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Mastrangelo M, Tolve M, Artiola C, Bove R, Carducci C, Carducci C, Angeloni A, Pisani F, Leuzzi V. Phenotypes and Genotypes of Inherited Disorders of Biogenic Amine Neurotransmitter Metabolism. Genes (Basel) 2023; 14:genes14020263. [PMID: 36833190 PMCID: PMC9957200 DOI: 10.3390/genes14020263] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023] Open
Abstract
Inherited disorders of biogenic amine metabolism are genetically determined conditions resulting in dysfunctions or lack of enzymes involved in the synthesis, degradation, or transport of dopamine, serotonin, adrenaline/noradrenaline, and their metabolites or defects of their cofactor or chaperone biosynthesis. They represent a group of treatable diseases presenting with complex patterns of movement disorders (dystonia, oculogyric crises, severe/hypokinetic syndrome, myoclonic jerks, and tremors) associated with a delay in the emergence of postural reactions, global development delay, and autonomic dysregulation. The earlier the disease manifests, the more severe and widespread the impaired motor functions. Diagnosis mainly depends on measuring neurotransmitter metabolites in cerebrospinal fluid that may address the genetic confirmation. Correlations between the severity of phenotypes and genotypes may vary remarkably among the different diseases. Traditional pharmacological strategies are not disease-modifying in most cases. Gene therapy has provided promising results in patients with DYT-DDC and in vitro models of DYT/PARK-SLC6A3. The rarity of these diseases, combined with limited knowledge of their clinical, biochemical, and molecular genetic features, frequently leads to misdiagnosis or significant diagnostic delays. This review provides updates on these aspects with a final outlook on future perspectives.
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Affiliation(s)
- Mario Mastrangelo
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- Azienda Ospedaliero Universitaria Policlinico Umberto I, 00161 Rome, Italy
| | - Manuela Tolve
- Azienda Ospedaliero Universitaria Policlinico Umberto I, 00161 Rome, Italy
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Cristiana Artiola
- Azienda Ospedaliero Universitaria Policlinico Umberto I, 00161 Rome, Italy
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Rossella Bove
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Claudia Carducci
- Azienda Ospedaliero Universitaria Policlinico Umberto I, 00161 Rome, Italy
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Carla Carducci
- Azienda Ospedaliero Universitaria Policlinico Umberto I, 00161 Rome, Italy
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Antonio Angeloni
- Azienda Ospedaliero Universitaria Policlinico Umberto I, 00161 Rome, Italy
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Francesco Pisani
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- Azienda Ospedaliero Universitaria Policlinico Umberto I, 00161 Rome, Italy
- Correspondence: ; Tel.: +39-649972930; Fax: +39-64440232
| | - Vincenzo Leuzzi
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- Azienda Ospedaliero Universitaria Policlinico Umberto I, 00161 Rome, Italy
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Bukhari-Parlakturk N, Frucht SJ. Isolated and combined dystonias: Update. HANDBOOK OF CLINICAL NEUROLOGY 2023; 196:425-442. [PMID: 37620082 DOI: 10.1016/b978-0-323-98817-9.00005-3] [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: 08/26/2023]
Abstract
Dystonia is a hyperkinetic movement disorder with a unique motor phenomenology that can manifest as an isolated clinical syndrome or combined with other neurological features. This chapter reviews the characteristic features of dystonia phenomenology and the syndromic approach to evaluating the disorders that may allow us to differentiate the isolated and combined syndromes. We also present the most common types of isolated and combined dystonia syndromes. Since accelerated gene discoveries have increased our understanding of the molecular mechanisms of dystonia pathogenesis, we also present isolated and combined dystonia syndromes by shared biological pathways. Examples of these converging mechanisms of the isolated and combined dystonia syndromes include (1) disruption of the integrated response pathway through eukaryotic initiation factor 2 alpha signaling, (2) disease of dopaminergic signaling, (3) alterations in the cerebello-thalamic pathway, and (4) disease of protein mislocalization and stability. The discoveries that isolated and combined dystonia syndromes converge in shared biological pathways will aid in the development of clinical trials and therapeutic strategies targeting these convergent molecular pathways.
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Affiliation(s)
- Noreen Bukhari-Parlakturk
- Department of Neurology, Movement Disorders Division, Duke University (NBP), Durham, NC, United States.
| | - Steven J Frucht
- Department of Neurology, NYU Grossman School of Medicine (SJF), New York, NY, United States
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Himmelreich N, Blau N, Thöny B. Molecular and metabolic bases of tetrahydrobiopterin (BH 4) deficiencies. Mol Genet Metab 2021; 133:123-136. [PMID: 33903016 DOI: 10.1016/j.ymgme.2021.04.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/09/2021] [Accepted: 04/09/2021] [Indexed: 01/01/2023]
Abstract
Tetrahydrobiopterin (BH4) deficiency is caused by genetic variants in the three genes involved in de novo cofactor biosynthesis, GTP cyclohydrolase I (GTPCH/GCH1), 6-pyruvoyl-tetrahydropterin synthase (PTPS/PTS), sepiapterin reductase (SR/SPR), and the two genes involved in cofactor recycling, carbinolamine-4α-dehydratase (PCD/PCBD1) and dihydropteridine reductase (DHPR/QDPR). Dysfunction in BH4 metabolism leads to reduced cofactor levels and may result in systemic hyperphenylalaninemia and/or neurological sequelae due to secondary deficiency in monoamine neurotransmitters in the central nervous system. More than 1100 patients with BH4 deficiency and 800 different allelic variants distributed throughout the individual genes are tabulated in database of pediatric neurotransmitter disorders PNDdb. Here we provide an update on the molecular-genetic analysis and structural considerations of these variants, including the clinical courses of the genotypes. From a total of 324 alleles, 11 are associated with the autosomal recessive form of GTPCH deficiency presenting with hyperphenylalaninemia (HPA) and neurotransmitter deficiency, 295 GCH1 variant alleles are detected in the dominant form of L-dopa-responsive dystonia (DRD or Segawa disease) while phenotypes of 18 alleles remained undefined. Autosomal recessive variants observed in the PTS (199 variants), PCBD1 (32 variants), and QDPR (141 variants) genes lead to HPA concomitant with central monoamine neurotransmitter deficiency, while SPR deficiency (104 variants) presents without hyperphenylalaninemia. The clinical impact of reported variants is essential for genetic counseling and important for development of precision medicine.
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Affiliation(s)
- Nastassja Himmelreich
- Center for Child and Adolescent Medicine, Dietmar-Hopp Metabolic Center, Division 1, Heidelberg, Germany
| | - Nenad Blau
- Division of Metabolism, University Children's Hospital Zürich, Zürich, Switzerland.
| | - Beat Thöny
- Division of Metabolism and Children's Research Centre, University Children's Hospital Zürich, Zürich, Switzerland.
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Froukh T. Genetic study in a family with dopa-responsive dystonia revealed a novel mutation in sepiapterin reductase gene. Pak J Med Sci 2019; 35:1736-1739. [PMID: 31777525 PMCID: PMC6861483 DOI: 10.12669/pjms.35.6.1181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Dopa-responsive dystonia due to sepiapterin reductase deficiency (OMIM#612716) is caused by recessive mutations in the gene encoding sepiapterin reductase (SPR), which plays an important role in the biosynthesis of tetrahydrobiopterin (BH4). One Jordanian patient to first cousin parents is reported in this study. The parents of the proband have recognized the symptoms of their daughter at six months old with motor developmental delay. The symptoms were progressed after-then to include speech delay, seizure, ataxia, oculomotor apraxia, dysarthia and choreoathetosis. Despite of these symptoms, the clinicians in Jordan were unable to diagnose the case. In August 2018, the proband (8 years old) was presented to the department of biotechnology and genetic engineering at Philadelphia University in Jordan for the purposes of performing whole exome sequencing (WES). Analysis of WES data has revealed novel homozygous frameshift variant in the gene SPR (NM_003124.4:c.40delG,p.Ala15Profs*100). The variant is heterozygous in the parents and in the healthy male siblings. Therefore, the studied case was diagnosed with sepiapterin reductase deficiency. Because this disease is likely to be treated recommendations were given to the family immediately to start treatments trials. The case in this study illustrates the difficulties of diagnosing sepiapterin reductase deficiency based on clinical symptoms only and thus renders the possibilities of early management. Also, this study reinforces the importance of running WES to undiagnosed neurodevelopmental cases.
