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Berlijn AM, Huvermann DM, Schneider S, Bellebaum C, Timmann D, Minnerop M, Peterburs J. The Role of the Human Cerebellum for Learning from and Processing of External Feedback in Non-Motor Learning: A Systematic Review. Cerebellum 2024:10.1007/s12311-024-01669-y. [PMID: 38379034 DOI: 10.1007/s12311-024-01669-y] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/07/2024] [Indexed: 02/22/2024]
Abstract
This review aimed to systematically identify and comprehensively review the role of the cerebellum in performance monitoring, focusing on learning from and on processing of external feedback in non-motor learning. While 1078 articles were screened for eligibility, ultimately 36 studies were included in which external feedback was delivered in cognitive tasks and which referenced the cerebellum. These included studies in patient populations with cerebellar damage and studies in healthy subjects applying neuroimaging. Learning performance in patients with different cerebellar diseases was heterogeneous, with only about half of all patients showing alterations. One patient study using EEG demonstrated that damage to the cerebellum was associated with altered neural processing of external feedback. Studies assessing brain activity with task-based fMRI or PET and one resting-state functional imaging study that investigated connectivity changes following feedback-based learning in healthy participants revealed involvement particularly of lateral and posterior cerebellar regions in processing of and learning from external feedback. Cerebellar involvement was found at different stages, e.g., during feedback anticipation and following the onset of the feedback stimuli, substantiating the cerebellum's relevance for different aspects of performance monitoring such as feedback prediction. Future research will need to further elucidate precisely how, where, and when the cerebellum modulates the prediction and processing of external feedback information, which cerebellar subregions are particularly relevant, and to what extent cerebellar diseases alter these processes.
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Affiliation(s)
- Adam M Berlijn
- Faculty of Mathematics and Natural Sciences, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty & University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany.
| | - Dana M Huvermann
- Faculty of Mathematics and Natural Sciences, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Neurology and Center for Translational and Behavioral Neurosciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Sandra Schneider
- Faculty of Mathematics and Natural Sciences, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Christian Bellebaum
- Faculty of Mathematics and Natural Sciences, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Dagmar Timmann
- Department of Neurology and Center for Translational and Behavioral Neurosciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Martina Minnerop
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty & University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty & Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Jutta Peterburs
- Faculty of Mathematics and Natural Sciences, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Systems Medicine and Department of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany
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Minnerop M, Leube B, Reinhardt A, Kölsche T, Lee JI, Blank C, Schnitzler A. Variable Age at Onset in AOPEP-Associated Dystonia. Mov Disord 2023; 38:2318-2319. [PMID: 38113317 DOI: 10.1002/mds.29629] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/11/2023] [Accepted: 07/24/2023] [Indexed: 12/21/2023] Open
Affiliation(s)
- Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Barbara Leube
- Institute of Human Genetics, Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Alisha Reinhardt
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Tristan Kölsche
- Department of Neurology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - John-Ih Lee
- Department of Neurology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Cornelia Blank
- Institute of Human Genetics, Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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3
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Németh AH, Antoniades CA, Dukart J, Minnerop M, Rentz C, Schuman BJ, van de Warrenburg B, Willemse I, Bertini E, Gupta AS, de Mello Monteiro CB, Almoajil H, Quinn L, Perlman SB, Horak F, Ilg W, Traschütz A, Vogel AP, Dawes H. Using Smartphone Sensors for Ataxia Trials: Consensus Guidance by the Ataxia Global Initiative Working Group on Digital-Motor Biomarkers. Cerebellum 2023:10.1007/s12311-023-01608-3. [PMID: 38015365 DOI: 10.1007/s12311-023-01608-3] [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] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 11/29/2023]
Abstract
Smartphone sensors are used increasingly in the assessment of ataxias. To date, there is no specific consensus guidance regarding a priority set of smartphone sensor measurements, or standard assessment criteria that are appropriate for clinical trials. As part of the Ataxia Global Initiative Digital-Motor Biomarkers Working Group (AGI WG4), aimed at evaluating key ataxia clinical domains (gait/posture, upper limb, speech and oculomotor assessments), we provide consensus guidance for use of internal smartphone sensors to assess key domains. Guidance was developed by means of a literature review and a two stage Delphi study conducted by an Expert panel, which surveyed members of AGI WG4, representing clinical, research, industry and patient-led experts, and consensus meetings by the Expert panel to agree on standard criteria and map current literature to these criteria. Seven publications were identified that investigated ataxias using internal smartphone sensors. The Delphi 1 survey ascertained current practice, and systems in use or under development. Wide variations in smartphones sensor use for assessing ataxia were identified. The Delphi 2 survey identified seven measures that were strongly endorsed as priorities in assessing 3/4 domains, namely gait/posture, upper limb, and speech performance. The Expert panel recommended 15 standard criteria to be fulfilled in studies. Evaluation of current literature revealed that none of the studies met all criteria, with most being early-phase validation studies. Our guidance highlights the importance of consensus, identifies priority measures and standard criteria, and will encourage further research into the use of internal smartphone sensors to measure ataxia digital-motor biomarkers.
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Affiliation(s)
- Andrea H Németh
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Chrystalina A Antoniades
- Neurometrology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Juergen Dukart
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty & University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Martina Minnerop
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty & University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty & University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Neuroscience and Medicine, (INM-1), Research Centre Jülich, Jülich, Germany
| | - Clara Rentz
- Institute of Neuroscience and Medicine, (INM-1), Research Centre Jülich, Jülich, Germany
| | | | - Bart van de Warrenburg
- Department of Neurology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, 6525, Nijmegen, Netherlands
| | - Ilse Willemse
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Enrico Bertini
- Unit of Neuromuscular and Neurodegenerative Disorders, Dept Neurosciences, Bambino Gesu' Children's Research Hospital, IRCCS, Rome, Italy
| | - Anoopum S Gupta
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Carlos Bandeira de Mello Monteiro
- Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
- School of Arts, Science and Humanities, University of São Paulo, São Paulo, SP, Brazil
| | - Hajar Almoajil
- Physical Therapy Department, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Damman, Saudi Arabia
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | | | - Fay Horak
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
- APDM Precision Motion, Clario, Portland, OR, USA
| | - Winfried Ilg
- Section Computational Sensomotorics, Hertie Institute for Clinical Brain Research, Tübingen, Germany
- Centre for Integrative Neuroscience (CIN), Tübingen, Germany
| | - Andreas Traschütz
- Research Division "Translational Genomics of Neurodegenerative Diseases", Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Adam P Vogel
- Centre for Neuroscience of Speech, The University of Melbourne, Melbourne, Australia
- Division of Translational Genomics of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Center for Neurology, University Hospital Tübingen, Tübingen, Germany
- Redenlab Inc, Melbourne, Australia
| | - Helen Dawes
- NIHR Exeter Biomedical Research Centre, Medical School, Faculty of Health and Life Sciences, College of Medicine and Health, St Lukes Campus, University of Exeter, Heavitree Road, Exeter, UK.
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Ilg W, Milne S, Schmitz-Hübsch T, Alcock L, Beichert L, Bertini E, Mohamed Ibrahim N, Dawes H, Gomez CM, Hanagasi H, Kinnunen KM, Minnerop M, Németh AH, Newman J, Ng YS, Rentz C, Samanci B, Shah VV, Summa S, Vasco G, McNames J, Horak FB. Quantitative Gait and Balance Outcomes for Ataxia Trials: Consensus Recommendations by the Ataxia Global Initiative Working Group on Digital-Motor Biomarkers. Cerebellum 2023:10.1007/s12311-023-01625-2. [PMID: 37955812 DOI: 10.1007/s12311-023-01625-2] [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] [Subscribe] [Scholar Register] [Accepted: 10/20/2023] [Indexed: 11/14/2023]
Abstract
With disease-modifying drugs on the horizon for degenerative ataxias, ecologically valid, finely granulated, digital health measures are highly warranted to augment clinical and patient-reported outcome measures. Gait and balance disturbances most often present as the first signs of degenerative cerebellar ataxia and are the most reported disabling features in disease progression. Thus, digital gait and balance measures constitute promising and relevant performance outcomes for clinical trials.This narrative review with embedded consensus will describe evidence for the sensitivity of digital gait and balance measures for evaluating ataxia severity and progression, propose a consensus protocol for establishing gait and balance metrics in natural history studies and clinical trials, and discuss relevant issues for their use as performance outcomes.
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Affiliation(s)
- Winfried Ilg
- Section Computational Sensomotorics, Hertie Institute for Clinical Brain Research, Otfried-Müller-Straße 25, 72076, Tübingen, Germany.
- Centre for Integrative Neuroscience (CIN), Tübingen, Germany.
| | - Sarah Milne
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Melbourne University, Melbourne, VIC, Australia
- Physiotherapy Department, Monash Health, Clayton, VIC, Australia
- School of Primary and Allied Health Care, Monash University, Frankston, VIC, Australia
| | - Tanja Schmitz-Hübsch
- Experimental and Clinical Research Center, a cooperation of Max-Delbrueck Center for Molecular Medicine and Charité, Universitätsmedizin Berlin, Berlin, Germany
- Neuroscience Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Lisa Alcock
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - Lukas Beichert
- Department of Neurodegenerative Diseases and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Enrico Bertini
- Research Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesu' Children's Research Hospital, IRCCS, Rome, Italy
| | | | - Helen Dawes
- NIHR Exeter BRC, College of Medicine and Health, University of Exeter, Exeter, UK
| | | | - Hasmet Hanagasi
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | | | - Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1)), Research Centre Juelich, Juelich, Germany
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty & University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty & University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Andrea H Németh
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Jane Newman
- NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, UK
- Wellcome Centre for Mitochondrial Research, Newcastle University, Newcastle upon Tyne, UK
| | - Yi Shiau Ng
- Wellcome Centre for Mitochondrial Research, Newcastle University, Newcastle upon Tyne, UK
| | - Clara Rentz
- Institute of Neuroscience and Medicine (INM-1)), Research Centre Juelich, Juelich, Germany
| | - Bedia Samanci
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Vrutangkumar V Shah
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
- APDM Precision Motion, Clario, Portland, OR, USA
| | - Susanna Summa
- Movement Analysis and Robotics Laboratory (MARLab), Neurorehabilitation Unit, Neurological Science and Neurorehabilitation Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Gessica Vasco
- Movement Analysis and Robotics Laboratory (MARLab), Neurorehabilitation Unit, Neurological Science and Neurorehabilitation Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - James McNames
- APDM Precision Motion, Clario, Portland, OR, USA
- Department of Electrical and Computer Engineering, Portland State University, Portland, OR, USA
| | - Fay B Horak
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
- APDM Precision Motion, Clario, Portland, OR, USA
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5
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Traschütz A, Adarmes-Gómez AD, Anheim M, Baets J, Brais B, Gagnon C, Gburek-Augustat J, Doss S, Hanağası HA, Kamm C, Klivenyi P, Klockgether T, Klopstock T, Minnerop M, Münchau A, Renaud M, Santorelli FM, Schöls L, Thieme A, Vielhaber S, van de Warrenburg BP, Zanni G, Hilgers RD, Synofzik M. Responsiveness of the Scale for the Assessment and Rating of Ataxia and Natural History in 884 Recessive and Early Onset Ataxia Patients. Ann Neurol 2023; 94:470-485. [PMID: 37243847 DOI: 10.1002/ana.26712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/04/2022] [Revised: 04/04/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE The Scale for the Assessment and Rating of Ataxia (SARA) is the most widely applied clinical outcome assessment (COA) for genetic ataxias, but presents metrological and regulatory challenges. To facilitate trial planning, we characterize its responsiveness (including subitem-level relations to ataxia severity and patient-focused outcomes) across a large number of ataxias, and provide first natural history data for several of them. METHODS Subitem-level correlation and distribution-based analysis of 1,637 SARA assessments in 884 patients with autosomal recessive/early onset ataxia (370 with 2-8 longitudinal assessments) were complemented by linear mixed effects modeling to estimate progression and sample sizes. RESULTS Although SARA subitem responsiveness varied between ataxia severities, gait/stance showed a robust granular linear scaling across the broadest range (SARA < 25). Responsiveness was diminished by incomplete subscale use at intermediate or upper levels, nontransitions ("static periods"), and fluctuating decreases/increases. All subitems except nose-finger showed moderate-to-strong correlations to activities of daily living, indicating that metric properties-not content validity-limit SARA responsiveness. SARA captured mild-to-moderate progression in many genotypes (eg, SYNE1-ataxia: 0.55 points/yr, ataxia with oculomotor apraxia type 2: 1.14 points/yr, POLG-ataxia: 1.56 points/yr), but no change in others (autosomal recessive spastic ataxia of Charlevoix-Saguenay, COQ8A-ataxia). Whereas sensitivity to change was optimal in mild ataxia (SARA < 10), it substantially deteriorated in advanced ataxia (SARA > 25; 2.7-fold sample size). Use of a novel rank-optimized SARA without subitems finger-chase and nose-finger reduces sample sizes by 20 to 25%. INTERPRETATION This study comprehensively characterizes COA properties and annualized changes of the SARA across and within a large number of ataxias. It suggests specific approaches for optimizing its responsiveness that might facilitate regulatory qualification and trial design. ANN NEUROL 2023;94:470-485.
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Affiliation(s)
- Andreas Traschütz
- Research Division "Translational Genomics of Neurodegenerative Diseases," Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Astrid D Adarmes-Gómez
- Movement Disorders Unit, Department of Neurology and Clinical Neurophysiology, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital/CSIC/University of Seville, Seville, Spain
- Center for Biomedical Research Network on Neurodegenerative Diseases, Madrid, Spain
| | - Mathieu Anheim
- Department of Neurology, Hautepierre Hospital, University Hospitals of Strasbourg, Strasbourg, France
- Federation of Translational Medicine of Strasbourg, University of Strasbourg, Strasbourg, France
- Institute of Genetics and Molecular and Cellular Biology, INSERM-U964/CNRS-UMR7104/University of Strasbourg, Illkirch, France
| | - Jonathan Baets
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
- Neuromuscular Reference Center, Department of Neurology, Antwerp University Hospital, Antwerp, Belgium
| | - Bernard Brais
- Department of Neurology, McGill University, Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Cynthia Gagnon
- CHUS Research Center and Health and Social Services Center of Saguenay-Lac-Saint-Jean, Faculty of Medicine, University of Sherbrooke, Quebec, Quebec, Canada
| | - Janina Gburek-Augustat
- Division of Neuropediatrics, Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany
| | - Sarah Doss
- Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Free University of Berlin, Humboldt University of Berlin, Berlin, Germany
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Haşmet A Hanağası
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Christoph Kamm
- Department of Neurology, University of Rostock, Rostock, Germany
| | - Peter Klivenyi
- Interdisciplinary Excellence Center, Department of Neurology, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Thomas Klockgether
- Department of Neurology, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Thomas Klopstock
- Department of Neurology, Friedrich Baur Institute, Ludwig Maximilian University of Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
| | - Martina Minnerop
- Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Alexander Münchau
- Institute of Systems Motor Science, Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Mathilde Renaud
- Clinical Genetics Service, CHRU of Nancy, Nancy, France
- INSERM-U1256 NGERE, University of Lorraine, Nancy, France
| | | | - Ludger Schöls
- Research Division "Translational Genomics of Neurodegenerative Diseases," Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Andreas Thieme
- Department of Neurology and Center for Translational Neuro and Behavioral Sciences, Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Stefan Vielhaber
- Department of Neurology, Otto von Guericke University, Magdeburg, Germany
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Center for Behavioral Brain Sciences, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Bart P van de Warrenburg
- Department of Neurology, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ginevra Zanni
- Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Childrens' Hospital, IRCCS, Rome, Italy
| | | | - Matthis Synofzik
- Research Division "Translational Genomics of Neurodegenerative Diseases," Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
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6
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Cunha P, Petit E, Coutelier M, Coarelli G, Mariotti C, Faber J, Van Gaalen J, Damasio J, Fleszar Z, Tosi M, Rocca C, De Michele G, Minnerop M, Ewenczyk C, Santorelli FM, Heinzmann A, Bird T, Amprosi M, Indelicato E, Benussi A, Charles P, Stendel C, Romano S, Scarlato M, Le Ber I, Bassi MT, Serrano M, Schmitz-Hübsch T, Doss S, Van Velzen GAJ, Thomas Q, Trabacca A, Ortigoza-Escobar JD, D'Arrigo S, Timmann D, Pantaleoni C, Martinuzzi A, Besse-Pinot E, Marsili L, Cioffi E, Nicita F, Giorgetti A, Moroni I, Romaniello R, Casali C, Ponger P, Casari G, De Bot ST, Ristori G, Blumkin L, Borroni B, Goizet C, Marelli C, Boesch S, Anheim M, Filla A, Houlden H, Bertini E, Klopstock T, Synofzik M, Riant F, Zanni G, Magri S, Di Bella D, Nanetti L, Sequeiros J, Oliveira J, Van de Warrenburg B, Schöls L, Taroni F, Brice A, Durr A. Extreme phenotypic heterogeneity in non-expansion spinocerebellar ataxias. Am J Hum Genet 2023; 110:1098-1109. [PMID: 37301203 PMCID: PMC10357418 DOI: 10.1016/j.ajhg.2023.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 03/26/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
Although the best-known spinocerebellar ataxias (SCAs) are triplet repeat diseases, many SCAs are not caused by repeat expansions. The rarity of individual non-expansion SCAs, however, has made it difficult to discern genotype-phenotype correlations. We therefore screened individuals who had been found to bear variants in a non-expansion SCA-associated gene through genetic testing, and after we eliminated genetic groups that had fewer than 30 subjects, there were 756 subjects bearing single-nucleotide variants or deletions in one of seven genes: CACNA1A (239 subjects), PRKCG (175), AFG3L2 (101), ITPR1 (91), STUB1 (77), SPTBN2 (39), or KCNC3 (34). We compared age at onset, disease features, and progression by gene and variant. There were no features that reliably distinguished one of these SCAs from another, and several genes-CACNA1A, ITPR1, SPTBN2, and KCNC3-were associated with both adult-onset and infantile-onset forms of disease, which also differed in presentation. Nevertheless, progression was overall very slow, and STUB1-associated disease was the fastest. Several variants in CACNA1A showed particularly wide ranges in age at onset: one variant produced anything from infantile developmental delay to ataxia onset at 64 years of age within the same family. For CACNA1A, ITPR1, and SPTBN2, the type of variant and charge change on the protein greatly affected the phenotype, defying pathogenicity prediction algorithms. Even with next-generation sequencing, accurate diagnosis requires dialogue between the clinician and the geneticist.
