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Ciricugno A, Oldrati V, Cattaneo Z, Leggio M, Urgesi C, Olivito G. Cerebellar Neurostimulation for Boosting Social and Affective Functions: Implications for the Rehabilitation of Hereditary Ataxia Patients. CEREBELLUM (LONDON, ENGLAND) 2024; 23:1651-1677. [PMID: 38270782 PMCID: PMC11269351 DOI: 10.1007/s12311-023-01652-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 01/26/2024]
Abstract
Beyond motor deficits, spinocerebellar ataxia (SCA) patients also suffer cognitive decline and show socio-affective difficulties, negatively impacting on their social functioning. The possibility to modulate cerebello-cerebral networks involved in social cognition through cerebellar neurostimulation has opened up potential therapeutic applications for ameliorating social and affective difficulties. The present review offers an overview of the research on cerebellar neurostimulation for the modulation of socio-affective functions in both healthy individuals and different clinical populations, published in the time period 2000-2022. A total of 25 records reporting either transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) studies were found. The investigated clinical populations comprised different pathological conditions, including but not limited to SCA syndromes. The reviewed evidence supports that cerebellar neurostimulation is effective in improving social abilities in healthy individuals and reducing social and affective symptoms in different neurological and psychiatric populations associated with cerebellar damage or with impairments in functions that involve the cerebellum. These findings encourage to further explore the rehabilitative effects of cerebellar neurostimulation on socio-affective deficits experienced by patients with cerebellar abnormalities, as SCA patients. Nevertheless, conclusions remain tentative at this stage due to the heterogeneity characterizing stimulation protocols, study methodologies and patients' samples.
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Affiliation(s)
- Andrea Ciricugno
- IRCCS Mondino Foundation, 27100, Pavia, Italy.
- Department of Brain and Behavioral Science, University of Pavia, 27100, Pavia, Italy.
| | - Viola Oldrati
- Scientific Institute, IRCCS Eugenio Medea, 23842, Bosisio Parini, Italy
| | - Zaira Cattaneo
- IRCCS Mondino Foundation, 27100, Pavia, Italy
- Department of Human and Social Sciences, University of Bergamo, 24129, Bergamo, Italy
| | - Maria Leggio
- Department of Psychology, Sapienza University of Rome, 00185, Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179, Rome, Italy
| | - Cosimo Urgesi
- Scientific Institute, IRCCS Eugenio Medea, 23842, Bosisio Parini, Italy
- Laboratory of Cognitive Neuroscience, Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100, Udine, Italy
| | - Giusy Olivito
- Department of Psychology, Sapienza University of Rome, 00185, Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179, Rome, Italy
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Olivito G, Siciliano L, Leggio M, Van Overwalle F. Effective connectivity analysis of resting-state mentalizing brain networks in spinocerebellar ataxia type 2: A dynamic causal modeling study. Neuroimage Clin 2024; 43:103627. [PMID: 38843759 PMCID: PMC11190556 DOI: 10.1016/j.nicl.2024.103627] [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: 10/27/2023] [Revised: 05/31/2024] [Accepted: 05/31/2024] [Indexed: 06/24/2024]
Abstract
Neuroimaging studies on healthy subjects described the causal effective connectivity of cerebellar-cerebral social mentalizing networks, revealing the presence of closed-loops. These studies estimated effective connectivity by applying Dynamic Causal Modeling on task-related fMRI data of healthy subjects performing mentalizing tasks. Thus far, few studies have applied Dynamic Causal Modeling to resting-state fMRI (rsfMRI) data to test the effective connectivity within the cerebellar-cerebral mentalizing network in the absence of experimental manipulations, and no study applied Dynamic Causal Modeling on fMRI data of patients with cerebellar disorders typically showing social cognition deficits. Thus, in this research we applied spectral Dynamic Causal Modeling, to rsfMRI data of 13 patients affected by spinocerebellar ataxia type 2 (SCA2) and of 23 matched healthy subjects. Specifically, effective connectivity was tested between acknowledged mentalizing regions of interest: bilateral cerebellar Crus II, dorsal and ventral medial prefrontal cortex, bilateral temporo-parietal junctions and precuneus. SCA2 and healthy subjects shared some similarities in cerebellar-cerebral mentalizing effective connectivity at rest, confirming the presence of closed-loops between cerebellar and cerebral mentalizing regions in both groups. However, relative to healthy subjects, SCA2 patients showed effective connectivity variations mostly in cerebellar-cerebral closed loops, namely weakened inhibitory connectivity from the cerebellum to the cerebral cortex, but stronger inhibitory connectivity from the cerebral cortex to the cerebellum. The present study demonstrated that effective connectivity changes affect a function-specific mentalizing network in SCA2 patients, allowing to deepen the direction and strength of the causal effective connectivity mechanisms driven by the cerebellar damage associated with SCA2.
