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Martinelli I, Zucchi E, Simonini C, Gianferrari G, Zamboni G, Pinti M, Mandrioli J. The landscape of cognitive impairment in superoxide dismutase 1-amyotrophic lateral sclerosis. Neural Regen Res 2023; 18:1427-1433. [PMID: 36571338 PMCID: PMC10075107 DOI: 10.4103/1673-5374.361535] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Although mutations in the superoxide dismutase 1 gene account for only a minority of total amyotrophic lateral sclerosis cases, the discovery of this gene has been crucial for amyotrophic lateral sclerosis research. Since the identification of superoxide dismutase 1 in 1993, the field of amyotrophic lateral sclerosis genetics has considerably widened, improving our understanding of the diverse pathogenic basis of amyotrophic lateral sclerosis. In this review, we focus on cognitive impairment in superoxide dismutase 1-amyotrophic lateral sclerosis patients. Literature has mostly reported that cognition remains intact in superoxide dismutase 1-amyotrophic lateral sclerosis patients, but recent reports highlight frontal lobe function frailty in patients carrying different superoxide dismutase 1-amyotrophic lateral sclerosis mutations. We thoroughly reviewed all the various mutations reported in the literature to contribute to a comprehensive database of superoxide dismutase 1-amyotrophic lateral sclerosis genotype-phenotype correlation. Such a resource could ultimately improve our mechanistic understanding of amyotrophic lateral sclerosis, enabling a more robust assessment of how the amyotrophic lateral sclerosis phenotype responds to different variants across genes, which is important for the therapeutic strategy targeting genetic mutations. Cognition in superoxide dismutase 1-amyotrophic lateral sclerosis deserves further longitudinal research since this peculiar frailty in patients with similar mutations can be conditioned by external factors, including environment and other unidentified agents including modifier genes.
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Affiliation(s)
- Ilaria Martinelli
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia; Department of Neurosciences, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Elisabetta Zucchi
- Department of Neurosciences, Azienda Ospedaliero-Universitaria di Modena; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Cecilia Simonini
- Department of Neurosciences, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Giulia Gianferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanna Zamboni
- Department of Neurosciences, Azienda Ospedaliero-Universitaria di Modena; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Marcello Pinti
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Jessica Mandrioli
- Department of Neurosciences, Azienda Ospedaliero-Universitaria di Modena; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Dalla Bella E, Bersano E, Bruzzone MG, Gellera C, Pensato V, Lauria G, Consonni M. Behavioral and Cognitive Phenotypes of Patients With Amyotrophic Lateral Sclerosis Carrying SOD1 Variants. Neurology 2022; 99:e2052-e2062. [PMID: 35985819 PMCID: PMC9651465 DOI: 10.1212/wnl.0000000000201044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/13/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES SOD1 variants in patients with amyotrophic lateral sclerosis (ALS) have been associated with peculiar clinical features and disease progression but rarely with cognitive and behavioral impairment. This study aims at describing the features of frontotemporal syndromes in patients with ALS carrying SOD1 variants. METHODS Italian patients with ALS were consecutively enrolled between 2012 and 2020 at our Motor Neuron Disease Center. All underwent clinical assessment, extensive neurophysiologic test battery for the evaluation of cognitive functions and behavior, and targeted next-generation sequencing of SOD1, FUS, TARDBP, VCP, PFN1, TUBA4A, OPTN, SQSTM1, UBQLN2, and C9orf72 genes. Neuropsychological profiles of SOD1+ patients (SOD1+) were compared with those with no gene variants (SOD1-). To this aim, the occurrence of cognitive and behavioral impairment defined according to the current guidelines, the number of pathologic test performances based on Italian normative values, and scores of the Frontal Behavioral Inventory were collected. RESULTS Among 288 patients consecutively examined, we identified 8 known pathogenic SOD1 variants and one variant of uncertain significance (p.Ser26Asn) not previously described in 14 patients with ALS belonging to 11 families. The clinical phenotypes were mainly characterized by predominant lower motor neuron involvement with onset at the lower limbs, and one patient had bulbar onset. SOD1+ patients (n = 14) were compared with SOD1- patients (N = 274). SOD1+ patients were younger than SOD1-, and both groups had similar functional motor disabilities and disease duration. Based on the overall neuropsychological findings, the percentage of SOD1+ and SOD1- patients with altered profiles were approximately 60%. However, behavioral impairment defined by the Strong criteria, and most commonly featuring with irritability and mental rigidity, was more frequent in SOD1+ than SOD1- patients and mainly associated with variants in exon 5. Conversely, cognitive impairment was mainly found in SOD1- patients. DISCUSSION Our findings from a large cohort of deeply phenotyped patients with ALS demonstrated that behavioral involvement is more common than previously thought among patients harboring SOD1 variants and that it is independent from patients' age and disease stage. These findings could be relevant for the assessment of clinical trial outcomes and disease management.
