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Smith IC, Chakraborty S, Bourque PR, Sampaio ML, Melkus G, Lochmüller H, Woulfe J, Parks RJ, Brais B, Warman-Chardon J. Emerging and established biomarkers of oculopharyngeal muscular dystrophy. Neuromuscul Disord 2023; 33:824-834. [PMID: 37926637 DOI: 10.1016/j.nmd.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/25/2023] [Accepted: 09/27/2023] [Indexed: 11/07/2023]
Abstract
Oculopharyngeal muscular dystrophy (OPMD) is a rare, primarily autosomal dominant, late onset muscular dystrophy commonly presenting with ptosis, dysphagia, and subsequent weakness of proximal muscles. Although OPMD diagnosis can be confirmed with high confidence by genetic testing, the slow progression of OPMD poses a significant challenge to clinical monitoring and a barrier to assessing the efficacy of treatments during clinical trials. Accordingly, there is a pressing need for more sensitive measures of OPMD progression, particularly those which do not require a muscle biopsy. This review provides an overview of progress in OPMD biomarkers from clinical assessment, quantitative imaging, histological assessments, and genomics, as well as hypothesis-generating "omics" approaches. The ongoing search for biomarkers relevant to OPMD progression needs an integrative, longitudinal approach combining validated and experimental approaches which may include clinical, imaging, demographic, and biochemical assessment methods. A multi-omics approach to biochemical biomarker discovery could help provide context for differences found between individuals with varying levels of disease activity and provide insight into pathomechanisms and prognosis of OPMD.
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Affiliation(s)
- Ian C Smith
- The Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada
| | | | - Pierre R Bourque
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; Department of Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, ON K1H 8L6, Canada; Eric Poulin Centre for Neuromuscular Disease, University of Ottawa, Ottawa, ON K1Y 4E9, Canada
| | - Marcos L Sampaio
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; Eric Poulin Centre for Neuromuscular Disease, University of Ottawa, Ottawa, ON K1Y 4E9, Canada; Department of Medical Imaging, The Ottawa Hospital, Ottawa, Ontario K1Y 4E9, Canada; Department of Radiology, Radiation Oncology and Medical Physics, University of Ottawa, Ottawa, ON K1H 8L6, Canada
| | - Gerd Melkus
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; Eric Poulin Centre for Neuromuscular Disease, University of Ottawa, Ottawa, ON K1Y 4E9, Canada; Department of Medical Imaging, The Ottawa Hospital, Ottawa, Ontario K1Y 4E9, Canada; Department of Physics, Carleton University, Ottawa, ON K1S 5B6, Canada
| | - Hanns Lochmüller
- The Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; Department of Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, ON K1H 8L6, Canada; Eric Poulin Centre for Neuromuscular Disease, University of Ottawa, Ottawa, ON K1Y 4E9, Canada; Genetics, Children's Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada
| | - John Woulfe
- The Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada; Eric Poulin Centre for Neuromuscular Disease, University of Ottawa, Ottawa, ON K1Y 4E9, Canada; Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, ON K1Y 4E9, Canada
| | - Robin J Parks
- The Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada; Department of Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, ON K1H 8L6, Canada; Eric Poulin Centre for Neuromuscular Disease, University of Ottawa, Ottawa, ON K1Y 4E9, Canada
| | - Bernard Brais
- Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Jodi Warman-Chardon
- The Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; Department of Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, ON K1H 8L6, Canada; Eric Poulin Centre for Neuromuscular Disease, University of Ottawa, Ottawa, ON K1Y 4E9, Canada; Genetics, Children's Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada; Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec H3A 2B4, Canada.
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2
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Ishtayeh H, Galves M, Barnatan TT, Berdichevsky Y, Amer‐Sarsour F, Pasmanik‐Chor M, Braverman I, Blumen SC, Ashkenazi A. Oculopharyngeal muscular dystrophy mutations link the RNA-binding protein HNRNPQ to autophagosome biogenesis. Aging Cell 2023; 22:e13949. [PMID: 37559347 PMCID: PMC10577562 DOI: 10.1111/acel.13949] [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: 02/25/2023] [Revised: 06/22/2023] [Accepted: 07/15/2023] [Indexed: 08/11/2023] Open
Abstract
Autophagy is an intracellular degradative process with an important role in cellular homeostasis. Here, we show that the RNA binding protein (RBP), heterogeneous nuclear ribonucleoprotein Q (HNRNPQ)/SYNCRIP is required to stimulate early events in autophagosome biogenesis, in particular the induction of VPS34 kinase by ULK1-mediated beclin 1 phosphorylation. The RBPs HNRNPQ and poly(A) binding protein nuclear 1 (PABPN1) form a regulatory network that controls the turnover of distinct autophagy-related (ATG) proteins. We also show that oculopharyngeal muscular dystrophy (OPMD) mutations engender a switch from autophagosome stimulation to autophagosome inhibition by impairing PABPN1 and HNRNPQ control of the level of ULK1. The overexpression of HNRNPQ in OPMD patient-derived cells rescues the defective autophagy in these cells. Our data reveal a regulatory mechanism of autophagy induction that is compromised by PABPN1 disease mutations, and may thus further contribute to their deleterious effects.
