1
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Olszewska DA, Shetty A, Rajalingam R, Rodriguez-Antiguedad J, Hamed M, Huang J, Breza M, Rasheed A, Bahr N, Madoev H, Westenberger A, Trinh J, Lohmann K, Klein C, Marras C, Waln O. Genotype-phenotype relations for episodic ataxia genes: MDSGene systematic review. Eur J Neurol 2023; 30:3377-3393. [PMID: 37422902 DOI: 10.1111/ene.15969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/28/2023] [Accepted: 07/04/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Most episodic ataxias (EA) are autosomal dominantly inherited and characterized by recurrent attacks of ataxia and other paroxysmal and non-paroxysmal features. EA is often caused by pathogenic variants in the CACNA1A, KCNA1, PDHA1, and SLC1A3 genes, listed as paroxysmal movement disorders (PxMD) by the MDS Task Force on the Nomenclature of Genetic Movement Disorders. Little is known about the genotype-phenotype correlation of the different genetic EA forms. METHODS We performed a systematic review of the literature to identify individuals affected by an episodic movement disorder harboring pathogenic variants in one of the four genes. We applied the standardized MDSGene literature search and data extraction protocol to summarize the clinical and genetic features. All data are available via the MDSGene protocol and platform on the MDSGene website (https://www.mdsgene.org/). RESULTS Information on 717 patients (CACNA1A: 491, KCNA1: 125, PDHA1: 90, and SLC1A3: 11) carrying 287 different pathogenic variants from 229 papers was identified and summarized. We show the profound phenotypic variability and overlap leading to the absence of frank genotype-phenotype correlation aside from a few key 'red flags'. CONCLUSION Given this overlap, a broad approach to genetic testing using a panel or whole exome or genome approach is most practical in most circumstances.
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Affiliation(s)
- Diana Angelika Olszewska
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Aakash Shetty
- Department of Neurology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Rajasumi Rajalingam
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Jon Rodriguez-Antiguedad
- Movement Disorders Unit and Institut d'Investigacions Biomediques-Sant Pau, Hospital Sant Pau, Barcelona, Spain
| | - Moath Hamed
- Department of Neurosciences, NYP Brooklyn Methodist Hospital, Brooklyn, New York, USA
| | - Jana Huang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | | | - Ashar Rasheed
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Natascha Bahr
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Harutyan Madoev
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Ana Westenberger
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Joanne Trinh
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Katja Lohmann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Connie Marras
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Olga Waln
- Houston Methodist Neurological Institute, Weill Cornell Medical College, New York, New York, USA
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2
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Olszewska DA, Lang AE. Teaching Video NeuroImage: Unilateral Myorhythmia in a Patient With a Midbrain-Diencephalic Junction Cavernous Malformation. Neurology 2022; 98:e1510-e1511. [PMID: 35145007 DOI: 10.1212/wnl.0000000000200121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Diana Angelika Olszewska
- The Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University of Toronto, Canada
| | - Anthony E Lang
- The Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University of Toronto, Canada
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3
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Abstract
We report a case of severe amnestic syndrome following theophylline overdose. A woman in her early 30s was admitted to hospital where she developed status epilepticus following an intentional overdose of theophylline and lansoprazole. She developed a profound acidosis and required intubation in the intensive care unit. Following extubation the patient was noted to have a severe amnestic syndrome with poor short-term memory. A work-up to exclude infectious, autoimmune and paraneoplastic causes for encephalitis was undertaken. Cerebrospinal fluid analysis was normal and autoimmune encephalitis titres were negative. Initial MRI brain imaging demonstrated hyperintensities of the mesial temporal lobes bilaterally. Follow-up imaging at 4 months identified further interval reduction but persistent hippocampal hyperintensities. Theophylline toxicity with corresponding amnestic syndrome and hippocampal hyperintensities has been rarely reported. We believe this case with persistent abnormal Montreal Cognitive Assessment Score at 12 months correlates with persistent hippocampal abnormalities seen on imaging.
