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Zhao X, Ning H, Liu L, Zhu C, Zhang Y, Sun G, Ren H, Kong X. Genetic analysis of 37 cases with primary periodic paralysis in Chinese patients. Orphanet J Rare Dis 2024; 19:160. [PMID: 38609989 PMCID: PMC11015673 DOI: 10.1186/s13023-024-03170-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/30/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Primary periodic paralysis (PPP) is an inherited disorders of ion channel dysfunction characterized by recurrent episodes of flaccid muscle weakness, which can classified as hypokalemic (HypoPP), normokalemic (NormoPP), or hyperkalemic (HyperPP) according to the potassium level during the paralytic attacks. However, PPP is charactered by remarkable clinical and genetic heterogeneity, and the diagnosis of suspected patients is based on the characteristic clinical presentation then confirmed by genetic testing. At present, there are only limited cohort studies on PPP in the Chinese population. RESULTS We included 37 patients with a clinical diagnosis of PPP. Eleven (29.7%) patients were tested using a specific gene panel and 26 (70.3%) by the whole-exome sequencing (WES). Twenty-two cases had a genetic variant identified, representing a diagnostic rate of 59.5% (22/37). All the identified mutations were either in the SCN4A or the CACNA1S gene. The overall detection rate was comparable between the panel (54.5%: 6/11) and WES (61.5%: 16/26). The remaining patients unresolved through panel sequencing were further analyzed by WES, without the detection of any mutation. The novel atypical splicing variant c.2020-5G > A affects the normal splicing of the SCN4A mRNA, which was confirmed by minigene splicing assay. Among 21 patients with HypoPP, 15 patients were classified as HypoPP-2 with SCN4A variants, and 6 HypoPP-1 patients had CACNA1S variants. CONCLUSIONS Our results suggest that SCN4A alleles are the main cause in our cohort, with the remainder caused by CACNA1S alleles, which are the predominant cause in Europe and the United States. Additionally, this study identified 3 novel SCN4A and 2 novel CACNA1S variants, broadening the mutation spectrum of genes associated with PPP.
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Affiliation(s)
- Xuechao Zhao
- The Genetics and Prenatal Diagnosis Center, The Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zhengzhou University, Jianshe Rd, Erqi District, 450052, Zhengzhou, Henan, China
| | - Haofeng Ning
- Obstetrics and Gynaecology, The Seventh Affiliated Hospital, Sun Yat-Sen University, No 628 Zhenyuan Road Guangming District, 518107, Shenzhen, PR China
| | - Lina Liu
- The Genetics and Prenatal Diagnosis Center, The Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zhengzhou University, Jianshe Rd, Erqi District, 450052, Zhengzhou, Henan, China
| | - Chaofeng Zhu
- The Genetics and Prenatal Diagnosis Center, The Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zhengzhou University, Jianshe Rd, Erqi District, 450052, Zhengzhou, Henan, China
| | - Yinghui Zhang
- The Department of Endocrinology, The First Affiliated Hospital of Zhengzhou University, Jianshe Rd, Erqi District, 450052, Zhengzhou, Henan, China
| | - Guifang Sun
- The Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Jianshe Rd, Erqi District, 450052, Zhengzhou, Henan, China
| | - Huanan Ren
- The Genetics and Prenatal Diagnosis Center, The Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zhengzhou University, Jianshe Rd, Erqi District, 450052, Zhengzhou, Henan, China
| | - Xiangdong Kong
- The Genetics and Prenatal Diagnosis Center, The Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zhengzhou University, Jianshe Rd, Erqi District, 450052, Zhengzhou, Henan, China.
