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Research ArticleBrain

Brain Changes in Kallmann Syndrome

R. Manara, A. Salvalaggio, A. Favaro, V. Palumbo, V. Citton, A. Elefante, A. Brunetti, F. Di Salle, G. Bonanni, A.A. Sinisi and for the Kallmann Syndrome Neuroradiological Study Group
American Journal of Neuroradiology September 2014, 35 (9) 1700-1706; DOI: https://doi.org/10.3174/ajnr.A3946
R. Manara
aFrom the Department of Neuroradiology (R.M., F.D.S.), University of Salerno, Salerno, Italy
bIstituto di Ricovero e Cura a Carattere Scientifico S. Camillo (R.M., V.C.), Venezia, Italy
hENT section (R.M., A.S.), Department of Neurosciences, “Federico II” University, Napoli, Italy.
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A. Salvalaggio
cDepartments of Neurology (A.S.)
hENT section (R.M., A.S.), Department of Neurosciences, “Federico II” University, Napoli, Italy.
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A. Favaro
dPsychiatry (A.F.), Department of Neurosciences
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V. Palumbo
fDepartment of Clinical and Experimental Medicine and Surgery (V.P., A.A.S.), Endocrinology and Medical Andrology Section, Second University of Napoli, Napoli, Italy
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V. Citton
bIstituto di Ricovero e Cura a Carattere Scientifico S. Camillo (R.M., V.C.), Venezia, Italy
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A. Elefante
gDepartment of Neuroradiology (A.E., A.B.), Department of Scienze Biomediche Avanzate
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A. Brunetti
gDepartment of Neuroradiology (A.E., A.B.), Department of Scienze Biomediche Avanzate
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F. Di Salle
aFrom the Department of Neuroradiology (R.M., F.D.S.), University of Salerno, Salerno, Italy
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G. Bonanni
eUnità di Endocrinologia (G.B.), Department of Medicine, University of Padova, Padova, Italy
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A.A. Sinisi
fDepartment of Clinical and Experimental Medicine and Surgery (V.P., A.A.S.), Endocrinology and Medical Andrology Section, Second University of Napoli, Napoli, Italy
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    Fig 1.

    Conventional brain MR imaging findings in 45 patients with Kallmann syndrome. A, Midsagittal T1-weighted image of a patient with agenesia of the posterior portion of the corpus callosum (white arrows). B, Axial FLAIR image of the patient disclosing several multiple sclerosis–like white matter signal abnormalities in the centrum semiovale bilaterally. C, Non-enhanced axial T1-weighted image at the level of the internal acoustic meatus showing a right intra/extrameatal dumbell-shaped mass consistent with an acoustic schwannoma.

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    Fig 2.

    3D-T1-based whole-brain analyses on 42 patients with Kallmann syndrome versus 23 controls. A, Voxel-based morphometry findings. Clusters of significantly decreased white matter volume (colored areas in the multiplanar reconstructions in the first column) were detected exclusively and symmetrically in the posterior portion of the medial orbital-frontal gyrus close to the olfactory sulcus; no regions of increased white matter volume were detected in our sample. Clusters of significantly decreased (second column) and increased (third column) gray matter volume are shown as colored cortical areas in the volume-rendering technique images within or close to the olfactory sulci. B, Sulcation, curvature, and thickness findings. Colored areas represent increased (yellow-red) and decreased (blue) values in patients with KS. Almost all differences are clustered within the olfactory sulci and the neighboring cortex of the rectus and medial orbital-frontal gyri.

Tables

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  • Cortical areas >40 mm2 with significant differences between patients with Kallmann syndrome and controls by sulcation, curvature, and cortical thickness analyses

    HemisphereSize (mm2)Local Maximum, TalairachFDR ThresholdCerebral Region
    XYZ
    Sulcation
        Right394.05↓11.213.8−14.93.3429Olfactory sulcus and contiguous cortex of the rectus gyrus
        Right325.72↑16.428.7−23.73.3429Medial orbital-frontal gyrus
        Left518.07↓−9.816.0−15.43.3159Olfactory sulcus and contiguous cortex of the rectus gyrus
        Left252.41↑−19.633.2−17.33.3159Medial orbital-frontal gyrus
    Curvature
        Right372.85↑14.432.3−25.33.4704Medial orbital-frontal gyrus
        Right77.61↓11.716.6−14.23.4704Olfactory sulcus
        Right44.71↓11.537.9−19.13.4704Olfactory sulcus
        Left196.94↓−11.638.7−20.03.4704Olfactory sulcus
        Left114.79↑−19.632.7−14.93.4704Medial orbital-frontal gyrus
    Thickness
        Right568.97↑−14.130.7−19.23.3834Olfactory sulcus and contiguous cortex of the rectus and medial orbital-frontal gyri
        Left686.38↑13.733.4−23.33.2803Olfactory sulcus and contiguous cortex of the rectus and medial orbital-frontal gyri
        Left78.39↓12.748.633.53.2803Medial orbital-frontal sulcus
        Left40.54↓45.2−62.336.93.2803Lateral orbital-frontal gyrus
    • Note:—↑ indicates that patients with KS showed increased sulcation, curvature, and cortical thickness; ↓, patients with KS showed decreased sulcation, curvature, and cortical thickness; FDR, false discovery rate.

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American Journal of Neuroradiology: 35 (9)
American Journal of Neuroradiology
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R. Manara, A. Salvalaggio, A. Favaro, V. Palumbo, V. Citton, A. Elefante, A. Brunetti, F. Di Salle, G. Bonanni, A.A. Sinisi, for the Kallmann Syndrome Neuroradiological Study Group
Brain Changes in Kallmann Syndrome
American Journal of Neuroradiology Sep 2014, 35 (9) 1700-1706; DOI: 10.3174/ajnr.A3946

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Brain Changes in Kallmann Syndrome
R. Manara, A. Salvalaggio, A. Favaro, V. Palumbo, V. Citton, A. Elefante, A. Brunetti, F. Di Salle, G. Bonanni, A.A. Sinisi, for the Kallmann Syndrome Neuroradiological Study Group
American Journal of Neuroradiology Sep 2014, 35 (9) 1700-1706; DOI: 10.3174/ajnr.A3946
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