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Research ArticlePediatric Neuroimaging
Open Access

Longitudinal Assessment of Neuroradiologic Features in Wolfram Syndrome

A. Samara, H.M. Lugar, T. Hershey and J.S. Shimony
American Journal of Neuroradiology December 2020, 41 (12) 2364-2369; DOI: https://doi.org/10.3174/ajnr.A6831
A. Samara
aFrom the Department of Psychiatry (A.S., H.M.L.)
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H.M. Lugar
aFrom the Department of Psychiatry (A.S., H.M.L.)
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T. Hershey
aFrom the Department of Psychiatry (A.S., H.M.L.)
bNeurology (T.H.)
cMallinckrodt Institute of Radiology (T.H., J.S.S.), Washington University School of Medicine, St. Louis, Missouri
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J.S. Shimony
cMallinckrodt Institute of Radiology (T.H., J.S.S.), Washington University School of Medicine, St. Louis, Missouri
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  • FIG 1.
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    FIG 1.

    Sagittal, coronal, and axial MR images show pons signal abnormalities as T1 hypointensity and T2 hyperintensity in a patient with Wolfram syndrome (white arrows). Brain stem atrophy is also evident on this MR image.

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    FIG 2.

    Examples of neuroradiologic findings in patients with Wolfram syndrome. A, Thinning of the optic chiasm (white box) as seen in coronal T1-weighted images (left, patient with Wolfram syndrome; right, healthy control). B, Abnormal PPBS signal (white circles) in midline sagittal T1-weighted images (from left to right, absent, diminished, and physiologic signal). C, White matter hyperintensities in FLAIR MR imaging (white arrowheads).

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    FIG 3.

    Marked (A) and mild (B) cerebellar atrophy in patients with Wolfram syndrome, as shown in sagittal, coronal, and axial T1-weighted MR images (white arrows), compared with a healthy control (C).

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    FIG 4.

    A, Frequency of neuroradiologic signs in patients with Wolfram syndrome at first and last visits. B, The relationship between age and the number of neuroradiologic signs. A line connecting a circle-shaped point (first visit) and a triangle-shaped point (last visit) represents each patient.

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    Table 1:

    The demographic and clinical characteristics in patients with Wolfram syndrome at first and last follow-up visitsa

    First Visit (n = 30)Last Visit (n = 30)
    Age (yr)14 ± 619 ± 6
    Duration of disease (yr)3 ± 38 ± 4
    Diabetes mellitus29 (97) 30 (100)
    Vision impairment28 (93) 28 (93)
    Hearing loss 20 (67)23 (77)
    Diabetes insipidus15 (50)19 (63)
    Bladder dysfunction13 (43)26 (86)
    • ↵a For the age and duration of disease, means and SDs are reported. For comorbid conditions, numbers and percentages are reported.

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    Table 2:

    Neuroradiologic findings in brain MR images in patients with Wolfram syndromea

    Radiologic SignFirst Visit (n = 30)Last Visit (n = 30)
    Negative PPBS signb16 (53)21 (70)
    T1/T2 pons signal abnormalities16 (53)20 (67)
    Optic nerve atrophy9 (30)24 (80)c
    White matter T2 hyperintensitiesd8 (27)10 (33)
    Cerebellum atrophy7 (23)21 (70)c
    • ↵a Numbers and percentages are reported.

    • ↵b Absent and diminished PPBS sign.

    • ↵c P value < .01 (χ2 test).

    • ↵d FLAIR images were not available to evaluate white matter T2 hyperintensity for 1 scan, and T2-weighted images were used instead.

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American Journal of Neuroradiology: 41 (12)
American Journal of Neuroradiology
Vol. 41, Issue 12
1 Dec 2020
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A. Samara, H.M. Lugar, T. Hershey, J.S. Shimony
Longitudinal Assessment of Neuroradiologic Features in Wolfram Syndrome
American Journal of Neuroradiology Dec 2020, 41 (12) 2364-2369; DOI: 10.3174/ajnr.A6831

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Longitudinal Assessment of Neuroradiologic Features in Wolfram Syndrome
A. Samara, H.M. Lugar, T. Hershey, J.S. Shimony
American Journal of Neuroradiology Dec 2020, 41 (12) 2364-2369; DOI: 10.3174/ajnr.A6831
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