1
|
Schiff ND, Diringer M, Diserens K, Edlow BL, Gosseries O, Hill NJ, Hochberg LR, Ismail FY, Meyer IA, Mikell CB, Mofakham S, Molteni E, Polizzotto L, Shah SA, Stevens RD, Thengone D. Brain-Computer Interfaces for Communication in Patients with Disorders of Consciousness: A Gap Analysis and Scientific Roadmap. Neurocrit Care 2024:10.1007/s12028-023-01924-w. [PMID: 38286946 DOI: 10.1007/s12028-023-01924-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 01/31/2024]
Abstract
BACKGROUND We developed a gap analysis that examines the role of brain-computer interfaces (BCI) in patients with disorders of consciousness (DoC), focusing on their assessment, establishment of communication, and engagement with their environment. METHODS The Curing Coma Campaign convened a Coma Science work group that included 16 clinicians and neuroscientists with expertise in DoC. The work group met online biweekly and performed a gap analysis of the primary question. RESULTS We outline a roadmap for assessing BCI readiness in patients with DoC and for advancing the use of BCI devices in patients with DoC. Additionally, we discuss preliminary studies that inform development of BCI solutions for communication and assessment of readiness for use of BCIs in DoC study participants. Special emphasis is placed on the challenges posed by the complex pathophysiologies caused by heterogeneous brain injuries and their impact on neuronal signaling. The differences between one-way and two-way communication are specifically considered. Possible implanted and noninvasive BCI solutions for acute and chronic DoC in adult and pediatric populations are also addressed. CONCLUSIONS We identify clinical and technical gaps hindering the use of BCI in patients with DoC in each of these contexts and provide a roadmap for research aimed at improving communication for adults and children with DoC, spanning the clinical spectrum from intensive care unit to chronic care.
Collapse
Affiliation(s)
- Nicholas D Schiff
- Feil Family Brain and Mind Research Institute, Weill Cornell Medical College, New York, NY, USA.
| | - Michael Diringer
- Departments of Neurology and Neurosurgery, Washington University in St. Louis, St. Louis, MO, USA
| | - Karin Diserens
- Neurology and Acute Neurorehabilitation Unit, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Brian L Edlow
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, Centre du Cerveau, University Hospital of Liège, University of Liège & Centre du Cerveau, Liège, Belgium
| | - N Jeremy Hill
- National Center for Adaptive Neurotechnologies, Stratton VA Medical Center, Albany, NY, USA
- Electrical & Computer Engineering Department, State University of New York at Albany, Albany, NY, USA
| | - Leigh R Hochberg
- Veterans Affairs Rehabilitation Research & Development Center for Neurorestoration and Neurotechnology, Rehabilitation Research & Development Service, Providence VA Medical Center, Providence, RI, USA
- School of Engineering and Carney Institute for Brain Science, Brown University, Providence, RI, USA
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Fatima Y Ismail
- Department of Pediatrics, United Arab Emirates University, Al Ain, United Arab Emirates
- Department of Neurology, Adjunct Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ivo A Meyer
- Neurology and Acute Neurorehabilitation Unit, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Centre for Advanced Research in Sleep Medicine and Integrated Trauma Centre, Integrated University Health and Social Services Centre (CIUSSS) du Nord-de-L'Île-de-Montréal, Montreal, QC, Canada
| | - Charles B Mikell
- Department of Neurosurgery, Stony Brook University Hospital, Stony Brook, NY, USA
| | - Sima Mofakham
- Department of Neurosurgery, Stony Brook University Hospital, Stony Brook, NY, USA
- Department of Electrical and Computer Engineering, Stony Brook University, Stony Brook, NY, USA
| | - Erika Molteni
- School of Biomedical Engineering and Imaging Sciences, and Centre for Medical Engineering, King's College London, London, UK
| | - Leonard Polizzotto
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Sudhin A Shah
- Department of Radiology, Weill Cornell Medical College, New York, NY, USA
| | - Robert D Stevens
- Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | |
Collapse
|
5
|
Tremblay-Laganière C, Maroofian R, Nguyen TTM, Karimiani EG, Kirmani S, Akbar F, Ibrahim S, Afroze B, Doosti M, Ashrafzadeh F, Babaei M, Efthymiou S, Christoforou M, Sultan T, Ladda RL, McLaughlin HM, Truty R, Mahida S, Cohen JS, Baranano K, Ismail FY, Patel MS, Lehman A, Edmondson AC, Nagy A, Walker MA, Mercimek-Andrews S, Maki Y, Sachdev R, Macintosh R, Palmer EE, Mancini GMS, Barakat TS, Steinfeld R, Rüsch CT, Stettner GM, Wagner M, Wortmann SB, Kini U, Brady AF, Stals KL, Ismayilova N, Ellard S, Bernardo D, Nugent K, McLean SD, Antonarakis SE, Houlden H, Kinoshita T, Campeau PM, Murakami Y. PIGG variant pathogenicity assessment reveals characteristic features within 19 families. Genet Med 2021; 23:1873-1881. [PMID: 34113002 PMCID: PMC9900493 DOI: 10.1038/s41436-021-01215-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 05/01/2021] [Accepted: 05/04/2021] [Indexed: 02/08/2023] Open
