1
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Montano V, Orsucci D, Carelli V, La Morgia C, Valentino ML, Lamperti C, Marchet S, Musumeci O, Toscano A, Primiano G, Santorelli FM, Ticci C, Filosto M, Rubegni A, Mongini T, Tonin P, Servidei S, Ceravolo R, Siciliano G, Mancuso M. Adult-onset mitochondrial movement disorders: a national picture from the Italian Network. J Neurol 2021; 269:1413-1421. [PMID: 34259909 PMCID: PMC8857085 DOI: 10.1007/s00415-021-10697-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 05/13/2021] [Revised: 06/25/2021] [Accepted: 07/02/2021] [Indexed: 02/06/2023]
Abstract
Introduction Both prevalence and clinical features of the various movement disorders in adults with primary mitochondrial diseases are unknown. Methods Based on the database of the “Nation-wide Italian Collaborative Network of Mitochondrial Diseases”, we reviewed the clinical, genetic, neuroimaging and neurophysiological data of adult patients with primary mitochondrial diseases (n = 764) where ataxia, myoclonus or other movement disorders were part of the clinical phenotype. Results Ataxia, myoclonus and movement disorders were present in 105/764 adults (13.7%), with the onset coinciding or preceding the diagnosis of the mitochondrial disease in 49/105 (46.7%). Ataxia and parkinsonism were the most represented, with an overall prevalence at last follow-up of 59.1% and 30.5%, respectively. Hyperkinetic movement disorders were reported in 15.3% at last follow-up, being the less common reported movement disorders. The pathogenic m.8344A > G and POLG variants were always associated with a movement disorder, while LHON variants and mtDNA single deletions were more commonly found in the subjects who did not present a movement disorder. The most common neuroimaging features were cortical and/or cerebellar atrophy, white matter hyperintensities, basal ganglia abnormalities and nigro-striatal degeneration. Almost 70% of patients with parkinsonism responded to dopaminergic therapy, mainly levodopa, and 50% with myoclonus were successfully treated with levetiracetam. Conclusion Movement disorders, mainly ataxia and parkinsonism, are important findings in adult primary mitochondrial diseases. This study underlies the importance of looking for a mitochondrial etiology in the diagnostic flowchart of a movement disorder and may help direct genetic screening in daily practice. Supplementary Information The online version contains supplementary material available at 10.1007/s00415-021-10697-1.
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Affiliation(s)
- V Montano
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - D Orsucci
- Unit of Neurology, San Luca Hospital, Lucca, Italy
| | - V Carelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - C La Morgia
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy
| | - M L Valentino
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - C Lamperti
- UO Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - S Marchet
- UO Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - O Musumeci
- Unit of Neurology and Neuromuscular Disorders, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - A Toscano
- Unit of Neurology and Neuromuscular Disorders, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - G Primiano
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - F M Santorelli
- Molecular Medicine for Neurodegenerative and Neuromuscular Diseases Unit, IRCCS Stella Maris Foundation, Pisa, Italy
| | - C Ticci
- Molecular Medicine for Neurodegenerative and Neuromuscular Diseases Unit, IRCCS Stella Maris Foundation, Pisa, Italy
| | - M Filosto
- Department of Clinical and Experimental Sciences, ASST Spedali Civili Brescia and NeMO-Brescia Clinical Center for Neuromuscular Diseases, University of Brescia, Brescia, Italy
| | - A Rubegni
- Molecular Medicine for Neurodegenerative and Neuromuscular Diseases Unit, IRCCS Stella Maris Foundation, Pisa, Italy
| | - T Mongini
- Department of Neurosciences, University of Torino, Turin, Italy
| | - P Tonin
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Neurology, University of Verona, Verona, Italy
| | - S Servidei
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - R Ceravolo
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - G Siciliano
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Michelangelo Mancuso
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy.
