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Carpenter JC, Männikkö R, Heffner C, Heneine J, Sampedro‐Castañeda M, Lignani G, Schorge S. Progressive myoclonus epilepsy KCNC1 variant causes a developmental dendritopathy. Epilepsia 2021; 62:1256-1267. [PMID: 33735526 PMCID: PMC8436768 DOI: 10.1111/epi.16867] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Mutations in KCNC1 can cause severe neurological dysfunction, including intellectual disability, epilepsy, and ataxia. The Arg320His variant, which occurs in the voltage-sensing domain of the channel, causes a highly penetrant and specific form of progressive myoclonus epilepsy with severe ataxia, designated myoclonus epilepsy and ataxia due to potassium channel mutation (MEAK). KCNC1 encodes the voltage-gated potassium channel KV 3.1, a channel that is important for enabling high-frequency firing in interneurons, raising the possibility that MEAK is associated with reduced interneuronal function. METHODS To determine how this variant triggers MEAK, we expressed KV 3.1bR320H in cortical interneurons in vitro and investigated the effects on neuronal function and morphology. We also performed electrophysiological recordings of oocytes expressing KV 3.1b to determine whether the mutation introduces gating pore currents. RESULTS Expression of the KV 3.1bR320H variant profoundly reduced excitability of mature cortical interneurons, and cells expressing these channels were unable to support high-frequency firing. The mutant channel also had an unexpected effect on morphology, severely impairing neurite development and interneuron viability, an effect that could not be rescued by blocking KV 3 channels. Oocyte recordings confirmed that in the adult KV 3.1b isoform, R320H confers a dominant negative loss-of-function effect by slowing channel activation, but does not introduce potentially toxic gating pore currents. SIGNIFICANCE Overall, our data suggest that, in addition to the regulation of high-frequency firing, KV 3.1 channels play a hitherto unrecognized role in neuronal development. MEAK may be described as a developmental dendritopathy.
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Affiliation(s)
- Jenna C. Carpenter
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
| | - Roope Männikkö
- Department of Neuromuscular DiseasesUniversity College London Queen Square Institute of NeurologyLondonUK
| | - Catherine Heffner
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
| | - Jana Heneine
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
| | - Marisol Sampedro‐Castañeda
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
| | - Gabriele Lignani
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
| | - Stephanie Schorge
- Department of PharmacologyUniversity College London School of PharmacyLondonUK
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Oi K, Neshige S, Hitomi T, Kobayashi K, Tojima M, Matsuhashi M, Shimotake A, Fujii D, Matsumoto R, Kasama S, Kanda M, Wada Y, Maruyama H, Takahashi R, Ikeda A. Low-dose perampanel improves refractory cortical myoclonus by the dispersed and suppressed paroxysmal depolarization shifts in the sensorimotor cortex. Clin Neurophysiol 2019; 130:1804-1812. [PMID: 31401489 DOI: 10.1016/j.clinph.2019.07.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/31/2019] [Accepted: 07/09/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To elucidate the effects of perampanel (PER) on refractory cortical myoclonus for dose, etiology and somatosensory-evoked potential (SEP) findings. METHODS We examined 18 epilepsy patients with seizure and cortical myoclonus. Based on data accumulated before and after PER treatment, correlations among clinical scores in myoclonus and activities of daily life (ADL); early cortical components of SEP; and PER blood concentration, were analyzed. RESULTS PER (mean dose: 3.2 ± 2.1 mg/day) significantly improved seizures, myoclonus and ADL and significantly decreased the amplitude of and prolonged latency of giant SEP components. The degree of P25 and N33 prolongations (23.8 ± 1.6 to 24.7 ± 1.7 ms and 32.1 ± 4.0 to 33.7 ± 3.4 ms) were significantly correlated with improved ADL score (p = 0.019 and p = 0.025) and blood PER concentration (p = 0.011 and p = 0.025), respectively. CONCLUSIONS Low-dose PER markedly improved myoclonus and ADL in patients with refractory cortical myoclonus. Our results suggest that SEP, particularly P25 latency, can be used as a potential biomarker for assessing the objective effects of PER on intractable cortical myoclonus. SIGNIFICANCE In this study, PER lessened the degree of synchronized discharges in the postsynaptic neurons in the primary motor cortex.
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Affiliation(s)
- Kazuki Oi
- Department of Neurology, Kyoto University Graduate School of Medicine, Japan
| | - Shuichiro Neshige
- Department of Neurology, Kyoto University Graduate School of Medicine, Japan; Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan; Department of Futaba Emergency General Medicine Supportive Center, Fukushima Medical University, Japan
| | - Takefumi Hitomi
- Department of Neurology, Kyoto University Graduate School of Medicine, Japan; Department of Laboratory Medicine, Kyoto University Graduate School of Medicine, Japan
| | - Katsuya Kobayashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Japan
| | - Maya Tojima
- Department of Neurology, Kyoto University Graduate School of Medicine, Japan
| | - Masao Matsuhashi
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Japan
| | - Akihiro Shimotake
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Japan
| | - Daiki Fujii
- Department of Neurology, Kyoto University Graduate School of Medicine, Japan; Department of Neurology, Kurashiki Central Hospital, Japan
| | - Riki Matsumoto
- Department of Neurology, Kyoto University Graduate School of Medicine, Japan; Department of Neurology, Kobe University Graduate School of Medicine, Japan
| | - Shuhei Kasama
- Department of Neurology, Hyogo College of Medicine, Japan
| | | | - Yoshiaki Wada
- Department of Rehabilitation, Nissan Tamagawa Hospital, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Japan
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Japan.
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Tian WT, Liu XL, Xu YQ, Huang XJ, Zhou HY, Wang Y, Tang HD, Chen SD, Luan XH, Cao L. Progressive myoclonus epilepsy without renal failure in a Chinese family with a novel mutation in SCARB2 gene and literature review. Seizure 2018; 57:80-86. [PMID: 29605618 DOI: 10.1016/j.seizure.2018.03.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/16/2018] [Accepted: 03/13/2018] [Indexed: 10/17/2022] Open
Abstract
PURPOSE To describe the clinical and genetic features of a Chinese progressive myoclonus epilepsy (PME) patient related with SCARB2 mutation without renal impairment and review 27 SCARB2-related PME patients from 11 countries. METHODS The patient was a 27-year-old man with progressive action myoclonus, ataxia, epilepsy, dysarthria and absence of cognitive deterioration. Renal functional test was normal. Electroencephalography (EEG) showed progressively slowed background activity and sporadic generalized spike-and-wave discharges. Electromyography (EMG) showed slowed motor and sensory nerve conduction velocities and distal motor latency delay accompanied by normal compound motor action potential (CMAP) and amplitudes of sensory nerve action potential (SNAP). The amplitude of cortical components of brainstem auditory-evoked potential (BAEP) was normal with slightly prolonged latencies. Generalized atrophy, ventricle enlargement and white matter degeneration was observed in brain magnetic resonance imaging (MRI). Open muscle biopsy and genetic analysis were performed. Two hundred healthy individuals were set for control. Quantitative real time PCR (qPCR), western blotting and immunofluorescence were carried out to evaluate the fate of the SCARB2 mRNA and lysosomal-membrane type 2 (LIMP2) protein level. RESULTS One homozygous mutation in SCARB2 gene (c.1187 + 5G > T) was identified in the patient. Each of his parents carried a heterozygous variant. This mutation was not detected among the healthy controls and predicted to be damaging or disease causing by prediction tools. qPCR revealed a significantly lower level of SCARB2 mRNA in peripheral blood cell of the proband compared with his parents and healthy control individuals. Muscle biopsy showed mild variation in fiber size. Western blotting and immunofluorescence detected an extremely weak signal of LIMP2 protein from skeletal muscle of the proband. CONCLUSION In this study, we identified a SCARB2-related PME patient with normal renal function and a novel homozygous splicing mutation. SCARB2 gene should be analyzed in patients with progressive action myoclonus, epilepsy, peripheral neuropathy, without cognitive deterioration or renal failure.
