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Sahib A, Choudhury C. Ears of the lynx: A neuroradiological totemism. J Neurosci Rural Pract 2024; 15:402-403. [PMID: 38746501 PMCID: PMC11090552 DOI: 10.25259/jnrp_428_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/02/2024] [Indexed: 05/16/2024] Open
Affiliation(s)
- Akhil Sahib
- Department of Neurology, Gobind Ballabh Pant Institute of Post Graduate Medical Education and Research and Maulana Azad Medical College, Delhi, India
| | - Cankatika Choudhury
- Department of Neurology, Gobind Ballabh Pant Institute of Post Graduate Medical Education and Research and Maulana Azad Medical College, Delhi, India
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2
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Lim JH, Kang HM, Kim DH, Jeong B, Lee DY, Lee JR, Baek JY, Cho HS, Son MY, Kim DS, Kim NS, Jung CR. ARL6IP1 gene delivery reduces neuroinflammation and neurodegenerative pathology in hereditary spastic paraplegia model. J Exp Med 2024; 221:e20230367. [PMID: 37934410 PMCID: PMC10630151 DOI: 10.1084/jem.20230367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/24/2023] [Accepted: 09/25/2023] [Indexed: 11/08/2023] Open
Abstract
ARL6IP1 is implicated in hereditary spastic paraplegia (HSP), but the specific pathogenic mechanism leading to neurodegeneration has not been elucidated. Here, we clarified the molecular mechanism of ARL6IP1 in HSP using in vitro and in vivo models. The Arl6ip1 knockout (KO) mouse model was generated to represent the clinically involved frameshift mutations and mimicked the HSP phenotypes. Notably, in vivo brain histopathological analysis revealed demyelination of the axon and neuroinflammation in the white matter, including the corticospinal tract. In in vitro experiments, ARL6IP1 silencing caused cell death during neuronal differentiation and mitochondrial dysfunction by dysregulated autophagy. ARL6IP1 localized on mitochondria-associated membranes (MAMs) to maintain endoplasmic reticulum and mitochondrial homeostasis via direct interaction with LC3B and BCl2L13. ARL6IP1 played a crucial role in connecting the endoplasmic reticulum and mitochondria as a member of MAMs. ARL6IP1 gene therapy reduced HSP phenotypes and restored pathophysiological changes in the Arl6ip1 KO model. Our results established that ARL6IP1 could be a potential target for HSP gene therapy.
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Affiliation(s)
- Jung Hwa Lim
- Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
- Department of Functional Genomics, Korea University of Science and Technology, Daejeon, Republic of Korea
| | - Hyun Mi Kang
- Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
- Department of Functional Genomics, Korea University of Science and Technology, Daejeon, Republic of Korea
| | - Dae Hun Kim
- Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
- Department of Functional Genomics, Korea University of Science and Technology, Daejeon, Republic of Korea
| | - Bohyeon Jeong
- Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
| | - Da Yong Lee
- Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
- Department of Functional Genomics, Korea University of Science and Technology, Daejeon, Republic of Korea
| | - Jae-Ran Lee
- Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
- Department of Functional Genomics, Korea University of Science and Technology, Daejeon, Republic of Korea
| | - Jeong Yeob Baek
- Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
| | - Hyun-Soo Cho
- Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
- Department of Functional Genomics, Korea University of Science and Technology, Daejeon, Republic of Korea
| | - Mi-Young Son
- Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
- Department of Functional Genomics, Korea University of Science and Technology, Daejeon, Republic of Korea
| | - Dae Soo Kim
- Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
- Department of Functional Genomics, Korea University of Science and Technology, Daejeon, Republic of Korea
| | - Nam-Soon Kim
- Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
- Department of Functional Genomics, Korea University of Science and Technology, Daejeon, Republic of Korea
| | - Cho-Rok Jung
- Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
- Department of Functional Genomics, Korea University of Science and Technology, Daejeon, Republic of Korea
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3
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Kang YR, Nam TS, Kim JM, Kang KW, Choi SM, Lee SH, Kim BC, Kim MK. Clinical analysis in patients with SPG11 hereditary spastic paraplegia. Front Neurol 2023; 14:1198728. [PMID: 37396771 PMCID: PMC10310533 DOI: 10.3389/fneur.2023.1198728] [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] [Received: 04/02/2023] [Accepted: 05/26/2023] [Indexed: 07/04/2023] Open
Abstract
Background To analyze the clinical phenotype of hereditary spastic paraplegia (HSP) caused by SPG11 mutations (SPG11-HSP). Methods Among the 17 patients with sporadic HSP who performed whole exome sequencing analysis, six were diagnosed with SPG11-HSP. The clinical and radiologic findings and the results of the electrodiagnostic and neuropsychologic tests were reviewed retrospectively. Results The median age at onset was 16.5 years (range, 13-38 years). Progressive spastic paraparesis was a core feature, and the median spastic paraplegia rating scale score was 24/52 (range, 16-31 points). Additional major symptoms were pseudobulbar dysarthria, intellectual disability, bladder dysfunction, and being overweight. Minor symptoms included upper limbs rigidity and sensory axonopathy. The median body mass index was 26.2 kg/m2 (range, 25.2-32.3 kg/m2). The thin corpus callosum (TCC) was predominant at the rostral body or anterior midbody, and the ears of the lynx sign was seen in all. The follow-up MRI showed the worsening of periventricular white matter (PVWM) signal abnormalities with ventricular widening or the extension of the TCC. Motor evoked potentials (MEP) to the lower limbs showed an absent central motor conduction time (CMCT) in all subjects. The upper limb CMCT was initially absent in three subjects, although it became abnormal in all at the follow-up. The mini-mental state examination median score was 27/30 (range, 26-28) with selective impairment of the attention/calculation domain. The median score of the full-scale intelligence quotient was 48 (range, 42-72) on the Wechsler Adult Intelligence Scale test. Conclusion Attention/calculation deficits and being overweight as well as pseudobulbar dysarthria were common additional symptoms in patients with SPG11-HSP. The rostral body and anterior midbody of the corpus callosum were preferentially thinned, especially in the early stage of the disease. The TCC, PVWM signal changes, and MEP abnormality worsened as the disease progressed.
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Affiliation(s)
- You-Ri Kang
- Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Tai-Seung Nam
- Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Myung Kim
- Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Kyung Wook Kang
- Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seong-Min Choi
- Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seung-Han Lee
- Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Byeong C. Kim
- Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Myeong-Kyu Kim
- Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea
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4
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Azarvand Damirichi M, Karimi Moridani M, Mohammadi SE. Relationship between white matter alterations and contamination subgroup in obsessive compulsive disorder: A
diffusion tensor imaging
study. Hum Brain Mapp 2023; 44:3302-3310. [PMID: 36971658 PMCID: PMC10171548 DOI: 10.1002/hbm.26282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 01/27/2023] [Accepted: 03/06/2023] [Indexed: 03/29/2023] Open
Abstract
Approximately 2%-3% of the world population suffers from obsessive-compulsive disorder (OCD). Several brain regions have been involved in the pathophysiology of OCD, but brain volumes in OCD may vary depending on specific OCD symptom dimensions. The study aims to explore how white matter structure changes in particular OCD symptom dimensions. Prior studies attempt to find the correlation between Y-BOCS scores and OCD patients. However, in this study, we separated the contamination subgroup in OCD and compared directly to healthy control to find regions that exactly related to contamination symptoms. To evaluate structural alterations, diffusion tensor imaging was acquired from 30 OCD patients and 34 demographically matched healthy controls. Data were processed using tract-based spatial statistics (TBSS) analysis. First, by comparing all OCD to healthy controls, significant fractional anisotropy (FA) decreased in the right anterior thalamic radiation, right corticospinal tract, and forceps minor observed. Then by comparing the contamination subgroup to healthy control, FA decreases in the forceps minor region. Consequently, forceps minor plays a central role in the pathophysiology of contamination behaviors. Finally, other subgroups were compared to healthy control and discovered that FA in the right corticospinal tract and right anterior thalamic radiation is reduced.
