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Reisch A, Gerety G, Ding A, Narapareddy L, Narapareddy BR. Increasing awareness of rare PSP-F, where rehabilitation is the primary treatment: A case report. NeuroRehabilitation 2023; 53:239-247. [PMID: 37638453 DOI: 10.3233/nre-220235] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
BACKGROUND Progressive Supranuclear Palsy (PSP) is an incurable neurodegenerative disorder. One variant of PSP is a frontal lobe cognitive or behavioral presentation (PSP-F). Currently, the primary management of this disease is rooted in neurological rehabilitation, therefore, early, and accurate diagnosis is key. CASE REPORT Here we present a 60-year-old man with a 2-3-year history of functional decline and behavioral changes. He was misdiagnosed with a late-onset psychiatric disorder. During his second inpatient admission, a full workup for neurodegenerative diseases was performed, and the patient was ultimately diagnosed with probable PSP-F. We describe his neurological rehabilitation plan, examining recommendations before and after diagnosis. RESULTS After the neurodegenerative disorder diagnosis, the neurological rehabilitation plan, particularly PT and OT, changed drastically despite no change in clinical presentation emphasizing the value of an appropriate and early diagnosis. Furthermore, in an OT session, the patient demonstrated longitudinal improvement, emphasizing the importance of rehabilitation in these patient's lives. CONCLUSION Increased recognition of PSP variants amongst healthcare providers will allow more patients to receive early and appropriate diagnoses, so that they can benefit maximally from their neurological rehabilitation plans, maintain quality of life and experience longer periods of functioning. Furthermore, developing PSP-specific rehabilitation guidelines are crucial for improved outcomes. Correct diagnosis will also reduce the use of inappropriate and potentially harmful medications in these populations.
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Affiliation(s)
- Anne Reisch
- University of Connecticut, School of Medicine, Farmington, CT, USA
| | - Gregory Gerety
- Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - Andrew Ding
- Institute of Living, Hartford Hospital, Hartford, CT, USA
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Esagoff AI, Bray MJ, Shan G, Narapareddy L, Bernick CB, Peters ME, Narapareddy BR. Symptomatic Concussions, Depression, and Impulsivity in Fighters with a Family History of Dementia. Alzheimers Dement 2022. [DOI: 10.1002/alz.061121] [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] [Indexed: 12/24/2022]
Affiliation(s)
| | | | - Guogen Shan
- University of Florida, College of Public Health and Health Professions and College of Medicine Gainesville FL USA
| | - Laren Narapareddy
- Emory University, Nell Hodgson Woodruff School of Nursing Atlanta GA USA
| | - Charles B. Bernick
- Lou Ruvo Center for Brain Health, Cleveland Clinic Las Vegas NV USA
- University of Washington Seattle WA USA
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Narapareddy L, Rhon-Calderon EA, Vrooman LA, Baeza J, Nguyen DK, Mesaros C, Lan Y, Garcia BA, Schultz RM, Bartolomei MS. Sex-specific effects of in vitro fertilization on adult metabolic outcomes and hepatic transcriptome and proteome in mouse. FASEB J 2021; 35:e21523. [PMID: 33734487 DOI: 10.1096/fj.202002744r] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 12/18/2020] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 01/31/2023]
Abstract
Although in vitro fertilization (IVF) is associated with adverse perinatal outcomes, there is increasing concern about the long-term and sex-specific health implications. Augmenting our IVF mouse model to longitudinally investigate metabolic outcomes in offspring from optimal neonatal litter sizes, we found sex-specific metabolic outcomes in IVF offspring. IVF-conceived females had higher body weight and cholesterol levels compared to naturally conceived females, whereas IVF-conceived males had higher levels of triglycerides and insulin, and increased body fat composition. Through adult liver transcriptomics and proteomics, we identified sexually dimorphic dysregulation of the sterol regulatory element-binding protein (SREBP) pathways that are associated with the sex-specific phenotypes. We also found that global loss of DNA methylation in placenta was linked to higher cholesterol levels in IVF-conceived females. Our findings indicate that IVF procedures have long-lasting sex-specific effects on metabolic health of offspring and lay the foundation to utilize the placenta as a predictor of long-term outcomes.
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Affiliation(s)
- Laren Narapareddy
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.,Epigenetics Institute, Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Eric A Rhon-Calderon
- Epigenetics Institute, Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lisa A Vrooman
- Epigenetics Institute, Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Josue Baeza
- Epigenetics Institute, Department of Biochemistry and Biophysics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Duy K Nguyen
- Epigenetics Institute, Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Clementina Mesaros
- Center for Excellence in Environmental Toxicology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yemin Lan
- Epigenetics Institute, Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Benjamin A Garcia
- Epigenetics Institute, Department of Biochemistry and Biophysics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Richard M Schultz
- Department of Biology, School of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Marisa S Bartolomei
- Epigenetics Institute, Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Center for Excellence in Environmental Toxicology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Vrooman LA, Rhon-Calderon EA, Chao OY, Nguyen DK, Narapareddy L, Dahiya AK, Putt ME, Schultz RM, Bartolomei MS. Assisted reproductive technologies induce temporally specific placental defects and the preeclampsia risk marker sFLT1 in mouse. Development 2020; 147:147/11/dev186551. [PMID: 32471820 DOI: 10.1242/dev.186551] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 11/16/2019] [Accepted: 04/18/2020] [Indexed: 12/11/2022]
Abstract
Although widely used, assisted reproductive technologies (ARTs) are associated with adverse perinatal outcomes. To elucidate their underlying causes, we have conducted a longitudinal analysis of placental development and fetal growth using a mouse model to investigate the effects of individual ART procedures: hormone stimulation, in vitro fertilization (IVF), embryo culture and embryo transfer. We demonstrate that transfer of blastocysts naturally conceived without hormone stimulation and developed in vivo prior to transfer can impair early placentation and fetal growth, but this effect normalizes by term. In contrast, embryos cultured in vitro before transfer do not exhibit this compensation but rather display placental overgrowth, reduced fetal weight, reduced placental DNA methylation and increased levels of sFLT1, an anti-angiogenic protein implicated in causing the maternal symptoms of preeclampsia in humans. Increases in sFLT1 observed in this study suggest that IVF procedures could increase the risk for preeclampsia. Moreover, our results indicate that embryo culture is the major factor contributing to most placental abnormalities and should therefore be targeted for optimization.
