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Wade C, Williams T, Labrum R, Patel Y, Cali E, Davagnanam I, Adams ME, Barkhof F, Murphy E, Chataway J, Houlden H, Lynch DS. Leukoencephalopathy caused by a 17p13.3 microdeletion. J Neurol Neurosurg Psychiatry 2024; 95:290-292. [PMID: 37734926 DOI: 10.1136/jnnp-2023-331986] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/01/2023] [Indexed: 09/23/2023]
Affiliation(s)
- Charles Wade
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology, London, UCL Queen Square Institute of Neurology, London, UK
| | - Thomas Williams
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology, London, UCL Queen Square Institute of Neurology, London, UK
| | - Robyn Labrum
- Rare & Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | - Yogen Patel
- Rare & Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | - Elisa Cali
- Department of Neuromuscular Diseases, University College London, London, UK
| | - Indran Davagnanam
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
| | - Matthew E Adams
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
| | - Frederik Barkhof
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology, London, UCL Queen Square Institute of Neurology, London, UK
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
- Department of Radiology & Nuclear Medicine, Amsterdam UMC, Amsterdam, Netherlands
| | - Elaine Murphy
- Charles Dent Metabolic Unit, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London, UK
| | - Jeremy Chataway
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology, London, UCL Queen Square Institute of Neurology, London, UK
- National Institute for Health Research, University College London Hospitals, Biomedical Research Centre, London, UK
| | - Henry Houlden
- Department of Neuromuscular Diseases, University College London, London, UK
| | - David S Lynch
- Department of Neuromuscular Diseases, University College London, London, UK
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2
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Nóbrega PR, R. B. de Paiva A, Souza KS, de Souza JLB, G. S. B. Lima PL, da Silva DJ, Pitombeira MS, Borges VK, Dias DA, Bispo LM, Santos CF, Freua F, Silva PDS, Alves IS, Portella LB, Cunha PR, Salomao RPA, Pedroso JL, Miyajima VP, Miyajima F, Cali E, Wade C, Sudarsanam A, O’Driscoll M, Hayton T, Barsottini OGP, Klebe S, Kok F, Lucato LT, Houlden H, Depienne C, Lynch DS, Braga-Neto P. Expanding the phenotypic spectrum of CLCN2-related leucoencephalopathy and ataxia. Brain Commun 2023; 6:fcad273. [PMID: 38173802 PMCID: PMC10763528 DOI: 10.1093/braincomms/fcad273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/13/2023] [Accepted: 10/16/2023] [Indexed: 01/05/2024] Open
Abstract
Mutations in CLCN2 are a rare cause of autosomal recessive leucoencephalopathy with ataxia and specific imaging abnormalities. Very few cases have been reported to date. Here, we describe the clinical and imaging phenotype of 12 additional CLCN2 patients and expand the known phenotypic spectrum of this disorder. Informed consent was obtained for all patients. Patients underwent either whole-exome sequencing or focused/panel-based sequencing to identify variants. Twelve patients with biallelic CLCN2 variants are described. This includes three novel likely pathogenic missense variants. All patients demonstrated typical MRI changes, including hyperintensity on T2-weighted images in the posterior limbs of the internal capsules, midbrain cerebral peduncles, middle cerebellar peduncles and cerebral white matter. Clinical features included a variable combination of ataxia, headache, spasticity, seizures and other symptoms with a broad range of age of onset. This report is now the largest case series of patients with CLCN2-related leucoencephalopathy and reinforces the finding that, although the imaging appearance is uniform, the phenotypic expression of this disorder is highly heterogeneous. Our findings expand the phenotypic spectrum of CLCN2-related leucoencephalopathy by adding prominent seizures, severe spastic paraplegia and developmental delay.
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Affiliation(s)
- Paulo R Nóbrega
- Division of Neurology, Department of Clinical Medicine, Federal University of Ceara, Fortaleza, Ceara 60430-160, Brazil
- Neurogenetics Unit, Department of Neurology, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo 05403-000, Brazil
| | - Anderson R. B. de Paiva
- Neurogenetics Unit, Department of Neurology, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo 05403-000, Brazil
- Mendelics Genomic Analysis, Sao Paulo, Sao Paulo 02511-000, Brazil
- Department of Neurology, São Rafael Hospital, Rede D’Or São Luiz, Salvador, Bahia 41253-190, Brazil
| | - Katiane S Souza
- Neurogenetics Unit, Department of Neurology, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo 05403-000, Brazil
| | - Jorge Luiz B de Souza
- Center of Health Science, State University of Ceara, Fortaleza, Ceara 3101-9795, Brazil
| | | | | | - Milena Sales Pitombeira
- Hospital Geral de Fortaleza, Fortaleza, Ceara 60150-160, Brazil
- Department of Neurology, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo 05403-000, Brazil
| | - Viviennee K Borges
- Hospital de Clínicas, Universidade Federal de Uberlândia, Uberlandia, Minas Gerais 38405-320, Brazil
| | - Daniel A Dias
- Division of Radiology, Federal University of Ceara, Fortaleza, Ceara 60430-160, Brazil
| | - Luciana M Bispo
- Mendelics Genomic Analysis, Sao Paulo, Sao Paulo 02511-000, Brazil
- University Hospital, EBSERH/Federal University of Sergipe, Aracaju, Sergipe 49060-676, Brazil
| | - Carolina F Santos
- Universidade de Fortaleza, Fortaleza, Ceara 60811-905, Brazil
- Hospital Infantil Albert Sabin, Fortaleza, Ceara 60410-794, Brazil
| | - Fernando Freua
- Neurogenetics Unit, Department of Neurology, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo 05403-000, Brazil
| | | | | | | | | | - Rubens Paulo A Salomao
- Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, Sao Paulo, Sao Paulo 04021-001, Brazil
| | - José Luiz Pedroso
- Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, Sao Paulo, Sao Paulo 04021-001, Brazil
| | - Veridiana P Miyajima
- Centre for Clinical Diagnostics, Haematology and Haemotherapy Centre of Ceara (HEMOCE), Fortaleza, Ceara 60416-130, Brazil
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool L69 7BE, UK
| | - Fábio Miyajima
- Analytical Competence Molecular Epidemiology Lab (ACME), Oswaldo Cruz Foundation (Fiocruz), Fortaleza, Ceara 61773-270, Brazil
- Postgraduate Program in Medical Sciences, Federal University of Ceará (UFC), Fortaleza, Ceara 60020-181, Brazil
| | - Elisa Cali
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Charles Wade
- Queen Square MS Centre, UCL Institute of Neurology, London WC1N 3BG, UK
| | | | - Mary O’Driscoll
- West Midlands Regional Clinical Genetics Service, Birmingham Health Partners, Birmingham Women’s Hospital NHS Foundation Trust, Birmingham B15 2TG, UK
| | - Tom Hayton
- University Hospital Birmingham, Birmingham B15 2GW, UK
| | - Orlando G P Barsottini
- Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, Sao Paulo, Sao Paulo 04021-001, Brazil
| | - Stephan Klebe
- Department of Neurology, University of Würzburg, Essen 97080, Germany
| | - Fernando Kok
- Neurogenetics Unit, Department of Neurology, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo 05403-000, Brazil
- Mendelics Genomic Analysis, Sao Paulo, Sao Paulo 02511-000, Brazil
| | - Leandro Tavares Lucato
- Neuroradiology Section, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo,Sao Paulo, Sao Paulo 05403-010, Brazil
- Grupo Fleury, São Paulo, São Paulo 01333-011, Brazil
| | - Henry Houlden
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
- National Hospital for Neurology & Neurosurgery, London WC1N 3BG, UK
| | - Christel Depienne
- Institute of Human Genetics, University Hospital Essen, University Duisburg-Essen, Essen 45147, Germany
| | - David S Lynch
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
- National Hospital for Neurology & Neurosurgery, London WC1N 3BG, UK
| | - Pedro Braga-Neto
- Division of Neurology, Department of Clinical Medicine, Federal University of Ceara, Fortaleza, Ceara 60430-160, Brazil
- Center of Health Science, State University of Ceara, Fortaleza, Ceara 3101-9795, Brazil
- Postgraduate Program in Medical Sciences, Federal University of Ceará (UFC), Fortaleza, Ceara 60020-181, Brazil
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3
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Paiva ARBD, Pessoa ALS, Nóbrega PR, Moreno CAM, Lynch DS, Taniguti LM, Kitajima JP, Freua F, Della-Ripa B, Cunha P, Peixoto de Barcelos I, Macedo-Souza LI, Takeuchi CA, Garcia AMS, Nardes F, Fontão R, Antoniuk SA, Troncoso M, Spécola N, Durand C, Madeiro BDACS, Doriqui MJR, Vergara D, Houlden H, Kok F. Ceroid lipofuscinosis type 5: novel pathogenic variants and unexpected phenotypic findings. J Neurol Neurosurg Psychiatry 2023; 94:405-408. [PMID: 36737246 DOI: 10.1136/jnnp-2022-330135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 01/24/2023] [Indexed: 02/05/2023]
Affiliation(s)
- Anderson Rodrigues Brandão de Paiva
- Mendelics Genomic Analysis, São Paulo, SP, Brazil
- Neurology Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
- Neurology Department, Hospital São Rafael - Rede D'or São Luiz, Salvador, BA, Brazil
| | - André Luiz Santos Pessoa
- Hospital Infantil Albert Sabin, Fortaleza, CE, Brazil
- Universidade Estadual do Ceara, Fortaleza, CE, Brazil
| | - Paulo Ribeiro Nóbrega
- Neurology Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
- Neurology Department, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - Cristiane Araujo Martins Moreno
- Mendelics Genomic Analysis, São Paulo, SP, Brazil
- Neurology Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - David S Lynch
- Department of Neurogenetics, National Hospital for Neurology & Neurosurgery, Queen Square, London, UK
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | | | | | - Fernando Freua
- Neurology Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
- Neurology Department, Beneficência Portuguesa de São Paulo, São Paulo, SP, Brazil
| | - Bruno Della-Ripa
- Mendelics Genomic Analysis, São Paulo, SP, Brazil
- Neurology Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Paulina Cunha
- Neurology Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
- Institut du Cerveau (ICM), APHP, Pitié Salpêtrière Hospital, Paris, France
| | - Isabella Peixoto de Barcelos
- Neurology Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | | | | | - Flávia Nardes
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ramiro Fontão
- Neuropediatrics, Penna Hospital, Bahía Blanca, Buenos Aires, Argentina
| | | | - Monica Troncoso
- Pediatric Neurology Department, Hospital Clínico San Borja Arriarán, University of Chile, Santiago, Chile
| | - Norma Spécola
- Hospital de Niños Sor María Ludovica, La Plata, Argentina
| | - Consuelo Durand
- Laboratorio de Neuroquímica Dr. N.A. Chamoles, Buenos Aires, Argentina
| | | | | | - Diane Vergara
- Pediatric Neurology Department, Hospital Clínico San Borja Arriarán, University of Chile, Santiago, Chile
| | - Henry Houlden
- Department of Neurogenetics, National Hospital for Neurology & Neurosurgery, Queen Square, London, UK
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Fernando Kok
- Mendelics Genomic Analysis, São Paulo, SP, Brazil
- Neurology Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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4
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Freua F, Almeida MEDC, Nóbrega PR, Paiva ARBD, Della-Ripa B, Cunha P, Macedo-Souza LI, Bueno C, Lynch DS, Houlden H, Lucato LT, Kok F. Arginase 1 deficiency presenting as complicated hereditary spastic paraplegia. Cold Spring Harb Mol Case Stud 2022; 8:mcs.a006232. [PMID: 36180229 PMCID: PMC9632362 DOI: 10.1101/mcs.a006232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/20/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Argininemia or arginase deficiency is a metabolic disorder caused by pathogenic variants in ARG1 and consists of a variable association of progressive spastic paraplegia, intellectual disability, and seizures. Hereditary spastic paraplegia (HSP) is a group of inherited diseases whose main feature is a progressive gait disorder characterized by lower limb spasticity. This study presents 7 patients with arginase 1 deficiency from 6 different families, all with an initial diagnosis of complicated HSP. METHODS We evaluated the clinical data of 7 patients belonging to six independent families who were diagnosed with hyperargininemia in a neurogenetics outpatient clinic. RESULTS All patients had lower limb spasticity and six had global developmental delay. Five individuals had intellectual disability and two had epilepsy. Psychiatric abnormalities were seen in two patients. In two participants of this study, MRI disclosed thinning of the corpus callosum. Molecular diagnosis was made by whole exome sequencing. All variants were present in homozygosis; we identified two novel missense variants, one novel frameshift variant, and one previously published missense variant. DISCUSSION Clinical diagnosis of early onset complicated hereditary spastic paraplegia was made in all patients. Two patients were initially suspected of having SPG11 due to thinning of the corpus callosum. As argininemia may present with a highly penetrant phenotype of spastic paraplegia associated with additional symptoms, this disease may represent a specific entity amongst the complicated HSPs.
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Affiliation(s)
- Fernando Freua
- Neurogenetics Outpatient, Department of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil;;
| | - Mariana Espíndola de Castro Almeida
- Neurogenetics Outpatient, Department of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Paulo Ribeiro Nóbrega
- Neurogenetics Outpatient, Department of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Anderson Rodrigues Brandáo de Paiva
- Neurogenetics Outpatient, Department of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Bruno Della-Ripa
- Neurogenetics Outpatient, Department of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Paulina Cunha
- Neurogenetics Outpatient, Department of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Lúcia Inês Macedo-Souza
- Neurogenetics Outpatient, Department of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Clarissa Bueno
- Neurogenetics Outpatient, Department of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - David S Lynch
- Department of Neuromuscular Disease, UCL Institute of Neurology, Queen Square, London, UK
| | - Henry Houlden
- Department of Neuromuscular Disease, UCL Institute of Neurology, Queen Square, London, UK
| | - Leandro Tavares Lucato
- Department of Radiology, Hospital das Clínicas da Faculdade de Medicina da Universidade de Sáo Paulo, Sáo Paulo, Brazil
| | - Fernando Kok
- Neurogenetics Outpatient, Department of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de Sáo Paulo, Sáo Paulo, Brazil
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5
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Budhdeo S, de Paiva ARB, Wade C, Lopes LCG, Della-Ripa B, Davagnanam I, Lucato L, Mummery CJ, Kok F, Houlden H, Werring DJ, Lynch DS. A rare cause of monogenic cerebral small vessel disease and stroke: Cathepsin A-related arteriopathy with strokes and leukoencephalopathy (CARASAL). J Neurol 2022; 269:6673-6677. [PMID: 35904593 DOI: 10.1007/s00415-022-11302-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cathepsin A-related arteriopathy with strokes and leukoencephalopathy (CARASAL) is a rare monogenic cause of cerebral small vessel disease. To date, fewer than 15 patients with CARASAL have been described, all of common European ancestry. METHODS Clinical and imaging phenotypes of two patients are presented. Genetic variants were identified using targeted Sanger and focused exome sequencing, respectively. RESULTS Both patients carried the same pathogenic p.Arg325Cys mutation in CTSA. One patient of Chinese ethnicity presented with migraine, tinnitus and slowly progressive cognitive impairment with significant cerebral small vessel disease in the absence of typical cardiovascular risk factors. She later suffered an ischaemic stroke. A second patient from Brazil, of Italian ethnicity developed progressive dysphagia and dysarthria in his 50s, he later developed hearing loss and chronic disequilibrium. Magnetic resonance imaging in both cases demonstrated extensive signal change in the deep cerebral white matter, anterior temporal lobes, thalami, internal and external capsules and brainstem. CONCLUSIONS CARASAL should be considered in patients with early onset or severe cerebral small vessel disease, particularly where there are prominent symptoms or signs related to brainstem involvement, such as hearing dysfunction, tinnitus or dysphagia or where there is significant thalamic and brainstem involvement on imaging.
