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Verma S, Vats A, Ahuja V, Vats K, Khurana S, Vats Y, Gourie-Devi M, Wajid S, Ganguly NK, Chakraborti P, Taneja V. Functional consequences of familial ALS-associated SOD1 L84F in neuronal and muscle cells. FASEB J 2024; 38:e23461. [PMID: 38317639 DOI: 10.1096/fj.202301979r] [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: 10/11/2023] [Revised: 01/10/2024] [Accepted: 01/18/2024] [Indexed: 02/07/2024]
Abstract
Amyotrophic lateral sclerosis is a fatal neurodegenerative disorder characterized by progressive skeletal muscle denervation and loss of motor neurons that results in muscle atrophy and eventual death due to respiratory failure. Previously, we identified a novel SOD1L84F variation in a familial ALS case. In this study, we examined the functional consequences of SOD1L84F overexpression in the mouse motor neuron cell line (NSC-34). The cells expressing SOD1L84F showed increased oxidative stress and increased cell death. Interestingly, SOD1L84F destabilized the native dimer and formed high molecular weight SDS-resistant protein aggregates. Furthermore, SOD1L84F also decreased the percentage of differentiated cells and significantly reduced neurite length. A plethora of evidence suggested active involvement of skeletal muscle in disease initiation and progression. We observed differential processing of the mutant SOD1 and perturbations of cellular machinery in NSC-34 and muscle cell line C2C12. Unlike neuronal cells, mutant protein failed to accumulate in muscle cells probably due to the activated autophagy, as evidenced by increased LC3-II and reduced p62. Further, SOD1L84F altered mitochondrial dynamics only in NSC-34. In addition, microarray analysis also revealed huge variations in differentially expressed genes between NSC-34 and C2C12. Interestingly, SOD1L84F hampered the endogenous FUS autoregulatory mechanism in NSC-34 by downregulating retention of introns 6 and 7 resulting in a two-fold upregulation of FUS. No such changes were observed in C2C12. Our findings strongly suggest the differential processing and response towards the mutant SOD1 in neuronal and muscle cell lines.
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Affiliation(s)
- Sagar Verma
- Department of Biotechnology and Research, Sir Ganga Ram Hospital, Delhi, India
- Department of Biotechnology, Jamia Hamdard, Delhi, India
| | - Abhishek Vats
- Department of Biotechnology and Research, Sir Ganga Ram Hospital, Delhi, India
- Department of Biotechnology, Jamia Hamdard, Delhi, India
- Department of Ophthalmology, Wilmer Eye Institute, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Vanshika Ahuja
- Department of Biotechnology and Research, Sir Ganga Ram Hospital, Delhi, India
| | - Kavita Vats
- Department of Dermatology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Shiffali Khurana
- Department of Biotechnology and Research, Sir Ganga Ram Hospital, Delhi, India
| | - Yuvraj Vats
- Department of Biotechnology and Research, Sir Ganga Ram Hospital, Delhi, India
| | | | - Saima Wajid
- Department of Biotechnology, Jamia Hamdard, Delhi, India
| | | | - Pradip Chakraborti
- Department of Biotechnology, Jamia Hamdard, Delhi, India
- Department of Biotechnology, Panjab University, Chandigarh, India
| | - Vibha Taneja
- Department of Biotechnology and Research, Sir Ganga Ram Hospital, Delhi, India
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Khurana S, Vats A, Gourie-Devi M, Sharma A, Verma S, Faruq M, Dhawan U, Taneja V. Clinical and Genetic Analysis of A Father-Son Duo with Monomelic Amyotrophy: Case Report. Ann Indian Acad Neurol 2023; 26:983-988. [PMID: 38229655 PMCID: PMC10789418 DOI: 10.4103/aian.aian_609_23] [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: 07/10/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 01/18/2024] Open
Abstract
Monomelic Amyotrophy (MMA) is a rare neurological disorder restricted to one upper limb, predominantly affecting young males with an unknown aetiopathogenesis. We report a familial case of father-son duo affected by MMA. Whole exome sequencing identified genetic variations in SLIT1, RYR3 and ARPP21 involved in axon guidance, calcium homeostasis and regulation of calmodulin signaling respectively. This is the first attempt to define genetic modifiers associated with MMA from India and advocates to extend genetic screening to a larger cohort. Deciphering the functional consequences of variations in these genes will be crucial for unravelling the pathogenesis of MMA.
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Affiliation(s)
- Shiffali Khurana
- Department of Biotechnology and Research, Sir Ganga Ram Hospital, Delhi, India
- Department of Biomedical Science, Bhaskaracharya College of Applied Sciences, University of Delhi, Delhi, India
| | - Abhishek Vats
- Department of Biotechnology and Research, Sir Ganga Ram Hospital, Delhi, India
| | - Mandaville Gourie-Devi
- Department of Neurophysiology, Sir Ganga Ram Hospital, Delhi, India
- Department of Neurology, Sir Ganga Ram Hospital, Delhi, India
| | - Ankkita Sharma
- Department of Neurophysiology, Sir Ganga Ram Hospital, Delhi, India
| | - Sagar Verma
- Department of Biotechnology and Research, Sir Ganga Ram Hospital, Delhi, India
| | - Mohammed Faruq
- Council of Scientific and Industrial Research, Institute of Genomics and Integrative Biology, Delhi, India
| | - Uma Dhawan
- Department of Biomedical Science, Bhaskaracharya College of Applied Sciences, University of Delhi, Delhi, India
| | - Vibha Taneja
- Department of Biotechnology and Research, Sir Ganga Ram Hospital, Delhi, India
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Khanna L, Gourie-Devi M, Verma R. Autoimmune Encephalitis-A Diagnostic Challenge for the Neurologist. Neurology 2022. [DOI: 10.1212/01.wnl.0000903612.47691.5f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
ObjectiveAutoimmune encephalitis, is a clinically challenging entity with varied neurological presentations. As autoimmune serology is negative in over 50% cases, our objective was to prioritise the use of electroencephalography supported by MRI Brain or PET–CT imaging to make a definitive diagnosis of autoimmune encephalitis.BackgroundAutoimmune encephalitis is the consequence of an antibody mediated neuronal damage caused by cell surface antigens. However, antibody assays can be negative in early stages of the disease. Hence, we suggest the use of electroencephalogram along with MRI brain imaging or PET-CT scans to avoid diagnostic delays.Design/MethodsDuring a span of four years [2018–2022] a retrospective review of the case records of 50 patients of autoimmune encephalitis and 50 patients of non-autoimmune encephalitis were compared. Besides clinical examination, serum and cerebrospinal fluid viral and autoimmune antibody assay, electroencephalogram, Magnetic Resonance and FDG-PET- CT scans were used to confirm the diagnosis.Results60% patients were seronegative and 40 % were seropositive in the autoimmune group while 90% were seropositive and 10% seronegative in the non-autoimmune encephalitis group. Electroencephalography was abnormal in all cases of autoimmune encephalitis 100% [50/50] and in 80% [40/50] cases of viral encephalitis. In autoimmune encephalitis, MRI Brain revealed evidence of limbic encephalitis in 80% cases and FDG PET-CT scans were abnormal in the remaining 20%. In non-autoimmune encephalitis, MRI Brain was abnormal in 60% cases and FDG PET-CT was abnormal in 10%.ConclusionsIn seronegative autoimmune encephalitis, electroencephalographic abnormalities supported by MRI Brain imaging and PET-CT scans enabled early diagnosis in 100% cases [p value <0.001]. While in non-autoimmune encephalitis serology with electroencephalography, MRI Brain and PET-CT scans were diagnostic in 80% cases [p value <0.001]. However, as the sample size is small further studies are needed to confirm these findings.
