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Perucca L, Morello F, Robecchi Majnardi A. Coexistence of neurofibromatosis type I, multiple sclerosis, and ischemic stroke: A case report and literature review. SAGE Open Med Case Rep 2024; 12:2050313X241233191. [PMID: 38419798 PMCID: PMC10901064 DOI: 10.1177/2050313x241233191] [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: 09/26/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Neurofibromatosis type I and multiple sclerosis, when considered separately, are associated with a higher risk of cerebrovascular accident. The coexistence of neurofibromatosis type I and multiple sclerosis may lead to a further increase in cerebrovascular risk; however, this has not been reported in the literature. We report the case of a 37-year-old woman affected by both neurofibromatosis type I and multiple sclerosis: she was referred to our rehabilitation department because of a recent event of ischemic stroke. Moreover, we provide a comprehensive and updated review of all published cases reporting the coexistence of neurofibromatosis type I and multiple sclerosis to gather information regarding their association with cerebrovascular accidents.
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Affiliation(s)
- Laura Perucca
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milano, Italy
- Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano IRCCS, Ospedale San Luca, Milano, Italy
| | - Francesca Morello
- Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano IRCCS, Ospedale San Luca, Milano, Italy
| | - Antonio Robecchi Majnardi
- Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano IRCCS, Ospedale San Luca, Milano, Italy
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2
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Carvalho I, Quintas-Neves M, Pinto J, Santos AF, Pereira J. Primary Progressive Multiple Sclerosis in a Portuguese Patient With Neurofibromatosis Type 1. Cureus 2021; 13:e20561. [PMID: 35103140 PMCID: PMC8771896 DOI: 10.7759/cureus.20561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 11/06/2022] Open
Abstract
Neurofibromatosis type 1 (NF1) is a frequent genetic neurocutaneous syndrome and multiple sclerosis (MS) is an acquired demyelinating disease of the central nervous system. The association of both these diseases is rare. In this case report, we describe a 25-year-old man with gait impairment, upper limbs tremor, slurred speech, and urinary symptoms in the form of urinary urgency and incontinence. These symptoms started a year earlier and had a progressive course. Examination revealed scattered café-au-lait spots, right ptosis, bilateral horizontal and vertical nystagmus, mild dysarthria, quadriparesis with generalized hyperreflexia and bilateral Babinski signs, upper limb tremor, bilateral proprioceptive errors, bilateral appendicular dysmetria, and severe gait ataxia. Brain MRI showed lesions involving the deep and subcortical white matter, as well as thalami, with no enhancement after administration of gadolinium, suggestive of focal areas of signal intensity (FASI) in the setting of NF1. There were also oval lesions in the periventricular white matter, perpendicular to the ventricles and involving the corpus callosum, which were atypical for FASI. Spinal MRI also demonstrated several lesions, which mildly enhance after administration of gadolinium. Cerebrospinal fluid (CSF) examination revealed mild lymphocytic pleocytosis (18/μL), mildly elevated protein (0.53 g/L), normal glucose, and positive oligoclonal IgG bands. Extensive laboratory workup, including microbiological CSF studies, aquaporin-4-IgG, myelin-oligodendrocyte glycoprotein-IgG, autoimmune screening, and viral serology, was negative. The genetic study revealed a new mutation in the NF1 gene that was not previously reported. We intend to discuss the genetic and autoimmune mechanisms by which MS and NF1 appear to be related and draw attention to this association because a timely diagnosis of MS is important to prevent further disability in NF1 patients.
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Ciotti S, Cometa A, De Carlo C, Martini G, Marona A, Filippetti L, Carducci D, Baratta S, Zampolini M, Corea F. Neurofibromatosis Type 1 with Highly Active Relapsing-Remitting Multiple Sclerosis (RRMS). Eur J Case Rep Intern Med 2021; 8:002190. [PMID: 33768065 DOI: 10.12890/2021_002190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 12/23/2020] [Indexed: 11/05/2022] Open
Abstract
Neurofibromatosis type 1 (NF1) is an autosomal dominant neurocutaneous disease which confers an increased risk of malignant tumour development. Relapsing remitting multiple sclerosis (RRMS) is an inflammatory demyelinating disease of the central nervous system. The coexistence of multiple sclerosis and NF1 is rare but has been reported. Here, we describe the case of a 31-year-old man with NF1 and subacute walking problems with proximal pain in the lower limbs who was successfully treated with natalizumab. LEARNING POINTS The coexistence of multiple sclerosis (MS) and neurofibromatosis type 1 (NF1) is very rare but has been described in the literature.Follow-up of patients with NF1 is important as the early detection and management of MS can prevent further disability.Appropriate treatment and physical therapy can improve the patient's activity and social life.
