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Tokushige SI, Matsuda S, Tada M, Yabe I, Takeda A, Tanaka H, Hatakenaka M, Enomoto H, Kobayashi S, Shimizu K, Shimizu T, Kotsuki N, Inomata-Terada S, Furubayashi T, Ichikawa Y, Hanajima R, Tsuji S, Ugawa Y, Terao Y. Roles of the cerebellum and basal ganglia in temporal integration: Insights from a synchronized tapping task. Clin Neurophysiol 2024; 158:1-15. [PMID: 38113692 DOI: 10.1016/j.clinph.2023.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 10/07/2023] [Accepted: 11/25/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE The aim of this study was to clarify the roles of the cerebellum and basal ganglia for temporal integration. METHODS We studied 39 patients with spinocerebellar degeneration (SCD), comprising spinocerebellar atrophy 6 (SCA6), SCA31, Machado-Joseph disease (MJD, also called SCA3), and multiple system atrophy (MSA). Thirteen normal subjects participated as controls. Participants were instructed to tap on a button in synchrony with isochronous tones. We analyzed the inter-tap interval (ITI), synchronizing tapping error (STE), negative asynchrony, and proportion of delayed tapping as indicators of tapping performance. RESULTS The ITI coefficient of variation was increased only in MSA patients. The standard variation of STE was larger in SCD patients than in normal subjects, especially for MSA. Negative asynchrony, which is a tendency to tap the button before the tones, was prominent in SCA6 and MSA patients, with possible basal ganglia involvement. SCA31 patients exhibited normal to supranormal performance in terms of the variability of STE, which was surprising. CONCLUSIONS Cerebellar patients generally showed greater STE variability, except for SCA31. The pace of tapping was affected in patients with possible basal ganglia pathology. SIGNIFICANCE Our results suggest that interaction between the cerebellum and the basal ganglia is essential for temporal processing. The cerebellum and basal ganglia and their interaction regulate synchronized tapping, resulting in distinct tapping pattern abnormalities among different SCD subtypes.
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Affiliation(s)
- Shin-Ichi Tokushige
- Department of Neurology, Graduate School of Medicine, the University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Neurology, Faculty of Medicine, Kyorin University, 6-20-2 Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan
| | - Shunichi Matsuda
- Department of Neurology, Graduate School of Medicine, the University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Masayoshi Tada
- Department of Neurology, Brain Research Institute, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata 951-8585, Japan
| | - Ichiro Yabe
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan
| | - Atsushi Takeda
- Department of Neurology, Sendai Nishitaga Hospital, 2-11-11, Kagitori-honcho, Taihaku-ku, Sendai 982-8555, Japan
| | - Hiroyasu Tanaka
- Department of Neurology, Sendai Nishitaga Hospital, 2-11-11, Kagitori-honcho, Taihaku-ku, Sendai 982-8555, Japan
| | - Megumi Hatakenaka
- Department of Neurology, Morinomiya Hospital, 2-1-88, Morinomiya, Joto-ku, Osaka 536-0025, Japan
| | - Hiroyuki Enomoto
- Department of Neurology, Faculty of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan
| | - Shunsuke Kobayashi
- Department of Neurology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo 173-8606, Japan
| | - Kazutaka Shimizu
- Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, 36-1, Nishicho, Yonago, Tottori 683-8504, Japan
| | - Takahiro Shimizu
- Department of Neurology, Kitasato University School of Medicine, 1-15-1, Kitazato, Minami, Sagamihara, Kanagawa 252-0375, Japan
| | - Naoki Kotsuki
- Department of Neurology, Faculty of Medicine, Kyorin University, 6-20-2 Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan
| | - Satomi Inomata-Terada
- Department of Medical Physiology, School of Medicine, Kyorin University, 6-20-2, Shinkawa, Mitaka, Tokyo 181-8611, Japan
| | - Toshiaki Furubayashi
- Graduate School of Health and Environment Science, Tohoku Bunka Gakuen University, 6-45-1 Kunimi, Sendai, Miyagi 981-8551, Japan
| | - Yaeko Ichikawa
- Department of Neurology, Faculty of Medicine, Kyorin University, 6-20-2 Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan
| | - Ritsuko Hanajima
- Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, 36-1, Nishicho, Yonago, Tottori 683-8504, Japan
| | - Shoji Tsuji
- Department of Molecular Neurology, the University of Tokyo and International University of Health and Welfare, 4-3, Kozunomori, Narita-shi, Chiba-ken 286-8686, Japan
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan
| | - Yasuo Terao
- Department of Neurology, Graduate School of Medicine, the University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Medical Physiology, School of Medicine, Kyorin University, 6-20-2, Shinkawa, Mitaka, Tokyo 181-8611, Japan.
