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Prigogine C, Ruiz JM, Cebolla AM, Deconinck N, Servais L, Gailly P, Dan B, Cheron G. Cerebellar dysfunction in the mdx mouse model of Duchenne muscular dystrophy: An electrophysiological and behavioural study. Eur J Neurosci 2024. [PMID: 39415418 DOI: 10.1111/ejn.16566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 08/16/2024] [Accepted: 09/25/2024] [Indexed: 10/18/2024]
Abstract
Patients with Duchenne muscular dystrophy (DMD) commonly show specific cognitive deficits in addition to a severe muscle impairment caused by the absence of dystrophin expression in skeletal muscle. These cognitive deficits have been related to the absence of dystrophin in specific regions of the central nervous system, notably cerebellar Purkinje cells (PCs). Dystrophin has recently been involved in GABAA receptors clustering at postsynaptic densities, and its absence, by disrupting this clustering, leads to decreased inhibitory input to PC. We performed an in vivo electrophysiological study of the dystrophin-deficient muscular dystrophy X-linked (mdx) mouse model of DMD to compare PC firing and local field potential (LFP) in alert mdx and control C57Bl/10 mice. We found that the absence of dystrophin is associated with altered PC firing and the emergence of fast (~160-200 Hz) LFP oscillations in the cerebellar cortex of alert mdx mice. These abnormalities were not related to the disrupted expression of calcium-binding proteins in cerebellar PC. We also demonstrate that cerebellar long-term depression is altered in alert mdx mice. Finally, mdx mice displayed a force weakness, mild impairment of motor coordination and balance during behavioural tests. These findings demonstrate the existence of cerebellar dysfunction in mdx mice. A similar cerebellar dysfunction may contribute to the cognitive deficits observed in patients with DMD.
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Affiliation(s)
- Cynthia Prigogine
- Laboratory of Neurophysiology and Movement Biomechanics, Université Libre de Bruxelles, Brussels, Belgium
- Laboratory of Electrophysiology, Université de Mons, Mons, Belgium
| | | | - Ana Maria Cebolla
- Laboratory of Neurophysiology and Movement Biomechanics, Université Libre de Bruxelles, Brussels, Belgium
| | - Nicolas Deconinck
- Department of Pediatric Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium
| | | | - Philippe Gailly
- Laboratory of Cell Physiology, Université Catholique de Louvain, Brussels, Belgium
| | - Bernard Dan
- Laboratory of Neurophysiology and Movement Biomechanics, Université Libre de Bruxelles, Brussels, Belgium
- Rehabilitation Hospital Inkendaal, Vlezenbeek, Belgium
| | - Guy Cheron
- Laboratory of Neurophysiology and Movement Biomechanics, Université Libre de Bruxelles, Brussels, Belgium
- Laboratory of Electrophysiology, Université de Mons, Mons, Belgium
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2
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Gregg J, Wilson C, Curran D, Hanna D. Neurocognitive functioning among children and young people with Duchenne Muscular Dystrophy: A systematic review and meta-analysis. Clin Neuropsychol 2024:1-28. [PMID: 38509463 DOI: 10.1080/13854046.2024.2324500] [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: 09/14/2023] [Accepted: 02/22/2024] [Indexed: 03/22/2024]
Abstract
Objective: The neurocognitive aspects of DMD have received less attention than the physiological sequalae. This study conducted a systematic review and meta-analysis of available literature on the neurocognitive profile of children and young people with DMD. Method: Five databases (EMBASE, Medline, PsycInfo, Scopus and Web of Science) and the grey literature was searched on 27th January 2023. Eligible articles were available in English and reported neurocognitive outcomes. Neurocognitive domains reported in a comparable way across a minimum of three studies were included. The neurocognitive domains of Full-Scale IQ (FSIQ), Verbal IQ (VIQ), Performance IQ (PIQ) and Working memory (WMI) derived from Wechsler scales and receptive vocabulary ability derived from the Peabody Picture Verbal Test (PPVT) were included. A single mean meta-analysis was completed. Results: Relevant data was extracted and presented for 38 eligible studies; 2 of which are from grey literature. Results suggest children with DMD perform around 1SD below non-clinical norms for FSIQ, PIQ, VIQ and WMI. Unlike VIQ, scores derived from the PPVT were within the non-clinical norms. Studies were of moderate - high quality, there was significant heterogeneity and no publication bias. Conclusion: A systematic review of working memory has not previously been completed, it appears that children with DMD perform around 1SD below the mean, like FSIQ, PIQVIQ and WMI. The PPVT is a measure of receptive verbal ability and caution is recommended around the interchangeability of PPVT scores and the wider construct of verbal intelligence.
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Affiliation(s)
- Jayne Gregg
- Regional Neurosciences, Royal Victoria Hospital
| | - Colin Wilson
- Regional Acquired Brain Injury Unit, Musgrave Park Hospital, Belfast HSC Trust
| | - David Curran
- School of Psychology, Queens University Belfast/Northern HSC Trust
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3
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Hellebrekers DMJ, Wirken JMA, Lionarons JM, van Kuijk SMJ, Klinkenberg S, Vles JSH, Hendriksen JGM. Computerized working memory training in males with Duchenne muscular dystrophy: A single case experimental design study. Neuropsychol Rehabil 2023; 33:1325-1348. [PMID: 35876193 DOI: 10.1080/09602011.2022.2096080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 06/24/2022] [Indexed: 10/16/2022]
Abstract
Learning disabilities (LDs) and working memory problems (WM) are common brain-related comorbidities in Duchenne muscular dystrophy (DMD). Despite growing evidence on the efficacy of computerized WM training in children with LDs, research in DMD is lacking. This exploratory study assessed whether training (1) improves dystrophin-associated WM problems in DMD, (2) effects are present at post-intervention, 3 and 8 months follow-up, and (3) improves problems that arise from their LDs. A single case non-concurrent multiple baseline across patients design evaluated the target behaviour i.e. parental reports of WM problems of four DMD participants with LDs. Additionally, participants completed cognitive tests of verbal and visual WM, academics, attention, processing speed and fluid reasoning. Parents and teachers completed behavioural questionnaires. Testing and questionnaires were administered at baseline, post-intervention (T2), 3 (T3) and 8 (T4) months follow-up. Positive effects on target behaviour were found for three of four participants, but parental bias cannot be ruled out. Short and long-term, near-and far transfer effects were found for verbal and visual WM (T2:n = 2, T3&T4:n = 1), reading (T2:n = 4,T3:n = 3,T4:n = 2), arithmetic (all T:n = 1), processing speed (all T:n = 4) and fluid reasoning (T2:n = 1,T3&T4:n = 2). Behavioural questionnaires displayed minimal changes (T2:n = 1,T3&T4:n = 2). Promising WM training results are shown in DMD that merit further research.
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Affiliation(s)
- Danique M J Hellebrekers
- Centre for Neurological Learning Disabilities, Kempenhaeghe, Heeze, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jose M A Wirken
- Centre for Neurological Learning Disabilities, Kempenhaeghe, Heeze, The Netherlands
| | - Judith M Lionarons
- Centre for Neurological Learning Disabilities, Kempenhaeghe, Heeze, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Sander M J van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Sylvia Klinkenberg
- Centre for Neurological Learning Disabilities, Kempenhaeghe, Heeze, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Johan S H Vles
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jos G M Hendriksen
- Centre for Neurological Learning Disabilities, Kempenhaeghe, Heeze, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Dutch Duchenne Centre, Leiden, The Netherlands
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4
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Weerkamp PMM, Mol EM, Sweere DJJ, Schrans DGM, Vermeulen RJ, Klinkenberg S, Hurks PPM, Hendriksen JGM. Wechsler Scale Intelligence Testing in Males with Dystrophinopathies: A Review and Meta-Analysis. Brain Sci 2022; 12:1544. [PMID: 36421868 PMCID: PMC9688319 DOI: 10.3390/brainsci12111544] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Intelligence scores in males with Duchenne Muscular Dystrophy (DMD) and Becker Muscular Dystrophy (BMD) remain a major issue in clinical practice. We performed a literature review and meta-analysis to further delineate the intellectual functioning of dystrophinopathies. METHOD Published, peer-reviewed articles assessing intelligence, using Wechsler Scales, of males with DMD or BMD were searched from 1960 to 2022. Meta-analysis with random-effects models was conducted, assessing weighted, mean effect sizes of full-scale IQ (FSIQ) scores relative to normative data (Mean = 100, Standard Deviation = 15). Post hoc we analysed differences between performance and verbal intelligence scores. RESULTS 43 studies were included, reporting data on 1472 males with dystrophinopathies; with FSIQ scores available for 1234 DMD (k = 32) and 101 BMD (k = 7). DMD males score, on average, one standard deviation below average (FSIQ = 84.76) and significantly lower than BMD (FSIQ = 92.11). Compared to a previous meta-analysis published in 2001, we find, on average, significantly higher FSIQ scores in DMD. CONCLUSION Males with Duchenne have, on average, significantly lower FSIQ scores than BMD males and the general population. Clinicians must consider lower intelligence in dystrophinopathies to ensure good clinical practice.
