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Govaarts R, Doorenweerd N, Najac CF, Broek EM, Tamsma ME, Hollingsworth KG, Niks EH, Ronen I, Straub V, Kan HE. Probing diffusion of water and metabolites to assess white matter microstructure in Duchenne muscular dystrophy. NMR IN BIOMEDICINE 2024:e5212. [PMID: 39005110 DOI: 10.1002/nbm.5212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 05/15/2024] [Accepted: 06/15/2024] [Indexed: 07/16/2024]
Abstract
Duchenne muscular dystrophy (DMD) is a progressive X-linked neuromuscular disorder caused by the absence of functional dystrophin protein. In addition to muscle, dystrophin is expressed in the brain in both neurons and glial cells. Previous studies have shown altered white matter microstructure in patients with DMD using diffusion tensor imaging (DTI). However, DTI measures the diffusion properties of water, a ubiquitous molecule, making it difficult to unravel the underlying pathology. Diffusion-weighted spectroscopy (DWS) is a complementary technique which measures diffusion properties of cell-specific intracellular metabolites. Here we performed both DWS and DTI measurements to disentangle intra- and extracellular contributions to white matter changes in patients with DMD. Scans were conducted in patients with DMD (15.5 ± 4.6 y/o) and age- and sex-matched healthy controls (16.3 ± 3.3 y/o). DWS measurements were obtained in a volume of interest (VOI) positioned in the left parietal white matter. Apparent diffusion coefficients (ADCs) were calculated for total N-acetylaspartate (tNAA), choline compounds (tCho), and total creatine (tCr). The tNAA/tCr and tCho/tCr ratios were calculated from the non-diffusion-weighted spectrum. Mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD), and fractional anisotropy of water within the VOI were extracted from DTI measurements. DWS and DTI data from patients with DMD (respectively n = 20 and n = 18) and n = 10 healthy controls were included. No differences in metabolite ADC or in concentration ratios were found between patients with DMD and controls. In contrast, water diffusion (MD, t = -2.727, p = 0.011; RD, t = -2.720, p = 0.011; AD, t = -2.715, p = 0.012) within the VOI was significantly higher in patients compared with healthy controls. Taken together, our study illustrates the potential of combining DTI and DWS to gain a better understanding of microstructural changes and their association with disease mechanisms in a clinical setting.
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Affiliation(s)
- Rosanne Govaarts
- C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Duchenne Centre Netherlands, Leiden, The Netherlands
| | - Nathalie Doorenweerd
- C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- John Walton Muscular Dystrophy Research Centre, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Chloé F Najac
- C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Emma M Broek
- C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Maud E Tamsma
- C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Kieren G Hollingsworth
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Erik H Niks
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Duchenne Centre Netherlands, Leiden, The Netherlands
| | - Itamar Ronen
- C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, Brighton, UK
| | - Volker Straub
- John Walton Muscular Dystrophy Research Centre, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Hermien E Kan
- C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Duchenne Centre Netherlands, Leiden, The Netherlands
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Arreguin AJ, Shao Z, Colognato H. Dmd mdx mice have defective oligodendrogenesis, delayed myelin compaction and persistent hypomyelination. Dis Model Mech 2024; 17:dmm050115. [PMID: 38721692 PMCID: PMC11095635 DOI: 10.1242/dmm.050115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/28/2024] [Indexed: 05/18/2024] Open
Abstract
Duchenne muscular dystrophy (DMD) is caused by mutations in the DMD gene, resulting in the loss of dystrophin, a large cytosolic protein that links the cytoskeleton to extracellular matrix receptors in skeletal muscle. Aside from progressive muscle damage, many patients with DMD also have neurological deficits of unknown etiology. To investigate potential mechanisms for DMD neurological deficits, we assessed postnatal oligodendrogenesis and myelination in the Dmdmdx mouse model. In the ventricular-subventricular zone (V-SVZ) stem cell niche, we found that oligodendrocyte progenitor cell (OPC) production was deficient, with reduced OPC densities and proliferation, despite a normal stem cell niche organization. In the Dmdmdx corpus callosum, a large white matter tract adjacent to the V-SVZ, we also observed reduced OPC proliferation and fewer oligodendrocytes. Transmission electron microscopy further revealed significantly thinner myelin, an increased number of abnormal myelin structures and delayed myelin compaction, with hypomyelination persisting into adulthood. Our findings reveal alterations in oligodendrocyte development and myelination that support the hypothesis that changes in diffusion tensor imaging seen in patients with DMD reflect developmental changes in myelin architecture.
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Affiliation(s)
- Andrea J. Arreguin
- Department of Pharmacological Sciences, Stony Brook University, Stony Brook, NY 11794, USA
- Medical Scientist Training Program (MSTP), Stony Brook University, Stony Brook, NY 11794-8651, USA
| | - Zijian Shao
- Department of Pharmacological Sciences, Stony Brook University, Stony Brook, NY 11794, USA
| | - Holly Colognato
- Department of Pharmacological Sciences, Stony Brook University, Stony Brook, NY 11794, USA
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3
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Pezzoni L, Brusa R, Difonzo T, Magri F, Velardo D, Corti S, Comi GP, Saetti MC. Cognitive abnormalities in Becker muscular dystrophy: a mysterious link between dystrophin deficiency and executive functions. Neurol Sci 2024; 45:1691-1698. [PMID: 37968431 PMCID: PMC10943145 DOI: 10.1007/s10072-023-07169-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/28/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Distrophinopathies are a heterogeneous group of neuromuscular disorders due to mutations in the DMD gene. Different isoforms of dystrophin are also expressed in the cerebral cortex and Purkinje cells. Despite cognitive abnormalities in Duchenne muscular dystrophy subjects that have been described in the literature, little is known about a comprehensive cognitive profile in Becker muscular dystrophy patients. AIM The aim of this study was to assess cognitive functioning in Becker muscular dystrophy patients by using an extensive neuropsychological battery. Our hypothesis is that the most impaired functions are the highly intentional and conscious ones, such as working memory functions, which require a prolonged state of cellular activation. METHODS We performed an extensive neuropsychological assessment on 28 Becker muscular dystrophy patients from 18 to 65 years old. As control subjects, we selected 20 patients with limb-girdle muscular dystrophy, whose clinical picture was similar except for cognitive integrity. The evaluation, although extended to all areas, was focused on prefrontal control skills, with a distinction between inhibitory processes of selective attention and activating processes of working memory. RESULTS AND CONCLUSIONS Significant underperformances were found exclusively in the Dual Task and PASAT tests, to demonstrate a selective impairment of working memory that, while not causing intellectual disability, reduces the intellectual potential of patients with Becker muscular dystrophy.
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Affiliation(s)
- Laura Pezzoni
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
| | - Roberta Brusa
- ASST Ovest Milanese, Ospedale Di Legnano, Neurology Unit, Legnano, Milan, Italy
| | - Teresa Difonzo
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
| | - Francesca Magri
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
| | - Daniele Velardo
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neuromuscular and Rare Diseases Unit, Milan, Italy
| | - Stefania Corti
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neuromuscular and Rare Diseases Unit, Milan, Italy
- Department of Pathophysiology and Transplants, Dino Ferrari Center, University of Milan, Milan, Italy
| | - Giacomo Pietro Comi
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
- Department of Pathophysiology and Transplants, Dino Ferrari Center, University of Milan, Milan, Italy
| | - Maria Cristina Saetti
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy.
- Department of Pathophysiology and Transplants, Dino Ferrari Center, University of Milan, Milan, Italy.