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Affiliation(s)
- Sanjay Budhdeo
- Department for Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
- National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Anderson Rodrigues Brandão de Paiva
- Neurology Department, Neurogenetics Unit, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Neurology Department, Hospital São Rafael-Rede D'Or São Luiz, Salvador, Brazil
| | - Charles Wade
- National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Laura Cardia Gomes Lopes
- Department of Neurology, Psychology and Psychiatry, Universidade Estadual de São Paulo (UNESP), Botucatu, SP, Brazil
| | - Bruno Della-Ripa
- Neurology Department, Neurogenetics Unit, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Indran Davagnanam
- Lysholm Department of Neuroradiology, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - Leandro Lucato
- Diagnostic Neuroradiology Section, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Catherine J Mummery
- Dementia Research Centre, Department of Neurodegenerative Disease, National Hospital for Neurology and Neurosurgery, London, UK
| | - Fernando Kok
- Neurology Department, Neurogenetics Unit, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Mendelics Genomic Analysis, São Paulo, Brazil
| | - Henry Houlden
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology, London, UK
| | - David J Werring
- Stroke Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - David S Lynch
- National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology, London, UK.
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6
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Melo ESD, Paiva ARBD, de Amorim AD, Lima de Carvalho JR, Bezerra MER, van der Linden V, Lynch DS, Kok F. Extreme Clinical Variability Among Carriers of Pathogenic Variant in SSBP1. Mov Disord 2022; 37:879-881. [PMID: 35142387 DOI: 10.1002/mds.28956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
- Eduardo Sousa de Melo
- Department of Neuropsychiatry, Federal University of Pernambuco, Recife, Brazil.,Department of Neurology, Hospital das Clínicas de Pernambuco - Empresa Brasileira de Serviços Hospitalares, Federal University of Pernambuco, Recife, Brazil
| | - Anderson Rodrigues Brandão de Paiva
- Neurogenetics Unit, Neurology Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Neurology Department, Hospital São Rafael-Rede D'Or São Luiz, Salvador, Brazil
| | - Antônio Duarte de Amorim
- Neurogenetics Unit, Neurology Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Jose Ronaldo Lima de Carvalho
- Department of Ophthalmology, Hospital das Clínicas de Pernambuco - Empresa Brasileira de Serviços Hospitalares, Federal University of Pernambuco, Recife, Brazil.,Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | - Marcos Eugenio Ramalho Bezerra
- Department of Neurology, Hospital das Clínicas de Pernambuco - Empresa Brasileira de Serviços Hospitalares, Federal University of Pernambuco, Recife, Brazil
| | | | - David S Lynch
- National Hospital for Neurology and Neurosurgery, Queen Sq, London, United Kingdom
| | - Fernando Kok
- Neurogenetics Unit, Neurology Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Mendelics Genomic Analysis, São Paulo, Brazil
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7
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Papapetropoulos S, Pontius A, Finger E, Karrenbauer V, Lynch DS, Brennan M, Zappia S, Koehler W, Schoels L, Hayer SN, Konno T, Ikeuchi T, Lund T, Orthmann-Murphy J, Eichler F, Wszolek ZK. Adult-Onset Leukoencephalopathy With Axonal Spheroids and Pigmented Glia: Review of Clinical Manifestations as Foundations for Therapeutic Development. Front Neurol 2022; 12:788168. [PMID: 35185751 PMCID: PMC8850408 DOI: 10.3389/fneur.2021.788168] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/14/2021] [Indexed: 12/11/2022] Open
Abstract
A comprehensive review of published literature was conducted to elucidate the genetics, neuropathology, imaging findings, prevalence, clinical course, diagnosis/clinical evaluation, potential biomarkers, and current and proposed treatments for adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP), a rare, debilitating, and life-threatening neurodegenerative disorder for which disease-modifying therapies are not currently available. Details on potential efficacy endpoints for future interventional clinical trials in patients with ALSP and data related to the burden of the disease on patients and caregivers were also reviewed. The information in this position paper lays a foundation to establish an effective clinical rationale and address the clinical gaps for creation of a robust strategy to develop therapeutic agents for ALSP, as well as design future clinical trials, that have clinically meaningful and convergent endpoints.
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Affiliation(s)
- Spyros Papapetropoulos
- Vigil Neuroscience, Inc, Cambridge, MA, United States
- Massachusetts General Hospital, Boston, MA, United States
- *Correspondence: Spyros Papapetropoulos
| | | | - Elizabeth Finger
- Clinical Neurological Sciences, Western University, London, ON, Canada
| | - Virginija Karrenbauer
- Neurology Medical Unit, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - David S. Lynch
- National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | | | | | | | - Ludger Schoels
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University Hospital Tuebingen, Tuebingen, Germany
- German Research Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Stefanie N. Hayer
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University Hospital Tuebingen, Tuebingen, Germany
- German Research Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Takuya Konno
- Brain Research Institute, Niigata University, Niigata, Japan
| | - Takeshi Ikeuchi
- Brain Research Institute, Niigata University, Niigata, Japan
| | - Troy Lund
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
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8
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Mackenzie S, Shafat M, Roddy H, Hyare H, Neill L, Marzolini MAV, Gilhooley M, Marafioti T, Kara E, Sanchez E, Rees J, Lynch DS, Thomson K, Ardeshna KM, Laurence A, Peggs KS, O'Reilly M, Roddie C. Pembrolizumab for the treatment of progressive multifocal leukoencephalopathy following anti‐CD19 CAR‐T therapy: a case report. eJHaem 2021; 2:848-853. [PMID: 35845220 PMCID: PMC9281485 DOI: 10.1002/jha2.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/18/2021] [Accepted: 07/20/2021] [Indexed: 11/12/2022]
Abstract
Progressive multifocal leukoencephalopathy (PML) is an opportunistic brain infection with few treatment options and poor survival when reversal of the underlying immune dysfunction is not achievable. JC polyomavirus reactivation resulting in PML can rarely complicate chimeric antigen receptor T‐cell (CAR‐T) therapy. We describe successful treatment of PML with Programmed death‐1 (PD‐1) blockade using pembrolizumab, 4 months following axicabtagene ciloleucel. Radiological features of immune reconstitution inflammatory syndrome without clinical deterioration were seen. Evidence of anti‐viral immune reconstitution by in vitro detection of JC‐specific T‐cells and sustained neurological recovery in this patient suggest PD‐1 blockade may be an effective treatment approach for PML post‐CAR‐T.
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Affiliation(s)
- Strachan Mackenzie
- UCL Cancer Institute Paul O'Gorman Building University College London London UK
- UCL Great Ormond Street Institute of Child Health University College London London UK
| | - Manar Shafat
- UCL Cancer Institute Paul O'Gorman Building University College London London UK
| | - Harriet Roddy
- UCL Cancer Institute Paul O'Gorman Building University College London London UK
| | - Harpreet Hyare
- Department of Haematology University College London Hospital NHS Foundation Trust London UK
- Department of Radiology University College London Hospital NHS Foundation Trust London UK
| | - Lorna Neill
- Department of Haematology University College London Hospital NHS Foundation Trust London UK
| | - Maria A. V. Marzolini
- Department of Haematology University College London Hospital NHS Foundation Trust London UK
| | - Michael Gilhooley
- The Institute of Ophthalmology University College London Bath Street London UK
| | - Teresa Marafioti
- Department of Histopathology University College London 60 Whitfield Street London UK
| | - Eleanna Kara
- Department of Neuropathology National Hospital of Neurology and Neurosurgery University College London Hospital NHS Foundation Trust Queen Square London UK
| | - Emilie Sanchez
- Department of Virology University College London Hospital NHS Foundation Trust London UK
| | - Jeremy Rees
- Institute of Neurology National Hospital of Neurology and Neurosurgery University College London Queen Square London UK
| | - David S. Lynch
- Institute of Neurology National Hospital of Neurology and Neurosurgery University College London Queen Square London UK
| | - Kirsty Thomson
- Department of Haematology University College London Hospital NHS Foundation Trust London UK
| | - Kirit M. Ardeshna
- Department of Haematology University College London Hospital NHS Foundation Trust London UK
| | - Arian Laurence
- Department of Haematology University College London Hospital NHS Foundation Trust London UK
| | - Karl S. Peggs
- UCL Cancer Institute Paul O'Gorman Building University College London London UK
- Department of Haematology University College London Hospital NHS Foundation Trust London UK
| | - Maeve O'Reilly
- Department of Haematology University College London Hospital NHS Foundation Trust London UK
| | - Claire Roddie
- UCL Cancer Institute Paul O'Gorman Building University College London London UK
- Department of Haematology University College London Hospital NHS Foundation Trust London UK
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9
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Yau WY, Sullivan R, Chen Z, Lynch DS, Vandrovcova J, Wood NW, Houlden H. GGC
Repeat Expansion in
NOTCH2NLC
Is Rare in European Leukoencephalopathy. Ann Neurol 2020; 88:641-642. [DOI: 10.1002/ana.25818] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/27/2020] [Accepted: 03/30/2020] [Indexed: 11/12/2022]
Affiliation(s)
- Wai Yan Yau
- Department of Neuromuscular DiseasesInstitute of Neurology, University College London UK
| | - Roisin Sullivan
- Department of Neuromuscular DiseasesInstitute of Neurology, University College London UK
| | - Zhongbo Chen
- Department of Neuromuscular DiseasesInstitute of Neurology, University College London UK
- Department of Neurodegenerative DiseasesInstitute of Neurology, University College London UK
| | - David S. Lynch
- Department of Neuromuscular DiseasesInstitute of Neurology, University College London UK
| | - Jana Vandrovcova
- Department of Neuromuscular DiseasesInstitute of Neurology, University College London UK
| | - Nicholas W. Wood
- Neurogenetics UnitNational Hospital for Neurology and Neurosurgery London UK
- Department of Clinical and Movement NeurosciencesUCL Queen Square Institute of Neurology London UK
| | - Henry Houlden
- Department of Neuromuscular DiseasesInstitute of Neurology, University College London UK
- Neurogenetics UnitNational Hospital for Neurology and Neurosurgery London UK
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10
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Williams T, Houlden H, Murphy E, John N, Fox NC, Schott JM, Adams M, Davagananam I, Chataway J, Lynch DS. How to diagnose difficult white matter disorders. Pract Neurol 2020; 20:280-286. [PMID: 32434903 DOI: 10.1136/practneurol-2020-002530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2020] [Indexed: 11/04/2022]
Abstract
Genetic and acquired disorders of white matter comprise a diverse group of conditions, with often overlapping clinical and radiological findings. Patients present with a variable combination of cognitive impairment, ataxia, spasticity or movement disorders, among others. There are many genetic causes, and the route to diagnosis involves comprehensive clinical assessment, radiological expertise, metabolic investigations and finally genetic studies. It is essential not to miss the treatable acquired causes. In this review, we present a practical approach to investigating patients with acquired and genetic disorders of white matter, based on the experience of a large international referral centre. We present a guide for clinicians, including pitfalls of testing, clinical pearls and where to seek advice.
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Affiliation(s)
- Thomas Williams
- Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, London, UK
| | - Henry Houlden
- Department of Neuromuscular Disease, UCL Institute of Neurology and the National Hospital for Neurology & Neurosurgery, London, UK
| | - Elaine Murphy
- Charles Dent Metabolic Unit, National Hospital for Neurology and Neurosurgery, London, UK
| | - Nevin John
- Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, London, UK
| | - Nick C Fox
- Dementia Research Centre, Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, UK
| | - Jonathan M Schott
- Dementia Research Centre, Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, UK
| | - Matthew Adams
- Lysholm Department of Neuroradiology, National Hospital for Neurology & Neurosurgery, London, UK
| | - Indran Davagananam
- Lysholm Department of Neuroradiology, National Hospital for Neurology & Neurosurgery, London, UK.,Department of Brain Repair and Rehabilitation (ID), UCL Institute of Neurology, London, UK
| | - Jeremy Chataway
- Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, London, UK
| | - David S Lynch
- Department of Neuromuscular Disease, UCL Institute of Neurology and the National Hospital for Neurology & Neurosurgery, London, UK
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11
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Lynch DS, Houlden H. Stem cell transplant arrests decline in case of CSF1R leukoencephalopathy. J Neurol Neurosurg Psychiatry 2019; 90:1306. [PMID: 31401565 DOI: 10.1136/jnnp-2019-321021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 06/17/2019] [Accepted: 06/21/2019] [Indexed: 11/04/2022]
Affiliation(s)
- David S Lynch
- Molecular Neuroscience, UCL Institute of Neurology, London, UK.,Leonard Wolfson Experimental Neurology Centre, UCL Institute of Neurology, London, UK
| | - Henry Houlden
- Department of Neuromuscular Diseases and MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
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12
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Bugiardini E, Khan AM, Phadke R, Lynch DS, Cortese A, Feng L, Gang Q, Pittman AM, Morrow JM, Turner C, Carr AS, Quinlivan R, Rossor AM, Holton JL, Parton M, Blake JC, Reilly MM, Houlden H, Matthews E, Hanna MG. Genetic and phenotypic characterisation of inherited myopathies in a tertiary neuromuscular centre. Neuromuscul Disord 2019; 29:747-757. [DOI: 10.1016/j.nmd.2019.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 06/12/2019] [Accepted: 08/09/2019] [Indexed: 02/06/2023]
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13
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Lynch DS, Wade C, Paiva ARBD, John N, Kinsella JA, Merwick Á, Ahmed RM, Warren JD, Mummery CJ, Schott JM, Fox NC, Houlden H, Adams ME, Davagnanam I, Murphy E, Chataway J. Practical approach to the diagnosis of adult-onset leukodystrophies: an updated guide in the genomic era. J Neurol Neurosurg Psychiatry 2019; 90:543-554. [PMID: 30467211 PMCID: PMC6581077 DOI: 10.1136/jnnp-2018-319481] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 09/24/2018] [Accepted: 10/07/2018] [Indexed: 12/13/2022]
Abstract
Adult-onset leukodystrophies and genetic leukoencephalopathies comprise a diverse group of neurodegenerative disorders of white matter with a wide age of onset and phenotypic spectrum. Patients with white matter abnormalities detected on MRI often present a diagnostic challenge to both general and specialist neurologists. Patients typically present with a progressive syndrome including various combinations of cognitive impairment, movement disorders, ataxia and upper motor neuron signs. There are a number of important and treatable acquired causes for this imaging and clinical presentation. There are also a very large number of genetic causes which due to their relative rarity and sometimes variable and overlapping presentations can be difficult to diagnose. In this review, we provide a structured approach to the diagnosis of inherited disorders of white matter in adults. We describe clinical and radiological clues to aid diagnosis, and we present an overview of both common and rare genetic white matter disorders. We provide advice on testing for acquired causes, on excluding small vessel disease mimics, and detailed advice on metabolic and genetic testing available to the practising neurologist. Common genetic leukoencephalopathies discussed in detail include CSF1R, AARS2, cerebral arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), and mitochondrial and metabolic disorders.
