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Published in: Child's Nervous System 11/2016

01-11-2016 | Review Paper

The many faces of paediatric mitochondrial disease on neuroimaging

Authors: Fabian Baertling, Dirk Klee, Tobias B. Haack, Holger Prokisch, Thomas Meitinger, Ertan Mayatepek, Jörg Schaper, Felix Distelmaier

Published in: Child's Nervous System | Issue 11/2016

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Abstract

The knowledge about the genetic spectrum underlying paediatric mitochondrial diseases is rapidly growing. As a consequence, the range of neuroimaging findings associated with mitochondrial diseases became extremely broad. This has important implications for radiologists and clinicians involved in the care of these patients. Here, we provide a condensed overview of brain magnetic resonance imaging (MRI) findings in children with genetically confirmed mitochondrial diseases. The neuroimaging spectrum ranges from classical Leigh syndrome with symmetrical lesions in basal ganglia and/or brain stem to structural abnormalities including cerebellar hypoplasia and corpus callosum dysgenesis. We highlight that, although some imaging patterns can be suggestive of a genetically defined mitochondrial syndrome, brain MRI-based candidate gene prioritization is only successful in a subset of patients.
Literature
1.
go back to reference Bricout M, Grevent D, Lebre AS, Rio M, Desguerre I, De Lonlay P, Valayannopoulos V, Brunelle F, Rotig A, Munnich A, Boddaert N (2015) Brain imaging in mitochondrial respiratory chain deficiency: combination of brain MRI features as a useful tool for genotype/phenotype correlations. J Med Genet 51:429–435CrossRef Bricout M, Grevent D, Lebre AS, Rio M, Desguerre I, De Lonlay P, Valayannopoulos V, Brunelle F, Rotig A, Munnich A, Boddaert N (2015) Brain imaging in mitochondrial respiratory chain deficiency: combination of brain MRI features as a useful tool for genotype/phenotype correlations. J Med Genet 51:429–435CrossRef
2.
go back to reference Kevelam SH, Rodenburg RJ, Wolf NI, Ferreira P, Lunsing RJ, Nijtmans LG, Mitchell A, Arroyo HA, Rating D, Vanderver A, van Berkel CG, Abbink TE, Heutink P, van der Knaap MS (2013) NUBPL mutations in patients with complex I deficiency and a distinct MRI pattern. Neurology 80:1577–1583CrossRefPubMedPubMedCentral Kevelam SH, Rodenburg RJ, Wolf NI, Ferreira P, Lunsing RJ, Nijtmans LG, Mitchell A, Arroyo HA, Rating D, Vanderver A, van Berkel CG, Abbink TE, Heutink P, van der Knaap MS (2013) NUBPL mutations in patients with complex I deficiency and a distinct MRI pattern. Neurology 80:1577–1583CrossRefPubMedPubMedCentral
3.
go back to reference Lebre AS, Rio M, Faivre d’Arcier L, Vernerey D, Landrieu P, Slama A, Jardel C, Laforet P, Rodriguez D, Dorison N, Galanaud D, Chabrol B, Paquis-Flucklinger V, Grevent D, Edvardson S, Steffann J, Funalot B, Villeneuve N, Valayannopoulos V, de Lonlay P, Desguerre I, Brunelle F, Bonnefont JP, Rotig A, Munnich A, Boddaert N (2010) A common pattern of brain MRI imaging in mitochondrial diseases with complex I deficiency. J Med Genet 48:16–23CrossRefPubMed Lebre AS, Rio M, Faivre d’Arcier L, Vernerey D, Landrieu P, Slama A, Jardel C, Laforet P, Rodriguez D, Dorison N, Galanaud D, Chabrol B, Paquis-Flucklinger V, Grevent D, Edvardson S, Steffann J, Funalot B, Villeneuve N, Valayannopoulos V, de Lonlay P, Desguerre I, Brunelle F, Bonnefont JP, Rotig A, Munnich A, Boddaert N (2010) A common pattern of brain MRI imaging in mitochondrial diseases with complex I deficiency. J Med Genet 48:16–23CrossRefPubMed
4.