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Affiliation(s)
- Giusy Olivito
- Department of Psychology, Sapienza University of Rome, Italy; Ataxia Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Libera Siciliano
- Department of Psychology, Sapienza University of Rome, Italy; Ataxia Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Maria Leggio
- Department of Psychology, Sapienza University of Rome, Italy; Ataxia Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy.
| | - Frank Van Overwalle
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Belgium
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Reumers SFI, Schutter DJLG, Maas RPPWM, de Leeuw FE, Kessels RPC, van de Warrenburg BPC. Cognitive Complaints and Their Impact on Daily Life in Patients with Degenerative Cerebellar Disorders. CEREBELLUM (LONDON, ENGLAND) 2024; 23:1042-1052. [PMID: 37779173 PMCID: PMC11102381 DOI: 10.1007/s12311-023-01607-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/23/2023] [Indexed: 10/03/2023]
Abstract
Cognitive and affective sequelae of cerebellar disease are receiving increased attention, but their actual rate of occurrence remains unclear. Complaints may have a significant impact on patients, affecting social behavior and psychological well-being. This study aims to explore the extent of subjective cognitive and affective symptoms in patients with degenerative ataxias in the Netherlands. An explorative study was set up in a heterogeneous group of degenerative ataxia patients. Self-reported cognition was evaluated in terms of executive functioning and affect (Dysexecutive Questionnaire/DEX), and memory/attention (Cognitive Failures Questionnaire/CFQ). The Daily Living Questionnaire (DLQ) was administered to quantify the impact on daily life. Furthermore, informants completed questionnaires to obtain insight into patients' self-awareness and social cognition (Observable Social Cognition Rating Scale/OSCARS). This study shows that subjective complaints in the domains of (1) executive functioning and/or (2) memory and attention were reported by 29% of all patients (n = 24/84). In addition, more difficulties in daily life in terms of language/comprehension and community/participation were reported, and this was more common for patients with cognitive complaints than those without. Discrepancies between patients and informants about executive functioning were present in both directions. Deficits in social cognition were not identified at the group level, but more social-cognitive problems were observed in patients with more executive problems rated by informants. Taken together, our findings indicate that cognitive complaints are common in patients with degenerative cerebellar disorders and have an impact on daily life functioning. These results may help to increase awareness of cognitive symptoms and their impact in patients with cerebellar ataxia, their significant others, and professional caregivers.
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Affiliation(s)
- Stacha F I Reumers
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - Dennis J L G Schutter
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Roderick P P W M Maas
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - Frank-Erik de Leeuw
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Medical Psychology and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
- Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - Bart P C van de Warrenburg
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands.
