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Suarez MK, Martin TJ, Ong SS. Thickened Retinal Nerve Fiber Layer Without Hypermyelination in Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay. JOURNAL OF VITREORETINAL DISEASES 2024; 8:466-470. [PMID: 39148574 PMCID: PMC11323503 DOI: 10.1177/24741264241251582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
Purpose: To report the retinal findings in a patient with autosomal recessive spastic ataxia of Charlevoix-Saguenay. Methods: A case was evaluated. Results: A 16-year-old male patient with a known diagnosis of autosomal recessive spastic ataxia of Charlevoix-Saguenay was referred for evaluation of retinal hypermyelination given its frequent association with the condition. The patient was asymptomatic with a best-corrected visual acuity of 20/20. Optical coherence tomography of the peripapillary retinal nerve fiber layer (RNFL) showed bilateral thickening in each eye (average thicknesses: 180 µm, right eye; 177 µm, left eye). An examination showed no myelinization of the RNFL. Conclusions: Most studies to date describe RNFL thickening secondary to hypermyelination as a characteristic finding in autosomal recessive spastic ataxia of Charlevoix-Saguenay. This case provides evidence that this thickening may be a result of hypertrophy rather than hypermyelination. Further investigation is needed to define the pathophysiologic cause of RNFL thickening in autosomal recessive spastic ataxia of Charlevoix-Saguenay.
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Affiliation(s)
- Mallory K. Suarez
- Department of Ophthalmology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Timothy J. Martin
- Department of Ophthalmology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Sally S. Ong
- Department of Ophthalmology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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2
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Tremblay M, Girard-Côté L, Brais B, Gagnon C. Documenting manifestations and impacts of autosomal recessive spastic ataxia of Charlevoix-Saguenay to develop patient-reported outcome. Orphanet J Rare Dis 2022; 17:369. [PMID: 36183078 PMCID: PMC9526980 DOI: 10.1186/s13023-022-02497-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Autosomal recessive cerebellar ataxias (ARCA) are a group of rare inherited disorders characterized by degeneration or abnormal development of the cerebellum. Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is one of the most prevalent in Europe. OBJECTIVES The aim of this study is to provide a better understanding of the manifestations and impacts of ARSACS. METHODS A systematic review of the literature was conducted, followed by a qualitative study using semistructured interviews and discussion groups to obtain the experience of people affected. RESULTS According to the PROMIS framework, the results show manifestations and impacts in three components of health: physical, mental, and social. Fatigue and struggles with balance and dexterity are the physical manifestations of the disease most often cited by participants. Negative affects such as frustration and depression are among the mental health impacts with some loss in cognitive abilities. Social health is the least documented component; nonetheless, people with the disease report significant impacts in terms of social relationships, activities and work. CONCLUSIONS These findings shed new light on the experience of people with recessive ataxia and identify key aspects to assess to improve their overall health.
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Affiliation(s)
- Marjolaine Tremblay
- Université de Sherbrooke, 2500, boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada. .,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, 2230 de l'Hôpital cp 1200, Jonquière, QC, G7X 7X2, Canada.
| | - Laura Girard-Côté
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, 2230 de l'Hôpital cp 1200, Jonquière, QC, G7X 7X2, Canada.,Université du Québec à Chicoutimi, 555, boulevard de l'Université, Chicoutimi, QC, G7H 2B1, Canada
| | - Bernard Brais
- McGill University, 845 Sherbrooke Street West, Montréal, QC, H3A 0G4, Canada.,Montreal Neurological Institute and Hospital, 3801 University Street, Montreal, QC, H3A 2B4, Canada
| | - Cynthia Gagnon
- Université de Sherbrooke, 2500, boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, 2230 de l'Hôpital cp 1200, Jonquière, QC, G7X 7X2, Canada.,Centre de recherche du Centre hospitalier universitaire de Sherbrooke, 3001, 12e Avenue Nord, aile 9, porte 6, Sherbrooke, QC, J1H 5N4, Canada
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3
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Douglas VP, Douglas KAA, Miller JB, Gaier ED. Absent Foveal Avascular Zone in Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay. J Neuroophthalmol 2021; 41:e166-e168. [PMID: 32991389 PMCID: PMC8564680 DOI: 10.1097/wno.0000000000001050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Vivian Paraskevi Douglas
- Harvard Retinal Imaging Lab (VPD, KAAD, JBM), Boston, Massachusetts; Department of Ophthalmology (VPD, KAAD, JBM, EDG), Harvard Medical School, Boston, Massachusetts; Retina Service (JBM), Massachusetts Eye and Ear, Boston, Massachusetts; Department of Ophthalmology (EDG), Boston Children's Hospital, Boston, Massachusetts; and Department of Brain and Cognitive Sciences (EDG), Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Massachusetts
