Get access

Brain magnetic resonance imaging findings in smith–lemli–opitz syndrome

Authors

  • Ryan W.Y. Lee,

    Corresponding author
    1. Department of Neurology and Developmental Medicine, Kennedy Krieger Institute, Baltimore, Maryland
    2. Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
    • Correspondence to:

      Ryan W.Y. Lee, M.D., Department of Neurology and Developmental Medicine, Kennedy Krieger Institute, 716 North Broadway Street, Baltimore, MD 21205.

      E-mail: leer@kennedykrieger.org

    Search for more papers by this author
  • Sandra K. Conley,

    1. Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
    Search for more papers by this author
  • Andrea Gropman,

    1. Department of Neurology, Children's National Medical Center, Washington, District of Columbia
    Search for more papers by this author
  • Forbes D. Porter,

    1. Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
    Search for more papers by this author
  • Eva H. Baker

    1. Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland
    Search for more papers by this author

  • Conflict of interest: none.

Abstract

Smith–Lemli–Opitz syndrome (SLOS) is a neurodevelopmental disorder caused by inborn errors of cholesterol metabolism resulting from mutations in 7-dehydrocholesterol reductase (DHCR7). There are only a few studies describing the brain imaging findings in SLOS. This study examines the prevalence of magnetic resonance imaging (MRI) abnormalities in the largest cohort of patients with SLOS to date. Fifty-five individuals with SLOS (27 M, 28 F) between age 0.17 years and 25.4 years (mean = 6.2, SD = 5.8) received a total of 173 brain MRI scans (mean = 3.1 per subject) on a 1.5T GE scanner between September 1998 and December 2003, or on a 3T Philips scanner between October 2010 and September 2012; all exams were performed at the Clinical Center of the National Institutes of Health. We performed a retrospective review of these imaging studies for both major and minor brain anomalies. Aberrant MRI findings were observed in 53 of 55 (96%) SLOS patients, with abnormalities of the septum pellucidum the most frequent (42/55, 76%) finding. Abnormalities of the corpus callosum were found in 38 of 55 (69%) patients. Other findings included cerebral atrophy, cerebellar atrophy, colpocephaly, white matter lesions, arachnoid cysts, Dandy–Walker variant, and type I Chiari malformation. Significant correlations were observed when comparing MRI findings with sterol levels and somatic malformations. Individuals with SLOS commonly have anomalies involving the midline and para-midline structures of the brain. Further studies are required to examine the relationship between structural brain abnormalities and neurodevelopmental disability in SLOS. © 2013 Wiley Periodicals, Inc.

Ancillary