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5
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Duan JQ, Liu H, Wu JQ. Case report: Novel mutations in the SPG11 gene in a case of autosomal recessive hereditary spastic paraplegia with a thin corpus callosum. Front Integr Neurosci 2023; 17:1117617. [PMID: 37035454 PMCID: PMC10079982 DOI: 10.3389/fnint.2023.1117617] [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] [Received: 12/06/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
A 24-year-old man presented with insidious onset progressive gait disturbance and was finally diagnosed with autosomal recessive hereditary spastic paraplegia. Two novel mutations, including a frameshift mutation (c.5687_5691del) and a non-sense mutation (c.751C>T), were identified in the SPG11 gene of the patient through whole genome sequencing. The frameshift mutation of c.5687_5691del leads to a change in amino acid synthesis beginning with amino acid No. 1896 arginine and terminating at the 8th amino acid after the change (p. Arg1896MetfsTer8). The non-sense mutation (c.751C>T) causes the conversion of codon 251st encoding the amino acid Gln into a stop codon (p. Gln251Ter), resulting in premature termination of peptide synthesis. Although confirmation of compound-heterozygosity could not be performed, our findings enriched the phenotypic spectrum of SPG11 mutations related to hereditary spastic paraplegia.
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Affiliation(s)
- Ji-Qing Duan
- Department of Intensive Care Unit, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Hui Liu
- Department of Intensive Care Unit, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Jia-Qiao Wu
- Department of Anesthesia, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- *Correspondence: Jia-Qiao Wu
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6
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Lan MY, Lu CS, Wu SL, Chen YF, Sung YF, Tu MC, Chang YY. Clinical and genetic characterization of a Taiwanese cohort with spastic paraparesis combined with cerebellar involvement. Front Neurol 2022; 13:1005670. [PMID: 36247768 PMCID: PMC9563621 DOI: 10.3389/fneur.2022.1005670] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/12/2022] [Indexed: 11/17/2022] Open
Abstract
Hereditary spastic paraplegias (HSPs) are a heterogeneous group of neurodegenerative disorders clinically characterized by progressive lower-limb spasticity. Cerebellar ataxia commonly co-occurs with complicated HSPs. HSP with concurrent cerebellar ataxia has significant clinical and genetic overlaps with hereditary cerebellar ataxia (HCA) and other inherited neurological diseases, adding to the challenge of planning genetic testing for the disease. In this study, we characterized clinical features of a cohort of 24 patients (male/female: 15/9) from 22 families who presented spastic paraparesis combined with cerebellar involvement, with a median disease onset age 20.5 (range 5–53) years. Aside from the core phenotype, 18 (75%) patients had additional neuropsychiatric and systemic manifestations. A stepwise genetic testing strategy stratified by mode of inheritance, distinct neuroimaging features (e.g., thin corpus callosum), population-specific prevalence and whole-exome sequencing was utilized to investigate the genetic etiology. Causative mutations in up to 10 genes traditionally related to HSP, HCA and other neurogenetic diseases (autosomal recessive spastic ataxia of Charlevoix-Saguenay, neurodegeneration with brain iron accumulation, and progressive encephalopathy with brain atrophy and thin corpus callosum) were detected in 16 (73%) of the 22 pedigrees. Our study revealed the genetic complexity of HSP combined with cerebellar involvement. In contrast to the marked genetic diversity, the functions of the causative genes are restricted to a limited number of physiological themes. The functional overlap might reflect common underlying pathogenic mechanisms, to which the corticospinal tract and cerebellar neuron circuits may be especially vulnerable.
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Affiliation(s)
- Min-Yu Lan
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Center for Parkinson's Disease, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Center for Mitochondrial Research and Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chin-Song Lu
- Professor Lu Neurological Clinic, Taoyuan, Taiwan
- Department of Neurology, Landseed International Hospital, Taoyuan, Taiwan
| | - Shey-Lin Wu
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
- Department of Electrical Engineering, National Changhua University of Education, Changhua, Taiwan
| | - Ying-Fa Chen
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Center for Parkinson's Disease, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yueh-Feng Sung
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Min-Chien Tu
- Department of Neurology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
- Department of Neurology, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yung-Yee Chang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Center for Parkinson's Disease, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- *Correspondence: Yung-Yee Chang
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7
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Rattay TW, Schöls L, Zeltner L, Rohrschneider WK, Ernemann U, Lindig T. "Ears of the lynx" sign and thin corpus callosum on MRI in heterozygous SPG11 mutation carriers. J Neurol 2022; 269:6148-6151. [PMID: 35614164 DOI: 10.1007/s00415-022-11198-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Tim W Rattay
- Department of Neurodegenerative Diseases, Center for Neurology and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany.,German Center of Neurodegenerative Diseases (DZNE), Tübingen, Germany.,Center for Rare Diseases (ZSE), University of Tübingen, Tübingen, Germany
| | - Ludger Schöls
- Department of Neurodegenerative Diseases, Center for Neurology and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany. .,German Center of Neurodegenerative Diseases (DZNE), Tübingen, Germany. .,Center for Rare Diseases (ZSE), University of Tübingen, Tübingen, Germany.
| | - Lena Zeltner
- Department of Neurodegenerative Diseases, Center for Neurology and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany.,Center for Rare Diseases (ZSE), University of Tübingen, Tübingen, Germany
| | | | - Ulrike Ernemann
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Tobias Lindig
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
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8
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Singh S, Israrahmed A, Mall RV, Singh V. 'Ears of the Lynx' sign: an important and useful MRI clue for diagnosis of hereditary spastic paraplegia (HSP) caused by mutation in SPG 15 gene. BMJ Case Rep 2021; 14:e242275. [PMID: 34598955 PMCID: PMC8488712 DOI: 10.1136/bcr-2021-242275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2021] [Indexed: 11/08/2022] Open
Affiliation(s)
- Somesh Singh
- Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Amrin Israrahmed
- Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Rana Vishwadeep Mall
- Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Vivek Singh
- Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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9
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Pozner T, Regensburger M, Engelhorn T, Winkler J, Winner B. Janus-faced spatacsin (SPG11): involvement in neurodevelopment and multisystem neurodegeneration. Brain 2020; 143:2369-2379. [PMID: 32355960 PMCID: PMC7447516 DOI: 10.1093/brain/awaa099] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/12/2020] [Accepted: 02/05/2020] [Indexed: 12/11/2022] Open
Abstract
Hereditary spastic paraplegia (HSP) is a heterogeneous group of rare motor neuron disorders characterized by progressive weakness and spasticity of the lower limbs. HSP type 11 (SPG11-HSP) is linked to pathogenic variants in the SPG11 gene and it represents the most frequent form of complex autosomal recessive HSP. The majority of SPG11-HSP patients exhibit additional neurological symptoms such as cognitive decline, thin corpus callosum, and peripheral neuropathy. Yet, the mechanisms of SPG11-linked spectrum diseases are largely unknown. Recent findings indicate that spatacsin, the 280 kDa protein encoded by SPG11, may impact the autophagy-lysosomal machinery. In this update, we summarize the current knowledge of SPG11-HSP. In addition to clinical symptoms and differential diagnosis, our work aims to link the different clinical manifestations with the respective structural abnormalities and cellular in vitro phenotypes. Moreover, we describe the impact of localization and function of spatacsin in different neuronal systems. Ultimately, we propose a model in which spatacsin bridges between neurodevelopmental and neurodegenerative phenotypes of SPG11-linked disorders.
