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Jha SK, Nelson VK, Suryadevara PR, Panda SP, Pullaiah CP, Nuli MV, Kamal M, Imran M, Ausali S, Abomughaid MM, Srivastava R, Deka R, Pritam P, Gupta N, Shyam H, Singh IK, Pandey BW, Dewanjee S, Jha NK, Jafari SM. Cannabidiol and Neurodegeneration: From Molecular Mechanisms to Clinical Benefits. Ageing Res Rev 2024:102386. [PMID: 38969143 DOI: 10.1016/j.arr.2024.102386] [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: 11/15/2023] [Revised: 05/23/2024] [Accepted: 06/18/2024] [Indexed: 07/07/2024]
Abstract
Neurodegenerative disorders (NDs) such as Alzheimer's disease, Parkinson's disease, Huntington's disease, multiple sclerosis, and amyotrophic lateral sclerosis are severe and life-threatening conditions in which significant damage of functional neurons occurs to produce malfunction of psycho-motor functions. NDs are an important cause of death in the elderly population worldwide. These disorders are commonly associated with the progression of age, oxidative stress, and environmental pollutants, which are the major etiological factors. Abnormal aggregation of specific proteins such as α-synuclein, amyloid-β, huntingtin, and tau, and accumulation of its associated oligomers in neurons are the hallmark pathological features of NDs. Existing therapeutic options for NDs are only symptomatic relief and do not address root-causing factors, such as protein aggregation, oxidative stress, and neuroinflammation. Cannabidiol is a non-psychotic natural cannabinoid obtained from Cannabis sativa that possesses multiple pharmacological actions, including antioxidant, anti-inflammatory, and neuroprotective effects in various NDs and other neurological disorders both in vitro and in vivo. Cannabidiol has gained attention as a promising therapeutic drug candidate for the management of neurodegenerative disorders, such as Alzheimer's disease and Parkinson's disease, by inhibiting protein aggregation, free radicals, and neuroinflammation. In parallel, CBD has shown positive results in other neurological disorders, such as epilepsy, depression, schizophrenia, and anxiety, as well as adjuvant treatment with existing standard therapeutic agents. Hence, the present review focuses on exploring the possible molecular mechanisms in controlling various neurological disorders as well as its clinical applications in NDs including epilepsy, depression and anxiety. In this way, the current review will serve as a standalone reference for the researchers working in this area.
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Affiliation(s)
- Saurabh Kumar Jha
- Department of Zoology, Kalindi College, University of Delhi, 110008, India.
| | - Vinod Kumar Nelson
- Center for global health research, saveetha medical college, saveetha institute of medical and technical sciences, India
| | | | - Siva Prasad Panda
- Institute of Pharmaceutical Research, GLA University, Mathura, Uttar Pradesh-281406
| | - Chitikela P Pullaiah
- Department of Chemistry, Siddha Central Research Institute, Central Council for Research in Siddha, Ministry of AYUSH, Govt. of India, Chennai, Tamil Nadu, India
| | - Mohana Vamsi Nuli
- Raghavendra Institute of Pharmaceutical Education and Research, Anantapur, India
| | - Mehnaz Kamal
- Department of Pharmaceutical Chemistry, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Mohd Imran
- Department of Pharmaceutical Chemistry, College of Pharmacy, Northern Border University, Rafha 91911, Saudi Arabia
| | - Saijyothi Ausali
- College of Pharmacy, MNR higher education and research academy campus, MNR Nagar, Sangareddy-502294, India
| | - Mosleh Mohammad Abomughaid
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, University of Bisha, Bisha 61922, Saudi Arabia
| | - Rashi Srivastava
- Department of Chemical & Biochemical Engineering, Indian Institute of Technology, Patna, 800013 India
| | - Rahul Deka
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Pingal Pritam
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Neha Gupta
- School of Studies in Biotechnology, Jiwaji University, Gwalior, Madhya Pradesh, India
| | - Harishankar Shyam
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Indrakant K Singh
- Molecular Biology Research Lab., Department of Zoology, Deshbandhu College & Delhi School of Public Health, Institute of Eminence, University of Delhi, New Delhi, 110019 India
| | | | - Saikat Dewanjee
- Advanced Pharmacognosy Research Laboratory, Department of Pharmaceutical Technology, Jadavpur University, Kolkata 700 032, West Bengal, India
| | - Niraj Kumar Jha
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, Uttar Pradesh, India; School of Bioengineering & Biosciences, Lovely Professional University, Phagwara 144411, India.
