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Hadouiri N, Fournel I, Thauvin-Robinet C, Jacquin-Piques A, Ornetti P, Gueugnon M. Walking test outcomes in adults with genetic neuromuscular diseases: a systematic literature review of their measurement properties. Eur J Phys Rehabil Med 2024; 60:257-269. [PMID: 38300152 PMCID: PMC11114158 DOI: 10.23736/s1973-9087.24.08095-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 12/11/2023] [Accepted: 01/19/2024] [Indexed: 02/02/2024]
Abstract
INTRODUCTION Neuromuscular diseases (NMDs) include a large group of heterogeneous diseases. NMDs frequently involve gait disorders, which affect quality of life. Several walking tests and tools have been described in the literature, but there is no consensus regarding the use of walking tests and tools in NMDs or of their measurement properties for walking outcomes. The aim of this review is to present an overview of walking tests, including their measurement properties when used in adults with inherited or genetic NMDs. The aim is to help clinicians and researchers choose the most appropriate test for their objective. EVIDENCE ACQUISITION A systematic review was conducted after consulting MEDLINE (via PubMed), EMBASE, Science direct, Google Scholar and Cochrane Central Register of Controlled Trials databases for published studies in which walking outcome measurement properties were assessed. The validity, reliability, measurement error and responsiveness properties were evaluated in terms of statistical methods and methodological design qualities using the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. EVIDENCE SYNTHESIS We included 46 studies in NMDs. These studies included 15 different walking tests and a wide variety of walking outcomes, assessed with six types of walking tools. Overall, the 6MWT was the most studied test in terms of measurement properties. The methodological design and statistical methods of most studies evaluating construct validity, reliability and measurement error were "very good." The majority of outcome measurements were valid and reliable. However, studies on responsiveness as minimal important difference or minimal important change were lacking or were found to have inadequate methodological and statistical methods according to the COSMIN guidelines. CONCLUSIONS Most walking outcomes were found to be valid and reliable in NMDs. However, in view of the growing number of clinical trials, further studies are needed to clarify additional measurement properties.
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Affiliation(s)
- Nawale Hadouiri
- Department of Physical Medicine and Rehabilitation, Dijon-Bourgogne University Hospital, Dijon, France -
- UMR-Inserm 1231, Génétique des Anomalies du Développement (GAD), Bourgogne Franche-Comté University, Dijon, France -
- INSERM, CIC 1432, Clinical Investigation Center, Plurithematic Module, Technological Investigation Platform, Dijon-Bourgogne University Hospital, Dijon, France -
| | - Isabelle Fournel
- Clinical Investigation Center, CHU Dijon, Dijon, France
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | - Christel Thauvin-Robinet
- UMR-Inserm 1231, Génétique des Anomalies du Développement (GAD), Bourgogne Franche-Comté University, Dijon, France
- Fédération Hospitalo-Universitaire Médecine Translationnelle et Anomalies du Développement (TRANSLAD), CHU Dijon Bourgogne, Dijon, France
- Centre de Référence Maladies Rares "Maladies neurogénétiques", CHU Dijon Bourgogne, Dijon, France
| | - Agnès Jacquin-Piques
- Centre de Compétences Maladies Rares "Maladies neuromusculaires", Department of Neurology, Dijon University Hospital, Dijon, France
| | - Paul Ornetti
- Department of Rheumatology, Dijon-Bourgogne University Hospital, Dijon, France
- INSERM, UMR1093-CAPS, Bourgogne Franche-Comté University, Dijon, France
| | - Mathieu Gueugnon
- INSERM, CIC 1432, Clinical Investigation Center, Plurithematic Module, Technological Investigation Platform, Dijon-Bourgogne University Hospital, Dijon, France
- INSERM, UMR1093-CAPS, Bourgogne Franche-Comté University, Dijon, France
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Jeon H, Jang SY, Kwak G, Yi YW, You MH, Park NY, Jo JH, Yang JW, Jang HJ, Jeong SY, Moon SK, Doo HM, Nahm M, Kim D, Chang JW, Choi BO, Hong YB. TGFβ4 alleviates the phenotype of Charcot-Marie-Tooth disease type 1A. Brain 2023; 146:3608-3615. [PMID: 37143322 DOI: 10.1093/brain/awad147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 03/30/2023] [Accepted: 04/14/2023] [Indexed: 05/06/2023] Open
Abstract
The duplication of the peripheral myelin protein 22 (PMP22) gene causes a demyelinating type of neuropathy, commonly known as Charcot-Marie-Tooth disease type 1A (CMT1A). Development of effective drugs for CMT1A still remains as an unmet medical need. In the present study, we assessed the role of the transforming growth factor beta 4 (TGFβ4)/Nodal axis in the pathogenesis of CMT1A. First, we identified PMP22 overexpression-induced Nodal expression in Schwann cells, which might be one of the downstream effectors in CMT1A. Administration of Nodal protein at the developmental stage of peripheral nerves induced the demyelinating phenotype in vivo. Second, we further isolated TGFβ4 as an antagonist that could abolish Nodal-induced demyelination. Finally, we developed a recombinant TGFβ4-fragment crystallizable (Fc) fusion protein, CX201, and demonstrated that its application had promyelinating efficacy in Schwann cells. CX201 administration improved the demyelinating phenotypes of CMT1A mouse models at both pre-symptomatic and post-symptomatic stages. These results suggest that the TGFβ4/Nodal axis plays a crucial role in the pathogenesis of CMT1A and might be a potential therapeutic target for CMT1A.
