Neuroradiological findings (MRS, MRI, SPECT) in infantile neuronal ceroid-lipofuscinosis (infantile CLN1) at different stages of the disease.

• Infantile neuronal ceroid-lipofuscinosis (infantile CLN1) is a progressive and uniformly fatal lysosomal storage disease of the nervous system. The purpose of this study was to compare the findings of various radiological examinations of the brain in the course of infantile CLN1 in order to evaluate the relative usefulness of the methods and their potential for monitoring therapeutic interventions. We examined eight infantile CLN1 patients, 51 studies, in various stages of the disease--preclinical to late stage--with proton magnetic resonance spectroscopy (1H-MRS), MRI, and perfusion SPECT, and in addition three benzodiazepine (BZ) receptor ligand SPECT studies. Both 1H-MRS and MRI showed abnormal findings before clinical manifestations of the disease. Cortical hypoperfusion and loss of cortical BZ receptors revealed by SPECT appeared simultaneously with clinical signs. After the age of 4 years MRI and SPECT alterations progressed minimally, whereas 1H-MRS showed progressive deterioration of neurometabolism. Of the four methods used in this study, MRI proved to be the most practicable for diagnosing infantile CLN1; the final diagnosis of infantile CLN1 is confirmed by the characteristic clinical picture and DNA or PPT enzyme analysis. The combination of 1H- MRS and MRI could be most useful for monitoring therapeutic interventions.

Keyword

Aspartic Acid/*analogs & derivatives/metabolism

Brain/blood supply/metabolism/pathology

Child

Child; Preschool

Choline/metabolism

Creatinine/metabolism

Humans

Infant

Infant; Newborn

Magnetic Resonance Imaging

Magnetic Resonance Spectroscopy

Neuronal Ceroid-Lipofuscinosis/*metabolism/*pathology

Oximes/diagnostic use

Radiopharmaceuticals/diagnostic use

Research Support; Non-U.S. Gov't

Tomography; Emission-Computed; Single-Photon

MEDICINE

MEDICIN

Publication and Content Type

ref (subject category)

art (subject category)