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Servelhere KR, Casseb RF, de Lima FD, Rezende TJR, Ramalho LP, França MC. Spinal Cord Gray and White Matter Damage in Different Hereditary Spastic Paraplegia Subtypes. AJNR Am J Neuroradiol 2021; 42:610-615. [PMID: 33478946 DOI: 10.3174/ajnr.a7017] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/04/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Spinal cord damage is a hallmark of hereditary spastic paraplegias, but it is still not clear whether specific subtypes of the disease have distinctive patterns of spinal cord gray (GM) and white (WM) matter involvement. We compared cervical cross-sectional GM and WM areas in patients with distinct hereditary spastic paraplegia subtypes. We also assessed whether these metrics correlated with clinical parameters. MATERIALS AND METHODS We analyzed 37 patients (17 men; mean age, 47.3 [SD, 16.5] years) and 21 healthy controls (7 men; mean age, 42.3 [SD, 13.2] years). There were 7 patients with spastic paraplegia type 3A (SPG3A), 12 with SPG4, 10 with SPG7, and 8 with SPG11. Image acquisition was performed on a 3T MR imaging scanner, and T2*-weighted 2D images were assessed by the Spinal Cord Toolbox. Statistical analyses were performed in SPSS using nonparametric tests and false discovery rate-corrected P values < .05. RESULTS The mean disease duration for the hereditary spastic paraplegia group was 22.4 [SD, 13.8] years and the mean Spastic Paraplegia Rating Scale score was 22.8 [SD, 11.0]. We failed to identify spinal cord atrophy in SPG3A and SPG7. In contrast, we found abnormalities in patients with SPG4 and SPG11. Both subtypes had spinal cord GM and WM atrophy. SPG4 showed a strong inverse correlation between GM area and disease duration (ρ = -0.903, P < .001). CONCLUSIONS Cervical spinal cord atrophy is found in some but not all hereditary spastic paraplegia subtypes. Spinal cord damage in SPG4 and 11 involves both GM and WM.
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Affiliation(s)
- K R Servelhere
- From the School of Medical Sciences (K.R.S., F.D.d.L. T.J.R.R., L.P.R., M.C.F.), University of Campinas, Campinas, Brazil
| | - R F Casseb
- Seaman Family MR Research Center (R.F.C.), University of Calgary, Calgary, Alberta, Canada
| | - F D de Lima
- From the School of Medical Sciences (K.R.S., F.D.d.L. T.J.R.R., L.P.R., M.C.F.), University of Campinas, Campinas, Brazil
| | - T J R Rezende
- From the School of Medical Sciences (K.R.S., F.D.d.L. T.J.R.R., L.P.R., M.C.F.), University of Campinas, Campinas, Brazil
| | - L P Ramalho
- From the School of Medical Sciences (K.R.S., F.D.d.L. T.J.R.R., L.P.R., M.C.F.), University of Campinas, Campinas, Brazil
| | - M C França
- From the School of Medical Sciences (K.R.S., F.D.d.L. T.J.R.R., L.P.R., M.C.F.), University of Campinas, Campinas, Brazil
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Martinez ARM, de Lima FD, Martins MP, Pereira IE, Miotto N, Mazo DFC, Vigani AG, da Costa LBE, Stucchi RSB, Almeida JRS, Nucci A, França MC. Sensory neuronopathy is a specific and disabling neurological manifestation of autoimmune hepatitis. Eur J Neurol 2020; 27:2072-2078. [PMID: 32441838 DOI: 10.1111/ene.14355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 05/15/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE Neurological manifestations have been identified in the context of autoimmune hepatitis (AIH). Previous case reports highlighted the association between AIH and sensory neuronopathy (SN). Despite that, little is known about the frequency of AIH-related SN and its clinical/neurophysiological profile. Moreover, it is not clear whether SN is an AIH-specific manifestation or related to chronic liver damage. METHODS Seventy consecutive AIH patients were enrolled and their characteristics were compared with 52 consecutive patients with chronic active hepatitis B. All subjects underwent clinical and neurophysiological evaluation. Further comparisons were performed between AIH SN and AIH non-SN patients. RESULTS Mean ages and male:female proportions in the AIH and chronic active hepatitis B groups were 42.2 ± 16.3/51.7 ± 13.6 years and 14:56/29:23, respectively. The frequencies of carpal tunnel syndrome, radiculopathy and polyneuropathy were similar between groups. In contrast, SN was identified only in AIH patients (5/70 vs. 0/52, P = 0.04); the overall prevalence of AIH-related SN was 7% with an average profile of a woman in her 40s with asymmetric onset of sensory deficits that chronically evolved to disabling proprioceptive ataxia associated with marked dysautonomia. Neurological disability and hepatocellular damage did not follow in parallel. Anti-fibroblast growth factor receptor type 3 antibodies were found in 3/5 (60%) of the patients with AIH-related SN. Clinical or demographic predictors of SN in the context of AIH could not be identified. CONCLUSION Sensory neuronopathy, but not other peripheral nervous system diseases, is a specific AIH neurological manifestation. It is often disabling and, in contrast to hepatocellular injury, does not respond to immunosuppression.