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Affiliation(s)
- Silvia Ciotti
- USL Umbria 2, Department of Rehabilitation, S.C.R.I.N. Trevi, Italy
| | - Antonella Cometa
- USL Umbria 2, Department of Rehabilitation, S.M. Stella, Orvieto, Italy
| | - Claudia De Carlo
- USL Umbria 2, Department of Rehabilitation, Domus Gratiae, Terni, Italy
| | - Giancarlo Martini
- USL Umbria 2, Department of Rehabilitation, Ospedale di Cascia, Italy
| | - Andrea Marona
- USL Umbria 2, Department of Neuroradiology, Ospedale S.G. Battista di Foligno, Italy
| | - Laura Filippetti
- USL Umbria 2, Department of Rehabilitation, S.C.R.I.N. Trevi, Italy
| | - Diego Carducci
- USL Umbria 2, Department of Rehabilitation and Neurology, Ospedale S.G. Battista di Foligno, Italy
| | - Silvano Baratta
- USL Umbria 2, Department of Rehabilitation, S.C.R.I.N. Trevi, Italy
| | - Mauro Zampolini
- USL Umbria 2, Department of Rehabilitation and Neurology, Ospedale S.G. Battista di Foligno, Italy
| | - Francesco Corea
- USL Umbria 2, Department of Rehabilitation, S.C.R.I.N. Trevi, Italy
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Bergqvist C, Hemery F, Ferkal S, Wolkenstein P. Neurofibromatosis I and multiple sclerosis. Orphanet J Rare Dis 2020; 15:186. [PMID: 32664938 PMCID: PMC7362462 DOI: 10.1186/s13023-020-01463-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 07/07/2020] [Indexed: 12/11/2022] Open
Abstract
Neurofibromatosis 1 (NF1) is one of the most common autosomal dominant genetic disorders with a birth incidence as high as 1:2000. It is caused by mutations in the NF1 gene on chromosome 17 which encodes neurofibromin, a regulator of neuronal differentiation. While NF1 individuals are predisposed to develop benign and malignant nervous system tumors, various non-tumoral neurological conditions including multiple sclerosis (MS) have also been reported to occur more frequently in NF1. The number of epidemiologic studies on MS in NF1 individuals is very limited. The aim of this study was to determine the estimated population proportion of MS in NF1 patients followed in our Referral Centre for Neurofibromatosis using the Informatics for Integrated Biology and the Bedside (i2b2) platform to extract information from the hospital’s electronic health records. We found a total 1507 patients with confirmed NF1, aged 18 years (y) and above (mean age 39.2y, range 18-88y; 57% women). Five NF1 individuals were found to have MS, yielding an estimated population proportion of 3.3 per 1000 (0.0033, 95% Confidence Interval 0.0014–0.0077). The median age at diagnosis was 45 y (range 28–49 y). Three patients had relapsing-remitting MS and two patients had secondary progressive MS. Patients with NF1 were found to be twice more likely to develop MS than the general population in France (odds ratio 2.2), however this result was not statistically significant (95% Confidence Interval 0.91–5.29). Our results show that patients with NF1 might have a slight increased tendency to develop MS; however, due to the small sample size of our study, the results may not be sufficiently powered to detect this rare association. Large-scale epidemiological studies based on nationwide datasets are needed to confirm our findings. These findings further emphasize the need for a focused follow-up of patients with NF1, as early detection and management of MS can prevent further neurological disability.