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Affiliation(s)
- Hasan Ishtayeh
- The Department of Cell and Developmental Biology, Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| | - Margarita Galves
- The Department of Cell and Developmental Biology, Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| | - Tania T. Barnatan
- The Department of Cell and Developmental Biology, Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| | - Yevgeny Berdichevsky
- The Department of Cell and Developmental Biology, Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| | - Fatima Amer‐Sarsour
- The Department of Cell and Developmental Biology, Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| | - Metsada Pasmanik‐Chor
- Bioinformatics Unit, G.S. Wise Faculty of Life ScienceTel Aviv UniversityTel AvivIsrael
| | - Itzhak Braverman
- Department of Otolaryngology, Head and Neck SurgeryHillel Yaffe Medical CenterHaderaIsrael
- Rappaport Faculty of Medicine, TechnionHaifaIsrael
| | - Sergiu C. Blumen
- Rappaport Faculty of Medicine, TechnionHaifaIsrael
- Department of NeurologyHillel Yaffe Medical CenterHaderaIsrael
| | - Avraham Ashkenazi
- The Department of Cell and Developmental Biology, Faculty of MedicineTel Aviv UniversityTel AvivIsrael
- Sagol School of NeuroscienceTel Aviv UniversityTel AvivIsrael
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Infante JM, Nepomuceno BL. Choked: A Case Report of Oculopharyngeal Muscular Dystrophy Mimicking Hypothyroidism From the Philippines. Cureus 2023; 15:e41025. [PMID: 37519616 PMCID: PMC10373107 DOI: 10.7759/cureus.41025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Oculopharyngeal muscular dystrophy (OPMD) is a late-onset myopathic genetic disorder characterized by chronic progressive dysphagia and ptosis with or without proximal limb weakness. It is most often caused by an abnormal alanine-encoding (GCN) trinucleotide repeat expansion in the first exon of the poly(A)-binding protein nuclear 1 (PABPN1) gene. Patients with hypothyroidism may similarly report bilateral ptosis, dysphagia, and limb weakness. Here, we report the case of a 65-year-old Austrian female with hypothyroidism living in the Philippines who presented with gradually progressive ptosis, dysphagia, and intermittent choking episodes. No known relatives had similar symptoms. Physical examination showed bilateral symmetric ptosis, good cough reflex, and good limb muscle strength. Electromyographic studies of facial and laryngeal muscles were found to be normal. Thyroid evaluation showed biochemically hyperthyroid status while taking Levothyroxine. With a clinical suspicion for genetic progressive myopathy, we considered OPMD. Genetic testing revealed abnormal expansion of GCN trinucleotide repeats in the PABPN1 gene. We describe the first reported case of OPMD with detected PABPN1 gene expansion in the Philippines simulating hypothyroidism symptoms, suggesting possible points for misidentification and underdiagnosis of OPMD in developing countries.
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Affiliation(s)
- Jerome M Infante
- Institute for Neurosciences, Section of Neurology, St. Luke's Medical Center, Quezon City, PHL
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Lin F, Yang K, Lin MT, Zheng FZ, Chen L, Ding YL, Ye ZX, Lin X, Wang N, Wang ZQ. The phenotypic and genotypic features of Chinese patients with oculopharyngeal muscular dystrophy. Ann Clin Transl Neurol 2023; 10:426-439. [PMID: 36691350 PMCID: PMC10014010 DOI: 10.1002/acn3.51733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/03/2023] [Accepted: 01/09/2023] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE Oculopharyngeal muscular dystrophy (OPMD) is a late-onset inherited neuromuscular disorder, with progressive ptosis and dysphagia as common manifestations. To date, OPMD has rarely been reported among East Asians. The present study summarizes the phenotypic and genotypic features of Chinese patients with OPMD. METHODS Twenty-one patients with molecularly confirmed OPMD from 9 unrelated families were identified by direct sequencing of the polyadenlyate binding protein nuclear-1 (PABPN1) gene. Immunofluorescence staining of muscle biopsies was conducted to identify the components of protein degradation pathways involved in OPMD. RESULTS In our cohort, the genetically confirmed OPMD group had a mean age at onset of 50.6 ± 4.2 years (range 45-60 years). Ptosis (42.9%) was the most common initial symptom; patients with ptosis as the first symptom subsequently developed dysphagia within a median time of 5.5 years (range 1-19 years). Evidence of external ophthalmoplegia was found in 38.1% of patients. A total of 33.3% of the patients developed muscle weakness at a median age at onset of 66 years (range 50-70 years), with neck flexor involvement in all patients. Five genotypes were observed in our cohort, including classical (GCG)9-11 repeats in 7 families and non-GCG elongations with additional GCA expansions in 2 families. OPMD muscle biopsies revealed rimmed vacuoles and intranuclear filamentous inclusions. The PABPN1 protein showed substantial accumulation in the nuclei of muscle fiber aggregates and closely colocalized with p62, LC3B and FK2. INTERPRETATION Our findings indicate wide genetic heterogeneity in OPMD in the Chinese population and demonstrate abnormalities in protein degradation pathways in this disease.
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Affiliation(s)
- Feng Lin
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 350005, Fujian, Fuzhou, China
| | - Kang Yang
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 350005, Fujian, Fuzhou, China
| | - Min-Ting Lin
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 350005, Fujian, Fuzhou, China.,Fujian Key Laboratory of Molecular Neurology, 350005, Fuzhou, China
| | - Fu-Ze Zheng
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 350005, Fujian, Fuzhou, China.,Fujian Key Laboratory of Molecular Neurology, 350005, Fuzhou, China
| | - Long Chen
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 350005, Fujian, Fuzhou, China
| | - Yuan-Liang Ding
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 350005, Fujian, Fuzhou, China.,Fujian Key Laboratory of Molecular Neurology, 350005, Fuzhou, China
| | - Zhi-Xian Ye
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 350005, Fujian, Fuzhou, China
| | - Xin Lin
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 350005, Fujian, Fuzhou, China
| | - Ning Wang
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 350005, Fujian, Fuzhou, China.,Fujian Key Laboratory of Molecular Neurology, 350005, Fuzhou, China
| | - Zhi-Qiang Wang
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 350005, Fujian, Fuzhou, China.,Fujian Key Laboratory of Molecular Neurology, 350005, Fuzhou, China
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Jordan DR, Klapper SR, Farmer J. Oculopharyngeal Muscular Dystrophy Ptosis, Mueller's Muscle Involvement, and a Review of Management Over 34 Years. Ophthalmic Plast Reconstr Surg 2022; 38:535-542. [PMID: 35030153 DOI: 10.1097/iop.0000000000002118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To review the management of the ptosis associated with oculopharyngeal muscular dystrophy (OPMD) from one author's experience over 34 years, demonstrate Mueller's muscle involvement in this disease, and how this impacts the preferred choice of surgery. METHODS Retrospective, nonrandomized comparative case series. Forty patients with OPMD who underwent primary bilateral ptosis surgery through an anterior eyelid incision and had their Mueller's muscle biopsied (one side) and sent for histopathologic analysis were selected for chart review. The main outcome measure was the presence or absence of dystrophic changes in the biopsied Mueller's muscle. RESULTS In 29/40 biopsies (72.5%), there were dystrophic changes and fatty infiltration of Mueller's muscle identified histopathologically. CONCLUSIONS Mueller's muscle is involved in the dystrophic process more often than expected contributing to ptosis in the OPMD syndrome. A combined Mueller's-aponeurotic advancement is more effective at elevating the eyelid than simply advancing the aponeurosis when Mueller's is fatty infiltrated at the time of external levator advancement surgery in our experience. Management strategies for ptosis surgery in OPMD are reviewed. The age of onset, levator muscle function, previous ptosis repair, how debilitated the patient is with their disease process systemically, as well as the presence of other eye problems (e.g., dry eye, prior glaucoma filtering procedures, history of corneal surgery, laser refractive procedure) are important clinical considerations in patients with OPMD.