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Affiliation(s)
- Paulina Cunha
- Sorbonne Université, Paris Brain Institute (ICM), Pitié-Salpêtrière Hospital, AP-HP, INSERM, CNRS, University Hospital Pitié-Salpêtrière, CS21414, 75646 PARIS Cedex 13, France
| | - Emilien Petit
- Sorbonne Université, Paris Brain Institute (ICM), Pitié-Salpêtrière Hospital, AP-HP, INSERM, CNRS, University Hospital Pitié-Salpêtrière, CS21414, 75646 PARIS Cedex 13, France
| | - Marie Coutelier
- Sorbonne Université, Paris Brain Institute (ICM), Pitié-Salpêtrière Hospital, AP-HP, INSERM, CNRS, University Hospital Pitié-Salpêtrière, CS21414, 75646 PARIS Cedex 13, France
| | - Giulia Coarelli
- Sorbonne Université, Paris Brain Institute (ICM), Pitié-Salpêtrière Hospital, AP-HP, INSERM, CNRS, University Hospital Pitié-Salpêtrière, CS21414, 75646 PARIS Cedex 13, France
| | - Caterina Mariotti
- Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Jennifer Faber
- German Center for Neurodegenerative Disease (DZNE), 53127 Bonn, Germany; Department of Neurology, University Hospital of Bonn, 53111 Bonn, Germany
| | - Judith Van Gaalen
- Department of Neurology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, 6525 Nijmegen, the Netherlands
| | - Joana Damasio
- Neurology Department, Hospital de Santo António, Centro Hospitalar Universitário de Santo António, 4099-001 Porto, Portugal; CGPP, IBMC-Institute for Molecular and Cell Biology & UnIGENe, i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal
| | - Zofia Fleszar
- German Center for Neurodegenerative Disease (DZNE), 72076 Tübingen, Germany; Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research & Center of Neurology, University of Tübingen, 72076 Tübingen, Germany
| | - Michele Tosi
- Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesu' Children's Research Hospital, IRCCS, 00165 Rome, Italy
| | - Clarissa Rocca
- Department of Neuromuscular Diseases, UCL Queen's Square Institute of Neurology, Queen's Square House, Queen's Square, WC1N 3BG London, UK
| | - Giovanna De Michele
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, 52428 Jülich, Germany; Institute of Clinical Neuroscience and Medical Psychology and Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty & University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany
| | - Claire Ewenczyk
- Sorbonne Université, Paris Brain Institute (ICM), Pitié-Salpêtrière Hospital, AP-HP, INSERM, CNRS, University Hospital Pitié-Salpêtrière, CS21414, 75646 PARIS Cedex 13, France
| | - Filippo M Santorelli
- Molecular Medicine & Neurogenetics, IRCCS Fondazione Stella Maris, 56128 Calambrone, Italy
| | - Anna Heinzmann
- Sorbonne Université, Paris Brain Institute (ICM), Pitié-Salpêtrière Hospital, AP-HP, INSERM, CNRS, University Hospital Pitié-Salpêtrière, CS21414, 75646 PARIS Cedex 13, France
| | - Thomas Bird
- University of Washington, Seattle, WA 98195, USA
| | - Matthias Amprosi
- Center for Rare Movement Disorders, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Elisabetta Indelicato
- Center for Rare Movement Disorders, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Alberto Benussi
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, Italy
| | - Perrine Charles
- Sorbonne Université, Paris Brain Institute (ICM), Pitié-Salpêtrière Hospital, AP-HP, INSERM, CNRS, University Hospital Pitié-Salpêtrière, CS21414, 75646 PARIS Cedex 13, France
| | - Claudia Stendel
- German Center for Neurodegenerative Disease (DZNE), München, Germany; Department of Neurology, Friedrich-Baur Institute, University Hospital of Ludwig-Maximilians-University, Munich Cluster for Systems Neurology (SyNergy), 80336 Munich, Germany
| | - Silvia Romano
- Neurosciences, Mental Health, and Sensory Organs (NESMOS) Department, S. Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy
| | - Marina Scarlato
- San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Isabelle Le Ber
- Sorbonne Université, Paris Brain Institute (ICM), Pitié-Salpêtrière Hospital, AP-HP, INSERM, CNRS, University Hospital Pitié-Salpêtrière, CS21414, 75646 PARIS Cedex 13, France
| | - Maria Teresa Bassi
- Scientific Institute I.R.C.C.S. Eugenio Medea, 23842 Bosisio Parini, Italy
| | - Mercedes Serrano
- Pediatric Neurology Department, Sant Joan de Déu Hospital, 08950 Barcelona, Spain
| | - Tanja Schmitz-Hübsch
- Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Sarah Doss
- Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Gijs A J Van Velzen
- Department of Neurology, Leiden University Medical Center, 2333 Leiden, the Netherlands
| | - Quentin Thomas
- Department of Clinical Genetics, Dijon University Hospital, 21000 Dijon, France
| | - Antonio Trabacca
- Scientific Institute I.R.C.C.S. Eugenio Medea, 23842 Bosisio Parini, Italy
| | | | - Stefano D'Arrigo
- Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Dagmar Timmann
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, 45147 Essen, Germany
| | - Chiara Pantaleoni
- Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Andrea Martinuzzi
- Scientific Institute I.R.C.C.S. Eugenio Medea, 23842 Bosisio Parini, Italy
| | - Elsa Besse-Pinot
- Department of Neurology, Clermont-Ferrand University Hospital, 63000 Clermont-Ferrand, France
| | - Luca Marsili
- Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH 45219, USA
| | - Ettore Cioffi
- Sapienza University of Rome, Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino, 04100 Latina, Italy
| | - Francesco Nicita
- Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesu' Children's Research Hospital, IRCCS, 00165 Rome, Italy
| | - Alejandro Giorgetti
- Computational Biomedicine, Institute for Advanced Simulations IAS-5 and Institute of Neuroscience and Medicine INM-9, Forschungszentrum Jülich GmbH, 52428 Jülich, Germany; Department of Biotechnology, Università degli Studi di Verona, 37134 Verona, Italy
| | - Isabella Moroni
- Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Romina Romaniello
- Scientific Institute I.R.C.C.S. Eugenio Medea, 23842 Bosisio Parini, Italy
| | - Carlo Casali
- Sapienza University of Rome, Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino, 04100 Latina, Italy
| | - Penina Ponger
- Neurology Department, Tel-Aviv Sourasky Medical Center, 6329302 Tel-Aviv, Israel; Sackler School of Medicine, Tel-Aviv University, 6997801 Tel-Aviv, Israel
| | - Giorgio Casari
- San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Susanne T De Bot
- Department of Neurology, Leiden University Medical Center, 2333 Leiden, the Netherlands
| | - Giovanni Ristori
- Neurosciences, Mental Health, and Sensory Organs (NESMOS) Department, S. Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy
| | - Lubov Blumkin
- Sackler School of Medicine, Tel-Aviv University, 6997801 Tel-Aviv, Israel; Pediatric Movement Disorders Clinic, Pediatric Neurology Unit, Wolfson Medical Center, 5822012 Holon, Israel
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, Italy
| | - Cyril Goizet
- University Bordeaux, Equipe « Neurogénétique Translationnelle - NRGEN », INCIA CNRS UMR5287 Université Bordeaux and Centre de Reference Maladies Rares « Neurogénétique », Service de Génétique Médicale, Bordeaux University Hospital (CHU Bordeaux), 33000 Bordeaux, France
| | - Cecilia Marelli
- MMDN, University Montpellier, EPHE, INSERM and Expert Center for Neurogenetic Diseases, CHU, 34095 Montpellier, France
| | - Sylvia Boesch
- Center for Rare Movement Disorders, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Mathieu Anheim
- Department of Neurology, Strasbourg University Hospital, 67098 Strasbourg, France; Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964; CNRS-UMR7104; University of Strasbourg, 67400 Illkirch-Graffenstaden, France
| | - Alessandro Filla
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Henry Houlden
- Department of Neuromuscular Diseases, UCL Queen's Square Institute of Neurology, Queen's Square House, Queen's Square, WC1N 3BG London, UK
| | - Enrico Bertini
- Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesu' Children's Research Hospital, IRCCS, 00165 Rome, Italy
| | - Thomas Klopstock
- German Center for Neurodegenerative Disease (DZNE), München, Germany; Department of Neurology, Friedrich-Baur Institute, University Hospital of Ludwig-Maximilians-University, Munich Cluster for Systems Neurology (SyNergy), 80336 Munich, Germany
| | - Matthis Synofzik
- German Center for Neurodegenerative Disease (DZNE), 72076 Tübingen, Germany; Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research & Center of Neurology, University of Tübingen, 72076 Tübingen, Germany
| | - Florence Riant
- Department of Neurovascular Molecular Genetics, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, 75010 Paris, France
| | - Ginevra Zanni
- Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesu' Children's Research Hospital, IRCCS, 00165 Rome, Italy
| | - Stefania Magri
- Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Daniela Di Bella
- Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Lorenzo Nanetti
- Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Jorge Sequeiros
- CGPP, IBMC-Institute for Molecular and Cell Biology & UnIGENe, i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal
| | - Jorge Oliveira
- CGPP, IBMC-Institute for Molecular and Cell Biology & UnIGENe, i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal
| | - Bart Van de Warrenburg
- Department of Neurology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, 6525 Nijmegen, the Netherlands
| | - Ludger Schöls
- German Center for Neurodegenerative Disease (DZNE), 72076 Tübingen, Germany; Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research & Center of Neurology, University of Tübingen, 72076 Tübingen, Germany
| | - Franco Taroni
- Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Alexis Brice
- Sorbonne Université, Paris Brain Institute (ICM), Pitié-Salpêtrière Hospital, AP-HP, INSERM, CNRS, University Hospital Pitié-Salpêtrière, CS21414, 75646 PARIS Cedex 13, France
| | - Alexandra Durr
- Sorbonne Université, Paris Brain Institute (ICM), Pitié-Salpêtrière Hospital, AP-HP, INSERM, CNRS, University Hospital Pitié-Salpêtrière, CS21414, 75646 PARIS Cedex 13, France.
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7
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Jäschke D, Steiner KM, Chang DI, Claaßen J, Uslar E, Thieme A, Gerwig M, Pfaffenrot V, Hulst T, Gussew A, Maderwald S, Göricke SL, Minnerop M, Ladd ME, Reichenbach JR, Timmann D, Deistung A. Age-related differences of cerebellar cortex and nuclei: MRI findings in healthy controls and its application to spinocerebellar ataxia (SCA6) patients. Neuroimage 2023; 270:119950. [PMID: 36822250 DOI: 10.1016/j.neuroimage.2023.119950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/06/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023] Open
Abstract
Understanding cerebellar alterations due to healthy aging provides a reference point against which pathological findings in late-onset disease, for example spinocerebellar ataxia type 6 (SCA6), can be contrasted. In the present study, we investigated the impact of aging on the cerebellar nuclei and cerebellar cortex in 109 healthy controls (age range: 16 - 78 years) using 3 Tesla magnetic resonance imaging (MRI). Findings were compared with 25 SCA6 patients (age range: 38 - 78 years). A subset of 16 SCA6 (included: 14) patients and 50 controls (included: 45) received an additional MRI scan at 7 Tesla and were re-scanned after one year. MRI included T1-weighted, T2-weighted FLAIR, and multi-echo T2*-weighted imaging. The T2*-weighted phase images were converted to quantitative susceptibility maps (QSM). Since the cerebellar nuclei are characterized by elevated iron content with respect to their surroundings, two independent raters manually outlined them on the susceptibility maps. T1-weighted images acquired at 3T were utilized to automatically identify the cerebellar gray matter (GM) volume. Linear correlations revealed significant atrophy of the cerebellum due to tissue loss of cerebellar cortical GM in healthy controls with increasing age. Reduction of the cerebellar GM was substantially stronger in SCA6 patients. The volume of the dentate nuclei did not exhibit a significant relationship with age, at least in the age range between 18 and 78 years, whereas mean susceptibilities of the dentate nuclei increased with age. As previously shown, the dentate nuclei volumes were smaller and magnetic susceptibilities were lower in SCA6 patients compared to age- and sex-matched controls. The significant dentate volume loss in SCA6 patients could also be confirmed with 7T MRI. Linear mixed effects models and individual paired t-tests accounting for multiple comparisons revealed no statistical significant change in volume and susceptibility of the dentate nuclei after one year in neither patients nor controls. Importantly, dentate volumes were more sensitive to differentiate between SCA6 (Cohen's d = 3.02) and matched controls than the cerebellar cortex volume (d = 2.04). In addition to age-related decline of the cerebellar cortex and atrophy in SCA6 patients, age-related increase of susceptibility of the dentate nuclei was found in controls, whereas dentate volume and susceptibility was significantly decreased in SCA6 patients. Because no significant changes of any of these parameters was found at follow-up, these measures do not allow to monitor disease progression at short intervals.
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Affiliation(s)
- Dominik Jäschke
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen 45147, Germany; Department of Radiology and Nuclear Medicine, University Hospital Basel, Basel 4031, Switzerland
| | - Katharina M Steiner
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen 45147, Germany; LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Duisburg-Essen, Essen 45147, Germany
| | - Dae-In Chang
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen 45147, Germany; Clinic for Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital of the Ruhr-University Bochum, Bochum 44791, Germany
| | - Jens Claaßen
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen 45147, Germany; Fachklinik für Neurologie, MEDICLIN Klinik Reichshof, Reichshof-Eckenhagen 51580, Germany
| | - Ellen Uslar
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen 45147, Germany
| | - Andreas Thieme
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen 45147, Germany
| | - Marcus Gerwig
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen 45147, Germany
| | - Viktor Pfaffenrot
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen 45141, Germany
| | - Thomas Hulst
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen 45147, Germany; Erasmus University College, Rotterdam 3011 HP, the Netherlands
| | - Alexander Gussew
- University Clinic and Outpatient Clinic for Radiology, Department for Radiation Medicine, University Hospital Halle (Saale), Ernst-Grube-Str. 40, Halle (Saale) 06120, Germany
| | - Stefan Maderwald
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen 45141, Germany
| | - Sophia L Göricke
- Institute of Diagnostic and Interventional Neuroradiology, Essen University Hospital, University of Duisburg-Essen, Essen 45141, Germany
| | - Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, Juelich 52425, Germany; Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf 40225, Germany; Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf 40225, Germany
| | - Mark E Ladd
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen 45141, Germany; Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany; Faculty of Physics and Astronomy and Faculty of Medicine, Heidelberg University, Heidelberg 69120, Germany
| | - Jürgen R Reichenbach
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Jena 07743, Germany
| | - Dagmar Timmann
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen 45147, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen 45141, Germany
| | - Andreas Deistung
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen 45147, Germany; University Clinic and Outpatient Clinic for Radiology, Department for Radiation Medicine, University Hospital Halle (Saale), Ernst-Grube-Str. 40, Halle (Saale) 06120, Germany; Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Jena 07743, Germany.
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8
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Traschütz A, Adarmes-Gomez AD, Anheim M, Baets J, Falkenburger BH, Gburek-Augustat J, Doss S, Kamm C, Klivenyi P, Grobe-Einsler M, Klopstock T, Minnerop M, Münchau A, Pane C, Renaud M, Santorelli FM, Schöls L, Timmann D, Vielhaber S, Haack TB, van de Warrenburg BP, Zanni G, Synofzik M. Autosomal Recessive Cerebellar Ataxias in Europe: Frequency, Onset, and Severity in 677 Patients. Mov Disord 2023. [PMID: 37027459 DOI: 10.1002/mds.29397] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/01/2023] [Accepted: 03/21/2023] [Indexed: 04/08/2023] Open
Affiliation(s)
- Andreas Traschütz
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Astrid D Adarmes-Gomez
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas, Madrid, Spain
| | - Mathieu Anheim
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch, France
| | - Jonathan Baets
- Translational Neurosciences, Faculty of Medicine and Health Sciences, UAntwerpen, Antwerp, Belgium
- Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
- Neuromuscular Reference Centre, Department of Neurology, Antwerp University Hospital, Antwerp, Belgium
| | | | - Janina Gburek-Augustat
- Division of Neuropaediatrics, Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany
| | - Sarah Doss
- Department of Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Christoph Kamm
- Department of Neurology, University of Rostock, Rostock, Germany
| | - Peter Klivenyi
- Interdisciplinary Excellence Centre, Department of Neurology, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Marcus Grobe-Einsler
- Department of Neurology, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Thomas Klopstock
- Department of Neurology, Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich, Munich, Germany
- German Center for Neurodegenerative Diseases, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, Juelich, Germany
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty & University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty & University Hospital Düsseldorf, Heinrich-Heine University, Düsseldorf, Germany
| | - Alexander Münchau
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Chiara Pane
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | - Mathilde Renaud
- Service de Génétique Clinique, CHRU de Nancy, Nancy, France
- INSERM-U1256 NGERE, Université de Lorraine, Nancy, France
| | | | - Ludger Schöls
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Dagmar Timmann
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences, Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Stefan Vielhaber
- Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany
- German Center for Neurodegenerative Diseases within the Helmholtz Association, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Tobias B Haack
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Bart P van de Warrenburg
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ginevra Zanni
- Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Childrens' Hospital, IRCCS, Rome, Italy
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
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9
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Rentz C, Far MS, Boltes M, Schnitzler A, Amunts K, Dukart J, Minnerop M. System Comparison for Gait and Balance Monitoring Used for the Evaluation of a Home-Based Training. Sensors (Basel) 2022; 22:4975. [PMID: 35808470 PMCID: PMC9269735 DOI: 10.3390/s22134975] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
There are currently no standard methods for evaluating gait and balance performance at home. Smartphones include acceleration sensors and may represent a promising and easily accessible tool for this purpose. We performed an interventional feasibility study and compared a smartphone-based approach with two standard gait analysis systems (force plate and motion capturing systems). Healthy adults (n = 25, 44.1 ± 18.4 years) completed two laboratory evaluations before and after a three-week gait and balance training at home. There was an excellent agreement between all systems for stride time and cadence during normal, tandem and backward gait, whereas correlations for gait velocity were lower. Balance variables of both standard systems were moderately intercorrelated across all stance tasks, but only few correlated with the corresponding smartphone measures. Significant differences over time were found for several force plate and mocap system-obtained gait variables of normal, backward and tandem gait. Changes in balance variables over time were more heterogeneous and not significant for any system. The smartphone seems to be a suitable method to measure cadence and stride time of different gait, but not balance, tasks in healthy adults. Additional optimizations in data evaluation and processing may further improve the agreement between the analysis systems.
