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Peall KJ, Owen MJ, Hall J. Rare genetic brain disorders with overlapping neurological and psychiatric phenotypes. Nat Rev Neurol 2024; 20:7-21. [PMID: 38001363 DOI: 10.1038/s41582-023-00896-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 11/26/2023]
Abstract
Understanding rare genetic brain disorders with overlapping neurological and psychiatric phenotypes is of increasing importance given the potential for developing disease models that could help to understand more common, polygenic disorders. However, the traditional clinical boundaries between neurology and psychiatry result in frequent segregation of these disorders into distinct silos, limiting cross-specialty understanding that could facilitate clinical and biological advances. In this Review, we highlight multiple genetic brain disorders in which neurological and psychiatric phenotypes are observed, but for which in-depth, cross-spectrum clinical phenotyping is rarely undertaken. We describe the combined phenotypes observed in association with genetic variants linked to epilepsy, dystonia, autism spectrum disorder and schizophrenia. We also consider common underlying mechanisms that centre on synaptic plasticity, including changes to synaptic and neuronal structure, calcium handling and the balance of excitatory and inhibitory neuronal activity. Further investigation is needed to better define and replicate these phenotypes in larger cohorts, which would help to gain greater understanding of the pathophysiological mechanisms and identify common therapeutic targets.
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Affiliation(s)
- Kathryn J Peall
- Neuroscience and Mental Health Innovation Institute, Cardiff University, Cardiff, UK.
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
| | - Michael J Owen
- Neuroscience and Mental Health Innovation Institute, Cardiff University, Cardiff, UK
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Jeremy Hall
- Neuroscience and Mental Health Innovation Institute, Cardiff University, Cardiff, UK
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
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2
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Vimercati A, Tannorella P, Orlandini E, Calzari L, Moro M, Guzzetti S, Selicorni A, Crippa M, Larizza L, Bonati MT, Russo S. Case report: atypical Silver-Russell syndrome patient with hand dystonia: the valuable support of the consensus statement to the wide syndromic spectrum. Front Genet 2023; 14:1198821. [PMID: 37529781 PMCID: PMC10387531 DOI: 10.3389/fgene.2023.1198821] [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: 04/03/2023] [Accepted: 06/19/2023] [Indexed: 08/03/2023] Open
Abstract
The amount of Insulin Growth Factor 2 (IGF2) controls the rate of embryonal and postnatal growth. The IGF2 and adjacent H19 are the imprinted genes of the telomeric cluster in the 11p15 chromosomal region regulated by differentially methylated regions (DMRs) or imprinting centers (ICs): H19/IGF2:IG-DMR (IC1). Dysregulation due to IC1 Loss-of-Methylation (LoM) or Gain-of-Methyaltion (GoM) causes Silver-Russell syndrome (SRS) or Beckwith-Wiedemann syndrome (BWS) disorders associated with growth retardation or overgrowth, respectively. Specific features define each of the two syndromes, but isolated asymmetry is a common cardinal feature, which is considered sufficient for a diagnosis in the BWS spectrum. Here, we report the case of a girl with right body asymmetry, which suggested BWS spectrum. Later, BWS/SRS molecular analysis identified IC1_LoM revealing the discrepant diagnosis of SRS. A clinical re-evaluation identified a relative macrocephaly and previously unidentified growth rate at lower limits of normal at birth, feeding difficulties, and asymmetry. Interestingly, and never previously described in IC1_LoM SRS patients, since the age of 16, she has developed hand-writer's cramps, depression, and bipolar disorder. Trio-WES identified a VPS16 heterozygous variant [NM_022575.4:c.2185C>G:p.Leu729Val] inherited from her healthy mother. VPS16 is involved in the endolysosomal system, and its dysregulation is linked to autosomal dominant dystonia with incomplete penetrance and variable expressivity. IGF2 involvement in the lysosomal pathway led us to speculate that the neurological phenotype of the proband might be triggered by the concurrent IGF2 deficit and VPS16 alteration.
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Affiliation(s)
- Alessandro Vimercati
- Research Laboratory of Medical Cytogenetics and Molecular Genetics, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Pierpaola Tannorella
- Research Laboratory of Medical Cytogenetics and Molecular Genetics, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Eleonora Orlandini
- Specialty School of Pediatrics, Alma Mater University of Bologna, Bologna, Italy
| | - Luciano Calzari
- Bioinformatics and Statistical Genomics Unit, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Mirella Moro
- Department of Endocrine and Metabolic Diseases and Lab of Endocrine and Metabolic Research, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Sara Guzzetti
- Research Laboratory of Medical Cytogenetics and Molecular Genetics, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | | | - Milena Crippa
- Research Laboratory of Medical Cytogenetics and Molecular Genetics, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Lidia Larizza
- Research Laboratory of Medical Cytogenetics and Molecular Genetics, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Maria Teresa Bonati
- Unit of Medical Genetics, Institute for Maternal and Child Health Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Burlo Garofalo, Trieste, Italy
| | - Silvia Russo
- Research Laboratory of Medical Cytogenetics and Molecular Genetics, IRCCS Istituto Auxologico Italiano, Milano, Italy
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3
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Chandarana M, Saraf U, Divya KP, Krishnan S, Kishore A. Myoclonus- A Review. Ann Indian Acad Neurol 2021; 24:327-338. [PMID: 34446993 PMCID: PMC8370153 DOI: 10.4103/aian.aian_1180_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 11/29/2020] [Accepted: 12/09/2020] [Indexed: 11/19/2022] Open
Abstract
Myoclonus is a hyperkinetic movement disorder characterized by a sudden, brief, involuntary jerk. Positive myoclonus is caused by abrupt muscle contractions, while negative myoclonus by sudden cessation of ongoing muscular contractions. Myoclonus can be classified in various ways according to body distribution, relation to activity, neurophysiology, and etiology. The neurophysiological classification of myoclonus by means of electrophysiological tests is helpful in guiding the best therapeutic strategy. Given the diverse etiologies of myoclonus, a thorough history and detailed physical examination are key to the evaluation of myoclonus. These along with basic laboratory testing and neurophysiological studies help in narrowing down the clinical possibilities. Though symptomatic treatment is required in the majority of cases, treatment of the underlying etiology should be the primary aim whenever possible. Symptomatic treatment is often not satisfactory, and a combination of different drugs is often required to control the myoclonus. This review addresses the etiology, classification, clinical approach, and management of myoclonus.
