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Laß J, Lüth T, Schlüter K, Schaake S, Laabs BH, Much C, Jamora RD, Rosales RL, Saranza G, Diesta CCE, Pearson CE, König IR, Brüggemann N, Klein C, Westenberger A, Trinh J. Stability of Mosaic Divergent Repeat Interruptions in X-Linked Dystonia-Parkinsonism. Mov Disord 2024; 39:1145-1153. [PMID: 38616406 DOI: 10.1002/mds.29809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/27/2024] [Accepted: 03/25/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND X-Linked dystonia-parkinsonism (XDP) is an adult-onset neurodegenerative disorder characterized by rapidly progressive dystonia and parkinsonism. Mosaic Divergent Repeat Interruptions affecting motif Length and Sequence (mDRILS) were recently found within the TAF1 SVA repeat tract and were shown to associate with repeat stability and age at onset in XDP, specifically the AGGG [5'-SINE-VNTR-Alu(AGAGGG)2AGGG(AGAGGG)n] mDRILS. OBJECTIVE This study aimed to investigate the stability of mDRILS frequencies and stability of (AGAGGG)n repeat length during transmission in parent-offspring pairs. METHODS Fifty-six families (n = 130) were investigated for generational transmission of repeat length and mDRILS. The mDRILS stability of 16 individuals was assessed at two sampling points 1 year apart. DNA was sequenced with long-read technologies after long-range polymerase chain reaction amplification of the TAF1 SVA. Repeat number and mDRILS were detected with Noise-Cancelling Repeat Finder (NCRF). RESULTS When comparing the repeat domain, 51 of 65 children had either contractions or expansions of the repeat length. The AGGG frequency remained stable across generations at 0.074 (IQR: 0.069-0.078) (z = -0.526; P = 0.599). However, the median AGGG frequency in children with an expansion (0.072 [IQR: 0.066-0.076]) was lower compared with children with retention or contraction (0.080 [IQR: 0.073-0.083]) (z = -0.007; P = 0.003). In a logistic regression model, the AGGG frequency predicted the outcome of either expansion or retention/contraction when including repeat number and sex as covariates (β = 80.7; z-score = 2.63; P = 0.0085). The AGGG frequency varied slightly over 1 year (0.070 [IQR: 0.063-0.080] to 0.073 [IQR: 0.069-0.078]). CONCLUSIONS Our results show that a higher AGGG frequency may stabilize repeats across generations. This highlights the importance of further investigating mDRILS as a disease-modifying factor with generational differences. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Joshua Laß
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Theresa Lüth
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | | | - Susen Schaake
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Björn-Hergen Laabs
- Institute of Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany
| | - Christoph Much
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Roland Dominic Jamora
- Department of Neurosciences, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Raymond L Rosales
- Department of Neurology and Psychiatry, University of Santo Tomas and the CNS-Metropolitan Medical Center, Manila, Philippines Section of Neurology, Manila, Philippines
| | - Gerard Saranza
- Department of Internal Medicine, Chong Hua Hospital, Cebu, Philippines
| | - Cid Czarina E Diesta
- Department of Neurosciences, Movement Disorders Clinic, Makati Medical Center, Makati City, Philippines
| | | | - Inke R König
- Institute of Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany
| | - Norbert Brüggemann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Ana Westenberger
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Joanne Trinh
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
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Shambetova C, Klein C. Genetic testing for non-parkinsonian movement disorders: Navigating the diagnostic maze. Parkinsonism Relat Disord 2024; 121:106033. [PMID: 38429185 DOI: 10.1016/j.parkreldis.2024.106033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/01/2024] [Accepted: 02/09/2024] [Indexed: 03/03/2024]
Abstract
Genetic testing has become a valuable diagnostic tool for movement disorders due to substantial advancements in understanding their genetic basis. However, the heterogeneity of movement disorders poses a significant challenge, with many genes implicated in different subtypes. This paper aims to provide a neurologist's perspective on approaching patients with hereditary hyperkinetic disorders with a focus on select forms of dystonia, paroxysmal dyskinesia, chorea, and ataxia. Age at onset, initial symptoms, and their severity, as well as the presence of any concurrent neurological and non-neurological features, contribute to the individual clinical profiles of hereditary non-parkinsonian movement disorders, aiding in the selection of appropriate genetic testing strategies. There are also more specific diagnostic clues that may facilitate the decision-making process and may be highly specific for certain conditions, such as diurnal fluctuations and l-dopa response in dopa-responsive dystonia, and triggering factors, duration and frequency of attacks in paroxysmal dyskinesia. While the genetic and mutational spectrum across non-parkinsonian movement disorders is broad, certain groups of diseases tend to be associated with specific types of pathogenic variants, such as repeat expansions in many of the ataxias. Some of these pathogenic variants cannot be detected by standard methods, such as panel or exome sequencing, but require the investigation of intronic regions for repeat expansions, such as Friedreich's or FGF14-linked ataxia. With our advancing knowledge of the genetic underpinnings of movement disorders, the incorporation of precise and personalized diagnostic strategies can enhance patient care, prognosis, and the application and development of targeted therapeutic interventions.
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Affiliation(s)
- Cholpon Shambetova
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany; Center for Continuing and Distance Learning, I. K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
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Menšíková K, Steele JC, Rosales R, Colosimo C, Spencer P, Lannuzel A, Ugawa Y, Sasaki R, Giménez-Roldán S, Matej R, Tuckova L, Hrabos D, Kolarikova K, Vodicka R, Vrtel R, Strnad M, Hlustik P, Otruba P, Prochazka M, Bares M, Boluda S, Buee L, Ransmayr G, Kaňovský P. Endemic parkinsonism: clusters, biology and clinical features. Nat Rev Neurol 2023; 19:599-616. [PMID: 37684518 DOI: 10.1038/s41582-023-00866-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 09/10/2023]
Abstract
The term 'endemic parkinsonism' refers to diseases that manifest with a dominant parkinsonian syndrome, which can be typical or atypical, and are present only in a particular geographically defined location or population. Ten phenotypes of endemic parkinsonism are currently known: three in the Western Pacific region; two in the Asian-Oceanic region; one in the Caribbean islands of Guadeloupe and Martinique; and four in Europe. Some of these disease entities seem to be disappearing over time and therefore are probably triggered by unique environmental factors. By contrast, other types persist because they are exclusively genetically determined. Given the geographical clustering and potential overlap in biological and clinical features of these exceptionally interesting diseases, this Review provides a historical reference text and offers current perspectives on each of the 10 phenotypes of endemic parkinsonism. Knowledge obtained from the study of these disease entities supports the hypothesis that both genetic and environmental factors contribute to the development of neurodegenerative diseases, not only in endemic parkinsonism but also in general. At the same time, this understanding suggests useful directions for further research in this area.