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Affiliation(s)
- Hyeonjin Jeon
- Department of Translational Biomedical Sciences, Graduate School of Dong-A University, Busan 49201, Korea
- Dementia Research Group, Korea Brain Research Institute, Daegu 41062, Korea
| | - So Young Jang
- Department of Translational Biomedical Sciences, Graduate School of Dong-A University, Busan 49201, Korea
| | - Geon Kwak
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul 06351, Korea
- BioMedicine Lab., CKD Research Institute, ChongKunDang Pharm., Yongin 16995, Korea
| | - Yong Weon Yi
- Department of Biochemistry, College of Medicine, Dankook University, Cheonan 31116, Korea
| | - Mi-Hyeon You
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Na Young Park
- Department of Translational Biomedical Sciences, Graduate School of Dong-A University, Busan 49201, Korea
| | - Ju Hee Jo
- Department of Translational Biomedical Sciences, Graduate School of Dong-A University, Busan 49201, Korea
| | - Ji Won Yang
- Department of Translational Biomedical Sciences, Graduate School of Dong-A University, Busan 49201, Korea
| | - Hye Ji Jang
- Department of Translational Biomedical Sciences, Graduate School of Dong-A University, Busan 49201, Korea
| | - Sun-Young Jeong
- BioMedicine Lab., CKD Research Institute, ChongKunDang Pharm., Yongin 16995, Korea
| | - Seung Kee Moon
- BioMedicine Lab., CKD Research Institute, ChongKunDang Pharm., Yongin 16995, Korea
| | - Hyun Myung Doo
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul 06351, Korea
| | - Minyeop Nahm
- Dementia Research Group, Korea Brain Research Institute, Daegu 41062, Korea
| | - Donghoon Kim
- Department of Translational Biomedical Sciences, Graduate School of Dong-A University, Busan 49201, Korea
- Department of Pharmacology, College of Medicine, Dong-A University, Busan 49201, Korea
| | - Jong Wook Chang
- Stem Cell and Regenerative Medicine Institute, Samsung Medical Center, Seoul 06351, Korea
| | - Byung-Ok Choi
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul 06351, Korea
- Stem Cell and Regenerative Medicine Institute, Samsung Medical Center, Seoul 06351, Korea
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
| | - Young Bin Hong
- Department of Translational Biomedical Sciences, Graduate School of Dong-A University, Busan 49201, Korea
- Department of Biochemistry, College of Medicine, Dong-A University, Busan 49201, Korea
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Ghosh S, Tourtellotte WG. The Complex Clinical and Genetic Landscape of Hereditary Peripheral Neuropathy. ANNUAL REVIEW OF PATHOLOGY-MECHANISMS OF DISEASE 2021; 16:487-509. [PMID: 33497257 DOI: 10.1146/annurev-pathol-030320-100822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Hereditary peripheral neuropathy (HPN) is a complex group of neurological disorders caused by mutations in genes expressed by neurons and Schwann cells. The inheritance of a single mutation or multiple mutations in several genes leads to disease phenotype. Patients exhibit symptoms during development, at an early age or later in adulthood. Most of the mechanistic understanding about these neuropathies comes from animal models and histopathological analyses of postmortem human tissues. Diagnosis is often very complex due to the heterogeneity and overlap in symptoms and the frequent overlap between various genes and different mutations they possess. Some symptoms in HPN are common through different subtypes such as axonal degeneration, demyelination, and loss of motor and sensory neurons, leading to similar physiologic abnormalities. Recent advances in gene-targeted therapies, genetic engineering, and next-generation sequencing have augmented our understanding of the underlying pathogenetic mechanisms of HPN.
