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Wang M, Li H, Zhou Q, Zhao Q, Wang M, Geng Y, Kang H. Case report: Misdiagnosed orolingual dyskinesia as a consequence of seizures in a chorea-acanthocytosis patient with a novel VPS13A variation from a family with consanguineous marriage. Front Neurol 2024; 15:1352467. [PMID: 38933328 PMCID: PMC11199768 DOI: 10.3389/fneur.2024.1352467] [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: 12/08/2023] [Accepted: 05/16/2024] [Indexed: 06/28/2024] Open
Abstract
Chorea-acanthocytosis (ChAc) is a rare autosomal recessive inherited syndrome with heterogeneous symptoms, which makes it a challenge for early diagnosis. The mutation of VPS13A is considered intimately related to the pathogenesis of ChAc. To date, diverse mutation patterns of VPS13A, consisting of missense, nonsense, and frameshift mutations, have been reported. In this study, we first report a clinical case that was misdiagnosed as epilepsy due to recurrent seizures accompanied by tongue bite for 9 months, which was not rectified until seizures were controlled and involuntary orolingual movements with awareness became prominent and were confirmed to be orolingual dyskinesia. The patient was eventually diagnosed as ChAc based on whole-exome sequencing revealing novel homozygous c.2061dup (frameshift mutation) and c.6796A > T dual mutations in VPS13A. The patient from a family with consanguineous marriage manifested epileptic seizures at onset, including both generalized tonic-clonic seizures and absence but normal long-term electroencephalography, and gradually developed orofacial dyskinesia, including involuntary tongue protrusion, tongue biting and ulcers, involuntary open jaws, occasionally frequent eye blinks, and head swings. The first test of the peripheral blood smear was negative, and repeated checks confirmed an elevated percentage of acanthocytes by 15-21.3%. Structural brain MRI indicated a mildly swollen left hippocampus and parahippocampal gyrus and a progressively decreased volume of the bilateral hippocampus 1 year later, along with atrophy of the head of the caudate nucleus but no progression in 1 year. We deeply analyzed the reasons for long-term misdiagnosis in an effort to achieve a more comprehensive understanding of ChAc, thus facilitating early diagnosis and treatment in future clinical practice.
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Affiliation(s)
- Mengying Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Huimin Li
- Department of Neurology, The Central Hospital of Wuhan, Wuhan, Hubei, China
| | - Qing Zhou
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qin Zhao
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Man Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yumei Geng
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Huicong Kang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Department of Neurology, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
- Key Laboratory of Vascular Aging, Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Cincotta MC, Walker RH. Recent advances in non-Huntington's disease choreas. Parkinsonism Relat Disord 2024; 122:106045. [PMID: 38378310 DOI: 10.1016/j.parkreldis.2024.106045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 02/10/2024] [Indexed: 02/22/2024]
Abstract
INTRODUCTION Chorea is primarily due to an imbalance of basal ganglia output pathways, often due to dysfunction or degeneration of the caudate nucleus and putamen, and can be due to many causes. METHODS We reviewed the recent literature to identify newly-recognized causes of chorea, including auto-immune, metabolic, and genetic. We also focused upon developments in mechanisms relating to underlying pathophysiology of certain genetic choreas and advances in therapeutics. RESULTS Novel autoantibodies continue to be identified as causes of chorea. Both COVID-19 infection and vaccination are reported to result rarely in chorea, although in some cases causality is not clearly established. Advances in genetic testing continue to find more causes of chorea, and to expand the phenotype of known genetic disorders. Deep brain stimulation can be successful in certain circumstances. CONCLUSION Our understanding of mechanisms underlying this movement disorder continues to advance, however much remains to be elucidated.
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Affiliation(s)
- Molly C Cincotta
- Department of Neurology, Temple University, Philadelphia, PA, 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.
