1
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Vázquez-Mojena Y, Rodríguez-Córdova Y, Dominguez-Barrios Y, León-Arcia K, Miranda-Becerra D, Gonzalez-Zaldivar Y, Guerra-Bustillos G, Ziemann U, Auburger G, Rodríguez-Labrada R, Robinson-Agramonte MDLÁ, Velázquez-Pérez L. Peripheral Inflammation Links with the Severity of Clinical Phenotype in Spinocerebellar Ataxia 2. Mov Disord 2023. [PMID: 36811296 DOI: 10.1002/mds.29359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/20/2023] [Accepted: 02/03/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND The role of peripheral inflammation in spinocerebellar ataxia type 2 (SCA2) is unknown. OBJECTIVE The objective of this study was to identify peripheral inflammation biomarkers and their relationship with the clinical and molecular features. METHODS Blood cell count-derived inflammatory indices were measured in 39 SCA2 subjects and their matched controls. Clinical scores of ataxia, nonataxia, and cognitive dysfunction were assessed. RESULTS The neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the Systemic Inflammation Index (SII), and the Aggregate Index of Systemic Inflammation (AISI) were significantly increased in SCA2 subjects compared with controls. The increases in PLR, SII, and AISI were even observed in preclinical carriers. NLR, PLR, and SII were correlated with the Scale for the Assessment and Rating of Ataxia speech item score rather than with the total score. The NLR and SII were correlated with the nonataxia and the cognitive scores. CONCLUSIONS Peripheral inflammatory indices are biomarkers in SCA2, which may help to design future immunomodulatory trials and advance our understanding of the disease. © 2023 International Parkinson and Movement Disorder Society.
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Affiliation(s)
| | | | | | - Karen León-Arcia
- Department of Molecular Biology, Cuban Centre for Neuroscience, Havana, Cuba
| | - David Miranda-Becerra
- Department of Educational Neurosciences, Cuban Centre for Neuroscience, Havana, Cuba
| | - Yanetza Gonzalez-Zaldivar
- Molecular Genetics Department, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguin, Cuba
| | | | - Ulf Ziemann
- Department of Neurology and Stroke, Eberhard-Karls University of Tübingen, Tübingen, Germany.,Department Neurology and Stroke, Hertie-Institute for Clinical Brain Research, Eberhard-Karls University of Tübingen, Tübingen, Germany
| | - Georg Auburger
- Experimental Neurology, Faculty of Medicine, Goethe University, Frankfurt, Germany
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2
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Malek N, Makawita C, Al‐Sami Y, Aslanyan A, de Silva R. A Systematic Review of the Spectrum and Prevalence of Non-Motor Symptoms in Adults with Hereditary Cerebellar Ataxias. Mov Disord Clin Pract 2022; 9:1027-1039. [PMID: 36339305 PMCID: PMC9631846 DOI: 10.1002/mdc3.13532] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 07/11/2022] [Accepted: 07/19/2022] [Indexed: 11/09/2022] Open
Abstract
Background Cerebellar ataxias comprise a large group of heterogeneous disorders with both motor and non-motor symptoms (NMS). Objective We wanted to ascertain the reported prevalence of NMS in different subtypes of hereditary cerebellar ataxias. Methods Systematic review of studies of hereditary cerebellar ataxias (involving >5 patients) who were assessed for NMS, published in the English literature in PUBMED and EMBASE databases from 1947 to 2021. Results A total of 35 papers, with data from 1311 autosomal dominant spinocerebellar ataxia (SCA), 893 autosomal recessive cerebellar ataxia (ARCA), and 53 X-linked ataxia cases were included with a total of 450 controls. Mean age for SCA cases at diagnosis was 47.6 (SD, 14.9) years, for ARCA cases was 34.6 (SD, 14.7) years and for X-linked ataxia cases was 68.6 (9.1) years. The prevalence of cognitive problems in SCAs was between 23% and 75% (ranging from mild to severe), being least prevalent in SCA6. The prevalence of depression in SCAs was between 13% and 69% and sleep disorders were between 7% and 80%. Pain was reported by 18% to 60% of patients, especially in SCA3, and fatigue by 53% to 70%. The prevalence of reported cognitive dysfunction in ARCA was 12.5% to 100% and depression between 14% and 51%. The prevalence of anxiety in X-linked ataxias (FXTAS) was 17 % and depression 55%. Conclusions The presence of NMS in hereditary cerebellar ataxias is common. The prevalence and spectrum of NMS in SCAs, ARCAs, and X-linked ataxias vary. In routine clinical practice, NMS in cerebellar ataxias are under-recognized and certainly under-reported. Therefore, they are unlikely to be addressed adequately. Improved ascertainment of NMS in cerebellar ataxias in clinical practice will enable holistic treatment of these patients.
