101
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Shinar S, Balakumar P, Shah V, Chong K, Uster T, Chitayat D. Fetal Macrocephaly: A Novel Sonographic Finding in Congenital Myotonic Dystrophy. AJP Rep 2020; 10:e294-e299. [PMID: 33133763 PMCID: PMC7591365 DOI: 10.1055/s-0040-1716742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/04/2020] [Indexed: 11/15/2022] Open
Abstract
Objective Sonographic clues to the diagnosis of congenital myotonic dystrophy (CDM) are limited, particularly in the absence of family history of myotonic dystrophy (DM). We reviewed cases of CDM for unique prenatal findings. Study Design A single-center case series of fetuses with CMD with characteristic prenatal findings confirmed postnatally. Results Four fetuses with pre- or postnatally diagnosed CDM presented with macrocephaly in utero. While head measurements were appropriate for gestational age until midgestation, third-trimester head circumference and biparietal diameter were both >2 standard deviation (SD) above the mean in all. Abdominal and femur measurements were otherwise appropriate for gestation. Postnatally, the occipitofrontal circumference was >2 SD above the mean in all, confirming the diagnosis of macrocephaly. Conclusion CDM should be included in the differential diagnosis of third-trimester macrocephaly, especially in the presence of additional sonographic clues and when maternal medical history and physical examination are suggestive of DM.
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Affiliation(s)
- Shiri Shinar
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Ontario Fetal Centre, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Parry Balakumar
- Undergraduate school, McGill University, Montreal, Quebec, Canada
| | - Vibhuti Shah
- Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Karen Chong
- Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Tami Uster
- Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - David Chitayat
- Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada.,Division of Clinical Genetics and Metabolism, Department of Pediatrics, University of Toronto, The Hospital for Sickkids, Toronto, Ontario, Canada
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102
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Ramon-Duaso C, Rodríguez-Morató J, Selma-Soriano E, Fernández-Avilés C, Artero R, de la Torre R, Pozo ÓJ, Robledo P. Protective effects of mirtazapine in mice lacking the Mbnl2 gene in forebrain glutamatergic neurons: Relevance for myotonic dystrophy 1. Neuropharmacology 2020; 170:108030. [PMID: 32171677 DOI: 10.1016/j.neuropharm.2020.108030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 01/17/2023]
Abstract
Myotonic dystrophy type 1 (DM1) is a multisystemic disorder characterized by muscle weakness and wasting and by important central nervous system-related symptoms including impairments in executive functions, spatial abilities and increased anxiety and depression. The Mbnl2 gene has been implicated in several phenotypes consistent with DM1 neuropathology. In this study, we developed a tissue-specific knockout mouse model lacking the Mbnl2 gene in forebrain glutamatergic neurons to examine its specific contribution to the neurobiological perturbations related to DM1. We found that these mice exhibit long-term cognitive deficits and a depressive-like state associated with neuronal loss, increased microglia and decreased neurogenesis, specifically in the dentate gyrus (DG). Chronic treatment with the atypical antidepressant mirtazapine (3 and 10 mg/kg) for 21 days rescued these behavioral alterations, reduced inflammatory microglial overexpression, and reversed neuronal loss in the DG. We also show that mirtazapine re-established 5-HT1A and histaminergic H1 receptor gene expression in the hippocampus. Finally, metabolomics studies indicated that mirtazapine increased serotonin, noradrenaline, gamma-aminobutyric acid and adenosine production. These data suggest that loss of Mbnl2 gene in the glutamatergic neurons of hippocampus and cortex may underlie the most relevant DM1 neurobiological and behavioral features, and provide evidence that mirtazapine could be a novel potential candidate to alleviate these debilitating symptoms in DM1 patients.
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Affiliation(s)
- Carla Ramon-Duaso
- Integrative Pharmacology and Systems Neuroscience, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University (CEXS-UPF), Barcelona, Spain
| | - Jose Rodríguez-Morató
- Integrative Pharmacology and Systems Neuroscience, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University (CEXS-UPF), Barcelona, Spain; CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBERON), Instituto de Salud Carlos III, Madrid, Spain
| | - Estela Selma-Soriano
- Translational Genomics Group, Incliva Health Research Institute, Valencia, Spain; Interdisciplinary Research Structure for Biotechnology and Biomedicine (ERI BIOTECMED), University of Valencia, Valencia, Spain; CIPF-INCLIVA Joint Unit, Spain
| | - Cristina Fernández-Avilés
- Integrative Pharmacology and Systems Neuroscience, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Rubén Artero
- Translational Genomics Group, Incliva Health Research Institute, Valencia, Spain; Interdisciplinary Research Structure for Biotechnology and Biomedicine (ERI BIOTECMED), University of Valencia, Valencia, Spain; CIPF-INCLIVA Joint Unit, Spain
| | - Rafael de la Torre
- Integrative Pharmacology and Systems Neuroscience, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University (CEXS-UPF), Barcelona, Spain; CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBERON), Instituto de Salud Carlos III, Madrid, Spain
| | - Óscar J Pozo
- Integrative Pharmacology and Systems Neuroscience, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Patricia Robledo
- Integrative Pharmacology and Systems Neuroscience, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University (CEXS-UPF), Barcelona, Spain.
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103
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Nicolau S, Liewluck T, Milone M. Myopathies with finger flexor weakness: Not only inclusion-body myositis. Muscle Nerve 2020; 62:445-454. [PMID: 32478919 DOI: 10.1002/mus.26914] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/29/2020] [Accepted: 05/03/2020] [Indexed: 12/11/2022]
Abstract
Muscle disorders are characterized by differential involvement of various muscle groups. Among these, weakness predominantly affecting finger flexors is an uncommon pattern, most frequently found in sporadic inclusion-body myositis. This finding is particularly significant when the full range of histopathological findings of inclusion-body myositis is not found on muscle biopsy. Prominent finger flexor weakness, however, is also observed in other myopathies. It occurs commonly in myotonic dystrophy types 1 and 2. In addition, individual reports and small case series have documented finger flexor weakness in sarcoid and amyloid myopathy, and in inherited myopathies caused by ACTA1, CRYAB, DMD, DYSF, FLNC, GAA, GNE, HNRNPDL, LAMA2, MYH7, and VCP mutations. Therefore, the finding of finger flexor weakness requires consideration of clinical, myopathological, genetic, electrodiagnostic, and sometimes muscle imaging findings to establish a diagnosis.
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Affiliation(s)
- Stefan Nicolau
- Department of Neurology, Mayo Clinic, 200 1st Street SW, Rochester, Minnesota, 55905, USA
| | - Teerin Liewluck
- Department of Neurology, Mayo Clinic, 200 1st Street SW, Rochester, Minnesota, 55905, USA
| | - Margherita Milone
- Department of Neurology, Mayo Clinic, 200 1st Street SW, Rochester, Minnesota, 55905, USA
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104
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Peristeri E, Aloizou AM, Keramida P, Tsouris Z, Siokas V, Mentis AFA, Dardiotis E. Cognitive Deficits in Myopathies. Int J Mol Sci 2020; 21:ijms21113795. [PMID: 32471196 PMCID: PMC7312055 DOI: 10.3390/ijms21113795] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/23/2020] [Accepted: 05/25/2020] [Indexed: 02/07/2023] Open
Abstract
Myopathies represent a wide spectrum of heterogeneous diseases mainly characterized by the abnormal structure or functioning of skeletal muscle. The current paper provides a comprehensive overview of cognitive deficits observed in various myopathies by consulting the main libraries (Pubmed, Scopus and Google Scholar). This review focuses on the causal classification of myopathies and concomitant cognitive deficits. In most studies, cognitive deficits have been found after clinical observations while lesions were also present in brain imaging. Most studies refer to hereditary myopathies, mainly Duchenne muscular dystrophy (DMD), and myotonic dystrophies (MDs); therefore, most of the overview will focus on these subtypes of myopathies. Most recent bibliographical sources have been preferred.
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Affiliation(s)
- Eleni Peristeri
- Department of Neurology, Laboratory of Neurogenetics, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, PC 41110 Larissa, Greece; (E.P.); (A.-M.A.); (P.K.); (Z.T.); (V.S.)
| | - Athina-Maria Aloizou
- Department of Neurology, Laboratory of Neurogenetics, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, PC 41110 Larissa, Greece; (E.P.); (A.-M.A.); (P.K.); (Z.T.); (V.S.)
| | - Paraskevi Keramida
- Department of Neurology, Laboratory of Neurogenetics, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, PC 41110 Larissa, Greece; (E.P.); (A.-M.A.); (P.K.); (Z.T.); (V.S.)
| | - Zisis Tsouris
- Department of Neurology, Laboratory of Neurogenetics, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, PC 41110 Larissa, Greece; (E.P.); (A.-M.A.); (P.K.); (Z.T.); (V.S.)
| | - Vasileios Siokas
- Department of Neurology, Laboratory of Neurogenetics, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, PC 41110 Larissa, Greece; (E.P.); (A.-M.A.); (P.K.); (Z.T.); (V.S.)
| | - Alexios-Fotios A. Mentis
- Public Health Laboratories, Hellenic Pasteur Institute, PC 11521 Athens, Greece;
- Department of Microbiology, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, PC 41110 Larissa, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Laboratory of Neurogenetics, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, PC 41110 Larissa, Greece; (E.P.); (A.-M.A.); (P.K.); (Z.T.); (V.S.)
- Correspondence: ; Tel.:+ 30-241-350-1137
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105
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Tavanez JP, Caetano R, Branco C, Brito IM, Miragaia-Pereira A, Vassilevskaia T, Quina AS, Cunha C. Hepatitis delta virus interacts with splicing factor SF3B155 and alters pre-mRNA splicing of cell cycle control genes. FEBS J 2020; 287:3719-3732. [PMID: 32352217 DOI: 10.1111/febs.15352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/14/2019] [Accepted: 04/28/2020] [Indexed: 11/28/2022]
Abstract
Hepatitis delta virus (HDV) is the agent responsible for the most severe form of human viral hepatitis. The HDV genome consists of a single-stranded circular RNA molecule that encodes for one single protein, the delta antigen. Given its simplicity, HDV must make use of several host cellular proteins to accomplish its life cycle processes, including transcription, replication, post-transcriptional, and post-translational modifications. Consequently, identification of the interactions established between HDV components and host proteins assumes a pivotal interest in the search of novel therapeutic targets. Here, we used the yeast three-hybrid system to screen a human liver cDNA library to identify host proteins that interact with the HDV genomic RNA. One of the identified proteins corresponded to the splicing factor SF3B155, a component of the U2snRNP complex that is essential for the early recognition of 3' splice sites in the pre-mRNAs of human genes. We show that the interaction between the HDV genomic RNA and SF3B155 occurs in vivo and that the expression of HDV promotes changes in splicing of human genes whose alternative splicing is SF3B155-dependent. We further show that expression of HDV triggers alterations in several constitutive and alternative splicing events in the tumor suppressor RBM5 transcript, with consequent reduction of its protein levels. This is the first description that HDV expression promotes changes in the splicing of human genes, and we suggest that the HDV-induced alternative splicing changes, through SF3B155 sequester, may contribute for the early progression to hepatocellular carcinoma characteristic of HDV-infected patients.
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Affiliation(s)
- João Paulo Tavanez
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa (UNL), Portugal
| | - Rafael Caetano
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa (UNL), Portugal
| | - Cristina Branco
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa (UNL), Portugal
| | - Inês Margarida Brito
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa (UNL), Portugal
| | - Ana Miragaia-Pereira
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa (UNL), Portugal
| | - Tatiana Vassilevskaia
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa (UNL), Portugal
| | - Ana Sofia Quina
- CESAM - Centre for Environmental and Marine Studies, Universidade de Aveiro, Portugal.,Faculdade de Ciências da Universidade de Lisboa, Portugal
| | - Celso Cunha
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa (UNL), Portugal
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106
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Spaziani M, Semeraro A, Bucci E, Rossi F, Garibaldi M, Papassifachis MA, Pozza C, Anzuini A, Lenzi A, Antonini G, Radicioni AF. Hormonal and metabolic gender differences in a cohort of myotonic dystrophy type 1 subjects: a retrospective, case-control study. J Endocrinol Invest 2020; 43:663-675. [PMID: 31786795 DOI: 10.1007/s40618-019-01156-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 11/23/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE Myotonic dystrophy type 1 (DM1) is a genetic disorder caused by CTG expansion in the DMPK gene. The aim was to investigate the endocrine and metabolic aspects of DM1. PATIENTS AND METHODS Retrospective, case-control study. We compared pituitary, thyroid, adrenal, gonadal and liver function and glycolipid metabolism of 63 DM1 patients against 100 control subjects. Given age-related differences, 2 further subgroups were created to investigate the pituitary-gonadal axis: < 41 (1a) and ≥ 41 (1b) years old for male subjects and < 46 (2a) and ≥ 46 (2b) years old for female subjects. Testicular and thyroid ultrasounds were also performed in the DM1 group. RESULTS FT3 and FT4 were significantly lower in DM1 men than controls, while for both males and females, thyroglobulin, ACTH and cortisol were significantly higher in the DM1 group. Gonadotropin levels were significantly higher and inhibin B and DHEA-S levels significantly lower in DM1 patients than controls for both male subgroups. Testosterone and SHBG were significantly higher in controls than in patients for subgroup 1a. Prolactin was significantly higher in patients in subgroups 1b, while testosterone was lower in subgroup 2a than in age-matched female controls. A correlation between the number of CTG repeats and the percentage of male hypogonadal subjects was found. Finally, there was a worse glucose and lipid pattern and significantly higher transaminase and gamma-GT levels in both male and female patients. CONCLUSIONS The high frequency of endocrine and metabolic abnormalities in DM1 highlights the importance of endocrine monitoring to enable the prompt initiation of a suitable therapy.
