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Acosta-Uribe J, Villegas-Lanau A, Vallejo D, Ramírez-Aguilar L, Solano JM, Mejía-Cupajita B, Aguillón D, Moreno S, Méndez LG, Baena A, Madrigal L, Bocanegra Y, Quiroz YT, García GP, Vasquez D, Arbeláez A, Lopera F, Beach TG, Kosik KS, White CL, Giraldo-Chica M. Primary lateral sclerosis associated with PSEN1 Pro284Leu variant in a Colombian family: Clinical and neuropathological features. Alzheimers Dement 2024. [PMID: 39072908 DOI: 10.1002/alz.14133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/18/2024] [Accepted: 06/20/2024] [Indexed: 07/30/2024]
Abstract
INTRODUCTION This study investigates primary lateral sclerosis (PLS) as a rare manifestation of the presenilin 1 (PSEN1) NM_000021 c.851C > T p.Pro284Leu variant in three siblings of a Colombian family, outlining its clinical and neuropathological features and their relationship to Alzheimer's disease (AD). METHODS Data were gathered using clinical evaluations, next-generation genetic sequencing, magnetic resonance imaging, biomarker analysis, and neuropathological examination. RESULTS Carriers of the PSEN1 Pro284Leu variant exhibited classic PLS symptoms, including unilateral onset and bulbar syndromes, along with cognitive decline. Neuropathology showed corticospinal tract degeneration without amyloid beta deposition in spinal white matter. DISCUSSION Our findings suggest an overlap between PLS and AD pathology in PSEN1 variant carriers. Results support considering PLS when diagnosing AD-related motor syndromes and including PSEN1 evaluation when performing genetic testing for PLS. The study highlights the need for further research to clarify the PLS-AD relationship, informing future treatments and clinical trials. HIGHLIGHTS Pathogenic variants in presenilin 1 (PSEN1) can manifest as hereditary primary lateral sclerosis PSEN1 Pro284Leu carriers present motor, cognitive, and behavioral alterations Cases had corticospinal tract microgliosis and severe Aβ pathology in motor cortex There was no evidence of amyloid deposition in the spinal cord white matter All the neuropathology images are available for online visualization Myelin pallor in the spinal cord is confined to the lateral corticospinal tracts.
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Affiliation(s)
- Juliana Acosta-Uribe
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Antioquia, Colombia
- Neuroscience Research Institute and Molecular, Cellular and Developmental Biology Department, University of California, Santa Barbara, California, USA
| | - Andrés Villegas-Lanau
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Dionis Vallejo
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Antioquia, Colombia
- Department of Neurology, Medical School, and Alma Mater Hospital, Universidad de Antioquia, Medellín, Antioquia, Colombia
- Neuro Clínica, Medellín, Antioquia, Colombia
| | - Laura Ramírez-Aguilar
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Juan M Solano
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Antioquia, Colombia
- Department of Neurology, Medical School, and Alma Mater Hospital, Universidad de Antioquia, Medellín, Antioquia, Colombia
- Neuro Clínica, Medellín, Antioquia, Colombia
| | - Bárbara Mejía-Cupajita
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Antioquia, Colombia
- Neuroscience Research Institute and Molecular, Cellular and Developmental Biology Department, University of California, Santa Barbara, California, USA
| | - David Aguillón
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Sonia Moreno
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Luis G Méndez
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Ana Baena
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Lucía Madrigal
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Yamile Bocanegra
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Yakeel T Quiroz
- Departments of Psychiatry and Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Gloria P García
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Daniel Vasquez
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Andrés Arbeláez
- Hospital Pablo Tobón Uribe and Link - Diagnóstico Digital, Medellín, Colombia
| | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Thomas G Beach
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Kenneth S Kosik
- Neuroscience Research Institute and Molecular, Cellular and Developmental Biology Department, University of California, Santa Barbara, California, USA
| | - Charles L White
- Neuropathology Section, Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Margarita Giraldo-Chica
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Antioquia, Colombia
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Arber C, Belder CRS, Tomczuk F, Gabriele R, Buhidma Y, Farrell C, O'Connor A, Rice H, Lashley T, Fox NC, Ryan NS, Wray S. The presenilin 1 mutation P436S causes familial Alzheimer's disease with elevated Aβ43 and atypical clinical manifestations. Alzheimers Dement 2024; 20:4717-4726. [PMID: 38824433 PMCID: PMC11247678 DOI: 10.1002/alz.13904] [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: 12/07/2023] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 06/03/2024]