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Affiliation(s)
- Christina Bergqvist
- Faculty of Medicine, Universite Paris-Est Creteil , Créteil, France.,Department of Dermatology, Hopital Henri Mondor, Assistance Publique-Hôpital Paris (AP-HP), Créteil, France
| | - François Hemery
- Department of Medical Informatics, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux Paris (AP-HP), Créteil, France
| | - Salah Ferkal
- Department of Dermatology, Hopital Henri Mondor, Assistance Publique-Hôpital Paris (AP-HP), Créteil, France.,INSERM, Centre d'Investigation Clinique 006, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux Paris (AP-HP), Referral Center of Neurofibromatosis, Créteil, France
| | - Pierre Wolkenstein
- Faculty of Medicine, Universite Paris-Est Creteil , Créteil, France. .,Department of Dermatology, Hopital Henri Mondor, Assistance Publique-Hôpital Paris (AP-HP), Créteil, France. .,INSERM, Centre d'Investigation Clinique 006, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux Paris (AP-HP), Referral Center of Neurofibromatosis, Créteil, France.
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5
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Helbing DL, Brodhun M, Tiedge O, Morrison H, Rosahl SK. Neurofibromatosis type 2 and multiple sclerosis. Mult Scler Relat Disord 2019; 39:101890. [PMID: 31862656 DOI: 10.1016/j.msard.2019.101890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 10/27/2019] [Accepted: 12/08/2019] [Indexed: 10/25/2022]
Abstract
Comorbidity of neurofibromatosis type 2 (NF2) and multiple sclerosis (MS) has rarely been reported. Since immunological mechanisms have been implicated in Nf2, coexistence of the two entities may offer insights into schwannoma pathogenesis with respect to the impact of the immune system. We present the case of a woman with a de novo mutation in the NF2 gene who later developed MS. In addition, we found a significantly higher count of T cells in a laryngeal schwannoma of this patient as compared to a schwannoma removed from a NF2 patient without MS. This finding correlated with a higher growth rate in the case of NF+MS.
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Affiliation(s)
- Dario-Lucas Helbing
- Department of Neurosurgery, Helios Klinikum, Erfurt 99089, Germany; Leibniz Institute for Age Research, Fritz Lipmann Institute, Jena 07745, Germany; Faculty of Medicine, Friedrich-Schiller-University Jena, 07743, Jena, Germany.
| | - Michael Brodhun
- Department of Pathology, Helios Klinikum, Erfurt 99089, Germany
| | - Oliver Tiedge
- Department of Neurology, St. Georg Klinikum and MVZ, Eisenach 99817, Germany
| | - Helen Morrison
- Leibniz Institute for Age Research, Fritz Lipmann Institute, Jena 07745, Germany
| | - Steffen K Rosahl
- Department of Neurosurgery, Helios Klinikum, Erfurt 99089, Germany.
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6
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Iwanowski P, Kowalska M, Prendecki M, Dorszewska J, Kozubski W, Rydzanicz M, Płoski R, Losy J. Primary progressive multiple sclerosis and neurofibromatosis type 1. Mult Scler Relat Disord 2019; 32:66-69. [PMID: 31048186 DOI: 10.1016/j.msard.2019.04.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 04/11/2019] [Accepted: 04/12/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is a common inflammatory demyelinating disease of the central nervous system. The clinical phenotype is probably modified by interactions from genetic and environmental factors. Neurofibromatosis type 1 (NF1) is an autosomal dominant neurocutaneous disease. NF1 gene mutations lead to clinical manifestation in the peripheral and central nervous system. Coexistence of MS and NF1 is a rare condition. OBJECTIVE To report the case of the patient with primary progressive MS (PPMS) and NF1. METHODS A retrospective analysis of a patient who has undergone whole exome sequencing confirmed by Sanger sequencing. RESULTS We reported a novel de novo c.6817delC deletion and rs1801052 polymorphism in NF1 gene associated with NF1 symptoms, as well as numerous polymorphisms in SPG7, SPG15, SPG39 genes responsible for benign spastic paraplegia. CONCLUSION Co-occurrence of PPMS and NF1 may be a consequence of genetic changes.