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Affiliation(s)
- Naveed Malek
- Department of NeurologyQueen's HospitalEssexUnited Kingdom
| | | | - Yaqub Al‐Sami
- Department of NeurologyQueen's HospitalEssexUnited Kingdom
| | - Aram Aslanyan
- Department of NeurologyQueen's HospitalEssexUnited Kingdom
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3
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Velázquez-Pérez L, Rodríguez-Labrada R, González-Garcés Y, Vázquez-Mojena Y, Pérez-Rodríguez R, Ziemann U. Neurophysiological features in spinocerebellar ataxia type 2: Prospects for novel biomarkers. Clin Neurophysiol 2021; 135:1-12. [PMID: 34998091 DOI: 10.1016/j.clinph.2021.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/05/2021] [Accepted: 12/13/2021] [Indexed: 12/12/2022]
Abstract
Electrophysiological biomarkers are useful to assess the degeneration and progression of the nervous system in pre-ataxic and ataxic stages of the Spinocerebellar Ataxia Type 2 (SCA2). These biomarkers are essentially defined by their clinical significance, discriminating patients and/or preclinical subjects from healthy controls in cross-sectional studies, their significant changes over time in longitudinal studies, and their correlation with the cytosine-guanine-adenine (CAG) repeat expansion and/or clinical ataxia scores, time of evolution and time to ataxia onset. We classified electrophysiological biomarkers into three main types: (1) preclinical, (2) disease progression and (3) genetic damage. We review the data that identify sural nerve potential amplitude, maximum saccadic velocity, sleep efficiency, rapid eye movement (REM) sleep percentage, K-complex density, REM sleep without atonia percentage, corticomuscular coherence, central motor conduction time, visual P300 latency, and antisaccadic error correction latency as reliable preclinical, progression and/or genetic damage biomarkers of SCA2. These electrophysiological biomarkers will facilitate the conduction of clinical trials that test the efficacy of emerging treatments in SCA2.
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Affiliation(s)
- Luis Velázquez-Pérez
- Cuban Academy of Sciences, Cuba st 460, Between Amargura and Teniente Rey, La Habana Vieja, La Habana, Cuba; Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad st 26, Between 12th and 16th Streets, Holguín, Cuba.
| | | | - Yasmany González-Garcés
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad st 26, Between 12th and 16th Streets, Holguín, Cuba
| | | | - Roberto Pérez-Rodríguez
- Machine Learning Department, Holguin University, Ave Celia Sánchez Between Ave de los Internacionalistas y Final, Hilda Torres, Holguín, Cuba
| | - Ulf Ziemann
- Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany; Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
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4
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Kim DH, Kim R, Lee JY, Lee KM. Clinical, Imaging, and Laboratory Markers of Premanifest Spinocerebellar Ataxia 1, 2, 3, and 6: A Systematic Review. J Clin Neurol 2021; 17:187-199. [PMID: 33835738 PMCID: PMC8053554 DOI: 10.3988/jcn.2021.17.2.187] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 12/26/2022] Open
Abstract
Background and Purpose Premanifest mutation carriers with spinocerebellar ataxia (SCA) can exhibit subtle abnormalities before developing ataxia. We summarized the preataxic manifestations of SCA1, -2, -3, and -6, and their associations with ataxia onset. Methods We included studies of the premanifest carriers of SCA published between January 1998 and December 2019 identified in Scopus and PubMed by searching for terms including ‘spinocerebellar ataxia’ and several synonyms of ‘preataxic manifestation’. We systematically reviewed the results obtained in studies categorized based on clinical, imaging, and laboratory markers. Results We finally performed a qualitative analysis of 48 papers. Common preataxic manifestations appearing in multiple SCA subtypes were muscle cramps, abnormal muscle reflexes, instability in gait and posture, lower Composite Cerebellar Functional Severity scores, abnormalities in video-oculography and transcranial magnetic stimulation, and gray-matter loss and volume reduction in the brainstem and cerebellar structures. Also, decreased sensory amplitudes in nerve conduction studies were observed in SCA2. Eotaxin and neurofilament light-chain levels were revealed as sensitive blood biomarkers in SCA3. Concerning potential predictive markers, hyporeflexia and abnormalities of somatosensory evoked potentials showed correlations with the time to ataxia onset in SCA2 carriers. However, no longitudinal data were found for the other SCA gene carriers. Conclusions Our results suggest that preataxic manifestations vary among SCA1, -2, -3, and -6, with some subtypes sharing specific features. Combining various markers into a standardized index for premanifest carriers may be useful for early screening and assessing the risk of disease progression in SCA carriers.
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Affiliation(s)
- Dong Hoi Kim
- Seoul National University College of Medicine, Seoul, Korea.,Department of Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Ryul Kim
- Department of Neurology, Inha University Hospital, Incheon, Korea
| | - Jee Young Lee
- Seoul National University College of Medicine, Seoul, Korea.,Department of Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
| | - Kyoung Min Lee
- Seoul National University College of Medicine, Seoul, Korea.,Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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5
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Rodriguez-Graña T, Rodríguez-Labrada R, Santana-Porbén S, Reynaldo-Cejas L, Medrano-Montero J, Canales-Ochoa N, Silva-Ricardo Y, Torres-Vega R, González-Zaldivar Y, Almaguer-Gotay D, Auburger G, Velázquez-Pérez L. Weight loss is correlated with disease severity in Spinocerebellar ataxia type 2: a cross-sectional cohort study. Nutr Neurosci 2021; 25:1747-1755. [PMID: 33687306 DOI: 10.1080/1028415x.2021.1895479] [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: 10/22/2022]
Abstract
BACKGROUND Body weight changes occur frequently during advanced stages of Spinocerebellar Ataxia type 2 (SCA2), nevertheless limited information exists on biomarkers of nutritional status of these patients. OBJECTIVE. To assess changes in surrogate nutritional markers of SCA2 patients; to explore their associations with expanded CAG repeats and disease severity. METHODS One-hundred-thirteen SCA2 patients and 50 healthy controls underwent a comprehensive anthropometrical and biochemical assessment protocol of the nutritional status. Neurological and genotype assessments were also performed. RESULTS A decrease in weight, body mass index (BMI), cutaneous skinfold thickness, fat mass, arm muscle circumference, calf circumference and skeletal muscle mass was observed in SCA2 patients compared to the controls. The total/HDL cholesterol ratio was significantly reduced in patients. BMI was correlated with the age at onset. Overall, anthropometric measures were correlated with clinical markers of disease severity and were more evident in severe and moderate cases. CONCLUSIONS Using anthropometric measures in the assessment of the nutritional status of SCA2 patients might provide hints about pathophysiological mechanisms that underlie metabolic abnormalities in SCA2. Anthropometric are close related with disease severity and progression, and trigger preventive therapies aimed to ameliorate weight loss and wasting in these patients.
