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Panagiotakaki E, De Grandis E, Stagnaro M, Heinzen EL, Fons C, Sisodiya S, de Vries B, Goubau C, Weckhuysen S, Kemlink D, Scheffer I, Lesca G, Rabilloud M, Klich A, Ramirez-Camacho A, Ulate-Campos A, Campistol J, Giannotta M, Moutard ML, Doummar D, Hubsch-Bonneaud C, Jaffer F, Cross H, Gurrieri F, Tiziano D, Nevsimalova S, Nicole S, Neville B, van den Maagdenberg AMJM, Mikati M, Goldstein DB, Vavassori R, Arzimanoglou A. Clinical profile of patients with ATP1A3 mutations in Alternating Hemiplegia of Childhood-a study of 155 patients. Orphanet J Rare Dis 2015; 10:123. [PMID: 26410222 PMCID: PMC4583741 DOI: 10.1186/s13023-015-0335-5] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 09/01/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mutations in the gene ATP1A3 have recently been identified to be prevalent in patients with alternating hemiplegia of childhood (AHC2). Based on a large series of patients with AHC, we set out to identify the spectrum of different mutations within the ATP1A3 gene and further establish any correlation with phenotype. METHODS Clinical data from an international cohort of 155 AHC patients (84 females, 71 males; between 3 months and 52 years) were gathered using a specifically formulated questionnaire and analysed relative to the mutational ATP1A3 gene data for each patient. RESULTS In total, 34 different ATP1A3 mutations were detected in 85 % (132/155) patients, seven of which were novel. In general, mutations were found to cluster into five different regions. The most frequent mutations included: p.Asp801Asn (43 %; 57/132), p.Glu815Lys (16 %; 22/132), and p.Gly947Arg (11 %; 15/132). Of these, p.Glu815Lys was associated with a severe phenotype, with more severe intellectual and motor disability. p.Asp801Asn appeared to confer a milder phenotypic expression, and p.Gly947Arg appeared to correlate with the most favourable prognosis, compared to the other two frequent mutations. Overall, the comparison of the clinical profiles suggested a gradient of severity between the three major mutations with differences in intellectual (p = 0.029) and motor (p = 0.039) disabilities being statistically significant. For patients with epilepsy, age at onset of seizures was earlier for patients with either p.Glu815Lys or p.Gly947Arg mutation, compared to those with p.Asp801Asn mutation (p < 0.001). With regards to the five mutation clusters, some clusters appeared to correlate with certain clinical phenotypes. No statistically significant clinical correlations were found between patients with and without ATP1A3 mutations. CONCLUSIONS Our results, demonstrate a highly variable clinical phenotype in patients with AHC2 that correlates with certain mutations and possibly clusters within the ATP1A3 gene. Our description of the clinical profile of patients with the most frequent mutations and the clinical picture of those with less common mutations confirms the results from previous studies, and further expands the spectrum of genotype-phenotype correlations. Our results may be useful to confirm diagnosis and may influence decisions to ensure appropriate early medical intervention in patients with AHC. They provide a stronger basis for the constitution of more homogeneous groups to be included in clinical trials.
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Affiliation(s)
- Eleni Panagiotakaki
- Epilepsy, Sleep and Pediatric Neurophysiology Department (ESEFNP), University Hospitals of Lyon (HCL), Lyon, France.
| | - Elisa De Grandis
- Department of Child Neuropsychiatry, G. Gaslini Hospital, University of Genoa, Genoa, Italy
| | - Michela Stagnaro
- Department of Child Neuropsychiatry, G. Gaslini Hospital, University of Genoa, Genoa, Italy
| | - Erin L Heinzen
- Center for Human Genome Variation, Duke University School of Medicine, Durham, NC, USA.,Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Carmen Fons
- Department of Child Neurology, Sant Joan de Déu Hospital, Barcelona, Spain
| | - Sanjay Sisodiya
- Department of Clinical and Experimental Epilepsy, University College London Institute of Neurology, London, UK
| | - Boukje de Vries
- Department of Human Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Christophe Goubau
- Department of Child Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Sarah Weckhuysen
- Department of Molecular Genetics, Neurogenetics Group, VIB, Antwerp, Belgium
| | - David Kemlink
- Department of Neurology, Charles University, First Faculty of Medicine and Teaching Hospital, Prague, Czech Republic
| | - Ingrid Scheffer
- Department of Medicine, University of Melbourne, Austin Health, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - Gaëtan Lesca
- Department of Genetics, University Hospitals of Lyon (HCL) and Claude Bernard Lyon I University, Lyon, France.,Lyon Neuroscience Research Center (CRNL), CNRS UMR 5292, INSERM U1028, Lyon, France
| | - Muriel Rabilloud
- Biostatistics Department, University Hospitals of Lyon and UMR 5558, Lyon, France
| | - Amna Klich
- Biostatistics Department, University Hospitals of Lyon and UMR 5558, Lyon, France
| | - Alia Ramirez-Camacho
- Epilepsy, Sleep and Pediatric Neurophysiology Department (ESEFNP), University Hospitals of Lyon (HCL), Lyon, France.,Department of Child Neurology, Sant Joan de Déu Hospital, Barcelona, Spain
| | | | - Jaume Campistol
- Department of Child Neurology, Sant Joan de Déu Hospital, Barcelona, Spain
| | | | - Marie-Laure Moutard
- Department of Child Neurology, Armand Trousseau Hospital, APHP, Paris, France
| | - Diane Doummar
- Department of Child Neurology, Armand Trousseau Hospital, APHP, Paris, France
| | | | - Fatima Jaffer
- Department of Clinical and Experimental Epilepsy, University College London Institute of Neurology, London, UK
| | - Helen Cross
- Institute of Child Health, University College London, London, UK
| | - Fiorella Gurrieri
- Institute of Medical Genetics, University Cattolica del Sacro Cuore, Policlinics A. Gemelli, Rome, Italy
| | - Danilo Tiziano
- Institute of Medical Genetics, University Cattolica del Sacro Cuore, Policlinics A. Gemelli, Rome, Italy
| | - Sona Nevsimalova
- Department of Neurology, Charles University, First Faculty of Medicine and Teaching Hospital, Prague, Czech Republic
| | - Sophie Nicole
- Institut National de la Santé et de la Recherche Médicale, U975, Centre de Recherche de l'Institut du Cerveau et de la Moelle, Paris, France.,Centre National de la Recherche Scientifique, UMR7225, Paris, France
| | - Brian Neville
- Institute of Child Health, University College London, London, UK
| | - Arn M J M van den Maagdenberg
- Department of Human Genetics, Leiden University Medical Centre, Leiden, The Netherlands.,Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Mohamad Mikati
- Division of Pediatric Neurology and Department of Neurobiology, Duke University, School of Medicine, Durham, NC, USA
| | - David B Goldstein
- Center for Human Genome Variation, Duke University School of Medicine, Durham, NC, USA.,Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Rosaria Vavassori
- Associazione Italiana per la Sindrome di Emiplegia Alternante (A.I.S.EA Onlus), Lecco, Italy
| | - Alexis Arzimanoglou
- Epilepsy, Sleep and Pediatric Neurophysiology Department (ESEFNP), University Hospitals of Lyon (HCL), Lyon, France.,DYCOG team, Lyon Neuroscience Research Centre (CRNL), INSERM U1028; CNRS UMR 5292, Lyon, France
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202
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Termsarasab P, Yang AC, Frucht SJ. Intermediate Phenotypes of ATP1A3 Mutations: Phenotype-Genotype Correlations. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2015; 5:336. [PMID: 26417536 PMCID: PMC4578012 DOI: 10.7916/d8mg7ns8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Accepted: 08/25/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND ATP1A3-related disorders include rapid-onset dystonia-parkinsonism (RDP or DYT12), alternating hemiplegia of childhood (AHC), and CAPOS syndrome (Cerebellar ataxia, Areflexia, Pes cavus, Optic atrophy, and Sensorineural hearing loss). CASE REPORT We report two cases with intermediate forms between RDP and AHC. Patient 1 initially presented with the AHC phenotype, but the RDP phenotype emerged at age 14 years. The second patient presented with levodopa-responsive paroxysmal oculogyria, a finding never before reported in ATP1A3-related disorders. Genetic testing confirmed heterozygous changes in the ATP1A3 gene in both patients, one of them novel. DISCUSSION Intermediate phenotypes of RDP and AHC support the concept that these two disorders are part of a spectrum. We add our cases to the phenotype-genotype correlations of ATP1A3-related disorders.
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Affiliation(s)
- Pichet Termsarasab
- Movement Disorder Division, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Amy C Yang
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Steven J Frucht
- Movement Disorder Division, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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203
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Brown A, Clark JD. A Parent's Journey: Incorporating Principles of Palliative Care into Practice for Children with Chronic Neurologic Diseases. Semin Pediatr Neurol 2015; 22:159-65. [PMID: 26358425 DOI: 10.1016/j.spen.2015.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Rather than in conflict or in competition with the curative model of care, pediatric palliative care is a complementary and transdisciplinary approach used to optimize medical care for children with complex medical conditions. It provides care to the whole child, including physical, mental, and spiritual dimensions, in addition to support for the family. Through the voice of a parent, the following case-based discussion demonstrates how the fundamentals of palliative care medicine, when instituted early in the course of disease, can assist parents and families with shared medical decision making, ultimately improving the quality of life for children with life-limiting illnesses. Pediatric neurologists, as subspecialists who provide medical care for children with chronic and complex conditions, should consider invoking the principles of palliative care early in the course of a disease process, either through applying general facets or, if available, through consultation with a specialty palliative care service.
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Affiliation(s)
- Allyson Brown
- Department of Pediatrics, Division of Critical Care Medicine, University of Washington School of Medicine, Seattle, WA; Department of Pediatrics, Seattle Children's Hospital, Seattle, WA
| | - Jonna D Clark
- Department of Pediatrics, Seattle Children's Hospital, Seattle, WA; Treuman Katz Center for Pediatric Bioethics, University of Washington School of Medicine, Seattle, WA.
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204
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Shrivastava AN, Redeker V, Fritz N, Pieri L, Almeida LG, Spolidoro M, Liebmann T, Bousset L, Renner M, Léna C, Aperia A, Melki R, Triller A. α-synuclein assemblies sequester neuronal α3-Na+/K+-ATPase and impair Na+ gradient. EMBO J 2015; 34:2408-23. [PMID: 26323479 DOI: 10.15252/embj.201591397] [Citation(s) in RCA: 152] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 07/21/2015] [Indexed: 11/09/2022] Open
Abstract
Extracellular α-synuclein (α-syn) assemblies can be up-taken by neurons; however, their interaction with the plasma membrane and proteins has not been studied specifically. Here we demonstrate that α-syn assemblies form clusters within the plasma membrane of neurons. Using a proteomic-based approach, we identify the α3-subunit of Na+/K+-ATPase (NKA) as a cell surface partner of α-syn assemblies. The interaction strength depended on the state of α-syn, fibrils being the strongest, oligomers weak, and monomers none. Mutations within the neuron-specific α3-subunit are linked to rapid-onset dystonia Parkinsonism (RDP) and alternating hemiplegia of childhood (AHC). We show that freely diffusing α3-NKA are trapped within α-syn clusters resulting in α3-NKA redistribution and formation of larger nanoclusters. This creates regions within the plasma membrane with reduced local densities of α3-NKA, thereby decreasing the efficiency of Na+ extrusion following stimulus. Thus, interactions of α3-NKA with extracellular α-syn assemblies reduce its pumping activity as its mutations in RDP/AHC.
