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Shaheen AR, Yannuzzi NA, Kennedy T, Yannuzzi LA. RETINAL VASCULAR DISEASE IN LIMB-GIRDLE MUSCULAR DYSTROPHY. Retin Cases Brief Rep 2024; 18:39-42. [PMID: 36007191 DOI: 10.1097/icb.0000000000001329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE To report bilateral retinal vascular occlusive disease in limb-girdle muscular dystrophy (LGMD). METHODS Case report. RESULTS A 34-year-old Asian woman was referred for evaluation and management of central retinal vein occlusion. Ultra-wide-field fluorescein angiography showed resolving initial peripheral retinal vein occlusion in one eye and peripheral venular segmental staining in the fellow asymmetric eye. Genetic testing established the diagnosis of LGMD. CONCLUSION Similar to other forms of muscular dystrophy, LGMD is caused by genetic abnormalities in sarcolemma proteins, a key structural component that connects the intracellular cytoskeleton of a myofiber to the extracellular matrix. Like other muscular dystrophies, LGMD may be associated with retinal vascular abnormalities noted. In this case, retinal vascular smooth muscle dysfunction was seen in LGMD, analogous to reported vascular abnormalities in other muscular dystrophies such as facioscapulohumeral dystrophy and Duchenne muscular dystrophy.
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Sun KX, Chen YY, Li Z, Zheng SJ, Wan WJ, Ji Y, Hu K. Genipin relieves diabetic retinopathy by down-regulation of advanced glycation end products via the mitochondrial metabolism related signaling pathway. World J Diabetes 2023; 14:1349-1368. [PMID: 37771331 PMCID: PMC10523227 DOI: 10.4239/wjd.v14.i9.1349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/04/2023] [Accepted: 08/07/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Glycation is an important step in aging and oxidative stress, which can lead to endothelial dysfunction and cause severe damage to the eyes or kidneys of diabetics. Inhibition of the formation of advanced glycation end products (AGEs) and their cell toxicity can be a useful therapeutic strategy in the prevention of diabetic retinopathy (DR). Gardenia jasminoides Ellis (GJE) fruit is a selective inhibitor of AGEs. Genipin is an active compound of GJE fruit, which can be employed to treat diabetes. AIM To confirm the effect of genipin, a vital component of GJE fruit, in preventing human retinal microvascular endothelial cells (hRMECs) from AGEs damage in DR, to investigate the effect of genipin in the down-regulation of AGEs expression, and to explore the role of the CHGA/UCP2/glucose transporter 1 (GLUT1) signal pathway in this process. METHODS In vitro, cell viability was tested to determine the effects of different doses of glucose and genipin in hRMECs. Cell Counting Kit-8 (CCK-8), colony formation assay, flow cytometry, immunofluorescence, wound healing assay, transwell assay, and tube-forming assay were used to detect the effect of genipin on hRMECs cultured in high glucose conditions. In vivo, streptozotocin (STZ) induced mice were used, and genipin was administered by intraocular injection (IOI). To explore the effect and mechanism of genipin in diabetic-induced retinal dysfunction, reactive oxygen species (ROS), mitochondrial membrane potential (MMP), and 2-[N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl) amino]-2-deoxy-d-glucose (2-NBDG) assays were performed to explore energy metabolism and oxidative stress damage in high glucose-induced hRMECs and STZ mouse retinas. Immunofluorescence and Western blot were used to investigate the expression of inflammatory cytokines [vascular endothelial growth factor (VEGF), SCG3, tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β, IL-18, and nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing 3 (NLRP3)]. The protein expression of the receptor of AGEs (RAGE) and the mitochondria-related signal molecules CHGA, GLUT1, and UCP2 in high glucose-induced hRMECs and STZ mouse retinas were measured and compared with the genipin-treated group. RESULTS The results of CCK-8 and colony formation assay showed that genipin promoted cell viability in high glucose (30 mmol/L D-Glucose)-induced hRMECs, especially at a 0.4 μmol/L dose for 7 d. Flow cytometry results showed that high glucose can increase apoptosis rate by 30%, and genipin alleviated cell apoptosis in AGEs-induced hRMECs. A high glucose environment promoted ATP, ROS, MMP, and 2-NBDG levels, while genipin inhibited these phenotypic abnormalities in AGEs-induced hRMECs. Furthermore, genipin remarkably reduced the levels of the pro-inflammatory cytokines TNF-α, IL-1β, IL-18, and NLRP3 and impeded the expression of VEGF and SCG3 in AGEs-damaged hRMECs. These results showed that genipin can reverse high glucose induced damage with regard to cell proliferation and apoptosis in vitro, while reducing energy metabolism, oxidative stress, and inflammatory injury caused by high glucose. In addition, ROS levels and glucose uptake levels were higher in the retina from the untreated eye than in the genipin-treated eye of STZ mice. The expression of inflammatory cytokines and pathway protein in the untreated eye compared with the genipin-treated eye was significantly increased, as measured by Western blot. These results showed that IOI of genipin reduced the expression of CHGA, UCP2, and GLUT1, maintained the retinal structure, and decreased ROS, glucose uptake, and inflammation levels in vivo. In addition, we found that SCG3 expression might have a higher sensitivity in DR than VEGF as a diagnostic marker at the protein level. CONCLUSION Our study suggested that genipin ameliorates AGEs-induced hRMECs proliferation, apoptosis, energy metabolism, oxidative stress, and inflammatory injury, partially via the CHGA/UCP2/GLUT1 pathway. Control of advanced glycation by IOI of genipin may represent a strategy to prevent severe retinopathy and vision loss.
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Affiliation(s)
- Ke-Xin Sun
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Yan-Yi Chen
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Zhen Li
- Department of Ophthalmology, The People’s Hospital of Leshan, Leshan 400000, Sichuan Province, China
| | - Shi-Jie Zheng
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Wen-Juan Wan
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Yan Ji
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Ke Hu
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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Shahin S, Lu B, Zhou Y, Xu H, Chetsawang J, Baloh RH, Wang S. MFN1 augmentation prevents retinal degeneration in a Charcot-Marie-Tooth type 2A mouse model. iScience 2023; 26:106270. [PMID: 36936780 PMCID: PMC10014277 DOI: 10.1016/j.isci.2023.106270] [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: 10/17/2022] [Revised: 12/30/2022] [Accepted: 02/20/2023] [Indexed: 03/12/2023] Open
Abstract
Charcot-Marie-Tooth disease type 2A (CMT2A), the most common inherited peripheral axonal neuropathy, is associated with more than 100 dominant mutations, including R94Q as the most abundant mutation in the Mitofusin2 (MFN2) gene. CMT2A is characterized by progressive motor and sensory loss, color-vision defects, and progressive loss of visual acuity. We used a well-established transgenic mouse model of CMT2A with R94Q mutation on MFN2 gene (MFN2 R94Q ) to investigate the functional and morphological changes in retina. We documented extensive vision loss due to photoreceptor degeneration, retinal ganglion cell and their axonal loss, retinal secondary neuronal and synaptic alternation, and Müller cell gliosis in the retina of MFN2 R94Q mice. Imbalanced MFN1/MFN2 ratio and dysregulated mitochondrial fusion/fission result in retinal degeneration via P62/LC3B-mediated mitophagy/autophagy in MFN2 R94Q mice. Finally, transgenic MFN1 augmentation (MFN2 R94Q :MFN1) rescued vision and retinal morphology to wild-type level via restoring homeostasis in mitochondrial MFN1/MFN2 ratio, fusion/fission cycle, and PINK1-dependent, Parkin-independent mitophagy.
