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Tsimpanouli ME, Ghimire A, Barget AJ, Weston R, Paulson HL, Costa MDC, Watson BO. Sleep Alterations in a Mouse Model of Spinocerebellar Ataxia Type 3. Cells 2022; 11:cells11193132. [PMID: 36231095 PMCID: PMC9563426 DOI: 10.3390/cells11193132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/20/2022] [Accepted: 09/29/2022] [Indexed: 11/16/2022] Open
Abstract
Spinocerebellar ataxia type 3 (SCA3) is a neurodegenerative disorder showing progressive neuronal loss in several brain areas and a broad spectrum of motor and non-motor symptoms, including ataxia and altered sleep. While sleep disturbances are known to play pathophysiologic roles in other neurodegenerative disorders, their impact on SCA3 is unknown. Using spectrographic measurements, we sought to quantitatively characterize sleep electroencephalography (EEG) in SCA3 transgenic mice with confirmed disease phenotype. We first measured motor phenotypes in 18-31-week-old homozygous SCA3 YACMJD84.2 mice and non-transgenic wild-type littermate mice during lights-on and lights-off periods. We next implanted electrodes to obtain 12-h (zeitgeber time 0-12) EEG recordings for three consecutive days when the mice were 26-36 weeks old. EEG-based spectroscopy showed that compared to wild-type littermates, SCA3 homozygous mice display: (i) increased duration of rapid-eye movement sleep (REM) and fragmentation in all sleep and wake states; (ii) higher beta power oscillations during REM and non-REM (NREM); and (iii) additional spectral power band alterations during REM and wake. Our data show that sleep architecture and EEG spectral power are dysregulated in homozygous SCA3 mice, indicating that common sleep-related etiologic factors may underlie mouse and human SCA3 phenotypes.
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Affiliation(s)
- Maria-Efstratia Tsimpanouli
- Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
- Correspondence: (M.-E.T.); (M.d.C.C.); (B.O.W.)
| | - Anjesh Ghimire
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Anna J. Barget
- Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ridge Weston
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Henry L. Paulson
- Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Maria do Carmo Costa
- Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
- Correspondence: (M.-E.T.); (M.d.C.C.); (B.O.W.)
| | - Brendon O. Watson
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
- Correspondence: (M.-E.T.); (M.d.C.C.); (B.O.W.)
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Baldelli L, Provini F. Fragmentary Hypnic Myoclonus and Other Isolated Motor Phenomena of Sleep. Sleep Med Clin 2021; 16:349-361. [PMID: 33985659 DOI: 10.1016/j.jsmc.2021.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Excessive fragmentary hypnic myoclonus, hypnic jerks, hypnagogic foot tremor, alternating leg muscle activation, and sleep-related cramps are less known sleep-related motor disorders (SRMDs). These manifestations are frequently missed or misinterpreted polygraphic findings that can be frequently confused with the more frequent SRMDs. These symptoms can present as isolated motor symptoms but can be also the cause of otherwise cryptogenic insomnias and somnolence. Expanding the knowledge on these isolated symptoms and defining their polygraphic and clinical features are essential for their identification. However, clear cut-offs to discern between the isolated phenomenon and the disorder are still to be found.
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Affiliation(s)
- Luca Baldelli
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Ospedale Bellaria, Via Altura 3, Bologna 40139, Italy
| | - Federica Provini
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Ospedale Bellaria, Via Altura 3, Bologna 40139, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
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Rossi M, van der Veen S, Merello M, Tijssen MAJ, van de Warrenburg B. Myoclonus-Ataxia Syndromes: A Diagnostic Approach. Mov Disord Clin Pract 2020; 8:9-24. [PMID: 33426154 DOI: 10.1002/mdc3.13106] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/30/2020] [Accepted: 10/14/2020] [Indexed: 12/30/2022] Open
Abstract
Background A myriad of disorders combine myoclonus and ataxia. Most causes are genetic and an increasing number of genes are being associated with myoclonus-ataxia syndromes (MAS), due to recent advances in genetic techniques. A proper etiologic diagnosis of MAS is clinically relevant, given the consequences for genetic counseling, treatment, and prognosis. Objectives To review the causes of MAS and to propose a diagnostic algorithm. Methods A comprehensive and structured literature search following PRISMA criteria was conducted to identify those disorders that may combine myoclonus with ataxia. Results A total of 135 causes of combined myoclonus and ataxia were identified, of which 30 were charted as the main causes of MAS. These include four acquired entities: opsoclonus-myoclonus-ataxia syndrome, celiac disease, multiple system atrophy, and sporadic prion diseases. The distinction between progressive myoclonus epilepsy and progressive myoclonus ataxia poses one of the main diagnostic dilemmas. Conclusions Diagnostic algorithms for pediatric and adult patients, based on clinical manifestations including epilepsy, are proposed to guide the differential diagnosis and corresponding work-up of the most important and frequent causes of MAS. A list of genes associated with MAS to guide genetic testing strategies is provided. Priority should be given to diagnose or exclude acquired or treatable disorders.
