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Yamout B, Al-Jumah M, Sahraian MA, Almalik Y, Khaburi JA, Shalaby N, Aljarallah S, Bohlega S, Dahdaleh M, Almahdawi A, Khoury SJ, Koussa S, Slassi E, Daoudi S, Aref H, Mrabet S, Zeineddine M, Zakaria M, Inshasi J, Gouider R, Alroughani R. Consensus recommendations for diagnosis and treatment of Multiple Sclerosis: 2023 revision of the MENACTRIMS guidelines. Mult Scler Relat Disord 2024; 83:105435. [PMID: 38245998 DOI: 10.1016/j.msard.2024.105435] [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: 10/26/2023] [Revised: 12/21/2023] [Accepted: 01/06/2024] [Indexed: 01/23/2024]
Abstract
With evolving diagnostic criteria and the advent of new oral and parenteral therapies for Multiple Sclerosis (MS), most current diagnostic and treatment algorithms need revision and updating. The diagnosis of MS relies on incorporating clinical and paraclinical findings to prove dissemination in space and time and exclude alternative diseases that can explain the findings at hand. The differential diagnostic workup should be guided by clinical and laboratory red flags to avoid unnecessary tests. Appropriate selection of MS therapies is critical to maximize patient benefit. The current guidelines review the current diagnostic criteria for MS and the scientific evidence supporting treatment of acute relapses, radiologically isolated syndrome, clinically isolated syndrome, relapsing remitting MS, progressive MS, pediatric cases and pregnant women. The purpose of these guidelines is to provide practical recommendations and algorithms for the diagnosis and treatment of MS based on current scientific evidence and clinical experience.
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Affiliation(s)
- B Yamout
- Neurology Institute and Multiple Sclerosis Center, Harley Street Medical Center, Abu Dhabi, United Arab Emirates.
| | - M Al-Jumah
- InterHealth hospital, Multiple Sclerosis Center, Riyadh, Saudi Arabia
| | - M A Sahraian
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Y Almalik
- Division of Neurology, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, National Guard Health Affairs, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - J Al Khaburi
- Department of Neurology, The Royal Hospital, Sultanate of Oman
| | - N Shalaby
- Neurology Department, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | | | - S Bohlega
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | | | - A Almahdawi
- Consultant Neurologist, Neurology Unit, Baghdad Teaching Hospital, Medical City Complex, Iraq
| | - S J Khoury
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon
| | - S Koussa
- Multiple Sclerosis Center, Geitaoui Lebanese University Hospital, Beirut, Lebanon
| | - E Slassi
- Hôpital Cheikh Khalifa Ibn Zaid, Casablanca, Morocco
| | - S Daoudi
- Hospital Center Nedir Mohamed, Faculty of Medicine, University Mouloud Mammeri Tizi-Ouzou, Algeria
| | - H Aref
- Neurology Department, Ain Shams University, Cairo, Egypt
| | - S Mrabet
- Department of Neurology, CIC, Razi Universitary Hospital, University of Tunis El Manar, Tunis, Tunisia
| | - M Zeineddine
- Middle East and North Africa Committee for Treatment and Research in Multiple Sclerosis (MENACTRIMS), Beirut, Lebanon
| | | | - J Inshasi
- Department of Neurology, Rashid Hospital and Dubai Medical College, Dubai Health Authority, Dubai, United Arab Emirates
| | - R Gouider
- Department of Neurology, CIC, Razi Universitary Hospital, University of Tunis El Manar, Tunis, Tunisia
| | - R Alroughani
- Amiri Hospital, Arabian Gulf Street, Sharq, Kuwait
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Jagota P, Ugawa Y, Aldaajani Z, Ibrahim NM, Ishiura H, Nomura Y, Tsuji S, Diesta C, Hattori N, Onodera O, Bohlega S, Al-Din A, Lim SY, Lee JY, Jeon B, Pal PK, Shang H, Fujioka S, Kukkle PL, Phokaewvarangkul O, Lin CH, Shambetova C, Bhidayasiri R. Nine Hereditary Movement Disorders First Described in Asia: Their History and Evolution. J Mov Disord 2023; 16:231-247. [PMID: 37309109 PMCID: PMC10548072 DOI: 10.14802/jmd.23065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/19/2023] [Accepted: 05/26/2023] [Indexed: 06/14/2023] Open
Abstract
Clinical case studies and reporting are important to the discovery of new disorders and the advancement of medical sciences. Both clinicians and basic scientists play equally important roles leading to treatment discoveries for both cures and symptoms. In the field of movement disorders, exceptional observation of patients from clinicians is imperative, not just for phenomenology but also for the variable occurrences of these disorders, along with other signs and symptoms, throughout the day and the disease course. The Movement Disorders in Asia Task Force (TF) was formed to help enhance and promote collaboration and research on movement disorders within the region. As a start, the TF has reviewed the original studies of the movement disorders that were preliminarily described in the region. These include nine disorders that were first described in Asia: Segawa disease, PARK-Parkin, X-linked dystonia-parkinsonism, dentatorubral-pallidoluysian atrophy, Woodhouse-Sakati syndrome, benign adult familial myoclonic epilepsy, Kufor-Rakeb disease, tremulous dystonia associated with mutation of the calmodulin-binding transcription activator 2 gene, and paroxysmal kinesigenic dyskinesia. We hope that the information provided will honor the original researchers and help us learn and understand how earlier neurologists and basic scientists together discovered new disorders and made advances in the field, which impact us all to this day.
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Affiliation(s)
- Priya Jagota
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, Faculty of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Zakiyah Aldaajani
- Neurology Unit, King Fahad Military Medical Complex, Dhahran, Saudi Arabia
| | - Norlinah Mohamed Ibrahim
- Neurology Unit, Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hiroyuki Ishiura
- Department of Neurology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshiko Nomura
- Yoshiko Nomura Neurological Clinic for Children, Tokyo, Japan
| | - Shoji Tsuji
- Institute of Medical Genomics, International University of Health and Welfare, Narita, Chiba, Japan
| | - Cid Diesta
- Section of Neurology, Department of Neuroscience, Makati Medical Center, NCR, Makati City, Philippines
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Osamu Onodera
- Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan
| | - Saeed Bohlega
- Department of Neurosciences, King Faisal Specialist Hospital & Research Center, Riyad, Saudi Arabia
| | - Amir Al-Din
- Mid Yorkshire Hospitals National Health Services Trust, Wakefield, UK
| | - Shen-Yang Lim
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- The Mah Pooi Soo & Tan Chin Nam Centre for Parkinson’s & Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jee-Young Lee
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center & Seoul National University Medical College, Seoul, Korea
| | - Beomseok Jeon
- Department of Neurology, Seoul National University, Seoul, Korea
- Movement Disorder Center, Seoul National University Hospital, Seoul, Korea
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Huifang Shang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shinsuke Fujioka
- Department of Neurology, Fukuoka University, Faculty of Medicine, Fukuoka, Japan
| | - Prashanth Lingappa Kukkle
- Center for Parkinson’s Disease and Movement Disorders, Manipal Hospital, Bangalore, India
- Parkinson's Disease and Movement Disorders Clinic, Bangalore, India
| | - Onanong Phokaewvarangkul
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Chin-Hsien Lin
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | | | - Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand
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Bohlega S, Abusrair AH, Al-Qahtani Z, Guzmán-Vega FJ, Ramakrishnan R, Aldosari H, Aldakheel A, Al-Qahtani S, Monies D, Arold ST. Expanding the genotype-phenotype landscape of PDE10A-associated movement disorders. Parkinsonism Relat Disord 2023; 108:105323. [PMID: 36805523 DOI: 10.1016/j.parkreldis.2023.105323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND Phosphodiesterase 10A (PDE10A) controls body movements by regulating cyclic adenosine monophosphate signaling in the basal ganglia. Two classes of PDE10A variants are reported with distinctive genotype-phenotype correlation. The autosomal recessive mutations in the GAF-A and catalytic domains are associated with compromised membrane localization, and manifest with infantile onset chorea, developmental, and cognition delay with normal brain MRI. Conversely, autosomal dominant mutations in the GAF-B domain cause protein aggregates which results in childhood onset chorea in the context of normal cognition and development, with striatal lesions. METHODS Phenotypic characteristics of affected individuals with PDE10A mutations belonging to a single family were recorded. In addition, Sanger sequencing and in silico analysis were used to identify the mutations. Homozygosity mapping was applied together with whole exome sequencing. RESULTS Four individuals from a consanguineous family affected with PDE10A mutations were observed for up to 40 years. Although these individuals displayed a clinical phenotype attributed to the recessive GAF-A mutations, they revealed a bi-allelic GAF-B mutation (c.883G > A:p. D295 N; p.Asp295Asn) that was segregated with all affected individuals. In addition to chorea, we observed peculiar foot deformities and pronounced social phobia, with normal brain MRI. In silico structural analysis suggested that the GAF-B mutation blocked allosteric PDE10A activation. The resulting lack of PDE10A activity likely phenocopies GAF-A mutations, and this is achieved through a distinct mechanism. CONCLUSIONS Collectively, our findings demonstrate the association of recessive and dominant phenotypes of known variants, and further expands the genotype-phenotype landscape of PDE10A-associated movement disorders.
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Affiliation(s)
- Saeed Bohlega
- Movement Disorders Program, Neuroscience Centre, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Riyadh, Kingdom of Saudi Arabia.
| | - Ali H Abusrair
- Movement Disorders Program, Neuroscience Centre, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Riyadh, Kingdom of Saudi Arabia
| | - Zainah Al-Qahtani
- Movement Disorders Program, Neuroscience Centre, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Riyadh, Kingdom of Saudi Arabia
| | - Francisco J Guzmán-Vega
- Bioscience Program, Biological and Environmental Science and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia; Computational Biology Research Center, King Abdullah University of Science and Technology, (KAUST), Thuwal, Kingdom of Saudi Arabia
| | - Reshmi Ramakrishnan
- Bioscience Program, Biological and Environmental Science and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia; Computational Biology Research Center, King Abdullah University of Science and Technology, (KAUST), Thuwal, Kingdom of Saudi Arabia
| | - Haya Aldosari
- Department of Genetics, Research Centre, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Riyadh, Kingdom of Saudi Arabia
| | - Amaal Aldakheel
- Movement Disorders Program, Neuroscience Centre, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Riyadh, Kingdom of Saudi Arabia
| | - Salma Al-Qahtani
- Movement Disorders Program, Neuroscience Centre, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Riyadh, Kingdom of Saudi Arabia
| | - Dorota Monies
- Department of Genetics, Research Centre, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Riyadh, Kingdom of Saudi Arabia
| | - Stefan T Arold
- Bioscience Program, Biological and Environmental Science and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia; Computational Biology Research Center, King Abdullah University of Science and Technology, (KAUST), Thuwal, Kingdom of Saudi Arabia; Centre de Biologie Structurale (CBS), INSERM, CNRS, Université de Montpellier, F-34090, Montpellier, France
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Khouj E, Bohlega S, Alkuraya FS. Cerebrotendinous xanthomatosis: A candidate for ACMG list of secondary findings? Clin Genet 2023; 103:125-126. [PMID: 36129065 DOI: 10.1111/cge.14230] [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: 06/16/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Ebtissal Khouj
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Saeed Bohlega
- Department of Neuroscience, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Fowzan S Alkuraya
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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Abusrair AH, Elsekaily W, Bohlega S. Tremor in Parkinson's Disease: From Pathophysiology to Advanced Therapies. Tremor Other Hyperkinet Mov (N Y) 2022; 12:29. [PMID: 36211804 PMCID: PMC9504742 DOI: 10.5334/tohm.712] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/26/2022] [Indexed: 11/22/2022] Open
Abstract
Background Tremor is one of the most prevalent symptoms in Parkinson's Disease (PD). The progression and management of tremor in PD can be challenging, as response to dopaminergic agents might be relatively poor, particularly in patients with tremor-dominant PD compared to the akinetic/rigid subtype. In this review, we aim to highlight recent advances in the underlying pathogenesis and treatment modalities for tremor in PD. Methods A structured literature search through Embase was conducted using the terms "Parkinson's Disease" AND "tremor" OR "etiology" OR "management" OR "drug resistance" OR "therapy" OR "rehabilitation" OR "surgery." After initial screening, eligible articles were selected with a focus on published literature in the last 10 years. Discussion The underlying pathophysiology of tremor in PD remains complex and incompletely understood. Neurodegeneration of dopaminergic neurons in the retrorubral area, in addition to high-power neural oscillations in the cerebello-thalamo-cortical circuit and the basal ganglia, play a major role. Levodopa is the first-line therapeutic option for all motor symptoms, including tremor. The addition of dopamine agonists or anticholinergics can lead to further tremor reduction. Botulinum toxin injection is an effective alternative for patients with pharmacological-resistant tremor who are not seeking advanced therapies. Deep brain stimulation is the most well-established advanced therapy owing to its long-term efficacy, reversibility, and effectiveness in other motor symptoms and fluctuations. Magnetic resonance-guided focused ultrasound is a promising modality, which has the advantage of being incisionless. Cortical and peripheral electrical stimulation are non-invasive innovatory techniques that have demonstrated good efficacy in suppressing intractable tremor.
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Affiliation(s)
- Ali H. Abusrair
- Department of Clinical Neurosciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
- Division of Neurology, Department of Internal Medicine, Qatif Health Network, Qatif, Saudi Arabia
| | - Walaa Elsekaily
- College of Medicine, AlFaisal University, Riyadh, Saudi Arabia
| | - Saeed Bohlega
- Movement Disorders Program, Neurosciences Centre, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
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Abstract
BackgroundMethanol (methyl alcohol) is a form of toxic alcohol that is found in illicit alcohol as well as household products such as solvents and paint removers. The most common cause of methanol poisoning is through ingestion of adulterated alcohol; however, other routes of poisoning may also occur including cutaneous exposure and, rarely, inhalation.Methods/resultsWe are reporting a case of a young woman with vision loss, parkinsonism and widespread cerebral artery spasms due to methanol inhalation from domestically made perfume.ConclusionOur case highlights the increased need for awareness on the part of the public and health authorities with regard to the manufacturing and use of homemade perfumes produced with poorly processed alcohol having a high methyl alcohol content.
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Affiliation(s)
- Walaa B Mohammed
- Department of Neuroscience, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Salma Tarabzouni
- Department of Neuroscience, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Saeed Bohlega
- Department of Neuroscience, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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Alharbi N, Matar R, Cupler E, Al-Hindi H, Murad H, Alhomud I, Monies D, Alshehri A, Alyahya M, Meyer B, Bohlega S. Clinical, Neurophysiological, Radiological, Pathological, and Genetic Features of Dysferlinopathy in Saudi Arabia. Front Neurosci 2022; 16:815556. [PMID: 35273475 PMCID: PMC8902167 DOI: 10.3389/fnins.2022.815556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTo characterize the phenotypic, neurophysiological, radiological, pathological, and genetic profile of 33 Saudi Arabian families with dysferlinopathy.MethodsA descriptive observational study was done on a cohort of 112 Saudi Arabian families with LGMD. Screening for the Dysferlin (DYSF) gene was done in a tertiary care referral hospital in Saudi Arabia. Clinical, Neurophysiological, Radiological, Pathological, and Genetic findings in subjects with dysferlin mutation were the primary outcome variables. Statistical analysis was done by Epi-info.Results33 out of 112 families (29.46%) registered in the LGMD cohort had Dysferlinopathy. 53 subjects (28 males, 52.83%) from 33 families were followed up for various periods ranging from 1 to 28 years. The mean age of onset was 17.79 ± 3.48 years (Range 10 to 25 years). Miyoshi Myopathy phenotype was observed in 50.94% (27 out of 53), LGMDR2 phenotype in 30.19% (16 out of 53), and proximodistal phenotype in 15.09% (8 out of 53) of the subjects. Loss of ambulation was observed in 39.62% (21 out of 53 subjects). Electrophysiological, Radiological, and histopathological changes were compatible with the diagnosis. Mean serum Creatinine Kinase was 6,464.45 ± 4,149.24 with a range from 302 to 21,483 IU/L. In addition, 13 dysferlin mutations were identified two of them were compound heterozygous. One founder mutation was observed c.164_165insA in 19 unrelated families.ConclusionThe prevalence of Dysferlinopathy was 29.46% in the native Saudi LGMD cohort. It is the most prevalent subtype seconded by calpainopathy. The clinical course varied among the study subjects and was consistent with those reported from different ethnic groups. One founder mutation was identified. Initial screening of the founder mutations in new families is highly recommended.
