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Bumoko GMM, Sadiki NH, Rwatambuga A, Kayembe KP, Okitundu DL, Mumba Ngoyi D, Muyembe JJT, Banea JP, Boivin MJ, Tshala-Katumbay D. Lower serum levels of selenium, copper, and zinc are related to neuromotor impairments in children with konzo. J Neurol Sci 2015; 349:149-53. [PMID: 25592410 DOI: 10.1016/j.jns.2015.01.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 12/31/2014] [Accepted: 01/02/2015] [Indexed: 11/16/2022]
Abstract
We assessed the relationship between key trace elements and neurocognitive and motor impairments observed in konzo, a motor neuron disease associated with cassava cyanogenic exposure in nutritionally challenged African children. Serum concentrations of iron, copper, zinc, selenium, and neurotoxic lead, mercury, manganese, cadmium, and cobalt were measured in 123 konzo children (mean age 8.53 years) and 87 non-konzo children (mean age 9.07 years) using inductively coupled plasma mass spectrometry (ICPMS). Concentrations of trace elements were compared and related to performance scores on the Kaufman Assessment Battery for Children, 2nd edition (KABC-II) for cognition and Bruininks-Oseretsky Test, 2nd edition (BOT-2) for motor proficiency. Children with konzo had low levels of selenium, copper, and zinc relative to controls. Selenium concentration significantly correlated with serum 8,12-iso-iPF2α-VI isoprostane (Spearman r=0.75, p<0.01) and BOT-2 scores (r=0.31, p=0.00) in children with konzo. Elemental deficiency was not associated with poor cognition. Mean (SD) urinary level of thiocyanate was 388.03 (221.75) μmol/l in non-konzo compared to 518.59 (354.19) μmol/l in konzo children (p<0.01). Motor deficits associated with konzo may possibly be driven by the combined effects of cyanide toxicity and Se deficiency on prooxidant mechanisms. Strategies to prevent konzo may include dietary supplementation with trace elements, preferentially, those with antioxidant and cyanide-scavenging properties.
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Affiliation(s)
- G M-M Bumoko
- Department of Neurology, University of Kinshasa, Democratic Republic Of Congo
| | - N H Sadiki
- School of Public Health, University of Kinshasa, Democratic Republic Of Congo
| | - A Rwatambuga
- Oregon Institute of Occupational Health Sciences and Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - K P Kayembe
- School of Public Health, University of Kinshasa, Democratic Republic Of Congo
| | - D L Okitundu
- Department of Neurology, University of Kinshasa, Democratic Republic Of Congo
| | - D Mumba Ngoyi
- Department of Tropical Medicine, University of Kinshasa, Democratic Republic Of Congo; Institut National de Recherches Biomedicales, Democratic Republic Of Congo
| | - J-J T Muyembe
- Department of Tropical Medicine, University of Kinshasa, Democratic Republic Of Congo; Institut National de Recherches Biomedicales, Democratic Republic Of Congo
| | - J-P Banea
- Department of Nutrition, School of Public Health & National Nutrition Program, Ministry of Health, Democratic Republic Of Congo
| | - M J Boivin
- Department of Psychiatry and Neurology/Ophthalmology, Michigan State University, East Lansing, MI, USA
| | - D Tshala-Katumbay
- Department of Neurology, University of Kinshasa, Democratic Republic Of Congo; Institut National de Recherches Biomedicales, Democratic Republic Of Congo; Oregon Institute of Occupational Health Sciences and Department of Neurology, Oregon Health & Science University, Portland, OR, USA.
