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Sierra-Marcos A, Ribosa-Nogué R, Vidal-Robau N, Aldecoa I, Turón E, Rodríguez-Santiago B, Turón M, Boronat S, Molina-Porcel L. Inherited SCN1A missense mutation in a Dravet Syndrome family: Neuropathological correlation, family screening and implications for adult carriers. Epilepsy Res 2024; 199:107266. [PMID: 38061235 DOI: 10.1016/j.eplepsyres.2023.107266] [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: 05/16/2023] [Revised: 11/16/2023] [Accepted: 11/27/2023] [Indexed: 01/13/2024]
Abstract
INTRODUCTION Neuropathological findings in Dravet Syndrome (DS) are scarce, especially in adult patients, and often do not have a genetic confirmation. Additionally, the missense SCN1A pathogenic variant found has only been described as de novo mutation in previous literature. METHODS We describe the clinical and genetic findings of a family (including three sisters and his father), using Sanger sequencing in the three sisters and in postmortem brain tissue in the father. The present study also shows the neuropathological findings of the father. RESULTS Despite the presence of long term drug resistant epilepsy, starting with febrile seizures between 6 and 12 months of age, and intellectual disability (ID), the three sisters were diagnosed with DS in adulthood, identifying a missense SCN1A pathogenic variant in exon 20, previously described as de novo -p.Gly1332Glu (c .3995 G>A). The oldest sister had the most severe phenotype, with severe ID and wheel chair dependency, passing away at 52. The other two sisters had a moderate phenotype, being at the present seizure free, but with significant comorbidities, such as crouch gait and parkinsonism. Several relatives from the paternal path (including the father) presented epilepsy, but without ID. The father was diagnosed with Alzheimer´s Disease (AD) at 60, and because he donated his brain, the same variant was confirmed in postmortem study. Neither the MRI nor the histopathology showed specific morphological changes for DS, consistent with previous studies. CONCLUSIONS This work supports the need to review the clinical and genetic spectra of DS in adults with epilepsy and unknown ID. The clinical consequences of this syndrome seem to have a functional rather than a structural basis, supported by the absence of specific neuropathological findings.
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Affiliation(s)
- A Sierra-Marcos
- Epilepsy Unit, Neurology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
| | - R Ribosa-Nogué
- Epilepsy Unit, Neurology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - N Vidal-Robau
- Pathology Department, Biomedical Diagnostic Centre (CDB), Hospital Clinic, Barcelona, Spain
| | - I Aldecoa
- Pathology Department, Biomedical Diagnostic Centre (CDB), Hospital Clinic, Barcelona, Spain; Neurological Tissue Bank, Biobanc-Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - E Turón
- Child Neurology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - B Rodríguez-Santiago
- Genetics Department, Hospital de la Santa Creu i Sant Pau, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
| | - M Turón
- Neuropsychology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - S Boronat
- Pathology Department, Biomedical Diagnostic Centre (CDB), Hospital Clinic, Barcelona, Spain
| | - L Molina-Porcel
- Neurological Tissue Bank, Biobanc-Hospital Clínic-IDIBAPS, Barcelona, Spain; Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
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Delaby C, Alcolea D, Carmona-Iragui M, Illán-Gala I, Morenas-Rodríguez E, Barroeta I, Altuna M, Estellés T, Santos-Santos M, Turon-Sans J, Muñoz L, Ribosa-Nogué R, Sala-Matavera I, Sánchez-Saudinos B, Subirana A, Videla L, Benejam B, Sirisi S, Lehmann S, Belbin O, Clarimon J, Blesa R, Pagonabarraga J, Rojas-Garcia R, Fortea J, Lleó A. Differential levels of Neurofilament Light protein in cerebrospinal fluid in patients with a wide range of neurodegenerative disorders. Sci Rep 2020; 10:9161. [PMID: 32514050 PMCID: PMC7280194 DOI: 10.1038/s41598-020-66090-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [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: 12/17/2019] [Accepted: 03/14/2020] [Indexed: 12/29/2022] Open
Abstract
Cerebrospinal fluid (CSF) biomarkers are useful in the diagnosis and the prediction of progression of several neurodegenerative diseases. Among them, CSF neurofilament light (NfL) protein has particular interest, as its levels reflect neuroaxonal degeneration, a common feature in various neurodegenerative diseases. In the present study, we analyzed NfL levels in the CSF of 535 participants of the SPIN (Sant Pau Initiative on Neurodegeneration) cohort including cognitively normal participants, patients with Alzheimer disease (AD), Down syndrome (DS), frontotemporal dementia (FTD), amyotrophic lateral sclerosis (ALS), dementia with Lewy bodies (DLB), progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS). We evaluated the differences in CSF NfL accross groups and its association with other CSF biomarkers and with cognitive scales. All neurogenerative diseases showed increased levels of CSF NfL, with the highest levels in patients with ALS, FTD, CBS and PSP. Furthermore, we found an association of CSF NfL levels with cognitive impairment in patients within the AD and FTD spectrum and with AD pathology in DLB and DS patients. These results have implications for the use of NfL as a marker in neurodegenerative diseases.
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Affiliation(s)
- C Delaby
- Université de Montpellier, CHU de Montpellier, Laboratoire de Biochimie-Protéomique clinique, INSERM U1183, Montpellier, France.,Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain
| | - D Alcolea
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain
| | - M Carmona-Iragui
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain.,Barcelona Down Medical Center, Fundació Catalana Síndrome de Down, Barcelona, Spain
| | - I Illán-Gala
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain
| | - E Morenas-Rodríguez
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain
| | - I Barroeta
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain
| | - M Altuna
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain
| | - T Estellés
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain
| | - M Santos-Santos
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain
| | - J Turon-Sans
- Department of Neurology, Neuromuscular Diseases Unit, MND Clinic, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Raras, Ciberer, Spain
| | - L Muñoz
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain
| | - R Ribosa-Nogué
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain
| | - I Sala-Matavera
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain
| | - B Sánchez-Saudinos
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain
| | - A Subirana
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain
| | - L Videla
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain.,Barcelona Down Medical Center, Fundació Catalana Síndrome de Down, Barcelona, Spain
| | - B Benejam
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain.,Barcelona Down Medical Center, Fundació Catalana Síndrome de Down, Barcelona, Spain
| | - S Sirisi
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain
| | - S Lehmann
- Université de Montpellier, CHU de Montpellier, Laboratoire de Biochimie-Protéomique clinique, INSERM U1183, Montpellier, France
| | - O Belbin
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain
| | - J Clarimon
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain
| | - R Blesa
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain
| | - J Pagonabarraga
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain.,Department of Neurology, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain
| | - R Rojas-Garcia
- Department of Neurology, Neuromuscular Diseases Unit, MND Clinic, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Raras, Ciberer, Spain
| | - J Fortea
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain.,Barcelona Down Medical Center, Fundació Catalana Síndrome de Down, Barcelona, Spain
| | - A Lleó
- Department of Neurology, Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - IIB Sant Pau, Barcelona, Spain. .,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Ciberned, Spain.
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