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Affiliation(s)
- M Spaziani
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Level - 1, Room 33, Rome, Italy.
- Centre for Rare Diseases, Policlinico Umberto I, Rome, Italy.
| | - A Semeraro
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Level - 1, Room 33, Rome, Italy
- Centre for Rare Diseases, Policlinico Umberto I, Rome, Italy
| | - E Bucci
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - F Rossi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Level - 1, Room 33, Rome, Italy
- Centre for Rare Diseases, Policlinico Umberto I, Rome, Italy
| | - M Garibaldi
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - M A Papassifachis
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Level - 1, Room 33, Rome, Italy
- Centre for Rare Diseases, Policlinico Umberto I, Rome, Italy
| | - C Pozza
- Centre for Rare Diseases, Policlinico Umberto I, Rome, Italy
| | - A Anzuini
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Level - 1, Room 33, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Level - 1, Room 33, Rome, Italy
| | - G Antonini
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - A F Radicioni
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Level - 1, Room 33, Rome, Italy
- Centre for Rare Diseases, Policlinico Umberto I, Rome, Italy
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107
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Kurkiewicz A, Cooper A, McIlwaine E, Cumming SA, Adam B, Krahe R, Puymirat J, Schoser B, Timchenko L, Ashizawa T, Thornton CA, Rogers S, McClure JD, Monckton DG. Towards development of a statistical framework to evaluate myotonic dystrophy type 1 mRNA biomarkers in the context of a clinical trial. PLoS One 2020; 15:e0231000. [PMID: 32287265 PMCID: PMC7156058 DOI: 10.1371/journal.pone.0231000] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 03/13/2020] [Indexed: 12/11/2022] Open
Abstract
Myotonic dystrophy type 1 (DM1) is a rare genetic disorder, characterised by muscular dystrophy, myotonia, and other symptoms. DM1 is caused by the expansion of a CTG repeat in the 3'-untranslated region of DMPK. Longer CTG expansions are associated with greater symptom severity and earlier age at onset. The primary mechanism of pathogenesis is thought to be mediated by a gain of function of the CUG-containing RNA, that leads to trans-dysregulation of RNA metabolism of many other genes. Specifically, the alternative splicing (AS) and alternative polyadenylation (APA) of many genes is known to be disrupted. In the context of clinical trials of emerging DM1 treatments, it is important to be able to objectively quantify treatment efficacy at the level of molecular biomarkers. We show how previously described candidate mRNA biomarkers can be used to model an effective reduction in CTG length, using modern high-dimensional statistics (machine learning), and a blood and muscle mRNA microarray dataset. We show how this model could be used to detect treatment effects in the context of a clinical trial.
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Affiliation(s)
- Adam Kurkiewicz
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Anneli Cooper
- Institute of Molecular Cell and Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Emily McIlwaine
- Institute of Molecular Cell and Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Sarah A. Cumming
- Institute of Molecular Cell and Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Berit Adam
- Institute of Molecular Cell and Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Ralf Krahe
- Department of Genetics, University of Texas, MD Anderson Cancer Center, Houston, TX, United States of America
| | - Jack Puymirat
- Laboratory of Human Genetics, CHUL Medical Research Centre, University of Laval, Quebec City, QC, Canada
| | - Benedikt Schoser
- Department of Neurology, Friedrich Baur Institute, Ludwig Maximilians University, Munich, Germany
| | - Lubov Timchenko
- Department of Pediatrics, Division of Neurology, Cincinnati Children’s Hosptial, University of Cincinnati, College of Medicine, Cincinnati, Ohio, United States of America
| | | | - Charles A. Thornton
- University of Rochester, Medical Center School of Medicine and Dentistry, Rochester, New York, United States of America
| | - Simon Rogers
- School of Computing Science, University of Glasgow, Glasgow, United Kingdom
| | - John D. McClure
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Darren G. Monckton
- Institute of Molecular Cell and Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
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108
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Subramony SH, Wymer JP, Pinto BS, Wang ET. Sleep disorders in myotonic dystrophies. Muscle Nerve 2020; 62:309-320. [DOI: 10.1002/mus.26866] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 03/15/2020] [Accepted: 03/16/2020] [Indexed: 12/25/2022]
Affiliation(s)
- Sub H. Subramony
- Department of NeurologyUniversity of Florida College of Medicine, McKnight Brain Institute Gainesville Florida
| | - James P. Wymer
- Department of NeurologyUniversity of Florida College of Medicine, McKnight Brain Institute Gainesville Florida
| | - Belinda S. Pinto
- Department of Molecular Genetics & Microbiology, Center for NeuroGenetics, UF Genetics InstituteUniversity of Florida College of Medicine Gainesville Florida
| | - Eric T. Wang
- Department of Molecular Genetics & Microbiology, Center for NeuroGenetics, UF Genetics InstituteUniversity of Florida College of Medicine Gainesville Florida
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109
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García-Puga M, Saenz-Antoñanzas A, Fernández-Torrón R, Munain ALD, Matheu A. Myotonic Dystrophy type 1 cells display impaired metabolism and mitochondrial dysfunction that are reversed by metformin. Aging (Albany NY) 2020; 12:6260-6275. [PMID: 32310829 PMCID: PMC7185118 DOI: 10.18632/aging.103022] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 03/03/2020] [Indexed: 12/26/2022]
Abstract
Myotonic dystrophy type 1 (DM1; MIM #160900) is an autosomal dominant disorder, clinically characterized by progressive muscular weakness and multisystem degeneration. The broad phenotypes observed in patients with DM1 resemble the appearance of a multisystem accelerated aging process. However, the molecular mechanisms underlying these phenotypes remain largely unknown. In this study, we characterized the impact of metabolism and mitochondria on fibroblasts and peripheral blood mononuclear cells (PBMCs) derived from patients with DM1 and healthy individuals. Our results revealed a decrease in oxidative phosphorylation system (OXPHOS) activity, oxygen consumption rate (OCR), ATP production, energy metabolism, and mitochondrial dynamics in DM1 fibroblasts, as well as increased accumulation of reactive oxygen species (ROS). PBMCs of DM1 patients also displayed reduced mitochondrial dynamics and energy metabolism. Moreover, treatment with metformin reversed the metabolic and mitochondrial defects as well as additional accelerated aging phenotypes, such as impaired proliferation, in DM1-derived fibroblasts. Our results identify impaired cell metabolism and mitochondrial dysfunction as important drivers of DM1 pathophysiology and, therefore, reveal the efficacy of metformin treatment in a pre-clinical setting.
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Affiliation(s)
- Mikel García-Puga
- Neuroscience Area, Biodonostia Health Research Institute, San Sebastian, Spain.,Cellular Oncology Group, Biodonostia Health Research Institute, San Sebastian, Spain
| | | | - Roberto Fernández-Torrón
- Neuroscience Area, Biodonostia Health Research Institute, San Sebastian, Spain.,Neurology Department, Donostia University Hospital, OSAKIDETZA, San Sebastian, Spain.,CIBERNED, Carlos III Institute, Madrid, Spain
| | - Adolfo Lopez de Munain
- Neuroscience Area, Biodonostia Health Research Institute, San Sebastian, Spain.,Neurology Department, Donostia University Hospital, OSAKIDETZA, San Sebastian, Spain.,CIBERNED, Carlos III Institute, Madrid, Spain.,Faculty of Medicine and Nursery, Department of Neurosciences, University of the Basque Country, San Sebastian, Spain
| | - Ander Matheu
- Cellular Oncology Group, Biodonostia Health Research Institute, San Sebastian, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain.,CIBERfes, Carlos III Institute, Madrid, Spain
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110
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Gutiérrez Gutiérrez G, Díaz-Manera J, Almendrote M, Azriel S, Eulalio Bárcena J, Cabezudo García P, Camacho Salas A, Casanova Rodríguez C, Cobo A, Díaz Guardiola P, Fernández-Torrón R, Gallano Petit M, García Pavía P, Gómez Gallego M, Gutiérrez Martínez A, Jericó I, Kapetanovic García S, López de Munaín Arregui A, Martorell L, Morís de la Tassa G, Moreno Zabaleta R, Muñoz-Blanco J, Olivar Roldán J, Pascual Pascual S, Peinado Peinado R, Pérez H, Poza Aldea J, Rabasa M, Ramos A, Rosado Bartolomé A, Rubio Pérez M, Urtizberea J, Zapata-Wainberg G, Gutiérrez-Rivas E. Guía clínica para el diagnóstico y seguimiento de la distrofia miotónica tipo 1, DM1 o enfermedad de Steinert. Neurologia 2020; 35:185-206. [DOI: 10.1016/j.nrl.2019.01.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 01/05/2019] [Indexed: 01/18/2023] Open
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111
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Gutiérrez Gutiérrez G, Díaz-Manera J, Almendrote M, Azriel S, Eulalio Bárcena J, Cabezudo García P, Camacho Salas A, Casanova Rodríguez C, Cobo A, Díaz Guardiola P, Fernández-Torrón R, Gallano Petit M, García Pavía P, Gómez Gallego M, Gutiérrez Martínez A, Jericó I, Kapetanovic García S, López de Munaín Arregui A, Martorell L, Morís de la Tassa G, Moreno Zabaleta R, Muñoz-Blanco J, Olivar Roldán J, Pascual Pascual S, Peinado Peinado R, Pérez H, Poza Aldea J, Rabasa M, Ramos A, Rosado Bartolomé A, Rubio Pérez M, Urtizberea J, Zapata-Wainberg G, Gutiérrez-Rivas E. Clinical guide for the diagnosis and follow-up of myotonic dystrophy type 1, MD1 or Steinert's disease. NEUROLOGÍA (ENGLISH EDITION) 2020. [DOI: 10.1016/j.nrleng.2019.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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112
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Lenzoni S, Bozzoni V, Burgio F, de Gelder B, Wennberg A, Botta A, Pegoraro E, Semenza C. Recognition of emotions conveyed by facial expression and body postures in myotonic dystrophy (DM). Cortex 2020; 127:58-66. [PMID: 32169676 DOI: 10.1016/j.cortex.2020.02.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 10/04/2019] [Accepted: 02/07/2020] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Neuromuscular diseases may be of neuropsychological interest insofar as they may affect representations based on embodied cognition theories. Previous studies have shown impaired ability to recognize facial emotions and an association between facial emotion recognition and visuospatial abilities in myotonic dystrophy type 1 (DM1) patients. Here we examined the ability of both DM1 and DM2 patients to recognize emotions expressed by body postures and its relation, and their association with cognitive performance. METHODS Participants included 34 DM1 patients, 8 DM2 patients, and 24 healthy control subjects. Emotional recognition ability was assessed through two computerized matching tasks (face and bodies). A neuropsychological battery was used to measure cognition in three domains and global cognition. We used univariate and adjusted linear regression models to investigate the association between cognition and emotion recognition performance. RESULTS DM patients (combined DM1 and DM2) performed worse on emotional facial expression (p = .006) and body posture (p = .004) accuracy measures than healthy controls. In linear regression models, DM patients' facial expression accuracy was associated with executive function (p = .013) and visuospatial (p < .001) z-scores. Body posture accuracy was associated with visuospatial (p = .001) and memory (p = .012) z-scores. There were no associations among controls or between cognition and reaction time. DISCUSSION These findings suggest that impaired emotional recognition among DM patients is also extended to emotions conveyed by body postures. Consistent with embodied cognition theories, people affected in their body and its movement may have impaired sensorimotor representation in ways that have yet to be fully understood.
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Affiliation(s)
- Sabrina Lenzoni
- Department of Neurosciences (Padova Neuroscience Center), Università degli Studi di Padova, Italy.
| | - Virginia Bozzoni
- Department of Neurosciences (Padova Neuroscience Center), Università degli Studi di Padova, Italy.
| | | | | | - Alexandra Wennberg
- Department of Neurosciences (Padova Neuroscience Center), Università degli Studi di Padova, Italy.
| | - Annalisa Botta
- Department of Biomedicine and Prevention, Medical Genetics Section, University of Rome Tor Vergata, Rome, Italy.
| | - Elena Pegoraro
- Department of Neurosciences (Padova Neuroscience Center), Università degli Studi di Padova, Italy.
| | - Carlo Semenza
- Department of Neurosciences (Padova Neuroscience Center), Università degli Studi di Padova, Italy; IRCCS San Camillo Hospital, Venice, Italy.
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113
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Wang J, Liu M, Shang W, Chen Z, Peng G. Myotonic dystrophy type 1 accompanied with normal pressure hydrocephalus: a case report and literature review. BMC Neurol 2020; 20:53. [PMID: 32050933 PMCID: PMC7017494 DOI: 10.1186/s12883-020-01636-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/05/2020] [Indexed: 01/13/2023] Open
Abstract
Background Myotonic dystrophy type 1 (DM1) is the most common disease that can cause muscle weakness and atrophy among adults. Normal pressure hydrocephalus (NPH) is characterized by the triad of gait disturbance, cognitive impairment and urinary incontinence. The association between DM1 and NPH is extremely rare. We report a Chinese female patient with DM1 in association with NPH. Case presentation The patient presented with a history of 3-year of walking instability and cognitive impairment. Her brain MRI showed ventriculomegaly with normal cerebrospinal fluid (CSF) pressure and the CSF tap-test was positive, which indicated the diagnosis of probable NPH. DM1 was confirmed by genetic testing. Conclusions Four patients with DM1-NPH association were found before. The association between NPH and DM1 may not be just a coincidence, NPH may occur in DM1 later in life and it is vital to recognize the association as a shunt surgery may improve patients’ quality of life.
