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Schon KR, O'Donovan DG, Briggs M, Rowe JB, Wijesekera L, Chinnery PF, van den Ameele J. Multisystem pathology in McLeod syndrome. Neuropathology 2024; 44:109-114. [PMID: 37438874 DOI: 10.1111/neup.12935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/12/2023] [Accepted: 06/24/2023] [Indexed: 07/14/2023]
Abstract
We present a comprehensive characterization of clinical, neuropathological, and multisystem features of a man with genetically confirmed McLeod neuroacanthocytosis syndrome, including video and autopsy findings. A 61-year-old man presented with a movement disorder and behavioral change. Examination showed dystonic choreiform movements in all four limbs, reduced deep-tendon reflexes, and wide-based gait. He had oromandibular dyskinesia causing severe dysphagia. Elevated serum creatinine kinase (CK) was first noted in his thirties, but investigations, including muscle biopsy at that time, were inconclusive. Brain magnetic resonance imaging showed white matter volume loss, atrophic basal ganglia, and chronic small vessel ischemia. Despite raised CK, electromyography did not show myopathic changes. Exome gene panel testing was negative, but targeted genetic analysis revealed a hemizygous pathogenic variant in the XK gene c.895C > T p.(Gln299Ter), consistent with a diagnosis of McLeod syndrome. The patient died of sepsis, and autopsy showed astrocytic gliosis and atrophy of the basal ganglia, diffuse iron deposition in the putamen, and mild Alzheimer's pathology. Muscle pathology was indicative of mild chronic neurogenic atrophy without overt myopathic features. He had non-specific cardiomyopathy and splenomegaly. McLeod syndrome is an ultra-rare neurodegenerative disorder caused by X-linked recessive mutations in the XK gene. Diagnosis has management implications since patients are at risk of severe transfusion reactions and cardiac complications. When a clinical diagnosis is suspected, candidate genes should be interrogated rather than solely relying on exome panels.
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Affiliation(s)
- Katherine R Schon
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Medical Research Council Mitochondrial Biology Unit, University of Cambridge, Cambridge, UK
- East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Dominic G O'Donovan
- Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Mayen Briggs
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - James B Rowe
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Lokesh Wijesekera
- Department of Clinical Neurophysiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Patrick F Chinnery
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Medical Research Council Mitochondrial Biology Unit, University of Cambridge, Cambridge, UK
| | - Jelle van den Ameele
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Medical Research Council Mitochondrial Biology Unit, University of Cambridge, Cambridge, UK
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2
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Dieter M, Kevin P, Tobias V, Andreas H, Lorenz N, Kathrin K, Nikolaus K, Juergen B, Jan R, Adrian D. Polysomnographic findings in the ultra-rare McLeod syndrome: further documentation of sleep apnea as a possible feature. J Clin Sleep Med 2024; 20:339-344. [PMID: 37811906 PMCID: PMC11019222 DOI: 10.5664/jcsm.10854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/10/2023]
Abstract
STUDY OBJECTIVES McLeod syndrome is a very rare multisystemic neurodegenerative disease linked to mutations in the XK gene. It has cardiac, neurologic, and neuromuscular manifestations and shares similarities with Huntington's disease. The aim of this study was to evaluate sleep patterns of patients affected by McLeod syndrome. METHODS This retrospective case series of four males who underwent diagnostic polysomnography (mean age 53.8 ± 2.5 years) includes self-reported and objective evaluation of sleep using the Epworth Sleepiness Scale, genetic tests, documentation of clinical course and features, and laboratory-based full-night attended video-polysomnography. RESULTS In three out of four patients, an Epworth Sleepiness Scale score ≥ 7 was evident. The average apnea-hypopnea index was 45.0 ± 19.0, with predominantly obstructive phenotype in three patients and predominant central events (central sleep apnea syndrome) in one patient. A significantly increased periodic limb movement index during sleep was observed in all patients. All patients tolerated continuous positive airway pressure or pressure controlled therapy. CONCLUSIONS Polysomnography of all patients confirmed sleep apnea syndrome as a feature of McLeod syndrome. Three patients were diagnosed with obstructive sleep apnea and one with central sleep apnea syndrome. In addition, periodic limb movement index was increased in all patients. CITATION Dieter M, Kevin P, Tobias V, et al. Polysomnographic findings in the ultra-rare McLeod syndrome: further documentation of sleep apnea as a possible feature. J Clin Sleep Med. 2024;20(3):339-344.
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Affiliation(s)
- Munker Dieter
- Department of Medicine V, University Hospital, LMU Munich, Member of the German Center for Lung Research (DZL), Comprehensive Pneumology Center Munich, Munich, Germany
| | - Peikert Kevin
- Translational Neurodegeneration Section “Albrecht-Kossel,” Department of Neurology, University Medical Center, University of Rostock, Rostock, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen Rostock/Greifswald, Rostock, Germany
- United Neuroscience Campus Lund-Rostock, Rostock Site, Rostock, Germany
| | - Veit Tobias
- Department of Medicine V, University Hospital, LMU Munich, Member of the German Center for Lung Research (DZL), Comprehensive Pneumology Center Munich, Munich, Germany
| | - Hermann Andreas
- Translational Neurodegeneration Section “Albrecht-Kossel,” Department of Neurology, University Medical Center, University of Rostock, Rostock, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen Rostock/Greifswald, Rostock, Germany
- Center for Transdisciplinary Neurosciences Rostock, University Medical Center, Rostock, Germany
| | - Nowak Lorenz
- Department of Sleep Medicine, Asklepios Lung Clinic, Gauting, Germany
| | - Kahnert Kathrin
- Department of Medicine V, University Hospital, LMU Munich, Member of the German Center for Lung Research (DZL), Comprehensive Pneumology Center Munich, Munich, Germany
| | - Kneidinger Nikolaus
- Department of Medicine V, University Hospital, LMU Munich, Member of the German Center for Lung Research (DZL), Comprehensive Pneumology Center Munich, Munich, Germany
| | - Behr Juergen
- Department of Medicine V, University Hospital, LMU Munich, Member of the German Center for Lung Research (DZL), Comprehensive Pneumology Center Munich, Munich, Germany
| | - Remi Jan
- Department of Neurology, University Hospital of LMU Munich, Munich, Germany
| | - Danek Adrian
- Department of Neurology, University Hospital of LMU Munich, Munich, Germany
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3
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Boppana HK, Thakkar S, Patel HP, Bou Chaaya RG, Feitell S. A Case of McLeod's Syndrome Presenting with Severe Decompensated Heart Failure. Methodist Debakey Cardiovasc J 2023; 19:75-78. [PMID: 37720304 PMCID: PMC10503528 DOI: 10.14797/mdcvj.1164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/18/2023] [Indexed: 09/19/2023] Open
Abstract
McLeod's syndrome (MLS) is an X-linked disorder caused by mutations in the XK gene with neurological manifestations as well as cardiomyopathy. This is a case of acute exacerbation of heart failure in a 44-year-old White male with a confirmed diagnosis of MLS, which was managed with guideline-directed medical therapy and placement of an implantable cardioverter defibrillator with recovery in ejection fraction.
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Affiliation(s)
| | | | - Harsh P. Patel
- Southern Illinois School of Medicine, Springfield, Illinois, US
| | | | - Scott Feitell
- Sands Constellation Heart Institute, Rochester General Hospital, Rochester, New York, US
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4
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Cincotta MC, Walker RH. Diagnostic Uncertainties: Chorea. Semin Neurol 2023; 43:65-80. [PMID: 36882120 DOI: 10.1055/s-0043-1763506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
Chorea is a hyperkinetic movement disorder with a multitude of potential etiologies, both acquired and inherited. Although the differential diagnosis for new-onset chorea is extensive, there are often clues in the history, exam, and basic testing that can help to narrow the options. Evaluation for treatable or reversible causes should take priority, as rapid diagnosis can lead to more favorable outcomes. While Huntington's disease is most common genetic cause of chorea, multiple phenocopies also exist and should be considered if Huntington gene testing is negative. The decision of what additional genetic testing to pursue should be based on both clinical and epidemiological factors. The following review provides an overview of the many possible etiologies as well as a practical approach for a patient presenting with new-onset chorea.
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Affiliation(s)
- Molly C Cincotta
- Department of Neurology, Temple University, Philadelphia, Pennsylvania
| | - Ruth H Walker
- Department of Neurology, James J. Peters Veterans Affairs Medical Center and Mount Sinai School of Medicine, Bronx, New York
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5
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Chhetri G, Ke Y, Wang P, Usman M, Li Y, Sapp E, Wang J, Ghosh A, Islam MA, Wang X, Boudi A, DiFiglia M, Li X. Impaired XK recycling for importing manganese underlies striatal vulnerability in Huntington's disease. J Cell Biol 2022; 221:213461. [PMID: 36099524 PMCID: PMC9475296 DOI: 10.1083/jcb.202112073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 06/15/2022] [Accepted: 07/29/2022] [Indexed: 02/08/2023] Open
Abstract
Mutant huntingtin, which causes Huntington's disease (HD), is ubiquitously expressed but induces preferential loss of striatal neurons by unclear mechanisms. Rab11 dysfunction mediates homeostatic disturbance of HD neurons. Here, we report that Rab11 dysfunction also underscores the striatal vulnerability in HD. We profiled the proteome of Rab11-positive endosomes of HD-vulnerable striatal cells to look for protein(s) linking Rab11 dysfunction to striatal vulnerability in HD and found XK, which triggers the selective death of striatal neurons in McLeod syndrome. XK was trafficked together with Rab11 and was diminished on the surface of immortalized HD striatal cells and striatal neurons in HD mouse brains. We found that XK participated in transporting manganese, an essential trace metal depleted in HD brains. Introducing dominantly active Rab11 into HD striatal cells improved XK dynamics and increased manganese accumulation in an XK-dependent manner. Our study suggests that impaired Rab11-based recycling of XK onto cell surfaces for importing manganese is a driver of striatal dysfunction in Huntington's disease.