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2
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La Morgia C, Maresca A, Caporali L, Valentino ML, Carelli V. Mitochondrial diseases in adults. J Intern Med 2020; 287:592-608. [PMID: 32463135 DOI: 10.1111/joim.13064] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/07/2020] [Accepted: 02/21/2020] [Indexed: 02/07/2023]
Abstract
Mitochondrial medicine is a field that expanded exponentially in the last 30 years. Individually rare, mitochondrial diseases as a whole are probably the most frequent genetic disorder in adults. The complexity of their genotype-phenotype correlation, in terms of penetrance and clinical expressivity, natural history and diagnostic algorithm derives from the dual genetic determination. In fact, in addition to the about 1.500 genes encoding mitochondrial proteins that reside in the nuclear genome (nDNA), we have the 13 proteins encoded by the mitochondrial genome (mtDNA), for which 22 specific tRNAs and 2 rRNAs are also needed. Thus, besides Mendelian genetics, we need to consider all peculiarities of how mtDNA is inherited, maintained and expressed to fully understand the pathogenic mechanisms of these disorders. Yet, from the initial restriction to the narrow field of oxidative phosphorylation dysfunction, the landscape of mitochondrial functions impinging on cellular homeostasis, driving life and death, is impressively enlarged. Finally, from the clinical standpoint, starting from the neuromuscular field, where brain and skeletal muscle were the primary targets of mitochondrial dysfunction as energy-dependent tissues, after three decades virtually any subspecialty of medicine is now involved. We will summarize the key clinical pictures and pathogenic mechanisms of mitochondrial diseases in adults.
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Affiliation(s)
- C La Morgia
- From the, Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy
| | - A Maresca
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy
| | - L Caporali
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy
| | - M L Valentino
- From the, Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy
| | - V Carelli
- From the, Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy
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3
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Vacchiano V, Tonon C, Mitolo M, Evangelisti S, Carbonelli M, Liguori R, Lodi R, Carelli V, La Morgia C. Functional MRI study in a case of Charles Bonnet syndrome related to LHON. BMC Neurol 2019; 19:350. [PMID: 31888524 PMCID: PMC6937628 DOI: 10.1186/s12883-019-1579-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 04/14/2019] [Accepted: 12/17/2019] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Charles Bonnet syndrome is characterized by simple or complex visual hallucinations (VH) due to damage along the visual pathways. We report a functional MRI study of brain correlates of VH in the context of a severe optic atrophy in a patient with Leber's Hereditary Optic Neuropathy (LHON). CASE REPORT A 62-year-old man was diagnosed with LHON (11778/ND4 mtDNA mutation) after subacute visual loss in left eye (right eye was amblyopic). One month later, he experienced VH of a few seconds consisting in "moving red and blue miniature cartoons". One year later VH content changed in colored mosaic (10-15 s duration), usually stress-related, and blue and white flashes (2-5 s), triggered by unexpected auditory stimuli. Audiometry revealed mild sensorineural hearing loss. Three block design functional MRI paradigms were administrated: 1) random "clap", 2) "checkerboard" and 3) non-random "beep". After random "claps" simple flashes were evoked with bilateral activation of primary and secondary visual cortex, cuneus, precuneus and insula. Neither hallucinations nor cortex activation were registered after "checkerboard" stimulation, due to the severe visual impairment. Primary and secondary auditory cortices were "beep"-activated, without eliciting VH by non-random "beep". CONCLUSIONS The peculiarity of our case is that VH were triggered by random auditory stimuli, possibly due to a cross-modal plasticity between visual and auditory networks, likely influenced by the sensorineural deafness. Functional alterations of both networks in resting conditions have been demonstrated in LHON patients, even without an auditory deficit. Finally, the absence of VH triggered by expected stimuli is consistent with the "expectation suppression theory", based on increased neural activations after unexpected but not by predicted events.
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Affiliation(s)
- V Vacchiano
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Via Altura, 3, 40139, Bologna, Italy.,Unit of Neurology, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - C Tonon
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Diagnostica Funzionale Neuroradiologica, Bologna, Italy.,Functional MR Unit, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - M Mitolo
- Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - S Evangelisti
- Functional MR Unit, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - M Carbonelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Via Altura, 3, 40139, Bologna, Italy
| | - R Liguori
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Via Altura, 3, 40139, Bologna, Italy.,Unit of Neurology, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - R Lodi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Diagnostica Funzionale Neuroradiologica, Bologna, Italy.,Functional MR Unit, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - V Carelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Via Altura, 3, 40139, Bologna, Italy.,Unit of Neurology, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - C La Morgia
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Via Altura, 3, 40139, Bologna, Italy. .,Unit of Neurology, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.