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Affiliation(s)
- Pien M. M. Weerkamp
- Expert Centre for Neurological and Developmental Learning Disabilities, Kempenhaeghe, Sterkselseweg 65, 5591 VE Heeze, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, UNS40, 6229 ER Maastricht, The Netherlands
| | - Eva M. Mol
- Expert Centre for Neurological and Developmental Learning Disabilities, Kempenhaeghe, Sterkselseweg 65, 5591 VE Heeze, The Netherlands
- Klimmendaal Academy, Klimmendaal Rehabilitation Specialists, Heijenoordseweg 5, 6813 GG Arnhem, The Netherlands
| | - Dirk J. J. Sweere
- Expert Centre for Neurological and Developmental Learning Disabilities, Kempenhaeghe, Sterkselseweg 65, 5591 VE Heeze, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, UNS40, 6229 ER Maastricht, The Netherlands
| | | | - R. Jeroen Vermeulen
- School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, UNS40, 6229 ER Maastricht, The Netherlands
- Department of Neurology, Maastricht University Medical Centre, 6229 ER Maastricht, The Netherlands
| | - Sylvia Klinkenberg
- Expert Centre for Neurological and Developmental Learning Disabilities, Kempenhaeghe, Sterkselseweg 65, 5591 VE Heeze, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, UNS40, 6229 ER Maastricht, The Netherlands
- Department of Neurology, Maastricht University Medical Centre, 6229 ER Maastricht, The Netherlands
| | - Petra P. M. Hurks
- School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, UNS40, 6229 ER Maastricht, The Netherlands
- Department of Neurology, Maastricht University Medical Centre, 6229 ER Maastricht, The Netherlands
| | - Jos G. M. Hendriksen
- Expert Centre for Neurological and Developmental Learning Disabilities, Kempenhaeghe, Sterkselseweg 65, 5591 VE Heeze, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, UNS40, 6229 ER Maastricht, The Netherlands
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5
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Dp71 and intellectual disability in Indonesian patients with Duchenne muscular dystrophy. PLoS One 2022; 17:e0276640. [PMID: 36315559 PMCID: PMC9621454 DOI: 10.1371/journal.pone.0276640] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 10/10/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTIONS Duchenne muscular dystrophy (DMD) is an X-linked recessive progressive muscular disease marked by developmental delays due to mutations in the DMD gene, which encodes dystrophin. Brain comorbidity adds to the burden of limited mobility and significantly impacts patients' quality of life and their family. The changes of expression of dystrophin isoforms in the brain due to DMD gene mutations are thought to be related to the cognitive and neurobehavior profiles of DMD. OBJECTIVES This cross-sectional study aimed to characterize cognitive and neurodevelopmental profiles of patients with DMD and to explore underlying genotype-phenotype associations. METHODS Patients with DMD aged 5-18 years from Dr Sardjito Hospital and Universitas Gadjah Mada Academic Hospital from 2017-2022 were included. Multiplex ligation-dependent probe amplification and whole exome sequencing were used to determine mutations in the DMD genes. Cognitive function was measured by intelligence quotient testing using the Wechsler Intelligence Scale for Children and adaptive function tests with Vineland Adaptive Behavior Scales. The Autism Mental Status Exam and Abbreviated Conner's Rating Scale were used to screen for autism spectrum disorder (ASD) and attention deficit and hyperactivity disorder (ADHD), respectively. RESULTS The mean total IQ score of DMD patients was lower than that of the general population (80.6 ± 22.0 vs 100 ± 15), with intellectual disability observed in 15 boys (29.4%). Of the 51 patients with DMD, the Dp71 group had the lowest cognitive performance with a total IQ score (46 ± 24.8; p = 0.003), while the Dp427 group and Dp140 group's total IQ scores were 83.0 ± 24.6 and 84.2 ± 17.5 respectively. There were no DMD patients with ASD, while 4 boys (7.8%) had comorbidity with ADHD. CONCLUSION Boys with DMD are at higher risk of intellectual disability. The risk appears to increase with mutations at the 3' end of the gene (Dp71 disruption). Moreover, Dp71 disruption might not be associated with ADHD and ASD in patients with DMD.
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Neuropsychological and behavioral profile in a cohort of Becker Muscular Dystrophy pediatric patients. Neuromuscul Disord 2022; 32:736-742. [DOI: 10.1016/j.nmd.2022.07.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/20/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022]
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Koeks Z, Hellebrekers DMJ, van de Velde NM, Alleman I, Spitali P, van Duyvenvoorde HA, Verschuuren JJGM, Hendriksen JGM, Niks EH. The neurocognitive profile of adults with Becker muscular dystrophy in the Netherlands. J Neuromuscul Dis 2022; 9:543-553. [PMID: 35723110 PMCID: PMC9398065 DOI: 10.3233/jnd-210770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: In Becker muscular dystrophy evidence for neurocognitive and behavioral comorbidity is evolving. More insight into the extend of these problems is of great importance for early detection and remediation in clinical practice. Objective: In this study we aimed to describe the neurocognitive and behavioral features of a Dutch adult cohort of BMD patients, and to evaluate correlations to motor function outcomes. Methods: 28 adult BMD patients were included. Intelligence, executive functioning, verbal memory and reaction times were assessed cross-sectionally. Additionally, patients completed questionnaires on behavioral and emotional symptoms, psychosocial and executive functions. Results were compared to normative data and correlated with disease severity as measured by the 10-meter run/walk test and Performance of the Upper Limb version 1.2. Results: 15 patients (53.6%) had a high educational level despite frequent grade repeating (48.3%) during primary or secondary school. Neuropsychological testing revealed that intellectual abilities, verbal memory, processing speed and executive functioning were statistically significant below average, but still within normal range. Regarding outcomes of the behavioral questionnaires, no significant differences were reported compared to the norm population. No relevant correlations with disease severity were found. Conclusions: This cohort of adult BMD patients exhibits minor cognitive impairments and no significant behavioral problems. The lower outcomes on processing speed and verbal memory, combined with the relatively high prevalence of grade repeating during primary and secondary school, implies that these minor impairments played a role in childhood. However, the on average high educational levels suggests that they grow out of their cognitive impairments with ageing.
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Affiliation(s)
- Zaıda Koeks
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Danique M J Hellebrekers
- Centre for Neurological Learning Disabilities, Kempenhaeghe, Heeze, the Netherlands.,School for Mental Health and Neuroscience>, Maastricht University, Maastricht, The Netherlands
| | - Nienke M van de Velde
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Duchenne Center Netherlands
| | - Iris Alleman
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - Pietro Spitali
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Jan J G M Verschuuren
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Duchenne Center Netherlands
| | - Jos G M Hendriksen
- Centre for Neurological Learning Disabilities, Kempenhaeghe, Heeze, the Netherlands.,School for Mental Health and Neuroscience>, Maastricht University, Maastricht, The Netherlands.,Duchenne Center Netherlands
| | - Erik H Niks
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Duchenne Center Netherlands
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8
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Biagi L, Lenzi S, Cipriano E, Fiori S, Bosco P, Cristofani P, Astrea G, Pini A, Cioni G, Mercuri E, Tosetti M, Battini R. Neural substrates of neuropsychological profiles in dystrophynopathies: A pilot study of diffusion tractography imaging. PLoS One 2021; 16:e0250420. [PMID: 33939732 PMCID: PMC8092766 DOI: 10.1371/journal.pone.0250420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 04/06/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Cognitive difficulties and neuropsychological alterations in Duchenne and Becker muscular dystrophy (DMD, BMD) boys are not yet sufficiently explored, although this topic could have a relevant impact, finding novel biomarkers of disease both at genetics and neuroimaging point of view. The current study aims to: 1) analyze the neuropsychological profile of a group of DMD and BMD boys without cognitive impairment with an assessment of their executive functions; 2) explore the structural connectivity in DMD, BMD, and age-matched controls focusing on cortico-subcortical tracts that connect frontal cortex, basal ganglia, and cerebellum via the thalamus; 3) explore possible correlations between altered structural connectivity and clinical neuropsychological measures. Materials and methods This pilot study included 15 boys (5 DMD subjects, 5 BMD subjects, and 5 age-matched typically developing, TD). They were assessed using a neuropsychological assessment protocol including cognitive and executive functioning assessment and performed a 1.5T MRI brain exam including advance Diffusion Weighted Imaging (DWI) method for tractography. Structural connectivity measurements were extracted along three specific tracts: Cortico-Ponto-Cerebellar Tract (CPCT), Cerebellar-Thalamic Tract (CTT), and Superior Longitudinal Fasciculus (SLF). Cortical-Spinal Tract (CST) was selected for reference, as control tract. Results Regarding intellectual functioning, a major impairment in executive functions compared to the general intellectual functioning was observed both for DMD (mean score = 86.20; SD = 11.54) and for BMD children (mean score = 88; SD = 3.67). Mean FA resulted tendentially always lower in DMD compared to both BMD and TD groups for all the examined tracts. The differences in FA were statistically significant for the right CTT (DMD vs BMD, p = 0.002, and DMD vs TD, p = 0.0015) and the right CPCT (DMD vs TD, p = 0.008). Concerning DMD, significant correlations emerged between FA-R-CTT and intellectual quotients (FIQ, p = 0.044; ρs = 0.821), and executive functions (Denomination Total, p = 0.044, ρs = 0.821; Inhibition Total, p = 0.019, ρs = 0.900). BMD showed a significant correlation between FA-R-CPCT and working memory index (p = 0.007; ρs = 0.949). Discussion and conclusion In this pilot study, despite the limitation of sample size, the findings support the hypothesis of the involvement of a cerebellar-thalamo-cortical loop for the neuropsychological profile of DMD, as the CTT and the CPCT are involved in the network and the related brain structures are known to be implied in executive functions. Our results suggest that altered WM connectivity and reduced fibre organization in cerebellar tracts, probably due to the lack of dystrophin in the brain, may render less efficient some neuropsychological functions in children affected by dystrophinopathies. The wider multicentric study could help to better establish the role of cerebellar connectivity in neuropsychological profile for dystrophinopathies, identifying possible novel diagnostic and prognostic biomarkers.