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Affiliation(s)
- Norah Alharbi
- Department of Clinical Science, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | - Edward Cupler
- Department of Neuroscience, King Faisal Specialist Hospital, and Research Center, Jeddah, Saudi Arabia
| | - Hindi Al-Hindi
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Hatem Murad
- Department of Neuroscience, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Iftteah Alhomud
- Department of Neuroscience, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Dorota Monies
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ali Alshehri
- Department of Neuroscience, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mossaed Alyahya
- Department of Neuroscience, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Brian Meyer
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Saeed Bohlega
- Department of Neuroscience, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- *Correspondence: Saeed Bohlega,
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Bohlega S, Elboghdady A, Al-Johani A, Mahajan K, Mughari MK, Al-Saqa'aby M, Mohamed O, Alarieh R, Al Malik Y. Economic Evaluation of Cladribine Tablets in Patients With High Disease Activity-Relapsing-Remitting Multiple Sclerosis in the Kingdom of Saudi Arabia. Value Health Reg Issues 2021; 25:189-195. [PMID: 34425468 DOI: 10.1016/j.vhri.2021.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 02/25/2021] [Accepted: 03/11/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Cladribine tablets are the first short-course oral treatment approved for high disease activity relapsing-remitting multiple sclerosis (HDA-RRMS) across various countries. This analysis assessed the cost-effectiveness of introducing cladribine tablets as a treatment option for patients with high disease activity compared with other HDA-RRMS therapies in the Kingdom of Saudi Arabia (KSA). METHODS The cost-effectiveness model was adapted from the KSA payer's perspective. Data for the model's adaptation were retrieved from the literature and validated by key opinion leaders. The comparators considered in the model were alemtuzumab, dimethyl fumarate, fingolimod, interferon beta-1a (subcutaneous and intramuscular) and beta-1b, natalizumab, and teriflunomide. A sensitivity analysis was also performed to assess the robustness of the analysis. RESULTS The cost-effectiveness results showed cladribine tablets as the dominant strategy (ie, less costly and more effective) versus all the comparators. The incremental cost and quality-adjusted life-years gained were largely driven by drug acquisition cost and delayed expanded disability status scale progression, respectively. Cladribine tablets showed an 81% to 100% probability of being cost-effective at a threshold of Saudi Riyal 225 326 per quality-adjusted life-years gained against different comparators. CONCLUSIONS Cladribine tablets are a dominant treatment option for patients with HDA-RRMS from the payer perspective in the KSA.
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Affiliation(s)
- Saeed Bohlega
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ahmed Elboghdady
- Merck Serono Middle East FZ LTD, an affiliate of Merck KGaA, Darmstadt, Germany
| | | | | | | | - Mai Al-Saqa'aby
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | | | | | - Yaser Al Malik
- King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
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Al Jumah M, Abulaban A, Aggad H, Al Bunyan R, AlKhawajah M, Al Malik Y, Almejally M, Alnajashi H, Alshamrani F, Bohlega S, Cupler EJ, ElBoghdady A, Makkawi S, Qureshi S, Shami S. Managing multiple sclerosis in the Covid19 era: a review of the literature and consensus report from a panel of experts in Saudi Arabia. Mult Scler Relat Disord 2021; 51:102925. [PMID: 33857897 PMCID: PMC7992311 DOI: 10.1016/j.msard.2021.102925] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 03/10/2021] [Accepted: 03/21/2021] [Indexed: 12/17/2022]
Abstract
Disease-modifying therapies (DMT) for relapsing-remitting MS (RRMS) act on the immune system, suggesting a need for caution during the SARS-CoV2/Covid-19 pandemic. A group of experts in MS care from Saudi Arabia convened to consider the impact of Covid-19 on MS care in that country, and to develop consensus recommendations on the current application of DMT therapy. Covid-19 has led to disruption to the care of MS in Saudi Arabia as elsewhere. The Expert Panel considered a DMT's overall tolerability/safety profile to be the most important consideration on whether or not to prescribe at this time. Treatment can be started or continued with interferon beta, teriflunomide, dimethyl fumarate, or natalizumab, as these DMTs are not associated with increased risk of infection (there was no consensus on the initiation of other DMTs). A consensus also supported continuing treatment regimens with fingolimod (or siponimod) and cladribine tablets for a patient without active Covid-19. No DMT should be imitated in a patient with active Covid-19, and (only) interferon beta could be continued in the case of Covid-19 infection. Vaccination against Covid-19 is a therapeutic priority for people with MS. New treatment should be delayed for 2–4 weeks for vaccination. Where treatment is already ongoing, vaccination against Covid-19 should be administered immediately without disruption of treatment (first-line DMTs, natalizumab, fingolimod), when lymphocytes have recovered sufficiently (cladribine tablets, alemtuzumab) or 4 months after the last dose (ocrelizumab). These recommendations will need to be refined and updated as new clinical evidence in this area emerges.
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Affiliation(s)
- Mohammed Al Jumah
- Neurology Department, King Fahad Medical City, Riyadh, Saudi Arabia.
| | - Ahmad Abulaban
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Department of Medicine, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Hani Aggad
- Neurology Department, King Abdallah Medical Complex, Jeddah, Saudi Arabia
| | - Reem Al Bunyan
- Department of Neurology, Neurosciences Center, King Fahad Specialist Hospital Dammam, Saudi Arabia
| | - Mona AlKhawajah
- Department of Neurosciences, King Faisal Specialist Hospital and Research Center, Riyadh Saudi Arabia
| | - Yaser Al Malik
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Division of Neurology, King Abdulaziz Medical City (National Guard Health Affairs), Riyadh, Saudi Arabia
| | - Mousa Almejally
- Neurology Department, Heraa General Hospital, Makkah, Saudi Arabia
| | - Hind Alnajashi
- Neurology Division, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Saeed Bohlega
- Department of Neurosciences, King Faisal Specialist Hospital and Research Center, Jeddah Saudi Arabia
| | - Edward J Cupler
- Department of Neurosciences, King Faisal Specialist Hospital and Research Center, Jeddah Saudi Arabia
| | - Ahmed ElBoghdady
- Merck Serono Middle East FZ LTD, Riyadh, Saudi Arabia, an affiliate of Merck KGaA, Darmstadt, Germany
| | - Seraj Makkawi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; Department of Medicine, Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia
| | - Shireen Qureshi
- Neurology Department, Johns Hopkins Aramco Healthcare (JHAH), Dhahran, Saudi Arabia
| | - Sahar Shami
- Itkan Health Consulting, Riyadh, Saudi Arabia
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10
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Dressler D, Altavista MC, Altenmueller E, Bhidayasiri R, Bohlega S, Chana P, Chung TM, Colosimo C, Fheodoroff K, Garcia-Ruiz PJ, Jeon B, Jin L, Kanovsky P, Milanov I, Micheli F, Orlova O, Pandey S, Pirtosek Z, Relja M, Rosales R, Sagástegui-Rodríguez JA, Shahidi GA, Timerbaeva S, Wan X, Walter U, Saberi FA. Consensus guidelines for botulinum toxin therapy: general algorithms and dosing tables for dystonia and spasticity. J Neural Transm (Vienna) 2021; 128:321-335. [PMID: 33635442 PMCID: PMC7969540 DOI: 10.1007/s00702-021-02312-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 01/22/2021] [Indexed: 12/01/2022]
Abstract
Botulinum toxin (BT) therapy is a complex and highly individualised therapy defined by treatment algorithms and injection schemes describing its target muscles and their dosing. Various consensus guidelines have tried to standardise and to improve BT therapy. We wanted to update and improve consensus guidelines by: (1) Acknowledging recent advances of treatment algorithms. (2) Basing dosing tables on statistical analyses of real-life treatment data of 1831 BT injections in 36 different target muscles in 420 dystonia patients and 1593 BT injections in 31 different target muscles in 240 spasticity patients. (3) Providing more detailed dosing data including typical doses, dose variabilities, and dosing limits. (4) Including total doses and target muscle selections for typical clinical entities thus adapting dosing to different aetiologies and pathophysiologies. (5) In addition, providing a brief and concise review of the clinical entity treated together with general principles of its BT therapy. For this, we collaborated with IAB—Interdisciplinary Working Group for Movement Disorders which invited an international panel of experts for the support.
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Affiliation(s)
- Dirk Dressler
- Movement Disorders Section, Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | | | - Eckart Altenmueller
- Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Hannover, Germany
| | - Roongroj Bhidayasiri
- Chulalongkorn Centre for Excellence on Parkinson's Disease and Related Disorders, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Saeed Bohlega
- Department of Neurology, King Faisal Specialist Hospital, Riyyad, Kingdom of Saudi Arabia
| | - Pedro Chana
- Department of Neurology, University de Santiago de Chile, Santiago de Chile, Chile
| | | | - Carlo Colosimo
- Department of Neurology, Santa Maria University Hospital, Terni, Italy
| | | | | | - Beomseok Jeon
- Department of Neurology, Seoul National University, Seoul, Republic of Korea
| | - Lingjing Jin
- Department of Neurology, Tongji University School of Medicine, Shanghai, China
| | - Petr Kanovsky
- Department of Neurology, Palacky University, Olomouc, Czech Republic
| | - Ivan Milanov
- Department of Neurology, Medical University of Sofia, Sofia, Bulgaria
| | - Federico Micheli
- Department of Neurology, Hospital de Clínicas José de San Martín, University of Buenos Aires, Buenos Aires, Argentina
| | | | - Sanjay Pandey
- Department of Neurology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
| | - Zvezdan Pirtosek
- Department of Neurology, Ljubljana University, Ljubljana, Slovenia
| | - Maja Relja
- Department of Neurology, University of Zagreb, Zagreb, Croatia
| | - Raymond Rosales
- Department of Neurology, University of Santo Tomas, Manila, Philippines
| | | | - Gholam Ali Shahidi
- Department of Neurology, Iran University of Medical Sciences, Tehran, Iran
| | | | - Xinhua Wan
- Department of Neurology, Peking Union Medical College, Beijing, China
| | - Uwe Walter
- Department of Neurology, Rostock University, Rostock, Germany
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11
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AlSharoqi IA, Aljumah M, Bohlega S, Boz C, Daif A, El-Koussa S, Inshasi J, Kurtuncu M, Müller T, Retief C, Sahraian MA, Shaygannejad V, Slassi I, Taha K, Zakaria M, Sørensen PS. Immune Reconstitution Therapy or Continuous Immunosuppression for the Management of Active Relapsing-Remitting Multiple Sclerosis Patients? A Narrative Review. Neurol Ther 2020; 9:55-66. [PMID: 32297127 PMCID: PMC7229056 DOI: 10.1007/s40120-020-00187-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Indexed: 12/26/2022] Open
Abstract
The majority of disease-modifying drugs (DMDs) available for the management of active relapsing-remitting multiple sclerosis (RMS) depend on continuous drug intake for maintained efficacy, with escalation to a more active drug when an unacceptable level of disease activity returns. Among continuously applied regimens, interferons and glatiramer acetate act as immunomodulators, while dimethyl fumarate, fingolimod, ocrelizumab, natalizumab and teriflunomide are associated with continuous immunosuppression. By contrast, immune reconstitution therapy (IRT) provides efficacy that outlasts a short course of treatment. Autologous hemopoietic stem cell transplantation is perhaps the classic example of IRT, but this invasive and intensive therapy has challenging side-effects. A short treatment course of a pharmacologic agent hypothesized to act as an IRT, such as Cladribine Tablets 3.5 mg/kg or alemtuzumab, can provide long-term suppression of MS disease activity, without need for continuous treatment (the anti-CD20 mechanism of ocrelizumab has the potential to act as an IRT, but is administered continuously, at 6-monthly intervals). Cladribine Tablets 3.5 mg/kg shows some selectivity in targeting adaptive immunity with a lesser effect on innate immunity. The introduction of IRT-like disease-modifying drugs (DMDs) challenges the traditional maintenance/escalation mode of treatment and raises new questions about how disease activity is measured. In this review, we consider a modern classification of DMDs for MS and its implications for the care of patients in the IRT era.
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Affiliation(s)
- Isa Ahmed AlSharoqi
- Department of Clinical Neurosciences, Salmaniya Medical Complex, PO Box 12, Manama, Bahrain.
| | - Mohamed Aljumah
- King Fahad Medical City, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | - Saeed Bohlega
- Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Cavit Boz
- Department of Neurology, Karadeniz Technical University, Trabzon, Turkey
| | - Abdelkader Daif
- King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | | | - Jihad Inshasi
- Neurology Department, Rashid Hospital and Dubai Medical College, Dubai Health Authority, Dubai, United Arab Emirates
| | - Murat Kurtuncu
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Thomas Müller
- Department of Neurology, St. Joseph Hospital Berlin-Weissensee, Gartenstr. 1, 13088, Berlin, Germany
| | | | - Mohammad Ali Sahraian
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Shaygannejad
- Isfahan Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ilham Slassi
- Department of Neurology, Sheikh Khalifa Ibn Zaid Hospital, Mohammed VI University, Casablanca, Morocco
| | | | - Magd Zakaria
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Per Soelberg Sørensen
- Danish Multiple Sclerosis Center, University of Copenhagen-Rigshospitalet, Copenhagen, Denmark
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12
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Yamout B, Sahraian M, Bohlega S, Al-Jumah M, Goueider R, Dahdaleh M, Inshasi J, Hashem S, Alsharoqi I, Khoury S, Alkhawajah M, Koussa S, Al Khaburi J, Almahdawi A, Alsaadi T, Slassi E, Daodi S, Zakaria M, Alroughani R. Consensus recommendations for the diagnosis and treatment of multiple sclerosis: 2019 revisions to the MENACTRIMS guidelines. Mult Scler Relat Disord 2019; 37:101459. [PMID: 31670208 DOI: 10.1016/j.msard.2019.101459] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/11/2019] [Accepted: 10/18/2019] [Indexed: 12/19/2022]
Abstract
With evolving diagnostic criteria and the advent of new oral and parenteral therapies for MS, most current diagnostic and treatment algorithms need revision and updating. The diagnosis of MS relies on incorporating clinical and paraclinical findings to prove dissemination in space and in time, and exclude alternative diseases that can explain the findings at hand. The differential diagnostic workup should be guided by clinical and laboratory red flags to avoid unnecessary tests. Appropriate selection of multiple sclerosis (MS) therapies is critical to maximize patient benefit. The current guidelines review the scientific evidence supporting treatment of acute relapses, radiologically isolated syndrome, clinically isolated syndrome, relapsing remitting MS, and progressive MS. The purpose of these guidelines is to provide practical recommendations and algorithms for the diagnosis and treatment of MS based on current scientific evidence and clinical experience.
