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Lin CYR, Kuo SH, Opal P. Cognitive, Emotional, and Other Non-motor Symptoms of Spinocerebellar Ataxias. Curr Neurol Neurosci Rep 2024; 24:47-54. [PMID: 38270820 PMCID: PMC10922758 DOI: 10.1007/s11910-024-01331-4] [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] [Accepted: 01/05/2024] [Indexed: 01/26/2024]
Abstract
PURPOSE OF REVIEW Spinocerebellar ataxias (SCAs) are autosomal dominant degenerative syndromes that present with ataxia and brain stem abnormalities. This review describes the cognitive and behavioral symptoms of SCAs in the context of recent knowledge of the role of the cerebellum in higher intellectual function. RECENT FINDINGS Recent studies suggest that patients with spinocerebellar ataxia can display cognitive deficits even early in the disease. These have been given the term cerebellar cognitive affective syndrome (CCAS). CCAS can be tracked using newly developed rating scales. In addition, patients with spinocerebellar ataxia also display impulsive and compulsive behavior, depression, anxiety, fatigue, and sleep disturbances. This review stresses the importance of recognizing non-motor symptoms in SCAs. There is a pressing need for novel therapeutic interventions to address these symptoms given their deleterious impact on patients' quality of life.
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Affiliation(s)
- Chi-Ying R Lin
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Sheng-Han Kuo
- Department of Neurology and Initiative for Columbia Ataxia and Tremor, Columbia University Irving Medical Center, New York, NY, USA
| | - Puneet Opal
- Davee Department of Neurology and Department of Cell and Developmental Biology, Northwestern University Feinberg School of Medicine, 303 East Chicago Avenue, Chicago, IL, 60611, USA.
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Peng Y, Tu Q, Han Y, Gao L, Wan C. Incidence of different pressure patterns of spinal cerebellar ataxia and analysis of imaging and genetic diagnosis. Open Life Sci 2023; 18:20220762. [PMID: 38152578 PMCID: PMC10751992 DOI: 10.1515/biol-2022-0762] [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: 08/20/2023] [Revised: 09/23/2023] [Accepted: 10/03/2023] [Indexed: 12/29/2023] Open
Abstract
Neurologists have a difficult time identifying sporadic cerebellar ataxia. Multiple system atrophy of the cerebellar type (MSA-C), spontaneous late cortical cerebellar atrophy, and prolonged alcohol use are a few possible causes. In a group of people with sporadic cerebellar ataxia that was not MSA-C, an autosomal-dominant spinocerebellar ataxia (SCA) mutation was recently discovered. Chinese single-hospital cohort will be used in this study to genetic screen for SCA-related genes. One hundred forty individuals with CA were monitored over 8 years. Thirty-one individuals had familial CA, 109 patients had sporadic CA, 73 had MSA-C, and 36 had non-MSA-C sporadic CA. In 28 of the 31 non-MSA-C sporadic patients who requested the test, we carried out gene analysis, including SCA1, SCA2, SCA3, SCA6, SCA7, SCA8, SCA12, SCA17, SCA31, and dentatorubro-pallidoluysian atrophy (DRPLA). The control group consisted of family members of the patients. In 57% of the instances with spontaneous CA that were not MSA-C, gene abnormalities were discovered. The most frequent exception among individuals with sporadic CA was SCA6 (36%), followed by monsters in SCA1, 2, 3, 8, and DRPLA. In contrast, 75% of the patients with familial CA had gene abnormalities, the most frequent of which was SCA6 abnormality. The age of 69 vs 59 was higher, and the CAG repeat length was a minor age of 23 vs 25 in the former instances compared to the last one among individuals with SCA6 anomalies that were sporadic as opposed to familial cases. In sporadic CA, autosomal-dominant mutations in SCA genes, notably in SCA6, are common. Although the cause of the increased incidence of SCA6 mutations is unknown, it may be related to a greater age of onset and varied penetrance of SCA6 mutations.
