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Perosanz A, Martínez O, Espinosa-Blanco P, García I, Al-Rashaida M, López-Paz JF. Comparative analysis of emotional facial expression recognition and empathy in children with prader-willi syndrome and autism spectrum disorder. BMC Psychol 2024; 12:94. [PMID: 38395942 PMCID: PMC10893661 DOI: 10.1186/s40359-024-01590-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Prader-Willi Syndrome (PWS) is a rare neurodevelopmental disorder that is often comorbid with Autism Spectrum Disorder (ASD). Due to the close association between these two conditions, and recognizing that Theory of Mind (ToM) is related to social behaviors in ASD, there is a growing interest in studying the reciprocity of social communication between these two groups. METHOD The primary objective of this study was to compare how children (n = 45) with PWS (n = 15), ASD (n = 15), and a control group (n = 15) respond to emotion recognition of facial expressions and empathy, which are both concepts related to ToM. The study utilized two tools named FEEL and Deusto-e-Motion 1.0. We also evaluated the Working Memory index of the WISC-IV scale, the Social Perception domain of the NEPSY-II battery, and the SCQ in both clinical groups. RESULTS Our findings suggest that individuals with PWS exhibit lower accuracy in recognizing facial expressions and empathy compared to the control group. Both clinical groups exhibited a delayed reaction time compared to the control group. Children with PWS display difficulties in recognizing emotions of disgust and surprise. In terms of cognitive empathy, children with PWS showed a greater inclination to respond to disgust as compared to children with ASD. CONCLUSIONS This study represents the initial stage in comprehending the emotional and empathetic abilities of children with PWS and ASD. The findings can provide valuable insights for developing future interventions.
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Affiliation(s)
- Ane Perosanz
- Faculty of Health Sciences, Department of Psychology, University of Deusto, Avenida de las Universidades, 24, 48007, Bilbao, Biscay, Spain.
| | - Oscar Martínez
- Faculty of Health Sciences, Department of Psychology, University of Deusto, Avenida de las Universidades, 24, 48007, Bilbao, Biscay, Spain
| | - Patricia Espinosa-Blanco
- Faculty of Health Sciences, Department of Psychology, University of Deusto, Avenida de las Universidades, 24, 48007, Bilbao, Biscay, Spain
| | - Irune García
- Faculty of Health Sciences, Department of Psychology, University of Deusto, Avenida de las Universidades, 24, 48007, Bilbao, Biscay, Spain
| | - Mohammad Al-Rashaida
- College of Education, Department of Special Education, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Juan Francisco López-Paz
- Faculty of Health Sciences, Department of Psychology, University of Deusto, Avenida de las Universidades, 24, 48007, Bilbao, Biscay, Spain
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van Abswoude DH, Pellikaan K, Nguyen N, Rosenberg AGW, Davidse K, Hoekstra FME, Rood IM, Poitou C, Grugni G, Høybye C, Markovic TP, Caixàs A, Crinò A, van den Berg SAA, van der Lely AJ, de Graaff LCG. Corrigendum: Kidney disease in adults with Prader-Willi syndrome: international cohort study and systematic literature review. Front Endocrinol (Lausanne) 2024; 15:1357219. [PMID: 38318297 PMCID: PMC10839894 DOI: 10.3389/fendo.2024.1357219] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/04/2024] [Indexed: 02/07/2024] Open
Abstract
[This corrects the article DOI: 10.3389/fendo.2023.1168648.].
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Affiliation(s)
- Denise H van Abswoude
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Center for Adults with Rare Genetic Syndromes, Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Dutch Center of Reference for Prader-Willi Syndrome, Rotterdam, Netherlands
- Academic Center for Growth Disorders, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Karlijn Pellikaan
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Center for Adults with Rare Genetic Syndromes, Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Dutch Center of Reference for Prader-Willi Syndrome, Rotterdam, Netherlands
- Academic Center for Growth Disorders, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Naomi Nguyen
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Anna G W Rosenberg
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Center for Adults with Rare Genetic Syndromes, Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Dutch Center of Reference for Prader-Willi Syndrome, Rotterdam, Netherlands
- Academic Center for Growth Disorders, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Kirsten Davidse
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Center for Adults with Rare Genetic Syndromes, Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Dutch Center of Reference for Prader-Willi Syndrome, Rotterdam, Netherlands
- Academic Center for Growth Disorders, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Franciska M E Hoekstra
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Internal Medicine, Division of Nephrology, Reinier de Graaf Gasthuis, Delft, Netherlands
| | - Ilse M Rood
- Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Christine Poitou
- Assistance Publique-Hôpitaux de Paris, Rare Diseases Center of Reference 'Prader-Willi Syndrome and Obesity with Eating Disorders' (PRADORT), Nutrition Department, Institute of Cardiometabolism and Nutrition (ICAN), Pitié-Salpêtrière Hospital, Sorbonne Université, National Institute of Health and Medical Research (INSERM), Nutriomics, Paris, France
- International Network for Research, Management & Education on adults with Prader-Willi Syndrome (INfoRMEd-PWS)
- European Reference Network on Rare Endocrine Conditions (ENDO-ERN)
| | - Graziano Grugni
- International Network for Research, Management & Education on adults with Prader-Willi Syndrome (INfoRMEd-PWS)
- European Reference Network on Rare Endocrine Conditions (ENDO-ERN)
- Division of Auxology, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Piancavallo, Italy
| | - Charlotte Høybye
- International Network for Research, Management & Education on adults with Prader-Willi Syndrome (INfoRMEd-PWS)
- European Reference Network on Rare Endocrine Conditions (ENDO-ERN)
- Department of Molecular Medicine and Surgery, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
- Department of Endocrinology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - Tania P Markovic
- International Network for Research, Management & Education on adults with Prader-Willi Syndrome (INfoRMEd-PWS)
- Metabolism & Obesity Service, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- Charles Perkins Center and Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Assumpta Caixàs
- International Network for Research, Management & Education on adults with Prader-Willi Syndrome (INfoRMEd-PWS)
- Department of Endocrinology and Nutrition, Parc Tauli Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT) Instituto de Salud Carlos III (CERCA-ISCIII), Sabadell, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Antonino Crinò
- International Network for Research, Management & Education on adults with Prader-Willi Syndrome (INfoRMEd-PWS)
- Reference Center for Prader-Willi syndrome, Bambino Gesù Hospital, Research Institute, Palidoro, Italy
- Center for Rare Diseases and Congenital Defects, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Sjoerd A A van den Berg
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Clinical Chemistry, Erasmus Medical Center (MC), University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Aart J van der Lely
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Center for Adults with Rare Genetic Syndromes, Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Academic Center for Growth Disorders, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Laura C G de Graaff
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Center for Adults with Rare Genetic Syndromes, Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Dutch Center of Reference for Prader-Willi Syndrome, Rotterdam, Netherlands
- Academic Center for Growth Disorders, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- European Reference Network on Rare Endocrine Conditions (ENDO-ERN)
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van Abswoude DH, Pellikaan K, Nguyen N, Rosenberg AGW, Davidse K, Hoekstra FME, Rood IM, Poitou C, Grugni G, Høybye C, Markovic TP, Caixàs A, Crinò A, van den Berg SAA, van der Lely AJ, de Graaff LCG. Kidney disease in adults with Prader-Willi syndrome: international cohort study and systematic literature review. Front Endocrinol (Lausanne) 2023; 14:1168648. [PMID: 37547314 PMCID: PMC10402738 DOI: 10.3389/fendo.2023.1168648] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
Background Prader-Willi syndrome (PWS) is a rare, complex, genetic disorder characterized by hyperphagia, hypotonia, delayed psychomotor development, low muscle mass and hypothalamic dysfunction. Adults with PWS often have obesity, hypertension and type 2 diabetes mellitus (DM2), known risk factors for cardiovascular disease (CVD) and chronic kidney disease (CKD). Early symptoms of CVD and CKD may be masked by intellectual disability and inability to express physical complaints. Furthermore, kidney diseases are often asymptomatic. Therefore, renal and cardiovascular disease might be missed in patients with PWS. Microalbuminuria is an early sign of microvascular damage in the kidneys and other vascular beds. Therefore, we screened our adult PWS cohort for the presence of elevated urinary albumin and (micro)albuminuria. Methods We retrospectively collected anthropometric measurements, blood pressure, medical history, medication use, urine dipstick and biochemical measurements form electronic patient files. In addition, we performed a systematic literature review on kidney disease in PWS. Results We included 162 adults with genetically confirmed PWS (56% male, median age 28 years), of whom 44 (27%) had DM2. None had known CVD. All subjects had normal estimated glomerular filtration rate (eGFR) according to non-PWS reference intervals. Elevated urinary albumin or (micro)albuminuria was present in 28 (18%); 19 out of 75 (25%) had an increased urinary albumin-to-creatinine ratio (UACR) and 10 out of 57 (18%) had an increased urinary protein-to-creatinine ratio. Elevated urinary albumin was present at a young age (median age 26 (IQR 24-32) years) and was associated with an significantly higher BMI and LDL-cholesterol levels and higher prevalence of DM2, hypertension and dyslipidemia than those with normal UACR (p=0.027, p=0.019, p<0.001, p<0.001, p=0.011 and respectively). Conclusion Upon screening, one in every five adults with PWS had increased urinary albumin or (micro)albuminuria, early signs of microvascular disease. All had normal eGFR, according to non-PWS reference intervals, and none had a formal diagnosis of CVD. As muscle mass is low in PWS, creatinine levels and eGFR may be spuriously normal. Urinalysis in this patient group can be used as a screening tool for microvascular (kidney) disease. We propose an algorithm for the detection and management of microvascular disease in adults with PWS.