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4
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Rezende Filho FM, Bremner F, Pedroso JL, de Andrade JBC, Marianelli BF, Lourenço CM, Marques-Júnior W, França MC, Kok F, Sallum JMF, Parkinson MH, Barsottini OG, Giunti P. Retinal Architecture in Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS): Insights into Disease Pathogenesis and Biomarkers. Mov Disord 2021; 36:2027-2035. [PMID: 33893680 DOI: 10.1002/mds.28612] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/01/2021] [Accepted: 03/15/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) causes unique retinal abnormalities, which have not been systematically investigated. OBJECTIVE To deeply phenotype the retina in ARSACS in order to better understand its pathogenesis and identify potential biomarkers. METHODS We evaluated 29 patients with ARSACS, 66 with spinocerebellar ataxia (SCA), 38 with autosomal recessive cerebellar ataxia (ATX), 22 with hereditary spastic paraplegia (SPG), 21 cases of papilledema, and 20 healthy controls (total n = 196 subjects). Participants underwent visual acuity assessment, intraocular pressure measurement, fundoscopy, and macular and peripapillary optical coherence tomography (OCT). Macular layers thicknesses in ARSACS were compared with those of age-matched healthy controls. Ophthalmologists analyzed the scans for abnormal signs in the different patient groups. Linear regression analysis was conducted to look for associations between retinal changes and age, age at onset, disease duration, and Scale for the Assessment and Rating of Ataxia (SARA) scores in ARSACS. RESULTS Only patients with ARSACS exhibited peripapillary retinal striations (82%) on fundoscopy, and their OCT scans revealed foveal hypoplasia (100%), sawtooth appearance (89%), papillomacular fold (86%), and macular microcysts (18%). Average peripapillary retinal nerve fiber layer (pRNFL) was thicker in ARSACS than in SCA, ATX, SPG, and controls; a cut-off of 121 μm was 100% accurate in diagnosing ARSACS. All macular layers were thicker in ARSACS when compared to healthy controls. RNFL thickness in the inferior sector of the macula positively correlated with SARA scores. CONCLUSIONS Retinal abnormalities are highly specific for ARSACS, and suggest retinal hyperplasia due to abnormal retinal development. OCT may provide potential biomarkers for future clinical trials. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Flávio Moura Rezende Filho
- Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Fion Bremner
- Department of Neuro-Ophthalmology, National Hospital for Neurology & Neurosurgery, London, UK
| | - José Luiz Pedroso
- Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - João Brainer Clares de Andrade
- Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | | | | | - Wilson Marques-Júnior
- Department of Neurology, University of São Paulo, School of Medicine, Ribeirão Preto, Brazil
| | - Marcondes C França
- Department of Neurology, Universidade Estadual de Campinas, Campinas, Brazil
| | - Fernando Kok
- Mendelics Genomic Analysis, São Paulo, Brazil.,Department of Neurology, University of São Paulo, School of Medicine, São Paulo, Brazil
| | - Juliana M F Sallum
- Department of Ophthalmology, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Michael H Parkinson
- Department of Clinical and Movement Neurosciences, Ataxia Centre, UCL, Queen Square Institute of Neurology, London, UK
| | - Orlando G Barsottini
- Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Paola Giunti
- Department of Clinical and Movement Neurosciences, Ataxia Centre, UCL, Queen Square Institute of Neurology, London, UK
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5
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Lal V, Mehta S, Takkar A, Ray S. Ophthalmological findings in movement disorders. ANNALS OF MOVEMENT DISORDERS 2021. [DOI: 10.4103/aomd.aomd_35_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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6
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Smirnov V, Marks C, Debruyne P, Riquet A, Defoort-Dhellemmes S. Ataxie spino-cérébelleuse : quand le fond d’œil fait le diagnostic. J Fr Ophtalmol 2020; 43:676-677. [DOI: 10.1016/j.jfo.2019.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 10/18/2019] [Indexed: 11/28/2022]
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7
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de Freitas JL, Rezende Filho FM, Sallum JM, França MC, Pedroso JL, Barsottini OG. Ophthalmological changes in hereditary spastic paraplegia and other genetic diseases with spastic paraplegia. J Neurol Sci 2020; 409:116620. [DOI: 10.1016/j.jns.2019.116620] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/16/2019] [Accepted: 12/05/2019] [Indexed: 01/05/2023]
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Functional Transcriptome Analysis in ARSACS KO Cell Model Reveals a Role of Sacsin in Autophagy. Sci Rep 2019; 9:11878. [PMID: 31417125 PMCID: PMC6695435 DOI: 10.1038/s41598-019-48047-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 07/02/2019] [Indexed: 02/06/2023] Open
Abstract
Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is a rare early-onset neurological disease caused by mutations in SACS, which encodes sacsin. The complex architecture of sacsin suggests that it could be a key player in cellular protein quality control system. Molecular chaperones that operate in protein folding/unfolding and assembly/disassembly patterns have been described as essential modulators of selectivity during the autophagy process. We performed RNA-sequencing analysis to generate a whole-genome molecular signature profile of sacsin knockout cells. Using data analysis of biological processes significantly disrupted due to loss of sacsin, we confirmed the presence of decreased mitochondrial function associated with increased oxidative stress, and also provided a demonstration of a defective autophagic pathway in sacsin-depleted cells. Western blotting assays revealed decreased expression of LC3 and increased levels of p62 even after treatment with the lysosomal inhibitor bafilomycin A1, indicating impairment of the autophagic flux. Moreover, we found reduced co-immunolocalization of the autophagosome marker LC3 with lysosomal and mitochondrial markers suggesting fusion inhibition of autophagic compartments and subsequent failed cargo degradation, in particular failed degradation of damaged mitochondria. Pharmacological up-regulation of autophagy restored correct autophagic flux in sacsin knockout cells. These results corroborate the hypothesis that sacsin may play a role in autophagy. Chemical manipulation of this pathway might represent a new target to alleviate clinical and pathological symptoms, delaying the processes of neurodegeneration in ARSACS.
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9
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Rezende Filho FM, Parkinson MH, Pedroso JL, Poh R, Faber I, Lourenço CM, Júnior WM, França Junior MC, Kok F, Sallum JMF, Giunti P, Barsottini OGP. Clinical, ophthalmological, imaging and genetic features in Brazilian patients with ARSACS. Parkinsonism Relat Disord 2019; 62:148-155. [DOI: 10.1016/j.parkreldis.2018.12.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/17/2018] [Accepted: 12/19/2018] [Indexed: 01/26/2023]
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10
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Dougherty SC, Harper A, Al Saif H, Vorona G, Haines SR. A Chromosomal Deletion and New Frameshift Mutation Cause ARSACS in an African-American. Front Neurol 2018; 9:956. [PMID: 30498468 PMCID: PMC6249318 DOI: 10.3389/fneur.2018.00956] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 10/25/2018] [Indexed: 01/18/2023] Open
Abstract
Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS) is a rare, progressive, neurodegenerative disease characterized by ataxia, spasticity and polyneuropathy. First described in the French-Canadian population of Quebec in 1978, ARSACS has since been identified in multiple patients worldwide. In this clinical case report, we describe the evaluation of an 11-years-old African-American male who presented to neuromuscular clinic for assessment of a gait abnormality. He had a history of gross motor delay since early childhood, frequent falls and a below average IQ. Chromosomal microarray revealed a 1.422 megabase loss in the 13q12.12 region, which includes the SACS gene. Next Generation Sequencing then showed a novel, predicted to be pathogenic missense mutation (c.11824dup) of this gene. His clinical presentation and neurological imaging further confirmed the diagnosis of ARSACS. To our knowledge, this is the first reported case of this disease in the African-American population of the United States. This case report further highlights the growing trend of identifying genetic diseases previously restricted to single, ethnically isolated regions in many different ethnic groups worldwide.
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Affiliation(s)
- Sean C Dougherty
- Department of Neurology, Virginia Commonwealth University, Richmond, VA, United States
| | - Amy Harper
- Department of Neurology, Virginia Commonwealth University, Richmond, VA, United States
| | - Hind Al Saif
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, United States
| | - Gregory Vorona
- Department of Radiology, Virginia Commonwealth University, Richmond, VA, United States
| | - Scott R Haines
- Department of Neurology, Virginia Commonwealth University, Richmond, VA, United States
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11
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Lynch DR, McCormick A, Schadt K, Kichula E. Pediatric Ataxia: Focus on Chronic Disorders. Semin Pediatr Neurol 2018; 25:54-64. [PMID: 29735117 DOI: 10.1016/j.spen.2018.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Evaluation of a pediatric patient presenting with ataxia can be expensive and time consuming. Acute causes tend to have a clear developmental paradigm, but chronic presentations are more likely to be secondary to a genetic disorder, either one that primarily causes ataxia or that presents ataxia as one of a multitude of symptoms. Evaluation should focus on a quick diagnosis for those that have treatment options and for those that require other systemic monitoring. Friedreich ataxia is the most common, and genetic testing can easily confirm the suspicion. Testing for vitamin E (for ataxia with isolated vitamin E deficiency) and alpha fetoprotein (for Ataxia Telangiectasia or AT) are important, as is empiric treatment with coenzyme Q10 for those genetic abnormalities that can lead to coenzyme Q deficiency. Clear family history, disease progression, physical examination focusing on type of ataxia and other associated neurologic features, and investigation of systemic involvement can help in focusing clinical assessment.
