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Koros C, Simitsi AM, Papagiannakis N, Bougea A, Antonelou R, Pachi I, Sfikas E, Stanitsa E, Angelopoulou E, Constantinides VC, Papageorgiou SG, Potagas C, Stamelou M, Stefanis L. Precision Dopaminergic Treatment in a Cohort of Parkinson's Disease Patients Carrying Autosomal Recessive Gene Variants: Clinical Cohort Data and a Mini Review. Neurol Int 2024; 16:833-844. [PMID: 39195564 DOI: 10.3390/neurolint16040062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 07/24/2024] [Accepted: 07/27/2024] [Indexed: 08/29/2024] Open
Abstract
INTRODUCTION Parkinson's disease (PD) patients harboring recessive gene variants exhibit a distinct clinical phenotype with an early disease onset and relatively mild symptoms. Data concerning individualized therapy for autosomal recessive PD forms are still scarce. METHODS Demographic and treatment data of a cohort of PD carriers of recessive genes (nine homozygous or compound heterozygous PRKN carriers, four heterozygous PRKN carriers, and three biallelic PINK1 carriers) were evaluated. RESULTS The average levodopa equivalent daily dose (LEDD) was 806.8 ± 453.5 (range 152-1810) in PRKN carriers and 765 ± 96.6 (range 660-850) in PINK1 carriers. The majority responded to low/moderate doses of levodopa. The response to dopamine agonists (DAs) was often favorable both as initial and longitudinal therapy. In total, 8/13 PRKN and 1/3 PINK1 carriers were treated with amantadine successfully, and this also applied to patients who could not tolerate levodopa or DAs. CONCLUSIONS In the era of personalized treatment, the therapeutic approach in recessive PD gene carriers might differ as compared to idiopathic PD. Lower LEDD doses were efficient even in patients with a very long disease duration, while a few patients were doing well without any levodopa treatment decades after disease initiation. DAs or amantadine could be used as a first and main line treatment regimen if well tolerated. Literature data on therapeutic strategies in carriers of pathogenic mutations in recessive PD genes, including device-aided treatments, will be further discussed.
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Affiliation(s)
- Christos Koros
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Athina-Maria Simitsi
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Nikolaos Papagiannakis
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Anastasia Bougea
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Roubina Antonelou
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Ioanna Pachi
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Evangelos Sfikas
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Evangelia Stanitsa
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Efthalia Angelopoulou
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Vasilios C Constantinides
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Sokratis G Papageorgiou
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Constantin Potagas
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | | | - Leonidas Stefanis
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
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2
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Salles PA, Fernández HH, Mata IF. Surgicogenomics in GBA1-related Parkinson disease: Is the glass half full or half empty? Parkinsonism Relat Disord 2024; 124:106981. [PMID: 38714481 DOI: 10.1016/j.parkreldis.2024.106981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2024]
Affiliation(s)
- Philippe A Salles
- Center for Movement Disorders CETRAM, Santiago, Chile; Neuroscience Institute, Clinica Davila, Santiago, Chile; Department of Neurology, Clinica Alemana, Santiago, Chile
| | | | - Ignacio F Mata
- Genomic Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
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3
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Balestrino R, Martone T, Toffoli M, Montanaro E, Fabbri M, Artusi CA, Romagnolo A, Zibetti M, Rizzone M, Goldwurm S, Lopiano L, Schapira AHV. Levodopa-carbidopa intestinal gel infusion (LCIG) in Parkinson disease with genetic mutations. Neurol Sci 2024; 45:1489-1497. [PMID: 37926749 DOI: 10.1007/s10072-023-07173-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 10/30/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Levodopa-carbidopa intestinal gel infusion (LCIG) is a therapeutic option for advanced Parkinson disease (PD) patients with troublesome motor complications, unresponsive to conventional oral treatment. There is some evidence to suggest that the genetic background may influence the clinical presentation and rate of