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Cordeiro EF, Marzola EL, Maekawa RS, Santos MR, Assunção LG, Massafera MP, Oliveira JD, Batista TG, Sales MCOPD, Maria-Engler SS, Di Mascio P, Medeiros MHD, Ronsein GE, Loureiro APDM. Nicotinamide riboside Induced Energy Stress and Metabolic Reprogramming in BEAS-2B Cells. Chem Res Toxicol 2024; 37:1246-1268. [PMID: 38990804 PMCID: PMC11337214 DOI: 10.1021/acs.chemrestox.3c00312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 06/17/2024] [Accepted: 06/24/2024] [Indexed: 07/13/2024]
Abstract
Nicotinamide riboside (NR), a NAD+ precursor, has received attention due to several health benefits it has induced in experimental models. Studies in cultured cells, animals, and humans consistently show increased NAD+ availability after NR supplementation, which is considered the only mode of NR action that leads to health benefits. In the present study, we show that a persistently low NR concentration (1 μM) in the growth medium of BEAS-2B human cells, grown in a monolayer, induces energy stress, which precedes a cellular NAD+ increase after 192 h. NR concentrations greater than 1 μM under the specified conditions were cytotoxic in the 2D cell culture model, while all concentrations tested in the 3D cell culture model (BEAS-2B cell spheroids exposed to 1, 5, 10, and 50 μM NR) induced apoptosis. Shotgun proteomics revealed that NR modulated the abundance of proteins, agreeing with the observed effects on cellular energy metabolism and cell growth or survival. Energy stress may activate pathways that lead to health benefits such as cancer prevention. Accordingly, the premalignant 1198 cell line was more sensitive to NR cytotoxicity than the phenotypically normal parent BEAS-2B cell line. The role of a mild energy stress induced by low concentrations of NR in its beneficial effects deserves further investigation. On the other hand, strategies to increase the bioavailability of NR require attention to toxic effects that may arise.
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Affiliation(s)
- Everson
Willian Fialho Cordeiro
- Departamento
de Análises Clínicas e Toxicológicas, Faculdade
de Ciências Farmacêuticas, Universidade de São Paulo, Av. Prof. Lineu Prestes 580, CEP 05508-000 São Paulo, Brazil
| | - Elisabete Leide Marzola
- Departamento
de Análises Clínicas e Toxicológicas, Faculdade
de Ciências Farmacêuticas, Universidade de São Paulo, Av. Prof. Lineu Prestes 580, CEP 05508-000 São Paulo, Brazil
| | - Ricardo Soei Maekawa
- Departamento
de Análises Clínicas e Toxicológicas, Faculdade
de Ciências Farmacêuticas, Universidade de São Paulo, Av. Prof. Lineu Prestes 580, CEP 05508-000 São Paulo, Brazil
| | - Matheus Relvas
dos Santos
- Departamento
de Análises Clínicas e Toxicológicas, Faculdade
de Ciências Farmacêuticas, Universidade de São Paulo, Av. Prof. Lineu Prestes 580, CEP 05508-000 São Paulo, Brazil
| | - Lucas Gade Assunção
- Departamento
de Análises Clínicas e Toxicológicas, Faculdade
de Ciências Farmacêuticas, Universidade de São Paulo, Av. Prof. Lineu Prestes 580, CEP 05508-000 São Paulo, Brazil
| | - Mariana Pereira Massafera
- Departamento
de Bioquímica, Instituto de Química, Universidade de São Paulo, Av. Prof. Lineu Prestes 748, CEP 05508-000 São Paulo, Brazil
| | - Joseana de Oliveira
- Departamento
de Análises Clínicas e Toxicológicas, Faculdade
de Ciências Farmacêuticas, Universidade de São Paulo, Av. Prof. Lineu Prestes 580, CEP 05508-000 São Paulo, Brazil
| | - Thainá Gomes
Cury Batista
- Departamento
de Análises Clínicas e Toxicológicas, Faculdade
de Ciências Farmacêuticas, Universidade de São Paulo, Av. Prof. Lineu Prestes 580, CEP 05508-000 São Paulo, Brazil
| | - Maria Cármen Oliveira Pinho de Sales
- Departamento
de Análises Clínicas e Toxicológicas, Faculdade
de Ciências Farmacêuticas, Universidade de São Paulo, Av. Prof. Lineu Prestes 580, CEP 05508-000 São Paulo, Brazil
| | - Silvya Stuchi Maria-Engler
- Departamento
de Análises Clínicas e Toxicológicas, Faculdade
de Ciências Farmacêuticas, Universidade de São Paulo, Av. Prof. Lineu Prestes 580, CEP 05508-000 São Paulo, Brazil
| | - Paolo Di Mascio
- Departamento
de Bioquímica, Instituto de Química, Universidade de São Paulo, Av. Prof. Lineu Prestes 748, CEP 05508-000 São Paulo, Brazil
