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van der Veen S, Eggink H, Elting JWJ, Sival D, Verschuuren-Bemelmans CC, de Koning TJ, Tijssen MAJ. The natural history of progressive myoclonus ataxia. Neurobiol Dis 2024; 199:106555. [PMID: 38844245 DOI: 10.1016/j.nbd.2024.106555] [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: 03/02/2024] [Revised: 05/22/2024] [Accepted: 06/03/2024] [Indexed: 06/16/2024] Open
Abstract
Progressive myoclonus ataxia (PMA) is a rare clinical syndrome characterized by the presence of progressive myoclonus and ataxia, and can be accompanied by mild cognitive impairment and infrequent epileptic seizures. This is the first study to describe the natural history of PMA and identify clinical, electrophysiological, and genetic features explaining the variability in disease progression. A Dutch cohort of consecutive patients meeting the criteria of the refined definition of PMA was included. The current phenotype was assessed during in-person consultation by movement disorders experts, and retrospective data was collected to describe disease presentation and progression, including brain imaging and therapy efficacy. Extensive genetic and electrophysiological tests were performed. The presence of cortical hyperexcitability was determined, by either the identification of a cortical correlate of myoclonic jerks with simultaneous electromyography-electroencephalography or a giant somatosensory evoked potential. We included 34 patients with PMA with a median disease duration of 15 years and a clear progressive course in most patients (76%). A molecular etiology was identified in 82% patients: ATM, CAMTA1, DHDDS, EBF3, GOSR2, ITPR1, KCNC3, NUS1, POLR1A, PRKCG, SEMA6B, SPTBN2, TPP1, ZMYND11, and a 12p13.32 deletion. The natural history is a rather homogenous onset of ataxia in the first two years of life followed by myoclonus in the first 5 years of life. Main accompanying neurological dysfunctions included cognitive impairment (62%), epilepsy (38%), autism spectrum disorder (27%), and behavioral problems (18%). Disease progression showed large variability ranging from an epilepsy free PMA phenotype (62%) to evolution towards a progressive myoclonus epilepsy (PME) phenotype (18%): the existence of a PMA-PME spectrum. Cortical hyperexcitability could be tested in 17 patients, and was present in 11 patients and supported cortical myoclonus. Interestingly, post-hoc analysis showed that an absence of cortical hyperexcitability, suggesting non-cortical myoclonus, was associated with the PMA-end of the spectrum with no epilepsy and milder myoclonus, independent of disease duration. An association between the underlying genetic defects and progression on the PMA-PME spectrum was observed. By describing the natural history of the largest cohort of published patients with PMA so far, we see a homogeneous onset with variable disease progression, in which phenotypic evolution to PME occurs in the minority. Genetic and electrophysiological features may be of prognostic value, especially the determination of cortical hyperexcitability. Furthermore, the identification of cortical and non-cortical myoclonus in PMA helps us gain insight in the underlying pathophysiology of myoclonus.
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Affiliation(s)
- Sterre van der Veen
- Department of Neurology, University of Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands; Expertise Centre Movement Disorders Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands
| | - Hendriekje Eggink
- Department of Neurology, University of Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands; Expertise Centre Movement Disorders Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands
| | - Jan Willem J Elting
- Department of Neurology, University of Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands; Expertise Centre Movement Disorders Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands
| | - Deborah Sival
- Expertise Centre Movement Disorders Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands; Department of Pediatrics, University of Groningen, University Medical Center Groningen, 9700 RB, Groningen, the Netherlands
| | - Corien C Verschuuren-Bemelmans
- Expertise Centre Movement Disorders Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands; Department of Genetics, University of Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands
| | - Tom J de Koning
- Expertise Centre Movement Disorders Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands; Department of Genetics, University of Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands; Pediatrics, department of Clinical Sciences, Lund University, 22185 Lund, Sweden
| | - Marina A J Tijssen
- Department of Neurology, University of Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands; Expertise Centre Movement Disorders Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands.
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Westenberger A, Skrahina V, Usnich T, Beetz C, Vollstedt EJ, Laabs BH, Paul JJ, Curado F, Skobalj S, Gaber H, Olmedillas M, Bogdanovic X, Ameziane N, Schell N, Aasly JO, Afshari M, Agarwal P, Aldred J, Alonso-Frech F, Anderson R, Araújo R, Arkadir D, Avenali M, Balal M, Benizri S, Bette S, Bhatia P, Bonello M, Braga-Neto P, Brauneis S, Cardoso FEC, Cavallieri F, Classen J, Cohen L, Coletta D, Crosiers D, Cullufi P, Dashtipour K, Demirkiran M, de Carvalho Aguiar P, De Rosa A, Djaldetti R, Dogu O, dos Santos Ghilardi MG, Eggers C, Elibol B, Ellenbogen A, Ertan S, Fabiani G, Falkenburger BH, Farrow S, Fay-Karmon T, Ferencz GJ, Fonoff ET, Fragoso YD, Genç G, Gorospe A, Grandas F, Gruber D, Gudesblatt M, Gurevich T, Hagenah J, Hanagasi HA, Hassin-Baer S, Hauser RA, Hernández-Vara J, Herting B, Hinson VK, Hogg E, Hu MT, Hummelgen E, Hussey K, Infante J, Isaacson SH, Jauma S, Koleva-Alazeh N, Kuhlenbäumer G, Kühn A, Litvan I, López-Manzanares L, Luxmore M, Manandhar S, Marcaud V, Markopoulou K, Marras C, McKenzie M, Matarazzo M, Merello M, Mollenhauer B, Morgan JC, Mullin S, Musacchio T, Myers B, Negrotti A, Nieves A, Nitsan Z, Oskooilar N, Öztop-Çakmak Ö, Pal G, Pavese N, Percesepe A, Piccoli T, Pinto de Souza C, Prell T, Pulera M, Raw J, Reetz K, Reiner J, Rosenberg D, Ruiz-Lopez M, Ruiz Martinez J, Sammler E, Santos-Lobato BL, Saunders-Pullman R, Schlesinger I, Schofield CM, Schumacher-Schuh AF, Scott B, Sesar Á, Shafer SJ, Sheridan R, Silverdale M, Sophia R, Spitz M, Stathis P, Stocchi F, Tagliati M, Tai YF, Terwecoren A, Thonke S, Tönges L, Toschi G, Tumas V, Urban PP, Vacca L, Vandenberghe W, Valente EM, Valzania F, Vela-Desojo L, Weill C, Weise D, Wojcieszek J, Wolz M, Yahalom G, Yalcin-Cakmakli G, Zittel S, Zlotnik Y, Kandaswamy KK, Balck A, Hanssen H, Borsche M, Lange LM, Csoti I, Lohmann K, Kasten M, Brüggemann N, Rolfs A, Klein C, Bauer P. Relevance of genetic testing in the gene-targeted trial era: the Rostock Parkinson's disease study. Brain 2024; 147:2652-2667. [PMID: 39087914 PMCID: PMC11292909 DOI: 10.1093/brain/awae188] [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: 12/12/2023] [Revised: 02/27/2024] [Accepted: 03/24/2024] [Indexed: 08/02/2024] Open
Abstract
Estimates of the spectrum and frequency of pathogenic variants in Parkinson's disease (PD) in different populations are currently limited and biased. Furthermore, although therapeutic modification of several genetic targets has reached the clinical trial stage, a major obstacle in conducting these trials is that PD patients are largely unaware of their genetic status and, therefore, cannot be recruited. Expanding the number of investigated PD-related genes and including genes related to disorders with overlapping clinical features in large, well-phenotyped PD patient groups is a prerequisite for capturing the full variant spectrum underlying PD and for stratifying and prioritizing patients for gene-targeted clinical trials. The Rostock Parkinson's disease (ROPAD) study is an observational clinical study aiming to determine the frequency and spectrum of genetic variants contributing to PD in a large international cohort. We investigated variants in 50 genes with either an established relevance for PD or possible phenotypic overlap in a group of 12 580 PD patients from 16 countries [62.3% male; 92.0% White; 27.0% positive family history (FH+), median age at onset (AAO) 59 years] using a next-generation sequencing panel. Altogether, in 1864 (14.8%) ROPAD participants (58.1% male; 91.0% White, 35.5% FH+, median AAO 55 years), a PD-relevant genetic test (PDGT) was positive based on GBA1 risk variants (10.4%) or pathogenic/likely pathogenic variants in LRRK2 (2.9%), PRKN (0.9%), SNCA (0.2%) or PINK1 (0.1%) or a combination of two genetic findings in two genes (∼0.2%). Of note, the adjusted positive PDGT fraction, i.e. the fraction of positive PDGTs per country weighted by the fraction of the population of the world that they represent, was 14.5%. Positive PDGTs were identified in 19.9% of patients with an AAO ≤ 50 years, in 19.5% of patients with FH+ and in 26.9% with an AAO ≤ 50 years and FH+. In comparison to the idiopathic PD group (6846 patients with benign variants), the positive PDGT group had a significantly lower AAO (4 years, P = 9 × 10-34). The probability of a positive PDGT decreased by 3% with every additional AAO year (P = 1 × 10-35). Female patients were 22% more likely to have a positive PDGT (P = 3 × 10-4), and for individuals with FH+ this likelihood was 55% higher (P = 1 × 10-14). About 0.8% of the ROPAD participants had positive genetic testing findings in parkinsonism-, dystonia/dyskinesia- or dementia-related genes. In the emerging era of gene-targeted PD clinical trials, our finding that ∼15% of patients harbour potentially actionable genetic variants offers an important prospect to affected individuals and their families and underlines the need for genetic testing in PD patients. Thus, the insights from the ROPAD study allow for data-driven, differential genetic counselling across the spectrum of different AAOs and family histories and promote a possible policy change in the application of genetic testing as a routine part of patient evaluation and care in PD.
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Affiliation(s)
- Ana Westenberger
- Institute of Neurogenetics, University of Lübeck, University Medical Center Schleswig-Holstein, 23538 Lübeck, Schleswig-Holstein, Germany
| | - Volha Skrahina
- CENTOGENE GmbH, 18055 Rostock, Mecklenburg-Vorpommern, Germany
| | - Tatiana Usnich
- Institute of Neurogenetics, University of Lübeck, University Medical Center Schleswig-Holstein, 23538 Lübeck, Schleswig-Holstein, Germany
| | - Christian Beetz
- CENTOGENE GmbH, 18055 Rostock, Mecklenburg-Vorpommern, Germany
| | - Eva-Juliane Vollstedt
- Institute of Neurogenetics, University of Lübeck, University Medical Center Schleswig-Holstein, 23538 Lübeck, Schleswig-Holstein, Germany
| | - Björn-Hergen Laabs
- Institute of Medical Biometry and Statistics, University of Lübeck, University Medical Center Schleswig-Holstein, 23562 Lübeck, Schleswig-Holstein, Germany
| | - Jefri J Paul
- CENTOGENE GmbH, 18055 Rostock, Mecklenburg-Vorpommern, Germany
| | - Filipa Curado
- CENTOGENE GmbH, 18055 Rostock, Mecklenburg-Vorpommern, Germany
| | - Snezana Skobalj
- CENTOGENE GmbH, 18055 Rostock, Mecklenburg-Vorpommern, Germany
| | - Hanaa Gaber
- CENTOGENE GmbH, 18055 Rostock, Mecklenburg-Vorpommern, Germany
- Department of Clinical Project Management, IQVIA, 60549 Frankfurt am Main, Hessen, Germany
| | | | | | - Najim Ameziane
- CENTOGENE GmbH, 18055 Rostock, Mecklenburg-Vorpommern, Germany
| | - Nathalie Schell
- Institute of Neurogenetics, University of Lübeck, University Medical Center Schleswig-Holstein, 23538 Lübeck, Schleswig-Holstein, Germany
| | - Jan Olav Aasly
- Department of Neurology, St. Olavs Hospital, 7006 Trondheim, Trøndelag, Norway
- Department of Neuroscience, Norwegian University of Science and Technology, 7034 Trondheim, Norway
| | - Mitra Afshari
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA
| | - Pinky Agarwal
- Evergreen Health Neuroscience Institute, Kirkland, WA 98034, USA
| | - Jason Aldred
- Inland Northwest Research, Spokane, WA 99202, USA
| | - Fernando Alonso-Frech
- Department of Neurology, Movement Disorders Unit, Hospital Clínico San Carlos, 28040 Madrid, Madrid, Spain
| | | | - Rui Araújo
- Department of Neurology, Centro Hospitalar Universitário de São João, 4200-319 Porto, Porto District, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, 4200-319 Porto, Porto District, Portugal
| | - David Arkadir
- Department of Neurology, Faculty of Medicine, Hadassah Medical Organization, Hebrew University, 91120 Jerusalem, Jerusalem District, Israel
| | - Micol Avenali
- Neurogenetics Research Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Lombardy, Italy
| | - Mehmet Balal
- Department of Neurology, School of Medicine, Çukurova University, 01330 Adana, Adana, Turkey
| | - Sandra Benizri
- Movement Disorders Unit, Assuta Ramat Ha Hayal Hospital, 69710 Tel Aviv, Tel Aviv District, Israel
| | - Sagari Bette
- Parkinson’s Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL 33486, USA
| | | | - Michael Bonello
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, Merseyside L9 7LJ, UK
| | - Pedro Braga-Neto
- Division of Neurology, Department of Clinical Medicine, Federal University of Ceará, 60430-140 Fortaleza, Brazil
- Center of Health Science, Universidade Estadual do Ceará, 60714-903 Fortaleza, Ceará, Brazil
| | | | - Francisco Eduardo Costa Cardoso
- Movement Disorders Unit, Neurology Service, Department of Internal Medicine, Federal University of Minas Gerais, 31270-901 Belo Horizonte, Minas Gerais, Brazil
| | - Francesco Cavallieri
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Emilia-Romagna, Italy
| | - Joseph Classen
- Department of Neurology, Leipzig University Medical Center, 04103 Leipzig, Saxony, Germany
| | | | - Della Coletta
- Department of Neurology, Universidade do Estado do Amazonas, 69050-010 Manaus AM, Amazonas, Brazil
| | - David Crosiers
- Department of Neurology, Antwerp University Hospital, 2650 Edegem, Flemish, Belgium
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Flemish, Belgium
| | - Paskal Cullufi
- Pediatric Department, University Hospital ‘Mother Teresa’, 1001 Tirana, Tirana County, Albania
| | - Khashayar Dashtipour
- Department of Neurology, Division of Movement Disorders, Loma Linda University School of Medicine, Loma Linda, CA 92354, USA
| | - Meltem Demirkiran
- Department of Neurology, School of Medicine, Çukurova University, 01330 Adana, Adana, Turkey
| | - Patricia de Carvalho Aguiar
- Department of Neurology and Neurosurgery, Hospital Israelita Albert Einstein, 05651-901 Sao Paulo, Sao Paulo, Brazil
| | - Anna De Rosa
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, 80131 Naples, Campania Region, Italy
| | - Ruth Djaldetti
- Department of Neurology, Movement Disorders Clinic, Rabin Medical Center-Beilinson Hospital, 49100 Petach Tikva, Central District, Israel
- Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Tel Aviv District, Israel
| | - Okan Dogu
- Department of Neurology, Mersin University, 33343 Mersin, Mersin Province, Turkey
| | - Maria Gabriela dos Santos Ghilardi
- Laboratory of Neuroscience, Hospital Sírio-Libanês, 01308-050 São Paulo, São Paulo, Brazil
- Department of Neurology, University of São Paulo Medical School, 01246-903 São Paulo, São Paulo, Brazil
| | - Carsten Eggers
- Department of Neurology, University Hospital Marburg, 35037 Marburg, Hesse, Germany
- Department of Neurology, Knappschaftskrankenhaus Bottrop, 46242 Bottrop, North Rhine-Westphalia, Germany
| | - Bulent Elibol
- Department of Neurology, Faculty of Medicine, Hacettepe University, 06100 Ankara, Ankara, Turkey
| | - Aaron Ellenbogen
- Michigan Institute for Neurological Disorders, Farmington Hills, MI 48334, USA
- Quest Research Institute, Farmington Hills, MI 48334, USA
| | - Sibel Ertan
- Department of Neurology, Koç University, 34450 Istanbul, Istanbul, Turkey
| | - Giorgio Fabiani
- Movement Disorders Unit, Hospital Angelina Caron, 83430-000 Curitiba, Paraná, Brazil
| | - Björn H Falkenburger
- Department of Neurology, University Hospital and Faculty of Medicine Carl Gustav Carus, 01307 Dresden, Saxony, Germany
| | - Simon Farrow
- Clinical Research Center of Nevada, Las Vegas, NV 89119, USA
| | - Tsviya Fay-Karmon
- Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Tel Aviv District, Israel
- Movement Disorders Institute and Department of Neurology, Chaim Sheba Medical Center, 52621 Ramat-Gan, Tel Aviv District, Israel
| | - Gerald J Ferencz
- Shore Neurology, RWJBarnabas Health Medical Group, Toms River, NJ 08755, USA
| | - Erich Talamoni Fonoff
- Laboratory of Neuroscience, Hospital Sírio-Libanês, 01308-050 São Paulo, São Paulo, Brazil
- Department of Neurology, University of São Paulo Medical School, 01246-903 São Paulo, São Paulo, Brazil
| | - Yara Dadalti Fragoso
- Department of Neurology, Universidade Metropolitana de Santos, 11070-100 Santos SP, São Paulo, Brazil
| | - Gençer Genç
- Department of Neurology, Şişli Etfal Training and Research Hospital, University of Health Sciences, 34371 Istanbul, Istanbul, Turkey
| | - Arantza Gorospe
- Department of Neurology, de Navarra University Hospital, 31008 Pamplona, Navarre, Spain
| | - Francisco Grandas
- Movement Disorders Unit, University General Hospital Gregorio Marañón, 28007 Madrid, Madrid, Spain
| | - Doreen Gruber
- Movement Disorders Clinic, 14547 Beelitz-Heilstätten, Brandenburg, Germany
| | - Mark Gudesblatt
- NYU Langone South Shore Neurologic Associates, Islip, NY 11751, USA
| | - Tanya Gurevich
- Movement Disorders Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv University, 6423906 Tel Aviv, Tel Aviv District, Israel
| | - Johann Hagenah
- Department of Neurology, Westküstenklinikum Heide, 25746 Heide, Schleswig-Holstein, Germany
| | - Hasmet A Hanagasi
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Istanbul, Turkey
| | - Sharon Hassin-Baer
- Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Tel Aviv District, Israel
- Movement Disorders Institute and Department of Neurology, Chaim Sheba Medical Center, 52621 Ramat-Gan, Tel Aviv District, Israel
| | - Robert A Hauser
- University of South Florida Parkinson’s Disease and Movement Disorders Center of Excellence, Tampa, FL 33612, USA
| | - Jorge Hernández-Vara
- Neurology Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, 08035 Barcelona, Catalonia, Spain
| | - Birgit Herting
- Neurological Clinic, Diakonie-Klinikum Schwäbisch Hall, 74523 Schwäbisch Hall, Baden-Württemberg, Germany
| | - Vanessa K Hinson
- Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Elliot Hogg
- Department of Neurosurgery, Cedars-Sinai Medical Center, Movement Disorder Program, Los Angeles, CA 90048, USA
| | - Michele T Hu
- Nuffield Department of Clinical Neurosciences, Division of Clinical Neurology, University of Oxford, Oxford OX3 9DU, UK