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Affiliation(s)
- Piotr Iwanowski
- Chair and Department of Neurology, Poznan University of Medical Sciences, 49 Przybyszewskiego Street, 60-355 Poznan, Poland.
| | - Marta Kowalska
- Laboratory of Neurobiology, Department of Neurology, Poznan University of Medical Sciences, 49 Przybyszewskiego Street, 60-355 Poznan, Poland
| | - Michał Prendecki
- Laboratory of Neurobiology, Department of Neurology, Poznan University of Medical Sciences, 49 Przybyszewskiego Street, 60-355 Poznan, Poland
| | - Jolanta Dorszewska
- Laboratory of Neurobiology, Department of Neurology, Poznan University of Medical Sciences, 49 Przybyszewskiego Street, 60-355 Poznan, Poland
| | - Wojciech Kozubski
- Chair and Department of Neurology, Poznan University of Medical Sciences, 49 Przybyszewskiego Street, 60-355 Poznan, Poland
| | - Małgorzata Rydzanicz
- Department of Medical Genetics, Medical University of Warsaw, 3c Pawinskiego St., 02-106 Warsaw, Poland
| | - Rafał Płoski
- Department of Medical Genetics, Medical University of Warsaw, 3c Pawinskiego St., 02-106 Warsaw, Poland
| | - Jacek Losy
- Department of Clinical Neuroimmunology, Chair and Department of Neurology, Poznan University of Medical Sciences, 49 Przybyszewskiego Street, 60-355 Poznan, Poland
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7
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Elsayed SM, Fahmy N, Gamal R, Wafik M, Zamzam D, Fahmy M, Suelam M. Neurofibromatosis type 1 and multiple sclerosis: Genetically related diseases. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2017. [DOI: 10.1016/j.ejmhg.2016.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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8
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Gutmann DH, Ferner RE, Listernick RH, Korf BR, Wolters PL, Johnson KJ. Neurofibromatosis type 1. Nat Rev Dis Primers 2017; 3:17004. [PMID: 28230061 DOI: 10.1038/nrdp.2017.4] [Citation(s) in RCA: 399] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Neurofibromatosis type 1 is a complex autosomal dominant disorder caused by germline mutations in the NF1 tumour suppressor gene. Nearly all individuals with neurofibromatosis type 1 develop pigmentary lesions (café-au-lait macules, skinfold freckling and Lisch nodules) and dermal neurofibromas. Some individuals develop skeletal abnormalities (scoliosis, tibial pseudarthrosis and orbital dysplasia), brain tumours (optic pathway gliomas and glioblastoma), peripheral nerve tumours (spinal neurofibromas, plexiform neurofibromas and malignant peripheral nerve sheath tumours), learning disabilities, attention deficits, and social and behavioural problems, which can negatively affect quality of life. With the identification of NF1 and the generation of accurate preclinical mouse strains that model some of these clinical features, therapies that target the underlying molecular and cellular pathophysiology for neurofibromatosis type 1 are becoming available. Although no single treatment exists, current clinical management strategies include early detection of disease phenotypes (risk assessment) and biologically targeted therapies. Similarly, new medical and behavioural interventions are emerging to improve the quality of life of patients. Although considerable progress has been made in understanding this condition, numerous challenges remain; a collaborative and interdisciplinary approach is required to manage individuals with neurofibromatosis type1 and to develop effective treatments.
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Affiliation(s)
- David H Gutmann
- Department of Neurology, Washington University School of Medicine, Box 8111, 660 S. Euclid Avenue, St. Louis, Missouri 63110, USA
| | - Rosalie E Ferner
- Department of Neurology, Guy's and St. Thomas' NHS Foundation Trust, London, UK.,Department of Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Robert H Listernick
- Department of Academic General Pediatrics and Primary Care, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Bruce R Korf
- Department of Genetics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Pamela L Wolters
- Pediatric Oncology Branch, National Cancer Institute, Bethesda, Maryland, USA
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9
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Mohebi N, Moghaddasi M, Maryam Z. Relapsing Remitting Multiple Sclerosis in an Iranian Patient with Neurofibromatosis Type I. Neurol Int 2015; 7:5966. [PMID: 26487929 PMCID: PMC4591495 DOI: 10.4081/ni.2015.5966] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Revised: 06/05/2015] [Accepted: 06/15/2015] [Indexed: 11/23/2022] Open
Abstract
Neurofibromatosis type 1 (NF-1) is a common hereditary neuro-cutaneous disease, with known gene mutations, that mainly involves the skin and nervous system. Multiple sclerosis (MS) is an acquired inflammatory disease in which the myelin of nerve cells in the brain and spinal cord is damaged. These two disease do not share any apparent pathological similarities. We herein present a 32-year-old woman with definite NF-1, who has recently been diagnosed with MS, which to the best of our knowledge is a rare co-occurrence. Though there are often neurologic sign and symptoms in patients with NF-1, they should not always be considered as the natural history of the disease, and other overlapped pathologies should be kept in mind, in order to not miss or postpone the efficient treatment.