progression of PD. Whether the genetic background influences the outcome of device-assisted therapies is currently debated. Some studies have investigated the effectiveness of deep brain stimulation (DBS) in PD patients with different genetic background, while evidence is lacking regarding LCIG. METHODS A cohort of LCIG patients underwent genetic testing. The motor and neuropsychological outcomes of LCIG were retrospectively analyzed. RESULTS Fifty-six patients were analyzed, nine of them (15%) had at least one mutation/variant in a PD-associated gene: five GBA1, two SNCA, one LRRK2, one PRKN; 13 (23%) carried the BDNF Val66Met polymorphism. The mean duration of follow-up was 4.9 ± 2.6 years. There were no significant differences in motor or neuropsychological outcomes between patients with and without these gene mutations/variants. No cognitive worsening was observed at follow-up among GBA-PD patients, and they responded well to LCIG in terms of motor symptoms. CONCLUSIONS Overall, we observed a significant benefit in terms of motor complications in our cohort, including patients carrying genetic mutations/variants. Due to the small sample and limited number of patients carrying genetic mutations/variants, no definitive conclusions can be drawn yet on the genotype impact on LCIG outcome. A careful selection of patients, regardless of the genetic background, is pivotal for an optimal outcome of LCIG.
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Affiliation(s)
- R Balestrino
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.
- Neurology 2 Unit, A.O.U., Città Della Salute E Della Scienza Di Torino, Corso Bramante 88, 10124, Turin, Italy.
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.
- Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele Scientific Institute, Milan, Italy.
- Neurology and Neurorehabiliation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
- Vita-Salute San Raffaele University, Milan, Italy.
| | - T Martone
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - M Toffoli
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - E Montanaro
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
- Neurology 2 Unit, A.O.U., Città Della Salute E Della Scienza Di Torino, Corso Bramante 88, 10124, Turin, Italy
| | - M Fabbri
- Department of Neurosciences, Clinical Investigation Center 1436, NS-Park/FCRIN Network and NeuroToul COEN Center, Toulouse University Hospital, INSERM, University of Toulouse 3, Parkinson Toulouse Expert Center, Toulouse, France
| | - C A Artusi
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
- Neurology 2 Unit, A.O.U., Città Della Salute E Della Scienza Di Torino, Corso Bramante 88, 10124, Turin, Italy
| | - A Romagnolo
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
- Neurology 2 Unit, A.O.U., Città Della Salute E Della Scienza Di Torino, Corso Bramante 88, 10124, Turin, Italy
| | - M Zibetti
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
- Neurology 2 Unit, A.O.U., Città Della Salute E Della Scienza Di Torino, Corso Bramante 88, 10124, Turin, Italy
| | - M Rizzone
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
- Neurology 2 Unit, A.O.U., Città Della Salute E Della Scienza Di Torino, Corso Bramante 88, 10124, Turin, Italy
| | - S Goldwurm
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - L Lopiano
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
- Neurology 2 Unit, A.O.U., Città Della Salute E Della Scienza Di Torino, Corso Bramante 88, 10124, Turin, Italy
| | - A H V Schapira
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
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Moes HR, Henriksen T, Sławek J, Phokaewvarangkul O, Buskens E, van Laar T. Tools and criteria to select patients with advanced Parkinson's disease for device-aided therapies: a narrative review. J Neural Transm (Vienna) 2023; 130:1359-1377. [PMID: 37500937 PMCID: PMC10645650 DOI: 10.1007/s00702-023-02656-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/16/2023] [Indexed: 07/29/2023]
Abstract
This article provides an overview of the various screening and selection tools which have been developed over the past 25 years to identify patients with Parkinson's disease (PD) possibly eligible for device-aided therapies (DATs). For the available screening tools, we describe the target therapies (subtypes of DAT), development methods, validation data, and their use in clinical practice. In addition, the historical background and potential utility of these screening tools are discussed. The challenges in developing and validating these tools are also addressed, taking into account the differences in population, the local health care organization, and resource availability.