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Affiliation(s)
- Wo-Tu Tian
- Department of Neurology and Institute of Neurology, Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Xiao-Li Liu
- Department of Neurology and Institute of Neurology, Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Department of Neurology, Shanghai Fengxian District Central Hospital, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, Shanghai, 201406, China.
| | - Yang-Qi Xu
- Department of Neurology and Institute of Neurology, Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Xiao-Jun Huang
- Department of Neurology and Institute of Neurology, Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Hai-Yan Zhou
- Department of Neurology and Institute of Neurology, Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Ying Wang
- Department of Neurology and Institute of Neurology, Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Hui-Dong Tang
- Department of Neurology and Institute of Neurology, Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Sheng-Di Chen
- Department of Neurology and Institute of Neurology, Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Xing-Hua Luan
- Department of Neurology and Institute of Neurology, Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Li Cao
- Department of Neurology and Institute of Neurology, Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
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Baron O, Boudi A, Dias C, Schilling M, Nölle A, Vizcay-Barrena G, Rattray I, Jungbluth H, Scheper W, Fleck RA, Bates GP, Fanto M. Stall in Canonical Autophagy-Lysosome Pathways Prompts Nucleophagy-Based Nuclear Breakdown in Neurodegeneration. Curr Biol 2017; 27:3626-3642.e6. [PMID: 29174892 PMCID: PMC5723708 DOI: 10.1016/j.cub.2017.10.054] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 09/19/2017] [Accepted: 10/20/2017] [Indexed: 12/31/2022]
Abstract
The terminal stages of neuronal degeneration and death in neurodegenerative diseases remain elusive. Autophagy is an essential catabolic process frequently failing in neurodegeneration. Selective autophagy routes have recently emerged, including nucleophagy, defined as degradation of nuclear components by autophagy. Here, we show that, in a mouse model for the polyglutamine disease dentatorubral-pallidoluysian atrophy (DRPLA), progressive acquirement of an ataxic phenotype is linked to severe cerebellar cellular pathology, characterized by nuclear degeneration through nucleophagy-based LaminB1 degradation and excretion. We find that canonical autophagy is stalled in DRPLA mice and in human fibroblasts from patients of DRPLA. This is evidenced by accumulation of p62 and downregulation of LC3-I/II conversion as well as reduced Tfeb expression. Chronic autophagy blockage in several conditions, including DRPLA and Vici syndrome, an early-onset autolysosomal pathology, leads to the activation of alternative clearance pathways including Golgi membrane-associated and nucleophagy-based LaminB1 degradation and excretion. The combination of these alternative pathways and canonical autophagy blockade, results in dramatic nuclear pathology with disruption of the nuclear organization, bringing about terminal cell atrophy and degeneration. Thus, our findings identify a novel progressive mechanism for the terminal phases of neuronal cell degeneration and death in human neurodegenerative diseases and provide a link between autophagy block, activation of alternative pathways for degradation, and excretion of cellular components.
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Affiliation(s)
- Olga Baron
- Department of Basic and Clinical Neuroscience, King's College London, 125 Coldharbour Lane, SE5 9NU London, UK
| | - Adel Boudi
- Department of Basic and Clinical Neuroscience, King's College London, 125 Coldharbour Lane, SE5 9NU London, UK
| | - Catarina Dias
- Department of Basic and Clinical Neuroscience, King's College London, 125 Coldharbour Lane, SE5 9NU London, UK
| | - Michael Schilling
- Department of Basic and Clinical Neuroscience, King's College London, 125 Coldharbour Lane, SE5 9NU London, UK
| | - Anna Nölle
- Department of Clinical Genetics and Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands; Department of Functional Genome Analysis, VU University, Amsterdam, the Netherlands
| | - Gema Vizcay-Barrena
- Centre for Ultrastructural Imaging, King's College London, SE1 1UL London, UK
| | - Ivan Rattray
- Department Medical and Molecular Genetics, School of Basic and Biomedical Sciences, King's College London, SE1 9RT London, UK
| | - Heinz Jungbluth
- Department of Basic and Clinical Neuroscience, King's College London, 125 Coldharbour Lane, SE5 9NU London, UK; Department of Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, UK; Randall Division for Cell and Molecular Biophysics, Muscle Signaling Section, King's College London, London, UK
| | - Wiep Scheper
- Department of Clinical Genetics and Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands; Department of Functional Genome Analysis, VU University, Amsterdam, the Netherlands
| | - Roland A Fleck
- Centre for Ultrastructural Imaging, King's College London, SE1 1UL London, UK
| | - Gillian P Bates
- Department Medical and Molecular Genetics, School of Basic and Biomedical Sciences, King's College London, SE1 9RT London, UK; Sobell Department of Motor Neuroscience, UCL Institute of Neurology, WC1N 3BG London, UK
| | - Manolis Fanto
- Department of Basic and Clinical Neuroscience, King's College London, 125 Coldharbour Lane, SE5 9NU London, UK.
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Ranza E, Garcia-Tarodo S, Varvagiannis K, Guipponi M, Lobrinus JA, Bottani A, Kern I, Kurian M, Pittet MP, Antonarakis SE, Fluss J, Korff CM. SERPINI1 pathogenic variants: An emerging cause of childhood-onset progressive myoclonic epilepsy. Am J Med Genet A 2017; 173:2456-2460. [PMID: 28631894 DOI: 10.1002/ajmg.a.38317] [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] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 05/16/2017] [Indexed: 12/16/2023]
Abstract
Progressive myoclonic epilepsies are rare neurodegenerative diseases with a wide spectrum of clinical presentations and genetic heterogeneity that render their diagnosis perplexing. Discovering new imputable genes has been an ongoing process in recent years. We present two pediatric cases of progressive myoclonic epilepsy with SERPINI1 pathogenic variants that lead to a severe presentation; we highlight the importance of including this gene, previously known as causing an adult-onset dementia-epilepsy syndrome, in the genetic work-up of childhood-onset progressive myoclonic epilepsies.
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Affiliation(s)
- Emmanuelle Ranza
- Service of Genetic Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Stephanie Garcia-Tarodo
- Pediatric Neurology Unit, Department of Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
| | | | - Michel Guipponi
- Service of Genetic Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Johannes A Lobrinus
- Neuropathology Unit, Department of Clinical Pathology, Geneva University Hospitals, Geneva, Switzerland
| | - Armand Bottani
- Service of Genetic Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Ilse Kern
- Pediatric Metabolism Unit, Department of Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
| | - Mary Kurian
- Pediatric Neurology Unit, Department of Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
| | - Marie-Pascale Pittet
- Pediatric Neurology Unit, Department of Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
| | - Stylianos E Antonarakis
- Service of Genetic Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Genetic Medicine and Development, University of Geneva Medical Faculty, Geneva, Switzerland
- iGE3 Institute of Genetics and Genomics of Geneva, Geneva, Switzerland
| | - Joel Fluss
- Pediatric Neurology Unit, Department of Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
| | - Christian M Korff
- Pediatric Neurology Unit, Department of Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
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Abstract
Action myoclonus-renal failure syndrome (AMRF) is an autosomal recessive progressive myoclonus epilepsy (PME) associated with renal dysfunction that appears in the second or third decade of life and that is caused by loss-of-function mutations in the SCARB2 gene encoding lysosomal integral membrane protein type 2 (LIMP2). Recent reports have documented cases with PME associated with SCARB2 mutations without renal compromise. Additional neurological features can be demyelinating peripheral neuropathy, hearing loss and dementia. The course of the disease in relentlessly progressive. In this paper we provide an updated overview of the clinical and genetic features of SCARB2-related PME and on the functions of the LIMP2 protein.
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Affiliation(s)
- Leanne Dibbens
- Epilepsy Research Group, School of Pharmacy and Medical Sciences, University of South Australia, and Sansom Institute for Health Research, South Australia, Australia
| | | | - Paul Saftig
- Biochemical Institute, Christian-Albrechts-University Kiel, Germany
| | - Guido Rubboli
- Danish Epilepsy Center, Filadelfia/University of Copenhagen, Dianalund, Denmark, IRCCS, Institute of Neurologicak Sciences, Bellaria Hospital, Bologna, Italy
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Coşkun T, Kiziltan M, Gündüz A, Delil Ş, Yeni N, Özkara Ç. Blink reflex in progressive myoclonic epilepsies. Seizure 2015; 29:169-73. [PMID: 26076862 DOI: 10.1016/j.seizure.2015.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 05/08/2015] [Accepted: 05/09/2015] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Progressive myoclonic epilepsies (PME) include a heterogeneous group of disorders. The brainstem is involved in these disorders, as demonstrated by neuroimaging and autopsy studies. The blink reflex (BR) is characteristically elicited after supraorbital electrical stimulation. The BR has two components, an ipsilateral R1 and bilateral R2 (R2 and R2c). The central generator of the BR is the brainstem. In this study, we aimed to investigate the functional status of the brainstem using the BR in PME cases with different etiological factors. METHODS We prospectively included 17 patients with a diagnosis of PME (8 male, 47.1%) who were examined between June 2009 and June 2012. For comparison, we included 41 healthy volunteers (18 male 43.9%) who did not have any neurological or systemic diseases. We recorded responses bilaterally over the orbicularis oculi muscles after supraorbital stimulation in all participants. RESULTS The R1 and R2 components of the BR were obtained in all healthy subjects with normal latencies, whereas abnormalities in the R2 and R2c components were observed at significantly higher rates in the PME patients. The mean latencies of the bilateral R2 and R2c components were significantly prolonged, and the amplitudes were diminished in the PME patients. Disease duration and the use of multiple antiepileptic drugs were related to abnormal R2s. CONCLUSION The abnormalities of the R2 and R2c components of the BR confirmed the inhibition of the reticular formation. The findings are probably related to disease processes and partially due to the use of multiple antiepileptic drugs.