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Affiliation(s)
- Denise H. van Abswoude
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Center for Adults with Rare Genetic Syndromes, Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Dutch Center of Reference for Prader–Willi Syndrome, Rotterdam, Netherlands
- Academic Center for Growth Disorders, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Karlijn Pellikaan
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Center for Adults with Rare Genetic Syndromes, Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Dutch Center of Reference for Prader–Willi Syndrome, Rotterdam, Netherlands
- Academic Center for Growth Disorders, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Naomi Nguyen
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Anna G. W. Rosenberg
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Center for Adults with Rare Genetic Syndromes, Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Dutch Center of Reference for Prader–Willi Syndrome, Rotterdam, Netherlands
- Academic Center for Growth Disorders, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Kirsten Davidse
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Center for Adults with Rare Genetic Syndromes, Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Dutch Center of Reference for Prader–Willi Syndrome, Rotterdam, Netherlands
- Academic Center for Growth Disorders, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Franciska M. E. Hoekstra
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Internal Medicine, Division of Nephrology, Reinier de Graaf Gasthuis, Delft, Netherlands
| | - Ilse M. Rood
- Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Christine Poitou
- Assistance Publique-Hôpitaux de Paris, Rare Diseases Center of Reference ‘Prader-Willi Syndrome and Obesity with Eating Disorders’ (PRADORT), Nutrition Department, Institute of Cardiometabolism and Nutrition (ICAN), Pitié-Salpêtrière Hospital, Sorbonne Université, National Institute of Health and Medical Research (INSERM), Nutriomics, Paris, France
- International Network for Research, Management & Education on adults with Prader-Willi Syndrome (INfoRMEd-PWS)
- European Reference Network on Rare Endocrine Conditions (ENDO-ERN)
| | - Graziano Grugni
- International Network for Research, Management & Education on adults with Prader-Willi Syndrome (INfoRMEd-PWS)
- European Reference Network on Rare Endocrine Conditions (ENDO-ERN)
- Division of Auxology, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Piancavallo, Italy
| | - Charlotte Høybye
- International Network for Research, Management & Education on adults with Prader-Willi Syndrome (INfoRMEd-PWS)
- European Reference Network on Rare Endocrine Conditions (ENDO-ERN)
- Department of Molecular Medicine and Surgery, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
- Department of Endocrinology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - Tania P. Markovic
- International Network for Research, Management & Education on adults with Prader-Willi Syndrome (INfoRMEd-PWS)
- Metabolism & Obesity Service, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- Charles Perkins Center and Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Assumpta Caixàs
- International Network for Research, Management & Education on adults with Prader-Willi Syndrome (INfoRMEd-PWS)
- Department of Endocrinology and Nutrition, Parc Tauli Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT) Instituto de Salud Carlos III (CERCA-ISCIII), Sabadell, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Antonino Crinò
- International Network for Research, Management & Education on adults with Prader-Willi Syndrome (INfoRMEd-PWS)
- Reference Center for Prader-Willi syndrome, Bambino Gesù Hospital, Research Institute, Palidoro, Italy
- Center for Rare Diseases and Congenital Defects, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Sjoerd A. A. van den Berg
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Clinical Chemistry, Erasmus Medical Center (MC), University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Aart J. van der Lely
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Center for Adults with Rare Genetic Syndromes, Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Academic Center for Growth Disorders, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Laura C. G. de Graaff
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Center for Adults with Rare Genetic Syndromes, Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Dutch Center of Reference for Prader–Willi Syndrome, Rotterdam, Netherlands
- Academic Center for Growth Disorders, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- European Reference Network on Rare Endocrine Conditions (ENDO-ERN)
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Hope S, Nærland T, Olav Kolset S, Ueland T, Andreassen OA, Nordstrøm M. Systemic immune profile in Prader-Willi syndrome: elevated matrix metalloproteinase and myeloperoxidase and reduced macrophage inhibitory factor. Orphanet J Rare Dis 2023; 18:185. [PMID: 37430349 DOI: 10.1186/s13023-023-02730-5] [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: 10/14/2022] [Accepted: 05/14/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Prader-Willi syndrome (PWS) is a rare genetic neurodevelopmental syndrome with highly increased risk of obesity and cardiovascular disease (CVD). Recent evidence suggests that inflammation is implicated in the pathogenesis. Here we investigated CVD related immune markers to shed light on pathogenetic mechanisms. METHODS We performed a cross-sectional study with 22 participants with PWS and 22 healthy controls (HC), and compared levels of 21 inflammatory markers that reflect activity in different aspects of CVD related immune pathways and analyzed their association with clinical CVD risk factors. RESULTS Serum levels of matrix metalloproteinase 9 (MMP-9) was (median (range)) 121 (182) ng/ml in PWS versus 44 (51) ng/ml in HC, p = 1 × 10-9), myeloperoxidase (MPO) was 183 (696) ng/ml versus 65 (180) ng/ml, p = 1 × 10-5) and macrophage inhibitory factor (MIF) was 46 (150) ng/ml versus 121 (163) ng/ml (p = 1 × 10-3), after adjusting for age and sex. Also other markers tended to be elevated (OPG, sIL2RA, CHI3L1, VEGF) but not significantly after Bonferroni correction (p > 0.002). As expected PWS had higher body mass index, waist circumference, leptin, C-reactive protein, glycosylated hemoglobin (HbA1c), VAI and cholesterol, but MMP-9, MPO and MIF remained significantly different in PWS after adjustment for these clinical CVD risk factors. CONCLUSION PWS had elevated levels of MMP-9 and MPO and of reduced levels of MIF, which were not secondary to comorbid CVD risk factors. This immune profile suggests enhanced monocyte/neutrophil activation, impaired macrophage inhibition with enhanced extracellular matrix remodeling. These findings warrant further studies targeting these immune pathways in PWS.
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Affiliation(s)
- Sigrun Hope
- K.G. Jebsen Centre for Neurodevelopmental disorders, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
- Department of Neurohabilitation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.
- Nevsom, Department of Rare Diagnoses and Disabilities, Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.
| | - Terje Nærland
- K.G. Jebsen Centre for Neurodevelopmental disorders, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Nevsom, Department of Rare Diagnoses and Disabilities, Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Svein Olav Kolset
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Rikshospitalet, Oslo, Norway
- K.G. Jebsen, TREC, University of Tromsø, Tromsø, Norway
| | - Ole A Andreassen
- K.G. Jebsen Centre for Neurodevelopmental disorders, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- NORMENT: Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Marianne Nordstrøm
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Frambu Resource Centre for Rare Disorders, Siggerud, Norway
- Unit for Rare Neuromuscular Disorders, Movement, Muscle and Neurodegeneration, Department of Neurology, Oslo University Hospital, Oslo, Norway
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Hou Y, Deng F, Guo J, Lv L, Ouyang H, Wang X, Luo Y, Chen X, Wang F. Distinct lipids profiles and associations with clinical indicators and gut microbiota in Prader-Willi syndrome children. Endocrinology 2023:7180073. [PMID: 37232361 DOI: 10.1210/endocr/bqad084] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/20/2023] [Accepted: 05/25/2023] [Indexed: 05/27/2023]
Abstract
Lipid metabolism is tightly linked to adiposity. Prader-Willi syndrome (PWS) is a typical genetic disorder caused obesity, however, the distinct lipidomic profiles in PWS children have not been thoroughly investigated. Herein, serum lipidomics analysis were simultaneously explored in PWS, simple obesity (SO) and normal children (Normal). Results indicated that the total concentration of phosphatidylcholine (PC) and lysophosphatidylcholine (LPC) in PWS group were significantly deceased in comparison with both SO and Normal group. In contrast, compared with Normal group, there was an overall significantly increase on TAG level in both PWS and SO groups, with the highest was found in SO group. 39 and 50 differential lipid species were screened among three groups, and between obesity (PWS and SO) and Normal group, respectively. Correlation analysis revealed distinct profiles in PWS that different from other two groups. Notably, PC(P16:0/18:1), PE(P18:0-20:3), PE(P18:0-20:4)) showed significant negative correlation with Body mass index (BMI) soly in PWS groups. As for PE(P16:0-18:2), it showed negative association with BMI and weight in PWS group, but significant positive correlation in SO group, no statistical significant association were found in Normal group. We also found a significantly negative correlation between Blautia genus abundance and several significantly changed lipids, including LPC(14:0), LPC(16:0), TAG(C50:2/C51:9), TAG(C52:2/C53:9), TAG(C52:3/C53:10) and TAG(C52:4/C53:11), but no significant correlation in Normal group and SO group. Similarly, in PWS group, Neisseria genus was significantly negatively associated with CAR(14:1), CAR(18:0), PE(P18:0/20:3) and PE(P18:0/20:4), and extremely positively associated with TAG(C52:2/C53:9), while no obvious correlations were observed in Normal group and SO group.
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Affiliation(s)
- Yaping Hou
- Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511400, Guangdong, China
- Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou 511400, Guangdong, China
| | - Fuli Deng
- School of Food Science and Engineering, South China University of Technology, Guangzhou 510640, Guangdong, China
| | - Jia Guo
- School of Food Science and Engineering, South China University of Technology, Guangzhou 510640, Guangdong, China
| | - Lijuan Lv
- Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511400, Guangdong, China
- Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou 511400, Guangdong, China
| | - Haimei Ouyang
- Department of Pediatrics, Guangdong Women and Children Hospital, Guangzhou 511400, Guangdong, China
| | - Xingwang Wang
- Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511400, Guangdong, China
- Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou 511400, Guangdong, China
| | - Yasha Luo
- Clinical Laboratory Centre, Guangdong Women and Children Hospital, Guangzhou 511400, Guangdong, China
| | - Xiuwen Chen
- Surgery Department, Guangdong Women and Children Hospital, Guangzhou 511400, Guangdong, China
| | - Fanghua Wang
- School of Food Science and Engineering, South China University of Technology, Guangzhou 510640, Guangdong, China
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Xu Y, Hou X, Guo H, Yao Z, Fan X, Xu C, Li G, Wang Y, Sun Y, Gao L, Song Y, Zhao J. CD16 + monocytes are involved in the hyper-inflammatory state of Prader-Willi Syndrome by single-cell transcriptomic analysis. Front Immunol 2023; 14:1153730. [PMID: 37251380 PMCID: PMC10213932 DOI: 10.3389/fimmu.2023.1153730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/27/2023] [Indexed: 05/31/2023] Open
Abstract
Background Patients with Prader-Willi syndrome (PWS) have a reduced life expectancy due to inflammation-related disease including cardiovascular disease and diabetes. Abnormal activation of peripheral immune system is postulated as a contributor. However, detailed features of the peripheral immune cells in PWS have not been fully elucidated. Methods Serum inflammatory cytokines were measured in healthy controls (n=13) and PWS patients (n=10) using a 65- multiplex cytokine assays. Changes of the peripheral immune cells in PWS was assessed by single-cell RNA sequencing (scRNA-seq) and high-dimensional mass cytometry (CyTOF) using peripheral blood mononuclear cells (PBMCs) from PWS patients (n=6) and healthy controls (n=12). Results PWS patients exhibited hyper-inflammatory signatures in PBMCs and monocytes were the most pronounced. Most inflammatory serum cytokines were increased in PWS, including IL-1β, IL-2R, IL-12p70, and TNF-α. The characteristics of monocytes evaluated by scRNA-seq and CyTOF showed that CD16+ monocytes were significantly increased in PWS patients. Functional pathway analysis revealed that CD16+ monocytes upregulated pathways in PWS were closely associated with TNF/IL-1β- driven inflammation signaling. The CellChat analysis identified CD16+ monocytes transmitted chemokine and cytokine signaling to drive inflammatory process in other cell types. Finally, we explored the PWS deletion region 15q11-q13 might be responsible for elevated levels of inflammation in the peripheral immune system. Conclusion The study highlights that CD16+ monocytes contributor to the hyper-inflammatory state of PWS which provides potential targets for immunotherapy in the future and expands our knowledge of peripheral immune cells in PWS at the single cell level for the first time.
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Affiliation(s)
- Yunyun Xu
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, Jinan, China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, China
| | - Xu Hou
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Stem Cell Research Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Honglin Guo
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, China
| | - Zhenyu Yao
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, China
| | - Xiude Fan
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, China
| | - Chao Xu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, China
| | - Guimei Li
- Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yanzhou Wang
- Department of Pediatric Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yan Sun
- Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Ling Gao
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, China
- Scientific Research Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yongfeng Song
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, Jinan, China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, China
| | - Jiajun Zhao
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, Jinan, China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, China
- Stem Cell Research Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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Camblats AM, Mathey S, Robert C, Estival S, Chevalère J, Maire J, Tauber M, Laurier V, Tricot J, Mourre F, Postal V. Interference effect of food and emotional stimuli in Stroop-like tasks for children and adults with Prader-Willi Syndrome. J Clin Exp Neuropsychol 2023:1-16. [PMID: 37113059 DOI: 10.1080/13803395.2023.2207777] [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] [Indexed: 04/29/2023]
Abstract
Interference effect of food and emotional stimuli in Stroop-like tasks for children and adults with Prader-Willi Syndrome. The aim of this work was to study the way items related to food or emotion are processed by a population known to have difficulties with dietary restriction, namely individuals with Prader-Willi Syndrome (PWS). Given the presence of intellectual disability (ID) in PWS, our experiments were designed to examine whether these difficulties were specific to PWS or linked with their ID. Two modified Stroop tasks (i.e., a food version and an emotional version) were administered to seventy-four children (aged between 6 and 16 years old) divided into three groups (one with PWS, one with ID matched on age and Intellectual Quotient (IQ), and one healthy group matched on age) and to eighty-four adults (aged between 18 and 48 years old) distributed in the same three groups. For both tasks, a picture version was used for the children and a word version for the adults. For the food Stroop task, (Experiment 1), materials were composed of low or high-caloric food items and stimuli not related to food. The results show a food Stroop effect for children and adults with PWS that was absent in the group of healthy participants. Moreover, a food Stroop effect was also significant for adults with ID. For the emotional Stroop task (Experiment 2), materials were composed of negative, positive and neutral stimuli. The emotional Stroop effect was also obtained for children and adults with PWS as well as for the healthy group, but not for the age- and IQ-matched group. For the PWS groups, results show a preservation to process positive pictures for children and difficulties to process negative stimuli for both age-groups. These results suggest that people with PWS have difficulties in disengaging their attention when food stimuli are present in their environment and poorer abilities to process negative ones. These difficulties endure in adulthood.