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Affiliation(s)
- Tatyana Pozner
- Department of Stem Cell Biology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Martin Regensburger
- Department of Stem Cell Biology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany.,Department of Neurology, FAU Erlangen-Nürnberg, Erlangen, Germany.,Department of Molecular Neurology, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Tobias Engelhorn
- Department of Neuroradiology, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Jürgen Winkler
- Department of Molecular Neurology, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Beate Winner
- Department of Stem Cell Biology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany.,Center of Rare Diseases Erlangen (ZSEER), FAU Erlangen-Nürnberg, Erlangen, Germany
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10
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Liang S, Zhang J, Zhang Q, Li L, Zhang Y, Jin T, Zhang B, He X, Chen L, Tao J, Li Z, Liu W, Chen L. Longitudinal tracing of white matter integrity on diffusion tensor imaging in the chronic cerebral ischemia and acute cerebral ischemia. Brain Res Bull 2020; 154:135-141. [DOI: 10.1016/j.brainresbull.2019.10.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/18/2019] [Accepted: 10/30/2019] [Indexed: 10/25/2022]
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Abstract
PURPOSE OF REVIEW Hereditary myelopathies are very diverse genetic disorders, and many of them represent a widespread neurodegenerative process rather than isolated spinal cord dysfunction. This article reviews various types of inherited myelopathies, with emphasis on hereditary spastic paraplegias and spastic ataxias. RECENT FINDINGS The ever-growing number of myelopathy-causing genes and broadening of phenotype-genotype correlations makes the molecular diagnosis of inherited myelopathies a daunting task. This article emphasizes the main phenotypic clusters among inherited myelopathies that can facilitate the diagnostic process. This article focuses on newly identified genetic causes and the most important identifying clinical features that can aid the diagnosis, including the presence of a characteristic age of onset and additional neurologic signs such as leukodystrophy, thin corpus callosum, or amyotrophy. SUMMARY The exclusion of potentially treatable causes of myelopathy remains the most important diagnostic step. Syndromic diagnosis can be supported by molecular diagnosis, but the genetic diagnosis at present does not change the management. Moreover, a negative genetic test does not exclude the diagnosis of a hereditary myelopathy because comprehensive molecular testing is not yet available, and many disease-causing genes remain unknown.
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12
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Wagner F, Titelbaum DS, Engisch R, Coskun EK, Waugh JL. Subtle Imaging Findings Aid the Diagnosis of Adolescent Hereditary Spastic Paraplegia and Ataxia. Clin Neuroradiol 2019; 29:215-221. [PMID: 29379980 DOI: 10.1007/s00062-018-0665-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 01/11/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE Hereditary spastic paraplegia (HSP) and hereditary spastic ataxia (HSA) are a heterogeneous group of genetic disorders characterized by progressive lower limb spasticity resulting from pyramidal tract dysfunction. By identifying critical imaging findings within the clinical context of spasticity, radiologists are uniquely positioned to recommend specific genetic testing, and thus facilitate diagnosis. METHODS We present two examples of HSP and HSA that had gone clinically unrecognized for years, and in which magnetic resonance imaging played a critical role in the diagnosis. RESULTS Radiologists' awareness of HSP and HSA, combined with a critical review of the clinical history and characteristic imaging findings led to specific genetic testing and a definitive diagnosis. CONCLUSION Awareness of HSP and HSA among radiologists will expedite more accurate diagnosis, explanation of patient symptoms, recommendation for syndrome-specific treatment, and family planning considerations.
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Affiliation(s)
- Franca Wagner
- Department of Diagnostic and Interventional Neuroradiology, University Hospital of Bern, University of Bern, Bern, Switzerland.
| | | | - Renate Engisch
- Department of Radiology, Luzerner Kantonsspital, Lucerne, Switzerland
| | | | - Jeff L Waugh
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
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13
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Mulroy E, Balint B, Adams ME, Campion T, Merello M, Bhatia KP. Animals in the Brain. Mov Disord Clin Pract 2019; 6:189-198. [PMID: 30949548 DOI: 10.1002/mdc3.12734] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 01/18/2019] [Accepted: 01/23/2019] [Indexed: 11/10/2022] Open
Abstract
Background Pareidolic associations are commonly used in medical education to enhance perception of radiological abnormalities. A number of animal-inspired neuroradiological pareidolias have been defined which should alert clinicians to specific movement disorder diagnoses. Methods A review of the published literature detailing neuroradiological abnormalities in movement disorder syndromes was conducted, looking specifically for established animal-inspired pareidolic associations. Results A number of animal-inspired neuroradiological patterns with specific movement disorder associations have been defined. These include eye of the tiger sign, face of the panda sign, swallow tail sign, hummingbird sign, Mickey Mouse sign, ears of the lynx sign, dragonfly cerebellum, tadpole sign, tigroid/leopard skin sign, and bat wing sign. Conclusion Pareidolias represent a quick and easy way of enhancing perception, thereby improving the efficiency and accuracy of image analysis. Movement disorder physicians should keep in mind these associations, given that they will likely facilitate scan analysis.
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Affiliation(s)
- Eoin Mulroy
- Department of Clinical and Movement Neurosciences National Hospital for Neurology and Neurosurgery Queen Square London United Kingdom
| | - Bettina Balint
- Department of Clinical and Movement Neurosciences National Hospital for Neurology and Neurosurgery Queen Square London United Kingdom.,Department of Neurology University Hospital Heidelberg Germany
| | - Matthew E Adams
- Department of Neuroradiology National Hospital for Neurology and Neurosurgery Queen Square London United Kingdom
| | - Tom Campion
- Department of Neuroradiology National Hospital for Neurology and Neurosurgery Queen Square London United Kingdom
| | - Marcelo Merello
- Movement Disorders Section, Neuroscience Department Raul Carrea Institute for Neurological Research (FLENI) Buenos Aires Argentina.,Argentine National Scientific and Technological Research Council (CONICET) Buenos Aires Argentina
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences National Hospital for Neurology and Neurosurgery Queen Square London United Kingdom
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14
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Rudenskaya GE, Kadnikova VA, Ryzhkova OP. [Common forms of hereditary spastic paraplegias]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:94-104. [PMID: 30874534 DOI: 10.17116/jnevro201911902194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
A group of hereditary spastic paraplegias includes about 80 spastic paraplegia genes (SPG): forms with identified (almost 70) or only mapped (about 10) genes. Methods of next generation sequencing (NGS), along with new SPG discovering, modify knowledge about earlier delineated SPG. Clinical and genetic characteristics of common autosomal dominant (SPG4, SPG3, SPG31) and autosomal recessive (SPG11, SPG7, SPG15) forms are presented.