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Affiliation(s)
- B Yamout
- Nehme and Therese Tohme MS Center, American University of Beirut Medical Center, Beirut, Lebanon.
| | - M Sahraian
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - S Bohlega
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - M Al-Jumah
- King Fahad Medical Cit, MOH, Riyadh, Saudi Arabia
| | - R Goueider
- Service de Neurologie, Hôpital Razi, Manouba, Tunis
| | | | - J Inshasi
- Department of Neurology, Rashid Hospital and Dubai Medical College, Dubai Health Authority, Dubai, United Arab Emirates
| | - S Hashem
- Faculty of Medicine, Cairo University, Cairo, Egypt
| | - I Alsharoqi
- Dept of Clinical Neurosciences, Salmaniya Medical Complex, Manama, Bahrain
| | - S Khoury
- Nehme and Therese Tohme MS Center, American University of Beirut Medical Center, Beirut, Lebanon
| | - M Alkhawajah
- Department of Neurology, The Royal Hospital, Sultanate of Oman
| | - S Koussa
- MS Center- Geitaoui Lebanese University Hospital, Beirut, Lebanon
| | - J Al Khaburi
- Department of Neurology, The Royal Hospital, Sultanate of Oman
| | - A Almahdawi
- Consultant neurologist, neurology unit, Baghdad Teaching Hospital, Medical City Complex, Iraq
| | - T Alsaadi
- American Center for Psychiatry & Neurology- UAE
| | - E Slassi
- Hôpital Cheikh Khalifa Ibn Zaid, Casablanca- Morocco
| | - S Daodi
- Hospital Center Nedir Mohamed, Faculty of Medicine University Mouloud Mammeri Tizi-ouzou Algeria
| | | | - R Alroughani
- Amiri Hospital, Arabian Gulf Street, Sharq, Kuwait
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13
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Monies D, Abouelhoda M, Assoum M, Moghrabi N, Rafiullah R, Almontashiri N, Alowain M, Alzaidan H, Alsayed M, Subhani S, Cupler E, Faden M, Alhashem A, Qari A, Chedrawi A, Aldhalaan H, Kurdi W, Khan S, Rahbeeni Z, Alotaibi M, Goljan E, Elbardisy H, ElKalioby M, Shah Z, Alruwaili H, Jaafar A, Albar R, Akilan A, Tayeb H, Tahir A, Fawzy M, Nasr M, Makki S, Alfaifi A, Akleh H, Yamani S, Bubshait D, Mahnashi M, Basha T, Alsagheir A, Khaled MA, Alsaleem K, Almugbel M, Badawi M, Bashiri F, Bohlega S, Sulaiman R, Tous E, Ahmed S, Algoufi T, Al-Mousa H, Alaki E, Alhumaidi S, Alghamdi H, Alghamdi M, Sahly A, Nahrir S, Al-Ahmari A, Alkuraya H, Almehaidib A, Abanemai M, Alsohaibaini F, Alsaud B, Arnaout R, Abdel-Salam GMH, Aldhekri H, AlKhater S, Alqadi K, Alsabban E, Alshareef T, Awartani K, Banjar H, Alsahan N, Abosoudah I, Alashwal A, Aldekhail W, Alhajjar S, Al-Mayouf S, Alsemari A, Alshuaibi W, Altala S, Altalhi A, Baz S, Hamad M, Abalkhail T, Alenazi B, Alkaff A, Almohareb F, Al Mutairi F, Alsaleh M, Alsonbul A, Alzelaye S, Bahzad S, Manee AB, Jarrad O, Meriki N, Albeirouti B, Alqasmi A, AlBalwi M, Makhseed N, Hassan S, Salih I, Salih MA, Shaheen M, Sermin S, Shahrukh S, Hashmi S, Shawli A, Tajuddin A, Tamim A, Alnahari A, Ghemlas I, Hussein M, Wali S, Murad H, Meyer BF, Alkuraya FS. Lessons Learned from Large-Scale, First-Tier Clinical Exome Sequencing in a Highly Consanguineous Population. Am J Hum Genet 2019; 105:879. [PMID: 31585110 DOI: 10.1016/j.ajhg.2019.09.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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14
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Wakil SM, Alhissi S, Al Dossari H, Alqahtani A, Shibin S, Melaiki BT, Finsterer J, Al-Hashem A, Bohlega S, Alazami AM. Truncating ARL6IP1 variant as the genetic cause of fatal complicated hereditary spastic paraplegia. BMC Med Genet 2019; 20:119. [PMID: 31272422 PMCID: PMC6610916 DOI: 10.1186/s12881-019-0851-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 06/19/2019] [Indexed: 01/01/2023]
Abstract
Background Mutations in ARL6IP1, which encodes a tetraspan membrane protein localized to the endoplasmic reticulum (ER), have been recently described in a large family with a complicated form of hereditary spastic paraplegia (HSP). Case presentation We sought to expand the HSP phenotype associated with ARL6IP1 variants by examining a Saudi kindred with a clinically more severe presentation, which resulted in spontaneous neonatal death of both affected siblings. Clinical features encompassed not only spastic paraplegia but also developmental delay, microcephaly, cerebral atrophy, periventricular leukoencephalopathy, hypotonia, seizures, spasticity, jejunal stricture, gastrointestinal reflux, neuropathy, dysmorphism and respiratory distress. We performed clinical assessment and radiological studies of this family, in addition to homozygosity mapping and whole exome sequencing (WES) to identify the disease-associated variant. Homozygosity mapping localized the causative gene to a region on chromosome 16 harboring ARL6IP1. WES of the index case identified the homoallelic nonsense variant, c.112C > T in ARL6IP1 that segregated with the phenotype and was predicted to result in loss of the protein. Allelic expression analysis of the parents demonstrated downward pressure on the mutant allele, suggestive of nonsense-mediated decay. Conclusions Our report shows that the phenotype associated with ARL6IP1 variants may be broader and more acute than so far reported and identifies fatal HSP as the severe end of the phenotypic spectrum of ARL6IP1 variants.
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Affiliation(s)
- Salma M Wakil
- Department of Genetics, Research Centre, King Faisal Specialist Hospital & Research Centre, MBC-03, P.O. Box 3354, Riyadh, 11211, Saudi Arabia. .,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia.
| | - Safa Alhissi
- Department of Genetics, Research Centre, King Faisal Specialist Hospital & Research Centre, MBC-03, P.O. Box 3354, Riyadh, 11211, Saudi Arabia
| | - Haya Al Dossari
- Department of Genetics, Research Centre, King Faisal Specialist Hospital & Research Centre, MBC-03, P.O. Box 3354, Riyadh, 11211, Saudi Arabia
| | - Ayesha Alqahtani
- Department of Genetics, Research Centre, King Faisal Specialist Hospital & Research Centre, MBC-03, P.O. Box 3354, Riyadh, 11211, Saudi Arabia
| | - Sherin Shibin
- Department of Genetics, Research Centre, King Faisal Specialist Hospital & Research Centre, MBC-03, P.O. Box 3354, Riyadh, 11211, Saudi Arabia
| | - Brahim T Melaiki
- Prince Sultan Riyadh Military Medical City, Riyadh, Saudi Arabia
| | - Josef Finsterer
- Department of Neurology, Krankenanstalt Rudolfstiftung, Messerli Institute, Postfach 20, 1180, Vienna, Austria
| | - Amal Al-Hashem
- Prince Sultan Riyadh Military Medical City, Riyadh, Saudi Arabia
| | - Saeed Bohlega
- Department of Neurosciences, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Anas M Alazami
- Department of Genetics, Research Centre, King Faisal Specialist Hospital & Research Centre, MBC-03, P.O. Box 3354, Riyadh, 11211, Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
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15
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Monies D, Abouelhoda M, Assoum M, Moghrabi N, Rafiullah R, Almontashiri N, Alowain M, Alzaidan H, Alsayed M, Subhani S, Cupler E, Faden M, Alhashem A, Qari A, Chedrawi A, Aldhalaan H, Kurdi W, Khan S, Rahbeeni Z, Alotaibi M, Goljan E, Elbardisy H, ElKalioby M, Shah Z, Alruwaili H, Jaafar A, Albar R, Akilan A, Tayeb H, Tahir A, Fawzy M, Nasr M, Makki S, Alfaifi A, Akleh H, Yamani S, Bubshait D, Mahnashi M, Basha T, Alsagheir A, Abu Khaled M, Alsaleem K, Almugbel M, Badawi M, Bashiri F, Bohlega S, Sulaiman R, Tous E, Ahmed S, Algoufi T, Al-Mousa H, Alaki E, Alhumaidi S, Alghamdi H, Alghamdi M, Sahly A, Nahrir S, Al-Ahmari A, Alkuraya H, Almehaidib A, Abanemai M, Alsohaibaini F, Alsaud B, Arnaout R, Abdel-Salam GMH, Aldhekri H, AlKhater S, Alqadi K, Alsabban E, Alshareef T, Awartani K, Banjar H, Alsahan N, Abosoudah I, Alashwal A, Aldekhail W, Alhajjar S, Al-Mayouf S, Alsemari A, Alshuaibi W, Altala S, Altalhi A, Baz S, Hamad M, Abalkhail T, Alenazi B, Alkaff A, Almohareb F, Al Mutairi F, Alsaleh M, Alsonbul A, Alzelaye S, Bahzad S, Manee AB, Jarrad O, Meriki N, Albeirouti B, Alqasmi A, AlBalwi M, Makhseed N, Hassan S, Salih I, Salih MA, Shaheen M, Sermin S, Shahrukh S, Hashmi S, Shawli A, Tajuddin A, Tamim A, Alnahari A, Ghemlas I, Hussein M, Wali S, Murad H, Meyer BF, Alkuraya FS. Lessons Learned from Large-Scale, First-Tier Clinical Exome Sequencing in a Highly Consanguineous Population. Am J Hum Genet 2019; 104:1182-1201. [PMID: 31130284 DOI: 10.1016/j.ajhg.2019.04.011] [Citation(s) in RCA: 142] [Impact Index Per Article: 28.4] [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: 12/19/2018] [Accepted: 04/11/2019] [Indexed: 12/16/2022] Open
Abstract
We report the results of clinical exome sequencing (CES) on >2,200 previously unpublished Saudi families as a first-tier test. The predominance of autosomal-recessive causes allowed us to make several key observations. We highlight 155 genes that we propose to be recessive, disease-related candidates. We report additional mutational events in 64 previously reported candidates (40 recessive), and these events support their candidacy. We report recessive forms of genes that were previously associated only with dominant disorders and that have phenotypes ranging from consistent with to conspicuously distinct from the known dominant phenotypes. We also report homozygous loss-of-function events that can inform the genetics of complex diseases. We were also able to deduce the likely causal variant in most couples who presented after the loss of one or more children, but we lack samples from those children. Although a similar pattern of mostly recessive causes was observed in the prenatal setting, the higher proportion of loss-of-function events in these cases was notable. The allelic series presented by the wealth of recessive variants greatly expanded the phenotypic expression of the respective genes. We also make important observations about dominant disorders; these observations include the pattern of de novo variants, the identification of 74 candidate dominant, disease-related genes, and the potential confirmation of 21 previously reported candidates. Finally, we describe the influence of a predominantly autosomal-recessive landscape on the clinical utility of rapid sequencing (Flash Exome). Our cohort's genotypic and phenotypic data represent a unique resource that can contribute to improved variant interpretation through data sharing.
