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Cao MC, Cawston EE, Chen G, Brooks C, Douwes J, McLean D, Graham ES, Dragunow M, Scotter EL. Serum biomarkers of neuroinflammation and blood-brain barrier leakage in amyotrophic lateral sclerosis. BMC Neurol 2022; 22:216. [PMID: 35690735 PMCID: PMC9188104 DOI: 10.1186/s12883-022-02730-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 03/07/2022] [Indexed: 11/10/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is an incurable and rapidly progressive neurological disorder. Biomarkers are critical to understanding disease causation, monitoring disease progression and assessing the efficacy of treatments. However, robust peripheral biomarkers are yet to be identified. Neuroinflammation and breakdown of the blood-brain barrier (BBB) are common to familial and sporadic ALS and may produce a unique biomarker signature in peripheral blood. Using cytometric bead array (n = 15 participants per group (ALS or control)) and proteome profiling (n = 6 participants per group (ALS or control)), we assessed a total of 106 serum cytokines, growth factors, and BBB breakdown markers in the serum of control and ALS participants. Further, primary human brain pericytes, which maintain the BBB, were used as a biosensor of inflammation following pre-treatment with ALS serum. Principal components analysis of all proteome profile data showed no clustering of control or ALS sera, and no individual serum proteins met the threshold for statistical difference between ALS and controls (adjusted P values). However, the 20 most changed proteins between control and ALS sera showed a medium effect size (Cohen’s d = 0.67) and cluster analysis of their levels together identified three sample subsets; control-only, mixed control-ALS, and ALS-only. These 20 proteins were predominantly pro-angiogenic and growth factors, including fractalkine, BDNF, EGF, PDGF, Dkk-1, MIF and angiopoietin-2. S100β, a protein highly concentrated in glial cells and therefore a marker of BBB leakage when found in blood, was unchanged in ALS serum, suggesting that serum protein profiles were reflective of peripheral rather than CNS biofluids. Finally, primary human brain pericytes remained proliferative and their secretome was unchanged by chronic exposure to ALS serum. Our exploratory study suggests that individual serum cytokine levels may not be robust biomarkers in small studies of ALS, but that larger studies using multiplexed analysis of pro-angiogenic and growth factors may identify a peripheral signature of ALS pathogenesis.
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Affiliation(s)
- Maize C Cao
- Department of Pharmacology and Clinical Pharmacology, University of Auckland, 85 Park Road, Auckland, 1023, New Zealand.,Centre for Brain Research, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Erin E Cawston
- Department of Pharmacology and Clinical Pharmacology, University of Auckland, 85 Park Road, Auckland, 1023, New Zealand.,Centre for Brain Research, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Grace Chen
- Centre for Public Health Research, Massey University, PO Box 75, Wellington, 6140, New Zealand
| | - Collin Brooks
- Centre for Public Health Research, Massey University, PO Box 75, Wellington, 6140, New Zealand
| | - Jeroen Douwes
- Centre for Public Health Research, Massey University, PO Box 75, Wellington, 6140, New Zealand
| | - Dave McLean
- Centre for Public Health Research, Massey University, PO Box 75, Wellington, 6140, New Zealand
| | - E Scott Graham
- Centre for Brain Research, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.,Department of Molecular Medicine and Pathology, University of Auckland, 85 Park Road, Auckland, 1023, New Zealand
| | - Mike Dragunow
- Department of Pharmacology and Clinical Pharmacology, University of Auckland, 85 Park Road, Auckland, 1023, New Zealand. .,Centre for Brain Research, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
| | - Emma L Scotter
- Department of Pharmacology and Clinical Pharmacology, University of Auckland, 85 Park Road, Auckland, 1023, New Zealand. .,Centre for Brain Research, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
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Sun Q, Zhao X, Li S, Yang F, Wang H, Cui F, Huang X. CSF Neurofilament Light Chain Elevation Predicts ALS Severity and Progression. Front Neurol 2020; 11:919. [PMID: 32982935 PMCID: PMC7484044 DOI: 10.3389/fneur.2020.00919] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/16/2020] [Indexed: 12/11/2022] Open
Abstract
Objectives: This study compared neurofilament light chain (NFL) levels in the cerebrospinal fluid (CSF) of patients with sporadic amyotrophic lateral sclerosis (sALS) with levels in patients with other neurological diseases and healthy controls and assessed correlations between NFL levels and clinical indicators of sALS. Methods: We used enzyme-linked immunosorbent assays to determine the NFL levels in the CSF of 45 patients with sALS, 21 patients with other central nervous system diseases (OCNSDs), 18 with immune-mediated peripheral neuropathy (IMPN), 14 with non-immune-mediated peripheral neuropathy (NIMPN), and 19 healthy controls (HCs). Results: The median NFL levels in the CSF of the sALS, OCNSD, IMPN, NIMPN, and HC groups were 6510, 5372, 4320, 1477, and 756 pg/mL, respectively. The CSF NFL levels did not differ significantly among the sALS, IMPN, and OCNSD groups, but were significantly higher than those of the NIMPN and HC groups. The NFL CSF levels were significantly higher in the NIMPN group than the HCs. There was a negative correlation between the NFL level and ALS function score (ALSFRS-R), and a positive correlation with the disease progression rate in patients with sALS. Conclusion: CSF NFL may not be sufficient to distinguish ALS from other central nervous system diseases or peripheral neuropathy, but it predicts ALS severity and progression.
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Affiliation(s)
- Qionghua Sun
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing, China.,College of Medicine, Nankai University, Tianjin, China
| | - Xue Zhao
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing, China.,College of Medicine, Nankai University, Tianjin, China
| | - Siyuan Li
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Fei Yang
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Hongfen Wang
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Fang Cui
- Neurological Department of Hainan Hospital, Chinese PLA General Hospital, Sanya, China
| | - Xusheng Huang
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing, China.,College of Medicine, Nankai University, Tianjin, China
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Sun Q, Yang F, Wang H, Cui F, Li Y, Li S, Ren Y, Lan W, Li M, Zhu W, Sun X, He Z, Zhao X, Yang L, Huang X. Elevated serum ferritin level as a predictor of reduced survival in patients with sporadic amyotrophic lateral sclerosis in China: a retrospective study. Amyotroph Lateral Scler Frontotemporal Degener 2019; 20:186-191. [PMID: 30652532 DOI: 10.1080/21678421.2018.1555599] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective: The objective of this study was to compare iron metabolic variables in the serum and cerebrospinal fluid (CSF) of patients with sporadic amyotrophic lateral sclerosis (sALS) with those of patients with multiple system atrophy (MSA) and control subjects. We also assessed the correlations of these variables with sALS progression and severity and estimated their roles in predicting prognosis. Methods: We retrospectively collected iron metabolic parameters, including serum levels of iron, ferritin, transferrin levels and total iron binding capacity and the CSF level of ferritin, from 435 sALS patients, 176 MSA patients and 431 control subjects. Results: Serum ferritin levels were significantly higher in the sALS group compared with the MSA and control groups in both males (p = 0.001 and p < 0.0001, respectively) and females (p = 0.034 and p < 0.0001, respectively). However, serum transferrin levels were significantly lower in females of the sALS group compared with the MSA (p = 0.016) and control (p = 0.015) groups. The CSF ferritin level and the serum levels of total iron binding capacity and iron were similar among the sALS, MSA and control groups. Survival analysis demonstrated that higher serum ferritin levels were predictors of reduced survival of sALS patients. No correlations between iron metabolic variables and clinical parameters were found. Conclusion: An elevated serum ferritin level is associated with reduced survival of sALS patients. However, the levels of iron metabolic parameters were not associated with clinical deterioration or disease severity at diagnosis.
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Affiliation(s)
- Qionghua Sun
- a College of Medicine , Nankai University , Tianjin , China
| | - Fei Yang
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China
| | - Hongfen Wang
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China
| | - Fang Cui
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China
| | - Yanran Li
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China
| | - Siyuan Li
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China
| | - Yuting Ren
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China.,c Department of Neurology , Beijing Tiantan Hospital, Capital Medical University , Beijing , China
| | - Wenjie Lan
- a College of Medicine , Nankai University , Tianjin , China
| | - Mao Li
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China
| | - Wenjia Zhu
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China.,c Department of Neurology , Beijing Tiantan Hospital, Capital Medical University , Beijing , China
| | - Xiaosun Sun
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China
| | - Zhengqing He
- b Department of Neurology , Chinese PLA General Hospital , Beijing , China
| | - Xue Zhao
- a College of Medicine , Nankai University , Tianjin , China
| | - Li Yang
- a College of Medicine , Nankai University , Tianjin , China
| | - Xusheng Huang
- a College of Medicine , Nankai University , Tianjin , China.,b Department of Neurology , Chinese PLA General Hospital , Beijing , China
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Sánchez-Díaz G, Escobar F, Badland H, Arias-Merino G, Posada de la Paz M, Alonso-Ferreira V. Geographic Analysis of Motor Neuron Disease Mortality and Heavy Metals Released to Rivers in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2522. [PMID: 30423874 PMCID: PMC6266970 DOI: 10.3390/ijerph15112522] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 11/07/2018] [Accepted: 11/08/2018] [Indexed: 12/12/2022]
Abstract
The etiology of motor neuron disease (MND) is still unknown. The aims of this study were to: (1) analyze MND mortality at a fine-grained level; and (2) explore associations of MND and heavy metals released into Spanish river basins. MND deaths were extracted from the Spanish nationwide mortality registry (2007⁻2016). Standardized mortality ratios (SMRs) for MND were estimated at a municipal level. Sites that emitted quantities of heavy metals above the regulatory thresholds were obtained from the European Pollutant Release and Transfer Register database (2007⁻2015). The relative risks for non-exposed and exposed municipalities (considering a downstream 20 km river section) by type of heavy metal were analyzed using a log-linear model. SMRs were significantly higher in central and northern municipalities. SMRs were 1.14 (1.10⁻1.17) higher in areas exposed to heavy metals than in non-exposed areas: 0.95 (0.92⁻0.96). Considering the different metals, we found the following increased MND death risks in exposed areas: 20.9% higher risk for lead, 20.0% for zinc, 16.7% for arsenic, 15.7% for chromium, 15.4% for cadmium, 12.7% for copper, and 12.4% for mercury. This study provides associations between MND death risk and heavy metals in exposed municipalities. Further studies investigating heavy metal exposure are needed to progress in MND understanding.
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Affiliation(s)
- Germán Sánchez-Díaz
- Institute of Rare Diseases Research (IIER), Instituto de Salud Carlos III, Madrid 28029, Spain.
- Department of Geology, Geography and Environmental Sciences, University of Alcala, Alcalá de Henares 28801, Spain.
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Madrid 28029, Spain.
| | - Francisco Escobar
- Department of Geology, Geography and Environmental Sciences, University of Alcala, Alcalá de Henares 28801, Spain.
| | - Hannah Badland
- Healthy Liveable Cities Group, Centre for Urban Research, RMIT University, Melbourne VIC 3001, Australia.
| | - Greta Arias-Merino
- Institute of Rare Diseases Research (IIER), Instituto de Salud Carlos III, Madrid 28029, Spain.
| | - Manuel Posada de la Paz
- Institute of Rare Diseases Research (IIER), Instituto de Salud Carlos III, Madrid 28029, Spain.
