CACNA1A-associated epilepsy: Electroclinical findings and treatment response on seizures in 18 patients

CACNA1A pathogenic mutations are involved in various neurological phenotypes including episodic ataxia (EA2), spinocerebellar ataxia (SCA6), and familial hemiplegic migraine (FHM1). Epilepsy is poorly documented. We studied 18 patients (10 males) carrying de novo or inherited CACNA1A mutations, with median age of 2,5 years at epilepsy onset. Eight mutations were novel. Two variants known leading to gain of function (GOF) were found in 5 patients. Five other patients had non-sense variants leading to loss of function (LOF). Seizures were most often revealed by either status epilepticus (SE) (n = 8), eventually triggered by fever (n = 5), or absences/behavioural arrests (n = 7). Non-epileptic paroxysmal events were frequent and consisted in recurrent hemiplegic accesses (n = 9), jitteriness in the neonatal period (n = 6), and ocular paroxysmal events (n = 9). Most of the patients had early permanent cerebellar dysfunction (n = 16) and early moderate to severe global developmental delay (GDD)/intellectual deficiency (ID) (n = 17). MRI was often abnormal, with cerebellar (n = 8) and/or cerebral (n = 6) atrophy. Stroke-like occurred in 2 cases. Some antiepileptic drugs including topiramate, levetiracetam, lamotrigine and valproate were effective on seizures. Acetazolamide and calcium channel blockers were often effective when used. More than half of the patients had refractory epilepsy. CACNA1A mutation should be evoked in front of 2 main electro-clinical phenotypes that are associated with permanent cerebellar dysfunction and moderate to severe GDD/ID. The first one, found in all 5 patients with GOF variants, is characterized by intractable seizures, early and recurrent SE and hemiplegic accesses. The second, less severe, found in 5 patients with LOF variants, is characterized by refractory early onset absence seizures.

Technical note: Effect of determining baseline plasma urea nitrogen concentrations on subsequent posttreatment plasma urea nitrogen concentrations in 20- to 50-kilogram pigs

Plasma urea N (PUN) has been used as an indicator of AA requirements and efficiency of AA utilization in swine. However, PUN concentrations vary among a population of pigs, even a population with a close range of BW and fed the same diet. Thus, pretreatment or baseline PUN concentrations are used as a covariate to reduce variation of posttreatment PUN. However, this procedure increases experimental costs and stress to the pigs. Data from 14 experiments (26 to 28 d in duration) conducted using PUN as a response variable were compiled into 1 data set. Each experiment had 4 to 6 treatments. The purpose of this technical report was to summarize the effect of determining pretreatment baseline PUN concentrations on subsequent posttreatment PUN concentrations in 20- to 50-kg pigs. In all experiments, pigs were fed corn- and soybean meal-based diets and low-CP diets with various AA additions; pigs were assigned to dietary treatments in a randomized complete block design with a minimum of 4 replicates of 3 to 5 pigs each. Before the start of each experiment, all pigs were fed a common diet for a minimum of 3 d. Blood samples were collected from each pig before allotment to dietary treatments (d 0) and at the end of each experiment. The baseline (d 0) PUN was analyzed as a covariate for posttreatment PUN. Data from each experiment were analyzed without and with baseline PUN in the statistical model. In all experiments combined, there were 768 possible treatment comparisons. The covariate baseline PUN was statistically significant (P < 0.10) in 9 of 14 experiments. However, only 8 treatment differences changed statistical significance as a result of analyzing the data with baseline PUN as a covariate. These 8 treatment differences were in 3 experiments. These results indicate that it is not always necessary to determine baseline PUN concentrations when feeding diets with large differences in AA content.

Maximizing the use of supplemental amino acids in corn-soybean meal diets for 20- to 45-kilogram pigs