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4
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Geuens S, Van Dessel J, Govaarts R, Ikelaar NA, Meijer OC, Kan HE, Niks EH, Goemans N, Lemiere J, Doorenweerd N, De Waele L. Comparison of two corticosteroid regimens on brain volumetrics in patients with Duchenne muscular dystrophy. Ann Clin Transl Neurol 2023; 10:2324-2333. [PMID: 37822297 PMCID: PMC10723242 DOI: 10.1002/acn3.51922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE Duchenne muscular dystrophy (DMD) is a neuromuscular disorder in which many patients also have neurobehavioral problems. Corticosteroids, the primary pharmacological treatment for DMD, have been shown to affect brain morphology in other conditions, but data in DMD are lacking. This study aimed to investigate the impact of two corticosteroid regimens on brain volumetrics in DMD using magnetic resonance imaging (MRI). METHODS In a cross-sectional, two-center study, T1-weighted MRI scans were obtained from three age-matched groups (9-18 years): DMD patients treated daily with deflazacort (DMDd, n = 20, scan site: Leuven), DMD patients treated intermittently with prednisone (DMDi, n = 20, scan site: Leiden), and healthy controls (n = 40, both scan sites). FSL was used to perform voxel-based morphometry analyses and to calculate intracranial, total brain, gray matter, white matter, and cerebrospinal fluid volumes. A MANCOVA was employed to compare global volumetrics between groups, with site as covariate. RESULTS Both patient groups displayed regional differences in gray matter volumes compared to the control group. The DMDd group showed a wider extent of brain regions affected and a greater difference overall. This was substantiated by the global volume quantification: the DMDd group, but not the DMDi group, showed significant differences in gray matter, white matter, and cerebrospinal fluid volumes compared to the control group, after correction for intracranial volume. INTERPRETATION Volumetric differences in the brain are considered part of the DMD phenotype. This study suggests an additional impact of corticosteroid treatment showing a contrast between pronounced alterations seen in patients receiving daily corticosteroid treatment and more subtle differences in those treated intermittently.
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Affiliation(s)
- Sam Geuens
- Child NeurologyUniversity Hospitals LeuvenLeuvenBelgium
- Department of Development and RegenerationKU LeuvenLeuvenBelgium
| | - Jeroen Van Dessel
- Department of Neurosciences, Center for Developmental PsychiatryUPC‐KU LeuvenLeuvenBelgium
| | - Rosanne Govaarts
- C.J. Gorter MRI Center, RadiologyLeiden University Medical CenterLeidenNetherlands
- Duchenne Center NetherlandsLeidenNetherlands
| | - Nadine A. Ikelaar
- Duchenne Center NetherlandsLeidenNetherlands
- Department of NeurologyLeiden University Medical CenterLeidenNetherlands
| | - Onno C. Meijer
- Department of MedicineLeiden University Medical CenterLeidenNetherlands
| | - Hermien E. Kan
- C.J. Gorter MRI Center, RadiologyLeiden University Medical CenterLeidenNetherlands
- Duchenne Center NetherlandsLeidenNetherlands
| | - Erik H. Niks
- Duchenne Center NetherlandsLeidenNetherlands
- Department of NeurologyLeiden University Medical CenterLeidenNetherlands
| | | | - Jurgen Lemiere
- Pediatric Hemato‐OncologyUniversity Hospitals LeuvenLeuvenBelgium
- Department Oncology, Pediatric OncologyKU LeuvenLeuvenBelgium
| | - Nathalie Doorenweerd
- C.J. Gorter MRI Center, RadiologyLeiden University Medical CenterLeidenNetherlands
| | - Liesbeth De Waele
- Child NeurologyUniversity Hospitals LeuvenLeuvenBelgium
- Department of Development and RegenerationKU LeuvenLeuvenBelgium
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5
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Andrews JG, Galindo MK, Thomas S, Mathews KD, Whitehead N. DMD Gene and Dystrophinopathy Phenotypes Associated With Mutations: A Systematic Review for Clinicians. J Clin Neuromuscul Dis 2023; 24:171-187. [PMID: 37219861 DOI: 10.1097/cnd.0000000000000436] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
ABSTRACT The diagnosis of Duchenne and Becker muscular dystrophy (DBMD) is made by genetic testing in approximately 95% of cases. Although specific mutations can be associated with skeletal muscle phenotype, pulmonary and cardiac comorbidities (leading causes of death in Duchenne) have not been associated with Duchenne muscular dystrophy mutation type or location and vary within families. Therefore, identifying predictors for phenotype severity beyond frameshift prediction is important clinically. We performed a systematic review assessing research related to genotype-phenotype correlations in DBMD. While there are severity differences across the spectrum and within mild and severe forms of DBMD, few protective or exacerbating mutations within the dystrophin gene were reported. Except for intellectual disability, clinical test results reporting genotypic information are insufficient for clinical prediction of severity and comorbidities and the predictive validity is too low to be useful when advising families. Including expanded information coupled with proposed severity predictions in clinical genetic reports for DBMD is critical for improving anticipatory guidance.
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Affiliation(s)
- Jennifer G Andrews
- Department of Pediatrics, College of Medicine, University of Arizona, Tucson, AZ
| | | | | | - Katherine D Mathews
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA; and
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6
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Crawford AH, Hornby NL, de la Fuente AG, Piercy RJ. Brain magnetic resonance imaging in the DE50-MD dog model of Duchenne muscular dystrophy reveals regional reductions in cerebral gray matter. BMC Neurosci 2023; 24:21. [PMID: 36932329 PMCID: PMC10024360 DOI: 10.1186/s12868-023-00788-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 02/24/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Duchenne muscular dystrophy is a X-linked disease characterized by severe and progressive muscle weakness, alongside cognitive impairment and a range of neurobehavioral disorders secondary to brain dystrophin deficiency. Duchenne muscular dystrophy patients have reduced cerebral gray matter and altered white matter ultrastructure (detected by magnetic resonance imaging) compared to age-matched controls. METHODS We studied the DE50-MD canine model of Duchenne muscular dystrophy, which is deficient in full length brain dystrophin (Dp427) isoforms and has a neurocognitive phenotype. Eight DE50-MD and 6 age-matched littermate wild type male dogs underwent serial brain magnetic resonance imaging from 14 to 33 months of age. RESULTS Reduced regional gray matter was detected in DE50-MD dogs compared with wildtype, including the piriform lobe, hippocampus and cingulate gyrus. Lateral ventricle volume was larger in DE50-MD dogs. Differences did not progress over time. White matter volume did not differ between DE50-MD and wildtype dogs. There was no difference in brain nor cranial vault volume between DE50-MD and wildtype dogs. CONCLUSION Dystrophin deficiency in the canine brain results in structural changes that likely contribute to the neurocognitive phenotype.
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Affiliation(s)
- Abbe H. Crawford
- grid.20931.390000 0004 0425 573XComparative Neuromuscular Diseases Laboratory, Department of Clinical Science and Services, Royal Veterinary College, London, UK
| | - Natasha L. Hornby
- grid.20931.390000 0004 0425 573XComparative Neuromuscular Diseases Laboratory, Department of Clinical Science and Services, Royal Veterinary College, London, UK
| | - Alerie G. de la Fuente
- grid.513062.30000 0004 8516 8274Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, Spain
- Institute of Neurosciences CSIC-UMH, San Juan de Alicante, Spain
- grid.4777.30000 0004 0374 7521Wellcome-Wolfson Institute for Experimental Medicine, Queen’s University, Belfast, UK
| | - Richard J. Piercy
- grid.20931.390000 0004 0425 573XComparative Neuromuscular Diseases Laboratory, Department of Clinical Science and Services, Royal Veterinary College, London, UK
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7
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Cheng B, Xu H, Zhou H, Guo Y, Roberts N, Li N, Hu X, Chen X, Xu K, Lan Y, Ma X, Cai X, Guo Y. Connectomic disturbances in Duchenne muscular dystrophy with mild cognitive impairment. Cereb Cortex 2023:6982730. [PMID: 36627244 DOI: 10.1093/cercor/bhac542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 01/12/2023] Open
Abstract
Duchenne muscular dystrophy (DMD) is frequently associated with mild cognitive deficits. However, the underlying disrupted brain connectome and the neural basis remain unclear. In our current study, 38 first-episode, treatment-naive patients with DMD and 22 matched healthy controls (HC) were enrolled and received resting-sate functional magnetic resonance imaging scans. Voxel-based degree centrality (DC), seed-based functional connectivity (FC), and clinical correlation were performed. Relative to HC, DMD patients had lower height, full Intellectual Quotients (IQ), and IQ-verbal comprehension. Significant increment of DC of DMD patients were found in the left dorsolateral prefrontal cortex (DLPFC.L) and right dorsomedial prefrontal cortex (DMPFC.R), while decreased DC were found in right cerebellum posterior lobe (CPL.R), right precentral/postcentral gyrus (Pre/Postcentral G.R). DMD patients had stronger FC in CPL.R-bilateral lingual gyrus, Pre/Postcentral G.R-Insular, and DMPFC.R-Precuneus.R, had attenuated FC in DLPFC.L-Insular. These abnormally functional couplings were closely associated with the extent of cognitive impairment, suggested an over-activation of default mode network and executive control network, and a suppression of primary sensorimotor cortex and cerebellum-visual circuit. The findings collectively suggest the distributed brain connectome disturbances maybe a neuroimaging biomarker in DMD patients with mild cognitive impairment.