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Affiliation(s)
- Tania Rodriguez-Graña
- Centre for the Research and Rehabilitation of Hereditary Ataxias, El Llano, Holguin, Cuba.,Medical University of Holguin, Holguin, Cuba
| | - Roberto Rodríguez-Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, El Llano, Holguin, Cuba.,Cuban Neuroscience Centre, La Havana, Cuba
| | | | - Lorenzo Reynaldo-Cejas
- Centre for the Research and Rehabilitation of Hereditary Ataxias, El Llano, Holguin, Cuba
| | | | - Nalia Canales-Ochoa
- Centre for the Research and Rehabilitation of Hereditary Ataxias, El Llano, Holguin, Cuba
| | | | - Reidenis Torres-Vega
- Centre for the Research and Rehabilitation of Hereditary Ataxias, El Llano, Holguin, Cuba
| | | | - Dennis Almaguer-Gotay
- Centre for the Research and Rehabilitation of Hereditary Ataxias, El Llano, Holguin, Cuba
| | - Georg Auburger
- Exp. Neurology, Medical Faculty, Goethe University, Frankfurt am Main, Germany
| | - Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, El Llano, Holguin, Cuba.,Cuban Academy of Sciences, La Habana, Cuba
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6
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Nigri A, Sarro L, Mongelli A, Pinardi C, Porcu L, Castaldo A, Ferraro S, Grisoli M, Bruzzone MG, Gellera C, Taroni F, Mariotti C, Nanetti L. Progression of Cerebellar Atrophy in Spinocerebellar Ataxia Type 2 Gene Carriers: A Longitudinal MRI Study in Preclinical and Early Disease Stages. Front Neurol 2020; 11:616419. [PMID: 33384659 PMCID: PMC7770103 DOI: 10.3389/fneur.2020.616419] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/17/2020] [Indexed: 12/14/2022] Open
Abstract
Spinocerebellar ataxias type 2 (SCA2) is an autosomal dominant inherited disease caused by expanded trinucleotide repeats (≥32 CAG) within the coding region of ATXN2 gene. Age of disease onset primarily depends on the length of the expanded region. The majority of subjects carrying the mutation remain free of clinical signs for few decades (“pre-symptomatic” stage), but in proximity of disease onset subtle neurophysiological, cognitive, and structural brain imaging changes may occur. Aims of the present study are to determine the time-window in which early clinical and neurodegenerative MRI changes may be identified, and to evaluate the rate of the disease progression in both preclinical and early disease phases. We performed a 1-year longitudinal study in 42 subjects: 14 SCA2 patients (mean age 39 years, disease duration 7 years, SARA score 9 points), 13 presymptomatic SCA2 subjects (preSCA2, mean age 39 years, expected time to disease onset 16 years), and 15 gene-negative healthy controls (mean age 33 years). All participants underwent genetic test, neurological examination, cognitive tests, and brain MRI. Evaluations were repeated at 1-year interval. Baseline MRI evaluations in SCA2 patients showed significant atrophy in cerebellum, brainstem, basal ganglia and cortex compared to controls, while preSCA2 subjects had isolated volume loss in the pons, and cortical thinning in specific frontal and parietal areas, namely rostral-middle-frontal and precuneus. One-year longitudinal follow-up demonstrated, in SCA2 patients, volume reduction in cerebellum, pons, superior cerebellar peduncles, and midbrain, and only in the cerebellum in preSCA2 subjects. No progression in clinical or cognitive measures was observed in preSCA2 subjects. The rate of volume loss in the cerebellum and subcortical regions greatly differed between patients and preSCA2. In conclusion, our pilot study demonstrated that MRI measures are highly sensitive to identify longitudinal structural changes in SCA2 patients, and in preSCA2 up to a decade before expected disease onset. These findings may contribute in the understanding of early neurodegenerative processes and may be useful in future therapeutical trials.
