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Vavla M, Arrigoni F, Nordio A, De Luca A, Pizzighello S, Petacchi E, Paparella G, D'Angelo MG, Brighina E, Russo E, Fantin M, Colombo P, Martinuzzi A. Functional and Structural Brain Damage in Friedreich's Ataxia. Front Neurol 2018; 9:747. [PMID: 30237783 PMCID: PMC6135889 DOI: 10.3389/fneur.2018.00747] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 05/18/2018] [Accepted: 08/17/2018] [Indexed: 11/13/2022] Open
Abstract
Friedreich's ataxia (FRDA) is a rare hereditary neurodegenerative disorder caused by a GAA repeat expansion in the FXN gene. There is still no cure or quantitative biomarkers reliaby correlating with the progression rate and disease severity. Investigation of functional and structural alterations characterizing white (WM) and gray matter (GM) in FRDA are needed prerequisite to monitor progression and response to treatment. Here we report the results of a multimodal cross-sectional MRI study of FRDA including Voxel-Based Morphometry (VBM), diffusion-tensor imaging (DTI), functional MRI (fMRI), and a correlation analysis with clinical severity scores. Twenty-one early-onset FRDA patients and 18 age-matched healthy controls (HCs) were imaged at 3T. All patients underwent a complete cognitive and clinical assessment with ataxia scales. VBM analysis showed GM volume reduction in FRDA compared to HCs bilaterally in lobules V, VI, VIII (L>R), as well as in the crus of cerebellum, posterior lobe of the vermis, in the flocculi and in the left tonsil. Voxel-wise DTI analysis showed a diffuse fractional anisotropy reduction and mean, radial, axial (AD) diffusivity increase in both infratentorial and supratentorial WM. ROI-based analysis confirmed the results showing differences of the same DTI metrics in cortico-spinal-tracts, forceps major, corpus callosum, posterior thalamic radiations, cerebellar penduncles. Additionally, we observed increased AD in superior (SCP) and middle cerebellar peduncles. The WM findings correlated with age at onset (AAO), short-allelle GAA, and disease severity. The intragroup analysis of fMRI data from right-handed 14 FRDA and 15 HCs showed similar findings in both groups, including activation in M1, insula and superior cerebellar hemisphere (lobules V-VIII). Significant differences emerged only during the non-dominant hand movement, with HCs showing a stronger activation in the left superior cerebellar hemisphere compared to FRDA. Significant correlations were found between AAO and the fMRI activation in cerebellar anterior and posterior lobes, insula and temporal lobe. Our multimodal neuroimaging protocol suggests that MRI is a useful tool to document the extension of the neurological impairment in FRDA.
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Affiliation(s)
- Marinela Vavla
- Severe Developmental Disabilities Unit, Scientific Institute, IRCCS "Eugenio Medea", Conegliano, Italy
| | - Filippo Arrigoni
- Neuroimaging Lab, Scientific Institute IRCCS "Eugenio Medea", Bosisio Parini, Italy
| | - Andrea Nordio
- Neuroimaging Lab, Scientific Institute IRCCS "Eugenio Medea", Bosisio Parini, Italy.,Department of Information Engineering, University of Padova, Padova, Italy
| | - Alberto De Luca
- Neuroimaging Lab, Scientific Institute IRCCS "Eugenio Medea", Bosisio Parini, Italy
| | - Silvia Pizzighello
- Severe Developmental Disabilities Unit, Scientific Institute, IRCCS "Eugenio Medea", Conegliano, Italy
| | - Elisa Petacchi
- Severe Developmental Disabilities Unit, Scientific Institute, IRCCS "Eugenio Medea", Conegliano, Italy
| | - Gabriella Paparella
- Severe Developmental Disabilities Unit, Scientific Institute, IRCCS "Eugenio Medea", Conegliano, Italy
| | - Maria Grazia D'Angelo
- NeuroMuscular Unit, Department of NeuroRehabilitation, IRCCS "Eugenio Medea", Bosisio Parini, Italy
| | - Erika Brighina
- NeuroMuscular Unit, Department of NeuroRehabilitation, IRCCS "Eugenio Medea", Bosisio Parini, Italy
| | - Emanuela Russo
- Severe Developmental Disabilities Unit, Scientific Institute, IRCCS "Eugenio Medea", Conegliano, Italy
| | - Marianna Fantin
- Severe Developmental Disabilities Unit, Scientific Institute, IRCCS "Eugenio Medea", Conegliano, Italy
| | - Paola Colombo
- Neuroimaging Lab, Scientific Institute IRCCS "Eugenio Medea", Bosisio Parini, Italy
| | - Andrea Martinuzzi
- Severe Developmental Disabilities Unit, Scientific Institute, IRCCS "Eugenio Medea", Conegliano, Italy
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Politano L, Scutifero M, Patalano M, Sagliocchi A, Zaccaro A, Civati F, Brighina E, Vita G, Messina S, Sframeli M, Elena Lombardo M, Scalise R, Colia G, Catteruccia M, Berardinelli A, Motta MC, Gaiani A, Semplicini C, Bello L, Astrea G, Ricci G, Grazia D'Angelo M, Vita G, Pane M, D'Amico A, Balottin U, Angelini C, Battini R, Magliano L. Integrated care of muscular dystrophies in Italy. Part 1. Pharmacological treatment and rehabilitative interventions. Acta Myol 2017; 36:19-24. [PMID: 28690390 PMCID: PMC5479104] [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: 11/12/2022]
