1
|
van der Veen S, Eggink H, Elting JWJ, Sival D, Verschuuren-Bemelmans CC, de Koning TJ, Tijssen MAJ. The natural history of progressive myoclonus ataxia. Neurobiol Dis 2024; 199:106555. [PMID: 38844245 DOI: 10.1016/j.nbd.2024.106555] [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: 03/02/2024] [Revised: 05/22/2024] [Accepted: 06/03/2024] [Indexed: 06/16/2024] Open
Abstract
Progressive myoclonus ataxia (PMA) is a rare clinical syndrome characterized by the presence of progressive myoclonus and ataxia, and can be accompanied by mild cognitive impairment and infrequent epileptic seizures. This is the first study to describe the natural history of PMA and identify clinical, electrophysiological, and genetic features explaining the variability in disease progression. A Dutch cohort of consecutive patients meeting the criteria of the refined definition of PMA was included. The current phenotype was assessed during in-person consultation by movement disorders experts, and retrospective data was collected to describe disease presentation and progression, including brain imaging and therapy efficacy. Extensive genetic and electrophysiological tests were performed. The presence of cortical hyperexcitability was determined, by either the identification of a cortical correlate of myoclonic jerks with simultaneous electromyography-electroencephalography or a giant somatosensory evoked potential. We included 34 patients with PMA with a median disease duration of 15 years and a clear progressive course in most patients (76%). A molecular etiology was identified in 82% patients: ATM, CAMTA1, DHDDS, EBF3, GOSR2, ITPR1, KCNC3, NUS1, POLR1A, PRKCG, SEMA6B, SPTBN2, TPP1, ZMYND11, and a 12p13.32 deletion. The natural history is a rather homogenous onset of ataxia in the first two years of life followed by myoclonus in the first 5 years of life. Main accompanying neurological dysfunctions included cognitive impairment (62%), epilepsy (38%), autism spectrum disorder (27%), and behavioral problems (18%). Disease progression showed large variability ranging from an epilepsy free PMA phenotype (62%) to evolution towards a progressive myoclonus epilepsy (PME) phenotype (18%): the existence of a PMA-PME spectrum. Cortical hyperexcitability could be tested in 17 patients, and was present in 11 patients and supported cortical myoclonus. Interestingly, post-hoc analysis showed that an absence of cortical hyperexcitability, suggesting non-cortical myoclonus, was associated with the PMA-end of the spectrum with no epilepsy and milder myoclonus, independent of disease duration. An association between the underlying genetic defects and progression on the PMA-PME spectrum was observed. By describing the natural history of the largest cohort of published patients with PMA so far, we see a homogeneous onset with variable disease progression, in which phenotypic evolution to PME occurs in the minority. Genetic and electrophysiological features may be of prognostic value, especially the determination of cortical hyperexcitability. Furthermore, the identification of cortical and non-cortical myoclonus in PMA helps us gain insight in the underlying pathophysiology of myoclonus.
Collapse
Affiliation(s)
- Sterre van der Veen
- Department of Neurology, University of Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands; Expertise Centre Movement Disorders Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands
| | - Hendriekje Eggink
- Department of Neurology, University of Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands; Expertise Centre Movement Disorders Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands
| | - Jan Willem J Elting
- Department of Neurology, University of Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands; Expertise Centre Movement Disorders Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands
| | - Deborah Sival
- Expertise Centre Movement Disorders Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands; Department of Pediatrics, University of Groningen, University Medical Center Groningen, 9700 RB, Groningen, the Netherlands
| | - Corien C Verschuuren-Bemelmans
- Expertise Centre Movement Disorders Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands; Department of Genetics, University of Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands
| | - Tom J de Koning
- Expertise Centre Movement Disorders Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands; Department of Genetics, University of Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands; Pediatrics, department of Clinical Sciences, Lund University, 22185 Lund, Sweden
| | - Marina A J Tijssen
- Department of Neurology, University of Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands; Expertise Centre Movement Disorders Groningen, University Medical Centre Groningen, 9700 RB, Groningen, the Netherlands.
| |
Collapse
|
2
|
Tian X, Ding C, Liu M, Dai L, Xie Z, Fang T. Bilateral globus pallidus internus-deep brain stimulation in a 5-year-old boy with SGCE-related myoclonus dystonia syndrome. Pediatr Investig 2024; 8:154-156. [PMID: 38910854 PMCID: PMC11193369 DOI: 10.1002/ped4.12421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/31/2024] [Indexed: 06/25/2024] Open
Affiliation(s)
- Xiaojuan Tian
- Department of Neurology, Neurological CenterBeijing Children's Hospital, Capital Medical University, National Center For Children's HealthBeijingChina
| | - Changhong Ding
- Department of Neurology, Neurological CenterBeijing Children's Hospital, Capital Medical University, National Center For Children's HealthBeijingChina
| | - Ming Liu
- Department of Neurology, Neurological CenterBeijing Children's Hospital, Capital Medical University, National Center For Children's HealthBeijingChina
| | - Lifang Dai
- Department of Neurology, Neurological CenterBeijing Children's Hospital, Capital Medical University, National Center For Children's HealthBeijingChina
| | - Zixing Xie
- Department of Functional Neurosurgery, Neurological CenterBeijing Children's Hospital, Capital Medical University, National Center For Children's HealthBeijingChina
| | - Tie Fang
- Department of Functional Neurosurgery, Neurological CenterBeijing Children's Hospital, Capital Medical University, National Center For Children's HealthBeijingChina
| |
Collapse
|
3
|
Klinman E, Gooch C, Perlmutter JS, Davis AA, Maiti B. Novel SGCE Mutation in a Patient With Myoclonus-Dystonia: A Case Report. Neurol Genet 2024; 10:e200128. [PMID: 38486676 PMCID: PMC10932734 DOI: 10.1212/nxg.0000000000200128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/12/2023] [Indexed: 03/17/2024]
Abstract
Objectives Characterize the presentation, workup, and management of SGCE myoclonus-dystonia, a rare genetic condition, in a patient with atypical presenting symptoms and no family history of movement abnormalities. Methods A woman with myoclonus and dystonia was identified based on clinical history and physical examination. Workup was conducted to determine the cause of her symptoms, including whole-exome sequencing. Myoclonus-dystonia is associated with more than 100 distinct mutations in MYC/DYT-SGCE that account for only half of the total myoclonus-dystonia patients. As such, this case required intensive genetic analyses rather than screening only for a small subset of well-characterized mutations. Results Childhood onset myoclonus and worsening dystonia with age were identified in a young woman. She underwent screening for common causes of twitching movements, followed by whole-exome sequencing which identified a de novo novel variant in the SGCE gene, resulting in a diagnosis of SGCE myoclonus-dystonia. Discussion Myoclonus-dystonia should be considered in patients with symptoms of head and upper extremity myoclonus early in life, especially with co-occurring dystonia, even in the absence of a family history of similar symptoms. Diagnosis of this condition should take place using sequencing, as new mutations continue to be discovered.
Collapse
Affiliation(s)
- Eva Klinman
- From the Department of Neurology (E.K., J.S.P., A.A.D., B.M.); and Division of Genetics and Genomic Medicine (C.G.), Department of Pediatrics, Washington University School of Medicine, St Louis, MO
| | - Catherine Gooch
- From the Department of Neurology (E.K., J.S.P., A.A.D., B.M.); and Division of Genetics and Genomic Medicine (C.G.), Department of Pediatrics, Washington University School of Medicine, St Louis, MO
| | - Joel S Perlmutter
- From the Department of Neurology (E.K., J.S.P., A.A.D., B.M.); and Division of Genetics and Genomic Medicine (C.G.), Department of Pediatrics, Washington University School of Medicine, St Louis, MO
| | - Albert A Davis
- From the Department of Neurology (E.K., J.S.P., A.A.D., B.M.); and Division of Genetics and Genomic Medicine (C.G.), Department of Pediatrics, Washington University School of Medicine, St Louis, MO
| | - Baijayanta Maiti
- From the Department of Neurology (E.K., J.S.P., A.A.D., B.M.); and Division of Genetics and Genomic Medicine (C.G.), Department of Pediatrics, Washington University School of Medicine, St Louis, MO
| |
Collapse
|
4
|
Tarrano C, Galléa C, Delorme C, McGovern EM, Atkinson-Clement C, Barnham IJ, Brochard V, Thobois S, Tranchant C, Grabli D, Degos B, Corvol JC, Pedespan JM, Krystkowiak P, Houeto JL, Degardin A, Defebvre L, Valabrègue R, Beranger B, Apartis E, Vidailhet M, Roze E, Worbe Y. Association of abnormal explicit sense of agency with cerebellar impairment in myoclonus-dystonia. Brain Commun 2024; 6:fcae105. [PMID: 38601915 PMCID: PMC11004927 DOI: 10.1093/braincomms/fcae105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 02/20/2024] [Accepted: 03/26/2024] [Indexed: 04/12/2024] Open
Abstract
Non-motor aspects in dystonia are now well recognized. The sense of agency, which refers to the experience of controlling one's own actions, has been scarcely studied in dystonia, even though its disturbances can contribute to movement disorders. Among various brain structures, the cerebral cortex, the cerebellum, and the basal ganglia are involved in shaping the sense of agency. In myoclonus dystonia, resulting from a dysfunction of the motor network, an altered sense of agency may contribute to the clinical phenotype of the condition. In this study, we compared the explicit and implicit sense of agency in patients with myoclonus dystonia caused by a pathogenic variant of SGCE (DYT-SGCE) and control participants. We utilized behavioural tasks to assess the sense of agency and performed neuroimaging analyses, including structural, resting-state functional connectivity, and dynamic causal modelling, to explore the relevant brain regions involved in the sense of agency. Additionally, we examined the relationship between behavioural performance, symptom severity, and neuroimaging findings. We compared 19 patients with DYT-SGCE and 24 healthy volunteers. Our findings revealed that patients with myoclonus-dystonia exhibited a specific impairment in explicit sense of agency, particularly when implicit motor learning was involved. However, their implicit sense of agency remained intact. These patients also displayed grey-matter abnormalities in the motor cerebellum, as well as increased functional connectivity between the cerebellum and pre-supplementary motor area. Dynamic causal modelling analysis further identified reduced inhibitory effects of the cerebellum on the pre-supplementary motor area, decreased excitatory effects of the pre-supplementary motor area on the cerebellum, and increased self-inhibition within the pre-supplementary motor area. Importantly, both cerebellar grey-matter alterations and functional connectivity abnormalities between the cerebellum and pre-supplementary motor area were found to correlate with explicit sense of agency impairment. Increased self-inhibition within the pre-supplementary motor area was associated with less severe myoclonus symptoms. These findings highlight the disruption of higher-level cognitive processes in patients with myoclonus-dystonia, further expanding the spectrum of neurological and psychiatric dysfunction already identified in this disorder.