Abstract
PURPOSE Phosphatidylinositol Glycan Anchor Biosynthesis, class G (PIGG) is an ethanolamine phosphate transferase catalyzing the modification of glycosylphosphatidylinositol (GPI). GPI serves as an anchor on the cell membrane for surface proteins called GPI-anchored proteins (GPI-APs). Pathogenic variants in genes involved in the biosynthesis of GPI cause inherited GPI deficiency (IGD), which still needs to be further characterized. METHODS We describe 22 individuals from 19 unrelated families with biallelic variants in PIGG. We analyzed GPI-AP surface levels on granulocytes and fibroblasts for three and two individuals, respectively. We demonstrated enzymatic activity defects for PIGG variants in vitro in a PIGG/PIGO double knockout system. RESULTS Phenotypic analysis of reported individuals reveals shared PIGG deficiency-associated features. All tested GPI-APs were unchanged on granulocytes whereas CD73 level in fibroblasts was decreased. In addition to classic IGD symptoms such as hypotonia, intellectual disability/developmental delay (ID/DD), and seizures, individuals with PIGG variants of null or severely decreased activity showed cerebellar atrophy, various neurological manifestations, and mitochondrial dysfunction, a feature increasingly recognized in IGDs. Individuals with mildly decreased activity showed autism spectrum disorder. CONCLUSION This in vitro system is a useful method to validate the pathogenicity of variants in PIGG and to study PIGG physiological functions.
Collapse
Affiliation(s)
- Camille Tremblay-Laganière
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine and University of Montreal, Montreal, QC, Canada
| | - Reza Maroofian
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
| | - Thi Tuyet Mai Nguyen
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine and University of Montreal, Montreal, QC, Canada
| | - Ehsan Ghayoor Karimiani
- Genetics Research Centre, Molecular and Clinical Sciences Institute, St. George’s Hospital, University of London, London, UK.,Next Generation Genetic Polyclinic, Mashhad, Iran
| | - Salman Kirmani
- Department of Pediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | - Fizza Akbar
- Department of Pediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | - Shahnaz Ibrahim
- Department of Pediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | - Bushra Afroze
- Department of Pediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | | | - Farah Ashrafzadeh
- Department of Pediatric Neurology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Meisam Babaei
- Department of Pediatrics, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Stephanie Efthymiou
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
| | - Marilena Christoforou
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
| | - Tipu Sultan
- Department of Pediatric Neurology, Institute of Child Health, The Children’s Hospital Lahore, Lahore, Pakistan
| | - Roger L. Ladda
- Department of Pediatrics, Milton S Hershey Medical Centre, Hershey, PA, USA
| | | | | | - Sonal Mahida
- Division of Neurogenetics, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Julie S. Cohen
- Division of Neurogenetics, Kennedy Krieger Institute, Baltimore, MD, USA.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kristin Baranano
- Division of Neurogenetics, Kennedy Krieger Institute, Baltimore, MD, USA.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Fatima Y. Ismail
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Pediatrics, United Arab Emirates University, Al Ain, UAE
| | - Millan S. Patel
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Anna Lehman
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Andrew C. Edmondson
- Division of Human Genetics, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Amanda Nagy
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Melissa A. Walker
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Saadet Mercimek-Andrews
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Medical Genetics, Faculty of Medicine & Dentistry, University of Alberta, Stollery Children’s Hospital, Alberta Health Services, Edmonton, AB, Canada
| | - Yuta Maki
- Department of Chemistry, Graduate School of Science, Osaka University, Toyonaka, Osaka, Japan.,Project Research Center for Fundamental Sciences, Graduate School of Science, Osaka University, Toyonaka, Osaka, Japan
| | - Rani Sachdev
- Sydney Children’s Hospital, Centre for Clinical Genetics, Sydney Children’s Hospital, High St, Randwick, UK.,School of Women’s and Children’s Health, University of New South Wales, High St, Randwick, UK
| | - Rebecca Macintosh
- Sydney Children’s Hospital, Centre for Clinical Genetics, Sydney Children’s Hospital, High St, Randwick, UK
| | - Elizabeth E. Palmer
- Sydney Children’s Hospital, Centre for Clinical Genetics, Sydney Children’s Hospital, High St, Randwick, UK.,School of Women’s and Children’s Health, University of New South Wales, High St, Randwick, UK
| | - Grazia M. S. Mancini
