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Ng ASL, Tan AH, Tan YJ, Lim JL, Lian MM, Dy Closas AM, Ahmad-Annuar A, Viswanathan S, Chia YK, Foo JN, Lim WK, Tan EK, Lim SY. Identification of Genetic Variants in Progressive Supranuclear Palsy in Southeast Asia. Mov Disord 2024. [PMID: 39149795 DOI: 10.1002/mds.29932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 06/21/2024] [Accepted: 07/01/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Progressive supranuclear palsy (PSP) is largely a sporadic disease with few reported familial cases. Genome-wide association studies (GWAS) in sporadic PSP in Caucasian populations have identified MAPT as the most commonly associated genetic risk locus with the strongest effect size. At present there are limited data on genetic factors associated with PSP in Asian populations. OBJECTIVES Our goal was to investigate the genetic factors associated with PSP in Southeast Asian PSP patients. METHODS Next-generation sequencing (whole-exome, whole-genome and targeted sequencing) was performed in two Asian cohorts, comprising 177 PSP patients. RESULTS We identified 17 pathogenic or likely pathogenic variants in 16 PSP patients (9%), eight of which were novel. The most common relevant genetic variants identified were in MAPT, GBA1, OPTN, SYNJ1, and SQSTM1. Other variants detected were in TBK1, PRNP, and ABCA7-genes that have been implicated in other neurodegenerative diseases. Eighteen patients had a positive family history, of whom two carried pathogenic MAPT variants, and one carried a likely pathogenic GBA1 variant. None of the patients had expanded repeats in C9orf72. Furthermore, we found 16 different variants of uncertain significance in 21 PSP patients in PSEN2, ABCA7, SMPD1, MAPT, ATP13A2, OPTN, SQSTM1, CYLD, and BSN. CONCLUSIONS The genetic findings in our PSP cohorts appear to be somewhat distinct from those in Western populations, and also suggest an overlap of the genetic architecture between PSP and other neurodegenerative diseases. Further functional studies and validation in independent Asian cohorts will be useful for improving our understanding of PSP genetics and guiding genetic screening strategies in these populations. © 2024 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Adeline Su Lyn Ng
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- Neuroscience and Behavioural Disorders Programme, Duke-NUS Medical School, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Ai Huey Tan
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Mah Pooi Soo and Tan Chin Nam Centre for Parkinson's and Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Yi Jayne Tan
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| | - Jia Lun Lim
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Michelle Mulan Lian
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Alfand Marl Dy Closas
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Mah Pooi Soo and Tan Chin Nam Centre for Parkinson's and Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Metro Davao Medical and Research Center, Davao Doctors Hospital, Davao City, Philippines
| | - Azlina Ahmad-Annuar
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Yuen Kang Chia
- Department of Neurology, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia
| | - Jia Nee Foo
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - Weng Khong Lim
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
- Singhealth Duke-NUS Institute of Precision Medicine, Singapore
- Cancer and Stem Cell Biology Program, Duke-NUS Medical School, Singapore
- SingHealth Duke-NUS Genomic Medicine Centre, Singapore
| | - Eng-King Tan
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- Neuroscience and Behavioural Disorders Programme, Duke-NUS Medical School, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Shen-Yang Lim
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Mah Pooi Soo and Tan Chin Nam Centre for Parkinson's and Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Guimarães TG, Parmera JB, Castro MAA, Cury RG, Barbosa ER, Kok F. X-Linked Levodopa-Responsive Parkinsonism-Epilepsy Syndrome: A Novel PGK1 Mutation and Literature Review. Mov Disord Clin Pract 2024; 11:556-566. [PMID: 38341651 PMCID: PMC11078492 DOI: 10.1002/mdc3.13992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 01/03/2024] [Accepted: 01/21/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Genetic underpinnings in Parkinson's disease (PD) and parkinsonian syndromes are challenging, and recent discoveries regarding their genetic pathways have led to potential gene-specific treatment trials. CASES We report 3 X-linked levodopa (l-dopa)-responsive parkinsonism-epilepsy syndrome cases due to a hemizygous variant in the phosphoglycerate kinase 1 (PGK1) gene. The likely pathogenic variant NM_000291.4 (PGK1):c.950G > A;p.(Gly317Asp) was identified in a hemizygous state. LITERATURE REVIEW Only 8 previous cases have linked this phenotype to PGK1, a gene more commonly associated with hemolytic anemia and myopathy. The unusual association of epilepsy, psychiatric symptoms, action tremor, limb dystonia, cognitive symptoms, and l-dopa-responsive parkinsonism must draw attention to PGK1 mutations, especially because this gene is absent from most commercial hereditary parkinsonism panels. CONCLUSIONS This report aims to shed light on an overlooked gene that causes hereditary parkinsonian syndromes. Further research regarding genetic pathways in PD may provide a better understanding of its pathophysiology and open possibilities for new disease-modifying trials, such as SNCA, LRRK2, PRKN, PINK1, and DJ-1 genes.
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Affiliation(s)
- Thiago Gonçalves Guimarães
- Department of Neurology, Movement Disorders CenterUniversity of São PauloSão PauloBrazil
- Department of Neurology, Neurogenetics CenterUniversity of São PauloSão PauloBrazil
| | - Jacy Bezerra Parmera
- Department of Neurology, Movement Disorders CenterUniversity of São PauloSão PauloBrazil
| | | | - Rubens Gisbert Cury
- Department of Neurology, Movement Disorders CenterUniversity of São PauloSão PauloBrazil
| | - Egberto Reis Barbosa
- Department of Neurology, Movement Disorders CenterUniversity of São PauloSão PauloBrazil
| | - Fernando Kok
- Department of Neurology, Neurogenetics CenterUniversity of São PauloSão PauloBrazil
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Sousa M, Maamari B, Bremova T, Nuoffer JM, Wiest R, Amstutz D, Krack P, Bartholdi D, Tinkhauser G. Late adult-onset Niemann Pick type C (NPC): An "atypical" typical presentation at the age of 62. Parkinsonism Relat Disord 2024; 120:105460. [PMID: 37355399 DOI: 10.1016/j.parkreldis.2023.105460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 05/09/2023] [Indexed: 06/26/2023]
Affiliation(s)
- M Sousa
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Switzerland
| | - B Maamari
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - T Bremova
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland; Center for Rare Disorders, Institute of Clinical Chemistry Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - J M Nuoffer
- Center for Rare Disorders, Institute of Clinical Chemistry Inselspital, Bern University Hospital, University of Bern, Switzerland; University Children's Hospital Pediatric Endocrinology, Diabetology and Metabolism, Bern, Switzerland
| | - R Wiest
- Department of Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - D Amstutz
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Switzerland
| | - P Krack
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - D Bartholdi
- Department of Human Genetics, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - G Tinkhauser
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
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Necpál J, Borsek M, Jeleňová B. PSP-Richardson syndrome mimics: An overview and pragmatic approach. Rev Neurol (Paris) 2024; 180:12-23. [PMID: 37543508 DOI: 10.1016/j.neurol.2023.02.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 01/09/2023] [Accepted: 02/03/2023] [Indexed: 08/07/2023]
Abstract
Progressive supranuclear palsy-Richardson syndrome (PSP-RS) is a sporadic atypical parkinsonian syndrome with levodopa-unresponsive axial-predominant parkinsonism, early postural instability, vertical supranuclear gaze palsy, dysarthria, executive dysfunction and behavioural changes. PSP-RS can be mimicked by numbers of other disorders, generally known as PSP mimics, or PSP-like syndromes. Their aetiological spectrum includes neurodegenerative (mostly genetic), vascular, infectious and drug-induced illnesses as well as other causes. Based on the available data, we have tried to create a definition of PSP-RS mimics: a syndrome resembling PSP-RS with at least one of the following red flags: 1) positive family history; 2) onset before 45 years of age; 3) rapid or stepwise progression; 4) acute or subacute onset; 5) atypical symptoms and/or signs; 6) normal or atypical brain MRI; 7) history of HIV or untreated syphilis, aortal surgery or recent therapy with dopamine-blocking agents. We have suggested a short diagnostic algorithm leading to the identification of PSP-RS mimics and the recommended diagnostic work-up. The key point of the diagnostic process is the early identification and treatment of potentially treatable PSP-RS mimics.
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Affiliation(s)
- J Necpál
- 2nd Department of Neurology, Faculty of Medicine, Comenius University, Bratislava, Slovakia; Department of Neurology, Zvolen Hospital, Kuzmányho nábrežie, 28, 960 01 Zvolen, Slovakia.
| | - M Borsek
- Department of Neurology, Zvolen Hospital, Kuzmányho nábrežie, 28, 960 01 Zvolen, Slovakia
| | - B Jeleňová
- Department of Neurology, Zvolen Hospital, Kuzmányho nábrežie, 28, 960 01 Zvolen, Slovakia
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Aloisio S, Satolli S, Bellini G, Lopriore P. Parkinsonism in complex neurogenetic disorders: lessons from hereditary dementias, adult-onset ataxias and spastic paraplegias. Neurol Sci 2023; 44:3379-3388. [PMID: 37648940 PMCID: PMC10495519 DOI: 10.1007/s10072-023-07044-9] [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: 08/02/2023] [Accepted: 08/22/2023] [Indexed: 09/01/2023]
Abstract
Parkinsonism is a syndrome characterized by bradykinesia in combination with either rest tremor, rigidity, or both. These features are the cardinal manifestations of Parkinson's disease, the most common cause of parkinsonism, and atypical parkinsonian disorders. However, parkinsonism can be a manifestation of complex neurological and neurodegenerative genetically determined disorders, which have a vast and heterogeneous motor and non-motor phenotypic features. Hereditary dementias, adult-onset ataxias and spastic paraplegias represent only few of this vast group of neurogenetic diseases. This review will provide an overview of parkinsonism's clinical features within adult-onset neurogenetic diseases which a neurologist could face with. Understanding parkinsonism and its characteristics in the context of the aforementioned neurological conditions may provide insights into pathophysiological mechanisms and have important clinical implications, including diagnostic and therapeutic aspects.
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Affiliation(s)
- Simone Aloisio
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Sara Satolli
- Molecular Medicine for Neurodegenerative and Neuromuscular Diseases Unit, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Gabriele Bellini
- Department of Clinical and Experimental Medicine, Neurological Institute, University of Pisa, Pisa, Italy
| | - Piervito Lopriore
- Department of Clinical and Experimental Medicine, Neurological Institute, University of Pisa, Pisa, Italy.
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Chen X, Cen Z, Wang B, Liu P, Luo W. Multiple System Atrophy-like Phenotype Accompanied by Prominent Weight Loss and Fatigue. Mov Disord Clin Pract 2023; 10:S45-S47. [PMID: 37636226 PMCID: PMC10448613 DOI: 10.1002/mdc3.13802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 05/10/2023] [Accepted: 05/24/2023] [Indexed: 08/29/2023] Open
Affiliation(s)
- Xinhui Chen
- Department of Neurology, The Second Affiliated HospitalZhejiang University School of MedicineZhejiangChina
| | - Zhidong Cen
- Department of Neurology, The Second Affiliated HospitalZhejiang University School of MedicineZhejiangChina
| | - Bo Wang
- Department of Neurology, The Second Affiliated HospitalZhejiang University School of MedicineZhejiangChina
| | - Peng Liu
- Department of NeurologyTaizhou Central Hospital (Taizhou University Hospital)ZhejiangChina
| | - Wei Luo
- Department of Neurology, The Second Affiliated HospitalZhejiang University School of MedicineZhejiangChina
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Malaquias MJ, Igreja L, Nogueira C, Pereira C, Vilarinho L, Quelhas D, Freixo JP, Oliveira J, Magalhães M. Diagnosis across a cohort of "atypical" atypical and complex parkinsonism. Parkinsonism Relat Disord 2023; 111:105408. [PMID: 37105015 DOI: 10.1016/j.parkreldis.2023.105408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/26/2023] [Accepted: 04/16/2023] [Indexed: 04/29/2023]
Abstract
INTRODUCTION The diagnostic approach for adulthood parkinsonism can be challenging when atypical features hamper its classification in one of the two main parkinsonian groups: Parkinson's disease or atypical parkinsonian syndromes (APS). Atypical features are usually associated with non-sporadic neurodegenerative causes. METHODS Retrospective analysis of patients with a working clinical diagnosis of "atypical" APS and complex parkinsonism. "Atypical" APS were classified according to the diagnostic research criteria and the "4-step diagnostic approach" (Stamelou et al. 2013). When not indicated, the final aetiological diagnosis was prospectively assessed. Brain MRI of progressive supranuclear palsy (PSP) look-alikes was reviewed by a neuroradiologist. RESULTS Among 18 patients enrolled, ten were assigned to the "atypical" APS and eight to the complex parkinsonism group. In the "atypical" APS group, nine patients had PSP and one had corticobasal degeneration. In the PSP group the median magnetic resonance parkinsonism index was 17.1. A final aetiological diagnosis was established for 11 patients, four from the complex parkinsonism (L-2-hidroxiglutaric aciduria and DiGeorge syndrome) and seven from the "atypical" APS (Perry syndrome, postencephalitic PSP, vascular PSP, and MTP-AT6 mitochondrial disease) group. CONCLUSIONS In this study, the identification of atypical APS features, as proposed in the "4-step diagnostic approach", successfully guided the investigation of alternative diagnoses. Distinctive non-neurodegenerative etiologies causing "atypical" atypical and complex parkinsonism were uncovered, including acquired (post-encephalitis and vascular) and genetic (MTP-AT6 mitochondrial disease mimicking PSP, described for the first time) ones. In the future, accurate clinical identification and distinction between neurodegenerative and non-neurodegenerative parkinsonism etiologies will allow for refining clinical trials.