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Affiliation(s)
- Amulya Nidhi Shrivastava
- École Normale Supérieure, Institut de Biologie de l'ENS (IBENS) INSERM CNRS PSL Research University, Paris, France
| | - Virginie Redeker
- Paris-Saclay Institute of Neuroscience CNRS, Gif-sur-Yvette, France
| | - Nicolas Fritz
- Department of Women and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Laura Pieri
- Paris-Saclay Institute of Neuroscience CNRS, Gif-sur-Yvette, France
| | - Leandro G Almeida
- École Normale Supérieure, Institut de Biologie de l'ENS (IBENS) INSERM CNRS PSL Research University, Paris, France
| | - Maria Spolidoro
- École Normale Supérieure, Institut de Biologie de l'ENS (IBENS) INSERM CNRS PSL Research University, Paris, France
| | - Thomas Liebmann
- Department of Women and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Luc Bousset
- Paris-Saclay Institute of Neuroscience CNRS, Gif-sur-Yvette, France
| | - Marianne Renner
- École Normale Supérieure, Institut de Biologie de l'ENS (IBENS) INSERM CNRS PSL Research University, Paris, France
| | - Clément Léna
- École Normale Supérieure, Institut de Biologie de l'ENS (IBENS) INSERM CNRS PSL Research University, Paris, France
| | - Anita Aperia
- Department of Women and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Ronald Melki
- Paris-Saclay Institute of Neuroscience CNRS, Gif-sur-Yvette, France
| | - Antoine Triller
- École Normale Supérieure, Institut de Biologie de l'ENS (IBENS) INSERM CNRS PSL Research University, Paris, France
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205
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Jaffer F, Avbersek A, Vavassori R, Fons C, Campistol J, Stagnaro M, De Grandis E, Veneselli E, Rosewich H, Gianotta M, Zucca C, Ragona F, Granata T, Nardocci N, Mikati M, Helseth AR, Boelman C, Minassian BA, Johns S, Garry SI, Scheffer IE, Gourfinkel-An I, Carrilho I, Aylett SE, Parton M, Hanna MG, Houlden H, Neville B, Kurian MA, Novy J, Sander JW, Lambiase PD, Behr ER, Schyns T, Arzimanoglou A, Cross JH, Kaski JP, Sisodiya SM. Faulty cardiac repolarization reserve in alternating hemiplegia of childhood broadens the phenotype. Brain 2015; 138:2859-74. [PMID: 26297560 PMCID: PMC4671482 DOI: 10.1093/brain/awv243] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 06/30/2015] [Indexed: 12/29/2022] Open
Abstract
Alternating hemiplegia of childhood is a rare disorder caused by de novo mutations in the ATP1A3 gene, expressed in neurons and cardiomyocytes. As affected individuals may survive into adulthood, we use the term 'alternating hemiplegia'. The disorder is characterized by early-onset, recurrent, often alternating, hemiplegic episodes; seizures and non-paroxysmal neurological features also occur. Dysautonomia may occur during hemiplegia or in isolation. Premature mortality can occur in this patient group and is not fully explained. Preventable cardiorespiratory arrest from underlying cardiac dysrhythmia may be a cause. We analysed ECG recordings of 52 patients with alternating hemiplegia from nine countries: all had whole-exome, whole-genome, or direct Sanger sequencing of ATP1A3. Data on autonomic dysfunction, cardiac symptoms, medication, and family history of cardiac disease or sudden death were collected. All had 12-lead electrocardiogram recordings available for cardiac axis, cardiac interval, repolarization pattern, and J-point analysis. Where available, historical and prolonged single-lead electrocardiogram recordings during electrocardiogram-videotelemetry were analysed. Half the cohort (26/52) had resting 12-lead electrocardiogram abnormalities: 25/26 had repolarization (T wave) abnormalities. These abnormalities were significantly more common in people with alternating hemiplegia than in an age-matched disease control group of 52 people with epilepsy. The average corrected QT interval was significantly shorter in people with alternating hemiplegia than in the disease control group. J wave or J-point changes were seen in six people with alternating hemiplegia. Over half the affected cohort (28/52) had intraventricular conduction delay, or incomplete right bundle branch block, a much higher proportion than in the normal population or disease control cohort (P = 0.0164). Abnormalities in alternating hemiplegia were more common in those ≥16 years old, compared with those <16 (P = 0.0095), even with a specific mutation (p.D801N; P = 0.045). Dynamic, beat-to-beat or electrocardiogram-to-electrocardiogram, changes were noted, suggesting the prevalence of abnormalities was underestimated. Electrocardiogram changes occurred independently of seizures or plegic episodes. Electrocardiogram abnormalities are common in alternating hemiplegia, have characteristics reflecting those of inherited cardiac channelopathies and most likely amount to impaired repolarization reserve. The dynamic electrocardiogram and neurological features point to periodic systemic decompensation in ATP1A3-expressing organs. Cardiac dysfunction may account for some of the unexplained premature mortality of alternating hemiplegia. Systematic cardiac investigation is warranted in alternating hemiplegia of childhood, as cardiac arrhythmic morbidity and mortality are potentially preventable.
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Affiliation(s)
- Fatima Jaffer
- 1 MRC Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK 2 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Andreja Avbersek
- 3 NIHR UCLH Biomedical Research Centre Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK 4 Epilepsy Society, Chalfont-St-Peter, Bucks, SL9 0RJ, UK
| | - Rosaria Vavassori
- 5 A.I.S.EA Onlus, Via Sernovella, 37 - Verderio Superiore, 23878 Lecco, Italy
| | - Carmen Fons
- 6 Paediatric Neurology Department, Hospital Sant Joan de Déu, P° de Sant Joan de Déu, 2 08950 Esplugues de Llobregat, Barcelona University, Barcelona, Spain
| | - Jaume Campistol
- 6 Paediatric Neurology Department, Hospital Sant Joan de Déu, P° de Sant Joan de Déu, 2 08950 Esplugues de Llobregat, Barcelona University, Barcelona, Spain
| | - Michela Stagnaro
- 7 Child Neuropsychiatry Unit, Istituto Giannina Gaslini, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children's Sciences, Istituto Giannina Gaslini, Largo Gaslini 5, 26148, University of Genoa, Genoa, Italy
| | - Elisa De Grandis
- 7 Child Neuropsychiatry Unit, Istituto Giannina Gaslini, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children's Sciences, Istituto Giannina Gaslini, Largo Gaslini 5, 26148, University of Genoa, Genoa, Italy
| | - Edvige Veneselli
- 7 Child Neuropsychiatry Unit, Istituto Giannina Gaslini, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children's Sciences, Istituto Giannina Gaslini, Largo Gaslini 5, 26148, University of Genoa, Genoa, Italy
| | - Hendrik Rosewich
- 8 University Medical Center Göttingen, Georg August University, Department of Pediatrics and Adolescent Medicine, Division of Pediatric Neurology, Georg August University, Robert Koch Strasse 40, 37099 Göttingen, Germany
| | - Melania Gianotta
- 9 Child Neurology Unit IRCCS Istituto delle Scienze Neurologiche di Bologna, Ospedale Bellaria, Via Altura 3, 40139 Bologna, Italy
| | - Claudio Zucca
- 10 Clinical Neurophysiology Unit, IRCCS "E. Medea", Via Don L. Monza 20, 23842 Bosisio Parini (LC), Italy
| | - Francesca Ragona
- 11 Department of Pediatric Neuroscience, IRCCS Foundation Neurological Institute C. Besta, Via Celoria 11, 20133 Milano, Italy
| | - Tiziana Granata
- 11 Department of Pediatric Neuroscience, IRCCS Foundation Neurological Institute C. Besta, Via Celoria 11, 20133 Milano, Italy
| | - Nardo Nardocci
- 11 Department of Pediatric Neuroscience, IRCCS Foundation Neurological Institute C. Besta, Via Celoria 11, 20133 Milano, Italy
| | - Mohamed Mikati
- 12 Division of Paediatric Neurology, Duke University, T0913J Children Health Centre, Duke University Medical Centre, Durham, USA
| | - Ashley R Helseth
- 12 Division of Paediatric Neurology, Duke University, T0913J Children Health Centre, Duke University Medical Centre, Durham, USA
| | - Cyrus Boelman
- 13 Division of Neurology, Department of Paediatrics, The Hospital for Sick Children and University of Toronto, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8
| | - Berge A Minassian
- 13 Division of Neurology, Department of Paediatrics, The Hospital for Sick Children and University of Toronto, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8
| | - Sophia Johns
- 14 Inherited Cardiovascular Diseases Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, and Institute of Cardiovascular Science, University College London, London, WC1N 3JH, UK
| | - Sarah I Garry
- 15 Florey Institute of Neurosciences and Mental Health, and Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - Ingrid E Scheffer
- 15 Florey Institute of Neurosciences and Mental Health, and Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - Isabelle Gourfinkel-An
- 16 Centre de reference epilepsies rares et Sclérose tubéreuse de Bourneville (site Parisien adolescents-adultes), Hôpital Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital 75651 Paris cedex 13, France
| | - Ines Carrilho
- 17 Neuropediatric Department Centro Hospitalar do Porto, Rua da Boavista, 8274050-111, Porto, Portugal
| | - Sarah E Aylett
- 18 Clinical Neurosciences, Developmental Neuroscience Programme, UCL Institute of Child Health, & Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK
| | - Matthew Parton
- 1 MRC Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK
| | - Michael G Hanna
- 1 MRC Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK
| | - Henry Houlden
- 2 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Brian Neville
- 18 Clinical Neurosciences, Developmental Neuroscience Programme, UCL Institute of Child Health, & Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK
| | - Manju A Kurian
- 19 Molecular Neurosciences, Developmental Neurosciences Programme, UCL Institute of Child Health and Department of Neurology, Great Ormond Street Hospital, London, London, WC1N 3JH, UK
| | - Jan Novy
- 3 NIHR UCLH Biomedical Research Centre Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK 4 Epilepsy Society, Chalfont-St-Peter, Bucks, SL9 0RJ, UK
| | - Josemir W Sander
- 3 NIHR UCLH Biomedical Research Centre Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK 4 Epilepsy Society, Chalfont-St-Peter, Bucks, SL9 0RJ, UK
| | - Pier D Lambiase
- 20 Department of Cardiac Electrophysiology, The Heart Hospital, Institute of Cardiovascular Science, University College London, 16-18 Westmoreland St, London W1G 8PH, UK
| | - Elijah R Behr
- 21 Cardiac and Cell Sciences Institute, St George's University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Tsveta Schyns
- 22 European Network for Research on Alternating Hemiplegia, ENRAH, Brussels, Belgium
| | - Alexis Arzimanoglou
- 23 Epilepsy, Sleep and Paediatric Neurophysiology Department (ESEFNP), University Hospitals of Lyon (HCL), and DYCOG team, Lyon Neuroscience Research Centre (CRNL), INSERM U1028; CNRS UMR 5292, Lyon, France
| | - J Helen Cross
- 18 Clinical Neurosciences, Developmental Neuroscience Programme, UCL Institute of Child Health, & Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK 24 Young Epilepsy, St. Piers Lane, Lingfield, Surrey RH7 6PW, UK
| | - Juan P Kaski
- 14 Inherited Cardiovascular Diseases Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, and Institute of Cardiovascular Science, University College London, London, WC1N 3JH, UK
| | - Sanjay M Sisodiya
- 3 NIHR UCLH Biomedical Research Centre Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK 4 Epilepsy Society, Chalfont-St-Peter, Bucks, SL9 0RJ, UK
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206
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Qu J, Yang ZQ, Zhang Y, Mao CX, Wang ZB, Mao XY, Zhou BT, Yin JY, He H, Long HY, Gong JE, Xiao B, Zhou HH, Liu ZQ. Common variants of ATP1A3 but not ATP1A2 are associated with Chinese genetic generalized epilepsies. J Neurol Sci 2015; 354:56-62. [DOI: 10.1016/j.jns.2015.04.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Revised: 04/01/2015] [Accepted: 04/27/2015] [Indexed: 12/26/2022]
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207
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Fremont R, Tewari A, Khodakhah K. Aberrant Purkinje cell activity is the cause of dystonia in a shRNA-based mouse model of Rapid Onset Dystonia-Parkinsonism. Neurobiol Dis 2015; 82:200-212. [PMID: 26093171 DOI: 10.1016/j.nbd.2015.06.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 06/08/2015] [Accepted: 06/09/2015] [Indexed: 11/19/2022] Open
Abstract
Loss-of-function mutations in the α3 isoform of the sodium pump are responsible for Rapid Onset Dystonia-Parkinsonism (RDP). A pharmacologic model of RDP replicates the most salient features of RDP, and implicates both the cerebellum and basal ganglia in the disorder; dystonia is associated with aberrant cerebellar output, and the parkinsonism-like features are attributable to the basal ganglia. The pharmacologic agent used to generate the model, ouabain, is selective for sodium pumps. However, close to the infusion sites in vivo it likely affects all sodium pump isoforms. Therefore, it remains to be established whether selective loss of α3-containing sodium pumps replicates the pharmacologic model. Moreover, while the pharmacologic model suggested that aberrant firing of Purkinje cells was the main cause of abnormal cerebellar output, it did not allow the scrutiny of this hypothesis. To address these questions RNA interference using small hairpin RNAs (shRNAs) delivered via adeno-associated viruses (AAV) was used to specifically knockdown α3-containing sodium pumps in different regions of the adult mouse brain. Knockdown of the α3-containing sodium pumps mimicked both the behavioral and electrophysiological changes seen in the pharmacologic model of RDP, recapitulating key aspects of the human disorder. Further, we found that knockdown of the α3 isoform altered the intrinsic pacemaking of Purkinje cells, but not the neurons of the deep cerebellar nuclei. Therefore, acute knockdown of proteins associated with inherited dystonias may be a good strategy for developing phenotypic genetic mouse models where traditional transgenic models have failed to produce symptomatic mice.