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Affiliation(s)
- Clara Rentz
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, 52428 Juelich, Germany; (K.A.); (M.M.)
| | - Mehran Sahandi Far
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Juelich, 52428 Juelich, Germany; (M.S.F.); (J.D.)
- Institute of Systems Neuroscience, Medical Faculty, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Maik Boltes
- Institute for Advanced Simulation (IAS-7), Research Centre Juelich, 52428 Juelich, Germany;
| | - Alfons Schnitzler
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany;
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Katrin Amunts
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, 52428 Juelich, Germany; (K.A.); (M.M.)
- C. and O. Vogt Institute for Brain Research, Medical Faculty, University Hospital Duesseldorf, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Juergen Dukart
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Juelich, 52428 Juelich, Germany; (M.S.F.); (J.D.)
- Institute of Systems Neuroscience, Medical Faculty, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, 52428 Juelich, Germany; (K.A.); (M.M.)
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany;
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany
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10
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Cordts I, Önder D, Traschütz A, Kobeleva X, Karin I, Minnerop M, Koertvelyessy P, Biskup S, Forchhammer S, Binder J, Tzschach A, Meiss F, Schmidt A, Kreiß M, Cremer K, Mensah MA, Park J, Rautenberg M, Deininger N, Sturm M, Lingor P, Klopstock T, Weiler M, Marxreiter F, Synofzik M, Posch C, Sirokay J, Klockgether T, Haack TB, Deschauer M. Adult-Onset Neurodegeneration in Nucleotide Excision Repair Disorders (NERD ND ): Time to Move Beyond the Skin. Mov Disord 2022; 37:1707-1718. [PMID: 35699229 DOI: 10.1002/mds.29071] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 01/05/2022] [Revised: 03/06/2022] [Accepted: 03/21/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Variants in genes of the nucleotide excision repair (NER) pathway have been associated with heterogeneous clinical presentations ranging from xeroderma pigmentosum to Cockayne syndrome and trichothiodystrophy. NER deficiencies manifest with photosensitivity and skin cancer, but also developmental delay and early-onset neurological degeneration. Adult-onset neurological features have been reported in only a few xeroderma pigmentosum cases, all showing at least mild skin manifestations. OBJECTIVE The aim of this multicenter study was to investigate the frequency and clinical features of patients with biallelic variants in NER genes who are predominantly presenting with neurological signs. METHODS In-house exome and genome datasets of 14,303 patients, including 3543 neurological cases, were screened for deleterious variants in NER-related genes. Clinical workup included in-depth neurological and dermatological assessments. RESULTS We identified 13 patients with variants in ERCC4 (n = 8), ERCC2 (n = 4), or XPA (n = 1), mostly proven biallelic, including five different recurrent and six novel variants. All individuals had adult-onset progressive neurological deterioration with ataxia, dementia, and frequently chorea, neuropathy, and spasticity. Brain magnetic resonance imaging showed profound global brain atrophy in all patients. Dermatological examination did not show any skin cancer or pronounced ultraviolet damage. CONCLUSIONS We introduce NERDND as adult-onset neurodegeneration (ND ) within the spectrum of autosomal recessive NER disorders (NERD). Our study demonstrates that NERDND is probably an underdiagnosed cause of neurodegeneration in adulthood and should be considered in patients with overlapping cognitive and movement abnormalities. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Isabell Cordts
- Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Demet Önder
- Department of Neurology, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Andreas Traschütz
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Xenia Kobeleva
- Department of Neurology, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Ivan Karin
- Friedrich-Baur-Institute, Department of Neurology, University Hospital of the Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
| | - Martina Minnerop
- Institute of Neuroscience and Medicine, Research Centre Jülich, Jülich, Germany.,Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Peter Koertvelyessy
- Department of Neurology, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Saskia Biskup
- CeGaT GmbH und Praxis für Humangenetik Tübingen, Tübingen, Germany
| | - Stephan Forchhammer
- Division of Dermatooncology, Department of Dermatology, University of Tübingen, Tübingen, Germany
| | | | - Andreas Tzschach
- Institute of Human Genetics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Frank Meiss
- Department of Dermatology and Venereology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Axel Schmidt
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
| | - Martina Kreiß
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
| | - Kirsten Cremer
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
| | - Martin A Mensah
- Institute of Medical Genetics and Human Genetics, Charité-Universitätsmedizin Berlin, Berlin, Germany.,BIH Biomedical Innovation Academy, Digital Clinician Scientist Program, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Germany
| | - Joohyun Park
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Maren Rautenberg
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Natalie Deininger
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Marc Sturm
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Paul Lingor
- Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Thomas Klopstock
- Friedrich-Baur-Institute, Department of Neurology, University Hospital of the Ludwig-Maximilians-University (LMU) Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,German Center for Neurodegenerative Diseases, Munich, Germany
| | - Markus Weiler
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Franz Marxreiter
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Center for Rare Diseases (ZSEER), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Matthis Synofzik
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Christian Posch
- Department of Dermatology and Allergy, School of Medicine, German Cancer Consortium, Technical University of Munich, Munich, Germany.,Faculty of Medicine, Sigmund Freud University Vienna, Vienna, Austria
| | - Judith Sirokay
- Department of Dermatology and Allergy, University Hospital Bonn, Bonn, Germany
| | - Thomas Klockgether
- Department of Neurology, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Tobias B Haack
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.,Centre for Rare Diseases, University of Tübingen, Tübingen, Germany
| | - Marcus Deschauer
- Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
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11
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Thieme A, Faber J, Sulzer P, Reetz K, Dogan I, Barkhoff M, Krahe J, Jacobi H, Aktories JE, Minnerop M, Elben S, van der Veen R, Müller J, Batsikadze G, Konczak J, Synofzik M, Roeske S, Timmann D. The CCAS-scale in hereditary ataxias: helpful on the group level, particularly in SCA3, but limited in individual patients. J Neurol 2022; 269:4363-4374. [PMID: 35364683 PMCID: PMC9293809 DOI: 10.1007/s00415-022-11071-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 11/11/2021] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 12/02/2022]
Abstract
Background A brief bedside test has recently been introduced by Hoche et al. (Brain, 2018) to screen for the Cerebellar Cognitive Affective Syndrome (CCAS) in patients with cerebellar disease. Objective This multicenter study tested the ability of the CCAS-Scale to diagnose CCAS in individual patients with common forms of hereditary ataxia. Methods A German version of the CCAS-Scale was applied in 30 SCA3, 14 SCA6 and 20 FRDA patients, and 64 healthy participants matched for age, sex, and level of education. Based on original cut-off values, the number of failed test items was assessed, and CCAS was considered possible (one failed item), probable (two failed items) or definite (three failed items). In addition a total sum raw score was calculated. Results On a group level, failed items were significantly higher and total sum scores were significantly lower in SCA3 patients compared to matched controls. SCA6 and FRDA patients performed numerically below controls, but respective group differences failed to reach significance. The ability of the CCAS-Scale to diagnose CCAS in individual patients was limited to severe cases failing three or more items. Milder cases failing one or two items showed a great overlap with the performance of controls exhibiting a substantial number of false-positive test results. The word fluency test items differentiated best between patients and controls. Conclusions As a group, SCA3 patients performed below the level of SCA6 and FRDA patients, possibly reflecting additional cerebral involvement. Moreover, the application of the CCAS-Scale in its present form results in a high number of false-positive test results, that is identifying controls as patients, reducing its usefulness as a screening tool for CCAS in individual patients. Supplementary Information The online version contains supplementary material available at 10.1007/s00415-022-11071-5.
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Affiliation(s)
- Andreas Thieme
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
| | - Jennifer Faber
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Helmholtz Association, Venusberg-Campus 1/99, 53127, Bonn, Germany.,Department of Neurology, Bonn University Hospital, Rheinische Friedrich-Wilhelms University Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Patricia Sulzer
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, Eberhard-Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE) Tübingen, Helmholtz Association, Otfried-Müller-Str. 23, 72076, Tübingen, Germany
| | - Kathrin Reetz
- JARA-BRAIN Institute, Molecular Neuroscience and Neuroimaging, Research Center Jülich, Wilhelm-Johnen-Str., 52425, Jülich, Germany.,Department of Neurology, Aachen University Hospital, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Pauwelstr. 30, 52074, Aachen, Germany
| | - Imis Dogan
- JARA-BRAIN Institute, Molecular Neuroscience and Neuroimaging, Research Center Jülich, Wilhelm-Johnen-Str., 52425, Jülich, Germany.,Department of Neurology, Aachen University Hospital, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Pauwelstr. 30, 52074, Aachen, Germany
| | - Miriam Barkhoff
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Helmholtz Association, Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Janna Krahe
- JARA-BRAIN Institute, Molecular Neuroscience and Neuroimaging, Research Center Jülich, Wilhelm-Johnen-Str., 52425, Jülich, Germany.,Department of Neurology, Aachen University Hospital, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Pauwelstr. 30, 52074, Aachen, Germany
| | - Heike Jacobi
- Department of Neurology, Heidelberg University Hospital, Ruprecht-Karls University Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Julia-Elisabeth Aktories
- Department of Neurology, Heidelberg University Hospital, Ruprecht-Karls University Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Martina Minnerop
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.,Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Wilhelm-Johnen-Str., 52425, Jülich, Germany
| | - Saskia Elben
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Raquel van der Veen
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Johanna Müller
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Giorgi Batsikadze
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Jürgen Konczak
- School of Kinesiology, University of Minnesota, 400 Cooke Hall 1900 University Ave S E, Minneapolis, MN, 55455, USA
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, Eberhard-Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE) Tübingen, Helmholtz Association, Otfried-Müller-Str. 23, 72076, Tübingen, Germany
| | - Sandra Roeske
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Helmholtz Association, Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Dagmar Timmann
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
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12
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Pieperhoff P, Südmeyer M, Dinkelbach L, Hartmann CJ, Ferrea S, Moldovan AS, Minnerop M, Diaz-Pier S, Schnitzler A, Amunts K. Regional changes of brain structure during progression of idiopathic Parkinson’s disease – a longitudinal study using deformation based morphometry. Cortex 2022; 151:188-210. [DOI: 10.1016/j.cortex.2022.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 02/04/2022] [Accepted: 03/12/2022] [Indexed: 12/14/2022]
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13
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Deistung A, Jäschke D, Draganova R, Pfaffenrot V, Hulst T, Steiner KM, Thieme A, Giordano IA, Klockgether T, Tunc S, Münchau A, Minnerop M, Göricke SL, Reichenbach JR, Timmann D. Quantitative susceptibility mapping reveals alterations of dentate nuclei in common types of degenerative cerebellar ataxias. Brain Commun 2022; 4:fcab306. [PMID: 35291442 PMCID: PMC8914888 DOI: 10.1093/braincomms/fcab306] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 10/28/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
The cerebellar nuclei are a brain region with high iron content. Surprisingly,
little is known about iron content in the cerebellar nuclei and its possible
contribution to pathology in cerebellar ataxias, with the only exception of
Friedreich’s ataxia. In the present exploratory cross-sectional study,
quantitative susceptibility mapping was used to investigate volume, iron
concentration and total iron content of the dentate nuclei in common types of
hereditary and non-hereditary degenerative ataxias. Seventy-nine patients with
spinocerebellar ataxias of types 1, 2, 3 and 6; 15 patients with
Friedreich’s ataxia; 18 patients with multiple system atrophy, cerebellar
type and 111 healthy controls were also included. All underwent 3 T MRI
and clinical assessments. For each specific ataxia subtype, voxel-based and
volumes-of-interest-based group analyses were performed in comparison with a
corresponding age- and sex-matched control group, both for volume, magnetic
susceptiblity (indicating iron concentration) and susceptibility mass
(indicating total iron content) of the dentate nuclei. Spinocerebellar ataxia of
type 1 and multiple system atrophy, cerebellar type patients showed higher
susceptibilities in large parts of the dentate nucleus but unaltered
susceptibility masses compared with controls. Friedreich’s ataxia
patients and, only on a trend level, spinocerebellar ataxia of type 2 patients
showed higher susceptibilities in more circumscribed parts of the dentate. In
contrast, spinocerebellar ataxia of type 6 patients revealed lower
susceptibilities and susceptibility masses compared with controls throughout the
dentate nucleus. Spinocerebellar ataxia of type 3 patients showed no significant
changes in susceptibility and susceptibility mass. Lower volume of the dentate
nuclei was found to varying degrees in all ataxia types. It was most pronounced
in spinocerebellar ataxia of type 6 patients and least prominent in
spinocerebellar ataxia of type 3 patients. The findings show that alterations in
susceptibility revealed by quantitative susceptibility mapping are common in the
dentate nuclei in different types of cerebellar ataxias. The most striking
changes in susceptibility were found in spinocerebellar ataxia of type 1,
multiple system atrophy, cerebellar type and spinocerebellar ataxia of type 6.
Because iron content is known to be high in glial cells but not in neurons of
the cerebellar nuclei, the higher susceptibility in spinocerebellar ataxia of
type 1 and multiple system atrophy, cerebellar type may be explained by a
reduction of neurons (increase in iron concentration) and/or an increase in
iron-rich glial cells, e.g. microgliosis. Hypomyelination also leads to higher
susceptibility and could also contribute. The lower susceptibility in SCA6
suggests a loss of iron-rich glial cells. Quantitative susceptibility maps
warrant future studies of iron content and iron-rich cells in ataxias to gain a
more comprehensive understanding of the pathogenesis of these diseases.
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Affiliation(s)
- Andreas Deistung
- University Clinic and Outpatient Clinic for Radiology, Department for Radiation Medicine, University Hospital Halle (Saale), Halle (Saale), Germany
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Jena, Germany
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, Essen, Germany
| | - Dominik Jäschke
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, Essen, Germany
| | - Rossitza Draganova
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, Essen, Germany
| | - Viktor Pfaffenrot
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
| | - Thomas Hulst
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, Essen, Germany
- Erasmus University College, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Katharina M. Steiner
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, Essen, Germany
| | - Andreas Thieme
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, Essen, Germany
| | - Ilaria A. Giordano
- Department of Neurology, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Thomas Klockgether
- Department of Neurology, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Sinem Tunc
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Alexander Münchau
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Center Juelich, Juelich, Germany
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, 40225 Duesseldorf, Germany
| | - Sophia L. Göricke
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, Essen University Hospital, Essen, Germany
| | - Jürgen R. Reichenbach
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Jena, Germany
| | - Dagmar Timmann
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, Essen, Germany
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14
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Traschütz A, Reich S, Adarmes AD, Anheim M, Ashrafi MR, Baets J, Basak AN, Bertini E, Brais B, Gagnon C, Gburek-Augustat J, Hanagasi HA, Heinzmann A, Horvath R, de Jonghe P, Kamm C, Klivenyi P, Klopstock T, Minnerop M, Münchau A, Renaud M, Roxburgh RH, Santorelli FM, Schirinzi T, Sival DA, Timmann D, Vielhaber S, Wallner M, van de Warrenburg BP, Zanni G, Zuchner S, Klockgether T, Schüle R, Schöls L, Synofzik M. The ARCA Registry: A Collaborative Global Platform for Advancing Trial Readiness in Autosomal Recessive Cerebellar Ataxias. Front Neurol 2021; 12:677551. [PMID: 34248822 PMCID: PMC8267795 DOI: 10.3389/fneur.2021.677551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 05/20/2021] [Indexed: 01/19/2023] Open
Abstract
Autosomal recessive cerebellar ataxias (ARCAs) form an ultrarare yet expanding group of neurodegenerative multisystemic diseases affecting the cerebellum and other neurological or non-neurological systems. With the advent of targeted therapies for ARCAs, disease registries have become a precious source of real-world quantitative and qualitative data complementing knowledge from preclinical studies and clinical trials. Here, we review the ARCA Registry, a global collaborative multicenter platform (>15 countries, >30 sites) with the overarching goal to advance trial readiness in ARCAs. It presents a good clinical practice (GCP)- and general data protection regulation (GDPR)-compliant professional-reported registry for multicenter web-based capture of cross-center standardized longitudinal data. Modular electronic case report forms (eCRFs) with core, extended, and optional datasets allow data capture tailored to the participating site's variable interests and resources. The eCRFs cover all key data elements required by regulatory authorities [European Medicines Agency (EMA)] and the European Rare Disease (ERD) platform. They capture genotype, phenotype, and progression and include demographic data, biomarkers, comorbidity, medication, magnetic resonance imaging (MRI), and longitudinal clinician- or patient-reported ratings of ataxia severity, non-ataxia features, disease stage, activities of daily living, and (mental) health status. Moreover, they are aligned to major autosomal-dominant spinocerebellar ataxia (SCA) and sporadic ataxia (SPORTAX) registries in the field, thus allowing for joint and comparative analyses not only across ARCAs but also with SCAs and sporadic ataxias. The registry is at the core of a systematic multi-component ARCA database cluster with a linked biobank and an evolving study database for digital outcome measures. Currently, the registry contains more than 800 patients with almost 1,500 visits representing all ages and disease stages; 65% of patients with established genetic diagnoses capture all the main ARCA genes, and 35% with unsolved diagnoses are targets for advanced next-generation sequencing. The ARCA Registry serves as the backbone of many major European and transatlantic consortia, such as PREPARE, PROSPAX, and the Ataxia Global Initiative, with additional data input from SPORTAX. It has thus become the largest global trial-readiness registry in the ARCA field.