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Affiliation(s)
- Maria João Malaquias
- Neurology Department, Centro Hospitalar Universitário de Santo António, Porto, Portugal.
| | - Liliana Igreja
- Neuroradiology Department, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Célia Nogueira
- Newborn Screening, Metabolism and Genetics Unit, Human Genetics Department, National Institute of Health, Porto, Portugal
| | - Cristina Pereira
- Newborn Screening, Metabolism and Genetics Unit, Human Genetics Department, National Institute of Health, Porto, Portugal
| | - Laura Vilarinho
- Newborn Screening, Metabolism and Genetics Unit, Human Genetics Department, National Institute of Health, Porto, Portugal
| | - Dulce Quelhas
- Unidade de Bioquímica Genética, Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - João Parente Freixo
- Center for Predictive and Preventive Genetics (CGPP), Institute for Molecular and Cell Biology (IBMC), Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal
| | - Jorge Oliveira
- Center for Predictive and Preventive Genetics (CGPP), Institute for Molecular and Cell Biology (IBMC), Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal
| | - Marina Magalhães
- Neurology Department, Centro Hospitalar Universitário de Santo António, Porto, Portugal
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New insights from a multi-ethnic Asian progressive supranuclear palsy cohort. Parkinsonism Relat Disord 2023; 108:105296. [PMID: 36682278 DOI: 10.1016/j.parkreldis.2023.105296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 01/15/2023] [Accepted: 01/18/2023] [Indexed: 01/21/2023]
Abstract
BACKGROUND Progressive supranuclear palsy (PSP) is a rare, disabling, neurodegenerative disease, with few studies done in Asian populations. METHODS We prospectively characterized the clinical features and disease burden in a consecutively-recruited multi-ethnic Asian PSP cohort. Patients were extensively phenotyped using the Movement Disorder Society (MDS-PSP) clinical diagnostic criteria and the PSP-Clinical Deficits Scale (PSP-CDS). Caregiver burden was measured using the modified Zarit Burden Interview (ZBI). Investigations (neuroimaging and genetic tests) were reviewed. RESULTS There were 104 patients (64.4% male; 67.3% Chinese, 21.2% Indians, 9.6% Malays), consisting of 48.1% Richardson syndrome (PSP-RS), 37.5% parkinsonian phenotype (PSP-P), and 10.6% progressive gait freezing phenotype (PSP-PGF). Mean age at motor onset was 66.3 ± 7.7 years, with no significant differences between the PSP phenotypes. Interestingly, REM-sleep behaviour disorder (RBD) symptoms and visual hallucinations (considered rare in PSP) were reported in 23.5% and 22.8% of patients, respectively, and a family history of possible neurodegenerative or movement disorder in 20.4%. PSP-CDS scores were highest (worst) in PSP-RS; and correlated moderately with disease duration (rs = 0.45, P < 0.001) and weakly with caregiver burden (rs = 0.22, P = 0.029) in the overall cohort. Three of 48 (6.3%) patients who had whole-exome sequencing harboured pathogenic/likely pathogenic GBA variants. CONCLUSIONS Significant heterogeneity in clinical features and disease burden, and high rates of RBD symptoms, visual hallucinations, and familial involvement were observed in this relatively large cohort. Our findings highlight important considerations when assessing Asian patients, and provide further support for the notion of overlapping neurobiology between PSP and Lewy body disorders.
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Tseng FS, Foo JQX, Mai AS, Tan EK. The genetic basis of multiple system atrophy. J Transl Med 2023; 21:104. [PMID: 36765380 PMCID: PMC9912584 DOI: 10.1186/s12967-023-03905-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/19/2023] [Indexed: 02/12/2023] Open
Abstract
Multiple system atrophy (MSA) is a heterogenous, uniformly fatal neurodegenerative ɑ-synucleinopathy. Patients present with varying degrees of dysautonomia, parkinsonism, cerebellar dysfunction, and corticospinal degeneration. The underlying pathophysiology is postulated to arise from aberrant ɑ-synuclein deposition, mitochondrial dysfunction, oxidative stress and neuroinflammation. Although MSA is regarded as a primarily sporadic disease, there is a possible genetic component that is poorly understood. This review summarizes current literature on genetic risk factors and potential pathogenic genes and loci linked to both sporadic and familial MSA, and underlines the biological mechanisms that support the role of genetics in MSA. We discuss a broad range of genes that have been associated with MSA including genes related to Parkinson's disease (PD), oxidative stress, inflammation, and tandem gene repeat expansions, among several others. Furthermore, we highlight various genetic polymorphisms that modulate MSA risk, including complex gene-gene and gene-environment interactions, which influence the disease phenotype and have clinical significance in both presentation and prognosis. Deciphering the exact mechanism of how MSA can result from genetic aberrations in both experimental and clinical models will facilitate the identification of novel pathophysiologic clues, and pave the way for translational research into the development of disease-modifying therapeutic targets.
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Affiliation(s)
- Fan Shuen Tseng
- grid.163555.10000 0000 9486 5048Division of Medicine, Singapore General Hospital, Singapore, Singapore
| | - Joel Qi Xuan Foo
- grid.276809.20000 0004 0636 696XDepartment of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
| | - Aaron Shengting Mai
- grid.4280.e0000 0001 2180 6431Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Eng-King Tan
- Department of Neurology, National Neuroscience Institute, Singapore, 169856, Singapore. .,Duke-NUS Medical School, Singapore, Singapore.
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Khemani P, Elliott M, Levine T. An atypical clinical course of a 71-year-old man with right arm weakness and ataxia. Parkinsonism Relat Disord 2022; 105:154-156. [PMID: 35504790 DOI: 10.1016/j.parkreldis.2022.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 02/05/2022] [Accepted: 02/15/2022] [Indexed: 01/09/2023]
Affiliation(s)
- Pravin Khemani
- Swedish Neuroscience Institute, 500 17th Ave, Suite 540, Seattle, WA, 98122, USA.
| | - Michael Elliott
- Swedish Neuroscience Institute, 500 17th Ave, Suite 540, Seattle, WA, 98122, USA.
| | - Todd Levine
- CND Lifesciences, 5070 North 40th Street, Suite 220, Phoenix, AZ, 85018, USA.
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Pantelyat A. Progressive Supranuclear Palsy and Corticobasal Syndrome. Continuum (Minneap Minn) 2022; 28:1364-1378. [DOI: 10.1212/con.0000000000001158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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12
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Iglseder B, Lange R. [Atypical Parkinson's syndrome in old age]. Z Gerontol Geriatr 2022; 55:421-430. [PMID: 35748931 DOI: 10.1007/s00391-022-02077-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 11/29/2022]
Abstract
Atypical Parkinson syndromes represent a neuropathologically heterogeneous group and include the clinical entities dementia with Lewy bodies (DLB), multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD). The DLB and MSA are characterized by deposition of the protein alpha-synuclein (synucleinopathy), PSP and CBD are characterized by deposition of tau protein, often in the form of neurofibrillary tangles in nerve and glial cells (tauopathy). Misfolding and aggregation of the aforementioned proteins causes degeneration of the affected cell populations but the disease also spreads to anatomically neighboring brain regions, thus contributing to disease progression. The clinical characteristics (poor response to dopaminergic treatment, ataxia, apraxia, vertical gaze palsy and rapid progression) enable a differentiation from idiopathic Parkinson's disease.
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Affiliation(s)
- Bernhard Iglseder
- Uniklinikum Salzburg, Christian-Doppler-Klinik, Ignaz-Harrer-Straße 79, 5020, Salzburg, Österreich
| | - Rüdiger Lange
- Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Breslauerstr. 201, 90471, Nürnberg, Deutschland.