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Affiliation(s)
- Eleonora Dalla Bella
- From the 3rd Neurology Unit and Motor Neuron Diseases Centre (E.D.B., E.B., G.L., M.C.), Neuroradiology Unit (M.G.B.), Diagnostic and Technology Department, and Unit of Medical Genetics and Neurogenetics (C.G., V.P.), Fondazione IRCCS Istituto Neurologico "Carlo Besta"; Milan, and Department of Biomedical and Clinical and Sciences "Luigi Sacco" (E.B., G.L.), University of Milan, Italy
| | - Enrica Bersano
- From the 3rd Neurology Unit and Motor Neuron Diseases Centre (E.D.B., E.B., G.L., M.C.), Neuroradiology Unit (M.G.B.), Diagnostic and Technology Department, and Unit of Medical Genetics and Neurogenetics (C.G., V.P.), Fondazione IRCCS Istituto Neurologico "Carlo Besta"; Milan, and Department of Biomedical and Clinical and Sciences "Luigi Sacco" (E.B., G.L.), University of Milan, Italy
| | - Maria Grazia Bruzzone
- From the 3rd Neurology Unit and Motor Neuron Diseases Centre (E.D.B., E.B., G.L., M.C.), Neuroradiology Unit (M.G.B.), Diagnostic and Technology Department, and Unit of Medical Genetics and Neurogenetics (C.G., V.P.), Fondazione IRCCS Istituto Neurologico "Carlo Besta"; Milan, and Department of Biomedical and Clinical and Sciences "Luigi Sacco" (E.B., G.L.), University of Milan, Italy
| | - Cinzia Gellera
- From the 3rd Neurology Unit and Motor Neuron Diseases Centre (E.D.B., E.B., G.L., M.C.), Neuroradiology Unit (M.G.B.), Diagnostic and Technology Department, and Unit of Medical Genetics and Neurogenetics (C.G., V.P.), Fondazione IRCCS Istituto Neurologico "Carlo Besta"; Milan, and Department of Biomedical and Clinical and Sciences "Luigi Sacco" (E.B., G.L.), University of Milan, Italy
| | - Viviana Pensato
- From the 3rd Neurology Unit and Motor Neuron Diseases Centre (E.D.B., E.B., G.L., M.C.), Neuroradiology Unit (M.G.B.), Diagnostic and Technology Department, and Unit of Medical Genetics and Neurogenetics (C.G., V.P.), Fondazione IRCCS Istituto Neurologico "Carlo Besta"; Milan, and Department of Biomedical and Clinical and Sciences "Luigi Sacco" (E.B., G.L.), University of Milan, Italy
| | - Giuseppe Lauria
- From the 3rd Neurology Unit and Motor Neuron Diseases Centre (E.D.B., E.B., G.L., M.C.), Neuroradiology Unit (M.G.B.), Diagnostic and Technology Department, and Unit of Medical Genetics and Neurogenetics (C.G., V.P.), Fondazione IRCCS Istituto Neurologico "Carlo Besta"; Milan, and Department of Biomedical and Clinical and Sciences "Luigi Sacco" (E.B., G.L.), University of Milan, Italy.