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Khanna L, Agrawal C, Gourie-Devi M, Bhandari AS. Neuromyotonia: A Sequel to Indigenous Medication. Ann Indian Acad Neurol 2022; 25:513-514. [PMID: 35936639 PMCID: PMC9350791 DOI: 10.4103/aian.aian_697_21] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Laxmi Khanna
- Department of Neurophysiology, Sir Ganga Ram Hospital, New Delhi, India
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Gourie-Devi M. Silver Jubilee Year of Annals of Indian Academy of Neurology: Commemorative Volume. Ann Indian Acad Neurol 2022; 25:327-329. [PMID: 35936577 PMCID: PMC9350763 DOI: 10.4103/aian.aian_455_22] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- M Gourie-Devi
- Emeritus Professor of Neurology, Institute of Human Behaviour and Allied Sciences, New Delhi, India
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Khanna L, Agrawal C, Gourie-Devi M, Bhandari AS. Seronegative Autoimmune Encephalitis: A Challenge for the Neurologist. Ann Indian Acad Neurol 2022; 25:280-283. [PMID: 35693642 PMCID: PMC9175409 DOI: 10.4103/aian.aian_362_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/20/2021] [Accepted: 06/24/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Laxmi Khanna
- Department of Neurology and Neurophysiology, Sir Ganga Ram Hospital, New Delhi, India
| | - Chandrashekar Agrawal
- Department of Neurology and Neurophysiology, Sir Ganga Ram Hospital, New Delhi, India
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Verma S, Khurana S, Vats A, Sahu B, Ganguly NK, Chakraborti P, Gourie-Devi M, Taneja V. Neuromuscular Junction Dysfunction in Amyotrophic Lateral Sclerosis. Mol Neurobiol 2022; 59:1502-1527. [PMID: 34997540 DOI: 10.1007/s12035-021-02658-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/18/2021] [Indexed: 12/11/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal neurological disorder characterized by progressive degeneration of motor neurons leading to skeletal muscle denervation. Earlier studies have shown that motor neuron degeneration begins in motor cortex and descends to the neuromuscular junction (NMJ) in a dying forward fashion. However, accumulating evidences support that ALS is a distal axonopathy where early pathological changes occur at the NMJ, prior to onset of clinical symptoms and propagates towards the motor neuron cell body supporting "dying back" hypothesis. Despite several evidences, series of events triggering NMJ disassembly in ALS are still obscure. Neuromuscular junction is a specialized tripartite chemical synapse which involves a well-coordinated communication among the presynaptic motor neuron, postsynaptic skeletal muscle, and terminal Schwann cells. This review provides comprehensive insight into the role of NMJ in ALS pathogenesis. We have emphasized the molecular alterations in cellular components of NMJ leading to loss of effective neuromuscular transmission in ALS. Further, we provide a preview into research involved in exploring NMJ as potential target for designing effective therapies for ALS.
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Affiliation(s)
- Sagar Verma
- Department of Research, Sir Ganga Ram Hospital, Delhi, India.,Department of Biotechnology, Jamia Hamdard, Delhi, India
| | - Shiffali Khurana
- Department of Research, Sir Ganga Ram Hospital, Delhi, India.,Department of Biomedical Science, Bhaskaracharya College of Applied Sciences, University of Delhi, Delhi, India
| | - Abhishek Vats
- Department of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bandana Sahu
- Department of Research, Sir Ganga Ram Hospital, Delhi, India
| | | | | | | | - Vibha Taneja
- Department of Research, Sir Ganga Ram Hospital, Delhi, India.
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Khanna L, Kumar P, Bhandari AS, Gourie-Devi M. Association of Infantile Spasms and Hypsarrhythmia with Primary Microcephaly- Three Case Reports. Ann Indian Acad Neurol 2021; 24:609-612. [PMID: 34728968 PMCID: PMC8513969 DOI: 10.4103/aian.aian_909_20] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 08/30/2020] [Accepted: 09/11/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Laxmi Khanna
- Department of Neurophysiology, Sir Ganga Ram Hospital, New Delhi, India
| | - Praveen Kumar
- Department of Neurophysiology, Sir Ganga Ram Hospital, New Delhi, India
| | | | - M Gourie-Devi
- Department of Neurophysiology, Sir Ganga Ram Hospital, New Delhi, India
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Singh G, Sharma M, Kumar GA, Rao NG, Prasad K, Mathur P, Pandian JD, Steinmetz JD, Biswas A, Pal PK, Prakash S, Sylaja PN, Nichols E, Dua T, Kaur H, Alladi S, Agarwal V, Aggarwal S, Ambekar A, Bagepally BS, Banerjee TK, Bender RG, Bhagwat S, Bhargava S, Bhatia R, Chakma JK, Chowdhary N, Dey S, Dirac MA, Feigin VL, Ganguli A, Golechha MJ, Gourie-Devi M, Goyal V, Gupta G, Gupta PC, Gupta R, Gururaj G, Hemalatha R, Jeemon P, Johnson CO, Joshi P, Kant R, Kataki AC, Khurana D, Krishnankutty RP, Kyu HH, Lim SS, Lodha R, Ma R, Malhotra R, Malhotra R, Mathai M, Mehrotra R, Misra UK, Mutreja P, Naghavi M, Naik N, Nguyen M, Pandey A, Parmar P, Perianayagam A, Prabhakaran D, Rath GK, Reinig N, Roth GA, Sagar R, Sankar MJ, Shaji KS, Sharma RS, Sharma S, Singh R, Srivastava MVP, Stark BA, Tandon N, Thakur JS, ThekkePurakkal AS, Thomas SV, Tripathi M, Vongpradith A, Wunrow HY, Xavier D, Shukla DK, Reddy KS, Panda S, Dandona R, Murray CJL, Vos T, Dhaliwal RS, Dandona L. The burden of neurological disorders across the states of India: the Global Burden of Disease Study 1990-2019. Lancet Glob Health 2021; 9:e1129-e1144. [PMID: 34273302 PMCID: PMC8295043 DOI: 10.1016/s2214-109x(21)00164-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/18/2021] [Accepted: 03/08/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND A systematic understanding of the burden of neurological disorders at the subnational level is not readily available for India. We present a comprehensive analysis of the disease burden and trends of neurological disorders at the state level in India. METHODS Using all accessible data from multiple sources, we estimated the prevalence or incidence and disability-adjusted life-years (DALYs) for neurological disorders from 1990 to 2019 for all states of India as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. We assessed the contribution of each neurological disorder to deaths and DALYs in India in 2019, their trends in prevalence or incidence and DALY rates over time, and heterogeneity between the states of India. We also assessed the Pearson correlation coefficient between Socio-demographic Index (SDI) of the states and the prevalence or incidence and DALY rates of each neurological disorder. Additionally, we estimated the contribution of known risk factors to DALYs from neurological disorders. We calculated 95% uncertainty intervals (UIs) for the mean estimates. FINDINGS The contribution of non-communicable neurological disorders to total DALYs in India doubled from 4·0% (95% UI 3·2-5·0) in 1990 to 8·2% (6·6-10·2) in 2019, and the contribution of injury-related neurological disorders increased from 0·2% (0·2-0·3) to 0·6% (0·5-0·7). Conversely, the contribution of communicable neurological disorders decreased from 4·1% (3·5-4·8) to 1·1% (0·9-1·5) during the same period. In 2019, the largest contributors to the total neurological disorder DALYs in India were stroke (37·9% [29·9-46·1]), headache disorders (17·5% [3·6-32·5]), epilepsy (11·3% [9·0-14·3]), cerebral palsy (5·7% [4·2-7·7]), and encephalitis (5·3% [3·7-8·9]). The crude DALY rate of several neurological disorders had considerable heterogeneity between the states in 2019, with the highest variation for tetanus (93·2 times), meningitis (8·3 times), and stroke (5·5 times). SDI of the states had a moderate significant negative correlation with communicable neurological disorder DALY rate and a moderate significant positive correlation with injury-related neurological disorder DALY rate in 2019. For most of the non-communicable neurological disorders, there was an increase in prevalence or incidence from 1990 to 2019. Substantial decreases were evident in the incidence and DALY rates of communicable neurological disorders during the same period. Migraine and multiple sclerosis were more prevalent among females than males and traumatic brain injuries were more common among males than females in 2019. Communicable diseases contributed to the majority of total neurological disorder DALYs in children younger than 5 years, and non-communicable neurological disorders were the highest contributor in all other age groups. In 2019, the leading risk factors contributing to DALYs due to non-communicable neurological disorders in India included high systolic blood pressure, air pollution, dietary risks, high fasting plasma glucose, and high body-mass index. For communicable disorders, the identified risk factors with modest contributions to DALYs were low birthweight and short gestation and air pollution. INTERPRETATION The increasing contribution of non-communicable and injury-related neurological disorders to the overall disease burden in India, and the substantial state-level variation in the burden of many neurological disorders highlight the need for state-specific health system responses to address the gaps in neurology services related to awareness, early identification, treatment, and rehabilitation. FUNDING Bill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.
