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Doherty CM, Howard P, O'Donnell LF, Zuccarino R, Wastling S, Milev E, Banks T, Shah S, Zafeiropoulos N, Stephens KJ, Sarkozy A, Grider T, Feely SME, Manzur A, Shy RR, Skorupinska M, Pipis M, Nicolaisen E, McDowell A, Dilek N, Rossor AM, Laura M, Clark C, Muntoni F, Thedens D, Thornton J, Morrow JM, Shy ME, Reilly MM. Quantitative Foot Muscle Magnetic Resonance Imaging Reliably Measures Disease Progression in Children and Adolescents with Charcot-Marie-Tooth Disease Type 1A. Ann Neurol 2024. [PMID: 38613459 DOI: 10.1002/ana.26934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/13/2024] [Accepted: 03/19/2024] [Indexed: 04/15/2024]
Abstract
Quantitative muscle fat fraction (FF) responsiveness is lower in younger Charcot-Marie-Tooth disease type 1A (CMT1A) patients with lower baseline calf-level FF. We investigated the practicality, validity, and responsiveness of foot-level FF in this cohort involving 22 CMT1A patients and 14 controls. The mean baseline foot-level FF was 25.9 ± 20.3% in CMT1A patients, and the 365-day FF (n = 15) increased by 2.0 ± 2.4% (p < 0.001 vs controls). Intrinsic foot-level FF demonstrated large responsiveness (12-month standardized response mean (SRM) of 0.86) and correlated with the CMT examination score (ρ = 0.58, P = 0.01). Intrinsic foot-level FF has the potential to be used as a biomarker in future clinical trials involving younger CMT1A patients. ANN NEUROL 2024.
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Affiliation(s)
- Carolynne M Doherty
- Center for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Paige Howard
- Roy and Lucille Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Luke F O'Donnell
- Center for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Riccardo Zuccarino
- Roy and Lucille Carver College of Medicine, University of Iowa, Iowa City, IA, USA
- Fondazione Serena Onlus, Centro Clinico NeMO Trento, Italy
| | - Stephen Wastling
- Lysholm Department of Radiology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Evelin Milev
- Dubowitz Neuromuscular Center, Great Ormond Street Hospital, London, UK
| | - Tina Banks
- Department of Radiology, Great Ormond Street Hospital, London, UK
| | - Sachit Shah
- Lysholm Department of Radiology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Nick Zafeiropoulos
- Lysholm Department of Radiology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Katherine J Stephens
- Roy and Lucille Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Anna Sarkozy
- Dubowitz Neuromuscular Center, Great Ormond Street Hospital, London, UK
| | - Tiffany Grider
- Roy and Lucille Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Shawna M E Feely
- Division of Pediatric Neurology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Adnan Manzur
- Dubowitz Neuromuscular Center, Great Ormond Street Hospital, London, UK
| | - Rosemary R Shy
- Roy and Lucille Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Mariola Skorupinska
- Center for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Menelaos Pipis
- Center for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Emma Nicolaisen
- Roy and Lucille Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Amy McDowell
- Center for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
- Lysholm Department of Radiology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Nuran Dilek
- University of Rochester School of Medicine and Dentistry, New York, NY, USA
| | - Alexander M Rossor
- Center for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Matilde Laura
- Center for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | | | - Francesco Muntoni
- Dubowitz Neuromuscular Center, Great Ormond Street Hospital, London, UK
| | - Daniel Thedens
- Roy and Lucille Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - John Thornton
- Lysholm Department of Radiology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Jasper M Morrow
- Center for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Michael E Shy
- Roy and Lucille Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Mary M Reilly
- Center for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
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2
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Doherty CM, Morrow JM, Zuccarino R, Howard P, Wastling S, Pipis M, Zafeiropoulos N, Stephens KJ, Grider T, Feely SME, Nopoulous P, Skorupinska M, Milev E, Nicolaisen E, Dudzeic M, McDowell A, Dilek N, Muntoni F, Rossor AM, Shah S, Laura M, Yousry TA, Thedens D, Thornton J, Shy ME, Reilly MM. Lower limb muscle MRI fat fraction is a responsive outcome measure in CMT X1, 1B and 2A. Ann Clin Transl Neurol 2024; 11:607-617. [PMID: 38173284 DOI: 10.1002/acn3.51979] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 11/23/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVE With potential therapies for many forms of Charcot-Marie-Tooth disease (CMT), responsive outcome measures are urgently needed for clinical trials. Quantitative lower limb MRI demonstrated progressive calf intramuscular fat accumulation in the commonest form, CMT1A with large responsiveness. In this study, we evaluated the responsiveness and validity in the three other common forms, due to variants in GJB1 (CMTX1), MPZ (CMT1B) and MFN2 (CMT2A). METHODS 22 CMTX1, 21 CMT1B and 21 CMT2A patients and matched controls were assessed at a 1-year interval. Intramuscular fat fraction (FF) was evaluated using three-point Dixon MRI at thigh and calf level along with clinical measures including CMT examination score, clinical strength assessment, CMT-HI and plasma neurofilament light chain. RESULTS All patient groups had elevated muscle fat fraction at thigh and calf levels, with highest thigh FF and atrophy in CMT2A. There was moderate correlation between calf muscle FF and clinical measures (CMTESv2 rho = 0.405; p = 0.001, ankle MRC strength rho = -0.481; p < 0.001). Significant annualised progression in calf muscle FF was seen in all patient groups (CMTX1 2.0 ± 2.0%, p < 0.001, CMT1B 1.6 ± 2.1% p = 0.004 and CMT2A 1.6 ± 2.1% p = 0.002). Greatest increase was seen in patients with 10-70% FF at baseline (calf 2.7 ± 2.3%, p < 0.0001 and thigh 1.7 ± 2.1%, p = 0.01). INTERPRETATION Our results confirm that calf muscle FF is highly responsive over 12 months in three additional common forms of CMT which together with CMT1A account for 90% of genetically confirmed cases. Calf muscle MRI FF should be a valuable outcome measure in upcoming CMT clinical trials.
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Affiliation(s)
- Carolynne M Doherty
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Jasper M Morrow
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Riccardo Zuccarino
- Roy and Lucille Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
- Fondazione Serena Onlus, Centro Clinico NeMO Trento, Pergine Valsugana, Italy
| | - Paige Howard
- Roy and Lucille Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Stephen Wastling
- Lysholm Department of Radiology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Menelaos Pipis
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Nick Zafeiropoulos
- Lysholm Department of Radiology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Katherine J Stephens
- Roy and Lucille Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Tiffany Grider
- Roy and Lucille Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Shawna M E Feely
- Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington, USA
| | - Peggy Nopoulous
- Roy and Lucille Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Mariola Skorupinska
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | | | - Emma Nicolaisen
- Roy and Lucille Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Magdalena Dudzeic
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Amy McDowell
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
- Lysholm Department of Radiology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Nuran Dilek
- University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | | | - Alexander M Rossor
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Sachit Shah
- Lysholm Department of Radiology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Matilde Laura
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Tarek A Yousry
- Lysholm Department of Radiology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Daniel Thedens
- Roy and Lucille Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - John Thornton
- Lysholm Department of Radiology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Michael E Shy
- Roy and Lucille Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Mary M Reilly
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
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Pipis M, Jaunmuktane Z, Marafioti T, Brandner S, Smith EC, D'Sa S, Lunn MP, Cwynarski K, Fialho D, Shah S, Fuller GN, Reilly MM. Nerve biopsy in T-cell lymphoma with neurolymphomatosis: where and when. Pract Neurol 2024:pn-2023-003992. [PMID: 38272664 DOI: 10.1136/pn-2023-003992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2024] [Indexed: 01/27/2024]
Abstract
Peripheral T-cell lymphomas are rare heterogeneous haematological malignancies that may also involve peripheral nerves in a very small subset of cases. We report a patient with a diagnostically challenging cutaneous T-cell lymphoma and multifocal mononeuropathies in whom a targeted nerve biopsy identified lymphomatous infiltration of nerves and expedited combination treatment with chemotherapy and an autologous stem cell transplant. She showed an excellent response with a complete metabolic response on positron emission tomography imaging and significant clinical improvement, maintained 5 years post-treatment.