| | - Marisa Helena
Gennari de Medeiros
- Departamento
de Bioquímica, Instituto de Química, Universidade de São Paulo, Av. Prof. Lineu Prestes 748, CEP 05508-000 São Paulo, Brazil
| | - Graziella Eliza Ronsein
- Departamento
de Bioquímica, Instituto de Química, Universidade de São Paulo, Av. Prof. Lineu Prestes 748, CEP 05508-000 São Paulo, Brazil
| | - Ana Paula de Melo Loureiro
- Departamento
de Análises Clínicas e Toxicológicas, Faculdade
de Ciências Farmacêuticas, Universidade de São Paulo, Av. Prof. Lineu Prestes 580, CEP 05508-000 São Paulo, Brazil
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2
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Wenzek F, Biallas A, Müller S. Nicotinamide Riboside: What It Takes to Incorporate It into RNA. Molecules 2024; 29:3788. [PMID: 39202867 PMCID: PMC11357040 DOI: 10.3390/molecules29163788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 08/06/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024] Open
Abstract
Nicotinamide is an important functional compound and, in the form of nicotinamide adenine dinucleotide (NAD), is used as a co-factor by protein-based enzymes to catalyze redox reactions. In the context of the RNA world hypothesis, it is therefore reasonable to assume that ancestral ribozymes could have used co-factors such as NAD or its simpler analog nicotinamide riboside (NAR) to catalyze redox reactions. The only described example of such an engineered ribozyme uses a nicotinamide moiety bound to the ribozyme through non-covalent interactions. Covalent attachment of NAR to RNA could be advantageous, but the demonstration of such scenarios to date has suffered from the chemical instability of both NAR and its reduced form, NARH, making their use in oligonucleotide synthesis less straightforward. Here, we review the literature describing the chemical properties of the oxidized and reduced species of NAR, their synthesis, and previous attempts to incorporate either species into RNA. We discuss how to overcome the stability problem and succeed in generating RNA structures incorporating NAR.
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Affiliation(s)
| | | | - Sabine Müller
- Institute of Biochemistry, University of Greifswald, Felix-Hausdorff-Str. 4, 17487 Greifswald, Germany; (F.W.); (A.B.)
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3
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Hayat F, Deason JT, Bryan RL, Terkeltaub R, Song W, Kraus WL, Pluth J, Gassman NR, Migaud ME. Synthesis, Detection, and Metabolism of Pyridone Ribosides, Products of NAD Overoxidation. Chem Res Toxicol 2024; 37:248-258. [PMID: 38198686 PMCID: PMC10880730 DOI: 10.1021/acs.chemrestox.3c00264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024]
Abstract
Pyridone-containing adenine dinucleotides, ox-NAD, are formed by overoxidation of nicotinamide adenine dinucleotide (NAD+) and exist in three distinct isomeric forms. Like the canonical nucleosides, the corresponding pyridone-containing nucleosides (PYR) are chemically stable, biochemically versatile, and easily converted to nucleotides, di- and triphosphates, and dinucleotides. The 4-PYR isomer is often reported with its abundance increasing with the progression of metabolic diseases, age, cancer, and oxidative stress. Yet, the pyridone-derived nucleotides are largely under-represented in the literature. Here, we report the efficient synthesis of the series of ox-NAD and pyridone nucleotides and measure the abundance of ox-NAD in biological specimens using liquid chromatography coupled with mass spectrometry (LC-MS). Overall, we demonstrate that all three forms of PYR and ox-NAD are found in biospecimens at concentrations ranging from nanomolar to midmicromolar and that their presence affects the measurements of NAD(H) concentrations when standard biochemical redox-based assays are applied. Furthermore, we used liver extracts and 1H NMR spectrometry to demonstrate that each ox-NAD isomer can be metabolized to its respective PYR isomer. Together, these results suggest a need for a better understanding of ox-NAD in the context of human physiology since these species are endogenous mimics of NAD+, the key redox cofactor in metabolism and bioenergetics maintenance.