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Affiliation(s)
- Andreas Traschütz
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Selina Reich
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Astrid D. Adarmes
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas, Madrid, Spain
| | - Mathieu Anheim
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch, France
| | - Mahmoud Reza Ashrafi
- Department of Pediatric Neurology, Ataxia Clinic, Growth and Development Research Center, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Jonathan Baets
- Translational Neurosciences, Faculty of Medicine and Health Sciences, UAntwerpen, Antwerp, Belgium
- Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
- Department of Neurology, Neuromuscular Reference Centre, Antwerp University Hospital, Antwerp, Belgium
| | - A. Nazli Basak
- Neurodegeneration Research Laboratory, Suna and Inan Kiraç Foundation, KUTTAM, Koç University School of Medicine, Istanbul, Turkey
| | - Enrico Bertini
- Unit of Neuromuscular and Neurodegenerative Diseases, Department of Neurosciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Bernard Brais
- Department of Neurology, McGill University, Montreal Neurological Institute, Montréal, QC, Canada
| | - Cynthia Gagnon
- Centre de Recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les Innovations en Santé, Sherbrooke University, Sherbrooke, QC, Canada
| | - Janina Gburek-Augustat
- Division of Neuropaediatrics, Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany
| | - Hasmet A. Hanagasi
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Anna Heinzmann
- AP-HP, Department of Genetics, Pitié-Salpêtrière University Hospital, Paris, France
| | - Rita Horvath
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Peter de Jonghe
- Translational Neurosciences, Faculty of Medicine and Health Sciences, UAntwerpen, Antwerp, Belgium
- Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
- Department of Neurology, Neuromuscular Reference Centre, Antwerp University Hospital, Antwerp, Belgium
| | - Christoph Kamm
- Department of Neurology, University of Rostock, Rostock, Germany
| | - Peter Klivenyi
- Department of Neurology, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary
| | - Thomas Klopstock
- Department of Neurology, Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, Juelich, Germany
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Alexander Münchau
- Neurogenetics, Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Mathilde Renaud
- Service de Génétique Clinique, CHRU de Nancy, Nancy, France
- INSERM-U1256 NGERE, Université de Lorraine, Nancy, France
| | - Richard H. Roxburgh
- Auckland District Health Board, Auckland, New Zealand
- Centre of Brain Research Neurogenetics Research Clinic, University of Auckland, Auckland, New Zealand
| | | | - Tommaso Schirinzi
- Neurorehabilitation Unit, Department of Neurosciences, IRCCS Bambino Gesù Children Hospital, Rome, Italy
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Deborah A. Sival
- Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, Netherlands
| | - Dagmar Timmann
- Department of Neurology, Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Stefan Vielhaber
- Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany
- German Center for Neurodegenerative Diseases (DZNE) Within the Helmholtz Association, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
| | | | - Bart P. van de Warrenburg
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Ginevra Zanni
- Unit of Neuromuscular and Neurodegenerative Diseases, Department of Neurosciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Stephan Zuchner
- Dr. John T. Macdonald Foundation Department of Human Genetics and John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Thomas Klockgether
- Department of Neurology, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Rebecca Schüle
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Ludger Schöls
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | | | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
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15
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Thieme A, Röske S, Faber J, Sulzer P, Minnerop M, Elben S, Reetz K, Dogan I, Barkhoff M, Konczak J, Wondzinski E, Siebler M, Hetze S, Müller O, Sure U, Klockgether T, Synofzik M, Timmann D. Reference values for the Cerebellar Cognitive Affective Syndrome Scale: age and education matter. Brain 2021; 144:e20. [PMID: 33367632 DOI: 10.1093/brain/awaa417] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 09/29/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Andreas Thieme
- Department of Neurology, Essen University Hospital, University of Duisburg-Essen, 45147 Essen, Germany
| | - Sandra Röske
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Helmholtz Association, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Jennifer Faber
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Helmholtz Association, Venusberg-Campus 1, 53127 Bonn, Germany.,Department of Neurology, Bonn University Hospital, Rheinische Friedrich-Wilhelms University Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Patricia Sulzer
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, Eberhard Karls University Tübingen, 72076 Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE) Tübingen, Helmholtz Association, 72076 Tübingen, Germany
| | - Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, 52425 Jülich, Germany.,Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University Düsseldorf, 40225 Düsseldorf, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, 40225 Düsseldorf, Germany
| | - Saskia Elben
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University Düsseldorf, 40225 Düsseldorf, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, 40225 Düsseldorf, Germany
| | - Kathrin Reetz
- Department of Neurology, Aachen University Hospital, Rheinisch-Westfälische Technische Hochschule Aachen (RWTH), 52074 Aachen, Germany.,JARA-BRAIN Institute, Molecular Neuroscience and Neuroimaging, Research Centre Jülich, 52425 Jülich, Germany
| | - Imis Dogan
- Department of Neurology, Aachen University Hospital, Rheinisch-Westfälische Technische Hochschule Aachen (RWTH), 52074 Aachen, Germany.,JARA-BRAIN Institute, Molecular Neuroscience and Neuroimaging, Research Centre Jülich, 52425 Jülich, Germany
| | - Miriam Barkhoff
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Helmholtz Association, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Jürgen Konczak
- School of Kinesiology, University of Minnesota, 400 Cooke Hall, Minneapolis, MN 55455, USA
| | - Elke Wondzinski
- Department of Neurology and Neurorehabilitation, MediClin Fachklinik Rhein/Ruhr, 45219 Essen, Germany
| | - Mario Siebler
- Department of Neurology and Neurorehabilitation, MediClin Fachklinik Rhein/Ruhr, 45219 Essen, Germany
| | - Susann Hetze
- Department of Neurosurgery, Essen University Hospital, University of Duisburg-Essen, 45147 Essen, Germany
| | - Oliver Müller
- Department of Neurosurgery, Essen University Hospital, University of Duisburg-Essen, 45147 Essen, Germany
| | - Ulrich Sure
- Department of Neurosurgery, Essen University Hospital, University of Duisburg-Essen, 45147 Essen, Germany
| | - Thomas Klockgether
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Helmholtz Association, Venusberg-Campus 1, 53127 Bonn, Germany.,Department of Neurology, Bonn University Hospital, Rheinische Friedrich-Wilhelms University Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, Eberhard Karls University Tübingen, 72076 Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE) Tübingen, Helmholtz Association, 72076 Tübingen, Germany
| | - Dagmar Timmann
- Department of Neurology, Essen University Hospital, University of Duisburg-Essen, 45147 Essen, Germany
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16
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Jacobi H, Minnerop M. [Adult-onset ataxias]. Nervenarzt 2021; 92:379-389. [PMID: 33751151 DOI: 10.1007/s00115-021-01099-9] [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] [Subscribe] [Scholar Register] [Accepted: 02/17/2021] [Indexed: 11/29/2022]
Abstract
Adult-onset ataxias are clinically and etiologically heterogeneous disorders affecting the cerebellum and its afferent and efferent connections. Early symptoms are usually a progressive ataxia of gait and stance, followed by limb ataxia, cerebellar dysarthria and oculomotor disturbances. In addition, various neurological and non-neurological symptoms may occur. Hereditary, acquired, and sporadic degenerative ataxias are distinguished. A detailed medical history and clinical examination as well as cranial magnetic resonance imaging are essential for the diagnostic work-up; however, specific biochemical or genetic tests are often required to make a definitive diagnosis. Besides rehabilitative therapies, specific drugs or dietary recommendations are available for some types of ataxia. An early and precise diagnosis is important to avoid redundant diagnostics and for counselling of patients and their relatives.
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Affiliation(s)
- Heike Jacobi
- Klinik und Poliklinik für Neurologie, Uniklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
| | - Martina Minnerop
- Institut für Neurowissenschaften und Medizin (INM-1), Forschungszentrum Jülich, Jülich, Deutschland.,Institut für klinische Neurowissenschaften und medizinische Psychologie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland.,Klinik für Neurologie, Zentrum für Bewegungsstörungen und Neuromodulation, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
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17
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Schmitz-Hübsch T, Lux S, Bauer P, Brandt AU, Schlapakow E, Greschus S, Scheel M, Gärtner H, Kirlangic ME, Gras V, Timmann D, Synofzik M, Giorgetti A, Carloni P, Shah JN, Schöls L, Kopp U, Bußenius L, Oberwahrenbrock T, Zimmermann H, Pfueller C, Kadas EM, Rönnefarth M, Grosch AS, Endres M, Amunts K, Paul F, Doss S, Minnerop M. Spinocerebellar ataxia type 14: refining clinicogenetic diagnosis in a rare adult-onset disorder. Ann Clin Transl Neurol 2021; 8:774-789. [PMID: 33739604 PMCID: PMC8045942 DOI: 10.1002/acn3.51315] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/29/2020] [Accepted: 01/13/2021] [Indexed: 12/29/2022] Open
Abstract
Objectives Genetic variant classification is a challenge in rare adult‐onset disorders as in SCA‐PRKCG (prior spinocerebellar ataxia type 14) with mostly private conventional mutations and nonspecific phenotype. We here propose a refined approach for clinicogenetic diagnosis by including protein modeling and provide for confirmed SCA‐PRKCG a comprehensive phenotype description from a German multi‐center cohort, including standardized 3D MR imaging. Methods This cross‐sectional study prospectively obtained neurological, neuropsychological, and brain imaging data in 33 PRKCG variant carriers. Protein modeling was added as a classification criterion in variants of uncertain significance (VUS). Results Our sample included 25 cases confirmed as SCA‐PRKCG (14 variants, thereof seven novel variants) and eight carriers of variants assigned as VUS (four variants) or benign/likely benign (two variants). Phenotype in SCA‐PRKCG included slowly progressive ataxia (onset at 4–50 years), preceded in some by early‐onset nonprogressive symptoms. Ataxia was often combined with action myoclonus, dystonia, or mild cognitive‐affective disturbance. Inspection of brain MRI revealed nonprogressive cerebellar atrophy. As a novel finding, a previously not described T2 hyperintense dentate nucleus was seen in all SCA‐PRKCG cases but in none of the controls. Interpretation In this largest cohort to date, SCA‐PRKCG was characterized as a slowly progressive cerebellar syndrome with some clinical and imaging features suggestive of a developmental disorder. The observed non‐ataxia movement disorders and cognitive‐affective disturbance may well be attributed to cerebellar pathology. Protein modeling emerged as a valuable diagnostic tool for variant classification and the newly described T2 hyperintense dentate sign could serve as a supportive diagnostic marker of SCA‐PRKCG.
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Affiliation(s)
- Tanja Schmitz-Hübsch
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health Berlin, Berlin, Germany.,Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Silke Lux
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Peter Bauer
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.,CENTOGENE AG, Rostock, Germany
| | - Alexander U Brandt
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health Berlin, Berlin, Germany.,Department of Neurology, University of California, Irvine, CA, USA
| | - Elena Schlapakow
- Department of Neurology, University Hospital Bonn, Bonn, Germany.,Center for Rare Diseases, University of Bonn, Bonn, Germany
| | - Susanne Greschus
- Department of Radiology, University Hospital Bonn, Bonn, Germany
| | - Michael Scheel
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health Berlin, Berlin, Germany.,Department of Neuroradiology, Charité -Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Hanna Gärtner
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, Juelich, Germany
| | - Mehmet E Kirlangic
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, Juelich, Germany.,Institute for Biomedical Engineering and Computer Science, Technische Universität Ilmenau, Ilmenau, Germany
| | - Vincent Gras
- Institute of Neuroscience and Medicine (INM-4), Research Centre Juelich, Juelich, Germany
| | - Dagmar Timmann
- Department of Neurology, Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Alejandro Giorgetti
- Computational Biophysics, German Research School for Simulation Sciences, and Computational Biomedicine, Institute for Advanced Simulation (IAS-5) and Institute of Neuroscience and Medicine (INM-9), Research Centre Juelich, Juelich, Germany.,Department of Biotechnology, University of Verona, Verona, 37134, Italy
| | - Paolo Carloni
- Computational Biophysics, German Research School for Simulation Sciences, and Computational Biomedicine, Institute for Advanced Simulation (IAS-5) and Institute of Neuroscience and Medicine (INM-9), Research Centre Juelich, Juelich, Germany
| | - Jon N Shah
- Institute of Neuroscience and Medicine (INM-4), Research Centre Juelich, Juelich, Germany.,Department of Neurology, Faculty of Medicine, JARA, RWTH Aachen University, Aachen, Germany
| | - Ludger Schöls
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Ute Kopp
- Klinik und Hochschulambulanz für Neurologie, Charité -Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Lisa Bußenius
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, Juelich, Germany.,Institute for Biochemistry and Molecular Cell Biology, Center for Experimental Medicine, University Clinic Hamburg Eppendorf, Hamburg, Germany
| | - Timm Oberwahrenbrock
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health Berlin, Berlin, Germany
| | - Hanna Zimmermann
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health Berlin, Berlin, Germany
| | - Caspar Pfueller
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health Berlin, Berlin, Germany
| | - Ella-Maria Kadas
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health Berlin, Berlin, Germany
| | - Maria Rönnefarth
- Klinik und Hochschulambulanz für Neurologie, Charité -Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Anne-Sophie Grosch
- Klinik und Hochschulambulanz für Neurologie, Charité -Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Matthias Endres
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health Berlin, Berlin, Germany.,Klinik und Hochschulambulanz für Neurologie, Charité -Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.,Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Berlin, Germany
| | - Katrin Amunts
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, Juelich, Germany.,C. and O. Vogt Institute for Brain Research, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Friedemann Paul
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health Berlin, Berlin, Germany.,Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.,Klinik und Hochschulambulanz für Neurologie, Charité -Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Sarah Doss
- Klinik und Hochschulambulanz für Neurologie, Charité -Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.,Movement Disorders Section, Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, Juelich, Germany.,Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
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18
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Thieme A, Roeske S, Faber J, Sulzer P, Minnerop M, Elben S, Jacobi H, Reetz K, Dogan I, Barkhoff M, Konczak J, Wondzinski E, Siebler M, Mueller O, Sure U, Schmahmann JD, Klockgether T, Synofzik M, Timmann D. Validation of a German version of the Cerebellar Cognitive Affective/ Schmahmann Syndrome Scale: preliminary version and study protocol. Neurol Res Pract 2020; 2:39. [PMID: 33324939 PMCID: PMC7650062 DOI: 10.1186/s42466-020-00071-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 01/13/2020] [Accepted: 06/01/2020] [Indexed: 11/10/2022] Open
Abstract
Background Traditionally, cerebellar disorders including ataxias have been associated with deficits in motor control and motor learning. Since the 1980's growing evidence has emerged that cerebellar diseases also impede cognitive and affective processes such as executive and linguistic functions, visuospatial abilities and regulation of emotion and affect. This combination of non-motor symptoms has been named Cerebellar Cognitive Affective/ Schmahmann Syndrome (CCAS). To date, diagnosis relies on non-standardized bedside cognitive examination and, if available, detailed neuropsychological test batteries. Recently, a short and easy applicable bedside test (CCAS Scale) has been developed to screen for CCAS. It has been validated in an US-American cohort of adults with cerebellar disorders and healthy controls. As yet, the CCAS Scale has only been available in American English. We present a German version of the scale and the study protocol of its ongoing validation in a German-speaking patient cohort. Methods A preliminary German version has been created from the original CCAS Scale using a standardized translation procedure. This version has been pre-tested in cerebellar patients and healthy controls including medical experts and laypersons to ensure that instructions are well understandable, and that no information has been lost or added during translation. This preliminary German version will be validated in a minimum of 65 patients with cerebellar disease and 65 matched healthy controls. We test whether selectivity and sensitivity of the German CCAS Scale is comparable to the original CCAS Scale using the same cut-off values for each of the test items, and the same pass/ fail criteria to determine the presence of CCAS. Furthermore, internal consistency, test-retest and interrater reliability will be evaluated. In addition, construct validity will be tested in a subset of patients and controls in whom detailed neuropsychological testing will be available. Secondary aims will be examination of possible correlations between clinical features (e.g. disease duration, clinical ataxia scores) and CCAS scores. Perspective The overall aim is to deliver a validated bedside test to screen for CCAS in German-speaking patients which can also be used in future natural history and therapeutic trials. Study registration The study is registered at the German Clinical Study Register (DRKS-ID: DRKS00016854).
