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Emperador S, Habbane M, López-Gallardo E, Del Rio A, Llobet L, Mateo J, Sanz-López AM, Fernández-García MJ, Sánchez-Tocino H, Benbunan-Ferreiro S, Calabuig-Goena M, Narvaez-Palazón C, Fernández-Vega B, González-Iglesias H, Urreizti R, Artuch R, Pacheu-Grau D, Bayona-Bafaluy P, Montoya J, Ruiz-Pesini E. Identification and characterization of a new pathologic mutation in a large Leber hereditary optic neuropathy pedigree. Orphanet J Rare Dis 2024; 19:148. [PMID: 38582886 PMCID: PMC10999093 DOI: 10.1186/s13023-024-03165-2] [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: 10/29/2023] [Accepted: 03/30/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND Most patients suffering from Leber hereditary optic neuropathy carry one of the three classic pathologic mutations, but not all individuals with these genetic alterations develop the disease. There are different risk factors that modify the penetrance of these mutations. The remaining patients carry one of a set of very rare genetic variants and, it appears that, some of the risk factors that modify the penetrance of the classical pathologic mutations may also affect the phenotype of these other rare mutations. RESULTS We describe a large family including 95 maternally related individuals, showing 30 patients with Leber hereditary optic neuropathy. The mutation responsible for the phenotype is a novel transition, m.3734A > G, in the mitochondrial gene encoding the ND1 subunit of respiratory complex I. Molecular-genetic, biochemical and cellular studies corroborate the pathogenicity of this genetic change. CONCLUSIONS With the study of this family, we confirm that, also for this very rare mutation, sex and age are important factors modifying penetrance. Moreover, this pedigree offers an excellent opportunity to search for other genetic or environmental factors that additionally contribute to modify penetrance.
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Affiliation(s)
- Sonia Emperador
- Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, 50009- and 50013, Zaragoza, Spain
- Instituto de Investigación Sanitaria (IIS) de Aragón, 50009, Zaragoza, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Mouna Habbane
- Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, 50009- and 50013, Zaragoza, Spain
- Laboratoire Biologie Et Santé, Faculté Des Sciences Ben M'Sick, Hassan II University of Casablanca, 20670, Casablanca, Morocco
| | - Ester López-Gallardo
- Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, 50009- and 50013, Zaragoza, Spain
- Instituto de Investigación Sanitaria (IIS) de Aragón, 50009, Zaragoza, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Alejandro Del Rio
- Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, 50009- and 50013, Zaragoza, Spain
| | - Laura Llobet
- Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, 50009- and 50013, Zaragoza, Spain
- Instituto de Investigación Sanitaria (IIS) de Aragón, 50009, Zaragoza, Spain
- Certest Biotec, 50840-San Mateo de Gállego, Zaragoza, Spain
| | - Javier Mateo
- Servicio de Oftalmología, Hospital Clínico Universitario Lozano Blesa, 50009, Zaragoza, Spain
| | - Ana María Sanz-López
- Servicio de Oftalmología, Hospital Universitario de Toledo, 45004, Toledo, Spain
| | | | | | - Sol Benbunan-Ferreiro
- Servicio de Oftalmología. Hospital Universitario Río Hortega, 47012, Valladolid, Spain
| | - María Calabuig-Goena
- Servicio de Oftalmología. Hospital Universitario Río Hortega, 47012, Valladolid, Spain
| | | | | | - Hector González-Iglesias
- Instituto de Productos Lácteos de Asturias, Consejo Superior de Investigaciones Científicas (IPLA-CSIC), 33300-Villaviciosa, Asturias, Spain
| | - Roser Urreizti
- Centro de Investigaciones Biomédicas en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Departament de Bioquímica Clínica, Institut de Recerca Sant Joan de Déu, 08950, Barcelona, Spain
| | - Rafael Artuch
- Centro de Investigaciones Biomédicas en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Departament de Bioquímica Clínica, Institut de Recerca Sant Joan de Déu, 08950, Barcelona, Spain
| | - David Pacheu-Grau
- Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, 50009- and 50013, Zaragoza, Spain
- Instituto de Investigación Sanitaria (IIS) de Aragón, 50009, Zaragoza, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Pilar Bayona-Bafaluy
- Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, 50009- and 50013, Zaragoza, Spain
- Instituto de Investigación Sanitaria (IIS) de Aragón, 50009, Zaragoza, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Instituto de Biocomputación y Física de Sistemas Complejos (BIFI), Universidad de Zaragoza, 50018, Zaragoza, Spain
| | - Julio Montoya
- Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, 50009- and 50013, Zaragoza, Spain.