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Affiliation(s)
- Faisal Hayat
- Mitchell
Cancer Institute, Frederick P. Whiddon College of Medicine, Department
of Pharmacology, University of South Alabama, 1660 Springhill Avenue, Mobile, Alabama 36604, United States
| | - J. Trey Deason
- Mitchell
Cancer Institute, Frederick P. Whiddon College of Medicine, Department
of Pharmacology, University of South Alabama, 1660 Springhill Avenue, Mobile, Alabama 36604, United States
| | - Ru Liu Bryan
- School
of Medicine, University of California, San
Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
- VA
San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, California 92161, United States
| | - Robert Terkeltaub
- School
of Medicine, University of California, San
Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
- VA
San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, California 92161, United States
| | - Weidan Song
- Cecil
H. and Ida Green Center for Reproductive Biology Sciences, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
| | - W. Lee Kraus
- Cecil
H. and Ida Green Center for Reproductive Biology Sciences, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
| | - Janice Pluth
- Department
of Health Physics and Diagnostic Sciences, University of Nevada, Las Vegas, 4505 S. Maryland Pkwy, Las
Vegas, Nevada 89154, United States
| | - Natalie R. Gassman
- Department
of Pharmacology and Toxicology, Heersink School of Medicine, University of Alabama, Birmingham, 1720 second Ave S, Birmingham, Alabama 35294, United States
| | - Marie E. Migaud
- Mitchell
Cancer Institute, Frederick P. Whiddon College of Medicine, Department
of Pharmacology, University of South Alabama, 1660 Springhill Avenue, Mobile, Alabama 36604, United States
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4
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Huang Z, Wang X, Li N, Song F, Zhou J. Systematic engineering of Escherichia coli for efficient production of nicotinamide riboside from nicotinamide and 3-cyanopyridine. BIORESOURCE TECHNOLOGY 2023; 377:128953. [PMID: 36963699 DOI: 10.1016/j.biortech.2023.128953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 06/18/2023]
Abstract
Nicotinamide riboside (NR), a key biosynthetic precursor of NAD+, is receiving increasing attention because of its role. In this study, a whole-cell catalysis method to efficiently synthesize NR was established. First, the performance of 5'-nucleotidase (UshA) from Escherichia coli was confirmed to have high catalytic activity to synthesize NR. Then, the endogenous NR degradation pathway was detected, and the genes (rihA, rihB, and rihC) involved in NR degradation were knocked out, which enabled NR biosynthesis. In addition, the important role of the signal peptide of UshA in NR transport had been confirmed. Subsequently, nitrile hydratase was introduced to achieve the conversion of 3-cyanopyridine to NR. Finally, the NR titer reached 25.6 and 29.8 g/L with nicotinamide and 3-cyanopyridine, respectively, as substrates in a 5-L bioreactor, the efficient biosynthesis of NR in E. coli by using nicotinamide and 3-cyanopyridine.
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Affiliation(s)
- Zhongshi Huang
- Science Center for Future Foods, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China; Key Laboratory of Industrial Biotechnology, Ministry of Education and School of Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China; Engineering Research Center of Ministry of Education on Food Synthetic Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China; Jiangsu Province Engineering Research Center of Food Synthetic Biotechnology, Jiangnan University, Wuxi 214122, China
| | - Xinglong Wang
- Science Center for Future Foods, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China; Key Laboratory of Industrial Biotechnology, Ministry of Education and School of Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China
| | - Ning Li
- Science Center for Future Foods, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China; Key Laboratory of Industrial Biotechnology, Ministry of Education and School of Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China
| | - Fuqiang Song
- Science Center for Future Foods, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China; Key Laboratory of Industrial Biotechnology, Ministry of Education and School of Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China
| | - Jingwen Zhou
- Science Center for Future Foods, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China; Key Laboratory of Industrial Biotechnology, Ministry of Education and School of Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China; Engineering Research Center of Ministry of Education on Food Synthetic Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China; Jiangsu Province Engineering Research Center of Food Synthetic Biotechnology, Jiangnan University, Wuxi 214122, China.
