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Siow SF, Yeow D, Rudaks LI, Jia F, Wali G, Sue CM, Kumar KR. Outcome Measures and Biomarkers for Clinical Trials in Hereditary Spastic Paraplegia: A Scoping Review. Genes (Basel) 2023; 14:1756. [PMID: 37761896 PMCID: PMC10530989 DOI: 10.3390/genes14091756] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 08/30/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Hereditary spastic paraplegia (HSP) is characterized by progressive lower limb spasticity. There is no disease-modifying treatment currently available. Therefore, standardized, validated outcome measures to facilitate clinical trials are urgently needed. We performed a scoping review of outcome measures and biomarkers for HSP to provide recommendations for future studies and identify areas for further research. We searched Embase, Medline, Scopus, Web of Science, and the Central Cochrane database. Seventy studies met the inclusion criteria, and eighty-three outcome measures were identified. The Spastic Paraplegia Rating Scale (SPRS) was the most widely used (27 studies), followed by the modified Ashworth Scale (18 studies) and magnetic resonance imaging (17 studies). Patient-reported outcome measures (PROMs) were infrequently used to assess treatment outcomes (28% of interventional studies). Diffusion tensor imaging, gait analysis and neurofilament light chain levels were the most promising biomarkers in terms of being able to differentiate patients from controls and correlate with clinical disease severity. Overall, we found variability and inconsistencies in use of outcome measures with a paucity of longitudinal data. We highlight the need for (1) a standardized set of core outcome measures, (2) validation of existing biomarkers, and (3) inclusion of PROMs in HSP clinical trials.
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Affiliation(s)
- Sue-Faye Siow
- Sydney Medical School, University of Sydney, Camperdown 2050, Australia (C.M.S.)
- Department of Clinical Genetics, Royal North Shore Hospital, St Leonards 2065, Australia
| | - Dennis Yeow
- Sydney Medical School, University of Sydney, Camperdown 2050, Australia (C.M.S.)
- Neuroscience Research Australia, University of New South Wales, Randwick 2031, Australia
- Rare Disease Program, Garvan Institute of Medical Research, Darlinghurst 2010, Australia
- Translational Neurogenomics Group, Molecular Medicine Laboratory and Department of Neurology, Concord Hospital, Concord 2139, Australia
- Neurodegenerative Service, Prince of Wales Hospital, Randwick 2031, Australia
| | - Laura I. Rudaks
- Sydney Medical School, University of Sydney, Camperdown 2050, Australia (C.M.S.)
- Department of Clinical Genetics, Royal North Shore Hospital, St Leonards 2065, Australia
- Rare Disease Program, Garvan Institute of Medical Research, Darlinghurst 2010, Australia
- Translational Neurogenomics Group, Molecular Medicine Laboratory and Department of Neurology, Concord Hospital, Concord 2139, Australia
| | - Fangzhi Jia
- Sydney Medical School, University of Sydney, Camperdown 2050, Australia (C.M.S.)
| | - Gautam Wali
- Sydney Medical School, University of Sydney, Camperdown 2050, Australia (C.M.S.)
- Neuroscience Research Australia, University of New South Wales, Randwick 2031, Australia
| | - Carolyn M. Sue
- Sydney Medical School, University of Sydney, Camperdown 2050, Australia (C.M.S.)
- Neuroscience Research Australia, University of New South Wales, Randwick 2031, Australia
- Neurodegenerative Service, Prince of Wales Hospital, Randwick 2031, Australia
- School of Clinical Medicine, UNSW Medicine & Health, University of New South Wales, Kensington 2052, Australia
| | - Kishore R. Kumar
- Sydney Medical School, University of Sydney, Camperdown 2050, Australia (C.M.S.)