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Affiliation(s)
- David S Lynch
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK .,Department of Neurology, Royal Free Hospital, London, UK
| | - Charles Wade
- Department of Neurology, Royal Free Hospital, London, UK
| | | | - Nevin John
- Department of Neuroinflammation, UCL Institute of Neurology, London, UK
| | - Justin A Kinsella
- Department of Neurology, St Vincent's University Hospital University College Dublin, Dublin, Ireland
| | - Áine Merwick
- Department of Neurology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Rebekah M Ahmed
- Memory and Cognition Clinic, Department of Clinical Neurosciences, Royal Prince Alfred Hospital and the Brain and Mind Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Jason D Warren
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | | | | | - Nick C Fox
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Henry Houlden
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Matthew E Adams
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Indran Davagnanam
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, UK.,Brain Repair & Rehabilitation, UCL Institute of Neurology, London, UK
| | - Elaine Murphy
- Charles Dent Metabolic Unit, National Hospital for Neurology and Neurosurgery Queen Square, London, UK
| | - Jeremy Chataway
- Department of Neuroinflammation, UCL Institute of Neurology, London, UK
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14
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de Paiva ARB, Lynch DS, Melo US, Lucato LT, Freua F, de Assis BDR, Barcelos I, Listik C, de Castro Dos Santos D, Macedo-Souza LI, Houlden H, Kok F. PUS3 mutations are associated with intellectual disability, leukoencephalopathy, and nephropathy. Neurol Genet 2019; 5:e306. [PMID: 30697592 PMCID: PMC6340380 DOI: 10.1212/nxg.0000000000000306] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 11/08/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Anderson Rodrigues Brandão de Paiva
- Neurogenetics Unit (A.R.B.d.P., F.F., B.D.R.d.A., I.B., C.L., D.d.C.d.S., F.K.), Neurology Department, Hospital das Clínicas da Universidade de São Paulo, Brazil; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Leonard Wolfson Experimental Neurology Centre (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Human Genome and Stem Cell Research Center (U.S.M., L.I.M.-S., F.K.), Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, Brazil; and Neuroradiology Section (L.T.L.), Hospital das Clínicas da Universidade de São Paulo, Brazil
| | - David S Lynch
- Neurogenetics Unit (A.R.B.d.P., F.F., B.D.R.d.A., I.B., C.L., D.d.C.d.S., F.K.), Neurology Department, Hospital das Clínicas da Universidade de São Paulo, Brazil; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Leonard Wolfson Experimental Neurology Centre (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Human Genome and Stem Cell Research Center (U.S.M., L.I.M.-S., F.K.), Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, Brazil; and Neuroradiology Section (L.T.L.), Hospital das Clínicas da Universidade de São Paulo, Brazil
| | - Uirá Souto Melo
- Neurogenetics Unit (A.R.B.d.P., F.F., B.D.R.d.A., I.B., C.L., D.d.C.d.S., F.K.), Neurology Department, Hospital das Clínicas da Universidade de São Paulo, Brazil; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Leonard Wolfson Experimental Neurology Centre (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Human Genome and Stem Cell Research Center (U.S.M., L.I.M.-S., F.K.), Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, Brazil; and Neuroradiology Section (L.T.L.), Hospital das Clínicas da Universidade de São Paulo, Brazil
| | - Leandro Tavares Lucato
- Neurogenetics Unit (A.R.B.d.P., F.F., B.D.R.d.A., I.B., C.L., D.d.C.d.S., F.K.), Neurology Department, Hospital das Clínicas da Universidade de São Paulo, Brazil; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Leonard Wolfson Experimental Neurology Centre (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Human Genome and Stem Cell Research Center (U.S.M., L.I.M.-S., F.K.), Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, Brazil; and Neuroradiology Section (L.T.L.), Hospital das Clínicas da Universidade de São Paulo, Brazil
| | - Fernando Freua
- Neurogenetics Unit (A.R.B.d.P., F.F., B.D.R.d.A., I.B., C.L., D.d.C.d.S., F.K.), Neurology Department, Hospital das Clínicas da Universidade de São Paulo, Brazil; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Leonard Wolfson Experimental Neurology Centre (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Human Genome and Stem Cell Research Center (U.S.M., L.I.M.-S., F.K.), Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, Brazil; and Neuroradiology Section (L.T.L.), Hospital das Clínicas da Universidade de São Paulo, Brazil
| | - Bruno Della Ripa de Assis
- Neurogenetics Unit (A.R.B.d.P., F.F., B.D.R.d.A., I.B., C.L., D.d.C.d.S., F.K.), Neurology Department, Hospital das Clínicas da Universidade de São Paulo, Brazil; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Leonard Wolfson Experimental Neurology Centre (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Human Genome and Stem Cell Research Center (U.S.M., L.I.M.-S., F.K.), Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, Brazil; and Neuroradiology Section (L.T.L.), Hospital das Clínicas da Universidade de São Paulo, Brazil
| | - Isabella Barcelos
- Neurogenetics Unit (A.R.B.d.P., F.F., B.D.R.d.A., I.B., C.L., D.d.C.d.S., F.K.), Neurology Department, Hospital das Clínicas da Universidade de São Paulo, Brazil; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Leonard Wolfson Experimental Neurology Centre (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Human Genome and Stem Cell Research Center (U.S.M., L.I.M.-S., F.K.), Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, Brazil; and Neuroradiology Section (L.T.L.), Hospital das Clínicas da Universidade de São Paulo, Brazil
| | - Clarice Listik
- Neurogenetics Unit (A.R.B.d.P., F.F., B.D.R.d.A., I.B., C.L., D.d.C.d.S., F.K.), Neurology Department, Hospital das Clínicas da Universidade de São Paulo, Brazil; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Leonard Wolfson Experimental Neurology Centre (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Human Genome and Stem Cell Research Center (U.S.M., L.I.M.-S., F.K.), Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, Brazil; and Neuroradiology Section (L.T.L.), Hospital das Clínicas da Universidade de São Paulo, Brazil
| | - Diego de Castro Dos Santos
- Neurogenetics Unit (A.R.B.d.P., F.F., B.D.R.d.A., I.B., C.L., D.d.C.d.S., F.K.), Neurology Department, Hospital das Clínicas da Universidade de São Paulo, Brazil; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Leonard Wolfson Experimental Neurology Centre (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Human Genome and Stem Cell Research Center (U.S.M., L.I.M.-S., F.K.), Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, Brazil; and Neuroradiology Section (L.T.L.), Hospital das Clínicas da Universidade de São Paulo, Brazil
| | - Lúcia Inês Macedo-Souza
- Neurogenetics Unit (A.R.B.d.P., F.F., B.D.R.d.A., I.B., C.L., D.d.C.d.S., F.K.), Neurology Department, Hospital das Clínicas da Universidade de São Paulo, Brazil; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Leonard Wolfson Experimental Neurology Centre (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Human Genome and Stem Cell Research Center (U.S.M., L.I.M.-S., F.K.), Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, Brazil; and Neuroradiology Section (L.T.L.), Hospital das Clínicas da Universidade de São Paulo, Brazil
| | - Henry Houlden
- Neurogenetics Unit (A.R.B.d.P., F.F., B.D.R.d.A., I.B., C.L., D.d.C.d.S., F.K.), Neurology Department, Hospital das Clínicas da Universidade de São Paulo, Brazil; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Leonard Wolfson Experimental Neurology Centre (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Human Genome and Stem Cell Research Center (U.S.M., L.I.M.-S., F.K.), Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, Brazil; and Neuroradiology Section (L.T.L.), Hospital das Clínicas da Universidade de São Paulo, Brazil
| | - Fernando Kok
- Neurogenetics Unit (A.R.B.d.P., F.F., B.D.R.d.A., I.B., C.L., D.d.C.d.S., F.K.), Neurology Department, Hospital das Clínicas da Universidade de São Paulo, Brazil; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Leonard Wolfson Experimental Neurology Centre (D.S.L., H.H.), UCL Institute of Neurology, London, UK; Human Genome and Stem Cell Research Center (U.S.M., L.I.M.-S., F.K.), Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, Brazil; and Neuroradiology Section (L.T.L.), Hospital das Clínicas da Universidade de São Paulo, Brazil
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15
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O’Connor E, Vandrovcova J, Bugiardini E, Chelban V, Manole A, Davagnanam I, Wiethoff S, Pittman A, Lynch DS, Efthymiou S, Marino S, Manzur AY, Roberts M, Hanna MG, Houlden H, Matthews E, Wood NW. Mutations in XRCC1 cause cerebellar ataxia and peripheral neuropathy. J Neurol Neurosurg Psychiatry 2018; 89:1230-1232. [PMID: 29472272 PMCID: PMC6227798 DOI: 10.1136/jnnp-2017-317581] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 01/19/2018] [Accepted: 01/24/2018] [Indexed: 11/04/2022]
Affiliation(s)
- Emer O’Connor
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - Jana Vandrovcova
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - Enrico Bugiardini
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - Viorica Chelban
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - Andreea Manole
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - Indran Davagnanam
- Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, UK
| | - Sarah Wiethoff
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - Alan Pittman
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - David S Lynch
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - Stephanie Efthymiou
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - Silvia Marino
- Department of Neuropathology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Adnan Y Manzur
- Department of Neurology, Great Ormond Street Hospital for Children, London, UK
| | - Mark Roberts
- Department of Neurology, Salford Royal NHS Foundation Trust, Manchester, UK
| | - Michael G Hanna
- Medical Research Council Center for Neuromuscular Diseases, University College London and National Hospital for Neurology and Neurosurgery, London, UK
| | - Henry Houlden
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - Emma Matthews
- Medical Research Council Center for Neuromuscular Diseases, University College London and National Hospital for Neurology and Neurosurgery, London, UK
| | - Nicholas W Wood
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
- Neurogenetics Laboratory, The National Hospital for Neurology and Neurosurgery, London, UK
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16
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Melo US, Freua F, Lynch DS, Ripa BD, Tenorio RB, Saute JAM, de Souza Leite F, Kitajima J, Houlden H, Zatz M, Kok F. Clinical aspects of hereditary spastic paraplegia 76 and novel CAPN1 mutations. Clin Genet 2018; 94:482-483. [PMID: 30198554 DOI: 10.1111/cge.13428] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 07/23/2018] [Accepted: 07/26/2018] [Indexed: 11/30/2022]
Affiliation(s)
- U S Melo
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, São Paulo, Brazil
| | - F Freua
- Neurogenetics Outpatient Service, Neurology Department, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
| | - D S Lynch
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - B D Ripa
- Neurogenetics Outpatient Service, Neurology Department, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
| | - R B Tenorio
- Serviços de Genética Médica e Neurologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - J A M Saute
- Serviços de Genética Médica e Neurologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - F de Souza Leite
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, São Paulo, Brazil
| | | | - H Houlden
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - M Zatz
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, São Paulo, Brazil
| | - F Kok
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, São Paulo, Brazil.,Neurogenetics Outpatient Service, Neurology Department, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil.,Mendelics, São Paulo, Brazil
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17
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Gurgel-Giannetti J, Lynch DS, de Paiva ARB, Lucato LT, Yamamoto G, Thomsen C, Basu S, Freua F, Giannetti AV, de Assis BDR, Ribeiro MDO, Barcelos I, Sayão Souza K, Monti F, Melo US, Amorim S, Silva LGL, Macedo-Souza LI, Vianna-Morgante AM, Hirano M, Van der Knaap MS, Lill R, Vainzof M, Oldfors A, Houlden H, Kok F. A novel complex neurological phenotype due to a homozygous mutation in FDX2. Brain 2018; 141:2289-2298. [PMID: 30010796 PMCID: PMC6061701 DOI: 10.1093/brain/awy172] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 11/15/2017] [Revised: 03/30/2018] [Accepted: 04/26/2018] [Indexed: 11/14/2022] Open
Abstract
Defects in iron-sulphur [Fe-S] cluster biogenesis are increasingly recognized as causing neurological disease. Mutations in a number of genes that encode proteins involved in mitochondrial [Fe-S] protein assembly lead to complex neurological phenotypes. One class of proteins essential in the early cluster assembly are ferredoxins. FDX2 is ubiquitously expressed and is essential in the de novo formation of [2Fe-2S] clusters in humans. We describe and genetically define a novel complex neurological syndrome identified in two Brazilian families, with a novel homozygous mutation in FDX2. Patients were clinically evaluated, underwent MRI, nerve conduction studies, EMG and muscle biopsy. To define the genetic aetiology, a combination of homozygosity mapping and whole exome sequencing was performed. We identified six patients from two apparently unrelated families with autosomal recessive inheritance of a complex neurological phenotype involving optic atrophy and nystagmus developing by age 3, followed by myopathy and recurrent episodes of cramps, myalgia and muscle weakness in the first or second decade of life. Sensory-motor axonal neuropathy led to progressive distal weakness. MRI disclosed a reversible or partially reversible leukoencephalopathy. Muscle biopsy demonstrated an unusual pattern of regional succinate dehydrogenase and cytochrome c oxidase deficiency with iron accumulation. The phenotype was mapped in both families to the same homozygous missense mutation in FDX2 (c.431C > T, p.P144L). The deleterious effect of the mutation was validated by real-time reverse transcription polymerase chain reaction and western blot analysis, which demonstrated normal expression of FDX2 mRNA but severely reduced expression of FDX2 protein in muscle tissue. This study describes a novel complex neurological phenotype with unusual MRI and muscle biopsy features, conclusively mapped to a mutation in FDX2, which encodes a ubiquitously expressed mitochondrial ferredoxin essential for early [Fe-S] cluster biogenesis.
