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Montano V, Orsucci D, Carelli V, La Morgia C, Valentino ML, Lamperti C, Marchet S, Musumeci O, Toscano A, Primiano G, Santorelli FM, Ticci C, Filosto M, Rubegni A, Mongini T, Tonin P, Servidei S, Ceravolo R, Siciliano G, Mancuso M. Adult-onset mitochondrial movement disorders: a national picture from the Italian Network. J Neurol 2021; 269:1413-1421. [PMID: 34259909 PMCID: PMC8857085 DOI: 10.1007/s00415-021-10697-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 05/13/2021] [Revised: 06/25/2021] [Accepted: 07/02/2021] [Indexed: 02/06/2023]
Abstract
Introduction Both prevalence and clinical features of the various movement disorders in adults with primary mitochondrial diseases are unknown. Methods Based on the database of the “Nation-wide Italian Collaborative Network of Mitochondrial Diseases”, we reviewed the clinical, genetic, neuroimaging and neurophysiological data of adult patients with primary mitochondrial diseases (n = 764) where ataxia, myoclonus or other movement disorders were part of the clinical phenotype. Results Ataxia, myoclonus and movement disorders were present in 105/764 adults (13.7%), with the onset coinciding or preceding the diagnosis of the mitochondrial disease in 49/105 (46.7%). Ataxia and parkinsonism were the most represented, with an overall prevalence at last follow-up of 59.1% and 30.5%, respectively. Hyperkinetic movement disorders were reported in 15.3% at last follow-up, being the less common reported movement disorders. The pathogenic m.8344A > G and POLG variants were always associated with a movement disorder, while LHON variants and mtDNA single deletions were more commonly found in the subjects who did not present a movement disorder. The most common neuroimaging features were cortical and/or cerebellar atrophy, white matter hyperintensities, basal ganglia abnormalities and nigro-striatal degeneration. Almost 70% of patients with parkinsonism responded to dopaminergic therapy, mainly levodopa, and 50% with myoclonus were successfully treated with levetiracetam. Conclusion Movement disorders, mainly ataxia and parkinsonism, are important findings in adult primary mitochondrial diseases. This study underlies the importance of looking for a mitochondrial etiology in the diagnostic flowchart of a movement disorder and may help direct genetic screening in daily practice. Supplementary Information The online version contains supplementary material available at 10.1007/s00415-021-10697-1.
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Affiliation(s)
- V Montano
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - D Orsucci
- Unit of Neurology, San Luca Hospital, Lucca, Italy
| | - V Carelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - C La Morgia
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy
| | - M L Valentino
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - C Lamperti
- UO Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - S Marchet
- UO Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - O Musumeci
- Unit of Neurology and Neuromuscular Disorders, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - A Toscano
- Unit of Neurology and Neuromuscular Disorders, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - G Primiano
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - F M Santorelli
- Molecular Medicine for Neurodegenerative and Neuromuscular Diseases Unit, IRCCS Stella Maris Foundation, Pisa, Italy
| | - C Ticci
- Molecular Medicine for Neurodegenerative and Neuromuscular Diseases Unit, IRCCS Stella Maris Foundation, Pisa, Italy
| | - M Filosto
- Department of Clinical and Experimental Sciences, ASST Spedali Civili Brescia and NeMO-Brescia Clinical Center for Neuromuscular Diseases, University of Brescia, Brescia, Italy
| | - A Rubegni
- Molecular Medicine for Neurodegenerative and Neuromuscular Diseases Unit, IRCCS Stella Maris Foundation, Pisa, Italy
| | - T Mongini
- Department of Neurosciences, University of Torino, Turin, Italy
| | - P Tonin
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Neurology, University of Verona, Verona, Italy
| | - S Servidei
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - R Ceravolo
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - G Siciliano
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Michelangelo Mancuso
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy.
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2
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Rinninella E, Pizzoferrato M, Cintoni M, Servidei S, Mele MC. Nutritional support in mitochondrial diseases: the state of the art. Eur Rev Med Pharmacol Sci 2019; 22:4288-4298. [PMID: 30024619 DOI: 10.26355/eurrev_201807_15425] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Mitochondrial diseases are a group of rare multisystem disorders characterized by genetic heterogeneity and pleomorphic clinical manifestations. The clinical burden may be heavy for patients and their caregivers. There are no therapies of proven efficacy until now and a multidisciplinary supportive care is therefore necessary. Since the common pathogenic mechanism is the insufficient energy production by defective mitochondria, nutrition may play a crucial role. However, no guidelines are still available. The article reports the current evidence, highlighting nutrition both as support and as therapy. The estimate of nutritional status, energy needs and nutritional behaviors are firstly discussed. Then, we go in-depth on the scientific rationale and the clinical evidence of the use of anti-oxidants and enzyme-cofactors in the clinical practice. In particular, we analyze the role of Coenzyme Q10, Creatine monohydrate, α-lipoic acid, riboflavin, arginine and citrulline, folinic acid, carnitine, vitamin C, K, and E. Every attempt at nutritional intervention should be made knowing patient's disease and focusing on his/her energy and nutrients' requirements. For this reason, clinicians expert in mitochondrial medicine and clinical nutritionists should work together to ameliorate care in these fragile patients.
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Affiliation(s)
- E Rinninella
- UOC Nutrizione Clinica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
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3
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Luigetti M, Sauchelli D, Primiano G, Cuccagna C, Bernardo D, Lo Monaco M, Servidei S. Mitochondrial neuropathy: considerations on pathogenesis. Eur J Neurol 2018; 23:e55. [PMID: 27431029 DOI: 10.1111/ene.13049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 04/21/2016] [Indexed: 11/26/2022]
Affiliation(s)
- M Luigetti
- Institute of Neurology, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - D Sauchelli
- Institute of Neurology, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - G Primiano
- Institute of Neurology, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - C Cuccagna
- Institute of Neurology, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - D Bernardo
- Institute of Neurology, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - M Lo Monaco
- Institute of Neurology, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - S Servidei
- Institute of Neurology, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
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4
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Barbato F, Di Paolantonio A, Distefano M, Mastrorosa A, Sabatelli M, Servidei S, Luigetti M. Recurrent miller fisher: a new case report and a literature review. Clin Ter 2017; 168:e208-e213. [PMID: 28612899 DOI: 10.7417/t.2017.2008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Miller Fisher syndrome (MFS) is considered to be an uncommon variant of Guillain-Barré Syndrome. The disease is clinically characterized by acute ataxia of limbs, areflexia and ophthalmoplegia, although the set of symptoms and signs can be quite heterogeneous, with a benign and monophasic course. We describe a case of recurrent MFS where there have been four clinical episodes occurred with complete remission after each relapse. Last recurrence was treated with oral steroids. The reported frequency of recurrent MFS in literature is variable as well as the best treatment in these cases. We add a new case treated with steroid and we perform a review of the literature.
