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Grassini A, Cermelli A, Roveta F, Zotta M, Lesca A, Marcinnò A, Ferrandes F, Piella E, Boschi S, Lombardo C, Brusco A, Gallone S, Rubino E, Bruni A, Rainero I. Cognitive dysfunction, social behavior disorder, cerebellar ataxia, and atypical brain FDG-PET presentation in spinocerebellar ataxia 17: a case report. Neurol Sci 2024:10.1007/s10072-024-07453-4. [PMID: 38494459 DOI: 10.1007/s10072-024-07453-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/09/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Spinocerebellar ataxia 17 (SCA17) is a rare autosomal dominant form of inherited ataxia, caused by heterozygous trinucleotide repeat expansions encoding glutamine in the TATA box-binding protein (TBP) gene. CASE DESCRIPTION We describe the clinical history, neuropsychological, and neuroimaging findings of a 42-year-old patient who presented for medical attention showing prevalent behavioral and cognitive problems along with progressively worsening gait disturbances. The patient's family history indicated the presence of SCA17 in the maternal lineage. Genetic analysis confirmed a heterozygous 52-CAG pathological expansion repeat in TBP (normal interval, 25-40 CAG. Brain 18-fluorodeoxyglucose positron emission tomography (FDG-PET) showed bilateral hypometabolism in the sensorimotor cortex, with a slight predominance on the right, as well as in the striatal nuclei and thalamic hypermetabolism, a finding similar to what is observed in Huntington's disease. The patient also underwent neuropsychological evaluation, which revealed mild cognitive impairment and difficulties in social interaction and understanding other's emotions (Faux Pas Test and Reading the Mind in the Eyes Test). CONCLUSION Our report emphasizes the importance of considering SCA17 as a possible diagnosis in patients with a prevalent progressive cognitive and behavioral disorders, even with a pattern of FDG-PET hypometabolism not primarily indicative of this disease.
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Affiliation(s)
- Alberto Grassini
- Aging Brain and Memory Clinic, Department of Neuroscience, "Rita Levi Montalcini", Memory Clinic, University of Torino, Via Cherasco 15, 10126, Turin, Italy.
| | - Aurora Cermelli
- Aging Brain and Memory Clinic, Department of Neuroscience, "Rita Levi Montalcini", Memory Clinic, University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Fausto Roveta
- Aging Brain and Memory Clinic, Department of Neuroscience, "Rita Levi Montalcini", Memory Clinic, University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Michela Zotta
- Nuclear Medicine, Città Della Salute E Della Scienza University Hospital, Turin, Italy
| | - Adriana Lesca
- Nuclear Medicine, Città Della Salute E Della Scienza University Hospital, Turin, Italy
| | - Andrea Marcinnò
- Aging Brain and Memory Clinic, Department of Neuroscience, "Rita Levi Montalcini", Memory Clinic, University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Fabio Ferrandes
- Aging Brain and Memory Clinic, Department of Neuroscience, "Rita Levi Montalcini", Memory Clinic, University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Elisa Piella
- Aging Brain and Memory Clinic, Department of Neuroscience, "Rita Levi Montalcini", Memory Clinic, University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Silvia Boschi
- Aging Brain and Memory Clinic, Department of Neuroscience, "Rita Levi Montalcini", Memory Clinic, University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Chiara Lombardo
- Aging Brain and Memory Clinic, Department of Neuroscience, "Rita Levi Montalcini", Memory Clinic, University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Alfredo Brusco
- Department of Neuroscience and Mental Health, Città Della Salute E Della Scienza University Hospital, Turin, Italy
- Medical Genetics Unit, Città Della Salute E Della Scienza University Hospital, Turin, Italy
| | - Salvatore Gallone
- Department of Neuroscience and Mental Health, Città Della Salute E Della Scienza University Hospital, Turin, Italy
| | - Elisa Rubino
- Aging Brain and Memory Clinic, Department of Neuroscience, "Rita Levi Montalcini", Memory Clinic, University of Torino, Via Cherasco 15, 10126, Turin, Italy
- Department of Neuroscience and Mental Health, Città Della Salute E Della Scienza University Hospital, Turin, Italy
| | - Amalia Bruni
- Regional Neurogenetic Centre, Department of Primary Care, ASP Catanzaro, Lamezia Terme, Italy
| | - Innocenzo Rainero
