Infantile tauopathies: Hemimegalencephaly; tuberous sclerosis complex; focal cortical dysplasia 2; ganglioglioma
Abstract
Tau is a normal microtubule-associated protein; mutations to phosphorylated or acetylated forms are neurotoxic. In many dementias of adult life tauopathies cause neuronal degeneration. Four developmental disorders of the fetal and infant brain are presented, each of which exhibits up-regulation of tau. Microtubules are cytoskeletal structures that provide the strands of mitotic spindles and specify cellular polarity, growth, lineage, differentiation, migration and axonal transport of molecules. Phosphorylated tau is abnormal in immature as in mature neurons. Several malformations are demonstrated in which upregulated tau may be important in pathogenesis. All produce highly epileptogenic cortical foci. The prototype infantile tauopathy is (1) hemimegalencephaly (HME); normal tau is degraded by a mutant AKT3 or AKT1 gene as the aetiology of focal somatic mosaicism in the periventricular neuroepithelium. HME may be isolated or associated with neurocutaneous syndromes, particularly epidermal naevus syndromes, also due to somatic mutations. Other tauopathies of early life include: (2) tuberous sclerosis complex; (3) focal cortical dysplasia type 2b (FCD2b); and (4) ganglioglioma, a tumor with dysplastic neurons and neoplastic glial cells. Pathological tau in these infantile cases alters cellular growth and architecture, synaptic function and tissue organization, but does not cause neuronal loss. All infantile tauopathies are defined neuropathologically as a tetrad of (1) dysmorphic and megalocytic neurons; (2) activation of the mTOR signaling pathway; (3) post-zygotic somatic mosaicism; and (4) upregulation of phosphorylated tau. HME and FCD2b may be the same disorder with different timing of the somatic mutation in the mitotic cycles of the neuroepithelium. HME and FCD2b may be the same disorder with different timing of the somatic mutation in the mitotic cycles of the neuroepithelium. Tauopathies must be considered in infantile neurological disease and no longer restricted to adult dementias. The mTOR inhibitor everolimus, already demonstrated to be effective in TSC, also may be a potential treatment in other infantile tauopathies.
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TSC is an infantile tauopathy accumulating phosphorylated tau.
“This is based on prior studies which have shown that TSC is an infantile tauopathy accumulating phosphorylated tau [10].”
From Tuberous sclerosis complex is a novel, amyloid-independent tauopathy associated with elevated phosphorylated 3R/4R tau aggregation (2022) · cites this paper as [10]
The compact NFTs observed are morphologically most like those seen in primary age-related tauopathy (PART), Alzheimer's disease (AD), and chronic traumatic encephalopathy (CTE), but the topographical distribution and immunostaining characteristics differ from these more common tauopathies.
“The compact NFTs observed are morphologically most like those seen in primary age-related tauopathy (PART) [4], Alzheimer’s disease (AD) [22], and chronic traumatic encephalopathy (CTE) [13, 14], but the topographical distribution and immunostaining characteristics differ from these more common tauopathies in several respects.”
From Tuberous sclerosis complex is associated with a novel human tauopathy (2023) · cites this paper as [22]
Overactivation of other mTOR pathway proteins is linked to tau pathology.
“Interestingly, an overactivation of other mTOR pathway proteins are also linked to tau pathology.22,23”
From Association of Cognitive and Behavioral Features Between Adults With Tuberous Sclerosis and Frontotemporal Dementia (2020) · cites this paper as [22]
TSC is considered one of a group of juvenile tauopathies.
“In fact, TSC is considered 1 of a group of juvenile tauopathies.22”
From Association of Cognitive and Behavioral Features Between Adults With Tuberous Sclerosis and Frontotemporal Dementia (2020) · cites this paper as [22]
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- Authors
- Sarnat, H. B., & Flores-Sarnat, L.
- Affiliations
- University of Calgary (CA)
- Corresponding author
- Sarnat, Harvey B.
- ORCID
- Sarnat, Harvey B.
- Venue
- Brain and Development
- Publisher
- Elsevier BV
- Published
- 2015-06
- Volume
- 37
- Issue
- 6
- Pages
- 553-562
- ISSN
- 0387-7604 (ISSN-L)
- OpenAlex
- W1989822657
- Semantic Scholar
- 69044d1f638de472b5a1c0813170f5d2a28edbe6
- Cited by
- 73
- References
- 105
- Citations by year
- 2025: 3 · 2024: 1 · 2023: 7 · 2022: 7 · 2021: 7 · 2020: 7 · 2019: 8 · 2018: 8 · 2017: 10 · 2016: 7 · 2015: 6 · 2014: 1 · 2012: 1
- FWCI
- 5.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Brain and Development (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
- Health Sciences › Medicine › Physiology › Tuberous Sclerosis Complex Research
- Keywords
- hemimegalencephaly, tuberous sclerosis complex, ganglioglioma, tau phosphorylation, somatic mosaicism, mTOR signaling, everolimus, neurocutaneous syndrome, developmental brain malformations
- MeSH terms
- Brain, Epilepsy, Humans, Infant, Male, Microtubules, Neurons, Phosphorylation, Tuberous Sclerosis, tau Proteins, Ganglioglioma, Tauopathies, TOR Serine-Threonine Kinases, Malformations of Cortical Development, Group I, Hemimegalencephaly
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