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Affiliation(s)
- Bochao Cheng
- Department of Radiology, West China Second University Hospital, Sichuan University, South Renmin Road, Wuhou District, Chengdu, 610041, China.,Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Guoxue Street, Wuhou District, Chengdu, 610041, China
| | - Huayan Xu
- Department of Radiology, West China Second University Hospital, Sichuan University, South Renmin Road, Wuhou District, Chengdu, 610041, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, South Renmin Road, Wuhou District, Chengdu, 610041, China
| | - Hui Zhou
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, South Renmin Road, Wuhou District, Chengdu, 610041, China
| | - Yi Guo
- Department of Radiology, West China Second University Hospital, Sichuan University, South Renmin Road, Wuhou District, Chengdu, 610041, China.,Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Guoxue Street, Wuhou District, Chengdu, 610041, China
| | - Neil Roberts
- Edinburgh Imaging Facility, School of Clinical Sciences, The Queen's Medical Research Institute (QMRI), University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, United Kingdom
| | - Na Li
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, South Renmin Road, Wuhou District, Chengdu, 610041, China
| | - Xiao Hu
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, South Renmin Road, Wuhou District, Chengdu, 610041, China
| | - Xijian Chen
- Department of Radiology, West China Second University Hospital, Sichuan University, South Renmin Road, Wuhou District, Chengdu, 610041, China
| | - Ke Xu
- Department of Radiology, West China Second University Hospital, Sichuan University, South Renmin Road, Wuhou District, Chengdu, 610041, China
| | - Yu Lan
- Department of Radiology, West China Second University Hospital, Sichuan University, South Renmin Road, Wuhou District, Chengdu, 610041, China
| | - Xuejing Ma
- Department of Radiology, The First People's Hospital of Zunyi, Zunyi Medical University, Fenghuang Road, Huichuan District, Zunyi, 563099, China
| | - Xiaotang Cai
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, South Renmin Road, Wuhou District, Chengdu, 610041, China
| | - Yingkun Guo
- Department of Radiology, West China Second University Hospital, Sichuan University, South Renmin Road, Wuhou District, Chengdu, 610041, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, South Renmin Road, Wuhou District, Chengdu, 610041, China
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8
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Colvin MK, Truba N, Sorensen S, Henricson E, Kinnett K. Dystrophinopathy and the brain: A parent project muscular dystrophy (PPMD) meeting report November 11-12, 2021, New York City, NY. Neuromuscul Disord 2022; 32:935-944. [PMID: 36323606 DOI: 10.1016/j.nmd.2022.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Mary K Colvin
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
| | - Natalie Truba
- Department of Psychology and Neurology, Nationwide Children's Hospital, Columbus, OH, USA
| | | | | | - Kathi Kinnett
- Parent Project Muscular Dystrophy, Washington DC, USA
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9
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Pascual-Morena C, Cavero-Redondo I, Álvarez-Bueno C, Jiménez-López E, Saz-Lara A, Martínez-García I, Martínez-Vizcaíno V. Global prevalence of intellectual developmental disorder in dystrophinopathies: A systematic review and meta-analysis. Dev Med Child Neurol 2022; 65:734-744. [PMID: 36440509 DOI: 10.1111/dmcn.15481] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 09/16/2022] [Accepted: 11/08/2022] [Indexed: 11/29/2022]
Abstract
AIM To estimate the global prevalence of intellectual developmental disorder (IDD) and the IDD prevalence-genotype association in Becker muscular dystrophy (BMD) or Duchenne muscular dystrophy (DMD) according to the affected isoforms of the DMD gene: Dp427, Dp140, Dp71. METHOD Systematic searches in MEDLINE, Scopus, Web of Science, and the Cochrane Library were conducted from inception of each database to March 2022. Observational studies that determined the prevalence of IDD in the population with BMD or DMD were included. Meta-analyses of IDD prevalence and prevalence ratios of the IDD-genotype association were conducted. RESULTS Forty-nine studies were included. The prevalence of IDD in BMD was 8.0% (95% confidence interval 5.0-11.0), and in DMD it was 22.0% (18.0-27.0). Meta-analyses of IDD-genotype association showed a deleterious association between IDD and the number of isoforms affected in DMD, with a prevalence ratio = 0.43 (0.28-0.64) and 0.17 (0.09-0.34) for Dp140+ /Dp71+ versus Dp140- /Dp71+ and Dp140+ /Dp71+ versus Dp140- /Dp71- comparisons respectively. However, in BMD, there was no association for Dp140+ /Dp71+ versus Dp140- /Dp71+ . INTERPRETATION There is a high prevalence of IDD in BMD and DMD. Moreover, the number of isoforms affected is strongly and negatively associated with the prevalence of IDD in DMD.
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Affiliation(s)
| | - Iván Cavero-Redondo
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.,Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Alicia Saz-Lara
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | | | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.,Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
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10
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Kaplan KM, Morgan KG. The importance of dystrophin and the dystrophin associated proteins in vascular smooth muscle. Front Physiol 2022; 13:1059021. [PMID: 36505053 PMCID: PMC9732661 DOI: 10.3389/fphys.2022.1059021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/14/2022] [Indexed: 11/26/2022] Open
Abstract
This review details the role of dystrophin and the dystrophin associated proteins (DAPs) in the vascular smooth muscle. Dystrophin is most comprehensively studied in the skeletal muscle due to serious symptoms found related to the skeletal muscle of patients with muscular dystrophy. Mutations in the dystrophin gene, or DAPs genes, result in a wide range of muscular dystrophies. In skeletal muscle, dystrophin is known to act to as a cytoskeletal stabilization protein and protects cells against contraction-induced damage. In skeletal muscle, dystrophin stabilizes the plasma membrane by transmitting forces generated by sarcomeric contraction to the extracellular matrix (ECM). Dystrophin is a scaffold that binds the dystroglycan complex (DGC) and has many associated proteins (DAPs). These DAPs include sarcoglycans, syntrophins, dystroglycans, dystrobrevin, neuronal nitric oxide synthase, and caveolins. The DAPs provide biomechanical support to the skeletal or cardiac plasma membrane during contraction, and loss of one or several of these DAPs leads to plasma membrane fragility. Dystrophin is expressed near the plasma membrane of all muscles, including cardiac and vascular smooth muscle, and some neurons. Dystrophic mice have noted biomechanical irregularities in the carotid arteries and spontaneous motor activity in portal vein altered when compared to wild type mice. Additionally, some studies suggest the vasculature of patients and animal models with muscular dystrophy is abnormal. Although the function of dystrophin and the DAPs in vascular smooth muscle is not thoroughly established in the field, this review makes the point that these proteins are expressed, and important and further study is warranted.
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11
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Lange J, Gillham O, Alkharji R, Eaton S, Ferrari G, Madej M, Flower M, Tedesco FS, Muntoni F, Ferretti P. Dystrophin deficiency affects human astrocyte properties and response to damage. Glia 2022; 70:466-490. [PMID: 34773297 DOI: 10.1002/glia.24116] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 01/03/2023]
Abstract
In addition to progressive muscular degeneration due to dystrophin mutations, 1/3 of Duchenne muscular dystrophy (DMD) patients present cognitive deficits. However, there is currently an incomplete understanding about the function of the multiple dystrophin isoforms in human brains. Here, we tested the hypothesis that dystrophin deficiency affects glial function in DMD and could therefore contribute to neural impairment. We investigated human dystrophin isoform expression with development and differentiation and response to damage in human astrocytes from control and induced pluripotent stem cells from DMD patients. In control cells, short dystrophin isoforms were up-regulated with development and their expression levels changed differently upon neuronal and astrocytic differentiation, as well as in 2-dimensional versus 3-dimensional astrocyte cultures. All DMD-astrocytes tested displayed altered morphology, proliferative activity and AQP4 expression. Furthermore, they did not show any morphological change in response to inflammatory stimuli and their number was significantly lower as compared to stimulated healthy astrocytes. Finally, DMD-astrocytes appeared to be more sensitive than controls to oxidative damage as shown by their increased cell death. Behavioral and metabolic defects in DMD-astrocytes were consistent with gene pathway dysregulation shared by lines with different mutations as demonstrated by bulk RNA-seq analysis. Together, our DMD model provides evidence for altered astrocyte function in DMD suggesting that defective astrocyte responses may contribute to neural impairment and might provide additional potential therapeutic targets.