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Affiliation(s)
- Tawfiq Froukh
- Tawfiq Froukh, Department of Biotechnology and Genetic Engineering, Philadelphia University, Jerash Road, Amman (19392) Jordan
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Kuseyri O, Weissbach A, Bruggemann N, Klein C, Giżewska M, Karall D, Scholl-Bürgi S, Romanowska H, Krzywińska-Zdeb E, Monavari AA, Knerr I, Yapıcı Z, Leuzzi V, Opladen T. Pregnancy management and outcome in patients with four different tetrahydrobiopterin disorders. J Inherit Metab Dis 2018; 41:849-863. [PMID: 29594647 DOI: 10.1007/s10545-018-0169-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 02/27/2018] [Accepted: 03/05/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Inborn errors of tetrahydrobiopterin (BH4) biosynthesis or recycling are a group of very rare neurometabolic diseases. Following growing awareness and improved availability of drug treatment the number of patients with BH4 disorders reaching adulthood is constantly increasing. Pregnancy care of patients with these disorders is therefore a new challenge for clinicians. METHODS This retrospective study summarises for the first time clinical and biochemical monitoring data of 16 pregnancies in seven women with different disorders of BH4 metabolism and evaluates treatment regimens before and during pregnancy in relation to the obstetrical outcome and paediatric follow-up. RESULTS Worsening of pre-existing neurological symptoms or occurrence of new symptoms during pregnancy was not observed in most of the cases. Treatment regimens remained mostly unchanged. Pregnancies were not complicated by disease-specific features. Organ abnormalities, miscarriage, prematurity, IUGR and chromosomal changes were occasionally reported, without showing any association with the standard drug treatment for BH4 deficiencies. CONCLUSION Although our data on 16 pregnancies in seven patients did not present any association of standard drug treatment with an increased rate of pregnancy complications, abnormal obstetrical or paediatric outcome, an intensive clinical and biochemical supervision by a multidisciplinary team before, during and after the pregnancy in any BH4 deficiency is essential since available data on pregnancies in patients with BH4 deficiencies is limited.
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Affiliation(s)
- O Kuseyri
- Division of Child Neurology and Metabolic Diseases, University Children's Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany.
| | - A Weissbach
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - N Bruggemann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - C Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - M Giżewska
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - D Karall
- Department of Paediatrics I, Inherited Metabolic Disorders, Medical University of Innsbruck, Innsbruck, Austria
| | - S Scholl-Bürgi
- Department of Paediatrics I, Inherited Metabolic Disorders, Medical University of Innsbruck, Innsbruck, Austria
| | - H Romanowska
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - E Krzywińska-Zdeb
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - A A Monavari
- National Centre for Inherited Metabolic Disorders, Temple Street Children's University Hospital, Dublin, Ireland
| | - I Knerr
- National Centre for Inherited Metabolic Disorders, Temple Street Children's University Hospital, Dublin, Ireland
| | - Z Yapıcı
- Department of Child Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - V Leuzzi
- Department of Paediatrics and Child Neurology and Psychiatry, Sapienza Università di Roma, Roma, Italy
| | - T Opladen
- Division of Child Neurology and Metabolic Diseases, University Children's Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
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Shalash AS, Rösler TW, Müller SH, Salama M, Deuschl G, Müller U, Opladen T, Petersen BS, Franke A, Hopfner F, Kuhlenbäumer G, Höglinger GU. c.207C>G mutation in sepiapterin reductase causes autosomal dominant dopa-responsive dystonia. NEUROLOGY-GENETICS 2017; 3:e197. [PMID: 29147684 PMCID: PMC5682855 DOI: 10.1212/nxg.0000000000000197] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/21/2017] [Indexed: 12/20/2022]
Abstract
Objective: To elucidate the genetic cause of an Egyptian family with dopa-responsive dystonia (DRD), a childhood-onset dystonia, responding therapeutically to levodopa, which is caused by mutations in various genes. Methods: Rare variants in all coding exons of GCH1 were excluded by Sanger sequencing. Exome sequencing was applied for 1 unaffected and 2 affected family members. To investigate the functional consequences of detected genetic variants, urinary sepiapterin concentrations were determined by high-performance liquid chromatography. Results: A heterozygous rare nonsynonymous variant in exon 1 of sepiapterin reductase (SPR, c.207C>G, p.Asp69Glu) was found in all affected family members. Urinary concentrations of sepiapterin were above the standard of normal controls in most SPR mutation carriers, suggesting functional biochemical consequences of the mutation. Variant filtering of all genes involved in the tetrahydrobiopterin pathway, required for levodopa synthesis, revealed an additional common variant in dihydrofolate reductase (DHFR, rs70991108). The presence of both variants was significantly stronger associated with the biochemical abnormality and the clinical disease state as opposed to 1 variant only. Conclusions: The rare SPR mutation can cause autosomal dominant DRD with incomplete penetrance. The common DHFR variant might have synergistic effects on production of tetrahydrobiopterin and levodopa, thereby increasing penetrance.
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Affiliation(s)
- Ali S Shalash
- Department of Neurology (A.S.S.), Ain Shams University, Cairo, Egypt; German Center for Neurodegenerative Diseases (DZNE) (T.W.R., G.U.H.), Munich, Germany; Department of Neurology (T.W.R., G.U.H.), Technical University of Munich, Germany; Department of Neurology (S.H.M., G.D., F.H., G.K.), University Hospital Schleswig Holstein, Kiel, Germany; Medical Experimental Research Center (MERC) (M.S.), Mansoura University, Egypt; Institute for Human Genetics (U.M.), University of Giessen, Germany; Division of Neuropediatrics and Metabolic Medicine (T.O.), University Children's Hospital, Heidelberg, Germany; and Institute of Clinical Molecular Biology (B.-S.P., A.F.), Christian-Albrechts-Universität zu Kiel, Germany
| | - Thomas W Rösler
- Department of Neurology (A.S.S.), Ain Shams University, Cairo, Egypt; German Center for Neurodegenerative Diseases (DZNE) (T.W.R., G.U.H.), Munich, Germany; Department of Neurology (T.W.R., G.U.H.), Technical University of Munich, Germany; Department of Neurology (S.H.M., G.D., F.H., G.K.), University Hospital Schleswig Holstein, Kiel, Germany; Medical Experimental Research Center (MERC) (M.S.), Mansoura University, Egypt; Institute for Human Genetics (U.M.), University of Giessen, Germany; Division of Neuropediatrics and Metabolic Medicine (T.O.), University Children's Hospital, Heidelberg, Germany; and Institute of Clinical Molecular Biology (B.-S.P., A.F.), Christian-Albrechts-Universität zu Kiel, Germany
| | - Stefanie H Müller
- Department of Neurology (A.S.S.), Ain Shams University, Cairo, Egypt; German Center for Neurodegenerative Diseases (DZNE) (T.W.R., G.U.H.), Munich, Germany; Department of Neurology (T.W.R., G.U.H.), Technical University of Munich, Germany; Department of Neurology (S.H.M., G.D., F.H., G.K.), University Hospital Schleswig Holstein, Kiel, Germany; Medical Experimental Research Center (MERC) (M.S.), Mansoura University, Egypt; Institute for Human Genetics (U.M.), University of Giessen, Germany; Division of Neuropediatrics and Metabolic Medicine (T.O.), University Children's Hospital, Heidelberg, Germany; and Institute of Clinical Molecular Biology (B.-S.P., A.F.), Christian-Albrechts-Universität zu Kiel, Germany
| | - Mohamed Salama
- Department of Neurology (A.S.S.), Ain Shams University, Cairo, Egypt; German Center for Neurodegenerative Diseases (DZNE) (T.W.R., G.U.H.), Munich, Germany; Department of Neurology (T.W.R., G.U.H.), Technical University of Munich, Germany; Department of Neurology (S.H.M., G.D., F.H., G.K.), University Hospital Schleswig Holstein, Kiel, Germany; Medical Experimental Research Center (MERC) (M.S.), Mansoura University, Egypt; Institute for Human Genetics (U.M.), University of Giessen, Germany; Division of Neuropediatrics and Metabolic Medicine (T.O.), University Children's Hospital, Heidelberg, Germany; and Institute of Clinical Molecular Biology (B.-S.P., A.F.), Christian-Albrechts-Universität zu Kiel, Germany
| | - Günther Deuschl
- Department of Neurology (A.S.S.), Ain Shams University, Cairo, Egypt; German Center for Neurodegenerative Diseases (DZNE) (T.W.R., G.U.H.), Munich, Germany; Department of Neurology (T.W.R., G.U.H.), Technical University of Munich, Germany; Department of Neurology (S.H.M., G.D., F.H., G.K.), University Hospital Schleswig Holstein, Kiel, Germany; Medical Experimental Research Center (MERC) (M.S.), Mansoura University, Egypt; Institute for Human Genetics (U.M.), University of Giessen, Germany; Division of Neuropediatrics and Metabolic Medicine (T.O.), University Children's Hospital, Heidelberg, Germany; and Institute of Clinical Molecular Biology (B.-S.P., A.F.), Christian-Albrechts-Universität zu Kiel, Germany
| | - Ulrich Müller