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Affiliation(s)
- F Barbato
- Institute of Neurology, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of Sacred Heart, Rome
| | - A Di Paolantonio
- Institute of Neurology, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of Sacred Heart, Rome
| | - M Distefano
- Institute of Neurology, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of Sacred Heart, Rome
| | - A Mastrorosa
- Institute of Neurology, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of Sacred Heart, Rome
| | - M Sabatelli
- Institute of Neurology, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of Sacred Heart, Rome
| | - S Servidei
- Institute of Neurology, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of Sacred Heart, Rome
| | - M Luigetti
- Institute of Neurology, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of Sacred Heart, Rome - Fondazione Don Carlo Gnocchi, Milan, Italy
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5
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Capuano A, Vollono C, Rubino M, Mei D, Calì C, De Angelis A, Di Trapani G, Servidei S, Della Marca G. Hypnic Headache: Actigraphic and Polysomnographic Study of a Case. Cephalalgia 2016; 25:466-9. [PMID: 15910573 DOI: 10.1111/j.1468-2982.2005.00871.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- A Capuano
- Institute of Neurology, Department of Neurosciences, Catholic University, 8-00168 Rome, Italy
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6
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Luigetti M, Sauchelli D, Primiano G, Cuccagna C, Bernardo D, Lo Monaco M, Servidei S. Peripheral neuropathy is a common manifestation of mitochondrial diseases: a single-centre experience. Eur J Neurol 2016; 23:1020-7. [DOI: 10.1111/ene.12954] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 11/26/2015] [Indexed: 12/16/2022]
Affiliation(s)
- M. Luigetti
- Department of Geriatrics; Neurosciences and Orthopedics; Institute of Neurology; Catholic University of the Sacred Heart; Rome Italy
| | - D. Sauchelli
- Department of Geriatrics; Neurosciences and Orthopedics; Institute of Neurology; Catholic University of the Sacred Heart; Rome Italy
| | - G. Primiano
- Department of Geriatrics; Neurosciences and Orthopedics; Institute of Neurology; Catholic University of the Sacred Heart; Rome Italy
| | - C. Cuccagna
- Department of Geriatrics; Neurosciences and Orthopedics; Institute of Neurology; Catholic University of the Sacred Heart; Rome Italy
| | - D. Bernardo
- Department of Geriatrics; Neurosciences and Orthopedics; Institute of Neurology; Catholic University of the Sacred Heart; Rome Italy
| | - M. Lo Monaco
- Department of Geriatrics; Neurosciences and Orthopedics; Institute of Neurology; Catholic University of the Sacred Heart; Rome Italy
| | - S. Servidei
- Department of Geriatrics; Neurosciences and Orthopedics; Institute of Neurology; Catholic University of the Sacred Heart; Rome Italy
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7
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Musumeci O, la Marca G, Spada M, Mondello S, Danesino C, Comi GP, Pegoraro E, Antonini G, Marrosu G, Liguori R, Morandi L, Moggio M, Massa R, Ravaglia S, Di Muzio A, Filosto M, Tonin P, Di Iorio G, Servidei S, Siciliano G, Angelini C, Mongini T, Toscano A. LOPED study: looking for an early diagnosis in a late-onset Pompe disease high-risk population. J Neurol Neurosurg Psychiatry 2016; 87:5-11. [PMID: 25783438 DOI: 10.1136/jnnp-2014-310164] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 02/20/2015] [Indexed: 11/03/2022]
Abstract
OBJECTIVE A multicentre observational study was aimed to assess the prevalence of late-onset Pompe disease (LOPD) in a large high-risk population, using the dried blood spot (DBS) as a main screening tool. DESIGN/METHODS 17 Italian neuromuscular centres were involved in the late-onset Pompe early diagnosis (LOPED) study. Inclusion criteria were: (1) age ≥5 years, (2) persistent hyperCKaemia and (3) muscle weakness at upper and/or lower limbs (limb-girdle muscle weakness, LGMW). Acid α-glucosidase (GAA) activity was measured separately on DBS by fluorometric as well as tandem mass spectrometry methods. A DBS retest was performed in patients resulted positive at first assay. For the final diagnosis, GAA deficiency was confirmed by a biochemical assay in skeletal muscle, whereas genotype was assessed by GAA molecular analysis. RESULTS In a 14-month period, we studied 1051 cases: 30 positive samples (2.9%) were detected by first DBS screening, whereas, after retesting, 21 samples were still positive. Biochemical and molecular genetic studies finally confirmed LOPD diagnosis in 17 cases (1.6%). The median time from the onset of symptoms/signs to diagnosis was 5 years. Among those patients, 35% showed presymptomatic hyperCKaemia and 59% showed hyperCKaemia+LGMW, whereas 6% manifested with LGMW. CONCLUSIONS LOPED study suggests that GAA activity should be accurately screened by DBS in all patients referring for isolated hyperCKaemia and/or LGMW. A timely diagnosis was performed in five patients with presymptomatic hyperCKaemia, but two had already manifested with relevant changes on muscle morphology and MRI. Consequently, enzyme replacement therapy was started in 14/17 patients, including the 2 patients still clinically presymptomatic but with a laboratory evidence of disease progression.
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Affiliation(s)
- O Musumeci
- Department of Neurosciences, University of Messina, Messina, Italy
| | - G la Marca
- Department of Neurosciences, Psychology, Pharmacology and Child Health, University of Florence, Florence, Italy
| | - M Spada
- Department of Neuroscience, University of Turin, Turin, Italy
| | - S Mondello
- Department of Neurosciences, University of Messina, Messina, Italy
| | | | - G P Comi
- Neuroscience Section, Department of Pathophysiology and Transplantation (DEPT), Neurology Unit, Dino Ferrari Centre, University of Milan, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - E Pegoraro
- Neurological Clinic, University of Padova, Padova, Italy
| | - G Antonini
- Department of Neurology, Mental Health and Sensory Organs (NESMOS) Faculty of Medicine and Psychology University of Rome "Sapienza", Rome, Italy
| | | | - R Liguori
- IRCCS Istituto di Scienze Neurologiche and Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - L Morandi
- Neuroimmunology and Neuromuscular Diseases Unit, Foundation IRCCS Neurological Institute "Carlo Besta", Italy
| | - M Moggio
- Neuromuscular Unit-Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Dino Ferrari Centre University of Milan, Milan, Italy
| | - R Massa
- University of Tor Vergata, Roma, Italy
| | | | - A Di Muzio
- Centro Malattie Neuromuscolari e Centro Studi sull'Invecchiamento (CeSI), Chieti, Italy
| | - M Filosto
- University Hospital Spedali Civili, Neurological Clinic, Brescia, Italy
| | - P Tonin
- Neurological Clinic, University of Verona, Verona, Italy
| | | | - S Servidei
- Institute of Neurology, Catholic University, Rome, Italy
| | - G Siciliano
- Neurological Clinic, University of Pisa, Pisa, Italy
| | - C Angelini
- Neurological Clinic, University of Padova, Padova, Italy IRCCS S Camillo, Venice, Italy
| | - T Mongini
- Department of Neurosciences 'Rita Levi Montalcini', University of Turin, Turin, Italy
| | - A Toscano
- Department of Neurosciences, University of Messina, Messina, Italy
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8
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Sancricca C, Primiano G, Bernardo D, Sauchelli D, Cuccagna C, Servidei S. Frequency of Cerebrovascular Abnormalities in Patients with Late-Onset Pompe Disease: Our Experience. J Neuromuscul Dis 2015; 2:S55-S56. [PMID: 27858647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- C Sancricca
- Department of Neurology, Catholic University, Rome, Italy
| | - G Primiano
- Department of Neurology, Catholic University, Rome, Italy
| | - D Bernardo
- Department of Neurology, Catholic University, Rome, Italy
| | - D Sauchelli
- Department of Neurology, Catholic University, Rome, Italy
| | - C Cuccagna
- Department of Neurology, Catholic University, Rome, Italy
| | - S Servidei
- Department of Neurology, Catholic University, Rome, Italy
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9
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Sancricca C, Primiano G, Bernardo D, Sauchelli D, Cuccagna C, Servidei S. Frequency of Cerebrovascular Abnormalities in Patients with Late-Onset Pompe Disease: Our Experience. J Neuromuscul Dis 2015. [DOI: 10.3233/jnd-159049] [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: 11/15/2022]
Affiliation(s)
- C. Sancricca
- Department of Neurology, Catholic University, Rome, Italy
| | - G. Primiano
- Department of Neurology, Catholic University, Rome, Italy
| | - D. Bernardo
- Department of Neurology, Catholic University, Rome, Italy
| | - D. Sauchelli
- Department of Neurology, Catholic University, Rome, Italy
| | - C. Cuccagna
- Department of Neurology, Catholic University, Rome, Italy
| | - S. Servidei
- Department of Neurology, Catholic University, Rome, Italy
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10
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D'Amico A, Fattori F, Bellacchio E, Catteruccia M, Servidei S, Bertini E. A new de novo missense mutation in MYH2 expands clinical and genetic findings in hereditary myosin myopathies. Neuromuscul Disord 2013; 23:437-40. [PMID: 23489661 PMCID: PMC3639366 DOI: 10.1016/j.nmd.2013.02.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 02/06/2013] [Accepted: 02/11/2013] [Indexed: 11/30/2022]
Abstract
Congenital myopathy related to mutations in myosin MyHC IIa gene (MYH2) is a rare neuromuscular disease. A single dominant missense mutation has been reported so far in a family in which the affected members had congenital joint contractures at birth, external ophthalmoplegia and proximal muscle weakness. Afterward only additional 4 recessive mutations have been identified in 5 patients presenting a mild non-progressive early-onset myopathy associated with ophthalmoparesis. We report a new de novo MYH2 missense mutation in a baby affected by a congenital myopathy characterized by severe dysphagia, respiratory distress at birth and external ophthalmoplegia. We describe clinical, histopathological and muscle imaging findings expanding the clinical and genetic spectrum of MYH2-related myopathy.