Abstract
This paper describes the pharmacological therapies and rehabilitative interventions received by 502 patients with Muscular Dystrophies, evaluated in relation to patient's socio-demographic and clinical variables, and geographical areas. Data were collected by the MD-Socio-Demographic and Clinical Schedule (MD-SC-CS) and by the Family Problems Questionnaire (FPQ). The most part of the enrolled patients were in drug treatment. The number of the medications increased in relation to patient's age, disability degree and duration of illness and was higher among patients with Duchenne Muscular Dystrophy (DMD) compared with Becker (BMD) or Limb-Girdle Muscular Dystrophies (LGMD). Steroids (deflazacort or prednisone) were the drug most frequently used, followed by cardiologic and bone metabolism drugs. In general, patients using steroids were younger and had a shorter duration of illness; patients using cardiac drugs and dietary supplements were older and had a longer duration of illness. Rehabilitative interventions were provided to about 70% (351/502) of patients, mainly DMD. Of these, physiotherapy was the more frequent treatment (96.6%) and was prevalently performed in rehabilitative centres (about 70% of patients) and at home in only 30%. Hydrokinetic-therapy was practiced by 6.8% of patients. Respiratory rehabilitation was provided to 47.0% of patients (165/351) and assisted mechanical ventilaventilation to 13.1% (46). The amount of rehabilitative interventions increased in relation to the patient's age, level of disability and duration of illness. Compared to Central and Northern Italy, in Southern Italy there was a higher attention to cardiological impairment as shown by a higher number of patients receiving heart drugs. No statistically significant differences concerning the possibility to have access to rehabilitative interventions were noted among the three geographical areas. However, patient living in Southern Italy tend to receive rehabilitation more often at home.
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Affiliation(s)
- Luisa Politano
- Cardiomyology and Medical Genetics, Department of Experimental Medicine, Campania University "Luigi Vanvitelli" (former denomination: Second University of Naples), Italy;,Address for correspondence: Luisa Politano, Cardiomyology and Medical Genetics, Department of Experimental Medicine, Campania University "Luigi Vanvitelli", Primo Policlinico, piazza Miraglia, 80138 Naples, Italy. E-mail:
| | - Marianna Scutifero
- Cardiomyology and Medical Genetics, Department of Experimental Medicine, Campania University "Luigi Vanvitelli" (former denomination: Second University of Naples), Italy
| | - Melania Patalano
- Department of Psychology, Campania University "Luigi Vanvitelli", Italy
| | | | - Antonella Zaccaro
- Department of Psychology, Campania University "Luigi Vanvitelli", Italy
| | - Federica Civati
- NeuroMuscular Unit, Department of NeuroRehabilitation, IRCCS "E. Medea", Bosisio Parini (LC), Italy
| | - Erika Brighina
- NeuroMuscular Unit, Department of NeuroRehabilitation, IRCCS "E. Medea", Bosisio Parini (LC), Italy
| | | | | | | | | | - Roberta Scalise
- Department of Paediatric Neurology, Catholic University, Rome, Italy
| | - Giulia Colia
- Unit of Neuromuscular and Neurodegenerative Diseases, Bambin Gesù Children's Hospital, Rome, Italy
| | - Maria Catteruccia
- Unit of Neuromuscular and Neurodegenerative Diseases, Bambin Gesù Children's Hospital, Rome, Italy
| | - Angela Berardinelli
- Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Maria Chiara Motta
- Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | | | | | - Luca Bello
- Department of Neurosciences, University of Padova, Italy
| | - Guja Astrea
- Developmental Neuroscience, IRCCS Stella Maris, Pisa Italy
| | - Giulia Ricci
- Developmental Neuroscience, IRCCS Stella Maris, Pisa Italy
| | - Maria Grazia D'Angelo
- NeuroMuscular Unit, Department of NeuroRehabilitation, IRCCS "E. Medea", Bosisio Parini (LC), Italy
| | | | - Marika Pane
- Department of Paediatric Neurology, Catholic University, Rome, Italy
| | - Adele D'Amico
- Unit of Neuromuscular and Neurodegenerative Diseases, Bambin Gesù Children's Hospital, Rome, Italy
| | - Umberto Balottin
- Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | | | | | - Lorenza Magliano
- Department of Psychology, Campania University "Luigi Vanvitelli", Italy