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Jin S, Sun Z, Fang X, Chen H, Yang W, Wang S, Fan J. A chorea-acanthocytosis patient with novel mutations in the VPS13A gene without acanthocyte. Neurol Sci 2024; 45:2057-2061. [PMID: 37985634 DOI: 10.1007/s10072-023-07174-0] [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: 04/07/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023]
Abstract
Chorea-acanthocytosis (ChAc) is a rare clinical genetic disorder of the nervous system, which is characterized by choreiform movement disorder, cognitive decline, and psychiatric disorders. ChAc is mostly diagnosed based on its typical clinical manifestations and the increased number of acanthocytes in peripheral blood smears. Here, we report a patient, who has the characteristic clinical manifestations of ChAc with limb choreiform movements, involuntary lip and tongue bites, seizures, and emotional instability. However, her blood smear was negative for acanthocytes with scanning electron microscopy. We later identified two novel pathogenic mutations in the patient's vacuolar protein sorting homolog 13 A (VPS13A) on chromosome 9q21 by targeted gene sequencing, and she was definitively diagnosed with "ChAc." After treatment with carbamazepine, haloperidol, the patient's symptoms gradually improved. We consider that an acanthocyte negative blood smear cannot rule out ChAC diagnosis, and genetic testing is the "gold standard" for the diagnosis. Through a review of previous research, it is rare for a patient to have a clear diagnosis of ChAc by genetic testing, but whose blood smear is negative for acanthocytes with electron microscopy. In addition, in this report, we discovered two novel pathogenic mutations, which have not been reported previously, and extended the genetic characteristics of ChAc.
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Affiliation(s)
- Shan Jin
- The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Shushan District, No.117, Meishan Road, Hefei, 230000, Anhui, China
| | - Zhengzhe Sun
- Anhui University of Traditional Chinese Medicine, Hefei, Anhui, China
| | - Xiang Fang
- The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Shushan District, No.117, Meishan Road, Hefei, 230000, Anhui, China.
| | - Huaizhen Chen
- The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Shushan District, No.117, Meishan Road, Hefei, 230000, Anhui, China
| | - Wenming Yang
- The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Shushan District, No.117, Meishan Road, Hefei, 230000, Anhui, China
- Key Laboratory of Xin'an Medicine Ministry of Education, Hefei, Anhui, China
| | - Shan Wang
- Anhui University of Traditional Chinese Medicine, Hefei, Anhui, China
| | - Jinwei Fan
- Anhui University of Traditional Chinese Medicine, Hefei, Anhui, China
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4
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Schon KR, O'Donovan DG, Briggs M, Rowe JB, Wijesekera L, Chinnery PF, van den Ameele J. Multisystem pathology in McLeod syndrome. Neuropathology 2024; 44:109-114. [PMID: 37438874 DOI: 10.1111/neup.12935] [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: 05/05/2023] [Revised: 06/12/2023] [Accepted: 06/24/2023] [Indexed: 07/14/2023]
Abstract
We present a comprehensive characterization of clinical, neuropathological, and multisystem features of a man with genetically confirmed McLeod neuroacanthocytosis syndrome, including video and autopsy findings. A 61-year-old man presented with a movement disorder and behavioral change. Examination showed dystonic choreiform movements in all four limbs, reduced deep-tendon reflexes, and wide-based gait. He had oromandibular dyskinesia causing severe dysphagia. Elevated serum creatinine kinase (CK) was first noted in his thirties, but investigations, including muscle biopsy at that time, were inconclusive. Brain magnetic resonance imaging showed white matter volume loss, atrophic basal ganglia, and chronic small vessel ischemia. Despite raised CK, electromyography did not show myopathic changes. Exome gene panel testing was negative, but targeted genetic analysis revealed a hemizygous pathogenic variant in the XK gene c.895C > T p.(Gln299Ter), consistent with a diagnosis of McLeod syndrome. The patient died of sepsis, and autopsy showed astrocytic gliosis and atrophy of the basal ganglia, diffuse iron deposition in the putamen, and mild Alzheimer's pathology. Muscle pathology was indicative of mild chronic neurogenic atrophy without overt myopathic features. He had non-specific cardiomyopathy and splenomegaly. McLeod syndrome is an ultra-rare neurodegenerative disorder caused by X-linked recessive mutations in the XK gene. Diagnosis has management implications since patients are at risk of severe transfusion reactions and cardiac complications. When a clinical diagnosis is suspected, candidate genes should be interrogated rather than solely relying on exome panels.
