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Si L, Wang Z, Li XY, Song Y, Yao T, Xu E, Wang X, Wang C. Novel mutations and molecular pathways identified in patients with brain iron accumulation disorders. Neurogenetics 2023; 24:231-241. [PMID: 37453004 DOI: 10.1007/s10048-023-00725-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
Brain iron accumulation disorders (BIADs) are a group of diseases characterized by iron overload in deep gray matter nuclei, which is a common feature of neurodegenerative diseases. Although genetic factors have been reported to be one of the etiologies, much more details about the genetic background and molecular mechanism of BIADs remain unclear. This study aimed to illustrate the genetic characteristics of BIADs and clarify their molecular mechanisms. A total of 84 patients with BIADs were recruited from April 2018 to October 2022 at Xuanwu Hospital. Clinical characteristics including family history, consanguineous marriage history, and age at onset (AAO) were collected and assessed by two senior neurologists. Neuroimaging data were conducted for all the patients, including cranial magnetic resonance imaging (MRI) and susceptibility-weighted imaging (SWI). Whole-exome sequencing (WES) and capillary electrophoresis for detecting sequence mutation and trinucleotide repeat expansion, respectively, were conducted on all patients and part of their parents (whose samples were available). Variant pathogenicity was assessed according to the American College of Medical Genetics and Association for Molecular Pathology (ACMG/AMP). The NBIA and NBIA-like genes with mutations were included for bioinformatic analysis, using Gene Ontology (GO) annotation and Kyoto Encyclopedia of Genes and Genome (KEGG). GO annotation and KEGG pathway analysis were performed on Metascape platform. In the 84 patients, 30 (35.7%) were found to carry mutations, among which 20 carried non-dynamic mutations (missense, stop-gained, frameshift, inframe, and exonic deletion) and 10 carried repeat expansion mutations. Compared with sporadic cases, familial cases had more genetic variants (non-dynamic mutation: P=0.025, dynamic mutation: P=0.003). AAO was 27.85±10.42 years in cases with non-dynamic mutations, which was significantly younger than those without mutations (43.13±17.17, t=3.724, P<0.001) and those with repeated expansions (45.40±8.90, t=4.550, P<0.001). Bioinformatic analysis suggested that genes in lipid metabolism, autophagy, mitochondria regulation, and ferroptosis pathways are more likely to be involved in the pathogenesis of BIADs. This study broadens the genetic spectrum of BIADs and has important implications in genetic counselling and clinical diagnosis. Patients diagnosed as BIADs with early AAO and family history are more likely to carry mutations. Bioinformatic analysis provides new insights into the molecular pathogenesis of BIADs, which may shed lights on the therapeutic strategy for neurodegenerative diseases.
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Affiliation(s)
- Lianghao Si
- Department of Neurology & Neurobiology, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China
| | - Zhanjun Wang
- Department of Neurology & Neurobiology, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China
| | - Xu-Ying Li
- Department of Neurology & Neurobiology, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China
| | - Yang Song
- Department of Neurology & Neurobiology, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China
| | - Tingyan Yao
- Department of Neurology & Neurobiology, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China
| | - Erhe Xu
- Department of Neurology & Neurobiology, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China
| | - Xianling Wang
- Department of Neurology & Neurobiology, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China
| | - Chaodong Wang
- Department of Neurology & Neurobiology, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China.
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Olszewska DA, Rawal S, Fearon C, Alcaide‐Leon P, Stell R, Paramanandan V, Lynch T, Jawad T, Vittal P, Barton B, Miyajima H, Kono S, Kandadai RM, Borgohain R, Lang AE. Neuroimaging Pearls from the MDS Congress Video Challenge. Part 1: Genetic Disorders. Mov Disord Clin Pract 2022; 9:297-310. [PMID: 35402643 PMCID: PMC8974871 DOI: 10.1002/mdc3.13412] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 02/05/2023] Open
Abstract
We selected several "imaging pearls" presented during the Movement Disorder Society (MDS) Video Challenge for this review. While the event, as implicated by its name, was video-centered, we would like to emphasize the important role of imaging in making the correct diagnosis. We divided this anthology into two parts: genetic and acquired disorders. Genetic cases described herein were organized by the inheritance pattern and the focus was put on the imaging findings and differential diagnoses. Despite the overlapping phenotypes, certain described disorders have pathognomonic MRI brain findings that would provide either the "spot" diagnosis or result in further investigations leading to the diagnosis. Despite this, the diagnosis is often challenging with a broad differential diagnosis, and hallmark findings may be present for only a limited time.
