Abnormal development of the human cerebral cortex: genetics, functional consequences and treatment options.
Genetic studies have identified several of the genes associated with malformations of cortical development which might disrupt each of the main stages of cell proliferation and specification, neuronal migration and late cortical organization. The largest malformation groups, focal cortical dysplasia, heterotopia and polymicrogyria, express different perturbations of these stages and carry a variable propensity for lacking activation, preservation or reorganization of cortical function and for atypical cortical organization. Some patients have obvious neurological impairment, whereas others show unexpected deficits that are detectable only by screening. Drug-resistant epilepsy is frequent but might be amenable to surgical treatment. However, the epileptogenic zone might include remote cortical and subcortical regions. Completeness of resection, a key factor for successful surgery, might be difficult, especially in proximity to eloquent cortex. Surgical planning should be based on assessments of structural imaging and of the major functions relevant to the area in question in any such patient.
Guerrini
Renzo
R
Department of Neurology and Neurosurgery, Children's Hospital A. Meyer, University of Florence, Viale Pieraccini 24, 50139, Florence, Italy. r.guerrini@meyer.it
Dobyns
William B
WB
Barkovich
A James
AJ
D002465:Cell Movement; D049109:Cell Proliferation; D002540:Cerebral Cortex / Q000002:abnormalities* / Q000254:growth & development / Q000378:metabolism / Q000473:pathology; D006801:Humans; D054220:Malformations of Cortical Development / Q000145:classification* / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D009419:Nerve Tissue Proteins / Q000145:classification / Q000235:genetics* / Q000378:metabolism
D009419:Nerve Tissue Proteins