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Affiliation(s)
- Malco Rossi
- Movement Disorders Section Neuroscience Department Buenos Aires Argentina.,Argentine National Scientific and Technological Research Council (CONICET) Buenos Aires Argentina
| | - Sterre van der Veen
- Pontificia Universidad Católica Argentina (UCA) Buenos Aires Argentina.,Department of Neurology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Marcelo Merello
- Movement Disorders Section Neuroscience Department Buenos Aires Argentina.,Argentine National Scientific and Technological Research Council (CONICET) Buenos Aires Argentina.,Pontificia Universidad Católica Argentina (UCA) Buenos Aires Argentina
| | - Marina A J Tijssen
- Department of Neurology University of Groningen, University Medical Center Groningen Groningen The Netherlands.,Expertise Center Movement Disorders Groningen University Medical Center Groningen (UMCG) Groningen The Netherlands
| | - Bart van de Warrenburg
- Department of Neurology, Donders Institute for Brain, Cognition & Behaviour Radboud University Medical Center Nijmegen The Netherlands
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Nepozitek J, Dostalova S, Kemlink D, Friedrich L, Prihodova I, Ibarburu Lorenzo y Losada V, Dusek P, Bezdicek O, Nikolai T, Perinova P, Dall'Antonia I, Dusek P, Ruml M, Ruzicka E, Sonka K. Fragmentary myoclonus in idiopathic rapid eye movement sleep behaviour disorder. J Sleep Res 2019; 28:e12819. [DOI: 10.1111/jsr.12819] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 11/26/2018] [Accepted: 12/04/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Jiri Nepozitek
- Department of Neurology and Center of Clinical Neuroscience; First Faculty of Medicine; Charles University and General University Hospital; Prague Czech Republic
| | - Simona Dostalova
- Department of Neurology and Center of Clinical Neuroscience; First Faculty of Medicine; Charles University and General University Hospital; Prague Czech Republic
| | - David Kemlink
- Department of Neurology and Center of Clinical Neuroscience; First Faculty of Medicine; Charles University and General University Hospital; Prague Czech Republic
| | - Latica Friedrich
- Department of Neurology and Center of Clinical Neuroscience; First Faculty of Medicine; Charles University and General University Hospital; Prague Czech Republic
- University Department of Neurology; Sveti Duh University Hospital; Zagreb Croatia
| | - Iva Prihodova
- Department of Neurology and Center of Clinical Neuroscience; First Faculty of Medicine; Charles University and General University Hospital; Prague Czech Republic
| | - Veronika Ibarburu Lorenzo y Losada
- Department of Neurology and Center of Clinical Neuroscience; First Faculty of Medicine; Charles University and General University Hospital; Prague Czech Republic
| | - Petr Dusek
- Department of Neurology and Center of Clinical Neuroscience; First Faculty of Medicine; Charles University and General University Hospital; Prague Czech Republic
| | - Ondrej Bezdicek
- Department of Neurology and Center of Clinical Neuroscience; First Faculty of Medicine; Charles University and General University Hospital; Prague Czech Republic
| | - Tomas Nikolai
- Department of Neurology and Center of Clinical Neuroscience; First Faculty of Medicine; Charles University and General University Hospital; Prague Czech Republic
| | - Pavla Perinova
- Department of Neurology and Center of Clinical Neuroscience; First Faculty of Medicine; Charles University and General University Hospital; Prague Czech Republic
| | - Irene Dall'Antonia
- Department of Neurology and Center of Clinical Neuroscience; First Faculty of Medicine; Charles University and General University Hospital; Prague Czech Republic
| | - Pavel Dusek
- Department of Neurology and Center of Clinical Neuroscience; First Faculty of Medicine; Charles University and General University Hospital; Prague Czech Republic
| | - Martin Ruml
- Department of Neurology and Center of Clinical Neuroscience; First Faculty of Medicine; Charles University and General University Hospital; Prague Czech Republic
