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Drobotenko MI, Lyasota OM, Hernandez-Caceres JL, Labrada RR, Svidlov AA, Dorohova АA, Baryshev MG, Nechipurenko YD, Pérez LV, Dzhimak SS. Abnormal open states patterns in the ATXN2 DNA sequence depends on the CAG repeats length. Int J Biol Macromol 2024; 276:133849. [PMID: 39004246 DOI: 10.1016/j.ijbiomac.2024.133849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/04/2024] [Accepted: 07/11/2024] [Indexed: 07/16/2024]
Abstract
Hereditary ataxias are one of the «anticipation diseases» types. Spinocerebral ataxia type 2 occurs when the number of CAG repeats in the coding region of the ATXN2 gene exceeds 34 or more. In healthy people, the CAG repeat region in the ATXN2 gene usually consists of 22-23 CAG trinucleotides. Mutations that increase the length of CAG repeats can cause severe neurodegenerative and neuromuscular disorders known as trinucleotide repeat expansion diseases. The mechanisms causing such diseases are associated with non-canonical configurations that can be formed in the CAG repeat region during replication, transcription or repair. This makes it relevant to study the zones of open states that arise in the region of CAG repeats under torque. The purpose of this work is to study, using mathematical modeling, zones of open states in the region of CAG repeats of the ATXN2 gene, caused by torque. It has been established that the torque effect on the 1st exon of the ATXN2 gene, in addition to the formation of open states in the promoter region, can lead to the formation of additional various sizes open states zones in the CAG repeats region. Moreover, the frequency of additional large zones genesis increases with increasing number of CAG repeats. The inverse of this frequency correlates with the dependence of the disease onset average age on the CAG repeats length. The obtained results will allow us to get closer to understanding the genetic mechanisms that cause trinucleotide repeat diseases.
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Affiliation(s)
- Mikhail I Drobotenko
- Department of Radiophysics and Nanothechnology, Kuban State University, 350040 Krasnodar, Russian Federation
| | - Oksana M Lyasota
- Laboratory of Problems of Stable Isotope Spreading in Living Systems, Southern Scientific Center of the Russian Academy of Sciences, 344006 Rostov-on-Don, Russian Federation
| | | | | | - Alexandr A Svidlov
- Laboratory of Problems of Stable Isotope Spreading in Living Systems, Southern Scientific Center of the Russian Academy of Sciences, 344006 Rostov-on-Don, Russian Federation
| | - Аnna A Dorohova
- Department of Radiophysics and Nanothechnology, Kuban State University, 350040 Krasnodar, Russian Federation; Laboratory of Problems of Stable Isotope Spreading in Living Systems, Southern Scientific Center of the Russian Academy of Sciences, 344006 Rostov-on-Don, Russian Federation
| | - Mikhail G Baryshev
- Laboratory of Problems of Stable Isotope Spreading in Living Systems, Southern Scientific Center of the Russian Academy of Sciences, 344006 Rostov-on-Don, Russian Federation
| | - Yury D Nechipurenko
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russian Federation
| | | | - Stepan S Dzhimak
- Department of Radiophysics and Nanothechnology, Kuban State University, 350040 Krasnodar, Russian Federation; Laboratory of Problems of Stable Isotope Spreading in Living Systems, Southern Scientific Center of the Russian Academy of Sciences, 344006 Rostov-on-Don, Russian Federation.
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2
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Sanchez-Flores M, Corral-Juan M, Gasch-Navalón E, Cirillo D, Sanchez I, Matilla-Dueñas A. Novel genotype-phenotype correlations, differential cerebellar allele-specific methylation, and a common origin of the (ATTTC) n insertion in spinocerebellar ataxia type 37. Hum Genet 2024; 143:211-232. [PMID: 38396267 PMCID: PMC11043136 DOI: 10.1007/s00439-024-02644-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 01/17/2024] [Indexed: 02/25/2024]
Abstract
Spinocerebellar ataxia subtype 37 (SCA37) is a rare disease originally identified in ataxia patients from the Iberian Peninsula with a pure cerebellar syndrome. SCA37 patients carry a pathogenic intronic (ATTTC)n repeat insertion flanked by two polymorphic (ATTTT)n repeats in the Disabled-1 (DAB1) gene leading to cerebellar dysregulation. Herein, we determine the precise configuration of the pathogenic 5'(ATTTT)n-(ATTTC)n-3'(ATTTT)n SCA37 alleles by CRISPR-Cas9 and long-read nanopore sequencing, reveal their epigenomic signatures in SCA37 lymphocytes, fibroblasts, and cerebellar samples, and establish new molecular and clinical correlations. The 5'(ATTTT)n-(ATTTC)n-3'(ATTTT)n pathogenic allele configurations revealed repeat instability and differential methylation signatures. Disease age of onset negatively correlated with the (ATTTC)n, and positively correlated with the 3'(ATTTT)n. Geographic origin and gender significantly correlated with age of onset. Furthermore, significant predictive regression models were obtained by machine learning for age of onset and disease evolution by considering gender, the (ATTTC)n, the 3'(ATTTT)n, and seven CpG positions differentially methylated in SCA37 cerebellum. A common 964-kb genomic region spanning the (ATTTC)n insertion was identified in all SCA37 patients analysed from Portugal and Spain, evidencing a common origin of the SCA37 mutation in the Iberian Peninsula originating 859 years ago (95% CI 647-1378). In conclusion, we demonstrate an accurate determination of the size and configuration of the regulatory 5'(ATTTT)n-(ATTTC)n-3'(ATTTT)n repeat tract, avoiding PCR bias amplification using CRISPR/Cas9-enrichment and nanopore long-read sequencing, resulting relevant for accurate genetic diagnosis of SCA37. Moreover, we determine novel significant genotype-phenotype correlations in SCA37 and identify differential cerebellar allele-specific methylation signatures that may underlie DAB1 pathogenic dysregulation.
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Affiliation(s)
- Marina Sanchez-Flores
- Neurogenetics Unit, Department of Neuroscience, Germans Trias i Pujol Research Institute (IGTP), Universitat Autònoma de Barcelona-Can Ruti Campus, Carretera de Can Ruti, Camí de les Escoles s/n, 08916, Badalona, Spain
| | - Marc Corral-Juan
- Neurogenetics Unit, Department of Neuroscience, Germans Trias i Pujol Research Institute (IGTP), Universitat Autònoma de Barcelona-Can Ruti Campus, Carretera de Can Ruti, Camí de les Escoles s/n, 08916, Badalona, Spain
| | - Esther Gasch-Navalón
- Neurogenetics Unit, Department of Neuroscience, Germans Trias i Pujol Research Institute (IGTP), Universitat Autònoma de Barcelona-Can Ruti Campus, Carretera de Can Ruti, Camí de les Escoles s/n, 08916, Badalona, Spain
| | | | - Ivelisse Sanchez
- Neurogenetics Unit, Department of Neuroscience, Germans Trias i Pujol Research Institute (IGTP), Universitat Autònoma de Barcelona-Can Ruti Campus, Carretera de Can Ruti, Camí de les Escoles s/n, 08916, Badalona, Spain
| | - Antoni Matilla-Dueñas
- Neurogenetics Unit, Department of Neuroscience, Germans Trias i Pujol Research Institute (IGTP), Universitat Autònoma de Barcelona-Can Ruti Campus, Carretera de Can Ruti, Camí de les Escoles s/n, 08916, Badalona, Spain.
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3
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Cornejo-Olivas M, Solis-Ponce L, Araujo-Aliaga I, Milla-Neyra K, Ortega O, Illanes-Manrique M, Mazzetti P, Manrique-Enciso C, Cubas-Montecino D, Saraiva-Pereira ML, Jardim LB, Sarapura-Castro E. Machado Joseph-Disease Is Rare in the Peruvian Population. CEREBELLUM (LONDON, ENGLAND) 2023; 22:1192-1199. [PMID: 36323979 DOI: 10.1007/s12311-022-01491-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
Spinocerebellar ataxia type 3 or Machado-Joseph disease (MJD/SCA3) is the most prevalent autosomal dominant cerebellar ataxia worldwide, but its frequency varies by geographic region. We describe MJD/SCA3 patients diagnosed in a tertiary healthcare institution in Peru. In a cohort of 341 individuals (253 probands) with clinical ataxia diagnosis, seven MJD/SCA3 probands were identified and their pedigrees extended, detecting a total of 18 MJD/SCA3 cases. Out of 506 alleles from all probands from this cohort, the 23-CAG repeat was the most common ATXN3 allele (31.8%), followed by the 14-CAG repeat allele (26.1%). Normal alleles ranged from 12 to 38 repeats while pathogenic alleles ranged from 64 to 75 repeats. We identified 80 large normal (LN) alleles (15.8%). Five out of seven families declared an affected family member traced back to foreign countries (England, Japan, China, and Trinidad and Tobago). MJD/SCA3 patients showed ataxia, accompanied by pyramidal signs, dysarthria, and dysphagia as well as abnormal oculomotor movements. In conclusion, ATXN3 allelic distribution in non-MJD/SCA3 patients with ataxia is similar to the distribution in normal individuals around the world, whereas LN allele frequency reinforces no correlation with the frequency of MJD/SCA3. Evidence of any atypical MJD/SCA3 phenotype was not found. Furthermore, haplotypes are required to confirm the foreign origin of MJD/SCA3 in the Peruvian population.
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Affiliation(s)
- Mario Cornejo-Olivas
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, Lima, Peru.
- Carrera de Medicina Humana, Universidad Científica del Sur, Lima, Peru.
| | - Lesly Solis-Ponce
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Instituto Nacional de Salud, Lima, Peru
| | - Ismael Araujo-Aliaga
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Karina Milla-Neyra
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Olimpio Ortega
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Maryenela Illanes-Manrique
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Global Brain Health Institute, University of California, San Francisco, CA, USA
| | - Pilar Mazzetti
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Carla Manrique-Enciso
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Diana Cubas-Montecino
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Maria Luiza Saraiva-Pereira
- Serviço de Genética Médica e Centros de Pesquisa Clínica e Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Deptos. de Bioquímica e Medicina Interna, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Laura B Jardim
- Serviço de Genética Médica e Centros de Pesquisa Clínica e Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Deptos. de Bioquímica e Medicina Interna, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Rodriguez-Labrada R, Ortega-Sanchez R, Hernández Casaña P, Santos Morales O, Padrón-Estupiñan MDC, Batista-Nuñez M, Jiménez Rodríguez D, Canales-Ochoa N, Peña Acosta A, Medrano Montero J, Labrada Aguilera PE, Estupiñán Rodriguez A, Vazquez-Mojena Y, Almaguer Gotay D, Aymed-García J, García-García I, Torres Vega R, Viada González C, Valenzuela Silva CM, Silva Ricardo Y, Columbié Ximelis J, Tribin Rivero K, Valle Cabrera R, García-Rodriguez JC, Crombet Ramos T, Amaro-González D, Rodriguez-Obaya T, Velázquez-Pérez L. Erythropoietin in Spinocerebellar Ataxia Type 2: Feasibility and Proof-of-Principle Issues from a Randomized Controlled Study. Mov Disord 2022; 37:1516-1525. [PMID: 35607776 DOI: 10.1002/mds.29045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 02/16/2022] [Accepted: 03/21/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Several pieces of evidence have shown the neurotrophic effect of erythropoietin (EPO) and its introduction in the therapeutic practice of neurological diseases. However, its usefulness in the treatment of spinocerebellar ataxia type 2 (SCA2) has not been proven despite the fact that it is endogenously reduced in these patients. OBJECTIVE The study aims to investigate the safety, tolerability, and clinical effects of a nasally administered recombinant EPO in SCA2 patients. METHODS Thirty-four patients were enrolled in this double-blind, randomized, placebo-controlled, phase I-II clinical trial of the nasally administered human-recombinant EPO (NeuroEPO) for 6 months. The primary outcome was the change in the spinocerebellar ataxia functional index (SCAFI), while other motor, neuropsychological, and oculomotor measures were assessed. RESULTS The 6-month changes in SCAFI score were slightly higher in the patients allocated to NeuroEPO treatment than placebo in spite of the important placebo effect observed for this parameter. However, saccade latency was significantly decreased in the NeuroEPO group but not in placebo. The frequency and severity of adverse events were similar between both groups, without evidences of hematopoietic activity of the drug. CONCLUSIONS This study demonstrated the safety and tolerability of NeuroEPO in SCA2 patients after 6 months of treatments and suggested a small clinical effect of this drug on motor and cognitive abnormalities, but confirmatory studies are warranted. © 2022 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Roberto Rodriguez-Labrada
- Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH), Holguín, Cuba.,Cuban Centre for Neurosciences, Havana, Cuba
| | | | | | | | | | - Maricela Batista-Nuñez
- Otorhinolaryngology Department, "Octavio de la Concepción" Pediatric Hospital, Holguín, Cuba
| | | | - Nalia Canales-Ochoa
- Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH), Holguín, Cuba
| | - Arnoy Peña Acosta
- Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH), Holguín, Cuba
| | | | | | | | - Yaimee Vazquez-Mojena
- Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH), Holguín, Cuba.,Cuban Centre for Neurosciences, Havana, Cuba
| | | | | | | | - Reydenis Torres Vega
- Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH), Holguín, Cuba
| | | | | | | | | | | | | | | | | | | | | | - Luis Velázquez-Pérez
- Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH), Holguín, Cuba.,Cuban Academy of Sciences, Havana, Cuba
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Velázquez-Pérez L, Rodríguez-Labrada R, González-Garcés Y, Vázquez-Mojena Y, Pérez-Rodríguez R, Ziemann U. Neurophysiological features in spinocerebellar ataxia type 2: Prospects for novel biomarkers. Clin Neurophysiol 2021; 135:1-12. [PMID: 34998091 DOI: 10.1016/j.clinph.2021.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/05/2021] [Accepted: 12/13/2021] [Indexed: 12/12/2022]
Abstract
Electrophysiological biomarkers are useful to assess the degeneration and progression of the nervous system in pre-ataxic and ataxic stages of the Spinocerebellar Ataxia Type 2 (SCA2). These biomarkers are essentially defined by their clinical significance, discriminating patients and/or preclinical subjects from healthy controls in cross-sectional studies, their significant changes over time in longitudinal studies, and their correlation with the cytosine-guanine-adenine (CAG) repeat expansion and/or clinical ataxia scores, time of evolution and time to ataxia onset. We classified electrophysiological biomarkers into three main types: (1) preclinical, (2) disease progression and (3) genetic damage. We review the data that identify sural nerve potential amplitude, maximum saccadic velocity, sleep efficiency, rapid eye movement (REM) sleep percentage, K-complex density, REM sleep without atonia percentage, corticomuscular coherence, central motor conduction time, visual P300 latency, and antisaccadic error correction latency as reliable preclinical, progression and/or genetic damage biomarkers of SCA2. These electrophysiological biomarkers will facilitate the conduction of clinical trials that test the efficacy of emerging treatments in SCA2.