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Affiliation(s)
- Tülin Coşkun
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, Turkey
| | - Meral Kiziltan
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, Turkey
| | - Ayşegül Gündüz
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, Turkey.
| | - Şakir Delil
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, Turkey
| | - Naz Yeni
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, Turkey
| | - Çiğdem Özkara
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, Turkey
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8
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Perandones C, Micheli FE, Pellene LA, Bayly MA, Berkovic SF, Dibbens LM. A case of severe hearing loss in action myoclonus renal failure syndrome resulting from mutation in SCARB2. Mov Disord 2012; 27:1200-1. [PMID: 22767442 DOI: 10.1002/mds.25083] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Revised: 04/30/2012] [Accepted: 05/17/2012] [Indexed: 11/07/2022] Open
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Hopfner F, Schormair B, Knauf F, Berthele A, Tölle TR, Baron R, Maier C, Treede RD, Binder A, Sommer C, Maihöfner C, Kunz W, Zimprich F, Heemann U, Pfeufer A, Näbauer M, Kääb S, Nowak B, Gieger C, Lichtner P, Trenkwalder C, Oexle K, Winkelmann J. Novel SCARB2 mutation in action myoclonus-renal failure syndrome and evaluation of SCARB2 mutations in isolated AMRF features. BMC Neurol 2011; 11:134. [PMID: 22032306 PMCID: PMC3222607 DOI: 10.1186/1471-2377-11-134] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2011] [Accepted: 10/27/2011] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Action myoclonus-renal failure syndrome is a hereditary form of progressive myoclonus epilepsy associated with renal failure. It is considered to be an autosomal-recessive disease related to loss-of-function mutations in SCARB2. We studied a German AMRF family, additionally showing signs of demyelinating polyneuropathy and dilated cardiomyopathy. To test the hypothesis whether isolated appearance of individual AMRF syndrome features could be related to heterozygote SCARB2 mutations, we screened for SCARB2 mutations in unrelated patients showing isolated AMRF features. METHODS In the AMRF family all exons of SCARB2 were analyzed by Sanger sequencing. The mutation screening of unrelated patients with isolated AMRF features affected by either epilepsy (n = 103, progressive myoclonus epilepsy or generalized epilepsy), demyelinating polyneuropathy (n = 103), renal failure (n = 192) or dilated cardiomyopathy (n = 85) was performed as high resolution melting curve analysis of the SCARB2 exons. RESULTS A novel homozygous 1 bp deletion (c.111delC) in SCARB2 was found by sequencing three affected homozygous siblings of the affected family. A heterozygous sister showed generalized seizures and reduction of nerve conduction velocity in her legs. No mutations were found in the epilepsy, renal failure or dilated cardiomyopathy samples. In the polyneuropathy sample two individuals with demyelinating disease were found to be carriers of a SCARB2 frameshift mutation (c.666delCCTTA). CONCLUSIONS Our findings indicate that demyelinating polyneuropathy and dilated cardiomyopathy are part of the action myoclonus-renal failure syndrome. Moreover, they raise the possibility that in rare cases heterozygous SCARB2 mutations may be associated with PNP features.
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Affiliation(s)
- Franziska Hopfner
- Institute of Human Genetics, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Human Genetics, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Barbara Schormair
- Institute of Human Genetics, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Franziska Knauf
- Institute of Human Genetics, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Achim Berthele
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
- Member of the German Research Network on Neuropathic Pain (DFNS
| | - Thomas R Tölle
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
- Member of the German Research Network on Neuropathic Pain (DFNS
| | - Ralf Baron
- Sektion Neurologische Schmerzforschung und -therapie, Department of Neurology, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
- Member of the German Research Network on Neuropathic Pain (DFNS
| | - Christoph Maier
- BG University Hospital Bergmannsheil Bochum, Bochum, Germany
- Member of the German Research Network on Neuropathic Pain (DFNS
| | - Rolf-Detlef Treede
- Lehrstuhl für Neurophysiology, Medizinische Fakultät Mannheim der Ruprecht-Karls-Universität Heidelberg, Mannheim, Germany
- Member of the German Research Network on Neuropathic Pain (DFNS
| | - Andreas Binder
- Sektion Neurologische Schmerzforschung und -therapie, Department of Neurology, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
- Member of the German Research Network on Neuropathic Pain (DFNS
| | - Claudia Sommer
- Department of Neurology, Universitätsklinikum Würzburg, Würzburg, Germany
- Member of the German Research Network on Neuropathic Pain (DFNS
| | - Christian Maihöfner
- Department of Neurology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Member of the German Research Network on Neuropathic Pain (DFNS
| | - Wolfram Kunz
- Department of Epileptology and Life & Brain Center, Universität Bonn, Bonn, Germany
| | - Friedrich Zimprich
- Department of Clinical Neurology, Medical University of Vienna, Vienna, Austria
| | - Uwe Heemann
- Department of Nephrology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Arne Pfeufer
- Institute of Human Genetics, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Human Genetics, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Michael Näbauer
- Department of Medicine I, University Hospital Grosshadern, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Stefan Kääb
- Department of Medicine I, University Hospital Grosshadern, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Barbara Nowak
- Zentrum für Nieren- und Hochdruckkrankheiten, Immenstadt and Oberstdorf, Germany
| | - Christian Gieger
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Peter Lichtner
- Institute of Human Genetics, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Human Genetics, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Claudia Trenkwalder
- Paracelsus-Elena-Klinik, Center of Parkinsonism and Movement Disorders, Kassel, Germany
| | - Konrad Oexle
- Institute of Human Genetics, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Juliane Winkelmann
- Institute of Human Genetics, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Human Genetics, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
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10
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Panzica F, Varotto G, Canafoglia L, Rossi Sebastiano D, Visani E, Franceschetti S. EEG-EMG coherence estimated using time-varying autoregressive models in movement-activated myoclonus in patients with progressive myoclonic epilepsies. Annu Int Conf IEEE Eng Med Biol Soc 2010; 2010:1642-1645. [PMID: 21096138 DOI: 10.1109/iembs.2010.5626652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We aimed this study at verifying the appropriateness of bivariate time-varying autoregressive models in detecting EEG-EMG relationships and identifying the characteristics of myoclonus-related EEG changes in patients with two forms of progressive myoclonus epilepsy (PME). Our results indicate that TVAR analysis was able to detect the presence of prominent peaks of EEG-EMG coherence between the EMG and contralateral frontocentral EEG derivation in all patients, revealing differences in time-frequency spectral profiles associated to the two different forms of PMEs, possibly correlated with the severity of myoclonus.
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Affiliation(s)
- Ferruccio Panzica
- Dept. of Neurophysiology and Diagnostic Epileptology, Fondazione IRCCS Istituto Neurologico C. Besta Milano, Italy.
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11
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Kurihara M, Takahashi K, Kohagizawa T, Yamauchi Y, Ida H. [Female with dentatorubral-pallidoluysian atrophy followed for 14 years from the pre-clinical stage: availability of gait analysis]. No To Hattatsu 2009; 41:294-298. [PMID: 19618887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We presented a 28-year-old female with dentatorubral-pallidoluysian atrophy (DRPLA) who had been followed from the pre-clinical stage. Her mother and elder brother were diagnosed as DRPLA at autopsy. Though the genetic diagnosis was not performed, we diagnosed this patient as DRPLA from her clinical course and family history. She first visited our hospital at age 14 with a symptoms of mental retardation. Generalized tonic-clonic type epilepsy developed at age 15, and valproate was prescribed from age 24. Gait disturbance and mental deterioration gradually progressed from age 15. We had performed gait analyses and brain MRI studies at regular intervals from age 14 to 27. She could walk even with gait disturbance until her early 20s. At one year after marked ataxia was recorded on gait analysis, she rapidly regressed and became unable to walk. Following this patient over a long period of time presented an opportunity to gather informative data regarding the progression of this disorder.
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Affiliation(s)
- Mana Kurihara
- Department of Pediatrics, the Kanagawa Rehabilitation Center, Atsugi, Kanagawa.
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12
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Hashi R, Nakamura A, Sugimoto T, Kaneko K. [Electroencephalographic changes in sisters with infantile-onset dentatorubral-pallidoluysian atrophy (DRPLA)]. No To Hattatsu 2007; 39:445-449. [PMID: 18027567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We report the clinical course and results of electroencephalographic (EEG) examinations in 2 sisters with infantile dentatorubral pallidoluysian atrophy (DRPLA). Typical development was seen until the age of 6 months. From that age, however, development was delayed. The elder sister experienced astatic seizure at the age of 3 years. She began to deteriorate and had difficulty in controlling her body movement at the age of 3 years and 7 months. Magnetic resonance imaging revealed marked cerebellar atrophy and genetic analysis of the DRPLA gene led to a diagnosis of DRPLA. Repeat size of the CAG base sequence was 86/19. Neurological deterioration was rapid and controlling convulsions using antiepileptic drugs was difficult. EEG was characterized by high-voltage slow waves and poor development of basic wave through the follow-up period. In contrast, the younger sister showed only mild developmental delay, and could stand independently at the 2 years and 9 months. Repeat size of the CAG base sequence was 79/11. Myoclonic seizures developed at 4 years and 7 months, but have been well controlled using sodium valproate. EEG showed diffuse 3-4 Hz spike-and-wave complexes that were rather different from the findings in her elder sister.