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Affiliation(s)
- Menelaos Pipis
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
- Department of Neurology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Zane Jaunmuktane
- Department of Neuropathology, The National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, UK
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Teresa Marafioti
- Department of Histopathology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Sebastian Brandner
- Department of Neuropathology, The National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, UK
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Elaine C Smith
- Department of Rheumatology, Cheltenham General Hospital, Cheltenham, UK
| | - Shirley D'Sa
- Department of Clinical Haematology, UCLH NHS Foundation Trust, London, UK
| | - Michael P Lunn
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Kate Cwynarski
- Department of Clinical Haematology, UCLH NHS Foundation Trust, London, UK
| | - Doreen Fialho
- Department of Clinical Neurophysiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sachit Shah
- Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, UK
| | - Geraint N Fuller
- Department of Neurology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
| | - Mary M Reilly
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
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4
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O'Donnell LF, Pipis M, Thornton JS, Kanber B, Wastling S, McDowell A, Zafeiropoulos N, Laura M, Skorupinska M, Record CJ, Doherty CM, Herrmann DN, Zetterberg H, Heslegrave AJ, Laban R, Rossor AM, Morrow JM, Reilly MM. Quantitative MRI outcome measures in CMT1A using automated lower limb muscle segmentation. J Neurol Neurosurg Psychiatry 2023:jnnp-2023-332454. [PMID: 37979968 DOI: 10.1136/jnnp-2023-332454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/25/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Lower limb muscle magnetic resonance imaging (MRI) obtained fat fraction (FF) can detect disease progression in patients with Charcot-Marie-Tooth disease 1A (CMT1A). However, analysis is time-consuming and requires manual segmentation of lower limb muscles. We aimed to assess the responsiveness, efficiency and accuracy of acquiring FF MRI using an artificial intelligence-enabled automated segmentation technique. METHODS We recruited 20 CMT1A patients and 7 controls for assessment at baseline and 12 months. The three-point-Dixon fat water separation technique was used to determine thigh-level and calf-level muscle FF at a single slice using regions of interest defined using Musclesense, a trained artificial neural network for lower limb muscle image segmentation. A quality control (QC) check and correction of the automated segmentations was undertaken by a trained observer. RESULTS The QC check took on average 30 seconds per slice to complete. Using QC checked segmentations, the mean calf-level FF increased significantly in CMT1A patients from baseline over an average follow-up of 12.5 months (1.15%±1.77%, paired t-test p=0.016). Standardised response mean (SRM) in patients was 0.65. Without QC checks, the mean FF change between baseline and follow-up, at 1.15%±1.68% (paired t-test p=0.01), was almost identical to that seen in the corrected data, with a similar overall SRM at 0.69. CONCLUSIONS Using automated image segmentation for the first time in a longitudinal study in CMT, we have demonstrated that calf FF has similar responsiveness to previously published data, is efficient with minimal time needed for QC checks and is accurate with minimal corrections needed.
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Affiliation(s)
- Luke F O'Donnell
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Menelaos Pipis
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - John S Thornton
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Baris Kanber
- UCL Centre for Medical Image Computing, London, UK
| | - Stephen Wastling
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Amy McDowell
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Nick Zafeiropoulos
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Matilde Laura
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Mariola Skorupinska
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Christopher J Record
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Carolynne M Doherty
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - David N Herrmann
- Department of Neurology, University of Rochester, Rochester, New York, USA
| | - Henrik Zetterberg
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | - Amanda J Heslegrave
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | | | - Alexander M Rossor
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Jasper M Morrow
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Mary M Reilly
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
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Pipis M, Won S, Poh R, Efthymiou S, Polke JM, Skorupinska M, Blake J, Rossor AM, Moran JJ, Munot P, Muntoni F, Laura M, Svaren J, Reilly MM. Post-transcriptional microRNA repression of PMP22 dose in severe Charcot-Marie-Tooth disease type 1. Brain 2023; 146:4025-4032. [PMID: 37337674 PMCID: PMC10545524 DOI: 10.1093/brain/awad203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/13/2023] [Accepted: 04/23/2023] [Indexed: 06/21/2023] Open
Abstract
Copy number variation (CNV) may lead to pathological traits, and Charcot-Marie-Tooth disease type 1A (CMT1A), the commonest inherited peripheral neuropathy, is due to a genomic duplication encompassing the dosage-sensitive PMP22 gene. MicroRNAs act as repressors on post-transcriptional regulation of gene expression and in rodent models of CMT1A, overexpression of one such microRNA (miR-29a) has been shown to reduce the PMP22 transcript and protein level. Here we present genomic and functional evidence, for the first time in a human CNV-associated phenotype, of the 3' untranslated region (3'-UTR)-mediated role of microRNA repression on gene expression. The proband of the family presented with an early-onset, severe sensorimotor demyelinating neuropathy and harboured a novel de novo deletion in the PMP22 3'-UTR. The deletion is predicted to include the miR-29a seed binding site and transcript analysis of dermal myelinated nerve fibres using a novel platform, revealed a marked increase in PMP22 transcript levels. Functional evidence from Schwann cell lines harbouring the wild-type and mutant 3'-UTR showed significantly increased reporter assay activity in the latter, which was not ameliorated by overexpression of a miR-29a mimic. This shows the importance of miR-29a in regulating PMP22 expression and opens an avenue for therapeutic drug development.
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Affiliation(s)
- Menelaos Pipis
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Seongsik Won
- Waisman Center and Department of Comparative Biosciences, University of Wisconsin, Madison, WI 53706, USA
| | - Roy Poh
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Stephanie Efthymiou
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - James M Polke
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Mariola Skorupinska
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Julian Blake
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
- Department of Clinical Neurophysiology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
| | - Alexander M Rossor
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - John J Moran
- Waisman Center and Department of Comparative Biosciences, University of Wisconsin, Madison, WI 53706, USA
| | - Pinki Munot
- Dubowitz Neuromuscular Centre, NIHR Biomedical Research Centre at UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital, London WC1N 1EH, UK
| | - Francesco Muntoni
- Dubowitz Neuromuscular Centre, NIHR Biomedical Research Centre at UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital, London WC1N 1EH, UK
| | - Matilde Laura
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - John Svaren
- Waisman Center and Department of Comparative Biosciences, University of Wisconsin, Madison, WI 53706, USA
| | - Mary M Reilly
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
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Record CJ, Pipis M, Poh R, Polke JM, Reilly MM. Beware next-generation sequencing gene panels as the first-line genetic test in Charcot-Marie-Tooth disease. J Neurol Neurosurg Psychiatry 2023; 94:327-328. [PMID: 36376020 PMCID: PMC10023303 DOI: 10.1136/jnnp-2022-330223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Christopher J Record
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Menelaos Pipis
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Roy Poh
- Neurogenetics Laboratory, UCL Queen Square Institute of Neurology, London, UK
| | - James M Polke
- Neurogenetics Laboratory, UCL Queen Square Institute of Neurology, London, UK
| | - Mary M Reilly
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
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Palmer DA, Dooley H, Pipis M, Patten P, Silber E. A Novel approach using O-CVP to treat paraneoplastic NMO spectrum disorder associated with follicular lymphoma. BMJ Case Rep 2022; 15:15/11/e252822. [DOI: 10.1136/bcr-2022-252822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune neuroinflammatory disorder of the central nervous system that very rarely may be a paraneoplastic phenomenon. We describe the case of a woman with a longitudinally extensive transverse myelitis (LETM). We identified a previously undiagnosed, follicular lymphoma and she was treated with the immunochemotherapy regime (obinutuzumab, cyclophosphamide, vincristine and prednisolone; O-CVP) for paraneoplastic NMOSD. Following two cycles, there was almost complete radiological remission of the myelitis and the patient showed some improvement in her neurological function. This case illustrates the heterogeneous aetiology that LETM may have and that O-CVP may be used as therapeutic option in patients with NMOSD driven by follicular lymphoma.