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Affiliation(s)
- Mitesh Chandarana
- Comprehensive Care Centre for Movement Disorders, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Udit Saraf
- Comprehensive Care Centre for Movement Disorders, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - K P Divya
- Comprehensive Care Centre for Movement Disorders, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Syam Krishnan
- Comprehensive Care Centre for Movement Disorders, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Asha Kishore
- Comprehensive Care Centre for Movement Disorders, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
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4
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Mood and emotional disorders associated with parkinsonism, Huntington disease, and other movement disorders. HANDBOOK OF CLINICAL NEUROLOGY 2021; 183:175-196. [PMID: 34389117 DOI: 10.1016/b978-0-12-822290-4.00015-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This chapter provides a review of mood, emotional disorders, and emotion processing deficits associated with diseases that cause movement disorders, including Parkinson's disease, Lewy body dementia, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, frontotemporal dementia with parkinsonism, Huntington's disease, essential tremor, dystonia, and tardive dyskinesia. For each disorder, a clinical description of the common signs and symptoms, disease progression, and epidemiology is provided. Then the mood and emotional disorders associated with each of these diseases are described and discussed in terms of clinical presentation, incidence, prevalence, and alterations in quality of life. Alterations of emotion communication, such as affective speech prosody and facial emotional expression, associated with these disorders are also discussed. In addition, if applicable, deficits in gestural and lexical/verbal emotion are reviewed. Throughout the chapter, the relationships among mood and emotional disorders, alterations of emotional experiences, social communication, and quality of life, as well as treatment, are emphasized.
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Li J, Liu Y, Li Q, Huang X, Zhou D, Xu H, Zhao F, Mi X, Wang R, Jia F, Xu F, Yang J, Liu D, Deng X, Zhang Y. Mutation in ε-Sarcoglycan Induces a Myoclonus-Dystonia Syndrome-Like Movement Disorder in Mice. Neurosci Bull 2020; 37:311-322. [PMID: 33355901 DOI: 10.1007/s12264-020-00612-5] [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: 02/24/2020] [Accepted: 06/09/2020] [Indexed: 10/22/2022] Open
Abstract
Myoclonus dystonia syndrome (MDS) is an inherited movement disorder, and most MDS-related mutations have so far been found in the ε-sarcoglycan (SGCE) coding gene. By generating SGCE-knockout (KO) and human 237 C > T mutation knock-in (KI) mice, we showed here that both KO and KI mice exerted typical movement defects similar to those of MDS patients. SGCE promoted filopodia development in vitro and inhibited excitatory synapse formation both in vivo and in vitro. Loss of function of SGCE leading to excessive excitatory synapses that may ultimately contribute to MDS pathology. Indeed, using a zebrafish MDS model, we found that among 1700 screened chemical compounds, Vigabatrin was the most potent in readily reversing MDS symptoms of mouse disease models. Our study strengthens the notion that mutations of SGCE lead to MDS and most likely, SGCE functions to brake synaptogenesis in the CNS.
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Affiliation(s)
- Jiao Li
- State Key Laboratory of Membrane Biology, College of Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Peking University, Beijing, 100871, China
| | - Yiqiong Liu
- State Key Laboratory of Membrane Biology, College of Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Peking University, Beijing, 100871, China
| | - Qin Li
- State Key Laboratory of Membrane Biology, College of Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Peking University, Beijing, 100871, China
| | - Xiaolin Huang
- State Key Laboratory of Membrane Biology, College of Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Peking University, Beijing, 100871, China
| | - Dingxi Zhou
- State Key Laboratory of Membrane Biology, College of Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Peking University, Beijing, 100871, China
| | - Hanjian Xu
- State Key Laboratory of Membrane Biology, College of Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Peking University, Beijing, 100871, China
| | - Feng Zhao
- State Key Laboratory of Membrane Biology, College of Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Peking University, Beijing, 100871, China
| | - Xiaoxiao Mi
- State Key Laboratory of Membrane Biology, College of Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Peking University, Beijing, 100871, China
| | - Ruoxu Wang
- College of Life Sciences, Wuhan University, Wuhan, 430027, China
| | - Fan Jia
- Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Fuqiang Xu
- Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Jing Yang
- State Key Laboratory of Membrane Biology, College of Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Peking University, Beijing, 100871, China
| | - Dong Liu
- State Key Laboratory of Membrane Biology, College of Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Peking University, Beijing, 100871, China
| | - Xuliang Deng
- State Key Laboratory of Membrane Biology, College of Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Peking University, Beijing, 100871, China.
| | - Yan Zhang
- State Key Laboratory of Membrane Biology, College of Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Peking University, Beijing, 100871, China.
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Weissbach A, Saranza G, Domingo A. Combined dystonias: clinical and genetic updates. J Neural Transm (Vienna) 2020; 128:417-429. [PMID: 33099685 DOI: 10.1007/s00702-020-02269-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/09/2020] [Indexed: 12/28/2022]
Abstract
The genetic combined dystonias are a clinically and genetically heterogeneous group of neurologic disorders defined by the overlap of dystonia and other movement disorders such as parkinsonism or myoclonus. The number of genes associated with combined dystonia syndromes has been increasing due to the wider recognition of clinical features and broader use of genetic testing. Nevertheless, these diseases are still rare and represent only a small subgroup among all dystonias. Dopa-responsive dystonia (DYT/PARK-GCH1), rapid-onset dystonia-parkinsonism (DYT/PARK-ATP1A3), X-linked dystonia-parkinsonism (XDP, DYT/PARK-TAF1), and young-onset dystonia-parkinsonism (DYT/PARK-PRKRA) are monogenic combined dystonias accompanied by parkinsonian features. Meanwhile, MYC/DYT-SGCE and MYC/DYT-KCTD17 are characterized by dystonia in combination with myoclonus. In the past, common molecular pathways between these syndromes were the center of interest. Although the encoded proteins rather affect diverse cellular functions, recent neurophysiological evidence suggests similarities in the underlying mechanism in a subset. This review summarizes recent developments in the combined dystonias, focusing on clinico-genetic features and neurophysiologic findings. Disease-modifying therapies remain unavailable to date; an overview of symptomatic therapies for these disorders is also presented.