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Affiliation(s)
- Soumitra Ghosh
- Department of Pathology and Laboratory Medicine, Neurology, and Neurological Surgery, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA;
| | - Warren G Tourtellotte
- Department of Pathology and Laboratory Medicine, Neurology, and Neurological Surgery, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA;
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Evers P, Barber P, Wittich W. Telephone Accessibility for Individuals with Dual Sensory Impairments: A Case Study. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2019. [DOI: 10.1177/0145482x1210600106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Paul Evers
- MAB-Mackay Rehabilitation Centre, 3500 boulevard Decarie, Montreal, Quebec, Canada H4A 3J5
| | - Paul Barber
- MAB-Mackay Rehabilitation Centre, 7000 Sherbrooke Street West, Montreal, Quebec, Canada H4B 1R3
| | - Walter Wittich
- Centre de recherche institut universitaire de gériatrie de Montréal, University of Montreal, Centre de recherche interdisciplinaire en réadaptation (CRIR) du Montreal métropolitain, Research Coordinator, MAB-Mackay Rehabilitation Centre, Montreal, Quebec, Canada
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Judhan RJ, Maharaj SR, Perry A, Dellon AL, Maharaj D. Charcot-marie-tooth disease presenting as a nonhealing ulcer in a 26-year-old man. Microsurgery 2012; 32:223-6. [DOI: 10.1002/micr.21947] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2011] [Revised: 10/29/2011] [Accepted: 11/01/2011] [Indexed: 11/11/2022]
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Dere E, Zlomuzica A. The role of gap junctions in the brain in health and disease. Neurosci Biobehav Rev 2011; 36:206-17. [PMID: 21664373 DOI: 10.1016/j.neubiorev.2011.05.015] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Revised: 05/25/2011] [Accepted: 05/27/2011] [Indexed: 11/19/2022]
Abstract
Gap junctions connect the cytosolic compartments of adjacent cells for direct electrotonic and metabolic cell-to-cell communication. Gap junctions between glial cells or neurons are ubiquitously expressed in the brain and play a role in brain development including cell differentiation, cell migration and survival, tissue homeostasis, as well as in human diseases including hearing loss, skin disease, neuropathies, epilepsy, brain trauma, and cardiovascular disease. Furthermore, gap junctions are involved in the synchronization and rhythmic oscillation of hippocampal and neocotical neuronal ensembles which might be important for memory formation and consolidation. In this review the accumulated evidence from mouse mutant and pharmacological studies using gap junction blockers is summarized and the progress made in dissecting the physiological, pathophysiological and behavioral roles of gap junction mediated intercellular communication in the brain is discussed.
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Affiliation(s)
- Ekrem Dere
- Université Pierre et Marie Curie, Paris 6, UFR des Sciences de la Vie, UMR 7102, Neurobiologie des Processus Adaptatifs, 9 quai St Bernard, 75005 Paris, France.
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Gap junctions in inherited human disease. Pflugers Arch 2010; 460:451-66. [PMID: 20140684 DOI: 10.1007/s00424-010-0789-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 01/05/2010] [Accepted: 01/12/2010] [Indexed: 12/16/2022]
Abstract
Gap junctions (GJ) provide direct intercellular communication. The structures underlying these cell junctions are membrane-associated channels composed of six integral membrane connexin (Cx) proteins, which can form communicating channels connecting the cytoplasms of adjacent cells. This provides coupled cells with a direct pathway for sharing ions, nutrients, or small metabolites to establish electrical coupling or balancing metabolites in various tissues. Genetic approaches have uncovered a still growing number of mutations in Cxs related to human diseases including deafness, skin disease, peripheral and central neuropathies, cataracts, or cardiovascular dysfunctions. The discovery of a growing number of inherited human disorders provides an unequivocal demonstration that gap junctional communication is crucial for diverse physiological processes.
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Chen SR, Lin KP, Kuo HC, Chen CM, Hsieh ST, Lee MJ, Yang CC, Liu CS, Huang CC, Lyu RK, Ro LS. Comparison of two PCR-based molecular methods in the diagnosis of CMT 1A and HNPP diseases in Chinese. Clin Neurol Neurosurg 2008; 110:466-71. [DOI: 10.1016/j.clineuro.2008.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2007] [Revised: 12/19/2007] [Accepted: 02/02/2008] [Indexed: 12/19/2022]
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9
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Don R, Serrao M, Vinci P, Ranavolo A, Cacchio A, Ioppolo F, Paoloni M, Procaccianti R, Frascarelli F, De Santis F, Pierelli F, Frascarelli M, Santilli V. Foot drop and plantar flexion failure determine different gait strategies in Charcot-Marie-Tooth patients. Clin Biomech (Bristol, Avon) 2007; 22:905-16. [PMID: 17686557 DOI: 10.1016/j.clinbiomech.2007.06.002] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2007] [Revised: 06/14/2007] [Accepted: 06/19/2007] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To describe the temporal, kinetic, kinematic, electromyographic and energetic aspects of gait in Charcot-Marie-Tooth patients with foot drop and plantar flexion failure. METHODS A sample of 21 patients fulfilling clinical, electrodiagnostic and genetic criteria for Charcot-Marie-Tooth disease were evaluated by computerized gait analysis system and compared to a group of matched healthy subjects. Patients were classified as having isolate foot drop (group 1) and association of foot drop and plantar flexion failure (group 2). RESULTS While it was impossible to detect a reliable gait pattern when the group of patients was considered as a whole and compared to healthy subjects, we observed two distinctive gait patterns when patients were subdivided as group 1 or 2. Group 1 showed a gait pattern with some characteristics of the "steppage pattern". The complex motor strategy adopted by this group leads to reduce the swing velocity and to preserve the step length in spite of a high energy consumption. Group 2 displayed a "clumsy pattern" characterized by very slow gait with reduced step length, a broader support area and great reduction in the cadence. This group of patients is characterized by a low energy consumption and greater energy recovery, due above all to the primary deficit and the various compensatory mechanisms. CONCLUSIONS Such between-group differences in gait pattern can be related to both primary motor deficits and secondary compensatory mechanisms. Foot drop and plantar flexion failure affect the overall gait strategy in Charcot-Marie-Tooth patients.