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Madrid 28029, Spain.
| | - Verónica Alonso-Ferreira
- Institute of Rare Diseases Research (IIER), Instituto de Salud Carlos III, Madrid 28029, Spain.
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Madrid 28029, Spain.
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Wang J, Kothalkar PV, Kim M, Bandini A, Cao B, Yunusova Y, Campbell TF, Heitzman D, Green JR. Automatic prediction of intelligible speaking rate for individuals with ALS from speech acoustic and articulatory samples. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 20:669-679. [PMID: 30409057 PMCID: PMC6506394 DOI: 10.1080/17549507.2018.1508499] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Purpose: This research aimed to automatically predict intelligible speaking rate for individuals with Amyotrophic Lateral Sclerosis (ALS) based on speech acoustic and articulatory samples. Method: Twelve participants with ALS and two normal subjects produced a total of 1831 phrases. NDI Wave system was used to collect tongue and lip movement and acoustic data synchronously. A machine learning algorithm (i.e. support vector machine) was used to predict intelligible speaking rate (speech intelligibility × speaking rate) from acoustic and articulatory features of the recorded samples. Result: Acoustic, lip movement, and tongue movement information separately, yielded a R2 of 0.652, 0.660, and 0.678 and a Root Mean Squared Error (RMSE) of 41.096, 41.166, and 39.855 words per minute (WPM) between the predicted and actual values, respectively. Combining acoustic, lip and tongue information we obtained the highest R2 (0.712) and the lowest RMSE (37.562 WPM). Conclusion: The results revealed that our proposed analyses predicted the intelligible speaking rate of the participant with reasonably high accuracy by extracting the acoustic and/or articulatory features from one short speech sample. With further development, the analyses may be well-suited for clinical applications that require automatic speech severity prediction.
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Affiliation(s)
- Jun Wang
- a Department of Bioengineering , Speech Disorders & Technology Lab
- b Callier Center for Communication Disorders, University of Texas at Dallas , Richardson , TX , USA
| | | | - Myungjong Kim
- a Department of Bioengineering , Speech Disorders & Technology Lab
| | - Andrea Bandini
- c Department of Speech-Language Pathology , University of Toronto , Toronto , Canada
| | - Beiming Cao
- a Department of Bioengineering , Speech Disorders & Technology Lab
| | - Yana Yunusova
- c Department of Speech-Language Pathology , University of Toronto , Toronto , Canada
| | - Thomas F Campbell
- b Callier Center for Communication Disorders, University of Texas at Dallas , Richardson , TX , USA
| | | | - Jordan R Green
- e Department of Communication Sciences and Disorders , MGH Institute of Health Professions , Boston , MA , USA
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6
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Diagnostic and prognostic power of CSF Tau in amyotrophic lateral sclerosis. J Neurol 2018; 265:2353-2362. [PMID: 30116940 DOI: 10.1007/s00415-018-9008-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 08/06/2018] [Accepted: 08/07/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that still lacks reliable diagnostic biomarkers. This study aims to evaluate the diagnostic and prognostic potential of CSF total Tau (t-Tau), phospho-Tau (p-Tau) and p-Tau/t-Tau ratio in ALS patients using CSF neurofilament light (NFL) as the reference biomarker. METHODS Eighty-five incident ALS, 30 ALS-mimicking (AM) diseases and 51 other non-neurodegenerative diseases (ONND) were included in the study. RESULTS ALS patients had higher levels of CSF t-Tau and lower p-Tau/t-Tau ratio than AM (p = 0.005 and p = 0.006) and ONND (p < 0.001). CSF t-Tau levels discriminated ALS from AM with a sensitivity of 69% and specificity of 60%, and from ONND with a sensitivity of 88% and specificity of 51%. These values were lower than the accuracy of CSF NFL in ALS (sensitivity 86% and specificity 87% in distinguishing ALS from AM and sensitivity 83% and specificity 75% from ONND); CSF t-Tau correlated with progression rate and SNIP. CSF p-Tau did not show relation with any ALS clinical features. CSF NFL significantly correlated with all considered clinical parameters. High levels of CSF t-Tau and NFL were related to poor survival. CONCLUSION CSF t-Tau showed no reliable diagnostic significance but the relation between the high levels of CSF t-Tau and short survival suggests the potential prognostic role of this biomarker in ALS. However, CSF NFL was confirmed to be the most reliable and efficient tool for diagnosis and prediction of clinical progression and survival in ALS patients.
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7
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Longinetti E, Mariosa D, Larsson H, Almqvist C, Lichtenstein P, Ye W, Fang F. Physical and cognitive fitness in young adulthood and risk of amyotrophic lateral sclerosis at an early age. Eur J Neurol 2016; 24:137-142. [DOI: 10.1111/ene.13165] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 08/29/2016] [Indexed: 12/12/2022]
Affiliation(s)
- E. Longinetti
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; Stockholm
| | - D. Mariosa
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; Stockholm
| | - H. Larsson
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; Stockholm
- Department of Medical Sciences; Örebro University; Örebro
| | - C. Almqvist
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; Stockholm
- Lung and Allergy Unit; Astrid Lindgren Children's Hospital; Karolinska University Hospital; Stockholm Sweden
| | - P. Lichtenstein
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; Stockholm
| | - W. Ye
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; Stockholm
| | - F. Fang
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; Stockholm
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Mathis S, Couratier P, Julian A, Vallat JM, Corcia P, Le Masson G. Management and therapeutic perspectives in amyotrophic lateral sclerosis. Expert Rev Neurother 2016; 17:263-276. [DOI: 10.1080/14737175.2016.1227705] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Stéphane Mathis
- Department of Neurology, Neuro-Muscular Unit and ALS Center, CHU de Bordeaux, groupe hospitalier Pellegrin, Bordeaux, France
| | - Philippe Couratier
- Department of Neurology, ALS center, Centre de compétence SLA-fédération Tours-Limoges, CHU de Limoges, Limoges, France
| | - Adrien Julian
- Department of Neurology, CHU Poitiers, University of Poitiers, Poitiers, France
| | - Jean-Michel Vallat
- Department and Laboratory of Neurology, Centre de Référence ‘neuropathies périphériques rares’, University Hospital of Limoges, Limoges, France
| | - Philippe Corcia
- Department of Neurology, ALS center, Centre de compétence SLA-fédération Tours-Limoges, CHU de Tours, Tours, France
| | - Gwendal Le Masson
- Department of Neurology, Neuro-Muscular Unit and ALS Center, CHU de Bordeaux, groupe hospitalier Pellegrin, Bordeaux, France
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Wang J, Kothalkar PV, Kim M, Yunusova Y, Campbell TF, Heitzman D, Green JR. Predicting Intelligible Speaking Rate in Individuals with Amyotrophic Lateral Sclerosis from a Small Number of Speech Acoustic and Articulatory Samples. WORKSHOP ON SPEECH AND LANGUAGE PROCESSING FOR ASSISTIVE TECHNOLOGIES 2016; 2016:91-97. [PMID: 29423454 PMCID: PMC5800530 DOI: 10.21437/slpat.2016-16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurological disease that affects the speech motor functions, resulting in dysarthria, a motor speech disorder. Speech and articulation deterioration is an indicator of the disease progression of ALS; timely monitoring of the disease progression is critical for clinical management of these patients. This paper investigated machine prediction of intelligible speaking rate of nine individuals with ALS based on a small number of speech acoustic and articulatory samples. Two feature selection techniques - decision tree and gradient boosting - were used with support vector regression for predicting the intelligible speaking rate. Experimental results demonstrated the feasibility of predicting intelligible speaking rate from only a small number of speech samples. Furthermore, adding articulatory features to acoustic features improved prediction performance, when decision tree was used as the feature selection technique.
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Affiliation(s)
- Jun Wang
- Speech Disorders & Technology Lab, Department of Bioengineering, University of Texas at Dallas, Richardson, Texas, United States
- Callier Center for Communication Disorders, University of Texas at Dallas, Richardson, Texas, United States
| | - Prasanna V Kothalkar
- Speech Disorders & Technology Lab, Department of Bioengineering, University of Texas at Dallas, Richardson, Texas, United States
| | - Myungjong Kim
- Speech Disorders & Technology Lab, Department of Bioengineering, University of Texas at Dallas, Richardson, Texas, United States
| | - Yana Yunusova
- Department of Speech-Language Pathology, University of Toronto, Toronto, Canada
| | - Thomas F Campbell
- Callier Center for Communication Disorders, University of Texas at Dallas, Richardson, Texas, United States
| | - Daragh Heitzman
- MDA/ALS Center, Texas Neurology, Dallas, Texas, United States
| | - Jordan R Green
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA, United States
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Vernay A, Therreau L, Blot B, Risson V, Dirrig-Grosch S, Waegaert R, Lequeu T, Sellal F, Schaeffer L, Sadoul R, Loeffler JP, René F. A transgenic mouse expressing CHMP2Bintron5 mutant in neurons develops histological and behavioural features of amyotrophic lateral sclerosis and frontotemporal dementia. Hum Mol Genet 2016; 25:3341-3360. [PMID: 27329763 DOI: 10.1093/hmg/ddw182] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 06/06/2016] [Accepted: 06/07/2016] [Indexed: 12/11/2022] Open
Abstract
Mutations in the charged multivesicular body protein 2B (CHMP2B) are associated with frontotemporal dementia (FTD), amyotrophic lateral sclerosis (ALS), and with a mixed ALS-FTD syndrome. To model this syndrome, we generated a transgenic mouse line expressing the human CHMP2Bintron5 mutant in a neuron-specific manner. These mice developed a dose-dependent disease phenotype. A longitudinal study revealed progressive gait abnormalities, reduced muscle strength and decreased motor coordination. CHMP2Bintron5 mice died due to generalized paralysis. When paralyzed, signs of denervation were present as attested by altered electromyographic profiles, by decreased number of fully innervated neuromuscular junctions, by reduction in size of motor endplates and by a decrease of sciatic nerve axons area. However, spinal motor neurons cell bodies were preserved until death. In addition to the motor dysfunctions, CHMP2Bintron5 mice progressively developed FTD-relevant behavioural modifications such as disinhibition, stereotypies, decrease in social interactions, compulsivity and change in dietary preferences. Furthermore, neurons in the affected spinal cord and brain regions showed accumulation of p62-positive cytoplasmic inclusions associated or not with ubiquitin and CHMP2Bintron5 As observed in FTD3 patients, these inclusions were negative for TDP-43 and FUS. Moreover, astrogliosis and microgliosis developed with age. Altogether, these data indicate that the neuronal expression of human CHMP2Bintron5 in areas involved in motor and cognitive functions induces progressive motor alterations associated with dementia symptoms and with histopathological hallmarks reminiscent of both ALS and FTD.