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Affiliation(s)
- Saba Shahin
- Board of Governors Regenerative Medicine Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Bin Lu
- Board of Governors Regenerative Medicine Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Yueqin Zhou
- Board of Governors Regenerative Medicine Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Hui Xu
- Board of Governors Regenerative Medicine Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Jason Chetsawang
- Board of Governors Regenerative Medicine Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Robert H. Baloh
- Board of Governors Regenerative Medicine Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Shaomei Wang
- Board of Governors Regenerative Medicine Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Corresponding author
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Ziccardi L, Barbano L, Antonelli G, Cioffi E, Di Renzo A, Gioiosa V, Marcotulli C, Grzybowski A, Casali C, Parisi V. Retinal and Visual Pathways Involvement in Carriers of Friedreich's Ataxia. Diagnostics (Basel) 2022; 12:diagnostics12123135. [PMID: 36553143 PMCID: PMC9777201 DOI: 10.3390/diagnostics12123135] [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: 11/12/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022] Open
Abstract
Friedreich’s ataxia (FRDA) is a rare autosomal recessive neurodegenerative disorder due to the homozygous pathological expansion of guanine-adenine-adenine (GAA) triplet repeats in the first intron of the FXN gene, which encodes for the mitochondrial protein frataxin. In the visual system, the typical manifestations are ocular motility abnormality, optic neuropathy, and retinopathy. Despite the evidence of ophthalmological impairment in FRDA patients, there is a lack of information about the morpho-functional condition of the retina and of the optic pathways in healthy heterozygous carriers of Friedreich’s ataxia (C-FRDA). Ten C-FRDA subjects (providing 20 eyes) and thirty-five Controls (providing 70 eyes) underwent a complete neurological and ophthalmological examination comprehensive of functional (full-field Electroretinogram (ffERG), multifocal Electroretinogram (mfERG), Visual Evoked Potential (VEP), and Pattern Reversal Electroretinogram (PERG)) and morphological assessments (Optical Coherence Tomography, OCT) of the retina, macula, retinal ganglion cells, and visual pathways. The groups’ data were compared using a two-sample t-test. Pearson’s test was used to investigate the morpho-functional correlations. Statistically significant differences (p < 0.01) between C-FRDA and Control eyes for the values of the following parameters were found: ffERG b-wave amplitude, mfERG Response Amplitude Densities, PERG P50 implicit time and P50-N95 amplitude, VEP P100 implicit time, Retinal Nerve Fiber Layer (RNFL) Overall, and Nasal thickness. The values of the OCT macular volume were not statistically different (p > 0.01) between the two Groups. Therefore, our data suggest that, in C-FRDA, a dysfunction of retinal elements without morphological macular impairment may occur. In addition, a morphological impairment of RNFL associated with an abnormal neural conduction along the visual pathways can be also detected.
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Affiliation(s)
- Lucia Ziccardi
- IRCCS—Fondazione Bietti, Via Livenza 1, 00198 Rome, Italy
| | - Lucilla Barbano
- IRCCS—Fondazione Bietti, Via Livenza 1, 00198 Rome, Italy
- Correspondence: ; Tel.: +39-06-85356727; Fax: +39-06-84242333
| | | | - Ettore Cioffi
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Valeria Gioiosa
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00185 Rome, Italy
| | - Christian Marcotulli
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00185 Rome, Italy
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Michała Oczapowskiego 2, 10455 Olsztyn, Poland
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Mickiewicza 24/3B, 60-836 Poznań, Poland
| | - Carlo Casali
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00185 Rome, Italy
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Ryan B, O’Mara Baker A, Ilse C, Brickell KL, Kersten HM, Williams JM, Addis DR, Tippett LJ, Curtis MA. The New Zealand Genetic Frontotemporal Dementia Study (FTDGeNZ): a longitudinal study of pre-symptomatic biomarkers. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2101483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Brigid Ryan
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, New Zealand
| | - Ashleigh O’Mara Baker
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- School of Psychology, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, New Zealand
| | - Christina Ilse
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, New Zealand
| | - Kiri L. Brickell
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, New Zealand
| | - Hannah M. Kersten
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Joanna M. Williams
- Department of Anatomy, University of Otago, Dunedin, New Zealand
- Brain Health Research Centre, University of Otago, Dunedin, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, New Zealand
| | - Donna Rose Addis
- School of Psychology, University of Auckland, Auckland, New Zealand
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
- Department of Psychology, University of Toronto, Toronto, Canada
| | - Lynette J. Tippett
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- School of Psychology, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, New Zealand
| | - Maurice A. Curtis
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, New Zealand
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6
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Eriksen KO, Wigers AR, Wedding IM, Erichsen AK, Barøy T, Søberg K, Jørstad ØK. A novel homozygous variant in the SPG7 gene presenting with childhood optic nerve atrophy. Am J Ophthalmol Case Rep 2022; 26:101400. [PMID: 35243150 PMCID: PMC8861420 DOI: 10.1016/j.ajoc.2022.101400] [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: 09/28/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose To describe a case of hereditary spastic ataxia (HSP) presenting with childhood optic nerve atrophy and report a novel homozygous variant in the SPG7 gene. Observations A 57-year-old man suffering from progressive optic nerve atrophy since childhood eventually underwent genetic testing. A targeted whole exome gene sequencing panel for optic neuropathy identified a novel homozygous variant in the SPG7 gene, c.2T > G, p.(Met?), which likely abolished production of paraplegin, an inner mitochondrial membrane protein. Subsequent neurologic examination revealed subtle signs of spastic paraplegia and ataxia in keeping with the genetic diagnosis of SPG7. Conclusion and importance Spastic paraplegia 7 (SPG7) is an autosomal recessive form of the neurodegenerative disorder HSP. Pure HSP is characterized by spastic paraparesis in the lower limbs, whereas complicated HSP presents additional neurological manifestations. This case report adds to the evidence that SPG7 can present with childhood optic nerve atrophy, preceding the characteristic SPG7 manifestations. SPG7 should be considered in the workup of suspected hereditary optic neuropathy. Spastic paraplegia 7 (SPG7) may present with childhood optic nerve atrophy. In this case we identified a likely pathogenic, homozygous variant in the SPG7 gene: c.2T > G, p.(Met1?). Workup for suspected hereditary optic neuropathy should include testing for SPG7.
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Affiliation(s)
- Kathrine O. Eriksen
- Department of Ophthalmology, Oslo University Hospital, Norway
- Corresponding author. Department of ophthalmology, Oslo University Hospital, Postboks 4950 Nydalen, 0424, OSLO, Norway.
| | | | | | | | - Tuva Barøy
- Department of Medical Genetics, Oslo University Hospital, Norway
| | | | - Øystein Kalsnes Jørstad
- Department of Ophthalmology, Oslo University Hospital, Norway
- Faculty of Medicine, University of Oslo, Norway
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7
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Ko PY, Glass IA, Crandall S, Weiss A, Dorschner MO, Kelly JP, Phillips JO, Lopez J. Two Missense CACNA1A Variants in a Single Family with Variable Neurobehavioral, Cerebellar, Epileptic, and Oculomotor Features. Neuropediatrics 2021; 52:186-191. [PMID: 33445191 DOI: 10.1055/s-0040-1721686] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We describe two novel missense variants in CACNA1A segregating in a family with variable severity of ataxia/oculomotor dysfunction, neurobehavioral impairments, and epilepsy. The most severe outcome occurred in a compound heterozygous proband, which could represent variable expression of the paternal allele or biallelic modulation of calcium channel function. Acetazolamide and lamotrigine were effective for seizure control.