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Affiliation(s)
- A D'Amico
- Laboratory of Molecular Medicine for Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
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11
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Mancuso M, Angelini C, Bertini E, Carelli V, Comi GP, Minetti C, Moggio M, Mongini T, Servidei S, Tonin P, Toscano A, Uziel G, Zeviani M, Siciliano G. Fatigue and exercise intolerance in mitochondrial diseases. Literature revision and experience of the Italian Network of mitochondrial diseases. Neuromuscul Disord 2013. [PMID: 23182644 PMCID: PMC3526786 DOI: 10.1016/j.nmd.2012.10.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Fatigue and exercise intolerance are common symptoms of mitochondrial diseases, but difficult to be clinically assessed. New methods to quantify these rather common complaints are strongly needed in the clinical practice. Coenzyme Q10 administration and aerobic exercise may improve exercise intolerance, but more definite studies are still pending. Herein, we have revised "how to measure" and "how to treat" these symptoms of mitochondrial patients. Subsequently, we reviewed the clinical data of the 1164 confirmed mitochondrial patients present in the Italian nation-wide database of mitochondrial disease, with special regard to exercise intolerance. We observed that more of 20% of mitochondrial patients complain of exercise intolerance. This symptom seems to be frequently associated with specific patient groups and/or genotypes. Ragged red fibers and COX-negative fibers are more often present in subjects with exercise intolerance, whereas lactate levels could not predict this symptom. Multicenter efforts are strongly needed for rare disorders such as mitochondrial diseases, and may represent the basis for more rigorous longitudinal studies.
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Affiliation(s)
- M Mancuso
- Neurological Clinic, University of Pisa, Italy.
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12
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Tasca G, Monforte M, Iannaccone E, Laschena F, Ottaviani P, Silvestri G, Masciullo M, Mirabella M, Servidei S, Ricci E. Muscle MRI in female carriers of dystrophinopathy. Eur J Neurol 2012; 19:1256-60. [PMID: 22583668 DOI: 10.1111/j.1468-1331.2012.03753.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Accepted: 04/02/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Duchenne muscular dystrophy carriers represent a rare condition that needs to be recognized because of the possible implications for prenatal diagnosis. Muscle biopsy is currently the diagnostic instrument of choice in sporadic patients. We wanted to verify whether muscle magnetic resonance imaging (MRI) could identify a pattern of involvement suggestive of this condition and whether it was similar to that reported in Duchenne and Becker muscular dystrophy. METHODS Evaluation of pelvic and lower limb MRI scans of 12 dystrophinopathy carriers was performed. RESULTS We found a frequent involvement of the quadratus femoris, gluteus maximus and medius, biceps femoris long head, adductor magnus, vasti and paraspinal muscles, whilst the popliteus, iliopsoas, recti abdominis, sartorius, and gracilis were relatively spared. Asymmetry was a major feature on MRI; it could be detected significantly more often than with sole clinical examination and even in patients without weakness. CONCLUSIONS The pattern we describe here is similar to that reported in Duchenne and Becker muscular dystrophy, although asymmetry represents a major distinctive feature. Muscle MRI was more sensitive than clinical examination for detecting single muscle involvement and asymmetry. Further studies are needed to verify the consistency of this pattern in larger cohorts and to assess whether muscle MRI can improve diagnostic accuracy in carriers with normal dystrophin staining on muscle biopsy.
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Affiliation(s)
- G Tasca
- Don Carlo Gnocchi Onlus Foundation, Rome, Italy.
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13
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Angelini C, Semplicini C, Ravaglia S, Bembi B, Servidei S, Pegoraro E, Moggio M, Filosto M, Sette E, Crescimanno G, Tonin P, Parini R, Morandi L, Marrosu G, Greco G, Musumeci O, Di Iorio G, Siciliano G, Donati MA, Carubbi F, Ermani M, Mongini T, Toscano A. Observational clinical study in juvenile-adult glycogenosis type 2 patients undergoing enzyme replacement therapy for up to 4 years. J Neurol 2011; 259:952-8. [PMID: 22081099 DOI: 10.1007/s00415-011-6293-5] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Revised: 10/07/2011] [Accepted: 10/12/2011] [Indexed: 11/24/2022]
Abstract
The objective of this study was to describe a large Italian cohort of patients with late-onset glycogen storage disease type 2 (GSDII) at various stages of disease progression and to evaluate the clinical effectiveness of alglucosidase alpha enzyme replacement therapy (ERT). Previous studies showed in late-onset patients ERT efficacy against placebo and variable response in uncontrolled studies. Seventy-four juvenile or adult GSDII patients were treated with ERT in a multicenter open label, non-randomized study, from 12 months up to 54 months. Recombinant human alpha glucosidase (rh-GAA) was injected by intravenous route at 20 mg/kg every second week. Patients were divided into three groups according to ERT duration: Group A received treatment for 12-23 months (n = 16), Group B for 24-35 months (n = 14), and Group C for more than 36 months (n = 44). Clinical assessment included a 6-min walk test (6MWT), forced vital capacity (FVC), the Walton and Gardner-Medwin score, the number of hours of ventilation, body mass index, echocardiography and blood creatine kinase (CK). Included in our cohort were 33 males and 41 females (M:F = 0.8:1), with a mean age at first symptoms of 28.3 years (range 2-55 years) and a mean age of 43 years at study entry (range 7-72 years). Seven wheelchair bound patients, as well as 27 patients requiring ventilation support, were included. After treatment we could observe an increase in distance walked on the 6MWT in the large majority of patients (48/58; 83%), with an overall mean increase of 63 m (from 320 ± 161 to 383 ± 178 m). After treatment in the majority of patients FVC was improved or unchanged (45/69; 65%). In ventilated patients we observed an improvement in average number of hours off the ventilator (from 15.6 to 12.1 h). Six patients stopped mechanical ventilation and two others started it. The effect of therapy was not related to ERT duration. Nine of 64 patients (13%) that underwent to echocardiography showed a variable degree of cardiac hypertrophy (left ventriculum or septum), and a positive effect was observed after 36 months of ERT in one adult case. Discontinuation of treatment occurred in four patients: one drop-off case, one patient died for a sepsis after 34 months of treatment and two patients stopped ERT for worsening of general clinical condition. Mild adverse effects were observed in four cases (5%). This study represents the largest cohort of late-onset GSDII patients treated with ERT, and confirm a positive effect of treatment. These results, obtained in a large case series on therapy, indicate a favourable effect of ERT therapy, even in more advanced stage of the disease.