| | - Seid Mahdi Jafari
- Department of Food Materials and Process Design Engineering, Gorgan University of Agricultural Sciences and Natural Resources, Gorgan, Iran; Universidade de Vigo, Nutrition and Bromatology Group, Department of Analytical Chemistry and Food Science, Faculty of Science, E-32004 Ourense, Spain
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Ochoa-Morales A, Dávila-Ortiz de Montellano DJ, Chávez-Oliveros M, Rodríguez-Agudelo Y, Longoria-Ibarrola M, Sosa-Ortiz AL, Boll MC, Jara-Prado A, Yescas-Gómez P, Guerrero-Camacho J, Ramírez-García MÁ. Presymptomatic Testing for Huntington's Disease in Mexico: 28 Years of Experience. Arch Med Res 2024; 55:103004. [PMID: 38714041 DOI: 10.1016/j.arcmed.2024.103004] [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: 01/15/2024] [Revised: 04/09/2024] [Accepted: 04/23/2024] [Indexed: 05/09/2024]
Abstract
INTRODUCTION Huntington's disease (HD) is a genetic neurodegenerative disorder with dominant inheritance. Our center in Mexico City has offered presymptomatic testing (PT) since 1995. OBJECTIVE To describe the main clinical and demographic characteristics of at-risk HD individuals who applied to the PT program, the reasons for seeking it, and the molecular results. METHODS A cross-sectional study was conducted with sociodemographic and clinical data of all PT applicants from 1995-2023. Reasons for seeking PT were assessed using a modified questionnaire. In addition, anxiety, and depressive symptoms before and after PT were evaluated with Beck's instruments; cognitive impairment (CI) was assessed with the Mini-Mental State Examination (MMSE) and molecular results. RESULTS 214 people applied for PT (2.1% of the at-risk population identified in our center); 63% were women (mean age of 37.11 years). 204 (95.3%) were accepted and 190 received results. 70% indicated that the main reason for applying for PT was to inform their offspring about the risk of inheriting HD. Significant differences were observed in the reasons for seeking PT by age group. Although some subjects received treatment, Beck's instrument scores did not indicate special attention or pharmacological treatment. The MMSE showed probable CI in 20 subjects. Of those who received results, 37% were carriers of a full penetrance allele. CONCLUSION Our center has the only formal PT program for HD in Mexico. The reasons for seeking PT are varied and age-related. Although PT is offered to all subjects at risk for HD, uptake remains low.
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Affiliation(s)
- Adriana Ochoa-Morales
- Genetics Department, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
| | | | - Mireya Chávez-Oliveros
- Clinical Neuropsychology Laboratory, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez. Mexico City, Mexico
| | - Yaneth Rodríguez-Agudelo
- Clinical Neuropsychology Laboratory, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez. Mexico City, Mexico
| | - Mariana Longoria-Ibarrola
- Dementia Laboratory, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
| | - Ana Luisa Sosa-Ortiz
- Dementia Laboratory, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
| | - Marie-Catherine Boll
- Clinical Research Laboratory, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
| | - Aurelio Jara-Prado
- Genetics Department, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
| | - Petra Yescas-Gómez
- Genetics Department, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
| | - Jorge Guerrero-Camacho
- Genetics Department, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
| | - Miguel Ángel Ramírez-García
- Genetics Department, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico.