- Instituto de Investigación Sanitaria (IIS) de Aragón, 50009, Zaragoza, Spain.
- Centro de Investigaciones Biomédicas en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029, Madrid, Spain.
| | - Eduardo Ruiz-Pesini
- Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, 50009- and 50013, Zaragoza, Spain.
- Instituto de Investigación Sanitaria (IIS) de Aragón, 50009, Zaragoza, Spain.
- Centro de Investigaciones Biomédicas en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029, Madrid, Spain.
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Wang L, Ji Y, Ding H, Tian Q, Fan K, Shi D, Yu C, Qin W. Abnormal cerebral blood flow in patients with Leber's hereditary optic neuropathy. Brain Imaging Behav 2023; 17:471-480. [PMID: 37368154 DOI: 10.1007/s11682-023-00775-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 06/28/2023]
Abstract
PURPOSE The study aimed to unravel abnormal cerebral blood flow (CBF) in patients with Leber's hereditary optic neuropathy (LHON) using arterial spin labeling (ASL) and to investigate the associations among disrupted CBF, disease duration, and neuro-ophthalmological impairment. METHODS ASL perfusion imaging data was collected from 20 patients with acute LHON, 29 patients with chronic LHON, and 37 healthy controls. We used a one-way analysis of covariance to test the intergroup differences in CBF. Linear and nonlinear curve fit models were applied to explore the associations among CBF, disease duration, and neuro-ophthalmological metrics. RESULTS Brain regions differed in LHON patients, including the left sensorimotor and bilateral visual areas (p < 0.05, cluster-wise family-wise error correction). Acute and chronic LHON patients demonstrated lower CBF in bilateral calcarine than the healthy controls. Chronic LHON had lower CBF in the left middle frontal gyrus and sensorimotor cortex, and temporal-partial junction than the healthy controls and acute LHON. A significant logarithmic negative correlation was shown between CBF of left middle frontal gyrus and disease duration. A significant linear positive correlation was found between retinal nerve fiber layer thickness and CBF in left middle frontal gyrus, and negative correlations between loss of variance and CBF in left middle frontal gyrus and sensorimotor cortex (p < 0.05, Bonferroni correction). CONCLUSION LHON patients exhibited reduced CBF in the visual pathway, sensorimotor and higher-tier cognitive areas. Disease duration and neuro-ophthalmological impairments can influence the metabolism of non-visual areas.
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Affiliation(s)
- Ling Wang
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, 450003, China
| | - Yi Ji
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Hao Ding
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
- School of Medical Imaging, Tianjin Medical University, Tianjin, 300070, China
| | - Qin Tian
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, 450003, China
| | - Ke Fan
- Henan Eye Institute, Henan Eye Hospital, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, 450003, China
| | - Dapeng Shi
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, 450003, China.
- Department of Medical Imaging, Henan Provincial People's Hospital, Sanquan College of Xinxiang Medical University, Weiwu Road No. 7, Jinshui District, ZhengZhou, Henan Province, China.
| | - Chunshui Yu
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China.
- Department of Radiology, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, China.
| | - Wen Qin
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China.
- Department of Radiology, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, China.