Collapse
Affiliation(s)
- Clément Tarrano
- CNRS UMR 7225, Sorbonne Université, Paris Brain Institute—Institut du Cerveau et de la Moelle épinière, Inserm U1127, Paris 75013, France
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Neurology, Clinical Investigation Center for Neurosciences, Paris 75013, France
| | - Cécile Galléa
- CNRS UMR 7225, Sorbonne Université, Paris Brain Institute—Institut du Cerveau et de la Moelle épinière, Inserm U1127, Paris 75013, France
- Department of Research Neuroimaging, Centre de NeuroImagerie de Recherche (CENIR), Sorbonne Université, Paris 75013, France
| | - Cécile Delorme
- CNRS UMR 7225, Sorbonne Université, Paris Brain Institute—Institut du Cerveau et de la Moelle épinière, Inserm U1127, Paris 75013, France
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Neurology, Clinical Investigation Center for Neurosciences, Paris 75013, France
| | - Eavan M McGovern
- Department of Neurology, Beaumont Hospital, Dublin 9, D09 VY21, Ireland
- School of Medicine, Royal College of Surgeons in Ireland, Dublin 2, D02 YN77, Ireland
| | - Cyril Atkinson-Clement
- CNRS UMR 7225, Sorbonne Université, Paris Brain Institute—Institut du Cerveau et de la Moelle épinière, Inserm U1127, Paris 75013, France
- School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
| | | | - Vanessa Brochard
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Neurology, Clinical Investigation Center for Neurosciences, Paris 75013, France
| | - Stéphane Thobois
- Department of Neurology, Hospices Civils de Lyon, Lyon 69000, France
| | - Christine Tranchant
- Département de Neurologie, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg 67098, France
- INSERM-U964/CNRS-UMR7104, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Université de Strasbourg, Illkirch 67404, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg 67000, France
| | - David Grabli
- CNRS UMR 7225, Sorbonne Université, Paris Brain Institute—Institut du Cerveau et de la Moelle épinière, Inserm U1127, Paris 75013, France
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Neurology, Clinical Investigation Center for Neurosciences, Paris 75013, France
| | - Bertrand Degos
- Department of Neurology, Assistance Publique-Hôpitaux de Paris, Avicenne Hospital, Sorbonne Paris Nord, Bobigny 93000, France
| | - Jean Christophe Corvol
- CNRS UMR 7225, Sorbonne Université, Paris Brain Institute—Institut du Cerveau et de la Moelle épinière, Inserm U1127, Paris 75013, France
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Neurology, Clinical Investigation Center for Neurosciences, Paris 75013, France
| | - Jean-Michel Pedespan
- Department of Neuropediatry, Universitary Hospital of Pellegrin, Bordeaux 33076, France
| | - Pierre Krystkowiak
- Department of Neurology, Abu Dhabi Stem Cells Centre, Abu Dhabi, United Arab Emirates
| | - Jean-Luc Houeto
- Department of Neurology CHU Limoges, Inserm U1094, IRD U270, Univ. Limoges, EpiMaCT—Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges 87000, France
| | - Adrian Degardin
- Department of Neurology, Tourcoing Hospital, Tourcoing 59599, France
| | - Luc Defebvre
- Department of Neurology, University of Lille, Lille 59000, France
- Department of Neurology, Lille Centre of Excellence for Neurodegenerative Diseases » (LiCEND), Lille F-59000, France
| | - Romain Valabrègue
- CNRS UMR 7225, Sorbonne Université, Paris Brain Institute—Institut du Cerveau et de la Moelle épinière, Inserm U1127, Paris 75013, France
- Department of Research Neuroimaging, Centre de NeuroImagerie de Recherche (CENIR), Sorbonne Université, Paris 75013, France
| | - Benoit Beranger
- CNRS UMR 7225, Sorbonne Université, Paris Brain Institute—Institut du Cerveau et de la Moelle épinière, Inserm U1127, Paris 75013, France
- Department of Research Neuroimaging, Centre de NeuroImagerie de Recherche (CENIR), Sorbonne Université, Paris 75013, France
| | - Emmanuelle Apartis
- CNRS UMR 7225, Sorbonne Université, Paris Brain Institute—Institut du Cerveau et de la Moelle épinière, Inserm U1127, Paris 75013, France
- Department of Neurophysiology, Saint-Antoine Hospital, Paris 75012, France
| | - Marie Vidailhet
- CNRS UMR 7225, Sorbonne Université, Paris Brain Institute—Institut du Cerveau et de la Moelle épinière, Inserm U1127, Paris 75013, France
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Neurology, Clinical Investigation Center for Neurosciences, Paris 75013, France
| | - Emmanuel Roze
- CNRS UMR 7225, Sorbonne Université, Paris Brain Institute—Institut du Cerveau et de la Moelle épinière, Inserm U1127, Paris 75013, France
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Neurology, Clinical Investigation Center for Neurosciences, Paris 75013, France
| | - Yulia Worbe
- CNRS UMR 7225, Sorbonne Université, Paris Brain Institute—Institut du Cerveau et de la Moelle épinière, Inserm U1127, Paris 75013, France
- Department of Neurophysiology, Saint-Antoine Hospital, Paris 75012, France
| |
Collapse
|
5
|
Lunardini F, Satolli S, Levi V, Rossi Sebastiano D, Zorzi GS. The effect of GPi-DBS assessed by gait analysis in DYT11 dystonia: a case study. Neurol Sci 2024; 45:335-340. [PMID: 37700178 PMCID: PMC10761383 DOI: 10.1007/s10072-023-07063-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/04/2023] [Indexed: 09/14/2023]
Affiliation(s)
- Francesca Lunardini
- Department of Child Neurology, Child Neuropsychiatry Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Giovanni Celoria 11, 20133, Milan, Italy.
| | - Sara Satolli
- Department of Child Neurology, Child Neuropsychiatry Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Giovanni Celoria 11, 20133, Milan, Italy
| | - Vincenzo Levi
- Department of Neurosurgery, Functional Neurosurgery Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Giovanna Simonetta Zorzi
- Department of Child Neurology, Child Neuropsychiatry Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Giovanni Celoria 11, 20133, Milan, Italy
| |
Collapse
|
6
|
Garg D, Kapoor H, Ahmad I, Aroosa M, Agarwal A, Srivastava AK, Faruq M. Childhood onset myoclonus-dystonia associated with a novel KCTD17 variant in an Indian patient. Parkinsonism Relat Disord 2023; 117:105925. [PMID: 37944475 DOI: 10.1016/j.parkreldis.2023.105925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/28/2023] [Accepted: 10/31/2023] [Indexed: 11/12/2023]
Affiliation(s)
- Divyani Garg
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Himanshi Kapoor
- Genomics and Molecular Medicine, CSIR-Institute of Genomics and Integrative Biology (CSIR -IGIB), Mall Road, Delhi, 110007, India
| | - Istaq Ahmad
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Mir Aroosa
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, 110029, India; Genomics and Molecular Medicine, CSIR-Institute of Genomics and Integrative Biology (CSIR -IGIB), Mall Road, Delhi, 110007, India
| | - Ayush Agarwal
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Achal Kumar Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Mohammed Faruq
- Genomics and Molecular Medicine, CSIR-Institute of Genomics and Integrative Biology (CSIR -IGIB), Mall Road, Delhi, 110007, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India; Genomics and Molecular Medicine Division, CSIR - Institute of Genomics and Integrative Biology, New Delhi, India.
| |
Collapse
|
7
|
Brooker SM, Mencacci NE. The expanding genetic landscape of myoclonus-dystonia syndrome: YY1 and ATP1A3 are added to the list. Parkinsonism Relat Disord 2023; 117:105929. [PMID: 37981540 DOI: 10.1016/j.parkreldis.2023.105929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Affiliation(s)
- Sarah M Brooker
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Niccolò E Mencacci
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
| |
Collapse
|
8
|
Van Der Veen S, Tijssen MAJ, Berkovic SF. The Muddle of Myoclonus: Many Guises, 2 Disciplines, Consensus Needed. Neurol Clin Pract 2023; 13:e200187. [PMID: 37664134 PMCID: PMC10473854 DOI: 10.1212/cpj.0000000000200187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 07/18/2023] [Indexed: 09/05/2023]
Abstract
Myoclonus is often approached in different ways by epileptologists and movement disorder specialists, leading to confusion in the literature. Multiplicity and inconsistency over the past 2 centuries resulted in a lack of precision and ambiguity of the terminology. We show that this is a current problem in which one phenomenon has been described with many terms and vice versa. Of more importance, we discuss the conceptualization of myoclonus from perspectives of both fields and focus on the borderland that exists, especially in the spectrum of cortical and epileptic myoclonus. By giving 2 examples, we illustrate the conundrum: the spectrum of progressive myoclonus epilepsies and progressive myoclonic ataxias and "cortical tremor" observed in familial cortical myoclonic tremor with epilepsy or familial adult myoclonic epilepsy. We attempt to facilitate to bridge these subspecialties and form the base for a uniform understanding to take this issue forward toward future classifications, discussions, and scientific research.
Collapse
Affiliation(s)
- Sterre Van Der Veen
- Department of Neurology (SVDV, MAJT), University of Groningen, University Medical Centre Groningen; Expertise Centre Movement Disorders Groningen (SVDV, MAJT), University Medical Centre Groningen; and Epilepsy Research Centre (SVDV, SFB), Department of Medicine, University of Melbourne, Austin Health
| | - Marina A J Tijssen
- Department of Neurology (SVDV, MAJT), University of Groningen, University Medical Centre Groningen; Expertise Centre Movement Disorders Groningen (SVDV, MAJT), University Medical Centre Groningen; and Epilepsy Research Centre (SVDV, SFB), Department of Medicine, University of Melbourne, Austin Health
| | - Samuel F Berkovic
- Department of Neurology (SVDV, MAJT), University of Groningen, University Medical Centre Groningen; Expertise Centre Movement Disorders Groningen (SVDV, MAJT), University Medical Centre Groningen; and Epilepsy Research Centre (SVDV, SFB), Department of Medicine, University of Melbourne, Austin Health
| |
Collapse
|
9
|
Surillo-Dahdah L, Morfi-Pagán CA. Two-Generation Epsilon-Sarcoglycan Gene (SGCE) Mutation-Associated Myoclonus-Dystonia (DYT-SGCE) Misdiagnosed as Tourette's Syndrome: A Case Series. Cureus 2023; 15:e45289. [PMID: 37846277 PMCID: PMC10576872 DOI: 10.7759/cureus.45289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/18/2023] Open
Abstract
This case series provides a diagnosis of myoclonus-dystonia syndrome (MDS) in two patients whose original presentation was thought to be Tourette's syndrome. The first patient presented with dystonia and myoclonus, which progressively worsened with age, and was diagnosed with an epsilon-sarcoglycan gene (SGCE) mutation. The patient's father, who was diagnosed in his childhood with Tourette's syndrome, also received genetic testing, which proved that to be a misdiagnosis and confirmed that he was the carrier of the SGCE mutation. Both patients were subjected to a levodopa trial, which proved to be an effective treatment. To our knowledge, these are the first reported cases of heterozygous pathogenic mutation of SGCE in Puerto Rico.
Collapse
Affiliation(s)
- Laura Surillo-Dahdah
- Department of Neurology, Institute of Neuroscience, Manatí Medical Center, Manatí, PRI
| | | |
Collapse
|
10
|
Higinbotham AS, DeBrosse SD, Kilbane CW. A Genetics Pearl for Counseling Patients with Epsilon-Sarcoglycan Myoclonus-Dystonia. Tremor Other Hyperkinet Mov (N Y) 2023; 13:24. [PMID: 37637852 PMCID: PMC10453946 DOI: 10.5334/tohm.783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/05/2023] [Indexed: 08/29/2023] Open
Abstract
Background Epsilon-sarcoglycan (SGCE) myoclonus-dystonia is autosomal dominant (AD) with reduced penetrance due to maternal imprinting 95% of the time. Patients may lack family history delaying diagnosis and treatment. Additionally, counseling patients on their risk of passing on the variant differs for females versus males. Case Report A woman in her thirties with typical phenotype of myoclonus-dystonia but lacking an AD pedigree was found to have a pathogenic variant in the SGCE gene. She was counseled that her daughters each have a 2.5% chance of expressing the phenotype. Discussion Understanding the genetics of SGCE-myoclonus-dystonia enables effective genetic counseling and arrival at a timely diagnosis and treatment. Summary In an era of advancing genetic analysis and precision medicine-based treatments, neurologists will be faced with increasing responsibility to properly counsel patients on the results of genetic testing. This case highlights a genetics pearl for counseling patients with epsilon-sarcoglycan myoclonus-dystonia, an autosomal dominant condition with penetrance differing by sex.