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Affiliation(s)
| | - David S Lynch
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
- Leonard Wolfson Experimental Neurology Centre, UCL Institute of Neurology, London, UK
| | | | - Leandro Tavares Lucato
- Neuroradiology Section, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
| | - Guilherme Yamamoto
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, São Paulo, Brazil
| | - Christer Thomsen
- Department of Pathology and Genetics, Sahlgrenska University Hospital, University of Gothenburg, Sweden
| | - Somsuvro Basu
- Institute for Cytobiology and Cytopathology, Philipps-Universität Marburg, Robert-Koch-Strasse 6, 35032 Marburg, Germany
| | - Fernando Freua
- Neurogenetics Unit, Neurology Department, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
| | | | - Bruno Della Ripa de Assis
- Neurogenetics Unit, Neurology Department, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
| | - Mara Dell Ospedale Ribeiro
- Neurogenetics Unit, Neurology Department, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
| | - Isabella Barcelos
- Neurogenetics Unit, Neurology Department, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
| | - Katiane Sayão Souza
- Neurogenetics Unit, Neurology Department, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
| | - Fernanda Monti
- Neurogenetics Unit, Neurology Department, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
| | - Uirá Souto Melo
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, São Paulo, Brazil
| | - Simone Amorim
- Neurogenetics Unit, Neurology Department, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
| | - Leonardo G L Silva
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, São Paulo, Brazil
| | - Lúcia Inês Macedo-Souza
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, São Paulo, Brazil
| | - Angela M Vianna-Morgante
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, São Paulo, Brazil
| | - Michio Hirano
- Department of Neurology, Columbia University Medical Center, New York, USA
| | - Marjo S Van der Knaap
- Department of Child Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - Roland Lill
- Institute for Cytobiology and Cytopathology, Philipps-Universität Marburg, Robert-Koch-Strasse 6, 35032 Marburg, Germany
- LOEWE Center for Synthetic Microbiology, SynMikro, Hans-Meerwein-Strasse, 35043 Marburg, Germany
| | - Mariz Vainzof
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, São Paulo, Brazil
| | - Anders Oldfors
- Department of Pathology and Genetics, Sahlgrenska University Hospital, University of Gothenburg, Sweden
| | - Henry Houlden
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
- Leonard Wolfson Experimental Neurology Centre, UCL Institute of Neurology, London, UK
| | - Fernando Kok
- Neurogenetics Unit, Neurology Department, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Instituto de Biociências, Universidade de São Paulo, São Paulo, Brazil
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18
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Lynch DS, Chelban V, Vandrovcova J, Pittman A, Wood NW, Houlden H. GLS loss of function causes autosomal recessive spastic ataxia and optic atrophy. Ann Clin Transl Neurol 2018; 5:216-221. [PMID: 29468182 PMCID: PMC5817843 DOI: 10.1002/acn3.522] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 12/07/2017] [Accepted: 12/07/2017] [Indexed: 11/08/2022] Open
Abstract
We describe a consanguineous family in which two brothers were affected by childhood onset spastic ataxia with optic atrophy and loss of motor and language skills. Through a combination of homozygosity mapping and whole-genome sequencing, we identified a homozygous copy number variant in GLS as the cause. The duplication leads to complete knockout of GLS expression. GLS encodes the brain- and kidney-specific enzyme glutaminase, which hydrolyzes glutamine for the production of glutamate, the most abundant central nervous system neurotransmitter. This is the first report implicating GLS loss of function in human disease.
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Affiliation(s)
- David S Lynch
- Department of Molecular Neuroscience UCL Institute of Neurology Queen Sq London WC1N 3BG United Kingdom
| | - Viorica Chelban
- Department of Molecular Neuroscience UCL Institute of Neurology Queen Sq London WC1N 3BG United Kingdom
| | - Jana Vandrovcova
- Department of Molecular Neuroscience UCL Institute of Neurology Queen Sq London WC1N 3BG United Kingdom
| | - Alan Pittman
- Department of Molecular Neuroscience UCL Institute of Neurology Queen Sq London WC1N 3BG United Kingdom
| | - Nicholas W Wood
- Department of Molecular Neuroscience UCL Institute of Neurology Queen Sq London WC1N 3BG United Kingdom
| | - Henry Houlden
- Department of Molecular Neuroscience UCL Institute of Neurology Queen Sq London WC1N 3BG United Kingdom.,Neurogenetics Unit National Hospital for Neurology & Neurosurgery Queen Sq London WC1N 3BG United Kingdom
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19
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Bugiardini E, Morrow JM, Shah S, Wood CL, Lynch DS, Pitmann AM, Reilly MM, Houlden H, Matthews E, Parton M, Hanna MG, Straub V, Yousry TA. The Diagnostic Value of MRI Pattern Recognition in Distal Myopathies. Front Neurol 2018; 9:456. [PMID: 29997562 PMCID: PMC6028608 DOI: 10.3389/fneur.2018.00456] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 05/29/2018] [Indexed: 12/14/2022] Open
Abstract
Objective: Distal myopathies are a diagnostically challenging group of diseases. We wanted to understand the value of MRI in the current clinical setting and explore the potential for optimizing its clinical application. Methods: We retrospectively audited the diagnostic workup in a distal myopathy patient cohort, reassessing the diagnosis, whilst documenting the usage of MRI. We established a literature based distal myopathies MRI pattern template and assessed its diagnostic utility in terms of sensitivity, specificity, and potential impact on the diagnostic workup. Results: Fifty-five patients were included; in 38 with a comprehensive set of data the diagnostic work-up was audited. The median time from symptoms onset to diagnosis was 12.1 years. The initial genetic diagnostic rate was 39%; 18% were misdiagnosed as neuropathies and 13% as inclusion body myositis (IBM). Based on 21 publications we established a MRI pattern template. Its overall sensitivity (50%) and specificity (32%) were low. However in some diseases (e.g., MYOT-related myopathy, TTN-HMERF) MRI correctly identified the causative gene. The number of genes suggested by MRI pattern analysis was smaller compared to clinical work up (median 1 vs. 9, p < 0.0001) but fewer genes were correctly predicted (5/10 vs. 7/10). MRI analysis ruled out IBM in all cases. Conclusion: In the diagnostic work-up of distal myopathies, MRI is useful in assisting genetic testing and avoiding misdiagnosis (IBM). The overall low sensitivity and specificity limits its generalized use when traditional single gene test methods are applied. However, in the context of next generation sequencing MRI may represent a valuable tool for interpreting complex genetic results.
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Affiliation(s)
- Enrico Bugiardini
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Jasper M. Morrow
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Sachit Shah
- Neuroradiological Academic Unit, UCL Institute of Neurology, London, United Kingdom
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Claire L. Wood
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle upon Tyne, United Kingdom
| | - David S. Lynch
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - Alan M. Pitmann
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - Mary M. Reilly
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, United Kingdom
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - Henry Houlden
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - Emma Matthews
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Matt Parton
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Michael G. Hanna
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, United Kingdom
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - Volker Straub
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle upon Tyne, United Kingdom
| | - Tarek A. Yousry
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, United Kingdom
- Neuroradiological Academic Unit, UCL Institute of Neurology, London, United Kingdom
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom
- *Correspondence: Tarek A. Yousry
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20
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Lynch DS, Loh SHY, Harley J, Noyce AJ, Martins LM, Wood NW, Houlden H, Plun-Favreau H. Nonsyndromic Parkinson disease in a family with autosomal dominant optic atrophy due to OPA1 mutations. Neurol Genet 2017; 3:e188. [PMID: 28955727 PMCID: PMC5610041 DOI: 10.1212/nxg.0000000000000188] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 07/05/2017] [Indexed: 01/17/2023]
Affiliation(s)
- David S Lynch
- Department of Molecular Neuroscience (D.S.L., J.H., N.W.W., H.H., H.P.-F.), UCL Institute of Neurology, London, UK; MRC Toxicology Unit (S.H.Y.L., L.M.M.), Leicester, UK; Reta Lila Weston Institute of Neurological Studies (A.J.N.), UCL Institute of Neurology, London, UK; and Neurogenetics Laboratory (H.H.), National Hospital for Neurology and Neurosurgery, London, UK
| | - Samantha H Y Loh
- Department of Molecular Neuroscience (D.S.L., J.H., N.W.W., H.H., H.P.-F.), UCL Institute of Neurology, London, UK; MRC Toxicology Unit (S.H.Y.L., L.M.M.), Leicester, UK; Reta Lila Weston Institute of Neurological Studies (A.J.N.), UCL Institute of Neurology, London, UK; and Neurogenetics Laboratory (H.H.), National Hospital for Neurology and Neurosurgery, London, UK
| | - Jasmine Harley
- Department of Molecular Neuroscience (D.S.L., J.H., N.W.W., H.H., H.P.-F.), UCL Institute of Neurology, London, UK; MRC Toxicology Unit (S.H.Y.L., L.M.M.), Leicester, UK; Reta Lila Weston Institute of Neurological Studies (A.J.N.), UCL Institute of Neurology, London, UK; and Neurogenetics Laboratory (H.H.), National Hospital for Neurology and Neurosurgery, London, UK
| | - Alastair J Noyce
- Department of Molecular Neuroscience (D.S.L., J.H., N.W.W., H.H., H.P.-F.), UCL Institute of Neurology, London, UK; MRC Toxicology Unit (S.H.Y.L., L.M.M.), Leicester, UK; Reta Lila Weston Institute of Neurological Studies (A.J.N.), UCL Institute of Neurology, London, UK; and Neurogenetics Laboratory (H.H.), National Hospital for Neurology and Neurosurgery, London, UK
| | - L Miguel Martins
- Department of Molecular Neuroscience (D.S.L., J.H., N.W.W., H.H., H.P.-F.), UCL Institute of Neurology, London, UK; MRC Toxicology Unit (S.H.Y.L., L.M.M.), Leicester, UK; Reta Lila Weston Institute of Neurological Studies (A.J.N.), UCL Institute of Neurology, London, UK; and Neurogenetics Laboratory (H.H.), National Hospital for Neurology and Neurosurgery, London, UK
| | - Nicholas W Wood
- Department of Molecular Neuroscience (D.S.L., J.H., N.W.W., H.H., H.P.-F.), UCL Institute of Neurology, London, UK; MRC Toxicology Unit (S.H.Y.L., L.M.M.), Leicester, UK; Reta Lila Weston Institute of Neurological Studies (A.J.N.), UCL Institute of Neurology, London, UK; and Neurogenetics Laboratory (H.H.), National Hospital for Neurology and Neurosurgery, London, UK
| | - Henry Houlden
- Department of Molecular Neuroscience (D.S.L., J.H., N.W.W., H.H., H.P.-F.), UCL Institute of Neurology, London, UK; MRC Toxicology Unit (S.H.Y.L., L.M.M.), Leicester, UK; Reta Lila Weston Institute of Neurological Studies (A.J.N.), UCL Institute of Neurology, London, UK; and Neurogenetics Laboratory (H.H.), National Hospital for Neurology and Neurosurgery, London, UK
| | - Helene Plun-Favreau
- Department of Molecular Neuroscience (D.S.L., J.H., N.W.W., H.H., H.P.-F.), UCL Institute of Neurology, London, UK; MRC Toxicology Unit (S.H.Y.L., L.M.M.), Leicester, UK; Reta Lila Weston Institute of Neurological Studies (A.J.N.), UCL Institute of Neurology, London, UK; and Neurogenetics Laboratory (H.H.), National Hospital for Neurology and Neurosurgery, London, UK
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21
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Chelban V, Tucci A, Lynch DS, Polke JM, Santos L, Jonvik H, Groppa S, Wood NW, Houlden H. Truncating mutations in SPAST patients are associated with a high rate of psychiatric comorbidities in hereditary spastic paraplegia. J Neurol Neurosurg Psychiatry 2017; 88:681-687. [PMID: 28572275 PMCID: PMC5537546 DOI: 10.1136/jnnp-2017-315796] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 04/02/2017] [Accepted: 04/13/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND The hereditary spastic paraplegias (HSPs) are a rare and heterogeneous group of neurodegenerative disorders that are clinically characterised by progressive lower limb spasticity. They are classified as either 'pure' or 'complex' where spastic paraplegia is complicated with additional neurological features. Mutations in the spastin gene (SPAST) are the most common cause of HSP and typically present with a pure form. METHODS We assessed in detail the phenotypic and genetic spectrum of SPAST-related HSP focused on 118 patients carrying SPAST mutations. RESULTS This study, one of the largest cohorts of genetically confirmed spastin patients to date, contributes with the discovery of a significant number of novel SPAST mutations. Our data reveal a high rate of complex cases (25%), with psychiatric disorders among the most common comorbidity (10% of all SPASTpatients). Further, we identify a genotype-phenotype correlation between patients carrying loss-of-function mutations in SPAST and the presence of psychiatric disorders.