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Wenning GK, Stankovic I, Vignatelli L, Fanciulli A, Calandra‐Buonaura G, Seppi K, Palma J, Meissner WG, Krismer F, Berg D, Cortelli P, Freeman R, Halliday G, Höglinger G, Lang A, Ling H, Litvan I, Low P, Miki Y, Panicker J, Pellecchia MT, Quinn N, Sakakibara R, Stamelou M, Tolosa E, Tsuji S, Warner T, Poewe W, Kaufmann H. The Movement Disorder Society Criteria for the Diagnosis of Multiple System Atrophy. Mov Disord 2022; 37:1131-1148. [PMID: 35445419 PMCID: PMC9321158 DOI: 10.1002/mds.29005] [Citation(s) in RCA: 248] [Impact Index Per Article: 124.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/25/2022] [Accepted: 02/28/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The second consensus criteria for the diagnosis of multiple system atrophy (MSA) are widely recognized as the reference standard for clinical research, but lack sensitivity to diagnose the disease at early stages. OBJECTIVE To develop novel Movement Disorder Society (MDS) criteria for MSA diagnosis using an evidence-based and consensus-based methodology. METHODS We identified shortcomings of the second consensus criteria for MSA diagnosis and conducted a systematic literature review to answer predefined questions on clinical presentation and diagnostic tools relevant for MSA diagnosis. The criteria were developed and later optimized using two Delphi rounds within the MSA Criteria Revision Task Force, a survey for MDS membership, and a virtual Consensus Conference. RESULTS The criteria for neuropathologically established MSA remain unchanged. For a clinical MSA diagnosis a new category of clinically established MSA is introduced, aiming for maximum specificity with acceptable sensitivity. A category of clinically probable MSA is defined to enhance sensitivity while maintaining specificity. A research category of possible prodromal MSA is designed to capture patients in the earliest stages when symptoms and signs are present, but do not meet the threshold for clinically established or clinically probable MSA. Brain magnetic resonance imaging markers suggestive of MSA are required for the diagnosis of clinically established MSA. The number of research biomarkers that support all clinical diagnostic categories will likely grow. CONCLUSIONS This set of MDS MSA diagnostic criteria aims at improving the diagnostic accuracy, particularly in early disease stages. It requires validation in a prospective clinical and a clinicopathological study. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
| | - Iva Stankovic
- Neurology Clinic, University Clinical Center of Serbia, Faculty of Medicine, University of BelgradeBelgradeSerbia
| | - Luca Vignatelli
- IRCCS, Istituto delle Scienze Neurologiche di BolognaBolognaItaly
| | | | - Giovanna Calandra‐Buonaura
- IRCCS, Istituto delle Scienze Neurologiche di BolognaBolognaItaly
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
| | - Klaus Seppi
- Department of NeurologyInnsbruck Medical UniversityInnsbruckAustria
| | - Jose‐Alberto Palma
- Department of Neurology, Dysautonomia Center, Langone Medical CenterNew York University School of MedicineNew YorkNew YorkUSA
| | - Wassilios G. Meissner
- French Reference Center for MSA, Department of Neurology for Neurodegenerative DiseasesUniversity Hospital Bordeaux, 33076 Bordeaux and Institute of Neurodegenerative Diseases, University Bordeaux, CNRSBordeauxFrance
- Department of MedicineUniversity of Otago, Christchurch, and New Zealand Brain Research InstituteChristchurchNew Zealand
| | - Florian Krismer
- Department of NeurologyInnsbruck Medical UniversityInnsbruckAustria
| | - Daniela Berg
- Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of TübingenTübingenGermany
- Department of NeurologyChristian‐Albrechts‐University KielKielGermany
| | - Pietro Cortelli
- IRCCS, Istituto delle Scienze Neurologiche di BolognaBolognaItaly
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
| | - Roy Freeman
- Department of Neurology, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA
| | - Glenda Halliday
- Brain and Mind Centre, Faculty of Medicine and HealthSchool of Medical Sciences, The University of SydneySydneyNew South WalesAustralia
| | - Günter Höglinger
- Department of NeurologyHanover Medical SchoolHanoverGermany
- German Center for Neurodegenerative DiseasesMunichGermany
| | - Anthony Lang
- Edmond J. Safra Program in Parkinson's DiseaseUniversity Health Network and the Division of Neurology, University of TorontoTorontoCanada
| | - Helen Ling
- Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of NeurologyLondonUnited Kingdom
- Reta Lila Weston Institute of Neurological StudiesUCL Queen Square Institute of NeurologyLondonUnited Kingdom
| | - Irene Litvan
- Department of NeurosciencesParkinson and Other Movement Disorders Center, University of CaliforniaSan DiegoCaliforniaUSA
| | - Phillip Low
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | - Yasuo Miki
- Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of NeurologyLondonUnited Kingdom
- Department of NeuropathologyInstitute of Brain Science, Hirosaki University Graduate School of MedicineHirosakiJapan
| | - Jalesh Panicker
- UCL Queen Square Institute of NeurologyLondonUnited Kingdom
- Department of Uro‐NeurologyThe National Hospital for Neurology and Neurosurgery, Queen SquareLondonUnited Kingdom
| | - Maria Teresa Pellecchia
- Department of MedicineSurgery and Dentistry “Scuola Medica Salernitana”, Neuroscience Section, University of SalernoSalernoItaly
| | - Niall Quinn
- UCL Queen Square Institute of NeurologyLondonUnited Kingdom
| | - Ryuji Sakakibara
- Neurology, Internal MedicineSakura Medical Center, Toho UniversitySakuraJapan
| | - Maria Stamelou
- Parkinson's Disease and Movement Disorders DepartmentHYGEIA Hospital, and Aiginiteion Hospital, University of AthensAthensGreece
- Philipps University Marburg, Germany and European University of CyprusNicosiaCyprus
| | - Eduardo Tolosa
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) Hospital Clínic, IDIBAPS, Universitat de BarcelonaCataloniaSpain
- Movement Disorders Unit, Neurology ServiceHospital Clínic de BarcelonaCataloniaSpain
| | - Shoji Tsuji
- Department of Molecular NeurologyThe University of Tokyo, Graduate School of MedicineTokyoJapan
- International University of Health and WelfareChibaJapan
| | - Tom Warner
- Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of NeurologyLondonUnited Kingdom
| | - Werner Poewe
- Department of NeurologyInnsbruck Medical UniversityInnsbruckAustria
| | - Horacio Kaufmann
- Department of Neurology, Dysautonomia Center, Langone Medical CenterNew York University School of MedicineNew YorkNew YorkUSA
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14
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Ruiz-Barrio I, Horta-Barba A, Illán-Gala I, Kulisevsky J, Pagonabarraga J. Genotype-Phenotype Correlation in Progressive Supranuclear Palsy Syndromes: Clinical and Radiological Similarities and Specificities. Front Neurol 2022; 13:861585. [PMID: 35557621 PMCID: PMC9087829 DOI: 10.3389/fneur.2022.861585] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/23/2022] [Indexed: 11/24/2022] Open
Abstract
The progressive supranuclear palsy (PSP) syndrome encompasses different entities. PSP disease of sporadic origin is the most frequent presentation, but different genetic mutations can lead either to monogenic variants of PSP disease, or to other conditions with a different pathophysiology that eventually may result in PSP phenotype. PSP syndrome of monogenic origin is poorly understood due to the low prevalence and variable expressivity of some mutations. Through this review, we describe how early age of onset, family history of early dementia, parkinsonism, dystonia, or motor neuron disease among other clinical features, as well as some neuroimaging signatures, may be the important clues to suspect PSP syndrome of monogenic origin. In addition, a diagnostic algorithm is proposed that may be useful to guide the genetic diagnosis once there is clinical suspicion of a monogenic PSP syndrome.
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Affiliation(s)
- Iñigo Ruiz-Barrio
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Andrea Horta-Barba
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red - Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Ignacio Illán-Gala
- Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,Sant Pau Memory Unit, Neurology Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Jaime Kulisevsky
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red - Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Javier Pagonabarraga
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red - Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
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15
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Debnath M, Dey S, Sreenivas N, Pal PK, Yadav R. Genetic and Epigenetic Constructs of Progressive Supranuclear Palsy. Ann Neurosci 2022; 29:177-188. [PMID: 36419517 PMCID: PMC9676335 DOI: 10.1177/09727531221089396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/20/2022] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND Progressive supranuclear palsy (PSP) is a rapidly progressive primary tauopathy characterized by vertical gaze palsy, postural instability, and mild dementia. PSP shows high clinical and pathologic heterogeneity. Although a few risk factors exist, such as advanced age and environmental toxins, the precise etiology remains largely elusive. Compelling evidence now suggests that genetic background plays a pivotal role in the pathogenetic pathways of PSP. Notably, PSP is genetically and phenotypically a complex disorder. Given the tau pathology, several studies in the past have identified microtubule-associated protein tau (MAPT) gene mutations/variations and its haplotype as the major genetic risk factor of PSP, both in the sporadic and the familial forms. Subsequently, genome-wide association studies (GWAS) also identified several novel risk variants. However, these genetic risk determinants fail to explain the pathogenetic basis of PSP and its phenotypic spectrum in majority of the cases. Some genetic variants are known to confer the risk, while others seem to act as modifier genes. SUMMARY Besides the complex genetic basis of PSP, the pathobiological mechanisms, differential diagnosis, and management of patients with PSP have further been complicated by genetic conditions that mimic the phenotypes of PSP. This is now becoming increasingly apparent that interactions between genetic and environmental factors significantly contribute to PSP development. Further, the effect of environmental factors seems to be mediated through epigenetic modifications. KEY MESSAGE Herein, we provide a comprehensive overview of the genetic and epigenetic constructs of PSP and highlight the relevance of genetic and epigenetic findings in the pathobiology of PSP.
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Affiliation(s)
- Monojit Debnath
- Department of Human Genetics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
- These two authors have contributed equally
| | - Saikat Dey
- Department of Human Genetics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
- These two authors have contributed equally
| | - Nikhitha Sreenivas
- Department of Human Genetics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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16
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Cai H, Pang Y, Jia L. Generation of an induced pluripotent stem cell line (ICNDXHi001-A) from a patient with frontotemporal dementia carrying a heterozygous mutation c.796C > G (p.L266V) in MAPT. Stem Cell Res 2022; 59:102654. [PMID: 34995843 DOI: 10.1016/j.scr.2022.102654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/24/2021] [Accepted: 01/01/2022] [Indexed: 11/24/2022] Open
Abstract
Frontotemporal dementia (FTD) caused by microtubule-associated protein tau (MAPT) mutations is not rare and is almost fully penetrant. However, no disease-modifying treatment for FTD is currently available. Here, we demonstrated the establishment and characterization of a novel human induced pluripotent stem cell (iPSC) line ICNDXHi001-A from a patient with FTD carrying genetic variant MAPT c.796C > G (p.L266V). The generated cell line showed trilineage differentiation potential, expression of pluripotency markers, a normal karyotype, and retention of MAPT mutation. The study provides a useful model to further elucidate the underlying mechanisms of FTD and to facilitate novel therapy development.
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Affiliation(s)
- Huimin Cai
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Yana Pang
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Longfei Jia
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China.
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17
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Krzosek P, Madetko N, Migda A, Migda B, Jaguś D, Alster P. Differential Diagnosis of Rare Subtypes of Progressive Supranuclear Palsy and PSP-Like Syndromes—Infrequent Manifestations of the Most Common Form of Atypical Parkinsonism. Front Aging Neurosci 2022; 14:804385. [PMID: 35221993 PMCID: PMC8864174 DOI: 10.3389/fnagi.2022.804385] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/10/2022] [Indexed: 12/11/2022] Open
Abstract
Presently, there is increasing interest in rare PSP (progressive supranuclear palsy) variants, including PSP-PGF (PSP-progressive gait freezing), PSP-PI (PSP-postural instability), PSP-OM (PSP-ocular motor dysfunction), PSP-C (PSP-predominant cerebellar ataxia), PSP-CBS (PSP-corticobasal syndrome), PSP-SL (PSP-speech/language disorders), and PSP-PLS (PSP-primary lateral sclerosis). Diagnosis of these subtypes is usually based on clinical symptoms, thus thorough examination with anamnesis remains a major challenge for clinicians. The individual phenotypes often show great similarity to various neurodegenerative diseases and other genetic, autoimmune, or infectious disorders, manifesting as PSP-mimicking syndromes. At the current stage of knowledge, it is not possible to isolate a specific marker to make a definite ante-mortem diagnosis. The purpose of this review is to discuss recent developments in rare PSP phenotypes and PSP-like syndromes.
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Affiliation(s)
- Patrycja Krzosek
- Students’ Scientific Association of the Department of Neurology, Medical University of Warsaw, Warsaw, Poland
- *Correspondence: Patrycja Krzosek,
| | - Natalia Madetko
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | - Anna Migda
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Bartosz Migda
- Diagnostic Ultrasound Lab, Department of Pediatric Radiology, Medical Faculty, Medical University of Warsaw, Warsaw, Poland
| | - Dominika Jaguś
- Diagnostic Ultrasound Lab, Department of Pediatric Radiology, Medical Faculty, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Alster
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
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18
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Kauppila LA, Ten Holter SE, van de Warrenburg B, Bloem BR. A Guide for the Differential Diagnosis of Multiple System Atrophy in Clinical Practice. JOURNAL OF PARKINSON'S DISEASE 2022; 12:2015-2027. [PMID: 36057832 PMCID: PMC9661336 DOI: 10.3233/jpd-223392] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
Multiple system atrophy (MSA) is a sporadic and progressive neurodegenerative disorder with a complex differential diagnosis. A range of disorders- also of nondegenerative etiology- can mimic MSA, expanding its differential diagnosis. Both misdiagnosis and diagnostic delays are relatively common in clinical practice. A correct diagnosis is vital for daily clinical practice, in order to facilitate proper counselling and to timely install therapies in treatable disorders that mimic MSA. A correct diagnosis is also essential for including properly classified individuals into research studies that aim to better understand the pathophysiology of MSA, to develop specific biomarkers or to evaluate novel symptomatic or disease-modifying therapies. Here, we offer some practical guidance to support the diagnostic process, by highlighting conditions that may be considered as MSA lookalikes, by emphasizing some key clinical aspects of these mimics, and by discussing several useful ancillary diagnostic tests.
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Affiliation(s)
- Linda Azevedo Kauppila
- CNS – Campus Neurológico, Lisbon, Portugal
- Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Susanne E.M. Ten Holter
- Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Bart van de Warrenburg
- Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Bastiaan R. Bloem
- Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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19
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Fedorova NV, Bril EV, Kulua TK, Mikhaylova AD. [Progressive supranuclear palsy]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:111-119. [PMID: 34184486 DOI: 10.17116/jnevro2021121051111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Progressive supranuclear palsy (PSP) is a heterogeneous progressive neurodegenerative disease characterized by onset after 50 years old, Parkinson's syndrome, early development of postural instability, absence or transient reaction to levodopa drugs, neuropsychological disorders, dysphagia and dysarthria and eye movement disorders. The review provides an analysis of modern data on etiology, clinical presentation, differential diagnosis of the disease. The morphological picture and neuroimaging features, as well as modern ideas about treatment, are described. A great clinical polymorphism of the disease, as well as its similarity to other neurodegenerative diseases, manifested by Parkinson's syndrome, complicates the diagnosis of PSP. Establishing an accurate diagnosis makes it possible to determine the prognosis and further tactics of patient management.