Abstract
INTRODUCTION Familial Alzheimer's disease (fAD) is heterogeneous in terms of age at onset and clinical presentation. A greater understanding of the pathogenicity of fAD variants and how these contribute to heterogeneity will enhance our understanding of the mechanisms of AD more widely. METHODS To determine the pathogenicity of the unclassified PSEN1 P436S mutation, we studied an expanded kindred of eight affected individuals, with magnetic resonance imaging (MRI) (two individuals), patient-derived induced pluripotent stem cell (iPSC) models (two donors), and post-mortem histology (one donor). RESULTS An autosomal dominant pattern of inheritance of fAD was seen, with an average age at symptom onset of 46 years and atypical features. iPSC models and post-mortem tissue supported high production of amyloid beta 43 (Aβ43). PSEN1 peptide maturation was unimpaired. DISCUSSION We confirm that the P436S mutation in PSEN1 causes atypical fAD. The location of the mutation in the critical PSEN1 proline-alanine-leucine-proline (PALP) motif may explain the early age at onset despite appropriate protein maturation. HIGHLIGHTS PSEN1 P436S mutations cause familial Alzheimer's disease. This mutation is associated with atypical clinical presentation. Induced pluripotent stem cells (iPSCs) and post-mortem studies support increased amyloid beta (Aβ43) production. Early age at onset highlights the importance of the PALP motif in PSEN1 function.
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Affiliation(s)
- Charles Arber
- Department of Neurodegenerative DiseaseUCL Queen Square Institute of NeurologyLondonUK
| | - Christopher R. S. Belder
- Dementia Research CentreUCL Queen Square Institute of NeurologyLondonUK
- UCL Queen Square Institute of NeurologyUK Dementia Research Institute at UCLLondonUK
- Adelaide Medical SchoolThe University of AdelaideAdelaideSouth AustraliaAustralia
| | - Filip Tomczuk
- Department of GeneticsInstitute of Psychiatry and NeurologyWarsawPoland
| | - Rebecca Gabriele
- Department of Neurodegenerative DiseaseUCL Queen Square Institute of NeurologyLondonUK
| | - Yazead Buhidma
- Department of Neurodegenerative DiseaseUCL Queen Square Institute of NeurologyLondonUK
| | - Clíona Farrell
- Department of Neurodegenerative DiseaseUCL Queen Square Institute of NeurologyLondonUK
- UCL Queen Square Institute of NeurologyUK Dementia Research Institute at UCLLondonUK
| | | | - Helen Rice
- Department of Neurodegenerative DiseaseUCL Queen Square Institute of NeurologyLondonUK
- Dementia Research CentreUCL Queen Square Institute of NeurologyLondonUK
- UCL Queen Square Institute of NeurologyUK Dementia Research Institute at UCLLondonUK
| | - Tammaryn Lashley
- Department of Neurodegenerative DiseaseUCL Queen Square Institute of NeurologyLondonUK
| | - Nick C. Fox
- Department of Neurodegenerative DiseaseUCL Queen Square Institute of NeurologyLondonUK
- Dementia Research CentreUCL Queen Square Institute of NeurologyLondonUK
- UCL Queen Square Institute of NeurologyUK Dementia Research Institute at UCLLondonUK
| | - Natalie S. Ryan
- Department of Neurodegenerative DiseaseUCL Queen Square Institute of NeurologyLondonUK
- Dementia Research CentreUCL Queen Square Institute of NeurologyLondonUK
- UCL Queen Square Institute of NeurologyUK Dementia Research Institute at UCLLondonUK
| | - Selina Wray
- Department of Neurodegenerative DiseaseUCL Queen Square Institute of NeurologyLondonUK
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Chandy T. Intervention of next-generation sequencing in diagnosis of Alzheimer's disease: challenges and future prospects. Dement Neuropsychol 2023; 17:e20220025. [PMID: 37577182 PMCID: PMC10417152 DOI: 10.1590/1980-5764-dn-2022-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 04/10/2023] [Accepted: 05/17/2023] [Indexed: 08/15/2023] Open
Abstract
Clinical diagnosis of several neurodegenerative disorders based on clinical phenotype is challenging due to its heterogeneous nature and overlapping disease manifestations. Therefore, the identification of underlying genetic mechanisms is of paramount importance for better diagnosis and therapeutic regimens. With the emergence of next-generation sequencing, it becomes easier to identify all gene variants in the genome simultaneously, with a system-wide and unbiased approach. Presently various bioinformatics databases are maintained on discovered gene variants and phenotypic indications are available online. Since individuals are unique in their genome, evaluation based on their genetic makeup helps evolve the diagnosis, counselling, and treatment process at the personal level. This article aims to briefly summarize the utilization of next-generation sequencing in deciphering the genetic causes of Alzheimer's disease and address the limitations of whole genome and exome sequencing.