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Affiliation(s)
- Junyang Wang
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China
| | - Ming Liu
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China
| | - Wenjie Shang
- Department of Neurology, Shengzhou People's Hospital, 666 Dangui Road, Shengzhou, 312403, China
| | - Zhongqin Chen
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China
| | - Guoping Peng
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China.
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114
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Jeng CJ, Fu SJ, You CY, Peng YJ, Hsiao CT, Chen TY, Tang CY. Defective Gating and Proteostasis of Human ClC-1 Chloride Channel: Molecular Pathophysiology of Myotonia Congenita. Front Neurol 2020; 11:76. [PMID: 32117034 PMCID: PMC7026490 DOI: 10.3389/fneur.2020.00076] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 01/22/2020] [Indexed: 01/17/2023] Open
Abstract
The voltage-dependent ClC-1 chloride channel, whose open probability increases with membrane potential depolarization, belongs to the superfamily of CLC channels/transporters. ClC-1 is almost exclusively expressed in skeletal muscles and is essential for stabilizing the excitability of muscle membranes. Elucidation of the molecular structures of human ClC-1 and several CLC homologs provides important insight to the gating and ion permeation mechanisms of this chloride channel. Mutations in the human CLCN1 gene, which encodes the ClC-1 channel, are associated with a hereditary skeletal muscle disease, myotonia congenita. Most disease-causing CLCN1 mutations lead to loss-of-function phenotypes in the ClC-1 channel and thus increase membrane excitability in skeletal muscles, consequently manifesting as delayed relaxations following voluntary muscle contractions in myotonic subjects. The inheritance pattern of myotonia congenita can be autosomal dominant (Thomsen type) or recessive (Becker type). To date over 200 myotonia-associated ClC-1 mutations have been identified, which are scattered throughout the entire protein sequence. The dominant inheritance pattern of some myotonia mutations may be explained by a dominant-negative effect on ClC-1 channel gating. For many other myotonia mutations, however, no clear relationship can be established between the inheritance pattern and the location of the mutation in the ClC-1 protein. Emerging evidence indicates that the effects of some mutations may entail impaired ClC-1 protein homeostasis (proteostasis). Proteostasis of membrane proteins comprises of biogenesis at the endoplasmic reticulum (ER), trafficking to the surface membrane, and protein turn-over at the plasma membrane. Maintenance of proteostasis requires the coordination of a wide variety of different molecular chaperones and protein quality control factors. A number of regulatory molecules have recently been shown to contribute to post-translational modifications of ClC-1 and play critical roles in the ER quality control, membrane trafficking, and peripheral quality control of this chloride channel. Further illumination of the mechanisms of ClC-1 proteostasis network will enhance our understanding of the molecular pathophysiology of myotonia congenita, and may also bring to light novel therapeutic targets for skeletal muscle dysfunction caused by myotonia and other pathological conditions.
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Affiliation(s)
- Chung-Jiuan Jeng
- Institute of Anatomy and Cell Biology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Ssu-Ju Fu
- Institute of Anatomy and Cell Biology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Physiology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chia-Ying You
- Department of Physiology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Jheng Peng
- Department of Physiology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Cheng-Tsung Hsiao
- Department of Physiology, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tsung-Yu Chen
- Center for Neuroscience, University of California, Davis, Davis, CA, United States
| | - Chih-Yung Tang
- Department of Physiology, College of Medicine, National Taiwan University, Taipei, Taiwan.,College of Medicine, Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan
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115
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An J, Xie Z, Jia F, Wang Z, Yuan Y, Zhang J, Fang J. Quantitative coordination evaluation for screening children with Duchenne muscular dystrophy. CHAOS (WOODBURY, N.Y.) 2020; 30:023116. [PMID: 32113230 DOI: 10.1063/1.5126116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 01/08/2020] [Indexed: 06/10/2023]
Abstract
As the potential for a treatment of Duchenne muscular dystrophy (DMD) grows, the need for methods for the early diagnosis of DMD becomes more and more important. Clinical experiences suggest that children with DMD will show some lack of motor ability in the early stage when compared with children at the same age, especially in balance and coordination abilities. Is it possible to quantify the coordination differences between DMD and typically developing (TD) children to achieve the goal of screening for DMD diseases? In this study, we introduced a Local Manifold Structure Mapping approach in phase space and extracted a novel index, relative coupling coefficient (RCC), from gait pattern signals, which were acquired by wearable accelerometers to evaluate the coordination of children with DMD during a walking task. Furthermore, we compared the RCC of 100 children with DMD and 100 TD children in four different age groups and verified the feasibility and reliability of the proposed indices to distinguish children with TD from DMD. T-test results show that, for all age groups, children of the same age with DMD and TD show significant differences in RCC (p < 0.001). Moreover, RCC comprehensively reflects that the coordination ability of DMD patients under walking tasks gradually decreases with age, which is consistent with clinical experience. As a functional biomarker extracted in the phase space of the gait data, the proposed coupling degree index RCC could sensitively distinguish between DMD and TD children at the same age and provide alternative insights and potentially valuable tools for the screening of DMD.
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Affiliation(s)
- Jian An
- Academy of Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
| | - Zhiying Xie
- Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - Fan Jia
- Academy of Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
| | - Zhaoxia Wang
- Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - Yun Yuan
- Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - Jue Zhang
- Academy of Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
| | - Jing Fang
- Academy of Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
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116
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Swinnen B, Robberecht W, Van Den Bosch L. RNA toxicity in non-coding repeat expansion disorders. EMBO J 2020; 39:e101112. [PMID: 31721251 PMCID: PMC6939197 DOI: 10.15252/embj.2018101112] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 09/30/2019] [Accepted: 10/09/2019] [Indexed: 12/11/2022] Open
Abstract
Several neurodegenerative disorders like amyotrophic lateral sclerosis (ALS) and spinocerebellar ataxia (SCA) are caused by non-coding nucleotide repeat expansions. Different pathogenic mechanisms may underlie these non-coding repeat expansion disorders. While gain-of-function mechanisms, such as toxicity associated with expression of repeat RNA or toxicity associated with repeat-associated non-ATG (RAN) products, are most frequently connected with these disorders, loss-of-function mechanisms have also been implicated. We review the different pathways that have been linked to non-coding repeat expansion disorders such as C9ORF72-linked ALS/frontotemporal dementia (FTD), myotonic dystrophy, fragile X tremor/ataxia syndrome (FXTAS), SCA, and Huntington's disease-like 2. We discuss modes of RNA toxicity focusing on the identity and the interacting partners of the toxic RNA species. Using the C9ORF72 ALS/FTD paradigm, we further explore the efforts and different methods used to disentangle RNA vs. RAN toxicity. Overall, we conclude that there is ample evidence for a role of RNA toxicity in non-coding repeat expansion diseases.
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Affiliation(s)
- Bart Swinnen
- Department of NeurosciencesExperimental NeurologyLeuven Brain Institute (LBI)KU Leuven – University of LeuvenLeuvenBelgium
- Laboratory of NeurobiologyVIB, Center for Brain & Disease ResearchLeuvenBelgium
- Department of NeurologyUniversity Hospitals LeuvenLeuvenBelgium
| | - Wim Robberecht
- Department of NeurosciencesExperimental NeurologyLeuven Brain Institute (LBI)KU Leuven – University of LeuvenLeuvenBelgium
- Laboratory of NeurobiologyVIB, Center for Brain & Disease ResearchLeuvenBelgium
- Department of NeurologyUniversity Hospitals LeuvenLeuvenBelgium
| | - Ludo Van Den Bosch
- Department of NeurosciencesExperimental NeurologyLeuven Brain Institute (LBI)KU Leuven – University of LeuvenLeuvenBelgium
- Laboratory of NeurobiologyVIB, Center for Brain & Disease ResearchLeuvenBelgium
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117
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Christou M, Wengel J, Sokratous K, Kyriacou K, Nikolaou G, Phylactou LA, Mastroyiannopoulos NP. Systemic Evaluation of Chimeric LNA/2'-O-Methyl Steric Blockers for Myotonic Dystrophy Type 1 Therapy. Nucleic Acid Ther 2019; 30:80-93. [PMID: 31873063 PMCID: PMC7133450 DOI: 10.1089/nat.2019.0811] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Myotonic dystrophy type 1 (DM1) is a dominantly inherited, multisystemic disorder characterized clinically by delayed muscle relaxation and weakness. The disease is caused by a CTG repeat expansion in the 3′ untranslated region (3′ UTR) of the DMPK gene, which leads to the expression of a toxic gain-of-function mRNA. The expanded CUG repeat mRNA sequesters the MBNL1 splicing regulator in nuclear-retained foci structures, resulting in loss of protein function and disruption of alternative splicing homeostasis. In this study, we used CAG repeat antisense oligonucleotides (ASOs), composed of locked nucleic acid (LNA)- and 2′-O-methyl (2′OMe)-modified bases in a chimeric design, to alleviate CUGexpanded-mediated toxicity. Chimeric 14–18mer LNA/2′OMe oligonucleotides, exhibiting an LNA incorporation of ∼33%, significantly ameliorated the misregulated alternative splicing of Mbnl1-dependent exons in primary DM1 mouse myoblasts and tibialis anterior muscles of DM1 mice. Subcutaneous delivery of 14mer and 18mer LNA/2′OMe chimeras in DM1 mice resulted in high levels of accumulation in all tested skeletal muscles, as well as in the diaphragm and heart tissue. Despite the efficient delivery, chimeric LNA/2′OMe oligonucleotides were not able, even at a high-dosage regimen (400 mg/kg/week), to correct the misregulated splicing of Serca1 exon 22 in skeletal muscles. Nevertheless, oligonucleotide doses were well-tolerated as determined by histological and plasma biochemistry analyses. Our results provide proof of concept that inhibition of MBNL1 sequestration by systemic delivery of a steric-blocking ASO is extremely challenging, considering the large number of target sites that need to be occupied per RNA molecule. Although not suitable for DM1 therapy, chimeric LNA/2′OMe oligonucleotides could prove to be highly beneficial for other diseases, such as Duchenne muscular dystrophy, that require inhibition of a single target site per RNA molecule.
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Affiliation(s)
- Melina Christou
- Department of Molecular Genetics, Function & Therapy, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus.,The Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Jesper Wengel
- Department of Physics, Chemistry and Pharmacy, Biomolecular Nanoscale Engineering Center, University of Southern Denmark, Odense M, Denmark
| | - Kleitos Sokratous
- Department of Electron Microscopy and Molecular Pathology, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus.,Bioinformatics Group, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Kyriacos Kyriacou
- The Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus.,Department of Electron Microscopy and Molecular Pathology, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Georgios Nikolaou
- Veterinary Diagnostic Laboratory, Vet Ex Machina Ltd, Nicosia, Cyprus
| | - Leonidas A Phylactou
- Department of Molecular Genetics, Function & Therapy, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus.,The Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Nikolaos P Mastroyiannopoulos
- Department of Molecular Genetics, Function & Therapy, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus.,The Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
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118
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Dosage effect of multiple genes accounts for multisystem disorder of myotonic dystrophy type 1. Cell Res 2019; 30:133-145. [PMID: 31853004 PMCID: PMC7015062 DOI: 10.1038/s41422-019-0264-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 11/09/2019] [Indexed: 12/19/2022] Open
Abstract
Multisystem manifestations in myotonic dystrophy type 1 (DM1) may be due to dosage reduction in multiple genes induced by aberrant expansion of CTG repeats in DMPK, including DMPK, its neighboring genes (SIX5 or DMWD) and downstream MBNL1. However, direct evidence is lacking. Here, we develop a new strategy to generate mice carrying multigene heterozygous mutations to mimic dosage reduction in one step by injection of haploid embryonic stem cells with mutant Dmpk, Six5 and Mbnl1 into oocytes. The triple heterozygous mutant mice exhibit adult-onset DM1 phenotypes. With the additional mutation in Dmwd, the quadruple heterozygous mutant mice recapitulate many major manifestations in congenital DM1. Moreover, muscle stem cells in both models display reduced stemness, providing a unique model for screening small molecules for treatment of DM1. Our results suggest that the complex symptoms of DM1 result from the reduced dosage of multiple genes.
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119
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Passeri E, Sansone VA, Sconfienza LM, Messina C, Meola G, Corbetta S. Fragility fractures and bone mineral density in male patients affected by type 1 and type 2 myotonic dystrophy. Neuromuscul Disord 2019; 30:28-34. [PMID: 31902642 DOI: 10.1016/j.nmd.2019.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 11/13/2019] [Accepted: 11/15/2019] [Indexed: 12/18/2022]
Abstract
Myotonic dystrophy is a multisystemic disorder affecting skeletal muscle. Male patients have an increased risk of fractures and develop a number of endocrine/metabolic impairments known to adversely affect bone health. The aim of this study was primarily to determine the occurrence of fragility fractures and the bone mineralization status (lumbar spine, hip and total body by dual X-ray absorptiometry) in 36 male patients affected with type 1 myotonic dystrophy and 13 male patients affected with type 2 myotonic dystrophy. Fragility fractures occurred in 15 type 1 and 7 type 2 myotonic dystrophy in non-classical osteoporotic sites, such as metatarses. Hip osteopenia was the most frequent finding, particularly in type 2 (n = 6) than type 1 myotonic dystrophy patients (n = 1), while osteoporosis was rare. Patients with type 1 myotonic dystrophy presented higher total body bone mass density than patients with type 2 myotonic dystrophy and healthy controls and lumbar spine was associated positively with the severity of the disease. Gonadic failure, with low testosterone and reduced INSL3 levels, visceral adiposity and insulin resistance correlated with reduced body mass index in both type 1 and type 2 myotonic dystrophic patients. The independent determinant of fragility fractures were low total body mass index, low blood testosterone and low global muscle mass.