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Affiliation(s)
- Luis Velázquez-Pérez
- Cuban Academy of Sciences, Cuba st 460, Between Amargura and Teniente Rey, La Habana Vieja, La Habana, Cuba; Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad st 26, Between 12th and 16th Streets, Holguín, Cuba.
| | | | - Yasmany González-Garcés
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad st 26, Between 12th and 16th Streets, Holguín, Cuba
| | | | - Roberto Pérez-Rodríguez
- Machine Learning Department, Holguin University, Ave Celia Sánchez Between Ave de los Internacionalistas y Final, Hilda Torres, Holguín, Cuba
| | - Ulf Ziemann
- Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany; Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
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Li PP, Moulick R, Feng H, Sun X, Arbez N, Jin J, Marque LO, Hedglen E, Chan HE, Ross CA, Pulst SM, Margolis RL, Woodson S, Rudnicki DD. RNA Toxicity and Perturbation of rRNA Processing in Spinocerebellar Ataxia Type 2. Mov Disord 2021; 36:2519-2529. [PMID: 34390268 PMCID: PMC8884117 DOI: 10.1002/mds.28729] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/03/2021] [Accepted: 07/12/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Spinocerebellar ataxia type 2 (SCA2) is a neurodegenerative disease caused by expansion of a CAG repeat in Ataxin-2 (ATXN2) gene. The mutant ATXN2 protein with a polyglutamine tract is known to be toxic and contributes to the SCA2 pathogenesis. OBJECTIVE Here, we tested the hypothesis that the mutant ATXN2 transcript with an expanded CAG repeat (expATXN2) is also toxic and contributes to SCA2 pathogenesis. METHODS The toxic effect of expATXN2 transcripts on SK-N-MC neuroblastoma cells and primary mouse cortical neurons was evaluated by caspase 3/7 activity and nuclear condensation assay, respectively. RNA immunoprecipitation assay was performed to identify RNA binding proteins (RBPs) that bind to expATXN2 RNA. Quantitative PCR was used to examine if ribosomal RNA (rRNA) processing is disrupted in SCA2 and Huntington's disease (HD) human brain tissue. RESULTS expATXN2 RNA induces neuronal cell death, and aberrantly interacts with RBPs involved in RNA metabolism. One of the RBPs, transducin β-like protein 3 (TBL3), involved in rRNA processing, binds to both expATXN2 and expanded huntingtin (expHTT) RNA in vitro. rRNA processing is disrupted in both SCA2 and HD human brain tissue. CONCLUSION These findings provide the first evidence of a contributory role of expATXN2 transcripts in SCA2 pathogenesis, and further support the role of expHTT transcripts in HD pathogenesis. The disruption of rRNA processing, mediated by aberrant interaction of RBPs with expATXN2 and expHTT transcripts, suggest a point of convergence in the pathogeneses of repeat expansion diseases with potential therapeutic implications. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Pan P. Li
- Department of Psychiatry and Behavioral Sciences, Division of NeurobiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Roumita Moulick
- T.C. Jenkins Department of BiophysicsJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Hongxuan Feng
- Department of Psychiatry and Behavioral Sciences, Division of NeurobiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Xin Sun
- Department of Psychiatry and Behavioral Sciences, Division of NeurobiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Nicolas Arbez
- Department of Psychiatry and Behavioral Sciences, Division of NeurobiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Jing Jin
- Department of Psychiatry and Behavioral Sciences, Division of NeurobiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Leonard O. Marque
- Department of Psychiatry and Behavioral Sciences, Division of NeurobiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Erin Hedglen
- Department of Psychiatry and Behavioral Sciences, Division of NeurobiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - H.Y. Edwin Chan
- Biochemistry Program, School of Life SciencesThe Chinese University of Hong KongHong KongChina
| | - Christopher A. Ross
- Department of Psychiatry and Behavioral Sciences, Division of NeurobiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of NeurologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of NeuroscienceJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Stefan M. Pulst
- Department of NeurologyUniversity of UtahSalt Lake CityUtahUSA
| | - Russell L. Margolis
- Department of Psychiatry and Behavioral Sciences, Division of NeurobiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of NeurologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Sarah Woodson
- T.C. Jenkins Department of BiophysicsJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Dobrila D. Rudnicki
- Department of Psychiatry and Behavioral Sciences, Division of NeurobiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
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7
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McIntosh CS, Li D, Wilton SD, Aung-Htut MT. Polyglutamine Ataxias: Our Current Molecular Understanding and What the Future Holds for Antisense Therapies. Biomedicines 2021; 9:1499. [PMID: 34829728 PMCID: PMC8615177 DOI: 10.3390/biomedicines9111499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 02/07/2023] Open
Abstract
Polyglutamine (polyQ) ataxias are a heterogenous group of neurological disorders all caused by an expanded CAG trinucleotide repeat located in the coding region of each unique causative gene. To date, polyQ ataxias encompass six disorders: spinocerebellar ataxia types 1, 2, 3, 6, 7, and 17 and account for a larger group of disorders simply known as polyglutamine disorders, which also includes Huntington's disease. These diseases are typically characterised by progressive ataxia, speech and swallowing difficulties, lack of coordination and gait, and are unfortunately fatal in nature, with the exception of SCA6. All the polyQ spinocerebellar ataxias have a hallmark feature of neuronal aggregations and share many common pathogenic mechanisms, such as mitochondrial dysfunction, impaired proteasomal function, and autophagy impairment. Currently, therapeutic options are limited, with no available treatments that slow or halt disease progression. Here, we discuss the common molecular and clinical presentations of polyQ spinocerebellar ataxias. We will also discuss the promising antisense oligonucleotide therapeutics being developed as treatments for these devastating diseases. With recent advancements and therapeutic approvals of various antisense therapies, it is envisioned that some of the studies reviewed may progress into clinical trials and beyond.
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Affiliation(s)
- Craig S. McIntosh
- Molecular Therapy Laboratory, Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute Murdoch University, Discovery Way, Murdoch, WA 6150, Australia; (C.S.M.); (D.L.); (S.D.W.)
- Perron Institute for Neurological and Translational Science, Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA 6009, Australia
| | - Dunhui Li
- Molecular Therapy Laboratory, Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute Murdoch University, Discovery Way, Murdoch, WA 6150, Australia; (C.S.M.); (D.L.); (S.D.W.)
- Perron Institute for Neurological and Translational Science, Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA 6009, Australia
| | - Steve D. Wilton
- Molecular Therapy Laboratory, Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute Murdoch University, Discovery Way, Murdoch, WA 6150, Australia; (C.S.M.); (D.L.); (S.D.W.)
- Perron Institute for Neurological and Translational Science, Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA 6009, Australia
| | - May T. Aung-Htut
- Molecular Therapy Laboratory, Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute Murdoch University, Discovery Way, Murdoch, WA 6150, Australia; (C.S.M.); (D.L.); (S.D.W.)
- Perron Institute for Neurological and Translational Science, Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA 6009, Australia
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8
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Rodríguez-Labrada R, Batista-Izquierdo A, González-Melix Z, Reynado-Cejas L, Vázquez-Mojena Y, Sanz YA, Canales-Ochoa N, González-Zaldívar Y, Dogan I, Reetz K, Velázquez-Pérez L. Cognitive Decline Is Closely Associated with Ataxia Severity in Spinocerebellar Ataxia Type 2: a Validation Study of the Schmahmann Syndrome Scale. THE CEREBELLUM 2021; 21:391-403. [PMID: 34313938 DOI: 10.1007/s12311-021-01305-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/05/2021] [Indexed: 01/10/2023]
Abstract
The cerebellar cognitive affective syndrome scale (CCAS-S) was designed to detect specific cognitive dysfunctions in cerebellar patients but is scarcely validated in spinocerebellar ataxias (SCA). The objective of this study is to determine the usefulness of the CCAS-S in a Cuban cohort of SCA2 patients and the relationship of its scores with disease severity. The original scale underwent a forward and backward translation into Spanish language, followed by a pilot study to evaluate its comprehensibility. Reliability, discriminant, and convergent validity assessments were conducted in 64 SCA2 patients and 64 healthy controls matched for sex, age, and education. Fifty patients completed the Montreal Cognitive Assessment (MoCA) test. The CCAS-S showed an acceptable internal consistency (Cronbach's alpha = 0.74) while its total raw score and the number of failed tests showed excellent (ICC = 0.94) and good (ICC = 0.89) test-retest reliability, respectively. Based on original cut-offs, the sensitivity of CCAS-S to detect possible/probable/definite CCAS was notably high (100%/100%/91%), but specificities were low (6%/30/64%) because the decreased specificity observed in four items. CCAS-S performance was significantly influenced by ataxia severity in patients and by education in both groups. CCAS-S scores correlated with MoCA scores, but showed higher sensitivity than MoCA to detect cognitive impairments in patients. The CCAS-S is particularly useful to detect cognitive impairments in SCA2 but some transcultural and/or age and education-dependent adaptations could be necessary to improve its diagnostic properties. Furthermore, this scale confirmed the parallelism between cognitive and motor deficits in SCA2, giving better insights into the disease pathophysiology and identifying novel outcomes for clinical trials.
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Affiliation(s)
- Roberto Rodríguez-Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.
- Cuban Center for Neurosciences, 190st between 25st and 27st, Cubanacan, Playa, 11300, Havana, Cuba.
| | | | | | | | - Yaimeé Vázquez-Mojena
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
- Cuban Center for Neurosciences, 190st between 25st and 27st, Cubanacan, Playa, 11300, Havana, Cuba
| | | | - Nalia Canales-Ochoa
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | | | - Imis Dogan
- Department of Neurology, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | - Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.
- Cuban Academy of Sciences, Cuba st 460, Between Teniente Rey St and Compostela St, Habana Vieja, 19100, Havana, Cuba.
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9
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Sonakar AK, Shamim U, Srivastava MP, Faruq M, Srivastava AK. SCA2 in the Indian population: Unified haplotype and variable phenotypic patterns in a large case series. Parkinsonism Relat Disord 2021; 89:139-145. [PMID: 34298214 DOI: 10.1016/j.parkreldis.2021.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 07/06/2021] [Accepted: 07/10/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Spinocerebellar ataxia-2 is one of the most prevalent SCA type across the world and one of the commonest in India. We aimed to characterize SCA2 patients both clinically and genetically (ATXN2-CAG repeats and its haplotypic background). METHODS A total of 436 SCA2 patients were recruited consecutively comprising individuals of multiple ethnicities and two large multigenerational families. A detailed clinical evaluation and genetic analysis for CAG repeat length estimation and two marker based haplotype analysis [rs695871 and rs695872 located 177 bp and 106 bp upstream of CAG sequence in Exon 1 of ATXN2] was performed. RESULTS Generalized limb ataxia and slow saccades were prevalent features in majority of our patients, while hyporeflexia and extrapyramidal features were less commonly observed manifestations. Slow ocular saccades, upper limb ataxia and tremor showed significant associations with age of onset, CAG repeat length and disease duration. We observed a 100% association of C-C haplotype with the expanded ATXN2 repeats. CONCLUSION This study represents the largest study of SCA2 Indian patients that highlights the clinico-genetic manifestations and haplotype analysis. A significant proportion of patients have not shown the characteristic slow saccades and hyporeflexia thus indicating the influences of other factors in modulation of the disease which warrants further investigations. The observation of CC haplotype in all our SCA2 patients indicates a common origin across all Indian sub populations and that also indicate a common global founder event in the past.
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Affiliation(s)
- Akhilesh K Sonakar
- Department of Neurology, Neuroscience Centre, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Uzma Shamim
- Genomics and Molecular Medicine, CSIR - Institute of Genomics and Integrative Biology, Delhi, 110007, India
| | - Mv Padma Srivastava
- Department of Neurology, Neuroscience Centre, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Mohd Faruq
- Genomics and Molecular Medicine, CSIR - Institute of Genomics and Integrative Biology, Delhi, 110007, India.
| | - Achal K Srivastava
- Department of Neurology, Neuroscience Centre, All India Institute of Medical Sciences, New Delhi, 110029, India.
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10
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Rodríguez-Labrada R, Martins AC, Magaña JJ, Vazquez-Mojena Y, Medrano-Montero J, Fernandez-Ruíz J, Cisneros B, Teive H, McFarland KN, Saraiva-Pereira ML, Cerecedo-Zapata CM, Gomez CM, Ashizawa T, Velázquez-Pérez L, Jardim LB. Founder Effects of Spinocerebellar Ataxias in the American Continents and the Caribbean. THE CEREBELLUM 2021; 19:446-458. [PMID: 32086717 DOI: 10.1007/s12311-020-01109-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Spinocerebellar ataxias (SCAs) comprise a heterogeneous group of autosomal dominant disorders. The relative frequency of the different SCA subtypes varies broadly among different geographical and ethnic groups as result of genetic drifts. This review aims to provide an update regarding SCA founders in the American continents and the Caribbean as well as to discuss characteristics of these populations. Clusters of SCAs were detected in Eastern regions of Cuba for SCA2, in South Brazil for SCA3/MJD, and in Southeast regions of Mexico for SCA7. Prevalence rates were obtained and reached 154 (municipality of Báguano, Cuba), 166 (General Câmara, Brazil), and 423 (Tlaltetela, Mexico) patients/100,000 for SCA2, SCA3/MJD, and SCA7, respectively. In contrast, the scattered families with spinocerebellar ataxia type 10 (SCA10) reported all over North and South Americas have been associated to a common Native American ancestry that may have risen in East Asia and migrated to Americas 10,000 to 20,000 years ago. The comprehensive review showed that for each of these SCAs corresponded at least the development of one study group with a large production of scientific evidence often generalizable to all carriers of these conditions. Clusters of SCA populations in the American continents and the Caribbean provide unusual opportunity to gain insights into clinical and genetic characteristics of these disorders. Furthermore, the presence of large populations of patients living close to study centers can favor the development of meaningful clinical trials, which will impact on therapies and on quality of life of SCA carriers worldwide.