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Affiliation(s)
- Pin-Yi Ko
- Division of Pediatric Neurology, Department of Neurology, University of Washington, Seattle, Washington, United States
| | - Ian A Glass
- Center for Integrative Brain Research, Seattle, Washington, United States.,Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, Washington, United States.,Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, Washington, United States
| | - Suzanne Crandall
- Department of Neurology, Saint Luke's Hospital of Kansas City, Kansas City, Missouri, United States
| | - Avery Weiss
- Department of Ophthalmology, University of Washington, Seattle, Washington, United States
| | - Michael O Dorschner
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, Washington, United States
| | - John P Kelly
- Department of Ophthalmology, University of Washington, Seattle, Washington, United States
| | - James O Phillips
- Department of Otolaryngology-HNS, University of Washington, Seattle, Washington, United States
| | - Jonathan Lopez
- Division of Pediatric Neurology, Department of Neurology, University of Washington, Seattle, Washington, United States
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8
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Li X, Fan F, Chen X, Li J, Ning L, Lin K, Chen Z, Qin Z, Yeung AS, Li X, Wang L, So KF. Computer Vision for Brain Disorders Based Primarily on Ocular Responses. Front Neurol 2021; 12:584270. [PMID: 33967931 PMCID: PMC8096911 DOI: 10.3389/fneur.2021.584270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 03/15/2021] [Indexed: 11/18/2022] Open
Abstract
Real-time ocular responses are tightly associated with emotional and cognitive processing within the central nervous system. Patterns seen in saccades, pupillary responses, and spontaneous blinking, as well as retinal microvasculature and morphology visualized via office-based ophthalmic imaging, are potential biomarkers for the screening and evaluation of cognitive and psychiatric disorders. In this review, we outline multiple techniques in which ocular assessments may serve as a non-invasive approach for the early detections of various brain disorders, such as autism spectrum disorder (ASD), Alzheimer's disease (AD), schizophrenia (SZ), and major depressive disorder (MDD). In addition, rapid advances in artificial intelligence (AI) present a growing opportunity to use machine learning-based AI, especially computer vision (CV) with deep-learning neural networks, to shed new light on the field of cognitive neuroscience, which is most likely to lead to novel evaluations and interventions for brain disorders. Hence, we highlight the potential of using AI to evaluate brain disorders based primarily on ocular features.
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Affiliation(s)
- Xiaotao Li
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China.,Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, United States.,BIAI INC., Chelmsford, MA, United States.,BIAI Intelligence Biotech LLC, Shenzhen, China
| | - Fangfang Fan
- Department of Neurology, Harvard Medical School, Harvard University, Boston, MA, United States
| | - Xuejing Chen
- Retina Division, Department of Ophthalmology, Boston University Eye Associates, Boston University, Boston, MA, United States
| | - Juan Li
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China.,BIAI INC., Chelmsford, MA, United States.,BIAI Intelligence Biotech LLC, Shenzhen, China
| | - Li Ning
- Center for High Performance Computing, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Kangguang Lin
- Department of Affective Disorders and Academician Workstation of Mood and Brain Sciences, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.,Guangdong-Hong Kong-Macau Institute of Central Nervous System (CNS) Regeneration, Jinan University, Guangzhou, China
| | - Zan Chen
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Zhenyun Qin
- Key Laboratory for Nonlinear Mathematical Models and Methods, School of Mathematical Science, Fudan University, Shanghai, China
| | - Albert S Yeung
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Xiaojian Li
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Liping Wang
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Kwok-Fai So
- Guangdong-Hong Kong-Macau Institute of Central Nervous System (CNS) Regeneration, Jinan University, Guangzhou, China.,The State Key Laboratory of Brain and Cognitive Sciences, Department of Ophthalmology, University of Hong Kong, Pok Fu Lam, Hong Kong
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9
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Bogdanova-Mihaylova P, Chen H, Plapp HM, Gorman C, Alexander MD, McHugh JC, Moran S, Early A, Cassidy L, Lynch T, Murphy SM, Walsh RA. Neurophysiological and ophthalmological findings of SPG7-related spastic ataxia: a phenotype study in an Irish cohort. J Neurol 2021; 268:3897-3907. [PMID: 33774748 DOI: 10.1007/s00415-021-10507-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mutations in SPG7 are increasingly identified as a common cause of spastic ataxia. We describe a cohort of Irish patients with recessive SPG7-associated phenotype. METHODS Comprehensive phenotyping was performed with documentation of clinical, neurophysiological, optical coherence tomography (OCT) and genetic data from individuals with SPG7 attending two academic neurology units in Dublin, including the National Ataxia Clinic. RESULTS Thirty-two symptomatic individuals from 25 families were identified. Mean age at onset was 39.1 years (range 12-61), mean disease duration 17.8 years (range 5-45), mean disease severity as quantified with the scale for the assessment and rating of ataxia 9/40 (range 3-29). All individuals displayed variable ataxia and spasticity within a spastic-ataxic phenotype, and additional ocular abnormalities. Two had spasmodic dysphonia and three had colour vision deficiency. Brain imaging consistently revealed cerebellar atrophy (n = 29); neurophysiology demonstrated a length-dependent large-fibre axonal neuropathy in 2/27 studied. The commonest variant was c.1529C > T (p.Ala510Val), present in 21 families. Five novel variants were identified. No significant thinning of average retinal nerve fibre layer (RNFL) was demonstrated on OCT (p = 0.61), but temporal quadrant reduction was evident compared to controls (p < 0.05), with significant average and temporal RNFL decline over time. Disease duration, severity and visual acuity were not correlated with RNFL thickness. CONCLUSIONS Our results highlight that recessive SPG7 mutations may account for spastic ataxia with peripheral neuropathy in only a small proportion of patients. RNFL abnormalities with predominant temporal RNFL reduction are common and OCT should be considered part of the routine assessment in spastic ataxia.
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Affiliation(s)
- Petya Bogdanova-Mihaylova
- National Ataxia Clinic, Department of Neurology, Tallaght University Hospital, Tallaght, Dublin 24, Ireland.
| | - Hongying Chen
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - Ciara Gorman
- Department of Clinical Neurophysiology, Tallaght University Hospital, Dublin 24, Ireland
| | - Michael D Alexander
- Department of Clinical Neurophysiology, Tallaght University Hospital, Dublin 24, Ireland.,Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland
| | - John C McHugh
- Department of Clinical Neurophysiology, Tallaght University Hospital, Dublin 24, Ireland
| | - Sharon Moran
- National Ataxia Clinic, Department of Neurology, Tallaght University Hospital, Tallaght, Dublin 24, Ireland
| | - Anne Early
- Department of Ophthalmology, Tallaght University Hospital, Dublin 24, Ireland
| | - Lorraine Cassidy
- Department of Ophthalmology, Tallaght University Hospital, Dublin 24, Ireland
| | - Timothy Lynch
- Dublin Neurological Institute at the Mater Hospital, University College Dublin, Dublin, Ireland.,Health Affairs, University College Dublin, Dublin, Ireland
| | - Sinéad M Murphy
- National Ataxia Clinic, Department of Neurology, Tallaght University Hospital, Tallaght, Dublin 24, Ireland.,Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland
| | - Richard A Walsh
- National Ataxia Clinic, Department of Neurology, Tallaght University Hospital, Tallaght, Dublin 24, Ireland.,Dublin Neurological Institute at the Mater Hospital, University College Dublin, Dublin, Ireland.,Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland
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10
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Clinical Characteristics, Differential Diagnosis and Genetic Analysis of Concentric Retinitis Pigmentosa. Life (Basel) 2021; 11:life11030260. [PMID: 33809962 PMCID: PMC8004166 DOI: 10.3390/life11030260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/17/2021] [Accepted: 03/21/2021] [Indexed: 01/12/2023] Open
Abstract
Concentric retinitis pigmentosa (RP), in which retinal degeneration is limited in the periphery, is rare and little information exists to date on the subject. Herein, we describe the clinical and genetic characteristics of this atypical form of RP. We retrospectively reviewed our database and identified 14 patients with concentric RP. Additionally, 14 patients with age-matched typical RP were also included. Patients with concentric RP had better visual acuity (logarithm of minimum angle of resolution −0.04 vs. 0.32, p = 0.047) and preserved ellipsoid zones (7630 µm vs. 2646 µm, p < 0.001) compared to typical RP. The electroretinogram showed subnormal but recordable responses in patients with concentric RP. Genetic testing was done in nine patients with concentric RP and revealed causative mutations in the EYS gene in one patient and the RP9 gene in one patient. Two patients had myotonic dystrophy and the diagnosis was revised as myotonic dystrophy-associated retinopathy. Concentric RP is a rare, atypical form of RP with better visual function. There is some overlap in the causative genes in concentric and typical RP. Myotonic dystrophy-associated retinopathy is an important differential diagnosis.