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4
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Carelli V, La Morgia C. Leber's hereditary optic neuropathy: the neurologist point of view. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.02322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- V. Carelli
- Department of Biomedical and Neuromotor Sciences; IRCCS Institute of Neurological Sciences of Bologna; Bologna Italy
- Department of Biomedical and Neuromotor Sciences; University of Bologna; Bologna Italy
| | - C. La Morgia
- Department of Biomedical and Neuromotor Sciences; IRCCS Institute of Neurological Sciences of Bologna; Bologna Italy
- Department of Biomedical and Neuromotor Sciences; University of Bologna; Bologna Italy
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5
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Sadun A, Ross-Cisneros F, Tian J, Anderson K, Irvine A, Karanjia R, La Morgia C, McManus M, Wallace D, Carelli V. LHON: A look into nuclear and environmental factors; What is “sufficient”? Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.02671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A. Sadun
- Ophthalmology; Doheny Eye Center UCLA; Pasadena CA USA
- Ophthalmology; Doheny Eye Institute; Los Angeles CA USA
| | | | - J. Tian
- Ophthalmology; Doheny Eye Center UCLA; Pasadena CA USA
| | - K. Anderson
- Ophthalmology; Doheny Eye Center UCLA; Pasadena CA USA
| | - A. Irvine
- Ophthalmology; Doheny Eye Center UCLA; Pasadena CA USA
| | - R. Karanjia
- Ophthalmology; Doheny Eye Center UCLA; Pasadena CA USA
- Ophthalmology; Ottawa Hospital Research Insitute; Ottawa Canada
- Eye Institute; University of Ottawa; Ottawa Canada
| | - C. La Morgia
- IRCCS Instituto delle Scienze Neurologiche di Bologna; UOC Clinica Neurologica; Bologna Italy
| | - M. McManus
- Center for Mitochondrial and Epigenomic Medicine; Children's Hospital of Philadelphia; Philadelphia PA USA
| | - D. Wallace
- Center for Mitochondrial and Epigenomic Medicine; Children's Hospital of Philadelphia; Philadelphia PA USA
| | - V. Carelli
- IRCCS Instituto delle Scienze Neurologiche di Bologna; UOC Clinica Neurologica; Bologna Italy
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6
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La Morgia C, Caporali L, Di Vito L, Carbonelli M, Valentino M, Liguori R, Barboni P, Carelli V. Neurological involvement in mitochondrial eye diseases. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.03654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- C. La Morgia
- IRCCS Institute of Neurological Sciences of Bologna - Bellaria Hospital; Unit of Neurology; Bologna Italy
- Department of Biomedical and Neuromotor Sciences; University of Bologna; Bologna Italy
| | - L. Caporali
- IRCCS Institute of Neurological Sciences of Bologna - Bellaria Hospital; Unit of Neurology; Bologna Italy
| | - L. Di Vito
- IRCCS Institute of Neurological Sciences of Bologna - Bellaria Hospital; Unit of Neurology; Bologna Italy
| | - M. Carbonelli
- IRCCS Institute of Neurological Sciences of Bologna - Bellaria Hospital; Unit of Neurology; Bologna Italy
| | - M.L. Valentino
- IRCCS Institute of Neurological Sciences of Bologna - Bellaria Hospital; Unit of Neurology; Bologna Italy
- Department of Biomedical and Neuromotor Sciences; University of Bologna; Bologna Italy
| | - R. Liguori
- IRCCS Institute of Neurological Sciences of Bologna - Bellaria Hospital; Unit of Neurology; Bologna Italy
- Department of Biomedical and Neuromotor Sciences; University of Bologna; Bologna Italy
| | - P. Barboni
- IRCCS Institute of Neurological Sciences of Bologna - Bellaria Hospital; Unit of Neurology; Bologna Italy
- Studio Oculistico D'Azeglio; Bologna Italy
| | - V. Carelli
- IRCCS Institute of Neurological Sciences of Bologna - Bellaria Hospital; Unit of Neurology; Bologna Italy
- Department of Biomedical and Neuromotor Sciences; University of Bologna; Bologna Italy
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7
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Liu H, La Morgia C, Di Vito L, Nazarali S, Gauthier I, Syed M, Chahal J, Ammar M, Carbonelli M, De Negri A, Sadun A, Carelli V, Karanjia R. Differences in onset between eyes in patients with Leber's hereditary optic neuropathy (LHON). Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0t039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- H. Liu
- Medicine; University of Ottawa; Ottawa Canada
| | - C. La Morgia
- Ophthalmology; IRCCS-Institute of Neurological Sciences of Bologna; Bologna Italy
- Department of Biomedical and NeuroMotor Sciences, Ophthalmology; Bologna Italy
| | - L. Di Vito
- Ophthalmology; IRCCS-Institute of Neurological Sciences of Bologna; Bologna Italy
| | - S. Nazarali
- Medicine; University of Ottawa; Ottawa Canada
| | - I. Gauthier
- Medicine; University of Ottawa; Ottawa Canada
| | - M. Syed
- Medicine; University of Ottawa; Ottawa Canada
| | - J. Chahal