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Tagliani S, Malaventura C, Ceccato C, Parmeggiani F, Suppiej A. Leber Mitochondrial Optic Neuropathy in Pediatric Females With Focus on Very Early Onset Cases. J Child Neurol 2023; 38:5-15. [PMID: 36659874 DOI: 10.1177/08830738221149962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The aim of this study was to describe the phenotype of Leber hereditary optic neuropathy occurring in pediatric females. This disease generally affects young adult males, but it can occur also in females, and research data in this population is lacking. The very early onset can challenge the diagnosis and delay treatment. We searched PubMed through February 2021 and identified 226 pediatric females with genetically confirmed Leber hereditary optic neuropathy and added a new case of a 3-year-old female. The male-female ratio was 1.8:1; the mean onset age in females was 11 years with the onset at 3 years of age occurring in 3 females only. Acute onset with mild visual impairment was the most common presentation, associated with optic disc edema in 16%. Differential diagnoses are pseudotumor cerebri, optic nerve drusen and optic neuritis. The outcome is poor with partial recovery in 50%, despite some receiving Idebenone therapy.
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Affiliation(s)
- Sara Tagliani
- Department of Medical Sciences, Pediatric Section, University Hospital of Ferrara, Ferrara, Italy
| | - Cristina Malaventura
- Department of Medical Sciences, Pediatric Section, University Hospital of Ferrara, Ferrara, Italy
| | | | - Francesco Parmeggiani
- Department of Translational Medicine and for Romagna, 9299University of Ferrara, Ferrara, Italy.,ERN-EYE Network - Center for Retinitis Pigmentosa of Veneto Region, 196013Camposampiero Hospital, Padova, Italy
| | - Agnese Suppiej
- Department of Medical Sciences, Pediatric Section, University Hospital of Ferrara, Ferrara, Italy.,87812Robert Hollman Foundation, Padova, Italy.,ERN-EYE Network - Center for Retinitis Pigmentosa of Veneto Region, 196013Camposampiero Hospital, Padova, Italy
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Andreeva NA, Murakhovskaya YK, Krylova TD, Tsygankova PG, Sheremet NL. [Rare pathogenic nucleotide variants of mitochondrial DNA associated with Leber's hereditary optic neuropathy]. Vestn Oftalmol 2023; 139:166-174. [PMID: 38235644 DOI: 10.17116/oftalma2023139061166] [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: 01/19/2024]
Abstract
Patients with Leber Hereditary Optic Neuropathy (LHON) in most cases have one of the three most common mutations: m.11778G>A in the ND4 gene, m.3460G>A in the ND1 gene, or m.14484T>C in the ND6 gene. According to the international Mitomap database, in addition to these three most common mutations, there are 16 other primary mutations that are even more rare. There are nucleotide substitutions that are classified as candidate or conditionally pathogenic mutations. Their involvement in the disease development is not proven due to insufficient research. Moreover, in many publications, the authors describe new primary and potential mitochondrial DNA mutations associated with LHON, which are not yet included in the genetic data bases. This makes it possible to expand the diagnostic spectrum during genetic testing in the future. The advancements in genetic diagnostic technologies allow confirmation of the clinical diagnosis of LHON. The importance of genetic verification of the disease is determined by the existing problem of differential diagnosis of hereditary optic neuropathies with optic neuropathies of a different origin.