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Affiliation(s)
- David R Lynch
- Departments of Pediatrics and Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
| | - Ashley McCormick
- Departments of Pediatrics and Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Kimberly Schadt
- Departments of Pediatrics and Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Elizabeth Kichula
- Departments of Pediatrics and Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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12
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Parkinson MH, Bartmann AP, Clayton LMS, Nethisinghe S, Pfundt R, Chapple JP, Reilly MM, Manji H, Wood NJ, Bremner F, Giunti P. Optical coherence tomography in autosomal recessive spastic ataxia of Charlevoix-Saguenay. Brain 2018. [DOI: 10.1093/brain/awy028] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Michael H Parkinson
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
- National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Ana P Bartmann
- National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Lisa M S Clayton
- National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Suran Nethisinghe
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Rolph Pfundt
- Department of Human Genetics, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - J Paul Chapple
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - Mary M Reilly
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
- National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK
| | - Hadi Manji
- National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Nicholas J Wood
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
- National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Fion Bremner
- National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Paola Giunti
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
- National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
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13
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Borruat FX, Holder GE, Bremner F. Inner Retinal Dysfunction in the Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay. Front Neurol 2017; 8:523. [PMID: 29075231 PMCID: PMC5643501 DOI: 10.3389/fneur.2017.00523] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 09/20/2017] [Indexed: 11/25/2022] Open
Abstract
The autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is associated with structural retinal abnormalities either directly visible on funduscopy or revealed by optical coherence tomography (OCT). Most patients with ARSACS have a whitish peripapillary appearance corresponding to a thickening of the peripapillary retinal nerve fiber layer. OCT has also shown an absence of the physiological foveal depression. Abnormal electroretinography (ERG) has previously been reported in only two cases, without further details. This report describes a patient with ARSACS in whom careful full-field ERG revealed dysfunction of the retinal On− bipolar cells with sparing of photoreceptor function. This is the first report of inner retinal dysfunction in ARSACS.
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Affiliation(s)
| | - Graham E Holder
- Moorfields Eye Hospital, London, United Kingdom.,University College London Institute of Ophthalmology, London, United Kingdom
| | - Fion Bremner
- The National Hospital for Neurology and Neurosurgery, London, United Kingdom
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14
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Bansagi B, Griffin H, Whittaker RG, Antoniadi T, Evangelista T, Miller J, Greenslade M, Forester N, Duff J, Bradshaw A, Kleinle S, Boczonadi V, Steele H, Ramesh V, Franko E, Pyle A, Lochmüller H, Chinnery PF, Horvath R. Genetic heterogeneity of motor neuropathies. Neurology 2017; 88:1226-1234. [PMID: 28251916 PMCID: PMC5373778 DOI: 10.1212/wnl.0000000000003772] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 01/06/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To study the prevalence, molecular cause, and clinical presentation of hereditary motor neuropathies in a large cohort of patients from the North of England. METHODS Detailed neurologic and electrophysiologic assessments and next-generation panel testing or whole exome sequencing were performed in 105 patients with clinical symptoms of distal hereditary motor neuropathy (dHMN, 64 patients), axonal motor neuropathy (motor Charcot-Marie-Tooth disease [CMT2], 16 patients), or complex neurologic disease predominantly affecting the motor nerves (hereditary motor neuropathy plus, 25 patients). RESULTS The prevalence of dHMN is 2.14 affected individuals per 100,000 inhabitants (95% confidence interval 1.62-2.66) in the North of England. Causative mutations were identified in 26 out of 73 index patients (35.6%). The diagnostic rate in the dHMN subgroup was 32.5%, which is higher than previously reported (20%). We detected a significant defect of neuromuscular transmission in 7 cases and identified potentially causative mutations in 4 patients with multifocal demyelinating motor neuropathy. CONCLUSIONS Many of the genes were shared between dHMN and motor CMT2, indicating identical disease mechanisms; therefore, we suggest changing the classification and including dHMN also as a subcategory of Charcot-Marie-Tooth disease. Abnormal neuromuscular transmission in some genetic forms provides a treatable target to develop therapies.