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Affiliation(s)
- Laura Biagi
- Laboratory of Medical Physics and Magnetic Resonance, IRCCS Fondazione Stella Maris, Calambrone, Pisa, Italy
| | - Sara Lenzi
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa, Italy
| | - Emilio Cipriano
- Laboratory of Medical Physics and Magnetic Resonance, IRCCS Fondazione Stella Maris, Calambrone, Pisa, Italy
- Department of Physics, University of Pisa, Pisa, Italy
| | - Simona Fiori
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa, Italy
| | - Paolo Bosco
- Laboratory of Medical Physics and Magnetic Resonance, IRCCS Fondazione Stella Maris, Calambrone, Pisa, Italy
| | - Paola Cristofani
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa, Italy
| | - Guia Astrea
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa, Italy
| | - Antonella Pini
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa, Italy
| | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Eugenio Mercuri
- Pediatric Neurology Unit, Catholic University and Nemo Center, Policlinico Universitario Gemelli, Rome, Italy
| | - Michela Tosetti
- Laboratory of Medical Physics and Magnetic Resonance, IRCCS Fondazione Stella Maris, Calambrone, Pisa, Italy
| | - Roberta Battini
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- * E-mail:
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9
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Battini R, Lenzi S, Lucibello S, Chieffo D, Moriconi F, Cristofani P, Bulgheroni S, Cumbo F, Pane M, Baranello G, Alfieri P, Astrea G, Cioni G, Vicari S, Mercuri E. Longitudinal data of neuropsychological profile in a cohort of Duchenne muscular dystrophy boys without cognitive impairment. Neuromuscul Disord 2021; 31:319-327. [PMID: 33658162 DOI: 10.1016/j.nmd.2021.01.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/24/2021] [Accepted: 01/29/2021] [Indexed: 12/18/2022]
Abstract
The aim of the study was to re-assess neuropsychological profile in a group of boys with Duchenne muscular dystrophy without intellectual disability and neuropsychiatric disorder three years apart from a previous evaluation, to establish possible changes over time. We were also interested in defining more in detail correlation between genotype and neuropsychological phenotype. Thirty-three of the previous 40 subjects (mean age at follow up: 10 years and 7 months) agreed to participate in the follow up study and to perform the new assessment. The results confirm a typical neuropsychological profile, with difficulty in the manipulation of stored information, poor abstract reasoning and planning capacity and impulsiveness, supporting the involvement of a cerebellar striatal cortical network for these children. The more detailed description of subgroups of subjects, according to the real expression of Dp140, let to reveal possible genotype-neuropsychological phenotype correlations, and a more general neuropsychological impairment emerged in boys without Dp140 expression.
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Affiliation(s)
- R Battini
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 341/ ABC, Calambrone, Pisa 56128, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Via Savi10, 56126 Pisa, Italy.
| | - S Lenzi
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 341/ ABC, Calambrone, Pisa 56128, Italy
| | - S Lucibello
- Pediatric Neurology Unit, Catholic University and Nemo Center, Policlinico Universitario Gemelli Largo Agostino Gemelli, 8. Rome, Italy
| | - D Chieffo
- Pediatric Neurology Unit, Catholic University and Nemo Center, Policlinico Universitario Gemelli Largo Agostino Gemelli, 8. Rome, Italy
| | - F Moriconi
- Pediatric Neurology Unit, Catholic University and Nemo Center, Policlinico Universitario Gemelli Largo Agostino Gemelli, 8. Rome, Italy
| | - P Cristofani
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 341/ ABC, Calambrone, Pisa 56128, Italy
| | - S Bulgheroni
- Developmental Neurology Division, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, Italy
| | - F Cumbo
- Child and Adolescent Neuropsychiatry Unit, Department of Neurological and Psychiatric Science, IRCCS Bambino Gesù Children's Hospital, Piazza di Sant'Onofrio, 4. Rome 00165, Italy
| | - M Pane
- Pediatric Neurology Unit, Catholic University and Nemo Center, Policlinico Universitario Gemelli Largo Agostino Gemelli, 8. Rome, Italy
| | - G Baranello
- Developmental Neurology Division, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, Italy
| | - P Alfieri
- Child and Adolescent Neuropsychiatry Unit, Department of Neurological and Psychiatric Science, IRCCS Bambino Gesù Children's Hospital, Piazza di Sant'Onofrio, 4. Rome 00165, Italy
| | - G Astrea
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 341/ ABC, Calambrone, Pisa 56128, Italy
| | - G Cioni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 341/ ABC, Calambrone, Pisa 56128, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Via Savi10, 56126 Pisa, Italy
| | - S Vicari
- Child and Adolescent Neuropsychiatry Unit, Department of Neurological and Psychiatric Science, IRCCS Bambino Gesù Children's Hospital, Piazza di Sant'Onofrio, 4. Rome 00165, Italy; Department of Life Sciences and Public Health, Catholic University, Largo Agostino Gemelli, 8, Rome, Italy
| | - E Mercuri
- Pediatric Neurology Unit, Catholic University and Nemo Center, Policlinico Universitario Gemelli Largo Agostino Gemelli, 8. Rome, Italy
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10
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Tyagi R, Arvind H, Goyal M, Anand A, Mohanty M. Working Memory Alterations Plays an Essential Role in Developing Global Neuropsychological Impairment in Duchenne Muscular Dystrophy. Front Psychol 2021; 11:613242. [PMID: 33519636 PMCID: PMC7843380 DOI: 10.3389/fpsyg.2020.613242] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/01/2020] [Indexed: 11/13/2022] Open
Abstract
Background Neuropsychological profile of Indian Duchenne muscular dystrophy (DMD) subjects remains unidentified and needs to be evaluated. Methods A total of 69 DMD and 66 controls were subjected to detailed intelligence and neuropsychological assessment. The factor indexes were derived from various components of Malin's Intelligence Scale for Indian Children (MISIC) and Rey Auditory Verbal Learning Test (RAVLT). Results Poor verbal and visual memory profiles were demonstrated by DMDs, which include RAVLT-immediate recall (IR) (p = 0.042), RAVLT-delayed recall (DR) (p = 0.009), Rey-Osterrieth complex figure test (RCFT)-IR (p = 0.001), and RCFT-DR (p = 0.001). RAVLT-memory efficiency index demonstrated poor verbal memory efficiency (p = 0.008). Significant differences in the functioning of working memory axis [RAVLT T1 (p = 0.015), recency T1 (p = 0.004), Digit Span Backward (p = 0.103)] were observed along with reduced performance in visuomotor coordination, visuospatial, and visual recognition abilities. Block designing efficiency index and attention fraction showed a normal performance in DMD kids. Conclusion Working memory deficits were found to be the crucial element of cognitive functioning in DMD cases. Working memory interventions may be beneficial to improve the neuropsychological profile in DMD.
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Affiliation(s)
- Rahul Tyagi
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Harshita Arvind
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manoj Goyal
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Akshay Anand
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manju Mohanty
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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11
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Hellebrekers DMJ, Doorenweerd N, Sweere DJJ, van Kuijk SMJ, Aartsma-Rus AM, Klinkenberg S, Vles JSH, Hendriksen JGM. Longitudinal follow-up of verbal span and processing speed in Duchenne muscular dystrophy. Eur J Paediatr Neurol 2020; 25:120-126. [PMID: 31964551 DOI: 10.1016/j.ejpn.2020.01.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 12/18/2019] [Accepted: 01/03/2020] [Indexed: 11/28/2022]
Abstract
Neurocognitive deficits are frequently described in Duchenne muscular dystrophy (DMD), but it is unknown how these progress over time. Our aim was to longitudinally assess verbal span capacity and information processing speed in DMD and to explore a genotype-phenotype relation. Verbal span and processing speed scores were available of 28 males with DMD on two time-points, with a mean time interval of 28.34 months (SD = 16.09). The cohort contained of six patients missing only dystrophin isoform Dp427, sixteen missing Dp427 and Dp140, and six were undeterminable. A lower verbal span capacity was found at the first and second assessment, whereas processing speed was normal at both time-points. Post-hoc analyses suggested lower scores on verbal span and processing speed for patients missing Dp427 and Dp140. In DMD, a developmental stagnation in verbal span capacity, irrespective of normal processing speed, is detected through longitudinal follow-up. This appears more pronounced in patients missing Dp427 and Dp140.