Collapse
Affiliation(s)
- Alissa S. Higinbotham
- Neurological Institute, University Hospitals Cleveland Medical Center, US
- Case Western Reserve University, US
| | - Suzanne D. DeBrosse
- Neurological Institute, University Hospitals Cleveland Medical Center, US
- Case Western Reserve University, US
- Center for Human Genetics, University Hospitals Cleveland Medical Center, US
| | - Camilla W. Kilbane
- Neurological Institute, University Hospitals Cleveland Medical Center, US
- Case Western Reserve University, US
| |
Collapse
|
11
|
Zhao M, Chen H, Yan X, Li J, Lu C, Cui B, Huo W, Cao S, Guo H, Liu S, Yang C, Liu Y, Yin F. Subthalamic deep brain stimulation for primary dystonia: defining an optimal location using the medial subthalamic nucleus border as anatomical reference. Front Aging Neurosci 2023; 15:1187167. [PMID: 37547744 PMCID: PMC10400903 DOI: 10.3389/fnagi.2023.1187167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/27/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Although the subthalamic nucleus (STN) has proven to be a safe and effective target for deep brain stimulation (DBS) in the treatment of primary dystonia, the rates of individual improvement vary considerably. On the premise of selecting appropriate patients, the location of the stimulation contacts in the dorsolateral sensorimotor area of the STN may be an important factor affecting therapeutic effects, but the optimal location remains unclear. This study aimed to define an optimal location using the medial subthalamic nucleus border as an anatomical reference and to explore the influence of the location of active contacts on outcomes and programming strategies in a series of patients with primary dystonia. Methods Data from 18 patients who underwent bilateral STN-DBS were retrospectively acquired and analyzed. Patients were assessed preoperatively and postoperatively (1 month, 3 months, 6 months, 1 year, 2 years, and last follow-up after neurostimulator initiation) using the Toronto Western Spasmodic Torticollis Rating Scale (for cervical dystonia) and the Burke-Fahn-Marsden Dystonia Rating Scale (for other types). Optimal parameters and active contact locations were determined during clinical follow-up. The position of the active contacts relative to the medial STN border was determined using postoperative stereotactic MRI. Results The clinical improvement showed a significant negative correlation with the y-axis position (anterior-posterior; A+, P-). The more posterior the electrode contacts were positioned in the dorsolateral sensorimotor area of the STN, the better the therapeutic effects. Cluster analysis of the improvement rates delineated optimal and sub-optimal groups. The optimal contact coordinates from the optimal group were 2.56 mm lateral, 0.15 mm anterior, and 1.34 mm superior relative to the medial STN border. Conclusion STN-DBS was effective for primary dystonia, but outcomes were dependent on the active contact location. Bilateral stimulation contacts located behind or adjacent to Bejjani's line were most likely to produce ideal therapeutic effects. These findings may help guide STN-DBS preoperative planning, stimulation programming, and prognosis for optimal therapeutic efficacy in primary dystonia.
Collapse
Affiliation(s)
- Mingming Zhao
- Department of Neurosurgery, Aerospace Center Hospital, Beijing, China
| | - Hui Chen
- Department of Neurosurgery, Aerospace Center Hospital, Beijing, China
| | - Xin Yan
- Department of Neurosurgery, Aerospace Center Hospital, Beijing, China
| | - Jianguang Li
- Department of Neurosurgery, Aerospace Center Hospital, Beijing, China
| | - Chao Lu
- Department of Neurosurgery, Aerospace Center Hospital, Beijing, China
| | - Bin Cui
- Department of Radiology, Aerospace Center Hospital, Beijing, China
| | - Wenjun Huo
- Department of Neurosurgery, Aerospace Center Hospital, Beijing, China
| | - Shouming Cao
- Department of Neurosurgery, Aerospace Center Hospital, Beijing, China
| | - Hui Guo
- Department of Neurosurgery, Aerospace Center Hospital, Beijing, China
| | - Shuang Liu
- Department of Neurosurgery, Aerospace Center Hospital, Beijing, China
| | - Chunjuan Yang
- Department of Neurosurgery, Aerospace Center Hospital, Beijing, China
| | - Ying Liu
- Department of Neurosurgery, Aerospace Center Hospital, Beijing, China
| | - Feng Yin
- Department of Neurosurgery, Aerospace Center Hospital, Beijing, China
| |
Collapse
|
12
|
Correa-Vela M, Carvalho J, Ferrero-Turrion J, Cazurro-Gutiérrez A, Vanegas M, Gonzalez V, Alvárez R, Marcé-Grau A, Moreno A, Macaya-Ruiz A, Pérez-Dueñas B. Early recognition of SGCE-myoclonus-dystonia in children. Dev Med Child Neurol 2023; 65:207-214. [PMID: 35723607 DOI: 10.1111/dmcn.15298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/20/2022] [Accepted: 05/03/2022] [Indexed: 01/09/2023]
Abstract
AIM To evaluate early dystonic features in children and adolescents with SGCE-myoclonus-dystonia. METHOD In this cross-sectional study, 49 patients (26 females and 23 males) with SGCE-myoclonus-dystonia (aged 15y 2mo, SD 12y) with childhood-onset (2y 10mo, SD 1y 10mo) dystonia were examined using a standardized video recorded protocol. Dystonia was rated using the Writer's Cramp and Gait Dystonia Rating Scales. Disability and impairment for handwriting and walking were also rated. RESULTS Dystonia was present at rest (n=1), posture (n=12), and during specific motor tasks (n=45) such as writing (n=35), walking (n=23), and running (n=20). Most children reported disability while performing these tasks. Early dystonic patterns were identified for writer's cramp and gait dystonia, the latter named the 'circular shaking leg', 'dragging leg', and 'hobby-horse gait' patterns. Sensory tricks were used by five and eight children to improve dystonia and myoclonus during writing and walking respectively. The rating scales accurately measured the severity of action dystonia and correlated with self-reported disability. INTERPRETATION Children with SGCE-myoclonus-dystonia show recognizable dystonic patterns and sensory tricks that may lead to an early diagnosis and timely therapeutic approach. Isolated writer's cramp is a key feature in childhood and should prompt SCGE analysis. The proposed action dystonia scales could be used to monitor disease course and response to treatment. WHAT THIS PAPER ADDS Most children with SGCE-myoclonus-dystonia got writer's cramp and had walking and running dystonia. Writer's cramp was a key feature and should prompt SGCE genetic investigation. 'Circular shaking leg', 'dragging leg', and 'hobby-horse gait' were recognized as early gait patterns. Children used sensory tricks to improve myoclonus and dystonia, suggesting common pathophysiological mechanisms. Action dystonia rating scales are valid tools to assess severity in children.
Collapse
Affiliation(s)
- Marta Correa-Vela
- Department of Pediatric Neurology, Vall d'Hebron Hospital Universitari, Pediatric.,Departament de Pediatria, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joao Carvalho
- Pediatric Neurology, Centro de Desenvolvimento da Criança Torrado da Silva, Hospital Garcia de Orta. Almada, Portugal
| | | | | | - Maria Vanegas
- Department of Pediatric Neurology, Vall d'Hebron Hospital Universitari, Pediatric.,Paediatric Department, Evelina Children's Hospital, London, UK
| | | | - Ramiro Alvárez
- Department of Neurology, Hospital Germans Trias, Barcelona, Spain
| | - Anna Marcé-Grau
- Department of Pediatric Neurology, Vall d'Hebron Hospital Universitari, Pediatric
| | - Antonio Moreno
- Departament de Pediatria, Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Pediatrics, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,CIBER of Rare Diseases (CIBERER), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Alfons Macaya-Ruiz
- Department of Pediatric Neurology, Vall d'Hebron Hospital Universitari, Pediatric.,Departament de Pediatria, Universitat Autònoma de Barcelona, Barcelona, Spain.,Neurology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Belén Pérez-Dueñas
- Department of Pediatric Neurology, Vall d'Hebron Hospital Universitari, Pediatric.,Departament de Pediatria, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBER of Rare Diseases (CIBERER), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Neurology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| |
Collapse
|
13
|
Roze E. Early identification of children with myoclonus-dystonia: Is it time for a revision of diagnostic criteria? Dev Med Child Neurol 2023; 65:151-152. [PMID: 35670203 PMCID: PMC10084109 DOI: 10.1111/dmcn.15310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 05/23/2022] [Indexed: 01/04/2023]
|
14
|
The multiple twists in the tale: Brain iron accumulation, facial jerks, and truncal dystonia. Parkinsonism Relat Disord 2023; 106:105014. [PMID: 35339370 DOI: 10.1016/j.parkreldis.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/07/2022] [Accepted: 03/05/2022] [Indexed: 02/06/2023]
|
15
|
Bukhari-Parlakturk N, Frucht SJ. Isolated and combined dystonias: Update. HANDBOOK OF CLINICAL NEUROLOGY 2023; 196:425-442. [PMID: 37620082 DOI: 10.1016/b978-0-323-98817-9.00005-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Dystonia is a hyperkinetic movement disorder with a unique motor phenomenology that can manifest as an isolated clinical syndrome or combined with other neurological features. This chapter reviews the characteristic features of dystonia phenomenology and the syndromic approach to evaluating the disorders that may allow us to differentiate the isolated and combined syndromes. We also present the most common types of isolated and combined dystonia syndromes. Since accelerated gene discoveries have increased our understanding of the molecular mechanisms of dystonia pathogenesis, we also present isolated and combined dystonia syndromes by shared biological pathways. Examples of these converging mechanisms of the isolated and combined dystonia syndromes include (1) disruption of the integrated response pathway through eukaryotic initiation factor 2 alpha signaling, (2) disease of dopaminergic signaling, (3) alterations in the cerebello-thalamic pathway, and (4) disease of protein mislocalization and stability. The discoveries that isolated and combined dystonia syndromes converge in shared biological pathways will aid in the development of clinical trials and therapeutic strategies targeting these convergent molecular pathways.
Collapse
Affiliation(s)
- Noreen Bukhari-Parlakturk
- Department of Neurology, Movement Disorders Division, Duke University (NBP), Durham, NC, United States.
| | - Steven J Frucht
- Department of Neurology, NYU Grossman School of Medicine (SJF), New York, NY, United States
| |
Collapse
|
16
|
Clinical features and genetic analysis of SGCE myoclonus-dystonia: A case report. Parkinsonism Relat Disord 2022; 104:91-93. [PMID: 36274329 DOI: 10.1016/j.parkreldis.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 01/09/2023]
Abstract
Myoclonus-dystonia caused by mutations in the SGCE gene is clinically characterized by early onset, myoclonus, and dystonia. Here we describe a family in which several members exhibit varying degrees of myoclonus and dystonia, caused by a novel heterozygous mutation in the SGCE gene.
Collapse
|
17
|
Imbriani P, Sciamanna G, El Atiallah I, Cerri S, Hess EJ, Pisani A. Synaptic effects of ethanol on striatal circuitry: therapeutic implications for dystonia. FEBS J 2022; 289:5834-5849. [PMID: 34217152 PMCID: PMC9786552 DOI: 10.1111/febs.16106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/21/2021] [Accepted: 07/02/2021] [Indexed: 12/30/2022]
Abstract
Alcohol consumption affects motor behavior and motor control. Both acute and chronic alcohol abuse have been extensively investigated; however, the therapeutic efficacy of alcohol on some movement disorders, such as myoclonus-dystonia or essential tremor, still does not have a plausible mechanistic explanation. Yet, there are surprisingly few systematic trials with known GABAergic drugs mimicking the effect of alcohol on neurotransmission. In this brief survey, we aim to summarize the effects of EtOH on striatal function, providing an overview of its cellular and synaptic actions in a 'circuit-centered' view. In addition, we will review both experimental and clinical evidence, in the attempt to provide a plausible mechanistic explanation for alcohol-responsive movement disorders, with particular emphasis on dystonia. Different hypotheses emerge, which may provide a rationale for the utilization of drugs that mimic alcohol effects, predicting potential drug repositioning.
Collapse
Affiliation(s)
- Paola Imbriani
- Department of Systems MedicineUniversity of Rome ‘Tor Vergata’Italy,IRCCS Fondazione Santa LuciaRomeItaly
| | - Giuseppe Sciamanna
- Department of Systems MedicineUniversity of Rome ‘Tor Vergata’Italy,IRCCS Fondazione Santa LuciaRomeItaly
| | - Ilham El Atiallah
- Department of Systems MedicineUniversity of Rome ‘Tor Vergata’Italy,IRCCS Fondazione Santa LuciaRomeItaly
| | | | - Ellen J. Hess
- Departments of Pharmacology and Chemical Biology and NeurologyEmory UniversityAtlantaGAUSA
| | - Antonio Pisani
- IRCCS Mondino FoundationPaviaItaly,Department of Brain and Behavioral SciencesUniversity of PaviaItaly
| |
Collapse
|
18
|
A mixed-ethnicity myoclonus-dystonia patient with a novel SGCE nonsense mutation: a case report. BMC Neurol 2022; 22:11. [PMID: 34986800 PMCID: PMC8729002 DOI: 10.1186/s12883-021-02530-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/18/2021] [Indexed: 12/04/2022] Open
Abstract
Background Myoclonus-dystonia is a rare movement disorder with an autosomal dominant inheritance pattern characterized by a combination of myoclonic jerks and dystonia that may have psychiatric manifestations. Our aim is to present neurologic and psychiatric phenotypic characteristics in the first Filipino bi-ethnic myoclonus-dystonia patient and her father. Case presentation We investigated a Filipino myoclonus-dystonia patient with a positive family history. This 21-year-old woman of mixed Filipino-Greek ethnicity presented with involuntary jerking movements of her upper extremities, head, and trunk. Her symptoms affected her activities of daily living which led her to develop moderate depression, mild to moderate anxiety, and mild obsessive-compulsive disorder (OCD). Her 49-year-old Greek father suffered from adolescence-onset myoclonus-dystonia. Conclusion Genetic testing revealed a novel epsilon-sarcoglycan (SGCE) gene nonsense mutation c.821C > A; p.Ser274* that confirmed our clinical diagnosis. For co-morbid anxiety, depression, and OCD, this patient was given duloxetine, in addition to clonazepam for the myoclonus and dystonia.