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Affiliation(s)
- Anna Nigri
- Department of Neuroradiology, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Lidia Sarro
- Department of Medical Genetics and Neurogenetics, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy.,Ospedale Martini, Turin, Italy
| | - Alessia Mongelli
- Department of Medical Genetics and Neurogenetics, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Chiara Pinardi
- Department of Neuroradiology, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Luca Porcu
- Laboratory of Methodology for Clinical Research, Oncology Department, Istituto di Ricerche Farmacologiche Mario Negri Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Anna Castaldo
- Department of Medical Genetics and Neurogenetics, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Stefania Ferraro
- Department of Neuroradiology, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Marina Grisoli
- Department of Neuroradiology, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Maria Grazia Bruzzone
- Department of Neuroradiology, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Cinzia Gellera
- Department of Medical Genetics and Neurogenetics, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Franco Taroni
- Department of Medical Genetics and Neurogenetics, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Caterina Mariotti
- Department of Medical Genetics and Neurogenetics, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Lorenzo Nanetti
- Department of Medical Genetics and Neurogenetics, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
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7
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Velázquez-Pérez L, Rodriguez-Labrada R, González-Garcés Y, Arrufat-Pie E, Torres-Vega R, Medrano-Montero J, Ramirez-Bautista B, Vazquez-Mojena Y, Auburger G, Horak F, Ziemann U, Gomez CM. Prodromal Spinocerebellar Ataxia Type 2 Subjects Have Quantifiable Gait and Postural Sway Deficits. Mov Disord 2020; 36:471-480. [PMID: 33107647 DOI: 10.1002/mds.28343] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/14/2020] [Accepted: 09/29/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The search for valid preclinical biomarkers of cerebellar dysfunction is a key research goal for the upcoming era of early interventional approaches in spinocerebellar ataxias. This study aims to describe novel preclinical biomarkers of subtle gait and postural sway abnormalities in prodromal spinocerebellar ataxia type 2 (pre-SCA2). METHODS Thirty pre-SCA2 patients and their matched healthy controls underwent quantitative assessments of gait and postural sway using a wearable sensor-based system and semiquantitative evaluation of cerebellar features by SARA (Scale for the Assessment and Rating of Ataxia) score. RESULTS Quantitative analysis of natural gait showed a significantly larger variability of the swing period, toe-off angle and toe-out angle in pre-SCA2, and larger mean coronal and transverse ranges of motion of the trunk at the lumbar location and of the sagittal range of motion of the trunk at the sternum location compared to controls. During tandem gait, pre-SCA2 subjects showed larger lumbar, trunk, and arm ranges of motion than controls. Postural sway analysis showed excessive body oscillation that was increased in tandem stance. Overall, these abnormalities were detected in pre-SCA2 patients without clinical evidence of abnormalities in SARA. The toe-off angle and swing time variability were significantly correlated with the time to ataxia onset, whereas the toe-off angle and transverse range of motion at trunk position during tandem gait were significantly associated with the SARA score. CONCLUSIONS This study demonstrates early alteration of gait and postural sway control in prodromal SCA2 using a wearable sensor-based system. This offers new pathophysiological hints into this early disease stage and provides novel potential biomarkers for future clinical trials. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Luis Velázquez-Pérez
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Cuban Academy of Sciences, La Habana Vieja, Cuba
| | - Roberto Rodriguez-Labrada
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Department of Molecular Biology, Cuban Neuroscience Centre, Playa, Cuba
| | - Yasmani González-Garcés
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | - Eduardo Arrufat-Pie
- Department of Neurorehabilitation, Clinical & Surgical Hospital "Manuel Piti Fajardo,", Plaza de la Revolución, Cuba
| | - Reidenis Torres-Vega
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | - Jacqueline Medrano-Montero
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | | | - Yaimeé Vazquez-Mojena
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Department of Molecular Biology, Cuban Neuroscience Centre, Playa, Cuba
| | - Georg Auburger
- Experimental Neurology, Department of Neurology, Experimental Neurology, Medical School, Goethe University, Frankfurt am Main, Germany
| | - Fay Horak
- Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
| | - Ulf Ziemann
- Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany.,Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
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8
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Moscovich M, Heinzel S, Postuma RB, Reilmann R, Klockgether T, Jacobi H, Höglinger G, Berg D. How specific are non-motor symptoms in the prodrome of Parkinson's disease compared to other movement disorders? Parkinsonism Relat Disord 2020; 81:213-218. [PMID: 33039276 DOI: 10.1016/j.parkreldis.2020.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/16/2020] [Accepted: 10/03/2020] [Indexed: 01/03/2023]
Abstract
The clinical diagnosis of Parkinson's disease (PD) based on motor signs is often preceded by several non-motor symptoms that can indicate early prodromal neurodegenerative processes. Such prodromal symptoms can aid the early detection of PD, but their specificity for prodromal PD in comparison to prodromes of other movement disorders is still largely unclear. We here aim to give a first insight into the published evidence of prodromal non-motor symptoms in PD, dementia with Lewy bodies (DLB), multiple system atrophy (MSA), Huntington's disease (HD), progressive supranuclear palsy (PSP) and spinocerebellar ataxia (SCA). REM-sleep behavior disorder (RBD) and autonomic dysfunction have been observed in the prodromes of PD, MSA, DLB and SCA. Depression and cognitive decline have been reported for prodromal PD, DLB, HD, SCA, and PSP. Olfactory loss has only been described in prodromal PD/DLB. However, estimating the specificity of prodromal non-motor symptoms in PD is so far complicated by scarce prospective evidence and study limitations. Information on marker specificity is a prerequisite for an accurate early (differential) diagnosis of prodromal diseases, as well as specific recruitment for targeted neuroprotective interventions. We here would like to raise awareness of these issues and encourage further prospective research of prodromal non-motor symptoms in neurodegenerative movement disorders and other diseases.
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Affiliation(s)
- Mariana Moscovich
- Department of Neurology, Christian-Albrechts University, Kiel, Germany.