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Affiliation(s)
- C Angelini
- Department of Neurosciences, University of Padova, Via Giustiniani 5, 35128, Padova, Italy.
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14
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Mancuso M, Angelini C, Bertini E, Caldarazzo Ienco E, Carelli V, Comi G, Minetti C, Mongini T, Orsucci D, Servidei S, Tonin P, Toscano A, Uziel G, Santantonio P, Siciliano G. P-9
Construction of a database for a nation-wide
Italian collaborative network of mitochondrial
diseases. ACTA MYOLOGICA 2011. [PMCID: PMC3235854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - C. Angelini
- Department of Neurosciences, University of Padua, Italy
| | - E. Bertini
- "Bambino Gesù Children's Hospital, Rome, Italy
| | | | - V. Carelli
- Department of Neurological Sciences, University of Bologna, Italy
| | - G.P. Comi
- Department of Neurological Sciences, University of Milan, Italy
| | - C. Minetti
- Department of Paediatrics, University of Genoa, Italy
| | - T. Mongini
- Centre for Neuromuscular Diseases, Department of Neuroscience, University of Turin, Italy
| | | | - S. Servidei
- Department of Neurosciences, Catholic University, Rome, Italy
| | - P. Tonin
- Neurological Institute, University of Verona, Italy
| | - A. Toscano
- Department of Neurosciences, Psychiatry and Anesthesiology, University of Messina, Italy
| | - G. Uziel
- Istituto Nazionale Neurologico "C. Besta", Milan, Italy
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15
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Angelini C, Semplicini C, Pegoraro E, Filosto M, Marrosu G, Piras R, Mongini T, Vercelli L, Tonin P, Servidei S, Di Giacopo R, Crescimanno G, Ravaglia S, Toscano A, Musumeci O, Siciliano G, Ricci G, Di Iorio, Cipullo F, Moggio M, Comi G, Lucchini V, Morandi L. O-3
Clinical features and outcome measures during
1 year enzyme replacement therapy in late
onset GSD II patients. ACTA MYOLOGICA 2011. [PMCID: PMC3235874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/30/2022]
Affiliation(s)
- C. Angelini
- University of Padova, Department of Neurosciences, Padova, Italy
| | - C. Semplicini
- University of Padova, Department of Neurosciences, Padova, Italy
| | - E. Pegoraro
- University of Padova, Department of Neurosciences, Padova, Italy
| | | | | | | | - T. Mongini
- University of Torino, Centre for Neuromuscular Diseases, Department of Neurosciences, Torino, Italy
| | - L. Vercelli
- University of Torino, Centre for Neuromuscular Diseases, Department of Neurosciences, Torino, Italy
| | | | | | | | | | | | - A. Toscano
- Department of Neurosciences, Psichiatry and Anesthesiology, University of Messina, Italy
| | - O. Musumeci
- Department of Neurosciences, Psichiatry and Anesthesiology, University of Messina, Italy
| | | | | | | | | | - M. Moggio
- Deparment of Neurological Sciences, University of Milan, Italy
| | - G. Comi
- Deparment of Neurological Sciences, University of Milan, Italy
| | - V. Lucchini
- Deparment of Neurological Sciences, University of Milan, Italy
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16
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Angelini C, Semplicini C, Ravaglia S, Bembi B, Servidei S, Moggio M, Filosto M, Sette E, Pegoraro E, Crescimanno G, Tonin P, Parini R, Morandi L, Marrosu G, Greco G, Musumeci O, Di Iorio G, Siciliano G, Donati M, Mongini T, Toscano A, Vercelli L, Di Giacopo R, Lucchini V, Tugnoli V, Rigoldi M, Piras R, Giannini F, Gasperini S, Volpi L, Diodato D, Ariatti A. I-4
Long-term follow-up effects on enzyme
replacement treatment of adult form of acid
maltase deficiency myopathy. ACTA MYOLOGICA 2011. [PMCID: PMC3235867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- C. Angelini
- Coordinators of the Italian Group on GSDII, University of Padova, Torino and Messina, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - T. Mongini
- Coordinators of the Italian Group on GSDII, University of Padova, Torino and Messina, Italy
| | - A. Toscano
- Coordinators of the Italian Group on GSDII, University of Padova, Torino and Messina, Italy
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17
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Della Marca G, Dittoni S, Catteruccia M, Frusciante R, Madia F, Losurdo A, Testani E, Vollono C, Servidei S. RESTLESS LEGS SYNDROME WITH PERIODIC LIMB MOVEMENTS: A POSSIBLE CAUSE OF IDIOPATHIC HYPERCKEMIA. Neurology 2009; 73:643-5. [DOI: 10.1212/wnl.0b013e3181b38995] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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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18
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Fasano A, Natoli GF, Cianfoni A, Ferraro D, Loria G, Bentivoglio AR, Servidei S. Acute necrotizing encephalopathy: a relapsing case in a European adult. J Neurol Neurosurg Psychiatry 2008; 79:227-8. [PMID: 17846107 DOI: 10.1136/jnnp.2007.127670] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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19
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Angelini C, Toscano A, Mongini T, Comi G, Gauthier R, Servidei S, Ravaglia S, Bruno C, Semplicini C. M.P.5.06 Protocol for enzyme replacement therapy in late-onset glycogenosis type II (GSDII). Neuromuscul Disord 2007. [DOI: 10.1016/j.nmd.2007.06.423] [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: 11/28/2022]
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20
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Bruno MK, Lee HY, Auburger GWJ, Friedman A, Nielsen JE, Lang AE, Bertini E, Van Bogaert P, Averyanov Y, Hallett M, Gwinn-Hardy K, Sorenson B, Pandolfo M, Kwiecinski H, Servidei S, Fu YH, Ptácek L. Genotype-phenotype correlation of paroxysmal nonkinesigenic dyskinesia. Neurology 2007; 68:1782-9. [PMID: 17515540 DOI: 10.1212/01.wnl.0000262029.91552.e0] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Paroxysmal nonkinesigenic dyskinesia (PNKD) is a rare disorder characterized by episodic hyperkinetic movement attacks. We have recently identified mutations in the MR-1 gene causing familial PNKD. METHODS We reviewed the clinical features of 14 kindreds with familial dyskinesia that was not clearly induced by movement or during sleep. Of these 14 kindreds, 8 had MR-1 mutations and 6 did not. RESULTS Patients with PNKD with MR-1 mutations had their attack onset in youth (infancy and early childhood). Typical attacks consisted of a mixture of chorea and dystonia in the limbs, face, and trunk, and typical attack duration lasted from 10 minutes to 1 hour. Caffeine, alcohol, and emotional stress were prominent precipitants. Attacks had a favorable response to benzodiazepines, such as clonazepam and diazepam. Attacks in families without MR-1 mutations were more variable in their age at onset, precipitants, clinical features, and response to medications. Several were induced by persistent exercise. CONCLUSIONS Paroxysmal nonkinesigenic dyskinesia (PNKD) should be strictly defined based on age at onset and ability to precipitate attacks with caffeine and alcohol. Patients with this clinical presentation (which is similar to the phenotype initially reported by Mount and Reback) are likely to harbor myofibrillogenesis regulator 1 (MR-1) gene mutations. Other "PNKD-like" families exist, but atypical features suggests that these subjects are clinically distinct from PNKD and do not have MR-1 mutations. Some may represent paroxysmal exertional dyskinesia.