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Affiliation(s)
- Aurélia Vernay
- INSERM, U1118, Mécanismes Centraux et Périphériques de la Neurodégénérescence, F-67000 Strasbourg, France.,Université de Strasbourg, UMRS1118, Faculté de Médecine, Fédération de Médecine Translationelle de Strasbourg, F-67000 Strasbourg, France
| | - Ludivine Therreau
- INSERM, U1118, Mécanismes Centraux et Périphériques de la Neurodégénérescence, F-67000 Strasbourg, France.,Université de Strasbourg, UMRS1118, Faculté de Médecine, Fédération de Médecine Translationelle de Strasbourg, F-67000 Strasbourg, France
| | - Béatrice Blot
- INSERM U836, Grenoble Institut des Neurosciences, Université Joseph Fourier, F-38700 La Tronche, France
| | - Valérie Risson
- Laboratoire de Biologie Moléculaire de la Cellule, UMR5239 CNRS/ENS Lyon/UCBL/HCL Ecole normale supérieure de Lyon, F-69364 Lyon Cedex 07, France
| | - Sylvie Dirrig-Grosch
- INSERM, U1118, Mécanismes Centraux et Périphériques de la Neurodégénérescence, F-67000 Strasbourg, France.,Université de Strasbourg, UMRS1118, Faculté de Médecine, Fédération de Médecine Translationelle de Strasbourg, F-67000 Strasbourg, France
| | - Robin Waegaert
- INSERM, U1118, Mécanismes Centraux et Périphériques de la Neurodégénérescence, F-67000 Strasbourg, France.,Université de Strasbourg, UMRS1118, Faculté de Médecine, Fédération de Médecine Translationelle de Strasbourg, F-67000 Strasbourg, France
| | - Thiebault Lequeu
- INSERM, U1118, Mécanismes Centraux et Périphériques de la Neurodégénérescence, F-67000 Strasbourg, France.,Université de Strasbourg, UMRS1118, Faculté de Médecine, Fédération de Médecine Translationelle de Strasbourg, F-67000 Strasbourg, France
| | - François Sellal
- INSERM, U1118, Mécanismes Centraux et Périphériques de la Neurodégénérescence, F-67000 Strasbourg, France.,Neurology department, Hôpitaux civils and CMRR, F-68000 Colmar, France
| | - Laurent Schaeffer
- Laboratoire de Biologie Moléculaire de la Cellule, UMR5239 CNRS/ENS Lyon/UCBL/HCL Ecole normale supérieure de Lyon, F-69364 Lyon Cedex 07, France
| | - Rémy Sadoul
- INSERM U836, Grenoble Institut des Neurosciences, Université Joseph Fourier, F-38700 La Tronche, France
| | - Jean-Philippe Loeffler
- INSERM, U1118, Mécanismes Centraux et Périphériques de la Neurodégénérescence, F-67000 Strasbourg, France.,Université de Strasbourg, UMRS1118, Faculté de Médecine, Fédération de Médecine Translationelle de Strasbourg, F-67000 Strasbourg, France
| | - Frédérique René
- INSERM, U1118, Mécanismes Centraux et Périphériques de la Neurodégénérescence, F-67000 Strasbourg, France .,Université de Strasbourg, UMRS1118, Faculté de Médecine, Fédération de Médecine Translationelle de Strasbourg, F-67000 Strasbourg, France
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11
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Costagli M, Donatelli G, Biagi L, Caldarazzo Ienco E, Siciliano G, Tosetti M, Cosottini M. Magnetic susceptibility in the deep layers of the primary motor cortex in Amyotrophic Lateral Sclerosis. NEUROIMAGE-CLINICAL 2016; 12:965-969. [PMID: 27995062 PMCID: PMC5153607 DOI: 10.1016/j.nicl.2016.04.011] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 03/29/2016] [Accepted: 04/30/2016] [Indexed: 01/14/2023]
Abstract
Amyotrophic Lateral Sclerosis (ALS) is a progressive neurological disorder that entails degeneration of both upper and lower motor neurons. The primary motor cortex (M1) in patients with upper motor neuron (UMN) impairment is pronouncedly hypointense in Magnetic Resonance (MR) T2* contrast. In the present study, 3D gradient-recalled multi-echo sequences were used on a 7 Tesla MR system to acquire T2*-weighted images targeting M1 at high spatial resolution. MR raw data were used for Quantitative Susceptibility Mapping (QSM). Measures of magnetic susceptibility correlated with the expected concentration of non-heme iron in different regions of the cerebral cortex in healthy subjects. In ALS patients, significant increases in magnetic susceptibility co-localized with the T2* hypointensity observed in the middle and deep layers of M1. The magnetic susceptibility, hence iron concentration, of the deep cortical layers of patients' M1 subregions corresponding to Penfield's areas of the hand and foot in both hemispheres significantly correlated with the clinical scores of UMN impairment of the corresponding limbs. QSM therefore reflects the presence of iron deposits related to neuroinflammatory reaction and cortical microgliosis, and might prove useful in estimating M1 iron concentration, as a possible radiological sign of severe UMN burden in ALS patients. Magnetic susceptibility (χ) was measured in ALS patients' and healthy controls' M1. In healthy subjects' cortex, χ correlated with the expected concentration of iron. In patients, increased χ co-localized with T2* hypointensity in M1 deeper layers. χ correlated with clinical scores of upper motor neuron impairment in patients. χ could be a radiological sign of iron deposits and severe UMN burden in ALS.
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Affiliation(s)
- M Costagli
- Imago7 Research Foundation, Pisa, Italy; Laboratory of Medical Physics and Biotechnologies for Magnetic Resonance, IRCCS Stella Maris, Pisa, Italy
| | - G Donatelli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - L Biagi
- Laboratory of Medical Physics and Biotechnologies for Magnetic Resonance, IRCCS Stella Maris, Pisa, Italy
| | - E Caldarazzo Ienco
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - G Siciliano
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Tosetti
- Imago7 Research Foundation, Pisa, Italy; Laboratory of Medical Physics and Biotechnologies for Magnetic Resonance, IRCCS Stella Maris, Pisa, Italy
| | - M Cosottini
- Imago7 Research Foundation, Pisa, Italy; Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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12
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Cosottini M, Donatelli G, Costagli M, Caldarazzo Ienco E, Frosini D, Pesaresi I, Biagi L, Siciliano G, Tosetti M. High-Resolution 7T MR Imaging of the Motor Cortex in Amyotrophic Lateral Sclerosis. AJNR Am J Neuroradiol 2016; 37:455-61. [PMID: 26680464 DOI: 10.3174/ajnr.a4562] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 08/12/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND PURPOSE Amyotrophic lateral sclerosis is a progressive motor neuron disorder that involves degeneration of both upper and lower motor neurons. In patients with amyotrophic lateral sclerosis, pathologic studies and ex vivo high-resolution MR imaging at ultra-high field strength revealed the co-localization of iron and activated microglia distributed in the deep layers of the primary motor cortex. The aims of the study were to measure the cortical thickness and evaluate the distribution of iron-related signal changes in the primary motor cortex of patients with amyotrophic lateral sclerosis as possible in vivo biomarkers of upper motor neuron impairment. MATERIALS AND METHODS Twenty-two patients with definite amyotrophic lateral sclerosis and 14 healthy subjects underwent a high-resolution 2D multiecho gradient-recalled sequence targeted on the primary motor cortex by using a 7T scanner. Image analysis consisted of the visual evaluation and quantitative measurement of signal intensity and cortical thickness of the primary motor cortex in patients and controls. Qualitative and quantitative MR imaging parameters were correlated with electrophysiologic and laboratory data and with clinical scores. RESULTS Ultra-high field MR imaging revealed atrophy and signal hypointensity in the deep layers of the primary motor cortex of patients with amyotrophic lateral sclerosis with a diagnostic accuracy of 71%. Signal hypointensity of the deep layers of the primary motor cortex correlated with upper motor neuron impairment (r = -0.47; P < .001) and with disease progression rate (r = -0.60; P = .009). CONCLUSIONS The combined high spatial resolution and sensitivity to paramagnetic substances of 7T MR imaging demonstrate in vivo signal changes of the cerebral motor cortex that resemble the distribution of activated microglia within the cortex of patients with amyotrophic lateral sclerosis. Cortical thinning and signal hypointensity of the deep layers of the primary motor cortex could constitute a marker of upper motor neuron impairment in patients with amyotrophic lateral sclerosis.
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Affiliation(s)
- M Cosottini
- From the Department of Translational Research and New Technologies in Medicine and Surgery (M.Cosottini) and Neurology Unit
| | - G Donatelli
- Neuroradiology Unit (G.D., I.P.), Department of Diagnostic and Interventional Radiology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - M Costagli
- IMAGO7 Foundation (M.Costagli), Pisa, Italy
| | - E Caldarazzo Ienco
- Department of Clinical and Experimental Medicine (E.C.I., D.F., G.S.), University of Pisa, Pisa, Italy
| | - D Frosini
- Department of Clinical and Experimental Medicine (E.C.I., D.F., G.S.), University of Pisa, Pisa, Italy
| | - I Pesaresi
- Neuroradiology Unit (G.D., I.P.), Department of Diagnostic and Interventional Radiology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - L Biagi
- IRCCS Stella Maris (L.B., M.T.), Pisa, Italy
| | - G Siciliano
- Department of Clinical and Experimental Medicine (E.C.I., D.F., G.S.), University of Pisa, Pisa, Italy
| | - M Tosetti
- IRCCS Stella Maris (L.B., M.T.), Pisa, Italy
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Spalloni A, Longone P. Cognitive impairment in amyotrophic lateral sclerosis, clues from the SOD1 mouse. Neurosci Biobehav Rev 2016; 60:12-25. [DOI: 10.1016/j.neubiorev.2015.11.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 11/09/2015] [Accepted: 11/16/2015] [Indexed: 12/11/2022]
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Seer C, Fürkötter S, Vogts MB, Lange F, Abdulla S, Dengler R, Petri S, Kopp B. Executive Dysfunctions and Event-Related Brain Potentials in Patients with Amyotrophic Lateral Sclerosis. Front Aging Neurosci 2015; 7:225. [PMID: 26733861 PMCID: PMC4683183 DOI: 10.3389/fnagi.2015.00225] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 11/20/2015] [Indexed: 01/12/2023] Open
Abstract
A growing body of evidence implies psychological disturbances in amyotrophic lateral sclerosis (ALS). Specifically, executive dysfunctions occur in up to 50% of ALS patients. The recently shown presence of cytoplasmic aggregates (TDP-43) in ALS patients and in patients with behavioral variants of frontotemporal dementia suggests that these two disease entities form the extremes of a spectrum. The present study aimed at investigating behavioral and electrophysiological indices of conflict processing in patients with ALS. A non-verbal variant of the flanker task demanded two-choice responses to target stimuli that were surrounded by flanker stimuli which either primed the correct response or the alternative response (the latter case representing the conflict situation). Behavioral performance, event-related potentials (ERP), and lateralized readiness potentials (LRP) were analyzed in 21 ALS patients and 20 controls. In addition, relations between these measures and executive dysfunctions were examined. ALS patients performed the flanker task normally, indicating preserved conflict processing. In similar vein, ERP and LRP indices of conflict processing did not differ between groups. However, ALS patients showed enhanced posterior negative ERP waveform deflections, possibly indicating increased modulation of visual processing by frontoparietal networks in ALS. We also found that the presence of executive dysfunctions was associated with more error-prone behavior and enhanced LRP amplitudes in ALS patients, pointing to a prefrontal pathogenesis of executive dysfunctions and to a potential link between prefrontal and motor cortical functional dysregulation in ALS, respectively.
