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Campins-Romeu M, Sastre-Bataller I, Conde-Sardón R, Baviera-Muñoz R, Morata-Martínez C, Freire-Álvarez E, Gutiérrez-Martín A, Martínez-Torres I. Combined subthalamic nucleus and globus pallidus internus deep brain stimulation in Parkinson's disease. Rev Neurol 2023; 77:83-86. [PMID: 37466135 PMCID: PMC10662243 DOI: 10.33588/rn.7703.2022250] [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] [Received: 01/10/2023] [Indexed: 07/20/2023]
Abstract
INTRODUCTION Subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) are the main surgical approaches for advanced Parkinson's disease. Stimulation is usually applied bilaterally in the same brain structure. However, when various motor symptoms concomitantly present in the same patient, simultaneous modulation of different brain structures may be a suitable alternative. CASE REPORT We present a patient with advanced Parkinson's disease with a combined DBS neurosurgery. Left STN DBS optimally controlled the off right hemibody symptomatology while left side troublesome dyskinesias were successfully relieved by right GPi stimulation. DISCUSSION Combined STN/GPi stimulation can be considered a suitable approach when challenging motor symptomatology arises in advanced Parkinson's disease patients.
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Affiliation(s)
- Marina Campins-Romeu
- Movement Disorders Unit. Neurology Department (M. Campins-Romeu, I. Sastre-Bataller, C. Morata-Martínez, I. Martínez- Torres)Movement Disorders Unit. Neurology DepartmentMovement Disorders Unit. Neurology DepartmentValenciaSpain
| | - Isabel Sastre-Bataller
- Movement Disorders Unit. Neurology Department (M. Campins-Romeu, I. Sastre-Bataller, C. Morata-Martínez, I. Martínez- Torres)Movement Disorders Unit. Neurology DepartmentMovement Disorders Unit. Neurology DepartmentValenciaSpain
| | - Rebeca Conde-Sardón
- Functional Neurosurgery Unit. Functional Neurosurgery Department. Hospital Universitario y Politécnico La FeHospital Universitario y Politécnico La FeHospital Universitario y Politécnico La FeValenciaSpain
| | - Raquel Baviera-Muñoz
- Health Research Institute La Fe. Valencia (R. Baviera-Muñoz)Health Research Institute La FeHealth Research Institute La FeValenciaSpain
| | - Carlos Morata-Martínez
- Movement Disorders Unit. Neurology Department (M. Campins-Romeu, I. Sastre-Bataller, C. Morata-Martínez, I. Martínez- Torres)Movement Disorders Unit. Neurology DepartmentMovement Disorders Unit. Neurology DepartmentValenciaSpain
| | - Eric Freire-Álvarez
- Hospital General Universitario de Elche (E. Freire-Álvarez)Hospital General Universitario de ElcheHospital General Universitario de ElcheElche, AlicanteSpain
- Hospital IMED Elche. Elche, Alicante, Spain (E. Freire-Álvarez)Hospital IMED ElcheHospital IMED ElcheElche, AlicanteSpain
| | - Antonio Gutiérrez-Martín
- Functional Neurosurgery Unit. Functional Neurosurgery Department. Hospital Universitario y Politécnico La FeHospital Universitario y Politécnico La FeHospital Universitario y Politécnico La FeValenciaSpain
| | - Irene Martínez-Torres
- Movement Disorders Unit. Neurology Department (M. Campins-Romeu, I. Sastre-Bataller, C. Morata-Martínez, I. Martínez- Torres)Movement Disorders Unit. Neurology DepartmentMovement Disorders Unit. Neurology DepartmentValenciaSpain
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Sastre-Bataller I, Campins-Romeu M, Marcos-Carrión A, Gutiérrez-Martín A, Conde-Sardón R, Losada-López M, Santabárbara-Gómez JM, León-Guijarro JL, Belloch V, Lozano AM, Martínez-Torres I. Gait Function after High-Intensity Focused Ultrasound Thalamotomy for Essential Tremor: Searching for Technique Optimization. Stereotact Funct Neurosurg 2023; 101:12-21. [PMID: 36696885 DOI: 10.1159/000527374] [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: 01/16/2022] [Accepted: 09/07/2022] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Essential tremor (ET) is one of the most prevalent movement disorders in adults and may be highly disabling for some. Magnetic resonance image-guided high-intensity focused ultrasound (MRIgFUS) has been shown to control tremor efficaciously and with acceptable risk. To date, paresthesia and ataxia are the most common adverse effects (AE). Nevertheless, the impact of MRIgFUS thalamotomy on balance is not well established. METHODS Thirty-two patients underwent MRIgFUS for ET and completed 6 months of follow-up. Tremor severity and functional disability were assessed using the