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Affiliation(s)
| | - Stéphanie Mathey
- laboratoire de Psychologie EA4139, Université de Bordeaux, Bordeaux, France
| | - Christelle Robert
- laboratoire de Psychologie EA4139, Université de Bordeaux, Bordeaux, France
| | - Séverine Estival
- laboratoire de Psychologie EA4139, Université de Bordeaux, Bordeaux, France
| | - Johann Chevalère
- Laboratoire de Psychologie Sociale et Cognitive (LAPSCO), UMR 6024, CNRS & Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Jenna Maire
- Unité de recherche CERES, Institut Catholique de Toulouse, Toulouse, France
| | - Maïthé Tauber
- Centre de Référence du Syndrome de Prader-Willi, CHU Toulouse, Toulouse, France
| | - Virginie Laurier
- Centre de Référence des maladies rares PRADORT pour le Syndrome de Prader-Willi et autres et autres Obésités Rares avec TCA, AP-HP Hôpital Marin, Hendaye, France
| | - Julie Tricot
- Centre de Référence des maladies rares PRADORT pour le Syndrome de Prader-Willi et autres et autres Obésités Rares avec TCA, AP-HP Hôpital Marin, Hendaye, France
| | - Fabien Mourre
- Centre de Référence des maladies rares PRADORT pour le Syndrome de Prader-Willi et autres et autres Obésités Rares avec TCA, AP-HP Hôpital Marin, Hendaye, France
| | - Virginie Postal
- laboratoire de Psychologie EA4139, Université de Bordeaux, Bordeaux, France
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8
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Aureli A, Bocchini S, Mariani M, Crinò A, Cappa M, Fintini D. A rare occurrence of non-classic congenital adrenal hyperplasia and type 1 diabetes mellitus in a girl with Prader-Willi Syndrome: Case report and review of the literature. Front Endocrinol (Lausanne) 2023; 14:1148318. [PMID: 37124733 PMCID: PMC10130376 DOI: 10.3389/fendo.2023.1148318] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/23/2023] [Indexed: 05/02/2023] Open
Abstract
Prader-Willi syndrome (PWS) is a rare genetic disorder resulting from lack of expression of the paternally derived chromosome 15q11-13, associated with several complications, including pubertal disorders, short stature, hyperphagia, obesity, glucose metabolism abnormalities, scoliosis, obstructive sleep apnea syndrome (OSAS) and behavioral problems. We report the case of a girl affected by PWS who presented at the age of 5.9 with premature pubarche, accelerated linear growth and advanced bone age (BA). She was subsequently diagnosed with non-classic congenital adrenal hyperplasia (CAH) confirmed by genetic analysis. Considering the clinical, biochemical, and genetic findings, hydrocortisone therapy was started to prevent rapid BA acceleration and severe compromission of final height. During infancy, short stature and low levels of insulin-like growth factor-1 (IGF-1) for age and gender led to suspicion of growth hormone deficiency (GHD), confirmed by stimulation testing (arginine and clonidine). rhGH therapy was administered and continued until final height was reached. During endocrinological follow up she developed impaired glucose tolerance with positive markers of β-cell autoimmunity (anti-glutamic acid decarboxylase antibodies, GAD Ab), which evolved over time into type 1 diabetes mellitus and insulin therapy with a basal-bolus scheme and an appropriate diet were needed.
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Affiliation(s)
- Alessia Aureli
- Prader-Willi Reference Center, Endocrinology Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Sarah Bocchini
- Prader-Willi Reference Center, Endocrinology Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Michela Mariani
- Prader-Willi Reference Center, Endocrinology Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Antonino Crinò
- Center for Rare Diseases and Congenital Defects, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Marco Cappa
- Prader-Willi Reference Center, Endocrinology Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Danilo Fintini
- Prader-Willi Reference Center, Endocrinology Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
- *Correspondence: Danilo Fintini,
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Luccarelli J. Demographics and medical comorbidities among hospitalized patients with Prader-Willi Syndrome: A National Inpatient Sample analysis. Am J Med Genet A 2022; 188:2899-2907. [PMID: 35838073 PMCID: PMC9474715 DOI: 10.1002/ajmg.a.62901] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/17/2022] [Accepted: 06/30/2022] [Indexed: 01/31/2023]
Abstract
Prader-Willi Syndrome (PWS) is a multi-system genetic disorder characterized by hyperphagia and a range of medical complications. While register and cohort studies have explored the natural course of the syndrome, there is little nationally-representative data. In this study the National Inpatient Sample, a de-identified all-payors database of acute care hospital discharges in the United States, was queried for patients discharged with a diagnosis of PWS in 2019. Hospitalizations involving PWS were compared to hospitalizations without a PWS diagnosis matched based on demographic and hospital factors. In total, 540 hospitalizations (95% CI: 513-567) included a diagnosis of PWS. Median age at time of admission was 22 years, with an interquartile range of 6.3-37.8 years. Respiratory conditions accounted for 110 (20.4%) of primary discharge diagnoses, with infectious conditions for 70 (13.0%) and digestive conditions for 65 (12.0%). Hospitalizations involving PWS were significantly more likely to involve respiratory failure (OR 5.49; 95% CI 3.86-7.80), septicemia (OR 2.80, 95% CI 1.97-3.96), or intestinal obstruction and ileus (OR 6.29; 95% CI 3.70-10.7) compared to matched hospitalizations without PWS. Obesity was diagnosed in 230 PWS hospitalizations (42.6%; OR 3.86, 95% CI 3.17-4.72 relative to non-PWS hospitalizations). These results point to an ongoing need for the improved diagnosis and treatment of PWS complications, and highlight the importance of specific billing codes for rare diseases to enhance the collection of real world evidence.
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Affiliation(s)
- James Luccarelli
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, McLean Hospital, Belmont, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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10
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Dimitropoulos A, Doernberg EA, Russ SW, Zyga O. Intervention Response by Genetic Subtype: PRETEND-Preschool Program for Children with Prader-Willi Syndrome via Remote Parent Training. J Autism Dev Disord 2022; 52:5191-5206. [PMID: 35932366 PMCID: PMC9361891 DOI: 10.1007/s10803-022-05695-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 11/30/2022]
Abstract
Prader-Willi Syndrome (PWS) is a rare neurodevelopmental disorder associated with social cognitive challenges, and pretend play has been demonstrated as a tool to achieve developmental goals. Following previous report on feasibility and acceptability of a remote, play-based parent-training program (Zyga, Russ, & Dimitropoulos, 2018), we now report on preliminary efficacy of this program to enhance pretend play skills and social cognitive skills in preschoolers with PWS. Results across two studies demonstrated efficacy when live-coaching play sessions incorporated children into the intervention. Increases in play skills were observed for children with the mUPD subtype of PWS who underwent intervention, compared with children with mUPD who were waitlisted. Children with DEL subtype were less likely to respond to intervention. Implications for results are discussed.
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Affiliation(s)
| | | | | | - Olena Zyga
- Cleveland Clinic Center for Autism, Rocky River, OH, USA
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Saima S, Ihara H, Ogata H, Gito M, Murakami N, Oto Y, Ishii A, Takahashi A, Nagai T. Relationship Between Sensory Processing and Autism Spectrum Disorder-Like Behaviors in Prader-Willi Syndrome. Am J Intellect Dev Disabil 2022; 127:249-263. [PMID: 35443050 DOI: 10.1352/1944-7558-127.3.249] [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] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 07/20/2021] [Indexed: 06/14/2023]
Abstract
The relationship between sensory processing and ASD-like and associated behaviors in patients with Prader-Willi Syndrome (PWS) remains relatively unexplored. Examining this relationship, 51 adults with PWS were administered the Pervasive Developmental Disorders Autism Society Japan Rating Scale (PARS), Short Sensory Profile (SSP-J), Food-Related Problem Questionnaire (FRPQ), and Aberrant Behavior Checklist (ABC-J). Based on SSP-J z-scores, participants were classified into three severity groups. Analysis of variance was performed to compare the behavioral scores of these three groups. Statistically significant group differences were observed in PARS (p = .006, ηp2 = .194) and ABC-J (p = .006, ηp2 = .193) scores. Our findings suggest that the level of sensory processing may predict ASD-like and aberrant behaviors in adults with PWS, implying the importance of a proper assessment for early intervention.
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Affiliation(s)
- Sohei Saima
- Sohei Saima, Hiroshi Ihara, Hiroyuki Ogata, Masao Gito, Nobuyuki Murakami, Yuji Oto, Atsushi Ishii, and Asami Takahashi, Dokkyo Medical University Saitama Medical Center, Japan
| | - Hiroshi Ihara
- Sohei Saima, Hiroshi Ihara, Hiroyuki Ogata, Masao Gito, Nobuyuki Murakami, Yuji Oto, Atsushi Ishii, and Asami Takahashi, Dokkyo Medical University Saitama Medical Center, Japan
| | - Hiroyuki Ogata
- Sohei Saima, Hiroshi Ihara, Hiroyuki Ogata, Masao Gito, Nobuyuki Murakami, Yuji Oto, Atsushi Ishii, and Asami Takahashi, Dokkyo Medical University Saitama Medical Center, Japan
| | - Masao Gito
- Sohei Saima, Hiroshi Ihara, Hiroyuki Ogata, Masao Gito, Nobuyuki Murakami, Yuji Oto, Atsushi Ishii, and Asami Takahashi, Dokkyo Medical University Saitama Medical Center, Japan
| | - Nobuyuki Murakami
- Sohei Saima, Hiroshi Ihara, Hiroyuki Ogata, Masao Gito, Nobuyuki Murakami, Yuji Oto, Atsushi Ishii, and Asami Takahashi, Dokkyo Medical University Saitama Medical Center, Japan
| | - Yuji Oto
- Sohei Saima, Hiroshi Ihara, Hiroyuki Ogata, Masao Gito, Nobuyuki Murakami, Yuji Oto, Atsushi Ishii, and Asami Takahashi, Dokkyo Medical University Saitama Medical Center, Japan
| | - Atsushi Ishii
- Sohei Saima, Hiroshi Ihara, Hiroyuki Ogata, Masao Gito, Nobuyuki Murakami, Yuji Oto, Atsushi Ishii, and Asami Takahashi, Dokkyo Medical University Saitama Medical Center, Japan
| | - Asami Takahashi
- Sohei Saima, Hiroshi Ihara, Hiroyuki Ogata, Masao Gito, Nobuyuki Murakami, Yuji Oto, Atsushi Ishii, and Asami Takahashi, Dokkyo Medical University Saitama Medical Center, Japan
| | - Toshiro Nagai
- Toshiro Nagai, Nakagawanosato Ryoiku Center, Japan. Sohei Saima and Hiroshi Ihara contributed equally to this article
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Grootjen LN, Uyl NEM, van Beijsterveldt IALP, Damen L, Kerkhof GF, Hokken-Koelega ACS. Prenatal and Neonatal Characteristics of Children with Prader-Willi Syndrome. J Clin Med 2022; 11:679. [PMID: 35160130 DOI: 10.3390/jcm11030679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 12/10/2022] Open
Abstract
Objective: Prader-Willi syndrome (PWS) is a rare genetic syndrome with a wide spectrum of clinical features in early life. Late diagnoses are still present. We characterized the perinatal and neonatal features of PWS, compared them with those of healthy newborns and assessed the prenatal and neonatal differences between the genetic subtypes. Design: A cohort study in children with PWS. The prevalence of variables was compared with healthy infants (PLUTO cohort) and to population statistics from literature. Patients: 244 infants with PWS and 365 healthy infants. Measurements: Data on prenatal and neonatal variables in both cohorts. Population statistics were collected through an extensive literature search. Results: A higher prevalence of maternal age >35 years was found in PWS compared to healthy infants and population statistics, and the highest maternal age was found in the mUPD group. Higher prevalence of polyhydramnios, caesarean section, labour induction and breech presentation, and lower birth weight SDS was found in PWS compared to healthy infants. High prevalences of decreased fetal movements (78.5%), hypotonia (100%), cryptorchism (95.9%) and poor sucking/tube feeding (93.9%) were found in PWS. Conclusions: This study presents an overview of prenatal and neonatal variables in infants with PWS compared to healthy infants. Our findings may increase clinical awareness of the early perinatal signs of PWS by obstetricians, neonatologists and all those involved in infant care, enabling early diagnosis and start of multidisciplinary treatment.