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MESH Headings
- Absorptiometry, Photon
- Adult
- Body Mass Index
- Bone Density
- Bone Diseases, Metabolic/diagnostic imaging
- Bone Diseases, Metabolic/etiology
- Bone Diseases, Metabolic/metabolism
- Bone Diseases, Metabolic/pathology
- Fractures, Bone/diagnostic imaging
- Fractures, Bone/etiology
- Fractures, Bone/metabolism
- Fractures, Bone/pathology
- Humans
- Male
- Middle Aged
- Muscle, Skeletal/pathology
- Myotonic Dystrophy/complications
- Myotonic Dystrophy/metabolism
- Myotonic Dystrophy/pathology
- Osteoporosis/diagnostic imaging
- Osteoporosis/etiology
- Osteoporosis/metabolism
- Osteoporosis/pathology
- Pelvic Bones/diagnostic imaging
- Pelvic Bones/pathology
- Testosterone/blood
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Affiliation(s)
- E Passeri
- Endocrinology and Diabetology Service, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, Milan 20161, Italy
| | - V A Sansone
- Neurorehabilitation Unit, University of Milan, The NEMO (NEuroMuscular Omniservice) Clinical Center, Milan 20162, Italy; Department of Biomedical Sciences for Health, University of Milan, Milan 20133, Italy
| | - L M Sconfienza
- Department of Biomedical Sciences for Health, University of Milan, Milan 20133, Italy; Diagnostic and Interventional Radiology Unit, IRCCS Istituto Ortopedico Galeazzi, Milan 20161, Italy
| | - C Messina
- Department of Biomedical Sciences for Health, University of Milan, Milan 20133, Italy; Diagnostic and Interventional Radiology Unit, IRCCS Istituto Ortopedico Galeazzi, Milan 20161, Italy
| | - G Meola
- Department of Biomedical Sciences for Health, University of Milan, Milan 20133, Italy; Neurology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan 20097, Italy
| | - S Corbetta
- Endocrinology and Diabetology Service, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, Milan 20161, Italy; Department of Biomedical, Surgical and Odontoiatric Sciences, University of Milan, Milan 20122, Italy.
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120
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Gois Beghini D, Iwao Horita S, Monteiro da Fonseca Cardoso L, Anastacio Alves L, Nagaraju K, Henriques-Pons A. A Promising Future for Stem-Cell-Based Therapies in Muscular Dystrophies-In Vitro and In Vivo Treatments to Boost Cellular Engraftment. Int J Mol Sci 2019; 20:ijms20215433. [PMID: 31683627 PMCID: PMC6861917 DOI: 10.3390/ijms20215433] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 08/28/2019] [Accepted: 09/23/2019] [Indexed: 02/06/2023] Open
Abstract
Muscular dystrophies (MD) are a group of genetic diseases that lead to skeletal muscle wasting and may affect many organs (multisystem). Unfortunately, no curative therapies are available at present for MD patients, and current treatments mainly address the symptoms. Thus, stem-cell-based therapies may present hope for improvement of life quality and expectancy. Different stem cell types lead to skeletal muscle regeneration and they have potential to be used for cellular therapies, although with several limitations. In this review, we propose a combination of genetic, biochemical, and cell culture treatments to correct pathogenic genetic alterations and to increase proliferation, dispersion, fusion, and differentiation into new or hybrid myotubes. These boosted stem cells can also be injected into pretreate recipient muscles to improve engraftment. We believe that this combination of treatments targeting the limitations of stem-cell-based therapies may result in safer and more efficient therapies for MD patients. Matricryptins have also discussed.
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Affiliation(s)
- Daniela Gois Beghini
- Laboratório de Inovações em Terapias, Ensino e Bioprodutos, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro (RJ) 21040-900, Brazil.
| | - Samuel Iwao Horita
- Laboratório de Inovações em Terapias, Ensino e Bioprodutos, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro (RJ) 21040-900, Brazil.
| | | | - Luiz Anastacio Alves
- Laboratório de Comunicação Celular, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro (RJ) 21040-900, Brazil.
| | - Kanneboyina Nagaraju
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, Binghamton University, New York, NY 13902, USA.
| | - Andrea Henriques-Pons
- Laboratório de Inovações em Terapias, Ensino e Bioprodutos, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro (RJ) 21040-900, Brazil.
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121
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Naro A, Portaro S, Milardi D, Billeri L, Leo A, Militi D, Bramanti P, Calabrò RS. Paving the way for a better understanding of the pathophysiology of gait impairment in myotonic dystrophy: a pilot study focusing on muscle networks. J Neuroeng Rehabil 2019; 16:116. [PMID: 31533780 PMCID: PMC6751609 DOI: 10.1186/s12984-019-0590-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/09/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND A proper rehabilitation program targeting gait is mandatory to maintain the quality of life of patients with Myotonic dystrophy type 1 (DM1). Assuming that gait and balance impairment simply depend on the degree of muscle weakness is potentially misleading. In fact, the involvement of the Central Nervous System (CNS) in DM1 pathophysiology calls into account the deterioration of muscle coordination in gait impairment. Our study aimed at demonstrating the presence and role of muscle connectivity deterioration in patients with DM1 by a CNS perspective by investigating signal synergies using a time-frequency spectral coherence and multivariate analyses on lower limb muscles while walking upright. Further, we sought at determining whether muscle networks were abnormal secondarily to the muscle impairment or primarily to CNS damage (as DM1 is a multi-system disorder also involving the CNS). In other words, muscle network deterioration may depend on a weakening in signal synergies (that express the neural drive to muscles deduced from surface electromyography data). METHODS Such an innovative approach to estimate muscle networks and signal synergies was carried out in seven patients with DM1 and ten healthy controls (HC). RESULTS Patients with DM1 showed a commingling of low and high frequencies among muscle at both within- and between-limbs level, a weak direct neural coupling concerning inter-limb coordination, a modest network segregation, high integrative network properties, and an impoverishment in the available signal synergies, as compared to HCs. These network abnormalities were independent from muscle weakness and myotonia. CONCLUSIONS Our results suggest that gait impairment in patients with DM1 depends also on a muscle network deterioration that is secondary to signal synergy deterioration (related to CNS impairment). This suggests that muscle network deterioration may be a primary trait of DM1 rather than a maladaptive mechanism to muscle degeneration. This information may be useful concerning the implementation of proper rehabilitative strategies in patients with DM1. It will be indeed necessary not only addressing muscle weakness but also gait-related muscle connectivity to improve functional ambulation in such patients.
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Affiliation(s)
- Antonino Naro
- IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, SS 113, Ctr. Casazza, 98124 Messina, Italy
| | - Simona Portaro
- IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, SS 113, Ctr. Casazza, 98124 Messina, Italy
| | - Demetrio Milardi
- IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, SS 113, Ctr. Casazza, 98124 Messina, Italy
| | - Luana Billeri
- IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, SS 113, Ctr. Casazza, 98124 Messina, Italy
| | - Antonino Leo
- IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, SS 113, Ctr. Casazza, 98124 Messina, Italy
| | | | - Placido Bramanti
- IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, SS 113, Ctr. Casazza, 98124 Messina, Italy
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, SS 113, Ctr. Casazza, 98124 Messina, Italy
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Ausems CRM, Raaijmakers RHL, van den Broek WJAA, Willemse M, van Engelen BGM, Wansink DG, van Bokhoven H. Intrinsic Myogenic Potential of Skeletal Muscle-Derived Pericytes from Patients with Myotonic Dystrophy Type 1. MOLECULAR THERAPY-METHODS & CLINICAL DEVELOPMENT 2019; 15:120-132. [PMID: 31649961 PMCID: PMC6804802 DOI: 10.1016/j.omtm.2019.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 09/04/2019] [Indexed: 12/21/2022]
Abstract
Pericytes are multipotent, vessel-associated progenitors that exhibit high proliferative capacity, can cross the blood-muscle barrier, and have the ability to home to muscle tissue and contribute to myogenesis. Consequently, pericyte-based therapies hold great promise for muscular dystrophies. A complex multi-system disorder exhibiting muscular dystrophy for which pericytes might be a valuable cell source is myotonic dystrophy type 1 (DM1). DM1 is caused by an unstable (CTG)n repeat in the DMPK gene and characterized by skeletal muscle weakness, muscle wasting, and myotonia. We have successfully isolated alkaline phosphatase-positive pericytes from skeletal muscle of DM1 patients and a transgenic mouse model. Intranuclear (CUG)n RNA foci, a pathogenic DM1 hallmark, were identified in human and mouse pericytes. Notably, pericytes from DM1 patients maintained similar growth parameters and innate myogenic characteristics in vitro compared to cells from unaffected controls. Our in vitro results thus demonstrate the potential of pericytes to ameliorate muscle features in DM1 in a therapeutic setting.
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Affiliation(s)
- Cornelia Rosanne Maria Ausems
- Department of Human Genetics, Radboud University Medical Center, Donders lnstitute for Brain Cognition and Behavior, 6525 GA Nijmegen, the Netherlands.,Department of Neurology, Radboud University Medical Center, Donders lnstitute for Brain Cognition and Behavior, 6500 HB Nijmegen, the Netherlands.,Department of Cell Biology, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, 6525 GA Nijmegen, the Netherlands
| | - Renée Henrica Lamberta Raaijmakers
- Department of Human Genetics, Radboud University Medical Center, Donders lnstitute for Brain Cognition and Behavior, 6525 GA Nijmegen, the Netherlands.,Department of Neurology, Radboud University Medical Center, Donders lnstitute for Brain Cognition and Behavior, 6500 HB Nijmegen, the Netherlands.,Department of Cell Biology, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, 6525 GA Nijmegen, the Netherlands
| | | | - Marieke Willemse
- Department of Cell Biology, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, 6525 GA Nijmegen, the Netherlands
| | - Baziel Gerardus Maria van Engelen
- Department of Neurology, Radboud University Medical Center, Donders lnstitute for Brain Cognition and Behavior, 6500 HB Nijmegen, the Netherlands
| | - Derick Gert Wansink
- Department of Cell Biology, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, 6525 GA Nijmegen, the Netherlands
| | - Hans van Bokhoven
- Department of Human Genetics, Radboud University Medical Center, Donders lnstitute for Brain Cognition and Behavior, 6525 GA Nijmegen, the Netherlands
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123
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The mutation of Transportin 3 gene that causes limb girdle muscular dystrophy 1F induces protection against HIV-1 infection. PLoS Pathog 2019; 15:e1007958. [PMID: 31465518 PMCID: PMC6715175 DOI: 10.1371/journal.ppat.1007958] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 07/03/2019] [Indexed: 01/10/2023] Open
Abstract
The causative mutation responsible for limb girdle muscular dystrophy 1F (LGMD1F) is one heterozygous single nucleotide deletion in the stop codon of the nuclear import factor Transportin 3 gene (TNPO3). This mutation causes a carboxy-terminal extension of 15 amino acids, producing a protein of unknown function (TNPO3_mut) that is co-expressed with wild-type TNPO3 (TNPO3_wt). TNPO3 has been involved in the nuclear transport of serine/arginine-rich proteins such as splicing factors and also in HIV-1 infection through interaction with the viral integrase and capsid. We analyzed the effect of TNPO3_mut on HIV-1 infection using PBMCs from patients with LGMD1F infected ex vivo. HIV-1 infection was drastically impaired in these cells and viral integration was reduced 16-fold. No significant effects on viral reverse transcription and episomal 2-LTR circles were observed suggesting that the integration of HIV-1 genome was restricted. This is the second genetic defect described after CCR5Δ32 that shows strong resistance against HIV-1 infection.
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124
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Berends J, Tieleman AA, Horlings CGC, Smulders FHP, Voermans NC, van Engelen BGM, Raaphorst J. High incidence of falls in patients with myotonic dystrophy type 1 and 2: A prospective study. Neuromuscul Disord 2019; 29:758-765. [PMID: 31540818 DOI: 10.1016/j.nmd.2019.08.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 08/14/2019] [Accepted: 08/21/2019] [Indexed: 01/01/2023]
Abstract
We aimed to examine the incidence as well as the circumstances and the consequences of falling in adult patients with myotonic dystrophy type 1 and 2 (DM1/DM2). We performed a prospective cohort study in 209 subjects, of which 102 had DM1, 42 had DM2 and 65 healthy controls. An assessment of their falls was carried out during 100 consecutive days. In addition, falls during the previous year were reported. The primary outcome measure was the number of self-reported falls per participant during these 100 days. The secondary outcome measures included self-reported causes, circumstances and consequences of the falls. Mean (SD) falls per participant in 100 days was seven- to eightfold higher in patients with DM1 (0.74 (0.14)) and DM2 (0.62 (0.20)) compared to the controls (0.09 (0.04); p < 0.001)). Sixteen percent of DM1 and 17% of DM2 patients fell at least twice. Two-thirds of the falls occurred inside. Fifty percent of falls resulted in an injury, including a head trauma in four patients. Compared to non-fallers, those patients who fell were older (DM1/DM2), had a lower DM1-Activ score (DM1), had more muscle weakness (DM1), and reported less confidence in balance (DM1). This study demonstrates a high incidence and clinical relevance of falling in patients with DM1 and DM2. Fall prevention strategies in both DM1 and DM2 should focus on adaptations of the home environment and the patient's interaction in this environment.
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Affiliation(s)
- Joost Berends
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Alide A Tieleman
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Corinne G C Horlings
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Neurology, Medical University Innsbruck, Austria.
| | - Fran H P Smulders
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Nicol C Voermans
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Baziel G M van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Joost Raaphorst
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands; Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, Netherlands
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125
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Reddy K, Jenquin JR, Cleary JD, Berglund JA. Mitigating RNA Toxicity in Myotonic Dystrophy using Small Molecules. Int J Mol Sci 2019; 20:E4017. [PMID: 31426500 PMCID: PMC6720693 DOI: 10.3390/ijms20164017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/13/2019] [Accepted: 08/16/2019] [Indexed: 12/26/2022] Open
Abstract
This review, one in a series on myotonic dystrophy (DM), is focused on the development and potential use of small molecules as therapeutics for DM. The complex mechanisms and pathogenesis of DM are covered in the associated reviews. Here, we examine the various small molecule approaches taken to target the DNA, RNA, and proteins that contribute to disease onset and progression in myotonic dystrophy type 1 (DM1) and 2 (DM2).
