1
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Pocratsky AM, Nascimento F, Özyurt MG, White IJ, Sullivan R, O’Callaghan BJ, Smith CC, Surana S, Beato M, Brownstone RM. Pathophysiology of Dyt1- Tor1a dystonia in mice is mediated by spinal neural circuit dysfunction. Sci Transl Med 2023; 15:eadg3904. [PMID: 37134150 PMCID: PMC7614689 DOI: 10.1126/scitranslmed.adg3904] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/14/2023] [Indexed: 05/05/2023]
Abstract
Dystonia, a neurological disorder defined by abnormal postures and disorganized movements, is considered to be a neural circuit disorder with dysfunction arising within and between multiple brain regions. Given that spinal neural circuits constitute the final pathway for motor control, we sought to determine their contribution to this movement disorder. Focusing on the most common inherited form of dystonia in humans, DYT1-TOR1A, we generated a conditional knockout of the torsin family 1 member A (Tor1a) gene in the mouse spinal cord and dorsal root ganglia (DRG). We found that these mice recapitulated the phenotype of the human condition, developing early-onset generalized torsional dystonia. Motor signs emerged early in the mouse hindlimbs before spreading caudo-rostrally to affect the pelvis, trunk, and forelimbs throughout postnatal maturation. Physiologically, these mice bore the hallmark features of dystonia, including spontaneous contractions at rest and excessive and disorganized contractions, including cocontractions of antagonist muscle groups, during voluntary movements. Spontaneous activity, disorganized motor output, and impaired monosynaptic reflexes, all signs of human dystonia, were recorded from isolated mouse spinal cords from these conditional knockout mice. All components of the monosynaptic reflex arc were affected, including motor neurons. Given that confining the Tor1a conditional knockout to DRG did not lead to early-onset dystonia, we conclude that the pathophysiological substrate of this mouse model of dystonia lies in spinal neural circuits. Together, these data provide new insights into our current understanding of dystonia pathophysiology.
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Affiliation(s)
- Amanda M. Pocratsky
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London; London, WC1N 3BG, UK
| | - Filipe Nascimento
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London; London, WC1N 3BG, UK
| | - M. Görkem Özyurt
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London; London, WC1N 3BG, UK
| | - Ian J. White
- Laboratory for Molecular Cell Biology, University College London; London, WC1E 6BT, UK
| | - Roisin Sullivan
- Department of Molecular Neuroscience, UCL Queen Square Institute of Neurology, University College London; London, WC1N 3BG, UK
| | - Benjamin J. O’Callaghan
- Department of Molecular Neuroscience, UCL Queen Square Institute of Neurology, University College London; London, WC1N 3BG, UK
| | - Calvin C. Smith
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London; London, WC1N 3BG, UK
| | - Sunaina Surana
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London; London, WC1N 3BG, UK
- UK Dementia Research Institute, University College London; London, WC1E 6BT, UK
| | - Marco Beato
- Department of Neuroscience, Physiology, and Pharmacology, University College London; London, WC1E 6BT, UK
| | - Robert M. Brownstone
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London; London, WC1N 3BG, UK
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2
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Frederick NM, Pooler MM, Shah P, Didonna A, Opal P. Pharmacological perturbation reveals deficits in D2 receptor responses in Thap1 null mice. Ann Clin Transl Neurol 2021; 8:2302-2308. [PMID: 34802187 PMCID: PMC8670318 DOI: 10.1002/acn3.51481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/28/2021] [Accepted: 10/30/2021] [Indexed: 11/17/2022] Open
Abstract
The primary dystonia DYT6 is caused by mutations in the transcription factor Thanatos‐associated protein 1 (THAP1). To understand THAP1’s functions, we generated mice lacking THAP1 in the nervous system. THAP1 loss causes locomotor deficits associated with transcriptional changes. Since many of the genes misregulated involve dopaminergic signaling, we pharmacologically challenged the two striatal canonical dopamine pathways: the direct, regulated by the D1 receptor, and the indirect, regulated by the D2 receptor. We discovered that depleting THAP1 specifically interferes with the D2 receptor responses, pointing to a selective misregulation of the indirect pathway in DYT6 with implications for pathogenesis and treatment.
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Affiliation(s)
- Natalie M Frederick
- Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, 60611, USA.,Northwestern University Interdepartmental Neuroscience Program, Northwestern University, Evanston, Illinois, 60208, USA
| | - Morgan M Pooler
- Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, 60611, USA
| | - Parth Shah
- Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, 60611, USA
| | - Alessandro Didonna
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, 94158, USA
| | - Puneet Opal
- Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, 60611, USA.,Department of Cell and Molecular Biology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, 60611, USA
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3
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Grütz K, Klein C. Dystonia updates: definition, nomenclature, clinical classification, and etiology. J Neural Transm (Vienna) 2021; 128:395-404. [PMID: 33604773 PMCID: PMC8099848 DOI: 10.1007/s00702-021-02314-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/23/2021] [Indexed: 12/17/2022]
Abstract
A plethora of heterogeneous movement disorders is grouped under the umbrella term dystonia. The clinical presentation ranges from isolated dystonia to multi-systemic disorders where dystonia is only a co-occurring sign. In the past, definitions, nomenclature, and classifications have been repeatedly refined, adapted, and extended to reflect novel findings and increasing knowledge about the clinical, etiologic, and scientific background of dystonia. Currently, dystonia is suggested to be classified according to two axes. The first axis offers precise categories for the clinical presentation grouped into age at onset, body distribution, temporal pattern and associated features. The second, etiologic, axis discriminates pathological findings, as well as inheritance patterns, mode of acquisition, or unknown causality. Furthermore, the recent recommendations regarding terminology and nomenclature of inherited forms of dystonia and related syndromes are illustrated in this article. Harmonized, specific, and internationally widely used classifications provide the basis for future systematic dystonia research, as well as for more personalized patient counseling and treatment approaches.
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Affiliation(s)
- Karen Grütz
- Institute of Neurogenetics, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
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4
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Fernandez-Cerado C, Legarda GP, Velasco-Andrada MS, Aguil A, Ganza-Bautista NG, Lagarde JBB, Soria J, Jamora RDG, Acuña PJ, Vanderburg C, Sapp E, DiFiglia M, Murcar MG, Campion L, Ozelius LJ, Alessi AK, Singh-Bains MK, Waldvogel HJ, Faull RLM, Macalintal-Canlas R, Muñoz EL, Penney EB, Ang MA, Diesta CCE, Bragg DC, Acuña-Sunshine G. Promise and challenges of dystonia brain banking: establishing a human tissue repository for studies of X-Linked Dystonia-Parkinsonism. J Neural Transm (Vienna) 2021; 128:575-587. [PMID: 33439365 PMCID: PMC8099813 DOI: 10.1007/s00702-020-02286-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/01/2020] [Indexed: 01/20/2023]
Abstract
X-Linked Dystonia-Parkinsonism (XDP) is a neurodegenerative disease affecting individuals with ancestry to the island of Panay in the Philippines. In recent years there has been considerable progress at elucidating the genetic basis of XDP and candidate disease mechanisms in patient-derived cellular models, but the neural substrates that give rise to XDP in vivo are still poorly understood. Previous studies of limited XDP postmortem brain samples have reported a selective dropout of medium spiny neurons within the striatum, although neuroimaging of XDP patients has detected additional abnormalities in multiple brain regions beyond the basal ganglia. Given the need to fully define the CNS structures that are affected in this disease, we created a brain bank in Panay to serve as a tissue resource for detailed studies of XDP-related neuropathology. Here we describe this platform, from donor recruitment and consent to tissue collection, processing, and storage, that was assembled within a predominantly rural region of the Philippines with limited access to medical and laboratory facilities. Thirty-six brains from XDP individuals have been collected over an initial 4 years period. Tissue quality was assessed based on histologic staining of cortex, RNA integrity scores, detection of neuronal transcripts in situ by fluorescent hybridization chain reaction, and western blotting of neuronal and glial proteins. The results indicate that this pipeline preserves tissue integrity to an extent compatible with a range of morphologic, molecular, and biochemical analyses. Thus the algorithms that we developed for working in rural communities may serve as a guide for establishing similar brain banks for other rare diseases in indigenous populations.