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Cobo J, Coronas R, Pousa E, Oliva JC, Giménez-Palop O, Caixàs A. An adapted scale to evaluate insight in Prader-Willi Syndrome. Med Clin (Barc) 2021; 159:130-133. [PMID: 34696903 DOI: 10.1016/j.medcli.2021.07.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/03/2021] [Accepted: 07/05/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To develop an insight scale for Prader-Willi Syndrome (PWS), a genetically determined neurodevelopmental disorder with different psychopathological and behavioural problems. METHODOLOGY A sample of 36 PWS patients (58.3% women) attended at the Endocrinological Department of the Corporació Sanitària Parc Taulí (Sabadell, Barcelona) was evaluated. Insight was assessed by means of an adapted version of the Scale of Unawareness of Mental Disorder (SUMD), including three general insight dimensions: awareness of having a PWS, awareness of the effects of psychopharmacological medication and awareness of the social consequences, as well as three items that assess awareness of each particular symptom of the disease (obesity/overweight, excessive appetite and excessive food intake). RESULTS The final Scale included six items and demonstrated an adequate internal consistency (Cronbach Alfa of 0.857 for Caregivers and 0.798 for Clinicians) but a high inter-rate variability. External validation using an Analytical-Visual Insight Scale was adequate. CONCLUSIONS The Adapted version for Prader-Willi patients of the Scale of Unawareness of Mental Disorder (APW-SUD) showed adequate psychometric properties and it is an easy to administer means to assess insight in this population.
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Affiliation(s)
- Jesus Cobo
- Mental Health Department, Corporació Sanitària Parc Taulí - Universitat Autònoma de Barcelona - Institut d'Investigació i Innovació Parc Taulí (I3PT), CIBERSAM, Sabadell, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Insight Barcelona Research Group, Societat Catalana de Psiquiatria i Salut Mental, Barcelona, Spain.
| | - Ramón Coronas
- Mental Health Department, Corporació Sanitària Parc Taulí - Universitat Autònoma de Barcelona - Institut d'Investigació i Innovació Parc Taulí (I3PT), CIBERSAM, Sabadell, Spain
| | - Esther Pousa
- Insight Barcelona Research Group, Societat Catalana de Psiquiatria i Salut Mental, Barcelona, Spain; Psychiatry Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Joan-Carles Oliva
- Statistic Unit, Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
| | - Olga Giménez-Palop
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT), Medicine Department, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Assumpta Caixàs
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT), Medicine Department, Universitat Autònoma de Barcelona, Sabadell, Spain
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14
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Estival S, Chevalère J, Laurier V, Mourre F, Tricot J, Postal V. Study of the deficit in planning abilities of adults with Prader-Willi Syndrome. Res Dev Disabil 2021; 117:104056. [PMID: 34371306 DOI: 10.1016/j.ridd.2021.104056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 07/20/2021] [Accepted: 08/01/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Prader-Willi syndrome (PWS) is a complex developmental genetic disorder associated with intellectual disability and deficits in executive functions which result in disorganisation and poor personal autonomy. AIMS This study aimed to determine impairments in planning skills of adults with PWS, in relation with their intellectual disabilities, as well as the influence of food compulsions on their performance. METHODS AND PROCEDURES A modified version of the Zoo Map from the Behavioural Assessment of the Dysexecutive Syndrome was used in three groups: a group of adults with PWS in comparison with two groups both matched on chronological age, one with typical development (TD) and one with intellectual disability (ID). OUTCOMES AND RESULTS Compared to TD adults, both adults with PWS and ID showed increased planning time and lower raw scores on the planning task. The execution time and the number of errors were higher in the PWS group compared to the comparison groups. All three groups performed worse in the non-food condition only for number of errors and raw score. CONCLUSIONS AND IMPLICATIONS Planning abilities were impaired in PWS adults. Results also showed that intellectual level plays a role in participants' performance. These findings are essential to understand the difficulties of people with PWS daily life.
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Affiliation(s)
- Séverine Estival
- Laboratoire de Psychologie LabPsy EA4139, Université de Bordeaux, France.
| | - Johann Chevalère
- Laboratoire de Psychologie LabPsy EA4139, Université de Bordeaux, France
| | | | - Fabien Mourre
- Hôpital Marin AP-HP, Unité Prader-Willi, Hendaye, France
| | - Julie Tricot
- Hôpital Marin AP-HP, Unité Prader-Willi, Hendaye, France
| | - Virginie Postal
- Laboratoire de Psychologie LabPsy EA4139, Université de Bordeaux, France
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15
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Correa‐da‐Silva F, Fliers E, Swaab DF, Yi C. Hypothalamic neuropeptides and neurocircuitries in Prader Willi syndrome. J Neuroendocrinol 2021; 33:e12994. [PMID: 34156126 PMCID: PMC8365683 DOI: 10.1111/jne.12994] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/19/2021] [Accepted: 05/04/2021] [Indexed: 02/06/2023]
Abstract
Prader-Willi Syndrome (PWS) is a rare and incurable congenital neurodevelopmental disorder, resulting from the absence of expression of a group of genes on the paternally acquired chromosome 15q11-q13. Phenotypical characteristics of PWS include infantile hypotonia, short stature, incomplete pubertal development, hyperphagia and morbid obesity. Hypothalamic dysfunction in controlling body weight and food intake is a hallmark of PWS. Neuroimaging studies have demonstrated that PWS subjects have abnormal neurocircuitry engaged in the hedonic and physiological control of feeding behavior. This is translated into diminished production of hypothalamic effector peptides which are responsible for the coordination of energy homeostasis and satiety. So far, studies with animal models for PWS and with human post-mortem hypothalamic specimens demonstrated changes particularly in the infundibular and the paraventricular nuclei of the hypothalamus, both in orexigenic and anorexigenic neural populations. Moreover, many PWS patients have a severe endocrine dysfunction, e.g. central hypogonadism and/or growth hormone deficiency, which may contribute to the development of increased fat mass, especially if left untreated. Additionally, the role of non-neuronal cells, such as astrocytes and microglia in the hypothalamic dysregulation in PWS is yet to be determined. Notably, microglial activation is persistently present in non-genetic obesity. To what extent microglia, and other glial cells, are affected in PWS is poorly understood. The elucidation of the hypothalamic dysfunction in PWS could prove to be a key feature of rational therapeutic management in this syndrome. This review aims to examine the evidence for hypothalamic dysfunction, both at the neuropeptidergic and circuitry levels, and its correlation with the pathophysiology of PWS.
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Affiliation(s)
- Felipe Correa‐da‐Silva
- Department of Endocrinology and MetabolismAmsterdam Gastroenterology Endocrinology and MetabolismAmsterdam University Medical Center (UMC)University of AmsterdamAmsterdamThe Netherlands
- Laboratory of EndocrinologyAmsterdam University Medical Center (UMC)University of AmsterdamAmsterdamThe Netherlands
- Department of Neuropsychiatric DisordersNetherlands Institute for NeuroscienceAn Institute of the Royal Netherlands Academy of Arts and SciencesAmsterdamThe Netherlands
| | - Eric Fliers
- Department of Endocrinology and MetabolismAmsterdam Gastroenterology Endocrinology and MetabolismAmsterdam University Medical Center (UMC)University of AmsterdamAmsterdamThe Netherlands
| | - Dick F. Swaab
- Department of Neuropsychiatric DisordersNetherlands Institute for NeuroscienceAn Institute of the Royal Netherlands Academy of Arts and SciencesAmsterdamThe Netherlands
| | - Chun‐Xia Yi
- Department of Endocrinology and MetabolismAmsterdam Gastroenterology Endocrinology and MetabolismAmsterdam University Medical Center (UMC)University of AmsterdamAmsterdamThe Netherlands
- Laboratory of EndocrinologyAmsterdam University Medical Center (UMC)University of AmsterdamAmsterdamThe Netherlands
- Department of Neuropsychiatric DisordersNetherlands Institute for NeuroscienceAn Institute of the Royal Netherlands Academy of Arts and SciencesAmsterdamThe Netherlands
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Rios-Flores IM, Bobadilla-Morales L, Peña Padilla C, Corona-Rivera A, Acosta-Fernández E, Santana-Hernández J, Brukman-Jiménez SA, Corona Rivera JR. [Prader-Willi and Angelman syndromes: case series diagnosed by MS-MLPA assay]. Rev Med Inst Mex Seguro Soc 2021; 59:170-178. [PMID: 34232598] [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] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 02/20/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Prader Willi syndrome (PWS) and Angelman syndrome (AS) are neurodevelopmental disorders caused by deletions or methylation defects, making a loss of expression of imprinted genes located in the 15q11-q13 region, and these can be assessed by different cytogenomic and molecular techniques. We report a case series of patients with PWS and AS evaluated through the MS-MLPA assay. CLINICAL CASES We studied four patients with a clinical diagnosis of PWS and another with AS, evaluated as far as possible with karyotype and FISH, and with MS-MLPA assay for the 15q11-q13 region in all cases. In patients with PWS, neonatal hypotonia was the main reason for consultation and in three of them we identified a deletion of 15q11-q13 by MS-MLPA, also confirmed by FISH; and in the other one, an abnormal methylation pattern consistent with a maternal uniparental disomy. The patient with AS presented with a typical picture which led to the identification of a deletion in 15q11-q13 by MS-MLPA, also confirmed by FISH. CONCLUSIONS The use of the MS-MLPA assay for the 15q11-q13 region was very useful for the diagnosis and identification of the genomic and epigenetic defects involved in either PWS and AS.