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Martinuzzi A, Montanaro D, Vavla M, Paparella G, Bonanni P, Musumeci O, Brighina E, Hlavata H, Rossi G, Aghakhanyan G, Martino N, Baratto A, D’Angelo MG, Peruch F, Fantin M, Arnoldi A, Citterio A, Vantaggiato C, Rizzo V, Toscano A, Bresolin N, Bassi MT. Clinical and Paraclinical Indicators of Motor System Impairment in Hereditary Spastic Paraplegia: A Pilot Study. PLoS One 2016; 11:e0153283. [PMID: 27077743 PMCID: PMC4831837 DOI: 10.1371/journal.pone.0153283] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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: 10/08/2015] [Accepted: 03/25/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Hereditary spastic paraplegias (HSP) are a composite and genetically heterogeneous group of conditions mainly expressed by the impairment of the central motor system ("pure" forms). The involvement of other components of the central nervous system or of other systems is described in the "complicate" forms. The definition of an investigation protocol capable, by assembling clinical and paraclinical indicators to fully represent the extent of the motor system impairment, would help both the clinical handling of these conditions and contribute to our understanding of their pathogenesis. METHODS We applied a clinical and paraclinical protocol which included tools exploring motor and non motor functioning, neurophysiology and MRI to a composite cohort of 70 molecularly defined HSP patients aged 3 to 65, to define for each indicator its significance in detailing the presence and the severity of the pathology. RESULTS Clinically increased deep tendon reflexes and lower limb (LL) weakness are constant findings in all patients. The "complicated" forms are characterized by peripheral motor impairment, cognitive and cerebellar involvement. The Spastic Paraplegia Rating Scale efficiently reflects the severity of functional problems and correlates with disease duration. Neurophysiology consistently documents the impairment of the central motor pathway to the LLs. Nevertheless, the upper extremities and sensory system involvement is a frequent finding. MRI diffusion tensor imaging (DTI) highlighted a significant alteration of FA and MD. Combining the sampling of the various portion of the cortico-spinal tract (CST) DTI consistently discriminated patients from controls. CONCLUSION We propose a graded clinical and paraclinical protocol for HSP phenotype definition, indicating for each tool the discriminative and descriptive capacity. Our protocol applied to 9 different forms of HSP showed that the functional impairment often extends beyond the CST. The novel DTI approach may add significant elements in disease recognition, staging and mapping.
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Affiliation(s)
- Andrea Martinuzzi
- IRCCS E. Medea, Polo Regionale di Conegliano, Conegliano (TV), Italy
- * E-mail:
| | - Domenico Montanaro
- Fondazione CNR/Regione Toscana G. Monasterio, Unit of Neuroradiology, Pisa, Italy
| | - Marinela Vavla
- IRCCS E. Medea, Polo Regionale di Conegliano, Conegliano (TV), Italy
| | | | - Paolo Bonanni
- IRCCS E. Medea, Polo Regionale di Conegliano, Conegliano (TV), Italy
| | - Olimpia Musumeci
- University of Messina, Department of Neurosciences, Messina, Italy
| | - Erika Brighina
- IRCCS E. Medea, Neurorehabilitation Department, Bosisio Parini (LC), Italy
| | - Hana Hlavata
- Fondazione CNR/Regione Toscana G. Monasterio, Unit of Neuroradiology, Pisa, Italy
| | - Giuseppe Rossi
- Institute of Clinical Physiology, National Council of Research, Unit of Epidemiology and Biostatistics, Pisa, Italy
| | - Gayane Aghakhanyan
- Fondazione CNR/Regione Toscana G. Monasterio, Unit of Neuroradiology, Pisa, Italy
| | - Nicola Martino
- ULSS 7-Pieve di Soligo, Department of Imaging, Conegliano (TV), Italy
| | | | | | - Francesca Peruch
- IRCCS E. Medea, Polo Regionale di Conegliano, Conegliano (TV), Italy
| | - Marianna Fantin
- IRCCS E. Medea, Polo Regionale di Conegliano, Conegliano (TV), Italy
| | - Alessia Arnoldi
- IRCCS E. Medea, Laboratory of Molecular Biology, Bosisio Parini (LC), Italy
| | - Andrea Citterio
- IRCCS E. Medea, Laboratory of Molecular Biology, Bosisio Parini (LC), Italy
| | - Chiara Vantaggiato
- IRCCS E. Medea, Laboratory of Molecular Biology, Bosisio Parini (LC), Italy
| | - Vincenzo Rizzo
- University of Messina, Department of Neurosciences, Messina, Italy
| | - Antonio Toscano
- University of Messina, Department of Neurosciences, Messina, Italy
| | - Nereo Bresolin
- IRCCS Fondazione Policlinico, University of Milano, Department of Neuroscience, Milano, Italy
| | - Maria Teresa Bassi
- IRCCS E. Medea, Laboratory of Molecular Biology, Bosisio Parini (LC), Italy
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Magliano L, Patalano M, Sagliocchi A, Scutifero M, Zaccaro A, D'angelo MG, Civati F, Brighina E, Vita G, Vita GL, Messina S, Sframeli M, Pane M, Lombardo ME, Scalise R, D'amico A, Colia G, Catteruccia M, Balottin U, Berardinelli A, Chiara Motta M, Angelini C, Gaiani A, Semplicini C, Bello L, Battini R, Astrea G, Politano L. Burden, professional support, and social network in families of children and young adults with muscular dystrophies. Muscle Nerve 2015; 52:13-21. [PMID: 25363165 PMCID: PMC5029774 DOI: 10.1002/mus.24503] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2014] [Indexed: 11/11/2022]