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Li H, Yanoga F, Abdel-Rahman MH, Cebulla CM. Presumed spinocerebellar ataxia 7: challenges without molecular diagnosis. Clin Exp Optom 2021; 104:547-549. [PMID: 33689625 DOI: 10.1080/08164622.2021.1878822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- He Li
- Havener Eye Institute, Department of Ophthalmology and Visual Science, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Fatoumata Yanoga
- Havener Eye Institute, Department of Ophthalmology and Visual Science, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Mohamed H Abdel-Rahman
- Havener Eye Institute, Department of Ophthalmology and Visual Science, The Ohio State University Wexner Medical Center, Columbus, OH, USA.,Division of Human Genetics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Colleen M Cebulla
- Havener Eye Institute, Department of Ophthalmology and Visual Science, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Ulgiati F, Lhoir S, Balikova I, Tenoutasse S, Boros E, Vilain C, Heinrichs C, Brachet C. The Retina in Patients With Triple A Syndrome: A Window Into Neurodegeneration? Front Endocrinol (Lausanne) 2021; 12:729056. [PMID: 34867779 PMCID: PMC8633871 DOI: 10.3389/fendo.2021.729056] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/15/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Experimental evidence suggests that the clinical manifestations of Triple A syndrome result from oxidative stress. Several conditions caused by oxidative stress display retinal involvement. Our objective was to assess the retina and optic nerve involvement in children with Triple A syndrome. METHODS Eleven patients with genetically proven Triple A syndrome followed-up in our centre were approached for study participation. The main outcome was the measurement of the thicknesses of the different retinal layers by Optical Coherence Tomography (OCT). RESULTS 9 patients with triple A syndrome had OCT measurements. 7 patients were children and 2 were adults; 4 were females and 5 were males. The 7 paediatric patients had at least two OCT measured at a mean interval of 7.9 months after the first one. The average Retinal Nerve Fibre Layer thickness was 74 ± 10 µm in patients compared to the paediatric reference range of 100 ± 2 µm (p<0.05). CONCLUSIONS AND RELEVANCE This is the first study to document retinal layer thicknesses in a series of patients with Triple A syndrome. Nearly all retinal thickness and peripapillary RNFL measurements were very significantly inferior to the reference range in Triple A patients, whatever their age. RNFL thinning was more marked at the temporal part of the optic nerve. OCT being non-invasive, it represents a promising tool to assess the severity of neurodegeneration in patients with Triple A syndrome.
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Affiliation(s)
- Fiorenza Ulgiati
- Paediatric Endocrinology Unit – Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium
| | - Sophie Lhoir
- Pediatric Ophthalmology Unit, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium
| | - Irina Balikova
- Pediatric Ophthalmology Unit, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium
| | - Sylvie Tenoutasse
- Paediatric Endocrinology Unit – Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium
| | - Emese Boros
- Paediatric Endocrinology Unit – Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium
| | - Catheline Vilain
- Department of Genetics, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB) Center of Human Genetics, Université Libre de Bruxelles, Brussels, Belgium
| | - Claudine Heinrichs
- Paediatric Endocrinology Unit – Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium
| | - Cécile Brachet
- Paediatric Endocrinology Unit – Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium
- *Correspondence: Cécile Brachet,
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Marianelli BF, Filho FMR, Salles MV, de Andrade JBC, Pedroso JL, Sallum JMF, Barsottini OGP. A Proposal for Classification of Retinal Degeneration in Spinocerebellar Ataxia Type 7. THE CEREBELLUM 2020; 20:384-391. [PMID: 33196954 DOI: 10.1007/s12311-020-01215-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 12/17/2022]
Abstract
The aim of this study is to propose a classification system for the spinocerebellar ataxia type 7 retinal degeneration (SCA7-RD). Twenty patients with molecularly confirmed SCA7 underwent slit lamp examination, fundus photography, and optical coherence tomography (Spectralis®). Scale for the Assessment and Rating of Ataxia (SARA) and International Cooperative Ataxia Rating Scale (ICARS) were applied, and age, sex, age at symptom onset, and number of CAG expansions were recorded. After analyzing the ophthalmological findings in each participant, a panel of retinal disease experts created a qualitative classification system for SCA7-RD comprising four stages. We assessed the correlations of retinal degeneration severity with SARA and ICARS scores, number of CAG repeats in ATXN7 allele, and age at symptom onset. We graded retinal degeneration as stage 1 in nine participants, as stage 2 in five, and as stage 3 in six. No differences in age and visual symptoms duration were found between groups. SARA and ICARS scores correlated with the severity of SCA7-RD on the classification system (p = 0.024 and p = 0.014, respectively). After adjusting for disease duration, retinal disease stage association with SARA and ICARS scores remained significant (ANCOVA, p < 0.05). The classification system for SCA7-RD was able to characterize different disease stages representing the landmarks in the cone-rod dystrophy natural history. Neurodegeneration appears to occur in parallel in the cerebellum and in the visual pathway. We conclude that retinal degeneration in SCA7 is a potential biomarker of the neurological phenotype severity.
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Affiliation(s)
- Bruna Ferraço Marianelli
- Division of Retina and Vitreous, Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, SP, Brazil. .,, Vitória, Brazil.
| | - Flávio Moura Rezende Filho
- Division of General Neurology and Ataxia Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Mariana Vallim Salles
- Division of Retina and Vitreous, Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - João Brainer Clares de Andrade
- Division of General Neurology and Ataxia Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - José Luiz Pedroso
- Division of General Neurology and Ataxia Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Juliana Maria Ferraz Sallum
- Division of Retina and Vitreous, Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Orlando Graziani P Barsottini
- Division of General Neurology and Ataxia Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Park JY, Joo K, Woo SJ. Ophthalmic Manifestations and Genetics of the Polyglutamine Autosomal Dominant Spinocerebellar Ataxias: A Review. Front Neurosci 2020; 14:892. [PMID: 32973440 PMCID: PMC7472957 DOI: 10.3389/fnins.2020.00892] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/30/2020] [Indexed: 12/20/2022] Open
Abstract
Spinocerebellar ataxia (SCA) is a part of the cerebellar neurodegenerative disease group that is diverse in genetics and phenotypes. It usually shows autosomal dominant inheritance. SCAs, always together with the cerebellar degeneration, may exhibit clinical deficits in brainstem or eye, especially retina or optic nerve. Interestingly, autosomal dominant SCAs share a common genetic mechanism; the length of the glutamine chain is abnormally expanded due to the increase in the cytosine–adenine–guanine (CAG) repeats of the disease causing gene. Studies have suggested that the mutant ataxin induces alteration of protein conformation and abnormal aggregation resulting in nuclear inclusions, and causes cellular loss of photoreceptors through a toxic effect. As a result, these pathologic changes induce a downregulation of genes involved in the phototransduction, development, and differentiation of photoreceptors such as CRX, one of the photoreceptor transcription factors. However, the exact mechanism of neuronal degeneration by mutant ataxin restricted to only certain type of neuronal cell including cerebellar Purkinje neurons and photoreceptor is still unclear. The most common SCAs are types 1, 2, 3, 6, 7, and 17 which contain about 80% of autosomal dominant SCA cases. Various aspects of eye movement abnormalities are evident depending on the degree of cerebellar and brainstem degeneration in SCAs. In addition, certain types of SCAs such as SCA7 are characterized by both cerebellar ataxia and visual loss mainly due to retinal degeneration. The severity of the retinopathy can vary from occult macular photoreceptor disruption to extensive retinal atrophy and is correlated with the number of CAG repeats. The value of using optical coherence tomography in conjunction with electrodiagnostic and genetic testing is emphasized as the combination of these tests can provide critical information regarding the etiology, morphological evaluation, and functional significances. Therefore, ophthalmologists need to recognize and differentiate SCAs in order to properly diagnose and evaluate the disease. In this review, we have described and discussed SCAs showing ophthalmic abnormalities with particular attention to their ophthalmic features, neurodegenerative mechanisms, genetics, and future perspectives.