Collapse
|
19
|
Yoganathan S, Kumar M, Sharma S, Patel S, Danda S, Thomas M. SGCE Myoclonus-Dystonia: An Inherited Movement Disorder. Neurology 2021; 98:289. [PMID: 34906973 DOI: 10.1212/wnl.0000000000013209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Sangeetha Yoganathan
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Madhan Kumar
- Department of Paediatrics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Suvasini Sharma
- Neurology Division, Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi- 110 001, India
| | - Smruti Patel
- Neurology Division, Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi- 110 001, India
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College, Vellore- 632004, Tamil Nadu, India
| | - Maya Thomas
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| |
Collapse
|
20
|
WARS2 mutations cause dopa-responsive early-onset parkinsonism and progressive myoclonus ataxia. Parkinsonism Relat Disord 2021; 94:54-61. [PMID: 34890876 DOI: 10.1016/j.parkreldis.2021.11.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/12/2021] [Accepted: 11/28/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Sixteen subjects with biallelic WARS2 variants encoding the tryptophanyl mitochondrial aminoacyl-tRNA synthetase, presenting with a neonatal- or infantile-onset mitochondrial disease, have been reported to date. Here we present six novel cases with WARS2-related diseases and expand the spectrum to later onset phenotypes including dopa-responsive early-onset parkinsonism and progressive myoclonus-ataxia. METHODS Six individuals from four families underwent whole-exome sequencing within research and diagnostic settings. Following the identification of a genetic defect, in-depth phenotyping and protein expression studies were performed. RESULTS A relatively common (gnomAD MAF = 0.0033) pathogenic p.(Trp13Gly) missense variant in WARS2 was detected in trans in all six affected individuals in combination with different pathogenic alleles (exon 2 deletion in family 1; p.(Leu100del) in family 2; p.(Gly50Asp) in family 3; and p.(Glu208*) in family 4). Two subjects presented with action tremor around age 10-12 years and developed tremor-dominant parkinsonism with prominent neuropsychiatric features later in their 20s. Two subjects presented with a progressive myoclonus-ataxia dominant phenotype. One subject presented with spasticity, choreo-dystonia, myoclonus, and speech problems. One subject presented with speech problems, ataxia, and tremor. Western blotting analyses in patient-derived fibroblasts showed a markedly decreased expression of the full-length WARS2 protein in both subjects carrying p.(Trp13Gly) and an exon-2 deletion in compound heterozygosity. CONCLUSIONS This study expands the spectrum of the disease to later onset phenotypes of early-onset tremor-dominant parkinsonism and progressive myoclonus-ataxia phenotypes.
Collapse
|
21
|
Ganguly J, Bernaola MT, Goobie S, Prasad A, Jog M. Myoclonus‐Dystonia Presentation of
ATM
Gene Mutation in a Canadian Mennonite. Mov Disord Clin Pract 2021; 9:264-267. [DOI: 10.1002/mdc3.13369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/04/2021] [Accepted: 10/24/2021] [Indexed: 12/26/2022] Open
Affiliation(s)
- Jacky Ganguly
- Movement Disorder Centre, London Health Sciences Centre The University of Western Ontario London Ontario Canada
| | - Mellany Tuesta Bernaola
- Movement Disorder Centre, London Health Sciences Centre The University of Western Ontario London Ontario Canada
| | - Sharan Goobie
- Division of Medical Genetics Dalhousie University Halifax Nova Scotia Canada
| | - Asuri Prasad
- Department of Pediatrics, London Health Sciences Centre The University of Western Ontario London Ontario Canada
| | | |
Collapse
|
22
|
Myoclonic dystonia (DYT11) responsive to lacosamide: a case report. Acta Neurol Belg 2021; 122:1631-1632. [PMID: 34273089 DOI: 10.1007/s13760-021-01756-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 07/12/2021] [Indexed: 10/20/2022]
|
23
|
Cazurro-Gutiérrez A, Marcé-Grau A, Correa-Vela M, Salazar A, Vanegas MI, Macaya A, Bayés À, Pérez-Dueñas B. ε-Sarcoglycan: Unraveling the Myoclonus-Dystonia Gene. Mol Neurobiol 2021; 58:3938-3952. [PMID: 33886091 DOI: 10.1007/s12035-021-02391-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/08/2021] [Indexed: 01/23/2023]
Abstract
Myoclonus-dystonia (MD) is a rare childhood-onset movement disorder, with an estimated prevalence of about 2 per 1,000,.000 in Europe, characterized by myoclonic jerks in combination with focal or segmental dystonia. Pathogenic variants in the gene encoding ε-sarcoglycan (SGCE), a maternally imprinted gene, are the most frequent genetic cause of MD. To date, the exact role of ε-sarcoglycan and the pathogenic mechanisms that lead to MD are still unknown. However, there are more than 40 reported isoforms of human ε-sarcoglycan, pointing to a complex biology of this protein. Additionally, some of these are brain-specific isoforms, which may suggest an important role within the central nervous system. In the present review, we aim to provide an overview of the current state of knowledge of ε-sarcoglycan. We will focus on the genetic landscape of SGCE and the presence and plausible role of ε-sarcoglycan in the brain. Finally, we discuss the importance of the brain-specific isoforms and hypothesize that SGCE may play essential roles in normal synaptic functioning and their alteration will be strongly related to MD.
Collapse
Affiliation(s)
- Ana Cazurro-Gutiérrez
- Paediatric Neurology Research Group, Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Vall d'Hebrón Research Institute, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Marcé-Grau
- Paediatric Neurology Research Group, Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Vall d'Hebrón Research Institute, Barcelona, Spain
| | - Marta Correa-Vela
- Paediatric Neurology Research Group, Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Vall d'Hebrón Research Institute, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ainara Salazar
- Paediatric Neurology Research Group, Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Vall d'Hebrón Research Institute, Barcelona, Spain
- Paediatric Neurology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - María I Vanegas
- Paediatric Neurology Research Group, Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Vall d'Hebrón Research Institute, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - Alfons Macaya
- Paediatric Neurology Research Group, Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Vall d'Hebrón Research Institute, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Paediatric Neurology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Àlex Bayés
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Molecular Physiology of the Synapse Laboratory, Biomedical Research Institute Sant Pau, Barcelona, Spain
| | - Belén Pérez-Dueñas
- Paediatric Neurology Research Group, Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Vall d'Hebrón Research Institute, Barcelona, Spain.
- Universitat Autònoma de Barcelona, Barcelona, Spain.
- Paediatric Neurology Department, Hospital Vall d'Hebron, Barcelona, Spain.
| |
Collapse
|
24
|
Kutschenko A, Staege S, Grütz K, Glaß H, Kalmbach N, Gschwendtberger T, Henkel LM, Heine J, Grünewald A, Hermann A, Seibler P, Wegner F. Functional and Molecular Properties of DYT-SGCE Myoclonus-Dystonia Patient-Derived Striatal Medium Spiny Neurons. Int J Mol Sci 2021; 22:3565. [PMID: 33808167 PMCID: PMC8037318 DOI: 10.3390/ijms22073565] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/18/2021] [Accepted: 03/24/2021] [Indexed: 01/20/2023] Open
Abstract
Myoclonus-dystonia (DYT-SGCE, formerly DYT11) is characterized by alcohol-sensitive, myoclonic-like appearance of fast dystonic movements. It is caused by mutations in the SGCE gene encoding ε-sarcoglycan leading to a dysfunction of this transmembrane protein, alterations in the cerebello-thalamic pathway and impaired striatal plasticity. To elucidate underlying pathogenic mechanisms, we investigated induced pluripotent stem cell (iPSC)-derived striatal medium spiny neurons (MSNs) from two myoclonus-dystonia patients carrying a heterozygous mutation in the SGCE gene (c.298T>G and c.304C>T with protein changes W100G and R102X) in comparison to two matched healthy control lines. Calcium imaging showed significantly elevated basal intracellular Ca2+ content and lower frequency of spontaneous Ca2+ signals in SGCE MSNs. Blocking of voltage-gated Ca2+ channels by verapamil was less efficient in suppressing KCl-induced Ca2+ peaks of SGCE MSNs. Ca2+ amplitudes upon glycine and acetylcholine applications were increased in SGCE MSNs, but not after GABA or glutamate applications. Expression of voltage-gated Ca2+ channels and most ionotropic receptor subunits was not altered. SGCE MSNs showed significantly reduced GABAergic synaptic density. Whole-cell patch-clamp recordings displayed elevated amplitudes of miniature postsynaptic currents and action potentials in SGCE MSNs. Our data contribute to a better understanding of the pathophysiology and the development of novel therapeutic strategies for myoclonus-dystonia.
Collapse
Grants
- Karlheinz-Hartmann-Stiftung (Hannover, Germany), Ellen-Schmidt-Program (Hannover, Germany), Hermann and Lilly Schilling Stiftung für medizinische Forschung im Stifterverband, German Research Foundation (FOR2488) Karlheinz-Hartmann-Stiftung (Hannover, Germany), Ellen-Schmidt-Program (Hannover, Germany), Hermann and Lilly Schilling Stiftung für medizinische Forschung im Stifterverband, German Research Foundation (FOR2488)
Collapse
Affiliation(s)
- Anna Kutschenko
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; (A.K.); (S.S.); (N.K.); (T.G.); (L.M.H.); (J.H.)
| | - Selma Staege
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; (A.K.); (S.S.); (N.K.); (T.G.); (L.M.H.); (J.H.)
- Center for Systems Neuroscience, Bünteweg 2, 30559 Hannover, Germany
| | - Karen Grütz
- Institute of Neurogenetics, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; (K.G.); (A.G.); (P.S.)
| | - Hannes Glaß
- Translational Neurodegeneration Section “Albrecht-Kossel“, Department of Neurology, University Medical Center, University of Rostock, Gehlsheimer Str. 20, 18147 Rostock, Germany; (H.G.); (A.H.)
| | - Norman Kalmbach
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; (A.K.); (S.S.); (N.K.); (T.G.); (L.M.H.); (J.H.)
| | - Thomas Gschwendtberger
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; (A.K.); (S.S.); (N.K.); (T.G.); (L.M.H.); (J.H.)
- Center for Systems Neuroscience, Bünteweg 2, 30559 Hannover, Germany
| | - Lisa M. Henkel
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; (A.K.); (S.S.); (N.K.); (T.G.); (L.M.H.); (J.H.)
- Center for Systems Neuroscience, Bünteweg 2, 30559 Hannover, Germany
| | - Johanne Heine
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; (A.K.); (S.S.); (N.K.); (T.G.); (L.M.H.); (J.H.)
| | - Anne Grünewald
- Institute of Neurogenetics, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; (K.G.); (A.G.); (P.S.)
| | - Andreas Hermann
- Translational Neurodegeneration Section “Albrecht-Kossel“, Department of Neurology, University Medical Center, University of Rostock, Gehlsheimer Str. 20, 18147 Rostock, Germany; (H.G.); (A.H.)
- German Center for Neurodegenerative Diseases Rostock/Greifswald, 18147 Rostock, Germany
- Center for Transdisciplinary Neurosciences Rostock (CTNR), University Medical Center, University of Rostock, 18147 Rostock, Germany
| | - Philip Seibler
- Institute of Neurogenetics, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; (K.G.); (A.G.); (P.S.)
| | - Florian Wegner
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; (A.K.); (S.S.); (N.K.); (T.G.); (L.M.H.); (J.H.)