- Aging Brain and Memory Clinic, Department of Neuroscience, "Rita Levi Montalcini", Memory Clinic, University of Torino, Via Cherasco 15, 10126, Turin, Italy
- Department of Neuroscience and Mental Health, Città Della Salute E Della Scienza University Hospital, Turin, Italy
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Cermelli A, Roveta F, Giorgis L, Boschi S, Grassini A, Ferrandes F, Lombardo C, Marcinnò A, Rubino E, Rainero I. Is headache a risk factor for dementia? A systematic review and meta-analysis. Neurol Sci 2024; 45:1017-1030. [PMID: 37721571 PMCID: PMC10858119 DOI: 10.1007/s10072-023-07069-0] [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: 04/11/2023] [Accepted: 09/09/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE In this systematic review and meta-analysis, we critically evaluate available evidence regarding the association between primary headaches and subsequent decline of cognitive function and dementia. BACKGROUND Recent studies suggested that headache disorders may increase the risk for dementia. However, available studies are conflicting. METHODS To identify qualifying studies, we searched scientific databases, including Pubmed, Scopus, Web of Science, Science Direct and BMC, screening for relevant papers. In order to reduce the heterogeneity between different studies, the analyses were further subdivided according to the clinical diagnoses and the study methodologies. RESULTS We identified 23 studies investigating the association between primary headaches and the risk of dementia. Of these, 18 met our inclusion criteria for meta-analysis (covering 924.140 individuals). Overall effect-size shows that primary headaches were associated with a small increase in dementia risk (OR = 1,15; CI 95%: 1,03-1,28; p = 0,02). Analyzing subgroups, we found that migraine was associated with both a moderate increased risk of all-cause dementia (OR = 1,26; p = 0,00; 95% CI: 1,13-1,40) as well as a moderate increased risk of Alzheimer's disease (OR = 2,00; p = 0,00; 95% CI: 1,46-2,75). This association was significant in both case-control and retrospective cohort studies but not in prospective studies. CONCLUSIONS Our study supports the presence of a link between primary headaches and dementia. However, in the subgroup analysis, only patients with migraine showed a moderate increase risk for all-cause dementia and for Alzheimer's disease. Additional rigorous studies are needed to elucidate the possible role of primary headaches on the risk of developing cognitive impairment and dementia.
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Affiliation(s)
- Aurora Cermelli
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Fausto Roveta
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Lia Giorgis
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Silvia Boschi
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Alberto Grassini
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Fabio Ferrandes
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Chiara Lombardo
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Andrea Marcinnò
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Elisa Rubino
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza, Corso Bramante 88, Turin, Italy
| | - Innocenzo Rainero
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy.
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza, Corso Bramante 88, Turin, Italy.
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Roveta F, Marcinnò A, Grassini A, Ferrandes F, Cermelli A, Boschi S, Gallone S, Atzori C, Imperiale D, Dentelli P, Pasini B, Brusco A, Rubino E, Rainero I. A Novel PSEN1 Variant Leading to Posterior Cortical Atrophy: A Case Report. J Alzheimers Dis Rep 2023; 7:469-473. [PMID: 37313494 PMCID: PMC10259045 DOI: 10.3233/adr230023] [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: 03/20/2023] [Accepted: 04/21/2023] [Indexed: 06/15/2023] Open
Abstract
We describe a 52-year-old patient with a progressive visuospatial disorder and apraxia. Neuropsychological assessment, neuroradiological findings, and Alzheimer's disease (AD) core biomarker assay on cerebrospinal fluid led to a diagnosis of posterior cortical atrophy due to AD. We performed a next generation sequencing dementia-gene panel and found the c.1301 C>T p.(Ala434Val) variant in the Presenilin1 (PSEN1) gene. The missense change affects the PAL (Pro433-Ala434-Leu435) motif critical for catalytic activity of the macromolecular γ-secretase complex. Evolutionary and integrated bioinformatic tools predicted a deleterious effect of the variant supporting its role in the AD pathogenesis.