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Affiliation(s)
- Romildo Don
- Department of Physical Medicine and Rehabilitation, Movement Analysis Laboratory, La Sapienza University of Rome, Italy.
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Shabo G, Pasman JW, van Alfen N, Willemsen MAAP. The spectrum of polyneuropathies in childhood detected with electromyography. Pediatr Neurol 2007; 36:393-6. [PMID: 17560501 DOI: 10.1016/j.pediatrneurol.2007.02.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2006] [Revised: 10/23/2006] [Accepted: 02/27/2007] [Indexed: 12/01/2022]
Abstract
Only a few studies have been reported describing polyneuropathies in a series of children. To study the clinical and neurophysiological spectrum of polyneuropathies in a large series of children and obtain an overview of their etiologies, this retrospective study reevaluated all electromyograms and electrophysiologic studies performed between 1995 and 2004 in children under 17 years of age at the Radboud University Nijmegen Medical Center, a tertiary neuromuscular reference center. Electromyograms revealing polyneuropathy were selected for further analysis (n = 118), and the medical records were reviewed to supplement electromyographic findings with the clinical diagnosis. Hereditary polyneuropathies made up 68% of the total, and 54% of these were isolated polyneuropathies; in the remaining 46%, polyneuropathy was part of a more complex disorder. The acquired polyneuropathies were primarily inflammatory. Nerve biopsies had been performed in 22 of the 118 cases (19%) and led to a diagnosis in 4 cases. Despite sophisticated investigation, 11 cases (9%) remained unclassified for underlying cause. Hereditary motor and sensory neuropathies are the most common type of polyneuropathy in childhood, followed by polyneuropathies as part of an inborn error of metabolism and inflammatory polyneuropathies (in patients in whom electromyography was used to diagnose the neuropathy). In the full series of patients, nerve biopsy did not play a prominent role in the diagnostic work-up of childhood polyneuropathies, due to the increasing availability of other laboratory (genetic and metabolic) diagnostic tools. Nerve biopsy nonetheless proved to have an important diagnostic yield in selected, complex cases.
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Affiliation(s)
- George Shabo
- Department of Pediatric Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Szigeti K, Nelis E, Lupski JR. Molecular diagnostics of Charcot-Marie-Tooth disease and related peripheral neuropathies. Neuromolecular Med 2007; 8:243-54. [PMID: 16775379 DOI: 10.1385/nmm:8:1-2:243] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2006] [Revised: 01/13/2006] [Accepted: 01/13/2006] [Indexed: 12/20/2022]
Abstract
DNA diagnostics plays an important role in the characterization and management of patients manifesting inherited peripheral neuropathies. We describe the clinical integration of molecular diagnostics with medical history, physical examination, and electrophysiological studies. Molecular testing can help establish a secure diagnosis, enable genetic counseling regarding recurrence risk, potentially provide prognostic information, and in the near future may be important for the choice of therapies.
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Affiliation(s)
- Kinga Szigeti
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
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12
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Jacob KN, Garg A. Laminopathies: multisystem dystrophy syndromes. Mol Genet Metab 2006; 87:289-302. [PMID: 16364671 DOI: 10.1016/j.ymgme.2005.10.018] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2005] [Revised: 10/12/2005] [Accepted: 10/12/2005] [Indexed: 11/26/2022]
Abstract
Laminopathies are a heterogeneous group of genetic disorders due to abnormalities in type A lamins and can manifest varied clinical features affecting many organs including the skeletal and cardiac muscle, adipose tissue, nervous system, cutaneous tissue, and bone. Mutations in the gene encoding lamins A and C (LMNA) cause primary laminopathies, including various types of lipodystrophies, muscular dystrophies and progeroid syndromes, mandibuloacral dysplasia, dilated cardiomyopathies, and restrictive dermopathy. The secondary laminopathies are due to mutations in ZMPSTE24 gene which encodes for a zinc metalloproteinase involved in processing of prelamin A into mature lamin A and cause mandibuloacral dysplasia and restrictive dermopathy. Skin fibroblast cells from many patients with laminopathies show a range of abnormal nuclear morphology including bleb formation, honeycombing, and presence of multi-lobulated nuclei. The mechanisms by which mutations in LMNA gene cause multisystem dystrophy are an active area of current investigation. Further studies are needed to understand the underlying mechanisms of marked pleiotropy in laminopathies.