- Center for Systems Neuroscience, Bünteweg 2, 30559 Hannover, Germany
| |
Collapse
|
25
|
Kim HJ, Jeon B. Arching deep brain stimulation in dystonia types. J Neural Transm (Vienna) 2021; 128:539-547. [PMID: 33740122 DOI: 10.1007/s00702-021-02304-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/11/2020] [Indexed: 12/29/2022]
Abstract
Although medical treatment including botulinum toxic injection is the first-line treatment for dystonia, response is insufficient in many patients. In these patients, deep brain stimulation (DBS) can provide significant clinical improvement. Mounting evidence indicates that DBS is an effective and safe treatment for dystonia, especially for idiopathic and inherited isolated generalized/segmental dystonia, including DYT-TOR1A. Other inherited dystonia and acquired dystonia also respond to DBS to varying degrees. For Meige syndrome (craniofacial dystonia), other focal dystonia, and some rare inherited dystonia, further evidences are still needed to evaluate the role of DBS. Because short disease duration at DBS surgery and absence of fixed musculoskeletal deformity are associated with better outcome, DBS should be considered as early as possible when indicated after careful evaluation including genetic work-up. This review will focus on the factors to be considered in DBS for patients with dystonia and the outcome of DBS in the different types of dystonia.
Collapse
Affiliation(s)
- Han-Joon Kim
- Department of Neurology and Movement Disorder Center, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
| | - Beomseok Jeon
- Department of Neurology and Movement Disorder Center, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
| |
Collapse
|
26
|
Dzinovic I, Serranová T, Prouteau C, Colin E, Ziegler A, Winkelmann J, Jech R, Zech M. Myoclonic dystonia phenotype related to a novel calmodulin-binding transcription activator 1 sequence variant. Neurogenetics 2021; 22:137-141. [PMID: 33677721 DOI: 10.1007/s10048-021-00637-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/23/2021] [Indexed: 11/29/2022]
Abstract
Intragenic rearrangements and sequence variants in the calmodulin-binding transcription activator 1 gene (CAMTA1) can result in a spectrum of clinical presentations, most notably congenital ataxia with or without intellectual disability. We describe for the first time a myoclonic dystonia-predominant phenotype associated with a novel CAMTA1 sequence variant. Furthermore, by identifying an additional, recurrent CAMTA1 sequence variant in an individual with a more typical neurodevelopmental disease manifestation, we contribute to the elucidation of phenotypic variability associated with CAMTA1 gene mutations.
Collapse
Affiliation(s)
- Ivana Dzinovic
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany
| | - Tereza Serranová
- Department of Neurology, 1st Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Clement Prouteau
- Department of Biochemistry and Genetics, University Hospital Angers, Angers, France
| | - Estelle Colin
- Department of Biochemistry and Genetics, University Hospital Angers, Angers, France
| | - Alban Ziegler
- Department of Biochemistry and Genetics, University Hospital Angers, Angers, France
| | - Juliane Winkelmann
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany.,Institute of Human Genetics, Technical University of Munich, Munich, Germany.,Lehrstuhl für Neurogenetik, Technische Universität München, Munich, Germany.,Munich Cluster for Systems Neurology, SyNergy, Munich, Germany
| | - Robert Jech
- Munich Cluster for Systems Neurology, SyNergy, Munich, Germany.
| | - Michael Zech
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany. .,Institute of Human Genetics, Technical University of Munich, Munich, Germany.
| |
Collapse
|
27
|
Tisch S, Kumar KR. Pallidal Deep Brain Stimulation for Monogenic Dystonia: The Effect of Gene on Outcome. Front Neurol 2021; 11:630391. [PMID: 33488508 PMCID: PMC7820073 DOI: 10.3389/fneur.2020.630391] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 12/09/2020] [Indexed: 11/13/2022] Open
Abstract
Globus pallidus internus deep brain stimulation (GPi DBS) is the most effective intervention for medically refractory segmental and generalized dystonia in both children and adults. Predictive factors for the degree of improvement after GPi DBS include shorter disease duration and dystonia subtype with idiopathic isolated dystonia usually responding better than acquired combined dystonias. Other factors contributing to variability in outcome may include body distribution, pattern of dystonia and DBS related factors such as lead placement and stimulation parameters. The responsiveness to DBS appears to vary between different monogenic forms of dystonia, with some improving more than others. The first observation in this regard was reports of superior DBS outcomes in DYT-TOR1A (DYT1) dystonia, although other studies have found no difference. Recently a subgroup with young onset DYT-TOR1A, more rapid progression and secondary worsening after effective GPi DBS, has been described. Myoclonus dystonia due to DYT-SCGE (DYT11) usually responds well to GPi DBS. Good outcomes following GPi DBS have also been documented in X-linked dystonia Parkinsonism (DYT3). In contrast, poorer, more variable DBS outcomes have been reported in DYT-THAP1 (DYT6) including a recent larger series. The outcome of GPi DBS in other monogenic isolated and combined dystonias including DYT-GNAL (DYT25), DYT-KMT2B (DYT28), DYT-ATP1A3 (DYT12), and DYT-ANO3 (DYT24) have been reported with varying results in smaller numbers of patients. In this article the available evidence for long term GPi DBS outcome between different genetic dystonias is reviewed to reappraise popular perceptions of expected outcomes and revisit whether genetic diagnosis may assist in predicting DBS outcome.
Collapse
Affiliation(s)
- Stephen Tisch
- Department of Neurology, St Vincent's Hospital, University of New South Wales, Sydney, NSW, Australia
| | - Kishore Raj Kumar
- Molecular Medicine Laboratory and Neurology Department, Concord Clinical School, Concord Repatriation General Hospital, The University of Sydney, Sydney, NSW, Australia
- Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| |
Collapse
|
28
|
Tarrano C, Lamy JC, Delorme C, McGovern EM, Atkinson-Clement C, Brochard V, Thobois S, Tranchant C, Grabli D, Degos B, Corvol JC, Pedespan JM, Krystkoviak P, Houeto JL, Degardin A, Defebvre L, Apartis E, Vidailhet M, Roze E, Worbe Y. Tactile Temporal Discrimination Is Impaired in Myoclonus-Dystonia. Mov Disord 2020; 35:2356-2357. [PMID: 32960985 DOI: 10.1002/mds.28253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/08/2020] [Accepted: 07/10/2020] [Indexed: 11/08/2022] Open
Affiliation(s)
- Clément Tarrano
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'Hôpital, Paris, France
| | - Jean-Charles Lamy
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France
| | - Cécile Delorme
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'Hôpital, Paris, France
| | - Eavan M McGovern
- Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'Hôpital, Paris, France.,Department of Neurology, St Vincent's University Hospital Dublin, Dublin, Ireland
| | - Cyril Atkinson-Clement
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France
| | - Vanessa Brochard
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France.,Centre d'Investigation Clinique 1422, INSERM/APHP, Paris, France
| | - Stéphane Thobois
- University of Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Bron, France.,Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Bron, France
| | - Christine Tranchant
- Hopital de Hautepierre, Neurologie, Strasbourg, France.,Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - David Grabli
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'Hôpital, Paris, France
| | - Bertrand Degos
- Assistance Publique-Hôpitaux de Paris, Department of Neurology, Hôpital Avicennes, Bobigny, France
| | - Jean-Christophe Corvol
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'Hôpital, Paris, France
| | | | - Pierre Krystkoviak
- Department of Neurology, Amiens University Medical Center, Amiens, France
| | - Jean-Luc Houeto
- Service de Neurologie, CIC-INSERM 1402, CHU de Poitiers, Poitiers, France
| | - Adrian Degardin
- Department of Neurology, Centre hospitalier de Tourcoing, Tourcoing, France
| | - Luc Defebvre
- University Lille, CHU Lille, INSERM, U1172 - Degenerative & Vascular Cognitive Disorders, Lille, France.,Lille Centre of Excellence for Neurodegenerative Diseases (LiCEND), Lille, France
| | - Emmanuelle Apartis
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France.,Departement of Neurophysiology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marie Vidailhet
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'Hôpital, Paris, France
| | - Emmanuel Roze
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'Hôpital, Paris, France
| | - Yulia Worbe
- Sorbonne Université, Paris, France.,Inserm U1127, CNRS UMR 7225, UM 75, ICM, Paris, France.,Departement of Neurophysiology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| |
Collapse
|
29
|
Vanegas MI, Marcé-Grau A, Martí-Sánchez L, Mellid S, Baide-Mairena H, Correa-Vela M, Cazurro A, Rodríguez C, Toledo L, Fernández-Ramos JA, Pons R, Aguilera-Albesa S, Martí MJ, Eiris J, Iglesias G, De Fabregues O, Maqueda E, Garriz-Luis M, Madruga M, Espinós C, Macaya A, Cabrera JC, Pérez-Dueñas B. Delineating the motor phenotype of SGCE-myoclonus dystonia syndrome. Parkinsonism Relat Disord 2020; 80:165-174. [PMID: 33022436 DOI: 10.1016/j.parkreldis.2020.09.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 09/03/2020] [Accepted: 09/15/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To perform phenotype and genotype characterization in myoclonus-dystonia patients and to validate clinical rating tools. METHOD Two movement disorders experts rated patients with the Burke-Fahn-Marsden and Unified-Myoclonus rating scales using a video-recording protocol. Clinimetric analysis was performed. SGCE mutations were screened by Sanger sequencing and multiplex ligation-dependent probe amplification. RESULTS 48 patients were included and 43/48 rated. Mean age at assessment was 12.9±10.5 years (range 3-51) and 88% were ≤18 years of age. Myoclonus was a universal sign with a rostro-caudal severity-gradient. Myoclonus increased in severity and spread to lower limbs during action tests. Stimulus-evoked myoclonus was observed in 86.8% cases. Dystonia was common but mild. It had a focal distribution and was action-induced, causing writer's cramp (69%) and gait dystonia (34%). The severity of both myoclonus and dystonia had a strong impact on hand writing and walking difficulties. The Unified Myoclonus Rating scale showed the best clinimetric properties for the questionnaire, action myoclonus and functional subscales, and exceeded the Burke-Fahn-Marsden scale in its utility in assessing functional impairment in MDS patients. Twenty-one different SGCE mutations were identified in 45/48 patients, eleven being novel (most prevalent p. Val187*, founder mutation in Canary Islands). CONCLUSION This study quantifies the severity of the motor phenotype in SGCE-myoclonus dystonia syndrome, with a special focus on children, and identifies disabilities in gross and fine motor tasks that are essential for childhood development. Our results contribute to the knowledge of SGCE-related MDS in the early stage of evolution, where disease-modifying therapies could be initiated in order to prevent long-term social and physical burdens.
Collapse
Affiliation(s)
- Maria I Vanegas
- Paediatric Neurology Research Group, Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Spain; Universitat de Barcelona, Barcelona, Spain
| | - Anna Marcé-Grau
- Paediatric Neurology Research Group, Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Spain
| | - Laura Martí-Sánchez
- Universitat de Barcelona, Barcelona, Spain; Department of Clinical Biochemistry, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Sara Mellid
- Paediatric Neurology Research Group, Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Heidy Baide-Mairena
- Paediatric Neurology Research Group, Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain; Paediatric Department, Hospital General de Granollers, Granollers, Spain
| | - Marta Correa-Vela
- Paediatric Neurology Research Group, Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Cazurro
- Paediatric Neurology Research Group, Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carla Rodríguez
- Paediatric Neurology Department, Hospital Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Laura Toledo
- Paediatric Neurology Department, Hospital Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | | | - Roser Pons
- Paediatric Neurology Unit, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Hospital Agia Sofia, Athens, Greece
| | - Sergio Aguilera-Albesa
- Paediatric Neurology Unit, Department of Pediatrics, Complejo Hospitalario de Navarra, Navarrabiomed, Pamplona, Spain
| | - Maria José Martí
- Parkinson's Disease & Movement Disorders Unit, Neurology Department, Hospital Clínic de Barcelona/IDIBAPS/University of Barcelona, Institut de Neurociències, Barcelona, Spain
| | - Jesús Eiris
- Paediatric Neurology Department, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Gema Iglesias
- Pediatric Neurology Department, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Oriol De Fabregues
- Movement Disorders Unit, Department of Neurology Vall d'Hebron University Hospital, Neurodegenerative Diseases Group Barcelona, Spain
| | - Elena Maqueda
- Paediatric Neurology Department, Hospital Parc Taulí, Sabadell, Spain
| | - Maite Garriz-Luis
- Paediatric Neurology Unit, Clínica Universidad de Navarra, Pamplona, Spain
| | - Marcos Madruga
- Paediatric Neurology Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Carmen Espinós
- Unit of Genetics and Genomics of Neuromuscular and Neurodegenerative disorders, Centro de Investigación Príncipe Felipe (CIPF), Valencia, Spain
| | - Alfons Macaya
- Paediatric Neurology Research Group, Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain; Paediatric Neurology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - José Carlos Cabrera
- Paediatric Neurology Department, Hospital Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Belén Pérez-Dueñas
- Paediatric Neurology Research Group, Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Spain; Paediatric Neurology Department, Hospital Vall d'Hebron, Barcelona, Spain.