go back to reference Lake NJ, Compton AG, Rahman S, Thorburn DR (2016) Leigh syndrome: one disorder, more than 75 monogenic causes. Ann Neurol 79:190–203CrossRefPubMed Lake NJ, Compton AG, Rahman S, Thorburn DR (2016) Leigh syndrome: one disorder, more than 75 monogenic causes. Ann Neurol 79:190–203CrossRefPubMed
5.
go back to reference Baertling F, Rodenburg RJ, Schaper J, Smeitink JA, Koopman WJ, Mayatepek E, Morava E, Distelmaier F (2014) A guide to diagnosis and treatment of Leigh syndrome. J Neurol Neurosurg Psychiatry 85:257–265CrossRefPubMed Baertling F, Rodenburg RJ, Schaper J, Smeitink JA, Koopman WJ, Mayatepek E, Morava E, Distelmaier F (2014) A guide to diagnosis and treatment of Leigh syndrome. J Neurol Neurosurg Psychiatry 85:257–265CrossRefPubMed
7.
go back to reference Lake NJ, Bird MJ, Isohanni P, Paetau A (2015) Leigh syndrome: neuropathology and pathogenesis. J Neuropathol Exp Neurol 74:482–492CrossRefPubMed Lake NJ, Bird MJ, Isohanni P, Paetau A (2015) Leigh syndrome: neuropathology and pathogenesis. J Neuropathol Exp Neurol 74:482–492CrossRefPubMed
8.
go back to reference Medina L, Chi TL, DeVivo DC, Hilal SK (1990) MR findings in patients with subacute necrotizing encephalomyelopathy (Leigh syndrome): correlation with biochemical defect. AJR Am J Roentgenol 154:1269–1274CrossRefPubMed Medina L, Chi TL, DeVivo DC, Hilal SK (1990) MR findings in patients with subacute necrotizing encephalomyelopathy (Leigh syndrome): correlation with biochemical defect. AJR Am J Roentgenol 154:1269–1274CrossRefPubMed
9.
go back to reference Valanne L, Ketonen L, Majander A, Suomalainen A, Pihko H (1998) Neuroradiologic findings in children with mitochondrial disorders. AJNR Am J Neuroradiol 19:369–377PubMed Valanne L, Ketonen L, Majander A, Suomalainen A, Pihko H (1998) Neuroradiologic findings in children with mitochondrial disorders. AJNR Am J Neuroradiol 19:369–377PubMed
11.
12.
go back to reference Lin DD, Crawford TO, Barker PB (2003) Proton MR spectroscopy in the diagnostic evaluation of suspected mitochondrial disease. AJNR Am J Neuroradiol 24:33–41PubMed Lin DD, Crawford TO, Barker PB (2003) Proton MR spectroscopy in the diagnostic evaluation of suspected mitochondrial disease. AJNR Am J Neuroradiol 24:33–41PubMed
13.
go back to reference Sijens PE, Smit GP, Rodiger LA, van Spronsen FJ, Oudkerk M, Rodenburg RJ, Lunsing RJ (2008) MR spectroscopy of the brain in Leigh syndrome. Brain Dev 30:579–583CrossRefPubMed Sijens PE, Smit GP, Rodiger LA, van Spronsen FJ, Oudkerk M, Rodenburg RJ, Lunsing RJ (2008) MR spectroscopy of the brain in Leigh syndrome. Brain Dev 30:579–583CrossRefPubMed
14.
go back to reference Danhauser K, Haack TB, Alhaddad B, Melcher M, Seibt A, Strom TM, Meitinger T, Klee D, Mayatepek E, Prokisch H, Distelmaier F (2016) EARS2 mutations cause fatal neonatal lactic acidosis, recurrent hypoglycemia and agenesis of corpus callosum. Metab Brain Dis 31:717–721CrossRefPubMed Danhauser K, Haack TB, Alhaddad B, Melcher M, Seibt A, Strom TM, Meitinger T, Klee D, Mayatepek E, Prokisch H, Distelmaier F (2016) EARS2 mutations cause fatal neonatal lactic acidosis, recurrent hypoglycemia and agenesis of corpus callosum. Metab Brain Dis 31:717–721CrossRefPubMed
15.
go back to reference Bonfante E, Koenig MK, Adejumo RB, Perinjelil V, Riascos RF (2015) The neuroimaging of Leigh syndrome: case series and review of the literature. Pediatr Radiol 46:443–451CrossRef Bonfante E, Koenig MK, Adejumo RB, Perinjelil V, Riascos RF (2015) The neuroimaging of Leigh syndrome: case series and review of the literature. Pediatr Radiol 46:443–451CrossRef
16.