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Affiliation(s)
| | - V A Kadnikova
- Research Centre for Medical Genetics, Moscow, Russia
| | - O P Ryzhkova
- Research Centre for Medical Genetics, Moscow, Russia
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15
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Ortega RPM, Rosemberg S. Hereditary spastic paraplegia: a clinical and epidemiological study of a Brazilian pediatric population. ARQUIVOS DE NEURO-PSIQUIATRIA 2019; 77:10-18. [PMID: 30758437 DOI: 10.1590/0004-282x20180153] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 10/15/2018] [Indexed: 11/22/2022]
Abstract
AIMS To investigate hereditary spastic paraplegia (HSP) in a pediatric Brazilian sample. METHODS Epidemiological, clinical, radiological and laboratory data were analyzed in 35 patients. RESULTS Simple HSP (HSP-S) was detected in 12 patients, and complicated HSP (HSP-C) was detected in 23 patients. The mean age of onset of symptoms was 2.9 years in HSP-S and 1.6 years in HSP-C (p = 0.023). The disease was more severe in HSP-C. There were no differences in sex, ethnic background, or family history between groups. Intellectual disability was the most frequent finding associated with HSP-C. Peripheral axonal neuropathy was found in three patients. In the HSP-C group, MRI was abnormal in 13 patients. The MRI abnormalities included nonspecific white matter lesions, cerebellar atrophy, thinning of the corpus callosum and the "ear of the lynx sign". CONCLUSIONS In children with spastic paraplegia, HSP must be considered whenever similar pathologies, mainly diplegic cerebral palsy, are ruled out.
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Affiliation(s)
| | - Sérgio Rosemberg
- Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo SP, Brasil.,Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo SP, Brasil
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16
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da Graça FF, de Rezende TJR, Vasconcellos LFR, Pedroso JL, Barsottini OGP, França MC. Neuroimaging in Hereditary Spastic Paraplegias: Current Use and Future Perspectives. Front Neurol 2019; 9:1117. [PMID: 30713518 PMCID: PMC6346681 DOI: 10.3389/fneur.2018.01117] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 12/05/2018] [Indexed: 12/13/2022] Open
Abstract
Hereditary spastic paraplegias (HSP) are a large group of genetic diseases characterized by progressive degeneration of the long tracts of the spinal cord, namely the corticospinal tracts and dorsal columns. Genotypic and phenotypic heterogeneity is a hallmark of this group of diseases, which makes proper diagnosis and management often challenging. In this scenario, magnetic resonance imaging (MRI) emerges as a valuable tool to assist in the exclusion of mimicking disorders and in the detailed phenotypic characterization. Some neuroradiological signs have been reported in specific subtypes of HSP and are therefore helpful to guide genetic testing/interpretation. In addition, advanced MRI techniques enable detection of subtle structural abnormalities not visible on routine scans in the spinal cord and brain of subjects with HSP. In particular, quantitative spinal cord morphometry and diffusion tensor imaging look promising tools to uncover the pathophysiology and to track progression of these diseases. In the current review article, we discuss the current use and future perspectives of MRI in the context of HSP.
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Affiliation(s)
- Felipe Franco da Graça
- Department of Neurology and Neuroimaging Laboratory, University of Campinas (UNICAMP), Campinas, Brazil
| | | | | | - José Luiz Pedroso
- Department of Neurology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Marcondes C França
- Department of Neurology and Neuroimaging Laboratory, University of Campinas (UNICAMP), Campinas, Brazil
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17
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Pascual B, de Bot ST, Daniels MR, França MC, Toro C, Riverol M, Hedera P, Bassi MT, Bresolin N, van de Warrenburg BP, Kremer B, Nicolai J, Charles P, Xu J, Singh S, Patronas NJ, Fung SH, Gregory MD, Masdeu JC. "Ears of the Lynx" MRI Sign Is Associated with SPG11 and SPG15 Hereditary Spastic Paraplegia. AJNR Am J Neuroradiol 2019; 40:199-203. [PMID: 30606727 DOI: 10.3174/ajnr.a5935] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/30/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND PURPOSE The "ears of the lynx" MR imaging sign has been described in case reports of hereditary spastic paraplegia with a thin corpus callosum, mostly associated with mutations in the spatacsin vesicle trafficking associated gene, causing Spastic Paraplegia type 11 (SPG11). This sign corresponds to long T1 and T2 values in the forceps minor of the corpus callosum, which appears hyperintense on FLAIR and hypointense on T1-weighted images. Our purpose was to determine the sensitivity and specificity of the ears of the lynx MR imaging sign for genetic cases compared with common potential mimics. MATERIALS AND METHODS Four independent raters, blinded to the diagnosis, determined whether the ears of the lynx sign was present in each of a set of 204 single anonymized FLAIR and T1-weighted MR images from 34 patients with causal mutations associated with SPG11 or Spastic Paraplegia type 15 (SPG15). 34 healthy controls, and 34 patients with multiple sclerosis. RESULTS The interrater reliability for FLAIR images was substantial (Cohen κ, 0.66-0.77). For these images, the sensitivity of the ears of the lynx sign across raters ranged from 78.8 to 97.0 and the specificity ranged from 90.9 to 100. The accuracy of the sign, measured by area under the receiver operating characteristic curve, ranged from very good (87.1) to excellent (93.9). CONCLUSIONS The ears of the lynx sign on FLAIR MR imaging is highly specific for the most common genetic subtypes of hereditary spastic paraplegia with a thin corpus callosum. When this sign is present, there is a high likelihood of a genetic mutation, particularly associated with SPG11 or SPG15, even in the absence of a family history.
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Affiliation(s)
- B Pascual
- From the Departments of Neurology (B.P., M.R.D., J.C.M.)
| | - S T de Bot
- Department of Neurology (S.T.d.B.), Leiden University Medical Centre, Leiden, the Netherlands
| | - M R Daniels
- From the Departments of Neurology (B.P., M.R.D., J.C.M.)
| | - M C França
- Department of Neurology (M.C.F.), University of Campinas, Campinas, Brazil
| | - C Toro
- National Institutes of Health Intramural Research Program (C.T., N.J.P., M.D.G.), Bethesda, Maryland
| | - M Riverol
- Department of Neurology (M.R.), Clínica Universidad de Navarra, Pamplona, Spain
| | - P Hedera
- Department of Neurology (P.H.), Vanderbilt University Medical Center, Nashville, Tennessee
| | - M T Bassi
- Laboratory of Molecular Biology (M.T.B.), Scientific Institute Istituto di Ricovero e Cura a Carattere Scientifico E. Medea, Bosisio Parini, Lecco, Italy
| | - N Bresolin
- Department of Neuroscience and Mental Health (N.B.), University Hospital Policlinico Ca'Granda, University of Milan, Milan, Italy
| | - B P van de Warrenburg
- Department of Neurology (B.P.v.d.W.), Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - B Kremer
- Department of Neurology (B.K.), University Medical Center Groningen, Groningen, the Netherlands
| | - J Nicolai
- Department of Neurology (J.N.), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - P Charles
- Department of Genetics (P.C.), Hôpital Pitié-Salpêtrière, Paris, France
| | | | - S Singh
- Radiology (S.S., S.H.F.), Houston Methodist Research Institute, Houston, Texas
| | - N J Patronas
- National Institutes of Health Intramural Research Program (C.T., N.J.P., M.D.G.), Bethesda, Maryland
| | - S H Fung
- Radiology (S.S., S.H.F.), Houston Methodist Research Institute, Houston, Texas
| | - M D Gregory
- National Institutes of Health Intramural Research Program (C.T., N.J.P., M.D.G.), Bethesda, Maryland
| | - J C Masdeu
- From the Departments of Neurology (B.P., M.R.D., J.C.M.)