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Affiliation(s)
- Caroline Seer
- Department of Neurology, Hannover Medical School Hannover, Germany
| | | | - Maj-Britt Vogts
- Department of Neurology, Hannover Medical School Hannover, Germany
| | - Florian Lange
- Department of Neurology, Hannover Medical School Hannover, Germany
| | - Susanne Abdulla
- Department of Neurology, Hannover Medical SchoolHannover, Germany; Department of Neurology, Otto-von-Guericke University MagdeburgMagdeburg, Germany; Department of Neurology, German Center for Neurodegenerative DiseasesMagdeburg, Germany
| | - Reinhard Dengler
- Department of Neurology, Hannover Medical School Hannover, Germany
| | - Susanne Petri
- Department of Neurology, Hannover Medical School Hannover, Germany
| | - Bruno Kopp
- Department of Neurology, Hannover Medical School Hannover, Germany
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Grad LI, Pokrishevsky E, Silverman JM, Cashman NR. Exosome-dependent and independent mechanisms are involved in prion-like transmission of propagated Cu/Zn superoxide dismutase misfolding. Prion 2015; 8:331-5. [PMID: 25551548 PMCID: PMC4601269 DOI: 10.4161/19336896.2014.983398] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS), a fatal adult-onset degenerative neuromuscular disorder with a poorly defined etiology, progresses in an orderly spatiotemporal manner from one or more foci within the nervous system, reminiscent of prion disease pathology. We have previously shown that misfolded mutant Cu/Zn superoxide dismutase (SOD1), mutation of which is associated with a subset of ALS cases, can induce endogenous wild-type SOD1 misfolding in the intracellular environment in a templating fashion similar to that of misfolded prion protein. Our recent observations further extend the prion paradigm of pathological SOD1 to help explain the intercellular transmission of disease along the neuroaxis. It has been shown that both mutant and misfolded wild-type SOD1 can traverse cell-to-cell either as protein aggregates that are released from dying cells and taken up by neighboring cells via macropinocytosis, or released to the extracellular environment on the surface of exosomes secreted from living cells. Furthermore, once propagation of misfolded wild-type SOD1 has been initiated in human cell culture, it continues over multiple passages of transfer and cell growth. Propagation and transmission of misfolded wild-type SOD1 is therefore a potential mechanism in the systematic progression of ALS pathology.
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Affiliation(s)
- Leslie I Grad
- a Department of Medicine (Neurology), Brain Research Center ; University of British Columbia ; Vancouver , BC Canada
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Donnelly CJ, Grima JC, Sattler R. Aberrant RNA homeostasis in amyotrophic lateral sclerosis: potential for new therapeutic targets? Neurodegener Dis Manag 2015; 4:417-37. [PMID: 25531686 DOI: 10.2217/nmt.14.36] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder characterized by progressive motor neuron degeneration. The disease pathogenesis is multifaceted in that multiple cellular and molecular pathways have been identified as contributors to the disease progression. Consequently, numerous therapeutic targets have been pursued for clinical development, unfortunately with little success. The recent discovery of mutations in RNA modulating genes such as TARDBP/TDP-43, FUS/TLS or C9ORF72 changed our understanding of neurodegenerative mechanisms in ALS and introduced the role of dysfunctional RNA processing as a significant contributor to disease pathogenesis. This article discusses the latest findings on such RNA toxicity pathways in ALS and potential novel therapeutic approaches.
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Affiliation(s)
- Christopher J Donnelly
- Brain Science Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
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17
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Goveas J, O'Dwyer L, Mascalchi M, Cosottini M, Diciotti S, De Santis S, Passamonti L, Tessa C, Toschi N, Giannelli M. Diffusion-MRI in neurodegenerative disorders. Magn Reson Imaging 2015; 33:853-76. [PMID: 25917917 DOI: 10.1016/j.mri.2015.04.006] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 04/18/2015] [Accepted: 04/19/2015] [Indexed: 12/11/2022]
Abstract
The ability to image the whole brain through ever more subtle and specific methods/contrasts has come to play a key role in understanding the basis of brain abnormalities in several diseases. In magnetic resonance imaging (MRI), "diffusion" (i.e. the random, thermally-induced displacements of water molecules over time) represents an extraordinarily sensitive contrast mechanism, and the exquisite structural detail it affords has proven useful in a vast number of clinical as well as research applications. Since diffusion-MRI is a truly quantitative imaging technique, the indices it provides can serve as potential imaging biomarkers which could allow early detection of pathological alterations as well as tracking and possibly predicting subtle changes in follow-up examinations and clinical trials. Accordingly, diffusion-MRI has proven useful in obtaining information to better understand the microstructural changes and neurophysiological mechanisms underlying various neurodegenerative disorders. In this review article, we summarize and explore the main applications, findings, perspectives as well as challenges and future research of diffusion-MRI in various neurodegenerative disorders including Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, Huntington's disease and degenerative ataxias.
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Affiliation(s)
- Joseph Goveas
- Department of Psychiatry and Behavioral Medicine, and Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Laurence O'Dwyer
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt, Germany
| | - Mario Mascalchi
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy; Quantitative and Functional Neuroradiology Research Program at Meyer Children and Careggi Hospitals of Florence, Florence, Italy
| | - Mirco Cosottini
- Department of Translational Research and New Surgical and Medical Technologies, University of Pisa, Pisa, Italy; Unit of Neuroradiology, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", Pisa, Italy
| | - Stefano Diciotti
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Cesena, Italy
| | - Silvia De Santis
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
| | - Luca Passamonti
- Institute of Bioimaging and Molecular Physiology, National Research Council, Catanzaro, Italy; Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Carlo Tessa
- Division of Radiology, "Versilia" Hospital, AUSL 12 Viareggio, Lido di Camaiore, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, Medical Physics Section, University of Rome "Tor Vergata", Rome, Italy; Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Marco Giannelli
- Unit of Medical Physics, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", Pisa, Italy.
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Rosenfeld J, Strong MJ. Challenges in the Understanding and Treatment of Amyotrophic Lateral Sclerosis/Motor Neuron Disease. Neurotherapeutics 2015; 12:317-25. [PMID: 25572957 PMCID: PMC4404444 DOI: 10.1007/s13311-014-0332-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
With the acceleration in our understanding of ALS and the related motor neuron disease has come even greater challenges in reconciling all of the proposed pathogenic mechanisms and how this will translate into impactful treatments. Fundamental issues such as diagnostic definition(s) of the disease spectrum, relevant biomarkers, the impact of multiple novel genetic mutations and the significant effect of symptomatic treatments on disease progression are all areas of active investigation. In this review, we will focus on these key issues and highlight the challenges that confront both clinicians and basic science researchers.
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Affiliation(s)
- Jeffrey Rosenfeld
- Central California Neuroscience Institute, UCSF Fresno, Division of Neurology, Fresno, CA, USA,
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19
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Grad LI, Cashman NR. Prion-like activity of Cu/Zn superoxide dismutase: implications for amyotrophic lateral sclerosis. Prion 2015; 8:33-41. [PMID: 24394345 DOI: 10.4161/pri.27602] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Neurodegenerative diseases belong to a larger group of protein misfolding disorders, known as proteinopathies. There is increasing experimental evidence implicating prion-like mechanisms in many common neurodegenerative disorders, including Alzheimer disease, Parkinson disease, the tauopathies, and amyotrophic lateral sclerosis (ALS), all of which feature the aberrant misfolding and aggregation of specific proteins. The prion paradigm provides a mechanism by which a mutant or wild-type protein can dominate pathogenesis through the initiation of self-propagating protein misfolding. ALS, a lethal disease characterized by progressive degeneration of motor neurons is understood as a classical proteinopathy; the disease is typified by the formation of inclusions consisting of aggregated protein within and around motor neurons that can contribute to neurotoxicity. It is well established that misfolded/oxidized SOD1 protein is highly toxic to motor neurons and plays a prominent role in the pathology of ALS. Recent work has identified propagated protein misfolding properties in both mutant and wild-type SOD1, which may provide the molecular basis for the clinically observed contiguous spread of the disease through the neuroaxis. In this review we examine the current state of knowledge regarding the prion-like properties of SOD1 and comment on its proposed mechanisms of intercellular transmission.
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20
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Grad LI, Fernando SM, Cashman NR. From molecule to molecule and cell to cell: prion-like mechanisms in amyotrophic lateral sclerosis. Neurobiol Dis 2015; 77:257-65. [PMID: 25701498 DOI: 10.1016/j.nbd.2015.02.009] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 08/13/2014] [Accepted: 02/09/2015] [Indexed: 12/12/2022] Open
Abstract
Prions, self-proliferating infectious agents consisting of misfolded protein, are most often associated with aggressive neurodegenerative diseases in animals and humans. Akin to the contiguous spread of a living pathogen, the prion paradigm provides a mechanism by which a mutant or wild-type misfolded protein can dominate pathogenesis through self-propagating protein misfolding, and subsequently spread from region to region through the central nervous system. The prion diseases, along with more common neurodegenerative disorders such as Alzheimer's disease, Parkinson's disease and the tauopathies belong to a larger group of protein misfolding disorders termed proteinopathies that feature aberrant misfolding and aggregation of specific proteins. Amyotrophic lateral sclerosis (ALS), a lethal disease characterized by progressive degeneration of motor neurons is currently understood as a classical proteinopathy; the disease is typified by the formation of inclusions consisting of aggregated protein within motor neurons that contribute to neurotoxicity. It is well established that misfolded/aggregated proteins such as SOD1 and TDP-43 contribute to the toxicity of motor neurons and play a prominent role in the pathology of ALS. Recent work has identified propagated protein misfolding properties in both mutant and wild-type SOD1, and to a lesser extent TDP-43, which may provide the molecular basis for the clinically observed contiguous spread of the disease through the neuroaxis. In this review we examine the current state of knowledge regarding the prion-like properties of proteins associated with ALS pathology as well as their possible mechanisms of transmission.
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Affiliation(s)
- Leslie I Grad
- Department of Medicine (Neurology), Brain Research Centre, University of British Columbia, 2211 Wesbrook Mall, Vancouver BC, Canada, V6T 2B5
| | - Sarah M Fernando
- Department of Medicine (Neurology), Brain Research Centre, University of British Columbia, 2211 Wesbrook Mall, Vancouver BC, Canada, V6T 2B5
| | - Neil R Cashman
- Department of Medicine (Neurology), Brain Research Centre, University of British Columbia, 2211 Wesbrook Mall, Vancouver BC, Canada, V6T 2B5.
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21
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Smith RN, Agharkar AS, Gonzales EB. A review of creatine supplementation in age-related diseases: more than a supplement for athletes. F1000Res 2014; 3:222. [PMID: 25664170 PMCID: PMC4304302 DOI: 10.12688/f1000research.5218.1] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/10/2014] [Indexed: 12/12/2022] Open
Abstract
Creatine is an endogenous compound synthesized from arginine, glycine and methionine. This dietary supplement can be acquired from food sources such as meat and fish, along with athlete supplement powders. Since the majority of creatine is stored in skeletal muscle, dietary creatine supplementation has traditionally been important for athletes and bodybuilders to increase the power, strength, and mass of the skeletal muscle. However, new uses for creatine have emerged suggesting that it may be important in preventing or delaying the onset of neurodegenerative diseases associated with aging. On average, 30% of muscle mass is lost by age 80, while muscular weakness remains a vital cause for loss of independence in the elderly population. In light of these new roles of creatine, the dietary supplement's usage has been studied to determine its efficacy in treating congestive heart failure, gyrate atrophy, insulin insensitivity, cancer, and high cholesterol. In relation to the brain, creatine has been shown to have antioxidant properties, reduce mental fatigue, protect the brain from neurotoxicity, and improve facets/components of neurological disorders like depression and bipolar disorder. The combination of these benefits has made creatine a leading candidate in the fight against age-related diseases, such as Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, long-term memory impairments associated with the progression of Alzheimer's disease, and stroke. In this review, we explore the normal mechanisms by which creatine is produced and its necessary physiology, while paying special attention to the importance of creatine supplementation in improving diseases and disorders associated with brain aging and outlining the clinical trials involving creatine to treat these diseases.