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Affiliation(s)
- Kaalak Reddy
- The RNA Institute, University at Albany-SUNY, Albany, NY 12222, USA.
| | - Jana R Jenquin
- Center for NeuroGenetics and Biochemistry & Molecular Biology, University of Florida, Gainesville, FL 32608, USA
| | - John D Cleary
- The RNA Institute, University at Albany-SUNY, Albany, NY 12222, USA
| | - J Andrew Berglund
- The RNA Institute, University at Albany-SUNY, Albany, NY 12222, USA.
- Center for NeuroGenetics and Biochemistry & Molecular Biology, University of Florida, Gainesville, FL 32608, USA.
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Lo Scrudato M, Poulard K, Sourd C, Tomé S, Klein AF, Corre G, Huguet A, Furling D, Gourdon G, Buj-Bello A. Genome Editing of Expanded CTG Repeats within the Human DMPK Gene Reduces Nuclear RNA Foci in the Muscle of DM1 Mice. Mol Ther 2019; 27:1372-1388. [PMID: 31253581 PMCID: PMC6697452 DOI: 10.1016/j.ymthe.2019.05.021] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 05/22/2019] [Accepted: 05/29/2019] [Indexed: 12/21/2022] Open
Abstract
Myotonic dystrophy type 1 (DM1) is caused by a CTG repeat expansion located in the 3' UTR of the DMPK gene. Expanded DMPK transcripts aggregate into nuclear foci and alter the function of RNA-binding proteins, leading to defects in the alternative splicing of numerous pre-mRNAs. To date, there is no curative treatment for DM1. Here we investigated a gene-editing strategy using the CRISPR-Cas9 system from Staphylococcus aureus (Sa) to delete the CTG repeats in the human DMPK locus. Co-expression of SaCas9 and selected pairs of single-guide RNAs (sgRNAs) in cultured DM1 patient-derived muscle line cells carrying 2,600 CTG repeats resulted in targeted DNA deletion, ribonucleoprotein foci disappearance, and correction of splicing abnormalities in various transcripts. Furthermore, a single intramuscular injection of recombinant AAV vectors expressing CRISPR-SaCas9 components in the tibialis anterior muscle of DMSXL (myotonic dystrophy mouse line carrying the human DMPK gene with >1,000 CTG repeats) mice decreased the number of pathological RNA foci in myonuclei. These results establish the proof of concept that genome editing of a large trinucleotide expansion is feasible in muscle and may represent a useful strategy to be further developed for the treatment of myotonic dystrophy.
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Affiliation(s)
- Mirella Lo Scrudato
- Genethon, INSERM UMR_S951, Univ Evry, Université Paris Saclay, 91000 Evry, France
| | - Karine Poulard
- Genethon, INSERM UMR_S951, Univ Evry, Université Paris Saclay, 91000 Evry, France
| | - Célia Sourd
- Genethon, INSERM UMR_S951, Univ Evry, Université Paris Saclay, 91000 Evry, France
| | - Stéphanie Tomé
- INSERM UMR 1163, Institut Imagine, Université Paris Descartes-Sorbonne Paris Cité, 75015 Paris, France
| | - Arnaud F Klein
- INSERM, Association Institut de Myologie, Centre de Recherche en Myologie, Sorbonne Université, 75013 Paris, France
| | - Guillaume Corre
- Genethon, INSERM UMR_S951, Univ Evry, Université Paris Saclay, 91000 Evry, France
| | - Aline Huguet
- INSERM UMR 1163, Institut Imagine, Université Paris Descartes-Sorbonne Paris Cité, 75015 Paris, France
| | - Denis Furling
- INSERM, Association Institut de Myologie, Centre de Recherche en Myologie, Sorbonne Université, 75013 Paris, France
| | - Geneviève Gourdon
- INSERM UMR 1163, Institut Imagine, Université Paris Descartes-Sorbonne Paris Cité, 75015 Paris, France
| | - Ana Buj-Bello
- Genethon, INSERM UMR_S951, Univ Evry, Université Paris Saclay, 91000 Evry, France.
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127
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Lee KY, Chang HC, Seah C, Lee LJ. Deprivation of Muscleblind-Like Proteins Causes Deficits in Cortical Neuron Distribution and Morphological Changes in Dendritic Spines and Postsynaptic Densities. Front Neuroanat 2019; 13:75. [PMID: 31417371 PMCID: PMC6682673 DOI: 10.3389/fnana.2019.00075] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/11/2019] [Indexed: 02/06/2023] Open
Abstract
Myotonic dystrophy (Dystrophia Myotonica; DM) is the most common adult-onset muscular dystrophy and its brain symptoms seriously affect patients’ quality of life. It is caused by extended (CTG)n expansions at 3′-UTR of DMPK gene (DM type 1, DM1) or (CCTG)n repeats in the intron 1 of CNBP gene (DM type 2, DM2) and the sequestration of Muscleblind-like (MBNL) family proteins by transcribed (CUG)n RNA hairpin is the main pathogenic mechanism for DM. The MBNL proteins are splicing factors regulating posttranscriptional RNA during development. Previously, Mbnl knockout (KO) mouse lines showed molecular and phenotypic evidence that recapitulate DM brains, however, detailed morphological study has not yet been accomplished. In our studies, control (Mbnl1+/+; Mbnl2cond/cond; Nestin-Cre−/−), Mbnl2 conditional KO (2KO, Mbnl1+/+; Mbnl2cond/cond; Nestin-Cre+/−) and Mbnl1/2 double KO (DKO, Mbnl1ΔE3/ΔE3; Mbnl2cond/cond; Nestin-Cre+/−) mice were generated by crossing three individual lines. Immunohistochemistry for evaluating density and distribution of cortical neurons; Golgi staining for depicting the dendrites/dendritic spines; and electron microscopy for analyzing postsynaptic ultrastructure were performed. We found distributional defects in cortical neurons, reduction in dendritic complexity, immature dendritic spines and alterations of postsynaptic densities (PSDs) in the mutants. In conclusion, loss of function of Mbnl1/2 caused fundamental defects affecting neuronal distribution, dendritic morphology and postsynaptic architectures that are reminiscent of predominantly immature and fetal phenotypes in DM patients.
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Affiliation(s)
- Kuang-Yung Lee
- Department of Neurology, Chang Gung Memorial Hospital, Keelung, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ho-Ching Chang
- Graduate Institute of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Carol Seah
- Department of Neurology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Li-Jen Lee
- Graduate Institute of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan.,Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan.,Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
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128
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Alsaggaf R, St George DMM, Zhan M, Pfeiffer RM, Wang Y, Anderson LA, Liu Z, Koshiol J, Bauer AJ, Wagner KR, Greene MH, Amr S, Gadalla SM. Benign tumors in myotonic dystrophy type I target disease-related cancer sites. Ann Clin Transl Neurol 2019; 6:1510-1518. [PMID: 31402615 PMCID: PMC6689687 DOI: 10.1002/acn3.50856] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 07/03/2019] [Indexed: 01/07/2023] Open
Abstract
Objectives Recent evidence showed that myotonic dystrophy type I (DM1) patients are at increased risk of certain cancers, but the risk of benign tumors is unknown. We compared the risk of benign tumors in DM1 patients with matched DM1‐free individuals and assessed the association between benign tumors and subsequent cancers. Methods We identified 927 DM1 patients and 13,085 DM1‐free individuals matched on gender, birth‐year, clinic, and clinic‐registration year from the UK Clinical Practice Research Datalink, a primary care records database. We used Cox regression models for statistical analyses. Results DM1 patients had elevated risks of thyroid nodules (Hazard Ratio [HR] = 10.4; 95% Confidence Interval [CI] = 3.91–27.52; P < 0.001), benign tumors of the brain or nervous system (HR = 8.4; 95% CI = 2.48–28.47; P < 0.001), colorectal polyps (HR = 4.3; 95% CI = 1.76–10.41; P = 0.001), and possibly uterine fibroids (HR = 2.7; 95% CI = 1.22–5.88; P = 0.01). Pilomatricomas and salivary gland adenomas occurred almost exclusively in DM1 patients (Fisher's exact P < 0.001). The HR for colorectal polyps was elevated in DM1 males but not in females (HR = 8.2 vs. 1.3, respectively; P‐heterogeneity < 0.001), whereas endocrine and brain tumors occurred exclusively in females. The data suggested an association between benign tumors and subsequent cancer in classic DM1 patients (HR = 2.7; 95% CI = 0.93–7.59; P = 0.07). Interpretation Our study showed a similar site‐specific benign tumor profile to that previously reported for DM1‐associated cancers. The possible association between benign tumors and subsequent cancer in classic DM1 patients warrants further investigation as it may guide identifying patients at elevated risk of cancer. Our findings underscore the importance of following population‐based screening recommendations in DM1 patients, for example, for colorectal cancer.
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Affiliation(s)
- Rotana Alsaggaf
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.,Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland
| | | | - Min Zhan
- Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland
| | - Ruth M Pfeiffer
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Youjin Wang
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Lesley A Anderson
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Zhiwei Liu
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Jill Koshiol
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Andrew J Bauer
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Pediatrics, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kathryn R Wagner
- Hugo W. Moser Research Institute at Kennedy Krieger Institute, Baltimore, Maryland, USA.,Departments of Neurology and Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mark H Greene
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Sania Amr
- Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland.,Marlene and Stuart Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland, USA
| | - Shahinaz M Gadalla
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
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129
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Guía clínica para el diagnóstico y seguimiento de la distrofia miotónica tipo 1, DM1 o enfermedad de Steinert. Med Clin (Barc) 2019; 153:82.e1-82.e17. [DOI: 10.1016/j.medcli.2018.10.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/15/2018] [Accepted: 10/18/2018] [Indexed: 01/19/2023]
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130
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Solbakken G, Bjørnarå B, Kirkhus E, Nguyen B, Hansen G, Frich JC, Ørstavik K. MRI of trunk muscles and motor and respiratory function in patients with myotonic dystrophy type 1. BMC Neurol 2019; 19:135. [PMID: 31216995 PMCID: PMC6582475 DOI: 10.1186/s12883-019-1357-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 06/06/2019] [Indexed: 12/14/2022] Open
Abstract
Background Myotonic Dystrophy 1 (DM1) causes progressive myopathy of extremity muscles. DM1 may also affect muscles of the trunk. The aim of this study was to investigate fat infiltration and muscle size in trunk muscles in DM1 patients, and in an age and gender matched control group. Further, explore how fat infiltration and degree of atrophy in these muscles are associated with motor and respiratory function in DM1 patients. Method We measured fat infiltration and trunk muscle size by MRI in 20 patients with genetically confirmed classic form of DM1, and compared these cases with 20 healthy, age and gender matched controls. In the DM1 group, we investigated correlations between MRI findings and clinical measures of muscle strength, mobility and respiration. We used sum scores for fat infiltration and muscle size in trunk flexors and trunk extensors in the analysis of group differences and correlations. Results Significant differences between cases and controls were present for fat infiltration in trunk flexors (p = 0.001) and trunk extensors (p = < 0.001), and for muscle size in trunk flexors (p = 0.002) and trunk extensors (p = 0.030). Fat infiltration in trunk flexors were significant correlated to back extension strength (rho = − 0.523 p = 0.018), while muscle size in trunk flexors was significantly correlated to trunk flexion strength (rho = 0.506 p = 0.023). Fat infiltration in trunk flexors was significantly correlated with lower general mobility (rho = − 0.628, p = 0.003), reduced balance (rho = 0.630, p < 0.003) and forced vital capacity (rho − 0.487 p = 0.040). Conclusions Trunk muscles in DM1 patients had significant higher levels of fat infiltration and reduced muscle size compared to age and gender matched controls. In DM1 patients, fat infiltration was associated with reduced muscle strength, mobility, balance and lung function, while muscle size was associated with reduced muscle strength and lung function. These findings are of importance for clinical management of the disease and could be useful additional outcome measures in future intervention studies. Electronic supplementary material The online version of this article (10.1186/s12883-019-1357-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gro Solbakken
- Department of Neurology, Rheumatology and Rehabilitation, Drammen Hospital Vestre Viken Hospital Trust, P.O. Box 800, 3004, Drammen, Norway. .,Institute of Clinical Medicine University of Oslo, P.O. Box 1171 Blindern, 0318, Oslo, Norway.
| | - Bård Bjørnarå
- Department of Diagnostic Imaging, Drammen Hospital, Vestre Viken Hospital Trust, P.O. Box 800, 3004, Drammen, Norway
| | - Eva Kirkhus
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Oslo. P.O. Box 4950 Nydalen, N-0424, Oslo, Norway
| | - Bac Nguyen
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Oslo. P.O. Box 4950 Nydalen, N-0424, Oslo, Norway
| | - Gunnar Hansen
- Department of Neurology, Rheumatology and Rehabilitation, Drammen Hospital Vestre Viken Hospital Trust, P.O. Box 800, 3004, Drammen, Norway
| | - Jan C Frich
- Faculty of Medicine, University of Oslo, P.O. Box 1130 Blindern, 0318, Oslo, Oslo, Norway
| | - Kristin Ørstavik
- Department of Neurology, Section for Rare Neuromuscular Disorders, Oslo University Hospital, Oslo. P.O. Box 4950 Nydalen, N-0424, Oslo, Norway
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131
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Holmøy AKT, Johannessen CH, Hope S, van Walsem MR, Aanonsen NO, Hassel B. Uncovering health and social care needs among myotonic dystrophy patients: Utility of the Needs and Provisions Complexity Scale. Acta Neurol Scand 2019; 139:526-532. [PMID: 30848487 DOI: 10.1111/ane.13086] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/21/2019] [Accepted: 03/04/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Myotonic dystrophy type 1 (DM1) is a slowly progressive multisystem disorder. Guidelines recommend multidisciplinary follow-up. We aimed to investigate the presence of unmet health and social care needs among patients with DM1 and whether unmet needs correlated with motor function, cognitive impairments, or quality of life. MATERIAL AND METHODS Patients were 22 adults with DM1. "Needs and Provisions Complexity Scale" (NPCS) was applied to evaluate the individual's needs and provision of health and social services. The Muscular Impairment Rating Scale (MIRS) was used to measure motor function and disease stage. All patients underwent neuropsychological testing. The EQ-5D-3L questionnaire was used to evaluate the patients' health-related quality of life (HRQoL). RESULTS Median time from diagnosis was 11 years (range: 1-40). Twenty patients had developed needs related to social care, personal care, and rehabilitation that had not been met, whereas need for medical follow-up was largely met. The more pronounced the muscular impairment, the more unmet needs were experienced by DM1 patients (r = 0.50, P = 0.019). Degree of unmet needs did not correlate with full-scale IQ (r = -0.27, P = 0.23) or HRQoL (r = -0.14, P = 0.55). CONCLUSION Using NPCS, we discovered that patients with DM1 had unmet needs with respect to social care, personal care, and rehabilitation although their need for medical follow-up was met. Thus, the use of NPCS helped bring our practice in better accordance with guidelines. A higher MIRS grade should alert the clinician to the likelihood of unmet needs.