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Milovanović A, Westenberger A, Stanković I, Tamaš O, Branković M, Marjanović A, Laabs BH, Brand M, Rajalingam R, Marras C, Lohmann K, Branković V, Novaković I, Petrović I, Svetel M, Klein C, Kostić VS, Dragašević-Mišković N. ANO10-Related Spinocerebellar Ataxia: MDSGene Systematic Literature Review and a Romani Case Series. Mov Disord 2024; 39:887-892. [PMID: 38469933 DOI: 10.1002/mds.29729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/09/2023] [Accepted: 01/11/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Biallelic pathogenic variants in the ANO10 gene cause autosomal recessive progressive ataxia (ATX-ANO10). METHODS Following the MDSGene protocol, we systematically investigated genotype-phenotype relationships in ATX-ANO10 based on the clinical and genetic data from 82 published and 12 newly identified patients. RESULTS Most patients (>80%) had loss-of-function (LOF) variants. The most common variant was c.1150_1151del, found in all 29 patients of Romani ancestry, who had a 14-year earlier mean age at onset than patients homozygous for other LOF variants. We identified previously undescribed clinical features of ATX-ANO10 (e.g., facial muscle involvement and strabismus) suggesting the involvement of brainstem pathology, and we propose a diagnostic algorithm that may aid clinical ATX-ANO10 diagnosis. CONCLUSIONS The early disease onset in patients with c.1150_1151del may indicate the existence of genetic/environmental disease-modifying factors in the Romani population. Our findings will inform patient counseling and may improve our understanding of the disease mechanism. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Andona Milovanović
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Ana Westenberger
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Iva Stanković
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Olivera Tamaš
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marija Branković
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Ana Marjanović
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Björn-Hergen Laabs
- Institute of Medical Biometry and Statistics, University of Lübeck, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Max Brand
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Rajasumi Rajalingam
- Department of Medicine, Division of Neurology, Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Canada
| | - Connie Marras
- Department of Medicine, Division of Neurology, Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Canada
| | - Katja Lohmann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Vesna Branković
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Ivana Novaković
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Igor Petrović
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marina Svetel
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Vladimir S Kostić
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Natasa Dragašević-Mišković
- Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
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Tamaš O, Mijajlović M, Švabić T, Kostić M, Marić G, Milovanović A, Jeremić M, Dragašević-Mišković N. Transcranial Sonography Characteristics of Cerebellar Neurodegenerative Ataxias. Brain Sci 2024; 14:340. [PMID: 38671992 PMCID: PMC11048096 DOI: 10.3390/brainsci14040340] [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: 03/18/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Cerebellar neurodegenerative ataxias are a group of disorders affecting the cerebellum and its pathways with different neurological structures. Transcranial sonography (TCS) has been used for the evaluation of brain parenchymal structures in various diseases because of its fast and safe utilization, especially in neuropsychiatric and neurodegenerative diseases. The aim of our study was to investigate TCS characteristics of patients with neurodegenerative cerebellar ataxias. In our study, we included 74 patients with cerebellar degenerative ataxia; 36.5% had autosomal dominant onset, while 33.8% had sporadic onset. Standardized ultrasonographic planes were used for the identification of brain structures of interest. The SARA, INAS, neuropsychological and psychiatric scales were used for the further clinical evaluation of our study participants. The brainstem raphe was discontinued in 33.8% of the patients. The substantia nigra (SN) hyperechogenicity was identified in 79.7%. The third and fourth ventricle enlargement had 79.7% and 45.9% of patients, respectively. A positive and statistically significant correlation was found between SN hyperechogenicity with dystonia (p < 0.01), rigidity and dyskinesia (p < 0.05). The higher SARA total score is statistically significantly correlated with the larger diameter of the III (r = 0.373; p = 0.001) and IV ventricles (r = 0.324; p = 0.005). In such patients, the echogenicity of substantia nigra has been linked to extrapyramidal signs, and raphe discontinuity to depression. Furthermore, ataxia and its clinical subtypes have positively correlated with the IV ventricle diameter, indicating brain atrophy and brain mass reduction.
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Affiliation(s)
- Olivera Tamaš
- Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (T.Š.); (A.M.); (M.J.); (N.D.-M.)
| | - Milija Mijajlović
- Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (T.Š.); (A.M.); (M.J.); (N.D.-M.)
| | - Tamara Švabić
- Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (T.Š.); (A.M.); (M.J.); (N.D.-M.)
| | - Milutin Kostić
- Institute of Mental Health, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Gorica Marić
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Andona Milovanović
- Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (T.Š.); (A.M.); (M.J.); (N.D.-M.)
| | - Marta Jeremić
- Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (T.Š.); (A.M.); (M.J.); (N.D.-M.)
| | - Nataša Dragašević-Mišković
- Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (T.Š.); (A.M.); (M.J.); (N.D.-M.)