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Affiliation(s)
- Eimear Joyce
- Neurology, University Hospital Galway, Galway, Ireland
| | - Diana Angelika Olszewska
- Neurology, University Hospital Galway, Galway, Ireland.,Dublin Neurological Institute, Mater Misericordiae University Hospital, Dublin 7, Ireland
| | - Shane Davy
- Department of Anatomy, University of Dublin Trinity College, Dublin, Ireland.,Radiology, University Hospital Galway, Galway, Ireland
| | - Timothy J Counihan
- Neurology, University Hospital Galway, Galway, Ireland.,School of Medicine, NUIG, Galway, Ireland
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4
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Tamás G, Fabbri M, Falup-Pecurariu C, Teodoro T, Kurtis MM, Aliyev R, Bonello M, Brozova H, Coelho MS, Contarino MF, Corvol JC, Dietrichs E, Ben Djebara M, Elmgreen SB, Groppa S, Kadastik-Eerme L, Khatiashvili I, Kostić V, Krismer F, Hassan Mansour A, Odin P, Gavriliuc O, Olszewska DA, Relja M, Scheperjans F, Skorvanek M, Smilowska K, Taba P, Tavadyan Z, Valante R, Vujovic B, Waldvogel D, Yalcin-Cakmakli G, Chitnis S, Ferreira JJ. Lack of Accredited Clinical Training in Movement Disorders in Europe, Egypt, and Tunisia. J Parkinsons Dis 2020; 10:1833-1843. [PMID: 32651331 DOI: 10.3233/jpd-202000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Little information is available on the official postgraduate and subspecialty training programs in movement disorders (MD) in Europe and North Africa. OBJECTIVE To survey the accessible MD clinical training in these regions. METHODS We designed a survey on clinical training in MD in different medical fields, at postgraduate and specialized levels. We assessed the characteristics of the participants and the facilities for MD care in their respective countries. We examined whether there are structured, or even accredited postgraduate, or subspecialty MD training programs in neurology, neurosurgery, internal medicine, geriatrics, neuroradiology, neuropediatrics, and general practice. Participants also shared their suggestions and needs. RESULTS The survey was completed in 31/49 countries. Structured postgraduate MD programs in neurology exist in 20 countries; structured neurology subspecialty training exists in 14 countries and is being developed in two additional countries. Certified neurology subspecialty training was reported to exist in 7 countries. Recommended reading lists, printed books, and other materials are the most popular educational tools, while courses, lectures, webinars, and case presentations are the most popular learning formats. Mandatory activities and skills to be certified were not defined in 15/31 countries. Most participants expressed their need for a mandatory postgraduate MD program and for certified MD sub-specialization programs in neurology. CONCLUSION Certified postgraduate and subspecialty training exists only in a minority of European countries and was not found in the surveyed Egypt and Tunisia. MD training should be improved in many countries.
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Affiliation(s)
- Gertrúd Tamás
- Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Margherita Fabbri
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Italy.,Instituto de Medicina Molecular, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Portugal
| | | | - Tiago Teodoro
- Instituto de Medicina Molecular, Lisbon, Portugal.,Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's, University of London, London, UK.,Ashford and St Peter's Hospital NHS Trust, Chertsey, Surrey, UK
| | - Mónica M Kurtis
- Movement Disorders Unit, Neurology Department, Hospital Ruber Internacional, Madrid, Spain
| | - Rahim Aliyev
- Department of Neurology and Clinical Neurophysiology, Azerbaijan State Advanced Training Institute for Doctors named after A. Aliyev, Baku, Republic of Azerbaijan
| | - Michael Bonello
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Hana Brozova
- Department of Neurology and Center of Clinical Neuroscience, Charles University, First Faculty of Medicine, Prague, Czech Republic
| | - Miguel Soares Coelho
- Instituto de Medicina Molecular, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Portugal.,Department of Neurosciences, Neurology Service, Hospital Santa Maria, Lisbon, Portugal
