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Dincã DM, Lallemant L, González-Barriga A, Cresto N, Braz SO, Sicot G, Pillet LE, Polvèche H, Magneron P, Huguet-Lachon A, Benyamine H, Azotla-Vilchis CN, Agonizantes-Juárez LE, Tahraoui-Boris J, Martinat C, Hernández-Hernández O, Auboeuf D, Rouach N, Bourgeois CF, Gourdon G, Gomes-Pereira M. Myotonic dystrophy RNA toxicity alters morphology, adhesion and migration of mouse and human astrocytes. Nat Commun 2022; 13:3841. [PMID: 35789154 PMCID: PMC9253038 DOI: 10.1038/s41467-022-31594-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 06/21/2022] [Indexed: 11/24/2022] Open
Abstract
Brain dysfunction in myotonic dystrophy type 1 (DM1), the prototype of toxic RNA disorders, has been mainly attributed to neuronal RNA misprocessing, while little attention has been given to non-neuronal brain cells. Here, using a transgenic mouse model of DM1 that expresses mutant RNA in various brain cell types (neurons, astroglia, and oligodendroglia), we demonstrate that astrocytes exhibit impaired ramification and polarization in vivo and defects in adhesion, spreading, and migration. RNA-dependent toxicity and phenotypes are also found in human transfected glial cells. In line with the cell phenotypes, molecular analyses reveal extensive expression and accumulation of toxic RNA in astrocytes, which result in RNA spliceopathy that is more severe than in neurons. Astrocyte missplicing affects primarily transcripts that regulate cell adhesion, cytoskeleton, and morphogenesis, and it is confirmed in human brain tissue. Our findings demonstrate that DM1 impacts astrocyte cell biology, possibly compromising their support and regulation of synaptic function. Myotonic dystrophy type 1 (DM1) is characterized by debilitating neurological symptoms. Dinca et al. demonstrate the pronounced impact of DM1 on the morphology and RNA metabolism of astrocytes. Their findings suggest astroglial pathology in DM1 brain dysfunction.
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Affiliation(s)
- Diana M Dincã
- Sorbonne Université, Inserm, Centre de Recherche en Myologie, 75013, Paris, France
| | - Louison Lallemant
- Sorbonne Université, Inserm, Centre de Recherche en Myologie, 75013, Paris, France
| | | | - Noémie Cresto
- Neuroglial Interactions in Cerebral Physiology and Pathologies, Center for Interdisciplinary Research in Biology, Collège de France, CNRS, Inserm, Labex Memolife, 75005, Paris, France
| | - Sandra O Braz
- Sorbonne Université, Inserm, Centre de Recherche en Myologie, 75013, Paris, France.,Inserm UMR1163, Institut Imagine, Université Paris Cite, 75015, Paris, France
| | - Géraldine Sicot
- Sorbonne Université, Inserm, Centre de Recherche en Myologie, 75013, Paris, France
| | - Laure-Elise Pillet
- Neuroglial Interactions in Cerebral Physiology and Pathologies, Center for Interdisciplinary Research in Biology, Collège de France, CNRS, Inserm, Labex Memolife, 75005, Paris, France.,Doctoral School N°562, Paris Descartes University, Paris, 75006, France
| | - Hélène Polvèche
- Inserm/UEVE UMR861, Université Paris Saclay I-STEM, 91110, Corbeil-Essonnes, France
| | - Paul Magneron
- Sorbonne Université, Inserm, Centre de Recherche en Myologie, 75013, Paris, France
| | - Aline Huguet-Lachon
- Sorbonne Université, Inserm, Centre de Recherche en Myologie, 75013, Paris, France
| | - Hélène Benyamine
- Sorbonne Université, Inserm, Centre de Recherche en Myologie, 75013, Paris, France
| | - Cuauhtli N Azotla-Vilchis
- Laboratory of Genomic Medicine, Department of Genetics, National Rehabilitation Institute (INR-LGII), Mexico City, Mexico
| | - Luis E Agonizantes-Juárez
- Laboratory of Genomic Medicine, Department of Genetics, National Rehabilitation Institute (INR-LGII), Mexico City, Mexico
| | - Julie Tahraoui-Boris
- Inserm/UEVE UMR861, Université Paris Saclay I-STEM, 91110, Corbeil-Essonnes, France
| | - Cécile Martinat
- Inserm/UEVE UMR861, Université Paris Saclay I-STEM, 91110, Corbeil-Essonnes, France
| | - Oscar Hernández-Hernández
- Laboratory of Genomic Medicine, Department of Genetics, National Rehabilitation Institute (INR-LGII), Mexico City, Mexico
| | - Didier Auboeuf
- Laboratoire de Biologie et Modelisation de la Cellule, Ecole Normale Superieure de Lyon, CNRS, UMR 5239, Inserm, U1293, Universite Claude Bernard Lyon 1, 46 allée d'Italie, 69364, Lyon, France
| | - Nathalie Rouach
- Neuroglial Interactions in Cerebral Physiology and Pathologies, Center for Interdisciplinary Research in Biology, Collège de France, CNRS, Inserm, Labex Memolife, 75005, Paris, France
| | - Cyril F Bourgeois
- Laboratoire de Biologie et Modelisation de la Cellule, Ecole Normale Superieure de Lyon, CNRS, UMR 5239, Inserm, U1293, Universite Claude Bernard Lyon 1, 46 allée d'Italie, 69364, Lyon, France
| | - Geneviève Gourdon
- Sorbonne Université, Inserm, Centre de Recherche en Myologie, 75013, Paris, France.