- Department of Neurology (A.S.S.), Ain Shams University, Cairo, Egypt; German Center for Neurodegenerative Diseases (DZNE) (T.W.R., G.U.H.), Munich, Germany; Department of Neurology (T.W.R., G.U.H.), Technical University of Munich, Germany; Department of Neurology (S.H.M., G.D., F.H., G.K.), University Hospital Schleswig Holstein, Kiel, Germany; Medical Experimental Research Center (MERC) (M.S.), Mansoura University, Egypt; Institute for Human Genetics (U.M.), University of Giessen, Germany; Division of Neuropediatrics and Metabolic Medicine (T.O.), University Children's Hospital, Heidelberg, Germany; and Institute of Clinical Molecular Biology (B.-S.P., A.F.), Christian-Albrechts-Universität zu Kiel, Germany
| | - Thomas Opladen
- Department of Neurology (A.S.S.), Ain Shams University, Cairo, Egypt; German Center for Neurodegenerative Diseases (DZNE) (T.W.R., G.U.H.), Munich, Germany; Department of Neurology (T.W.R., G.U.H.), Technical University of Munich, Germany; Department of Neurology (S.H.M., G.D., F.H., G.K.), University Hospital Schleswig Holstein, Kiel, Germany; Medical Experimental Research Center (MERC) (M.S.), Mansoura University, Egypt; Institute for Human Genetics (U.M.), University of Giessen, Germany; Division of Neuropediatrics and Metabolic Medicine (T.O.), University Children's Hospital, Heidelberg, Germany; and Institute of Clinical Molecular Biology (B.-S.P., A.F.), Christian-Albrechts-Universität zu Kiel, Germany
| | - Britt-Sabina Petersen
- Department of Neurology (A.S.S.), Ain Shams University, Cairo, Egypt; German Center for Neurodegenerative Diseases (DZNE) (T.W.R., G.U.H.), Munich, Germany; Department of Neurology (T.W.R., G.U.H.), Technical University of Munich, Germany; Department of Neurology (S.H.M., G.D., F.H., G.K.), University Hospital Schleswig Holstein, Kiel, Germany; Medical Experimental Research Center (MERC) (M.S.), Mansoura University, Egypt; Institute for Human Genetics (U.M.), University of Giessen, Germany; Division of Neuropediatrics and Metabolic Medicine (T.O.), University Children's Hospital, Heidelberg, Germany; and Institute of Clinical Molecular Biology (B.-S.P., A.F.), Christian-Albrechts-Universität zu Kiel, Germany
| | - Andre Franke
- Department of Neurology (A.S.S.), Ain Shams University, Cairo, Egypt; German Center for Neurodegenerative Diseases (DZNE) (T.W.R., G.U.H.), Munich, Germany; Department of Neurology (T.W.R., G.U.H.), Technical University of Munich, Germany; Department of Neurology (S.H.M., G.D., F.H., G.K.), University Hospital Schleswig Holstein, Kiel, Germany; Medical Experimental Research Center (MERC) (M.S.), Mansoura University, Egypt; Institute for Human Genetics (U.M.), University of Giessen, Germany; Division of Neuropediatrics and Metabolic Medicine (T.O.), University Children's Hospital, Heidelberg, Germany; and Institute of Clinical Molecular Biology (B.-S.P., A.F.), Christian-Albrechts-Universität zu Kiel, Germany
| | - Franziska Hopfner
- Department of Neurology (A.S.S.), Ain Shams University, Cairo, Egypt; German Center for Neurodegenerative Diseases (DZNE) (T.W.R., G.U.H.), Munich, Germany; Department of Neurology (T.W.R., G.U.H.), Technical University of Munich, Germany; Department of Neurology (S.H.M., G.D., F.H., G.K.), University Hospital Schleswig Holstein, Kiel, Germany; Medical Experimental Research Center (MERC) (M.S.), Mansoura University, Egypt; Institute for Human Genetics (U.M.), University of Giessen, Germany; Division of Neuropediatrics and Metabolic Medicine (T.O.), University Children's Hospital, Heidelberg, Germany; and Institute of Clinical Molecular Biology (B.-S.P., A.F.), Christian-Albrechts-Universität zu Kiel, Germany
| | - Gregor Kuhlenbäumer
- Department of Neurology (A.S.S.), Ain Shams University, Cairo, Egypt; German Center for Neurodegenerative Diseases (DZNE) (T.W.R., G.U.H.), Munich, Germany; Department of Neurology (T.W.R., G.U.H.), Technical University of Munich, Germany; Department of Neurology (S.H.M., G.D., F.H., G.K.), University Hospital Schleswig Holstein, Kiel, Germany; Medical Experimental Research Center (MERC) (M.S.), Mansoura University, Egypt; Institute for Human Genetics (U.M.), University of Giessen, Germany; Division of Neuropediatrics and Metabolic Medicine (T.O.), University Children's Hospital, Heidelberg, Germany; and Institute of Clinical Molecular Biology (B.-S.P., A.F.), Christian-Albrechts-Universität zu Kiel, Germany
| | - Günter U Höglinger
- Department of Neurology (A.S.S.), Ain Shams University, Cairo, Egypt; German Center for Neurodegenerative Diseases (DZNE) (T.W.R., G.U.H.), Munich, Germany; Department of Neurology (T.W.R., G.U.H.), Technical University of Munich, Germany; Department of Neurology (S.H.M., G.D., F.H., G.K.), University Hospital Schleswig Holstein, Kiel, Germany; Medical Experimental Research Center (MERC) (M.S.), Mansoura University, Egypt; Institute for Human Genetics (U.M.), University of Giessen, Germany; Division of Neuropediatrics and Metabolic Medicine (T.O.), University Children's Hospital, Heidelberg, Germany; and Institute of Clinical Molecular Biology (B.-S.P., A.F.), Christian-Albrechts-Universität zu Kiel, Germany
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Qu Z, Zhang H, Huang M, Shi G, Liu Z, Xie P, Li H, Wang W, Xu G, Zhang Y, Yang L, Huang G, Takahashi JS, Zhang WJ, Xu Y. Loss of ZBTB20 impairs circadian output and leads to unimodal behavioral rhythms. eLife 2016; 5. [PMID: 27657167 PMCID: PMC5033604 DOI: 10.7554/elife.17171] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 09/01/2016] [Indexed: 12/15/2022] Open
Abstract
Many animals display morning and evening bimodal activities in the day/night cycle. However, little is known regarding the potential components involved in the regulation of bimodal behavioral rhythms in mammals. Here, we identified that the zinc finger protein gene Zbtb20 plays a crucial role in the regulation of bimodal activities in mice. Depletion of Zbtb20 in nerve system resulted in the loss of early evening activity, but the increase of morning activity. We found that Zbtb20-deficient mice exhibited a pronounced decrease in the expression of Prokr2 and resembled phenotypes of Prok2 and Prokr2-knockout mice. Injection of adeno-associated virus-double-floxed Prokr2 in suprachiasmatic nucleus could partly restore evening activity in Nestin-Cre; Zbtb20fl/fl (NS-ZB20KO) mice. Furthermore, loss of Zbtb20 in Foxg1 loci, but intact in the suprachiasmatic nucleus, was not responsible for the unimodal activity of NS-ZB20KO mice. Our study provides evidence that ZBTB20-mediated PROKR2 signaling is critical for the evening behavioral rhythms. DOI:http://dx.doi.org/10.7554/eLife.17171.001
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Affiliation(s)
- Zhipeng Qu
- MOE Key Laboratory of Model Animal for Disease Study, Model Animal Research Center, Nanjing University, Nanjing, China
| | - Hai Zhang
- Department of Pathophysiology, Second Military Medical University, Shanghai, China
| | - Moli Huang
- Cambridge-Suda Genomic Research Center, Soochow University, Suzhou, China
| | - Guangsen Shi
- MOE Key Laboratory of Model Animal for Disease Study, Model Animal Research Center, Nanjing University, Nanjing, China
| | - Zhiwei Liu
- Cambridge-Suda Genomic Research Center, Soochow University, Suzhou, China
| | - Pancheng Xie
- MOE Key Laboratory of Model Animal for Disease Study, Model Animal Research Center, Nanjing University, Nanjing, China
| | - Hui Li
- Department of Pathophysiology, Second Military Medical University, Shanghai, China
| | - Wei Wang
- Cambridge-Suda Genomic Research Center, Soochow University, Suzhou, China
| | - Guoqiang Xu
- College of Pharmaceutical Sciences, Soochow University, Suzhou, China
| | - Yang Zhang
- Cambridge-Suda Genomic Research Center, Soochow University, Suzhou, China
| | - Ling Yang
- Cambridge-Suda Genomic Research Center, Soochow University, Suzhou, China
| | - Guocun Huang
- Department of Neuroscience, University of Texas Southwestern Medical Center, Dallas, United States
| | - Joseph S Takahashi
- Department of Neuroscience, University of Texas Southwestern Medical Center, Dallas, United States
| | - Weiping J Zhang
- Department of Pathophysiology, Second Military Medical University, Shanghai, China
| | - Ying Xu
- MOE Key Laboratory of Model Animal for Disease Study, Model Animal Research Center, Nanjing University, Nanjing, China.,Cambridge-Suda Genomic Research Center, Soochow University, Suzhou, China
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Smit M, Bartels AL, van Faassen M, Kuiper A, Niezen-Koning KE, Kema IP, Dierckx RA, de Koning TJ, Tijssen MA. Serotonergic perturbations in dystonia disorders-a systematic review. Neurosci Biobehav Rev 2016; 65:264-75. [PMID: 27073048 DOI: 10.1016/j.neubiorev.2016.03.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/02/2016] [Accepted: 03/22/2016] [Indexed: 11/26/2022]
Abstract
Dystonia is a hyperkinetic movement disorder characterized by sustained or intermittent muscle contractions. Emerging data describe high prevalences of non-motor symptoms, including psychiatric co-morbidity, as part of the phenotype of dystonia. Basal ganglia serotonin and serotonin-dopamine interactions gain attention, as imbalances are known to be involved in extrapyramidal movement and psychiatric disorders. We systematically reviewed the literature for human and animal studies relating to serotonin and its role in dystonia. An association between dystonia and the serotonergic system was reported with decreased levels of 5-hydroxyindolacetic acid, the main metabolite of serotonin. A relation between dystonia and drugs affecting the serotonergic system was described in 89 cases in 49 papers. Psychiatric co-morbidity was frequently described, but likely underestimated as it was not systematically examined. Currently, there are no good (pharmaco)therapeutic options for most forms of dystonia or associated non-motor symptoms. Further research using selective serotonergic drugs in appropriate models of dystonia is required to establish the role of the serotonergic system in dystonia and to guide us to new therapeutic strategies.