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Affiliation(s)
- Nafiseh Mohebi
- Department of Neurology, Iran University of Medical Science , Tehran, Iran
| | - Mehdi Moghaddasi
- Department of Neurology, Iran University of Medical Science , Tehran, Iran
| | - Zaribafian Maryam
- Department of Neurology, Iran University of Medical Science , Tehran, Iran
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10
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Madubata CC, Olsen MA, Stwalley DL, Gutmann DH, Johnson KJ. Neurofibromatosis type 1 and chronic neurological conditions in the United States: an administrative claims analysis. Genet Med 2015; 17:36-42. [PMID: 24901347 PMCID: PMC4257895 DOI: 10.1038/gim.2014.70] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 05/08/2014] [Indexed: 01/11/2023] Open
Abstract
PURPOSE Neurofibromatosis type 1 has been linked to several neurological conditions, including epilepsy, Parkinson disease, headache, multiple sclerosis, and sleep disturbances, predominantly through case reports and patient series that lack comparison groups. Our objective was to assess whether specific neurological conditions occur more frequently in individuals with neurofibromatosis type 1 versus those without neurofibromatosis type 1. METHODS We used the 2006-2010 MarketScan Commercial Claims and Encounters database to examine associations between neurological conditions and neurofibromatosis type 1. The neurofibromatosis type 1 group was identified through ≥2 International Classification of Diseases, Ninth Revision, Clinical Modification neurofibromatosis codes (237.70, 237.71) occurring ≥30 days apart or one inpatient neurofibromatosis code. A nonneurofibromatosis type 1 comparison group was frequency matched to the neurofibromatosis type 1 group on age and enrollment length at a 10:1 ratio. Unconditional logistic regression was employed to calculate adjusted odds ratios and 95% confidence intervals for associations between neurofibromatosis and neurological conditions. RESULTS Compared with the nonneurofibromatosis type 1 group (n = 85,790), the neurofibromatosis type 1 group (n = 8,579) had significantly higher odds of health insurance claims for epilepsy (odds ratio: 7.3; 95% confidence interval: 6.4-8.3), Parkinson disease (odds ratio: 3.1; 95% confidence interval: 1.3-7.5), headache (odds ratio: 2.9; 95% confidence interval: 2.6-3.1), multiple sclerosis (odds ratio: 1.9; 95% confidence interval: 1.2-2.9), and sleep disturbances/disorder (odds ratio: 1.4; 95% confidence interval: 1.2-3.6). CONCLUSION This large study provides strong evidence for positive associations between several neurological conditions and neurofibromatosis type 1.