| | - Mário Gomes-Pereira
- Sorbonne Université, Inserm, Centre de Recherche en Myologie, 75013, Paris, France.
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3
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Ballester-Lopez A, Núñez-Manchón J, Koehorst E, Linares-Pardo I, Almendrote M, Lucente G, Guanyabens N, Lopez-Osias M, Suárez-Mesa A, Hanick SA, Chojnacki J, Lucia A, Pintos-Morell G, Coll-Cantí J, Martínez-Piñeiro A, Ramos-Fransi A, Nogales-Gadea G. Three-dimensional imaging in myotonic dystrophy type 1: Linking molecular alterations with disease phenotype. NEUROLOGY-GENETICS 2020; 6:e484. [PMID: 32802949 PMCID: PMC7413607 DOI: 10.1212/nxg.0000000000000484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/05/2020] [Indexed: 12/31/2022]
Abstract
Objective We aimed to determine whether 3D imaging reconstruction allows identifying molecular:clinical associations in myotonic dystrophy type 1 (DM1). Methods We obtained myoblasts from 6 patients with DM1 and 6 controls. We measured cytosine-thymine-guanine (CTG) expansion and detected RNA foci and muscleblind like 1 (MBNL1) through 3D reconstruction. We studied dystrophia myotonica protein kinase (DMPK) expression and splicing alterations of MBNL1, insulin receptor, and sarcoplasmic reticulum Ca(2+)-ATPase 1. Results Three-dimensional analysis showed that RNA foci (nuclear and/or cytoplasmic) were present in 45%-100% of DM1-derived myoblasts we studied (range: 0-6 foci per cell). RNA foci represented <0.6% of the total myoblast nuclear volume. CTG expansion size was associated with the number of RNA foci per myoblast (r = 0.876 [95% confidence interval 0.222-0.986]) as well as with the number of cytoplasmic RNA foci (r = 0.943 [0.559-0.994]). Although MBNL1 colocalized with RNA foci in all DM1 myoblast cell lines, colocalization only accounted for 1% of total MBNL1 expression, with the absence of DM1 alternative splicing patterns. The number of RNA foci was associated with DMPK expression (r = 0.967 [0.079-0.999]). On the other hand, the number of cytoplasmic RNA foci was correlated with the age at disease onset (r = -0.818 [-0.979 to 0.019]). Conclusions CTG expansion size modulates RNA foci number in myoblasts derived from patients with DM1. MBNL1 sequestration plays only a minor role in the pathobiology of the disease in these cells. Higher number of cytoplasmic RNA foci is related to an early onset of the disease, a finding that should be corroborated in future studies.