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Barwell T, Seroude L. Polyglutamine disease in peripheral tissues. Hum Mol Genet 2023; 32:3303-3311. [PMID: 37642359 DOI: 10.1093/hmg/ddad138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 08/31/2023] Open
Abstract
This year is a milestone anniversary of the discovery that Huntington's disease is caused by the presence of expanded polyglutamine repeats in the huntingtin gene leading to the formation of huntingtin aggregates. 30 years have elapsed and there is still no cure and the only FDA-approved treatment to alleviate the debilitating locomotor impairments presents several adverse effects. It has long been neglected that the huntingtin gene is almost ubiquitously expressed in many tissues outside of the nervous system. Growing evidence indicates that these peripheral tissues can contribute to the symptoms of the disease. New findings in Drosophila have shown that the selective expression of mutant huntingtin in muscle or fat is sufficient to cause detrimental effects in the absence of any neurodegeneration. In addition, it was discovered that a completely different tissue distribution of Htt aggregates in Drosophila muscles is responsible for a drastic aggravation of the detrimental effects. This review examines the peripheral tissues that express huntingtin with an added focus on the nature and distribution of the aggregates, if any.
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Affiliation(s)
- Taylor Barwell
- Department of Biology, Queen's University, 116 Barrie St, Kingston, ON K7L 3N6, Canada
| | - Laurent Seroude
- Department of Biology, Queen's University, 116 Barrie St, Kingston, ON K7L 3N6, Canada
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3
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Kolesnikova TO, Demin KA, Costa FV, Zabegalov KN, de Abreu MS, Gerasimova EV, Kalueff AV. Towards Zebrafish Models of CNS Channelopathies. Int J Mol Sci 2022; 23:ijms232213979. [PMID: 36430455 PMCID: PMC9693542 DOI: 10.3390/ijms232213979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/06/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
Abstract
Channelopathies are a large group of systemic disorders whose pathogenesis is associated with dysfunctional ion channels. Aberrant transmembrane transport of K+, Na+, Ca2+ and Cl- by these channels in the brain induces central nervous system (CNS) channelopathies, most commonly including epilepsy, but also migraine, as well as various movement and psychiatric disorders. Animal models are a useful tool for studying pathogenesis of a wide range of brain disorders, including channelopathies. Complementing multiple well-established rodent models, the zebrafish (Danio rerio) has become a popular translational model organism for neurobiology, psychopharmacology and toxicology research, and for probing mechanisms underlying CNS pathogenesis. Here, we discuss current prospects and challenges of developing genetic, pharmacological and other experimental models of major CNS channelopathies based on zebrafish.
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Affiliation(s)
| | - Konstantin A. Demin
- Institute of Translational Biomedicine, St. Petersburg State University, 199034 St. Petersburg, Russia
- Institute of Experimental Medicine, Almazov National Medical Research Centre, Ministry of Healthcare of Russian Federation, 197341 St. Petersburg, Russia
| | - Fabiano V. Costa
- Neurobiology Program, Sirius University of Science and Technology, 354349 Sochi, Russia
| | | | - Murilo S. de Abreu
- Moscow Institute of Physics and Technology, 141701 Moscow, Russia
- Correspondence: (M.S.d.A.); (A.V.K.); Tel.: +55-54-99605-9807 (M.S.d.A.); +1-240-899-9571 (A.V.K.); Fax: +1-240-899-9571 (A.V.K.)
| | - Elena V. Gerasimova
- Neurobiology Program, Sirius University of Science and Technology, 354349 Sochi, Russia
| | - Allan V. Kalueff
- Neurobiology Program, Sirius University of Science and Technology, 354349 Sochi, Russia
- Institute of Translational Biomedicine, St. Petersburg State University, 199034 St. Petersburg, Russia
- Institute of Experimental Medicine, Almazov National Medical Research Centre, Ministry of Healthcare of Russian Federation, 197341 St. Petersburg, Russia
- Moscow Institute of Physics and Technology, 141701 Moscow, Russia
- Laboratory of Preclinical Bioscreening, Granov Russian Research Center of Radiology and Surgical Technologies, Ministry of Healthcare of Russian Federation, 197758 St. Petersburg, Russia
- Ural Federal University, 620002 Yekaterinburg, Russia
- Scientific Research Institute of Neurosciences and Medicine, 630117 Novosibirsk, Russia
- Correspondence: (M.S.d.A.); (A.V.K.); Tel.: +55-54-99605-9807 (M.S.d.A.); +1-240-899-9571 (A.V.K.); Fax: +1-240-899-9571 (A.V.K.)