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Affiliation(s)
- Rika Hashi
- Department of Pediatrics, Otokoyama Hospital, Kansai Medical University, Yawata, Kyoto.
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13
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Miyata R, Hayashi M, Tanuma N, Shioda K, Fukatsu R, Mizutani S. Oxidative stress in neurodegeneration in dentatorubral-pallidoluysian atrophy. J Neurol Sci 2007; 264:133-9. [PMID: 17949751 DOI: 10.1016/j.jns.2007.08.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2007] [Accepted: 08/08/2007] [Indexed: 01/21/2023]
Abstract
Dentatorubral-pallidoluysian atrophy (DRPLA) is one of the CAG-repeat diseases, and is classified into juvenile and early adult types showing progressive myoclonus epilepsy (PME) in addition to late adult type. We immunohistochemically examined accumulation of oxidative products and expression of superoxide dismutase (SOD) in autopsy cases of DRPLA. Oxidative products to nucleosides, 8-hydroxy-2'-deoxyguanosine and 8-hydroxyguanosine, were accumulated in the lenticulate nucleus predominantly in DRPLA cases having PME. Neuronal accumulation of 4-hydroxy nonenal, a reactive lipid aldehyde, was found in the hippocampus, globus pallidus and cerebellar dentate nucleus in adult DRPLA cases and controls. Cytoplasmic immunoreactivity for Cu/ZnSOD was reduced in the external segment of globus pallidus, dentate nucleus and cerebellar cortex in DRPLA cases. Mitochondrial immunoreactivity for MnSOD was reduced in the lenticulate nucleus and cerebellum in DRPLA cases having PME. Some DRPLA cases showed reduced immunoreactivity for MnSOD in the cerebral cortex. Coexistence of reduced SOD expression and polyglutamine was observed in a few cases. It has been discussed in Huntington's disease that expanded polyglutamine can lead to oxidative neurodegeneration. It is likely that oxidative stress can be involved in DRPLA, although relationship with expanded polyglutamine remains to be elusive.
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Affiliation(s)
- Rie Miyata
- Department of Pediatrics, Tokyo Kita Shakai Hoken Hospital, 4-17-56 Akabanedai, Kita-ku, Tokyo 115-0053, Japan.
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Tsuji S. [Molecular mechanisms of neurodegeneration in polyglutamine diseases]. Nihon Ronen Igakkai Zasshi 2007; 44:154-7. [PMID: 17539196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
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15
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Sinha S, Satishchandra P, Gayathri N, Yasha TC, Shankar SK. Progressive myoclonic epilepsy: A clinical, electrophysiological and pathological study from South India. J Neurol Sci 2007; 252:16-23. [PMID: 17166519 DOI: 10.1016/j.jns.2006.09.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2006] [Revised: 08/18/2006] [Accepted: 09/27/2006] [Indexed: 11/18/2022]
Abstract
Progressive myoclonic epilepsy (PME) is a syndrome complex encompassing different diagnostic entities and often cause problems in diagnosis. We describe the clinical, electrophysiological and pathological features of 97 patients with the diagnosis of PME evaluated over 25 years. Case records of confirmed patients of Neuronal ceroid lipofuscinosis (NCL = 40), Lafora body disease (LBD = 38), Myoclonic epilepsy with ragged red fibers (MERRF = 10), and probable Unverricht-Lundberg disease (ULD = 9) were reviewed. The mean age at onset in patients with NCL (n = 40) was 5.9+/-9.1 years (M:F:: 28:12). Subtypes of NCL were: late infantile (n = 19), infantile (n = 8), juvenile (n = 11) and adult (n = 2) NCL. EEG (n = 37) showed varying degree of diffuse slowing of background activity in 94.6% and epileptiform discharges in 81.1% of patients. Slow frequency photic stimulation evoked photo-convulsive response in 5 patients only. Giant SSEP was demonstrated in 7 and VEP study revealed a prolonged P100 (2) and absent waveform (7). Electrophysiological features of neuropathy were present in 3 patients. Presence of PAS and Luxol Fast Blue (LFB) positive, auto fluorescent (AF) ceroid material in brain tissue (n = 12) and electron microscopy of brain (n = 5), skin (n = 28) and muscle (n = 1) samples showing curvilinear and lamellar bodies established the diagnosis. Patients of LBD (mean age of onset at 14.4+/-3.9 years, M:F:: 24:14) with triad of PME symptoms were evaluated. EEG (n = 37) showed variable slowing of background activity in 94.6% and epileptiform discharges in 97.4%. Photosensitivity with fast frequency was observed only in 5 patients. CT (n = 32) and MRI (n = 4) revealed diffuse cortical atrophy. Giant SSEP was demonstrated in 24 patients of LBD while VEP study revealed a prolonged P100 (4) and absent waveform (8). Electrophysiological features of neuropathy were present in one patient. Diagnosis was established by the presence of PAS positive diastase resistant, Lugol's Iodine labeled inclusions in sweat glands of axillary skin (n = 35), brain (n = 2) and liver (n = 1). Ten patients with MERRF (mean age at onset: 14.6+/-5.8 years; M: F:: 3:2) had triad of PME symptoms. Muscle biopsy revealed oxidative reaction product and classical ragged red fibers. In nine patients of PME without cognitive decline, probable diagnosis of ULD (mean age at onset: 13.8+/-9.5 years) was considered after biopsy of skin and/or muscle excluded other forms of PMEs. Neuronal ceroid lipofuscinosis and Lafora body diseases were the common causes of PME in the series from south India. This is one of the largest series from the Indian subcontinent to the best of our knowledge. Photosensitivity is notably less common in LBD/NCL in this series distinctly different from those reported in the literature. Further exploration is required to determine whether different genotype is responsible. Morphological changes were helpful in diagnosis and could be confirmed by biopsy of peripheral tissues like skin and muscle in majority (60%). Electron microscopy was helpful in the diagnosis NCL and MERRF.
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Affiliation(s)
- S Sinha
- Department of Neurology, National Institute of Mental Health and NeuroSciences (NIMHANS), Bangalore, India.
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Abstract
Unverricht-Lundborg disease (ULD) is the purest and least severe type of progressive myoclonus epilepsy (PME), and is not associated with progressive cognitive deficit. Symptoms stabilize in adulthood, with a varying degree of permanent, often severe handicap that is mostly due to myoclonus. The disorder follows an autosomal recessive transmission pattern, with onset between 8 and 15 years years of age of generalized tonic-clonic or clonic-tonic-clonic seizures, action myoclonus (massive or segmental), photosensitivity, and often ataxia. Prevalence varies, it is highest in certain isolates (Finland, La Réunion Island) and in region with higher levels of inbreeding (Maghreb). ULD is due to a deficit in cystatin B (stefin B), but the mechanisms leading to the clinical symptoms are not well understood. The causative gene, PME1, was identified in 1991 and localized to chromosome 21q22.3. The mutations are mainly expansions of the CCCCGCCCCGCG dodecamer, but less common point mutations were also found. A variant has been recently reported in a Palestinian family, with localization on chromosome 12. The diagnosis of ULD is made on the basis of family history, age at onset, geographical and ethnic context, and on the typical features of myoclonus and epilepsy, in the absence of cognitive and sensory deficits. Neurophysiological evaluation yields interesting, but unspecific results. There are no biological or pathological markers for ULD. Molecular analysis confirms the diagnosis in most patients. Genetic testing for heterozygotes and even prenatal diagnosis are possible, although seldom performed, if the mutation has been identified. In spite of intensive research, ULD has yet to reveal all of its secrets. It remains a quasi "idiopathic" type of PME, with limited progression. Clinicians and patients are still waiting for an etiologically oriented treatment, which should, ideally, be admnistered early in the course of the disease, if possible before the onset of invalidating symptoms.
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Affiliation(s)
- P Genton
- Centre Saint-Paul--H. Gastaut, Marseille.