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Affiliation(s)
| | - G Paul Legarda
- Sunshine Care Foundation, 5800, Roxas City, Capiz, Philippines
| | | | - Abegail Aguil
- Sunshine Care Foundation, 5800, Roxas City, Capiz, Philippines
| | | | | | - Jasmin Soria
- Sunshine Care Foundation, 5800, Roxas City, Capiz, Philippines
| | - Roland Dominic G Jamora
- Department of Neurosciences, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Patrick J Acuña
- Sunshine Care Foundation, 5800, Roxas City, Capiz, Philippines.,Department of Neurology, The Collaborative Center for X-linked Dystonia-Parkinsonism, Massachusetts General Hospital, Boston, MA, 02129, USA
| | - Charles Vanderburg
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, 02142, USA
| | - Ellen Sapp
- Department of Neurology, The Collaborative Center for X-linked Dystonia-Parkinsonism, Massachusetts General Hospital, Boston, MA, 02129, USA
| | - Marian DiFiglia
- Department of Neurology, The Collaborative Center for X-linked Dystonia-Parkinsonism, Massachusetts General Hospital, Boston, MA, 02129, USA
| | - Micaela G Murcar
- Department of Neurology, The Collaborative Center for X-linked Dystonia-Parkinsonism, Massachusetts General Hospital, Boston, MA, 02129, USA
| | - Lindsey Campion
- Department of Neurology, The Collaborative Center for X-linked Dystonia-Parkinsonism, Massachusetts General Hospital, Boston, MA, 02129, USA
| | - Laurie J Ozelius
- Department of Neurology, The Collaborative Center for X-linked Dystonia-Parkinsonism, Massachusetts General Hospital, Boston, MA, 02129, USA
| | - Amy K Alessi
- Department of Neurology, The Collaborative Center for X-linked Dystonia-Parkinsonism, Massachusetts General Hospital, Boston, MA, 02129, USA
| | - Malvindar K Singh-Bains
- Department of Anatomy with Medical Imaging, Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Henry J Waldvogel
- Department of Anatomy with Medical Imaging, Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Richard L M Faull
- Department of Anatomy with Medical Imaging, Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | | | - Edwin L Muñoz
- Department of Pathology, College of Medicine, University of the Philippines, Manila, Philippines
| | - Ellen B Penney
- Department of Neurology, The Collaborative Center for X-linked Dystonia-Parkinsonism, Massachusetts General Hospital, Boston, MA, 02129, USA
| | - Mark A Ang
- Department of Pathology, College of Medicine, University of the Philippines, Manila, Philippines
| | | | - D Cristopher Bragg
- Department of Neurology, The Collaborative Center for X-linked Dystonia-Parkinsonism, Massachusetts General Hospital, Boston, MA, 02129, USA.
| | - Geraldine Acuña-Sunshine
- Sunshine Care Foundation, 5800, Roxas City, Capiz, Philippines. .,Department of Neurology, The Collaborative Center for X-linked Dystonia-Parkinsonism, Massachusetts General Hospital, Boston, MA, 02129, USA.
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5
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Li J, Liang CC, Pappas SS, Dauer WT. TorsinB overexpression prevents abnormal twisting in DYT1 dystonia mouse models. eLife 2020; 9:e54285. [PMID: 32202496 PMCID: PMC7141835 DOI: 10.7554/elife.54285] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 03/23/2020] [Indexed: 12/13/2022] Open
Abstract
Genetic redundancy can be exploited to identify therapeutic targets for inherited disorders. We explored this possibility in DYT1 dystonia, a neurodevelopmental movement disorder caused by a loss-of-function (LOF) mutation in the TOR1A gene encoding torsinA. Prior work demonstrates that torsinA and its paralog torsinB have conserved functions at the nuclear envelope. This work established that low neuronal levels of torsinB dictate the neuronal selective phenotype of nuclear membrane budding. Here, we examined whether torsinB expression levels impact the onset or severity of abnormal movements or neuropathological features in DYT1 mouse models. We demonstrate that torsinB levels bidirectionally regulate these phenotypes. Reducing torsinB levels causes a dose-dependent worsening whereas torsinB overexpression rescues torsinA LOF-mediated abnormal movements and neurodegeneration. These findings identify torsinB as a potent modifier of torsinA LOF phenotypes and suggest that augmentation of torsinB expression may retard or prevent symptom development in DYT1 dystonia.
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Affiliation(s)
- Jay Li
- Medical Scientist Training Program, University of MichiganAnn ArborUnited States
- Cellular and Molecular Biology Graduate Program, University of MichiganAnn ArborUnited States
| | - Chun-Chi Liang
- Department of Neurology, University of MichiganAnn ArborUnited States
| | - Samuel S Pappas
- Peter O’Donnell Jr. Brain Institute, Departments of Neuroscience and Neurology & Neurotherapeutics, University of Texas SouthwesternDallasUnited States
| | - William T Dauer
- Department of Neurology, University of MichiganAnn ArborUnited States
- Peter O’Donnell Jr. Brain Institute, Departments of Neuroscience and Neurology & Neurotherapeutics, University of Texas SouthwesternDallasUnited States
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6
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Frederick NM, Shah PV, Didonna A, Langley MR, Kanthasamy AG, Opal P. Loss of the dystonia gene Thap1 leads to transcriptional deficits that converge on common pathogenic pathways in dystonic syndromes. Hum Mol Genet 2019; 28:1343-1356. [PMID: 30590536 DOI: 10.1093/hmg/ddy433] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 11/26/2018] [Accepted: 12/11/2018] [Indexed: 12/15/2022] Open
Abstract
Dystonia is a movement disorder characterized by involuntary and repetitive co-contractions of agonist and antagonist muscles. Dystonia 6 (DYT6) is an autosomal dominant dystonia caused by loss-of-function mutations in the zinc finger transcription factor THAP1. We have generated Thap1 knock-out mice with a view to understanding its transcriptional role. While germ-line deletion of Thap1 is embryonic lethal, mice lacking one Thap1 allele-which in principle should recapitulate the haploinsufficiency of the human syndrome-do not show a discernable phenotype. This is because mice show autoregulation of Thap1 mRNA levels with upregulation at the non-affected locus. We then deleted Thap1 in glial and neuronal precursors using a nestin-conditional approach. Although these mice do not exhibit dystonia, they show pronounced locomotor deficits reflecting derangements in the cerebellar and basal ganglia circuitry. These behavioral features are associated with alterations in the expression of genes involved in nervous system development, synaptic transmission, cytoskeleton, gliosis and dopamine signaling that link DYT6 to other primary and secondary dystonic syndromes.