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5
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Kropotov A, Kulikova V, Solovjeva L, Yakimov A, Nerinovski K, Svetlova M, Sudnitsyna J, Plusnina A, Antipova M, Khodorkovskiy M, Migaud ME, Gambaryan S, Ziegler M, Nikiforov A. Purine nucleoside phosphorylase controls nicotinamide riboside metabolism in mammalian cells. J Biol Chem 2022; 298:102615. [PMID: 36265580 PMCID: PMC9667316 DOI: 10.1016/j.jbc.2022.102615] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 11/13/2022] Open
Abstract
Nicotinamide riboside (NR) is an effective precursor of nicotinamide adenine dinucleotide (NAD) in human and animal cells. NR supplementation can increase the level of NAD in various tissues and thereby improve physiological functions that are weakened or lost in experimental models of aging or various human pathologies. However, there are also reports questioning the efficacy of NR supplementation. Indeed, the mechanisms of its utilization by cells are not fully understood. Herein, we investigated the role of purine nucleoside phosphorylase (PNP) in NR metabolism in mammalian cells. Using both PNP overexpression and genetic knockout, we show that after being imported into cells by members of the equilibrative nucleoside transporter family, NR is predominantly metabolized by PNP, resulting in nicotinamide (Nam) accumulation. Intracellular cleavage of NR to Nam is prevented by the potent PNP inhibitor Immucillin H in various types of mammalian cells. In turn, suppression of PNP activity potentiates NAD synthesis from NR. Combining pharmacological inhibition of PNP with NR supplementation in mice, we demonstrate that the cleavage of the riboside to Nam is strongly diminished, maintaining high levels of NR in blood, kidney, and liver. Moreover, we show that PNP inhibition stimulates Nam mononucleotide and NAD+ synthesis from NR in vivo, in particular, in the kidney. Thus, we establish PNP as a major regulator of NR metabolism in mammals and provide evidence that the health benefits of NR supplementation could be greatly enhanced by concomitant downregulation of PNP activity.
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Affiliation(s)
- Andrey Kropotov
- Institute of Cytology, Russian Academy of Sciences, St Petersburg, Russia
| | - Veronika Kulikova
- Institute of Cytology, Russian Academy of Sciences, St Petersburg, Russia,Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, St Petersburg, Russia
| | - Ljudmila Solovjeva
- Institute of Cytology, Russian Academy of Sciences, St Petersburg, Russia
| | - Alexander Yakimov
- Institute of Cytology, Russian Academy of Sciences, St Petersburg, Russia,Research Center of Nanobiotechnologies, Peter the Great St Petersburg Polytechnic University, St Petersburg, Russia
| | - Kirill Nerinovski
- Department of Nuclear Physics Research Methods, St Petersburg State University, St Petersburg, Russia
| | - Maria Svetlova
- Institute of Cytology, Russian Academy of Sciences, St Petersburg, Russia
| | - Julia Sudnitsyna
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, St Petersburg, Russia
| | - Alena Plusnina
- Institute of Cytology, Russian Academy of Sciences, St Petersburg, Russia
| | - Maria Antipova
- Institute of Cytology, Russian Academy of Sciences, St Petersburg, Russia
| | - Mikhail Khodorkovskiy
- Institute of Cytology, Russian Academy of Sciences, St Petersburg, Russia,Research Center of Nanobiotechnologies, Peter the Great St Petersburg Polytechnic University, St Petersburg, Russia
| | - Marie E. Migaud
- Mitchell Cancer Institute, University of South Alabama, Mobile, Alabama, USA
| | - Stepan Gambaryan
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, St Petersburg, Russia
| | - Mathias Ziegler
- Department of Biomedicine, University of Bergen, Bergen, Norway,For correspondence: Andrey Nikiforov; Mathias Ziegler
| | - Andrey Nikiforov
- Institute of Cytology, Russian Academy of Sciences, St Petersburg, Russia,For correspondence: Andrey Nikiforov; Mathias Ziegler
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6
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Canto C. NAD + Precursors: A Questionable Redundancy. Metabolites 2022; 12:metabo12070630. [PMID: 35888754 PMCID: PMC9316858 DOI: 10.3390/metabo12070630] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 11/12/2022] Open
Abstract
The last decade has seen a strong proliferation of therapeutic strategies for the treatment of metabolic and age-related diseases based on increasing cellular NAD+ bioavailability. Among them, the dietary supplementation with NAD+ precursors—classically known as vitamin B3—has received most of the attention. Multiple molecules can act as NAD+ precursors through independent biosynthetic routes. Interestingly, eukaryote organisms have conserved a remarkable ability to utilize all of these different molecules, even if some of them are scarcely found in nature. Here, we discuss the possibility that the conservation of all of these biosynthetic pathways through evolution occurred because the different NAD+ precursors might serve specialized purposes.