| |
Collapse
|
30
|
Mure H, Toyoda N, Morigaki R, Fujita K, Takagi Y. Clinical Outcome and Intraoperative Neurophysiology of the Lance-Adams Syndrome Treated with Bilateral Deep Brain Stimulation of the Globus Pallidus Internus: A Case Report and Review of the Literature. Stereotact Funct Neurosurg 2020; 98:399-403. [PMID: 32894852 DOI: 10.1159/000509318] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/10/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND The Lance-Adams syndrome (LAS) is a myoclonus syndrome caused by hypoxic-ischemic encephalopathy. LAS cases could be refractory to first-line medications, and the neuronal mechanism underlying LAS pathology remains unknown. OBJECTIVES To describe a patient with LAS who underwent bilateral globus pallidus internus (GPi) stimulation and discuss the pathophysiology of LAS with intraoperative electrophysiological findings. PATIENTS A 79-year-old woman presented with a history of cardiopulmonary arrest due to internal carotid artery rupture following carotid endarterectomy after successful cardiopulmonary resuscitation. However, within 1 month, the patient developed sensory stimulation-induced myoclonus in her face and extremities. Because her myoclonic symptoms were refractory to pharmacotherapy, deep brain stimulation of the GPi was performed 1 year after the hypoxic attack. RESULTS Continuous bilateral GPi stimulation with optimal parameter settings remarkably improved the patient's myoclonic symptoms. At the 2-year follow-up, her Unified Myoclonus Rating Scale score decreased from 90 to 24. In addition, we observed burst firing and interburst pause patterns on intraoperative microelectrode recordings of the bilateral GPi and stimulated this area as the therapeutic target. CONCLUSION Our results show that impairment in the basal ganglion circuitry might be involved in the pathogenesis of myoclonus in patients with LAS.
Collapse
Affiliation(s)
- Hideo Mure
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan, .,Parkinson's Disease and Dystonia Research Center, Tokushima University Hospital, Tokushima, Japan,
| | - Naoto Toyoda
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Ryoma Morigaki
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan.,Parkinson's Disease and Dystonia Research Center, Tokushima University Hospital, Tokushima, Japan.,Department of Advanced Brain Research, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Koji Fujita
- Parkinson's Disease and Dystonia Research Center, Tokushima University Hospital, Tokushima, Japan.,Department of Clinical Neuroscience, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Yasushi Takagi
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan.,Department of Advanced Brain Research, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| |
Collapse
|
31
|
Todisco M, Gana S, Cosentino G, Errichiello E, Arceri S, Avenali M, Valente EM, Alfonsi E. KCTD17-related myoclonus-dystonia syndrome: clinical and electrophysiological findings of a patient with atypical late onset. Parkinsonism Relat Disord 2020; 78:129-133. [DOI: 10.1016/j.parkreldis.2020.07.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/26/2020] [Accepted: 07/27/2020] [Indexed: 11/27/2022]
|
32
|
Wu J, Tang H, Chen S, Cao L. Mechanisms and Pharmacotherapy for Ethanol-Responsive Movement Disorders. Front Neurol 2020; 11:892. [PMID: 32982923 PMCID: PMC7477383 DOI: 10.3389/fneur.2020.00892] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 07/13/2020] [Indexed: 12/12/2022] Open
Abstract
Ethanol-responsive movement disorders are a group of movement disorders of which clinical manifestation could receive significant improvement after ethanol intake, including essential tremor, myoclonus-dystonia, and some other hyperkinesia. Emerging evidence supports that the sensitivity of these conditions to ethanol might be attributed to similar anatomical targets and pathophysiologic mechanisms. Cerebellum and cerebellum-related networks play a critical role in these diseases. Suppression of inhibitory neurotransmission and hyper-excitability of these regions are the key points for pathogenesis. GABA pathways, the main inhibitory system involved in these regions, were firstly linked to the pathogenesis of these diseases, and GABAA receptors and GABAB receptors play critical roles in ethanol responsiveness. Moreover, impairment of low-voltage-activated calcium channels, which were considered as a contributor to oscillation activity of the nervous system, also participates in the sensitivity of ethanol in relevant disease. Glutamate transporters and receptors that are closely associated with GABA pathways are the action sites for ethanol as well. Accordingly, alternative medicines aiming at these shared mechanisms appeared subsequently to mimic ethanol-like effects with less liability, and some of them have achieved positive effects on different diseases with well-tolerance. However, more clinical trials with a large sample and long-term follow-ups are needed for pragmatic use of these medicines, and further investigations on mechanisms will continue to deepen the understanding of these diseases and also accelerate the discovery of ideal treatment.
Collapse
Affiliation(s)
- Jingying Wu
- Department of Neurology and Institute of Neurology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huidong Tang
- Department of Neurology and Institute of Neurology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shengdi Chen
- Department of Neurology and Institute of Neurology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Cao
- Department of Neurology and Institute of Neurology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
33
|
Atkinson-Clement C, Tarrano C, Porte CA, Wattiez N, Delorme C, McGovern EM, Brochard V, Thobois S, Tranchant C, Grabli D, Degos B, Corvol JC, Pedespan JM, Krystkoviak P, Houeto JL, Degardin A, Defebvre L, Valabregue R, Rosso C, Apartis E, Vidailhet M, Pouget P, Roze E, Worbe Y. Dissociation in reactive and proactive inhibitory control in Myoclonus dystonia. Sci Rep 2020; 10:13933. [PMID: 32811896 PMCID: PMC7434767 DOI: 10.1038/s41598-020-70926-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 07/27/2020] [Indexed: 12/03/2022] Open
Abstract
Myoclonus-dystonia (MD) is a syndrome characterized by myoclonus of subcortical origin and dystonia, frequently associated with psychiatric comorbidities. The motor and psychiatric phenotypes of this syndrome likely result from cortico-striato-thamalo-cerebellar-cortical pathway dysfunction. We hypothesized that reactive and proactive inhibitory control may be altered in these patients. Using the Stop Signal Task, we assessed reactive and proactive inhibitory control in MD patients with (n = 12) and without (n = 21) deep brain stimulation of the globus pallidus interna and compared their performance to matched healthy controls (n = 24). Reactive inhibition was considered as the ability to stop an already initiated action and measured using the stop signal reaction time. Proactive inhibition was assessed through the influence of several consecutive GO or STOP trials on decreased response time or inhibitory process facilitation. The proactive inhibition was solely impaired in unoperated MD patients. Patients with deep brain stimulation showed impairment in reactive inhibition, independent of presence of obsessive–compulsive disorders. This impairment in reactive inhibitory control correlated with intrinsic severity of myoclonus (i.e. pre-operative score). The results point to a dissociation in reactive and proactive inhibitory control in MD patients with and without deep brain stimulation of the globus pallidus interna.
Collapse
Affiliation(s)
- Cyril Atkinson-Clement
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France
| | - Clement Tarrano
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Department of Neurology, CHU Côte de Nacre, Université Caen Normandie, Caen, France
| | - Camille-Albane Porte
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France
| | - Nicolas Wattiez
- Inserm, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Sorbonne University, Paris, France
| | - Cécile Delorme
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Eavan M McGovern
- Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Department of Neurology, St Vincent's University Hospital Dublin, Dublin, Ireland
| | - Vanessa Brochard
- INSERM/APHP, Centre d'Investigation Clinique 1422, Paris, France
| | - Stéphane Thobois
- Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, University of Lyon, Bron, France.,Service de Neurologie C, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - Christine Tranchant
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - David Grabli
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Bertrand Degos
- Department of Neurology, Hôpital Avicennes, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Jean-Christophe Corvol
- Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | | | - Pierre Krystkoviak
- Department of Neurology, Amiens University Medical Center, Amiens, France
| | - Jean-Luc Houeto
- Service de Neurologie, CIC-INSERM 1402, CHU de Poitiers, Poitiers, France
| | - Adrian Degardin
- Department of Neurology, Centre Hospitalier de Tourcoing, Tourcoing, France
| | - Luc Defebvre
- INSERM, U1171-Degenerative and Vascular Cognitive Disorders, CHU Lille, Université de Lille, Lille, France.,Lille Centre of Excellence for Neurodegenerative Diseases (LiCEND), Lille, France
| | - Romain Valabregue
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France.,UMR S 975, CNRS UMR 7225, ICM, Centre de NeuroImagerie de Recherche (CENIR), Sorbonne Université, Paris, France
| | - Charlotte Rosso
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France.,Assistance Publique-Hôpitaux de Paris, Urgences Cérébro-Vasculaires, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Emmanuelle Apartis
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France.,Department of Neurophysiology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marie Vidailhet
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Pierre Pouget
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France
| | - Emmanuel Roze
- Sorbonne University, 75005, Paris, France.,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Yulia Worbe
- Sorbonne University, 75005, Paris, France. .,Inserm U1127, CNRS UMR7225, UM75, ICM, 75013, Paris, France. .,Movement Investigation and Therapeutics Team, Paris, France. .,Department of Neurophysiology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
| |
Collapse
|
34
|
Abstract
Background: Myoclonus-dystonia due to SGCE mutations (OMIM: 159900) most commonly presents during childhood with mainly upper body myoclonus, and mild dystonia affecting the neck and arms. Case reports: Herein, we report patients misdiagnosed during childhood with Tourette syndrome and dyskinetic cerebral palsy, and, during adulthood, found to harbor SGCE frameshift mutations. Discussion: Myoclonus-dystonia may be underdiagnosed due to phenotypic misclassification during childhood. SGCE mutations should be included in the differential diagnosis of childhood movement disorders that ostensibly manifest with tics, myoclonus, or abnormal posturing secondary to dystonia and/or spasticity. Highlights: Due to pleiotropy, variable penetrance, broad differential, and hereditary effects of imprinting, the diagnosis of a disorder of childhood onset, myoclonus-dystonia due to SGCE mutations, may be delayed until adulthood, often compromising appropriate clinical management and genetic counseling.
Collapse
|
35
|
Martins J, Gabriel D, Borges T, Soares G, Temudo T. Child Neurology: Myoclonus-dystonia in Russell-Silver Syndrome: Two syndromes caused by one genetic defect. Neurology 2020; 95:e936-e938. [PMID: 32636321 DOI: 10.1212/wnl.0000000000010076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Joana Martins
- From the Pediatric Neurology Unit (J.M., T.T.) and Pediatric Endocrinology Unit (T.B.), Centro Materno Infantil do Norte; Neurology Department (D.G.); and Medical Genetics Department (G.S.), Centro de Genética Médica Dr. Jacinto Magalhães; Centro Hospitalar Universitário do Porto (J.M., T.B., G.S., T.T.), Porto, Portugal.
