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Sharma P, Sonakar AK, Tyagi N, Suroliya V, Kumar M, Kutum R, Asokchandran V, Ambawat S, Shamim U, Anand A, Ahmad I, Shakya S, Uppili B, Mathur A, Parveen S, Jain S, Singh J, Seth M, Zahra S, Joshi A, Goel D, Sahni S, Kamai A, Wadhwa S, Murali A, Saifi S, Chowdhury D, Pandey S, Anand KS, Narasimhan RL, Laskar S, Kushwaha S, Kumar M, Shaji CV, Srivastava MVP, Srivastava AK, Faruq M. Genetics of Ataxias in Indian Population: A Collative Insight from a Common Genetic Screening Tool. ADVANCED GENETICS (HOBOKEN, N.J.) 2022; 3:2100078. [PMID: 36618024 PMCID: PMC9744545 DOI: 10.1002/ggn2.202100078] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Indexed: 01/11/2023]
Abstract
Cerebellar ataxias (CAs) represent a group of autosomal dominant and recessive neurodegenerative disorders affecting cerebellum with or without spinal cord. Overall, CAs have preponderance for tandem nucleotide repeat expansions as an etiological factor (10 TREs explain nearly 30-40% of ataxia cohort globally). The experience of 10 years of common genetic ataxia subtypes for ≈5600 patients' referrals (Pan-India) received at a single center is shared herein. Frequencies (in %, n) of SCA types and FRDA in the sample cohort are observed as follows: SCA12 (8.6%, 490); SCA2 (8.5%, 482); SCA1 (4.8%, 272); SCA3 (2%, 113); SCA7 (0.5%, 28); SCA6 (0.1%, 05); SCA17 (0.1%, 05), and FRDA (2.2%, 127). A significant amount of variability in TRE lengths at each locus is observed, we noted presence of biallelic expansion, co-occurrence of SCA-subtypes, and the presence of premutable normal alleles. The frequency of mutated GAA-FRDA allele in healthy controls is 1/158 (0.63%), thus an expected FRDA prevalence of 1:100 000 persons. The data of this study are relevant not only for clinical decision making but also for guidance in direction of genetic investigations, transancestral comparison of genotypes, and lastly provide insight for policy decision for the consideration of SCAs under rare disease category.
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Affiliation(s)
- Pooja Sharma
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India,Academy for Scientific and Innovative ResearchGhaziabadUttar Pradesh201002India
| | | | - Nishu Tyagi
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India,Academy for Scientific and Innovative ResearchGhaziabadUttar Pradesh201002India
| | - Varun Suroliya
- Neurology DepartmentNeuroscience CentreNew Delhi110029India
| | - Manish Kumar
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India,Academy for Scientific and Innovative ResearchGhaziabadUttar Pradesh201002India
| | - Rintu Kutum
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India
| | - Vivekananda Asokchandran
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India,Academy for Scientific and Innovative ResearchGhaziabadUttar Pradesh201002India
| | - Sakshi Ambawat
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India
| | - Uzma Shamim
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India
| | - Avni Anand
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India
| | - Ishtaq Ahmad
- Neurology DepartmentNeuroscience CentreNew Delhi110029India
| | - Sunil Shakya
- Neurology DepartmentNeuroscience CentreNew Delhi110029India
| | - Bharathram Uppili
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India,Academy for Scientific and Innovative ResearchGhaziabadUttar Pradesh201002India
| | - Aradhana Mathur
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India
| | - Shaista Parveen
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India
| | - Shweta Jain
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India
| | - Jyotsna Singh
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India,Neurology DepartmentNeuroscience CentreNew Delhi110029India
| | - Malika Seth
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India
| | - Sana Zahra
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India,Academy for Scientific and Innovative ResearchGhaziabadUttar Pradesh201002India
| | - Aditi Joshi
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India
| | - Divya Goel
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India
| | - Shweta Sahni
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India
| | - Asangla Kamai
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India,Academy for Scientific and Innovative ResearchGhaziabadUttar Pradesh201002India
| | - Saruchi Wadhwa
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India,Academy for Scientific and Innovative ResearchGhaziabadUttar Pradesh201002India