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Gomes Rodrigues F, Pipis M, Heeren TFC, Fruttiger M, Gantner M, Vermeirsch S, Okada M, Friedlander M, Reilly MM, Egan C. Description of a patient cohort with Hereditary Sensory Neuropathy Type 1 without retinal disease Macular Telangiectasia type 2 - implications for retinal screening in HSN1. J Peripher Nerv Syst 2022; 27:215-224. [PMID: 35837722 DOI: 10.1111/jns.12508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/15/2022] [Accepted: 07/08/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Pathogenic variants in the genes encoding serine palmitoyl transferase (SPTLC1 or SPTLC2) are the most common causes of the rare peripheral nerve disorder Hereditary Sensory Neuropathy Type 1 (HSN1). Macular telangiectasia type 2 (MacTel), a retinal disorder associated with disordered serine-glycine metabolism and has been described in some patients with HSN1. This study aims to further investigate this association in a cohort of people with HSN1. METHODS Fourteen patients with a clinically and genetically confirmed diagnosis of HSN1 from the National Hospital for Neurology and Neurosurgery (NHNN, University College London Hospitals NHS Foundation Trust, London, United Kingdom) were recruited to the MacTel Registry, between July 2018 and April 2019. Two additional patients were identified from the dataset of the international clinical registry study (www.lmri.net). Ocular examination included fundus autofluorescence, blue light and infrared reflectance, macular pigment optical density mapping, and optical coherence tomography. RESULTS Twelve patients had a pathogenic variant in the SPTLC1 gene, with p.Cys133Trp in eleven cases (92%) and p.Cys133Tyr in one case (8%). Four patients had a variant in the SPTLC2 gene. None of the patients showed clinical evidence of MacTel. INTERPRETATION The link between HSN1 and MacTel seems more complex than can solely be explained by the genetic variants. An extension of the spectrum of SPTLC1/2-related disease with phenotypic pleiotropy is proposed. HSN1 patients should be screened for visual symptoms and referred for specialist retinal screening, but the association of the two diseases is likely to be variable and remains unexplained. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Filipa Gomes Rodrigues
- Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK.,National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.,University College London Institute of Ophthalmology, London, UK.,Ophthalmology Department, Hospital de Vila Franca de Xira, Vila Franca de Xira, Portugal
| | - Menelaos Pipis
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Tjebo F C Heeren
- Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK.,National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.,University College London Institute of Ophthalmology, London, UK
| | - Marcus Fruttiger
- University College London Institute of Ophthalmology, London, UK
| | | | - Sandra Vermeirsch
- Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK.,University College London Institute of Ophthalmology, London, UK.,Hôpital ophtalmique Jules-Gonin, Fondation asile des aveugles, Université de Lausanne, Switzerland
| | - Mali Okada
- Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | | | - Mary M Reilly
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Catherine Egan
- Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK.,National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.,University College London Institute of Ophthalmology, London, UK
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Doherty C, Pipis M, Hosktote C, Rossor A, Reilly M. 136 Coincidential hydrocephalus in twins with CMT1X. J Neurol Neurosurg Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn.461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe association of CMT1X with white matter abnormalities and “stroke like episodes” has long been recognised, and a recent review of the 133 patients with CMT1X in our cohort found that 10/26 MRI brain scans showed white matter abnormalities.(1) The literature describes very occasional patients who have any type of CMT and hydrocephalus.CasesA pair of monozygotic twins have the p.Trp24Cys GJB1 mutation which segregates with CMT in their family, with recognised phenotypic variability in the women, attributable to X-inactivation. One of the twins presented in their 20’s with headache and visual obscurations due to hydrocephalus resulting from decompensation of a previously diagnosed aqueductal stenosis. The second twin had migraine at age 27, an MRI identified lateral and third ventricular dilatation due to focal narrowing with an aqueductal web. An endoscopic third ventriculocysternostomy was performed. An affected cousin with the family GJB1 mutation has normal brain imaging.DiscussionDespite the finding of hydrocephalus in both affected twins, further family evaluation confirmed the hydrocephalous not to segregate with the GJB1 mutation. This highlights the importance of detailed phenotype segregation studies before diagnosing an atypical phenotype with genetic diseases. Alterna- tive genetic causes for the hydrocephalus are being sought.1) Vivekanandam V, Hoskote C, Rossor AM, Reilly MM. CNS phenotype in X linked Charcot- Marie-Tooth disease. J Neurol Neurosurg Psychiatry 2018 Dec 5;90(9).carolynnedoherty@doctors.org.uk|NIHR Bursary93
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Doherty CM, Pipis M, Skorupinska M, Shah S, Morrow J, Rossor AM, Reilly MM. 101 Neuromuscular MRI in assessment of variants of unknown significance in inherited neuropathy and associated disorders. J Neurol Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundA problem frequently faced by neurologists is the interpretation of genetic variants of unknown significance(VUS). Unlike in many muscle diseases, specific patterns of muscle involvement are not typically demonstrated on muscle MRI of inherited neuropathy patients. Imaging muscle involvement can be of assistance when assessing VUS.Case ExamplesTwo unrelated individuals with axonal CMT were identified to have a novel p.Lys554Glu DNM2 mutation. Neuromuscular MRI was consistent with the clinical findings and similar to literature descriptions, supporting the pathogenicity of this variant.Spinal Muscular Atrophy Lower Extremity Dominant (SMA-LED) due to DYNC1H1 mutations can be associ- ated with sparing and relative hypertrophy of the adductor longus and semitendinosus muscles at the thigh level, with diffuse involvement at the calf level, sparing the anterior-medial muscles1 on MRI. These features were demonstrated in the imaging of a proband with SMA-LED has two mutations in DYNC1H1, one of which is novel. The novel p.His75Pro mutation was also found in his mother who has normal clinical examination and neuromuscular MRI, suggesting that the previously described p.Arg251His mutation2 was the cause of the neuromuscular phenotype in the proband.DiscussionMRI has a role supporting the diagnosis of inherited neuropathies, and in evaluating VUS.Scoto et al. Novel mutations expand the clinical spectrum of DYNC1H1-associated SMA. Neurology.2015Feb17;84:668–679Antoniadi et al. Application of targeted multi-gene panel testing for the diagnosis of inherited peripheral neuropathy provides high diagnostic yield.BMCMedGenet.2015Sep21;16:84.c.doherty@ucl.ac.uk
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Pipis M, Doherty C, Skorupinska M, Laura M, Rossor A, Reilly M. Beware: adult-onset and fast-progressing Charcot-Marie-Tooth disease chameleons. J Neurol Neurosurg Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Differentiating between an acquired and genetic aetiology of peripheral neuropathy poses a challenge to the neurologist. Contributing factors to this include a lack of family history of neuropathy, a rapid progres- sion of the clinical syndrome and/or the presence of features that are considered atypical for inherited neuropathies such as non-length dependent weakness and denervation.We present 6 patients with genetically confirmed CMT (2 NEFH, 3 MME and 1 TFG), who presented in adulthood with a rapid course of disease progression. The mean age of symptom onset was 37.8yrs (range 33–49) and despite an average disease duration of only 12.8yrs (range 7–16), 50% of patients (3/6) required a wheelchair or stick for mobility. All patients developed significant proximal involvement early on in the course of their disease with half of them having persistent evidence of non-length dependent weakness and denervation. All sporadic cases had CSF examinations and investigations for inflammatory causes of neuropathy, 1 patient had 2 courses of IVIG and another was considered for a nerve biopsy prior to achieving a genetic diagnosis.Certain adult onset CMT subtypes may mimic acquired neuropathies and in order to avoid missing treatable causes, the pursuit of both diagnostic avenues is often necessary.m.pipis@ucl.ac.uk
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Record CJ, Pipis M, Rossor AM, Laura M, Skorupinska M, Cortese A, Reilly MM. Charcot-Marie-Tooth disease secondary to biallelic mutations in SORD. J Neurol Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
IntroductionSORD is a newly described autosomal recessive gene that is emerging as the commonest cause of autosomal recessive CMT (Charcot-Marie-Tooth disease) and hereditary motor neuropathy (HMN).MethodsWe present nine cases of SORD-related neuropathy.ResultsNine unrelated patients were found to have biallelic mutations in SORD. Eight were male (89%) and median age of assessment was 34 years (range 18–55 years). Median age of symptom onset was 15 years (range 12–18 years) and all patients initially presented with difficulty walking and/or problems involving distal lower limbs. Only one patient (11%) had sensory symptoms. 5/9 (56%) had distal upper limb weakness and all had distal lower limb weakness. Sensory examination was abnormal to at least one modality in 7/9 cases (78%). The median CMT Examination and CMT Neuropathy Scores were 6 (range 2–12) and 7.5 (range 3–14) respectively. Neurophysiology showed conduction velocities in the axonal or intermediate ranges in all cases. Clinical diagnosis was distal HMN in 5/9 (56%), CMT2 in 2/9 (22%) and CMT intermediate in 2/9 (22%).ConclusionsThe SORD phenotype is typically a slowly progressive, length-dependent motor neuropathy of onset during the second decade. Sensory symptoms are rare and sensory signs minimal.chris.record@ucl.ac.uk
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Doherty CM, Pipis M, Skorupinska M, Manzur A, Muntoni F, Shah S, Morrow J, Rossor AM, Reilly MM. 100 All that glitters is not GARS. J Neurol Neurosurg Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundA 22-year-old woman was initially assessed in the context of a family history of distal wasting and weakness, typically with upper limb onset, then lower limb involvement. When assessed as a child her phenotype was recognised to be atypical compared to her sister, but she was thought to be affected. Ultimately the family was diagnosed with distal hereditary motor neuropathy due to a GARS mutation. However, this patient did not carry the mutation, prompting further evaluation.CaseAt age 11 the left foot was smaller with some toe clawing and cavus deformity. Left sided wasting of tibialis anterior and the posterior compartment was seen, ankle dorsiflexors were grade 3.ResultsNerve conduction studies and EMG were normal in the right leg and arms. Chronic denervation was identified in L4, L5 and S1. MRI of lumbar spine was normal. However, 2 areas of marked thickening and enhancement were seen in the left sciatic nerve in the upper thigh and a further lesion in the mid- thigh. Fascicular preservation of the nerve was felt to be strongly suggestive of a perineurioma.DiscussionThis case highlights the importance of careful phenotyping when validating novel variants in potentially causative genes.c.doherty@ucl.ac.uk
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Record CJ, Pipis M, Blake J, Curro R, Lunn MP, Rossor AM, Laura M, Cortese A, Reilly MM. Unusual upper limb features in SORD neuropathy. J Peripher Nerv Syst 2022; 27:175-177. [PMID: 35419909 DOI: 10.1111/jns.12492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 03/23/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Christopher J Record
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK.,National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Menelaos Pipis
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK.,National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Julian Blake
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK.,National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.,Department of Clinical Neurophysiology, Norfolk and Norwich University Hospital, Norwich, UK
| | - Riccardo Curro
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK.,National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Michael P Lunn
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK.,National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Alexander M Rossor
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK.,National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Matilde Laura
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK.,National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Andrea Cortese
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK.,National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Mary M Reilly
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK.,National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
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Pipis M, Cortese A, Polke JM, Poh R, Vandrovcova J, Laura M, Skorupinska M, Jacquier A, Juntas-Morales R, Latour P, Petiot P, Sole G, Fromes Y, Shah S, Blake J, Choi BO, Chung KW, Stojkovic T, Rossor AM, Reilly MM. Charcot-Marie-Tooth disease type 2CC due to NEFH variants causes a progressive, non-length-dependent, motor-predominant phenotype. J Neurol Neurosurg Psychiatry 2022; 93:48-56. [PMID: 34518334 PMCID: PMC8685631 DOI: 10.1136/jnnp-2021-327186] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/08/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Neurofilaments are the major scaffolding proteins for the neuronal cytoskeleton, and variants in NEFH have recently been described to cause axonal Charcot-Marie-Tooth disease type 2CC (CMT2CC). METHODS In this large observational study, we present phenotype-genotype correlations on 30 affected and 3 asymptomatic mutation carriers from eight families. RESULTS The majority of patients presented in adulthood with motor-predominant and lower limb-predominant symptoms and the average age of onset was 31.0±15.1 years. A prominent feature was the development of proximal weakness early in the course of the disease. The disease progressed rapidly, unlike other Charcot-Marie-Tooth disease (CMT) subtypes, and half of the patients (53%) needed to use a wheelchair on average 24.1 years after symptom onset. Furthermore, 40% of patients had evidence of early ankle plantarflexion weakness, a feature which is observed in only a handful of CMT subtypes. Neurophysiological studies and MRI of the lower limbs confirmed the presence of a non-length-dependent neuropathy in the majority of patients.All families harboured heterozygous frameshift variants in the last exon of NEFH, resulting in a reading frameshift to an alternate open reading frame and the translation of approximately 42 additional amino acids from the 3' untranslated region (3'-UTR). CONCLUSIONS This phenotype-genotype study highlights the unusual phenotype of CMT2CC, which is more akin to spinal muscular atrophy rather than classic CMT. Furthermore, the study will enable more informative discussions on the natural history of the disease and will aid in NEFH variant interpretation in the context of the disease's unique molecular genetics.