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Kimani S, Sinei K, Bukachi F, Tshala-Katumbay D, Maitai C. Memory deficits associated with sublethal cyanide poisoning relative to cyanate toxicity in rodents. Metab Brain Dis 2014; 29:105-12. [PMID: 24293006 PMCID: PMC3944471 DOI: 10.1007/s11011-013-9459-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 11/21/2013] [Indexed: 01/17/2023]
Abstract
Food (cassava) linamarin is metabolized into neurotoxicants cyanide and cyanate, metabolites of which we sought to elucidate the differential toxicity effects on memory. Young 6-8 weeks old male rats were treated intraperitoneally with either 2.5 mg/kg body weight (bw) cyanide (NaCN), or 50 mg/kg bw cyanate (NaOCN), or 1 μl/g bw saline, daily for 6 weeks. Short-term and long-term memories were assessed using a radial arm maze (RAM) testing paradigm. Toxic exposures had an influence on short-term working memory with fewer correct arm entries (F(2, 19) = 4.57 p < 0.05), higher working memory errors (WME) (F(2, 19) = 5.09, p < 0.05) and longer RAM navigation time (F(2, 19) = 3.91, p < 0.05) for NaOCN relative to NaCN and saline treatments. The long-term working memory was significantly impaired by cyanide with fewer correct arm entries (F(2, 19) = 7.45, p < 0.01) and increased working memory errors (F(2, 19) = 9.35 p < 0.05) in NaCN relative to NaOCN or vehicle treated animals. Reference memory was not affected by either cyanide or cyanate. Our study findings provide an experimental evidence for the biological plausibility that cassava cyanogens may induce cognition deficits. Differential patterns of memory deficits may reflect the differences in toxicity mechanisms of NaOCN relative to NaCN. Cognition deficits associated with cassava cyanogenesis may reflect a dual toxicity effect of cyanide and cyanate.
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Affiliation(s)
- S Kimani
- Department of Pharmacology and Pharmacognosy & School of Nursing Sciences, University of Nairobi, Kenyatta National Hospital, P.O. Box 19676, Nairobi, Kenya,
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Okitundu D, Sombo MT, Kabamle J, Mashukanu N, Kazadi T, Mumba D, Boivin M, Tshala-Katumbay D. The phenomenology and epistemology of konzo: Readings from the Kahemba Outbreak, Democratic Republic of Congo. Part I: Socioeconomic aspects. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kassa R, Monterroso V, David LL, Tshala-Katumbay D. Diagnostic and therapeutic potential of tetanus toxin-derivatives in neurological diseases. J Mol Neurosci 2013; 51:788-91. [PMID: 23842888 DOI: 10.1007/s12031-013-0065-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 06/27/2013] [Indexed: 01/05/2023]
Abstract
We assessed the ex vivo reactivity of peptidic constructs of Tet1 (analog of tetanus toxin non-virulent C fragment) with sequence homology to the cysteine-active site of thioredoxin (Tet1THO) or tetralysine (Tet1PLYS) with oxidative species or axonopathic sodium cyanate (NaOCN), respectively. We then assessed their neuronal uptake in vivo in laboratory animals. The reactivity of Tet1PLYS with NaOCN (1:2.5 to 1:37.5 molar ratios) or Tet1THO with hydrogen peroxide (1:0.4 to 1:6.2 molar ratios) was assessed by mass spectrometry. Green fluorescence protein (GFP)-tagged Tet1-derivatives (3 mg/ml in artificial cerebrospinal fluid) were administered daily to rats by intramuscular injection in latissimus dorsi at lumborum at the dose of 1 μl/g of body weight, for 3 days. Motor neuron uptake was assessed after double immunolabeling for GFP and choline acetyltransferase. Mass spectrometry analysis successfully demonstrated the ex vivo reactivity of Tet1-derivatives in a concentration-dependent manner. Confocal microscopy revealed the localization of Tet1-derivatives in axons and motor neuron cell bodies. Intramuscular delivery of Tet1-derivatives appears to be a practical approach to circumvent the blood nerve barrier and selectively deliver small molecules to the nervous system, for diagnostic and/or treatment purposes.