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Affiliation(s)
- Anne Weissbach
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Gerard Saranza
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada
| | - Aloysius Domingo
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA. .,Collaborative Center for X-Linked Dystonia-Parkinsonism, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
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7
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Atkinson-Clement C, Tarrano C, Porte CA, Wattiez N, Delorme C, McGovern EM, Brochard V, Thobois S, Tranchant C, Grabli D, Degos B, Corvol JC, Pedespan JM, Krystkoviak P, Houeto JL, Degardin A, Defebvre L, Valabregue R, Rosso C, Apartis E, Vidailhet M, Pouget P, Roze E, Worbe Y. Dissociation in reactive and proactive inhibitory control in Myoclonus dystonia. Sci Rep 2020; 10:13933. [PMID: 32811896 PMCID: PMC7434767 DOI: 10.1038/s41598-020-70926-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 07/27/2020] [Indexed: 12/03/2022] Open
Abstract
Myoclonus-dystonia (MD) is a syndrome characterized by myoclonus of subcortical origin and dystonia, frequently associated with psychiatric comorbidities. The motor and psychiatric phenotypes of this syndrome likely result from cortico-striato-thamalo-cerebellar-cortical pathway dysfunction. We hypothesized that reactive and proactive inhibitory control may be altered in these patients. Using the Stop Signal Task, we assessed reactive and proactive inhibitory control in MD patients with (n = 12) and without (n = 21) deep brain stimulation of the globus pallidus interna and compared their performance to matched healthy controls (n = 24). Reactive inhibition was considered as the ability to stop an already initiated action and measured using the stop signal reaction time. Proactive inhibition was assessed through the influence of several consecutive GO or STOP trials on decreased response time or inhibitory process facilitation. The proactive inhibition was solely impaired in unoperated MD patients. Patients with deep brain stimulation showed impairment in reactive inhibition, independent of presence of obsessive–compulsive disorders. This impairment in reactive inhibitory control correlated with intrinsic severity of myoclonus (i.e. pre-operative score). The results point to a dissociation in reactive and proactive inhibitory control in MD patients with and without deep brain stimulation of the globus pallidus interna.
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Affiliation(s)
- Cyril Atkinson-Clement
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France
| | - Clement Tarrano
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Department of Neurology, CHU Côte de Nacre, Université Caen Normandie, Caen, France
| | - Camille-Albane Porte
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France
| | - Nicolas Wattiez
- Inserm, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Sorbonne University, Paris, France
| | - Cécile Delorme
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Eavan M McGovern
- Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Department of Neurology, St Vincent's University Hospital Dublin, Dublin, Ireland
| | - Vanessa Brochard
- INSERM/APHP, Centre d'Investigation Clinique 1422, Paris, France
| | - Stéphane Thobois
- Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, University of Lyon, Bron, France.,Service de Neurologie C, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - Christine Tranchant
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - David Grabli
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Bertrand Degos
- Department of Neurology, Hôpital Avicennes, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Jean-Christophe Corvol
- Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | | | - Pierre Krystkoviak
- Department of Neurology, Amiens University Medical Center, Amiens, France
| | - Jean-Luc Houeto
- Service de Neurologie, CIC-INSERM 1402, CHU de Poitiers, Poitiers, France
| | - Adrian Degardin
- Department of Neurology, Centre Hospitalier de Tourcoing, Tourcoing, France
| | - Luc Defebvre
- INSERM, U1171-Degenerative and Vascular Cognitive Disorders, CHU Lille, Université de Lille, Lille, France.,Lille Centre of Excellence for Neurodegenerative Diseases (LiCEND), Lille, France
| | - Romain Valabregue
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France.,UMR S 975, CNRS UMR 7225, ICM, Centre de NeuroImagerie de Recherche (CENIR), Sorbonne Université, Paris, France
| | - Charlotte Rosso
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France.,Assistance Publique-Hôpitaux de Paris, Urgences Cérébro-Vasculaires, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Emmanuelle Apartis
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France.,Department of Neurophysiology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marie Vidailhet
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Pierre Pouget
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France
| | - Emmanuel Roze
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Yulia Worbe
- Sorbonne University, 75005, Paris, France. .,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France. .,Movement Investigation and Therapeutics Team, Paris, France. .,Department of Neurophysiology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
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8
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Washburn S, Fremont R, Moreno-Escobar MC, Angueyra C, Khodakhah K. Acute cerebellar knockdown of Sgce reproduces salient features of myoclonus-dystonia (DYT11) in mice. eLife 2019; 8:52101. [PMID: 31868164 PMCID: PMC6959989 DOI: 10.7554/elife.52101] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 12/20/2019] [Indexed: 12/15/2022] Open
Abstract
Myoclonus dystonia (DYT11) is a movement disorder caused by loss-of-function mutations in SGCE and characterized by involuntary jerking and dystonia that frequently improve after drinking alcohol. Existing transgenic mouse models of DYT11 exhibit only mild motor symptoms, possibly due to rodent-specific developmental compensation mechanisms, which have limited the study of neural mechanisms underlying DYT11. To circumvent potential compensation, we used short hairpin RNA (shRNA) to acutely knock down Sgce in the adult mouse and found that this approach produced dystonia and repetitive, myoclonic-like, jerking movements in mice that improved after administration of ethanol. Acute knockdown of Sgce in the cerebellum, but not the basal ganglia, produced motor symptoms, likely due to aberrant cerebellar activity. The acute knockdown model described here reproduces the salient features of DYT11 and provides a platform to study the mechanisms underlying symptoms of the disorder, and to explore potential therapeutic options.