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Affiliation(s)
- Carles Canto
- Nestlé Institute of Health Sciences, Nestlé Research Ltd., EPFL Campus, Innovation Park, Building G, 1015 Lausanne, Switzerland; ; Tel.: +41-(0)-216326116
- School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
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7
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Veenhuis SJ, van Os NJ, Janssen AJ, van Gerven MH, Coene KL, Engelke UF, Wevers RA, Tinnevelt GH, ter Heine R, van de Warrenburg BP, Weemaes CM, Roeleveld N, Willemsen MA. Nicotinamide Riboside Improves Ataxia Scores and Immunoglobulin Levels in Ataxia Telangiectasia. Mov Disord 2021; 36:2951-2957. [PMID: 34515380 PMCID: PMC9291897 DOI: 10.1002/mds.28788] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 08/16/2021] [Accepted: 08/24/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Treatment of animal models with ataxia telangiectasia (A-T) with nicotinamide riboside (NR) improved their neurological outcome and survival. OBJECTIVE The aim of this study is to investigate the effects of NR in patients with A-T. METHODS In this open-label, proof-of-concept study, 24 patients with A-T were treated with NR during four consecutive months. The effects of NR on ataxia, dysarthria, quality of life, and laboratory parameters were analyzed. RESULTS During treatment, ataxia scores improved; mean total Scale for the Assessment and Rating of Ataxia and International Cooperative Ataxia Rating Scale scores decreased to 2.4 and 10.1 points, respectively. After NR withdrawal, ataxia scores worsened. In immunodeficient patients, the mean serum IgG concentration increased substantially until the end of the study period with 0.52 g/L. Untargeted metabolomics analysis revealed increased plasma levels of NR metabolites and purine nucleosides during treatment. Adverse effects did not occur. CONCLUSIONS Treatment with NR is tolerated well and associated with improvement in ataxia and serum immunoglobulin concentrations in patients with A-T. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Stefanie J.G. Veenhuis
- Department of PediatricsAmalia Children's Hospital, Radboud University Medical CenterNijmegenThe Netherlands
- Donders Institute for Brain, Cognition and BehaviorRadboud University Medical CenterNijmegenThe Netherlands
| | - Nienke J.H. van Os
- Donders Institute for Brain, Cognition and BehaviorRadboud University Medical CenterNijmegenThe Netherlands
- Department of NeurologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Anjo J.W.M. Janssen
- Department of RehabilitationRadboud University Medical CenterNijmegenThe Netherlands
| | | | - Karlien L.M. Coene
- Department of Laboratory Medicine, Translation Metabolic LaboratoryRadboud University Medical CenterNijmegenThe Netherlands
| | - Udo. F.H. Engelke
- Department of Laboratory Medicine, Translation Metabolic LaboratoryRadboud University Medical CenterNijmegenThe Netherlands
| | - Ron A. Wevers
- Department of Laboratory Medicine, Translation Metabolic LaboratoryRadboud University Medical CenterNijmegenThe Netherlands
| | - Gerjen H. Tinnevelt
- Institute for Molecules and MaterialsRadboud UniversityNijmegenThe Netherlands
| | - Rob ter Heine
- Department of PharmacyRadboud University Medical CenterNijmegenThe Netherlands
- Radboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Bart P.C. van de Warrenburg
- Donders Institute for Brain, Cognition and BehaviorRadboud University Medical CenterNijmegenThe Netherlands
- Department of NeurologyRadboud University Medical CenterNijmegenThe Netherlands
- Center of Expertise for Parkinson & Movement DisordersRadboud University Medical CenterNijmegenThe Netherlands
| | - Corry M.R. Weemaes
- Department of PediatricsAmalia Children's Hospital, Radboud University Medical CenterNijmegenThe Netherlands
| | - Nel Roeleveld
- Radboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
- Department for Health EvidenceRadboud University Medical CenterNijmegenThe Netherlands
| | - Michèl A.A.P. Willemsen
- Department of PediatricsAmalia Children's Hospital, Radboud University Medical CenterNijmegenThe Netherlands
- Donders Institute for Brain, Cognition and BehaviorRadboud University Medical CenterNijmegenThe Netherlands
- Center of Expertise for Parkinson & Movement DisordersRadboud University Medical CenterNijmegenThe Netherlands
- Department of Pediatric NeurologyAmalia Children's Hospital, Radboud University Medical CenterNijmegenThe Netherlands
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