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Affiliation(s)
- N A Andreeva
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
| | - Yu K Murakhovskaya
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - T D Krylova
- Research Centre for Medical Genetics, Moscow, Russia
| | | | - N L Sheremet
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
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Zhao J, Sun H, Zhu H, Chang Q, Wang J. Optic nerve lesion length is a biomarker of visual disability in the pre-chronic phase of Leber's hereditary optic neuropathy. Clin Neurol Neurosurg 2022; 224:107542. [PMID: 36459841 DOI: 10.1016/j.clineuro.2022.107542] [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: 09/30/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The current research aims to investigate relationships between the optic nerve (ON) lesion length with visual function in the pre-chronic phase ( illness duration < 12 months) of LHON. METHODS Orbital MRI was retrospectively analyzed for 45 patients with LHON in the pre-chronic phase. ON lesion length was measured by 2 trained independent readers and it was recorded as multiplication of the number of abnormal MRI slices and slice thickness on T2-STIR sequence in the coronal plane. Decimal visual acuity was converted to the logarithm of minimum angle of resolution. Intra-class correlation coefficients (ICCs) were used to assess intra- and inter-observer agreements. Pearson's correlation analysis and multivariate linear regression models were performed to analyze the correlations of the lesion length with best corrected visual acuity (BCVA) and visual field parameters. RESULTS 81 afflicted eyes were selected. The ICCs for intra-observer and inter-observer analyses were 0.989 and 0.980 respectively. Both Pearson's correlation analysis and multivariate linear regression models indicated a significant positive correlation between the BCVA or mean deviation (MD) and ON lesion length (rBCVA=0.368, PBCVA=0.001; rMD=-0.269, PMD=0.045) with a coefficient of determination (R2) of 0.152 and 0.114 respectively adjusted for patients' sex, age of onset, onset of vision loss to performance of MRI, mitochondrial DNA mutations. CONCLUSION ON length with T2-STIR hyperintensities was positively associated with both BCVA and MD, and it was suspected to be a biomarker of visual disability in the pre-chronic phase of LHON.
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Affiliation(s)
- Juan Zhao
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, China
| | - Houliang Sun
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, China
| | - Hongyu Zhu
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, China
| | - Qinglin Chang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, China
| | - Jiawei Wang
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, China.
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Yao S, Zhou Q, Yang M, Li Y, Jin X, Guo Q, Yang L, Qin F, Lei B. Multi-mtDNA Variants May Be a Factor Contributing to Mitochondrial Function Variety in the Skin-Derived Fibroblasts of Leber's Hereditary Optic Neuropathy Patients. Front Mol Neurosci 2022; 15:920221. [PMID: 35909448 PMCID: PMC9326446 DOI: 10.3389/fnmol.2022.920221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/13/2022] [Indexed: 12/17/2022] Open
Abstract
Heterogeneity is a major feature of Leber's hereditary optic neuropathy (LHON) and has a significant impact on the manifestation and diagnosis of the disease. This study explored whether multiple variations in mitochondrial genes were associated with the heterogeneity, mainly phenotypic heterogeneity. Ophthalmic examinations were conducted in two probands with LHON with G11778A and multiple mitochondrial DNA gene (mtDNA) variants. Skin fibroblast cell lines were generated from patients and age- and sex-matched controls. ROS levels, mitochondrial membrane potential, cell energy respiration, and metabolic functions were measured. Flow cytometry and cell viability tests were performed to evaluate the cell apoptosis levels and fate. We found that cells with more mtDNA variants had higher ROS levels, lower mitochondrial membrane potential, and weaker respiratory function. Flow cytometry and cell viability testing showed that multiple mtDNA variants are associated with different levels of cell viability and apoptosis. In conclusion, we found that skin-derived fibroblast cells from G11778A LHON patients could be used as models for LHON research. Multi-mtDNA variants contribute to mitochondrial function variety, which may be associated with heterogeneity in patients with LHON.