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Affiliation(s)
- Boglarka Bansagi
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK
| | - Helen Griffin
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK
| | - Roger G Whittaker
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK
| | - Thalia Antoniadi
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK
| | - Teresinha Evangelista
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK
| | - James Miller
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK
| | - Mark Greenslade
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK
| | - Natalie Forester
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK
| | - Jennifer Duff
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK
| | - Anna Bradshaw
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK
| | - Stephanie Kleinle
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK
| | - Veronika Boczonadi
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK
| | - Hannah Steele
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK
| | - Venkateswaran Ramesh
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK
| | - Edit Franko
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK
| | - Angela Pyle
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK
| | - Hanns Lochmüller
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK
| | - Patrick F Chinnery
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK
| | - Rita Horvath
- From the MRC Centre for Neuromuscular Diseases and John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine (B.B., H.G., T.E., J.D., A.B., V.B., H.S., E.F., A.P., H.L., P.F.C., R.H.), and Institute of Neuroscience (R.G.W., J.M.), Newcastle University, Newcastle upon Tyne; Bristol Genetics Laboratory (T.A., M.G., N.F.), Pathology Sciences, North Bristol NHS Trust, Southmead Hospital; Medical Genetic Center (S.K.), Munich, Germany; Department of Paediatric Neurology (V.R.), Royal Victoria Infirmary, Newcastle upon Tyne Foundation Hospitals NHS Trust; Nuffield Department of Clinical Neurosciences (E.F.), University of Oxford; and Department of Clinical Neurosciences (P.F.C.), Cambridge Biomedical Campus, University of Cambridge, UK.
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15
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Palmio J, Kärppä M, Baumann P, Penttilä S, Moilanen J, Udd B. Novel compound heterozygous mutation in SACS gene leads to a milder autosomal recessive spastic ataxia of Charlevoix-Saguenay, ARSACS, in a Finnish family. Clin Case Rep 2016; 4:1151-1156. [PMID: 27980752 PMCID: PMC5134137 DOI: 10.1002/ccr3.722] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 08/31/2016] [Accepted: 09/20/2016] [Indexed: 11/06/2022] Open
Abstract
Autosomal recessive spastic ataxia of Charlevoix-Saguenay is a rare disorder outside Quebec causing childhood-onset cerebellar ataxia, peripheral neuropathy, and pyramidal tract signs. A Finnish family with milder form of ARSACS was found to harbor three mutations, p.E1100K, p.N1489S, and p.M1359T, in SACS gene. The mutations segregated with the disease.
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Affiliation(s)
- Johanna Palmio
- Department of Neurology Neuromuscular Research Center Tampere University and University Hospital Tampere Finland
| | - Mikko Kärppä
- Department of Neurology Oulu University Hospital and University of Oulu Oulu Finland
| | - Peter Baumann
- Department of Neurology Lapland Central Hospital Rovaniemi Finland
| | - Sini Penttilä
- Department of Neurology Neuromuscular Research Center Tampere University and University Hospital Tampere Finland
| | - Jukka Moilanen
- Department of Clinical Genetics and Medical Research Center Oulu Oulu University Hospital and University of Oulu Oulu Finland
| | - Bjarne Udd
- Department of Neurology Neuromuscular Research Center Tampere University and University Hospital Tampere Finland; Folkhälsan Institute of Genetics and the Department of Medical Genetics Haartman Institute University of Helsinki Helsinki Finland; Department of Neurology Vaasa Central Hospital Vaasa Finland
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16
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Shah CT, Ward TS, Matsumoto JA, Shildkrot Y. Foveal hypoplasia in autosomal recessive spastic ataxia of Charlevoix-Saguenay. J AAPOS 2016; 20:81-3. [PMID: 26917082 DOI: 10.1016/j.jaapos.2015.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 10/07/2015] [Accepted: 10/07/2015] [Indexed: 10/22/2022]
Abstract
A 14-year-old boy presented with a presumed diagnosis of autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS). The neurological examination, nerve conduction study, and brain imaging results were all consistent with the diagnosis. The ophthalmologic examination was notable for a prominent myelinated nerve fiber layer extending from the disk along the major temporal arcades in both eyes. Loss of foveal depression was noted clinically and on spectral domain optical coherence tomography. This case highlights a novel finding that may aid in the diagnosis of ARSACS.
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Affiliation(s)
- Christopher T Shah
- Department of Ophthalmology, University of Virginia, Charlottesville, Virginia
| | - Tyson S Ward
- Department of Ophthalmology, University of Virginia, Charlottesville, Virginia
| | - Julie A Matsumoto
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia
| | - Yevgeniy Shildkrot
- Department of Ophthalmology, University of Virginia, Charlottesville, Virginia.