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Affiliation(s)
- Gaurav Chhetri
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Yuting Ke
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China.,Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
| | - Ping Wang
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA.,Department of Neurology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Ji'nan, China
| | - Muhammad Usman
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Li
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Ellen Sapp
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
| | - Jing Wang
- Instrumental Analysis Center, Shanghai Jiao Tong University, Shanghai, China
| | - Arabinda Ghosh
- Department of Botany, Microbiology Division, Gauhati University, Guwahati, Assam, India
| | - Md Ariful Islam
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaolong Wang
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Adel Boudi
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
| | - Marian DiFiglia
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
| | - Xueyi Li
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China.,Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA
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Torres V, Painous C, Santacruz P, Sánchez A, Sanz C, Grau‐Junyent JM, Muñoz E. Very Long Time Persistent
HyperCKemia
as the First Manifestation of
McLeod
Syndrome: A Case Report. Mov Disord Clin Pract 2022; 9:821-824. [DOI: 10.1002/mdc3.13502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/24/2022] [Accepted: 06/02/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Viviana Torres
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociencies Hospital Clínic of Barcelona Barcelona Spain
| | - Cèlia Painous
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociencies Hospital Clínic of Barcelona Barcelona Spain
| | - Pilar Santacruz
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociencies Hospital Clínic of Barcelona Barcelona Spain
| | - Aurora Sánchez
- Biochemistry and Molecular Genetics Department Centre de Diagnòstic Biomèdic, Hospital Clínic of Barcelona Barcelona Spain
| | - Cristina Sanz
- Blood Bank and Transfusion Service Banc de Sang i Teixits, Hospital Clínic of Barcelona Barcelona Spain
| | - Josep M. Grau‐Junyent
- Laboratory of Muscle Research and Mitochondrial Function, Department of Internal Medicine Hospital Clínic of Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- University of Barcelona Barcelona Spain
| | - Esteban Muñoz
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociencies Hospital Clínic of Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- University of Barcelona Barcelona Spain
- European Reference Network‐Rare Neurological Diseases (ERN‐RND) Barcelona Spain
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7
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Xia S, Yu X, Song F, Sun B, Wang Y. McLeod syndrome with a novel XK frameshift mutation: A case report. Medicine (Baltimore) 2022; 101:e28996. [PMID: 35451392 PMCID: PMC8913091 DOI: 10.1097/md.0000000000028996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/16/2022] [Indexed: 11/26/2022] Open
Abstract
RATIONALE McLeod syndrome (MLS) is a rare X-linked neurohematologic disorder caused by loss-of-function mutations in the XK gene. However, variations in the XK gene remain to be elucidated. Here, we report the clinical phenotype and genetic features of a patient with MLS caused by a novel frameshift mutation in the XK gene. PATIENT CONCERNS A 44-year-old man presented with chorea, cognitive impairment, mental disorders, and seizures accompanied by peripheral neuropathy, hyperCKemia, and acanthocytosis. The proband's mother had a mild chorea. One older brother who died 10 years ago without a confirmed diagnosis showed symptoms of both chorea and mental disorders, while the other brother also developed mild chorea. DIAGNOSIS The patient was diagnosed with MLS based on the family history, clinical manifestations, and accessory examinations. Whole-exome sequencing studies revealed a novel frameshift mutation resulting from a nucleotide variation in exon 2 (452delA) that leads to an amino acid residue conversion from Gln to Arg and early termination of the XK protein (Gln151ArgfsTer2). The patient and one of his older brothers were hemizygotes, and his mother was heterozygous. INTERVENTIONS The patient was treated with haloperidol to control chorea and levetiracetam to control seizures. OUTCOMES Six months after treatment, the proband was seizure-free, but showed little improvement in chorea and cognitive dysfunction. LESSON We describe a family with MLS caused by a novel frameshift mutation in the XK gene. The causes of the mild clinical presentation in the proband's mother require further investigation.
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Affiliation(s)
- Shilin Xia
- Clinical Laboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xinrui Yu
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Fan Song
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Bo Sun
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ying Wang
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
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8
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Li Z, Wang D, Liao H, Zhang S, Guo W, Chen L, Lu L, Huang T, Cai YD. Exploring the Genomic Patterns in Human and Mouse Cerebellums Via Single-Cell Sequencing and Machine Learning Method. Front Genet 2022; 13:857851. [PMID: 35309141 PMCID: PMC8930846 DOI: 10.3389/fgene.2022.857851] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/09/2022] [Indexed: 12/29/2022] Open
Abstract
In mammals, the cerebellum plays an important role in movement control. Cellular research reveals that the cerebellum involves a variety of sub-cell types, including Golgi, granule, interneuron, and unipolar brush cells. The functional characteristics of cerebellar cells exhibit considerable differences among diverse mammalian species, reflecting a potential development and evolution of nervous system. In this study, we aimed to recognize the transcriptional differences between human and mouse cerebellum in four cerebellar sub-cell types by using single-cell sequencing data and machine learning methods. A total of 321,387 single-cell sequencing data were used. The 321,387 cells included 4 cell types, i.e., Golgi (5,048, 1.57%), granule (250,307, 77.88%), interneuron (60,526, 18.83%), and unipolar brush (5,506, 1.72%) cells. Our results showed that by using gene expression profiles as features, the optimal classification model could achieve very high even perfect performance for Golgi, granule, interneuron, and unipolar brush cells, respectively, suggesting a remarkable difference between the genomic profiles of human and mouse. Furthermore, a group of related genes and rules contributing to the classification was identified, which might provide helpful information for deepening the understanding of cerebellar cell heterogeneity and evolution.
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Affiliation(s)
- ZhanDong Li
- College of Food Engineering, Jilin Engineering Normal University, Changchun, China
| | - Deling Wang
- Department of Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - HuiPing Liao
- Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - ShiQi Zhang
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Wei Guo
- Key Laboratory of Stem Cell Biology, Shanghai Jiao Tong University School of Medicine (SJTUSM) & Shanghai Institutes for Biological Sciences (SIBS), Chinese Academy of Sciences (CAS), Shanghai, China
| | - Lei Chen
- College of Information Engineering, Shanghai Maritime University, Shanghai, China
| | - Lin Lu
- Department of Radiology, Columbia University Medical Center, New York, NY, United States
- *Correspondence: Lin Lu, ; Tao Huang, ; Yu-Dong Cai,
| | - Tao Huang
- Bio-Med Big Data Center, CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
- *Correspondence: Lin Lu, ; Tao Huang, ; Yu-Dong Cai,
| | - Yu-Dong Cai
- School of Life Sciences, Shanghai University, Shanghai, China
- *Correspondence: Lin Lu, ; Tao Huang, ; Yu-Dong Cai,
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9
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Skripkina NA, Datieva VK, Levin OS. [Case-report of neuroacanthocytosis associated with a compound mutation in the VPS13A gene]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:104-110. [PMID: 34693697 DOI: 10.17116/jnevro2021121091104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Neuroacanthocytosis is a group of neurodegenerative diseases manifested by a combition of neurological symptoms (most often choreic hyperkinesis) and the presence of an increased number of acanthocytes (erythrocytes with horns) in the peripheral blood. This group includes chorea-acanthocytosis, MacLeod's syndrome, pantothenate kinase-associated neurodegeneration, Huntington-like disease type 2, and some other very rare diseases. This article presents a genetically confirmed clinical case of chorea-acanthocytosis associated with a compound mutation in the VPS13A gene, discusses in detail the stages of a diagnostic search, presents an algorithm for examining patients with chorea.
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Affiliation(s)
- N A Skripkina
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - V K Datieva
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - O S Levin
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
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10
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Ryu HS, Hong CM. Brain F-18 FDG and F-18 FP-CIT PET/CT Findings of c.856_860delCTCTA Mutation McLeod Syndrome. Cogn Behav Neurol 2021; 34:207-211. [PMID: 34473672 DOI: 10.1097/wnn.0000000000000267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 09/10/2020] [Indexed: 11/26/2022]
Abstract
McLeod syndrome is a rare X-linked recessive genetic disorder that is caused by mutations of the XK gene. It is one of the core neuroacanthocytosis syndromes. We report the case of a 67-year-old man who presented to Kyungpook National University Hospital in the Republic of Korea with progressive worsening of generalized chorea and dystonia. He had no recognized family history of neurologic illness. A peripheral blood smear showed increased acanthocytes. His serum creatine kinase levels were 894 U/L. A brain MRI showed atrophy of the bilateral striatal nuclei. An F-18 F-N-(3-fluoropropyl)-2β-carboxymethoxy-3β-(4-iodophenyl) nortropane PET/CT showed moderately decreased dopamine transporter uptake in the putamen and severely decreased uptake in the caudate nucleus. An F-18 fludeoxyglucose PET/CT demonstrated markedly decreased metabolism at the caudate nucleus and the putamen. Whole exome sequencing revealed hemizygous pathogenic mutations of the XK gene (c.856_860delCTCTA;p.Leu286TyrfsTer16). We believe that these findings provide useful information regarding the clinical features of individuals with McLeod syndrome.
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Affiliation(s)
| | - Chae Moon Hong
- Nuclear Medicine, Kyungpook National University Hospital, Daegu, South Korea
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11
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Haas C, Levin D, Milone M, Vardiman-Ditmanson J, Mathers C. McLeod Syndrome in a Commercial Airline Pilot. Aerosp Med Hum Perform 2021; 92:734-737. [PMID: 34645554 DOI: 10.3357/amhp.5759.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND: The following case report describes the first known case of McLeod Syndrome in a commercial airline pilot. The case describes a 56-yr-old experienced pilot who showed a slow and subtle decline in cognitive function and muscle control in the cockpit. On further examination, the pilots erratic behavior and movement along with lab abnormalities pointed toward McLeod Syndrome. CASE REPORT: The pilot was recommended for evaluation by his fellow crewmembers due to his fidgetiness, clumsiness, and lack of focus during critical portions of flight. The pilot reported having a long-standing history of elevated CK levels. Further lab investigations revealed acanthocytes on blood smear while neurological evaluation detected chorea. The combination of clinical and laboratory features along with genetic test results were all consistent with McLeod Syndrome. DISCUSSION: The case highlights how subtle behavioral and motor coordination changes can be a warning sign for an underlying progressive neurological disorder that requires further workup and referral. Haas C, Levin D, Milone M, Vardiman-Ditmanson J, Mathers C. McLeod syndrome in a commercial airline pilot. Aerosp Med Hum Perform. 2021; 92(9):734737.
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12
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Reimann J, Kornblum C. Towards Central Nervous System Involvement in Adults with Hereditary Myopathies. J Neuromuscul Dis 2021; 7:367-393. [PMID: 32773394 PMCID: PMC7592671 DOI: 10.3233/jnd-200507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
There is increasing evidence of central nervous system involvement in numerous neuromuscular disorders primarily considered diseases of skeletal muscle. Our knowledge on cerebral affection in myopathies is expanding continuously due to a better understanding of the genetic background and underlying pathophysiological mechanisms. Intriguingly, there is a remarkable overlap of brain pathology in muscular diseases with pathomechanisms involved in neurodegenerative or neurodevelopmental disorders. A rapid progress in advanced neuroimaging techniques results in further detailed insight into structural and functional cerebral abnormalities. The spectrum of clinical manifestations is broad and includes movement disorders, neurovascular complications, paroxysmal neurological symptoms like migraine and epileptic seizures, but also behavioural abnormalities and cognitive dysfunction. Cerebral involvement implies a high socio-economic and personal burden in adult patients sometimes exceeding the everyday challenges associated with muscle weakness. It is especially important to clarify the nature and natural history of brain affection against the background of upcoming specific treatment regimen in hereditary myopathies that should address the brain as a secondary target. This review aims to highlight the character and extent of central nervous system involvement in patients with hereditary myopathies manifesting in adulthood, however also includes some childhood-onset diseases with brain abnormalities that transfer into adult neurological care.