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Affiliation(s)
- Katherine R Schon
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Medical Research Council Mitochondrial Biology Unit, University of Cambridge, Cambridge, UK
- East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Dominic G O'Donovan
- Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Mayen Briggs
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - James B Rowe
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Lokesh Wijesekera
- Department of Clinical Neurophysiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Patrick F Chinnery
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Medical Research Council Mitochondrial Biology Unit, University of Cambridge, Cambridge, UK
| | - Jelle van den Ameele
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Medical Research Council Mitochondrial Biology Unit, University of Cambridge, Cambridge, UK
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Mulroy E, Baschieri F, Magrinelli F, Latorre A, Cortelli P, Bhatia KP. Movement Disorders and Liver Disease. Mov Disord Clin Pract 2021; 8:828-842. [PMID: 34401403 PMCID: PMC8354085 DOI: 10.1002/mdc3.13238] [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: 11/17/2020] [Revised: 04/24/2021] [Accepted: 04/27/2021] [Indexed: 12/15/2022] Open
Abstract
The association of movement disorders with structural or functional hepatic disease occurs in three principal scenarios: (1) combined involvement of both organ systems from a single disease entity, (2) nervous system dysfunction resulting from exposure to toxic compounds in the setting of defective hepatic clearance, or (3) hepatic and/or neurological injury secondary to exposure to exogenous drugs or toxins. An important early step in the workup of any patient with combined movement disorders and liver disease is the exclusion of Wilson's disease. Diagnostic delay remains common for this treatable disorder, and this has major implications for patient outcomes. Thereafter, a structured approach integrating variables such as age of onset, tempo of progression, nature and severity of liver involvement, movement disorder phenomenology, exposure to drugs/toxins and laboratory/neuroimaging findings is key to ensuring timely diagnosis and disease‐specific therapy. Herein, we provide an overview of disorders which may manifest with a combination of movement disorders and liver disease, structured under the three headings as detailed above. In each section, the most common disorders are discussed, along with important clinical pearls, suggested diagnostic workup, differential diagnoses and where appropriate, treatment considerations.
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Affiliation(s)
- Eoin Mulroy
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom
| | - Francesca Baschieri
- IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italy.,Dipartimento di Scienze Biomediche e Neuromotorie Università di Bologna Bologna Italy
| | - Francesca Magrinelli
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom.,Department of Neurosciences Biomedicine and Movement Sciences, University of Verona Verona Italy
| | - Anna Latorre
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom
| | - Pietro Cortelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italy.,Dipartimento di Scienze Biomediche e Neuromotorie Università di Bologna Bologna Italy
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom
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Quick S, Heidrich FM, Winkler MV, Winkler AH, Ibrahim K, Linke A, Speiser U, Grabmaier U, Buhmann C, Marxreiter F, Saft C, Danek A, Hermann A, Peikert K. Cardiac manifestation is evident in chorea-acanthocytosis but different from McLeod syndrome. Parkinsonism Relat Disord 2021; 88:90-95. [PMID: 34153885 DOI: 10.1016/j.parkreldis.2021.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/30/2021] [Accepted: 05/14/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION We aimed to study the various cardiac manifestations of the two core neuroacanthocytosis (NA) syndromes, namely chorea-acanthocytosis (ChAc) and McLeod syndrome (MLS). So far, cardiac involvement has been described as specific feature only for MLS. METHODS We studied six patients with ChAc (mean age 44.5 years, five men, one woman) and six patients with MLS (mean age 57.1 years, all men). Cardiac evaluation included echocardiography and/or cardiac magnetic resonance imaging (cardiac MRI), 24-h ECG-recording and examination of cardiac biomarkers. RESULTS Cardiac involvement of ChAc was found in four of six patients. Two patients showed mildly reduced left ventricular ejection fraction (LVEF), two other patients mild to moderate left ventricular (LV) dilatation. Neither an increase in ventricular ectopic beats nor ventricular tachycardia were evident in ChAc. Four of five MLS patients showed left ventricle dilatation and reduced left ventricular ejection fraction (LVEF). Two of these, in addition, had critical ventricular tachycardia. High sensitive troponin T was elevated in all patients, for whom data were available (n = 10). In contrast, elevation of high sensitive troponin I was found in one of six ChAc and one of two MLS patients. CONCLUSION For the first time, we reveal cardiac involvement in a cohort of six ChAc patients, while the risk to develop heart failure seems lower than in MLS. Our study confirms the malignant nature of MLS in terms of ventricular arrhythmias and progression to advanced heart failure. Herein, we define disease-specific recommendations for cardiac assessment in both conditions.