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Affiliation(s)
- Alfonsina Ballester-Lopez
- Neuromuscular and Neuropediatric Research Group (A.B.-L., J.N.-M., E.K., I.L.-P., M.A., G.L., M.L.-O., A.S.-M., S.A.H., G.P.-M., J.C.-C., A.M.-P., A.R.-F., G.N.-G.), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Campus Can Ruti, Universitat Autònoma de Barcelona, Badalona; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (A.B.-L., G.P.-M., J.C.-C., G.N.-G.), Instituto de Salud Carlos III, Madrid; Neuromuscular Pathology Unit. Neurology Service. Neuroscience department (M.A., G.L., N.G., J.C.-C., A.M.-P., A.R.-F.), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona; IrsiCaixa AIDS Research Institute (J.C.), Badalona, Spain; Faculty of Sport Sciences (A.L.), Universidad Europea de Madrid; Instituto de Investigación Hospital 12 de Octubre (i+12) (A.L.), Madrid; and Division of Rare Diseases. University Hospital Vall d'Hebron (G.P.-M.), Barcelona, Spain
| | - Judit Núñez-Manchón
- Neuromuscular and Neuropediatric Research Group (A.B.-L., J.N.-M., E.K., I.L.-P., M.A., G.L., M.L.-O., A.S.-M., S.A.H., G.P.-M., J.C.-C., A.M.-P., A.R.-F., G.N.-G.), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Campus Can Ruti, Universitat Autònoma de Barcelona, Badalona; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (A.B.-L., G.P.-M., J.C.-C., G.N.-G.), Instituto de Salud Carlos III, Madrid; Neuromuscular Pathology Unit. Neurology Service. Neuroscience department (M.A., G.L., N.G., J.C.-C., A.M.-P., A.R.-F.), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona; IrsiCaixa AIDS Research Institute (J.C.), Badalona, Spain; Faculty of Sport Sciences (A.L.), Universidad Europea de Madrid; Instituto de Investigación Hospital 12 de Octubre (i+12) (A.L.), Madrid; and Division of Rare Diseases. University Hospital Vall d'Hebron (G.P.-M.), Barcelona, Spain
| | - Emma Koehorst
- Neuromuscular and Neuropediatric Research Group (A.B.-L., J.N.-M., E.K., I.L.-P., M.A., G.L., M.L.-O., A.S.-M., S.A.H., G.P.-M., J.C.-C., A.M.-P., A.R.-F., G.N.-G.), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Campus Can Ruti, Universitat Autònoma de Barcelona, Badalona; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (A.B.-L., G.P.-M., J.C.-C., G.N.-G.), Instituto de Salud Carlos III, Madrid; Neuromuscular Pathology Unit. Neurology Service. Neuroscience department (M.A., G.L., N.G., J.C.-C., A.M.-P., A.R.-F.), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona; IrsiCaixa AIDS Research Institute (J.C.), Badalona, Spain; Faculty of Sport Sciences (A.L.), Universidad Europea de Madrid; Instituto de Investigación Hospital 12 de Octubre (i+12) (A.L.), Madrid; and Division of Rare Diseases. University Hospital Vall d'Hebron (G.P.-M.), Barcelona, Spain
| | - Ian Linares-Pardo
- Neuromuscular and Neuropediatric Research Group (A.B.-L., J.N.-M., E.K., I.L.-P., M.A., G.L., M.L.-O., A.S.-M., S.A.H., G.P.-M., J.C.-C., A.M.-P., A.R.-F., G.N.-G.), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Campus Can Ruti, Universitat Autònoma de Barcelona, Badalona; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (A.B.-L., G.P.-M., J.C.-C., G.N.-G.), Instituto de Salud Carlos III, Madrid; Neuromuscular Pathology Unit. Neurology Service. Neuroscience department (M.A., G.L., N.G., J.C.-C., A.M.-P., A.R.-F.), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona; IrsiCaixa AIDS Research Institute (J.C.), Badalona, Spain; Faculty of Sport Sciences (A.L.), Universidad Europea de Madrid; Instituto de Investigación Hospital 12 de Octubre (i+12) (A.L.), Madrid; and Division of Rare Diseases. University Hospital Vall d'Hebron (G.P.-M.), Barcelona, Spain
| | - Miriam Almendrote