Four experiments were conducted to determine the Lys requirement, the maximum amount of supplemental Lys that does not decrease growth performance, and to determine the order of limiting AA beyond Lys, Thr, Trp, and Met in a corn-soybean meal diet for 20- to 45-kg pigs. All experiments were conducted for 27 to 28 d with purebred or crossbred barrows and gilts, which were blocked by initial BW. Treatments were replicated with 4 to 6 pens of 4 to 6 pigs per pen. In all experiments, pigs and feeders were weighed on d 0, 14, and 27 or 28. At the beginning and end of all experiments, blood samples were obtained from all pigs to determine plasma urea N (PUN) concentrations. In Exp. 1, 0.830, 0.872, 0.913, and 0.955% standardized ileal digestible (SID) Lys was fed, whereas 0.747, 0.788, 0.830, 0.872, and 0.913% SID Lys was fed in Exp. 2. Broken-line analysis requirement estimates could not be estimated from any response variable in Exp. 1, but in Exp. 2, using ADG and PUN, the estimated SID Lys requirement was 0.83%. In Exp. 3, 0, 0.118, 0.191, 0.264, and 0.335% supplemental Lys was added to achieve 0.83% SID Lys in all diets, and Thr, Trp, and Met were supplemented to maintain Thr:Lys, Trp:Lys, and TSAA:Lys of 0.65, 0.18, and 0.60, respectively. Based on ADG, ADFI, and G:F, up to 0.23% supplemental Lys can be added along with supplemental Thr, Trp, and Met without negatively affecting growth performance; PUN was linearly decreased (P < 0.001) by supplemental Lys. In Exp. 4, treatments were 1) positive control (PC) without supplemental AA, 2) negative control (NC) with 0.335% supplemental Lys + 0.140% l-Thr + 0.035% l-Trp + 0.117% dl-Met, 3) NC + 0.044% l-Val, 4) NC + 0.021% l-Ile, and 5) NC + 0.044% l-Val + 0.021% l-Ile. Individual addition of Val and Ile did not improve (P > 0.10) ADG or G:F compared with the NC. The combined addition of Val + Ile resulted in ADG that was intermediate between the PC and NC diets but not different from either diet (P > 0.10); G:F was not improved (P > 0.10) to that observed in pigs fed the PC diet. The PUN was not different (P > 0.10) among pigs fed diets with supplemental AA but less (P < 0.10) than pigs fed the PC. The results of this research indicate that the Lys requirement for 20- to 45-kg pigs is 0.83% SID Lys, up to 0.23% supplemental Lys (0.29% l-Lys·HCl or 0.45% l-Lys·SO(4)) can be added along with supplemental Thr, Trp, and Met without negatively affecting growth performance, and another AA besides Val and Ile may be limiting growth performance in a corn-soybean meal diet with 0.335% supplemental Lys.

Effects of dietary spray-dried plasma protein on sow productivity during lactation

Seventy-two primiparous and multiparous sows (36 per dietary treatment) farrowed in 4 groups were used to evaluate the effects of spray-dried plasma protein (SDP) on sow and litter performance during lactation. Dietary lactation treatments consisted of a corn-soybean meal control and a corn-soybean meal diet containing 0.5% SDP. Both diets were formulated to contain 1.0% total Lys and 3.46 Mcal/kg of ME and were fed from d 107 +/- 1.2 of gestation to weaning. Sows were allotted to dietary treatment based on breed, parity, and the date of d 107 of gestation. Litters were standardized within diet, and pigs were weaned at an average age of 19 +/- 2.1 d. Sows were fed 3 times daily during lactation. After weaning, sows were fed a common gestation diet and checked twice daily for estrus. Sows were grouped by parity (young sows, <or=3; mature sows, >3) for statistical analysis. The data were analyzed as a 2 x 2 factorial arrangement of treatments; the factors were parity (<or=3 or >3) and SDP (0 or 0.5%). Treatment differences were considered significant at P < 0.10. Mature sows had a greater BW on d 107 of gestation, on d 1 postfarrowing, and at weaning; greater lactation ADFI; and greater litter BW after cross-fostering, but pig survival to weaning was decreased. Sows fed SDP had a greater gestation interval, litter BW at weaning, and litter ADG, with 1 less lactation day. The effect of SDP addition was dependent on sow parity, as noted by numerous SDP x parity interactions. The addition of SDP increased lactation ADFI in mature sows but decreased ADFI in young sows. Mature sows fed SDP had a greater number of pigs weaned per litter, litter and pig weaning weights, pig survival to weaning, and number of pigs weaned per litter weighing more than 3.6 kg, but the SDP diet had little to no effect on these responses in young sows. Subsequent farrowing data were collected, but no dietary treatment effects (P > 0.10) were observed. The results of this research indicate that SDP increased productivity of sows in parity 4 or greater.