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Squitieri F, Esmaeilzadeh M, Ciarmiello A, Jankovic J. Caudate glucose hypometabolism in a subject carrying an unstable allele of intermediate CAG(33) repeat length in the Huntington's disease gene. Mov Disord 2011; 26:925-7. [PMID: 21370274 DOI: 10.1002/mds.23623] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 12/03/2010] [Accepted: 12/08/2010] [Indexed: 11/06/2022] Open
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52
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CHEN RM, HOU MT, CHANG NW, CHEN YT, TSAI JEFFREYJP. CUMULATIVE SPECTRAL REPEAT FINDER (CSRF): A SPECTRAL APPROACH FOR IDENTIFYING THE LENGTH OF REPEATS IN DNA SEQUENCES. INT J ARTIF INTELL T 2011. [DOI: 10.1142/s0218213011000073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Repetitive sequences of DNA are meaningful and of great importance to human functions. Previous researchers have proposed various methods to discover repetitive sequences in DNA sequence. However, the unknown lengths for repetitive sequences are usually predicted randomly or determined by rules of thumb rather than using a systematical criterion. We propose a new algorithm based on the cumulative Fourier spectral contents of DNA sequence to identify the candidate lengths of repetitive sequences or repeats in DNA sequences. After the candidate lengths of repeats are known, one can identify the repeats and their copy numbers using an exact method. Both of the simulated and real datasets are used to illustrate the performance of the proposed algorithm. The results are also compared to two well-known methods such as Spectral Repeat Finder (SRF) and Gibbs sampler. Furthermore, we demonstrate the use of CSRF in some well-known repeats-finding methods such as SRF, Gibbs sampler, MEME.
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Affiliation(s)
- R. M. CHEN
- Department of Computer Science and Information Engineering, National University of Tainan, Tainan, Taiwan 70005, Taiwan
| | - M. T. HOU
- Department of Computer Science and Information Engineering, National University of Tainan, Tainan, Taiwan 70005, Taiwan
| | - N. W. CHANG
- Department of Computer Science and Information Engineering, National University of Tainan, Tainan, Taiwan 70005, Taiwan
| | - Y. T. CHEN
- Department of Computer Science and Information Engineering, National University of Tainan, Tainan, Taiwan 70005, Taiwan
| | - JEFFREY J. P. TSAI
- Department of Computer Science, University of Illinois, Chicago, Chicago, IL 60607, USA
- Department of Bioinformatics, Asia University, Taichung, Taiwan 41354, Taiwan
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53
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Shannon KM. Huntington's disease - clinical signs, symptoms, presymptomatic diagnosis, and diagnosis. HANDBOOK OF CLINICAL NEUROLOGY 2011; 100:3-13. [PMID: 21496568 DOI: 10.1016/b978-0-444-52014-2.00001-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
HD is a complex illness, with a broad clinical picture that begins years before clear motor onset and evolves over decades to a terminal state of extreme disability. It challenges the resources of families and communities and the skills of medical and ancillary health care providers. A broader understanding of the phenotypes, progression, and genetic basis of HD may elevate the standard of care for these deserving patients.
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Affiliation(s)
- Kathleen M Shannon
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA.
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54
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Abstract
It has been more than 17 years since the causative mutation for Huntington's disease was discovered as the expansion of the triplet repeat in the N-terminal portion of the Huntingtin (HTT) gene. In the intervening time, researchers have discovered a great deal about Huntingtin's involvement in a number of cellular processes. However, the role of Huntingtin in the key pathogenic mechanism leading to neurodegeneration in the disease process has yet to be discovered. Here, we review the body of knowledge that has been uncovered since gene discovery and include discussions of the HTT gene, CAG triplet repeat expansion, HTT expression, protein features, posttranslational modifications, and many of its known protein functions and interactions. We also highlight potential pathogenic mechanisms that have come to light in recent years.
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Affiliation(s)
- Karen N McFarland
- Department of Neurology, University of Florida, Gainesville, FL 32610-0236, USA.
