1
|
Ghodsinezhad V, Ghoreishi A, Rohani M, Dadfar M, Mohammadzadeh A, Rostami A, Rahimi H. Identification of four novel mutations in VSP13A in Iranian patients with Chorea-acanthocytosis (ChAc). Mol Genet Genomics 2024; 299:39. [PMID: 38519717 DOI: 10.1007/s00438-024-02111-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/13/2024] [Indexed: 03/25/2024]
Abstract
Chorea-acanthocytosis (ChAc) is a rare autosomal recessive neurodegenerative disorder characterized by a variety of involuntary movements, predominantly chorea, and the presence of acanthocytosis in peripheral blood smears. ChAc is caused by mutations in the vacuolar protein sorting-associated protein 13A (VPS13A) gene. The aim of the present study was to conduct a clinical and genetic analysis of five patients with suspected ChAc in Iran. This study included five patients who were referred to the genetic department of the Endocrinology and Metabolism Research Institute between 2020 and 2022, with a suspicion of ChAc. Clinical features and the presence of characteristic MRI findings were evaluated in the patients. Whole-exome sequencing (WES) followed by Sanger sequencing was employed to identify the disease-causing variants. The functional effects of novel mutations were analyzed by specific bioinformatics prediction tools. WES and data analysis revealed the presence of five distinct VPS13A mutations in the patients, four of which were novel. These included one nonsense mutation (p.L984X), and three splice site mutations (c.755-1G>A, c.144+1 G>C, c.2512+1G>A). All mutations were validated by Sanger sequencing, and in silico analysis predicted that all mutations were pathogenic. This study provides the first molecular genetic characteristics of Iranian patients with ChAc, identifying four novel mutations in the VPS13A gene. These findings expand the VPS13A variants spectrum and confirm the clinical variability in ChAc patients.
Collapse
Affiliation(s)
- Vadieh Ghodsinezhad
- Department of Genetics and Molecular Medicine, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Abdoreza Ghoreishi
- Department of Neurology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mohammad Rohani
- Department of Neurology, Rasoul Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahdi Dadfar
- Skull Base Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Akbar Mohammadzadeh
- Department of Genetics and Molecular Medicine, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Ali Rostami
- Department of Pharmacology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Hamzeh Rahimi
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran.
- Texas Biomedical Research Institute, San Antonio, TX, USA.
| |
Collapse
|
2
|
Wu Q, Li Z, Cheng Y, Hu H, Gao H, Wang J, Han D. Acupuncture for treating symptoms associated with chorea-acanthocytosis: A CARE-compliant case report. Explore (NY) 2023; 19:127-130. [PMID: 34819264 DOI: 10.1016/j.explore.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 11/06/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND Chorea-acanthocytosis (ChAc) is the most common type of neuroacanthocytosis syndromes. Characteristic movement disorders of ChAc are choreiform movements affecting both trunk and extremities. Acanthocytosis in peripheral blood smear, elevated serum creatine kinase, atrophy of heads of caudate nuclei and dilation of the anterior horn of the lateral ventricles in magnetic resonance imaging could assist the diagnosis of ChAc. OBJECTIVE We aimed to report on the use of acupuncture to successfully improve ChAc symptoms. METHOD A patient with definite ChAc was admitted, who had suffered from involuntary tongue protrusion for about 10 years. Acupuncture treatment was administrated for 3 times a week for 2 months. The chorea tremor control area, Baihui (GV20), Sishencong (EX-HN1), Shenting (GV24), Benshen (GB13, bilateral), Yintang (GV29), Neiguan (PC6, bilateral), Tongli (HT5, bilateral), Zusanli (ST36, bilateral), Sanyinjiao (SP6, bilateral), Dicang (ST4, bilateral), Chengjiang (CV24), Lianquan (CV23), Jinjin (EX-HN12) and Yuye (EX-HN13) were selected as acupunture points. RESULTS Previous drug dosage was reduced and the frequency of involuntary tongue protrusion was significantly reduced. Other clinical symptoms were also well controlled. Peripheral blood smear still indicated an increased proportion of red lineage, but blood analyses revealed improvement at follow-up. CONCLUSIONS For patients who do not response well to conventional medical treatments, acupuncture might be used as an alternative treatment for symptoms related to ChAc.