| | - Maria Fiorella Contarino
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Jean-Christophe Corvol
- Department of Neurology, Sorbonne Université, Assistance Publique Hôpitaux de Paris, Inserm, CNRS, Hôpital Pitié-Salpêtrière, Institut du Cerveau et de la Moelle, Paris, France
| | - Espen Dietrichs
- Department of Neurology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Mouna Ben Djebara
- Department of Neurology, Razi Hospital, Faculté de Médecine de Tunis, University Tunis-El Manar, Tunisia
| | | | - Sergiu Groppa
- Department of Neurology, Movement Disorders, Imaging and Neurostimulation, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Liis Kadastik-Eerme
- Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.,Department of Neurology, Tartu University Hospital, Tartu, Estonia
| | - Irine Khatiashvili
- Department of Clinical Neurology, Tbilisi State Medical University, Tbilisi, Georgia
| | - Vladimir Kostić
- Department of Neurology CCS, University of Belgrade, Belgrade, Serbia
| | - Florian Krismer
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Alia Hassan Mansour
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Per Odin
- Department of Clinical Sciences, Division of Neurology, Lund University, Lund, Sweden
| | - Olga Gavriliuc
- Department of Neurology, State University of Medicine and Pharmacy Nicolae Testemitanu, Chisinau, Republic of Moldova
| | - Diana Angelika Olszewska
- Department of Neurology, Dublin Neurological Institute at the Mater Misericordiae University Hospital, Dublin, Ireland
| | - Maja Relja
- Croatian Academy of Medical Sciences and School of Medicine, Zagreb University, Zagreb, Croatia
| | - Filip Scheperjans
- Department of Neurology, Helsinki University Hospital, and Department of Neurological Sciences (Neurology), University of Helsinki, Helsinki, Finland
| | - Matej Skorvanek
- Department of Neurology, Faculty of Medicine, P. J. Safarik University, Kosice, Slovak Republic.,Department of Neurology, University Hospital L. Pasteur, Kosice, Slovak Republic
| | | | - Pille Taba
- Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.,Department of Neurology, Tartu University Hospital, Tartu, Estonia
| | - Zaruhi Tavadyan
- Department of Neurology and Neurosurgery, National Institute of Health, Yerevan, Armenia.,"Somnus" Sleep and Movement Disorders Clinic, Yerevan, Armenia
| | - Ramona Valante
- Department of Neurology, Pauls Stradiņš Clinical University Hospital, Riga, Latvia
| | - Balsa Vujovic
- Department of Neurology, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Daniel Waldvogel
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | | | - Shilpa Chitnis
- Department of Neurology and Neurotherapeutics, Southwestern Medical Center, University of Texas, Dallas, Texas, US
| | - Joaquim J Ferreira
- Instituto de Medicina Molecular, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Portugal.,CNS - Campus Neurológico Sénior, Torres Vedras, Portugal
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Paramanandam V, Olszewska DA, Shakya B, Chalissery AJ, O'Connell M, Farrell M, Lynch T. Reply to Comment on: A 57-Year-Old Woman With Progressive Left Hand Clumsiness and Falls. Mov Disord Clin Pract 2020; 7:581-582. [PMID: 32626813 PMCID: PMC7328408 DOI: 10.1002/mdc3.12964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 03/31/2020] [Indexed: 11/07/2022] Open
Affiliation(s)
- Vijayashankar Paramanandam
- Centre for Brain Health, Dublin Neurological Institute at the Mater MisericordiaeUniversity HospitalDublinIreland
| | - Diana Angelika Olszewska
- Centre for Brain Health, Dublin Neurological Institute at the Mater MisericordiaeUniversity HospitalDublinIreland
| | | | - Albi Jose Chalissery
- Centre for Brain Health, Dublin Neurological Institute at the Mater MisericordiaeUniversity HospitalDublinIreland
| | - Martin O'Connell
- Department of RadiologyMater Misericordiae University HospitalDublinIreland
| | | | - Tim Lynch
- Centre for Brain Health, Dublin Neurological Institute at the Mater MisericordiaeUniversity HospitalDublinIreland
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6