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Affiliation(s)
| | - Lucina Bobadilla-Morales
- Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", División de Auxiliares de Diagnóstico y Paramédicos, Unidad de Citogenética. Guadalajara, Jalisco, México
| | - Christian Peña Padilla
- Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", División de Pediatría, Servicio de Genética. Guadalajara, Jalisco, México
| | - Alfredo Corona-Rivera
- Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", División de Auxiliares de Diagnóstico y Paramédicos, Unidad de Citogenética. Guadalajara, Jalisco, México
| | - Elizabeth Acosta-Fernández
- Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", División de Pediatría, Servicio de Genética. Guadalajara, Jalisco, México
| | - Jennifer Santana-Hernández
- Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", División de Auxiliares de Diagnóstico y Paramédicos, Unidad de Citogenética. Guadalajara, Jalisco, México
| | - Sinhue Alejandro Brukman-Jiménez
- Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", División de Auxiliares de Diagnóstico y Paramédicos, Unidad de Citogenética. Guadalajara, Jalisco, México
| | - Jorge Román Corona Rivera
- Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Departamento de Biología Molecular y Genómica, Instituto de Genética Humana "Dr. Enrique Corona Rivera". Guadalajara, Jalisco, México
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Mercado M. [Epigenetics of Prader-Willi Syndrome: A good example of translational medicine]. Rev Med Inst Mex Seguro Soc 2021; 59:106-107. [PMID: 34231979] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In this editorial the author presents a study, concerning Prader-Willi syndrome, which is paradigmatic for translational medicine, given that it creates a synergy between genetics and molecular biology, in order to improve the care for patients suffering from this syndrome.
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Affiliation(s)
- Moisés Mercado
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Unidad de Investigación Médica en Enfermedades Endocrinas. Ciudad de México, México
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Cobo J, Coronas R, Pousa E, Oliva JC, Giménez-Palop O, Esteba-Castillo S, Novell R, Palao DJ, Caixàs A. Multidimensional Evaluation of Awareness in Prader-Willi Syndrome. J Clin Med 2021; 10:2007. [PMID: 34067179 PMCID: PMC8125854 DOI: 10.3390/jcm10092007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 04/30/2021] [Accepted: 05/06/2021] [Indexed: 01/08/2023] Open
Abstract
There are no studies about insight or awareness of illness in patients with Prader-Willi Syndrome (PWS). The objective of this study was to explore the level of awareness of the disorder, of the need for medication, and of the social consequences of the disease, as well as of its main symptoms in PWS. We also aimed to explore relationships between awareness and sociodemographic and clinical characteristics, and to compare all data with a matched sample of patients with psychosis. Insight was assessed by an Adapted version of the Scale of Unawareness of Mental Disorder in a cross-sectional pilot study at a University Hospital. Thirty-six individuals with PWS (58.3% women) were included. Results showed that PWS patients had a good awareness of the illness and of the effects of medication, in contrast to a lack of awareness of illness' social consequences. Awareness of obesity/overweight was excellent, as was the awareness of excessive appetite. Awareness of excessive food intake was only mild. Insight correlated with age and functionality, but not with BMI. PWS patients showed a better insight into the illness but a similar awareness of the effects of the medication and of the social consequences of the disease as compared to schizophrenia-spectrum patients. This profile of insight may have relevant clinical implications.
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Affiliation(s)
- Jesús Cobo
- Mental Health Department, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona—CIBERSAM, 08208 Sabadell, Spain; (R.C.); (D.J.P.)
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
- Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain; (J.-C.O.); (O.G.-P.)
- Insight Barcelona Research Group, Societat Catalana de Psiquiatria i Salut Mental, 08017 Barcelona, Spain;
| | - Ramón Coronas
- Mental Health Department, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona—CIBERSAM, 08208 Sabadell, Spain; (R.C.); (D.J.P.)
- Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain; (J.-C.O.); (O.G.-P.)
| | - Esther Pousa
- Insight Barcelona Research Group, Societat Catalana de Psiquiatria i Salut Mental, 08017 Barcelona, Spain;
- Psychiatry Department, Hospital Universitari St. Pau, 08041 Barcelona, Spain
| | - Joan-Carles Oliva
- Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain; (J.-C.O.); (O.G.-P.)
- Statistic Unit, Fundació Parc Taulí I3PT, 08208 Sabadell, Spain
| | - Olga Giménez-Palop
- Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain; (J.-C.O.); (O.G.-P.)
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, Corporació Sanitària ParcTaulí—Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
- Medicine Department, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
| | - Susanna Esteba-Castillo
- Specialized Service in Mental Health and Intellectual Disability, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Salt, 17190 Girona, Spain; (S.E.-C.); (R.N.)
- Neurodevelopment Group, Girona Biomedical Research Institute—IDIBGI, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Salt, 17190 Girona, Spain
| | - Ramon Novell
- Specialized Service in Mental Health and Intellectual Disability, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Salt, 17190 Girona, Spain; (S.E.-C.); (R.N.)
- Neurodevelopment Group, Girona Biomedical Research Institute—IDIBGI, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Salt, 17190 Girona, Spain
| | - Diego J. Palao
- Mental Health Department, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona—CIBERSAM, 08208 Sabadell, Spain; (R.C.); (D.J.P.)
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
- Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain; (J.-C.O.); (O.G.-P.)
| | - Assumpta Caixàs
- Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain; (J.-C.O.); (O.G.-P.)
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, Corporació Sanitària ParcTaulí—Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
- Medicine Department, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
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Thuilleaux D, Méresse G, Mourre F. [Living with Prader Willi syndrome]. Rev Prat 2020; 70:1109. [PMID: 33739657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Denise Thuilleaux
- Centre de référence du syndrome de Prader-Willi et autres syndromes avec troubles du comportement alimentaire, hôpital marin de Hendaye, AP-HP, Hendaye, France.Commentaires de Gérard Méresse,Association Prader-Willi France
| | - Gérard Méresse
- Centre de référence du syndrome de Prader-Willi et autres syndromes avec troubles du comportement alimentaire, hôpital marin de Hendaye, AP-HP, Hendaye, France.Commentaires de Gérard Méresse,Association Prader-Willi France
| | - Fabien Mourre
- Centre de référence du syndrome de Prader-Willi et autres syndromes avec troubles du comportement alimentaire, hôpital marin de Hendaye, AP-HP, Hendaye, France.Commentaires de Gérard Méresse,Association Prader-Willi France
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20
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Lian WJ, Duan P, Lu XP, Lu TT, Zheng H. Chromosome 14-linked disease misdiagnosed as Prader-Willi syndrome. J BIOL REG HOMEOS AG 2020; 34:619-622. [PMID: 32517437 DOI: 10.23812/19-477-l-69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- W J Lian
- Henan University of Chinese Medicine, Zhengzhou, China
| | - P Duan
- Henan University of Chinese Medicine, Zhengzhou, China
| | - X P Lu
- Department of Pediatrics, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - T T Lu
- Department of Pediatrics, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - H Zheng
- Department of Pediatrics, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
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Abstract
The European Marketing Authorization for recombinant human growth hormone (rhGH) in children with Prader-Willi syndrome was the first indication for metabolic and body composition effects in children. In the US it is indicated for short stature associated with PWS. Recombinant hGH is the first treatment for the PWS population and radically changed the care of these children by facilitating access to physicians who prescribe rhGH, mainly paediatric endocrinologists, and manage the organization of multidisciplinary care. Recombinant hGH treatment improved linear growth, body composition, and socialization not only in children but also in young adults. The pathophysiology of combined hormonal deficiencies including GH is starting to be unravelled. We now have to focus on co-morbidities that are not modified by rhGH treatment, such as feeding disorders and behaviour problems, to truly change the life of patients. The transition of care from adolescents to young adults also remains a challenge.
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Affiliation(s)
- Maïthé Tauber
- Centre de référence du syndrome de Prader-Willi, Hôpital des Enfants, CHU Toulouse, France, 2Axe Pédiatrique du CIC 9302/INSERM. Hôpital des Enfants, Toulouse, France, 3INSERM U1043, Centre de Physiopathologie de Toulouse Purpan, UPS, France, E-mail:
| | - Gwenaelle Diene
- Centre de référence du syndrome de Prader-Willi, Hôpital des Enfants, CHU Toulouse, France, INSERM UMR 1027-Université Toulouse III Hôpital Paule de Viguier, Toulouse, France
| | - Catherine Molinas
- Centre de référence du syndrome de Prader-Willi, Hôpital des Enfants, CHU Toulouse, France, Axe Pédiatrique du CIC 9302/INSERM. Hôpital des Enfants, Toulouse, France, INSERM U1043, Centre de Physiopathologie de Toulouse Purpan, UPS, France
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22
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Singh D, Sasson A, Rusciano V, Wakimoto Y, Pinkhasov A, Angulo M. Cycloid Psychosis Comorbid with Prader-Willi Syndrome: A Case Series. Am J Med Genet A 2019; 179:1241-1245. [PMID: 31070005 DOI: 10.1002/ajmg.a.61181] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 10/17/2018] [Revised: 02/06/2019] [Accepted: 04/07/2019] [Indexed: 11/09/2022]
Abstract
Psychosis is a relatively common psychiatric phenomenon seen in patients with Prader-Willi Syndrome (PWS). However, the presentation is atypical and difficult to classify within currently defined affective or psychotic disorders. This distinct presentation may be better understood as a phenomenon called "cycloid psychosis," described as an episodic psychosis with rapid full recovery between episodes. This study retrospectively analyzed the cases of 12 patients with genetically confirmed PWS who presented to an ambulatory psychiatric center for a change in behavior consistent with psychosis. Each case was then assessed for symptoms of cycloid psychosis, bipolar disorder, depression with psychotic features, schizophrenia, and schizoaffective disorder. Out of the 12 patients, 11 (91.7%) met the currently described diagnostic criteria for cycloid psychosis. Of the 12 patients, 7 (58.3%) also met the diagnostic criteria for bipolar disorder, and 1 (8.3%) also met the diagnostic criteria for schizoaffective disorder. None of the patients met the criteria for schizophrenia or depression with psychotic features. The findings in this study suggest that cycloid psychosis and bipolar disorder may both be comorbid with PWS. Psychiatric comorbidities in patients with PWS are atypical and clinicians should be aware of conditions such as cycloid psychosis when managing this vulnerable population.
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Affiliation(s)
- Deepan Singh
- Department of Behavioral Health, NYU Winthrop Hospital, Mineola, New York
| | - Arielle Sasson
- Renaissance School of Medicine, Stony Brook University, Stony Brook, New York
| | - Vanessa Rusciano
- Department of Behavioral Health, NYU Winthrop Hospital, Mineola, New York
| | - Yuji Wakimoto
- Renaissance School of Medicine, Stony Brook University, Stony Brook, New York
| | - Aaron Pinkhasov
- Department of Behavioral Health, NYU Winthrop Hospital, Mineola, New York
| | - Moris Angulo
- Pediatrics, Genetics-Endocrine Center, NYU-Winthrop University Hospital, Mineola, New York
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23
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Lima FCB, do Nascimento Junior EB, Teixeira SS, Coelho FM, Oliveira GDP. Thinking outside the box: cataplexy without narcolepsy. Sleep Med 2019; 61:118-121. [PMID: 31427075 DOI: 10.1016/j.sleep.2019.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 01/02/2023]
Abstract
Cataplexy is a transient loss of muscle tone that can be triggered by emotions such as laughter, excitement or fear. Other causes of cataplexy include Niemann-Pick type C Disease, Angelman Syndrome, Norrie Disease, Prader-Willi Syndrome. In addition, cataplexy can be a side effect of several drugs (eg, lamotrigine, clozapine, and gamma-hydroxybutyrate). Yet, the most prevalent causes of cataplexy without narcolepsy are rare genetic diseases; which explains why cataplexy is classically linked to narcolepsy. Therefore, it is essential disconnecting cataplexy from narcolepsy especially in pediatric population and after use of a few medications. In this review, we described few conditions of cataplexy not related to narcolepsy. We performed a review of literature (MEDLINE and EMBASE database), without limited date or publication restrictions.