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Affiliation(s)
- Katerina Menšíková
- Department of Neurology and Clinical Neuroscience Center, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
- University Hospital, Olomouc, Czech Republic
| | | | - Raymond Rosales
- Research Center for Health Sciences, Faculty of Medicine and Surgery, University of Santo Tomás, Manila, The Philippines
- St Luke's Institute of Neuroscience, Metro, Manila, The Philippines
| | - Carlo Colosimo
- Department of Neurology, Santa Maria University Hospital, Terni, Italy
| | - Peter Spencer
- Department of Neurology, School of Medicine, Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Annie Lannuzel
- Départment de Neurologie, Centre Hospitalier Universitaire de la Guadeloupe, Pointe-á-Pitre, France
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, Fukushima Medical University, Fukushima, Japan
| | - Ryogen Sasaki
- Department of Neurology, Kuwana City Medical Center, Kuwana, Japan
| | | | - Radoslav Matej
- Department of Pathology, 3rd Medical Faculty, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic
- Department of Pathology and Molecular Medicine, 3rd Medical Faculty, Charles University and Thomayer University Hospital, Prague, Czech Republic
| | - Lucie Tuckova
- University Hospital, Olomouc, Czech Republic
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Dominik Hrabos
- University Hospital, Olomouc, Czech Republic
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Kristyna Kolarikova
- University Hospital, Olomouc, Czech Republic
- Department of Clinical and Molecular Genetics, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Radek Vodicka
- University Hospital, Olomouc, Czech Republic
- Department of Clinical and Molecular Genetics, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Radek Vrtel
- University Hospital, Olomouc, Czech Republic
- Department of Clinical and Molecular Genetics, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Miroslav Strnad
- Department of Neurology and Clinical Neuroscience Center, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
- University Hospital, Olomouc, Czech Republic
- Laboratory of Growth Regulators, Faculty of Science, Palacky University, Olomouc, Czech Republic
| | - Petr Hlustik
- Department of Neurology and Clinical Neuroscience Center, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
- University Hospital, Olomouc, Czech Republic
| | - Pavel Otruba
- Department of Neurology and Clinical Neuroscience Center, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
- University Hospital, Olomouc, Czech Republic
| | - Martin Prochazka
- University Hospital, Olomouc, Czech Republic
- Department of Clinical and Molecular Genetics, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Martin Bares
- First Department of Neurology, Masaryk University Medical School, Brno, Czech Republic
- St Anne University Hospital, Brno, Czech Republic
| | - Susana Boluda
- Département de Neuropathologie, Hôpital La Pitié - Salpêtrière, Paris, France
| | - Luc Buee
- Lille Neuroscience & Cognition Research Centre, INSERM U1172, Lille, France
| | - Gerhard Ransmayr
- Department of Neurology, Faculty of Medicine, Johannes Kepler University, Linz, Austria
| | - Petr Kaňovský
- Department of Neurology and Clinical Neuroscience Center, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic.
- University Hospital, Olomouc, Czech Republic.
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Jamora RDG, Khu KJO, Sy MCC, Pascual JSG, Legaspi GD, Aguilar JA. Transcranial magnetic resonance-guided focused ultrasound pallidothalamic tractotomy for patients with X-linked dystonia-parkinsonism: a study protocol. BMC Neurol 2023; 23:306. [PMID: 37596524 PMCID: PMC10436542 DOI: 10.1186/s12883-023-03344-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 07/25/2023] [Indexed: 08/20/2023] Open
Abstract
Transcranial magnetic resonance-guided focused ultrasound (MRgFUS) is a noninvasive method for controlling tremor and has recently been used in patients with X-linked dystonia-parkinsonism (XDP). This study aims to determine the improvement in dystonia and parkinsonism in patients with XDP after MRgFUS pallidothalamic tractotomy. This prospective study will be conducted at the Philippine General Hospital, University of the Philippines Manila. The primary outcome measure is the change in the pre- and post-treatment XDP-Movement Disorder Society of the Philippines Scale scores. In addition, demographic and clinical data will be collected, including the Burke-Fahn-Marsden Dystonia Rating Scale, Part III of the Movement Disorder Society-Unified Parkinson's disease Rating Scale score, XDP clinical and functional stage, the five-level EuroQol five-dimensional questionnaire, Montreal Cognitive Assessment scores, MRgFUS treatment parameters, and adverse events. Patients will be assessed within 24 hours of treatment, then at 2 weeks, 3 months, 6 months, 9 months, and 12 months post-treatment. This protocol was approved by the University of the Philippines Manila Research Ethics Board (UPMREB 2022-0271-01). Data collection began in January 2023. This protocol has been registered with ClinicalTrials.gov: Trial Registration number: NCT05592028.
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Affiliation(s)
- Roland Dominic G Jamora
- Division of Adult Neurology, Department of Neurosciences, College of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
| | - Kathleen Joy O Khu
- Division of Neurosurgery, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Marie Charmaine C Sy
- Division of Adult Neurology, Department of Neurosciences, College of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Juan Silvestre G Pascual
- Division of Neurosurgery, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Gerardo D Legaspi
- Division of Neurosurgery, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Jose A Aguilar
- Division of Neurosurgery, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
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X-linked dystonia parkinsonism: epidemiology, genetics, clinical features, diagnosis, and treatment. Acta Neurol Belg 2023; 123:45-55. [PMID: 36418540 DOI: 10.1007/s13760-022-02144-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022]
Abstract
X-linked dystonia parkinsonism (XDP) is a rare X-linked recessive degenerative movement disorder that only affects Filipino descent, predominantly males. Its underlying cause is associated with the genetic alterations in the TAF1/DYT3 multiple transcription system. SINE-VNTR-Alu (SVA) retrotransposon insertion was suggested to be the responsible genetic mutation. Clinically, it initially presents as focal dystonia and generalizes within years. Parkinsonism arises years later and coexists with dystonia. Nonmotor symptoms like cognitive impairment and mood disorders are also common among XDP patients. XDP diagnosis relies on clinical history and physical examination. On imaging, abnormalities of the striatum, such as atrophy, are widely seen and can explain the clinical presentations with a three-model pathway of the striatum. Treatments aim for symptomatic relief of dystonia and parkinsonism and to prevent complications. Oral medications, chemo-denervation, and surgery are used in XDP patients. This review summarizes the currently important information regarding XDP, providing a synoptic overview and understanding of XDP for future studies.
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Pozojevic J, von Holt BH, Westenberger A. Factors influencing reduced penetrance and variable expressivity in X-linked dystonia-parkinsonism. MED GENET-BERLIN 2022; 34:97-102. [PMID: 38835911 PMCID: PMC11007627 DOI: 10.1515/medgen-2022-2135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
X-linked dystonia-parkinsonism (XDP) is a neurodegenerative movement disorder that primarily affects adult Filipino men. It is caused by a founder retrotransposon insertion in TAF1 that contains a hexanucleotide repeat, the number of which differs among the patients and correlates with the age at disease onset (AAO) and other clinical parameters. A recent work has identified additional genetic modifiers of age-associated penetrance in XDP, bringing to light the DNA mismatch repair genes MSH3 and PMS2. Despite X-linked recessive inheritance, a minor subset of patients are female, manifesting the disease via various mechanisms such as homozygosity, imbalanced X-chromosome inactivation, or aneuploidy. Here, we summarize and discuss clinical and genetic aspects of XDP, with a focus on variable disease expressivity as a consequence of subtle genetic differences within a seemingly homogenous population of patients.