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Affiliation(s)
- Harmen R Moes
- Department of Neurology, University of Groningen, University Medical Center Groningen, 9713 GZ, Groningen, The Netherlands
| | - Tove Henriksen
- Department of Neurology, Movement Disorder Clinic, Bispebjerg Hospital, Copenhagen, Denmark
| | - Jarosław Sławek
- Department of Neurology, St Adalbert Hospital Copernicus, Gdansk, Poland
- Department of Neurological and Psychiatric Nursing, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - Onanong Phokaewvarangkul
- Chulalongkorn Center of Excellence for Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Erik Buskens
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Teus van Laar
- Department of Neurology, University of Groningen, University Medical Center Groningen, 9713 GZ, Groningen, The Netherlands.
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5
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Dulski J, Uitti RJ, Ross OA, Wszolek ZK. Genetic architecture of Parkinson’s disease subtypes – Review of the literature. Front Aging Neurosci 2022; 14:1023574. [PMID: 36337703 PMCID: PMC9632166 DOI: 10.3389/fnagi.2022.1023574] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022] Open
Abstract
The heterogeneity of Parkinson’s disease (PD) has been recognized since its description by James Parkinson over 200 years ago. The complexity of motor and non-motor PD manifestations has led to many attempts of PD subtyping with different prognostic outcomes; however, the pathophysiological foundations of PD heterogeneity remain elusive. Genetic contributions to PD may be informative in understanding the underpinnings of PD subtypes. As such, recognizing genotype-phenotype associations may be crucial for successful gene therapy. We review the state of knowledge on the genetic architecture underlying PD subtypes, discussing the monogenic forms, as well as oligo- and polygenic risk factors associated with various PD subtypes. Based on our review, we argue for the unification of PD subtyping classifications, the dichotomy of studies on genetic factors and genetic modifiers of PD, and replication of results from previous studies.
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Affiliation(s)
- Jarosław Dulski
- Department of Neurology, Mayo Clinic, Jacksonville, FL, United States
- Division of Neurological and Psychiatric Nursing, Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland
- Department of Neurology, St. Adalbert Hospital, Copernicus PL Ltd., Gdańsk, Poland
| | - Ryan J. Uitti
- Department of Neurology, Mayo Clinic, Jacksonville, FL, United States
| | - Owen A. Ross
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, United States
| | - Zbigniew K. Wszolek
- Department of Neurology, Mayo Clinic, Jacksonville, FL, United States
- *Correspondence: Zbigniew K. Wszolek,
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6
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Salles PA, Mata IF. Steering the genes into the field of deep brain stimulation. Parkinsonism Relat Disord 2022; 103:166-168. [PMID: 36109294 DOI: 10.1016/j.parkreldis.2022.09.006] [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] [Indexed: 11/26/2022]
Affiliation(s)
- Philippe A Salles
- Centro de Trastornos Del Movimiento CETRAM, Santiago, Chile; Movement Disorders Section, Neurology Department, Clínica Alemana, Santiago, Chile; Movement Disorders Section, Neuroscience Center, Clínica Dávila, Santiago, Chile.
| | - Ignacio F Mata
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, OH, USA.
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7
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Salles PA, Liao J, Shuaib U, Mata IF, Fernandez HH. A Review on Response to Device-Aided Therapies Used in Monogenic Parkinsonism and GBA Variants Carriers: A Need for Guidelines and Comparative Studies. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1703-1725. [PMID: 35662127 PMCID: PMC9535575 DOI: 10.3233/jpd-212986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Parkinson's disease (PD) is in some cases predisposed-or-caused by genetic variants, contributing to the expression of different phenotypes. Regardless of etiology, as the disease progresses, motor fluctuations and/or levodopa-induced dyskinesias limit the benefit of pharmacotherapy. Device-aided therapies are good alternatives in advanced disease, including deep brain stimulation (DBS), levodopa-carbidopa intestinal gel, and continuous subcutaneous infusion of apomorphine. Candidate selection and timing are critical for the success of such therapies. Genetic screening in DBS cohorts has shown a higher proportion of mutation carriers than in general cohorts, suggesting that genetic factors may influence candidacy for advanced therapies. The response of monogenic PD to device therapies is not well established, and the contribution of genetic information to decision-making is still a matter of debate. The limited evidence regarding gene-dependent response to device-aided therapies is reviewed here. An accurate understanding of the adequacy and responses of different mutation carriers to device-aided therapies requires the development of specific studies with long-term monitoring.