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Affiliation(s)
- Danique M J Hellebrekers
- Kempenhaeghe, Centre for Neurological Learning Disabilities, Heeze, the Netherlands; School for Mental Health & Neuroscience, Maastricht University, Maastricht, the Netherlands.
| | - Nathalie Doorenweerd
- Department of Radiology, Leiden University Medical Centre, the Netherlands; John Walton Muscular Dystrophy Research Centre, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Dirk J J Sweere
- Kempenhaeghe, Centre for Neurological Learning Disabilities, Heeze, the Netherlands
| | - Sander M J van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessments, Maastricht University Medical Centre, the Netherlands
| | | | - Sylvia Klinkenberg
- Kempenhaeghe, Centre for Neurological Learning Disabilities, Heeze, the Netherlands; School for Mental Health & Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Neurology, Maastricht University Medical Centre, the Netherlands
| | - Johan S H Vles
- School for Mental Health & Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Jos G M Hendriksen
- Kempenhaeghe, Centre for Neurological Learning Disabilities, Heeze, the Netherlands; School for Mental Health & Neuroscience, Maastricht University, Maastricht, the Netherlands.
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12
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Abstract
OBJECTIVES The aim of this study was to investigate executive skills in children with dystrophinopathy and to examine the association between executive functions and dystrophin gene mutation position. METHODS Fifty boys with dystrophinopathy (mean age, 11 years 0 months; ages range, 5 to 17 years) completed measures of intellectual functioning (IF), working memory and executive functioning [including Digit Span (working memory) and measures from the NIH Toolbox (selective attention/inhibitory control, set shifting, working memory, and processing speed)]. Parents completed the Behavior Rating Inventory of Executive Function (BRIEF). Mutation positions were categorized into three groups (upstream exon 30, 31-62, and downstream exon 63). Paired-samples t tests compared performance on executive measures to IF, and a one-way (three-group) multivariate analysis of covariance compared cognitive performance with mutation location controlling for motor functioning. RESULTS Mean performance on all executive measures was significantly lower than IF. Parents were also more likely to rate their child with dystrophinopathy as having clinically significant executive difficulties on the Shift, Emotional Control, and Behavior Regulation indices of the BRIEF. Mutation analyses resulted in small groups limiting power to detect subtle differences. Those with a downstream mutation position had significantly poorer performance on IF and Total Digit Span, but not on other measures of executive function including behavior. CONCLUSIONS Individuals with dystrophinopathy have executive skill deficits, but they are not generally associated with more distal mutations. (JINS, 2019, 25, 146-155).
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13
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Abstract
OBJECTIVES To examine academic performance in dystrophinopathy as a function of dystrophin gene mutation position as well as intellectual function, executive skills, socioeconomic status (SES), behavior, and physical ability. METHODS In a cross-sectional study, boys with dystrophinopathy (ages 5-17; n=50) completed tests of academics (Woodcock-Johnson-III: spelling, reading, calculation and total scores), executive functioning (selective attention/inhibitory control, set shifting, working memory, and processing speed), single word comprehension and nonverbal reasoning. Motor skills were assessed and parents provided demographic information and child behavioral assessments. Dystrophin gene mutation positions were dichotomized into groups (upstream versus downstream of exon 43, location of isoforms previously linked to intellectual impairment). Genetic mutation groups were compared on measures of academic achievement, and multiple regression analyses examined unique and joint contributions of executive skills, intelligence quotient (IQ), SES, motor abilities, behavior, and mutation positions to academic outcomes. RESULTS Academic performance was slightly, yet significantly, lower than IQ and varied as a function of dystrophin gene position, wherein boys possessing the downstream mutation exhibited greater impairment than boys with the upstream mutation. Digit span forward (indexing verbal span), but no other measure of executive function, contributed significant variance to total academic achievement, spelling and calculation. CONCLUSIONS Weak academic performance is associated with dystrophinopathy and is more common in downstream mutations. A specific deficit in verbal span may underlie inefficiencies observed in children with dystrophinopathy and may drive deficits impacting academic abilities. (JINS, 2018, 24, 928-938).
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14
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Colvin MK, Poysky J, Kinnett K, Damiani M, Gibbons M, Hoskin J, Moreland S, Trout CJ, Weidner N. Psychosocial Management of the Patient With Duchenne Muscular Dystrophy. Pediatrics 2018; 142:S99-S109. [PMID: 30275254 DOI: 10.1542/peds.2018-0333l] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/26/2018] [Indexed: 11/24/2022] Open
Abstract
In this article, we outline a comprehensive plan for the psychosocial management of patients with Duchenne muscular dystrophy (DMD) across the life span. In 2010, the Centers for Disease Control and Prevention sponsored the development of multidisciplinary management guidance for DMD, and in 2018, that guidance was updated. In the intervening years, a new emphasis was placed on studying and addressing the psychosocial issues that affect patients with DMD, driven in part by improved patient survival. Once viewed as ancillary to managing the significant medical needs of patients with DMD, it is now standard practice to integrate psychosocial management into the multidisciplinary management of the disease. It is also increasingly recognized that neurodevelopmental disorders in DMD occur at a higher rate than what was previously understood and that these disorders warrant early and intensive intervention. In this article, we expand on the content found in the 2018 DMD Care Considerations.
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Affiliation(s)
- Mary K Colvin
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts;
| | | | - Kathi Kinnett
- Parent Project Muscular Dystrophy, Hackensack, New Jersey
| | - Mario Damiani
- Parent Project Muscular Dystrophy, Hackensack, New Jersey
| | | | - Janet Hoskin
- University of East London, London, United Kingdom
| | | | | | - Norbert Weidner
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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15
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Chaussenot R, Amar M, Fossier P, Vaillend C. Dp71-Dystrophin Deficiency Alters Prefrontal Cortex Excitation-Inhibition Balance and Executive Functions. Mol Neurobiol 2018; 56:2670-2684. [PMID: 30051354 DOI: 10.1007/s12035-018-1259-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 07/17/2018] [Indexed: 01/19/2023]
Abstract
In the Duchenne muscular dystrophy (DMD) syndrome, mutations affecting expression of Dp71, the main dystrophin isoform of the multipromoter dmd gene in brain, have been associated with intellectual disability and neuropsychiatric disturbances. Patients' profile suggests alterations in prefrontal cortex-dependent executive processes, but the specific dysfunctions due to Dp71 deficiency are unclear. Dp71 is involved in brain ion homeostasis, and its deficiency is expected to increase neuronal excitability, which might compromise the integrity of neuronal networks undertaking high-order cognitive functions. Here, we used electrophysiological (patch clamp) and behavioral techniques in a transgenic mouse that display a selective loss of Dp71 and no muscular dystrophy, to identify changes in prefrontal cortex excitatory/inhibitory (E/I) balance and putative executive dysfunctions. We found prefrontal cortex E/I balance is shifted toward enhanced excitation in Dp71-null mice. This is associated with a selective alteration of AMPA receptor-mediated glutamatergic transmission and reduced synaptic plasticity, while inhibitory transmission is unaffected. Moreover, Dp71-null mice display deficits in cognitive processes that depend on prefrontal cortex integrity, such as cognitive flexibility and sensitivity of spatial working memory to proactive interference. Our data suggest that impaired cortical E/I balance and executive dysfunctions contribute to the intellectual and behavioral disturbances associated with Dp71 deficiency in DMD, in line with current neurobehavioral models considering these functions as key pathophysiological factors in various neurodevelopmental disorders. These new insights in DMD neurobiology also suggest new directions for therapeutic developments targeting excitatory neurotransmission, as well as for guidance of academic environment in severely affected DMD children.
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Affiliation(s)
- Rémi Chaussenot
- Neuroscience Paris-Saclay Institute (Neuro-PSI), UMR 9197, Université Paris Sud, CNRS, Université Paris Saclay, Orsay, France
| | - Muriel Amar
- Neuroscience Paris-Saclay Institute (Neuro-PSI), UMR 9197, Université Paris Sud, CNRS, Université Paris Saclay, Orsay, France.,Laboratoire de Toxinologie moléculaire et Biotechnologies, Institut des Sciences du Vivant Frédéric Joliot, CEA de Saclay, 91191, Gif-sur-Yvette, France
| | - Philippe Fossier
- Neuroscience Paris-Saclay Institute (Neuro-PSI), UMR 9197, Université Paris Sud, CNRS, Université Paris Saclay, Orsay, France
| | - Cyrille Vaillend
- Neuroscience Paris-Saclay Institute (Neuro-PSI), UMR 9197, Université Paris Sud, CNRS, Université Paris Saclay, Orsay, France.