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Affiliation(s)
- N V Fedorova
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - E V Bril
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia.,Russian State Research Center - Burnasyan Federal Medical Biophysical Center, Moscow, Russia
| | - T K Kulua
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - A D Mikhaylova
- Russian State Research Center - Burnasyan Federal Medical Biophysical Center, Moscow, Russia
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20
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Of Criteria and Men-Diagnosing Atypical Parkinsonism: Towards an Algorithmic Approach. Brain Sci 2021; 11:brainsci11060695. [PMID: 34070571 PMCID: PMC8230204 DOI: 10.3390/brainsci11060695] [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: 04/15/2021] [Revised: 05/20/2021] [Accepted: 05/22/2021] [Indexed: 02/02/2023] Open
Abstract
Diagnosing atypical parkinsonism can be an error-exposed undertaking in the context of elaborate criteria coupled with time restraints on their comprehensive application. We conducted a retrospective, descriptive study of diagnostic accuracy among physicians at two tertiary neurology centers in Romania and developed an algorithmic tool for comparison purposes. As many as 90 patients qualified for inclusion in the study, with 77 patients actually complying with atypical parkinsonism criteria. Overall, physician-established diagnoses may be incorrect in about one-fourth of cases. The reasons for this finding span a wide range of possibilities, from terminology-related inaccuracies to criteria sophistication. A Boolean-logic algorithmic approach to diagnosis might decrease misdiagnosis rates. These findings prepare the ground for the future refinement of an algorithmic application to be fully validated in a prospective study for the benefit of patients and health professionals alike.
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21
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Nicoletti V, Palermo G, Del Prete E, Mancuso M, Ceravolo R. Understanding the Multiple Role of Mitochondria in Parkinson's Disease and Related Disorders: Lesson From Genetics and Protein-Interaction Network. Front Cell Dev Biol 2021; 9:636506. [PMID: 33869180 PMCID: PMC8047151 DOI: 10.3389/fcell.2021.636506] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/16/2021] [Indexed: 12/12/2022] Open
Abstract
As neurons are highly energy-demanding cell, increasing evidence suggests that mitochondria play a large role in several age-related neurodegenerative diseases. Synaptic damage and mitochondrial dysfunction have been associated with early events in the pathogenesis of major neurodegenerative diseases, including Parkinson’s disease, atypical parkinsonisms, and Huntington disease. Disruption of mitochondrial structure and dynamic is linked to increased levels of reactive oxygen species production, abnormal intracellular calcium levels, and reduced mitochondrial ATP production. However, recent research has uncovered a much more complex involvement of mitochondria in such disorders than has previously been appreciated, and a remarkable number of genes and proteins that contribute to the neurodegeneration cascade interact with mitochondria or affect mitochondrial function. In this review, we aim to summarize and discuss the deep interconnections between mitochondrial dysfunction and basal ganglia disorders, with an emphasis into the molecular triggers to the disease process. Understanding the regulation of mitochondrial pathways may be beneficial in finding pharmacological or non-pharmacological interventions to delay the onset of neurodegenerative diseases.
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Affiliation(s)
- Valentina Nicoletti
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giovanni Palermo
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Eleonora Del Prete
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Michelangelo Mancuso
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Roberto Ceravolo
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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22
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Wittke C, Petkovic S, Dobricic V, Schaake S, Respondek G, Weissbach A, Madoev H, Trinh J, Vollstedt EJ, Kuhnke N, Lohmann K, Dulovic Mahlow M, Marras C, König IR, Stamelou M, Bonifati V, Lill CM, Kasten M, Huppertz HJ, Höglinger G, Klein C. Genotype-Phenotype Relations for the Atypical Parkinsonism Genes: MDSGene Systematic Review. Mov Disord 2021; 36:1499-1510. [PMID: 34396589 PMCID: PMC9070562 DOI: 10.1002/mds.28517] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/16/2020] [Accepted: 01/03/2021] [Indexed: 11/25/2022] Open
Abstract
This Movement Disorder Society Genetic mutation database Systematic Review focuses on monogenic atypical parkinsonism with mutations in the ATP13A2, DCTN1, DNAJC6, FBXO7, SYNJ1, and VPS13C genes. We screened 673 citations and extracted genotypic and phenotypic data for 140 patients (73 families) from 77 publications. In an exploratory fashion, we applied an automated classification procedure via an ensemble of bootstrap-aggregated (“bagged”) decision trees to distinguish these 6 forms of monogenic atypical parkinsonism and found a high accuracy of 86.5% (95% CI, 86.3%–86.7%) based on the following 10 clinical variables: age at onset, spasticity and pyramidal signs, hypoventilation, decreased body weight, minimyoclonus, vertical gaze palsy, autonomic symptoms, other nonmotor symptoms, levodopa response quantification, and cognitive decline. Comparing monogenic atypical with monogenic typical parkinsonism using 2063 data sets from Movement Disorder Society Genetic mutation database on patients with SNCA, LRRK2, VPS35, Parkin, PINK1, and DJ-1 mutations, the age at onset was earlier in monogenic atypical parkinsonism (24 vs 40 years; P = 1.2647 × 10−12) and levodopa response less favorable than in patients with monogenic typical presentations (49% vs 93%). In addition, we compared monogenic to nonmonogenic atypical parkinsonism using data from 362 patients with progressive supranuclear gaze palsy, corticobasal degeneration, multiple system atrophy, or frontotemporal lobar degeneration. Although these conditions share many clinical features with the monogenic atypical forms, they can typically be distinguished based on their later median age at onset (64 years; IQR, 57–70 years). In conclusion, age at onset, presence of specific signs, and degree of levodopa response inform differential diagnostic considerations and genetic testing indications in atypical forms of parkinsonism.
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Affiliation(s)
- Christina Wittke
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | - Sonja Petkovic
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | | | - Susen Schaake
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | | | - Gesine Respondek
- Department of Neurology, Technische Universität München, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Anne Weissbach
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | - Harutyun Madoev
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | - Joanne Trinh
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | | | - Neele Kuhnke
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | - Katja Lohmann
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | | | - Connie Marras
- Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Inke R König
- Institute of Medical Biometry and Statistics, University of Luebeck, Luebeck, Germany
| | - Maria Stamelou
- Parkinson's Disease and Movement Disorders Department, HYGEIA Hospital, Athens, Greece.,School of Medicine, European University of Cyprus, Nicosia, Cyprus.,Neurology Clinic, Philipps-University, Marburg, Germany
| | - Vincenzo Bonifati
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Christina M Lill
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | - Meike Kasten
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany.,Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
| | | | - Günter Höglinger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
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23
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Picillo M, Ginevrino M, Dati G, Scannapieco S, Vallelunga A, Siano P, Volpe G, Ceravolo R, Nicoletti V, Cicero E, Nicoletti A, Zappia M, Peverelli S, Silani V, Pellecchia MT, Valente EM, Barone P. Genetic characterization of a cohort with familial parkinsonism and cognitive-behavioral syndrome: A Next Generation Sequencing study. Parkinsonism Relat Disord 2021; 84:82-90. [PMID: 33601107 DOI: 10.1016/j.parkreldis.2021.01.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/21/2021] [Accepted: 01/25/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To perform the genetic characterization of a cohort with familial parkinsonism and cognitive-behavioral syndrome. METHODS A Next Generation Sequencing - based targeted sequencing of 32 genes associated to various neurodegenerative phenotypes, plus a screening for SNCA Copy Number Variations and C9orf72 repeat expansion, was applied in a cohort of 85 Italian patients presenting with parkinsonism and cognitive and/or behavioral syndrome and a positive familial history for any neurodegenerative disorder (i.e., dementia, movement disorders, amyotrophic lateral sclerosis). RESULTS Through this combined genetic approach, we detected potentially relevant genetic variants in 25.8% of patients with familial parkinsonism and cognitive and/or behavioral syndrome. Peculiar phenotypes are described (Cortico-basal syndrome with APP, Posterior Cortical Atrophy with GBA, Progressive Supranuclear Palsy-like with GRN, Multiple System Atrophy with TARDBP). The majority of patients presented a rigid-bradykinetic parkinsonian syndrome, while rest tremor was less common. Myoclonic jerks, pyramidal signs, dystonic postures and vertical gaze disturbances were more frequently associated with the presence of a pathogenic variant in one of the tested genes. CONCLUSIONS Given the syndromic approach adopted in our study, we were able to provide a detailed clinical description of patients beyond the boundaries of specific clinical diagnoses and describe peculiar phenotypes. This observation further supports the knowledge that genetic disorders present phenotypic overlaps across different neurodegenerative syndromes, highlighting the limitations of current clinical diagnostic criteria defining sharp boundaries between distinct conditions.
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Affiliation(s)
- Marina Picillo
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience Section, University of Salerno, Italy
| | - Monia Ginevrino
- Istituto di Medicina Genomica, Università Cattolica Del Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italy; Laboratory of Medical Genetics, Bambino Gesù Children's Hospital, Rome, Italy
| | - Giovanna Dati
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience Section, University of Salerno, Italy
| | - Sara Scannapieco
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience Section, University of Salerno, Italy
| | - Annamaria Vallelunga
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience Section, University of Salerno, Italy
| | - Pietro Siano
- Neurology Unit, University Hospital A.O.U. OO.RR. San Giovanni di Dio e Ruggi D'Aragona, Scuola Medica Salernitana, Salerno, Italy
| | - Giampiero Volpe
- Neurology Unit, University Hospital A.O.U. OO.RR. San Giovanni di Dio e Ruggi D'Aragona, Scuola Medica Salernitana, Salerno, Italy
| | - Roberto Ceravolo
- Dipartimento di Medicina Clinica e Sperimentale Università di Pisa, Italy, Università di Pisa, Pisa, Italy
| | - Valentina Nicoletti
- Dipartimento di Medicina Clinica e Sperimentale Università di Pisa, Italy, Università di Pisa, Pisa, Italy
| | - Edoardo Cicero
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Mario Zappia
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Silvia Peverelli
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milano, Italy; Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milan, Italy
| | - Maria Teresa Pellecchia
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience Section, University of Salerno, Italy
| | - Enza Maria Valente
- Department of Molecular Medicine, University of Pavia, Pavia, Italy; IRCCS Mondino Foundation, Pavia, Italy.
| | - Paolo Barone
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience Section, University of Salerno, Italy.
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24
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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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25
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Nasri A, Ben Djebara M, Sghaier I, Mrabet S, Zidi S, Gargouri A, Kacem I, Gouider R. Atypical parkinsonian syndromes in a North African tertiary referral center. Brain Behav 2021; 11:e01924. [PMID: 33179436 PMCID: PMC7821582 DOI: 10.1002/brb3.1924] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 09/06/2020] [Accepted: 10/14/2020] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Data on epidemiology of atypical parkinsonian syndromes (APS) in North African countries are limited. Our objective was to study the epidemiological features of APS in a Tunisian population. METHODS We conducted a 17-year retrospective cross-sectional descriptive study in the Department of Neurology at Razi University Hospital. We included all patients responding to consensus diagnosis criteria of APS. We recorded demographic and clinical data. Group differences were assessed with a post hoc ANOVA with a Bonferroni error correction. RESULTS We included 464 APS patients. Hospital prevalence of APS among all parkinsonism cases was 20.6%. Mean annual increase of incidence defined as newly diagnosed APS cases per year reached 38.8%/year. APS were divided into 4 etiological subgroups: dementia with Lewy bodies (DLB; 56.7%); progressive supranuclear palsy(PSP; 16.2%); multiple system atrophy (MSA; 14.6%); and finally corticobasal syndrome (CBS; 12.5%). Sex-ratio was 1.2. This male predominance was found in all subgroups except MSA (p = .013). Mean age at onset was 68.5 years, most belated in DLB (69.7 years; p < .001). Young-onset parkinsonism (<40 years) was found only in MSA subgroup (p = .031). Parkinsonism was of late onset (>70 years) in 50.7% of patients and was significantly associated with DLB subgroup (p = .013). Inaugural parkinsonism was associated with CBS and MSA (p = .0497), and gait disorders at disease onset were associated with PSP and MSA (p = .0062). Cognitive and mood disorders were more marked in DLB and most preserved in MSA. Consanguinity was more marked in CBS (p = .037), and family history of dementia and psychiatric diseases was more common in DLB. Thirty-seven families with similar cases of APS were identified. CONCLUSIONS This is the largest African epidemiological study on APS. In our population, APS were frequent and dominated by DLB. The age of onset of parkinsonism was the most decisive feature for differential diagnosis.