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Harmelink M. Uncommon Causes of Rhabdomyolysis. Crit Care Clin 2022; 38:271-85. [DOI: 10.1016/j.ccc.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Riederer I, Mendes-da-cruz DA, da Fonseca GC, González MN, Brustolini O, Rocha C, Loss G, de Carvalho JB, Menezes MT, Raphael LMS, Gerber A, Bonaldo MC, Butler-browne G, Mouly V, Cotta-de-almeida V, Savino W, Ribeiro de Vasconcelos AT. Zika virus disrupts gene expression in human myoblasts and myotubes: Relationship with susceptibility to infection. PLoS Negl Trop Dis 2022; 16:e0010166. [PMID: 35171909 PMCID: PMC8923442 DOI: 10.1371/journal.pntd.0010166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 03/15/2022] [Accepted: 01/12/2022] [Indexed: 11/30/2022] Open
Abstract
The tropism of Zika virus (ZIKV) has been described in the nervous system, blood, placenta, thymus, and skeletal muscle. We investigated the mechanisms of skeletal muscle susceptibility to ZIKV using an in vitro model of human skeletal muscle myogenesis, in which myoblasts differentiate into myotubes. Myoblasts were permissive to ZIKV infection, generating productive viral particles, while myotubes controlled ZIKV replication. To investigate the underlying mechanisms, we used gene expression profiling. First, we assessed gene changes in myotubes compared with myoblasts in the model without infection. As expected, we observed an increase in genes and pathways related to the contractile muscle system in the myotubes, a reduction in processes linked to proliferation, migration and cytokine production, among others, confirming the myogenic capacity of our system in vitro. A comparison between non-infected and infected myoblasts revealed more than 500 differentially expressed genes (DEGs). In contrast, infected myotubes showed almost 2,000 DEGs, among which we detected genes and pathways highly or exclusively expressed in myotubes, including those related to antiviral and innate immune responses. Such gene modulation could explain our findings showing that ZIKV also invades myotubes but does not replicate in these differentiated cells. In conclusion, we showed that ZIKV largely (but differentially) disrupts gene expression in human myoblasts and myotubes. Identifying genes involved in myotube resistance can shed light on potential antiviral mechanisms against ZIKV infection. The ZIKV was responsible for a large pandemic surge between 2015 and 2016; Brazil was the epicenter with very high numbers of congenital ZIKV syndrome that included microcephaly, myalgia, among other manifestations. We have observed in previous work that muscle progenitor cells (myoblasts) are infected by ZIKV, while differentiated cells (myotubes) do not present viral proteins. In the present study, we confirmed human myoblasts susceptibility to ZIKV infection and myotubes resistance. In fact, we show that myotubes are also susceptible to ZIKV entry but control the productive infection. We also elucidated the transcriptional mechanisms triggered by the ZIKV, which stimulated a more complex intrinsic antiviral response in myotubes than in myoblasts. Such particular gene modulation of the differentiated cells could offer clues to antiviral mechanisms. It would explain susceptibility differences between adults, where muscle progenitor cells are quiescent in the steady-state, and foetuses that have large amounts of these cells proliferating in order to grow muscles.
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Kim HR, Jeon JW, Lee EJ, Ham YR, Na KR, Lee KW, Park KH, Kim SY, Choi DE. Confirming Genetic Abnormalities of Hypokalemic Periodic Paralysis Using Next-Generation Sequencing: A Case Report and Literature Review. Electrolyte Blood Press 2021; 19:10-14. [PMID: 34290819 PMCID: PMC8267070 DOI: 10.5049/ebp.2021.19.1.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 11/05/2022] Open
Abstract
Hypokalemic periodic paralysis (hypoPP) is a disorder characterized by episodic, short-lived, and hypo-reflexive skeletal muscle weakness. HypoPP is a rare disease caused by genetic mutations related to expression of sodium or calcium ion channels. Most mutations are associated with autosomal dominant inheritance, but some are found in patients with no relevant family history. A 28-year-old man who visited the emergency room for paralytic attack was assessed in this study. He exhibited motor weakness in four limbs. There was no previous medical history or family history. The initial electrocardiogram showed a flat T wave and QT prolongation. His blood test was delayed, and sudden hypotension and bradycardia were observed. The blood test showed severe hypokalemia. After correcting hypokalemia, his muscle paralysis recovered without any neurological deficits. The patient's thyroid function and long exercise test results were normal. However, because of the history of high carbohydrate diet and exercise, hypoPP was suspected. Hence, next-generation sequencing (NGS) was performed, and a mutation of Arg669His was noted in the SCN4A gene. Although hypoPP is a rare disease, it can be suspected in patients with hypokalemic paralysis, and iden tification of this condition is important for preventing further attacks and improving patient outcomes. Diagnosing hypoPP through targeted NGS is a cost-effective and useful method.