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17
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Pilliod J, Moutton S, Lavie J, Maurat E, Hubert C, Bellance N, Anheim M, Forlani S, Mochel F, N'Guyen K, Thauvin-Robinet C, Verny C, Milea D, Lesca G, Koenig M, Rodriguez D, Houcinat N, Van-Gils J, Durand CM, Guichet A, Barth M, Bonneau D, Convers P, Maillart E, Guyant-Marechal L, Hannequin D, Fromager G, Afenjar A, Chantot-Bastaraud S, Valence S, Charles P, Berquin P, Rooryck C, Bouron J, Brice A, Lacombe D, Rossignol R, Stevanin G, Benard G, Burglen L, Durr A, Goizet C, Coupry I. New practical definitions for the diagnosis of autosomal recessive spastic ataxia of Charlevoix-Saguenay. Ann Neurol 2015; 78:871-86. [PMID: 26288984 DOI: 10.1002/ana.24509] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Revised: 08/12/2015] [Accepted: 08/14/2015] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is caused by mutations in the SACS gene. SACS encodes sacsin, a protein whose function remains unknown, despite the description of numerous protein domains and the recent focus on its potential role in the regulation of mitochondrial physiology. This study aimed to identify new mutations in a large population of ataxic patients and to functionally analyze their cellular effects in the mitochondrial compartment. METHODS A total of 321 index patients with spastic ataxia selected from the SPATAX network were analyzed by direct sequencing of the SACS gene, and 156 patients from the ATAXIC project presenting with congenital ataxia were investigated either by targeted or whole exome sequencing. For functional analyses, primary cultures of fibroblasts were obtained from 11 patients carrying either mono- or biallelic variants, including 1 case harboring a large deletion encompassing the entire SACS gene. RESULTS We identified biallelic SACS variants in 33 patients from SPATAX, and in 5 nonprogressive ataxia patients from ATAXIC. Moreover, a drastic and recurrent alteration of the mitochondrial network was observed in 10 of the 11 patients tested. INTERPRETATION Our results permit extension of the clinical and mutational spectrum of ARSACS patients. Moreover, we suggest that the observed mitochondrial network anomalies could be used as a trait biomarker for the diagnosis of ARSACS when SACS molecular results are difficult to interpret (ie, missense variants and heterozygous truncating variant). Based on our findings, we propose new diagnostic definitions for ARSACS using clinical, genetic, and cellular criteria.
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Affiliation(s)
- Julie Pilliod
- Rare Diseases Laboratory: Genetics and Metabolism, University of Bordeaux, Bordeaux, France
| | - Sébastien Moutton
- Rare Diseases Laboratory: Genetics and Metabolism, University of Bordeaux, Bordeaux, France.,Medical Genetics Service, Pellegrin University Hospital Center, Bordeaux, France
| | - Julie Lavie
- Rare Diseases Laboratory: Genetics and Metabolism, University of Bordeaux, Bordeaux, France
| | - Elise Maurat
- Rare Diseases Laboratory: Genetics and Metabolism, University of Bordeaux, Bordeaux, France
| | - Christophe Hubert
- Functional Genomics Center, University of Bordeaux, Bordeaux, France
| | - Nadège Bellance
- Rare Diseases Laboratory: Genetics and Metabolism, University of Bordeaux, Bordeaux, France
| | - Mathieu Anheim
- Neurology Service, Strasbourg University Hospitals, Strasbourg, France.,Molecular Cell Biology Genetics Institute, INSERM U964/CNRS UMR7104, University of Strasbourg, Illkirch-Graffenstaden, France.,Strasbourg Federation of Translational Medicine, University of Strasbourg, Illkirch-Graffenstaden, France
| | - Sylvie Forlani
- Genetics Service, Pitié-Salpêtrière Hospital, Public Hospital Network of Paris, Paris, France
| | - Fanny Mochel
- Genetics Service, Pitié-Salpêtrière Hospital, Public Hospital Network of Paris, Paris, France.,Brain and Spinal Cord Institute, INSERM U1127, CNRS UMR7225, Sorbonne Universities-Pierre and Marie Curie University, Paris, France
| | - Karine N'Guyen
- Department of Medical Genetics, Timone Hospital, Marseille, France
| | | | - Christophe Verny
- Nantes Angers le Mans University and Neurology Service, CNRS UMR6214, INSERM U1083, University Hospital Center, Angers, France
| | - Dan Milea
- Ophthalmology Service, Angers University Hospital Center, Angers, France and Singapore National Eye Centre, Singapore Eye Research Institute, Duke-National University of Singapore, Singapore
| | - Gaëtan Lesca
- Genetics Service, Lyon University Hospital Center, Lyon, France
| | - Michel Koenig