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Affiliation(s)
- Philippe A Salles
- Center for Neurological Restoration, Cleveland Clinic Neurological Institute, Cleveland, OH, USA.,Centro de Trastornos del Movimiento, CETRAM, Santiago, Chile
| | - James Liao
- Center for Neurological Restoration, Cleveland Clinic Neurological Institute, Cleveland, OH, USA
| | - Umar Shuaib
- Center for Neurological Restoration, Cleveland Clinic Neurological Institute, Cleveland, OH, USA
| | - Ignacio F Mata
- Lerner Research Institute, Genomic Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Hubert H Fernandez
- Center for Neurological Restoration, Cleveland Clinic Neurological Institute, Cleveland, OH, USA
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8
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Pal G, Mangone G, Ouyang B, Ehrlich D, Saunders-Pullman R, Bressman S, Alcalay RN, Marder K, Aasly J, Mouradian M, Anderson S, Bernard B, Stebbins G, Sani S, Afshari M, Verhagen L, de Bie RM, Foltynie T, Hall D, Corvol JC, Goetz CG. Reply to: Cognitive Effects of Deep Brain Stimulation in GBA-Related Parkinson's Disease. Ann Neurol 2022; 92:345-346. [PMID: 35687082 PMCID: PMC10540153 DOI: 10.1002/ana.26433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 06/08/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Gian Pal
- Department of Neurology, Rutgers-Robert Wood Johnson
Medical School, New Brunswick, NJ, USA
- Department of Neurological Sciences, Rush University
Medical Center, Chicago, IL, USA
| | - Graziella Mangone
- Sorbonne Université, Assistance Publique
Hôpitaux de Paris, Inserm, CNRS, Institut du Cerveau – Paris Brain
Institute – ICM, Pitié-Salpêtrière Hospital, Department
of Neurology, Centre d’Investigation Clinique Neurosciences, Paris,
France
| | - Bichun Ouyang
- Department of Neurological Sciences, Rush University
Medical Center, Chicago, IL, USA
| | - Debra Ehrlich
- Parkinson’s Disease Clinic, Office of the Clinical
Director, NIH/NINDS, Bethesda, MD, USA
| | - Rachel Saunders-Pullman
- Department of Neurology, Mount Sinai Beth Israel, Icahn
School of Medicine at Mount Sinai, New York, New York, USA
| | - Susan Bressman
- Department of Neurology, Mount Sinai Beth Israel, Icahn
School of Medicine at Mount Sinai, New York, New York, USA
| | - Roy N. Alcalay
- Department of Neurology, College of Physicians and
Surgeons, Columbia University Medical Center, New York, NY, USA
| | - Karen Marder
- Department of Neurology, College of Physicians and
Surgeons, Columbia University Medical Center, New York, NY, USA
| | - Jan Aasly
- Department of Neurology, St. Olavs Hospital and Department
of Neuroscience, Norwegian University of Science and Technology, Trondheim, 7030,
Norway
| | - Maral Mouradian
- Department of Neurology, Rutgers-Robert Wood Johnson
Medical School, New Brunswick, NJ, USA
- Robert Wood Johnson Medical School Institute for
Neurological Therapeutics, Rutgers Biomedical and Health Sciences, Piscataway, NJ,
USA
| | - Sharlet Anderson
- Department of Neurological Sciences, Rush University
Medical Center, Chicago, IL, USA
| | - Bryan Bernard
- Department of Neurological Sciences, Rush University
Medical Center, Chicago, IL, USA
| | - Glenn Stebbins
- Department of Neurological Sciences, Rush University
Medical Center, Chicago, IL, USA
| | - Sepehr Sani