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Affiliation(s)
- Menelaos Pipis
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Andrea Cortese
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - James M Polke
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Roy Poh
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Jana Vandrovcova
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Matilde Laura
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Mariola Skorupinska
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Arnaud Jacquier
- Institut NeuroMyoGène, CNRS UMR5310, INSERM U1217, Universite de Lyon, Lyon, France
| | - Raul Juntas-Morales
- Clinique du Motoneurone et Pathologies Neuromusculaires, CHRU de Montpellier, Montpellier, France
| | - Philippe Latour
- Centre de Biologie et Pathologie Est, Hospices Civils de Lyon, Lyon, France
| | - Philippe Petiot
- Neurologie et Explorations Fonctionnelles Neurologiques, Centre de Référence Maladies Neuromusculaires, Hospices Civils de Lyon, Lyon, France
| | - Guilhem Sole
- Centre de Référence des Maladies Neuromusculaires, CHU Bordeaux GH Pellegrin, Bordeaux, France
| | - Yves Fromes
- Institut de Myologie, Laboratoire RMN, Hôpital Pitié-Salpêtrière, Paris, France
| | - Sachit Shah
- Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, London, UK
| | - Julian Blake
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
- Department of Clinical Neurophysiology, Norfolk and Norwich University Hospital, Norfolk, UK
| | - Byung-Ok Choi
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ki Wha Chung
- Department of Biological Sciences, Kongju National University, Gongju, South Korea
| | - Tanya Stojkovic
- AP-HP, Reference Center for Neuromuscular Disorders, University Hospital Pitié Salpêtrière, Paris, France
- Centre de Recherche en Myologie, Inserm UMRS974, Sorbonne Universite, Paris, France
| | - Alexander M Rossor
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Mary M Reilly
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
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Gilley J, Jackson O, Pipis M, Estiar MA, Al-Chalabi A, Danzi MC, van Eijk KR, Goutman SA, Harms MB, Houlden H, Iacoangeli A, Kaye J, Lima L, Ravits J, Rouleau GA, Schüle R, Xu J, Züchner S, Cooper-Knock J, Gan-Or Z, Reilly MM, Coleman MP. Enrichment of SARM1 alleles encoding variants with constitutively hyperactive NADase in patients with ALS and other motor nerve disorders. eLife 2021; 10:e70905. [PMID: 34796871 PMCID: PMC8735862 DOI: 10.7554/elife.70905] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 11/18/2021] [Indexed: 11/13/2022] Open
Abstract
SARM1, a protein with critical NADase activity, is a central executioner in a conserved programme of axon degeneration. We report seven rare missense or in-frame microdeletion human SARM1 variant alleles in patients with amyotrophic lateral sclerosis (ALS) or other motor nerve disorders that alter the SARM1 auto-inhibitory ARM domain and constitutively hyperactivate SARM1 NADase activity. The constitutive NADase activity of these seven variants is similar to that of SARM1 lacking the entire ARM domain and greatly exceeds the activity of wild-type SARM1, even in the presence of nicotinamide mononucleotide (NMN), its physiological activator. This rise in constitutive activity alone is enough to promote neuronal degeneration in response to otherwise non-harmful, mild stress. Importantly, these strong gain-of-function alleles are completely patient-specific in the cohorts studied and show a highly significant association with disease at the single gene level. These findings of disease-associated coding variants that alter SARM1 function build on previously reported genome-wide significant association with ALS for a neighbouring, more common SARM1 intragenic single nucleotide polymorphism (SNP) to support a contributory role of SARM1 in these disorders. A broad phenotypic heterogeneity and variable age-of-onset of disease among patients with these alleles also raises intriguing questions about the pathogenic mechanism of hyperactive SARM1 variants.
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Affiliation(s)
- Jonathan Gilley
- John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of CambridgeCambridgeUnited Kingdom
| | - Oscar Jackson
- John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of CambridgeCambridgeUnited Kingdom
| | - Menelaos Pipis
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for NeurologyLondonUnited Kingdom
| | - Mehrdad A Estiar
- Department of Human Genetics, McGill UniversityMontrealCanada
- The Neuro (Montreal Neurological Institute-Hospital), McGill UniversityMontrealCanada
| | - Ammar Al-Chalabi
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonLondonUnited Kingdom
- Department of Neurology, King's College Hospital, King’s College LondonLondonUnited Kingdom
| | - Matt C Danzi
- Dr. John T. Macdonald Foundation Department of Human Genetics and John P. Hussman Institute for Human Genomics, University of Miami Miller School of MedicineMiamiUnited States
| | - Kristel R van Eijk
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht UniversityUtrechtNetherlands
| | - Stephen A Goutman
- Department of Neurology, University of MichiganAnn ArborUnited States
| | - Matthew B Harms
- Institute for Genomic Medicine, Columbia UniversityNew YorkUnited States
| | - Henry Houlden
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for NeurologyLondonUnited Kingdom
| | - Alfredo Iacoangeli
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonLondonUnited Kingdom
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUnited Kingdom
- National Institute for Health Research Biomedical Research Centre and Dementia Unit at South London and Maudsley NHS Foundation Trust and King's College LondonLondonUnited Kingdom
| | - Julia Kaye
- Center for Systems and Therapeutics, Gladstone InstitutesSan FranciscoUnited States
| | - Leandro Lima
- Center for Systems and Therapeutics, Gladstone InstitutesSan FranciscoUnited States
- Gladstone Institute of Data Science and Biotechnology, Gladstone InstitutesSan FranciscoUnited States
| | - Queen Square Genomics
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for NeurologyLondonUnited Kingdom
| | - John Ravits
- Department of Neurosciences, University of California, San DiegoLa JollaUnited States
| | - Guy A Rouleau
- Department of Human Genetics, McGill UniversityMontrealCanada
- The Neuro (Montreal Neurological Institute-Hospital), McGill UniversityMontrealCanada
- Department of Neurology and Neurosurgery, McGill UniversityMontrealCanada
| | - Rebecca Schüle
- Center for Neurology and Hertie Institute für Clinical Brain Research, University of Tübingen, German Center for Neurodegenerative DiseasesTübingenGermany
| | - Jishu Xu
- Center for Neurology and Hertie Institute für Clinical Brain Research, University of Tübingen, German Center for Neurodegenerative DiseasesTübingenGermany
| | - Stephan Züchner
- Dr. John T. Macdonald Foundation Department of Human Genetics and John P. Hussman Institute for Human Genomics, University of Miami Miller School of MedicineMiamiUnited States
| | - Johnathan Cooper-Knock
- Sheffield Institute for Translational Neuroscience, University of SheffieldSheffieldUnited Kingdom
| | - Ziv Gan-Or
- Department of Human Genetics, McGill UniversityMontrealCanada
- The Neuro (Montreal Neurological Institute-Hospital), McGill UniversityMontrealCanada
- Department of Neurology and Neurosurgery, McGill UniversityMontrealCanada
| | - Mary M Reilly
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for NeurologyLondonUnited Kingdom
| | - Michael P Coleman
- John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of CambridgeCambridgeUnited Kingdom
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Spaulding EL, Hines TJ, Bais P, Tadenev ALD, Schneider R, Jewett D, Pattavina B, Pratt SL, Morelli KH, Stum MG, Hill DP, Gobet C, Pipis M, Reilly MM, Jennings MJ, Horvath R, Bai Y, Shy ME, Alvarez-Castelao B, Schuman EM, Bogdanik LP, Storkebaum E, Burgess RW. The integrated stress response contributes to tRNA synthetase-associated peripheral neuropathy. Science 2021; 373:1156-1161. [PMID: 34516839 PMCID: PMC8908546 DOI: 10.1126/science.abb3414] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Dominant mutations in ubiquitously expressed transfer RNA (tRNA) synthetase genes cause axonal peripheral neuropathy, accounting for at least six forms of Charcot-Marie-Tooth (CMT) disease. Genetic evidence in mouse and Drosophila models suggests a gain-of-function mechanism. In this study, we used in vivo, cell type–specific transcriptional and translational profiling to show that mutant tRNA synthetases activate the integrated stress response (ISR) through the sensor kinase GCN2 (general control nonderepressible 2). The chronic activation of the ISR contributed to the pathophysiology, and genetic deletion or pharmacological inhibition of Gcn2 alleviated the peripheral neuropathy. The activation of GCN2 suggests that the aberrant activity of the mutant tRNA synthetases is still related to translation and that inhibiting GCN2 or the ISR may represent a therapeutic strategy in CMT.