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Affiliation(s)
- Jenny Lange
- Department of Developmental Biology and Cancer, Stem Cells and Regenerative Medicine Section, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Olivia Gillham
- Department of Developmental Biology and Cancer, Stem Cells and Regenerative Medicine Section, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Reem Alkharji
- Department of Developmental Biology and Cancer, Stem Cells and Regenerative Medicine Section, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Simon Eaton
- Department of Developmental Biology and Cancer, Stem Cells and Regenerative Medicine Section, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Giulia Ferrari
- Department of Cell and Developmental Biology, University College London, London, UK
| | - Monika Madej
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Michael Flower
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Francesco Saverio Tedesco
- Department of Cell and Developmental Biology, University College London, London, UK
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- The Francis Crick Institute, 1 Midland Road, London, UK
| | - Francesco Muntoni
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, Great Ormond Street Institute of Child Health, University College London, & Great Ormond Street Hospital Trust, London, UK
| | - Patrizia Ferretti
- Department of Developmental Biology and Cancer, Stem Cells and Regenerative Medicine Section, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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12
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Mori-Yoshimura M, Aizawa K, Shigemoto Y, Ishihara N, Minami N, Nishino I, Yoshida S, Sato N, Takahashi Y. Frontal lobe-dominant cerebral blood flow reduction and atrophy can be progressive in Duchenne muscular dystrophy. Neuromuscul Disord 2022; 32:477-485. [DOI: 10.1016/j.nmd.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/07/2022] [Accepted: 02/16/2022] [Indexed: 10/19/2022]
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13
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Preethish-Kumar V, Shah A, Polavarapu K, Kumar M, Safai A, Vengalil S, Nashi S, Deepha S, Govindaraj P, Afsar M, Rajeswaran J, Nalini A, Saini J, Ingalhalikar M. Disrupted structural connectome and neurocognitive functions in Duchenne muscular dystrophy: classifying and subtyping based on Dp140 dystrophin isoform. J Neurol 2021; 269:2113-2125. [PMID: 34505932 DOI: 10.1007/s00415-021-10789-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/31/2021] [Accepted: 08/31/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Neurocognitive disabilities in Duchenne muscular dystrophy (DMD) children beginning in early childhood and distal DMD gene deletions involving disruption of Dp140 isoform are more likely to manifest significant neurocognitive impairments. MRI data analysis techniques like brain-network metrics can provide information on microstructural integrity and underlying pathophysiology. METHODS A prospective study on 95 participants [DMD = 57, and healthy controls (HC) = 38]. The muscular dystrophy functional rating scale (MDFRS) scores, neuropsychology batteries, and multiplex ligand-dependent probe amplification (MLPA) testing were used for clinical assessment, IQ estimation, and genotypic classification. Diffusion MRI and network-based statistics were used to analyze structural connectomes at various levels and correlate with clinical markers. RESULTS Motor and executive sub-networks were extracted and analyzed. Out of 57 DMD children, 23 belong to Dp140 + and 34 to Dp140- subgroup. Motor disabilities are pronounced in Dp140- subgroup as reflected by lower MDFRS scores. IQ parameters are significantly low in all-DMD cases; however, the Dp140- has specifically lowest scores. Significant differences were observed in global efficiency, transitivity, and characteristic path length between HC and DMD. Subgroup analysis demonstrates that the significance is mainly driven by participants with Dp140- than Dp140 + isoform. Finally, a random forest classifier model illustrated an accuracy of 79% between HC and DMD and 90% between DMD- subgroups. CONCLUSIONS Current findings demonstrate structural network-based characterization of abnormalities in DMD, especially prominent in Dp140-. Our observations suggest that participants with Dp140 + have relatively intact connectivity while Dp140- show widespread connectivity alterations at global, nodal, and edge levels. This study provides valuable insights supporting the genotype-phenotype correlation of brain-behavior involvement in DMD children.
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Affiliation(s)
| | - Apurva Shah
- Symbiosis Centre for Medical Image Analysis, Symbiosis International University, Mulshi, Pune, Maharashtra, India
| | - Kiran Polavarapu
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Manoj Kumar
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Apoorva Safai
- Symbiosis Centre for Medical Image Analysis, Symbiosis International University, Mulshi, Pune, Maharashtra, India
| | - Seena Vengalil
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Saraswati Nashi
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Sekar Deepha
- Neuromuscular Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Periyasamy Govindaraj
- Neuromuscular Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Mohammad Afsar
- Department of Neuropsychology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Jamuna Rajeswaran
- Department of Neuropsychology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Atchayaram Nalini
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Jitender Saini
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India.
| | - Madhura Ingalhalikar
- Symbiosis Centre for Medical Image Analysis, Symbiosis International University, Mulshi, Pune, Maharashtra, India.
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14
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Naarding KJ, Doorenweerd N, Koeks Z, Hendriksen RGF, Chotkan KA, Krom YD, de Groot IJM, Straathof CS, Niks EH, Kan HE. Decision-Making And Selection Bias in Four Observational Studies on Duchenne and Becker Muscular Dystrophy. J Neuromuscul Dis 2021; 7:433-442. [PMID: 32925089 PMCID: PMC7902964 DOI: 10.3233/jnd-200541] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Natural history data are essential for trial design in Duchenne (DMD) and Becker muscular dystrophy (BMD), but recruitment for observational studies can be challenging. OBJECTIVE We reviewed reasons why patients or caregivers declined participation, and compared characteristics of participants and non-participants to assess possible selection bias in four observational studies, three on DMD and one on BMD. METHODS Three pediatric DMD studies focused on cross-sectional cognitive function and brain MRI (DMDbrain, n = 35 and DMDperfusion, n = 12), and on longitudinal upper extremity function and muscle MRI (DMDarm, n = 22). One adult BMD study assessed longitudinal functioning (n = 36). Considerations for non-participation were retrospectively reviewed from screening logs. Age, travel-time, DMD gene mutations and age at loss of ambulation (DMDarm and BMD study only), of participants and non-participants were derived from the Dutch Dystrophinopathy Database and compared using nonparametric tests (p < 0.05). RESULTS The perceived burden of the protocol (38.2%), use of MRI (30.4%), and travel-time to the study site (19.1%) were the most frequently reported considerations for non-participation. Only few patients reported lack of personal gain (0.0- 5.9%). Overall, participating patients were representative for the studied sub-populations, except for a younger age of DMDarm study participants and a complete lack of participants with a mutation beyond exon 63. CONCLUSION Optimizing patient involvement in protocol design, improving MRI experiences, and integrating research into clinics are important factors to decrease burden and facilitate participation. Nationwide registries are essential to compare participants and non-participants and ensure representative observational research. Specific effort is needed to include patients with distal mutations in cognitive studies.