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Affiliation(s)
- M Smit
- University of Groningen, University Medical Center Groningen, Department of Neurology, PO Box 30.001, 9700, RB Groningen, The Netherlands.
| | - A L Bartels
- University of Groningen, University Medical Center Groningen, Department of Neurology, PO Box 30.001, 9700, RB Groningen, The Netherlands; Ommelander Hospital Group, Department of Neurology, PO Box 30.000, 9930 RA Delfzijl, The Netherlands.
| | - M van Faassen
- University of Groningen, University Medical Center Groningen, Department of Laboratory Medicine, PO Box 30.001, 9700, RB Groningen, The Netherlands.
| | - A Kuiper
- University of Groningen, University Medical Center Groningen, Department of Neurology, PO Box 30.001, 9700, RB Groningen, The Netherlands.
| | - K E Niezen-Koning
- University of Groningen, University Medical Center Groningen, Department of Laboratory Medicine, PO Box 30.001, 9700, RB Groningen, The Netherlands.
| | - I P Kema
- University of Groningen, University Medical Center Groningen, Department of Laboratory Medicine, PO Box 30.001, 9700, RB Groningen, The Netherlands.
| | - R A Dierckx
- University of Groningen, University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, PO Box 30.001, 9700 RB Groningen, The Netherlands.
| | - T J de Koning
- University of Groningen, University Medical Center Groningen, Department of Genetics, PO Box 30.001, 9700 RB Groningen, The Netherlands.
| | - M A Tijssen
- University of Groningen, University Medical Center Groningen, Department of Neurology, PO Box 30.001, 9700, RB Groningen, The Netherlands.
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Antelmi E, Stamelou M, Liguori R, Bhatia KP. Nonmotor Symptoms in Dopa-Responsive Dystonia. Mov Disord Clin Pract 2015; 2:347-356. [PMID: 30363518 DOI: 10.1002/mdc3.12211] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Revised: 05/15/2015] [Accepted: 05/15/2015] [Indexed: 02/02/2023] Open
Abstract
Background Dopa-responsive dystonia (DRD) is a rare inherited dystonia, caused by an autosomal dominantly inherited defect in the gene GCH1 that encodes guanosine triphosphate cyclohydrolase 1. It catalyzes the first and rate-limiting enzyme in the biosynthesis of tetrahydrobiopterin, which is the essential co-factor for aromatic amino acid hydroxylases. Mutation results in the typical scenario of a young-onset lower-limb dystonia with diurnal fluctuations, concurrent or subsequent development of parkinsonism and excellent response to levodopa. Given the myriad functions of tetrahydrobiopterin, it is reasonable that other systems, apart from motor, would also be impaired. So far, non-motor symptoms have been overlooked and very few and often contrasting data are currently available on the matter. Methods Here by searching the Medline database for publications between 1971 to March 2015, we render an in-depth analysis of all published data on non-motor symptoms in DRD. Results Depression and subtle sleep quality impairment have been reported among the different cohorts, while current data do not support any alterations of the cardiologic and autonomic systems. However, there is debate about the occurrence of sleep-related movement disorders and cognitive function. Non-motor symptoms are instead frequently reported among the clinical spectrum of other neurotransmitter disorders which may sometimes mimic DRD phenotype, ie, DRD plus diseases. Conclusions Further studies in larger and treatment-naïve cohorts are needed to better elucidate the extend of non-motor symptoms in DRD and also to consider treatment for these.
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Affiliation(s)
- Elena Antelmi
- Department of Biomedical and Neuromotor Sciences Alma Mater Studiorum University of Bologna Bologna Italy.,Sobell Department of Motor Neuroscience and Movement Disorders University College London (UCL) Institute of Neurology London United Kingdom
| | - Maria Stamelou
- Second Department of Neurology University of Athens Athens Greece.,Neurology Clinic Philipps University Marburg Germany
| | - Rocco Liguori
- Department of Biomedical and Neuromotor Sciences Alma Mater Studiorum University of Bologna Bologna Italy.,IRCCS Institute of Neurological Sciences Bologna Italy
| | - Kailash P Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders University College London (UCL) Institute of Neurology London United Kingdom
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10
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LeDoux MS. Dystonia. Mov Disord 2015. [DOI: 10.1016/b978-0-12-405195-9.00024-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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11
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Abstract
Dopa-responsive dystonia (DRD) has a classic presentation of childhood or adolescent-onset dystonia, mild parkinsonism, marked diurnal fluctuations, improvement with sleep or rest, and a dramatic and sustained response to low doses of L-dopa without motor fluctuations or dyskinesias. However, there have been many papers on patients with a wide range of features, which report them as DRD mainly because they had dystonic syndromes with L-dopa responsiveness. Many mutations in the dopaminergic system have been found as molecular genetic defects. Therefore, the clinical and genetic spectra of DRD are unclear, which lead to difficulties in diagnostic work-ups and planning treatments. We propose the concept of DRD and DRD-plus to clarify the confusion in this area and to help understand the pathophysiology and clinical features, which will help in guiding diagnostic investigations and planning treatments. We critically reviewed the literature on atypical cases and discussed the limitations of the gene study.
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Affiliation(s)
- Woong-Woo Lee
- Movement Disorder Center, CRI, Seoul National University Hospital, Seoul, Korea
- Department of Neurology, College of Medicine, Seoul National University, Seoul, Korea
| | - Beom Seok Jeon
- Movement Disorder Center, CRI, Seoul National University Hospital, Seoul, Korea
- Department of Neurology, College of Medicine, Seoul National University, Seoul, Korea
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
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12
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Hereditäre Dystonien. MED GENET-BERLIN 2013. [DOI: 10.1007/s11825-013-0388-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Zusammenfassung
Dystonien sind eine klinisch und ätiologisch heterogene Gruppe von Bewegungsstörungen. Charakteristisch sind unwillkürliche Muskelkontraktionen, die zu drehenden, schraubenden und repetitiven Bewegungen führen und sehr schmerzhaft sein können. Die Dystonie kann dabei das einzige Symptom sein („isolierte Dystonie“) oder von anderen Symptomen begleitet werden („kombinierte Dystonie“), sie kann aber auch eine Manifestation jedweder das Zentralnervensystem betreffenden Erkrankung sein, die das motorische System in Mitleidenschaft zieht (z. B. neurodegenerative, ischämische, traumatische Prozesse). In den letzten 20 Jahren hat die Entwicklung neuer molekulargenetischer Technologien zur Entdeckung neuer Gene geführt, die vielen Dystoniesubtypen zugrunde liegen, und eine verbesserte Klassifizierung sowie einen tieferen Einblick in die Pathophysiologie ermöglicht. Es wird eine aktuelle Übersicht über die genetisch determinierten Dystonien mit Fokus auf den sog. isolierten bzw. kombinierten Formen vorgelegt. Die Zusammenstellung phänotypischer Charakteristika zu spezifischen genetischen Veränderungen soll dem Kliniker ermöglichen, anhand konkreter klinischer Manifestationen eine entsprechende molekulargenetische Abklärung in die Wege zu leiten.