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Affiliation(s)
- Andreas Thieme
- Department of Neurology, Essen University Hospital, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Sandra Roeske
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Helmholtz Association, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Jennifer Faber
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Helmholtz Association, Venusberg-Campus 1, 53127 Bonn, Germany.,Department of Neurology, Bonn University Hospital, Rheinische Friedrich-Wilhelms University Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Patricia Sulzer
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, Eberhard Karls University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany.,German Center for Neurodegenerative Diseases (DZNE) Tuebingen, Helmholtz Association, Otfried-Mueller-Straße 23, 72076 Tuebingen, Germany
| | - Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, Wilhelm-Johnen-Str., 52425 Juelich, Germany.,Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Saskia Elben
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Heike Jacobi
- Department of Neurology, Heidelberg University Hospital, Ruprecht-Karls University Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Kathrin Reetz
- Institute of Neuroscience and Medicine (INM-11), Research Centre Juelich, Wilhelm-Johnen-Str., 52425 Juelich, Germany.,Department of Neurology, Aachen University Hospital, Rheinisch-Westfaelische Technische Hochschule Aachen (RWTH), Pauwelstr. 30, 52074 Aachen, Germany.,JARA-BRAIN Institute, Molecular Neuroscience and Neuroimaging, Research Centre Juelich, Wilhelm-Johnen-Str., 52425 Juelich, Germany
| | - Imis Dogan
- Institute of Neuroscience and Medicine (INM-11), Research Centre Juelich, Wilhelm-Johnen-Str., 52425 Juelich, Germany.,Department of Neurology, Aachen University Hospital, Rheinisch-Westfaelische Technische Hochschule Aachen (RWTH), Pauwelstr. 30, 52074 Aachen, Germany.,JARA-BRAIN Institute, Molecular Neuroscience and Neuroimaging, Research Centre Juelich, Wilhelm-Johnen-Str., 52425 Juelich, Germany
| | - Miriam Barkhoff
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Helmholtz Association, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Juergen Konczak
- School of Kinesiology, University of Minnesota, 400 Cooke Hall 1900 University Ave S E, Minneapolis, MN 55455 USA
| | - Elke Wondzinski
- Department of Neurology and Neurorehabilitation, MediClin Fachklinik Rhein/ Ruhr, Auf der Roetsch 2, 45219 Essen, Germany
| | - Mario Siebler
- Department of Neurology and Neurorehabilitation, MediClin Fachklinik Rhein/ Ruhr, Auf der Roetsch 2, 45219 Essen, Germany
| | - Oliver Mueller
- Present Address: Department of Neurosurgery, Klinikum Dortmund, Muensterstr. 240, 44145 Dortmund, Germany.,Department of Neurosurgery, Essen University Hospital, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Ulrich Sure
- Department of Neurosurgery, Essen University Hospital, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Jeremy D Schmahmann
- Department of Neurology, Ataxia Center, Cognitive Behavioral Neurology Unit, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114 USA
| | - Thomas Klockgether
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Helmholtz Association, Venusberg-Campus 1, 53127 Bonn, Germany.,Department of Neurology, Bonn University Hospital, Rheinische Friedrich-Wilhelms University Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, Eberhard Karls University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany.,German Center for Neurodegenerative Diseases (DZNE) Tuebingen, Helmholtz Association, Otfried-Mueller-Straße 23, 72076 Tuebingen, Germany
| | - Dagmar Timmann
- Department of Neurology, Essen University Hospital, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany
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19
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Ihl T, Kadas EM, Oberwahrenbrock T, Endres M, Klockgether T, Schroeter J, Brandt AU, Paul F, Minnerop M, Doss S, Schmitz-Hübsch T, Zimmermann HG. Investigation of Visual System Involvement in Spinocerebellar Ataxia Type 14. Cerebellum 2020; 19:469-482. [PMID: 32338350 PMCID: PMC7351844 DOI: 10.1007/s12311-020-01130-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Spinocerebellar ataxia type 14 (SCA-PRKCG, formerly SCA14) is a rare, slowly progressive disorder caused by conventional mutations in protein kinase Cγ (PKCγ). The disease usually manifests with ataxia, but previous reports suggested PRKCG variants in retinal pathology. To systematically investigate for the first time visual function and retinal morphology in patients with SCA-PRKCG. Seventeen patients with PRKCG variants and 17 healthy controls were prospectively recruited, of which 12 genetically confirmed SCA-PRKCG patients and 14 matched controls were analyzed. We enquired a structured history for visual symptoms. Vision-related quality of life was obtained with the National Eye Institute Visual Function Questionnaire (NEI-VFQ) including the Neuro-Ophthalmic Supplement (NOS). Participants underwent testing of visual acuity, contrast sensitivity, visual fields, and retinal morphology with optical coherence tomography (OCT). Measurements of the SCA-PRKCG group were analyzed for their association with clinical parameters (ataxia rating and disease duration). SCA-PRKCG patients rate their vision-related quality of life in NEI-VFQ significantly worse than controls. Furthermore, binocular visual acuity and contrast sensitivity were worse in SCA-PRKCG patients compared with controls. Despite this, none of the OCT measurements differed between groups. NEI-VFQ and NOS composite scores were related to ataxia severity. Additionally, we describe one patient with a genetic variant of uncertain significance in the catalytic domain of PKCγ who, unlike all confirmed SCA-PRKCG, presented with a clinically silent epitheliopathy. SCA-PRKCG patients had reduced binocular vision and vision-related quality of life. Since no structural retinal damage was found, the pathomechanism of these findings remains unclear.
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Affiliation(s)
- Thomas Ihl
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Ella M Kadas
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Timm Oberwahrenbrock
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Matthias Endres
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- German Center for Neurodegenerative Diseases (DZNE), partner site, Berlin, Germany
| | - Thomas Klockgether
- Department of Neurology, University Hospital of Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Jan Schroeter
- University Tissue Bank, Cornea Bank Berlin, Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Alexander U Brandt
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Neurology, University of California, Irvine, CA, USA
| | - Friedemann Paul
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, Juelich, Germany
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
- Department of Neurology and Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Sarah Doss
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Neurological Sciences, Movement Disorders Section, University of Nebraska Medical Center, Omaha, NE, USA
| | - Tanja Schmitz-Hübsch
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Hanna G Zimmermann
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
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20
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Nikolov P, Hassan SS, Aytulun A, Hartmann CJ, Kohlhase J, Schnitzler A, Albrecht P, Minnerop M, Groiss SJ. Cerebellar Involvement in DYT-THAP1 Dystonia. Cerebellum 2019; 18:969-971. [DOI: 10.1007/s12311-019-01062-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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21
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Minnerop M, Kurzwelly D, Wagner H, Schüle R, Ramirez A. Reply: Biallelic POLR3A variants confirmed as a frequent cause of hereditary ataxia and spastic paraparesis. Brain 2019; 142:e13. [PMID: 30847463 DOI: 10.1093/brain/awz042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, Jülich, Germany.,Center for Movement Disorders and Neuromodulation, Department of Neurology and Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | | | - Holger Wagner
- Division for Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
| | - Rebecca Schüle
- Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center of Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Alfredo Ramirez
- Division for Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany.,Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
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22
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Schmitz D, Muenzing SEA, Schober M, Schubert N, Minnerop M, Lippert T, Amunts K, Axer M. Derivation of Fiber Orientations From Oblique Views Through Human Brain Sections in 3D-Polarized Light Imaging. Front Neuroanat 2018; 12:75. [PMID: 30323745 PMCID: PMC6173061 DOI: 10.3389/fnana.2018.00075] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 08/27/2018] [Indexed: 11/13/2022] Open
Abstract
3D-Polarized Light Imaging (3D-PLI) enables high-resolution three-dimensional mapping of the nerve fiber architecture in unstained histological brain sections based on the intrinsic birefringence of myelinated nerve fibers. The interpretation of the measured birefringent signals comes with conjointly measured information about the local fiber birefringence strength and the fiber orientation. In this study, we present a novel approach to disentangle both parameters from each other based on a weighted least squares routine (ROFL) applied to oblique polarimetric 3D-PLI measurements. This approach was compared to a previously described analytical method on simulated and experimental data obtained from a post mortem human brain. Analysis of the simulations revealed in case of ROFL a distinctly increased level of confidence to determine steep and flat fiber orientations with respect to the brain sectioning plane. Based on analysis of histological sections of a human brain dataset, it was demonstrated that ROFL provides a coherent characterization of cortical, subcortical, and white matter regions in terms of fiber orientation and birefringence strength, within and across sections. Oblique measurements combined with ROFL analysis opens up new ways to determine physical brain tissue properties by means of 3D-PLI microscopy.
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Affiliation(s)
- Daniel Schmitz
- Institute of Neuroscience and Medicine-1 (INM-1), Forschungszentrum Jülich, Jülich, Germany
| | - Sascha E A Muenzing
- Institute of Neuroscience and Medicine-1 (INM-1), Forschungszentrum Jülich, Jülich, Germany
| | - Martin Schober
- Institute of Neuroscience and Medicine-1 (INM-1), Forschungszentrum Jülich, Jülich, Germany
| | - Nicole Schubert
- Institute of Neuroscience and Medicine-1 (INM-1), Forschungszentrum Jülich, Jülich, Germany
| | - Martina Minnerop
- Institute of Neuroscience and Medicine-1 (INM-1), Forschungszentrum Jülich, Jülich, Germany.,>Center for Movement Disorders and Neuromodulation, Department of Neurology and Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Thomas Lippert
- Jülich Supercomputing Center, Forschungszentrum Jülich, Jülich, Germany.,Bergische Universität Wuppertal, Wuppertal, Germany
| | - Katrin Amunts
- Institute of Neuroscience and Medicine-1 (INM-1), Forschungszentrum Jülich, Jülich, Germany.,C. and O. Vogt Institute for Brain Research, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Markus Axer
- Institute of Neuroscience and Medicine-1 (INM-1), Forschungszentrum Jülich, Jülich, Germany
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23
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Abstract
Neuroimaging in myotonic dystrophies provided a major contribution to the insight into brain involvement which is highly prevalent in these multisystemic disorders. Particular in Myotonic Dystrophy Type 1, conventional MRI first revealed hyperintense white matter lesions, predominantly localized in the anterior temporal lobe. Brain atrophy and ventricle enlargement were additional early findings already described almost 30 years ago. Since then, more advanced and sophisticated imaging methods have been applied in Myotonic Dystrophy Types 1 and 2. Involvement of actually normal appearing white matter and widespread cortical affection in PET studies were key results toward the recognition of diffuse and not only focally localized brain pathology in vivo. Later, structural abnormalities of both, gray and white matter, have been found in both forms of the disorder, albeit more prominent in myotonic dystrophy type 1. In Type 1, a consistent widespread cortical and subcortical involvement of gray and white matter affecting all lobes, brainstem and cerebellum was observed. Spectroscopy studies gave additional evidence of neuronal and glial damage in both types. Central questions regarding the origin and spatiotemporal evolution of the CNS involvement and its relevance for clinical symptoms had already been raised 30 years ago, however are still not answered. Results of correlation analyses between neuroimaging and clinical parameters are diverse and with few exceptions not well reproducible across studies. It may be related to the fact that most of the reported studies included only small numbers of subjects, sometimes even not separating Myotonic Dystrophy Type 1 from Type 2. But this heterogeneity may also support the current point of view that the clinical impairments are not simply linked to specific and regionally circumscribed structural or functional brain alterations. It seems more convincing that disturbed networks build the functional and structural substrate of clinical symptoms in these disorders as it is proposed in other neuropsychiatric diseases. Consecutively, structural and functional network analyses may provide additional information regarding the link between brain pathology and clinical symptoms. Up to now, only cross-sectional neuroimaging studies have been published. To analyze the temporal evolution of brain affection, longitudinal studies are urgently needed, and systematic natural history data would be useful to identify potential biomarkers for therapeutic studies.
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Affiliation(s)
- Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Center Juelich, Juelich, Germany.,Department of Neurology and Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Center for Movement Disorders and Neuromodulation, Heinrich-Heine University, Düsseldorf, Germany
| | - Carla Gliem
- Department of Neurology, University Hospital of Bonn, Bonn, Germany
| | - Cornelia Kornblum
- Department of Neurology, University Hospital of Bonn, Bonn, Germany.,Center for Rare Diseases Bonn (ZSEB), University Hospital of Bonn, Bonn, Germany
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24
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Minnerop M, Kurzwelly D, Rattay TW, Timmann D, Hengel H, Synofzik M, Stendel C, Horvath R, Schüle R, Ramirez A. Reply: POLR3A variants in hereditary spastic paraplegia and ataxia. Brain 2018; 141:e2. [PMID: 29236946 PMCID: PMC5837678 DOI: 10.1093/brain/awx291] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Affiliation(s)
- Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, 52425 Jülich, Germany
- Department of Neurology, University of Bonn, 53127 Bonn, Germany
| | - Delia Kurzwelly
- Department of Neurology, University of Bonn, 53127 Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
| | - Tim W Rattay
- Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen, Germany
| | - Dagmar Timmann
- Department of Neurology, University of Duisburg-Essen, 45147 Essen, Germany
| | - Holger Hengel
- Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen, Germany
| | - Matthis Synofzik
- Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen, Germany
| | - Claudia Stendel
- Department of Neurology, Friedrich-Baur-Institute, Ludwig-Maximilians-Universität, 80336 Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), 81337 Munich, Germany
| | - Rita Horvath
- Wellcome Trust Centre for Mitochondrial Research, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne NE1 3BZ, UK
| | - Rebecca Schüle
- Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen, Germany
| | - Alfredo Ramirez
- Department of Psychiatry and Psychotherapy, University of Bonn, 53127 Bonn, Germany
- Institute of Human Genetics, University of Bonn, 53127 Bonn, Germany
- Department of Psychiatry and Psychotherapy, University of Cologne, 50937 Cologne, Germany
- Clinic for Neurodegenerative diseases and geriatric psychiatry, University of Bonn, 53127 Bonn, Germany
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25
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Minnerop M, Kurzwelly D, Wagner H, Soehn AS, Reichbauer J, Tao F, Rattay TW, Peitz M, Rehbach K, Giorgetti A, Pyle A, Thiele H, Altmüller J, Timmann D, Karaca I, Lennarz M, Baets J, Hengel H, Synofzik M, Atasu B, Feely S, Kennerson M, Stendel C, Lindig T, Gonzalez MA, Stirnberg R, Sturm M, Roeske S, Jung J, Bauer P, Lohmann E, Herms S, Heilmann-Heimbach S, Nicholson G, Mahanjah M, Sharkia R, Carloni P, Brüstle O, Klopstock T, Mathews KD, Shy ME, de Jonghe P, Chinnery PF, Horvath R, Kohlhase J, Schmitt I, Wolf M, Greschus S, Amunts K, Maier W, Schöls L, Nürnberg P, Zuchner S, Klockgether T, Ramirez A, Schüle R. Hypomorphic mutations in POLR3A are a frequent cause of sporadic and recessive spastic ataxia. Brain 2017; 140:1561-1578. [PMID: 28459997 PMCID: PMC6402316 DOI: 10.1093/brain/awx095] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [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: 10/21/2016] [Revised: 02/08/2017] [Accepted: 02/26/2017] [Indexed: 11/12/2022] Open
Abstract
Despite extensive efforts, half of patients with rare movement disorders such as hereditary spastic paraplegias and cerebellar ataxias remain genetically unexplained, implicating novel genes and unrecognized mutations in known genes. Non-coding DNA variants are suspected to account for a substantial part of undiscovered causes of rare diseases. Here we identified mutations located deep in introns of POLR3A to be a frequent cause of hereditary spastic paraplegia and cerebellar ataxia. First, whole-exome sequencing findings in a recessive spastic ataxia family turned our attention to intronic variants in POLR3A, a gene previously associated with hypomyelinating leukodystrophy type 7. Next, we screened a cohort of hereditary spastic paraplegia and cerebellar ataxia cases (n = 618) for mutations in POLR3A and identified compound heterozygous POLR3A mutations in ∼3.1% of index cases. Interestingly, >80% of POLR3A mutation carriers presented the same deep-intronic mutation (c.1909+22G>A), which activates a cryptic splice site in a tissue and stage of development-specific manner and leads to a novel distinct and uniform phenotype. The phenotype is characterized by adolescent-onset progressive spastic ataxia with frequent occurrence of tremor, involvement of the central sensory tracts and dental problems (hypodontia, early onset of severe and aggressive periodontal disease). Instead of the typical hypomyelination magnetic resonance imaging pattern associated with classical POLR3A mutations, cases carrying c.1909+22G>A demonstrated hyperintensities along the superior cerebellar peduncles. These hyperintensities may represent the structural correlate to the cerebellar symptoms observed in these patients. The associated c.1909+22G>A variant was significantly enriched in 1139 cases with spastic ataxia-related phenotypes as compared to unrelated neurological and non-neurological phenotypes and healthy controls (P = 1.3 × 10-4). In this study we demonstrate that (i) autosomal-recessive mutations in POLR3A are a frequent cause of hereditary spastic ataxias, accounting for about 3% of hitherto genetically unclassified autosomal recessive and sporadic cases; and (ii) hypomyelination is frequently absent in POLR3A-related syndromes, especially when intronic mutations are present, and thus can no longer be considered as the unifying feature of POLR3A disease. Furthermore, our results demonstrate that substantial progress in revealing the causes of Mendelian diseases can be made by exploring the non-coding sequences of the human genome.