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Affiliation(s)
- Karin J Naarding
- Department of Neurology, Leiden University Medical Center (LUMC), Leiden, Netherlands.,Duchenne Center Netherlands
| | - Nathalie Doorenweerd
- C.J. Gorter Center for High Field MRI, Department of Radiology, LUMC, Leiden, Netherlands.,John Walton Muscular Dystrophy Research Centre, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Zaïda Koeks
- Department of Neurology, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Ruben G F Hendriksen
- C.J. Gorter Center for High Field MRI, Department of Radiology, LUMC, Leiden, Netherlands
| | - Kinita A Chotkan
- Department of Neurology, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Yvonne D Krom
- Department of Neurology, Leiden University Medical Center (LUMC), Leiden, Netherlands.,Duchenne Center Netherlands
| | - Imelda J M de Groot
- Duchenne Center Netherlands.,Department of Rehabilitation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Chiara S Straathof
- Department of Neurology, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Erik H Niks
- Department of Neurology, Leiden University Medical Center (LUMC), Leiden, Netherlands.,Duchenne Center Netherlands
| | - Hermien E Kan
- Duchenne Center Netherlands.,C.J. Gorter Center for High Field MRI, Department of Radiology, LUMC, Leiden, Netherlands
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15
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Biagi L, Lenzi S, Cipriano E, Fiori S, Bosco P, Cristofani P, Astrea G, Pini A, Cioni G, Mercuri E, Tosetti M, Battini R. Neural substrates of neuropsychological profiles in dystrophynopathies: A pilot study of diffusion tractography imaging. PLoS One 2021; 16:e0250420. [PMID: 33939732 PMCID: PMC8092766 DOI: 10.1371/journal.pone.0250420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 04/06/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Cognitive difficulties and neuropsychological alterations in Duchenne and Becker muscular dystrophy (DMD, BMD) boys are not yet sufficiently explored, although this topic could have a relevant impact, finding novel biomarkers of disease both at genetics and neuroimaging point of view. The current study aims to: 1) analyze the neuropsychological profile of a group of DMD and BMD boys without cognitive impairment with an assessment of their executive functions; 2) explore the structural connectivity in DMD, BMD, and age-matched controls focusing on cortico-subcortical tracts that connect frontal cortex, basal ganglia, and cerebellum via the thalamus; 3) explore possible correlations between altered structural connectivity and clinical neuropsychological measures. Materials and methods This pilot study included 15 boys (5 DMD subjects, 5 BMD subjects, and 5 age-matched typically developing, TD). They were assessed using a neuropsychological assessment protocol including cognitive and executive functioning assessment and performed a 1.5T MRI brain exam including advance Diffusion Weighted Imaging (DWI) method for tractography. Structural connectivity measurements were extracted along three specific tracts: Cortico-Ponto-Cerebellar Tract (CPCT), Cerebellar-Thalamic Tract (CTT), and Superior Longitudinal Fasciculus (SLF). Cortical-Spinal Tract (CST) was selected for reference, as control tract. Results Regarding intellectual functioning, a major impairment in executive functions compared to the general intellectual functioning was observed both for DMD (mean score = 86.20; SD = 11.54) and for BMD children (mean score = 88; SD = 3.67). Mean FA resulted tendentially always lower in DMD compared to both BMD and TD groups for all the examined tracts. The differences in FA were statistically significant for the right CTT (DMD vs BMD, p = 0.002, and DMD vs TD, p = 0.0015) and the right CPCT (DMD vs TD, p = 0.008). Concerning DMD, significant correlations emerged between FA-R-CTT and intellectual quotients (FIQ, p = 0.044; ρs = 0.821), and executive functions (Denomination Total, p = 0.044, ρs = 0.821; Inhibition Total, p = 0.019, ρs = 0.900). BMD showed a significant correlation between FA-R-CPCT and working memory index (p = 0.007; ρs = 0.949). Discussion and conclusion In this pilot study, despite the limitation of sample size, the findings support the hypothesis of the involvement of a cerebellar-thalamo-cortical loop for the neuropsychological profile of DMD, as the CTT and the CPCT are involved in the network and the related brain structures are known to be implied in executive functions. Our results suggest that altered WM connectivity and reduced fibre organization in cerebellar tracts, probably due to the lack of dystrophin in the brain, may render less efficient some neuropsychological functions in children affected by dystrophinopathies. The wider multicentric study could help to better establish the role of cerebellar connectivity in neuropsychological profile for dystrophinopathies, identifying possible novel diagnostic and prognostic biomarkers.
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Affiliation(s)
- Laura Biagi
- Laboratory of Medical Physics and Magnetic Resonance, IRCCS Fondazione Stella Maris, Calambrone, Pisa, Italy
| | - Sara Lenzi
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa, Italy
| | - Emilio Cipriano
- Laboratory of Medical Physics and Magnetic Resonance, IRCCS Fondazione Stella Maris, Calambrone, Pisa, Italy
- Department of Physics, University of Pisa, Pisa, Italy
| | - Simona Fiori
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa, Italy
| | - Paolo Bosco
- Laboratory of Medical Physics and Magnetic Resonance, IRCCS Fondazione Stella Maris, Calambrone, Pisa, Italy
| | - Paola Cristofani
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa, Italy
| | - Guia Astrea
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa, Italy
| | - Antonella Pini
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa, Italy
| | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Eugenio Mercuri
- Pediatric Neurology Unit, Catholic University and Nemo Center, Policlinico Universitario Gemelli, Rome, Italy
| | - Michela Tosetti
- Laboratory of Medical Physics and Magnetic Resonance, IRCCS Fondazione Stella Maris, Calambrone, Pisa, Italy
| | - Roberta Battini
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- * E-mail:
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16
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Tang F, Xiao D, Chen L, Gao H, Li X. Role of Munc18-1 in the biological functions and pathogenesis of neurological disorders (Review). Mol Med Rep 2021; 23:198. [PMID: 33495808 PMCID: PMC7821349 DOI: 10.3892/mmr.2021.11837] [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: 09/07/2020] [Accepted: 12/30/2020] [Indexed: 11/06/2022] Open
Abstract
The release of neurotransmitters following the fusion of synaptic vesicles and the presynaptic membrane is an important process in the transmission of neuronal information. Syntaxin-binding protein 1 (Munc18-1) is a synaptic fusion protein binding protein, which mainly regulates synaptic vesicle fusion and neurotransmitter release by interacting with soluble N-ethylmaleimide sensitive factor attachment protein receptor. In addition to affecting neurotransmitter transmission, Munc18-1 is also involved in regulating neurosynaptic plasticity, neurodevelopment and neuroendocrine cell release functions (including thyroxine and insulin release). A number of previous studies have demonstrated that Munc18-1 has diverse and vital biological functions, and that its abnormal expression serves an important role in the pathogenesis of a variety of neurological diseases, including epileptic encephalopathy, schizophrenia, autism, Parkinsons disease, Alzheimers disease, multiple sclerosis, Duchennes muscular dystrophy and neuronal ceroid lipofuscinosis. The present review summarizes the function of Munc18-1 and its possible relationship to the pathogenesis of various neurological diseases.
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Affiliation(s)
- Fajuan Tang
- Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Dongqiong Xiao
- Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Lin Chen
- Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Hu Gao
- Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Xihong Li
- Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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17
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Doorenweerd N, de Rover M, Marini-Bettolo C, Hollingsworth KG, Niks EH, Hendriksen JGM, Kan HE, Straub V. Resting-state functional MRI shows altered default-mode network functional connectivity in Duchenne muscular dystrophy patients. Brain Imaging Behav 2021; 15:2297-2307. [PMID: 33389442 PMCID: PMC8500880 DOI: 10.1007/s11682-020-00422-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 07/28/2020] [Accepted: 11/24/2020] [Indexed: 11/29/2022]
Abstract
Duchenne muscular dystrophy (DMD) is an X-linked recessive neuromuscular disorder caused by absence of dystrophin protein. Dystrophin is expressed in muscle, but also in the brain. Difficulties with attention/inhibition, working memory and information processing are well described in DMD patients but their origin is poorly understood. The default mode network (DMN) is one of the networks involved in these processes. Therefore we aimed to assess DMN connectivity in DMD patients compared to matched controls, to better understand the cognitive profile in DMD. T1-weighted and resting state functional MRI scans were acquired from 33 DMD and 24 male age-matched controls at two clinical sites. Scans were analysed using FMRIB Software Library (FSL). Differences in the DMN were assessed using FSL RANDOMISE, with age as covariate and threshold-free cluster enhancement including multiple comparison correction. Post-hoc analyses were performed on the visual network, executive control network and fronto-parietal network with the same methods. In DMD patients, the level of connectivity was higher in areas within the control DMN (hyperconnectivity) and significant connectivity was found in areas outside the control DMN. No hypoconnectivity was found and no differences in the visual network, executive control network and fronto-parietal network. We showed differences both within and in areas outside the DMN in DMD. The specificity of our findings to the DMN can help provide a better understanding of the attention/inhibition, working memory and information processing difficulties in DMD.