| | - Sebastian Heinzel
- Department of Neurology, Christian-Albrechts University, Kiel, Germany
| | - Ronald B Postuma
- Department of Neurology, McGill University, Montreal, Quebec, Canada
| | - Ralf Reilmann
- George-Huntington-Institute, Technology-Park Muenster, Muenster, Germany; Department of Clinical Radiology, University of Muenster, Muenster, Germany; Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | - Thomas Klockgether
- Department of Neurology, University of Bonn, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Heike Jacobi
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Günter Höglinger
- Department of Neurology, Technische Universität München, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Daniela Berg
- Department of Neurology, Christian-Albrechts University, Kiel, Germany
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9
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Robinson-Agramonte MDLA, Gonçalves CA, Farina de Almeida R, González Quevedo A, Chow S, Velázquez Pérez L, Díaz de la Fé A, Sesterheim P, Souza DOG. Neuroinflammation and Neuromodulation in Neurological Diseases. Behav Sci (Basel) 2019; 9:E99. [PMID: 31547441 PMCID: PMC6770731 DOI: 10.3390/bs9090099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/05/2019] [Accepted: 09/09/2019] [Indexed: 02/06/2023] Open
Abstract
Neuroimmunology is a relatively young science. This discipline has emerged today from the research field as a mature and fully developed innovative research area that integrates not only pure topics of neuroimmunology, but also expands on wider fields such as neuroplasticity, neuronal reserve and neuromodulation in association with clinical events, amongst which behavioral disorders stand out. The Cuban School of Neuroimmunology-a recent meeting that took place in Havana, Cuba-focused on topics based on the molecular mechanisms of neuroinflammation in neurological disorders involving behavioral manifestations, such as multiple sclerosis (MS), autism, cerebellar ataxias, Alzheimer´s disease and stroke among others, as well as on the use of new interventional technologies in neurology. Professor Luis Velazquez, from the Cuban Academy of Sciences, dictated an interesting lecture on Spinocerebellar ataxias, a genetic disorder where recent hypotheses related to the influence of neuroinflammation as a neurobiological factor influencing the progression of this disease have emerged. At the same time, the use of new interventional technologies in neurology was discussed, including those referring to novel disease modifying therapies in the course of MS and the use of transcranial magnetic stimulation in several neurological diseases, the latter reinforcing how interventional strategies in the form of non-invasive bran stimulation can contribute to physical rehabilitation in neurology. This paper summarizes the highlights of the most relevant topics presented during the First Cuban School of Neuroimmunology, organized by the Cuban Network of Neuroimmunology, held in June 2019.
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Affiliation(s)
| | | | | | | | - Sandra Chow
- MSL N&I Centro America y el Caribe.Biopharm Medical Affairs, Guatemala
| | - Luis Velázquez Pérez
- Center for the Research and Rehabilitation of Hereditary Ataxias (CIRAH), Holguin 80100, Cuba
| | - Amado Díaz de la Fé
- International Center for Neurological Restoration, Ave 25 # 15805 b/w 158 and 160, Havana 11300, Cuba
| | - Patricia Sesterheim
- Institute of Cardiology of Rio Grande do Sul, Experimental Center, Porto Alegre 90650-090, Brazil
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10
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Sleep spindles and K-complex activities are decreased in spinocerebellar ataxia type 2: relationship to memory and motor performances. Sleep Med 2019; 60:188-196. [PMID: 31186215 DOI: 10.1016/j.sleep.2019.04.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 04/10/2019] [Accepted: 04/12/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Sleep spindles and K-complexes are electroencephalographic hallmarks of non-rapid eye movement (non-REM) sleep that provide valuable information into brain functioning, plasticity and sleep functions in normal and pathological conditions. However, they have not been systematically investigated in spinocerebellar ataxias (SCA). To close this gap, the current study was carried out to quantify sleep spindles and K-complexes in SCA2 and to assess their relationship with clinical and molecular measures, as well as with memory and attention/executive functioning. METHODS In this study, 20 SCA2 patients, 20 preclinical carriers and 20 healthy controls underwent whole-night polysomnographic (PSG) recordings as well as sleep interviews, ataxia scoring and neuropsychological assessments. Sleep spindles and K-complexes were automatically detected during non-REM sleep stage 2 (N2). Their densities were evaluated as events/minute. RESULTS Compared to controls, sleep spindle density was significantly reduced in SCA2 patients and preclinical subjects. By contrast, K-complex density was specifically and significantly decreased only in SCA2 patients. Reduced spindle activity correlated with measures of verbal memory, whereas reduced K-complex activity correlated with age, ataxia severity and N3 sleep percentage in SCA2 patients. CONCLUSIONS Findings document an impairment of N2 sleep microstructure in SCA2 already in prodromal stages, suggesting an early involvement of thalamo-cortical and/or cortical circuits underlying the generation of sleep spindles and K-complexes. Thus, sleep spindle density may serve as useful biomarker for deficits of neural plasticity mechanisms underlying verbal memory alterations in patients. It may also serve as promising outcome measure in further therapeutical trials targeting memory decline in SCA2. With regard to K-complexes, they have potential usefulness as marker of sleep protection.
