PT  - JOURNAL ARTICLE
AU  - U. Löbel
AU  - J. Sedlacik
AU  - M. Nickel
AU  - S. Lezius
AU  - J. Fiehler
AU  - I. Nestrasil
AU  - A. Kohlschütter
AU  - A. Schulz
TI  - Volumetric Description of Brain Atrophy in Neuronal Ceroid Lipofuscinosis 2: Supratentorial Gray Matter Shows Uniform Disease Progression
AID  - 10.3174/ajnr.A4816
DP  - 2016 Oct 01
TA  - American Journal of Neuroradiology
PG  - 1938--1943
VI  - 37
IP  - 10
4099  - http://www.ajnr.org/content/37/10/1938.short
4100  - http://www.ajnr.org/content/37/10/1938.full
SO  - Am. J. Neuroradiol.2016 Oct 01; 37
AB  - BACKGROUND AND PURPOSE: Experimental therapies for ceroid lipofuscinosis, neuronal, 2 (CLN2), a genetic disorder of childhood associated with progressive brain atrophy, are currently being developed. Because quantitative descriptions of the natural course of brain volume loss are needed to evaluate novel therapies, we performed MR imaging volumetry of patients with CLN2 to identify a suitable MR imaging marker of disease progression.MATERIALS AND METHODS: Thirteen patients (8 females, 5 males) were recruited from a prospective natural disease cohort of patients with neuronal ceroid lipofuscinosis. Repeated MR imaging volumetric analysis (29 datasets) was performed by using the FreeSurfer Software Suite. Follow-up time ranged from 8 months to 5.3 years. MR imaging–segmented brain volumes were correlated to patient age and clinical scores.RESULTS: Segmented brain volumes correlated significantly with patient age (lateral ventricles, r = 0.606, P = .001; supratentorial cortical GM, r = −0.913, P < .001; supratentorial WM, r = −0.865, P < .001; basal ganglia/thalamus, r = −0.832, P < .001; cerebellar GM, r = −0.659, P < .001; cerebellar WM, r = −0.830, P < .001) and clinical scores (lateral ventricles, r = −0.692, P < .001; supratentorial cortical GM, r = 0.862, P < .001; supratentorial WM, r = 0.735, P < .001; basal ganglia/thalamus, r = 0.758, P < .001; cerebellar GM, r = 0.609, P = .001; cerebellar WM, r = 0.638, P < .001). Notably, supratentorial cortical GM showed a uniform decline across the patient cohort. During late stages of the disease when the clinical score was zero, segmented brain volumes still correlated with patient age; this finding suggests that MR imaging volumetry allows quantitative assessment of disease progression at stages when it cannot be detected by clinical assessment alone.CONCLUSIONS: Automated MR imaging volumetry, as a nonsubjective and highly sensitive tool, is feasible in CLN2 disease and provides a quantitative basis to evaluate novel experimental therapies.CLNceroid lipofuscinosis, neuronalNCLneuronal ceroid lipofuscinosesTPP1tripeptidyl-peptidase-1