Cerebellar atrophy in human and murine succinic semialdehyde dehydrogenase deficiency

Abstract

Human succinic semialdehyde dehydrogenase deficiency, an autosomal recessive disorder of γ-aminobutyric acid (GABA) catabolism, was modeled by a murine model sharing the phenotype of ataxia and seizures. Magnetic resonance imaging (MRI) with volumetry was obtained on 7 patients versus controls, and MRI with stereology was derived in 3 murine genotypes: null, wild-type, and heterozygous mutants. All patients had T1 hypointensity and T2 hyperintensity in globus pallidus, and 5 also had similar changes in subthalamic and cerebellar dentate nuclei. There was a trend for patients to have a smaller cerebellar vermis. Homozygous null mice had significantly lower total brain and cerebellar volumes than wild-types and heterozygotes. Stereology confirmed cerebellar atrophy and was otherwise normal in multiple regions. Cerebellar volume loss is present in the murine disorder with a trend for cerebellar atrophy in patients. Reduced cerebellar volume can reflect neurodegeneration and may be related to the clinical manifestations.

Figure 1

(A) Midsaggittal 1.5 T magnetic resonance imaging (MRI) demonstrating cerebellar atrophy predominantly affecting the midline vermis in subject with succinic semialdehyde dehydrogenase deficiency. (B) Axial 1.5 T MRI demonstrating cerebellar atrophy predominantly affecting the midline vermis in subject with succinic semialdehyde dehydrogenase deficiency.