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Rodero-Romero A, Monreal E, Sainz-Amo R, García Domínguez JM, Villarrubia N, Veiga-González JL, Fernández-Velasco JI, Goicochea-Briceño H, Rodríguez-Jorge F, Sainz de la Maza S, Chico-García JL, Muriel A, Masjuan J, Costa-Frossard L, Villar LM. Establishing Normal Serum Values of Neurofilament Light Chains and Glial Fibrillary Acidic Protein Considering the Effects of Age and Other Demographic Factors in Healthy Adults. Int J Mol Sci 2024; 25:7808. [PMID: 39063050 PMCID: PMC11277397 DOI: 10.3390/ijms25147808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 07/11/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
Multiple studies have shown the importance of blood-based biomarkers indicating axonal damage (serum neurofilament light chains [sNfL]) or astroglia activation (serum glial fibrillary acidic protein [sGFAP]) for monitoring different neurological diseases. However, normal values of these variables remain to be clearly defined, partly due to the influence of different demographic factors. We investigated demographic differences in a cohort of healthy volunteers. A cross-sectional study was conducted including 116 healthy controls with ages between 18 and 69 years (67.5% females; n = 79). sNfL and sGFAP concentrations were measured using single-molecule arrays. Age and body mass index affected sNfL values, and age was found to be the most important factor. The normal values changed with age, and we established normal values for individuals younger than 45 years as <10 pg/mL and for controls older than 45 years as <15 pg/mL. We established normal values at <10 pg/mL for individuals younger than 45 years and <15 pg/mL for older individuals. Alternatively, a Z-score of 1.5 was relevant for all controls. sGFAP was only affected by age. Differences in normal values were evident by 55 years. The highest normality limit for sGFAP was 140 pg/mL for controls under 55 years and 280 for older controls. We defined normal levels for sNfL and sGFAP and their corresponding age-associated changes. These data may contribute to the application of such variables in clinical practice.
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Affiliation(s)
- Alexander Rodero-Romero
- Department of Immunology, Hospital Universitario Ramón y Cajal, Red Española de Esclerosis Múltiple (REEM), Red de Enfermedades Inflamatorias (REI), ISCIII, Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain; (A.R.-R.); (N.V.); (J.L.V.-G.); (J.I.F.-V.)
| | - Enric Monreal
- Department of Neurology, Hospital Universitario Ramón y Cajal, Red Española de Esclerosis Múltiple (REEM), Red de Enfermedades Inflamatorias (REI), ISCIII, Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain; (E.M.); (R.S.-A.); (F.R.-J.); (S.S.d.l.M.); (J.L.C.-G.); (J.M.); (L.C.-F.)
| | - Raquel Sainz-Amo
- Department of Neurology, Hospital Universitario Ramón y Cajal, Red Española de Esclerosis Múltiple (REEM), Red de Enfermedades Inflamatorias (REI), ISCIII, Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain; (E.M.); (R.S.-A.); (F.R.-J.); (S.S.d.l.M.); (J.L.C.-G.); (J.M.); (L.C.-F.)
| | | | - Noelia Villarrubia
- Department of Immunology, Hospital Universitario Ramón y Cajal, Red Española de Esclerosis Múltiple (REEM), Red de Enfermedades Inflamatorias (REI), ISCIII, Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain; (A.R.-R.); (N.V.); (J.L.V.-G.); (J.I.F.-V.)
| | - Jose Luís Veiga-González
- Department of Immunology, Hospital Universitario Ramón y Cajal, Red Española de Esclerosis Múltiple (REEM), Red de Enfermedades Inflamatorias (REI), ISCIII, Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain; (A.R.-R.); (N.V.); (J.L.V.-G.); (J.I.F.-V.)
| | - José Ignacio Fernández-Velasco
- Department of Immunology, Hospital Universitario Ramón y Cajal, Red Española de Esclerosis Múltiple (REEM), Red de Enfermedades Inflamatorias (REI), ISCIII, Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain; (A.R.-R.); (N.V.); (J.L.V.-G.); (J.I.F.-V.)