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Affiliation(s)
- Amina Nasri
- Neurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health"Razi University HospitalTunisTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Mouna Ben Djebara
- Neurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health"Razi University HospitalTunisTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Ikram Sghaier
- Neurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health"Razi University HospitalTunisTunisia
| | - Saloua Mrabet
- Neurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health"Razi University HospitalTunisTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Sabrina Zidi
- Neurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health"Razi University HospitalTunisTunisia
| | - Amina Gargouri
- Neurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health"Razi University HospitalTunisTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Imen Kacem
- Neurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health"Razi University HospitalTunisTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Riadh Gouider
- Neurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health"Razi University HospitalTunisTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
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26
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Wen Y, Zhou Y, Jiao B, Shen L. Genetics of Progressive Supranuclear Palsy: A Review. JOURNAL OF PARKINSON'S DISEASE 2021; 11:93-105. [PMID: 33104043 PMCID: PMC7990399 DOI: 10.3233/jpd-202302] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/26/2020] [Indexed: 02/06/2023]
Abstract
Progressive supranuclear palsy (PSP) is an atypical parkinsonism with prominent 4R-tau neuropathology, and the classical clinical phenotype is characterized by vertical supranuclear gaze palsy, unprovoked falls, akinetic-rigid syndrome and cognitive decline. Though PSP is generally regarded as sporadic, there is increasing evidence suggesting that a series of common and rare genetic variants impact on sporadic and familial forms of PSP. To date, more than 10 genes have been reported to show a potential association with PSP. Among these genes, the microtubule-associated protein tau (MAPT) is the risk locus with the strongest effect size on sporadic PSP in the case-control genome-wide association studies (GWAS). Additionally, MAPT mutations are the most common cause of familial PSP while the leucine-rich repeat kinase 2 (LRRK2) is a rare monogenic cause of PSP, and several other gene mutations may mimic the PSP phenotype, like the dynactin subunit 1 (DCTN1). In total, 15 MAPT mutations have been identified in cases with PSP, and the mean age at onset is much earlier than in cases carrying LRRK2 or DCTN1 mutations. GWAS have further identified several risk loci of PSP, proposing molecular pathways related to PSP. The present review focused on genetic studies on PSP and summarized genetic factors of PSP, which may help to elucidate the underlying pathogenesis and provide new perspectives for therapeutic strategies.
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Affiliation(s)
- Yafei Wen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, PR China
| | - Yafang Zhou
- Department of Geriatrics Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, PR China
| | - Bin Jiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, PR China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, Hunan, PR China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, Hunan, PR China
| | - Lu Shen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, PR China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, Hunan, PR China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, Hunan, PR China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, Hunan, PR China
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27
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Ganguly J, Jog M. Tauopathy and Movement Disorders-Unveiling the Chameleons and Mimics. Front Neurol 2020; 11:599384. [PMID: 33250855 PMCID: PMC7674803 DOI: 10.3389/fneur.2020.599384] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 09/30/2020] [Indexed: 12/11/2022] Open
Abstract
The spectrum of tauopathy encompasses heterogenous group of neurodegenerative disorders characterized by neural or glial deposition of pathological protein tau. Clinically they can present as cognitive syndromes, movement disorders, motor neuron disease, or mixed. The heterogeneity in clinical presentation, genetic background, and underlying pathology make it difficult to classify and clinically approach tauopathy. In the literature, tauopathies are thus mostly highlighted from pathological perspective. From clinical standpoint, cognitive syndromes are often been focussed while reviewing tauopathies. However, the spectrum of tauopathy has also evolved significantly in the domain of movement disorders and has transgressed beyond the domain of primary tauopathies. Secondary tauopathies from neuroinflammation or autoimmune insults and some other "novel" tauopathies are increasingly being reported in the current literature, while some of them are geographically isolated. Because of the overlapping clinical phenotypes, it often becomes difficult for the clinician to diagnose them clinically and have to wait for the pathological confirmation by autopsy. However, each of these tauopathies has some clinical and radiological signatures those can help in clinical diagnosis and targeted genetic testing. In this review, we have exposed the heterogeneity of tauopathy from a movement disorder perspective and have provided a clinical approach to diagnose them ante mortem before confirmatory autopsy. Additionally, phenotypic variability of these disorders (chameleons) and the look-alikes (mimics) have been discussed with potential clinical pointers for each of them. The review provides a framework within which new and as yet undiscovered entities can be classified in the future.
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Affiliation(s)
| | - Mandar Jog
- Movement Disorder Centre, London Health Sciences Centre, University of Western Ontario, London, ON, Canada
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28
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Abate F, Dati G, Ginevrino M, Valente EM, Barone P, Picillo M. APP-Related Corticobasal Syndrome: Expanding the List of Corticobasal Degeneration Look Alikes. Mov Disord Clin Pract 2020; 7:849-851. [PMID: 33043082 DOI: 10.1002/mdc3.13037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/18/2020] [Accepted: 07/21/2020] [Indexed: 11/08/2022] Open
Affiliation(s)
- Filomena Abate
- Center for Neurodegenerative Diseases, Department of Medicine, Surgery and Dentistry, Neuroscience Section University of Salerno Salerno Italy
| | - Giovanna Dati
- Center for Neurodegenerative Diseases, Department of Medicine, Surgery and Dentistry, Neuroscience Section University of Salerno Salerno Italy
| | - Monia Ginevrino
- Institute of Genomic Medicine Catholic University, Agostino Gemelli IRCCS University Hospital Foundation Rome Italy.,Laboratory of Medical Genetics Bambino Gesù Children's Hospital Rome Italy
| | - Enza M Valente
- Department of Molecular Medicine University of Pavia Pavia Italy.,IRCCS Mondino Foundation Pavia, Italy
| | - Paolo Barone
- Center for Neurodegenerative Diseases, Department of Medicine, Surgery and Dentistry, Neuroscience Section University of Salerno Salerno Italy
| | - Marina Picillo
- Center for Neurodegenerative Diseases, Department of Medicine, Surgery and Dentistry, Neuroscience Section University of Salerno Salerno Italy
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29
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Wenning GK. Parkinsonism and dysautonomia: Multiple system atrophy? Parkinsonism Relat Disord 2020; 77:150-151. [DOI: 10.1016/j.parkreldis.2019.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 07/28/2019] [Accepted: 08/09/2019] [Indexed: 10/26/2022]
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30
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López Botello CK, Estrada-Bellmann I, Castillo-Torres SA, Martínez-Roque DG, Soto-Rincón CA, Chavez-Luevanos B, Ancer Rodríguez PR. Reader response: Muscle-targeted nutritional support for rehabilitation in patients with parkinsonian syndrome. Neurology 2020; 95:142-143. [DOI: 10.1212/wnl.0000000000009899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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31
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Procopio R, Gagliardi M, D'Amelio M, Brighina L, Nicoletti G, Morelli M, Bonapace G, Quattrone A, Annesi G. DCTN1 mutation analysis in Italian patients with PSP, MSA, and DLB. Neurobiol Aging 2020; 93:143.e5-143.e7. [PMID: 32402491 DOI: 10.1016/j.neurobiolaging.2020.04.006] [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: 01/29/2020] [Revised: 04/01/2020] [Accepted: 04/06/2020] [Indexed: 11/28/2022]
Abstract
DCTN1 encodes the largest subunit of dynactin complex essential in the retrograde axonal transport and cytoplasmic transport of vesicles; mutations in DCTN1 have been reported predominantly in individuals with Perry syndrome and, recently, in patients with progressive supranuclear palsy. Our genetic screening of DCTN1 in 79 patients with progressive supranuclear palsy, 100 patients with multiple system atrophy, and 28 patients with dementia with Lewy bodies from Italy revealed only synonymous and intronic variants, suggesting that DCTN1 mutations do not have a key role in the development of atypical parkinsonism in the Italian population.
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Affiliation(s)
- Radha Procopio
- Institute of Molecular Bioimaging and Physiology, National Research Council, Section of Germaneto, Catanzaro, Italy; Institute of Neurology, Department of Medical and Surgical Sciences, University Magna Graecia, Catanzaro, Italy
| | - Monica Gagliardi
- Institute of Molecular Bioimaging and Physiology, National Research Council, Section of Germaneto, Catanzaro, Italy.
| | - Marco D'Amelio
- Department of Experimental Biomedicine and Clinical Neuroscience (BioNeC), University of Palermo, Palermo, Italy
| | - Laura Brighina
- Department of Neurology, Milan Center for Neuroscience, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Giuseppe Nicoletti
- Institute of Molecular Bioimaging and Physiology, National Research Council, Section of Germaneto, Catanzaro, Italy
| | - Maurizio Morelli
- Institute of Neurology, Department of Medical and Surgical Sciences, University Magna Graecia, Catanzaro, Italy
| | | | - Aldo Quattrone
- Neuroscience Center, University Magna Graecia, Catanzaro, Italy
| | - Grazia Annesi
- Institute of Molecular Bioimaging and Physiology, National Research Council, Section of Germaneto, Catanzaro, Italy
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32
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Di Battista ME, Dell'Acqua C, Galimberti D, Serpente M, Boccaletto F, Gallucci M. A case of bipolar disorder developing into atypical parkinsonism and presenting with frontotemporal asymmetrical brain degeneration. A TREDEM Registry Case Report. Bipolar Disord 2020; 22:201-203. [PMID: 31876068 DOI: 10.1111/bdi.12883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Maria E Di Battista
- Cognitive Impairment Center, Local Health Authority n. 2 Marca Trevigiana, Treviso, Italy
| | - Carola Dell'Acqua
- Cognitive Impairment Center, Local Health Authority n. 2 Marca Trevigiana, Treviso, Italy.,Department of Neuroscience & Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Daniela Galimberti
- Dino Ferrari Center, University of Milan, Milan, Italy.,Fondazione IRCCS Ca' Granda, Neurodegenerative Disease Unit, Milan, Italy
| | - Maria Serpente
- Dino Ferrari Center, University of Milan, Milan, Italy.,Fondazione IRCCS Ca' Granda, Neurodegenerative Disease Unit, Milan, Italy
| | - Franco Boccaletto
- Nuclear Medicine Unit, Local Health Authority n. 2 Marca Trevigiana, Treviso, Italy
| | - Maurizio Gallucci
- Cognitive Impairment Center, Local Health Authority n. 2 Marca Trevigiana, Treviso, Italy
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33
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Kresojević N, Mandić-Stojmenović G, Dobričić V, Petrović I, Brajković L, Stefanova E, Svetel M, Kostić V. Very Late-Onset Niemann Pick Type C Disease: Example of Progressive Supranuclear Palsy Look-Alike Disorder. Mov Disord Clin Pract 2020; 7:211-214. [PMID: 32071943 DOI: 10.1002/mdc3.12892] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 12/11/2019] [Accepted: 12/14/2019] [Indexed: 11/10/2022] Open
Affiliation(s)
| | - Gorana Mandić-Stojmenović
- Neurology Clinic, Clinical Centre of Serbia Belgrade Serbia.,School of Medicine, University of Belgrade Belgrade Serbia
| | | | - Igor Petrović
- Neurology Clinic, Clinical Centre of Serbia Belgrade Serbia.,School of Medicine, University of Belgrade Belgrade Serbia
| | | | - Elka Stefanova
- Neurology Clinic, Clinical Centre of Serbia Belgrade Serbia.,School of Medicine, University of Belgrade Belgrade Serbia
| | - Marina Svetel
- Neurology Clinic, Clinical Centre of Serbia Belgrade Serbia.,School of Medicine, University of Belgrade Belgrade Serbia
| | - Vladimir Kostić
- Neurology Clinic, Clinical Centre of Serbia Belgrade Serbia.,School of Medicine, University of Belgrade Belgrade Serbia
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34
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Respondek G, Stamelou M, Höglinger GU. Classification of atypical parkinsonism per pathology versus phenotype. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2019; 149:37-47. [PMID: 31779821 DOI: 10.1016/bs.irn.2019.10.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The umbrella term "atypical parkinsonism" refers to a clinical presentation with various causes, emphasizing the clinical commonality of diseases in which atypical parkinsonism can present. This term is useful for describing the phenomenology of a movement disorder and to classify patients according to their clinical presentation. In contrast to this classification per phenotype, a classification per pathology is needed when it comes to understanding the pathogenesis and designing and delivering disease-modifying therapeutic interventions. Clinico-pathological correlation studies have revealed enormous clinical heterogeneity and vast clinical overlap in pathologically defined diseases related to atypical parkinsonism. Thus, the classification of patients with atypical parkinsonism per phenotype has limited validity for predicting the underlying pathology. This chapter will contrast the phenotype-driven classification and the pathology-driven classification of neurodegenerative diseases related to atypical parkinsonism and discuss future directions to improve pathology-specific diagnosis.