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16
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Battini R, Chieffo D, Bulgheroni S, Piccini G, Pecini C, Lucibello S, Lenzi S, Moriconi F, Pane M, Astrea G, Baranello G, Alfieri P, Vicari S, Riva D, Cioni G, Mercuri E. Cognitive profile in Duchenne muscular dystrophy boys without intellectual disability: The role of executive functions. Neuromuscul Disord 2017; 28:122-128. [PMID: 29305139 DOI: 10.1016/j.nmd.2017.11.018] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 11/19/2017] [Accepted: 11/29/2017] [Indexed: 11/16/2022]
Abstract
The aim of our prospective observational study was to assess profiles of cognitive function and a possible impairment of executive functions in a cohort of boys with Duchenne muscular dystrophy without intellectual and behavior disability. Forty Duchenne boys (range of age: 6 years to 11 years and 6 months) were assessed by Wechsler Intelligence scale and battery of tests including tasks assessing working memory and executive functions (inhibition and switching, problem solving and planning). In our cohort some aspects of cognitive function were often impaired. These included multitasking, problem solving, inhibition and working memory necessary to plan and direct goal oriented behavior. Our results support the suggestion that aspects of cognitive function could be impaired even in boys without intellectual disability and support the hypothesis that executive functions may play an important role in specific aspects of cognitive impairment in Duchenne muscular dystrophy.
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Affiliation(s)
- R Battini
- Pediatric Neurology Unit, Fondazione Policlinico Gemelli, and Nemo Center, UCSC Rome, Italy; Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone (Pisa), Italy
| | - D Chieffo
- Pediatric Neurology Unit, Fondazione Policlinico Gemelli, and Nemo Center, UCSC Rome, Italy
| | - S Bulgheroni
- Developmental Neurology Division, IRCCS Fondazione Istituto Neurologico C. Besta, Milan, Italy
| | - G Piccini
- Unit of Child Neuropsichiatry, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - C Pecini
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone (Pisa), Italy
| | - S Lucibello
- Pediatric Neurology Unit, Fondazione Policlinico Gemelli, and Nemo Center, UCSC Rome, Italy
| | - S Lenzi
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone (Pisa), Italy
| | - F Moriconi
- Pediatric Neurology Unit, Fondazione Policlinico Gemelli, and Nemo Center, UCSC Rome, Italy
| | - M Pane
- Pediatric Neurology Unit, Fondazione Policlinico Gemelli, and Nemo Center, UCSC Rome, Italy
| | - G Astrea
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone (Pisa), Italy
| | - G Baranello
- Developmental Neurology Division, IRCCS Fondazione Istituto Neurologico C. Besta, Milan, Italy
| | - P Alfieri
- Unit of Child Neuropsichiatry, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - S Vicari
- Unit of Child Neuropsichiatry, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - D Riva
- Developmental Neurology Division, IRCCS Fondazione Istituto Neurologico C. Besta, Milan, Italy
| | - G Cioni
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone (Pisa), Italy; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - E Mercuri
- Pediatric Neurology Unit, Fondazione Policlinico Gemelli, and Nemo Center, UCSC Rome, Italy.
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17
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Bisiacchi P, Mento G, Tarantino V, Burlina A. Subclinical executive function impairment in children with asymptomatic, treated phenylketonuria: A comparison with children with immunodeficiency virus. Cogn Neuropsychol 2017; 35:200-208. [PMID: 29117799 DOI: 10.1080/02643294.2017.1396207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In this study we compared the neuropsychological profile of phenylketonuria (PKU) and human immunodeficiency virus (HIV) to examine the specificity of the executive function (EF) impairment reported in these two patologies. A total of 55 age-matched children and adolescents were assessed, including 11 patients with PKU, 16 patients with HIV and 28 healthy controls, underwent a neuropsychological assessment. Although neither the PKU nor the HIV group scored below the normative ranges, both groups showed lower scores in neuropsychological tests engaging EFs than controls. In addition, compared to patients with PKU the HIV group performed significantly worse in the Trail-Making Test A, Corsi Span and Verbal Fluency. These findings suggest that EF impairments in PKU (a) are limited to EFs (i.e., working memory and attentional shifting), (b) are not simply due to generalized processing speed deficits and
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Affiliation(s)
- Patrizia Bisiacchi
- a Department of General Psychology , University of Padua , Padua , Italy
| | - Giovanni Mento
- a Department of General Psychology , University of Padua , Padua , Italy
| | | | - Alberto Burlina
- c Division of Inherited Metabolic Diseases , University Hospital Padua
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18
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Remmelink E, Aartsma-Rus A, Smit AB, Verhage M, Loos M, van Putten M. Cognitive flexibility deficits in a mouse model for the absence of full-length dystrophin. GENES BRAIN AND BEHAVIOR 2017; 15:558-67. [PMID: 27220066 DOI: 10.1111/gbb.12301] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 05/14/2016] [Accepted: 05/20/2016] [Indexed: 11/28/2022]
Abstract
Duchenne muscular dystrophy (DMD) is a progressive muscle-wasting disorder, caused by mutations in the DMD gene and the resulting lack of dystrophin. The DMD gene has seven promoters, giving rise to multiple full-length and shorter isoforms. Besides the expression of dystrophin in muscles, the majority of dystrophin isoforms is expressed in brain and dystrophinopathy can lead to cognitive deficits, including intellectual impairments and deficits in executive function. In contrast to the muscle pathology, the impact of the lack of dystrophin on the brain is not very well studied. Here, we study the behavioral consequences of a lack of full-length dystrophin isoforms in mdx mice, particularly with regard to domains of executive functions and anxiety. We observed a deficit in cognitive flexibility in mdx mice in the absence of motor dysfunction or general learning impairments using two independent behavioral tests. In addition, increased anxiety was observed, but its expression depended on the context. Overall, these results suggest that the absence of full-length dystrophin in mice has specific behavioral effects that compare well to deficits observed in DMD patients.
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Affiliation(s)
- E Remmelink
- Sylics (Synaptologics B.V.), The Netherlands.,Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University, The Netherlands.,Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University Amsterdam, The Netherlands
| | - A Aartsma-Rus
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - A B Smit
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University, The Netherlands
| | - M Verhage
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University Amsterdam, The Netherlands
| | - M Loos
- Sylics (Synaptologics B.V.), The Netherlands
| | - M van Putten
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
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19
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Capelini CM, da Silva TD, Tonks J, Watson S, Alvarez MPB, de Menezes LDC, Favero FM, Caromano FA, Massetti T, de Mello Monteiro CB. Improvements in motor tasks through the use of smartphone technology for individuals with Duchenne muscular dystrophy. Neuropsychiatr Dis Treat 2017; 13:2209-2217. [PMID: 28860778 PMCID: PMC5571857 DOI: 10.2147/ndt.s125466] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND In individuals severely affected with Duchenne muscular dystrophy (DMD), virtual reality has recently been used as a tool to enhance community interaction. Smartphones offer the exciting potential to improve communication, access, and participation, and present the unique opportunity to directly deliver functionality to people with disabilities. OBJECTIVE To verify whether individuals with DMD improve their motor performance when undertaking a visual motor task using a smartphone game. PATIENTS AND METHODS Fifty individuals with DMD and 50 healthy, typically developing (TD) controls, aged 10-34 years participated in the study. The functional characterization of the sample was determined through Vignos, Egen Klassifikation, and the Motor Function Measure scales. To complete the task, individuals moved a virtual ball around a virtual maze and the time in seconds was measured after every attempt in order to analyze improvement of performance after the practice trials. Motor performance (time to finish each maze) was measured in phases of acquisition, short-term retention, and transfer. RESULTS Use of the smartphone maze game promoted improvement in performance during acquisition in both groups, which remained in the retention phase. At the transfer phases, with alternative maze tasks, the performance in DMD group was similar to the performance of TD group, with the exception of the transfer to the contralateral hand (nondominant). However, the group with DMD demonstrated longer movement time at all stages of learning, compared with the TD group. CONCLUSION The practice of a visual motor task delivered via smartphone game promoted an improvement in performance with similar patterns of learning in both groups. Performance can be influenced by task difficulty, and for people with DMD, motor deficits are responsible for the lower speed of execution. This study indicates that individuals with DMD showed improved performance in a short-term motor learning protocol using a smartphone. We advocate that this technology could be used to promote function in this population.