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Affiliation(s)
- David R Jordan
- Department of Ophthalmology, The Ottawa Hospital General Campus, Ottawa, Ontario, Canada
| | - Stephen R Klapper
- Department of Ophthalmology, Indiana University School of medicine, Indianapolis, Indiana, U.S.A
| | - James Farmer
- Department of Pathology, The Ottawa Hospital General Campus, Ottawa, Ontario, Canada
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Richard P, Stojkovic T, Metay C, Lacau St Guily J, Trollet C. Distrofia muscolare oculofaringea. Neurologia 2022. [DOI: 10.1016/s1634-7072(22)46725-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Côté C, Fortin J, Brais B, Youssof S, Gagnon C. Cross-cultural adaptation of the SWAL-QOL and the Sydney Swallow Questionnaire (SSQ) into French-Canadian and preliminary assessment for their use in an oculopharyngeal muscular dystrophy (OPMD) population. Qual Life Res 2021; 31:293-302. [PMID: 34292466 DOI: 10.1007/s11136-021-02915-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Patient-reported outcomes (PRO) assessing dysphagia are an essential component of clinical trials to consider how patients feel and function in response to treatments. The selected PRO needs to be translated in several languages using a systematic process ensuring its validity and equivalence for use in multicenter clinical trials. The main objectives were to translate the SWAL-QOL and the Sydney Swallow Questionnaire (SSQ) into French Canadian (SWAL-QOL-FC and SSQ-FC) and to assess their appropriateness for patients with oculopharyngeal muscular dystrophy (OPMD). METHODS A forward- and back-translation process was followed including independent mother-tongue translators followed by committee review. Known-groups validity was assessed by comparing scores of OPMD French-Canadian participants (n = 21) known to differ in dysphagia severity according to the 80-ml drinking test score. A Mann-Whitney test was used to compare the mean scores. Cognitive interviews were conducted later on to ensure a posteriori cultural equivalence among French-Canadian participants (n = 28). RESULTS Evidences of adequate known-groups validity was shown for the SSQ-FC. Only two domains out of 10 of the SWAL-QOL-FC (burden and eating duration) showed adequate known-groups validity. In addition, the difference in the mean composite score was not significant. Several conceptual equivalence issues were found in both questionnaires as a result of the cognitive interviews. CONCLUSION This study provided evidence that the SSQ-FC presents better validity than the SWAL-QOL-FC in a small sample size of OPMD participants. The findings of the cognitive interviews suggest the need to develop an OPMD-specific questionnaire to capture better the whole spectrum of disease severity.
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Affiliation(s)
- Claudia Côté
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Québec, Canada. .,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Québec, Canada. .,Centre de recherche Charles-Le Moyne-Saguenay-Lac-St-Jean sur les innovations en santé, University of Sherbrooke, Sherbrooke, Québec, Canada.
| | - Julie Fortin
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Québec, Canada
| | - Bernard Brais
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Québec, Canada
| | - Sarah Youssof
- Department of Neurology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Cynthia Gagnon
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Québec, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Québec, Canada.,Centre de recherche Charles-Le Moyne-Saguenay-Lac-St-Jean sur les innovations en santé, University of Sherbrooke, Sherbrooke, Québec, Canada
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Yamashita S. Recent Progress in Oculopharyngeal Muscular Dystrophy. J Clin Med 2021; 10:jcm10071375. [PMID: 33805441 PMCID: PMC8036457 DOI: 10.3390/jcm10071375] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/18/2021] [Accepted: 03/26/2021] [Indexed: 12/23/2022] Open
Abstract
Oculopharyngeal muscular dystrophy (OPMD) is a late-onset intractable myopathy, characterized by slowly progressive ptosis, dysphagia, and proximal limb weakness. It is caused by the abnormal expansion of the alanine-encoding (GCN)n trinucleotide repeat in the exon 1 of the polyadenosine (poly[A]) binding protein nuclear 1 gene (11-18 repeats in OPMD instead of the normal 10 repeats). As the disease progresses, the patients gradually develop a feeling of suffocation, regurgitation of food, and aspiration pneumonia, although the initial symptoms and the progression patterns vary among the patients. Autologous myoblast transplantation may provide therapeutic benefits by reducing swallowing problems in these patients. Therefore, it is important to assemble information on such patients for the introduction of effective treatments in nonendemic areas. Herein, we present a concise review of recent progress in clinical and pathological studies of OPMD and introduce an idea for setting up a nation-wide OPMD disease registry in Japan. Since it is important to understand patients' unmet medical needs, realize therapeutically targetable symptoms, and identify indices of therapeutic efficacy, our attempt to establish a unique patient registry of OPMD will be a helpful tool to address these urgent issues.