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Affiliation(s)
| | - Cecilie Haggag Johannessen
- Department of Neurohabilitation Oslo University Hospital Ullevål Oslo Norway
- NORMENT, KG Jebsen Centre of Psychosis Research, Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Sigrun Hope
- Department of Neurohabilitation Oslo University Hospital Ullevål Oslo Norway
- NORMENT, KG Jebsen Centre of Psychosis Research, Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Marleen R. van Walsem
- Department of Neurohabilitation Oslo University Hospital Ullevål Oslo Norway
- Research center for Habilitation and Rehabilitation Models and Services, Institute of Health and Society University of Oslo Oslo Norway
| | - Nils Olav Aanonsen
- Department of Neurohabilitation Oslo University Hospital Ullevål Oslo Norway
| | - Bjørnar Hassel
- Department of Neurohabilitation Oslo University Hospital Ullevål Oslo Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
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Luetkens JA, von Landenberg C, Isaak A, Faron A, Kuetting D, Gliem C, Dabir D, Kornblum C, Thomas D. Comprehensive Cardiac Magnetic Resonance for Assessment of Cardiac Involvement in Myotonic Muscular Dystrophy Type 1 and 2 Without Known Cardiovascular Disease. Circ Cardiovasc Imaging 2019; 12:e009100. [PMID: 31137956 DOI: 10.1161/circimaging.119.009100] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Julian A Luetkens
- Department of Radiology (J.A.L., A.I., A.F., D.K., D.D., D.T.), University Hospital Bonn, Germany
| | | | - Alexander Isaak
- Department of Radiology (J.A.L., A.I., A.F., D.K., D.D., D.T.), University Hospital Bonn, Germany
| | - Anton Faron
- Department of Radiology (J.A.L., A.I., A.F., D.K., D.D., D.T.), University Hospital Bonn, Germany
| | - Daniel Kuetting
- Department of Radiology (J.A.L., A.I., A.F., D.K., D.D., D.T.), University Hospital Bonn, Germany
| | - Carla Gliem
- Department of Neurology (C.v.L., C.G., C.K.), University Hospital Bonn, Germany
| | - Darius Dabir
- Department of Radiology (J.A.L., A.I., A.F., D.K., D.D., D.T.), University Hospital Bonn, Germany
| | - Cornelia Kornblum
- Department of Neurology (C.v.L., C.G., C.K.), University Hospital Bonn, Germany.,Center for Rare Diseases Bonn (C.K.), University Hospital Bonn, Germany
| | - Daniel Thomas
- Department of Radiology (J.A.L., A.I., A.F., D.K., D.D., D.T.), University Hospital Bonn, Germany
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Heskamp L, van Nimwegen M, Ploegmakers MJ, Bassez G, Deux JF, Cumming SA, Monckton DG, van Engelen BGM, Heerschap A. Lower extremity muscle pathology in myotonic dystrophy type 1 assessed by quantitative MRI. Neurology 2019; 92:e2803-e2814. [PMID: 31118244 PMCID: PMC6598795 DOI: 10.1212/wnl.0000000000007648] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 02/07/2019] [Indexed: 01/08/2023] Open
Abstract
Objective To determine the value of quantitative MRI in providing imaging biomarkers for disease in 20 different upper and lower leg muscles of patients with myotonic dystrophy type 1 (DM1). Methods We acquired images covering these muscles in 33 genetically and clinically well-characterized patients with DM1 and 10 unaffected controls. MRIs were recorded with a Dixon method to determine muscle fat fraction, muscle volume, and contractile muscle volume, and a multi-echo spin-echo sequence was used to determine T2 water relaxation time (T2water), reflecting putative edema. Results Muscles in patients with DM1 had higher fat fractions than muscles of controls (15.6 ± 11.1% vs 3.7 ± 1.5%). In addition, patients had smaller muscle volumes (902 ± 232 vs 1,097 ± 251 cm3), smaller contractile muscle volumes (779 ± 247 vs 1,054 ± 246 cm3), and increased T2water (33.4 ± 1.0 vs 31.9 ± 0.6 milliseconds), indicating atrophy and edema, respectively. Lower leg muscles were affected most frequently, especially the gastrocnemius medialis and soleus. Distribution of fat content per muscle indicated gradual fat infiltration in DM1. Between-patient variation in fat fraction was explained by age (≈45%), and another ≈14% was explained by estimated progenitor CTG repeat length (r2 = 0.485) and somatic instability (r2 = 0.590). Fat fraction correlated with the 6-minute walk test (r = −0.553) and muscular impairment rating scale (r = 0.537) and revealed subclinical muscle involvement. Conclusion This cross-sectional quantitative MRI study of 20 different lower extremity muscles in patients with DM1 revealed abnormal values for muscle fat fraction, volume, and T2water, which therefore may serve as objective biomarkers to assess disease state of skeletal muscles in these patients. ClinicalTrials.gov identifier NCT02118779.
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Affiliation(s)
- Linda Heskamp
- From the Department of Radiology and Nuclear Medicine (L.H., M.J.P., A.H.) and Department of Neurology (M.v.N., B.G.M.v.E.), Radboud University Medical Center, Nijmegen, the Netherlands; Neuromuscular Reference Center (G.B.), Sorbonne University, INSERM UMRS 974, AP-HP, Pitié-Salpêtrière Hospital; Department of Radiology (J.-F.D.), Henri Mondor University Hospital, Paris, France; and Institute of Molecular, Cell and Systems Biology (S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, UK.
| | - Marlies van Nimwegen
- From the Department of Radiology and Nuclear Medicine (L.H., M.J.P., A.H.) and Department of Neurology (M.v.N., B.G.M.v.E.), Radboud University Medical Center, Nijmegen, the Netherlands; Neuromuscular Reference Center (G.B.), Sorbonne University, INSERM UMRS 974, AP-HP, Pitié-Salpêtrière Hospital; Department of Radiology (J.-F.D.), Henri Mondor University Hospital, Paris, France; and Institute of Molecular, Cell and Systems Biology (S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Marieke J Ploegmakers
- From the Department of Radiology and Nuclear Medicine (L.H., M.J.P., A.H.) and Department of Neurology (M.v.N., B.G.M.v.E.), Radboud University Medical Center, Nijmegen, the Netherlands; Neuromuscular Reference Center (G.B.), Sorbonne University, INSERM UMRS 974, AP-HP, Pitié-Salpêtrière Hospital; Department of Radiology (J.-F.D.), Henri Mondor University Hospital, Paris, France; and Institute of Molecular, Cell and Systems Biology (S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Guillaume Bassez
- From the Department of Radiology and Nuclear Medicine (L.H., M.J.P., A.H.) and Department of Neurology (M.v.N., B.G.M.v.E.), Radboud University Medical Center, Nijmegen, the Netherlands; Neuromuscular Reference Center (G.B.), Sorbonne University, INSERM UMRS 974, AP-HP, Pitié-Salpêtrière Hospital; Department of Radiology (J.-F.D.), Henri Mondor University Hospital, Paris, France; and Institute of Molecular, Cell and Systems Biology (S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Jean-Francois Deux
- From the Department of Radiology and Nuclear Medicine (L.H., M.J.P., A.H.) and Department of Neurology (M.v.N., B.G.M.v.E.), Radboud University Medical Center, Nijmegen, the Netherlands; Neuromuscular Reference Center (G.B.), Sorbonne University, INSERM UMRS 974, AP-HP, Pitié-Salpêtrière Hospital; Department of Radiology (J.-F.D.), Henri Mondor University Hospital, Paris, France; and Institute of Molecular, Cell and Systems Biology (S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Sarah A Cumming
- From the Department of Radiology and Nuclear Medicine (L.H., M.J.P., A.H.) and Department of Neurology (M.v.N., B.G.M.v.E.), Radboud University Medical Center, Nijmegen, the Netherlands; Neuromuscular Reference Center (G.B.), Sorbonne University, INSERM UMRS 974, AP-HP, Pitié-Salpêtrière Hospital; Department of Radiology (J.-F.D.), Henri Mondor University Hospital, Paris, France; and Institute of Molecular, Cell and Systems Biology (S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Darren G Monckton
- From the Department of Radiology and Nuclear Medicine (L.H., M.J.P., A.H.) and Department of Neurology (M.v.N., B.G.M.v.E.), Radboud University Medical Center, Nijmegen, the Netherlands; Neuromuscular Reference Center (G.B.), Sorbonne University, INSERM UMRS 974, AP-HP, Pitié-Salpêtrière Hospital; Department of Radiology (J.-F.D.), Henri Mondor University Hospital, Paris, France; and Institute of Molecular, Cell and Systems Biology (S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Baziel G M van Engelen
- From the Department of Radiology and Nuclear Medicine (L.H., M.J.P., A.H.) and Department of Neurology (M.v.N., B.G.M.v.E.), Radboud University Medical Center, Nijmegen, the Netherlands; Neuromuscular Reference Center (G.B.), Sorbonne University, INSERM UMRS 974, AP-HP, Pitié-Salpêtrière Hospital; Department of Radiology (J.-F.D.), Henri Mondor University Hospital, Paris, France; and Institute of Molecular, Cell and Systems Biology (S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Arend Heerschap
- From the Department of Radiology and Nuclear Medicine (L.H., M.J.P., A.H.) and Department of Neurology (M.v.N., B.G.M.v.E.), Radboud University Medical Center, Nijmegen, the Netherlands; Neuromuscular Reference Center (G.B.), Sorbonne University, INSERM UMRS 974, AP-HP, Pitié-Salpêtrière Hospital; Department of Radiology (J.-F.D.), Henri Mondor University Hospital, Paris, France; and Institute of Molecular, Cell and Systems Biology (S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
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Ceballos-Sáenz D, Zapata-Aldana E, Singeris S, Hicks R, Johnson N, Campbell C. Body composition in patients with congenital myotonic dystrophy. Muscle Nerve 2019; 60:176-179. [PMID: 31074869 DOI: 10.1002/mus.26509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 05/02/2019] [Accepted: 05/07/2019] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Congenital myotonic dystrophy (CDM) is a rare neuromuscular disorder characterized by severe hypotonia and muscle weakness at birth that tends to improve with age. Understanding lean body and bone mass in this population has important research and clinical implications. The main objective of this study was to determine whether older children with CDM had muscle mass similar to healthy controls. METHODS Thirty-five patients with CDM (3-13 years old) were enrolled. We analyzed lean body mass (LBM) and bone mineral content using the mechanostat framework, which allows calculation of z-scores for sex, age, and height. RESULTS All patients had low LBM z-scores (muscle mass); however, higher LBM z-score was positively correlated with age (r = 0.45, P = 0.006), showing that it is closer to normal in older patients. DISCUSSION Unlike other neuromuscular diseases, older children with CDM have a muscle mass closer to age-matched controls, consistent with the clinical profile of increasing strength in childhood. Muscle Nerve 60: 176-179, 2019.