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Affiliation(s)
| | | | - Alessandro Didonna
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Monica R Langley
- Parkinson Disorders Research Program, Iowa Center for Advanced Neurotoxicology, Department of Biomedical Sciences, Iowa State University, Ames, IA, USA
| | - Anumantha G Kanthasamy
- Parkinson Disorders Research Program, Iowa Center for Advanced Neurotoxicology, Department of Biomedical Sciences, Iowa State University, Ames, IA, USA
| | - Puneet Opal
- Davee Department of Neurology.,Department of Cell and Molecular Biology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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7
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Iacono D, Geraci-Erck M, Peng H, Rabin ML, Kurlan R. Hypertrophy of nigral neurons in Torsin1A deletion (DYT1) carriers manifesting dystonia. Parkinsonism Relat Disord 2019; 58:63-69. [DOI: 10.1016/j.parkreldis.2018.08.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 08/14/2018] [Accepted: 08/28/2018] [Indexed: 01/29/2023]
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8
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Abstract
Dystonia is a neurological condition characterized by abnormal involuntary movements or postures owing to sustained or intermittent muscle contractions. Dystonia can be the manifesting neurological sign of many disorders, either in isolation (isolated dystonia) or with additional signs (combined dystonia). The main focus of this Primer is forms of isolated dystonia of idiopathic or genetic aetiology. These disorders differ in manifestations and severity but can affect all age groups and lead to substantial disability and impaired quality of life. The discovery of genes underlying the mendelian forms of isolated or combined dystonia has led to a better understanding of its pathophysiology. In some of the most common genetic dystonias, such as those caused by TOR1A, THAP1, GCH1 and KMT2B mutations, and idiopathic dystonia, these mechanisms include abnormalities in transcriptional regulation, striatal dopaminergic signalling and synaptic plasticity and a loss of inhibition at neuronal circuits. The diagnosis of dystonia is largely based on clinical signs, and the diagnosis and aetiological definition of this disorder remain a challenge. Effective symptomatic treatments with pharmacological therapy (anticholinergics), intramuscular botulinum toxin injection and deep brain stimulation are available; however, future research will hopefully lead to reliable biomarkers, better treatments and cure of this disorder.
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9
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Iacono D, Lee P, Hallett M, Perl D. Possible Post-Traumatic Focal Dystonia Associated with Tau Pathology Localized to Putamen-Globus Pallidus. Mov Disord Clin Pract 2018; 5:492-498. [PMID: 30637269 DOI: 10.1002/mdc3.12626] [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: 08/15/2017] [Revised: 03/28/2018] [Accepted: 04/05/2018] [Indexed: 11/07/2022] Open
Abstract
Background Dystonia is often associated with damage to basal ganglia (BG), but neuropathological assessments of these cases are infrequent. Methods A brain was assessed with possible post-traumatic focal dystonia that appeared after an accident occurred during childhood. Results Tau pathology was found within putamen and globus pallidus of the right hemisphere, and chronic traumatic encephalopathy (CTE) was observed in the cortex of the left hemisphere. No diffuse axonal injury (DAI), β-amyloid, ubiquitin, p62, or pTDP43 pathology was found. Conclusions Post-traumatic dystonia could be associated with post-traumatic tau pathology formation. However, more cases are necessary to establish causality. The tau lesions found in the BG of this patient did not fit within CTE criteria. We hypothesize that due to the anatomo-histological characteristics of the BG, tau pathology associated with brain traumas produce histopathological patterns different from sulcal-tau pathology, which is the only tau pathology distribution currently accepted as pathognomonic of CTE.
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Affiliation(s)
- Diego Iacono
- Brain Tissue Repository & Neuropathology Core, Center for Neuroscience and Regenerative Medicine (CNRM) Uniformed Services University (USU) Bethesda MD.,Department of Neurology, F. Edward Hébert School of Medicine Uniformed Services University (USU) Bethesda MD.,Department of Pathology, F. Edward Hébert School of Medicine Uniformed Services University (USU) Bethesda MD.,The Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF) Bethesda MD.,Complex Neurodegenerative Disorders, Motor Neuron Disorders Unit, National Institute of Neurological Disorders and Stroke, NINDS NIH Bethesda MD
| | - Patricia Lee
- Brain Tissue Repository & Neuropathology Core, Center for Neuroscience and Regenerative Medicine (CNRM) Uniformed Services University (USU) Bethesda MD.,The Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF) Bethesda MD
| | - Mark Hallett
- Human Motor Control Section, Medical Neurology Branch, NINDS NIH Bethesda MD
| | - Daniel Perl
- Brain Tissue Repository & Neuropathology Core, Center for Neuroscience and Regenerative Medicine (CNRM) Uniformed Services University (USU) Bethesda MD.,Department of Pathology, F. Edward Hébert School of Medicine Uniformed Services University (USU) Bethesda MD
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10
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Yalcin-Cakmakli G, Rose SJ, Villalba RM, Williams L, Jinnah HA, Hess EJ, Smith Y. Striatal Cholinergic Interneurons in a Knock-in Mouse Model of L-DOPA-Responsive Dystonia. Front Syst Neurosci 2018; 12:28. [PMID: 29997483 PMCID: PMC6030733 DOI: 10.3389/fnsys.2018.00028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 06/04/2018] [Indexed: 01/29/2023] Open
Abstract
Striatal cholinergic dysfunction is a common phenotype associated with various forms of dystonia in which anti-cholinergic drugs have some therapeutic benefits. However, the underlying substrate of striatal cholinergic defects in dystonia remain poorly understood. In this study, we used a recently developed knock-in mouse model of dopamine-responsive dystonia (DRD) with strong symptomatic responses to anti-cholinergic drugs, to assess changes in the prevalence and morphology of striatal cholinergic interneurons (ChIs) in a model of generalized dystonia. Unbiased stereological neuronal counts and Sholl analysis were used to address these issues. To determine the potential effect of aging on the number of ChIs, both young (3 months old) and aged (15 months old) mice were used. For purpose of comparisons with ChIs, the number of GABAergic parvalbumin (PV)-immunoreactive striatal interneurons was also quantified in young mice. Overall, no significant change in the prevalence of ChIs and PV-immunoreactive cells was found throughout various functional regions of the striatum in young DRD mice. Similar results were found for ChIs in aged animals. Subtle changes in the extent and complexity of the dendritic tree of ChIs were found in middle and caudal regions of the striatum in DRD mice. Additional immunohistochemical data also suggested lack of significant change in the expression of striatal cholinergic M1 and M4 muscarinic receptors immunoreactivity in DRD mice. Thus, together with our previous data from a knock-in mouse model of DYT-1 dystonia (Song et al., 2013), our data further suggest that the dysregulation of striatal cholinergic transmission in dystonia is not associated with major neuroplastic changes in the morphology or prevalence of striatal ChIs. HighlightsThere is no significant change in the number of striatal ChIs in young and aged mice model of DRD There is no significant change in the prevalence of striatal GABAergic PV-containing interneurons in the striatum of young mice models of DRD Subtle morphological changes in the dendritic arborization of striatal ChIs are found in the middle and caudal tiers of the striatum in young mice models of DRD The levels of both M1 and M4 muscarinic receptors immunoreactivity are not significantly changed in the striatum of DRD mice Major changes in the prevalence and morphology of striatal ChIs are unlikely to underlie striatal cholinergic dysfunction in DRD
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Affiliation(s)
- Gul Yalcin-Cakmakli
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, United States
| | - Samuel J Rose
- Department of Pharmacology, Emory University, Atlanta, GA, United States
| | - Rosa M Villalba
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, United States
| | - Lagena Williams
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, United States
| | - Hyder A Jinnah
- Department of Neurology, Emory University, Atlanta, GA, United States
| | - Ellen J Hess
- Department of Pharmacology, Emory University, Atlanta, GA, United States.,Department of Neurology, Emory University, Atlanta, GA, United States
| | - Yoland Smith
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, United States.,Department of Neurology, Emory University, Atlanta, GA, United States
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11
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Abstract
Dystonia is a heterogeneous disorder characterized by involuntary muscle contractions, twisting movements, and abnormal postures in various body regions. It is widely accepted that the basal ganglia are involved in the pathogenesis of dystonia. A growing body of evidence, however, is challenging the traditional view and suggest that the cerebellum may also play a role in dystonia. Studies on animals indicate that experimental manipulations of the cerebellum lead to dystonic-like movements. Several clinical observations, including those from secondary dystonia cases as well as neurophysiologic and neuroimaging studies in human patients, provide further evidence in humans of a possible relationship between cerebellar abnormalities and dystonia. Claryfing the role of the cerebellum in dystonia is an important step towards providing alternative treatments based on noninvasive brain stimulation techniques.