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Affiliation(s)
- Dorota Monies
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia; Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Mohammed Abouelhoda
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia; Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Mirna Assoum
- Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Nabil Moghrabi
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia; Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Rafiullah Rafiullah
- Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Naif Almontashiri
- Clinical Molecular and Biochemical Genetics, Taibah University, Madinah 42353, Saudi Arabia
| | - Mohammed Alowain
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Hamad Alzaidan
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Moeen Alsayed
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Shazia Subhani
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia; Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Edward Cupler
- Neurosciences Department, King Faisal Specialist Hospital and Research Centre, Jeddah 23433, Saudi Arabia
| | - Maha Faden
- Genetics and Metabolism, King Saud Medical Complex, Riyadh 12746, Saudi Arabia
| | - Amal Alhashem
- Pediatrics Department, Prince Sultan Military Medical Complex, Riyadh 12233, Saudi Arabia
| | - Alya Qari
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Aziza Chedrawi
- Neurosciences Department, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
| | - Hisham Aldhalaan
- Neurosciences Department, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
| | - Wesam Kurdi
- Obstetrics and Gynecology Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Sameena Khan
- Neurosciences Department, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
| | - Zuhair Rahbeeni
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Maha Alotaibi
- Genetics and Metabolism, King Saud Medical Complex, Riyadh 12746, Saudi Arabia
| | - Ewa Goljan
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia; Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Hadeel Elbardisy
- Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Mohamed ElKalioby
- Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia; Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Zeeshan Shah
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia; Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Hibah Alruwaili
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia; Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Amal Jaafar
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia; Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Ranad Albar
- Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia
| | - Asma Akilan
- Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Hamsa Tayeb
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia; Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Asma Tahir
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia; Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Mohammed Fawzy
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia; Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Mohammed Nasr
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia; Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Shaza Makki
- Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Abdullah Alfaifi
- Pediatrics Department, Security Forces Hospital, Riyadh 11481, Saudi Arabia
| | - Hanna Akleh
- Academic and Training Affairs, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Suad Yamani
- Neurosciences Department, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
| | - Dalal Bubshait
- Pediatrics Department, King Fahad Hospital of the University, Al-Khobar 31952, Saudi Arabia
| | - Mohammed Mahnashi
- Genetics and Medicine, King Fahd Central Hospital, Gizan 82666, Saudi Arabia
| | - Talal Basha
- Pediatrics Department, King Faisal Specialist Hospital and Research Centre, Jeddah 23433, Saudi Arabia
| | - Afaf Alsagheir
- Pediatrics Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Musad Abu Khaled
- Neurosciences Department, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
| | - Khalid Alsaleem
- Pediatrics Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Maisoon Almugbel
- Obstetrics and Gynecology Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Manal Badawi
- Neurosciences Department, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
| | - Fahad Bashiri
- Department of Pediatrics, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh 11461, Saudi Arabia
| | - Saeed Bohlega
- Neurosciences Department, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
| | - Raashida Sulaiman
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Ehab Tous
- Neurosciences Department, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
| | - Syed Ahmed
- Pediatric Hematology and Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Talal Algoufi
- Pediatric Hematology and Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Hamoud Al-Mousa
- Allergy - Immunology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Emadia Alaki
- Allergy - Immunology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Susan Alhumaidi
- Pediatrics Department, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Hadeel Alghamdi
- Pediatrics Department, King Faisal Specialist Hospital and Research Centre, Jeddah 23433, Saudi Arabia
| | - Malak Alghamdi
- Pediatrics Department, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Ahmed Sahly
- Pediatrics Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Shapar Nahrir
- Pediatrics Department, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Ali Al-Ahmari
- Pediatric Hematology and Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
| | - Hisham Alkuraya
- Vitreoretinal Surgery, Specialized Medical Centre, Riyadh 11564, Saudi Arabia
| | - Ali Almehaidib
- Gastroenterology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Mohammed Abanemai
- Gastroenterology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Fahad Alsohaibaini
- Gastroenterology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Bandar Alsaud
- Allergy - Immunology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Rand Arnaout
- Allergy - Immunology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | | | - Hasan Aldhekri
- Pediatrics Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Suzan AlKhater
- Pediatrics Department, King Fahad Hospital of the University, Al-Khobar 31952, Saudi Arabia; Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia
| | - Khalid Alqadi
- Neurosciences Department, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
| | - Essam Alsabban
- Pediatrics Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Turki Alshareef
- Pediatric Nephrology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Khalid Awartani
- Obstetrics and Gynecology Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Hanaa Banjar
- Pediatric Pulmonology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Nada Alsahan
- Obstetrics and Gynecology Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Ibraheem Abosoudah
- Pediatric Hematology and Oncology, King Faisal Specialist Hospital and Research Centre, Jeddah 23433, Saudi Arabia
| | - Abdullah Alashwal
- Pediatric Endocrine and Metabolism, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Wajeeh Aldekhail
- Gastroenterology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Sami Alhajjar
- Pediatric Infectious Diseases, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Sulaiman Al-Mayouf
- Pediatrics Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Abdulaziz Alsemari
- Neurosciences Department, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
| | - Walaa Alshuaibi
- Pediatrics Department, King Khalid University Hospital, Riyadh 12372, Saudi Arabia
| | - Saeed Altala
- Pediatrics Department, Armed Forces Hospital, Khamis Mushait 62451, Saudi Arabia
| | - Abdulhadi Altalhi
- Pediatric Nephrology, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Salah Baz
- Neurosciences Department, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
| | - Muddathir Hamad
- Pediatrics Department, King Khalid University Hospital, Riyadh 12372, Saudi Arabia
| | - Tariq Abalkhail
- Neurosciences Department, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
| | - Badi Alenazi
- Pediatrics Department, Alyamama Hospital, Riyadh 14222, Saudi Arabia
| | - Alya Alkaff
- Obstetrics and Gynecology Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Fahad Almohareb
- Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Fuad Al Mutairi
- King Abdullah International Medical Research Centre, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11564, Saudi Arabia; Medical Genetic Division, Department of Pediatrics, King Abdulaziz Medical City, Riyadh 14611, Saudi Arabia
| | - Mona Alsaleh
- Pediatric Hematology and Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Abdullah Alsonbul
- Pediatric Rheumatology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Somaya Alzelaye
- Pediatric Endocrine and Diabetes, Al Qunfudah General Hospital, Al Qunfudhah 28821, Saudi Arabia
| | - Shakir Bahzad
- Kuwait Medical Genetics Center, Kuwait City 65000, Kuwait
| | - Abdulaziz Bin Manee
- Pediatrics Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Ola Jarrad
- Pediatrics Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Neama Meriki
- Maternal and Fetal Medicine, King Khalid University Hospital, Riyadh 12372, Saudi Arabia
| | - Bassem Albeirouti
- Hematology and Oncology, King Faisal Specialist Hospital and Research Centre, Jeddah 23433, Saudi Arabia
| | - Amal Alqasmi
- Pediatrics Department, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Mohammed AlBalwi
- Department of Pathology and Laboratory Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia
| | - Nawal Makhseed
- Pediatrics Department, Alsoor Clinic, Kuwait City 65000, Kuwait
| | - Saeed Hassan
- Pediatrics Department, King Khalid University Hospital, Riyadh 12372, Saudi Arabia
| | - Isam Salih
- Hepatic-Pancreatic Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Mustafa A Salih
- Department of Pediatrics, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh 11461, Saudi Arabia
| | - Marwan Shaheen
- Hematology and Bone Marrow Transplant, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Saadeh Sermin
- Pediatric Nephrology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Shamsad Shahrukh
- Neurosciences Department, King Faisal Specialist Hospital and Research Centre, Jeddah 23433, Saudi Arabia
| | - Shahrukh Hashmi
- Hematology and Bone Marrow Transplant, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Ayman Shawli
- Department of Pediatrics, King Abdulaziz Medical City, Jeddah 9515, Saudi Arabia
| | - Ameen Tajuddin
- Neurology, King Fahad Hospital, Medina 59046, Saudi Arabia
| | - Abdullah Tamim
- Pediatrics Neurology, King Faisal Specialist Hospital and Research Centre, Jeddah 23433, Saudi Arabia
| | - Ahmed Alnahari
- Pediatric Department, King Fahad Central Hospital, Gizan, 82666, Saudi Arabia
| | - Ibrahim Ghemlas
- Pediatric Hematology and Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Maged Hussein
- Nephrology Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Sami Wali
- Pediatrics Department, Prince Sultan Military Medical Complex, Riyadh 12233, Saudi Arabia
| | - Hatem Murad
- Neurosciences Department, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
| | - Brian F Meyer
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia; Saudi Diagnostic Laboratories, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Fowzan S Alkuraya
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia.
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Abusrair AH, Bohlega S, Al-Semari A, Al-Ajlan FS, Al-Ahmadi K, Mohamed B, AlDakheel A. Brain MR Imaging Findings in Woodhouse-Sakati Syndrome. AJNR Am J Neuroradiol 2018; 39:2256-2262. [PMID: 30409855 DOI: 10.3174/ajnr.a5879] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 09/29/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND PURPOSE Woodhouse-Sakati syndrome is a rare autosomal recessive disorder characterized by hypogonadism, alopecia, diabetes mellitus, and progressive extrapyramidal signs. The disease is caused by biallelic pathogenic variants in the DCAF17 gene. The purpose of this study was to describe the spectrum of brain MR imaging abnormalities in Woodhouse-Sakati syndrome. MATERIALS AND METHODS We reviewed brain MR images of 26 patients with a clinical and genetic diagnosis of Woodhouse-Sakati syndrome (12 males, 14 females; age range, 16-45 years; mean age, 26.6 years). Follow-up studies were conducted for 6 patients. RESULTS All patients had abnormal MR imaging findings. The most common abnormalities were a small pituitary gland (76.9%), pronounced basal ganglia iron deposition (73%), and white matter lesions in 69.2%. White matter lesions showed frontoparietal and periventricular predominance. All white matter lesions spared subcortical U-fibers and were nonenhanced. Prominent perivascular spaces (15.3%) and restricted diffusion in the splenium of the corpus callosum (7.6%) were less frequent findings. Follow-up studies showed expansion of white matter lesions with iron deposition further involving the red nucleus and substantia nigra. Older age was associated with a more severe degree of white matter lesions (P < .001). CONCLUSIONS Small pituitary gland, accentuated iron deposition in the globus pallidus, and nonenhancing frontoparietal/periventricular white matter lesions were the most noted abnormalities seen in our cohort. The pattern and extent of these findings were observed to correlate with older age, reflecting a possible progressive myelin destruction and/or axonal loss. The presence of pituitary hypoplasia and white matter lesions can further distinguish Woodhouse-Sakati syndrome from other neurodegenerative diseases with brain iron accumulation subtypes.
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Affiliation(s)
- A H Abusrair
- From the Departments of Neurosciences (A.H.A., S.B., A.A.-S., F.S.A.-A., B.M., A.A.)
| | - S Bohlega
- From the Departments of Neurosciences (A.H.A., S.B., A.A.-S., F.S.A.-A., B.M., A.A.)
| | - A Al-Semari
- From the Departments of Neurosciences (A.H.A., S.B., A.A.-S., F.S.A.-A., B.M., A.A.)
| | - F S Al-Ajlan
- From the Departments of Neurosciences (A.H.A., S.B., A.A.-S., F.S.A.-A., B.M., A.A.)
| | - K Al-Ahmadi
- Radiology (K.A.-A.), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - B Mohamed
- From the Departments of Neurosciences (A.H.A., S.B., A.A.-S., F.S.A.-A., B.M., A.A.)
| | - A AlDakheel
- From the Departments of Neurosciences (A.H.A., S.B., A.A.-S., F.S.A.-A., B.M., A.A.)
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17
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Monies D, Abou Al-Shaar H, Goljan EA, Al-Younes B, Al-Breacan MMA, Al-Saif MM, Wakil SM, Meyer BF, Khabar KSA, Bohlega S. Identification of a novel genetic locus underlying tremor and dystonia. Hum Genomics 2017; 11:25. [PMID: 29110692 PMCID: PMC5674688 DOI: 10.1186/s40246-017-0123-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 10/27/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Five affected individuals with syndromic tremulous dystonia, spasticity, and white matter disease from a consanguineous extended family covering a period of over 24 years are presented. A positional cloning approach utilizing genome-wide linkage, homozygozity mapping and whole exome sequencing was used for genetic characterization. The impact of a calmodulin-binding transcription activator 2, (CAMTA2) isoform 2, hypomorphic mutation on mRNA and protein abundance was studied using fluorescent reporter expression cassettes. Human brain sub-region cDNA libraries were used to study the expression pattern of CAMTA2 transcript variants. RESULTS Linkage analysis and homozygozity mapping localized the disease allele to a 2.1 Mb interval on chromosome 17 with a LOD score of 4.58. Whole exome sequencing identified a G>A change in the transcript variant 2 5'UTR of CAMTA2 that was only 6 bases upstream of the translation start site (c.-6G > A) (NM_001171166.1) and segregated with disease in an autosomal recessive manner. Transfection of wild type and mutant 5'UTR-linked fluorescent reporters showed no impact upon mRNA levels but a significant reduction in the protein fluorescent activity implying translation inhibition. CONCLUSIONS Mutation of CAMTA2 resulting in post-transcriptional inhibition of its own gene activity likely underlies a novel syndromic tremulous dystonia.
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Affiliation(s)
- Dorota Monies
- Department of Genetics, King Faisal Specialist Hospital, and Research Centre, PO Box 3354, Riyadh, 11211, Saudi Arabia. .,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia.
| | - Hussam Abou Al-Shaar
- Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11211, Saudi Arabia
| | - Ewa A Goljan
- Department of Genetics, King Faisal Specialist Hospital, and Research Centre, PO Box 3354, Riyadh, 11211, Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Banan Al-Younes
- Department of Genetics, King Faisal Specialist Hospital, and Research Centre, PO Box 3354, Riyadh, 11211, Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | | | - Maher Mohammed Al-Saif
- Biomolecular Medicine, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Salma M Wakil
- Department of Genetics, King Faisal Specialist Hospital, and Research Centre, PO Box 3354, Riyadh, 11211, Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Brian F Meyer
- Department of Genetics, King Faisal Specialist Hospital, and Research Centre, PO Box 3354, Riyadh, 11211, Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Khalid S A Khabar
- Biomolecular Medicine, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Saeed Bohlega
- Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia. .,Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11211, Saudi Arabia.
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18
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Dreser A, Vollrath JT, Sechi A, Johann S, Roos A, Yamoah A, Katona I, Bohlega S, Wiemuth D, Tian Y, Schmidt A, Vervoorts J, Dohmen M, Beyer C, Anink J, Aronica E, Troost D, Weis J, Goswami A. The ALS-linked E102Q mutation in Sigma receptor-1 leads to ER stress-mediated defects in protein homeostasis and dysregulation of RNA-binding proteins. Cell Death Differ 2017; 24:1655-1671. [PMID: 28622300 PMCID: PMC5596426 DOI: 10.1038/cdd.2017.88] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [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: 11/11/2015] [Revised: 03/14/2017] [Accepted: 03/22/2017] [Indexed: 12/21/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is characterized by the selective degeneration of motor neurons (MNs) and their target muscles. Misfolded proteins which often form intracellular aggregates are a pathological hallmark of ALS. Disruption of the functional interplay between protein degradation (ubiquitin proteasome system and autophagy) and RNA-binding protein homeostasis has recently been suggested as an integrated model that merges several ALS-associated proteins into a common pathophysiological pathway. The E102Q mutation in one such candidate gene, the endoplasmic reticulum (ER) chaperone Sigma receptor-1 (SigR1), has been reported to cause juvenile ALS. Although loss of SigR1 protein contributes to neurodegeneration in several ways, the molecular mechanisms underlying E102Q-SigR1-mediated neurodegeneration are still unclear. In the present study, we showed that the E102Q-SigR1 protein rapidly aggregates and accumulates in the ER and associated compartments in transfected cells, leading to structural alterations of the ER, nuclear envelope and mitochondria and to subsequent defects in proteasomal degradation and calcium homeostasis. ER defects and proteotoxic stress generated by E102Q-SigR1 aggregates further induce autophagy impairment, accumulation of stress granules and cytoplasmic aggregation of the ALS-linked RNA-binding proteins (RBPs) matrin-3, FUS, and TDP-43. Similar ultrastructural abnormalities as well as altered protein degradation and misregulated RBP homeostasis were observed in primary lymphoblastoid cells (PLCs) derived from E102Q-SigR1 fALS patients. Consistent with these findings, lumbar α-MNs of both sALS as well as fALS patients showed cytoplasmic matrin-3 aggregates which were not co-localized with pTDP-43 aggregates. Taken together, our results support the notion that E102Q-SigR1-mediated ALS pathogenesis comprises a synergistic mechanism of both toxic gain and loss of function involving a vicious circle of altered ER function, impaired protein homeostasis and defective RBPs.