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Affiliation(s)
- Satoshi Yamashita
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan
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Brisson JD, Gagnon C, Brais B, Côté I, Mathieu J. A study of impairments in oculopharyngeal muscular dystrophy. Muscle Nerve 2020; 62:201-207. [PMID: 32270505 DOI: 10.1002/mus.26888] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 03/31/2020] [Accepted: 04/05/2020] [Indexed: 12/30/2022]
Abstract
INTRODUCTION In this study we aimed to document the prevalence and age of onset of motor impairments and other key symptoms in oculopharyngeal muscular dystrophy (OPMD). METHODS Retrospective chart review of patients followed at the Saguenay Neuromuscular Clinic (Quebec, Canada). RESULTS A total of 333 participants with the (GCN)13 mutation were included. Before the age of 75 years, 27% of them had walking limitations, 14% could not climb stairs independently, and 14% used a wheelchair for long distances or daily living. The median age of onset was 54 years for ptosis and dysphagia and 58 years for lower limb proximal weakness. Other frequent symptoms included fatigue, pharyngeal pooling of thickened secretions, and dysphonia. The median age at death was 77 years and the main cause was respiratory disease. DISCUSSION This study provides important information to help anticipatory guidance for affected people and for the development of therapeutic trials in OPMD.
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Affiliation(s)
- Jean-Denis Brisson
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Québec, Canada.,Clinique des maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Québec, Canada
| | - Cynthia Gagnon
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Québec, Canada.,Centre de recherche Charles-Le Moyne-Saguenay-Lac-St-Jean sur les innovations en santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Bernard Brais
- Department of Neurology, McGill University, Montreal Neurological Institute, Montréal, Quebec, Canada
| | - Isabelle Côté
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Québec, Canada
| | - Jean Mathieu
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Québec, Canada.,Clinique des maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Québec, Canada
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Verma AK, Khan E, Bhagwat SR, Kumar A. Exploring the Potential of Small Molecule-Based Therapeutic Approaches for Targeting Trinucleotide Repeat Disorders. Mol Neurobiol 2019; 57:566-584. [DOI: 10.1007/s12035-019-01724-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/29/2019] [Indexed: 12/18/2022]
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Côté C, Gagnon C, Youssof S, sKurtz N, Brais B. The requirement for a disease-specific patient-reported outcome measure of dysphagia in oculopharyngeal muscular dystrophy. Muscle Nerve 2018; 59:445-450. [PMID: 30575974 DOI: 10.1002/mus.26405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 12/11/2018] [Accepted: 12/15/2018] [Indexed: 12/22/2022]
Abstract
INTRODUCTION There is no patient-reported outcome (PRO) questionnaire specifically designed to assess oropharyngeal dysphagia in oculopharyngeal muscular dystrophy (OPMD). To select a suitable questionnaire, content validity of the existing questionnaires must be assessed. This study sought (1) to identify dysphagia-related symptoms in OPMD and (2) to assess content validity of currently available PRO for the assessment of dysphagia severity in OPMD. METHODS A two-step literature review was conducted of dysphagia-related symptom identification and oropharyngeal dysphagia-related PRO. Symptoms were validated with an expert panel by using a Delphi survey. Content validity of PRO questionnaires was documented through content analysis. RESULTS Ten PRO questionnaires were identified. None of the questionnaires cover the entire symptom spectrum in OPMD and thus lack content validity. DISCUSSION The development and validation of a new PRO questionnaire to assess dysphagia in OPMD is required to establish the importance of symptomatic relief from new treatments. Muscle Nerve 59:445-450, 2019.
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Affiliation(s)
- Claudia Côté
- Centre de recherche Charles-Le-Moyne-Saguenay-Lac-St-Jean sur les innovations en santé (CR-CSIS), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Québec, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), CIUSSS du Saguenay-Lac-St-Jean, Québec, Canada
| | - Cynthia Gagnon
- Centre de recherche Charles-Le-Moyne-Saguenay-Lac-St-Jean sur les innovations en santé (CR-CSIS), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Québec, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), CIUSSS du Saguenay-Lac-St-Jean, Québec, Canada
| | - Sarah Youssof
- Department of Neurology, University of New Mexico, Albuquerque, New Mexico
| | - Nicolette sKurtz
- Department of Neurology, University of New Mexico, Albuquerque, New Mexico
| | - Bernard Brais
- Department of Neurology and Neurosurgery, McGill University, Québec, Canada
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van der Sluijs BM, Raz V, Lammens M, van den Heuvel LP, Voermans NC, van Engelen BGM. Intranuclear Aggregates Precede Clinical Onset in Oculopharyngeal Muscular Dystrophy. J Neuromuscul Dis 2018; 3:101-109. [PMID: 27854203 DOI: 10.3233/jnd-150118] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Oculopharyngeal muscular dystrophy (OPMD) has long been characterized by a combination of bilateral ptosis and dysphagia and subsequent limb girdle weakness. The role of the typical intranuclear inclusion in the pathophysiology is unresolved. OBJECTIVE The aim of this study was to describe the clinical and histopathological features of oculopharyngeal muscular dystrophy (OPMD). We examined this in a Dutch cohort including presymptomatic Ala-expanded-PABPN1 carriers and late symptomatic patients. METHODS We performed a prospective, observational study in OPMD patients and adult children of genetically confirmed OPMD patients. The study includes a structured history, a detailed neurological examination, muscle histology and biochemical analysis. Forty patients and 18 adult children participated in this study, among whom were six presymptomatic mutation carriers. One patient died during the study and had given permission to autopsy. RESULTS In addition to the characteristic OPMD symptoms including ptosis and dysphagia, other symptoms such as limb girdle and axial weakness, and external ophthalmoplegia were frequently observed. Intranuclear aggregates were observed in the biopsies of presymptomatic carriers. Biochemical analysis of the biopsies of the presymptomatic carriers showed no mitochondrial dysfunction. The autopsy showed that muscle weakness correlated with histopathological findings in five different muscles in an individual patient. CONCLUSIONS The main findings of this nationwide study are the presence of intranuclear aggregates before clinical onset and the absence of mitochondrial changes in Ala-expanded-PABPN1 carriers. This indicates that the expression of Ala-expanded-PABPN1 causes the formation of nuclear aggregates before the onset of muscle weakness. Normal results of biochemical analysis in presymptomatic carriers suggest that possible mitochondrial dysfunction occurs later. Furthermore we confirmed that limb girdle weakness occurs frequently in Dutch OPMD patients. This study thus expands the OPMD research towards characterization of presymptomatic carriers.