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Affiliation(s)
- Rachel Fremont
- Dominick P Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Ambika Tewari
- Dominick P Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Kamran Khodakhah
- Dominick P Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
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208
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Regulation of cough by neuronal Na(+)-K(+) ATPases. Curr Opin Pharmacol 2015; 22:140-5. [PMID: 26048736 DOI: 10.1016/j.coph.2015.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 04/29/2015] [Accepted: 05/01/2015] [Indexed: 01/10/2023]
Abstract
The Na(+)-K(+) ATPases play an essential role in establishing the sodium gradients in excitable cells. Multiple isoforms of the sodium pumps have been identified, with tissue and cell specific expression patterns. Because the vagal afferent nerves regulating cough must be activated at sustained high frequencies of action potential patterning to achieve cough initiation thresholds, it is a certainty that sodium pump function is essential to maintaining cough reflex sensitivities in health and in disease. The mechanisms by which Na(+)-K(+) ATPases regulate bronchopulmonary vagal afferent nerve excitability are reviewed as are potential therapeutic strategies targeting the sodium pumps in cough.
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Viollet L, Glusman G, Murphy KJ, Newcomb TM, Reyna SP, Sweney M, Nelson B, Andermann F, Andermann E, Acsadi G, Barbano RL, Brown C, Brunkow ME, Chugani HT, Cheyette SR, Collins A, DeBrosse SD, Galas D, Friedman J, Hood L, Huff C, Jorde LB, King MD, LaSalle B, Leventer RJ, Lewelt AJ, Massart MB, Mérida MR, Ptáček LJ, Roach JC, Rust RS, Renault F, Sanger TD, Sotero de Menezes MA, Tennyson R, Uldall P, Zhang Y, Zupanc M, Xin W, Silver K, Swoboda KJ. Alternating Hemiplegia of Childhood: Retrospective Genetic Study and Genotype-Phenotype Correlations in 187 Subjects from the US AHCF Registry. PLoS One 2015; 10:e0127045. [PMID: 25996915 PMCID: PMC4440742 DOI: 10.1371/journal.pone.0127045] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 04/11/2015] [Indexed: 11/21/2022] Open
Abstract
Mutations in ATP1A3 cause Alternating Hemiplegia of Childhood (AHC) by disrupting function of the neuronal Na+/K+ ATPase. Published studies to date indicate 2 recurrent mutations, D801N and E815K, and a more severe phenotype in the E815K cohort. We performed mutation analysis and retrospective genotype-phenotype correlations in all eligible patients with AHC enrolled in the US AHC Foundation registry from 1997-2012. Clinical data were abstracted from standardized caregivers’ questionnaires and medical records and confirmed by expert clinicians. We identified ATP1A3 mutations by Sanger and whole genome sequencing, and compared phenotypes within and between 4 groups of subjects, those with D801N, E815K, other ATP1A3 or no ATP1A3 mutations. We identified heterozygous ATP1A3 mutations in 154 of 187 (82%) AHC patients. Of 34 unique mutations, 31 (91%) are missense, and 16 (47%) had not been previously reported. Concordant with prior studies, more than 2/3 of all mutations are clustered in exons 17 and 18. Of 143 simplex occurrences, 58 had D801N (40%), 38 had E815K (26%) and 11 had G937R (8%) mutations. Patients with an E815K mutation demonstrate an earlier age of onset, more severe motor impairment and a higher prevalence of status epilepticus. This study further expands the number and spectrum of ATP1A3 mutations associated with AHC and confirms a more deleterious effect of the E815K mutation on selected neurologic outcomes. However, the complexity of the disorder and the extensive phenotypic variability among subgroups merits caution and emphasizes the need for further studies.
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Affiliation(s)
- Louis Viollet
- Pediatric Motor Disorders Research Program, Departments of Neurology and Pediatrics, University of Utah, Salt Lake City, Utah, United States of America
| | - Gustavo Glusman
- Institute for Systems Biology, Seattle, Washington, United States of America
| | - Kelley J. Murphy
- Pediatric Motor Disorders Research Program, Departments of Neurology and Pediatrics, University of Utah, Salt Lake City, Utah, United States of America
| | - Tara M. Newcomb
- Pediatric Motor Disorders Research Program, Departments of Neurology and Pediatrics, University of Utah, Salt Lake City, Utah, United States of America
| | - Sandra P. Reyna
- Pediatric Motor Disorders Research Program, Departments of Neurology and Pediatrics, University of Utah, Salt Lake City, Utah, United States of America
| | - Matthew Sweney
- Pediatric Motor Disorders Research Program, Departments of Neurology and Pediatrics, University of Utah, Salt Lake City, Utah, United States of America
| | - Benjamin Nelson
- Pediatric Motor Disorders Research Program, Departments of Neurology and Pediatrics, University of Utah, Salt Lake City, Utah, United States of America
| | - Frederick Andermann
- Neurogenetics Unit, Montreal Neurologic Institute and Hospital, McGill University, Montreal Quebec, Canada
| | - Eva Andermann
- Neurogenetics Unit, Montreal Neurologic Institute and Hospital, McGill University, Montreal Quebec, Canada
| | - Gyula Acsadi
- Departments of Pediatrics and Neurology, Connecticut Children's Medical Center and University of Connecticut School of Medicine, Hartford, CT, United States of America
| | - Richard L. Barbano
- Department of Neurology, University of Rochester School of Medicine, Rochester, New York, United States of America
| | - Candida Brown
- Diablo Valley Child Neurology, an affiliate of Stanford Health Alliance, Pleasant Hill, California, United States of America
| | - Mary E. Brunkow
- Institute for Systems Biology, Seattle, Washington, United States of America
| | - Harry T. Chugani
- Division of Pediatric Neurology, Children's Hospital of Michigan, Wayne State University, Detroit, Michigan, United States of America
| | - Sarah R. Cheyette
- Department of Child Neurology, Palo Alto Medical Foundation Redwood City Clinic, Redwood City, California, United States of America
| | - Abigail Collins
- Department of Pediatric Neurology, Children’s Hospital Colorado, University of Colorado Hospital, Aurora, Colorado, United States of America
| | - Suzanne D. DeBrosse
- Departments of Genetics and Genome Sciences, Pediatrics, and Neurology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio, United States of America
| | - David Galas
- Pacific Northwest Diabetes Research Institute, Seattle, Washington, United States of America
| | - Jennifer Friedman
- Departments of Neuroscience and Pediatrics, University of California San Diego, San Diego, California, United States of America
| | - Lee Hood
- Institute for Systems Biology, Seattle, Washington, United States of America
| | - Chad Huff
- Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, United States of America
| | - Lynn B. Jorde
- Department of Human Genetics, University of Utah, Salt Lake City, Utah, United States of America
| | - Mary D. King
- Departments of Pediatrics and Neurology, University College Dublin School of Medicine and Medical Science, Dublin, Ireland
| | - Bernie LaSalle
- Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Richard J. Leventer
- Children’s Neuroscience Centre, Murdoch Childrens Research Institute, University of Melbourne Department of Paediatrics, The Royal Children’s Hospital Melbourne, Parkville Victoria, Australia
| | - Aga J. Lewelt
- Department of Pediatrics, College of Medicine Jacksonville, University of Florida, Jacksonville, Florida, United States of America
| | - Mylynda B. Massart
- Department of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Mario R. Mérida
- Stevens Henager College, Salt Lake City, Utah, United States of America
| | - Louis J. Ptáček
- Department of Neurology, University of California San Francisco, San Francisco, California, United States of America
| | - Jared C. Roach
- Institute for Systems Biology, Seattle, Washington, United States of America
| | - Robert S. Rust
- Center for Medical Ethics and Humanities in Medicine, University Of Virginia UVA health system, Charlottesville, Virginia, United States of America
| | - Francis Renault
- Departement de Neurophysiologie. Hopital Armand Trousseau APHP, Paris, France
| | - Terry D. Sanger
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California, United States of America
| | | | - Rachel Tennyson
- Pediatric Motor Disorders Research Program, Departments of Neurology and Pediatrics, University of Utah, Salt Lake City, Utah, United States of America
| | - Peter Uldall
- Department of Paediatrics and Adolescent Medicine, Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Yue Zhang
- Study Design and Biostatistics Center, University of Utah, Salt Lake City, Utah, United States of America
| | - Mary Zupanc
- Department of Neurology, Children’s Hospital Orange County, and Department of Pediatrics, University of California, Orange, California, United States of America
| | - Winnie Xin
- Center for Human Genetic Research, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Kenneth Silver
- Departments of Pediatrics and Neurology, University of Chicago and Comer Children's Hospital, Chicago, Illinois, United States of America
| | - Kathryn J. Swoboda
- Pediatric Motor Disorders Research Program, Departments of Neurology and Pediatrics, University of Utah, Salt Lake City, Utah, United States of America
- * E-mail:
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Developmental expression analysis of Na, K-ATPase α subunits in Xenopus. Dev Genes Evol 2015; 225:105-11. [PMID: 25772274 DOI: 10.1007/s00427-015-0497-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 03/03/2015] [Indexed: 10/23/2022]
Abstract
Na, K-ATPase is an integral membrane protein complex responsible for maintaining the ionic gradients of Na(+) and K(+) across the plasma membrane and has a variety of cellular functions including neuronal activity. Studies in several organisms have shown that this protein complex regulates multiple aspects of embryonic development and is responsible for the pathogenesis of several human diseases. Here, we report the cloning and expression of Na, K-ATPase α2 (atp1a2) and α3 (atp1a3) subunits during Xenopus development and compare the expression patterns of each subunit. Using in situ hybridization in whole embryos and on sections, we show that all three α subunits are co-expressed in the pronephric kidney, with varying expression in neurogenic derivatives. The atp1a2 has a unique expression in the ependymal cell layer of the developing brain that is not shared with other α subunits. The Na, K-ATPase α1 (atp1a1), and atp1a3 share many expression domains in placode derivatives, including the otic vesicle, lens, ganglion of the anterodorsal lateral line nerve, and ganglia of the facial and anteroventral lateral line nerve and olfactory cells. All the subunits share a common expression domain, the myocardium.
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211
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Nye BL, Thadani VM. Migraine and epilepsy: review of the literature. Headache 2015; 55:359-80. [PMID: 25754865 DOI: 10.1111/head.12536] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2015] [Indexed: 01/03/2023]
Abstract
Migraine and epilepsy are disorders that are common, paroxysmal, and chronic. In many ways they are clearly different diseases, yet there are some pathophysiological overlaps, and overlaps in clinical symptomatology, particularly with regard to visual and other sensory disturbances, pain, and alterations of consciousness. Epidemiological studies have revealed that the two diseases are comorbid in a number of individuals. Both are now recognized as originating from electrical disturbances in the brain, although their wider manifestations involve the recruitment of multiple pathogenic mechanisms. An initial excess of neuronal activity in migraine leads to cortical spreading depression and aura, with the subsequent recruitment of the trigeminal nucleus leading to central sensitization and pain. In epilepsy, neuronal overactivity leads to the recruitment of larger populations of neurons firing in a rhythmic manner that constitutes an epileptic seizure. Migraine aura and headaches may act as a trigger for epileptic seizures. Epilepsy is not infrequently accompanied by preictal, ictal, and postictal headaches that often have migrainous features. Genetic links are also apparent between the two disorders, and are particularly evident in the familial hemiplegic migraine syndromes where different mutations can produce either migraine, epilepsy, or both. Also, various medications are found to be effective for both migraine and epilepsy, again pointing to a commonality and overlap between the two disorders.
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Affiliation(s)
- Barbara L Nye
- Department of Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
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212
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A functional correlate of severity in alternating hemiplegia of childhood. Neurobiol Dis 2015; 77:88-93. [PMID: 25681536 DOI: 10.1016/j.nbd.2015.02.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Revised: 01/19/2015] [Accepted: 02/04/2015] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Mutations in ATP1A3, the gene that encodes the α3 subunit of the Na(+)/K(+) ATPase, are the primary cause of alternating hemiplegia of childhood (AHC). Correlations between different mutations and AHC severity were recently reported, with E815K identified in severe and D801N and G947R in milder cases. This study aims to explore the molecular pathological mechanisms in AHC and to identify functional correlates for mutations associated with different levels of disease severity. METHODS Human wild type ATP1A3, and E815K, D801N and G947R mutants were expressed in Xenopus laevis oocytes and Na(+)/K(+) ATPase function measured. Structural homology models of the human α3 subunit containing AHC mutations were created. RESULTS The AHC mutations examined all showed similar levels of reduction in forward cycling. Wild type forward cycling was reduced by coexpression with any mutant, indicating dominant negative interactions. Proton transport was measured and found to be selectively impaired only in E815K. Homology modeling showed that D801 and G947 lie within or near known cation binding sites while E815 is more distal. Despite its effect on proton transport, E815K was also distant from the proposed proton transport route. INTERPRETATION Loss of forward cycling and dominant negativity are common and likely necessary pathomechanisms for AHC. In addition, loss of proton transport correlated with severity of AHC. D801N and G947R are likely to directly disrupt normal Na(+)/K(+) binding while E815K may disrupt forward cycling and proton transport via allosteric mechanisms yet to be elucidated.