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Affiliation(s)
- Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich,
52425 Jülich, Germany
- Department of Neurology, University of Bonn, 53127 Bonn, Germany
| | - Delia Kurzwelly
- Department of Neurology, University of Bonn, 53127 Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn,
Germany
| | - Holger Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, 53127
Bonn, Germany
| | - Anne S Soehn
- Institute of Medical Genetics and Applied Genomics, University of
Tübingen, 72076 Tübingen, Germany
| | - Jennifer Reichbauer
- Center for Neurology and Hertie Institute for Clinical Brain Research,
University of Tübingen, 72076 Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen,
Germany
| | - Feifei Tao
- Dr. John T. Macdonald Foundation Department of Human Genetics and John
P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine,
Miami, Florida 33136, USA
| | - Tim W Rattay
- Center for Neurology and Hertie Institute for Clinical Brain Research,
University of Tübingen, 72076 Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen,
Germany
| | - Michael Peitz
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn,
Germany
- Institute of Reconstructive Neurobiology, Life and Brain Center, 53127
Bonn, Germany
| | - Kristina Rehbach
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn,
Germany
- Institute of Reconstructive Neurobiology, Life and Brain Center, 53127
Bonn, Germany
| | - Alejandro Giorgetti
- Computational Biophysics, German Research School for Simulation
Sciences, and Computational Biomedicine, Institute for Advanced Simulation (IAS-5) and
Institute of Neuroscience and Medicine (INM-9), Research Centre Juelich, 52425 Jülich,
Germany
- Department of Biotechnology, University of Verona, 37134 Verona,
Italy
| | - Angela Pyle
- Institute of Genetic Medicine, Newcastle University, Newcastle upon
Tyne NE1 3BZ, UK
| | - Holger Thiele
- Cologne Center for Genomics (CCG), University of Cologne, 50931
Cologne, Germany
| | - Janine Altmüller
- Cologne Center for Genomics (CCG), University of Cologne, 50931
Cologne, Germany
- Institute of Human Genetics, University Hospital of Cologne, 50931
Cologne, Germany
| | - Dagmar Timmann
- Department of Neurology, University of Duisburg-Essen, 45147 Essen,
Germany
| | - Ilker Karaca
- Department of Psychiatry and Psychotherapy, University of Bonn, 53127
Bonn, Germany
| | - Martina Lennarz
- Department of Psychiatry and Psychotherapy, University of Bonn, 53127
Bonn, Germany
| | - Jonathan Baets
- Neurogenetics Group, VIB-Department of Molecular Genetics, VIB, 2610
Antwerp, Belgium
- Department of Neurology, Antwerp University Hospital, 2650 Antwerp,
Belgium
- Institute Born-Bunge, University of Antwerp, 2610 Antwerp,
Belgium
| | - Holger Hengel
- Center for Neurology and Hertie Institute for Clinical Brain Research,
University of Tübingen, 72076 Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen,
Germany
| | - Matthis Synofzik
- Center for Neurology and Hertie Institute for Clinical Brain Research,
University of Tübingen, 72076 Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen,
Germany
| | - Burcu Atasu
- German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen,
Germany
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical
Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - Shawna Feely
- Department of Neurology, University of Iowa, 52242 Iowa, USA
| | - Marina Kennerson
- Northcott Neuroscience Laboratory, ANZAC Research Institute, Concord
NSW 2139, Australia
- Molecular Medicine Laboratory, Concord Hospital, Concord NSW 2139,
Australia
- Sydney Medical School, University of Sydney, Sydney NSW 2006,
Australia
| | - Claudia Stendel
- Department of Neurology, Friedrich-Baur-Institute,
Ludwig-Maximilians-Universität, 80336 Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), 81337 Munich,
Germany
| | - Tobias Lindig
- Department of Diagnostic and Interventional Neuroradiology, University
Hospital Tübingen, 72076 Tübingen, Germany
| | - Michael A Gonzalez
- Dr. John T. Macdonald Foundation Department of Human Genetics and John
P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine,
Miami, Florida 33136, USA
| | - Rüdiger Stirnberg
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn,
Germany
| | - Marc Sturm
- Institute of Medical Genetics and Applied Genomics, University of
Tübingen, 72076 Tübingen, Germany
| | - Sandra Roeske
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn,
Germany
| | - Johanna Jung
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn,
Germany
| | - Peter Bauer
- Institute of Medical Genetics and Applied Genomics, University of
Tübingen, 72076 Tübingen, Germany
| | - Ebba Lohmann
- German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen,
Germany
- Department of Neurology, Antwerp University Hospital, 2650 Antwerp,
Belgium
- Behavioural Neurology and Movement Disorders Unit, Department of
Neurology, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey
| | - Stefan Herms
- Institute of Human Genetics, University of Bonn, 53127 Bonn,
Germany
- Department of Genomics, Life and Brain Center, University of Bonn,
53127, Bonn, Germany
- Division of Medical Genetics, University Hospital and Department of
Biomedicine, University of Basel, CH-4058, Basel, Switzerland
| | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, University of Bonn, 53127 Bonn,
Germany
- Department of Genomics, Life and Brain Center, University of Bonn,
53127, Bonn, Germany
| | - Garth Nicholson
- Northcott Neuroscience Laboratory, ANZAC Research Institute, Concord
NSW 2139, Australia
- Molecular Medicine Laboratory, Concord Hospital, Concord NSW 2139,
Australia
- Sydney Medical School, University of Sydney, Sydney NSW 2006,
Australia
| | - Muhammad Mahanjah
- Child Neurology and Development Center, Hillel-Yaffe Medical Center,
38100 Hadera, Israel
- Bruce and Ruth Rappaport Faculty of Medicine, Technion, 31096 Haifa,
Israel
| | - Rajech Sharkia
- The Triangle Regional Research and Development Center, P. O. Box-2167,
Kfar Qari’ 30075, Israel
- Beit-Berl Academic College, Beit-Berl 44905, Israel
| | - Paolo Carloni
- Computational Biophysics, German Research School for Simulation
Sciences, and Computational Biomedicine, Institute for Advanced Simulation (IAS-5) and
Institute of Neuroscience and Medicine (INM-9), Research Centre Juelich, 52425 Jülich,
Germany
| | - Oliver Brüstle
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn,
Germany
- Institute of Reconstructive Neurobiology, Life and Brain Center, 53127
Bonn, Germany
| | - Thomas Klopstock
- Department of Neurology, Friedrich-Baur-Institute,
Ludwig-Maximilians-Universität, 80336 Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), 81337 Munich,
Germany
- Munich Cluster of Systems Neurology (SyNergy), 80336 Munich,
Germany
| | - Katherine D Mathews
- Department of Pediatrics, Carver College of Medicine, University of
Iowa, 52242 Iowa, USA
| | - Michael E Shy
- Department of Neurology, University of Iowa, 52242 Iowa, USA
| | - Peter de Jonghe
- Neurogenetics Group, VIB-Department of Molecular Genetics, VIB, 2610
Antwerp, Belgium
- Department of Neurology, Antwerp University Hospital, 2650 Antwerp,
Belgium
- Institute Born-Bunge, University of Antwerp, 2610 Antwerp,
Belgium
| | - Patrick F Chinnery
- Institute of Genetic Medicine, Newcastle University, Newcastle upon
Tyne NE1 3BZ, UK
- Department of Clinical Neurosciences, Cambridge Biomedical Campus,
University of Cambridge, Cambridge CB2 0QQ, UK
| | - Rita Horvath
- Wellcome Trust Centre for Mitochondrial Research, Institute of Genetic
Medicine, Newcastle University, Newcastle upon Tyne NE1 3BZ, UK
| | | | - Ina Schmitt
- Department of Neurology, University of Bonn, 53127 Bonn, Germany
| | - Michael Wolf
- Departement of Orthodontics, University of Bonn, 53111 Bonn,
Germany
| | - Susanne Greschus
- Department of Radiology, University of Bonn, 53127 Bonn, Germany
| | - Katrin Amunts
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich,
52425 Jülich, Germany
- C. & O. Vogt-Institute of Brain Research, University of Düsseldorf,
40212 Düsseldorf, Germany
| | - Wolfgang Maier
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn,
Germany
- Department of Psychiatry and Psychotherapy, University of Bonn, 53127
Bonn, Germany
| | - Ludger Schöls
- Center for Neurology and Hertie Institute for Clinical Brain Research,
University of Tübingen, 72076 Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen,
Germany
| | - Peter Nürnberg
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich,
52425 Jülich, Germany
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn,
Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne,
50931 Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in
Aging-Associated Diseases (CECAD), University of Cologne, 50931 Cologne, Germany
| | - Stephan Zuchner
- Dr. John T. Macdonald Foundation Department of Human Genetics and John
P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine,
Miami, Florida 33136, USA
| | - Thomas Klockgether
- Department of Neurology, University of Bonn, 53127 Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn,
Germany
| | - Alfredo Ramirez
- Department of Psychiatry and Psychotherapy, University of Bonn, 53127
Bonn, Germany
- Institute of Human Genetics, University of Bonn, 53127 Bonn,
Germany
- Department of Psychiatry and Psychotherapy, University of Cologne,
50937 Cologne, Germany
| | - Rebecca Schüle
- Center for Neurology and Hertie Institute for Clinical Brain Research,
University of Tübingen, 72076 Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen,
Germany
- Dr. John T. Macdonald Foundation Department of Human Genetics and John
P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine,
Miami, Florida 33136, USA
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Michelis JP, Hattingen E, Gaertner FC, Minnerop M, Träber F, Biskup S, Klockgether T, Paus S. Expanded phenotype and hippocampal involvement in a novel compound heterozygosity of adult PLA2G6 associated neurodegeneration (PARK14). Parkinsonism Relat Disord 2017; 37:111-113. [PMID: 28094106 DOI: 10.1016/j.parkreldis.2017.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 01/06/2017] [Accepted: 01/09/2017] [Indexed: 10/20/2022]
Affiliation(s)
- Joan Philipp Michelis
- Department of Neurology, University of Bonn, and German Center for Neurodegenerative Diseases, Sigmund-Freud-Straße 25, 53127 Bonn, Germany.
| | - Elke Hattingen
- Neuroradiology, Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, Germany
| | - Florian C Gaertner
- Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, Germany
| | - Martina Minnerop
- Research Centre Juelich, Institute of Neuroscience and Medicine (INM-1), 52425 Jülich, Germany; Department of Neurology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
| | - Frank Träber
- Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
| | - Saskia Biskup
- CeGaT GmbH, Center for Genomics and Transcriptomics Tübingen, Germany; Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Thomas Klockgether
- Department of Neurology, University of Bonn, and German Center for Neurodegenerative Diseases, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
| | - Sebastian Paus
- Department of Neurology, University of Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, Germany
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27
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Kämereit L, Lux S, Kirlangic M, Sproß C, Caspers S, Eickhoff S, Moebus S, Pundt N, Jöckel KH, Erbel R, Zilles K, Amunts K, Minnerop M. EP 117. 1000BRAINS study: Motor performance in the elderly – Not all parameters decline with age. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.05.160] [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: 11/26/2022]
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28
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Schmitz-Hübsch T, Brandt AU, Pfueller C, Zange L, Seidel A, Kühn AA, Paul F, Minnerop M, Doss S. Accuracy and repeatability of two methods of gait analysis - GaitRite™ und Mobility Lab™ - in subjects with cerebellar ataxia. Gait Posture 2016; 48:194-201. [PMID: 27289221 DOI: 10.1016/j.gaitpost.2016.05.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [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: 10/20/2015] [Revised: 04/27/2016] [Accepted: 05/24/2016] [Indexed: 02/02/2023]
Abstract
Instrumental gait analysis is increasingly recognized as a useful tool for the evaluation of movement disorders. The various assessment devices available to date have mostly been evaluated in healthy populations only. We aimed to explore whether reliability and validity seen in healthy subjects can also be assumed in subjects with cerebellar ataxic gait. Gait was recorded simultaneously with two devices - a sensor-embedded walkway and an inertial sensor based system - to explore test accuracy in two groups of subjects: one with mild to moderate cerebellar ataxia due to a subtype of autosomal-dominantly inherited neurodegenerative disorder (SCA14), the other were healthy subjects matched for age and height (CTR). Test precision was assessed by retest within session for each device. In conclusion, accuracy and repeatability of gait measurements were not compromised by ataxic gait disorder. The accuracy of spatial measures was speed-dependent and a direct comparison of stride length from both devices will be most reliably made at comfortable speed. Measures of stride variability had low agreement between methods in CTR and at retest in both groups. However, the marked increase of stride variability in ataxia outweighs the observed amount of imprecision.
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Affiliation(s)
- Tanja Schmitz-Hübsch
- Department of Neurology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Charite Platz 1, 10117 Berlin, Germany.
| | - Alexander U Brandt
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Charite Platz 1, 10117 Berlin, Germany
| | - Caspar Pfueller
- Department of Neurology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Leonora Zange
- Department of Neurology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Adrian Seidel
- Department of Neurology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Andrea A Kühn
- Department of Neurology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Charite Platz 1, 10117 Berlin, Germany
| | - Friedemann Paul
- Department of Neurology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Charite Platz 1, 10117 Berlin, Germany
| | - Martina Minnerop
- Research Centre Juelich, Institute of Neuroscience and Medicine (INM-1), 52425 Jülich, Germany; Department of Neurology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
| | - Sarah Doss
- Department of Neurology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
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Stefanescu M, Dohnalek M, Maderwald S, Thürling M, Minnerop M, Beck A, Schlamann M, Diedrichsen J, Ladd M, Timmann D. V16. MRI abnormalities of the cerebellar cortex and nuclei in SCA3, SCA6, and Friedreich’s ataxia. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.094] [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: 11/15/2022]
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Doss S, Rinnenthal JL, Schmitz-Hübsch T, Brandt AU, Papazoglou S, Lux S, Maul S, Würfel J, Endres M, Klockgether T, Minnerop M, Paul F. Cerebellar neurochemical alterations in spinocerebellar ataxia type 14 appear to include glutathione deficiency. J Neurol 2015; 262:1927-35. [PMID: 26041613 DOI: 10.1007/s00415-015-7788-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 05/15/2015] [Accepted: 05/17/2015] [Indexed: 12/16/2022]
Abstract
Autosomal dominant ataxia type 14 (SCA14) is a rare usually adult-onset progressive disorder with cerebellar neurodegeneration caused by mutations in protein kinase C gamma. We set out to examine cerebellar and extracerebellar neurochemical changes in SCA14 by MR spectroscopy. In 13 SCA14 patients and 13 healthy sex- and age-matched controls, 3-T single-voxel brain proton MR spectroscopy was performed in a cerebellar voxel of interest (VOI) at TE = 30 ms to obtain a neurochemical profile of metabolites with short relaxation times. In the cerebellum and in additional VOIs in the prefrontal cortex, motor cortex, and somatosensory cortex, a second measurement was performed at TE = 144 ms to mainly extract the total N-acetyl-aspartate (tNAA) signal besides the signals for total creatine (tCr) and total choline (tCho). The cerebellar neurochemical profile revealed a decrease in glutathione (6.12E-06 ± 2.50E-06 versus 8.91E-06 ± 3.03E-06; p = 0028) and tNAA (3.78E-05 ± 5.67E-06 versus 4.25E-05 ± 5.15E-06; p = 0023) and a trend for reduced glutamate (2.63E-05 ± 6.48E-06 versus 3.15E-05 ± 7.61E-06; p = 0062) in SCA14 compared to controls. In the tNAA-focused measurement, cerebellar tNAA (296.6 ± 42.6 versus 351.7 ± 16.5; p = 0004) and tCr (272.1 ± 25.2 versus 303.2 ± 31.4; p = 0004) were reduced, while the prefrontal, somatosensory and motor cortex remained unaffected compared to controls. Neuronal pathology in SCA14 detected by MR spectroscopy was restricted to the cerebellum and did not comprise cortical regions. In the cerebellum, we found in addition to signs of neurodegeneration a glutathione reduction, which has been associated with cellular damage by oxidative stress in other neurodegenerative diseases such as Parkinson's disease and Friedreich's ataxia.
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Affiliation(s)
- Sarah Doss
- Department of Neurology, Charité, Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany,
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31
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Tellmann S, Bludau S, Eickhoff S, Mohlberg H, Minnerop M, Amunts K. Cytoarchitectonic mapping of the human brain cerebellar nuclei in stereotaxic space and delineation of their co-activation patterns. Front Neuroanat 2015; 9:54. [PMID: 26029057 PMCID: PMC4429588 DOI: 10.3389/fnana.2015.00054] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 04/19/2015] [Indexed: 12/22/2022] Open
Abstract
The cerebellar nuclei are involved in several brain functions, including the modulation of motor and cognitive performance. To differentiate their participation in these functions, and to analyze their changes in neurodegenerative and other diseases as revealed by neuroimaging, stereotaxic maps are necessary. These maps reflect the complex spatial structure of cerebellar nuclei with adequate spatial resolution and detail. Here we report on the cytoarchitecture of the dentate, interposed (emboliform and globose) and fastigial nuclei, and introduce 3D probability maps in stereotaxic MNI-Colin27 space as a prerequisite for subsequent meta-analysis of their functional involvement. Histological sections of 10 human post mortem brains were therefore examined. Differences in cell density were measured and used to distinguish a dorsal from a ventral part of the dentate nucleus. Probabilistic maps were calculated, which indicate the position and extent of the nuclei in 3D-space, while considering their intersubject variability. The maps of the interposed and the dentate nuclei differed with respect to their interaction patterns and functions based on meta-analytic connectivity modeling and quantitative functional decoding, respectively. For the dentate nucleus, significant (p < 0.05) co-activations were observed with thalamus, supplementary motor area (SMA), putamen, BA 44 of Broca's region, areas of superior and inferior parietal cortex, and the superior frontal gyrus (SFG). In contrast, the interposed nucleus showed more limited co-activations with SMA, area 44, putamen, and SFG. Thus, the new stereotaxic maps contribute to analyze structure and function of the cerebellum. These maps can be used for anatomically reliable and precise identification of degenerative alteration in MRI-data of patients who suffer from various cerebellar diseases.