- Neuromuscular and Neuropediatric Research Group (A.B.-L., J.N.-M., E.K., I.L.-P., M.A., G.L., M.L.-O., A.S.-M., S.A.H., G.P.-M., J.C.-C., A.M.-P., A.R.-F., G.N.-G.), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Campus Can Ruti, Universitat Autònoma de Barcelona, Badalona; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (A.B.-L., G.P.-M., J.C.-C., G.N.-G.), Instituto de Salud Carlos III, Madrid; Neuromuscular Pathology Unit. Neurology Service. Neuroscience department (M.A., G.L., N.G., J.C.-C., A.M.-P., A.R.-F.), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona; IrsiCaixa AIDS Research Institute (J.C.), Badalona, Spain; Faculty of Sport Sciences (A.L.), Universidad Europea de Madrid; Instituto de Investigación Hospital 12 de Octubre (i+12) (A.L.), Madrid; and Division of Rare Diseases. University Hospital Vall d'Hebron (G.P.-M.), Barcelona, Spain
| | - Giuseppe Lucente
- Neuromuscular and Neuropediatric Research Group (A.B.-L., J.N.-M., E.K., I.L.-P., M.A., G.L., M.L.-O., A.S.-M., S.A.H., G.P.-M., J.C.-C., A.M.-P., A.R.-F., G.N.-G.), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Campus Can Ruti, Universitat Autònoma de Barcelona, Badalona; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (A.B.-L., G.P.-M., J.C.-C., G.N.-G.), Instituto de Salud Carlos III, Madrid; Neuromuscular Pathology Unit. Neurology Service. Neuroscience department (M.A., G.L., N.G., J.C.-C., A.M.-P., A.R.-F.), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona; IrsiCaixa AIDS Research Institute (J.C.), Badalona, Spain; Faculty of Sport Sciences (A.L.), Universidad Europea de Madrid; Instituto de Investigación Hospital 12 de Octubre (i+12) (A.L.), Madrid; and Division of Rare Diseases. University Hospital Vall d'Hebron (G.P.-M.), Barcelona, Spain
| | - Nicolau Guanyabens
- Neuromuscular and Neuropediatric Research Group (A.B.-L., J.N.-M., E.K., I.L.-P., M.A., G.L., M.L.-O., A.S.-M., S.A.H., G.P.-M., J.C.-C., A.M.-P., A.R.-F., G.N.-G.), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Campus Can Ruti, Universitat Autònoma de Barcelona, Badalona; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (A.B.-L., G.P.-M., J.C.-C., G.N.-G.), Instituto de Salud Carlos III, Madrid; Neuromuscular Pathology Unit. Neurology Service. Neuroscience department (M.A., G.L., N.G., J.C.-C., A.M.-P., A.R.-F.), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona; IrsiCaixa AIDS Research Institute (J.C.), Badalona, Spain; Faculty of Sport Sciences (A.L.), Universidad Europea de Madrid; Instituto de Investigación Hospital 12 de Octubre (i+12) (A.L.), Madrid; and Division of Rare Diseases. University Hospital Vall d'Hebron (G.P.-M.), Barcelona, Spain
| | - Marta Lopez-Osias
- Neuromuscular and Neuropediatric Research Group (A.B.-L., J.N.-M., E.K., I.L.-P., M.A., G.L., M.L.-O., A.S.-M., S.A.H., G.P.-M., J.C.-C., A.M.-P., A.R.-F., G.N.-G.), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Campus Can Ruti, Universitat Autònoma de Barcelona, Badalona; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (A.B.-L., G.P.-M., J.C.-C., G.N.-G.), Instituto de Salud Carlos III, Madrid; Neuromuscular Pathology Unit. Neurology Service. Neuroscience department (M.A., G.L., N.G., J.C.-C., A.M.-P., A.R.-F.), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona; IrsiCaixa AIDS Research Institute (J.C.), Badalona, Spain; Faculty of Sport Sciences (A.L.), Universidad Europea de Madrid; Instituto de Investigación Hospital 12 de Octubre (i+12) (A.L.), Madrid; and Division of Rare Diseases. University Hospital Vall d'Hebron (G.P.-M.), Barcelona, Spain
| | - Adrián Suárez-Mesa