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55
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Reiner A, Dragatsis I, Dietrich P. Genetics and neuropathology of Huntington's disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2011; 98:325-72. [PMID: 21907094 PMCID: PMC4458347 DOI: 10.1016/b978-0-12-381328-2.00014-6] [Citation(s) in RCA: 155] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Huntington's disease (HD) is an autosomal dominant progressive neurodegenerative disorder that prominently affects the basal ganglia, leading to affective, cognitive, behavioral and motor decline. The basis of HD is a CAG repeat expansion to >35 CAG in a gene that codes for a ubiquitous protein known as huntingtin, resulting in an expanded N-terminal polyglutamine tract. The size of the expansion is correlated with disease severity, with increasing CAG accelerating the age of onset. A variety of possibilities have been proposed as to the mechanism by which the mutation causes preferential injury to the basal ganglia. The present chapter provides a basic overview of the genetics and pathology of HD.
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Affiliation(s)
- Anton Reiner
- Department of Anatomy & Neurobiology, The University of Tennessee Health Science Center, 855 Monroe Ave. Memphis, TN 38163, USA
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56
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Frank S. Tetrabenazine: the first approved drug for the treatment of chorea in US patients with Huntington disease. Neuropsychiatr Dis Treat 2010; 6:657-65. [PMID: 20957126 PMCID: PMC2951749 DOI: 10.2147/ndt.s6430] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Huntington disease (HD) is a dominantly inherited progressive neurological disease characterized by chorea, an involuntary brief movement that tends to flow between body regions. HD is typically diagnosed based on clinical findings in the setting of a family history and may be confirmed with genetic testing. Predictive testing is available to those at risk, but only experienced clinicians should perform the counseling and testing. Multiple areas of the brain degenerate mainly involving the neurotransmitters dopamine, glutamate, and γ-aminobutyric acid. Although pharmacotherapies theoretically target these neurotransmitters, few well-conducted trials for symptomatic or neuroprotective interventions yielded positive results. Tetrabenazine (TBZ) is a dopamine-depleting agent that may be one of the more effective agents for reducing chorea, although it has a risk of potentially serious adverse effects. Some newer antipsychotic agents, such as olanzapine and aripiprazole, may have adequate efficacy with a more favorable adverse-effect profile than older antipsychotic agents for treating chorea and psychosis. This review will address the epidemiology and diagnosis of HD as background for understanding potential pharmacological treatment options. Because TBZ is the only US Food and Drug Administration-approved medication in the United States for HD, the focus of this review will be on its pharmacology, efficacy, safety, and practical uses. There are no current treatments to change the course of HD, but education and symptomatic therapies can be effective tools for clinicians to use with patients and families affected by HD.
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Affiliation(s)
- Samuel Frank
- Boston University School of Medicine, 72 East Concord St, C329, Boston, Massachusetts, USA.
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57
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58
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Phibbs FT, Hedera P. UPDATE ON THE GENETICS OF MOVEMENT DISORDERS. Continuum (Minneap Minn) 2010; 16:77-95. [DOI: 10.1212/01.con.0000348901.09963.f5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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59
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60
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Abstract
Huntington's disease (HD) is a relentless neurodegenerative disease that results in profound disability through a triad of motor, cognitive and neuropsychiatric symptoms. At present, there are very few therapeutic interventions available with the exception of a limited number of drugs that offer mild symptomatic relief. Although the genetic basis of the disease has been identified, the mechanisms behind the cellular pathogenesis are still not clear and as a result no candidate drugs with the potential for disease modification have been found clinically until now. One of the major limitations in assessing the usefulness of drug treatments in HD is the lack of well-designed, double-blind, placebo-controlled clinical trials. Most studies have been open-label, using a small number of patients and tend to concentrate on the motor features of the disease, primarily the chorea. This review discusses the treatments now used for HD before evaluating the newer drugs at present being explored in both the clinic and in the laboratory in mouse models of the disease.
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Affiliation(s)
- Sarah L Mason
- Cambridge Centre for Brain Repair, ED Adrian Building, Forvie Site, Robinson Way, Cambridge CB20PY, UK.