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Affiliation(s)
- Viorica Chelban
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.,National Hospital for Neurology and Neurosurgery, London, UK.,Department of Neurology and Neurosurgery, Institute of Emergency Medicine, Chisinau, Republic of Moldova
| | - Arianna Tucci
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.,National Hospital for Neurology and Neurosurgery, London, UK.,Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milano, Italy
| | - David S Lynch
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.,National Hospital for Neurology and Neurosurgery, London, UK
| | - James M Polke
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.,National Hospital for Neurology and Neurosurgery, London, UK.,Neurogenetics Laboratory, UCL Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Liana Santos
- Neurogenetics Laboratory, UCL Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Hallgeir Jonvik
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.,National Hospital for Neurology and Neurosurgery, London, UK
| | - Stanislav Groppa
- Department of Neurology and Neurosurgery, Institute of Emergency Medicine, Chisinau, Republic of Moldova
| | - Nicholas W Wood
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.,National Hospital for Neurology and Neurosurgery, London, UK
| | - Henry Houlden
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.,National Hospital for Neurology and Neurosurgery, London, UK.,Neurogenetics Laboratory, UCL Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London, UK
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22
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Hwang YT, Lakshmanan R, Davagnanam I, Thompson AGB, Lynch DS, Houlden H, Bajaj N, Eriksson SH, Bamiou DE, Warren JD. Brainstem phenotype of cathepsin A-related arteriopathy with strokes and leukoencephalopathy. Neurol Genet 2017; 3:e165. [PMID: 28702507 PMCID: PMC5499977 DOI: 10.1212/nxg.0000000000000165] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 05/12/2017] [Indexed: 11/15/2022]
Affiliation(s)
- Yun Tae Hwang
- Dementia Research Centre (Y.T.H., J.D.W.), Department of Neurodegenerative Disease (A.G.B.T.), Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, and UCL Ear Institute (D.-E.B.), University College London; Lysholm Department of Neuroradiology (R.L., I.D.) and Department of Clinical and Experimental Epilepsy (S.H.E.), National Hospital for Neurology and Neurosurgery, London; and Department of Neurology (N.B.), Queen's Medical Centre, Nottingham, United Kingdom
| | - Rahul Lakshmanan
- Dementia Research Centre (Y.T.H., J.D.W.), Department of Neurodegenerative Disease (A.G.B.T.), Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, and UCL Ear Institute (D.-E.B.), University College London; Lysholm Department of Neuroradiology (R.L., I.D.) and Department of Clinical and Experimental Epilepsy (S.H.E.), National Hospital for Neurology and Neurosurgery, London; and Department of Neurology (N.B.), Queen's Medical Centre, Nottingham, United Kingdom
| | - Indran Davagnanam
- Dementia Research Centre (Y.T.H., J.D.W.), Department of Neurodegenerative Disease (A.G.B.T.), Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, and UCL Ear Institute (D.-E.B.), University College London; Lysholm Department of Neuroradiology (R.L., I.D.) and Department of Clinical and Experimental Epilepsy (S.H.E.), National Hospital for Neurology and Neurosurgery, London; and Department of Neurology (N.B.), Queen's Medical Centre, Nottingham, United Kingdom
| | - Andrew G B Thompson
- Dementia Research Centre (Y.T.H., J.D.W.), Department of Neurodegenerative Disease (A.G.B.T.), Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, and UCL Ear Institute (D.-E.B.), University College London; Lysholm Department of Neuroradiology (R.L., I.D.) and Department of Clinical and Experimental Epilepsy (S.H.E.), National Hospital for Neurology and Neurosurgery, London; and Department of Neurology (N.B.), Queen's Medical Centre, Nottingham, United Kingdom
| | - David S Lynch
- Dementia Research Centre (Y.T.H., J.D.W.), Department of Neurodegenerative Disease (A.G.B.T.), Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, and UCL Ear Institute (D.-E.B.), University College London; Lysholm Department of Neuroradiology (R.L., I.D.) and Department of Clinical and Experimental Epilepsy (S.H.E.), National Hospital for Neurology and Neurosurgery, London; and Department of Neurology (N.B.), Queen's Medical Centre, Nottingham, United Kingdom
| | - Henry Houlden
- Dementia Research Centre (Y.T.H., J.D.W.), Department of Neurodegenerative Disease (A.G.B.T.), Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, and UCL Ear Institute (D.-E.B.), University College London; Lysholm Department of Neuroradiology (R.L., I.D.) and Department of Clinical and Experimental Epilepsy (S.H.E.), National Hospital for Neurology and Neurosurgery, London; and Department of Neurology (N.B.), Queen's Medical Centre, Nottingham, United Kingdom
| | - Nin Bajaj
- Dementia Research Centre (Y.T.H., J.D.W.), Department of Neurodegenerative Disease (A.G.B.T.), Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, and UCL Ear Institute (D.-E.B.), University College London; Lysholm Department of Neuroradiology (R.L., I.D.) and Department of Clinical and Experimental Epilepsy (S.H.E.), National Hospital for Neurology and Neurosurgery, London; and Department of Neurology (N.B.), Queen's Medical Centre, Nottingham, United Kingdom
| | - Sofia H Eriksson
- Dementia Research Centre (Y.T.H., J.D.W.), Department of Neurodegenerative Disease (A.G.B.T.), Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, and UCL Ear Institute (D.-E.B.), University College London; Lysholm Department of Neuroradiology (R.L., I.D.) and Department of Clinical and Experimental Epilepsy (S.H.E.), National Hospital for Neurology and Neurosurgery, London; and Department of Neurology (N.B.), Queen's Medical Centre, Nottingham, United Kingdom
| | - Doris-Eva Bamiou
- Dementia Research Centre (Y.T.H., J.D.W.), Department of Neurodegenerative Disease (A.G.B.T.), Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, and UCL Ear Institute (D.-E.B.), University College London; Lysholm Department of Neuroradiology (R.L., I.D.) and Department of Clinical and Experimental Epilepsy (S.H.E.), National Hospital for Neurology and Neurosurgery, London; and Department of Neurology (N.B.), Queen's Medical Centre, Nottingham, United Kingdom
| | - Jason D Warren
- Dementia Research Centre (Y.T.H., J.D.W.), Department of Neurodegenerative Disease (A.G.B.T.), Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology, and UCL Ear Institute (D.-E.B.), University College London; Lysholm Department of Neuroradiology (R.L., I.D.) and Department of Clinical and Experimental Epilepsy (S.H.E.), National Hospital for Neurology and Neurosurgery, London; and Department of Neurology (N.B.), Queen's Medical Centre, Nottingham, United Kingdom
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23
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Bugiardini E, Rossor AM, Lynch DS, Swash M, Pittman AM, Blake JC, Hanna MG, Houlden H, Holton JL, Reilly MM, Matthews E. Homozygous mutation in HSPB1 causing distal vacuolar myopathy and motor neuropathy. Neurol Genet 2017; 3:e168. [PMID: 28702508 PMCID: PMC5499975 DOI: 10.1212/nxg.0000000000000168] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 04/24/2017] [Indexed: 11/15/2022]
Affiliation(s)
- Enrico Bugiardini
- MRC Centre for Neuromuscular Diseases (E.B., A.M.R., J.C.B., M.G.H., J.L.H., M.M.R., E.M.), UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., A.M.P., M.G.H., H.H., J.L.H.), and Division of Neuropathology (J.L.H.), UCL Institute of Neurology, London; Department of Neurology (M.S.), The Royal London Hospital; and Department of Clinical Neurophysiology (J.C.B.), Norfolk and Norwich University Hospital, UK
| | - Alexander M Rossor
- MRC Centre for Neuromuscular Diseases (E.B., A.M.R., J.C.B., M.G.H., J.L.H., M.M.R., E.M.), UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., A.M.P., M.G.H., H.H., J.L.H.), and Division of Neuropathology (J.L.H.), UCL Institute of Neurology, London; Department of Neurology (M.S.), The Royal London Hospital; and Department of Clinical Neurophysiology (J.C.B.), Norfolk and Norwich University Hospital, UK
| | - David S Lynch
- MRC Centre for Neuromuscular Diseases (E.B., A.M.R., J.C.B., M.G.H., J.L.H., M.M.R., E.M.), UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., A.M.P., M.G.H., H.H., J.L.H.), and Division of Neuropathology (J.L.H.), UCL Institute of Neurology, London; Department of Neurology (M.S.), The Royal London Hospital; and Department of Clinical Neurophysiology (J.C.B.), Norfolk and Norwich University Hospital, UK
| | - Michael Swash
- MRC Centre for Neuromuscular Diseases (E.B., A.M.R., J.C.B., M.G.H., J.L.H., M.M.R., E.M.), UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., A.M.P., M.G.H., H.H., J.L.H.), and Division of Neuropathology (J.L.H.), UCL Institute of Neurology, London; Department of Neurology (M.S.), The Royal London Hospital; and Department of Clinical Neurophysiology (J.C.B.), Norfolk and Norwich University Hospital, UK
| | - Alan M Pittman
- MRC Centre for Neuromuscular Diseases (E.B., A.M.R., J.C.B., M.G.H., J.L.H., M.M.R., E.M.), UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., A.M.P., M.G.H., H.H., J.L.H.), and Division of Neuropathology (J.L.H.), UCL Institute of Neurology, London; Department of Neurology (M.S.), The Royal London Hospital; and Department of Clinical Neurophysiology (J.C.B.), Norfolk and Norwich University Hospital, UK
| | - Julian C Blake
- MRC Centre for Neuromuscular Diseases (E.B., A.M.R., J.C.B., M.G.H., J.L.H., M.M.R., E.M.), UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., A.M.P., M.G.H., H.H., J.L.H.), and Division of Neuropathology (J.L.H.), UCL Institute of Neurology, London; Department of Neurology (M.S.), The Royal London Hospital; and Department of Clinical Neurophysiology (J.C.B.), Norfolk and Norwich University Hospital, UK
| | - Michael G Hanna
- MRC Centre for Neuromuscular Diseases (E.B., A.M.R., J.C.B., M.G.H., J.L.H., M.M.R., E.M.), UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., A.M.P., M.G.H., H.H., J.L.H.), and Division of Neuropathology (J.L.H.), UCL Institute of Neurology, London; Department of Neurology (M.S.), The Royal London Hospital; and Department of Clinical Neurophysiology (J.C.B.), Norfolk and Norwich University Hospital, UK
| | - Henry Houlden
- MRC Centre for Neuromuscular Diseases (E.B., A.M.R., J.C.B., M.G.H., J.L.H., M.M.R., E.M.), UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., A.M.P., M.G.H., H.H., J.L.H.), and Division of Neuropathology (J.L.H.), UCL Institute of Neurology, London; Department of Neurology (M.S.), The Royal London Hospital; and Department of Clinical Neurophysiology (J.C.B.), Norfolk and Norwich University Hospital, UK
| | - Janice L Holton
- MRC Centre for Neuromuscular Diseases (E.B., A.M.R., J.C.B., M.G.H., J.L.H., M.M.R., E.M.), UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., A.M.P., M.G.H., H.H., J.L.H.), and Division of Neuropathology (J.L.H.), UCL Institute of Neurology, London; Department of Neurology (M.S.), The Royal London Hospital; and Department of Clinical Neurophysiology (J.C.B.), Norfolk and Norwich University Hospital, UK
| | - Mary M Reilly
- MRC Centre for Neuromuscular Diseases (E.B., A.M.R., J.C.B., M.G.H., J.L.H., M.M.R., E.M.), UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., A.M.P., M.G.H., H.H., J.L.H.), and Division of Neuropathology (J.L.H.), UCL Institute of Neurology, London; Department of Neurology (M.S.), The Royal London Hospital; and Department of Clinical Neurophysiology (J.C.B.), Norfolk and Norwich University Hospital, UK
| | - Emma Matthews
- MRC Centre for Neuromuscular Diseases (E.B., A.M.R., J.C.B., M.G.H., J.L.H., M.M.R., E.M.), UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., A.M.P., M.G.H., H.H., J.L.H.), and Division of Neuropathology (J.L.H.), UCL Institute of Neurology, London; Department of Neurology (M.S.), The Royal London Hospital; and Department of Clinical Neurophysiology (J.C.B.), Norfolk and Norwich University Hospital, UK
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Chelban V, Patel N, Vandrovcova J, Zanetti MN, Lynch DS, Ryten M, Botía JA, Bello O, Tribollet E, Efthymiou S, Davagnanam I, Bashiri FA, Wood NW, Rothman JE, Alkuraya FS, Houlden H, Houlden H. Mutations in NKX6-2 Cause Progressive Spastic Ataxia and Hypomyelination. Am J Hum Genet 2017; 100:969-977. [PMID: 28575651 PMCID: PMC5473715 DOI: 10.1016/j.ajhg.2017.05.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 05/08/2017] [Indexed: 11/29/2022] Open
Abstract
Progressive limb spasticity and cerebellar ataxia are frequently found together in clinical practice and form a heterogeneous group of degenerative disorders that are classified either as pure spastic ataxia or as complex spastic ataxia with additional neurological signs. Inheritance is either autosomal dominant or autosomal recessive. Hypomyelinating features on MRI are sometimes seen with spastic ataxia, but this is usually mild in adults and severe and life limiting in children. We report seven individuals with an early-onset spastic-ataxia phenotype. The individuals come from three families of different ethnic backgrounds. Affected members of two families had childhood onset disease with very slow progression. They are still alive in their 30s and 40s and show predominant ataxia and cerebellar atrophy features on imaging. Affected members of the third family had a similar but earlier-onset presentation associated with brain hypomyelination. Using a combination of homozygozity mapping and exome sequencing, we mapped this phenotype to deleterious nonsense or homeobox domain missense mutations in NKX6-2. NKX6-2 encodes a transcriptional repressor with early high general and late focused CNS expression. Deficiency of its mouse ortholog results in widespread hypomyelination in the brain and optic nerve, as well as in poor motor coordination in a pattern consistent with the observed human phenotype. In-silico analysis of human brain expression and network data provides evidence that NKX6-2 is involved in oligodendrocyte maturation and might act within the same pathways of genes already associated with central hypomyelination. Our results support a non-redundant developmental role of NKX6-2 in humans and imply that NKX6-2 mutations should be considered in the differential diagnosis of spastic ataxia and hypomyelination.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Henry Houlden
- Department of Molecular Neuroscience, University College London, London WC1N 3BG, UK; Neurogenetics Laboratory, The National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK
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25
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Lynch DS, Zhang WJ, Lakshmanan R, Kinsella JA, Uzun GA, Karbay M, Tüfekçioglu Z, Hanagasi H, Burke G, Foulds N, Hammans SR, Bhattacharjee A, Wilson H, Adams M, Walker M, Nicoll JAR, Chataway J, Fox N, Davagnanam I, Phadke R, Houlden H. Analysis of Mutations in AARS2 in a Series of CSF1R-Negative Patients With Adult-Onset Leukoencephalopathy With Axonal Spheroids and Pigmented Glia. JAMA Neurol 2017; 73:1433-1439. [PMID: 27749956 DOI: 10.1001/jamaneurol.2016.2229] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) is a frequent cause of adult-onset leukodystrophy known to be caused by autosomal dominant mutations in the CSF1R (colony-stimulating factor 1) gene. The discovery that CSF1R mutations cause ALSP led to more accurate prognosis and genetic counseling for these patients in addition to increased interest in microglia as a target in neurodegeneration. However, it has been known since the discovery of the CSF1R gene that there are patients with typical clinical and radiologic evidence of ALSP who do not carry pathogenic CSF1R mutations. These patients include those in whom the pathognomonic features of axonal spheroids and pigmented microglia have been found. Achieving a genetic diagnosis in these patients is important to our understanding of this disorder. Objective To genetically characterize a group of patients with typical features of ALSP who do not carry CSF1R mutations. Design, Settings, and Participants In this case series study, 5 patients from 4 families were identified with clinical, radiologic, or pathologic features of ALSP in whom CSF1R mutations had been excluded previously by sequencing. Data were collected between May 2014 and September 2015 and analyzed between September 2015 and February 2016. Main Outcomes and Measures Focused exome sequencing was used to identify candidate variants. Family studies, long-range polymerase chain reaction with cloning, and complementary DNA sequencing were used to confirm pathogenicity. Results Of these 5 patients, 4 were men (80%); mean age at onset of ALSP was 29 years (range, 15-44 years). Biallelic mutations in the alanyl-transfer (t)RNA synthetase 2 (AARS2) gene were found in all 5 patients. Frameshifting and splice site mutations were common, found in 4 of 5 patients, and sequencing of complementary DNA from affected patients confirmed that the variants were loss of function. All patients presented in adulthood with prominent cognitive, neuropsychiatric, and upper motor neuron signs. Magnetic resonance imaging in all patients demonstrated a symmetric leukoencephalopathy with punctate regions of restricted diffusion, typical of ALSP. In 1 patient, brain biopsy demonstrated axonal spheroids and pigmented microglia, which are the pathognomonic signs of ALSP. Conclusions and Relevance This work indicates that mutations in the tRNA synthetase AARS2 gene cause a recessive form of ALSP. The CSF1R and AARS2 proteins have different cellular functions but overlap in a final common pathway of neurodegeneration. This work points to novel targets for research and will lead to improved diagnostic rates in patients with adult-onset leukoencephalopathy.