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Paciorkowski AR, McDaniel SS, Jansen LA, Tully H, Tuttle E, Ghoneim DH, Tupal S, Gunter SA, Vasta V, Zhang Q, Tran T, Liu YB, Ozelius LJ, Brashear A, Sweadner KJ, Dobyns WB, Hahn S. Novel mutations in ATP1A3 associated with catastrophic early life epilepsy, episodic prolonged apnea, and postnatal microcephaly. Epilepsia 2015; 56:422-30. [PMID: 25656163 DOI: 10.1111/epi.12914] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Mutations of ATP1A3 have been associated with rapid onset dystonia-parkinsonism and more recently with alternating hemiplegia of childhood. Here we report one child with catastrophic early life epilepsy and shortened survival, and another with epilepsy, episodic prolonged apnea, postnatal microcephaly, and severe developmental disability. Novel heterozygous mutations (p.Gly358Val and p.Ile363Asn) were identified in ATP1A3 in these children. METHODS Subjects underwent next-generation sequencing under a research protocol. Clinical data were collected retrospectively. The biochemical effects of the mutations on ATP1A3 protein function were investigated. Postmortem neuropathologic specimens from control and affected subjects were studied. RESULTS The mutations localized to the P domain of the Na,K-ATPase α3 protein, and resulted in significant reduction of Na,K-ATPase activity in vitro. We demonstrate in both control human brain tissue and that from the subject with the p.Gly358Val mutation that ATP1A3 immunofluorescence is prominently associated with interneurons in the cortex, which may provide some insight into the pathogenesis of the disease. SIGNIFICANCE The findings indicate these mutations cause severe phenotypes of ATP1A3-related disorder spectrum that include catastrophic early life epilepsy, episodic apnea, and postnatal microcephaly.
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Affiliation(s)
- Alex R Paciorkowski
- Departments of Neurology, Pediatrics, and Biomedical Genetics, University of Rochester Medical Center, Rochester, New York, U.S.A; Center for Neural Development and Disease, University of Rochester Medical Center, Rochester, New York, U.S.A
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214
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Balint B, Bhatia KP. Isolated and combined dystonia syndromes - an update on new genes and their phenotypes. Eur J Neurol 2015; 22:610-7. [DOI: 10.1111/ene.12650] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 11/12/2014] [Indexed: 11/27/2022]
Affiliation(s)
- B. Balint
- Sobell Department of Motor Neuroscience and Movement Disorders; UCL Institute of Neurology; London UK
- Department of Neurology; University Hospital Heidelberg; Heidelberg Germany
| | - K. P. Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders; UCL Institute of Neurology; London UK
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215
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P2C-Type ATPases and Their Regulation. Mol Neurobiol 2015; 53:1343-1354. [DOI: 10.1007/s12035-014-9076-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 12/29/2014] [Indexed: 12/12/2022]
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216
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The expanding spectrum of neurological phenotypes in children with ATP1A3 mutations, Alternating Hemiplegia of Childhood, Rapid-onset Dystonia-Parkinsonism, CAPOS and beyond. Pediatr Neurol 2015; 52:56-64. [PMID: 25447930 PMCID: PMC4352574 DOI: 10.1016/j.pediatrneurol.2014.09.015] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 09/09/2014] [Accepted: 09/23/2014] [Indexed: 01/04/2023]
Abstract
BACKGROUND ATP1A3 mutations have now been recognized in infants and children presenting with a diverse group of neurological phenotypes, including Rapid-onset Dystonia-Parkinsonism (RDP), Alternating Hemiplegia of Childhood (AHC), and most recently, Cerebellar ataxia, Areflexia, Pes cavus, Optic atrophy, and Sensorineural hearing loss (CAPOS) syndrome. METHODS Existing literature on ATP1A3-related disorders in the pediatric population were reviewed, with attention to clinical features and associated genotypes among those with RDP, AHC, or CAPOS syndrome phenotypes. RESULTS While classically defined phenotypes associated with AHC, RDP, and CAPOS syndromes are distinct, common elements among ATP1A3-related neurological disorders include characteristic episodic neurological symptoms and signs that vary in severity, duration, and frequency of occurrence. Affected children typically present in the context of an acute onset of paroxysmal, episodic neurological symptoms ranging from oculomotor abnormalities, hypotonia, paralysis, dystonia, ataxia, seizure-like episodes, or encephalopathy. Neurodevelopmental delays or persistence of dystonia, chorea, or ataxia after resolution of an initial episode are common, providing important clues for diagnosis. CONCLUSIONS The phenotypic spectrum of ATP1A3-related neurological disorders continues to expand beyond the distinct yet overlapping phenotypes in patients with AHC, RDP, and CAPOS syndromes. ATP1A3 mutation analysis is appropriate to consider in the diagnostic algorithm for any child presenting with episodic or fluctuating ataxia, weakness or dystonia whether they manifest persistence of neurological symptoms between episodes. Additional work is needed to better identify and classify affected patients and develop targeted treatment approaches.
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Schneider SA. Clinical Phenomenology and Genetics of Other Parkinsonian Syndromes Associated with Either Dystonia or Spasticity. Mov Disord 2015. [DOI: 10.1016/b978-0-12-405195-9.00057-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kinoshita PF, Yshii LM, Vasconcelos AR, Orellana AMM, Lima LDS, Davel APC, Rossoni LV, Kawamoto EM, Scavone C. Signaling function of Na,K-ATPase induced by ouabain against LPS as an inflammation model in hippocampus. J Neuroinflammation 2014; 11:218. [PMID: 25551197 PMCID: PMC4307894 DOI: 10.1186/s12974-014-0218-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Accepted: 12/08/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Ouabain (OUA) is a newly recognized hormone that is synthesized in the adrenal cortex and hypothalamus. Low doses of OUA can activate a signaling pathway by interaction with Na,K-ATPase, which is protective against a number of insults. OUA has central and peripheral anti-inflammatory effects. Lipopolysaccharide (LPS), via toll-like receptor 4 activation, is a widely used model to induce systemic inflammation. This study used a low OUA dose to evaluate its effects on inflammation induced by LPS injection in rats. METHODS Adult male Wistar rats received acute intraperitoneal (ip) OUA (1.8 μg/kg) or saline 20 minutes before LPS (200 μg/kg, ip) or saline injection. Some of the animals had their femoral artery catheterized in order to assess arterial blood pressure values before and after OUA administration. Na,K-ATPase activity, cytokine mRNA levels, apoptosis-related proteins, NF-κB activation brain-derived neurotrophic factor BDNF, corticosterone and TNF-α levels were measured. RESULTS OUA pretreatment decreased mRNA levels of the pro-inflammatory cytokines, inducible nitric oxide synthase (iNOS) and IL-1β, which are activated by LPS in the hippocampus, but with no effect on serum measures of these factors. None of these OUA effects were linked to Na,K-ATPase activity. The involvement of the inflammatory transcription factor NF-κB in the OUA effect was indicated by its prevention of LPS-induced nuclear translocation of the NF-κB subunit, RELA (p65), as well as the decreased cytosol levels of the NF-κB inhibitor, IKB, in the hippocampus. OUA pretreatment reversed the LPS-induced glial fibrillary acidic protein (GFAP) activation and associated inflammation in the dentate gyrus. OUA also prevented LPS-induced increases in the hippocampal Bax/Bcl2 ratio suggesting an anti-apoptotic action in the brain. CONCLUSION Our results suggest that a low dose of OUA has an important anti-inflammatory effect in the rat hippocampus. This effect was associated with decreased GFAP induction by LPS in the dentate gyrus, a brain area linked to adult neurogenesis.
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Affiliation(s)
- Paula Fernanda Kinoshita
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, 05508-900, São Paulo, Brazil.
| | - Lidia Mitiko Yshii
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, 05508-900, São Paulo, Brazil.
| | - Andrea Rodrigues Vasconcelos
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, 05508-900, São Paulo, Brazil.
| | - Ana Maria Marques Orellana
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, 05508-900, São Paulo, Brazil.
| | - Larissa de Sá Lima
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, 05508-900, São Paulo, Brazil.
| | - Ana Paula Couto Davel
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
| | - Luciana Venturini Rossoni
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
| | - Elisa Mitiko Kawamoto
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, 05508-900, São Paulo, Brazil.
| | - Cristoforo Scavone
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, 05508-900, São Paulo, Brazil.
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Hunanyan AS, Fainberg NA, Linabarger M, Arehart E, Leonard AS, Adil SM, Helseth AR, Swearingen AK, Forbes SL, Rodriguiz RM, Rhodes T, Yao X, Kibbi N, Hochman DW, Wetsel WC, Hochgeschwender U, Mikati MA. Knock-in mouse model of alternating hemiplegia of childhood: behavioral and electrophysiologic characterization. Epilepsia 2014; 56:82-93. [PMID: 25523819 DOI: 10.1111/epi.12878] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Mutations in the ATP1α3 subunit of the neuronal Na+/K+-ATPase are thought to be responsible for seizures, hemiplegias, and other symptoms of alternating hemiplegia of childhood (AHC). However, the mechanisms through which ATP1A3 mutations mediate their pathophysiologic consequences are not yet understood. The following hypotheses were investigated: (1) Our novel knock-in mouse carrying the most common heterozygous mutation causing AHC (D801N) will exhibit the manifestations of the human condition and display predisposition to seizures; and (2) the underlying pathophysiology in this mouse model involves increased excitability in response to electrical stimulation of Schaffer collaterals and abnormal predisposition to spreading depression (SD). METHODS We generated the D801N mutant mouse (Mashlool, Mashl+/-) and compared mutant and wild-type (WT) littermates. Behavioral tests, amygdala kindling, flurothyl-induced seizure threshold, spontaneous recurrent seizures (SRS), and other paroxysmal activities were compared between groups. In vitro electrophysiologic slice experiments on hippocampus were performed to assess predisposition to hyperexcitability and SD. RESULTS Mutant mice manifested a distinctive phenotype similar to that of humans with AHC. They had abnormal impulsivity, memory, gait, motor coordination, tremor, motor control, endogenous nociceptive response, paroxysmal hemiplegias, diplegias, dystonias, and SRS, as well as predisposition to kindling, to flurothyl-induced seizures, and to sudden unexpected death. Hippocampal slices of mutants, in contrast to WT animals, showed hyperexcitable responses to 1 Hz pulse-trains of electrical stimuli delivered to the Schaffer collaterals and had significantly longer duration of K+-induced SD responses. SIGNIFICANCE Our model reproduces the major characteristics of human AHC, and indicates that ATP1α3 dysfunction results in abnormal short-term plasticity with increased excitability (potential mechanism for seizures) and a predisposition to more severe SD responses (potential mechanism for hemiplegias). This model of the human condition should help in understanding the molecular pathways underlying these phenotypes and may lead to identification of novel therapeutic strategies of ATP1α3 related disorders and seizures.