- Ophthalmology; Doheny Eye Institute; Los Angeles United States
| | - M. Ammar
- Ophthalmology; Doheny Eye Institute; Los Angeles United States
| | - M. Carbonelli
- Ophthalmology; IRCCS-Institute of Neurological Sciences of Bologna; Bologna Italy
- Ophthalmology; Studio Oculistico D'Azeglio; Bologna Italy
| | - A.M. De Negri
- Ophthalmology; S.Camillo-Forlanini Hospital; Rome Italy
| | - A. Sadun
- Ophthalmology; Doheny Eye Institute; Los Angeles United States
- Ophthalmology; David Geffen School of Medicine at UCLA; Los Angeles United States
| | - V. Carelli
- Ophthalmology; IRCCS-Institute of Neurological Sciences of Bologna; Bologna Italy
| | - R. Karanjia
- Medicine; University of Ottawa; Ottawa Canada
- Ophthalmology; IRCCS-Institute of Neurological Sciences of Bologna; Bologna Italy
- Ophthalmology; David Geffen School of Medicine at UCLA; Los Angeles United States
- Ophthalmology; Ottawa Hospital Research Institute; Ottawa Canada
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8
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Pisani F, Pavlidis E, Facini C, La Morgia C, Fusco C, Cantalupo G. A 15-year epileptogenic period after perinatal brain injury. Funct Neurol 2017; 32:49-53. [PMID: 28380324 DOI: 10.11138/fneur/2017.32.1.049] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Seizures are a frequent acute neurological event in the neonatal period. Up to 12 to 18% of all seizures in newborns are due to perinatal stroke and up to 39% of affected children can then develop epilepsy in childhood. We report the case of a young patient who presented stroke-related seizures in the neonatal period and then developed focal symptomatic epilepsy at 15 years of age, and in whom the epileptic focus was found to co-localize with the site of his ischemic brain lesion. Such a prolonged silent period before onset of remote symptomatic epilepsy has not previously been reported. This case suggests that newborns with seizures due to a neonatal stroke are at higher risk of epilepsy and that the epileptogenic process in these subjects can last longer than a decade.
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9
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Giordano L, Deceglie S, d'Adamo P, Valentino ML, La Morgia C, Fracasso F, Roberti M, Cappellari M, Petrosillo G, Ciaravolo S, Parente D, Giordano C, Maresca A, Iommarini L, Del Dotto V, Ghelli AM, Salomao SR, Berezovsky A, Belfort R, Sadun AA, Carelli V, Loguercio Polosa P, Cantatore P. Cigarette toxicity triggers Leber's hereditary optic neuropathy by affecting mtDNA copy number, oxidative phosphorylation and ROS detoxification pathways. Cell Death Dis 2015; 6:e2021. [PMID: 26673666 PMCID: PMC4720897 DOI: 10.1038/cddis.2015.364] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 11/04/2015] [Accepted: 11/05/2015] [Indexed: 01/15/2023]
Abstract
Leber's hereditary optic neuropathy (LHON), the most frequent mitochondrial disease, is associated with mitochondrial DNA (mtDNA) point mutations affecting Complex I subunits, usually homoplasmic. This blinding disorder is characterized by incomplete penetrance, possibly related to several genetic modifying factors. We recently reported that increased mitochondrial biogenesis in unaffected mutation carriers is a compensatory mechanism, which reduces penetrance. Also, environmental factors such as cigarette smoking have been implicated as disease triggers. To investigate this issue further, we first assessed the relationship between cigarette smoke and mtDNA copy number in blood cells from large cohorts of LHON families, finding that smoking was significantly associated with the lowest mtDNA content in affected individuals. To unwrap the mechanism of tobacco toxicity in LHON, we exposed fibroblasts from affected individuals, unaffected mutation carriers and controls to cigarette smoke condensate (CSC). CSC decreased mtDNA copy number in all cells; moreover, it caused significant reduction of ATP level only in mutated cells including carriers. This implies that the bioenergetic compensation in carriers is hampered by exposure to smoke derivatives. We also observed that in untreated cells the level of carbonylated proteins was highest in affected individuals, whereas the level of several detoxifying enzymes was highest in carriers. Thus, carriers are particularly successful in reactive oxygen species (ROS) scavenging capacity. After CSC exposure, the amount of detoxifying enzymes increased in all cells, but carbonylated proteins increased only in LHON mutant cells, mostly from affected individuals. All considered, it appears that exposure to smoke derivatives has a more deleterious effect in affected individuals, whereas carriers are the most efficient in mitigating ROS rather than recovering bioenergetics. Therefore, the identification of genetic modifiers that modulate LHON penetrance must take into account also the exposure to environmental triggers such as tobacco smoke.
