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      Assessment of whole-brain white matter by DTI in autosomal recessive spastic ataxia of charlevoix-saguenay

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      Author
      Oguz, K. K.
      Haliloglu, G.
      Temucin, C.
      Gocmen, R.
      Has, A. C.
      Doerschner, K.
      Dolgun, A.
      Alikasifoglu, M.
      Date
      2013
      Source Title
      American Journal of Neuroradiology
      Print ISSN
      0195-6108
      Electronic ISSN
      1936-959X
      Publisher
      American Society of Neuroradiology
      Volume
      34
      Issue
      10
      Pages
      1952 - 1957
      Type
      Article
      Item Usage Stats
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      Abstract
      BACKGROUND AND PURPOSE: Extension and characteristics of WM involvement other than the brain stem remain inadequately investigated in ARSACS. The aim of this study was to investigate whole-brain WM alterations in patients with ARSACS. MATERIALS AND METHODS: Nine Turkish unrelated patients with ARSACS and 9 sex- and age-matched healthy control participants underwent neurologic examination, molecular studies, electrophysiologic studies, and DTI of the brain. TBSS was used for whole-brain voxelwise analysis of FA, AD, RD, mean diffusivity of WM. Tractographies for the CST and TPF were also computed. RESULTS: Molecular studies revealed 8 novel mutations (3 nonsense, 4 missense, and 1 frameshift insertion) and a missense variation in the SACS gene. Thick TPF displaced and compressed the CST in the pons. The TPF had increased FA, decreased RD, and increased AD, which may be attributed to hypertrophy and/or hypermyelination. Widespread decreased FA and increased RD, suggesting demyelination, was found in the limbic, commissural, and projection fibers. In addition to demyelination, CST coursing cranial and caudal to the pons also showed a marked decrease in AD, suggesting axonal degeneration. Electrophysiologic studies revealed findings that concur with demyelination and axonal involvement. CONCLUSIONS: In addition to developmental changes of the TPF and their effects on the CST in the brain stem, axonal degeneration mainly along the pyramidal tracts and widespread demyelination in WM also occur in patients with ARSACS. Widespread tissue damage may be associated with extensive loss of sacsin protein in the brain and may explain a wide range of progressive neurologic abnormalities in patients with ARSACS.
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      http://hdl.handle.net/11693/20797
      Published Version (Please cite this version)
      http://dx.doi.org/10.3174/ajnr.A3488
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      • Department of Psychology 170
      • National Magnetic Resonance Research Center (UMRAM) 198
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