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Khurana S, Gourie-Devi M, Sharma S, Kushwaha S. Burden of Stroke in India During 1960 to 2018: A Systematic Review and Meta-Analysis of Community Based Surveys. Neurol India 2021; 69:547-559. [PMID: 34169841 DOI: 10.4103/0028-3886.317240] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Stroke is a heterogeneous disorder comprising of clinical subtypes and many risk factors, also alluded to as cerebrovascular disorders (CVDs). Increase in the global burden of stroke in developed and developing countries has been alarming. To galvanize the efforts towards the prevention and treatment, there is a need for robust data on the burden of stroke. Objective The aim of this study was to estimate the burden of stroke, a systematic review of community-based studies was conducted. Material and Methods Systematic search of PubMed and Google Scholar for studies from January 1960 to December 2018 was done. The articles were screened and the data was retrieved and sorted into incidence, prevalence and mortality rates. Meta-analysis was done on Medcalc statistical software version 19.2.6. Results Prevalence rate of stroke for total population inclusive of urban and rural population, varied from 44.54 to 150/100000.For the urban population prevalence rate was 45 to 487/100000 and 55 to 388.4/100000 for rural population. The incidence rate varied from 33 to 123/100000 in the urban population and in the rural population it was estimated to be 123.57/100000. The 30 days case fatality rate of stroke varied from 41.08% to 42.06% in urban population and 18% to 46.3%.in the rural population. Conclusions Systematic review and meta-analysis reveal that the stroke burden in India is quite high.
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Affiliation(s)
- Sarbjeet Khurana
- Associate Professor and Head, Department of Epidemiology, ICMR, Delhi, India
| | | | - Shweta Sharma
- Scientist C (Medical), Division of NCD, ICMR, Delhi, India
| | - Suman Kushwaha
- Associate Professor and Head, Department of Neurology, Institute of Human Behaviour and Allied Sciences [IHBAS], Dilshad Garden, Delhi, India
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Bhandari AS, Gourie-Devi M, Kumar P, Khanna L. A Case of Musicogenic Epilepsy. Journal of Pediatric Epilepsy 2021. [DOI: 10.1055/s-0041-1725993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractMusicogenic epilepsy is a relatively rare form of epilepsy characterized by seizures triggered by specific music experiences, with an estimated prevalence of 1/10,000,000 population. In this article, we reported a case of 12-year-old boy patient with a history of recent onset focal seizures associated with an aura of formed visual hallucinations, feeling of familiarity (déjà vu), and impending fear lasting for seconds to a minute followed by eye blinking, oral automatisms, and unresponsiveness for almost 15 minutes. These episodes, most often, were provoked by music. Video electroencephalogram (EEG) done in our institute was suggestive of reflex musicogenic epilepsy arising from the left anterior temporal lobe. Magnetic resonance imaging of the brain 3T with epilepsy protocol confirmed video EEG findings, with an abnormal signal intensity in the left hippocampal and mesial temporal lobe. Treatment included lifestyle modification and antiepileptic drugs.
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Affiliation(s)
| | | | - Praveen Kumar
- Department of Pediatrics, Sir Ganga Ram Hospital, New Delhi, India
| | - Laxmi Khanna
- Department of Neurophysiology, Sir Ganga Ram Hospital, New Delhi, India
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Bhatia S, Bijarnia-Mahay S, Dubey S, Gourie-Devi M. Familial Prion Disease: First Indian Kindred with Gerstmann-Sträussler-Scheinker Syndrome. Neurol India 2020; 68:1431-1434. [PMID: 33342883 DOI: 10.4103/0028-3886.304068] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Gerstmann-Sträussler-Scheinker (GSS) syndrome is a devastating hereditary prion disease, presenting in 4th-5th decade with progressive ataxia and dementia. Pathogenic variants in the PRNP gene lead to aggregation of misfolded prion protein which results in neurodegeneration and death within a few years of onset. A key feature of prion disorders is conversion of normal prion protein (PrPc) into its misfolded form (PrPSc). Genetic modifiers include methionine at position 129 in prion protein and octapeptide repeats. We present an Indian kindred with c. 305C > T, p.Pro102Leu mutation in PRNP gene causing GSS in multiple members and discuss the impact of the polymorphism at position 129 on the severity of illness.
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Affiliation(s)
- Sameer Bhatia
- Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Sunita Bijarnia-Mahay
- Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Sudisha Dubey
- Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital, New Delhi, India
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Verma S, Vats A, Gourie-Devi M, Khurana S, Ganguly NK, Chakraborti P, Taneja V. Modelling a Novel Superoxide Dismutase 1 Mutation in Motor Neurons: An Insight into Molecular Pathomechanism of Amyotrophic Lateral Sclerosis. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.04997] [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: 11/11/2022]
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Gourie-Devi M. Enigma of tropical spastic paraplegia. Neurol India 2020; 68:268-269. [DOI: 10.4103/0028-3886.284367] [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: 11/04/2022]
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Abstract
Background Amyotrophic lateral sclerosis (ALS) is a relatively rare neurological disorder affecting upper and lower motor neurons in the brain and spinal cord with survival for 3-5 years and rarely beyond 10 years. Sleep disturbances in ALS are underreported and undertreated and there is no related data from India. This study aimed to assess the frequency of sleep disorders in patients of ALS and their determinants. Methods Patients with definite and probable ALS as per the El Escorial criteria were recruited from May 2014 to April 2016. Functional impairment, presence of sleep specific abnormalities and anxiety and depression were assessed using standardized questionnaires. Results Forty patients with ALS (23 male; 17 female) with their median age at presentation being 58.5 years (range 44-75 years) and the median duration of illness being 18 months (range: 4-120 months) were includedin the study. Half of the patients had poor sleep quality, which was significantly worse across all components of Pittsburgh Sleep Quality Index (PSQI) compared to controls. Sleep disorders were observed in 70%, insomnia in 65%, sleep disordered breathing/hypoventilation in 52.5% and restless legs syndrome in 5% patients. Night time awakenings attributable to symptoms associated with ALS were noted in 85%, and anxiety and depression in 57.5% patients. Excessive daytime somnolence emerged as an independent predictor for the presence of sleep disorders in ALS patients on multivariate logistic regression [P = 0.043, odd's ratio (OR) 1.435; 95% confidence interval[CI] (1.011-2.036)]. Conclusion This is the first study from India providing insight into the presence of sleep disorders in ALS. About half of the patients of ALS had a poor sleep quality and two-thirds suffered from sleep disturbances.