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17
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Abstract
The neural dysfunction at the origin of myoclonus may locate at various anatomical levels within the central nervous system, including the motor cortices. Transcranial magnetic stimulation (TMS) can be used to assess the balance between inhibitory and excitatory processes involved in the regulation of motor cortex activity and thereby, may be of value to determine the pathophysiological mechanisms of myoclonus. Using paired-pulse paradigms with various interstimulus intervals, TMS studies showed that intracortical inhibition (ICI) was reduced in progressive myoclonic epilepsy (PME). In contrast, ICI was decreased only for short interstimulus intervals in patients with juvenile myoclonic epilepsy (JME). Transcallosal inhibition and sensorimotor integration were also both altered in PME but not in JME. Actually, the loss of inhibitory regulation within the central nervous system might represent an intrinsic mechanism of myoclonus, whether of epileptic origin or not. Finally, the other TMS parameters of excitability (motor threshold, silent period, intracortical facilitation) were found normal in most cases of myoclonus. According to these observations, it was quite conceivable that the application of repetitive trains of TMS (rTMS) at inhibitory low-frequency (around 1 Hz) might be able to relieve myoclonus by restoring ICI. A few reported cases illustrate the efficacy of low-frequency rTMS to alleviate myoclonic symptoms. Therapeutic-like perspectives are opened for rTMS in these forms of myoclonus that are related to motor cortical hyperexcitability secondary to the loss of ICI.
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Affiliation(s)
- J-P Lefaucheur
- Service de physiologie, explorations fonctionnelles, hôpital Henri-Mondor, Assistance publique-Hôpitaux de Paris, 51, avenue du Marechal-Lattre-de-Tassigny, 94010 Créteil, France.
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Uozumi T, Tamagawa A, Hashimoto T, Tsuji S. High-frequency oscillations in the human motor system. ACTA ACUST UNITED AC 2006; 59:143-7. [PMID: 16893105 DOI: 10.1016/s1567-424x(09)70024-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
- Takenori Uozumi
- Department of Neurology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu City, Fukuoka, Japan.
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Affiliation(s)
- Subramaniam Ganesh
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology, Kanpur 208 016, India.
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20
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Chan EM, Andrade DM, Franceschetti S, Minassian B. Progressive myoclonus epilepsies: EPM1, EPM2A, EPM2B. Adv Neurol 2005; 95:47-57. [PMID: 15508913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- Elayne M Chan
- Program in Genetics and Genomic Biology, The Hospital for Sick Children, Toronto, Canada
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21
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Badhwar A, Berkovic SF, Dowling JP, Gonzales M, Narayanan S, Brodtmann A, Berzen L, Caviness J, Trenkwalder C, Winkelmann J, Rivest J, Lambert M, Hernandez-Cossio O, Carpenter S, Andermann F, Andermann E. Action myoclonus-renal failure syndrome: characterization of a unique cerebro-renal disorder. ACTA ACUST UNITED AC 2004; 127:2173-82. [PMID: 15364701 DOI: 10.1093/brain/awh263] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Action myoclonus-renal failure syndrome (AMRF) is a distinctive form of progressive myoclonus epilepsy associated with renal dysfunction. The syndrome was not recognized prior to the advent of dialysis and renal transplantation because of its rapidly fatal course if renal failure is untreated. The first and only description of AMRF was in four French Canadian patients in three families (Andermann et al., 1986). We now describe 15 individuals with AMRF from five countries, including a follow-up of the four French Canadian patients, allowing a more complete characterization of this disease. Our 15 patients with AMRF belong to nine different families. Segregation analyses were compatible with autosomal recessive inheritance. In addition, our findings show that AMRF can present with either renal or neurological features. Tremor (onset 17-26 years, mean 19.8 years, median 19 years) and progressively disabling action myoclonus (onset 14-29 years, mean 21.7 years, median 21 years), with infrequent generalized seizures (onset 20-28 years, mean 22.7 years, median 22 years) and cerebellar features are characteristic. Proteinuria, detected between ages 9 and 30 years in all cases, progressed to renal failure in 12 out of 15 patients within 0-8 years after proteinuria detection. Brain autopsy in two patients revealed extraneuronal pigment accumulation. Renal biopsies showed collapsing glomerulopathy, a severe variant of focal glomerulosclerosis. This study extends the AMRF phenotype, and demonstrates a more extensive ethnic and geographic distribution of a syndrome originally believed to be confined to individuals of French Canadian ancestry. The independent progression of neurological and renal disorders in AMRF suggests a unitary molecular lesion with pleiotropic effects. Our results demonstrate that the renal lesion in AMRF is a recessive form of collapsing glomerulopathy. Genes identified for focal segmental glomerulosclerosis and involved with the function of the glomerular basement membrane and related proteins are thus good candidates. Treatment can improve quality of life and extend the lifespan of these patients. Dialysis and renal transplantation are effective for the renal but not the neurological features, which continue to progress even in the presence of normalized renal function; the latter can be managed with anti-myoclonic and anti-epileptic drugs.
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Affiliation(s)
- AmanPreet Badhwar
- Neurogenetics Unit, Montreal Neurological Hospital and Institute, Montreal, Quebec, Canada
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Abstract
Progressive myoclonic epilepsies (PMEs) are a group of rare disorders characterized by the occurrence of seizures, myoclonus, and progressive neurological dysfunction. This article discusses epidemiology, genetics, pathology, clinical manifestations, EEG characteristics, methods of diagnosis and treatment of the most common causes of PME, including Unverricht-Lundborg Disease (Baltic Myoclonus), MERRF, neuronal ceroid lipofuscinosis, dentatorubropallidoluysan atrophy, Gaucher disease, Lafora disease, and sialidosis. The aim of this paper is to provide clinicians with useful clinical information in order to facilitate the diagnosis and treatment of these rare diseases.
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Affiliation(s)
- Mary L Zupanc
- Department of Neurology and Pediatrics, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA
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Shoji M. [Dentatorubral-pallidoluysian atrophy]. Nihon Rinsho 2004; 62 Suppl:132-5. [PMID: 15011335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- Mikio Shoji
- Department of Neurology, Division of Neuroscience, Biophysical Science, Okayama University Graduate School of Medicine and Dentistry
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Brännvall K, Hjelm H, Korhonen L, Lahtinen U, Lehesjoki AE, Lindholm D. Cystatin-B is expressed by neural stem cells and by differentiated neurons and astrocytes. Biochem Biophys Res Commun 2003; 308:369-74. [PMID: 12901878 DOI: 10.1016/s0006-291x(03)01386-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Mutation in the gene encoding cystatin-B (CSTB) has been shown to cause progressive myoclonus epilepsy. Mice with a gene deletion of CSTB exhibit increased apoptosis of specific neurons but the physiological role of CSTB in brain cells is not fully understood. In the present study, we have examined the expression of CSTB in neural stem cells (NSC) and in differentiating mature brain cells. The results show that CSTB is present in embryonic and adult NSC and in the neuroepithelium. CSTB was expressed by both neurons and glial cells differentiated from NSC and in hippocampal cultures. CSTB localized mainly to the nucleus in NSC and in neurons, whilst in astrocytes CSTB was also in the cytoplasm. Double labeling showed that CSTB was present in the lysosomes in glial cells. The results demonstrate a nuclear expression of CSTB in NSC and in neurons, suggesting novel function for this molecule.
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Affiliation(s)
- Karin Brännvall
- Department of Neuroscience, Neurobiology, Uppsala University, Biomedical Centre, Box 587, S-751 23 Uppsala, Sweden
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Le Ber I, Camuzat A, Castelnovo G, Azulay JP, Genton P, Gastaut JL, Broglin D, Labauge P, Brice A, Durr A. Prevalence of dentatorubral-pallidoluysian atrophy in a large series of white patients with cerebellar ataxia. Arch Neurol 2003; 60:1097-9. [PMID: 12925365 DOI: 10.1001/archneur.60.8.1097] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Dentatorubral-pallidoluysian atrophy (DRPLA) is a rare neurodegenerative disorder mainly diagnosed in Japan. Its prevalence is low in other countries. Three phenotypes are described: choreoathetoid movements, cerebellar ataxia, and progressive myoclonic epilepsy. OBJECTIVE To evaluate the frequency of DRPLA in European patients with sporadic or autosomal dominant cerebellar ataxia. METHODS We analyzed a series of 809 index patients with either autosomal dominant cerebellar ataxia (416 families) or progressive cerebellar ataxia without a family history of the disease (393 cases) for the DRPLA mutation. RESULTS We identified a CAG repeat expansion in the DRPLA gene in one family and in one patient without a family history. The familial case illustrates the phenomenon of anticipation and the previously established correlation between the phenotype and size of the expansion. A censored-history family or expansion of large normal CAG repeats during paternal transmission could be implicated in the patient without a family history. CONCLUSIONS This study enables us to estimate the frequency of the disease as 0.25% in both families with autosomal dominant cerebellar ataxia and sporadic cases of ataxia in our series, confirming the very low frequency of DRPLA in Europe. In both familial and sporadic cases, molecular testing for DRPLA could be restricted to patients with ataxia with one of the following features: chorea, dementia, or myoclonic epilepsy.