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Affiliation(s)
- Samantha Washburn
- Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, New York, United States
| | - Rachel Fremont
- Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, New York, United States
| | - Maria Camila Moreno-Escobar
- Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, New York, United States
| | - Chantal Angueyra
- Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, New York, United States
| | - Kamran Khodakhah
- Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, New York, United States
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Menozzi E, Balint B, Latorre A, Valente EM, Rothwell JC, Bhatia KP. Twenty years on: Myoclonus-dystonia and ε-sarcoglycan - neurodevelopment, channel, and signaling dysfunction. Mov Disord 2019; 34:1588-1601. [PMID: 31449710 DOI: 10.1002/mds.27822] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/19/2019] [Accepted: 07/14/2019] [Indexed: 12/26/2022] Open
Abstract
Myoclonus-dystonia is a clinical syndrome characterized by a typical childhood onset of myoclonic jerks and dystonia involving the neck, trunk, and upper limbs. Psychiatric symptomatology, namely, alcohol dependence and phobic and obsessive-compulsive disorder, is also part of the clinical picture. Zonisamide has demonstrated effectiveness at reducing both myoclonus and dystonia, and deep brain stimulation seems to be an effective and long-lasting therapeutic option for medication-refractory cases. In a subset of patients, myoclonus-dystonia is associated with pathogenic variants in the epsilon-sarcoglycan gene, located on chromosome 7q21, and up to now, more than 100 different pathogenic variants of the epsilon-sarcoglycan gene have been described. In a few families with a clinical phenotype resembling myoclonus-dystonia associated with distinct clinical features, variants have been identified in genes involved in novel pathways such as calcium channel regulation and neurodevelopment. Because of phenotypic similarities with epsilon-sarcoglycan gene-related myoclonus-dystonia, these conditions can be collectively classified as "myoclonus-dystonia syndromes." In the present article, we present myoclonus-dystonia caused by epsilon-sarcoglycan gene mutations, with a focus on genetics and underlying disease mechanisms. Second, we review those conditions falling within the spectrum of myoclonus-dystonia syndromes, highlighting their genetic background and involved pathways. Finally, we critically discuss the normal and pathological function of the epsilon-sarcoglycan gene and its product, suggesting a role in the stabilization of the dopaminergic membrane via regulation of calcium homeostasis and in the neurodevelopmental process involving the cerebello-thalamo-pallido-cortical network. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Elisa Menozzi
- Department of Biomedical, Metabolic and Neural Sciences, University-Hospital of Modena and Reggio Emilia, Modena, Italy.,Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Bettina Balint
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.,Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | - Anna Latorre
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Enza Maria Valente
- Department of Molecular Medicine, University of Pavia, Pavia, Italy.,Neurogenetics Unit, IRCCS Santa Lucia Foundation, Rome, Italy
| | - John C Rothwell
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
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Psychiatric symptoms in myoclonus-dystonia syndrome are just concomitant features regardless of the SGCE gene mutation. Parkinsonism Relat Disord 2017; 42:73-77. [DOI: 10.1016/j.parkreldis.2017.06.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 06/01/2017] [Accepted: 06/22/2017] [Indexed: 11/23/2022]
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Newby RE, Thorpe DE, Kempster PA, Alty JE. A History of Dystonia: Ancient to Modern. Mov Disord Clin Pract 2017; 4:478-485. [PMID: 28920067 PMCID: PMC5573933 DOI: 10.1002/mdc3.12493] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 02/22/2017] [Accepted: 03/08/2017] [Indexed: 11/25/2022] Open
Abstract
Before 1911, when Hermann Oppenheim introduced the term dystonia, this movement disorder lacked a unifying descriptor. While words like epilepsy, apoplexy, and palsy have had their meanings since antiquity, references to dystonia are much harder to identify in historical documents. Torticollis is an exception, although there is difficulty distinguishing dystonic torticollis from congenital muscular torticollis. There are, nevertheless, possible representations of dystonia in literature and visual art from the pre-modern world. Eighteenth century systematic nosologists such as Linnaeus, de Sauvages, and Cullen had attempted to classify some spasmodic conditions, including torticollis. But only after Charcot's contributions to clinical neuroscience were the various forms of generalized and focal dystonia clearly delineated. They were categorized as névroses: Charcot's term for conditions without an identifiable neuroanatomical cause. For a time thereafter, psychoanalytic models of dystonia based on Freud's ideas about unconscious conflicts transduced into physical symptoms were ascendant, although there was always a dissenting "organic" school. With the rise of subspecialization in movement disorders during the 1970s, the pendulum swung strongly back toward organic causation. David Marsden's clinical and electrophysiological research on the adult-onset focal dystonias was particularly important in establishing a physical basis for these disorders. We are still in a period of "living history" of dystonia, with much yet to be understood about pathophysiology. Rigidly dualistic models have crumbled in the face of evidence of electrophysiological and psychopathological overlap between organic and functional dystonia. More flexible biopsychosocial frameworks may address the demand for new diagnostic and therapeutic rationales.
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Affiliation(s)
- Rachel E Newby
- Neurosciences Department Monash Medical Centre Melbourne Victoria Australia
- Department of Neurology Leeds General Infirmary Leeds United Kingdom
- Hull York Medical School University of York York United Kingdom
| | - Deborah E Thorpe
- Centre for Medieval Studies University of York York United Kingdom
- Centre for Chronic Diseases and Disorders (C2D2)/Electronics Department University of York York United Kingdom
| | - Peter A Kempster
- Neurosciences Department Monash Medical Centre Melbourne Victoria Australia
- Department of Medicine Monash University Melbourne Victoria Australia
| | - Jane E Alty
- Department of Neurology Leeds General Infirmary Leeds United Kingdom
- Hull York Medical School University of York York United Kingdom
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Reilly MT, Noronha A, Goldman D, Koob GF. Genetic studies of alcohol dependence in the context of the addiction cycle. Neuropharmacology 2017; 122:3-21. [PMID: 28118990 DOI: 10.1016/j.neuropharm.2017.01.017] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 01/13/2017] [Accepted: 01/19/2017] [Indexed: 12/16/2022]
Abstract
Family, twin and adoption studies demonstrate clearly that alcohol dependence and alcohol use disorders are phenotypically complex and heritable. The heritability of alcohol use disorders is estimated at approximately 50-60% of the total phenotypic variability. Vulnerability to alcohol use disorders can be due to multiple genetic or environmental factors or their interaction which gives rise to extensive and daunting heterogeneity. This heterogeneity makes it a significant challenge in mapping and identifying the specific genes that influence alcohol use disorders. Genetic linkage and (candidate gene) association studies have been used now for decades to map and characterize genomic loci and genes that underlie the genetic vulnerability to alcohol use disorders. These approaches have been moderately successful in identifying several genes that contribute to the complexity of alcohol use disorders. Recently, genome-wide association studies have become one of the major tools for identifying genes for alcohol use disorders by examining correlations between millions of common single-nucleotide polymorphisms with diagnosis status. Genome-wide association studies are just beginning to uncover novel biology; however, the functional significance of results remains a matter of extensive debate and uncertainty. In this review, we present a select group of genome-wide association studies of alcohol dependence, as one example of a way to generate functional hypotheses, within the addiction cycle framework. This analysis may provide novel directions for validating the functional significance of alcohol dependence candidate genes. This article is part of the Special Issue entitled "Alcoholism".
