1
|
Pallarès-Sastre M, García M, Rouco-Axpe I, Amayra I. A systematic review of social cognition in hereditary ataxia patients: Evidence from neuroimaging studies. Brain Res 2024; 1827:148765. [PMID: 38219813 DOI: 10.1016/j.brainres.2024.148765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/03/2024] [Accepted: 01/10/2024] [Indexed: 01/16/2024]
Affiliation(s)
- Mercè Pallarès-Sastre
- Neuro-e-Motion Research Team, Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain.
| | - Maitane García
- Neuro-e-Motion Research Team, Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Idoia Rouco-Axpe
- Neurology Service. Cruces University Hospital. BioCruces Health Research Institute, Barakaldo-Bizkaia, Spain
| | - Imanol Amayra
- Neuro-e-Motion Research Team, Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| |
Collapse
|
2
|
Dorsemans AC, Coarelli G, Heinzmann A, Verdon B, De Luca M, Petit E, Pierron L, Levy-Soussan M, Durr A, Gargiulo M, Ewenczyk C. End-of-Life Discussions With Patients and Caregivers Affected By Neurogenetic Diseases. Neurol Clin Pract 2023; 13:e200199. [PMID: 37854177 PMCID: PMC10581072 DOI: 10.1212/cpj.0000000000200199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/06/2023] [Indexed: 10/20/2023]
Abstract
Background and Objectives No effective cure is available for neurogenetic diseases such as Huntington disease, spinocerebellar ataxias, and Friedreich ataxia, all of which cause progressive motor, cognitive, and psychiatric symptoms leading, in the long term, to severe communication (among other) impairments. In end-of-life situations, advanced directives (indications formulated by the patient about end-of-life choices) are one decision-making resource for relatives, caregivers, and health care professionals. Given the slowly progressive nature of these diseases, the related disabilities, and their hereditary component, patients, caregivers, and neurologists are often at a loss concerning the right course of action to take. Our study's aim was to explore patients' and caregivers' perceptions, needs, and expectations around anticipated end-of-life discussions and advanced directives. Methods DIRAGENE is an observational, cross-sectional, mixed-methods study with a patient-centered component and a primary caregiver-centered component. Observations include disease severity, psychosocial, and emotional scales; in-house questionnaires; and semidirected interviews. Results We included 124 participants, of which 81 were patients and 43 primary caregivers. Only 16% of the participants knew specifically about advanced directives and 7% had written documents vs 30% and 18% in the general French population, respectively, adjusted for age. Qualitative analysis of the interviews with 15 couples showed notable dissimilarities in ideas about advanced directives between patients and caregivers and that the underlying pathology, severity, and inheritability are less relevant factors regarding end-of-life discussions than age, environment, prior experiences with death, and history of family illness. Most patients (95%) and caregivers (98%) found that participating in the study was helpful in bringing awareness to end-of-life issues, wished to prioritize discussing them with loved ones, and requested assistance in managing them throughout the course of the disease. Discussion Being affected by severe neurogenetic diseases does not seem to prompt individuals to give much thought to end-of-life planning. However, patients and caregivers welcome comprehensive information and expect progressive support from trained health care professionals in having such discussions. Routine integration of these conversations into medical management through a holistic and adapted approach will benefit patients with illnesses with unfavorable long-term prognoses.
Collapse
Affiliation(s)
- Anne-Claire Dorsemans
- Sorbonne Université (A-CD, GC, AH, EP, AD, CE), Paris Brain Institute (ICM Institut du Cerveau), APHP, INSERM, CRNS; Université Paris Cité (A-CD, BV, MDL, MG), Laboratoire de Psychologie Clinique, Psychopathologie, Psychanalyse, Boulogne-Billancourt; Genetic Department (GC, AH, LP, MG, CE), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Mobile Palliative Care Unit (ML-S), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Université Paris Cité (ML-S), Team Science, Normes, Démocratie, SND UMR 8011, Sorbonne Université Lettres; and Institute of Myology (MG), Pitié-Salpêtrière University Hospital, Paris, France
| | - Giulia Coarelli
- Sorbonne Université (A-CD, GC, AH, EP, AD, CE), Paris Brain Institute (ICM Institut du Cerveau), APHP, INSERM, CRNS; Université Paris Cité (A-CD, BV, MDL, MG), Laboratoire de Psychologie Clinique, Psychopathologie, Psychanalyse, Boulogne-Billancourt; Genetic Department (GC, AH, LP, MG, CE), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Mobile Palliative Care Unit (ML-S), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Université Paris Cité (ML-S), Team Science, Normes, Démocratie, SND UMR 8011, Sorbonne Université Lettres; and Institute of Myology (MG), Pitié-Salpêtrière University Hospital, Paris, France