| | - Eduardo Hummelgen
- Neurology Service, Hospital Angelina Caron, 83430-000 Curitiba, Paraná, Brazil
| | - Kelly Hussey
- University of South Florida Parkinson’s Disease and Movement Disorders Center of Excellence, Tampa, FL 33612, USA
| | - Jon Infante
- Service of Neurology, University Hospital ‘Marqués de Valdecilla (IDIVAL)’, University of Cantabria, and ‘Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED)’, 39008 Santander, Cantabria, Spain
| | - Stuart H Isaacson
- Parkinson’s Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL 33486, USA
| | - Serge Jauma
- Neurology Service, Hospital Universitari de Bellvitge, 08907 Barcelona, Catalonia, Spain
| | | | - Gregor Kuhlenbäumer
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Schleswig-Holstein, Germany
| | - Andrea Kühn
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité, University Medicine Berlin, 10117 Berlin, Berlin, Germany
| | - Irene Litvan
- Parkinson and Other Movement Disorders Center, University of California San Diego Health, La Jolla, San Diego, CA 92037, USA
| | - Lydia López-Manzanares
- Department of Neurology, Movement Disorders Unit, La Princesa University Hospital, 28006 Madrid, Madrid, Spain
| | - McKenzie Luxmore
- Department of Neurology, Duke University School of Medicine, Durham, NC 27710, USA
| | | | - Veronique Marcaud
- Department of Neurology, Saint Joseph Hospital, 75014 Paris, Île-de-France, France
| | - Katerina Markopoulou
- Department of Neurology, NorthShore University HealthSystem, Evanston, IL 60201, USA
- Department of Neurology, Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Connie Marras
- The Edmond J Safra Program in Parkinson’s Disease, Toronto Western Hospital, University of Toronto, Toronto, Ontario M5T 2S8, Canada
| | | | - Michele Matarazzo
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Fundación Hospitales de Madrid, Hospital Universitario HM Puerta del Sur, HM Hospitales, 28938 Madrid, Madrid, Spain
| | - Marcelo Merello
- Movement Disorders Service FLENI, CONICET, C1428 Buenos Aires, Ciudad Autónoma de Buenos Aires (CABA), Argentina
| | - Brit Mollenhauer
- Paracelsus-Elena-Klinik, 34128 Kassel, Hesse, Germany
- Department of Neurology, University Medical Centre Göttingen, 37075 Göttingen, Lower Saxony, Germany
| | - John C Morgan
- Movement & Memory Disorder Programs, Department of Neurology, Augusta University Medical Center, Augusta, GA 30912, USA
| | - Stephen Mullin
- Institute of Translational and Stratified Medicine, University of Plymouth School of Medicine, Plymouth, Devon PL6 8BU, UK
| | - Thomas Musacchio
- Department of Neurology, University Hospital of Würzburg, 97080 Würzburg, Bavaria, Germany
| | | | - Anna Negrotti
- Department of General and Specialized Medicine, Neurology Unit, University Hospital of Parma, 43126 Parma, Emilia-Romagna, Italy
| | | | - Zeev Nitsan
- Department of Neurology, Barzilai Medical Center, 78278 Ashkelon, Southern District, Israel
- Faculty of Health Sciences, Ben Gurion University of the Negev, 84105 Beer-Sheva, Southern District, Israel
| | - Nader Oskooilar
- Pharmacology Research Institute, Newport Beach, CA 92660, USA
| | - Özgür Öztop-Çakmak
- Department of Neurology, Koç University, 34450 Istanbul, Istanbul, Turkey
| | - Gian Pal
- Department of Neurology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
| | - Nicola Pavese
- Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, Tyne and Wear NE4 5PL, UK
| | - Antonio Percesepe
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Emilia-Romagna, Italy
| | - Tommaso Piccoli
- Unit of Neurology, Department of Biomedicine, Neurosciences and advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Sicily, Italy
| | - Carolina Pinto de Souza
- Department of Neurology, São Francisco Hospital, University of São Paulo, 01236-030 São Paulo, São Paulo, Brazil
| | - Tino Prell
- Department of Neurology, Jena University Hospital, 07747 Jena, Thuringia, Germany
- Department of Geriatrics, Halle University Hospital, 06120 Halle, Saxony-Anhalt, Germany
| | - Mark Pulera
- Pharmacology Research Institute, Encino, CA 91316, USA
| | - Jason Raw
- Clinical Research Unit, Pennine Acute Hospitals NHS Trust, Oldham, Greater Manchester OL1 2JH, UK
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, 52074 Aachen, North Rhine-Westphalia, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Research Centre Jülich, 52428 Jülich, North Rhine-Westphalia, Germany
| | - Johnathan Reiner
- Department of Neurology, Movement Disorders Clinic, Rabin Medical Center-Beilinson Hospital, 49100 Petach Tikva, Central District, Israel
- Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Tel Aviv District, Israel
| | - David Rosenberg
- Pharmacology Research Institute, Los Alamitos, CA 90720, USA
| | - Marta Ruiz-Lopez
- Department of Neurology, University Hospital Cruces, Biocruces Research Institute, 48903 Barakaldo, Basque Country, Spain
| | - Javier Ruiz Martinez
- Department of Neurology, Hospital Universitario Donostia, 20014 San Sebastian, Basque Country, Spain
| | - Esther Sammler
- Medical Research Council Protein Phosphorylation and Ubiquitylation Unit, University of Dundee, Dundee DD1 5EH, UK
- Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
| | | | | | - Ilana Schlesinger
- Rambam Health Care Campus, Technion Faculty of Medicine, 31096 Haifa, Haifa District, Israel
| | - Christine M Schofield
- Research and Development Unit, Royal Cornwall Hospitals Trust, Truro, Cornwall TR1 3LJ, UK
| | - Artur F Schumacher-Schuh
- Neurological Services, Clinical Hospital of Porto Alegre, 90035-903 Porto Alegre, Rio Grande do Sul, Brazil
| | - Burton Scott
- Department of Neurology, Duke University School of Medicine, Durham, NC 27710, USA
| | - Ángel Sesar
- Department of Neurology, University Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Galicia, Spain
| | - Stuart J Shafer
- Vero Beach Neurology and Research Institute, Vero Beach, FL 32960, USA
| | - Ray Sheridan
- Geriatric Medicine, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, Devon EX2 5DW, UK
| | - Monty Silverdale
- Division of Neurology, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, Manchester, Greater Manchester M6 8HD, UK
| | - Rani Sophia
- Department of Geriatric Medicine, Yeovil Hospital, Yeovil, Somerset BA21 4AT, UK
| | - Mariana Spitz
- Neurology, Pedro Ernesto University Hospital, 20551-030 Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pantelis Stathis
- Department of Neurology, Mediterraneo Hospital, 166 75 Glyfada-Athens, Attica, Greece
| | - Fabrizio Stocchi
- University and Institute for Research and Medical Care, IRCCS San Raffaele, 00166 Rome, Lazio, Italy
| | - Michele Tagliati
- Nuffield Department of Clinical Neurosciences, Division of Clinical Neurology, University of Oxford, Oxford OX3 9DU, UK
| | - Yen F Tai
- Division of Medicine and Integrated Care, Charing Cross Hospital, Imperial College Healthcare Trust, London W6 8RF, UK
| | | | - Sven Thonke
- Department of Neurology, Klinikum Hanau, 63450 Hanau, Hesse, Germany
| | - Lars Tönges
- Department of Neurology, St. Josef-Hospital and Neurodegeneration Research, Protein Research Unit Ruhr (PURE), Ruhr University Bochum, 44791 Bochum, North Rhine-Westphalia, Germany
- Neurodegeneration Research, Protein Research Unit Ruhr (PURE), Ruhr University Bochum, 44791 Bochum, North Rhine-Westphalia, Germany
| | - Giulia Toschi
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Emilia-Romagna, Italy
| | - Vitor Tumas
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School of University of São Paulo, 14049-900 São Paulo, São Paulo, Brazil
| | - Peter Paul Urban
- Department of Neurology, Asklepios Klinik Barmbek, 22307 Hamburg, Hamburg, Germany
| | - Laura Vacca
- University and Institute for Research and Medical Care, IRCCS San Raffaele, 00166 Rome, Lazio, Italy
| | - Wim Vandenberghe
- Department of Neurology, University Hospitals Leuven, 3000 Leuven, Flanders, Belgium
- Department of Neurosciences, KU Leuven, 3000 Leuven, Flanders, Belgium
| | - Enza Maria Valente
- Neurogenetics Research Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Lombardy, Italy
| | - Franco Valzania
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Emilia-Romagna, Italy
| | - Lydia Vela-Desojo
- Neurology Unit, Hospital Fundación Alcorcón, 28922 Madrid, Madrid, Spain
| | - Caroline Weill
- Neurogenetics Research Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - David Weise
- Department of Neurology, Asklepios Fachklinikum Stadtroda, 07646 Stadtroda, Thuringia, Germany
- Department of Neurology, University of Leipzig, 04103 Leipzig, Saxony, Germany
| | | | - Martin Wolz
- Department of Neurology, Elblandklinikum Meißen, 01662 Meißen, Saxony, Germany
| | - Gilad Yahalom
- Department of Neurology and the Movement Disorders Unit, Shaare Zedek Medical Center, 9103102 Jerusalem, Jerusalem District, Israel
| | - Gul Yalcin-Cakmakli
- Department of Neurology, Faculty of Medicine, Hacettepe University, 06100 Ankara, Ankara, Turkey
| | - Simone Zittel
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Hamburg, Germany
| | - Yair Zlotnik
- Neurology Department, Soroka University Medical Center, 84101 Beer Sheva, Southern District, Israel
| | | | - Alexander Balck
- Institute of Neurogenetics, University of Lübeck, University Medical Center Schleswig-Holstein, 23538 Lübeck, Schleswig-Holstein, Germany
- Department of Neurology, University of Lübeck, 23562 Lübeck, Schleswig-Holstein, Germany
| | - Henrike Hanssen
- Institute of Neurogenetics, University of Lübeck, University Medical Center Schleswig-Holstein, 23538 Lübeck, Schleswig-Holstein, Germany
- Department of Neurology, University of Lübeck, 23562 Lübeck, Schleswig-Holstein, Germany
| | - Max Borsche
- Institute of Neurogenetics, University of Lübeck, University Medical Center Schleswig-Holstein, 23538 Lübeck, Schleswig-Holstein, Germany
- Department of Neurology, University of Lübeck, 23562 Lübeck, Schleswig-Holstein, Germany
| | - Lara M Lange
- Institute of Neurogenetics, University of Lübeck, University Medical Center Schleswig-Holstein, 23538 Lübeck, Schleswig-Holstein, Germany
- Department of Neurology, University of Lübeck, 23562 Lübeck, Schleswig-Holstein, Germany
| | - Ilona Csoti
- Neurology Service, Hospital Universitari de Bellvitge, 08907 Barcelona, Catalonia, Spain
| | - Katja Lohmann
- Institute of Neurogenetics, University of Lübeck, University Medical Center Schleswig-Holstein, 23538 Lübeck, Schleswig-Holstein, Germany
| | - Meike Kasten
- Institute of Neurogenetics, University of Lübeck, University Medical Center Schleswig-Holstein, 23538 Lübeck, Schleswig-Holstein, Germany
| | - Norbert Brüggemann
- Institute of Neurogenetics, University of Lübeck, University Medical Center Schleswig-Holstein, 23538 Lübeck, Schleswig-Holstein, Germany
- Department of Neurology, University of Lübeck, 23562 Lübeck, Schleswig-Holstein, Germany
| | - Arndt Rolfs
- CENTOGENE GmbH, 18055 Rostock, Mecklenburg-Vorpommern, Germany
- Department of Neurology, University of Rostock, 18057 Rostock, Mecklenburg-Vorpommern, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, University Medical Center Schleswig-Holstein, 23538 Lübeck, Schleswig-Holstein, Germany
| | - Peter Bauer
- CENTOGENE GmbH, 18055 Rostock, Mecklenburg-Vorpommern, Germany
- Department of Internal Medicine, University of Rostock, 18057 Rostock, Mecklenburg-Vorpommern, Germany
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3
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Maver A, Lohmann K, Borovečki F, Wolstenholme N, Taylor RL, Spielmann M, Haack TB, Gerberding M, Peterlin B, Graessner H. Quality assurance for next-generation sequencing diagnostics of rare neurological diseases in the European Reference Network. Eur J Hum Genet 2024; 32:1014-1021. [PMID: 38839988 PMCID: PMC11292006 DOI: 10.1038/s41431-024-01639-2] [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: 01/22/2024] [Revised: 03/26/2024] [Accepted: 05/14/2024] [Indexed: 06/07/2024] Open
Abstract
In the past decade, next-generation sequencing (NGS) has revolutionised genetic diagnostics for rare neurological disorders (RND). However, the lack of standardised technical, interpretative, and reporting standards poses a challenge for ensuring consistent and high-quality diagnostics globally. To address this, the European Reference Network for Rare Neurological Diseases (ERN-RND) collaborated with the European Molecular Genetics Quality Network (EMQN) to establish an external quality assessment scheme for NGS-based diagnostics in RNDs. The scheme, initiated in 2021 with a pilot involving 29 labs and followed by a second round in 2022 with 42 labs, aimed to evaluate the performance of laboratories in genetic testing for RNDs. Each participating lab analysed genetic data from three hypothetical cases, assessing genotyping, interpretation, and clerical accuracy. Despite a majority of labs using exome or genome sequencing, there was considerable variability in gene content, sequencing quality, adherence to standards, and clinical guidance provision. Results showed that while most labs provided correct molecular diagnoses, there was significant variability in reporting technical quality, adherence to interpretation standards, reporting strategies, and clinical commentary. Notably, some labs returned results with the potential for adverse medical outcomes. This underscores the need for further harmonisation, guideline development, and external quality assessment in the evolving landscape of genomic diagnostics for RNDs. Overall, the experience with the scheme highlighted the generally good quality of participating labs but emphasised the imperative for ongoing improvement in data analysis, interpretation, and reporting to enhance patient safety.
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Affiliation(s)
- Aleš Maver
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Katja Lohmann
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | - Fran Borovečki
- Department of Neurology, University Hospital Centre Zagreb, Zagreb, Croatia
| | | | - Rachel L Taylor
- EMQN CIC, Unit 4 Enterprise Hse, Manchester Science Park, Manchester, UK
| | - Malte Spielmann
- Institute of Human Genetics, University of Lübeck, Lübeck, Germany
| | - Tobias B Haack
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Matthias Gerberding
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Borut Peterlin
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Holm Graessner
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.
- Centre for Rare Diseases, University of Tübingen, Tübingen, Germany.
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4
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Moura J, Oliveira J, Santos M, Costa S, Silva L, Lemos C, Barros J, Sequeiros J, Damásio J. Spinocerebellar Ataxias: Phenotypic Spectrum of PolyQ versus Non-Repeat Expansion Forms. CEREBELLUM (LONDON, ENGLAND) 2024:10.1007/s12311-024-01723-9. [PMID: 39048885 DOI: 10.1007/s12311-024-01723-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/17/2024] [Indexed: 07/27/2024]
Abstract
Spinocerebellar ataxias (SCA) are most frequently due to (CAG)n (coding for polyglutamine, polyQ) expansions and, less so, to expansion of other oligonucleotide repeats (non-polyQ) or other type of variants (non-repeat expansion SCA). In this study we compared polyQ and non-repeat expansion SCA, in a cohort of patients with hereditary ataxia followed at a tertiary hospital. From a prospective study, 88 patients (51 families) with SCA were selected, 74 (40 families) of whom genetically diagnosed. Thirty-eight patients (51.4%, 19 families) were confirmed as having a polyQ (no other repeat-expansions were identified) and 36 (48.6%, 21 families) a non-repeat expansion SCA. Median age-at-onset was 39.5 [30.0-45.5] for polyQ and 7.0 years [1.00-21.50] for non-repeat expansion SCA. PolyQ SCA were associated with cerebellar onset, and non-repeat expansion forms with non-cerebellar onset. Time to diagnosis was longer for non-repeat expansion SCA. The most common polyQ SCA were Machado-Joseph disease (MJD/SCA3) (73.7%) and SCA2 (15.8%); whereas in non-repeat expansion SCA ATX-CACNA1A (14.3%), ATP1A3-related ataxia, ATX-ITPR1, ATX/HSP-KCNA2, and ATX-PRKCG (9.5% each) predominated. Disease duration (up to inclusion) was significantly higher in non-repeat expansion SCA, but the difference in SARA score was not statistically significant. Cerebellar peduncles and pons atrophy were more common in polyQ ataxias, as was axonal neuropathy. SCA had a wide range of genetic etiology, age-at-onset and presentation. Proportion of polyQ and non-repeat expansion SCA was similar; the latter had a higher genetic heterogeneity. While polyQ ataxias were typically linked to cerebellar onset in adulthood, non-repeat expansion forms associated with early onset and non-cerebellar presentations.
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Affiliation(s)
- João Moura
- Neurology Department, Centro Hospitalar Universitário de Santo António, ULS de Santo António, Porto, Portugal
| | - Jorge Oliveira
- Centro de Genética Preditiva e Preventiva (CGPP), IBMC - Institute for Molecular and Cell Biology, Universidade do Porto, Porto, Portugal
- IBMC - Institute for Molecular and Cell Biology, i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Mariana Santos
- IBMC - Institute for Molecular and Cell Biology, i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Sara Costa
- Neurology Department, Centro Hospitalar Universitário de Santo António, ULS de Santo António, Porto, Portugal
| | - Lénia Silva
- Neurology Department, Centro Hospitalar Universitário de Santo António, ULS de Santo António, Porto, Portugal
| | - Carolina Lemos
- IBMC - Institute for Molecular and Cell Biology, i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- ICBAS School of Medicine and Biomedical Sciences, Universidade do Porto, Porto, Portugal
| | - José Barros
- Neurology Department, Centro Hospitalar Universitário de Santo António, ULS de Santo António, Porto, Portugal
- ICBAS School of Medicine and Biomedical Sciences, Universidade do Porto, Porto, Portugal
| | - Jorge Sequeiros
- Centro de Genética Preditiva e Preventiva (CGPP), IBMC - Institute for Molecular and Cell Biology, Universidade do Porto, Porto, Portugal
- IBMC - Institute for Molecular and Cell Biology, i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- ICBAS School of Medicine and Biomedical Sciences, Universidade do Porto, Porto, Portugal
| | - Joana Damásio
- Neurology Department, Centro Hospitalar Universitário de Santo António, ULS de Santo António, Porto, Portugal.
- Centro de Genética Preditiva e Preventiva (CGPP), IBMC - Institute for Molecular and Cell Biology, Universidade do Porto, Porto, Portugal.
- IBMC - Institute for Molecular and Cell Biology, i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.
- ICBAS School of Medicine and Biomedical Sciences, Universidade do Porto, Porto, Portugal.