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Affiliation(s)
- Shun Yao
- Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, Zhengzhou, China
| | - Qingru Zhou
- Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, Zhengzhou, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Mingzhu Yang
- Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, Zhengzhou, China
| | - Ya Li
- Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, Zhengzhou, China
| | - Xiuxiu Jin
- Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, Zhengzhou, China
| | - Qingge Guo
- Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, Zhengzhou, China
| | - Lin Yang
- Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, Zhengzhou, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Fangyuan Qin
- Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Bo Lei
- Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, Zhengzhou, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
- *Correspondence: Bo Lei
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Stephenson KAJ, McAndrew J, Kenna PF, Cassidy L. The Natural History of Leber's Hereditary Optic Neuropathy in an Irish Population and Assessment for Prognostic Biomarkers. Neuroophthalmology 2022; 46:159-170. [PMID: 35574161 PMCID: PMC9103396 DOI: 10.1080/01658107.2022.2032761] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
In this study we have assessed the clinical and genetic characteristics of an Irish Leber's hereditary optic neuropathy (LHON) cohort and assessed for useful biomarkers of visual prognosis. We carried out a retrospective review of clinical data of patients with genetically confirmed LHON presenting to an Irish tertiary referral ophthalmic hospital. LHON diagnosis was made on classic clinical signs with genetic confirmation. Alternate diagnoses were excluded with serological investigations and neuro-imaging. Serial logarithm of the minimum angle of resolution (logMAR) visual acuity (VA) was stratified into 'on-chart' for logMAR 1.0 or better and 'off-chart' if worse than logMAR 1.0. Serial optical coherence tomography scans of the retinal nerve fibre layer (RNFL) and ganglion cell complex (GCC) monitored structure. Idebenone-treated and untreated patients were contrasted. Statistical analyses were performed to assess correlations of presenting characteristics with final VA. Forty-four patients from 34 pedigrees were recruited, of which 87% were male and 75% harboured the 11778 mutation. Legal blindness status was reached in 56.8% of patients by final review (mean 74 months). Preservation of initial nasal RNFL was the best predictor of on-chart final VA. Females had worse final VA than males and patients presenting at < 20 years of age had superior final VA. Idebenone therapy (50% of cohort) yielded no statistically significant benefit to final VA, although study design precludes definitive comment on efficacy. The reported cases represent the calculated majority of LHON pedigrees in Ireland. Visual outcomes were universally poor; however, VA may not be the most appropriate outcome measure and certain patient-reported outcome measures may be of more use when assessing future LHON interventions.
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Affiliation(s)
- Kirk A. J. Stephenson
- Department of Neuro-ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland,CONTACT Kirk A. J. Stephenson Department of Neuro-ophthalmology, Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin2 D02 XK51, Ireland
| | - Joseph McAndrew
- Department of Neuro-ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Paul F. Kenna
- Department of Neuro-ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Lorraine Cassidy
- Department of Neuro-ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
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Zhao J, Zhang Q, Wang J. Magnetic Resonance Imaging Findings in the Pregeniculate Visual Pathway in Leber Hereditary Optic Neuropathy. J Neuroophthalmol 2022; 42:e153-e158. [PMID: 34417770 PMCID: PMC8834162 DOI: 10.1097/wno.0000000000001383] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Current research has not provided a consistent and qualitative description of MRI features in Leber hereditary optic neuropathy (LHON). Our study aims to investigate the MRI findings in the pregeniculate visual pathway and discuss their clinical significance in LHON. METHODS Orbital MRI was retrospectively analyzed for 53 patients with LHON (101 afflicted eyes) admitted to the Department of Neurology, Beijing Tongren Hospital, Capital Medical University, from 2014 to 2019. We described the imaging abnormalities and discussed their associations with the time interval from the onset of vision loss to the performance of MRI (TIOVP), prevalence of m.11778G>A, and best-corrected visual acuity (BCVA). RESULTS T2 hyperintense signal (HS) was determined in 82 afflicted eyes, with 34 located in the intraorbital segment (IO) of the optic nerve (ON), 26 in the IO concurrent with intracanalicular segment (ICn), 14 in the IO and ICn concurrent with intracranial segment (ICr) of the ON, 4 in the IO, ICn, and ICr concurrent with optic chiasm (OCh), and 4 in the IO, ICn, ICr, and OCh concurrent with optic tract (OTr). MRI was normal in the remaining 19 afflicted eyes. Among the 6 groups, no statistical differences were found in the TIOVP (P = 0.071), prevalence of m.11778G>A (P = 0.234), and BCVA (P = 0.076). As T2 HS extended, the BCVA gradually decreased. Nineteen of the 54 afflicted eyes revealed contrast enhancement, with the TIOVP ranging from 0.25 to 6 months. CONCLUSIONS T2 HS was common in the pregeniculate visual pathway in LHON. It was not correlated with the prevalence of m.11778G>A and did not benefit in disease staging. As it extended, the BCVA gradually decreased. Contrast enhancement was relatively rare, always occurring in the subacute stage.