| | - Anna Heinzmann
- Sorbonne Université (A-CD, GC, AH, EP, AD, CE), Paris Brain Institute (ICM Institut du Cerveau), APHP, INSERM, CRNS; Université Paris Cité (A-CD, BV, MDL, MG), Laboratoire de Psychologie Clinique, Psychopathologie, Psychanalyse, Boulogne-Billancourt; Genetic Department (GC, AH, LP, MG, CE), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Mobile Palliative Care Unit (ML-S), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Université Paris Cité (ML-S), Team Science, Normes, Démocratie, SND UMR 8011, Sorbonne Université Lettres; and Institute of Myology (MG), Pitié-Salpêtrière University Hospital, Paris, France
| | - Benoit Verdon
- Sorbonne Université (A-CD, GC, AH, EP, AD, CE), Paris Brain Institute (ICM Institut du Cerveau), APHP, INSERM, CRNS; Université Paris Cité (A-CD, BV, MDL, MG), Laboratoire de Psychologie Clinique, Psychopathologie, Psychanalyse, Boulogne-Billancourt; Genetic Department (GC, AH, LP, MG, CE), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Mobile Palliative Care Unit (ML-S), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Université Paris Cité (ML-S), Team Science, Normes, Démocratie, SND UMR 8011, Sorbonne Université Lettres; and Institute of Myology (MG), Pitié-Salpêtrière University Hospital, Paris, France
| | - Manuella De Luca
- Sorbonne Université (A-CD, GC, AH, EP, AD, CE), Paris Brain Institute (ICM Institut du Cerveau), APHP, INSERM, CRNS; Université Paris Cité (A-CD, BV, MDL, MG), Laboratoire de Psychologie Clinique, Psychopathologie, Psychanalyse, Boulogne-Billancourt; Genetic Department (GC, AH, LP, MG, CE), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Mobile Palliative Care Unit (ML-S), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Université Paris Cité (ML-S), Team Science, Normes, Démocratie, SND UMR 8011, Sorbonne Université Lettres; and Institute of Myology (MG), Pitié-Salpêtrière University Hospital, Paris, France
| | - Elodie Petit
- Sorbonne Université (A-CD, GC, AH, EP, AD, CE), Paris Brain Institute (ICM Institut du Cerveau), APHP, INSERM, CRNS; Université Paris Cité (A-CD, BV, MDL, MG), Laboratoire de Psychologie Clinique, Psychopathologie, Psychanalyse, Boulogne-Billancourt; Genetic Department (GC, AH, LP, MG, CE), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Mobile Palliative Care Unit (ML-S), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Université Paris Cité (ML-S), Team Science, Normes, Démocratie, SND UMR 8011, Sorbonne Université Lettres; and Institute of Myology (MG), Pitié-Salpêtrière University Hospital, Paris, France
| | - Lucie Pierron
- Sorbonne Université (A-CD, GC, AH, EP, AD, CE), Paris Brain Institute (ICM Institut du Cerveau), APHP, INSERM, CRNS; Université Paris Cité (A-CD, BV, MDL, MG), Laboratoire de Psychologie Clinique, Psychopathologie, Psychanalyse, Boulogne-Billancourt; Genetic Department (GC, AH, LP, MG, CE), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Mobile Palliative Care Unit (ML-S), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Université Paris Cité (ML-S), Team Science, Normes, Démocratie, SND UMR 8011, Sorbonne Université Lettres; and Institute of Myology (MG), Pitié-Salpêtrière University Hospital, Paris, France
| | - Michèle Levy-Soussan
- Sorbonne Université (A-CD, GC, AH, EP, AD, CE), Paris Brain Institute (ICM Institut du Cerveau), APHP, INSERM, CRNS; Université Paris Cité (A-CD, BV, MDL, MG), Laboratoire de Psychologie Clinique, Psychopathologie, Psychanalyse, Boulogne-Billancourt; Genetic Department (GC, AH, LP, MG, CE), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Mobile Palliative Care Unit (ML-S), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Université Paris Cité (ML-S), Team Science, Normes, Démocratie, SND UMR 8011, Sorbonne Université Lettres; and Institute of Myology (MG), Pitié-Salpêtrière University Hospital, Paris, France
| | - Alexandra Durr
- Sorbonne Université (A-CD, GC, AH, EP, AD, CE), Paris Brain Institute (ICM Institut du Cerveau), APHP, INSERM, CRNS; Université Paris Cité (A-CD, BV, MDL, MG), Laboratoire de Psychologie Clinique, Psychopathologie, Psychanalyse, Boulogne-Billancourt; Genetic Department (GC, AH, LP, MG, CE), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Mobile Palliative Care Unit (ML-S), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Université Paris Cité (ML-S), Team Science, Normes, Démocratie, SND UMR 8011, Sorbonne Université Lettres; and Institute of Myology (MG), Pitié-Salpêtrière University Hospital, Paris, France
| | - Marcela Gargiulo
