Abstract

BackgroundType II focal cortical dysplasias (FCDs) are malformations of cortical development characterised by the disorganisation of the normal neocortical structure and the presence of dysmorphic neurons (DNs) and balloon cells (BCs). The pathogenesis of FCDs has not yet been clearly established, although a number of histopathological patterns and molecular findings suggest that they may be due to abnormal neuronal and glial proliferation and migration processes.In order to gain further insights into cortical layering disruption and investigate the origin of DNs and BCs, we used in situ RNA hybridisation of human surgical specimens with a neuropathologically definite diagnosis of Type IIa/b FCD and a panel of layer-specific genes (LSGs) whose expression covers all cortical layers. We also used anti-phospho-S6 ribosomal protein antibody to investigate mTOR pathway hyperactivation.ResultsLSGs were expressed in both normal and abnormal cells (BCs and DNs) but their distribution was different. Normal-looking neurons, which were visibly reduced in the core of the lesion, were apparently located in the appropriate cortical laminae thus indicating a partial laminar organisation. On the contrary, DNs and BCs, labelled with anti-phospho-S6 ribosomal protein antibody, were spread throughout the cortex without any apparent rule and showed a highly variable LSG expression pattern. Moreover, LSGs did not reveal any differences between Type IIa and IIb FCD.ConclusionThese findings suggest the existence of hidden cortical lamination involving normal-looking neurons, which retain their ability to migrate correctly in the cortex, unlike DNs which, in addition to their morphological abnormalities and mTOR hyperactivation, show an altered migratory pattern.Taken together these data suggest that an external or environmental hit affecting selected precursor cells during the very early stages of cortical development may disrupt normal cortical development.

Highlights

  • Focal cortical dysplasias (FCDs) are malformations of cortical development that are frequently associated with intractable epilepsy and are characterised by cortical dyslamination and abnormal cell morphology [1]

  • The aim of this study was to investigate the expression of a panel of layer-specific genes (LSGs) covering all cortical layers (Cux2, Rorβ, Er81, Nurr1 and CTGF) in surgical specimens from a cohort of 20 patients with a neuropathological diagnosis of Type IIa/b focal cortical dysplasias (FCDs) in order to learn more about cortical layering disruption and the origin of dysmorphic neurons (DNs) and balloon cells (BCs)

  • On the basis of the magnetic resonance imaging (MRI) diagnostic criteria recently described by Colombo et al [29], the imaging investigation allowed a diagnosis of Type II FCD in 19 patients

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Summary

Introduction

Focal cortical dysplasias (FCDs) are malformations of cortical development that are frequently associated with intractable epilepsy and are characterised by cortical dyslamination and abnormal cell morphology [1]. The most recent classification [2] recognises three types of FCD, with Type II being divided into two subtypes on the basis of the presence of dysmorphic neurons (DNs) alone (type IIa) or DNs together with balloon cells (BCs; Type IIb). In both cases, cortical architecture is profoundly altered within the core of the lesion, where DNs and normal-sized pyramidal cells co-exist with an overall reduction in neuronal density [3,4]. Type II focal cortical dysplasias (FCDs) are malformations of cortical development characterised by the disorganisation of the normal neocortical structure and the presence of dysmorphic neurons (DNs) and balloon cells (BCs). We used anti-phospho-S6 ribosomal protein antibody to investigate mTOR pathway hyperactivation

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