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Peall KJ, Ng J, Dy ME, Sharma N, Pope S, Heales S, Friedman JR, Kurian MA. Low CSF 5-HIAA in Myoclonus Dystonia. Mov Disord 2017; 32:1647-1649. [PMID: 28949039 DOI: 10.1002/mds.27117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/03/2017] [Accepted: 06/07/2017] [Indexed: 11/07/2022] Open
Affiliation(s)
- Kathryn J Peall
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, United Kingdom
| | - Joanne Ng
- Developmental Neurosciences, UCL Great Ormond Street-Institute of Child Health, London, United Kingdom
- Department of Neurology, Great Ormond Street Hospital, London, United Kingdom
| | - Marisela E Dy
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, Massachusetts, USA
| | - Nutan Sharma
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, Massachusetts, USA
| | - Simon Pope
- Neurometabolic Unit, The National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Simon Heales
- Neurometabolic Unit, The National Hospital for Neurology and Neurosurgery, London, United Kingdom
- Centre for Translational Omics, UCL Great Ormond Street, Institute of Child Health, London, United Kingdom
| | - Jennifer R Friedman
- Departments of Neurosciences and Pediatrics, UC San Diego School, Rady Children's Hospital and Rady Children's Institute for Genomic Medicine, San Diego, California, USA
| | - Manju A Kurian
- Developmental Neurosciences, UCL Great Ormond Street-Institute of Child Health, London, United Kingdom
- Department of Neurology, Great Ormond Street Hospital, London, United Kingdom
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Ortez C, Duarte ST, Ormazábal A, Serrano M, Pérez A, Pons R, Pineda M, Yapici Z, Fernández-Álvarez E, Domingo-Jiménez R, De Castro P, Artuch R, García-Cazorla A. Cerebrospinal fluid synaptic proteins as useful biomarkers in tyrosine hydroxylase deficiency. Mol Genet Metab 2015; 114:34-40. [PMID: 25468651 DOI: 10.1016/j.ymgme.2014.10.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 10/27/2014] [Accepted: 10/28/2014] [Indexed: 11/24/2022]
Abstract
Tyrosine hydroxylase (TH) deficiency is an inborn error of dopamine biosynthesis and a cause of early parkinsonism. Two clinical phenotypes have been described. Type "B": early onset severe encephalopathy; type "A": later onset, less severe and better response to L-dopa. We aimed to study the expression of several key dopaminergic and gabaergic synaptic proteins in the cerebrospinal fluid (CSF) of a series of patients with TH deficiency and their possible relation with the clinical phenotype and response to L-DOPA. Dopamine transporter (DAT), D2-receptor and vesicular monoamine transporter (VMAT2) were measured in the CSF of 10 subjects with TH deficiency by Western blot analysis. In 3 patients, data of pre- and post-treatment with L-DOPA were available, and in one of them, GABA vesicular transporter was determined. Results were compared to an age-matched control population. The concentration of D2-receptors in CSF was significantly higher in patients with TH deficiency than in controls. Similarly, DAT and vesicular monoamine transporter type 2 were up-regulated. Studies performed before L-DOPA, and on L-DOPA therapy showed a paradoxical response with D2 receptor expression increase as L-Dopa doses and homovanillic concentration gradually raised in a B phenotype patient. The opposite results were found in two patients with A phenotype. However, this is a very small sample, and further studies are needed to conclude robust differences between phenotypes. Synaptic proteins are detectable in the CSF and their quantification can be useful for understanding the pathophysiology of neurotransmitter defects and potentially to adjust and personalize treatments in the future.
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Affiliation(s)
- C Ortez
- Department of Neurology, CIBER-ER Biomedical Network Research Centre on Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain; Hospital Sant Joan de Déu (HSJD), CIBER-ER Biomedical Network Research Centre on Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain
| | - S T Duarte
- Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal; Hospital Dona Estefânia, CHLC, Lisbon, Portugal
| | - A Ormazábal
- Department of Biochemistry, CIBER-ER Biomedical Network Research Centre on Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain; Hospital Sant Joan de Déu (HSJD), CIBER-ER Biomedical Network Research Centre on Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain
| | - M Serrano
- Hospital Sant Joan de Déu (HSJD), CIBER-ER Biomedical Network Research Centre on Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain
| | - A Pérez
- Department of Neurology, CIBER-ER Biomedical Network Research Centre on Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain
| | - R Pons
- Department of Pediatrics, University of Athens, Aghia Sofia Hospital, Athens, Greece
| | - M Pineda
- Department of Neurology, CIBER-ER Biomedical Network Research Centre on Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain; Hospital Sant Joan de Déu (HSJD), CIBER-ER Biomedical Network Research Centre on Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain
| | - Z Yapici
- Istanbul Faculty of Medicine, Department of Child Neurology, Istanbul, Turkey
| | - E Fernández-Álvarez
- Department of Neurology, CIBER-ER Biomedical Network Research Centre on Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain
| | - R Domingo-Jiménez
- Departament of Pediatric Neurology, Hospital V. Arrixaca, Murcia, Spain
| | - P De Castro
- Department of Pediatric Neurology, Hospital Gregorio Marañón, Madrid, Spain
| | - R Artuch
- Department of Biochemistry, CIBER-ER Biomedical Network Research Centre on Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain; Hospital Sant Joan de Déu (HSJD), CIBER-ER Biomedical Network Research Centre on Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain
| | - A García-Cazorla
- Department of Neurology, CIBER-ER Biomedical Network Research Centre on Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain; Department of Biochemistry, CIBER-ER Biomedical Network Research Centre on Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain.