- Sorbonne Université (A-CD, GC, AH, EP, AD, CE), Paris Brain Institute (ICM Institut du Cerveau), APHP, INSERM, CRNS; Université Paris Cité (A-CD, BV, MDL, MG), Laboratoire de Psychologie Clinique, Psychopathologie, Psychanalyse, Boulogne-Billancourt; Genetic Department (GC, AH, LP, MG, CE), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Mobile Palliative Care Unit (ML-S), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Université Paris Cité (ML-S), Team Science, Normes, Démocratie, SND UMR 8011, Sorbonne Université Lettres; and Institute of Myology (MG), Pitié-Salpêtrière University Hospital, Paris, France
| | - Claire Ewenczyk
- Sorbonne Université (A-CD, GC, AH, EP, AD, CE), Paris Brain Institute (ICM Institut du Cerveau), APHP, INSERM, CRNS; Université Paris Cité (A-CD, BV, MDL, MG), Laboratoire de Psychologie Clinique, Psychopathologie, Psychanalyse, Boulogne-Billancourt; Genetic Department (GC, AH, LP, MG, CE), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Mobile Palliative Care Unit (ML-S), Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP); Université Paris Cité (ML-S), Team Science, Normes, Démocratie, SND UMR 8011, Sorbonne Université Lettres; and Institute of Myology (MG), Pitié-Salpêtrière University Hospital, Paris, France
| |
Collapse
|
3
|
Simona K, Veronika M, Zahinoor I, Martin V. Neuropsychiatric symptoms in spinocerebellar ataxias and Friedreich ataxia. Neurosci Biobehav Rev 2023; 150:105205. [PMID: 37137435 DOI: 10.1016/j.neubiorev.2023.105205] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 04/14/2023] [Accepted: 04/29/2023] [Indexed: 05/05/2023]
Abstract
Apart from its role in motor coordination, the importance of the cerebellum in cognitive and affective processes has been recognized in the past few decades. Spinocerebellar ataxias (SCA) and Friedreich ataxia (FRDA) are rare neurodegenerative diseases of the cerebellum presenting mainly with a progressive loss of gait and limb coordination, dysarthria, and other motor disturbances, but also a range of cognitive and neuropsychiatric symptoms. This narrative review summarizes the current knowledge on neuropsychiatric impairment in SCA and FRDA. We discuss the prevalence, clinical features and treatment approaches in the most commonly reported domains of depression, anxiety, apathy, agitation and impulse dyscontrol, and psychosis. Since these symptoms have a considerable impact on patients' quality of life, we argue that further research is mandated to improve the detection and treatment options of neuropsychiatric co-morbidities in ataxia patients.
Collapse
Affiliation(s)
- Karamazovova Simona
- Center of Hereditary Ataxias, Department of Neurology, 2nd Faculty of Medicine and Motol University Hospital, Charles University, Prague, Czech Republic
| | - Matuskova Veronika
- Center of Hereditary Ataxias, Department of Neurology, 2nd Faculty of Medicine and Motol University Hospital, Charles University, Prague, Czech Republic.
| | - Ismail Zahinoor
- Departments of Psychiatry, Clinical Neurosciences, and Community Health Sciences, Cumming School of Medicine; Hotchkiss Brain Institute and O'Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Vyhnalek Martin
- Center of Hereditary Ataxias, Department of Neurology, 2nd Faculty of Medicine and Motol University Hospital, Charles University, Prague, Czech Republic
| |
Collapse
|
4
|
Determinant of the cerebellar cognitive affective syndrome in Friedreich's ataxia. J Neurol 2023; 270:2969-2974. [PMID: 36790547 DOI: 10.1007/s00415-023-11623-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/10/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Individuals with Friedreich's ataxia (FRDA) display significantly lower performances in many cognitive domains with a pattern of impairment that falls within the cerebellar cognitive affective syndrome (CCAS). OBJECTIVE To assess in a large cohort of individuals with FRDA, the main determinant of the CCAS using multiple variable regression models. METHODS This is a monocentric observational study that included 39 individuals with FRDA. Ataxic motor symptoms were evaluated with the SARA and cognitive functions with the CCAS-Scale (CCAS-S). Age, SARA, GAA1, Age of symptoms onset (ASO), Age and disease duration (DD) were chosen as covariates in a linear regression model to predict CCAS-S failed items and covariates in a logistic regression model to predict definite CCAS. RESULTS Patients mean age, SARA score, ASO, DD and GAA1 were respectively of 29 ± 14, 22 ± 10, 14 ± 11, 15 ± 9 and 712 ± 238 (4 point-mutations). Mean CCAS-S raw score was of 86 ± 16, mean number of failed items was 2.9 ± 1.6. Twenty-three individuals had definite CCAS. The multiple linear regression model with age, SARA, ASO, DD & GAA1 as covariates was statistically significant to predict CCAS-S failed items. The SARA was the only significant coefficient in regression models for predicting CCAS-S failed items number and the definite CCAS occurrence. CONCLUSIONS CCAS is highly prevalent in adult individuals with FRDA. CCAS is predicted by ataxic motor symptoms severity. This finding supports common core cerebellar pathophysiology in both cognitive and motor symptoms in FRDA and warrants screening for CCAS, especially in patients with SARA > 20.