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Affiliation(s)
- M K Bruno
- Department of Neurology, University of California, San Francisco, CA 94158, USA
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21
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Miller TM, Dias da Silva MR, Miller HA, Kwiecinski H, Mendell JR, Tawil R, McManis P, Griggs RC, Angelini C, Servidei S, Petajan J, Dalakas MC, Ranum LPW, Fu YH, Ptácek LJ. Correlating phenotype and genotype in the periodic paralyses. Neurology 2005; 63:1647-55. [PMID: 15534250 DOI: 10.1212/01.wnl.0000143383.91137.00] [Citation(s) in RCA: 178] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Periodic paralyses and paramyotonia congenita are rare disorders causing disabling weakness and myotonia. Mutations in sodium, calcium, and potassium channels have been recognized as causing disease. OBJECTIVE To analyze the clinical phenotype of patients with and without discernible genotype and to identify other mutations in ion channel genes associated with disease. METHODS The authors have reviewed clinical data in patients with a diagnosis of hypokalemic periodic paralysis (56 kindreds, 71 patients), hyperkalemic periodic paralysis (47 kindreds, 99 patients), and paramyotonia congenita (24 kindreds, 56 patients). For those patients without one of the classically known mutations, the authors analyzed the entire coding region of the SCN4A, KCNE3, and KCNJ2 genes and portions of the coding region of the CACNA1S gene in order to identify new mutations. RESULTS Mutations were identified in approximately two thirds of kindreds with periodic paralysis or paramyotonia congenita. The authors found differences between the disorders and between those with and without identified mutations in terms of age at onset, frequency of attacks, duration of attacks, fixed proximal weakness, precipitants of attacks, myotonia, electrophysiologic studies, serum potassium levels, muscle biopsy, response to potassium administration, and response to treatment with acetazolamide. CONCLUSIONS Hypokalemic periodic paralysis, hyperkalemic periodic paralysis, and paramyotonia congenita may be distinguished based on clinical data. This series of 226 patients (127 kindreds) confirms some clinical features of this disorder with notable exceptions: In this series, patients without mutations had a less typical clinical presentation including an older age at onset, no changes in diet as a precipitant, and absence of vacuolar myopathy on muscle biopsy.
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Affiliation(s)
- T M Miller
- Department of Neurology, University of California San Francisco 94143-2922, USA
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22
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Diaco M, Ancarini F, Montalto M, Verrechia E, Evoli A, Servidei S, Gasbarrini G, Manna R. Association of myasthenia gravis and antisynthetase syndrome: a case report. Int J Immunopathol Pharmacol 2005; 17:395-9. [PMID: 15461874 DOI: 10.1177/039463200401700320] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Myasthenia gravis is a chronic disease of neuromuscular transmission caused by loss of acetylcholine receptors. It can be found in association with other autoimmune disorders. We report the case of a 47-yr-old woman affected by Myasthenia gravis who complained of fever, progressive weakness of proximal limb muscle, arthritis and Raynauds phenomenon and dyspnea. Chest X-rays and CT scan showed an interstitial lung disease; laboratory data indicated an inflammatory picture and increased serum muscle enzymes. Evaluation for infectious, metabolic, iatrogenic and neoplastic aetiologies was unrevealing. The patients clinical condition together with positive results on antisynthetase antibody assay lead to the diagnosis of antisynthetase syndrome. To our knowledge, this is the first report on the association of Myasthenia gravis with antisynthetase syndrome.
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Affiliation(s)
- M Diaco
- Department of Internal Medicine, Catholic University, Rome, Italy
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23
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D'Amico A, Tessa A, Sabino A, Bertini E, Santorelli FM, Servidei S. Incomplete penetrance in an SPG3A-linked family with a new mutation in the atlastin gene. Neurology 2004; 62:2138-9. [PMID: 15184642 DOI: 10.1212/01.wnl.0000127698.88895.85] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- A D'Amico
- Department of Neuroscience, Catholic University, Rome, Italy
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24
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Lamperti C, Naini A, Hirano M, De Vivo DC, Bertini E, Servidei S, Valeriani M, Lynch D, Banwell B, Berg M, Dubrovsky T, Chiriboga C, Angelini C, Pegoraro E, DiMauro S. Cerebellar ataxia and coenzyme Q10 deficiency. Neurology 2003; 60:1206-8. [PMID: 12682339 DOI: 10.1212/01.wnl.0000055089.39373.fc] [Citation(s) in RCA: 160] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The authors measured coenzyme Q10 (CoQ10) concentration in muscle biopsies from 135 patients with genetically undefined cerebellar ataxia. Thirteen patients with childhood-onset ataxia and cerebellar atrophy had markedly decreased levels of CoQ10. Associated symptoms included seizures, developmental delay, mental retardation, and pyramidal signs. These findings confirm the existence of an ataxic presentation of CoQ10 deficiency, which may be responsive to CoQ10 supplementation.
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Affiliation(s)
- C Lamperti
- Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA
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26
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Broccolini A, Pescatori M, D'Amico A, Sabino A, Silvestri G, Ricci E, Servidei S, Tonali PA, Mirabella M. An Italian family with autosomal recessive inclusion-body myopathy and mutations in the GNE gene. Neurology 2002; 59:1808-9. [PMID: 12473780 DOI: 10.1212/01.wnl.0000031808.04545.e0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- A Broccolini
- Institute of Neurology, Catholic University, Rome, Italy.
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27
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Uncini A, Galluzzi G, Di Muzio A, De Angelis MV, Ricci E, Scoppetta C, Servidei S. Facioscapulohumeral muscular dystrophy presenting isolated monomelic lower limb atrophy. Report of two patients with and without 4q35 rearrangement. Neuromuscul Disord 2002; 12:874-7. [PMID: 12398841 DOI: 10.1016/s0960-8966(02)00027-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Facioscapulohumeral muscular dystrophy has a distinctive regional distribution but variable clinical expression and may be markedly asymmetrical. We report two patients presenting weakness and wasting confined to a single lower limb. Creatine kinase was slightly increased, electromyogram and muscle biopsy were myopathic. Muscle computed tomography showed normal shoulder, mid-arm, pelvic and mid-thigh scans but involvement of calf muscles. In both cases, weakness of facial and periscapular muscles was found in other family members unaware of the disease. Molecular analysis showed 4q35 deletion in one family. These cases broaden the presentation of facioscapulohumeral muscular dystrophy to include isolated monomelic atrophy of lower limb with calf muscle involvement.
