cerebral imaging findings in mucopolysaccharidosis types II and VI. J Inherit Metab Dis 31(Suppl 1):110
go back to reference da Rocha AF, da Costa LC, Rocha FT et al (2006) Mental retardation: a MRI study of 146 Brazilian children. Arq Neuropsiquiatr 64:186–192PubMedCrossRef da Rocha AF, da Costa LC, Rocha FT et al (2006) Mental retardation: a MRI study of 146 Brazilian children. Arq Neuropsiquiatr 64:186–192PubMedCrossRef
go back to reference Durkin MS, Hasan ZM, Hasan KZ (1998) Prevalence and correlates of mental retardation among children in Karachi, Pakistan. Am J Epidemiol 147:281–288PubMedCrossRef Durkin MS, Hasan ZM, Hasan KZ (1998) Prevalence and correlates of mental retardation among children in Karachi, Pakistan. Am J Epidemiol 147:281–288PubMedCrossRef
go back to reference Giugliani R, Harmatz P, Wraith JE (2007) Management guidelines for mucopolysaccharidosis VI. Pediatrics 120:405–418PubMedCrossRef Giugliani R, Harmatz P, Wraith JE (2007) Management guidelines for mucopolysaccharidosis VI. Pediatrics 120:405–418PubMedCrossRef
go back to reference Harmatz P, Ketteridge D, Giugliani R et al (2005) Direct comparison of measures of endurance, mobility, and joint function during enzyme-replacement therapy of Mucopolysaccharidosis VI (Maroteaux-Lamy Syndrome): results after 48 weeks in a phase 2 open-labem clinical study of recombinant human N-acetylgalactosamine 4-sulfatase. Pediatrics 115:681–689CrossRef Harmatz P, Ketteridge D, Giugliani R et al (2005) Direct comparison of measures of endurance, mobility, and joint function during enzyme-replacement therapy of Mucopolysaccharidosis VI (Maroteaux-Lamy Syndrome): results after 48 weeks in a phase 2 open-labem clinical study of recombinant human N-acetylgalactosamine 4-sulfatase. Pediatrics 115:681–689CrossRef
go back to reference Harmatz P, Giugliani R, Schwartz I et al (2006) Enzyme replacement therapy for mucopolysaccharidosis VI: a phase 3, randomized, double-blind, placebo-controled, multinacional study of recombinant human N-Acetylgalactosamine4-sulfatase (recombinant human arylsulfatse B or RhASB) and follow-on open-label extension study. J Pediatr 148:533–539PubMedCrossRef Harmatz P, Giugliani R, Schwartz I et al (2006) Enzyme replacement therapy for mucopolysaccharidosis VI: a phase 3, randomized, double-blind, placebo-controled, multinacional study of recombinant human N-Acetylgalactosamine4-sulfatase (recombinant human arylsulfatse B or RhASB) and follow-on open-label extension study. J Pediatr 148:533–539PubMedCrossRef
go back to reference Jong JCN, Wevers RA, Liebrand-van Sambeek R (1992) Measuring urinary glycosaminoglycans in the presence of protein: an improved screening procedure for mucopolysaccharidoses based on dimethylmethylene blue. Clin Chem 38:803–807PubMed Jong JCN, Wevers RA, Liebrand-van Sambeek R (1992) Measuring urinary glycosaminoglycans in the presence of protein: an improved screening procedure for mucopolysaccharidoses based on dimethylmethylene blue. Clin Chem 38:803–807PubMed
go back to reference Karageorgos L, Brooks DA, Pollard A et al (2007) Mutational analysis of 105 mucopolysaccharidosis type VI patients. Hum Mutat 28:897–903PubMedCrossRef Karageorgos L, Brooks DA, Pollard A et al (2007) Mutational analysis of 105 mucopolysaccharidosis type VI patients. Hum Mutat 28:897–903PubMedCrossRef
go back to reference Kurihara M, Kumagai K, Goto K et al (1992) Severe type Hunter’s syndrome. Polysomnographic and neuropathological study. Neuropediatrics 23:248–56 Kurihara M, Kumagai K, Goto K et al (1992) Severe type Hunter’s syndrome. Polysomnographic and neuropathological study. Neuropediatrics 23:248–56
go back to reference Malm G, Lund AM, Månsson JE et al (2008) Mucopolysaccharidoses in the Scandinavian countries: incidence and prevalence. Acta Paediatr 97:1577–1581PubMedCrossRef Malm G, Lund AM, Månsson JE et al (2008) Mucopolysaccharidoses in the Scandinavian countries: incidence and prevalence. Acta Paediatr 97:1577–1581PubMedCrossRef
go back to reference Matheus MG, Castillo M, Smith JK et al (2004) Brain MRI findings in patients wit mucopolysaccharidosis types I and II and mild clinical presentation. Neuradiology 46:666–672 Matheus MG, Castillo M, Smith JK et al (2004) Brain MRI findings in patients wit mucopolysaccharidosis types I and II and mild clinical presentation. Neuradiology 46:666–672