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Affiliation(s)
- Arsen S Hunanyan
- Division of Pediatric Neurology, Department of Pediatrics, School of Medicine, Duke University, Durham, North Carolina, U.S.A
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Talsma AD, Chaves JF, LaMonaca A, Wieczorek ED, Palladino MJ. Genome-wide screen for modifiers of Na (+) /K (+) ATPase alleles identifies critical genetic loci. Mol Brain 2014; 7:89. [PMID: 25476251 PMCID: PMC4302446 DOI: 10.1186/s13041-014-0089-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 11/20/2014] [Indexed: 12/22/2022] Open
Abstract
Background Mutations affecting the Na+/ K+ATPase (a.k.a. the sodium-potassium pump) genes cause conditional locomotor phenotypes in flies and three distinct complex neurological diseases in humans. More than 50 mutations have been identified affecting the human ATP1A2 and ATP1A3 genes that are known to cause rapid-onset Dystonia Parkinsonism, familial hemiplegic migraine, alternating hemiplegia of childhood, and variants of familial hemiplegic migraine with neurological complications including seizures and various mood disorders. In flies, mutations affecting the ATPalpha gene have dramatic phenotypes including altered longevity, neural dysfunction, neurodegeneration, myodegeneration, and striking locomotor impairment. Locomotor defects can manifest as conditional bang-sensitive (BS) or temperature-sensitive (TS) paralysis: phenotypes well-suited for genetic screening. Results We performed a genome-wide deficiency screen using three distinct missense alleles of ATPalpha and conditional locomotor function assays to identify novel modifier loci. A secondary screen confirmed allele-specificity of the interactions and many of the interactions were mapped to single genes and subsequently validated. We successfully identified 64 modifier loci and used classical mutations and RNAi to confirm 50 single gene interactions. The genes identified include those with known function, several with unknown function or that were otherwise uncharacterized, and many loci with no described association with locomotor or Na+/K+ ATPase function. Conclusions We used an unbiased genome-wide screen to find regions of the genome containing elements important for genetic modulation of ATPalpha dysfunction. We have identified many critical regions and narrowed several of these to single genes. These data demonstrate there are many loci capable of modifying ATPalpha dysfunction, which may provide the basis for modifying migraine, locomotor and seizure dysfunction in animals. Electronic supplementary material The online version of this article (doi:10.1186/s13041-014-0089-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Aaron D Talsma
- Department of Pharmacology & Chemical Biology, University of Pittsburgh School of Medicine, 3501 Fifth Avenue, BST3 7042, Pittsburgh, PA, 15261, USA. .,Pittsburgh Institute for Neurodegenerative Diseases, University of Pittsburgh School of Medicine, 3501 Fifth Avenue, BST3 7042, Pittsburgh, PA, 15261, USA.
| | - John F Chaves
- Department of Pharmacology & Chemical Biology, University of Pittsburgh School of Medicine, 3501 Fifth Avenue, BST3 7042, Pittsburgh, PA, 15261, USA. .,Pittsburgh Institute for Neurodegenerative Diseases, University of Pittsburgh School of Medicine, 3501 Fifth Avenue, BST3 7042, Pittsburgh, PA, 15261, USA.
| | - Alexandra LaMonaca
- Department of Pharmacology & Chemical Biology, University of Pittsburgh School of Medicine, 3501 Fifth Avenue, BST3 7042, Pittsburgh, PA, 15261, USA. .,Pittsburgh Institute for Neurodegenerative Diseases, University of Pittsburgh School of Medicine, 3501 Fifth Avenue, BST3 7042, Pittsburgh, PA, 15261, USA.
| | - Emily D Wieczorek
- Department of Pharmacology & Chemical Biology, University of Pittsburgh School of Medicine, 3501 Fifth Avenue, BST3 7042, Pittsburgh, PA, 15261, USA. .,Pittsburgh Institute for Neurodegenerative Diseases, University of Pittsburgh School of Medicine, 3501 Fifth Avenue, BST3 7042, Pittsburgh, PA, 15261, USA.
| | - Michael J Palladino
- Department of Pharmacology & Chemical Biology, University of Pittsburgh School of Medicine, 3501 Fifth Avenue, BST3 7042, Pittsburgh, PA, 15261, USA. .,Pittsburgh Institute for Neurodegenerative Diseases, University of Pittsburgh School of Medicine, 3501 Fifth Avenue, BST3 7042, Pittsburgh, PA, 15261, USA.
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222
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Boelman C, Lagman-Bartolome AM, MacGregor DL, McCabe J, Logan WJ, Minassian BA. Identical ATP1A3 mutation causes alternating hemiplegia of childhood and rapid-onset dystonia parkinsonism phenotypes. Pediatr Neurol 2014; 51:850-3. [PMID: 25439493 DOI: 10.1016/j.pediatrneurol.2014.08.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 08/06/2014] [Accepted: 08/23/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Alternating hemiplegia of childhood and rapid-onset dystonia parkinsonism are two separate movement disorders with different dominant mutations in the same sodium-potassium transporter ATPase subunit gene, ATP1A3. PATIENT We present a child with topiramate-responsive alternating hemiplegia of childhood who was tested for an ATP1A3 gene mutation. RESULTS Gene sequencing revealed an identical ATP1A3 mutation as in three typical adult-onset rapid-onset dystonia parkinsonism cases but never previously described in an alternating hemiplegia of childhood case. CONCLUSION The discordance of these phenotypes suggests that there are other undiscovered environmental, genetic, or epigenetic factors influencing the development of alternating hemiplegia of childhood or rapid-onset dystonia parkinsonism.
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Affiliation(s)
- Cyrus Boelman
- Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada.
| | | | - Daune L MacGregor
- Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jane McCabe
- Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Willam J Logan
- Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Berge A Minassian
- Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
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223
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Wilcox R, Brænne I, Brüggemann N, Winkler S, Wiegers K, Bertram L, Anderson T, Lohmann K. Genome sequencing identifies a novel mutation in ATP1A3 in a family with dystonia in females only. J Neurol 2014; 262:187-93. [PMID: 25359261 DOI: 10.1007/s00415-014-7547-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 10/10/2014] [Accepted: 10/15/2014] [Indexed: 01/28/2023]
Abstract
Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal movements or postures. Several genetic causes of dystonia have been elucidated but genetic causes of dystonia specifically affecting females have not yet been described. In the present study, we investigated a large dystonia family from New Zealand in which only females were affected. They presented with a generalized form of the disorder including laryngeal, cervical, and arm dystonia. We found a novel, likely disease-causing, three base-pair deletion (c.443_445delGAG, p.Ser148del) in ATP1A3 in this family by combining genome and exome sequencing. Mutations in ATP1A3 have previously been linked to rapid-onset dystonia-parkinsonism (RDP), alternating hemiplegia of childhood (AHC), and CAPOS syndrome. Therefore, we re-examined our patients with a specific focus on typical symptoms of these conditions. It turned out that all patients reported a rapid onset of dystonic symptoms following a trigger suggesting a diagnosis of RDP. Notably, none of the patients showed clear symptoms of parkinsonism or symptoms specific for AHC or CAPOS. The ATP1A3 gene is located on chromosome 19q13.2, thus, providing no obvious explanation for the preponderance to affect females. Interestingly, we also identified one unaffected male offspring carrying the p.Ser148del mutation suggesting reduced penetrance of this mutation, a phenomenon that has also been observed for other RDP-causing mutations in ATP1A3. Although phenotypic information in this family was initially incomplete, the identification of the p.Ser148del ATP1A3 mutation elicited clinical re-examination of patients subsequently allowing establishing the correct diagnosis, a phenomenon known as "reverse phenotyping".
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Affiliation(s)
- Robert Wilcox
- Department of Neurology, Flinders Medical Centre, Adelaide, Australia
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224
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Abnormal high-frequency burst firing of cerebellar neurons in rapid-onset dystonia-parkinsonism. J Neurosci 2014; 34:11723-32. [PMID: 25164667 DOI: 10.1523/jneurosci.1409-14.2014] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Loss-of-function mutations in the α3 isoform of the Na(+)/K(+) ATPase (sodium pump) are responsible for rapid-onset dystonia parkinsonism (DYT12). Recently, a pharmacological model of DYT12 was generated implicating both the cerebellum and basal ganglia in the disorder. Notably, partially blocking sodium pumps in the cerebellum was necessary and sufficient for induction of dystonia. Thus, a key question that remains is how partially blocking sodium pumps in the cerebellum induces dystonia. In vivo recordings from dystonic mice revealed abnormal high-frequency bursting activity in neurons of the deep cerebellar nuclei (DCN), which comprise the bulk of cerebellar output. In the same mice, Purkinje cells, which provide strong inhibitory drive to DCN cells, also fired in a similarly erratic manner. In vitro studies demonstrated that Purkinje cells are highly sensitive to sodium pump dysfunction that alters the intrinsic pacemaking of these neurons, resulting in erratic burst firing similar to that identified in vivo. This abnormal firing abates when sodium pump function is restored and dystonia caused by partial block of sodium pumps can be similarly alleviated. These findings suggest that persistent high-frequency burst firing of cerebellar neurons caused by sodium pump dysfunction underlies dystonia in this model of DYT12.
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225
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Sugimoto H, Ikeda K, Kawakami K. Heterozygous mice deficient in Atp1a3 exhibit motor deficits by chronic restraint stress. Behav Brain Res 2014; 272:100-10. [DOI: 10.1016/j.bbr.2014.06.048] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 06/13/2014] [Accepted: 06/23/2014] [Indexed: 11/30/2022]
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226
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Dalziel AC, Bittman J, Mandic M, Ou M, Schulte PM. Origins and functional diversification of salinity-responsive Na(+) , K(+) ATPase α1 paralogs in salmonids. Mol Ecol 2014; 23:3483-503. [PMID: 24917532 DOI: 10.1111/mec.12828] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 06/03/2014] [Accepted: 06/04/2014] [Indexed: 01/17/2023]
Abstract
The Salmoniform whole-genome duplication is hypothesized to have facilitated the evolution of anadromy, but little is known about the contribution of paralogs from this event to the physiological performance traits required for anadromy, such as salinity tolerance. Here, we determined when two candidate, salinity-responsive paralogs of the Na(+) , K(+) ATPase α subunit (α1a and α1b) evolved and studied their evolutionary trajectories and tissue-specific expression patterns. We found that these paralogs arose during a small-scale duplication event prior to the Salmoniform, but after the teleost, whole-genome duplication. The 'freshwater paralog' (α1a) is primarily expressed in the gills of Salmoniformes and an unduplicated freshwater sister species (Esox lucius) and experienced positive selection in the freshwater ancestor of Salmoniformes and Esociformes. Contrary to our predictions, the 'saltwater paralog' (α1b), which is more widely expressed than α1a, did not experience positive selection during the evolution of anadromy in the Coregoninae and Salmonine. To determine whether parallel mutations in Na(+) , K(+) ATPase α1 may contribute to salinity tolerance in other fishes, we studied independently evolved salinity-responsive Na(+) , K(+) ATPase α1 paralogs in Anabas testudineus and Oreochromis mossambicus. We found that a quarter of the mutations occurring between salmonid α1a and α1b in functionally important sites also evolved in parallel in at least one of these species. Together, these data argue that paralogs contributing to salinity tolerance evolved prior to the Salmoniform whole-genome duplication and that strong selection and/or functional constraints have led to parallel evolution in salinity-responsive Na(+) , K(+) ATPase α1 paralogs in fishes.
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Affiliation(s)
- Anne C Dalziel
- Department of Zoology, Biodiversity Research Center, University of British Columbia, 6270 University Blvd, Vancouver, British Columbia, Canada, V6T 1Z4; Department of Biology, Pavillon Charles-Eugène-Marchand, Université Laval, 1030 Avenue de la Médecine, Québec City, Québec, Canada, G1V 0A6
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227
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Olson HE, Poduri A, Pearl PL. Genetic forms of epilepsies and other paroxysmal disorders. Semin Neurol 2014; 34:266-79. [PMID: 25192505 DOI: 10.1055/s-0034-1386765] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Genetic mechanisms explain the pathophysiology of many forms of epilepsy and other paroxysmal disorders, such as alternating hemiplegia of childhood, familial hemiplegic migraine, and paroxysmal dyskinesias. Epilepsy is a key feature of well-defined genetic syndromes including tuberous sclerosis complex, Rett syndrome, Angelman syndrome, and others. There is an increasing number of single-gene causes or susceptibility factors associated with several epilepsy syndromes, including the early-onset epileptic encephalopathies, benign neonatal/infantile seizures, progressive myoclonus epilepsies, genetic generalized and benign focal epilepsies, epileptic aphasias, and familial focal epilepsies. Molecular mechanisms are diverse, and a single gene can be associated with a broad range of phenotypes. Additional features, such as dysmorphisms, head size, movement disorders, and family history may provide clues to a genetic diagnosis. Genetic testing can impact medical care and counseling. We discuss genetic mechanisms of epilepsy and other paroxysmal disorders, tools and indications for genetic testing, known genotype-phenotype associations, the importance of genetic counseling, and a look toward the future of epilepsy genetics.