| | - Evzen Ruzicka
- Department of Neurology and Center of Clinical Neuroscience; First Faculty of Medicine; Charles University and General University Hospital; Prague Czech Republic
| | - Karel Sonka
- Department of Neurology and Center of Clinical Neuroscience; First Faculty of Medicine; Charles University and General University Hospital; Prague Czech Republic
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Seshagiri DV, Botta R, Sasidharan A, Kumar Pal P, Jain S, Yadav R, Kutty BM. Assessment of Sleep Spindle Density among Genetically Positive Spinocerebellar Ataxias Types 1, 2, and 3 Patients. Ann Neurosci 2018; 25:106-111. [PMID: 30140122 DOI: 10.1159/000484516] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 10/19/2017] [Indexed: 01/18/2023] Open
Abstract
Objective The effect of thalamic degeneration in patients with spinocerebellar ataxias (SCA) and sleep spindle (SS) abnormalities has not been studied so far, although there is a strong association between these disorders. This study was done to evaluate and compare the SS densities (SSDs) of genetically proven autosomal dominant SCA1, SCA2 and SCA3 patients with controls. Methods Prospectively and genetically confirmed cases of SCA and controls were recruited. Patients were assessed clinically, were evaluated with sleep questionnaires and an overnight polysomnography was performed. SSDs were analyzed using neuroloop gain plugin of Polyman version 1.15 software. Results Eighteen patients of SCA1 (n = 6), SCA2 (n = 5), SCA3 (n = 7) and 6 controls were recruited in our study. The mean age of SCA1 patients was 39.2 ± 5.4, of SCA2 patients was 30.8 ± 9.5 and of SCA3 patients was 35.4 ± 6.4 years. The mean duration of illness in SCA1 was 4.7 ± 1.7 years, in SCA2 it was 4.3 ± 4.4 years and in SCA3 it was 5 ± 2.3 years. The median SSD values (percentage loop gain) during stage 2 of non-rapid eye movement sleep were 16.9% in SCA1, 0% in SCA2, 1.2% in SCA3 and 59.5% in controls. There was a significant difference in SSD values in SCA2 (p = 0.04), SCA3 (p = 0.02) patients and controls. Conclusion SSDs were significantly decreased in patients with SCA, which is a novel finding. This is likely due to the "thalamic switch" disruption, observed as reduced SSDs in SCA2 and SCA3. Sleep spindle deficits could act as one of the biomarkers of ongoing neurodegeneration in the thalamic circuitry of SCA patients.
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Affiliation(s)
| | - Ragasudha Botta
- Department of Clinical Neurosciences, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Arun Sasidharan
- Department of Neurophysiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Pramod Kumar Pal
- Department of Clinical Neurosciences, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Sanjeev Jain
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Ravi Yadav
- Department of Clinical Neurosciences, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Bindu M Kutty
- Department of Neurophysiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
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Abstract
Excessive fragmentary myoclonus (EFM) is a polysomnographic finding registered by the surface electromyography (EMG) and characterized as a result of the muscle activity consisting of sudden, isolated, arrhythmic, asynchronous and asymmetric brief twitches. The EMG potentials are defined by the exact criteria in The International Classification of the Sleep Disorders, 3rdedition and they appear with high intensity in all sleep stages. Clinical significance of EFM is unclear. It was observed in combination with other diseases and features such as obstructive and central sleep apnea, narcolepsy, periodic limb movements, insomnia, neurodegenerative disorders and peripheral nerve dysfunction. Relation to such wide range of diseases supports the opinion that EFM is nor a specific sleep disorder nor a specific polysomnographic sign. The option that EFM is a normal variant has also not been ruled out so far.