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Affiliation(s)
- Fausto Roveta
- Aging Brain and Memory Clinic, Department of Neuroscience, University of Torino, Torino, Italy
| | - Andrea Marcinnò
- Aging Brain and Memory Clinic, Department of Neuroscience, University of Torino, Torino, Italy
| | - Alberto Grassini
- Aging Brain and Memory Clinic, Department of Neuroscience, University of Torino, Torino, Italy
| | - Fabio Ferrandes
- Aging Brain and Memory Clinic, Department of Neuroscience, University of Torino, Torino, Italy
| | - Aurora Cermelli
- Aging Brain and Memory Clinic, Department of Neuroscience, University of Torino, Torino, Italy
| | - Silvia Boschi
- Aging Brain and Memory Clinic, Department of Neuroscience, University of Torino, Torino, Italy
| | - Salvatore Gallone
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza University Hospital, Torino, Italy
| | | | | | - Patrizia Dentelli
- Medical Genetics Unit, Cittàdella Salute e della Scienza University Hospital, Torino, Italy
- Department of Medical Sciences, University of Torino, Torino, Italy
| | - Barbara Pasini
- Medical Genetics Unit, Cittàdella Salute e della Scienza University Hospital, Torino, Italy
- Department of Medical Sciences, University of Torino, Torino, Italy
| | - Alfredo Brusco
- Medical Genetics Unit, Cittàdella Salute e della Scienza University Hospital, Torino, Italy
- Department of Medical Sciences, University of Torino, Torino, Italy
| | - Elisa Rubino
- Aging Brain and Memory Clinic, Department of Neuroscience, University of Torino, Torino, Italy
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza University Hospital, Torino, Italy
| | - Innocenzo Rainero
- Aging Brain and Memory Clinic, Department of Neuroscience, University of Torino, Torino, Italy
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza University Hospital, Torino, Italy
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Rubino E, Marcinnò A, Grassini A, Piella EM, Ferrandes F, Roveta F, Boschi S, Cermelli A, Gallone S, Savi L, Rainero I. Polymorphisms of the Proinflammatory Cytokine Genes Modulate the Response to NSAIDs but Not to Triptans in Migraine Attacks. Int J Mol Sci 2022; 24:ijms24010657. [PMID: 36614097 PMCID: PMC9820603 DOI: 10.3390/ijms24010657] [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: 11/22/2022] [Revised: 12/21/2022] [Accepted: 12/26/2022] [Indexed: 01/03/2023] Open
Abstract
Migraine is a common neurovascular disorder characterized by recurrent episodes of headache and associated neurological symptoms. At present, a significant portion of patients do not obtain a satisfactory response to acute pain-relieving therapies, including NSAIDs and triptans. In this context, pharmacogenetics plays a key role in the understanding of such a diverse response. In order to investigate whether functional polymorphisms in proinflammatory cytokine genes (IL-1α, IL-1β, IL-1RN; IL-6 and TNF-α) may influence the response to acute treatment, 313 consecutive patients with episodic migraine without aura were enrolled. Pain relief by administration of NSAIDs or triptans for three consecutive migraine attacks was evaluated. We found a significant association between A allele of the TNF-α promoter (−308 A/G) and a lack of efficacy after NSAID administration (p < 0.01, OR 2.51, 95% CI: 1.33 < OR < 4.75 compared to the G allele). Remaining polymorphisms had no significant effect on pain relief. Our study showed that a functional polymorphism in the TNF-α gene significantly modulates the clinical response to NSAID administration in acute attacks. Patients with higher production of the active cytokine during stress showed a significantly lower anti-migraine effect. Our results further support a role for TNF-α in the pathophysiological mechanisms of migraine attack.