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Affiliation(s)
- Matthew T Reilly
- National Institutes of Health (NIH), National Institute on Alcohol Abuse and Alcoholism (NIAAA), Division of Neuroscience and Behavior, 5635 Fishers Lane, Bethesda, MD 20852, USA.
| | - Antonio Noronha
- National Institutes of Health (NIH), National Institute on Alcohol Abuse and Alcoholism (NIAAA), Division of Neuroscience and Behavior, 5635 Fishers Lane, Bethesda, MD 20852, USA
| | - David Goldman
- National Institutes of Health (NIH), National Institute on Alcohol Abuse and Alcoholism (NIAAA), Chief, Laboratory of Neurogenetics, 5635 Fishers Lane, Bethesda, MD 20852, USA
| | - George F Koob
- National Institutes of Health (NIH), National Institute on Alcohol Abuse and Alcoholism (NIAAA), Director NIAAA, 5635 Fishers Lane, Bethesda, MD 20852, USA
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Torres JAKL, Rosales RL. Nonmotor Symptoms in Dystonia. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 134:1335-1371. [DOI: 10.1016/bs.irn.2017.05.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Newby R, Alty J, Kempster P. Functional dystonia and the borderland between neurology and psychiatry: New concepts. Mov Disord 2016; 31:1777-1784. [PMID: 27753149 DOI: 10.1002/mds.26805] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 08/21/2016] [Accepted: 08/29/2016] [Indexed: 01/07/2023] Open
Abstract
Mind-brain dualism has dominated historical commentary on dystonia, a dichotomous approach that has left our conceptual grasp of it stubbornly incomplete. This is particularly true of functional dystonia, most diagnostically challenging of all functional movement disorders, in which the question of inherent psychogenicity remains a focus of debate. Phenomenological signs considered in isolation lack the specificity to distinguish organic and nonorganic forms, and dystonia's variability has frustrated attempts to develop objective laboratory-supported standards. Diagnostic criteria for functional dystonia that place emphasis on psychiatric symptoms perform poorly in studies of reliability, partly explained by the high frequency of psychopathology in organic dystonia. Novel approaches from the cognitive neurosciences may offer a way forward. Theory on Bayesian statistical prediction in cognitive processing is supported by sufficient experimental evidence for this model to be taken seriously as a way of reconciling contradictory notions about voluntary and unconscious motor control in functional movement disorders. In a Bayesian formulation of functional dystonia, misallocation of attention and abnormal predictive beliefs generate movements that are executed without a sense of agency. Building on this framework, there is a consensus that a biopsychosocial approach is required and that a unified philosophy of brain and mind is the best way to locate dystonia in the neurology-psychiatry borderland. At a practical level, movement disorder neurologists are best placed to differentiate organic from functional dystonia. The main role of psychiatrists is in the diagnosis and management of the primarily psychiatric disorders that often accompany dystonia. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Rachel Newby
- Neurosciences Department, Monash Medical Centre, Clayton, Victoria, Australia.,Department of Neurology, Leeds General Infirmary, Leeds, UK
| | - Jane Alty
- Department of Neurology, Leeds General Infirmary, Leeds, UK
| | - Peter Kempster
- Neurosciences Department, Monash Medical Centre, Clayton, Victoria, Australia.,Department of Medicine, Monash University, Clayton, Victoria, Australia
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Multani N, Moro E, Lang A, Zurowski M, Duff Canning S, Tartaglia MC. Progression of neuropsychiatric and cognitive features due to exons 2 to 5 deletion in the epsilon-sarcoglycan gene: a case report. Neurocase 2016; 22:215-9. [PMID: 26652670 DOI: 10.1080/13554794.2015.1120312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Physical symptoms of myoclonus dystonia due to epsilon-sarcoglycan mutations are well documented; however, the progression of neuropsychiatric and cognitive symptoms remains unclear. We present a case of a 34-year-old woman with early childhood onset of myoclonic jerks, dystonic posture and developmental delay due to exons 2 to 5 deletion in the epsilon-sarcoglycan gene. Over time, she developed neuropsychiatric symptoms. She underwent bilateral deep brain stimulation of the ventral intermediate nucleus of the thalamus for her motor symptoms, which greatly improved but she exhibited slow deterioration of her neuropsychiatric and cognitive symptoms, particularly apathy, aggression and severe executive dysfunction.
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Affiliation(s)
- Namita Multani
- a Memory Clinic , University Health Network , Toronto , ON , Canada
| | - Elena Moro
- b Movement Disorders Unit, Department of Psychiatry and Neurology , Centre Hospitalier Universitaire de Grenoble , Grenoble , France
| | - Anthony Lang
- c Morton and Gloria Shulman Movement Disorder Unit and E.J. Safra Parkinson Disease Program, Toronto Western Hospital , UHN, University of Toronto , Toronto , ON , Canada
| | - Mateusz Zurowski
- d Department of Psychiatry , University Health Network, University of Toronto , Toronto , ON , Canada
| | - Sarah Duff Canning
- c Morton and Gloria Shulman Movement Disorder Unit and E.J. Safra Parkinson Disease Program, Toronto Western Hospital , UHN, University of Toronto , Toronto , ON , Canada
| | - Maria Carmela Tartaglia
- a Memory Clinic , University Health Network , Toronto , ON , Canada.,e Tanz Centre for Research in Neurodegenerative Diseases, Krembil Discovery Tower University of Toronto , Toronto , ON , Canada
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Peall KJ, Dijk JM, Saunders-Pullman R, Dreissen YEM, van Loon I, Cath D, Kurian MA, Owen MJ, Foncke EMJ, Morris HR, Gasser T, Bressman S, Asmus F, Tijssen MAJ. Psychiatric disorders, myoclonus dystonia and SGCE: an international study. Ann Clin Transl Neurol 2015; 3:4-11. [PMID: 26783545 PMCID: PMC4704478 DOI: 10.1002/acn3.263] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 09/25/2015] [Indexed: 01/22/2023] Open
Abstract
Objective Myoclonus‐dystonia (M‐D) is a hyperkinetic movement disorder, typically alcohol‐responsive upper body myoclonus and dystonia. The majority of autosomal dominant familial cases are caused by epsilon‐sarcoglycan gene (SGCE) mutations. Previous publications have observed increased rates of psychiatric disorders amongst SGCE mutation‐positive populations. We analyzed the psychiatric data from four international centers, forming the largest cohort to date, to further determine the extent and type of psychiatric disorders in M‐D. Methods Psychiatric data from SGCE mutation‐positive M‐D cohorts, collected by movement disorder specialists in the Netherlands, United Kingdom, United States, and Germany, were analyzed. These data were collected using standardized, systematic questionnaires allowing classification of symptoms according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM‐IV) criteria. Based on motor findings and SGCE mutation analysis, participants were classified into one of three groups: manifesting carriers, nonmanifesting carriers and noncarriers. Results Data from 307 participants were evaluated (140 males, 167 females, mean age at examination: 42.5 years). Two‐thirds of motor affected mutation carriers (n = 132) had ≥1 psychiatric diagnosis, specific, and social phobias being most common followed by alcohol dependence and obsessive‐compulsive disorder (OCD). Compared to familial controls, affected mutation carriers had significantly elevated overall rates of psychiatric disorders (P < 0.001). The most significant differences were observed with alcohol dependence (P < 0.001), OCD (P < 0.001), social and specific phobias (P < 0.001). Interpretation M‐D due to SGCE mutations is associated with specific psychiatric disorders, most commonly OCD, anxiety‐related disorders, and alcohol dependence. These suggest either a potential pleiotropic function for SGCE within the central nervous system or a secondary effect of the motor disorder.