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Affiliation(s)
- Jens Reimann
- Department of Neurology, Section of Neuromuscular Diseases, University Hospital Bonn, Germany.,Center for Rare Diseases, University Hospital Bonn, Germany
| | - Cornelia Kornblum
- Department of Neurology, Section of Neuromuscular Diseases, University Hospital Bonn, Germany.,Center for Rare Diseases, University Hospital Bonn, Germany
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13
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Quick S, Heidrich FM, Winkler MV, Winkler AH, Ibrahim K, Linke A, Speiser U, Grabmaier U, Buhmann C, Marxreiter F, Saft C, Danek A, Hermann A, Peikert K. Cardiac manifestation is evident in chorea-acanthocytosis but different from McLeod syndrome. Parkinsonism Relat Disord 2021; 88:90-95. [PMID: 34153885 DOI: 10.1016/j.parkreldis.2021.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/30/2021] [Accepted: 05/14/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION We aimed to study the various cardiac manifestations of the two core neuroacanthocytosis (NA) syndromes, namely chorea-acanthocytosis (ChAc) and McLeod syndrome (MLS). So far, cardiac involvement has been described as specific feature only for MLS. METHODS We studied six patients with ChAc (mean age 44.5 years, five men, one woman) and six patients with MLS (mean age 57.1 years, all men). Cardiac evaluation included echocardiography and/or cardiac magnetic resonance imaging (cardiac MRI), 24-h ECG-recording and examination of cardiac biomarkers. RESULTS Cardiac involvement of ChAc was found in four of six patients. Two patients showed mildly reduced left ventricular ejection fraction (LVEF), two other patients mild to moderate left ventricular (LV) dilatation. Neither an increase in ventricular ectopic beats nor ventricular tachycardia were evident in ChAc. Four of five MLS patients showed left ventricle dilatation and reduced left ventricular ejection fraction (LVEF). Two of these, in addition, had critical ventricular tachycardia. High sensitive troponin T was elevated in all patients, for whom data were available (n = 10). In contrast, elevation of high sensitive troponin I was found in one of six ChAc and one of two MLS patients. CONCLUSION For the first time, we reveal cardiac involvement in a cohort of six ChAc patients, while the risk to develop heart failure seems lower than in MLS. Our study confirms the malignant nature of MLS in terms of ventricular arrhythmias and progression to advanced heart failure. Herein, we define disease-specific recommendations for cardiac assessment in both conditions.
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Affiliation(s)
- Silvio Quick
- Department of Cardiology, Angiology and Intensive Care, Klinikum Chemnitz gGmbH, Medizincampus Chemnitz der Technischen Universität Dresden, Dresden, Germany.
| | - Felix Matthias Heidrich
- Department of Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Dresden, Germany
| | - Max-Valentin Winkler
- Department of Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Dresden, Germany
| | - Anna Helene Winkler
- Department of Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Dresden, Germany
| | - Karim Ibrahim
- Department of Cardiology, Angiology and Intensive Care, Klinikum Chemnitz gGmbH, Medizincampus Chemnitz der Technischen Universität Dresden, Dresden, Germany
| | - Axel Linke
- Department of Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Dresden, Germany
| | - Uwe Speiser
- Department of Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Dresden, Germany
| | - Ulrich Grabmaier
- Medizinische Klinik und Poliklinik I, Klinikum der Universität, LMU Munich, 81377, Munich, Germany; German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, 80802, Munich, Germany
| | - Carsten Buhmann
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Franz Marxreiter
- Movement Disorders Outpatient Clinic, Department of Molecular Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany; Center for Rare Movement Disorders, Department of Molecular Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Carsten Saft
- Department of Neurology, St. Josef Hospital, Ruhr-University, Gudrunstraße 56, 44791, Bochum, Germany
| | - Adrian Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, München, Germany
| | - Andreas Hermann
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Translational Neurodegeneration Section "Albrecht-Kossel", Department of Neurology, University Medical Center, University of Rostock, Rostock, Germany; DZNE, German Center for Neurodegenerative Diseases, Research Site Rostock/Greifswald, Rostock, Germany; Center for Transdisciplinary Neurosciences Rostock (CTNR), University Medical Center Rostock, University of Rostock, Rostock, Germany
| | - Kevin Peikert
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Translational Neurodegeneration Section "Albrecht-Kossel", Department of Neurology, University Medical Center, University of Rostock, Rostock, Germany.
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14
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Rossi M, Wainsztein N, Merello M. Cardiac Involvement in Movement Disorders. Mov Disord Clin Pract 2021; 8:651-668. [PMID: 34307738 DOI: 10.1002/mdc3.13188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 02/23/2021] [Accepted: 03/02/2021] [Indexed: 02/06/2023] Open
Abstract
Background Several conditions represented mainly by movement disorders are associated with cardiac disease, which can be overlooked in clinical practice in the context of a prominent primary neurological disorder. Objectives To review neurological conditions that combine movement disorders and primary cardiac involvement. Methods A comprehensive and structured literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria was conducted to identify disorders combining movement disorders and cardiac disease. Results Some movement disorders are commonly or prominently associated with cardiac disease. Neurological and cardiac symptoms may share underlying physiopathological mechanisms in diseases, such as Friedreich's ataxia and Wilson's disease, and in certain metabolic disorders, including Refsum disease, Gaucher disease, a congenital disorder of glycosylation, or cerebrotendinous xanthomatosis. In certain conditions, such as Sydenham's chorea or dilated cardiomyopathy with ataxia syndrome (ATX-DNAJC19), heart involvement can present early in the course of disease, whereas in others such as Friedreich's ataxia or Refsum disease, cardiac symptoms tend to present in later stages. In another 68 acquired or inherited conditions, cardiac involvement or movement disorders are seldom reported. Conclusions As cardiac disease is part of the phenotypic spectrum of several movement disorders, heart involvement should be carefully investigated and increased awareness of this association encouraged as it may represent a leading cause of morbidity and mortality.
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Affiliation(s)
- Malco Rossi
- Sección Movimientos Anormales, Departamento de Neurociencias Instituto de Investigaciones Neurológicas Raúl Carrea, Fleni Buenos Aires Argentina.,Argentine National Scientific and Technological Research Council Buenos Aires Argentina
| | - Nestor Wainsztein
- Departamento de Medicina Interna Unidad de Cuidados Críticos, Fleni Buenos Aires Argentina
| | - Marcelo Merello
- Sección Movimientos Anormales, Departamento de Neurociencias Instituto de Investigaciones Neurológicas Raúl Carrea, Fleni Buenos Aires Argentina.,Argentine National Scientific and Technological Research Council Buenos Aires Argentina.,Pontificia Universidad Católica Argentina Buenos Aires Argentina
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15
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Darras A, Peikert K, Rabe A, Yaya F, Simionato G, John T, Dasanna AK, Buvalyy S, Geisel J, Hermann A, Fedosov DA, Danek A, Wagner C, Kaestner L. Acanthocyte Sedimentation Rate as a Diagnostic Biomarker for Neuroacanthocytosis Syndromes: Experimental Evidence and Physical Justification. Cells 2021; 10:788. [PMID: 33918219 PMCID: PMC8067274 DOI: 10.3390/cells10040788] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/26/2021] [Accepted: 03/30/2021] [Indexed: 01/28/2023] Open
Abstract
(1) Background: Chorea-acanthocytosis and McLeod syndrome are the core diseases among the group of rare neurodegenerative disorders called neuroacanthocytosis syndromes (NASs). NAS patients have a variable number of irregularly spiky erythrocytes, so-called acanthocytes. Their detection is a crucial but error-prone parameter in the diagnosis of NASs, often leading to misdiagnoses. (2) Methods: We measured the standard Westergren erythrocyte sedimentation rate (ESR) of various blood samples from NAS patients and healthy controls. Furthermore, we manipulated the ESR by swapping the erythrocytes and plasma of different individuals, as well as replacing plasma with dextran. These measurements were complemented by clinical laboratory data and single-cell adhesion force measurements. Additionally, we followed theoretical modeling approaches. (3) Results: We show that the acanthocyte sedimentation rate (ASR) with a two-hour read-out is significantly prolonged in chorea-acanthocytosis and McLeod syndrome without overlap compared to the ESR of the controls. Mechanistically, through modern colloidal physics, we show that acanthocyte aggregation and plasma fibrinogen levels slow down the sedimentation. Moreover, the inverse of ASR correlates with the number of acanthocytes (R2=0.61, p=0.004). (4) Conclusions: The ASR/ESR is a clear, robust and easily obtainable diagnostic marker. Independently of NASs, we also regard this study as a hallmark of the physical view of erythrocyte sedimentation by describing anticoagulated blood in stasis as a percolating gel, allowing the application of colloidal physics theory.
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Affiliation(s)
- Alexis Darras
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.R.); (F.Y.); (G.S.); (T.J.); (C.W.)
| | - Kevin Peikert
- Translational Neurodegeneration Section “Albrecht-Kossel”, Department of Neurology, University Medical Center Rostock, University of Rostock, 18051 Rostock, Germany; (K.P.); (A.H.)
- Neurodegenerative Diseases, Department of Neurology, Technische Universität Dresden, 01062 Dresden, Germany
| | - Antonia Rabe
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.R.); (F.Y.); (G.S.); (T.J.); (C.W.)
- Theoretical Medicine and Biosciences, Saarland University, 66424 Homburg, Germany
| | - François Yaya
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.R.); (F.Y.); (G.S.); (T.J.); (C.W.)
- Laboratoire Interdisciplinaire de Physique, UMR 5588, 38402 Saint Martin d’Hères, France
| | - Greta Simionato
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.R.); (F.Y.); (G.S.); (T.J.); (C.W.)
- Institute for Clinical and Experimental Surgery, Saarland University, 66424 Homburg, Germany;
| | - Thomas John
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.R.); (F.Y.); (G.S.); (T.J.); (C.W.)
| | - Anil Kumar Dasanna
- Institute of Biological Information Processing and Institute for Advanced Simulation, Forschungszentrum Jülich, 52425 Jülich, Germany; (A.K.D.); (S.B.); (D.A.F.)
| | - Semen Buvalyy
- Institute of Biological Information Processing and Institute for Advanced Simulation, Forschungszentrum Jülich, 52425 Jülich, Germany; (A.K.D.); (S.B.); (D.A.F.)
| | - Jürgen Geisel
- Institute for Clinical and Experimental Surgery, Saarland University, 66424 Homburg, Germany;
| | - Andreas Hermann
- Translational Neurodegeneration Section “Albrecht-Kossel”, Department of Neurology, University Medical Center Rostock, University of Rostock, 18051 Rostock, Germany; (K.P.); (A.H.)
- Neurodegenerative Diseases, Department of Neurology, Technische Universität Dresden, 01062 Dresden, Germany
- DZNE, German Center for Neurodegenerative Diseases, Research Site Rostock/Greifswald, 18051 Rostock, Germany
- Center for Transdisciplinary Neurosciences Rostock (CTNR), University Medical Center Rostock, University of Rostock, 18051 Rostock, Germany
| | - Dmitry A. Fedosov
- Institute of Biological Information Processing and Institute for Advanced Simulation, Forschungszentrum Jülich, 52425 Jülich, Germany; (A.K.D.); (S.B.); (D.A.F.)
| | - Adrian Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, 81366 Munich, Germany;
| | - Christian Wagner
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.R.); (F.Y.); (G.S.); (T.J.); (C.W.)