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Affiliation(s)
- Jelena Pozojevic
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, BMF, Building 67; Ratzeburger Allee 160, 23538 Lübeck, Germany
- Institute of Human Genetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Björn-Hergen von Holt
- Institute of Medical Biometry and Statistics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Ana Westenberger
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, BMF, Building 67; Ratzeburger Allee 160, 23538 Lübeck, Germany
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Zeng Q, Pan H, Zhao Y, Wang Y, Xu Q, Tan J, Yan X, Li J, Tang B, Guo J. Association Study of TAF1 Variants in Parkinson’s Disease. Front Neurosci 2022; 16:846095. [PMID: 35464305 PMCID: PMC9024305 DOI: 10.3389/fnins.2022.846095] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/15/2022] [Indexed: 11/24/2022] Open
Abstract
Increasing evidence reveals sex as an important factor in the development of Parkinson’s disease (PD), but associations between genes on the sex chromosomes and PD remain unknown. TAF1 is a gene located on the X chromosome which is known to cause X-linked syndromic mental retardation-33 (MRXS33) and X-linked Dystonia-Parkinsonism (XDP). In this study, we conducted whole-exome sequencing (WES) among 1,917 patients with early-onset or familial PD and 1,652 controls in a Chinese population. We detected a hemizygous frameshift variant c.29_53dupGGA(CAG)2CTACCATCA(CTG)2C (p.A19Dfs*50) in two unrelated male patients. Further segregation analysis showed an unaffected family member carried this variant, which suggested the penetrance of the variant may be age-related and incomplete. To verify the effects of TAF1 on PD, genetic analyses were carried separately by gender. Analysis of rare variants by optimal sequence kernel association (SKAT-O) test showed a nominally significant difference in variant burden between the male PD patients and controls (2.01 vs. 1.38%, p = 0.027). In the female group, none of the variant types showed significant association with PD in this study. In conclusion, we found rare variants in TAF1 may be implicated in PD, but further genetic and functional analyses were needed.
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Affiliation(s)
- Qian Zeng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Hongxu Pan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yuwen Zhao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yige Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Qian Xu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Jieqiong Tan
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
| | - Xinxiang Yan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Jinchen Li
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Centre for Medical Genetics, Central South University, Changsha, China
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Beisha Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Centre for Medical Genetics, Central South University, Changsha, China
| | - Jifeng Guo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Centre for Medical Genetics, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- *Correspondence: Jifeng Guo,
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Monogenic Parkinson’s Disease: Genotype, Phenotype, Pathophysiology, and Genetic Testing. Genes (Basel) 2022; 13:genes13030471. [PMID: 35328025 PMCID: PMC8950888 DOI: 10.3390/genes13030471] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/24/2022] [Accepted: 03/02/2022] [Indexed: 02/07/2023] Open
Abstract
Parkinson’s disease may be caused by a single pathogenic variant (monogenic) in 5–10% of cases, but investigation of these disorders provides valuable pathophysiological insights. In this review, we discuss each genetic form with a focus on genotype, phenotype, pathophysiology, and the geographic and ethnic distribution. Well-established Parkinson’s disease genes include autosomal dominant forms (SNCA, LRRK2, and VPS35) and autosomal recessive forms (PRKN, PINK1 and DJ1). Furthermore, mutations in the GBA gene are a key risk factor for Parkinson’s disease, and there have been major developments for X-linked dystonia parkinsonism. Moreover, atypical or complex parkinsonism may be due to mutations in genes such as ATP13A2, DCTN1, DNAJC6, FBXO7, PLA2G6, and SYNJ1. Furthermore, numerous genes have recently been implicated in Parkinson’s disease, such as CHCHD2, LRP10, TMEM230, UQCRC1, and VPS13C. Additionally, we discuss the role of heterozygous mutations in autosomal recessive genes, the effect of having mutations in two Parkinson’s disease genes, the outcome of deep brain stimulation, and the role of genetic testing. We highlight that monogenic Parkinson’s disease is influenced by ethnicity and geographical differences, reinforcing the need for global efforts to pool large numbers of patients and identify novel candidate genes.
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Pozojevic J, Algodon SM, Cruz JN, Trinh J, Brüggemann N, Laß J, Grütz K, Schaake S, Tse R, Yumiceba V, Kruse N, Schulz K, Sreenivasan VKA, Rosales RL, Jamora RDG, Diesta CCE, Matschke J, Glatzel M, Seibler P, Händler K, Rakovic A, Kirchner H, Spielmann M, Kaiser FJ, Klein C, Westenberger A. Transcriptional Alterations in X-Linked Dystonia–Parkinsonism Caused by the SVA Retrotransposon. Int J Mol Sci 2022; 23:ijms23042231. [PMID: 35216353 PMCID: PMC8875906 DOI: 10.3390/ijms23042231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/09/2022] [Accepted: 02/14/2022] [Indexed: 02/05/2023] Open
Abstract
X-linked dystonia–parkinsonism (XDP) is a severe neurodegenerative disorder that manifests as adult-onset dystonia combined with parkinsonism. A SINE-VNTR-Alu (SVA) retrotransposon inserted in an intron of the TAF1 gene reduces its expression and alters splicing in XDP patient-derived cells. As a consequence, increased levels of the TAF1 intron retention transcript TAF1-32i can be found in XDP cells as compared to healthy controls. Here, we investigate the sequence of the deep intronic region included in this transcript and show that it is also present in cells from healthy individuals, albeit in lower amounts than in XDP cells, and that it undergoes degradation by nonsense-mediated mRNA decay. Furthermore, we investigate epigenetic marks (e.g., DNA methylation and histone modifications) present in this intronic region and the spanning sequence. Finally, we show that the SVA evinces regulatory potential, as demonstrated by its ability to repress the TAF1 promoter in vitro. Our results enable a better understanding of the disease mechanisms underlying XDP and transcriptional alterations caused by SVA retrotransposons.
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Affiliation(s)
- Jelena Pozojevic
- Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany; (J.P.); (S.M.A.); (J.N.C.); (J.T.); (N.B.); (J.L.); (K.G.); (S.S.); (R.T.); (P.S.); (A.R.)
- Institute of Human Genetics, University of Lübeck, 23538 Lübeck, Germany; (V.Y.); (N.K.); (K.S.); (V.K.A.S.); (K.H.); (H.K.); (M.S.)
| | - Shela Marie Algodon
- Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany; (J.P.); (S.M.A.); (J.N.C.); (J.T.); (N.B.); (J.L.); (K.G.); (S.S.); (R.T.); (P.S.); (A.R.)
| | - Joseph Neos Cruz
- Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany; (J.P.); (S.M.A.); (J.N.C.); (J.T.); (N.B.); (J.L.); (K.G.); (S.S.); (R.T.); (P.S.); (A.R.)
| | - Joanne Trinh
- Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany; (J.P.); (S.M.A.); (J.N.C.); (J.T.); (N.B.); (J.L.); (K.G.); (S.S.); (R.T.); (P.S.); (A.R.)
| | - Norbert Brüggemann
- Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany; (J.P.); (S.M.A.); (J.N.C.); (J.T.); (N.B.); (J.L.); (K.G.); (S.S.); (R.T.); (P.S.); (A.R.)