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Affiliation(s)
- Kathryn J Peall
- Department of Neurology University Medical Center Groningen Groningen The Netherlands; Institute of Psychological Medicine and Clinical Neurosciences MRC Centre for Neuropsychiatric Genetics and Genomics Cardiff University Cardiff United Kingdom
| | - Joke M Dijk
- Department of Neurology The Academic Medical Center Amsterdam The Netherlands
| | | | | | - Ilke van Loon
- Department of Neurology The Academic Medical Center Amsterdam The Netherlands
| | - Danielle Cath
- Department of Behavioural Sciences - Clinical and Health Psychology University of Utrecht Utrecht The Netherlands
| | - Manju A Kurian
- Institute of Child Health - Neurosciences Unit University College London London United Kingdom; Department of Neurology Great Ormond Street Hospital London United Kingdom
| | - Michael J Owen
- Institute of Psychological Medicine and Clinical Neurosciences MRC Centre for Neuropsychiatric Genetics and Genomics Cardiff University Cardiff United Kingdom
| | | | - Huw R Morris
- Institute of Psychological Medicine and Clinical Neurosciences MRC Centre for Neuropsychiatric Genetics and Genomics Cardiff University Cardiff United Kingdom
| | - Thomas Gasser
- Department for Neurodegenerative Diseases Hertie Institute for Clinical Brain Research Tubingen Germany
| | - Susan Bressman
- The Saul R. Korey Department of Neurology Beth Israel Medical Centre New York
| | - Friedrich Asmus
- Department for Neurodegenerative Diseases Hertie Institute for Clinical Brain Research Tubingen Germany
| | - Marina A J Tijssen
- Department of Neurology University Medical Center Groningen Groningen The Netherlands
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Peall KJ, Kuiper A, de Koning TJ, Tijssen MAJ. Non-motor symptoms in genetically defined dystonia: Homogenous groups require systematic assessment. Parkinsonism Relat Disord 2015. [PMID: 26210889 DOI: 10.1016/j.parkreldis.2015.07.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Dystonia is a movement disorder involving sustained or intermittent muscle contractions resulting in abnormal movements and postures. Identification of disease causing genes has allowed examination of genetically homogenous groups. Unlike the motor symptoms, non-motor characteristics are less clearly defined, despite their impact on a patient's quality of life. This review aims to examine the evidence for non-motor symptoms, addressing cohort size and methods of assessment in each study. METHODS A systematic and standardised search strategy was used to identify the published literature relating to psychiatric symptoms, cognition, sleep disorders, sensory abnormalities and pain in each of the genetically determined dystonias. Studies were divided according to cohort size, method of assessment and whether comparison was made to an appropriate control group. RESULTS Ninety-five articles were identified including reported clinical histories (n = 42), case reports and smaller case series (n = 12), larger case series (n = 23) and case-control cohorts (n = 18). Psychiatric symptoms were the most frequently investigated with anxiety, depression and Obsessive-Compulsive disorder being most common. Cognitive impairment involved either global deficits or isolated difficulties in specific domains. Disturbances to sleep were most common in the dopa-responsive dystonias. Sensory testing in DYT1 cases identified an intermediate subclinical phenotype. CONCLUSION Non-motor symptoms form an integral component of the dystonia phenotype. However, future studies should involve a complete assessment of all symptom subtypes in order to understand the frequency and gene-specificity of these symptoms. This will enable early symptom identification, appropriate clinical management, and provide additional outcome measures in future clinical trials.
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Affiliation(s)
- K J Peall
- Department of Neurology, University of Groningen, Groningen, The Netherlands; Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK.
| | - A Kuiper
- Department of Neurology, University of Groningen, Groningen, The Netherlands.
| | - T J de Koning
- Department of Neurology, University of Groningen, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands.
| | - M A J Tijssen
- Department of Neurology, University of Groningen, Groningen, The Netherlands.
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McCann H, Fung VSC, Klein C, Halliday GM. Unusual α-synuclein and cerebellar pathologies in a case of hereditary myoclonus-dystonia without SGCE mutation. Neuropathol Appl Neurobiol 2015; 41:837-42. [PMID: 25582306 DOI: 10.1111/nan.12216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 01/07/2015] [Indexed: 01/10/2023]
Affiliation(s)
- Heather McCann
- Sydney Brain Bank, Neuroscience Research Australia, Sydney, Australia
| | - Victor S C Fung
- Sydney Medical School, University of Sydney, Sydney, Australia.,Movement Disorders Unit, Department of Neurology, Westmead Hospital, Sydney, Australia
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Glenda M Halliday
- Sydney Brain Bank, Neuroscience Research Australia, Sydney, Australia.,School of Medical Sciences, UNSW Medicine, Sydney, Australia
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Abstract
The basal ganglia were originally thought to be associated purely with motor control. However, dysfunction and pathology of different regions and circuits are now known to give rise to many clinical manifestations beyond the association of basal ganglia dysfunction with movement disorders. Moreover, disorders that were thought to be caused by dysfunction of the basal ganglia only, such as Parkinson's disease and Huntington's disease, have diverse abnormalities distributed not only in the brain but also in the peripheral and autonomic nervous systems; this knowledge poses new questions and challenges. We discuss advances and the unanswered questions, and ways in which progress might be made.