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Tamaš O, Marić G, Kostić M, Milovanović A, Đurđević K, Salak Đokić B, Stefanova E, Pekmezović T, Dragašević-Mišković N. The Impact of Demographic and Clinical Factors on the Quality of Life in Patients with Neurodegenerative Cerebellar Ataxias. Brain Sci 2023; 14:1. [PMID: 38275506 PMCID: PMC10813613 DOI: 10.3390/brainsci14010001] [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: 10/19/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024] Open
Abstract
In neurodegenerative cerebellar ataxias, not only ataxia but also extra-cerebellar signs have a significant impact on patients' health related to quality of life (HRQoL). The aim of this study was to evaluate the various aspects of HRQoL and predictors of QoL in patients with neurodegenerative cerebellar ataxias. We included a total of 107 patients with cerebellar degenerative ataxia. Patients filled out the validated Serbian version of the SF-36 used for the assessment of HRQoL. All patients were clinically evaluated using SARA, INAS, and neuropsychological tests to assess their global cognitive status and different psychiatric scales. The most frequent types of neurodegenerative cerebellar ataxias were autosomal dominant ataxias (38.3%) and sporadic ataxias (32.7%). Mean age at diagnosis was 35.3 ± 16.23 years, and disease duration was on average 12.1 ± 9.91 years. Mean total SF-36 score was 50.63 ± 20.50. Hierarchical regression analysis showed that in the case of the PHC score, the most significant predictors are the patient's actual age, severity of ataxia, and ACE total score. For MHC, the Hamilton depression score was the most important predictor. Our study has shown that HRQoL measured by SF-36 in patients with neurodegenerative cerebellar disorders is strongly influenced by impaired mobility and depression.
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Affiliation(s)
- Olivera Tamaš
- Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.M.); (B.S.Đ.); (E.S.); (N.D.-M.)
| | - Gorica Marić
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (G.M.); (T.P.)
| | - Milutin Kostić
- Institute of Mental Health, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Andona Milovanović
- Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.M.); (B.S.Đ.); (E.S.); (N.D.-M.)
| | - Katarina Đurđević
- Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.M.); (B.S.Đ.); (E.S.); (N.D.-M.)
| | - Biljana Salak Đokić
- Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.M.); (B.S.Đ.); (E.S.); (N.D.-M.)
| | - Elka Stefanova
- Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.M.); (B.S.Đ.); (E.S.); (N.D.-M.)
| | - Tatjana Pekmezović
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (G.M.); (T.P.)
| | - Nataša Dragašević-Mišković
- Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.M.); (B.S.Đ.); (E.S.); (N.D.-M.)
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Olivito G, Siciliano L, Clausi S, Lupo M, Baiocco R, Gragnani A, Saettoni M, Delle Chiaie R, Laghi F, Leggio M. The Cerebellum Gets Social: Evidence from an Exploratory Study of Cerebellar, Neurodevelopmental, and Psychiatric Disorders. Biomedicines 2023; 11:309. [PMID: 36830846 PMCID: PMC9953169 DOI: 10.3390/biomedicines11020309] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
Social prediction is a key feature of social cognition (SC), a function in which the modulating role of the cerebellum is recognized. Accordingly, cerebellar alterations are reported in cerebellar pathologies, neurodevelopmental disorders, and psychiatric conditions that show SC deficits. Nevertheless, to date, no study has directly compared populations representative of these three conditions with respect to SC and cerebellar alterations. Therefore, the present exploratory study aimed to compare the SC profiles of individuals with cerebellar neurodegenerative disorders (CB), autism (ASD), bipolar disorder type 2 (BD2), or healthy subjects (HS) using a battery of social tests requiring different degrees of prediction processing. The patterns of cerebellar gray matter (GM) alterations were compared among the groups using voxel-based morphometry. Compared to HS, the clinical groups showed common SC deficits in tasks involving a moderate to high level of prediction. The behavioral results of the clinical groups are consistent with the presence of overlapping GM reduction in cerebellar right Crus II, an area notably involved in complex social processing and prediction. Although exploratory and preliminary, these results deepen the cerebellar role in social prediction and highlight the transdiagnostic value of the cerebellum in social functioning and prediction in pathologies of different aetiologies, forecasting novel possibilities for shared interventions.