- Department of Neurology, University Hospital Schleswig Holstein, 23538 Lübeck, Germany
| | - Joshua Laß
- Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany; (J.P.); (S.M.A.); (J.N.C.); (J.T.); (N.B.); (J.L.); (K.G.); (S.S.); (R.T.); (P.S.); (A.R.)
| | - Karen Grütz
- Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany; (J.P.); (S.M.A.); (J.N.C.); (J.T.); (N.B.); (J.L.); (K.G.); (S.S.); (R.T.); (P.S.); (A.R.)
| | - Susen Schaake
- Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany; (J.P.); (S.M.A.); (J.N.C.); (J.T.); (N.B.); (J.L.); (K.G.); (S.S.); (R.T.); (P.S.); (A.R.)
| | - Ronnie Tse
- Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany; (J.P.); (S.M.A.); (J.N.C.); (J.T.); (N.B.); (J.L.); (K.G.); (S.S.); (R.T.); (P.S.); (A.R.)
| | - Veronica Yumiceba
- Institute of Human Genetics, University of Lübeck, 23538 Lübeck, Germany; (V.Y.); (N.K.); (K.S.); (V.K.A.S.); (K.H.); (H.K.); (M.S.)
| | - Nathalie Kruse
- Institute of Human Genetics, University of Lübeck, 23538 Lübeck, Germany; (V.Y.); (N.K.); (K.S.); (V.K.A.S.); (K.H.); (H.K.); (M.S.)
| | - Kristin Schulz
- Institute of Human Genetics, University of Lübeck, 23538 Lübeck, Germany; (V.Y.); (N.K.); (K.S.); (V.K.A.S.); (K.H.); (H.K.); (M.S.)
| | - Varun K. A. Sreenivasan
- Institute of Human Genetics, University of Lübeck, 23538 Lübeck, Germany; (V.Y.); (N.K.); (K.S.); (V.K.A.S.); (K.H.); (H.K.); (M.S.)
| | - Raymond L. Rosales
- The Hospital Neuroscience Institute, Department of Neurology and Psychiatry and The FMS-Research Center for Health Sciences, University of Santo Tomas, Manila 1008, Philippines;
| | - Roland Dominic G. Jamora
- Department of Neurosciences, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines;
| | - Cid Czarina E. Diesta
- Department of Neurosciences, Movement Disorders Clinic, Makati Medical Center, Makati City 1229, Philippines;
| | - Jakob Matschke
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.M.); (M.G.)
| | - Markus Glatzel
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.M.); (M.G.)
| | - Philip Seibler
- Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany; (J.P.); (S.M.A.); (J.N.C.); (J.T.); (N.B.); (J.L.); (K.G.); (S.S.); (R.T.); (P.S.); (A.R.)
| | - Kristian Händler
- Institute of Human Genetics, University of Lübeck, 23538 Lübeck, Germany; (V.Y.); (N.K.); (K.S.); (V.K.A.S.); (K.H.); (H.K.); (M.S.)
| | - Aleksandar Rakovic
- Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany; (J.P.); (S.M.A.); (J.N.C.); (J.T.); (N.B.); (J.L.); (K.G.); (S.S.); (R.T.); (P.S.); (A.R.)
| | - Henriette Kirchner
- Institute of Human Genetics, University of Lübeck, 23538 Lübeck, Germany; (V.Y.); (N.K.); (K.S.); (V.K.A.S.); (K.H.); (H.K.); (M.S.)
| | - Malte Spielmann
- Institute of Human Genetics, University of Lübeck, 23538 Lübeck, Germany; (V.Y.); (N.K.); (K.S.); (V.K.A.S.); (K.H.); (H.K.); (M.S.)
- Human Molecular Genomics Group, Max Planck Institute for Molecular Genetics, 14195 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Lübeck/Kiel, 23538 Lübeck, Germany
| | - Frank J. Kaiser
- Institut für Humangenetik, Universitätsklinikum Essen, Universität Duisburg-Essen, 45147 Essen, Germany;
- Essener Zentrum für Seltene Erkrankungen, Universitätsmedizin Essen, 45147 Essen, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany; (J.P.); (S.M.A.); (J.N.C.); (J.T.); (N.B.); (J.L.); (K.G.); (S.S.); (R.T.); (P.S.); (A.R.)
- Correspondence: (C.K.); (A.W.)
| | - Ana Westenberger
- Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany; (J.P.); (S.M.A.); (J.N.C.); (J.T.); (N.B.); (J.L.); (K.G.); (S.S.); (R.T.); (P.S.); (A.R.)
- Correspondence: (C.K.); (A.W.)
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Lüth T, Laβ J, Schaake S, Wohlers I, Pozojevic J, Jamora RDG, Rosales RL, Brüggemann N, Saranza G, Diesta CCE, Schlüter K, Tse R, Reyes CJ, Brand M, Busch H, Klein C, Westenberger A, Trinh J. Elucidating Hexanucleotide Repeat Number and Methylation within the X-Linked Dystonia-Parkinsonism (XDP)-Related SVA Retrotransposon in TAF1 with Nanopore Sequencing. Genes (Basel) 2022; 13:genes13010126. [PMID: 35052466 PMCID: PMC8775018 DOI: 10.3390/genes13010126] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 12/13/2022] Open
Abstract
Background: X-linked dystonia-parkinsonism (XDP) is an adult-onset neurodegenerative disorder characterized by progressive dystonia and parkinsonism. It is caused by a SINE-VNTR-Alu (SVA) retrotransposon insertion in the TAF1 gene with a polymorphic (CCCTCT)n domain that acts as a genetic modifier of disease onset and expressivity. Methods: Herein, we used Nanopore sequencing to investigate SVA genetic variability and methylation. We used blood-derived DNA from 96 XDP patients for amplicon-based deep Nanopore sequencing and validated it with fragment analysis which was performed using fluorescence-based PCR. To detect methylation from blood- and brain-derived DNA, we used a Cas9-targeted approach. Results: High concordance was observed for hexanucleotide repeat numbers detected with Nanopore sequencing and fragment analysis. Within the SVA locus, there was no difference in genetic variability other than variations of the repeat motif between patients. We detected high CpG methylation frequency (MF) of the SVA and flanking regions (mean MF = 0.94, SD = ±0.12). Our preliminary results suggest only subtle differences between the XDP patient and the control in predicted enhancer sites directly flanking the SVA locus. Conclusions: Nanopore sequencing can reliably detect SVA hexanucleotide repeat numbers, methylation and, lastly, variation in the repeat motif.
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Affiliation(s)
- Theresa Lüth
- Institute of Neurogenetics, University of Luebeck, 23538 Luebeck, Germany; (T.L.); (J.L.); (S.S.); (J.P.); (N.B.); (K.S.); (R.T.); (C.J.R.); (M.B.); (C.K.); (A.W.)
| | - Joshua Laβ
- Institute of Neurogenetics, University of Luebeck, 23538 Luebeck, Germany; (T.L.); (J.L.); (S.S.); (J.P.); (N.B.); (K.S.); (R.T.); (C.J.R.); (M.B.); (C.K.); (A.W.)
| | - Susen Schaake
- Institute of Neurogenetics, University of Luebeck, 23538 Luebeck, Germany; (T.L.); (J.L.); (S.S.); (J.P.); (N.B.); (K.S.); (R.T.); (C.J.R.); (M.B.); (C.K.); (A.W.)
| | - Inken Wohlers
- Medical Systems Biology Division, Luebeck Institute of Experimental Dermatology, University of Luebeck, 23538 Luebeck, Germany; (I.W.); (H.B.)
- Institute for Cardiogenetics, University of Luebeck, 23538 Luebeck, Germany
| | - Jelena Pozojevic
- Institute of Neurogenetics, University of Luebeck, 23538 Luebeck, Germany; (T.L.); (J.L.); (S.S.); (J.P.); (N.B.); (K.S.); (R.T.); (C.J.R.); (M.B.); (C.K.); (A.W.)
| | - Roland Dominic G. Jamora
- Department of Neurosciences, College of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines;
| | - Raymond L. Rosales
- Department of Neurology and Psychiatry, The Hospital Neuroscience Institute, University of Santo Tomas, Manila 1008, Philippines;
| | - Norbert Brüggemann
- Institute of Neurogenetics, University of Luebeck, 23538 Luebeck, Germany; (T.L.); (J.L.); (S.S.); (J.P.); (N.B.); (K.S.); (R.T.); (C.J.R.); (M.B.); (C.K.); (A.W.)