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Affiliation(s)
- Silvio Quick
- Department of Cardiology, Angiology and Intensive Care, Klinikum Chemnitz gGmbH, Medizincampus Chemnitz der Technischen Universität Dresden, Dresden, Germany.
| | - Felix Matthias Heidrich
- Department of Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Dresden, Germany
| | - Max-Valentin Winkler
- Department of Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Dresden, Germany
| | - Anna Helene Winkler
- Department of Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Dresden, Germany
| | - Karim Ibrahim
- Department of Cardiology, Angiology and Intensive Care, Klinikum Chemnitz gGmbH, Medizincampus Chemnitz der Technischen Universität Dresden, Dresden, Germany
| | - Axel Linke
- Department of Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Dresden, Germany
| | - Uwe Speiser
- Department of Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Dresden, Germany
| | - Ulrich Grabmaier
- Medizinische Klinik und Poliklinik I, Klinikum der Universität, LMU Munich, 81377, Munich, Germany; German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, 80802, Munich, Germany
| | - Carsten Buhmann
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Franz Marxreiter
- Movement Disorders Outpatient Clinic, Department of Molecular Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany; Center for Rare Movement Disorders, Department of Molecular Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Carsten Saft
- Department of Neurology, St. Josef Hospital, Ruhr-University, Gudrunstraße 56, 44791, Bochum, Germany
| | - Adrian Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, München, Germany
| | - Andreas Hermann
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Translational Neurodegeneration Section "Albrecht-Kossel", Department of Neurology, University Medical Center, University of Rostock, Rostock, Germany; DZNE, German Center for Neurodegenerative Diseases, Research Site Rostock/Greifswald, Rostock, Germany; Center for Transdisciplinary Neurosciences Rostock (CTNR), University Medical Center Rostock, University of Rostock, Rostock, Germany
| | - Kevin Peikert
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Translational Neurodegeneration Section "Albrecht-Kossel", Department of Neurology, University Medical Center, University of Rostock, Rostock, Germany.
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Rabe A, Kihm A, Darras A, Peikert K, Simionato G, Dasanna AK, Glaß H, Geisel J, Quint S, Danek A, Wagner C, Fedosov DA, Hermann A, Kaestner L. The Erythrocyte Sedimentation Rate and Its Relation to Cell Shape and Rigidity of Red Blood Cells from Chorea-Acanthocytosis Patients in an Off-Label Treatment with Dasatinib. Biomolecules 2021; 11:biom11050727. [PMID: 34066168 PMCID: PMC8151862 DOI: 10.3390/biom11050727] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Chorea-acanthocytosis (ChAc) is a rare hereditary neurodegenerative disease with deformed red blood cells (RBCs), so-called acanthocytes, as a typical marker of the disease. Erythrocyte sedimentation rate (ESR) was recently proposed as a diagnostic biomarker. To date, there is no treatment option for affected patients, but promising therapy candidates, such as dasatinib, a Lyn-kinase inhibitor, have been identified. Methods: RBCs of two ChAc patients during and after dasatinib treatment were characterized by the ESR, clinical hematology parameters and the 3D shape classification in stasis based on an artificial neural network. Furthermore, mathematical modeling was performed to understand the contribution of cell morphology and cell rigidity to the ESR. Microfluidic measurements were used to compare the RBC rigidity between ChAc patients and healthy controls. Results: The mechano-morphological characterization of RBCs from two ChAc patients in an off-label treatment with dasatinib revealed differences in the ESR and the acanthocyte count during and after the treatment period, which could not directly be related to each other. Clinical hematology parameters were in the normal range. Mathematical modeling indicated that RBC rigidity is more important for delayed ESR than cell shape. Microfluidic experiments confirmed a higher rigidity in the normocytes of ChAc patients compared to healthy controls. Conclusions: The results increase our understanding of the role of acanthocytes and their associated properties in the ESR, but the data are too sparse to answer the question of whether the ESR is a suitable biomarker for treatment success, whereas a correlation between hematological and neuronal phenotype is still subject to verification.
