title: Tuberous sclerosis-like lesions in epileptogenic human neocortex lack allelic loss at the TSC1 and TSC2 regions.
abstract: Glioneuronal malformations with a striking histological resemblance to cortical tubers of tuberous sclerosis, but no extracerebral stigmata of this phacomatosis, are frequently encountered in patients with chronic pharmacoresistant epilepsies. It is controversial as to whether these lesion represent a forme fruste of tuberous sclerosis or a distinct entity. The recently reported loss of heterozygosity (LOH) at the regions of the TSC1 or TSC2 locus in hamartomas obtained from different organs of patients with established tuberous sclerosis, including cortical tubers, stimulated us to examine epilepsy-associated tuberous sclerosis-like glioneuronal malformations with respect to LOH at the TSC1 and TSC2 loci of chromosomes 9q34 and 16p 13.3, respectively. The analysis was carried out on DNA derived from paraffin-embedded brain tissues of 11 patients. For 5 patients, peripheral blood leukocytes were also available for DNA extraction. We performed microsatellite analysis with five markers on chromosome 9 and four markers on chromosome 16. In addition, polymerase chain reaction-restriction fragment length polymorphism (RFLP) analysis was performed using a polymorphic EcoRV restriction site in exon 40 of the TSC2 gene. No LOH was identified in any of the cases. These findings do not support a relationship between the epilepsy-associated glioneuronal lesions and tuberous sclerosis. However, tuberous sclerosis is genetically heterogeneous and microsatellite and RFLP analysis cannot exclude small deletions or point mutations. Thus, given the histopathological similarity of glioneuronal malformations in epilepsy patients to cortical tubers, further molecular genetic studies will be needed as our understanding of the molecular basis of tuberous sclerosis increases to completely clarify the relationship of these lesions to tuberous sclerosis.
authors.affiliation: Department of Neuropathology, University of Bonn Medical Center, Germany.
authors.forename: H K
authors.initials: HK
authors.lastname: Wolf
authors.forename: S
authors.initials: S
authors.lastname: Normann
authors.forename: A J
authors.initials: AJ
authors.lastname: Green
authors.forename: I
authors.initials: I
authors.lastname: von Bakel
authors.forename: I
authors.initials: I
authors.lastname: Blümcke
authors.forename: T
authors.initials: T
authors.lastname: Pietsch
authors.forename: O D
authors.initials: OD
authors.lastname: Wiestler
authors.forename: A
authors.initials: A
authors.lastname: von Deimling
mesh_terms: D000293:Adolescent; D000328:Adult; D000483:Alleles; D002540:Cerebral Cortex / Q000473:pathology*; D002648:Child; D002885:Chromosomes, Human, Pair 16; D002899:Chromosomes, Human, Pair 9; D004827:Epilepsy / Q000235:genetics / Q000473:pathology*; D017353:Gene Deletion; D016147:Genes, Tumor Suppressor; D005819:Genetic Markers; D006579:Heterozygote; D006801:Humans; D012097:Repressor Proteins / Q000235:genetics*; D014402:Tuberous Sclerosis / Q000235:genetics / Q000473:pathology*; D000077005:Tuberous Sclerosis Complex 2 Protein; D025521:Tumor Suppressor Proteins
chemical_list: D005819:Genetic Markers; D012097:Repressor Proteins; C000624653:TSC2 protein, human; D000077005:Tuberous Sclerosis Complex 2 Protein; D025521:Tumor Suppressor Proteins