Essential Tremor Rating Scale and the Quality of Life in Essential Tremor Questionnaire. The Berg Balance Scale (BBS) was applied to objectively measure balance status. RESULTS All treatments were successful. The sonication target was 1-2 mm above the depth of the intercommissural line. Procedures lasted less the 2 h, with an average of 8 sonications per patient. Twenty-four patients were included in the tremor analysis. The hand tremor score was improved by 76% after 6 months of follow-up and 87% of patients self-reported marked improvement (≥75%). Disability scores showed marked improvement (78%), leading to a significant improvement in quality of life. At the final follow-up, 48% of the patients reported no side effects. When present, AE were generally transient and were considered mild in 96% of affected patients. Paresthesia and subjective feeling of unsteadiness were the most common persistent complaints (23% and 20%, respectively). Regarding objective ataxia, BBS scores remained stable throughout follow-up for most patients. Only 2 patients suffered a mild worsening of balance although no patients experienced moderate or severe ataxia. CONCLUSIONS Subjective feeling of unsteadiness is one of the most frequent AE after MRIgFUS, although objective ataxia is infrequent and mild. Selecting the most appropriate lesion location and procedural parameters should increase treatment benefits while reducing side effects.
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Affiliation(s)
| | - Marina Campins-Romeu
- Movement Disorders Unit, Department of Neurology, Hospital La Fe, Valencia, Spain
| | | | | | - Rebeca Conde-Sardón
- Unit of Functional Neurosurgery, Department of Neurosurgery, Hospital La Fe, Valencia, Spain
| | - Mireya Losada-López
- Department of Neurology, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | | | | | - Vicente Belloch
- Neuroradiology Unit, Ascires Biomedical Group, Valencia, Spain
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Baviera-Muñoz R, Carretero-Vilarroig L, Vázquez-Costa JF, Morata-Martínez C, Campins-Romeu M, Muelas N, Sastre-Bataller I, Martínez-Torres I, Pérez-García J, Sivera R, Sevilla T, Vilchez JJ, Jaijo T, Espinós C, Millán JM, Bataller L, Aller E. Diagnostic Efficacy of Genetic Studies in a Series of Hereditary Cerebellar Ataxias in Eastern Spain. Neurol Genet 2022; 8:e200038. [DOI: 10.1212/nxg.0000000000200038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 09/01/2022] [Indexed: 11/16/2022]
Abstract
Background and ObjectivesTo determine the diagnostic efficacy of clinical exome-targeted sequencing (CES) and spinocerebellar ataxia 36 (SCA36) screening in a real-life cohort of patients with cerebellar ataxia (CA) from Eastern Spain.MethodsA total of 130 unrelated patients with CA, negative for common trinucleotide repeat expansions (SCA1, SCA2, SCA3, SCA6, SCA7, SCA8, SCA12, SCA17, dentatorubral pallidoluysian atrophy [DRPLA], and Friedreich ataxia), were studied with CES. Bioinformatic and genotype-phenotype analyses were performed to assess the pathogenicity of the variants encountered. Copy number variants were analyzed when appropriate. In undiagnosed dominant and sporadic cases, repeat primed PCR was used to screen for the presence of a repeat expansion in theNOP56gene.ResultsCES identified pathogenic or likely pathogenic variants in 50 families (39%), including 23 novel variants. Overall, there was a high genetic heterogeneity, and the most frequent genetic diagnosis wasSPG7(n = 15), followed bySETX(n = 6),CACNA1A(n = 5),POLR3A(n = 4), andSYNE1(n = 3). In addition, 17 families displayed likely pathogenic/pathogenic variants in 14 different genes:KCND3(n = 2),KIF1C(n = 2),CYP27A1A(n = 2),AFG3L2(n = 1),ANO10(n = 1),CAPN1(n = 1),CWF19L1(n = 1),ITPR1(n = 1),KCNA1(n = 1),OPA1(n = 1),PNPLA6(n = 1),SPG11(n = 1),SPTBN2(n = 1), andTPP1(n = 1). Twenty-two novel variants were characterized. SCA36 was diagnosed in 11 families, all with autosomal dominant (AD) presentation. SCA36 screening increased the total diagnostic rate to 47% (n = 61/130). Ultimately, undiagnosed patients showed delayed age at onset (p< 0.05) and were more frequently sporadic.DiscussionOur study provides insight into the genetic landscape of CA in Eastern Spain. Although CES was an effective approach to capture genetic heterogeneity, most patients remained undiagnosed. SCA36 was found to be a relatively frequent form and, therefore, should be tested prior to CES in familial AD presentations in particular geographical regions.