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Affiliation(s)
- Jun Young Park
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Kwangsic Joo
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Se Joon Woo
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, South Korea
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de Freitas JL, Rezende Filho FM, Sallum JM, França MC, Pedroso JL, Barsottini OG. Ophthalmological changes in hereditary spastic paraplegia and other genetic diseases with spastic paraplegia. J Neurol Sci 2020; 409:116620. [DOI: 10.1016/j.jns.2019.116620] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/16/2019] [Accepted: 12/05/2019] [Indexed: 01/05/2023]
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Trummer B, Haubenberger D, Blackstone C. Clinical Trial Designs and Measures in Hereditary Spastic Paraplegias. Front Neurol 2018; 9:1017. [PMID: 30627115 PMCID: PMC6309810 DOI: 10.3389/fneur.2018.01017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 11/12/2018] [Indexed: 01/19/2023] Open
Abstract
Hereditary spastic paraplegias (HSPs) are a large group of genetically-diverse neurologic disorders characterized clinically by a common feature of lower extremity spasticity and gait difficulties. Current therapies are predominantly symptomatic, and even then usually provide inadequate relief of symptoms. Going forward, HSP therapeutics development requires a systematic analysis of quantifiable measures and tools to assess treatment response. This review summarizes promising therapeutic targets, assessment measures, and previous clinical trials for the HSPs. Oxidative stress, signaling pathways, microtubule dynamics, and gene rescue/replacement have been proposed as potential treatment targets or modalities. Quantitative evaluation of pre-clinical rodent HSP models emphasize rotarod performance, foot base angle, grip strength, stride length, beam walking, critical speed, and body weight. Clinical measures of HSP in humans include 10-m gait velocity, the Spastic Paraplegia Rating Scale (SPRS), Ashworth Spasticity Scale, Fugl-Meyer Scale, timed up-and-go, and the Gillette Functional Assessment Questionnaire. We conducted a broad search for past clinical trials in HSPs and identified trials that investigated pharmacological agents including atorvastatin, gabapentin, L-threonine, botulinum toxin, dalfampridine, methylphenidate, and baclofen. We provide recommendations for future HSP treatment directions based on these prior research experiences as well as regulatory insight.
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Affiliation(s)
- Brian Trummer
- Neurogenetics Branch, Clinical Research Program, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
- Clinical Trials Unit, Clinical Research Program, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - Dietrich Haubenberger
- Clinical Trials Unit, Clinical Research Program, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - Craig Blackstone
- Neurogenetics Branch, Clinical Research Program, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
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Rodrigues MJ, O’Grady GL, Hammond-Tooke G, Kidd A, Love DO, Baker RK, Roxburgh RH. The New Zealand Neuromuscular Disease Patient Registry; Five Years and a Thousand Patients. J Neuromuscul Dis 2018; 4:183-188. [PMID: 28800337 PMCID: PMC5611797 DOI: 10.3233/jnd-170240] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The New Zealand Neuromuscular Disease Patient Registry has been recruiting for five years. Its primary aim is to enable people with neuromuscular disease to participate in research including clinical trials. It has contributed data to large anonymised cohort studies and many feasibility studies, and has provided practical information and advice to researchers wanting to work with people with neuromuscular conditions. 1019 people have enrolled since the Registry's launch in August 2011 with over 70 different diagnoses. Of these; 8 patients have been involved in clinical trials, 134 in other disease-specific research and 757 have contributed anonymised data to cohort studies. As a result the Registry is now effectively facilitating almost all neuromuscular research currently taking place in New Zealand.
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Affiliation(s)
- Miriam J. Rodrigues
- Neurology, Auckland City Hospital, Auckland, New Zealand
- Muscular Dystrophy Association of New Zealand, Penrose, Auckland, New Zealand
| | - Gina L. O’Grady
- Paediatric Neurology, Starship Children’s Hospital, Auckland, New Zealand
| | - Graeme Hammond-Tooke
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
- Department of Neurology, Dunedin Hospital, Dunedin, New Zealand
| | - Alexa Kidd
- Canterbury Health Laboratories, Canterbury District Health Board, Christchurch, New Zealand
| | - Donald O. Love
- Diagnostic Genetics, LabPLUS, Department of Pathology and Laboratory Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Ronelle K. Baker
- Muscular Dystrophy Association of New Zealand, Penrose, Auckland, New Zealand
| | - Richard H. Roxburgh
- Neurology, Auckland City Hospital, Auckland, New Zealand
- School of Medicine, Faculty of Medical and Health Sciences and Centre for Brain Research, University of Auckland, Auckland, New Zealand
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Özen B, Öztürk H, Çatlı G, Dündar B. An Assessment of Retinal Nerve Fiber Layer Thickness in Non-Diabetic Obese Children and Adolescents. J Clin Res Pediatr Endocrinol 2018; 10:13-18. [PMID: 28739552 PMCID: PMC5838367 DOI: 10.4274/jcrpe.4810] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE Obesity affects almost all systems in the body. This includes the retinal nerve fibers which may be damaged due to a chronic inflammatory process. To determine changes in retinal nerve fiber layer (RNFL) thickness in non-diabetic children and adolescents using optical coherence tomography (OCT) and to evaluate the relationship between this change, metabolic risk factors and pubertal stage. METHODS Thirty-eight obese and 40 healthy children and adolescents aged 10-18 years were included in the study. RNFL measurements from the optic disk and all surrounding quadrants were obtained using OCT from both eyes of the individuals in the study groups. Correlations between RNFL thickness and age, auxological measurements, pubertal stage, systolic and diastolic blood pressure, homeostasis model assessment-insulin resistance (HOMA-IR) index and lipid values were investigated. RESULTS A general decrease was observed in RNFL thickness in obese subjects compared to the controls, the decrease being highest in the inferior quadrant, although these differences were not statistically significant (p>0.05). RNFL thickness was negatively correlated with body mass index (BMI) standard deviation score (SDS) in both groups (control group r=-0.345, p=0.029; obese group r=-0.355, p=0.022). Significant negative correlations were determined between diastolic blood pressure, HOMA-IR, low density lipoprotein cholesterol level and RNFL thickness (r=-0.366, p=0.024; r=-0.394, p=0.016; and r=-0.374, p=0.022, respectively) in the obese group, while there was no association between these parameters and RNFL thickness in the control group. CONCLUSION In this cross-sectional study, no statistically significant difference in RNFL thicknesses between the obese and control groups was determined. However, RNFL thickness was found to decrease in both healthy and obese children as BMI-SDS values increased. Further prospective studies may be of benefit to determine whether the decrease in RNFL values might become more pronounced on long-term follow-up.