Collapse
Affiliation(s)
- Qiqi Wu
- The Third Clinical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Zengtu Li
- Department of Massage, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yingying Cheng
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Hantong Hu
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Hong Gao
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiawei Wang
- The Third Clinical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Dexiong Han
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
| |
Collapse
|
3
|
Ghadery CM, Kalia LV, Connolly BS. Movement disorders of the mouth: a review of the common phenomenologies. J Neurol 2022; 269:5812-5830. [PMID: 35904592 DOI: 10.1007/s00415-022-11299-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 11/26/2022]
Abstract
Movement disorders of the mouth encompass a spectrum of hyperactive movements involving the muscles of the orofacial complex. They are rare conditions and are described in the literature primarily in case reports originating from neurologists, psychiatrists, and the dental community. The focus of this review is to provide a phenomenological description of different oral motor disorders including oromandibular dystonia, orofacial dyskinesia and orolingual tremor, and to offer management strategies for optimal treatment based on the current literature. A literature search of full text studies using PubMed/Medline and Cochrane library combined with a manual search of the reference lists was conducted until June 2021. Results from this search included meta-analyses, systematic reviews, reviews, clinical studies, case series, and case reports published by neurologists, psychiatrists, dentists and oral and maxillofacial surgeons. Data garnered from these sources were used to provide an overview of most commonly encountered movement disorders of the mouth, aiding physicians in recognizing these rare conditions and in initiating appropriate therapy.
Collapse
Affiliation(s)
- C M Ghadery
- Division of Neurology, Department of Medicine, McMaster University, 237 Barton Street East, Hamilton, ON, L8L 2X2, Canada
| | - L V Kalia
- Division of Neurology, Department of Medicine, Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - B S Connolly
- Division of Neurology, Department of Medicine, McMaster University, 237 Barton Street East, Hamilton, ON, L8L 2X2, Canada.
| |
Collapse
|
4
|
Vaisfeld A, Bruno G, Petracca M, Bentivoglio AR, Servidei S, Vita MG, Bove F, Straccia G, Dato C, Di Iorio G, Sampaolo S, Peluso S, De Rosa A, De Michele G, Barghigiani M, Galatolo D, Tessa A, Santorelli F, Chiurazzi P, Melone MAB. Neuroacanthocytosis Syndromes in an Italian Cohort: Clinical Spectrum, High Genetic Variability and Muscle Involvement. Genes (Basel) 2021; 12:genes12030344. [PMID: 33652783 PMCID: PMC7996727 DOI: 10.3390/genes12030344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/17/2021] [Accepted: 02/22/2021] [Indexed: 01/12/2023] Open
Abstract
Neuroacanthocytosis (NA) syndromes are a group of genetically defined diseases characterized by the association of red blood cell acanthocytosis, progressive degeneration of the basal ganglia and neuromuscular features with characteristic persistent hyperCKemia. The main NA syndromes include autosomal recessive chorea-acanthocytosis (ChAc) and X-linked McLeod syndrome (MLS). A series of Italian patients selected through a multicenter study for these specific neurological phenotypes underwent DNA sequencing of the VPS13A and XK genes to search for causative mutations. Where it has been possible, muscle biopsies were obtained and thoroughly investigated with histochemical assays. A total of nine patients from five different families were diagnosed with ChAC and had mostly biallelic changes in the VPS13A gene (three nonsense, two frameshift, three splicing), while three patients from a single X-linked family were diagnosed with McLeod syndrome and had a deletion in the XK gene. Despite a very low incidence (only one thousand cases of ChAc and a few hundred MLS cases reported worldwide), none of the 8 VPS13A variants identified in our patients is shared by two families, suggesting the high genetic variability of ChAc in the Italian population. In our series, in line with epidemiological data, McLeod syndrome occurs less frequently than ChAc, although it can be easily suspected because of its X-linked mode of inheritance. Finally, histochemical studies strongly suggest that muscle pathology is not simply secondary to the axonal neuropathy, frequently seen in these patients, but primary myopathic alterations can be detected in both NA syndromes.
Collapse
Affiliation(s)
- Alessandro Vaisfeld
- Istituto di Medicina Genomica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
| | - Giorgia Bruno
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Interuniversity Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.B.); (G.S.); (C.D.); (G.D.I.); (S.S.); (M.A.B.M.)
| | - Martina Petracca
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Neurologia, 00168 Roma, Italy; (M.P.); (A.R.B.); (M.G.V.); (F.B.)
| | - Anna Rita Bentivoglio
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Neurologia, 00168 Roma, Italy; (M.P.); (A.R.B.); (M.G.V.); (F.B.)