Abstract
Introduction: This study explores burden and social and professional support in families of young patients with muscular dystrophies (MDs) in Italy. Methods: The study was carried out on 502 key relatives of 4‐ to 25‐year‐old patients suffering from Duchenne, Becker, or Limb‐Girdle MD who were living with at least 1 adult relative. Results: A total of 77.1% of relatives reported feelings of loss, 74.0% had feelings of sadness, and 59.1% had constraints in leisure activities. Burden was higher among relatives of patients with higher disability and who spent more daily hours in caregiving. Practical difficulties were higher among relatives who perceived lower help in patient emergencies and less practical support by their social network. Psychological burden was higher in those relatives who were unemployed, those with poorer support in emergencies, and those with lower social contacts. Conclusions: Caring for patients with MDs may be demanding for relatives even in the early stages of these disorders, especially when social support is poor and the patient's disability increases. Muscle Nerve52: 13–21, 2015
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Affiliation(s)
- Lorenza Magliano
- Department of Psychology, Second University of Naples, Viale Ellittico, 31, I-81100 Caserta, Italy
| | - Melania Patalano
- Department of Psychology, Second University of Naples, Viale Ellittico, 31, I-81100 Caserta, Italy
| | - Alessandra Sagliocchi
- Department of Psychology, Second University of Naples, Viale Ellittico, 31, I-81100 Caserta, Italy
| | - Marianna Scutifero
- Cardiomyology and Medical Genetics, Department of Experimental Medicine, Second University of Naples (SUN), Italy
| | - Antonella Zaccaro
- Cardiomyology and Medical Genetics, Department of Experimental Medicine, Second University of Naples (SUN), Italy
| | - Maria Grazia D'angelo
- NeuroMuscular Unit, Department of NeuroRehabilitation, IRCCS "E. Medea", Bosisio Parini (Lc), Italy
| | - Federica Civati
- NeuroMuscular Unit, Department of NeuroRehabilitation, IRCCS "E. Medea", Bosisio Parini (Lc), Italy
| | - Erika Brighina
- NeuroMuscular Unit, Department of NeuroRehabilitation, IRCCS "E. Medea", Bosisio Parini (Lc), Italy
| | - Giuseppe Vita
- Department of Neurosciences, University of Messina, Rome, Italy
| | - Gian Luca Vita
- Department of Neurosciences, University of Messina, Rome, Italy
| | - Sonia Messina
- Department of Neurosciences, University of Messina, Rome, Italy
| | - Maria Sframeli
- Department of Neurosciences, University of Messina, Rome, Italy
| | - Marika Pane
- Department of Paediatric Neurology, Catholic University, Rome, Italy
| | | | - Roberta Scalise
- Department of Paediatric Neurology, Catholic University, Rome, Italy
| | - Adele D'amico
- Unit of Neuromuscular and Neurodegenerative Diseases, Bambin Gesù Children's Hospital, Rome, Italy
| | - Giulia Colia
- Unit of Neuromuscular and Neurodegenerative Diseases, Bambin Gesù Children's Hospital, Rome, Italy
| | - Michela Catteruccia
- Unit of Neuromuscular and Neurodegenerative Diseases, Bambin Gesù Children's Hospital, Rome, Italy
| | - Umberto Balottin
- Department of Brain and Behavioural Sciences - Child Neuropsychiatry Unit, University of Pavia, Italy
| | | | | | | | | | | | - Luca Bello
- Department of Neurosciences, University of Padova, Italy
| | | | - Guja Astrea
- Developmental Neuroscience, IRCCS Stella Maris, Pisa, Italy
| | - Luisa Politano
- Cardiomyology and Medical Genetics, Department of Experimental Medicine, Second University of Naples (SUN), Italy
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Colombo P, Civati F, Mani E, Gandossini S, Brighina E, Comi G, Bresolin N, Turconi A, Molteni M, Nobile M, D’Angelo M. G.P.174. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Saracchi E, Castelli M, Bassi MT, Brighina E, Cereda D, Marzorati L, Patassini M, Appollonio I, Ferrarese C, Brighina L. A novel heterozygous SETX mutation in a patient presenting with chorea and motor neuron disease. Amyotroph Lateral Scler Frontotemporal Degener 2014; 15:138-40. [PMID: 24533459 DOI: 10.3109/21678421.2013.865751] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Enrico Saracchi
- Department of Neurology, San Gerardo Hospital, University of Milano-Bicocca , Monza
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7
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Magliano L, Patalano M, Sagliocchi A, Scutifero M, Zaccaro A, D'Angelo MG, Civati F, Brighina E, Vita G, Vita GL, Messina S, Sframeli M, Pane M, Lombardo ME, Scalise R, D'Amico A, Colia G, Catteruccia M, Balottin U, Berardinelli A, Motta MC, Angelini C, Gaiani A, Semplicini C, Bello L, Battini R, Astrea G, Ricci G, Politano L. "I have got something positive out of this situation": psychological benefits of caregiving in relatives of young people with muscular dystrophy. J Neurol 2013; 261:188-95. [PMID: 24202786 PMCID: PMC3895206 DOI: 10.1007/s00415-013-7176-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 10/24/2013] [Indexed: 11/26/2022]