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Affiliation(s)
- Diana A. Olszewska
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital—UHN, Division of NeurologyUniversity of TorontoTorontoOntarioCanada
| | - Sapna Rawal
- Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western HospitalUniversity Health NetworkTorontoOntarioCanada
| | - Conor Fearon
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital—UHN, Division of NeurologyUniversity of TorontoTorontoOntarioCanada
| | - Paula Alcaide‐Leon
- Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western HospitalUniversity Health NetworkTorontoOntarioCanada
| | - Rick Stell
- Movement Disorders Unit, Perron Institute of Neurological Translational ScienceSir Charles Gairdner HospitalPerthWestern AustraliaAustralia
| | | | - Tim Lynch
- Centre for Brain HealthDublin Neurological Institute at the Mater Misericordiae University HospitalDublinIreland
- School of Medicine and Medical ScienceUniversity College DublinDublinIreland
| | - Tania Jawad
- Department of NeurologyThe Royal Free HospitalLondonUnited Kingdom
| | - Padmaja Vittal
- Northwestern Medicine Central Dupage HospitalNeurodegenerative Diseases CenterWinfieldIllinoisUSA
| | - Brandon Barton
- Rush University Medical CenterChicagoIllinoisUSA
- Parkinson's Disease Research, Education, and Clinical Care ConsortiumJesse Brown VA Medical CenterChicagoIllinoisUSA
| | - Hiroaki Miyajima
- First Department of MedicineHamamatsu University School of MedicineHamamatsuJapan
| | | | | | - Rupam Borgohain
- Department of NeurologyNizam's Institute of Medical SciencesHyderabadIndia
| | - Anthony E. Lang
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital—UHN, Division of NeurologyUniversity of TorontoTorontoOntarioCanada
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Salcedo-Arellano MJ, Wang JY, McLennan YA, Doan M, Cabal-Herrera AM, Jimenez S, Wolf-Ochoa MW, Sanchez D, Juarez P, Tassone F, Durbin-Johnson B, Hagerman RJ, Martínez-Cerdeño V. Cerebral Microbleeds in Fragile X-Associated Tremor/Ataxia Syndrome. Mov Disord 2021; 36:1935-1943. [PMID: 33760253 PMCID: PMC10929604 DOI: 10.1002/mds.28559] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Fragile X-associated tremor/ataxia syndrome is a neurodegenerative disease of late onset developed by carriers of the premutation in the fragile x mental retardation 1 (FMR1) gene. Pathological features of neurodegeneration in fragile X-associated tremor/ataxia syndrome include toxic levels of FMR1 mRNA, ubiquitin-positive intranuclear inclusions, white matter disease, iron accumulation, and a proinflammatory state. OBJECTIVE The objective of this study was to analyze the presence of cerebral microbleeds in the brains of patients with fragile X-associated tremor/ataxia syndrome and investigate plausible causes for cerebral microbleeds in fragile X-associated tremor/ataxia syndrome. METHODS We collected cerebral and cerebellar tissue from 15 fragile X-associated tremor/ataxia syndrome cases and 15 control cases carrying FMR1 normal alleles. We performed hematoxylin and eosin, Perls and Congo red stains, ubiquitin, and amyloid β protein immunostaining. We quantified the number of cerebral microbleeds, amount of iron, presence of amyloid β within the capillaries, and number of endothelial cells containing intranuclear inclusions. We evaluated the relationships between pathological findings using correlation analysis. RESULTS We found intranuclear inclusions in the endothelial cells of capillaries and an increased number of cerebral microbleeds in the brains of those with fragile X-associated tremor/ataxia syndrome, both of which are indicators of cerebrovascular dysfunction. We also found a suggestive association between the amount of capillaries that contain amyloid β in the cerebral cortex and the rate of disease progression. CONCLUSION We propose microangiopathy as a pathologic feature of fragile X-associated tremor/ataxia syndrome. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- María Jimena Salcedo-Arellano
- Department of Pediatrics, University of California Davis School of Medicine, Sacramento, CA, USA
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Sacramento, CA, USA
- Institute for Pediatric Regenerative Medicine and Shriners Hospitals for Children Northern California, Sacramento, CA, USA
- Department of Pathology and Laboratory Medicine, UC Davis School of Medicine, Sacramento, CA, USA
| | - Jun Yi Wang
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Sacramento, CA, USA
- Center for Mind and Brain, University of California Davis, Davis, CA, USA
| | - Yingratana A McLennan
- Department of Pediatrics, University of California Davis School of Medicine, Sacramento, CA, USA
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Sacramento, CA, USA
- Institute for Pediatric Regenerative Medicine and Shriners Hospitals for Children Northern California, Sacramento, CA, USA
| | - Mai Doan
- Institute for Pediatric Regenerative Medicine and Shriners Hospitals for Children Northern California, Sacramento, CA, USA
- Department of Pathology and Laboratory Medicine, UC Davis School of Medicine, Sacramento, CA, USA
| | - Ana Maria Cabal-Herrera
- Group on Congenital Malformations and Dysmorphology, Faculty of Health, Universidad del Valle (MACOS), Cali, Colombia
| | - Sara Jimenez
- Institute for Pediatric Regenerative Medicine and Shriners Hospitals for Children Northern California, Sacramento, CA, USA
- Department of Pathology and Laboratory Medicine, UC Davis School of Medicine, Sacramento, CA, USA
| | - Marisol W Wolf-Ochoa
- Institute for Pediatric Regenerative Medicine and Shriners Hospitals for Children Northern California, Sacramento, CA, USA
- Department of Pathology and Laboratory Medicine, UC Davis School of Medicine, Sacramento, CA, USA
| | - Desiree Sanchez
- Institute for Pediatric Regenerative Medicine and Shriners Hospitals for Children Northern California, Sacramento, CA, USA
- Department of Pathology and Laboratory Medicine, UC Davis School of Medicine, Sacramento, CA, USA
| | - Pablo Juarez
- Institute for Pediatric Regenerative Medicine and Shriners Hospitals for Children Northern California, Sacramento, CA, USA
- Department of Pathology and Laboratory Medicine, UC Davis School of Medicine, Sacramento, CA, USA
| | - Flora Tassone
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Sacramento, CA, USA
- Department of Biochemistry and Molecular Medicine, UC Davis School of Medicine, Sacramento, CA, USA
| | - Blythe Durbin-Johnson
- Division of Biostatistics, Department of Public Health Sciences, UC Davis School of Medicine, Sacramento, CA, USA
| | - Randi J Hagerman
- Department of Pediatrics, University of California Davis School of Medicine, Sacramento, CA, USA
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Sacramento, CA, USA
| | - Verónica Martínez-Cerdeño
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Sacramento, CA, USA
- Institute for Pediatric Regenerative Medicine and Shriners Hospitals for Children Northern California, Sacramento, CA, USA
- Department of Pathology and Laboratory Medicine, UC Davis School of Medicine, Sacramento, CA, USA
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Abstract
PURPOSE OF REVIEW The diagnosis of neurodegeneration with brain iron accumulation (NBIA) typically associates various extrapyramidal and pyramidal features, cognitive and psychiatric symptoms with bilateral hypointensities in the globus pallidus on iron-sensitive magnetic resonance images, reflecting the alteration of iron homeostasis in this area. This article details the contribution of MRI in the diagnosis by summarizing and comparing MRI patterns of the various NBIA subtypes. RECENT FINDINGS MRI almost always shows characteristic changes combining iron accumulation and additional neuroimaging abnormalities. Iron-sensitive MRI shows iron deposition in the basal ganglia, particularly in bilateral globus pallidus and substantia nigra. Other regions may be affected depending on the NBIA subtypes including the cerebellum and dentate nucleus, the midbrain, the striatum, the thalamus, and the cortex. Atrophy of the cerebellum, brainstem, corpus callosum and cortex, and white matter changes may be associated and worsen with disease duration. Iron deposition can be quantified using R2 or quantitative susceptibility mapping. SUMMARY Recent MRI advances allow depicting differences between the various subtypes of NBIA, providing a useful analytical framework for clinicians. Standardization of protocols for image acquisition and analysis may help improving the detection of imaging changes associated with NBIA and the quantification of iron deposition.