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Affiliation(s)
| | - Ana Carolina Martins
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, 91540-070, Brazil
| | - Jonathan J Magaña
- Department of Genetics, Laboratory of Genomic Medicine, National Rehabilitation Institute (INR-LGII), 14389, Mexico City, Mexico
| | - Yaimeé Vazquez-Mojena
- Centre for the Research and Rehabilitation of Hereditary Ataxias, 80100, Holguín, Cuba
| | | | - Juan Fernandez-Ruíz
- Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autonoma de Mexico, 04510, Mexico City, Mexico
| | - Bulmaro Cisneros
- Department of Genetics and Molecular Biology, Center of Research and Advanced Studies (CINVESTAV-IPN), 07360, Mexico City, Mexico
| | - Helio Teive
- Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clínicas Federal University of Paraná, Curitiba, PR, 80240-440, Brazil
| | | | - Maria Luiza Saraiva-Pereira
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, 91540-070, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, 90035-903, Brazil
- Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, 90035-903, Brazil
| | - César M Cerecedo-Zapata
- Department of Genetics, Laboratory of Genomic Medicine, National Rehabilitation Institute (INR-LGII), 14389, Mexico City, Mexico
- Rehabilitation and Social Inclusion Center of Veracruz (CRIS-DIF), Xalapa, 91070, Veracruz, Mexico
| | | | - Tetsuo Ashizawa
- Program of Neuroscience, Houston Methodist Research Institute, Houston, TX, 77030, USA
| | - Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, 80100, Holguín, Cuba.
- Cuban Academy of Sciences, 10100, La Havana, Cuba.
| | - Laura Bannach Jardim
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, 91540-070, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, 90035-903, Brazil
- Departamento de Medicina Interna, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, 90035-903, Brazil
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11
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Rodriguez-Graña T, Rodríguez-Labrada R, Santana-Porbén S, Reynaldo-Cejas L, Medrano-Montero J, Canales-Ochoa N, Silva-Ricardo Y, Torres-Vega R, González-Zaldivar Y, Almaguer-Gotay D, Auburger G, Velázquez-Pérez L. Weight loss is correlated with disease severity in Spinocerebellar ataxia type 2: a cross-sectional cohort study. Nutr Neurosci 2021; 25:1747-1755. [PMID: 33687306 DOI: 10.1080/1028415x.2021.1895479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Body weight changes occur frequently during advanced stages of Spinocerebellar Ataxia type 2 (SCA2), nevertheless limited information exists on biomarkers of nutritional status of these patients. OBJECTIVE. To assess changes in surrogate nutritional markers of SCA2 patients; to explore their associations with expanded CAG repeats and disease severity. METHODS One-hundred-thirteen SCA2 patients and 50 healthy controls underwent a comprehensive anthropometrical and biochemical assessment protocol of the nutritional status. Neurological and genotype assessments were also performed. RESULTS A decrease in weight, body mass index (BMI), cutaneous skinfold thickness, fat mass, arm muscle circumference, calf circumference and skeletal muscle mass was observed in SCA2 patients compared to the controls. The total/HDL cholesterol ratio was significantly reduced in patients. BMI was correlated with the age at onset. Overall, anthropometric measures were correlated with clinical markers of disease severity and were more evident in severe and moderate cases. CONCLUSIONS Using anthropometric measures in the assessment of the nutritional status of SCA2 patients might provide hints about pathophysiological mechanisms that underlie metabolic abnormalities in SCA2. Anthropometric are close related with disease severity and progression, and trigger preventive therapies aimed to ameliorate weight loss and wasting in these patients.
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Affiliation(s)
- Tania Rodriguez-Graña
- Centre for the Research and Rehabilitation of Hereditary Ataxias, El Llano, Holguin, Cuba.,Medical University of Holguin, Holguin, Cuba
| | - Roberto Rodríguez-Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, El Llano, Holguin, Cuba.,Cuban Neuroscience Centre, La Havana, Cuba
| | | | - Lorenzo Reynaldo-Cejas
- Centre for the Research and Rehabilitation of Hereditary Ataxias, El Llano, Holguin, Cuba
| | | | - Nalia Canales-Ochoa
- Centre for the Research and Rehabilitation of Hereditary Ataxias, El Llano, Holguin, Cuba
| | | | - Reidenis Torres-Vega
- Centre for the Research and Rehabilitation of Hereditary Ataxias, El Llano, Holguin, Cuba
| | | | - Dennis Almaguer-Gotay
- Centre for the Research and Rehabilitation of Hereditary Ataxias, El Llano, Holguin, Cuba
| | - Georg Auburger
- Exp. Neurology, Medical Faculty, Goethe University, Frankfurt am Main, Germany
| | - Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, El Llano, Holguin, Cuba.,Cuban Academy of Sciences, La Habana, Cuba
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12
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Almaguer-Mederos LE, Pérez-Ávila I, Aguilera-Rodríguez R, Velázquez-Garcés M, Almaguer-Gotay D, Hechavarría-Pupo R, Rodríguez-Estupiñán A, Auburger G. Body Mass Index Is Significantly Associated With Disease Severity in Spinocerebellar Ataxia Type 2 Patients. Mov Disord 2021; 36:1372-1380. [PMID: 33548146 DOI: 10.1002/mds.28498] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 12/09/2020] [Accepted: 12/21/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Spinocerebellar ataxia type 2 is a progressive neurodegenerative disorder due to an unstable expansion of a CAG repeat in the ATXN2 gene. Although weight loss has been associated with disease progression in several neurodegenerative conditions, it has been barely assessed in patients with spinocerebellar ataxia type 2. OBJECTIVE The objective of this study was to test whether body mass index is altered in patients with spinocerebellar ataxia type 2 with varying expansion sizes from early to late disease stages. METHODS A cross-sectional case-control study was performed, which included 222 clinically and molecularly diagnosed patients and 214 sex- and age-matched healthy individuals. ATXN2 genotypes and sex were considered as risk factors. Clinical outcomes included the body mass index, age at onset, disease duration, Scale for the Assessment and Rating of Ataxia score, disease stage, dysphagia, and progression rate. Multiple linear regression models were generated. RESULTS Body mass index was significantly decreased in male patients, but not in female patients, relative to control subjects. In addition to sex, body mass index was significantly associated with age at onset and progression rate. Conversely, body mass index, along with repeat length in ATXN2 expanded alleles and disease duration, was associated with Scale for the Assessment and Rating of Ataxia score. In addition, body mass index, along with the age at onset and the repeat length in ATXN2 normal and expanded alleles, has a significant influence on progression rate. CONCLUSIONS Body mass index might be a useful biomarker of disease severity, particularly in male patients with spinocerebellar ataxia type 2 in the context of nutritional interventions or clinical trials assessing the efficacy of promising new drugs. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
| | - Ilbedis Pérez-Ávila
- Center for the Investigation and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Center for Sports Medicine, Holguín, Cuba
| | | | | | - Dennis Almaguer-Gotay
- Center for the Investigation and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | | | | | - Georg Auburger
- Experimental Neurology, Goethe University Medical Faculty, Frankfurt, Germany
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13
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Han F, Su D, Qu C. Spinocerebellar ataxia type 40: A case report and literature review. Transl Neurosci 2021; 12:379-384. [PMID: 34721893 PMCID: PMC8525662 DOI: 10.1515/tnsci-2020-0190] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/05/2021] [Accepted: 09/22/2021] [Indexed: 12/22/2022] Open
Abstract
Spinocerebellar ataxias (SCAs) are a group of neurodegenerative diseases with ataxia as the main clinical manifestation. The phenotypes, gene mutations, and involved sites of different subtypes show a high degree of heterogeneity. The incidence of SCA varies greatly among different subtypes and the case of SCA40 is extremely rare. The aim of this study is to report a rare case of SCA40 and systematically review the incidence, gene mutation, and phenotype of SCAs, especially SCA40.
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Affiliation(s)
- Fengyue Han
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250100, China
| | - Dan Su
- Department of Neurology, Jinan Shizhong District People's Hospital, Jinan, Shandong, 250100, China
| | - Chuanqiang Qu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250100, China
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14
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Velázquez-Pérez L, Rodriguez-Labrada R, González-Garcés Y, Arrufat-Pie E, Torres-Vega R, Medrano-Montero J, Ramirez-Bautista B, Vazquez-Mojena Y, Auburger G, Horak F, Ziemann U, Gomez CM. Prodromal Spinocerebellar Ataxia Type 2 Subjects Have Quantifiable Gait and Postural Sway Deficits. Mov Disord 2020; 36:471-480. [PMID: 33107647 DOI: 10.1002/mds.28343] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/14/2020] [Accepted: 09/29/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The search for valid preclinical biomarkers of cerebellar dysfunction is a key research goal for the upcoming era of early interventional approaches in spinocerebellar ataxias. This study aims to describe novel preclinical biomarkers of subtle gait and postural sway abnormalities in prodromal spinocerebellar ataxia type 2 (pre-SCA2). METHODS Thirty pre-SCA2 patients and their matched healthy controls underwent quantitative assessments of gait and postural sway using a wearable sensor-based system and semiquantitative evaluation of cerebellar features by SARA (Scale for the Assessment and Rating of Ataxia) score. RESULTS Quantitative analysis of natural gait showed a significantly larger variability of the swing period, toe-off angle and toe-out angle in pre-SCA2, and larger mean coronal and transverse ranges of motion of the trunk at the lumbar location and of the sagittal range of motion of the trunk at the sternum location compared to controls. During tandem gait, pre-SCA2 subjects showed larger lumbar, trunk, and arm ranges of motion than controls. Postural sway analysis showed excessive body oscillation that was increased in tandem stance. Overall, these abnormalities were detected in pre-SCA2 patients without clinical evidence of abnormalities in SARA. The toe-off angle and swing time variability were significantly correlated with the time to ataxia onset, whereas the toe-off angle and transverse range of motion at trunk position during tandem gait were significantly associated with the SARA score. CONCLUSIONS This study demonstrates early alteration of gait and postural sway control in prodromal SCA2 using a wearable sensor-based system. This offers new pathophysiological hints into this early disease stage and provides novel potential biomarkers for future clinical trials. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Luis Velázquez-Pérez
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Cuban Academy of Sciences, La Habana Vieja, Cuba
| | - Roberto Rodriguez-Labrada
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Department of Molecular Biology, Cuban Neuroscience Centre, Playa, Cuba
| | - Yasmani González-Garcés
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | - Eduardo Arrufat-Pie
- Department of Neurorehabilitation, Clinical & Surgical Hospital "Manuel Piti Fajardo,", Plaza de la Revolución, Cuba
| | - Reidenis Torres-Vega
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | - Jacqueline Medrano-Montero
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | | | - Yaimeé Vazquez-Mojena
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Department of Molecular Biology, Cuban Neuroscience Centre, Playa, Cuba
| | - Georg Auburger
- Experimental Neurology, Department of Neurology, Experimental Neurology, Medical School, Goethe University, Frankfurt am Main, Germany
| | - Fay Horak
- Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
| | - Ulf Ziemann
- Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany.,Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
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15
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Lin CC, Ashizawa T, Kuo SH. Collaborative Efforts for Spinocerebellar Ataxia Research in the United States: CRC-SCA and READISCA. Front Neurol 2020; 11:902. [PMID: 32982927 PMCID: PMC7479060 DOI: 10.3389/fneur.2020.00902] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 07/14/2020] [Indexed: 12/11/2022] Open
Abstract
Spinocerebellar ataxias are progressive neurodegenerative disorders primarily affecting the cerebellum. Although the first disease-causing gene was identified nearly 30 years ago, there is no known cure to date, and only a few options exist for symptomatic treatment, with modest effects. The recently developed tools in molecular biology, such as CRISPR/Cas9 and antisense oligonucleotides, can directly act on the disease mechanisms at the genomic or RNA level in disease models. In a nutshell, we are finally just one step away from clinical trials with therapies targeting the underlying genetic cause. However, we still face the challenges for rare neurodegenerative diseases: difficulty in obtaining a large cohort size for sufficient statistical power and the need for biomarkers and clinical outcome assessments (COA) with adequate sensitivity to reflect progression or treatment responses. To overcome these obstacles, ataxia experts form research networks for clinical trial readiness. In this review, we retrace our steps of the collaborative efforts among ataxia researchers in the United States over the years to study and treat these relentless disorders and the future directions of such research networks.
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Affiliation(s)
- Chih-Chun Lin
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, United States
- Initiative for Columbia Ataxia and Tremor, Columbia University, New York, NY, United States
| | - Tetsuo Ashizawa
- Department of Neurology, Houston Methodist Research Institute, Houston, TX, United States
| | - Sheng-Han Kuo
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, United States
- Initiative for Columbia Ataxia and Tremor, Columbia University, New York, NY, United States
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16
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Frequency and distribution of polyQ disease intermediate-length repeat alleles in healthy Italian population. Neurol Sci 2020; 41:1475-1482. [PMID: 31940111 DOI: 10.1007/s10072-019-04233-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 12/30/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Huntington disease (HD) and spinocerebellar ataxia type 1-2-17 (SCA1-2-17) are adult-onset autosomal dominant diseases, caused by triplet repeat expansions in the HTT, ATXN1, ATXN2, and TBP genes. Alleles with a repeat number just below the pathological threshold are associated with reduced penetrance and meiotic instability and are defined as intermediate alleles (IAs). OBJECTIVES We aimed to determine the frequencies of IAs in healthy Italian subjects and to compare the proportion of the IAs with the prevalence of the respective diseases. METHODS We analyzed the triplet repeat size in HTT, ATXN1, ATXN2, and TBP genes in the DNA samples from 729 consecutive adult healthy Italian subjects. RESULTS IAs associated with reduced penetrance were found in ATXN2 gene (1 subject, 0.1%) and TBP gene (0.82%). IAs at risk for meiotic instability were found in HTT (5.3%) and ATXN2 genes (2.7%). In ATXN1, we found a low percentage of IAs (0.4%). Alleles lacking the common CAT interruption within the CAG sequence were also rare (0.3%). CONCLUSIONS The high frequencies of IAs in HTT and ATXN2 genes suggest a correlation with the prevalence of the diseases in our population and support the hypothesis that IAs could represent a reservoir of new pathological expansions. On the opposite, ATXN1-IA were very rare in respect to the prevalence of SCA1 in our country, and TBP- IA were more frequent than expected, suggesting that other mechanisms could influence the occurrence of novel pathological expansions.