go back to reference Giribaldi G, Doria-Lamba L, Biancheri R, Severino M, Rossi A, Santorelli FM, Schiaffino C, Caruso U, Piemonte F, Bruno C (2012) Intermittent-relapsing pyruvate dehydrogenase complex deficiency: a case with clinical, biochemical, and neuroradiological reversibility. Dev Med Child Neurol 54:472–476CrossRefPubMed Giribaldi G, Doria-Lamba L, Biancheri R, Severino M, Rossi A, Santorelli FM, Schiaffino C, Caruso U, Piemonte F, Bruno C (2012) Intermittent-relapsing pyruvate dehydrogenase complex deficiency: a case with clinical, biochemical, and neuroradiological reversibility. Dev Med Child Neurol 54:472–476CrossRefPubMed
17.
go back to reference El-Hattab AW, Adesina AM, Jones J, Scaglia F (2015) MELAS syndrome: clinical manifestations, pathogenesis, and treatment options. Mol Genet Metab 116:4–12CrossRefPubMed El-Hattab AW, Adesina AM, Jones J, Scaglia F (2015) MELAS syndrome: clinical manifestations, pathogenesis, and treatment options. Mol Genet Metab 116:4–12CrossRefPubMed
18.
go back to reference Yatsuga S, Povalko N, Nishioka J, Katayama K, Kakimoto N, Matsuishi T, Kakuma T, Koga Y (2012) MELAS: a nationwide prospective cohort study of 96 patients in Japan. Biochim Biophys Acta 1820:619–624CrossRefPubMed Yatsuga S, Povalko N, Nishioka J, Katayama K, Kakimoto N, Matsuishi T, Kakuma T, Koga Y (2012) MELAS: a nationwide prospective cohort study of 96 patients in Japan. Biochim Biophys Acta 1820:619–624CrossRefPubMed
20.
go back to reference Ito H, Mori K, Kagami S (2010) Neuroimaging of stroke-like episodes in MELAS. Brain Dev 33:283–288CrossRefPubMed Ito H, Mori K, Kagami S (2010) Neuroimaging of stroke-like episodes in MELAS. Brain Dev 33:283–288CrossRefPubMed
21.
go back to reference Ohama E, Ohara S, Ikuta F, Tanaka K, Nishizawa M, Miyatake T (1987) Mitochondrial angiopathy in cerebral blood vessels of mitochondrial encephalomyopathy. Acta Neuropathol 74:226–233CrossRefPubMed Ohama E, Ohara S, Ikuta F, Tanaka K, Nishizawa M, Miyatake T (1987) Mitochondrial angiopathy in cerebral blood vessels of mitochondrial encephalomyopathy. Acta Neuropathol 74:226–233CrossRefPubMed
22.
go back to reference Betts J, Jaros E, Perry RH, Schaefer AM, Taylor RW, Abdel-All Z, Lightowlers RN, Turnbull DM (2006) Molecular neuropathology of MELAS: level of heteroplasmy in individual neurones and evidence of extensive vascular involvement. Neuropathol Appl Neurobiol 32:359–373CrossRefPubMed Betts J, Jaros E, Perry RH, Schaefer AM, Taylor RW, Abdel-All Z, Lightowlers RN, Turnbull DM (2006) Molecular neuropathology of MELAS: level of heteroplasmy in individual neurones and evidence of extensive vascular involvement. Neuropathol Appl Neurobiol 32:359–373CrossRefPubMed
23.