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de Jesus JR, Arruda MAZ. Unravelling neurological disorders through metallomics-based approaches. Metallomics 2020; 12:1878-1896. [PMID: 33237082 DOI: 10.1039/d0mt00234h] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Understanding the biological process involving metals and biomolecules in the brain is essential for establishing the origin of neurological disorders, such as neurodegenerative and psychiatric diseases. From this perspective, this critical review presents recent advances in this topic, showing possible mechanisms involving the disruption of metal homeostasis and the pathogenesis of neurological disorders. We also discuss the main challenges observed in metallomics studies associated with neurological disorders, including those related to sample preparation and analyte quantification.
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6
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Clinical characteristics and diagnostic clues to Neurometabolic causes of dystonia. J Neurol Sci 2020; 419:117167. [DOI: 10.1016/j.jns.2020.117167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/22/2020] [Accepted: 09/29/2020] [Indexed: 12/30/2022]
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Caplan DN, Rapalino O, Karaa A, Rosovsky RP, Uljon S. Case 35-2020: A 59-Year-Old Woman with Type 1 Diabetes Mellitus and Obtundation. N Engl J Med 2020; 383:1974-1983. [PMID: 33176089 DOI: 10.1056/nejmcpc2002412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- David N Caplan
- From the Departments of Neurology (D.N.C.), Radiology (O.R.), Pediatrics (A.K.), Medicine (R.P.R.), and Pathology (S.U.), Massachusetts General Hospital, and the Departments of Neurology (D.N.C.), Radiology (O.R.), Pediatrics (A.K.), Medicine (R.P.R.), and Pathology (S.U.), Harvard Medical School - both in Boston
| | - Otto Rapalino
- From the Departments of Neurology (D.N.C.), Radiology (O.R.), Pediatrics (A.K.), Medicine (R.P.R.), and Pathology (S.U.), Massachusetts General Hospital, and the Departments of Neurology (D.N.C.), Radiology (O.R.), Pediatrics (A.K.), Medicine (R.P.R.), and Pathology (S.U.), Harvard Medical School - both in Boston
| | - Amel Karaa
- From the Departments of Neurology (D.N.C.), Radiology (O.R.), Pediatrics (A.K.), Medicine (R.P.R.), and Pathology (S.U.), Massachusetts General Hospital, and the Departments of Neurology (D.N.C.), Radiology (O.R.), Pediatrics (A.K.), Medicine (R.P.R.), and Pathology (S.U.), Harvard Medical School - both in Boston
| | - Rachel P Rosovsky
- From the Departments of Neurology (D.N.C.), Radiology (O.R.), Pediatrics (A.K.), Medicine (R.P.R.), and Pathology (S.U.), Massachusetts General Hospital, and the Departments of Neurology (D.N.C.), Radiology (O.R.), Pediatrics (A.K.), Medicine (R.P.R.), and Pathology (S.U.), Harvard Medical School - both in Boston
| | - Sacha Uljon
- From the Departments of Neurology (D.N.C.), Radiology (O.R.), Pediatrics (A.K.), Medicine (R.P.R.), and Pathology (S.U.), Massachusetts General Hospital, and the Departments of Neurology (D.N.C.), Radiology (O.R.), Pediatrics (A.K.), Medicine (R.P.R.), and Pathology (S.U.), Harvard Medical School - both in Boston
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8
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Hinarejos I, Machuca C, Sancho P, Espinós C. Mitochondrial Dysfunction, Oxidative Stress and Neuroinflammation in Neurodegeneration with Brain Iron Accumulation (NBIA). Antioxidants (Basel) 2020; 9:antiox9101020. [PMID: 33092153 PMCID: PMC7589120 DOI: 10.3390/antiox9101020] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/16/2020] [Accepted: 10/17/2020] [Indexed: 12/13/2022] Open
Abstract
The syndromes of neurodegeneration with brain iron accumulation (NBIA) encompass a group of invalidating and progressive rare diseases that share the abnormal accumulation of iron in the basal ganglia. The onset of NBIA disorders ranges from infancy to adulthood. Main clinical signs are related to extrapyramidal features (dystonia, parkinsonism and choreoathetosis), and neuropsychiatric abnormalities. Ten NBIA forms are widely accepted to be caused by mutations in the genes PANK2, PLA2G6, WDR45, C19ORF12, FA2H, ATP13A2, COASY, FTL1, CP, and DCAF17. Nonetheless, many patients remain without a conclusive genetic diagnosis, which shows that there must be additional as yet undiscovered NBIA genes. In line with this, isolated cases of known monogenic disorders, and also, new genetic diseases, which present with abnormal brain iron phenotypes compatible with NBIA, have been described. Several pathways are involved in NBIA syndromes: iron and lipid metabolism, mitochondrial dynamics, and autophagy. However, many neurodegenerative conditions share features such as mitochondrial dysfunction and oxidative stress, given the bioenergetics requirements of neurons. This review aims to describe the existing link between the classical ten NBIA forms by examining their connection with mitochondrial impairment as well as oxidative stress and neuroinflammation.
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Affiliation(s)
- Isabel Hinarejos
- Unit of Genetics and Genomics of Neuromuscular and Neurodegenerative Disorders, Centro de Investigación Príncipe Felipe (CIPF), 46012 Valencia, Spain; (I.H.); (C.M.); (P.S.)
- Rare Diseases Joint Units, CIPF-IIS La Fe & INCLIVA, 46012 Valencia, Spain
| | - Candela Machuca
- Unit of Genetics and Genomics of Neuromuscular and Neurodegenerative Disorders, Centro de Investigación Príncipe Felipe (CIPF), 46012 Valencia, Spain; (I.H.); (C.M.); (P.S.)
- Rare Diseases Joint Units, CIPF-IIS La Fe & INCLIVA, 46012 Valencia, Spain
- Unit of Stem Cells Therapies in Neurodegenerative Diseases, Centro de Investigación Príncipe Felipe (CIPF), 46012 Valencia, Spain
| | - Paula Sancho
- Unit of Genetics and Genomics of Neuromuscular and Neurodegenerative Disorders, Centro de Investigación Príncipe Felipe (CIPF), 46012 Valencia, Spain; (I.H.); (C.M.); (P.S.)