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5
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Sanesteban-Beceiro E, Fenollar-Cortés M, Herrero-Forte C, Gómez-Mayordomo V, Catalán-Alonso MJ, Alonso-Frech F. Expanding the Phenotypic Variability of PMPCA-Related Ataxia. Mov Disord Clin Pract 2024; 11:894-896. [PMID: 38696267 PMCID: PMC11233841 DOI: 10.1002/mdc3.14057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 03/27/2024] [Accepted: 04/10/2024] [Indexed: 05/04/2024] Open
Affiliation(s)
| | - María Fenollar-Cortés
- Clinical Genetics Unit, Clinical Analysis Department, Institut of Laboratory Medicine, IdISSC, Clínico San Carlos Hospital, Madrid, Spain
| | - Clara Herrero-Forte
- Clinical Genetics Unit, Clinical Analysis Department, Institut of Laboratory Medicine, IdISSC, Clínico San Carlos Hospital, Madrid, Spain
| | - Victor Gómez-Mayordomo
- Department of Neurology, Vithas Madrid La Milagrosa University Hospital, Vithas Hospital Group, Madrid, Spain
| | - María J Catalán-Alonso
- Movement Disorders Unit, Neurology Department, IdISSC, Clínico San Carlos Hospital, Madrid, Spain
| | - Fernando Alonso-Frech
- Movement Disorders Unit, Neurology Department, IdISSC, Clínico San Carlos Hospital, Madrid, Spain
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6
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Indelicato E, Romito LM, Harrer P, Golfrè Andreasi N, Colangelo I, Kopajtich R, Winkelmann J, Prokisch H, Garavaglia B, Zech M. Genome Aggregation Database Version 4-New Challenges of Variant Analysis in Movement Disorders. Mov Disord 2024; 39:1237-1238. [PMID: 38516945 DOI: 10.1002/mds.29797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/28/2024] [Accepted: 03/08/2024] [Indexed: 03/23/2024] Open
Affiliation(s)
- Elisabetta Indelicato
- Department of Neurology, Center for Rare Movement Disorders Innsbruck, Medical University Innsbruck, Innsbruck, Austria
- Institute of Neurogenomics, Helmholtz Munich, Neuherberg, Germany
- Institute of Human Genetics, School of Medicine, Technical University of Munich, Munich, Germany
| | - Luigi Michele Romito
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Philip Harrer
- Institute of Neurogenomics, Helmholtz Munich, Neuherberg, Germany
- Institute of Human Genetics, School of Medicine, Technical University of Munich, Munich, Germany
| | - Nico Golfrè Andreasi
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Isabel Colangelo
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Robert Kopajtich
- Institute of Neurogenomics, Helmholtz Munich, Neuherberg, Germany
- Institute of Human Genetics, School of Medicine, Technical University of Munich, Munich, Germany
| | - Juliane Winkelmann
- Institute of Neurogenomics, Helmholtz Munich, Neuherberg, Germany
- Institute of Human Genetics, School of Medicine, Technical University of Munich, Munich, Germany
- DZPG, Deutsches Zentrum für Psychische Gesundheit, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Holger Prokisch
- Institute of Neurogenomics, Helmholtz Munich, Neuherberg, Germany
- Institute of Human Genetics, School of Medicine, Technical University of Munich, Munich, Germany
| | - Barbara Garavaglia
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Michael Zech
- Institute of Neurogenomics, Helmholtz Munich, Neuherberg, Germany
- Institute of Human Genetics, School of Medicine, Technical University of Munich, Munich, Germany
- Institute for Advanced Study, Technical University of Munich, Garching, Germany
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7
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Bernal-Conde LD, Peña-Martínez V, Morato-Torres CA, Ramos-Acevedo R, Arias-Carrión Ó, Padilla-Godínez FJ, Delgado-González A, Palomero-Rivero M, Collazo-Navarrete O, Soto-Rojas LO, Gómez-Chavarín M, Schüle B, Guerra-Crespo M. Alpha-Synuclein Gene Alterations Modulate Tyrosine Hydroxylase in Human iPSC-Derived Neurons in a Parkinson's Disease Animal Model. Life (Basel) 2024; 14:728. [PMID: 38929711 PMCID: PMC11204703 DOI: 10.3390/life14060728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 05/27/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
Parkinson's disease (PD) caused by SNCA gene triplication (3XSNCA) leads to early onset, rapid progression, and often dementia. Understanding the impact of 3XSNCA and its absence is crucial. This study investigates the differentiation of human induced pluripotent stem cell (hiPSC)-derived floor-plate progenitors into dopaminergic neurons. Three different genotypes were evaluated in this study: patient-derived hiPSCs with 3XSNCA, a gene-edited isogenic line with a frame-shift mutation on all SNCA alleles (SNCA 4KO), and a normal wild-type control. Our aim was to assess how the substantia nigra pars compacta (SNpc) microenvironment, damaged by 6-hydroxydopamine (6-OHDA), influences tyrosine hydroxylase-positive (Th+) neuron differentiation in these genetic variations. This study confirms successful in vitro differentiation into neuronal lineage in all cell lines. However, the SNCA 4KO line showed unusual LIM homeobox transcription factor 1 alpha (Lmx1a) extranuclear distribution. Crucially, both 3XSNCA and SNCA 4KO lines had reduced Th+ neuron expression, despite initial successful neuronal differentiation after two months post-transplantation. This indicates that while the SNpc environment supports early neuronal survival, SNCA gene alterations-either amplification or knock-out-negatively impact Th+ dopaminergic neuron maturation. These findings highlight SNCA's critical role in PD and underscore the value of hiPSC models in studying neurodegenerative diseases.
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Affiliation(s)
- Luis Daniel Bernal-Conde
- Laboratory of Regenerative Medicine, Physiology Department, Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04510, Mexico; (L.D.B.-C.); (V.P.-M.); (C.A.M.-T.); (R.R.-A.); (F.J.P.-G.); (A.D.-G.); (M.G.-C.)
- Molecular Neuropathology Department, Neuroscience Division, Institute of Cell Physiology, National Autonomous University of Mexico, Mexico City 04510, Mexico
| | - Verónica Peña-Martínez
- Laboratory of Regenerative Medicine, Physiology Department, Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04510, Mexico; (L.D.B.-C.); (V.P.-M.); (C.A.M.-T.); (R.R.-A.); (F.J.P.-G.); (A.D.-G.); (M.G.-C.)
- Molecular Neuropathology Department, Neuroscience Division, Institute of Cell Physiology, National Autonomous University of Mexico, Mexico City 04510, Mexico
| | - C. Alejandra Morato-Torres
- Laboratory of Regenerative Medicine, Physiology Department, Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04510, Mexico; (L.D.B.-C.); (V.P.-M.); (C.A.M.-T.); (R.R.-A.); (F.J.P.-G.); (A.D.-G.); (M.G.-C.)
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94304, USA;
| | - Rodrigo Ramos-Acevedo
- Laboratory of Regenerative Medicine, Physiology Department, Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04510, Mexico; (L.D.B.-C.); (V.P.-M.); (C.A.M.-T.); (R.R.-A.); (F.J.P.-G.); (A.D.-G.); (M.G.-C.)
- Molecular Neuropathology Department, Neuroscience Division, Institute of Cell Physiology, National Autonomous University of Mexico, Mexico City 04510, Mexico
| | - Óscar Arias-Carrión
- Movement and Sleep Disorders Unit, Dr. Manuel Gea González General Hospital, Mexico City 14080, Mexico;
| | - Francisco J. Padilla-Godínez
- Laboratory of Regenerative Medicine, Physiology Department, Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04510, Mexico; (L.D.B.-C.); (V.P.-M.); (C.A.M.-T.); (R.R.-A.); (F.J.P.-G.); (A.D.-G.); (M.G.-C.)
- Molecular Neuropathology Department, Neuroscience Division, Institute of Cell Physiology, National Autonomous University of Mexico, Mexico City 04510, Mexico
| | - Alexa Delgado-González
- Laboratory of Regenerative Medicine, Physiology Department, Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04510, Mexico; (L.D.B.-C.); (V.P.-M.); (C.A.M.-T.); (R.R.-A.); (F.J.P.-G.); (A.D.-G.); (M.G.-C.)
- Molecular Neuropathology Department, Neuroscience Division, Institute of Cell Physiology, National Autonomous University of Mexico, Mexico City 04510, Mexico
| | - Marcela Palomero-Rivero
- Neurodevelopment and Physiology Department, Neuroscience Division, Institute of Cell Physiology, National Autonomous University of Mexico, Mexico City 04510, Mexico;
| | - Omar Collazo-Navarrete
- National Laboratory of Genomic Resources, Institute of Biomedical Research, National Autonomous University of Mexico, Mexico City 04510, Mexico;
| | - Luis O. Soto-Rojas
- Laboratory of Molecular Pathogenesis, Laboratory 4, Building A4, Medical Surgeon Career, Faculty of Higher Studies Iztacala, National Autonomous University of Mexico, Mexico City 54090, Mexico;
| | - Margarita Gómez-Chavarín
- Laboratory of Regenerative Medicine, Physiology Department, Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04510, Mexico; (L.D.B.-C.); (V.P.-M.); (C.A.M.-T.); (R.R.-A.); (F.J.P.-G.); (A.D.-G.); (M.G.-C.)
| | - Birgitt Schüle
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94304, USA;
| | - Magdalena Guerra-Crespo
- Laboratory of Regenerative Medicine, Physiology Department, Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04510, Mexico; (L.D.B.-C.); (V.P.-M.); (C.A.M.-T.); (R.R.-A.); (F.J.P.-G.); (A.D.-G.); (M.G.-C.)
- Molecular Neuropathology Department, Neuroscience Division, Institute of Cell Physiology, National Autonomous University of Mexico, Mexico City 04510, Mexico
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8
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Milovanović A, Westenberger A, Stanković I, Tamaš O, Branković M, Marjanović A, Laabs BH, Brand M, Rajalingam R, Marras C, Lohmann K, Branković V, Novaković I, Petrović I, Svetel M, Klein C, Kostić VS, Dragašević-Mišković N. ANO10-Related Spinocerebellar Ataxia: MDSGene Systematic Literature Review and a Romani Case Series. Mov Disord 2024; 39:887-892. [PMID: 38469933 DOI: 10.1002/mds.29729] [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: 09/11/2023] [Revised: 12/09/2023] [Accepted: 01/11/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Biallelic pathogenic variants in the ANO10 gene cause autosomal recessive progressive ataxia (ATX-ANO10). METHODS Following the MDSGene protocol, we systematically investigated genotype-phenotype relationships in ATX-ANO10 based on the clinical and genetic data from 82 published and 12 newly identified patients. RESULTS Most patients (>80%) had loss-of-function (LOF) variants. The most common variant was c.1150_1151del, found in all 29 patients of Romani ancestry, who had a 14-year earlier mean age at onset than patients homozygous for other LOF variants. We identified previously undescribed clinical features of ATX-ANO10 (e.g., facial muscle involvement and strabismus) suggesting the involvement of brainstem pathology, and we propose a diagnostic algorithm that may aid clinical ATX-ANO10 diagnosis. CONCLUSIONS The early disease onset in patients with c.1150_1151del may indicate the existence of genetic/environmental disease-modifying factors in the Romani population. Our findings will inform patient counseling and may improve our understanding of the disease mechanism. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Andona Milovanović
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Ana Westenberger
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Iva Stanković
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Olivera Tamaš
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marija Branković
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Ana Marjanović
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Björn-Hergen Laabs
- Institute of Medical Biometry and Statistics, University of Lübeck, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Max Brand
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Rajasumi Rajalingam
- Department of Medicine, Division of Neurology, Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Canada
| | - Connie Marras
- Department of Medicine, Division of Neurology, Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Canada
| | - Katja Lohmann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Vesna Branković
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Ivana Novaković
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Igor Petrović
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marina Svetel
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Vladimir S Kostić
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Natasa Dragašević-Mišković
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
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9
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Khani M, Cerquera-Cleves C, Kekenadze M, Crea PAW, Singleton AB, Bandres-Ciga S. Towards a Global View of Parkinson's Disease Genetics. Ann Neurol 2024; 95:831-842. [PMID: 38557965 PMCID: PMC11060911 DOI: 10.1002/ana.26905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/22/2024] [Accepted: 02/25/2024] [Indexed: 04/04/2024]
Abstract
Parkinson's disease (PD) is a global health challenge, yet historically studies of PD have taken place predominantly in European populations. Recent genetics research conducted in non-European populations has revealed novel population-specific genetic loci linked to PD risk, highlighting the importance of studying PD globally. These insights have broadened our understanding of PD etiology, which is crucial for developing disease-modifying interventions. This review comprehensively explores the global genetic landscape of PD, emphasizing the scientific rationale for studying underrepresented populations. It underscores challenges, such as genotype-phenotype heterogeneity and inclusion difficulties for non-European participants, emphasizing the ongoing need for diverse and inclusive research in PD. ANN NEUROL 2024;95:831-842.
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Affiliation(s)
- Marzieh Khani
- Center for Alzheimer’s and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Catalina Cerquera-Cleves
- Pontificia Universidad Javeriana, San Ignacio Hospital, Neurology Unit, Bogotá, Colombia
- CHU de Québec Research Center, Axe Neurosciences, Laval University. Quebec City, Canada
| | - Mariam Kekenadze
- Tbilisi State Medical University, Tbilisi, 0141, Georgia
- University College London, Queen Square Institute of Neurology , WC1N 3BG, London, UK
| | - Peter A. Wild Crea
- Center for Alzheimer’s and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Andrew B. Singleton
- Center for Alzheimer’s and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Sara Bandres-Ciga
- Center for Alzheimer’s and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
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10
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Chopra A, Lang AE, Höglinger G, Outeiro TF. Towards a biological diagnosis of PD. Parkinsonism Relat Disord 2024; 122:106078. [PMID: 38472075 DOI: 10.1016/j.parkreldis.2024.106078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024]
Abstract
Since the original description by James Parkinson, Parkinson's disease (PD) has intrigued us for over 200 years. PD is a progressive condition that is incurable so far, and affects millions of people worldwide. Over the years, our knowledge has expanded tremendously, and a range of criteria have been put forward and used to try to define PD. However, owing to the complexity of the problem, it is still not consensual how to diagnose and classify a disease that manifests with diverse features, and that responds differently to existing therapies and to those under development. We are now living a time when 'biological' information is becoming abundant, precise, and accessible enabling us to attempt to incorporate different sources of information to classify different forms of PD. These refinements are essential for basic science, as they will enable us to develop improved models for studying PD, and to implement new findings into clinical practice, as this will be the path towards effective personalized medicine.
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Affiliation(s)
- Avika Chopra
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Göttingen, Göttingen, Germany
| | - Anthony E Lang
- Edmond J Safra Program in Parkinson's Disease, Krembil Brain Institute, University Health Network and the Department of Medicine, University of Toronto, Canada
| | - Günter Höglinger
- Department of Neurology, LMU University Hospital, Ludwig-Maximilians-Universität (LMU) München, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Tiago F Outeiro
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Göttingen, Göttingen, Germany; Max Planck Institute for Multidisciplinary Sciences, Göttingen, Germany; Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK; German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany.
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11
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Atasu B, Simón-Sánchez J, Hanagasi H, Bilgic B, Hauser AK, Guven G, Heutink P, Gasser T, Lohmann E. Dissecting genetic architecture of rare dystonia: genetic, molecular and clinical insights. J Med Genet 2024; 61:443-451. [PMID: 38458754 DOI: 10.1136/jmg-2022-109099] [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: 12/08/2022] [Accepted: 12/24/2023] [Indexed: 03/10/2024]
Abstract
BACKGROUND Dystonia is one of the most common movement disorders. To date, the genetic causes of dystonia in populations of European descent have been extensively studied. However, other populations, particularly those from the Middle East, have not been adequately studied. The purpose of this study is to discover the genetic basis of dystonia in a clinically and genetically well-characterised dystonia cohort from Turkey, which harbours poorly studied populations. METHODS Exome sequencing analysis was performed in 42 Turkish dystonia families. Using co-expression network (CEN) analysis, identified candidate genes were interrogated for the networks including known dystonia-associated genes and genes further associated with the protein-protein interaction, animal model-based characteristics and clinical findings. RESULTS We identified potentially disease-causing variants in the established dystonia genes (PRKRA, SGCE, KMT2B, SLC2A1, GCH1, THAP1, HPCA, TSPOAP1, AOPEP; n=11 families (26%)), in the uncommon forms of dystonia-associated genes (PCCB, CACNA1A, ALDH5A1, PRKN; n=4 families (10%)) and in the candidate genes prioritised based on the pathogenicity of the variants and CEN-based analyses (n=11 families (21%)). The diagnostic yield was found to be 36%. Several pathways and gene ontologies implicated in immune system, transcription, metabolic pathways, endosomal-lysosomal and neurodevelopmental mechanisms were over-represented in our CEN analysis. CONCLUSIONS Here, using a structured approach, we have characterised a clinically and genetically well-defined dystonia cohort from Turkey, where dystonia has not been widely studied, and provided an uncovered genetic basis, which will facilitate diagnostic dystonia research.
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Affiliation(s)
- Burcu Atasu
- Eberhard Karls Universität Tübingen Hertie Institut für klinische Hirnforschung Allgemeine Neurologie, Tubingen, Germany
| | - Javier Simón-Sánchez
- Eberhard Karls Universität Tübingen Hertie Institut für klinische Hirnforschung Allgemeine Neurologie, Tubingen, Germany
| | - Hasmet Hanagasi
- Department of Neurology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Basar Bilgic
- Department of Neurology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Ann-Kathrin Hauser
- Eberhard Karls Universität Tübingen Hertie Institut für klinische Hirnforschung Allgemeine Neurologie, Tubingen, Germany
| | - Gamze Guven
- Genetics Department, Aziz Sancar Institute of Experimental Medicine, Istanbul, Turkey
| | | | - Thomas Gasser
- Eberhard Karls Universität Tübingen Hertie Institut für klinische Hirnforschung Allgemeine Neurologie, Tubingen, Germany
| | - Ebba Lohmann
- Eberhard Karls Universität Tübingen Hertie Institut für klinische Hirnforschung Allgemeine Neurologie, Tubingen, Germany
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12
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Shambetova C, Klein C. Genetic testing for non-parkinsonian movement disorders: Navigating the diagnostic maze. Parkinsonism Relat Disord 2024; 121:106033. [PMID: 38429185 DOI: 10.1016/j.parkreldis.2024.106033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/01/2024] [Accepted: 02/09/2024] [Indexed: 03/03/2024]
Abstract
Genetic testing has become a valuable diagnostic tool for movement disorders due to substantial advancements in understanding their genetic basis. However, the heterogeneity of movement disorders poses a significant challenge, with many genes implicated in different subtypes. This paper aims to provide a neurologist's perspective on approaching patients with hereditary hyperkinetic disorders with a focus on select forms of dystonia, paroxysmal dyskinesia, chorea, and ataxia. Age at onset, initial symptoms, and their severity, as well as the presence of any concurrent neurological and non-neurological features, contribute to the individual clinical profiles of hereditary non-parkinsonian movement disorders, aiding in the selection of appropriate genetic testing strategies. There are also more specific diagnostic clues that may facilitate the decision-making process and may be highly specific for certain conditions, such as diurnal fluctuations and l-dopa response in dopa-responsive dystonia, and triggering factors, duration and frequency of attacks in paroxysmal dyskinesia. While the genetic and mutational spectrum across non-parkinsonian movement disorders is broad, certain groups of diseases tend to be associated with specific types of pathogenic variants, such as repeat expansions in many of the ataxias. Some of these pathogenic variants cannot be detected by standard methods, such as panel or exome sequencing, but require the investigation of intronic regions for repeat expansions, such as Friedreich's or FGF14-linked ataxia. With our advancing knowledge of the genetic underpinnings of movement disorders, the incorporation of precise and personalized diagnostic strategies can enhance patient care, prognosis, and the application and development of targeted therapeutic interventions.