- Rare Disease Program, Garvan Institute of Medical Research, Darlinghurst 2010, Australia
- Translational Neurogenomics Group, Molecular Medicine Laboratory and Department of Neurology, Concord Hospital, Concord 2139, Australia
- School of Clinical Medicine, UNSW Medicine & Health, University of New South Wales, Kensington 2052, Australia
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9
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Wiessner M, Maroofian R, Ni MY, Pedroni A, Müller JS, Stucka R, Beetz C, Efthymiou S, Santorelli FM, Alfares AA, Zhu C, Uhrova Meszarosova A, Alehabib E, Bakhtiari S, Janecke AR, Otero MG, Chen JYH, Peterson JT, Strom TM, De Jonghe P, Deconinck T, De Ridder W, De Winter J, Pasquariello R, Ricca I, Alfadhel M, van de Warrenburg BP, Portier R, Bergmann C, Ghasemi Firouzabadi S, Jin SC, Bilguvar K, Hamed S, Abdelhameed M, Haridy NA, Maqbool S, Rahman F, Anwar N, Carmichael J, Pagnamenta A, Wood NW, Tran Mau-Them F, Haack T, Di Rocco M, Ceccherini I, Iacomino M, Zara F, Salpietro V, Scala M, Rusmini M, Xu Y, Wang Y, Suzuki Y, Koh K, Nan H, Ishiura H, Tsuji S, Lambert L, Schmitt E, Lacaze E, Küpper H, Dredge D, Skraban C, Goldstein A, Willis MJH, Grand K, Graham JM, Lewis RA, Millan F, Duman Ö, Dündar N, Uyanik G, Schöls L, Nürnberg P, Nürnberg G, Catala Bordes A, Seeman P, Kuchar M, Darvish H, Rebelo A, Bouçanova F, Medard JJ, Chrast R, Auer-Grumbach M, Alkuraya FS, Shamseldin H, Al Tala S, Rezazadeh Varaghchi J, Najafi M, Deschner S, Gläser D, Hüttel W, Kruer MC, Kamsteeg EJ, Takiyama Y, Züchner S, Baets J, Synofzik M, Schüle R, Horvath R, Houlden H, Bartesaghi L, Lee HJ, Ampatzis K, Pierson TM, Senderek J. Biallelic variants in HPDL cause pure and complicated hereditary spastic paraplegia. Brain 2021; 144:1422-1434. [PMID: 33970200 PMCID: PMC8219359 DOI: 10.1093/brain/awab041] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/04/2020] [Accepted: 12/02/2020] [Indexed: 01/19/2023] Open
Abstract
Human 4-hydroxyphenylpyruvate dioxygenase-like (HPDL) is a putative iron-containing non-heme oxygenase of unknown specificity and biological significance. We report 25 families containing 34 individuals with neurological disease associated with biallelic HPDL variants. Phenotypes ranged from juvenile-onset pure hereditary spastic paraplegia to infantile-onset spasticity and global developmental delays, sometimes complicated by episodes of neurological and respiratory decompensation. Variants included bona fide pathogenic truncating changes, although most were missense substitutions. Functionality of variants could not be determined directly as the enzymatic specificity of HPDL is unknown; however, when HPDL missense substitutions were introduced into 4-hydroxyphenylpyruvate dioxygenase (HPPD, an HPDL orthologue), they impaired the ability of HPPD to convert 4-hydroxyphenylpyruvate into homogentisate. Moreover, three additional sets of experiments provided evidence for a role of HPDL in the nervous system and further supported its link to neurological disease: (i) HPDL was expressed in the nervous system and expression increased during neural differentiation; (ii) knockdown of zebrafish hpdl led to abnormal motor behaviour, replicating aspects of the human disease; and (iii) HPDL localized to mitochondria, consistent with mitochondrial disease that is often associated with neurological manifestations. Our findings suggest that biallelic HPDL variants cause a syndrome varying from juvenile-onset pure hereditary spastic paraplegia to infantile-onset spastic tetraplegia associated with global developmental delays.