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Affiliation(s)
- A R M Martinez
- Department of Neurology - Neuromuscular Division, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - F D de Lima
- Department of Neurology - Neuromuscular Division, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - M P Martins
- Department of Neurology - Neuromuscular Division, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - I E Pereira
- Department of Internal Medicine - Gastroenterology Division (Gastrocentro), University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - N Miotto
- Department of Internal Medicine - Infectious Diseases Division, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - D F C Mazo
- Department of Internal Medicine - Gastroenterology Division (Gastrocentro), University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - A G Vigani
- Department of Internal Medicine - Infectious Diseases Division, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - L B E da Costa
- Department of Pathology - Hepatic Disorders Division, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - R S B Stucchi
- Department of Internal Medicine - Infectious Diseases Division, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - J R S Almeida
- Department of Internal Medicine - Gastroenterology Division (Gastrocentro), University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - A Nucci
- Department of Neurology - Neuromuscular Division, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - M C França
- Department of Neurology - Neuromuscular Division, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
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Pascual B, de Bot ST, Daniels MR, França MC, Toro C, Riverol M, Hedera P, Bassi MT, Bresolin N, van de Warrenburg BP, Kremer B, Nicolai J, Charles P, Xu J, Singh S, Patronas NJ, Fung SH, Gregory MD, Masdeu JC. "Ears of the Lynx" MRI Sign Is Associated with SPG11 and SPG15 Hereditary Spastic Paraplegia. AJNR Am J Neuroradiol 2019; 40:199-203. [PMID: 30606727 DOI: 10.3174/ajnr.a5935] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/30/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND PURPOSE The "ears of the lynx" MR imaging sign has been described in case reports of hereditary spastic paraplegia with a thin corpus callosum, mostly associated with mutations in the spatacsin vesicle trafficking associated gene, causing Spastic Paraplegia type 11 (SPG11). This sign corresponds to long T1 and T2 values in the forceps minor of the corpus callosum, which appears hyperintense on FLAIR and hypointense on T1-weighted images. Our purpose was to determine the sensitivity and specificity of the ears of the lynx MR imaging sign for genetic cases compared with common potential mimics. MATERIALS AND METHODS Four independent raters, blinded to the diagnosis, determined whether the ears of the lynx sign was present in each of a set of 204 single anonymized FLAIR and T1-weighted MR images from 34 patients with causal mutations associated with SPG11 or Spastic Paraplegia type 15 (SPG15). 34 healthy controls, and 34 patients with multiple sclerosis. RESULTS The interrater reliability for FLAIR images was substantial (Cohen κ, 0.66-0.77). For these images, the sensitivity of the ears of the lynx sign across raters ranged from 78.8 to 97.0 and the specificity ranged from 90.9 to 100. The accuracy of the sign, measured by area under the receiver operating characteristic curve, ranged from very good (87.1) to excellent (93.9). CONCLUSIONS The ears of the lynx sign on FLAIR MR imaging is highly specific for the most common genetic subtypes of hereditary spastic paraplegia with a thin corpus callosum. When this sign is present, there is a high likelihood of a genetic mutation, particularly associated with SPG11 or SPG15, even in the absence of a family history.
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Affiliation(s)
- B Pascual
- From the Departments of Neurology (B.P., M.R.D., J.C.M.)
| | - S T de Bot
- Department of Neurology (S.T.d.B.), Leiden University Medical Centre, Leiden, the Netherlands
| | - M R Daniels
- From the Departments of Neurology (B.P., M.R.D., J.C.M.)