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Affiliation(s)
- Tijimol Chandy
- MedGenome Labs Pvt. Ltd., Bangalore-560100, Karnataka, India
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Ringman JM, Dorrani N, Fernández SG, Signer R, Martinez-Agosto J, Lee H, Douine ED, Qiao Y, Shi Y, D’Orazio L, Pawar S, Robbie L, Kashani AH, Singer M, Byers JT, Magaki S, Guzman S, Sagare A, Zlokovic B, Cederbaum S, Nelson S, Sheikh-Bahaei N, Chui HC, Chávez-Gutiérrez L, Vinters HV. Characterization of spastic paraplegia in a family with a novel PSEN1 mutation. Brain Commun 2023; 5:fcad030. [PMID: 36895955 PMCID: PMC9991506 DOI: 10.1093/braincomms/fcad030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 09/09/2022] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
Spastic paraparesis has been described to occur in 13.7% of PSEN1 mutations and can be the presenting feature in 7.5%. In this paper, we describe a family with a particularly young onset of spastic paraparesis due to a novel mutation in PSEN1 (F388S). Three affected brothers underwent comprehensive imaging protocols, two underwent ophthalmological evaluations and one underwent neuropathological examination after his death at age 29. Age of onset was consistently at age 23 with spastic paraparesis, dysarthria and bradyphrenia. Pseudobulbar affect followed with progressive gait problems leading to loss of ambulation in the late 20s. Cerebrospinal fluid levels of amyloid-β, tau and phosphorylated tau and florbetaben PET were consistent with Alzheimer's disease. Flortaucipir PET showed an uptake pattern atypical for Alzheimer's disease, with disproportionate signal in posterior brain areas. Diffusion tensor imaging showed decreased mean diffusivity in widespread areas of white matter but particularly in areas underlying the peri-Rolandic cortex and in the corticospinal tracts. These changes were more severe than those found in carriers of another PSEN1 mutation, which can cause spastic paraparesis at a later age (A431E), which were in turn more severe than among persons carrying autosomal dominant Alzheimer's disease mutations not causing spastic paraparesis. Neuropathological examination confirmed the presence of cotton wool plaques previously described in association with spastic parapresis and pallor and microgliosis in the corticospinal tract with severe amyloid-β pathology in motor cortex but without unequivocal disproportionate neuronal loss or tau pathology. In vitro modelling of the effects of the mutation demonstrated increased production of longer length amyloid-β peptides relative to shorter that predicted the young age of onset. In this paper, we provide imaging and neuropathological characterization of an extreme form of spastic paraparesis occurring in association with autosomal dominant Alzheimer's disease, demonstrating robust diffusion and pathological abnormalities in white matter. That the amyloid-β profiles produced predicted the young age of onset suggests an amyloid-driven aetiology though the link between this and the white matter pathology remains undefined.