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Campins-Romeu M, Sastre-Bataller I, Pons-Beltrán V, Baviera-Muñoz R, Losada-López M, Morata-Martínez C, Pérez-García J, Martínez-Torres I. [Adverse effects and complications of continuous intestinal infusion of levodopa-carbidopa in a cohort of patients with Parkinson's disease in a tertiary hospital]. Rev Neurol 2022; 74:143-148. [PMID: 35211947 DOI: 10.33588/rn.7405.2021482] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Continuous intestinal infusion of levodopa/carbidopa is a second-line treatment indicated in advanced stages of Parkinson's disease (PD). For its implantation, a percutaneous endoscopic gastrostomy must be performed. OBJECTIVES The main objective has been to describe the frequency and characteristics of the side effects associated with this treatment. As a secondary objective, we have analyzed the epidemiological and clinical characteristics of the PD patients who have received this treatment in our hospital. PATIENTS AND METHODS Descriptive, single-center, retrospective study for a consecutive sample of PD patients treated with Continuous intestinal infusion of Levodopa/Carbidopa from the beginning of 2006 to the end of August 2021. RESULTS 81 treatment planifications have been analyzed. Treatment success (duration greater than 12 months) was achieved in 78.1% (n = 50) of the patients in whom this follow-up period was available. The median duration of treatment was 35 months. 58.6% of the patients presented some type of complication. A total of 43 minor complications and 16 serious adverse events were reported. CONCLUSION The constitution of an experienced multidisciplinary team is essential to guarantee the adequate management and follow-up of these patients.
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Affiliation(s)
| | | | - V Pons-Beltrán
- Hospital Universitari i Politècnic La Fe, Valencia, España
| | | | - M Losada-López
- Hospital Universitari i Politècnic La Fe, Valencia, España
| | | | - J Pérez-García
- Hospital Universitari i Politècnic La Fe, Valencia, España
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López-Ariztegui N, Mata-Alvarez Santullano M, Tegel I, Almeida F, Sarasa P, Rojo R, Rico-Villademoros F, Abril-Jaramillo J, Bermejo P, Borrue C, Caballol N, Campins-Romeu M, Clavero P, García-Caldentey J, Gómez-Mayordomo V, Labandeira C, Martí-Andrés G, Martínez-Castrillo JC, Martinez-Poles J, Muñoz T, Salom JM, Valderrama-Martín C, Vinagre-Aragón A. [Opicapone for the treatment of Parkinson's disease: real-life data in Spain]. Rev Neurol 2021; 73:S01-S14. [PMID: 34897643 DOI: 10.33588/rn.73s02.2021461] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Opicapone is a catechol-O-methyl-transferase (iCOMT) inhibitor authorized in Europe in 2016 and indicated as adjunctive therapy to preparations of levodopa/ DOPA decarboxylase inhibitors in adult patients with Parkinson's disease and end-of-dose motor fluctuations who cannot be stabilised on those combinations. The efficacy of opicapone in these patients has been demonstrated in two pivotal randomized clinical trials, BIPARK I and BIPARK II, in which it has demonstrated its superiority versus placebo and non-inferiority versus entacapone. Although they constitute the gold standard for the evaluation of interventions, randomized clinical trials present limitations of external validity due to the use of strict eligibility criteria. Therefore, it is considered necessary to have a more comprehensive evaluation of the efficacy of the drug, complementing the information obtained from randomized clinical trials with that of "real world or real clinical practice" studies. The objective of this review has been to collect and put into perspective the information available on opicapone coming from real clinical practice studies in Spain. The data from Spain with opicapone in 18 series with more than 1,000 patients in total, confirm the safety and efficacy previously reported with this iCOMT. Furthermore, they show that opicapone is especially useful in patients with a less advanced stage of the disease and mild motor fluctuations, which would suggest that the earlier its introduction in the therapeutic scheme for the management of motor fluctuations, the better is the benefit-risk ratio for the drug.