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Iwasa S, Akaguchi R, Okuno H, Nakanishi K, Ueta K, Morioka S. Changes in Standing Postural Control Ability in a Case of Spinocerebellar Ataxia Type 31 With Physical Therapy Focusing on the Center of Gravity Sway Variables and Lower Leg Muscle Activity. Cureus 2023; 15:e51033. [PMID: 38264384 PMCID: PMC10805122 DOI: 10.7759/cureus.51033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2023] [Indexed: 01/25/2024] Open
Abstract
Spinocerebellar degeneration (SCD) is a progressive disease characterized by cerebellar ataxia or the posterior spinal cord. Among these, spinocerebellar ataxia type 31 (SCA31) is genetically more common in the Japanese population and is characterized by pure ataxia, resulting in severe disturbances in postural balance, with common falls. Therefore, rehabilitation is important to improve postural balance. Light touch is a known method of reducing postural sway, which acts with the light touching of an object with the body. We herein present a case of a patient with SCA31 who was trained in a standing position by lightly touching the back of the body to a wall surface. Dynamic interarticular coordination exercises were also performed as part of the rehabilitation program. As a result, even in the progressive SCA31, improvements in standing postural balance and activities of daily living contributed to improvements in the patient's postural balance. We followed the progress of postural control ability using the center of gravity sway measurement and electromyography and described some interesting characteristics of the patient's postural control ability in this report.
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Affiliation(s)
- Shiori Iwasa
- Physical Therapy, Faculty of Health Sciences, Kio University, Nara, JPN
| | - Ryo Akaguchi
- Neurorehabilitation, Graduate School of Health Sciences, Kio University, Nara, JPN
- Rehabilitation, Setsunan General Hospital, Osaka, JPN
| | | | - Koji Nakanishi
- Neurorehabilitation, Graduate School of Health Sciences, Kio University, Nara, JPN
| | - Kozo Ueta
- Physical Medicine and Rehabilitation, Neurorehabilitation Research Center, Kio University, Nara, JPN
| | - Shu Morioka
- Physical Medicine and Rehabilitation, Neurorehabilitation Research Center, Kio University, Nara, JPN
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Inomata-Terada S, Fukuda H, Tokushige SI, Matsuda SI, Hamada M, Ugawa Y, Tsuji S, Terao Y. Abnormal saccade profiles in hereditary spinocerebellar degeneration reveal cerebellar contribution to visually guided saccades. Clin Neurophysiol 2023; 154:70-84. [PMID: 37572405 DOI: 10.1016/j.clinph.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/17/2023] [Accepted: 07/16/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVE To study how the pathophysiology underlying hereditary spinocerebellar degeneration (spinocerebellar ataxia; SCA) with pure cerebellar manifestation evolves with disease progression using saccade recordings. METHODS We recorded visually- (VGS) and memory-guided saccade (MGS) task performance in a homogeneous population of 20 genetically proven SCA patients (12 SCA6 and eight SCA31 patients) and 19 normal controls. RESULTS For VGS but not MGS, saccade latency and amplitude were increased and more variable than those in normal subjects, which correlated with cerebellar symptom severity assessed using the International Cooperative Ataxia Rating Scale (ICARS). Parameters with significant correlations with cerebellar symptoms showed an aggravation after disease stage progression (ICARS > 50). The saccade velocity profile exhibited shortened acceleration and prolonged deceleration, which also correlated with disease progression. The main sequence relationship between saccade amplitude and peak velocity as well as saccade inhibitory control were preserved. CONCLUSIONS The cerebellum may be involved in initiating VGS, which was aggravated acutely during disease stage progression. Dysfunction associated with disease progression occurs mainly in the cerebellum and brainstem interaction but may also eventually involve cortical saccade processing. SIGNIFICANCE Saccade recording can reveal cerebellar pathophysiology underlying SCA with disease progression.
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Affiliation(s)
- Satomi Inomata-Terada
- Department of Medical Physiology, Faculty of Medicine, Kyorin University, Tokyo, Japan; Department of Neurology, Graduate School of Medicine, University of Tokyo, Japan
| | - Hideki Fukuda
- Segawa Memorial Neurological Clinic for Children, Tokyo, Japan
| | | | - Shun-Ichi Matsuda
- Department of Neurology, Graduate School of Medicine, University of Tokyo, Japan
| | - Masashi Hamada
- Department of Neurology, Graduate School of Medicine, University of Tokyo, Japan
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, Fukushima Medical University, Fukushima, Japan
| | - Shoji Tsuji
- Department of Neurology, Graduate School of Medicine, University of Tokyo, Japan
| | - Yasuo Terao
- Department of Medical Physiology, Faculty of Medicine, Kyorin University, Tokyo, Japan; Department of Neurology, Graduate School of Medicine, University of Tokyo, Japan.