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61
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Hendricks AE, Latourelle JC, Lunetta KL, Cupples LA, Wheeler V, MacDonald ME, Gusella JF, Myers RH. Estimating the probability of de novo HD cases from transmissions of expanded penetrant CAG alleles in the Huntington disease gene from male carriers of high normal alleles (27-35 CAG). Am J Med Genet A 2009; 149A:1375-81. [PMID: 19507258 PMCID: PMC2724761 DOI: 10.1002/ajmg.a.32901] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Huntington disease (HD) is a dominantly transmitted neurodegenerative disorder that arises from expansion of a CAG trinucleotide repeat on chromosome 4p16.3. CAG repeat allele lengths are defined as fully penetrant at >or=40, reduced penetrance at 36-39, high normal at 27-35, and normal at or=36) to offspring. We estimated the conditional probability of an offspring inheriting an expanded penetrant allele given a father with a high normal allele by applying probability definitions and rules to estimates of HD incidence, paternal birth rate, frequency of de novo HD, and frequency of high normal alleles in the general population. The estimated probability that a male high normal allele carrier will have an offspring with an expanded penetrant allele ranges from 1/6,241 to 1/951. These estimates may be useful in genetic counseling for male high normal allele carriers.
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Affiliation(s)
- Audrey E Hendricks
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts 02118, USA
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62
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Gupta A, Jankovic J. Spinocerebellar ataxia 8: variable phenotype and unique pathogenesis. Parkinsonism Relat Disord 2009; 15:621-6. [PMID: 19559641 DOI: 10.1016/j.parkreldis.2009.06.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Revised: 06/01/2009] [Accepted: 06/02/2009] [Indexed: 12/16/2022]
Abstract
Spinocerebellar ataxia 8 (SCA8), a triplet repeat expansion disorder, is genetically distinct from the other inherited ataxias, but its unusually variable phenotype can make its diagnosis difficult. In this review we describe 3 new cases of genetically verified SCA8 to highlight the broad clinical spectrum of symptoms observed with this disorder and to draw attention to the features of myoclonus and migraine headaches, which in the context of cerebellar ataxia warrants the clinician to consider SCA8 as a potential diagnosis. We also address the controversy surrounding the genetic testing approach for diagnosing SCA8. Finally, we evaluate the evidence that SCA8 may affect calcium channel function and that the presentation of episodic ataxia and migraines suggests a clinical and pathogenic overlap of SCA8 with the channelopathies.
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Affiliation(s)
- Amitabh Gupta
- Department of Neurology, University of Toronto, Toronto, ON, Canada M5T 2S8
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63
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Semaka A, Warby S, Leavitt BR, Hayden MR. Re: Autopsy-proven Huntington's disease with 29 trinucleotide repeats. Mov Disord 2009; 23:1794-5; author reply 1793. [PMID: 18548612 DOI: 10.1002/mds.21820] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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64
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Reynolds N. Re: Autopsy-proven Huntington's disease with 29 trinucleotide repeats. Mov Disord 2009; 23:1795-6; author reply 1793. [PMID: 18548610 DOI: 10.1002/mds.21821] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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65
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Phillips W, Shannon KM, Barker RA. The current clinical management of Huntington's disease. Mov Disord 2009; 23:1491-504. [PMID: 18581443 DOI: 10.1002/mds.21971] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Huntington's disease is a neurodegenerative condition, characterized by movement disorders, cognitive decline, and psychiatric disturbance. We review the pharmacological management of the various movement disorders associated with the disease, the cognitive decline and the commonly encountered behavioral disturbances. We discuss the nonclassical features of the disease, important in the management of these patients. Nonpharmacological support including genetic counseling and therapy and the importance of palliative care are also addressed. Finally, experimental approaches that may soon impact upon clinical practice are discussed.