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Affiliation(s)
| | | | - I Tegel
- Laboratorios Bial, S.A., Madrid, España
| | - F Almeida
- Laboratorios Bial, S.A., Madrid, España
| | - P Sarasa
- Laboratorios Bial, S.A., Madrid, España
| | - R Rojo
- Universidad Alfonso X El Sabio, Villanueva de la Cañada, España
| | | | | | - P Bermejo
- Hospital Universitario Puerta de Hierro-Majadahonda, 28035 Majadahonda, España
| | - C Borrue
- Hospital Universitario Infanta Sofía, Madrid, España
| | - N Caballol
- Hospital de San Juan Despí Moisès Broggi, Sant Joan Despí, España
| | | | - P Clavero
- Complejo Hospitalario de Navarra, Pamplona, Pamplona, España
| | | | | | | | | | | | | | - T Muñoz
- Hospital Universitario Regional de Málaga, Málaga, España
| | - J M Salom
- Hospital Clínico Universitario de Valencia, 46010 Valencia, España
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Baviera-Muñoz R, Martínez-Rubio D, Sastre-Bataller I, Campins-Romeu M, Losada-López M, Pérez-García J, Novella-Maestre E, Martínez-Torres I, Espinós C. A 3.9-Mb Deletion on 2p11.2 Comprising the REEP1 Gene Causes Early-Onset Atypical Parkinsonism. Neurol Genet 2021; 7:e642. [PMID: 34825060 PMCID: PMC8610491 DOI: 10.1212/nxg.0000000000000642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/18/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Raquel Baviera-Muñoz
- Health Research Institute (R.B.-M.), Hospital Universitari i Politècnic La Fe; Unit of Rare Neurodegenerative Diseases (D.M.-R., C.E.), Centro de Investigación Príncipe Felipe (CIPF); Joint Units INCLIVA & IIS La Fe Rare Diseases (D.M.-R., C.E.); Movement Disorders Unit (I.S.-B., M.C.-R., M.L.-L., J.P.-G., I.M.-T.), Neurology Department, Hospital Universitari i Politècnic La Fe; Department of Genetics (E.N.-M.), Hospital Universitari i Politècnic La Fe; and Health Sciences Faculty, Universidad Internacional de Valencia (VIU) (E.N.-M.), Valencia, Spain
| | - Dolores Martínez-Rubio
- Health Research Institute (R.B.-M.), Hospital Universitari i Politècnic La Fe; Unit of Rare Neurodegenerative Diseases (D.M.-R., C.E.), Centro de Investigación Príncipe Felipe (CIPF); Joint Units INCLIVA & IIS La Fe Rare Diseases (D.M.-R., C.E.); Movement Disorders Unit (I.S.-B., M.C.-R., M.L.-L., J.P.-G., I.M.-T.), Neurology Department, Hospital Universitari i Politècnic La Fe; Department of Genetics (E.N.-M.), Hospital Universitari i Politècnic La Fe; and Health Sciences Faculty, Universidad Internacional de Valencia (VIU) (E.N.-M.), Valencia, Spain
| | - Isabel Sastre-Bataller
- Health Research Institute (R.B.-M.), Hospital Universitari i Politècnic La Fe; Unit of Rare Neurodegenerative Diseases (D.M.-R., C.E.), Centro de Investigación Príncipe Felipe (CIPF); Joint Units INCLIVA & IIS La Fe Rare Diseases (D.M.-R., C.E.); Movement Disorders Unit (I.S.-B., M.C.-R., M.L.-L., J.P.-G., I.M.-T.), Neurology Department, Hospital Universitari i Politècnic La Fe; Department of Genetics (E.N.-M.), Hospital Universitari i Politècnic La Fe; and Health Sciences Faculty, Universidad Internacional de Valencia (VIU) (E.N.-M.), Valencia, Spain
| | - Marina Campins-Romeu
- Health Research Institute (R.B.-M.), Hospital Universitari i Politècnic La Fe; Unit of Rare Neurodegenerative Diseases (D.M.-R., C.E.), Centro de Investigación Príncipe Felipe (CIPF); Joint Units INCLIVA & IIS La Fe Rare Diseases (D.M.-R., C.E.); Movement Disorders Unit (I.S.-B., M.C.-R., M.L.-L., J.P.-G., I.M.-T.), Neurology Department, Hospital Universitari i Politècnic La Fe; Department of Genetics (E.N.-M.), Hospital Universitari i Politècnic La Fe; and Health Sciences Faculty, Universidad Internacional de Valencia (VIU) (E.N.-M.), Valencia, Spain