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Affiliation(s)
- Matteo Bologna
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy; Neuromed Institute IRCCS, Pozzilli, Italy
| | - Alfredo Berardelli
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy; Neuromed Institute IRCCS, Pozzilli, Italy.
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12
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Whittaker HT, Qui Y, Bettencourt C, Houlden H. Multiple system atrophy: genetic risks and alpha-synuclein mutations. F1000Res 2017; 6:2072. [PMID: 29225795 PMCID: PMC5710304 DOI: 10.12688/f1000research.12193.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2017] [Indexed: 12/28/2022] Open
Abstract
Multiple system atrophy (MSA) is one of the few neurodegenerative disorders where we have a significant understanding of the clinical and pathological manifestations but where the aetiology remains almost completely unknown. Research to overcome this hurdle is gaining momentum through international research collaboration and a series of genetic and molecular discoveries in the last few years, which have advanced our knowledge of this rare synucleinopathy. In MSA, the discovery of α-synuclein pathology and glial cytoplasmic inclusions remain the most significant findings. Families with certain types of α-synuclein mutations develop diseases that mimic MSA, and the spectrum of clinical and pathological features in these families suggests a spectrum of severity, from late-onset Parkinson's disease to MSA. Nonetheless, controversies persist, such as the role of common α-synuclein variants in MSA and whether this disorder shares a common mechanism of spreading pathology with other protein misfolding neurodegenerative diseases. Here, we review these issues, specifically focusing on α-synuclein mutations.
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Affiliation(s)
- Heather T Whittaker
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Yichen Qui
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
| | - Conceição Bettencourt
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.,Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
| | - Henry Houlden
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.,MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK.,Neurogenetics Laboratory, The National Hospital for Neurology and Neurosurgery, London, UK
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13
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Shakkottai VG, Batla A, Bhatia K, Dauer WT, Dresel C, Niethammer M, Eidelberg D, Raike RS, Smith Y, Jinnah HA, Hess EJ, Meunier S, Hallett M, Fremont R, Khodakhah K, LeDoux MS, Popa T, Gallea C, Lehericy S, Bostan AC, Strick PL. Current Opinions and Areas of Consensus on the Role of the Cerebellum in Dystonia. THE CEREBELLUM 2017; 16:577-594. [PMID: 27734238 DOI: 10.1007/s12311-016-0825-6] [Citation(s) in RCA: 156] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A role for the cerebellum in causing ataxia, a disorder characterized by uncoordinated movement, is widely accepted. Recent work has suggested that alterations in activity, connectivity, and structure of the cerebellum are also associated with dystonia, a neurological disorder characterized by abnormal and sustained muscle contractions often leading to abnormal maintained postures. In this manuscript, the authors discuss their views on how the cerebellum may play a role in dystonia. The following topics are discussed: The relationships between neuronal/network dysfunctions and motor abnormalities in rodent models of dystonia. Data about brain structure, cerebellar metabolism, cerebellar connections, and noninvasive cerebellar stimulation that support (or not) a role for the cerebellum in human dystonia. Connections between the cerebellum and motor cortical and sub-cortical structures that could support a role for the cerebellum in dystonia. Overall points of consensus include: Neuronal dysfunction originating in the cerebellum can drive dystonic movements in rodent model systems. Imaging and neurophysiological studies in humans suggest that the cerebellum plays a role in the pathophysiology of dystonia, but do not provide conclusive evidence that the cerebellum is the primary or sole neuroanatomical site of origin.
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Affiliation(s)
- Vikram G Shakkottai
- Department of Neurology, University of Michigan, Room 4009, BSRB, 109 Zina Pitcher Place, Ann Arbor, MI, 48109-2200, USA. .,Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, 48109-2200, USA.
| | - Amit Batla
- Sobell Department of Motor Neuroscience and Movement Disorders, University College London, London, UK
| | - Kailash Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders, University College London, London, UK
| | - William T Dauer
- Department of Neurology, University of Michigan, Room 4009, BSRB, 109 Zina Pitcher Place, Ann Arbor, MI, 48109-2200, USA.,Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Christian Dresel
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Martin Niethammer
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Robert S Raike
- Global Research Organization, Medtronic Inc. Neuromodulation, Minneapolis, MN, USA
| | - Yoland Smith
- Yerkes National Primate Center and Department of Neurology, Emory University, Atlanta, GA, USA
| | - H A Jinnah
- Department of Neurology, Human Genetics and Pediatrics, Emory University, Atlanta, GA, USA
| | - Ellen J Hess
- Departments of Pharmacology and Neurology, Emory University, Atlanta, GA, USA
| | - Sabine Meunier
- Institut du Cerveau et de la Moelle épinière (ICM), Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR, S 1127, Paris, France.,Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Mark Hallett
- Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Rachel Fremont
- Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, New York, NY, USA
| | - Kamran Khodakhah
- Dominick P. Purpura Department of Neuroscience, Department of Psychiatry and Behavioral Sciences, and The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, New York, NY, USA
| | - Mark S LeDoux
- Departments of Neurology, and Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Traian Popa
- Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013, Paris, France
| | - Cécile Gallea
- Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013, Paris, France.,Centre de NeuroImagerie de Recherche - CENIR, ICM, F-75013, Paris, France
| | - Stéphane Lehericy
- Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013, Paris, France
| | - Andreea C Bostan
- Systems Neuroscience Institute and Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Peter L Strick
- Systems Neuroscience Institute and Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Neurobiology, University of Pittsburgh Brain Institute, University of Pittsburgh, Pittsburgh, PA, USA
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Fremont R, Tewari A, Angueyra C, Khodakhah K. A role for cerebellum in the hereditary dystonia DYT1. eLife 2017; 6. [PMID: 28198698 PMCID: PMC5340526 DOI: 10.7554/elife.22775] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 02/14/2017] [Indexed: 02/06/2023] Open
Abstract
DYT1 is a debilitating movement disorder caused by loss-of-function mutations in torsinA. How these mutations cause dystonia remains unknown. Mouse models which have embryonically targeted torsinA have failed to recapitulate the dystonia seen in patients, possibly due to differential developmental compensation between rodents and humans. To address this issue, torsinA was acutely knocked down in select brain regions of adult mice using shRNAs. TorsinA knockdown in the cerebellum, but not in the basal ganglia, was sufficient to induce dystonia. In agreement with a potential developmental compensation for loss of torsinA in rodents, torsinA knockdown in the immature cerebellum failed to produce dystonia. Abnormal motor symptoms in knockdown animals were associated with irregular cerebellar output caused by changes in the intrinsic activity of both Purkinje cells and neurons of the deep cerebellar nuclei. These data identify the cerebellum as the main site of dysfunction in DYT1, and offer new therapeutic targets. DOI:http://dx.doi.org/10.7554/eLife.22775.001 Dystonia is the third most common type of movement disorder after Parkinson’s disease and tremor. Patients with dystonia experience prolonged involuntary contractions of their muscles, often causing uncontrollable postures or repetitive movements. Almost thirty years ago, genetic studies revealed that a mutation in the gene that encodes a protein called torsinA causes the most common type of dystonia, called DYT1. Exactly how mutations that affect