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      Prenatal Diagnosis of Lissencephaly Type 2 using Three-dimensional Ultrasound and Fetal MRI: Case Report and Review of the Literature Translated title: Diagnóstico pré-natal de lissencefalia tipo 2 por meio da ultrassonografia e ressonância magnética fetal: relato de caso e revisão da literatura

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          Abstract

          Abstract Lissencephaly is a genetic heterogeneous autosomal recessive disorder characterized by the classical triad: brain malformations, eye anomalies, and congenital muscular dystrophy. Prenatal diagnosis is feasible by demonstrating abnormal development of sulci and gyri. Magnetic resonance imaging (MRI) may enhance detection of developmental cortical disorders as well as ocular anomalies. We describe a case of early diagnosis of lissencephaly type 2 detected at the time of routine second trimester scan by three-dimensional ultrasound and fetal MRI. Gross pathology confirmed the accuracy of the prenatal diagnosis while histology showed the typical feature of cobblestone cortex. As the disease is associated with poor perinatal prognosis, early and accurate prenatal diagnosis is important for genetic counseling and antenatal care.

          Translated abstract

          Resumo Lissencefalia são doenças genéticas autossômicas recessivas heterogêneas caracterizadas pela tríade clássica: malformações do cérebro, anomalias oculares e distrofia muscular congênita. Diagnóstico pré-natal é factível pela demonstração do desenvolvimento anormal de sulcos e giros. Ressonância magnética ( RM ) melhora a detecção de distúrbios do desenvolvimento cortical, bem como as anomalias oculares. Descrevemos um caso de diagnóstico precoce de lisencefalia tipo 2 detectado no momento do ultrassom morfológico de segundo trimestre pela ultrassonografia tridimensional e RM fetal. A macroscopia confirmou a acurácia do diagnóstico pré-natal, enquanto que a microscopia mostrou a típica característica de córtex em cobblestone. Como a doença está associada à um pobre prognóstico perinatal, o precoce e acurado diagnóstico pré-natal é importante para o aconselhamento genético e seguimento da gestação.

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          Most cited references37

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          G protein-coupled receptor 56 and collagen III, a receptor-ligand pair, regulates cortical development and lamination.

          GPR56, an orphan G protein-coupled receptor (GPCR) from the family of adhesion GPCRs, plays an indispensable role in cortical development and lamination. Mutations in the GPR56 gene cause a malformed cerebral cortex in both humans and mice that resembles cobblestone lissencephaly, which is characterized by overmigration of neurons beyond the pial basement membrane. However, the molecular mechanisms through which GPR56 regulates cortical development remain elusive due to the unknown status of its ligand. Here we identify collagen, type III, alpha-1 (gene symbol Col3a1) as the ligand of GPR56 through an in vitro biotinylation/proteomics approach. Further studies demonstrated that Col3a1 null mutant mice exhibit overmigration of neurons beyond the pial basement membrane and a cobblestone-like cortical malformation similar to the phenotype seen in Gpr56 null mutant mice. Functional studies suggest that the interaction of collagen III with its receptor GPR56 inhibits neural migration in vitro. As for intracellular signaling, GPR56 couples to the Gα(12/13) family of G proteins and activates RhoA pathway upon ligand binding. Thus, collagen III regulates the proper lamination of the cerebral cortex by acting as the major ligand of GPR56 in the developing brain.
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            Prenatal diagnosis of cobblestone lissencephaly associated with Walker-Warburg syndrome based on a specific sonographic pattern.

            We report a specific sonographic cerebral pattern of cobblestone lissencephaly (CL) that has not been described previously. This pattern was encountered in four index cases and allowed prenatal diagnosis of CL associated with Walker-Warburg syndrome. The pattern included both an outer echogenic band with reduced pericerebral space, corresponding to an infra- and supratentorial extracortical layer of neuroglial overmigration on pathological examination, and a 'Z'-shaped appearance of the brainstem. This pattern was found as early as 14 weeks' gestation in one of our cases.
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              Prenatal diagnosis of retinal nonattachment in the Walker-Warburg syndrome.

              We report on the prenatal ultrasonographic diagnosis of Walker-Warburg syndrome based on cerebral and ocular findings. The ultrasound study done at 37 weeks gestation documented hydrocephalus and retinal nonattachment consistent with this syndrome. The ability to detect retinal nonattachment prenatally may have implications for the prenatal diagnosis of other conditions which have early retinal nonattachment as one of their findings. However, it is uncertain how early in pregnancy this defect can be detected.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rbgo
                Revista Brasileira de Ginecologia e Obstetrícia
                Rev. Bras. Ginecol. Obstet.
                Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
                1806-9339
                April 2016
                : 38
                : 4
                : 201-206
                Affiliations
                [1 ] AUSL Reggio Emilia Italy
                [2 ] Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) "Arcispedale Santa Maria Nuova" Italy
                [3 ] Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) "Arcispedale Santa Maria Nuova" Italy
                [4 ] Universidade Federal de São Paulo Brazil
                Article
                S0100-72032016000400201
                10.1055/s-0036-1582126
                27088705
                5d7c556d-b29c-409a-aab9-b7c890ff7e9a

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0100-7203&lng=en
                Categories
                OBSTETRICS & GYNECOLOGY

                Obstetrics & Gynecology
                lisencefalia,cobblestone córtex,aconselhamento genético,ressonância magnética,patologia,diagnóstico pré-natal,ultrassom tridimensional,lissencephaly,cobblestone cortex,genetic counseling,magnetic resonance imaging,pathology,prenatal diagnosis,three-dimensional ultrasound

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