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Lindsay E, Storey E. Cognitive Changes in the Spinocerebellar Ataxias Due to Expanded Polyglutamine Tracts: A Survey of the Literature. Brain Sci 2017; 7:brainsci7070083. [PMID: 28708110 PMCID: PMC5532596 DOI: 10.3390/brainsci7070083] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 06/27/2017] [Accepted: 07/06/2017] [Indexed: 12/18/2022] Open
Abstract
The dominantly-inherited ataxias characterised by expanded polyglutamine tracts—spinocere bellar ataxias (SCAs) 1, 2, 3, 6, 7, 17, dentatorubral pallidoluysian atrophy (DRPLA) and, in part, SCA 8—have all been shown to result in various degrees of cognitive impairment. We survey the literature on the cognitive consequences of each disorder, attempting correlation with their published neuropathological, magnetic resonance imaging (MRI) and clinical features. We suggest several psychometric instruments for assessment of executive function, whose results are unlikely to be confounded by visual, articulatory or upper limb motor difficulties. Finally, and with acknowledgement of the inadequacies of the literature to date, we advance a tentative classification of these disorders into three groups, based on the reported severity of their cognitive impairments, and correlated with their neuropathological topography and MRI findings: group 1—SCAs 6 and 8—mild dysexecutive syndrome based on disruption of cerebello-cortical circuitry; group 2—SCAs 1, 2, 3, and 7—more extensive deficits based largely on disruption of striatocortical in addition to cerebello-cerebral circuitry; and group 3—SCA 17 and DRPLA—in which cognitive impairment severe enough to cause a dementia syndrome is a frequent feature.
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Affiliation(s)
- Evelyn Lindsay
- Department of Medicine (Neuroscience), Monash University (Alfred Hospital Campus), Commercial Road, Melbourne, VIC 3004, Australia.
| | - Elsdon Storey
- Department of Medicine (Neuroscience), Monash University (Alfred Hospital Campus), Commercial Road, Melbourne, VIC 3004, Australia.
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Lo RY, Figueroa KP, Pulst SM, Lin CY, Perlman S, Wilmot G, Gomez CM, Schmahmann J, Paulson H, Shakkottai VG, Ying SH, Zesiewicz T, Bushara K, Geschwind M, Xia G, Subramony SH, Ashizawa T, Kuo SH. Vascular risk factors and clinical progression in spinocerebellar ataxias. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2015; 5:287. [PMID: 25713748 PMCID: PMC4314609 DOI: 10.7916/d89885s0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 12/14/2014] [Indexed: 12/01/2022]
Abstract
Background The contributions of vascular risk factors to spinocerebellar ataxia (SCA) are not known. Methods We studied 319 participants with SCA 1, 2, 3, and 6 and repeatedly measured clinical severity using the Scale for Assessment and Rating of Ataxia (SARA) for 2 years. Vascular risk factors were summarized by CHA2DS2-VASc scores as the vascular risk factor index. We employed regression models to study the effects of vascular risk factors on ataxia onset and progression after adjusting for age, sex, and pathological CAG repeats. Our secondary analyses took hyperlipidemia into account. Results Nearly 60% of SCA participants were at low vascular risks with CHA2DS2-VASc = 0, and 31% scored 2 or greater. Higher CHA2DS2-VASc scores were not associated with either earlier onset or faster progression of ataxia. These findings were not altered after accounting for hyperlipidemia. Discussion Vascular risks are not common in SCAs and are not associated with earlier onset or faster ataxia progression.
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Affiliation(s)
- Raymond Y Lo
- Department of Neurology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| | - Karla P Figueroa
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Stefan M Pulst
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Chi-Ying Lin
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Susan Perlman
- Department of Neurology, University of California, Los Angeles, CA, USA
| | - George Wilmot
- Department of Neurology, Emory University, Atlanta, GA, USA
| | | | - Jeremy Schmahmann
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Henry Paulson
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | | | - Sarah H Ying
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Theresa Zesiewicz
- Department of Neurology, University of South Florida, Tampa, FL, USA
| | - Khalaf Bushara
- Department of Neurology, University of Minnesota, Minneapolis, MN, USA
| | - Michael Geschwind
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Guangbin Xia
- Department of Neurology and McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - S H Subramony
- Department of Neurology and McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Tetsuo Ashizawa
- Department of Neurology and McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Sheng-Han Kuo
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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Kapoor M, Greenough G. Spectrum of sleep disorders in a patient with spinocerebellar ataxia 13. J Clin Sleep Med 2015; 11:177-9. [PMID: 25406272 DOI: 10.5664/jcsm.4468] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 10/13/2014] [Indexed: 11/13/2022]
Abstract
We report the case of a 52-year-old female with spinocerebellar ataxia (SCA) 13. She presented with complaints of insomnia and had a history of restless legs syndrome. Her polysomnogram revealed that she had a significantly elevated periodic limb movement index, mild obstructive sleep apnea, and the absence of REM sleep. Sleep disorders have previously been described in patients with SCA 1, SCA 2, SCA 3, and SCA 6. To our knowledge, this is the first description of sleep disorders in a patient with SCA 13.
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Affiliation(s)
- Mukesh Kapoor
- Dartmouth Hitchcock Medical Center, Sleep Disorders Center, Lebanon, NH
| | - Glen Greenough
- Dartmouth Hitchcock Medical Center, Sleep Disorders Center, Lebanon, NH
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Comprehensive phenotype of the p.Arg420his allelic form of spinocerebellar ataxia type 13. THE CEREBELLUM 2014; 12:932-6. [PMID: 23912307 PMCID: PMC3824261 DOI: 10.1007/s12311-013-0507-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The p.Arg420His allelic form of spinocerebellar ataxia type 13 has been reported in a large Filipino kindred, as well as three European index cases, one with an affected offspring. Haplotype analysis has confirmed independent mutational events. All individuals share adult-onset, predominantly cerebellar signs and a slowly progressive course. However, a comprehensive phenotypic description has yet to be published on SCA13p.Arg420His. In this study, we present the results of a detailed neurological clinical and diagnostic testing on 21 mutation-positive members of a four-generation Filipino family to further define this disease, aiding diagnosis and prognosis.
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Krebs CE, Paisán-Ruiz C. The use of next-generation sequencing in movement disorders. Front Genet 2012; 3:75. [PMID: 22593763 PMCID: PMC3351011 DOI: 10.3389/fgene.2012.00075] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 04/21/2012] [Indexed: 12/12/2022] Open
Abstract
New advances in genomic technology are being introduced at a greater speed and are revolutionizing the field of genetics for both complex and Mendelian diseases. For instance, during the past few years, genome-wide association studies (GWAS) have identified a large number of significant associations between genomic loci and movement disorders such as Parkinson's disease and progressive supranuclear palsy. GWAS are carried out through the use of high-throughput SNP genotyping arrays, which are also used to perform linkage analyses in families previously considered statistically underpowered for genetic analyses. In inherited movement disorders, using this latter technology, it has repeatedly been shown that mutations in a single gene can lead to different phenotypes, while the same clinical entity can be caused by mutations in different genes. This is being highlighted with the use of next-generation sequencing technologies and leads to the search for genes or genetic modifiers that contribute to the phenotypic expression of movement disorders. Establishing an accurate genome-epigenome-phenotype relationship is becoming a major challenge in the post-genomic research that should be facilitated through the implementation of both functional and cellular analyses.
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Affiliation(s)
- Catharine E Krebs
- Department of Neurology, Mount Sinai School of Medicine New York, NY, USA
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