- Physics and Materials Science Research Unit, University of Luxembourg, 1511 Luxembourg, Luxembourg
| | - Lars Kaestner
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.R.); (F.Y.); (G.S.); (T.J.); (C.W.)
- Theoretical Medicine and Biosciences, Saarland University, 66424 Homburg, Germany
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16
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Vaisfeld A, Bruno G, Petracca M, Bentivoglio AR, Servidei S, Vita MG, Bove F, Straccia G, Dato C, Di Iorio G, Sampaolo S, Peluso S, De Rosa A, De Michele G, Barghigiani M, Galatolo D, Tessa A, Santorelli F, Chiurazzi P, Melone MAB. Neuroacanthocytosis Syndromes in an Italian Cohort: Clinical Spectrum, High Genetic Variability and Muscle Involvement. Genes (Basel) 2021; 12:genes12030344. [PMID: 33652783 PMCID: PMC7996727 DOI: 10.3390/genes12030344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/17/2021] [Accepted: 02/22/2021] [Indexed: 01/12/2023] Open
Abstract
Neuroacanthocytosis (NA) syndromes are a group of genetically defined diseases characterized by the association of red blood cell acanthocytosis, progressive degeneration of the basal ganglia and neuromuscular features with characteristic persistent hyperCKemia. The main NA syndromes include autosomal recessive chorea-acanthocytosis (ChAc) and X-linked McLeod syndrome (MLS). A series of Italian patients selected through a multicenter study for these specific neurological phenotypes underwent DNA sequencing of the VPS13A and XK genes to search for causative mutations. Where it has been possible, muscle biopsies were obtained and thoroughly investigated with histochemical assays. A total of nine patients from five different families were diagnosed with ChAC and had mostly biallelic changes in the VPS13A gene (three nonsense, two frameshift, three splicing), while three patients from a single X-linked family were diagnosed with McLeod syndrome and had a deletion in the XK gene. Despite a very low incidence (only one thousand cases of ChAc and a few hundred MLS cases reported worldwide), none of the 8 VPS13A variants identified in our patients is shared by two families, suggesting the high genetic variability of ChAc in the Italian population. In our series, in line with epidemiological data, McLeod syndrome occurs less frequently than ChAc, although it can be easily suspected because of its X-linked mode of inheritance. Finally, histochemical studies strongly suggest that muscle pathology is not simply secondary to the axonal neuropathy, frequently seen in these patients, but primary myopathic alterations can be detected in both NA syndromes.
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Affiliation(s)
- Alessandro Vaisfeld
- Istituto di Medicina Genomica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
| | - Giorgia Bruno
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Interuniversity Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.B.); (G.S.); (C.D.); (G.D.I.); (S.S.); (M.A.B.M.)
| | - Martina Petracca
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Neurologia, 00168 Roma, Italy; (M.P.); (A.R.B.); (M.G.V.); (F.B.)
| | - Anna Rita Bentivoglio
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Neurologia, 00168 Roma, Italy; (M.P.); (A.R.B.); (M.G.V.); (F.B.)
- Dipartimento Universitario di Neuroscienze, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Serenella Servidei
- Dipartimento Universitario di Neuroscienze, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Neurofisiopatologia, 00168 Rome, Italy
| | - Maria Gabriella Vita
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Neurologia, 00168 Roma, Italy; (M.P.); (A.R.B.); (M.G.V.); (F.B.)
| | - Francesco Bove
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Neurologia, 00168 Roma, Italy; (M.P.); (A.R.B.); (M.G.V.); (F.B.)
- Dipartimento Universitario di Neuroscienze, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Giulia Straccia
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Interuniversity Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.B.); (G.S.); (C.D.); (G.D.I.); (S.S.); (M.A.B.M.)
| | - Clemente Dato
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Interuniversity Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.B.); (G.S.); (C.D.); (G.D.I.); (S.S.); (M.A.B.M.)
| | - Giuseppe Di Iorio
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Interuniversity Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.B.); (G.S.); (C.D.); (G.D.I.); (S.S.); (M.A.B.M.)
| | - Simone Sampaolo
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Interuniversity Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.B.); (G.S.); (C.D.); (G.D.I.); (S.S.); (M.A.B.M.)
| | - Silvio Peluso
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, 80138 Naples, Italy; (S.P.); (A.D.R.); (G.D.M.)
| | - Anna De Rosa
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, 80138 Naples, Italy; (S.P.); (A.D.R.); (G.D.M.)
| | - Giuseppe De Michele
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, 80138 Naples, Italy; (S.P.); (A.D.R.); (G.D.M.)
| | - Melissa Barghigiani
- Molecular Medicine, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (M.B.); (D.G.); (A.T.); (F.S.)
| | - Daniele Galatolo
- Molecular Medicine, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (M.B.); (D.G.); (A.T.); (F.S.)
| | - Alessandra Tessa
- Molecular Medicine, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (M.B.); (D.G.); (A.T.); (F.S.)
| | - Filippo Santorelli
- Molecular Medicine, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (M.B.); (D.G.); (A.T.); (F.S.)
| | - Pietro Chiurazzi
- Istituto di Medicina Genomica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC Genetica Medica, 00168 Roma, Italy
- Correspondence: ; Tel.: +39-338-8361006
| | - Mariarosa Anna Beatrice Melone
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Interuniversity Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.B.); (G.S.); (C.D.); (G.D.I.); (S.S.); (M.A.B.M.)
- Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, Temple University, Philadelphia, PA 19122-6078, USA
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17
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Montagnese F, Grabmaier U, Abicht A, Schoser B. Dilative cardiomyopathy displaying double trouble etiology: Myocarditis and Mcleod syndrome? Clin Neurol Neurosurg 2020; 197:106122. [DOI: 10.1016/j.clineuro.2020.106122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 11/15/2022]
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18
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Lhomme F, Peyrard T, Babinet J, Abou-Chahla W, Durieu I, Moshous D, Neven B, Rohrlich PS, Albinni S, Amiranoff D, Dumont MD, Lortholary O, Héritier S, Marguet C, Suarez F, Fischer A, Blanche S, Hermine O, Mahlaoui N. Chronic Granulomatous Disease with the McLeod Phenotype: a French National Retrospective Case Series. J Clin Immunol 2020; 40:752-762. [PMID: 32562208 DOI: 10.1007/s10875-020-00791-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 05/07/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND X-linked chronic granulomatous disease (CGD) is a primary immunodeficiency caused by mutations in the CYBB gene (located on Xp21.1). Patients with large deletions on chromosome Xp21.1 can present with the McLeod phenotype and also Duchenne muscular dystrophy or retinitis pigmentosa. The objective of the present study was to describe a series of French patients with CGD and the McLeod phenotype. METHODS We retrospectively collected data from the medical records of 8 patients with CGD and the McLeod phenotype registered at the French National Reference Center for blood types. RESULTS The median age at diagnosis of CGD was 1.2 years, the median age at diagnosis of the McLeod phenotype was 4.5 years, and the median length of follow-up was 15.2 years. Four patients displayed allo-immunization, with anti-KEL20 and anti-XK1 (formerly known as anti-KL) antibodies. Five of the 6 patients with available blood smears had acanthocytosis. Neuropsychiatric, muscle-related, and ocular manifestations were present in 4, 2, and 1 of the patients, respectively. Three of the 4 patients having undergone allogeneic hematopoietic stem cell transplantation (HSCT) are alive. Overall, 5 patients are alive, and 3 are alive and well. CONCLUSION This is the largest yet descriptive study of a series of patients with X-linked CGD and the McLeod phenotype. Although this disease combination is rare, the timely, accurate diagnosis of the McLeod phenotype is critical because of the serious post-transfusion complications. However, HSCT can be considered in these patients.
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Affiliation(s)
| | - Thierry Peyrard
- Département Centre National de Référence pour les Groupes Sanguins (CNRGS), Institut national de la transfusion sanguine (INTS), 75522, Paris, Cedex 11, France.,UMR_S1134 Inserm, Université de Paris, 75015, Paris, France.,Laboratory of Excellence of Red Cells (GRex), Institut Imagine, 75015, Paris, France
| | - Jérôme Babinet
- Département Centre National de Référence pour les Groupes Sanguins (CNRGS), Institut national de la transfusion sanguine (INTS), 75522, Paris, Cedex 11, France
| | | | - Isabelle Durieu
- Department of Internal Medicine, Adult Cystic Fibrosis Care Center, Hospices Civils de Lyon, Lyon, France.,EA HESPER 7425, Université Claude Bernard Lyon 1, 43 Boulevard du 11 Novembre 1918, 69100, Villeurbanne, France
| | - Despina Moshous
- Pediatric Immuno-Hematology and Rheumatology Unit, Assistance Publique-Hôpitaux de Paris (AP-HP), Necker-Enfants Malades University Hospital, Paris, France.,Sorbonne Paris Cité, Imagine Institute, Paris Descartes University, Paris, France
| | - Bénédicte Neven
- Pediatric Immuno-Hematology and Rheumatology Unit, Assistance Publique-Hôpitaux de Paris (AP-HP), Necker-Enfants Malades University Hospital, Paris, France.,Sorbonne Paris Cité, Imagine Institute, Paris Descartes University, Paris, France
| | | | - Souha Albinni
- Établissement français du sang, Assistance Publique-Hôpitaux de Paris (AP-HP), Necker-Enfants malades University Hospital, Paris, France
| | - Denise Amiranoff
- Établissement français du sang, Assistance Publique-Hôpitaux de Paris (AP-HP), Necker-Enfants malades University Hospital, Paris, France
| | - Marie-Dominique Dumont
- Établissement français du sang, Assistance Publique-Hôpitaux de Paris (AP-HP), Necker-Enfants malades University Hospital, Paris, France
| | - Olivier Lortholary
- Sorbonne Paris Cité, Imagine Institute, Paris Descartes University, Paris, France.,Centre d'Infectiologie Necker-Pasteur, Assistance Publique-Hôpitaux de Paris (AP-HP), Necker-Enfants Malades University Hospital, Paris, France
| | - Sébastien Héritier
- Department of Pediatric Hematology and Oncology, Assistance Publique-Hôpitaux de Paris (AP-HP), Trousseau Hospital, Sorbonne University Medical School, Paris, France
| | | | - Felipe Suarez
- Department of Hematology, Assistance Publique-Hôpitaux de Paris (AP-HP), Necker-Enfants Malades University Hospital, Paris, France.,INSERM UMR 1163, CNRS ERL 8254, Imagine Institute, Sorbonne Paris Cité, Paris Descartes University, Paris, France.,French National Reference Center for Primary Immune Deficiencies (CEREDIH), Assistance Publique-Hôpitaux de Paris (AP-HP), Necker-Enfants Malades University Hospital, Paris, France
| | - Alain Fischer
- Pediatric Immuno-Hematology and Rheumatology Unit, Assistance Publique-Hôpitaux de Paris (AP-HP), Necker-Enfants Malades University Hospital, Paris, France.,Sorbonne Paris Cité, Imagine Institute, Paris Descartes University, Paris, France.,French National Reference Center for Primary Immune Deficiencies (CEREDIH), Assistance Publique-Hôpitaux de Paris (AP-HP), Necker-Enfants Malades University Hospital, Paris, France.,Collège de France, Paris, France
| | - Stéphane Blanche
- Pediatric Immuno-Hematology and Rheumatology Unit, Assistance Publique-Hôpitaux de Paris (AP-HP), Necker-Enfants Malades University Hospital, Paris, France.,Sorbonne Paris Cité, Imagine Institute, Paris Descartes University, Paris, France.,French National Reference Center for Primary Immune Deficiencies (CEREDIH), Assistance Publique-Hôpitaux de Paris (AP-HP), Necker-Enfants Malades University Hospital, Paris, France
| | - Olivier Hermine
- Laboratory of Excellence of Red Cells (GRex), Institut Imagine, 75015, Paris, France.,Department of Hematology, Assistance Publique-Hôpitaux de Paris (AP-HP), Necker-Enfants Malades University Hospital, Paris, France.,INSERM UMR 1163, CNRS ERL 8254, Imagine Institute, Sorbonne Paris Cité, Paris Descartes University, Paris, France.,French National Reference Center for Primary Immune Deficiencies (CEREDIH), Assistance Publique-Hôpitaux de Paris (AP-HP), Necker-Enfants Malades University Hospital, Paris, France
| | - Nizar Mahlaoui
- Pediatric Immuno-Hematology and Rheumatology Unit, Assistance Publique-Hôpitaux de Paris (AP-HP), Necker-Enfants Malades University Hospital, Paris, France. .,Sorbonne Paris Cité, Imagine Institute, Paris Descartes University, Paris, France. .,French National Reference Center for Primary Immune Deficiencies (CEREDIH), Assistance Publique-Hôpitaux de Paris (AP-HP), Necker-Enfants Malades University Hospital, Paris, France.