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Affiliation(s)
- Rachel N. Smith
- Department of Pharmacology & Neuroscience, UNT Health Science Center, Fort Worth, TX, TX, 76107, USA
| | - Amruta S. Agharkar
- Department of Pharmacology & Neuroscience, UNT Health Science Center, Fort Worth, TX, TX, 76107, USA
| | - Eric B. Gonzales
- Department of Pharmacology & Neuroscience, UNT Health Science Center, Fort Worth, TX, TX, 76107, USA
- Institute for Aging and Alzheimer’s Disease Research, UNT Health Science Center, Fort Worth, TX, TX, 76107, USA
- Cardiovascular Research Institute, UNT Health Science Center, Fort Worth, TX, TX, 76107, USA
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22
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Vianello A, Concas A. Tracheostomy ventilation in ALS: A Japanese bias. J Neurol Sci 2014; 344:3-4. [DOI: 10.1016/j.jns.2014.06.050] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 06/23/2014] [Indexed: 12/13/2022]
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Paoli A, Bianco A, Damiani E, Bosco G. Ketogenic diet in neuromuscular and neurodegenerative diseases. BIOMED RESEARCH INTERNATIONAL 2014; 2014:474296. [PMID: 25101284 PMCID: PMC4101992 DOI: 10.1155/2014/474296] [Citation(s) in RCA: 130] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 05/30/2014] [Indexed: 12/14/2022]
Abstract
An increasing number of data demonstrate the utility of ketogenic diets in a variety of metabolic diseases as obesity, metabolic syndrome, and diabetes. In regard to neurological disorders, ketogenic diet is recognized as an effective treatment for pharmacoresistant epilepsy but emerging data suggests that ketogenic diet could be also useful in amyotrophic lateral sclerosis, Alzheimer, Parkinson's disease, and some mitochondriopathies. Although these diseases have different pathogenesis and features, there are some common mechanisms that could explain the effects of ketogenic diets. These mechanisms are to provide an efficient source of energy for the treatment of certain types of neurodegenerative diseases characterized by focal brain hypometabolism; to decrease the oxidative damage associated with various kinds of metabolic stress; to increase the mitochondrial biogenesis pathways; and to take advantage of the capacity of ketones to bypass the defect in complex I activity implicated in some neurological diseases. These mechanisms will be discussed in this review.
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Affiliation(s)
- Antonio Paoli
- Department of Biomedical Sciences, University of Padova, Via Marzolo 3, 35031 Padova, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, University of Palermo, Via Eleonora Duse 2, 90146 Palermo, Italy
| | - Ernesto Damiani
- Department of Biomedical Sciences, University of Padova, Via Marzolo 3, 35031 Padova, Italy
| | - Gerardo Bosco
- Department of Biomedical Sciences, University of Padova, Via Marzolo 3, 35031 Padova, Italy
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Malek AM, Barchowsky A, Bowser R, Heiman-Patterson T, Lacomis D, Rana S, Youk A, Stickler D, Lackland DT, Talbott EO. Environmental and occupational risk factors for amyotrophic lateral sclerosis: a case-control study. NEURODEGENER DIS 2013; 14:31-8. [PMID: 24246552 DOI: 10.1159/000355344] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 08/27/2013] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND/AIMS Environmental and occupational exposures are implicated as risk factors for amyotrophic lateral sclerosis (ALS), the etiology of which is largely unknown, although no causal relationships have been established. OBJECTIVE The aim of the study was to evaluate the associations of personal risk factors and self-reported environmental and occupational exposures with risk of ALS. METHODS The cases involved ALS patients (n = 66) identified from major neurological centers in Pittsburgh and Philadelphia, Pa., USA, from 2008 to 2010. The age-, race- and sex-matched controls included outpatient hospital and population-based controls (n = 66). A detailed questionnaire obtaining data on occupation, vocational and avocational exposure as well as personal lifestyle factors was administered. RESULTS Occupational exposure to metals (odds ratio, OR = 3.65; 95% CI: 1.15, 11.60) and pesticides (OR = 6.50; 95% CI: 1.78, 23.77) was related to increased risk of ALS after controlling for smoking and education. No associations were found for occupational exposure to organic or aromatic solvents. CONCLUSION Workers exposed to metals and pesticides may be at greater risk of ALS. Future research should involve more accurate exposure assessment through the use of job exposure matrices, confirmation of occupation and biomarkers.
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Affiliation(s)
- Angela M Malek
- Department of Neurosciences, College of Medicine, Medical University of South Carolina, Charleston, S.C., USA
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Unexpected death of a ventilator-dependent amyotrophic lateral sclerosis patient. REVISTA PORTUGUESA DE PNEUMOLOGIA 2013; 19:175-8. [PMID: 23746424 DOI: 10.1016/j.rppneu.2012.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 11/24/2012] [Accepted: 12/18/2012] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a fatal, progressive, neurodegenerative disease and most patients affected die of respiratory compromise and/or pneumonia within 2-3 years of diagnosis. As ALS progresses, ventilator assistance is required. In the end stages of the disease, patients suffer from respiratory failure and may become ventilator-dependent. Deaths due to malfunction of mechanical ventilators are reported but there are very few forensic autopsy records. We report the case of a 69-year-old ALS female ventilator-dependent, trachostomised patient who was found dead by her husband, with the ventilator in "stand-by" mode. METHOD A forensic autopsy was performed. Samples of internal organs were taken for histological and toxicological examination. The ventilator internal memory was also analysed and tested in order to find possible malfunction. RESULTS Gross examination did not reveal any sign of trauma but showed brain and lung congestion. Pulmonary histological examination revealed thickening of peribronchial interstitial space, alveolar over-distension, break of inter-alveolar walls and diffuse alveolar haemorrhages. Focal microhemorrhages were also detected in other organs. Analysis of the ventilator internal memory showed that during the night of death, there had been several voltage drops. Specific tests revealed malfunction of the internal battery which was unable to provide the necessary voltage, as a consequence the ventilator switched off, stopping ventilation. Battery malfunction reduced the volume of the ventilator alarm, which was not heard by the caregiver. CONCLUSION Histological pattern, with acute pulmonary emphysema and focal polivisceral haemorrhages, is strongly suggestive of a death due to "acute" asphyxia. The authors also discuss the need for strict supervision and follow up of these ventilatory dependent patients and their devices.
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Anesthetic management of the patient with amyotrophic lateral sclerosis. J Anesth 2013; 27:909-18. [DOI: 10.1007/s00540-013-1644-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 05/13/2013] [Indexed: 12/19/2022]
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Giagheddu M, Puggioni G, Tacconi P, Pirastru MI, Cannas A, Tamburini G, Congia S. Amyotrophic lateral sclerosis in Sardinia (Italy): epidemiologic features from 1957 to 2000. Acta Neurol Scand 2013; 127:251-9. [PMID: 22881448 DOI: 10.1111/j.1600-0404.2012.01705.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2012] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To evaluate epidemiological variables of amyotrophic lateral sclerosis (ALS) in Sardinia (Italy) in the 1991-2000 periods and compare them with the preceding decades. MATERIAL AND METHODS Survey, critical reappraisal or clinical re-evaluation of all ALS cases with onset in the decade 1991-2000; calculation of crude and age-adjusted incidence, duration of disease, survival rates and the latency between onset of symptoms and diagnosis. RESULTS A significant increase in the mean annual incidence was observed in comparison with the values found in the two previous decades, 1971-1980 and 1981-1990. The distribution of the disease in various areas of the island was found to be not at all homogeneous. No significant modifications of the duration of the disease and survival rates were observed. CONCLUSION The role of particular exogenous factors, albeit still unclear, can be invoked.
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Affiliation(s)
- M. Giagheddu
- Department of Cardiovascular and Neurological Sciences; University of Cagliari; Cagliari; Italy
| | - G. Puggioni
- Department of Economic and Social Sciences; University of Cagliari; Cagliari; Italy
| | - P. Tacconi
- Department of Cardiovascular and Neurological Sciences; University of Cagliari; Cagliari; Italy
| | - M. I. Pirastru
- Department of Neurology; University of Sassari; Sassari; Italy
| | - A. Cannas
- Department of Cardiovascular and Neurological Sciences; University of Cagliari; Cagliari; Italy
| | - G. Tamburini
- Department of Cardiovascular and Neurological Sciences; University of Cagliari; Cagliari; Italy
| | - S. Congia
- Department of Cardiovascular and Neurological Sciences; University of Cagliari; Cagliari; Italy
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Piotrkiewicz M, Hausmanowa-Petrusewicz I. Amyotrophic lateral sclerosis: a dying motor unit? Front Aging Neurosci 2013; 5:7. [PMID: 23533375 PMCID: PMC3607785 DOI: 10.3389/fnagi.2013.00007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 02/26/2013] [Indexed: 12/11/2022] Open
Affiliation(s)
- Maria Piotrkiewicz
- Department of Engineering of Nervous and Muscular System, Nałęcz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences Warsaw, Poland
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Brown DR. Gene regulation as a potential avenue for the treatment of neurodegenerative disorders. Expert Opin Drug Discov 2013; 4:515-24. [PMID: 23485084 DOI: 10.1517/17460440902849237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND As more people live to an older age, the frequency of diseases associated with longer life begins to increase. Neurodegenerative disorders are the worst of these in that there is now no treatment that offers any real improvement. For this reason, any new avenue of research that could lead to a treatment needs to be rigorously pursued. In many cases, neurodegenerative diseases are associated with the expression of a protein with an altered conformation or that generates a breakdown product associated with the cause. Clearly, the prevention of this process is a key therapeutic target. OBJECTIVE In this review, the potential for regulating gene expression to prevent or reverse neurodegenerative disease is explored. CONCLUSIONS Whereas much research has been directed at the proteins associated with neurodegeneration, understanding what controls their expression presents a new way this issue could be studied.