- Neuromuscular and Neuropediatric Research Group (A.B.-L., J.N.-M., E.K., I.L.-P., M.A., G.L., M.L.-O., A.S.-M., S.A.H., G.P.-M., J.C.-C., A.M.-P., A.R.-F., G.N.-G.), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Campus Can Ruti, Universitat Autònoma de Barcelona, Badalona; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (A.B.-L., G.P.-M., J.C.-C., G.N.-G.), Instituto de Salud Carlos III, Madrid; Neuromuscular Pathology Unit. Neurology Service. Neuroscience department (M.A., G.L., N.G., J.C.-C., A.M.-P., A.R.-F.), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona; IrsiCaixa AIDS Research Institute (J.C.), Badalona, Spain; Faculty of Sport Sciences (A.L.), Universidad Europea de Madrid; Instituto de Investigación Hospital 12 de Octubre (i+12) (A.L.), Madrid; and Division of Rare Diseases. University Hospital Vall d'Hebron (G.P.-M.), Barcelona, Spain
| | - Shaliza Ann Hanick
- Neuromuscular and Neuropediatric Research Group (A.B.-L., J.N.-M., E.K., I.L.-P., M.A., G.L., M.L.-O., A.S.-M., S.A.H., G.P.-M., J.C.-C., A.M.-P., A.R.-F., G.N.-G.), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Campus Can Ruti, Universitat Autònoma de Barcelona, Badalona; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (A.B.-L., G.P.-M., J.C.-C., G.N.-G.), Instituto de Salud Carlos III, Madrid; Neuromuscular Pathology Unit. Neurology Service. Neuroscience department (M.A., G.L., N.G., J.C.-C., A.M.-P., A.R.-F.), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona; IrsiCaixa AIDS Research Institute (J.C.), Badalona, Spain; Faculty of Sport Sciences (A.L.), Universidad Europea de Madrid; Instituto de Investigación Hospital 12 de Octubre (i+12) (A.L.), Madrid; and Division of Rare Diseases. University Hospital Vall d'Hebron (G.P.-M.), Barcelona, Spain
| | - Jakub Chojnacki
- Neuromuscular and Neuropediatric Research Group (A.B.-L., J.N.-M., E.K., I.L.-P., M.A., G.L., M.L.-O., A.S.-M., S.A.H., G.P.-M., J.C.-C., A.M.-P., A.R.-F., G.N.-G.), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Campus Can Ruti, Universitat Autònoma de Barcelona, Badalona; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (A.B.-L., G.P.-M., J.C.-C., G.N.-G.), Instituto de Salud Carlos III, Madrid; Neuromuscular Pathology Unit. Neurology Service. Neuroscience department (M.A., G.L., N.G., J.C.-C., A.M.-P., A.R.-F.), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona; IrsiCaixa AIDS Research Institute (J.C.), Badalona, Spain; Faculty of Sport Sciences (A.L.), Universidad Europea de Madrid; Instituto de Investigación Hospital 12 de Octubre (i+12) (A.L.), Madrid; and Division of Rare Diseases. University Hospital Vall d'Hebron (G.P.-M.), Barcelona, Spain
| | - Alejandro Lucia
- Neuromuscular and Neuropediatric Research Group (A.B.-L., J.N.-M., E.K., I.L.-P., M.A., G.L., M.L.-O., A.S.-M., S.A.H., G.P.-M., J.C.-C., A.M.-P., A.R.-F., G.N.-G.), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Campus Can Ruti, Universitat Autònoma de Barcelona, Badalona; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (A.B.-L., G.P.-M., J.C.-C., G.N.-G.), Instituto de Salud Carlos III, Madrid; Neuromuscular Pathology Unit. Neurology Service. Neuroscience department (M.A., G.L., N.G., J.C.-C., A.M.-P., A.R.-F.), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona; IrsiCaixa AIDS Research Institute (J.C.), Badalona, Spain; Faculty of Sport Sciences (A.L.), Universidad Europea de Madrid; Instituto de Investigación Hospital 12 de Octubre (i+12) (A.L.), Madrid; and Division of Rare Diseases. University Hospital Vall d'Hebron (G.P.-M.), Barcelona, Spain
| | - Guillem Pintos-Morell
- Neuromuscular and Neuropediatric Research Group (A.B.-L., J.N.-M., E.K., I.L.-P., M.A., G.L., M.L.-O., A.S.-M., S.A.H., G.P.-M., J.C.-C., A.M.-P., A.R.-F., G.N.-G.), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Campus Can Ruti, Universitat Autònoma de Barcelona, Badalona; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (A.B.-L., G.P.-M., J.C.-C., G.N.-G.), Instituto de Salud Carlos III, Madrid; Neuromuscular Pathology Unit. Neurology Service. Neuroscience department (M.A., G.L., N.G., J.C.-C., A.M.-P., A.R.-F.), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona; IrsiCaixa AIDS Research Institute (J.C.), Badalona, Spain; Faculty of Sport Sciences (A.L.), Universidad Europea de Madrid; Instituto de Investigación Hospital 12 de Octubre (i+12) (A.L.), Madrid; and Division of Rare Diseases. University Hospital Vall d'Hebron (G.P.-M.), Barcelona, Spain