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Affiliation(s)
- R Kassa
- Center for Research on Occupational & Environmental Toxicology, Oregon Health & Science University (OHSU), 3181 Sam Jackson Park Road, mail code L606, Portland, OR, 97239, USA
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Luabeya MK, Mwanza JC, Mukendi KM, Tshala-Katumbay D. APRONES: neurology research and education in the Democratic Republic of the Congo. Neurology 2013; 80:1806-7. [PMID: 23650232 DOI: 10.1212/wnl.0b013e3182918c5e] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- M K Luabeya
- Centre Neuropsychopathologique, University of Kinshasa School of Medicine, Kinshasa, Democratic Republic of the Congo.
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Tshala-Katumbay D, Mumba N, Okitundu L, Kazadi K, Banea M, Tylleskär T, Boivin M, Muyembe-Tamfum JJ. Cassava food toxins, konzo disease, and neurodegeneration in sub-Sahara Africans. Neurology 2013; 80:949-51. [PMID: 23460617 DOI: 10.1212/wnl.0b013e3182840b81] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- D Tshala-Katumbay
- Department of Neurology and Center for Research on Occupational and Environmental Toxicology, Oregon Health & Science University, Portland, OR, USA.
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Kassa R, Monterroso V, Wentzell J, Ramos A, Couchi E, Lecomte MC, Iordanov M, Kretzschmar D, Nicolas G, Tshala-Katumbay D. Proximal giant neurofilamentous axonopathy in mice genetically engineered to resist calpain and caspase cleavage of α-II spectrin. J Mol Neurosci 2012; 47:631-8. [PMID: 22212489 PMCID: PMC3360998 DOI: 10.1007/s12031-011-9699-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Accepted: 12/21/2011] [Indexed: 11/27/2022]
Abstract
We use 1,2-diacetylbenzene (1,2-DAB) to probe molecular mechanisms of proximal giant neurofilamentous axonopathy (PGNA), a pathological hallmark of amyotrophic lateral sclerosis. The spinal cord proteome of rodents displaying 1,2-DAB PGNA suggests a reduction in the abundance of α-II spectrin (Spna2), a key protein in the maintenance of axonal integrity. Protein immunoblotting indicates that this reduction is due to Spna2 degradation. We investigated the importance of such degradation in 1,2-DAB PGNA. Spna2 mutant mice lacking a calpain- and/or caspase-sensitive domain (CSD), thus hypothetically resistant to 1,2-DAB, and wild-type littermates, were treated with 1,2-DAB, 35 mg/kg/day, or saline control, for 3 weeks. 1,2-DAB induced motor weakness and PGNA, irrespective of the genotype. Spna2-calpain breakdown products were not detected in mutant mice, which displayed a normal structure of the nervous system under saline treatment. Intriguingly, treatment with 1,2-DAB reduced the abundance of the caspase-specific 120-kDa Spna2 breakdown products. Our findings indicate that degradation of Spna2 by calpain- and/or caspase is not central to the pathogenesis of 1,2-DAB axonopathy. In addition, the Spna2-CSD seems to be not required for the maintenance of the cytoskeleton integrity. Our conceptual framework offers opportunities to study the role of calpain-caspase cross talk, including that of the protease degradomics, in models of axonal degeneration.