| | - Aparna Murali
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India
| | - Sheeba Saifi
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India
| | | | - Sanjay Pandey
- Department of NeurologyGB Pant HospitalDelhi110002India
| | - Kuljeet Singh Anand
- Department of NeurologyPost Graduate Institute of Medical Education and ResearchDr. Ram Manohar Lohia HospitalNew Delhi110001India
| | | | | | - Suman Kushwaha
- Department of NeurologyInstitute of Human Behaviour and Allied SciencesDelhi110095India
| | | | | | | | | | - Mohammed Faruq
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative Biology (CSIR‐IGIB)Mall RoadDelhi110007India,Academy for Scientific and Innovative ResearchGhaziabadUttar Pradesh201002India
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van Prooije T, Ibrahim NM, Azmin S, van de Warrenburg B. Spinocerebellar ataxias in Asia: Prevalence, phenotypes and management. Parkinsonism Relat Disord 2021; 92:112-118. [PMID: 34711523 DOI: 10.1016/j.parkreldis.2021.10.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/05/2021] [Accepted: 10/19/2021] [Indexed: 11/19/2022]
Abstract
This paper reviews and summarizes three main aspects of spinocerebellar ataxias (SCA) in the Asian population. First, epidemiological studies were comprehensively reviewed. Overall, the most common subtypes include SCA1, SCA2, SCA3, and SCA6, but there are large differences in the relative prevalence of these and other SCA subtypes between Asian countries. Some subtypes such as SCA12 and SCA31 are rather specific to certain Asian populations. Second, we summarized distinctive phenotypic manifestations of SCA patients of Asian origin, for example a frequent co-occurrence of parkinsonism in some SCA subtypes. Lastly, we have conducted an exploratory survey study to map SCA-specific expertise, resources, and management in various Asian countries. This showed large differences in accessibility, genetic testing facilities, and treatment options between lower and higher income Asian countries. Currently, many Asian SCA patients remain without a final genetic diagnosis. Lack of prevalence data on SCA, lack of patient registries, and insufficient access to genetic testing facilities hamper a wider understanding of these diseases in several (particularly lower income) Asian countries.
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Affiliation(s)
- Teije van Prooije
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6500 HB, Nijmegen, the Netherlands
| | - Norlinah Mohamed Ibrahim
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Shahrul Azmin
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Bart van de Warrenburg
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6500 HB, Nijmegen, the Netherlands.
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Perez Maturo J, Zavala L, Vega P, González-Morón D, Medina N, Salinas V, Rosales J, Córdoba M, Arakaki T, Garretto N, Rodríguez-Quiroga S, Kauffman MA. Overwhelming genetic heterogeneity and exhausting molecular diagnostic process in chronic and progressive ataxias: facing it up with an algorithm, a gene, a panel at a time. J Hum Genet 2020; 65:895-902. [DOI: 10.1038/s10038-020-0785-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 12/18/2022]
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Mastrangelo M. Clinical approach to neurodegenerative disorders in childhood: an updated overview. Acta Neurol Belg 2019; 119:511-521. [PMID: 31161467 DOI: 10.1007/s13760-019-01160-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 05/27/2019] [Indexed: 02/06/2023]
Abstract
Neurodegenerative disorders include a group of severe diseases that share a core including a gradual loss of previously acquired motor, sensory and cognitive functions. In pediatric age, the main diagnostic issues are the discrimination between the loss of previously acquired competencies and the lack of achievement of specific developmental milestones. An ideal classification of these disorders could be based on the combination of genetic, clinical and neuroimaging features. Diagnostic workup should be organized with a special attention to the few diseases with an available and effective therapeutic treatment. The present paper reports a proposal of classification that is based on the prominently involved structure and summarizes the hallmarks for clinical approach and therapeutic management.
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Affiliation(s)
- Mario Mastrangelo
- Division of Child Neurology and Psychiatry, Department of Human Neurosciences, Sapienza University of Rome, Via dei Sabelli 108, 00141, Rome, Italy.