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Affiliation(s)
- E. L. Spaulding
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME 04609, USA
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME 04469, USA
| | - T. J. Hines
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME 04609, USA
| | - P. Bais
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME 04609, USA
| | - A. L. D. Tadenev
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME 04609, USA
| | - R. Schneider
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME 04609, USA
| | - D. Jewett
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME 04609, USA
| | - B. Pattavina
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME 04609, USA
| | - S. L. Pratt
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME 04609, USA
- Neuroscience Program, Graduate School of Biomedical Sciences, Tufts University, Boston, MA, 02111 USA
| | - K. H. Morelli
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME 04609, USA
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME 04469, USA
| | - M. G. Stum
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME 04609, USA
| | - D. P. Hill
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME 04609, USA
| | - C. Gobet
- School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - M. Pipis
- MRC Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - M. M. Reilly
- MRC Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - M. J. Jennings
- Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK
| | - R. Horvath
- Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK
| | - Y. Bai
- Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - M. E. Shy
- Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | | | - E. M. Schuman
- Max Planck Institute for Brain Research, Frankfurt, Germany
| | - L. P. Bogdanik
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME 04609, USA
| | - E. Storkebaum
- Department of Molecular Neurobiology, Donders Institute for Brain, Cognition and Behaviour and Faculty of Science, Radboud University, Nijmegen, Netherlands
| | - R. W. Burgess
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME 04609, USA
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME 04469, USA
- Neuroscience Program, Graduate School of Biomedical Sciences, Tufts University, Boston, MA, 02111 USA
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Lunn MP, Carr AC, Keddie S, Pakpoor J, Pipis M, Willison HJ. Reply: Guillain-Barré syndrome, SARS-CoV-2 and molecular mimicry and Ongoing challenges in unravelling the association between COVID-19 and Guillain-Barré syndrome and Unclear association between COVID-19 and Guillain-Barré syndrome and Currently available data regarding the potential association between COVID-19 and Guillain-Barré syndrome. Brain 2021; 144:e47. [PMID: 33822006 PMCID: PMC8083496 DOI: 10.1093/brain/awab070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 01/01/2023] Open
Affiliation(s)
- Michael P Lunn
- Department of Neuromuscular Diseases, University College London,
London, UK
- National Hospital for Neurology and Neurosurgery, University College London
Hospitals NHS Foundation Trust, London, UK
| | - Aisling C Carr
- National Hospital for Neurology and Neurosurgery, University College London
Hospitals NHS Foundation Trust, London, UK
| | - Stephen Keddie
- Department of Neuromuscular Diseases, University College London,
London, UK
- National Hospital for Neurology and Neurosurgery, University College London
Hospitals NHS Foundation Trust, London, UK
| | | | - Menelaos Pipis
- Department of Neuromuscular Diseases, University College London,
London, UK
- National Hospital for Neurology and Neurosurgery, University College London
Hospitals NHS Foundation Trust, London, UK
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19
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Keddie S, Pakpoor J, Mousele C, Pipis M, Machado PM, Foster M, Record CJ, Keh RYS, Fehmi J, Paterson RW, Bharambe V, Clayton LM, Allen C, Price O, Wall J, Kiss-Csenki A, Rathnasabapathi DP, Geraldes R, Yermakova T, King-Robson J, Zosmer M, Rajakulendran S, Sumaria S, Farmer SF, Nortley R, Marshall CR, Newman EJ, Nirmalananthan N, Kumar G, Pinto AA, Holt J, Lavin TM, Brennan KM, Zandi MS, Jayaseelan DL, Pritchard J, Hadden RDM, Manji H, Willison HJ, Rinaldi S, Carr AS, Lunn MP. Epidemiological and cohort study finds no association between COVID-19 and Guillain-Barré syndrome. Brain 2021; 144:682-693. [PMID: 33313649 PMCID: PMC7799186 DOI: 10.1093/brain/awaa433] [Citation(s) in RCA: 154] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/06/2020] [Accepted: 11/19/2020] [Indexed: 02/06/2023] Open
Abstract
Reports of Guillain-Barré syndrome (GBS) have emerged during the Coronavirus disease 2019 (COVID-19) pandemic. This epidemiological and cohort study sought to investigate any causative association between COVID-19 infection and GBS. The epidemiology of GBS cases reported to the UK National Immunoglobulin Database was studied from 2016 to 2019 and compared to cases reported during the COVID-19 pandemic. Data were stratified by hospital trust and region, with numbers of reported cases per month. UK population data for COVID-19 infection were collated from UK public health bodies. In parallel, but separately, members of the British Peripheral Nerve Society prospectively reported incident cases of GBS during the pandemic at their hospitals to a central register. The clinical features, investigation findings and outcomes of COVID-19 (definite or probable) and non-COVID-19 associated GBS cases in his cohort were compared. The incidence of GBS treated in UK hospitals from 2016 to 2019 was 1.65–1.88 per 100 000 individuals per year. In 2020, GBS and COVID-19 incidences varied between regions and did not correlate with one another (r = 0.06, 95% confidence interval: −0.56 to 0.63, P = 0.86). GBS incidence fell between March and May 2020 compared to the same months of 2016–19. In an independent cohort study, 47 GBS cases were reported (COVID-19 status: 13 definite, 12 probable, 22 non-COVID-19). There were no significant differences in the pattern of weakness, time to nadir, neurophysiology, CSF findings or outcome between these groups. Intubation was more frequent in the COVID-19 affected cohort (7/13, 54% versus 5/22, 23% in COVID-19-negative) likely related to COVID-19 pulmonary involvement. Although it is not possible to entirely rule out the possibility of a link this study finds no epidemiological or phenotypic clues of SARS-CoV-2 being causative of GBS. GBS incidence has fallen during the pandemic, which may be the influence of lockdown measures reducing transmission of GBS inducing pathogens such as Campylobacter jejuni and respiratory viruses.