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Affiliation(s)
- David S Lynch
- Department of Molecular Neuroscience, University College London Institute of Neurology, London, England2The Leonard Wolfson Experimental Neurology Centre, University College London Institute of Neurology, London, England
| | - Wei Jia Zhang
- Department of Molecular Neuroscience, University College London Institute of Neurology, London, England3Department of Neurology, Royal Free Hospital, London, England
| | - Rahul Lakshmanan
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, London, England
| | - Justin A Kinsella
- Dementia Research Centre, Department of Neurodegeneration, The National Hospital for Neurology and Neurosurgery, University College London Institute of Neurology, London, England6University College Dublin, Department of Neurology, St Vincent's University Hospital, Dublin, Ireland
| | - Günes Altiokka Uzun
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Merih Karbay
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Zeynep Tüfekçioglu
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Hasmet Hanagasi
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Georgina Burke
- Department of Neurology, Queen Alexandra Hospital, Portsmouth, England9Wessex Neurological Centre, University Hospital Southampton, Southampton, England
| | - Nicola Foulds
- Wessex Clinical Genetics Services, Princess Anne Hospital, Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, England
| | - Simon R Hammans
- Department of Neurology, Queen Alexandra Hospital, Portsmouth, England
| | | | - Heather Wilson
- Department of Neurology, Royal Free Hospital, London, England
| | - Matthew Adams
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, London, England
| | - Mark Walker
- Clinical Neurosciences, Clinical & Experimental Sciences, University of Southampton, Department of Cellular Pathology, Southampton General Hospital, Southampton, England
| | - James A R Nicoll
- Clinical Neurosciences, Clinical & Experimental Sciences, University of Southampton, Department of Cellular Pathology, Southampton General Hospital, Southampton, England
| | - Jeremy Chataway
- Department of Neuroinflammation, University College London Institute of Neurology, London, England
| | - Nick Fox
- Dementia Research Centre, Department of Neurodegeneration, The National Hospital for Neurology and Neurosurgery, University College London Institute of Neurology, London, England
| | - Indran Davagnanam
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, London, England
| | - Rahul Phadke
- Division of Neuropathology and Department of Neurodegenerative Disease, The National Hospital for Neurology and Neurosurgery, University College London Institute of Neurology, London, England
| | - Henry Houlden
- Department of Molecular Neuroscience, University College London Institute of Neurology, London, England14Neurogenetics Laboratory, The National Hospital for Neurology and Neurosurgery, London, England
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26
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Lynch DS, Houlden H. Letter re: Mystery Case: CSF-1R mutation is a cause of intracranial cerebral calcifications, cysts, and leukoencephalopathy. Neurology 2017; 88:1978. [DOI: 10.1212/wnl.0000000000003948] [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: 11/15/2022] Open
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27
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Lynch DS, Rodrigues Brandão de Paiva A, Zhang WJ, Bugiardini E, Freua F, Tavares Lucato L, Macedo-Souza LI, Lakshmanan R, Kinsella JA, Merwick A, Rossor AM, Bajaj N, Herron B, McMonagle P, Morrison PJ, Hughes D, Pittman A, Laurà M, Reilly MM, Warren JD, Mummery CJ, Schott JM, Adams M, Fox NC, Murphy E, Davagnanam I, Kok F, Chataway J, Houlden H. Clinical and genetic characterization of leukoencephalopathies in adults. Brain 2017; 140:1204-1211. [PMID: 28334938 PMCID: PMC5405235 DOI: 10.1093/brain/awx045] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 01/05/2017] [Accepted: 01/16/2017] [Indexed: 11/12/2022] Open
Abstract
Leukodystrophies and genetic leukoencephalopathies are a rare group of disorders leading to progressive degeneration of cerebral white matter. They are associated with a spectrum of clinical phenotypes dominated by dementia, psychiatric changes, movement disorders and upper motor neuron signs. Mutations in at least 60 genes can lead to leukoencephalopathy with often overlapping clinical and radiological presentations. For these reasons, patients with genetic leukoencephalopathies often endure a long diagnostic odyssey before receiving a definitive diagnosis or may receive no diagnosis at all. In this study, we used focused and whole exome sequencing to evaluate a cohort of undiagnosed adult patients referred to a specialist leukoencephalopathy service. In total, 100 patients were evaluated using focused exome sequencing of 6100 genes. We detected pathogenic or likely pathogenic variants in 26 cases. The most frequently mutated genes were NOTCH3, EIF2B5, AARS2 and CSF1R. We then carried out whole exome sequencing on the remaining negative cases including four family trios, but could not identify any further potentially disease-causing mutations, confirming the equivalence of focused and whole exome sequencing in the diagnosis of genetic leukoencephalopathies. Here we provide an overview of the clinical and genetic features of these disorders in adults.
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Affiliation(s)
- David S. Lynch
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
- 2 Leonard Wolfson Experimental Neurology Centre, UCL Institute of Neurology, London, UK
| | | | - Wei Jia Zhang
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Enrico Bugiardini
- 4 MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK
| | - Fernando Freua
- 3 Neurogenetics Unit, Neurology Department, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
| | - Leandro Tavares Lucato
- 5 Instituto de Radiologia, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
| | | | - Rahul Lakshmanan
- 7 Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Justin A. Kinsella
- 8 Neurology Department, St. Vincent’s University Hospital and University College Dublin, Ireland
| | - Aine Merwick
- 9 Charles Dent Metabolic Unit, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
- 10 Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Alexander M. Rossor
- 4 MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK
- 11 Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
| | - Nin Bajaj
- 12 Department of Neurology, Queens Medical Centre, Nottingham, UK
| | - Brian Herron
- 13 Department of Neuropathology, Royal Victoria Hospital, Belfast, Northern Ireland, UK
| | - Paul McMonagle
- 14 Department of Neurology, Royal Victoria Hospital, Belfast, Northern Ireland, UK
| | - Patrick J. Morrison
- 15 Centre for Cancer Research and Cell Biology, Queens University of Belfast, 97 Lisburn Road, Belfast BT9 7AE, UK
| | - Deborah Hughes
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Alan Pittman
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Matilde Laurà
- 4 MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK
| | - Mary M Reilly
- 4 MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK
| | - Jason D Warren
- 16 Dementia Research Centre, UCL Institute of Neurology, London, UK
| | | | | | - Matthew Adams
- 7 Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Nick C. Fox
- 16 Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Elaine Murphy
- 9 Charles Dent Metabolic Unit, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Indran Davagnanam
- 7 Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Fernando Kok
- 3 Neurogenetics Unit, Neurology Department, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
| | - Jeremy Chataway
- 17 Department of Neuroinflammation, UCL Institute of Neurology, London, UK
| | - Henry Houlden
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
- 18 Neurogenetics Laboratory, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
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28
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Lakshmanan R, Adams ME, Lynch DS, Kinsella JA, Phadke R, Schott JM, Murphy E, Rohrer JD, Chataway J, Houlden H, Fox NC, Davagnanam I. Redefining the phenotype of ALSP and AARS2 mutation-related leukodystrophy. Neurol Genet 2017; 3:e135. [PMID: 28243630 PMCID: PMC5312114 DOI: 10.1212/nxg.0000000000000135] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 01/04/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To provide an overview of the phenotype of 2 clinically, radiologically, and pathologically similar leukodystrophies, adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) and alanyl-transfer RNA synthetase 2 mutation-related leukodystrophy (AARS2-L), and highlight key differentiating features. METHODS ALSP and AARS2-L cases were identified from the adult-onset leukodystrophy database at our institution. In addition, cases with imaging findings were identified from a literature review. The phenotypic features were determined by combining published cases with those from our database. RESULTS A combined total of 74 cases of ALSP and 10 cases of AARS2-L with neuroimaging data were identified. The mean age at onset was 42 years in ALSP and 26 years in AARS2-L. Cognitive and motor symptoms were the most common symptoms overall in both. Ovarian failure was exclusive to AARS2-L, present in all known female cases. Both ALSP and AARS2-L showed a confluent, asymmetric, predominantly frontoparietal, periventricular pattern of white matter disease with subcortical U-fiber sparing; pyramidal tract and corpus callosum involvement; and diffusion changes in the white matter which we have termed "deep white matter diffusion dots." Central atrophy and corpus callosal thinning were prominent in ALSP and disproportionately mild in AARS2-L when present. ALSP also occasionally showed ventricular abnormalities and calcifications in the frontal periventricular white matter, features not seen in AARS2-L. AARS2-L demonstrates white matter rarefaction which suppresses on fluid-attenuated inversion recovery MRI sequences, a feature not seen in ALSP. CONCLUSIONS ALSP and AARS2-L share similar clinical, imaging, and pathologic characteristics with key differentiating features that we have highlighted.
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Affiliation(s)
- Rahul Lakshmanan
- Lysholm Department of Neuroradiology (R.L., M.E.A., I.D.), the National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology; the Leonard Wolfson Experimental Neurology Centre (D.S.L., J.A.K.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology; Dementia Research Centre (J.A.K., J.M.S., J.D.R., N.C.F.), Department of Neurodegeneration, UCL Institute of Neurology, UK; Department of Neurology (J.A.K.), St Vincent's University Hospital, University College Dublin, Ireland; Division of Neuropathology and Department of Neurodegenerative Disease (R.P.), Charles Dent Metabolic Unit (E.M.), Department of Neuroinflammation (J.C.), Neurogenetics Laboratory (H.H.), and Department of Brain Repair and Rehabilitation (I.D.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, UK
| | - Matthew E Adams
- Lysholm Department of Neuroradiology (R.L., M.E.A., I.D.), the National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology; the Leonard Wolfson Experimental Neurology Centre (D.S.L., J.A.K.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology; Dementia Research Centre (J.A.K., J.M.S., J.D.R., N.C.F.), Department of Neurodegeneration, UCL Institute of Neurology, UK; Department of Neurology (J.A.K.), St Vincent's University Hospital, University College Dublin, Ireland; Division of Neuropathology and Department of Neurodegenerative Disease (R.P.), Charles Dent Metabolic Unit (E.M.), Department of Neuroinflammation (J.C.), Neurogenetics Laboratory (H.H.), and Department of Brain Repair and Rehabilitation (I.D.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, UK
| | - David S Lynch
- Lysholm Department of Neuroradiology (R.L., M.E.A., I.D.), the National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology; the Leonard Wolfson Experimental Neurology Centre (D.S.L., J.A.K.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology; Dementia Research Centre (J.A.K., J.M.S., J.D.R., N.C.F.), Department of Neurodegeneration, UCL Institute of Neurology, UK; Department of Neurology (J.A.K.), St Vincent's University Hospital, University College Dublin, Ireland; Division of Neuropathology and Department of Neurodegenerative Disease (R.P.), Charles Dent Metabolic Unit (E.M.), Department of Neuroinflammation (J.C.), Neurogenetics Laboratory (H.H.), and Department of Brain Repair and Rehabilitation (I.D.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, UK
| | - Justin A Kinsella
- Lysholm Department of Neuroradiology (R.L., M.E.A., I.D.), the National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology; the Leonard Wolfson Experimental Neurology Centre (D.S.L., J.A.K.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology; Dementia Research Centre (J.A.K., J.M.S., J.D.R., N.C.F.), Department of Neurodegeneration, UCL Institute of Neurology, UK; Department of Neurology (J.A.K.), St Vincent's University Hospital, University College Dublin, Ireland; Division of Neuropathology and Department of Neurodegenerative Disease (R.P.), Charles Dent Metabolic Unit (E.M.), Department of Neuroinflammation (J.C.), Neurogenetics Laboratory (H.H.), and Department of Brain Repair and Rehabilitation (I.D.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, UK
| | - Rahul Phadke
- Lysholm Department of Neuroradiology (R.L., M.E.A., I.D.), the National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology; the Leonard Wolfson Experimental Neurology Centre (D.S.L., J.A.K.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology; Dementia Research Centre (J.A.K., J.M.S., J.D.R., N.C.F.), Department of Neurodegeneration, UCL Institute of Neurology, UK; Department of Neurology (J.A.K.), St Vincent's University Hospital, University College Dublin, Ireland; Division of Neuropathology and Department of Neurodegenerative Disease (R.P.), Charles Dent Metabolic Unit (E.M.), Department of Neuroinflammation (J.C.), Neurogenetics Laboratory (H.H.), and Department of Brain Repair and Rehabilitation (I.D.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, UK
| | - Jonathan M Schott
- Lysholm Department of Neuroradiology (R.L., M.E.A., I.D.), the National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology; the Leonard Wolfson Experimental Neurology Centre (D.S.L., J.A.K.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology; Dementia Research Centre (J.A.K., J.M.S., J.D.R., N.C.F.), Department of Neurodegeneration, UCL Institute of Neurology, UK; Department of Neurology (J.A.K.), St Vincent's University Hospital, University College Dublin, Ireland; Division of Neuropathology and Department of Neurodegenerative Disease (R.P.), Charles Dent Metabolic Unit (E.M.), Department of Neuroinflammation (J.C.), Neurogenetics Laboratory (H.H.), and Department of Brain Repair and Rehabilitation (I.D.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, UK
| | - Elaine Murphy
- Lysholm Department of Neuroradiology (R.L., M.E.A., I.D.), the National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology; the Leonard Wolfson Experimental Neurology Centre (D.S.L., J.A.K.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology; Dementia Research Centre (J.A.K., J.M.S., J.D.R., N.C.F.), Department of Neurodegeneration, UCL Institute of Neurology, UK; Department of Neurology (J.A.K.), St Vincent's University Hospital, University College Dublin, Ireland; Division of Neuropathology and Department of Neurodegenerative Disease (R.P.), Charles Dent Metabolic Unit (E.M.), Department of Neuroinflammation (J.C.), Neurogenetics Laboratory (H.H.), and Department of Brain Repair and Rehabilitation (I.D.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, UK