Collapse
|
5
|
Keita M, McIntyre K, Rodden LN, Schadt K, Lynch DR. Friedreich ataxia: clinical features and new developments. Neurodegener Dis Manag 2022; 12:267-283. [PMID: 35766110 PMCID: PMC9517959 DOI: 10.2217/nmt-2022-0011] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/15/2022] [Indexed: 11/21/2022] Open
Abstract
Friedreich's ataxia (FRDA), a neurodegenerative disease characterized by ataxia and other neurological features, affects 1 in 50,000-100,000 individuals in the USA. However, FRDA also includes cardiac, orthopedic and endocrine dysfunction, giving rise to many secondary disease characteristics. The multifaceted approach for clinical care has necessitated the development of disease-specific clinical care guidelines. New developments in FRDA include the advancement of clinical drug trials targeting the NRF2 pathway and frataxin restoration. Additionally, a novel understanding of gene silencing in FRDA, reflecting a variegated silencing pattern, will have applications to current and future therapeutic interventions. Finally, new perspectives on the neuroanatomy of FRDA and its developmental features will refine the time course and anatomical targeting of novel approaches.
Collapse
Affiliation(s)
- Medina Keita
- Departments of Pediatrics & Neurology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kellie McIntyre
- Departments of Pediatrics & Neurology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Layne N Rodden
- Departments of Pediatrics & Neurology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kim Schadt
- Departments of Pediatrics & Neurology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David R Lynch
- Departments of Pediatrics & Neurology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| |
Collapse
|
6
|
Zhang S, Shen L, Jiao B. Cognitive Dysfunction in Repeat Expansion Diseases: A Review. Front Aging Neurosci 2022; 14:841711. [PMID: 35478698 PMCID: PMC9036481 DOI: 10.3389/fnagi.2022.841711] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/24/2022] [Indexed: 11/16/2022] Open
Abstract
With the development of the sequencing technique, more than 40 repeat expansion diseases (REDs) have been identified during the past two decades. Moreover, the clinical features of these diseases show some commonality, and the nervous system, especially the cognitive function was affected in part by these diseases. However, the specific cognitive domains impaired in different diseases were inconsistent. Here, we survey literature on the cognitive consequences of the following disorders presenting cognitive dysfunction and summarizing the pathogenic genes, epidemiology, and different domains affected by these diseases. We found that the cognitive domains affected in neuronal intranuclear inclusion disease (NIID) were widespread including the executive function, memory, information processing speed, attention, visuospatial function, and language. Patients with C9ORF72-frontotemporal dementia (FTD) showed impairment in executive function, memory, language, and visuospatial function. While in Huntington's disease (HD), the executive function, memory, and information processing speed were affected, in the fragile X-associated tremor/ataxia syndrome (FXTAS), executive function, memory, information processing speed, and attention were impaired. Moreover, the spinocerebellar ataxias showed broad damage in almost all the cognitive domains except for the relatively intact language ability. Some other diseases with relatively rare clinical data also indicated cognitive dysfunction, such as myotonic dystrophy type 1 (DM1), progressive myoclonus epilepsy (PME), Friedreich ataxia (FRDA), Huntington disease like-2 (HDL2), and cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS). We drew a cognitive function landscape of the related REDs that might provide an aspect for differential diagnosis through cognitive domains and effective non-specific interventions for these diseases.
Collapse
Affiliation(s)
- Sizhe Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Lu Shen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
| | - Bin Jiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- *Correspondence: Bin Jiao
| |
Collapse
|
7
|
Thieme A, Faber J, Sulzer P, Reetz K, Dogan I, Barkhoff M, Krahe J, Jacobi H, Aktories JE, Minnerop M, Elben S, van der Veen R, Müller J, Batsikadze G, Konczak J, Synofzik M, Roeske S, Timmann D. The CCAS-scale in hereditary ataxias: helpful on the group level, particularly in SCA3, but limited in individual patients. J Neurol 2022; 269:4363-4374. [PMID: 35364683 PMCID: PMC9293809 DOI: 10.1007/s00415-022-11071-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 12/02/2022]
Abstract
Background A brief bedside test has recently been introduced by Hoche et al. (Brain, 2018) to screen for the Cerebellar Cognitive Affective Syndrome (CCAS) in patients with cerebellar disease. Objective This multicenter study tested the ability of the CCAS-Scale to diagnose CCAS in individual patients with common forms of hereditary ataxia. Methods A German version of the CCAS-Scale was applied in 30 SCA3, 14 SCA6 and 20 FRDA patients, and 64 healthy participants matched for age, sex, and level of education. Based on original cut-off values, the number of failed test items was assessed, and CCAS was considered possible (one failed item), probable (two failed items) or definite (three failed items). In addition a total sum raw score was calculated. Results On a group level, failed items were significantly higher and total sum scores were significantly lower in SCA3 patients compared to matched controls. SCA6 and FRDA patients performed numerically below controls, but respective group differences failed to reach significance. The ability of the CCAS-Scale to diagnose CCAS in individual patients was limited to severe cases failing three or more items. Milder cases failing one or two items showed a great overlap with the performance of controls exhibiting a substantial number of false-positive test results. The word fluency test items differentiated best between patients and controls. Conclusions As a group, SCA3 patients performed below the level of SCA6 and FRDA patients, possibly reflecting additional cerebral involvement. Moreover, the application of the CCAS-Scale in its present form results in a high number of false-positive test results, that is identifying controls as patients, reducing its usefulness as a screening tool for CCAS in individual patients. Supplementary Information The online version contains supplementary material available at 10.1007/s00415-022-11071-5.