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Affiliation(s)
- Heather E Olson
- Division of Epilepsy, Department of Neurology, Boston Children's Hospital, Boston, Massachusetts
| | - Annapurna Poduri
- Division of Epilepsy, Department of Neurology, Boston Children's Hospital, Boston, Massachusetts
| | - Phillip L Pearl
- Division of Epilepsy, Department of Neurology, Boston Children's Hospital, Boston, Massachusetts
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228
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Vila-Pueyo M, Pons R, Raspall-Chaure M, Marcé-Grau A, Carreño O, Sintas C, Cormand B, Pineda-Marfà M, Macaya A. Clinical and genetic analysis in alternating hemiplegia of childhood: Ten new patients from Southern Europe. J Neurol Sci 2014; 344:37-42. [DOI: 10.1016/j.jns.2014.06.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 06/04/2014] [Accepted: 06/09/2014] [Indexed: 10/25/2022]
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229
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A missense variant of the ATP1A2 gene is associated with a novel phenotype of progressive sensorineural hearing loss associated with migraine. Eur J Hum Genet 2014; 23:639-45. [PMID: 25138102 DOI: 10.1038/ejhg.2014.154] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Revised: 06/25/2014] [Accepted: 07/02/2014] [Indexed: 11/08/2022] Open
Abstract
Hereditary sensorineural hearing loss is an extremely clinical and genetic heterogeneous disorder in humans. Especially, syndromic hearing loss is subdivided by combinations of various phenotypes, and each subtype is related to different genes. We present a new form of progressive hearing loss with migraine found to be associated with a variant in the ATP1A2 gene. The ATP1A2 gene has been reported as the major genetic cause of familial migraine by several previous studies. A Korean family presenting progressive hearing loss with migraine was ascertained. The affected members did not show any aura or other neurologic symptoms during migraine attacks, indicating on a novel phenotype of syndromic hearing loss. To identify the causative gene, linkage analysis and whole-exome sequencing were performed. A novel missense variant, c.571G>A (p.(Val191Met)), was identified in the ATP1A2 gene that showed co-segregation with the phenotype in the family. In silico studies suggest that this variant causes a change in hydrophobic interactions and thereby slightly destabilize the A-domain of Na(+)/K(+)-ATPase. However, functional studies failed to show any effect of the p.(Val191Met) substitution on the catalytic rate of this enzyme. We describe a new phenotype of progressive hearing loss with migraine associated with a variant in the ATP1A2 gene. This study suggests that a variant in Na(+)/K(+)-ATPase can be involved in both migraine and hearing loss.
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230
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Abstract
The basal ganglia were originally thought to be associated purely with motor control. However, dysfunction and pathology of different regions and circuits are now known to give rise to many clinical manifestations beyond the association of basal ganglia dysfunction with movement disorders. Moreover, disorders that were thought to be caused by dysfunction of the basal ganglia only, such as Parkinson's disease and Huntington's disease, have diverse abnormalities distributed not only in the brain but also in the peripheral and autonomic nervous systems; this knowledge poses new questions and challenges. We discuss advances and the unanswered questions, and ways in which progress might be made.
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Affiliation(s)
- Jose A Obeso
- Movement Disorders Laboratory, Department of Neurology and Neuroscience Area, Clínica Universitaria and Medical School, and CIMA, University of Navarra, Pamplona, Spain; Centro de Investigación en Redes sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.
| | - Maria C Rodriguez-Oroz
- Centro de Investigación en Redes sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Department of Neurology, University Hospital Donostia and Neuroscience Unit BioDonostia Research Institute, San Sebastian, Ikerbasque, Basque Foundation for Science, Bilbao, Spain
| | - Maria Stamelou
- Movement Disorders Clinic, Second Department of Neurology, Attiko Hospital, University of Athens, Greece; Sobell Department of Motor Neurosciences and Movement Disorders, UCL Institute of Neurology, London, UK
| | - Kailash P Bhatia
- Sobell Department of Motor Neurosciences and Movement Disorders, UCL Institute of Neurology, London, UK
| | - David J Burn
- Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK
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231
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Goubau C, Buyse GM, Van Geet C, Freson K. The contribution of platelet studies to the understanding of disease mechanisms in complex and monogenetic neurological disorders. Dev Med Child Neurol 2014; 56:724-31. [PMID: 24579816 DOI: 10.1111/dmcn.12421] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/05/2014] [Indexed: 01/03/2023]
Abstract
Platelets, known for their role in primary haemostasis, prevent excessive bleeding after injury. The study of platelets has, therefore, traditionally focused on bleeding disorders. It has recently become evident, however, that platelet research can contribute to unravelling the disease mechanisms that underlie neuropathological disorders that have a subtle subclinical platelet phenotype. Platelets and neurosecretory cells have common gene expression profiles and share several biological features. This review provides a literature update on the use of platelets as easily accessible cells to study neurological disorders. We provide examples of the use of different platelet-based tests to understand the underlying pathophysiological mechanisms for both complex and monogenetic neuropathological disorders. In addition to the well-studied regulated granule secretion and serotonin metabolism, more recent studies have shown that defects in transcription factors, membrane transporters, G-protein signal transduction, and cytoskeletal proteins can be investigated using platelets to gain information on their role in neuropathology.
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Affiliation(s)
- Christophe Goubau
- Center for Molecular and Vascular Biology, University of Leuven, Leuven, Belgium; Department of Child Neurology, University Hospitals Leuven, Leuven, Belgium
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232
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Affiliation(s)
- Allison Brashear
- Department of Neurology, Wake Forest School of Medicine, Wake Forest Baptist Health
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233
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Vollono C, Rinalduzzi S, Miliucci R, Vigevano F, Valeriani M. Somatosensory system hyperexcitability in alternating hemiplegia of childhood. Eur J Neurol 2014; 21:1478-e97. [DOI: 10.1111/ene.12516] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 05/26/2014] [Indexed: 10/25/2022]
Affiliation(s)
- C. Vollono
- Unit of Neurophysiopathology and Sleep Medicine; Department of Geriatrics; Neurosciences and Orthopedics; Catholic University; Rome Italy
| | - S. Rinalduzzi
- Neurology Unit; ‘Sandro Pertini’ Hospital; Rome Italy
| | - R. Miliucci
- Neurology Division; Pediatric Hospital ‘Bambino Gesù’; IRCCS; Rome Italy
| | - F. Vigevano
- Neurology Division; Pediatric Hospital ‘Bambino Gesù’; IRCCS; Rome Italy
| | - M. Valeriani
- Neurology Division; Pediatric Hospital ‘Bambino Gesù’; IRCCS; Rome Italy
- Center for Sensory-Motor Interaction; Aalborg University; Aalborg Denmark
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234
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Weigand KM, Messchaert M, Swarts HG, Russel FG, Koenderink JB. Alternating Hemiplegia of Childhood mutations have a differential effect on Na+,K+-ATPase activity and ouabain binding. Biochim Biophys Acta Mol Basis Dis 2014; 1842:1010-6. [DOI: 10.1016/j.bbadis.2014.03.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 02/26/2014] [Accepted: 03/02/2014] [Indexed: 10/25/2022]
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235
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Oblak AL, Hagen MC, Sweadner KJ, Haq I, Whitlow CT, Maldjian JA, Epperson F, Cook JF, Stacy M, Murrell JR, Ozelius LJ, Brashear A, Ghetti B. Rapid-onset dystonia-parkinsonism associated with the I758S mutation of the ATP1A3 gene: a neuropathologic and neuroanatomical study of four siblings. Acta Neuropathol 2014; 128:81-98. [PMID: 24803225 PMCID: PMC4059967 DOI: 10.1007/s00401-014-1279-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 04/02/2014] [Accepted: 04/03/2014] [Indexed: 11/24/2022]
Abstract
Rapid-onset dystonia-parkinsonism (RDP) is a movement disorder associated with mutations in the ATP1A3 gene. Signs and symptoms of RDP commonly occur in adolescence or early adulthood and can be triggered by physical or psychological stress. Mutations in ATP1A3 are also associated with alternating hemiplegia of childhood (AHC). The neuropathologic substrate of these conditions is unknown. The central nervous system of four siblings, three affected by RDP and one asymptomatic, all carrying the I758S mutation in the ATP1A3 gene, was analyzed. This neuropathologic study is the first carried out in ATP1A3 mutation carriers, whether affected by RDP or AHC. Symptoms began in the third decade of life for two subjects and in the fifth for another. The present investigation aimed at identifying, in mutation carriers, anatomical areas potentially affected and contributing to RDP pathogenesis. Comorbid conditions, including cerebrovascular disease and Alzheimer disease, were evident in all subjects. We evaluated areas that may be relevant to RDP separately from those affected by the comorbid conditions. Anatomical areas identified as potential targets of I758S mutation were globus pallidus, subthalamic nucleus, red nucleus, inferior olivary nucleus, cerebellar Purkinje and granule cell layers, and dentate nucleus. Involvement of subcortical white matter tracts was also evident. Furthermore, in the spinal cord, a loss of dorsal column fibers was noted. This study has identified RDP-associated pathology in neuronal populations, which are part of complex motor and sensory loops. Their involvement would cause an interruption of cerebral and cerebellar connections which are essential for maintenance of motor control.
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Affiliation(s)
- Adrian L. Oblak
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN USA
| | - Matthew C. Hagen
- Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Kathleen J. Sweadner
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA USA
| | - Ihtsham Haq
- Department of Neurology, Wake Forest School of Medicine, Wake Forest Baptist Health, Winston-Salem, NC USA
| | - Christopher T. Whitlow
- Department of Radiology (Neuroradiology), Wake Forest Baptist Health, Winston-Salem, NC USA
| | - Joseph A. Maldjian
- Department of Radiology (Neuroradiology), Wake Forest Baptist Health, Winston-Salem, NC USA
| | - Francine Epperson
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN USA
| | - Jared F. Cook
- Department of Neurology, Wake Forest School of Medicine, Wake Forest Baptist Health, Winston-Salem, NC USA
| | - Mark Stacy
- Department of Neurology, Duke University School of Medicine, Duke Health, Durham, NC USA
| | - Jill R. Murrell
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN USA
| | - Laurie J. Ozelius
- Department of Genetics and Genomic Sciences and Neurology, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Allison Brashear
- Department of Neurology, Wake Forest School of Medicine, Wake Forest Baptist Health, Winston-Salem, NC USA
| | - Bernardino Ghetti
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN USA
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236
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Hu H, Roach JC, Coon H, Guthery SL, Voelkerding KV, Margraf RL, Durtschi JD, Tavtigian SV, Shankaracharya, Wu W, Scheet P, Wang S, Xing J, Glusman G, Hubley R, Li H, Garg V, Moore B, Hood L, Galas DJ, Srivastava D, Reese MG, Jorde LB, Yandell M, Huff CD. A unified test of linkage analysis and rare-variant association for analysis of pedigree sequence data. Nat Biotechnol 2014; 32:663-9. [PMID: 24837662 PMCID: PMC4157619 DOI: 10.1038/nbt.2895] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 04/04/2014] [Indexed: 01/02/2023]
Abstract
High-throughput sequencing of related individuals has become an important tool for studying human disease. However, owing to technical complexity and lack of available tools, most pedigree-based sequencing studies rely on an ad hoc combination of suboptimal analyses. Here we present pedigree-VAAST (pVAAST), a disease-gene identification tool designed for high-throughput sequence data in pedigrees. pVAAST uses a sequence-based model to perform variant and gene-based linkage analysis. Linkage information is then combined with functional prediction and rare variant case-control association information in a unified statistical framework. pVAAST outperformed linkage and rare-variant association tests in simulations and identified disease-causing genes from whole-genome sequence data in three human pedigrees with dominant, recessive and de novo inheritance patterns. The approach is robust to incomplete penetrance and locus heterogeneity and is applicable to a wide variety of genetic traits. pVAAST maintains high power across studies of monogenic, high-penetrance phenotypes in a single pedigree to highly polygenic, common phenotypes involving hundreds of pedigrees.