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Abstract
Dystonia has been defined as a syndrome of involuntary, sustained muscle contractions affecting one or more sites of the body, frequently causing twisting and repetitive movements or abnormal postures. Dystonia is also a clinical sign that can be the presenting or prominent manifestation of many neurodegenerative and neurometabolic disorders. Etiological categories include primary dystonia, secondary dystonia, heredodegenerative diseases with dystonia, and dystonia plus. Primary dystonia includes syndromes in which dystonia is the sole phenotypic manifestation with the exception that tremor can be present as well. Most primary dystonia begins in adults, and approximately 10% of probands report one or more affected family members. Many cases of childhood- and adolescent-onset dystonia are due to mutations in TOR1A and THAP1. Mutations in THAP1 and CIZ1 have been associated with sporadic and familial adult-onset dystonia. Although significant recent progress had been made in defining the genetic basis for most of the dystonia-plus and heredodegenerative diseases with dystonia, a major gap remains in understanding the genetic etiologies for most cases of adult-onset primary dystonia. Common themes in the cellular biology of dystonia include G1/S cell cycle control, monoaminergic neurotransmission, mitochondrial dysfunction, and the neuronal stress response.
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Affiliation(s)
- Mark S LeDoux
- Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA
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Yu L, Zhou H, Hu F, Xu Y. Two novel mutations of the GTP cyclohydrolase 1 gene and genotype-phenotype correlation in Chinese Dopa-responsive dystonia patients. Eur J Hum Genet 2012; 21:731-5. [PMID: 23211702 DOI: 10.1038/ejhg.2012.239] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The most common form of Dopa-responsive dystonia (DRD) is caused by heterozygous mutations in the GTP cyclohydrolase I (GCH1) gene. We screened two unrelated, DRD-symptomatic Chinese Han individuals, for GCH1 gene mutations by direct sequencing. As the clinical manifestations of DRD are highly variable, we also explored the association between genotype and phenotype in all Chinese DRD patients reported so far in the literature, comprising 62 DRD-affected patients from 36 Chinese families. Two novel missense mutations (T94M, L145F) and a novel variant (c. 453+6 G>T) were identified in our two new patients. None of these variants was detected in 200 healthy controls. On the basis of this and other reports, heterozygous mutations were detected in 90.3% of Chinese Han subjects with DRD. Seeming the age of onset for males and females, the mean age was 13 years older in males than in females (P=0.006). Different mutation types did not show any significant differences in age of onset, gender composition, initial symptoms, or the L-dopa dose that abolished the symptoms. Among DRD patients lacking missense or exon-intron boundary mutations, 68.4% were found to possess a large deletion in GCH1, which were detected by multiplex ligation-dependent probe amplification. Most GCH1 mutations were found to cluster in two regions of the coding sequence, suggesting the probable existence of mutation hotspot for the first time. The genotype-phenotype correlation described here may improve our understanding of DRD in Chinese individuals.
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Affiliation(s)
- Lihua Yu
- Department of Neurology, West China Hospital, Sichuan University, Sichuan Province, Chengdu, People's Republic of China
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15
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Friedman J, Roze E, Abdenur JE, Chang R, Gasperini S, Saletti V, Wali GM, Eiroa H, Neville B, Felice A, Parascandalo R, Zafeiriou DI, Arrabal-Fernandez L, Dill P, Eichler FS, Echenne B, Gutierrez-Solana LG, Hoffmann GF, Hyland K, Kusmierska K, Tijssen MAJ, Lutz T, Mazzuca M, Penzien J, Poll-The BT, Sykut-Cegielska J, Szymanska K, Thöny B, Blau N. Sepiapterin reductase deficiency: a treatable mimic of cerebral palsy. Ann Neurol 2012; 71:520-30. [PMID: 22522443 DOI: 10.1002/ana.22685] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Sepiapterin reductase deficiency (SRD) is an under-recognized levodopa-responsive disorder. We describe clinical, biochemical, and molecular findings in a cohort of patients with this treatable condition. We aim to improve awareness of the phenotype and available diagnostic and therapeutic strategies to reduce delayed diagnosis or misdiagnosis, optimize management, and improve understanding of pathophysiologic mechanisms. METHODS Forty-three individuals with SRD were identified from 23 international medical centers. The phenotype and treatment response were assessed by chart review using a detailed standardized instrument and by literature review for cases for which records were unavailable. RESULTS In most cases, motor and language delays, axial hypotonia, dystonia, weakness, oculogyric crises, and diurnal fluctuation of symptoms with sleep benefit become evident in infancy or childhood. Average age of onset is 7 months, with delay to diagnosis of 9.1 years. Misdiagnoses of cerebral palsy (CP) are common. Most patients benefit dramatically from levodopa/carbidopa, often with further improvement with the addition of 5-hydroxytryptophan. Cerebrospinal fluid findings are distinctive. Diagnosis is confirmed by mutation analysis and/or enzyme activity measurement in cultured fibroblasts. INTERPRETATION Common, clinical findings of SRD, aside from oculogyric crises and diurnal fluctuation, are nonspecific and mimic CP with hypotonia or dystonia. Patients usually improve dramatically with treatment. Consequently, we recommend consideration of SRD not only in patients with levodopa-responsive motor disorders, but also in patients with developmental delays with axial hypotonia, and patients with unexplained or atypical presumed CP. Biochemical investigation of cerebrospinal fluid is the preferred method of initial investigation. Early diagnosis and treatment are recommended to prevent ongoing brain dysfunction.
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Affiliation(s)
- Jennifer Friedman
- Departments of Neurosciences and Pediatrics, University of California at San Diego and Rady Children's Hospital, USA.
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Abstract
The last 25 years have seen remarkable advances in our understanding of the genetic etiologies of dystonia, new approaches into dissecting underlying pathophysiology, and independent progress in identifying effective treatments. In this review we highlight some of these advances, especially the genetic findings that have taken us from phenomenological to molecular-based diagnoses. Twenty DYT loci have been designated and 10 genes identified, all based on linkage analyses in families. Hand in hand with these genetic findings, neurophysiological and imaging techniques have been employed that have helped illuminate the similarities and differences among the various etiological dystonia subtypes. This knowledge is just beginning to yield new approaches to treatment including those based on DYT1 animal models. Despite the lag in identifying genetically based therapies, effective treatments, including impressive benefits from deep brain stimulation and botulinum toxin chemodenervation, have marked the last 25 years. The challenge ahead includes continued advancement into understanding dystonia's many underlying causes and associated pathology and using this knowledge to advance treatment including preventing genetic disease expression.
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Affiliation(s)
- Laurie J Ozelius
- Department of Genetics and Genomic Sciences, Mount Sinai School of Medicine, New York, New York, USA
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17
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Distonía hereditaria sensible a L-dopa secundaria a déficit de GTP ciclohidrolasa 1. An Pediatr (Barc) 2011; 75:55-7. [DOI: 10.1016/j.anpedi.2011.01.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2010] [Revised: 01/18/2011] [Accepted: 01/19/2011] [Indexed: 11/18/2022] Open
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18
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Arrabal L, Teresa L, Sánchez-Alcudia R, Castro M, Medrano C, Gutiérrez-Solana L, Roldán S, Ormazábal A, Pérez-Cerdá C, Merinero B, Pérez B, Artuch R, Ugarte M, Desviat LR. Genotype–phenotype correlations in sepiapterin reductase deficiency. A splicing defect accounts for a new phenotypic variant. Neurogenetics 2011; 12:183-91. [DOI: 10.1007/s10048-011-0279-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Accepted: 02/18/2011] [Indexed: 12/25/2022]
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Abstract
The list of genetic causes of syndromes of dystonia parkinsonism grows constantly. As a consequence, the diagnosis becomes more and more challenging for the clinician. Here, we summarize the important causes of dystonia parkinsonism including autosomal-dominant, recessive, and x-linked forms. We cover dopa-responsive dystonia, Wilson's disease, Parkin-, PINK1-, and DJ-1-associated parkinsonism (PARK2, 6, and 7), x-linked dystonia-parkinsonism/Lubag (DYT3), rapid-onset dystonia-parkinsonism (DYT12) and DYT16 dystonia, the syndromes of Neurodegeneration with Brain Iron Accumulation (NBIA) including pantothenate kinase (PANK2)- and PLA2G6 (PARK14)-associated neurodegeneration, neuroferritinopathy, Kufor-Rakeb disease (PARK9) and the recently described SENDA syndrome; FBXO7-associated neurodegeneration (PARK15), autosomal-recessive spastic paraplegia with a thin corpus callosum (SPG11), and dystonia parkinsonism due to mutations in the SLC6A3 gene encoding the dopamine transporter. They have in common that in all these syndromes there may be a combination of dystonic and parkinsonian features, which may be complicated by pyramidal tract involvement. The aim of this review is to familiarize the clinician with the phenotypes of these disorders.
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Affiliation(s)
- Susanne A Schneider
- Sobell Department for Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, UK.
