Evaluating brain white matter hyperintensity, IQ scores, and plasma neurofilament light chain concentration in early-treated patients with infantile-onset Pompe disease

• Published in: Genetics in medicine Vol. 25; no. 1; pp. 27 - 36
• Main Authors: Hsu, Yu-Kang, Chien, Yin-Hsiu, Shinn-Forng Peng, Steven, Hwu, Wuh-Liang, Lee, Wang-Tso, Lee, Ni-Chung, Po-Yu Huang, Eric, Weng, Wen-Chin
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2023
• Subjects: Adolescent; Adult; Biomarkers; Brain - diagnostic imaging; Brain - pathology; Brain MRI; Child; Child, Preschool; Glycogen Storage Disease Type II - drug therapy; Glycogen Storage Disease Type II - pathology; Humans; Infant; Infant, Newborn; Infantile-onset Pompe disease; Intermediate Filaments; IQ score; Magnetic Resonance Imaging - methods; Neuroaxonal injury; Neurofilament light chain; White Matter - diagnostic imaging; Young Adult; Neurofilament light chain; Infantile-onset Pompe disease; Brain MRI; Neuroaxonal injury; IQ score
• ISSN: 1098-3600; 1530-0366
• DOI: 10.1016/j.gim.2022.10.005

The study aimed to describe central nervous system (CNS) progression in patients with infantile-onset Pompe disease (IOPD) and explore the potential clinical impact and predictors. Patients with IOPD treated with enzyme replacement therapy were longitudinally followed with brain magnetic resonance imaging (MRI) and evaluation for IQ scores from 2004 to 2021. Investigation of CNS involvement focused on white matter (WM) abnormalities and was quantified using a scoring system for metachromatic leukodystrophy. MRI scores were correlated with plasma neurofilament light chain (NfL) concentration and IQ scores. A total of 19 patients who started enzyme replacement therapy at a mean age of 26 days were analyzed; the median age at last examination was 12.1 (range = 1.7-19) years. MRI abnormalities were found in all patients, from supratentorial central WM to U-fibers, then to infratentorial WM, and eventually to gray matter. MRI scores progressed (n = 16) at variable rates (range = 0.8-2.7/y) and were positively correlated with age (n = 16) and negatively correlated with IQ scores (n = 8). Plasma NfL concentration was positively correlated with MRI scores (r2 = 0.8569; P < .001; n = 13). Our results suggest that the progression of CNS involvement in IOPD may be associated with neuroaxonal injury and decreased IQ scores. NfL could serve as a biomarker for CNS involvement in IOPD.