| | - Monica Consonni
- From the 3rd Neurology Unit and Motor Neuron Diseases Centre (E.D.B., E.B., G.L., M.C.), Neuroradiology Unit (M.G.B.), Diagnostic and Technology Department, and Unit of Medical Genetics and Neurogenetics (C.G., V.P.), Fondazione IRCCS Istituto Neurologico "Carlo Besta"; Milan, and Department of Biomedical and Clinical and Sciences "Luigi Sacco" (E.B., G.L.), University of Milan, Italy
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Canosa A, Moglia C, Manera U, Vasta R, Torrieri MC, Arena V, D'Ovidio F, Palumbo F, Zucchetti JP, Iazzolino B, Peotta L, Calvo A, Pagani M, Chiò A. Metabolic brain changes across different levels of cognitive impairment in ALS: a 18F-FDG-PET study. J Neurol Neurosurg Psychiatry 2020; 92:jnnp-2020-323876. [PMID: 33229451 DOI: 10.1136/jnnp-2020-323876] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/17/2020] [Accepted: 10/26/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To identify the metabolic changes related to the various levels of cognitive deficits in amyotrophic lateral sclerosis (ALS) using 18F-2-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET) imaging. METHODS 274 ALS patients underwent neuropsychological assessment and brain 18F-FDG-PET at diagnosis. According to the criteria published in 2017, cognitive status was classified as ALS with normal cognition (ALS-Cn, n=132), ALS with behavioural impairment (ALS-Bi, n=66), ALS with cognitive impairment (ALS-Ci, n=30), ALS with cognitive and behavioural impairment (ALS-Cbi, n=26), ALS with frontotemporal dementia (ALS-FTD, n=20). We compared each group displaying some degree of cognitive and/or behavioural impairment to ALS-Cn patients, including age at PET, sex and ALS Functional Rating Scale-Revised as covariates. RESULTS We identified frontal lobe relative hypometabolism in cognitively impaired patients that resulted more extensive and significant across the continuum from ALS-Ci, through ALS-Cbi, to ALS-FTD. ALS-FTD patients also showed cerebellar relative hypermetabolism. ALS-Bi patients did not show any difference compared with ALS-Cn. CONCLUSIONS These data support the concept that patients with cognitive impairment have a more widespread neurodegenerative process compared with patients with a pure motor disease: the more severe the cognitive impairment, the more diffuse the metabolic changes. Otherwise, metabolic changes related to pure behavioural impairment need further characterisation.
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Affiliation(s)
- Antonio Canosa
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
- SC Neurologia 1U, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Cristina Moglia
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
- SC Neurologia 1U, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Umberto Manera
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
| | - Rosario Vasta
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
| | - Maria Claudia Torrieri
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
| | - Vincenzo Arena
- Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A, Turin, Italy
| | - Fabrizio D'Ovidio
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
| | - Francesca Palumbo
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
| | - Jean Pierre Zucchetti
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
| | - Barbara Iazzolino
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
| | - Laura Peotta
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
| | - Andrea Calvo
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
- SC Neurologia 1U, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
- Neuroscience Institute of Turin (NIT), Turin, Italy
| | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, C.N.R, Rome, Italy
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Adriano Chiò
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
- SC Neurologia 1U, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
- Neuroscience Institute of Turin (NIT), Turin, Italy
- Institute of Cognitive Sciences and Technologies, C.N.R, Rome, Italy
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Vaca G, Martinez-Gonzalez L, Fernandez A, Rojas-Prats E, Porras G, Cuevas EP, Gil C, Martinez A, Martin-Requero Á. Therapeutic potential of novel Cell Division Cycle Kinase 7 inhibitors on TDP-43-related pathogenesis such as Frontotemporal Lobar Degeneration (FTLD) and amyotrophic lateral sclerosis (ALS). J Neurochem 2020; 156:379-390. [PMID: 32628315 DOI: 10.1111/jnc.15118] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 06/23/2020] [Accepted: 06/25/2020] [Indexed: 11/28/2022]
Abstract
TDP-43 has been identified as the major component of protein aggregates found in affected neurons in FTLD-TDP and amyotrophic lateral sclerosis (ALS) patients. TDP-43 is hyperphosphorylated, ubiquitinated, and cleaved in the C-terminus. CDC-7 was reported to phosphorylate TDP-43. There are no effective treatments for either FTLD-TDP or ALS, being a pressing need for the search of new therapies. We hypothesized that modulating CDC-7 activity with small molecules that are able to interfere with TDP-43 phosphorylation could be a good therapeutic strategy for these diseases. Here, we have studied the effects of novel brain penetrant, thiopurine-based, CDC-7 inhibitors in TDP-43 homeostasis in immortalized lymphocytes from FTLD-TDP patients, carriers of a loss-of-function GRN mutation, as well as in cells derived from sporadic ALS patients. We found that selective CDC-7 inhibitors, ERP1.14a and ERP1.28a, are able to decrease the enhanced TDP-43 phosphorylation in cells derived from FTLD-TDP and ALS patients and to prevent cytosolic accumulation of TDP-43. Moreover, treatment of FTLD-TDP lymphoblasts with CDC-7 inhibitors leads to recovering the nuclear function of TDP-43-inducing CDK6 repression. We suggest that CDC-7 inhibitors, mainly the heterocyclic compounds here shown, may be considered as promising drug candidates for the ALS/FTD spectrum.