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Affiliation(s)
- Stephen Keddie
- Department of Neuromuscular Diseases, University College London, London, UK.,National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Christina Mousele
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Menelaos Pipis
- Department of Neuromuscular Diseases, University College London, London, UK.,National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Pedro M Machado
- Department of Neuromuscular Diseases, University College London, London, UK.,National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Mark Foster
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Ryan Y S Keh
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
| | - Janev Fehmi
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Ross W Paterson
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.,Darent Valley Hospital, Dartford, UK
| | - Viraj Bharambe
- The Walton Centre National Health Service (NHS) Foundation Trust, Liverpool, UK
| | | | | | - Olivia Price
- Basildon and Thurrock University Hospital Trust, Basildon, UK
| | - Jasmine Wall
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
| | | | | | - Ruth Geraldes
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.,Wexham Park Hospital, Frimley Health Foundation Trust, Berkshire, UK
| | | | | | - Maya Zosmer
- North Middlesex University Hospital NHS Trust, London, UK
| | - Sanjeev Rajakulendran
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.,North Middlesex University Hospital NHS Trust, London, UK
| | - Sheetal Sumaria
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Simon F Farmer
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Ross Nortley
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.,Wexham Park Hospital, Frimley Health Foundation Trust, Berkshire, UK
| | | | | | | | | | - Ashwin A Pinto
- Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - James Holt
- The Walton Centre National Health Service (NHS) Foundation Trust, Liverpool, UK
| | - Tim M Lavin
- Manchester Centre for Clinical Neuroscience, Salford Royal Hospital NHS Foundation Trust, Manchester, UK
| | | | - Michael S Zandi
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Dipa L Jayaseelan
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.,West Hertfordshire Hospitals NHS Trust, Watford, UK
| | | | | | - Hadi Manji
- Department of Neuromuscular Diseases, University College London, London, UK.,National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Simon Rinaldi
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Aisling S Carr
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Michael P Lunn
- Department of Neuromuscular Diseases, University College London, London, UK.,National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
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20
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Pipis M, Feely SME, Polke JM, Skorupinska M, Perez L, Shy RR, Laura M, Morrow JM, Moroni I, Pisciotta C, Taroni F, Vujovic D, Lloyd TE, Acsadi G, Yum SW, Lewis RA, Finkel RS, Herrmann DN, Day JW, Li J, Saporta M, Sadjadi R, Walk D, Burns J, Muntoni F, Ramchandren S, Horvath R, Johnson NE, Züchner S, Pareyson D, Scherer SS, Rossor AM, Shy ME, Reilly MM. Natural history of Charcot-Marie-Tooth disease type 2A: a large international multicentre study. Brain 2021; 143:3589-3602. [PMID: 33415332 PMCID: PMC7805791 DOI: 10.1093/brain/awaa323] [Citation(s) in RCA: 28] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 07/28/2020] [Indexed: 01/02/2023] Open
Abstract
Mitofusin-2 (MFN2) is one of two ubiquitously expressed homologous proteins in eukaryote cells, playing a critical role in mitochondrial fusion. Mutations in MFN2 (most commonly autosomal dominant) cause Charcot-Marie-Tooth disease type 2A (CMT2A), the commonest axonal form of CMT, with significant allelic heterogeneity. Previous, moderately-sized, cross sectional genotype-phenotype studies of CMT2A have described the phenotypic spectrum of the disease, but longitudinal natural history studies are lacking. In this large multicentre prospective cohort study of 196 patients with dominant and autosomal recessive CMT2A, we present an in-depth genotype-phenotype study of the baseline characteristics of patients with CMT2A and longitudinal data (1–2 years) to describe the natural history. A childhood onset of autosomal dominant CMT2A is the most predictive marker of significant disease severity and is independent of the disease duration. When compared to adult onset autosomal dominant CMT2A, it is associated with significantly higher rates of use of ankle-foot orthoses, full-time use of wheelchair, dexterity difficulties and also has significantly higher CMT Examination Score (CMTESv2) and CMT Neuropathy Score (CMTNSv2) at initial assessment. Analysis of longitudinal data using the CMTESv2 and its Rasch-weighted counterpart, CMTESv2-R, show that over 1 year, the CMTESv2 increases significantly in autosomal dominant CMT2A (mean change 0.84 ± 2.42; two-tailed paired t-test P = 0.039). Furthermore, over 2 years both the CMTESv2 (mean change 0.97 ± 1.77; two-tailed paired t-test P = 0.003) and the CMTESv2-R (mean change 1.21 ± 2.52; two-tailed paired t-test P = 0.009) increase significantly with respective standardized response means of 0.55 and 0.48. In the paediatric CMT2A population (autosomal dominant and autosomal recessive CMT2A grouped together), the CMT Pediatric Scale increases significantly both over 1 year (mean change 2.24 ± 3.09; two-tailed paired t-test P = 0.009) and over 2 years (mean change 4.00 ± 3.79; two-tailed paired t-test P = 0.031) with respective standardized response means of 0.72 and 1.06. This cross-sectional and longitudinal study of the largest CMT2A cohort reported to date provides guidance for variant interpretation, informs prognosis and also provides natural history data that will guide clinical trial design.
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Affiliation(s)
- Menelaos Pipis
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Shawna M E Feely
- Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - James M Polke
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Mariola Skorupinska
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Laura Perez
- Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Rosemary R Shy
- Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Matilde Laura
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Jasper M Morrow
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Isabella Moroni
- Department of Pediatric Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Chiara Pisciotta
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Franco Taroni
- Unit of Medical Genetics and Neurogenetics, Department of Diagnostics and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Dragan Vujovic
- Department of Neurology, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Thomas E Lloyd
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Gyula Acsadi
- Connecticut Children's Medical Center, Hartford, CT, USA
| | - Sabrina W Yum
- The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Richard A Lewis
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Richard S Finkel
- Center for Experimental Neurotherapeutics, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - David N Herrmann
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | - John W Day
- Department of Neurology, Stanford Health Care, Stanford, CA, USA
| | - Jun Li
- Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Mario Saporta
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Reza Sadjadi
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - David Walk
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Joshua Burns
- University of Sydney School of Health Sciences and Children's Hospital at Westmead, Sydney, Australia
| | - Francesco Muntoni
- Dubowitz Neuromuscular Centre, NIHR Biomedical Research Centre at UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital, London, UK
| | | | - Rita Horvath
- Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | | | - Stephan Züchner
- 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, USA
| | - Davide Pareyson
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Steven S Scherer
- Department of Neurology, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Alexander M Rossor
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Michael E Shy
- Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Mary M Reilly
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
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21
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Pipis M, Houlden H, Reilly MM. Advancing Charcot-Marie-Tooth disease diagnostics, through the UK 100,000 Genomes Project. MED GENET-BERLIN 2020. [DOI: 10.1515/medgen-2020-2037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Whole genome sequencing (WGS) is regarded by many as the pinnacle of contemporary molecular genetic testing, and has only been possible because of the rapid development and roll-out of next-generation sequencing technologies. It provides a phenotype-agnostic analysis of the genome and has important advantages compared to other techniques including a consistent coverage across the coding and non-coding genome, the application of high resolution homozygosity mapping and the ability to detect and highlight structural variation.
Realising this potential and with a bid to sequence 100,000 genomes, the UK rolled out the 100,000 Genomes Project as a proof of concept of integrating genomics in the national health service. Participants with cancer and rare diseases enrolled in the project whose infrastructure comprises of a central national biorepository and 13 regional genomic medicine centres where clinicians, geneticists and other scientists work as part of a multidisciplinary team. Amongst participants are also patients with genetically unclassified Charcot-Marie-Tooth disease who have benefited substantially from improved diagnostic rates and many more stand to benefit as the analysis of genomic data is ongoing.
WGS is an important tool as we head towards more personalised medicine and in our quest to improve public health and treat and where possible prevent disease.
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Affiliation(s)
- Menelaos Pipis
- MRC Centre for Neuromuscular Diseases , UCL Queen Square Institute of Neurology , London , UK
| | - Henry Houlden
- MRC Centre for Neuromuscular Diseases , UCL Queen Square Institute of Neurology , London , UK
| | - Mary M. Reilly
- MRC Centre for Neuromuscular Diseases , UCL Queen Square Institute of Neurology , London , UK
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22
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Bray P, Cornett KMD, Estilow T, Pareyson D, Zuccarino R, Skorupinska M, Pipis M, Sowden JE, Scherer S, Reilly MM, Shy ME, Herrmann DN, Burns J, Eichinger KJ. Reliability of the Charcot-Marie-Tooth functional outcome measure. J Peripher Nerv Syst 2020; 25:288-291. [PMID: 32844461 PMCID: PMC7520097 DOI: 10.1111/jns.12406] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 06/30/2020] [Revised: 07/31/2020] [Accepted: 08/03/2020] [Indexed: 01/28/2023]
Abstract
The CMT-FOM is a 13-item clinical outcome assessment (COA) that measures physical ability in adults with Charcot-Marie-Tooth disease (CMT). Test-retest reliability, internal consistency and convergent validity have been established for the CMT-FOM. This current study sought to establish inter-rater reliability. Following an in-person training of six international clinical evaluators we recruited 10 participants with genetically diagnosed CMT1A, (aged 18-74 years, 6 female). Participants were evaluated using the CMT-FOM over 2 days. Participants were given at least a 3 hour rest between evaluations, and were assessed twice each day. Following the provision of training by master trainers, all 13 items of the CMT-FOM exhibited excellent inter-rater reliability for raw scores (ICC1,1 0.825-0.989) and z-scores (ICC1,1 0.762-0.969). Reliability of the CMT-FOM total score was excellent (ICC1,1 0.983, 95% CI 0.958-0.995). The CMT-FOM is a reliable COA used by clinical evaluators internationally. The next steps are to establish further validation through psychometric evaluation of the CMT-FOM in the Accelerate Clinical Trials in CMT (ACT-CMT) study.