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17
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Velázquez-Pérez L, Medrano-Montero J, Rodríguez-Labrada R, Canales-Ochoa N, Campins Alí J, Carrillo Rodes FJ, Rodríguez Graña T, Hernández Oliver MO, Aguilera Rodríguez R, Domínguez Barrios Y, Torres Vega R, Flores Angulo L, Cordero Navarro NY, Sigler Villanueva AA, Gámez Rodríguez O, Sagaró Zambrano I, Navas Napóles NY, García Zacarías J, Serrano Barrera OR, Ramírez Bautista MB, Estupiñán Rodríguez A, Guerra Rondón LA, Vázquez-Mojena Y, González-Zaldivar Y, Almaguer Mederos LE, Leyva-Mérida A. Hereditary Ataxias in Cuba: A Nationwide Epidemiological and Clinical Study in 1001 Patients. THE CEREBELLUM 2020; 19:252-264. [DOI: 10.1007/s12311-020-01107-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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18
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Cornejo-Olivas M, Inca-Martinez M, Castilhos RM, Furtado GV, Mattos EP, Bampi GB, Leistner-Segal S, Marca V, Mazzetti P, Saraiva-Pereira ML, Jardim LB. Genetic Analysis of Hereditary Ataxias in Peru Identifies SCA10 Families with Incomplete Penetrance. THE CEREBELLUM 2020; 19:208-215. [PMID: 31900855 DOI: 10.1007/s12311-019-01098-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Relative frequency of hereditary ataxias remains unknown in many regions of Latin America. We described the relative frequency in spinocerebellar ataxias (SCA) due to (CAG)n and to (ATTCT)n expansions, as well as Friedreich ataxia (FRDA), among cases series of ataxic individuals from Peru. Among ataxic index cases from 104 families (38 of them with and 66 without autosomal dominant pattern of inheritance), we identified 22 SCA10, 8 SCA2, 3 SCA6, 2 SCA3, 2 SCA7, 1 SCA1, and 9 FRDA cases (or families). SCA10 was by far the most frequent one. Findings in SCA10 and FRDA families were of note. Affected genitors were not detected in 7 out of 22 SCA10 nuclear families; then overall maximal penetrance of SCA10 was estimated as 85%; in multiplex families, penetrance was 94%. Two out of nine FRDA cases carried only one allele with a GAA expansion. SCA10 was the most frequent hereditary ataxia in Peru. Our data suggested that ATTCT expansions at ATXN10 might not be fully penetrant and/or instability between generations might frequently cross the limits between non-penetrant and penetrant lengths. A unique distribution of inherited ataxias in Peru requires specific screening panels, considering SCA10 as first line of local diagnosis guidelines.
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Affiliation(s)
- Mario Cornejo-Olivas
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, 1271 Ancash St, Barrios Altos, 15003, Lima, Peru. .,Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Miguel Inca-Martinez
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, 1271 Ancash St, Barrios Altos, 15003, Lima, Peru.,Lerner Research Institute, Genomic Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Raphael Machado Castilhos
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Serviço de Neurologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Gabriel Vasata Furtado
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Laboratório de Identificação Genética, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Eduardo Preusser Mattos
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Laboratório de Identificação Genética, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Giovana Bavia Bampi
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Laboratório de Identificação Genética, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Sandra Leistner-Segal
- Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Victoria Marca
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, 1271 Ancash St, Barrios Altos, 15003, Lima, Peru
| | - Pilar Mazzetti
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, 1271 Ancash St, Barrios Altos, 15003, Lima, Peru
| | - Maria Luiza Saraiva-Pereira
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Laboratório de Identificação Genética, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Instituto de Genética Médica Populacional (INAGEMP), Porto Alegre, Brazil
| | - Laura Bannach Jardim
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Laboratório de Identificação Genética, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Departamento de Medicina Interna, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Instituto de Genética Médica Populacional (INAGEMP), Porto Alegre, Brazil
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19
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Teive HAG, Meira AT, Camargo CHF, Munhoz RP. The Geographic Diversity of Spinocerebellar Ataxias (SCAs) in the Americas: A Systematic Review. Mov Disord Clin Pract 2019; 6:531-540. [PMID: 31538086 DOI: 10.1002/mdc3.12822] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/20/2019] [Accepted: 07/25/2019] [Indexed: 12/26/2022] Open
Abstract
Background The frequency and presentation of each of the most common forms of spinocerebellar ataxias (SCAs) varies widely. In the case of the Americas, this diversity is particularly dynamic given additional social, demographic, and cultural characteristics. Objective To describe the regional prevalence and clinical phenotypes of SCAs throughout the continent. Methods A literature search was performed in both MEDLINE and LILACS databases. The research was broadened to include the screening of reference lists of systematic review articles for additional studies. Investigations dating from the earliest available through 2019. Only studies in English, Portuguese, and Spanish were included. We analyzed publications with genetically confirmed cases only, ranging from robust samples with epidemiological data to case reports and case series from each country or regions. Results Overall, SCA3 is the most common form in the continent. Region-specific prevalence and ranking of the common forms vary. On the other hand, region-specific phenotypic variations were not consistently found based on the available literature analyzed, with the exception of the absence of epilepsy in SCA10 consistently described in a particular cluster of cases in South Brazil. Conclusion Systematic, multinational studies analyzing in detail the true frequencies of SCAs across the Americas as well as distinct clinical signs and clues of each form would be ideal to look for these potential variations.
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Affiliation(s)
- Hélio A G Teive
- Movement Disorders Unit, Neurology Service, Internal Medicine Department Hospital de Clínicas, Federal University of Parana Curitiba Parana Brazil.,Neurological Diseases Group Graduate Program of Internal Medicine, Hospital de Clínicas, Federal University of Parana Curitiba Parana Brazil
| | - Alex T Meira
- Movement Disorders Unit, Neurology Service, Internal Medicine Department Hospital de Clínicas, Federal University of Parana Curitiba Parana Brazil
| | - Carlos Henrique F Camargo
- Neurological Diseases Group Graduate Program of Internal Medicine, Hospital de Clínicas, Federal University of Parana Curitiba Parana Brazil
| | - Renato P Munhoz
- Movement Disorders Centre Toronto Western Hospital, University of Toronto Toronto Ontario Canada
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20
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Verma AK, Khan E, Bhagwat SR, Kumar A. Exploring the Potential of Small Molecule-Based Therapeutic Approaches for Targeting Trinucleotide Repeat Disorders. Mol Neurobiol 2019; 57:566-584. [DOI: 10.1007/s12035-019-01724-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/29/2019] [Indexed: 12/18/2022]
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21
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Sleep spindles and K-complex activities are decreased in spinocerebellar ataxia type 2: relationship to memory and motor performances. Sleep Med 2019; 60:188-196. [PMID: 31186215 DOI: 10.1016/j.sleep.2019.04.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 04/10/2019] [Accepted: 04/12/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Sleep spindles and K-complexes are electroencephalographic hallmarks of non-rapid eye movement (non-REM) sleep that provide valuable information into brain functioning, plasticity and sleep functions in normal and pathological conditions. However, they have not been systematically investigated in spinocerebellar ataxias (SCA). To close this gap, the current study was carried out to quantify sleep spindles and K-complexes in SCA2 and to assess their relationship with clinical and molecular measures, as well as with memory and attention/executive functioning. METHODS In this study, 20 SCA2 patients, 20 preclinical carriers and 20 healthy controls underwent whole-night polysomnographic (PSG) recordings as well as sleep interviews, ataxia scoring and neuropsychological assessments. Sleep spindles and K-complexes were automatically detected during non-REM sleep stage 2 (N2). Their densities were evaluated as events/minute. RESULTS Compared to controls, sleep spindle density was significantly reduced in SCA2 patients and preclinical subjects. By contrast, K-complex density was specifically and significantly decreased only in SCA2 patients. Reduced spindle activity correlated with measures of verbal memory, whereas reduced K-complex activity correlated with age, ataxia severity and N3 sleep percentage in SCA2 patients. CONCLUSIONS Findings document an impairment of N2 sleep microstructure in SCA2 already in prodromal stages, suggesting an early involvement of thalamo-cortical and/or cortical circuits underlying the generation of sleep spindles and K-complexes. Thus, sleep spindle density may serve as useful biomarker for deficits of neural plasticity mechanisms underlying verbal memory alterations in patients. It may also serve as promising outcome measure in further therapeutical trials targeting memory decline in SCA2. With regard to K-complexes, they have potential usefulness as marker of sleep protection.
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22
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Velázquez-Pérez L, Rodríguez-Diaz JC, Rodríguez-Labrada R, Medrano-Montero J, Aguilera Cruz AB, Reynaldo-Cejas L, Góngora-Marrero M, Estupiñán-Rodríguez A, Vázquez-Mojena Y, Torres-Vega R. Neurorehabilitation Improves the Motor Features in Prodromal SCA2: A Randomized, Controlled Trial. Mov Disord 2019; 34:1060-1068. [PMID: 30958572 DOI: 10.1002/mds.27676] [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: 10/03/2018] [Revised: 02/28/2019] [Accepted: 03/07/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The search for early interventions is a novel approach in spinocerebellar ataxias, but there are few studies supporting this notion. This article aimed to assess the efficacy of neurorehabilitation treatment in prodromal spinocerebellar ataxia type 2. METHODS Thirty spinocerebellar ataxia type 2 preclinical carriers were enrolled in a randomized, controlled trial using neurorehabilitation. The intervention in the treated group was 4 hours per day, 5 days per week for 12 weeks, emphasizing static balance, gait, and limb coordination. The control group did not receive rehabilitation. The primary outcome measure was the time for 5-m tandem gait over the floor. Secondary outcomes included other timed tests with increased motor complexity, as well as the scores of the SARA and the Inventory of Non-ataxia Symptoms. RESULTS The times for 5-m tandem gait over the floor and the mattress were significantly reduced only in the rehabilitated group. Moreover, the times upholding the tandem stance over a mattress and the seesaw were notably increased only in this group. Likewise, the finger-nose and the heel-shin tests were improved in the rehabilitated group alone. The SARA score and the count of nonataxia symptoms were unchanged. CONCLUSIONS This rehabilitation program improves the subtle gait, postural and coordinative deficits in prodromal spinocerebellar ataxia type 2, which provided novel hints about the preservation of motor learning and neural plasticity mechanisms in early disease stages, leading chances for other interventional approaches in this and other spinocerebellar ataxias. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Cuban Academy of Sciences, Havana, Cuba
| | | | - Roberto Rodríguez-Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Cuban Academy of Sciences, Havana, Cuba.,School of Physical Culture and Sport, University of Holguín, Holguín, Cuba
| | - Jacqueline Medrano-Montero
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,School of Physical Culture and Sport, University of Holguín, Holguín, Cuba
| | | | | | | | | | - Yaimeé Vázquez-Mojena
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Cuban Academy of Sciences, Havana, Cuba.,School of Physical Culture and Sport, University of Holguín, Holguín, Cuba
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23
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Rodríguez-Labrada R, Velázquez-Pérez L, Ortega-Sánchez R, Peña-Acosta A, Vázquez-Mojena Y, Canales-Ochoa N, Medrano-Montero J, Torres-Vega R, González-Zaldivar Y. Insights into cognitive decline in spinocerebellar Ataxia type 2: a P300 event-related brain potential study. CEREBELLUM & ATAXIAS 2019; 6:3. [PMID: 30873287 PMCID: PMC6399884 DOI: 10.1186/s40673-019-0097-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/21/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Cognitive decline is a common non-motor feature characterizing Spinocerebellar Ataxia type 2 (SCA2) during the prodromal stage, nevertheless a reduced number of surrogate biomarkers of these alterations have been described. OBJECTIVE To provide insights into cognitive dysfunction in SCA2 patients using P300 event-related potentials (ERP) and to evaluate these measures as biomarkers of the disease. METHODS A cross-sectional study was performed with 30 SCA2 patients, 20 preclinical carriers and 33 healthy controls, who underwent visual, auditory P300 ERPs, and neurological examinations and ataxia scoring. RESULTS SCA2 patients showed significant increase in P300 latencies and decrease of P300 amplitudes for visual and auditory stimuli, whereas preclinical carriers exhibit a less severe, but significant prolongation of P300 latencies. Multiple regression analyses disclosed a significant effect of SARA score on visual P300 abnormalities in patients as well as of the time to ataxia onset on visual P300 latencies in preclinical carriers. CONCLUSIONS This paper demonstrated the role of P300 ERP for the study of attentional, discriminative and working memory abnormalities in SCA2 patients and for the search of surrogate biomarkers from prodromal to the symptomatic stages. Moreover, our findings provide psychophysiological evidences supporting the cerebellar involvement in cognitive processes and allows us to identify promising outcome measures for future trials focusing on cognitive dysfunction.