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Affiliation(s)
| | - Talita Dias da Silva
- Department of Medicine, Paulista School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil
| | - James Tonks
- University of Exeter Medical School, Exeter.,University of Lincoln, Lincoln.,Haven Clinical Psychology Practice, Cornwall
| | - Suzanna Watson
- The Cambridge Centre for Paediatric Neuropsychologicial Rehabilitation, Cambridge, UK
| | | | | | - Francis Meire Favero
- Department of Medicine, Paulista School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil
| | | | - Thais Massetti
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of São Paulo
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20
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Filippini M, Guerra A, Negosanti A, Santi S, Sarajlija J, Musti MA, Gobbi G, Lassonde M, Pini A. Mismatch Negativity Recording in Children With Duchenne Muscular Dystrophy: A Preliminary Study Integrating Neurophysiological and Neuropsychological Results. J Child Neurol 2016; 31:1468-1474. [PMID: 27422795 DOI: 10.1177/0883073816656404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 05/26/2016] [Indexed: 11/15/2022]
Abstract
Many studies on Duchenne muscular dystrophy children support the hypothesis of a specific neuropsychological phenotype affecting mostly phonological skills. This prospective study aimed to shed light on the role of phonological abilities. Fourteen Duchenne muscular dystrophy children and 7 healthy children underwent mismatch negativity. Moreover, verbal intelligence, visuospatial attention, immediate verbal memory, working memory, grammar, vocabulary, visuomotor skills, reading, text comprehension, writing, and arithmetic were tested in Duchenne muscular dystrophy children. No significant difference between control and Duchenne muscular dystrophy children was found neither for mismatch negativity amplitude (P = .191 and .116, respectively) nor for latency (P = .135). Eight (57.14%) patients showed an impairment of immediate verbal memory and of visuomotor skills, 7 (63.64%) patients had a deficit in writing and arithmetic skills, even with a mean normal intelligence quotient. Taken together, the results put in evidence a heterogeneous neuropsychological profile not explainable on the basis of a phonological deficit.
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Affiliation(s)
- Melissa Filippini
- Child Neurology Unit, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Angelo Guerra
- Child Neurology Unit, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | | | - Sara Santi
- Child Neurology Unit, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Jasenka Sarajlija
- Child Neurology Unit, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | | | - Giuseppe Gobbi
- Child Neurology Unit, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Maryse Lassonde
- Department of Psychology, Université de Montréal, Montréal, Canada
| | - Antonella Pini
- Child Neurology Unit, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
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21
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Digit Span Performance in Children with Dystrophinopathy: A Verbal Span or Working Memory Contribution? J Int Neuropsychol Soc 2016; 22:777-84. [PMID: 27268852 DOI: 10.1017/s1355617716000461] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES In a large cohort of boys with dystrophinopathies and their unaffected siblings, we examined whether consistently observed performance on digit span is due primarily to a verbal span or executive deficit. We additionally assessed whether digit span performance contributed to the observed variability in reading performance noted in this population. METHODS Performance of 170 boys with dystrophinopathy was compared to 95 unaffected sibling controls on measures of verbal function, reading, and digit span. Maximum digit span forward (DSF) and backward (DSB) lengths were converted to Z-scores using normative data. Independent sample t tests, analysis of variance, and hierarchical multiple regression were run (α=0.05). RESULTS Probands performed worse than controls on digit span, even after accounting for differences in general verbal function (p<.0001). Differences were significant for both DSF (p<.005) and DSB (p<.0001) span length, and an interaction effect yielded significantly worse DSB compared with DSF (p=.01). Reading performance was also lower in probands (p<.0001). The contribution of general level of verbal function, and forward and backward span lengths, did not vary between groups. CONCLUSIONS In boys with dystrophinopathy, decreased performance on digit span appears to be due to both decreased span forward (measuring verbal span only) and backward (measuring verbal span and working memory). The extent to which sibling controls exhibited better performance compared to the probands was significantly greater for backward span when compared with forward span. Thus, immediate verbal memory and executive control are differentially compromised among boys with dystrophinopathy, and both of these abilities independently contribute to reading performance. (JINS, 2016, 22, 777-784).
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22
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Malheiros SRP, da Silva TD, Favero FM, de Abreu LC, Fregni F, Ribeiro DC, de Mello Monteiro CB. Computer task performance by subjects with Duchenne muscular dystrophy. Neuropsychiatr Dis Treat 2016; 12:41-8. [PMID: 26766911 PMCID: PMC4699593 DOI: 10.2147/ndt.s87735] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
AIMS Two specific objectives were established to quantify computer task performance among people with Duchenne muscular dystrophy (DMD). First, we compared simple computational task performance between subjects with DMD and age-matched typically developing (TD) subjects. Second, we examined correlations between the ability of subjects with DMD to learn the computational task and their motor functionality, age, and initial task performance. METHOD The study included 84 individuals (42 with DMD, mean age of 18±5.5 years, and 42 age-matched controls). They executed a computer maze task; all participants performed the acquisition (20 attempts) and retention (five attempts) phases, repeating the same maze. A different maze was used to verify transfer performance (five attempts). The Motor Function Measure Scale was applied, and the results were compared with maze task performance. RESULTS In the acquisition phase, a significant decrease was found in movement time (MT) between the first and last acquisition block, but only for the DMD group. For the DMD group, MT during transfer was shorter than during the first acquisition block, indicating improvement from the first acquisition block to transfer. In addition, the TD group showed shorter MT than the DMD group across the study. CONCLUSION DMD participants improved their performance after practicing a computational task; however, the difference in MT was present in all attempts among DMD and control subjects. Computational task improvement was positively influenced by the initial performance of individuals with DMD. In turn, the initial performance was influenced by their distal functionality but not their age or overall functionality.
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Affiliation(s)
| | - Talita Dias da Silva
- Department of Medicine, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Francis Meire Favero
- Department of Medicine, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | | | - Felipe Fregni
- Center for Neurosciences, University of São Paulo, São Paulo, Brazil
| | - Denise Cardoso Ribeiro
- Post-graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Carlos Bandeira de Mello Monteiro
- School of Medicine of ABC, Santo Andre, Brazil; Post-graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
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23
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Banihani R, Smile S, Yoon G, Dupuis A, Mosleh M, Snider A, McAdam L. Cognitive and Neurobehavioral Profile in Boys With Duchenne Muscular Dystrophy. J Child Neurol 2015; 30:1472-82. [PMID: 25660133 DOI: 10.1177/0883073815570154] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 01/04/2015] [Indexed: 01/18/2023]
Abstract
Duchenne muscular dystrophy is a progressive neuromuscular condition that has a high rate of cognitive and learning disabilities as well as neurobehavioral disorders, some of which have been associated with disruption of dystrophin isoforms. Retrospective cohort of 59 boys investigated the cognitive and neurobehavioral profile of boys with Duchenne muscular dystrophy. Full-scale IQ of < 70 was seen in 27%; learning disability in 44%, intellectual disability in 19%; attention-deficit/hyperactivity disorder in 32%; autism spectrum disorders in 15%; and anxiety in 27%. Mutations affecting Dp260 isoform and 5'untranslated region of Dp140 were observed in 60% with learning disability, 50% intellectual disability, 77% with autism spectrum disorders, and 94% with anxiety. No statistically significant correlation was noted between comorbidities and dystrophin isoforms; however, there is a trend of cumulative loss of dystrophin isoforms with declining full-scale IQ. Enhanced psychology testing to include both cognitive and neurobehavioral disorders is recommended for all individuals with Duchenne muscular dystrophy.
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Affiliation(s)
- Rudaina Banihani
- Department of Paediatrics, Division of Developmental Paediatrics, University of Toronto, Toronto, ON, Canada Child Development Program, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada Department of Paediatrics, Hospital for Sick Children, Toronto, ON, Canada
| | - Sharon Smile
- Department of Paediatrics, Division of Developmental Paediatrics, University of Toronto, Toronto, ON, Canada Child Development Program, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada Department of Paediatrics, Hospital for Sick Children, Toronto, ON, Canada Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Grace Yoon
- Departments of Clinical and Metabolic Genetics, Hospital for Sick Children, Toronto, ON, Canada Department of Paediatrics, Hospital for Sick Children, Toronto, ON, Canada
| | - Annie Dupuis
- Biostatistics, Design and Analysis Division, Child Health Evaluative Sciences Research Program, Research Institute, Hospital for Sick Children, Toronto, ON, Canada Dalla Lana School of Public Health, Department of Biostatistics, University of Toronto, Toronto, ON, Canada
| | - Maureen Mosleh
- Child Development Program, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Andrea Snider
- Child Development Program, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Laura McAdam
- Department of Paediatrics, Division of Developmental Paediatrics, University of Toronto, Toronto, ON, Canada Child Development Program, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
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24
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Astrea G, Pecini C, Gasperini F, Brisca G, Scutifero M, Bruno C, Santorelli FM, Cioni G, Politano L, Chilosi AM, Battini R. Reading impairment in Duchenne muscular dystrophy: A pilot study to investigate similarities and differences with developmental dyslexia. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 45-46:168-177. [PMID: 26255617 DOI: 10.1016/j.ridd.2015.07.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 07/13/2015] [Accepted: 07/25/2015] [Indexed: 06/04/2023]
Abstract
Below-average reading performances have been reported in individuals with Duchenne muscular dystrophy (DMD), but literacy problems in these subjects have yet to be characterized. In this study, the presence and characteristics of literacy deficits in boys with DMD were investigated through a comparison with typically developing children and with children affected by developmental dyslexia, with the aim of clarifying whether DMD and developmental dyslexia have overlapping profiles of literacy deficits and whether these deficits are associated, as in children with dyslexia, with impairments in phonological processing and rapid lexical access. The results confirmed the high incidence of literacy problems in boys with DMD and revealed a profile less severe than, but qualitatively similar to, that of Italian children with developmental dyslexia. Both groups showed specific difficulties in reading and writing words and a reduced rapid automatized naming (RAN) speed. This is the first time that a RAN speed deficit has been documented in DMD. Moreover, the boys with DMD and the subgroup of dyslexic children with a previous language delay showed additional deficits in phonological processing. The impairments highlighted in this study could explain the reading difficulties observed in boys with DMD and suggest that there is a need for targeted preschool interventions.