- Rare Diseases Joint Units, CIPF-IIS La Fe & INCLIVA, 46012 Valencia, Spain
| | - Carmen Espinós
- Unit of Genetics and Genomics of Neuromuscular and Neurodegenerative Disorders, Centro de Investigación Príncipe Felipe (CIPF), 46012 Valencia, Spain; (I.H.); (C.M.); (P.S.)
- Rare Diseases Joint Units, CIPF-IIS La Fe & INCLIVA, 46012 Valencia, Spain
- Department of Genetics, University of Valencia, 46100 Valencia, Spain
- Correspondence: ; Tel.: +34-963-289-680
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Lee JH, Yun JY, Gregory A, Hogarth P, Hayflick SJ. Brain MRI Pattern Recognition in Neurodegeneration With Brain Iron Accumulation. Front Neurol 2020; 11:1024. [PMID: 33013674 PMCID: PMC7511538 DOI: 10.3389/fneur.2020.01024] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 08/05/2020] [Indexed: 01/08/2023] Open
Abstract
Most neurodegeneration with brain iron accumulation (NBIA) disorders can be distinguished by identifying characteristic changes on magnetic resonance imaging (MRI) in combination with clinical findings. However, a significant number of patients with an NBIA disorder confirmed by genetic testing have MRI features that are atypical for their specific disease. The appearance of specific MRI patterns depends on the stage of the disease and the patient's age at evaluation. MRI interpretation can be challenging because of heterogeneously acquired MRI datasets, individual interpreter bias, and lack of quantitative data. Therefore, optimal acquisition and interpretation of MRI data are needed to better define MRI phenotypes in NBIA disorders. The stepwise approach outlined here may help to identify NBIA disorders and delineate the natural course of MRI-identified changes.
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Affiliation(s)
- Jae-Hyeok Lee
- Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan-si, South Korea
| | - Ji Young Yun
- Department of Neurology, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Allison Gregory
- Departments of Molecular and Medical Genetics, Oregon Health and Science University, Portland, OR, United States
| | - Penelope Hogarth
- Departments of Molecular and Medical Genetics, Oregon Health and Science University, Portland, OR, United States
| | - Susan J Hayflick
- Departments of Molecular and Medical Genetics, Oregon Health and Science University, Portland, OR, United States
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Fagerberg CR, Taylor A, Distelmaier F, Schrøder HD, Kibæk M, Wieczorek D, Tarnopolsky M, Brady L, Larsen MJ, Jamra RA, Seibt A, Hejbøl EK, Gade E, Markovic L, Klee D, Nagy P, Rouse N, Agarwal P, Dolinsky VW, Bakovic M. Choline transporter-like 1 deficiency causes a new type of childhood-onset neurodegeneration. Brain 2020; 143:94-111. [PMID: 31855247 DOI: 10.1093/brain/awz376] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 09/11/2019] [Accepted: 10/07/2019] [Indexed: 12/14/2022] Open
Abstract
Cerebral choline metabolism is crucial for normal brain function, and its homoeostasis depends on carrier-mediated transport. Here, we report on four individuals from three families with neurodegenerative disease and homozygous frameshift mutations (Asp517Metfs*19, Ser126Metfs*8, and Lys90Metfs*18) in the SLC44A1 gene encoding choline transporter-like protein 1. Clinical features included progressive ataxia, tremor, cognitive decline, dysphagia, optic atrophy, dysarthria, as well as urinary and bowel incontinence. Brain MRI demonstrated cerebellar atrophy and leukoencephalopathy. Moreover, low signal intensity in globus pallidus with hyperintensive streaking and low signal intensity in substantia nigra were seen in two individuals. The Asp517Metfs*19 and Ser126Metfs*8 fibroblasts were structurally and functionally indistinguishable. The most prominent ultrastructural changes of the mutant fibroblasts were reduced presence of free ribosomes, the appearance of elongated endoplasmic reticulum and strikingly increased number of mitochondria and small vesicles. When chronically treated with choline, those characteristics disappeared and mutant ultrastructure resembled healthy control cells. Functional analysis revealed diminished choline transport yet the membrane phosphatidylcholine content remained unchanged. As part of the mechanism to preserve choline and phosphatidylcholine, choline transporter deficiency was implicated in impaired membrane homeostasis of other phospholipids. Choline treatments could restore the membrane lipids, repair cellular organelles and protect mutant cells from acute iron overload. In conclusion, we describe a novel childhood-onset neurometabolic disease caused by choline transporter deficiency with autosomal recessive inheritance.
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Affiliation(s)
| | - Adrian Taylor
- Department of Human Health and Nutritional Sciences, University of Guelph, Canada
| | - Felix Distelmaier
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Heinrich-Heine University, Düsseldorf, Germany
| | | | - Maria Kibæk
- Children Hospital of H. C Andersen, Odense University Hospital, Odense, Denmark
| | - Dagmar Wieczorek
- Institute of Human Genetics, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Mark Tarnopolsky
- Department of Pediatrics, Neuromuscular and Neurometabolic Clinic, McMaster University Medical Centre, Hamilton, Canada
| | - Lauren Brady
- Department of Pediatrics, Neuromuscular and Neurometabolic Clinic, McMaster University Medical Centre, Hamilton, Canada
| | - Martin J Larsen
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Rami A Jamra
- Institute of Human Genetics, Leipzig University, Germany and Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Annette Seibt
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Heinrich-Heine University, Düsseldorf, Germany
| | | | - Else Gade
- Department of Ophthalmology, Odense University Hospital, 5000 Odense C, Denmark
| | - Ljubo Markovic
- Department of Radiology, Odense University Hospital, 5000 Odense C, Denmark
| | - Dirk Klee
- Department of Diagnostic and Interventional Radiology, Heinrich-Heine University, Düsseldorf, Germany
| | | | | | - Prasoon Agarwal
- Department of Pharmacology and Therapeutics, University of Manitoba, Canada
| | - Vernon W Dolinsky
- Department of Pharmacology and Therapeutics, University of Manitoba, Canada
| | - Marica Bakovic
- Department of Human Health and Nutritional Sciences, University of Guelph, Canada
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11
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Van Cauter S, Severino M, Ammendola R, Van Berkel B, Vavro H, van den Hauwe L, Rumboldt Z. Bilateral lesions of the basal ganglia and thalami (central grey matter)-pictorial review. Neuroradiology 2020; 62:1565-1605. [PMID: 32761278 PMCID: PMC7405775 DOI: 10.1007/s00234-020-02511-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/30/2020] [Indexed: 12/11/2022]
Abstract
The basal ganglia and thalami are paired deep grey matter structures with extensive metabolic activity that renders them susceptible to injury by various diseases. Most pathological processes lead to bilateral lesions, which may be symmetric or asymmetric, frequently showing characteristic patterns on imaging studies. In this comprehensive pictorial review, the most common and/or typical genetic, acquired metabolic/toxic, infectious, inflammatory, vascular and neoplastic pathologies affecting the central grey matter are subdivided according to the preferential location of the lesions: in the basal ganglia, in the thalami or both. The characteristic imaging findings are described with emphasis on the differential diagnosis and clinical context.