Abstract
This paper focuses on the psychological benefits of caregiving in key relatives of patients with muscular dystrophies (MD), a group of rare diseases characterized by progressive weakness and restriction of the patient's functional abilities. We describe whether relatives perceived caregiving to be a positive experience and test whether relatives' perceptions vary in relation to their view of the patient as a valued person, the degree of involvement in care, and the level of support provided by social network and professionals. The study sample included 502 key relatives of patients aged 4-25 years, suffering from Duchenne, Becker, or limb-girdle MD, in treatment for at least 6 months to one of the eight participating centers, living with at least one relative aged 18-80 years. Of key relatives, 88 % stated that they had gotten something positive out of the situation, 96 % considered their patients to be sensitive, and 94 % viewed their patients as talented. Positive aspects of caregiving were more recognized by key relatives who were more convinced that the patient was sensitive and who perceived that they received higher level of professional help and psychological social support. These results suggest that most key relatives consider that their caregiving experience has had a positive impact on their lives, despite the practical difficulties of caring for patients with MD. Professionals should help relatives to identify the benefits of caregiving without denying its difficulties. Clinicians themselves should develop positive attitudes towards family involvement in the care of patients with long-term diseases.
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Affiliation(s)
- Lorenza Magliano
- Department of Psychology, Second University of Naples (SUN), Viale Ellittico, 31, 81100, Naples, Caserta, Italy,
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8
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Vantaggiato C, Crimella C, Airoldi G, Polishchuk R, Bonato S, Brighina E, Scarlato M, Musumeci O, Toscano A, Martinuzzi A, Santorelli FM, Ballabio A, Bresolin N, Clementi E, Bassi MT. Defective autophagy in spastizin mutated patients with hereditary spastic paraparesis type 15. ACTA ACUST UNITED AC 2013; 136:3119-39. [PMID: 24030950 DOI: 10.1093/brain/awt227] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [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: 01/08/2023]
Abstract
Hereditary spastic paraparesis type 15 is a recessive complicated form of the disease clinically characterized by slowly progressive spastic paraparesis and mental deterioration with onset between the first and second decade of life. Thinning of corpus callosum is the neuroradiological distinctive sign frequently associated with white matter abnormalities. The causative gene, ZFYVE26, encodes a large protein of 2539 amino acid residues, termed spastizin, containing three recognizable domains: a zinc finger, a leucine zipper and a FYVE domain. Spastizin protein has a diffuse cytoplasmic distribution and co-localizes partially with early endosomes, the endoplasmic reticulum, microtubules and vesicles involved in protein trafficking. In addition, spastizin localizes to the mid-body during the final step of mitosis and contributes to successful cytokinesis. Spastizin interacts with Beclin 1, a protein required for cytokinesis and autophagy, which is the major lysosome-mediated degradation process in the cell. In view of the Beclin 1-spastizin interaction, we investigated the possible role of spastizin in autophagy. We carried out this analysis by using lymphoblast and fibroblast cells derived from four different spastizin mutated patients (p.I508N, p.L243P, p.R1209fsX, p.S1312X) and from control subjects. Of note, the truncating p.R1209fsX and p.S1312X mutations lead to loss of spastizin protein. The results obtained indicate that spastizin interacts with the autophagy related Beclin 1-UVRAG-Rubicon multiprotein complex and is required for autophagosome maturation. In cells lacking spastizin or with mutated forms of the protein, spastizin interaction with Beclin 1 is lost although the formation of the Beclin 1-UVRAG-Rubicon complex can still be observed. However, in these cells we demonstrate an impairment of autophagosome maturation and an accumulation of immature autophagosomes. Autophagy defects with autophagosome accumulation can be observed also in neuronal cells upon spastizin silencing. These results indicate that autophagy is a central process in the pathogenesis of complicated forms of hereditary spastic paraparesis with thin corpus callosum.