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20
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Genetics and Pharmacological Treatment of Dystonia. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2011. [DOI: 10.1016/b978-0-12-381328-2.00019-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register]
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Abstract
IMPORTANCE OF THE FIELD Dystonia is a neurological syndrome characterized by involuntary twisting movements and unnatural postures. It has many different manifestations and causes, and many different treatment options are available. These options include physical and occupational therapy, oral medications, intramuscular injection of botulinum toxins, and neurosurgical interventions. AREAS COVERED IN THIS REVIEW In this review, we first summarize the treatment options available, then we provide suggestions from our own experience for how these can be applied in different types of dystonia. In preparing this review article, an extensive literature search was undertaken using PubMed. Only selected references from 1970 to 2008 are cited. WHAT THE READER WILL GAIN This review is intended to provide the clinician with a practical guide to the treatment of dystonia. TAKE HOME MESSAGE Treatment of dystonia begins with proper diagnosis and classification, followed by an appropriate search for underlying etiology, and an assessment of the functional impairment associated with the dystonia. The therapeutic approach, which is usually limited to symptomatic therapy, must then be tailored to the individual needs of the patient.
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Affiliation(s)
- Leslie J Cloud
- Emory University, Department of Neurology, 1841 Clifton Road NE, Room 329, Atlanta, GA 30029, USA
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22
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Cao L, Zheng L, Tang WG, Xiao Q, Zhang T, Tang HD, He SB, Wang XJ, Ding JQ, Chen SD. Four novel mutations in the GCH1 gene of Chinese patients with dopa-responsive dystonia. Mov Disord 2010; 25:755-60. [DOI: 10.1002/mds.22646] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Abstract
The torsion dystonias encompass a broad collection of etiologic subtypes, often divided into primary and secondary classes. Tremendous advances have been made in uncovering the genetic basis of dystonia, including discovery of a gene causing early onset primary torsion dystonia-a GAG deletion in exon 5 of the DYT1 gene that encodes torsinA. Although the exact function of torsinA remains elusive, evidence suggests aberrant localization and interaction of mutated protein; this may result in an abnormal response to stress or interference with cytoskeletal events and the development of neuronal brain pathways. Breakthroughs include the discovery of a genetic modifier that protects against clinical expression in DYT1 dystonia and the identification of the gene causing DYT6, THAP1. The authors review genetic etiologies and discuss phenotypes as well as counseling of patients regarding prognosis and progression of the disease. They also address pharmacologic and surgical treatment options for various forms of dystonia.
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Affiliation(s)
- Cordelia S Schwarz
- Department of Neurology, Beth Israel Medical Center, Phillips Ambulatory Care Center, New York, NY 10003, USA
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Clot F, Grabli D, Cazeneuve C, Roze E, Castelnau P, Chabrol B, Landrieu P, Nguyen K, Ponsot G, Abada M, Doummar D, Damier P, Gil R, Thobois S, Ward AJ, Hutchinson M, Toutain A, Picard F, Camuzat A, Fedirko E, Sân C, Bouteiller D, LeGuern E, Durr A, Vidailhet M, Brice A. Exhaustive analysis of BH4 and dopamine biosynthesis genes in patients with Dopa-responsive dystonia. Brain 2009; 132:1753-63. [PMID: 19491146 DOI: 10.1093/brain/awp084] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Dopa-responsive dystonia is a childhood-onset dystonic disorder, characterized by a dramatic response to low dose of L-Dopa. Dopa-responsive dystonia is mostly caused by autosomal dominant mutations in the GCH1 gene (GTP cyclohydrolase1) and more rarely by autosomal recessive mutations in the TH (tyrosine hydroxylase) or SPR (sepiapterin reductase) genes. In addition, mutations in the PARK2 gene (parkin) which causes autosomal recessive juvenile parkinsonism may present as Dopa-responsive dystonia. In order to evaluate the relative frequency of the mutations in these genes, but also in the genes involved in the biosynthesis and recycling of BH4, and to evaluate the associated clinical spectrum, we have studied a large series of index patients (n = 64) with Dopa-responsive dystonia, in whom dystonia improved by at least 50% after L-Dopa treatment. Fifty seven of these patients were classified as pure Dopa-responsive dystonia and seven as Dopa-responsive dystonia-plus syndromes. All patients were screened for point mutations and large rearrangements in the GCH1 gene, followed by sequencing of the TH and SPR genes, then PTS (pyruvoyl tetrahydropterin synthase), PCBD (pterin-4a-carbinolamine dehydratase), QDPR (dihydropteridin reductase) and PARK2 (parkin) genes. We identified 34 different heterozygous point mutations in 40 patients, and six different large deletions in seven patients in the GCH1 gene. Except for one patient with mental retardation and a large deletion of 2.3 Mb encompassing 10 genes, all patients had stereotyped clinical features, characterized by pure Dopa-responsive dystonia with onset in the lower limbs and an excellent response to low doses of L-Dopa. Dystonia started in the first decade of life in 40 patients (85%) and before the age of 1 year in one patient (2.2%). Three of the 17 negative GCH1 patients had mutations in the TH gene, two in the SPR gene and one in the PARK2 gene. No mutations in the three genes involved in the biosynthesis and recycling of BH4 were identified. The clinical presentations of patients with mutations in TH and SPR genes were strikingly more complex, characterized by mental retardation, oculogyric crises and parkinsonism and they were all classified as Dopa-responsive dystonia-plus syndromes. Patient with mutation in the PARK2 gene had Dopa-responsive dystonia with a good improvement with L-Dopa, similar to Dopa-responsive dystonia secondary to GCH1 mutations. Although the yield of mutations exceeds 80% in pure Dopa-responsive dystonia and Dopa-responsive dystonia-plus syndromes groups, the genes involved are clearly different: GCH1 in the former and TH and SPR in the later.
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Affiliation(s)
- Fabienne Clot
- AP-HP, Département de Génétique et Cytogénétique, Groupe Hospitalier Pitié Salpêtrière, Paris, France
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Polymorphisms of sepiapterin reductase gene alter promoter activity and may influence risk of bipolar disorder. Pharmacogenet Genomics 2009; 19:330-7. [PMID: 19415819 DOI: 10.1097/fpc.0b013e328328f82c] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES In a previous investigation, we observed altered expression of sepiapterin reductase (SPR) in cultured neural cells chronically exposed to paroxetine. SPR is an enzyme, which catalyzes the final step in the synthesis of tetrahydrobiopterin (BH4). BH4 is an essential cofactor for synthesis of many neurotransmitters including serotonin. Given the pivotal role of SPR in neurotransmitter production, we sought to test the hypothesis that SPR would influence susceptibility to mood disorders and patient response to antidepressants. METHODS We tested for association of SPR promoter polymorphisms with antidepressant response in a well-characterized triad cohort of mood disorders. We evaluated the functional effect of these variants using the Dual-Luciferase Reporter Gene Assay System in two independent cell lines. RESULTS Two promoter single nucleotide polymorphisms (rs1876487 and rs2421095) in SPR were identified that occurred in three distinct haplotypes. We found a statistically significant association of haplotype pair 2,3 with bipolar I disorder [odds ratio: 5.47; 95% confidence interval: (1.68-17.88); P<0.005] and the personality measure self-transcendence (P = 0.020). Moreover, we found preliminary evidence that individuals with haplotype pair 2,3 responded better to the treatment with selective serotonin reuptake inhibitors. Reporter gene assays revealed a 1.4-fold to 1.6-fold decrease in the transcription rate of the two less common haplotypes (2 and 3) compared with haplotype 1, in the two cell lines investigated. CONCLUSION This reduced transcription rate for SPR promoter haplotypes 2 and 3 may impact on BH4-mediated neurotransmitter production, thus suggesting a biological process through which SPR gene variants might influence antidepressant response and susceptibility to bipolar disorder.
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Kronsbein HC, Jastorff AM, Maccarrone G, Stalla G, Wurst W, Holsboer F, Turck CW, Deussing JM. CRHR1-dependent effects on protein expression and posttranslational modification in AtT-20 cells. Mol Cell Endocrinol 2008; 292:1-10. [PMID: 18582531 DOI: 10.1016/j.mce.2008.05.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2008] [Revised: 05/26/2008] [Accepted: 05/27/2008] [Indexed: 01/11/2023]
Abstract
Corticotropin-releasing hormone (CRH) plays a major role in coordinating the organism's stress response, including the activity of the hypothalamic-pituitary-adrenocortical axis. The molecular underpinnings of CRH-dependent signal transduction mechanisms in the anterior pituitary have not yet been revealed in detail. In order to dissect the signal transduction cascades activated by CRH receptor type 1, a comparative proteome approach was performed in vitro utilizing murine corticotroph AtT-20 cells. Alterations in protein expression and posttranslational modification in response to CRH stimulation were studied by 2D gel electrophoresis. Selected candidates were analyzed by immunoblotting and quantitative real-time PCR. The differential analyses revealed proteins regulated or modified related to diverse cellular processes. Amongst others we identified alterations in PRKAR1A, the regulatory subunit of protein kinase A; in PGK1 and PGAM1, key regulators of glycolysis; and in proteins involved in proteasome-mediated proteolysis, PSMC2 and PSMA3. These results offer novel entry points to molecular mechanisms underlying stress responses elicited via the hypothalamic-pituitary-adrenocortical axis.