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Flanagan K. 'A medical case history … ': Huntington's disease and psychiatry. Soc Sci Med 2022; 311:115311. [PMID: 36063596 DOI: 10.1016/j.socscimed.2022.115311] [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: 08/11/2021] [Revised: 08/08/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022]
Abstract
An important insight arising from the work of Michel Foucault is greater attention to the ways medical science produces subjects. In the case of Huntington's disease, the subjectivity produced has historically been constructed as dysfunctional and threatening, while the subjectivity of the researcher was unscrutinised. This paper describes a Foucauldian analysis of 20th century medical and social scientific literature on the social consequences of Huntington's disease. It identifies three features of Huntington's disease as central to its discursive construction: its genetic transmission pattern, its age of onset and its behavioural symptoms. These qualities, converted into medical and psychiatric knowledge, facilitated the absorption of Huntington's disease into eugenicist discourse, a connection reflected throughout the literature. Through various techniques of power, especially genetic pedigrees, and the normalised appropriation and exploitation of patients' identities and data within psychiatry, affected individuals were subjectified as contaminated and threatening, and implicated in the intergenerational transmission of social dysfunction.
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Pierron L, Hennessy J, Tezenas du Montcel S, Coarelli G, Heinzmann A, Schaerer E, Herson A, Petit E, Gargiulo M, Durr A. Informing about genetic risk in families with Huntington disease: comparison of attitudes across two decades. Eur J Hum Genet 2020; 29:672-679. [PMID: 33299145 DOI: 10.1038/s41431-020-00776-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/09/2020] [Accepted: 11/13/2020] [Indexed: 01/01/2023] Open
Abstract
The low uptake of presymptomatic testing in Huntington disease prompted us to question family members on how they handle the transmission of information regarding genetic risk. We hypothesised that in 2019, parents would inform their at-risk children about their genetic risk more and at a younger age than in 2000, given the availability of prenatal diagnosis, French legislation changes since 2011, and recent therapeutic advances. We made a questionnaire available about the transmission of genetic information within families with Huntington disease in 2000 and 2019. We obtained 443 questionnaires (295 in 2019 and 148 in 2000). Participants were mainly at-risk for Huntington disease (n = 113), affected (n = 85), and spouses (n = 154). In 2019, participants had a higher mean education level (p < 0.01) and a mean age of 44.1 ± 15.1 years (vs 48.1 ± 11.4 years in 2000, p < 0.01). They had been informed about the risk of being a carrier at around 30 years of age (29.0 ± 14.2 in 2019 vs 32.2 ± 13.8 in 2000, p = 0.09). However, they would inform at an earlier age (≤18 years, 67% vs 59%, p = 0.16). Information on transmission risk had been given primarily by parents (45% vs 30%, p = 0.06). In addition, genetic testing for relatives unaware of their status was recommended more frequently in 2019 (46% vs 32%, p < 0.001). Respondents in 2019 recommended genetic testing more often but overall attitudes towards information and testing have not changed significantly over the 19-year time period since the questionnaire was first delivered even despite recent clinical trials potential disease modifying therapies.
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Affiliation(s)
- Lucie Pierron
- AP-HP, Department of Genetics, Pitié-Salpêtrière University Hospital, Paris, France
| | - Juliette Hennessy
- Sorbonne Université, Paris Brain Institute (ICM), AP-HP, INSERM, CNRS, Pitié-Salpêtrière University Hospital, Paris, France
| | - Sophie Tezenas du Montcel
- Sorbonne Université, Medical Information Unit, AP-HP, INSERM, Institut Pierre Louis de Santé Publique, Pitié-Salpêtrière University Hospital, Paris, France
| | - Giulia Coarelli
- Sorbonne Université, Paris Brain Institute (ICM), AP-HP, INSERM, CNRS, Pitié-Salpêtrière University Hospital, Paris, France
| | - Anna Heinzmann
- Sorbonne Université, Paris Brain Institute (ICM), AP-HP, INSERM, CNRS, Pitié-Salpêtrière University Hospital, Paris, France
| | - Elodie Schaerer
- AP-HP, Department of Genetics, Pitié-Salpêtrière University Hospital, Paris, France.,AP-HP, Institute of Myology, Pitié-Salpêtrière University Hospital, Paris, France
| | - Ariane Herson
- AP-HP, Department of Genetics, Pitié-Salpêtrière University Hospital, Paris, France.,AP-HP, Institute of Myology, Pitié-Salpêtrière University Hospital, Paris, France
| | - Elodie Petit
- Sorbonne Université, Paris Brain Institute (ICM), AP-HP, INSERM, CNRS, Pitié-Salpêtrière University Hospital, Paris, France
| | - Marcela Gargiulo
- AP-HP, Department of Genetics, Pitié-Salpêtrière University Hospital, Paris, France. .,AP-HP, Institute of Myology, Pitié-Salpêtrière University Hospital, Paris, France. .,Université de Paris, Laboratoire de Psychologie Clinique et Psychopathologie, Sorbonne Paris Cité, Institut de Psychologie, EA 4056, Paris, France.