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Affiliation(s)
- Isabelle Le Ber
- Institut National de la Santé et de la Recherche Médicale U289, Fédération de Neurologie, Hôpital Salpêtrière, Assistance Publique-Hôpitaux de Paris, 47 boulevard de l'Hôpital, 75651 Paris CEDEX 13, France
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26
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Panzica F, Canafoglia L, Franceschetti S, Binelli S, Ciano C, Visani E, Avanzini G. Movement-activated myoclonus in genetically defined progressive myoclonic epilepsies: EEG-EMG relationship estimated using autoregressive models. Clin Neurophysiol 2003; 114:1041-52. [PMID: 12804673 DOI: 10.1016/s1388-2457(03)00066-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To study electroencephalography-electromyography (EEG-EMG) relationships in patients with different forms of progressive myoclonic epilepsies (PME). METHODS EEG-EMG auto-spectra, coherence and phase functions were estimated by means of bivariate and time varying autoregressive (AR) models in 15 patients: 8 with Unverricht-Lundborg, 4 with Lafora body disease, and 3 with sialidosis. RESULTS The coherence spectra of the EMG epochs including action myoclonus and contralateral frontocentral EEG derivations showed a main beta peak (average coherence: 0.60-0.79) in all patients, regardless of the type of PME. The time lag from cortex to muscle was 13.0-21.3 ms. Significantly, coherent gamma activity was consistently found only in the 3 patients with sialidosis; the most heterogeneous results were obtained in the patients with Lafora disease, who showed a more complex coherence profile. Periods of normal muscle contractions, which could be recorded in patients with Unverricht-Lundborg PME, were characterised by the presence of an EEG-EMG beta coherence peak on the same frequency as in the case of action myoclonus, but with a lower coherence value. CONCLUSIONS AR models were capable of describing EEG-EMG relationships in patients with PME, and indicated that coherent cortical and EMG beta oscillations are crucially involved in the generation of myoclonus. Moreover, they could detect the uneven spectral profiles characterising the different forms of PME.
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Affiliation(s)
- F Panzica
- National Neurological Institute C. Besta, Via Celoria 11, 20133, Milan, Italy
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Naito H. [Dentatorubral-pallidoluysian atrophy]. Ryoikibetsu Shokogun Shirizu 2003:194-7. [PMID: 12483859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
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29
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Terashima T, Kawai H, Fujitani M, Maeda K, Yasuda H. SUMO-1 co-localized with mutant atrophin-1 with expanded polyglutamines accelerates intranuclear aggregation and cell death. Neuroreport 2002; 13:2359-64. [PMID: 12488827 DOI: 10.1097/00001756-200212030-00038] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To investigate the implication of small ubiquitin-related modifier-1 (SUMO-1) in the formation of neuronal intranuclear inclusions in polyglutamine diseases, we examined the localization of SUMO-1 in dentatorubral-pallidoluysian atrophy (DRPLA) brain tissues and PC12 cells expressing truncated atrophin-1 with expanded poly-glutamine stretches. SUMO-1 was co-localized with neuronal intranuclear inclusions in DRPLA brain and the DRPLA model cells, which showed that the aggregates formed by expanded polyglutamine stretches were highly SUMOlylated. In addition, to examine the role of SUMO-1 in nuclear aggregate formation and cell death, either SUMO-1 or DeltaSUMO-1, which is a SUMOlylation defective mutant lacking the C-terminal motif, was co-transfected with atrophin-1 with expanded polyglutamine stretches. Co-transfection of DeltaSUMO-1 decreased number of the cells with nuclear aggregates and consequent apoptosis of PC12 cells, both of which were markedly enhanced by co-transfection of SUMO-1 with atrophin-1 with expanded polyglutamine stretches. These results suggest that SUMO-1 is implicated in the pathogenesis of DRPLA and accelerates aggregate formation and cell death.
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Affiliation(s)
- Tomoya Terashima
- Division of Neurology, Department of Medicine, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
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30
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Abstract
Dentatorubral-pallidoluysian atrophy (DRPLA) is a rare autosomal-dominant neurodegenerative disorder characterized by variable combination of clinical manifestations including ataxia, myoclonus, seizures, dementia, and choreic movements. Head tremor has been rarely reported. We report a 66-year-old-woman with genetically determined DRPLA who presented with head tremor. A "no-no" type head tremor was the initial and the most prominent symptom, and mild cerebellar signs and choreic movements were also observed later. Neither hand tremor nor dystonia was noted. The patient did not show dementia, myoclonus, or seizures. Surface electromyogram (EMG) revealed 3.5-4 Hz rhythmic EMG bursts in both sternocleidomastoid muscles. DNA analysis disclosed expanded trinucleotide repeats (n = 54) in the DRPLA gene. We suggest that isolated head tremor can be a clinical manifestation of DRPLA.
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Affiliation(s)
- H Ohizumi
- Department of Neurology, Juntendo University Izu-Nagaoka Hospital, Tagata, Shizuoka, Japan
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Tsuji S. Dentatorubral-pallidoluysian atrophy: clinical aspects and molecular genetics. Adv Neurol 2002; 89:231-9. [PMID: 11968450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Shoji Tsuji
- Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan
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32
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Abstract
To understand the pathogenetic mechanisms underlying polyglutamine (polyQ) diseases, we investigated the mechanisms of the formation of aggregate bodies containing expanded polyQ stretches, focusing on dentatorubral-pallidoluysian atrophy (DRPLA). We demonstrated that the expression of a truncated DRPLA protein containing expanded polyQ stretches in COS-7 cells resulted in the formation of perinuclear aggregate bodies that are co-localized with gamma-tubulin, a protein marker for the microtubules-organizing center (MTOC). A collapsed vimentin network surrounded these aggregate bodies. Furthermore, disruption of the microtubules (MTs) with nocodazole resulted in the formation of small aggregate bodies that were scattered throughout the cytoplasm. These findings suggest that the truncated DRPLA proteins containing expanded polyQ stretches unfold and form small aggregate bodies in the cell periphery. These aggregates move on MTs to the MTOC, where they remain as distinct 'aggresomes''.
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Affiliation(s)
- Takayoshi Shimohata
- Department of Neurology, Brain Research Institute, Niigata University, 1-757 Asahimachi, Niigata 951-8181, Japan
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33
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Abstract
ABSTRACT We clinically and genetically studied three patients in a family with dentatorubro-pallidoluysian atrophy (DRPLA). The proband patient had 58/24 CAG repeat alleles of the DRPLA gene (normal < or = 34 repeats). Cerebellar ataxia first developed in the 6-7th decades and was the predominant feature for more than 10 years in all three, after which two of them manifested dementia and choreiform movements in the advanced stage. Atrophy of the cerebellum and brain stem an CT or MRI had suggested dominant spinocerebellar ataxia as a diagnosis in their ataxia-predominant stage, with a diagnosis of DRPLA being impossible based on the clinical findings alone. Our experience implies that DRPLA must be taken into account in the differential diagnosis of late onset ataxic disorders, since it can easily be overlooked.
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Affiliation(s)
- Ichiro Yabe
- Department of Neurology, Hokkaido University School of Medicine, N-15 W-7, Kita-ku, Sapporo 060-8638, Japan
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34
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Ishii A, Ohkoshi N. [May-White syndrome(myoclonus, ataxia, deafness)]. Ryoikibetsu Shokogun Shirizu 2002:198-202. [PMID: 11596369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- A Ishii
- Department of Neurology, Institute of Clinical Medicine, University of Tsukuba
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35
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Abstract
The genetic progressive myoclonus epilepsies (PMEs) are clinically characterized by the triad of stimulus sensitive myoclonus (segmental lightning like muscular jerks), epilepsy (grand mal and absences) and progressive neurologic deterioration (dementia, ataxia, and various neurologic signs depending on the cause). Etiologically heterogenous, PMEs are rare and mostly autosomal recessive disorders, with the exception of autosomal dominant dentatorubral-pallidoluysian atrophy and mitochondrial encephalomyopathy with ragged red fibers (MERRF). In the last five years, specific mutations have been defined in Lafora disease (gene for laforin or dual specificity phosphatase in 6q24), Unverricht-Lundborg disease (cystatin B in 21q22.3), Jansky-Bielschowsky ceroid lipofuscinoses (CLN2 gene for tripeptidyl peptidase 1 in 11q15), Finnish variant of late infantile ceroid lipofuscinoses (CLN5 gene in 13q21-32 encodes 407 amino acids with two transmembrane helices of unknown function), juvenile ceroid lipofuscinoses or Batten disease (CLN3 gene in 16p encodes 438 amino acid protein of unknown function), a subtype of Batten disease and infantile ceroid lipofuscinoses of the Haltia-Santavuori type (both are caused by mutations in palmitoyl-protein thiosterase gene at 1p32), dentadorubropallidoluysian atrophy (CAG repeats in a gene in 12p13.31) and the mitochondrial syndrome MERRF (tRNA Lys mutation in mitochondrial DNA). In this review, we cover mainly these rapid advances.