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Affiliation(s)
- Manuela Wiessner
- Friedrich-Baur-Institute, Department of Neurology, LMU Munich, Munich, Germany
| | - Reza Maroofian
- Department of Neuromuscular Disorders, Institute of Neurology, University College London, London, UK
| | - Meng-Yuan Ni
- Department of Biochemistry, National Defense Medical Center, Neihu, Taipei, Taiwan
| | - Andrea Pedroni
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Juliane S Müller
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Rolf Stucka
- Friedrich-Baur-Institute, Department of Neurology, LMU Munich, Munich, Germany
| | - Christian Beetz
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Stephanie Efthymiou
- Department of Neuromuscular Disorders, Institute of Neurology, University College London, London, UK
| | | | - Ahmed A Alfares
- Department of Pediatrics, College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Changlian Zhu
- Henan Key Laboratory of Child Brain Injury, Institute of Neuroscience and Third Affliated Hospital of Zhengzhou University, Zhengzhou, China
- Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Göteborg, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Anna Uhrova Meszarosova
- DNA Laboratory, Department of Paediatric Neurology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Elham Alehabib
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayeh Bakhtiari
- Barrow Neurological Institute, Phoenix Children's Hospital and University of Arizona College of Medicine, Phoenix, USA
| | - Andreas R Janecke
- Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria
- Division of Human Genetics, Medical University of Innsbruck, Innsbruck, Austria
| | - Maria Gabriela Otero
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | | | - James T Peterson
- Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Tim M Strom
- Institute of Human Genetics, Technische Universität Mänchen, Munich, Germany
| | - Peter De Jonghe
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium
- Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerpen, Belgium
- Neuromuscular Reference Centre, Department of Neurology, Antwerp University Hospital, Antwerpen, Belgium
| | - Tine Deconinck
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
| | - Willem De Ridder
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium
- Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerpen, Belgium
- Neuromuscular Reference Centre, Department of Neurology, Antwerp University Hospital, Antwerpen, Belgium
| | - Jonathan De Winter
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium
- Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerpen, Belgium
- Neuromuscular Reference Centre, Department of Neurology, Antwerp University Hospital, Antwerpen, Belgium
| | | | - Ivana Ricca
- Molecular Medicine Unit, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Majid Alfadhel
- Genetics Division, Department of Pediatrics, King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNG-HA), Riyadh, Saudi Arabia
| | - Bart P van de Warrenburg
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ruben Portier
- Polikliniek Neurologie Enschede, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Carsten Bergmann
- Medizinische Genetik Mainz, Limbach Genetics, Mainz, Germany
- Department of Medicine, Nephrology, University Hospital Freiburg, Germany
| | | | - Sheng Chih Jin
- Department of Genetics, Washington University School of Medicine, St. Louis, USA
| | - Kaya Bilguvar
- Department of Genetics, Yale University School of Medicine, New Haven, USA
- Yale Center for Genome Analysis, Yale University, New Haven, USA
| | - Sherifa Hamed
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Mohammed Abdelhameed
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Nourelhoda A Haridy
- Department of Neuromuscular Disorders, Institute of Neurology, University College London, London, UK
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Shazia Maqbool
- Development and Behavioural Paediatrics Department, Institute of Child Health and The Children Hospital, Lahore, Pakistan
| | - Fatima Rahman
- Development and Behavioural Paediatrics Department, Institute of Child Health and The Children Hospital, Lahore, Pakistan
| | - Najwa Anwar
- Development and Behavioural Paediatrics Department, Institute of Child Health and The Children Hospital, Lahore, Pakistan
| | - Jenny Carmichael
- Oxford Regional Clinical Genetics Service, Northampton General Hospital, Northampton, UK
| | - Alistair Pagnamenta
- NIHR Oxford BRC, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Nick W Wood
- Department of Neuromuscular Disorders, Institute of Neurology, University College London, London, UK
- The National Hospital for Neurology and Neurosurgery, London, UK
| | - Frederic Tran Mau-Them
- Unité Fonctionnelle 6254 d'Innovation en Diagnostique Génomique des Maladies Rares, Pôle de Biologie, CHU Dijon Bourgogne, Dijon, France
| | - Tobias Haack
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | | | - Maja Di Rocco
- Rare Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Isabella Ceccherini
- Genetics and Genomics of Rare Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Michele Iacomino
- Medical Genetics Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Federico Zara
- Medical Genetics Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Vincenzo Salpietro
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- Pediatric Neurology and Neuromuscular Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Marcello Scala
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- Pediatric Neurology and Neuromuscular Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Marta Rusmini
- Genetics and Genomics of Rare Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Yiran Xu