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Affiliation(s)
- Antonia Rabe
- Theoretical Medicine and Biosciences, Saarland University, 66424 Homburg, Germany;
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.K.); (A.D.); (G.S.); (S.Q.); (C.W.)
| | - Alexander Kihm
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.K.); (A.D.); (G.S.); (S.Q.); (C.W.)
| | - Alexis Darras
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.K.); (A.D.); (G.S.); (S.Q.); (C.W.)
| | - Kevin Peikert
- Translational Neurodegeneration Section “Albrecht-Kossel”, Department of Neurology, University Medical Center Rostock, University of Rostock, 18051 Rostock, Germany; (K.P.); (H.G.); (A.H.)
- Department of Neurology, Technische Universität Dresden, 01307 Dresden, Germany
| | - Greta Simionato
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.K.); (A.D.); (G.S.); (S.Q.); (C.W.)
- Institute for Clinical and Experimental Surgery, Saarland University, 66424 Homburg, Germany
| | - Anil Kumar Dasanna
- Institute of Biological Information Processing and Institute for Advanced Simulation, Forschungszentrum Jülich, 52425 Jülich, Germany; (A.K.D.); (D.A.F.)
| | - Hannes Glaß
- Translational Neurodegeneration Section “Albrecht-Kossel”, Department of Neurology, University Medical Center Rostock, University of Rostock, 18051 Rostock, Germany; (K.P.); (H.G.); (A.H.)
| | - Jürgen Geisel
- Central Laboratory, Saarland University Medical Centre, 66424 Homburg, Germany;
| | - Stephan Quint
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.K.); (A.D.); (G.S.); (S.Q.); (C.W.)
- Cysmic GmbH, 66123 Saarbrücken, Germany
| | - Adrian Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, 81366 Munich, Germany;
| | - Christian Wagner
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.K.); (A.D.); (G.S.); (S.Q.); (C.W.)
- Physics and Materials Science Research Unit, University of Luxembourg, 1511 Luxembourg, Luxembourg
| | - Dmitry A. Fedosov
- Institute of Biological Information Processing and Institute for Advanced Simulation, Forschungszentrum Jülich, 52425 Jülich, Germany; (A.K.D.); (D.A.F.)
| | - Andreas Hermann
- Translational Neurodegeneration Section “Albrecht-Kossel”, Department of Neurology, University Medical Center Rostock, University of Rostock, 18051 Rostock, Germany; (K.P.); (H.G.); (A.H.)
- Department of Neurology, Technische Universität Dresden, 01307 Dresden, Germany
- DZNE, German Center for Neurodegenerative Diseases, Research Site Rostock/Greifswald, 18051 Rostock, Germany
- Center for Transdisciplinary Neurosciences Rostock (CTNR), University Medical Center Rostock, University of Rostock, 18051 Rostock, Germany
| | - Lars Kaestner
- Theoretical Medicine and Biosciences, Saarland University, 66424 Homburg, Germany;
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.K.); (A.D.); (G.S.); (S.Q.); (C.W.)
- Correspondence: ; Tel.: +49-681-302-2417
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Rossi M, Wainsztein N, Merello M. Cardiac Involvement in Movement Disorders. Mov Disord Clin Pract 2021; 8:651-668. [PMID: 34307738 DOI: 10.1002/mdc3.13188] [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: 05/16/2020] [Revised: 02/23/2021] [Accepted: 03/02/2021] [Indexed: 02/06/2023] Open
Abstract
Background Several conditions represented mainly by movement disorders are associated with cardiac disease, which can be overlooked in clinical practice in the context of a prominent primary neurological disorder. Objectives To review neurological conditions that combine movement disorders and primary cardiac involvement. Methods A comprehensive and structured literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria was conducted to identify disorders combining movement disorders and cardiac disease. Results Some movement disorders are commonly or prominently associated with cardiac disease. Neurological and cardiac symptoms may share underlying physiopathological mechanisms in diseases, such as Friedreich's ataxia and Wilson's disease, and in certain metabolic disorders, including Refsum disease, Gaucher disease, a congenital disorder of glycosylation, or cerebrotendinous xanthomatosis. In certain conditions, such as Sydenham's chorea or dilated cardiomyopathy with ataxia syndrome (ATX-DNAJC19), heart involvement can present early in the course of disease, whereas in others such as Friedreich's ataxia or Refsum disease, cardiac symptoms tend to present in later stages. In another 68 acquired or inherited conditions, cardiac involvement or movement disorders are seldom reported. Conclusions As cardiac disease is part of the phenotypic spectrum of several movement disorders, heart involvement should be carefully investigated and increased awareness of this association encouraged as it may represent a leading cause of morbidity and mortality.