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Affiliation(s)
- B M van der Sluijs
- Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Neurology, Gelre Hospital Zutphen, Zutphen, The Netherlands
| | - V Raz
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - M Lammens
- Department of Pathology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium.,Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - L P van den Heuvel
- Department of Laboratory Medicine and Pediatrics, Translational Metabolic Laboratory, Radboud University Medical Centre, The Netherlands
| | - N C Voermans
- Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - B G M van Engelen
- Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
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Youssof S, Romero-Clark C, Warner T, Plowman E. Dysphagia-related quality of life in oculopharyngeal muscular dystrophy: Psychometric properties of the SWAL-QOL instrument. Muscle Nerve 2017; 56:28-35. [PMID: 27759888 DOI: 10.1002/mus.25441] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 10/13/2016] [Accepted: 10/18/2016] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The Swallowing Quality of Life instrument (SWAL-QOL) is a patient-reported outcome measure of swallowing-related quality of life (SR-QoL). Its psychometric properties in oculopharyngeal muscular dystrophy (OPMD) are not known. METHODS We administered the SWAL-QOL to U.S. OPMD Registry participants. We described SR-QoL profiles and assessed reliability and validity. RESULTS The mean composite score in 113 individuals with OPMD was 54.4 ± 20.7, indicating moderate impairment. Severe impairments were observed in eating duration, burden, and fatigue scales. Internal consistency reliability of all scales was found to be satisfactory, and 9 of 10 scales demonstrated adequate test-retest reliability. Data confirmed 86% of hypotheses, supporting construct validity. The SWAL-QOL limitations in OPMD include: floor/ceiling effects in 7 of 10 scales and low specificity of sleep, fatigue, and communication scales for dysphagia. CONCLUSIONS SR-QoL is reduced in OPMD. Given several limitations of the SWAL-QOL, development of an improved dysphagia-specific QoL instrument for OPMD is warranted. Muscle Nerve 56: 28-35, 2017.
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Affiliation(s)
- Sarah Youssof
- Department of Neurology, MSC 10 5620, 1, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, 87131, USA
| | - Carol Romero-Clark
- Speech, Language, Swallow Center, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Teddy Warner
- Department of Family and Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Emily Plowman
- Speech, Language and Hearing Sciences, Center for Respiratory Research & Rehabilitation, University of Florida, Gainesville, Florida, USA
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Richard P, Roth F, Stojkovic T, Trollet C. Distrofia muscolare oculofaringea. Neurologia 2017. [DOI: 10.1016/s1634-7072(16)81777-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Youssof S. The relationship between physical symptoms and health-related quality of life in oculopharyngeal muscular dystrophy. Muscle Nerve 2016; 53:694-9. [PMID: 26453481 DOI: 10.1002/mus.24932] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2015] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Oculopharyngeal muscular dystrophy (OPMD) causes ptosis, dysphagia, and limb weakness. Health-related quality of life (HRQoL) and its relationship to physical symptoms was investigated. METHODS The 36-item Short Form (SF-36) was completed by 89 participants in the U.S. OPMD Registry. Multiple hierarchical regression was used to determine the relative contributions of dysphagia severity and lower extremity functional impairment to the physical (PCS) and mental (MCS) components of the SF-36. RESULTS HRQoL was reduced in OPMD compared with population norms. Lower extremity functional impairment explained a significant proportion of variance in PCS and MCS. Dysphagia symptom severity explained a moderate amount of variance only in MCS. Dysphagia symptom severity had the strongest associations with general health perception and social functioning domains. CONCLUSIONS Lower extremity functional impairment in OPMD deserves attention due to its large influence on HRQoL. Both generic and dysphagia-specific measures are necessary to assess HRQoL in OPMD.
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Affiliation(s)
- Sarah Youssof
- Department of Neurology, University of New Mexico Health Sciences Center, MSC 10 5620, Albuquerque, New Mexico, 87131, USA
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Youssof S, Schrader R, Bear D, Morrison L. Hip flexion weakness is associated with impaired mobility in oculopharyngeal muscular dystrophy: a retrospective study with implications for trial design. Neuromuscul Disord 2014; 25:238-46. [PMID: 25500011 DOI: 10.1016/j.nmd.2014.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 11/06/2014] [Accepted: 11/18/2014] [Indexed: 11/15/2022]
Abstract
Oculopharyngeal muscular dystrophy (OPMD) is a rare myopathy for which validated outcome measures are lacking, posing a barrier to clinical trials. Our goal was to identify factors associated with impaired mobility in OPMD in order to guide development of surrogate endpoints in future clinical trials. One hundred forty-four individuals with OPMD were included in this retrospective, single-center study. We made novel use of parametric time-to-event analysis to model age at initial use of assistive device for ambulation. We hypothesized that limb weakness and other markers of disease severity are associated with earlier use of assistive devices. 23.6% of individuals (34/144) progressed to use of assistive devices (mean age 66.0 ± 9.6 y). Earlier age at assistive device was associated with hip flexion Medical Research Council grade ≤3 (p <0.0001), earlier disease onset (p <0.0001), and lack of blepharoptosis surgery (p = 0.011). Markers of dysphagia severity were not associated with earlier progression to assistive devices. Our study is the first to show a statistical association between hip flexion weakness and impaired mobility in OPMD, indicating that hip flexion strength could be explored as a surrogate endpoint for use in clinical trials. Since severity of disease features may be discordant within individuals, composite outcome measures are warranted.