| | - M C França
- Department of Neurology (M.C.F.), University of Campinas, Campinas, Brazil
| | - C Toro
- National Institutes of Health Intramural Research Program (C.T., N.J.P., M.D.G.), Bethesda, Maryland
| | - M Riverol
- Department of Neurology (M.R.), Clínica Universidad de Navarra, Pamplona, Spain
| | - P Hedera
- Department of Neurology (P.H.), Vanderbilt University Medical Center, Nashville, Tennessee
| | - M T Bassi
- Laboratory of Molecular Biology (M.T.B.), Scientific Institute Istituto di Ricovero e Cura a Carattere Scientifico E. Medea, Bosisio Parini, Lecco, Italy
| | - N Bresolin
- Department of Neuroscience and Mental Health (N.B.), University Hospital Policlinico Ca'Granda, University of Milan, Milan, Italy
| | - B P van de Warrenburg
- Department of Neurology (B.P.v.d.W.), Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - B Kremer
- Department of Neurology (B.K.), University Medical Center Groningen, Groningen, the Netherlands
| | - J Nicolai
- Department of Neurology (J.N.), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - P Charles
- Department of Genetics (P.C.), Hôpital Pitié-Salpêtrière, Paris, France
| | | | - S Singh
- Radiology (S.S., S.H.F.), Houston Methodist Research Institute, Houston, Texas
| | - N J Patronas
- National Institutes of Health Intramural Research Program (C.T., N.J.P., M.D.G.), Bethesda, Maryland
| | - S H Fung
- Radiology (S.S., S.H.F.), Houston Methodist Research Institute, Houston, Texas
| | - M D Gregory
- National Institutes of Health Intramural Research Program (C.T., N.J.P., M.D.G.), Bethesda, Maryland
| | - J C Masdeu
- From the Departments of Neurology (B.P., M.R.D., J.C.M.)
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Rezende TJR, Martinez ARM, Faber I, Girotto Takazaki KA, Martins MP, de Lima FD, Lopes-Cendes I, Cendes F, França MC. Developmental and neurodegenerative damage in Friedreich's ataxia. Eur J Neurol 2018; 26:483-489. [PMID: 30326180 DOI: 10.1111/ene.13843] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [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: 06/29/2018] [Accepted: 10/04/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE Friedreich's ataxia (FRDA) is the most common autosomal-recessive ataxia worldwide. It is characterized by early onset, sensory abnormalities and slowly progressive ataxia. All magnetic resonance imaging (MRI)-based studies have focused on the evaluation of adult patients. Therefore, we designed a cross-sectional multimodal MRI-based study to investigate the anatomical substrates involved in the early stages of FRDA. METHODS We enrolled 37 patients (12 children) and 38 controls. All subjects underwent MRI in a 3T device to assess gray and white matter. We used measures from FreeSurfer and CERES to evaluate the cerebral and cerebellar cortices. The T1 multiatlas assessed deep gray matter. The diffusion tensor imaging multiatlas was used to investigate microstructural abnormalities in brain white matter and SpineSeg was used to assess the cervical spinal cord. All analyses were corrected for multiple comparisons. RESULTS Comparison with age-matched controls showed that pediatric patients have spinal cord, inferior cerebellar peduncle and red nucleus damage. In contrast, adult patients showed more widespread white matter damage than pediatric patients. With regard to gray matter, we found cortical thinning at the left central sulcus and volumetric reduction in the thalami and hippocampi only in adult patients. Finally, values of fractional anisotropy in adult patients and radial diffusivity in pediatric patients from the inferior cerebellar peduncle correlated with disease duration and ataxia severity, respectively. CONCLUSIONS Structural damage in FRDA begins in the spinal cord and inferior cerebellar peduncle as well as the red nucleus, and progresses to cerebral areas in adulthood. These results shed some light on the early stages of FRDA and highlight potential neuroimaging markers for therapeutic trials.