| | - Mireya Losada-López
- Health Research Institute (R.B.-M.), Hospital Universitari i Politècnic La Fe; Unit of Rare Neurodegenerative Diseases (D.M.-R., C.E.), Centro de Investigación Príncipe Felipe (CIPF); Joint Units INCLIVA & IIS La Fe Rare Diseases (D.M.-R., C.E.); Movement Disorders Unit (I.S.-B., M.C.-R., M.L.-L., J.P.-G., I.M.-T.), Neurology Department, Hospital Universitari i Politècnic La Fe; Department of Genetics (E.N.-M.), Hospital Universitari i Politècnic La Fe; and Health Sciences Faculty, Universidad Internacional de Valencia (VIU) (E.N.-M.), Valencia, Spain
| | - Julia Pérez-García
- Health Research Institute (R.B.-M.), Hospital Universitari i Politècnic La Fe; Unit of Rare Neurodegenerative Diseases (D.M.-R., C.E.), Centro de Investigación Príncipe Felipe (CIPF); Joint Units INCLIVA & IIS La Fe Rare Diseases (D.M.-R., C.E.); Movement Disorders Unit (I.S.-B., M.C.-R., M.L.-L., J.P.-G., I.M.-T.), Neurology Department, Hospital Universitari i Politècnic La Fe; Department of Genetics (E.N.-M.), Hospital Universitari i Politècnic La Fe; and Health Sciences Faculty, Universidad Internacional de Valencia (VIU) (E.N.-M.), Valencia, Spain
| | - Edurne Novella-Maestre
- Health Research Institute (R.B.-M.), Hospital Universitari i Politècnic La Fe; Unit of Rare Neurodegenerative Diseases (D.M.-R., C.E.), Centro de Investigación Príncipe Felipe (CIPF); Joint Units INCLIVA & IIS La Fe Rare Diseases (D.M.-R., C.E.); Movement Disorders Unit (I.S.-B., M.C.-R., M.L.-L., J.P.-G., I.M.-T.), Neurology Department, Hospital Universitari i Politècnic La Fe; Department of Genetics (E.N.-M.), Hospital Universitari i Politècnic La Fe; and Health Sciences Faculty, Universidad Internacional de Valencia (VIU) (E.N.-M.), Valencia, Spain
| | - Irene Martínez-Torres
- Health Research Institute (R.B.-M.), Hospital Universitari i Politècnic La Fe; Unit of Rare Neurodegenerative Diseases (D.M.-R., C.E.), Centro de Investigación Príncipe Felipe (CIPF); Joint Units INCLIVA & IIS La Fe Rare Diseases (D.M.-R., C.E.); Movement Disorders Unit (I.S.-B., M.C.-R., M.L.-L., J.P.-G., I.M.-T.), Neurology Department, Hospital Universitari i Politècnic La Fe; Department of Genetics (E.N.-M.), Hospital Universitari i Politècnic La Fe; and Health Sciences Faculty, Universidad Internacional de Valencia (VIU) (E.N.-M.), Valencia, Spain
| | - Carmen Espinós
- Health Research Institute (R.B.-M.), Hospital Universitari i Politècnic La Fe; Unit of Rare Neurodegenerative Diseases (D.M.-R., C.E.), Centro de Investigación Príncipe Felipe (CIPF); Joint Units INCLIVA & IIS La Fe Rare Diseases (D.M.-R., C.E.); Movement Disorders Unit (I.S.-B., M.C.-R., M.L.-L., J.P.-G., I.M.-T.), Neurology Department, Hospital Universitari i Politècnic La Fe; Department of Genetics (E.N.-M.), Hospital Universitari i Politècnic La Fe; and Health Sciences Faculty, Universidad Internacional de Valencia (VIU) (E.N.-M.), Valencia, Spain
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Baviera-Muñoz R, Campins-Romeu M, Carretero-Vilarroig L, Sastre-Bataller I, Martínez-Torres I, Vázquez-Costa JF, Muelas N, Sevilla T, Vílchez JJ, Aller E, Jaijo T, Bataller L, Espinós C. Clinical and genetic characteristics of 21 Spanish patients with biallelic pathogenic SPG7 mutations. J Neurol Sci 2021; 429:118062. [PMID: 34500365 DOI: 10.1016/j.jns.2021.118062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/08/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 12/27/2022]
Abstract