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Affiliation(s)
- Cholpon Shambetova
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany; Center for Continuing and Distance Learning, I. K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
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13
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Jia X, Chen Q, Yao C, Asakawa T, Zhang Y. α-synuclein regulates Cyclin D1 to promote abnormal initiation of the cell cycle and induce apoptosis in dopamine neurons. Biomed Pharmacother 2024; 173:116444. [PMID: 38503238 DOI: 10.1016/j.biopha.2024.116444] [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: 10/08/2023] [Revised: 03/09/2024] [Accepted: 03/15/2024] [Indexed: 03/21/2024] Open
Abstract
The etiology of Parkinson's disease (PD) is characterized by the death of dopamine neurons in the substantia nigra pars compacta, while misfolding and abnormal aggregation of α-synuclein (α-syn) are core pathological features. Previous studies have suggested that damage to dopamine neurons may be related to cell cycle dysregulation, but the specific mechanisms remain unclear. In this study, a PD mouse model was induced by stereotactic injection of α-syn into the nucleus, and treated with the cell cycle inhibitor, roscovitine (Rosc). The results demonstrated that Rosc improved behavioral disorders caused by α-syn, increased TH protein expression, inhibited α-syn and p-α-syn protein expression, and reduced the expression levels of G1/S phase cell cycle genes Cyclin D1, Cyclin E, CDK2, CDK4, E2F and pRB. Additionally, Rosc decreased Bax and Caspase-3 expression caused by α-syn, while increasing Bcl-2 protein expression. Meanwhile, we observed that α-syn can influence neuronal cell autophagy by decreasing the expression level of Beclin 1 and increasing the expression level of P62. However, Rosc can improve this phenomenon. In a cell model induced by α-syn in dopamine neuron injury cells, knockdown of Cyclin D1 led to similar results as those observed in animal experiments: Knocking down Cyclin D1 improved the abnormal initiation of the cell cycle caused by α-syn and regulated cellular autophagy, resulting in a reduction of apoptosis in dopamine neurons. In summary, exogenous α-syn can lead to the accumulation of α-syn and phosphorylated α-syn in dopamine neurons, increase key factors of the G1/S phase cell cycle such as Cyclin D1, and regulate downstream related indicators, causing the cell cycle to restart and leading to apoptosis of dopamine neurons. This exacerbates PD symptoms. However, knockdown of Cyclin D1 inhibits the progression of the cell cycle and can reverse this situation. These findings suggest that a Cyclin D inhibitor may be a novel therapeutic target for treating PD.
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Affiliation(s)
- Xiaokang Jia
- School of Traditional Chinese Medicine, Hainan Medical University, Haikou, Hainan 571199, China
| | - Qiliang Chen
- School of Basic Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China
| | - Ciyu Yao
- Department of Dermatology, Fuzhou Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine, FuZhou, Fujian 350000, China
| | - Tetsuya Asakawa
- Institute of Neurology, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong 518112, China.
| | - Yuanyuan Zhang
- The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, Guangdong 518112, China.
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14
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Dhar D, Holla VV, Kumari R, Yadav R, Kamble N, Muthusamy B, Pal PK. Clinical and genetic profile of patients with dystonia: An experience from a tertiary neurology center from India. Parkinsonism Relat Disord 2024; 120:105986. [PMID: 38219528 DOI: 10.1016/j.parkreldis.2023.105986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 12/15/2023] [Accepted: 12/28/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND The genetics of dystonia have varied across different ethnicities worldwide. Its significance has become more apparent with the advent of deep brain stimulation. OBJECTIVE To study the clinico-genetic profile of patients with probable genetic dystonia using whole exome sequencing (WES). METHODS A prospective, cross-sectional study was conducted from May 2021 to September 2022, enrolling patients with dystonia of presumed genetic etiology for WES. The study compared genetically-determined cases harboring pathogenic/likely-pathogenic variants (P/LP subgroup) with the presumed idiopathic or unsolved cases. RESULTS We recruited 65 patients (males, 69.2%) whose mean age of onset (AAO) and assessment were 25.0 ± 16.6 and 31.7 ± 15.2 years, respectively. Fifteen had pathogenic/likely-pathogenic variants (yield = 23.1%), 16 (24.6%) had variants of uncertain significance (VUS), 2 were heterozygous carriers while the remaining 32 cases tested negative (presumed idiopathic group). The P/LP subgroup had a significantly younger AAO (16.8 ± 12.3 vs 31.3 ± 17.0 years, p = 0.009), longer duration of illness (10.9 ± 10.3 vs 4.8 ± 4.3 years, p = 0.006), higher prevalence of generalized dystonia (n = 12, 80.0% vs n = 10, 31.3%, p = 0.004), lower-limb onset (n = 5, 33.3% vs n = 1, 3.1%, p = 0.009), higher motor (p = 0.035) and disability scores (p = 0.042). The classical DYT genes with pathogenic/likely pathogenic variants included 3 cases each of TOR1A, and KMT2B, and single cases each of SGCE, EIF2AK2, and VPS16. Non-DYT pathogenic/likely-pathogenic cases included PINK1, PANK2, CTSF, POLG, MICU1, and TSPOAP1. CONCLUSIONS The yield of WES was 23.1% among cases of probable genetic dystonia. Pathogenic or likely pathogenic variants in TOR1A, KMT2B, and SGCE genes were commoner. The absence of family history emphasizes the importance of accurate assessment of clinical predictors before genetic testing.
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Affiliation(s)
- Debjyoti Dhar
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India
| | - Vikram V Holla
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India
| | - Riyanka Kumari
- Institute of Bioinformatics, International Technology Park, Bengaluru 560066, India; Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India
| | - Nitish Kamble
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India
| | - Babylakshmi Muthusamy
- Institute of Bioinformatics, International Technology Park, Bengaluru 560066, India; Manipal Academy of Higher Education, Manipal 576104, Karnataka, India.
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India.
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15
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Thomsen M, Marth K, Loens S, Everding J, Junker J, Borngräber F, Ott F, Jesús S, Gelderblom M, Odorfer T, Kuhlenbäumer G, Kim HJ, Schaeffer E, Becktepe J, Kasten M, Brüggemann N, Pfister R, Kollewe K, Krauss JK, Lohmann E, Hinrichs F, Berg D, Jeon B, Busch H, Altenmüller E, Mir P, Kamm C, Volkmann J, Zittel S, Ferbert A, Zeuner KE, Rolfs A, Bauer P, Kühn AA, Bäumer T, Klein C, Lohmann K. Large-Scale Screening: Phenotypic and Mutational Spectrum in Isolated and Combined Dystonia Genes. Mov Disord 2024; 39:526-538. [PMID: 38214203 DOI: 10.1002/mds.29693] [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: 10/02/2023] [Revised: 11/16/2023] [Accepted: 12/01/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Pathogenic variants in several genes have been linked to genetic forms of isolated or combined dystonia. The phenotypic and genetic spectrum and the frequency of pathogenic variants in these genes have not yet been fully elucidated, neither in patients with dystonia nor with other, sometimes co-occurring movement disorders such as Parkinson's disease (PD). OBJECTIVES To screen >2000 patients with dystonia or PD for rare variants in known dystonia-causing genes. METHODS We screened 1207 dystonia patients from Germany (DysTract consortium), Spain, and South Korea, and 1036 PD patients from Germany for pathogenic variants using a next-generation sequencing gene panel. The impact on DNA methylation of KMT2B variants was evaluated by analyzing the gene's characteristic episignature. RESULTS We identified 171 carriers (109 with dystonia [9.0%]; 62 with PD [6.0%]) of 131 rare variants (minor allele frequency <0.005). A total of 52 patients (48 dystonia [4.0%]; four PD [0.4%, all with GCH1 variants]) carried 33 different (likely) pathogenic variants, of which 17 were not previously reported. Pathogenic biallelic variants in PRKRA were not found. Episignature analysis of 48 KMT2B variants revealed that only two of these should be considered (likely) pathogenic. CONCLUSION This study confirms pathogenic variants in GCH1, GNAL, KMT2B, SGCE, THAP1, and TOR1A as relevant causes in dystonia and expands the mutational spectrum. Of note, likely pathogenic variants only in GCH1 were also found among PD patients. For DYT-KMT2B, the recently described episignature served as a reliable readout to determine the functional effect of newly identified variants. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Mirja Thomsen
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Katrin Marth
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University Hospital Rostock, Rostock, Germany
| | - Sebastian Loens
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Institute of Systems Motor Science, CBBM, University of Lübeck, Lübeck, Germany
| | - Judith Everding
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Johanna Junker
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | | | - Fabian Ott
- Medical Systems Biology Group, Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Silvia Jesús
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Mathias Gelderblom
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thorsten Odorfer
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Gregor Kuhlenbäumer
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Han-Joon Kim
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Eva Schaeffer
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Jos Becktepe
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Meike Kasten
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Psychiatry, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Norbert Brüggemann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | | | - Katja Kollewe
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Joachim K Krauss
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - Ebba Lohmann
- Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE)-Tübingen, Tübingen, Germany
| | - Frauke Hinrichs
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Daniela Berg
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Beomseok Jeon
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Hauke Busch
- Medical Systems Biology Group, Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Eckart Altenmüller
- Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Hanover, Germany
| | - Pablo Mir
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Christoph Kamm
- Department of Neurology, University Hospital Rostock, Rostock, Germany
| | - Jens Volkmann
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Simone Zittel
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Kirsten E Zeuner
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Arndt Rolfs
- Medical Faculty, University of Rostock, Rostock, Germany
- Agyany Pharmaceuticals, Jerusalem, Israel
| | | | - Andrea A Kühn
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Bäumer
- Institute of Systems Motor Science, CBBM, University of Lübeck, Lübeck, Germany
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
- Center of Rare Diseases, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Katja Lohmann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
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16
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Farrow SL, Gokuladhas S, Schierding W, Pudjihartono M, Perry JK, Cooper AA, O'Sullivan JM. Identification of 27 allele-specific regulatory variants in Parkinson's disease using a massively parallel reporter assay. NPJ Parkinsons Dis 2024; 10:44. [PMID: 38413607 PMCID: PMC10899198 DOI: 10.1038/s41531-024-00659-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/12/2024] [Indexed: 02/29/2024] Open
Abstract
Genome wide association studies (GWAS) have identified a number of genomic loci that are associated with Parkinson's disease (PD) risk. However, the majority of these variants lie in non-coding regions, and thus the mechanisms by which they influence disease development, and/or potential subtypes, remain largely elusive. To address this, we used a massively parallel reporter assay (MPRA) to screen the regulatory function of 5254 variants that have a known or putative connection to PD. We identified 138 loci with enhancer activity, of which 27 exhibited allele-specific regulatory activity in HEK293 cells. The identified regulatory variant(s) typically did not match the original tag variant within the PD associated locus, supporting the need for deeper exploration of these loci. The existence of allele specific transcriptional impacts within HEK293 cells, confirms that at least a subset of the PD associated regions mark functional gene regulatory elements. Future functional studies that confirm the putative targets of the empirically verified regulatory variants will be crucial for gaining a greater understanding of how gene regulatory network(s) modulate PD risk.
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Affiliation(s)
- Sophie L Farrow
- Liggins Institute, The University of Auckland, Auckland, New Zealand.
- The Maurice Wilkins Centre, The University of Auckland, Auckland, New Zealand.
| | | | - William Schierding
- Liggins Institute, The University of Auckland, Auckland, New Zealand
- The Maurice Wilkins Centre, The University of Auckland, Auckland, New Zealand
- Department of Ophthalmology, The University of Auckland, Auckland, New Zealand
| | | | - Jo K Perry
- Liggins Institute, The University of Auckland, Auckland, New Zealand
- The Maurice Wilkins Centre, The University of Auckland, Auckland, New Zealand
| | - Antony A Cooper
- Australian Parkinsons Mission, Garvan Institute of Medical Research, Sydney, NSW, Australia
- St Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Justin M O'Sullivan
- Liggins Institute, The University of Auckland, Auckland, New Zealand.
- The Maurice Wilkins Centre, The University of Auckland, Auckland, New Zealand.
- Australian Parkinsons Mission, Garvan Institute of Medical Research, Sydney, NSW, Australia.
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore, Singapore.
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.
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17
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Nishide M, Le Marquand K, Davis MR, Halmágyi GM, Fellner A, Narayanan RK, Kennerson ML, Reddel SW, Worgan L, Panegyres PK, Kumar KR. Two New Families and a Literature Review of ELOVL4-Associated Spinocerebellar Ataxia Type 34. CEREBELLUM (LONDON, ENGLAND) 2024; 23:268-277. [PMID: 36696030 PMCID: PMC10864522 DOI: 10.1007/s12311-023-01522-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/18/2023] [Indexed: 01/26/2023]
Abstract
Autosomal dominant variants in ELOVL4 cause spinocerebellar ataxia type 34 (SCA34; ATX-ELOVL4), classically associated with a skin condition known as erythrokeratoderma. Here, we report a large Italian-Maltese-Australian family with spinocerebellar ataxia. Notably, while there were dermatological manifestations (eczema), erythrokeratoderma was not present. Using a next-generation sequencing panel, we identified a previously reported ELOVL4 variant, NM_022726.4: c.698C > T p.(Thr233Met). The variant was initially classified as a variant of uncertain significance; however, through segregation studies, we reclassified the variant as likely pathogenic. We next identified an individual from another family (Algerian-Maltese-Australian) with the same ELOVL4 variant with spinocerebellar ataxia but without dermatological manifestations. We subsequently performed the first dedicated literature review of ELOVL4-associated ataxia to gain further insights into genotype-phenotype relationships. We identified a total of 60 reported cases of SCA34 to date. The majority had gait ataxia (88.3%), limb ataxia (76.7%), dysarthria (63.3%), and nystagmus (58.3%). Of note, skin lesions related to erythrokeratoderma were seen in a minority of cases (33.3%). Other extracerebellar manifestations included pyramidal tract signs, autonomic disturbances, retinitis pigmentosa, and cognitive impairment. For brain MRI data, cerebellar atrophy was seen in all cases (100%), whereas the hot cross bun sign (typically associated with multiple system atrophy type C) was seen in 32.4% of cases. Our family study and literature review highlight the variable phenotypic spectrum of SCA34. Importantly, it shows that erythrokeratoderma is not found in most cases and that, while a dermatological assessment may be helpful in these patients, SCA34 diagnosis should be considered irrespective of dermatological manifestations.
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Affiliation(s)
- Masahiro Nishide
- Sydney Medical School, University of Sydney, Camperdown, NSW, 2050, Australia
| | - Kathleen Le Marquand
- Clinical Genetics Service, Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia
| | - Mark R Davis
- Department of Diagnostic Genomics, Path West Laboratory Medicine, QEII Medical Centre, Hospital Avenue, Nedlands, WA, Australia
| | - Gábor M Halmágyi
- Neurology Department, Royal Prince Alfred Hospital, Camperdown and the University of Sydney, Sydney, NSW, 2050, Australia
| | - Avi Fellner
- Garvan Institute of Medical Research, Darlinghurst, NSW, 2010, Australia
- Raphael Recanati Genetics Institute, Rabin Medical Center, Beilinson Hospital, 4941492, Petah Tikva, Israel
- Department of Neurology, Rabin Medical Center, Beilinson Hospital, 4941492, Petah Tikva, Israel
| | - Ramesh K Narayanan
- Sydney Medical School, University of Sydney, Camperdown, NSW, 2050, Australia
- Northcott Neuroscience Laboratory, ANZAC Research Institute, Concord, NSW, 2139, Australia
| | - Marina L Kennerson
- Sydney Medical School, University of Sydney, Camperdown, NSW, 2050, Australia
- Northcott Neuroscience Laboratory, ANZAC Research Institute, Concord, NSW, 2139, Australia
- Molecular Medicine Laboratory, Concord Repatriation General Hospital, Concord, NSW, 2139, Australia
| | - Stephen W Reddel
- Department of Neurology, Concord Repatriation General Hospital, Concord, NSW, 2139, Australia
| | - Lisa Worgan
- Clinical Genetics Service, Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia
| | - Peter K Panegyres
- Neurodegenerative Disorders Research Pty Ltd, West Perth, WA, 6005, Australia
- School of Medicine, The University of Western Australia, Nedlands, WA, 6008, Australia
| | - Kishore R Kumar
- Sydney Medical School, University of Sydney, Camperdown, NSW, 2050, Australia.
- Garvan Institute of Medical Research, Darlinghurst, NSW, 2010, Australia.
- Molecular Medicine Laboratory, Concord Repatriation General Hospital, Concord, NSW, 2139, Australia.
- Department of Neurology, Concord Repatriation General Hospital, Concord, NSW, 2139, Australia.
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18
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Momin SMB, Aquilina K, Bulstrode H, Taira T, Kalia S, Natalwala A. MRI-Guided Focused Ultrasound for the Treatment of Dystonia: A Narrative Review. Cureus 2024; 16:e54284. [PMID: 38500932 PMCID: PMC10945285 DOI: 10.7759/cureus.54284] [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: 02/16/2024] [Indexed: 03/20/2024] Open
Abstract
Contemporary surgical management of dystonia includes neuromodulation via deep brain stimulation (DBS) or ablative techniques such as radiofrequency (RF) ablation. MRI-guided focused ultrasound (MRgFUS) is an emerging modality that uses high-intensity ultrasound to precisely ablate targets in the brain; this is incisionless, potentially avoiding the surgical risks of a burr hole and transcortical tract to reach the anatomical target. There is some evidence of efficacy in essential tremor and Parkinson's disease (PD), but, to date, there is no study aggregating the evidence of MRgFUS in dystonia. In this narrative review, we searched Medline, Embase, CINAHL, EBSCO, and ClinicalTrials.gov for primary studies and clinical trials on MRgFUS in the treatment of dystonia. Data were analyzed concerning dystonia phenotype, reported outcomes, and complications. PD-related dystonia was also included within the scope of the review. Using our search criteria, six articles on the use of MRgFUS in adult dystonia and three articles on the use of FUS in dystonia in PD were included. Four trials on the use of FUS in dystonia were also found on ClinicalTrials.gov, one of which was completed in December 2013. All included studies showed evidence of symptomatic improvement, mostly in focal hand dystonia; improvements were also found in dystonia-associated tremor, cervicobrachial dystonia, and dystonia-associated chronic neuropathic pain as well as PD-related dystonia. Reported complications included transient neurological deficits and persistent arm pain in one study. However, the evidence is limited to level-4 case series at present. MRgFUS is an emerging modality that appears to be safe and effective, particularly in focal hand dystonia, without major adverse effects. However, the quality of evidence is low at present, and long-term outcomes are unknown. High-quality prospective studies comparing MRgFUS to other surgical techniques will be useful in determining its role in the management of dystonia.