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Affiliation(s)
- John M Ringman
- Department of Neurology, Keck School of Medicine at University of Southern California, Los Angeles, CA 90033, USA
| | | | - Sara Gutiérrez Fernández
- Department of Neurosciences, VIB-KU Leuven Center for Brain & Disease Research, Leuven 3000, Belgium
- Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven 3000, Belgium
| | - Rebecca Signer
- Department of Human Genetics, UCLA, Los Angeles, CA 90095, USA
| | | | - Hane Lee
- Department of Human Genetics, UCLA, Los Angeles, CA 90095, USA
- Department of Pathology and Laboratory Medicine, UCLA, Los Angeles, CA 90095, USA
| | - Emilie D Douine
- Department of Human Genetics, UCLA, Los Angeles, CA 90095, USA
| | - Yuchuan Qiao
- Department of Neurology, USC Stevens Neuroimaging and Informatics Institute, Los Angeles, CA 90033, USA
| | - Yonggang Shi
- Department of Neurology, USC Stevens Neuroimaging and Informatics Institute, Los Angeles, CA 90033, USA
| | - Lina D’Orazio
- Department of Neurology, Keck School of Medicine at University of Southern California, Los Angeles, CA 90033, USA
| | - Sanjay Pawar
- Department of Neurology, Keck School of Medicine at University of Southern California, Los Angeles, CA 90033, USA
| | - Leah Robbie
- Department of Neurology, Keck School of Medicine at University of Southern California, Los Angeles, CA 90033, USA
| | - Amir H Kashani
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Maxwell Singer
- Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Joshua T Byers
- Section of Neuropathology, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Shino Magaki
- Section of Neuropathology, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Sam Guzman
- Department of Pathology, Keck School of Medicine at USC, Los Angeles, CA 90033, USA
| | - Abhay Sagare
- Zilkha Neurogenetics Institute, University of Southern California, Los Angeles, CA 90033, USA
| | - Berislav Zlokovic
- Zilkha Neurogenetics Institute, University of Southern California, Los Angeles, CA 90033, USA
| | - Stephen Cederbaum
- Department of Pediatrics, UCLA, Los Angeles, CA 90095, USA
- Department of Human Genetics, UCLA, Los Angeles, CA 90095, USA
| | - Stanley Nelson
- Department of Pediatrics, UCLA, Los Angeles, CA 90095, USA
- Department of Human Genetics, UCLA, Los Angeles, CA 90095, USA
- Department of Pathology and Laboratory Medicine, UCLA, Los Angeles, CA 90095, USA
| | - Nasim Sheikh-Bahaei
- Department of Radiology, University of Southern California, Los Angeles, CA 90033, USA
| | - Helena C Chui
- Department of Neurology, Keck School of Medicine at University of Southern California, Los Angeles, CA 90033, USA
| | - Lucía Chávez-Gutiérrez
- Department of Neurosciences, VIB-KU Leuven Center for Brain & Disease Research, Leuven 3000, Belgium
- Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven 3000, Belgium
| | - Harry V Vinters
- Section of Neuropathology, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
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Rudenskaya GE, Petukhova MS, Zabnenkova VV, Cherevatova TB, Ryzhkova OP. [Early-onset familial Alzheimer's disease with spastic paraparesis associated with PSEN1 gene]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:120-127. [PMID: 37994898 DOI: 10.17116/jnevro2023123111120] [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] [Indexed: 11/24/2023]
Abstract
A familial case of a rare autosomal dominant Alzheimer's disease (AD), related to PSEN1 gene (AD3, OMIM 607822), differing from common multifactorial form by earlier onset and, in part of cases, by accompanying neurological signs, spastic paraparesis particularly, is presented. The first sign in a female proband and in her son was paraparesis manifested at the age of 29 and 21 years, respectively. Cognitive disturbances developed soon; the former diagnosis was hereditary spastic paraplegia with cognitive impairment, In the proband examined in 2008 at 33 years old the diagnosis was not established. In the son examined in 2022 at 27 years old whole-exome sequencing detected a novel PSEN1 missense mutation p.Thr421Ala. The mutation was confirmed by Sanger sequencing in him, found out in the proband (who was severely disabled by that time) and excluded in her unaffected mother. Except for different age of onset, AD3 in two patients was similar, though in whole it is variable, also in relatives. The variability and rareness of the disease hampers clinical diagnostics. Massive parallel sequencing is a most reliable diagnostic method.