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Affiliation(s)
- Gabriela Vaca
- Department of Molecular Biomedicine, Centro de Investigaciones Biológicas, Margarita Salas (CSIC), Madrid, Spain
| | - Loreto Martinez-Gonzalez
- Department of Structural and Chemical Biology, Centro de Investigaciones Biológicas, Margarita Salas (CSIC), Madrid, Spain
| | - Ana Fernandez
- Department of Molecular Biomedicine, Centro de Investigaciones Biológicas, Margarita Salas (CSIC), Madrid, Spain
| | - Elisa Rojas-Prats
- Department of Structural and Chemical Biology, Centro de Investigaciones Biológicas, Margarita Salas (CSIC), Madrid, Spain
| | - Gracia Porras
- Department of Molecular Biomedicine, Centro de Investigaciones Biológicas, Margarita Salas (CSIC), Madrid, Spain
| | - Eva P Cuevas
- Department of Structural and Chemical Biology, Centro de Investigaciones Biológicas, Margarita Salas (CSIC), Madrid, Spain
| | - Carmen Gil
- Department of Structural and Chemical Biology, Centro de Investigaciones Biológicas, Margarita Salas (CSIC), Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Martinez
- Department of Structural and Chemical Biology, Centro de Investigaciones Biológicas, Margarita Salas (CSIC), Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Ángeles Martin-Requero
- Department of Molecular Biomedicine, Centro de Investigaciones Biológicas, Margarita Salas (CSIC), Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
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Martinelli I, Zucchi E, Gessani A, Fini N, Chiò A, Pecoraro V, Trenti T, Mandrioli J. A novel p.N66T mutation in exon 3 of the SOD1 gene: report of two families of ALS patients with early cognitive impairment. Amyotroph Lateral Scler Frontotemporal Degener 2020; 21:296-300. [PMID: 32248719 DOI: 10.1080/21678421.2020.1746344] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Introduction: To date more than 180 different mutations in the SOD1 gene have been described in ALS; some of these mutations are associated to peculiar clinical features and have contributed to the understanding of disease heterogeneity. Only 5% of SOD1 mutations involve exon 3. Here we report a novel mutation c.197A > C in the exon 3 of the SOD1 gene in two apparently unrelated ALS families with early respiratory and cognitive impairment.Case report: In the first family two brothers developed ALS in their seventies, with arm weakness followed by bulbar involvement and behavioral breakdown. An unrelated 57-year-old man presented with progressive leg weakness and mild compromised executive functions without known family history for ALS/FTD and underwent invasive ventilation in a few months. A novel missense mutation A to C at codon 197 in exon 3 causing aminoacid substitution of arginine by threonine (N66T) was found for all of them. Harmful consequences of c.197A > C mutation on SOD1 function were suggested by in silico prediction and homology with other known mutations at the same position.Discussion and conclusion: Here, we report two apparently unrelated ALS families carrying a novel SOD1 mutation (N66T), supporting its pathogenic role by primary analysis, and characterized by early bulbar, respiratory, and cognitive involvement. Early cognitive impairment has been rarely described in ALS caused by SOD1 mutations, and mainly in the later phases of the disease. This report provides additional data on the SOD1 mutation spectrum and clinical presentation of ALS, widening phenotypical characterization of SOD1 ALS.