Spastic paraplegia type 7 (SPG7) is one of the most common hereditary spastic paraplegias. SPG7 mutations most often lead to spastic paraparesis (HSP) and/or hereditary cerebellar ataxia (HCA), frequently with mixed phenotypes. We sought to clinically and genetically characterize a Spanish cohort of SPG7 patients. Patients were recruited from our HCA and HSP cohorts. We identified twenty-one patients with biallelic pathogenic SPG7 mutations. Mean age at onset was 37.4 years (SD ± 14.3). The most frequent phenotype was spastic ataxia (57%), followed by pure spastic paraplegia (19%) and complex phenotypes (19%). Isolated patients presented with focal or multifocal dystonia, subclinical myopathy or ophthalmoplegia. p.Ala510Val was the most frequent pathogenic variant encountered. Compound heterozygous for p.Ala510Val displayed younger onset (p < 0.05) and more complex phenotypes (p < 0.05) than p.Ala510Val homozygotes. Two novel variants were found: p.Lys559Argfs*33 and p.Ala312Glu. In conclusion, spastic ataxia is the most common phenotype found in Spanish patients. Nonetheless, SPG7 analysis should also be considered in patients with less frequent clinical findings such as dystonia or ophthalmoplegia especially when these symptoms are associated with mild spastic ataxia.
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Affiliation(s)
- Raquel Baviera-Muñoz
- Department of Neurology, Hospital Universitari I Politècnic La Fe, Valencia, Spain; Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Rare Diseases Joint Unit, CIPF-IIS La Fe, Valencia, Spain
| | - Marina Campins-Romeu
- Department of Neurology, Hospital Universitari I Politècnic La Fe, Valencia, Spain; Rare Diseases Joint Unit, CIPF-IIS La Fe, Valencia, Spain
| | - Lidón Carretero-Vilarroig
- Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Rare Diseases Joint Unit, CIPF-IIS La Fe, Valencia, Spain; Cell Biology Department, University of Valencia, Valencia, Spain
| | - Isabel Sastre-Bataller
- Department of Neurology, Hospital Universitari I Politècnic La Fe, Valencia, Spain; Rare Diseases Joint Unit, CIPF-IIS La Fe, Valencia, Spain
| | - Irene Martínez-Torres
- Department of Neurology, Hospital Universitari I Politècnic La Fe, Valencia, Spain; Rare Diseases Joint Unit, CIPF-IIS La Fe, Valencia, Spain
| | - Juan F Vázquez-Costa
- Department of Neurology, Hospital Universitari I Politècnic La Fe, Valencia, Spain; Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Rare Diseases Joint Unit, CIPF-IIS La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain
| | - Nuria Muelas
- Department of Neurology, Hospital Universitari I Politècnic La Fe, Valencia, Spain; Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Rare Diseases Joint Unit, CIPF-IIS La Fe, Valencia, Spain
| | - Teresa Sevilla
- Department of Neurology, Hospital Universitari I Politècnic La Fe, Valencia, Spain; Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Rare Diseases Joint Unit, CIPF-IIS La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | - Juan J Vílchez
- Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Rare Diseases Joint Unit, CIPF-IIS La Fe, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | - Elena Aller
- Rare Diseases Joint Unit, CIPF-IIS La Fe, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain; Department of Genetics, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Teresa Jaijo
- Rare Diseases Joint Unit, CIPF-IIS La Fe, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain; Department of Genetics, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Luis Bataller
- Department of Neurology, Hospital Universitari I Politècnic La Fe, Valencia, Spain; Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Rare Diseases Joint Unit, CIPF-IIS La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain; Department of Medicine, University of Valencia, Valencia, Spain.
