ArticleNeuropathology and applied neurobiology2022
Blinded review of hippocampal neuropathology in sudden unexplained death in childhood reveals inconsistent observations and similarities to explained paediatric deaths.
Article in Neuropathology and applied neurobiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Focal granule cell bilamination of the dentate gyrus-its prevalence across the human age spectrum and review of the literature.Journal of neuropathology and experimental neurology · 2025Review
- Raphe and ventrolateral medulla proteomics in sudden unexplained death in childhood with febrile seizure history.Acta neuropathologica · 2024Article
- Forensic neuropathology in the past decade: a scoping literature review.Forensic science, medicine, and pathology · 2024Article
- Video Analyses of Sudden Unexplained Deaths in Toddlers.Neurology · 2024Article
- Neurodevelopmental disorders: 2023 update.Free neuropathology · 2023Article
- Proteomic differences in hippocampus and cortex of sudden unexplained death in childhood.Acta neuropathologica · 2022Article
- Medullary Serotonergic Binding Deficits and Hippocampal Abnormalities in Sudden Infant Death Syndrome: One or Two Entities?Frontiers in pediatrics · 2021Article
- Neuropathology in the North American sudden unexpected death in epilepsy registry.Brain communications · 2021Article
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15 authors.
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Abstract
aimsHippocampal findings are implicated in the pathogenesis of sudden unexplained death in childhood (SUDC), although some studies have identified similar findings in sudden explained death in childhood (SEDC) cases. We blindly reviewed hippocampal histology in SUDC and SEDC controls.
methodsHippocampal haematoxylin and eosin (H&E) slides (n = 67; 36 SUDC, 31 controls) from clinical and forensic collaborators were evaluated by nine blinded reviewers: three board-certified forensic pathologists, three neuropathologists and three dual-certified neuropathologists/forensic pathologists.
resultsAmong nine reviewers, about 50% of hippocampal sections were rated as abnormal (52.5% SUDC, 53.0% controls), with no difference by cause of death (COD) (p = 0.16) or febrile seizure history (p = 0.90). There was little agreement among nine reviewers on whether a slide was within normal range (Fleiss' κ = 0.014, p = 0.47). Within reviewer groups, there were no findings more frequent in SUDC compared with controls, with variability in pyramidal neuron and dentate gyrus findings. Across reviewer groups, there was concordance for bilamination and granule cell loss. Neither SUDC (51.2%) nor control (55.9%) slides were considered contributory to determining COD (p = 0.41).
conclusionsThe lack of an association of hippocampal findings in SUDC and controls, as well as inconsistency of observations by multiple blinded reviewers, indicates discrepancy with previous studies and an inability to reliably identify hippocampal maldevelopment associated with sudden death (HMASD). These findings underscore a need for larger studies to standardise evaluation of hippocampal findings, identifying the range of normal variation and changes unrelated to SUDC or febrile seizures. Molecular studies may help identify novel immunohistological markers that inform on COD.
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