- Henan Key Laboratory of Child Brain Injury, Institute of Neuroscience and Third Affliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yinghong Wang
- Department of Pediatrics, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Yasuhiro Suzuki
- Department of Pediatric Neurology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Kishin Koh
- Department of Neurology, Graduate School of Medical Sciences, University of Yamanashi, Yamanashi, Japan
| | - Haitian Nan
- Department of Neurology, Graduate School of Medical Sciences, University of Yamanashi, Yamanashi, Japan
| | - Hiroyuki Ishiura
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shoji Tsuji
- Institute of Medical Genomics, International University of Health and Welfare, Chiba, Japan
| | - Laëtitia Lambert
- Department of Clinical Genetics, CHRU Nancy, UMR_S INSERM N-GERE 1256, Université de Lorraine - Faculté de Médecine, Nancy, France
| | | | - Elodie Lacaze
- Department of Medical Genetics, Le Havre Hospital, Le Havre, France
| | - Hanna Küpper
- Department of Pediatric Neurology, University Children's Hospital Tübingen, Tübingen, Germany
| | - David Dredge
- Neurology Department, Massachusetts General Hospital, Boston, USA
| | - Cara Skraban
- Roberts Individualized Medical Genetics Center, Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Amy Goldstein
- Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Mary J H Willis
- Department of Pediatrics, Naval Medical Center San Diego, San Diego, USA
| | - Katheryn Grand
- Department of Pediatrics, Medical Genetics, Cedars-Sinai Medical Center, Los Angeles, USA
| | - John M Graham
- Department of Pediatrics, Medical Genetics, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Richard A Lewis
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, USA
| | | | - Özgür Duman
- Department of Pediatric Neurology, Akdeniz University Hospital, Antalya, Turkey
| | - Nihal Dündar
- Department of Pediatric Neurology, Izmir Katip Celebi University, Izmir, Turkey
| | - Gökhan Uyanik
- Center for Medical Genetics, Hanusch Hospital, Vienna, Austria
- Medical School, Sigmund Freud Private University, Vienna, Austria
| | - Ludger Schöls
- Hertie Institute for Clinical Brain Research (HIH), Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Peter Nürnberg
- Cologne Center for Genomics, Faculty of Medicine and Cologne University Hospital, University of Cologne, Cologne, Germany
| | - Gudrun Nürnberg
- Cologne Center for Genomics, Faculty of Medicine and Cologne University Hospital, University of Cologne, Cologne, Germany
| | - Andrea Catala Bordes
- DNA Laboratory, Department of Paediatric Neurology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Pavel Seeman
- DNA Laboratory, Department of Paediatric Neurology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Martin Kuchar
- Department of Paediatric Neurology, Liberec Hospital, Liberec, Czech Republic
| | - Hossein Darvish
- Neuroscience Research Center, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Adriana Rebelo
- Dr. John T. Macdonald Foundation Department of Human Genetics, John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, USA
| | - Filipa Bouçanova
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jean-Jacques Medard
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Roman Chrast
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Michaela Auer-Grumbach
- Department of Orthopaedics and Traumatology, Medical University of Vienna, Vienna, Austria
| | - Fowzan S Alkuraya
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Hanan Shamseldin
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Saeed Al Tala
- Department of Pediatrics, Genetic Unit, Armed Forces Hospital, Khamis Mushayt, Saudi Arabia
| | | | - Maryam Najafi
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Dieter Gläser
- genetikum, Center for Human Genetics, Neu-Ulm, Germany
| | - Wolfgang Hüttel
- Institut für Pharmazeutische Wissenschaften, Albert-Ludwigs-Universität Freiburg, Freibug, Germany
| | - Michael C Kruer
- Barrow Neurological Institute, Phoenix Children's Hospital and University of Arizona College of Medicine, Phoenix, USA
| | - Erik-Jan Kamsteeg
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Yoshihisa Takiyama
- Department of Neurology, Graduate School of Medical Sciences, University of Yamanashi, Yamanashi, Japan
| | - Stephan Züchner
- Dr. John T. Macdonald Foundation Department of Human Genetics, John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, USA
| | - Jonathan Baets
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium
- Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerpen, Belgium
- Neuromuscular Reference Centre, Department of Neurology, Antwerp University Hospital, Antwerpen, Belgium
| | - Matthis Synofzik
- Hertie Institute for Clinical Brain Research (HIH), Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Rebecca Schüle
- Hertie Institute for Clinical Brain Research (HIH), Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Rita Horvath
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Henry Houlden
- Department of Neuromuscular Disorders, Institute of Neurology, University College London, London, UK
| | - Luca Bartesaghi
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Hwei-Jen Lee
- Department of Biochemistry, National Defense Medical Center, Neihu, Taipei, Taiwan
| | | | - Tyler Mark Pierson
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, USA
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, USA
- Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, USA
- Center for the Undiagnosed Patient, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Jan Senderek
- Friedrich-Baur-Institute, Department of Neurology, LMU Munich, Munich, Germany
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