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Affiliation(s)
- Ilaria Martinelli
- Department of Neuroscience, Ospedale Civile S. Agostino Estense, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - Elisabetta Zucchi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Annalisa Gessani
- Department of Neuroscience, Ospedale Civile S. Agostino Estense, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - Nicola Fini
- Department of Neuroscience, Ospedale Civile S. Agostino Estense, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - Adriano Chiò
- ALS Center "Rita Levi Montalcini" Department of Neuroscience, University of Torino, Torino, Italy; Azienda Ospedaliero Universitaria Città della Salute e della Scienza, Torino, Italy; The Neuroscience Institute of Torino, Torino, Italy
| | - Valentina Pecoraro
- Laboratory of Toxycology and Advanced Diagnostics, Department of Laboratory Medicine and Pathology, Ospedale Civile S. Agostino Estense, Modena, Italy
| | - Tommaso Trenti
- Laboratory of Toxycology and Advanced Diagnostics, Department of Laboratory Medicine and Pathology, Ospedale Civile S. Agostino Estense, Modena, Italy
| | - Jessica Mandrioli
- Department of Neuroscience, Ospedale Civile S. Agostino Estense, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
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6
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Rajagopalan V, Pioro EP. Longitudinal 18F-FDG PET and MRI Reveal Evolving Imaging Pathology That Corresponds to Disease Progression in a Patient With ALS-FTD. Front Neurol 2019; 10:234. [PMID: 30941090 PMCID: PMC6433744 DOI: 10.3389/fneur.2019.00234] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 02/22/2019] [Indexed: 12/11/2022] Open
Abstract
Single time point positron emission tomography (PET) studies of patients with amyotrophic lateral sclerosis and frontotemporal dementia (ALS-FTD), have demonstrated hypometabolism or hypermetabolism in certain brain regions. To determine whether longitudinal (at baseline and 20.4 months later) PET and magnetic resonance imaging (MRI) reveal evolving brain imaging pathology corresponding to clinical progression in a patient with ALS-FTD, cerebral glucose metabolic rate, cortical thickness (CT) and cortical area (CA) were obtained and symmetric percent change (SPC) for each calculated. The patient had worsening symptoms and signs of bulbar-onset upper motor neuron-predominant ALS as well as language and behavioral dysfunction. At baseline, minimally decreased ALSFRS-R (42/48) reflecting bulbar dysfunction was observed, along with language and executive function difficulties. At follow-up, bulbar and limb function rapidly declined as revealed by lower ALSFRS-R (27/48) and worsening language and cognitive function. PET revealed either hyper- and hypo-metabolic changes in several brain regions, especially in the left hemisphere. Marked clinical decline was accompanied by worsening cerebral and subcortical hyper and hypo-metabolism along with CT changes in regions known to degenerate in the primary progressive aphasia (PPA) form of ALS-FTD. Our case report demonstrates the progressive functional and structural neuroimaging abnormalities underlying clinical motor and neurocognitive deficits evolving in a patient with bulbar-onset ALS-FTD. Correlating neurological and neurocognitive decline with PET and MRI neuroimaging measures can provide better insights into pathophysiological mechanisms of ALS and ALS-FTD.
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Affiliation(s)
- Venkateswaran Rajagopalan
- Department of Electrical and Electronics Engineering, Birla Institute of Technology and Science Pilani, Hyderabad, India.,Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Erik P Pioro
- Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States.,Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
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McCombe PA, Wray NR, Henderson RD. Extra-motor abnormalities in amyotrophic lateral sclerosis: another layer of heterogeneity. Expert Rev Neurother 2017; 17:561-577. [PMID: 27983884 DOI: 10.1080/14737175.2017.1273772] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease defined by the presence of muscle weakness. The motor features of disease are heterogeneous in site of onset and progression. There are also extra-motor features in some patients. The genetic basis for extra-motor features is uncertain. The heterogeneity of ALS is an issue for clinical trials. Areas covered: This paper reviews the range and prevalence of extra-motor features associated with ALS, and highlights the current information about genetic associations with extra-motor features. Expert commentary: There are extra-motor features of ALS, but these are not found in all patients. The most common is cognitive abnormality. More data is required to ascertain whether extra-motor features arise with progression of disease. Extra-motor features are reported in patients with a range of causative genetic mutations, but are not found in all patients with these mutations. Further studies are required of the heterogeneity of ALS, and genotype/phenotype correlations are required, taking note of extra-motor features.
