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Evaluation of clinical findings and neurofibromatosis type 1 bright objects on brain magnetic resonance images of 60 Turkish patients with NF1 gene variants

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Abstract

Neurofibromatosis type 1 (NF1) is caused by mutations in the NF1 gene. This retrospective study aims to evaluate the clinical manifestations and brain magnetic resonance images (MRI) analysis in 60 genetically confirmed NF1 patients. The results of next-generation sequencing (NGS), Sanger sequencing, and MLPA of NF1 gene were evaluated. A total of 54 different variants were identified. Fourteen out of them were novel variants (25.9%). Patients who complied with NIH criteria had most frequently frameshift variants (11/32 patients), and those with only CALMs had missense variants (9/28 patients). Neurofibromatosis type 1 bright objects (NBOs) on T2-weighted MRI were detected in 42 patients (42/56; 75%). These brain lesions were detected mostly in basal ganglia and in cerebellar vermis. NBOs were detected more in the patients who complied with NIH criteria (80.6%) compared to those who were only CALMs (68%). While frameshift variants (33.3%) were the most common type variants in the patients who had NBOs, the most common variants were splicing (35.7%) and missense (35.7%) variants in the patients whose MRIs were normal. Frameshift variants (11/28 patients; 39.3%) were the most common in the patients with more than one brain locus involvement. Therefore, we consider that frameshift variants may be associated with increased incidence of NBOs and involvement of more than one brain locus. In addition, NBOs may occur less frequently in the patients with splicing variants. To our knowledge, this is the first study evaluated the relationship between NF1 gene variants and NBOs. Future studies may help us understand the etiology of NBOs.

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Authors and Affiliations

  1. Department of Medical Genetics, Dr. Behcet Uz Children’s Hospital, Izmir, Turkey

    Filiz Hazan

  2. Department of Pediatric Genetics, Dr. Behcet Uz Children’s Hospital, Izmir, Turkey

    Semra Gürsoy

  3. Department of Pediatric Neurology, Dr. Behcet Uz Children’s Hospital, Izmir, Turkey

    Aycan Unalp & Unsal Yılmaz

  4. Department of Pediatric Hematology and Oncology, Dr. Behcet Uz Children’s Hospital, Izmir, Turkey

    Bengü Demirağ & Sultan Aydin Köker

  5. Department of Medical Genetics, Tepecik Training and Research Hospital, Izmir, Turkey

    Berk Ozyılmaz & Kadri Murat Erdogan

  6. Department of Orthopaedics and Traumatology, Tepecik Training and Research Hospital, Izmir, Turkey

    Önder Kalenderer & Serkan Erkuş

  7. Department of Radiology, Alsancak Imaging Center, Izmir, Turkey

    Müge Gürçınar

  8. Division of Medical Genetics, Duzen Laboratories Group, Ankara, Turkey

    Ajlan Tükün

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  1. Filiz Hazan
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Correspondence to Sultan Aydin Köker.

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Hazan, F., Gürsoy, S., Unalp, A. et al. Evaluation of clinical findings and neurofibromatosis type 1 bright objects on brain magnetic resonance images of 60 Turkish patients with NF1 gene variants. Neurol Sci 42, 2045–2057 (2021). https://doi.org/10.1007/s10072-020-04988-0

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