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CC BY 4.0 · Arq Neuropsiquiatr 2023; 81(09): 809-815
DOI: 10.1055/s-0043-1772601
Original Article

Sjogren-Larsson syndrome brain volumetric reductions demonstrated with an automated software

Reduções volumétricas cerebrais da síndrome de Sjogren-Larsson demonstradas com um software automatizado
José Thiago de Souza de Castro 
1   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Anestesiologia, Oncologia e Radiologia, Campinas SP, Brazil.
,
Camilo Lotfi Saab 
1   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Anestesiologia, Oncologia e Radiologia, Campinas SP, Brazil.
,
Mariam Patrícia Auada Souto 
2   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Clínica Médica, Campinas SP, Brazil.
,
Juliane Giselle Ortolam 
1   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Anestesiologia, Oncologia e Radiologia, Campinas SP, Brazil.
,
Carlos Eduardo Steiner 
3   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Medicina Translacional , Campinas SP, Brazil.
,
Thiago Junqueira Ribeiro de Rezende 
4   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Neurologia, Campinas SP, Brazil.
,
Fabiano Reis 
1   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Anestesiologia, Oncologia e Radiologia, Campinas SP, Brazil.
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Abstract

Background Sjogren-Larsson syndrome (SLS) is a neurocutaneous disease with an autosomal recessive inheritance, caused by mutations in the gene that encodes fatty aldehyde dehydrogenase (ALDH3A2), clinically characterized by ichthyosis, spastic diplegia, and cognitive impairment. Brain imaging plays an essential role in the diagnosis, demonstrating a nonspecific leukoencephalopathy. Data regarding brain atrophy and grey matter involvement is scarce and discordant.

Objective We performed a volumetric analysis of the brain of two siblings with SLS with the aim of detecting deep grey matter nuclei, cerebellar grey matter, and brainstem volume reduction in these patients.

Methods Volume data obtained from the brain magnetic resonance imaging (MRI) of the two patients using an automated segmentation software (Freesurfer) was compared with the volumes of a healthy control group.

Results Statistically significant volume reduction was found in the cerebellum cortex, the brainstem, the thalamus, and the pallidum nuclei.

Conclusion Volume reduction in grey matter leads to the hypothesis that SLS is not a pure leukoencephalopathy. Grey matter structures affected in the present study suggest a dysfunction more prominent in the thalamic motor pathways.

Resumo

Antecedentes A Síndrome de Sjogren-Larsson (SSL) é uma doença neurocutânea de herança autossômica recessiva, causada por mutações no gene que codifica a aldeído graxo desidrogenase (ALDH3A2), caracterizada clinicamente por ictiose, diplegia espástica e comprometimento cognitivo. A imagiologia cerebral desempenha um papel essencial no diagnóstico, demonstrando uma leucoencefalopatia inespecífica. Dados sobre atrofia cerebral e envolvimento da substância cinzenta são escassos e discordantes.

Objetivo Realizamos uma análise volumétrica do cérebro de dois irmãos com SLS com o objetivo de detectar núcleos profundos de substância cinzenta, substância cerebral cinzenta e redução do volume do tronco encefálico nestes pacientes.

Métodos Os dados de volume obtidos da ressonância magnética (RM) cerebral dos dois pacientes usando um software de segmentação automática (Freesurfer) foram comparados com os volumes de um grupo controle saudável.

Resultados Redução de volume estatisticamente significativa foi encontrada no córtex do cerebelo, no tronco cerebral, no tálamo e nos núcleos pálidos.

Conclusão A redução do volume da substância cinzenta leva à hipótese de que a SSL não é uma leucoencefalopatia pura. As estruturas da substância cinzenta afetadas no presente estudo sugerem uma disfunção mais proeminente nas vias motoras talâmicas.

Keywords

Sjogren-Larsson Syndrome - Neurocutaneous Syndromes - Thalamic Diseases - Brain Diseases

Palavras-chave

Síndrome de Sjogren-Larsson - Síndromes Neurocutâneas - Doenças Talâmicas - Encefalopatias

Authors' Contributions

JTSC, CLS, MPAS, JGO, CES: conceptualization, data curation, investigation, resources; TJRR: software; FR: supervision, validation, visualization.




Publication History

Received: 25 November 2022

Accepted: 05 June 2023

Article published online:
04 October 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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