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Affiliation(s)
- Hae Ri Kim
- Department of Internal Medicine, Division of Nephrology, Chungnam National University Sejong Hospital, Sejong, Republic of Korea
| | - Jae Wan Jeon
- Department of Internal Medicine, Division of Nephrology, Chungnam National University Sejong Hospital, Sejong, Republic of Korea
| | - Eu Jin Lee
- Department of Internal Medicine, Division of Nephrology, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Young Rok Ham
- Department of Internal Medicine, Division of Nephrology, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Ki Ryang Na
- Department of Internal Medicine, Division of Nephrology, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Kang Wook Lee
- Department of Internal Medicine, Division of Nephrology, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Kee Hong Park
- Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea
| | - Seon Young Kim
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Dae Eun Choi
- Department of Internal Medicine, Division of Nephrology, Chungnam National University Hospital, Daejeon, Republic of Korea
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Sun J, Luo S, Suetterlin KJ, Song J, Huang J, Zhu W, Xi J, Zhou L, Lu J, Lu J, Zhao C, Hanna MG, Männikkö R, Matthews E, Qiao K. Clinical and genetic spectrum of a Chinese cohort with SCN4A gene mutations. Neuromuscul Disord 2021; 31:829-838. [PMID: 33965302 DOI: 10.1016/j.nmd.2021.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 03/02/2021] [Accepted: 03/31/2021] [Indexed: 10/21/2022]
Abstract
Skeletal muscle sodium channelopathies due to SCN4A gene mutations have a broad clinical spectrum. However, each phenotype has been reported in few cases of Chinese origin. We present detailed phenotype and genotype data from a cohort of 40 cases with SCN4A gene mutations seen in neuromuscular diagnostic service in Huashan hospital, Fudan University. Cases were referred from 6 independent provinces from 2010 to 2018. A questionnaire covering demographics, precipitating factors, episodes of paralysis and myotonia was designed to collect the clinical information. Electrodiagnostic studies and muscle MRI were retrospectively analyzed. The clinical spectrum of patients included: 6 Hyperkalemic periodic paralysis (15%), 18 Hypokalemic periodic paralysis (45%), 7 sodium channel myotonia (17.5%), 4 paramyotonia congenita (10%) and 5 heterozygous asymptomatic mutation carriers (12.5%). Review of clinical information highlights a significant delay to diagnosis (median 15 years), reports of pain and myalgia in the majority of patients, male predominance, circadian rhythm and common precipitating factors. Electrodiagnostic studies revealed subclinical myotonic discharges and a positive long exercise test in asymptomatic carriers. Muscle MRI identified edema and fatty infiltration in gastrocnemius and soleus. A total of 13 reported and 2 novel SCN4A mutations were identified with most variants distributed in the transmembrane helix S4 to S6, with a hotspot mutation p.Arg675Gln accounting for 32.5% (13/40) of the cohort. Our study revealed a higher proportion of periodic paralysis in SCN4A-mutated patients compared with cohorts from England and the Netherlands. It also highlights the importance of electrodiagnostic studies in diagnosis and segregation studies.
