Anatomical changes and pathophysiology of the brain in mucopolysaccharidosis disorders

Brian W. Bigger, David J. Begley, Daniela Virgintino, Alexey V. Pshezhetsky

Research output: Contribution to journalArticlepeer-review


Mucopolysaccharidosis (MPS) disorders are caused by deficiencies in lysosomal enzymes, leading to impaired glycosaminoglycan (GAG) degradation. The resulting GAG accumulation in cells and connective tissues ultimately results in widespread tissue and organ dysfunction. The seven MPS types currently described are heterogeneous and progressive disorders, with somatic and neurological manifestations depending on the type of accumulating GAG. Heparan sulfate (HS) is one of the GAGs stored in patients with MPS I, II, and VII and the main GAG stored in patients with MPS III. These disorders are associated with significant central nervous system (CNS) abnormalities that can manifest as impaired cognition, hyperactive and/or aggressive behavior, epilepsy, hydrocephalus, and sleeping problems. This review discusses the anatomical and pathophysiological CNS changes accompanying HS accumulation as well as the mechanisms believed to cause CNS abnormalities in MPS patients. The content of this review is based on presentations and discussions on these topics during a meeting on the brain in MPS attended by an international group of MPS experts.
Original languageEnglish
Pages (from-to)322-331
Number of pages10
JournalMolecular genetics and metabolism
Issue number4
Early online date10 Aug 2018
Publication statusPublished - Dec 2018


  • Gangliosides
  • Heparan sulfate proteoglycans
  • Mucopolysaccharidosis
  • Neuropathology


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