Collapse
Affiliation(s)
- Andreas Thieme
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
| | - Jennifer Faber
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Helmholtz Association, Venusberg-Campus 1/99, 53127, Bonn, Germany.,Department of Neurology, Bonn University Hospital, Rheinische Friedrich-Wilhelms University Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Patricia Sulzer
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, Eberhard-Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE) Tübingen, Helmholtz Association, Otfried-Müller-Str. 23, 72076, Tübingen, Germany
| | - Kathrin Reetz
- JARA-BRAIN Institute, Molecular Neuroscience and Neuroimaging, Research Center Jülich, Wilhelm-Johnen-Str., 52425, Jülich, Germany.,Department of Neurology, Aachen University Hospital, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Pauwelstr. 30, 52074, Aachen, Germany
| | - Imis Dogan
- JARA-BRAIN Institute, Molecular Neuroscience and Neuroimaging, Research Center Jülich, Wilhelm-Johnen-Str., 52425, Jülich, Germany.,Department of Neurology, Aachen University Hospital, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Pauwelstr. 30, 52074, Aachen, Germany
| | - Miriam Barkhoff
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Helmholtz Association, Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Janna Krahe
- JARA-BRAIN Institute, Molecular Neuroscience and Neuroimaging, Research Center Jülich, Wilhelm-Johnen-Str., 52425, Jülich, Germany.,Department of Neurology, Aachen University Hospital, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Pauwelstr. 30, 52074, Aachen, Germany
| | - Heike Jacobi
- Department of Neurology, Heidelberg University Hospital, Ruprecht-Karls University Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Julia-Elisabeth Aktories
- Department of Neurology, Heidelberg University Hospital, Ruprecht-Karls University Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Martina Minnerop
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.,Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Wilhelm-Johnen-Str., 52425, Jülich, Germany
| | - Saskia Elben
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Raquel van der Veen
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Johanna Müller
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Giorgi Batsikadze
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Jürgen Konczak
- School of Kinesiology, University of Minnesota, 400 Cooke Hall 1900 University Ave S E, Minneapolis, MN, 55455, USA
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, Eberhard-Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE) Tübingen, Helmholtz Association, Otfried-Müller-Str. 23, 72076, Tübingen, Germany
| | - Sandra Roeske
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Helmholtz Association, Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Dagmar Timmann
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| |
Collapse
|
8
|
Naeije G, Schulz JB, Corben LA. The cognitive profile of Friedreich ataxia: a systematic review and meta-analysis. BMC Neurol 2022; 22:97. [PMID: 35300598 PMCID: PMC8928653 DOI: 10.1186/s12883-022-02615-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Study the cognitive profile of individuals with Friedreich ataxia (FRDA) and seek evidence for correlations between clinical, genetic and imaging characteristics and neuropsychological impairments. METHODS Based on PRISMA guidelines, a meta-analysis was realized using the Pubmed and Scopus databases to identify studies (1950-2021) reporting neuropsychological test results in genetically confirmed FRDA and control participants in at least one of the following cognitive domains: attention/executive, language, memory and visuo-spatial functions as well as emotion. Studies using identical outcomes in a minimum of two studies were pooled. Pooled effect sizes were calculated with Cohen's d. RESULTS Eighteen studies were included. Individuals with FRDA displayed significantly lower performance than individuals without FRDA in most language, attention, executive function, memory visuospatial function, emotion regulation and social cognitive tasks. Among the included studies, thirteen studies examined the relationship between neuropsychological test results and clinical parameters and reported significant association with disease severity and six studies reviewed the relationship between neuroimaging measures and cognitive performance and mainly reported links between reduced cognitive performance and changes in cerebellar structure. CONCLUSIONS Individuals with FRDA display significantly lower performances in many cognitive domains compared to control participants. The spectrum of the cognitive profile alterations in FRDA and its correlation with disease severity and cerebellar structural parameters suggest a cerebellar role in the pathophysiology of FRDA cognitive impairments.