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Affiliation(s)
- Nathalie Doorenweerd
- John Walton Muscular Dystrophy Research Centre, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK. .,C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, C-03-Q, P.O. Box 9600, 2300, RC, Leiden, The Netherlands.
| | - Mischa de Rover
- Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands.,Clinical Psychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Chiara Marini-Bettolo
- John Walton Muscular Dystrophy Research Centre, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Kieren G Hollingsworth
- Newcastle Magnetic Resonance Centre, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Erik H Niks
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,
| | - Jos G M Hendriksen
- .,Department of Neurological Learning Disabilities, Kempenhaeghe Epilepsy Center, Heeze, The Netherlands.,Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Hermien E Kan
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, C-03-Q, P.O. Box 9600, 2300, RC, Leiden, The Netherlands.,
| | - Volker Straub
- John Walton Muscular Dystrophy Research Centre, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
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18
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Preethish-Kumar V, Shah A, Kumar M, Ingalhalikar M, Polavarapu K, Afsar M, Rajeswaran J, Vengalil S, Nashi S, Thomas PT, Sadasivan A, Warrier M, Nalini A, Saini J. In Vivo Evaluation of White Matter Abnormalities in Children with Duchenne Muscular Dystrophy Using DTI. AJNR Am J Neuroradiol 2020; 41:1271-1278. [PMID: 32616576 DOI: 10.3174/ajnr.a6604] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 03/23/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND PURPOSE Duchenne muscular dystrophy is an X-linked disorder characterized by progressive muscle weakness and prominent nonmotor manifestations, such as a low intelligence quotient and neuropsychiatric disturbance. We investigated WM integrity in patients with Duchenne muscular dystrophy using DTI. MATERIALS AND METHODS Fractional anisotropy and mean, axial, and radial diffusivity (DTI measures) were used to assess WM microstructural integrity along with neuropsychological evaluation in patients with Duchenne muscular dystrophy (n = 60) and controls (n = 40). Exon deletions in the DMD gene were confirmed using multiplex ligation-dependent probe amplification. Patients were classified into proximal (DMD Dp140+) and distal (DMD Dp140-) subgroups based on the location of the exon deletion and expression of short dystrophin Dp140 isoform. WM integrity was examined using whole-brain Tract-Based Spatial Statistics and atlas-based analysis of DTI data. The Pearson correlation was performed to investigate the possible relationship between neuropsychological scores and DTI metrics. RESULTS The mean ages of Duchenne muscular dystrophy and control participants were 8.0 ± 1.2 years and 8.2 ± 1.4 years, respectively. The mean age at disease onset was 4.1 ± 1.8 years, and mean illness duration was 40.8 ± 25.2 months. Significant differences in neuropsychological scores were observed between the proximal and distal gene-deletion subgroups, with more severe impairment in the distal-deletion subgroup (P < .05). Localized fractional anisotropy changes were seen in the corpus callosum, parietal WM, and fornices in the patient subgroup with Dp140+, while widespread changes were noted in the Dp140- subgroup. The Dp140+ subgroup showed increased axial diffusivity in multiple WM regions relative to the Dp140- subgroup. No significant correlation was observed between clinical and neuropsychological scores and diffusion metrics. CONCLUSIONS Widespread WM differences are evident in patients with Duchenne muscular dystrophy relative to healthy controls. Distal mutations in particular are associated with extensive WM abnormalities and poor neuropsychological profiles.
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Affiliation(s)
| | - A Shah
- Symbiosis Centre for Medical Image Analysis (A.Shah, M.I.), Symbiosis International University, Mulshi Pune, Maharashtra, India
| | - M Kumar
- Neuroimaging and Interventional Radiology (M.K., J.S.)
| | - M Ingalhalikar
- Symbiosis Centre for Medical Image Analysis (A.Shah, M.I.), Symbiosis International University, Mulshi Pune, Maharashtra, India
| | - K Polavarapu
- From the Departments of Neurology (V.P.-K., K.P., S.V., S.N., A.N.)
| | - M Afsar
- Neuropsychology (M.A., J.R.)
| | | | - S Vengalil
- From the Departments of Neurology (V.P.-K., K.P., S.V., S.N., A.N.)
| | - S Nashi
- From the Departments of Neurology (V.P.-K., K.P., S.V., S.N., A.N.)
| | - P T Thomas
- Psychiatric Social Work (P.T.T., A.Sadasivan, M.W.), National Institute of Mental Health and Neurosciences, Bangalore, India
| | - A Sadasivan
- Psychiatric Social Work (P.T.T., A.Sadasivan, M.W.), National Institute of Mental Health and Neurosciences, Bangalore, India
| | - M Warrier
- Psychiatric Social Work (P.T.T., A.Sadasivan, M.W.), National Institute of Mental Health and Neurosciences, Bangalore, India
| | - A Nalini
- From the Departments of Neurology (V.P.-K., K.P., S.V., S.N., A.N.)
| | - J Saini
- Neuroimaging and Interventional Radiology (M.K., J.S.)
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19
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20
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Nardes F, Araújo APDQC, Ribeiro MG, Bittar M, Gomes HF. The Mini-Mental State Examination (MMSE) as a Cognitive Screening Tool in Duchenne Muscular Dystrophy. ANNALS OF CHILD NEUROLOGY 2020. [DOI: 10.26815/acn.2020.00052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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21
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Boehler JF, Ricotti V, Gonzalez JP, Soustek-Kramer M, Such L, Brown KJ, Schneider JS, Morris CA. Membrane recruitment of nNOSµ in microdystrophin gene transfer to enhance durability. Neuromuscul Disord 2019; 29:735-741. [PMID: 31521486 DOI: 10.1016/j.nmd.2019.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 07/23/2019] [Accepted: 07/31/2019] [Indexed: 12/25/2022]
Abstract
Several gene transfer clinical trials are currently ongoing with the common aim of delivering a shortened version of dystrophin, termed a microdystrophin, for the treatment of Duchenne muscular dystrophy (DMD). However, one of the main differences between these trials is the microdystrophin protein produced following treatment. Each gene transfer product is based on different selections of dystrophin domain combinations to assemble microdystrophin transgenes that maintain functional dystrophin domains and fit within the packaging limits of an adeno-associated virus (AAV) vector. While domains involved in mechanical function, such as the actin-binding domain and β-dystroglycan binding domain, have been identified for many years and included in microdystrophin constructs, more recently the neuronal nitric oxide synthase (nNOS) domain has also been identified due to its role in enhancing nNOS membrane localization. As nNOS membrane localization has been established as an important requirement for prevention of functional ischemia in skeletal muscle, inclusion of the nNOS domain into a microdystrophin construct represents an important consideration. The aim of this mini review is to highlight what is currently known about the nNOS domain of dystrophin and to describe potential implications of this domain in a microdystrophin gene transfer clinical trial.
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Affiliation(s)
- Jessica F Boehler
- Solid Biosciences, 141 Portland Street, Cambridge, MA 02139, United States
| | - Valeria Ricotti
- Solid Biosciences, 141 Portland Street, Cambridge, MA 02139, United States
| | - J Patrick Gonzalez
- Solid Biosciences, 141 Portland Street, Cambridge, MA 02139, United States
| | | | - Lauren Such
- Solid Biosciences, 141 Portland Street, Cambridge, MA 02139, United States
| | - Kristy J Brown
- Solid Biosciences, 141 Portland Street, Cambridge, MA 02139, United States
| | - Joel S Schneider
- Solid Biosciences, 141 Portland Street, Cambridge, MA 02139, United States
| | - Carl A Morris
- Solid Biosciences, 141 Portland Street, Cambridge, MA 02139, United States.