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Yu X, Ji K, Lin Y, Xu X, Wang W, Li Y, Lu JQ, Zhao Y, Yan C. Leber hereditary optic neuropathy and dystonia overlapping mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes due to m.14459G>A mutation. Neurol Sci 2021; 42:5123-5130. [PMID: 33779865 DOI: 10.1007/s10072-021-05155-9] [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: 08/17/2020] [Accepted: 02/26/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To report a Chinese family with combined m.14459G>A mutation and m.6064A>T mutation of which the female proband presenting unique Leber hereditary optic neuropathy and dystonia (LDYT) overlapping mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) phenotype. METHODS Clinical information of the pedigree was collected. We performed muscle biopsy and whole-length mitochondrial DNA (mtDNA) sequencing on the proband. The activity of respiratory chain complexes in immortalized lymphoblasts was determined. RESULTS The current 23-year-old proband suffered from vision decline at age 15 and developed seizures and dystonia with bilateral lesions in precentral gyri at age 18. When she was 21, the lesions in bilateral putamen were found with elevated cerebrospinal fluid lactate. Her mother had optic atrophy; one of her brother died at age 4 with respiratory distress; and the other 8-year-old brother was asymptomatic. Muscle biopsy of the proband was unremarkable. The mtDNA sequencing revealed a heteroplasmic m.14459G>A mutation and a previously unreported m.6064A>T mutation. The respiratory chain complex I activity in the proband's immortalized lymphoblasts was 50% less than the normal control; while there was no statistical difference between the proband and the normal control in the activity of complex IV. CONCLUSIONS We presented the first case exhibiting LDYT and MELAS phenotype with m.14459G>A mutation, and the decreased complex I activity contributed to the pathogenicity. Our study expanded the clinical spectrum of m.14459G>A mutation.
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Affiliation(s)
- Xiaolin Yu
- Department of Geriatrics Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, China.,Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Kunqian Ji
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Yan Lin
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Xuebi Xu
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Wei Wang
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Ying Li
- Department of Geriatrics Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Jian-Qiang Lu
- Department of Pathology and Molecular Medicine/Neuropathology, McMaster University, Hamilton, Ontario, Canada
| | - Yuying Zhao
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Shandong University, Jinan, Shandong, China.
| | - Chuanzhu Yan
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Shandong University, Jinan, Shandong, China. .,Mitochondrial Medicine Laboratory, Qilu Hospital (Qingdao), Shandong University, Qingdao, Shandong, China. .,Brain Science Research Institute, Shandong University, Jinan, Shandong, China.
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Zhang J, Wang L, Ding H, Fan K, Tian Q, Liang M, Sun Z, Shi D, Qin W. Abnormal large-scale structural rich club organization in Leber's hereditary optic neuropathy. NEUROIMAGE-CLINICAL 2021; 30:102619. [PMID: 33752075 PMCID: PMC8010853 DOI: 10.1016/j.nicl.2021.102619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 02/23/2021] [Accepted: 03/02/2021] [Indexed: 12/24/2022]
Abstract
LHON patients suffered large-scale structural network disruption. Non-rich club connections may be more vulnerable in the LHON. Both primary and secondary connectivity damage may coexist in the LHON.