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Ishikawa K, Nagai Y. Molecular Mechanisms and Future Therapeutics for Spinocerebellar Ataxia Type 31 (SCA31). Neurotherapeutics 2019; 16:1106-1114. [PMID: 31755042 PMCID: PMC6985187 DOI: 10.1007/s13311-019-00804-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Spinocerebellar ataxia type 31 (SCA31) is one of the autosomal-dominant neurodegenerative disorders that shows progressive cerebellar ataxia as a cardinal symptom. This disease is caused by a 2.5- to 3.8-kb-long complex pentanucleotide repeat containing (TGGAA)n, (TAGAA)n, (TAAAA)n, and (TAAAATAGAA)n in an intron of the gene called BEAN1 (brain expressed, associated with Nedd4). By comparing various pentanucleotide repeats in this particular locus among control Japanese and Caucasian populations, it was found that (TGGAA)n was the only sequence segregating with SCA31, strongly suggesting the pathogenicity of (TGGAA)n. The complex repeat also lies in an intron of another gene, TK2 (thymidine kinase 2), which is transcribed in the opposite direction, indicating that the complex repeat is bi-directionally transcribed as noncoding repeats. In SCA31 human brains, (UGGAA)n, the BEAN1 transcript of SCA31 mutation was found to form abnormal RNA structures called RNA foci in cerebellar Purkinje cell nuclei. Subsequent RNA pulldown analysis disclosed that (UGGAA)n binds to RNA-binding proteins TDP-43, FUS, and hnRNP A2/B1. In fact, TDP-43 was found to co-localize with RNA foci in human SCA31 Purkinje cells. To dissect the pathogenesis of (UGGAA)n in SCA31, we generated transgenic fly models of SCA31 by overexpressing SCA31 complex pentanucleotide repeats in Drosophila. We found that the toxicity of (UGGAA)n is length- and expression level-dependent, and it was dampened by co-expressing TDP-43, FUS, and hnRNP A2/B1. Further investigation revealed that TDP-43 ameliorates (UGGAA)n toxicity by directly fixing the abnormal structure of (UGGAA)n. This led us to propose that TDP-43 acts as an RNA chaperone against toxic (UGGAA)n. Further research on the role of RNA-binding proteins as RNA chaperones may provide a novel therapeutic strategy for SCA31.
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Affiliation(s)
- Kinya Ishikawa
- Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
- The Center for Personalized Medicine for Healthy Aging, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Yoshitaka Nagai
- Department of Neurotherapeutics, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Degenerative Neurological Diseases, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
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Sun YM, Lu C, Wu ZY. Spinocerebellar ataxia: relationship between phenotype and genotype - a review. Clin Genet 2016; 90:305-14. [PMID: 27220866 DOI: 10.1111/cge.12808] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 05/16/2016] [Accepted: 05/16/2016] [Indexed: 12/12/2022]
Abstract
Spinocerebellar ataxia (SCA) comprises a large group of heterogeneous neurodegenerative disorders inherited in an autosomal dominant fashion. It is characterized by progressive cerebellar ataxia with oculomotor dysfunction, dysarthria, pyramidal signs, extrapyramidal signs, pigmentary retinopathy, peripheral neuropathy, cognitive impairment and other symptoms. It is classified according to the clinical manifestations or genetic nosology. To date, 40 SCAs have been characterized, and include SCA1-40. The pathogenic genes of 28 SCAs were identified. In recent years, with the widespread clinical use of next-generation sequencing, the genes underlying SCAs, and the mutants as well as the affected phenotypes were identified. These advances elucidated the phenotype-genotype relationship in SCAs. We reviewed the recent clinical advances, genetic features and phenotype-genotype correlations involving each SCA and its differentiation. The heterogeneity of the disease and the genetic diagnosis might be attributed to the regional distribution and clinical characteristics. Therefore, recognition of the phenotype-genotype relationship facilitates genetic testing, prognosis and monitoring of symptoms.
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Affiliation(s)
- Y-M Sun
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - C Lu
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, the Collaborative Innovation Center for Brain Science, Zhejiang University School of Medicine, Hangzhou, China.,Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Z-Y Wu
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, the Collaborative Innovation Center for Brain Science, Zhejiang University School of Medicine, Hangzhou, China. .,Joint Institute for Genetics and Genome Medicine between Zhejiang University and University of Toronto, Zhejiang University, Hangzhou, China.
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Louis ED. Non-motor symptoms in essential tremor: A review of the current data and state of the field. Parkinsonism Relat Disord 2015; 22 Suppl 1:S115-8. [PMID: 26343494 DOI: 10.1016/j.parkreldis.2015.08.034] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 08/27/2015] [Accepted: 08/28/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The motor features of essential tremor (ET) include its hallmark element, kinetic tremor, yet non-motor features are increasingly being recognized as an accompanying part of what was previously viewed as a solely motor disorder. Given the evolving state of the ET field with respect to these non-motor features, the purpose of this manuscript is to critically review the current data. METHODS A PubMed search was conducted on July 1, 2015. The term "essential tremor" was crossed in sequential order with 13 additional search terms (e.g., "cognitive", "dementia", "depression"). The total number of unique hits was 322. RESULTS Numerous studies seem to substantiate the presence of a range of non-motor features occurring in excess in ET cases compared to age-matched controls. These comprise cognitive features (including a full spectrum from mild cognitive difficulty through to frank dementia), psychiatric (including depression, apathy, anxiety, and personality characteristics), sensory (hearing and possibly olfactory abnormalities), and other non-motor features (e.g., sleep dysregulation). Emerging evidence suggests that some of these features could be primary disease features that pre-date motor features of ET. CONCLUSIONS The presence of numerous non-motor features in ET is increasingly evident. The biological basis of these features deserves additional study.
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Affiliation(s)
- Elan D Louis
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA; Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA; Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA.
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