the torsinA protein give rise to DYT1 remains unclear, and there are still no effective treatments for the disorder. Part of the problem is that we do not fully understand how torsinA works, or which of its many proposed functions is relevant to dystonia. Moreover, attempts to study DYT1 using genetically modified mice have proved largely unsuccessful. This is because mice that simply express the same genetic mutations that cause dystonia in humans do not show the overt symptoms of dystonia. Fremont, Tewari et al. have now generated a mouse ‘model’ that does show symptoms of dystonia, and used these model mice to investigate the role of torsinA in the disorder. Acutely reducing the amount of torsinA protein in a region of the brain called the cerebellum induced the symptoms of dystonia in the mice. Conversely, reducing the amount of torsinA in a different brain area known as the basal ganglia had no such effect, even though both the cerebellum and the basal ganglia contribute to movement. Furthermore, neither manipulation had any effect in juvenile mice, which suggests that, in contrast to humans, young mice can compensate for the loss of torsinA. Fremont, Tewari et al. also found that the loss of torsinA causes the cerebellum to generate incorrect output signals, which in turn trigger the abnormal movements seen in dystonia. In the future, further studies of the model mice could identify the exact changes that occur in neurons following the loss of torsinA from the cerebellum. Understanding these changes could potentially pave the way for developing effective treatments for DYT1 and other dystonias. DOI:http://dx.doi.org/10.7554/eLife.22775.002
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Affiliation(s)
- Rachel Fremont
- Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, New York, United States
| | - Ambika Tewari
- Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, New York, United States
| | - Chantal Angueyra
- Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, New York, United States
| | - Kamran Khodakhah
- Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, New York, United States
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15
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Arkadir D, Radulescu A, Raymond D, Lubarr N, Bressman SB, Mazzoni P, Niv Y. DYT1 dystonia increases risk taking in humans. eLife 2016; 5. [PMID: 27249418 PMCID: PMC4951192 DOI: 10.7554/elife.14155] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Accepted: 05/28/2016] [Indexed: 02/03/2023] Open
Abstract
It has been difficult to link synaptic modification to overt behavioral changes. Rodent models of DYT1 dystonia, a motor disorder caused by a single gene mutation, demonstrate increased long-term potentiation and decreased long-term depression in corticostriatal synapses. Computationally, such asymmetric learning predicts risk taking in probabilistic tasks. Here we demonstrate abnormal risk taking in DYT1 dystonia patients, which is correlated with disease severity, thereby supporting striatal plasticity in shaping choice behavior in humans. DOI:http://dx.doi.org/10.7554/eLife.14155.001 We learn to choose better options and avoid worse ones through trial and error, but exactly how this happens is still unclear. One idea is that we learn 'values' for options: whenever we choose an option and get more reward than originally expected (for example, if an unappetizing-looking food turns out to be very tasty), the value of that option increases. Likewise, if we get less reward than expected, the chosen option’s value decreases. This learning process is hypothesized to work via the strengthening and weakening of connections between neurons in two parts of the brain: the cortex and the striatum. In this model, the activity of the neurons in the cortex represents the options, and the value of these options is represented by the activity of neurons in the striatum. Strengthening the connections is thought to increase the value of the stimulus, but this theory has been difficult to test. In humans, a single genetic mutation causes a movement disorder called DYT1 dystonia, in which muscles contract involuntarily. In rodents, the same mutation causes the connections between the neurons in the cortex and the striatum to become too strong. If the theory about value learning is true, this strengthening should affect the decisions of patients that have DYT1 dystonia. Arkadir et al. got healthy people and people with DYT1 dystonia to play a game where they had to choose between a 'sure' option and a 'risky' option. Picking the sure option guaranteed the player would receive a small amount of money, whereas the risky option gave either double this amount or nothing. The theory predicts that the double rewards should cause the patients to learn abnormally high values, which would lure them into making risky choices. Indeed, Arkadir et al. found that players with DYT1 dystonia were more likely to choose the risky option, with the people who had more severe symptoms of dystonia having a greater tendency towards taking risks. Arkadir et al. showed that these results correspond with a model that suggests that people with DYT1 dystonia learn excessively from unexpected wins but show weakened learning after losses, causing them to over-estimate the value of risky choices. This imbalance mirrors the previous results that showed an inappropriate strengthening of the connections between neurons in rodents, and so suggests that similar changes occur in the brains of humans. Thus it appears that the changes in the strength of the connections between neurons translate into changes in behavior. This pattern of results might also mean that the movement problems seen in people with DYT1 dystonia may be because they over-learn movements that previously led to a desired outcome and cannot sufficiently suppress movements that are no longer useful. Testing this idea will require further experiments. DOI:http://dx.doi.org/10.7554/eLife.14155.002
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Affiliation(s)
- David Arkadir
- Department of Neurology, Hadassah Medical Center and the Hebrew University, Jerusalem, Israel
| | - Angela Radulescu
- Department of Psychology, Princeton University, Princeton, United States.,Princeton Neuroscience Institute, Princeton University, Princeton, United States
| | - Deborah Raymond
- Department of Neurology, Beth Israel Medical Center, New York, United States
| | - Naomi Lubarr
- Department of Neurology, Beth Israel Medical Center, New York, United States
| | - Susan B Bressman
- Department of Neurology, Beth Israel Medical Center, New York, United States
| | - Pietro Mazzoni
- The Neurological Institute, Columbia University, New York, United States
| | - Yael Niv
- Department of Psychology, Princeton University, Princeton, United States.,Princeton Neuroscience Institute, Princeton University, Princeton, United States
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16
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Alexander J, Kalev O, Mehrabian S, Traykov L, Raycheva M, Kanakis D, Drineas P, Lutz MI, Ströbel T, Penz T, Schuster M, Bock C, Ferrer I, Paschou P, Kovacs GG. Familial early-onset dementia with complex neuropathologic phenotype and genomic background. Neurobiol Aging 2016; 42:199-204. [PMID: 27143436 DOI: 10.1016/j.neurobiolaging.2016.03.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 02/20/2016] [Accepted: 03/13/2016] [Indexed: 12/18/2022]
Abstract
Despite significant progress in our understanding of hereditary neurodegenerative diseases, the list of genes associated with early-onset dementia is not yet complete. In the present study, we describe a familial neurodegenerative disorder characterized clinically as the behavioral and/or dysexecutive variant of Alzheimer's disease with neuroradiologic features of Alzheimer's disease, however, lacking amyloid-β deposits in the brain. Instead, we observed a complex, 4 repeat predominant, tauopathy, together with a TAR DNA-binding protein of 43 kDa proteinopathy. Whole-exome sequencing on 2 affected siblings and 1 unaffected aunt uncovered a large number of candidate genes, including LRRK2 and SYNE2. In addition, DDI1, KRBA1, and TOR1A genes possessed novel stop-gain mutations only in the patients. Pathway, gene ontology, and network interaction analysis indicated the involvement of pathways related to neurodegeneration but revealed novel aspects also. This condition does not fit into any well-characterized category of neurodegenerative disorders. Exome sequencing did not disclose a single disease-specific gene mutation suggesting that a set of genes working together in different pathways may contribute to the etiology of the complex phenotype.