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Affiliation(s)
- Gesine Respondek
- Department for Neurology Hannover Medical School (MHH), Hannover, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Maria Stamelou
- Parkinson's Disease and Movement Disorders Department, HYGEIA Hospital, Athens, Greece; Aiginiteion Hospital, First Department of Neurology, University of Athens, Greece; Clinic for Neurology, Philipps University, Marburg, Germany
| | - Günter U Höglinger
- Department for Neurology Hannover Medical School (MHH), Hannover, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
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35
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Paramanandam V, Olszewska DA, Shakya B, Chalissery AJ, O'Connell M, Farrell M, Lynch T. A 57-Year-Old Woman With Progressive Left Hand Clumsiness and Falls. Mov Disord Clin Pract 2019; 6:656-660. [PMID: 31745473 DOI: 10.1002/mdc3.12825] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 05/20/2019] [Accepted: 05/24/2019] [Indexed: 11/11/2022] Open
Abstract
Clinical History A 57-year old woman presented with left hand pain, periodic leg movement during sleep, gradual onset of stiffness, clumsiness, and falls. Neurological examination showed: generalized rigidity and bradykinesia. There was left hand dystonic posturing and ideomotor apraxia, as well as mirror movements of upper limbs and stimulus-sensitive myoclonus. The patient had a high-pitched voice and hypophonia (Video S1). Discussion Experts discuss localization and the syndromic diagnosis and predict the underlying pathology. The pathological diagnosis is then provided and clinical learning points are considered.
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Affiliation(s)
- Vijayashankar Paramanandam
- Centre for Brain Health Dublin Neurological Institute at the Mater Misericordiae University Hospital Dublin Ireland
| | - Diana Angelika Olszewska
- Centre for Brain Health Dublin Neurological Institute at the Mater Misericordiae University Hospital Dublin Ireland
| | | | - Albi Jose Chalissery
- Centre for Brain Health Dublin Neurological Institute at the Mater Misericordiae University Hospital Dublin Ireland
| | - Martin O'Connell
- Department of Radiology Mater Misericordiae University Hospital Dublin Ireland
| | - Michael Farrell
- Department of Neuropathology Beaumont Hospital Dublin Ireland
| | - Tim Lynch
- Centre for Brain Health Dublin Neurological Institute at the Mater Misericordiae University Hospital Dublin Ireland
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36
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Pollini L, Galosi S, Nardecchia F, Musacchia F, Castello R, Nigro V, Leuzzi V. Parkinsonism, Intellectual Disability, and Catatonia in a Young Male With MECP2 Variant. Mov Disord Clin Pract 2019; 7:118-119. [PMID: 31970230 DOI: 10.1002/mdc3.12865] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 10/01/2019] [Accepted: 10/16/2019] [Indexed: 12/31/2022] Open
Affiliation(s)
- Luca Pollini
- Department of Human Neuroscience Sapienza University of Rome Rome Italy
| | - Serena Galosi
- Department of Human Neuroscience Sapienza University of Rome Rome Italy
| | | | | | | | - Vincenzo Nigro
- Telethon Institute of Genetics and Medicine Pozzuoli Italy
| | - Vincenzo Leuzzi
- Department of Human Neuroscience Sapienza University of Rome Rome Italy
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37
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Giagkou N, Höglinger GU, Stamelou M. Progressive supranuclear palsy. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2019; 149:49-86. [PMID: 31779824 DOI: 10.1016/bs.irn.2019.10.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Progressive supranuclear palsy (PSP) is a neurodegenerative disease characterized pathologically by 4 repeat tau deposition in various cell types and anatomical regions. Richardson's syndrome (RS) is the initially described and one of the clinical phenotypes associated with PSP pathology, characterized by vertical supranuclear gaze paly in particular downwards, postural instability with early falls and subcortical frontal dementia. PSP can manifest as several other clinical phenotypes, including PSP-parkinsonism, -pure akinesia with gait freezing, -frontotemporal dementia, - corticobasal syndrome, - speech/language impairment. RS can also have a pathologic diagnosis other than PSP, including corticobasal degeneration, FTD-TDP-43 and others. New clinical diagnostic criteria take into account this phenotypic variability in an attempt to diagnose the disease earlier, given the current lack of a validated biomarker. At present, therapeutic options for PSP are symptomatic and insufficient. Recent large neuroprotective trials have failed to provide a positive clinical outcome, however, have led to the design of better studies that are ongoing and hold promise for a neuroprotective treatment for PSP.
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Affiliation(s)
- Nikolaos Giagkou
- Parkinson's Disease and Movement Disorders Department, HYGEIA Hospital, Athens, Greece
| | - Günter U Höglinger
- Department for Neurology Hannover Medical School (MHH), Hannover, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Maria Stamelou
- Parkinson's Disease and Movement Disorders Department, HYGEIA Hospital, Athens, Greece; Aiginiteion Hospital, First Department of Neurology, University of Athens, Greece; Clinic for Neurology, Philipps University, Marburg, Germany
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38
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Fanciulli A, Goebel G, Lazzeri G, Granata R, Kiss G, Strano S, Colosimo C, Pontieri FE, Kaufmann H, Seppi K, Poewe W, Wenning GK. Urinary retention discriminates multiple system atrophy from Parkinson's disease. Mov Disord 2019; 34:1926-1928. [PMID: 31710392 DOI: 10.1002/mds.27917] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 10/14/2019] [Accepted: 10/15/2019] [Indexed: 01/17/2023] Open
Affiliation(s)
| | - Georg Goebel
- Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria
| | - Giulia Lazzeri
- Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Roberta Granata
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gusztav Kiss
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Stefano Strano
- Department of Heart and Great Vessels "A. Reale", Sapienza University of Rom, Rome, Italy
| | - Carlo Colosimo
- Department of Neurology, Santa Maria Hospital, Terni, Italy
| | - Francesco E Pontieri
- Department of Neuroscience, Mental Health and Sensory Organs, "Sapienza" University of Rome, Rome, Italy
| | - Horacio Kaufmann
- Department of Neurology, Dysautonomia Center, New York University School of Medicine, New York, USA
| | - Klaus Seppi
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Werner Poewe
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gregor K Wenning
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
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39
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Meissner WG, Fernagut PO, Dehay B, Péran P, Traon APL, Foubert-Samier A, Lopez Cuina M, Bezard E, Tison F, Rascol O. Multiple System Atrophy: Recent Developments and Future Perspectives. Mov Disord 2019; 34:1629-1642. [PMID: 31692132 DOI: 10.1002/mds.27894] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/03/2019] [Accepted: 09/15/2019] [Indexed: 02/06/2023] Open
Abstract
Multiple system atrophy (MSA) is a rare and fatal neurodegenerative disorder characterized by a variable combination of parkinsonism, cerebellar impairment, and autonomic dysfunction. The pathologic hallmark is the accumulation of aggregated α-synuclein in oligodendrocytes, forming glial cytoplasmic inclusions, which qualifies MSA as a synucleinopathy together with Parkinson's disease and dementia with Lewy bodies. The underlying pathogenesis is still not well understood. Some symptomatic treatments are available, whereas neuroprotection remains an urgent unmet treatment need. In this review, we critically appraise significant developments of the past decade with emphasis on pathogenesis, diagnosis, prognosis, and treatment development. We further discuss unsolved questions and highlight some perspectives. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Wassilios G Meissner
- CRMR Atrophie Multisystématisée, CHU Bordeaux, Service de Neurologie, Bordeaux, France.,Institut des Maladies Neurodégénératives, Univ. de Bordeaux, Bordeaux, France.,CNRS, Institut des Maladies Neurodégénératives, Bordeaux, France.,Dept. of Medicine, University of Otago, Christchurch, New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Pierre-Olivier Fernagut
- Institut des Maladies Neurodégénératives, Univ. de Bordeaux, Bordeaux, France.,CNRS, Institut des Maladies Neurodégénératives, Bordeaux, France.,Laboratoire de Neurosciences Expérimentales et Cliniques, Université de Poitiers, Poitiers, France.,INSERM, Laboratoire de Neurosciences Expérimentales et Cliniques, Poitiers, France
| | - Benjamin Dehay
- Institut des Maladies Neurodégénératives, Univ. de Bordeaux, Bordeaux, France.,CNRS, Institut des Maladies Neurodégénératives, Bordeaux, France
| | - Patrice Péran
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Toulouse, France
| | - Anne Pavy-Le Traon
- Services de Neurologie, CRMR Atrophie Multisystématisée, Toulouse, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France
| | - Alexandra Foubert-Samier
- CRMR Atrophie Multisystématisée, CHU Bordeaux, Service de Neurologie, Bordeaux, France.,Institut des Maladies Neurodégénératives, Univ. de Bordeaux, Bordeaux, France.,Inserm, Bordeaux Population Health Research Center, Bordeaux University, Bordeaux, France
| | - Miguel Lopez Cuina
- Institut des Maladies Neurodégénératives, Univ. de Bordeaux, Bordeaux, France.,CNRS, Institut des Maladies Neurodégénératives, Bordeaux, France
| | - Erwan Bezard
- Institut des Maladies Neurodégénératives, Univ. de Bordeaux, Bordeaux, France.,CNRS, Institut des Maladies Neurodégénératives, Bordeaux, France
| | - François Tison
- CRMR Atrophie Multisystématisée, CHU Bordeaux, Service de Neurologie, Bordeaux, France.,Institut des Maladies Neurodégénératives, Univ. de Bordeaux, Bordeaux, France.,CNRS, Institut des Maladies Neurodégénératives, Bordeaux, France
| | - Olivier Rascol
- Services de Neurologie et de Pharmacologie Clinique, Centre de Reference AMS, Centre d'Investigation Clinique, Réseau NS-Park/FCRIN et Centre of Excellence for Neurodegenerative Disorders (COEN) de Toulouse, CHU de Toulouse, Toulouse 3 University, Toulouse, France
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40
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Tonda-Turo C, Origlia N, Mattu C, Accorroni A, Chiono V. Current Limitations in the Treatment of Parkinson's and Alzheimer's Diseases: State-of-the-Art and Future Perspective of Polymeric Carriers. Curr Med Chem 2019; 25:5755-5771. [PMID: 29473493 DOI: 10.2174/0929867325666180221125759] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 09/18/2017] [Accepted: 02/06/2018] [Indexed: 12/18/2022]
Abstract
Alzheimer's and Parkinson's diseases are the most common neurodegenerative diseases worldwide and their incidence is increasing due to the aging population. At the moment, the available therapies are not disease modifying and have several limitations, some of which are discussed in this review. One of the main limitations of these treatments is the low concentration that drugs reach in the central nervous system after systemic administration. Indeed, the presence of biological barriers, particularly the blood-brain barrier (BBB), hinders the effective drug delivery to the brain, reducing the potential benefit coming from the administration of the medication. In this review, the mechanisms of transport across the BBB and new methods to improve drug passage across the BBB are discussed. These methods include non-invasive solutions such as intranasal and intravitreal administration, and the use of nanotechnology solutions based on polymeric carriers when the drug is intravenously injected, orally taken for intestine adsorption or delivered through the dermal mucosa. Also, it provides an analysis of more invasive solutions that include intracranially injected hydrogels and implanted devices for local drug delivery. Efforts in finding new therapeutic drugs blocking neurodegenerative disease progression or reverting their course should be coupled with efforts addressed to efficient drug delivery systems. Hence, new pharmacology discoveries together with advancements in nanotechnologies and biomaterials for regenerative medicine are required to effectively counteract neurodegenerative diseases.