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Velázquez-Pérez L, Rodríguez-Diaz JC, Rodríguez-Labrada R, Medrano-Montero J, Aguilera Cruz AB, Reynaldo-Cejas L, Góngora-Marrero M, Estupiñán-Rodríguez A, Vázquez-Mojena Y, Torres-Vega R. Neurorehabilitation Improves the Motor Features in Prodromal SCA2: A Randomized, Controlled Trial. Mov Disord 2019; 34:1060-1068. [PMID: 30958572 DOI: 10.1002/mds.27676] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 02/28/2019] [Accepted: 03/07/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The search for early interventions is a novel approach in spinocerebellar ataxias, but there are few studies supporting this notion. This article aimed to assess the efficacy of neurorehabilitation treatment in prodromal spinocerebellar ataxia type 2. METHODS Thirty spinocerebellar ataxia type 2 preclinical carriers were enrolled in a randomized, controlled trial using neurorehabilitation. The intervention in the treated group was 4 hours per day, 5 days per week for 12 weeks, emphasizing static balance, gait, and limb coordination. The control group did not receive rehabilitation. The primary outcome measure was the time for 5-m tandem gait over the floor. Secondary outcomes included other timed tests with increased motor complexity, as well as the scores of the SARA and the Inventory of Non-ataxia Symptoms. RESULTS The times for 5-m tandem gait over the floor and the mattress were significantly reduced only in the rehabilitated group. Moreover, the times upholding the tandem stance over a mattress and the seesaw were notably increased only in this group. Likewise, the finger-nose and the heel-shin tests were improved in the rehabilitated group alone. The SARA score and the count of nonataxia symptoms were unchanged. CONCLUSIONS This rehabilitation program improves the subtle gait, postural and coordinative deficits in prodromal spinocerebellar ataxia type 2, which provided novel hints about the preservation of motor learning and neural plasticity mechanisms in early disease stages, leading chances for other interventional approaches in this and other spinocerebellar ataxias. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Cuban Academy of Sciences, Havana, Cuba
| | | | - Roberto Rodríguez-Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Cuban Academy of Sciences, Havana, Cuba.,School of Physical Culture and Sport, University of Holguín, Holguín, Cuba
| | - Jacqueline Medrano-Montero
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,School of Physical Culture and Sport, University of Holguín, Holguín, Cuba
| | | | | | | | | | - Yaimeé Vázquez-Mojena
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Cuban Academy of Sciences, Havana, Cuba.,School of Physical Culture and Sport, University of Holguín, Holguín, Cuba
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12
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Rodríguez-Labrada R, Velázquez-Pérez L, Ortega-Sánchez R, Peña-Acosta A, Vázquez-Mojena Y, Canales-Ochoa N, Medrano-Montero J, Torres-Vega R, González-Zaldivar Y. Insights into cognitive decline in spinocerebellar Ataxia type 2: a P300 event-related brain potential study. CEREBELLUM & ATAXIAS 2019; 6:3. [PMID: 30873287 PMCID: PMC6399884 DOI: 10.1186/s40673-019-0097-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/21/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Cognitive decline is a common non-motor feature characterizing Spinocerebellar Ataxia type 2 (SCA2) during the prodromal stage, nevertheless a reduced number of surrogate biomarkers of these alterations have been described. OBJECTIVE To provide insights into cognitive dysfunction in SCA2 patients using P300 event-related potentials (ERP) and to evaluate these measures as biomarkers of the disease. METHODS A cross-sectional study was performed with 30 SCA2 patients, 20 preclinical carriers and 33 healthy controls, who underwent visual, auditory P300 ERPs, and neurological examinations and ataxia scoring. RESULTS SCA2 patients showed significant increase in P300 latencies and decrease of P300 amplitudes for visual and auditory stimuli, whereas preclinical carriers exhibit a less severe, but significant prolongation of P300 latencies. Multiple regression analyses disclosed a significant effect of SARA score on visual P300 abnormalities in patients as well as of the time to ataxia onset on visual P300 latencies in preclinical carriers. CONCLUSIONS This paper demonstrated the role of P300 ERP for the study of attentional, discriminative and working memory abnormalities in SCA2 patients and for the search of surrogate biomarkers from prodromal to the symptomatic stages. Moreover, our findings provide psychophysiological evidences supporting the cerebellar involvement in cognitive processes and allows us to identify promising outcome measures for future trials focusing on cognitive dysfunction.
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Affiliation(s)
- Roberto Rodríguez-Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street # 26, 80100 Holguín, Cuba
- Faculty of Sport and Physical Culture, University of Holguín, Holguín, Cuba
- Cuban Academy of Science, street no. 460, Habana Vieja, La Habana, Cuba
| | - Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street # 26, 80100 Holguín, Cuba
- Cuban Academy of Science, street no. 460, Habana Vieja, La Habana, Cuba
- Medical University of Holguín, Lenin Avenue 1, Holguín, Cuba
| | - Ricardo Ortega-Sánchez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street # 26, 80100 Holguín, Cuba
| | - Arnoy Peña-Acosta
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street # 26, 80100 Holguín, Cuba
| | - Yaimeé Vázquez-Mojena
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street # 26, 80100 Holguín, Cuba
- Faculty of Sport and Physical Culture, University of Holguín, Holguín, Cuba
- Cuban Academy of Science, street no. 460, Habana Vieja, La Habana, Cuba
| | - Nalia Canales-Ochoa
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street # 26, 80100 Holguín, Cuba
| | - Jacqueline Medrano-Montero
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street # 26, 80100 Holguín, Cuba
- Faculty of Sport and Physical Culture, University of Holguín, Holguín, Cuba
| | - Reidenis Torres-Vega
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street # 26, 80100 Holguín, Cuba
| | - Yanetza González-Zaldivar
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street # 26, 80100 Holguín, Cuba
- Medical University of Holguín, Lenin Avenue 1, Holguín, Cuba
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13