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Chen SJ, Lee NC, Chien YH, Hwu WL, Lin CH. Heterogeneous nonataxic phenotypes of spinocerebellar ataxia in a Taiwanese population. Brain Behav 2019; 9:e01414. [PMID: 31523939 PMCID: PMC6790309 DOI: 10.1002/brb3.1414] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/10/2019] [Accepted: 08/26/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Spinocerebellar ataxia (SCA) presents with variable clinical presentations in addition to ataxia. The aim of this study was to reappraise the diverse nonataxic clinical characteristics of the five most common SCA subtypes in the Asian population. METHODS The clinical presentations of 90 patients with genetically confirmed SCA1, SCA2, SCA3, SCA6, or SCA17 were assessed retrospectively between November 2008 and September 2018 at a tertiary referral center in Taiwan. RESULTS Parkinsonism was the most common nonataxic phenotype (21.1%), with a greater prevalence than Caucasian and other Asian SCA carriers. Patients with parkinsonism feature had fewer CAG repeats in SCA2 (31.0 ± 4.5 vs. 36.9 ± 6.0, p = .03) and SCA3 (65.6 ± 7.9 vs. 70.0 ± 4.2, p = .02) compared to those with pure ataxia presentation. The average age of symptom onset was significantly higher in the parkinsonism group of SCA2 (51.5 ± 8.9 vs. 35.3 ± 12.6 years, p = .007) than those with pure ataxia. Focal or segmental dystonia was identified in 4.4% of SCA patients (n = 2 each SCA2 and SCA3). Nonmotor symptoms, including impaired cognition (6.1% of SCA2 and 8.3% of SCA3 patients) and depression (9.1% of SCA2 and 8.3% of SCA3 patients), were also common nonataxic features in our SCA patients. CONCLUSIONS Parkinsonism, dystonia, and cognitive-psychiatric symptoms are common features in patients with SCA mutations in our population. Our study identifies a different clinical spectrum of SCA1, SCA2, SCA3, SCA6, and SCA17 compared to Caucasians.
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Affiliation(s)
- Szu-Ju Chen
- Department of Neurology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.,National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan
| | - Ni-Chung Lee
- Department of Medical Genetics and Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yin-Hsiu Chien
- Department of Medical Genetics and Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wuh-Liang Hwu
- Department of Medical Genetics and Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chin-Hsien Lin
- Department of Neurology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
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Kandasamy M, Yesudhas A, Poornimai Abirami GP, Radhakrishnan RK, Roshan SA, Johnson E, Ravichandran VR, Biswas A, Shanmugaapriya S, Anusuyadevi M, Aigner L. Genetic reprogramming of somatic cells into neuroblasts through a co-induction of the doublecortin gene along the Yamanaka factors: A promising approach to model neuroregenerative disorders. Med Hypotheses 2019; 127:105-111. [PMID: 31088631 DOI: 10.1016/j.mehy.2019.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/28/2019] [Accepted: 04/11/2019] [Indexed: 12/25/2022]
Abstract
Neural stem cell (NSC) mediated adult neurogenesis represents the regenerative plasticity of the brain. The functionality of the neurogenic process appears to be operated by neuroblasts, the multipotent immature neuronal population of the adult brain. While neuroblasts have been realized to play a major role in synaptic remodeling and immunogenicity, neurodegenerative disorders have been characterized by failure in the terminal differentiation, maturation, integration and survival of newborn neuroblasts. Advancement in understanding the impaired neuroregenerative process along the neuropathological conditions has currently been limited by lack of an appropriate experimental model of neuroblasts. The genetic reprogramming of somatic cells into pluripotent state offers a potential strategy for the experimental modeling of brain disorders. Thus, the induced pluripotent stem cell (iPSC) based direct reprogramming of somatic cells into neuroblasts would represent a potential tool to understand the regenerative biology of the adult brain. Therefore, this concise article discusses the significance of iPSCs, the functional roles of neuroblasts in the adult brain and provides a research hypothesis for the direct reprogramming of somatic cells into neuroblasts through the co-induction of a potential proneurogenic marker, the doublecortin (DCX) gene along with the Yamanaka factors. The proposed cellular model of adult neurogenesis may provide us with further insights into neuropathogenesis of many neurodegenerative disorders and will provide a potential experimental platform for diagnostic, drug discovery and regenerative therapeutic strategies.