| | - Jonathan D Rohrer
- Lysholm Department of Neuroradiology (R.L., M.E.A., I.D.), the National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology; the Leonard Wolfson Experimental Neurology Centre (D.S.L., J.A.K.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology; Dementia Research Centre (J.A.K., J.M.S., J.D.R., N.C.F.), Department of Neurodegeneration, UCL Institute of Neurology, UK; Department of Neurology (J.A.K.), St Vincent's University Hospital, University College Dublin, Ireland; Division of Neuropathology and Department of Neurodegenerative Disease (R.P.), Charles Dent Metabolic Unit (E.M.), Department of Neuroinflammation (J.C.), Neurogenetics Laboratory (H.H.), and Department of Brain Repair and Rehabilitation (I.D.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, UK
| | - Jeremy Chataway
- Lysholm Department of Neuroradiology (R.L., M.E.A., I.D.), the National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology; the Leonard Wolfson Experimental Neurology Centre (D.S.L., J.A.K.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology; Dementia Research Centre (J.A.K., J.M.S., J.D.R., N.C.F.), Department of Neurodegeneration, UCL Institute of Neurology, UK; Department of Neurology (J.A.K.), St Vincent's University Hospital, University College Dublin, Ireland; Division of Neuropathology and Department of Neurodegenerative Disease (R.P.), Charles Dent Metabolic Unit (E.M.), Department of Neuroinflammation (J.C.), Neurogenetics Laboratory (H.H.), and Department of Brain Repair and Rehabilitation (I.D.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, UK
| | - Henry Houlden
- Lysholm Department of Neuroradiology (R.L., M.E.A., I.D.), the National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology; the Leonard Wolfson Experimental Neurology Centre (D.S.L., J.A.K.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology; Dementia Research Centre (J.A.K., J.M.S., J.D.R., N.C.F.), Department of Neurodegeneration, UCL Institute of Neurology, UK; Department of Neurology (J.A.K.), St Vincent's University Hospital, University College Dublin, Ireland; Division of Neuropathology and Department of Neurodegenerative Disease (R.P.), Charles Dent Metabolic Unit (E.M.), Department of Neuroinflammation (J.C.), Neurogenetics Laboratory (H.H.), and Department of Brain Repair and Rehabilitation (I.D.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, UK
| | - Nick C Fox
- Lysholm Department of Neuroradiology (R.L., M.E.A., I.D.), the National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology; the Leonard Wolfson Experimental Neurology Centre (D.S.L., J.A.K.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology; Dementia Research Centre (J.A.K., J.M.S., J.D.R., N.C.F.), Department of Neurodegeneration, UCL Institute of Neurology, UK; Department of Neurology (J.A.K.), St Vincent's University Hospital, University College Dublin, Ireland; Division of Neuropathology and Department of Neurodegenerative Disease (R.P.), Charles Dent Metabolic Unit (E.M.), Department of Neuroinflammation (J.C.), Neurogenetics Laboratory (H.H.), and Department of Brain Repair and Rehabilitation (I.D.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, UK
| | - Indran Davagnanam
- Lysholm Department of Neuroradiology (R.L., M.E.A., I.D.), the National Hospital for Neurology and Neurosurgery; Department of Molecular Neuroscience (D.S.L., H.H.), UCL Institute of Neurology; the Leonard Wolfson Experimental Neurology Centre (D.S.L., J.A.K.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology; Dementia Research Centre (J.A.K., J.M.S., J.D.R., N.C.F.), Department of Neurodegeneration, UCL Institute of Neurology, UK; Department of Neurology (J.A.K.), St Vincent's University Hospital, University College Dublin, Ireland; Division of Neuropathology and Department of Neurodegenerative Disease (R.P.), Charles Dent Metabolic Unit (E.M.), Department of Neuroinflammation (J.C.), Neurogenetics Laboratory (H.H.), and Department of Brain Repair and Rehabilitation (I.D.), the National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, UK
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29
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Scalco RS, Lorenzoni PJ, Lynch DS, Martins WA, Jungbluth H, Quinlivan R, Becker J, Houlden H. Polymyositis without Beneficial Response to Steroid Therapy: Should Miyoshi Myopathy be a Differential Diagnosis? Am J Case Rep 2017; 18:17-21. [PMID: 28053302 PMCID: PMC5228759 DOI: 10.12659/ajcr.900970] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Patient: Male, 16 Final Diagnosis: Miyoshi myopathy Symptoms: HyperCKemia • myalgia • weakness Medication: — Clinical Procedure: — Specialty: Neurology
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Affiliation(s)
- Renata Siciliani Scalco
- MRC Centre for Neuromuscular Diseases and Division of Molecular Neuroscience, University College London (UCL) Institute of Neurology, London, United Kingdom.,Department of Neurology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Capes Foundation, Ministry of Education, Brasilia, Brazil
| | - Paulo José Lorenzoni
- Service of Neuromuscular Disorders, Division of Neurology, Department of Internal Medicine, Universidade Federal do Paraná (UFPR), Curitiba, Brazil
| | - David S Lynch
- MRC Centre for Neuromuscular Diseases and Division of Molecular Neuroscience, University College London (UCL) Institute of Neurology, London, United Kingdom
| | - William Alves Martins
- Department of Neurology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Heinz Jungbluth
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London (KCL), London, United Kingdom.,Department of Paediatric Neurology, Evelina Children's Hospital, Guy's and St Thomas NHS Foundation Trust, London, United Kingdom.,Randall Division for Cell and Molecular Biophysics, Muscle Signalling Section, King's College London, London, United Kingdom
| | - Ros Quinlivan
- MRC Centre for Neuromuscular Diseases and Division of Molecular Neuroscience, University College London (UCL) Institute of Neurology, London, United Kingdom
| | - Jefferson Becker
- Department of Neurology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Henry Houlden
- MRC Centre for Neuromuscular Diseases and Division of Molecular Neuroscience, University College London (UCL) Institute of Neurology, London, United Kingdom
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30
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Lynch DS, Wood NW, Houlden H. Late-onset Lafora disease with prominent parkinsonism due to a rare mutation in EPM2A. Neurol Genet 2016; 2:e101. [PMID: 27574708 PMCID: PMC4988466 DOI: 10.1212/nxg.0000000000000101] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 07/25/2016] [Indexed: 11/20/2022]
Affiliation(s)
- David S Lynch
- Department of Molecular Neuroscience (D.S.L., N.W.W., H.H.), UCL Institute of Neurology; and Neurogenetics Laboratory (H.H.), National Hospital for Neurology & Neurosurgery, Queen Square, London
| | - Nicholas W Wood
- Department of Molecular Neuroscience (D.S.L., N.W.W., H.H.), UCL Institute of Neurology; and Neurogenetics Laboratory (H.H.), National Hospital for Neurology & Neurosurgery, Queen Square, London
| | - Henry Houlden
- Department of Molecular Neuroscience (D.S.L., N.W.W., H.H.), UCL Institute of Neurology; and Neurogenetics Laboratory (H.H.), National Hospital for Neurology & Neurosurgery, Queen Square, London
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31
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Kara E, Tucci A, Manzoni C, Lynch DS, Elpidorou M, Bettencourt C, Chelban V, Manole A, Hamed SA, Haridy NA, Federoff M, Preza E, Hughes D, Pittman A, Jaunmuktane Z, Brandner S, Xiromerisiou G, Wiethoff S, Schottlaender L, Proukakis C, Morris H, Warner T, Bhatia KP, Korlipara LVP, Singleton AB, Hardy J, Wood NW, Lewis PA, Houlden H. Genetic and phenotypic characterization of complex hereditary spastic paraplegia. Brain 2016; 139:1904-18. [PMID: 27217339 PMCID: PMC4939695 DOI: 10.1093/brain/aww111] [Citation(s) in RCA: 152] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 03/30/2016] [Indexed: 12/12/2022] Open
Abstract
The hereditary spastic paraplegias are a heterogeneous group of degenerative disorders that are clinically classified as either pure with predominant lower limb spasticity, or complex where spastic paraplegia is complicated with additional neurological features, and are inherited in autosomal dominant, autosomal recessive or X-linked patterns. Genetic defects have been identified in over 40 different genes, with more than 70 loci in total. Complex recessive spastic paraplegias have in the past been frequently associated with mutations in
SPG11
(spatacsin),
ZFYVE26/SPG15
,
SPG7
(paraplegin) and a handful of other rare genes, but many cases remain genetically undefined. The overlap with other neurodegenerative disorders has been implied in a small number of reports, but not in larger disease series. This deficiency has been largely due to the lack of suitable high throughput techniques to investigate the genetic basis of disease, but the recent availability of next generation sequencing can facilitate the identification of disease-causing mutations even in extremely heterogeneous disorders. We investigated a series of 97 index cases with complex spastic paraplegia referred to a tertiary referral neurology centre in London for diagnosis or management. The mean age of onset was 16 years (range 3 to 39). The
SPG11
gene was first analysed, revealing homozygous or compound heterozygous mutations in 30/97 (30.9%) of probands, the largest
SPG11
series reported to date, and by far the most common cause of complex spastic paraplegia in the UK, with severe and progressive clinical features and other neurological manifestations, linked with magnetic resonance imaging defects. Given the high frequency of
SPG11
mutations, we studied the autophagic response to starvation in eight affected
SPG11
cases and control fibroblast cell lines, but in our restricted study we did not observe correlations between disease status and autophagic or lysosomal markers. In the remaining cases, next generation sequencing was carried out revealing variants in a number of other known complex spastic paraplegia genes, including five in
SPG7
(5/97), four in
FA2H
(also known as
SPG35
) (4/97) and two in
ZFYVE26
/
SPG15
. Variants were identified in genes usually associated with pure spastic paraplegia and also in the Parkinson’s disease-associated gene
ATP13A2
, neuronal ceroid lipofuscinosis gene
TPP1
and the hereditary motor and sensory neuropathy
DNMT1
gene, highlighting the genetic heterogeneity of spastic paraplegia. No plausible genetic cause was identified in 51% of probands, likely indicating the existence of as yet unidentified genes.
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Affiliation(s)
- Eleanna Kara
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK 2 Alzheimer's Disease Research Centre, Department of Neurology, Harvard Medical School and Massachusetts General Hospital, 114 16th Street, Charlestown, MA 02129, USA
| | - Arianna Tucci
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK 3 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy
| | - Claudia Manzoni
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK 4 School of Pharmacy, University of Reading, Reading RG6 6AP, UK
| | - David S Lynch
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Marilena Elpidorou
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Conceicao Bettencourt
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Viorica Chelban
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Andreea Manole
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Sherifa A Hamed
- 5 Department of Neurology and Psychiatry, Assiut University Hospital, Faculty of Medicine, Assiut, Egypt
| | - Nourelhoda A Haridy
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK 5 Department of Neurology and Psychiatry, Assiut University Hospital, Faculty of Medicine, Assiut, Egypt
| | - Monica Federoff
- 6 Laboratory of Neurogenetics, NIH/NIA, Bethesda, MD 20892, USA
| | - Elisavet Preza
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Deborah Hughes
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Alan Pittman
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Zane Jaunmuktane
- 7 Division of Neuropathology and Department of Neurodegenerative Disease, The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Sebastian Brandner
- 7 Division of Neuropathology and Department of Neurodegenerative Disease, The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Georgia Xiromerisiou
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK 8 Department of Neurology, Papageorgiou Hospital, Thessaloniki, Greece
| | - Sarah Wiethoff
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Lucia Schottlaender
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Christos Proukakis
- 9 Department of Clinical Neuroscience, Royal Free Campus, UCL Institute of Neurology, London, UK
| | - Huw Morris
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK 9 Department of Clinical Neuroscience, Royal Free Campus, UCL Institute of Neurology, London, UK
| | - Tom Warner
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK 10 Reta Lila Weston Institute of Neurological Studies and Queen Square Brain Bank for Neurological Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Kailash P Bhatia
- 11 Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - L V Prasad Korlipara
- 11 Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | | | - John Hardy
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Nicholas W Wood
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK 12 Neurogenetics Laboratory, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
| | - Patrick A Lewis
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK 4 School of Pharmacy, University of Reading, Reading RG6 6AP, UK
| | - Henry Houlden
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK 2 Alzheimer's Disease Research Centre, Department of Neurology, Harvard Medical School and Massachusetts General Hospital, 114 16th Street, Charlestown, MA 02129, USA
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32
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Lynch DS, Jaunmuktane Z, Sheerin UM, Phadke R, Brandner S, Milonas I, Dean A, Bajaj N, McNicholas N, Costello D, Cronin S, McGuigan C, Rossor M, Fox N, Murphy E, Chataway J, Houlden H. Hereditary leukoencephalopathy with axonal spheroids: a spectrum of phenotypes from CNS vasculitis to parkinsonism in an adult onset leukodystrophy series. J Neurol Neurosurg Psychiatry 2016; 87:512-9. [PMID: 25935893 PMCID: PMC4853550 DOI: 10.1136/jnnp-2015-310788] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 04/06/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND Hereditary diffuse leukoencephalopathy with neuroaxonal spheroids (HDLS) is a hereditary, adult onset leukodystrophy which is characterised by the presence of axonal loss, axonal spheroids and variably present pigmented macrophages on pathological examination. It most frequently presents in adulthood with dementia and personality change. HDLS has recently been found to be caused by mutations in the colony stimulating factor-1 receptor (CSF1R) gene. METHODS In this study, we sequenced the CSF1R gene in a cohort of 48 patients from the UK, Greece and Ireland with adult onset leukodystrophy of unknown cause. RESULTS Five pathogenic mutations were found, including three novel mutations. The presentations ranged from suspected central nervous system (CNS) vasculitis to extrapyramidal to cognitive phenotypes. The case histories and imaging are presented here, in addition to neuropathological findings from two cases with novel mutations. CONCLUSION We estimate that CSF1R mutations account for 10% of idiopathic adult onset leukodystrophies and that genetic testing for CSF1R mutations is essential in adult patients presenting with undefined CNS vasculitis or a leukodystrophy with prominent neuropsychiatric signs or dementia.