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Affiliation(s)
- Paula Bray
- University of Sydney School of Health Sciences & Children’s Hospital at Westmead, Sydney, Australia
| | - Kayla MD Cornett
- University of Sydney School of Health Sciences & Children’s Hospital at Westmead, Sydney, Australia
| | - Timothy Estilow
- Department of Occupational Therapy, The Children’s Hospital of Philadelphia Philadelphia PA USA
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Davide Pareyson
- Fondazione IRCCS, Istituto Neurologico Carlo Besta, Milan, Italy
| | - Riccardo Zuccarino
- Carver College of Medicine, Dept of Neurology, University of Iowa, Iowa City, IA, USA
- Neuromuscular Omnicentre (NEMO)-Fondazione Serena Onlus, Via del Giappone 3, Arenzano, Genoa, Italy
| | - Mariola Skorupinska
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Menelaos Pipis
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Janet E Sowden
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Steven Scherer
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mary M Reilly
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Michael E Shy
- Carver College of Medicine, Dept of Neurology, University of Iowa, Iowa City, IA, USA
| | - David N Herrmann
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Joshua Burns
- University of Sydney School of Health Sciences & Children’s Hospital at Westmead, Sydney, Australia
| | - Katy J Eichinger
- Department of Neurology, University of Rochester, Rochester, NY, USA
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23
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Cortese A, Zhu Y, Rebelo AP, Negri S, Courel S, Abreu L, Bacon CJ, Bai Y, Bis-Brewer DM, Bugiardini E, Buglo E, Danzi MC, Feely SME, Athanasiou-Fragkouli A, Haridy NA, Isasi R, Khan A, Laurà M, Magri S, Pipis M, Pisciotta C, Powell E, Rossor AM, Saveri P, Sowden JE, Tozza S, Vandrovcova J, Dallman J, Grignani E, Marchioni E, Scherer SS, Tang B, Lin Z, Al-Ajmi A, Schüle R, Synofzik M, Maisonobe T, Stojkovic T, Auer-Grumbach M, Abdelhamed MA, Hamed SA, Zhang R, Manganelli F, Santoro L, Taroni F, Pareyson D, Houlden H, Herrmann DN, Reilly MM, Shy ME, Zhai RG, Zuchner S. Author Correction: Biallelic mutations in SORD cause a common and potentially treatable hereditary neuropathy with implications for diabetes. Nat Genet 2020; 52:640. [PMID: 32457452 DOI: 10.1038/s41588-020-0649-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Affiliation(s)
- Andrea Cortese
- 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, USA.
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK.
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Yi Zhu
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA
- Program in Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Adriana P Rebelo
- 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, USA
| | - Sara Negri
- Istituiti Clinici Scientifici Maugeri IRCCS, Environmental Research Center, Pavia, Italy
| | - Steve Courel
- 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, USA
| | - Lisa Abreu
- 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, USA
| | - Chelsea J Bacon
- Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Yunhong Bai
- Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Dana M Bis-Brewer
- 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, USA
| | - Enrico Bugiardini
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Elena Buglo
- 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, USA
| | - Matt C Danzi
- 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, USA
| | - Shawna M E Feely
- Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Alkyoni Athanasiou-Fragkouli
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Nourelhoda A Haridy
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt
| | - Rosario Isasi
- 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, USA
| | - Alaa Khan
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
- Molecular Diagnostic Unit, Clinical Laboratory Department, King Abdullah Medical City in Makkah, Mecca, Saudi Arabia
| | - Matilde Laurà
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Stefania Magri
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Menelaos Pipis
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Chiara Pisciotta
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Eric Powell
- 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, USA
| | - Alexander M Rossor
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Paola Saveri
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Janet E Sowden
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Stefano Tozza
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Jana Vandrovcova
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Julia Dallman
- Department of Biology, University of Miami, Coral Gables, FL, USA
| | - Elena Grignani
- Istituiti Clinici Scientifici Maugeri IRCCS, Environmental Research Center, Pavia, Italy
| | | | - Steven S Scherer
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Beisha Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Zhiqiang Lin
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Abdullah Al-Ajmi
- Division of Neurology, Department of Medicine, Al-Jahra Hospital, Al-Jahra, Kuwait
| | - Rebecca Schüle
- Department of Neurodegenerative Disease, Hertie-Institute for Clinical Brain Research, and Center for Neurology, University of Tübingen, Tübingen, Germany
- German Center of Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Matthis Synofzik
- Department of Neurodegenerative Disease, Hertie-Institute for Clinical Brain Research, and Center for Neurology, University of Tübingen, Tübingen, Germany
- German Center of Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Thierry Maisonobe
- Department of Neurophysiology, AP-HP, Sorbonne Université, Hôpital Pitié Salpêtrière, Paris, France
| | - Tanya Stojkovic
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, AP-HP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Michaela Auer-Grumbach
- Department of Orthopaedics and Traumatology, Medical University of Vienna, Vienna, Austria
| | - Mohamed A Abdelhamed
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt
| | - Sherifa A Hamed
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt
| | - Ruxu Zhang
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Lucio Santoro
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Franco Taroni
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Davide Pareyson
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Henry Houlden
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - David N Herrmann
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Mary M Reilly
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Michael E Shy
- Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - R Grace Zhai
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA.
- Program in Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - 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, USA.
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Cortese A, Zhu Y, Rebelo AP, Negri S, Courel S, Abreu L, Bacon CJ, Bai Y, Bis-Brewer DM, Bugiardini E, Buglo E, Danzi MC, Feely SME, Athanasiou-Fragkouli A, Haridy NA, Isasi R, Khan A, Laurà M, Magri S, Pipis M, Pisciotta C, Powell E, Rossor AM, Saveri P, Sowden JE, Tozza S, Vandrovcova J, Dallman J, Grignani E, Marchioni E, Scherer SS, Tang B, Lin Z, Al-Ajmi A, Schüle R, Synofzik M, Maisonobe T, Stojkovic T, Auer-Grumbach M, Abdelhamed MA, Hamed SA, Zhang R, Manganelli F, Santoro L, Taroni F, Pareyson D, Houlden H, Herrmann DN, Reilly MM, Shy ME, Zhai RG, Zuchner S. Biallelic mutations in SORD cause a common and potentially treatable hereditary neuropathy with implications for diabetes. Nat Genet 2020; 52:473-481. [PMID: 32367058 DOI: 10.1038/s41588-020-0615-4] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 03/20/2020] [Indexed: 01/08/2023]
Abstract
Here we report biallelic mutations in the sorbitol dehydrogenase gene (SORD) as the most frequent recessive form of hereditary neuropathy. We identified 45 individuals from 38 families across multiple ancestries carrying the nonsense c.757delG (p.Ala253GlnfsTer27) variant in SORD, in either a homozygous or compound heterozygous state. SORD is an enzyme that converts sorbitol into fructose in the two-step polyol pathway previously implicated in diabetic neuropathy. In patient-derived fibroblasts, we found a complete loss of SORD protein and increased intracellular sorbitol. Furthermore, the serum fasting sorbitol levels in patients were dramatically increased. In Drosophila, loss of SORD orthologs caused synaptic degeneration and progressive motor impairment. Reducing the polyol influx by treatment with aldose reductase inhibitors normalized intracellular sorbitol levels in patient-derived fibroblasts and in Drosophila, and also dramatically ameliorated motor and eye phenotypes. Together, these findings establish a novel and potentially treatable cause of neuropathy and may contribute to a better understanding of the pathophysiology of diabetes.
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Affiliation(s)
- Andrea Cortese
- 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, USA. .,Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK. .,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Yi Zhu
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA.,Program in Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Adriana P Rebelo
- 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, USA
| | - Sara Negri
- Istituiti Clinici Scientifici Maugeri IRCCS, Environmental Research Center, Pavia, Italy
| | - Steve Courel
- 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, USA
| | - Lisa Abreu
- 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, USA
| | - Chelsea J Bacon
- Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Yunhong Bai
- Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Dana M Bis-Brewer
- 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, USA
| | - Enrico Bugiardini
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Elena Buglo
- 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, USA
| | - Matt C Danzi
- 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, USA
| | - Shawna M E Feely
- Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Alkyoni Athanasiou-Fragkouli
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Nourelhoda A Haridy
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK.,Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt
| | | | - Rosario Isasi
- 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, USA
| | - Alaa Khan
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK.,Molecular Diagnostic Unit, Clinical Laboratory Department, King Abdullah Medical City in Makkah, Mecca, Saudi Arabia
| | - Matilde Laurà
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Stefania Magri
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Menelaos Pipis
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Chiara Pisciotta
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Eric Powell
- 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, USA
| | - Alexander M Rossor
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Paola Saveri
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Janet E Sowden
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Stefano Tozza
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Jana Vandrovcova
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Julia Dallman
- Department of Biology, University of Miami, Coral Gables, FL, USA
| | - Elena Grignani
- Istituiti Clinici Scientifici Maugeri IRCCS, Environmental Research Center, Pavia, Italy
| | | | - Steven S Scherer
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Beisha Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Zhiqiang Lin
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Abdullah Al-Ajmi
- Division of Neurology, Department of Medicine, Al-Jahra Hospital, Al-Jahra, Kuwait
| | - Rebecca Schüle
- Department of Neurodegenerative Disease, Hertie-Institute for Clinical Brain Research, and Center for Neurology, University of Tübingen, Tübingen, Germany.,German Center of Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Matthis Synofzik
- Department of Neurodegenerative Disease, Hertie-Institute for Clinical Brain Research, and Center for Neurology, University of Tübingen, Tübingen, Germany.,German Center of Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Thierry Maisonobe
- Department of Neurophysiology, AP-HP, Sorbonne Université, Hôpital Pitié Salpêtrière, Paris, France
| | - Tanya Stojkovic
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, AP-HP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Michaela Auer-Grumbach
- Department of Orthopaedics and Traumatology, Medical University of Vienna, Vienna, Austria
| | - Mohamed A Abdelhamed
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt
| | - Sherifa A Hamed
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt
| | - Ruxu Zhang
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Lucio Santoro
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Franco Taroni
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Davide Pareyson
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Henry Houlden
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - David N Herrmann
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Mary M Reilly
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Michael E Shy
- Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - R Grace Zhai
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA. .,Program in Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - 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, USA.