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Affiliation(s)
- Roberto Rodríguez-Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street # 26, 80100 Holguín, Cuba
- Faculty of Sport and Physical Culture, University of Holguín, Holguín, Cuba
- Cuban Academy of Science, street no. 460, Habana Vieja, La Habana, Cuba
| | - Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street # 26, 80100 Holguín, Cuba
- Cuban Academy of Science, street no. 460, Habana Vieja, La Habana, Cuba
- Medical University of Holguín, Lenin Avenue 1, Holguín, Cuba
| | - Ricardo Ortega-Sánchez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street # 26, 80100 Holguín, Cuba
| | - Arnoy Peña-Acosta
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street # 26, 80100 Holguín, Cuba
| | - Yaimeé Vázquez-Mojena
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street # 26, 80100 Holguín, Cuba
- Faculty of Sport and Physical Culture, University of Holguín, Holguín, Cuba
- Cuban Academy of Science, street no. 460, Habana Vieja, La Habana, Cuba
| | - Nalia Canales-Ochoa
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street # 26, 80100 Holguín, Cuba
| | - Jacqueline Medrano-Montero
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street # 26, 80100 Holguín, Cuba
- Faculty of Sport and Physical Culture, University of Holguín, Holguín, Cuba
| | - Reidenis Torres-Vega
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street # 26, 80100 Holguín, Cuba
| | - Yanetza González-Zaldivar
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street # 26, 80100 Holguín, Cuba
- Medical University of Holguín, Lenin Avenue 1, Holguín, Cuba
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Yearwood AK, Rethi S, Figueroa KP, Walker RH, Sobering AK. Diagnosis of Spinocerebellar Ataxia in the West Indies. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2018; 8:567. [PMID: 30191086 PMCID: PMC6123834 DOI: 10.7916/d8dv329c] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 06/07/2018] [Indexed: 12/11/2022]
Abstract
Background Access to medical care in many regions is limited by socioeconomic status, at both the individual and the community level. This report describes the diagnostic process of a family residing on an underserved Caribbean island where routine neurological care is typically addressed by general practitioners, and genetic diagnosis is not available through regular medical channels. The diagnosis and management of neurodegenerative disorders is especially challenging in this setting. Case Report We diagnosed a family with spinocerebellar ataxia type 3 (SCA3) in an underdeveloped nation with limited access to genetic medicine and no full-time neurologist. Discussion Molecular diagnosis of the SCAs can be challenging, even in developed countries. In the Caribbean, genetic testing is generally only available at a small number of academic centers. Diagnosis in this family was ultimately made by utilizing an international, pro bono, research-based collaborative process. Although access to appropriate resources, such as speech, physical, and occupational therapies, is limited on this island because of economic and geographical factors, the provision of a diagnosis appeared to be ultimately beneficial for this family. Identification of affected families highlights the need for access to genetic diagnosis in all communities, and can help direct resources where needed.
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Affiliation(s)
- Ashley K Yearwood
- Department of Biochemistry, St. George's University, St. George's, Grenada, West Indies
| | - Shruthi Rethi
- Department of Biochemistry, St. George's University, St. George's, Grenada, West Indies
| | - Karla P Figueroa
- University of Utah, Department of Neurology, Salt Lake City, UT, USA
| | - Ruth H Walker
- Department of Neurology, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA.,Department of Neurology, Mount Sinai School of Medicine, New York City, NY, USA
| | - Andrew K Sobering
- Department of Biochemistry, St. George's University, St. George's, Grenada, West Indies
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25
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Rodríguez-Díaz JC, Velázquez-Pérez L, Rodríguez Labrada R, Aguilera Rodríguez R, Laffita Pérez D, Canales Ochoa N, Medrano Montero J, Estupiñán Rodríguez A, Osorio Borjas M, Góngora Marrero M, Reynaldo Cejas L, González Zaldivar Y, Almaguer Gotay D. Neurorehabilitation therapy in spinocerebellar ataxia type 2: A 24-week, rater-blinded, randomized, controlled trial. Mov Disord 2018; 33:1481-1487. [PMID: 30132999 DOI: 10.1002/mds.27437] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 03/28/2018] [Accepted: 04/17/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Neurorehabilitation has become in a widely used approach in spinocerebellar ataxias, but there are scarce powerful clinical studies supporting this notion. OBJECTIVE The objective of this study was to assess the efficacy of a 24-week neurorehabilitative treatment in spinocerebellar ataxia type 2 patients. METHODS A total of 38 spinocerebellar ataxia type 2 patients were enrolled in a rater-blinded, 1:1 randomized, controlled trial using neurorehabilitation for 24 weeks. The treated group received 6 hours of neurorehabilitation therapy, emphasizing on balance, coordination, and muscle strengthening on weekdays, whereas the control group did not receive this intervention. Primary outcome measure was the Scale for the Assessment and Rating of Ataxia score, whereas secondary outcome measures included the count of Inventory of Non-Ataxia Symptoms and saccadic eye movement variables. RESULTS The rehabilitated group had high levels of adherence and retention to the therapy and showed a significant decrease of Scale for the Assessment and Rating of Ataxia score at 24 weeks when compared with the controls, mainly for the gait, stance, sitting, finger chase, and heel-shin test items. Changes in Scale for the Assessment and Rating of Ataxia scores were inversely correlated with the mutation size in the rehabilitated group. The nonataxia symptom count and saccadic measures were unchanged during the study. CONCLUSIONS A comprehensive 24-week rehabilitation program significantly improves the motor cerebellar symptoms of spinocerebellar ataxia type 2 patients as assessed by the ataxia rating score likely as result of the partial preservation of motor learning and neural plasticity mechanisms. These findings provide evidence in support of this therapeutic approach as palliative treatment in spinocerebellar ataxia type 2 suggesting its use in combination with other symptomatic or neuroprotective drugs and in prodromal stages. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
| | - Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Cuban Academy of Sciences, Havana, Cuba.,School of Physical Culture and Sport, University of Holguín, Holguín, Cuba
| | - Roberto Rodríguez Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Cuban Academy of Sciences, Havana, Cuba.,School of Physical Culture and Sport, University of Holguín, Holguín, Cuba
| | | | | | - Nalia Canales Ochoa
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | - Jacqueline Medrano Montero
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,School of Physical Culture and Sport, University of Holguín, Holguín, Cuba
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26
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Almaguer-Mederos L, Mesa J, González-Zaldívar Y, Almaguer-Gotay D, Cuello-Almarales D, Aguilera-Rodríguez R, Falcón N, Gispert S, Auburger G, Velázquez-Pérez L. Factors associated with ATXN2
CAG/CAA repeat intergenerational instability in Spinocerebellar ataxia type 2. Clin Genet 2018; 94:346-350. [DOI: 10.1111/cge.13380] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 05/01/2018] [Indexed: 12/13/2022]
Affiliation(s)
- L.E. Almaguer-Mederos
- Center for Investigation and Rehabilitation of Hereditary Ataxias; Holguín Cuba
- Medical University of Holguín; Holguín Cuba
| | - J.M.L. Mesa
- Center for Investigation and Rehabilitation of Hereditary Ataxias; Holguín Cuba
| | - Y. González-Zaldívar
- Center for Investigation and Rehabilitation of Hereditary Ataxias; Holguín Cuba
- Medical University of Holguín; Holguín Cuba
| | - D. Almaguer-Gotay
- Center for Investigation and Rehabilitation of Hereditary Ataxias; Holguín Cuba
- Medical University of Holguín; Holguín Cuba
| | - D. Cuello-Almarales
- Center for Investigation and Rehabilitation of Hereditary Ataxias; Holguín Cuba
| | - R. Aguilera-Rodríguez
- Center for Investigation and Rehabilitation of Hereditary Ataxias; Holguín Cuba
- Medical University of Holguín; Holguín Cuba
| | - N.S. Falcón
- Center for Investigation and Rehabilitation of Hereditary Ataxias; Holguín Cuba
| | - S. Gispert
- Experimental Neurology; Goethe University Medical School; Frankfurt am Main Germany
| | - G. Auburger
- Experimental Neurology; Goethe University Medical School; Frankfurt am Main Germany
| | - L. Velázquez-Pérez
- Center for Investigation and Rehabilitation of Hereditary Ataxias; Holguín Cuba
- Medical University of Holguín; Holguín Cuba
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Walker RH, Gatto EM, Bustamante ML, Bernal-Pacheco O, Cardoso F, Castilhos RM, Chana-Cuevas P, Cornejo-Olivas M, Estrada-Bellmann I, Jardim LB, López-Castellanos R, López-Contreras R, Maia DP, Mazzetti P, Miranda M, Rodríguez-Violante M, Teive H, Tumas V. Huntington's disease-like disorders in Latin America and the Caribbean. Parkinsonism Relat Disord 2018; 53:10-20. [PMID: 29853295 DOI: 10.1016/j.parkreldis.2018.05.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 04/24/2018] [Accepted: 05/18/2018] [Indexed: 12/11/2022]
Abstract
Diseases with a choreic phenotype can be due to a variety of genetic etiologies. As testing for Huntington's disease (HD) becomes more available in previously resource-limited regions, it is becoming apparent that there are patients in these areas with other rare genetic conditions which cause an HD-like phenotype. Documentation of the presence of these conditions is important in order to provide appropriate diagnostic and clinical care for these populations. Information for this article was gathered in two ways; the literature was surveyed for publications reporting a variety of genetic choreic disorders, and movement disorders specialists from countries in Latin America and the Caribbean were contacted regarding their experiences with chorea of genetic etiology. Here we discuss the availability of molecular diagnostics for HD and for other choreic disorders, along with a summary of the published reports of affected subjects, and authors' personal experiences from the regions. While rare, patients affected by non-HD genetic choreas are evidently present in Latin America and the Caribbean. HD-like 2 is particularly prevalent in countries where the population has African ancestry. The incidence of other conditions is likely determined by other variations in ethnic background and settlement patterns. As genetic resources and awareness of these disorders improve, more patients are likely to be identified, and have the potential to benefit from education, support, and ultimately molecular therapies.
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Affiliation(s)
- Ruth H Walker
- Department of Neurology, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA; Mount Sinai School of Medicine, New York, NY, USA.
| | - Emilia M Gatto
- Sanatorio Trinidad Mitre, INEBA, Buenos Aires, Argentina
| | - M Leonor Bustamante
- Human Genetics Program, Biomedical Sciences Institute, and Department of Psychiatry North Division, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | | | | | - Raphael M Castilhos
- Neurology Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Pedro Chana-Cuevas
- Facultad de Ciencias Medicas, Universidad de Santiago de Chile, Santiago, Chile
| | - Mario Cornejo-Olivas
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | | | - Laura B Jardim
- Departamento de Medicina Interna, Universidade Federal do Rio Grande do Sul, Brazil; Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Brazil
| | - Ricardo López-Castellanos
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Debora P Maia
- The Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Pilar Mazzetti
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Marcelo Miranda
- Department of Neurology, Clinica Las Condes, Santiago, Chile
| | | | - Helio Teive
- Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clínicas, Federal University of Parana, Curitiba, Brazil
| | - Vitor Tumas
- Department of Neuroscience and Behavior Sciences, Ribeirao Preto School of Medicine, University of Sao Paulo, Ribeirao Preto, Brazil
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28
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Velázquez-Pérez L, Rodríguez-Labrada R, Torres-Vega R, Ortega-Sánchez R, Medrano-Montero J, González-Piña R, Vázquez-Mojena Y, Auburger G, Ziemann U. Progression of corticospinal tract dysfunction in pre-ataxic spinocerebellar ataxia type 2: A two-years follow-up TMS study. Clin Neurophysiol 2018; 129:895-900. [PMID: 29550649 DOI: 10.1016/j.clinph.2018.01.066] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 01/13/2018] [Accepted: 01/23/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Corticospinal tract (CST) dysfunction is common in the pre-ataxic stage of spinocerebellar ataxia type 2 (SCA2) but quantitative assessment of its progression over time has not been explored. The aim of this study was to quantify the progression of CST dysfunction in pre-ataxic SCA2 using transcranial magnetic stimulation (TMS). METHODS Thirty-three pre-ataxic SCA2 mutation carriers and a 33 age- and gender-matched healthy controls were tested at baseline and 2-years follow-up by standardized clinical exams, validated clinical scales, and TMS. RESULTS Pre-ataxic SCA2 mutation carriers showed a significant increase of resting motor thresholds (RMT) to abductor pollicis brevis (APB) and tibialis anterior (TA) muscles, and of central motor conduction time (CMCT) to TA at 2-years follow-up, over and above changes in healthy controls. The changes in the pre-ataxic SCA2 mutation carriers were independent of the presence of clinical signs of CST dysfunction at baseline, and independent of conversion to clinically definite SCA2 at 2-years follow-up. CONCLUSIONS TMS markers of CST dysfunction progress significantly during the pre-ataxic stage of SCA2. SIGNIFICANCE TMS measures of CST dysfunction may provide biomarkers of disease progression prior to clinical disease expression that have potential utility for monitoring neuroprotective therapies in future clinical trials.
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Affiliation(s)
- Luis Velázquez-Pérez
- Dept. Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba; Medical University of Holguin "Mariana Grajales", Holguín, Cuba.
| | - Roberto Rodríguez-Labrada
- Dept. Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba; School of Physical Culture, University of Holguín, Holguín, Cuba
| | - Reidenis Torres-Vega
- Dept. Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | - Ricardo Ortega-Sánchez
- Dept. Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | - Jacqueline Medrano-Montero
- Dept. Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba; School of Physical Culture, University of Holguín, Holguín, Cuba
| | | | - Yaimeé Vázquez-Mojena
- Dept. Molecular Neurobiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Cuba
| | - Georg Auburger
- Exp. Neurology, Building 89, Goethe University Medical School, Theodor Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - Ulf Ziemann
- Dept. Neurology & Stroke, and Hertie Institute for Clinical Brain Research, University Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany.
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Reetz K, Rodríguez-Labrada R, Dogan I, Mirzazade S, Romanzetti S, Schulz JB, Cruz-Rivas EM, Alvarez-Cuesta JA, Aguilera Rodríguez R, Gonzalez Zaldivar Y, Auburger G, Velázquez-Pérez L. Brain atrophy measures in preclinical and manifest spinocerebellar ataxia type 2. Ann Clin Transl Neurol 2018; 5:128-137. [PMID: 29468174 PMCID: PMC5817824 DOI: 10.1002/acn3.504] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 10/06/2017] [Accepted: 10/21/2017] [Indexed: 01/11/2023] Open
Abstract
Objective Spinocerebellar ataxia type 2 (SCA2) is an autosomal dominantly inherited neurodegenerative disease mainly affecting the cerebellum and brainstem. In this Cuban-German research collaboration, we aimed to characterize atrophy patterns and associations with clinical measures in preclinical and manifest SCA2. Methods In this study, 16 nonmanifest SCA2 mutation carriers, 26 manifest patients with SCA2, and 18 healthy control subjects underwent magnetic resonance imaging, as well as genetic and clinical characterization including assessment of ataxia (Scale for the Assessment and Rating of Ataxia) and saccade velocity in Cuba were enrolled. Semiautomated quantitative volumetry of the cerebellum and brainstem, subdivided into the medulla oblongata, the pontine brainstem, and mesencephalon was performed. Additionally, the anteroposterior diameter of the pontine brainstem was measured. Results Analysis of volumetric data revealed degeneration of the cerebellum and brainstem, in particular of pontine volumes and the anteroposterior diameter of the pons, in both manifest SCA2 patients and individuals at risk for SCA2 compared to controls. Comparing patients with nonataxic preclinical SCA2 mutation carriers, we found more pronounced reductions of the pontine brainstem and cerebellum in manifest SCA2. Volumetric data further showed associations with CAG repeat length and predicted age of onset in preclinical SCA2 individuals, and by trend with ataxia signs in patients. Although saccade velocity was associated with reduction in the pontine brainstem in preclinical and manifest SCA2, reduced ability to suppress interfering stimuli measured by the Stroop task was related to cerebellar volume loss in patients. Interpretation Preclinical SCA2 mutation carriers exhibit brain abnormalities, which could be targeted as surrogate parameters for disease progression and in future preventive trials.