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Affiliation(s)
- Sarah Youssof
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM, United States.
| | - Ronald Schrader
- Clinical and Translational Science Center, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - David Bear
- Department of Cell Biology and Physiology, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Leslie Morrison
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
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Witting N, Mensah A, Køber L, Bundgaard H, Petri H, Duno M, Milea D, Vissing J. Ocular, bulbar, limb, and cardiopulmonary involvement in oculopharyngeal muscular dystrophy. Acta Neurol Scand 2014; 130:125-30. [PMID: 24611576 DOI: 10.1111/ane.12244] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess skeletal muscle weakness and progression as well as the cardiopulmonary involvement in oculopharyngeal muscular dystrophy (OPMD). MATERIALS AND METHODS Cross-sectional study including symptomatic patients with genetically confirmed OPMD. Patients were assessed by medical history, ptosis, ophthalmoplegia, facial and limb strength, and swallowing capability. Cardiopulmonary function was evaluated using forced expiratory capacity in 1 s (FEV1), electrocardiogram (ECG), Holter monitoring, and echocardiography. RESULTS We included 13 symptomatic patients (six males, mean age; 64 years (41-80) from 8 families. Ptosis was the first symptom in 8/13 patients followed by limb weakness in the remaining 5 patients Dysphagia was never the presenting symptom. At the time of examination, all affected patients had ptosis or had previously been operated for ptosis, while ophthalmoplegia was found in 9 patients. Dysphagia, tested by cold-water swallowing test, was abnormal in 9 patients (17-116 s, ref <8 s). Six patients could not climb stairs of whom two were wheelchair bound and one used a rollator. Six patients had reduced FEV1 (range 23%-59%). No cardiac involvement was identified. CONCLUSIONS Limiting limb weakness is common in OPMD and can even be the presenting symptom of the disease. In contrast, dysphagia was not the initial symptom in any of our patients, although it was obligatory for diagnosing OPMD before genetic testing became available. Mild respiratory dysfunction, but no cardiac involvement, was detected.
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Affiliation(s)
- N. Witting
- Department of Neurology and Neuromuscular Research Unit; University of Copenhagen; Rigshospitalet; Copenhagen Denmark
| | - A. Mensah
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
| | - L. Køber
- Department of Cardiology; The Heart Centre; University of Copenhagen; Rigshospitalet; Copenhagen Denmark
| | - H. Bundgaard
- Department of Cardiology; The Heart Centre; University of Copenhagen; Rigshospitalet; Copenhagen Denmark
| | - H. Petri
- Department of Cardiology; The Heart Centre; University of Copenhagen; Rigshospitalet; Copenhagen Denmark
| | - M. Duno
- Clinical Genetics; University of Copenhagen; Rigshospitalet; Copenhagen Denmark
| | - D. Milea
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- Singapore National Eye Centre; Singapore Eye Research Institute and Duke-NUS; Singapore City Singapore
| | - J. Vissing
- Department of Neurology and Neuromuscular Research Unit; University of Copenhagen; Rigshospitalet; Copenhagen Denmark
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Executive functions are impaired in heterozygote patients with oculopharyngeal muscular dystrophy. J Neurol 2011; 259:833-7. [PMID: 21956377 DOI: 10.1007/s00415-011-6255-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Revised: 09/09/2011] [Accepted: 09/14/2011] [Indexed: 10/17/2022]
Abstract
Oculopharyngeal muscular dystrophy (OPMD) is an autosomal dominant disorder caused by a small expansion of a short polyalanine tract in poly(A) binding protein nuclear 1 (PABPN1). It presents with adult onset of progressive eyelid drooping, swallowing difficulties and proximal limb weakness, usually without involvement of central nervous system (CNS). However, cognitive decline with relevant behavioural and psychological symptoms has been recently described in homozygous patients. In this study, we performed for the first time an extensive neuropsychological and neuropsychiatric evaluation on 11 OPMD heterozygote patients. We found that they were less efficient than a matched control sample on several tests, particularly those tapping executive functions. Moreover, the presence of negative correlation between GCN expansion size and some neuropsychological scores raises the issue that CNS involvement might be linked to the genetic defect, being worse in patients with larger expansion. Our results might be consistent with the toxic gain-of-function theory in the pathogenesis of OPMD and hint at a possible direct role of PABPN1 in the CNS also in heterozygote patients.
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The man who could not see what he could not eat. Surv Ophthalmol 2011; 56:461-5. [PMID: 21371731 DOI: 10.1016/j.survophthal.2010.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Revised: 11/18/2010] [Accepted: 11/23/2010] [Indexed: 11/23/2022]
Abstract
A 55-year-old Hispanic man born in New Mexico presented with progressively worsening bilateral upper eyelid ptosis and dysphagia. External levator advancement 5 years before did not improve his ptosis. A thorough systemic workup for myasthenia gravis was negative, but electromyography suggested a myopathic process. Molecular genetic testing was positive for oculopharyngeal muscular dystrophy.