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Affiliation(s)
- Lisa A Vrooman
- Epigenetics Institute, Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Eric A Rhon-Calderon
- Epigenetics Institute, Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Olivia Y Chao
- Epigenetics Institute, Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Duy K Nguyen
- Epigenetics Institute, Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Laren Narapareddy
- Epigenetics Institute, Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Family and Community Health, Claire M. Fagin School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Asha K Dahiya
- Epigenetics Institute, Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Mary E Putt
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Richard M Schultz
- Department of Biology, School of Arts and Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Marisa S Bartolomei
- Epigenetics Institute, Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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Narapareddy BR, Narapareddy L, Lin A, Wigh S, Nanavati J, Dougherty J, Nowrangi M, Roy D. Treatment of Depression After Traumatic Brain Injury: A Systematic Review Focused on Pharmacological and Neuromodulatory Interventions. Psychosomatics 2020; 61:481-497. [PMID: 32660873 DOI: 10.1016/j.psym.2020.04.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/16/2020] [Accepted: 04/16/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Depression is the most common psychiatric sequela after traumatic brain injury (TBI) and poses a variety of treatment challenges. There is a lack of clinical trials focused on biological interventions used to manage TBI depression. OBJECTIVE The aim of this systematic review is to summarize the current evidence of psychotropic and neuromodulatory interventions used to treat TBI depression and to provide directions for future research. METHODS Key words were used to describe the following search terms: "traumatic brain injury", "depression", "pharmacological/drug therapy", and "neuromodulation". Studies focused on pharmacotherapy or neuromodulation in TBI depression were identified in 5 databases: Medline (PubMed), EMBASE (Embase.com), the Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register), PsycINFO (EbscoHost), and Web of Science. Article inclusion/exclusion using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-based systematic protocol of extraction and evaluation was applied. Level of evidence for each study was determined using the American Academy of Neurology criteria. RESULTS The initial search provided 1473 citations. Twenty-two studies met inclusion criteria. Sixteen studies explored pharmacological interventions with emphasis on serotonergic agents. Results between studies were conflicting, and interventions did not always outperform placebos, although sertraline provided the highest level of evidence for treatment of TBI depression. Six studies examining neuromodulatory interventions show preliminary evidence of efficacy with a range of interventions and modes of delivery used. CONCLUSIONS Additional research including large-sample randomized-controlled trials using pharmacological, neuromodulation, or combination treatment is needed. These studies should incorporate premorbid psychosocial functioning, preinjury psychiatric disease, cognitive deficits, and functional recovery when examining outcomes.
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Affiliation(s)
- Bharat R Narapareddy
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Laren Narapareddy
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA
| | | | - Shreya Wigh
- University of New Mexico, College of Arts and Sciences, Albuquerque, NM
| | - Julie Nanavati
- Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Milap Nowrangi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Durga Roy
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
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Narapareddy L, Wildman DE, Armstrong DL, Weckle A, Bell AF, Patil CL, Tardif SD, Ross CN, Rutherford JN. Maternal weight affects placental DNA methylation of genes involved in metabolic pathways in the common marmoset monkey (Callithrix jacchus). Am J Primatol 2020; 82:e23101. [PMID: 32020652 PMCID: PMC7154656 DOI: 10.1002/ajp.23101] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 08/12/2019] [Revised: 12/09/2019] [Accepted: 12/14/2019] [Indexed: 12/13/2022]
Abstract
Accumulating evidence suggests that dysregulation of placental DNA methylation (DNAm) is a mechanism linking maternal weight during pregnancy to metabolic programming outcomes. The common marmoset, Callithrix jaccus, is a platyrrhine primate species that has provided much insight into studies of the primate placenta, maternal condition, and metabolic programming, yet the relationships between maternal weight and placental DNAm are unknown. Here, we report genome‐wide DNAm from term marmoset placentas using reduced representation bisulfite sequencing. We identified 74 genes whose DNAm pattern is associated with maternal weight during gestation. These genes are predominantly involved in energy metabolism and homeostasis, including the regulation of glycolytic and lipid metabolic processes pathways. The placental DNA methylation (DNAm) landscape of the marmoset placenta presents unique differences and similarities with human placental methylation patterns. Maternal weight is associated with placental DNAm in genes that are predominantly involved in energy metabolism and homeostasis. The impact of altered placental DNAm on placental function and development may also contribute to the potential role of placental DNAm in developmental programming in the marmoset monkey.
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Affiliation(s)
- Laren Narapareddy
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | - Derek E Wildman
- Genomics Program, College of Public Health, University of South Florida, Tampa, Florida
| | - Don L Armstrong
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Amy Weckle
- Illinois Water Resources Center, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Aleeca F Bell
- Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Crystal L Patil
- Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Suzette D Tardif
- Texas Biomedical Research Institute, Southwest National Primate Research Center, San Antonio, Texas
| | - Corinna N Ross
- Program of Biology, College of Arts and Sciences, Texas A&M University-San Antonio, San Antonio, Texas
| | - Julienne N Rutherford
- Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
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