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Affiliation(s)
- Katherine N Jacob
- Division of Nutrition and Metabolic Diseases, Department of Internal Medicine, Center for Human Nutrition, University of Texas Southwestern Medical Center, Dallas, 75390-9052, USA
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Arnold A, McEntagart M, Younger DS. Psychosocial issues that face patients with Charcot-Marie-Tooth disease: the role of genetic counseling. J Genet Couns 2006; 14:307-18. [PMID: 16047093 DOI: 10.1007/s10897-005-0760-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Charcot-Marie-Tooth (CMT) disease is a hereditary debilitating progressive muscular atrophy and sensory neuropathy of the distal extremities. CMT is usually non-life threatening. Signs of the disease usually present in childhood or in young adulthood and the level of disability can be variable within and between families. Research addressing specific psychosocial and emotional issues faced by individuals with CMT is limited. Fourteen adults with a clinical and/or molecular diagnosis of CMT (ages 32--74 years) consented to an audio taped interview. The format of the interview was based around an informal questionnaire to prompt and guide the interviewee to describe their experiences of living with a disabling genetic disorder. The interviews focused on their experiences of first symptoms and diagnosis, their life experience with CMT, their limitations due to disability and the role of genetic counseling. This study identifies and explores life issues that individuals with CMT may face, specifically grief over the loss of independence, emotional pain and stress such as embarrassment and guilt of passing on a gene mutation, impact on quality of life, the impact of wearing orthopedic devices, and fear of progressive disability. Our findings suggest that that there are emotional and psychosocial issues specific to affected individuals at different life stages and genetic counselors need to be aware of these issues in order to provide age appropriate support and advice to individuals affected by CMT.
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Affiliation(s)
- Angela Arnold
- Royal Free Hospital, 8th Floor Oncology Suite, Pond Street, London, NW3 2QG.
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Rubinstein J, Moghe R, Mizrachi A, Dissin J. Triptan use preceding life-threatening arrhythmias in charcot-marie-tooth: a case report and review of the literature. Clin Neuropharmacol 2004; 27:14-6. [PMID: 15090931 DOI: 10.1097/00002826-200401000-00006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Charcot-Marie-Tooth (CMT) identifies a rare group of inherited disorders of the peripheral nervous system that share clinical features of sensory and motor defects, but rarely affect cardiac function. The few references that relate CMT to cardiac pathology of any sort are so rare that their finding was considered either fortuitous or suggestive of an erroneous diagnosis. The 5-HT1B/1D agonists or triptan drug class was introduced to the clinical practice arena in the early 1990s, and since then several cardiac adverse events have been associated with its use. The authors report the case of a 41-year-old white woman with CMT who had been recently prescribed sumatriptan and who presented with sudden loss of consciousness associated with ventricular fibrillation. These findings have been reported in the literature, but the association of triptan-induced arrhythmias and degenerative neuropathies remains to be established. The authors propose, through this case report and review, that the relative rarity of CMT coupled with the lack of further investigation of their association with conduction abnormalities might have set the stage for underestimation of the potentially synergistic effect with triptans in their capacity to generate life-threatening arrhythmias.
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Affiliation(s)
- Jack Rubinstein
- Albert Einstein Medical Center, Philadelphia, Pennsylvania 19141, USA.
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Passage E, Norreel JC, Noack-Fraissignes P, Sanguedolce V, Pizant J, Thirion X, Robaglia-Schlupp A, Pellissier JF, Fontés M. Ascorbic acid treatment corrects the phenotype of a mouse model of Charcot-Marie-Tooth disease. Nat Med 2004; 10:396-401. [PMID: 15034573 DOI: 10.1038/nm1023] [Citation(s) in RCA: 268] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2004] [Accepted: 03/05/2004] [Indexed: 11/08/2022]
Abstract
Charcot-Marie-Tooth disease (CMT) is the most common hereditary peripheral neuropathy, affecting 1 in 2,500 people. The only treatment currently available is rehabilitation or corrective surgery. The most frequent form of the disease, CMT-1A, involves abnormal myelination of the peripheral nerves. Here we used a mouse model of CMT-1A to test the ability of ascorbic acid, a known promoter of myelination, to correct the CMT-1A phenotype. Ascorbic acid treatment resulted in substantial amelioration of the CMT-1A phenotype, and reduced the expression of PMP22 to a level below what is necessary to induce the disease phenotype. As ascorbic acid has already been approved by the FDA for other clinical indications, it offers an immediate therapeutic possibility for patients with the disease.