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Affiliation(s)
- Chiara Vantaggiato
- 1 Scientific Institute IRCCS E. Medea, Laboratory of Molecular Biology, 23842 Bosisio Parini, Lecco, Italy
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Tonelli A, D'Angelo MG, Arrigoni F, Brighina E, Arnoldi A, Citterio A, Bresolin N, Bassi MT. Atypical adult onset complicated spastic paraparesis with thin corpus callosum in two patients carrying a novelFA2Hmutation. Eur J Neurol 2012; 19:e127-9. [DOI: 10.1111/j.1468-1331.2012.03838.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 07/04/2012] [Indexed: 11/27/2022]
Affiliation(s)
- A. Tonelli
- Laboratory of Molecular Biology; E. Medea Scientific Institute; Bosisio Parini Lecco Italy
| | - M. G. D'Angelo
- Neuromuscular Unit; Department of Neurorehabilitation; E. Medea Scientific Institute; Bosisio Parini Lecco Italy
| | - F. Arrigoni
- Neuroimaging Unit; E. Medea Scientific Institute; Bosisio Parini Lecco Italy
| | - E. Brighina
- Neuromuscular Unit; Department of Neurorehabilitation; E. Medea Scientific Institute; Bosisio Parini Lecco Italy
| | - A. Arnoldi
- Laboratory of Molecular Biology; E. Medea Scientific Institute; Bosisio Parini Lecco Italy
| | - A. Citterio
- Laboratory of Molecular Biology; E. Medea Scientific Institute; Bosisio Parini Lecco Italy
| | - N. Bresolin
- Laboratory of Molecular Biology; E. Medea Scientific Institute; Bosisio Parini Lecco Italy
- Dino Ferrari Center; IRCCS Ca' Granda Foundation Ospedale Maggiore Policlinico; Department of Neurological Sciences; University of Milan; Milan Italy
| | - M. T. Bassi
- Laboratory of Molecular Biology; E. Medea Scientific Institute; Bosisio Parini Lecco Italy
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Magri F, Bo RD, D’Angelo MG, Sciacco M, Gandossini S, Govoni A, Napoli L, Ciscato P, Fortunato F, Brighina E, Bonato S, Bordoni A, Lucchini V, Corti S, Moggio M, Bresolin N, Comi GP. Frequency and characterisation of anoctamin 5 mutations in a cohort of Italian limb-girdle muscular dystrophy patients. Neuromuscul Disord 2012; 22:934-43. [PMID: 22742934 PMCID: PMC3500692 DOI: 10.1016/j.nmd.2012.05.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 04/30/2012] [Accepted: 05/03/2012] [Indexed: 12/03/2022]
Abstract
Limb-girdle muscular dystrophy (LGMD) 2L, caused by mutations in the anoctamin 5 (ANO5) gene, is the third most common LGMD in Northern and Central Europe, where the c.191dupA mutation causes the majority of cases. We evaluated data from 228 Italian LGMD patients to determine the prevalence of LGMD2L and the c.191dupA mutation, and to describe the clinical, muscle biopsy, and magnetic resonance imaging findings in these patients. Forty-three patients who lacked molecular diagnosis were studied for ANO5 mutations, and four novel mutations were found in three probands. Only one proband carried the c.191dupA mutation, which was compound heterozygous with c.2516T>G. Two probands were homozygous for the c.1627dupA and c.397A>T mutations, respectively, while a fourth proband had a compound heterozygous status (c.220C>T and c.1609T>C). Therefore occurrence and molecular epidemiology of LGMD2L in this Italian cohort differed from those observed in other European countries. ANO5 mutations accounted for ∼2% of our sample. Affected patients exhibited benign progression with variable onset and an absence of cardiac and respiratory impairment; muscle biopsy generally showed mild signs, except when performed on the quadriceps muscles; MRI showed predominant involvement of the posterior thigh. Overall these common clinical, morphological and imaging findings could be useful in differential diagnosis.