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Affiliation(s)
- Sofie Van Cauter
- Department of Medical Imaging, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600, Genk, Belgium. .,Department of Radiology, University Hospitals Leuven, Herestraat 39, 3000, Leuven, Belgium.
| | - Mariasavina Severino
- Neuroradiology Unit, IRCCS Instituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147, Genoa, Italy
| | - Rosamaria Ammendola
- Neuroradiology Unit, IRCCS Instituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147, Genoa, Italy
| | - Brecht Van Berkel
- Department of Medical Imaging, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600, Genk, Belgium.,Department of Radiology, University Hospitals Leuven, Herestraat 39, 3000, Leuven, Belgium
| | - Hrvoje Vavro
- Department of Diagnostic and Interventional Radiology, University Hospital Dubrava, Avenija Gojka Šuška 6, Zagreb, Croatia
| | - Luc van den Hauwe
- Department of Radiology, University Hospital Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium.,Department of Medical Imaging, AZ KLINA, Augustijnslei 100, 2930, Brasschaat, Belgium
| | - Zoran Rumboldt
- Department of Radiology, University of Rijeka School of Medicine, Ulica Braće Branchetta 20, 51000, Rijeka, Croatia.,Department of Radiology, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC, 29425, USA
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12
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Subramanian C, Yao J, Frank MW, Rock CO, Jackowski S. A pantothenate kinase-deficient mouse model reveals a gene expression program associated with brain coenzyme a reduction. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165663. [PMID: 31918006 DOI: 10.1016/j.bbadis.2020.165663] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/12/2019] [Accepted: 12/29/2019] [Indexed: 12/12/2022]
Abstract
Pantothenate kinase (PanK) is the first enzyme in the coenzyme A (CoA) biosynthetic pathway. The differential expression of the four-active mammalian PanK isoforms regulates CoA levels in different tissues and PANK2 mutations lead to Pantothenate Kinase Associated Neurodegeneration (PKAN). The molecular mechanisms that potentially underlie PKAN pathophysiology are investigated in a mouse model of CoA deficiency in the central nervous system (CNS). Both PanK1 and PanK2 contribute to brain CoA levels in mice and so a mouse model with a systemic deletion of Pank1 together with neuronal deletion of Pank2 was generated. Neuronal Pank2 expression in double knockout mice decreased starting at P9-11 triggering a significant brain CoA deficiency. The depressed brain CoA in the mice correlates with abnormal forelimb flexing and weakness that, in turn, contributes to reduced locomotion and abnormal gait. Biochemical analysis reveals a reduction in short-chain acyl-CoAs, including acetyl-CoA and succinyl-CoA. Comparative gene expression analysis reveals that the CoA deficiency in brain is associated with a large elevation of Hif3a transcript expression and significant reduction of gene transcripts in heme and hemoglobin synthesis. Reduction of brain heme levels is associated with the CoA deficiency. The data suggest a response to oxygen/glucose deprivation and indicate a disruption of oxidative metabolism arising from a CoA deficiency in the CNS.
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Affiliation(s)
| | - Jiangwei Yao
- St. Jude Children's Research Hospital, Memphis, TN 38105-3678, USA
| | - Matthew W Frank
- St. Jude Children's Research Hospital, Memphis, TN 38105-3678, USA
| | - Charles O Rock
- St. Jude Children's Research Hospital, Memphis, TN 38105-3678, USA
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13
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Kasapkara ÇS, Tümer L, Gregory A, Ezgü F, İnci A, Derinkuyu BE, Fox R, Rogers C, Hayflick S. A new NBIA patient from Turkey with homozygous C19ORF12 mutation. Acta Neurol Belg 2019; 119:623-625. [PMID: 30298423 DOI: 10.1007/s13760-018-1026-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 10/05/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Çiğdem Seher Kasapkara
- Department of Pediatric Metabolism and Nutrition, Dr. Sami Ulus Maternity and Children's Research and Education Hospital, Ankara, Turkey.