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Affiliation(s)
- Sheikh Muktadir Bin Momin
- Institute of Inflammation & Ageing, University of Birmingham, Birmingham, GBR
- Department of Neurosurgery, Queen Elizabeth Hospital, Birmingham, GBR
| | - Kristian Aquilina
- Department of Paediatric Neurosurgery, Great Ormond Street Hospital, London, GBR
| | - Harry Bulstrode
- Department of Neurosurgery, Wellcome-MRC Cambridge Stem Cell Institute, Addenbrooke's Hospital, Cambridge, GBR
| | - Takaomi Taira
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, JPN
| | - Suneil Kalia
- Division of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, CAN
| | - Ammar Natalwala
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, GBR
- Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, GBR
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19
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Höglinger GU, Adler CH, Berg D, Klein C, Outeiro TF, Poewe W, Postuma R, Stoessl AJ, Lang AE. A biological classification of Parkinson's disease: the SynNeurGe research diagnostic criteria. Lancet Neurol 2024; 23:191-204. [PMID: 38267191 DOI: 10.1016/s1474-4422(23)00404-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 09/08/2023] [Accepted: 10/06/2023] [Indexed: 01/26/2024]
Abstract
With the hope that disease-modifying treatments could target the molecular basis of Parkinson's disease, even before the onset of symptoms, we propose a biologically based classification. Our classification acknowledges the complexity and heterogeneity of the disease by use of a three-component system (SynNeurGe): presence or absence of pathological α-synuclein (S) in tissues or CSF; evidence of underlying neurodegeneration (N) defined by neuroimaging procedures; and documentation of pathogenic gene variants (G) that cause or strongly predispose to Parkinson's disease. These three components are linked to a clinical component (C), defined either by a single high-specificity clinical feature or by multiple lower-specificity clinical features. The use of a biological classification will enable advances in both basic and clinical research, and move the field closer to the precision medicine required to develop disease-modifying therapies. We emphasise the initial application of these criteria exclusively for research. We acknowledge its ethical implications, its limitations, and the need for prospective validation in future studies.
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Affiliation(s)
- Günter U Höglinger
- Department of Neurology, University Hospital, Ludwig-Maximilians-University (LMU) and German Center for Neurodegenerative Diseases, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Charles H Adler
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Daniela Berg
- Christian Albrechts University and University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lüebeck, Germany
| | - Tiago F Outeiro
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Göttingen, Göttingen, Germany; Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Werner Poewe
- Medical University Innsbruck, Innsbruck, Austria
| | - Ronald Postuma
- Department of Neurology, McGill University, Montreal Neurological Institute, Montreal, QC, Canada
| | - A Jon Stoessl
- Pacific Parkinson's Research Centre and Parkinson's Foundation Centre of Excellence, University of British Columbia, BC, Canada
| | - Anthony E Lang
- University Health Network's Krembil Brain Institute, Edmond J Safra Program in Parkinson's Disease and the Rossy PSP Centre, Toronto Western Hospital, Toronto, ON, Canada.
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20
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Zech M, Winkelmann J. Next-generation sequencing and bioinformatics in rare movement disorders. Nat Rev Neurol 2024; 20:114-126. [PMID: 38172289 DOI: 10.1038/s41582-023-00909-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/05/2024]
Abstract
The ability to sequence entire exomes and genomes has revolutionized molecular testing in rare movement disorders, and genomic sequencing is becoming an integral part of routine diagnostic workflows for these heterogeneous conditions. However, interpretation of the extensive genomic variant information that is being generated presents substantial challenges. In this Perspective, we outline multidimensional strategies for genetic diagnosis in patients with rare movement disorders. We examine bioinformatics tools and computational metrics that have been developed to facilitate accurate prioritization of disease-causing variants. Additionally, we highlight community-driven data-sharing and case-matchmaking platforms, which are designed to foster the discovery of new genotype-phenotype relationships. Finally, we consider how multiomic data integration might optimize diagnostic success by combining genomic, epigenetic, transcriptomic and/or proteomic profiling to enable a more holistic evaluation of variant effects. Together, the approaches that we discuss offer pathways to the improved understanding of the genetic basis of rare movement disorders.
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Affiliation(s)
- Michael Zech
- Institute of Human Genetics, School of Medicine, Technical University of Munich, Munich, Germany
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany
- Institute for Advanced Study, Technical University of Munich, Garching, Germany
| | - Juliane Winkelmann
- Institute of Human Genetics, School of Medicine, Technical University of Munich, Munich, Germany.
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany.
- Munich Cluster for Systems Neurology, SyNergy, Munich, Germany.
- DZPG, Deutsches Zentrum für Psychische Gesundheit, Munich, Germany.
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21
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Thomsen M, Lange LM, Zech M, Lohmann K. Genetics and Pathogenesis of Dystonia. ANNUAL REVIEW OF PATHOLOGY 2024; 19:99-131. [PMID: 37738511 DOI: 10.1146/annurev-pathmechdis-051122-110756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
Dystonia is a clinically and genetically highly heterogeneous neurological disorder characterized by abnormal movements and postures caused by involuntary sustained or intermittent muscle contractions. A number of groundbreaking genetic and molecular insights have recently been gained. While they enable genetic testing and counseling, their translation into new therapies is still limited. However, we are beginning to understand shared pathophysiological pathways and molecular mechanisms. It has become clear that dystonia results from a dysfunctional network involving the basal ganglia, cerebellum, thalamus, and cortex. On the molecular level, more than a handful of, often intertwined, pathways have been linked to pathogenic variants in dystonia genes, including gene transcription during neurodevelopment (e.g., KMT2B, THAP1), calcium homeostasis (e.g., ANO3, HPCA), striatal dopamine signaling (e.g., GNAL), endoplasmic reticulum stress response (e.g., EIF2AK2, PRKRA, TOR1A), autophagy (e.g., VPS16), and others. Thus, different forms of dystonia can be molecularly grouped, which may facilitate treatment development in the future.
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Affiliation(s)
- Mirja Thomsen
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany;
| | - Lara M Lange
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany;
| | - Michael Zech
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany
- Institute of Human Genetics, School of Medicine, Technical University of Munich, Munich, Germany
| | - Katja Lohmann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany;
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22
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Ben-Shlomo Y, Darweesh S, Llibre-Guerra J, Marras C, San Luciano M, Tanner C. The epidemiology of Parkinson's disease. Lancet 2024; 403:283-292. [PMID: 38245248 PMCID: PMC11123577 DOI: 10.1016/s0140-6736(23)01419-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 04/26/2023] [Accepted: 07/05/2023] [Indexed: 01/22/2024]
Abstract
The epidemiology of Parkinson's disease shows marked variations in time, geography, ethnicity, age, and sex. Internationally, prevalence has increased over and above demographic changes. There are several potential reasons for this increase, including the decline in other competing causes of death. Whether incidence is increasing, especially in women or in many low-income and middle-income countries where there is a shortage of high-quality data, is less certain. Parkinson's disease is more common in older people and men, and a variety of environmental factors have been suggested to explain why, including exposure to neurotoxic agents. Within countries, there appear to be ethnic differences in disease risk, although these differences might reflect differential access to health care. The cause of Parkinson's disease is multifactorial, and involves genetic and environmental factors. Both risk factors (eg, pesticides) and protective factors (eg, physical activity and tendency to smoke) have been postulated to have a role in Parkinson's disease, although elucidating causality is complicated by the long prodromal period. Following the establishment of public health strategies to prevent cardiovascular diseases and some cancers, chronic neurodegenerative diseases such as Parkinson's disease and dementia are gaining a deserved higher priority. Multipronged prevention strategies are required that tackle population-based primary prevention, high-risk targeted secondary prevention, and Parkinson's disease-modifying therapies for tertiary prevention. Future international collaborations will be required to triangulate evidence from basic, applied, and epidemiological research, thereby enhancing the understanding and prevention of Parkinson's disease at a global level.
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Affiliation(s)
- Yoav Ben-Shlomo
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Sirwan Darweesh
- Centre of Expertise for Parkinson and Movement Disorders, Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | | | - Connie Marras
- The Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Marta San Luciano
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Caroline Tanner
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
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23
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Pitz V, Makarious MB, Bandres-Ciga S, Iwaki H, Singleton AB, Nalls M, Heilbron K, Blauwendraat C. Analysis of rare Parkinson's disease variants in millions of people. NPJ Parkinsons Dis 2024; 10:11. [PMID: 38191580 PMCID: PMC10774311 DOI: 10.1038/s41531-023-00608-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 11/24/2023] [Indexed: 01/10/2024] Open
Abstract
Although many rare variants have been reportedly associated with Parkinson's disease (PD), many have not been replicated or have failed to replicate. Here, we conduct a large-scale replication of rare PD variants. We assessed a total of 27,590 PD cases, 6701 PD proxies, and 3,106,080 controls from three data sets: 23andMe, Inc., UK Biobank, and AMP-PD. Based on well-known PD genes, 834 variants of interest were selected from the ClinVar annotated 23andMe dataset. We performed a meta-analysis using summary statistics of all three studies. The meta-analysis resulted in five significant variants after Bonferroni correction, including variants in GBA1 and LRRK2. Another eight variants are strong candidate variants for their association with PD. Here, we provide the largest rare variant meta-analysis to date, providing information on confirmed and newly identified variants for their association with PD using several large databases. Additionally we also show the complexities of studying rare variants in large-scale cohorts.
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Affiliation(s)
- Vanessa Pitz
- Integrative Neurogenomics Unit, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA.
| | - Mary B Makarious
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
- UCL Movement Disorders Centre, University College London, London, UK
| | - Sara Bandres-Ciga
- Center for Alzheimer's and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Hirotaka Iwaki
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Center for Alzheimer's and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
- Data Tecnica International, Washington, DC, USA
| | - Andrew B Singleton
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Center for Alzheimer's and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Mike Nalls
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Center for Alzheimer's and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
- Data Tecnica International, Washington, DC, USA
| | | | - Cornelis Blauwendraat
- Integrative Neurogenomics Unit, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Center for Alzheimer's and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
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24
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Yeow D, Rudaks LI, Siow SF, Davis RL, Kumar KR. Genetic Testing of Movements Disorders: A Review of Clinical Utility. Tremor Other Hyperkinet Mov (N Y) 2024; 14:2. [PMID: 38222898 PMCID: PMC10785957 DOI: 10.5334/tohm.835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/04/2023] [Indexed: 01/16/2024] Open
Abstract
Currently, pathogenic variants in more than 500 different genes are known to cause various movement disorders. The increasing accessibility and reducing cost of genetic testing has resulted in increasing clinical use of genetic testing for the diagnosis of movement disorders. However, the optimal use case(s) for genetic testing at a patient level remain ill-defined. Here, we review the utility of genetic testing in patients with movement disorders and also highlight current challenges and limitations that need to be considered when making decisions about genetic testing in clinical practice. Highlights The utility of genetic testing extends across multiple clinical and non-clinical domains. Here we review different aspects of the utility of genetic testing for movement disorders and the numerous associated challenges and limitations. These factors should be weighed on a case-by-case basis when requesting genetic tests in clinical practice.
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Affiliation(s)
- Dennis Yeow
- Translational Neurogenomics Group, Neurology Department & Molecular Medicine Laboratory, Concord Repatriation General Hospital, Concord, NSW, Australia
- Concord Clinical School, Sydney Medical School, Faculty of Health & Medicine, University of Sydney, Concord, NSW, Australia
- Rare Disease Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- Department of Neurology, Prince of Wales Hospital, Randwick, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Laura I. Rudaks
- Translational Neurogenomics Group, Neurology Department & Molecular Medicine Laboratory, Concord Repatriation General Hospital, Concord, NSW, Australia
- Concord Clinical School, Sydney Medical School, Faculty of Health & Medicine, University of Sydney, Concord, NSW, Australia
- Rare Disease Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Sue-Faye Siow
- Department of Clinical Genetics, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Ryan L. Davis
- Rare Disease Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- Neurogenetics Research Group, Kolling Institute, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney and Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - Kishore R. Kumar
- Translational Neurogenomics Group, Neurology Department & Molecular Medicine Laboratory, Concord Repatriation General Hospital, Concord, NSW, Australia
- Concord Clinical School, Sydney Medical School, Faculty of Health & Medicine, University of Sydney, Concord, NSW, Australia
- Rare Disease Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
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25
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Saffie Awad P, Teixeira-Dos-Santos D, Santos-Lobato BL, Camargos S, Cornejo-Olivas M, de Mello Rieder CR, Mata IF, Chaná-Cuevas P, Klein C, Schumacher Schuh AF. Frequency of Hereditary and GBA1-Related Parkinsonism in Latin America: A Systematic Review and Meta-Analysis. Mov Disord 2024; 39:6-16. [PMID: 37921246 DOI: 10.1002/mds.29614] [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: 07/07/2023] [Revised: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Identifying hereditary parkinsonism is valuable for diagnosis, genetic counseling, patient prioritization in trials, and studying the disease for personalized therapies. However, most studies were conducted in Europeans, and limited data exist on admixed populations like those from Latin America. OBJECTIVES This study aims to assess the frequency and distribution of genetic parkinsonism in Latin America. METHODS We conducted a systematic review and meta-analysis of the frequency of parkinsonian syndromes associated with genetic pathogenic variants in Latin America. We defined hereditary parkinsonism as those caused by the genes outlined by the MDS Nomenclature of Genetic Movement Disorders and heterozygous carriers of GBA1 pathogenic variants. A systematic search was conducted in PubMed, Web of Science, Embase, and LILACS in August 2022. Researchers reviewed titles and abstracts, and disagreements were resolved by a third researcher. After this screening, five researchers reanalyzed the selection criteria and extracted information based on the full paper. The frequency for each parkinsonism-related gene was determined by the presence of pathogenic/likely pathogenic variants among screened patients. Cochran's Q and I2 tests were used to quantify heterogeneity. Meta-regression, publication bias tests, and sensitivity analysis regarding study quality were also used for LRRK2-, PRKN-, and GBA1-related papers. RESULTS We included 73 studies involving 3014 screened studies from 16 countries. Among 7668 Latin American patients, pathogenic variants were found in 19 different genes. The frequency of the pathogenic variants in LRRK2 was 1.38% (95% confidence interval [CI]: 0.52-2.57), PRKN was 1.16% (95% CI: 0.08-3.05), and GBA1 was 4.17% (95% CI: 2.57-6.08). For all meta-analysis, heterogeneity was high and publication bias tests were negative, except for PRKN, which was contradictory. Information on the number of pathogenic variants in the other genes is further presented in the text. CONCLUSIONS This study provides insights into hereditary and GBA1-related parkinsonism in Latin America. Lower GBA1 frequencies compared to European/North American cohorts may result from limited access to gene sequencing. Further research is vital for regional prevalence understanding, enabling personalized care and therapies. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Paula Saffie Awad
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Centro de Trastornos del Movimiento (CETRAM), Santiago, Chile
- Clínica Santa María, Santiago, Chile
| | | | - Bruno Lopes Santos-Lobato
- Hospital Ophir Loyola, Belém, Brazil
- Laboratório de Neuropatologia Experimental, Universidade Federal do Pará, Belém, Brazil
| | - Sarah Camargos
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mario Cornejo-Olivas
- Neurogenetics Working Group, Universidad Científica del Sur, Lima, Peru
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurologicas, Lima, Peru
| | | | - Ignacio F Mata
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Pedro Chaná-Cuevas
- Centro de Trastornos del Movimiento (CETRAM), Santiago, Chile
- Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago, Chile
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Artur F Schumacher Schuh
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Serviço de Neurologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Departamento de Farmacologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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26
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Garofalo M, Vansenne F, Sival DA, Verbeek DS. Pathogenetic Insights into Developmental Coordination Disorder Reveal Substantial Overlap with Movement Disorders. Brain Sci 2023; 13:1625. [PMID: 38137073 PMCID: PMC10741651 DOI: 10.3390/brainsci13121625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/09/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
Developmental Coordination Disorder (DCD) is a neurodevelopmental condition characterized by non-progressive central motor impairments. Mild movement disorder features have been observed in DCD. Until now, the etiology of DCD has been unclear. Recent studies suggested a genetic substrate in some patients with DCD, but comprehensive knowledge about associated genes and underlying pathogenetic mechanisms is still lacking. In this study, we first identified genes described in the literature in patients with a diagnosis of DCD according to the official diagnostic criteria. Second, we exposed the underlying pathogenetic mechanisms of DCD, by investigating tissue- and temporal gene expression patterns and brain-specific biological mechanisms. Third, we explored putative shared pathogenetic mechanisms between DCD and frequent movement disorders with a known genetic component, including ataxia, chorea, dystonia, and myoclonus. We identified 12 genes associated with DCD in the literature, which are ubiquitously expressed in the central nervous system throughout brain development. These genes are involved in cellular processes, neural signaling, and nervous system development. There was a remarkable overlap (62%) in pathogenetic mechanisms between DCD-associated genes and genes linked with movement disorders. Our findings suggest that some patients might have a genetic etiology of DCD, which could be considered part of a pathogenetic movement disorder spectrum.
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Affiliation(s)
- Martinica Garofalo
- Department of Pediatric Neurology, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (M.G.); (D.A.S.)
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), 9713 GZ Groningen, The Netherlands;
| | - Fleur Vansenne
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), 9713 GZ Groningen, The Netherlands;
- Department of Genetics, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Deborah A. Sival
- Department of Pediatric Neurology, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (M.G.); (D.A.S.)
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), 9713 GZ Groningen, The Netherlands;
| | - Dineke S. Verbeek
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), 9713 GZ Groningen, The Netherlands;
- Department of Genetics, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
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27
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Martínez-Rubio D, Hinarejos I, Argente-Escrig H, Marco-Marín C, Lozano MA, Gorría-Redondo N, Lupo V, Martí-Carrera I, Miranda C, Vázquez-López M, García-Pérez A, Marco-Hernández AV, Tomás-Vila M, Aguilera-Albesa S, Espinós C. Genetic Heterogeneity Underlying Phenotypes with Early-Onset Cerebellar Atrophy. Int J Mol Sci 2023; 24:16400. [PMID: 38003592 PMCID: PMC10671053 DOI: 10.3390/ijms242216400] [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: 09/14/2023] [Revised: 11/01/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
Cerebellar atrophy (CA) is a frequent neuroimaging finding in paediatric neurology, usually associated with cerebellar ataxia. The list of genes involved in hereditary forms of CA is continuously growing and reveals its genetic complexity. We investigated ten cases with early-onset cerebellar involvement with and without ataxia by exome sequencing or by a targeted panel with 363 genes involved in ataxia or spastic paraplegia. Novel variants were investigated by in silico or experimental approaches. Seven probands carry causative variants in well-known genes associated with CA or cerebellar hypoplasia: SETX, CACNA1G, CACNA1A, CLN6, CPLANE1, and TBCD. The remaining three cases deserve special attention; they harbour variants in MAST1, PI4KA and CLK2 genes. MAST1 is responsible for an ultrarare condition characterised by global developmental delay and cognitive decline; our index case added ataxia to the list of concomitant associated symptoms. PIK4A is mainly related to hypomyelinating leukodystrophy; our proband presented with pure spastic paraplegia and normal intellectual capacity. Finally, in a patient who suffers from mild ataxia with oculomotor apraxia, the de novo novel CLK2 c.1120T>C variant was found. The protein expression of the mutated protein was reduced, which may indicate instability that would affect its kinase activity.