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Affiliation(s)
- Yufen Peng
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Qi Tu
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Yao Han
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Liang Gao
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Chenyi Wan
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China
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Tang J, Song X, Zhao M, Chen H, Wang Y, Zhao B, Yu S, Ma T, Gao L. Oral administration of live combined Bacillus subtilis and Enterococcus faecium alleviates colonic oxidative stress and inflammation in osteoarthritic rats by improving fecal microbiome metabolism and enhancing the colonic barrier. Front Microbiol 2022; 13:1005842. [PMID: 36439850 PMCID: PMC9686382 DOI: 10.3389/fmicb.2022.1005842] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/30/2022] [Indexed: 10/02/2023] Open
Abstract
Osteoarthritis (OA) causes intestinal damage. The protective effect of probiotics on the intestine is indeed effective; however, the mechanism of protection against intestinal damage in OA is not clear. In this study, we used meniscal/ligamentous injury (MLI) to mimic OA in rats and explored the colonic protective effects of Bacillus subtilis and Enterococcus faecium on OA. Our study showed that treatment with B. subtilis and E. faecium attenuated colonic injury and reduced inflammatory and oxidative stress factors in the serum of osteoarthritic rats. α- and ß diversity of the fecal flora were not different among groups; no significant differences were observed in the abundances of taxa at the phylum and genus levels. We observed the presence of the depression-related genera Alistipes and Paraprevotella. Analysis of fecal untargeted metabolism revealed that histamine level was significantly reduced in the colon of OA rats, affecting intestinal function. Compared to that in the control group, the enriched metabolic pathways in the OA group were primarily for energy metabolisms, such as pantothenate and CoA biosynthesis, and beta-alanine metabolism. The treatment group had enriched linoleic acid metabolism, fatty acid biosynthesis, and primary bile acid biosynthesis, which were different from those in the control group. The differences in the metabolic pathways between the treatment and OA groups were more evident, primarily in symptom-related metabolic pathways such as Huntington's disease, spinocerebellar ataxia, energy-related central carbon metabolism in cancer, pantothenate and CoA biosynthesis metabolic pathways, as well as some neurotransmission and amino acid transport, and uptake- and synthesis-related metabolic pathways. On further investigation, we found that B. subtilis and E. faecium treatment enhanced the colonic barrier of OA rats, with elevated expressions of tight junction proteins occludin and Zonula occludens 1 and MUC2 mRNA. Intestinal permeability was reduced, and serum LPS levels were downregulated in the treatment group. B. subtilis and E. faecium also regulated the oxidative stress pathway Keap1/Nrf2, promoted the expression of the downstream protective proteins HO-1 and Gpx4, and reduced intestinal apoptosis. Hence, B. subtilis and E. faecium alleviate colonic oxidative stress and inflammation in OA rats by improving fecal metabolism and enhancing the colonic barrier.
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Affiliation(s)
- Jilang Tang
- Heilongjiang Key Laboratory for Laboratory Animals and Comparative Medicine, Harbin, China
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, China
| | - Xiaopeng Song
- Heilongjiang Key Laboratory for Laboratory Animals and Comparative Medicine, Harbin, China
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, China
| | - Mingchao Zhao
- Heilongjiang Key Laboratory for Laboratory Animals and Comparative Medicine, Harbin, China
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, China
| | - Hong Chen
- Heilongjiang Key Laboratory for Laboratory Animals and Comparative Medicine, Harbin, China
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, China
| | - Yingying Wang
- Heilongjiang Key Laboratory for Laboratory Animals and Comparative Medicine, Harbin, China
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, China
| | - Binger Zhao
- Heilongjiang Key Laboratory for Laboratory Animals and Comparative Medicine, Harbin, China
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, China
| | - Shiming Yu
- Heilongjiang Key Laboratory for Laboratory Animals and Comparative Medicine, Harbin, China
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, China
| | - Tianwen Ma
- Heilongjiang Key Laboratory for Laboratory Animals and Comparative Medicine, Harbin, China
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, China
| | - Li Gao
- Heilongjiang Key Laboratory for Laboratory Animals and Comparative Medicine, Harbin, China
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, China
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Yao T, Qiao H, Sun J, Li X, Song Y, Xu F, Gao L, Zhang D, Yan Z, Ye C, Lai H, Liang Z, Wu T, Wang CD. Clinical and Preclinical Neuroimaging Changes in Spinocerebellar Ataxia Type 12: A Study of Three Chinese Pedigrees. Eur Neurol 2022; 85:467-477. [PMID: 35853433 DOI: 10.1159/000525272] [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: 12/08/2021] [Accepted: 05/18/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Spinocerebellar ataxia type 12 (SCA12) is a rare SCA subtype with unclear clinical and imaging features. Also, the radiological changes in prodromal and early stages remain unknown. METHODS Ten symptomatic and two pre-symptomatic cases from three Chinese pedigrees received clinical assessments and imaging studies including routine magnetic resonance imaging (MRI), diffusion kurtosis imaging (DKI), and positron emission tomography (PET) using 18F-flurodeoxyglucose (FDG) to investigate glucose metabolism in brain and 18F-vesicle monoamine transporter 2 (VMAT2) to inspect the integrity of the dopaminergic neuron. Seventy-two healthy individuals were recruited as controls in the quantitative FDG-PET analysis. Imaging parameters were compared between symptomatic and presymptomatic cases with different disease durations. RESULTS Patients displayed prominent action tremor, moderate ataxia, and subtle parkinsonism with poor levodopa-response. MRI showed extensive but heterogeneous cerebral atrophy, which was most evident in the frontoparietal lobes. Cerebellar atrophy was apparent in later stages. DKI detected impaired fibers in the cerebellar peduncles. In both symptomatic and pre-symptomatic cases, PET-CT showed an earlier FDG decline than atrophic changes in multiple regions, and the frontoparietal lobes were the earliest and most severe. However, the VMAT2 density were normal in the putamen and caudate nucleus of most cases (7/8). CONCLUSIONS We first found that hypometabolism in the cerebral cortex, but not cerebellum, is an early and prominent change in SCA12. The integrity of presynaptic dopaminergic neurons remains largely spared during the whole disease process.