- Dipartimento Universitario di Neuroscienze, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Serenella Servidei
- Dipartimento Universitario di Neuroscienze, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Neurofisiopatologia, 00168 Rome, Italy
| | - Maria Gabriella Vita
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Neurologia, 00168 Roma, Italy; (M.P.); (A.R.B.); (M.G.V.); (F.B.)
| | - Francesco Bove
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Neurologia, 00168 Roma, Italy; (M.P.); (A.R.B.); (M.G.V.); (F.B.)
- Dipartimento Universitario di Neuroscienze, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Giulia Straccia
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Interuniversity Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.B.); (G.S.); (C.D.); (G.D.I.); (S.S.); (M.A.B.M.)
| | - Clemente Dato
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Interuniversity Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.B.); (G.S.); (C.D.); (G.D.I.); (S.S.); (M.A.B.M.)
| | - Giuseppe Di Iorio
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Interuniversity Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.B.); (G.S.); (C.D.); (G.D.I.); (S.S.); (M.A.B.M.)
| | - Simone Sampaolo
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Interuniversity Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.B.); (G.S.); (C.D.); (G.D.I.); (S.S.); (M.A.B.M.)
| | - Silvio Peluso
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, 80138 Naples, Italy; (S.P.); (A.D.R.); (G.D.M.)
| | - Anna De Rosa
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, 80138 Naples, Italy; (S.P.); (A.D.R.); (G.D.M.)
| | - Giuseppe De Michele
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, 80138 Naples, Italy; (S.P.); (A.D.R.); (G.D.M.)
| | - Melissa Barghigiani
- Molecular Medicine, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (M.B.); (D.G.); (A.T.); (F.S.)
| | - Daniele Galatolo
- Molecular Medicine, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (M.B.); (D.G.); (A.T.); (F.S.)
| | - Alessandra Tessa
- Molecular Medicine, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (M.B.); (D.G.); (A.T.); (F.S.)
| | - Filippo Santorelli
- Molecular Medicine, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (M.B.); (D.G.); (A.T.); (F.S.)
| | - Pietro Chiurazzi
- Istituto di Medicina Genomica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC Genetica Medica, 00168 Roma, Italy
- Correspondence: ; Tel.: +39-338-8361006
| | - Mariarosa Anna Beatrice Melone
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Interuniversity Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.B.); (G.S.); (C.D.); (G.D.I.); (S.S.); (M.A.B.M.)
- Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, Temple University, Philadelphia, PA 19122-6078, USA
| |
Collapse
|
5
|
Walker RH, Danek A. "Neuroacanthocytosis" - Overdue for a Taxonomic Update. Tremor Other Hyperkinet Mov (N Y) 2021; 11:1. [PMID: 33510935 PMCID: PMC7805383 DOI: 10.5334/tohm.583] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/16/2020] [Indexed: 11/20/2022] Open
Abstract
The term "neuroacanthocytosis" (NA) is used for a spectrum of neurological disorders in which there are thorny red blood cells. While NA historically referred to disorders of lipoprotein absorption, we have promoted it as an overarching term for a group of basal ganglia disorders, with specific reference to two diseases that we defined as "core" NA syndromes. "Neuroacanthocytosis" has also been used to refer to a specific, now genetically-defined disease, otherwise known as "chorea-acanthocytosis". These various usages have resulted in diagnostic confusion, and in a number of cases have quite likely prevented the pursuance of precise, molecular, diagnosis. Disease nomenclature is an ever-evolving field, especially in the current era of expanding genetics, and naming proposals are often far from ideal. We, however, suggest that the term "neuroacanthocytosis" should no longer be generally used and if so, only with appropriate understanding of its limitations. Further, we propose that chorea-acanthocytosis be renamed as "VPS13A disease" in accordance with its genetic etiology.
Collapse
Affiliation(s)
- Ruth H. Walker
- James J. Peters VAMC, Bronx, Department of Neurology, Mount Sinai School of Medicine, New York City, NY, US
| | - Adrian Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, Munich, Germany, DE
| |
Collapse
|