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Affiliation(s)
- R. Kassa
- Center for Research on Occupational and Environmental Toxicology, Oregon Health & Science University (OHSU), Portland, OR, USA
| | - V. Monterroso
- Department of Comparative Medicine, Oregon Health & Science University (OHSU), Portland, OR, USA
| | - J. Wentzell
- Center for Research on Occupational and Environmental Toxicology, Oregon Health & Science University (OHSU), Portland, OR, USA
| | - A.L. Ramos
- Center for Research on Occupational and Environmental Toxicology, Oregon Health & Science University (OHSU), Portland, OR, USA
| | - E. Couchi
- UFR de Médecine site Bichat, Institut Claude Bernard, Université Paris Diderot, Paris 7, France
| | - MC Lecomte
- INSERM, U665, Paris; Institut National de la Transfusion Sanguine, Paris, F-75015; Université Denis Diderot, Paris 7, France
| | - M Iordanov
- Department of Cell and Developmental Biology, Oregon Health & Science University (OHSU), Portland, OR, USA
| | - D. Kretzschmar
- Center for Research on Occupational and Environmental Toxicology, Oregon Health & Science University (OHSU), Portland, OR, USA
| | - G. Nicolas
- Institut Cochin, Université Paris-Descartes, CNRS (UMR 8104) & INSERM, U1016, Paris, France
| | - D. Tshala-Katumbay
- Center for Research on Occupational and Environmental Toxicology, Oregon Health & Science University (OHSU), Portland, OR, USA
- Department of Neurology, Oregon Health & Science University (OHSU), Portland, OR, USA
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Mwanza JC, Lysebo DE, Kayembe DL, Tshala-Katumbay D, Nyamabo LK, Tylleskär T, Plant GT. Visual Evoked Potentials in Konzo, a Spastic Paraparesis of Acute Onset in Africa. Ophthalmologica 2003; 217:381-6. [PMID: 14573969 DOI: 10.1159/000073066] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2003] [Accepted: 05/23/2003] [Indexed: 11/19/2022]
Abstract
AIM To assess whether or not visual evoked potentials (VEPs) are abnormal in konzo, a para/tetraparesis of sudden onset, and to correlate the findings to the clinical picture of the disorder. METHODS VEPs were recorded in 23 patients (9 men and 14 women, mean age: 23 +/- 10 years) suffering from konzo, and 38 healthy subjects (20 men and 18 women, mean age: 27 +/- 15 years). The mean P100 latencies and peak-to-peak N75-P100 amplitudes of each eye were measured and compared in the two groups. The mean interocular P100 latency and amplitude differences were calculated and also compared. RESULTS VEPs were abnormal in 11/23 patients (48%) consisting of P100 prolongation (7 subjects), absence of P100 wave (2 subjects) or an atypical waveform (2 subjects). The mean P100 latency value of the konzo group was significantly increased as compared with the mean (+ 2.5 SD) of the reference values from healthy subjects (p < 0.05). There was a statistically significant decrease of amplitude in konzo patients compared to normal subjects (p < 0.05) with, however, only 2 patients outside the 95% confidence limits. Six patients (27%) had abnormal VEPs despite normal visual acuity. These abnormalities were symmetric and a relation could be found between neither the duration nor the severity of the disease and the VEP perturbation. CONCLUSION The main features of these abnormalities are delayed P100 latency and decreased amplitude. These findings indicate involvement of visual pathways and seem to suggest the presence of axonal loss in the prechiasmal visual pathways in konzo. This study provides evidence that the neurodamage in konzo extends to the visual pathways.
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Affiliation(s)
- J-C Mwanza
- Department of Ophthalmology, Kinshasa University Hospital, Kinshasa, Democratic Republic of Congo.
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Mwanza JCK, Tshala-Katumbay D, Kayembe DL, Eeg-Olofsson KE, Tylleskär T. Neuro-ophthalmologic findings in konzo, an upper motor neuron disorder in Africa. Eur J Ophthalmol 2003; 13:383-9. [PMID: 12872796 DOI: 10.1177/112067210301300409] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To investigate the neuro-ophthalmological manifestations in konzo, a non-progressive symmetric spastic para/tetraparesis of acute onset associated with consumption of insufficiently processed bitter cassava roots combined with a low protein intake. METHODS Twenty-one Congolese konzo patients underwent neuro-ophthalmological investigations including visual acuity testing, assessment of light pupillary reflexes, evaluation of ocular motility and deviation, direct ophthalmoscopy, and visual field perimetry. Objective refraction including retinoscopy and keratometry, and slit-lamp biomicroscopy were also done. RESULTS Five patients had visual impairment, and 14 had temporal pallor of the optic disc. Fourteen presented visual field defects, the most frequent being concentric constriction and peripheral defects. Overall, 11 subjects had symptoms qualifying for the diagnosis of optic neuropathy. Two had spontaneous pendular nystagmus in primary position of gaze. Visual field defects and pallor of the optic discs were found in mild, moderate and severe forms of konzo. No correlation was found between the severity of the motor disability of konzo and the extent of visual field loss. CONCLUSIONS Konzo was associated with optic neuropathy and a few patients had nystagmus. Although the etiopathogenesis of this optic neuropathy remains to be elucidated, the symmetry of the involvement suggests a toxic origin. We suggest that cyanide causes the neuro-ophthalmological damage in konzo. However, the optic neuropathy in konzo patients does not resemble the features of the epidemic optic neuropathy in Tanzania, Cuba or Nigeria, Leber's hereditary optic neuropathy, tobacco amblyopia or vitamin B deficiency.