Collapse
Affiliation(s)
- Gilles Naeije
- Laboratoire de Cartographie fonctionnelle du Cerveau (LCFC), UNI - ULB Neuroscience Institute, Université libre de Bruxelles (ULB), 808 Lennik Street, 1070, Brussels, Belgium.
| | - Jörg B Schulz
- Department of Neurology, RWTH Aachen University Hospital, Pauwelsstraße 30, Aachen, Germany.,JARA Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, 52074, Aachen, Germany
| | - Louise A Corben
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Australia.,Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| |
Collapse
|
9
|
OUP accepted manuscript. Arch Clin Neuropsychol 2022; 37:904-915. [DOI: 10.1093/arclin/acac024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
|
10
|
Lynch DR, Schadt K, Kichula E, McCormack S, Lin KY. Friedreich Ataxia: Multidisciplinary Clinical Care. J Multidiscip Healthc 2021; 14:1645-1658. [PMID: 34234452 PMCID: PMC8253929 DOI: 10.2147/jmdh.s292945] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/04/2021] [Indexed: 12/17/2022] Open
Abstract
Friedreich ataxia (FRDA) is a multisystem disorder affecting 1 in 50,000-100,000 person in the United States. Traditionally viewed as a neurodegenerative disease, FRDA patients also develop cardiomyopathy, scoliosis, diabetes and other manifestation. Although it usually presents in childhood, it continues throughout life, thus requiring expertise from both pediatric and adult subspecialist in order to provide optimal management. The phenotype of FRDA is unique, giving rise to specific loss of neuronal pathways, a unique form of cardiomyopathy with early hypertrophy and later fibrosis, and diabetes incorporating components of both type I and type II disease. Vision loss, hearing loss, urinary dysfunction and depression also occur in FRDA. Many agents are reaching Phase III trials; if successful, these will provide a variety of new treatments for FRDA that will require many specialists who are not familiar with FRDA to provide clinical therapy. This review provides a summary of the diverse manifestation of FRDA, existing symptomatic therapies, and approaches for integrative care for future therapy in FRDA.
Collapse
Affiliation(s)
- David R Lynch
- Division of Neurology, Departments of Pediatrics and Neurology, Children’s Hospital of Philadelphia and the Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Kim Schadt
- Division of Neurology, Departments of Pediatrics and Neurology, Children’s Hospital of Philadelphia and the Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Elizabeth Kichula
- Division of Neurology, Departments of Pediatrics and Neurology, Children’s Hospital of Philadelphia and the Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Shana McCormack
- Division of Endocrinology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Kimberly Y Lin
- Division of Cardiology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, Philadelphia, PA, 19104, USA
| |
Collapse
|
11
|
Abstract
OBJECTIVE Friedreich's ataxia (FRDA) is the most common hereditary ataxia. It is a neurodegenerative disorder, characterized by progressive ataxia. FRDA is also associated with cognitive impairments. To date, the evolution of cognitive functioning is unknown. Our aim was to investigate the changes in the cognitive functioning of FRDA patients over an average eight-year timeframe. In addition, we aimed to study the relationship between cognitive changes and clinical variables. METHODS Twenty-nine FRDA patients who had been part of the sample of a previous study participated in the present study. The mean average time between the two assessments was 8.24 years. The participants completed an extensive battery of neuropsychological tests chosen to examine cognitive functioning in various cognitive domains: processing speed, attention, working memory, executive functions, verbal and visual memory, visuoperceptive and visuospatial skills, visuoconstructive functions and language. RESULTS At follow-up, cerebellar symptoms had worsened, and patients presented greater disability. Differences between baseline and follow-up were observed in motor and cognitive reaction times, several trials of the Stroop test, semantic fluency, and block designs. No other cognitive changes were observed. Deterioration in simple cognitive reactions times and block designs performance correlated with the progression of cerebellar symptoms. CONCLUSIONS Our study has demonstrated for the first time that patients with FRDA experience a significant decline over time in several cognitive domains. Specifically, after an eight-year period, FRDA patients worsened in processing speed, fluency, and visuoconstructive skills. This progression is unlikely to be due to greater motor or speech impairment.
Collapse
|
12
|
Shishegar R, Harding IH, Corben LA, Delatycki MB, Storey E, Egan GF, Georgiou-Karistianis N. Longitudinal Increases in Cerebral Brain Activation During Working Memory Performance in Friedreich Ataxia: 24-Month Data from IMAGE-FRDA. THE CEREBELLUM 2020; 19:182-191. [PMID: 31898277 DOI: 10.1007/s12311-019-01094-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Friedreich ataxia (FRDA) has been associated with functional abnormalities in cerebral and cerebellar networks, particularly in the ventral attention network. However, how functional alterations change with disease progression remains largely unknown. Longitudinal changes in brain activation, associated with working memory performance (N-back task), and grey matter volume were assessed over 24 months in 21 individuals with FRDA and 28 healthy controls using functional and structural magnetic resonance imaging, respectively. Participants also completed a neurocognitive battery assessing working memory (digit span), executive function (Stroop, Haylings), and set-shifting (Trail Making Test). Individuals with FRDA displayed significantly increased brain activation over 24 months in ventral attention brain regions, including bilateral insula and inferior frontal gyrus (pars triangularis and pars opercularis), compared with controls, but there was no difference in working memory (N-back) performance between groups. Moreover, there were no significant differences in grey matter volume changes between groups. Significant correlations between brain activations and both clinical severity and age at disease onset were observed in FRDA individuals only at 24 months. There was significant longitudinal decline in Trail Making Test (TMT) difference score (B-A) in individuals with FRDA, compared with controls. These findings provide the first evidence of increased longitudinal activation over time in the cerebral cortex in FRDA, compared with controls, despite comparable working memory performance. This finding represents a possible compensatory response in the ventral attention network to help sustain working memory performance in individuals with FRDA.