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Affiliation(s)
- Francesca Magri
- Dino Ferrari Centre, Department of Neurological Sciences, University of Milan, IRCCS Foundation Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberto Del Bo
- Dino Ferrari Centre, Department of Neurological Sciences, University of Milan, IRCCS Foundation Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Monica Sciacco
- Dino Ferrari Centre, Department of Neurological Sciences – Neuromuscular Unit University of Milan, IRCCS Foundation Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Alessandra Govoni
- Dino Ferrari Centre, Department of Neurological Sciences, University of Milan, IRCCS Foundation Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Napoli
- Dino Ferrari Centre, Department of Neurological Sciences – Neuromuscular Unit University of Milan, IRCCS Foundation Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Patrizia Ciscato
- Dino Ferrari Centre, Department of Neurological Sciences – Neuromuscular Unit University of Milan, IRCCS Foundation Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesco Fortunato
- Dino Ferrari Centre, Department of Neurological Sciences, University of Milan, IRCCS Foundation Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Erika Brighina
- Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Sara Bonato
- Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Andreina Bordoni
- Dino Ferrari Centre, Department of Neurological Sciences, University of Milan, IRCCS Foundation Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Valeria Lucchini
- Dino Ferrari Centre, Department of Neurological Sciences – Neuromuscular Unit University of Milan, IRCCS Foundation Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Corti
- Dino Ferrari Centre, Department of Neurological Sciences, University of Milan, IRCCS Foundation Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Maurizio Moggio
- Dino Ferrari Centre, Department of Neurological Sciences – Neuromuscular Unit University of Milan, IRCCS Foundation Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Nereo Bresolin
- Dino Ferrari Centre, Department of Neurological Sciences, University of Milan, IRCCS Foundation Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Giacomo Pietro Comi
- Dino Ferrari Centre, Department of Neurological Sciences, University of Milan, IRCCS Foundation Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Corresponding author. Adderess: Dipartimento di Scienze Neurologiche, Università di Milano, Padiglione Ponti, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy. Tel.: +39 02 55033817; fax: +39 02 50320430.
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D'Angelo MG, Gandossini S, Martinelli Boneschi F, Sciorati C, Bonato S, Brighina E, Comi GP, Turconi AC, Magri F, Stefanoni G, Brunelli S, Bresolin N, Cattaneo D, Clementi E. Nitric oxide donor and non steroidal anti inflammatory drugs as a therapy for muscular dystrophies: evidence from a safety study with pilot efficacy measures in adult dystrophic patients. Pharmacol Res 2012; 65:472-9. [PMID: 22306844 DOI: 10.1016/j.phrs.2012.01.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Revised: 01/16/2012] [Accepted: 01/16/2012] [Indexed: 01/22/2023]
Abstract
This open-label, single centre pilot study was designed to evaluate safety and tolerability of the combination of the drugs isosorbide dinitrate, a nitric oxide donor, and ibuprofen, a non steroid anti-inflammatory drug, in a cohort of adult dystrophic patients (Duchenne, Becker and Limb-Girdle Muscular Dystrophy). Seventy-one patients were recruited: 35, treated with the drug combination for 12 months, and 36 untreated. Safety and adverse events were assessed by reported signs and symptoms, physical examinations, blood tests, cardiac and respiratory function tests. Exploratory outcomes measure, such as the motor function measure scale, were also applied. Good safety and tolerability profiles of the long-term co-administration of the drugs were demonstrated. Few and transient side effects (i.e. headache and low blood pressure) were reported. Additionally, exploratory outcomes measures were feasible in all the disease population studied and evidenced a trend towards amelioration that reached statistical significance in one dimension of the MFM scale. Systemic administration of ibuprofen and isosorbide dinitrate provides an adequate safety margin for clinical studies aimed at assessing efficacy.