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Clinical Characterization and Blepharoptosis Surgery Outcomes in Hispanic New Mexicans With Oculopharyngeal Muscular Dystrophy. Ophthalmic Plast Reconstr Surg 2009; 25:103-8. [DOI: 10.1097/iop.0b013e3181994e21] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Oculopharyngeal muscular dystrophy as a rare differential diagnosis for unexplained dysphagia: a case report. CASES JOURNAL 2009; 2:94. [PMID: 19175930 PMCID: PMC2639567 DOI: 10.1186/1757-1626-2-94] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2008] [Accepted: 01/28/2009] [Indexed: 11/10/2022]
Abstract
INTRODUCTION We wish to report on a rare cause of dysphagia; oculopharyngeal muscular dystrophy (OPMD). It is a late adult onset autosomal dominant form of muscular dystrophy that constitutes as a rare diagnosis for any place outside of Canada and first case in southern Germany. CASE PRESENTATION We report the medical odyssey of a 57-year old male Caucasian patient. He was referred at our hospital for further clarification of a progressive dysphagia, which, at first view, was thought to be tumor related due to the patient's typical anamnesis. CONCLUSION The present report outlines the importance of considering this rare disease for general medicine practitioners as well as head and neck specialists as a differential diagnosis for swallowing disorders with, even at second view, uncertain cause.
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Abu-Baker A, Rouleau GA. Oculopharyngeal muscular dystrophy: Recent advances in the understanding of the molecular pathogenic mechanisms and treatment strategies. Biochim Biophys Acta Mol Basis Dis 2007; 1772:173-85. [PMID: 17110089 DOI: 10.1016/j.bbadis.2006.10.003] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2006] [Revised: 10/05/2006] [Accepted: 10/06/2006] [Indexed: 12/24/2022]
Abstract
Oculopharyngeal muscular dystrophy (OPMD) is an adult-onset disorder characterized by progressive eyelid drooping, swallowing difficulties and proximal limb weakness. OPMD is caused by a small expansion of a short polyalanine tract in the poly (A) binding protein nuclear 1 protein (PABPN1). The mechanism by which the polyalanine expansion mutation in PABPN1 causes disease is unclear. PABPN1 is a nuclear multi-functional protein which is involved in pre-mRNA polyadenylation, transcription regulation, and mRNA nucleocytoplasmic transport. The distinct pathological hallmark of OPMD is the presence of filamentous intranuclear inclusions (INIs) in patient's skeletal muscle cells. The exact relationship between mutant PABPN1 intranuclear aggregates and pathology is not clear. OPMD is a unique disease sharing common pathogenic features with other polyalanine disorders, as well as with polyglutamine and dystrophic disorders. This chapter aims to review the rapidly growing body of knowledge concerning OPMD. First, we outline the background of OPMD. Second, we compare OPMD with other trinucleotide repeat disorders. Third, we discuss the recent advances in the understanding of the molecular mechanisms underlying OPMD pathogenesis. Finally, we review recent therapeutic strategies for OPMD.
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Affiliation(s)
- Aida Abu-Baker
- Center for the Study of Brain Diseases, CHUM Research Center-Notre Dame Hospital, J.A. de Sève Pavillion, Room Y-3633, 1560, Sherbrooke Street East, Montreal, QC, Canada H2L 4M1
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Short GCG expansions in the PAB II gene for oculopharyngeal muscular dystrophy and diagnostic thereof. Expert Opin Ther Pat 2005. [DOI: 10.1517/13543776.9.11.1579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Bilgen C, Bilgen IG, Sener RN. Oculopharyngeal muscular dystrophy: clinical and CT findings. Comput Med Imaging Graph 2001; 25:527-9. [PMID: 11679216 DOI: 10.1016/s0895-6111(01)00021-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
A family affected with oculopharygeal muscular dystrophy (OPMD) is reported. This is an uncommon progressive myopathy. The proband presented for evaluation of secretory otitis media with effusion, as a result of tubal dysfunction. CT examination of the father revealed prominent muscular atrophy, and widespread fatty degeneration of the psoas, paraspinal, gluteal and femoral muscles.
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Affiliation(s)
- C Bilgen
- Department of Otorhinolaryngology, Ege University Medical School, Bornova, 35100 Izmir, Turkey
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Blumen SC, Brais B, Korczyn AD, Medinsky S, Chapman J, Asherov A, Nisipeanu P, Cod�re F, Bouchard JP, Fardeau M, Tom� FMS, Rouleau GA. Homozygotes for oculopharyngeal muscular dystrophy have a severe form of the disease. Ann Neurol 2001. [DOI: 10.1002/1531-8249(199907)46:1<115::aid-ana17>3.0.co;2-o] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Affiliation(s)
- J Zlotogora
- Department of Community Genetics, Ministry of Health, Israel
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Abstract
Oculopharyngeal muscular dystrophy (OPMD) is a late adult onset, autosomal dominant muscular dystrophy characterized by ptosis and dysphagia. The OPMD gene has been localized to chromosome 14q11.2-q13 in French-Canadian pedigrees. We report 2 non-French-Canadian families with OPMD. Affected ancestors were immigrants to the United States from Italy and Normandy. The Norman pedigree does not share the French-Canadian haplotype. OPMD appears to be a heterogeneous disorder with similar phenotypes, but probably with different gene loci.
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Affiliation(s)
- G B Creel
- 74th Medical Operations Squadron/SGOMU, Neurology Services, Wright-Patterson AFB, Ohio 45433, USA
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29
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Brais B, Bouchard JP, Xie YG, Rochefort DL, Chrétien N, Tomé FM, Lafrenière RG, Rommens JM, Uyama E, Nohira O, Blumen S, Korczyn AD, Heutink P, Mathieu J, Duranceau A, Codère F, Fardeau M, Rouleau GA, Korcyn AD. Short GCG expansions in the PABP2 gene cause oculopharyngeal muscular dystrophy. Nat Genet 1998; 18:164-7. [PMID: 9462747 DOI: 10.1038/ng0298-164] [Citation(s) in RCA: 513] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Autosomal dominant oculopharyngeal muscular dystrophy (OPMD) is an adult-onset disease with a world-wide distribution. It usually presents in the sixth decade with progressive swallowing difficulties (dysphagia), eyelid drooping (ptosis) and proximal limb weakness. Unique nuclear filament inclusions in skeletal muscle fibres are its pathological hallmark. We isolated the poly(A) binding protein 2 gene (PABP2) from a 217-kb candidate interval on chromosome 14q11 (B.B. et al., manuscript submitted). A (GCG)6 repeat encoding a polyalanine tract located at the N terminus of the protein was expanded to (GCG)8-13 in the 144 OPMD families screened. More severe phenotypes were observed in compound heterozygotes for the (GCG)9 mutation and a (GCG)7 allele that is found in 2% of the population, whereas homozygosity for the (GCG)7 allele leads to autosomal recessive OPMD. Thus the (GCG)7 allele is an example of a polymorphism which can act either as a modifier of a dominant phenotype or as a recessive mutation. Pathological expansions of the polyalanine tract may cause mutated PABP2 oligomers to accumulate as filament inclusions in nuclei.