Collapse
Affiliation(s)
- Rosita Shishegar
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Monash Biomedical Imaging, Monash University, Melbourne, Australia.,The Australian e-Health Research Centre, CSIRO, Melbourne, Australia
| | - Ian H Harding
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Louise A Corben
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Martin B Delatycki
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Clinical Genetics, Austin Health, Melbourne, Australia
| | - Elsdon Storey
- Department of Medicine, Monash University, Melbourne, Australia
| | - Gary F Egan
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Nellie Georgiou-Karistianis
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
| |
Collapse
|
13
|
Dellatolas G, Câmara-Costa H. The role of cerebellum in the child neuropsychological functioning. HANDBOOK OF CLINICAL NEUROLOGY 2020; 173:265-304. [PMID: 32958180 DOI: 10.1016/b978-0-444-64150-2.00023-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This chapter proposes a review of neuropsychologic and behavior findings in pediatric pathologies of the cerebellum, including cerebellar malformations, pediatric ataxias, cerebellar tumors, and other acquired cerebellar injuries during childhood. The chapter also contains reviews of the cerebellar mutism/posterior fossa syndrome, reported cognitive associations with the development of the cerebellum in typically developing children and subjects born preterm, and the role of the cerebellum in neurodevelopmental disorders such as autism spectrum disorders and developmental dyslexia. Cognitive findings in pediatric cerebellar disorders are considered in the context of known cerebellocerebral connections, internal cellular organization of the cerebellum, the idea of a universal cerebellar transform and computational internal models, and the role of the cerebellum in specific cognitive and motor functions, such as working memory, language, timing, or control of eye movements. The chapter closes with a discussion of the strengths and weaknesses of the cognitive affective syndrome as it has been described in children and some conclusions and perspectives.
Collapse
Affiliation(s)
- Georges Dellatolas
- GRC 24, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France.
| | - Hugo Câmara-Costa
- GRC 24, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France; Centre d'Etudes en Santé des Populations, INSERM U1018, Paris, France
| |
Collapse
|
14
|
Clinical, neuropathological, and genetic characterization of STUB1 variants in cerebellar ataxias: a frequent cause of predominant cognitive impairment. Genet Med 2020; 22:1851-1862. [PMID: 32713943 DOI: 10.1038/s41436-020-0899-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/26/2020] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Pathogenic variants in STUB1 were initially described in autosomal recessive spinocerebellar ataxia type 16 and dominant cerebellar ataxia with cerebellar cognitive dysfunction (SCA48). METHODS We analyzed a large series of 440 index cerebellar ataxia cases, mostly with dominant inheritance. RESULTS STUB1 variants were detected in 50 patients. Age at onset and severity were remarkably variable. Cognitive impairment, predominantly frontal syndrome, was observed in 54% of STUB1 variant carriers, including five families with Huntington or frontotemporal dementia disease-like phenotypes associated with ataxia, while no STUB1 variant was found in 115 patients with frontotemporal dementia. We report neuropathological findings of a STUB1 heterozygous patient, showing massive loss of Purkinje cells in the vermis and major loss in the cerebellar hemispheres without atrophy of the pons, hippocampus, or cerebral cortex. This screening of STUB1 variants revealed new features: (1) the majority of patients were women (70%) and (2) "second hits" in AFG3L2, PRKCG, and TBP were detected in three families suggesting synergic effects. CONCLUSION Our results reveal an unexpectedly frequent (7%) implication of STUB1 among dominantly inherited cerebellar ataxias, and suggest that the penetrance of STUB1 variants could be modulated by other factors, including sex and variants in other ataxia-related genes.
Collapse
|
15
|
Naeije G, Rai M, Allaerts N, Sjogard M, De Tiège X, Pandolfo M. Cerebellar cognitive disorder parallels cerebellar motor symptoms in Friedreich ataxia. Ann Clin Transl Neurol 2020; 7:1050-1054. [PMID: 32510804 PMCID: PMC7317641 DOI: 10.1002/acn3.51079] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/08/2020] [Accepted: 05/15/2020] [Indexed: 02/06/2023] Open
Abstract
Dentate nuclei (DN) are involved in cerebellar modulation of motor and cognitive functions, whose impairment causes ataxia and cerebellar cognitive affective syndrome (CCAS). Friedreich ataxia (FRDA) disease progression relates to degeneration of the dentate nucleus and dentato‐thalamic pathways, causing cerebellar ataxia. Volumetric MRI also shows mild loss in the cerebellar cortex, brainstem, and motor cortex. Cognitive deficits occur in FRDA, but their relationship with ataxia progression is not fully characterized. We found a significant positive correlation between severity of patients’ ataxia and more marked CCAS as assessed with the CCAS‐Scale. This relation could be related to progressive DN impairment.