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Affiliation(s)
- John Alexander
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupoli, Greece
| | - Ognian Kalev
- Institute of Pathology and Neuropathology, Landes-Nervenklinik Wagner-Jauregg, Linz, Austria
| | - Shima Mehrabian
- Department of Neurology, UH "Alexandrovska", Sofia, Bulgaria
| | | | | | - Dimitrios Kanakis
- Department of Pathology, School of Medicine, Democritus University of Thrace, Alexandroupoli, Greece
| | - Petros Drineas
- Department of Computer Science, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Mirjam I Lutz
- Institute of Neurology, Medical University Vienna, Vienna, Austria
| | - Thomas Ströbel
- Institute of Neurology, Medical University Vienna, Vienna, Austria
| | - Thomas Penz
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Michael Schuster
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Christoph Bock
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Isidro Ferrer
- Institute of Neuropathology, IDIBELL-Bellvitge University Hospital, University of Barcelona, Hospitalet de Llobregat; CIBERNED (Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas), Barcelona, Spain
| | - Peristera Paschou
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupoli, Greece.
| | - Gabor G Kovacs
- Institute of Neurology, Medical University Vienna, Vienna, Austria.
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17
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Richter A, Hamann M, Wissel J, Volk HA. Dystonia and Paroxysmal Dyskinesias: Under-Recognized Movement Disorders in Domestic Animals? A Comparison with Human Dystonia/Paroxysmal Dyskinesias. Front Vet Sci 2015; 2:65. [PMID: 26664992 PMCID: PMC4672229 DOI: 10.3389/fvets.2015.00065] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 11/13/2015] [Indexed: 12/17/2022] Open
Abstract
Dystonia is defined as a neurological syndrome characterized by involuntary sustained or intermittent muscle contractions causing twisting, often repetitive movements, and postures. Paroxysmal dyskinesias are episodic movement disorders encompassing dystonia, chorea, athetosis, and ballism in conscious individuals. Several decades of research have enhanced the understanding of the etiology of human dystonia and dyskinesias that are associated with dystonia, but the pathophysiology remains largely unknown. The spontaneous occurrence of hereditary dystonia and paroxysmal dyskinesia is well documented in rodents used as animal models in basic dystonia research. Several hyperkinetic movement disorders, described in dogs, horses and cattle, show similarities to these human movement disorders. Although dystonia is regarded as the third most common movement disorder in humans, it is often misdiagnosed because of the heterogeneity of etiology and clinical presentation. Since these conditions are poorly known in veterinary practice, their prevalence may be underestimated in veterinary medicine. In order to attract attention to these movement disorders, i.e., dystonia and paroxysmal dyskinesias associated with dystonia, and to enhance interest in translational research, this review gives a brief overview of the current literature regarding dystonia/paroxysmal dyskinesia in humans and summarizes similar hereditary movement disorders reported in domestic animals.
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Affiliation(s)
- Angelika Richter
- Faculty of Veterinary Medicine, Institute of Pharmacology, Pharmacy and Toxicology, University of Leipzig, Leipzig, Germany
| | - Melanie Hamann
- Department of Veterinary Medicine, Institute of Pharmacology and Toxicology, Free University Berlin, Berlin, Germany
| | - Jörg Wissel
- Department of Neurological Rehabilitation and Physical Therapy, Vivantes Hospital Spandau and Humboldt Hospital, Berlin, Germany
- Department of Neurology, Vivantes Hospital Spandau and Humboldt Hospital, Berlin, Germany
| | - Holger A. Volk
- Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
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18
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Paudel R, Li A, Hardy J, Bhatia KP, Houlden H, Holton J. DYT6 Dystonia: A Neuropathological Study. NEURODEGENER DIS 2015; 16:273-8. [PMID: 26610312 DOI: 10.1159/000440863] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 09/03/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Mutations in the thanatos-associated protein domain containing apoptosis-associated protein 1 gene (THAP1) are responsible for adult-onset isolated dystonia (DYT6). However, no neuropathological studies of genetically proven DYT6 cases have been previously reported. OBJECTIVE We report the first detailed neuropathological investigation carried out on two DYT6 brains. METHODS Genetic screening for THAP1 gene mutations using standard Sanger polymerase chain reaction sequencing identified 2 cases, 1 with a known pathogenic mutation and the other with a novel mutation. A detailed neuropathological assessment of the cases was performed. RESULTS Both DYT6 cases showed no significant neurodegeneration and no specific disease-related pathology. CONCLUSIONS No neuropathological features that could be defined as hallmark features of DYT6 dystonia were identified. Our study supports the notion that in isolated dystonia, there is no significant neurodegeneration or morphological lesions that can be identified using routine methods.
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Affiliation(s)
- Reema Paudel
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
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19
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Pappas SS, Darr K, Holley SM, Cepeda C, Mabrouk OS, Wong JMT, LeWitt TM, Paudel R, Houlden H, Kennedy RT, Levine MS, Dauer WT. Forebrain deletion of the dystonia protein torsinA causes dystonic-like movements and loss of striatal cholinergic neurons. eLife 2015; 4:e08352. [PMID: 26052670 PMCID: PMC4473728 DOI: 10.7554/elife.08352] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Accepted: 06/07/2015] [Indexed: 12/12/2022] Open
Abstract
Striatal dysfunction plays an important role in dystonia, but the striatal cell types that contribute to abnormal movements are poorly defined. We demonstrate that conditional deletion of the DYT1 dystonia protein torsinA in embryonic progenitors of forebrain cholinergic and GABAergic neurons causes dystonic-like twisting movements that emerge during juvenile CNS maturation. The onset of these movements coincides with selective degeneration of dorsal striatal large cholinergic interneurons (LCI), and surviving LCI exhibit morphological, electrophysiological, and connectivity abnormalities. Consistent with the importance of this LCI pathology, murine dystonic-like movements are reduced significantly with an antimuscarinic agent used clinically, and we identify cholinergic abnormalities in postmortem striatal tissue from DYT1 dystonia patients. These findings demonstrate that dorsal LCI have a unique requirement for torsinA function during striatal maturation, and link abnormalities of these cells to dystonic-like movements in an overtly symptomatic animal model. DOI:http://dx.doi.org/10.7554/eLife.08352.001 Dystonia is disorder of the nervous system that causes people to suffer from abnormal and involuntary twisting movements. These movements are triggered, in part, by irregularities in a part of the brain called the striatum. The most common view among researchers is that dystonia is caused by abnormal activity in an otherwise structurally normal nervous system. But, recent findings indicate that the degeneration of small populations of nerve cells in the brain may be important. The striatum is made up of several different types of nerve cells, but it is poorly understood which of these are affected in dystonia. One type of dystonia, which most often occurs in children, is caused by a defect in a protein called torsinA. Pappas et al. have now discovered that deleting the gene for torsinA from particular populations of nerve cells in the brains of mice (including a population in the striatum) causes abnormal twisting movements. Like people with dystonia, these mice developed the abnormal movements as juveniles, and the movements were suppressed with ‘anti-cholinergic’ medications. Pappas et al. then analyzed brain tissue from these mice and revealed that the twisting movements began at the same time that a single type of cell in the striatum—called ‘cholinergic interneurons’—degenerated. Postmortem studies of brain tissue from dystonia patients also revealed abnormalities of these neurons. Together these findings challenge the notion that dystonia occurs in a structurally normal nervous system and reveal that cholinergic interneurons in the striatum specifically require torsinA to survive. Following on from this work, the next challenges are to identify what causes the selective loss of cholinergic interneurons, and to investigate how this cell loss affects the activity within the striatum. DOI:http://dx.doi.org/10.7554/eLife.08352.002