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Affiliation(s)
| | | | | | - Fernando Morgadinho Coelho
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Departamento de Neurologia e Neurocirurgia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
| | - Giuliano da Paz Oliveira
- Universidade Federal do Piauí (UFPI), Parnaíba, PI, Brazil; Departamento de Neurologia e Neurocirurgia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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Pullen LC, Picone M, Tan L, Johnston C, Stark H. Cognitive Improvements in Children with Prader-Willi Syndrome Following Pitolisant Treatment-Patient Reports. J Pediatr Pharmacol Ther 2019; 24:166-171. [PMID: 31019411 DOI: 10.5863/1551-6776-24.2.166] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
While children with Prader-Willi Syndrome (PWS), a rare genetic disease with an incidence of 1:15,000, typically present with hypotonia and hyperphagia, their lives are made more difficult by an ever-present sleepiness as well as multiple neuro-cognitive dysfunctions, including cognitive defects. We describe a case series of 3 children who were treated with the histamine 3 receptor inverse agonist pitolisant. While this first-in-class inverse agonist is approved for another orphan disease (i.e., narcolepsy with or without cataplexy), we have observed that pediatric patients with PWS prescribed pitolisant demonstrate decreased daytime sleepiness and improved cognition, as evidenced by increased processing speed and improved mental clarity. Pitolisant may represent a novel therapeutic option that might relieve substantial PWS disease burden, including cognitive disability, excessive daytime sleepiness, and poor-quality nighttime sleep.
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Abstract
OBJECTIVES Prader-Willi syndrome (PWS) is a rare genetic disorder associated with varying degrees of hyperphagia, obesity, intellectual disability, and anxiety across the affected individuals' lifetimes. This study quantified caregiver priorities for potential treatment endpoints to identify unmet needs in PWS. METHODS The authors partnered with the International Consortium to Advance Clinical Trials for PWS (PWS-CTC) and a diverse stakeholder advisory board to develop a best-worst scaling instrument. Seven relevant endpoints were assessed using a balanced incomplete block design. Caregivers were asked to determine the most and least important of a sub-set of four endpoints in each task. Caregivers were recruited nationally though patient registries, email lists, and social media. Best-worst score was calculated to determine caregiver priorities; ranging from 0 (least important) to 10 (most important). A novel kernel-smoothing approach was used to analyze caregiver endpoint priority variations with relation to age of the PWS individual. RESULTS In total, 457 caregivers participated in the study. Respondents were mostly parents (97%), females (83%), and Caucasian (87%) who cared for a PWS individual ranging from 4-54 years. Caregivers value treatments addressing hyperphagia (score = 7.08, SE = 0.17) and anxiety (score = 6.35, SE = 0.16) as most important. Key variations in priorities were observed across age, including treatments targeting anxiety, temper outbursts, and intellectual functions. CONCLUSIONS This study demonstrates that caregivers prioritize hyperphagia and, using a novel method, demonstrates that this is independent of the age of the person with PWS. This is even the case for parents of young children who have yet to experience hyperphagia, indicating that these results are not subject to a hypothetical bias.
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Affiliation(s)
- Jui-Hua Tsai
- a Health Policy and Management Department, Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - Ann O Scheimann
- b Division of Pediatric Gastroenterology and Nutrition , Johns Hopkins Hospital , Baltimore , MD , USA
| | - Shawn E McCandless
- c Department of Pediatrics, University of Colorado Denver School of Medicine and Children's Hospital Colorado , Aurora , CO , USA
| | - Theresa V Strong
- d Foundation for Prader-Willi Research (FPWR) , Walnut , CA , USA
| | - John F P Bridges
- e Department of Biomedical Informatics , The Ohio State University College of Medicine , Columbus , OH , USA
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Xiao KK, Tomur S, Beckerman R, Cassidy K, Lypka M. Orthognathic Correction in Prader-Willi Syndrome: Occlusion and Sleep Restored. Cleft Palate Craniofac J 2018; 56:415-418. [PMID: 29750570 DOI: 10.1177/1055665618775724] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Children with Prader-Willi Syndrome (PWS) may present with a malocclusion and have a high propensity of developing obstructive sleep apnea (OSA). Obstructive sleep apnea is associated with short- and long-term adverse effects that negatively impact children with PWS. A case of a 15-year-old male with PWS, OSA, and a debilitating malocclusion is presented who underwent a combination of Le Fort 1 osteotomy, genioplasty, and tongue reduction to successfully treat his OSA and malocclusion. In select cases, orthognathic correction and other surgical therapies should be considered in patients with PWS.
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Affiliation(s)
- Keliang Kevin Xiao
- 1 Department of Plastic and Reconstructive Surgery, University of Kansas Medical School, Kansas City, MO, USA
| | - Shikhar Tomur
- 2 University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Robert Beckerman
- 2 University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.,3 Children's Mercy Hospital, Kansas City, MO, USA
| | | | - Michael Lypka
- 2 University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.,3 Children's Mercy Hospital, Kansas City, MO, USA
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Pelekhaty S, Menaker J. Venovenous Extracorporeal Membrane Oxygenation in an Adult Patient With Prader-Willi Syndrome: A Nutrition Case Report. Nutr Clin Pract 2018. [PMID: 29532505 DOI: 10.1002/ncp.10069] [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] [Indexed: 11/10/2022] Open
Abstract
Prader-Willi Syndrome (PWS) is a genetic condition that results in a constellation of symptoms and typically results in hyperphagia and obesity in adulthood. Critically ill adults with PWS present a unique challenge to the nutrition professional, particularly when they require support modalities such as extracorporeal membrane oxygenation (ECMO). The purpose of this case study is to review the nutrition care of a critically ill adult patient with PWS who required venovenous ECMO. The patient was successfully managed with a hypocaloric, high-protein approach, which did not result in the diagnosis of malnutrition during his hospitalization. The patient was ultimately transitioned off extracorporeal life support and discharged to a rehabilitation facility.
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Affiliation(s)
- Stacy Pelekhaty
- Department of Clinical Nutrition, University of Maryland Medical Center, Baltimore, Maryland, USA
| | - Jay Menaker
- Department of Surgery, University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA
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Viardot A, Purtell L, Nguyen TV, Campbell LV. Relative Contributions of Lean and Fat Mass to Bone Mineral Density: Insight From Prader-Willi Syndrome. Front Endocrinol (Lausanne) 2018; 9:480. [PMID: 30186239 PMCID: PMC6113716 DOI: 10.3389/fendo.2018.00480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 08/02/2018] [Indexed: 11/13/2022] Open
Abstract
Context: Low bone mineral density (BMD) is the most important risk factor for fragility fracture. Body weight is a simple screening predictor of difference in BMD between individuals. However, it is not clear which component of body weight, lean (LM), or fat mass (FM), is associated with BMD. People with the genetic disorder of Prader-Willi syndrome (PWS) uniquely have a reduced LM despite increased FM. Objective: We sought to define the individual impact of LM and FM on BMD by investigating subjects with and without PWS. Design, Setting and Participants: This cross-sectional study was conducted at the Clinical Research Facility of the Garvan Institute of Medical Research, with PWS and control participants recruited from a specialized PWS clinic and from the general public by advertisement, respectively. The study involved 11 adults with PWS, who were age- and sex-matched with 12 obese individuals (Obese group) and 10 lean individuals (Lean group). Main Outcome Measures: Whole body BMD was measured by dual-energy X-ray absorptiometry. Total body FM and LM were derived from the whole body scan. Differences in BMD between groups were assessed by the analysis of covariance model, taking into account the effects of LM and FM. Results: The PWS group had significantly shorter height than the lean and obese groups. As expected, there was no significant difference in FM between the Obese and PWS group, and no significant difference in LM between the Lean and PWS group. However, obese individuals had greater LM than lean individuals. BMD in lean individuals was significantly lower than in PWS individuals (1.13 g/cm2 vs. 1.21 g/cm2, p < 0.05) and obese individuals (1.13 g/cm2 vs. 1.25 g/cm2, p < 0.05). After adjusting for both LM and FM, there was no significant difference in BMD between groups, and the only significant predictor of BMD was LM. Conclusions: These data from the human genetic model Prader-Willi syndrome suggest that LM is a stronger determinant of BMD than fat mass.
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Affiliation(s)
- Alexander Viardot
- Diabetes and Metabolism Division, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- Department of Endocrinology, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia
- St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- *Correspondence: Alexander Viardot
| | - Louise Purtell
- Diabetes and Metabolism Division, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Tuan V. Nguyen
- St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Bone Biology Division, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- School of Biomedical Engineering, University of Technology Sydney, Ultimo, NSW, Australia
| | - Lesley V. Campbell
- Diabetes and Metabolism Division, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- Department of Endocrinology, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia
- St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
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Matarazzo V, Caccialupi L, Schaller F, Shvarev Y, Kourdougli N, Bertoni A, Menuet C, Voituron N, Deneris E, Gaspar P, Bezin L, Durbec P, Hilaire G, Muscatelli F. Necdin shapes serotonergic development and SERT activity modulating breathing in a mouse model for Prader-Willi syndrome. eLife 2017; 6:32640. [PMID: 29087295 PMCID: PMC5711373 DOI: 10.7554/elife.32640] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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: 10/09/2017] [Accepted: 10/29/2017] [Indexed: 12/31/2022] Open
Abstract
Prader-Willi syndrome (PWS) is a genetic neurodevelopmental disorder that presents with hypotonia and respiratory distress in neonates. The Necdin-deficient mouse is the only model that reproduces the respiratory phenotype of PWS (central apnea and blunted response to respiratory challenges). Here, we report that Necdin deletion disturbs the migration of serotonin (5-HT) neuronal precursors, leading to altered global serotonergic neuroarchitecture and increased spontaneous firing of 5-HT neurons. We show an increased expression and activity of 5-HT Transporter (SERT/Slc6a4) in 5-HT neurons leading to an increase of 5-HT uptake. In Necdin-KO pups, the genetic deletion of Slc6a4 or treatment with Fluoxetine, a 5-HT reuptake inhibitor, restored normal breathing. Unexpectedly, Fluoxetine administration was associated with respiratory side effects in wild-type animals. Overall, our results demonstrate that an increase of SERT activity is sufficient to cause the apneas in Necdin-KO pups, and that fluoxetine may offer therapeutic benefits to PWS patients with respiratory complications. Prader-Willi syndrome results from the disruption of a cluster of neighboring genes, including one called Necdin. Symptoms begin in early infancy and worsen with age. Affected children tend to develop an insatiable appetite, which often leads to obesity. They also experience serious problems with their breathing. Chest infections, high altitude and intense physical activity can be dangerous for children with Prader-Willi syndrome. This is because a slight shortage of oxygen may trigger breathing difficulties that could prove fatal. The brain cells that produce a chemical messenger called serotonin help to control breathing. Several lines of evidence suggest that loss of Necdin may trigger breathing difficulties in Prader-Willi syndrome via effects on the serotonin system. First, serotonin neurons produce the Necdin protein. Second, laboratory mice that lack the gene for Necdin have abnormally shaped serotonin neurons. Third, these mice show breathing difficulties like those of individuals with Prader-Willi syndrome. But while this implies a connection between serotonin, Necdin and breathing difficulties, it falls short of establishing a causal link. Matarazzo et al. now reveal an increase in the quantity and activity of a protein called the serotonin transporter in mutant mice that lacked the gene for Necdin compared to normal mice. Serotonin transporter proteins mop up the serotonin that neurons release when they signal to one another. Neurons in the mutant mice take up more serotonin than their counterparts in normal mice; this means they have less serotonin available for signaling. This may make it harder for the mutant mice to regulate their breathing. Drugs called selective serotonin-reuptake inhibitors (or SSRIs for short) can block the serotonin transporter. These drugs, which include Fluoxetine (also called Prozac), are antidepressants. Matarazzo et al. show that SSRIs temporarily restore normal breathing in young mice that lack the gene for Necdin. However, these drugs have harmful long-term effects on breathing in non-mutant mice. Further studies should test whether short-term use of SSRIs could offer immediate relief for breathing difficulties in infants and children with Prader-Willi syndrome.