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Affiliation(s)
- Helena C Kronsbein
- Max Planck Institute of Psychiatry, Kraepelinstrasse 2-10, D-80804 Munich, Germany
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McHugh PC, Rogers GR, Loudon B, Glubb DM, Joyce PR, Kennedy MA. Proteomic analysis of embryonic stem cell–derived neural cells exposed to the antidepressant paroxetine. J Neurosci Res 2008; 86:306-16. [PMID: 17868153 DOI: 10.1002/jnr.21482] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Antidepressant drugs can have significant effects on the mood of a patient suffering from major depression or other disorders. The pharmacological actions of these drugs generally affect the uptake or metabolism of the neurotransmitters serotonin, noradrenalin, and, to a lesser extent, dopamine. However, many aspects of antidepressant action are not understood. We conducted a proteomic analysis in a neuronal cell culture model in an attempt to identify molecules important to the operation of pathways functionally relevant to antidepressant action. The model involved generating cultures containing mixed neural and glial cells by controlled differentiation of mouse embryonic stem cells, followed by exposure to 1 microM paroxetine for 14 days. After antidepressant exposure, we observed increased expression or modification of sepiapterin reductase (SPR), heat shock protein 9A, RAS and EF-hand domain containing, and protein disulfide isomerase associated 3 and decreased expression or modification of creatine kinase, actin, prohibitin, a T-cell receptor alpha chain, defensin-related cryptdin 5, and the intermediate filament proteins glial fibrillary acidic protein and vimentin. SPR, the most strongly up-regulated protein observed, controls production of tetrahydrobiopterin, an essential cofactor for the synthesis of many neurotransmitters including serotonin, making it a plausible and intriguing candidate protein for involvement in mood control and antidepressant drug action. SPR and the other proteins identified may represent links to molecular processes of importance to mood dysregulation and control, and their respective genes may be novel candidates for the study of antidepressant pharmacogenetics.
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Affiliation(s)
- Patrick C McHugh
- Department of Pathology, University of Otago, Christchurch, New Zealand
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Benoist J, Roze E, Sedel F. Apport de l’analyse du liquide cérébrospinal pour le diagnostic des maladies métaboliques héréditaires. Rev Neurol (Paris) 2007; 163:950-9. [DOI: 10.1016/s0035-3787(07)92639-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Echenne B, Roubertie A, Assmann B, Lutz T, Penzien JM, Thöny B, Blau N, Hoffmann GF. Sepiapterin reductase deficiency: clinical presentation and evaluation of long-term therapy. Pediatr Neurol 2006; 35:308-13. [PMID: 17074599 DOI: 10.1016/j.pediatrneurol.2006.05.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2006] [Revised: 03/17/2006] [Accepted: 05/10/2006] [Indexed: 10/24/2022]
Abstract
Sepiapterin reductase deficiency has recently been recognized as a treatable, inborn error of pterin metabolism. This investigation is the first long-term clinical study demonstrating impressive positive, long-term effects of treatment in two cases of sepiapterin reductase deficiency after 2 and 5 years of treatment respectively. The two patients were not diagnosed before 7 and 13 years of age. These results highlight the importance of cerebrospinal fluid neurotransmitter investigations in childhood encephalopathy, in cases of unexplained early-onset neurologic handicap. Such a widened approach to the diagnostic efforts in early-onset encephalopathy with motor delay during childhood is important, as we have at our disposal a simple and effective treatment.
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Abstract
Dystonia, defined as a neurological syndrome characterised by involuntary, patterned, sustained, or repetitive muscle contractions of opposing muscles, causing twisting movements and abnormal postures, is one of the most disabling movement disorders. Although gene mutations and other causes are increasingly recognised, most patients have primary dystonia without a specific cause. Although pathogenesis-targeted treatment is still elusive, the currently available symptomatic treatment strategies are quite effective for some types of dystonia in relieving involuntary movements, correcting abnormal posture, preventing contractures, reducing pain, and improving function and quality of life. A small portion of patients have a known cause and respond to specific treatments, such as levodopa in dopa-responsive dystonia or drugs that prevent copper accumulation in Wilson's disease. Therapeutic options must be tailored to the needs of individual patients and include chemodenervation with botulinum toxin injections for patients with focal or segmental dystonia, and medical treatments or deep brain stimulation for patients with generalised dystonia.
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Affiliation(s)
- Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas 77030, USA.
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Ettl AK, Holzschuh J, Driever W. The zebrafish mutation m865 affects formation of dopaminergic neurons and neuronal survival, and maps to a genetic interval containing the sepiapterin reductase locus. ACTA ACUST UNITED AC 2006; 211 Suppl 1:73-86. [PMID: 17024299 DOI: 10.1007/s00429-006-0128-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2006] [Indexed: 10/24/2022]
Abstract
The zebrafish mutation m865 was isolated during a large-scale mutagenesis screen aimed at identifying genes involved in the development and maintenance of subgroups of neurons in the zebrafish central nervous system. The phenotype of m865 mutant embryos shows defects in the development of dopaminergic neurons in the pretectum and of retinal amacrine cells, as well as abnormal caudal dopaminergic cluster in the diencephalon. The effects of the mutation appear not to be restricted to dopaminergic neurons, as development of other neurotransmitter systems (serotonergic and cholinergic) is impaired as well. Furthermore, increased apoptosis is localized to the m865 mutant retina and in the optic tectum starting at 24hpf, and may lead to the observed reduced size of the mutant head and eye. Early patterning is not affected in m865 mutant embryos, and expression of genes known to play a role in dopaminergic cell differentiation is normal except for reduced expression of nurr1 in the mutant retina. Thus the m865 mutation does not specifically affect dopaminergic neuron development. m865 was genetically mapped to linkage group 5, and the critical genomic interval could be narrowed down to a region of 110 kb, containing four candidate genes. For one of these candidate genes, sepiapterin reductase (spr), a requirement for neuronal survival has previously been implicated, including dopaminergic neurons. Identification of the mutated gene should lead to a more detailed understanding of the defects observed in m865 mutant embryos, and potentially could enhance the understanding of the development and maintenance of specific dopaminergic neuronal populations.
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Affiliation(s)
- Anne-Kathrin Ettl
- Department of Developmental Biology, Institute Biology 1, University of Freiburg, Hauptstrasse 1, 79104, Freiburg, Germany
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Thöny B, Blau N. Mutations in the BH4-metabolizing genes GTP cyclohydrolase I, 6-pyruvoyl-tetrahydropterin synthase, sepiapterin reductase, carbinolamine-4a-dehydratase, and dihydropteridine reductase. Hum Mutat 2006; 27:870-8. [PMID: 16917893 DOI: 10.1002/humu.20366] [Citation(s) in RCA: 122] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Tetrahydrobiopterin (BH(4)) deficiencies are a highly heterogeneous group of disorders with several hundred patients, and so far a total of 193 different mutant alleles or molecular lesions identified in the GTP cyclohydrolase I (GTPCH), 6-pyruvoyl-tetrahydropterin synthase (PTPS), sepiapterin reductase (SR), carbinolamine-4a-dehydratase (PCD), or dihydropteridine reductase (DHPR) genes. The spectrum of mutations causing a reduction in one of the three biosynthetic (GTPCH, PTPS, and SR) or the two regenerating enzymes (PCD and DHPR) is tabulated and reviewed. Furthermore, current genomic variations or SNPs are also compiled. Mutations in GCH1 are scattered over the entire gene, and only 5 out of 104 mutant alleles, present in a homozygous state, are reported to cause the autosomal recessive form of inheritable hyperphenylalaninemia (HPA) associated with monoamine neurotransmitter deficiency. Almost all other 99 different mutant alleles in GCH1 are observed together with a wild-type allele and cause Dopa-responsive dystonia (DRD, Segawa disease) in a dominant fashion with reduced penetrance. Compound heterozygous or homozygous mutations are spread over the entire genes for PTS with 44 mutant alleles, for PCBD with nine mutant alleles, and for QDPR with 29 mutant alleles. These mutations cause an autosomal recessive inherited form of HPA, mostly accompanied by a deficiency of the neurotransmitters dopamine and serotonin. Lack of sepiapterin reductase activity, an autosomal recessive variant of BH(4) deficiency presenting without HPA, was diagnosed in patients with seven different mutant alleles in the SPR gene in exons 2 or 3 or in intron 2. Details on all mutations presented here are constantly updated in the BIOMDB database (www.bh4.org).