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Ohta E, Funayama M, Ichinose H, Toyoshima I, Urano F, Matsuo M, Tomoko N, Yukihiko K, Yoshino S, Yokoyama H, Shimazu H, Maeda K, Hasegawa K, Obata F. Novel mutations in the guanosine triphosphate cyclohydrolase 1 gene associated with DYT5 dystonia. Arch Neurol 2006; 63:1605-10. [PMID: 17101830 DOI: 10.1001/archneur.63.11.1605] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To better understand the relationship between mutation of the guanosine triphosphate cyclohydrolase I (GCH1) gene and the etiology of DYT5 dystonia and to accumulate data on the mutation in the Japanese population for genetic diagnosis of the disease. SETTING Japanese population. Patients Eight Japanese patients with suspected DYT5 dystonia were analyzed. Intervention Direct genomic sequencing of 6 exons of GCH1 was performed. MAIN OUTCOME MEASURES For patients who did not exhibit any abnormality in the sequence analysis, the possibility of exon deletions was examined. In cases for which cerebrospinal fluid was available, the concentrations of neopterin and biopterin were measured as an index of GCH1 enzyme activity. RESULTS In 2 patients, we found a new T106I mutation in exon 1 of GCH1, a position involved in the helix-turn-helix structure of the enzyme. In the third patient, we found a new mutation (a 15-base pair nucleotide deletion) in exon 5 that may cause a frameshift involving the active site. In the fourth patient, we detected a known nucleotide G>A substitution in the splice site of intron 5, which has been reported to produce exon 5-skipped messenger RNA. The concentrations of both neopterin and biopterin in the cerebrospinal fluid of the third and fourth patients were markedly lower than the normal range, indicating that the GCH1 enzyme was functionally abnormal in these mutations. Gene dosage analysis showed that the fifth patient had a deletion of both exon 3 and exon 4, whereas the sixth patient had a deletion of exon 3. CONCLUSIONS We found several novel, as well as known, GCH1 mutations in Japanese patients with DYT5 dystonia. In some of them, the GCH1 enzyme activity was proved to be impaired.
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Affiliation(s)
- Etsuro Ohta
- Division of Clinical Immunology, Graduate School of Medical Sciences, Kitasato University, Department of Neurology, National Sagamihara Hospital, Sagamihara, Kanagawa, Japan
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Assmann BE, Robinson RO, Surtees RAH, Bräutigam C, Heales SJR, Wevers RA, Zschocke J, Hyland K, Sharma R, Hoffmann GF. Infantile parkinsonism-dystonia and elevated dopamine metabolites in CSF. Neurology 2004; 62:1872-4. [PMID: 15159499 DOI: 10.1212/01.wnl.0000126440.16612.51] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Two girls and one boy are described, with severe infantile parkinsonism-dystonia. This syndrome is usually caused by endogenous dopamine deficiency but in these patients was associated with elevated dopamine metabolites in CSF and an unusual eye movement disorder: ocular flutter together with saccade initiation failure. Pyramidal tract signs also emerged in the course of the disease in two patients. This combination of symptoms and biochemical findings suggests a unique pathogenic mechanism.
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Affiliation(s)
- B E Assmann
- Department of General Pediatrics, University Children's Hospital, Duesseldorf, Germany.
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Simon DK, Nishino S, Scammell TE. Mistaken diagnosis of psychogenic gait disorder in a man with status cataplecticus ("Limp Man Syndrome"). Mov Disord 2004; 19:838-840. [PMID: 15254948 DOI: 10.1002/mds.20078] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
We report on a 45-year-old man with a history of multiple psychiatric admissions for a gait disorder and episodic weakness thought to be psychogenic who was subsequently diagnosed with status cataplecticus due to narcolepsy. The gait difficulties resolved with venlafaxine. This case demonstrates that status cataplecticus can be misdiagnosed as a psychogenic gait disorder.
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Affiliation(s)
- David K Simon
- Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Neurology, Boston, Massachusetts, USA
| | - Seiji Nishino
- Center for Narcolepsy, Stanford University, Palo Alto, California, USA
| | - Thomas E Scammell
- Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Neurology, Boston, Massachusetts, USA
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Abstract
The clinical expression of dopa-responsive dystonia (DRD) was found to be different in a pair of affected monozygotic twins. An earlier onset was associated with a more disabling course of disease. Whereas monozygosity was genetically proven, the search for pathogenic mutations in the GTP-cyclohydrolase-1 gene was negative. The contribution of environmental factors appeared minimal. Intrafamilial variability of DRD phenotype may be related to yet unknown non-Mendelian epigenetic or proteomic factors.
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Affiliation(s)
- H Grötzsch
- Neurology Department, University Hospital, Geneva, Switzerland
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