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Affiliation(s)
- Hao Hu
- Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Jared C Roach
- Institute for Systems Biology, Seattle, Washington, USA
| | - Hilary Coon
- Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | - Stephen L Guthery
- Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Karl V Voelkerding
- 1] Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA. [2] ARUP Institute for Clinical and Experimental Pathology, ARUP Laboratories, Salt Lake City, Utah, USA
| | - Rebecca L Margraf
- ARUP Institute for Clinical and Experimental Pathology, ARUP Laboratories, Salt Lake City, Utah, USA
| | - Jacob D Durtschi
- ARUP Institute for Clinical and Experimental Pathology, ARUP Laboratories, Salt Lake City, Utah, USA
| | - Sean V Tavtigian
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
| | - Shankaracharya
- Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Wilfred Wu
- Department of Human Genetics and USTAR Center for Genetic Discovery, University of Utah, Salt Lake City, Utah, USA
| | - Paul Scheet
- Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Shuoguo Wang
- Department of Genetics, Rutgers, the State University of New Jersey, Piscataway, New Jersey, USA
| | - Jinchuan Xing
- Department of Genetics, Rutgers, the State University of New Jersey, Piscataway, New Jersey, USA
| | | | - Robert Hubley
- Institute for Systems Biology, Seattle, Washington, USA
| | - Hong Li
- Institute for Systems Biology, Seattle, Washington, USA
| | - Vidu Garg
- 1] Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA. [2] Center for Cardiovascular and Pulmonary Research, Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Barry Moore
- Department of Human Genetics and USTAR Center for Genetic Discovery, University of Utah, Salt Lake City, Utah, USA
| | - Leroy Hood
- Institute for Systems Biology, Seattle, Washington, USA
| | - David J Galas
- 1] Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg. [2] Pacific Northwest Diabetes Research Institute, Seattle, Washington, USA
| | - Deepak Srivastava
- Gladstone Institute of Cardiovascular Disease and University of California, San Francisco, San Francisco, California, USA
| | | | - Lynn B Jorde
- Department of Human Genetics and USTAR Center for Genetic Discovery, University of Utah, Salt Lake City, Utah, USA
| | - Mark Yandell
- Department of Human Genetics and USTAR Center for Genetic Discovery, University of Utah, Salt Lake City, Utah, USA
| | - Chad D Huff
- Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
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237
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Reid CA, Mullen S, Kim TH, Petrou S. Epilepsy, energy deficiency and new therapeutic approaches including diet. Pharmacol Ther 2014; 144:192-201. [PMID: 24924701 DOI: 10.1016/j.pharmthera.2014.06.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 05/28/2014] [Indexed: 02/08/2023]
Abstract
Metabolic dysfunction leading to epilepsy is well recognised. Dietary therapy, in particular the ketogenic diet, is now considered an effective option. Recent genetic studies have highlighted the central role that metabolism can play in setting seizure susceptibility. Here we discuss various metabolic disorders implicated in epilepsy focusing on energy deficiency due to genetic and environmental causes. We argue that low, uncompensated brain glucose levels can precipitate seizures. We will also explore mechanisms of disease and therapy in an attempt to identify common metabolic pathways involved in modulating seizure susceptibility. Finally, newer therapeutic approaches based on diet manipulation in the context of energy deficiency are discussed.
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Affiliation(s)
- Christopher A Reid
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia.
| | - Saul Mullen
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia
| | - Tae Hwan Kim
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia
| | - Steven Petrou
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia; Centre for Neural Engineering, The University of Melbourne, Parkville, Melbourne, Australia; Department of Electrical Engineering, The University of Melbourne, Parkville, Melbourne, Australia
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238
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Heinzen EL, Arzimanoglou A, Brashear A, Clapcote SJ, Gurrieri F, Goldstein DB, Jóhannesson SH, Mikati MA, Neville B, Nicole S, Ozelius LJ, Poulsen H, Schyns T, Sweadner KJ, van den Maagdenberg A, Vilsen B. Distinct neurological disorders with ATP1A3 mutations. Lancet Neurol 2014; 13:503-14. [PMID: 24739246 DOI: 10.1016/s1474-4422(14)70011-0] [Citation(s) in RCA: 181] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Genetic research has shown that mutations that modify the protein-coding sequence of ATP1A3, the gene encoding the α3 subunit of Na(+)/K(+)-ATPase, cause both rapid-onset dystonia parkinsonism and alternating hemiplegia of childhood. These discoveries link two clinically distinct neurological diseases to the same gene, however, ATP1A3 mutations are, with one exception, disease-specific. Although the exact mechanism of how these mutations lead to disease is still unknown, much knowledge has been gained about functional consequences of ATP1A3 mutations using a range of in-vitro and animal model systems, and the role of Na(+)/K(+)-ATPases in the brain. Researchers and clinicians are attempting to further characterise neurological manifestations associated with mutations in ATP1A3, and to build on the existing molecular knowledge to understand how specific mutations can lead to different diseases.
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Affiliation(s)
- Erin L Heinzen
- Center for Human Genome Variation, Duke University, School of Medicine, Durham, NC, USA; Department of Medicine, Section of Medical Genetics, Duke University, School of Medicine, Durham, NC, USA.
| | - Alexis Arzimanoglou
- Epilepsy, Sleep and Pediatric Neurophysiology Department, HFME, University Hospitals of Lyon, France; Centre de Recherche en Neurosciences de Lyon, Centre National de la Recherche Scientifique, UMR 5292, INSERM U1028, Lyon, France
| | - Allison Brashear
- Department of Neurology, Wake Forest School of Medicine, Winston Salem, NC, USA
| | | | - Fiorella Gurrieri
- Istituto di Genetica Medica, Università Cattolica S Cuore, Rome, Italy
| | - David B Goldstein
- Center for Human Genome Variation, Duke University, School of Medicine, Durham, NC, USA; Department of Molecular Genetics and Microbiology, Duke University, School of Medicine, Durham, NC, USA
| | | | - Mohamad A Mikati
- Division of Pediatric Neurology, Duke University, School of Medicine, Durham, NC, USA; Department of Neurobiology, Duke University, School of Medicine, Durham, NC, USA
| | - Brian Neville
- Institute of Child Health, University College London, London, UK
| | - Sophie Nicole
- Institut National de la Santé et de la Recherche Médicale, U975, Centre de Recherche de l'Institut du Cerveau et de la Moelle, Paris, France; Centre National de la Recherche Scientifique, UMR7225, Paris, France; Université Pierre et Marie Curie Paris VI, UMRS975, Paris, France
| | - Laurie J Ozelius
- Department of Genetics and Genomic Sciences and Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hanne Poulsen
- Danish Research Institute for Translational Neuroscience, Nordic-EMBL Partnership of Molecular Medicine, Department of Molecular Biology and Genetics, Aarhus University, Aarhus, Denmark; Centre for Membrane Pumps in Cells and Disease-PUMPKIN, Danish National Research Foundation, Aarhus, Denmark
| | - Tsveta Schyns
- European Network for Research on Alternating Hemiplegia (ENRAH), Brussels, Belgium
| | | | - Arn van den Maagdenberg
- Department of Human Genetics and Department of Neurology, Leiden University Medical Centre, Leiden, Netherlands
| | - Bente Vilsen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
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239
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Haspel RL, Olsen RJ, Berry A, Hill CE, Pfeifer JD, Schrijver I, Kaul KL. Progress and potential: training in genomic pathology. Arch Pathol Lab Med 2014; 138:498-504. [PMID: 24678680 DOI: 10.5858/arpa.2013-0359-sa] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
CONTEXT Genomic medicine is revolutionizing patient care. Physicians in areas as diverse as oncology, obstetrics, and infectious disease have begun using next-generation sequencing assays as standard diagnostic tools. OBJECTIVE To review the role of pathologists in genomic testing as well as current educational programs and future training needs in genomic pathology. DATA SOURCES Published literature as well as personal experience based on committee membership and genomic pathology curricular design. CONCLUSIONS Pathologists, as the directors of the clinical laboratories, must be prepared to integrate genomic testing into their practice. The pathology community has made significant progress in genomics-related education. A continued coordinated and proactive effort will ensure a future vital role for pathologists in the evolving health care system and also the best possible patient care.
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Affiliation(s)
- Richard L Haspel
- From the Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (Dr Haspel); the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas (Dr Olsen); the Department of Pathology, University of California San Francisco, San Francisco (Dr Berry); the Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia (Dr Hill); the Department of Pathology, Washington University, St Louis, Missouri (Dr Pfeifer); the Departments of Pathology and Pediatrics and the Center for Genomics and Personalized Medicine, Stanford University Medical Center, Stanford, California (Dr Schrijver); and the Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, Illinois (Dr Kaul)
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240
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Longoni M, Marangi G, Zollino M. Utility and Challenges of Next Generation Sequencing in Pediatric Disorders. CURRENT PEDIATRICS REPORTS 2014. [DOI: 10.1007/s40124-014-0039-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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241
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One gene, many neuropsychiatric disorders: lessons from Mendelian diseases. Nat Neurosci 2014; 17:773-81. [PMID: 24866043 DOI: 10.1038/nn.3713] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 03/31/2014] [Indexed: 12/14/2022]
Abstract
Recent human genetic studies have consistently shown that mutations in the same gene or same genomic region can increase the risk of a broad range of complex neuropsychiatric disorders. Despite the steadily increasing number of examples of such nonspecific effects on risk, the underlying biological causes remain mysterious. Here we investigate the phenomenon of such nonspecific risk by identifying Mendelian disease genes that are associated with multiple diseases and explore what is known about the underlying mechanisms in these more 'simple' examples. Our analyses make clear that there are a variety of mechanisms at work, emphasizing how challenging it will be to elucidate the causes of nonspecific risk in complex disease. Ultimately, we conclude that functional approaches will be critical for explaining the causes of nonspecific risk factors discovered by human genetic studies of neuropsychiatric disorders.
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242
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van Veen S, Sørensen DM, Holemans T, Holen HW, Palmgren MG, Vangheluwe P. Cellular function and pathological role of ATP13A2 and related P-type transport ATPases in Parkinson's disease and other neurological disorders. Front Mol Neurosci 2014; 7:48. [PMID: 24904274 PMCID: PMC4033846 DOI: 10.3389/fnmol.2014.00048] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 05/05/2014] [Indexed: 12/14/2022] Open
Abstract
Mutations in ATP13A2 lead to Kufor-Rakeb syndrome, a parkinsonism with dementia. ATP13A2 belongs to the P-type transport ATPases, a large family of primary active transporters that exert vital cellular functions. However, the cellular function and transported substrate of ATP13A2 remain unknown. To discuss the role of ATP13A2 in neurodegeneration, we first provide a short description of the architecture and transport mechanism of P-type transport ATPases. Then, we briefly highlight key P-type ATPases involved in neuronal disorders such as the copper transporters ATP7A (Menkes disease), ATP7B (Wilson disease), the Na(+)/K(+)-ATPases ATP1A2 (familial hemiplegic migraine) and ATP1A3 (rapid-onset dystonia parkinsonism). Finally, we review the recent literature of ATP13A2 and discuss ATP13A2's putative cellular function in the light of what is known concerning the functions of other, better-studied P-type ATPases. We critically review the available data concerning the role of ATP13A2 in heavy metal transport and propose a possible alternative hypothesis that ATP13A2 might be a flippase. As a flippase, ATP13A2 may transport an organic molecule, such as a lipid or a peptide, from one membrane leaflet to the other. A flippase might control local lipid dynamics during vesicle formation and membrane fusion events.
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Affiliation(s)
- Sarah van Veen
- Laboratory of Cellular Transport Systems, Department of Cellular and Molecular Medicine, KU Leuven Leuven, Belgium
| | - Danny M Sørensen
- Laboratory of Cellular Transport Systems, Department of Cellular and Molecular Medicine, KU Leuven Leuven, Belgium
| | - Tine Holemans
- Laboratory of Cellular Transport Systems, Department of Cellular and Molecular Medicine, KU Leuven Leuven, Belgium
| | - Henrik W Holen
- Department of Plant and Environmental Sciences, Centre for Membrane Pumps in Cells and Disease - PUMPkin, University of Copenhagen Frederiksberg, Denmark
| | - Michael G Palmgren
- Department of Plant and Environmental Sciences, Centre for Membrane Pumps in Cells and Disease - PUMPkin, University of Copenhagen Frederiksberg, Denmark
| | - Peter Vangheluwe
- Laboratory of Cellular Transport Systems, Department of Cellular and Molecular Medicine, KU Leuven Leuven, Belgium
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243
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Abstract
The past year has been extremely successful with regard to the genetics of dystonia, with the identification of four new dystonia genes (CIZ1, ANO3, GNAL, and TUBB4A). This progress was primarily achieved because of the application of a new technology, next-generation DNA sequencing, which allows rapid and comprehensive assessment of a patient's genome. In addition, a combination of next-generation and traditional Sanger sequencing has expanded the phenotypic spectrum associated with some of the dystonia plus (ATP1A3) and paroxysmal (PRRT2) loci. This article reviews the newly identified genes and phenotypes and discusses the future applications of next-generation sequencing to dystonia research.
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Affiliation(s)
- Tania Fuchs
- Department of Genetics and Genomic Sciences, Ichan School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1498, New York, NY, 10029, USA,
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244
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ATP1A3 mutations and genotype-phenotype correlation of alternating hemiplegia of childhood in Chinese patients. PLoS One 2014; 9:e97274. [PMID: 24842602 PMCID: PMC4026576 DOI: 10.1371/journal.pone.0097274] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 04/17/2014] [Indexed: 11/19/2022] Open
Abstract
Alternating hemiplegia of childhood (AHC) is a rare and severe neurological disorder. ATP1A3 was recently identified as the causative gene. Here we report the first genetic study in Chinese AHC cohort. We performed whole-exome sequencing on three trios and three unrelated patients, and screened additional 41 typical cases and 100 controls by PCR-Sanger sequencing. ATP1A3 mutations were detected in 95.7% of typical AHC patients. At least 93.3% were de novo. Four late onset, atypical AHC patients were also mutation positive, suggesting the need for testing ATP1A3 mutations in atypical cases. Totally, 13 novel missense mutations (T370N, G706R, L770R, T771N, T771I, S772R, L802P, D805H, M806K, P808L, I810N, L839P and G893R) were identified in our study. By homology modeling of the mutant protein structures and calculation of an extensive list of molecular features, we identified two statistically significant molecular features, solvent accessibility and distance to metal ion, that distinguished disease-associated mutations from neutral variants. A logistic regression classifier achieved 92.9% accuracy by the average of 100 times of five-fold cross validations. Genotype-phenotype correlation analysis showed that patients with epilepsy were more likely to carry E815K mutation. In summary, ATP1A3 is the major pathogenic gene of AHC in Chinese patients; mutations have distinctive molecular features that discriminate them from neutral variants and are correlated with phenotypes.