Objective The purpose of this study was to investigate whether the large-scale structural rich club organization was abnormal in patients with Leber's hereditary optic neuropathy (LHON) using diffusion tensor imaging (DTI), and the associations among disrupted brain structural connectivity, disease duration, and neuro-ophthalmological impairment. Methods Nineteen acute, 34 chronic LHON patients, and 36 healthy controls (HC) underwent DTI and neuro-ophthalmological measurements. The brain structural network and rich club organization were constructed based on deterministic fiber tracking at the individual level. Then intergroup differences among the acute, chronic LHON patients and healthy controls (HC) in three types of structural connections, including rich club, feeder, and local ones, were compared. Network-based Statistics (NBS) was also used to test the intergroup connectivity differences for each fiber. Several linear and nonlinear curve fit models were applied to explore the associations among large-scale brain structural connectivity, disease duration, and neuro-ophthalmological metrics. Results Compared to the HC, both the acute and chronic LHON patients had consistently significantly lower fractional anisotropy (FA) and higher radial diffusion (RD) for feeder connections (p < 0.05, FDR correction). Acute LHON patients had significantly lower FA and higher RD for local connections (p < 0.05, FDR correction). There was no significant difference in large-scale brain structural connectivity between acute and chronic LHON (p > 0.05, FDR correction). NBS also identified reduced FA of three feeder connections and five local ones linking visual, auditory, and basal ganglia areas in LHON patients (p < 0.05, FDR correction). No structural connections showed linear or nonlinear association with either disease duration or neuro-ophthalmological indicators (p > 0.05, FDR correction). A significant negative correlation was shown between the retinal nerve fiber layer (RNFL) thickness and disease duration (p < 0.05, FDR correction). Conclusions Abnormal rich club organization of the structural network was identified in both the acute and chronic LHON. Furthermore, our findings suggest the coexistence of both primary and secondary connectivity damage in the LHON.
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Affiliation(s)
- Jiahui Zhang
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Ling Wang
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - Hao Ding
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China; School of Medical Imaging, Tianjin Medical University, Tianjin 300070, China
| | - Ke Fan
- Henan Eye Institute, Henan Eye Hospital, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - Qin Tian
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - Meng Liang
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China; School of Medical Imaging, Tianjin Medical University, Tianjin 300070, China
| | - Zhihua Sun
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China.
| | - Dapeng Shi
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou 450003, China.
| | - Wen Qin
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China.
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Rovcanin B, Jancic J, Pajic J, Rovcanin M, Samardzic J, Djuric V, Nikolic B, Ivancevic N, Novakovic I, Kostic V. Oxidative Stress Profile in Genetically Confirmed Cases of Leber's Hereditary Optic Neuropathy. J Mol Neurosci 2020; 71:1070-1081. [PMID: 33095398 DOI: 10.1007/s12031-020-01729-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/06/2020] [Indexed: 10/23/2022]
Abstract
The mechanisms of the complex pathophysiology of Leber's hereditary optic neuropathy (LHON) are still insufficiently clarified. The role of oxidative stress as an etiological factor has been proposed and demonstrated in vitro, but without conclusive data that rely on clinical samples. The aim of the study was to evaluate and characterize the existence of oxidative stress in the plasma of LHON patients and healthy individuals. Whole mitochondrial genome sequencing has been performed in order to identify primary LHON mutations. For the assessment of oxidative stress, the following biomarkers were determined in plasma: total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI), while oxidative damage of cellular proteins was estimated by quantifying advanced oxidation protein products (AOPP). All three primary LHON mutations (m.3460G > A, m.11778G > A and m.14484 T > C) were identified as a genetic cause of the disease, where the most prevalent one was m.11778G > A. LHON patients have a highly significant increase of TOS and a marked decrease of TAS levels, which suggests the existence of substantial oxidative stress. OSI is high in LHON patients, which definitely implies the presence of redox imbalance. Elevated level of AOPP in LHON patients refers to the significant deleterious effects of oxidative stress on cellular proteins. Oxidative stress parameters do not significantly differ between LHON individuals with different primary mutations. Both symptomatic and asymptomatic LHON patients have an augmented level of oxidative stress which suggests that primary mutations exhibit a pro-oxidative phenotype. Gender and smoking habit significantly influence examined biochemical parameters when LHON patients are compared with the control group. Different mitochondrial haplogroups are characterized by altered levels of OSI in LHON group. The absence of physiological correlations between redox parameters reflects the deregulation of homeostatic oxidative/antioxidative balance in LHON patients. This is the greatest series of LHON patients that were evaluated for oxidative stress and the first case-controlled study that evaluated TOS, TAS, OSI, and AOPP and their influence on disease phenotype. It is evident that the presence of oxidative stress represents an important pathophysiological event in LHON and that it could potentially serve as a circulatory biomarker for a therapy efficacy understanding.