| | - Haydee Goicochea-Briceño
- Department of Neurology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (J.M.G.D.)
| | - Fernando Rodríguez-Jorge
- Department of Neurology, Hospital Universitario Ramón y Cajal, Red Española de Esclerosis Múltiple (REEM), Red de Enfermedades Inflamatorias (REI), ISCIII, Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain; (E.M.); (R.S.-A.); (F.R.-J.); (S.S.d.l.M.); (J.L.C.-G.); (J.M.); (L.C.-F.)
| | - Susana Sainz de la Maza
- Department of Neurology, Hospital Universitario Ramón y Cajal, Red Española de Esclerosis Múltiple (REEM), Red de Enfermedades Inflamatorias (REI), ISCIII, Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain; (E.M.); (R.S.-A.); (F.R.-J.); (S.S.d.l.M.); (J.L.C.-G.); (J.M.); (L.C.-F.)
| | - Juan Luís Chico-García
- Department of Neurology, Hospital Universitario Ramón y Cajal, Red Española de Esclerosis Múltiple (REEM), Red de Enfermedades Inflamatorias (REI), ISCIII, Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain; (E.M.); (R.S.-A.); (F.R.-J.); (S.S.d.l.M.); (J.L.C.-G.); (J.M.); (L.C.-F.)
| | - Alfonso Muriel
- Department of Biostatistics, Hospital Universitario Ramón y Cajal, CIBERESP, Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain;
| | - Jaime Masjuan
- Department of Neurology, Hospital Universitario Ramón y Cajal, Red Española de Esclerosis Múltiple (REEM), Red de Enfermedades Inflamatorias (REI), ISCIII, Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain; (E.M.); (R.S.-A.); (F.R.-J.); (S.S.d.l.M.); (J.L.C.-G.); (J.M.); (L.C.-F.)
| | - Lucienne Costa-Frossard
- Department of Neurology, Hospital Universitario Ramón y Cajal, Red Española de Esclerosis Múltiple (REEM), Red de Enfermedades Inflamatorias (REI), ISCIII, Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain; (E.M.); (R.S.-A.); (F.R.-J.); (S.S.d.l.M.); (J.L.C.-G.); (J.M.); (L.C.-F.)
| | - Luisa María Villar
- Department of Immunology, Hospital Universitario Ramón y Cajal, Red Española de Esclerosis Múltiple (REEM), Red de Enfermedades Inflamatorias (REI), ISCIII, Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain; (A.R.-R.); (N.V.); (J.L.V.-G.); (J.I.F.-V.)
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Fareez F, Yahya S, Fong C, Moodley J, Provias J, Popovic S, Cenic A, Lu JQ. Spinal calcifying pseudoneoplasm of the neuraxis (CAPNON) associated with facet joint pathologies: CAPNON diagnostic and pathogenic insights. Hum Pathol 2024; 145:16-25. [PMID: 38336278 DOI: 10.1016/j.humpath.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/12/2024]
Abstract
Calcifying pseudoneoplasm of the neuraxis (CAPNON) is a rare tumor-like fibro-osseous lesion that can develop anywhere in the neuraxis. Approximately a half of reported CAPNONs developed in the spinal region, mostly close to the facet joint (FJ). The diagnosis of spinal CAPNONs is challenging given the existence of mimics and associated pathologies including calcific degeneration of the FJ ligaments (DFJL) and synovial cysts (SCs). The pathogenesis of CAPNON remains elusive, although there have been a few hypotheses including degenerative, reactive, proliferative and immune-mediated processes. Our present study examined clinical, radiological and pathological features of 12 spinal CAPNONs in comparison to 9 DFJL foci, and diagnostic and pathogenic relationship between CAPNONs and FJ pathologies. On imaging, CAPNONs were all tumor-like and typically bigger than DFJL foci. All CAPNONs showed pathologically diagnostic features including characteristic cores, consistently identifiable core-surrounding/peripheral palisading of macrophages and other cells including multinucleated giant cells, variable infiltration of CD8+ T-cells, and multifocal immunopositivity of neurofilament light chain (NF-L). These features were absent or limited in the DFJL foci with statistically significant differences from CAPNONs, except calcifications. Spinal CAPNONs co-existed with DFJL foci in all cases; some had transitional foci with overlapping focal CAPNON and DFJL-like features. These findings, along with our previously reported relationship between CAPNONs and SCs, suggest that spinal CAPNONs may occur in association with or in transition from calcifying/calcified degenerative lesions of FJ ligaments and/or SCs when a reactive proliferative process is complemented by other pathogenic changes such as immune-mediated pathology and NF-L deposition/expression.