- Department of Neurology, University of Luebeck, 23538 Luebeck, Germany
| | - Gerard Saranza
- Section of Neurology, Department of Internal Medicine, Chong Hua Hospital, Cebu City 6000, Philippines;
| | - Cid Czarina E. Diesta
- Department of Neurosciences, Movement Disorders Clinic, Makati Medical Center, Makati 1229, Philippines;
| | - Kathleen Schlüter
- Institute of Neurogenetics, University of Luebeck, 23538 Luebeck, Germany; (T.L.); (J.L.); (S.S.); (J.P.); (N.B.); (K.S.); (R.T.); (C.J.R.); (M.B.); (C.K.); (A.W.)
| | - Ronnie Tse
- Institute of Neurogenetics, University of Luebeck, 23538 Luebeck, Germany; (T.L.); (J.L.); (S.S.); (J.P.); (N.B.); (K.S.); (R.T.); (C.J.R.); (M.B.); (C.K.); (A.W.)
| | - Charles Jourdan Reyes
- Institute of Neurogenetics, University of Luebeck, 23538 Luebeck, Germany; (T.L.); (J.L.); (S.S.); (J.P.); (N.B.); (K.S.); (R.T.); (C.J.R.); (M.B.); (C.K.); (A.W.)
| | - Max Brand
- Institute of Neurogenetics, University of Luebeck, 23538 Luebeck, Germany; (T.L.); (J.L.); (S.S.); (J.P.); (N.B.); (K.S.); (R.T.); (C.J.R.); (M.B.); (C.K.); (A.W.)
| | - Hauke Busch
- Medical Systems Biology Division, Luebeck Institute of Experimental Dermatology, University of Luebeck, 23538 Luebeck, Germany; (I.W.); (H.B.)
- Institute for Cardiogenetics, University of Luebeck, 23538 Luebeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Luebeck, 23538 Luebeck, Germany; (T.L.); (J.L.); (S.S.); (J.P.); (N.B.); (K.S.); (R.T.); (C.J.R.); (M.B.); (C.K.); (A.W.)
| | - Ana Westenberger
- Institute of Neurogenetics, University of Luebeck, 23538 Luebeck, Germany; (T.L.); (J.L.); (S.S.); (J.P.); (N.B.); (K.S.); (R.T.); (C.J.R.); (M.B.); (C.K.); (A.W.)
| | - Joanne Trinh
- Institute of Neurogenetics, University of Luebeck, 23538 Luebeck, Germany; (T.L.); (J.L.); (S.S.); (J.P.); (N.B.); (K.S.); (R.T.); (C.J.R.); (M.B.); (C.K.); (A.W.)
- Correspondence:
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11
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Santiano RAS, Rosales RL. A Cross-Cultural Validation of the Filipino and Hiligaynon Versions of the Parts IIIB (Non-Motor Features) and IV (Activities of Daily Living) of the X-Linked Dystonia-Parkinsonism- MDSP Rating Scale. Clin Park Relat Disord 2022; 5:100100. [PMID: 34988424 PMCID: PMC8710412 DOI: 10.1016/j.prdoa.2021.100100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/30/2021] [Accepted: 06/05/2021] [Indexed: 01/20/2023] Open
Abstract
Introduction X-linked dystonia-parkinsonism (XDP) is a progressive movement disorder which also encompasses non-motor features and alterations in activities of daily living. The study aims to translate the Parts IIIB (Non-Motor Features) and IV (Activities of Daily Living) of the XDP-Movement Disorder Society of Philippines Rating Scale to Filipino and Hiligaynon and subsequently validate these versions, which are more understandable to the natives given that XDP originated from the Panay Islands in the Philippines. Methods This is a cross-cultural, cross-sectional validation study, composed of the following steps: forward translation, backward translation, panel reconciliation, pretesting, and field testing. Two sets of 10 XDP patients were recruited to the Filipino and Hiligaynon groups for pretesting and cognitive debriefing while another 2 sets of 50 XDP patients were assigned for field testing. Results The Filipino version had a good internal consistency with a Cronbach's alpha of 0.951 during the pretesting and 0.886 during the field testing. Similar results were seen in the Hiligaynon version (0.837; 0.900). Both also had good conceptual equivalence as demonstrated by significant Pearson r values of 0.384 to 0.814 for the Filipino and 0.355 to 0.800 for the Hiligaynon versions. Conclusion The Filipino and Hiligaynon versions of the Parts IIIB and IV of the XDP-MDSP scale are internally valid and reliable. These scales are considered acceptable to assess the severity of the non-motor features and difficulties in activities of daily living among XDP patients.
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Affiliation(s)
- Richelle Ann S Santiano
- Department of Neurology and Psychiatry, University of Santo Tomas Hospital, Espana, Manila, Philippines
| | - Raymond L Rosales
- The Neuroscience Institute, Department of Neurology and Psychiatry, University of Santo Tomas Hospital, Espana, Manila, Philippines.,Department of Neuroscience and Behavioral Medicine, Faculty of Medicine and Surgery, University of Santo Tomas, Espana, Manila, Philippines.,Movement Disorders Service and Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Philippines.,Collaborative Center for X-Linked Dystonia-Parkinsonism, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
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12
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Pozojevic J, Cruz JN, Westenberger A. X-linked dystonia-parkinsonism: over and above a repeat disorder. MED GENET-BERLIN 2021; 33:319-324. [PMID: 38835428 PMCID: PMC11006257 DOI: 10.1515/medgen-2021-2105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/24/2021] [Indexed: 06/06/2024]
Abstract
X-linked dystonia-parkinsonism (XDP) is an adult-onset neurodegenerative movement disorder, caused by a founder retrotransposon insertion in an intron of the TAF1 gene. This insertion contains a polymorphic hexanucleotide repeat (CCCTCT)n, the length of which inversely correlates with the age at disease onset (AAO) and other clinical parameters, aligning XDP with repeat expansion disorders. Nevertheless, many other pathogenic mechanisms are conceivably at play in XDP, indicating that in contrast to other repeat disorders, the (CCCTCT)n repeat may not be the actual (or only) disease cause. Here, we summarize and discuss genetic and molecular aspects of XDP, highlighting the role of the hexanucleotide repeat in age-related disease penetrance and expressivity.