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Affiliation(s)
- Edith Passage
- Institut National de la Santé et de la Recherche Médicale UMR491, IPHM, Faculté de Médecine de la Timone, 27 Bd. J. Moulin, 13385 Marseille Cedex 5, France
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Ota T, Osawa K. Marked improvement of glycaemic control with pioglitazone in a Type 2 diabetic patient associated with Charcot-Marie-Tooth disease. Diabet Med 2003; 20:420-1. [PMID: 12752495 DOI: 10.1046/j.1464-5491.2003.009173.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bernard R, Boyer A, Nègre P, Malzac P, Latour P, Vandenberghe A, Philip N, Lévy N. Prenatal detection of the 17p11.2 duplication in Charcot-Marie-Tooth disease type 1A: necessity of a multidisciplinary approach for heterogeneous disorders. Eur J Hum Genet 2002; 10:297-302. [PMID: 12082504 DOI: 10.1038/sj.ejhg.5200804] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2001] [Revised: 03/14/2002] [Accepted: 03/19/2002] [Indexed: 11/09/2022] Open
Abstract
Charcot-Marie-Tooth (CMT) disease is a typical example of a clinically and genetically heterogeneous disorder and, in most cases, is dominantly inherited and caused by a 1.5 megabase duplication on chromosome 17p11.2 containing the PMP22 gene. This is a non-lethal disease with a wide spectrum of severity, from asymptomatism to severe motor and sensory disability. Unpredictable degree of disability is usually the reason why prenatal diagnosis is required and must be addressed. Molecular procedures such as the use of polymorphic non microsatellite STRs, allowing very fast and reliable results even when requiring a gene dosage interpretation are now available and have been recently validated in post-natal diagnosis. Our results indicate that this approach is also the best-adapted method in case of prenatal diagnosis. Nevertheless, ethical considerations raised by prenatal diagnosis in CMT and more generally in non-lethal disorders remain to be actively considered. Here, we present our experience in genetic counselling, and address the psychological issues for 7 CMT at risk pregnancies. In five cases, a CMT1A duplication was evidenced; pregnancy was terminated in four of these cases and the parents from one affected foetus decided to pursue the pregnancy.
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Affiliation(s)
- Rafaëlle Bernard
- Département de Génétique Médicale, Hôpital d'enfants de la Timone, 13385 Marseille Cedex 05, France
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De Sandre-Giovannoli A, Chaouch M, Kozlov S, Vallat JM, Tazir M, Kassouri N, Szepetowski P, Hammadouche T, Vandenberghe A, Stewart CL, Grid D, Lévy N. Homozygous defects in LMNA, encoding lamin A/C nuclear-envelope proteins, cause autosomal recessive axonal neuropathy in human (Charcot-Marie-Tooth disorder type 2) and mouse. Am J Hum Genet 2002; 70:726-36. [PMID: 11799477 PMCID: PMC384949 DOI: 10.1086/339274] [Citation(s) in RCA: 359] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2001] [Accepted: 12/18/2001] [Indexed: 11/03/2022] Open
Abstract
The Charcot-Marie-Tooth (CMT) disorders comprise a group of clinically and genetically heterogeneous hereditary motor and sensory neuropathies, which are mainly characterized by muscle weakness and wasting, foot deformities, and electrophysiological, as well as histological, changes. A subtype, CMT2, is defined by a slight or absent reduction of nerve-conduction velocities together with the loss of large myelinated fibers and axonal degeneration. CMT2 phenotypes are also characterized by a large genetic heterogeneity, although only two genes---NF-L and KIF1Bbeta---have been identified to date. Homozygosity mapping in inbred Algerian families with autosomal recessive CMT2 (AR-CMT2) provided evidence of linkage to chromosome 1q21.2-q21.3 in two families (Zmax=4.14). All patients shared a common homozygous ancestral haplotype that was suggestive of a founder mutation as the cause of the phenotype. A unique homozygous mutation in LMNA (which encodes lamin A/C, a component of the nuclear envelope) was identified in all affected members and in additional patients with CMT2 from a third, unrelated family. Ultrastructural exploration of sciatic nerves of LMNA null (i.e., -/-) mice was performed and revealed a strong reduction of axon density, axonal enlargement, and the presence of nonmyelinated axons, all of which were highly similar to the phenotypes of human peripheral axonopathies. The finding of site-specific amino acid substitutions in limb-girdle muscular dystrophy type 1B, autosomal dominant Emery-Dreifuss muscular dystrophy, dilated cardiomyopathy type 1A, autosomal dominant partial lipodystrophy, and, now, AR-CMT2 suggests the existence of distinct functional domains in lamin A/C that are essential for the maintenance and integrity of different cell lineages. To our knowledge, this report constitutes the first evidence of the recessive inheritance of a mutation that causes CMT2; additionally, we suggest that mutations in LMNA may also be the cause of the genetically overlapping disorder CMT2B1.