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Affiliation(s)
- Jose A Obeso
- Movement Disorders Laboratory, Department of Neurology and Neuroscience Area, Clínica Universitaria and Medical School, and CIMA, University of Navarra, Pamplona, Spain; Centro de Investigación en Redes sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.
| | - Maria C Rodriguez-Oroz
- Centro de Investigación en Redes sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Department of Neurology, University Hospital Donostia and Neuroscience Unit BioDonostia Research Institute, San Sebastian, Ikerbasque, Basque Foundation for Science, Bilbao, Spain
| | - Maria Stamelou
- Movement Disorders Clinic, Second Department of Neurology, Attiko Hospital, University of Athens, Greece; Sobell Department of Motor Neurosciences and Movement Disorders, UCL Institute of Neurology, London, UK
| | - Kailash P Bhatia
- Sobell Department of Motor Neurosciences and Movement Disorders, UCL Institute of Neurology, London, UK
| | - David J Burn
- Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK
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Abstract
PURPOSE OF REVIEW Myoclonus remains a challenging movement phenotype to characterize, evaluate, and treat. A systematic assessment of the temporal sequence, phenomenology, and distribution of movements can assist in the rational approach to diagnosis and management. RECENT FINDINGS Cortical forms of myoclonus are increasingly recognized as primarily cerebellar disorders. A syndrome of orthostatic myoclonus has been recognized by electrophysiology in patients with neurodegenerative disorders, mainly in Alzheimer disease, accounting for impairments in gait and balance previously mischaracterized as normal pressure hydrocephalus or orthostatic tremor. Tyrosine hydroxylase deficiency and Silver-Russell syndrome (uniparental disomy of chromosome 7) have been established as two novel causes of the myoclonus-dystonia syndrome. Mutations in the glycine receptor (GlyR) α1-subunit gene (GLRA1) explain the major expression of hyperekplexia, an inherited excessive startle disorder, butnewly identified mutations in GlyR β-subunit (GLRB) and glycine transporter 2 (GlyT2) genes (SLC6A5) account for "minor" forms of this disorder manifested as excessive startle and hypnic jerks. The entity previously known as palatal myoclonus has been reclassified as palatal tremor in recognition of its clinical and electromyographic features and no longer enters the differential diagnosis of myoclonic disorders. Increasing documentation of psychogenic features in patients previously characterized as having propriospinal myoclonus has cast doubts on the existence of this distinctive disorder. SUMMARY Myoclonus can be a prominent manifestation of a wide range of disorders. Electrophysiologic testing aids in distinguishing myoclonus from other mimics and classifying them according to cortical, subcortical, or spinal origin, which assists the choice of treatment. Despite the lack of randomized clinical trials, levetiracetam appears most effective in patients with cortical myoclonus, whereas clonazepam remains the only first-line therapeutic option in subcortical and spinal myoclonus.
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Carecchio M, Magliozzi M, Copetti M, Ferraris A, Bernardini L, Bonetti M, Defazio G, Edwards MJ, Torrente I, Pellegrini F, Comi C, Bhatia KP, Valente EM. Defining the Epsilon-Sarcoglycan (SGCE) Gene Phenotypic Signature in Myoclonus-Dystonia: A Reappraisal of Genetic Testing Criteria. Mov Disord 2013; 28:787-94. [DOI: 10.1002/mds.25506] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 03/27/2013] [Accepted: 04/09/2013] [Indexed: 11/11/2022] Open
Affiliation(s)
- Miryam Carecchio
- Sobell Department of Motor Neuroscience and Movement Disorders; UCL Institute of Neurology; London United Kingdom
- Department of Neurology; Amedeo Avogadro University; Novara Italy
| | - Monia Magliozzi
- CSS-Mendel Laboratory; IRCCS Casa Sollievo della Sofferenza; San Giovanni Rotondo Italy
| | - Massimiliano Copetti
- Biostatistics Unit; IRCCS Casa Sollievo della Sofferenza; San Giovanni Rotondo Italy
| | - Alessandro Ferraris
- CSS-Mendel Laboratory; IRCCS Casa Sollievo della Sofferenza; San Giovanni Rotondo Italy
| | - Laura Bernardini
- CSS-Mendel Laboratory; IRCCS Casa Sollievo della Sofferenza; San Giovanni Rotondo Italy
| | - Monica Bonetti
- CSS-Mendel Laboratory; IRCCS Casa Sollievo della Sofferenza; San Giovanni Rotondo Italy
| | - Giovanni Defazio
- Department of Neurosciences and Sensory Organs; School of Motor Sciences; “Aldo Moro” University of Bari; Bari Italy
| | - Mark J. Edwards
- Sobell Department of Motor Neuroscience and Movement Disorders; UCL Institute of Neurology; London United Kingdom
| | - Isabella Torrente
- CSS-Mendel Laboratory; IRCCS Casa Sollievo della Sofferenza; San Giovanni Rotondo Italy
| | - Fabio Pellegrini
- Biostatistics Unit; IRCCS Casa Sollievo della Sofferenza; San Giovanni Rotondo Italy
- Laboratory of Clinical Epidemiology of Diabetes and Chronic Diseases; Consorzio Mario Negri Sud; Santa Maria Imbaro Italy
| | - Cristoforo Comi
- Department of Neurology; Amedeo Avogadro University; Novara Italy
| | - Kailash P. Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders; UCL Institute of Neurology; London United Kingdom
| | - Enza Maria Valente
- CSS-Mendel Laboratory; IRCCS Casa Sollievo della Sofferenza; San Giovanni Rotondo Italy
- Department of Medicine and Surgery; University of Salerno; Salerno Italy
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Peall KJ, Smith DJ, Kurian MA, Wardle M, Waite AJ, Hedderly T, Lin JP, Smith M, Whone A, Pall H, White C, Lux A, Jardine P, Bajaj N, Lynch B, Kirov G, O'Riordan S, Samuel M, Lynch T, King MD, Chinnery PF, Warner TT, Blake DJ, Owen MJ, Morris HR. SGCE mutations cause psychiatric disorders: clinical and genetic characterization. ACTA ACUST UNITED AC 2013; 136:294-303. [PMID: 23365103 DOI: 10.1093/brain/aws308] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Myoclonus dystonia syndrome is a childhood onset hyperkinetic movement disorder characterized by predominant alcohol responsive upper body myoclonus and dystonia. A proportion of cases are due to mutations in the maternally imprinted SGCE gene. Previous studies have suggested that patients with SGCE mutations may have an increased rate of psychiatric disorders. We established a cohort of patients with myoclonus dystonia syndrome and SGCE mutations to determine the extent to which psychiatric disorders form part of the disease phenotype. In all, 89 patients with clinically suspected myoclonus dystonia syndrome were recruited from the UK and Ireland. SGCE was analysed using direct sequencing and for copy number variants. In those patients where no mutation was found TOR1A (GAG deletion), GCH1, THAP1 and NKX2-1 were also sequenced. SGCE mutation positive cases were systematically assessed using standardized psychiatric interviews and questionnaires and compared with a disability-matched control group of patients with alcohol responsive tremor. Nineteen (21%) probands had a SGCE mutation, five of which were novel. Recruitment of family members increased the affected SGCE mutation positive group to 27 of whom 21 (77%) had psychiatric symptoms. Obsessive-compulsive disorder was eight times more likely (P < 0.001) in mutation positive cases, compulsivity being the predominant feature (P < 0.001). Generalized anxiety disorder (P = 0.003) and alcohol dependence (P = 0.02) were five times more likely in mutation positive cases than tremor controls. SGCE mutations are associated with a specific psychiatric phenotype consisting of compulsivity, anxiety and alcoholism in addition to the characteristic motor phenotype. SGCE mutations are likely to have a pleiotropic effect in causing both motor and specific psychiatric symptoms.