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Affiliation(s)
- T J R Rezende
- Department of Neurology and Neuroimaging Laboratory, School of Medical Sciences, University of Campinas (UNICAMP), Campinas
| | - A R M Martinez
- Department of Neurology and Neuroimaging Laboratory, School of Medical Sciences, University of Campinas (UNICAMP), Campinas
| | - I Faber
- Department of Neurology and Neuroimaging Laboratory, School of Medical Sciences, University of Campinas (UNICAMP), Campinas
| | - K A Girotto Takazaki
- Department of Neurology and Neuroimaging Laboratory, School of Medical Sciences, University of Campinas (UNICAMP), Campinas
| | - M P Martins
- Department of Neurology and Neuroimaging Laboratory, School of Medical Sciences, University of Campinas (UNICAMP), Campinas
| | - F D de Lima
- Department of Neurology and Neuroimaging Laboratory, School of Medical Sciences, University of Campinas (UNICAMP), Campinas
| | - I Lopes-Cendes
- Department of Medical Genetics, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - F Cendes
- Department of Neurology and Neuroimaging Laboratory, School of Medical Sciences, University of Campinas (UNICAMP), Campinas
| | - M C França
- Department of Neurology and Neuroimaging Laboratory, School of Medical Sciences, University of Campinas (UNICAMP), Campinas
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Faber I, Prota JRM, Martinez ARM, Lopes-Cendes I, França MC. A new phenotype associated with homozygous GRN mutations: complicated spastic paraplegia. Eur J Neurol 2016; 24:e3-e4. [PMID: 28000352 DOI: 10.1111/ene.13194] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 09/27/2016] [Indexed: 11/29/2022]
Affiliation(s)
- I Faber
- Department of Neurology, School of Medical Sciences, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - J R M Prota
- Department of Medical Genetics, School of Medical Sciences, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - A R M Martinez
- Department of Neurology, School of Medical Sciences, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - I Lopes-Cendes
- Department of Medical Genetics, School of Medical Sciences, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - M C França
- Department of Neurology, School of Medical Sciences, University of Campinas - UNICAMP, Campinas, SP, Brazil
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Santos TA, Maistro CEB, Silva CB, Oliveira MS, França MC, Castellano G. MRI Texture Analysis Reveals Bulbar Abnormalities in Friedreich Ataxia. AJNR Am J Neuroradiol 2015; 36:2214-8. [PMID: 26359147 PMCID: PMC7964265 DOI: 10.3174/ajnr.a4455] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 05/18/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND PURPOSE Texture analysis is an image processing technique that can be used to extract parameters able to describe meaningful features of an image or ROI. Texture analysis based on the gray level co-occurrence matrix gives a second-order statistical description of the image or ROI. In this work, the co-occurrence matrix texture approach was used to extract information from brain MR images of patients with Friedreich ataxia and a control group, to see whether texture parameters were different between these groups. A longitudinal analysis was also performed. MATERIALS AND METHODS Twenty patients and 21 healthy controls participated in the study. Both groups had 2 sets of T1-weighted MR images obtained 1 year apart for every subject. ROIs chosen for analysis were the medulla oblongata and pons. Texture parameters were obtained for these ROIs for every subject, for the 2 sets of images. These parameters were compared longitudinally within groups and transversally between groups. RESULTS The comparison between patients and the control group showed a significant differences for the medulla oblongata (t test, P < .05, Bonferroni-corrected) but did not show a statistically significant difference for the pons. Longitudinal comparison of images obtained 1 year apart did not show differences for either patients or for controls, in any of the analyzed structures. CONCLUSIONS Gray level co-occurrence matrix-based texture analysis showed statistically significant differences for the medulla oblongata of patients with Friedreich ataxia compared with controls. These results highlight the medulla as an important site of damage in Friedreich ataxia.
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Affiliation(s)
- T A Santos
- From the Neurophysics Group (T.A.S., C.E.B.M., M.S.O., G.C.), Gleb Wataghin Physics Institute Brazilian Institute of Neuroscience and Neurotechnology (BRAINN) (São Paulo Research Foundation) (T.A.S., C.E.B.M., C.B.S., M.S.O., M.C.F., G.C.), Campinas, São Paulo, Brazil
| | - C E B Maistro
- From the Neurophysics Group (T.A.S., C.E.B.M., M.S.O., G.C.), Gleb Wataghin Physics Institute Brazilian Institute of Neuroscience and Neurotechnology (BRAINN) (São Paulo Research Foundation) (T.A.S., C.E.B.M., C.B.S., M.S.O., M.C.F., G.C.), Campinas, São Paulo, Brazil
| | - C B Silva
- Department of Neurology (C.B.S., M.C.F.), Medical Sciences School, University of Campinas, Brazil Brazilian Institute of Neuroscience and Neurotechnology (BRAINN) (São Paulo Research Foundation) (T.A.S., C.E.B.M., C.B.S., M.S.O., M.C.F., G.C.), Campinas, São Paulo, Brazil
| | - M S Oliveira
- From the Neurophysics Group (T.A.S., C.E.B.M., M.S.O., G.C.), Gleb Wataghin Physics Institute Brazilian Institute of Neuroscience and Neurotechnology (BRAINN) (São Paulo Research Foundation) (T.A.S., C.E.B.M., C.B.S., M.S.O., M.C.F., G.C.), Campinas, São Paulo, Brazil
| | - M C França
- Department of Neurology (C.B.S., M.C.F.), Medical Sciences School, University of Campinas, Brazil Brazilian Institute of Neuroscience and Neurotechnology (BRAINN) (São Paulo Research Foundation) (T.A.S., C.E.B.M., C.B.S., M.S.O., M.C.F., G.C.), Campinas, São Paulo, Brazil
| | - G Castellano
- From the Neurophysics Group (T.A.S., C.E.B.M., M.S.O., G.C.), Gleb Wataghin Physics Institute Brazilian Institute of Neuroscience and Neurotechnology (BRAINN) (São Paulo Research Foundation) (T.A.S., C.E.B.M., C.B.S., M.S.O., M.C.F., G.C.), Campinas, São Paulo, Brazil.