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MESH Headings
- DNA, Mitochondrial/genetics
- DNA, Mitochondrial/metabolism
- Female
- Humans
- Male
- Optic Atrophy, Hereditary, Leber/etiology
- Optic Atrophy, Hereditary, Leber/genetics
- Optic Atrophy, Hereditary, Leber/metabolism
- Optic Atrophy, Hereditary, Leber/pathology
- Oxidative Phosphorylation
- Reactive Oxygen Species/metabolism
- Smoking/adverse effects
- Smoking/genetics
- Smoking/metabolism
- Smoking/pathology
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Affiliation(s)
- L Giordano
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
| | - S Deceglie
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
| | - P d'Adamo
- Department of Reproductive Sciences, Medical Genetics, Development and Public Health, University of Trieste, Trieste, Italy
- IRCCS-Burlo Garofolo Children Hospital, Trieste, Italy
| | - M L Valentino
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), Neurology Unit, University of Bologna, Bologna, Italy
| | - C La Morgia
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), Neurology Unit, University of Bologna, Bologna, Italy
| | - F Fracasso
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
| | - M Roberti
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
| | - M Cappellari
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
| | - G Petrosillo
- Institute of Biomembranes and Bioenergetics (IBBE) National Research Council (CNR), Bari, Italy
| | - S Ciaravolo
- Vectis s.r.l. Cava dei Tirreni (Salerno), Italy
| | - D Parente
- Vectis s.r.l. Cava dei Tirreni (Salerno), Italy
| | - C Giordano
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - A Maresca
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), Neurology Unit, University of Bologna, Bologna, Italy
| | - L Iommarini
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), Neurology Unit, University of Bologna, Bologna, Italy
| | - V Del Dotto
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - A M Ghelli
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - S R Salomao
- Department of Ophthalmology, and Visual Sciences, Paulista School of Medicine Federal University of Sao Paulo—UNIFESP, Sao Paulo, Brazil
| | - A Berezovsky
- Department of Ophthalmology, and Visual Sciences, Paulista School of Medicine Federal University of Sao Paulo—UNIFESP, Sao Paulo, Brazil
| | - R Belfort
- Department of Ophthalmology, and Visual Sciences, Paulista School of Medicine Federal University of Sao Paulo—UNIFESP, Sao Paulo, Brazil
| | - A A Sadun
- Doheny Eye Institute, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - V Carelli
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), Neurology Unit, University of Bologna, Bologna, Italy
| | - P Loguercio Polosa
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
| | - P Cantatore
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
- Institute of Biomembranes and Bioenergetics (IBBE) National Research Council (CNR), Bari, Italy
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10
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Sadun A, Carelli V, La Morgia C, Karanjia R. Leber's Hereditary Optic Neuropathy (LHON) mtDNA mutations cause cell death by overproduction of reactive oxygen species. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- A. Sadun
- Ophthalmology; Doheny Eye Center UCLA; Los Angeles United States
| | - V. Carelli
- Neurology; University of Bologna; Bologna Italy
| | | | - R. Karanjia
- Ophthalmology; Doheny Eye Center UCLA; Los Angeles United States
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Carelli V, La Morgia C, Caporali L, Maresca A, Giordano L, Valentino M, Barboni P, Cantatore P, d'Adamo P. Genetic landscape of Leber's hereditary optic neuropathy: reflection on pathogenic mechanisms. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- V. Carelli
- IRCCS Institute of Neurological Sciences of Bologna; Bellaria Hospital; Bologna Italy
- Neurology Unit; Deparment of Biomedical and Neuromotor Sciences (DIBINEM); University of Bologna; Bologna Italy
| | - C. La Morgia
- IRCCS Institute of Neurological Sciences of Bologna; Bellaria Hospital; Bologna Italy
- Neurology Unit; Deparment of Biomedical and Neuromotor Sciences (DIBINEM); University of Bologna; Bologna Italy
| | - L. Caporali
- IRCCS Institute of Neurological Sciences of Bologna; Bellaria Hospital; Bologna Italy