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245
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Weller CM, Leen WG, Neville BGR, Duncan JS, de Vries B, Geilenkirchen MA, Haan J, Kamsteeg EJ, Ferrari MD, van den Maagdenberg AMJM, Willemsen MAAP, Scheffer H, Terwindt GM. A novel SLC2A1 mutation linking hemiplegic migraine with alternating hemiplegia of childhood. Cephalalgia 2014; 35:10-5. [PMID: 24824604 DOI: 10.1177/0333102414532379] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Hemiplegic migraine (HM) and alternating hemiplegia of childhood (AHC) are rare episodic neurological brain disorders with partial clinical and genetic overlap. Recently, ATP1A3 mutations were shown to account for the majority of AHC patients. In addition, a mutation in the SLC2A1 gene was reported in a patient with atypical AHC. We therefore investigated whether mutations in these genes may also be involved in HM. Furthermore, we studied the role of SLC2A1 mutations in a small set of AHC patients without ATP1A3 mutations. METHODS We screened 42 HM patients (21 familial and 21 sporadic patients) for ATP1A3 and SLC2A1 mutations. In addition, four typical AHC patients and one atypical patient with overlapping symptoms of both disorders were screened for SLC2A1 mutations. RESULTS A pathogenic de novo SLC2A1 mutation (p.Gly18Arg) was found in the atypical patient with overlapping symptoms of AHC and hemiplegic migraine. No mutations were found in the HM and the other AHC patients. CONCLUSION Screening for a mutation in the SLC2A1 gene should be considered in patients with a complex phenotype with overlapping symptoms of hemiplegic migraine and AHC.
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Affiliation(s)
- Claudia M Weller
- Department of Human Genetics, Leiden University Medical Centre, the Netherlands
| | - Wilhelmina G Leen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, the Netherlands
| | - Brian G R Neville
- Neurosciences Unit, Institute of Child Health, UCL Medical School and Great Ormond Street Hospital for Children NHS Trust, UK
| | | | - Boukje de Vries
- Department of Human Genetics, Leiden University Medical Centre, the Netherlands
| | | | - Joost Haan
- Neurosciences Unit, Institute of Child Health, UCL Medical School and Great Ormond Street Hospital for Children NHS Trust, UK Department of Neurology, Rijnland Hospital, the Netherlands
| | - Erik-Jan Kamsteeg
- Department of Human Genetics, Institute for Genetic and Metabolic Disease, Radboud University Medical Centre, the Netherlands
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Center, the Netherlands
| | - Arn M J M van den Maagdenberg
- Department of Human Genetics, Leiden University Medical Centre, the Netherlands Department of Neurology, Leiden University Medical Center, the Netherlands
| | - Michèl A A P Willemsen
- Department of Paediatric Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, the Netherlands
| | - Hans Scheffer
- Department of Human Genetics, Institute for Genetic and Metabolic Disease, Radboud University Medical Centre, the Netherlands
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Center, the Netherlands
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246
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Mangano S, Fontana A, Spitaleri C, Mangano GR. Benign nocturnal alternating hemiplegia of childhood: a new case with unusual findings. Brain Dev 2014; 36:408-10. [PMID: 23820111 DOI: 10.1016/j.braindev.2013.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 06/06/2013] [Accepted: 06/07/2013] [Indexed: 11/26/2022]
Abstract
It has been described a neuro developmental disorder labelled "Benign nocturnal alternating hemiplegia of childhood" (BNAHC) characterized by recurrent attacks of nocturnal hemiplegia without progression to neurological or intellectual impairment. We report a female patient who at 11months revealed a motionless left arm, unusual crying without impairment of consciousness and obvious precipitating factors. The attacks occur during sleep in the early morning with lack of ictal and interictal electroencephalographic abnormalities, progressive neurological deficit, and cognitive impairment. Unlike previous reports of BNAHC our patient come from a family with a history of both migraine, hemiplegic migraine, and sleep disorders. Our study remarks on the typical features described in previous studies and stresses the uncommon aspects that could help to identify the disorder which is likely to have been underestimated. Despite some clinical similarities between BNAHC and familiar hemiplegic migraine and alternating hemiplegia of childhood, the genetic analyses of our patient did not reveal genetic mutations found in both disorders.
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Affiliation(s)
- Salvatore Mangano
- Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", Child Neuropsychiatry Unit, Università di Palermo, Palermo, Italy.
| | - Antonina Fontana
- Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", Child Neuropsychiatry Unit, Università di Palermo, Palermo, Italy
| | - Chiara Spitaleri
- Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", Child Neuropsychiatry Unit, Università di Palermo, Palermo, Italy
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247
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Ulate-Campos A, Fons C, Campistol J, Martorell L, Cancho-Candela R, Eiris J, López-Laso E, Pineda M, Sans A, Velázquez R. [Alternating hemiplegia of childhood: ATP1A3 gene analysis in 16 patients]. Med Clin (Barc) 2014; 143:25-8. [PMID: 24768197 DOI: 10.1016/j.medcli.2014.01.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 01/24/2014] [Accepted: 01/30/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVE Alternating hemiplegia in childhood (AHC) is a disease characterized by recurrent episodes of hemiplegia, tonic or dystonic crisis and abnormal ocular movements. Recently, mutations in the ATP1A3 gene have been identified as the causal mechanism of AHC. The objective is to describe a series of 16 patients with clinical and genetic diagnosis of AHC. PATIENTS AND METHOD It is a descriptive, retrospective, multicenter study of 16 patients with clinical diagnosis of AHC in whom mutations in ATP1A3 were identified. RESULTS Six heterozygous, de novo mutations were found in the ATP1A3 gene. The most frequent mutation was G2401A in 8 patients (50%) followed by G2443A in 3 patients (18.75%), G2893A in 2 patients (12.50%) and C2781G, G2893C and C2411T in one patient, respectively (6.25% each). CONCLUSIONS In the studied population with AHC, de novo mutations were detected in 100% of patients. The most frequent mutations were D801N y la E815K, as reported in other series.
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Affiliation(s)
- Adriana Ulate-Campos
- Servicio de Neurología Pediátrica, Hospital Universitario Sant Joan de Déu, Barcelona, España.
| | - Carmen Fons
- Servicio de Neurología Pediátrica, Hospital Universitario Sant Joan de Déu, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, España
| | - Jaume Campistol
- Servicio de Neurología Pediátrica, Hospital Universitario Sant Joan de Déu, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, España
| | - Loreto Martorell
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, España; Servicio de Genética Molecular, Hospital Universitario Sant Joan de Déu, Barcelona, España
| | - Ramón Cancho-Candela
- Unidad de Neurología Pediátrica, Servicio de Pediatría, Hospital Universitario Río Hortega, Valladolid, España
| | - Jesús Eiris
- Servicio de Neurología Pediátrica, Departamento de Pediatría, Hospital Clínico Universitario, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| | - Eduardo López-Laso
- Unidad de Neurología Pediátrica, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, España
| | | | - Anna Sans
- Servicio de Neurología Pediátrica, Hospital Universitario Sant Joan de Déu, Barcelona, España
| | - Ramón Velázquez
- Servicio de Neurología Infantil, Hospital Infantil Universitario La Paz, Madrid, España
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248
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Sheerin UM, Houlden H, Wood NW. Advances in the Genetics of Parkinson's Disease: A Guide for the Clinician. Mov Disord Clin Pract 2014; 1:3-13. [PMID: 30363913 DOI: 10.1002/mdc3.12000] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 12/19/2013] [Accepted: 12/19/2013] [Indexed: 12/13/2022] Open
Abstract
Over the last 16 years, insights in clinical and genetic characteristics of Parkinson's disease (PD) have increased substantially. We summarize the clinical, genetic, and pathological findings of autosomal dominant PD linked to mutations in SNCA, leucine-rich repeat kinase 2, vacuolar protein sorting-35, and eukaryotic translation initiation factor 4 gamma 1 and autosomal recessive PD linked to parkin,PINK1, and DJ-1, as well as autosomal recessive complicated parkinsonian syndromes caused by mutations in ATP13A2,FBXO7,PLA2G6,SYNJ1, and DNAJC6. We also review the advances in high- and low-risk genetic susceptibility factors and present multisystem disorders that may present with parkinsonism as the major clinical feature and provide recommendations for prioritization of genetic testing. Finally, we consider the challenges of future genetic research in PD.
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Affiliation(s)
- Una-Marie Sheerin
- Department of Molecular Neuroscience UCL Institute of Neurology University College London London United Kingdom
| | - Henry Houlden
- Department of Molecular Neuroscience UCL Institute of Neurology University College London London United Kingdom
| | - Nicholas W Wood
- UCL Department of Molecular Neuroscience and UCL Genetics Institute University College London London United Kingdom
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249
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Danielsson K, Mun LJ, Lordemann A, Mao J, Lin CHJ. Next-generation sequencing applied to rare diseases genomics. Expert Rev Mol Diagn 2014; 14:469-87. [PMID: 24702023 DOI: 10.1586/14737159.2014.904749] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Genomics has revolutionized the study of rare diseases. In this review, we overview the latest technological development, rare disease discoveries, implementation obstacles and bioethical challenges. First, we discuss the technology of genome and exome sequencing, including the different next-generation platforms and exome enrichment technologies. Second, we survey the pioneering centers and discoveries for rare diseases, including few of the research institutions that have contributed to the field, as well as an overview survey of different types of rare diseases that have had new discoveries due to next-generation sequencing. Third, we discuss the obstacles and challenges that allow for clinical implementation, including returning of results, informed consent and privacy. Last, we discuss possible outlook as clinical genomics receives wider adoption, as third-generation sequencing is coming onto the horizon, and some needs in informatics and software to further advance the field.
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Affiliation(s)
- Krissi Danielsson
- Rare Genomics Institute, 4100 Forest Park Ave, Suite 204, St. Louis, MO 63108, USA
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250
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Matilla-Dueñas A, Ashizawa T, Brice A, Magri S, McFarland KN, Pandolfo M, Pulst SM, Riess O, Rubinsztein DC, Schmidt J, Schmidt T, Scoles DR, Stevanin G, Taroni F, Underwood BR, Sánchez I. Consensus paper: pathological mechanisms underlying neurodegeneration in spinocerebellar ataxias. CEREBELLUM (LONDON, ENGLAND) 2014; 13:269-302. [PMID: 24307138 PMCID: PMC3943639 DOI: 10.1007/s12311-013-0539-y] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Intensive scientific research devoted in the recent years to understand the molecular mechanisms or neurodegeneration in spinocerebellar ataxias (SCAs) are identifying new pathways and targets providing new insights and a better understanding of the molecular pathogenesis in these diseases. In this consensus manuscript, the authors discuss their current views on the identified molecular processes causing or modulating the neurodegenerative phenotype in spinocerebellar ataxias with the common opinion of translating the new knowledge acquired into candidate targets for therapy. The following topics are discussed: transcription dysregulation, protein aggregation, autophagy, ion channels, the role of mitochondria, RNA toxicity, modulators of neurodegeneration and current therapeutic approaches. Overall point of consensus includes the common vision of neurodegeneration in SCAs as a multifactorial, progressive and reversible process, at least in early stages. Specific points of consensus include the role of the dysregulation of protein folding, transcription, bioenergetics, calcium handling and eventual cell death with apoptotic features of neurons during SCA disease progression. Unresolved questions include how the dysregulation of these pathways triggers the onset of symptoms and mediates disease progression since this understanding may allow effective treatments of SCAs within the window of reversibility to prevent early neuronal damage. Common opinions also include the need for clinical detection of early neuronal dysfunction, for more basic research to decipher the early neurodegenerative process in SCAs in order to give rise to new concepts for treatment strategies and for the translation of the results to preclinical studies and, thereafter, in clinical practice.
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Affiliation(s)
- A Matilla-Dueñas
- Health Sciences Research Institute Germans Trias i Pujol (IGTP), Ctra. de Can Ruti, Camí de les Escoles s/n, Badalona, Barcelona, Spain,
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