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18
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Faber I, Martinez ARM, Martins CR, Maia ML, Souza JP, Lourenço CM, Marques W, Montecchiani C, Orlacchio A, Pedroso JL, Barsottini OGP, Ramos CD, Lopes-Cendes Í, Friedman JH, Amorim BJ, França MC. SPG11-related parkinsonism: Clinical profile, molecular imaging and l-dopa response. Mov Disord 2018; 33:1650-1656. [PMID: 30306626 DOI: 10.1002/mds.27491] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 07/10/2018] [Accepted: 07/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Molecular imaging has proven to be a powerful tool to elucidate degenerated paths in a wide variety of neurological diseases and has not been systematically studied in hereditary spastic paraplegias. OBJECTIVES To investigate dopaminergic degeneration in a cohort of 22 patients with hereditary spastic paraplegia attributed to SPG11 mutations and evaluate treatment response to l-dopa. METHODS Patients and controls underwent single-photon emission computed tomography imaging utilizing 99m Tc-TRODAT-1 tracer. A single-blind trial with 600 mg of l-dopa was performed comparing UPDRS scores. RESULTS Reduced dopamine transporter density was universal among patients. Nigral degeneration was symmetrical and correlated with disease duration and motor and cognitive handicap. No statistically significant benefit could be demonstrated with l-dopa intake during the trial. CONCLUSION Disruption of presynaptic dopaminergic pathways is a widespread phenomenon in patients with SPG11 mutations, even in the absence of parkinsonism. Unresponsiveness to treatment could be related to postsynaptic damage that needs to be further investigated.
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Affiliation(s)
- Ingrid Faber
- Department of Neurology, University of Campinas (UNICAMP), Campinas, Brazil
| | | | | | - Maidane Luise Maia
- Division of Nuclear Medicine, Department of Radiology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Juliana Pasquotto Souza
- Division of Nuclear Medicine, Department of Radiology, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Wilson Marques
- Department of Neurology, University of São Paulo (USP-RP), Ribeirão Preto, Brazil
| | - Celeste Montecchiani
- Laboratorio di Neurogenetica, Centro Europeo di Ricerca sul Cervello (CERC)-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia, Rome, Italy
| | - Antonio Orlacchio
- Laboratorio di Neurogenetica, Centro Europeo di Ricerca sul Cervello (CERC)-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia, Rome, Italy.,Dipartimento di Scienze Chirurgiche e Biomediche, Università di Perugia, Perugia, Italy
| | - Jose Luiz Pedroso
- Department of Neurology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Celso Darío Ramos
- Division of Nuclear Medicine, Department of Radiology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Íscia Lopes-Cendes
- Department of Medical Genetics, University of Campinas (UNICAMP), Campinas, Brazil
| | - Joseph H Friedman
- Department of Neurology, Butler Hospital and Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Bárbara Juarez Amorim
- Division of Nuclear Medicine, Department of Radiology, University of Campinas (UNICAMP), Campinas, Brazil
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19
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Zhao N, Zhang J, Qiu M, Wang C, Xiang Y, Wang H, Xie J, Liu S, Wu J. Scalp acupuncture plus low-frequency rTMS promotes repair of brain white matter tracts in stroke patients: A DTI study. J Integr Neurosci 2018. [DOI: 10.3233/jin-170043] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Affiliation(s)
- Ning Zhao
- Department of Rehabilitation Medicine, Shenzhen Nanshan Hospital, Shenzhen University, Shenzhen, 518052, China
- Department of Rehabilitation Medicine, Shenzhen Nanshan District People’s Hospital, Shenzhen, 518052, China
| | - Jingna Zhang
- College of Biomedical Engineering, Third Military Medical University, Chongqing, 400038, China
| | - Mingguo Qiu
- College of Biomedical Engineering, Third Military Medical University, Chongqing, 400038, China
| | - Chunrong Wang
- Department of Radiology, Shenzhen Nanshan District People’s Hospital, Shenzhen, 518052, China
| | - Yun Xiang
- Department of Rehabilitation Medicine, Shenzhen Nanshan Hospital, Shenzhen University, Shenzhen, 518052, China
- Department of Rehabilitation Medicine, Shenzhen Nanshan District People’s Hospital, Shenzhen, 518052, China
| | - Hui Wang
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Jingwen Xie
- Department of Radiology, Shenzhen Nanshan District People’s Hospital, Shenzhen, 518052, China
| | - Shu Liu
- Hunan University of Chinese Medicine, Changsha, 410007, China
| | - Jing Wu
- Hunan University of Chinese Medicine, Changsha, 410007, China
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20
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Estrada-Cuzcano A, Martin S, Chamova T, Synofzik M, Timmann D, Holemans T, Andreeva A, Reichbauer J, De Rycke R, Chang DI, van Veen S, Samuel J, Schöls L, Pöppel T, Mollerup Sørensen D, Asselbergh B, Klein C, Zuchner S, Jordanova A, Vangheluwe P, Tournev I, Schüle R. Loss-of-function mutations in the ATP13A2/PARK9 gene cause complicated hereditary spastic paraplegia (SPG78). Brain 2017; 140:287-305. [PMID: 28137957 DOI: 10.1093/brain/aww307] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 09/29/2016] [Accepted: 10/19/2016] [Indexed: 12/23/2022] Open
Abstract
Hereditary spastic paraplegias are heterogeneous neurodegenerative disorders characterized by progressive spasticity of the lower limbs due to degeneration of the corticospinal motor neurons. In a Bulgarian family with three siblings affected by complicated hereditary spastic paraplegia, we performed whole exome sequencing and homozygosity mapping and identified a homozygous p.Thr512Ile (c.1535C > T) mutation in ATP13A2. Molecular defects in this gene have been causally associated with Kufor-Rakeb syndrome (#606693), an autosomal recessive form of juvenile-onset parkinsonism, and neuronal ceroid lipofuscinosis (#606693), a neurodegenerative disorder characterized by the intracellular accumulation of autofluorescent lipopigments. Further analysis of 795 index cases with hereditary spastic paraplegia and related disorders revealed two additional families carrying truncating biallelic mutations in ATP13A2. ATP13A2 is a lysosomal P5-type transport ATPase, the activity of which critically depends on catalytic autophosphorylation. Our biochemical and immunocytochemical experiments in COS-1 and HeLa cells and patient-derived fibroblasts demonstrated that the hereditary spastic paraplegia-associated mutations, similarly to the ones causing Kufor-Rakeb syndrome and neuronal ceroid lipofuscinosis, cause loss of ATP13A2 function due to transcript or protein instability and abnormal intracellular localization of the mutant proteins, ultimately impairing the lysosomal and mitochondrial function. Moreover, we provide the first biochemical evidence that disease-causing mutations can affect the catalytic autophosphorylation activity of ATP13A2. Our study adds complicated hereditary spastic paraplegia (SPG78) to the clinical continuum of ATP13A2-associated neurological disorders, which are commonly hallmarked by lysosomal and mitochondrial dysfunction. The disease presentation in our patients with hereditary spastic paraplegia was dominated by an adult-onset lower-limb predominant spastic paraparesis. Cognitive impairment was present in most of the cases and ranged from very mild deficits to advanced dementia with fronto-temporal characteristics. Nerve conduction studies revealed involvement of the peripheral motor and sensory nerves. Only one of five patients with hereditary spastic paraplegia showed clinical indication of extrapyramidal involvement in the form of subtle bradykinesia and slight resting tremor. Neuroimaging cranial investigations revealed pronounced vermian and hemispheric cerebellar atrophy. Notably, reduced striatal dopamine was apparent in the brain of one of the patients, who had no clinical signs or symptoms of extrapyramidal involvement.