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22
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Patel AM, Wierda K, Thorrez L, van Putten M, De Smedt J, Ribeiro L, Tricot T, Gajjar M, Duelen R, Van Damme P, De Waele L, Goemans N, Tanganyika-de Winter C, Costamagna D, Aartsma-Rus A, van Duyvenvoorde H, Sampaolesi M, Buyse GM, Verfaillie CM. Dystrophin deficiency leads to dysfunctional glutamate clearance in iPSC derived astrocytes. Transl Psychiatry 2019; 9:200. [PMID: 31434868 PMCID: PMC6704264 DOI: 10.1038/s41398-019-0535-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 05/07/2019] [Indexed: 12/11/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) results, beside muscle degeneration in cognitive defects. As neuronal function is supported by astrocytes, which express dystrophin, we hypothesized that loss of dystrophin from DMD astrocytes might contribute to these cognitive defects. We generated cortical neuronal and astrocytic progeny from induced pluripotent stem cells (PSC) from six DMD subjects carrying different mutations and several unaffected PSC lines. DMD astrocytes displayed cytoskeletal abnormalities, defects in Ca+2 homeostasis and nitric oxide signaling. In addition, defects in glutamate clearance were identified in DMD PSC-derived astrocytes; these deficits were related to a decreased neurite outgrowth and hyperexcitability of neurons derived from healthy PSC. Read-through molecule restored dystrophin expression in DMD PSC-derived astrocytes harboring a premature stop codon mutation, corrected the defective astrocyte glutamate clearance and prevented associated neurotoxicity. We propose a role for dystrophin deficiency in defective astroglial glutamate homeostasis which initiates defects in neuronal development.
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Affiliation(s)
- Abdulsamie M. Patel
- 0000 0001 0668 7884grid.5596.fStem Cell Institute Leuven, Dept. of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Keimpe Wierda
- 0000000104788040grid.11486.3aCenter for Brain & Disease Research, VIB, Leuven, Belgium
| | - Lieven Thorrez
- 0000 0001 0668 7884grid.5596.fKU Leuven Department of Development and Regeneration, Campus Kulak, Kortrijk, Belgium
| | - Maaike van Putten
- 0000000089452978grid.10419.3dDepartment of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Jonathan De Smedt
- 0000 0001 0668 7884grid.5596.fStem Cell Institute Leuven, Dept. of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Luis Ribeiro
- 0000000104788040grid.11486.3aCenter for Brain & Disease Research, VIB, Leuven, Belgium
| | - Tine Tricot
- 0000 0001 0668 7884grid.5596.fStem Cell Institute Leuven, Dept. of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Madhavsai Gajjar
- 0000 0001 0668 7884grid.5596.fStem Cell Institute Leuven, Dept. of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Robin Duelen
- 0000 0001 0668 7884grid.5596.fStem Cell Institute Leuven, Dept. of Development and Regeneration, KU Leuven, Leuven, Belgium ,0000 0001 0668 7884grid.5596.fTranslational Cardiomyology Lab, Stem Cell Biology and Embryology Unit, KU Leuven, Leuven, Belgium
| | - Philip Van Damme
- 0000000104788040grid.11486.3aCenter for Brain & Disease Research, VIB, Leuven, Belgium ,0000 0001 0668 7884grid.5596.fLaboratory of Neurobiology, Department of Neuroscience, KU Leuven, Leuven, Belgium ,0000 0004 0626 3338grid.410569.fNeurology Department, University Hospitals Leuven, Leuven, Belgium
| | - Liesbeth De Waele
- 0000 0001 0668 7884grid.5596.fKU Leuven Department of Development and Regeneration, Campus Kulak, Kortrijk, Belgium ,0000 0004 0626 3338grid.410569.fDepartment of Paediatric Child Neurology, University Hospitals Leuven, Leuven, Belgium ,0000 0001 0668 7884grid.5596.fVesalius Research Center, Laboratory of Neurobiology, KU Leuven, Leuven, Belgium
| | - Nathalie Goemans
- 0000 0004 0626 3338grid.410569.fDepartment of Paediatric Child Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Christa Tanganyika-de Winter
- 0000000089452978grid.10419.3dDepartment of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Domiziana Costamagna
- 0000 0001 0668 7884grid.5596.fStem Cell Institute Leuven, Dept. of Development and Regeneration, KU Leuven, Leuven, Belgium ,0000 0001 0668 7884grid.5596.fTranslational Cardiomyology Lab, Stem Cell Biology and Embryology Unit, KU Leuven, Leuven, Belgium
| | - Annemieke Aartsma-Rus
- 0000000089452978grid.10419.3dDepartment of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Hermine van Duyvenvoorde
- 0000000089452978grid.10419.3dLaboratory for Diagnostic Genome Analysis, Leiden University Medical Center, Leiden, The Netherlands
| | - Maurilio Sampaolesi
- 0000 0001 0668 7884grid.5596.fStem Cell Institute Leuven, Dept. of Development and Regeneration, KU Leuven, Leuven, Belgium ,0000 0001 0668 7884grid.5596.fTranslational Cardiomyology Lab, Stem Cell Biology and Embryology Unit, KU Leuven, Leuven, Belgium
| | - Gunnar M. Buyse
- 0000 0004 0626 3338grid.410569.fDepartment of Paediatric Child Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Catherine M. Verfaillie
- 0000 0001 0668 7884grid.5596.fStem Cell Institute Leuven, Dept. of Development and Regeneration, KU Leuven, Leuven, Belgium
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23
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Angelini C, Pinzan E. Advances in imaging of brain abnormalities in neuromuscular disease. Ther Adv Neurol Disord 2019; 12:1756286419845567. [PMID: 31105770 PMCID: PMC6503605 DOI: 10.1177/1756286419845567] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 03/05/2019] [Indexed: 01/18/2023] Open
Abstract
Brain atrophy, white matter abnormalities, and ventricular enlargement have been described in different neuromuscular diseases (NMDs). We aimed to provide a comprehensive overview of the substantial advancement of brain imaging in neuromuscular diseases by consulting the main libraries (Pubmed, Scopus and Google Scholar) including the more common forms of muscular dystrophies such as dystrophinopathies, dystroglycanopathies, myotonic dystrophies, facioscapulohumeral dystrophy, limb-girdle muscular dystrophy, congenital myotonia, and congenital myopathies. A consistent, widespread cortical and subcortical involvement of grey and white matter was found. Abnormalities in the functional connectivity in brain networks and metabolic alterations were observed with positron emission tomography (PET) and single photon emission computed tomography (SPECT). Pathological brain changes with cognitive dysfunction seemed to be frequently associated in NMDs. In particular, in congenital muscular dystrophies (CMDs), skeletal muscular weakness, severe hypotonia, WM abnormalities, ventricular dilatation and abnormalities in cerebral gyration were observed. In dystroglycanopathy 2I subtype (LGMD2I), adult patients showed subcortical atrophy and a WM periventricular involvement, moderate ventriculomegaly, and enlargement of subarachnoid spaces. Correlations with clinical features have been observed with brain imaging characteristics and alterations were prominent in congenital or childhood onset cases. In myotonic dystrophy type 2 (DM2) symptoms seem to be less severe than in type 1 (DM1). In Duchenne and Becker muscular dystrophies (DMD, BMD) cortical atrophy is associated with minimal ventricular dilatation and WM abnormalities. Late-onset glycogenosis type II (GSD II) or Pompe infantile forms are characterized by delayed myelination. Only in a few cases of oculopharyngeal muscular dystrophy (OPMD) central nervous system involvement has been described and associated with executive functions impairment.
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Affiliation(s)
- Corrado Angelini
- Fondazione Ospedale San Camillo IRCCS, Via
Alberoni 70, Venezia, 30126, Italia
| | - Elena Pinzan
- Fondazione Ospedale San Camillo IRCCS, Venezia,
Italia
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24
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Lindberg U, Kruuse C, Witting N, Jørgensen SL, Vissing J, Rostrup E, Larsson HBW. Altered somatosensory neurovascular response in patients with Becker muscular dystrophy. Brain Behav 2018; 8:e00985. [PMID: 30106246 PMCID: PMC5991560 DOI: 10.1002/brb3.985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 02/12/2018] [Accepted: 03/31/2018] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Patients with dystrophinopathies show low levels of neuronal nitric oxide synthase (nNOS), due to reduced or absent dystrophin expression, as nNOS is attached to the dystrophin-associated protein complex. Deficient nNOS function leads to functional ischemia during muscle activity. Dystrophin-like proteins with nNOS attached have also been identified in the brain. This suggests that a mechanism of cerebral functional ischemia with attenuation of normal activation-related vascular response may cause changes in brain function. METHODS The aim of this study was to investigate whether the brain response of patients with Becker muscular dystrophy (BMD) is dysfunctional compared to that of healthy controls. To investigate a potential change in brain activation response in patients with BMD, median nerve somatosensory evoked stimulation, with stimulation durations of 2, 4, and 10 s, was performed while recording electroencephalography and blood oxygen level-dependent (BOLD) functional magnetic resonance imaging. RESULTS Results in 14 male patients with BMD (36.2 ± 9.9 years) were compared with those of 10 healthy controls (34.4 ± 10.9 years). Compared to controls, the patients with BMD showed sustained cortical electrical activity and a significant smaller BOLD activation in contralateral primary somatosensory cortex and bilaterally in secondary somatosensory cortex. In addition, significant activation differences were found after long duration (10 s) stimuli in thalamus. CONCLUSION An altered neurovascular response in patients with BMD may increase our understanding of neurovascular coupling and the pathogenesis related to dystrophinopathy and nNOS.