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Affiliation(s)
- J Sun
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - S Luo
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200040, China; Department of Neurology, North Huashan Hospital, Fudan University, Shanghai, 200003, China
| | - K J Suetterlin
- Department of Neuromuscular Diseases, Queen Square Institute of Neurology, UCL, London, WC1N 3BG, United Kingdom
| | - J Song
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - J Huang
- Department of Clinical Electrophysiology, Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - W Zhu
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - J Xi
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - L Zhou
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - J Lu
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - J Lu
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - C Zhao
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - M G Hanna
- Department of Neuromuscular Diseases, Queen Square Institute of Neurology, UCL, London, WC1N 3BG, United Kingdom
| | - R Männikkö
- Department of Neuromuscular Diseases, Queen Square Institute of Neurology, UCL, London, WC1N 3BG, United Kingdom
| | - E Matthews
- Department of Neuromuscular Diseases, Queen Square Institute of Neurology, UCL, London, WC1N 3BG, United Kingdom; Atkinson Morley Neuromuscular Centre, Regional Neurosciences Centre, Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, United Kingdom
| | - K Qiao
- Department of Clinical Electrophysiology, Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, 200040, China.
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Wang Q, Zhao Z, Shen H, Bing Q, Li N, Hu J. The clinical and genetic heterogeneity analysis of five families with primary periodic paralysis. Channels (Austin) 2020; 15:20-30. [PMID: 33345742 PMCID: PMC7757828 DOI: 10.1080/19336950.2020.1857980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
To explore the clinical and genetic characteristics of five families with primary periodic paralysis (PPP). We reviewed clinical manifestations, laboratory results, electrocardiogram, electromyography, muscle biopsy, and genetic analysis from five families with PPP. Five families with PPP included: hypokalemic periodic paralysis type 1 (HypoPP1, CACNA1S, 1/5), hypokalemic periodic paralysis type 2 (HypoPP2, SCN4A, 2/5), normokalemic periodic paralysis (NormoPP, SCN4A, 1/5), and Andersen-Tawil syndrome (ATS, KCNJ2, 1/5). The basic clinical manifestations of five families were consistent with PPP, presenting with paroxysmal muscle weakness, with or without abnormal serum potassium. ATS was accompanied by ventricular arrhythmias, and skeletal and craniofacial anomalies, developing with a permanent fixed myopathy later. The electromyography showed diffuse myopathic discharge, and muscle biopsy showed tubular aggregates. Genetic testing revealed five families with PPP carried CACNA1S (R1242S), SCN4A (R675Q, T704M), and KCNJ2 (R218Q) respectively. The novel heterozygous R1242S mutation in CACNA1S caused a conformational change in the protein structure, and the amino acid of this mutation site was highly conserved among different species. SCN4A mutations led to two phenotypes of HypoPP2 and NormoPP. PPPs are autosomal dominant disorders of ion channel dysfunction characterized by episodic flaccid muscle weakness secondary to abnormal sarcolemmal excitability. PPPs are caused by mutations in skeletal muscle calcium channel CaV1.1 gene (CACNA1S), sodium channel NaV1.4 gene (SCN4A), and potassium channels Kir2.1, Kir3.4 genes (KCNJ2, KCNJ5), including HypoPP1, HypoPP2, NormoPP, HyperPP, and ATS, which have significant clinical and genetic heterogeneity. Diagnosis is based on the characteristic clinical presentation then confirmed by genetic testing.