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Affiliation(s)
- Malco Rossi
- Sección Movimientos Anormales, Departamento de Neurociencias Instituto de Investigaciones Neurológicas Raúl Carrea, Fleni Buenos Aires Argentina.,Argentine National Scientific and Technological Research Council Buenos Aires Argentina
| | - Nestor Wainsztein
- Departamento de Medicina Interna Unidad de Cuidados Críticos, Fleni Buenos Aires Argentina
| | - Marcelo Merello
- Sección Movimientos Anormales, Departamento de Neurociencias Instituto de Investigaciones Neurológicas Raúl Carrea, Fleni Buenos Aires Argentina.,Argentine National Scientific and Technological Research Council Buenos Aires Argentina.,Pontificia Universidad Católica Argentina Buenos Aires Argentina
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Darras A, Peikert K, Rabe A, Yaya F, Simionato G, John T, Dasanna AK, Buvalyy S, Geisel J, Hermann A, Fedosov DA, Danek A, Wagner C, Kaestner L. Acanthocyte Sedimentation Rate as a Diagnostic Biomarker for Neuroacanthocytosis Syndromes: Experimental Evidence and Physical Justification. Cells 2021; 10:788. [PMID: 33918219 PMCID: PMC8067274 DOI: 10.3390/cells10040788] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/26/2021] [Accepted: 03/30/2021] [Indexed: 01/28/2023] Open
Abstract
(1) Background: Chorea-acanthocytosis and McLeod syndrome are the core diseases among the group of rare neurodegenerative disorders called neuroacanthocytosis syndromes (NASs). NAS patients have a variable number of irregularly spiky erythrocytes, so-called acanthocytes. Their detection is a crucial but error-prone parameter in the diagnosis of NASs, often leading to misdiagnoses. (2) Methods: We measured the standard Westergren erythrocyte sedimentation rate (ESR) of various blood samples from NAS patients and healthy controls. Furthermore, we manipulated the ESR by swapping the erythrocytes and plasma of different individuals, as well as replacing plasma with dextran. These measurements were complemented by clinical laboratory data and single-cell adhesion force measurements. Additionally, we followed theoretical modeling approaches. (3) Results: We show that the acanthocyte sedimentation rate (ASR) with a two-hour read-out is significantly prolonged in chorea-acanthocytosis and McLeod syndrome without overlap compared to the ESR of the controls. Mechanistically, through modern colloidal physics, we show that acanthocyte aggregation and plasma fibrinogen levels slow down the sedimentation. Moreover, the inverse of ASR correlates with the number of acanthocytes (R2=0.61, p=0.004). (4) Conclusions: The ASR/ESR is a clear, robust and easily obtainable diagnostic marker. Independently of NASs, we also regard this study as a hallmark of the physical view of erythrocyte sedimentation by describing anticoagulated blood in stasis as a percolating gel, allowing the application of colloidal physics theory.
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Affiliation(s)
- Alexis Darras
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.R.); (F.Y.); (G.S.); (T.J.); (C.W.)
| | - Kevin Peikert
- Translational Neurodegeneration Section “Albrecht-Kossel”, Department of Neurology, University Medical Center Rostock, University of Rostock, 18051 Rostock, Germany; (K.P.); (A.H.)
- Neurodegenerative Diseases, Department of Neurology, Technische Universität Dresden, 01062 Dresden, Germany
| | - Antonia Rabe
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.R.); (F.Y.); (G.S.); (T.J.); (C.W.)
- Theoretical Medicine and Biosciences, Saarland University, 66424 Homburg, Germany
| | - François Yaya
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.R.); (F.Y.); (G.S.); (T.J.); (C.W.)