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Affiliation(s)
- Dolores Martínez-Rubio
- Rare Neurodegenerative Diseases Laboratory, Valencia Biomedical Research Foundation, Centro de Investigación Príncipe Felipe (CIPF), 46012 València, Spain
- Joint Unit CIPF-IIS La Fe Rare Diseases, 46012 València, Spain
| | - Isabel Hinarejos
- Rare Neurodegenerative Diseases Laboratory, Valencia Biomedical Research Foundation, Centro de Investigación Príncipe Felipe (CIPF), 46012 València, Spain
- Joint Unit CIPF-IIS La Fe Rare Diseases, 46012 València, Spain
| | | | - Clara Marco-Marín
- Structural Enzymopathology Unit, Instituto de Biomedicina de Valencia (IBV), Consejo Superior de Investigaciones Científicas (CSIC), 46022 València, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III (ISCIII), 28220 Madrid, Spain
| | - María Ana Lozano
- Rare Neurodegenerative Diseases Laboratory, Valencia Biomedical Research Foundation, Centro de Investigación Príncipe Felipe (CIPF), 46012 València, Spain
| | - Nerea Gorría-Redondo
- Paediatric Neurology Unit, Department of Paediatrics, Hospital Universitario de Navarra, Navarrabiomed, 31008 Pamplona, Spain
| | - Vincenzo Lupo
- Rare Neurodegenerative Diseases Laboratory, Valencia Biomedical Research Foundation, Centro de Investigación Príncipe Felipe (CIPF), 46012 València, Spain
| | - Itxaso Martí-Carrera
- Paediatric Neurology Unit, Department of Paediatrics, Hospital Universitario Donostia, 20014 Donostia, Spain
| | - Concepción Miranda
- Paediatric Neurology Unit, Department of Paediatrics, Hospital General Universitario Gregorio Marañón, 28027 Madrid, Spain
| | - María Vázquez-López
- Paediatric Neurology Unit, Department of Paediatrics, Hospital General Universitario Gregorio Marañón, 28027 Madrid, Spain
| | - Asunción García-Pérez
- Paediatric Neurology Unit, Department of Paediatrics, Hospital Universitario Fundación Alcorcón, Alcorcón, 28922 Madrid, Spain
| | - Ana Victoria Marco-Hernández
- Paediatric Neurology Unit, Department of Paediatrics, Hospital Universitari Doctor, Peset, 46017 València, Spain
| | - Miguel Tomás-Vila
- Paediatric Neurology Unit, Department of Paediatrics, Hospital Universitari i Politècnic La Fe, 46026 València, Spain
| | - Sergio Aguilera-Albesa
- Paediatric Neurology Unit, Department of Paediatrics, Hospital Universitario de Navarra, Navarrabiomed, 31008 Pamplona, Spain
| | - Carmen Espinós
- Rare Neurodegenerative Diseases Laboratory, Valencia Biomedical Research Foundation, Centro de Investigación Príncipe Felipe (CIPF), 46012 València, Spain
- Joint Unit CIPF-IIS La Fe Rare Diseases, 46012 València, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III (ISCIII), 28220 Madrid, Spain
- Biotechnology Department, Universitat Politècnica de València, 46022 València, Spain
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28
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Olszewska DA, Shetty A, Rajalingam R, Rodriguez-Antiguedad J, Hamed M, Huang J, Breza M, Rasheed A, Bahr N, Madoev H, Westenberger A, Trinh J, Lohmann K, Klein C, Marras C, Waln O. Genotype-phenotype relations for episodic ataxia genes: MDSGene systematic review. Eur J Neurol 2023; 30:3377-3393. [PMID: 37422902 DOI: 10.1111/ene.15969] [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: 03/29/2023] [Revised: 06/28/2023] [Accepted: 07/04/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Most episodic ataxias (EA) are autosomal dominantly inherited and characterized by recurrent attacks of ataxia and other paroxysmal and non-paroxysmal features. EA is often caused by pathogenic variants in the CACNA1A, KCNA1, PDHA1, and SLC1A3 genes, listed as paroxysmal movement disorders (PxMD) by the MDS Task Force on the Nomenclature of Genetic Movement Disorders. Little is known about the genotype-phenotype correlation of the different genetic EA forms. METHODS We performed a systematic review of the literature to identify individuals affected by an episodic movement disorder harboring pathogenic variants in one of the four genes. We applied the standardized MDSGene literature search and data extraction protocol to summarize the clinical and genetic features. All data are available via the MDSGene protocol and platform on the MDSGene website (https://www.mdsgene.org/). RESULTS Information on 717 patients (CACNA1A: 491, KCNA1: 125, PDHA1: 90, and SLC1A3: 11) carrying 287 different pathogenic variants from 229 papers was identified and summarized. We show the profound phenotypic variability and overlap leading to the absence of frank genotype-phenotype correlation aside from a few key 'red flags'. CONCLUSION Given this overlap, a broad approach to genetic testing using a panel or whole exome or genome approach is most practical in most circumstances.
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Affiliation(s)
- Diana Angelika Olszewska
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Aakash Shetty
- Department of Neurology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Rajasumi Rajalingam
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Jon Rodriguez-Antiguedad
- Movement Disorders Unit and Institut d'Investigacions Biomediques-Sant Pau, Hospital Sant Pau, Barcelona, Spain
| | - Moath Hamed
- Department of Neurosciences, NYP Brooklyn Methodist Hospital, Brooklyn, New York, USA
| | - Jana Huang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | | | - Ashar Rasheed
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Natascha Bahr
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Harutyan Madoev
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Ana Westenberger
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Joanne Trinh
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Katja Lohmann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Connie Marras
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Olga Waln
- Houston Methodist Neurological Institute, Weill Cornell Medical College, New York, New York, USA
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29
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Wali G, Li Y, Liyanage E, Kumar KR, Day ML, Sue CM. Pharmacological rescue of mitochondrial and neuronal defects in SPG7 hereditary spastic paraplegia patient neurons using high throughput assays. Front Neurosci 2023; 17:1231584. [PMID: 37766787 PMCID: PMC10520970 DOI: 10.3389/fnins.2023.1231584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
SPG7 is the most common form of autosomal recessive hereditary spastic paraplegia (HSP). There is a lack of HSP-SPG7 human neuronal models to understand the disease mechanism and identify new drug treatments. We generated a human neuronal model of HSP-SPG7 using induced pluripotent stem (iPS) cell technology. We first generated iPS cells from three HSP-SPG7 patients carrying different disease-causing variants and three healthy controls. The iPS cells were differentiated to form neural progenitor cells (NPCs) and then from NPCs to mature cortical neurons. Mitochondrial and neuronal defects were measured using a high throughout imaging and analysis-based assay in live cells. Our results show that compared to control NPCs, patient NPCs had aberrant mitochondrial morphology with increased mitochondrial size and reduced membrane potential. Patient NPCs develop to form mature cortical neurons with amplified mitochondrial morphology and functional defects along with defects in neuron morphology - reduced neurite complexity and length, reduced synaptic gene, protein expression and activity, reduced viability and increased axonal degeneration. Treatment of patient neurons with Bz-423, a mitochondria permeability pore regulator, restored the mitochondrial and neurite morphological defects and mitochondrial membrane potential back to control neuron levels and rescued the low viability and increased degeneration in patient neurons. This study establishes a direct link between mitochondrial and neuronal defects in HSP-SPG7 patient neurons. We present a strategy for testing mitochondrial targeting drugs to rescue neuronal defects in HSP-SPG7 patient neurons.
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Affiliation(s)
- Gautam Wali
- Neuroscience Research Australia, Sydney, NSW, Australia
- Kolling Institute for Medical Research, University of Sydney, NSW, Australia
| | - Yan Li
- Neuroscience Research Australia, Sydney, NSW, Australia
- Kolling Institute for Medical Research, University of Sydney, NSW, Australia
- University of New South Wales, Sydney, NSW, Australia
| | - Erandhi Liyanage
- Neuroscience Research Australia, Sydney, NSW, Australia
- Kolling Institute for Medical Research, University of Sydney, NSW, Australia
- University of New South Wales, Sydney, NSW, Australia
| | - Kishore R. Kumar
- University of New South Wales, Sydney, NSW, Australia
- Translational Neurogenomics Group, Molecular Medicine Laboratory and Department of Neurology, Concord Repatriation General Hospital, Concord Clinical School, University of Sydney, Concord, NSW, Australia
- Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Margot L. Day
- School of Medical Science, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Carolyn M. Sue
- Neuroscience Research Australia, Sydney, NSW, Australia
- Kolling Institute for Medical Research, University of Sydney, NSW, Australia
- University of New South Wales, Sydney, NSW, Australia
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30
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Di Luca DG, Grippe TC, Adams J, Chen R, Fasano A, Lozano A, Lang AE. Generalized Dystonia With Tremor and Myoclonus Associated With ANO3 Variant. Can J Neurol Sci 2023:1-3. [PMID: 37641940 DOI: 10.1017/cjn.2023.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Affiliation(s)
- Daniel G Di Luca
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON, Canada
- Division of Neurology, University of Toronto, Toronto, ON, Canada
- Krembil Brain Institute, Toronto, ON, Canada
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Talyta C Grippe
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON, Canada
- Division of Neurology, University of Toronto, Toronto, ON, Canada
- Krembil Brain Institute, Toronto, ON, Canada
| | - John Adams
- Ashgrove Medical Centre, Markham, ON, Canada
| | - Robert Chen
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON, Canada
- Division of Neurology, University of Toronto, Toronto, ON, Canada
- Krembil Brain Institute, Toronto, ON, Canada
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON, Canada
- Division of Neurology, University of Toronto, Toronto, ON, Canada
- Krembil Brain Institute, Toronto, ON, Canada
| | - Andres Lozano
- Krembil Brain Institute, Toronto, ON, Canada
- Department of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Anthony E Lang
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON, Canada
- Division of Neurology, University of Toronto, Toronto, ON, Canada
- Krembil Brain Institute, Toronto, ON, Canada
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31
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Deng X, Yuan L, Jankovic J, Deng H. The role of the PLA2G6 gene in neurodegenerative diseases. Ageing Res Rev 2023; 89:101957. [PMID: 37236368 DOI: 10.1016/j.arr.2023.101957] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/12/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023]
Abstract
PLA2G6-associated neurodegeneration (PLAN) represents a continuum of clinically and genetically heterogeneous neurodegenerative disorders with overlapping features. Usually, it encompasses three autosomal recessive diseases, including infantile neuroaxonal dystrophy or neurodegeneration with brain iron accumulation (NBIA) 2A, atypical neuronal dystrophy with childhood-onset or NBIA2B, and adult-onset dystonia-parkinsonism form named PARK14, and possibly a certain subtype of hereditary spastic paraplegia. PLAN is caused by variants in the phospholipase A2 group VI gene (PLA2G6), which encodes an enzyme involved in membrane homeostasis, signal transduction, mitochondrial dysfunction, and α-synuclein aggregation. In this review, we discuss PLA2G6 gene structure and protein, functional findings, genetic deficiency models, various PLAN disease phenotypes, and study strategies in the future. Our primary aim is to provide an overview of genotype-phenotype correlations of PLAN subtypes and speculate on the role of PLA2G6 in potential mechanisms underlying these conditions.
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Affiliation(s)
- Xinyue Deng
- Health Management Center, the Third Xiangya Hospital, Central South University, Changsha 410013, Hunan, China; Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha 410013, Hunan, China; Department of Neurology, the Third Xiangya Hospital, Central South University, Changsha 410013, Hunan, China
| | - Lamei Yuan
- Health Management Center, the Third Xiangya Hospital, Central South University, Changsha 410013, Hunan, China; Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha 410013, Hunan, China; Disease Genome Research Center, Central South University, Changsha 410013, Hunan, China
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX 77030-4202, USA
| | - Hao Deng
- Health Management Center, the Third Xiangya Hospital, Central South University, Changsha 410013, Hunan, China; Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha 410013, Hunan, China; Department of Neurology, the Third Xiangya Hospital, Central South University, Changsha 410013, Hunan, China; Disease Genome Research Center, Central South University, Changsha 410013, Hunan, China.
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32
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Müller-Nedebock AC, Dekker MCJ, Farrer MJ, Hattori N, Lim SY, Mellick GD, Rektorová I, Salama M, Schuh AFS, Stoessl AJ, Sue CM, Tan AH, Vidal RL, Klein C, Bardien S. Different pieces of the same puzzle: a multifaceted perspective on the complex biological basis of Parkinson's disease. NPJ Parkinsons Dis 2023; 9:110. [PMID: 37443150 DOI: 10.1038/s41531-023-00535-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/22/2023] [Indexed: 07/15/2023] Open
Abstract
The biological basis of the neurodegenerative movement disorder, Parkinson's disease (PD), is still unclear despite it being 'discovered' over 200 years ago in Western Medicine. Based on current PD knowledge, there are widely varying theories as to its pathobiology. The aim of this article was to explore some of these different theories by summarizing the viewpoints of laboratory and clinician scientists in the PD field, on the biological basis of the disease. To achieve this aim, we posed this question to thirteen "PD experts" from six continents (for global representation) and collated their personal opinions into this article. The views were varied, ranging from toxin exposure as a PD trigger, to LRRK2 as a potential root cause, to toxic alpha-synuclein being the most important etiological contributor. Notably, there was also growing recognition that the definition of PD as a single disease should be reconsidered, perhaps each with its own unique pathobiology and treatment regimen.
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Affiliation(s)
- Amica C Müller-Nedebock
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Stellenbosch University, Cape Town, South Africa
| | - Marieke C J Dekker
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Matthew J Farrer
- Norman Fixel Institute for Neurological Diseases, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Nobutaka Hattori
- Research Institute of Disease of Old Age, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Department of Neurology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Neurodegenerative Disorders Collaborative Laboratory, RIKEN Center for Brain Science, 2-1 Hirosawa, Wako, Saitama, 351-0106, Japan
| | - Shen-Yang Lim
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- The Mah Pooi Soo & Tan Chin Nam Centre for Parkinson's & Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - George D Mellick
- Griffith Institute of Drug Discovery (GRIDD), Griffith University, Brisbane, QLD, Australia
| | - Irena Rektorová
- First Department of Neurology and International Clinical Research Center, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Applied Neuroscience Research Group, CEITEC, Masaryk University, Brno, Czech Republic
| | - Mohamed Salama
- Institute of Global Health and Human Ecology (I-GHHE), The American University in Cairo (AUC), New Cairo, 11835, Egypt
- Faculty of Medicine, Mansoura University, Dakahleya, Egypt
- Atlantic Senior Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), Trinity College Dublin (TCD), Dublin, Ireland
| | - Artur F S Schuh
- Departamento de Farmacologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Serviço de Neurologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - A Jon Stoessl
- Pacific Parkinson's Research Centre, Department of Medicine (Division of Neurology), Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Carolyn M Sue
- Neuroscience Research Australia; Faculty of Medicine, University of New South Wales; Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Darlinghurst; Department of Neurology, Prince of Wales Hospital, South Eastern Sydney Local Health District, Randwick, NSW, Australia
| | - Ai Huey Tan
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- The Mah Pooi Soo & Tan Chin Nam Centre for Parkinson's & Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rene L Vidal
- Instituto de Neurociencia Biomédica (BNI), Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Centro FONDAP de Gerociencia, Salud Mental y Metabolismo (GERO), Santiago, Chile
- Centro de Biología Integrativa, Facultad de Ciencias, Universidad Mayor, Santiago, Chile
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany.
| | - Soraya Bardien
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Stellenbosch University, Cape Town, South Africa.
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33
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Bonnet C, Pellerin D, Roth V, Clément G, Wandzel M, Lambert L, Frismand S, Douarinou M, Grosset A, Bekkour I, Weber F, Girardier F, Robin C, Cacciatore S, Bronner M, Pourié C, Dreumont N, Puisieux S, Iruzubieta P, Dicaire MJ, Evoy F, Rioux MF, Hocquel A, La Piana R, Synofzik M, Houlden H, Danzi MC, Zuchner S, Brais B, Renaud M. Optimized testing strategy for the diagnosis of GAA-FGF14 ataxia/spinocerebellar ataxia 27B. Sci Rep 2023; 13:9737. [PMID: 37322040 PMCID: PMC10272173 DOI: 10.1038/s41598-023-36654-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/07/2023] [Indexed: 06/17/2023] Open
Abstract
Dominantly inherited GAA repeat expansions in FGF14 are a common cause of spinocerebellar ataxia (GAA-FGF14 ataxia; spinocerebellar ataxia 27B). Molecular confirmation of FGF14 GAA repeat expansions has thus far mostly relied on long-read sequencing, a technology that is not yet widely available in clinical laboratories. We developed and validated a strategy to detect FGF14 GAA repeat expansions using long-range PCR, bidirectional repeat-primed PCRs, and Sanger sequencing. We compared this strategy to targeted nanopore sequencing in a cohort of 22 French Canadian patients and next validated it in a cohort of 53 French index patients with unsolved ataxia. Method comparison showed that capillary electrophoresis of long-range PCR amplification products significantly underestimated expansion sizes compared to nanopore sequencing (slope, 0.87 [95% CI, 0.81 to 0.93]; intercept, 14.58 [95% CI, - 2.48 to 31.12]) and gel electrophoresis (slope, 0.84 [95% CI, 0.78 to 0.97]; intercept, 21.34 [95% CI, - 27.66 to 40.22]). The latter techniques yielded similar size estimates. Following calibration with internal controls, expansion size estimates were similar between capillary electrophoresis and nanopore sequencing (slope: 0.98 [95% CI, 0.92 to 1.04]; intercept: 10.62 [95% CI, - 7.49 to 27.71]), and gel electrophoresis (slope: 0.94 [95% CI, 0.88 to 1.09]; intercept: 18.81 [95% CI, - 41.93 to 39.15]). Diagnosis was accurately confirmed for all 22 French Canadian patients using this strategy. We also identified 9 French patients (9/53; 17%) and 2 of their relatives who carried an FGF14 (GAA)≥250 expansion. This novel strategy reliably detected and sized FGF14 GAA expansions, and compared favorably to long-read sequencing.
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Affiliation(s)
- Céline Bonnet
- Laboratoire de Génétique Médicale, Hôpitaux de Brabois - CHRU de Nancy, Nancy, France.
