Spectrum of brain changes in patients with congenital muscular dystrophy and FKRP gene mutations.
OBJECTIVE
To report the spectrum of brain magnetic resonance imaging findings in 13 patients with congenital muscular dystrophy and FKRP gene mutations and to explore possible genotype-phenotype correlations.


METHODS
We retrospectively reviewed brain magnetic resonance imaging in patients with congenital muscular dystrophy and FKRP gene mutations.


METHODS
Thirteen patients with congenital muscular dystrophy and mutations in the FKRP gene.


RESULTS
Five of the 13 patients had the typical phenotype originally described for congenital muscular dystrophy (MDC1C) with normal intelligence and normal brain magnetic resonance imaging while 3 other patients had isolated cerebellar cysts and mental retardation without any other sign of posterior fossa of supratentorial abnormalities. In the remaining 5 patients cerebellar cysts were associated with structural brain changes involving the posterior fossa and the cortex, ranging from focal unilateral periventricular nodular heterotopia to marked cerebellar dysplasia and pontine hypoplasia. In 2 of these 5 patients the severity and distribution of changes resembled muscle-eye-brain disease in 1 patient who had mild Walker-Warburg syndrome. The distribution of FKRP gene mutations identified in this group of patients did not reveal any obvious association with the severity of central nervous system involvement.


CONCLUSIONS
The severity of central nervous system involvement observed in our patients in contrast broadly reflected the severity of the disruption of alpha-dystroglycan glycosylation. In particular, dystroglycan expression was almost absent in the patients with muscle-eye-brain diseaselike phenotype and less severely reduced in the patients with congenital muscular dystrophy (MDC1C) with or without cerebellar cysts. This study further highlights the central role that dystroglycan has in neuronal migration.
Dubowitz Neuromuscular Centre, Department of Paediatrics, Imperial College, Hammersmith Hospital Campus, London, United Kingdom.
Eugenio
E
Mercuri
Haluk
H
Topaloglu
Martin
M
Brockington
Angela
A
Berardinelli
Anna
A
Pichiecchio
Filippo
F
Santorelli
Mary
M
Rutherford
Beril
B
Talim
Enzo
E
Ricci
Thomas
T
Voit
Francesco
F
Muntoni
D001921:Brain / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D007360:Intelligence; D008279:Magnetic Resonance Imaging; D008297:Male; D009136:Muscular Dystrophies / Q000151:congenital* / Q000235:genetics / Q000473:pathology*; D010430:Pentosyltransferases; D010641:Phenotype; D011506:Proteins / Q000235:genetics*; D012189:Retrospective Studies; D012720:Severity of Illness Index
D011506:Proteins; C443107:FKRP protein, human; D010430:Pentosyltransferases