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Affiliation(s)
- Alejandro Estrada-Cuzcano
- Molecular Neurogenomics Group, VIB Department of Molecular Genetics, University of Antwerp, Universiteitsplein 1, 2610 Antwerpen, Belgium
| | - Shaun Martin
- Laboratory of Cellular Transport Systems, Department of Cellular and Molecular Medicine, KU Leuven; 3000 Leuven, Belgium
| | - Teodora Chamova
- Department of Neurology, Medical University-Sofia, 1431 Sofia, Bulgaria
| | - Matthis Synofzik
- Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany.,German Center of Neurodegenerative Diseases (DZNE), 72076 Tübingen, Germany
| | - Dagmar Timmann
- Department of Neurology, Essen University Hospital, University of Duisburg-Essen, 45147 Essen, Germany
| | - Tine Holemans
- Laboratory of Cellular Transport Systems, Department of Cellular and Molecular Medicine, KU Leuven; 3000 Leuven, Belgium
| | - Albena Andreeva
- Department of Neurology, Medical University-Sofia, 1431 Sofia, Bulgaria
| | - Jennifer Reichbauer
- Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - Riet De Rycke
- Inflammation Research Center, VIB, Ghent, Belgium and Department of Biomedical Molecular Biology, Ghent University, 9052 Ghent, Belgium
| | - Dae-In Chang
- Inflammation Research Center, VIB, Ghent, Belgium and Department of Biomedical Molecular Biology, Ghent University, 9052 Ghent, Belgium
| | - Sarah van Veen
- Laboratory of Cellular Transport Systems, Department of Cellular and Molecular Medicine, KU Leuven; 3000 Leuven, Belgium
| | - Jean Samuel
- Department of Neurology, Medical University-Sofia, 1431 Sofia, Bulgaria
| | - Ludger Schöls
- Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany.,German Center of Neurodegenerative Diseases (DZNE), 72076 Tübingen, Germany
| | - Thorsten Pöppel
- Department of Nuclear Medicine, Essen University Hospital, University of Duisburg-Essen, 45147 Essen, Germany
| | - Danny Mollerup Sørensen
- Laboratory of Cellular Transport Systems, Department of Cellular and Molecular Medicine, KU Leuven; 3000 Leuven, Belgium
| | - Bob Asselbergh
- VIB Department of Molecular Genetics, University of Antwerp, Universiteitsplein 1, 2610 Antwerpen, Belgium
| | - Christine Klein
- Molecular Neurogenomics Group, VIB Department of Molecular Genetics, University of Antwerp, Universiteitsplein 1, 2610 Antwerpen, Belgium.,Molecular Neurogenomics Group, VIB Department of Molecular Genetics, University of Antwerp, Universiteitsplein 1, 2610 Antwerpen, Belgium
| | - Stephan Zuchner
- Molecular Neurogenomics Group, VIB Department of Molecular Genetics, University of Antwerp, Universiteitsplein 1, 2610 Antwerpen, Belgium
| | - Albena Jordanova
- Molecular Neurogenomics Group, VIB Department of Molecular Genetics, University of Antwerp, Universiteitsplein 1, 2610 Antwerpen, Belgium.,Molecular Neurogenomics Group, VIB Department of Molecular Genetics, University of Antwerp, Universiteitsplein 1, 2610 Antwerpen, Belgium.,Laboratory of Cellular Transport Systems, Department of Cellular and Molecular Medicine, KU Leuven; 3000 Leuven, Belgium
| | - Peter Vangheluwe
- Laboratory of Cellular Transport Systems, Department of Cellular and Molecular Medicine, KU Leuven; 3000 Leuven, Belgium
| | - Ivailo Tournev
- Department of Neurology, Medical University-Sofia, 1431 Sofia, Bulgaria.,Molecular Neurogenomics Group, VIB Department of Molecular Genetics, University of Antwerp, Universiteitsplein 1, 2610 Antwerpen, Belgium.,Department of Neurology, Medical University-Sofia, 1431 Sofia, Bulgaria
| | - Rebecca Schüle
- Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany .,German Center of Neurodegenerative Diseases (DZNE), 72076 Tübingen, Germany.,Molecular Neurogenomics Group, VIB Department of Molecular Genetics, University of Antwerp, Universiteitsplein 1, 2610 Antwerpen, Belgium
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21
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Spastizin mutation in hereditary spastic paraplegia with thin corpus callosum. J Neurol 2016; 263:2130-2. [DOI: 10.1007/s00415-016-8258-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 07/16/2016] [Accepted: 08/04/2016] [Indexed: 10/21/2022]
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22
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Fraidakis MJ, Brunetti M, Blackstone C, Filippi M, Chiò A. Novel Compound Heterozygous Spatacsin Mutations in a Greek Kindred with Hereditary Spastic Paraplegia SPG11 and Dementia. NEURODEGENER DIS 2016; 16:373-81. [PMID: 27318863 DOI: 10.1159/000444715] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 02/16/2016] [Indexed: 11/19/2022] Open
Abstract
SPG11 belongs to the autosomal recessive hereditary spastic paraplegias (HSP) and presents during childhood or puberty with a complex clinical phenotype encompassing learning difficulties, ataxia, peripheral neuropathy, amyotrophy, and mental retardation. We hereby present the case of a 30-year-old female patient with complex autosomal recessive HSP with thinning of the corpus callosum (TCC) and dementia that was compound heterozygous with two novel mutations in the SPG11 gene. Sequence analysis of the SPG11 gene revealed two novel mutations in a compound heterozygous state in the index patient (c.2431C>T/p.Gln811Ter and c.6755_6756insT/p.Glu2252Aspfs*88). MRI showed abnormal TCC, white matter (WM) hyperintensities periventricularly, and the 'ears of the lynx' sign. Diffusion tensor imaging showed a mild-to-moderate decrease in fractional anisotropy and an increase in mean diffusivity in WM compared to age-matched controls, while magnetic resonance spectroscopy showed abnormal findings in affected WM with a decrease in N-acetyl-aspartate in WM regions of interest. This is the first SPG11 kindred from the Greek population to be reported in the medical literature.
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Affiliation(s)
- Matthew J Fraidakis
- NEURORARE Centre for Rare and Genetic Neurological and Neuromuscular Diseases and Neurogenetics, Athens, Greece
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23
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Masdeu JC, Gadhia R, Faridar A. Brain CT and MRI: differential diagnosis of imaging findings. HANDBOOK OF CLINICAL NEUROLOGY 2016; 136:1037-54. [PMID: 27430457 DOI: 10.1016/b978-0-444-53486-6.00054-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Following a traditional approach, in Chapters 5 and 14-29 in the previous volume, diverse brain diseases are listed and their imaging findings described in detail. In this chapter the approach is from the imaging finding to the disease: for instance, what list of diseases can give rise to a contrast-enhancing mass in the cerebellopontine angle? Imaging findings that are reviewed in succession include the location of the lesion, its multiplicity and symmetry, its volume, ranging from atrophy to mass effect, its homogeneity, its density, measurable by computed tomography (CT), its appearance on T1, T2, and diffusion magnetic resonance imaging (MRI), and, finally, its characteristics after the infusion of intravenous contrast. A differential diagnosis for each finding is provided. While the approach adopted in this chapter is unconventional, we hope that it will be most helpful to anyone reading images. Furthermore, it could serve as the basis to create or complete image databases to guide in the interpretation of brain CT and MRI.