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Olszewska DA, Fallon EM, Pastores GM, Murphy K, Blanco A, Lynch T, Murphy SM. Autosomal Dominant Gene Negative Frontotemporal Dementia-Think of SCA17. Cerebellum 2019; 18:654-658. [PMID: 30617627 DOI: 10.1007/s12311-018-0998-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
SCA 17 is a rare, autosomal dominant disorder caused by TBP gene CAG/CAA repeat expansion. Ataxia and dementia are common. The presence of frontal dysfunction at outset of the disease may mimic frontotemporal dementia (FTD). Parkinsonism, chorea, dystonia, and pyramidal signs may occur. We report an Irish family with autosomal dominant partially penetrant frontal dementia with cerebellar atrophy due to SCA17 and present detailed neuropsychological assessment for the first time. A 44-year-old doctor presented with 18-month history of behavioral problems. She slowed down, became apathetic, and unable to multitask. She became more irritable and short tempered, and her work performance deteriorated. Brain MRI showed cerebellar atrophy and cerebellar hypometabolism was noted on FDG-PET. A sister developed personality changes at age 45 with apathy, and had problems with memory and social skills; another sister at age 39 became dysarthric and unsteady. A brother at age 52 demonstrated emotional lability, and became dysarthric, unsteady, and slowed down. Their mother aged 73 had an abnormal antalgic gait due to arthritis; their father was jocular and disinhibited. MAPT testing detected an exon 9 c.726C>T variant in the proband. Subsequent testing in nine siblings and both parents failed to show co-segregation with disease. SCA17 testing revealed a TBP gene 43 repeat expansion that co-segregated in all affected siblings and in the mother whose gait problems were initially attributed to arthritis. In over 80% of cases of FTD with clear autosomal dominant inheritance, causative gene defects involve MAPT, GRN, or C9orf72 mutations. A minority involves VCP, FUS, and CHMP2B. As evident from our case, SCA17 testing should also be considered, especially if cerebellar atrophy if found on imaging. Segregation analysis is crucial. MAPT variant (c.726C>T exon 9) detected in the family was deemed a polymorphism.
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Affiliation(s)
- Diana Angelika Olszewska
- Department of Neurology, Dublin Neurological Institute, Mater Misericordiae University Hospital, 57 Eccles Street, Dublin 7, Ireland.
| | - E M Fallon
- Department of Neurology, Dublin Neurological Institute, Mater Misericordiae University Hospital, 57 Eccles Street, Dublin 7, Ireland
| | - G M Pastores
- National Centre for Inherited Metabolic Disorders, Mater Misericordiae University Hospital, Dublin, Ireland
| | - K Murphy
- Department of Neurology, Sligo University Hospital, Sligo, Ireland
| | - A Blanco
- Department of Neuropsychology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - T Lynch
- Department of Neurology, Dublin Neurological Institute, Mater Misericordiae University Hospital, 57 Eccles Street, Dublin 7, Ireland
| | - S M Murphy
- Department of Neurology, The Adelaide and Meath Hospitals, Tallaght, Dublin, Ireland.,Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland
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7
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Paramanandam V, Olszewska DA, Shakya B, Chalissery AJ, O'Connell M, Farrell M, Lynch T. A 57-Year-Old Woman With Progressive Left Hand Clumsiness and Falls. Mov Disord Clin Pract 2019; 6:656-660. [PMID: 31745473 DOI: 10.1002/mdc3.12825] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 05/20/2019] [Accepted: 05/24/2019] [Indexed: 11/11/2022] Open
Abstract
Clinical History A 57-year old woman presented with left hand pain, periodic leg movement during sleep, gradual onset of stiffness, clumsiness, and falls. Neurological examination showed: generalized rigidity and bradykinesia. There was left hand dystonic posturing and ideomotor apraxia, as well as mirror movements of upper limbs and stimulus-sensitive myoclonus. The patient had a high-pitched voice and hypophonia (Video S1). Discussion Experts discuss localization and the syndromic diagnosis and predict the underlying pathology. The pathological diagnosis is then provided and clinical learning points are considered.