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Affiliation(s)
- Alice Dreser
- Institute of Neuropathology, RWTH Aachen University Medical School, Aachen, Germany
| | - Jan Tilmann Vollrath
- Institute of Neuropathology, RWTH Aachen University Medical School, Aachen, Germany
| | - Antonio Sechi
- Institute of Biomedical Engineering, Deparment of Cell Biology, RWTH Aachen University Medical School, Aachen, Germany
| | - Sonja Johann
- Institute of Neuroanatomy, RWTH Aachen University Medical School, Aachen, Germany
| | - Andreas Roos
- Institute of Neuropathology, RWTH Aachen University Medical School, Aachen, Germany
- Leibniz-Institut für Analytische Wissenschaften – ISAS – e.V., Dortmund, Germany
- Institute of Genetic Medicine, John Walton Muscular Dystrophy Research Centre, International Centre for Life, Central Parkway, Newcastle upon Tyne, England, UK
| | - Alfred Yamoah
- Institute of Neuropathology, RWTH Aachen University Medical School, Aachen, Germany
| | - Istvan Katona
- Institute of Neuropathology, RWTH Aachen University Medical School, Aachen, Germany
| | - Saeed Bohlega
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Dominik Wiemuth
- Institute of Physiology, RWTH Aachen University Medical School, Aachen Germany
| | - Yuemin Tian
- Institute of Physiology, RWTH Aachen University Medical School, Aachen Germany
| | - Axel Schmidt
- Institute of Physiology, RWTH Aachen University Medical School, Aachen Germany
| | - Jörg Vervoorts
- Institute of Biochemistry and Molecular Biology, RWTH Aachen University Medical School, Aachen, Germany
| | - Marc Dohmen
- Institute of Biochemistry and Molecular Biology, RWTH Aachen University Medical School, Aachen, Germany
| | - Cordian Beyer
- Institute of Neuroanatomy, RWTH Aachen University Medical School, Aachen, Germany
| | - Jasper Anink
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Eleonora Aronica
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Dirk Troost
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Joachim Weis
- Institute of Neuropathology, RWTH Aachen University Medical School, Aachen, Germany
| | - Anand Goswami
- Institute of Neuropathology, RWTH Aachen University Medical School, Aachen, Germany
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Alshubaili A, Abou-Al-Shaar H, Santhamoorthy P, Attia H, Bohlega S. Ultrasound-guided botulinum toxin A injection in the treatment of belly dancer's dyskinesia. BMC Neurol 2016; 16:226. [PMID: 27855646 PMCID: PMC5114732 DOI: 10.1186/s12883-016-0746-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 11/08/2016] [Indexed: 11/29/2022] Open
Abstract
Background Belly dancer’s dyskinesia is an extremely rare condition. It manifests as semicontinuous, slow, writhing, sinuous abdominal wall movements that are bothersome to the patient. Management of this condition is extremely difficult and challenging. Methods We describe four patients with belly dancer’s dyskinesia who were treated with Botulinum Toxin A (BTX) injections under ultrasound guidance. Results All patients underwent the same BTX injection procedure using an aseptic technique under ultrasound guidance. The patients responded well to the BTX injections after an unsatisfactory course of medical treatment. The patients reported complete abolishment of abnormal abdominal movements with no side effects. Conclusions We report a cohort of patients with belly dancer dyskinesia treated successfully with BTX injections. Ultrasound guidance for injections increases the accuracy and reduces the risk of the complications. BTX injection under ultrasound guidance is a safe and effective treatment modality that should be employed as a first-line in the management of patients with belly dancer’s dyskinesia. Electronic supplementary material The online version of this article (doi:10.1186/s12883-016-0746-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Hussam Abou-Al-Shaar
- Movement Disorder Program, Division of Neurology, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | - Hosam Attia
- Department of Radiology, Ibn Sina Hospital, Kuwait, Kuwait
| | - Saeed Bohlega
- Movement Disorder Program, Division of Neurology, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. .,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
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20
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Monies D, Alhindi HN, Almuhaizea MA, Abouelhoda M, Alazami AM, Goljan E, Alyounes B, Jaroudi D, AlIssa A, Alabdulrahman K, Subhani S, El-Kalioby M, Faquih T, Wakil SM, Altassan NA, Meyer BF, Bohlega S. A first-line diagnostic assay for limb-girdle muscular dystrophy and other myopathies. Hum Genomics 2016; 10:32. [PMID: 27671536 PMCID: PMC5037890 DOI: 10.1186/s40246-016-0089-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 09/17/2016] [Indexed: 11/23/2022] Open
Abstract
Background Fifty random genetically unstudied families (limb-girdle muscular dystrophy (LGMD)/myopathy) were screened with a gene panel incorporating 759 OMIM genes associated with neurological disorders. Average coverage of the CDS and 10 bp flanking regions of genes was 99 %. All families were referred to the Neurosciences Clinic of King Faisal Specialist Hospital and Research Centre, Saudi Arabia. Patients presented with muscle weakness affecting the pelvic and shoulder girdle. Muscle biopsy in all cases showed dystrophic or myopathic changes. Our main objective was to evaluate a neurological gene panel as a first-line diagnostic test for LGMD/myopathies. Results Our panel identified the mutation in 76 % of families (38/50; 11 novel). Thirty-four families had mutations in LGMD-related genes with four others having variants not typically associated with LGMD. The majority of cases had recessive inheritance with homoallelic pathogenic variants (97.4 %, 37/38), as expected considering the high rate of consanguinity in the study population. In one case, we detected a heterozygous mutation in DNAJB responsible for LGMD-1E. Our cohort included seven different subtypes of LGMD2. Mutations of DYSF were the most commonly identified cause of disease followed by that in CAPN3 and FKRP. Non-LGMD myopathies were due to mutations in genes associated with congenital disorder of glycosylation (ALG2), rigid spine muscular dystrophy 1 (SEPN1), inclusion body myopathy2/Nonaka myopathy (GNE), and neuropathy (WNK1). Whole exome sequencing (WES) of patients who remained undiagnosed with the neurological panel did not improve our diagnostic yield. Conclusions Our neurological panel achieved a high clinical sensitivity (76 %) and is an effective first-line laboratory test in patients with LGMD and other myopathies. This sensitive, cost-effective, and rapid assay significantly assists clinical practice especially in these phenotypically and genetically heterogeneous disorders. Moreover, the application of the American College of Medical Genetics (ACMG) and Association for Molecular Pathology (AMP) guidelines applied in the classification of variant pathogenecity provides a clear interpretation for physicians on the relevance of such findings. Electronic supplementary material The online version of this article (doi:10.1186/s40246-016-0089-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dorota Monies
- Department of Genetics, Research Centre, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia. .,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia.
| | - Hindi N Alhindi
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mohamed A Almuhaizea
- Department of Neuroscience, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mohamed Abouelhoda
- Department of Genetics, Research Centre, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Anas M Alazami
- Department of Genetics, Research Centre, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Ewa Goljan
- Department of Genetics, Research Centre, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Banan Alyounes
- Department of Genetics, Research Centre, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Dyala Jaroudi
- Department of Genetics, Research Centre, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Abdulelah AlIssa
- Department of Genetics, Research Centre, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Khalid Alabdulrahman
- Department of Genetics, Research Centre, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Shazia Subhani
- Department of Genetics, Research Centre, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Mohamed El-Kalioby
- Department of Genetics, Research Centre, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Tariq Faquih
- Department of Genetics, Research Centre, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Salma M Wakil
- Department of Genetics, Research Centre, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Nada A Altassan
- Department of Genetics, Research Centre, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Brian F Meyer
- Department of Genetics, Research Centre, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Saeed Bohlega
- Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia.,Department of Neuroscience, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Abou Al-Shaar H, Qadi N, Al-Hamed MH, Meyer BF, Bohlega S. Phenotypic comparison of individuals with homozygous or heterozygous mutation of NOTCH3 in a large CADASIL family. J Neurol Sci 2016; 367:239-43. [DOI: 10.1016/j.jns.2016.05.061] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 05/10/2016] [Accepted: 05/31/2016] [Indexed: 12/19/2022]
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Dressler D, Altenmueller E, Bhidayasiri R, Bohlega S, Chana P, Chung TM, Frucht S, Garcia-Ruiz PJ, Kaelin A, Kaji R, Kanovsky P, Laskawi R, Micheli F, Orlova O, Relja M, Rosales R, Slawek J, Timerbaeva S, Warner TT, Saberi FA. Erratum to: Strategies for treatment of dystonia. J Neural Transm (Vienna) 2016; 123:259. [PMID: 26546035 DOI: 10.1007/s00702-015-1471-8] [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: 11/28/2022]
Affiliation(s)
- Dirk Dressler
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany.
| | - Eckart Altenmueller
- Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Hannover, Germany
| | - Roongroj Bhidayasiri
- Chulalongkorn Centre for Excellence on Parkinson's Disease and Related Disorders, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Saeed Bohlega
- Department of Neurology, King Faisal Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
| | - Pedro Chana
- Centro de Estudios de Trastornos del Movimiento, University of Santiago, Santiago de Chile, Chile
| | - Tae Mo Chung
- Hospital Sao Joaquim Beneficencia Portuguesa, Sao Paulo, Brazil
| | - Steven Frucht
- Department of Neurology, Mount Sinai Medical Center, New York, NY, USA
| | | | - Alain Kaelin
- Neurocentro della Svizzera Italiana, Ospedale Regionale di Lugano, Lugano, Switzerland
| | - Ryuji Kaji
- Department of Neurology, University of Tokushima, Tokushima, Japan
| | - Petr Kanovsky
- Department of Neurology, Palacky University, Olomouc, Czech Republic
| | - Rainer Laskawi
- Department of Ear-, Nose and Throat, Universitätsmedizin Göttingen, Göttingen, Germany
| | - Federico Micheli
- Department of Neurology, Hospital de Clínicas José de San Martín, University of Buenos Aires, Buenos Aires, Argentina
| | | | - Maja Relja
- Department of Neurology, University of Zagreb, Zagreb, Croatia
| | - Raymond Rosales
- Department of Neurology, University of Santo Tomas, Manila, Philippines
| | - Jaroslaw Slawek
- Department of Neurological-Psychiatric Nursing, Medical University of Gdansk, Gdansk, Poland
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23
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Alqwaifly M, Bohlega S. Ataxia and Hypogonadotropic Hypogonadism with Intrafamilial Variability Caused by RNF216 Mutation. Neurol Int 2016; 8:6444. [PMID: 27441066 PMCID: PMC4935815 DOI: 10.4081/ni.2016.6444] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 02/09/2016] [Indexed: 11/29/2022] Open
Abstract
Gordon Holmes syndrome (GHS) is a distinct phenotype of autosomal recessive cerebellar ataxia, characterized by ataxia, dementia, reproductive defects and hypogonadism; it has been recently found to be associated with RNF216 mutation. We performed whole-exome sequencing and filtered the resulting novel variants by the coordinates of the shared autozygome. We identified a novel splicing variant in RNF216 that is likely to abolish the canonical splice site at the junction of exon/intron 13 (NM_207111.3:c.2061G>A). We herein report two patients with GHS caused by a novel RNF216 mutation as the first follow up report on RNF216-related GHS, and show interfamilial variability of phenotype supporting the previously reported RNF216-related cases.
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Affiliation(s)
- Mohammed Alqwaifly
- Department of Neurosciences, King Faisal Specialist Hospital and Research Center Riyadh , Saudi Arabia
| | - Saeed Bohlega
- Department of Neurosciences, King Faisal Specialist Hospital and Research Center Riyadh , Saudi Arabia
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24
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Hdiji O, Turki E, Bouzidi N, Bouchhima I, Damak M, Bohlega S, Mhiri C. Woodhouse-Sakati Syndrome: Report of the First Tunisian Family with the C2orf37 Gene Mutation. J Mov Disord 2016; 9:120-3. [PMID: 27240811 PMCID: PMC4886203 DOI: 10.14802/jmd.16003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 03/02/2016] [Accepted: 03/18/2016] [Indexed: 11/24/2022] Open
Abstract
Woodhouse-Sakati syndrome (WSS) is an infrequent autosomal recessive condition characterized by progressive extrapyramidal signs, mental retardation, hypogonadism, alopecia, and diabetes mellitus. This syndrome belongs to a heterogeneous group of inherited neurodegenerative disorders characterized iron accumulation in the brain, and it is caused by mutations of the C2orf37 gene. We report the first Tunisian family with two affected sisters presenting with a phenotype suggestive of WSS. We examined the index patient presenting with movement disorders and mental retardation and then searched for similar cases in her family, which identified a sister with similar signs. We performed a genetic study that confirmed the diagnosis and revealed a c.436delC mutation of the C2orf37 gene. Therefore, WSS is an important consideration in patients presenting with movement disorders and intellectual disability. A high consanguinity contributes to the clustering of such rare autosomal recessive syndromes.
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Affiliation(s)
- Olfa Hdiji
- Department of Neurology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Emna Turki
- Department of Neurology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Nouha Bouzidi
- Department of Neurology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Imen Bouchhima
- Department of Neurology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Mariem Damak
- Department of Neurology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Saeed Bohlega
- Department of Neurology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Chokri Mhiri
- Department of Neurology, Habib Bourguiba Hospital, Sfax, Tunisia
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25
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Bohlega S, Abou Al-Shaar H, Alkhairallah T, Al-Ajlan F, Hasan N, Alkahtani K. Levodopa-Carbidopa Intestinal Gel Infusion Therapy in Advanced Parkinson's Disease: Single Middle Eastern Center Experience. Eur Neurol 2015; 74:227-36. [DOI: 10.1159/000442151] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 11/02/2015] [Indexed: 11/19/2022]
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26
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Al Jasmi F, Al Jumah M, Alqarni F, Al-Sanna'a N, Al-Sharif F, Bohlega S, Cupler EJ, Fathalla W, Hamdan MA, Makhseed N, Nafissi S, Nilipour Y, Selim L, Shembesh N, Sunbul R, Tonekaboni SH. Diagnosis and treatment of late-onset Pompe disease in the Middle East and North Africa region: consensus recommendations from an expert group. BMC Neurol 2015; 15:205. [PMID: 26471939 PMCID: PMC4608291 DOI: 10.1186/s12883-015-0412-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 08/18/2015] [Indexed: 01/30/2023] Open
Abstract
Background Pompe disease is a rare autosomal recessive disorder caused by a deficiency of the lysosomal enzyme alpha-glucosidase responsible for degrading glycogen. Late-onset Pompe disease has a complex multisystem phenotype characterized by a range of symptoms. Methods An expert panel from the Middle East and North Africa (MENA) region met to create consensus-based guidelines for the diagnosis and treatment of late-onset Pompe disease for the MENA region, where the relative prevalence of Pompe disease is thought to be high but there is a lack of awareness and diagnostic facilities. Results These guidelines set out practical recommendations and include algorithms for the diagnosis and treatment of late-onset Pompe disease. They detail the ideal diagnostic workup, indicate the patients in whom enzyme replacement therapy should be initiated, and provide guidance on appropriate patient monitoring. Conclusions These guidelines will serve to increase awareness of the condition, optimize patient diagnosis and treatment, reduce disease burden, and improve patient outcomes.
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Affiliation(s)
| | - Fatma Al Jasmi
- Department of Pediatrics, College of Medicine and Health Science, United Arab Emirates University, P.O. Box 17666, Al-Ain, United Arab Emirates.
| | - Mohammed Al Jumah
- King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, NGHA, Riyadh, Kingdom of Saudi Arabia. .,Prince Mohammed Ben Abdulaziz Hospital, MOH, P.O. Box 22490, Riyadh, 11426, Kingdom of Saudi Arabia.
| | - Fatimah Alqarni
- Neurology Department, National Neurosciences Institute, King Fahad Medical City, P.O. Box 59046, Riyadh, 11525, Kingdom of Saudi Arabia.
| | - Nouriya Al-Sanna'a
- Johns Hopkins Aramco Healthcare, Pediatrics Services Division, Building 61/Room D-269, Dhahran, Kingdom of Saudi Arabia.
| | - Fawziah Al-Sharif
- Medical Genetics And Metabolic Consultant, MCH, PO Box 55954, Jeddah, 21544, Kingdom of Saudi Arabia.
| | - Saeed Bohlega
- Department of Neurosciences, MBC 76, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia.
| | - Edward J Cupler
- Department of Neuroscience, MBC J-76, King Faisal Specialist Hospital and Research Center, P.O. Box 40047, Jeddah, 21499, Kingdom of Saudi Arabia.
| | - Waseem Fathalla
- Department of Pediatrics, Division of Child Neurology, Mafraq Hospital, P.O. Box: 2951, Abu Dhabi, United Arab Emirates.
| | - Mohamed A Hamdan
- KidsHeart: American Fetal & Children's Heart Center, Dubai Healthcare City, P.O. Box 505193, Dubai, United Arab Emirates.
| | - Nawal Makhseed
- Pediatric Department, Jahra Hospital, Ministry of Health, P.O. Box 16586, Qadisiya, 35856, Kuwait.
| | - Shahriar Nafissi
- Department of Neurology, Tehran University of Medical Sciences, Shariati Hospital, North Karegar Street, Tehran, 14114, Iran.
| | - Yalda Nilipour
- Pediatric Pathology Research Center, Mofid Children Hospital, Shahid Beheshti Medical University (SBMU), Shariati Avenue, Tehran, 15468-155514, Iran.
| | - Laila Selim
- Pediatric Neurology and Neurometabolic Division, Cairo University Children Hospital (Abo el Reesh), 1-Aly Pasha Ibrahim Street, Near Sayeda Zeinab Metro Station, Cairo, Egypt.
| | - Nuri Shembesh
- Pediatrics and Pediatric Neurology, Benghazi University, P.O. Box 1565, Benghazi, Libya.
| | - Rawda Sunbul
- Department of Pediatrics, Qatif Central Hospital, P.O. Box 18476, Dammam, 31911, Eastern Province, Kingdom of Saudi Arabia.
| | - Seyed Hassan Tonekaboni
- Pediatric Neurology Research Center, Mofid Children Hospital, Shahid Beheshti Medical University (SBMU), Shariati Avenue, Tehran, 15468-155514, Iran.