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Affiliation(s)
- Samuel S Pappas
- Department of Neurology, University of Michigan, Ann Arbor, United States
| | - Katherine Darr
- Department of Neurology, University of Michigan, Ann Arbor, United States
| | - Sandra M Holley
- Intellectual and Developmental Disabilities Research Center, Brain Research Institute, Semel Institute for Neuroscience, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, United States
| | - Carlos Cepeda
- Intellectual and Developmental Disabilities Research Center, Brain Research Institute, Semel Institute for Neuroscience, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, United States
| | - Omar S Mabrouk
- Department of Pharmacology, University of Michigan, Ann Arbor, United States
| | - Jenny-Marie T Wong
- Department of Chemistry, University of Michigan, Ann Arbor, United States
| | - Tessa M LeWitt
- Department of Neurology, University of Michigan, Ann Arbor, United States
| | - Reema Paudel
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, United Kingdom
| | - Henry Houlden
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, United Kingdom
| | - Robert T Kennedy
- Department of Chemistry, University of Michigan, Ann Arbor, United States
| | - Michael S Levine
- Intellectual and Developmental Disabilities Research Center, Brain Research Institute, Semel Institute for Neuroscience, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, United States
| | - William T Dauer
- Department of Neurology, University of Michigan, Ann Arbor, United States
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20
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Accumulation of rare variants in the arylsulfatase G (ARSG) gene in task-specific dystonia. J Neurol 2015; 262:1340-3. [PMID: 25825126 DOI: 10.1007/s00415-015-7718-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 03/18/2015] [Accepted: 03/19/2015] [Indexed: 10/23/2022]
Abstract
Musician's dystonia and writer's cramp are examples of task-specific dystonia. Recently, the arylsulfatase G (ARSG) locus was suggested to be associated with musician's dystonia and writer's cramp by a genome-wide association study. To test for the presence of causal variants, the entire coding region and exon-intron boundaries of ARSG were sequenced in DNA samples from 158 musician's dystonia patients which were collected at the University of Music, Drama, and Media (Hanover, Germany), and 72 patients with writer's cramp which were recruited at the Academic Medical Centers in Amsterdam and Groningen, the Netherlands. The frequency of variants within ARSG was compared to publically available data at the exome variant server (EVS) from the NHLBI GO Exome Sequencing Project. We identified 11 single nucleotide variants (SNVs) in the patients including eight non-synonymous substitutions. All variants have previously been reported at EVS including two SNVs with a reported minor allele frequency <1%. One rare missense variant, rs61999318 (p.I493T), was significantly enriched in the group of writer's cramp patients compared to European Americans in EVS database (p = 0.0013). In patients with writer's cramp, there was an overall enrichment for rare, protein-changing variants compared to controls (p < 0.01). In conclusion, we did not detect any conclusive mutation in ARSG. However, we showed an association with rs61999318 in patients with writer's cramp that contributed to an overall enrichment for rare, protein-changing variants in these patients. Thus, our data provide further support for a role of ARSG variants in task-specific dystonia, especially writer's cramp.
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21
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Paudel R, Kiely A, Li A, Lashley T, Bandopadhyay R, Hardy J, Jinnah HA, Bhatia K, Houlden H, Holton JL. Neuropathological features of genetically confirmed DYT1 dystonia: investigating disease-specific inclusions. Acta Neuropathol Commun 2014; 2:159. [PMID: 25403864 PMCID: PMC4247124 DOI: 10.1186/s40478-014-0159-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 10/25/2014] [Indexed: 11/15/2022] Open
Abstract
Introduction Early onset isolated dystonia (DYT1) is linked to a three base pair deletion (ΔGAG) mutation in the TOR1A gene. Clinical manifestation includes intermittent muscle contraction leading to twisting movements or abnormal postures. Neuropathological studies on DYT1 cases are limited, most showing no significant abnormalities. In one study, brainstem intraneuronal inclusions immunoreactive for ubiquitin, torsinA and lamin A/C were described. Using the largest series reported to date comprising 7 DYT1 cases, we aimed to identify consistent neuropathological features in the disease and determine whether we would find the same intraneuronal inclusions as previously reported. Result The pathological changes of brainstem inclusions reported in DYT1 dystonia were not replicated in our case series. Other anatomical regions implicated in dystonia showed no disease-specific pathological intracellular inclusions or evidence of more than mild neuronal loss. Conclusion Our findings suggest that the intracellular inclusions described previously in DYT1 dystonia may not be a hallmark feature of the disorder. In isolated dystonia, DYT1 in particular, biochemical changes may be more relevant than the morphological changes. Electronic supplementary material The online version of this article (doi:10.1186/s40478-014-0159-x) contains supplementary material, which is available to authorized users.
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22
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Abnormal high-frequency burst firing of cerebellar neurons in rapid-onset dystonia-parkinsonism. J Neurosci 2014; 34:11723-32. [PMID: 25164667 DOI: 10.1523/jneurosci.1409-14.2014] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Loss-of-function mutations in the α3 isoform of the Na(+)/K(+) ATPase (sodium pump) are responsible for rapid-onset dystonia parkinsonism (DYT12). Recently, a pharmacological model of DYT12 was generated implicating both the cerebellum and basal ganglia in the disorder. Notably, partially blocking sodium pumps in the cerebellum was necessary and sufficient for induction of dystonia. Thus, a key question that remains is how partially blocking sodium pumps in the cerebellum induces dystonia. In vivo recordings from dystonic mice revealed abnormal high-frequency bursting activity in neurons of the deep cerebellar nuclei (DCN), which comprise the bulk of cerebellar output. In the same mice, Purkinje cells, which provide strong inhibitory drive to DCN cells, also fired in a similarly erratic manner. In vitro studies demonstrated that Purkinje cells are highly sensitive to sodium pump dysfunction that alters the intrinsic pacemaking of these neurons, resulting in erratic burst firing similar to that identified in vivo. This abnormal firing abates when sodium pump function is restored and dystonia caused by partial block of sodium pumps can be similarly alleviated. These findings suggest that persistent high-frequency burst firing of cerebellar neurons caused by sodium pump dysfunction underlies dystonia in this model of DYT12.
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Lehéricy S, Tijssen MAJ, Vidailhet M, Kaji R, Meunier S. The anatomical basis of dystonia: current view using neuroimaging. Mov Disord 2014; 28:944-57. [PMID: 23893451 DOI: 10.1002/mds.25527] [Citation(s) in RCA: 132] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2012] [Revised: 04/06/2013] [Accepted: 05/02/2013] [Indexed: 12/15/2022] Open
Abstract
This review will consider the knowledge that neuroimaging studies have provided to the understanding of the anatomy of dystonia. Major advances have occurred in the use of neuroimaging for dystonia in the past 2 decades. At present, the most developed imaging approaches include whole-brain or region-specific studies of structural or diffusion changes, functional imaging using fMRI or positron emission tomography (PET), and metabolic imaging using fluorodeoxyglucose PET. These techniques have provided evidence that regions other than the basal ganglia are involved in dystonia. In particular, there is increasing evidence that primary dystonia can be viewed as a circuit disorder, involving the basal ganglia-thalamo-cortical and cerebello-thalamo-cortical pathways. This suggests that a better understanding of the dysfunction in each region in the network and their interactions are important topics to address. Current views of interpretation of imaging data as cause or consequence of dystonia, and the postmortem correlates of imaging data are presented. The application of imaging as a tool to monitor therapy and its use as an outcome measure will be discussed. © 2013 Movement Disorder Society.
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Affiliation(s)
- Stéphane Lehéricy
- Institut du Cerveau et de la Moelle (ICM) epiniere, Centre de NeuroImagerie de Recherche (CENIR), Paris, France.