24.
go back to reference Iizuka T, Sakai F, Suzuki N, Hata T, Tsukahara S, Fukuda M, Takiyama Y (2002) Neuronal hyperexcitability in stroke-like episodes of MELAS syndrome. Neurology 59:816–824CrossRefPubMed Iizuka T, Sakai F, Suzuki N, Hata T, Tsukahara S, Fukuda M, Takiyama Y (2002) Neuronal hyperexcitability in stroke-like episodes of MELAS syndrome. Neurology 59:816–824CrossRefPubMed
25.
go back to reference Scaglia F, Wong LJ, Vladutiu GD, Hunter JV (2005) Predominant cerebellar volume loss as a neuroradiologic feature of pediatric respiratory chain defects. AJNR Am J Neuroradiol 26:1675–1680PubMed Scaglia F, Wong LJ, Vladutiu GD, Hunter JV (2005) Predominant cerebellar volume loss as a neuroradiologic feature of pediatric respiratory chain defects. AJNR Am J Neuroradiol 26:1675–1680PubMed
26.
go back to reference Holzerova E, Danhauser K, Haack TB, Kremer LS, Melcher M, Ingold I, Kobayashi S, Terrile C, Wolf P, Schaper J, Mayatepek E, Baertling F, Friedmann Angeli JP, Conrad M, Strom TM, Meitinger T, Prokisch H, Distelmaier F (2016) Human thioredoxin 2 deficiency impairs mitochondrial redox homeostasis and causes early-onset neurodegeneration. Brain 139:346–354CrossRefPubMed Holzerova E, Danhauser K, Haack TB, Kremer LS, Melcher M, Ingold I, Kobayashi S, Terrile C, Wolf P, Schaper J, Mayatepek E, Baertling F, Friedmann Angeli JP, Conrad M, Strom TM, Meitinger T, Prokisch H, Distelmaier F (2016) Human thioredoxin 2 deficiency impairs mitochondrial redox homeostasis and causes early-onset neurodegeneration. Brain 139:346–354CrossRefPubMed
27.
go back to reference Naini A, Lewis VJ, Hirano M, DiMauro S (2003) Primary coenzyme Q10 deficiency and the brain. Biofactors 18:145–152CrossRefPubMed Naini A, Lewis VJ, Hirano M, DiMauro S (2003) Primary coenzyme Q10 deficiency and the brain. Biofactors 18:145–152CrossRefPubMed
28.
go back to reference Baertling F, Haack TB, Rodenburg RJ, Schaper J, Seibt A, Strom TM, Meitinger T, Mayatepek E, Hadzik B, Selcan G, Prokisch H, Distelmaier F (2015) MRPS22 mutation causes fatal neonatal lactic acidosis with brain and heart abnormalities. Neurogenetics 16:237–240CrossRefPubMed Baertling F, Haack TB, Rodenburg RJ, Schaper J, Seibt A, Strom TM, Meitinger T, Mayatepek E, Hadzik B, Selcan G, Prokisch H, Distelmaier F (2015) MRPS22 mutation causes fatal neonatal lactic acidosis with brain and heart abnormalities. Neurogenetics 16:237–240CrossRefPubMed
29.
go back to reference Brito S, Thompson K, Campistol J, Colomer J, Hardy SA, He L, Fernandez-Marmiesse A, Palacios L, Jou C, Jimenez-Mallebrera C, Armstrong J, Montero R, Artuch R, Tischner C, Wenz T, McFarland R, Taylor RW (2015) Long-term survival in a child with severe encephalopathy, multiple respiratory chain deficiency and GFM1 mutations. Front Genet 6:102PubMedPubMedCentral Brito S, Thompson K, Campistol J, Colomer J, Hardy SA, He L, Fernandez-Marmiesse A, Palacios L, Jou C, Jimenez-Mallebrera C, Armstrong J, Montero R, Artuch R, Tischner C, Wenz T, McFarland R, Taylor RW (2015) Long-term survival in a child with severe encephalopathy, multiple respiratory chain deficiency and GFM1 mutations. Front Genet 6:102PubMedPubMedCentral
30.
go back to reference Vanderver A, Prust M, Tonduti D, Mochel F, Hussey HM, Helman G, Garbern J, Eichler F, Labauge P, Aubourg P, Rodriguez D, Patterson MC, Van Hove JL, Schmidt J, Wolf NI, Boespflug-Tanguy O, Schiffmann R, van der Knaap MS (2014) Case definition and classification of leukodystrophies and leukoencephalopathies. Mol Genet Metab 114:494–500CrossRef Vanderver A, Prust M, Tonduti D, Mochel F, Hussey HM, Helman G, Garbern J, Eichler F, Labauge P, Aubourg P, Rodriguez D, Patterson MC, Van Hove JL, Schmidt J, Wolf NI, Boespflug-Tanguy O, Schiffmann R, van der Knaap MS (2014) Case definition and classification of leukodystrophies and leukoencephalopathies. Mol Genet Metab 114:494–500CrossRef
31.