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Affiliation(s)
- Samhita Panda
- Department of Neurophysiology; Department of Sleep Medicine, Sir Ganga Ram Hospital, Delhi, India
| | | | - Ankkita Sharma
- Department of Neurophysiology, Sir Ganga Ram Hospital, Delhi, India
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Gourie-Devi M. Redefining neurology care at outpatient services of tertiary hospitals: Case for paradigm shift from tertiary to peripheral centers. Neurol India 2019; 67:648-649. [PMID: 31347523 DOI: 10.4103/0028-3886.263257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- M Gourie-Devi
- Department of Neurology, Institute of Human Behaviour and Allied Sciences; Department of Neurophysiology and Neurology, Sir Ganga Ram Hospital, New Delhi, India
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Affiliation(s)
- M. Gourie-Devi
- Emeritus Professor of Neurology, Institute of Human Behaviour and Allied Sciences, Senior Consultant Neurologist and Chairperson, Department of Neurophysiology, Sir Ganga Ram Hospital, New Delhi, India
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Arora NK, Nair MKC, Gulati S, Deshmukh V, Mohapatra A, Mishra D, Patel V, Pandey RM, Das BC, Divan G, Murthy GVS, Sharma TD, Sapra S, Aneja S, Juneja M, Reddy SK, Suman P, Mukherjee SB, Dasgupta R, Tudu P, Das MK, Bhutani VK, Durkin MS, Pinto-Martin J, Silberberg DH, Sagar R, Ahmed F, Babu N, Bavdekar S, Chandra V, Chaudhuri Z, Dada T, Dass R, Gourie-Devi M, Remadevi S, Gupta JC, Handa KK, Kalra V, Karande S, Konanki R, Kulkarni M, Kumar R, Maria A, Masoodi MA, Mehta M, Mohanty SK, Nair H, Natarajan P, Niswade AK, Prasad A, Rai SK, Russell PSS, Saxena R, Sharma S, Singh AK, Singh GB, Sumaraj L, Suresh S, Thakar A, Parthasarathy S, Vyas B, Panigrahi A, Saroch MK, Shukla R, Rao KVR, Silveira MP, Singh S, Vajaratkar V. Neurodevelopmental disorders in children aged 2-9 years: Population-based burden estimates across five regions in India. PLoS Med 2018; 15:e1002615. [PMID: 30040859 PMCID: PMC6057634 DOI: 10.1371/journal.pmed.1002615] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/15/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Neurodevelopmental disorders (NDDs) compromise the development and attainment of full social and economic potential at individual, family, community, and country levels. Paucity of data on NDDs slows down policy and programmatic action in most developing countries despite perceived high burden. METHODS AND FINDINGS We assessed 3,964 children (with almost equal number of boys and girls distributed in 2-<6 and 6-9 year age categories) identified from five geographically diverse populations in India using cluster sampling technique (probability proportionate to population size). These were from the North-Central, i.e., Palwal (N = 998; all rural, 16.4% non-Hindu, 25.3% from scheduled caste/tribe [SC-ST] [these are considered underserved communities who are eligible for affirmative action]); North, i.e., Kangra (N = 997; 91.6% rural, 3.7% non-Hindu, 25.3% SC-ST); East, i.e., Dhenkanal (N = 981; 89.8% rural, 1.2% non-Hindu, 38.0% SC-ST); South, i.e., Hyderabad (N = 495; all urban, 25.7% non-Hindu, 27.3% SC-ST) and West, i.e., North Goa (N = 493; 68.0% rural, 11.4% non-Hindu, 18.5% SC-ST). All children were assessed for vision impairment (VI), epilepsy (Epi), neuromotor impairments including cerebral palsy (NMI-CP), hearing impairment (HI), speech and language disorders, autism spectrum disorders (ASDs), and intellectual disability (ID). Furthermore, 6-9-year-old children were also assessed for attention deficit hyperactivity disorder (ADHD) and learning disorders (LDs). We standardized sample characteristics as per Census of India 2011 to arrive at district level and all-sites-pooled estimates. Site-specific prevalence of any of seven NDDs in 2-<6 year olds ranged from 2.9% (95% CI 1.6-5.5) to 18.7% (95% CI 14.7-23.6), and for any of nine NDDs in the 6-9-year-old children, from 6.5% (95% CI 4.6-9.1) to 18.5% (95% CI 15.3-22.3). Two or more NDDs were present in 0.4% (95% CI 0.1-1.7) to 4.3% (95% CI 2.2-8.2) in the younger age category and 0.7% (95% CI 0.2-2.0) to 5.3% (95% CI 3.3-8.2) in the older age category. All-site-pooled estimates for NDDs were 9.2% (95% CI 7.5-11.2) and 13.6% (95% CI 11.3-16.2) in children of 2-<6 and 6-9 year age categories, respectively, without significant difference according to gender, rural/urban residence, or religion; almost one-fifth of these children had more than one NDD. The pooled estimates for prevalence increased by up to three percentage points when these were adjusted for national rates of stunting or low birth weight (LBW). HI, ID, speech and language disorders, Epi, and LDs were the common NDDs across sites. Upon risk modelling, noninstitutional delivery, history of perinatal asphyxia, neonatal illness, postnatal neurological/brain infections, stunting, LBW/prematurity, and older age category (6-9 year) were significantly associated with NDDs. The study sample was underrepresentative of stunting and LBW and had a 15.6% refusal. These factors could be contributing to underestimation of the true NDD burden in our population. CONCLUSIONS The study identifies NDDs in children aged 2-9 years as a significant public health burden for India. HI was higher than and ASD prevalence comparable to the published global literature. Most risk factors of NDDs were modifiable and amenable to public health interventions.
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Affiliation(s)
| | - M. K. C. Nair
- Kerala University of Health Sciences, Medical College PO, Thrissur, Kerala, India
| | - Sheffali Gulati
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | | | | | - Devendra Mishra
- Department of Paediatrics, Maulana Azad Medical College, New Delhi, India
| | - Vikram Patel
- Sangath, Bardez, Goa, India
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Ravindra M. Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Bhagabati C. Das
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneshwar, Odisha, India
| | | | - G. V. S. Murthy
- Indian Institute of Public Health, Hyderabad, Telangana, India
| | - Thakur D. Sharma
- Himachal Foundation, Dharamshala, Kangra, Himachal Pradesh, India
| | - Savita Sapra
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Satinder Aneja
- Department of Paediatrics, Lady Hardinge Medical College, New Delhi, India
| | - Monica Juneja
- Department of Paediatrics, Maulana Azad Medical College, New Delhi, India
| | - Sunanda K. Reddy
- Centre for Applied Research and Education on Neurodevelopmental Impairments and Disability related Health Initiatives (CARENIDHI), New Delhi, India
| | - Praveen Suman
- Department of Paediatrics, Sir Ganga Ram Hospital, New Delhi, India
| | | | - Rajib Dasgupta
- Department of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India
| | - Poma Tudu
- The INCLEN Trust International, New Delhi, India
| | | | - Vinod K. Bhutani
- Department of Paediatrics, Stanford University School of Medicine and Lucile Packard Children’s Hospital, California, United States of America
| | - Maureen S. Durkin
- Department of Population Health Sciences and Paediatrics, and Waisman Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - Jennifer Pinto-Martin
- University of Pennsylvania School of Nursing and School of Medicine, Philadelphia, United States of America
| | - Donald H. Silberberg
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Science, New Delhi, India
| | - Faruqueuddin Ahmed
- Integral Institute of Medical Sciences & Research, Integral University, Lucknow, Uttar Pradesh, India
| | - Nandita Babu
- Department of Psychology, Delhi University, New Delhi, India
| | - Sandeep Bavdekar
- Department of Paediatrics, Seth GS Medical College & KEM Hospital, Mumbai, Maharashtra, India
| | - Vijay Chandra
- Department of Neurology, Paras Hospital, Gurugram, Haryana, India
| | - Zia Chaudhuri
- Department of Ophthalmology, Lady Hardinge Medical College, New Delhi, India
| | - Tanuj Dada
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rashna Dass
- Department of Paediatric Disciplines, Health City Hospital, Guwahati, Assam, India
| | - M. Gourie-Devi
- Department of Neurology, Institute of Human Behaviour and Allied Sciences & Department of Neurophysiology, Sir Ganga Ram Hospital, New Delhi, India
| | - S. Remadevi
- School of Health Policy and Planning, Kerala University of Health Sciences, Thiruvananthapuram, Kerala, India
| | - Jagdish C. Gupta
- Ali Yavar Jung National Institute of Speech and Hearing Disabilities, Department of Empowerment of Persons with Disabilities, Kasturba Niketan, New Delhi, India
| | - Kumud K. Handa
- Department of ENT & Head Neck Surgery, Medanta Medicity, Gurugram, Haryana, India
| | - Veena Kalra
- Department of Paediatrics, Indraprastha Apollo Hospital, New Delhi, India
| | - Sunil Karande
- Department of Paediatrics, Seth GS Medical College & KEM Hospital, Mumbai, Maharashtra, India
| | - Ramesh Konanki
- Department of Paediatric Neurology, Rainbow Children’s Hospital, Hyderabad, Telengana, India
| | - Madhuri Kulkarni
- Department of Paediatrics, Mumbai Port Trust Hospital, Mumbai, Maharashtra, India
| | - Rashmi Kumar
- Department of Paediatrics, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Arti Maria
- Department of Neonatology, Post Graduate Institute of Medical Education and Research and Dr. Ram Manohar Lohia Hospital, Delhi, India
| | - Muneer A. Masoodi
- Department of Community Medicine, Government Medical College, Srinagar, Kashmir, India
| | - Manju Mehta
- Department of Psychiatry, All India Institute of Medical Science, New Delhi, India
| | - Santosh Kumar Mohanty
- National Trust, Department of Empowerment of Persons with Disabilities, Ministry of Social Justice & Empowerment, Government of India, Delhi, India
| | - Harikumaran Nair
- Kerala University of Health Sciences, Medical College PO, Thrissur, Kerala, India
| | - Poonam Natarajan
- Vidya Sagar (formerly The Spastics Society of India), Chennai, Tamil Nadu, India
| | - A. K. Niswade
- Department of Paediatrics, Government Medical College, Nagpur, Maharashtra, India
| | - Atul Prasad
- Social Welfare Department, Government of Bihar, Patna, India
| | - Sanjay K. Rai
- Department of Community Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Paul S. S. Russell
- Department of Child & Adolescent Psychiatry and Facility for Children with Intellectual Disability, Christian Medical College, Vellore, Tamil Nadu, India
| | - Rohit Saxena
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Shobha Sharma
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Arun K. Singh
- Rashtriya Bal Swasthya Karyakram, Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi, India
| | - Gautam B. Singh
- Department of Otorhinolaryngology and Head and Neck Surgery (ENT), Lady Hardinge Medical College, New Delhi, India
| | - Leena Sumaraj
- Child Development Centre, Medical College Campus, Thiruvananthapuram, Kerala, India
| | | | - Alok Thakar
- Department of Otolaryngology & Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Sujatha Parthasarathy
- Department of Pediatric Neurology, The Hospital for Sick Children (SickKids), The Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Bhadresh Vyas
- Department of Paediatrics, M.P. Shah Government Medical College & G.G. Hospital, Jamnagar, Gujarat, India
| | - Ansuman Panigrahi
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneshwar, Odisha, India
| | - Munish K. Saroch
- Department of ENT, Dr. Rajender Prasad Government Medical College, Kangra, Himachal Pradesh, India
| | - Rajan Shukla
- Indian Institute of Public Health, Hyderabad, Telangana, India
| | - K. V. Raghava Rao
- RVM Institute of Medical Sciences and Research Center, Laxmakkapally, Telangana, India
| | - Maria P. Silveira
- Department of Paediatrics, Goa Medical College, Bambolim, Goa, India
| | - Samiksha Singh
- Indian Institute of Public Health, Hyderabad, Telangana, India
| | - Vivek Vajaratkar
- Sangath, Bardez, Goa, India
- Department of Orthopedic Surgery, Goa Medical College, Bambolim, Goa, India
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Sharma A, Gourie-Devi M. BS22. Study of autonomic nervous system activity based on gender differences. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.04.570] [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: 10/16/2022]
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Netravathi M, Kamble N, Satishchandra P, Gourie-Devi M, Pal PK. Six decades of Neurology at NIMHANS: A historical perspective. Neurol India 2018; 66:459-495. [PMID: 29547172 DOI: 10.4103/0028-3886.227272] [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] [Indexed: 11/04/2022]
Abstract
The Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka has a long tradition of excellence in education, teaching, research, and patient care. Its exceptional alumni, as well as current and past faculty members, have made considerable contributions to the development of neurological services throughout the world. The six decades of its existence have seen a momentous growth in clinical, investigative, and community Neurology. As a result of the immense scientific individual as well as collaborative contributions of the faculty members in various departments, the Institute has had the honour of attaining the status of an autonomous 'Institute of National Importance' under the Ministry of Health, Government of India, through a novel concept of collaboration and partnership of central and state governments. This article traces the dedicated pursuit of members of the Department of Neurology, NIMHANS, in managing neurologic diseases through compassionate patient-centred care, transformative research and education.