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Affiliation(s)
- A V Delgado-Escueta
- Comprehensive Epilepsy Program, Epilepsy Genetics/Genomics Laboratories, VA GLAHS-West Los Angeles Medical Center, University of California, 90095-1769, USA.
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36
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Abstract
OBJECTIVE Transcranial magnetic stimulation (TMS) has allowed investigators to study intracortical inhibition and facilitation and sensorimotor integration in motor disorders and epilepsy. The authors used TMS to elucidate the pathophysiology of reflex myoclonus with giant somatosensory evoked potentials (SEP). METHODS The authors studied four patients with progressive myoclonic epilepsy. All patients had giant SEP elicited by mixed and digital nerve stimulation. They studied the response to paired-pulse TMS at interstimulus intervals (ISI) ranging from 1 to 15 ms and the conditioning effect of digital electrical stimulation at ISI ranging from 10 to 100 ms on the motor evoked potential amplitude to TMS. RESULTS Digital stimulation markedly facilitated conditioned motor evoked potentials at ISI ranging from 25 to 40 ms in all patients. This pattern was significantly different from the inhibition observed in controls (n = 12) at the same ISI. In the patients, paired-pulse TMS showed a decrease in intracortical inhibition in the motor cortex in comparison with controls. CONCLUSIONS These findings suggest cortical and subcortical components of abnormal sensorimotor integration in addition to hyperexcitability of the sensory and motor cortex in our myoclonic patients.
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Affiliation(s)
- P Manganotti
- Department of Neurological Sciences and Vision, Section of Neurological Rehabilitation, University of Verona, Italy.
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37
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Yamada M, Sato T, Shimohata T, Hayashi S, Igarashi S, Tsuji S, Takahashi H. Interaction between neuronal intranuclear inclusions and promyelocytic leukemia protein nuclear and coiled bodies in CAG repeat diseases. The American Journal of Pathology 2001; 159:1785-95. [PMID: 11696439 PMCID: PMC1867069 DOI: 10.1016/s0002-9440(10)63025-8] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Neuronal intranuclear inclusions (NIIs) are a pathological hallmark of CAG repeat diseases. To elucidate the influence of NII formation on intranuclear substructures, we investigated the relationship of NIIs with nuclear bodies in brains of dentatorubral-pallidoluysian atrophy and Machado-Joseph disease. In both diseases, promyelocytic leukemia protein, a major component of the promyelocytic leukemia protein nuclear bodies, altered the normal distribution and was rearranged around NII, forming a single capsular structure. We further demonstrated that NIIs were present in close contact with coiled bodies, a highly dynamic domain that may be involved in the biogenesis of small nuclear ribonucleoproteins. The preferential association of intranuclear polyglutamine aggregates with coiled bodies was also confirmed in the dentatorubral-pallidoluysian atrophy transgenic mouse brain and culture cells expressing mutant atrophin-1. The results suggest that the interaction between NIIs and nuclear bodies may play a role in the pathogenesis of CAG repeat diseases.
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Affiliation(s)
- M Yamada
- Departments of Pathology, Brain Research Institute, Niigata University, Niigata, Japan.
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38
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Hashida H, Goto J, Suzuki T, Jeong S, Masuda N, Ooie T, Tachiiri Y, Tsuchiya H, Kanazawa I. Single cell analysis of CAG repeat in brains of dentatorubral-pallidoluysian atrophy (DRPLA). J Neurol Sci 2001; 190:87-93. [PMID: 11574112 DOI: 10.1016/s0022-510x(01)00596-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Somatic mosaicism of an expanded repeat is present in tissues of patients with triplet repeat diseases. Of the spinocerebellar ataxias associated with triplet repeat expansion, the most prominent heterogeneity of the expanded repeat is seen in dentatorubral-pallidoluysian atrophy (DRPLA). The common feature of this somatic mosaicism is the difference in the repeat numbers found in the cerebellum as compared to other tissues. The expanded allele in the cerebellum shows a smaller degree of expansion. We previously showed by microdissection analysis that the expanded allele in the granular layer in DRPLA cerebellum has less expansion than expanded alleles in the molecular layer and white matter. Whether this feature of lesser expansion in granule cells is common to other types of neurons is yet to be clarified. We used a newly developed excimer laser microdissection system to analyze somatic mosaicism in the brains of two patients, one with early- and another with late-onset DRPLA, and used single cell PCR to observe the cell-to-cell differences in repeat numbers. In the late onset patient, repeat expansion was more prominent in Purkinje cells than in granule cells, but less than that in the glial cells. In the early onset patient, repeat expansion in Purkinje cells was greater than in granule cells but did not differ from that in glial cells. These findings suggest that there is a difference in repeat expansion among neuronal subgroups and that the number of cell division cycles is not the only determinant of somatic mosaicism.
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Affiliation(s)
- H Hashida
- CREST, Japan Science and Technology Corporation, Japan.
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39
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Gambardella A, Muglia M, Labate A, Magariello A, Gabriele AL, Mazzei R, Pirritano D, Conforti FL, Patitucci A, Valentino P, Zappia M, Quattrone A. Juvenile Huntington's disease presenting as progressive myoclonic epilepsy. Neurology 2001; 57:708-11. [PMID: 11524486 DOI: 10.1212/wnl.57.4.708] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A 9-year-old girl, who had no family history of neurologic diseases in the first-degree relatives, had a 3-year history of progressive myoclonus epilepsy (PME). A thorough laboratory investigation was normal. As two sisters of her paternal grandmother were said to have Huntington's disease (HD), the authors looked for HD and found a CAG repeat expansion of 115 repeats. This diagnosis should be considered in addition to other causes in patients with PME. Moreover, the current case further supports the notion that HD should be considered even when a family history is not obvious.
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Affiliation(s)
- A Gambardella
- Institute of Neurology, School of Medicine, Catanzaro, Italy
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40
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Abstract
We describe a patient with progressive myoclonus epilepsy (PME), white matter hyperintensities in the corpus callosum, cerebral hemispheres, and left cerebral peduncle on magnetic resonance imaging (MRI), and positive oligoclonal bands. A phosphorus magnetic resonance spectrum was compatible with mitochondrial dysfunction. Abnormal white matter signals are not a feature of the known PME syndromes, although they occur in Leber's hereditary optic neuropathy (LHON). These abnormalities oriented the diagnosis toward mitochondrial disease.
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Affiliation(s)
- R A Marrie
- Department of Neurology, McGill University, Montreal, Quebec, Canada
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41
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Abstract
Our understanding of the genetic basis of epilepsy is progressing at a rapid pace. Gene mutations causing several of the inherited epilepsies have been mapped, and several more are likely to be added in coming years. In this review, we summarize the available information on the genetic basis of human epilepsies and epilepsy syndromes, emphasizing how genetic defects may correlate with the pathophysiological mechanisms of brain hyperexcitability. Mutations leading to epilepsy have been identified in genes encoding voltage- and ligand-gated ion channels (benign familial neonatal convulsions, autosomal dominant nocturnal frontal lobe epilepsy, generalized epilepsy with febrile seizures "plus"), neurotransmitter receptors (Angelman syndrome), the molecular cascade of cellular energy production (myoclonic epilepsy with ragged red fibers), and proteins without a known role in neuronal excitability (Unverricht-Lundborg disease). Gene defects can lead to epilepsy by altering multiple and diverse aspects of neuronal function.
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Affiliation(s)
- C E Stafstrom
- Departments of Neurology and Pediatrics, University of Wisconsin, Madison, Wisconsin 53792, USA.
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42
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Garvey MA, Toro C, Goldstein S, Altarescu G, Wiggs EA, Hallett M, Schiffmann R. Somatosensory evoked potentials as a marker of disease burden in type 3 Gaucher disease. Neurology 2001; 56:391-4. [PMID: 11171908 DOI: 10.1212/wnl.56.3.391] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The authors compared stretch-evoked somatosensory evoked potentials (SEP) of 18 type 3 Gaucher disease (GD3) patients (two with progressive myoclonus epilepsy [PME]) with 22 age-matched normal controls and six patients with type 1 (nonneuronopathic) Gaucher disease (GD1). The mean P1-N2 SEP amplitude in GD3 patients was significantly larger than the SEP in controls and in GD1 patients, and there was a significant negative correlation between SEP amplitude and the IQ of GD3 patients. The authors conclude that abnormal cortical inhibition is a unifying feature of GD3 patients and correlates with the degree of cognitive deficit.
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Affiliation(s)
- M A Garvey
- Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA.