- INSERM-U1256 NGERE, Université de Lorraine, Nancy, France.
| | - David Pellerin
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, University College London, London, UK
- Department of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, McGill University, Montreal, QC, Canada
| | - Virginie Roth
- Laboratoire de Génétique Médicale, Hôpitaux de Brabois - CHRU de Nancy, Nancy, France
| | - Guillemette Clément
- INSERM-U1256 NGERE, Université de Lorraine, Nancy, France
- Service de Neurologie, CHRU de Nancy, Nancy, France
| | - Marion Wandzel
- Laboratoire de Génétique Médicale, Hôpitaux de Brabois - CHRU de Nancy, Nancy, France
| | - Laëtitia Lambert
- INSERM-U1256 NGERE, Université de Lorraine, Nancy, France
- Service de Génétique Clinique, Hôpitaux de Brabois - CHRU de Nancy, Nancy, France
| | | | | | | | - Ines Bekkour
- Service de Neurologie, CHRU de Nancy, Nancy, France
| | - Frédéric Weber
- Laboratoire de Génétique Médicale, Hôpitaux de Brabois - CHRU de Nancy, Nancy, France
| | - Florent Girardier
- Laboratoire de Génétique Médicale, Hôpitaux de Brabois - CHRU de Nancy, Nancy, France
| | - Clément Robin
- Laboratoire de Génétique Médicale, Hôpitaux de Brabois - CHRU de Nancy, Nancy, France
| | - Stéphanie Cacciatore
- Laboratoire de Génétique Médicale, Hôpitaux de Brabois - CHRU de Nancy, Nancy, France
| | - Myriam Bronner
- Laboratoire de Génétique Médicale, Hôpitaux de Brabois - CHRU de Nancy, Nancy, France
| | - Carine Pourié
- INSERM-U1256 NGERE, Université de Lorraine, Nancy, France
| | | | | | - Pablo Iruzubieta
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, University College London, London, UK
- Department of Neurology, Donostia University Hospital, San Sebastian, Spain
- Neuroscience Area, Biodonostia Health Research Institute, San Sebastian, Spain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Marie-Josée Dicaire
- Department of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, McGill University, Montreal, QC, Canada
| | - François Evoy
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-France Rioux
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | | | - Roberta La Piana
- Department of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, McGill University, Montreal, QC, Canada
- Department of Diagnostic Radiology, McGill University, Montreal, QC, Canada
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Henry Houlden
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, University College London, London, UK
| | - Matt C Danzi
- Dr. John T. Macdonald Foundation Department of Human Genetics and John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Stephan Zuchner
- Dr. John T. Macdonald Foundation Department of Human Genetics and John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Bernard Brais
- Department of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, McGill University, Montreal, QC, Canada
- Department of Human Genetics, McGill University, Montreal, QC, Canada
| | - Mathilde Renaud
- INSERM-U1256 NGERE, Université de Lorraine, Nancy, France.
- Service de Neurologie, CHRU de Nancy, Nancy, France.
- Service de Génétique Clinique, Hôpitaux de Brabois - CHRU de Nancy, Nancy, France.
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Christen M, Gutierrez-Quintana R, James M, Faller KME, Lowrie M, Rusbridge C, Bossens K, Mellersh C, Pettitt L, Heinonen T, Lohi H, Jagannathan V, Leeb T. A TNR Frameshift Variant in Weimaraner Dogs with an Exercise-Induced Paroxysmal Movement Disorder. Mov Disord 2023; 38:1094-1099. [PMID: 37023257 DOI: 10.1002/mds.29391] [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: 12/07/2022] [Revised: 01/30/2023] [Accepted: 03/10/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Some paroxysmal movement disorders remain without an identified genetic cause. OBJECTIVES The aim was to identify the causal genetic variant for a paroxysmal dystonia-ataxia syndrome in Weimaraner dogs. METHODS Clinical and diagnostic investigations were performed. Whole genome sequencing of one affected dog was used to identify private homozygous variants against 921 control genomes. RESULTS Four Weimaraners were presented for episodes of abnormal gait. Results of examinations and diagnostic investigations were unremarkable. Whole genome sequencing revealed a private frameshift variant in the TNR (tenascin-R) gene in an affected dog, XM_038542431.1:c.831dupC, which is predicted to truncate more than 75% of the open read frame. Genotypes in a cohort of 4 affected and 70 unaffected Weimaraners showed perfect association with the disease phenotype. CONCLUSIONS We report the association of a TNR variant with a paroxysmal dystonia-ataxia syndrome in Weimaraners. It might be relevant to include sequencing of this gene in diagnosing humans with unexplained paroxysmal movement disorders. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Matthias Christen
- Institute of Genetics, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Rodrigo Gutierrez-Quintana
- Small Animal Hospital, School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
| | | | - Kiterie M E Faller
- Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, United Kingdom
| | - Mark Lowrie
- Dovecote Veterinary Hospital, Derby, United Kingdom
| | - Clare Rusbridge
- School of Veterinary Medicine, University of Surrey, Surrey, United Kingdom
| | - Kenny Bossens
- Nesto Veterinary Referral Center Orion, Herentals, Belgium
| | - Cathryn Mellersh
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Louise Pettitt
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Tiina Heinonen
- Department of Medical and Clinical Genetics, Department of Veterinary Biosciences, University of Helsinki, and Folkhälsan Research Center, Helsinki, Finland
| | - Hannes Lohi
- Department of Medical and Clinical Genetics, Department of Veterinary Biosciences, University of Helsinki, and Folkhälsan Research Center, Helsinki, Finland
| | - Vidhya Jagannathan
- Institute of Genetics, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Tosso Leeb
- Institute of Genetics, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Sun YM, Zhou XY, Liang XN, Lin JR, Xu YD, Chen C, Wei SD, Chen QS, Liu FT, Zhao J, Tang YL, Shen B, Gan LH, Lu B, Ding ZT, An Y, Wu JJ, Wang J. The genetic spectrum of a cohort of patients clinically diagnosed as Parkinson's disease in mainland China. NPJ Parkinsons Dis 2023; 9:76. [PMID: 37198191 DOI: 10.1038/s41531-023-00518-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 04/28/2023] [Indexed: 05/19/2023] Open
Abstract
So far, over 20 causative genes of monogenic Parkinson's disease (PD) have been identified. Some causative genes of non-parkinsonian entities may also manifest with parkinsonism mimicking PD. This study aimed to investigate the genetic characteristics of clinically diagnosed PD with early onset age or family history. A total of 832 patients initially diagnosed with PD were enrolled, of which, 636 were classified into the early-onset group and 196 were classified into the familial late-onset group. The genetic testing included the multiplex ligation-dependent probe amplification and next generation sequencing (target sequencing or whole-exome sequencing). The dynamic variants of spinocerebellar ataxia were tested in probands with family history. In the early-onset group, 30.03% of patients (191/636) harbored pathogenic/likely pathogenic (P/LP) variants in known PD-related genes (CHCHD2, DJ-1, GBA (heterozygous), LRRK2, PINK1, PRKN, PLA2G6, SNCA and VPS35). Variants in PRKN were the most prevalent, accounting for 15.72% of the early-onset patients, followed by GBA (10.22%), and PLA2G6 (1.89%). And 2.52% (16/636) had P/LP variants in causative genes of other diseases (ATXN3, ATXN2, GCH1, TH, MAPT, GBA (homozygous)). In the familial late-onset group, 8.67% of patients (17/196) carried P/LP variants in known PD-related genes (GBA (heterozygous), HTRA2, SNCA) and 2.04% (4/196) had P/LP variants in other genes (ATXN2, PSEN1, DCTN1). Heterozygous GBA variants (7.14%) were the most common genetic cause found in familial late-onset patients. Genetic testing is of vital importance in differential diagnosis especially in early-onset and familial PD. Our findings may also provide some clues to the nomenclature of genetic movement disorders.
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Affiliation(s)
- Yi-Min Sun
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xin-Yue Zhou
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiao-Niu Liang
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jin-Ran Lin
- Human Phenome Institute, Zhangjiang Fudan International Innovation Center, MOE Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, China
| | - Yi-Dan Xu
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chen Chen
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Si-Di Wei
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qi-Si Chen
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Feng-Tao Liu
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jue Zhao
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yi-Lin Tang
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Bo Shen
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Lin-Hua Gan
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Boxun Lu
- Neurology Department at Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, School of Life Sciences, Fudan University, Shanghai, China
| | - Zheng-Tong Ding
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yu An
- Human Phenome Institute, Zhangjiang Fudan International Innovation Center, MOE Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, China.
| | - Jian-Jun Wu
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China.
| | - Jian Wang
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China.
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Tan D, Wei C, Chen Z, Huang Y, Deng J, Li J, Liu Y, Bao X, Xu J, Hu Z, Wang S, Fan Y, Jiang Y, Wu Y, Wu Y, Wang S, Liu P, Zhang Y, Yang Z, Jiang Y, Zhang H, Hong D, Zhong N, Jiang H, Xiong H. CAG Repeat Expansion in THAP11 Is Associated with a Novel Spinocerebellar Ataxia. Mov Disord 2023. [PMID: 37148549 DOI: 10.1002/mds.29412] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/22/2023] [Accepted: 04/05/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND More than 50 loci are associated with spinocerebellar ataxia (SCA), and the most frequent subtypes share nucleotide repeats expansion, especially CAG expansion. OBJECTIVE The objective of this study was to confirm a novel SCA subtype caused by CAG expansion. METHODS We performed long-read whole-genome sequencing combined with linkage analysis in a five-generation Chinese family, and the finding was validated in another pedigree. The three-dimensional structure and function of THAP11 mutant protein were predicted. Polyglutamine (polyQ) toxicity of THAP11 gene with CAG expansion was assessed in skin fibroblasts of patients, human embryonic kidney 293 and Neuro-2a cells. RESULTS We identified THAP11 as the novel causative SCA gene with CAG repeats ranging from 45 to 100 in patients with ataxia and from 20 to 38 in healthy control subjects. Among the patients, the number of CAA interruptions within CAG repeats was decreased to 3 (up to 5-6 in controls), whereas the number of 3' pure CAG repeats was up to 32 to 87 (4-16 in controls), suggesting that the toxicity of polyQ protein was length dependent on the pure CAG repeats. Intracellular aggregates were observed in cultured skin fibroblasts from patients. THAP11 polyQ protein was more intensely distributed in the cytoplasm of cultured skin fibroblasts from patients, which was replicated with in vitro cultured neuro-2a transfected with 54 or 100 CAG repeats. CONCLUSIONS This study identified a novel SCA subtype caused by intragenic CAG repeat expansion in THAP11 with intracellular aggregation of THAP11 polyQ protein. Our findings extended the spectrum of polyQ diseases and offered a new perspective in understanding polyQ-mediated toxic aggregation. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Dandan Tan
- Department of Pediatrics, Peking University First Hospital, Beijing, P.R. China
| | - Cuijie Wei
- Department of Pediatrics, Peking University First Hospital, Beijing, P.R. China
| | - Zhao Chen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Yu Huang
- Department of Medical Genetics, School of Basic Medical Sciences, Peking University, Beijing, P.R. China
| | - Jianwen Deng
- Department of Neurology, Peking University First Hospital, Beijing, P.R. China
| | | | - Yidan Liu
- Department of Pediatrics, Peking University First Hospital, Beijing, P.R. China
| | - Xinhua Bao
- Department of Pediatrics, Peking University First Hospital, Beijing, P.R. China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, Beijing, P.R. China
| | - Jin Xu
- Center of Ultrastructural Pathology, Lab of Electron Microscopy, Peking University First Hospital, Beijing, P.R. China
| | - Zhengmao Hu
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, P.R. China
| | - Suxia Wang
- Center of Ultrastructural Pathology, Lab of Electron Microscopy, Peking University First Hospital, Beijing, P.R. China
| | - Yanbin Fan
- Department of Pediatrics, Peking University First Hospital, Beijing, P.R. China
| | - Yizheng Jiang
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, P.R. China
| | - Ye Wu
- Department of Pediatrics, Peking University First Hospital, Beijing, P.R. China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, Beijing, P.R. China
| | - Yuan Wu
- Department of Pediatrics, Peking University First Hospital, Beijing, P.R. China
| | - Shuang Wang
- Department of Pediatrics, Peking University First Hospital, Beijing, P.R. China
| | - Panyan Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Yuehua Zhang
- Department of Pediatrics, Peking University First Hospital, Beijing, P.R. China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, Beijing, P.R. China
| | - Zhixian Yang
- Department of Pediatrics, Peking University First Hospital, Beijing, P.R. China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, Beijing, P.R. China
| | - Yuwu Jiang
- Department of Pediatrics, Peking University First Hospital, Beijing, P.R. China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, Beijing, P.R. China
| | - Hong Zhang
- Institute of Cardiovascular Sciences and Key Laboratory of Molecular Cardiovascular Sciences, Peking University Health Science Center, Beijing, P.R. China
| | - Daojun Hong
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, P.R. China
| | - Nanbert Zhong
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
| | - Hong Jiang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, P.R. China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, P.R. China
- National Clinical Research Center for Geriatric Diseases, Central South University, Changsha, P.R. China
- National International Collaborative Research Center for Medical Metabolomics, Central South University, Changsha, P.R. China
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Hui Xiong
- Department of Pediatrics, Peking University First Hospital, Beijing, P.R. China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, Beijing, P.R. China
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Soliani L, Alcalá San Martín A, Balsells S, Hernando‐Davalillo C, Ortigoza‐Escobar JD. Chromosome Microarray Analysis for the Investigation of Deletions in Pediatric Movement Disorders: A Systematic Review of the Literature. Mov Disord Clin Pract 2023; 10:547-557. [PMID: 37070051 PMCID: PMC10105116 DOI: 10.1002/mdc3.13711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/19/2023] [Accepted: 02/19/2023] [Indexed: 03/06/2023] Open
Abstract
Background Chromosome microarray analysis (CMA) can detect copy number variants (CNV) beyond the resolution of standard G-banded karyotyping. De novo or inherited microdeletions may cause autosomal dominant movement disorders. Objectives The purpose of this study was to analyze the clinical characteristics, associated features, and genetic information of children with deletions in known genes that cause movement disorders and to make recommendations regarding the diagnostic application of CMA. Methods Clinical cases published in English were identified in scientific databases (PubMed, ClinVar, and DECIPHER) from January 1998 to July 2019 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Cases with deletions or microdeletions greater than 300 kb were selected. Information collected included age, sex, movement disorders, associated features, and the size and location of the deletion. Duplications or microduplications were not included. Results A total of 18.097 records were reviewed, and 171 individuals were identified. Ataxia (30.4%), stereotypies (23.9%), and dystonia (21%) were the most common movement disorders. A total of 16% of the patients demonstrated more than one movement disorder. The most common associated features were intellectual disability or developmental delay (78.9%) and facial dysmorphism (57.8%). The majority (77.7%) of microdeletions were smaller than 5 Mb. We find no correlation between movement disorders, their associated features, and the size of microdeletions. Conclusions Our results support the use of CMA as an investigational test in children with movement disorders. As the majority of identified articles were case reports and small case series (low quality), future efforts should focus on larger prospective studies to examine the causation of microdeletions in pediatric movement disorders.
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Affiliation(s)
- Luca Soliani
- IRCCS Istituto delle Scienze Neurologiche di Bologna UOC Neuropsichiatria dell'età PediatricaBolognaItaly
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC) Università di BolognaBolognaItaly
| | - Adrián Alcalá San Martín
- Department of Genetic and Molecular Medicine and Pediatric Institute of Rare DiseasesHospital Sant Joan de Déu BarcelonaBarcelonaSpain
| | - Sol Balsells
- Department of StatisticsInstitut de Recerca Sant Joan de DéuBarcelonaSpain
| | - Cristina Hernando‐Davalillo
- Department of Genetic and Molecular Medicine and Pediatric Institute of Rare DiseasesHospital Sant Joan de Déu BarcelonaBarcelonaSpain
| | - Juan Darío Ortigoza‐Escobar
- U‐703 Centre for Biomedical Research on Rare Diseases (CIBER‐ER)Instituto de Salud Carlos IIIBarcelonaSpain
- Movement Disorders Unit, Pediatric Neurology Department, Institut de RecercaHospital Sant Joan de Déu BarcelonaBarcelonaSpain
- European Reference Network for Rare Neurological Diseases (ERN‐RND)BarcelonaSpain
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Shafique A, Arif B, Chu ML, Moran E, Hussain T, Zamora FM, Wohler E, Sobreira N, Klein C, Lohmann K, Naz S. MRM2 variants in families with complex dystonic syndromes: evidence for phenotypic heterogeneity. J Med Genet 2023; 60:352-358. [PMID: 36002240 DOI: 10.1136/jmg-2022-108521] [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: 02/22/2022] [Accepted: 07/25/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Dystonia involves repetitive movements and muscle contractions leading to abnormal postures. We investigated patients in two families, DYAF11 and M, exhibiting dystonic or involuntary movement disorders. METHODS Clinical investigations were performed for all patients. Genetic analyses included genome-wide linkage analysis and exome sequencing followed by Sanger sequencing validation. MRM2-specific transcripts were analysed from participants' blood samples in Family DYAF11 after cloning of gene-specific cDNA. RESULTS Four affected siblings in Family DYAF11 had progressive dystonic features. Two patients in Family M exhibited a neurodevelopmental disorder accompanied by involuntary movements. In Family DYAF11, linkage was detected to the telomere at chromosome 7p22.3, spanning <2 Mb. Exome sequencing identified a donor splice-site variant, c.8+1G>T in MRM2, which segregated with the phenotype, corresponding to the linkage data since all affected individuals were homozygous while the obligate unaffected carriers were heterozygous for the variant. In the MRM2 c.8+1G>T allele, an aberrant alternative acceptor splice-site located within exon 2 was used in a subset of the transcripts, creating a frameshift in the open reading frame. Exome sequencing in Family M revealed a rare missense variant c.242C>T, p.(Ala81Val), which affected a conserved amino acid. CONCLUSIONS Our results expand the clinical and allelic spectrum of MRM2 variants. Previously, these descriptions were based on observations in a single patient, diagnosed with mitochondrial DNA depletion syndrome 17, in whom movement disorder was accompanied by recurrent strokes and epilepsy. We also demonstrate a subset of correctly spliced tt-ag MRM2 transcripts, raising the possibility to develop treatment by understanding the disease mechanism.