- Department of Neurosurgery, Rush University Medical Center,
Chicago, IL, USA
| | - Mitra Afshari
- Department of Neurological Sciences, Rush University
Medical Center, Chicago, IL, USA
| | - Leo Verhagen
- Department of Neurological Sciences, Rush University
Medical Center, Chicago, IL, USA
| | - Rob M.A. de Bie
- Amsterdam University Medical Centers, University of
Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam,
Netherlands
| | - Tom Foltynie
- Department of Clinical & Movement Neurosciences, UCL
Institute of Neurology, London, UK
| | - Deborah Hall
- Department of Neurological Sciences, Rush University
Medical Center, Chicago, IL, USA
| | - Jean-Christophe Corvol
- Sorbonne Université, Assistance Publique
Hôpitaux de Paris, Inserm, CNRS, Institut du Cerveau – Paris Brain
Institute – ICM, Pitié-Salpêtrière Hospital, Department
of Neurology, Centre d’Investigation Clinique Neurosciences, Paris,
France
| | - Christopher G. Goetz
- Department of Neurological Sciences, Rush University
Medical Center, Chicago, IL, USA
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9
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Hanna Al-Shaikh R, Milanowski LM, Holla VV, Kurihara K, Yadav R, Kamble N, Muthusamy B, Bellad A, Koziorowski D, Szlufik S, Hoffman-Zacharska D, Fujioka S, Tsuboi Y, Ross OA, Wierenga K, Uitti RJ, Wszolek Z, Pal PK. PLA2G6-associated neurodegeneration in four different populations-case series and literature review. Parkinsonism Relat Disord 2022; 101:66-74. [PMID: 35803092 DOI: 10.1016/j.parkreldis.2022.06.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND PLA2G6-Associated Neurodegeneration, PLAN, is subdivided into: Infantile neuroaxonal dystrophy, atypical neuroaxonal dystrophy, and adult-onset dystonia parkinsonism [1]. It is elicited by a biallelic pathogenic variant in phospholipase A2 group VI (PLA2G6) gene. In this study we describe new cases and provide a comprehensive review of previously published cases. METHODS Eleven patients, from four different institutions and four different countries. All underwent a comprehensive chart review. RESULTS Ages at onset ranged from 1 to 36 years, with a median of 16 and a mean of 16.18 ± 11.91 years. Phenotypic characteristics were heterogenous and resembled that of patients with infantile neuroaxonal dystrophy (n = 2), atypical neuroaxonal dystrophy (n = 1), adult-onset dystonia parkinsonism (n = 1), complex hereditary spastic paraparesis (n = 3), and early onset Parkinson's disease (n = 2). Parental genetic studies were performed for all patients and confirmed with sanger sequencing in five. Visual evoked potential illustrated optic atrophy in P4. Mineralization was evident in brain magnetic resonance imaging of P1, P2, P4, P5, P7, and P11. Single photon emission computed tomography was conducted for three patients, revealed decreased perfusion in the occipital lobes for P10. DaTscan was performed for P11 and showed decreased uptake in the deep gray matter, bilateral caudate nuclei, and bilateral putamen. Positive response to Apomorphine was noted for P10 and to Baclofen in P2, and P3. CONCLUSIONS PLAN encompasses a wide clinical spectrum. Age and symptom at onset are crucial when classifying patients. Reporting new variants is critical to draw more attention to this condition and identify biomarkers to arrive at potential therapeutics.
