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. 2022 Aug;53(4):239-245.
doi: 10.1055/a-1754-1142. Epub 2022 Jan 28.

High Incidence of Hippocampal Abnormalities in Pediatric Patients with Congenital Cytomegalovirus Infection

Takenori Natsume  1 , Yuji Inaba  1   2   3 , Yoshihiro Osawa  1 , Tetsuhiro Fukuyama  1
Affiliations

High Incidence of Hippocampal Abnormalities in Pediatric Patients with Congenital Cytomegalovirus Infection

Takenori Natsume et al. Neuropediatrics. 2022 Aug.

Abstract

Background: Congenital cytomegalovirus (CMV) infection exhibits polymicrogyria, intracranial calcification, white matter lesions, and several types of intracranial lesions on magnetic resonance imaging (MRI), in addition to various developmental disorders and epilepsies. However, little is known on the presence of hippocampal abnormality in this affliction. The aim of this study is to clarify the incidence of hippocampal abnormality in congenital CMV infection.

Methods: Seventeen children diagnosed as having congenital CMV infection along with 17 age-matched pediatric controls were retrospectively evaluated by brain MRI and clinical review. The measurement data were obtained from conventional coronal sections in this retrospective study. Hippocampal malrotation (HIMAL) was defined as a hippocampal diameter ratio (i.e., the ratio of the height and width of the hippocampus) of >0.92.

Results: Hippocampal diameter ratios were significantly higher in the congenital CMV infection group (0.99 [range: 0.70-1.58] on the right side and 0.85 [range: 0.66-1.39] on the left side) than in controls (0.71 [range: 0.58-0.91] and 0.70 [range: 0.50-1.00], respectively). HIMAL was present in 17 of 34 hippocampi (50%) in the congenital CMV infection group and 1 of 34 hippocampi (2.9%) in controls. No correlations were detected between HIMAL and intelligence quotient/developmental quotient or the occurrences of autism spectrum disorder or epilepsy.

Conclusion: This study is the first to demonstrate the incidence of hippocampal abnormality to be significantly higher in congenital CMV infection patients than in age-matched controls. Further study is necessary to clarify the associations of HIMAL with other clinical and developmental features.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Representative figures of HIMAL and the normal hippocampus. ( A ) Measurement of hippocampal diameter ratio (HDR). HDR = (d, height of hippocampus) / (e, width of hippocampus). ( B ) Measurement of medial distance ratio (MDR). MDR = (f, distance from midline to medial hippocampus) / (g, distance from midline to temporal neocortex). Magnetic resonance image sections for measurement were at the slice perpendicular to the hippocampal axis, where the width of the hippocampus was maximal in the hippocampal body. ( C ) Sagittal images at the slice of the inferior horn of the lateral ventricle in HIMAL. Enlargement of the inferior horn of the lateral ventricle is evident (arrow head). HIMAL, hippocampal malrotation.
Fig. 2
Fig. 2
Comparisons of hippocampal diameter ratio between the congenital CMV infection group and control group. There were significant differences for both the ( A ) right side ( p  < 0.001) and ( B ) left side ( p  = 0.003). Box whisker plots show 3horizontal bars indicating the 75th percentile, median, and 25th percentile values, respectively. Vertical bars indicate the mean maximal and minimal values. cCMV, congenital cytomegalovirus infection.
See this image and copyright information in PMC

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