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Affiliation(s)
- Annachiara De Sandre-Giovannoli
- INSERM U491, Génétique Médicale et Développement, Faculté de Médecine de la Timone, and Département de Génétique Médicale, Hôpital d’Enfants de la Timone, Marseille; Service de Neurologie, Centre Hospitalier Universitaire Ben-Aknoun, Service de Neurologie, Centre Hospitalier Universitaire Mustapha, and Institut Pasteur, Algiers, Algeria; Cancer and Developmental Biology Laboratory, National Cancer Institute–Frederick, Frederick, MD; Service de Neuropathologie, Centre Hospitalier Universitaire Dupuytren, Limoges, France; Laboratoire de Neurogénétique, Hôpital de l’Antiquaille, Lyon, France; and Généthon III, Évry, France
| | - Malika Chaouch
- INSERM U491, Génétique Médicale et Développement, Faculté de Médecine de la Timone, and Département de Génétique Médicale, Hôpital d’Enfants de la Timone, Marseille; Service de Neurologie, Centre Hospitalier Universitaire Ben-Aknoun, Service de Neurologie, Centre Hospitalier Universitaire Mustapha, and Institut Pasteur, Algiers, Algeria; Cancer and Developmental Biology Laboratory, National Cancer Institute–Frederick, Frederick, MD; Service de Neuropathologie, Centre Hospitalier Universitaire Dupuytren, Limoges, France; Laboratoire de Neurogénétique, Hôpital de l’Antiquaille, Lyon, France; and Généthon III, Évry, France
| | - Serguei Kozlov
- INSERM U491, Génétique Médicale et Développement, Faculté de Médecine de la Timone, and Département de Génétique Médicale, Hôpital d’Enfants de la Timone, Marseille; Service de Neurologie, Centre Hospitalier Universitaire Ben-Aknoun, Service de Neurologie, Centre Hospitalier Universitaire Mustapha, and Institut Pasteur, Algiers, Algeria; Cancer and Developmental Biology Laboratory, National Cancer Institute–Frederick, Frederick, MD; Service de Neuropathologie, Centre Hospitalier Universitaire Dupuytren, Limoges, France; Laboratoire de Neurogénétique, Hôpital de l’Antiquaille, Lyon, France; and Généthon III, Évry, France
| | - Jean-Michel Vallat
- INSERM U491, Génétique Médicale et Développement, Faculté de Médecine de la Timone, and Département de Génétique Médicale, Hôpital d’Enfants de la Timone, Marseille; Service de Neurologie, Centre Hospitalier Universitaire Ben-Aknoun, Service de Neurologie, Centre Hospitalier Universitaire Mustapha, and Institut Pasteur, Algiers, Algeria; Cancer and Developmental Biology Laboratory, National Cancer Institute–Frederick, Frederick, MD; Service de Neuropathologie, Centre Hospitalier Universitaire Dupuytren, Limoges, France; Laboratoire de Neurogénétique, Hôpital de l’Antiquaille, Lyon, France; and Généthon III, Évry, France
| | - Meriem Tazir
- INSERM U491, Génétique Médicale et Développement, Faculté de Médecine de la Timone, and Département de Génétique Médicale, Hôpital d’Enfants de la Timone, Marseille; Service de Neurologie, Centre Hospitalier Universitaire Ben-Aknoun, Service de Neurologie, Centre Hospitalier Universitaire Mustapha, and Institut Pasteur, Algiers, Algeria; Cancer and Developmental Biology Laboratory, National Cancer Institute–Frederick, Frederick, MD; Service de Neuropathologie, Centre Hospitalier Universitaire Dupuytren, Limoges, France; Laboratoire de Neurogénétique, Hôpital de l’Antiquaille, Lyon, France; and Généthon III, Évry, France
| | - Nadia Kassouri
- INSERM U491, Génétique Médicale et Développement, Faculté de Médecine de la Timone, and Département de Génétique Médicale, Hôpital d’Enfants de la Timone, Marseille; Service de Neurologie, Centre Hospitalier Universitaire Ben-Aknoun, Service de Neurologie, Centre Hospitalier Universitaire Mustapha, and Institut Pasteur, Algiers, Algeria; Cancer and Developmental Biology Laboratory, National Cancer Institute–Frederick, Frederick, MD; Service de Neuropathologie, Centre Hospitalier Universitaire Dupuytren, Limoges, France; Laboratoire de Neurogénétique, Hôpital de l’Antiquaille, Lyon, France; and Généthon III, Évry, France