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Affiliation(s)
| | | | | | - Yuri Shvarev
- Department of Women's and Children's Health, Karolinska Institute, Solna, Sweden
| | | | | | | | | | - Evan Deneris
- Department of Neurosciences, Case Western Reserve University, Cleveland, United States
| | - Patricia Gaspar
- UPMC Univ Paris 6, Institut du Fer à Moulin, INSERM, Paris, France
| | - Laurent Bezin
- Lyon Neuroscience Research Center, Université de Lyon, INSERM, CNRS, Lyon, France
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Lecka-Ambroziak A, Jędrzejczak M, Wysocka-Mincewicz M, Szalecki M. Sleep-related breathing disorders in patients with Prader-Willi syndrome depending on the period of growth hormone treatment. Endokrynol Pol 2017; 68:676-681. [PMID: 29022650 DOI: 10.5603/ep.a2017.0057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 07/23/2017] [Accepted: 07/24/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Sleep-related breathing disorders (SRBD) are commonly present in patients with Prader-Willi syndrome (PWS). Recombinant human growth hormone (rhGH) treatment is reported to improve breathing function in PWS, but the findings are not explicit. MATERIAL AND METHODS Screening polysomnography- polygraphy (PSG), assessing nasal respiratory flow, respiratory effort, and blood oxygen saturation, was used. Group 1 - before rhGH therapy (n = 11, mean age 3.0 years); PSG was repeated after the start of rhGH therapy in a mean time of 0.9 years in six patients (Group 1a). Group 2 - on rhGH treatment, for a mean time of four years (n = 17, mean age 8.8 years). Group 3 - without rhGH therapy due to severe obesity (n = 8, mean age 13.1 years). RESULTS Group 1 - mean apnoea-hypopnoea index (AHI) was 10.2, oxygen desaturation index (ODI)- 36.3, Group 1a- AHI 12.0, ODI 60.9, Group 2-AHI 9.0, ODI 25.1, Group 3- AHI 8.2, ODI 22.0. ODI was significantly higher in Group 1a than in the other groups (p < 0.005), but not strictly related to SRBD. The results in Group 2 did not differ significantly from those of Group 1. CONCLUSIONS Our study proves the high frequency of SRBD among PWS patients, with worsening of ODI after short-term rhGH therapy.
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Briegel W. [Neuropsychiatric aspects of Prader-Willi syndrome – a review]. Z Kinder Jugendpsychiatr Psychother 2017; 46:238-246. [PMID: 28613110 DOI: 10.1024/1422-4917/a000530] [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] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Prader-Willi Syndrome (PWS) is caused by the absence of paternal expression of imprinted genes in the region at 15q11–q13. With an estimated birth incidence of 1/15 000 – 1/30 000, PWS is one of the more frequent genetic syndromes among humans. Typical physical features include neonatal hypotonia and feeding problems, hypogonadism, hyperphagia in later childhood with consecutive obesity, and short stature. Most people with PWS show a mild to moderate intellectual disability. Furthermore, lability of mood, temper tantrums, skin-picking, and compulsive behaviors are quite typical for subjects with PWS. Psychotic disorders have also been found to be quite common in adulthood. This manuscript reviews current knowledge about the etiology, physical features, developmental aspects, behavioral phenotype, and psychiatric disorders that occur as well as existing psychopharmacological and psychotherapeutic interventions.
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Affiliation(s)
- Wolfgang Briegel
- 1 Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Leopoldina-Krankenhaus, Schweinfurt/ Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Julius-Maximilians-Universität, Würzburg
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Scheermeyer E, Harris M, Hughes I, Crock PA, Ambler G, Verge CF, Bergman P, Werther G, Craig ME, Choong CS, Davies PSW. Low dose growth hormone treatment in infants and toddlers with Prader-Willi syndrome is comparable to higher dosage regimens. Growth Horm IGF Res 2017; 34:1-7. [PMID: 28427039 DOI: 10.1016/j.ghir.2017.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 02/13/2017] [Accepted: 03/23/2017] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Evaluate benefit and risk of low dose growth hormone treatment (GHT, 4.5mg/m2/week) in very young children with Prader-Willi Syndrome (PWS). DESIGN Prospective longitudinal clinical intervention. METHODS We evaluated 31 infants (aged 2-12months) and 42 toddlers (13-24months) from the PWS-OZGROW database for height, weight and BMI using the World Health Organization standard deviation scores (SDSWHO) and PWS specific BMI (SDSPWS), bone age, insulin-like growth factor 1 (IGF-I) levels and adverse events over 3years of GHT. RESULTS At commencement of GHT infants had a lower BMI SDSWHO (-0.88 vs 0.40) than toddlers, while toddlers had a lower height SDSWHO (-1.44 vs -2.09) (both P<0.05). All increased height SDSWHO (2year delta height infants +1.26 SDS, toddlers+1.21 SDS), but infants normalised height sooner, achieving a height SDS of -0.56 within 1year, while toddlers achieved a height SDS of -0.88 in two years. BMI SDSWHO increased, while BMI SDSPWS decreased (both P<0.0001) and remained negative. The GHT response did not differ with gestation (preterm 23%) or genetic subtype (deletion vs maternal uniparental disomy). Bone age advancement paralleled chronological age. All children had low serum IGF-I at baseline which increased, but remained within the age-based reference range during GHT (for 81% in first year). Four children had spinal curvature at baseline; two improved, two progressed to a brace and two developed an abnormal curve over the observation period. Mild to severe central and/or obstructive sleep apnoea were observed in 40% of children prior to GHT initiation; 11% commenced GHT on positive airway pressure (PAP), oxygen or both. Eight children ceased GHT due to onset or worsening of sleep apnoea: 2 infants in the first few months and 6 children after 6-24months. Seven resumed GHT usually after adjusting PAP but five had adenotonsillectomy. One child ceased GHT temporarily due to respiratory illness. No other adverse events were reported. Two children substantially improved their breathing shortly after GHT initiation. CONCLUSION Initiation of GHT in infants with 4.5mg/m2/week was beneficial and comparable in terms of auxological response to a dose of 7mg/m2/week. Regular monitoring pre and post GH initiation assisted in early detection of adverse events. IGF-I levels increased with the lower dose but not excessively, which may lower potential long-term risks.
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Affiliation(s)
- Elly Scheermeyer
- Faculty of Medicine, Primary Care Clinical Unit, The University of Queensland, Brisbane, Australia; Child Health Research Centre, The University of Queensland, Brisbane, Australia.
| | - Mark Harris
- Lady Cilento Children's Hospital, Brisbane, Australia; Mater Research Institute - UQ, The University of Queensland, Brisbane, Australia
| | - Ian Hughes
- Mater Research Institute - UQ, The University of Queensland, Brisbane, Australia
| | - Patricia A Crock
- John Hunter Children's Hospital, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Geoffrey Ambler
- The Children's Hospital at Westmead and Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia
| | - Charles F Verge
- Sydney Children's Hospital, School of Women's and Children's Health, University of New South Wales, Sydney, Australia
| | | | | | - Maria E Craig
- The Children's Hospital at Westmead and Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia
| | - Catherine S Choong
- Princess Margaret Hospital, School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Peter S W Davies
- Child Health Research Centre, The University of Queensland, Brisbane, Australia
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Bassett JK, Chandler KE, Douzgou S. Two patients with chromosome 22q11.2 deletion presenting with childhood obesity and hyperphagia. Eur J Med Genet 2016; 59:401-3. [PMID: 27184501 DOI: 10.1016/j.ejmg.2016.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 05/10/2016] [Accepted: 05/12/2016] [Indexed: 12/13/2022]
Abstract
Chromosome 22q11.2 deletion syndrome is a clinically heterogeneous condition of intellectual disability, parathyroid and thyroid hypoplasia, palatal abnormalities, cardiac malformations and psychiatric symptoms. Hyperphagia and childhood obesity is widely reported in Prader-Willi Syndrome (PWS) but there is only one previous report of this presentation in chromosome 22q11.2 deletion syndrome. We describe two further cases of chromosome 22q11.2 deletion syndrome in which hyperphagia and childhood obesity were the presenting features. This may be a manifestation of obsessive behaviour secondary to some of the psychiatric features commonly seen in chromosome 22q11.2 deletion syndrome. Serious complications may result from hyperphagia and childhood obesity therefore early recognition and intervention is crucial. Due to the similar clinical presentation of these two patients to patients with PWS, it is suggested that the hyperphagia seen here should be managed in a similar way to how it is managed in PWS.
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Abstract
Prader-Willi syndrome is a neurodevelopmental disorder characterized by mental retardation and distinct physical, behavioral, and psychiatric features. Maladaptive behaviours, cognitive impairment, and impediments in speech and language seriously affect the early development and long-term functioning of individuals affected by the illness. We present a case of a 9-year-old child with Prader-Willi syndrome whose behavioural symptoms were treated with low-dose antipsychotic medications.
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Affiliation(s)
- Satyakam Mohapatra
- Mental Health Institute, Sriram Chandra Bhanj (SCB) Medical College, Cuttack, Odisha, India
| | - Udit Kumar Panda
- Mental Health Institute, Sriram Chandra Bhanj (SCB) Medical College, Cuttack, Odisha, India
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Höybye C. Growth hormone treatment of Prader-Willi syndrome has long-term, positive effects on body composition. Acta Paediatr 2015; 104:422-7. [PMID: 25557351 DOI: 10.1111/apa.12898] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [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: 06/27/2014] [Revised: 09/27/2014] [Accepted: 12/11/2014] [Indexed: 11/27/2022]
Abstract
AIM Growth hormone (GH) treatment is a relatively new concept in adults, and the knowledge of its long-term effects is limited. We studied ten men with Prader-Willi Syndrome (PWS) after more than 5 years of GH treatment. METHODS Study participants underwent a detailed physical examination, including blood tests. Five had received GH as childhood and five had started GH as adults. RESULTS The total duration of GH treatment was 16 ± 4 years in the childhood PWS group and 15 ± 1 years in the adulthood PWS group. Their respective mean ages were 27 ± 4 years and 44 ± 4 years, mean heights were 178 ± 11 cm and 156 ± 5 cm, and mean body mass indexes were 32.4 ± 10.3 kg/m(2) and 28.9 ± 4.6 kg/m(2) . There were no differences in body composition between the groups and all lipids and insulin-like growth factor 1 were normal or close to normal. Four had well-controlled type 2 diabetes. The GH doses in the childhood and adulthood groups were 0.4 mg and 0.3 mg, respectively. CONCLUSION Men with PWS who received GH treatment displayed positive effects on body composition independent of when the GH treatment had started. Only patients who gained weight developed diabetes. The duration of GH treatment should balance the benefits and observed side effects.