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Affiliation(s)
| | - M S Petukhova
- Research Centre for Medical Genetics, Moscow, Russia
| | | | | | - O P Ryzhkova
- Research Centre for Medical Genetics, Moscow, Russia
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Altuna M, Larumbe R, Zelaya MV, Moreno S, García-Solaesa V, Mendioroz M, Ramos MA, Erro ME. Progressive cognitive impairment and familial spastic paraparesis due to PRESENILIN 1 mutation: anatomoclinical characterization. J Neurol 2022; 269:4853-4862. [PMID: 35438347 DOI: 10.1007/s00415-022-11125-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Autosomal dominant Alzheimer's disease (ADAD) due to presenilin 1 (PSEN1) mutation can induce atypical neurological symptoms such as movement disorders and epileptic seizures in the context of early-onset progressive cognitive impairment. METHODS This study includes the anatomoclinical description of three patients of two generations of the same family with movement disorders and progressive cognitive impairment. All were evaluated by trained neurologists, underwent protocolized neuropsychological evaluation, and were assessed by structural (magnetic resonance) and functional (SPECT, PET-18FDG, or PET-18F-Florbetapir) brain imaging tests. A molecular genetic study was performed for all patients, and post-mortem confirmatory anatomopathological evaluation for one of them. RESULTS The three female patients had an age of onset of symptoms of 38-51 years. All developed progressive multidomain cognitive impairment, paraparesis, and dysarthria, two with ophthalmoparesis and one with untriggered epileptic seizures since early stages. Bilateral cortical fronto-parietal atrophy and global cortical hypoperfusion or posterior bilateral hypometabolism were detected. PET-18F-Florbetapir, when performed, was positive for amyloid cortical deposit. The molecular genetic study confirmed the PSEN1 mutation c.869-2 A>G. Postmortem study of one of them confirmed Alzheimer's disease anatomopathological features with classic cotton wool plaques (CWP), including coexistence of amyloid angiopathy and Lewy body co-pathology. DISCUSSION The phenotype of ADAD due to PSEN1 mutations is very heterogeneous between and across the same family. Family history assessment should include information not only about cognitive decline, but also about movement disorders and untriggered epileptic seizures. Further studies are needed to identify genetic or epigenetic factors that determine phenotypic diversity in this disease.
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Affiliation(s)
- Miren Altuna
- Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau-Biomedical Research Institute Sant Pau-Universitat Autònoma de Barcelona, Barcelona, Spain. .,Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain. .,CITA-Alzheimer Foundation, Donostia-San Sebastián, Spain.
| | - Rosa Larumbe
- Department of Neurology, Hospital Universitario de Navarra, Pamplona, Spain.,Neuroepigenetics Laboratory-Navarrabiomed, Hospital Universitario de Navarra, Universidad Pública de Navarra (UPNA), IdiSNA (Navarra Institute for Health Research), Pamplona, Spain
| | - María Victoria Zelaya
- Department of Pathological Anatomy, Hospital Universitario de Navarra, Pamplona, Spain
| | - Sira Moreno
- Department of Genetics, Hospital Universitario de Navarra, Pamplona, Spain
| | | | - Maite Mendioroz
- Department of Neurology, Hospital Universitario de Navarra, Pamplona, Spain.,Neuroepigenetics Laboratory-Navarrabiomed, Hospital Universitario de Navarra, Universidad Pública de Navarra (UPNA), IdiSNA (Navarra Institute for Health Research), Pamplona, Spain
| | | | - María Elena Erro
- Department of Neurology, Hospital Universitario de Navarra, Pamplona, Spain. .,Neuroepigenetics Laboratory-Navarrabiomed, Hospital Universitario de Navarra, Universidad Pública de Navarra (UPNA), IdiSNA (Navarra Institute for Health Research), Pamplona, Spain.
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