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Affiliation(s)
- Mahesh Kandasamy
- Laboratory of Stem Cells and Neuroregeneration, Department of Animal Science, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, India; School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, India; UGC-Faculty Recharge Programme (UGC-FRP), University Grants Commission, New Delhi, India.
| | - Ajisha Yesudhas
- Laboratory of Stem Cells and Neuroregeneration, Department of Animal Science, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, India
| | - G P Poornimai Abirami
- School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, India
| | - Risna Kanjirassery Radhakrishnan
- Laboratory of Stem Cells and Neuroregeneration, Department of Animal Science, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, India
| | - Syed Aasish Roshan
- Molecular Gerontology Laboratory, Department of Biochemistry, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, India
| | - Esther Johnson
- Laboratory of Stem Cells and Neuroregeneration, Department of Animal Science, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, India
| | - Vijaya Roobini Ravichandran
- Laboratory of Stem Cells and Neuroregeneration, Department of Animal Science, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, India
| | - Abir Biswas
- Molecular Gerontology Laboratory, Department of Biochemistry, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, India
| | | | - Muthuswamy Anusuyadevi
- School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, India; Molecular Gerontology Laboratory, Department of Biochemistry, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, India
| | - Ludwig Aigner
- Institute of Molecular Regenerative Medicine, Paracelsus Medical University, Salzburg, Austria; Spinal Cord Injury and Tissue Regeneration Center, Salzburg, Paracelsus Medical University, Salzburg, Austria.
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Costa IPD, Almeida BC, Sequeiros J, Amorim A, Martins S. A Pipeline to Assess Disease-Associated Haplotypes in Repeat Expansion Disorders: The Example of MJD/SCA3 Locus. Front Genet 2019; 10:38. [PMID: 30804982 PMCID: PMC6370646 DOI: 10.3389/fgene.2019.00038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 01/18/2019] [Indexed: 12/13/2022] Open
Abstract
At least 40 human diseases are associated with repeat expansions; yet, the mutational origin and instability mechanisms remain unknown for most of them. Previously, genetic epidemiology and predisposing backgrounds for the instability of some expanding loci have been studied in different populations through the analysis of diversity flanking the respective pathogenic repeats. Here, we aimed at developing a pipeline to assess disease-associated haplotypes at oligonucleotide repeat loci, combining analysis of single nucleotide polymorphisms (SNPs) and short tandem repeats (STRs). Machado-Joseph disease (MJD/SCA3), the most frequent dominant ataxia worldwide, was used as an example of a detailed procedure. Thus, to identify genetic backgrounds that segregate with expanded/mutated alleles in MJD, we selected a set of 26 SNPs and 7 STRs flanking the causative CAG repeat. Key criteria and steps for this selection are described, and included (1) haplotype blocks minimizing the occurrence of recombination (for SNPs); and (2) match scores to increase potential for polymorphic information content of repetitive sequences found in Tandem Repeats Finder (for STRs). To directly assess SNP haplotypes in phase with MJD expansions, we optimized a strategy with preferential amplification of normal over expanded alleles, in addition to SNP allele-specific amplifications; this allowed the identification of disease-associated SNP haplotypes, even when only the proband is available in a given family. To infer STR haplotypes, we optimized a multiplex PCR, including 7 STRs plus the MJD_CAG repeat, followed by analysis of segregation or the use of the PHASE software. This protocol is a ready-to-use tool to assess MJD haplotypes in different populations. The pipeline designed can be used to assess disease-associated haplotypes in other repeat-expansion diseases. This should be of great utility to study (1) genetic epidemiology (population-of-origin, age and spreading routes of mutations) and (2) mechanisms responsible for de novo expansions, in these neurological diseases; (3) to detect predisposing haplotypes and (4) phenotype modifiers; (5) to help solving cases of apparent homoallelism (two same-size normal alleles) in diagnosis; and (6) to identify the best targets for the development of allele-specific therapies in ethnically diverse patient populations.
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Affiliation(s)
- Inês P. D. Costa
- i3S – Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- IPATIMUP – Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal
| | - Beatriz C. Almeida
- i3S – Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- IPATIMUP – Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal
- Faculdade de Ciências da Universidade do Porto, Porto, Portugal
| | - Jorge Sequeiros
- i3S – Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- IBMC – Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
- ICBAS – Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - António Amorim
- i3S – Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- IPATIMUP – Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal
- Faculdade de Ciências da Universidade do Porto, Porto, Portugal
| | - Sandra Martins
- i3S – Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- IPATIMUP – Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal
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Srivastava A, Kumar D, Faruq M, Gundluru V. Spinocerebellar ataxia type 12: An update. ANNALS OF MOVEMENT DISORDERS 2019. [DOI: 10.4103/aomd.aomd_5_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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