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Affiliation(s)
- Branislav Rovcanin
- Center for Endocrine Surgery, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Koste Todorovica 8, 11000, Belgrade, Serbia. .,Center for Endocrine Surgery, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Koste Todorovica 8, 11000, Belgrade, Serbia.
| | - Jasna Jancic
- Center for Endocrine Surgery, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Koste Todorovica 8, 11000, Belgrade, Serbia.,Center for Endocrine Surgery, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Koste Todorovica 8, 11000, Belgrade, Serbia.,Clinic of Neurology and Psychiatry for Children and Youth, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Pajic
- Radiation Protection Department, Radiation Protection Center, Serbian Institute of Occupational Health Dr Dragomir Karajovic, Belgrade, Serbia
| | - Marija Rovcanin
- The Obstetrics and Gynecology Clinic Narodni Front, Belgrade, Serbia
| | - Janko Samardzic
- Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vesna Djuric
- Clinic of Neurology and Psychiatry for Children and Youth, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Blazo Nikolic
- Clinic of Neurology and Psychiatry for Children and Youth, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nikola Ivancevic
- Clinic of Neurology and Psychiatry for Children and Youth, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivana Novakovic
- Faculty of Medicine, Institute for Human Genetics, University of Belgrade, Belgrade, Serbia
| | - Vladimir Kostic
- Clinic of Neurology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Neuroanatomical Changes in Leber's Hereditary Optic Neuropathy: Clinical Application of 7T MRI Submillimeter Morphometry. Brain Sci 2020; 10:brainsci10060359. [PMID: 32526981 PMCID: PMC7348858 DOI: 10.3390/brainsci10060359] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 05/29/2020] [Accepted: 06/05/2020] [Indexed: 12/31/2022] Open
Abstract
Leber’s hereditary optic neuropathy (LHON) is one of the mitochondrial diseases that causes loss of central vision, progressive impairment and subsequent degeneration of retinal ganglion cells (RGCs). In recent years, diffusion tensor imaging (DTI) studies have revealed structural abnormalities in visual white matter tracts, such as the optic tract, and optic radiation. However, it is still unclear if the disease alters only some parts of the white matter architecture or whether the changes also affect other subcortical areas of the brain. This study aimed to improve our understanding of morphometric changes in subcortical brain areas and their associations with the clinical picture in LHON by the application of a submillimeter surface-based analysis approach to the ultra-high-field 7T magnetic resonance imaging data. To meet these goals, fifteen LHON patients and fifteen age-matched healthy subjects were examined. For all individuals, quantitative analysis of the morphometric results was performed. Furthermore, morphometric characteristics which differentiated the groups were correlated with variables covering selected aspects of the LHON clinical picture. Compared to healthy controls (HC), LHON carriers showed significantly lower volume of both palladiums (left p = 0.023; right p = 0.018), the right accumbens area (p = 0.007) and the optic chiasm (p = 0.014). Additionally, LHON patients have significantly higher volume of both lateral ventricles (left p = 0.034; right p = 0.02), both temporal horns of the lateral ventricles (left p = 0.016; right p = 0.034), 3rd ventricle (p = 0.012) and 4th ventricle (p = 0.002). Correlation between volumetric results and clinical data showed that volume of both right and left lateral ventricles significantly and positively correlated with the duration of the illness (left R = 0.841, p = 0.002; right R = 0.755, p = 0.001) and the age of the LHON participants (left R = 0.656, p = 0.007; right R = 0.691, p = 0.004). The abnormalities in volume of the LHON patients’ subcortical structures indicate that the disease can cause changes not only in the white matter areas constituting visual tracts, but also in the other subcortical brain structures. Furthermore, the correlation between those results and the illness duration suggests that the disease might have a neurodegenerative nature; however, to fully confirm this observation, longitudinal studies should be conducted.
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