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Affiliation(s)
- Charlotte Höybye
- Department of endocrinology; Metabolism and diabetology; Karolinska University Hospital and Department of molecular medicine and surgery; Karolinska Institute; Stockholm Sweden
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Lionti T, Reid SM, White SM, Rowell MM. A population-based profile of 160 Australians with Prader-Willi syndrome: trends in diagnosis, birth prevalence and birth characteristics. Am J Med Genet A 2014; 167A:371-8. [PMID: 25424396 DOI: 10.1002/ajmg.a.36845] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [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: 04/08/2014] [Accepted: 09/29/2014] [Indexed: 11/08/2022]
Abstract
Perceived temporal trends in recognition and diagnosis of Prader-Willi syndrome served as the rationale for an updated epidemiological profile of individuals with this syndrome. Data from the Victorian Prader-Willi Syndrome Register were used to explore birth prevalence, birth characteristics, timing of diagnosis, and molecular mechanism, and to identify trends over time. Maternal age, birth gestation, small for gestational age, and sex were compared across molecular mechanisms. Between 1951 and 2012 there were 160 individuals with Prader-Willi syndrome, known to the Victorian Prader-Willi Syndrome Register, who were born in the Australian state of Victoria. The birth prevalence for individuals with a molecular diagnosis of Prader-Willi syndrome was estimated to be 1:15,830 for 2003-2012. Compared to 1973-1981, the decade 2003-2012 saw an increase in the rate of molecular diagnosis from 58% to 96%, more complete identification of the molecular mechanism (42% vs. 83%), earlier molecular diagnosis (1.3 years vs. 8.6 weeks), and a rise in the relative proportion of maternal uniparental disomy from 0% to 45%. One quarter of infants was born preterm and 53% were small for gestational age. This study confirms a temporal change in diagnostic patterns, suggests a greater relative contribution of maternal uniparental disomy as a molecular mechanism, provides a more robust estimate of birth prevalence and provides evidence of in utero growth restriction for this group. These findings have important clinical and health service delivery implications and pave the way for further research in Prader-Willi syndrome.
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Affiliation(s)
- Tess Lionti
- Murdoch Childrens Research Institute, Melbourne, Australia
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Castner DM, Tucker JM, Wilson KS, Rubin DA. Patterns of habitual physical activity in youth with and without Prader-Willi Syndrome. Res Dev Disabil 2014; 35:3081-3088. [PMID: 25129202 DOI: 10.1016/j.ridd.2014.07.035] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 07/14/2014] [Accepted: 07/15/2014] [Indexed: 06/03/2023]
Abstract
Children classified as overweight or obese and those with disabilities are at a greater risk of not meeting the minimum recommendation of 60 min a day of moderate to vigorous physical activity (PA). Youth with Prader-Willi Syndrome (PWS) appear to participate in less PA compared to nonsyndromal children, likely due to syndrome-related factors. However, description of PA patterns in youth with PWS is lacking. The purpose of this study was to characterize PA in youth with PWS and to compare it to PA in children with nonsyndromal obesity. Twenty-four youth with PWS (ages 8-16 years) and 40 obese children without PWS (OB) (ages 8-11 years) wore accelerometers for eight consecutive days. Data were screened for compliance and classified into PA intensities: sedentary behavior (SED), light (LPA), moderate (MPA), vigorous (VPA) and moderate plus vigorous (MVPA). Youth with PWS spent 19.4% less time in weekly LPA (p=0.007) and 29.8% less time in weekly VPA compared to OB controls (p=0.036). All other intensities were similar between groups. In addition, PWS participated in less LPA and VPA during the weekends compared to OB, and less LPA on weekdays when compared to OB. There was also a trend towards PWS participating in less MVPA during the weekends and less VPA during the weekends than OB controls. There was a trend towards PWS participating in less VPA on weekends compared to weekdays, while OB participated similarly in VPA on weekdays and weekend days. On average, neither PWS nor OB children met minimum MVPA recommendations. The results suggest there is a need to design exercise programs for PWS youth that focus on integrating vigorous intensity activities, especially during the weekends when structured PA may not be available.
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Affiliation(s)
- Diobel M Castner
- Department of Kinesiology, California State University, Fullerton, 800 North State College Boulevard, Fullerton, CA 92834, USA.
| | - Jared M Tucker
- Healthy Weight Center, Helen DeVos Children's Hospital, 100 Michigan NE, Grand Rapids, MI 49503, USA.
| | - Kathleen S Wilson
- Department of Kinesiology, California State University, Fullerton, 800 North State College Boulevard, Fullerton, CA 92834, USA.
| | - Daniela A Rubin
- Department of Kinesiology, California State University, Fullerton, 800 North State College Boulevard, Fullerton, CA 92834, USA.
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Crockett DJ, Ahmed SR, Sowder DR, Wootten CT, Chinnadurai S, Goudy SL. Velopharyngeal dysfunction in children with Prader-Willi syndrome after adenotonsillectomy. Int J Pediatr Otorhinolaryngol 2014; 78:1731-4. [PMID: 25130946 DOI: 10.1016/j.ijporl.2014.07.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 07/22/2014] [Accepted: 07/24/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Prader-Willi syndrome (PWS) is a rare genetic disorder with an incidence rate of 1 in 10,000-30,000. Patients with PWS typically have symptoms related to hypotonia, obesity, and hypothalamic dysfunction. A high rate of obstructive sleep apnea (OSA) is found among this population of patients. Adenotonsillectomy has been advocated as a first line approach for treatment of OSA in patients with PWS. Velopharyngeal dysfunction (VPD) is a known complication of adenotonsillectomy. VPD can also be present in patients with global hypotonia, such as those with PWS. The objective of this study is to review the occurrence of VPD in patients with PWS after adenotonsillectomy for OSA. METHODS A retrospective review was performed of all patients with PWS and OSA from a tertiary pediatric hospital between the years of 2002 and 2012. Pre- and post-operative sleep studies and sleep disordered breathing symptoms, post-operative VPD assessment by the speech-language pathologist (SLP), and VPD treatments were evaluated. RESULTS Eleven patients (five males and six females), fitting the inclusion criteria, were identified. The age of the patient at the initial otolaryngologic evaluation ranged from 2 to 9 years. All patients underwent adenotonsillectomy for sleep disordered breathing. Four patients were diagnosed with post-operative hypernasality after assessment by a speech-language pathologist. The hypernasality ranged from mild to moderately severe. Of the four patients with hypernasality, two were found to have structural issues requiring surgery (pharyngeal flap). Both of the surgical patients experienced significant improvement in their VPD after surgery. The remaining two patients were found to have articulation error patterns that were considered more developmental in nature and both responded to speech therapy. All patients, except one, had improvement in their polysomnogram or sleep symptoms after adenotonsillectomy. However, three patients continue to require continuous positive airway pressure at night. CONCLUSION Velopharyngeal dysfunction may occur after adenotonsillectomy in patients with Prader-Willi Syndrome. Families should be counseled of this risk and the potential need for operative intervention to correct it.
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Affiliation(s)
- David J Crockett
- Vanderbilt University Medical Center, Department of Otolaryngology, 7209 Medical Center-East-South Tower, 1215 21st Avenue South, Nashville, TN, 37232, USA.
| | - Saqib R Ahmed
- Marshall University Medical Center, School of Medicine, 1600 Medical Center Drive, Huntington, WV, 25701, USA.
| | - Derrick R Sowder
- Vanderbilt University Medical Center, Hearing and Speech, 7209 Medical Center-East-South Tower, 1215 21st Avenue South, Nashville, TN, 37232, USA.
| | - Christopher T Wootten
- Vanderbilt University Medical Center, Department of Otolaryngology, 7209 Medical Center-East-South Tower, 1215 21st Avenue South, Nashville, TN, 37232, USA.
| | - Sivakumar Chinnadurai
- Vanderbilt University Medical Center, Department of Otolaryngology, 7209 Medical Center-East-South Tower, 1215 21st Avenue South, Nashville, TN, 37232, USA.
| | - Steven L Goudy
- Vanderbilt University Medical Center, Department of Otolaryngology, 7209 Medical Center-East-South Tower, 1215 21st Avenue South, Nashville, TN, 37232, USA.
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Colmers WF, Wevrick R. Leptin signaling defects in a mouse model of Prader-Willi syndrome: An orphan genetic obesity syndrome no more? Rare Dis 2013; 1:e24421. [PMID: 25002992 PMCID: PMC3927482 DOI: 10.4161/rdis.24421] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 03/22/2013] [Indexed: 11/19/2022] Open
Abstract
Prader-Willi syndrome (PWS) is a rare (~1 in 12,000) genetic disorder that involves at least six genes on chromosome 15q11–q13. Children with PWS not only rapidly gain weight and become severely obese because of reduced voluntary activity and increased food intake, but also exhibit growth hormone deficiency, excessive daytime sleepiness, endocrine dysregulation and infertility. These phenotypes suggest dysfunction of the hypothalamus, the brain region that regulates short- and long-term energy balance and other body functions. The physiological basis for obesity in children with PWS has eluded researchers for decades. Mercer et al. now demonstrate that Magel2, the murine ortholog of one of the PWS genes, is a component of the hypothalamic leptin-melanocortin pathway that is critical for energy balance. Most interestingly, disruptions of other components of this pathway cause obesity in both mice and humans, suggesting a mechanistic link between PWS and other rare genetic forms of severe childhood-onset obesity.
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Affiliation(s)
- William F Colmers
- Department of Pharmacology; University of Alberta; Edmonton, AB Canada
| | - Rachel Wevrick
- Department of Medical Genetics; University of Alberta; Edmonton, AB Canada
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Skokauskas N, Sweeny E, Meehan J, Gallagher L. Mental health problems in children with prader-willi syndrome. J Can Acad Child Adolesc Psychiatry 2012; 21:194-203. [PMID: 22876265 PMCID: PMC3413469] [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] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Accepted: 11/11/2011] [Indexed: 06/01/2023]
Abstract
BACKGROUND Prader-Willi Syndrome (PWS) is a genetically determined neurodevelopmental disorder, which occurs in approximately one in 22000 births. AIMS This study aimed to investigate psychiatric characteristics of children diagnosed with PWS compared with an age-, gender- and IQ-matched control group. The parents of children with PWS were assessed for psychological distress in comparison to the parents of the control group. Methodological limitations identified in previous studies were addressed in the present study. METHODS Psychiatric problems were evaluated in a sample of children with genetically confirmed PWS and an age- and IQ-matched control group using the Child Behaviour Checklist 6-18. Parental psychological distress for both groups was evaluated with the Brief Symptom Inventory. RESULTS Children with PWS had more severe somatic, social, and thought problems, and were more withdrawn-depressed in comparison to controls. Borderline difficulties were detected for the affective, somatic, and attention deficit-hyperactivity CBCL DSM-orientated subscales in the PWS group. Parents of PWS children, in comparison to controls, had more somatization, phobic anxiety, obsessive-compulsive, and anxiety problems. CONCLUSIONS PWS represents a complex psychological disorder with multiple areas of disturbances.
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Affiliation(s)
| | - Eileen Sweeny
- St. James’s Hospital, Dublin, Department of Child Psychiatry, Dublin, Ireland
| | - Judith Meehan
- Trinity College Dublin, Department of Paediatrics, Dublin, Ireland
| | - Louise Gallagher
- Trinity College Dublin, Department of Psychiatry, Dublin, Ireland
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