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Affiliation(s)
- Giusy Olivito
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Libera Siciliano
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Silvia Clausi
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
- Klinikos Center for Psychodiagnostics and Psychotherapy, Viale delle Milizie 38, 00192 Roma, Italy
| | - Michela Lupo
- Servizio di Tutela della Salute Mentale e Riabilitazione dell’Età Evolutiva ASL, Roma 2, 00145 Rome, Italy
| | - Roberto Baiocco
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Roma, Italy
| | - Andrea Gragnani
- Scuola di Psicoterapia Cognitiva SPC, 58100 Grosseto, Italy
- Associazione Psicologia Cognitiva (APC)/Scuola di Psicoterapia Cognitiva (SPC), 00185 Rome, Italy
| | - Marco Saettoni
- Scuola di Psicoterapia Cognitiva SPC, 58100 Grosseto, Italy
- Unità Funzionale Salute Mentale Adulti ASL Toscana Nord-Ovest Valle del Serchio, 56121 Pisa, Italy
| | - Roberto Delle Chiaie
- Department of Neuroscience and Mental Health–Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Roma, Italy
| | - Maria Leggio
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
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Malek N, Makawita C, Al‐Sami Y, Aslanyan A, de Silva R. A Systematic Review of the Spectrum and Prevalence of Non-Motor Symptoms in Adults with Hereditary Cerebellar Ataxias. Mov Disord Clin Pract 2022; 9:1027-1039. [PMID: 36339305 PMCID: PMC9631846 DOI: 10.1002/mdc3.13532] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 07/11/2022] [Accepted: 07/19/2022] [Indexed: 11/09/2022] Open
Abstract
Background Cerebellar ataxias comprise a large group of heterogeneous disorders with both motor and non-motor symptoms (NMS). Objective We wanted to ascertain the reported prevalence of NMS in different subtypes of hereditary cerebellar ataxias. Methods Systematic review of studies of hereditary cerebellar ataxias (involving >5 patients) who were assessed for NMS, published in the English literature in PUBMED and EMBASE databases from 1947 to 2021. Results A total of 35 papers, with data from 1311 autosomal dominant spinocerebellar ataxia (SCA), 893 autosomal recessive cerebellar ataxia (ARCA), and 53 X-linked ataxia cases were included with a total of 450 controls. Mean age for SCA cases at diagnosis was 47.6 (SD, 14.9) years, for ARCA cases was 34.6 (SD, 14.7) years and for X-linked ataxia cases was 68.6 (9.1) years. The prevalence of cognitive problems in SCAs was between 23% and 75% (ranging from mild to severe), being least prevalent in SCA6. The prevalence of depression in SCAs was between 13% and 69% and sleep disorders were between 7% and 80%. Pain was reported by 18% to 60% of patients, especially in SCA3, and fatigue by 53% to 70%. The prevalence of reported cognitive dysfunction in ARCA was 12.5% to 100% and depression between 14% and 51%. The prevalence of anxiety in X-linked ataxias (FXTAS) was 17 % and depression 55%. Conclusions The presence of NMS in hereditary cerebellar ataxias is common. The prevalence and spectrum of NMS in SCAs, ARCAs, and X-linked ataxias vary. In routine clinical practice, NMS in cerebellar ataxias are under-recognized and certainly under-reported. Therefore, they are unlikely to be addressed adequately. Improved ascertainment of NMS in cerebellar ataxias in clinical practice will enable holistic treatment of these patients.
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Affiliation(s)
- Naveed Malek
- Department of NeurologyQueen's HospitalEssexUnited Kingdom
| | | | - Yaqub Al‐Sami
- Department of NeurologyQueen's HospitalEssexUnited Kingdom
| | - Aram Aslanyan
- Department of NeurologyQueen's HospitalEssexUnited Kingdom
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9
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Abderrakib A, Ligot N, Naeije G. Cerebellar cognitive affective syndrome after acute cerebellar stroke. Front Neurol 2022; 13:906293. [PMID: 36034280 PMCID: PMC9403248 DOI: 10.3389/fneur.2022.906293] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/06/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction The cerebellum modulates both motor and cognitive behaviors, and a cerebellar cognitive affective syndrome (CCAS) was described after a cerebellar stroke in 1998. Yet, a CCAS is seldom sought for, due to a lack of practical screening scales. Therefore, we aimed at assessing both the prevalence of CCAS after cerebellar acute vascular lesion and the yield of the CCAS-Scale (CCAS-S) in an acute stroke setting. Materials and methods All patients admitted between January 2020 and January 2022 with acute onset of a cerebellar ischemic or haemorrhagic first stroke at the CUB-Hôpital Erasme and who could be evaluated by the CCAS-S within a week of symptom onset were included. Results Cerebellar acute vascular lesion occurred in 25/1,580 patients. All patients could complete the CCAS-S. A definite CCAS was evidenced in 21/25 patients. Patients failed 5.2 ± 2.12 items out of 8 and had a mean raw score of 68.2 ± 21.3 (normal values 82–120). Most failed items of the CCAS-S were related to verbal fluency, attention, and working memory. Conclusion A definite CCAS is present in almost all patients with acute cerebellar vascular lesions. CCAS is efficiently assessed by CCAS-S at bedside tests in acute stroke settings. The magnitude of CCAS likely reflects a cerebello-cortical diaschisis.
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