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Affiliation(s)
- A Uncini
- Centre for Neuromuscular Disease, University "G. d'Annunzio,", Chieti, Italy
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Mongini T, Doriguzzi C, Chiadò-Piat L, Silvestri G, Servidei S, Palmucci L. MERRF/MELAS overlap syndrome in a family with A3243G mtDNA mutation. Clin Neuropathol 2002; 21:72-6. [PMID: 12005255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Four members of a family were found to carry the A3243G mtDNA mutation. Clinical features varied from typical MELAS to myoclonic epilepsy to simple deafness without neurological signs. Several other members of the family had symptoms consistent with a mitochondrial disease. Muscle biopsy in 3 of the 4 patients showed the most prominent mitochondrial alterations with partial deficiency of cytochrome c oxidase in the case with the mildest phenotype. Mitochondrial DNA analysis detected a variable percentage of A3243G mutation, roughly correlating with the phenotype. The interesting feature of the family lies in the great intrafamilial variability of the severity of clinical expression, encompassing MELAS and MERRF features, associated with the A3243G mtDNA mutation. A search for the most common mtDNA mutations is recommended in all patients featuring incomplete MELAS or MERRF syndromes and in all familial cases presenting minimal clinical signs.
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Affiliation(s)
- T Mongini
- Paolo Peirolo Centre for Neuromuscular Diseases, Department of Neurosciences, University of Turin, Italy.
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Affiliation(s)
- S Servidei
- Department of Neurology, Policlinico Gemelli, Rome, Italy
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31
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Di Giovanni S, Mirabella M, Spinazzola A, Crociani P, Silvestri G, Broccolini A, Tonali P, Di Mauro S, Servidei S. Coenzyme Q10 reverses pathological phenotype and reduces apoptosis in familial CoQ10 deficiency. Neurology 2001; 57:515-8. [PMID: 11502923 DOI: 10.1212/wnl.57.3.515] [Citation(s) in RCA: 126] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Two brothers with myopathic coenzyme Q10 (CoQ10) deficiency responded dramatically to CoQ10 supplementation. Muscle biopsies before therapy showed ragged-red fibers, lipid storage, and complex I + III and II + III deficiency. Approximately 30% of myofibers had multiple features of apoptosis. After 8 months of treatment, excessive lipid storage resolved, CoQ10 level normalized, mitochondrial enzymes increased, and proportion of fibers with TUNEL-positive nuclei decreased to 10%. The authors conclude that muscle CoQ10 deficiency can be corrected by supplementation of CoQ10, which appears to stimulate mitochondrial proliferation and to prevent apoptosis.
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Affiliation(s)
- S Di Giovanni
- Institute of Neurology, Catholic University, Rome, Italy
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32
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Cicconi V, Carloni E, Franceschi F, Nocente R, Silveri NG, Manna R, Servidei S, Bentivoglio AR, Gasbarrini A, Gasbarrini G. Disappearance of antiphospholipid antibodies syndrome after Helicobacter pylori eradication. Am J Med 2001; 111:163-4. [PMID: 11501549 DOI: 10.1016/s0002-9343(01)00738-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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33
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Di Giovanni S, Mirabella M, Papacci M, Odoardi F, Silvestri G, Servidei S. Apoptosis and ROS detoxification enzymes correlate with cytochrome c oxidase deficiency in mitochondrial encephalomyopathies. Mol Cell Neurosci 2001; 17:696-705. [PMID: 11312605 DOI: 10.1006/mcne.2001.0970] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this work was to investigate in muscle the role of apoptosis and of oxidative stress in mitochondrial disorders with dysfunction of respiratory chain. In patients with cytochrome c oxidase deficiency (COX) we found a variable number of myofibers with apoptotic nuclei that matched with the level of enzymatic reduction and roughly correlated with muscle weakness. In parallel, a positive immunostaining for apoptosis-related proteins and Mn and Cu/Zn superoxide dismutase (SOD) were mostly localized in COX-negative fibers. Moreover, glutathione peroxidase activity was increased in muscles with high number of SOD-positive myofibers and prominent apoptotic features. No signs of apoptosis were observed in patients with deficiencies of complexes I and II and without muscle weakness. These data suggest that apoptosis along with increased ROS production, revealed by anti-oxidant enzymes overexpression, may play an important role in the pathophysiology of mitochondrial diseases associated with COX deficiency.
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Affiliation(s)
- S Di Giovanni
- Institute of Neurology, Catholic University, Largo A. Gemelli 8, Rome, 00168, Italy
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Malferrari G, Mirabella M, D'Alessandra Y, Servidei S, Biunno I. Deletion polymorphism of DNASE1L1, an X-linked DNase I-like gene, in acid maltase deficiency disorders. Exp Mol Pathol 2001; 70:173-4. [PMID: 11263960 DOI: 10.1006/exmp.2001.2374] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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35
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Affiliation(s)
- S Servidei
- Department of Neurology, Policlinico Gemelli, Rome, Italy
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36
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Servidei S. Mitochondrial encephalomyopathies: gene mutation. Neuromuscul Disord 2000; 10:X-XV. [PMID: 11183557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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37
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Sangiuolo F, Bruscia E, Capon F, Servidei S, Dallapiccola B, Novelli G. Fine mapping of a distinctive autosomal dominant vacuolar neuromyopathy using 11 novel microsatellite markers from chromosome band 19p13.3. Eur J Hum Genet 2000; 8:809-12. [PMID: 11039585 DOI: 10.1038/sj.ejhg.5200547] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
We previously mapped a distinctive autosomal dominant vacuolar neuromyopathy on human chromosome 19p13 in an 8cM region, delimited by D19S209 and D19S177 markers. We now report the fine mapping of the disease locus within an interval of 250 Kb by haplotype analysis performed using a set of 11 novel microsatellite markers isolated from the candidate region.
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Affiliation(s)
- F Sangiuolo
- Dipartimento di Biopatologia e Diagnostica per Immagini, Sezione di Genetica, Università Tor Vergata Rome, Italy
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38
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Abstract
OBJECTIVE To investigate the role of apoptosis in acute quadriplegic myopathy. BACKGROUND Acute quadriplegic myopathy is a muscular disease characterized by diffuse flaccid weakness occurring in patients with severe systemic illness and exposure to corticosteroids or neuroblocking agents. Myofiber atrophy and thick filament loss are the distinguishing pathologic features on muscle biopsy. Increased calpains expression and lysosomal and nonlysosomal proteolytic pathways have been claimed as possible pathogenic factors. Nevertheless, the mechanisms leading to myofiber atrophy and thick filament loss need further investigation. PATIENTS AND METHODS The expression of ubiquitin and proapoptotic proteases as well as DNA fragmentation in muscle biopsies from three patients with acute quadriplegic myopathy were studied. RESULTS All patients exhibited an important overexpression of caspases, calpain, cathepsin B, and ubiquitin, and the presence of numerous apoptotic nuclei in over 70% of myofibers. CONCLUSIONS These data suggest that apoptosis mediated by proteolytic proteases may play a role in the pathogenesis of acute quadriplegic myopathy.