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Affiliation(s)
- Anum Shafique
- School of Biological Sciences, University of the Punjab Quaid-i-Azam Campus, Lahore, Pakistan
| | - Beenish Arif
- School of Biological Sciences, University of the Punjab Quaid-i-Azam Campus, Lahore, Pakistan
| | - Mary Lynn Chu
- Department of Neurology, New York University Grossman School of Medicine, New York, New York, USA
- Langone Orthopedic Hospital, New York University, New York, New York, USA
| | - Ellen Moran
- Clinical Genetics, Center for Children, Hassenfeld Children's Hospital, New York University, New York, New York, USA
| | - Tooba Hussain
- School of Biological Sciences, University of the Punjab Quaid-i-Azam Campus, Lahore, Pakistan
| | | | - Elizabeth Wohler
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Nara Sobreira
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Katja Lohmann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Sadaf Naz
- School of Biological Sciences, University of the Punjab Quaid-i-Azam Campus, Lahore, Pakistan
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Wali G, Siow SF, Liyanage E, Kumar KR, Mackay-Sim A, Sue CM. Reduced acetylated α-tubulin in SPAST hereditary spastic paraplegia patient PBMCs. Front Neurosci 2023; 17:1073516. [PMID: 37144097 PMCID: PMC10152469 DOI: 10.3389/fnins.2023.1073516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 03/06/2023] [Indexed: 03/30/2023] Open
Abstract
HSP-SPAST is the most common form of hereditary spastic paraplegia (HSP), a neurodegenerative disease causing lower limb spasticity. Previous studies using HSP-SPAST patient-derived induced pluripotent stem cell cortical neurons have shown that patient neurons have reduced levels of acetylated α-tubulin, a form of stabilized microtubules, leading to a chain of downstream effects eventuating in increased vulnerability to axonal degeneration. Noscapine treatment rescued these downstream effects by restoring the levels of acetylated α-tubulin in patient neurons. Here we show that HSP-SPAST patient non-neuronal cells, peripheral blood mononuclear cells (PBMCs), also have the disease-associated effect of reduced levels of acetylated α-tubulin. Evaluation of multiple PBMC subtypes showed that patient T cell lymphocytes had reduced levels of acetylated α-tubulin. T cells make up to 80% of all PBMCs and likely contributed to the effect of reduced acetylated α-tubulin levels seen in overall PBMCs. We further showed that mouse administered orally with increasing concentrations of noscapine exhibited a dose-dependent increase of noscapine levels and acetylated α-tubulin in the brain. A similar effect of noscapine treatment is anticipated in HSP-SPAST patients. To measure acetylated α-tubulin levels, we used a homogeneous time resolved fluorescence technology-based assay. This assay was sensitive to noscapine-induced changes in acetylated α-tubulin levels in multiple sample types. The assay is high throughput and uses nano-molar protein concentrations, making it an ideal assay for evaluation of noscapine-induced changes in acetylated α-tubulin levels. This study shows that HSP-SPAST patient PBMCs exhibit disease-associated effects. This finding can help expedite the drug discovery and testing process.
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Stephen CD, Dy-Hollins M, Gusmao CMD, Qahtani XA, Sharma N. Dystonias: Clinical Recognition and the Role of Additional Diagnostic Testing. Semin Neurol 2023; 43:17-34. [PMID: 36972613 DOI: 10.1055/s-0043-1764292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Dystonia is the third most common movement disorder, characterized by abnormal, frequently twisting postures related to co-contraction of agonist and antagonist muscles. Diagnosis is challenging. We provide a comprehensive appraisal of the epidemiology and an approach to the phenomenology and classification of dystonia, based on the clinical characteristics and underlying etiology of dystonia syndromes. We discuss the features of common idiopathic and genetic forms of dystonia, diagnostic challenges, and dystonia mimics. Appropriate workup is based on the age of symptom onset, rate of progression, whether dystonia is isolated or combined with another movement disorder or complex neurological and other organ system eatures. Based on these features, we discuss when imaging and genetic should be considered. We discuss the multidisciplinary treatment of dystonia, including rehabilitation and treatment principles according to the etiology, including when pathogenesis-direct treatment is available, oral pharmacological therapy, chemodenervation with botulinum toxin injections, deep brain stimulation and other surgical therapies, and future directions.
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Affiliation(s)
| | - Marisela Dy-Hollins
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Xena Al Qahtani
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | - Nutan Sharma
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
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41
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Thomsen M, Lange LM, Klein C, Lohmann K. MDSGene: Extending the List of Isolated Dystonia Genes by VPS16, EIF2AK2, and AOPEP. Mov Disord 2023; 38:507-508. [PMID: 36670070 DOI: 10.1002/mds.29327] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 01/06/2023] [Indexed: 01/22/2023] Open
Affiliation(s)
- Mirja Thomsen
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Lara M Lange
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Katja Lohmann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
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42
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Kalia LV, Nimmo GAM, Mestre TA. Genetic Testing in Clinical Movement Disorders: A Case-Based Review. Semin Neurol 2023; 43:147-155. [PMID: 36854393 DOI: 10.1055/s-0043-1763507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Genetics are fundamental to understanding the pathophysiology of neurological disease, including movement disorders. Genetic testing in clinical practice has changed dramatically over the last few decades. While the likelihood of establishing an etiological diagnosis is greater now with increased access to testing and more advanced technologies, clinicians face challenges when deciding whether to test, then selecting the appropriate test, and ultimately interpreting and sharing the results with patients and families. In this review, we use a case-based approach to cover core aspects of genetic testing for the neurologist, namely, genetic testing in Parkinson's disease, interpretation of inconclusive genetic test reports, and genetic testing for repeat expansion disorders using Huntington disease as a prototype.
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Affiliation(s)
- Lorraine V Kalia
- Division of Neurology, Department of Medicine, Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic and Krembil Research Institute, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Graeme A M Nimmo
- Fred A. Litwin Family Centre for Genetic Medicine, Department of Medicine, Mount Sinai Hospital and Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada
| | - Tiago A Mestre
- Division of Neurology, Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa Brain and Mind Research Institute, The Ottawa Hospital, Ottawa, Ontario Canada
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43
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Castillo‐Torres SA, Rossi M, Paez‐Maggio M, Capparelli F, Gómez‐Arevalo G, Merello M. Early-Onset Dementia-Parkinsonism with Rapid Development of Motor Fluctuations and Dyskinesia Due to PSEN1 G206V Pathogenic Variant. Mov Disord Clin Pract 2023; 10:335-337. [PMID: 36825052 PMCID: PMC9941923 DOI: 10.1002/mdc3.13617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/07/2022] [Accepted: 10/29/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Malco Rossi
- Servicio de Movimientos Anormales, Departamento de NeurologíaFleniBuenos AiresArgentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)Buenos AiresArgentina
| | - Mauricio Paez‐Maggio
- Servicio de Movimientos Anormales, Departamento de NeurologíaFleniBuenos AiresArgentina
| | | | - Gonzalo Gómez‐Arevalo
- Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, and CONICETBuenos AiresArgentina
| | - Marcelo Merello
- Servicio de Movimientos Anormales, Departamento de NeurologíaFleniBuenos AiresArgentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)Buenos AiresArgentina
- Faculty of MedicinePontificial Catholic University of ArgentinaBuenos AiresArgentina
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44
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Rafehi H, Read J, Szmulewicz DJ, Davies KC, Snell P, Fearnley LG, Scott L, Thomsen M, Gillies G, Pope K, Bennett MF, Munro JE, Ngo KJ, Chen L, Wallis MJ, Butler EG, Kumar KR, Wu KHC, Tomlinson SE, Tisch S, Malhotra A, Lee-Archer M, Dolzhenko E, Eberle MA, Roberts LJ, Fogel BL, Brüggemann N, Lohmann K, Delatycki MB, Bahlo M, Lockhart PJ. An intronic GAA repeat expansion in FGF14 causes the autosomal-dominant adult-onset ataxia SCA50/ATX-FGF14. Am J Hum Genet 2023; 110:105-119. [PMID: 36493768 PMCID: PMC9892775 DOI: 10.1016/j.ajhg.2022.11.015] [Citation(s) in RCA: 58] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/19/2022] [Indexed: 12/13/2022] Open
Abstract
Adult-onset cerebellar ataxias are a group of neurodegenerative conditions that challenge both genetic discovery and molecular diagnosis. In this study, we identified an intronic (GAA) repeat expansion in fibroblast growth factor 14 (FGF14). Genetic analysis of 95 Australian individuals with adult-onset ataxia identified four (4.2%) with (GAA)>300 and a further nine individuals with (GAA)>250. PCR and long-read sequence analysis revealed these were pure (GAA) repeats. In comparison, no control subjects had (GAA)>300 and only 2/311 control individuals (0.6%) had a pure (GAA)>250. In a German validation cohort, 9/104 (8.7%) of affected individuals had (GAA)>335 and a further six had (GAA)>250, whereas 10/190 (5.3%) control subjects had (GAA)>250 but none were (GAA)>335. The combined data suggest (GAA)>335 are disease causing and fully penetrant (p = 6.0 × 10-8, OR = 72 [95% CI = 4.3-1,227]), while (GAA)>250 is likely pathogenic with reduced penetrance. Affected individuals had an adult-onset, slowly progressive cerebellar ataxia with variable features including vestibular impairment, hyper-reflexia, and autonomic dysfunction. A negative correlation between age at onset and repeat length was observed (R2 = 0.44, p = 0.00045, slope = -0.12) and identification of a shared haplotype in a minority of individuals suggests that the expansion can be inherited or generated de novo during meiotic division. This study demonstrates the power of genome sequencing and advanced bioinformatic tools to identify novel repeat expansions via model-free, genome-wide analysis and identifies SCA50/ATX-FGF14 as a frequent cause of adult-onset ataxia.
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Affiliation(s)
- Haloom Rafehi
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052, Australia,Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia
| | - Justin Read
- Bruce Lefroy Centre, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia,Department of Paediatrics, University of Melbourne, Royal Children’s Hospital, Parkville, VIC, Australia
| | - David J. Szmulewicz
- Cerebellar Ataxia Clinic, Eye and Ear Hospital, Melbourne, VIC, Australia,The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Kayli C. Davies
- Bruce Lefroy Centre, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia,Department of Paediatrics, University of Melbourne, Royal Children’s Hospital, Parkville, VIC, Australia
| | - Penny Snell
- Bruce Lefroy Centre, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
| | - Liam G. Fearnley
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052, Australia,Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia,Bruce Lefroy Centre, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
| | - Liam Scott
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052, Australia
| | - Mirja Thomsen
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Greta Gillies
- Bruce Lefroy Centre, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
| | - Kate Pope
- Bruce Lefroy Centre, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
| | - Mark F. Bennett
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052, Australia,Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia,Epilepsy Research Centre, Department of Medicine, University of Melbourne, Austin Health, Heidelberg, VIC, Australia
| | - Jacob E. Munro
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052, Australia,Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia
| | - Kathie J. Ngo
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Luke Chen
- Alfred Hospital, Department of Neurology, Melbourne, VIC, Australia
| | - Mathew J. Wallis
- Clinical Genetics Service, Austin Health, Melbourne, VIC, Australia,Department of Medicine, University of Melbourne, Austin Health, Melbourne, VIC, Australia,School of Medicine and Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | | | - Kishore R. Kumar
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia,Molecular Medicine Laboratory and Department of Neurology, Concord Repatriation General Hospital, Concord, NSW, Australia,Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Kathy HC. Wu
- School of Medicine, University of New South Wales, Sydney, NSW, Australia,Clinical Genomics, St Vincent’s Hospital, Darlinghurst, NSW, Australia,Discipline of Genomic Medicine, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia,School of Medicine, University of Notre Dame, Sydney, NSW, Australia
| | - Susan E. Tomlinson
- School of Medicine, University of Notre Dame, Sydney, NSW, Australia,Department of Neurology, St Vincent’s Hospital, Darlinghurst, NSW, Australia
| | - Stephen Tisch
- School of Medicine, University of New South Wales, Sydney, NSW, Australia,Department of Neurology, St Vincent’s Hospital, Darlinghurst, NSW, Australia
| | - Abhishek Malhotra
- Department of Neuroscience, University Hospital Geelong, Geelong, VIC, Australia
| | - Matthew Lee-Archer
- Launceston General Hospital, Tasmanian Health Service, Launceston, TAS, Australia
| | | | | | - Leslie J. Roberts
- Department of Neurology and Neurological Research, St. Vincent’s Hospital, Melbourne, VIC, Australia
| | - Brent L. Fogel
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, USA,Departments of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Norbert Brüggemann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany,Department of Neurology, University Medical Center Schleswig-Holstein, Campus Lübeck, Germany
| | - Katja Lohmann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Martin B. Delatycki
- Bruce Lefroy Centre, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia,Department of Paediatrics, University of Melbourne, Royal Children’s Hospital, Parkville, VIC, Australia,Victorian Clinical Genetics Services, Melbourne, VIC, Australia
| | - Melanie Bahlo
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052, Australia; Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia.
| | - Paul J. Lockhart
- Bruce Lefroy Centre, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia,Department of Paediatrics, University of Melbourne, Royal Children’s Hospital, Parkville, VIC, Australia,Corresponding author
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45
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Alecu JE, Saffari A, Jordan C, Srivastava S, Blackstone C, Ebrahimi-Fakhari D. De novo variants cause complex symptoms in HSP-ATL1 (SPG3A) and uncover genotype-phenotype correlations. Hum Mol Genet 2023; 32:93-103. [PMID: 35925862 PMCID: PMC9838092 DOI: 10.1093/hmg/ddac182] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/16/2022] [Accepted: 07/31/2022] [Indexed: 01/25/2023] Open
Abstract
Pathogenic variants in ATL1 are a known cause of autosomal-dominantly inherited hereditary spastic paraplegia (HSP-ATL1, SPG3A) with a predominantly 'pure' HSP phenotype. Although a relatively large number of patients have been reported, no genotype-phenotype correlations have been established for specific ATL1 variants. Confronted with five children carrying de novo ATL1 variants showing early, complex and severe symptoms, we systematically investigated the molecular and phenotypic spectrum of HSP-ATL1. Through a cross-sectional analysis of 537 published and novel cases, we delineate a distinct phenotype observed in patients with de novo variants. Guided by this systematic phenotyping approach and structural modelling of disease-associated variants in atlastin-1, we demonstrate that this distinct phenotypic signature is also prevalent in a subgroup of patients with inherited ATL1 variants and is largely explained by variant localization within a three-dimensional mutational cluster. Establishing genotype-phenotype correlations, we find that symptoms that extend well beyond the typical pure HSP phenotype (i.e. neurodevelopmental abnormalities, upper limb spasticity, bulbar symptoms, peripheral neuropathy and brain imaging abnormalities) are prevalent in patients with variants located within this mutational cluster.
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Affiliation(s)
- Julian E Alecu
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.,Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, 91054, Germany
| | - Afshin Saffari
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Catherine Jordan
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Siddharth Srivastava
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Craig Blackstone
- Movement Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Darius Ebrahimi-Fakhari
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.,Movement Disorders Program, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.,Intellectual and Developmental Disabilities Research Center, Boston Children's Hospital, Boston, MA 02115, USA.,The Manton Center for Orphan Disease Research, Boston Children's Hospital, Boston, MA 02115, USA
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46
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Vidailhet M. The multiple twists in the tale: Brain iron accumulation, facial jerks, and truncal dystonia: Expert commentary. Parkinsonism Relat Disord 2023; 106:105223. [PMID: 36435730 DOI: 10.1016/j.parkreldis.2022.11.015] [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: 11/08/2022] [Accepted: 11/13/2022] [Indexed: 11/21/2022]
Affiliation(s)
- M Vidailhet
- Department of Neurology AP-HP, Sorbonne Université, Paris Brain Institute, Salpetriere Hospital, Paris, France.
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47
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Mo A, Saffari A, Kellner M, Döbler-Neumann M, Jordan C, Srivastava S, Zhang B, Sahin M, Fink JK, Smith L, Posey JE, Alter KE, Toro C, Blackstone C, Soldatos AG, Christie M, Schüle R, Ebrahimi-Fakhari D. Early-Onset and Severe Complex Hereditary Spastic Paraplegia Caused by De Novo Variants in SPAST. Mov Disord 2022; 37:2440-2446. [PMID: 36103453 PMCID: PMC10062395 DOI: 10.1002/mds.29225] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/13/2022] [Accepted: 08/26/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Familial hereditary spastic paraplegia (HSP)-SPAST (SPG4) typically presents with a pure HSP phenotype. OBJECTIVE The aim of this study was to delineate the genotypic and phenotypic spectrum of children with de novo HSP-SPAST. METHODS This study used a systematic cross-sectional analysis of clinical and molecular features. RESULTS We report the clinical and molecular spectrum of 40 patients with heterozygous pathogenic de novo variants in SPAST (age range: 2.2-27.7 years). We identified 19 unique variants (16/40 carried the same recurrent variant, p.Arg499His). Symptom onset was in early childhood (median: 11.0 months, interquartile range: 6.0 months) with significant motor and speech delay, followed by progressive ascending spasticity, dystonia, neurogenic bladder dysfunction, gastrointestinal dysmotility, and epilepsy. The mean Spastic Paraplegia Rating Scale score was 32.8 ± 9.7 (standard deviation). CONCLUSIONS These results confirm that de novo variants in SPAST lead to a severe and complex form of HSP that differs from classic familial pure HSP-SPAST. Clinicians should be aware of this syndrome in the differential diagnosis for cerebral palsy. © 2022 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Alisa Mo
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Afshin Saffari
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Melanie Kellner
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Marion Döbler-Neumann
- Department of Pediatric Neurology, University Children’s Hospital, Tübingen, Germany
| | - Catherine Jordan
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Siddharth Srivastava
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Bo Zhang
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
- ICCTR Biostatistics and Research Design Center, Boston Children’s Hospital, Harvard Medical School, Boston, MA
| | - Mustafa Sahin
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - John K. Fink
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Linsley Smith
- Department of Neurology and Rehabilitation Medicine, Texas Scottish Rite Hospital, University of Texas Southwestern Medical Center, Dallas, TX, 75219, USA
| | - Jennifer E. Posey
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Katharine E. Alter
- Functional and Applied Biomechanics Section, Department of Rehabilitation Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Camilo Toro
- Undiagnosed Diseases Program, National Institutes of Health, Bethesda, MD, USA
| | - Craig Blackstone
- Movement Disorders Division, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ariane G. Soldatos
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Michelle Christie
- Department of Neurology and Rehabilitation Medicine, Texas Scottish Rite Hospital, University of Texas Southwestern Medical Center, Dallas, TX, 75219, USA
| | - Rebecca Schüle
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Darius Ebrahimi-Fakhari
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
- Movement Disorders Program, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
- The Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, MA, USA
- Intellectual and Developmental Disabilities Research Center, Boston Children’s Hospital, Boston, MA, USA
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48
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Stephen CD. The Dystonias. Continuum (Minneap Minn) 2022; 28:1435-1475. [PMID: 36222773 DOI: 10.1212/con.0000000000001159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
PURPOSE OF REVIEW This article discusses the most recent findings regarding the diagnosis, classification, and management of genetic and idiopathic dystonia. RECENT FINDINGS A new approach to classifying dystonia has been created with the aim to increase the recognition and diagnosis of dystonia. Molecular biology and genetic studies have identified several genes and biological pathways involved in dystonia. SUMMARY Dystonia is a common movement disorder involving abnormal, often twisting, postures and is a challenging condition to diagnose. The pathophysiology of dystonia involves abnormalities in brain motor networks in the context of genetic factors. Dystonia has genetic, idiopathic, and acquired forms, with a wide phenotypic spectrum, and is a common feature in complex neurologic disorders. Dystonia can be isolated or combined with another movement disorder and may be focal, segmental, multifocal, or generalized in distribution, with some forms only occurring during the performance of specific tasks (task-specific dystonia). Dystonia is classified by clinical characteristics and presumed etiology. The management of dystonia involves accurate diagnosis, followed by treatment with botulinum toxin injections, oral medications, and surgical therapies (mainly deep brain stimulation), as well as pathogenesis-directed treatments, including the prospect of disease-modifying or gene therapies.
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