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27
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28
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Cupler E, Al-Shehri E, Basndwah A, Kurdi K, Ali Q, Bohlega S, Al-Said Y. Hereditary spastic paraplegia with thin corpus callosum (HSP-TCC): 3 new families from Saudi Arabia with 2 novel SPG-11 mutations. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dressler D, Altenmueller E, Bhidayasiri R, Bohlega S, Chana P, Chung TM, Frucht S, Garcia-Ruiz PJ, Kaelin A, Kaji R, Kanovsky P, Laskawi R, Micheli F, Orlova O, Relja M, Rosales R, Slawek J, Timerbaeva S, Warner TT, Saberi FA. Strategies for treatment of dystonia. J Neural Transm (Vienna) 2015; 123:251-8. [PMID: 26370676 DOI: 10.1007/s00702-015-1453-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [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: 06/08/2015] [Accepted: 09/01/2015] [Indexed: 12/01/2022]
Abstract
Treatment of dystonias is generally symptomatic. To produce sufficient therapy effects, therefore, frequently a multimodal and interdisciplinary therapeutic approach becomes necessary, combining botulinum toxin therapy, deep brain stimulation, oral antidystonic drugs, adjuvant drugs and rehabilitation therapy including physiotherapy, occupational therapy, re-training, speech therapy, psychotherapy and sociotherapy. This review presents the recommendations of the IAB-Interdisciplinary Working Group for Movement Disorders Special Task Force on Interdisciplinary Treatment of Dystonia. It reviews the different therapeutic modalities and outlines a strategy to adapt them to the dystonia localisation and severity of the individual patient. Hints to emerging and future therapies will be given.
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Affiliation(s)
- Dirk Dressler
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany.
| | - Eckart Altenmueller
- Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Hannover, Germany
| | - Roongroj Bhidayasiri
- Chulalongkorn Centre for Excellence on Parkinson's Disease and Related Disorders, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Saeed Bohlega
- Department of Neurology, King Faisal Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
| | - Pedro Chana
- Centro de Estudios de Trastornos del Movimiento, University of Santiago, Santiago de Chile, Chile
| | - Tae Mo Chung
- Hospital Sao Joaquim Beneficencia Portuguesa, Sao Paulo, Brazil
| | - Steven Frucht
- Department of Neurology, Mount Sinai Medical Center, New York, NY, USA
| | | | - Alain Kaelin
- Neurocentro della Svizzera Italiana, Ospedale Regionale di Lugano, Lugano, Switzerland
| | - Ryuji Kaji
- Department of Neurology, University of Tokushima, Tokushima, Japan
| | - Petr Kanovsky
- Department of Neurology, Palacky University, Olomouc, Czech Republic
| | - Rainer Laskawi
- Department of Ear-, Nose and Throat, Universitätsmedizin Göttingen, Göttingen, Germany
| | - Federico Micheli
- Department of Neurology, Hospital de Clínicas José de San Martín, University of Buenos Aires, Buenos Aires, Argentina
| | | | - Maja Relja
- Department of Neurology, University of Zagreb, Zagreb, Croatia
| | - Raymond Rosales
- Department of Neurology, University of Santo Tomas, Manila, Philippines
| | - Jaroslaw Slawek
- Department of Neurological-Psychiatric Nursing, Medical University of Gdansk, Gdansk, Poland
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Abstract
Objectives: Characterization of the phenotypic, pathological, radiological, and genetic findings in 2 Saudi Arabian families with anoctaminopathies, and limb girdle muscular dystrophy type 2L (LGMD2L). Methods: Over a 2-year period from December 2010 to January 2013, the clinical presentations were analyzed and all genes responsible for limb girdle muscular dystrophy (LGMD) were screened in families seen at King Faisal Specialist Hospital and Research Centre, a tertiary care hospital in Riyadh, Saudi Arabia. Out of 66 families with LGMD, we identified 2 families (3.1%) with anoctaminopathy, ANO5 muscular dystrophy. Results: In the first case, a man presented with asymmetrical calves’ muscles weakness and atrophy, which was first noted at age 39. The creatinine kinase (CK) level was >20x normal, muscle biopsy showed necrotizing myopathic changes, and an MRI of the legs showed fatty-tissue replacement to muscle tissue with volume loss involving the gastrocnemius and soleus muscles in an asymmetrical fashion. Minimal disease progression was noted over 18 years of follow up. Exercise induced recurrent rhabdomyolysis was noted over the last 2 years. A novel ANO5 gene mutation (Arg58Trp) was found. In the second family, a male presented at the age of 41 with asymptomatic hyperCkemia and intermittent dyspnea. Over 10 years follow up, he became disabled with muscle cramps, rhabdomyolysis, myoglobinurea, and difficulty ambulating. Muscle biopsy showed necrotizing myopathy and perivascular and interstitial amyloid deposit in skeletal muscle. A homozygous deletion of 11.9 Kb encompassing exon 13 to exon 17 was found in the ANO5 gene. Full cardiac investigations were normal in both patients. Conclusion: The prevalence of LGMD2L is approximately 3.1% in a Saudi Arabian native LGMD cohort. Slowly progressive, late onset, and asymmetrical weakness was the salient features in these 2 families. The genetic findings were novel and will add to the spectrum of ANO5 known mutations.
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Affiliation(s)
- Saeed Bohlega
- Department of Neurosciences, MBC 76, King Faisal Specialist Hospital & Research Centre, PO Box 3354, Riyadh 11211, Kingdom of Saudi Arabia. E-mail:
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Yamout B, Alroughani R, Al-Jumah M, Goueider R, Dahdaleh M, Inshasi J, Hashem S, Alsharoqi I, Sahraian M, Khoury S, Alkawi Z, Koussa S, Zakaria M, Al Khaburi J, Alsaadi T, Bohlega S. Consensus recommendations for the diagnosis and treatment of multiple sclerosis: the Middle East North Africa Committee for Treatment and Research In Multiple Sclerosis (MENACTRIMS). Curr Med Res Opin 2015; 31:1349-61. [PMID: 25946578 DOI: 10.1185/03007995.2015.1047750] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
With evolving diagnostic criteria and the advent of new oral and parenteral therapies for MS, most current diagnostic and treatment algorithms need re-evaluation and updating. The diagnosis of MS relies on incorporating clinical and paraclinical findings to prove dissemination in space and in time, and exclude alternative diseases that can explain the findings at hand. The differential diagnostic workup should be guided by clinical and laboratory red flags to avoid unnecessary tests. Appropriate multiple sclerosis (MS) therapy selection is critical to maximize patient benefit. The current guidelines review the scientific evidence supporting treatment of acute relapses, radiologically isolated syndrome, clinically isolated syndrome, relapsing remitting MS, secondary progressive MS, and primary progressive MS. The purpose of these guidelines is to provide practical recommendations and algorithms for the diagnosis and treatment of MS based on current scientific evidence and clinical experience.
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Affiliation(s)
- B Yamout
- MS Center, American University of Beirut Medical Center , Beirut , Lebanon
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Alazami AM, Patel N, Shamseldin HE, Anazi S, Al-Dosari MS, Alzahrani F, Hijazi H, Alshammari M, Aldahmesh MA, Salih MA, Faqeih E, Alhashem A, Bashiri FA, Al-Owain M, Kentab AY, Sogaty S, Al Tala S, Temsah MH, Tulbah M, Aljelaify RF, Alshahwan SA, Seidahmed MZ, Alhadid AA, Aldhalaan H, AlQallaf F, Kurdi W, Alfadhel M, Babay Z, Alsogheer M, Kaya N, Al-Hassnan ZN, Abdel-Salam GMH, Al-Sannaa N, Al Mutairi F, El Khashab HY, Bohlega S, Jia X, Nguyen HC, Hammami R, Adly N, Mohamed JY, Abdulwahab F, Ibrahim N, Naim EA, Al-Younes B, Meyer BF, Hashem M, Shaheen R, Xiong Y, Abouelhoda M, Aldeeri AA, Monies DM, Alkuraya FS. Accelerating novel candidate gene discovery in neurogenetic disorders via whole-exome sequencing of prescreened multiplex consanguineous families. Cell Rep 2014; 10:148-61. [PMID: 25558065 DOI: 10.1016/j.celrep.2014.12.015] [Citation(s) in RCA: 307] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 11/19/2014] [Accepted: 12/08/2014] [Indexed: 02/02/2023] Open
Abstract
Our knowledge of disease genes in neurological disorders is incomplete. With the aim of closing this gap, we performed whole-exome sequencing on 143 multiplex consanguineous families in whom known disease genes had been excluded by autozygosity mapping and candidate gene analysis. This prescreening step led to the identification of 69 recessive genes not previously associated with disease, of which 33 are here described (SPDL1, TUBA3E, INO80, NID1, TSEN15, DMBX1, CLHC1, C12orf4, WDR93, ST7, MATN4, SEC24D, PCDHB4, PTPN23, TAF6, TBCK, FAM177A1, KIAA1109, MTSS1L, XIRP1, KCTD3, CHAF1B, ARV1, ISCA2, PTRH2, GEMIN4, MYOCD, PDPR, DPH1, NUP107, TMEM92, EPB41L4A, and FAM120AOS). We also encountered instances in which the phenotype departed significantly from the established clinical presentation of a known disease gene. Overall, a likely causal mutation was identified in >73% of our cases. This study contributes to the global effort toward a full compendium of disease genes affecting brain function.
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Affiliation(s)
- Anas M Alazami
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Nisha Patel
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Hanan E Shamseldin
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Shamsa Anazi
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Mohammed S Al-Dosari
- Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Fatema Alzahrani
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Hadia Hijazi
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Muneera Alshammari
- Department of Pediatrics, King Khalid University Hospital and College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mohammed A Aldahmesh
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Mustafa A Salih
- Department of Pediatrics, King Khalid University Hospital and College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | - Eissa Faqeih
- Department of Pediatrics, King Fahad Medical City, Riyadh 11525, Saudi Arabia
| | - Amal Alhashem
- Department of Anatomy and Cell Biology, College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia; Department of Pediatrics, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia
| | - Fahad A Bashiri
- Department of Pediatrics, King Khalid University Hospital and College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mohammed Al-Owain
- Department of Anatomy and Cell Biology, College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia; Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Amal Y Kentab
- Department of Pediatrics, King Khalid University Hospital and College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | - Sameera Sogaty
- Department of Pediatrics, King Fahad General Hospital, Jeddah 23325, Saudi Arabia
| | - Saeed Al Tala
- Department of Pediatrics, Armed Forces Hospital, Khamis Mushayt 62413, Saudi Arabia
| | - Mohamad-Hani Temsah
- Department of Pediatrics, King Khalid University Hospital and College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | - Maha Tulbah
- Department of Obstetrics & Gynecology, King Faisal Specialist Hospital, Riyadh 11211, Saudi Arabia
| | - Rasha F Aljelaify
- Center of Excellence for Genomics, King Abdulaziz City for Science and Technology, Riyadh 11442, Saudi Arabia
| | - Saad A Alshahwan
- Department of Pediatrics, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia
| | | | - Adnan A Alhadid
- Department of Pediatrics, King Khalid University Hospital and College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | - Hesham Aldhalaan
- Department of Neurosciences, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Fatema AlQallaf
- Department of Neurosciences, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Wesam Kurdi
- Department of Obstetrics & Gynecology, King Faisal Specialist Hospital, Riyadh 11211, Saudi Arabia
| | - Majid Alfadhel
- Division of Genetics, Department of Pediatrics, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh 14611, Saudi Arabia
| | - Zainab Babay
- Department of Obstetrics and Gynecology, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mohammad Alsogheer
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | - Namik Kaya
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Zuhair N Al-Hassnan
- Department of Anatomy and Cell Biology, College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia; Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Ghada M H Abdel-Salam
- Department of Clinical Genetics, Human Genetics and Genome Research Division, National Research Centre, Cairo 12345, Egypt
| | - Nouriya Al-Sannaa
- Department of Pediatrics, Johns Hopkins Aramco Healthcare, Dhahran 34465, Saudi Arabia
| | - Fuad Al Mutairi
- Division of Genetics, Department of Pediatrics, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh 14611, Saudi Arabia
| | - Heba Y El Khashab
- Department of Pediatrics, King Khalid University Hospital and College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; Department of Pediatrics, Children's Hospital, Ain Shams University, Cairo 01234, Egypt
| | - Saeed Bohlega
- Department of Neurosciences, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Xiaofei Jia
- Department of Molecular Biophysics and Biochemistry, Yale University, New Haven, CT 06520, USA
| | - Henry C Nguyen
- Department of Molecular Biophysics and Biochemistry, Yale University, New Haven, CT 06520, USA
| | - Rakad Hammami
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Nouran Adly
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Jawahir Y Mohamed
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Firdous Abdulwahab
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Niema Ibrahim
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Ewa A Naim
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 11442, Saudi Arabia
| | - Banan Al-Younes
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 11442, Saudi Arabia
| | - Brian F Meyer
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 11442, Saudi Arabia
| | - Mais Hashem
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Ranad Shaheen
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Yong Xiong
- Department of Molecular Biophysics and Biochemistry, Yale University, New Haven, CT 06520, USA
| | - Mohamed Abouelhoda
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 11442, Saudi Arabia
| | - Abdulrahman A Aldeeri
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia; Department of Internal Medicine, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | - Dorota M Monies
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 11442, Saudi Arabia
| | - Fowzan S Alkuraya
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia; Department of Anatomy and Cell Biology, College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia; Saudi Human Genome Program, King Abdulaziz City for Science and Technology, Riyadh 11442, Saudi Arabia.