- Molecular Genetics Laboratory, INSERM U827, Montpellier Regional University Hospital Center, Montpellier, France
| | - Diana Rodriguez
- Rare Diseases Reference Center "Defects and Congenital Diseases of the Cerebellum," Armand Trousseau Hospital, Public Hospital Network of Paris, Paris, France.,Robert Debré Hospital, INSERM U1141, Paris, France.,Genetics Service, Armand Trousseau Hospital, Public Hospital Network of Paris, Paris, France
| | - Nada Houcinat
- Medical Genetics Service, Pellegrin University Hospital Center, Bordeaux, France
| | - Julien Van-Gils
- Medical Genetics Service, Pellegrin University Hospital Center, Bordeaux, France
| | - Christelle M Durand
- Rare Diseases Laboratory: Genetics and Metabolism, University of Bordeaux, Bordeaux, France
| | - Agnès Guichet
- Neuropediatrics Service, Armand Trousseau Hospital, Public Hospital Network of Paris, Sorbonne Universities-Pierre and Marie Curie University, Paris, France
| | - Magalie Barth
- Neuropediatrics Service, Armand Trousseau Hospital, Public Hospital Network of Paris, Sorbonne Universities-Pierre and Marie Curie University, Paris, France
| | - Dominique Bonneau
- Neuropediatrics Service, Armand Trousseau Hospital, Public Hospital Network of Paris, Sorbonne Universities-Pierre and Marie Curie University, Paris, France
| | - Philippe Convers
- Nantes Angers le Mans University and Department of Biochemistry and Genetics, University Hospital Center, Angers, France
| | - Elisabeth Maillart
- Clinical Neurophysiology Service, Saint-Étienne University Hospital Center, Saint-Étienne, France
| | - Lucie Guyant-Marechal
- Neurology Service, Pitié-Salpêtrière Hospital, Public Hospital Network of Paris, Paris, France
| | - Didier Hannequin
- Neurology Service, Pitié-Salpêtrière Hospital, Public Hospital Network of Paris, Paris, France
| | | | - Alexandra Afenjar
- Rare Diseases Reference Center "Defects and Congenital Diseases of the Cerebellum," Armand Trousseau Hospital, Public Hospital Network of Paris, Paris, France.,Neurologist, Caen, France
| | - Sandra Chantot-Bastaraud
- Rare Diseases Reference Center "Defects and Congenital Diseases of the Cerebellum," Armand Trousseau Hospital, Public Hospital Network of Paris, Paris, France.,Neurologist, Caen, France
| | - Stéphanie Valence
- Rare Diseases Reference Center "Defects and Congenital Diseases of the Cerebellum," Armand Trousseau Hospital, Public Hospital Network of Paris, Paris, France.,Genetics Service, Armand Trousseau Hospital, Public Hospital Network of Paris, Paris, France
| | - Perrine Charles
- Genetics Service, Pitié-Salpêtrière Hospital, Public Hospital Network of Paris, Paris, France
| | - Patrick Berquin
- Amiens University Hospital Center, Pediatric Neurology Activity Center, Amiens, France
| | - Caroline Rooryck
- Rare Diseases Laboratory: Genetics and Metabolism, University of Bordeaux, Bordeaux, France.,Medical Genetics Service, Pellegrin University Hospital Center, Bordeaux, France
| | - Julie Bouron
- Medical Genetics Service, Pellegrin University Hospital Center, Bordeaux, France
| | - Alexis Brice
- Genetics Service, Pitié-Salpêtrière Hospital, Public Hospital Network of Paris, Paris, France.,Brain and Spinal Cord Institute, INSERM U1127, CNRS UMR7225, Sorbonne Universities-Pierre and Marie Curie University, Paris, France
| | - Didier Lacombe
- Rare Diseases Laboratory: Genetics and Metabolism, University of Bordeaux, Bordeaux, France.,Medical Genetics Service, Pellegrin University Hospital Center, Bordeaux, France
| | - Rodrigue Rossignol
- Rare Diseases Laboratory: Genetics and Metabolism, University of Bordeaux, Bordeaux, France
| | - Giovanni Stevanin
- Genetics Service, Pitié-Salpêtrière Hospital, Public Hospital Network of Paris, Paris, France.,Brain and Spinal Cord Institute, INSERM U1127, CNRS UMR7225, Sorbonne Universities-Pierre and Marie Curie University, Paris, France.,Laboratory of Neurogenetics, Practical School of Higher Studies, Paris, France
| | - Giovanni Benard
- Rare Diseases Laboratory: Genetics and Metabolism, University of Bordeaux, Bordeaux, France
| | - Lydie Burglen
- Rare Diseases Reference Center "Defects and Congenital Diseases of the Cerebellum," Armand Trousseau Hospital, Public Hospital Network of Paris, Paris, France.,Robert Debré Hospital, INSERM U1141, Paris, France.,Neurologist, Caen, France
| | - Alexandra Durr
- Genetics Service, Pitié-Salpêtrière Hospital, Public Hospital Network of Paris, Paris, France.,Brain and Spinal Cord Institute, INSERM U1127, CNRS UMR7225, Sorbonne Universities-Pierre and Marie Curie University, Paris, France
| | - Cyril Goizet