go back to reference Nascimento E, Figueiredo VLM (2002) WISC-II e WAIS-III: Alterações nas versões originais americanas decorrentes das adaptações para uso no Brasil. Psicol Reflex Crit 15:3–10CrossRef Nascimento E, Figueiredo VLM (2002) WISC-II e WAIS-III: Alterações nas versões originais americanas decorrentes das adaptações para uso no Brasil. Psicol Reflex Crit 15:3–10CrossRef
go back to reference Neufeld EF, Muenzer J (2001) The Mucopolysaccharidosis VI. In: Scriver CR, Beaudet AL, Sly WS, Valle D (eds) The metabolic and molecular basis of inherited disease, 8th edn. McGraw-Hill, New York, pp 3421–3452 Neufeld EF, Muenzer J (2001) The Mucopolysaccharidosis VI. In: Scriver CR, Beaudet AL, Sly WS, Valle D (eds) The metabolic and molecular basis of inherited disease, 8th edn. McGraw-Hill, New York, pp 3421–3452
go back to reference Sá G, Teixeira JF, Cruz R et al (2006) Neuroimaging features in mucopolysaccharidosis: their correlation with mental retardation. Rev Neurol 43:760–762PubMed Sá G, Teixeira JF, Cruz R et al (2006) Neuroimaging features in mucopolysaccharidosis: their correlation with mental retardation. Rev Neurol 43:760–762PubMed
go back to reference Thorne JA, Javadpour M, Hughes DG et al (2001) Craniovertebral abnormalities in type VI mucopolysaccharidosis (Maroteaux-Lamy syndrome). Neurosurgery 48:849–853PubMed Thorne JA, Javadpour M, Hughes DG et al (2001) Craniovertebral abnormalities in type VI mucopolysaccharidosis (Maroteaux-Lamy syndrome). Neurosurgery 48:849–853PubMed
go back to reference Valayannopoulos V, Nicely H, Harmatz P et al (2010) Mucopolysaccharidosis VI. Orphanet J Rare Dis 5:5PubMedCrossRef Valayannopoulos V, Nicely H, Harmatz P et al (2010) Mucopolysaccharidosis VI. Orphanet J Rare Dis 5:5PubMedCrossRef
go back to reference Vedolin L, Schwartz IVD, Komlos M et al (2007a) Brain MRI in mucopolysaccharidosis: effect of aging and correlation with biochemical findings. Neurology 69:917–924PubMedCrossRef Vedolin L, Schwartz IVD, Komlos M et al (2007a) Brain MRI in mucopolysaccharidosis: effect of aging and correlation with biochemical findings. Neurology 69:917–924PubMedCrossRef
go back to reference Vedolin L, Schwartz IV, Komlos M et al (2007b) Correlation of MR imaging and MR spectroscopy findings with cognitive impairment in mucopolysaccharidosis II. AJNR Am J Neuroradiol 28:1029–1033PubMedCrossRef Vedolin L, Schwartz IV, Komlos M et al (2007b) Correlation of MR imaging and MR spectroscopy findings with cognitive impairment in mucopolysaccharidosis II. AJNR Am J Neuroradiol 28:1029–1033PubMedCrossRef
go back to reference Vestermark S, Tonnesen T, Andersen MS et al (1987) Mental retardation in a patient with Maroteaux-Lamy. Clin Genet 31:114–117PubMedCrossRef Vestermark S, Tonnesen T, Andersen MS et al (1987) Mental retardation in a patient with Maroteaux-Lamy. Clin Genet 31:114–117PubMedCrossRef
go back to reference Vougioukas VI, Berlis A, Kopp MV et al (2001) Neurological interventions in children with Maroteaux-Lamy syndrome. Pediatr Neurosurg 35:35–38PubMedCrossRef Vougioukas VI, Berlis A, Kopp MV et al (2001) Neurological interventions in children with Maroteaux-Lamy syndrome. Pediatr Neurosurg 35:35–38PubMedCrossRef
go back to reference Wicker G, Prill V, Brooks D et al (1991) Mucopolysaccharidosis VI (maroteaux-Lamy sindrom) an intermediate clinical phenotype caused by substitution of valine for glycine at position 137 of arylsulfatase B. J Biol Chem 266:21386–21391PubMed Wicker G, Prill V, Brooks D et al (1991) Mucopolysaccharidosis VI (maroteaux-Lamy sindrom) an intermediate clinical phenotype caused by substitution of valine for glycine at position 137 of arylsulfatase B. J Biol Chem 266:21386–21391PubMed
Metadata
Title
Brain magnetic resonance imaging findings in patients with mucopolysaccharidosis VI
Authors
Ana C. M. Azevedo
Osvaldo Artigalás
Leonardo Vedolin
Márcia Komlós
Adriana Pires
Roberto Giugliani
Ida Vanessa D. Schwartz
Publication date
01-03-2013
Publisher
Springer Netherlands
Published in
Journal of Inherited Metabolic Disease / Issue 2/2013
Print ISSN: 0141-8955
Electronic ISSN: 1573-2665
DOI
https://doi.org/10.1007/s10545-012-9559-x

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