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Affiliation(s)
- Kathrin Reetz
- Department of Neurology RWTH Aachen University Pauwelsstr. 3052074 Aachen Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging Forschungszentrum Jülich GmbH and RWTH Aachen University 52074 Aachen Germany
| | - Roberto Rodríguez-Labrada
- Department Clinical Neurophysiology Centre for the Research and Rehabilitation of Hereditary Ataxias Calle Libertad 26 Holguín 80100 Cuba
| | - Imis Dogan
- Department of Neurology RWTH Aachen University Pauwelsstr. 3052074 Aachen Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging Forschungszentrum Jülich GmbH and RWTH Aachen University 52074 Aachen Germany
| | - Shahram Mirzazade
- Department of Neurology RWTH Aachen University Pauwelsstr. 3052074 Aachen Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging Forschungszentrum Jülich GmbH and RWTH Aachen University 52074 Aachen Germany
| | - Sandro Romanzetti
- Department of Neurology RWTH Aachen University Pauwelsstr. 3052074 Aachen Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging Forschungszentrum Jülich GmbH and RWTH Aachen University 52074 Aachen Germany
| | - Jörg B Schulz
- Department of Neurology RWTH Aachen University Pauwelsstr. 3052074 Aachen Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging Forschungszentrum Jülich GmbH and RWTH Aachen University 52074 Aachen Germany
| | - Edilia M Cruz-Rivas
- Department of Imaging Clinical-Surgical Hospital "Lucía Iñiguez". Avenue "Celia Sanchez 1 Holguín Cuba
| | - Jose A Alvarez-Cuesta
- Department of Imaging Clinical-Surgical Hospital "Lucía Iñiguez". Avenue "Celia Sanchez 1 Holguín Cuba
| | - Raul Aguilera Rodríguez
- Department Clinical Neurophysiology Centre for the Research and Rehabilitation of Hereditary Ataxias Calle Libertad 26 Holguín 80100 Cuba
| | - Yanetza Gonzalez Zaldivar
- Department Molecular Genetics Centre for the Research and Rehabilitation of Hereditary Ataxias Calle Libertad 26 Holguín 80100 Cuba
| | - Georg Auburger
- Experimental Neurology Goethe University Medical School 60590 Frankfurt/Main Germany
| | - Luis Velázquez-Pérez
- Department Clinical Neurophysiology Centre for the Research and Rehabilitation of Hereditary Ataxias Calle Libertad 26 Holguín 80100 Cuba
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Rodríguez-Labrada R, Vázquez-Mojena Y, Canales-Ochoa N, Medrano-Montero J, Velázquez-Pérez L. Heritability of saccadic eye movements in spinocerebellar ataxia type 2: insights into an endophenotype marker. CEREBELLUM & ATAXIAS 2017; 4:19. [PMID: 29276612 PMCID: PMC5738191 DOI: 10.1186/s40673-017-0078-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 12/07/2017] [Indexed: 12/19/2022]
Abstract
Background Saccade slowing has been proposed as endophenotype marker in Spinocerebellar Ataxia type 2 (SCA2), nevertheless the heritability of this trait has not been properly demonstrated. Thus the present paper was aimed to assess the heritability of different saccadic parameters in SCA2. Methods Forty-eight SCA2 patients, 25 preclinical carriers and 24 non-SCA2 mutation carriers underwent electronystagmographical assessments of saccadic eye movements as well as neurological examination and ataxia scoring. Estimates of heritability based on the intraclass correlation coefficients were calculated for saccade velocity, accuracy and latency as well as for age at disease onset from 36, 17 and 15 sibling pairs of SCA2 patients, preclinical carriers and controls, respectively. Results Saccade velocity was significantly reduced in SCA2 patients and preclinical carriers, whereas decreased saccade accuracy and increased saccade latency were only observed in the patients cohort. Intraclass correlation coefficient for saccade velocity was highly significant in SCA2 patients, estimating a heritability around 94%, whereas for the age at ataxia onset this estimate was around 68%. Conclusions Electronystagmographical measure of saccade velocity showed higher familial aggregation between SCA2 patients leading the suitability of this disease feature as endophenotype marker, with potential usefulness for the search of modifier genes and neurobiological underpinnings of the disease and as outcome measure in future neuroprotective clinical trials.
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Affiliation(s)
- Roberto Rodríguez-Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Calle Libertad 26, 80100 Holguín, Cuba.,School of Physical Culture, University of Holguín, 25th street 104, 80100 Holguín, Cuba
| | - Yaimeé Vázquez-Mojena
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Calle Libertad 26, 80100 Holguín, Cuba
| | - Nalia Canales-Ochoa
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Calle Libertad 26, 80100 Holguín, Cuba
| | - Jacqueline Medrano-Montero
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Calle Libertad 26, 80100 Holguín, Cuba.,School of Physical Culture, University of Holguín, 25th street 104, 80100 Holguín, Cuba
| | - Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Calle Libertad 26, 80100 Holguín, Cuba.,Medical University of Holguín, Lenin Avenue 4, 80100 Holguín, Cuba
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Velázquez-Pérez L, Tünnerhoff J, Rodríguez-Labrada R, Torres-Vega R, Ruiz-Gonzalez Y, Belardinelli P, Medrano-Montero J, Canales-Ochoa N, González-Zaldivar Y, Vazquez-Mojena Y, Auburger G, Ziemann U. Early corticospinal tract damage in prodromal SCA2 revealed by EEG-EMG and EMG-EMG coherence. Clin Neurophysiol 2017; 128:2493-2502. [PMID: 29101844 DOI: 10.1016/j.clinph.2017.10.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 09/18/2017] [Accepted: 10/08/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Clinical data suggest early involvement of the corticospinal tract (CST) in spinocerebellar ataxia type 2 (SCA2). Here we tested if early CST degeneration can be detected in prodromal SCA2 mutation carriers by electrophysiological markers of CST integrity. METHODS CST integrity was tested in 15 prodromal SCA2 mutation carriers, 19 SCA2 patients and 25 age-matched healthy controls, using corticomuscular (EEG-EMG) and intermuscular (EMG-EMG) coherence measures in upper and lower limb muscles. RESULTS Significant reductions of EEG-EMG and EMG-EMG coherences were observed in the SCA2 patients, and to a similar extent in the prodromal SCA2 mutation carriers. In prodromal SCA2, EEG-EMG and EMG-EMG coherences correlated with the predicted time to ataxia onset. CONCLUSIONS Findings indicate early CST neurodegeneration in SCA2. EEG-EMG and EMG-EMG coherence may serve as biomarkers of early CST neurodegeneration in prodromal SCA2 mutation carriers. SIGNIFICANCE Findings are important for developing preclinical disease markers in the context of currently emerging disease-modifying therapies of neurodegenerative disorders.
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Affiliation(s)
- Luis Velázquez-Pérez
- Dept. Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, 80100 Holguín, Cuba.
| | - Johannes Tünnerhoff
- Dept. Neurology & Stroke, and Hertie Institute for Clinical Brain Research, University Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany
| | - Roberto Rodríguez-Labrada
- Dept. Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, 80100 Holguín, Cuba
| | - Reidenis Torres-Vega
- Dept. Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, 80100 Holguín, Cuba
| | - Yusely Ruiz-Gonzalez
- Center for Studies on Electronics and Information Technologies, Central University of Las Villas, Villa Clara, Cuba
| | - Paolo Belardinelli
- Dept. Neurology & Stroke, and Hertie Institute for Clinical Brain Research, University Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany
| | - Jacqueline Medrano-Montero
- Dept. Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, 80100 Holguín, Cuba
| | - Nalia Canales-Ochoa
- Dept. Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, 80100 Holguín, Cuba
| | - Yanetza González-Zaldivar
- Dept. Molecular Neurobiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, 80100 Holguín, Cuba
| | - Yaimeé Vazquez-Mojena
- Dept. Molecular Neurobiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, 80100 Holguín, Cuba
| | - Georg Auburger
- Exp. Neurology, Building 89, Goethe University Medical School, Theodor Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - Ulf Ziemann
- Dept. Neurology & Stroke, and Hertie Institute for Clinical Brain Research, University Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany.
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Velázquez-Pérez LC, Rodríguez-Labrada R, Fernandez-Ruiz J. Spinocerebellar Ataxia Type 2: Clinicogenetic Aspects, Mechanistic Insights, and Management Approaches. Front Neurol 2017; 8:472. [PMID: 28955296 PMCID: PMC5601978 DOI: 10.3389/fneur.2017.00472] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 08/25/2017] [Indexed: 12/14/2022] Open
Abstract
Spinocerebellar ataxia type 2 (SCA2) is an autosomal dominant cerebellar ataxia that occurs as a consequence of abnormal CAG expansions in the ATXN2 gene. Progressive clinical features result from the neurodegeneration of cerebellum and extra-cerebellar structures including the pons, the basal ganglia, and the cerebral cortex. Clinical, electrophysiological, and imaging approaches have been used to characterize the natural history of the disease, allowing its classification into four distinct stages, with special emphasis on the prodromal stage, which is characterized by a plethora of motor and non-motor features. Neuropathological investigations of brain tissue from SCA2 patients reveal a widespread involvement of multiple brain systems, mainly cerebellar and brainstem systems. Recent findings linking ataxin-2 intermediate expansions to other neurodegenerative diseases such as amyotrophic lateral sclerosis have provided insights into the ataxin-2-related toxicity mechanism in neurodegenerative diseases and have raised new ethical challenges to molecular predictive diagnosis of SCA2. No effective neuroprotective therapies are currently available for SCA2 patients, but some therapeutic options such as neurorehabilitation and some emerging neuroprotective drugs have shown palliative benefits.
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Affiliation(s)
- Luis C Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Medical University of Holguín "Mariana Grajales", Holguín, Cuba
| | - Roberto Rodríguez-Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Physical Culture School, University of Holguin "Oscar Lucero", Holguín, Cuba
| | - Juan Fernandez-Ruiz
- Department of Physiology, Medicine School, UNAM, Cuernavaca, Mexico.,Psychology School, Universidad Veracruzana, Xalapa, Mexico
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Almaguer-Gotay D, Almaguer-Mederos LE, Aguilera-Rodríguez R, Rodríguez-Labrada R, Cuello-Almarales D, Estupiñán-Domínguez A, Velázquez-Pérez LC, González-Zaldívar Y, Vázquez-Mojena Y. Spinocerebellar Ataxia Type 2 Is Associated with the Extracellular Loss of Superoxide Dismutase but Not Catalase Activity. Front Neurol 2017; 8:276. [PMID: 28659860 PMCID: PMC5468381 DOI: 10.3389/fneur.2017.00276] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 05/29/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Spinocerebellar ataxia type 2 (SCA2) is an inherited and still incurable neurodegenerative disorder. Evidence suggests that pro-oxidant agents as well as factors involved in antioxidant cellular defenses are part of SCA2 physiopathology. AIM To assess the influence of superoxide dismutase (SOD3) and catalase (CAT) enzymatic activities on the SCA2 syndrome. METHOD Clinical, molecular, and electrophysiological variables, as well as SOD3 and CAT enzymatic activities were evaluated in 97 SCA2 patients and in 64 age- and sex-matched control individuals. RESULTS Spinocerebellar ataxia type 2 patients had significantly lower SOD3 enzymatic activity than the control group. However, there were no differences between patients and controls for CAT enzymatic activity. The effect size for the loss of patients' SOD3 enzymatic activity was 0.342, corresponding to a moderate effect. SOD3 and CAT enzymatic activities were not associated with the CAG repeat number at the ATXN2 gene. SOD3 and CAT enzymatic activities did not show significant associations with the age at onset, severity score, or the studied electrophysiological markers. CONCLUSION There is a reduced SOD3 enzymatic activity in SCA2 patients with no repercussion on the clinical phenotype.
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Affiliation(s)
- Dennis Almaguer-Gotay
- Center for the Research and Rehabilitation of Hereditary Ataxias (CIRAH), Holguín, Cuba
| | | | | | | | - Dany Cuello-Almarales
- Center for the Research and Rehabilitation of Hereditary Ataxias (CIRAH), Holguín, Cuba
| | | | | | | | - Yaimé Vázquez-Mojena
- Center for the Research and Rehabilitation of Hereditary Ataxias (CIRAH), Holguín, Cuba
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Figueroa KP, Coon H, Santos N, Velazquez L, Mederos LA, Pulst SM. Genetic analysis of age at onset variation in spinocerebellar ataxia type 2. NEUROLOGY-GENETICS 2017; 3:e155. [PMID: 28534046 PMCID: PMC5432368 DOI: 10.1212/nxg.0000000000000155] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 04/03/2017] [Indexed: 12/28/2022]
Abstract
Objective: To examine heritability of the residual variability of spinocerebellar ataxia type 2 (SCA2) age at onset (AO) after controlling for CAG repeat length. Methods: From 1955 to 2001, dates of birth, CAG repeat lengths, AO, sex, familial inheritances, and clinical manifestations were collected for a large Cuban SCA2 cohort of 382 affected individuals, including 129 parent-child pairs and 69 sibships. Analyses were performed with log-transformed AO in the GENMOD procedure to predict AO using repeat length, taking into account family structure. Because all relationships were first degree, the model was implemented with an exchangeable correlation matrix. Familial correlations were estimated using the Pedigree Analysis Package to control for similarity due to genetic relatedness. Results: For the entire sample, the mutant CAG repeat allele explained 69% of AO variance. When adjusted for pedigree structure, this decreased to 50%. Evidence for imprinting or sex-specific effects of the CAG repeat on AO was not found. For the entire sample, we determined an upper bound for heritability of the residual variance of 33% (p = 0.008). Heritability was higher in sib-sib pairs, especially in female sib-sib pairs, than in parent-child pairs. Conclusions: We established that a large proportion of AO variance in SCA2 was determined by genetic modifiers in addition to CAG repeat length. The genetic structure of heritability of the residual AO variance was surprisingly similar to Huntington disease, suggesting the presence of recessive modifying alleles and possibly X-chromosome–linked modifiers.