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19
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Rossi M, Farcy N, Starkstein SE, Merello M. Nosology and Phenomenology of Psychosis in Movement Disorders. Mov Disord Clin Pract 2020; 7:140-153. [PMID: 32071931 DOI: 10.1002/mdc3.12882] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/02/2019] [Accepted: 12/01/2019] [Indexed: 12/13/2022] Open
Abstract
Background Psychotic symptoms, such as delusions and hallucinations, are part of the clinical picture of several conditions presenting movement disorders. Phenomenology and epidemiology of psychosis in Parkinson's disease have received wide attention; however, the presence of psychosis in other movement disorders is, comparatively, less well known. Objectives To review psychotic symptoms present in different movement disorders. Methods A comprehensive and structured literature search was performed to identify and analyze data on patients with movement disorders and comorbid psychosis. Results In monogenic parkinsonisms, such as PARK-GBA, PARK-LRRK2, and PARK-SNCA, visual hallucinations related to dopamine replacement therapy are frequent as well as are delusions in PARK-LRRK2 and PARK-SNCA, but not in PARK-GBA. Different types of delusions and hallucinations are found in Huntington's disease and other choreic disorders. In Tourette's syndrome, paranoid delusions as well as visual, olfactory, and auditory hallucinations have been described, which usually develop after an average of 10 years of disease. Delusions in ataxias are more frequent in ATX-TBP, ATX-ATN1, and ATX-ATXN3, whereas it is rare in Friedreich's ataxia. Psychosis is also a prominent and frequent clinical feature in Fahr's disease, Wilson's disease, neurodegeneration with brain iron accumulation, and some lysosomal storage disorders, whereas it is uncommon in atypical parkinsonisms and dystonia. Psychosis usually occurs at late disease stages, but may appear as onset symptoms of the disease, especially in Wilson's disease, Huntington's disease, late-onset Tays-Sachs, and Niemann-Pick. Conclusion Psychosis is a frequent comorbidity in most hyper- and hypokinetic movement disorders. Appropriate recognition is relevant both in the early and late disease stages.
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Affiliation(s)
- Malco Rossi
- Movement Disorders Section, Neuroscience Department Raul Carrea Institute for Neurological Research (FLENI) Buenos Aires Argentina.,Pontificia Universidad Catolica Argentina (UCA) Buenos Aires Argentina
| | - Nicole Farcy
- Movement Disorders Section, Neuroscience Department Raul Carrea Institute for Neurological Research (FLENI) Buenos Aires Argentina
| | - Sergio E Starkstein
- School of Psychiatry and Clinical Neurosciences University of Western Australia Crawley WA Australia
| | - Marcelo Merello
- Movement Disorders Section, Neuroscience Department Raul Carrea Institute for Neurological Research (FLENI) Buenos Aires Argentina.,Pontificia Universidad Catolica Argentina (UCA) Buenos Aires Argentina.,Argentine National Scientific and Technological Research Council (CONICET) Buenos Aires Argentina
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Murakami T, Abe D, Matsumoto H, Tokimura R, Abe M, Tiksnadi A, Kobayashi S, Kaneko C, Urata Y, Nakamura M, Sano A, Ugawa Y. A patient with McLeod syndrome showing involvement of the central sensorimotor tracts for the legs. BMC Neurol 2019; 19:301. [PMID: 31775676 PMCID: PMC6882147 DOI: 10.1186/s12883-019-1526-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 11/12/2019] [Indexed: 11/17/2022] Open
Abstract
Background McLeod syndrome is a rare X-linked recessive acanthocytosis associated with neurological manifestations including progressive chorea, cognitive impairment, psychiatric disturbances, seizures, and sensorimotor axonal polyneuropathy. However, no studies have investigated the functioning of central sensorimotor tracts in patients with McLeod syndrome. Case presentation A 66-year-old man had experienced slowly progressive chorea and gait disturbance due to lower limb muscle weakness since his early fifties. Blood examinations showed erythrocyte acanthocytosis and the reduction of Kell antigens in red blood cells. Brain magnetic resonance imaging showed atrophy of the bilateral caudate nuclei and putamen. The diagnosis of McLeod syndrome was confirmed by the presence of a mutation of the XK gene on the X chromosome. Somatosensory-evoked potential and transcranial magnetic stimulation studies demonstrated that the central sensory and motor conduction times were abnormally prolonged for the lower extremity but normal for the upper extremity. Conclusions This is the first report of the involvement of the central sensorimotor tracts for the legs in a patient with McLeod syndrome. The clinical neurophysiological technique revealed the central sensorimotor tracts involvements clinically masked by neuropathy.
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Affiliation(s)
- Takenobu Murakami
- Department of Neurology, Fukushima Medical University, Fukushima, Japan. .,Department of Neurology, Tottori Prefectural Kousei Hospital, Kurayoshi, Japan.
| | - Dan Abe
- Department of Neurology, Fukushima Medical University, Fukushima, Japan
| | | | - Ryo Tokimura
- Department of Neurology, Fukushima Medical University, Fukushima, Japan
| | - Mitsunari Abe
- Center for Neurological Disorders, Fukushima Medical University, Fukushima, Japan
| | - Amanda Tiksnadi
- Department of Neurology, Fukushima Medical University, Fukushima, Japan
| | | | - Chikako Kaneko
- Department of Neurology, Southern Tohoku General Hospital, Koriyama, Japan
| | - Yuka Urata
- Department of Psychiatry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masayuki Nakamura
- Department of Psychiatry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Akira Sano
- Department of Psychiatry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yoshikazu Ugawa
- Department of Neurology, Fukushima Medical University, Fukushima, Japan.,Department of Neuro-regeneration, Fukushima Medical University, Fukushima, Japan
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21
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Involuntary movements, vocalizations and cognitive decline. Parkinsonism Relat Disord 2019; 79:135-137. [PMID: 31153763 DOI: 10.1016/j.parkreldis.2019.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 05/20/2019] [Indexed: 11/22/2022]
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22
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McLeod syndrome: Five new pedigrees with novel mutations. Parkinsonism Relat Disord 2019; 64:293-299. [PMID: 31103486 DOI: 10.1016/j.parkreldis.2019.04.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 04/20/2019] [Accepted: 04/29/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To present five new McLeod Syndrome (MLS) pedigrees with novel XK gene mutations, review the literature of this disorder, and discuss the typical and atypical clinical features noted with these new mutations. METHODS This is a multi-center retrospective review of five MLS cases with novel gene mutations. Genotypic and phenotypic information has been obtained from each center. RESULTS Five novel mutations are reported in this Case series. New clinical findings include prolonged asymptomatic elevated creatine kinase (CK) levels, vocal tics, presence of obstructive sleep apnea (OSA), and one patient of Vietnamese ethnicity. CONCLUSIONS We expand on the clinical and genetic spectrum of MLS demonstrating the clinical variability of MLS.
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23
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Balint B, Lang AE. Expert comment to: Novel Xp21.1 deletion associated with unusual features in large McLeod syndrome kindred. Parkinsonism Relat Disord 2019; 79:133-134. [PMID: 30858069 DOI: 10.1016/j.parkreldis.2019.02.024] [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: 11/26/2022]
Affiliation(s)
- Bettina Balint
- UCL Queen Square Institute of Neurology, Department of Clinical and Movement Neurosciences, London, United Kingdom; Department of Neurology, University Hospital, Heidelberg, Germany.