| | - Pierre Szepetowski
- INSERM U491, Génétique Médicale et Développement, Faculté de Médecine de la Timone, and Département de Génétique Médicale, Hôpital d’Enfants de la Timone, Marseille; Service de Neurologie, Centre Hospitalier Universitaire Ben-Aknoun, Service de Neurologie, Centre Hospitalier Universitaire Mustapha, and Institut Pasteur, Algiers, Algeria; Cancer and Developmental Biology Laboratory, National Cancer Institute–Frederick, Frederick, MD; Service de Neuropathologie, Centre Hospitalier Universitaire Dupuytren, Limoges, France; Laboratoire de Neurogénétique, Hôpital de l’Antiquaille, Lyon, France; and Généthon III, Évry, France
| | - Tarik Hammadouche
- INSERM U491, Génétique Médicale et Développement, Faculté de Médecine de la Timone, and Département de Génétique Médicale, Hôpital d’Enfants de la Timone, Marseille; Service de Neurologie, Centre Hospitalier Universitaire Ben-Aknoun, Service de Neurologie, Centre Hospitalier Universitaire Mustapha, and Institut Pasteur, Algiers, Algeria; Cancer and Developmental Biology Laboratory, National Cancer Institute–Frederick, Frederick, MD; Service de Neuropathologie, Centre Hospitalier Universitaire Dupuytren, Limoges, France; Laboratoire de Neurogénétique, Hôpital de l’Antiquaille, Lyon, France; and Généthon III, Évry, France
| | - Antoon Vandenberghe
- INSERM U491, Génétique Médicale et Développement, Faculté de Médecine de la Timone, and Département de Génétique Médicale, Hôpital d’Enfants de la Timone, Marseille; Service de Neurologie, Centre Hospitalier Universitaire Ben-Aknoun, Service de Neurologie, Centre Hospitalier Universitaire Mustapha, and Institut Pasteur, Algiers, Algeria; Cancer and Developmental Biology Laboratory, National Cancer Institute–Frederick, Frederick, MD; Service de Neuropathologie, Centre Hospitalier Universitaire Dupuytren, Limoges, France; Laboratoire de Neurogénétique, Hôpital de l’Antiquaille, Lyon, France; and Généthon III, Évry, France
| | - Colin L. Stewart
- INSERM U491, Génétique Médicale et Développement, Faculté de Médecine de la Timone, and Département de Génétique Médicale, Hôpital d’Enfants de la Timone, Marseille; Service de Neurologie, Centre Hospitalier Universitaire Ben-Aknoun, Service de Neurologie, Centre Hospitalier Universitaire Mustapha, and Institut Pasteur, Algiers, Algeria; Cancer and Developmental Biology Laboratory, National Cancer Institute–Frederick, Frederick, MD; Service de Neuropathologie, Centre Hospitalier Universitaire Dupuytren, Limoges, France; Laboratoire de Neurogénétique, Hôpital de l’Antiquaille, Lyon, France; and Généthon III, Évry, France
| | - Djamel Grid
- INSERM U491, Génétique Médicale et Développement, Faculté de Médecine de la Timone, and Département de Génétique Médicale, Hôpital d’Enfants de la Timone, Marseille; Service de Neurologie, Centre Hospitalier Universitaire Ben-Aknoun, Service de Neurologie, Centre Hospitalier Universitaire Mustapha, and Institut Pasteur, Algiers, Algeria; Cancer and Developmental Biology Laboratory, National Cancer Institute–Frederick, Frederick, MD; Service de Neuropathologie, Centre Hospitalier Universitaire Dupuytren, Limoges, France; Laboratoire de Neurogénétique, Hôpital de l’Antiquaille, Lyon, France; and Généthon III, Évry, France
| | - Nicolas Lévy
- INSERM U491, Génétique Médicale et Développement, Faculté de Médecine de la Timone, and Département de Génétique Médicale, Hôpital d’Enfants de la Timone, Marseille; Service de Neurologie, Centre Hospitalier Universitaire Ben-Aknoun, Service de Neurologie, Centre Hospitalier Universitaire Mustapha, and Institut Pasteur, Algiers, Algeria; Cancer and Developmental Biology Laboratory, National Cancer Institute–Frederick, Frederick, MD; Service de Neuropathologie, Centre Hospitalier Universitaire Dupuytren, Limoges, France; Laboratoire de Neurogénétique, Hôpital de l’Antiquaille, Lyon, France; and Généthon III, Évry, France
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