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Affiliation(s)
- Jelena Pozojevic
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Institute of Human Genetics, University of Lübeck, Lübeck, Germany
| | - Joseph Neos Cruz
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Disease Molecular Biology and Epigenetics Laboratory, University of the Philippines Diliman, Quezon City, Philippines
| | - Ana Westenberger
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
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13
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Capponi S, Stöffler N, Penney EB, Grütz K, Nizamuddin S, Vermunt MW, Castelijns B, Fernandez-Cerado C, Legarda GP, Velasco-Andrada MS, Muñoz EL, Ang MA, Diesta CCE, Creyghton MP, Klein C, Bragg DC, De Rijk P, Timmers HTM. Dissection of TAF1 neuronal splicing and implications for neurodegeneration in X-linked dystonia-parkinsonism. Brain Commun 2021; 3:fcab253. [PMID: 34746789 PMCID: PMC8567410 DOI: 10.1093/braincomms/fcab253] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/16/2021] [Accepted: 08/19/2021] [Indexed: 11/29/2022] Open
Abstract
X-linked dystonia-parkinsonism (XDP) is a monogenic neurodegenerative disorder of the basal ganglia, which presents as a combination of hyperkinetic movements and parkinsonian features. The underlying genetic mechanism involves the insertion of a SINE-VNTR-Alu retrotransposon within the TAF1 gene. Interestingly, alterations of TAF1 have been involved in multiple neurological diseases. In XDP, the SINE-VNTR-Alu insertion in TAF1 has been proposed to result in alternative splicing defects, including the decreased incorporation of a neuron-specific microexon annotated as 34′. This mechanism has become controversial as recent studies failed to provide support. In order to resolve this conundrum, we examined the alternative splicing patterns of TAF1 mRNAs in XDP and control brains. The impact of the disease-associated SINE-VNTR-Alu on alternative splicing of microexon 34′ was further investigated in cellular assays. Subsequently, microexon 34′ incorporation was explored by RT-PCR and Nanopore long-read sequencing of TAF1 mRNAs from XDP and control brains tissues. Using cell-based splicing assays, we demonstrate that presence of the disease-associated SINE-VNTR-Alu does not affect the inclusion of microexon 34′. In addition, we show that (1) microexon 34′-containing TAF1 mRNAs are detected at similar levels in XDP as in controls and that (2) the architecture of TAF1 transcripts is remarkably similar between XDP and controls brains. These results indicate that microexon 34′ incorporation into TAF1 mRNA is not affected in XDP brains. Our findings shift the current paradigm of XDP by discounting alternative splicing of TAF1 microexon 34′ as the molecular basis for this disease.
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Affiliation(s)
- Simona Capponi
- German Cancer Consortium (DKTK), Partner Site Freiburg, German Cancer Research Center (DKFZ), Department of Urology, Medical Center-University of Freiburg, 79106 Freiburg, Germany
| | - Nadja Stöffler
- German Cancer Consortium (DKTK), Partner Site Freiburg, German Cancer Research Center (DKFZ), Department of Urology, Medical Center-University of Freiburg, 79106 Freiburg, Germany
| | - Ellen B Penney
- The Collaborative Center for X-Linked Dystonia Parkinsonism (CCXDP), Department of Neurology, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Karen Grütz
- Institute of Neurogenetics, University of Lübeck, Lübeck 23538, Germany
| | - Sheikh Nizamuddin
- German Cancer Consortium (DKTK), Partner Site Freiburg, German Cancer Research Center (DKFZ), Department of Urology, Medical Center-University of Freiburg, 79106 Freiburg, Germany
| | - Marit W Vermunt
- Erasmus University Medical Center, Department of Developmental Biology, Rotterdam 3015 GD, The Netherlands
| | - Bas Castelijns
- Erasmus University Medical Center, Department of Developmental Biology, Rotterdam 3015 GD, The Netherlands
| | | | - G Paul Legarda
- Sunshine Care Foundation, Roxas City, 5800 Capiz, Philippines
| | | | - Edwin L Muñoz
- Department of Pathology, College of Medicine, University of the Philippines, 1000 Manila, Philippines
| | - Mark A Ang
- Department of Pathology, College of Medicine, University of the Philippines, 1000 Manila, Philippines
| | - Cid Czarina E Diesta
- Department of Neurosciences, Makati Medical Center, 1229 Makati City, Philippines
| | - Menno P Creyghton
- Erasmus University Medical Center, Department of Developmental Biology, Rotterdam 3015 GD, The Netherlands
| | - Christine Klein
- Institute of Neurogenetics and Department of Neurology, University of Lübeck, 23538 Lübeck, Germany
| | - D Cristopher Bragg
- The Collaborative Center for X-Linked Dystonia Parkinsonism (CCXDP), Department of Neurology, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Peter De Rijk
- Neuromics Support Facility, VIB Center for Molecular Neurology, VIB - University of Antwerp, B-2610 Antwerp, Belgium
| | - H T Marc Timmers
- German Cancer Consortium (DKTK), Partner Site Freiburg, German Cancer Research Center (DKFZ), Department of Urology, Medical Center-University of Freiburg, 79106 Freiburg, Germany
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14
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Morales-Briceno H, Fung VSC, Bhatia KP, Balint B. Parkinsonism and dystonia: Clinical spectrum and diagnostic clues. J Neurol Sci 2021; 433:120016. [PMID: 34642024 DOI: 10.1016/j.jns.2021.120016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 08/20/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
The links between the two archetypical basal ganglia disorders, dystonia and parkinsonism, are manifold and stem from clinical observations, imaging studies, animal models and genetics. The combination of both, i.e. the syndrome of dystonia-parkinsonism, is not uncommonly seen in movement disorders clinics and has a myriad of different underlying aetiologies, upon which treatment and prognosis depend. Based on a comprehensive literature review, we delineate the clinical spectrum of disorders presenting with dystonia-parkinsonism. The clinical approach depends primarily on the age at onset, associated neurological or systemic symptoms and neuroimaging. The tempo of disease progression, and the response to L-dopa are further important clues to tailor diagnostic approaches that may encompass dopamine transporter imaging, CSF analysis and, last but not least, genetic testing. Later in life, sporadic neurodegenerative conditions are the most frequent cause, but the younger the patient, the more likely the cause is unravelled by the recent advances of molecular genetics that are focus of this review. Here, knowledge of the associated phenotypic spectrum is key to guide genetic testing and interpretation of test results. This article is part of the Special Issue "Parkinsonism across the spectrum of movement disorders and beyond" edited by Joseph Jankovic, Daniel D. Truong and Matteo Bologna.
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Affiliation(s)
- Hugo Morales-Briceno
- Neurology Department, Movement Disorders Unit, Westmead Hospital, NSW, Sydney, Australia; Sydney Medical School, University of Sydney, Sydney, NSW 2145, Australia
| | - Victor S C Fung
- Neurology Department, Movement Disorders Unit, Westmead Hospital, NSW, Sydney, Australia; Sydney Medical School, University of Sydney, Sydney, NSW 2145, Australia
| | - Kailash P Bhatia
- UCL Queen Square Institute of Neurology Department of Clinical and Movement Neurosciences, Queen Square, London WC1N 3BG, United Kingdom
| | - Bettina Balint
- Department of Neurology, University Hospital Heidelberg, Germany.