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Affiliation(s)
- Chiara Tonda-Turo
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, 10129 Turin, Italy
| | - Nicola Origlia
- CNR, Neuroscience Institute Via G. Moruzzi 1, 56124 Pisa, Italy
| | - Clara Mattu
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, 10129 Turin, Italy
| | - Alice Accorroni
- CNR, Neuroscience Institute Via G. Moruzzi 1, 56124 Pisa, Italy.,Institute of Life Sciences, Scuola Superiore Sant'Anna, 56127 Pisa, Italy
| | - Valeria Chiono
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, 10129 Turin, Italy
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Segregation and potential functional impact of a rare stop-gain PABPC4L variant in familial atypical Parkinsonism. Sci Rep 2019; 9:13576. [PMID: 31537871 PMCID: PMC6753086 DOI: 10.1038/s41598-019-50102-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 09/03/2019] [Indexed: 01/23/2023] Open
Abstract
Atypical parkinsonian disorders (APDs) comprise a group of neurodegenerative diseases with heterogeneous clinical and pathological features. Most APDs are sporadic, but rare familial forms have also been reported. Epidemiological and post-mortem studies associated APDs with oxidative stress and cellular protein aggregates. Identifying molecular mechanisms that translate stress into toxic protein aggregation and neurodegeneration in APDs is an active area of research. Recently, ribonucleic acid (RNA) stress granule (SG) pathways were discussed to be pathogenically relevant in several neurodegenerative disorders including APDs. Using whole genome sequencing, mRNA expression analysis, transfection assays and cell imaging, we investigated the genetic and molecular basis of a familial neurodegenerative atypical parkinsonian disorder. We investigated a family with six living members in two generations exhibiting clinical symptoms consistent with atypical parkinsonism. Two affected family members suffered from parkinsonism that was associated with ataxia. Magnetic resonance imaging (MRI) of these patients showed brainstem and cerebellar atrophy. Whole genome sequencing identified a heterozygous stop-gain variant (c.C811T; p.R271X) in the Poly(A) binding protein, cytoplasmic 4-like (PABPC4L) gene, which co-segregated with the disease in the family. In situ hybridization showed that the murine pabpc4l is expressed in several brain regions and in particular in the cerebellum and brainstem. To determine the functional impact of the stop-gain variant in the PABPC4L gene, we investigated the subcellular localization of PABPC4L in heterologous cells. Wild-type PABPC4L protein localized predominantly to the cell nucleus, in contrast to the truncated protein encoded by the stop-gain variant p.R271X, which was found homogeneously throughout the cell. Interestingly, the wild-type, but not the truncated protein localized to RasGAP SH3 domain Binding Protein (G3BP)-labeled cytoplasmic granules in response to oxidative stress induction. This suggests that the PABPC4L variant alters intracellular distribution and possibly the stress granule associated function of the protein, which may underlie APD in this family. In conclusion, we present genetic and molecular evidence supporting the role of a stop-gain PABPC4L variant in a rare familial APD. Our data shows that the variant results in cellular mislocalization and inability of the protein to associate with stress granules.
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Urso D, Monje MHG, Piredda R, Ortu R, Pineda-Pardo JA, Martínez-Fernández R, Sechi G. Clinical Reasoning: A 58-year-old man with hand tremor and episodes of neck pain. Neurology 2019; 93:557-561. [PMID: 31527099 DOI: 10.1212/wnl.0000000000008130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Daniele Urso
- From the Department of Neurology, (D.U., R.P., R.O., G.P.S.), University of Sassari, Italy; University Hospital HM (M.H.G.M., J.A.P.P, R.M.F), CINAC, Madrid, Spain; and Neurodegeneration Imaging Group (D.U.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
| | - Mariana H G Monje
- From the Department of Neurology, (D.U., R.P., R.O., G.P.S.), University of Sassari, Italy; University Hospital HM (M.H.G.M., J.A.P.P, R.M.F), CINAC, Madrid, Spain; and Neurodegeneration Imaging Group (D.U.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Rosanna Piredda
- From the Department of Neurology, (D.U., R.P., R.O., G.P.S.), University of Sassari, Italy; University Hospital HM (M.H.G.M., J.A.P.P, R.M.F), CINAC, Madrid, Spain; and Neurodegeneration Imaging Group (D.U.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Renato Ortu
- From the Department of Neurology, (D.U., R.P., R.O., G.P.S.), University of Sassari, Italy; University Hospital HM (M.H.G.M., J.A.P.P, R.M.F), CINAC, Madrid, Spain; and Neurodegeneration Imaging Group (D.U.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - José A Pineda-Pardo
- From the Department of Neurology, (D.U., R.P., R.O., G.P.S.), University of Sassari, Italy; University Hospital HM (M.H.G.M., J.A.P.P, R.M.F), CINAC, Madrid, Spain; and Neurodegeneration Imaging Group (D.U.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Raul Martínez-Fernández
- From the Department of Neurology, (D.U., R.P., R.O., G.P.S.), University of Sassari, Italy; University Hospital HM (M.H.G.M., J.A.P.P, R.M.F), CINAC, Madrid, Spain; and Neurodegeneration Imaging Group (D.U.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - GianPietro Sechi
- From the Department of Neurology, (D.U., R.P., R.O., G.P.S.), University of Sassari, Italy; University Hospital HM (M.H.G.M., J.A.P.P, R.M.F), CINAC, Madrid, Spain; and Neurodegeneration Imaging Group (D.U.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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Jabbari E, Woodside J, Tan MMX, Pavese N, Bandmann O, Ghosh BCP, Massey LA, Capps E, Warner TT, Lees AJ, Revesz T, Holton JL, Williams NM, Grosset DG, Morris HR. The genetic and clinico-pathological profile of early-onset progressive supranuclear palsy. Mov Disord 2019; 34:1307-1314. [PMID: 31299107 PMCID: PMC6790973 DOI: 10.1002/mds.27786] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/05/2019] [Accepted: 06/13/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Studies on early-onset presentations of progressive supranuclear palsy (PSP) have been limited to those where a rare monogenic cause has been identified. Here, we have defined early-onset PSP (EOPSP) and investigated its genetic and clinico-pathological profile in comparison with late-onset PSP (LOPSP) and Parkinson's disease (PD). METHODS We included subjects from the Queen Square Brain Bank, PROSPECT-UK study, and Tracking Parkinson's study. Group comparisons of data were made using Welch's t-test and Kruskal-Wallis analysis of variance. EOPSP was defined as the youngest decile of motor age at onset (≤55 years) in the Queen Square Brain Bank PSP case series. RESULTS We identified 33 EOPSP, 328 LOPSP, and 2000 PD subjects. The early clinical features of EOPSP usually involve limb parkinsonism and gait freezing, with 50% of cases initially misdiagnosed as having PD. We found that an initial clinical diagnosis of EOPSP had lower diagnostic sensitivity (33%) and positive predictive value (38%) in comparison with LOPSP (80% and 76%) using a postmortem diagnosis of PSP as the gold standard. 3/33 (9%) of the EOPSP group had an underlying monogenic cause. Using a PSP genetic risk score (GRS), we showed that the genetic risk burden in the EOPSP (mean z-score, 0.59) and LOPSP (mean z-score, 0.48) groups was significantly higher (P < 0.05) when compared with the PD group (mean z-score, -0.08). CONCLUSIONS The initial clinical profile of EOPSP is often PD-like. At the group level, a PSP GRS was able to differentiate EOPSP from PD, and this may be helpful in future diagnostic algorithms. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Edwin Jabbari
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom.,Movement Disorders Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - John Woodside
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom.,Movement Disorders Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Manuela M X Tan
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom.,Movement Disorders Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Nicola Pavese
- Division of Neuroscience, Newcastle University, Newcastle, United Kingdom
| | - Oliver Bandmann
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, United Kingdom
| | - Boyd C P Ghosh
- Wessex Neurological Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Luke A Massey
- Department of Neurology, Poole Hospital NHS Foundation Trust, Poole, United Kingdom
| | - Erica Capps
- Care of the Elderly Department, Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, United Kingdom
| | - Tom T Warner
- Reta Lila Weston Institute, UCL Queen Square Institute of Neurology, London, United Kingdom.,Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Andrew J Lees
- Reta Lila Weston Institute, UCL Queen Square Institute of Neurology, London, United Kingdom.,Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Tamas Revesz
- Reta Lila Weston Institute, UCL Queen Square Institute of Neurology, London, United Kingdom.,Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Janice L Holton
- Reta Lila Weston Institute, UCL Queen Square Institute of Neurology, London, United Kingdom.,Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Nigel M Williams
- Institute of Psychological Medicine and Clinical Neurosciences, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - Donald G Grosset
- Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Huw R Morris
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom.,Movement Disorders Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
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44
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Latorre A, Del Gamba C, Menozzi E, Balint B, Brugger F, Bhatia KP. Abnormal DaTSCAN and Atypical Parkinsonism in SCA12. Mov Disord Clin Pract 2019; 6:400-402. [PMID: 31286011 DOI: 10.1002/mdc3.12751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 01/07/2019] [Accepted: 01/27/2019] [Indexed: 01/26/2023] Open
Affiliation(s)
- Anna Latorre
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom.,Department of Human Neurosciences Sapienza University of Rome Rome Italy
| | - Claudia Del Gamba
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom.,Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Elisa Menozzi
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom.,Department of Biomedical, Metabolic, and Neural Sciences University of Modena and Reggio Emilia Modena Italy
| | - Bettina Balint
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom.,Department of Neurology University Hospital Heidelberg Heidelberg Germany
| | - Florian Brugger
- Department of Neurology Kantonsspital St. Gallen St. Gallen Switzerland
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom
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Stankovic I, Quinn N, Vignatelli L, Antonini A, Berg D, Coon E, Cortelli P, Fanciulli A, Ferreira JJ, Freeman R, Halliday G, Höglinger GU, Iodice V, Kaufmann H, Klockgether T, Kostic V, Krismer F, Lang A, Levin J, Low P, Mathias C, Meissner WG, Kaufmann LN, Palma JA, Panicker JN, Pellecchia MT, Sakakibara R, Schmahmann J, Scholz SW, Singer W, Stamelou M, Tolosa E, Tsuji S, Seppi K, Poewe W, Wenning GK. A critique of the second consensus criteria for multiple system atrophy. Mov Disord 2019; 34:975-984. [PMID: 31034671 DOI: 10.1002/mds.27701] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/02/2019] [Accepted: 04/01/2019] [Indexed: 01/16/2023] Open
Affiliation(s)
- Iva Stankovic
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia.,Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Niall Quinn
- University College London, Institute of Neurology, Queen Square, London, UK
| | - Luca Vignatelli
- Istituto di Ricovero e Cura a Carattere Scientifico, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Angelo Antonini
- Department of Neuroscience, University of Padua, Padua, Italy
| | - Daniela Berg
- Department of Neurology, Christian Albrecht University, Kiel, Germany.,Hertie Institute for Clinical Brain Research Tübingen, Tübingen, Germany
| | - Elizabeth Coon
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Pietro Cortelli
- Istituto di Ricovero e Cura a Carattere Scientifico, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Dipartimento Scienze Biomediche e Neuromotorie, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Joaquim J Ferreira
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Roy Freeman
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Glenda Halliday
- Brain and Mind Centre, Sydney Medical School, University of Sydney, Camperdown, Australia; School of Medical Sciences, University of New South Wales, Wales, Kensington, Australia; and Neuroscience Research Australia, Randwick, Australia
| | - Günter U Höglinger
- Department of Neurology, Technische Universität München, and German Center for Neurodegenerative Diseases, München, Germany
| | - Valeria Iodice
- Autonomic Unit, National Hospital for Neurology and Neurosurgery, Queen Square/Division of Clinical Neurology, Institute of Neurology, University College London, London, UK
| | - Horacio Kaufmann
- Dysautonomia Center, Langone Medical Center, New York University School of Medicine, New York, New York, USA
| | - Thomas Klockgether
- Department of Neurology, University of Bonn, and German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Vladimir Kostic
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Florian Krismer
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Anthony Lang
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-Universität München, and German Center for Neurodegenerative Diseases, München, Germany
| | - Phillip Low
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Christopher Mathias
- Autonomic and Neurovascular Medicine Centre, Hospital of St John & St Elizabeth, London, UK.,Lindo Wing, Imperial College Healthcare National Health Service Trust, St Mary's Hospital, London, UK.,Queen Square Institute of Neurology, University College London, London, UK
| | - Wassillios G Meissner
- French Reference Center for MSA, Department of Neurology, University Hospital Bordeaux, Bordeaux, France.,Institute of Neurodegenerative Disorders, University Bordeaux, Bordeaux, France
| | - Lucy Norcliffe Kaufmann
- Dysautonomia Center, Langone Medical Center, New York University School of Medicine, New York, New York, USA
| | - Jose-Alberto Palma
- Dysautonomia Center, Langone Medical Center, New York University School of Medicine, New York, New York, USA
| | - Jalesh N Panicker
- University College London, Institute of Neurology, Queen Square, London, UK.,Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Maria Teresa Pellecchia
- Center for Neurodegenerative Diseases, Department of Medicine and Surgery, Neuroscience Section, University of Salerno, Fisciano, Italy
| | - Ryuji Sakakibara
- Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan
| | - Jeremy Schmahmann
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sonja W Scholz
- Neurodegenerative Diseases Research Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA.,Department of Neurology, Johns Hopkins University Medical Center, Baltimore, Maryland, USA
| | - Wolfgang Singer
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Maria Stamelou
- HYGEIA Hospital, Athens, Greece, Neurology Clinic, University Marburg, Marburg, Germany.,Department of Neurology, University of Athens, Athens, Greece
| | - Eduardo Tolosa
- Neurology Service, Hospital Clinic de Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain
| | - Shoji Tsuji
- Department of Molecular Neurology, The University of Tokyo, Graduate School of Medicine, Tokyo, Japan.,International University of Health and Welfare, Chiba, Japan
| | - Klaus Seppi
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Werner Poewe
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Gregor K Wenning
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
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Moretti DV. Available and future treatments for atypical parkinsonism. A systematic review. CNS Neurosci Ther 2019; 25:159-174. [PMID: 30294976 PMCID: PMC6488913 DOI: 10.1111/cns.13068] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/01/2018] [Accepted: 09/05/2018] [Indexed: 01/02/2023] Open
Abstract
AIMS Success in treating patients with atypical parkinsonian syndromes, namely progressive supranuclear palsy (PSP), cortico-basal degeneration (CBD), multiple system atrophy (MSA), Parkinson's disease with dementia (PDD), and Lewy body dementia with (LBD), remains exceedingly low. The present work overviews the most influential research literature collected on MEDLINE, ISI Web of Science, Cochrane Library, and Scopus for available treatment in atypical parkinsonisms without time restriction. DISCUSSION Transdermal rotigotine, autologous mesenchymal stem cells, tideglusib, and coenzyme Q10 along with donepezil, rivastigmine, memantine, and the deep brain stimulation have shown some benefits in alleviating symptoms in APS. Moreover, many new clinical trials are ongoing testing microtubule stabilizer, antitau monoclonal antibody, tau acetylation inhibition, cell replacement, selective serotonin reuptake inhibitor, active immunization, inhibition of toxic α-synuclein oligomers formation, and inhibition of microglia. CONCLUSION A detailed knowledge of the pathological mechanism underlying the disorders is needed, and disease-modifying therapies are required to offer better therapeutic options to physician and caregivers of APS patients.