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Romei M, D'Angelo MG, LoMauro A, Gandossini S, Bonato S, Brighina E, Marchi E, Comi GP, Turconi AC, Pedotti A, Bresolin N, Aliverti A. Low abdominal contribution to breathing as daytime predictor of nocturnal desaturation in adolescents and young adults with Duchenne Muscular Dystrophy. Respir Med 2011; 106:276-83. [PMID: 22083092 DOI: 10.1016/j.rmed.2011.10.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Revised: 10/18/2011] [Accepted: 10/19/2011] [Indexed: 11/25/2022]
Abstract
In the respiratory management of DMD patients it is still under debate what parameter should indicate the correct timing for institution of nocturnal non-invasive ventilation (NIV), in addition to forced vital capacity, which is generally considered as a prognostic marker of disease progression. The aim of this study was to determine if volume variations of rib cage and abdominal compartments measured by Opto-Electronic Plethysmography can be helpful to distinguish between those patients who are in the early stages of nocturnal oxygen desaturation development and those who do not yet. Pulmonary function, abdominal contribution to tidal volume and to inspiratory capacity (%Abd IC) and a set of breathing pattern indexes were assessed in 40 DMD patients older than 14 years and not yet under nocturnal NIV. ROC analysis revealed that among all the considered parameters, %Abd IC in supine position was the best discriminator between DeSat (at least 10% of the night time with SpO(2) < 95%) and NonDeSat patients, providing an area under the curve with 95%CI equal to 0.752. In conclusion, in adolescents and adults DMD patients who present either no sign or only mild nocturnal oxygen desaturation, a reduced abdominal contribution to inspiratory capacity is a marker of the onset of diaphragm weakness and should be considered to identify the correct timing for the institution of nocturnal NIV.
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Affiliation(s)
- M Romei
- IRCCS E. Medea, Bosisio Parini (Lc), Italy
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Cetin I, Barberis B, Brusati V, Brighina E, Mandia L, Arighi A, Radaelli T, Biondetti P, Bresolin N, Pardi G, Rango M. Lactate detection in the brain of growth-restricted fetuses with magnetic resonance spectroscopy. Am J Obstet Gynecol 2011; 205:350.e1-7. [PMID: 21861968 DOI: 10.1016/j.ajog.2011.06.020] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [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: 03/09/2011] [Revised: 04/29/2011] [Accepted: 06/06/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The objective of the study was to determine the feasibility of detecting fetal brain lactate, a marker of fetal metabolic acidemia, using a noninvasive technique, proton magnetic resonance spectroscopy ((1)H MRS), in intrauterine growth-restricted (IUGR) fetuses. STUDY DESIGN In vivo human fetal brain lactate detection was determined by (1)H MRS in 5 fetuses with IUGR. Oxygenation and acid-base balance data were obtained at birth. RESULTS (1)H MRS analysis showed the presence of a lactate peak in the brain of the most severely affected IUGR fetus, with abnormal umbilical artery Doppler and fetal heart rate tracing. This finding was consistent with the low oxygen content and high lactic acid concentration observed in umbilical blood obtained at delivery. CONCLUSION (1)H MRS allows the noninvasive detection of cerebral lactate in IUGR fetuses. Lactate detected by (1)H MRS may represent a possible marker of in utero cerebral injury or underperfusion.
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Affiliation(s)
- Irene Cetin
- Center for Fetal Research Giorgio Pardi, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
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Brighina E, Bresolin N, Pardi G, Rango M. Human fetal brain chemistry as detected by proton magnetic resonance spectroscopy. Pediatr Neurol 2009; 40:327-42. [PMID: 19380068 DOI: 10.1016/j.pediatrneurol.2008.11.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2008] [Revised: 11/03/2008] [Accepted: 11/19/2008] [Indexed: 11/25/2022]
Abstract
Magnetic resonance spectroscopy represents an invaluable tool for the in vivo study of brain development at the chemistry level. Whereas magnetic resonance spectroscopy has received wide attention in pediatric and adult settings, only a few studies were performed on the human fetal brain. They revealed changes occurring throughout gestation in the levels of the main metabolites detected by proton magnetic resonance spectroscopy (N-acetylaspartate, choline, myo-inositol, creatine, and glutamate), providing a reference for the normal metabolic brain development. Throughout the third trimester of gestation, N-acetylaspartate gradually increases, whereas choline undergoes a slow reduction during the process of myelination. Less clear are the modifications in creatine, myo-inositol, and glutamate levels. Under conditions of fetal distress, the meaning of lactate detection is unclear, and further studies are needed. Another field for investigation involves the possibility of early detection of glutamate levels in fetuses at risk for hypoxic-ischemic encephalopathy, because the role of glutamate excitotoxicity in this context is well-established. Because metabolic modifications may precede functional or morphologic changes in the central nervous system, magnetic resonance spectroscopy may likely serve as a powerful, noninvasive tool for the early diagnosis and prognosis of different pathologic conditions.
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Affiliation(s)
- Erika Brighina
- Foundation Instituto di Ricerca e Cura a Carattere Scientifico Policlinico, Mangiagalli and Regina Elena, University of Milan, Milan, Italy
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