Outcome of isolated agenesis of the corpus callosum: A population-based prospective study. (January 2018) - des Portes, Vincent
Abstract: Objectives: Neurodevelopmental outcome of apparently isolated agenesis of the corpus callosum (ACC) remains a major concern with uncertain prognosis. Despite "normal" IQ reported in a majority of patients, the rates of learning disabilities and severe outcome (ranging from 0% to 20%) are not clearly established. Methods: A large population-based series was investigated based on a longitudinal follow-up until school age, using Wechsler Intelligence scales at 3, 5, and 7 years. Results: Fifty women were referred to a tertiary referral unit for an "apparently" isolated ACC confirmed by ultrasound, foetal MRI, and karyotyping or array CGH. Twelve pregnancies were terminated, one foetus died in utero, one pregnancy outcome was unknown, and 36 babies were born. Two were lost to follow-up. Thirty-four children could be classified into three groups. Group 1 comprised two children (6%) with severe intellectual disability (one Mowat–Wilson syndrome and one ASD). Group 2 comprised 10 children (29%) who had learning disabilities and borderline intellectual functioning (VIQ and/or PIQ scores >70 and <85); three patients had hypopituitarism with additional MRI anomalies revealed after birth. Group 3 comprised 22 children (65%) who had both VIQ and PIQ >85 (−1 SD) with a normal school level. Longitudinal follow-up revealed weaker PIQ in younger children which improved with age. Conclusion: Our data indicate that intellectual ability is normal (IQ > 85) in approximately two thirds and borderline in just over a quarter of patients. However, a low risk of severe cognitive impairment exists, and this information should be shared with couples during prenatal counselling. Highlights: Neurodevelopmental outcome of apparently isolated agenesis of the corpus callosum remains a major concern in foetal medicine. The rates of both learning disabilities and severe outcome (ranging from 0% to 20%) are not clearly established. This study provides new data based on a large population-based longitudinal follow-up of 34 patients. 6% had severe Intellectual Disability, 29% borderline intellectual functioning and 65% strict normal IQ (>85). Visuospatial IQ was weaker in younger children.