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Affiliation(s)
- Faiha Fareez
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Sultan Yahya
- Department of Radiology, McMaster University, Hamilton, Ontario, Canada
| | - Crystal Fong
- Department of Radiology, McMaster University, Hamilton, Ontario, Canada
| | - Jinesa Moodley
- Department of Pathology, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - John Provias
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Snezana Popovic
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Aleksa Cenic
- Department of Surgery/Neurosurgery, McMaster University, Hamilton, Ontario, Canada
| | - Jian-Qiang Lu
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.
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Miteva D, Vasilev GV, Velikova T. Role of Specific Autoantibodies in Neurodegenerative Diseases: Pathogenic Antibodies or Promising Biomarkers for Diagnosis. Antibodies (Basel) 2023; 12:81. [PMID: 38131803 PMCID: PMC10740538 DOI: 10.3390/antib12040081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
Neurodegenerative diseases (NDDs) affect millions of people worldwide. They develop due to the pathological accumulation and aggregation of various misfolded proteins, axonal and synaptic loss and dysfunction, inflammation, cytoskeletal abnormalities, defects in DNA and RNA, and neuronal death. This leads to the activation of immune responses and the release of the antibodies against them. Recently, it has become clear that autoantibodies (Aabs) can contribute to demyelination, axonal loss, and brain and cognitive dysfunction. This has significantly changed the understanding of the participation of humoral autoimmunity in neurodegenerative disorders. It is crucial to understand how neuroinflammation is involved in neurodegeneration, to aid in improving the diagnostic and therapeutic value of Aabs in the future. This review aims to provide data on the immune system's role in NDDs, the pathogenic role of some specific Aabs against molecules associated with the most common NDDs, and their potential role as biomarkers for monitoring and diagnosing NDDs. It is suggested that the autoimmune aspects of NDDs will facilitate early diagnosis and help to elucidate previously unknown aspects of the pathobiology of these diseases.
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Affiliation(s)
- Dimitrina Miteva
- Department of Genetics, Faculty of Biology, Sofia University “St. Kliment Ohridski”, 8 Dragan Tzankov Str., 1164 Sofia, Bulgaria
- Medical Faculty, Sofia University St. Kliment Ohridski, 1 Kozyak str, 1407 Sofia, Bulgaria; (G.V.V.); (T.V.)
| | - Georgi V. Vasilev
- Medical Faculty, Sofia University St. Kliment Ohridski, 1 Kozyak str, 1407 Sofia, Bulgaria; (G.V.V.); (T.V.)
- Clinic of Neurology, Department of Emergency Medicine UMHAT “Sv. Georgi”, 4000 Plovdiv, Bulgaria
| | - Tsvetelina Velikova
- Medical Faculty, Sofia University St. Kliment Ohridski, 1 Kozyak str, 1407 Sofia, Bulgaria; (G.V.V.); (T.V.)