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Affiliation(s)
- Wendy Phillips
- Cambridge Centre for Brain Repair, E.D. Adrian Building, Forvie Site, Cambridge, United Kingdom
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66
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Brocklebank D, Gayán J, Andresen JM, Roberts SA, Young AB, Snodgrass SR, Penney JB, Ramos-Arroyo MA, Cha JJ, Rosas HD, Hersch SM, Feigin A, Cherny SS, Wexler NS, Housman DE, Cardon LR. Repeat instability in the 27-39 CAG range of the HD gene in the Venezuelan kindreds: Counseling implications. Am J Med Genet B Neuropsychiatr Genet 2009; 150B:425-9. [PMID: 18712713 PMCID: PMC4636008 DOI: 10.1002/ajmg.b.30826] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The instability of the CAG repeat size of the HD gene when transmitted intergenerationally has critical implications for genetic counseling practices. In particular, CAG repeats between 27 and 35 have been the subject of debate based on small samples. To address this issue, we analyzed allelic instability in the Venezuelan HD kindreds, the largest and most informative families ascertained for HD. We identified 647 transmissions. Our results indicate that repeats in the 27-35 CAG range are highly stable. Out of 69 transmitted alleles in this range, none expand into any penetrant ranges. Contrastingly, 14% of alleles transmitted from the incompletely penetrant range (36-39 CAGs) expand into the completely penetrant range, characterized by alleles with 40 or more CAG repeats. At least 12 of the 534 transmissions from the completely penetrant range contract into the incompletely penetrant range of 36-39 CAG repeats. In these kindreds, none of the individuals with 27-39 CAGs were symptomatic, even though they ranged in age from 11 to 82 years. We expect these findings to be helpful in updating genetic counseling practices.
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Affiliation(s)
- D Brocklebank
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.
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67
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Herishanu YO, Parvari R, Pollack Y, Shelef I, Marom B, Martino T, Cannella M, Squitieri F. Huntington disease in subjects from an Israeli Karaite community carrying alleles of intermediate and expanded CAG repeats in the HTT gene: Huntington disease or phenocopy? J Neurol Sci 2009; 277:143-6. [DOI: 10.1016/j.jns.2008.11.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2008] [Revised: 10/01/2008] [Accepted: 11/10/2008] [Indexed: 11/29/2022]
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68
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Kenney C, Jankovic J. Reply: Autopsy-proven Huntington's disease with 29 trinucleotide repeats. Mov Disord 2008. [DOI: 10.1002/mds.21814] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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69
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Andrich J, Arning L, Wieczorek S, Kraus PH, Gold R, Saft C. Huntington's disease as caused by 34 CAG repeats. Mov Disord 2008; 23:879-81. [PMID: 18307262 DOI: 10.1002/mds.21958] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Huntington's disease (HD) is an autosomal dominantly inherited neurodegenerative disorder caused by an abnormal expansion of a polymorphic stretch of CAG repeats in the coding 5' part of the HD gene on chromosome 4p. Expansions of CAG blocks beyond 35 repeats are associated with the clinical presentation of HD. There is an intermediate range of rare alleles between 27 and 35 CAG repeats with a higher risk for further expansion in subsequent generations. Here, we report a 75-year-old male with clinical features of HD and 34 CAG repeat units.
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Affiliation(s)
- Jürgen Andrich
- Department of Neurology, St. Josef Hospital Bochum, Ruhr-University Bochum, Gudrunstr. 56, Bochum, Germany
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70
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71
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Abstract
Huntington disease (HD) is a progressive heredoneurodegenerative disease manifested by chorea and other hyperkinetic (dystonia, myoclonus, tics) and hypokinetic (parkinsonism) movement disorders. In addition, a variety of psychiatric and behavioral symptoms, along with cognitive decline, contribute significantly to the patient's disability. Because there are no effective neuroprotective therapies that delay the progression of the disease, symptomatic treatment remains the cornerstone of medical management. Several classes of medications have been used to ameliorate the various symptoms of HD, including typical and atypical neuroleptics, dopamine depleters, antidepressants, antiglutamatergic drugs, GABA agonists, antiepileptic medications, acetylcholinesterase inhibitors, and botulinum toxin. Recently, surgical approaches including pallidotomy, deep brain stimulation, and fetal cell transplants have been used for the symptomatic treatment of HD. The selected therapy must be customized to the needs of each patient, minimizing the potential adverse effects. The primary aim of this article is to review the role of the different therapies, both available and investigational, for the treatment of the motor, psychiatric, behavioral, and cognitive symptoms of HD, and to examine their impact on the patient's functionality and quality of life.
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Affiliation(s)
- Octavian R. Adam
- grid.39382.33000000012160926XParkinson’s Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, 6550 Fannin, Suite 1801, 77030 Houston, TX
| | - Joseph Jankovic
- grid.39382.33000000012160926XParkinson’s Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, 6550 Fannin, Suite 1801, 77030 Houston, TX
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