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Abstract
This chapter focuses on neurodevelopmental diseases that are tightly linked to abnormal function of the striatum and connected structures. We begin with an overview of three representative diseases in which striatal dysfunction plays a key role--Tourette syndrome and obsessive-compulsive disorder, Rett's syndrome, and primary dystonia. These diseases highlight distinct etiologies that disrupt striatal integrity and function during development, and showcase the varied clinical manifestations of striatal dysfunction. We then review striatal organization and function, including evidence for striatal roles in online motor control/action selection, reinforcement learning, habit formation, and action sequencing. A key barrier to progress has been the relative lack of animal models of these diseases, though recently there has been considerable progress. We review these efforts, including their relative merits providing insight into disease pathogenesis, disease symptomatology, and basal ganglia function.
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Piccinin CC, Santos MCA, Piovesana LG, Campos LS, Guimarães RP, Campos BM, Torres FR, França MC, Amato-Filho AC, Lopes-Cendes I, Cendes F, D'Abreu A. Infratentorial gray matter atrophy and excess in primary craniocervical dystonia. Parkinsonism Relat Disord 2013; 20:198-203. [PMID: 24262871 DOI: 10.1016/j.parkreldis.2013.10.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 10/08/2013] [Accepted: 10/25/2013] [Indexed: 01/05/2023]
Abstract
BACKGROUND Primary craniocervical dystonia (CCD) is generally attributed to functional abnormalities in the cortico-striato-pallido-thalamocortical loops, but cerebellar pathways have also been implicated in neuroimaging studies. Hence, our purpose was to perform a volumetric evaluation of the infratentorial structures in CCD. METHODS We compared 35 DYT1/DYT6 negative patients with CCD and 35 healthy controls. Cerebellar volume was evaluated using manual volumetry (DISPLAY software) and infratentorial volume by voxel based morphometry of gray matter (GM) segments derived from T1 weighted 3 T MRI using the SUIT tool (SPM8/Dartel). We used t-tests to compare infratentorial volumes between groups. RESULTS Cerebellar volume was (1.14 ± 0.17) × 10(2) cm(3) for controls and (1.13 ± 0.14) × 10(2) cm(3) for patients; p = 0.74. VBM demonstrated GM increase in the left I-IV cerebellar lobules and GM decrease in the left lobules VI and Crus I and in the right lobules VI, Crus I and VIIIb. In a secondary analysis, VBM demonstrated GM increase also in the brainstem, mostly in the pons. CONCLUSION While gray matter increase is observed in the anterior lobe of the cerebellum and in the brainstem, the atrophy is concentrated in the posterior lobe of the cerebellum, demonstrating a differential pattern of infratentorial involvement in CCD. This study shows subtle structural abnormalities of the cerebellum and brainstem in primary CCD.
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Affiliation(s)
- Camila C Piccinin
- Neuroimaging Laboratory, UNICAMP, University of Campinas, Campinas, Brazil.
| | - Maria C A Santos
- Neuroimaging Laboratory, UNICAMP, University of Campinas, Campinas, Brazil
| | - Luiza G Piovesana
- Department of Neurology, UNICAMP, University of Campinas, Campinas, Brazil
| | - Lidiane S Campos
- Department of Neurology, UNICAMP, University of Campinas, Campinas, Brazil
| | - Rachel P Guimarães
- Neuroimaging Laboratory, UNICAMP, University of Campinas, Campinas, Brazil
| | - Brunno M Campos
- Neuroimaging Laboratory, UNICAMP, University of Campinas, Campinas, Brazil
| | - Fabio R Torres
- Department of Medical Genetics, UNICAMP, University of Campinas, Campinas, Brazil
| | - Marcondes C França
- Neuroimaging Laboratory, UNICAMP, University of Campinas, Campinas, Brazil; Department of Neurology, UNICAMP, University of Campinas, Campinas, Brazil
| | | | - Iscia Lopes-Cendes
- Department of Medical Genetics, UNICAMP, University of Campinas, Campinas, Brazil
| | - Fernando Cendes
- Neuroimaging Laboratory, UNICAMP, University of Campinas, Campinas, Brazil; Department of Neurology, UNICAMP, University of Campinas, Campinas, Brazil
| | - Anelyssa D'Abreu
- Neuroimaging Laboratory, UNICAMP, University of Campinas, Campinas, Brazil; Department of Neurology, UNICAMP, University of Campinas, Campinas, Brazil
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Abstract
Dystonia is a common movement disorder seen by neurologists in clinic. Genetic forms of the disease are important to recognize clinically and also provide valuable information about possible pathogenic mechanisms within the wider disorder. In the past few years, with the advent of new sequencing technologies, there has been a step change in the pace of discovery in the field of dystonia genetics. In just over a year, four new genes have been shown to cause primary dystonia (CIZ1, ANO3, TUBB4A and GNAL), PRRT2 has been identified as the cause of paroxysmal kinesigenic dystonia and other genes, such as SLC30A10 and ATP1A3, have been linked to more complicated forms of dystonia or new phenotypes. In this review, we provide an overview of the current state of knowledge regarding genetic forms of dystonia—related to both new and well-known genes alike—and incorporating genetic, clinical and molecular information. We discuss the mechanistic insights provided by the study of the genetic causes of dystonia and provide a helpful clinical algorithm to aid clinicians in correctly predicting the genetic basis of various forms of dystonia.
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Affiliation(s)
- Gavin Charlesworth
- Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
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Bressman SB, Saunders-Pullman R. Primary dystonia: moribund or viable. Mov Disord 2013; 28:906-13. [PMID: 23893447 DOI: 10.1002/mds.25528] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Revised: 04/29/2013] [Accepted: 05/02/2013] [Indexed: 12/21/2022] Open
Abstract
With increasing understanding of dystonia genetic etiologies and pathophysiology there has been renewed scrutiny and reappraisal of dystonia classification schemes and nomenclature. One important category that includes both clinical and etiologic criteria is primary dystonia. This editorialized review discusses the impact of recent findings on primary dystonia criteria and argues that it remains useful in clinical and research practice. © 2013 Movement Disorder Society.
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Affiliation(s)
- Susan B Bressman
- Department of Neurology, Beth Israel Medical Center, New York, New York, USA
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Prudente CN, Pardo CA, Xiao J, Hanfelt J, Hess EJ, Ledoux MS, Jinnah HA. Neuropathology of cervical dystonia. Exp Neurol 2012. [PMID: 23195594 DOI: 10.1016/j.expneurol.2012.11.019] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The aim of this study was to search for neuropathological changes in postmortem brain tissue of individuals with cervical dystonia (CD). Multiple regions of formalin-preserved brains were collected from patients with CD and controls and examined with an extensive battery of histopathological stains in a two-stage study design. In stage one, 4 CD brains underwent a broad screening neuropathological examination. In stage two, these 4 CD brains were combined with 2 additional CD brains, and the subjective findings were quantified and compared to 16 age-matched controls. The initial subjective neuropathological assessment revealed only two regions with relatively consistent changes. The substantia nigra had frequent ubiquitin-positive intranuclear inclusions known as Marinesco bodies. Additionally, the cerebellum showed patchy loss of Purkinje cells, areas of focal gliosis and torpedo bodies. Other brain regions showed minor or inconsistent changes. In the second stage of the analysis, quantitative studies failed to reveal significant differences in the numbers of Marinesco bodies in CD versus controls, but confirmed a significantly lower Purkinje cell density in CD. Molecular investigations revealed 4 of the CD cases and 2 controls to harbor sequence variants in non-coding regions of THAP1, and these cases had lower Purkinje cell densities regardless of whether they had CD. The findings suggest that subtle neuropathological changes such as lower Purkinje cell density may be found in primary CD when relevant brain regions are investigated with appropriate methods.
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Affiliation(s)
- C N Prudente
- Dept. of Neurology, Emory University, Atlanta, GA 30322, USA.
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