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Affiliation(s)
- M Netravathi
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Nitish Kamble
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - P Satishchandra
- Department of Neurology, National Institute of Mental Health and Neurosciences; Department of Neurology, Apollo Hospital, Bangalore, Karnataka, India
| | - M Gourie-Devi
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka; Department of Neurology, Institute of Human Behavior and Allied Sciences, New Delhi, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Affiliation(s)
- M Gourie-Devi
- Department of Neurology, National Institute of Medical Health & Neurosciences, Bangalore, India
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Vats A, Gourie-Devi M, Ahuja K, Sharma A, Wajid S, Ganguly NK, Taneja V. Expression analysis of protein homeostasis pathways in the peripheral blood mononuclear cells of sporadic amyotrophic lateral sclerosis patients. J Neurol Sci 2018; 387:85-91. [PMID: 29571878 DOI: 10.1016/j.jns.2018.01.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 01/24/2018] [Accepted: 01/28/2018] [Indexed: 01/05/2023]
Abstract
Misfolded protein aggregates are the hallmark of Amyotrophic Lateral Sclerosis (ALS) which suggests involvement of protein homeostasis pathways in etiology of ALS. However, status of protein homeostasis in peripheral blood of ALS is not well established. We analyzed expression levels of key genes of proteostasis pathways in peripheral blood mononuclear cells (PBMCs) of sporadic ALS (sALS) patients and healthy controls. Increased protein carbonylation was observed in patients reflecting oxidative damage in PBMCs. We observed increased transcript and protein levels of GRP78 suggesting Endoplasmic reticulum (ER) insult to cells. Further, significant upregulation of spliced XBP1 and two stress sensors: IRE1α/ERN1 and ATF6 indicated induction of unfolded protein response (UPR). Genes involved in autophagosome initiation (ULK1, ULK2, ATG13); nucleation and elongation (BECLIN1, ATG7, ATG16L1, ATG5, ATG10) and vesicular trafficking genes were significantly increased in patients. Increased lipidation of LC3 validated induction of autophagy. Accumulation of low molecular weight ubiquitinated proteins in patients suggested deregulation of proteasome (UPS) pathway. In addition, cytosolic chaperones (HSP70 and HSP27) and HSF1 were elevated in patients. Increased TDP43 indicated role of TDP43 in disease pathology. Our findings suggest that there is oxidative insult and upregulation of UPR, vesicular trafficking and autophagy in PBMCs of sALS patients.
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Affiliation(s)
- Abhishek Vats
- Department of Research, Sir Ganga Ram Hospital, Rajinder Nagar, Delhi 110060, India; Department of Biotechnology, Jamia Hamdard, Hamdard Nagar, New Delhi, Delhi 110062, India
| | - Mandaville Gourie-Devi
- Department of Neurophysiology, Sir Ganga Ram Hospital, Rajinder Nagar, Delhi 110060, India; Department of Neurology, Institute of Human Behaviour and Allied Sciences, New Delhi 110095, India
| | - Kavita Ahuja
- Department of Bio and Nano Technology, Guru Jambheshwar University of Science and Technology, Hisar, Haryana 125001, India
| | - Ankkita Sharma
- Department of Neurophysiology, Sir Ganga Ram Hospital, Rajinder Nagar, Delhi 110060, India
| | - Saima Wajid
- Department of Biotechnology, Jamia Hamdard, Hamdard Nagar, New Delhi, Delhi 110062, India
| | - Nirmal Kumar Ganguly
- Department of Research, Sir Ganga Ram Hospital, Rajinder Nagar, Delhi 110060, India
| | - Vibha Taneja
- Department of Research, Sir Ganga Ram Hospital, Rajinder Nagar, Delhi 110060, India.
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Vats A, Gourie-Devi M, Ganguly N, Wajid S, Taneja V. Molecular dynamic simulations and functional characterization of L84F SOD1 mutation associated with amyotrophic lateral sclerosis. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2022] [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: 11/28/2022]
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Vats A, Gourie-Devi M, Suroliya V, Verma S, Faruq M, Sharma A, Ganguly NK, Kukreti R, Wajid S, Taneja V. Analysis of C9orf72 repeat expansion in amyotrophic lateral sclerosis patients from North India. J Neurol Sci 2017; 373:55-57. [DOI: 10.1016/j.jns.2016.11.079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 11/05/2016] [Accepted: 11/30/2016] [Indexed: 01/21/2023]
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Gourie-Devi M, Gupta R, Sharma V, Pardasani V, Maheshwari S. An insight into death wish among patients with amyotrophic lateral sclerosis in India using "Wish-to-Die Questionnaire". Neurol India 2017; 65:46-51. [PMID: 28084237 DOI: 10.4103/0028-3886.198177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS In amyotrophic lateral sclerosis (ALS), death wish is expressed in a varying proportion of patients in different countries. In this first study from India, influence of belief system of religion/spirituality and attitude towards death, widely prevalent in the country, in decision making, was evaluated. MATERIAL AND METHODS Twenty ALS patients were assessed using 'Wish-to-Die Questionnaire' (WDQ) developed to reflect seven domains, namely religion/spirituality, belief in karma, meaning of life, hope, family support, financial support and death wish. Functional impairment, depression, hopelessness and suicidal ideation were assessed by ALS Functional Rating Scale, Beck's Depression Inventory, Beck Hopelessness Scale and The Scale of Suicidal Ideation, respectively. RESULTS On WDQ, all the 20 patients had belief in religion/spirituality, had hope and family support. Nineteen patients (95%) believed in karma, 16 (80%) still found life meaningful and 15 (75%) had financial support. Six patients (30%) had mild to moderate depression; hopelessness was present in 6 (30%) and suicidal ideation was present in one (5%). The 5 (25%) patients who expressed death wish did not significantly differ from others in 6 domains (religion/spirituality, belief in karma, meaning of life, hope, family support, financial support) of WDQ. The main reason in 3 patients who expressed death wish was lack of financial support. The fourth patient could not find meaning of life after the onset of illness, and the fifth wished to end his life since he had satisfactorily fulfilled all his responsibilities. CONCLUSION Smaller proportion of patients of ALS expressed death wish in India compared to the Western countries. This may be attributed to belief in religion/spirituality and karma, having meaning of life and family support. As this is the first report from India, useful information may be obtained if similar studies are done on a larger sample.