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Affiliation(s)
| | - Lukasz M Milanowski
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA; Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
| | - Vikram V Holla
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, India
| | | | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, India
| | - Nitish Kamble
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, India
| | - Babylakshmi Muthusamy
- Institute of Bioinformatics, Bengaluru, India; Manipal Academy of Higher Education, Manipal, India
| | - Anikha Bellad
- Institute of Bioinformatics, International Technology Park, Bangalore, 560066, India; Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Dariusz Koziorowski
- Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
| | - Stanislaw Szlufik
- Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
| | - Dorota Hoffman-Zacharska
- Department of Medical Genetics, Institute of Mother and Child, Warsaw, Poland; Institute of Genetics and Biotechnology, University of Warsaw, Warsaw, Poland
| | | | - Yoshio Tsuboi
- Department of Neurology, Fukuoka University, Fukuoka, Japan
| | - Owen A Ross
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA; Department of Clinical Genomics, Mayo Clinic, Jacksonville, FL, USA
| | - Klaas Wierenga
- Department of Clinical Genomics, Mayo Clinic, Jacksonville, FL, USA
| | - Ryan J Uitti
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, India
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10
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Salles PA, Mata IF, Fernandez HH. Looking back the importance of genetics in a patient with Parkinson disease and deep brain stimulation. Parkinsonism Relat Disord 2022; 99:96-98. [PMID: 35461777 DOI: 10.1016/j.parkreldis.2022.04.006] [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: 11/05/2021] [Revised: 04/03/2022] [Accepted: 04/11/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Philippe A Salles
- Center for the Neurological Restoration, Neurological Institute, Cleveland Clinic, OH, USA; Movement Disorders Center CETRAM, University of Santiago de Chile, Santiago, Chile.
| | - Ignacio F Mata
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, OH, USA
| | - Hubert H Fernandez
- Center for the Neurological Restoration, Neurological Institute, Cleveland Clinic, OH, USA
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11
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Pal G, Mangone G, Hill EJ, Ouyang B, Liu Y, Lythe V, Ehrlich D, Saunders-Pullman R, Shanker V, Bressman S, Alcalay RN, Garcia P, Marder KS, Aasly J, Mouradian MM, Link S, Rosenbaum M, Anderson S, Bernard B, Wilson R, Stebbins G, Nichols WC, Welter ML, Sani S, Afshari M, Verhagen L, de Bie RM, Foltynie T, Hall D, Corvol JC, Goetz CG. Parkinson Disease and Subthalamic Nucleus Deep Brain Stimulation: Cognitive Effects in GBA Mutation Carriers. Ann Neurol 2022; 91:424-435. [PMID: 34984729 PMCID: PMC8857042 DOI: 10.1002/ana.26302] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/01/2022] [Accepted: 01/03/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This study was undertaken to compare the rate of change in cognition between glucocerebrosidase (GBA) mutation carriers and noncarriers with and without subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson disease. METHODS Clinical and genetic data from 12 datasets were examined. Global cognition was assessed using the Mattis Dementia Rating Scale (MDRS). Subjects were examined for mutations in GBA and categorized as GBA carriers with or without DBS (GBA+DBS+, GBA+DBS-), and noncarriers with or without DBS (GBA-DBS+, GBA-DBS-). GBA mutation carriers were subcategorized according to mutation severity (risk variant, mild, severe). Linear mixed modeling was used to compare rate of change in MDRS scores over time among the groups according to GBA and DBS status and then according to GBA severity and DBS status. RESULTS Data were available for 366 subjects (58 GBA+DBS+, 82 GBA+DBS-, 98 GBA-DBS+, and 128 GBA-DBS- subjects), who were longitudinally followed (range = 36-60 months after surgery). Using the MDRS, GBA+DBS+ subjects declined on average 2.02 points/yr more than GBA-DBS- subjects (95% confidence interval [CI] = -2.35 to -1.69), 1.71 points/yr more than GBA+DBS- subjects (95% CI = -2.14 to -1.28), and 1.49 points/yr more than GBA-DBS+ subjects (95% CI = -1.80 to -1.18). INTERPRETATION Although not randomized, this composite analysis suggests that the combined effects of GBA mutations and STN-DBS negatively impact cognition. We advise that DBS candidates be screened for GBA mutations as part of the presurgical decision-making process. We advise that GBA mutation carriers be counseled regarding potential risks associated with STN-DBS so that alternative options may be considered. ANN NEUROL 2022;91:424-435.