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Hampel H, Hu Y, Cummings J, Mattke S, Iwatsubo T, Nakamura A, Vellas B, O'Bryant S, Shaw LM, Cho M, Batrla R, Vergallo A, Blennow K, Dage J, Schindler SE. Blood-based biomarkers for Alzheimer's disease: Current state and future use in a transformed global healthcare landscape. Neuron 2023; 111:2781-2799. [PMID: 37295421 PMCID: PMC10720399 DOI: 10.1016/j.neuron.2023.05.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 03/03/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023]
Abstract
Timely detection of the pathophysiological changes and cognitive impairment caused by Alzheimer's disease (AD) is increasingly pressing because of the advent of biomarker-guided targeted therapies that may be most effective when provided early in the disease. Currently, diagnosis and management of early AD are largely guided by clinical symptoms. FDA-approved neuroimaging and cerebrospinal fluid biomarkers can aid detection and diagnosis, but the clinical implementation of these testing modalities is limited because of availability, cost, and perceived invasiveness. Blood-based biomarkers (BBBMs) may enable earlier and faster diagnoses as well as aid in risk assessment, early detection, prognosis, and management. Herein, we review data on BBBMs that are closest to clinical implementation, particularly those based on measures of amyloid-β peptides and phosphorylated tau species. We discuss key parameters and considerations for the development and potential deployment of these BBBMs under different contexts of use and highlight challenges at the methodological, clinical, and regulatory levels.
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Affiliation(s)
- Harald Hampel
- Alzheimer's Disease and Brain Health, Eisai Inc., Nutley, NJ, USA.
| | - Yan Hu
- Alzheimer's Disease and Brain Health, Eisai Inc., Nutley, NJ, USA.
| | - Jeffrey Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Pam Quirk Brain Health and Biomarker Laboratory, Department of Brain Health, School of Integrated Health Sciences, University of Nevada Las Vegas (UNLV), Las Vegas, NV, USA
| | - Soeren Mattke
- Center for Improving Chronic Illness Care, University of Southern California, Los Angeles, CA, USA
| | - Takeshi Iwatsubo
- Department of Neuropathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akinori Nakamura
- Department of Biomarker Research, National Center for Geriatrics and Gerontology, Obu, Japan; Department of Cognition and Behavior Science, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Bruno Vellas
- University Paul Sabatier, Gérontopôle, Toulouse University Hospital, UMR INSERM 1285, Toulouse, France
| | - Sid O'Bryant
- Institute for Translational Research, Texas College of Osteopathic Medicine, Department of Family Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Leslie M Shaw
- Perelman School of Medicine, Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Min Cho
- Alzheimer's Disease and Brain Health, Eisai Inc., Nutley, NJ, USA
| | - Richard Batrla
- Alzheimer's Disease and Brain Health, Eisai Inc., Nutley, NJ, USA
| | - Andrea Vergallo
- Alzheimer's Disease and Brain Health, Eisai Inc., Nutley, NJ, USA
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Jeffrey Dage
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Suzanne E Schindler
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
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Pafiti A, Krashias G, Tzartos J, Tzartos S, Stergiou C, Gaglia E, Smoleski I, Christodoulou C, Pantzaris M, Lambrianides A. A Comparison of Two Analytical Approaches for the Quantification of Neurofilament Light Chain, a Biomarker of Axonal Damage in Multiple Sclerosis. Int J Mol Sci 2023; 24:10787. [PMID: 37445963 DOI: 10.3390/ijms241310787] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/26/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Neurofilament light chain (NfL), is a neuron-specific cytoskeletal protein detected in extracellular fluid following axonal damage. Extensive research has focused on NfL quantification in CSF, establishing it as a prognostic biomarker of disability progression in Multiple Sclerosis (MS). Our study used a new commercially available Enzyme-Linked Immunosorbent Assay (ELISA) kit and Single Molecular Array (Simoa) advanced technology to assess serum NfL levels in MS patients and Healthy Controls (HC). Verifying the most accurate, cost-effective methodology will benefit its application in clinical settings. Blood samples were collected from 54 MS patients and 30 HC. Protocols accompanying the kits were followed. The ELISA thershold was set as 3 S.D. above the mean of the HC. For Simoa, the Z-score calculation created by Jens Kuhle's group was applied (with permission). Samples exceeding the threshold or z-score ≥1.5 indicated subclinical disease activity. To our knowledge, this is the first study to find strong-positive correlation between ELISA and Simoa for the quantification of NfL in serum (r = 0.919). Despite the strong correlation, Simoa has better analytical sensitivity and can detect small changes in samples making it valuable in clinical settings. Further research is required to evaluate whether serum NfL quantification using ELISA could be utilized to predict disability progression.