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Affiliation(s)
- Stefanie Tellmann
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University and JARA-BrainAachen, Germany
- Institute of Neuroscience and Medicine (INM-1), Structural and Functional Organization of the Human Brain, Research Centre JülichJülich, Germany
| | - Sebastian Bludau
- Institute of Neuroscience and Medicine (INM-1), Structural and Functional Organization of the Human Brain, Research Centre JülichJülich, Germany
| | - Simon Eickhoff
- Institute of Neuroscience and Medicine (INM-1), Structural and Functional Organization of the Human Brain, Research Centre JülichJülich, Germany
- Institute for Clinical Neuroscience and Medical Psychology, Heinrich Heine UniversityDüsseldorf, Germany
| | - Hartmut Mohlberg
- Institute of Neuroscience and Medicine (INM-1), Structural and Functional Organization of the Human Brain, Research Centre JülichJülich, Germany
| | - Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Structural and Functional Organization of the Human Brain, Research Centre JülichJülich, Germany
| | - Katrin Amunts
- Institute of Neuroscience and Medicine (INM-1), Structural and Functional Organization of the Human Brain, Research Centre JülichJülich, Germany
- Cécile and Oskar Vogt Institute of Brain Research, Heinrich Heine UniversityDüsseldorf, Germany
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Stefanescu MR, Dohnalek M, Maderwald S, Thürling M, Minnerop M, Beck A, Schlamann M, Diedrichsen J, Ladd ME, Timmann D. Structural and functional MRI abnormalities of cerebellar cortex and nuclei in SCA3, SCA6 and Friedreich's ataxia. Brain 2015; 138:1182-97. [PMID: 25818870 DOI: 10.1093/brain/awv064] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 01/21/2015] [Indexed: 02/07/2023] Open
Abstract
Spinocerebellar ataxia type 3, spinocerebellar ataxia type 6 and Friedreich's ataxia are common hereditary ataxias. Different patterns of atrophy of the cerebellar cortex are well known. Data on cerebellar nuclei are sparse. Whereas cerebellar nuclei have long been thought to be preserved in spinocerebellar ataxia type 6, histology shows marked atrophy of the nuclei in Friedreich's ataxia and spinocerebellar ataxia type 3. In the present study susceptibility weighted imaging was used to assess atrophy of the cerebellar nuclei in patients with spinocerebellar ataxia type 6 (n = 12, age range 41-76 years, five female), Friedreich's ataxia (n = 12, age range 21-55 years, seven female), spinocerebellar ataxia type 3 (n = 10, age range 34-67 years, three female), and age- and gender-matched controls (total n = 23, age range 22-75 years, 10 female). T1-weighted magnetic resonance images were used to calculate the volume of the cerebellum. In addition, ultra-high field functional magnetic resonance imaging was performed with optimized normalization methods to assess function of the cerebellar cortex and nuclei during simple hand movements. As expected, the volume of the cerebellum was markedly reduced in spinocerebellar ataxia type 6, preserved in Friedreich's ataxia, and mildy reduced in spinocerebellar ataxia type 3. The volume of the cerebellar nuclei was reduced in the three patient groups compared to matched controls (P-values < 0.05; two-sample t-tests). Atrophy of the cerebellar nuclei was most pronounced in spinocerebellar ataxia type 6. On a functional level, hand-movement-related cerebellar activation was altered in all three disorders. Within the cerebellar cortex, functional magnetic resonance imaging signal was significantly reduced in spinocerebellar ataxia type 6 and Friedreich's ataxia compared to matched controls (P-values < 0.001, bootstrap-corrected cluster-size threshold; two-sample t-tests). The difference missed significance in spinocerebellar ataxia type 3. Within the cerebellar nuclei, reductions were significant when comparing spinocerebellar ataxia type 6 and Friedreich's ataxia to matched controls (P < 0.01, bootstrap-corrected cluster-size threshold; two-sample t-tests). Susceptibility weighted imaging allowed depiction of atrophy of the cerebellar nuclei in patients with Friedreich's ataxia and spinocerebellar ataxia type 3. In spinocerebellar ataxia type 6, pathology was not restricted to the cerebellar cortex but also involved the cerebellar nuclei. Functional magnetic resonance imaging data, on the other hand, revealed that pathology in Friedreich's ataxia and spinocerebellar ataxia type 3 is not restricted to the cerebellar nuclei. There was functional involvement of the cerebellar cortex despite no or little structural changes.
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Affiliation(s)
- Maria R Stefanescu
- 1 Department of Neurology, University of Duisburg-Essen, Essen, Germany 2 Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany
| | - Moritz Dohnalek
- 1 Department of Neurology, University of Duisburg-Essen, Essen, Germany
| | - Stefan Maderwald
- 2 Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany
| | - Markus Thürling
- 1 Department of Neurology, University of Duisburg-Essen, Essen, Germany 2 Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany
| | - Martina Minnerop
- 3 Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany 4 Department of Neurology, University of Bonn, Bonn, Germany
| | - Andreas Beck
- 5 Department of Computer Sciences, University of Düsseldorf, Düsseldorf, Germany
| | - Marc Schlamann
- 6 Department of Diagnostic and Interventional Radiology and Neuroradiology, University of Duisburg-Essen, Essen, Germany
| | - Joern Diedrichsen
- 7 Institute of Cognitive Neuroscience, University College London, London, UK
| | - Mark E Ladd
- 2 Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany 6 Department of Diagnostic and Interventional Radiology and Neuroradiology, University of Duisburg-Essen, Essen, Germany 8 Division of Medical Physics in Radiology, University of Heidelberg and German Cancer Research Centre, Heidelberg, Germany
| | - Dagmar Timmann
- 1 Department of Neurology, University of Duisburg-Essen, Essen, Germany
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Affiliation(s)
- Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich GmbH, Jülich, Germany
| | - Peter Bauer
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
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Merkel C, Minnerop M, Roeske S, Gaertner H, Schoene-Bake J, Adler S, Witt J, Anspach C, Schneider-Gold C, Betz R, Helmstaedter C, Tittgemeyer M, Amunts K, Klockgether T, Weber B, Kornblum C. G.P.130. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.160] [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: 11/26/2022]
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35
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Solbach K, Kraff O, Minnerop M, Beck A, Schöls L, Gizewski E, Ladd M, Timmann D. Cerebellar pathology in Friedreich's ataxia: atrophied dentate nuclei with normal iron content. Neuroimage Clin 2014; 6:93-9. [PMID: 25379420 PMCID: PMC4215469 DOI: 10.1016/j.nicl.2014.08.018] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 08/06/2014] [Accepted: 08/21/2014] [Indexed: 01/03/2023]
Abstract
BACKGROUND In Friedreich's ataxia (FA) the genetically decreased expression of the mitochondrial protein frataxin leads to disturbance of the mitochondrial iron metabolism. Within the cerebellum the dentate nuclei (DN) are primarily affected. Histopathological studies show atrophy and accumulation of mitochondrial iron in DN. Dentate iron content has been suggested as a biomarker to measure the effects of siderophores/antioxidant treatment of FA. We assessed the iron content and the volume of DN in FA patients and controls based on ultra-high-field MRI (7 Tesla) images. METHODS Fourteen FA patients (mean age 38.1 yrs) and 14 age- and gender-matched controls participated. Multi-echo gradient echo and susceptibility weighted imaging (SWI) sequences were acquired on a 7 T whole-body scanner. For comparison SWI images were acquired on a 1.5 T MR scanner. Volumes of the DN and cerebellum were assessed at 7 and 1.5 T, respectively. Parametric maps of T2 and T2* sequences were created and proton transverse relaxation rates were estimated as a measure of iron content. RESULTS In FA, the DN and the cerebellum were significantly smaller compared to controls. However, proton transverse relaxation rates of the DN were not significantly different between both groups. CONCLUSIONS Applying in vivo MRI methods we could demonstrate significant atrophy of the DN in the presence of normal iron content. The findings suggest that relaxation rates are not reliable biomarkers in clinical trials evaluating the potential effect of FA therapy.
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Affiliation(s)
- K. Solbach
- Department of Neurology, University of Duisburg-Essen, Hufelandstr. 55, Essen 45147, Germany
| | - O. Kraff
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Arendahls Wiese 199, Essen 45141, Germany
| | - M. Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich 52425, Germany
- Department of Neurology, University Hospital Bonn, Sigmund-Freud-straße 25, Bonn 53127, Germany
| | - A. Beck
- Department of Computer Sciences, University of Düsseldorf, Universitätsstraße 1, Düsseldorf 40225, Germany
| | - L. Schöls
- Department of Neurology, Eberhard Karls-University, Geschwister-Scholl-platz, Tübingen, Tübingen 72074, Germany
- Hertie Institute for Clinical Brain Research, Eberhard Karls-University Tübingen, Hoppe-Seyler-straße 3, Tübingen 72076, Germany
- German Research Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-straße 27, Tübingen 72076, Germany
| | - E.R. Gizewski
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University of Duisburg-Essen, Hufelandstr. 55, Essen 45147, Germany
| | - M.E. Ladd
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Arendahls Wiese 199, Essen 45141, Germany
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University of Duisburg-Essen, Hufelandstr. 55, Essen 45147, Germany
| | - D. Timmann
- Department of Neurology, University of Duisburg-Essen, Hufelandstr. 55, Essen 45147, Germany
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36
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Caspers S, Moebus S, Lux S, Pundt N, Schütz H, Mühleisen TW, Gras V, Eickhoff SB, Romanzetti S, Stöcker T, Stirnberg R, Kirlangic ME, Minnerop M, Pieperhoff P, Mödder U, Das S, Evans AC, Jöckel KH, Erbel R, Cichon S, Nöthen MM, Sturma D, Bauer A, Jon Shah N, Zilles K, Amunts K. Studying variability in human brain aging in a population-based German cohort-rationale and design of 1000BRAINS. Front Aging Neurosci 2014; 6:149. [PMID: 25071558 PMCID: PMC4094912 DOI: 10.3389/fnagi.2014.00149] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 06/17/2014] [Indexed: 12/26/2022] Open
Abstract
The ongoing 1000 brains study (1000BRAINS) is an epidemiological and neuroscientific investigation of structural and functional variability in the human brain during aging. The two recruitment sources are the 10-year follow-up cohort of the German Heinz Nixdorf Recall (HNR) Study, and the HNR MultiGeneration Study cohort, which comprises spouses and offspring of HNR subjects. The HNR is a longitudinal epidemiological investigation of cardiovascular risk factors, with a comprehensive collection of clinical, laboratory, socioeconomic, and environmental data from population-based subjects aged 45–75 years on inclusion. HNR subjects underwent detailed assessments in 2000, 2006, and 2011, and completed annual postal questionnaires on health status. 1000BRAINS accesses these HNR data and applies a separate protocol comprising: neuropsychological tests of attention, memory, executive functions and language; examination of motor skills; ratings of personality, life quality, mood and daily activities; analysis of laboratory and genetic data; and state-of-the-art magnetic resonance imaging (MRI, 3 Tesla) of the brain. The latter includes (i) 3D-T1- and 3D-T2-weighted scans for structural analyses and myelin mapping; (ii) three diffusion imaging sequences optimized for diffusion tensor imaging, high-angular resolution diffusion imaging for detailed fiber tracking and for diffusion kurtosis imaging; (iii) resting-state and task-based functional MRI; and (iv) fluid-attenuated inversion recovery and MR angiography for the detection of vascular lesions and the mapping of white matter lesions. The unique design of 1000BRAINS allows: (i) comprehensive investigation of various influences including genetics, environment and health status on variability in brain structure and function during aging; and (ii) identification of the impact of selected influencing factors on specific cognitive subsystems and their anatomical correlates.
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Affiliation(s)
- Svenja Caspers
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany
| | - Susanne Moebus
- Institute of Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen Essen, Germany
| | - Silke Lux
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany
| | - Noreen Pundt
- Institute of Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen Essen, Germany
| | - Holger Schütz
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany
| | - Thomas W Mühleisen
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany ; Department of Genomics, Life & Brain Center, University of Bonn Bonn, Germany ; Institute of Human Genetics, University of Bonn Bonn, Germany
| | - Vincent Gras
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany ; Institute for Clinical Neuroscience and Medical Psychology, University of Düsseldorf Düsseldorf, Germany
| | - Sandro Romanzetti
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany
| | - Tony Stöcker
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany
| | - Rüdiger Stirnberg
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany
| | - Mehmet E Kirlangic
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany
| | - Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany
| | - Peter Pieperhoff
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany
| | - Ulrich Mödder
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany
| | - Samir Das
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University Montreal, QC, Canada
| | - Alan C Evans
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University Montreal, QC, Canada
| | - Karl-Heinz Jöckel
- Institute of Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen Essen, Germany
| | - Raimund Erbel
- Department of Cardiology, University of Duisburg-Essen Essen, Germany
| | - Sven Cichon
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany ; Department of Genomics, Life & Brain Center, University of Bonn Bonn, Germany ; Institute of Human Genetics, University of Bonn Bonn, Germany ; Division of Medical Genetics, Department of Biomedicine, University of Basel Basel, Switzerland
| | - Markus M Nöthen
- Department of Genomics, Life & Brain Center, University of Bonn Bonn, Germany ; Institute of Human Genetics, University of Bonn Bonn, Germany
| | - Dieter Sturma
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany ; Institute for Science and Ethics, University of Bonn Bonn, Germany
| | - Andreas Bauer
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany ; Department of Neurology, Heinrich-Heine-University Düsseldorf Düsseldorf, Germany
| | - N Jon Shah
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany ; JARA-BRAIN, Jülich-Aachen Research Alliance Jülich, Germany ; Department of Neurology, RWTH Aachen University Aachen, Germany
| | - Karl Zilles
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany ; JARA-BRAIN, Jülich-Aachen Research Alliance Jülich, Germany ; Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen University Aachen, Germany
| | - Katrin Amunts
- Institute of Neuroscience and Medicine (INM-1, INM-2, INM-4, INM-8), Research Centre Jülich Jülich, Germany ; JARA-BRAIN, Jülich-Aachen Research Alliance Jülich, Germany ; C. and O. Vogt Institute for Brain Research, Heinrich-Heine-University Düsseldorf Düsseldorf, Germany
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Heim S, Pieperhoff P, Grande M, Kuijsten W, Wellner B, Sáez LE, Schulte S, Südmeyer M, Caspers S, Minnerop M, Binkofski F, Huber W, Amunts K. Longitudinal changes in brains of patients with fluent primary progressive aphasia. Brain Lang 2014; 131:11-19. [PMID: 23796527 DOI: 10.1016/j.bandl.2013.05.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 05/18/2013] [Indexed: 06/02/2023]
Abstract
Primary progressive aphasia (PPA) is a rare clinical dementia syndrome with predominant, progressive language impairment. Clinical symptoms, linguistic impairment and the course of the disease may vary considerably between patients. In order to capture these aspects, longitudinal assessments of neurofunctional changes in PPA including their relationship to behaviour and clinical symptoms are mandatory, ideally at intervals shorter than 1 year. Here, we report a longitudinal fMRI study investigating the development of lexical processing and their neural basis in PPA patients over 1year. Four logopenic PPA patients and four matched controls were scanned 3 times (T1, T2, T3, at 6months intervals) while performing a visual lexical decision task on German words and pseudowords. Group differences for the lexicality effect (pseudowords>words) were assessed at time point T1 and its longitudinal changes in the BOLD signal associated with the lexicality effect were analysed. Brain atrophy was assessed with a high-resolution MPRAGE sequence and analysed using deformation based morphometry (DBM). From the very beginning of the study, PPA patients showed reduced left-hemispheric and increased right-hemispheric activations compared to controls. During the progression of the disease, activation increased predominantly in left posterior middle temporal gyrus (pMTG) and inferior frontal junction area, whereas the same regions decreased in activity in control brains. Interestingly, DBM data showed that this increase in activation in PPA patients was accompanied by progressing atrophy in the same regions. At a behavioural level, the accuracy in the lexical decision task was comparably high for both groups during the whole period of examination, despite some large variability between patients. To conclude, the dissociation between (i) maintained high performance, (ii) increased activity in regions involved in lexical access such as pMTG, and (iii) progressive atrophy of the very same regions supports the notion of a compensatory mechanism in brains of PPA patients for maintaining language while brain atrophy is progressing. The activity increase within a left-lateralised fronto-temporal network seems vital for high-level performance, whereas initial right-hemispheric recruitment of homologue language regions, which is reminiscent of that in vascular aphasics, has no continuous impact on lexical performance.