| | - Denis Gabriel
- From the Pediatric Neurology Unit (J.M., T.T.) and Pediatric Endocrinology Unit (T.B.), Centro Materno Infantil do Norte; Neurology Department (D.G.); and Medical Genetics Department (G.S.), Centro de Genética Médica Dr. Jacinto Magalhães; Centro Hospitalar Universitário do Porto (J.M., T.B., G.S., T.T.), Porto, Portugal
| | - Teresa Borges
- From the Pediatric Neurology Unit (J.M., T.T.) and Pediatric Endocrinology Unit (T.B.), Centro Materno Infantil do Norte; Neurology Department (D.G.); and Medical Genetics Department (G.S.), Centro de Genética Médica Dr. Jacinto Magalhães; Centro Hospitalar Universitário do Porto (J.M., T.B., G.S., T.T.), Porto, Portugal
| | - Gabriela Soares
- From the Pediatric Neurology Unit (J.M., T.T.) and Pediatric Endocrinology Unit (T.B.), Centro Materno Infantil do Norte; Neurology Department (D.G.); and Medical Genetics Department (G.S.), Centro de Genética Médica Dr. Jacinto Magalhães; Centro Hospitalar Universitário do Porto (J.M., T.B., G.S., T.T.), Porto, Portugal
| | - Teresa Temudo
- From the Pediatric Neurology Unit (J.M., T.T.) and Pediatric Endocrinology Unit (T.B.), Centro Materno Infantil do Norte; Neurology Department (D.G.); and Medical Genetics Department (G.S.), Centro de Genética Médica Dr. Jacinto Magalhães; Centro Hospitalar Universitário do Porto (J.M., T.B., G.S., T.T.), Porto, Portugal
| |
Collapse
|
36
|
Macerollo A, Sajin V, Bonello M, Barghava D, Alusi SH, Eldridge PR, Osman-Farah J. Deep brain stimulation in dystonia: State of art and future directions. J Neurosci Methods 2020; 340:108750. [DOI: 10.1016/j.jneumeth.2020.108750] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 04/19/2020] [Accepted: 04/20/2020] [Indexed: 01/03/2023]
|
37
|
Fearon C, Peall KJ, Vidailhet M, Fasano A. Medical management of myoclonus-dystonia and implications for underlying pathophysiology. Parkinsonism Relat Disord 2020; 77:48-56. [PMID: 32622300 DOI: 10.1016/j.parkreldis.2020.06.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 05/19/2020] [Accepted: 06/16/2020] [Indexed: 12/14/2022]
Abstract
Myoclonus-dystonia is an early onset genetic disorder characterised by subcortical myoclonus and less prominent dystonia. Its primary causative gene is the epsilon-sarcoglycan gene but the syndrome of "myoclonic dystonia" has been shown to be a heterogeneous group of genetic disorders. The underlying pathophysiology of myoclonus-dystonia is incompletely understood, although it may relate to dysfunction of striatal monoamine neurotransmission or disruption of cerebellothalamic networks (possibly via a GABAergic deficit of Purkinje cells). A broad range of oral medical therapies have been used in the treatment of myoclonus-dystonia with a varying response, and limited data relating to efficacy and tolerability, yet this condition responds dramatically to alcohol. Few well conducted randomized controlled trials have been undertaken leading to an empirical ad hoc approach for many patients. We review the current evidence for pharmacological therapies in myoclonus-dystonia, discuss implications for underlying pathogenesis of the condition and propose a treatment algorithm for these patients.
Collapse
Affiliation(s)
- Conor Fearon
- Dublin Neurological Institute at the Mater Misericordiae University Hospital, Dublin, Ireland
| | - Kathryn J Peall
- Neurosciences and Mental Health Research Institute, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, CF24 4HQ, UK
| | - Marie Vidailhet
- AP-HP, Hôpital Salpetriere, Department of Neurology, F-75013, Paris, France; Institut du Cerveau et de la Moelle, ICM, F-75013, Paris, France; INSERM U1127, CNRS UMR 7225, Sorbonne Unversité, F-75013, Paris, France
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital - UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada; Krembil Research Institute, Toronto, Ontario, Canada; Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, ON, Canada.
| |
Collapse
|
38
|
Besa Lehmann V, Rosenbaum M, Bulman DE, Read T, Verhagen Metman L. A Case Report of Myoclonus-Dystonia with Isolated Myoclonus Phenotype and Novel Mutation Successfully Treated with Deep Brain Stimulation. Neurol Ther 2020; 9:187-191. [PMID: 32274660 PMCID: PMC7229070 DOI: 10.1007/s40120-020-00186-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Myoclonus-dystonia is an inherited disorder characterized by a combination of myoclonic jerks and dystonia. Mutations in the epsilon-sarcoglycan gene (SGCE) represent the main known genetic cause. In the last few years, deep brain stimulation (DBS) has shown significant promise in treating these patients. There is only one report in the literature of a patient with positive SGCE mutation and isolated myoclonus phenotype who has been successfully treated with DBS. CASE PRESENTATION We present a case of a 16-year-old young man with a history of quick jerks since childhood. They progressed gradually over the years involving the entire body and interfering with most of his daily activities. He had no dystonia. Genetic testing identified a single base deletion in exon 3 of the SGCE gene, considered very likely pathogenic. After unsuccessfully trying several oral medications, he underwent DBS of the globus pallidus internus (GPi). His Unified Myoclonus Rating Scale score during rest and with action improved by 92.8% and 82.6%, respectively. DISCUSSION The striking effect of DBS on myoclonic jerks confirms the superior benefit of DBS over oral medications. Further study is needed to determine the role of mutation status in predicting DBS response, especially considering that myoclonus-dystonia is genetically heterogeneous. CONCLUSION Our case confirms the poor response to oral medications and supports the use of GPi DBS for patients with genetically confirmed myoclonus-dystonia and isolated-myoclonus phenotype. In addition, our case represents familial myoclonus-dystonia due to a novel SGCE mutation.
Collapse
Affiliation(s)
| | - Marc Rosenbaum
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Dennis E Bulman
- Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada
| | - Tara Read
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Leo Verhagen Metman
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
39
|
Marks WA, Acord S, Bailey L, Honeycutt J. Neuromodulation in Childhood Onset Dystonia: Evolving Role of Deep Brain Stimulation. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2020. [DOI: 10.1007/s40141-020-00258-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
40
|
Artusi CA, Dwivedi A, Romagnolo A, Bortolani S, Marsili L, Imbalzano G, Sturchio A, Keeling EG, Zibetti M, Contarino MF, Fasano A, Tagliati M, Okun MS, Espay AJ, Lopiano L, Merola A. Differential response to pallidal deep brain stimulation among monogenic dystonias: systematic review and meta-analysis. J Neurol Neurosurg Psychiatry 2020; 91:426-433. [PMID: 32079672 DOI: 10.1136/jnnp-2019-322169] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/19/2019] [Accepted: 01/27/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Genetic subtypes of dystonia may respond differentially to deep brain stimulation of the globus pallidus pars interna (GPi DBS). We sought to compare GPi DBS outcomes among the most common monogenic dystonias. METHODS This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses and Meta-analysis of Observational Studies in Epidemiology guidelines. We searched PubMed for studies on genetically confirmed monogenic dystonia treated with GPi DBS documenting pre-surgical and post-surgical assessments using the Burke-Fahn-Marsden Dystonia Rating Scale Motor Score (BFMMS) and Burke-Fahn-Marsden Disability Score (BFMDS). We performed (i) meta-analysis for each gene mutation; (ii) weighted ordinary linear regression analyses to compare BFMMS and BFMDS outcomes between DYT-TOR1A and other monogenic dystonias, adjusting for age and disease duration and (iii) weighted linear regression analysis to estimate the effect of age, sex and disease duration on GPi DBS outcomes. Results were summarised with mean change and 95% CI. RESULTS DYT-TOR1A (68%, 38.4 points; p<0.001), DYT-THAP1 (37% 14.5 points; p<0.001) and NBIA/DYT-PANK2 (27%, 21.4 points; p<0.001) improved in BFMMS; only DYT-TOR1A improved in BFMDS (69%, 9.7 points; p<0.001). Improvement in DYT-TOR1A was significantly greater than in DYT-THAP1 (BFMMS -31%), NBIA/DYT-PANK2 (BFMMS -35%; BFMDS -53%) and CHOR/DYT-ADCY5 (BFMMS -36%; BFMDS -42%). Worse motor outcomes were associated with longer dystonia duration and older age at dystonia onset in DYT-TOR1A, longer dystonia duration in DYT/PARK-TAF1 and younger age at dystonia onset in DYT-SGCE. CONCLUSIONS GPi DBS outcomes vary across monogenic dystonias. These data serve to inform patient selection and prognostic counselling.
Collapse
Affiliation(s)
- Carlo Alberto Artusi
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Alok Dwivedi
- Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Alberto Romagnolo
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Sara Bortolani
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Luca Marsili
- Department of Neurology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Gabriele Imbalzano
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Andrea Sturchio
- Department of Neurology, University of Cincinnati, Cincinnati, Ohio, USA
| | | | - Maurizio Zibetti
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Maria Fiorella Contarino
- Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands.,Leids Universitair Medisch Centrum, Leiden, The Netherlands
| | - Alfonso Fasano
- Morton and Gloria Shulman Movement Disorders Clinic. Division of Neurology, Toronto Western Hospital, Toronto, Ontario, Canada.,Krembil Research Institute, Toronto, Ontario, Canada
| | - Michele Tagliati
- Department of Neurology, Cedars Sinai Medical Center, Los Angeles, California, USA
| | - M S Okun
- Department of Neurology, University of Florida, Gainesville, Florida, USA
| | - Alberto J Espay
- Department of Neurology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Leonardo Lopiano
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Aristide Merola
- Department of Neurology, Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| |
Collapse
|
41
|
Timmers ER, Peall KJ, Dijk JM, Zutt R, Tijssen CC, Bergmans B, Foncke EM, Tijssen MAJ. Natural Course of Myoclonus-Dystonia in Adulthood: Stable Motor Signs But Increased Psychiatry. Mov Disord 2020; 35:1077-1078. [PMID: 32212347 PMCID: PMC7317193 DOI: 10.1002/mds.28033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 02/27/2020] [Indexed: 12/21/2022] Open
Affiliation(s)
- Elze R Timmers
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Kathryn J Peall
- Neuroscience and Mental Health Research Institute, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Joke M Dijk
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Rodi Zutt
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Cees C Tijssen
- Department of Neurology, Elisabeth-TweeSteden Ziekenhuis, Tilburg, the Netherlands
| | - Bruno Bergmans
- Department of Neurology, A.Z. Sint-Jan Brugge-Oostende AV, Bruges, Belgium.,Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Elisabeth M Foncke
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Marina A J Tijssen
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| |
Collapse
|
42
|
Wang X, Yu X. Deep brain stimulation for myoclonus dystonia syndrome: a meta-analysis with individual patient data. Neurosurg Rev 2020; 44:451-462. [PMID: 31900736 DOI: 10.1007/s10143-019-01233-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/26/2019] [Accepted: 12/26/2019] [Indexed: 12/11/2022]
Abstract
Good outcomes have been reported in deep brain stimulation (DBS) for myoclonus-dystonia syndrome (M-D), a heritable disease characterized by childhood-onset myoclonic jerks and dystonia in the upper body. This meta-analysis was to evaluate the clinical outcomes consecutively, compare the stimulation targets, and identify potential prognostic factors. A systematic literature search was performed on PubMed, Web of Science, and Embase. The primary outcome was the percent improvement in Burke-Fahn-Marsden Dystonia Rating Scale movement (BFMDRS-M) scores for dystonia and Unified Myoclonus Rating Scale (UMRS) scores for myoclonus at the last follow-up visit. BFMDRS-disability scores of the patients were also summarized. Pearson correlation analyses were performed to identify the myoclonus and dystonia outcome predictors. Thirty-one studies reporting 71 patients were included. There were significant improvements in BFMDRS-M and BFMDRS-disability scores in each time category and at the last follow-up visit. Mean improvement (%) in UMRS was 79.5 ± 18.2, and 94.1% of the patients showed > 50% improvement in UMRS scores at the last follow-up visit. There was a significant trend toward improved myoclonus outcome with older age at onset and shorter disease duration. Most of the adverse events were mild and transient, and pallidal stimulation seemed to be better with respect to fewer stimulation-induced events. Based on the current data, DBS is effective for even the severe M-D. Surgery at an early stage may predict a better outcome. Although targets do not serve as the outcome predictors, pallidal stimulation may be preferred due to fewer stimulation-induced events.
Collapse
Affiliation(s)
- Xin Wang
- School of Medicine, Nankai University, Tianjin, China
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
| | - Xinguang Yu
- School of Medicine, Nankai University, Tianjin, China.