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Affiliation(s)
- Quanquan Wang
- Department of Neuromuscular Disease, The Third Hospital of Hebei Medical University , Shijiazhuang, Hebei, China
| | - Zhe Zhao
- Department of Neuromuscular Disease, The Third Hospital of Hebei Medical University , Shijiazhuang, Hebei, China
| | - Hongrui Shen
- Department of Neuromuscular Disease, The Third Hospital of Hebei Medical University , Shijiazhuang, Hebei, China
| | - Qi Bing
- Department of Neuromuscular Disease, The Third Hospital of Hebei Medical University , Shijiazhuang, Hebei, China
| | - Nan Li
- Department of Neuromuscular Disease, The Third Hospital of Hebei Medical University , Shijiazhuang, Hebei, China
| | - Jing Hu
- Department of Neuromuscular Disease, The Third Hospital of Hebei Medical University , Shijiazhuang, Hebei, China
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Taminato T, Mori-Yoshimura M, Miki J, Sasaki R, Sato N, Oya Y, Nishino I, Takahashi Y. Paramyotonia Congenita with Persistent Distal and Facial Muscle Weakness: A Case Report with Literature Review. J Neuromuscul Dis 2020; 7:193-201. [PMID: 32083589 DOI: 10.3233/jnd-190440] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Paramyotonia congenita (PC; OMIM 168300) is a non-dystrophic myotonia caused by mutations in the SCN4A gene. Transient muscle stiffness, usually induced by exposure to cold and aggravated by exercise, is the predominant clinical symptom, and interictal persistent weakness is uncommon. CASE REPORT We report a family with a history of PC accompanied by persistent hand muscle weakness with masticatory muscle involvement. Persistent weakness was exacerbated with age, and MR analysis showed marked atrophy of temporal, masseter, and finger flexor muscles with fatty replacement. The PC causative mutation T1313M in the SCN4A gene was prevalent in the family. Administration of acetazolamide chloride improved clinical symptoms and the results of cold and short exercise tests. Phenotypic variation within the family was remarkable, as the two younger affected patients did not present with persistent weakness or muscle atrophy. CONCLUSIONS PC associated with the T1313M mutation is a possible cause of persistent distal hand weakness.
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Affiliation(s)
- Tomoya Taminato
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Madoka Mori-Yoshimura
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Jun Miki
- Department of Neurology, Saku Central Hospital, Nagano Prefectural Federation of Agricultural Cooperatives for Health and Welfare, Nagano, Japan
| | - Ryogen Sasaki
- Department of Neurology, Kuwana City Medical Center, Mie, Japan
| | - Noriko Sato
- Department of Radiology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yasushi Oya
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Ichizo Nishino
- Department of Genome Medicine Development, Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yuji Takahashi
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
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Solé L, Wagnon JL, Tamkun MM. Functional analysis of three Na v1.6 mutations causing early infantile epileptic encephalopathy. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165959. [PMID: 32916281 DOI: 10.1016/j.bbadis.2020.165959] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/21/2020] [Accepted: 09/03/2020] [Indexed: 11/24/2022]
Abstract
The voltage-gated sodium channel Nav1.6 is associated with more than 300 cases of epileptic encephalopathy. Nav1.6 epilepsy-causing mutations are spread over the entire channel's structure and only 10% of mutations have been characterized at the molecular level, with most of them being gain of function mutations. In this study, we analyzed three previously uncharacterized Nav1.6 epilepsy-causing mutations: G214D, N215D and V216D, located within a mutation hot-spot at the S3-S4 extracellular loop of Domain1. Voltage clamp experiments showed a 6-16 mV hyperpolarizing shift in the activation mid-point for all three mutants. V216D presented the largest shift along with decreased current amplitude, enhanced inactivation and a lack of persistent current. Recordings at hyperpolarized potentials indicated that all three mutants presented gating pore currents. Furthermore, trafficking experiments performed in cultured hippocampal neurons demonstrated that the mutants trafficked properly to the cell surface, with no significant differences regarding surface expression within the axon initial segment or soma compared to wild-type. These trafficking data suggest that the disease-causing consequences are due to only changes in the biophysical properties of the channel. Interestingly, the patient carrying the V216D mutation, which is the mutant with the greatest electrophysiological changes as compared to wild-type, exhibited the most severe phenotype. These results emphasize that these mutations will mandate unique treatment approaches, for normal sodium channel blockers may not work given that the studied mutations present gating pore currents. This study emphasizes the importance of molecular characterization of disease-causing mutations in order to improve the pharmacological treatment of patients.
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Affiliation(s)
- Laura Solé
- Molecular, Cellular and Integrative Neurosciences Graduate Program, Colorado State University, Fort Collins, CO 80523, USA; Department of Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA
| | - Jacy L Wagnon
- Department of Neuroscience, Wexner Medical Center, The Ohio State University, Columbus, OH 43210, USA
| | - Michael M Tamkun
- Molecular, Cellular and Integrative Neurosciences Graduate Program, Colorado State University, Fort Collins, CO 80523, USA; Department of Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA; Department of Biochemistry and Molecular Biology, Colorado State University, Fort Collins, CO 80523, USA.