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Affiliation(s)
- Vijayashankar Paramanandam
- Centre for Brain Health Dublin Neurological Institute at the Mater Misericordiae University Hospital Dublin Ireland
| | - Diana Angelika Olszewska
- Centre for Brain Health Dublin Neurological Institute at the Mater Misericordiae University Hospital Dublin Ireland
| | | | - Albi Jose Chalissery
- Centre for Brain Health Dublin Neurological Institute at the Mater Misericordiae University Hospital Dublin Ireland
| | - Martin O'Connell
- Department of Radiology Mater Misericordiae University Hospital Dublin Ireland
| | - Michael Farrell
- Department of Neuropathology Beaumont Hospital Dublin Ireland
| | - Tim Lynch
- Centre for Brain Health Dublin Neurological Institute at the Mater Misericordiae University Hospital Dublin Ireland
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8
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Paramanandam V, Hadjivassiliou M, Olszewska DA, Munteanu T, Williams L, Magennis B, Fearon C, O'Connell M, Sarrigiannis P, Lynch T. Reversible Corticobasal Syndrome due to Coeliac Disease. Mov Disord Clin Pract 2019; 5:551-554. [PMID: 30637273 DOI: 10.1002/mdc3.12659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 05/18/2018] [Accepted: 06/08/2018] [Indexed: 11/10/2022] Open
Affiliation(s)
| | - Marios Hadjivassiliou
- Academic Department of Neurosciences Royal Hallamshire Hospital Sheffield South Yorkshire S1 3JD United Kingdom
| | | | - Tudor Munteanu
- Dublin Neurological Institute at the Mater Misericordiae University Hospital Ireland
| | - Laura Williams
- Dublin Neurological Institute at the Mater Misericordiae University Hospital Ireland
| | - Brian Magennis
- Dublin Neurological Institute at the Mater Misericordiae University Hospital Ireland
| | - Conor Fearon
- Dublin Neurological Institute at the Mater Misericordiae University Hospital Ireland
| | - Martin O'Connell
- Department of Radiology Mater Misericordiae University Hospital Ireland
| | - Ptolemaios Sarrigiannis
- Academic Department of Neurosciences Royal Hallamshire Hospital Sheffield South Yorkshire S1 3JD United Kingdom
| | - Tim Lynch
- Dublin Neurological Institute at the Mater Misericordiae University Hospital Ireland
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9
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Olszewska DA, Lynch T. Lysosomal Storage Disorders and Parkinson's Disease: New Susceptibility Loci Identified. Mov Disord Clin Pract 2018; 5:404-405. [DOI: 10.1002/mdc3.12625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 03/29/2018] [Accepted: 04/07/2018] [Indexed: 11/08/2022] Open
Affiliation(s)
| | - Tim Lynch
- Dublin Neurological Institute at the Mater Misericordiae University Hospital; Dublin Ireland
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10
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Cheran G, Silverman H, Manoochehri M, Goldman J, Lee S, Wu L, Cines S, Fallon E, Kelly BD, Olszewska DA, Heidebrink J, Shair S, Campbell S, Paulson H, Lynch T, Cosentino S, Huey ED. Psychiatric symptoms in preclinical behavioural-variant frontotemporal dementia in MAPT mutation carriers. J Neurol Neurosurg Psychiatry 2018; 89:449-455. [PMID: 29353234 PMCID: PMC6317727 DOI: 10.1136/jnnp-2017-317263] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 12/05/2017] [Accepted: 12/18/2017] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To characterise psychiatric symptoms in preclinical and early behavioural-variant frontotemporal dementia (bvFTD), a neurodegenerative disorder whose symptoms overlap with and are often mistaken for psychiatric illness. METHODS The present study reports findings from a systematic, global, prospective evaluation of psychiatric symptoms in 12 preclinical carriers of pathogenic MAPT mutations, not yet meeting bvFTD diagnostic criteria, and 46 familial non-carrier controls. Current psychiatric symptoms, informant-reported symptoms and lifetime prevalence of psychiatric disorders were assessed with The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and the Neuropsychiatric Inventory Questionnaire. Fisher exact test was used to compare carriers and non-carriers' lifetime prevalence of six DSM-IV disorders: major depressive disorder, panic attacks, alcohol abuse, generalised anxiety disorder, panic disorder, and depressive disorder not otherwise specified. Other DSM-IV disorders had insufficient prevalence across our sample for between-group comparisons, but are reported. RESULTS Non-carriers had greater prevalence of mood and anxiety disorders than has been reported for a general reference population. Preclinical carriers had lower lifetime prevalence of mood and anxiety disorders than non-carriers, except for depressive disorder not otherwise specified, an atypical syndrome comprising clinically significant depressive symptoms which fail to meet criteria for major depressive disorder. CONCLUSION Findings suggest that early psychiatric symptoms of emergent bvFTD may manifest as emotional blunting or mood changes not cleanly conforming to criteria for a DSM-defined mood disorder.