| | - Carmen Espinós
- Rare Diseases Joint Unit, CIPF-IIS La Fe, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain; Laboratory of Rare Neurodegenerative Diseases, Centro de Investigación Príncipe Felipe (CIPF), Valencia, Spain
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8
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Campins-Romeu M, Baviera-Muñoz R, Sastre-Bataller I, Bataller L, Jaijo T, Martínez-Torres I. Hereditary Spastic Paraplegia 7 Presenting as Multifocal Dystonia with Prominent Cranio-Cervical Involvement. Mov Disord Clin Pract 2021; 8:966-968. [PMID: 34405107 DOI: 10.1002/mdc3.13257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/08/2021] [Accepted: 05/04/2021] [Indexed: 12/27/2022] Open
Affiliation(s)
- Marina Campins-Romeu
- Movement Disorders Unit, Department of Neurology Hospital Universitari i Politècnic La Fe Valencia Spain
| | - Raquel Baviera-Muñoz
- Movement Disorders Unit, Department of Neurology Hospital Universitari i Politècnic La Fe Valencia Spain
| | - Isabel Sastre-Bataller
- Movement Disorders Unit, Department of Neurology Hospital Universitari i Politècnic La Fe Valencia Spain
| | - Luis Bataller
- Movement Disorders Unit, Department of Neurology Hospital Universitari i Politècnic La Fe Valencia Spain
| | - Teresa Jaijo
- Department of Genetics Hospital Universitari i Politècnic La Fe Valencia Spain
| | - Irene Martínez-Torres
- Movement Disorders Unit, Department of Neurology Hospital Universitari i Politècnic La Fe Valencia Spain
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Vázquez-Costa JF, Campins-Romeu M, Martínez-Payá JJ, Tembl JI, Del Baño-Aledo ME, Ríos-Díaz J, Fornés-Ferrer V, Chumillas MJ, Sevilla T. New insights into the pathophysiology of fasciculations in amyotrophic lateral sclerosis: An ultrasound study. Clin Neurophysiol 2018; 129:2650-2657. [PMID: 30292684 DOI: 10.1016/j.clinph.2018.09.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 09/02/2018] [Accepted: 09/16/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To describe the fasciculation pattern in ALS and to analyse its clinical and pathophysiological significance. METHODS Ultrasound of 19 muscles was performed in 44 patients with a recent diagnosis (<90 days) of ALS. The number of fasciculations was recorded in each muscle and the muscle thickness and strength were additionally measured in limb muscles. A subgroup of patients were electromyographically assessed. RESULTS US was performed in 835 muscles and EMG was available in 263 muscles. US detected fasciculations more frequently than EMG. Fasciculations were widespread, especially in upper limbs onset patients and in the cervical region. Fasciculations' number inversely associated with ALSFR-R and body mass index (BMI) and directly with BMI loss and upper motor neuron (UMN) impairment. Our statistical model suggest that fasciculations increase with the initial lower motor neuron (LMN) degeneration, reach their peak when the muscle became mildly to moderately weak, decreasing afterwards with increasing muscle weakness and atrophy. CONCLUSIONS Our study suggests that both UMN and LMN degeneration trigger fasciculations causing BMI loss. The degree of LMN impairment could account for differences in fasciculations' rates within and between muscles. SIGNIFICANCE In ALS, fasciculations could explain the link between hyperexcitability and BMI loss.
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Affiliation(s)
- J F Vázquez-Costa
- Neuromuscular Research Unit, Instituto de Investigación Sanitaria la Fe (IIS La Fe), Valencia, Spain; ALS Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, Spain.
| | - M Campins-Romeu
- ALS Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - J J Martínez-Payá
- ECOFISTEM Research Group, Health Sciences Department, Facultad de Ciencias de la Salud, Universidad Católica de Murcia, Campus de los Jerónimos s/n, 30107 Guadalupe (Murcia), Spain
| | - J I Tembl
- Neurosonology Laboratory, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - M E Del Baño-Aledo
- Physiotherapy Department, Facultad de Medicina, Campus de Espinardo 30100, Universidad de Murcia, Spain
| | - J Ríos-Díaz
- Centro de Ciencias de la Salud San Rafael, Universidad Antonio de Nebrija, Madrid, Paseo de la Habana 70 bis, 28036 Madrid, Spain; Fundación San Juan de Dios, Madrid, Spain
| | - V Fornés-Ferrer
- Biostatistics Unit, Instituto de Investigación Sanitaria la Fe (IIS La Fe), Valencia, Spain
| | - M J Chumillas
- Neuromuscular Research Unit, Instituto de Investigación Sanitaria la Fe (IIS La Fe), Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, Spain; ALS Unit, Department of Neurophisiology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - T Sevilla
- Neuromuscular Research Unit, Instituto de Investigación Sanitaria la Fe (IIS La Fe), Valencia, Spain; ALS Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
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