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Affiliation(s)
- Bediz Özen
- University of Health Sciences, Tepecik Training and Research Hospital, Clinic of Ophthalmology, İzmir, Turkey,* Address for Correspondence: University of Health Sciences, Tepecik Training and Research Hospital, Clinic of Ophthalmology, İzmir, Turkey Phone: +90 232 469 69 69 E-mail:
| | - Hakan Öztürk
- University of Health Sciences, Tepecik Training and Research Hospital, Clinic of Ophthalmology, İzmir, Turkey
| | - Gönül Çatlı
- Katip Çelebi University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Bumin Dündar
- Katip Çelebi University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
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20
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Evans LP, Newell EA, Mahajan M, Tsang SH, Ferguson PJ, Mahoney J, Hue CD, Vogel EW, Morrison B, Arancio O, Nichols R, Bassuk AG, Mahajan VB. Acute vitreoretinal trauma and inflammation after traumatic brain injury in mice. Ann Clin Transl Neurol 2018; 5:240-251. [PMID: 29560370 PMCID: PMC5846452 DOI: 10.1002/acn3.523] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 11/30/2017] [Accepted: 12/01/2017] [Indexed: 12/16/2022] Open
Abstract
Objective Limited attention has been given to ocular injuries associated with traumatic brain injury (TBI). The retina is an extension of the central nervous system and evaluation of ocular damage may offer a less‐invasive approach to gauge TBI severity and response to treatment. We aim to characterize acute changes in the mouse eye after exposure to two different models of TBI to assess the utility of eye damage as a surrogate to brain injury. Methods A model of blast TBI (bTBI) using a shock tube was compared to a lateral fluid percussion injury model (LFPI) using fluid pressure applied directly to the brain. Whole eyes were collected from mice 3 days post LFPI and 24 days post bTBI and were evaluated histologically using a hematoxylin and eosin stain. Results bTBI mice showed evidence of vitreous detachment in the posterior chamber in addition to vitreous hemorrhage with inflammatory cells. Subretinal hemorrhage, photoreceptor degeneration, and decreased cellularity in the retinal ganglion cell layer was also seen in bTBI mice. In contrast, eyes of LFPI mice showed evidence of anterior uveitis and subcapsular cataracts. Interpretation We demonstrated that variations in the type of TBI can result in drastically different phenotypic changes within the eye. As such, molecular and phenotypic changes in the eye following TBI may provide valuable information regarding the mechanism, severity, and ongoing pathophysiology of brain injury. Because vitreous samples are easily obtained, molecular changes within the eye could be utilized as biomarkers of TBI in human patients.
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Affiliation(s)
- Lucy P Evans
- Medical Scientist Training Program University of Iowa Iowa City Iowa.,Department of Pediatrics University of Iowa Iowa City Iowa
| | | | - MaryAnn Mahajan
- Omics Laboratory Department of Ophthalmology Stanford University Palo Alto California
| | - Stephen H Tsang
- Bernard and Shirlee Brown Glaucoma Laboratory and Barbara Donald Jonas Laboratory of Regenerative Medicine Columbia University New York New York.,Edward S. Harkness Eye Institute Columbia University New York New York.,Departments of Ophthalmology, Pathology & Cell Biology Institute of Human Nutrition Columbia University New York New York
| | | | | | - Christopher D Hue
- Department of Biomedical Engineering Columbia University New York New York
| | - Edward W Vogel
- Department of Biomedical Engineering Columbia University New York New York
| | - Barclay Morrison
- Department of Biomedical Engineering Columbia University New York New York
| | - Ottavio Arancio
- Department of Pathology & Cell Biology Taub Institute Columbia University New York New York
| | - Russell Nichols
- Department of Pathology & Cell Biology Taub Institute Columbia University New York New York
| | | | - Vinit B Mahajan
- Omics Laboratory Department of Ophthalmology Stanford University Palo Alto California.,Palo Alto Veterans Administration Palo Alto California
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Guha Mazumder A, Chatterjee S, Chatterjee S, Gonzalez JJ, Bag S, Ghosh S, Mukherjee A, Chatterjee J. Spectropathology-corroborated multimodal quantitative imaging biomarkers for neuroretinal degeneration in diabetic retinopathy. Clin Ophthalmol 2017; 11:2073-2089. [PMID: 29200821 PMCID: PMC5703157 DOI: 10.2147/opth.s140110] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Introduction Image-based early detection for diabetic retinopathy (DR) needs value addition due to lack of well-defined disease-specific quantitative imaging biomarkers (QIBs) for neuroretinal degeneration and spectropathological information at the systemic level. Retinal neurodegeneration is an early event in the pathogenesis of DR. Therefore, development of an integrated assessment method for detecting neuroretinal degeneration using spectropathology and QIBs is necessary for the early diagnosis of DR. Methods The present work explored the efficacy of intensity and textural features extracted from optical coherence tomography (OCT) images after selecting a specific subset of features for the precise classification of retinal layers using variants of support vector machine (SVM). Fourier transform infrared (FTIR) spectroscopy and nuclear magnetic resonance (NMR) spectroscopy were also performed to confirm the spectropathological attributes of serum for further value addition to the OCT, fundoscopy, and fluorescein angiography (FA) findings. The serum metabolomic findings were also incorporated for characterizing retinal layer thickness alterations and vascular asymmetries. Results Results suggested that OCT features could differentiate the retinal lesions indicating retinal neurodegeneration with high sensitivity and specificity. OCT, fundoscopy, and FA provided geometrical as well as optical features. NMR revealed elevated levels of ribitol, glycerophosphocholine, and uridine diphosphate N-acetyl glucosamine, while the FTIR of serum samples confirmed the higher expressions of lipids and β-sheet-containing proteins responsible for neoangiogenesis, vascular fragility, vascular asymmetry, and subsequent neuroretinal degeneration in DR. Conclusion Our data indicated that disease-specific spectropathological alterations could be the major phenomena behind the vascular attenuations observed through fundoscopy and FA, as well as the variations in the intensity and textural features observed in OCT images. Finally, we propose a model that uses spectropathology corroborated with specific QIBs for detecting neuroretinal degeneration in early diagnosis of DR.
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Affiliation(s)
- Arpan Guha Mazumder
- Multimodal Imaging and Computing for Theranostics Laboratory, School of Medical Science and Technology, Indian Institute of Technology-Kharagpur, Kharagpur, West Bengal, India.,Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Swarnadip Chatterjee
- Advanced Technology Development Centre, Indian Institute of Technology-Kharagpur, Kharagpur, West Bengal, India
| | - Saunak Chatterjee
- Multimodal Imaging and Computing for Theranostics Laboratory, School of Medical Science and Technology, Indian Institute of Technology-Kharagpur, Kharagpur, West Bengal, India
| | - Juan Jose Gonzalez
- Department of Computer and Electrical Engineering, Rice University, Houston, TX, USA
| | - Swarnendu Bag
- Department of Biotechnology, National Institute of Technology Sikkim, Ravangla Sub-Division, South Sikkim
| | - Sambuddha Ghosh
- Department of Ophthalmology, Calcutta National Medical College and Hospital, Kolkata, West Bengal
| | - Anirban Mukherjee
- Department of Electrical Engineering, Indian Institute of Technology-Kharagpur, Kharagpur, West Bengal, India
| | - Jyotirmoy Chatterjee
- Multimodal Imaging and Computing for Theranostics Laboratory, School of Medical Science and Technology, Indian Institute of Technology-Kharagpur, Kharagpur, West Bengal, India
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Rescue of Glaucomatous Neurodegeneration by Differentially Modulating Neuronal Endoplasmic Reticulum Stress Molecules. J Neurosci 2017; 36:5891-903. [PMID: 27225776 DOI: 10.1523/jneurosci.3709-15.2016] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 04/26/2016] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED Axon injury is an early event in neurodegenerative diseases that often leads to retrograde neuronal cell death and progressive permanent loss of vital neuronal functions. The connection of these two obviously sequential degenerative events, however, is elusive. Deciphering the upstream signals that trigger the neurodegeneration cascades in both neuronal soma and axon would be a key step toward developing the effective neuroprotectants that are greatly needed in the clinic. We showed previously that optic nerve injury-induced neuronal endoplasmic reticulum (ER) stress plays an important role in retinal ganglion cell (RGC) death. Using two in vivo mouse models of optic neuropathies (traumatic optic nerve injury and glaucoma) and adeno-associated virus-mediated RGC-specific gene targeting, we now show that differential manipulation of unfolded protein response pathways in opposite directions-inhibition of eukaryotic translation initiation factor 2α-C/EBP homologous protein and activation of X-box binding protein 1-promotes both RGC axons and somata survival and preserves visual function. Our results indicate that axon injury-induced neuronal ER stress plays an important role in both axon degeneration and neuron soma death. Neuronal ER stress is therefore a promising therapeutic target for glaucoma and potentially other types of neurodegeneration. SIGNIFICANCE STATEMENT Neuron soma and axon degeneration have distinct molecular mechanisms although they are clearly connected after axon injury. We previously demonstrated that axon injury induces neuronal endoplasmic reticulum (ER) stress and that manipulation of ER stress molecules synergistically promotes neuron cell body survival. Here we investigated the possibility that ER stress also plays a role in axon degeneration and whether ER stress modulation preserves neuronal function in neurodegenerative diseases. Our results suggest that neuronal ER stress is a general mechanism of degeneration for both neuronal cell body and axon, and that therapeutic targeting of ER stress produces significant functional recovery.