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Affiliation(s)
- David R Brown
- University of Bath, Department of Biology and Biochemistry, Bath, BA2 7AY, UK +44 1225 383133 ; +44 1225 386779 ;
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Britton D, Cleary S, Miller R. What is ALS and What is the Philosophy of Care? ACTA ACUST UNITED AC 2013. [DOI: 10.1044/sasd22.1.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Deanna Britton
- University of Washington—Rehabilitation MedicineSeattle, WA
| | - Stuart Cleary
- University of Alberta—Rehabilitation MedicineEdmonton, Alberta, Canada
| | - Robert Miller
- University of Washington—Speech & Hearing SciencesSeattle, WA
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Capitanio D, Vasso M, Ratti A, Grignaschi G, Volta M, Moriggi M, Daleno C, Bendotti C, Silani V, Gelfi C. Molecular signatures of amyotrophic lateral sclerosis disease progression in hind and forelimb muscles of an SOD1(G93A) mouse model. Antioxid Redox Signal 2012; 17:1333-50. [PMID: 22563797 PMCID: PMC3437050 DOI: 10.1089/ars.2012.4524] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIMS This study utilized proteomics, biochemical and enzymatic assays, and bioinformatics tools that characterize protein alterations in hindlimb (gastrocnemius) and forelimb (triceps) muscles in an amyotrophic lateral sclerosis (ALS) (SOD1(G93A)) mouse model. The aim of this study was to identify the key molecular signatures involved in disease progression. RESULTS Both muscle types have in common an early down-regulation of complex I. In the hindlimb, early increases in oxidative metabolism are associated with uncoupling of the respiratory chain, an imbalance of NADH/NAD(+), and an increase in reactive oxygen species (ROS) production. The NADH overflow due to complex I inactivation induces TCA flux perturbations, leading to citrate production, triggering fatty acid synthase (FAS), and lipid peroxidation. These early metabolic changes in the hindlimb followed by sustained and comparatively higher metabolic and cytoskeletal derangements over time precede and may catalyze the progressive muscle wasting in this muscle at the late stage. By contrast, in the forelimb, there is an early down-regulation of complexes I and II that is associated with the reduction of oxidative metabolism, which promotes metabolic homeostasis that is accompanied by a greater cytoskeletal stabilization response. However, these early compensatory systems diminish by a later time point. INNOVATION The identification of potential early- and late-stage disease molecular signatures in an ALS model: muscle albumin, complex I, complex II, citrate synthase, FAS, and phosphoinositide 3-kinase functions as diagnostic markers and peroxisome proliferator-activated receptor γ co-activator 1α (PGC1α), Sema-3A, and Rho-associated protein kinase 1 (ROCK1) play the role of disease progression markers. CONCLUSION The differing pattern of cellular metabolism and cytoskeletal derangements in the hind and forelimb identifies the potential dysmetabolism/hypermetabolism molecular signatures associated with disease progression, which may serve as diagnostic/disease progression markers in ALS patients.
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Affiliation(s)
- Daniele Capitanio
- Department of Biomedical Sciences for Health, University of Milan, Segrate, Italy
- Institute of Molecular Bioimaging and Physiology, National Research Council, Segrate, Italy
| | - Michele Vasso
- Department of Biomedical Sciences for Health, University of Milan, Segrate, Italy
- Institute of Molecular Bioimaging and Physiology, National Research Council, Segrate, Italy
| | - Antonia Ratti
- Department of Neurology and Laboratory of Neuroscience, “Dino Ferrari” Center, University of Milan, IRCCS Italian Institute for Auxology, Milan, Italy
| | - Giuliano Grignaschi
- Laboratory of Molecular Neurobiology, Department of Neuroscience, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Manuela Volta
- Department of Neurology and Laboratory of Neuroscience, “Dino Ferrari” Center, University of Milan, IRCCS Italian Institute for Auxology, Milan, Italy
| | - Manuela Moriggi
- Department of Biomedical Sciences for Health, University of Milan, Segrate, Italy
| | - Cristina Daleno
- Laboratory of Molecular Neurobiology, Department of Neuroscience, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Caterina Bendotti
- Laboratory of Molecular Neurobiology, Department of Neuroscience, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, “Dino Ferrari” Center, University of Milan, IRCCS Italian Institute for Auxology, Milan, Italy
| | - Cecilia Gelfi
- Department of Biomedical Sciences for Health, University of Milan, Segrate, Italy
- Institute of Molecular Bioimaging and Physiology, National Research Council, Segrate, Italy
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Zhao W, Varghese M, Vempati P, Dzhun A, Cheng A, Wang J, Lange D, Bilski A, Faravelli I, Pasinetti GM. Caprylic triglyceride as a novel therapeutic approach to effectively improve the performance and attenuate the symptoms due to the motor neuron loss in ALS disease. PLoS One 2012; 7:e49191. [PMID: 23145119 PMCID: PMC3492315 DOI: 10.1371/journal.pone.0049191] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 10/05/2012] [Indexed: 12/13/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder of motor neurons causing progressive muscle weakness, paralysis, and finally death. ALS patients suffer from asthenia and their progressive weakness negatively impacts quality of life, limiting their daily activities. They have impaired energy balance linked to lower activity of mitochondrial electron transport chain enzymes in ALS spinal cord, suggesting that improving mitochondrial function may present a therapeutic approach for ALS. When fed a ketogenic diet, the G93A ALS mouse shows a significant increase in serum ketones as well as a significantly slower progression of weakness and lower mortality rate. In this study, we treated SOD1-G93A mice with caprylic triglyceride, a medium chain triglyceride that is metabolized into ketone bodies and can serve as an alternate energy substrate for neuronal metabolism. Treatment with caprylic triglyceride attenuated progression of weakness and protected spinal cord motor neuron loss in SOD1-G93A transgenic animals, significantly improving their performance even though there was no significant benefit regarding the survival of the ALS transgenic animals. We found that caprylic triglyceride significantly promoted the mitochondrial oxygen consumption rate in vivo. Our results demonstrated that caprylic triglyceride alleviates ALS-type motor impairment through restoration of energy metabolism in SOD1-G93A ALS mice, especially during the overt stage of the disease. These data indicate the feasibility of using caprylic acid as an easily administered treatment with a high impact on the quality of life of ALS patients.
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Affiliation(s)
- Wei Zhao
- Department of Neurology, Mount Sinai School of Medicine, New York, New York, United States of America
- GRECC, James J Peters Veterans Affairs Medical Center, New York, New York, United States of America
| | - Merina Varghese
- Department of Neurology, Mount Sinai School of Medicine, New York, New York, United States of America
| | - Prashant Vempati
- Department of Neurology, Mount Sinai School of Medicine, New York, New York, United States of America
| | - Anastasiya Dzhun
- Department of Neurology, Mount Sinai School of Medicine, New York, New York, United States of America
| | - Alice Cheng
- Department of Neurology, Mount Sinai School of Medicine, New York, New York, United States of America
| | - Jun Wang
- Department of Neurology, Mount Sinai School of Medicine, New York, New York, United States of America
- GRECC, James J Peters Veterans Affairs Medical Center, New York, New York, United States of America
| | - Dale Lange
- Hospital for Special Surgery, New York, New York, United States of America
| | - Amanda Bilski
- Department of Neurology, Mount Sinai School of Medicine, New York, New York, United States of America
| | - Irene Faravelli
- Department of Neurology, Mount Sinai School of Medicine, New York, New York, United States of America
| | - Giulio Maria Pasinetti
- Department of Neurology, Mount Sinai School of Medicine, New York, New York, United States of America
- GRECC, James J Peters Veterans Affairs Medical Center, New York, New York, United States of America
- * E-mail:
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Cipresso P, Carelli L, Solca F, Meazzi D, Meriggi P, Poletti B, Lulé D, Ludolph AC, Silani V, Riva G. The use of P300-based BCIs in amyotrophic lateral sclerosis: from augmentative and alternative communication to cognitive assessment. Brain Behav 2012; 2:479-98. [PMID: 22950051 PMCID: PMC3432970 DOI: 10.1002/brb3.57] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2011] [Revised: 03/06/2012] [Accepted: 03/13/2012] [Indexed: 12/11/2022] Open
Abstract
The use of augmentative and alternative communication (AAC) tools in patients with amyotrophic lateral sclerosis (ALS), as effective means to compensate for the progressive loss of verbal and gestural communication, has been deeply investigated in the recent literature. The development of advanced AAC systems, such as eye-tracking (ET) and brain-computer interface (BCI) devices, allowed to bypass the important motor difficulties present in ALS patients. In particular, BCIs could be used in moderate to severe stages of the disease, since they do not require preserved ocular-motor ability, which is necessary for ET applications. Furthermore, some studies have proved the reliability of BCIs, regardless of the severity of the disease and the level of physical decline. However, the use of BCI in ALS patients still shows some limitations, related to both technical and neuropsychological issues. In particular, a range of cognitive deficits in most ALS patients have been observed. At the moment, no effective verbal-motor free measures are available for the evaluation of ALS patients' cognitive integrity; BCIs could offer a new possibility to administer cognitive tasks without the need of verbal or motor responses, as highlighted by preliminary studies in this field. In this review, we outline the essential features of BCIs systems, considering advantages and challenges of these tools with regard to ALS patients and the main applications developed in this field. We then outline the main findings with regard to cognitive deficits observed in ALS and some preliminary attempts to evaluate them by means of BCIs. The definition of specific cognitive profiles could help to draw flexible approaches tailored on patients' needs. It could improve BCIs efficacy and reduce patients' efforts. Finally, we handle the open question, represented by the use of BCIs with totally locked in patients, who seem unable to reliably learn to use such tool.