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15
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Balck A, Schaake S, Kuhnke NS, Domingo A, Madoev H, Margolesky J, Dobricic V, Alvarez-Fischer D, Laabs BH, Kasten M, Luo W, Nicolas G, Marras C, Lohmann K, Klein C, Westenberger A. Genotype-Phenotype Relations in Primary Familial Brain Calcification: Systematic MDSGene Review. Mov Disord 2021; 36:2468-2480. [PMID: 34432325 DOI: 10.1002/mds.28753] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/15/2021] [Accepted: 07/23/2021] [Indexed: 12/17/2022] Open
Abstract
This systematic MDSGene review covers individuals with confirmed genetic forms of primary familial brain calcification (PFBC) available in the literature. Data on 516 (47% men) individuals, carrying heterozygous variants in SLC20A2 (solute carrier family 20 member 2, 61%), PDGFB (platelet-derived growth factor subunit B, 12%), XPR1 (xenotropic and polytropic retrovirus receptor, 16%), or PDGFRB (platelet-derived growth factor receptor beta, 5%) or biallelic variants in MYORG (myogenesis-regulating glycosidase, 13%) or JAM2 (junctional adhesion molecule 2, 2%), were extracted from 93 articles. Nearly one-third of the mutation carriers were clinically unaffected. Carriers of PDGFRB variants were more likely to be clinically unaffected (~54%), and the penetrance of SLC20A2 and XPR1 variants (<70%) was lower in comparison to the remaining three genes (>85%). Among the 349 clinically affected patients, 27% showed only motor and 31% only nonmotor symptoms/signs, whereas the remaining 42% had a combination thereof. While parkinsonism and speech disturbance were the most frequently reported motor manifestations, cognitive deficits, headache, and depression were the major nonmotor symptoms/signs. The basal ganglia were always calcified, and the cerebellum, thalamus, and white matter contained calcifications in 58%, 53%, and 43%, respectively, of individuals. In autosomal-dominant PFBC, mutation severity influenced the number of calcified brain areas, which in turn correlated with the clinical status, whereby the risk of developing symptoms/signs more than doubled for each additional region with calcifications. Our systematic analysis provides the most comprehensive insight into genetic, clinical, and neuroimaging features of known PFBC forms, to date. In addition, it puts forth the penetrance estimates and newly discovered genotype-phenotype relations that will improve counseling of individuals with mutations in PFBC genes. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Alexander Balck
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany.,Department of Neurology, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Susen Schaake
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Neele Sophie Kuhnke
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Aloysius Domingo
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany.,Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Harutyun Madoev
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Jason Margolesky
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Valerija Dobricic
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany.,Lübeck Interdisciplinary Platform for Genome Analytics, University of Lübeck, Lübeck, Germany
| | - Daniel Alvarez-Fischer
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Björn-Hergen Laabs
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Meike Kasten
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany.,Institute of Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany
| | - Wei Luo
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Gael Nicolas
- Department of Genetics and CNR-MAJ, Normandie University, UNIROUEN, Inserm, Rouen, France
| | - Connie Marras
- The Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | - Katja Lohmann
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Ana Westenberger
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
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Laabs BH, Klein C, Pozojevic J, Domingo A, Brüggemann N, Grütz K, Rosales RL, Jamora RD, Saranza G, Diesta CCE, Wittig M, Schaake S, Dulovic-Mahlow M, Quismundo J, Otto P, Acuna P, Go C, Sharma N, Multhaupt-Buell T, Müller U, Hanssen H, Kilpert F, Franke A, Rolfs A, Bauer P, Dobričić V, Lohmann K, Ozelius LJ, Kaiser FJ, König IR, Westenberger A. Identifying genetic modifiers of age-associated penetrance in X-linked dystonia-parkinsonism. Nat Commun 2021; 12:3216. [PMID: 34050153 PMCID: PMC8163740 DOI: 10.1038/s41467-021-23491-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 04/23/2021] [Indexed: 02/06/2023] Open
Abstract
X-linked dystonia-parkinsonism is a neurodegenerative disorder caused by a founder retrotransposon insertion, in which a polymorphic hexanucleotide repeat accounts for ~50% of age at onset variability. Employing a genome-wide association study to identify additional factors modifying age at onset, we establish that three independent loci are significantly associated with age at onset (p < 5 × 10−8). The lead single nucleotide polymorphisms collectively account for 25.6% of the remaining variance not explained by the hexanucleotide repeat and 13.0% of the overall variance in age at onset in X-linked dystonia-parkinsonism with the protective alleles delaying disease onset by seven years. These regions harbor or lie adjacent to MSH3 and PMS2, the genes that were recently implicated in modifying age at onset in Huntington’s disease, likely through a common pathway influencing repeat instability. Our work indicates the existence of three modifiers of age at onset in X-linked dystonia-parkinsonism that likely affect the DNA mismatch repair pathway. Age at onset of X-linked dystonia-parkinsonism is 50% explained by the length of a repeat in an SVA insert. The authors perform a GWAS for genetic modifiers and discover three more loci, accounting for another 13% of variability in age at onset with the protective alleles delaying onset by seven years.
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Affiliation(s)
- Björn-Hergen Laabs
- Institute of Medical Biometry and Statistics, University of Lübeck, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
| | - Jelena Pozojevic
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,Section for Functional Genetics, Institute for Human Genetics, University of Lübeck, Lübeck, Germany
| | - Aloysius Domingo
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,The Collaborative Center for X-linked Dystonia Parkinsonism, Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Norbert Brüggemann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Karen Grütz
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Raymond L Rosales
- Department of Neurology, University of Santo Tomas Hospital, Manila, Philippines.,Department of Psychiatry, University of Santo Tomas Hospital, Manila, Philippines
| | - Roland Dominic Jamora
- Department of Neurosciences, College of Medicine - Philippine General Hospital, University of the Philippines, Manila, Philippines
| | - Gerard Saranza
- Department of Neurosciences, College of Medicine - Philippine General Hospital, University of the Philippines, Manila, Philippines
| | - Cid Czarina E Diesta
- Department of Neurosciences, Movement Disorders Clinic, Makati Medical Center, Makati City, Philippines
| | - Michael Wittig
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany.,University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
| | - Susen Schaake
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | | | - Jana Quismundo
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Pia Otto
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Patrick Acuna
- The Collaborative Center for X-linked Dystonia Parkinsonism, Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Criscely Go
- Department of Neurology, Jose Reyes Memorial Medical Center, Quezon City, Philippines
| | - Nutan Sharma
- The Collaborative Center for X-linked Dystonia Parkinsonism, Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Trisha Multhaupt-Buell
- The Collaborative Center for X-linked Dystonia Parkinsonism, Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Ulrich Müller
- Institut für Humangenetik, Justus-Liebig-Universität, Giessen, Germany
| | - Henrike Hanssen
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Fabian Kilpert
- Institute of Human Genetics, University Hospital Essen and University of Duisburg-Essen, Duisburg-Essen, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany.,University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
| | - Arndt Rolfs
- CENTOGENE GmbH, Rostock, Germany.,Medical Faculty, University of Rostock, Rostock, Germany
| | | | - Valerija Dobričić
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,Lübeck Interdisciplinary Platform for Genome Analytics, University of Lübeck, Lübeck, Germany
| | - Katja Lohmann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Laurie J Ozelius
- The Collaborative Center for X-linked Dystonia Parkinsonism, Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Frank J Kaiser
- Section for Functional Genetics, Institute for Human Genetics, University of Lübeck, Lübeck, Germany.,Institute of Human Genetics, University Hospital Essen and University of Duisburg-Essen, Duisburg-Essen, Germany.,EZSE - Essener Zentrum für Seltene Erkrankungen, Universitätstsmedizin Essen, Essen, Germany
| | - Inke R König
- Institute of Medical Biometry and Statistics, University of Lübeck, University Hospital Schleswig-Holstein, Lübeck, Germany.
| | - Ana Westenberger
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
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17
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Klein C, König IR. Exploring Uncharted Territory: Genetically Determined Sex Differences in Parkinson's Disease. Ann Neurol 2021; 90:15-18. [PMID: 33938006 DOI: 10.1002/ana.26091] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 04/26/2021] [Indexed: 12/22/2022]
Affiliation(s)
- Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Inke R König
- University Medical Center Schleswig-Holstein, Lübeck, Germany.,Institute of Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany
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18
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The importance of genetic testing for dystonia patients and translational research. J Neural Transm (Vienna) 2021; 128:473-481. [PMID: 33876307 PMCID: PMC8099821 DOI: 10.1007/s00702-021-02329-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/22/2021] [Indexed: 12/28/2022]
Abstract
Genetic testing through a variety of methods is a fundamental but underutilized approach for establishing the precise genetic diagnosis in patients with heritable forms of dystonia. Our knowledge of numerous dystonia-related genes, variants that they may contain, associated clinical presentations, and molecular disease mechanism may have significant translational potential for patients with genetically confirmed dystonia or their family members. Importantly, genetic testing permits the assembly of patient cohorts pertinent for dystonia-related research and developing therapeutics. Here we review the genetic testing approaches relevant to dystonia patients, and summarize and illustrate the multifold benefits of establishing an accurate molecular diagnosis for patients imminently or for translational research in the long run.