- Neurology Unit; Deparment of Biomedical and Neuromotor Sciences (DIBINEM); University of Bologna; Bologna Italy
| | - A. Maresca
- IRCCS Institute of Neurological Sciences of Bologna; Bellaria Hospital; Bologna Italy
- Neurology Unit; Deparment of Biomedical and Neuromotor Sciences (DIBINEM); University of Bologna; Bologna Italy
| | - L. Giordano
- Department of Biosciences, Biotechnologies and Biopharmaceutics; University of Bari; Bari Italy
| | - M.L. Valentino
- IRCCS Institute of Neurological Sciences of Bologna; Bellaria Hospital; Bologna Italy
- Neurology Unit; Deparment of Biomedical and Neuromotor Sciences (DIBINEM); University of Bologna; Bologna Italy
| | | | | | - P. d'Adamo
- IRCSS-Burlo Garofolo Children Hospital; University of Trieste; Trieste Italy
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Manners DN, Rizzo G, La Morgia C, Tonon C, Testa C, Barboni P, Malucelli E, Valentino ML, Caporali L, Strobbe D, Carelli V, Lodi R. Diffusion Tensor Imaging Mapping of Brain White Matter Pathology in Mitochondrial Optic Neuropathies. AJNR Am J Neuroradiol 2015; 36:1259-65. [PMID: 25792533 DOI: 10.3174/ajnr.a4272] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 12/05/2014] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND PURPOSE Brain white matter is frequently affected in mitochondrial diseases; optic atrophy gene 1-autosomal dominant optic atrophy and Leber hereditary optic neuropathy are the most frequent mitochondrial monosymptomatic optic neuropathies. In this observational study, brain white matter microstructure was characterized by DTI in patients with optic atrophy gene 1-autosomal dominant optic atrophy and Leber hereditary optic neuropathy, in relation to clinical and genetic features. MATERIALS AND METHODS Nineteen patients with optic atrophy gene 1-autosomal dominant optic atrophy and 17 with Leber hereditary optic neuropathy older than 18 years of age, all genetically diagnosed, and 19 healthy volunteers underwent DTI by using a 1.5T MR imaging scanner and neurologic and ophthalmologic assessments. Brain white matter DTI metrics were calculated for all participants, and, in patients, their correlations with genetics and clinical findings were calculated. RESULTS Compared with controls, patients with optic atrophy gene 1-autosomal dominant optic atrophy had an increased mean diffusivity in 29.2% of voxels analyzed within major white matter tracts distributed throughout the brain, while fractional anisotropy was reduced in 30.3% of voxels. For patients with Leber hereditary optic neuropathy, the proportion of altered voxels was only 0.5% and 5.5%, respectively, of which half was found within the optic radiation and 3.5%, in the smaller acoustic radiation. In almost all regions, fractional anisotropy diminished with age in patients with optic atrophy gene 1-autosomal dominant optic atrophy and correlated with average retinal nerve fiber layer thickness in several areas. Mean diffusivity increased in those with a missense mutation. Patients with Leber hereditary optic neuropathy taking idebenone had slightly milder changes. CONCLUSIONS Patients with Leber hereditary optic neuropathy had preferential involvement of the optic and acoustic radiations, consistent with trans-synaptic degeneration, whereas patients with optic atrophy gene 1-autosomal dominant optic atrophy presented with widespread involvement suggestive of a multisystemic, possibly a congenital/developmental, disorder. White matter changes in Leber hereditary optic neuropathy and optic atrophy gene 1-autosomal dominant optic atrophy may be exploitable as biomarkers.
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Affiliation(s)
- D N Manners
- From the Functional MR Unit (D.N.M., G.R., C.Tonon, C.Testa, R.L.)
| | - G Rizzo
- From the Functional MR Unit (D.N.M., G.R., C.Tonon, C.Testa, R.L.) Neurology Unit (G.R., C.L.M., M.L.V., L.C., D.S., V.C.), Department of Biomedical and NeuroMotor Sciences
| | - C La Morgia
- Neurology Unit (G.R., C.L.M., M.L.V., L.C., D.S., V.C.), Department of Biomedical and NeuroMotor Sciences "Istituto di Ricovero e Cura a Carattere Scientifico Istituto delle Scienze Neurologiche di Bologna" (C.L.M., M.L.V., L.C., D.S., V.C.), Bologna, Italy
| | - C Tonon
- From the Functional MR Unit (D.N.M., G.R., C.Tonon, C.Testa, R.L.)
| | - C Testa
- From the Functional MR Unit (D.N.M., G.R., C.Tonon, C.Testa, R.L.)