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Högl B, Stefani A. Restless legs syndrome and periodic leg movements in patients with movement disorders: Specific considerations. Mov Disord 2017; 32:669-681. [DOI: 10.1002/mds.26929] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 12/21/2016] [Indexed: 12/25/2022] Open
Affiliation(s)
- Birgit Högl
- Department of Neurology; Medical University of Innsbruck; Innsbruck Austria
| | - Ambra Stefani
- Department of Neurology; Medical University of Innsbruck; Innsbruck Austria
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McCarter SJ, St Louis EK. A 62-year-old Man with Facial and Finger Twitching. J Clin Sleep Med 2017; 12:272-5. [PMID: 26156946 DOI: 10.5664/jcsm.5502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 06/05/2015] [Indexed: 01/25/2023]
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Abstract
PURPOSE OF REVIEW This article provides a description on clinical features and pathophysiology of the main sleep disorders observed in Machado-Joseph disease (MJD). RECENT FINDINGS Pathological studies have clearly demonstrated that degenerative process in MJD is widespread in the nervous system, and not restricted to the cerebellum. Nonmotor manifestations are frequent and may include pain, cramps, dysautonomia, cognitive deficits, psychiatric manifestations, olfactory deficits, fatigue, nutritional issues, and sleep disorders. SUMMARY Sleep disorders are frequent in MJD, and include restless legs syndrome, rapid eye movement sleep behavior disorder, excessive daytime sleepiness, insomnia, sleep apnea, periodic limb movements during sleep, parasomnia, and others. Pathophysiological mechanisms related to sleep disorders in Machado-Joseph are complex and poorly understood. Considering that sleep complaints are a treatable condition, recognizing sleep disorders in MJD is relevant.
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Silva GMF, Pedroso JL, Dos Santos DF, Braga-Neto P, Do Prado LBF, De Carvalho LBC, Barsottini OGP, Do Prado GF. NREM-related parasomnias in Machado-Joseph disease: clinical and polysomnographic evaluation. J Sleep Res 2016; 25:11-5. [PMID: 26359123 DOI: 10.1111/jsr.12330] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 07/14/2015] [Indexed: 02/06/2023]
Abstract
Spinocerebellar ataxias (SCA) are autosomal dominant neurodegenerative disorders that affect the cerebellum and its connections, and have a marked clinical and genetic variability. Machado-Joseph disease (MJD) or spinocerebellar ataxia type 3 (SCA3)--MJD/SCA3--is the most common SCA worldwide. MJD/SCA3 is characterized classically by progressive ataxia and variable other motor and non-motor symptoms. Sleep disorders are common, and include rapid eye movement (REM) sleep behaviour disorder (RBD), restless legs syndrome (RLS), insomnia, excessive daytime sleepiness, excessive fragmentary myoclonus and sleep apnea. This study aims to focus upon determining the presence or not of non-REM (NREM)-related parasomnias in MJD/SCA 3, using data from polysomnography (PSG) and clinical evaluation. Forty-seven patients with clinical and genetic diagnosis of MJD/SCA3 and 47 control subjects were evaluated clinically and by polysomnography. MJD/SCA3 patients had a higher frequency of arousals from slow wave sleep (P < 0.001), parasomnia complaints (confusional arousal/sleep terrors, P = 0.001; RBD, P < 0.001; and nightmares, P < 0.001), REM sleep without atonia (P < 0.001), periodic limb movements of sleep index (PLMSi) (P < 0.001), percentage of N3 sleep (P < 0.001) and percentage of N1 sleep (P < 0.001). These data show that NREM-related parasomnias must be included in the spectrum of sleep disorders in MJD/SCA3 patients.
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Sobreira-Neto MA, Pena-Pereira MA, Sobreira EST, Chagas MHN, Tumas V, Fernandes RMF, Eckeli AL. Excessive fragmentary myoclonus in patients with Parkinson’s disease: prevalence and clinico-polysomnographic profile. Sleep Breath 2015; 19:997-1002. [DOI: 10.1007/s11325-014-1098-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 11/04/2014] [Accepted: 12/09/2014] [Indexed: 10/24/2022]
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