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Affiliation(s)
- Mandaville Gourie-Devi
- Department of Neurology, Institute of Human Behaviour and Allied Sciences, New Delhi, India
| | - Reema Gupta
- Department of Clinical Psychology, Institute of Human Behaviour and Allied Sciences, New Delhi; Department of Psychology, University of Delhi, India
| | - Vibha Sharma
- Department of Clinical Psychology, Institute of Human Behaviour and Allied Sciences, New Delhi, India
| | - Vibhor Pardasani
- Department of Neurology, Bombay Hospital Institute of Medical Sciences, Mumbai, India
| | - Siddharth Maheshwari
- Department of Neurology, Institute of Human Behaviour and Allied Sciences, New Delhi, India
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Gourie-Devi M. Epidemiology of neurological disorders in India: An erratum. Neurol India 2016; 64:1110-1. [PMID: 27625292 DOI: 10.4103/0028-3886.190298] [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: 11/04/2022]
Affiliation(s)
- M Gourie-Devi
- Department of Neurology, Institute of Human Behaviour and Allied Sciences and Department of Neurology, Sir Ganga Ram Hospital, New Delhi, India
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Shahrizaila N, Sobue G, Kuwabara S, Kim SH, Birks C, Fan DS, Bae JS, Hu CJ, Gourie-Devi M, Noto Y, Shibuya K, Goh KJ, Kaji R, Tsai CP, Cui L, Talman P, Henderson RD, Vucic S, Kiernan MC. Amyotrophic lateral sclerosis and motor neuron syndromes in Asia. J Neurol Neurosurg Psychiatry 2016; 87:821-30. [PMID: 27093948 DOI: 10.1136/jnnp-2015-312751] [Citation(s) in RCA: 54] [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: 02/07/2016] [Accepted: 03/23/2016] [Indexed: 12/11/2022]
Abstract
While the past 2 decades have witnessed an increasing understanding of amyotrophic lateral sclerosis (ALS) arising from East Asia, particularly Japan, South Korea, Taiwan and China, knowledge of ALS throughout the whole of Asia remains limited. Asia represents >50% of the world population, making it host to the largest patient cohort of ALS. Furthermore, Asia represents a diverse population in terms of ethnic, social and cultural backgrounds. In this review, an overview is presented that covers what is currently known of ALS in Asia from basic epidemiology and genetic influences, through to disease characteristics including atypical phenotypes which manifest a predilection for Asians. With the recent establishment of the Pan-Asian Consortium for Treatment and Research in ALS to facilitate collaborations between clinicians and researchers across the region, it is anticipated that Asia and the Pacific will contribute to unravelling the uncertainties in ALS.
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Affiliation(s)
- N Shahrizaila
- Faculty of Medicine, Neurology Unit, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia Brain and Mind Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - G Sobue
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - S Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - S H Kim
- Department of Neurology, Hanyang University Medical Center, Seoul, South Korea
| | - Carol Birks
- International Alliance of ALS/MND Associations, Sydney, New South Wales, Australia
| | - D S Fan
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - J S Bae
- Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - C J Hu
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - M Gourie-Devi
- Department of Neurology, Institute of Human Behaviour and Allied Sciences (IHBAS), New Delhi, Delhi, India
| | - Y Noto
- Brain and Mind Centre, University of Sydney, Camperdown, New South Wales, Australia Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - K Shibuya
- Brain and Mind Centre, University of Sydney, Camperdown, New South Wales, Australia Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - K J Goh
- Faculty of Medicine, Neurology Unit, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - R Kaji
- Department of Clinical Neuroscience, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - C P Tsai
- Department of Neurology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - L Cui
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - P Talman
- Neurology Unit, Calvary Health Care, Bethlehem Hospital, Caulfield, Victoria, Australia
| | - R D Henderson
- Department of Neurology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - S Vucic
- The Brain Dynamics Centre, Westmead Millennium Institute, Westmead, NSW and Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - M C Kiernan
- Brain and Mind Centre, University of Sydney, Camperdown, New South Wales, Australia
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Affiliation(s)
- M Gourie-Devi
- Emeritus Professor of Neurology, Department of Neurology, Institute of Human Behaviour and Allied Sciences (IHBAS), New Delhi; Chairperson, Department of Neurophysiology and Senior Consultant Neurologist, Sir Ganga Ram Hospital, New Delhi, Former Director and Professor of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Panda S, Gourie-Devi M, Sharma A, Sud A. Isolated deep peroneal nerve palsy: Role of magnetic resonance imaging in localization. Ann Indian Acad Neurol 2015; 18:451-3. [PMID: 26713021 PMCID: PMC4683888 DOI: 10.4103/0972-2327.169646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Samhita Panda
- Department of Neurophysiology, Sir Ganga Ram Hospital, New Delhi, India
| | | | - Ankkita Sharma
- Department of Neurophysiology, Sir Ganga Ram Hospital, New Delhi, India
| | - Aditi Sud
- Department of Radiology, Sir Ganga Ram Hospital, New Delhi, India
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Vats A, Gourie-Devi M, Verma M, Ramachandran S, Taneja B, Kukreti R, Taneja V. Identification of L84F mutation with a novel nucleotide change c.255G > T in the superoxide dismutase gene in a North Indian family with amyotrophic lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener 2015; 17:253-9. [DOI: 10.3109/21678421.2015.1111906] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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)
- Abhishek Vats
- Department of Research, Sir Ganga Ram Hospital, Rajinder Nagar, Delhi,
- Department of Biotechnology, Jamia Hamdard, Hamdard Nagar, New Delhi, Delhi,
| | - Mandaville Gourie-Devi
- Department of Neurophysiology, Sir Ganga Ram Hospital, Rajinder Nagar, Delhi,
- Department of Neurology, Institute of Human Behaviour and Allied Sciences, New Delhi,
| | - Meenakshi Verma
- CSIR-Institute of Genomics and Integrative Biology, Mall Road, New Delhi, and
| | | | - Bhupesh Taneja
- CSIR-Institute of Genomics and Integrative Biology, Mathura Road, New Delhi, Delhi, India
| | - Ritushree Kukreti
- CSIR-Institute of Genomics and Integrative Biology, Mall Road, New Delhi, and
| | - Vibha Taneja
- Department of Research, Sir Ganga Ram Hospital, Rajinder Nagar, Delhi,
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Gourie-Devi M. Epidemiology of neurological disorders in India: review of background, prevalence and incidence of epilepsy, stroke, Parkinson's disease and tremors. Neurol India 2015; 62:588-98. [PMID: 25591669 DOI: 10.4103/0028-3886.149365] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Growth and development of neuroepidemiology in India during the last four decades has been documented highlighting the historical milestones. The prevalence rates of the spectrum of neurological disorders from different regions of the country ranged from 967-4,070 with a mean of 2394 per 100,000 population, providing a rough estimate of over 30 million people with neurological disorders (excluding neuroinfections and traumatic injuries). Prevalence and incidence rates of common disorders including epilepsy, stroke, Parkinson's disease and tremors determined through population-based surveys show considerable variation across different regions of the country. The need for a standardized screening questionnaire, uniform methodology for case ascertainment and diagnosis is an essential requiste for generating robust national data on neurological disorders. Higher rates of prevalence of neurological disorders in rural areas, 6-8 million people with epilepsy and high case fatality rates of stroke (27-42%) call for urgent strategies to establish outreach neurology services to cater to remote and rural areas, develop National Epilepsy Control Program and establish stroke units at different levels of health care pyramid.