- Department of Clinical Genetics, Erasmus MC University Medical Center, Rotterdam, The Netherlands, CA, Rotterdam, The Netherlands
| | - Tahsin Stefan Barakat
- Department of Clinical Genetics, Erasmus MC University Medical Center, Rotterdam, The Netherlands, CA, Rotterdam, The Netherlands
| | - Robert Steinfeld
- Department of Pediatric Neurology, University Children’s Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christina T. Rüsch
- Department of Pediatric Neurology, University Children’s Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Georg M. Stettner
- Department of Pediatric Neurology, University Children’s Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Matias Wagner
- Institute of Human Genetics, School of Medicine, Technical University Munich, Munich, Germany.,Institute for Neurogenomics Helmholtz Zentrum München, Neuherberg, Germany
| | - Saskia B. Wortmann
- University Children’s Hospital, Paracelsus Medical School, Salzburg, Austria.,Amalias Children’s Hospital, RadboudUMC, Nijmegen, the Netherlands
| | - Usha Kini
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Angela F. Brady
- North West Thames Regional Genetics Service, London North West University Healthcare NHS Trust, Northwick Park Hospital, Harrow, UK
| | - Karen L. Stals
- Exeter Genomics Laboratory, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Naila Ismayilova
- Department of Paediatric Neurology, Chelsea and Westminster Hospital, London, UK
| | - Sian Ellard
- Exeter Genomics Laboratory, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.,Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Danilo Bernardo
- University of California San Francisco, Clinical Neurology, San Francisco, CA, UK
| | - Kimberly Nugent
- Department of Pediatrics, Baylor College of Medicine, The Children’s Hospital of San Antonio, San Antonio, TX, USA
| | - Scott D. McLean
- Department of Pediatrics, Baylor College of Medicine, The Children’s Hospital of San Antonio, San Antonio, TX, USA
| | - Stylianos E. Antonarakis
- Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland
| | - Henry Houlden
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
| | - Taroh Kinoshita
- Yabumoto Department of Intractable Disease Research, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan.,Department of Immunoglycobiology, World Premier International Immunology Frontier Research Center, Osaka University, Osaka, Japan
| | - Philippe M. Campeau
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine and University of Montreal, Montreal, QC, Canada
| | - Yoshiko Murakami
- Yabumoto Department of Intractable Disease Research, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan.,Department of Immunoglycobiology, World Premier International Immunology Frontier Research Center, Osaka University, Osaka, Japan
| |
Collapse
|
8
|
Ismail FY, Gordon-Lipkin E, Huether K, Blair I, Szólics M, Alsaadi T, Aziz F, Suleiman J, Schiess N. Pediatric Multiple Sclerosis in the United Arab Emirates: Characteristics From a Multicenter Study and Global Comparison. J Child Neurol 2018; 33:422-427. [PMID: 29607711 DOI: 10.1177/0883073818759103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We delineate the clinical characteristics, incidence, and prevalence of pediatric-onset multiple sclerosis in Abu Dhabi, United Arab Emirates, from 2010 to 2014. Eighty-two patients (65% female) were identified. Fifty-three (64.6%) were Emiratis (45 from Abu Dhabi and 8 from 5 other emirates) and 29 were expatriates. Mean age of onset was 15.9 years overall, 15.3 years in males and 16.3 years in females. Patients with onset before age 12 years presented with visual symptoms while those with onset after age 12 years presented with a mixture of visual, motor and sensory symptoms. Interferon beta-1a was the most frequently used disease-modifying therapy (48%). In Abu Dhabi Emirati nationals, the age- and sex-adjusted prevalences were 26/100 000 for males and 36/100 000 for females. The total incidence in Emirati nationals from 2010 to 2014 was 2.3/100 000 for ages 10 to 14 years and 7.2/100 000 for ages 15 to 19 years. By comparison with international cohorts, the incidence of pediatric-onset multiple sclerosis in Abu Dhabi is higher whereas gender distribution is similar.
Collapse
Affiliation(s)
- Fatima Y Ismail
- 1 Department of Neurology and Developmental Medicine, The Kennedy Krieger Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA.,2 Department of Pediatrics, United Arab Emirates University, Al Ain, UAE
| | - Eliza Gordon-Lipkin
- 1 Department of Neurology and Developmental Medicine, The Kennedy Krieger Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | | | - Iain Blair
- 4 Institute of Public Health United Arab Emirates University, Al Ain, UAE
| | | | - Taoufik Alsaadi
- 6 American Center for Psychiatry and Neurology, Abu Dhabi, UAE
| | - Faisal Aziz
- 4 Institute of Public Health United Arab Emirates University, Al Ain, UAE
| | - Jehan Suleiman
- 2 Department of Pediatrics, United Arab Emirates University, Al Ain, UAE.,7 Division of Neurology, Department of Pediatrics, Tawam Hospital, Al Ain, UAE
| | - Nicoline Schiess
- 8 Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|