- Laboratoire Interdisciplinaire de Physique, UMR 5588, 38402 Saint Martin d’Hères, France
| | - Greta Simionato
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.R.); (F.Y.); (G.S.); (T.J.); (C.W.)
- Institute for Clinical and Experimental Surgery, Saarland University, 66424 Homburg, Germany;
| | - Thomas John
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.R.); (F.Y.); (G.S.); (T.J.); (C.W.)
| | - Anil Kumar Dasanna
- Institute of Biological Information Processing and Institute for Advanced Simulation, Forschungszentrum Jülich, 52425 Jülich, Germany; (A.K.D.); (S.B.); (D.A.F.)
| | - Semen Buvalyy
- Institute of Biological Information Processing and Institute for Advanced Simulation, Forschungszentrum Jülich, 52425 Jülich, Germany; (A.K.D.); (S.B.); (D.A.F.)
| | - Jürgen Geisel
- Institute for Clinical and Experimental Surgery, Saarland University, 66424 Homburg, Germany;
| | - Andreas Hermann
- Translational Neurodegeneration Section “Albrecht-Kossel”, Department of Neurology, University Medical Center Rostock, University of Rostock, 18051 Rostock, Germany; (K.P.); (A.H.)
- Neurodegenerative Diseases, Department of Neurology, Technische Universität Dresden, 01062 Dresden, Germany
- DZNE, German Center for Neurodegenerative Diseases, Research Site Rostock/Greifswald, 18051 Rostock, Germany
- Center for Transdisciplinary Neurosciences Rostock (CTNR), University Medical Center Rostock, University of Rostock, 18051 Rostock, Germany
| | - Dmitry A. Fedosov
- Institute of Biological Information Processing and Institute for Advanced Simulation, Forschungszentrum Jülich, 52425 Jülich, Germany; (A.K.D.); (S.B.); (D.A.F.)
| | - Adrian Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, 81366 Munich, Germany;
| | - Christian Wagner
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.R.); (F.Y.); (G.S.); (T.J.); (C.W.)
- Physics and Materials Science Research Unit, University of Luxembourg, 1511 Luxembourg, Luxembourg
| | - Lars Kaestner
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany; (A.R.); (F.Y.); (G.S.); (T.J.); (C.W.)
- Theoretical Medicine and Biosciences, Saarland University, 66424 Homburg, Germany
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Patel RA, Hall DA, Eichenseer S, Bailey M. Movement Disorders and Hematologic Diseases. Mov Disord Clin Pract 2021; 8:193-207. [PMID: 33553488 DOI: 10.1002/mdc3.13129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/27/2020] [Accepted: 11/13/2020] [Indexed: 11/11/2022] Open
Abstract
Background Movement disorders can be associated with or caused by hematological abnormalities. The objective of this review is to highlight features that will aid in the clinician's recognition and treatment of these disorders. Methods MESH terms relevant to movement disorders and hematologic diseases were searched to identify conditions included in this narrative, educational review. Results Several conditions were identified, and they were organized by hematologic categories to include red blood cell abnormalities, white blood cell abnormalities, disorders of clotting and bleeding, hematologic malignancies, and others. Conclusions This review will increase providers' understanding of disorders that include movement disorders and hematologic abnormalities. Basic hematologic laboratories can aid in assessment of these disorders, to include complete blood count/hemogram and peripheral blood smear. Recognition is key, especially in the setting of underlying malignancy, vitamin deficiency, or other disorder in which treatment is available.
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Affiliation(s)
- Roshni Abee Patel
- Department of Neurological Sciences Rush University Medical Center Chicago Illinois USA
| | - Deborah A Hall
- Department of Neurological Sciences Rush University Medical Center Chicago Illinois USA
| | - Sheila Eichenseer
- Department of Neurology Medical College of Wisconsin Milwaukee Wisconsin USA
| | - Meagan Bailey
- Department of Neurological Sciences Rush University Medical Center Chicago Illinois USA
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11
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Involuntary movements, vocalizations and cognitive decline. Parkinsonism Relat Disord 2019; 79:135-137. [PMID: 31153763 DOI: 10.1016/j.parkreldis.2019.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 05/20/2019] [Indexed: 11/22/2022]
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