- Rare Diseases Laboratory: Genetics and Metabolism, University of Bordeaux, Bordeaux, France.,Medical Genetics Service, Pellegrin University Hospital Center, Bordeaux, France
| | - Isabelle Coupry
- Rare Diseases Laboratory: Genetics and Metabolism, University of Bordeaux, Bordeaux, France
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18
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Blumkin L, Bradshaw T, Michelson M, Kopler T, Dahari D, Lerman-Sagie T, Lev D, Chapple JP, Leshinsky-Silver E. Molecular and functional studies of retinal degeneration as a clinical presentation of SACS-related disorder. Eur J Paediatr Neurol 2015; 19:472-6. [PMID: 25819952 DOI: 10.1016/j.ejpn.2015.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 02/11/2015] [Accepted: 02/20/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND ARSACS (autosomal-recessive spastic ataxia of Charlevoix-Saguenay) is a neurodegenerative disorder caused by SACS gene mutations and characterized by a triad of symptoms: early-onset cerebellar ataxia, spasticity and peripheral neuropathy. A characteristic retinal nerve fiber hypertrophy has been reported in several individuals with ARSACS. METHODS We describe a patient with a unique clinical presentation of ataxia, nystagmus, dysarthria, hearing impairment, and retinal degeneration. Whole-exome-sequencing was performed as well as morphological studies in the patient's fibroblasts. RESULTS A compound heterozygosity for a novel D3269N and N2380K mutations in the SACS gene was found. The parents are carriers. Morphological studies revealed a dramatic decrease in the number of cell mitochondria as well as a difference in mitochondrial network morphology. CONCLUSIONS Retinal degeneration has never been reported in ARSACS. Since sacsin is involved in the mitochondrial fusion-fission process, we speculate that defected fission process may be responsible for an impaired mitochondrial function and retinal degeneration. Our patient has a unique clinical presentation of SACS mutations inconsistent with the classic ARSACS triad but also different from the "atypical" presentations described in the literature. Further studies are necessary to clarify the factors that modify the SACS related phenotype.
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Affiliation(s)
- Lubov Blumkin
- Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel; Metabolic-Neurogenetic Clinic, Wolfson Medical Center, Holon, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Teisha Bradshaw
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Marina Michelson
- Metabolic-Neurogenetic Clinic, Wolfson Medical Center, Holon, Israel; Institute of Medical Genetics, Wolfson Medical Center, Holon, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Tal Kopler
- Molecular Genetics Laboratory, Wolfson Medical Center, Holon, Israel
| | | | - Tally Lerman-Sagie
- Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel; Metabolic-Neurogenetic Clinic, Wolfson Medical Center, Holon, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Dorit Lev
- Metabolic-Neurogenetic Clinic, Wolfson Medical Center, Holon, Israel; Institute of Medical Genetics, Wolfson Medical Center, Holon, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - J Paul Chapple
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Esther Leshinsky-Silver
- Metabolic-Neurogenetic Clinic, Wolfson Medical Center, Holon, Israel; Toldot Genetics Ltd., Tel Aviv, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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19
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Retinal and pontine striations: neurodiagnostic signs of autosomal recessive spastic ataxia of Charlevoix-Saguenay. J Neuroophthalmol 2014; 34:369-71. [PMID: 25237835 DOI: 10.1097/wno.0000000000000174] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A 39-year-old man with long-standing ataxia, spasticity, dysarthria, and peripheral neuropathy was found to have diffuse thickening of the retinal nerve fiber layer in both eyes, as manifested by prominent retinal striations and confirmed by optical coherence tomography. Magnetic resonance imaging showed severe atrophy of the superior cerebellar vermis with linear "footprint" hypointensities in the pons with irregular striations. Genetic testing confirmed the diagnosis of spastic ataxia of Charlevoix-Saguenay (ARSACS). The clinical evaluation of progressive cerebellar ataxia should include a dedicated search for retinal nerve fiber layer thickening, which establishes the diagnosis of ARSACS.
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