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Affiliation(s)
- Ulrich Lindberg
- Functional Imaging UnitDepartment of Clinical PhysiologyNuclear Medicine and PETRigshospitalet GlostrupUniversity of CopenhagenGlostrupDenmark
- Lundbeck Foundation Center for Neurovascular signalling (LUCENS)Rigshospitalet GlostrupUniversity of CopenhagenGlostrupDenmark
| | - Christina Kruuse
- Lundbeck Foundation Center for Neurovascular signalling (LUCENS)Rigshospitalet GlostrupUniversity of CopenhagenGlostrupDenmark
- Neurovascular Research UnitDepartment of NeurologyHerlev Gentofte HospitalUniversity of CopenhagenHerlevDenmark
| | - Nanna Witting
- Copenhagen Neuromuscular CenterDepartment of NeurologyRigshospitaletUniversity of CopenhagenDenmark
| | - Stine Lundgaard Jørgensen
- Lundbeck Foundation Center for Neurovascular signalling (LUCENS)Rigshospitalet GlostrupUniversity of CopenhagenGlostrupDenmark
- Neurovascular Research UnitDepartment of NeurologyHerlev Gentofte HospitalUniversity of CopenhagenHerlevDenmark
| | - John Vissing
- Copenhagen Neuromuscular CenterDepartment of NeurologyRigshospitaletUniversity of CopenhagenDenmark
| | - Egill Rostrup
- Functional Imaging UnitDepartment of Clinical PhysiologyNuclear Medicine and PETRigshospitalet GlostrupUniversity of CopenhagenGlostrupDenmark
| | - Henrik Bo Wiberg Larsson
- Functional Imaging UnitDepartment of Clinical PhysiologyNuclear Medicine and PETRigshospitalet GlostrupUniversity of CopenhagenGlostrupDenmark
- Lundbeck Foundation Center for Neurovascular signalling (LUCENS)Rigshospitalet GlostrupUniversity of CopenhagenGlostrupDenmark
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25
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Doorenweerd N, Hooijmans M, Schubert SA, Webb AG, Straathof CSM, van Zwet EW, van Buchem MA, Verschuuren JJGM, Hendriksen JGM, Niks EH, Kan HE. Proton Magnetic Resonance Spectroscopy Indicates Preserved Cerebral Biochemical Composition in Duchenne Muscular Dystrophy Patients. J Neuromuscul Dis 2018; 4:53-58. [PMID: 28269793 DOI: 10.3233/jnd-160201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Duchenne muscular dystrophy (DMD) is caused by the absence of dystrophin. DMD is associated with specific learning and behavioural disabilities. In the brain, dystrophin is associated with GABAA receptors and aquaporin-4 in neurons and astrocytes, respectively, but little is known about its function. OBJECTIVE AND METHODS In this study we aimed to compare the biochemical composition between patients and healthy controls in brain regions that are naturally rich in dystrophin using magnetic resonance spectroscopy. Given previous conflicting results obtained at clinical field strengths, we obtained data using a 7 Tesla system with associated higher signal-to-noise ratio and spectral resolution. RESULTS Results indicated unchanged biochemical composition in all regions investigated, and increased variance in glutamate in the frontal cortex.
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Affiliation(s)
- Nathalie Doorenweerd
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden, The Netherlands.,Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Melissa Hooijmans
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | - Stephanie A Schubert
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | - Andrew G Webb
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | - Chiara S M Straathof
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Erik W van Zwet
- Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - Mark A van Buchem
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Jos G M Hendriksen
- Department of Neurological Learning Disabilities, Kempenhaeghe Epilepsy Center, Heeze, The Netherlands.,Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Erik H Niks
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Hermien E Kan
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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26
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Sokolova MG, Lobzin SV, Nikishina OA, Kiselev AV, Rezvantsev MV, Litvinenko IV, Gavrichenko AV. [Pathogenesis of cognitive disorders in patients with Duchenne muscular dystrophy]. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 117:78-84. [PMID: 29376988 DOI: 10.17116/jnevro201711712178-84] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AIM Clarification of the pathogenesis of cognitive disorders in patients with Duchenne muscular dystrophy in the clinical laboratory and molecular genetic study. MATERIAL AND METHODS Thirty-six male patients with Duchenne muscular dystrophy (DMD), aged from 5 to 22 years (mean age 13.7 years), were examined. The control group consisted of 30 healthy people (7-22 years old, mean age 13.8). The clinical, molecular-genetic and laboratory study was conducted. The search for mutations in the dystrophin gene was carried out using multiplex PCR and multiplex ligation-dependent probe amplification. The laboratory study included determination of neurotrophins: brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF) and ciliary neurotrophic factor (CNTF) using immunoenzyme method in serum. RESULTS AND CONCLUSION Severe cognitive impairment was found in 33% of patients with DMD. The distribution of mutations in the DMD gene was not uniform, most often the mutations were found in the region from exon 43 to exon 50. Serum concentration of NGF in patients with DMD was higher than in the control group (2391 pg/ml [1587; 4136] and 553 pg / ml [314; 864], respectively (p<0.001)). In the group of patients with cognitive disorders, there was a decreased concentration of BGF (23 670 [21 700; 30 720] pg/ml (p<0.001)). In patients with BGF concentration less than 31 000 pg/ml, the chances of cognitive disorders were more than 10 times higher (p<0.001, odds ratio OR=12.0, 95% CI [1.9-76.4]). Thus, biochemical mechanisms, such as NGF overexpression and BGF deficiency, are involved in the development of cognitive disorders in patients with DMD.
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Affiliation(s)
- M G Sokolova
- Mechnikov North-West State Medical University, St. Petersburg, Russia
| | - S V Lobzin
- Mechnikov North-West State Medical University, St. Petersburg, Russia
| | - O A Nikishina
- Mechnikov North-West State Medical University, St. Petersburg, Russia
| | - A V Kiselev
- Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | | | | | - A V Gavrichenko
- Mechnikov North-West State Medical University, St. Petersburg, Russia
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27
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Matsuo M, Awano H, Matsumoto M, Nagai M, Kawaguchi T, Zhang Z, Nishio H. Dystrophin Dp116: A yet to Be Investigated Product of the Duchenne Muscular Dystrophy Gene. Genes (Basel) 2017; 8:genes8100251. [PMID: 28974057 PMCID: PMC5664101 DOI: 10.3390/genes8100251] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 09/26/2017] [Indexed: 12/12/2022] Open
Abstract
The Duchenne muscular dystrophy (DMD) gene is one of the largest genes in the human genome. The gene exhibits a complex arrangement of seven alternative promoters, which drive the expression of three full length and four shorter isoforms. Dp116, the second smallest product of the DMD gene, is a Schwann cell-specific isoform encoded by a transcript corresponding to DMD exons 56–79, starting from a promoter/exon S1 within intron 55. The physiological roles of Dp116 are poorly understood, because of its extensive homology with other isoforms and its expression in specific tissues. This review summarizes studies on Dp116, focusing on clinical findings and alternative activation of the upstream translation initiation codon that is predicted to produce Dp118.
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Affiliation(s)
- Masafumi Matsuo
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe 651-2180, Japan.
| | - Hiroyuki Awano
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan.
| | - Masaaki Matsumoto
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan.
| | - Masashi Nagai
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan.
| | - Tatsuya Kawaguchi
- Biomedical Analysis and Pathology Research Group, Discovery Science and Technology Department, Daiichi Sankyo RD Novare Co., Tokyo 134-8630, Japan.
| | - Zhujun Zhang
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe 651-2180, Japan.
| | - Hisahide Nishio
- Department of Community Medicine and Social Healthcare Sciences, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan.
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