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Affiliation(s)
- K P Figueroa
- Department of Neurology (K.P.F., S.-M.P.), Department of Psychiatry (H.C.), University of Utah, Salt Lake City; Department of Surgery (N.S.), University of Miami, FL; and Center for the Research and Rehabilitation of Hereditary Ataxias (L.V., L.A.M.), Holguin, Cuba
| | - Hilary Coon
- Department of Neurology (K.P.F., S.-M.P.), Department of Psychiatry (H.C.), University of Utah, Salt Lake City; Department of Surgery (N.S.), University of Miami, FL; and Center for the Research and Rehabilitation of Hereditary Ataxias (L.V., L.A.M.), Holguin, Cuba
| | - Nieves Santos
- Department of Neurology (K.P.F., S.-M.P.), Department of Psychiatry (H.C.), University of Utah, Salt Lake City; Department of Surgery (N.S.), University of Miami, FL; and Center for the Research and Rehabilitation of Hereditary Ataxias (L.V., L.A.M.), Holguin, Cuba
| | - Luis Velazquez
- Department of Neurology (K.P.F., S.-M.P.), Department of Psychiatry (H.C.), University of Utah, Salt Lake City; Department of Surgery (N.S.), University of Miami, FL; and Center for the Research and Rehabilitation of Hereditary Ataxias (L.V., L.A.M.), Holguin, Cuba
| | - Luis Almaguer Mederos
- Department of Neurology (K.P.F., S.-M.P.), Department of Psychiatry (H.C.), University of Utah, Salt Lake City; Department of Surgery (N.S.), University of Miami, FL; and Center for the Research and Rehabilitation of Hereditary Ataxias (L.V., L.A.M.), Holguin, Cuba
| | - Stefan-M Pulst
- Department of Neurology (K.P.F., S.-M.P.), Department of Psychiatry (H.C.), University of Utah, Salt Lake City; Department of Surgery (N.S.), University of Miami, FL; and Center for the Research and Rehabilitation of Hereditary Ataxias (L.V., L.A.M.), Holguin, Cuba
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Velázquez-Pérez L, Rodríguez-Labrada R, Laffita-Mesa JM. Prodromal spinocerebellar ataxia type 2: Prospects for early interventions and ethical challenges. Mov Disord 2017; 32:708-718. [DOI: 10.1002/mds.26969] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/24/2017] [Accepted: 01/30/2017] [Indexed: 12/29/2022] Open
Affiliation(s)
| | | | - José Miguel Laffita-Mesa
- Centre for the Research and Rehabilitation of Hereditary Ataxias; Holguín Cuba
- Department of Clinical Neuroscience; Karolinska Universitetssjukhuset; Stockholm Sweden
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Cornelius N, Wardman JH, Hargreaves IP, Neergheen V, Bie AS, Tümer Z, Nielsen JE, Nielsen TT. Evidence of oxidative stress and mitochondrial dysfunction in spinocerebellar ataxia type 2 (SCA2) patient fibroblasts: Effect of coenzyme Q10 supplementation on these parameters. Mitochondrion 2017; 34:103-114. [PMID: 28263872 DOI: 10.1016/j.mito.2017.03.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 02/11/2017] [Accepted: 03/01/2017] [Indexed: 02/05/2023]
Abstract
Spinocerebellar ataxia type 2 (SCA2) is a rare neurodegenerative disorder caused by a CAG repeat expansion in the ataxin-2 gene. We show increased oxidative stress, abnormalities in the antioxidant system, changes in complexes involved in oxidative phosphorylation and changes in mitochondrial morphology in SCA2 patient fibroblasts compared to controls, and we show that treatment with CoQ10 can partially reverse these changes. Together, our results suggest that oxidative stress and mitochondrial dysfunction may be contributory factors to the pathophysiology of SCA2 and that therapeutic strategies involving manipulation of the antioxidant system could prove to be of clinical benefit.
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Affiliation(s)
- Nanna Cornelius
- Neurogenetics Research Laboratory, Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Jonathan H Wardman
- Neurogenetics Research Laboratory, Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Iain P Hargreaves
- Pharmacy and Biomolecular Sciences, James Parsons Building, John Moore's University, Liverpool L3 3AF, United Kingdom
| | - Viruna Neergheen
- Neurometabolic Unit, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
| | - Anne Sigaard Bie
- Neurogenetics Research Laboratory, Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Zeynep Tümer
- Applied Human Molecular Genetics, Kennedy Center, Department of Clinical Genetics, Rigshospitalet, Glostrup, University of Copenhagen, Denmark
| | - Jørgen E Nielsen
- Neurogenetics Research Laboratory, Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Danish Dementia Research Centre, Neurogenetics Clinic, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Section of Neurogenetics, Department of Cellular and Molecular Medicine, The Panum Institute, University of Copenhagen, Denmark.
| | - Troels T Nielsen
- Neurogenetics Research Laboratory, Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
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Velázquez-Pérez L, Rodríguez-Labrada R, Torres-Vega R, Medrano Montero J, Vázquez-Mojena Y, Auburger G, Ziemann U. Abnormal corticospinal tract function and motor cortex excitability in non-ataxic SCA2 mutation carriers: A TMS study. Clin Neurophysiol 2016; 127:2713-2719. [PMID: 27417041 DOI: 10.1016/j.clinph.2016.05.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 04/14/2016] [Accepted: 05/02/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate if the corticospinal tract is affected in the prodromal stage of spinocerebellar ataxia type 2 (SCA2), prior to development of the cerebellar syndrome. METHODS A cross-sectional study was conducted in 37 non-ataxic SCA2 mutation carriers and in age- and sex-matched healthy controls. All subjects underwent clinical assessment and transcranial magnetic stimulation to determine corticospinal tract integrity to the right abductor pollicis brevis and tibialis anterior muscles. RESULTS Non-ataxic SCA2 mutation carriers showed significantly higher resting and active motor thresholds for both muscles, and prolonged cortical silent periods and central motor conduction times (CMCT), compared to controls. CMCT to the tibialis anterior correlated directly with CAG repeat size, and inversely with predicted time to ataxia onset. CONCLUSION Findings provide novel electrophysiological evidence for affection of the corticospinal tract and motor cortex in prodromal SCA2. Slowed conduction in the corticospinal tract to the lower limbs reflects polyglutamine neurotoxicity, and predicts time to ataxia onset. SIGNIFICANCE Identification of corticospinal tract damage and decreases motor cortical excitability in the prodromal stage of SCA2 allows early disease monitoring. This will become important as soon as effective neuroprotective treatment will be available.
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Affiliation(s)
- Luis Velázquez-Pérez
- Dept. Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street 26, Holguin 80100, Cuba.
| | - Roberto Rodríguez-Labrada
- Dept. Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street 26, Holguin 80100, Cuba
| | - Reidenis Torres-Vega
- Dept. Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street 26, Holguin 80100, Cuba
| | - Jacqueline Medrano Montero
- Dept. Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street 26, Holguin 80100, Cuba
| | - Yaimeé Vázquez-Mojena
- Dept. Molecular Neurobiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad Street 26, Holguin 80100, Cuba
| | - Georg Auburger
- Exp. Neurology, Building 89, Goethe University Medical School, Theodor Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - Ulf Ziemann
- Dept. Neurology & Stroke, and Hertie Institute for Clinical Brain Research, University Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany
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Krysa W, Sulek A, Rakowicz M, Szirkowiec W, Zaremba J. High relative frequency of SCA1 in Poland reflecting a potential founder effect. Neurol Sci 2016; 37:1319-25. [PMID: 27193757 PMCID: PMC4956719 DOI: 10.1007/s10072-016-2594-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 04/26/2016] [Indexed: 11/02/2022]
Abstract
Spinocerebellar ataxias (SCAs) have irregular distributions worldwide. SCA1 is the most frequent in Poland, and no cases of SCA3 of Polish origin has yet been identified. In view of such patterns of SCAs occurrence, the relative frequency, geographical distribution and a possible founder effect of SCA1 were investigated. DNA samples of 134 probands with SCA1 and 228 controls were analysed. The genotyping of four markers, D6S89, D6S109, D6S274, D6S288, around the ATXN1 gene (SCA1) and sequencing of the selected variant of D6S89 were performed. The relative frequency of SCA1 was 68 %. The studied SCA1 pedigrees were irregularly distributed, with the highest concentration in Central Poland. Haplotyping revealed the association of ATXN1 gene mutation with a 197-bp variant of D6S89 marker (63 % of probands) and with a 184-bp variant of DS6274 (50.7 % of probands). Out of 61 SCA1 probands from Mazowieckie, 41 carried the same 197-bp variant. SCA1 relative frequency in Poland shows the highest value compared with the data from other countries worldwide. Due to the association with the mutation obtained for the investigated markers and the SCA1 pedigrees concentration in Central Poland, we hypothesise that it represents a potential founder effect.
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Affiliation(s)
- Wioletta Krysa
- Department of Genetics, Institute of Psychiatry and Neurology, Sobieskiego 9 Street, 02-957, Warsaw, Poland.
| | - Anna Sulek
- Department of Genetics, Institute of Psychiatry and Neurology, Sobieskiego 9 Street, 02-957, Warsaw, Poland
| | - Maria Rakowicz
- Department of Clinical Neurophysiology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Walentyna Szirkowiec
- Department of Genetics, Institute of Psychiatry and Neurology, Sobieskiego 9 Street, 02-957, Warsaw, Poland
| | - Jacek Zaremba
- Department of Genetics, Institute of Psychiatry and Neurology, Sobieskiego 9 Street, 02-957, Warsaw, Poland
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Platonov FA, Tyryshkin K, Tikhonov DG, Neustroyeva TS, Sivtseva TM, Yakovleva NV, Nikolaev VP, Sidorova OG, Kononova SK, Goldfarb LG, Renwick NM. Genetic fitness and selection intensity in a population affected with high-incidence spinocerebellar ataxia type 1. Neurogenetics 2016; 17:179-85. [PMID: 27106293 DOI: 10.1007/s10048-016-0481-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 04/10/2016] [Indexed: 11/30/2022]
Abstract
Spinocerebellar ataxia type 1 (SCA1) is the major and likely the only type of autosomal dominant cerebellar ataxia in the Sakha (Yakut) people of Eastern Siberia. The prevalence rate of SCA1 has doubled over the past 21 years peaking at 46 cases per 100,000 rural population. The age at death correlates closely with the number of CAG triplet repeats in the mutant ATXN1 gene (r = -0.81); most patients with low-medium (39-55) repeat numbers survived until the end of reproductive age. The number of CAG repeats expands in meiosis, particularly in paternal transmissions; the average total increase in intergenerational transmissions in our cohort was estimated at 1.6 CAG repeats. The fertility rates of heterozygous carriers of 39-55 CAG repeats in women were no different from those of the general Sakha population. Overall, the survival of mutation carriers through reproductive age, unaltered fertility rates, low childhood mortality in SCA1-affected families, and intergenerational transmission of increasing numbers of CAG repeats in the ATXN1 gene indicate that SCA1 in the Sakha population will be maintained at high prevalence levels. The low (0.19) Crow's index of total selection intensity in our SCA1 cohort implies that this mutation is unlikely to be eliminated through natural selection alone.
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Affiliation(s)
- Fedor A Platonov
- Institute of Health, M.K. Ammosov North-Eastern Federal University, Yakutsk, 677010, The Russian Federation
| | - Kathrin Tyryshkin
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Dmitriy G Tikhonov
- Institute of Health, M.K. Ammosov North-Eastern Federal University, Yakutsk, 677010, The Russian Federation
| | - Tatyana S Neustroyeva
- Institute of Health, M.K. Ammosov North-Eastern Federal University, Yakutsk, 677010, The Russian Federation
| | - Tatyana M Sivtseva
- Institute of Health, M.K. Ammosov North-Eastern Federal University, Yakutsk, 677010, The Russian Federation
| | - Natalya V Yakovleva
- Institute of Health, M.K. Ammosov North-Eastern Federal University, Yakutsk, 677010, The Russian Federation
| | - Valerian P Nikolaev
- Institute of Health, M.K. Ammosov North-Eastern Federal University, Yakutsk, 677010, The Russian Federation
| | - Oksana G Sidorova
- Center for Integrated Medical Research, Academy of Medical Sciences, Yakutsk, 677010, The Russian Federation
| | - Sardana K Kononova
- Center for Integrated Medical Research, Academy of Medical Sciences, Yakutsk, 677010, The Russian Federation
| | - Lev G Goldfarb
- National Institute of Neurological Disorder and Stoke, NIH, Bethesda, MD, 20892, USA.
| | - Neil M Renwick
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, K7L 3N6, Canada
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Rodríguez-Labrada R, Velázquez-Pérez L, Auburger G, Ziemann U, Canales-Ochoa N, Medrano-Montero J, Vázquez-Mojena Y, González-Zaldivar Y. Spinocerebellar ataxia type 2: Measures of saccade changes improve power for clinical trials. Mov Disord 2016; 31:570-8. [DOI: 10.1002/mds.26532] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 11/19/2015] [Accepted: 12/13/2015] [Indexed: 11/11/2022] Open
Affiliation(s)
- Roberto Rodríguez-Labrada
- Department of Clinical Neurophysiology; Center for the Research and Rehabilitation of Hereditary Ataxias; Holguín Cuba
| | - Luis Velázquez-Pérez
- Department of Clinical Neurophysiology; Center for the Research and Rehabilitation of Hereditary Ataxias; Holguín Cuba
| | - Georg Auburger
- Section of Experimental Neurology, Department of Neurology; Goethe University Medical School; Frankfurt am Main Germany
| | - Ulf Ziemann
- Department of Neurology & Stroke, and Hertie Institute for Clinical Brain Research; University Tübingen; Tübingen Germany
| | - Nalia Canales-Ochoa
- Department of Clinical Neurophysiology; Center for the Research and Rehabilitation of Hereditary Ataxias; Holguín Cuba
| | - Jacqueline Medrano-Montero
- Department of Clinical Neurophysiology; Center for the Research and Rehabilitation of Hereditary Ataxias; Holguín Cuba
| | - Yaimeé Vázquez-Mojena
- Department of Molecular Neurobiology; Center for the Research and Rehabilitation of Hereditary Ataxias; Holguín Cuba
| | - Yanetza González-Zaldivar
- Department of Molecular Neurobiology; Center for the Research and Rehabilitation of Hereditary Ataxias; Holguín Cuba
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Abstract
Spinocerebellar ataxia -2 is a progressive, degenerative genetic disease caused by an expanded (CAG) trinucleotide repetition on the chromosome 12 resulting in production of an abnormal protein called ataxin-2. There is no known effective management or cure in biomedicine for this genetic disease. In the present study a case of SCA2 that was treated with Ayurvedic intervention is reported. Ayurvedic treatments in this case were directed towards alleviating symptoms and to reduce severe disability due to progressive nature of disease. A 42 year old male patient was diagnosed for Vāta vyādhi (group of various neurological disorders) and was- treated with Śālisastika pinda svedana (sudation with bolus of medicated cooked rice) for 30 days-, Śirobasti (sudation of head with the help of a cap on head) with Aśvagandhā taila for 45 days and Balādi ksīra basti (enema with medicated milk) with Aśvagandhā taila anuvāsana (enema with oil) for 30 days in Karma basti krama (30 days regime of purification and oleation enema) along with a combination of Ayurvedic oral drugs which consisted of Brahadvātacintāmanirasa - 125 mg, Vasantāmaltī rasa- 125 mg, Daśamūla kvātha- 40 ml, Aśvagandhā cūrṇa (powder of Withania somnifera DUNAL)- 3g, Amrtā cūrṇa (powder of Tinospora cordifolia Willd.)- 500 mg, Muktāśukti pisti - 500 mg, Yogarāja Guggulu - 500 mg twice a day for 2 months. Patient's condition was assessed on the Scale for Assessment and Rating of Ataxia (SARA). Before treatment, mean SARA score was 35. This reduced to 15 after treatment. Good relief in dysarthria, fasciculation, heaviness in eye, blurred vision, axial tremor; constipation and quality of life were observed in this case.