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Idiopathic Bilateral Profound Hypotony in an Unknown Progressive Neurodegenerative Disorder. J Glaucoma 2017; 26:e168-e170. [PMID: 28221333 DOI: 10.1097/ijg.0000000000000639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To present a unique case of idiopathic bilateral hypotony in a patient with progressive, undiagnosed neurological decline, possibly due to mitochondrial disease, and to explore mechanisms of disease and potential treatment options. METHODS This is a case report. PATIENT A 17-year-old boy with a history of chronic progressive bilateral vision loss and hypotony in the setting of progressive gait abnormalities, lower extremity spasticity, nystagmus, and urinary retention starting around age 8. Despite extensive biochemical and genetic evaluation, no systemic etiology has been identified. He had no history of ocular trauma or surgery. RESULTS Examination confirmed the above history as well as decreased vision, significant bilateral astigmatism (7 D), short axial-eye-lengths, and disc edema with chorioretinal folds in the left eye. There was no inflammation or ciliary body detachment. We propose the etiology is similar to hypotony in myotonic dystrophy, in which low intraocular pressure may result from aqueous egress across the ciliary body face. The best treatment remains unclear, but surgical closure of the iridocorneal angle is under careful consideration. This may halt nonconventional (suprachoroidal) outflow. CONCLUSIONS Management of ocular hypotony is typically directed at the underlying etiology. Idiopathic hypotony poses a unique treatment challenge. If excess aqueous flow across the ciliary body face is responsible, intentional closure of the iridocorneal angle may preserve vision.
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Al-Khersan H, Hain T, Grassi MA. Vision Loss in a Teenage Girl With Postconcussion Syndrome. JAMA Ophthalmol 2017; 135:75-76. [PMID: 27892982 DOI: 10.1001/jamaophthalmol.2016.2830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Hasenin Al-Khersan
- Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
| | - Tim Hain
- Northwestern University, Chicago, Illinois
| | - Michael A Grassi
- Grassi Retina, Naperville, Illinois4Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago
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25
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Bek T. Mitochondrial dysfunction and diabetic retinopathy. Mitochondrion 2016; 36:4-6. [PMID: 27456429 DOI: 10.1016/j.mito.2016.07.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 07/12/2016] [Accepted: 07/21/2016] [Indexed: 11/18/2022]
Abstract
Mitochondrial dysfunction may predispose to the development of diabetes mellitus with the accompanying risk for developing diabetic retinopathy or may contribute directly to the diabetic metabolic dysregulation and thereby increase the risk of diabetic late complications including retinopathy. Diabetes mellitus in mitochondrial disease can lead to the development of vision threatening retinopathy, but visual acuity is often reduced secondary to neurological deficits resulting from the mitochondrial dysfunction. The relation between mitochondrial disease and diabetic retinopathy can be influenced by epigenetics where factors in the environment modify the expression of regulatory proteins coding for the elimination of reactive oxygen species.
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Affiliation(s)
- Toke Bek
- Department of Ophthalmology, Aarhus University Hospital, DK-8000 Aarhus C, Denmark.
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26
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Pacheco-Cervera J, Codoñer-Franch P, Simó-Jordá R, Pons-Vázquez S, Galbis-Estrada C, Pinazo-Durán MD. Reduced retinal nerve fibre layer thickness in children with severe obesity. Pediatr Obes 2015; 10:448-53. [PMID: 25559237 DOI: 10.1111/ijpo.12005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Accepted: 11/24/2014] [Indexed: 12/24/2022]
Abstract
BACKGROUND Some optic nerve diseases are silent and insidious. Recently, reduced thickness of retinal nerve fibre layer (RNFL) has been associated with increasing body mass index in adults. OBJECTIVES To investigate the association of childhood obesity with RNFL measured by optical coherence tomography imaging. METHODS Ninety-seven children aged 5-14 years classified according to standard deviation score of body mass index (SDS-BMI) were included. Parameters of metabolic risk, adipocytokines (leptin, adiponectin) and interleukin-6 were analyzed. All subjects underwent a comprehensive ophthalmologic examination with direct ophthalmoscopy. Evaluation of RNFL with optical coherence tomography of the head of the nerve was performed. RESULTS RNFL thickness on the average and inferior, superior and nasal quadrants were decreased in severely obese children (SDS-BMI > 4) with respect to the other groups. However, no statistically significant association was found between the different groups of children and RNFL thickness in the temporal quadrant. There was a significant inverse correlation of RNFL thickness with adiposity indices (P = 0.016), leptin (P = 0.029) and interleukin-6 (P = 0.030) in overweight and obese children. CONCLUSIONS These findings suggest that adiposity and obesity-related inflammatory factors may be associated with the loss of retinal ganglion cells in children.
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Affiliation(s)
- J Pacheco-Cervera
- Department of Ophthalmology, Doctor Peset University Hospital, Valencia, Spain
| | - P Codoñer-Franch
- Department of Pediatrics, Doctor Peset University Hospital, Valencia, Spain.,Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain
| | - R Simó-Jordá
- Department of Pediatrics, Doctor Peset University Hospital, Valencia, Spain
| | - S Pons-Vázquez
- Department of Ophthalmology, Doctor Peset University Hospital, Valencia, Spain
| | - C Galbis-Estrada
- Ophthalmic Research Unit Santiago Grisolia, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - M D Pinazo-Durán
- Department of Ophthalmology, Doctor Peset University Hospital, Valencia, Spain.,Ophthalmic Research Unit Santiago Grisolia, Faculty of Medicine, University of Valencia, Valencia, Spain.,Surgery-Ophthalmology Department, Faculty of Medicine, University of Valencia, Valencia, Spain
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Abstract
Mitochondrial dysfunction underlies many human disorders, including those that affect the visual system. The retinal ganglion cells, whose axons form the optic nerve, are often damaged by mitochondrial-related diseases which result in blindness. Both mitochondrial DNA (mtDNA) and nuclear gene mutations impacting many different mitochondrial processes can result in optic nerve disease. Of particular importance are mutations that impair mitochondrial network dynamics (fusion and fission), oxidative phosphorylation (OXPHOS), and formation of iron-sulfur complexes. Current genetic knowledge can inform genetic counseling and suggest strategies for novel gene-based therapies. Identifying new optic neuropathy-causing genes and defining the role of current and novel genes in disease will be important steps toward the development of effective and potentially neuroprotective therapies.