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25
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Cortese A, Tozza S, Yau WY, Rossi S, Beecroft SJ, Jaunmuktane Z, Dyer Z, Ravenscroft G, Lamont PJ, Mossman S, Chancellor A, Maisonobe T, Pereon Y, Cauquil C, Colnaghi S, Mallucci G, Curro R, Tomaselli PJ, Thomas-Black G, Sullivan R, Efthymiou S, Rossor AM, Laurá M, Pipis M, Horga A, Polke J, Kaski D, Horvath R, Chinnery PF, Marques W, Tassorelli C, Devigili G, Leonardis L, Wood NW, Bronstein A, Giunti P, Züchner S, Stojkovic T, Laing N, Roxburgh RH, Houlden H, Reilly MM. Cerebellar ataxia, neuropathy, vestibular areflexia syndrome due to RFC1 repeat expansion. Brain 2020; 143:480-490. [PMID: 32040566 PMCID: PMC7009469 DOI: 10.1093/brain/awz418] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/21/2019] [Accepted: 11/27/2019] [Indexed: 01/05/2023] Open
Abstract
Ataxia, causing imbalance, dizziness and falls, is a leading cause of neurological disability. We have recently identified a biallelic intronic AAGGG repeat expansion in replication factor complex subunit 1 (RFC1) as the cause of cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS) and a major cause of late onset ataxia. Here we describe the full spectrum of the disease phenotype in our first 100 genetically confirmed carriers of biallelic repeat expansions in RFC1 and identify the sensory neuropathy as a common feature in all cases to date. All patients were Caucasian and half were sporadic. Patients typically reported progressive unsteadiness starting in the sixth decade. A dry spasmodic cough was also frequently associated and often preceded by decades the onset of walking difficulty. Sensory symptoms, oscillopsia, dysautonomia and dysarthria were also variably associated. The disease seems to follow a pattern of spatial progression from the early involvement of sensory neurons, to the later appearance of vestibular and cerebellar dysfunction. Half of the patients needed walking aids after 10 years of disease duration and a quarter were wheelchair dependent after 15 years. Overall, two-thirds of cases had full CANVAS. Sensory neuropathy was the only manifestation in 15 patients. Sixteen patients additionally showed cerebellar involvement, and six showed vestibular involvement. The disease is very likely to be underdiagnosed. Repeat expansion in RFC1 should be considered in all cases of sensory ataxic neuropathy, particularly, but not only, if cerebellar dysfunction, vestibular involvement and cough coexist.
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Affiliation(s)
- Andrea Cortese
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Stefano Tozza
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Naples, Italy
| | - Wai Yan Yau
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Salvatore Rossi
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
- Department of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy; Institute of Neurology, Catholic University of the Sacred Heart, Rome, Italy
| | - Sarah J Beecroft
- Centre for Medical Research University of Western Australia, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia 6009, Australia
| | - Zane Jaunmuktane
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Zoe Dyer
- Auckland District Health Board (ADHB), Auckland, New Zealand; Centre of Brain Research Neurogenetics Research Clinic, University of Auckland, New Zealand
| | - Gianina Ravenscroft
- Centre for Medical Research University of Western Australia, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia 6009, Australia
| | - Phillipa J Lamont
- Neurogenetic Unit, Royal Perth Hospital, Perth, West Australia, Australia
| | - Stuart Mossman
- Department of Neurology, Wellington Hospital, Wellington 6021, New Zealand
| | - Andrew Chancellor
- Department of Neurology, Tauranga Hospital, Private Bag, Cameron Road, Tauranga 3171, New Zealand
| | - Thierry Maisonobe
- Sorbonne Université, AP-HP, Hôpital Pitié-Salpêtrière, Department of Neurophysiology, Paris France
| | - Yann Pereon
- CHU Nantes, Reference Centre for Neuromuscular Diseases, Hôtel-Dieu, Nantes, France
| | - Cecile Cauquil
- Department of Neurology, CHU Bicêtre, AP-HP, Le Kremlin-Bicêtre, France
| | | | | | - Riccardo Curro
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Pedro J Tomaselli
- Department of Neurology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Gilbert Thomas-Black
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Roisin Sullivan
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Stephanie Efthymiou
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Alexander M Rossor
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Matilde Laurá
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Menelaos Pipis
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Alejandro Horga
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - James Polke
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Diego Kaski
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Rita Horvath
- Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Patrick F Chinnery
- Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- MRC Mitochondrial Biology Unit, University of Cambridge, Cambridge, UK
| | - Wilson Marques
- Department of Neurology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Grazia Devigili
- UO Neurologia I, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - Lea Leonardis
- Division of Neurology, Institute of Clinical Neurophysiology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Nick W Wood
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Adolfo Bronstein
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Paola Giunti
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Stephan Züchner
- 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, USA
| | - Tanya Stojkovic
- Sorbonne Université, AP-HP, Hôpital Pitié-Salpêtrière, Centre de Référence des Maladies Neuromusculaires, Nord/Est/Ile-de-France, Inserm UMR_S 974, Paris, France
| | - Nigel Laing
- Centre for Medical Research University of Western Australia, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia 6009, Australia
- Neurogenetics Unit, Department of Diagnostic Genomics, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, Australia
| | - Richard H Roxburgh
- Auckland District Health Board (ADHB), Auckland, New Zealand; Centre of Brain Research Neurogenetics Research Clinic, University of Auckland, New Zealand
| | - Henry Houlden
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Mary M Reilly
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
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26
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Pipis M, Jaunmuktane Z, Brandner S, D’Sa S, Marafioti T, Shah S, Fuller G, Reilly MM. THUR 220 To c or not to c. J Neurol Neurosurg Psychiatry 2018. [DOI: 10.1136/jnnp-2018-abn.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Peripheral T-cell lymphomas (PTCLs) are rare and heterogeneous haematological malignancies that can rarely develop first in the peripheral nervous system, or more commonly, invade nerves from more usual primary locations. Patients with PTCLs usually respond poorly to treatment and have a poor clinical outcome.We report a patient with multiple skin lesions, multifocal mononeuropathies and constitutional symptoms all suggestive of a lymphoproliferative disorder, in whom repeat skin biopsies and clonality studies failed to achieve a diagnosis. Neurophysiological studies confirmed severe post-ganglionic lesions in the lower limbs including the sciatic, femoral, obturator, tibial and sural territories. Based on this neurotropic presentation we undertook a sural nerve biopsy, despite the clinical and neurophysiological presence of a nerve lesion more proximal to the biopsy site, and this allowed us to establish a final diagnosis of PTCL. The patient was treated successfully with chemotherapy and an autologous stem cell transplant.In our case PET imaging and MR neurography provided radiological evidence of widespread lesions in the subcutaneous and nerve tissues, and there is emerging evidence for the importance of PET imaging in the diagnostic work-up of PTCLs. Furthermore, a post-treatment PET scan confirmed the complete metabolic remission, highlighting its usefulness as a surveillance tool.
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27
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Khan A, Sultan T, Kriouile Y, Pipis M, Vandrovcova J, Tariq H, Efthymiou S, Salpietro V, Reilly M, Houlden H. Genetic investigation of inherited neuropathy in families from Middle East using next generation sequencing. Neuromuscul Disord 2018. [DOI: 10.1016/s0960-8966(18)30354-7] [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: 10/17/2022]
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28
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Pipis M, Clegg A, Brown M, Jarman P. PO239 Jerks in a traveller. J Neurol Psychiatry 2017. [DOI: 10.1136/jnnp-2017-abn.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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29
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Affiliation(s)
- Menelaos Pipis
- Accident and Emergency Department, Watford General Hospital, Watford WD18 0HB, UK
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