| | - Anthony E Lang
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital - UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
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24
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Peikert K, Danek A, Hermann A. Current state of knowledge in Chorea-Acanthocytosis as core Neuroacanthocytosis syndrome. Eur J Med Genet 2018; 61:699-705. [DOI: 10.1016/j.ejmg.2017.12.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 12/01/2017] [Accepted: 12/14/2017] [Indexed: 11/30/2022]
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25
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Sveinsson O, Udd B, Svenningsson P, Gassner C, Engström C, Laffita-Mesa JM, Solders G, Hertegård S, Savitcheva I, Jung HH, Tolnay M, Frey BM, Paucar M. WITHDRAWN: Novel Xp21.1 deletion associated with unusual features in a large McLeod syndrome kindred. Parkinsonism Relat Disord 2018:S1353-8020(18)30399-7. [PMID: 30305234 DOI: 10.1016/j.parkreldis.2018.09.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 09/03/2018] [Accepted: 09/10/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Olafur Sveinsson
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Bjarne Udd
- Neuromuscular Research Center, Tampere University Hospital and University of Tampere, Tampere, Finland; Department of Neurology, Vaasa Central Hospital, Vaasa, Finland
| | - Per Svenningsson
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Christoph Gassner
- Blood Transfusion Service Zürich, Swiss Red Cross (SRC), Zurich-Schlieren, Switzerland
| | - Charlotte Engström
- Blood Transfusion Service Zürich, Swiss Red Cross (SRC), Zurich-Schlieren, Switzerland
| | | | - Göran Solders
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neurophysiology, Karolinska University Hospital, Stockholm, Sweden
| | - Stellan Hertegård
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - Irina Savitcheva
- Department of Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Hans H Jung
- Department of Neurology, University Hospital Zurich, Switzerland
| | - Markus Tolnay
- Department of Neuropathology, Institute of Pathology, University Hospital in Basel, Switzerland
| | - Beat M Frey
- Blood Transfusion Service Zürich, Swiss Red Cross (SRC), Zurich-Schlieren, Switzerland
| | - Martin Paucar
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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26
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Fazio P, Paucar M, Svenningsson P, Varrone A. Novel Imaging Biomarkers for Huntington's Disease and Other Hereditary Choreas. Curr Neurol Neurosci Rep 2018; 18:85. [PMID: 30291526 PMCID: PMC6182636 DOI: 10.1007/s11910-018-0890-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF THE REVIEW Imaging biomarkers for neurodegenerative disorders are primarily developed with the goal to aid diagnosis, to monitor disease progression, and to assess the efficacy of disease-modifying therapies in support to clinical outcomes that may either show limited sensitivity or need extended time for their evaluation. This article will review the most recent concepts and findings in the field of neuroimaging applied to Huntington's disease and Huntington-like syndromes. Emphasis will be given to the discussion of potential pharmacodynamic biomarkers for clinical trials in Huntington's disease (HD) and of neuroimaging tools that can be used as diagnostic biomarkers in HD-like syndromes. RECENT FINDINGS Several magnetic resonance (MR) and positron emission tomography (PET) molecular imaging tools have been identified as potential pharmacodynamic biomarkers and others are in the pipeline after preclinical validation. MRI and 18F-fluorodeoxyglucose PET can be considered useful supportive diagnostic tools for the differentiation of other HD-like syndromes. New trials in HD have the primary goal to lower mutant huntingtin (mHTT) protein levels in the brain in order to reduce or alter the progression of the disease. MR and PET molecular imaging markers have been developed as tools to monitor disease progression and to evaluate treatment outcomes of disease-modifying trials in HD. These markers could be used alone or in combination for detecting structural and pharmacodynamic changes potentially associated with the lowering of mHTT.
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Affiliation(s)
- Patrik Fazio
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, R5:02 Karolinska University Hospital, SE-171 76, Stockholm, Sweden.
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.
| | - Martin Paucar
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Neuroscience, Centre for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Per Svenningsson
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Neuroscience, Centre for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Andrea Varrone
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, R5:02 Karolinska University Hospital, SE-171 76, Stockholm, Sweden
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Komiya H, Takasu M, Hashiguchi S, Uematsu E, Fukai R, Tanaka K, Tada M, Joki H, Takahashi T, Koyano S, Doi H, Takeuchi H, Tanaka F. A Case of McLeod Syndrome with A Novel XK Missense Mutation. Mov Disord Clin Pract 2018; 5:333-336. [PMID: 30800707 DOI: 10.1002/mdc3.12614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/15/2018] [Accepted: 03/02/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Hiroyasu Komiya
- Department of Neurology and Stroke Medicine Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku Yokohama, 236-0004 Japan
| | - Mutsuki Takasu
- Department of Neurology and Stroke Medicine Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku Yokohama, 236-0004 Japan.,Department of Neurology National Hospital Organization Yokohama Medical Center, Harajuku Totsuka-ku Yokohama, 245-8575 Japan
| | - Shunta Hashiguchi
- Department of Neurology and Stroke Medicine Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku Yokohama, 236-0004 Japan
| | - Eri Uematsu
- Department of Neurology and Stroke Medicine Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku Yokohama, 236-0004 Japan
| | - Ryoko Fukai
- Department of Neurology and Stroke Medicine Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku Yokohama, 236-0004 Japan
| | - Kenichi Tanaka
- Department of Neurology and Stroke Medicine Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku Yokohama, 236-0004 Japan
| | - Mikiko Tada
- Department of Neurology and Stroke Medicine Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku Yokohama, 236-0004 Japan
| | - Hideto Joki
- Department of Neurology and Stroke Medicine Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku Yokohama, 236-0004 Japan
| | - Tatsuya Takahashi
- Department of Neurology National Hospital Organization Yokohama Medical Center, Harajuku Totsuka-ku Yokohama, 245-8575 Japan
| | - Shigeru Koyano
- Department of Neurology and Stroke Medicine Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku Yokohama, 236-0004 Japan
| | - Hiroshi Doi
- Department of Neurology and Stroke Medicine Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku Yokohama, 236-0004 Japan
| | - Hideyuki Takeuchi
- Department of Neurology and Stroke Medicine Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku Yokohama, 236-0004 Japan
| | - Fumiaki Tanaka
- Department of Neurology and Stroke Medicine Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku Yokohama, 236-0004 Japan
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Díaz-Manera J, Sotoca-Fernández J, Alonso-Jiménez A, Marzo ME, Gallardo E, Segovia-Simón S, Siles AM, Illa I, Pagonabarraga J. Mcleod syndrome is a new cause of axial muscle weakness. Muscle Nerve 2018; 58. [PMID: 29381810 DOI: 10.1002/mus.26086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 01/22/2018] [Accepted: 01/24/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Jordi Díaz-Manera
- Neurology Department, Universitat Autònoma de Barcelona, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Valencia, Spain
| | - Javier Sotoca-Fernández
- Neurology Department, Universitat Autònoma de Barcelona, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Alicia Alonso-Jiménez
- Neurology Department, Universitat Autònoma de Barcelona, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Valencia, Spain
| | | | - Eduard Gallardo
- Neurology Department, Universitat Autònoma de Barcelona, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Valencia, Spain
| | - Sonia Segovia-Simón
- Neurology Department, Universitat Autònoma de Barcelona, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Valencia, Spain
| | - Ana María Siles
- Neurology Department, Universitat Autònoma de Barcelona, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Valencia, Spain
| | - Isabel Illa
- Neurology Department, Universitat Autònoma de Barcelona, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Valencia, Spain
| | - Javier Pagonabarraga
- Neurology Department, Universitat Autònoma de Barcelona, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
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Shook D, Brouwer R, de Zeeuw P, Oranje B, Durston S. XKR4 Gene Effects on Cerebellar Development Are Not Specific to ADHD. Front Cell Neurosci 2018; 11:396. [PMID: 29311829 PMCID: PMC5732973 DOI: 10.3389/fncel.2017.00396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 11/28/2017] [Indexed: 11/17/2022] Open
Abstract
A single-nucleotide polymorphism (SNP) of the XKR4 gene has been linked to Attention-Deficit/Hyperactivity Disorder (ADHD). This gene is preferentially expressed in cerebellum, a brain structure implicated in this disorder. This study investigated the effects of this SNP on cerebellar development in children with and without ADHD. We collected 279 longitudinal T1-weighted structural images and DNA from 58 children with ADHD and 64 typically developing (TD) children matched for age, IQ, and gender. Groups were divided by the XKR4 rs2939678 SNP into A-allele carriers versus subjects homozygous for the G-allele. Cerebellar lobular volumes were segmented into 35 regions of interest using MAGeTBrain, an automated multi-atlas segmentation pipeline for anatomical MRI, and statistically analyzed using linear mixed models. We found decreased gray matter (GM) volumes in ADHD compared to TD children in bilateral lobules VIIIA, left VIIIB, right VIIB, and vermis VI. Furthermore, we found a linear age by gene interaction in left lobule VIIB where subjects homozygous for the G-allele showed a decrease in volume over time compared to A-allele carriers. We further found quadratic age × gene and age × diagnosis interactions in left lobule IV. Subjects homozygous for the G-allele (the genotype overtransmitted in ADHD) showed more suppressed, almost flat quadratic growth curves compared to A-allele carriers, similar to individuals with ADHD compared to controls. However, there was no interaction between genotype and diagnosis, suggesting that any effects of this SNP on cerebellar development are not specific to the disorder.
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Affiliation(s)
- Devon Shook
- NICHE Laboratory, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Rachel Brouwer
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Patrick de Zeeuw
- NICHE Laboratory, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Bob Oranje
- NICHE Laboratory, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Sarah Durston
- NICHE Laboratory, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
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30
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Westhoff CM, Storry JR, Shaz BH. Human Blood Group Antigens and Antibodies. Hematology 2018. [DOI: 10.1016/b978-0-323-35762-3.00110-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Srivastava K, Stiles DA, Wagner FF, Flegel WA. Two large deletions extending beyond either end of the RHD gene and their red cell phenotypes. J Hum Genet 2018; 63:27-35. [PMID: 29215093 PMCID: PMC5764804 DOI: 10.1038/s10038-017-0345-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 08/12/2017] [Accepted: 08/14/2017] [Indexed: 01/22/2023]
Abstract
Only two partial deletions longer than 655 nucleotides had been reported for the RHD gene, constrained within the gene and causing DEL phenotypes. Using a combination of quantitative PCR and long-range PCR, we examined three distinct deletions affecting parts of the RHD gene in three blood donors. Their RHD nucleotide sequences and exact boundaries of the breakpoint regions were determined. DEL phenotypes were caused by a novel 18.4 kb deletion and a previously published 5.4 kb deletion of the RHD gene; a D-negative phenotype was caused by a novel 7.6 kb deletion. Examination of the deletion-flanking regions suggested microhomology-mediated end-joining, replication slippage, and non-homologous end-joining, respectively, as the most likely mechanisms for the three distinct deletions. We described two new deletions affecting parts of the RHD gene, much longer than any previously reported partial deletion: one was the first deletion observed at the 5' end of the RHD gene extending into the intergenic region, and the other the second deletion observed at its 3' end. Large deletions present at either end are a mechanism for a much reduced RhD protein expression or its complete loss. Exact molecular characterization of such deletions is instrumental for accurate RHD genotyping.
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Affiliation(s)
- Kshitij Srivastava
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, MSC 1184, 10 Center Drive, Bethesda, 20892, MD, USA
| | - David Alan Stiles
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, MSC 1184, 10 Center Drive, Bethesda, 20892, MD, USA
| | - Franz Friedrich Wagner
- Red Cross Blood Service NSTOB, Institute Springe, Eldagsener Strasse 38, 31830, Springe, Germany
| | - Willy Albert Flegel
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, MSC 1184, 10 Center Drive, Bethesda, 20892, MD, USA.
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Erythrogene: a database for in-depth analysis of the extensive variation in 36 blood group systems in the 1000 Genomes Project. Blood Adv 2016; 1:240-249. [PMID: 29296939 DOI: 10.1182/bloodadvances.2016001867] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 11/11/2016] [Indexed: 01/22/2023] Open
Abstract
Blood group genotyping has recently developed into a clinical tool to improve compatibility of blood transfusions and management of pregnancies. Next-generation sequencing (NGS) is rapidly moving toward routine practice for patient and donor typing and has the potential to remedy some of the limitations of currently used platforms. However, a large-scale investigation into the blood group genotypes obtained by NGS in a multiethnic cohort is lacking. The 1000 Genomes Project provides information on genome variation among 2504 individuals representing 26 populations worldwide. We extracted their NGS data for all 36 blood group systems to a custom-designed database. In total, 210 412 alleles from 43 blood group-related genes were imported and curated. Matching algorithms were developed to compare them to blood group variants identified to date. Of the 1241 non-synonymous variants identified in the coding regions, 241 are known blood group polymorphisms. Interestingly, 357 of the remaining 1000 variants are predicted to occur on extracellular portions of 31 different blood group-carrying proteins and some may represent undiscovered antigens. Of the alleles analyzed, 1504 were not previously described. The ABO/GBGT1/FUT2/FUT3 and GYPB/GYPC genes showed the highest degree of variation per kilobase coding sequence, and ACKR1 variants had the most skewed distribution across 5 continental superpopulations in the dataset. Results were exported to an online search engine, www.erythrogene.com, which presents data according to the allele nomenclature developed for clinical reporting by the International Society of Blood Transfusion. The established database deepens our knowledge on blood group polymorphism globally and provides a long-sought platform for future research.