| | - Jaume Coll-Cantí
- Neuromuscular and Neuropediatric Research Group (A.B.-L., J.N.-M., E.K., I.L.-P., M.A., G.L., M.L.-O., A.S.-M., S.A.H., G.P.-M., J.C.-C., A.M.-P., A.R.-F., G.N.-G.), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Campus Can Ruti, Universitat Autònoma de Barcelona, Badalona; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (A.B.-L., G.P.-M., J.C.-C., G.N.-G.), Instituto de Salud Carlos III, Madrid; Neuromuscular Pathology Unit. Neurology Service. Neuroscience department (M.A., G.L., N.G., J.C.-C., A.M.-P., A.R.-F.), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona; IrsiCaixa AIDS Research Institute (J.C.), Badalona, Spain; Faculty of Sport Sciences (A.L.), Universidad Europea de Madrid; Instituto de Investigación Hospital 12 de Octubre (i+12) (A.L.), Madrid; and Division of Rare Diseases. University Hospital Vall d'Hebron (G.P.-M.), Barcelona, Spain
| | - Alicia Martínez-Piñeiro
- Neuromuscular and Neuropediatric Research Group (A.B.-L., J.N.-M., E.K., I.L.-P., M.A., G.L., M.L.-O., A.S.-M., S.A.H., G.P.-M., J.C.-C., A.M.-P., A.R.-F., G.N.-G.), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Campus Can Ruti, Universitat Autònoma de Barcelona, Badalona; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (A.B.-L., G.P.-M., J.C.-C., G.N.-G.), Instituto de Salud Carlos III, Madrid; Neuromuscular Pathology Unit. Neurology Service. Neuroscience department (M.A., G.L., N.G., J.C.-C., A.M.-P., A.R.-F.), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona; IrsiCaixa AIDS Research Institute (J.C.), Badalona, Spain; Faculty of Sport Sciences (A.L.), Universidad Europea de Madrid; Instituto de Investigación Hospital 12 de Octubre (i+12) (A.L.), Madrid; and Division of Rare Diseases. University Hospital Vall d'Hebron (G.P.-M.), Barcelona, Spain
| | - Alba Ramos-Fransi
- Neuromuscular and Neuropediatric Research Group (A.B.-L., J.N.-M., E.K., I.L.-P., M.A., G.L., M.L.-O., A.S.-M., S.A.H., G.P.-M., J.C.-C., A.M.-P., A.R.-F., G.N.-G.), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Campus Can Ruti, Universitat Autònoma de Barcelona, Badalona; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (A.B.-L., G.P.-M., J.C.-C., G.N.-G.), Instituto de Salud Carlos III, Madrid; Neuromuscular Pathology Unit. Neurology Service. Neuroscience department (M.A., G.L., N.G., J.C.-C., A.M.-P., A.R.-F.), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona; IrsiCaixa AIDS Research Institute (J.C.), Badalona, Spain; Faculty of Sport Sciences (A.L.), Universidad Europea de Madrid; Instituto de Investigación Hospital 12 de Octubre (i+12) (A.L.), Madrid; and Division of Rare Diseases. University Hospital Vall d'Hebron (G.P.-M.), Barcelona, Spain
| | - Gisela Nogales-Gadea
- Neuromuscular and Neuropediatric Research Group (A.B.-L., J.N.-M., E.K., I.L.-P., M.A., G.L., M.L.-O., A.S.-M., S.A.H., G.P.-M., J.C.-C., A.M.-P., A.R.-F., G.N.-G.), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Campus Can Ruti, Universitat Autònoma de Barcelona, Badalona; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (A.B.-L., G.P.-M., J.C.-C., G.N.-G.), Instituto de Salud Carlos III, Madrid; Neuromuscular Pathology Unit. Neurology Service. Neuroscience department (M.A., G.L., N.G., J.C.-C., A.M.-P., A.R.-F.), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona; IrsiCaixa AIDS Research Institute (J.C.), Badalona, Spain; Faculty of Sport Sciences (A.L.), Universidad Europea de Madrid; Instituto de Investigación Hospital 12 de Octubre (i+12) (A.L.), Madrid; and Division of Rare Diseases. University Hospital Vall d'Hebron (G.P.-M.), Barcelona, Spain
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