| | - P Barboni
- Studio Oculistico d'Azeglio (P.B.), Bologna, Italy
| | - E Malucelli
- Department of Pharmacy and Biotechnology (E.M.), University of Bologna, Bologna, Italy
| | - M L Valentino
- Neurology Unit (G.R., C.L.M., M.L.V., L.C., D.S., V.C.), Department of Biomedical and NeuroMotor Sciences "Istituto di Ricovero e Cura a Carattere Scientifico Istituto delle Scienze Neurologiche di Bologna" (C.L.M., M.L.V., L.C., D.S., V.C.), Bologna, Italy
| | - L Caporali
- Neurology Unit (G.R., C.L.M., M.L.V., L.C., D.S., V.C.), Department of Biomedical and NeuroMotor Sciences "Istituto di Ricovero e Cura a Carattere Scientifico Istituto delle Scienze Neurologiche di Bologna" (C.L.M., M.L.V., L.C., D.S., V.C.), Bologna, Italy
| | - D Strobbe
- Neurology Unit (G.R., C.L.M., M.L.V., L.C., D.S., V.C.), Department of Biomedical and NeuroMotor Sciences "Istituto di Ricovero e Cura a Carattere Scientifico Istituto delle Scienze Neurologiche di Bologna" (C.L.M., M.L.V., L.C., D.S., V.C.), Bologna, Italy
| | - V Carelli
- Neurology Unit (G.R., C.L.M., M.L.V., L.C., D.S., V.C.), Department of Biomedical and NeuroMotor Sciences "Istituto di Ricovero e Cura a Carattere Scientifico Istituto delle Scienze Neurologiche di Bologna" (C.L.M., M.L.V., L.C., D.S., V.C.), Bologna, Italy
| | - R Lodi
- From the Functional MR Unit (D.N.M., G.R., C.Tonon, C.Testa, R.L.)
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La Morgia C, Barboni P, Rizzo G, Carbonelli M, Savini G, Scaglione C, Capellari S, Bonazza S, Giannoccaro MP, Calandra-Buonaura G, Liguori R, Cortelli P, Martinelli P, Baruzzi A, Carelli V. Loss of temporal retinal nerve fibers in Parkinson disease: a mitochondrial pattern? Eur J Neurol 2012; 20:198-201. [PMID: 22436028 DOI: 10.1111/j.1468-1331.2012.03701.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Optic nerve involvement is frequent in mitochondrial disease, and retinal abnormalities are described in Parkinson's disease (PD). METHODS We evaluated retinal nerve fiber layer (RNFL) thickness by optical coherence tomography in 43 patients with PD and in 86 age-matched controls. We considered separately the eyes ipsilateral and contralateral to the most affected body side in patients with PD. ancova analysis, Pearson test, and multiple regression analysis were used (P < 0.05). RESULTS Patients with PD showed significantly thinner temporal RNFL thickness compared to controls (P = 0.004), more evident in the eye contralateral to the most affected body side. Average RNFL thickness significantly correlated with age in both controls and patients with PD (P-values ranging from 0.001 to 0.019), whereas in patients with PD RNFL thickness did not correlate with clinical variables. CONCLUSIONS Our study reveals a loss of retinal nerve fibers in the temporal quadrant in PD, which is typically susceptible in mitochondrial optic neuropathies.