| | - Leyla Tümer
- Department of Pediatric Metabolism and Nutrition, Gazi University Hospital, Ankara, Turkey
| | - Allison Gregory
- Molecular and Medical Genetics, Pediatrics and Neurology, Oregon Health and Science University, Portland, Oregon, 97239, USA
| | - Fatih Ezgü
- Department of Pediatric Metabolism and Nutrition, Gazi University Hospital, Ankara, Turkey
| | - Aslı İnci
- Department of Pediatric Metabolism and Nutrition, Gazi University Hospital, Ankara, Turkey
| | - Betül Emine Derinkuyu
- Department of Pediatric Radiology, Dr. Sami Ulus Maternity and Children's Research and Education Hospital, Ankara, Turkey
| | - Rachel Fox
- Molecular and Medical Genetics, Pediatrics and Neurology, Oregon Health and Science University, Portland, Oregon, 97239, USA
| | - Caleb Rogers
- Molecular and Medical Genetics, Pediatrics and Neurology, Oregon Health and Science University, Portland, Oregon, 97239, USA
| | - Susan Hayflick
- Molecular and Medical Genetics, Pediatrics and Neurology, Oregon Health and Science University, Portland, Oregon, 97239, USA
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14
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Kaleka G, McCormick ME, Krishnan A. Beta-Propeller Protein-Associated Neurodegeneration (BPAN) Detected in a Child with Epileptic Spasms. Cureus 2019; 11:e5404. [PMID: 31632858 PMCID: PMC6795347 DOI: 10.7759/cureus.5404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This report discusses a 13-year-old girl diagnosed with beta-propeller protein-associated neurodegeneration (BPAN). BPAN is an X-linked neurodegeneration disorder associated with a mutation in the WDR45 gene. It typically presents in childhood with encephalopathy, developmental delay, and seizures. Following an initial static phase, these symptoms then progress to dementia, dystonia, and parkinsonism in early adulthood. Our child initially presented with epileptic spasms, global developmental delay, speech delay, hypotonia, spasticity, scoliosis, and gait disturbance. While these symptoms remained unchanged in early childhood, they depicted accelerated deterioration at age 12-13 rather than in adulthood. Her diagnosis was made based on her clinical presentation and review of imaging that led to specific genetic testing confirming the condition. The imaging findings were of markedly low signal on gradient T2* sequences in the globus pallidus and substantia nigra and T1 hyperintensity in the substantia nigra, with associated diffuse brain volume loss. Unlike other cases reported in the literature, there was no classic area of central hypointensity on T1 imaging in the substantia nigra.
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Affiliation(s)
- Guneet Kaleka
- Internal Medicine, Olive View - University of California Los Angeles Medical Center, Sylmar, USA
| | - M Eileen McCormick
- Pediatrics, Oakland University William Beaumont School of Medicine, Royal Oak, USA
| | - Anant Krishnan
- Radiology, Oakland University William Beaumont School of Medicine, Royal Oak, USA
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15
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Tiedemann LM, Reed D, Joseph A, Yoo SH. Ocular and systemic manifestations of beta-propeller protein-associated neurodegeneration. J AAPOS 2018; 22:403-405. [PMID: 30092264 DOI: 10.1016/j.jaapos.2018.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 03/13/2018] [Accepted: 03/15/2018] [Indexed: 10/28/2022]
Abstract
Beta-propeller protein-associated neurodegeneration (BPAN) is a rare genetic disorder characterized by neurodegeneration with brain iron accumulation (NBIA). We report an infant diagnosed with BPAN who was found to have high myopia and astigmatism, strabismus, and bilateral retinal pigmentary changes. While retinal pigmentary changes have been described in other disorders of NBIA, it has been only rarely reported in BPAN.
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Affiliation(s)
- Laura M Tiedemann
- George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Dallas Reed
- Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, Massachusetts; Department of Pediatrics, Division of Medical Genetics, Tufts Medical Center, Boston, Massachusetts
| | - Anthony Joseph
- Vitreoretinal Surgery and Disease, Ophthalmic Consultants of Boston, Boston, Massachusetts
| | - Sylvia H Yoo
- Department of Ophthalmology, New England Eye Center, Tufts Medical Center, Boston, Massachusetts.
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16
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Albanese A, Di Giovanni M, Lalli S. Dystonia: diagnosis and management. Eur J Neurol 2018; 26:5-17. [DOI: 10.1111/ene.13762] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 07/20/2018] [Indexed: 01/01/2023]
Affiliation(s)
- A. Albanese
- Unità Operativa di Neurologia IRCCS Istituto Clinico Humanitas Rozzano Milano Italy
- Istituto di Neurologia Università Cattolica del Sacro Cuore Milano Italy
| | - M. Di Giovanni
- Unità Operativa di Neurologia IRCCS Istituto Clinico Humanitas Rozzano Milano Italy
| | - S. Lalli
- Unità Operativa di Neurologia IRCCS Istituto Clinico Humanitas Rozzano Milano Italy
- Istituto di Neurologia Università Cattolica del Sacro Cuore Milano Italy
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17
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Razmeh S, Habibi AH, Orooji M, Alizadeh E, Moradiankokhdan K, Razmeh B. Pantothenate kinase-associated neurodegeneration: Clinical aspects, diagnosis and treatments. Neurol Int 2018; 10:7516. [PMID: 29844889 PMCID: PMC5937219 DOI: 10.4081/ni.2018.7516] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 12/29/2017] [Accepted: 02/04/2018] [Indexed: 01/06/2023] Open
Abstract
Pantothenate Kinase-Associated Neurodegeneration (PKAN) is an autosomal recessive disorder characterized by a mutation in the PANK2 gene. The clinical presentation may range from only speech disorder to severe generalized dystonia, spasticity, Visual loss, dysphagia and dementia. The hallmark of this disease is eyes of the tiger sign in the medial aspect of bilateral globus pallidus on T2-weighted MRI that is a hyperintense lesion surrounded by hypointensity. Common treatments for PKAN disease include anticholinergics, botulinum toxin, Oral and Intrathecal baclofen, Iron chelation drugs and surgical procedures such as ablative pallidotomy or thalamotomy, Deep brain stimulation. There are many controversies about the pathogenesis and treatment of this disease, and in recent years interesting studies have been done on PKAN disease and other similar diseases. This review summarizes the clinical presentation, etiology, imaging modalities and treatment.