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Affiliation(s)
- Beat Thöny
- Division of Clinical Chemistry and Biochemistry, University Children's Hospital, Zurich, Switzerland
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Abstract
Amine biosynthetic defects that result in dopamine deficiency encompass an increasingly broad spectrum of neurological phenotypes. This review highlights observations from the literature in addition to the author’s personal perspectives from ongoing studies of individuals and families with a select subset of these disorders: aromatic L-amino acid decarboxylase deficiency and dopa-responsive dystonia due to guanine triphosphate cyclohydrolase 1 and tyrosine hydroxylase deficiencies. These disorders, while demonstrating a shared dopamine deficiency state, highlight the complexities of the dopaminergic pathways in relation to variables including gender, circadian variation in neurotransmitter levels, receptor expression and neurological development. An improved understanding of the mechanisms involved in phenotypic expression and responses to treatment in inborn errors of amine biosynthesis will undoubtedly lead to advances in our understanding and treatment of more complex and common neurological disorders, such as Parkinson’s disease.
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Affiliation(s)
- Kathryn J Swoboda
- Associate Professor, Neurology, Adjunct Associate Professor, Pediatrics, , 50 North Medical Drive, Room 3R210 University of Utah School of Medicine, Salt Lake City, UT 84132, USA
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Yang S, Lee YJ, Kim JM, Park S, Peris J, Laipis P, Park YS, Chung JH, Oh SP. A murine model for human sepiapterin-reductase deficiency. Am J Hum Genet 2006; 78:575-87. [PMID: 16532389 PMCID: PMC1424682 DOI: 10.1086/501372] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2005] [Accepted: 01/17/2006] [Indexed: 11/03/2022] Open
Abstract
Tetrahydrobiopterin (BH(4)) is an essential cofactor for several enzymes, including all three forms of nitric oxide synthases, the three aromatic hydroxylases, and glyceryl-ether mono-oxygenase. A proper level of BH(4) is, therefore, necessary for the metabolism of phenylalanine and the production of nitric oxide, catecholamines, and serotonin. BH(4) deficiency has been shown to be closely associated with diverse neurological psychiatric disorders. Sepiapterin reductase (SPR) is an enzyme that catalyzes the final step of BH(4) biosynthesis. Whereas the number of cases of neuropsychological disorders resulting from deficiencies of other catalytic enzymes involved in BH(4) biosynthesis and metabolism has been increasing, only a handful of cases of SPR deficiency have been reported, and the role of SPR in BH(4) biosynthesis in vivo has been poorly understood. Here, we report that mice deficient in the Spr gene (Spr(-/-)) display disturbed pterin profiles and greatly diminished levels of dopamine, norepinephrine, and serotonin, indicating that SPR is essential for homeostasis of BH(4) and for the normal functions of BH(4)-dependent enzymes. The Spr(-/-) mice exhibit phenylketonuria, dwarfism, and impaired body movement. Oral supplementation of BH(4) and neurotransmitter precursors completely rescued dwarfism and phenylalanine metabolism. The biochemical and behavioral characteristics of Spr(-/-) mice share striking similarities with the symptoms observed in SPR-deficient patients. This Spr mutant strain of mice will be an invaluable resource to elucidate many important issues regarding SPR and BH(4) deficiencies.
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Affiliation(s)
- Seungkyoung Yang
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, and Department of Pathology, Chungnam National University School of Medicine, Daejeon, South Korea; Departments of Physiology and Functional Genomics and Biochemistry and Molecular Biology, University of Florida College of Medicine, and Department of Pharmacodynamics, University of Florida College of Pharmacy, Gainesville; and School of Biotechnology and Biomedical Science, Inje University, Kimhae, South Korea
| | - Young Jae Lee
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, and Department of Pathology, Chungnam National University School of Medicine, Daejeon, South Korea; Departments of Physiology and Functional Genomics and Biochemistry and Molecular Biology, University of Florida College of Medicine, and Department of Pharmacodynamics, University of Florida College of Pharmacy, Gainesville; and School of Biotechnology and Biomedical Science, Inje University, Kimhae, South Korea
| | - Jin-Man Kim
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, and Department of Pathology, Chungnam National University School of Medicine, Daejeon, South Korea; Departments of Physiology and Functional Genomics and Biochemistry and Molecular Biology, University of Florida College of Medicine, and Department of Pharmacodynamics, University of Florida College of Pharmacy, Gainesville; and School of Biotechnology and Biomedical Science, Inje University, Kimhae, South Korea
| | - Sean Park
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, and Department of Pathology, Chungnam National University School of Medicine, Daejeon, South Korea; Departments of Physiology and Functional Genomics and Biochemistry and Molecular Biology, University of Florida College of Medicine, and Department of Pharmacodynamics, University of Florida College of Pharmacy, Gainesville; and School of Biotechnology and Biomedical Science, Inje University, Kimhae, South Korea
| | - Joanna Peris
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, and Department of Pathology, Chungnam National University School of Medicine, Daejeon, South Korea; Departments of Physiology and Functional Genomics and Biochemistry and Molecular Biology, University of Florida College of Medicine, and Department of Pharmacodynamics, University of Florida College of Pharmacy, Gainesville; and School of Biotechnology and Biomedical Science, Inje University, Kimhae, South Korea
| | - Philip Laipis
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, and Department of Pathology, Chungnam National University School of Medicine, Daejeon, South Korea; Departments of Physiology and Functional Genomics and Biochemistry and Molecular Biology, University of Florida College of Medicine, and Department of Pharmacodynamics, University of Florida College of Pharmacy, Gainesville; and School of Biotechnology and Biomedical Science, Inje University, Kimhae, South Korea
| | - Young Shik Park
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, and Department of Pathology, Chungnam National University School of Medicine, Daejeon, South Korea; Departments of Physiology and Functional Genomics and Biochemistry and Molecular Biology, University of Florida College of Medicine, and Department of Pharmacodynamics, University of Florida College of Pharmacy, Gainesville; and School of Biotechnology and Biomedical Science, Inje University, Kimhae, South Korea
| | - Jae Hoon Chung
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, and Department of Pathology, Chungnam National University School of Medicine, Daejeon, South Korea; Departments of Physiology and Functional Genomics and Biochemistry and Molecular Biology, University of Florida College of Medicine, and Department of Pharmacodynamics, University of Florida College of Pharmacy, Gainesville; and School of Biotechnology and Biomedical Science, Inje University, Kimhae, South Korea
| | - S. Paul Oh
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, and Department of Pathology, Chungnam National University School of Medicine, Daejeon, South Korea; Departments of Physiology and Functional Genomics and Biochemistry and Molecular Biology, University of Florida College of Medicine, and Department of Pharmacodynamics, University of Florida College of Pharmacy, Gainesville; and School of Biotechnology and Biomedical Science, Inje University, Kimhae, South Korea
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Sharma M, Mueller JC, Zimprich A, Lichtner P, Hofer A, Leitner P, Maass S, Berg D, Dürr A, Bonifati V, De Michele G, Oostra B, Brice A, Wood NW, Muller-Myhsok B, Gasser T. The sepiapterin reductase gene region reveals association in the PARK3 locus: analysis of familial and sporadic Parkinson's disease in European populations. J Med Genet 2006; 43:557-62. [PMID: 16443856 PMCID: PMC2593029 DOI: 10.1136/jmg.2005.039149] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Parkinson's disease is a genetically complex disease with mixed mode of inheritance. Recently, a haplotype across the sepiapterin reductase (SPR) gene, which is located in the PARK3 linkage region, was shown to modulate age of onset of Parkinson's disease in sibships from North America. OBJECTIVE To make a thorough assessment of the SPR gene region in sporadic Parkinson's disease. METHODS A linkage study in 122 European sibship families with five microsatellite and 17 single nucleotide polymorphism (SNP) markers in and around the SPR gene region, and an association analysis in 340 sporadic cases of Parkinson's disease and 680 control subjects from Germany with 40 SNPs. Linkage was evaluated by non-parametric linkage scores and genotypic or haplotype association was tested by regression analysis, assuming different risk effect models. RESULTS Significant LOD scores between 2 and 3 were obtained at the two SPR-flanking markers D2S2110 and D2S1394 and seven SNP markers around the SPR gene. We found the previously reported promoter SNP rs1876487 also significantly associated with age of onset in our sib pair families (p-value 0.02). One strong linkage disequilibrium (LD) block of 45 kb including the entire SPR gene was observed. Within this LD block all 14 inter-correlated SNPs were significantly associated with Parkinson's disease affection status (p-value 0.004). CONCLUSIONS DNA polymorphisms in a highly intercorrelated LD block, which includes the SPR gene, appear to be associated with both sporadic and familial Parkinson's disease. This confirms a previous study showing that SPR potentially modulates the onset of or risk for Parkinson's disease.
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Affiliation(s)
- M Sharma
- Hertie-Institute for Clinical Brain Research, Department for Neurodegenerative Diseases, University of Tübingen, Hoppe-Seyler Str 3, 72076 Tübingen, Germany
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