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Modrego PJ, Gazulla J, Cobo AM, Andoni Urtizberea J. Une cause inhabituelle d’hyperCKémie. Med Sci (Paris) 2016; 32 Hors série n°2:12-13. [PMID: 27869070 DOI: 10.1051/medsci/201632s204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Les élévations du taux de créatine-phospho-kinase (CPK), ou hyperCKémies, constituent le lot quotidien de nombreux myologues. Leur grande diversité étiologique rend les choses difficiles en pratique clinique, plus encore lorsque l’hyperCKémie est isolée. Mis à part les élévations transitoires liées à certaines circonstances facilement identifiables (naissance, traumatisme, exercice musculaire extrême, exposition aux statines) ou certains facteurs ethniques, de nombreuses maladies neuromusculaires peuvent en être à l’origine. Il s’agit en premier lieu des dystrophies musculaires progressives et des myopathies métaboliques (glycogénoses surtout). Les progrès obtenus dans l’identification des causes des hyperCKémies ont sensiblement progressé ces dernières années grâce, notamment, à l’utilisation plus large du NGS. Dans l’observation ci-dessous, l’accent est mis sur une cause rare d’hyperCKémie pour laquelle un marqueur érythrocytaire simple permet d’évoquer le diagnostic.
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Affiliation(s)
- Pedro J Modrego
- Départment de Neurologie, Hospital Universitario Miguel Servet, Zaragoza 50009, Espagne
| | - José Gazulla
- Départment de Neurologie, Hospital Universitario Miguel Servet, Zaragoza 50009, Espagne
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Abstract
PURPOSE OF REVIEW This article reviews the clinical approach to the diagnosis of adult patients presenting with chorea, using Huntington disease (HD) as a point of reference, and presents the clinical elements that help in the diagnostic workup. Principles of management for chorea and some of the associated features of other choreic syndromes are also described. RECENT FINDINGS Mutations in the C9orf72 gene, previously identified in families with a history of frontotemporal dementia, amyotrophic lateral sclerosis, or both, have been recognized as one of the most prevalent causes of HD phenocopies in the white population. SUMMARY The diagnosis of chorea in adult patients is challenging. A varied number of associated causes require a physician to prioritize the investigations, and a detailed history of chorea and associated findings will help. For chorea presenting as part of a neurodegenerative syndrome, the consideration of a mutation in the C9orf72 gene is a new recommendation after excluding HD. There are no new treatment options for chorea, aside from dopamine blockers and tetrabenazine. There are no disease-modifying treatments for HD or other neurodegenerative choreic syndromes.
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Dulski J, Sołtan W, Schinwelski M, Rudzińska M, Wójcik-Pędziwiatr M, Wictor L, Schön F, Puschmann A, Klempíř J, Tilley L, Roth J, Tacik P, Fujioka S, Drozdowski W, Sitek E, Wszolek Z, Sławek J. Clinical variability of neuroacanthocytosis syndromes—a series of six patients with long follow-up. Clin Neurol Neurosurg 2016; 147:78-83. [DOI: 10.1016/j.clineuro.2016.05.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 02/28/2016] [Accepted: 05/29/2016] [Indexed: 11/26/2022]
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36
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Nagata S, Suzuki J, Segawa K, Fujii T. Exposure of phosphatidylserine on the cell surface. Cell Death Differ 2016; 23:952-61. [PMID: 26891692 DOI: 10.1038/cdd.2016.7] [Citation(s) in RCA: 298] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 01/11/2016] [Indexed: 12/15/2022] Open
Abstract
Phosphatidylserine (PtdSer) is a phospholipid that is abundant in eukaryotic plasma membranes. An ATP-dependent enzyme called flippase normally keeps PtdSer inside the cell, but PtdSer is exposed by the action of scramblase on the cell's surface in biological processes such as apoptosis and platelet activation. Once exposed to the cell surface, PtdSer acts as an 'eat me' signal on dead cells, and creates a scaffold for blood-clotting factors on activated platelets. The molecular identities of the flippase and scramblase that work at plasma membranes have long eluded researchers. Indeed, their identity as well as the mechanism of the PtdSer exposure to the cell surface has only recently been revealed. Here, we describe how PtdSer is exposed in apoptotic cells and in activated platelets, and discuss PtdSer exposure in other biological processes.
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Affiliation(s)
- S Nagata
- Laboratory of Biochemistry & Immunology, Immunology Frontier Research Center, Osaka University, Suita, Osaka 565-0871, Japan
| | - J Suzuki
- Laboratory of Biochemistry & Immunology, Immunology Frontier Research Center, Osaka University, Suita, Osaka 565-0871, Japan
| | - K Segawa
- Laboratory of Biochemistry & Immunology, Immunology Frontier Research Center, Osaka University, Suita, Osaka 565-0871, Japan
| | - T Fujii
- Laboratory of Biochemistry & Immunology, Immunology Frontier Research Center, Osaka University, Suita, Osaka 565-0871, Japan
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Walker RH. Management of Neuroacanthocytosis Syndromes. Tremor Other Hyperkinet Mov (N Y) 2015; 5:346. [PMID: 26504667 PMCID: PMC4613733 DOI: 10.7916/d8w66k48] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 09/24/2015] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND The two core neuroacanthocytosis (NA) syndromes, chorea-acanthocytosis (ChAc) and McLeod syndrome, are progressive neurodegenerative disorders that primarily affect the basal ganglia. The characteristic phenotype comprises a variety of movement disorders including chorea, dystonia, and parkinsonism, as well as psychiatric and cognitive symptoms attributable to basal ganglia dysfunction. These disorders are symptomatically managed on a case-by-case basis, with very few practitioners seeing more than a single case in their careers. METHODS A literature search was performed on PubMed utilizing the terms neuroacanthocytosis, chorea-acanthocytosis, and McLeod syndrome, and articles were reviewed for mentions of therapies, successful or otherwise. RESULTS There have been no blinded, controlled trials and only one retrospective case series describing ChAc. The various therapies that have been used in patients with NA syndromes are summarized. DISCUSSION Management remains at present purely symptomatic, which is similar in principle to other more common basal ganglia neurodegenerative disorders such as Huntington's disease (HD) and Parkinson's disease (PD). However, there are some specific issues particular to NA syndromes that merit attention. An integrated multidisciplinary approach is the ideal management strategy for these complex and multifaceted neurodegenerative disorders.
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Affiliation(s)
- Ruth H. Walker
- Department of Neurology, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
- Department of Neurology, Mount Sinai School of Medicine, New York City, NY, USA
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Neurodegeneration in the elderly – When the blood type matters: An overview of the McLeod syndrome with focus on hematological features. Transfus Apher Sci 2015; 52:277-84. [DOI: 10.1016/j.transci.2015.04.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Walker RH. Untangling the Thorns: Advances in the Neuroacanthocytosis Syndromes. J Mov Disord 2015; 8:41-54. [PMID: 26090076 PMCID: PMC4460540 DOI: 10.14802/jmd.15009] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 04/27/2015] [Accepted: 04/28/2015] [Indexed: 12/25/2022] Open
Abstract
There have been significant advances in neuroacanthocytosis (NA) syndromes in the past 20 years, however, confusion still exists regarding the precise nature of these disorders and the correct nomenclature. This article seeks to clarify these issues and to summarise the recent literature in the field. The four key NA syndromes are described here-chorea-acanthocytosis, McLeod syndrome, Huntington's disease-like 2, and pantothenate kinase- associated neurodegeneration. In the first two, acanthocytosis is a frequent, although not invariable, finding; in the second two, it occurs in approximately 10% of patients. Degeneration affecting the basal ganglia is the key neuropathologic finding, thus the clinical presentations can be remarkably similar. The characteristic phenotype comprises a variety of movement disorders, including chorea, dystonia, and parkinsonism, and also psychiatric and cognitive symptoms attributable to basal ganglia dysfunction. The age of onset, inheritance patterns, and ethnic background differ in each condition, providing diagnostic clues. Other investigations, including routine blood testing and neuroimaging can be informative. Genetic diagnosis, if available, provides a definitive diagnosis, and is important for genetic counseling, and hopefully molecular therapies in the future. In this article I provide a historical perspective on each NA syndrome. The first 3 disorders, chorea-acanthocytosis, McLeod syndrome, Huntington's disease-like 2, are discussed in detail, with a comprehensive review of the literature to date for each, while pantothenate kinase-associated neurodegeneration is presented in summary, as this disorder has recently been reviewed in this journal. Therapy for all of these diseases is, at present, purely symptomatic.
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Affiliation(s)
- Ruth H. Walker
- Department of Neurology, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
- Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA
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Abnormal red cell features associated with hereditary neurodegenerative disorders: the neuroacanthocytosis syndromes. Curr Opin Hematol 2015; 21:201-9. [PMID: 24626044 DOI: 10.1097/moh.0000000000000035] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW This review discusses the mechanisms involved in the generation of thorny red blood cells (RBCs), known as acanthocytes, in patients with neuroacanthocytosis, a heterogenous group of neurodegenerative hereditary disorders that include chorea-acanthocytosis (ChAc) and McLeod syndrome (MLS). RECENT FINDINGS Although molecular defects associated with neuroacanthocytosis have been identified recently, their pathophysiology and the related RBC abnormalities are largely unknown. Studies in ChAc RBCs have shown an altered association between the cytoskeleton and the integral membrane protein compartment in the absence of major changes in RBC membrane composition. In ChAc RBCs, abnormal Lyn kinase activation in a Syk-independent fashion has been reported recently, resulting in increased band 3 tyrosine phosphorylation and perturbation of the stability of the multiprotein band 3-based complexes bridging the membrane to the spectrin-based membrane skeleton. Similarly, in MLS, the absence of XK-protein, which is associated with the spectrin-actin-4.1 junctional complex, is associated with an abnormal membrane protein phosphorylation state, with destabilization of the membrane skeletal network resulting in generation of acanthocytes. SUMMARY A novel mechanism in generation of acanthocytes involving abnormal Lyn activation, identified in ChAc, expands the acanthocytosis phenomenon toward protein-protein interactions, controlled by phosphorylation-related abnormal signaling.
