Dejerine-Sottas disease in childhood-Genetic and sonographic heterogeneity

Brain Behav. 2018 Feb 21;8(4):e00919. doi: 10.1002/brb3.919. eCollection 2018 Apr.

Abstract

Introduction: The nerve sonographic features of Dejerine-Sottas disease (DSD) have not previously been described.

Methods: This exploratory cross-sectional, matched, case-control study investigated differences in nerve cross-sectional area (CSA) in children with DSD compared to healthy controls and children with Charcot-Marie-Tooth disease type 1A (CMT1A). CSA of the median, ulnar, tibial, and sural nerves was measured by peripheral nerve ultrasound. The mean difference in CSA between children with DSD, controls, and CMT1A was determined individually and within each group.

Results: Five children with DSD and five age- and sex-matched controls were enrolled. Data from five age-matched children with CMT1A was also included. Group comparison showed no mean difference in nerve CSA between children with DSD and controls. Individual analysis of each DSD patient with their matched control indicated an increase in nerve CSA in three of the five children. The largest increase was observed in a child with a heterozygous PMP22 point mutation (nerve CSA fivefold larger than a control and twofold larger than a child with CMT1A). Nerve CSA was moderately increased in two children-one with a heterozygous mutation in MPZ and the other of unknown genetic etiology.

Conclusions: Changes in nerve CSA on ultrasonography in children with DSD differ according to the underlying genetic etiology, confirming the variation in underlying pathobiologic processes and downstream morphological abnormalities of DSD subtypes. Nerve ultrasound may assist in the clinical phenotyping of DSD and act as an adjunct to known distinctive clinical and neurophysiologic findings of DSD subtypes. Larger studies in DSD cohorts are required to confirm these findings.

Keywords: Charcot–Marie–Tooth disease; Dejerine–Sottas disease; pediatric; peripheral neuropathy; ultrasound.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case-Control Studies
  • Charcot-Marie-Tooth Disease / diagnostic imaging*
  • Charcot-Marie-Tooth Disease / genetics
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Early Growth Response Protein 2 / genetics
  • Female
  • Hereditary Sensory and Motor Neuropathy / diagnostic imaging*
  • Hereditary Sensory and Motor Neuropathy / genetics
  • Hereditary Sensory and Motor Neuropathy / physiopathology
  • Heterozygote
  • Humans
  • Male
  • Median Nerve / diagnostic imaging
  • Median Nerve / pathology
  • Myelin P0 Protein / genetics
  • Myelin Proteins / genetics
  • Neural Conduction
  • Organ Size
  • Peripheral Nerves / diagnostic imaging*
  • Peripheral Nerves / pathology
  • Point Mutation
  • Sural Nerve / diagnostic imaging
  • Sural Nerve / pathology
  • Tibial Nerve / diagnostic imaging
  • Tibial Nerve / pathology
  • Ulnar Nerve / diagnostic imaging
  • Ulnar Nerve / pathology
  • Ultrasonography

Substances

  • EGR2 protein, human
  • Early Growth Response Protein 2
  • MPZ protein, human
  • Myelin P0 Protein
  • Myelin Proteins
  • PMP22 protein, human