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Affiliation(s)
- Delia Ceballos-Sáenz
- Paediatric Neurology Department, Children's Hospital, London Health Science Centre, 800 Commissioners Road East, PO Box 5012, London, Ontario, Canada, N6A 5W9
| | - Eugenio Zapata-Aldana
- Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Stephanie Singeris
- Paediatric Neurology Department, Children's Hospital, London Health Science Centre, 800 Commissioners Road East, PO Box 5012, London, Ontario, Canada, N6A 5W9
| | - Rhiannon Hicks
- Paediatric Neurology Department, Children's Hospital, London Health Science Centre, 800 Commissioners Road East, PO Box 5012, London, Ontario, Canada, N6A 5W9
| | - Nicholas Johnson
- Department of Neurology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Craig Campbell
- Paediatric Neurology Department, Children's Hospital, London Health Science Centre, 800 Commissioners Road East, PO Box 5012, London, Ontario, Canada, N6A 5W9.,Department of Paediatrics, Clinical Neurological Sciences and Epidemiology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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135
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Cardona A, Arnold WD, Kissel JT, Raman SV, Zareba KM. Myocardial fibrosis by late gadolinium enhancement cardiovascular magnetic resonance in myotonic muscular dystrophy type 1: highly prevalent but not associated with surface conduction abnormality. J Cardiovasc Magn Reson 2019; 21:26. [PMID: 31046780 PMCID: PMC6498496 DOI: 10.1186/s12968-019-0535-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 03/26/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Conduction disease and arrhythmias represent a major cause of mortality in myotonic muscular dystrophy type 1 (MMD1). Permanent pacemaker (PPM) implantation is the cornerstone of therapy to reduce cardiovascular mortality in MMD1. Cardiovascular magnetic resonance (CMR) studies demonstrate a high prevalence of myocardial fibrosis in MMD1, however the association between CMR myocardial fibrosis with late gadolinium enhancement (CMR-LGE) and surface conduction abnormality is not well established in MMD1. We investigated whether myocardial fibrosis by CMR-LGE is associated with surface conduction abnormalities meeting criteria for PPM implantation according to current guidelines in a cohort of patients with genetically confirmed MMD1. METHODS Patients with genetically confirmed MMD1 were retrospectively evaluated. 12-lead electrocardiography (ECG) performed within 6 months of CMR was necessary for inclusion. The severity and extent of MMD1 was quantified using a validated Muscular Impairment Rating Scale (MIRS). Based on current guidelines for device-based therapy of cardiac rhythm abnormalities, we defined surface conduction abnormality as the presence of ECG alterations meeting criteria for PPM implant (class I or II indications): PR interval > 200 ms (type I atrioventricular (AV) block) and/or mono or bifascicular block (QRS > 120 ms), or evidence of advanced AV block. Balanced steady-state free precession sequences (bSSFP) were used for assessment of left ventricular (LV) volumes and ejection fraction. MOdified Look-Locker Inversion Recovery (MOLLI) acquisition schemes were used to acquire T1 maps. Patients' charts were reviewed up to 12 months post-CMR for occurrence of PPM implantation. RESULTS Fifty-two patients (38% male, 41 ± 14 years) were included. Overall, 31 (60%) patients had a surface conduction abnormality and 22 (42%) demonstrated midwall myocardial fibrosis by CMR-LGE. After a median of 57 days from CMR exam, 15 patients (29%) underwent PPM implantation. Subjects with vs. without surface conduction abnormality had significantly longer disease length (15.5 vs. 7.8 years, p = 0.015) and higher disease severity on the MIRS scale (p = 0.041). High prevalence of myocardial fibrosis by CMR-LGE was detected in subjects with and without surface conduction abnormality with no significant difference between the two cohorts (42% vs. 43%, p = 0.999). By multivariate logistic regression analysis, disease length was the only independent variable associated with surface conduction abnormality (OR 1.071, 95%CI 1.003-1.144, p = 0.040); while CMR-LGE was not associated with conduction abnormality (ρ = - 0.009, p = 0.949). CONCLUSIONS Myocardial fibrosis by CMR-LGE is highly prevalent in MMD1 but not related to surface conduction abnormality meeting current guideline criteria for PPM implantation .
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Affiliation(s)
- Andrea Cardona
- Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, 473 W 12th Ave, Suite 200, Columbus, OH 43210 USA
- Division of Cardiology, University of Perugia, Rome, Italy
| | - William D. Arnold
- Division of Neuromuscular Disorders, The Ohio State University Wexner Medical Center, Columbus, OH USA
| | - John T. Kissel
- Division of Neuromuscular Disorders, The Ohio State University Wexner Medical Center, Columbus, OH USA
| | - Subha V. Raman
- Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, 473 W 12th Ave, Suite 200, Columbus, OH 43210 USA
| | - Karolina M. Zareba
- Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, 473 W 12th Ave, Suite 200, Columbus, OH 43210 USA
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136
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Affiliation(s)
- Garth W Strohbehn
- From the Department of Veterans Affairs (VA) Health Services Internal Medicine Service (G.W.S., S.S.), the Departments of Internal Medicine (G.W.S., S.S.) and Neurology (H.P.), and the Audiology and Speech-Language Pathology Service (J.M.), University of Michigan Medical School, and the Ann Arbor VA Health Services Research and Development Center of Excellence (S.S.) - all in Ann Arbor; and the Medical Service, San Francisco VA Medical Center, and the Department of Medicine, University of California, San Francisco - both in San Francisco (G.D.)
| | - Gurpreet Dhaliwal
- From the Department of Veterans Affairs (VA) Health Services Internal Medicine Service (G.W.S., S.S.), the Departments of Internal Medicine (G.W.S., S.S.) and Neurology (H.P.), and the Audiology and Speech-Language Pathology Service (J.M.), University of Michigan Medical School, and the Ann Arbor VA Health Services Research and Development Center of Excellence (S.S.) - all in Ann Arbor; and the Medical Service, San Francisco VA Medical Center, and the Department of Medicine, University of California, San Francisco - both in San Francisco (G.D.)
| | - Henry Paulson
- From the Department of Veterans Affairs (VA) Health Services Internal Medicine Service (G.W.S., S.S.), the Departments of Internal Medicine (G.W.S., S.S.) and Neurology (H.P.), and the Audiology and Speech-Language Pathology Service (J.M.), University of Michigan Medical School, and the Ann Arbor VA Health Services Research and Development Center of Excellence (S.S.) - all in Ann Arbor; and the Medical Service, San Francisco VA Medical Center, and the Department of Medicine, University of California, San Francisco - both in San Francisco (G.D.)
| | - Joseph Murray
- From the Department of Veterans Affairs (VA) Health Services Internal Medicine Service (G.W.S., S.S.), the Departments of Internal Medicine (G.W.S., S.S.) and Neurology (H.P.), and the Audiology and Speech-Language Pathology Service (J.M.), University of Michigan Medical School, and the Ann Arbor VA Health Services Research and Development Center of Excellence (S.S.) - all in Ann Arbor; and the Medical Service, San Francisco VA Medical Center, and the Department of Medicine, University of California, San Francisco - both in San Francisco (G.D.)
| | - Sanjay Saint
- From the Department of Veterans Affairs (VA) Health Services Internal Medicine Service (G.W.S., S.S.), the Departments of Internal Medicine (G.W.S., S.S.) and Neurology (H.P.), and the Audiology and Speech-Language Pathology Service (J.M.), University of Michigan Medical School, and the Ann Arbor VA Health Services Research and Development Center of Excellence (S.S.) - all in Ann Arbor; and the Medical Service, San Francisco VA Medical Center, and the Department of Medicine, University of California, San Francisco - both in San Francisco (G.D.)
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Suh MR, Kim DH, Jung J, Kim B, Lee JW, Choi WA, Kang SW. Clinical implication of maximal voluntary ventilation in myotonic muscular dystrophy. Medicine (Baltimore) 2019; 98:e15321. [PMID: 31045770 PMCID: PMC6504256 DOI: 10.1097/md.0000000000015321] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Patients with myotonic muscular dystrophy type 1 (DM1) tend to exhibit earlier respiratory insufficiency than patients with other neuromuscular diseases at similar or higher forced vital capacity (FVC). This study aimed to analyze several pulmonary function parameters to determine which factor contributes the most to early hypercapnia in patients with DM1.We analyzed ventilation status monitoring, pulmonary function tests (including FVC, maximal voluntary ventilation [MVV], and maximal inspiratory and expiratory pressure), and polysomnography in subjects with DM1 who were admitted to a single university hospital. The correlation of each parameter with hypercapnia was determined. Subgroup analysis was also performed by dividing the subjects into 2 subgroups according to usage of mechanical ventilation.Final analysis included 50 patients with a mean age of 42.9 years (standard deviation = 11.1), 46.0% of whom were male. The hypercapnia was negatively correlated with MVV, FVC, forced expiratory volume in 1 second (FEV1), and their ratios to predicted values in subjects with myotonic muscular dystrophy type 1. At the same partial pressure of carbon dioxide, the ratio to the predicted value was lowest for MVV, then FEV1, followed by FVC. Moreover, the P values for differences in MVV and its ratio to the predicted value between ventilator users and nonusers were the lowest.When screening ventilation failure in patients with DM1, MVV should be considered alongside other routinely measured parameters.
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Affiliation(s)
- Mi Ri Suh
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, GyeongGi-do
- Rehabilitation and Regeneration Research Center, CHA University School of Medicine, GyeongGi-do
- Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul
- The Graduate School, Yonsei University College of Medicine, Seoul
| | - Dong Hyun Kim
- Department of Physical Medicine and Rehabilitation, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul
| | - Jiho Jung
- Department of Rehabilitation Medicine and Pulmonary Rehabilitation Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul
| | - Bitnarae Kim
- Department of Rehabilitation Medicine and Pulmonary Rehabilitation Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul
- Department of Physical Therapy, Graduate School of Yonsei University, Gangwon-do
| | - Jang Woo Lee
- Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul
- Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Won Ah Choi
- Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul
- Department of Rehabilitation Medicine and Pulmonary Rehabilitation Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul
| | - Seong-Woong Kang
- Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul
- Department of Rehabilitation Medicine and Pulmonary Rehabilitation Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul
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Ota K, Nakamura Y, Nakamura E, Takashima S, Oka M, Ota K, Sakaue M, Sano Y, Takasu A. Massive abscess with prolonged respiratory failure due to newly diagnosed myotonic dystrophy: A case report. Medicine (Baltimore) 2019; 98:e15427. [PMID: 31027145 PMCID: PMC6831368 DOI: 10.1097/md.0000000000015427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
RATIONALE Myotonic dystrophy is a progressive multisystem genetic heterogeneous disorder. General anesthesia with opioids increases the risk of prolonged postanesthetic respiratory recovery in myotonic dystrophy patients. PATIENT CONCERNS A 20-year-old previously healthy woman was transferred to our emergency department for further workup of respiratory failure, and massive ascites with abscess caused by endometriosis. Hypercapnic respiratory failure persisted under intensive care unit (ICU) management, but finally improved after cessation of fentanyl as a sedative agent. DIAGNOSIS Myotonic dystrophy type 1. INTERVENTIONS Massive ascites with abscess was accordingly managed by drainage, antibiotics, and an antifungal agent. Myotonic dystrophy type 1 was confirmed after molecular genetic testing revealed a cytosine-thymine-guanine repeat length of 400 to 450 in the DMPK gene. OUTCOMES The patient was discharged without complications on hospital day 69. LESSONS Myotonic dystrophy should be considered when hypercapnic respiratory failure persists in sedated ICU patients. Opioids should not be used for perioperative management of patients with myotonic dystrophy.
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Affiliation(s)
| | - Yoshitsugu Nakamura
- Division of Neurology, Department of Internal Medicine IV, Osaka Medical College, Osaka, Japan
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van Cruchten RTP, Wieringa B, Wansink DG. Expanded CUG repeats in DMPK transcripts adopt diverse hairpin conformations without influencing the structure of the flanking sequences. RNA (NEW YORK, N.Y.) 2019; 25:481-495. [PMID: 30700578 PMCID: PMC6426290 DOI: 10.1261/rna.068940.118] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 01/24/2019] [Indexed: 06/09/2023]
Abstract
Myotonic dystrophy type 1 (DM1) is a complex neuromuscular disorder caused by expansion of a CTG repeat in the 3'-untranslated region (UTR) of the DMPK gene. Mutant DMPK transcripts form aberrant structures and anomalously associate with RNA-binding proteins (RBPs). As a first step toward better understanding of the involvement of abnormal DMPK mRNA folding in DM1 manifestation, we used SHAPE, DMS, CMCT, and RNase T1 structure probing in vitro for modeling of the topology of the DMPK 3'-UTR with normal and pathogenic repeat lengths of up to 197 CUG triplets. The resulting structural information was validated by disruption of base-pairing with LNA antisense oligonucleotides (AONs) and used for prediction of therapeutic AON accessibility and verification of DMPK knockdown efficacy in cells. Our model for DMPK RNA structure demonstrates that the hairpin formed by the CUG repeat has length-dependent conformational plasticity, with a structure that is guided by and embedded in an otherwise rigid architecture of flanking regions in the DMPK 3'-UTR. Evidence is provided that long CUG repeats may form not only single asymmetrical hairpins but also exist as branched structures. These newly identified structures have implications for DM1 pathogenic mechanisms, like sequestration of RBPs and repeat-associated non-AUG (RAN) translation.
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Affiliation(s)
- Remco T P van Cruchten
- Department of Cell Biology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, 6525 GA, The Netherlands
| | - Bé Wieringa
- Department of Cell Biology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, 6525 GA, The Netherlands
| | - Derick G Wansink
- Department of Cell Biology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, 6525 GA, The Netherlands
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Prevalence and predictor factors of respiratory impairment in a large cohort of patients with Myotonic Dystrophy type 1 (DM1): A retrospective, cross sectional study. J Neurol Sci 2019; 399:118-124. [DOI: 10.1016/j.jns.2019.02.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 02/04/2019] [Accepted: 02/06/2019] [Indexed: 12/13/2022]
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141
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Kim EY, Barefield DY, Vo AH, Gacita AM, Schuster EJ, Wyatt EJ, Davis JL, Dong B, Sun C, Page P, Dellefave-Castillo L, Demonbreun A, Zhang HF, McNally EM. Distinct pathological signatures in human cellular models of myotonic dystrophy subtypes. JCI Insight 2019; 4:122686. [PMID: 30730308 DOI: 10.1172/jci.insight.122686] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 01/31/2019] [Indexed: 01/06/2023] Open
Abstract
Myotonic dystrophy (DM) is the most common autosomal dominant muscular dystrophy and encompasses both skeletal muscle and cardiac complications. DM is nucleotide repeat expansion disorder in which type 1 (DM1) is due to a trinucleotide repeat expansion on chromosome 19 and type 2 (DM2) arises from a tetranucleotide repeat expansion on chromosome 3. Developing representative models of DM in animals has been challenging due to instability of nucleotide repeat expansions, especially for DM2, which is characterized by nucleotide repeat expansions often greater than 5,000 copies. To investigate mechanisms of human DM, we generated cellular models of DM1 and DM2. We used regulated MyoD expression to reprogram urine-derived cells into myotubes. In this myogenic cell model, we found impaired dystrophin expression, in the presence of muscleblind-like 1 (MBNL1) foci, and aberrant splicing in DM1 but not in DM2 cells. We generated induced pluripotent stem cells (iPSC) from healthy controls and DM1 and DM2 subjects, and we differentiated these into cardiomyocytes. DM1 and DM2 cells displayed an increase in RNA foci concomitant with cellular differentiation. iPSC-derived cardiomyocytes from DM1 but not DM2 had aberrant splicing of known target genes and MBNL sequestration. High-resolution imaging revealed tight association between MBNL clusters and RNA foci in DM1. Ca2+ transients differed between DM1- and DM2 iPSC-derived cardiomyocytes, and each differed from healthy control cells. RNA-sequencing from DM1- and DM2 iPSC-derived cardiomyocytes revealed distinct misregulation of gene expression, as well as differential aberrant splicing patterns. Together, these data support that DM1 and DM2, despite some shared clinical and molecular features, have distinct pathological signatures.