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Affiliation(s)
- Tingyan Yao
- Department of Neurology, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - Hongwen Qiao
- Department of Nuclear Medicine, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Junyan Sun
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, Beijing, China
| | - Xuying Li
- Department of Neurology, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - Yang Song
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Fanxi Xu
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Linlin Gao
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, Beijing, China
| | - Dongling Zhang
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, Beijing, China
| | - Zehong Yan
- School of Electronic and Information Engineering, Harbin Institute of Technology at Shenzhen, Shenzhen, China
| | | | - Hong Lai
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Zhigang Liang
- Department of Nuclear Medicine, Information Center Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Tao Wu
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, Beijing, China
| | - Chao-Dong Wang
- Department of Neurology, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing, China
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Clinical, Radiological, and Genetic Profile of Spinocerebellar Ataxia 12: A Hospital-Based Cohort Analysis. Tremor Other Hyperkinet Mov (N Y) 2022; 12:13. [PMID: 35531119 PMCID: PMC9029677 DOI: 10.5334/tohm.686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 04/01/2022] [Indexed: 01/28/2023] Open
Abstract
Introduction: Spinocerebellar ataxia type-12 (SCA12) is a rare form of SCA, most commonly reported from the Indian Agarwal and related families. In this study we describe the clinical, genetic, and radiological characteristics of a sizeable cohort of genetically proven SCA12. Methods: A retrospective chart-review of the genetically confirmed SCA12 patients from our centre. The demographic, clinical, and investigation findings were reviewed. Correlation of expanded repeats length with various demographic and clinical features were studied. Results: A total of 49 patients (34 males, 42 families) were included of which 79.6% belonged to Agarwal community. The mean age at onset and age at presentation were 46.38 ± 11.7 years and 53.16 ± 12.78 years respectively. The most common initial symptom was tremor (73.5%), followed by ataxia (18.4%). At presentation, 95.9% of the patients had tremor with predominant distribution in the bilateral upper limbs (85.7%). At presentation, 73.5% of patients had ataxia and 22.4% had cognitive dysfunction. The mean CAG repeat length in PPP2R2B in the expanded allele was 53.26 ± 6.10 (40–72). The lowest pathogenic expanded repeat sizes in PPP2R2B recorded in our cohort was 40 & 42 repeats from two patients with a consistent clinical phenotype. Another unusual phenotype was the presence of prominent myoclonus. There was no significant correlation between the age at onset of symptoms and the repeat size of CAG repeat. Conclusion: SCA12 is not confined to a single ethnicity. Upper limb tremor and ataxia were the most common presentation. Unusual presentation may cause diagnostic confusion especially when recorded in patients from non-Aggarwal families.
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Singh I, Swarup V, Shakya S, Kumar V, Gupta D, Rajan R, Radhakrishnan DM, Faruq M, Srivastava AK. Impact of SARS-CoV-2 Infection in Spinocerebellar Ataxia 12 Patients. Mov Disord 2021; 36:2459-2460. [PMID: 34529277 PMCID: PMC8662285 DOI: 10.1002/mds.28811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/05/2021] [Accepted: 09/08/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- Inder Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Vishnu Swarup
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Sunil Shakya
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Vikash Kumar
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Deepika Gupta
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Roopa Rajan
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Mohammed Faruq
- CSIR-Institute of Genomics and Integrative Biology, New Delhi, India
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