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Affiliation(s)
- M Gourie-Devi
- Department of Neurology, Institute of Human Behaviour and Allied Sciences and Senior Consultant in Neurology, Sir Ganga Ram Hospital, New Delhi, India
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Gourie-Devi M, Maheshwari S, Panda A, Bala K. Chin fasciculations in Madras motor neuron disease: A new clinical feature. Neurol India 2013; 61:653-5. [DOI: 10.4103/0028-3886.125275] [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: 11/04/2022]
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Grover S, Talwar P, Gourie-Devi M, Gupta M, Bala K, Sharma S, Baghel R, Kaur H, Sharma A, Kukreti R. Genetic polymorphisms in sex hormone metabolizing genes and drug response in women with epilepsy. Pharmacogenomics 2011; 11:1525-34. [PMID: 21121773 DOI: 10.2217/pgs.10.120] [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] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIMS It is hypothesized that functionally relevant polymorphisms in genes encoding metabolizing enzymes of sex steroids may influence drug response by directly predisposing women with epilepsy to seizure exacerbation. An alteration in estradiol:progesterone ratio is believed to play a role in seizure occurrence in women. CYP1A1 is a key enzyme involved in the metabolism of estradiol, with variants of the CYP1A1 gene having been reported to play a role in the alteration of sex hormone metabolism in women. The objective of the present study was to test for the association of genetic variants in CYP1A1 with seizure recurrence in patients diagnosed with epilepsy. MATERIALS & METHODS In the study, the association of five variants in CYP1A1 with seizure control in 228 patients with epilepsy on first-line antiepileptic drug therapy for a minimum period of 12 months was investigated. RESULTS A significant association of an intronic SNP, IVS1 +606C>A (rs2606345), with respect to seizure recurrence (genotypic: p = 3.3 × 10(-4); allelic: p = 7.2 × 10(-4); OR: 2.86; 95% CI: 1.5-5.3) in women with epilepsy from North India was observed. CONCLUSION Since CYP1A1 is not involved in the metabolism of any of the first-line antiepileptic drugs, these results imply that variants from genes encoding sex hormone metabolizing enzymes might act as markers for predicting response to antiepileptic drug therapy in women with epilepsy.
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Affiliation(s)
- Sandeep Grover
- Institute of Genomics & Integrative Biology (IGIB), Council of Scientific & Industrial Research (CSIR), Delhi, India
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Grover S, Talwar P, Baghel R, Kaur H, Gupta M, Gourie-Devi M, Bala K, Sharma S, Kukreti R. Genetic variability in estrogen disposition: Potential clinical implications for neuropsychiatric disorders. Am J Med Genet B Neuropsychiatr Genet 2010; 153B:1391-410. [PMID: 20886541 DOI: 10.1002/ajmg.b.31119] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [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: 04/19/2010] [Accepted: 08/03/2010] [Indexed: 01/20/2023]
Abstract
Variability in the physiological levels of neuroactive estrogens is widely believed to play a role in predisposition to several disorders of the central nervous system. Local biosynthesis of estrogens in the brain as well as their circulating serum levels are known to contribute to this pool of neuroactive steroids. It has been well accepted that estrogens modulate neuronal functions by affecting genesis, differentiation, excitability, and degeneration of nerve cells. These actions of estrogens appear to be more prominent in females with higher concentrations and marked variability of circulating serum levels occurring over a woman's lifetime. However, our knowledge regarding the variability of neuroactive steroid levels is very limited. Furthermore, several studies have recently reported differences in the synchronization of circulating and neuronal levels of estradiol. In the absence of reliable circulating steroid levels, knowledge of genetic variability in estrogen disposition may play a determining factor in predicting altered susceptibility or severity of neuropsychiatric disorders in women. Over the past decade, several genetic variants have been linked to both differential serum estrogen levels and predisposition to diverse types of neuropsychiatric disorders in women. Polymorphisms in genes encoding estrogen-metabolizing enzymes as well as estrogen receptors may account for this phenotypic variability. In this review, we attempt to show the contribution of genetics in determining estrogenicity in females with a particular emphasis on the central nervous system. This knowledge will further provide a driving force for unearthing the novel field of "Estrogen Pharmacogenomics." © 2010 Wiley-Liss, Inc.
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Affiliation(s)
- Sandeep Grover
- Council of Scientific and Industrial Research, Institute of Genomics and Integrative Biology, Delhi, India
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Grover S, Gourie-Devi M, Baghel R, Sharma S, Bala K, Gupta M, Narayanasamy K, Varma B, Gupta M, Kaur K, Talwar P, Kaur H, Giddaluru S, Sharma A, Brahmachari SK, Consortium IGV, Kukreti R. Genetic profile of patients with epilepsy on first-line antiepileptic drugs and potential directions for personalized treatment. Pharmacogenomics 2010; 11:927-41. [DOI: 10.2217/pgs.10.62] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: The first-line antiepileptic drugs, although affordable and effective in the control of seizures, are associated with adverse drug effects, and there is large interindividual variability in the appropriate dose at which patients respond favorably. This variability may partly be explained by functional consequences of genetic polymorphisms in the drug-metabolizing enzymes, such as the CYP450 family, microsomal epoxide hydrolase and UDP-glucuronosyltransferases, drug transporters, mainly ATP-binding cassette transporters, and drug targets, including sodium channels. The purpose of this study was to determine the allele and genotype frequencies of such genetic variants in patients with epilepsy from North India administered first-line antiepileptic drugs, such as phenobarbitone, phenytoin, carbamazepine and valproic acid, and compare them with worldwide epilepsy populations. Materials & methods: SNP screening of 19 functional variants from 12 genes in 392 patients with epilepsy was carried out, and the patients were classified with respect to the metabolizing rate of their drug-metabolizing enzymes, efflux rate of drug transporters and sensitivity of drug targets. Results: A total of 16 SNPs were found to be polymorphic, and the allelic frequencies for these SNPs were in conformance with Hardy–Weinberg equilibrium. Among all the polymorphisms studied, functional variants from genes encoding CYP2C19, EPHX1, ABCB1 and SCN1A were highly polymorphic in North Indian epilepsy patients, and might account for differential drug response to first-line antiepileptic drugs. Conclusion: Interethnic differences were elucidated for several polymorphisms that might be responsible for differential serum drug levels and optimal dose requirement for efficacious treatment.
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Affiliation(s)
- Sandeep Grover
- Institute of Genomics & Integrative Biology (IGIB), Council of Scientific & Industrial Research (CSIR), India
| | | | - Ruchi Baghel
- Institute of Genomics & Integrative Biology (IGIB), Council of Scientific & Industrial Research (CSIR), India
| | - Sangeeta Sharma
- Institute of Human Behavior & Allied Sciences (IHBAS), Delhi, India
| | - Kiran Bala
- Institute of Human Behavior & Allied Sciences (IHBAS), Delhi, India
| | - Meena Gupta
- Institute of Human Behavior & Allied Sciences (IHBAS), Delhi, India
| | | | - Binuja Varma
- The Centre for Genomic Application (TCGA), New Delhi, India
| | - Meenal Gupta
- Institute of Genomics & Integrative Biology (IGIB), Council of Scientific & Industrial Research (CSIR), India
| | - Kavita Kaur
- Institute of Genomics & Integrative Biology (IGIB), Council of Scientific & Industrial Research (CSIR), India
| | - Puneet Talwar
- Institute of Genomics & Integrative Biology (IGIB), Council of Scientific & Industrial Research (CSIR), India
| | - Harpreet Kaur
- Institute of Genomics & Integrative Biology (IGIB), Council of Scientific & Industrial Research (CSIR), India
| | - Sudheer Giddaluru
- Institute of Genomics & Integrative Biology (IGIB), Council of Scientific & Industrial Research (CSIR), India
| | - Abhay Sharma
- Institute of Genomics & Integrative Biology (IGIB), Council of Scientific & Industrial Research (CSIR), India
| | - Samir K Brahmachari
- Institute of Genomics & Integrative Biology (IGIB), Council of Scientific & Industrial Research (CSIR), India
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Shahani N, Gourie-Devi M, Nalini A, Rammohan P, Shobha K, Harsha HN, Raju TR. (‐)‐Deprenyl alleviates the degenerative changes induced in the neonatal rat spinal cord by CSF from amyotrophic lateral sclerosis patients. ACTA ACUST UNITED AC 2009; 5:172-9. [PMID: 15512906 DOI: 10.1080/14660820410017037] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Previous studies from our laboratory suggest the presence of toxic factor(s) in the cerebrospinal fluid (CSF) of patients with amyotrophic lateral sclerosis (ALS) which induces degenerative changes in the spinal cord neurons. The present work was carried out to investigate the role of (-)-deprenyl in attenuating these degenerative changes. CSF samples from ALS and non-ALS neurological patients were injected into the spinal subarachnoid space of 3-day-old rat pups, followed by a single dose (0.01 mg/kg body weight) of (-)-deprenyl, administered 24 h after CSF injection. After a further period of 24 h, the rats were sacrificed and the spinal cord sections were stained with antibodies against phosphorylated neurofilament (NF, SMI-31 antibody) and glial fibrillary acidic protein (GFAP). Activity of lactate dehydrogenase (LDH) was also measured. (-)-Deprenyl injection resulted in a significant (61%) decrease in the number of SMI-31 stained neuronal soma in the ventral horn of the spinal cord of ALS CSF exposed rats. This was accompanied by a reduction in the astrocytes immunoreactive for GFAP. There was also a significant (35%) decrease in the LDH activity following (-)-deprenyl treatment. These results suggest that (-)-deprenyl may confer neuroprotection against the toxic factor(s) present in ALS CSF.