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Rodríguez-Díaz JC, Velázquez-Pérez L, Rodríguez Labrada R, Aguilera Rodríguez R, Laffita Pérez D, Canales Ochoa N, Medrano Montero J, Estupiñán Rodríguez A, Osorio Borjas M, Góngora Marrero M, Reynaldo Cejas L, González Zaldivar Y, Almaguer Gotay D. Neurorehabilitation therapy in spinocerebellar ataxia type 2: A 24-week, rater-blinded, randomized, controlled trial. Mov Disord 2018; 33:1481-1487. [PMID: 30132999 DOI: 10.1002/mds.27437] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 03/28/2018] [Accepted: 04/17/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Neurorehabilitation has become in a widely used approach in spinocerebellar ataxias, but there are scarce powerful clinical studies supporting this notion. OBJECTIVE The objective of this study was to assess the efficacy of a 24-week neurorehabilitative treatment in spinocerebellar ataxia type 2 patients. METHODS A total of 38 spinocerebellar ataxia type 2 patients were enrolled in a rater-blinded, 1:1 randomized, controlled trial using neurorehabilitation for 24 weeks. The treated group received 6 hours of neurorehabilitation therapy, emphasizing on balance, coordination, and muscle strengthening on weekdays, whereas the control group did not receive this intervention. Primary outcome measure was the Scale for the Assessment and Rating of Ataxia score, whereas secondary outcome measures included the count of Inventory of Non-Ataxia Symptoms and saccadic eye movement variables. RESULTS The rehabilitated group had high levels of adherence and retention to the therapy and showed a significant decrease of Scale for the Assessment and Rating of Ataxia score at 24 weeks when compared with the controls, mainly for the gait, stance, sitting, finger chase, and heel-shin test items. Changes in Scale for the Assessment and Rating of Ataxia scores were inversely correlated with the mutation size in the rehabilitated group. The nonataxia symptom count and saccadic measures were unchanged during the study. CONCLUSIONS A comprehensive 24-week rehabilitation program significantly improves the motor cerebellar symptoms of spinocerebellar ataxia type 2 patients as assessed by the ataxia rating score likely as result of the partial preservation of motor learning and neural plasticity mechanisms. These findings provide evidence in support of this therapeutic approach as palliative treatment in spinocerebellar ataxia type 2 suggesting its use in combination with other symptomatic or neuroprotective drugs and in prodromal stages. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
| | - Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Cuban Academy of Sciences, Havana, Cuba.,School of Physical Culture and Sport, University of Holguín, Holguín, Cuba
| | - Roberto Rodríguez Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Cuban Academy of Sciences, Havana, Cuba.,School of Physical Culture and Sport, University of Holguín, Holguín, Cuba
| | | | | | - Nalia Canales Ochoa
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | - Jacqueline Medrano Montero
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,School of Physical Culture and Sport, University of Holguín, Holguín, Cuba
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Cheng N, Wied HM, Gaul JJ, Doyle LE, Reich SG. SCA2 presenting as a focal dystonia. JOURNAL OF CLINICAL MOVEMENT DISORDERS 2018; 5:6. [PMID: 30123518 PMCID: PMC6090825 DOI: 10.1186/s40734-018-0073-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 08/03/2018] [Indexed: 11/14/2022]
Abstract
BACKGROUND Spinocerebellar ataxia 2 (SCA2) is an autosomal dominant neurodegenerative disorder caused by CAG repeat expansions in ATXN2 on chromosome 12q24. Patients present with adult-onset progressive gait ataxia, slow saccades, nystagmus, dysarthria and peripheral neuropathy. Dystonia is known to occur as SCA2 advances, but is rarely the presenting symptom. CASE PRESENTATION A 43-year-old right handed woman presented with focal dystonia of the right hand which started two years earlier with difficulty writing. There were only mild cerebellar signs. Her mother was reported to have a progressive gait disorder and we subsequently learned that she had SCA2. A total of 10 maternal family members were similarly affected. Over the course of 10 years, the patient's cerebellar signs progressed only mildly however the dystonia worsened to the extent of inability to use her right hand. Dystonia did not improve significantly with botulinum toxin, levodopa or trihexyphenidyl, but has shown marked improvement since DBS implantation in the GPi. CONCLUSIONS We describe a patient with SCA2 who presented with focal dystonia of the right upper extremity. Subtle cerebellar signs as well as the family history became especially important given the absence of predominant gait ataxia. Our case emphasizes that focal dystonia is not only a feature of SCA2, but can also rarely be the presenting sign as well as the most prominent feature during the disease course.
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Affiliation(s)
- Nan Cheng
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD USA
| | - Heather M. Wied
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | | | - Lauren E. Doyle
- Department of Genetic Counseling, University of North Carolina Greensboro School of Health and Human Sciences, Greensboro, NC USA
| | - Stephen G. Reich
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD USA
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15
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Rodríguez-Labrada R, Vázquez-Mojena Y, Canales-Ochoa N, Medrano-Montero J, Velázquez-Pérez L. Heritability of saccadic eye movements in spinocerebellar ataxia type 2: insights into an endophenotype marker. CEREBELLUM & ATAXIAS 2017; 4:19. [PMID: 29276612 PMCID: PMC5738191 DOI: 10.1186/s40673-017-0078-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 12/07/2017] [Indexed: 12/19/2022]
Abstract
Background Saccade slowing has been proposed as endophenotype marker in Spinocerebellar Ataxia type 2 (SCA2), nevertheless the heritability of this trait has not been properly demonstrated. Thus the present paper was aimed to assess the heritability of different saccadic parameters in SCA2. Methods Forty-eight SCA2 patients, 25 preclinical carriers and 24 non-SCA2 mutation carriers underwent electronystagmographical assessments of saccadic eye movements as well as neurological examination and ataxia scoring. Estimates of heritability based on the intraclass correlation coefficients were calculated for saccade velocity, accuracy and latency as well as for age at disease onset from 36, 17 and 15 sibling pairs of SCA2 patients, preclinical carriers and controls, respectively. Results Saccade velocity was significantly reduced in SCA2 patients and preclinical carriers, whereas decreased saccade accuracy and increased saccade latency were only observed in the patients cohort. Intraclass correlation coefficient for saccade velocity was highly significant in SCA2 patients, estimating a heritability around 94%, whereas for the age at ataxia onset this estimate was around 68%. Conclusions Electronystagmographical measure of saccade velocity showed higher familial aggregation between SCA2 patients leading the suitability of this disease feature as endophenotype marker, with potential usefulness for the search of modifier genes and neurobiological underpinnings of the disease and as outcome measure in future neuroprotective clinical trials.