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Affiliation(s)
- Anna Pafiti
- Postgraduate School, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
- Neuroimmunology Department, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
| | - George Krashias
- Postgraduate School, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
- Department of Molecular Virology, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
| | - John Tzartos
- B' Neurology Department, School of Medicine, National and Kapodistrian University of Athens, "Attikon" Univeristy Hospital, 10676 Athens, Greece
- Tzartos NeuroDiagnostics, 3, Eslin Street, 11523 Athens, Greece
| | | | | | - Eftychia Gaglia
- Clinical Sciences, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
| | - Irene Smoleski
- Clinical Sciences, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
| | - Christina Christodoulou
- Postgraduate School, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
- Department of Molecular Virology, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
| | - Marios Pantzaris
- Postgraduate School, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
- Neuroimmunology Department, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
| | - Anastasia Lambrianides
- Postgraduate School, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
- Neuroimmunology Department, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
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Glascock J, Darras BT, Crawford TO, Sumner CJ, Kolb SJ, DiDonato C, Elsheikh B, Howell K, Farwell W, Valente M, Petrillo M, Tingey J, Jarecki J. Identifying Biomarkers of Spinal Muscular Atrophy for Further Development. J Neuromuscul Dis 2023; 10:937-954. [PMID: 37458045 PMCID: PMC10578234 DOI: 10.3233/jnd-230054] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Spinal muscular atrophy (SMA) is caused by bi-allelic, recessive mutations of the survival motor neuron 1 (SMN1) gene and reduced expression levels of the survival motor neuron (SMN) protein. Degeneration of alpha motor neurons in the spinal cord causes progressive skeletal muscle weakness. The wide range of disease severities, variable rates of decline, and heterogenous clinical responses to approved disease-modifying treatment remain poorly understood and limit the ability to optimize treatment for patients. Validation of a reliable biomarker(s) with the potential to support early diagnosis, inform disease prognosis and therapeutic suitability, and/or confirm response to treatment(s) represents a significant unmet need in SMA. OBJECTIVES The SMA Multidisciplinary Biomarkers Working Group, comprising 11 experts in a variety of relevant fields, sought to determine the most promising candidate biomarker currently available, determine key knowledge gaps, and recommend next steps toward validating that biomarker for SMA. METHODS The Working Group engaged in a modified Delphi process to answer questions about candidate SMA biomarkers. Members participated in six rounds of reiterative surveys that were designed to build upon previous discussions. RESULTS The Working Group reached a consensus that neurofilament (NF) is the candidate biomarker best poised for further development. Several important knowledge gaps were identified, and the next steps toward filling these gaps were proposed. CONCLUSIONS NF is a promising SMA biomarker with the potential for prognostic, predictive, and pharmacodynamic capabilities. The Working Group has identified needed information to continue efforts toward the validation of NF as a biomarker for SMA.
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Affiliation(s)
| | - Basil T. Darras
- Boston Children’s Hospital/Harvard Medical School, Boston, MA, USA
| | - Thomas O. Crawford
- Johns Hopkins University School of Medicine Departments of Neurology and Neuroscience, Department of Neurology and Pediatrics, Baltimore, MD, USA
| | - Charlotte J. Sumner
- Johns Hopkins University School of Medicine Departments of Neurology and Neuroscience, Department of Neurology and Pediatrics, Baltimore, MD, USA
| | - Stephen J. Kolb
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Department of Biological Chemistry & Pharmacology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | | | - Bakri Elsheikh
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Kelly Howell
- Spinal Muscular Atrophy Foundation, Jackson, WY, USA
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