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Affiliation(s)
- S Di Giovanni
- Institute of Neurology, Catholic University, Rome, Italy
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39
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Silvestri G, Rana M, Odoardi F, Modoni A, Paris E, Papacci M, Tonali P, Servidei S. Single-fiber PCR in MELAS(3243) patients: correlations between intratissue distribution and phenotypic expression of the mtDNA(A3243G) genotype. Am J Med Genet 2000; 94:201-6. [PMID: 10995506 DOI: 10.1002/1096-8628(20000918)94:3<201::aid-ajmg5>3.0.co;2-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We performed morphological, biochemical, and genetic studies, including single-fiber PCR (sf PCR), on muscle biopsies obtained from a mother and daughter with MELAS syndrome due to the A3243G transition of mitochondrial DNA (mtDNA). The severity of muscle involvement appeared quite distinct, in spite of the fact that both patients segregated similar mutant mtDNA levels on total muscle DNA. The daughter did not show any clinical muscle involvement: muscle biopsy revealed many ragged red fibers (RRFs) mostly positive for cytochrome-c oxidase (COX) activity. In contrast, her mother had developed a generalized myopathy without progressive external ophthalmoplegia (PEO), morphologically characterized by many COX-negative RRFs. Single-muscle fiber PCR demonstrated in both patients significantly higher percentages of wild-type mtDNA in normal fibers (daughter: 23.25 +/- 15.22; mother: 43.13 +/- 26.11) than in COX-positive RRFs (daughter: 11.25 +/- 5.22, P < 0.005; mother: 9.12 +/- 5.9, P < 0.001) and in COX-negative RRFs (daughter: 8.9 +/- 4.2, P < 0.001 mother: 4.8 +/- 2.8, P < 0.001). Wild-type mtDNA levels resulted higher also in COX-positive vs. COX-negative RRFs (daughter: P < 0.05; mother: P < 0.001). Our data confirm a direct correlation between A3243G levels and impairment of COX function at the single-muscle fiber level. Moreover, the evidence of a clinical myopathy in the patient with higher amounts of COX-negative RRFs bolsters the concept that a differential distribution of mutant mtDNAs at the cellular level may have effects on the clinical involvement of individual tissues. However, the occurrence of a similar morphological and biochemical muscle phenotype also in PEO(3243) patients suggests that other genetic factors involved in the interaction between mitochondrial and nuclear DNA, rather than the stochastic distribution of mtDNA genomes during embryogenesis, are primarily implicated in determining the various clinical expressions of the A3243G of mtDNA.
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Affiliation(s)
- G Silvestri
- Neurological Institute, Catholic University, Rome, Italy
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40
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Siciliano M, De Candia E, Ballarin S, Vecchio FM, Servidei S, Annese R, Landolfi R, Rossi L. Hepatocellular carcinoma complicating liver cirrhosis in type IIIa glycogen storage disease. J Clin Gastroenterol 2000; 31:80-2. [PMID: 10914784 DOI: 10.1097/00004836-200007000-00020] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Type III glycogen storage disease (GSD III) is an autosomal recessive disorder characterized by the accumulation of abnormal glycogen in the liver and, in most patients, in the muscle. Although liver fibrosis is a well-known consequence of GSD III, until now only eight cases of liver cirrhosis and two cases of hepatocellular carcinoma have been described in patients affected by this disease. In this case report, the authors describe the clinical history of a patient affected by GSD III who developed severe liver disease during her adult life, progressing from fibrosis to cirrhosis and finally to hepatocellular carcinoma. Until now, the hepatic involvement in GSD III has been considered by most authors as mild and almost always self-limiting. This report, together with the previously published cases, clearly indicates that severe and progressive liver disease may complicate this metabolic disorder. These observations advise a careful hepatologic follow-up of patients affected by GSD III.
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Affiliation(s)
- M Siciliano
- Istituto di Patologia Medica, Facoltà di Medicina e Chirurgia Università Cattolica del Sacro Cuore, Roma, Italy
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41
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Piluso G, Mirabella M, Ricci E, Belsito A, Abbondanza C, Servidei S, Puca AA, Tonali P, Puca GA, Nigro V. Gamma1- and gamma2-syntrophins, two novel dystrophin-binding proteins localized in neuronal cells. J Biol Chem 2000; 275:15851-60. [PMID: 10747910 DOI: 10.1074/jbc.m000439200] [Citation(s) in RCA: 109] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Dystrophin is the scaffold of a protein complex, disrupted in inherited muscular dystrophies. At the last 3' terminus of the gene, a protein domain is encoded, where syntrophins are tightly bound. These are a family of cytoplasmic peripheral membrane proteins. Three genes have been described encoding one acidic (alpha1) and two basic (beta1 and beta2) proteins of approximately 57-60 kDa. Here, we describe the characterization of two novel putative members of the syntrophin family, named gamma1- and gamma2-syntrophins. The human gamma1-syntrophin gene is composed of 19 exons and encodes a brain-specific protein of 517 amino acids. The human gamma2-syntrophin gene is composed of at least 17 exons, and its transcript is expressed in brain and, to a lesser degree, in other tissues. We mapped the gamma1-syntrophin gene to human chromosome 8q11 and the gamma2-syntrophin gene to chromosome 2p25. Yeast two-hybrid experiments and pull-down studies showed that both proteins can bind the C-terminal region of dystrophin and related proteins. We raised antibodies against these proteins and recognized expression in both rat and human central neurons, coincident with RNA in situ hybridization of adjacent sections. Our present findings suggest a differentiated role of a modified dystrophin-associated complex in the central nervous system.
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Affiliation(s)
- G Piluso
- Istituto di Patologia Generale ed Oncologia, Facoltà di Medicina, Seconda Università degli Studi di Napoli, 80138 Napoli, Italy
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42
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Silvestri G, Mongini T, Odoardi F, Modoni A, deRosa G, Doriguzzi C, Palmucci L, Tonali P, Servidei S. A new mtDNA mutation associated with a progressive encephalopathy and cytochrome c oxidase deficiency. Neurology 2000; 54:1693-6. [PMID: 10762520 DOI: 10.1212/wnl.54.8.1693] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The authors describe a novel pathogenic G5540A transition in the mitochondrial transfer RNA (tRNA)Trp gene of a sporadic encephalomyopathy characterized by spinocerebellar ataxia. Clinical features also included neurosensorial deafness, peripheral neuropathy, and dementia. Biochemistry revealed a severe reduction of cytochrome c oxidase (COX) activity. Single-fiber PCR demonstrated higher levels of mutant genomes in COX-negative ragged red fibers than in normal fibers. These findings confirm that COX is more susceptible than other respiratory chain complexes to mutations in the mitochondrial tRNATrp gene.
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Affiliation(s)
- G Silvestri
- Neurological Institute, Catholic University, Rome, Italy
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43
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Mirabella M, Christodoulou K, Di Giovanni S, Ricci E, Tonali P, Servidei S. An Italian family with autosomal recessive quadriceps-sparing inclusion-body myopathy (ARQS-IBM) linked to chromosome 9p1. Neurol Sci 2000; 21:99-102. [PMID: 10938188 DOI: 10.1007/s100720070103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We report an Italian family with autosomal recessive quadriceps-sparing inclusion-body myopathy (ARQS-IBM). The patients (two second cousins) developed a slowly progressive distal and proximal myopathy with complete sparing of the quadriceps. Muscle biopsy showed rimmed vacuoles in numerous muscle fibers, and electron microscopy documented accumulation of 15-21 nm filaments. DNA analysis established linkage to 9p1 and haplotype analysis revealed that the patients shared a recombined common haplotype. The gene locus of ARQS-IBM was initially mapped to chromosome 9p1-q1 in families of Iranian-Jewish origin and later confirmed in a few other ethnic groups. This is the first report of Italian patients with ARQS-IBM showing positive linkage to chromosome 9p1. Our data suggest that patients having distal and proximal myopathy with rimmed vacuoles and possible recessive inheritance, often classified as distal myopathies, should be thoroughly investigated according to the diagnostic criteria of h-IBM and, when positive, studied for linkage to chromosome 9p1.