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Affiliation(s)
- Ellis Y Kim
- Molecular Pathogenesis and Molecular Medicine, The University of Chicago, Chicago, Illinois, USA
| | - David Y Barefield
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Andy H Vo
- Committee on Development, Regeneration, and Stem Cell Biology, The University of Chicago, Chicago, Illinois, USA
| | - Anthony M Gacita
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Emma J Schuster
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Eugene J Wyatt
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Biqin Dong
- Department of Biomedical Engineering and.,Department of Mechanical Engineering, Northwestern University, Evanston, Illinois, USA
| | - Cheng Sun
- Department of Mechanical Engineering, Northwestern University, Evanston, Illinois, USA
| | - Patrick Page
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Lisa Dellefave-Castillo
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Alexis Demonbreun
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Elizabeth M McNally
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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142
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Abstract
Neuromuscular and chest wall diseases include a diverse group of conditions that share common risk factors for sleep-disordered breathing, including respiratory muscle weakness and/or thoracic restriction. Sleep-disordered breathing results from both the effects of normal sleep on ventilation and the additional challenges imposed by the underlying disorders. Patterns of sleep- disordered breathing vary with the specific diagnosis and stage of disease. Sleep hypoventilation precedes diurnal respiratory failure and may be difficult to recognize clinically because symptoms are nonspecific. Polysomnography has a role in both the diagnosis of sleep-disordered breathing and in the titration of effective noninvasive positive-pressure ventilation.
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Affiliation(s)
- Janet Hilbert
- Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University, Yale University School of Medicine, 300 Cedar Street, PO Box 208057, New Haven, CT 06520-8057, USA.
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143
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Heart involvement in patients with myotonic dystrophy type 2. Acta Neurol Belg 2019; 119:77-82. [PMID: 30536153 DOI: 10.1007/s13760-018-1052-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 11/21/2018] [Indexed: 10/27/2022]
Abstract
Myotonic dystrophy type 2 (DM2) is a slowly progressive, autosomal-dominant disease. This is a multisystemic disorder that affects the heart, which is one of the main causes of morbidity and mortality in DM2. The aim of the study was to define cardiac impairments in patients with DM2 and its association with sociodemographic and clinical features of patients. This retrospective study comprised 62 adult patients with DM2 hospitalized at the Neurology Clinic, Clinical Center of Serbia from 2013 until 2018, who underwent electrocardiography (ECG) and echocardiography examinations. Hypertension was observed in 42% of DM2 patients. One-fifth of DM2 patients had bradycardia, while other conduction and rhythm impairments were rare. Only one patient had a pacemaker implanted because of the first degree AV block associated with incomplete left bundle branch block. Echocardiography showed diastolic dysfunction of the left ventricle in 44% of patients, while systolic dysfunction was found in only 4%. Cardiomyopathy was observed in 18% of patients, of whom three-fourth had dilated type. Cardiac conduction and rhythm defects are relatively rare in DM2, while diastolic dysfunction is common. This suggests that regular ECG and echocardiography screening is needed in DM2. Adequate therapy should be introduced in patients with DM2 on time to reduce the frequency of heart complications and to prevent premature death.
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144
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Sleep Complaints, Sleep and Breathing Disorders in Myotonic Dystrophy Type 2. Curr Neurol Neurosci Rep 2019; 19:9. [DOI: 10.1007/s11910-019-0924-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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145
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Kasinathan A, Zehra Z, Anbazhagan J, Soundararajan P. Intellectual Disability: History Repeats Itself. Indian J Pediatr 2019; 86:189-190. [PMID: 30128630 DOI: 10.1007/s12098-018-2771-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 08/08/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Ananthanarayanan Kasinathan
- Department of Pediatrics, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pondicherry, Tamil Nadu, 607403, India.
| | - Zaheen Zehra
- Department of Pediatrics, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pondicherry, Tamil Nadu, 607403, India
| | - Jagadeesh Anbazhagan
- Department of Pediatrics, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pondicherry, Tamil Nadu, 607403, India
| | - P Soundararajan
- Department of Pediatrics, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pondicherry, Tamil Nadu, 607403, India
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146
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Okumura N, Hayashi R, Nakano M, Yoshii K, Tashiro K, Sato T, Blake DJ, Aleff R, Butz M, Highsmith EW, Wieben ED, Fautsch MP, Baratz KH, Komori Y, Nakahara M, Tourtas T, Schlötzer-Schrehardt U, Kruse F, Koizumi N. Effect of Trinucleotide Repeat Expansion on the Expression of TCF4 mRNA in Fuchs' Endothelial Corneal Dystrophy. Invest Ophthalmol Vis Sci 2019; 60:779-786. [PMID: 30811544 PMCID: PMC6392475 DOI: 10.1167/iovs.18-25760] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Purpose CTG trinucleotide repeat (TNR) expansion is frequently found in transcription factor 4 (TCF4) in Fuchs' endothelial corneal dystrophy (FECD), though the effect of TNR expansion on FECD pathophysiology remains unclear. The purpose of this study was to evaluate the effect of TNR expansion on TCF4 expression in corneal endothelium of patients with FECD. Methods Peripheral blood DNA and Descemet membrane with corneal endothelium were obtained from 203 German patients with FECD. The CTG TNR repeat length in TCF4 was determined by short tandem repeat (STR) assays and Southern blotting using genomic DNA. Genotyping of rs613872 in TCF4 was performed by PCR. TCF4 mRNA levels in corneal endothelium were evaluated by quantitative PCR using three different probes. Control corneal endothelial samples were obtained from 35 non-FECD subjects. Results The STR assay and Southern blotting showed that 162 of the 203 patients with FECD (80%) harbored CTG trinucleotide repeat lengths larger than 50. Quantitative PCR using all three probes demonstrated that TCF4 mRNA is significantly upregulated in the corneal endothelium of patients with FECD, regardless of the presence of TNR expansion. However, the length of the TNR tended to show a positive correlation with TCF4 expression level. No correlation was shown between the genotype of TCF4 SNP, rs613872, and the level of TCF4 expression. Conclusions Our findings showed that TCF4 mRNA is upregulated in the corneal endothelium of patients with FECD. Further studies on the effects of TCF4 upregulation on corneal endothelial cell function will aid in understanding the pathophysiology of FECD.
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Affiliation(s)
- Naoki Okumura
- Department of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Japan
| | - Ryosuke Hayashi
- Department of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Japan
| | - Masakazu Nakano
- Department of Genomic Medical Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kengo Yoshii
- Department of Mathematics and Statistics in Medical Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kei Tashiro
- Department of Genomic Medical Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takahiko Sato
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Derek J Blake
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, United Kingdom
| | - Ross Aleff
- Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota, United States
| | - Malinda Butz
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States
| | - Edward W Highsmith
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States
| | - Eric D Wieben
- Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota, United States
| | - Michael P Fautsch
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, United States
| | - Keith H Baratz
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, United States
| | - Yuya Komori
- Department of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Japan
| | - Makiko Nakahara
- Department of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Japan
| | - Theofilos Tourtas
- Department of Ophthalmology, University of Erlangen-Nürnberg, Erlangen, Germany
| | | | - Friedrich Kruse
- Department of Ophthalmology, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Noriko Koizumi
- Department of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Japan
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147
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Neurophysiological Evidence of Motor Network Reorganization in Myotonic Dystrophy Type 1. J Clin Neurophysiol 2019; 36:74-81. [DOI: 10.1097/wnp.0000000000000508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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148
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Alsaggaf R, St George DMM, Zhan M, Pfeiffer RM, Wang Y, Wagner KR, Greene MH, Amr S, Gadalla SM. Cancer Risk in Myotonic Dystrophy Type I: Evidence of a Role for Disease Severity. JNCI Cancer Spectr 2018; 2:pky052. [PMID: 30556050 DOI: 10.1093/jncics/pky052] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 08/20/2018] [Accepted: 08/28/2018] [Indexed: 12/31/2022] Open
Abstract
Background Myotonic dystrophy type 1 (DM1) is an inherited trinucleotide repeat disorder in which specific cancers have been implicated as part of the disease phenotype. This study aimed to assess whether cancer risk in DM1 patients is modified by disease severity. Methods Using the United Kingdom Clinical Practice Research Datalink (primary care electronic medical records), we identified a cohort of 927 DM1 and a matched cohort of 13 085 DM1-free individuals between January 1, 1988 and February 29, 2016. We used Cox regression models to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of organ-specific cancer risks. Analyses were stratified by age at DM1 diagnosis as a surrogate for disease severity. Statistical tests were two-sided. Results Patients with classic DM1 (age at diagnosis: 11-40 years) were at elevated risk of cancer overall (HR = 1.81; 95% CI = 1.12 to 2.93); cancers of the thyroid (HR = 15.93; 95% CI = 2.45 to 103.64), uterus (HR = 26.76; 95% CI = 2.32 to 309.26), and cutaneous melanoma (HR = 5.98; 95% CI = 1.24 to 28.79) accounted for the excess. In late-onset DM1 patients (age at diagnosis >40 years), a reduced overall cancer risk was observed (HR = 0.53; 95% CI = 0.32 to 0.85), possibly driven by the deficit in hematological malignancies (DM1 = 0 cases, DM1-free = 54 cases; P = .02). The difference between the observed HR for classic and late-onset DM1 was statistically significant (P < .001). Conclusions The observed difference in relative cancer risk between classic and late-onset DM1 patients compared with their DM1-free counterparts provides the first evidence that disease severity modifies DM1-related cancer susceptibility. This novel finding may guide clinical management and scientific investigations for the underlying molecular mechanisms in DM-related carcinogenesis.
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Affiliation(s)
- Rotana Alsaggaf
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD.,Department of Epidemiology and Public Health, University of Maryland, Baltimore, MD
| | | | - Min Zhan
- Department of Epidemiology and Public Health, University of Maryland, Baltimore, MD
| | - Ruth M Pfeiffer
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Youjin Wang
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Kathryn R Wagner
- Hugo W. Moser Research Institute at Kennedy Krieger Institute, Baltimore, MD.,Departments of Neurology and Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Mark H Greene
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Sania Amr
- Department of Epidemiology and Public Health, University of Maryland, Baltimore, MD.,Marlene and Stuart Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD
| | - Shahinaz M Gadalla
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
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149
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Comparison of brain magnetic resonance imaging between myotonic dystrophy type 1 and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy. PLoS One 2018; 13:e0208620. [PMID: 30521610 PMCID: PMC6283577 DOI: 10.1371/journal.pone.0208620] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 11/20/2018] [Indexed: 11/19/2022] Open
Abstract
Background Anterior temporal lobe hyperintensities detected by brain MRI are a recognized imaging hallmark of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Because similar findings may be present in patients with myotonic dystrophy type 1 (DM1), the brain MRI in these two diseases is often misinterpreted. We compared the MRI findings between the two entities to examine whether they display distinctive characteristics. Methods This retrospective, cross-sectional study reviewed medical records of patients with DM1 or CADASIL admitted to Asan Medical Center between September 1999 and September 2017. We compared the frequency and grades of white matter changes in specific spatial regions between the groups according to age-related white matter change scores. We also evaluated the presence of cerebral microbleeds. Results A total of 29 patients with DM1 and 68 with CADASIL who had undergone MRI were included in the analysis. The overall prevalence of white matter hyperintensities was 20 (69%) and 66 (97%) in DM1 and CADASIL, respectively (p < 0.001), whereas the frequency of anterior temporal lobe hyperintensities was comparable between the groups (10 [34.5%] in DM1 vs. 35 [51.5%] in CADASIL, p = 0.125). The brain MRI of patients with DM1 revealed more limited involvement of the frontal, parieto-occipital, external capsule and basal ganglia regions compared with imaging in patients with CADASIL. Cerebral microbleeds were not observed in any case of DM1 but were present in 31 of 45 (68.9%) cases of CADASIL. Conclusions Anterior temporal lobe involvement in DM1 is not infrequent compared with CADASIL. However, because brain MRI in patients with DM1 lacks other distinctive features seen in CADASIL, imaging might assist in differentiating these two conditions.
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150
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Romigi A, Franco V, Placidi F, Liguori C, Rastelli E, Vitrani G, Centonze D, Massa R. Comparative Sleep Disturbances in Myotonic Dystrophy Types 1 and 2. Curr Neurol Neurosci Rep 2018; 18:102. [DOI: 10.1007/s11910-018-0903-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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