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Affiliation(s)
- Gian Pal
- Department of Neurology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Graziella Mangone
- Sorbonne Université, Assistance Publique Hôpitaux de Paris, Inserm, CNRS, Institut du Cerveau – Paris Brain Institute – ICM, Pitié-Salpêtrière Hospital, Department of Neurology, Centre d’Investigation Clinique Neurosciences, Paris, France
| | - Emily J. Hill
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Bichun Ouyang
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Yuanqing Liu
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Vanessa Lythe
- Department of Clinical & Movement Neurosciences, UCL Institute of Neurology, London, UK
| | - Debra Ehrlich
- Parkinson’s Disease Clinic, Office of the Clinical Director, NIH/NINDS, Bethesda, MD, USA
| | - Rachel Saunders-Pullman
- Department of Neurology, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Vicki Shanker
- Department of Neurology, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Susan Bressman
- Department of Neurology, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Roy N. Alcalay
- Department of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
| | - Priscilla Garcia
- Department of Neurology, New York Medical College, Valhalla, NY, USA
| | - Karen S. Marder
- Department of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
| | - Jan Aasly
- Department of Neurology, St. Olavs Hospital and Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, 7030, Norway
| | - M. Maral Mouradian
- Department of Neurology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Robert Wood Johnson Medical School Institute for Neurological Therapeutics, Rutgers Biomedical and Health Sciences, Piscataway, NJ, USA
| | - Samantha Link
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Marc Rosenbaum
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Sharlet Anderson
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Bryan Bernard
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Robert Wilson
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Glenn Stebbins
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - William C. Nichols
- Division of Human Genetics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Marie-Laure Welter
- Sorbonne Université, Assistance Publique Hôpitaux de Paris, Inserm, CNRS, Institut du Cerveau – Paris Brain Institute – ICM, Pitié-Salpêtrière Hospital, Department of Neurology, Centre d’Investigation Clinique Neurosciences, Paris, France
- Normandie Univ, CHU Rouen, Department of Neurophysiology, Rouen, France
| | - Sepehr Sani
- Department of Neurosurgery, Rush University Medical Center, Chicago, IL, USA
| | - Mitra Afshari
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Leo Verhagen
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Rob M.A. de Bie
- Amsterdam University Medical Centers, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Tom Foltynie
- Department of Clinical & Movement Neurosciences, UCL Institute of Neurology, London, UK
| | - Deborah Hall
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Jean-Christophe Corvol
- Sorbonne Université, Assistance Publique Hôpitaux de Paris, Inserm, CNRS, Institut du Cerveau – Paris Brain Institute – ICM, Pitié-Salpêtrière Hospital, Department of Neurology, Centre d’Investigation Clinique Neurosciences, Paris, France
| | - Christopher G. Goetz
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
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Neri M, Braccia A, Panteghini C, Garavaglia B, Gualandi F, Cavallo MA, Scerrati A, Ferlini A, Sensi M. Parkinson's disease-dementia in trans LRP10 and GBA variants: Response to deep brain stimulation. Parkinsonism Relat Disord 2021; 92:72-75. [PMID: 34710740 DOI: 10.1016/j.parkreldis.2021.10.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/06/2021] [Accepted: 10/16/2021] [Indexed: 10/20/2022]
Abstract
We report on a patient with Parkinson's disease and dementia who underwent DBS with excellent response in motor features; the genotype is heterozygous for a novel LRP10 variant in trans with a GBA variant. He had a more severe phenotype compared to the father who only carries the LRP10 variant.