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Affiliation(s)
- M Mirabella
- Institute of Neurology, Catholic University, Policlinico Gemelli, Rome, Italy
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44
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Mirabella M, Silvestri G, de Rosa G, Di Giovanni S, Di Muzio A, Uncini A, Tonali P, Servidei S. GCG genetic expansions in Italian patients with oculopharyngeal muscular dystrophy. Neurology 2000; 54:608-14. [PMID: 10680791 DOI: 10.1212/wnl.54.3.608] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To screen Italian patients with oculopharyngeal muscular dystrophy (OPMD) for GCG repeat expansions in the Poly(A) binding-protein 2 (PABP2) gene. BACKGROUND Oculopharyngeal muscular dystrophy is an adult-onset autosomal dominant muscle disease linked to 14q11 pathologically characterized by unique 8.5 nm intranuclear filaments in skeletal muscle fibers. Short expansions of a (GCG)6 repeat located in exon 1 of the newly isolated PABP2 gene have been demonstrated in a large number of OPMD families. METHODS We studied 18 patients diagnosed with OPMD. A muscle biopsy was performed in 16 patients. Screening for the pathologic expansion was performed on a PCR amplified DNA fragment encompassing the GCG repeat. RESULTS Heterozygous (GCG)-repeat expansions were detected in 13 patients in association with (GCG)6 normal allele or (GCG)7 polymorphic allele. All the patients whose muscle biopsy showed typical 8.5 nm intranuclear filaments had a mutated PABP2 allele. Five patients with no intranuclear filaments were homozygous for the normal (GCG)6 allele. The pathologic expansion appeared to be stable with no variation among family members and between different tissues as blood and skeletal muscle in the same individual. CONCLUSIONS These data 1) further confirm PABP2 gene analysis as a valuable tool in OPMD diagnosis; 2) indicate that PABP2 gene mutations are always present among Italian patients with morphologically proven OPMD, suggesting genetic homogeneity of the disease; and 3) strengthen the putative role of mutated PABP2 protein in filamentous inclusions accumulation.
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Affiliation(s)
- M Mirabella
- Department of Neurology, Catholic University, Rome, Italy
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45
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Servidei S. Mitochondrial encephalomyopathies: gene mutation. Vol. 10 No. 2, February 2000. Neuromuscul Disord 2000; 10:IX-XIII. [PMID: 10714594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Affiliation(s)
- S Servidei
- Department of Neurology, Policlinico Gemelli, Rome, Italy
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46
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Mirabella M, Di Giovanni S, Silvestri G, Tonali P, Servidei S. Apoptosis in mitochondrial encephalomyopathies with mitochondrial DNA mutations: a potential pathogenic mechanism. Brain 2000; 123 ( Pt 1):93-104. [PMID: 10611124 DOI: 10.1093/brain/123.1.93] [Citation(s) in RCA: 91] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Mitochondrial encephalomyopathies caused by mitochondrial DNA (mtDNA) defects are a genetically and phenotypically heterogeneous group of disorders. The site, percentage and distribution of mutations do not explain the overall clinical heterogeneity that is found. Apoptosis (programmed cell death) is an evolutionarily conserved mechanism that is essential for tissue development and homeostasis. Dysregulation of apoptosis has been implicated in the pathogenesis of various human diseases, such as cancer and autoimmune and neurodegenerative disorders. Recent in vitro evidence has indicated the central role of mitochondria in the apoptotic process. We investigated the occurrence of apoptosis in muscle biopsies of 36 patients carrying different mtDNA mutations and four patients with inclusion body myositis and mitochondrial abnormalities. Apoptotic features, mainly localized in cytochrome c oxidase-negative fibres, were observed in muscle fibres of patients carrying a high percentage of single mtDNA deletions (>40%) and of tRNA point mutations (>70%). By contrast, no apoptotic changes were observed in inclusion body myositis and in patients carrying mutations of mtDNA structural genes. Our study suggests that apoptosis is not simply a means whereby cells with dysfunctional mitochondria are eliminated, but that it seems to play a role in the pathogenesis of mitochondrial disorders associated with mtDNA defects affecting mitochondrial protein synthesis. The imbalance and relative abundances of nuclear-encoded and mtDNA-encoded subunits may favour cytochrome c inactivation and release. Cytochrome c, together with respiratory chain dysfunction, could activate apoptotic pathways that, in turn, inhibit the rate of mitochondrial translation and the importation of nuclear-encoded mitochondrial protein precursors. This vicious circle may amplify the biochemical defects and tissue damage and contribute to the modulation of clinical features.
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Affiliation(s)
- M Mirabella
- Institute of Neurology, Catholic University, Rome, Italy
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47
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Servidei S. Mitochondrial encephalomyopathies: gene mutation. Neuromuscul Disord 2000; 10:XVI-XXIV. [PMID: 10677871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Affiliation(s)
- S Servidei
- Department of Neurology, Policlinico Gemelli, Rome, Italy
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48
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Servidei S. Mitochondrial encephalomyopathies: gene mutation. Neuromuscul Disord 1999; 9:IX-XIV. [PMID: 10619723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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49
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Servidei S. Mitochondrial encephalomyopathies: gene mutation. Neuromuscul Disord 1999; 9:IX-XIII. [PMID: 10545054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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50
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Servidei S, Capon F, Spinazzola A, Mirabella M, Semprini S, de Rosa G, Gennarelli M, Sangiuolo F, Ricci E, Mohrenweiser HW, Dallapiccola B, Tonali P, Novelli G. A distinctive autosomal dominant vacuolar neuromyopathy linked to 19p13. Neurology 1999; 53:830-7. [PMID: 10489050 DOI: 10.1212/wnl.53.4.830] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To characterize a kindred with a distinctive autosomal dominant neuromuscular disorder. BACKGROUND The authors studied a large Italian family affected by a progressive neuromyopathy. Ten individuals over three generations were affected. The disease was characterized by onset from the late teens to early 50s with distal leg weakness and atrophy, development of generalized muscle weakness with distal-to-proximal progression sparing facial and ocular muscles, dysphonia and dysphagia, pes cavus and areflexia, variable clinical expression ranging from subclinical myopathy to severely disabling weakness, and mixed neurogenic and myopathic abnormalities on electromyography. METHODS Morphologic, immunocytochemical, and ultrastructural studies were performed in muscle biopsies from three affected patients. A genomewide linkage analysis through the genotyping of 292 microsatellite markers spanning the 22 autosomes was undertaken to map the disorder segregating in this family. RESULTS All muscle biopsies showed variation of fiber size, panesterase-positive angular fibers, mild to severe fibrosis, and numerous "rimmed vacuoles." Electron microscopy failed to demonstrate the nuclear or cytoplasmic filamentous inclusions specific of inclusion-body myopathies and, accordingly, immunohistochemistry did not show any positivity with SMI-31 antibodies detecting hyperphosphorylated tau. Preliminary analysis of 292 microsatellite markers provided evidence for linkage to chromosome 19p13. CONCLUSIONS This distinctive autosomal dominant disorder is characterized by a vacuolar neuromyopathy. Localization to chromosome 19p13 will allow the genetic relationship between this disease and inherited myopathies with rimmed vacuoles, in particular autosomal dominant inclusion-body myopathies, to be defined.
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Affiliation(s)
- S Servidei
- Institute of Neurology, Catholic University and U.I.L.D.M., Rome, Italy
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