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Affiliation(s)
- B Brais
- Centre for Research in Neurosciences, McGill University, Montreal General Hospital, Québec, Canada
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Rowland LP, Hirano M, DiMauro S, Schon EA. Oculopharyngeal muscular dystrophy, other ocular myopathies, and progressive external ophthalmoplegia. Neuromuscul Disord 1997; 7 Suppl 1:S15-21. [PMID: 9392010 DOI: 10.1016/s0960-8966(97)00076-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Progressive external ophthalmoplegia comprises many different disorders. Those of childhood onset can be separated from juvenile or adult onset. Among those of later onset the most common causes are oculopharyngeal muscular dystrophy, oculopharyngodistal muscular dystrophy and the several mitochondrial disorders, especially those with large deletions of mitochondrial DNA (mtDNA) (sporadic), those with maternal inheritance (point mutations), or the autosomal dominant forms with multiple deletions of mtDNA. Ophthalmoplegia of presumably neurogenic origin is seen in some of the familial spinocerebellar ataxias. Advances in molecular genetics should provide information about affected gene products and, therefore, pathogenesis.
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Affiliation(s)
- L P Rowland
- Department of Neurology, Neurological Institute, New York, NY, USA
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Brunet G, Tomé FM, Eymard B, Robert JM, Fardeau M. Genealogical study of oculopharyngeal muscular dystrophy in France. Neuromuscul Disord 1997; 7 Suppl 1:S34-7. [PMID: 9392013 DOI: 10.1016/s0960-8966(97)00079-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This work is based on 54 probands affected by oculopharyngeal muscular dystrophy (OPMD). The muscle biopsy of all these patients showed the presence of the intranuclear inclusions, specific of this disease. The residence of the probands is concentrated in three clusters: the Paris, Marseilles and Bordeaux regions. The genealogical study was carried out on 43 probands, 10 of which did not have any ascendance in France for more than two generations. The geographic origin of the 33 patients of French descent was distributed over numerous regions, not including the Paris and Marseilles regions where many patients lived. This geographic dispersion and the rarity of common genealogies of the probands, did not suggest the existence of a recent founder effect, in contrast to what is observed in the French-Canadian community. The existence of a link between French and French-Canadian families is currently being investigated.
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Affiliation(s)
- G Brunet
- Centre d'Etudes Démographiques, Université Lumière-Lyon 2, France
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Blumen SC, Nisipeanu P, Sadeh M, Asherov A, Blumen N, Wirguin Y, Khilkevich O, Carasso RL, Korczyn AD. Epidemiology and inheritance of oculopharyngeal muscular dystrophy in Israel. Neuromuscul Disord 1997; 7 Suppl 1:S38-40. [PMID: 9392014 DOI: 10.1016/s0960-8966(97)00080-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Oculopharyngeal muscular dystrophy (OPMD) is considered frequent among French Canadians. Our previous observations suggested it is common also among the Jews originating from Bukhara in Uzbekistan, many of whom are now living in Israel. One hundred and seventeen OPMD patients were identified in a population of 70,000 people of Bukharian descent, resulting in a calculated minimal prevalence of 1:600. In all but three families age dependent autosomal dominant inheritance was documented. There is some evidence for genetic anticipation. Three young, severely ill, patients from two different families may be homozygotes, their parents being both affected. Bukhara Jews present the second largest known cluster and the prevalence is the highest in the world. The existence of very large families, intermarriage among carriers and probably homozygote offspring may be useful for genetic studies. A 'founder effect' may explain the high prevalence of OPMD in this population.
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Affiliation(s)
- S C Blumen
- Department of Neurology, Hillel Yafe Medical Center, Hadera, Israel
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Uyama E, Nohira O, Tomé FM, Chateau D, Tokunaga M, Ando M, Maki M, Okabe T, Uchino M. Oculopharyngeal muscular dystrophy in Japan. Neuromuscul Disord 1997; 7 Suppl 1:S41-9. [PMID: 9392015 DOI: 10.1016/s0960-8966(97)00081-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Oculopharyngeal muscular dystrophy (OPMD) in the European population has been frequently diagnosed, but except for one black family, the occurrence in other ethnic groups is uncertain. We identified two unrelated OPMD Japanese families, including 34 affected individuals. Major clinical manifestations were bilateral ptosis and dysphagia starting after age 40. Histologic studies of limb muscles revealed mild myogenic changes, occasional rimmed vacuoles, and small angulated fibers. By contrast, cricopharyngeal muscle showed a marked loss of fibers and massive proliferation of connective tissue. Intranuclear tubulofilamentous inclusions (ITFI) of 8.5 nm outer diameter were observed in 2-5% of the nuclei in four different biopsied muscles. One patient with recurrent aspirations underwent successful cricopharyngeal myotomy. Aerodynamic examination was useful to evaluate velopharyngeal closure function. Our investigations revealed that OPMD is a geographically widespread disorder, and ITFI may be the specific morphologic hallmark.
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Affiliation(s)
- E Uyama
- Department of Neurology, Kumamoto University School of Medicine, Japan
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