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Silén T, Forss N, Jensen O, Hari R. Abnormal reactivity of the approximately 20-Hz motor cortex rhythm in Unverricht Lundborg type progressive myoclonus epilepsy. Neuroimage 2000; 12:707-12. [PMID: 11112402 DOI: 10.1006/nimg.2000.0660] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The approximately 20-Hz component of the human mu rhythm originates predominantly in the primary motor cortex. We monitored with a whole-scalp neuromagnetometer the reactivity of the approximately 20-Hz rhythm as an index of the functional state of the primary motor cortex in seven patients suffering from Unverricht-Lundborg type (ULD) progressive myoclonus epilepsy (PME) and in seven healthy control subjects. In patients, the motor cortex rhythm was on average 5 Hz lower in frequency and its strength was double compared with controls. To study reactivity of the approximately 20-Hz rhythm, left and right median nerves were stimulated alternately at wrists. In controls, these stimuli elicited a small transient decrease, followed by a strong increase ("rebound") of the approximately 20-Hz level. In contrast, the patients showed no significant rebounds of the rhythm. As the approximately 20-Hz rebounds apparently reflect increased cortical inhibition, our results indicate that peripheral stimuli excite motor cortex for prolonged periods in patients with ULD.
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Affiliation(s)
- T Silén
- Brain Research Unit, Low Temperature Laboratory, Helsinki University of Technology, FIN-02015 HUT, Espoo, Finland
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44
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Tsuji S. [Dentatorubral-pallidoluysian atrophy (DRPLA)--discovery of the disease, DRPLA gene and the pathophysiology]. Rinsho Shinkeigaku 2000; 40:1287-9. [PMID: 11464481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
The clinical entity of dentatorubral-pallidoluysian atrophy (DRPLA) was discovered and established in Japan. The characteristic clinical genetic features of DRPLA including prominent anticipation prompted us to search the genes carrying CAG repeats as the candidate genes for DRPLA. Based on this approach, the DRPLA gene was discovered by two independent Japanese groups in 1994. Given that DRPLA is caused by expansion of CAG repeats, the molecular mechanisms of the anticipation and the broad clinical presentations of DRPLA depending on the age at onset are clearly understood as a function of the size and the instability of the CAG repeats. Recent studies have suggested that mutant proteins with expanded polyglutamine stretches have "gain-of-toxic" functions to neuronal cells. The molecular mechanisms of the "toxic" functions, however, have not been identified. Based on the recent findings that nuclear transport of the mutant proteins carrying expanded polyglutamine stretches is important in the pathogenesis, we screened nuclear proteins which bind to expanded polyglutamine stretches. We found that expanded polyglutamine stretches bind to TAFII130, a TATA-binding protein-associated factor, and interfere with CREB-dependent transcriptional activation. Since CREB-dependent transcriptional activation plays essential roles in neuronal survival and plasticity, such interference is expected to lead to neuronal dysfunction.
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Affiliation(s)
- S Tsuji
- Department of Neurology, Brain Research Institute, Niigata University
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45
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Abstract
An increasing number of inherited neurodegenerative diseases are known to be caused by trinucleotide repeat expansions in the respective genes. At least nine disorders result from a CAG trinucleotide repeat expansion which is translated into a polyglutamine stretch in the respective proteins: Huntington's disease (HD), dentatorubral pallidolysian atrophy (DRPLA), spinal bulbar muscular atrophy (SBMA), and several of the spinocerebellar ataxias (SCA1, 2, 3, 6, 7 and 12). Although the molecular steps leading to the specific neuropathology of each disease are unknown and are still under intensive investigation, there is increasing evidence that some CAG repeat disorders involve the induction of apoptotic mechanisms. This review summarizes the clinical and genetic features of each CAG repeat disorder and focuses on the common mechanistic steps involved in the disease progression of these so-called polyglutamine diseases. Among the common molecular features the formation of intranuclear inclusions, the recruitment of interacting polyglutamine-containing proteins, the involvement of the proteasome and molecular chaperones, and the activation of caspases are discussed with regard to their potential implication for the induction of cell death.
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Affiliation(s)
- B O Evert
- Department of Neurology, University of Bonn, Germany.
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46
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Touge T, Ichihara N, Ishibashi T, Ikeguchi M, Sasaki I, Takeuchi H. Afferent and efferent excitabilities of the transcortical loop in patients with dentatorubral-pallidoluysian atrophy. J Neurol Sci 2000; 176:28-36. [PMID: 10865089 DOI: 10.1016/s0022-510x(00)00294-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
To evaluate the excitabilities of the transcortical loop in patients with dentatorubral-pallidoluysian atrophy (DRPLA), we studied somatosensory evoked potentials (SEPs) and evoked EMG responses (V1 and V2) in 10 patients and age-matched controls. In addition, the facilitatory effects of somatosensory inputs on motor evoked potentials (MEPs) were studied in four patients and controls. We observed attenuated or prolonged cervical and subcortical potentials and prolonged middle latency components of SEPs. The amplitudes of V2 in patients were significantly lowered compared to those in the controls, while the amplitudes and latencies of V1 were similar between the two groups. Since V2 was considered as a transcortical reflex, our results suggest reduced excitabilities of the afferent pathway of the transcortical loop in patients with DRPLA. Median nerve stimulation (MNS) 25 to 30 ms preceding transcranial magnetic stimulation (TMS) facilitated MEPs in the thenar muscle in two of the four patients and in the controls. The facilitation of MEPs by MNS tended to be independent of the reduction in V2. Such a result suggests that different neural mechanisms elicit V2 and facilitate MEPs following peripheral nerve stimulation, although further studies are needed. The combination of SEPs, evoked EMG responses and MEPs may be a useful technique to detect abnormalities of input and output coordinations of the transcortical loop.
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Affiliation(s)
- T Touge
- Third Department of Internal Medicine, Kagawa Medical University, 1750-1, Ikenobe, Miki-cho, Kita-gun, Kagawa, Japan.
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Ragazzoni A, Ferri R, Di Russo F, Del Gracco S, Barcaro U, Navona C. Giant somatosensory evoked potentials in different clinical conditions: scalp topography and dipole source analysis. Electroencephalogr Clin Neurophysiol Suppl 1999; 49:81-9. [PMID: 10533091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- A Ragazzoni
- Department of Neurological and Psychiatric Sciences, University of Florence, Italy
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48
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Abstract
Dentatorubral and pallidoluysian atrophy (DRPLA) is an autosomal dominant cerebellar ataxia characterized clinically by myoclonus, epilepsy, cerebellar ataxia, choreoathetosis, and dementia with personality change. Histopathologically, DRPLA is characterized by a unique combination of degenerative changes in both the dentatofugal and the pallidofugal systems. Credit for the establishment of DRPLA as an entity is given to Naito and Oyagagi, who first noticed a strong heritability and an age of onset-dependent variability of the clinical features. Most papers on DRPLA research are written in Japanese, and are extensively reviewed here. After the gene was identified in 1994, DRPLA became known as one of the CAG repeat expansion diseases, in which the responsible gene is located on chromosome 12p and its product is called atrophin-1. Classical genetics revealed that DRPLA shows prominent "anticipation" and modern molecular genetics provided a clear explanation for this phenomenon, by demonstrating a strong instability of the expanded CAG repeat length through generations. The impact of gene analysis of DRPLA on the clinical genetics and neurology are discussed. Moreover, possible mechanism(s) underlying the neuronal cell death in DRPLA are discussed in terms of the molecular pathology.
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Affiliation(s)
- I Kanazawa
- Department of Neurology, Graduate School of Medicine, University of Tokyo, Tokyo 113-8655, Japan.
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49
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Abstract
The possible associations of myoclonic phenomenae, progressive or non-progressive encephalopathies and epileptic features are reviewed, with special emphasis on pediatric age. This leads to recognize the following five groups of conditions: (1) Myoclonus without encephalopathy and without epilepsy; (2) Encephalopathies with non-epileptic myoclonus; (3) Progressive encephalopathies presenting myoclonus seizures of epileptic syndromes (Progressive myoclonus epilepsies); (4) Epileptic encephalopathies with myoclonic seizures; (5) Myoclonic epilepsies. Within the first group, which also includes physiologic myoclonus, a more thorough description of "Benign sleep myoclonus of newborn" and "Benign myoclonus of early infancy" is given. Characteristics of group 2 are "Kinsbourne Syndrome" and certain types of "Hyperekplexia" which pose interesting differential diagnosis with stimulus-sensitive epilepsies. In group 3, the concept of progressive encephalopathies is stressed. The fourth group refers to severe epilepsies, mainly on infancy and childhood, which lead to mental retardation irrespective of their aetiology. Group 5 comprises the true myoclonic epilepsies, differentiating syndromes recognized as idiopathic--such as "Benign myoclonic epilepsy of infancy" and "Juvenile myoclonic epilepsy"--from those which are cryptogenic and carry a more cautious prognosis--as "Cryptogenic myoclonic and myoclonoastatic epilepsies" and "Severe myoclonic epilepsy of infancy". Other epileptic syndromes not usually considered as myoclonic epilepsies, but presenting sometimes as myoclonic seizures, are finally referred.
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Affiliation(s)
- N Fejerman
- Department of Neurology, Pediatric Hospital Juan P. Garrahan Buenos Aires, Argentina
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