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Affiliation(s)
- Gayathri Cheran
- G H Sergievsky Center & Taub Institute in the Department of Neurology, Columbia University Medical Center, New York, USA
| | - Hannah Silverman
- G H Sergievsky Center & Taub Institute in the Department of Neurology, Columbia University Medical Center, New York, USA
| | - Masood Manoochehri
- G H Sergievsky Center & Taub Institute in the Department of Neurology, Columbia University Medical Center, New York, USA
| | - Jill Goldman
- G H Sergievsky Center & Taub Institute in the Department of Neurology, Columbia University Medical Center, New York, USA
| | - Seonjoo Lee
- Department of Biostatistics, Mailman School of Public Health, Columbia University Medical Center, New York, USA
| | - Liwen Wu
- Department of Biostatistics, Mailman School of Public Health, Columbia University Medical Center, New York, USA
| | - Sarah Cines
- G H Sergievsky Center & Taub Institute in the Department of Neurology, Columbia University Medical Center, New York, USA
| | - Emer Fallon
- Department of Neurology, Dublin Neurological Institute at the Mater Misericordiae University Hospital, Dublin, Ireland
| | - Brendan Desmond Kelly
- Department of Neurology, Dublin Neurological Institute at the Mater Misericordiae University Hospital, Dublin, Ireland.,Department of Psychiatry, Trinity Centre for Health Sciences, Trinity College Dublin, Tallaght Hospital, Dublin, Ireland
| | - Diana Angelika Olszewska
- Department of Neurology, Dublin Neurological Institute at the Mater Misericordiae University Hospital, Dublin, Ireland
| | - Judith Heidebrink
- Department of Neurology, The University of Michigan, Ann Arbor, Michigan, USA
| | - Sarah Shair
- Department of Neurology, The University of Michigan, Ann Arbor, Michigan, USA
| | - Stephen Campbell
- Department of Neurology, The University of Michigan, Ann Arbor, Michigan, USA
| | - Henry Paulson
- Department of Neurology, The University of Michigan, Ann Arbor, Michigan, USA
| | - Timothy Lynch
- Department of Neurology, Dublin Neurological Institute at the Mater Misericordiae University Hospital, Dublin, Ireland
| | - Stephanie Cosentino
- G H Sergievsky Center & Taub Institute in the Department of Neurology, Columbia University Medical Center, New York, USA
| | - Edward D Huey
- Departments of Psychiatry & Neurology, Columbia University Medical Center, New York, USA
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11
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Olszewska DA, Fallon EM, Doyle S, Pastores G, Lynch T, Murphy SM. PO099 Autosomal dominant gene negative frontotemporal dementia-think sca17. J Neurol Neurosurg Psychiatry 2017. [DOI: 10.1136/jnnp-2017-abn.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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12
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Olszewska DA, Crowley P, Lynch T. PO098 A lesson from the dat scan. J Neurol Neurosurg Psychiatry 2017. [DOI: 10.1136/jnnp-2017-abn.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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13
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Olszewska DA, McCarthy A, Murray B, Magennis B, Connolly S, Lynch T. A Wolf in Sheep's Clothing: An "Alien Leg" in Corticobasal Syndrome. Tremor Other Hyperkinet Mov (N Y) 2017; 7:455. [PMID: 28469972 PMCID: PMC5409931 DOI: 10.7916/d86d5zt8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 03/31/2017] [Indexed: 12/01/2022]
Abstract
Background Alien limb phenomenon occurs in 50–60% of patients with corticobasal syndrome (CBS) and usually presents with an “alien hand” phenomenon. The “alien foot” presentation is rarer and may be misdiagnosed, as foot involvement can lead to erroneous localization of the clinical problem to the knee, hip, or back. Subsequently misdiagnoses such as myelopathy, radiculopathy, functional disorder, stiff leg syndrome, neuromyotonia, and painful leg moving toes syndrome may occur. Case report We describe two patients with alien foot symptoms that resulted in multiple opinions from different specialists, multiple diagnostic and therapeutic procedures, and delayed diagnosis. Eventually a diagnosis of CBS was made in both. Alien foot symptoms may be more common than initially thought and can result in a delayed diagnosis of CBS. Conclusion The inclusion of this clinical finding in recently proposed diagnostic criteria highlights the need for increased clinical awareness.