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Affiliation(s)
- David S Lynch
- Department of Molecular Neuroscience, The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, Queen Square, London, UK The Leonard Wolfson Experimental Neurology Centre, The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, London UK
| | - Zane Jaunmuktane
- Division of Neuropathology and Department of Neurodegenerative Disease, The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, Queen Square, London, UK
| | - Una-Marie Sheerin
- Department of Molecular Neuroscience, The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, Queen Square, London, UK
| | - Rahul Phadke
- Division of Neuropathology and Department of Neurodegenerative Disease, The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, Queen Square, London, UK
| | - Sebastian Brandner
- Division of Neuropathology and Department of Neurodegenerative Disease, The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, Queen Square, London, UK
| | - Ionnis Milonas
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andrew Dean
- Department of Neuropathology, Addenbrooke's Hospital, Cambridge, UK
| | - Nin Bajaj
- Department of Neurology, Queens Medical Centre, Nottingham, UK
| | - Nuala McNicholas
- Department of Neurology, Cork University Hospital, Wilton, Cork, Ireland
| | - Daniel Costello
- Department of Neurology, Cork University Hospital, Wilton, Cork, Ireland
| | - Simon Cronin
- Department of Neurology, Cork University Hospital, Wilton, Cork, Ireland
| | - Chris McGuigan
- University College Dublin, St. Vincent's University Hospital, Dublin, Ireland
| | - Martin Rossor
- Department of Neurodegeneration, Dementia Research Centre, London, UK
| | - Nick Fox
- Department of Neurodegeneration, Dementia Research Centre, London, UK
| | - Elaine Murphy
- Department of Neuroinflammation, The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, Queen Square, London, UK
| | - Jeremy Chataway
- Department of Neuroinflammation, The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, Queen Square, London, UK
| | - Henry Houlden
- Department of Molecular Neuroscience, The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, Queen Square, London, UK Neurogenetics Laboratory, The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, Queen Square, London, UK
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33
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Mencacci NE, Kamsteeg EJ, Nakashima K, R'Bibo L, Lynch DS, Balint B, Willemsen MAAP, Adams ME, Wiethoff S, Suzuki K, Davies CH, Ng J, Meyer E, Veneziano L, Giunti P, Hughes D, Raymond FL, Carecchio M, Zorzi G, Nardocci N, Barzaghi C, Garavaglia B, Salpietro V, Hardy J, Pittman AM, Houlden H, Kurian MA, Kimura H, Vissers LELM, Wood NW, Bhatia KP. De Novo Mutations in PDE10A Cause Childhood-Onset Chorea with Bilateral Striatal Lesions. Am J Hum Genet 2016; 98:763-71. [PMID: 27058447 PMCID: PMC4833291 DOI: 10.1016/j.ajhg.2016.02.015] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 02/17/2016] [Indexed: 12/11/2022] Open
Abstract
Chorea is a hyperkinetic movement disorder resulting from dysfunction of striatal medium spiny neurons (MSNs), which form the main output projections from the basal ganglia. Here, we used whole-exome sequencing to unravel the underlying genetic cause in three unrelated individuals with a very similar and unique clinical presentation of childhood-onset chorea and characteristic brain MRI showing symmetrical bilateral striatal lesions. All individuals were identified to carry a de novo heterozygous mutation in PDE10A (c.898T>C [p.Phe300Leu] in two individuals and c.1000T>C [p.Phe334Leu] in one individual), encoding a phosphodiesterase highly and selectively present in MSNs. PDE10A contributes to the regulation of the intracellular levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). Both substitutions affect highly conserved amino acids located in the regulatory GAF-B domain, which, by binding to cAMP, stimulates the activity of the PDE10A catalytic domain. In silico modeling showed that the altered residues are located deep in the binding pocket, where they are likely to alter cAMP binding properties. In vitro functional studies showed that neither substitution affects the basal PDE10A activity, but they severely disrupt the stimulatory effect mediated by cAMP binding to the GAF-B domain. The identification of PDE10A mutations as a cause of chorea further motivates the study of cAMP signaling in MSNs and highlights the crucial role of striatal cAMP signaling in the regulation of basal ganglia circuitry. Pharmacological modulation of this pathway could offer promising etiologically targeted treatments for chorea and other hyperkinetic movement disorders.
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Affiliation(s)
- Niccolò E Mencacci
- Department of Molecular Neuroscience, UCL Institute of Neurology, WC1N 3BG London, UK; Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Department of Pathophysiology and Transplantation, Centro Dino Ferrari, Università degli Studi di Milano, 20149 Milan, Italy
| | - Erik-Jan Kamsteeg
- Department of Human Genetics, Donders Centre for Brain, Cognition, and Behavior, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, the Netherlands
| | - Kosuke Nakashima
- CNS Drug Discovery Unit, Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 251-8555 Fujisawa, Japan
| | - Lea R'Bibo
- Department of Molecular Neuroscience, UCL Institute of Neurology, WC1N 3BG London, UK
| | - David S Lynch
- Department of Molecular Neuroscience, UCL Institute of Neurology, WC1N 3BG London, UK
| | - Bettina Balint
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, WC1N 3BG London, UK; Department of Neurology, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Michèl A A P Willemsen
- Department of Paediatric Neurology, Donders Centre for Brain, Cognition, and Behavior, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, the Netherlands
| | - Matthew E Adams
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, WC1N 3BG London, UK
| | - Sarah Wiethoff
- Department of Molecular Neuroscience, UCL Institute of Neurology, WC1N 3BG London, UK; Center for Neurology and Hertie Institute for Clinical Brain Research, Eberhard Karls University, 72076 Tübingen, Germany
| | - Kazunori Suzuki
- CNS Drug Discovery Unit, Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 251-8555 Fujisawa, Japan
| | - Ceri H Davies
- CNS Drug Discovery Unit, Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 251-8555 Fujisawa, Japan
| | - Joanne Ng
- Developmental Neurosciences, UCL Institute of Child Health, WC1N 1EH London, UK; Department of Neurology, Great Ormond Street Hospital, WC1N 3JH London, UK
| | - Esther Meyer
- Developmental Neurosciences, UCL Institute of Child Health, WC1N 1EH London, UK
| | - Liana Veneziano
- Institute of Translational Pharmacology, National Research Council, 00133 Rome, Italy
| | - Paola Giunti
- Department of Molecular Neuroscience, UCL Institute of Neurology, WC1N 3BG London, UK
| | - Deborah Hughes
- Department of Molecular Neuroscience, UCL Institute of Neurology, WC1N 3BG London, UK
| | - F Lucy Raymond
- Department of Medical Genetics, University of Cambridge, CB2 0XY Cambridge, UK
| | - Miryam Carecchio
- Neuropediatrics Unit, IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; Molecular Neurogenetics Unit, IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Giovanna Zorzi
- Neuropediatrics Unit, IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Nardo Nardocci
- Neuropediatrics Unit, IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Chiara Barzaghi
- Molecular Neurogenetics Unit, IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Barbara Garavaglia
- Molecular Neurogenetics Unit, IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Vincenzo Salpietro
- Department of Molecular Neuroscience, UCL Institute of Neurology, WC1N 3BG London, UK
| | - John Hardy
- Department of Molecular Neuroscience, UCL Institute of Neurology, WC1N 3BG London, UK; Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, WC1N 3BG London, UK
| | - Alan M Pittman
- Department of Molecular Neuroscience, UCL Institute of Neurology, WC1N 3BG London, UK; Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, WC1N 3BG London, UK
| | - Henry Houlden
- Department of Molecular Neuroscience, UCL Institute of Neurology, WC1N 3BG London, UK
| | - Manju A Kurian
- Developmental Neurosciences, UCL Institute of Child Health, WC1N 1EH London, UK; Department of Neurology, Great Ormond Street Hospital, WC1N 3JH London, UK
| | - Haruhide Kimura
- CNS Drug Discovery Unit, Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 251-8555 Fujisawa, Japan
| | - Lisenka E L M Vissers
- Department of Human Genetics, Donders Centre for Brain, Cognition, and Behavior, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, the Netherlands
| | - Nicholas W Wood
- Department of Molecular Neuroscience, UCL Institute of Neurology, WC1N 3BG London, UK.
| | - Kailash P Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, WC1N 3BG London, UK
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Lynch DS, Koutsis G, Tucci A, Panas M, Baklou M, Breza M, Karadima G, Houlden H. Hereditary spastic paraplegia in Greece: characterisation of a previously unexplored population using next-generation sequencing. Eur J Hum Genet 2015; 24:857-63. [PMID: 26374131 DOI: 10.1038/ejhg.2015.200] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 08/04/2015] [Accepted: 08/07/2015] [Indexed: 11/09/2022] Open
Abstract
Hereditary Spastic Paraplegia (HSP) is a syndrome characterised by lower limb spasticity, occurring alone or in association with other neurological manifestations, such as cognitive impairment, seizures, ataxia or neuropathy. HSP occurs worldwide, with different populations having different frequencies of causative genes. The Greek population has not yet been characterised. The purpose of this study was to describe the clinical presentation and molecular epidemiology of the largest cohort of HSP in Greece, comprising 54 patients from 40 families. We used a targeted next-generation sequencing (NGS) approach to genetically assess a proband from each family. We made a genetic diagnosis in >50% of cases and identified 11 novel variants. Variants in SPAST and KIF5A were the most common causes of autosomal dominant HSP, whereas SPG11 and CYP7B1 were the most common cause of autosomal recessive HSP. We identified a novel variant in SPG11, which led to disease with later onset and may be unique to the Greek population and report the first nonsense mutation in KIF5A. Interestingly, the frequency of HSP mutations in the Greek population, which is relatively isolated, was very similar to other European populations. We confirm that NGS approaches are an efficient diagnostic tool and should be employed early in the assessment of HSP patients.
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Affiliation(s)
- David S Lynch
- Department of Molecular Neuroscience, The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, London, UK.,The Leonard Wolfson Experimental Neurology Centre, The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, London, UK
| | - Georgios Koutsis
- Neurogenetics Unit, 1st Department of Neurology, School of Medicine, University of Athens, Athens, Greece
| | - Arianna Tucci
- Department of Molecular Neuroscience, The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, London, UK.,Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milano, Italy
| | - Marios Panas
- Neurogenetics Unit, 1st Department of Neurology, School of Medicine, University of Athens, Athens, Greece
| | - Markella Baklou
- Neurogenetics Unit, 1st Department of Neurology, School of Medicine, University of Athens, Athens, Greece
| | - Marianthi Breza
- Neurogenetics Unit, 1st Department of Neurology, School of Medicine, University of Athens, Athens, Greece
| | - Georgia Karadima
- Neurogenetics Unit, 1st Department of Neurology, School of Medicine, University of Athens, Athens, Greece
| | - Henry Houlden
- Department of Molecular Neuroscience, The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, London, UK.,Neurogenetics Laboratory, The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, London, UK
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Koutsis G, Lynch DS, Tucci A, Houlden H, Karadima G, Panas M. A novel ABCD1 mutation detected by next generation sequencing in presumed hereditary spastic paraplegia: A 30-year diagnostic delay caused by misleading biochemical findings. J Neurol Sci 2015; 355:199-201. [DOI: 10.1016/j.jns.2015.05.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 05/22/2015] [Accepted: 05/26/2015] [Indexed: 11/29/2022]
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Schmieg N, Thomas C, Yabe A, Lynch DS, Iglesias T, Chakravarty P, Schiavo G. Novel Kidins220/ARMS Splice Isoforms: Potential Specific Regulators of Neuronal and Cardiovascular Development. PLoS One 2015; 10:e0129944. [PMID: 26083449 PMCID: PMC4470590 DOI: 10.1371/journal.pone.0129944] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 05/14/2015] [Indexed: 01/19/2023] Open
Abstract
Kidins220/ARMS is a transmembrane protein playing a crucial role in neuronal and cardiovascular development. Kidins220/ARMS is a downstream target of neurotrophin receptors and interacts with several signalling and trafficking factors. Through computational modelling, we found two potential sites for alternative splicing of Kidins220/ARMS. The first is located between exon 24 and exon 29, while the second site replaces exon 32 by a short alternative terminal exon 33. Here we describe the conserved occurrence of several Kidins220/ARMS splice isoforms at RNA and protein levels. Kidins220/ARMS splice isoforms display spatio-temporal regulation during development with distinct patterns in different neuronal populations. Neurotrophin receptor stimulation in cortical and hippocampal neurons and neuroendocrine cells induces specific Kidins220/ARMS splice isoforms and alters the appearance kinetics of the full-length transcript. Remarkably, alternative terminal exon splicing generates Kidins220/ARMS variants with distinct cellular localisation: Kidins220/ARMS containing exon 32 is targeted to the plasma membrane and neurite tips, whereas Kidins220/ARMS without exon 33 mainly clusters the full-length protein in a perinuclear intracellular compartment in PC12 cells and primary neurons, leading to a change in neurotrophin receptor expression. Overall, this study demonstrates the existence of novel Kidins220/ARMS splice isoforms with unique properties, revealing additional complexity in the functional regulation of neurotrophin receptors, and potentially other signalling pathways involved in neuronal and cardiovascular development.
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Affiliation(s)
- Nathalie Schmieg
- Molecular Neuropathobiology Laboratory, Sobell Department of Motor Neuroscience & Movement Disorders, UCL Institute of Neurology, University College London, London WC1N 3BG, United Kingdom
- The Francis Crick Institute, 44 Lincoln’s Inn Fields, London WC2A 3LY, United Kingdom
| | - Claire Thomas
- The Francis Crick Institute, 44 Lincoln’s Inn Fields, London WC2A 3LY, United Kingdom
| | - Arisa Yabe
- The Francis Crick Institute, 44 Lincoln’s Inn Fields, London WC2A 3LY, United Kingdom
| | - David S. Lynch
- Molecular Neuropathobiology Laboratory, Sobell Department of Motor Neuroscience & Movement Disorders, UCL Institute of Neurology, University College London, London WC1N 3BG, United Kingdom
- Leonard Wolfson Centre for Experimental Neurology, University College London, 8 Queen Anne Street, London W1G 9LD, United Kingdom
| | - Teresa Iglesias
- Instituto de Investigaciones Biomédicas "Alberto Sols" (CSIC-UAM), C/ Arturo Duperier, 4, Madrid 28029, Spain
- CIBERNED (ISCIII), C/ Valderrebollo 5, Madrid 28031, Spain
| | - Probir Chakravarty
- The Francis Crick Institute, 44 Lincoln’s Inn Fields, London WC2A 3LY, United Kingdom
| | - Giampietro Schiavo
- Molecular Neuropathobiology Laboratory, Sobell Department of Motor Neuroscience & Movement Disorders, UCL Institute of Neurology, University College London, London WC1N 3BG, United Kingdom
- * E-mail:
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McLaughlin RL, Phukan J, McCormack W, Lynch DS, Greenway M, Cronin S, Saunders J, Slowik A, Tomik B, Andersen PM, Bradley DG, Jakeman P, Hardiman O. Angiogenin levels and ANG genotypes: dysregulation in amyotrophic lateral sclerosis. PLoS One 2010; 5:e15402. [PMID: 21085671 PMCID: PMC2978104 DOI: 10.1371/journal.pone.0015402] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Accepted: 09/10/2010] [Indexed: 11/18/2022] Open
Abstract
Objective To determine whether 5 single nucleotide polymorphisms (SNPs) associate with ALS in 3 different populations. We also assessed the contribution of genotype to angiogenin levels in plasma and CSF. Methods Allelic association statistics were calculated for polymorphisms in the ANG gene in 859 patients and 1047 controls from Sweden, Ireland and Poland. Plasma, serum and CSF angiogenin levels were quantified and stratified according to genotypes across the ANG gene. The contribution of SNP genotypes to variance in circulating angiogenin levels was estimated in patients and controls. Results All SNPs showed association with ALS in the Irish group. The SNP rs17114699 replicated in the Swedish cohort. No SNP associated in the Polish cohort. Age- and sex-corrected circulating angiogenin levels were significantly lower in patients than in controls (p<0.001). An allele dose-dependent regulation of angiogenin levels was observed in controls. This regulation was attenuated in the ALS cohort. A significant positive correlation between CSF plasma angiogenin levels was present in controls and abolished in ALS. Conclusions ANG variants associate with ALS in the Irish and Swedish populations, but not in the Polish. There is evidence of dysregulation of angiogenin expression in plasma and CSF in sporadic ALS. Angiogenin expression is likely to be important in the pathogenesis of ALS.
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