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Affiliation(s)
| | - Margaret A. Olsen
- Department of Medicine, School of Medicine, Washington University, St. Louis, Missouri 63110
- Department of Surgery, School of Medicine, Washington University, St. Louis, Missouri 63110
| | - Dustin L. Stwalley
- Department of Medicine, School of Medicine, Washington University, St. Louis, Missouri 63110
| | - David H. Gutmann
- Department of Neurology, School of Medicine, Washington University, St. Louis, Missouri 63110
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11
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Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014; 164A:1686-94. [DOI: 10.1002/ajmg.a.36530] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 02/14/2014] [Indexed: 11/07/2022]
Affiliation(s)
- Kimberly J. Johnson
- Brown School; Washington University; St. Louis Missouri
- Department of Pediatrics; School of Medicine; Washington University; St. Louis Missouri
- Siteman Cancer Center; Washington University; St. Louis Missouri
| | | | | | - David H. Gutmann
- Department of Neurology; School of Medicine; Washington University; St. Louis Missouri
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12
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Nandigam K, Mechtler LL, Smirniotopoulos JG. Neuroimaging of Neurocutaneous Diseases. Neurol Clin 2014; 32:159-92. [DOI: 10.1016/j.ncl.2013.07.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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13
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Jo YH, Kim HO, Song HR, Yoon KS. Identification of the NF1 gene mutation in Korean families with neurofibromatosis type 1. Genes Genomics 2014. [DOI: 10.1007/s13258-013-0132-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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14
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Riveros C, Mellor D, Gandhi KS, McKay FC, Cox MB, Berretta R, Vaezpour SY, Inostroza-Ponta M, Broadley SA, Heard RN, Vucic S, Stewart GJ, Williams DW, Scott RJ, Lechner-Scott J, Booth DR, Moscato P. A transcription factor map as revealed by a genome-wide gene expression analysis of whole-blood mRNA transcriptome in multiple sclerosis. PLoS One 2010; 5:e14176. [PMID: 21152067 PMCID: PMC2995726 DOI: 10.1371/journal.pone.0014176] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Accepted: 10/20/2010] [Indexed: 12/03/2022] Open
Abstract
Background Several lines of evidence suggest that transcription factors are involved in the pathogenesis of Multiple Sclerosis (MS) but complete mapping of the whole network has been elusive. One of the reasons is that there are several clinical subtypes of MS and transcription factors that may be involved in one subtype may not be in others. We investigate the possibility that this network could be mapped using microarray technologies and contemporary bioinformatics methods on a dataset derived from whole blood in 99 untreated MS patients (36 Relapse Remitting MS, 43 Primary Progressive MS, and 20 Secondary Progressive MS) and 45 age-matched healthy controls. Methodology/Principal Findings We have used two different analytical methodologies: a non-standard differential expression analysis and a differential co-expression analysis, which have converged on a significant number of regulatory motifs that are statistically overrepresented in genes that are either differentially expressed (or differentially co-expressed) in cases and controls (e.g., V$KROX_Q6, p-value <3.31E-6; V$CREBP1_Q2, p-value <9.93E-6, V$YY1_02, p-value <1.65E-5). Conclusions/Significance Our analysis uncovered a network of transcription factors that potentially dysregulate several genes in MS or one or more of its disease subtypes. The most significant transcription factor motifs were for the Early Growth Response EGR/KROX family, ATF2, YY1 (Yin and Yang 1), E2F-1/DP-1 and E2F-4/DP-2 heterodimers, SOX5, and CREB and ATF families. These transcription factors are involved in early T-lymphocyte specification and commitment as well as in oligodendrocyte dedifferentiation and development, both pathways that have significant biological plausibility in MS causation.
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Affiliation(s)
- Carlos Riveros
- Centre for Bioinformatics, Biomarker Discovery & Information-Based Medicine, University of Newcastle, and Hunter Medical Research Institute, Newcastle, Australia
| | - Drew Mellor
- Centre for Bioinformatics, Biomarker Discovery & Information-Based Medicine, University of Newcastle, and Hunter Medical Research Institute, Newcastle, Australia
- School of Computer Science and Software Engineering, The University of Western Australia, Crawley, Australia
| | - Kaushal S. Gandhi
- Westmead Millennium Institute, University of Sydney, Westmead, Australia