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Affiliation(s)
- Diana Angelika Olszewska
- Department of Neurology, Dublin Neurological Institute, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Allan McCarthy
- Department of Neurology, Dublin Neurological Institute, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Brian Murray
- Department of Neurology, Dublin Neurological Institute, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Brian Magennis
- Department of Neurology, Dublin Neurological Institute, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Sean Connolly
- Department of Clinical Neurophysiology, St Vincent's University Hospital, Dublin, Ireland
| | - Tim Lynch
- Department of Neurology, Dublin Neurological Institute, Mater Misericordiae University Hospital, Dublin, Ireland
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14
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Olszewska DA, Lynch T. Lewy Bodies' absence in grafted dopaminergic transplants in Parkinson's Disease. Mov Disord Clin Pract 2015; 2:369-370. [DOI: 10.1002/mdc3.12180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 03/13/2015] [Accepted: 03/20/2015] [Indexed: 11/10/2022] Open
Affiliation(s)
- Diana Angelika Olszewska
- Department of Neurology at the Dublin Neurological Institute; Mater Misericordiae University Hospital; Dublin Ireland
| | - Tim Lynch
- Department of Neurology at the Dublin Neurological Institute; Mater Misericordiae University Hospital; Dublin Ireland
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15
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Olszewska DA, Walsh R, Lynch T. SCA 6 with Writer's Cramp: The Phenotype Expanded. Mov Disord Clin Pract 2015; 3:83-86. [PMID: 30713900 DOI: 10.1002/mdc3.12222] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 06/25/2015] [Accepted: 06/26/2015] [Indexed: 12/27/2022] Open
Abstract
Spinocerebellar ataxia type 6 (SCA6) presents typically with a pure cerebellar syndrome. Only 1 SCA 6 patient with writer's cramp has been reported on and a family history of ataxia and writer's cramp has never been reported on. Two other SCA6 patients with a shoulder girdle/hand dystonia and unspecified upper-limb dystonia with a family history of ataxia have been reported on. We report on the largest family with SCA6 and writer's cramp. The proband developed dysarthria, ataxia, and writer's cramp by age 37. His father presented with ataxia at 55, followed by writer's cramp and dysarthria. The proband's brother developed ataxia at 41, followed by dysarthria and writer's cramp. A paternal uncle (deceased; not examined) and 58-yr-old brother both developed pure ataxia (genetic testing is pending). This large family with complex movement disorder demonstrates that it is important to consider SCA6 in a patient presenting with an ataxia and writer's cramp and supports cerebellum involvement in dystonia.
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Affiliation(s)
- Diana Angelika Olszewska
- Department of Neurology at the Dublin Neurological Institute Mater Misericordiae University Hospital Dublin Ireland
| | - Richard Walsh
- Department of Neurology at the Dublin at the Adelaide and Meath Hospital, Dublin National Children's Hospital Tallaght, Dublin Ireland
| | - Tim Lynch
- Department of Neurology at the Dublin Neurological Institute Mater Misericordiae University Hospital Dublin Ireland
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16
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Affiliation(s)
- Diana Angelika Olszewska
- Department of Neurology, Dublin Neurological Institute, Mater Misericordiae University Hospital , Dublin , Ireland
| | - Tim Lynch
- Department of Neurology, Dublin Neurological Institute, Mater Misericordiae University Hospital , Dublin , Ireland
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17
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Olszewska DA, Fearon C, Lynch T. New Perception of Mitochondrial Regulatory Pathway in Parkinsonism - Ubiquitin, PINK1, and Parkin. Front Neurol 2014; 5:247. [PMID: 25505445 PMCID: PMC4241835 DOI: 10.3389/fneur.2014.00247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 11/12/2014] [Indexed: 11/13/2022] Open
Affiliation(s)
- Diana Angelika Olszewska
- Department of Neurology at the Dublin Neurological Institute, Mater Misericordiae University Hospital , Dublin , Ireland
| | - Conor Fearon
- Department of Neurology at the Dublin Neurological Institute, Mater Misericordiae University Hospital , Dublin , Ireland
| | - Tim Lynch
- Department of Neurology at the Dublin Neurological Institute, Mater Misericordiae University Hospital , Dublin , Ireland
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