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Bohlega S. Epidemiology of MS. Mult Scler Relat Disord 2014. [DOI: 10.1016/j.msard.2014.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Alroughani R, Aref H, Bohlega S, Sherooqi I, Dahdaleh M, Feki I, Jumah M, Al-Kawi M, Koussa S, Yamout B. Natalizumab treatment for multiple sclerosis: Middle East and North Africa regional recommendations for patient selection and monitoring. Mult Scler Relat Disord 2014. [DOI: 10.1016/j.msard.2014.09.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kalra S, Silman A, Akman-Demir G, Bohlega S, Bohrani-Haghighi A, Constantinescu C, Houman H, Mahr A, Salvarani C, Sfikakis PP, Siva A, Al-Araji A. INTERNATIONAL CONSENSUS PROJECT: NEURO-BEHCET DISEASE. J Neurol Neurosurg Psychiatry 2014. [DOI: 10.1136/jnnp-2014-309236.160] [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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Shehata HS, El-Tamawy MS, Mohieldin N, Edrees M, Bohlega S. Oromandibular dystonia in yemeni patients with khat chewing: a response to botulinum toxin treatment. Neurol Int 2014; 6:5385. [PMID: 24987506 PMCID: PMC4077212 DOI: 10.4081/ni.2014.5385] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 04/07/2014] [Indexed: 11/23/2022] Open
Abstract
Khat-(Catha edulis)related oromandibular dystonia is a difficult-to-treat subset of movement disorders that involve masticatory muscles with diverse and incapacitating manifestations. The aim of this study was to evaluate the efficacy of Botulinum toxin-type A therapy in khat chewer Yemeni patients with oromandibular dystonia. This prospective study included 18 khat-chewers Yemeni patients with refractory oromandibular dystonia, who were subjected to Botulinum toxin-A injection and followed up for 3 months thereafter. Primary efficacy outcome was the global impression scale, and secondary outcome measure was the Unified Dystonia Rating Scale. Patients showed improvement of both efficacy measures, maximum satisfactory responses were detected at the forth week after injection. No major adverse events were detected. Botulinum toxin-A is considered an effective and safe treatment option for refractory oromandibular dystonia in khat-chewers
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Affiliation(s)
| | | | | | | | - Saeed Bohlega
- Department of Neurosciences, King Faisal Specialist Hospital and Research Centre , Riyadh, Saudi Arabia
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Monies DM, Al-Hindi HN, Al-Muhaizea MA, Jaroudi DJ, Al-Younes B, Naim EA, Wakil SM, Meyer BF, Bohlega S. Clinical and pathological heterogeneity of a congenital disorder of glycosylation manifesting as a myasthenic/myopathic syndrome. Neuromuscul Disord 2014; 24:353-9. [DOI: 10.1016/j.nmd.2013.12.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Revised: 12/07/2013] [Accepted: 12/24/2013] [Indexed: 01/05/2023]
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Wakil SM, Ramzan K, Abuthuraya R, Hagos S, Al-Dossari H, Al-Omar R, Murad H, Chedrawi A, Al-Hassnan ZN, Finsterer J, Bohlega S. Infantile-onset ascending hereditary spastic paraplegia with bulbar involvement due to the novel ALS2 mutation c.2761C>T. Gene 2013; 536:217-20. [PMID: 24315819 DOI: 10.1016/j.gene.2013.11.043] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 11/14/2013] [Accepted: 11/18/2013] [Indexed: 11/17/2022]
Abstract
Recessive mutations in the alsin gene cause three clinically distinct motor neuron diseases: juvenile amyotrophic lateral sclerosis (ALS2), juvenile primary lateral sclerosis (JPLS) and infantile-onset ascending hereditary spastic paraplegia (IAHSP). A total of 23 different ALS2 mutations have been described for the three disorders so far. Most of these mutations result in a frameshift leading to a premature truncation of the alsin protein. We report the novel ALS2 truncating mutation c.2761C>T; p.R921X detected by homozygosity mapping and sequencing in two infants affected by IAHSP with bulbar involvement. The mutation c.2761C>T resides in the pleckstrin domain, a characteristic segment of guanine nucleotide exchange factors of the Rho GTPase family, which is involved in the overall neuronal development or maintenance. This study highlights the importance of using homozygosity mapping combined with candidate gene analysis to identify the underlying genetic defect as in this Saudi consanguineous family.
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Affiliation(s)
- Salma M Wakil
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
| | - Khushnooda Ramzan
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Rula Abuthuraya
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Samya Hagos
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Haya Al-Dossari
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Rana Al-Omar
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hatem Murad
- Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Aziza Chedrawi
- Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Zuhair N Al-Hassnan
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | | | - Saeed Bohlega
- Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Bohlega S, Inshasi J, Al Tahan AR, Madani AB, Qahtani H, Rieckmann P. Multiple sclerosis in the Arabian Gulf countries: a consensus statement. J Neurol 2013; 260:2959-63. [PMID: 23504049 PMCID: PMC3843364 DOI: 10.1007/s00415-013-6876-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 02/12/2013] [Accepted: 02/14/2013] [Indexed: 12/01/2022]
Abstract
The epidemiology of multiple sclerosis (MS) is rapidly changing in many parts of the world. Based on the Kurtzke classification, the Arabian Gulf Region is located in a low-risk zone for MS; however, recent studies suggest a moderate-to-high prevalence nearby (31-55 MS per 10,0000 individuals), with an increase in incidence in recent years. The relapsing-remitting disease course ratio is 2.5:1 versus the primary progressive type. In a geographic area that was previously associated with low prevalence; the recent high prevalence and fast rising incidence of MS in the gulf countries, encouraged the neurologists of this region to meet in a consensus panel, in order to share our latest findings in terms of MS epidemiology and consent on MS management in the Arabian Gulf. Therefore 20 key opinion leader neurologists and MS experts representing various countries of the Arabian Gulf have met in Dubai on the 2 and 3 February 2012, they shared their latest epidemiological findings, discussed recent MS aspects in the region, and consented on MS management relevantly to this geographic area.
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Affiliation(s)
- Saeed Bohlega
- King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia,
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Wakil SM, Monies DM, Ramzan K, Hagos S, Bastaki L, Meyer BF, Bohlega S. Novel B4GALNT1 mutations in a complicated form of hereditary spastic paraplegia. Clin Genet 2013; 86:500-1. [PMID: 24283893 DOI: 10.1111/cge.12312] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 10/31/2013] [Accepted: 11/04/2013] [Indexed: 11/26/2022]
Affiliation(s)
- S M Wakil
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Kalra S, Silman A, Akman-Demir G, Bohlega S, Borhani-Haghighi A, Constantinescu C, Houman H, Mahr A, Salvarani C, Sfikakis P, Siva A, Al-Araji A. Diagnosis and management of neuro-Behçet's disease: International consensus recommendations. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Yamout B, Alroughani R, Al-Jumah M, Khoury S, Abouzeid N, Dahdaleh M, Alsharoqi I, Inshasi J, Hashem S, Zakaria M, ElKallab K, Alsaadi T, Tawfeek T, Bohlega S. Consensus guidelines for the diagnosis and treatment of multiple sclerosis. Curr Med Res Opin 2013; 29:611-21. [PMID: 23514115 DOI: 10.1185/03007995.2013.787979] [Citation(s) in RCA: 18] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The diagnosis of multiple sclerosis (MS) is dependent on the presence of clinical and paraclinical evidence demonstrating dissemination of central nervous system lesions in both space and time, as well as the exclusion of other disorders. Diagnostic criteria were originally promulgated in 1965 by the Schumacher committee and modified subsequently by the Poser committee to include paraclinical evidence. The most recent criteria are the 2010 modifications of the 2001 McDonald criteria, which are focused on making an earlier diagnosis of MS. This article provides guidelines, derived from clinical experience as well as evidence-based medicine, for the diagnosis and management of MS with special emphasis on practices in the Middle East.
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Affiliation(s)
- B Yamout
- American University of Beirut Medical Center, Beirut, Lebanon.
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Abstract
OBJECTIVE Primary lateral sclerosis (PLS) is a motor neuron disorder that exclusively affects upper motor neurons leading to their degeneration. Mutations in the ALS2 gene encoding the protein Alsin have been described previously in the juvenile form of the disease. In this study, we identify mutation of the ERLIN2 gene in juvenile PLS patients and describe an in vitro model for loss of ERLIN2 function. METHODS Single nucleotide polymorphism arrays were used for homozygosity mapping. DNA sequencing of candidate genes was used to detect the underlying mutation. Level of ERLIN2 mRNA was measured by quantitative real time polymerase chain reaction. Knocking down ERLIN2 in NSC34 cells was accomplished by short-hairpin RNA interference. RESULTS We identified a splice junction mutation in the ERLIN2 gene-a component of the endoplasmic reticulum (ER) lipid rafts-that resulted in abnormal splicing of ERLIN2 transcript and nonsense-mediated decay of ERLIN2 mRNA. Knocking down ERLIN2 in NSC34 cells suppressed their growth in culture. INTERPRETATION Recently, we found that mutation of SIGMAR1, a component of ER lipid rafts, leads to juvenile amyotrophic lateral sclerosis. The identification of mutation in another component of the ER lipid rafts in juvenile PLS patients emphasizes their role in motor neuron function. Furthermore, the discovered effect of ERLIN2 loss on cell growth may advance understanding of the mechanism behind motor neuron degeneration in PLS.
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Affiliation(s)
- Amr Al-Saif
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
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Wakil SM, Bohlega S, Hagos S, Baz B, Al Dossari H, Ramzan K, Al-Hassnan ZN. A novel splice site mutation in ERLIN2 causes hereditary spastic paraplegia in a Saudi family. Eur J Med Genet 2012; 56:43-5. [PMID: 23085305 DOI: 10.1016/j.ejmg.2012.10.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2012] [Accepted: 10/10/2012] [Indexed: 01/19/2023]
Abstract
Hereditary Spastic Paraplegias (HSP) encompass a clinically and genetically heterogeneous group of neurodegenerative disorders characterized by insidiously progressive weakness and spasticity of the lower extremities. We describe a consanguineous Saudi family segregating a complicated form of HSP in an autosomal recessive pattern. The two affected siblings had early onset, cognitive, speech and motor involvement with spasticity of the lower extremities. Their upper extremities were mildly hypertonic. An intronic splice acceptor site mutation in ERLIN2 was found to be responsible for causing this disorder found in this family. ERLIN2 is a mediator of endoplasmic reticulum degradation pathway (ERAD) which helps to remove the aberrant proteins. Our results, in concurrence with previous studies suggest that alteration in ERLIN2 is one of the causes of complicated HSP, thereby increasing the spectrum of known mutations in SPG18.
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Affiliation(s)
- Salma M Wakil
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh 11211, Saudi Arabia.
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Fayolle G, Levick W, Lajiness-O'Neill R, Fastenau P, Briskin S, Bass N, Silva M, Critchfield E, Nakase-Richardson R, Hertza J, Loughan A, Perna R, Northington S, Boyd S, Anderson A, Peery S, Chafetz M, Maris M, Ramezani A, Sylvester C, Goldberg K, Constantinou M, Karekla M, Hall J, Edwards M, Balldin V, Strutt A, Pavlik V, Marquez de la Plata C, Cullum M, lacritz L, Reisch J, Massman P, Royall D, Barber R, Younes S, Wiechmann A, O'Bryant S, Patel K, Suhr J, Patel K, Suhr J, Chari S, Yokoyama J, Bettcher B, Karydas A, Miller B, Kramer J, Zec R, Fritz S, Kohlrus S, Robbs R, Ala T, Gifford K, Cantwell N, Romano R, Jefferson A, Holland A, Newton S, Bunting J, Coe M, Carmona J, Harrison D, Puente A, Terry D, Faraco C, Brown C, Patel A, Watts A, Kent A, Siegel J, Miller S, Ernst W, Chelune G, Holdnack J, Sheehan J, Duff K, Pedraza O, Crawford J, Terry D, Puente A, Brown C, Faraco C, Watts A, Patel A, Kent A, Siegel J, Miller L, Younes S, Hobson Balldin V, Benavides H, Johnson L, Hall J, Tshuma L, O'Bryant S, Dezhkam N, Hayes L, Love C, Stephens B, Webbe F, Allen C, Lemann E, Davis A, Pierson E, Lutz J, Piehl J, Holler K, Kavanaugh B, Tayim F, Llanes S, Mulligan K, Poston K, Riccio C, Beathard J, Cohen M, Stolberg P, Hart J, Jones W, Mayfield J, Allen D, Weller J, Dunham K, Demireva P, McInerney K, Suhr J, Dykstra J, Riddle T, Suhr J, Primus M, Riccio C, Highsmith J, Everhart D, Shadi S, Lehockey K, Sullivan S, Lucas M, Mandava S, Murphy B, Donovick P, Lalwani L, Rosselli M, Coad S, Carrasco R, Sofko C, Scarisbrick D, Golden C, Coad S, Zuckerman S, Golden C, Perna R, Loughan A, Hertza J, Brand J, Rivera Mindt M, Denney R, Schaffer S, Alper K, Devinsky O, Barr W, Langer K, Fraiman J, Scagliola J, Roman E, Martinez A, Cohen M, Dunham K, Riccio C, Martin P, Robbins J, Golden C, Axelrod B, Etherton J, Konopacki K, Moses J, Juliano A, Whiteside D, Rolin S, Widmann G, Franzwa M, Sokal B, Mark V, Doyle K, Morgan E, Weber E, Bondi M, Delano-Wood L, Grant I, Sibson J, Woods S, Andrews P, McGregor S, Golden C, Etherton J, Allen C, Cormier R, Cumley N, Elek M, Green M, Ogbeide S, Kruger A, Pacheco L, Robinson G, Welch H, Etherton J, Allen C, Cormier R, Cumley N, Kruger A, Pacheco L, Glover M, Parriott D, Jones W, Loe S, Hughes L, Natta L, Moses J, Vincent A, Roebuck-Spencer T, Bryan C, Padua M, Denney R, Moses J, Quenicka W, McGoldirck K, Bennett T, Soper H, Collier S, Connolly