| | - Fiona C. McKay
- Westmead Millennium Institute, University of Sydney, Westmead, Australia
| | - Mathew B. Cox
- Centre for Bioinformatics, Biomarker Discovery & Information-Based Medicine, University of Newcastle, and Hunter Medical Research Institute, Newcastle, Australia
- Hunter Medical Research Institute, Newcastle, Australia
| | - Regina Berretta
- Centre for Bioinformatics, Biomarker Discovery & Information-Based Medicine, University of Newcastle, and Hunter Medical Research Institute, Newcastle, Australia
| | - S. Yahya Vaezpour
- Centre for Bioinformatics, Biomarker Discovery & Information-Based Medicine, University of Newcastle, and Hunter Medical Research Institute, Newcastle, Australia
- Department of Computer Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Mario Inostroza-Ponta
- Centre for Bioinformatics, Biomarker Discovery & Information-Based Medicine, University of Newcastle, and Hunter Medical Research Institute, Newcastle, Australia
- Departamento de Ingeniería Informática, Universidad de Santiago de Chile, Santiago, Chile
| | - Simon A. Broadley
- School of Medicine, Griffith University, Brisbane, Australia
- Department of Neurology, Gold Coast Hospital, Southport, Australia
| | - Robert N. Heard
- Westmead Millennium Institute, University of Sydney, Westmead, Australia
| | - Stephen Vucic
- Westmead Millennium Institute, University of Sydney, Westmead, Australia
| | - Graeme J. Stewart
- Westmead Millennium Institute, University of Sydney, Westmead, Australia
| | | | - Rodney J. Scott
- Centre for Bioinformatics, Biomarker Discovery & Information-Based Medicine, University of Newcastle, and Hunter Medical Research Institute, Newcastle, Australia
| | - Jeanette Lechner-Scott
- Centre for Bioinformatics, Biomarker Discovery & Information-Based Medicine, University of Newcastle, and Hunter Medical Research Institute, Newcastle, Australia
| | - David R. Booth
- Westmead Millennium Institute, University of Sydney, Westmead, Australia
| | - Pablo Moscato
- Centre for Bioinformatics, Biomarker Discovery & Information-Based Medicine, University of Newcastle, and Hunter Medical Research Institute, Newcastle, Australia
- Australian Research Council Centre of Excellence in Bioinformatics, St Lucia, Australia
- * E-mail:
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15
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The sad plight of multiple sclerosis research (low on fact, high on fiction): critical data to support it being a neurocristopathy. Inflammopharmacology 2010; 18:265-90. [PMID: 20862553 DOI: 10.1007/s10787-010-0054-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Accepted: 08/26/2010] [Indexed: 10/19/2022]
Abstract
The literature for evidence of autoimmunity in multiple sclerosis (MS) is analysed critically. In contrast to the accepted theory, the human counterpart of the animal model experimental autoimmune demyelinating disease, experimental allergic encephalomyelitis (EAE), is not MS but a different demyelinating disorder, i.e. acute disseminated encephalomyelitis and acute haemorrhagic leucoencephalitis. Extrapolation of EAE research to MS has been guided largely by faith and a blind acceptance rather than sound, scientific rationale. No specific or sensitive immunological test exists that is diagnostic of MS despite the extensive application of modern technology. Immunosuppression has failed to have any consistent effect on prognosis or disease progression. The available data on MS immunotherapy are conflicting, at times contradictory and are based on findings in animals with EAE. They show predominantly a 30% effect in relapsing/remitting MS which suggests powerful placebo effect. Critical analysis of the epidemiological data shows no association with any specific autoimmune diseases, but does suggest that geographic factors and age at development posit an early onset possibly dependent on environmental influences. Certain neurological diseases are, however, found in association with MS, namely hypertrophic peripheral neuropathy, neurofibromatosis-1, cerebral glioma, glioblastoma multiforme and certain familial forms of narcolepsy. These share a common genetic influence possibly from genes on chromosome 17 affecting cell proliferation. A significant number of these disorders are of neural crest origin, the classical example being abnormalities of the Schwann cell. These and other data allow us to propose that MS is a developmental neural crest disorder, i.e. a cristopathy, implicating glial cell dysfunction with diffuse blood-brain barrier breakdown. The data on transcription factor SOX10 mutations in animals may explain these bizarre clinical associations with MS and the phenotypic variability of such alterations (Cossais et al. 2010). Research directed to the area of neural crest associations is likely to be rewarding.