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11
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Shi J, Qu Q, Liu H, Cui W, Zhang Y, Lv H, Lu Z. SCN4A p.R675Q Mutation Leading to Normokalemic Periodic Paralysis: A Family Report and Literature Review. Front Neurol 2019; 10:1138. [PMID: 31708864 PMCID: PMC6824318 DOI: 10.3389/fneur.2019.01138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/10/2019] [Indexed: 11/22/2022] Open
Abstract
Objective: To investigate the clinical features, skeletal muscle imaging, and muscle pathological characteristics of normokalemic periodic paralysis (NormoKPP) caused by mutation of SCN4A gene p.R675Q. Methods: The clinical data, skeletal muscle imaging, pathological data, and gene test results of a family with NormoKPP were collected in detail in October 2018. The previous literature was reviewed and used for comparative analysis. Results: The proband was a 28-year-old male with paroxysmal weakness of both lower limbs for 14 years. Limb weakness was mainly manifested in the proximal extremities of both lower limbs, which occurred two to three times a year. The muscle weakness of each attack lasted for 1–2 weeks and gradually recovered. The blood potassium levels were normal. The abnormal signals of the posterior thigh muscle group and the medial calf muscle group could be seen on the magnetic resonance imaging (MRI) of the skeletal muscle, and the target-fiber could be seen in some muscle fibers in muscle pathology. The father of the proband and his brother had the same symptoms. In the same family, 10 people received genetic testing. The results showed that five had a mutation of SCN4A gene p.R675Q. The mutation gene came from the father of the proband. Conclusion: NormoKPP is a clinically rare form of sodium ion channel disease. The clinical manifestations, skeletal muscle imaging, and pathological changes are different from the common hypokalemic periodic paralysis. SCN4A gene detection is an important means for the diagnosis of NormoKPP.
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Affiliation(s)
- Jiejing Shi
- Department of Neurology, Jiaozuo People's Hospital of Henan Province, Jiaozuo, China
| | - Qianqian Qu
- Department of Neurology, Jiaozuo People's Hospital of Henan Province, Jiaozuo, China
| | - Haiyan Liu
- Department of Neurology, Jiaozuo People's Hospital of Henan Province, Jiaozuo, China
| | - Wenhao Cui
- Department of Neurology, Jiaozuo People's Hospital of Henan Province, Jiaozuo, China
| | - Yan Zhang
- Department of Neurology, Jiaozuo People's Hospital of Henan Province, Jiaozuo, China
| | - Haidong Lv
- Department of Neurology, Jiaozuo People's Hospital of Henan Province, Jiaozuo, China
| | - Zuneng Lu
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
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Duan BC, Wong LC, Lee WT. Alternating hemiplegia and paroxysmal torticollis caused by SCN4A mutation: A new phenotype? Neurology 2019; 93:673-674. [PMID: 31492720 DOI: 10.1212/wnl.0000000000008212] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/10/2019] [Indexed: 11/15/2022] Open
Affiliation(s)
- Bi Chun Duan
- From the Department of Pediatrics (B.C.D.), Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan; Department of Pediatrics (L.-C.W.), Cathay General Hospital; Department of Pediatric Neurology (W.-T.L.), National Taiwan University Children's Hospital; and Graduate Institute of Brain and Mind Sciences (W.-T.L.) and Department of Pediatrics (W.-T.L.), National Taiwan University College of Medicine, Taipei
| | - Lee-Chin Wong
- From the Department of Pediatrics (B.C.D.), Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan; Department of Pediatrics (L.-C.W.), Cathay General Hospital; Department of Pediatric Neurology (W.-T.L.), National Taiwan University Children's Hospital; and Graduate Institute of Brain and Mind Sciences (W.-T.L.) and Department of Pediatrics (W.-T.L.), National Taiwan University College of Medicine, Taipei
| | - Wang-Tso Lee
- From the Department of Pediatrics (B.C.D.), Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan; Department of Pediatrics (L.-C.W.), Cathay General Hospital; Department of Pediatric Neurology (W.-T.L.), National Taiwan University Children's Hospital; and Graduate Institute of Brain and Mind Sciences (W.-T.L.) and Department of Pediatrics (W.-T.L.), National Taiwan University College of Medicine, Taipei.