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Affiliation(s)
- Marcella Neri
- Unit of Medical Genetics, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
| | - Arianna Braccia
- Department of Neuroscience and Rehabilitation, Azienda Ospedaliera-Universitaria S. Anna, Fer-rara, Italy
| | - Celeste Panteghini
- Medical Genetics and Neurogenetics Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Barbara Garavaglia
- Medical Genetics and Neurogenetics Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Francesca Gualandi
- Unit of Medical Genetics, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Michele Alessandro Cavallo
- Department of Neuroscience and Rehabilitation, Azienda Ospedaliera-Universitaria S. Anna, Fer-rara, Italy
| | - Alba Scerrati
- Department of Neuroscience and Rehabilitation, Azienda Ospedaliera-Universitaria S. Anna, Fer-rara, Italy
| | - Alessandra Ferlini
- Unit of Medical Genetics, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Mariachiara Sensi
- Department of Neuroscience and Rehabilitation, Azienda Ospedaliera-Universitaria S. Anna, Fer-rara, Italy
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13
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David FJ, Munoz MJ, Shils JL, Pauciulo MW, Hale PT, Nichols WC, Afshari M, Sani S, Verhagen Metman L, Corcos DM, Pal GD. Subthalamic Peak Beta Ratio Is Asymmetric in Glucocerebrosidase Mutation Carriers With Parkinson's Disease: A Pilot Study. Front Neurol 2021; 12:723476. [PMID: 34659089 PMCID: PMC8514636 DOI: 10.3389/fneur.2021.723476] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/24/2021] [Indexed: 01/18/2023] Open
Abstract
Introduction: Up to 27% of individuals undergoing subthalamic nucleus deep brain stimulation (STN-DBS) have a genetic form of Parkinson's disease (PD). Glucocerebrosidase (GBA) mutation carriers, compared to sporadic PD, present with a more aggressive disease, less asymmetry, and fare worse on cognitive outcomes with STN-DBS. Evaluating STN intra-operative local field potentials provide the opportunity to assess and compare symmetry between GBA and non-GBA mutation carriers with PD; thus, providing insight into genotype and STN physiology, and eligibility for and programming of STN-DBS. The purpose of this pilot study was to test differences in left and right STN resting state beta power in non-GBA and GBA mutation carriers with PD. Materials and Methods: STN (left and right) resting state local field potentials were recorded intraoperatively from 4 GBA and 5 non-GBA patients with PD while off medication. Peak beta power expressed as a ratio to total beta power (peak beta ratio) was compared between STN hemispheres and groups while co-varying for age, age of disease onset, and disease severity. Results: Peak beta ratio was significantly different between the left and the right STN for the GBA group (p < 0.01) but not the non-GBA group (p = 0.56) after co-varying for age, age of disease onset, and disease severity. Discussion: Peak beta ratio in GBA mutation carriers was more asymmetric compared with non-mutation carriers and this corresponded with the degree of clinical asymmetry as measured by rating scales. This finding suggests that GBA mutation carriers have a physiologic signature that is distinct from that found in sporadic PD.
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Affiliation(s)
- Fabian J David
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
| | - Miranda J Munoz
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
| | - Jay L Shils
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, United States
| | - Michael W Pauciulo
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Philip T Hale
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - William C Nichols
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Mitra Afshari
- Department of Neurological Science, Rush University Medical Center, Chicago, IL, United States
| | - Sepehr Sani
- Department of Neurosurgery, Rush University Medical Center, Chicago, IL, United States
| | - Leo Verhagen Metman
- Department of Neurological Science, Rush University Medical Center, Chicago, IL, United States
| | - Daniel M Corcos
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
| | - Gian D Pal
- Department of Neurological Science, Rush University Medical Center, Chicago, IL, United States.,Department of Neurology, Rutgers University, New Brunswick, NJ, United States
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