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Affiliation(s)
- Kathryn J Peall
- MRC Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Henry Wellcome Building, Heath Park, Cardiff, UK.
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Sheridan MB, Bytyci Telegrafi A, Stinnett V, Umeh CC, Mari Z, Dawson TM, Bodurtha J, Batista DAS. Myoclonus-dystonia and Silver-Russell syndrome resulting from maternal uniparental disomy of chromosome 7. Clin Genet 2013; 84:368-72. [PMID: 23237735 DOI: 10.1111/cge.12075] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 12/10/2012] [Accepted: 12/10/2012] [Indexed: 11/28/2022]
Abstract
Myoclonus-dystonia (M-D) is a movement disorder that is often associated with mutations in epsilon-sarcoglycan (SGCE), a maternally imprinted gene at 7q21.3. We report a 24-year-old male with short stature (<5th percentile) and a movement disorder clinically consistent with M-D. Single nucleotide polymorphism (SNP) array did not identify significant copy number changes, but revealed three long continuous stretches of homozygosity on chromosome 7 suggestive of uniparental disomy. Parental SNP arrays confirmed that the proband had maternal uniparental disomy of chromosome 7 (mUPD7) with regions of heterodisomy and isodisomy. mUPD7 is the cause of approximately 5-10% of Silver-Russell syndrome (SRS), a disorder characterized by prenatal and postnatal growth retardation. Although SRS was not suspected in our patient, these findings explain his short stature. SGCE methylation testing showed loss of the unmethylated paternal allele. Our findings provide a unifying diagnosis for his short stature and M-D and help to optimize his medication regimen. In conclusion, we show that M-D is a clinical feature that may be associated with SRS due to mUPD7. Individuals with mUPD7 should be monitored for the development of movement disorders. Conversely, individuals with M-D and short stature should be evaluated for SRS.
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Affiliation(s)
- M B Sheridan
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Weissbach A, Kasten M, Grünewald A, Brüggemann N, Trillenberg P, Klein C, Hagenah J. Prominent psychiatric comorbidity in the dominantly inherited movement disorder myoclonus-dystonia. Parkinsonism Relat Disord 2013; 19:422-5. [PMID: 23332219 DOI: 10.1016/j.parkreldis.2012.12.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Revised: 12/06/2012] [Accepted: 12/19/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Neurological and psychiatric disorders show clinical overlap suggesting a shared pathophysiological background. We evaluated myoclonus-dystonia, a monogenic movement disorder as a disease model for inherited psychopathology. METHOD We investigated 12 SGCE mutation carriers using standardized neurological and psychiatric examinations to assign DSM-IV diagnoses. Furthermore, we analyzed all studies in the Medline database which included psychiatric information on SGCE mutation-positive patients. RESULTS Of our twelve SGCE mutation carriers, 10 were older than 16 years. Two of them (20%) reported psychiatric diagnoses before our examination, which resulted in at least one psychiatric diagnosis in seven (70%) patients, most frequently anxiety (60%), depression (30%) or both. Substance abuse was observed in 20%, whereas obsessive-compulsive disorders were absent. One mutation carrier showed Axis 2 features. In the literature analysis, the ten studies using standardized tools covering DSM-IV criteria reported prevalences similar to those in our sample. This was three times the frequency of psychiatric disorders detected in 13 studies using clinical history or patient report only. CONCLUSION About two thirds of SGCE mutation carriers develop psychiatric comorbidity and >80% are previously undiagnosed.
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Affiliation(s)
- Anne Weissbach
- Section of Clinical and Molecular Neurogenetics at the Department of Neurology, University of Luebeck, Luebeck, Germany
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The dystrophin–glycoprotein complex in brain development and disease. Trends Neurosci 2012; 35:487-96. [DOI: 10.1016/j.tins.2012.04.004] [Citation(s) in RCA: 139] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 04/03/2012] [Accepted: 04/15/2012] [Indexed: 11/23/2022]
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Waite A, De Rosa MC, Brancaccio A, Blake DJ. A gain-of-glycosylation mutation associated with myoclonus-dystonia syndrome affects trafficking and processing of mouse ε-sarcoglycan in the late secretory pathway. Hum Mutat 2011; 32:1246-58. [PMID: 21796726 DOI: 10.1002/humu.21561] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Accepted: 06/20/2011] [Indexed: 11/07/2022]
Abstract
Missense mutations in the SGCE gene encoding ε-sarcoglycan account for approximately 15% of SGCE-positive cases of myoclonus-dystonia syndrome (MDS) in humans. In this study, we show that while the majority of MDS-associated missense mutants modeled with a murine ε-sarcoglycan cDNA are substrates for endoplasmic reticulum-associated degradation, one mutant, M68T (analogous to human c.275T>C, p.M92T), located in the Ig-like domain of ε-sarcoglycan, results in a gain-of-glycosylation mutation producing a protein that is targeted to the plasma membrane, albeit at reduced levels compared to wild-type ε-sarcoglycan. Removal of the ectopic N-linked glycan failed to restore efficient plasma membrane targeting of M68T demonstrating that the substitution rather than the glycan was responsible for the trafficking defect of this mutant. M68T also colocalized with CD63-positive vesicles in the endosomal-lysosomal system and was found to be more susceptible to lysosomal proteolysis than wild-type ε-sarcoglycan. Finally, we demonstrate impaired ectodomain shedding of M68T, a process that occurs physiologically for ε-sarcoglycan resulting in the lysosomal trafficking of the intracellular C-terminal domain of the protein. Our findings show that functional analysis of rare missense mutations can provide a mechanistic insight into the pathogenesis of MDS and the physiological role of ε-sarcoglycan.
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Affiliation(s)
- Adrian Waite
- Department of Psychological Medicine and Neurology, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Heath Park, Cardiff, UK
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