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Affiliation(s)
- Guja Astrea
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 331, 56128 Calambrone, Pisa, Italy.
| | - Chiara Pecini
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 331, 56128 Calambrone, Pisa, Italy.
| | - Filippo Gasperini
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 331, 56128 Calambrone, Pisa, Italy.
| | - Giacomo Brisca
- Center of Myology and Neurodegenerative Disorders, Department of Neuroscience, IRCCS G. Gaslini Institute, Via Gerolamo Gaslini, 5, 16148 Genoa, Italy.
| | - Marianna Scutifero
- Department of Experimental Medicine, Cardiomyology and Medical Genetics, Second University of Naples, Piazza Miraglia, 80131 Naples, Italy.
| | - Claudio Bruno
- Center of Myology and Neurodegenerative Disorders, Department of Neuroscience, IRCCS G. Gaslini Institute, Via Gerolamo Gaslini, 5, 16148 Genoa, Italy.
| | - Filippo Maria Santorelli
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 331, 56128 Calambrone, Pisa, Italy.
| | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 331, 56128 Calambrone, Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Italy.
| | - Luisa Politano
- Department of Experimental Medicine, Cardiomyology and Medical Genetics, Second University of Naples, Piazza Miraglia, 80131 Naples, Italy.
| | - Anna Maria Chilosi
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 331, 56128 Calambrone, Pisa, Italy.
| | - Roberta Battini
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 331, 56128 Calambrone, Pisa, Italy.
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25
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Nichols B, Takeda S, Yokota T. Nonmechanical Roles of Dystrophin and Associated Proteins in Exercise, Neuromuscular Junctions, and Brains. Brain Sci 2015; 5:275-98. [PMID: 26230713 PMCID: PMC4588140 DOI: 10.3390/brainsci5030275] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 06/29/2015] [Accepted: 07/21/2015] [Indexed: 02/06/2023] Open
Abstract
Dystrophin-glycoprotein complex (DGC) is an important structural unit in skeletal muscle that connects the cytoskeleton (f-actin) of a muscle fiber to the extracellular matrix (ECM). Several muscular dystrophies, such as Duchenne muscular dystrophy, Becker muscular dystrophy, congenital muscular dystrophies (dystroglycanopathies), and limb-girdle muscular dystrophies (sarcoglycanopathies), are caused by mutations in the different DGC components. Although many early studies indicated DGC plays a crucial mechanical role in maintaining the structural integrity of skeletal muscle, recent studies identified novel roles of DGC. Beyond a mechanical role, these DGC members play important signaling roles and act as a scaffold for various signaling pathways. For example, neuronal nitric oxide synthase (nNOS), which is localized at the muscle membrane by DGC members (dystrophin and syntrophins), plays an important role in the regulation of the blood flow during exercise. DGC also plays important roles at the neuromuscular junction (NMJ) and in the brain. In this review, we will focus on recently identified roles of DGC particularly in exercise and the brain.
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Affiliation(s)
- Bailey Nichols
- Department of Medical Genetics, University of Alberta Faculty of Medicine and Dentistry.
| | - Shin'ichi Takeda
- Department of Molecular Therapy, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-higashi, Kodaira, Tokyo 187-8502, Japan.
| | - Toshifumi Yokota
- Department of Medical Genetics, University of Alberta Faculty of Medicine and Dentistry.
- Muscular Dystrophy Canada Research Chair, 8812-112 St, Edmonton, AB T6G 2H7, Canada.
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Chaussenot R, Edeline JM, Le Bec B, El Massioui N, Laroche S, Vaillend C. Cognitive dysfunction in the dystrophin-deficient mouse model of Duchenne muscular dystrophy: A reappraisal from sensory to executive processes. Neurobiol Learn Mem 2015; 124:111-22. [PMID: 26190833 DOI: 10.1016/j.nlm.2015.07.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 07/09/2015] [Accepted: 07/10/2015] [Indexed: 01/08/2023]
Abstract
Duchenne muscular dystrophy (DMD) is associated with language disabilities and deficits in learning and memory, leading to intellectual disability in a patient subpopulation. Recent studies suggest the presence of broader deficits affecting information processing, short-term memory and executive functions. While the absence of the full-length dystrophin (Dp427) is a common feature in all patients, variable mutation profiles may additionally alter distinct dystrophin-gene products encoded by separate promoters. However, the nature of the cognitive dysfunctions specifically associated with the loss of distinct brain dystrophins is unclear. Here we show that the loss of the full-length brain dystrophin in mdx mice does not modify the perception and sensorimotor gating of auditory inputs, as assessed using auditory brainstem recordings and prepulse inhibition of startle reflex. In contrast, both acquisition and long-term retention of cued and trace fear memories were impaired in mdx mice, suggesting alteration in a functional circuit including the amygdala. Spatial learning in the water maze revealed reduced path efficiency, suggesting qualitative alteration in mdx mice learning strategy. However, spatial working memory performance and cognitive flexibility challenged in various behavioral paradigms in water and radial-arm mazes were unimpaired. The full-length brain dystrophin therefore appears to play a role during acquisition of associative learning as well as in general processes involved in memory consolidation, but no overt involvement in working memory and/or executive functions could be demonstrated in spatial learning tasks.
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Affiliation(s)
- Rémi Chaussenot
- Paris-Saclay Neuroscience Institute, UMR 9197, CNRS, F-91405 Orsay, France; Univ. Paris-Sud, UMR 9197, F-91405 Orsay, France; Université Paris-Saclay, France
| | - Jean-Marc Edeline
- Paris-Saclay Neuroscience Institute, UMR 9197, CNRS, F-91405 Orsay, France; Univ. Paris-Sud, UMR 9197, F-91405 Orsay, France; Université Paris-Saclay, France
| | - Benoit Le Bec
- Paris-Saclay Neuroscience Institute, UMR 9197, CNRS, F-91405 Orsay, France; Univ. Paris-Sud, UMR 9197, F-91405 Orsay, France; Université Paris-Saclay, France
| | - Nicole El Massioui
- Paris-Saclay Neuroscience Institute, UMR 9197, CNRS, F-91405 Orsay, France; Univ. Paris-Sud, UMR 9197, F-91405 Orsay, France; Université Paris-Saclay, France
| | - Serge Laroche
- Paris-Saclay Neuroscience Institute, UMR 9197, CNRS, F-91405 Orsay, France; Univ. Paris-Sud, UMR 9197, F-91405 Orsay, France; Université Paris-Saclay, France
| | - Cyrille Vaillend
- Paris-Saclay Neuroscience Institute, UMR 9197, CNRS, F-91405 Orsay, France; Univ. Paris-Sud, UMR 9197, F-91405 Orsay, France; Université Paris-Saclay, France.
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27
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Dystrophin induced cognitive impairment: mechanisms, models and therapeutic strategies. Ann Neurosci 2015; 22:108-18. [PMID: 26130916 PMCID: PMC4480258 DOI: 10.5214/ans.0972.7531.221210] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 01/19/2015] [Accepted: 03/05/2015] [Indexed: 12/13/2022] Open
Abstract
Existence of conserved domains in dystrophin and its associated complexes provide an opportunity to understand the role of dystrophin associated signalling and its association with neuronal metabolism in a variety of model organisms. We critically reviewed the studies till 2013 through established search engines and databases. Thus, we review the role of dystrophin and its isoforms in different animal models at developmental stages in the neuronal metabolism to enhance the therapeutic strategies. Dystrophin interacts with other proteins in such a way that, when affected, it results in co-morbidities including autism and other neuropsychiatric disorders. It is speculated that various signalling molecules may converge to disrupt neuronal metabolism not adequately studied. TGF-β, RhoGAP and CAM mediated signalling molecules are the chief cause of mortalities due to respiratory and cardiac involvement but remain underevaluated targets for cognitive impairment in DMD/BMD. Manipulation of these signalling pathways could be potent intervention in dystrophin induced cognitive impairment while complementary therapeutic approaches may also be helpful in the treatment of cognitive impairment associated with DMD/BMD.