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19
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Ng AR, Jamora RDG, Rosales RL. X-linked dystonia Parkinsonism: crossing a new threshold. J Neural Transm (Vienna) 2021; 128:567-573. [PMID: 33721107 DOI: 10.1007/s00702-021-02324-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/28/2021] [Indexed: 12/22/2022]
Abstract
X-linked dystonia parkinsonism (XDP) is a neurodegenerative disorder that has received significant interest on several fronts. Although much still remains to be elucidated regarding the disease cause, a robust amount of data has been produced in recent years compared to when it was first described in 1976. The debilitating nature of the overlapping dystonia and parkinsonism that characterizes this disorder has fueled much of the interest in unraveling its cause, clinical presentation, symptom progression, treatment and impact on the afflicted patients as well as their caregivers. Having made several significant advances in genetic studies, neuropathology, neurophysiology and clinical characterization, we are entering a new threshold in the study of this disorder, hopefully bringing us closer to potential treatments and possible cures. This review will focus on new information gathered regarding the motor and non-motor features of XDP, deep brain stimulation (DBS) as a potential treatment for XDP and the utility of the recently validated XDP-Movement Disorder Society of the Philippines (MDSP)-rating scale.
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Affiliation(s)
- Arlene R Ng
- Movement Disorders Service and Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines. .,Institute for Neurosciences, St. Luke's Medical Center Global City, Rizal Drive cor. 32nd Ave, Bonifacio Global City, 1634, Taguig City, Philippines.
| | - Roland Dominic G Jamora
- Movement Disorders Service and Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines.,Department of Neurosciences, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.,Institute for Neurosciences, St. Luke's Medical Center Global City, Rizal Drive cor. 32nd Ave, Bonifacio Global City, 1634, Taguig City, Philippines
| | - Raymond L Rosales
- Movement Disorders Service and Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines.,Department of Neurology and Psychiatry, University of Santo Tomas Hospital, Manila, Philippines.,Center for Neurodiagnostic and Therapeutic Services, Metropolitan Medical Center, Manila, Philippines
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20
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Jamora RDG, Suratos CTR, Bautista JEC, Ramiro GMI, Westenberger A, Klein C, Ledesma LK. Neurocognitive profile of patients with X-linked dystonia-parkinsonism. J Neural Transm (Vienna) 2021; 128:671-678. [PMID: 33638704 DOI: 10.1007/s00702-021-02317-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/08/2021] [Indexed: 11/30/2022]
Abstract
X-linked dystonia-parkinsonism (XDP) is a debilitating movement disorder endemic to the Panay Island, Philippines. Most studies focus on motor symptoms, hence we reviewed the neurocognitive profile of XDP patients. Neurocognitive testing of XDP patients focused on five domains: general intellectual functioning, episodic memory, language, attention and executive function, and affect. Twenty-nine genetically confirmed patients were included. Twenty-six (89.6%) had impairments in one or more domains, while only three had no impairment in any domain. Attention and executive function was the most commonly affected domain (n = 23, 79.3%). Deficits in general intellect, episodic memory, attention and executive function and affect were seen in our subset of XDP patients. The striatal pathology affecting the frontostriatal circuitry mandating these cognitive processes is mainly implicated in these impairments. The results of our study provided further evidence on the extent of cognitive impairment in XDP using a select battery of neurocognitive tests.
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Affiliation(s)
- Roland Dominic G Jamora
- Division of Adult Neurology, Department of Neurosciences, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Taft Ave., Ermita, 1000, Manila, Philippines. .,Movement Disorders Service and Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Global City, Philippines.
| | - Cezar Thomas R Suratos
- Division of Adult Neurology, Department of Neurosciences, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Taft Ave., Ermita, 1000, Manila, Philippines
| | - Jesi Ellen C Bautista
- Division of Adult Neurology, Department of Neurosciences, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Taft Ave., Ermita, 1000, Manila, Philippines
| | - Gail Melissa I Ramiro
- Division of Adult Neurology, Department of Neurosciences, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Taft Ave., Ermita, 1000, Manila, Philippines
| | - Ana Westenberger
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Lourdes K Ledesma
- Division of Adult Neurology, Department of Neurosciences, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Taft Ave., Ermita, 1000, Manila, Philippines.,Ledesma Clinic for Neuropsychological Services, Pasig City, Philippines
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21
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GP2
: The Global Parkinson's Genetics Program. Mov Disord 2021; 36:842-851. [PMID: 33513272 PMCID: PMC9290711 DOI: 10.1002/mds.28494] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/17/2020] [Accepted: 12/21/2020] [Indexed: 12/17/2022] Open
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22
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Weissbach A, Saranza G, Domingo A. Combined dystonias: clinical and genetic updates. J Neural Transm (Vienna) 2020; 128:417-429. [PMID: 33099685 DOI: 10.1007/s00702-020-02269-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/09/2020] [Indexed: 12/28/2022]
Abstract
The genetic combined dystonias are a clinically and genetically heterogeneous group of neurologic disorders defined by the overlap of dystonia and other movement disorders such as parkinsonism or myoclonus. The number of genes associated with combined dystonia syndromes has been increasing due to the wider recognition of clinical features and broader use of genetic testing. Nevertheless, these diseases are still rare and represent only a small subgroup among all dystonias. Dopa-responsive dystonia (DYT/PARK-GCH1), rapid-onset dystonia-parkinsonism (DYT/PARK-ATP1A3), X-linked dystonia-parkinsonism (XDP, DYT/PARK-TAF1), and young-onset dystonia-parkinsonism (DYT/PARK-PRKRA) are monogenic combined dystonias accompanied by parkinsonian features. Meanwhile, MYC/DYT-SGCE and MYC/DYT-KCTD17 are characterized by dystonia in combination with myoclonus. In the past, common molecular pathways between these syndromes were the center of interest. Although the encoded proteins rather affect diverse cellular functions, recent neurophysiological evidence suggests similarities in the underlying mechanism in a subset. This review summarizes recent developments in the combined dystonias, focusing on clinico-genetic features and neurophysiologic findings. Disease-modifying therapies remain unavailable to date; an overview of symptomatic therapies for these disorders is also presented.
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Affiliation(s)
- Anne Weissbach
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Gerard Saranza
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada
| | - Aloysius Domingo
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA. .,Collaborative Center for X-Linked Dystonia-Parkinsonism, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
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