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China.
| |
Collapse
|
43
|
Myoclonus-dystonia: Distinctive motor and non-motor phenotype from other dystonia syndromes. Parkinsonism Relat Disord 2019; 69:85-90. [DOI: 10.1016/j.parkreldis.2019.10.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 10/05/2019] [Accepted: 10/16/2019] [Indexed: 11/22/2022]
|
44
|
van Coller R, Bardien S, Neethling A, Carr J, Schutte C. A South African family with myoclonus-dystonia syndrome with a novel mutation in the SGCE gene responding to deep brain stimulation. Parkinsonism Relat Disord 2019; 68:63-64. [PMID: 31621622 DOI: 10.1016/j.parkreldis.2019.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/17/2019] [Accepted: 10/02/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Riaan van Coller
- Department of Neurology, University of Pretoria, Pretoria, South Africa.
| | - Soraya Bardien
- Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Annika Neethling
- Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Jonathan Carr
- Division of Neurology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Clara Schutte
- Department of Neurology, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
45
|
van der Veen S, Zutt R, Klein C, Marras C, Berkovic SF, Caviness JN, Shibasaki H, de Koning TJ, Tijssen MAJ. Nomenclature of Genetically Determined Myoclonus Syndromes: Recommendations of the International Parkinson and Movement Disorder Society Task Force. Mov Disord 2019; 34:1602-1613. [PMID: 31584223 PMCID: PMC6899848 DOI: 10.1002/mds.27828] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 07/09/2019] [Accepted: 07/24/2019] [Indexed: 12/12/2022] Open
Abstract
Genetically determined myoclonus disorders are a result of a large number of genes. They have wide clinical variation and no systematic nomenclature. With next-generation sequencing, genetic diagnostics require stringent criteria to associate genes and phenotype. To improve (future) classification and recognition of genetically determined movement disorders, the Movement Disorder Society Task Force for Nomenclature of Genetic Movement Disorders (2012) advocates and renews the naming system of locus symbols. Here, we propose a nomenclature for myoclonus syndromes and related disorders with myoclonic jerks (hyperekplexia and myoclonic epileptic encephalopathies) to guide clinicians in their diagnostic approach to patients with these disorders. Sixty-seven genes were included in the nomenclature. They were divided into 3 subgroups: prominent myoclonus syndromes, 35 genes; prominent myoclonus syndromes combined with another prominent movement disorder, 9 genes; disorders that present usually with other phenotypes but can manifest as a prominent myoclonus syndrome, 23 genes. An additional movement disorder is seen in nearly all myoclonus syndromes: ataxia (n = 41), ataxia and dystonia (n = 6), and dystonia (n = 5). However, no additional movement disorders were seen in related disorders. Cognitive decline and epilepsy are present in the vast majority. The anatomical origin of myoclonus is known in 64% of genetic disorders: cortical (n = 34), noncortical areas (n = 8), and both (n = 1). Cortical myoclonus is commonly seen in association with ataxia, and noncortical myoclonus is often seen with myoclonus-dystonia. This new nomenclature of myoclonus will guide diagnostic testing and phenotype classification. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Sterre van der Veen
- Department of Neurology, University Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Rodi Zutt
- Department of Neurology, University Groningen, University Medical Center Groningen, Groningen, Netherlands.,Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Connie Marras
- Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Samuel F Berkovic
- Epilepsy Research Center, Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria, Australia
| | - John N Caviness
- Department of Neurology, Mayo Clinic, Scottsdale, Arizona, USA
| | | | - Tom J de Koning
- Department of Neurology, University Groningen, University Medical Center Groningen, Groningen, Netherlands.,Department of Genetics, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Marina A J Tijssen
- Department of Neurology, University Groningen, University Medical Center Groningen, Groningen, Netherlands
| |
Collapse
|
46
|
Tarrano C, Wattiez N, Delorme C, McGovern EM, Brochard V, Thobois S, Tranchant C, Grabli D, Degos B, Corvol J, Pedespan J, Krystkoviak P, Houeto J, Degardin A, Defebvre L, Valabrègue R, Vidailhet M, Pouget P, Roze E, Worbe Y. Visual Sensory Processing is Altered in Myoclonus Dystonia. Mov Disord 2019; 35:151-160. [DOI: 10.1002/mds.27857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/04/2019] [Accepted: 08/08/2019] [Indexed: 11/12/2022] Open
Affiliation(s)
- Clément Tarrano
- Sorbonne Université Paris, France; Inserm U1127, CNRS UMR 7225, UM 75, ICM Paris France
- Assistance Publique‐Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié‐Salpêtrière, Paris, France; Department of Neurology Groupe Hospitalier Pitié‐Salpêtrière Paris France
- Department of Neurology CHU Côte de Nacre, Université Caen Normandie Caen France
| | - Nicolas Wattiez
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique Paris France
| | - Cécile Delorme
- Sorbonne Université Paris, France; Inserm U1127, CNRS UMR 7225, UM 75, ICM Paris France
- Assistance Publique‐Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié‐Salpêtrière, Paris, France; Department of Neurology Groupe Hospitalier Pitié‐Salpêtrière Paris France
| | - Eavan M. McGovern
- Assistance Publique‐Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié‐Salpêtrière, Paris, France; Department of Neurology Groupe Hospitalier Pitié‐Salpêtrière Paris France
- Department of Neurology St Vincent's University Hospital Dublin Dublin Ireland
| | | | - Stéphane Thobois
- University of Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Bron, France; Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C Bron France
| | - Christine Tranchant
- Service de Neurologie Hôpitaux Universitaires de Strasbourg, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM‐U964/CNRS‐UMR7104/Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg Strasbourg France
| | - David Grabli
- Sorbonne Université Paris, France; Inserm U1127, CNRS UMR 7225, UM 75, ICM Paris France
- Assistance Publique‐Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié‐Salpêtrière, Paris, France; Department of Neurology Groupe Hospitalier Pitié‐Salpêtrière Paris France
| | - Bertrand Degos
- Assistance Publique‐Hôpitaux de Paris, Department of Neurology Hôpital Avicennes Bobigny France
| | - Jean‐Christophe Corvol
- Assistance Publique‐Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié‐Salpêtrière, Paris, France; Department of Neurology Groupe Hospitalier Pitié‐Salpêtrière Paris France
| | | | | | - Jean‐Luc Houeto
- Service de Neurologie, CIC‐INSERM 1402, CHU de Poitiers Poitiers France
| | - Adrian Degardin
- Department of Neurology Centre hospitalier de Tourcoing Tourcoing France
| | - Luc Defebvre
- Université de Lille, CHU Lille, INSERM, U1171–Degenerative & Vascular Cognitive Disorders, Lille, France; Lille Centre of Excellence for Neurodegenerative Diseases (LiCEND) Lille France
| | - Romain Valabrègue
- Sorbonne Université Paris, France; Inserm U1127, CNRS UMR 7225, UM 75, ICM Paris France
- Centre de NeuroImagerie de Recherche (CENIR) Sorbonne Université, UMR S 975, CNRS UMR 7225, ICM Paris France
| | - Marie Vidailhet
- Sorbonne Université Paris, France; Inserm U1127, CNRS UMR 7225, UM 75, ICM Paris France
- Assistance Publique‐Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié‐Salpêtrière, Paris, France; Department of Neurology Groupe Hospitalier Pitié‐Salpêtrière Paris France
| | - Pierre Pouget
- Sorbonne Université Paris, France; Inserm U1127, CNRS UMR 7225, UM 75, ICM Paris France
| | - Emmanuel Roze
- Sorbonne Université Paris, France; Inserm U1127, CNRS UMR 7225, UM 75, ICM Paris France
- Assistance Publique‐Hôpitaux de Paris, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié‐Salpêtrière, Paris, France; Department of Neurology Groupe Hospitalier Pitié‐Salpêtrière Paris France
| | - Yulia Worbe
- Sorbonne Université Paris, France; Inserm U1127, CNRS UMR 7225, UM 75, ICM Paris France
- Department of Neurophysiology Saint‐Antoine Hospital, Assistance Publique‐Hôpitaux de Paris Paris France
| |
Collapse
|
47
|
Menozzi E, Balint B, Latorre A, Valente EM, Rothwell JC, Bhatia KP. Twenty years on: Myoclonus-dystonia and ε-sarcoglycan - neurodevelopment, channel, and signaling dysfunction. Mov Disord 2019; 34:1588-1601. [PMID: 31449710 DOI: 10.1002/mds.27822] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/19/2019] [Accepted: 07/14/2019] [Indexed: 12/26/2022] Open
Abstract
Myoclonus-dystonia is a clinical syndrome characterized by a typical childhood onset of myoclonic jerks and dystonia involving the neck, trunk, and upper limbs. Psychiatric symptomatology, namely, alcohol dependence and phobic and obsessive-compulsive disorder, is also part of the clinical picture. Zonisamide has demonstrated effectiveness at reducing both myoclonus and dystonia, and deep brain stimulation seems to be an effective and long-lasting therapeutic option for medication-refractory cases. In a subset of patients, myoclonus-dystonia is associated with pathogenic variants in the epsilon-sarcoglycan gene, located on chromosome 7q21, and up to now, more than 100 different pathogenic variants of the epsilon-sarcoglycan gene have been described. In a few families with a clinical phenotype resembling myoclonus-dystonia associated with distinct clinical features, variants have been identified in genes involved in novel pathways such as calcium channel regulation and neurodevelopment. Because of phenotypic similarities with epsilon-sarcoglycan gene-related myoclonus-dystonia, these conditions can be collectively classified as "myoclonus-dystonia syndromes." In the present article, we present myoclonus-dystonia caused by epsilon-sarcoglycan gene mutations, with a focus on genetics and underlying disease mechanisms. Second, we review those conditions falling within the spectrum of myoclonus-dystonia syndromes, highlighting their genetic background and involved pathways. Finally, we critically discuss the normal and pathological function of the epsilon-sarcoglycan gene and its product, suggesting a role in the stabilization of the dopaminergic membrane via regulation of calcium homeostasis and in the neurodevelopmental process involving the cerebello-thalamo-pallido-cortical network. © 2019 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Elisa Menozzi
- Department of Biomedical, Metabolic and Neural Sciences, University-Hospital of Modena and Reggio Emilia, Modena, Italy.,Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Bettina Balint
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.,Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | - Anna Latorre
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Enza Maria Valente
- Department of Molecular Medicine, University of Pavia, Pavia, Italy.,Neurogenetics Unit, IRCCS Santa Lucia Foundation, Rome, Italy
| | - John C Rothwell
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| |
Collapse
|
48
|
Haeri G, Shahidi G, Fasano A, Rohani M. Gait Impairment in Myoclonus-Dystonia (DYT- SGCE). TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2019; 9:tre-09-656. [PMID: 31413899 PMCID: PMC6691910 DOI: 10.7916/tohm.v0.656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 06/25/2019] [Indexed: 12/01/2022]
Abstract
Background Myoclonus–dystonia usually presents variable combination of myoclonus and dystonia mainly affecting the neck and arms, but leg involvement, especially as the presenting sign, is not common. Case report A 29-year-old lady with a heterozygous mutation in Epsilon-sarcoglycan (SGCE) gene is presented with rapid jerks of the right leg interfering with walking. She has also manifested dystonic posture and jerks of the trunk and proximal upper limbs. Discussion Although it is not typical, leg involvement could be a manifestation of myoclonus–dystonia either at presentation or during disease progression.
Collapse
Affiliation(s)
- Ghazal Haeri
- Department of Neurology, Hazrat Rasool Hospital, Iran University of Medical Sciences, Tehran, IR
| | - Gholamali Shahidi
- Department of Neurology, Hazrat Rasool Hospital, Iran University of Medical Sciences, Tehran, IR
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, CA.,Division of Neurology, University of Toronto, Toronto, Ontario, CA.,Krembil Brain Institute, Toronto, Ontario, CA
| | - Mohammad Rohani
- Department of Neurology, Hazrat Rasool Hospital, Iran University of Medical Sciences, Tehran, IR
| |
Collapse
|
49
|
Abstract
PURPOSE OF REVIEW This article provides an overview of the clinical features and disorders associated with movement disorders in childhood. This article discusses movement disorder phenomena and their clinical presentation in infants and children and presents a diagnostic approach to suspected genetic disorders with a focus on treatable conditions. RECENT FINDINGS Technologic advances in molecular genetic testing over the past decade continue to lead to the discovery of new diseases. This article discusses the clinical presentation and early experience with treatment for several recently described genetic forms of infantile-onset and childhood-onset dystonia and chorea. SUMMARY The clinical spectrum of pediatric movement disorders is broad and heterogeneous, ranging from acute or transient self-limited conditions to conditions that cause profound lifelong motor disability. Most movement disorders in childhood are chronic, and the large number of rare, genetic conditions associated with pediatric movement disorders can pose a significant diagnostic challenge. Recognition of distinctive diagnostic clues in the history and examination can facilitate the diagnosis of potentially treatable disorders.
Collapse
|
50
|
Delamarre A, Chelly J, Guehl D, Drouot N, Tranchant C, Anheim M, Burbaud P. Novel anoctamin-3 missense mutation responsible for early-onset myoclonic dystonia. Parkinsonism Relat Disord 2019; 64:346-348. [DOI: 10.1016/j.parkreldis.2019.04.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/15/2019] [Accepted: 04/25/2019] [Indexed: 01/07/2023]
|