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Da Y, Lei L, Jurkat-Rott K, Lehmann-Horn F. Successful treatment of periodic paralysis with coenzyme Q10: two case reports. Acta Myol 2016; 35:107-108. [PMID: 28344441 PMCID: PMC5343741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Primary periodic paralyses (PPs) are autosomal dominant ion channel disorders characterized by episodic flaccid weakness associated with variations in serum potassium level. The main prophylactic therapy of choice for PPsis carbonic anhydrase inhibitors that are not always effective. In this report, we described two PP patients who were successfully treated with coenzyme Q10. They remained asymptomatic since initiation of treatment, which may be associated with promotion of energy synthesis, anti-oxidant activity, influence of the fiber type composition and regulation of the expression of gene. To our knowledge, this is the first report of primary periodic paralyses which have been successfully treated with CoQ10. More observations need to substantiate this clinical finding in PPs.
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Affiliation(s)
- Yuwei Da
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China;,Address for correspondence: Yuwei Da, Department of Neurology, Xuan Wu Hospital, Capital Medical University, Chang Chun Street, Beijing 100053, China. Tel. +86 10 83198493. Fax +86 10 83171070. E-mail: ; Frank Lehmann-Horn, Division of Neurophysiology, Ulm University, Germany. E-mail:
| | - Lin Lei
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | | | - Frank Lehmann-Horn
- Division of Neurophysiology, Ulm University, Germany,Address for correspondence: Yuwei Da, Department of Neurology, Xuan Wu Hospital, Capital Medical University, Chang Chun Street, Beijing 100053, China. Tel. +86 10 83198493. Fax +86 10 83171070. E-mail: ; Frank Lehmann-Horn, Division of Neurophysiology, Ulm University, Germany. E-mail:
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Yang X, Jia H, An R, Xi J, Xu Y. Sequence CLCN1 and SCN4A in patients with Nondystrophic myotonias in Chinese populations: Genetic and pedigree analysis of 10 families and review of the literature. Channels (Austin) 2016; 11:55-65. [PMID: 27415035 DOI: 10.1080/19336950.2016.1212140] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Myotonia congenita (MC), paramyotonia congenita (PC) and sodium channel myotonias(SCM) were belonged to Non-dystrophic myotonias, in which muscle relaxation is delayed after voluntary or evoked contraction. These diseases can not be simply distinguished only based on symptoms and signs but also on genetics: more than 100 mutations in the CLCN1 gene have been associated with MC, while at least 20 mutations in the SCN4A gene have been associated with PC and SCM. Most of these genetics studies have been conducted outside China, only several MC, PC, and SCM families accepted gene scan were reported in China. Therefore we analyzed genetic mutations in CLCN1 and SCN4A in 10 Chinese families clinically diagnosed with Non-dystrophic myotonias. Our result revealed 12 potential disease-causing mutations(3 mutations were novel) that were present in the probands and affected family members. We also reviewed all available literature on mutations linked to these 3 disease in Chinese populations. Our results may help identify genetic determinants as well as clarify genotype-phenotype relationships.
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Affiliation(s)
- Xinglong Yang
- a Department of Neurology , West China Hospital, Sichuan University , Chengdu , Sichuan Province , P.R. China
| | - Hua Jia
- a Department of Neurology , West China Hospital, Sichuan University , Chengdu , Sichuan Province , P.R. China
| | - Ran An
- a Department of Neurology , West China Hospital, Sichuan University , Chengdu , Sichuan Province , P.R. China
| | - Jing Xi
- a Department of Neurology , West China Hospital, Sichuan University , Chengdu , Sichuan Province , P.R. China
| | - Yanming Xu
- a Department of Neurology , West China Hospital, Sichuan University , Chengdu , Sichuan Province , P.R. China
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