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Affiliation(s)
- Pietro Cipresso
- Applied Technology for Neuro‐Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Laura Carelli
- Department of Neurology and Laboratory of Neuroscience ‐ “Dino Ferrari” Center ‐ Università degli Studi di Milano ‐ IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Federica Solca
- Department of Neurology and Laboratory of Neuroscience ‐ “Dino Ferrari” Center ‐ Università degli Studi di Milano ‐ IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Daniela Meazzi
- Applied Technology for Neuro‐Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Paolo Meriggi
- Polo Tecnologico–Biomedical Technology Department, Fondazione Don Carlo Gnocchi Onlus, Milano, Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience ‐ “Dino Ferrari” Center ‐ Università degli Studi di Milano ‐ IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Dorothée Lulé
- Department of Neurology ‐ University of Ulm, Ulm, Germany
| | | | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience ‐ “Dino Ferrari” Center ‐ Università degli Studi di Milano ‐ IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro‐Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Tortelli R, Ruggieri M, Cortese R, D'Errico E, Capozzo R, Leo A, Mastrapasqua M, Zoccolella S, Leante R, Livrea P, Logroscino G, Simone IL. Elevated cerebrospinal fluid neurofilament light levels in patients with amyotrophic lateral sclerosis: a possible marker of disease severity and progression. Eur J Neurol 2012; 19:1561-7. [DOI: 10.1111/j.1468-1331.2012.03777.x] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 04/24/2012] [Indexed: 12/13/2022]
Affiliation(s)
- R. Tortelli
- Department of Neurosciences and Sense Organs; University of Bari; Policlinico Bari Italy
| | - M. Ruggieri
- Department of Neurosciences and Sense Organs; University of Bari; Policlinico Bari Italy
| | - R. Cortese
- Department of Neurosciences and Sense Organs; University of Bari; Policlinico Bari Italy
| | - E. D'Errico
- Department of Neurosciences and Sense Organs; University of Bari; Policlinico Bari Italy
| | - R. Capozzo
- Department of Neurosciences and Sense Organs; University of Bari; Policlinico Bari Italy
| | - A. Leo
- Department of Neurosciences and Sense Organs; University of Bari; Policlinico Bari Italy
| | - M. Mastrapasqua
- Department of Neurosciences and Sense Organs; University of Bari; Policlinico Bari Italy
| | - S. Zoccolella
- Department of Neurosciences and Sense Organs; University of Bari; Policlinico Bari Italy
| | - R. Leante
- Department of Neurosciences and Sense Organs; University of Bari; Policlinico Bari Italy
| | - P. Livrea
- Department of Neurosciences and Sense Organs; University of Bari; Policlinico Bari Italy
| | - G. Logroscino
- Department of Neurosciences and Sense Organs; University of Bari; Policlinico Bari Italy
| | - I. L. Simone
- Department of Neurosciences and Sense Organs; University of Bari; Policlinico Bari Italy
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Tarasiuk J, Kułakowska A, Drozdowski W, Kornhuber J, Lewczuk P. CSF markers in amyotrophic lateral sclerosis. J Neural Transm (Vienna) 2012; 119:747-57. [DOI: 10.1007/s00702-012-0806-y] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 04/16/2012] [Indexed: 11/29/2022]
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Oh H, Sin MK, Schepp KG, Choi-Kwon S. Depressive Symptoms and Functional Impairment Among Amyotrophic Lateral Sclerosis Patients in South Korea. Rehabil Nurs 2012; 37:136-44. [DOI: 10.1002/rnj.00045] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Ignjatović A, Stević Z, Lavrnić D, Nikolić-Kokić A, Blagojević D, Spasić M, Spasojević I. Inappropriately chelated iron in the cerebrospinal fluid of amyotrophic lateral sclerosis patients. ACTA ACUST UNITED AC 2012; 13:357-62. [DOI: 10.3109/17482968.2012.665929] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Moreno-Martet M, Mestre L, Loría F, Guaza C, Fernández-Ruiz J, de Lago E. Identification of receptors and enzymes for endocannabinoids in NSC-34 cells: relevance for in vitro studies with cannabinoids in motor neuron diseases. Neurosci Lett 2011; 508:67-72. [PMID: 22206832 DOI: 10.1016/j.neulet.2011.12.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 11/17/2011] [Accepted: 12/14/2011] [Indexed: 02/07/2023]
Abstract
NSC-34 cells, a hybridoma cell line derived from the fusion of neuroblastoma cells with mice spinal cord cells, have been widely used as an in vitro model for the study of motor neuron diseases [i.e. amyotrophic lateral sclerosis (ALS)]. In the present study, they were used to characterize different elements of the cannabinoid signaling system, which have been reported to serve as targets for the neuroprotective action of different natural and synthetic cannabinoid compounds. Using RT-PCR, Western blotting and immunocytochemistry, we first identified the presence of the cannabinoid CB(1) receptor in these cells. As expected, CB(2) receptor is not expressed in this neuronal cell line, a result that is concordant with the idea that this receptor type is preferentially expressed in glial elements. Diacylglycerol-lipase (DAGL) and N-arachidonoylphosphatidylethanolamine-phospholipase D (NAPE-PLD), the enzymes that synthesize endocannabinoids, have also been detected in these cells using RT-PCR, and the same happened with the endocannabinoid-degrading enzymes fatty acid amide hydrolase (FAAH) and monoacylglycerol-lipase (MAGL). The presence of the CB(1) receptor in these cells supports the idea that this receptor may play a role in the regulation of cellular survival face to excitotoxic injury. Interestingly, the expression of CB(1) receptor (and also the FAAH enzyme) was strongly up-regulated after differentiation of these cells, as previously reported with glutamate receptors. No changes were found for NAPE-PLD, DAGL and MAGL. Assuming that glutamate toxicity is one of the major causes of neuronal damage in ALS and other motor neurons diseases, the differentiated NSC-34 cells might serve as a useful model for studying neuroprotection with cannabinoids in conditions of excitotoxic injury, mitochondrial malfunctioning and oxidative stress.
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Affiliation(s)
- Miguel Moreno-Martet
- Departamento de Bioquímica y Biología Molecular, Instituto Universitario de Investigación en Neuroquímica, Facultad de Medicina, Universidad Complutense, 28040 Madrid, Spain
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Steinacker P, Fang L, Kuhle J, Petzold A, Tumani H, Ludolph AC, Otto M, Brettschneider J. Soluble beta-amyloid precursor protein is related to disease progression in amyotrophic lateral sclerosis. PLoS One 2011; 6:e23600. [PMID: 21858182 PMCID: PMC3156148 DOI: 10.1371/journal.pone.0023600] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Accepted: 07/20/2011] [Indexed: 11/18/2022] Open
Abstract
Background Biomarkers of disease progression in amyotrophic lateral sclerosis (ALS) could support the identification of beneficial drugs in clinical trials. We aimed to test whether soluble fragments of beta-amyloid precursor protein (sAPPα and sAPPß) correlated with clinical subtypes of ALS and were of prognostic value. Methodology/Principal Findings In a cross-sectional study including patients with ALS (N = 68) with clinical follow-up data over 6 months, Parkinson's disease (PD, N = 20), and age-matched controls (N = 40), cerebrospinal fluid (CSF) levels of sAPPα a, sAPPß and neurofilaments (NfHSMI35) were measured by multiplex assay, Progranulin by ELISA. CSF sAPPα and sAPPß levels were lower in ALS with a rapidly-progressive disease course (p = 0.03, and p = 0.02) and with longer disease duration (p = 0.01 and p = 0.01, respectively). CSF NfHSMI35 was elevated in ALS compared to PD and controls, with highest concentrations found in patients with rapid disease progression (p<0.01). High CSF NfHSMI3 was linked to low CSF sAPPα and sAPPß (p = 0.001, and p = 0.007, respectively). The ratios CSF NfHSMI35/CSF sAPPα,-ß were elevated in patients with fast progression of disease (p = 0.002 each). CSF Progranulin decreased with ongoing disease (p = 0.04). Conclusions This study provides new CSF candidate markers associated with progression of disease in ALS. The data suggest that a deficiency of cellular neuroprotective mechanisms (decrease of sAPP) is linked to progressive neuro-axonal damage (increase of NfHSMI35) and to progression of disease.
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Affiliation(s)
| | - Lubin Fang
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Jens Kuhle
- Department of Neurology, University of Basel, Basel, Switzerland
| | - Axel Petzold
- Department of Neuroimmunology, UCL Institute of Neurology/National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
| | | | | | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
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Correlation of cerebral spinal fluid pH and HCO3- with disease progression in ALS. J Neurol Sci 2011; 307:74-8. [DOI: 10.1016/j.jns.2011.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Revised: 05/06/2011] [Accepted: 05/11/2011] [Indexed: 12/12/2022]
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Piotrkiewicz M, Hausmanowa-Petrusewicz I. Motoneuron afterhyperpolarisation duration in amyotrophic lateral sclerosis. J Physiol 2011; 589:2745-54. [PMID: 21486815 DOI: 10.1113/jphysiol.2011.204891] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Motor unit (MU) potentials were registered from 20 ALS patients and 13 age-matched control individuals during isometric constant force contractions of brachial biceps (BB). The registered signals were decomposed into single MU potential trains. The estimates of duration of the afterhyperpolarisation (AHP) in MNs, derived from the interspike interval variability, was compared between ALS patients (124 MNs) and control subjects (111 MNs) and no significant differences were encountered. However, the relationship between TI and age for patients appeared to be qualitatively different from that of the control group. The dependence of patients' AHPs on relative force deficit (RFD), which quantified muscle involvement, was more specific. For RFDs below 30%, the AHP estimate was significantly lower than control values and then increased thereafter with increasing RFDs. Moreover, firing rates of patients with the smallest RFDs were significantly higher while firing rates of patients with the greatest RFDs were significantly lower than control values. The AHP shortening in the early stages of muscle impairment is consistent with the decrease in firing threshold of ‘fast' MNs found in spinal cord slices from neonatal SOD1 mice. The later elongation of the AHP may be caused by the higher vulnerability of ‘fast' MNs to degeneration and by the influence of reinnervation. Our results are comparable to what has been observed in acute experiments in animal models, providing a bridge between animal and clinical research that may be relevant for identification of mechanism(s) underlying neurodegeneration in ALS.
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Affiliation(s)
- Maria Piotrkiewicz
- Nacz Institute of Biocybernetics and Biomedical Engineering, PAS, Warsaw, Poland.
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Lee JC, Jin Y, Jin J, Kang BG, Nam DH, Joo KM, Cha CI. Functional neural stem cell isolation from brains of adult mutant SOD1 (SOD1(G93A)) transgenic amyotrophic lateral sclerosis (ALS) mice. Neurol Res 2010; 33:33-7. [PMID: 20810028 DOI: 10.1179/016164110x12807570509899] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The aim of present study is to investigate more functional neural stem cells (NSCs) could be isolated from brains with amyotrophic lateral sclerosis (ALS) and expanded in vitro, based on previous reports demonstrating de novo neurogenesis is enhanced to replace degenerating neural tissue. METHODS Thirteen- or eighteen-week-old mutant human Cu/Zn superoxide dismutase (SOD1(G93A)) transgenic ALS and wild-type SOD1 transgenic control mice were utilized. Changes in numbers of NSCs in the dentate gyrus were analyzed by immunohistochemistry against nestin and CD133. NSCs were primarily cultured from hippocampus of ALS or control mice. Expression of NSC markers, in vitro expansion capacity, and differentiating potential were compared. RESULTS Hippocampus of 13-week-old pre-symptomatic ALS mice harbor more cells that can be propagated for more than 12 passages in vitro, compared with same age control mice. Primarily-cultured cells formed neurospheres in the NSC culture medium, expressed NSC markers, and differentiated into cells with differentiated neural cell characteristics in the differentiation condition confirming that they are NSCs. In contrast, long-term expansible NSCs could not be derived from brains of 18-week-old symptomatic ALS mice with the same experimental techniques, although they had comparable nestin-immunoreactive cells in the dentate gyrus. DISCUSSION These results would suggest that increased neuroregeneration in early phase of ALS could be translated to regenerative approaches; however, long-term exposure to ALS microenvironments could abolish functional capacities of NSCs.
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Affiliation(s)
- Jae Chul Lee
- Department of Anatomy, Seoul National University College of Medicine, Seoul, Korea
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Spasojević I, Stević Z, Nikolić-Kokić A, Jones DR, Blagojević D, Spasić MB. Different roles of radical scavengers--ascorbate and urate in the cerebrospinal fluid of amyotrophic lateral sclerosis patients. Redox Rep 2010; 15:81-6. [PMID: 20500989 DOI: 10.1179/174329210x12650506623320] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Ferrous iron, released from iron deposits in the motor cortex and other brain regions of amyotrophic lateral sclerosis (ALS) patients, participates in the Fenton reaction in cerebrospinal fluid (CSF) alongside H(2)O(2), which is continuously released by neuronal cells. In vivo, the production of notoriously reactive hydroxyl radicals via this reaction could lead to the progression of the disease. Herein, we have examined the effect of ascorbate and uric acid on the production of hydroxyl radicals in CSF from both sporadic ALS patients and control subjects. Electron paramagnetic resonance spectroscopy identified ascorbyl radicals in CSF from ALS patients whereas it was undetectable in control CSF. The addition of H(2)O(2) to the CSF from ALS patients provoked further formation of ascorbyl radicals and the formation of hydroxyl radicals ex vivo. The hydroxyl addition of uric acid to CSF from ALS patients diminished the production of hydroxyl radicals. In conclusion, there are clear differences between the roles of the two examined radical scavengers in the CSF of ALS patients indicating that the use of ascorbate could have unfavourable effects in ALS patients.