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Affiliation(s)
- Stefan Heim
- Section Structural Functional Brain Mapping, Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany; JARA - Translational Brain Medicine, Jülich and Aachen, Germany; Research Centre Jülich, Institute of Neuroscience and Medicine (INM-1, INM-2), Jülich, Germany; Section Neurological Cognition Research, Department of Neurology, Medical School, RWTH Aachen University, Aachen, Germany.
| | - Peter Pieperhoff
- JARA - Translational Brain Medicine, Jülich and Aachen, Germany; Research Centre Jülich, Institute of Neuroscience and Medicine (INM-1, INM-2), Jülich, Germany
| | - Marion Grande
- JARA - Translational Brain Medicine, Jülich and Aachen, Germany; Section Neurological Cognition Research, Department of Neurology, Medical School, RWTH Aachen University, Aachen, Germany
| | - Wiebke Kuijsten
- JARA - Translational Brain Medicine, Jülich and Aachen, Germany; Research Centre Jülich, Institute of Neuroscience and Medicine (INM-1, INM-2), Jülich, Germany
| | - Barbara Wellner
- Section Structural Functional Brain Mapping, Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany; JARA - Translational Brain Medicine, Jülich and Aachen, Germany; Research Centre Jülich, Institute of Neuroscience and Medicine (INM-1, INM-2), Jülich, Germany
| | - Louise Etcheverry Sáez
- Section Structural Functional Brain Mapping, Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany; JARA - Translational Brain Medicine, Jülich and Aachen, Germany; Research Centre Jülich, Institute of Neuroscience and Medicine (INM-1, INM-2), Jülich, Germany
| | - Stephanie Schulte
- JARA - Translational Brain Medicine, Jülich and Aachen, Germany; Research Centre Jülich, Institute of Neuroscience and Medicine (INM-1, INM-2), Jülich, Germany
| | - Martin Südmeyer
- Department of Neurology, University Hospital HHU, Düsseldorf, Germany
| | - Svenja Caspers
- Research Centre Jülich, Institute of Neuroscience and Medicine (INM-1, INM-2), Jülich, Germany
| | - Martina Minnerop
- JARA - Translational Brain Medicine, Jülich and Aachen, Germany; Research Centre Jülich, Institute of Neuroscience and Medicine (INM-1, INM-2), Jülich, Germany
| | - Ferdinand Binkofski
- Section Neurological Cognition Research, Department of Neurology, Medical School, RWTH Aachen University, Aachen, Germany
| | - Walter Huber
- Section Neurological Cognition Research, Department of Neurology, Medical School, RWTH Aachen University, Aachen, Germany
| | - Katrin Amunts
- Section Structural Functional Brain Mapping, Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany; JARA - Translational Brain Medicine, Jülich and Aachen, Germany; Research Centre Jülich, Institute of Neuroscience and Medicine (INM-1, INM-2), Jülich, Germany; C. and O. Vogt Instutute for Brain Research, Heinrich-Heine-University, Düsseldorf, Germany
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Roeske S, Filla I, Heim S, Amunts K, Helmstaedter C, Wüllner U, Wagner M, Klockgether T, Minnerop M. Reply to: Cognitive dysfunction in spinocerebellar ataxia type 3: variable topographies and patterns. Mov Disord 2013; 29:157-8. [PMID: 24338591 DOI: 10.1002/mds.25755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 10/23/2013] [Accepted: 10/30/2013] [Indexed: 12/25/2022] Open
Affiliation(s)
- Sandra Roeske
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department of Neurology, University Hospital of Bonn, Bonn, Germany
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39
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Gärtner H, Minnerop M, Pieperhoff P, Schleicher A, Zilles K, Altenmüller E, Amunts K. Brain morphometry shows effects of long-term musical practice in middle-aged keyboard players. Front Psychol 2013; 4:636. [PMID: 24069009 PMCID: PMC3779931 DOI: 10.3389/fpsyg.2013.00636] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 08/27/2013] [Indexed: 12/13/2022] Open
Abstract
To what extent does musical practice change the structure of the brain? In order to understand how long-lasting musical training changes brain structure, 20 male right-handed, middle-aged professional musicians and 19 matched controls were investigated. Among the musicians, 13 were pianists or organists with intensive practice regimes. The others were either music teachers at schools or string instrumentalists, who had studied the piano at least as a subsidiary subject, and practiced less intensively. The study was based on T1-weighted MR images, which were analyzed using deformation-based morphometry. Cytoarchitectonic probabilistic maps of cortical areas and subcortical nuclei as well as myeloarchitectonic maps of fiber tracts were used as regions of interest to compare volume differences in the brains of musicians and controls. In addition, maps of voxel-wise volume differences were computed and analyzed. Musicians showed a significantly better symmetric motor performance as well as a greater capability of controlling hand independence than controls. Structural MRI-data revealed significant volumetric differences between the brains of keyboard players, who practiced intensively and controls in right sensorimotor areas and the corticospinal tract as well as in the entorhinal cortex and the left superior parietal lobule. Moreover, they showed also larger volumes in a comparable set of regions than the less intensively practicing musicians. The structural changes in the sensory and motor systems correspond well to the behavioral results, and can be interpreted in terms of plasticity as a result of intensive motor training. Areas of the superior parietal lobule and the entorhinal cortex might be enlarged in musicians due to their special skills in sight-playing and memorizing of scores. In conclusion, intensive and specific musical training seems to have an impact on brain structure, not only during the sensitive period of childhood but throughout life.
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Affiliation(s)
- H Gärtner
- Institute of Neuroscience and Medicine (INM-1), Forschungszentrum Jülich Jülich, Germany
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Ganos C, Zittel S, Minnerop M, Schunke O, Heinbokel C, Gerloff C, Zühlke C, Bauer P, Klockgether T, Münchau A, Bäumer T. Clinical and Neurophysiological Profile of Four German Families with Spinocerebellar Ataxia Type 14. Cerebellum 2013; 13:89-96. [DOI: 10.1007/s12311-013-0522-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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41
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Giordano I, Bogdanow M, Jacobi H, Jahn K, Minnerop M, Schoels L, Synofzik M, Teufel J, Klockgether T. Experience in a short-term trial with 4-Aminopyridine in cerebellar ataxia. J Neurol 2013; 260:2175-6. [DOI: 10.1007/s00415-013-7029-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 06/24/2013] [Accepted: 06/25/2013] [Indexed: 10/26/2022]
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Roeske S, Filla I, Heim S, Amunts K, Helmstaedter C, Wüllner U, Wagner M, Klockgether T, Minnerop M. Progressive cognitive dysfunction in spinocerebellar ataxia type 3. Mov Disord 2013; 28:1435-8. [PMID: 23736996 DOI: 10.1002/mds.25512] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [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: 02/06/2013] [Revised: 04/09/2013] [Accepted: 04/16/2013] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Although it is well established that there is cognitive dysfunction in spinocerebellar ataxia type 3 (SCA3), it is unknown whether cognition deteriorates with disease progression. We therefore prospectively studied cognitive function in patients with SCA3. METHODS Eleven patients with SCA3 were assessed using an extensive neuropsychological test battery and retested after 3.5 ± 0.4 years. RESULTS In addition to ataxia and motor control, verbal learning and verbal and figural memory deteriorated significantly during the follow-up period. An increase in depressive symptoms was not observed. CONCLUSIONS The observation that memory and learning abilities deteriorated with disease progression suggests that cognitive dysfunction is an integral part of SCA3. Because the applied tests for memory function did not require motor responses, cognitive decline cannot be attributed to progressive cerebellar ataxia. The deterioration of verbal and figural memory can be explained either by extracerebellar pathology or by disruption of cerebellar-cerebral circuitries.
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Affiliation(s)
- Sandra Roeske
- German Center for Neurodegenerative Diseases, Bonn, Germany; Department of Neurology, University Hospital of Bonn, Bonn, Germany
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Minnerop M, Herbst M, Fimmers R, Kaabar P, Matz B, Klockgether T, Wüllner U. Erratum to: Bell’s palsy. J Neurol 2013. [DOI: 10.1007/s00415-013-6865-7] [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: 11/30/2022]
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Abstract
Spinocerebellar ataxias are genetically heterogeneous autosomal dominant ataxia disorders. To date more than 30 different subtypes are known. In Germany particularly SCA1, SCA2, SCA3 and SCA6 are prevalent, as well as the less frequent subtypes SCA5, SCA14, SCA15, SCA17 and SCA28. Genetic causes range from coding repeat expansions (polyglutamine diseases), to non-coding expansions as well as conventional mutations. In some subtypes the genetic background is currently unknown. Age of onset, typical clinical findings and geographic distribution may help to reach a correct diagnosis; however a definitive diagnosis requires molecular genetic testing.
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Affiliation(s)
- H Jacobi
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland.
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Etcheverry L, Seidel B, Grande M, Schulte S, Pieperhoff P, Südmeyer M, Minnerop M, Binkofski F, Huber W, Grodzinsky Y, Amunts K, Heim S. The time course of neurolinguistic and neuropsychological symptoms in three cases of logopenic primary progressive aphasia. Neuropsychologia 2012; 50:1708-18. [PMID: 22484080 DOI: 10.1016/j.neuropsychologia.2012.03.028] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [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: 06/22/2011] [Revised: 03/12/2012] [Accepted: 03/22/2012] [Indexed: 11/19/2022]
Abstract
Primary progressive aphasia (PPA) is a rare clinical dementia syndrome affecting predominantly language abilities. Word-finding difficulties and comprehension deficits despite relatively preserved cognitive functions are characteristic symptoms during the first two years, and distinguish PPA from other dementia types like Alzheimer's disease. However, the dynamics of changes in language and non-linguistic abilities are not well understood. Most studies on progression used cross-sectional designs, which provide only limited insight into the course of the disease. Here we report the results of a longitudinal study in three cases of logopenic PPA over a period of 18 months, with exemplary longitudinal data from one patient even over 46 months. A comprehensive battery of neurolinguistic and neuropsychological tests was applied four times at intervals of six months. Over this period, deterioration of verbal abilities such as picture naming, story retelling, and semantic word recall was found, and the individual decline was quantified and compared between the three patients. Furthermore, decrease in non-verbal skills such as divided attention and increasing apraxia was observed in all three patients. In addition, inter-subject variability in the progression with different focuses was observed, with one patient developing a non-fluent PPA variant. The longitudinal, multivariate investigation of logopenic PPA thus provides novel insights into the progressive deterioration of verbal as well as non-verbal abilities. These deficits may further interact and thus form a multi-causal basis for the patients' problems in every-day life which need to be considered when planning individually targeted intervention in PPA.
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Affiliation(s)
- Louise Etcheverry
- Research Centre Jülich, Institute for Neuroscience and Medicine (INM-1, INM-2), Jülich, Germany
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Minnerop M, Greschus S, Lütjohann D, Klockgether T. Never neglect inspecting the leg in movement disorders. ACTA ACUST UNITED AC 2012; 69:782-3. [PMID: 22351851 DOI: 10.1001/archneurol.2011.1523] [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: 11/14/2022]
Affiliation(s)
- Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, D52425 Jülich, Germany.
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47
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Heinzel A, Minnerop M, Schäfer R, Müller HW, Franz M, Hautzel H. Alexithymia in healthy young men: a voxel-based morphometric study. J Affect Disord 2012; 136:1252-6. [PMID: 21723620 DOI: 10.1016/j.jad.2011.06.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 06/10/2011] [Accepted: 06/11/2011] [Indexed: 11/15/2022]
Abstract
BACKGROUND Alexithymia is a personality construct predominately associated with an impaired ability to identify and communicate emotions. Functional imaging studies showed that an altered function of the anterior cingulate cortex (ACC) may be relevant in alexithymia. In this study we investigated if the altered functional anatomy is related to structural changes (A) in the whole brain and (B) specifically in the ACC by applying a region-of-interest analysis. METHODS 33 high- and 31 low-alexithymic right-handed young male subjects (selected by the 20-item Toronto Alexithymia Scale, TAS-20) were investigated using voxel-based morphometry (VBM) on high-resolution 3D magnetic resonance images. The group differences were analyzed by applying voxel-wise comparisons using two-sample t-tests. Moreover regression analyses with regard to the individual TAS-20 sum scores were calculated. RESULTS Neither the subtraction analyses nor the correlation analyses revealed significant differences between high- and low-alexithymic subjects. Thus, according to our results, the null hypothesis of no structural difference between the groups could not be rejected. LIMITATIONS The findings cannot be generalized to female subjects. CONCLUSIONS Our results did not reveal morphological differences between high- and low-alexithymic subjects. The functional differences known from imaging studies could not be attributed to underlying anatomical changes. Thus, the personality trait of alexithymia might be associated with fewer morphological abnormalities than previously assumed.
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Affiliation(s)
- Alexander Heinzel
- Department of Nuclear Medicine, Medical Faculty, University of Düsseldorf, Juelich, Germany.
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48
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Minnerop M, Weber B, Schoene-Bake JC, Roeske S, Mirbach S, Anspach C, Schneider-Gold C, Betz RC, Helmstaedter C, Tittgemeyer M, Klockgether T, Kornblum C. The brain in myotonic dystrophy 1 and 2: evidence for a predominant white matter disease. ACTA ACUST UNITED AC 2011; 134:3530-46. [PMID: 22131273 PMCID: PMC3235566 DOI: 10.1093/brain/awr299] [Citation(s) in RCA: 168] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Myotonic dystrophy types 1 and 2 are progressive multisystemic disorders with potential brain involvement. We compared 22 myotonic dystrophy type 1 and 22 myotonic dystrophy type 2 clinically and neuropsychologically well-characterized patients and a corresponding healthy control group using structural brain magnetic resonance imaging at 3 T (T1/T2/diffusion-weighted). Voxel-based morphometry and diffusion tensor imaging with tract-based spatial statistics were applied for voxel-wise analysis of cerebral grey and white matter affection (Pcorrected < 0.05). We further examined the association of structural brain changes with clinical and neuropsychological data. White matter lesions rated visually were more prevalent and severe in myotonic dystrophy type 1 compared with controls, with frontal white matter most prominently affected in both disorders, and temporal lesions restricted to myotonic dystrophy type 1. Voxel-based morphometry analyses demonstrated extensive white matter involvement in all cerebral lobes, brainstem and corpus callosum in myotonic dystrophy types 1 and 2, while grey matter decrease (cortical areas, thalamus, putamen) was restricted to myotonic dystrophy type 1. Accordingly, we found more prominent white matter affection in myotonic dystrophy type 1 than myotonic dystrophy type 2 by diffusion tensor imaging. Association fibres throughout the whole brain, limbic system fibre tracts, the callosal body and projection fibres (e.g. internal/external capsules) were affected in myotonic dystrophy types 1 and 2. Central motor pathways were exclusively impaired in myotonic dystrophy type 1. We found mild executive and attentional deficits in our patients when neuropsychological tests were corrected for manual motor dysfunctioning. Regression analyses revealed associations of white matter affection with several clinical parameters in both disease entities, but not with neuropsychological performance. We showed that depressed mood and fatigue were more prominent in patients with myotonic dystrophy type 1 with less white matter affection (early disease stages), contrary to patients with myotonic dystrophy type 2. Thus, depression in myotonic dystrophies might be a reactive adjustment disorder rather than a direct consequence of structural brain damage. Associations of white matter affection with age/disease duration as well as patterns of cerebral water diffusion parameters pointed towards an ongoing process of myelin destruction and/or axonal loss in our cross-sectional study design. Our data suggest that both myotonic dystrophy types 1 and 2 are serious white matter diseases with prominent callosal body and limbic system affection. White matter changes dominated the extent of grey matter changes, which might argue against Wallerian degeneration as the major cause of white matter affection in myotonic dystrophies.
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Affiliation(s)
- Martina Minnerop
- Department of Neurology, University Hospital of Bonn, 53105 Bonn, Germany
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Affiliation(s)
- Oliver Kaut
- Department of Neurology, University of Bonn, Bonn, Germany
| | - Niels Allert
- Neurological Rehabilitation Centre Godeshoehe, Bonn, Germany
| | - Christoph Coch
- Institute of Clinical Chemistry and Pharmacology, CSSC (Clinical Study Support Core), University of Bonn, Bonn, Germany
| | - Sebastian Paus
- Department of Neurology, University of Bonn, Bonn, Germany
| | - Agata Grzeska
- Department of Neurology, University of Bonn, Bonn, Germany
| | - Martina Minnerop
- Department of Neurology, University of Bonn, Bonn, Germany
- Institute of Neurosciences and Medicine (INM-1), Research Centre Jülich, Germany
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50
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Minnerop M, Lüders E, Specht K, Ruhlmann J, Schimke N, Thompson PM, Chou YY, Toga AW, Abele M, Wüllner U, Klockgether T. Callosal tissue loss in multiple system atrophy--a one-year follow-up study. Mov Disord 2011; 25:2613-20. [PMID: 20623690 DOI: 10.1002/mds.23318] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Multiple system atrophy (MSA) is a neurodegenerative disease not only affecting the basal ganglia, brainstem, cerebellum, and intermediolateral cell columns of the spinal cord but also the cerebral cortex. Clinically, cerebellar (MSA-C) and parkinsonian variants of MSA (MSA-P) are distinguished. We investigated 14 MSA patients (10 MSA-C, 4 MSA-P, men: 7, women: 7; age: 61.1 ± 3.3 years) and 14 matched controls (men: 7, women: 7; age: 58.6 ± 5.1 years) with voxel-based morphometry (VBM) to analyze gray and white matter differences both at baseline and at follow-up, 1 year later. Baseline comparisons between patients and controls confirmed significantly less gray matter in MSA in the cerebellum and cerebral cortex, and significantly less white matter in the cerebellar peduncles and brainstem. Comparisons of tissue-loss profiles (i.e., baseline versus follow-up) between patients and controls, revealed white matter reduction in MSA along the middle cerebellar peduncles, reflecting degeneration of the ponto-cerebellar tract as a particularly prominent and progressive morphological alteration in MSA. Comparisons between baseline and follow-up, separately performed in patients and controls, revealed additional white matter reduction in MSA along the corpus callosum at follow-up. This was replicated through additional shape-based analyses indicating a reduced callosal thickness in the anterior and posterior midbody, extending posteriorly into the isthmus. Callosal atrophy may possibly reflect a disease-specific pattern of neurodegeneration and cortical atrophy, fitting well with the predominant impairment of motor functions in the MSA patients.
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Affiliation(s)
- Martina Minnerop
- Institute of Neurosciences and Medicine-1, Research Centre Jülich, Jülich, Germany.
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