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Affiliation(s)
- C La Morgia
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
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Carelli V, La Morgia C, Valentino ML, Rizzo G, Carbonelli M, De Negri AM, Sadun F, Carta A, Guerriero S, Simonelli F, Sadun AA, Aggarwal D, Liguori R, Avoni P, Baruzzi A, Zeviani M, Montagna P, Barboni P. Idebenone Treatment In Leber's Hereditary Optic Neuropathy. Brain 2011; 134:e188. [DOI: 10.1093/brain/awr180] [Citation(s) in RCA: 157] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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La Morgia C, Parchi P, Capellari S, Lodi R, Tonon C, Rinaldi R, Mondini S, Cirignotta F. 'Agrypnia excitata' in a case of sporadic Creutzfeldt-Jakob disease VV2. J Neurol Neurosurg Psychiatry 2009; 80:244-6. [PMID: 19151026 DOI: 10.1136/jnnp.2008.149344] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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La Morgia C, Achilli A, Iommarini L, Barboni P, Pala M, Olivieri A, Zanna C, Vidoni S, Tonon C, Lodi R, Vetrugno R, Mostacci B, Liguori R, Carroccia R, Montagna P, Rugolo M, Torroni A, Carelli V. Rare mtDNA variants in Leber hereditary optic neuropathy families with recurrence of myoclonus. Neurology 2008; 70:762-70. [PMID: 18216301 DOI: 10.1212/01.wnl.0000295505.74234.d0] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the mechanisms underlying myoclonus in Leber hereditary optic neuropathy (LHON). METHODS Five patients and one unaffected carrier from two Italian families bearing the homoplasmic 11778/ND4 and 3460/ND1 mutations underwent a uniform investigation including neurophysiologic studies, muscle biopsy, serum lactic acid after exercise, and muscle ((31)P) and cerebral ((1)H) magnetic resonance spectroscopy (MRS). Biochemical investigations on fibroblasts and complete mitochondrial DNA (mtDNA) sequences of both families were also performed. RESULTS All six individuals had myoclonus. In spite of a normal EEG background and the absence of giant SEPs and C reflex, EEG-EMG back-averaging showed a preceding jerk-locked EEG potential, consistent with a cortical generator of the myoclonus. Specific comorbidities in the 11778/ND4 family included muscular cramps and psychiatric disorders, whereas features common to both families were migraine and cardiologic abnormalities. Signs of mitochondrial proliferation were seen in muscle biopsies and lactic acid elevation was observed in four of six patients. (31)P-MRS was abnormal in five of six patients and (1)H-MRS showed ventricular accumulation of lactic acid in three of six patients. Fibroblast ATP depletion was evident at 48 hours incubation with galactose in LHON/myoclonus patients. Sequence analysis revealed haplogroup T2 (11778/ND4 family) and U4a (3460/ND1 family) mtDNAs. A functional role for the non-synonymous 4136A>G/ND1, 9139G>A/ATPase6, and 15773G>A/cyt b variants was supported by amino acid conservation analysis. CONCLUSIONS Myoclonus and other comorbidities characterized our Leber hereditary optic neuropathy (LHON) families. Functional investigations disclosed a bioenergetic impairment in all individuals. Our sequence analysis suggests that the LHON plus phenotype in our cases may relate to the synergic role of mtDNA variants.
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Affiliation(s)
- C La Morgia
- Dipartimento di Scienze Neurologiche, Università di Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy
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Carroccia R, Rinaldi R, Cenacchi G, Badiali De Giorgi L, Tarantino L, Valentino M, Baldin E, Pizza F, La Morgia C, Coccolo F, Zavatta M, Santoro A, Carelli V. M.P.1.14 Asymptomatic mitochondrial myopathy with mtDNA multiple deletions revealed by propofol-induced multiple organ failure with rhabdomyolysis. Neuromuscul Disord 2007. [DOI: 10.1016/j.nmd.2007.06.039] [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: 11/16/2022]
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Bellan M, La Morgia C, Liguori R, Villanova M, Carroccia R, Avoni P, Barboni P, Lodi R, Tonon C, Sadun F, Baruzzi A, Carelli V. G.P.18.05 Myopathy and retinopathy are novel features in a patient with Mohr-Tranebjaerg syndrome. Neuromuscul Disord 2007. [DOI: 10.1016/j.nmd.2007.06.432] [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: 10/22/2022]
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La Morgia C, Mondini S, Guarino M, Bonifazi F, Cirignotta F. Busulfan neurotoxicity and EEG abnormalities: a case report. Neurol Sci 2004; 25:95-7. [PMID: 15221628 DOI: 10.1007/s10072-004-0237-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2003] [Accepted: 03/04/2004] [Indexed: 11/26/2022]
Abstract
A 21-year-old woman with acute lymphoblastic leukemia underwent bone marrow transplantation (BMT). The conditioning regimen consisted of an association of busulfan (BU) and cyclophosphamide (Cy). The day after starting BU, she suffered a generalized tonic-clonic seizure. Electroencephalography (EEG) performed the day after the seizure showed diffuse polyspikes and spike-and-wave discharges. EEG on the following days showed persistent abnormalities (slowing of background activity intermixed with diffuse slow waves and isolated delta and theta bursts). These abnormalities persisted for about 20 days with complete normalization one month after the seizure. We suggest that BU is implicated in these abnormalities and emphasize the importance of EEG recording before and after bone marrow transplantation to disclose BU neurotoxicity.
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Affiliation(s)
- C La Morgia
- Neurology Unit, S. Orsola-Malpighi Hospital, University of Bologna, Via Albertoni 15, I-40138 Bologna, Italy.
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