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Affiliation(s)
- J C K Mwanza
- Department of Ophthalmology, Kinshasa University Hospital, Kinshasa.
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Tshala-Katumbay D, Edebol Eeg-Olofsson K, Kazadi-Kayembe T, Fällmar P, Tylleskär T, Kayembe-Kalula T. Abnormalities of somatosensory evoked potentials in konzo--an upper motor neuron disorder. Clin Neurophysiol 2002; 113:10-5. [PMID: 11801419 DOI: 10.1016/s1388-2457(01)00705-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine whether the somatosensory pathways are involved or not in konzo. METHODS In 1998, 21 konzo subjects (15 females and 6 males; mean age 21 years) underwent a SEP study with a two-channel-equipment (Medtronic Keypoint, Denmark) whereas in 2000, 15 subjects (7 females and 8 males; mean age 21 years) participated in a study with a 4-channel-equipment. RESULTS Most subjects (19/21 in 1998 and 12/15 in 2000) showed normal median SEPs. The remainders had no median cortical responses. All 21 subjects in 1998 and 9 out of 15 in 2000 showed abnormalities of tibial SEPs mainly consisting of absence of cortical responses, prolonged cortical latencies, and central sensory delay to the lumbar spine. Most subjects showed normal absolute latencies both at peripheral and spinal levels. The SEP findings did not correlate with the severity, neither the duration of konzo, nor the experience or not of sensory symptoms at the onset of the disease. CONCLUSION Our findings are not specific of konzo. However, they suggest involvement of intracranial somatosensory pathways and point to similarities with other motor neuron diseases.
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Tshala-Katumbay D, Eeg-Olofsson KE, Tylleskär T, Kazadi-Kayembe T. Impairments, disabilities and handicap pattern in konzo--a non-progressive spastic para/tetraparesis of acute onset. Disabil Rehabil 2001; 23:731-6. [PMID: 11732562 DOI: 10.1080/09638280110055075] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To assess impairments, disabilities and handicap pattern in konzo. METHOD The study included 17 konzo subjects, of which three were males and 14 females (mean age 21, median 18 years). A detailed neurological examination was performed on all subjects. Subsequently, an assessment of impairments, disabilities and handicap was done with a constructed rating scale partially based on the ICIDH-2 framework. RESULTS The overall disablement picture in all subjects consisted of motor dysfunction in lower limbs leading to limitations in walking and movement activities, and restrictions in mobility. Hip mobility was severely impaired in most cases (15/17). Although konzo subjects showed normal muscle power in upper limbs (13/17), they had impaired fine motor function (10/17). CONCLUSION Further studies are needed to assess the effectiveness of the WHO criteria for konzo in defining its forms. The applicability of the ICIDH-2 framework in this study demonstrates the possibility of its use as a common language among researchers in the field of motor disorders. However, a revision is suggested of its taxonomy, and a definition of operational criteria to clarify the content of different qualifiers provided to assess the level of functioning or disability.
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Affiliation(s)
- D Tshala-Katumbay
- Centre Neuropsychopathologique de Kinshasa (CNPP), Universitè de Kinshasa, Democratic Republic of Congo.
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