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Affiliation(s)
- Neelam Shahani
- Department of Neurobiology, University of Osnabrueck, D- 49076 Osnabrueck, Germany
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Nalini A, Thennarasu K, Gourie-Devi M, Shenoy S, Kulshreshtha D. Clinical characteristics and survival pattern of 1153 patients with amyotrophic lateral sclerosis: Experience over 30 years from India. J Neurol Sci 2008; 272:60-70. [DOI: 10.1016/j.jns.2008.04.034] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2008] [Revised: 04/16/2008] [Accepted: 04/22/2008] [Indexed: 10/22/2022]
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Ramamohan PY, Gourie-Devi M, Nalini A, Shobha K, Ramamohan Y, Joshi P, Raju TR. Cerebrospinal fluid from amyotrophic lateral sclerosis patients causes fragmentation of the Golgi apparatus in the neonatal rat spinal cord. ACTA ACUST UNITED AC 2007; 8:79-82. [PMID: 17453633 DOI: 10.1080/08037060601145489] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
We have previously shown in our laboratory that cerebrospinal fluid from ALS patients (ALS-CSF) contains putative toxic factor(s). In the present study we determined the effect of ALS-CSF on the integrity of the Golgi apparatus of spinal motor neurons in the neonatal rats. CSF was injected intrathecally into three-day-old rat pups and subsequently the ultrastructural changes in the motor neurons were studied after 48 h, 1, 2 and 3 weeks. We observed that ALS-CSF causes fragmentation of the Golgi apparatus in a considerable number of motor neurons in the spinal cord. This was further confirmed when motor neurons were stained with an antibody against a medial Golgi protein (MG160). Thus, we suggest that the putative toxin(s) present in ALS-CSF may cause impairment in the protein processing leading to motor neuron death.
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Affiliation(s)
- Priti Y Ramamohan
- Department of Neurophysiology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
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Gourie-Devi M. Cranial neuropathy in patients with leprosy. Neurol India 2006; 54:248-9. [PMID: 16936380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
- M Gourie-Devi
- Institute of Human Behavior and Allied Sciences and Department of Neurophysiology, Sir Gangaram Hospital, New Delhi, India.
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Gourie-Devi M. Psychiatric symptoms in neurological practice: Comment on herpes simplex encephalitis and obsessive- compulsive disorder. Ann Indian Acad Neurol 2006. [DOI: 10.4103/0972-2327.27666] [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: 11/04/2022] Open
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Desai A, Chandramuki A, Gourie-Devi M, Ravi V. Detection of Japanese encephalitis virus antigens in the CSF using monoclonal antibodies. ACTA ACUST UNITED AC 2005; 2:191-9. [PMID: 15566765 DOI: 10.1016/0928-0197(94)90022-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/1993] [Revised: 11/30/1993] [Accepted: 12/21/1993] [Indexed: 11/28/2022]
Abstract
BACKGROUND Antigen detection in the CSF is an invaluable tool in the diagnosis of viral infections of the nervous system, especially in the early phase of the illness. Very little information is available on the use of antigen detection in the diagnosis of Japanese encephalitis (JE). OBJECTIVES Evaluation of two monoclonal antibody-based antigen detection methods in the diagnosis of JE in comparison with the detection of virus-specific IgM antibodies in the CSF. STUDY DESIGN In this study 115 patients with a clinical diagnosis of JE were investigated. A reverse passive haemagglutination test for the detection of soluble JEV antigens, an immunofluorescent assay for the detection of cell-associated antigen and an IgM capture ELISA for the detection of virus specific IgM antibodies in the CSF were used. RESULTS Laboratory confirmation of JE was possible in 92/115 patients. Virus-specific IgM was detected in 75/92 and JEV antigen was detected in 52/92 patients. Soluble antigen was detected in 37/52, cell-associated antigen in 30/52. There was no significant difference in the sensitivity of the two antigen detection systems used. CONCLUSIONS Diagnosis by antigen detection could be done less frequently than by demonstration of virus-specific IgM antibodies in the spinal fluid. However, antigen detection proved useful during the first week of illness when IgM antibodies were not detected in the CSF.
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Affiliation(s)
- A Desai
- Department of Neurovirology, National Institute of Mental Health and Neuro Sciences, Bangalore 560029, India
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Gourie-Devi M, Gururaj G, Satishchandra P, Subbakrishna DK. Prevalence of neurological disorders in Bangalore, India: a community-based study with a comparison between urban and rural areas. Neuroepidemiology 2004; 23:261-8. [PMID: 15297791 DOI: 10.1159/000080090] [Citation(s) in RCA: 121] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A population-based neuroepidemiological survey of 102,557 individuals in urban and rural Bangalore in Southern India was conducted to determine the prevalence and pattern of neurological disorders. The study population included subjects from urban (51,502) and rural (51,055) areas, identified through a two-stage stratified random sampling method. Trained social workers administered the screening questionnaire, which had been tested and validated in an earlier pilot study and a neurologist examined the individuals who screened positive. Adults, children (<15 years) and elderly adults (>60 years) constituted 61, 34 and 5% of the study group, respectively. There was a distinct difference in education, occupation and income levels between urban and rural areas with all these parameters being lower in the rural population. In the surveyed population, 3,206 individuals with neurological disorders were detected resulting in crude and age-adjusted prevalence rates of 3,126 and 3,355 per 100,000 population, respectively. The prevalence rate among children, middle-aged (31-40 years) and elderly adults was 2,653, 3,932 and 5,012 per 100,000 population, respectively. The prevalence of neurological disorders among women (3,617) was higher compared with men (2,657). The prevalence rate in urban and rural populations was 2,190 and 4,070/1,00,000, respectively, implying that neurological disorders were twice as frequent in rural areas as in urban areas. The prevalence rates per 100,000 population of the most frequent disorders in the descending order of frequency were: headache (1,119), epilepsy (883), febrile convulsions (330), cerebrovascular disorder (150), and mental retardation (142). This large-scale population-based survey provides data that will be crucial for developing hospital and community-based neurological services in India and other developing countries.
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Affiliation(s)
- M Gourie-Devi
- Department of Neurology, National Institute of Mental Health & Neurosciences, Bangalore, India.
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Abstract
Based on data originating from neuroepidemiologic studies in India, epilepsy has been identified as a public health problem. The treatment gap varies from 50 to 70% among persons with epilepsy and is compounded further by limited availability of neurologists, often working in urban metropolises, thus restricting the availability of services in a predominantly rural agrarian country. Cost-effective, sustainable epilepsy care programs are urgently required in India. To bridge this wide gap, a district model was developed with the central focus on training the district medical officers in providing epilepsy care with sensitization of state health administrators and nodal neurologists to support and sustain the program. Workshops were conducted for all three groups during the period 1999-2001, with the involvement of 21 state health administrators, 148 district medical officers, and 28 neurologists. Preliminary evaluation indicates a growing interest, enthusiastic commitment, and willingness among health professionals to expand epilepsy care to the periphery. The program revealed that it is possible to reach people with epilepsy on the premise of early diagnosis and management, need-based referral network, and a rational planning for uninterrupted availability of antiepileptic drugs along with education of families. Policy-level initiatives are required further to transform this on a wider scale and to evaluate the efficacy and effectiveness of this approach.
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Affiliation(s)
- M Gourie-Devi
- Department of Neurology, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
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Abstract
Madras motor neuron disease (MMND) has the characteristic features of onset in the young, atrophy and weakness of the limbs, multiple cranial nerve palsies particularly the seventh, ninth to twelfth and sensorineural hearing loss with unique geographic distribution to southern part of India. During a period of 28 years (1974-2001), 7 (13%) among 54 patients of MMND seen at a tertiary referral center at Bangalore, India, had the additional features of optic atrophy in all and cerebellar involvement in three of them. There were three males and four females, the mean age at onset was 11.7 years, with a mean duration of illness of 6.4 years. All except one patient were ambulant and independent in the activities of daily living. Family history of MMND was present in more than a quarter (28.6%) of patients. Compared to MMND, these patients had onset of illness at a younger age and family history was more frequently observed, however, these differences were not statistically significant. Bulbar palsy was an invariable feature, being present in all patients compared to 38.3% of MMND and the difference was statistically significant (p=0.003). This clinical profile may be considered to be a variant of Madras motor neuron disease (MMNDV).
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Affiliation(s)
- M Gourie-Devi
- Department of Neurology, National Institute of Mental Health and Neurosciences, 506 029, Bangalore, India.
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