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Affiliation(s)
- Ivan Spasojević
- Institute for Multidisciplinary Research, University of Belgrade, Kneza Viseslava 1, 11000 Belgrade, Serbia.
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Vianello A, Arcaro G, Palmieri A, Ermani M, Braccioni F, Gallan F, Soraru' G, Pegoraro E. Survival and quality of life after tracheostomy for acute respiratory failure in patients with amyotrophic lateral sclerosis. J Crit Care 2010; 26:329.e7-14. [PMID: 20655697 DOI: 10.1016/j.jcrc.2010.06.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Revised: 05/24/2010] [Accepted: 06/14/2010] [Indexed: 12/13/2022]
Abstract
BACKGROUND Acute respiratory failure (ARF) is a common event in the advanced stage of amyotrophic lateral sclerosis (ALS) and may be rarely a presenting symptom. Frequently, such patients require intubation and mechanical ventilation (MV) and, in a large proportion, receive tracheostomy, as a consequence of weaning failure. In our study, we investigated postdischarge survival and quality of life (QoL) after tracheostomy for ARF in patients with ALS. METHODS DESIGN This study is a retrospective chart review combined with prospective evaluation of QoL and degree of depression. SETTING The study was conducted in an adult, respiratory intensive care unit in a university hospital. PATIENTS Amyotrophic lateral sclerosis patients with tracheostomy for ARF between January 1, 1995 and April 30, 2008 were investigated. INTERVENTION AND MEASUREMENTS (a) A retrospective chart review was used and (b) prospective administration of the 11-item short-form Life Satisfaction Index (LSI-11) and Beck Depression Inventory (BDI) questionnaires to survivors, at least 1 month after discharge from hospital, was performed. RESULTS Sixty patients were studied retrospectively. None of the patients died in the hospital after tracheostomy. Forty-two patients (70%) were discharged completely MV dependent, and 17 patients (28.3%) were partially MV dependent. One patient (1.6%) was liberated from MV. The median survival after tracheostomy was 21 months (range, 0-155 months). The survival rate was 65% by 1 year and 45% by 2 years after tracheostomy. Survival was significantly shorter in patients older than 60 years at tracheostomy, with a hazard ratio of dying of 2.1 (95% confidence interval, 1.1-3.9). All 13 survivors completed the LSI-11 and BDI. The mean (SD) cumulative score on the LSI-11 was 9.3 (3.6; range, 0-22; higher values indicating better QoL), similar to that obtained from a control group consisting of individuals with ALS who had not received tracheostomy (9.3 ± 4.3) and to that reported for persons in the general population. Only 15% of the tracheostomized patients (2/13) were severely depressed, according to BDI; 11 of 13 patients reported a positive view of tracheostomy and said that they would want to undergo this procedure if they could make the decision again. CONCLUSIONS Patients with ALS have a high chance of long-term survival after tracheostomy for ARF. Although administered at the time of a respiratory crisis without being discussed in advance, tracheostomy shows good acceptance and results in acceptable QoL.
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Affiliation(s)
- Andrea Vianello
- Respiratory Intensive Care Unit, City Hospital of Padova, Padova 35128, Italy.
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Golomb BA, Kwon EK, Koperski S, Evans MA. Amyotrophic lateral sclerosis-like conditions in possible association with cholesterol-lowering drugs: an analysis of patient reports to the University of California, San Diego (UCSD) Statin Effects Study. Drug Saf 2009; 32:649-61. [PMID: 19591530 DOI: 10.2165/00002018-200932080-00004] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND While cases of amyotrophic lateral sclerosis (ALS) or ALS-like conditions have arisen in apparent association with HMG-CoA reductase inhibitors ('statins') and/or other lipid-lowering drugs (collectively termed 'statins' in this paper for brevity), additional information is needed to understand whether the connection may be causal. The University of California, San Diego (UCSD) Statin Effects Study is a patient-targeted adverse event surveillance project focused on lipid-lowering agents, whose aim is to capitalize on patient reporting to further define characteristics and natural history of statin adverse effects (AEs), and to ascertain whether a patient-targeted surveillance system might lead to presumptive identification of previously unrecognized AEs. ALS was a candidate 'new' AE identified through this process. The aim of the analysis presented here was to examine characteristics and natural history of reported statin-associated ALS-like conditions with attention to factors that may bear on the issue of causality. METHODS For the present analysis, we focused on cases of statin-associated ALS that were reported to our study group prior to publication of a possible statin-ALS association. Of 35 identified subjects who had contacted the UCSD Statin Effects Study group to report ALS or an ALS-like condition, 18 could not be reached (e.g. contact information was no longer valid). Six were unable to participate (e.g. due to progression of their disease). Of the 11 who could be contacted and were able to participate, one declined to give informed consent. The remaining ten, with either a formal or probable diagnosis of ALS in the context of progressive muscle wasting/weakness arising in association with lipid-lowering drug therapy, completed a mail or phone survey eliciting information about ALS symptom onset and change in association with drug use/modification and development of statin-associated AEs. We reviewed findings in the context of literature on statin antioxidant/pro-oxidant balance, as well as ALS mechanisms involving oxidative stress and mitochondrial dysfunction. RESULTS All ten subjects reported amelioration of symptoms with drug discontinuation and/or onset or exacerbation of symptoms with drug change, rechallenge or dose increase. Three subjects initiated coenzyme Q10 supplementation; all reported initial benefit. All subjects reportedly developed statin AEs (not indicative of ALS) prior to ALS symptom onset, strongly disproportionate to expectation (p < 0.001). Since this reflects induction of pro-oxidant effects from statins, these findings lend weight to a literature-supported mechanism by which induction by statins of oxidative stress with amplification of mitochondrial dysfunction, arising in a vulnerable subgroup, may propel mechanisms underlying both AEs and, more rarely, ALS. CONCLUSION A theoretical foundation and preliminary clinical observations suggest that statins (and other lipid-lowering drugs) may rarely be associated with ALS in vulnerable individuals in whom pro-oxidant effects of statins predominate. Our observations have explanatory relevance extending to ALS causes that are not statin associated and to statin-associated neurodegenerative conditions that are not ALS. They suggest means for identification of a possible vulnerable subgroup. Indeed whether statins may, in contrast, confer ALS protection when antioxidant effects predominate merits examination.
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Affiliation(s)
- Beatrice A Golomb
- Department of Medicine, University of California, San Diego, California 92093-0995, USA.
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Proteome analysis reveals candidate markers of disease progression in amyotrophic lateral sclerosis (ALS). Neurosci Lett 2009; 468:23-7. [PMID: 19853641 DOI: 10.1016/j.neulet.2009.10.053] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2009] [Revised: 09/16/2009] [Accepted: 10/16/2009] [Indexed: 11/20/2022]
Abstract
OBJECTIVES In amyotrophic lateral sclerosis (ALS) the pathological determinants of disease progression remain poorly understood. We aimed to identify a characteristic CSF protein pattern that could provide new candidate biomarkers of disease progression in ALS. METHODS Using the two-dimensional difference in gel electrophoresis (2-D-DIGE), we compared CSF samples from patients with ALS that showed a rapid progression of disease (ALS-rp, n=9) over a follow-up time of 2 years and from patients with ALS that showed a slow progression of disease over follow-up (ALS-sl, n=9) over the same period. Protein spots that showed significant differences between patients and controls were selected for further analysis by MALDI-TOF mass spectrometry. For validation of identified spots ELISA and nephelometry were performed for two candidate proteins on a second cohort of patients (n=40). RESULTS We identified 6 different proteins and their isoforms which were all upregulated in ALS-rp as compared to ALS-sl (heat shock protein1, alpha-1 antitrypsin, fetuin-A precursor, transferrin, transthyretin (TTR), nebulin-related anchoring protein). For Fetuin-A and TTR, our findings could be confirmed by quantitative assay. CONCLUSIONS Fetuin-A and TTR are promising candidate markers for disease progression in ALS that warrant further evaluation on a larger cohort of patients.
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Ohnishi S, Ito H, Suzuki Y, Adachi Y, Wate R, Zhang J, Nakano S, Kusaka H, Ikehara S. Intra-bone marrow-bone marrow transplantation slows disease progression and prolongs survival in G93A mutant SOD1 transgenic mice, an animal model mouse for amyotrophic lateral sclerosis. Brain Res 2009; 1296:216-24. [PMID: 19686706 DOI: 10.1016/j.brainres.2009.08.012] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Revised: 08/04/2009] [Accepted: 08/05/2009] [Indexed: 12/13/2022]
Abstract
It has been reported that bone marrow transplantation (BMT) has clinical effects on not only hematopoietic diseases and autoimmune diseases but also solid malignant tumors and metabolic diseases. We have found that intra-bone marrow-bone marrow transplantation (IBM-BMT) is superior to conventional intravenous BMT, since IBM-BMT enables rapid recovery of donor hematopoiesis and reduces the extent of graft-versus-host disease (GVHD). In this experiment, we examined the effects of IBM-BMT on symptomatic G93A mutant SOD1 transgenic mice (mSOD1 Tg mice), a model mouse line for amyotrophic lateral sclerosis (ALS). Symptomatic mSOD1 Tg mice (12 weeks old) were irradiated with 6Gyx2 at a 4-hour interval, one day before IBM-BMT. The mice were transplanted with bone marrow cells (BMCs) from 12-wk-old eGFP-transgenic C57BL/6 mice (eGFP Tg mice) or BMCs from 12-wk-old mSOD1 Tg mice. The ALS model mice transplanted with BMCs from eGFP Tg mice showed longer survival and slower disease progression than those transplanted with BMCs from mSOD1 Tg mice or untreated mSOD1 Tg mice. There was a significantly high number of eGFP(+) cells in the anterior horn of the spinal cord of the mSOD1 Tg mice transplanted with BMCs of eGFP Tg mice, some of which expressed Iba-1, a marker of microglia, although they did not differentiate into neural cells. These results suggest that the replacement with normal hematopoietic cells improved the neural cell environment, thereby slowing the progression of the disease.
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Affiliation(s)
- Shizuo Ohnishi
- Department of Neurology, Kansai Medical University, Moriguchi City, Osaka, Japan
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Terry PD, Kamel F, Umbach DM, Lehman TA, Hu H, Sandler DP, Taylor JA. VEGF PROMOTER HAPLOTYPE AND AMYOTROPHIC LATERAL SCLEROSIS (ALS). J Neurogenet 2009; 18:429-34. [PMID: 15763997 DOI: 10.1080/01677060490894450] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Vascular endothelial growth factor (VEGF) is a cytokine essential for angiogenesis. A recent study found that haplotypes, determined by three SNPs (-2,578C/A, - 1,154 G/A, and - 634G/C) in the VEGF upstream promoter/leader sequence, were associated with risk of amyotrophic lateral sclerosis(ALS). We used samples and data from a case-control study to examine the relation of ALS to VEGF haplotype. Genotypes at each of the three polymorphic sites were determined using allele-specific primer extension reactions followed by MALDI-TOF. We found a 3-fold increased risk among individuals homozygous for the AAG or AGG haplotypes (95%CI = 0.7 - 13.4), consistent with the findings of the previous study. Given the wide confidence interval, our findings should be interpreted cautiously.
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Affiliation(s)
- Paul D Terry
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health/DHHS, Research Triangle Park, NC 27709, USA.
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