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Affiliation(s)
- Janey L Wiggs
- Department of Ophthalmology, Harvard Medical School and Massachusetts Eye and Ear, Boston, Massachusetts 02114;
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28
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Optical coherence tomography findings in Huntington's disease: a potential biomarker of disease progression. J Neurol 2015; 262:2457-65. [PMID: 26233693 DOI: 10.1007/s00415-015-7869-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 07/15/2015] [Accepted: 07/17/2015] [Indexed: 10/23/2022]
Abstract
Previous reports of ocular abnormalities in Huntington's disease (HD) have detailed eye movement disorders. The objective of this case-control study was to investigate optic nerve and macular morphology in HD using optical coherence tomography (OCT). A total of 26 HD patients and 29 controls underwent a thorough ophthalmic examination including spectral domain OCT scans of the macula and peripapillary retinal nerve fibre layer (RNFL). Genetic testing results, disease duration, HD disease burden scores and Unified HD Rating Scale motor scores were acquired for HD patients. Temporal RNFL thickness was significantly reduced in the HD group (62.3 vs. 69.8 μm, p = 0.005), and there was a significant negative correlation between temporal RNFL thickness and disease duration (R (2) = -0.51, p = 0.04). Average peripapillary RNFL thickness was not significantly different between the HD and control groups. There was a significant negative correlation between macular volume and disease duration (R (2) = -0.71, p = 0.002), and motor scores (R (2) = -0.56, p = 0.01). Colour vision was significantly poorer in the HD group. Temporal RNFL is preferentially thinned in HD patients, possibly implicating mitochondrial dysfunction as the temporal RNFL is reduced in the patients with some mitochondrial disorders, including Leber's hereditary optic neuropathy. The correlation between the decrease in macular volume and temporal RNFL, and increasing disease severity suggests that OCT may be a useful biomarker for disease progression in HD. Larger, longitudinal studies are required.
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Ocular and neurodevelopmental features of Duchenne muscular dystrophy: a signature of dystrophin function in the central nervous system. Eur J Hum Genet 2015; 24:562-8. [PMID: 26081639 DOI: 10.1038/ejhg.2015.135] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 05/01/2015] [Accepted: 05/12/2015] [Indexed: 01/16/2023] Open
Abstract
Multiple isoforms of dystrophin (Dp427, Dp260, Dp140, Dp71) are expressed differentially in the central nervous system (CNS) including the retinal layers. Disruption of these protein products is responsible for cognitive dysfunction, electroretinogram (ERG) abnormalities and behavioural disorders in Duchenne muscular dystrophy (DMD). We studied the ocular characteristics and neuropsychiatric profile of 16 DMD boys. The ISCEV standard, full-field flash ERGs were assessed. Intellectual ability and behavioural disturbances were measured. All genotypes were associated with mildly abnormal photopic ERG a:b-wave amplitude ratios. In addition, we identified the following genotype/phenotype correlations: boys with mutations upstream of exon 30 (ie, isolated Dp427 altered expression) showed normal scotopic a:b ratios, abnormal photopic oscillatory potential OP2 and normal scotopic OP2. Conversely, all boys with DMD mutations downstream of exon 30 showed profoundly 'negative' scotopic ERGs (a:b ratios >1). In these patients, the involvement of Dp260 isoform resulted in the absence of slow rod pathway signalling in15 Hz scotopic flicker ERGs. These boys had abnormal scotopic OP2 and normal photopic OP2. Finally, children with mutations also affecting Dp71 were associated with more pronounced electronegative ERGs. When correlating ERGs to neurodevelopmental outcome, we found a positive correlation between negative scotopic ERGs and neurodevelopmental disturbances, and the most severe findings were in boys with Dp71 disruption. These findings suggest a strong association between DMD mutations affecting different DMD isoforms with characteristically abnormal scotopic ERGs and severe neurodevelopmental problems. The role of the ERG as a potential biomarker for dystrophin function in the CNS and response to novel genetic therapies warrants further exploration.
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Bosco A, Romero CO, Ambati BK, Vetter ML. In vivo dynamics of retinal microglial activation during neurodegeneration: confocal ophthalmoscopic imaging and cell morphometry in mouse glaucoma. J Vis Exp 2015:e52731. [PMID: 25992962 DOI: 10.3791/52731] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Microglia, which are CNS-resident neuroimmune cells, transform their morphology and size in response to CNS damage, switching to an activated state with distinct functions and gene expression profiles. The roles of microglial activation in health, injury and disease remain incompletely understood due to their dynamic and complex regulation in response to changes in their microenvironment. Thus, it is critical to non-invasively monitor and analyze changes in microglial activation over time in the intact organism. In vivo studies of microglial activation have been delayed by technical limitations to tracking microglial behavior without altering the CNS environment. This has been particularly challenging during chronic neurodegeneration, where long-term changes must be tracked. The retina, a CNS organ amenable to non-invasive live imaging, offers a powerful system to visualize and characterize the dynamics of microglia activation during chronic disorders. This protocol outlines methods for long-term, in vivo imaging of retinal microglia, using confocal ophthalmoscopy (cSLO) and CX3CR1(GFP/+) reporter mice, to visualize microglia with cellular resolution. Also, we describe methods to quantify monthly changes in cell activation and density in large cell subsets (200-300 cells per retina). We confirm the use of somal area as a useful metric for live tracking of microglial activation in the retina by applying automated threshold-based morphometric analysis of in vivo images. We use these live image acquisition and analyses strategies to monitor the dynamic changes in microglial activation and microgliosis during early stages of retinal neurodegeneration in a mouse model of chronic glaucoma. This approach should be useful to investigate the contributions of microglia to neuronal and axonal decline in chronic CNS disorders that affect the retina and optic nerve.
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Affiliation(s)
| | - Cesar O Romero
- Department of Neurobiology & Anatomy, University of Utah
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Bosco A, Romero CO, Breen KT, Chagovetz AA, Steele MR, Ambati BK, Vetter ML. Neurodegeneration severity can be predicted from early microglia alterations monitored in vivo in a mouse model of chronic glaucoma. Dis Model Mech 2015; 8:443-55. [PMID: 25755083 PMCID: PMC4415894 DOI: 10.1242/dmm.018788] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 02/26/2015] [Indexed: 12/30/2022] Open
Abstract
Microglia serve key homeostatic roles, and respond to neuronal perturbation and decline with a high spatiotemporal resolution. The course of all chronic CNS pathologies is thus paralleled by local microgliosis and microglia activation, which begin at early stages of the disease. However, the possibility of using live monitoring of microglia during early disease progression to predict the severity of neurodegeneration has not been explored. Because the retina allows live tracking of fluorescent microglia in their intact niche, here we investigated their early changes in relation to later optic nerve neurodegeneration. To achieve this, we used the DBA/2J mouse model of inherited glaucoma, which develops progressive retinal ganglion cell degeneration of variable severity during aging, and represents a useful model to study pathogenic mechanisms of retinal ganglion cell decline that are similar to those in human glaucoma. We imaged CX3CR1(+/GFP) microglial cells in vivo at ages ranging from 1 to 5 months by confocal scanning laser ophthalmoscopy (cSLO) and quantified cell density and morphological activation. We detected early microgliosis at the optic nerve head (ONH), where axonopathy first manifests, and could track attenuation of this microgliosis induced by minocycline. We also observed heterogeneous and dynamic patterns of early microglia activation in the retina. When the same animals were aged and analyzed for the severity of optic nerve pathology at 10 months of age, we found a strong correlation with the levels of ONH microgliosis at 3 to 4 months. Our findings indicate that live imaging and monitoring the time course and levels of early retinal microgliosis and microglia activation in glaucoma could serve as indicators of future neurodegeneration severity.
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Affiliation(s)
- Alejandra Bosco
- Department of Neurobiology and Anatomy, University of Utah, Salt Lake City, UT 84132, USA
| | - Cesar O Romero
- Department of Neurobiology and Anatomy, University of Utah, Salt Lake City, UT 84132, USA
| | - Kevin T Breen
- Department of Neurobiology and Anatomy, University of Utah, Salt Lake City, UT 84132, USA
| | - Alexis A Chagovetz
- Department of Human Genetics, University of Utah, Salt Lake City, UT 84132, USA
| | - Michael R Steele
- Department of Neurobiology and Anatomy, University of Utah, Salt Lake City, UT 84132, USA
| | - Balamurali K Ambati
- Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT 84132, USA
| | - Monica L Vetter
- Department of Neurobiology and Anatomy, University of Utah, Salt Lake City, UT 84132, USA
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