| | - Alexandra Durr
- Sorbonne Université, Paris Brain Institute (ICM), AP-HP, INSERM, CNRS, Pitié-Salpêtrière University Hospital, Paris, France.
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Nurmi SM, Halkoaho A, Moilanen J, Remes AM, Solje E. The ethical implications of genetic testing in neurodegenerative diseases: A systematic review. Scand J Caring Sci 2020; 35:1057-1074. [PMID: 33210792 DOI: 10.1111/scs.12932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 09/30/2020] [Accepted: 10/19/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Availability of genetic testing in neurodegenerative disorders has developed rapidly. This growing ability is providing specific genetic information to individuals and, in turn, their families, raising ethical concerns. However, family members' perspective is a seldom-studied phenomenon. AIM The aim of this systematic review was to describe the ethical aspect of genetic testing in neurodegenerative diseases from the perspective of at-risk family members. METHOD A systematic review of data was performed in accordance with the PRISMA statement. The data search was conducted using the CINAHL, PubMed and Scopus databases to identify original peer-reviewed studies published between January 2009 and April 2019. A total of 24 articles were selected. The data were analysed using inductive content analysis. FINDINGS On the basis of the analysis, four central ethical implications were identified: (i) decision-making in genetic testing as a dilemma: balance between autonomy and responsibility, (ii) the individual's right to make a voluntary and informed decision for genetic testing, (iii) conflicting emotions after knowing one's genetic status and (iv) privacy and confidentiality of genetic information: the fear of genetic discrimination and stigma. CONCLUSIONS The findings of this review increase understanding about the central ethical implications of genetic testing in neurodegenerative diseases from the perspective of family members, and identify and underline outstanding needs for further research.
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Affiliation(s)
| | - Arja Halkoaho
- Tampere University of Applied Sciences, Tampere, Finland
| | - Jukka Moilanen
- Department of Clinical Genetics, Oulu University Hospital, Medical Research Center Oulu and PEDEGO Research Unit, University of Oulu, Oulu, Finland
| | - Anne M Remes
- Unit of Clinical Neuroscience, Neurology, University of Oulu and Medical Research Center (MRC) Oulu, Oulu University Hospital, Oulu, Finland
| | - Eino Solje
- Institute of Clinical Medicine-Neurology, University of Eastern Finland, Kuopio, Finland.,Neuro Center, Neurology, Kuopio University Hospital, Kuopio, Finland
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Anderson KE, Eberly S, Marder KS, Oakes D, Kayson E, Young A, Shoulson I. The choice not to undergo genetic testing for Huntington disease: Results from the PHAROS study. Clin Genet 2019; 96:28-34. [DOI: 10.1111/cge.13529] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/30/2019] [Accepted: 02/02/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Karen E. Anderson
- Department of Psychiatry, Georgetown University Washington DC
- Department of Neurology, Georgetown University Washington DC
| | - Shirley Eberly
- Department of Biostatistics and Computational Biology, University of Rochester Rochester NY
| | - Karen S. Marder
- Department of Neurology, Columbia Vagelos College of Physicians and Surgeons, Columbia University New York NY
| | - David Oakes
- Department of Biostatistics and Computational Biology, University of Rochester Rochester NY
| | - Elise Kayson
- Center for Health + Technology/Clinical Trials Coordination Center, University of Rochester, NY
| | - Anne Young
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Ira Shoulson
- Department of Neurology, University of Rochester Rochester NY
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Dondanville DS, Hanson-Kahn AK, Kavanaugh MS, Siskind CE, Fanos JH. "This could be me": exploring the impact of genetic risk for Huntington's disease young caregivers. J Community Genet 2018; 10:291-302. [PMID: 30430455 DOI: 10.1007/s12687-018-0395-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 10/24/2018] [Indexed: 11/29/2022] Open
Abstract