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Genetics of Huntington Disease (HD), HD-Like Disorders, and Other Choreiform Disorders. Mov Disord 2015. [DOI: 10.1016/b978-0-12-405195-9.00030-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Liu J, Bader B, Danek A. Neuroacanthocytosis in china: a review of published reports. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2014; 4:248. [PMID: 25374764 PMCID: PMC4219110 DOI: 10.7916/d8q23xdx] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 07/21/2014] [Indexed: 12/03/2022]
Abstract
Background Neuroacanthocytosis (NA) syndromes are a group of rare diseases characterized by the presence of acanthocytes and neuronal multisystem pathology, including chorea-acanthocytosis (ChAc), McLeod syndrome (MLS), Huntington's disease-like 2 (HDL-2), and pantothenate kinase-associated neurodegeneration (PKAN). China has the largest population in the world, which makes it a good location for investigating rare diseases like NA. Methods We searched Medline, ISI Proceedings, China National Knowledge Infrastructure, and Wanfang Data for literature published through December 31, 2013 for all the published Chinese NA case reports and extracted the clinical and laboratory findings. Results A total of 42 studies describing 66 cases were found to be eligible for inclusion. Age of symptom onset ranged from 5 to 74 years. The most common findings included hyperkinetic movements (88%), orofacial dyskinesia (80%), dystonia (67%), and dysarthria (68%), as well as caudate atrophy or enlarged lateral ventricles on neuroimaging (64%), and elevated creatine kinase (52%). Most cases were not confirmed by any specific molecular tests. Only two cases were genetically studied and diagnosed as ChAc or MLS. Discussion In view of the prevalence of NA syndromes in other countries, the number of patients in China appears to be underestimated. Chinese NA patients may benefit from the establishment of networks that offer specific diagnoses and care for rare diseases.
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Affiliation(s)
- Jia Liu
- Neurologische Klinik, Klinikum der Universität München, 81377 München, Germany
| | - Benedikt Bader
- Neurologische Klinik, Klinikum der Universität München, 81377 München, Germany
| | - Adrian Danek
- Neurologische Klinik, Klinikum der Universität München, 81377 München, Germany
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Online Diagnosis System: a webserver for analysis of Sanger sequencing-based genetic testing data. Methods 2014; 69:230-6. [PMID: 25063568 DOI: 10.1016/j.ymeth.2014.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 06/25/2014] [Accepted: 07/05/2014] [Indexed: 11/24/2022] Open
Abstract
Sanger sequencing is a well-established molecular technique for diagnosis of genetic diseases. In these tests, DNA sequencers produce vast amounts of data that need to be examined and annotated within a short period of time. To achieve this goal, an online bioinformatics platform that can automate the process is essential. However, to date, there is no such integrated bioinformatics platform available. To fulfill this gap, we developed the Online Diagnosis System (ODS), which is a freely available webserver and supports the commonly used file format of Sanger sequencing data. ODS seamlessly integrates base calling, single nucleotide variation (SNV) identification, and SNV annotation into one single platform. It also allows laboratorians to manually inspect the quality of the identified SNVs in the final report. ODS can significantly reduce the data analysis time therefore allows Sanger sequencing-based genetic testing to be finished in a timely manner. ODS is freely available at http://sunlab.lihs.cuhk.edu.hk/ODS/.
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Man BL, Yuen YP, Fu YP. The first report of a Chinese family with McLeod syndrome. BMJ Case Rep 2014; 2014:bcr-2013-202785. [PMID: 24895410 DOI: 10.1136/bcr-2013-202785] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We report the first case of a Chinese family with McLeod syndrome (MLS). The two affected brothers show significant phenotypic heterogeneity. The index case has peripheral acanthocytosis, choreoathetosis of his feet, a slowly progressive neuropathy and myopathy, and an elevated serum creatine kinase (CK) level. His elder brother has more prominent chorea of the shoulders, epilepsy, a rapidly progressive neuropathy and normal serum CK. The diagnosis of MLS was confirmed by a genetic test which showed a hemizygous frameshift mutation in the XK gene.
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Affiliation(s)
- Bik Ling Man
- Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong, Hong Kong
| | - Yuet Ping Yuen
- Department of Chemical Pathology, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Yat Pang Fu
- Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong, Hong Kong
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Araten DJ, Zamechek L, Halverson G. No evidence of hypermutability in red cells from patients with paroxysmal nocturnal hemoglobinuria using the XK gene. Haematologica 2014; 99:e142-4. [PMID: 24816235 DOI: 10.3324/haematol.2013.099457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- David J Araten
- Assistant Professor, Department of Medicine, Division of Hematology, Department of Veterans Affairs New York Harbor Healthcare System, New York, NY The Division of Hematology, Department of Medicine, Laura and Isaac Perlmutter Cancer Center at NYU Langone, New York, NY
| | - Leah Zamechek
- The Division of Hematology, Department of Medicine, Laura and Isaac Perlmutter Cancer Center at NYU Langone, New York, NY
| | - Gregory Halverson
- Hoxworth Immunohematology Reference Lab, University of Cincinnati, Cincinnati, OH, USA
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A novel XK gene mutation in a Taiwanese family with McLeod syndrome. J Neurol Sci 2014; 340:221-4. [DOI: 10.1016/j.jns.2014.02.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 02/19/2014] [Accepted: 02/24/2014] [Indexed: 11/16/2022]
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Wiethoff S, Xiromerisiou G, Bettencourt C, Kioumi A, Tsiptsios I, Tychalas A, Evaggelia M, George K, Makris V, Hardy J, Houlden H. Novel single base-pair deletion in exon 1 of XK gene leading to McLeod syndrome with chorea, muscle wasting, peripheral neuropathy, acanthocytosis and haemolysis. J Neurol Sci 2014; 339:220-2. [PMID: 24529944 PMCID: PMC3988988 DOI: 10.1016/j.jns.2014.01.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 01/22/2014] [Accepted: 01/27/2014] [Indexed: 11/16/2022]
Abstract
We present a 70-year-old male patient of Greek origin with choreatic movements of the tongue and face, lower limb muscle weakness, peripheral neuropathy, elevated creatinephosphokinase (CPK), acanthocytosis and haemolysis in the absence of Kell RBC antigens with an additional Factor IX-deficiency. Genetic testing for mutations in the three exons of the XK gene revealed a previously unreported hemizygous single base-pair frameshift deletion at exon 1 (c.229delC, p.Leu80fs). In conclusion, we hereby describe a rare phenotype of a patient with McLeod syndrome which was discovered coincidentally during routine blood group testing and consecutively genetically confirmed.
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Affiliation(s)
- Sarah Wiethoff
- Department of Molecular Neuroscience, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK; MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | | | - Conceição Bettencourt
- Department of Molecular Neuroscience, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK; MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK.
| | - Anna Kioumi
- Department of Haematology, Papageorgiou Hospital, Thessaloniki, Greece
| | - Iakovos Tsiptsios
- Department of Neurology, Papageorgiou Hospital, Thessaloniki, Greece
| | | | | | - Kaltsounis George
- Department of Haematology, Papageorgiou Hospital, Thessaloniki, Greece
| | - Vasileios Makris
- Orthopedic Department, Papageorgiou Hospital, Thessaloniki, Greece
| | - John Hardy
- Department of Molecular Neuroscience, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK; MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - Henry Houlden
- Department of Molecular Neuroscience, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK; MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
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Abstract
PURPOSE OF REVIEW The differential diagnosis of chorea syndromes may be complex and includes various genetic disorders such as Huntington's disease and mimicking disorders called Huntington's disease-like (HDL) phenotypes. To familiarize clinicians with these (in some cases very rare) conditions we will summarize the main characteristics. RECENT FINDINGS HDL disorders are rare and account for about 1% of cases presenting with a Huntington's disease phenotype. They share overlapping clinical features, so making the diagnosis purely on clinical grounds may be challenging, however presence of certain characteristics may be a clue (e.g. prominent orofacial involvement in neuroferritinopathy etc.), Information of ethnic descent will also guide genetic work-up [HDL2 in Black Africans; dentatorubral-pallidoluysian atrophy (DRPLA) in Japanese etc.], Huntington's disease, the classical HDL disorders (except HDL3) and DRPLA are repeat disorders with anticipation effect and age-dependent phenotype in some, but genetic underpinnings may be more complicated in the other chorea syndromes. SUMMARY With advances in genetics more and more rare diseases are disentangled, allowing molecular diagnoses in a growing number of choreic patients. Hopefully, with better understanding of their pathophysiology we are moving towards mechanistic therapies.
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Zhu X, Cho ES, Sha Q, Peng J, Oksov Y, Kam SY, Ho M, Walker RH, Lee S. Giant axon formation in mice lacking Kell, XK, or Kell and XK: animal models of McLeod neuroacanthocytosis syndrome. THE AMERICAN JOURNAL OF PATHOLOGY 2014; 184:800-7. [PMID: 24405768 DOI: 10.1016/j.ajpath.2013.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 10/21/2013] [Accepted: 11/13/2013] [Indexed: 01/07/2023]
Abstract
McLeod neuroacanthocytosis syndrome (MLS) is a rare X-linked multisystem disease caused by XK gene mutations and characterized by hematological and neurological abnormalities. XK, a putative membrane transporter, is expressed ubiquitously and is covalently linked to Kell, an endothelin-3-converting enzyme (ECE-3). Absence of XK results in reduction of Kell at sites where both proteins are coexpressed. To elucidate the functional roles of XK, Kell, and the XK-Kell complex associated with pathogenesis in MLS, we studied the pathology of the spinal cord, anterior roots, sciatic nerve, and skeletal muscle from knockout mouse models, using Kel(-/-), Xk(-/-), Kel(-/-)Xk(-/-), and wild-type mice aged 6 to 18 months. A striking finding was that giant axons were frequently associated with paranodal demyelination. The pathology suggests probable anterograde progression from the spinal cord to the sciatic nerve. The neuropathological abnormalities were found in all three genotypes, but were more marked in the double-knockout Kel(-/-)Xk(-/-) mice than in either Kel(-/-) or Xk(-/-) mice. Skeletal muscles from Xk(-/-) and Kel(-/-)Xk(-/-) mice showed mild abnormalities, but those from Kel(-/-) mice were similar to the wild type. The more marked neuropathological abnormalities in Kel(-/-)Xk(-/-) mice suggest a possible functional association between XK and Kell in nonerythroid tissues.
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Affiliation(s)
- Xiang Zhu
- Department of Pathology, Peking University Health Science Center, Beijing, China; New York Blood Center, New York, New York.
| | - Eun-Sook Cho
- Department of Pathology and Laboratory Medicine (Neuropathology), Rutgers University-New Jersey Medical School, Newark, New Jersey
| | - Quan Sha
- New York Blood Center, New York, New York; Department of Cell Line Development, Immunomedics, Morris Plains, New Jersey
| | | | | | - Siok Yuen Kam
- Division of Medical Sciences, National Cancer Center, Singapore
| | - Mengfatt Ho
- Division of Medical Sciences, National Cancer Center, Singapore
| | - Ruth H Walker
- Department of Neurology, James J. Peters VAMC, Bronx, New York; Department of Neurology, Mount Sinai School of Medicine, New York, New York
| | - Soohee Lee
- New York Blood Center, New York, New York
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