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Spinicci G, Cherchi MV, Murru R, Conti M, Marrosu MG. A case of neurofibromatosis and multiple sclerosis. Neurol Sci 2010; 31:631-4. [DOI: 10.1007/s10072-010-0252-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Accepted: 03/01/2010] [Indexed: 10/19/2022]
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Etemadifar M, Fatehi F, Sahraian MA, Borhanihaghighi A, Ardestani PM, Kaji-Esfahani M, Maghzi AH. Multiple sclerosis and neurofibromatosis type 1: report of seven patients from Iran. Mult Scler 2009; 15:1126-30. [DOI: 10.1177/1352458509106612] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Introduction Co-occurrence of multiple sclerosis (MS) and neurofibromatosis type 1 (NF1) is rare. Case reports In this study, we describe the clinical and neuroimaging features of seven patients with NF1 and MS. In our patients, six patients with MS were women, in all of them history of NF1 existed. Three of our patients had primary progressive, one had secondary progressive MS, and three relapsing–remitting MS. Optic neuritis as presenting symptoms was seen in three patients, and motor manifestation as presenting symptom was observed in three patients. The risk of having both NF1 and MS seemed to be higher than would be expected based on the prevalence rates of the two diseases in the general population. Conclusion The findings of this study suggest a possible casual relationship between MS and NF1, indicating higher risk of MS among patients with NF1.
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Affiliation(s)
- M Etemadifar
- Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran; Isfahan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Isfahan Research Committee of Multiple Sclerosis (IRCOMS), Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - F Fatehi
- Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran; Isfahan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Isfahan Research Committee of Multiple Sclerosis (IRCOMS), Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran; Isfahan Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - MA Sahraian
- Department of Neurology and Sina MS Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - A Borhanihaghighi
- Department of Neurology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - PM Ardestani
- Department of Anatomy, Neuroscience lab II, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - M Kaji-Esfahani
- Department of Radiology, Islamic Azad University of Najafabad, Isfahan, Iran
| | - AH Maghzi
- Isfahan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Isfahan Research Committee of Multiple Sclerosis (IRCOMS), Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran; Neuroimmunology unit, Neuroscience Center, Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, London, UK
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Serrano-Fernández P, Ibrahim SM, Zettl UK, Thiesen HJ, Gödde R, Epplen JT, Möller S. Intergenomic consensus in multifactorial inheritance loci: the case of multiple sclerosis. Genes Immun 2005; 5:615-20. [PMID: 15573086 DOI: 10.1038/sj.gene.6364134] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Genetic linkage and association studies define chromosomal regions, quantitative trait loci (QTLs), which influence the phenotype of polygenic diseases. Here, we describe a global approach to determine intergenomic consensus of those regions in order to fine map QTLs and select particularly promising candidate genes for disease susceptibility or other polygenic traits. Exemplarily, human multiple sclerosis (MS) susceptibility regions were compared for sequence similarity with mouse and rat QTLs in its animal model experimental allergic encephalomyelitis (EAE). The number of intergenomic MS/EAE consensus genes (295) is significantly higher than expected if the animal model was unrelated to the human disease. Hence, this approach contributes to the empirical evaluation of animal models for their applicability to the study of human diseases.
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Affiliation(s)
- P Serrano-Fernández
- Institute of Immunology, University of Rostock, Schillingallee 70, 18055 Rostock, Germany.
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Feuillet L, Boudinet H, Casseron W, Uzenot D, Pelletier J, Ali Cherif A. Association neurofibromatose de type I et sclérose en plaques. Rev Neurol (Paris) 2004; 160:447-51. [PMID: 15103270 DOI: 10.1016/s0035-3787(04)70927-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Association between neurofibromatosis type 1 (NF-1) and multiple sclerosis (MS) has been very rarely described. We report the case of a 40-year-old woman presenting familial NF-1 who had café au lait spots and cutaneous neurofibromatosis since childhood. Five years earlier, she experienced a first episode of unilateral optic neuritis, recurrent sensory and motor disturbances, then gait ataxia and pyramidal tract dysfunction with progressive walking impairment. Altered evoked potentials, CSF analysis and cerebral MRI findings were consistent with the diagnosis of MS (secondary progressive form after relapsing-remitting phase). We review major demographic, clinical and laboratory data of MS associated with NF-1 and discuss about the potential pathophisiological mechanisms implied.
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Affiliation(s)
- L Feuillet
- Service de Neurologie, Faculté de Médecine de Marseille, Université de la Méditerranée. Assistance Publique - Hôpitaux de Marseille, Hôpital la Timone, Marseille
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