Huntington's disease (HD) is a predominantly adult-onset, genetic, neurodegenerative condition. Children of affected individuals have a 50% risk of inheriting HD and often assume caregiving roles for their parent. Studies specifically focused on HD young caregivers have proposed that the genetic risk component of HD "exacerbates" the caregiving experience and identified common responsibilities, burdens, and support needs, but none have explored the relationship between the caregiving role and perception of genetic risk. In an attempt to understand this relationship, we conducted a qualitative study to explore the interaction between a young caregiver's perception of genetic risk, the caregiving experience, and thoughts about and plans for predictive testing. Thirteen individuals between 15 and 25 years who provided care for a parent with HD were recruited from two HD youth groups and local support groups. Interviews were recorded, transcribed, and analyzed thematically. Two themes emerged: (1) caregiving and thoughts about risk and (2) caregiving and perceived opinions towards genetic testing. Our findings suggest that the genetic risk colors the caregiving experience by evoking feelings about the future and a potential diagnosis of HD, in addition to impacting plans for predictive testing. Genetic counselors can use these findings to inform their understanding of caregiver experiences, which can aid them when helping patients explore their motivations for testing during a genetic counseling session. Future studies should explore the extent to which health care providers acknowledge the work of young caregivers in the home and provide support to these individuals.
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Affiliation(s)
- Danielle S Dondanville
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA. .,Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Andrea K Hanson-Kahn
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA.,Department of Pediatrics, Division of Medical Genetics, Stanford University Medical Center, Stanford, CA, USA
| | - Melinda S Kavanaugh
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Carly E Siskind
- Department of Neurology, Stanford Health Care, Palo Alto, CA, USA
| | - Joanna H Fanos
- Children's Hospital Oakland Research Institute, Oakland, CA, USA
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Downing NR, Lourens S, De Soriano I, Long JD, Paulsen JS. Phenotype Characterization of HD Intermediate Alleles in PREDICT-HD. J Huntingtons Dis 2017; 5:357-368. [PMID: 27983559 DOI: 10.3233/jhd-160185] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Huntington disease (HD) is a neurodegenerative disease caused by a CAG repeat expansion on chromosome 4. Pathology is associated with CAG repeat length. Prior studies examining people in the intermediate allele (IA) range found subtle differences in motor, cognitive, and behavioral domains compared to controls. OBJECTIVE The purpose of this study was to examine baseline and longitudinal differences in motor, cognitive, behavioral, functional, and imaging outcomes between persons with CAG repeats in three ranges: normal (≤26), intermediate (27-35), and reduced penetrance (36-39). METHODS We examined longitudinal data from 389 participants in three allele groups: 280 normal controls (NC), 21 intermediate allele [IA], and 88 reduced penetrance [RP]. We used linear mixed models to identify differences in baseline and longitudinal outcomes between groups. Three models were tested: 1) no baseline or longitudinal differences; 2) baseline differences but no longitudinal differences; and 3) baseline and longitudinal differences. RESULTS Model 1 was the best fitting model for most outcome variables. Models 2 and 3 were best fitting for some of the variables. We found baseline and longitudinal trends of declining performance across increasing CAG repeat length groups, but no significant differences between the NC and IA groups. CONCLUSION We did not find evidence to support differences in the IA group compared to the NC group. These findings are limited by a small IA sample size.
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Affiliation(s)
| | - Spencer Lourens
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Isabella De Soriano
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Jeffrey D Long
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.,Department of Biostatistics, College of Public Health, The University of Iowa, Iowa City, IA, USA
| | - Jane S Paulsen
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.,Department of Neurology, Carver College of Medicine, The University of Iowa, Iowa City, IA, USA.,Department of Psychological and Brain Sciences, The University of Iowa, Iowa City, IA, USA
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