Collapse
Affiliation(s)
- Gilles Naeije
- Laboratoire de Cartographie Fonctionnelle du Cerveau, ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium.,Department of Neurology, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Myriam Rai
- Laboratoire de Neurologie Expérimentale, ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Nick Allaerts
- Department of Neurology, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Martin Sjogard
- Laboratoire de Cartographie Fonctionnelle du Cerveau, ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Xavier De Tiège
- Laboratoire de Cartographie Fonctionnelle du Cerveau, ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Massimo Pandolfo
- Department of Neurology, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium.,Laboratoire de Neurologie Expérimentale, ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium
| |
Collapse
|
16
|
Xiong E, Lynch AE, Corben LA, Delatycki MB, Subramony SH, Bushara K, Gomez CM, Hoyle JC, Yoon G, Ravina B, Mathews KD, Wilmot G, Zesiewicz T, Susan Perlman M, Farmer JM, Rummey C, Lynch DR. Health related quality of life in Friedreich Ataxia in a large heterogeneous cohort. J Neurol Sci 2019; 410:116642. [PMID: 31901720 DOI: 10.1016/j.jns.2019.116642] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 12/09/2019] [Accepted: 12/20/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION This study assessed the Health Related Quality of Life (HRQOL) of individuals with Friedreich Ataxia (FRDA) through responses to HRQOL questionnaires. METHODS The SF-36, a generic HRQOL instrument, and symptom specific scales examining vision, fatigue, pain and bladder function were administered to individuals with FRDA and analyzed by comparison with disease features. Multiple linear regression models were used to study independent effects of genetic severity and age. Assessments were performed at baseline then intermittently after that. RESULTS Subjects were on average young adults. For the SF36, the subscale with the lowest HRQOL score was the physical function scale, while the emotional well-being score was the highest. The physical function scale correlated with age of onset, duration, and subject age. In assessment of symptom specific scales, bladder control scores (BLCS) correlated with duration and age, while impact of visual impairment scores (IVIS) correlated with duration. In linear regression models, the BLCS, Pain Effect Score, and IVIS scores were predicted by age and GAA length; modified fatigue impact scale scores were predicted only by GAA length. Physical function and role limitation scores declined over time. No change was seen over time in other SF-36 subscores. Symptom specific scales also worsened over time, most notably the IVIS and BLCS. CONCLUSION The SF-36 and symptom specific scales capture dysfunction in FRDA in a manner that reflects disease status. HRQOL dysfunction was greatest on physically related scales; such scales correlated with disease duration, indicating that they worsen with progressing disease.
Collapse
Affiliation(s)
- Emily Xiong
- Division of Neurology, Children's Hospital of Philadelphia, 502 Abramson Research Center, 3615 Civic Center Blvd, Philadelphia, PA 19104-4318, United States of America
| | - Abigail E Lynch
- Division of Neurology, Children's Hospital of Philadelphia, 502 Abramson Research Center, 3615 Civic Center Blvd, Philadelphia, PA 19104-4318, United States of America
| | - Louise A Corben
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville 3052, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville 3052, Victoria, Australia
| | - Martin B Delatycki
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville 3052, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville 3052, Victoria, Australia
| | - S H Subramony
- Department of Neurology, McKnight Brain Institute, Room L3-100, 1149 Newell Drive, Gainesville, FL 32611, United States of America
| | | | | | | | - Grace Yoon
- Divisions of Neurology and Clinical and Metabolic Genetics, Department of Paediatrics, The Hospital for Sick Children, Canada Hospital, University of Toronto, Toronto, ON, United States of America
| | | | | | | | | | - M Susan Perlman
- Uniersity of California Los Angeles, United States of America
| | - Jennifer M Farmer
- Friedreich's Ataxia Research Alliance, 533 W Uwchlan Ave, Downingtown, PA 19335, United States of America
| | | | - David R Lynch
- Division of Neurology, Children's Hospital of Philadelphia, 502 Abramson Research Center, 3615 Civic Center Blvd, Philadelphia, PA 19104-4318, United States of America.
| |
Collapse
|
17
|
Speech and Language Disorders in Friedreich Ataxia: Highlights on Phenomenology, Assessment, and Therapy. THE CEREBELLUM 2019; 19:126-130. [DOI: 10.1007/s12311-019-01084-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
18
|
García M, Amayra I, Lázaro E, López-Paz JF, Martínez O, Pérez M, Berrocoso S, Al-Rashaida M. Comparison between decompressed and non-decompressed Chiari Malformation type I patients: A neuropsychological study. Neuropsychologia 2018; 121:135-143. [DOI: 10.1016/j.neuropsychologia.2018.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 10/29/2018] [Accepted: 11/04/2018] [Indexed: 12/09/2022]
|
19
|
Crescentini C. Commentary: Novelty seeking and reward dependence-related large-scale brain networks functional connectivity variation during salience expectancy. Front Psychol 2018. [PMID: 29535669 PMCID: PMC5835221 DOI: 10.3389/fpsyg.2018.00242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|