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Affiliation(s)
- P A McCombe
- a The University of Queensland Centre for Clinical Research and Department of Neurology, Royal Brisbane and Women's Hospital , Brisbane , Australia
| | - N R Wray
- b The University of Queensland Institute for Molecular Bioscience , Brisbane , Australia
| | - R D Henderson
- a The University of Queensland Centre for Clinical Research and Department of Neurology, Royal Brisbane and Women's Hospital , Brisbane , Australia
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8
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Burrell JR, Halliday GM, Kril JJ, Ittner LM, Götz J, Kiernan MC, Hodges JR. The frontotemporal dementia-motor neuron disease continuum. Lancet 2016; 388:919-31. [PMID: 26987909 DOI: 10.1016/s0140-6736(16)00737-6] [Citation(s) in RCA: 240] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Early reports of cognitive and behavioural deficits in motor neuron disease might have been overlooked initially, but the concept of a frontotemporal dementia-motor neuron disease continuum has emerged during the past decade. Frontotemporal dementia-motor neuron disease is now recognised as an important dementia syndrome, which presents substantial challenges for diagnosis and management. Frontotemporal dementia, motor neuron disease, and frontotemporal dementia-motor neuron disease are characterised by overlapping patterns of TAR DNA binding protein (TDP-43) pathology, while the chromosome 9 open reading frame 72 (C9orf72) repeat expansion is common across the disease spectrum. Indeed, the C9orf72 repeat expansion provides important clues to disease pathogenesis and suggests potential therapeutic targets. Variable diagnostic criteria identify motor, cognitive, and behavioural deficits, but further refinement is needed to define the clinical syndromes encountered in frontotemporal dementia-motor neuron disease.
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Affiliation(s)
- James R Burrell
- Neuroscience Research Australia, Sydney, NSW, Australia; Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Glenda M Halliday
- Neuroscience Research Australia, Sydney, NSW, Australia; Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Jillian J Kril
- Disciplines of Medicine and Pathology, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Lars M Ittner
- Neuroscience Research Australia, Sydney, NSW, Australia; Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Jürgen Götz
- Clem Jones Centre for Ageing Dementia Research, Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia
| | - Matthew C Kiernan
- Neuroscience Research Australia, Sydney, NSW, Australia; Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - John R Hodges
- Neuroscience Research Australia, Sydney, NSW, Australia; Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
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Niu Q, Yi Y, Sun X, Li T, Zhang B, Chen H, Wang X, Xu Q, Shi M, Jin Q. The G41D mutation in the superoxide dismutase 1 gene is associated with slow motor neuron progression and mild cognitive impairment in a Chinese family with amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2016; 87:788-9. [PMID: 26069299 PMCID: PMC4941133 DOI: 10.1136/jnnp-2015-310545] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 05/13/2015] [Indexed: 12/14/2022]
Affiliation(s)
- Qi Niu
- Department of Neurology, The People's Hospital of Jiangsu Province, Nanjing, Jiangsu Province, China
| | - Yongxiang Yi
- Department of Surgery, The Second Hospital of Nanjing, Nanjing, Jiangsu Province, China
| | - Xueping Sun
- Department of Gynecology and Obstetrics, The People's Hospital of Jiangsu Province, Nanjing, Jiangsu Province, China
| | - Tiannv Li
- Department of Radiology, The People's Hospital of Jiangsu Province, Nanjing, Jiangsu Province, China
| | - Bingfeng Zhang
- Department of Neurology, The People's Hospital of Jiangsu Province, Nanjing, Jiangsu Province, China
| | - Hong Chen
- Department of Neurology, The People's Hospital of Jiangsu Province, Nanjing, Jiangsu Province, China
| | - Xingxia Wang
- Department of Neurology, The People's Hospital of Jiangsu Province, Nanjing, Jiangsu Province, China
| | - Qingchen Xu
- Department of Neurology, Nanjing First Hospital, Nanjing, Jiangsu Province, China
| | - Mingchao Shi
- Department of Neurology, The People's Hospital of Jiangsu Province, Nanjing, Jiangsu Province, China
| | - Qingwen Jin
- Department of Neurology, The People's Hospital of Jiangsu Province, Nanjing, Jiangsu Province, China
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