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28
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Piccini G, Gazzellini S, D'Amico A, Pane M, Castelli E, Vicari S, Alfieri P. Developmental lag of visuospatial attention in Duchenne muscular dystrophy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 36C:55-61. [PMID: 25462465 DOI: 10.1016/j.ridd.2014.09.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 09/22/2014] [Indexed: 06/04/2023]
Abstract
Children with Duchenne muscular dystrophy (DMD) present a specific deficit of voluntary attention but to date there has been no clear characterization of their attentional skills. The present study investigated the hypothesis that DMD patients present deficits of both voluntary and automatic visuospatial attention systems and that their performance could be equivalent to that of younger healthy males. Twenty males (mean age 10 years) with diagnosis of DMD, 20 age-matched healthy males (10 years 3 months) and 20 healthy younger males (7 years 6 months) were required to perform two visuospatial attention tasks: voluntary and automatic. In the voluntary task, the performance of the DMD group was significantly worse than that of the age-matched group, and equal to that of the younger controls. In the automatic attention task also, the performance of the DMD patients was less efficient than that of the age-matched controls and equal to that of the younger children. This study supports the previous report of voluntary attention deficit in DMD and extends the evidence to include also an automatic attention system deficit. The development level of attention in DMD patients is below that expected for their age and corresponds to a delay of about three years.
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Affiliation(s)
- Giorgia Piccini
- Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
| | - Simone Gazzellini
- Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Adele D'Amico
- Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Marika Pane
- Department of Paediatric Neurology, Catholic University, Rome, Italy
| | - Enrico Castelli
- Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Stefano Vicari
- Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Paolo Alfieri
- Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
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29
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Krasowska E, Zabłocki K, Górecki DC, Swinny JD. Aberrant location of inhibitory synaptic marker proteins in the hippocampus of dystrophin-deficient mice: implications for cognitive impairment in duchenne muscular dystrophy. PLoS One 2014; 9:e108364. [PMID: 25260053 PMCID: PMC4178163 DOI: 10.1371/journal.pone.0108364] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 08/27/2014] [Indexed: 11/29/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) is a neuromuscular disease that arises from mutations in the dystrophin-encoding gene. Apart from muscle pathology, cognitive impairment, primarily of developmental origin, is also a significant component of the disorder. Convergent lines of evidence point to an important role for dystrophin in regulating the molecular machinery of central synapses. The clustering of neurotransmitter receptors at inhibitory synapses, thus impacting on synaptic transmission, is of particular significance. However, less is known about the role of dystrophin in influencing the precise expression patterns of proteins located within the pre- and postsynaptic elements of inhibitory synapses. To this end, we exploited molecular markers of inhibitory synapses, interneurons and dystrophin-deficient mouse models to explore the role of dystrophin in determining the stereotypical patterning of inhibitory connectivity within the cellular networks of the hippocampus CA1 region. In tissue from wild-type (WT) mice, immunoreactivity of neuroligin2 (NL2), an adhesion molecule expressed exclusively in postsynaptic elements of inhibitory synapses, and the vesicular GABA transporter (VGAT), a marker of GABAergic presynaptic elements, were predictably enriched in strata pyramidale and lacunosum moleculare. In acute contrast, NL2 and VGAT immunoreactivity was relatively evenly distributed across all CA1 layers in dystrophin-deficient mice. Similar changes were evident with the cannabinoid receptor 1, vesicular glutamate transporter 3, parvalbumin, somatostatin and the GABAA receptor alpha1 subunit. The data show that in the absence of dystrophin, there is a rearrangement of the molecular machinery, which underlies the precise spatio-temporal pattern of GABAergic synaptic transmission within the CA1 sub-field of the hippocampus.
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Affiliation(s)
- Elżbieta Krasowska
- Laboratory of Cellular Metabolism, Nencki Institute of Experimental Biology, Warsaw, Poland
- School of Pharmacy and Biomedical Sciences, Institute for Biomedical and Biomolecular Sciences, University of Portsmouth, Portsmouth, United Kingdom
| | - Krzysztof Zabłocki
- Laboratory of Cellular Metabolism, Nencki Institute of Experimental Biology, Warsaw, Poland
| | - Dariusz C. Górecki
- School of Pharmacy and Biomedical Sciences, Institute for Biomedical and Biomolecular Sciences, University of Portsmouth, Portsmouth, United Kingdom
| | - Jerome D. Swinny
- School of Pharmacy and Biomedical Sciences, Institute for Biomedical and Biomolecular Sciences, University of Portsmouth, Portsmouth, United Kingdom
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30
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Vojinovic D, Adams HHH, van der Lee SJ, Ibrahim-Verbaas CA, Brouwer R, van den Hout MCGN, Oole E, van Rooij J, Uitterlinden A, Hofman A, van IJcken WFJ, Aartsma-Rus A, van Ommen GB, Ikram MA, van Duijn CM, Amin N. The dystrophin gene and cognitive function in the general population. Eur J Hum Genet 2014; 23:837-43. [PMID: 25227141 DOI: 10.1038/ejhg.2014.183] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 08/04/2014] [Accepted: 08/10/2014] [Indexed: 12/26/2022] Open
Abstract
The aim of our study is to investigate whether single-nucleotide dystrophin gene (DMD) variants associate with variability in cognitive functions in healthy populations. The study included 1240 participants from the Erasmus Rucphen family (ERF) study and 1464 individuals from the Rotterdam Study (RS). The participants whose exomes were sequenced and who were assessed for various cognitive traits were included in the analysis. To determine the association between DMD variants and cognitive ability, linear (mixed) modeling with adjustment for age, sex and education was used. Moreover, Sequence Kernel Association Test (SKAT) was used to test the overall association of the rare genetic variants present in the DMD with cognitive traits. Although no DMD variant surpassed the prespecified significance threshold (P<1 × 10(-4)), rs147546024:A>G showed strong association (β = 1.786, P-value = 2.56 × 10(-4)) with block-design test in the ERF study, while another variant rs1800273:G>A showed suggestive association (β = -0.465, P-value = 0.002) with Mini-Mental State Examination test in the RS. Both variants are highly conserved, although rs147546024:A>G is an intronic variant, whereas rs1800273:G>A is a missense variant in the DMD which has a predicted damaging effect on the protein. Further gene-based analysis of DMD revealed suggestive association (P-values = 0.087 and 0.074) with general cognitive ability in both cohorts. In conclusion, both single variant and gene-based analyses suggest the existence of variants in the DMD which may affect cognitive functioning in the general populations.
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Affiliation(s)
- Dina Vojinovic
- 1] Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Clinic for Neurology and Psychiatry for Children and Youth, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Hieab H H Adams
- 1] Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Sven J van der Lee
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Rutger Brouwer
- Center for Biomics, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Edwin Oole
- Center for Biomics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jeroen van Rooij
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Andre Uitterlinden
- 1] Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands [3] Netherlands Consortium on Health Aging and National Genomics Initiative, Leiden, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Annemieke Aartsma-Rus
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - GertJan B van Ommen
- 1] Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands [2] Center of Medical Systems Biology, Leiden, The Netherlands
| | - M Arfan Ikram
- 1] Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands [3] Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Cornelia M van Duijn
- 1] Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Netherlands Consortium on Health Aging and National Genomics Initiative, Leiden, The Netherlands [3] Center of Medical Systems Biology, Leiden, The Netherlands
| | - Najaf Amin
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
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31
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Snow WM, Anderson JE, Fry M. Regional and genotypic differences in intrinsic electrophysiological properties of cerebellar Purkinje neurons from wild-type and dystrophin-deficient mdx mice. Neurobiol Learn Mem 2014; 107:19-31. [DOI: 10.1016/j.nlm.2013.10.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 10/10/2013] [Accepted: 10/25/2013] [Indexed: 10/26/2022]
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32
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Snow WM, Anderson JE, Jakobson LS. Neuropsychological and neurobehavioral functioning in Duchenne muscular dystrophy: a review. Neurosci Biobehav Rev 2013; 37:743-52. [PMID: 23545331 DOI: 10.1016/j.neubiorev.2013.03.016] [Citation(s) in RCA: 117] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 03/21/2013] [Accepted: 03/22/2013] [Indexed: 11/16/2022]
Abstract
Duchenne muscular dystrophy (DMD) is a genetic condition affecting predominantly boys that is characterized by fatal muscle weakness. While there is no cure, recent therapeutic advances have extended the lifespan of those with DMD considerably. Although the physiological basis of muscle pathology is well-documented, less is known regarding the cognitive, behavioral, and psychosocial functioning of those afflicted. Several lines of evidence point to central nervous system involvement as an organic feature of DMD, challenging our view of the disorder as strictly neuromuscular. This report provides a review of the literature on neuropsychological and neurobehavioral functioning in DMD. Recent research identifying associations with DMD and neuropsychiatric disorders is also discussed. Lastly, the review presents implications of findings related to nonmotor aspects of DMD for improving the quality of life in those affected. While the literature is often contradictory in nature, this review highlights some key findings for consideration by clinicians, educators and parents when developing therapeutic interventions for this population.
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Affiliation(s)
- Wanda M Snow
- Department of Psychology, Faculty of Arts, P404 Duff Roblin Building, 190 Dysart Road, University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada.
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