go back to reference Baertling F, Schaper J, Mayatepek E, Distelmaier F (2013) Teaching neuroimages: rapidly progressive leukoencephalopathy in mitochondrial complex I deficiency. Neurology 81:e10–e11CrossRefPubMed Baertling F, Schaper J, Mayatepek E, Distelmaier F (2013) Teaching neuroimages: rapidly progressive leukoencephalopathy in mitochondrial complex I deficiency. Neurology 81:e10–e11CrossRefPubMed
32.
go back to reference Huemer M, Karall D, Schossig A, Abdenur JE, Al Jasmi F, Biagosch C, Distelmaier F, Freisinger P, Graham BH, Haack TB, Hauser N, Hertecant J, Ebrahimi-Fakhari D, Konstantopoulou V, Leydiker K, Lourenco CM, Scholl-Burgi S, Wilichowski E, Wolf NI, Wortmann SB, Taylor RW, Mayr JA, Bonnen PE, Sperl W, Prokisch H, McFarland R (2015) Clinical, morphological, biochemical, imaging and outcome parameters in 21 individuals with mitochondrial maintenance defect related to FBXL4 mutations. J Inherit Metab Dis 38:905–914CrossRefPubMedPubMedCentral Huemer M, Karall D, Schossig A, Abdenur JE, Al Jasmi F, Biagosch C, Distelmaier F, Freisinger P, Graham BH, Haack TB, Hauser N, Hertecant J, Ebrahimi-Fakhari D, Konstantopoulou V, Leydiker K, Lourenco CM, Scholl-Burgi S, Wilichowski E, Wolf NI, Wortmann SB, Taylor RW, Mayr JA, Bonnen PE, Sperl W, Prokisch H, McFarland R (2015) Clinical, morphological, biochemical, imaging and outcome parameters in 21 individuals with mitochondrial maintenance defect related to FBXL4 mutations. J Inherit Metab Dis 38:905–914CrossRefPubMedPubMedCentral
33.
go back to reference Wortmann SB, Zietkiewicz S, Kousi M, Szklarczyk R, Haack TB, Gersting SW, Muntau AC, Rakovic A, Renkema GH, Rodenburg RJ, Strom TM, Meitinger T, Rubio-Gozalbo ME, Chrusciel E, Distelmaier F, Golzio C, Jansen JH, van Karnebeek C, Lillquist Y, Lucke T, Ounap K, Zordania R, Yaplito-Lee J, van Bokhoven H, Spelbrink JN, Vaz FM, Pras-Raves M, Ploski R, Pronicka E, Klein C, Willemsen MA, de Brouwer AP, Prokisch H, Katsanis N, Wevers RA (2015) CLPB mutations cause 3-methylglutaconic aciduria, progressive brain atrophy, intellectual disability, congenital neutropenia, cataracts, movement disorder. Am J Hum Genet 96:245–257CrossRefPubMedPubMedCentral Wortmann SB, Zietkiewicz S, Kousi M, Szklarczyk R, Haack TB, Gersting SW, Muntau AC, Rakovic A, Renkema GH, Rodenburg RJ, Strom TM, Meitinger T, Rubio-Gozalbo ME, Chrusciel E, Distelmaier F, Golzio C, Jansen JH, van Karnebeek C, Lillquist Y, Lucke T, Ounap K, Zordania R, Yaplito-Lee J, van Bokhoven H, Spelbrink JN, Vaz FM, Pras-Raves M, Ploski R, Pronicka E, Klein C, Willemsen MA, de Brouwer AP, Prokisch H, Katsanis N, Wevers RA (2015) CLPB mutations cause 3-methylglutaconic aciduria, progressive brain atrophy, intellectual disability, congenital neutropenia, cataracts, movement disorder. Am J Hum Genet 96:245–257CrossRefPubMedPubMedCentral
Metadata
Title
The many faces of paediatric mitochondrial disease on neuroimaging
Authors
Fabian Baertling
Dirk Klee
Tobias B. Haack
Holger Prokisch
Thomas Meitinger
Ertan Mayatepek
Jörg Schaper
Felix Distelmaier
Publication date
01-11-2016
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 11/2016
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-016-3190-3

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