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Brain anatomical substrates of mirror movements in Kallmann syndrome.
[kallmann syndrome]
Among
male
patients
affected
by
Kallmann
syndrome
,
a
genetically
determined
disease
due
to
defective
neural
migration
leading
to
hypogonadropic
hypogonadism
and
hypo
/
anosmia
,
about
40
%
present
the
peculiar
phenomenon
of
mirror
movements
,
i
.
e
.
involuntary
movements
mirroring
contralateral
voluntary
hand
movements
.
Several
pathogenic
hypotheses
have
been
proposed
,
but
the
ultimate
neurological
mechanisms
are
still
elusive
.
The
aim
of
the
present
study
was
to
investigate
brain
anatomical
substrates
of
mirror
movements
in
Kallmann
syndrome
by
means
of
a
panel
of
quantitative
MRI
analyses
.
Forty
-
nine
male
Kallmann
syndrome
patients
underwent
brain
MRI
.
The
study
protocol
included
3
D-
T
1
-
weighted
gradient
echo
,
fluid
attenuated
inversion
recovery
and
diffusion
tensor
imaging
.
Voxel-based
morphometry
,
sulcation
,
curvature
and
cortical
thickness
analyses
and
tract
based
spatial
statistics
were
performed
using
SPM
8
,
Freesurfer
and
FSL
.
All
patients
underwent
a
complete
physical
and
neurological
examination
including
the
evaluation
of
mirror
movements
(
according
to
the
Woods
and
Teuber
criteria
)
.
Kallmann
syndrome
patients
presenting
with
mirror
movements
(
16
/
49
,
32
%
)
displayed
the
following
brain
changes
:
1
)
increased
gray
matter
density
in
the
depth
of
the
left
precentral
sulcus
behind
the
middle
frontal
gyrus
;
2
)
decreased
cortical
thickness
in
the
precentral
gyrus
bilaterally
,
in
the
depth
of
right
precentral
sulcus
and
in
the
posterior
portion
of
the
right
superior
frontal
gyrus
;
and
3
)
decreased
fractional
anisotropy
in
the
left
hemisphere
involving
the
temporal
lobe
and
peritrigonal
white
matter
.
No
differences
were
shown
by
cortical
curvature
and
sulcation
analyses
.
The
composite
array
of
brain
changes
observed
in
Kallmann
syndrome
patients
with
mirror
movements
likely
represents
the
anatomical-structural
underpinnings
leading
to
the
peculiar
derangement
of
the
complex
circuitry
committed
to
unilateral
hand
voluntary
movements
.
Diseases
Validation
Diseases presenting
"hand movements"
symptom
coats disease
kallmann syndrome
monosomy 21
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