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Affiliation(s)
- Elisa Rubino
- Department of Neurosciences “Rita Levi Montalcini”, University of Torino, 10126 Torino, Italy
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza di Torino, 10126 Torino, Italy
- Correspondence:
| | - Andrea Marcinnò
- Department of Neurosciences “Rita Levi Montalcini”, University of Torino, 10126 Torino, Italy
| | - Alberto Grassini
- Department of Neurosciences “Rita Levi Montalcini”, University of Torino, 10126 Torino, Italy
| | - Elisa Maria Piella
- Department of Neurosciences “Rita Levi Montalcini”, University of Torino, 10126 Torino, Italy
| | - Fabio Ferrandes
- Department of Neurosciences “Rita Levi Montalcini”, University of Torino, 10126 Torino, Italy
| | - Fausto Roveta
- Department of Neurosciences “Rita Levi Montalcini”, University of Torino, 10126 Torino, Italy
| | - Silvia Boschi
- Department of Neurosciences “Rita Levi Montalcini”, University of Torino, 10126 Torino, Italy
| | - Aurora Cermelli
- Department of Neurosciences “Rita Levi Montalcini”, University of Torino, 10126 Torino, Italy
| | - Salvatore Gallone
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza di Torino, 10126 Torino, Italy
| | - Lidia Savi
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza di Torino, 10126 Torino, Italy
| | - Innocenzo Rainero
- Department of Neurosciences “Rita Levi Montalcini”, University of Torino, 10126 Torino, Italy
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza di Torino, 10126 Torino, Italy
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Roveta F, Cermelli A, Boschi S, Ferrandes F, Grassini A, Marcinnò A, Spina M, Rubino E, Borsello T, Vercelli A, Rainero I. Synaptic Proteins as Fluid Biomarkers in Alzheimer's Disease: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2022; 90:1381-1393. [PMID: 36278349 DOI: 10.3233/jad-220515] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Indexed: 11/05/2022]
Abstract
BACKGROUND Synaptic disruption precedes neuronal death and correlates with clinical features of Alzheimer's disease (AD). The identification of fluid biomarkers of synaptic damage is emerging as a goal for early and accurate diagnosis of the disease. OBJECTIVE To perform a systematic review and meta-analysis to determine whether fluid biomarkers of synaptic damage are impaired in AD. METHODS PubMed, Scopus, EMBASE, and Web of Science were searched for articles reporting synaptic proteins as fluid biomarkers in AD and cognitively unimpaired (CU) individuals. Pooled effect sizes were determined using the Hedge G method with random effects. Questions adapted from the Quality Assessment of Diagnostic Accuracy Studies were applied for quality assessment. A protocol for this study has been previously registered in PROSPERO (registration number: CRD42021277487). RESULTS The search strategy identified 204 articles that were assessed for eligibility. A total of 23 studies were included in the systematic review and 15 were included in the meta-analysis. For Neurogranin, 827 AD and 1,237 CU subjects were included in the meta-analysis, showing a significant increase in cerebrospinal fluid of patients with AD compared to CU individuals, with an effect size of 1.01 (p < 0.001). A significant increase in SNAP-25 and GAP-43 levels in CSF of patients with AD was observed. CONCLUSION Neurogranin, SNAP-25, and GAP-43 are possible biomarkers of synaptic damage in AD, and other potential synaptic biomarkers are emerging. This meta-analysis also revealed that there are still relatively few studies investigating these biomarkers in patients with AD or other dementias and showed wide heterogeneity in literature.
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Affiliation(s)
- Fausto Roveta
- Department of Neuroscience Rita Levi Montalcini, University of Torino, Torino, Italy
| | - Aurora Cermelli
- Department of Neuroscience Rita Levi Montalcini, University of Torino, Torino, Italy
| | - Silvia Boschi
- Department of Neuroscience Rita Levi Montalcini, University of Torino, Torino, Italy
| | - Fabio Ferrandes
- Department of Neuroscience Rita Levi Montalcini, University of Torino, Torino, Italy
| | - Alberto Grassini
- Department of Neuroscience Rita Levi Montalcini, University of Torino, Torino, Italy
| | - Andrea Marcinnò
- Department of Neuroscience Rita Levi Montalcini, University of Torino, Torino, Italy
| | - Margherita Spina
- Department of Neuroscience Rita Levi Montalcini, University of Torino, Torino, Italy
| | - Elisa Rubino
- Department of Neuroscience Rita Levi Montalcini, University of Torino, Torino, Italy
| | - Tiziana Borsello
- Department of Pharmacological and Biomolecular Sciences University of Milano, Milan, Italy
- Mario Negri Institute for Pharmacological Research, University of Milano, Milan, Italy
| | - Alessandro Vercelli
- Department of Neuroscience Rita Levi Montalcini, University of Torino, Torino, Italy
- Neuroscience Institute Cavalieri Ottolenghi, University of Torino, Orbassano, Italy
| | - Innocenzo Rainero
- Department of Neuroscience Rita Levi Montalcini, University of Torino, Torino, Italy
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