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Batla A, De Pablo-Fernandez E, Erro R, Reich M, Calandra-Buonaura G, Barbosa P, Balint B, Ling H, Islam S, Cortelli P, Volkmann J, Quinn N, Holton JL, Warner TT, Bhatia KP. Young-onset multiple system atrophy: Clinical and pathological features. Mov Disord 2018; 33:1099-1107. [DOI: 10.1002/mds.27450] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 02/19/2018] [Accepted: 04/19/2018] [Indexed: 01/07/2023] Open
Affiliation(s)
- Amit Batla
- University College London (UCL) Institute of Neurology; London UK
| | - Eduardo De Pablo-Fernandez
- Reta Lila Weston Institute of Neurological Studies; UCL Institute of Neurology; London UK
- Queen Square Brain Bank for Neurological Disorders, UCL Institute of Neurology; London UK
| | - Roberto Erro
- University College London (UCL) Institute of Neurology; London UK
- Center for Neurodegenerative diseases, Department of Medicine, Surgery and Dentistry; University of Salerno; Salerno Italy
| | - Martin Reich
- Department of Neurology; University Clinic of Würzburg; Würzburg Germany
| | - Giovanna Calandra-Buonaura
- Istituti di Ricovero e Cura a Carattere. Scientifico (IRCCS) Institute of Science and Neurology of Bologna; Bologna Italy
- Department of Biomedical and Neuromotor Sciences; University of Bologna; Bologna Italy
| | - Pedro Barbosa
- Reta Lila Weston Institute of Neurological Studies; UCL Institute of Neurology; London UK
- Queen Square Brain Bank for Neurological Disorders, UCL Institute of Neurology; London UK
| | - Bettina Balint
- University College London (UCL) Institute of Neurology; London UK
- Department of Neurology; University Hospital Heidelberg; Heidelberg Germany
| | - Helen Ling
- Reta Lila Weston Institute of Neurological Studies; UCL Institute of Neurology; London UK
- Queen Square Brain Bank for Neurological Disorders, UCL Institute of Neurology; London UK
| | | | - Pietro Cortelli
- Istituti di Ricovero e Cura a Carattere. Scientifico (IRCCS) Institute of Science and Neurology of Bologna; Bologna Italy
- Department of Biomedical and Neuromotor Sciences; University of Bologna; Bologna Italy
| | - Jens Volkmann
- Department of Neurology; University Clinic of Würzburg; Würzburg Germany
| | - Niall Quinn
- National Hospital for Neurology and Neurosurgery; London UK
| | - Janice L. Holton
- Reta Lila Weston Institute of Neurological Studies; UCL Institute of Neurology; London UK
- Queen Square Brain Bank for Neurological Disorders, UCL Institute of Neurology; London UK
- Department of Molecular Neuroscience, UCL Institute of Neurology; University College London; London UK
| | - Thomas T. Warner
- Reta Lila Weston Institute of Neurological Studies; UCL Institute of Neurology; London UK
- Queen Square Brain Bank for Neurological Disorders, UCL Institute of Neurology; London UK
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48
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Di Fonzo A, Monfrini E, Erro R. Genetics of Movement Disorders and the Practicing Clinician; Who and What to Test for? Curr Neurol Neurosci Rep 2018; 18:37. [PMID: 29789954 DOI: 10.1007/s11910-018-0847-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW This review aims to provide the basic knowledge on the genetics of hypokinetic and hyperkinetic movement disorders to guide clinicians in the decision of "who and what to test for?" RECENT FINDINGS In recent years, the identification of various genetic causes of hypokinetic and hyperkinetic movement disorders has had a great impact on a better definition of different clinical syndromes. Indeed, the advent of next-generation sequencing (NGS) techniques has provided an impressive step forward in the easy identification of genetic forms. However, this increased availability of genetic testing has challenges, including the ethical issue of genetic testing in unaffected family members, "commercially" available home testing kits and the increasing number and relevance of "variants of unknown significance." The emergent role of genetic factors has important implications on clinical practice and counseling. As a consequence, it is fundamental that practicing neurologists have a proper knowledge of the genetic background of the diseases and perform an accurate selection of who has to be tested and for which gene mutations.
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Affiliation(s)
- Alessio Di Fonzo
- IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Edoardo Monfrini
- IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Roberto Erro
- Neurodegenerative disease center (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, SA, Italy.
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Yabe I, Yaguchi H, Kato Y, Miki Y, Takahashi H, Tanikawa S, Shirai S, Takahashi I, Kimura M, Hama Y, Matsushima M, Fujioka S, Kano T, Watanabe M, Nakagawa S, Kunieda Y, Ikeda Y, Hasegawa M, Nishihara H, Ohtsuka T, Tanaka S, Tsuboi Y, Hatakeyama S, Wakabayashi K, Sasaki H. Mutations in bassoon in individuals with familial and sporadic progressive supranuclear palsy-like syndrome. Sci Rep 2018; 8:819. [PMID: 29339765 PMCID: PMC5770378 DOI: 10.1038/s41598-018-19198-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 12/27/2017] [Indexed: 12/21/2022] Open
Abstract
Clinical diagnosis of progressive supranuclear palsy (PSP) is sometimes difficult because various phenotypes have been identified. Here, we report a mutation in the bassoon (BSN) gene in a family with PSP-like syndrome. Their clinical features resembled not only those of PSP patients but also those of individuals with multiple system atrophy and Alzheimer's disease. The neuropathological findings showed a novel three + four repeat tauopathy with pallido-luysio-nigral degeneration and hippocampal sclerosis. Whole-exome analysis of this family identified a novel missense mutation in BSN. Within the pedigree, the detected BSN mutation was found only in affected individuals. Further genetic analyses were conducted in probands from four other pedigrees with PSP-like syndrome and in 41 sporadic cases. Three missense mutations in BSN that are very rarely listed in databases of healthy subjects were found in four sporadic cases. Western blot analysis of tau following the overexpression of wild-type or mutated BSN revealed the possibility that wild-type BSN reduced tau accumulation, while mutated BSN lost this function. An association between BSN and neurological diseases has not been previously reported. Our results revealed that the neurodegenerative disorder associated with the original proband's pedigree is a novel tauopathy, differing from known dementia and parkinsonism syndromes, including PSP.
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Affiliation(s)
- Ichiro Yabe
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
| | - Hiroaki Yaguchi
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.,Department of Biochemistry, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yasutaka Kato
- Department of Cancer Pathology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.,Laboratory of Oncology, Hokuto Hospital, Obihiro, Japan
| | - Yasuo Miki
- Department of Neuropathology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hidehisa Takahashi
- Department of Biochemistry, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoshi Tanikawa
- Department of Cancer Pathology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shinichi Shirai
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ikuko Takahashi
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Mari Kimura
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yuka Hama
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Masaaki Matsushima
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shinsuke Fujioka
- Department of Neurology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Takahiro Kano
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Masashi Watanabe
- Department of Biochemistry, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shin Nakagawa
- Department of Psychiatry, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | | | - Yoshio Ikeda
- Department of Neurology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Masato Hasegawa
- Department of Dementia and Higher Brain Function, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Hiroshi Nishihara
- Department of Cancer Pathology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.,Division of Clinical Cancer Genomics, Cancer Center, Keio University School of Medicine, Tokyo, Japan
| | - Toshihisa Ohtsuka
- Department of Biochemistry, Faculty of Medicine/Graduate School of Medicine, University of Yamanashi, Chuo, Japan
| | - Shinya Tanaka
- Department of Cancer Pathology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.,Global Station for Soft Matter, Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Shigetsugu Hatakeyama
- Department of Biochemistry, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Koichi Wakabayashi
- Department of Neuropathology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hidenao Sasaki
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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Abstract
Multiple system atrophy (MSA) is an orphan, fatal, adult-onset neurodegenerative disorder of uncertain etiology that is clinically characterized by various combinations of parkinsonism, cerebellar, autonomic, and motor dysfunction. MSA is an α-synucleinopathy with specific glioneuronal degeneration involving striatonigral, olivopontocerebellar, and autonomic nervous systems but also other parts of the central and peripheral nervous systems. The major clinical variants correlate with the morphologic phenotypes of striatonigral degeneration (MSA-P) and olivopontocerebellar atrophy (MSA-C). While our knowledge of the molecular pathogenesis of this devastating disease is still incomplete, updated consensus criteria and combined fluid and imaging biomarkers have increased its diagnostic accuracy. The neuropathologic hallmark of this unique proteinopathy is the deposition of aberrant α-synuclein in both glia (mainly oligodendroglia) and neurons forming glial and neuronal cytoplasmic inclusions that cause cell dysfunction and demise. In addition, there is widespread demyelination, the pathogenesis of which is not fully understood. The pathogenesis of MSA is characterized by propagation of misfolded α-synuclein from neurons to oligodendroglia and cell-to-cell spreading in a "prion-like" manner, oxidative stress, proteasomal and mitochondrial dysfunction, dysregulation of myelin lipids, decreased neurotrophic factors, neuroinflammation, and energy failure. The combination of these mechanisms finally results in a system-specific pattern of neurodegeneration and a multisystem involvement that are specific for MSA. Despite several pharmacological approaches in MSA models, addressing these pathogenic mechanisms, no effective neuroprotective nor disease-modifying therapeutic strategies are currently available. Multidisciplinary research to elucidate the genetic and molecular background of the deleterious cycle of noxious processes, to develop reliable biomarkers and targets for effective treatment of this hitherto incurable disorder is urgently needed.
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