M, Hanratty A, Di Pinto M, Magnuson S, Dunham K, Handel E, Davidson K, Livers E, Frantz S, Allen J, Jerard T, Moses J, Pierce S, Sakhai S, Newton S, Warchol A, Holland A, Bunting J, Coe M, Carmona J, Harrison D, Barney S, Thaler N, Sutton G, Strauss G, Allen D, Hunter B, Bennett T, Quenicka W, McGoldrick K, Soper H, Sordahl J, Torrence N, John S, Gavett B, O'Bryant S, Shadi S, Denney R, Nichols C, Riccio C, Cohen M, Dennison A, Wasserman T, Schleicher-Dilks S, Adler M, Golden C, Olivier T, Schleicher-Dilks S, Golden C, LeMonda B, McGinley J, Pritchett A, Chang L, Cloak C, Cunningham E, Lohaugen G, Skranes J, Ernst T, Parke E, Thaler N, Etcoff L, Allen D, Andrews P, McGregor S, Golden C, Northington S, Daniels R, Loughan A, Perna R, Hertza J, Hochsztein N, Miles-Mason E, Granader Y, Vasserman M, MacAllister W, Casto B, Peery S, Patrick K, Hurewitz F, Chute D, Booth A, Koch C, Roid G, Balkema N, Kiefel J, Bell L, Maerlender A, Belkin T, Katzenstein J, Semerjian C, Culotta V, Band E, Yosick R, Burns T, Arenivas A, Bearden D, Olson K, Jacobson K, Ubogy S, Sterling C, Taub E, Griffin A, Rickards T, Uswatte G, Davis D, Sweeney K, Llorente A, Boettcher A, Hill B, Ploetz D, Kline J, Rohling M, O'Jile J, Holler K, Petrauskas V, Long J, Casey J, Long J, Petrauskas V, Duda T, Hodsman S, Casey J, Stricker S, Martner S, Hansen R, Ferraro F, Tangen R, Hanratty A, Tanabe M, O'Callaghan E, Houskamp B, McDonald L, Pick L, Guardino D, Pick L, Pietz T, Kayser K, Gray R, Letteri A, Crisologo A, Witkin G, Sanders J, Mrazik M, Harley A, Phoong M, Melville T, La D, Gomez R, Berthelson L, Robbins J, Lane E, Golden C, Rahman P, Konopka L, Fasfous A, Zink D, Peralta-Ramirez N, Perez-Garcia M, Puente A, Su S, Lin G, Kiely T, Gomez R, Schatzberg A, Keller J, Dykstra J, Suhr J, Feigon M, Renteria L, Fong M, Piper L, Lee E, Vordenberg J, Contardo C, Magnuson S, Doninger N, Luton L, Balkema N, Drane D, Phelan A, Stricker W, Poreh A, Wolkenberg F, Spira J, Lin G, Su S, Kiely T, Gomez R, Schatzberg A, Keller J, DeRight J, Jorgensen R, Fitzpatrick L, Crowe S, Woods S, Doyle K, Weber E, Cameron M, Cattie J, Cushman C, Grant I, Blackstone K, Woods S, Weber E, Grant I, Moore D, Roberg B, Somogie M, Thelen J, Lovelace C, Bruce J, Gerstenecker A, Mast B, Litvan I, Hargrave D, Schroeder R, Buddin W, Baade L, Heinrichs R, Thelen J, Roberg B, Somogie M, Lovelace C, Bruce J, Boseck J, Berry K, Koehn E, Davis A, Meyer B, Gelder B, Sussman Z, Espe-Pfeifer P, Musso M, Barker A, Jones G, Gouvier W, Weber E, Woods S, Grant I, Johnson V, Zaytsev L, Freier-Randall M, Sutton G, Thaler N, Ringdahl E, Allen D, Olsen J, Byrd D, Rivera-Mindt M, Fellows R, Morgello S, Wheaton V, Jaehnert S, Ellis C, Olavarria H, Loftis J, Huckans M, Pimental P, Frawley J, Welch M, Jennette K, Rinehardt E, Schoenberg M, Strober L, Genova H, Wylie G, DeLuca J, Chiaravalloti N, Hertza J, Loughan A, Perna R, Northington S, Boyd S, Hertza J, Loughan A, Perna R, Northington S, Boyd S, Ibrahim E, Seiam A, Ibrahim E, Bohlega S, Rinehardt E, Lloyd H, Goldberg M, Marceaux J, Fallows R, McCoy K, Yehyawi N, Luther E, Hilsabeck R, Fulton R, Stevens P, Erickson S, Dodzik P, Williams R, Dsurney J, Najafizadeh L, McGovern J, Chowdhry F, Acevedo A, Bakhtiar A, Karamzadeh N, Amyot F, Gandjbakhche A, Haddad M, Taub E, Johnson M, Wade J, Harper L, Rickards T, Sterling C, Barghi A, Uswatte G, Mark V, Balkema N, Christopher G, Marcus D, Spady M, Bloom J, Wiechmann A, Hall J, Loughan A, Perna R, Hertza J, Northington S, Zimmer A, Webbe F, Miller M, Schuster D, Ebner H, Mortimer B, Webbe F, Palmer G, Happe M, Paxson J, Jurek B, Graca J, Meyers J, Lange R, Brickell T, French L, Lange R, Iverson G, Shewchuk J, Madler B, Heran M, Brubacher J, Brickell T, Lange R, Ivins B, French L, Baldassarre M, Paper T, Herrold A, Chin A, Zgaljardic D, Oden K, Lambert M, Dickson S, Miller R, Plenger P, Jacobson K, Olson K, Sutherland E, Glatts C, Schatz P, Walker K, Philip N, McClaughlin S, Mooney S, Seats E, Carnell V, Raintree J, Brown D, Hodges C, Amerson E, Kennedy C, Moore J, Schatz P, Ferris C, Roebuck-Spencer T, Vincent A, Bryan C, Catalano D, Warren A, Monden K, Driver S, Chau P, Seegmiller R, Baker M, Malach S, Mintz J, Villarreal R, Peterson A, Leininger S, Strong C, Donders J, Merritt V, Vargas G, Rabinowitz A, Arnett P, Whipple E, Schultheis M, Robinson K, Iacovone D, Biester R, Alfano D, Nicholls M, Vargas G, Rabinowitz A, Arnett P, Rabinowitz A, Vargas G, Arnett P, Klas P, Jeffay E, Zakzanis K, Vandermeer M, Jeffay E, Zakzanis K, Womble M, Rohling M, Hill B, Corley E, Considine C, Fichtenberg N, Harrison J, Pollock M, Mouanoutoua A, Brimager A, Lebby P, Sullivan K, Edmed S, Silva M, Nakase-Richardson R, Critchfield E, Kieffer K, McCarthy M, Wiegand L, Lindsey H, Hernandez M, Puente A, Noniyeva Y, Lapis Y, Padua M, Poole J, Brooks B, McKay C, Mrazik M, Meeuwisse W, Emery C, Brooks B, Mazur-Mosiewicz A, Sherman E, Brooks B, Mazur-Mosiewicz A, Kirkwood M, Sherman E, Gunner J, Miele A, Silk-Eglit G, Lynch J, McCaffrey R, Stewart J, Tsou J, Scarisbrick D, Chan R, Bure-Reyes A, Cortes L, Gindy S, Golden C, Hunter B, Biddle C, Shah D, Jaberg P, Moss R, Horner M, VanKirk K, Dismuke C, Turner T, Muzzy W, Dunnam M, Miele A, Warner G, Donnelly K, Donnelly J, Kittleson J, Bradshaw C, Alt M, Margolis S, Ostroy E, Rolin S, Higgins K, Denney R, Rolin S, Eng K, Biddle C, Akeson S, Wall J, Davis J, Hansel J, Hill B, Rohling M, Wang B, Womble M, Gervais R, Greiffenstein M, Denning J, Denning J, Schroeder R, Buddin W, Hargrave D, VonDran E, Campbell E, Brockman C, Heinrichs R, Baade L, Buddin W, Hargrave D, Schroeder R, Teichner G, Waid R, Buddin W, Schroeder R, Teichner G, Waid R, Buican B, Armistead-Jehle P, Bailie J, Dilay A, Cottingham M, Boyd C, Asmussen S, Neff J, Schalk S, Jensen L, DenBoer J, Hall S, DenBoer J, Schalk S, Jensen L, Hall S, Miele A, Lynch J, McCaffrey R, Holcomb E, Axelrod B, Demakis G, Rimland C, Ward J, Ross M, Bailey M, Stubblefield A, Smigielski J, Geske J, Karpyak V, Reese C, Larrabee G, Suhr J, Silk-Eglit G, Gunner J, Miele A, Lynch J, McCaffrey R, Allen L, Celinski M, Gilman J, Davis J, Wall J, LaDuke C, DeMatteo D, Heilbrun K, Swirsky-Sacchetti T, Lindsey H, Puente A, Dedman A, Withers K, Chafetz M, Deneen T, Denney R, Fisher J, Spray B, Savage R, Wiener H, Tyer J, Ningaonkar V, Devlin B, Go R, Sharma V, Tsou J, Golden C, Fontanetta R, Calderon C, Coad S, Golden C, Calderon C, Fontaneta R, Coad S, Golden C, Ringdahl E, Thaler N, Sutton G, Vertinski M, Allen D, Verbiest R, Thaler N, Snyder J, Kinney J, Allen D, Rach A, Young J, Crouse E, Schretlen D, Weaver J, Buchholz A, Gordon B, Macciocchi S, Seel R, Godsall R, Brotsky J, DiRocco A, Houghton-Faryna E, Bolinger E, Hollenbeck C, Hart J, Thaler N, Vertinski M, Ringdahl E, Allen D, Lee B, Strauss G, Adams J, Martins D, Catalano L, Waltz J, Gold J, Haas G, Brown L, Luther J, Goldstein G, Kiely T, Kelley E, Lin G, Su S, Raba C, Gomez R, Trettin L, Solvason H, Schatzberg A, Keller J, Vertinski M, Thaler N, Allen D, Gold J, Buchanan R, Strauss G, Baldock D, Ringdahl E, Sutton G, Thaler N, Allen D, Fallows R, Marceaux J, McCoy K, Yehyawi N, Luther E, Hilsabeck R, Etherton J, Phelps T, Richmond S, Tapscott B, Thomlinson S, Cordeiro L, Wilkening G, Parikh M, Graham L, Grosch M, Hynan L, Weiner M, Cullum C, Hobson Balldin V, Menon C, Younes S, Hall J, Strutt A, Pavlik V, Marquez de la Plata C, Cullum M, Lacritz L, Reisch J, Massman P, Royall D, Barber R, O'Bryant S, Castro-Couch M, Irani F, Houshyarnejad A, Norman M, Peery S, Fonseca F, Bure-Reyes A, Browne B, Alvarez J, Jiminez Y, Baez V, Cortes L, Golden C, Fonseca F, Bure-Reyes A, Coad S, Alvarez J, Browne B, Baez V, Golden C, Resendiz C, Scott B, Farias G, York M, Lozano V, Mahoney M, Strutt A, Hernandez Mejia M, Puente A, Bure-Reyes A, Fonseca F, Baez V, Alvarez J, Browne B, Coad S, Jiminez Y, Cortes L, Golden C, Bure-Reyes A, Pacheco E, Homs A, Acevedo A, Ownby R, Nici J, Hom J, Lutz J, Dean R, Finch H, Pierce S, Moses J, Mann S, Feinberg J, Choi A, Kaminetskaya M, Pierce C, Zacharewicz M, Axelrod B, Gavett B, Horwitz J, Edwards M, O'Bryant S, Ory J, Gouvier W, Carbuccia K, Ory J, Carbuccia K, Gouvier W, Morra L, Garcon S, Lucas M, Donovick P, Whearty K, Campbell K, Camlic S, Donovick P, Edwards M, Balldin V, Hall J, Strutt A, Pavlik V, Marquez de la Plata C, Cullum C, Lacritz L, Reisch J, Massman P, Barber R, Royall D, Younes S, O'Bryant S, Brinckman D, Schultheis M, Ehrhart L, Weisser V, Medaglia J, Merzagora A, Reckess G, Ho T, Testa S, Gordon B, Schretlen D, Woolery H, Farcello C, Klimas N, Thaler N, Allen D, Meyer J, Vargas G, Rabinowitz A, Barwick F, Arnett P, Womble M, Rohling M, Hill B, Corley E, Drayer K, Rohling M, Ploetz D, Womble M, Hill B, Baldock D, Ringdahl E, Sutton G, Thaler N, Allen D, Galusha J, Schmitt A, Livingston R, Stewart R, Quarles L, Pagitt M, Barke C, Baker A, Baker N, Cook N, Ahern D, Correia S, Resnik L, Barnabe K, Gnepp D, Benjamin M, Zlatar Z, Garcia A, Harnish S, Crosson B, Rickards T, Mark V, Taub E, Sterling C, Vaughan L, Uswatte G, Fedio A, Sexton J, Cummings S, Logemann A, Lassiter N, Fedio P, Gremillion A, Nemeth D, Whittington T, Hansen R, Reckow J, Ferraro F, Lewandowski C, Cole J, Lewandowski A, Spector J, Ford-Johnson L, Lengenfelder J, Genova H, Sumowski J, DeLuca J, Chiaravalloti N, Loughan A, Perna R, Hertza J, Morse C, McKeever J, Zhao L, Leist T, Schultheis M, Marcinak J, Piecora K, Al-Khalil K, Webbe F, Mulligan K, Robbins J, Berthelson L, Martin P, Golden C, Piecora K, Marcinak J, Al-Khalil K, Webbe F, Mulligan K, Stewart J, Acevedo A, Ownby R, Thompson L, Kowalczyk W, Golub S, Davis A, Lemann E, Piehl J, Rita N, Moss L, Davis A, Boseck J, Berry K, Koehn E, Meyer B, Gelder B, Davis A, Nogin R, Moss L, Drapeau C, Malm S, Davis A, Lemann E, Koehn E, Drapeau C, Malm S, Boseck J, Armstrong L, Glidewell R, Orr W, Mears G. Grand Rounds. Arch Clin Neuropsychol 2012. [DOI: 10.1093/arclin/acs070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Al Tassan N, Khalil D, Shinwari J, Al Sharif L, Bavi P, Abduljaleel Z, Abu Dhaim N, Magrashi A, Bobis S, Ahmed H, Alahmed S, Bohlega S. A missense mutation in PIK3R5 gene in a family with ataxia and oculomotor apraxia. Hum Mutat 2011; 33:351-4. [PMID: 22065524 DOI: 10.1002/humu.21650] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Accepted: 10/24/2011] [Indexed: 01/23/2023]
Abstract
Autosomal recessive ataxias are heterogeneous group of disorders characterized by cerebellar atrophy and peripheral sensorimotor neuropathy. Molecular characterization of this group of disorders identified a number of genes contributing to these overlapping phenotypes. Ataxia with oculomotor apraxia type 2 (AOA2) is an autosomal recessive form of ataxia caused by mutations in the SETX gene. We report on a consanguineous family with autosomal recessive inheritance and clinical characteristics of AOA2, and no mutations in the SETX gene. We mapped the AOA locus in this family to chromosome 17p12-p13. Sequencing of all genes in the refined region identified a homozygous missense mutation in PIK3R5 that was absent in 477 normal controls. Our characterization of the PIK3R5 protein and findings suggest that it may play a role in the development of the cerebellum and vermis.
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Affiliation(s)
- Nada Al Tassan
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
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Al-Saif A, Al-Mohanna F, Bohlega S. A mutation in sigma-1 receptor causes juvenile amyotrophic lateral sclerosis. Ann Neurol 2011; 70:913-9. [PMID: 21842496 DOI: 10.1002/ana.22534] [Citation(s) in RCA: 327] [Impact Index Per Article: 25.2] [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: 05/18/2011] [Revised: 06/08/2011] [Accepted: 06/24/2011] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized by loss of motor neurons in the brain and spinal cord, leading to muscle weakness and eventually death from respiratory failure. ALS is familial in about 10% of cases, with SOD1 mutations accounting for 20% of familial cases. Here we describe a consanguineous family segregating juvenile ALS in an autosomal recessive pattern and describe the genetic variant responsible for the disorder. METHODS We performed homozygosity mapping and direct sequencing to detect the genetic variant and tested the effect of this variant on a motor neuron-like cell line model (NSC34) expressing the wild-type or mutant gene. RESULTS We identified a shared homozygosity region in affected individuals that spans ~120 kbp on chromosome 9p13.3 containing 9 RefSeq genes. Sequencing the SIGMAR1 gene revealed a mutation affecting a highly conserved amino acid located in the transmembrane domain of the encoded protein, sigma-1 receptor. The mutated protein showed an aberrant subcellular distribution in NSC34 cells. Furthermore, cells expressing the mutant protein were less resistant to apoptosis induced by endoplasmic reticulum stress. INTERPRETATION Sigma-1 receptors are known to have neuroprotective properties, and recently Sigmar1 knockout mice have been described to have motor deficiency. Our findings emphasize the role of sigma-1 receptors in motor neuron function and disease.
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Affiliation(s)
- Amr Al-Saif
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
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Abstract
Mutations in the NOTCH3 gene are responsible for cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), an adult onset hereditary angiopathy leading to ischemic stroke, vascular dementia and psychiatric disorders. All mutation of NOTCH3 described so far are striking stereotyped leading to the gain or loss of cystiene residue in a given epidermal growth factor (EGF), like repeat. We report an Arabic family affected with CADASIL mutation, G1790 C, in Exon 11 of the NOTCH3 gene. This is the first novel mutation reported in Arabic CADASIL patients. This finding confirms that mutations in NOTCH3 are associated with the pathogenesis of CADASIL across different ethnic background.
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Affiliation(s)
- Saeed Bohlega
- Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Bohlega S. Novel mutation of the NOTCH3 gene in Arabic family with CADASIL. Neurol Int 2011. [DOI: 10.4081/1931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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