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Affiliation(s)
| | | | | | | | | | - Behroz Razmeh
- Kermanshah University of Medical Sciences, Kermanshah, Iran
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18
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Lee JH, Gregory A, Hogarth P, Rogers C, Hayflick SJ. Looking Deep into the Eye-of-the-Tiger in Pantothenate Kinase-Associated Neurodegeneration. AJNR Am J Neuroradiol 2018; 39:583-588. [PMID: 29371252 DOI: 10.3174/ajnr.a5514] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 10/31/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND PURPOSE A detailed delineation of the MR imaging changes in the globus pallidus in pantothenate kinase-associated neurodegeneration will be helpful for diagnosis and monitoring of patients. The aim of this study was to determine the morphologic spectrum of the "eye-of-the-tiger" sign and the topographic pattern of iron deposition in a group of patients with pantothenate kinase-associated neurodegeneration. MATERIALS AND METHODS Seventy-four MR imaging scans from 54 individuals with PANK2 mutations were analyzed for signal patterns in the globus pallidus. Sixteen SWI data from 15 patients who underwent 1.5T (n = 7), 3T (n = 7), and 7T (n = 2) MR imaging were included to visualize the iron topography. RESULTS The linear hyperintensity alongside the medial border of the globus pallidus was the earliest T2 signal change. This finding was evident before SWI changes from iron deposition became visible. T2WI performed in early childhood mostly showed isolated hyperintense signal. In adult patients, marked signal reduction within an earlier hyperintense center resulting from iron accumulation led to the loss of signal difference between the central and surrounding areas. Signal hypointensity on SWI progressed from the medial to the lateral portion of the globus pallidus with increasing age. The fiber connections between the medial globus pallidus and the anteromedial aspect of the substantia nigra and subthalamic nucleus were markedly hypointense on SWI. CONCLUSIONS In pantothenate kinase-associated neurodegeneration, the globus pallidus MR imaging changes using SWI develop as region-specific and age-dependent phenomena. Signal inhomogeneity was observed across the globus pallidus in pantothenate kinase-associated neurodegeneration and should be considered when determining the concentration of iron.
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Affiliation(s)
- J-H Lee
- From the Departments of Molecular and Medical Genetics (J.-H.L., A.G., P.H., C.R., S.J.H.) .,Department of Neurology (J.-H.L.), Pusan National University Yangsan Hospital, Medical Research Institute, Pusan National University School of Medicine, Yangsan, South Korea
| | - A Gregory
- From the Departments of Molecular and Medical Genetics (J.-H.L., A.G., P.H., C.R., S.J.H.)
| | - P Hogarth
- From the Departments of Molecular and Medical Genetics (J.-H.L., A.G., P.H., C.R., S.J.H.).,Neurology (P.H., S.J.H.)
| | - C Rogers
- From the Departments of Molecular and Medical Genetics (J.-H.L., A.G., P.H., C.R., S.J.H.)
| | - S J Hayflick
- From the Departments of Molecular and Medical Genetics (J.-H.L., A.G., P.H., C.R., S.J.H.) .,Neurology (P.H., S.J.H.).,Pediatrics (S.J.H.), Oregon Health & Science University, Portland, Oregon
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19
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Limongi JCP. Neurodegeneration with brain iron accumulation. ARQUIVOS DE NEURO-PSIQUIATRIA 2017; 74:517-8. [PMID: 27487369 DOI: 10.1590/0004-282x20160102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 06/08/2016] [Indexed: 11/21/2022]
Affiliation(s)
- João Carlos Papaterra Limongi
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil
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20
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Salomão RPA, Pedroso JL, Gama MTD, Dutra LA, Maciel RH, Godeiro-Junior C, Chien HF, Teive HAG, Cardoso F, Barsottini OGP. A diagnostic approach for neurodegeneration with brain iron accumulation: clinical features, genetics and brain imaging. ARQUIVOS DE NEURO-PSIQUIATRIA 2017; 74:587-96. [PMID: 27487380 DOI: 10.1590/0004-282x20160080] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 04/26/2016] [Indexed: 02/08/2023]
Abstract
Neurodegeneration with brain iron accumulation (NBIA) represents a heterogeneous and complex group of inherited neurodegenerative diseases, characterized by excessive iron accumulation, particularly in the basal ganglia. Common clinical features of NBIA include movement disorders, particularly parkinsonism and dystonia, cognitive dysfunction, pyramidal signs, and retinal abnormalities. The forms of NBIA described to date include pantothenase kinase-associated neurodegeneration (PKAN), phospholipase A2 associated neurodegeneration (PLAN), neuroferritinopathy, aceruloplasminemia, beta-propeller protein-associated neurodegeneration (BPAN), Kufor-Rakeb syndrome, mitochondrial membrane protein-associated neurodegeneration (MPAN), fatty acid hydroxylase-associated neurodegeneration (FAHN), coenzyme A synthase protein-associated neurodegeneration (CoPAN) and Woodhouse-Sakati syndrome. This review is a diagnostic approach for NBIA cases, from clinical features and brain imaging findings to the genetic etiology.
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Affiliation(s)
- Rubens Paulo Araújo Salomão
- Universidade Federal de São Paulo, Departamento de Neurologia, Divisão de Neurologia Geral, São Paulo SP, Brasil
| | - José Luiz Pedroso
- Universidade Federal de São Paulo, Departamento de Neurologia, Divisão de Neurologia Geral, São Paulo SP, Brasil
| | - Maria Thereza Drumond Gama
- Universidade Federal de São Paulo, Departamento de Neurologia, Divisão de Neurologia Geral, São Paulo SP, Brasil
| | - Lívia Almeida Dutra
- Universidade Federal de São Paulo, Departamento de Neurologia, Divisão de Neurologia Geral, São Paulo SP, Brasil
| | - Ricardo Horta Maciel
- Universidade Federal de Minas Gerais, Clínica de Desordens do Movimento, Departmento de Neurologia, Belo Horizonte MG, Brasil
| | - Clécio Godeiro-Junior
- Universidade Federal do Rio Grande do Norte, Unidade de Transtornos do Movimento, Departamento de Medicina Integrada, Natal RN, Brasil
| | - Hsin Fen Chien
- Universidade de São Paulo, Instituto de Ortopedia e Traumatologia, São Paulo SP, Brasil
| | - Hélio A G Teive
- Universidade Federal do Paraná, Hospital de Clínicas, Unidade de Desordens do Movimento, Curitiba PR, Brasil
| | - Francisco Cardoso
- Universidade Federal de Minas Gerais, Clínica de Desordens do Movimento, Departmento de Neurologia, Belo Horizonte MG, Brasil
| | - Orlando G P Barsottini
- Universidade Federal de São Paulo, Departamento de Neurologia, Divisão de Neurologia Geral, São Paulo SP, Brasil
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21
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Gore E, Appleby BS, Cohen ML, DeBrosse SD, Leverenz JB, Miller BL, Siedlak SL, Zhu X, Lerner AJ. Clinical and imaging characteristics of late onset mitochondrial membrane protein-associated neurodegeneration (MPAN). Neurocase 2016; 22:476-483. [PMID: 27801611 PMCID: PMC5568540 DOI: 10.1080/13554794.2016.1247458] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 10/07/2016] [Indexed: 12/14/2022]
Abstract
Young onset dementias present significant diagnostic challenges. We present the case of a 35-year-old Kuwaiti man with social withdrawal, drowsiness, irritability, anxiety, aphasia, memory loss, hypereflexia, and Parkinsonism. Brain MRI showed bilateral symmetric gradient echo hypointensities in the globi pallidi and substantiae nigrae. Left cortical hypometabolism was seen on brain fluorodeoxyglucose positron emission tomography. A cortical brain biopsy revealed a high Lewy body burden. Genetic testing revealed a homozygous p.T11M mutation in the C19orf12 gene consistent with mitochondrial membrane protein-associated neurodegeneration. This is the oldest onset age of MPAN reported.