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Affiliation(s)
- Joseph C Masdeu
- Department of Neurology, Houston Methodist Hospital, Houston, TX, USA.
| | - Rajan Gadhia
- Department of Neurology, Houston Methodist Hospital, Houston, TX, USA
| | - Alireza Faridar
- Department of Neurology, Houston Methodist Hospital, Houston, TX, USA
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24
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Abstract
Hereditary and metabolic myelopathies are a heterogeneous group of neurologic disorders characterized by clinical signs suggesting spinal cord dysfunction. Spastic weakness, limb ataxia without additional cerebellar signs, impaired vibration, and positional sensation are hallmark phenotypic features of these disorders. Hereditary, and to some extent, metabolic myelopathies are now recognized as more widespread systemic processes with axonal loss and demyelination. However, the concept of predominantly spinal cord disorders remains clinically helpful to differentiate these disorders from other neurodegenerative conditions. Furthermore, metabolic myelopathies are potentially treatable and an earlier diagnosis increases the likelihood of a good clinical recovery. This chapter reviews major types of degenerative myelopathies, hereditary spastic paraplegia, motor neuron disorders, spastic ataxias, and metabolic disorders, including leukodystrophies and nutritionally induced myelopathies, such as vitamin B12, E, and copper deficiencies. Neuroimaging studies usually detect a nonspecific spinal cord atrophy or demyelination of the corticospinal tracts and dorsal columns. Brain imaging can be also helpful in myelopathies caused by generalized neurodegeneration. Given the nonspecific nature of neuroimaging findings, we also review metabolic or genetic assays needed for the specific diagnosis of hereditary and metabolic myelopathies.
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Affiliation(s)
- Peter Hedera
- Department of Neurology, Vanderbilt University, Nashville, TN, USA.
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25
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Giannoccaro MP, Liguori R, Arnoldi A, Donadio V, Avoni P, Bassi MT. Atypical late-onset hereditary spastic paraplegia with thin corpus callosum due to novel compound heterozygous mutations in the SPG11 gene. J Neurol 2014; 261:1825-7. [DOI: 10.1007/s00415-014-7443-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 07/10/2014] [Accepted: 07/13/2014] [Indexed: 11/24/2022]
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26
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Sonam K, Bindu PS, Gayathri N, Khan NA, Govindaraju C, Arvinda HR, Nagappa M, Sinha S, Thangaraj K, Taly AB. The "double panda" sign in Leigh disease. J Child Neurol 2014; 29:980-2. [PMID: 23599247 DOI: 10.1177/0883073813484968] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Accepted: 03/11/2013] [Indexed: 11/16/2022]
Abstract
Although the "face of the giant panda" sign on magnetic resonance imaging (MRI) is traditionally considered to be characteristic of Wilson disease, it has also been reported in other metabolic disorders. This study describes the characteristic "giant panda" sign on MRI in a child with Leigh disease. The diagnosis was based on the history of neurological regression; examination findings of oculomotor abnormalities, hypotonia, and dystonia; raised serum lactate levels; and characteristic brain stem and basal ganglia signal changes on MRI. The midbrain and pontine tegmental signal changes were consistent with the "face of the giant panda and her cub" sign. In addition to Wilson disease, metabolic disorders such as Leigh disease should also be considered in the differential diagnosis of this rare imaging finding.
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Affiliation(s)
- Kothari Sonam
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - P S Bindu
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Narayanappa Gayathri
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Nahid Akhtar Khan
- Department of Evolutionary and Medical Genetics, Centre for Cellular and Molecular Biology, Hyderabad, India
| | - C Govindaraju
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Hanumanthapura R Arvinda
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Madhu Nagappa
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Sanjib Sinha
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - K Thangaraj
- Department of Evolutionary and Medical Genetics, Centre for Cellular and Molecular Biology, Hyderabad, India
| | - Arun B Taly
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
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Renvoisé B, Chang J, Singh R, Yonekawa S, FitzGibbon EJ, Mankodi A, Vanderver A, Schindler A, Toro C, Gahl WA, Mahuran DJ, Blackstone C, Pierson TM. Lysosomal abnormalities in hereditary spastic paraplegia types SPG15 and SPG11. Ann Clin Transl Neurol 2014; 1:379-389. [PMID: 24999486 PMCID: PMC4078876 DOI: 10.1002/acn3.64] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective Hereditary spastic paraplegias (HSPs) are among the most genetically diverse inherited neurological disorders, with over 70 disease loci identified (SPG1-71) to date. SPG15 and SPG11 are clinically similar, autosomal recessive disorders characterized by progressive spastic paraplegia along with thin corpus callosum, white matter abnormalities, cognitive impairment, and ophthalmologic abnormalities. Furthermore, both have been linked to early-onset parkinsonism. Methods We describe two new cases of SPG15 and investigate cellular changes in SPG15 and SPG11 patient-derived fibroblasts, seeking to identify shared pathogenic themes. Cells were evaluated for any abnormalities in cell division, DNA repair, endoplasmic reticulum, endosomes, and lysosomes. Results Fibroblasts prepared from patients with SPG15 have selective enlargement of LAMP1-positive structures, and they consistently exhibited abnormal lysosomal storage by electron microscopy. A similar enlargement of LAMP1-positive structures was also observed in cells from multiple SPG11 patients, though prominent abnormal lysosomal storage was not evident. The stabilities of the SPG15 protein spastizin/ZFYVE26 and the SPG11 protein spatacsin were interdependent. Interpretation Emerging studies implicating these two proteins in interactions with the late endosomal/lysosomal adaptor protein complex AP-5 are consistent with shared abnormalities in lysosomes, supporting a converging mechanism for these two disorders. Recent work with Zfyve26−/− mice revealed a similar phenotype to human SPG15, and cells in these mice had endolysosomal abnormalities. SPG15 and SPG11 are particularly notable among HSPs because they can also present with juvenile parkinsonism, and this lysosomal trafficking or storage defect may be relevant for other forms of parkinsonism associated with lysosomal dysfunction.
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Affiliation(s)
- Benoît Renvoisé
- Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Jaerak Chang
- Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Rajat Singh
- Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Sayuri Yonekawa
- Research Institute, Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
| | - Edmond J FitzGibbon
- Laboratory of Sensorimotor Research, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ami Mankodi
- Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Adeline Vanderver
- Department of Neurology, Children's National Medical Center, Washington, DC, USA
| | - Alice Schindler
- Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Camilo Toro
- Office of the Clinical Director, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA ; NIH Undiagnosed Diseases Program, National Institutes of Health, Office of Rare Diseases Research and National Human Genome Research Institute, Bethesda, MD, USA
| | - William A Gahl
- Office of the Clinical Director, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA ; NIH Undiagnosed Diseases Program, National Institutes of Health, Office of Rare Diseases Research and National Human Genome Research Institute, Bethesda, MD, USA
| | - Don J Mahuran
- Research Institute, Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
| | - Craig Blackstone
- Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Tyler Mark Pierson
- Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA ; NIH Undiagnosed Diseases Program, National Institutes of Health, Office of Rare Diseases Research and National Human Genome Research Institute, Bethesda, MD, USA ; Departments of Pediatrics and Neurology, and the Regenerative Medicine Institute, Cedars- Sinai Medical Center, Los Angeles, CA, USA
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Faber I, Servelhere KR, Martinez ARM, D?Abreu A, Lopes-Cendes I, França Jr MC. Clinical features and management of hereditary spastic paraplegia. ARQUIVOS DE NEURO-PSIQUIATRIA 2014; 72:219-26. [DOI: 10.1590/0004-282x20130248] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 11/29/2013] [Indexed: 12/12/2022]
Abstract
Hereditary spastic paraplegia (HSP) is a group of genetically-determined disorders characterized by progressive spasticity and weakness of lower limbs. An apparently sporadic case of adult-onset spastic paraplegia is a frequent clinical problem and a significant proportion of cases are likely to be of genetic origin. HSP is clinically divided into pure and complicated forms. The later present with a wide range of additional neurological and systemic features. To date, there are up to 60 genetic subtypes described. All modes of monogenic inheritance have been described: autosomal dominant, autosomal recessive, X-linked and mitochondrial traits. Recent advances point to abnormal axonal transport as a key mechanism leading to the degeneration of the long motor neuron axons in the central nervous system in HSP. In this review we aim to address recent advances in the field, placing emphasis on key diagnostic features that will help practicing neurologists to identify and manage these conditions.