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Affiliation(s)
- Roberto Rodríguez-Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Calle Libertad 26, 80100 Holguín, Cuba.,School of Physical Culture, University of Holguín, 25th street 104, 80100 Holguín, Cuba
| | - Yaimeé Vázquez-Mojena
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Calle Libertad 26, 80100 Holguín, Cuba
| | - Nalia Canales-Ochoa
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Calle Libertad 26, 80100 Holguín, Cuba
| | - Jacqueline Medrano-Montero
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Calle Libertad 26, 80100 Holguín, Cuba.,School of Physical Culture, University of Holguín, 25th street 104, 80100 Holguín, Cuba
| | - Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Calle Libertad 26, 80100 Holguín, Cuba.,Medical University of Holguín, Lenin Avenue 4, 80100 Holguín, Cuba
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16
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Velázquez-Pérez LC, Rodríguez-Labrada R, Fernandez-Ruiz J. Spinocerebellar Ataxia Type 2: Clinicogenetic Aspects, Mechanistic Insights, and Management Approaches. Front Neurol 2017; 8:472. [PMID: 28955296 PMCID: PMC5601978 DOI: 10.3389/fneur.2017.00472] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 08/25/2017] [Indexed: 12/14/2022] Open
Abstract
Spinocerebellar ataxia type 2 (SCA2) is an autosomal dominant cerebellar ataxia that occurs as a consequence of abnormal CAG expansions in the ATXN2 gene. Progressive clinical features result from the neurodegeneration of cerebellum and extra-cerebellar structures including the pons, the basal ganglia, and the cerebral cortex. Clinical, electrophysiological, and imaging approaches have been used to characterize the natural history of the disease, allowing its classification into four distinct stages, with special emphasis on the prodromal stage, which is characterized by a plethora of motor and non-motor features. Neuropathological investigations of brain tissue from SCA2 patients reveal a widespread involvement of multiple brain systems, mainly cerebellar and brainstem systems. Recent findings linking ataxin-2 intermediate expansions to other neurodegenerative diseases such as amyotrophic lateral sclerosis have provided insights into the ataxin-2-related toxicity mechanism in neurodegenerative diseases and have raised new ethical challenges to molecular predictive diagnosis of SCA2. No effective neuroprotective therapies are currently available for SCA2 patients, but some therapeutic options such as neurorehabilitation and some emerging neuroprotective drugs have shown palliative benefits.
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Affiliation(s)
- Luis C Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Medical University of Holguín "Mariana Grajales", Holguín, Cuba
| | - Roberto Rodríguez-Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Physical Culture School, University of Holguin "Oscar Lucero", Holguín, Cuba
| | - Juan Fernandez-Ruiz
- Department of Physiology, Medicine School, UNAM, Cuernavaca, Mexico.,Psychology School, Universidad Veracruzana, Xalapa, Mexico
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17
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Rizzo JR, Hosseini M, Wong EA, Mackey WE, Fung JK, Ahdoot E, Rucker JC, Raghavan P, Landy MS, Hudson TE. The Intersection between Ocular and Manual Motor Control: Eye-Hand Coordination in Acquired Brain Injury. Front Neurol 2017; 8:227. [PMID: 28620341 PMCID: PMC5451505 DOI: 10.3389/fneur.2017.00227] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 05/11/2017] [Indexed: 11/13/2022] Open
Abstract
Acute and chronic disease processes that lead to cerebral injury can often be clinically challenging diagnostically, prognostically, and therapeutically. Neurodegenerative processes are one such elusive diagnostic group, given their often diffuse and indolent nature, creating difficulties in pinpointing specific structural abnormalities that relate to functional limitations. A number of studies in recent years have focused on eye-hand coordination (EHC) in the setting of acquired brain injury (ABI), highlighting the important set of interconnected functions of the eye and hand and their relevance in neurological conditions. These experiments, which have concentrated on focal lesion-based models, have significantly improved our understanding of neurophysiology and underscored the sensitivity of biomarkers in acute and chronic neurological disease processes, especially when such biomarkers are combined synergistically. To better understand EHC and its connection with ABI, there is a need to clarify its definition and to delineate its neuroanatomical and computational underpinnings. Successful EHC relies on the complex feedback- and prediction-mediated relationship between the visual, ocular motor, and manual motor systems and takes advantage of finely orchestrated synergies between these systems in both the spatial and temporal domains. Interactions of this type are representative of functional sensorimotor control, and their disruption constitutes one of the most frequent deficits secondary to brain injury. The present review describes the visually mediated planning and control of eye movements, hand movements, and their coordination, with a particular focus on deficits that occur following neurovascular, neurotraumatic, and neurodegenerative conditions. Following this review, we also discuss potential future research directions, highlighting objective EHC as a sensitive biomarker complement within acute and chronic neurological disease processes.
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Affiliation(s)
- John-Ross Rizzo
- Department of Rehabilitation Medicine, New York University Langone Medical Center, New York, NY, United States.,Department of Neurology, New York University Langone Medical Center, New York, NY, United States
| | - Maryam Hosseini
- Department of Rehabilitation Medicine, New York University Langone Medical Center, New York, NY, United States
| | - Eric A Wong
- Department of Rehabilitation Medicine, New York University Langone Medical Center, New York, NY, United States
| | - Wayne E Mackey
- Department of Psychology and Center for Neural Science, New York University, New York, NY, United States
| | - James K Fung
- Department of Rehabilitation Medicine, New York University Langone Medical Center, New York, NY, United States
| | - Edmond Ahdoot
- Department of Rehabilitation Medicine, New York University Langone Medical Center, New York, NY, United States
| | - Janet C Rucker
- Department of Neurology, New York University Langone Medical Center, New York, NY, United States.,Department of Ophthalmology, New York University Langone Medical Center, New York, NY, United States
| | - Preeti Raghavan
- Department of Rehabilitation Medicine, New York University Langone Medical Center, New York, NY, United States
| | - Michael S Landy
- Department of Psychology and Center for Neural Science, New York University, New York, NY, United States
| | - Todd E Hudson
- Department of Rehabilitation Medicine, New York University Langone Medical Center, New York, NY, United States.,Department of Neurology, New York University Langone Medical Center, New York, NY, United States
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