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Affiliation(s)
- Sarvesh Kumar Singh
- Department of Panchkarma, National Institute of Ayurveda, Jaipur, Rajasthan, India
| | - Kshipra Rajoria
- Department of Panchkarma, M.J.F. Ayurvedic College and Hospital, Jaipur, Rajasthan, India
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Spinocerebellar ataxias in Venezuela: genetic epidemiology and their most likely ethnic descent. J Hum Genet 2015; 61:215-22. [DOI: 10.1038/jhg.2015.131] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 09/08/2015] [Accepted: 10/09/2015] [Indexed: 12/13/2022]
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Neurogenetics in Peru: clinical, scientific and ethical perspectives. J Community Genet 2015; 6:251-7. [PMID: 26013639 DOI: 10.1007/s12687-015-0239-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 05/18/2015] [Indexed: 10/23/2022] Open
Abstract
Neurogenetics, the science that studies the genetic basis of the development and function of the nervous system, is a discipline of recent development in Peru, an emerging Latin American country. Herein, we review the clinical, scientific and ethical aspects regarding the development of this discipline, starting with the first molecular diagnosis of neurogenetic diseases, to family and population-based genetic association studies. Neurogenetics in Peru aims to better explain the epidemiology of monogenic and complex neurodegenerative disorders that will help in implementing public health policies for these disorders. The characterization of Peru and its health system, legal issues regarding rare diseases and the historical milestones in neurogenetics are also discussed.
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Comprehensive study of early features in spinocerebellar ataxia 2: delineating the prodromal stage of the disease. THE CEREBELLUM 2015; 13:568-79. [PMID: 24906824 DOI: 10.1007/s12311-014-0574-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The prodromal phase of spinocerebellar ataxias (SCAs) has not been systematically studied. Main findings come from a homogeneous SCA type 2 (SCA2) population living in Cuba. The aim of this study was to characterize extensively the prodromal phase of SCA2 by several approaches. Thirty-seven non-ataxic SCA2 mutation carriers and its age- and sex-matched controls underwent clinical assessments, including standardized neurological exam, structured interviews and clinical scales, and looking for somatic and autonomic features, as well as a neuropsychological battery, antisaccadic recordings, and MRI scans. Main clinical somatic features of non-ataxic mutation carriers were cramps, sensory symptoms, sleep disorders, and hyperreflexia, whereas predominating autonomic symptoms were pollakiuria/nocturia, constipation, and frequent throat clearing. Cognitive impairments included early deficits of executive functions and visual memory, suggesting the involvement of cerebro-cerebellar-cerebral loops and/or reduced cholinergic basal forebrain input to the cortex. Antisaccadic task revealed impaired oculomotor inhibitory control but preserved ability for error correction. Cognitive and antisaccadic deficits were higher as carriers were closer to the estimated onset of ataxia, whereas higher Scale for the Assessment and Rating of Ataxia (SARA) scores were associated most notably to vermis atrophy. The recognition of early features of SCA2 offers novel insights into the prodromal phase and physiopathological base of the disease, allowing the assessment of its progression and the efficacy of treatments, in particular at early phases when therapeutical options should be most effective.
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Cruz-Mariño T, Vázquez-Mojena Y, Velázquez-Pérez L, González-Zaldívar Y, Aguilera-Rodríguez R, Velázquez-Santos M, Estupiñán-Rodríguez A, Laffita-Mesa JM, Almaguer-Mederos LE, Paneque M. SCA2 predictive testing in Cuba: challenging concepts and protocol evolution. J Community Genet 2015; 6:265-73. [PMID: 25893506 DOI: 10.1007/s12687-015-0226-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 04/08/2015] [Indexed: 12/14/2022] Open
Abstract
Spinocerebellar ataxia type 2 (SCA2) is a neurodegenerative disease caused by a CAG repeat expansion in the ATXN2 gene. Cuba has the highest prevalence (6.57 cases/10(5) inhabitants) of SCA2 in the world. The existence of 753 affected individuals and 7173 relatives at risk prompted the development in 2001 of the first predictive testing program in the country. The medical records of over 1193 individuals, who requested the test within a 13-year period, were analyzed retrospectively. The presymptomatic and the prenatal tests had uptake rates of 43.4 and 23.9 %, respectively. Several ethical challenges resulted from this program. These include the following: (1) withdrawal due to the initial protocol's length; (2) the request to participate by 16 at-risk adolescents; (3) the decision made by ten out of 33 couples with a test-positive fetus to carry the pregnancy to term, leading to de facto predictive testing of minors; (4) the elevated frequency of the ATXN2 gene large normal alleles (≥23 to 31 repeats) in the reference population. These issues have led to major changes in the guidelines of the predictive testing protocol: (1) the protocol length was shortened; (2) the inclusion criteria were expanded to reach at-risk adolescents with an interest in prenatal diagnosis; (3) interdisciplinary follow-up was offered to families in which test-positive fetuses were not aborted; (4) prenatal testing was made available to carriers of large normal alleles with ≥27 CAG repeats. The profiles of the participants were similar to those reported for other predictive testing programs for conditions like Huntington disease and familial adenomatous polyposis. The genetic counseling practices at the community level, the ample health education provided to the at-risk population, together with multidisciplinary and specialized attention to the affected families, are lessons from the Cuban experience that can be relevant for other international teams conducting predictive testing for other late-onset neurodegenerative disorders.
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Affiliation(s)
- Tania Cruz-Mariño
- Predictive Genetics Department, Center for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba,
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González-Zaldívar Y, Vázquez-Mojena Y, Laffita-Mesa JM, Almaguer-Mederos LE, Rodríguez-Labrada R, Sánchez-Cruz G, Aguilera-Rodríguez R, Cruz-Mariño T, Canales-Ochoa N, MacLeod P, Velázquez-Pérez L. Epidemiological, clinical, and molecular characterization of Cuban families with spinocerebellar ataxia type 3/Machado-Joseph disease. CEREBELLUM & ATAXIAS 2015; 2:1. [PMID: 26331044 PMCID: PMC4552099 DOI: 10.1186/s40673-015-0020-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 02/12/2015] [Indexed: 12/20/2022]
Abstract
Background Spinocerebellar Ataxia Type 3/Machado-Joseph Disease (SCA3/MJD) is a hereditary neurodegenerative disorder resulting from the expansion of CAG repeats in the ATXN3 gene. It is the most common autosomal dominant ataxia in the world, but its frequency prevalence in Cuba remains uncertain. We undertook a national study in order to characterize the ATXN3 gene and to determine the prevalence of SCA3/MJD in Cuba. Results Twenty-two individuals belonging to 8 non-related families were identified as carriers of an expanded ATXN3 allele. The affected families come from the central and western region of the country. Ataxia of gait was the initial symptom in all of the cases. The normal alleles ranged between 14 and 33 CAG repeats while the expanded ones ranged from 63 to 77 repeats. The mean age at onset was 40 ± 9 years and significantly correlated with the number of CAG repeats in the expanded alleles. Conclusions This disorder was identified as the second most common form of spinocerebellar ataxia (SCA) in Cuba based on molecular testing, and showing a different geographical distribution from that of SCA2. This research constitutes the first clinical and molecular characterization of Cuban SCA3 families, opening the way for the implementation of predictive diagnosis for at risk family members.
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Affiliation(s)
- Yanetza González-Zaldívar
- Centre for the Research and Rehabilitation of Hereditary Ataxias (CIRAH), Libertad Street 26, Holguín, Postal code 80100 Cuba
| | - Yaimeé Vázquez-Mojena
- Centre for the Research and Rehabilitation of Hereditary Ataxias (CIRAH), Libertad Street 26, Holguín, Postal code 80100 Cuba
| | - José M Laffita-Mesa
- Centre for the Research and Rehabilitation of Hereditary Ataxias (CIRAH), Libertad Street 26, Holguín, Postal code 80100 Cuba
| | - Luis E Almaguer-Mederos
- Centre for the Research and Rehabilitation of Hereditary Ataxias (CIRAH), Libertad Street 26, Holguín, Postal code 80100 Cuba
| | - Roberto Rodríguez-Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias (CIRAH), Libertad Street 26, Holguín, Postal code 80100 Cuba
| | - Gilberto Sánchez-Cruz
- Centre for the Research and Rehabilitation of Hereditary Ataxias (CIRAH), Libertad Street 26, Holguín, Postal code 80100 Cuba
| | - Raúl Aguilera-Rodríguez
- Centre for the Research and Rehabilitation of Hereditary Ataxias (CIRAH), Libertad Street 26, Holguín, Postal code 80100 Cuba
| | - Tania Cruz-Mariño
- Centre for the Research and Rehabilitation of Hereditary Ataxias (CIRAH), Libertad Street 26, Holguín, Postal code 80100 Cuba
| | - Nalia Canales-Ochoa
- Centre for the Research and Rehabilitation of Hereditary Ataxias (CIRAH), Libertad Street 26, Holguín, Postal code 80100 Cuba
| | - Patrick MacLeod
- Division of Medical Genetics, Department of Pathology, Laboratory Medicine and Medical Genetics, Victoria General Hospital, Victoria, Canada
| | - Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias (CIRAH), Libertad Street 26, Holguín, Postal code 80100 Cuba
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Salas-Vargas J, Mancera-Gervacio J, Velázquez-Pérez L, Rodrígez-Labrada R, Martínez-Cruz E, Magaña JJ, Durand-Rivera A, Hernández-Hernández O, Cisneros B, Gonzalez-Piña R. Spinocerebellar ataxia type 7: a neurodegenerative disorder with peripheral neuropathy. Eur Neurol 2015; 73:173-8. [PMID: 25614072 DOI: 10.1159/000370239] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 11/30/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Autosomal dominant spinocerebellar ataxias (SCA) are a group of inherited neurodegenerative disorders that typically show peripheral neuropathy. SCA7 is one of the rarest forms of SCA (<1/100,000 individuals). However, the disease shows a prevalence of ∼800/100,000 inhabitants in certain regions of Mexico. This low global prevalence may explain, at least in part, the isolated anecdotal and limited clinical data regarding peripheral neuropathy in SCA7 patients. AIM To assess sensory and motor peripheral nerve action potentials in an SCA7 patients group and in healthy volunteers, and subsequently correlate the electrophysiological findings with clinical and genetic features. MATERIALS AND METHODS We enrolled in our study, 13 symptomatic SCA7 patients with a confirmed molecular and clinical diagnosis, and 19 healthy volunteers as the control group. Nerve conduction studies were carried out using standard electromyography recording methods. The sensory and motor latency, amplitude and conduction velocity were recorded in both experimental groups and analyzed using the Student's t-test. RESULTS SCA7 patients showed a significant prolongation of sensory nerve conduction latencies, as well as a decrease in sensory amplitudes. Decreases in motor amplitudes and peroneal conduction velocity were also observed. Finally, we found an association between CAG repeats and the severity of cerebellar and non-cerebellar symptoms with electrophysiological signs of demyelinization. DISCUSSION Our results reveal the existence of a critical sensorimotor peripheral neuropathy in SCA7 patients. Moreover, we show that using sensitive electrophysiological tools to evaluate nerve conduction can improve the diagnosis and design of therapeutic options based on pharmacological and rehabilitative strategies. CONCLUSION These findings demonstrate that SCA7 is a disease that globally affects the peripheral nervous system.
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Affiliation(s)
- José Salas-Vargas
- Centro de Rehabilitación e Inclusión Social de Veracruz, Xalapa, Mexico
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Executive deficit in spinocerebellar ataxia type 2 is related to expanded CAG repeats: Evidence from antisaccadic eye movements. Brain Cogn 2014; 91:28-34. [DOI: 10.1016/j.bandc.2014.07.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 07/22/2014] [Accepted: 07/28/2014] [Indexed: 11/16/2022]
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Velázquez-Pérez L, Rodríguez-Labrada R, Canales-Ochoa N, Montero JM, Sánchez-Cruz G, Aguilera-Rodríguez R, Almaguer-Mederos LE, Laffita-Mesa JM. Progression of early features of spinocerebellar ataxia type 2 in individuals at risk: a longitudinal study. Lancet Neurol 2014; 13:482-9. [DOI: 10.1016/s1474-4422(14)70027-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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