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Rapidly deteriorating course in Dutch hereditary spastic paraplegia type 11 patients. Eur J Hum Genet 2013; 21:1312-5. [PMID: 23443022 DOI: 10.1038/ejhg.2013.27] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 12/23/2012] [Accepted: 01/22/2013] [Indexed: 12/12/2022] Open
Abstract
Although SPG11 is the most common complicated hereditary spastic paraplegia, our knowledge of the long-term prognosis and life expectancy is limited. We therefore studied the disease course of all patients with a proven SPG11 mutation as tested in our laboratory, the single Dutch laboratory providing SPG11 mutation analysis, between 1 January 2009 and 1 January 2011. We identified nine different SPG11 mutations, four of which are novel, in nine index patients. Eighteen SPG11 patients from these nine families were studied by means of a retrospective chart analysis and additional interview/examination. Ages at onset were between 4 months and 14 years; 39% started with learning difficulties rather than gait impairment. Brain magnetic resonance imaging showed a thin corpus callosum and typical periventricular white matter changes in the frontal horn region (known as the 'ears-of the lynx'-sign) in all. Most patients became wheelchair bound after a disease duration of 1 to 2 decades. End-stage disease consisted of loss of spontaneous speech, severe dysphagia, spastic tetraplegia with peripheral nerve involvement and contractures. Several patients died of complications between ages 30 and 48 years, 3-4 decades after onset of gait impairment. Other relevant features during the disease were urinary and fecal incontinence, obesity and psychosis. Our study of 18 Dutch SPG11-patients shows the potential serious long-term consequences of SPG11 including a possibly restricted life span.
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Denora PS, Santorelli FM, Bertini E. Hereditary spastic paraplegias: one disease for many genes, and still counting. HANDBOOK OF CLINICAL NEUROLOGY 2013; 113:1899-912. [PMID: 23622413 DOI: 10.1016/b978-0-444-59565-2.00060-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Hereditary spastic paraplegias (HSPs) are genetically heterogeneous Mendelian disorders characterized by spastic gait with stiffness and weakness in the legs and an associated plethora of neurological or extraneurological signs in "complicated" forms. Major advances have been made during the past two decades in our understanding of their molecular bases with the identification of a large number of gene loci and the cloning of a set of them. The combined genetic and clinical information obtained has permitted a new, molecularly-driven classification and an improved diagnosis of these conditions. This represents a prerequisite for better counseling in families and more appropriate therapeutic options. However, further heterogeneity is expected and new insight into the possible mechanisms anticipated.
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Affiliation(s)
- Paola S Denora
- Molecular Medicine and Unit of Neuromuscular and Neurodegenerative Diseases, IRCCS-Children's Hospital Bambino Gesù, Rome, Italy
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Pacheco FT, Rego MM, do Rego JIM, da Rocha AJ. “Ears of the Lynx” Sign in a Marchiafava-Bignami patient: Structural Basis and Fiber-Tracking DTI Contribution to the Understanding of this Imaging Abnormality. J Neuroimaging 2012; 24:205-7. [DOI: 10.1111/j.1552-6569.2012.00714.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 02/02/2012] [Accepted: 03/15/2012] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Milena Morais Rego
- Division of Neurology and Neurosurgery; Hospital Regional do Vale do Ribeira, Pariquera-Açu - SP; Brazil
| | - Jose Iram Mendonça do Rego
- Division of Neurology and Neurosurgery; Hospital Regional do Vale do Ribeira, Pariquera-Açu - SP; Brazil
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Vanderver A, Tonduti D, Auerbach S, Schmidt JL, Parikh S, Gowans GC, Jackson KE, Brock PL, Patterson M, Nehrebecky M, Godfrey R, Zein WM, Gahl W, Toro C. Neurotransmitter abnormalities and response to supplementation in SPG11. Mol Genet Metab 2012; 107:229-33. [PMID: 22749184 PMCID: PMC3517733 DOI: 10.1016/j.ymgme.2012.05.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Accepted: 05/26/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To report the detection of secondary neurotransmitter abnormalities in a group of SPG11 patients and describe treatment with l-dopa/carbidopa and sapropterin. DESIGN Case reports. SETTING National Institutes of Health in the Undiagnosed Disease Program; Children's National Medical Center in the Myelin Disorders Bioregistry Program. PATIENTS Four SPG11 patients with a clinical picture of progressive spastic paraparesis complicated by extrapyramidal symptoms and maculopathy. INTERVENTIONS L-Dopa/carbidopa and sapropterin. RESULTS 3/4 patients presented secondary neurotransmitter abnormalities; 4/4 partially responded to L-dopa as well as sapropterin. CONCLUSIONS In the SPG11 patient with extrapyramidal symptoms, a trial of L-dopa/carbidopa and sapropterin and/or evaluation of cerebrospinal fluid neurotransmitters should be considered.
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Affiliation(s)
- Adeline Vanderver
- Department of Neurology, Children's National Medical Center, Washington, DC 20010-2970, USA.
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Filippi M, Agosta F, Abrahams S, Fazekas F, Grosskreutz J, Kalra S, Kassubek J, Silani V, Turner MR, Masdeu JC. EFNS guidelines on the use of neuroimaging in the management of motor neuron diseases. Eur J Neurol 2010; 17:526-e20. [PMID: 20136647 DOI: 10.1111/j.1468-1331.2010.02951.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND PURPOSE These European Federation of Neurological Societies guidelines on neuroimaging of motor neuron diseases (MNDs) are designed to provide practical help for the neurologists to make appropriate use of neuroimaging techniques in patients with MNDs, which ranges from diagnostic and monitoring aspects to the in vivo study of the pathobiology of such conditions. METHODS Literature searches were performed before expert members of the Task Force wrote proposal. Then, consensus was reached by circulating drafts of the manuscript to the Task Force members and by discussion of the classification of evidence and recommendations. RESULTS AND CONCLUSIONS The use of conventional MRI in patients suspected of having a MND is yet restricted to exclude other causes of signs and symptoms of MN pathology [class IV, level good clinical practice point (GCPP)]. Although the detection of corticospinal tract hyperintensities on conventional MRI and a T2-hypointense rim in the pre-central gyrus can support a pre-existing suspicion of MND, the specific search of these abnormalities for the purpose of making a firm diagnosis of MND is not recommended (class IV, level GCPP). At present, advanced neuroimaging techniques, including diffusion tensor imaging and proton magnetic resonance spectroscopic imaging, do not have a role in the diagnosis or routine monitoring of MNDs yet (class IV, level GCPP). However, it is strongly advisable to incorporate measures derived from these techniques into new clinical trials as exploratory outcomes to gain additional insights into disease pathophysiology and into the value of these techniques in the (longitudinal) assessment of MNDs (class IV, level GCPP).
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Affiliation(s)
- M Filippi
- Neuroimaging Research Unit, Division of Neuroscience, Scientific Institute and University Hospital San Raffaele, Institute of Experimental Neurology, Milan, Italy.
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Ciccolella M, Santorelli FM, Biancheri R, Rossi A. SPG5-related spastic paraplegia and white matter abnormalities. Neuromuscul Disord 2009. [DOI: 10.1016/j.nmd.2009.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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