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Affiliation(s)
- Ethan Gore
- Department of Neurology, University Hospitals Case Medical Center, Beachwood, OH, USA
| | - Brian S. Appleby
- Departments of Neurology and Psychiatry, University Hospitals Case Medical Center, 3619 Park East Drive, Beachwood, OH, USA
| | - Mark L. Cohen
- Department of Pathology, University Hospitals Case Medical Center, Cleveland, OH, USA
| | - Suzanne D. DeBrosse
- Departments of Genetics and Genome Sciences, Pediatrics, and Neurology, University Hospitals Case Medical Center, Cleveland, OH, USA
| | - James B. Leverenz
- Cleveland Clinic Lou Ruvo Center for Brain Health, Cleveland, OH, USA
| | - Bruce L. Miller
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Sandra L. Siedlak
- Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
| | - Xiongwei Zhu
- Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
| | - Alan J. Lerner
- Department of Neurology, University Hospitals Case Medical Center, Beachwood, OH, USA
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22
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Nassif D, Pereira JS, Spitz M, Capitão C, Faria A. Neurodegeneration with brain iron accumulation: A case report. Dement Neuropsychol 2016; 10:160-164. [PMID: 29213449 PMCID: PMC5642409 DOI: 10.1590/s1980-5764-2016dn1002014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Pantothenate kinase-associated neurodegeneration (PKAN) is an autosomal recessive disorder caused by mutation in the PANK2 gene. It is characterized by abnormal brain iron accumulation, mainly in the globus pallidus. PKAN is included in a group of disorders known as neurodegeneration with brain iron accumulation (NBIA). We report a case of atypical PKAN with its most characteristic presentation, exhibiting marked psychiatric symptoms, speech disorder and focal dystonia. Brain MRI has great diagnostic importance in this group of disorders and, in this case, disclosed the eye-of-the-tiger sign. Genetic testing confirmed the diagnosis.
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Affiliation(s)
- Daniel Nassif
- Movement Disorders Sector, Neurology Service, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - João Santos Pereira
- Movement Disorders Sector, Neurology Service, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro RJ, Brazil.,Post Graduate Stricto Sensu Program in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Mariana Spitz
- Movement Disorders Sector, Neurology Service, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro RJ, Brazil.,Post Graduate Stricto Sensu Program in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Cláudia Capitão
- Movement Disorders Sector, Neurology Service, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Alessandra Faria
- Movement Disorders Sector, Neurology Service, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro RJ, Brazil
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23
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24
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Pavese N, Tai YF. Genetic and degenerative disorders primarily causing other movement disorders. HANDBOOK OF CLINICAL NEUROLOGY 2016; 135:507-523. [PMID: 27432681 DOI: 10.1016/b978-0-444-53485-9.00025-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In this chapter, we will discuss the contributions of structural and functional imaging to the diagnosis and management of genetic and degenerative diseases that lead to the occurrence of movement disorders. We will mainly focus on Huntington's disease, Wilson's disease, dystonia, and neurodegeneration with brain iron accumulation, as they are the more commonly encountered clinical conditions within this group.
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Affiliation(s)
- Nicola Pavese
- Division of Brain Sciences, Imperial College London, UK; Aarhus University, Denmark.
| | - Yen F Tai
- Division of Brain Sciences, Imperial College London, UK
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25
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Schneider SA. Neurodegenerations with Brain Iron Accumulation. Parkinsonism Relat Disord 2016; 22 Suppl 1:S21-5. [DOI: 10.1016/j.parkreldis.2015.08.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 08/12/2015] [Accepted: 08/12/2015] [Indexed: 10/23/2022]
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26
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Walker RH. Untangling the Thorns: Advances in the Neuroacanthocytosis Syndromes. J Mov Disord 2015; 8:41-54. [PMID: 26090076 PMCID: PMC4460540 DOI: 10.14802/jmd.15009] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 04/27/2015] [Accepted: 04/28/2015] [Indexed: 12/25/2022] Open
Abstract
There have been significant advances in neuroacanthocytosis (NA) syndromes in the past 20 years, however, confusion still exists regarding the precise nature of these disorders and the correct nomenclature. This article seeks to clarify these issues and to summarise the recent literature in the field. The four key NA syndromes are described here-chorea-acanthocytosis, McLeod syndrome, Huntington's disease-like 2, and pantothenate kinase- associated neurodegeneration. In the first two, acanthocytosis is a frequent, although not invariable, finding; in the second two, it occurs in approximately 10% of patients. Degeneration affecting the basal ganglia is the key neuropathologic finding, thus the clinical presentations can be remarkably similar. The characteristic phenotype comprises a variety of movement disorders, including chorea, dystonia, and parkinsonism, and also psychiatric and cognitive symptoms attributable to basal ganglia dysfunction. The age of onset, inheritance patterns, and ethnic background differ in each condition, providing diagnostic clues. Other investigations, including routine blood testing and neuroimaging can be informative. Genetic diagnosis, if available, provides a definitive diagnosis, and is important for genetic counseling, and hopefully molecular therapies in the future. In this article I provide a historical perspective on each NA syndrome. The first 3 disorders, chorea-acanthocytosis, McLeod syndrome, Huntington's disease-like 2, are discussed in detail, with a comprehensive review of the literature to date for each, while pantothenate kinase-associated neurodegeneration is presented in summary, as this disorder has recently been reviewed in this journal. Therapy for all of these diseases is, at present, purely symptomatic.
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Affiliation(s)
- Ruth H. Walker
- Department of Neurology, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
- Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA
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