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de Rezende TJR, D'Abreu A, Guimarães RP, Lopes TM, Lopes-Cendes I, Cendes F, Castellano G, França MC. Cerebral cortex involvement in Machado-Joseph disease. Eur J Neurol 2014; 22:277-83, e23-4. [PMID: 25251537 DOI: 10.1111/ene.12559] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 07/25/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE Machado-Joseph disease (MJD/SCA3) is the most frequent spinocerebellar ataxia, characterized by brainstem, basal ganglia and cerebellar damage. Few magnetic resonance imaging based studies have investigated damage in the cerebral cortex. The objective was to determine whether patients with MJD/SCA3 have cerebral cortex atrophy, to identify regions more susceptible to damage and to look for the clinical and neuropsychological correlates of such lesions. METHODS Forty-nine patients with MJD/SCA3 (mean age 47.7 ± 13.0 years, 27 men) and 49 matched healthy controls were enrolled. All subjects underwent magnetic resonance imaging scans in a 3 T device, and three-dimensional T1 images were used for volumetric analyses. Measurement of cortical thickness and volume was performed using the FreeSurfer software. Groups were compared using ancova with age, gender and estimated intracranial volume as covariates, and a general linear model was used to assess correlations between atrophy and clinical variables. RESULTS Mean CAG expansion, Scale for Assessment and Rating of Ataxia (SARA) score and age at onset were 72.1 ± 4.2, 14.7 ± 7.3 and 37.5 ± 12.5 years, respectively. The main findings were (i) bilateral paracentral cortex atrophy, as well as the caudal middle frontal gyrus, superior and transverse temporal gyri, and lateral occipital cortex in the left hemisphere and supramarginal gyrus in the right hemisphere; (ii) volumetric reduction of basal ganglia and hippocampi; (iii) a significant correlation between SARA and brainstem and precentral gyrus atrophy. Furthermore, some of the affected cortical regions showed significant correlations with neuropsychological data. CONCLUSIONS Patients with MJD/SCA3 have widespread cortical and subcortical atrophy. These structural findings correlate with clinical manifestations of the disease, which support the concept that cognitive/motor impairment and cerebral damage are related in disease.
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Affiliation(s)
- T J R de Rezende
- Department of Neurology, University of Campinas (UNICAMP), Campinas, Brazil; Department of Cosmic Rays and Chronology, University of Campinas (UNICAMP), Campinas, Brazil
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Bonilha da Silva C, Bergo FPG, D'Abreu A, Cendes F, Lopes-Cendes I, França MC. Dentate nuclei T2 relaxometry is a reliable neuroimaging marker in Friedreich's ataxia. Eur J Neurol 2014; 21:1131-1136. [DOI: 10.1111/ene.12448] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 03/17/2014] [Indexed: 11/29/2022]
Affiliation(s)
- C. Bonilha da Silva
- Department of Neurology and Neuroimaging Laboratory; Faculty of Medicine; University of Campinas - UNICAMP; Campinas SP Brazil
| | - F. P. G. Bergo
- Department of Neurology and Neuroimaging Laboratory; Faculty of Medicine; University of Campinas - UNICAMP; Campinas SP Brazil
| | - A. D'Abreu
- Department of Neurology and Neuroimaging Laboratory; Faculty of Medicine; University of Campinas - UNICAMP; Campinas SP Brazil
| | - F. Cendes
- Department of Neurology and Neuroimaging Laboratory; Faculty of Medicine; University of Campinas - UNICAMP; Campinas SP Brazil
| | - I. Lopes-Cendes
- Department of Medical Genetics; Faculty of Medicine; University of Campinas - UNICAMP; Campinas SP Brazil
| | - M. C. França
- Department of Neurology and Neuroimaging Laboratory; Faculty of Medicine; University of Campinas - UNICAMP; Campinas SP Brazil
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Vale SHL, Leite LD, Alves CX, Dantas MMG, Costa JBS, Marchini JS, França MC, Brandão-Neto J. Zinc pharmacokinetic parameters in the determination of body zinc status in children. Eur J Clin Nutr 2013; 68:203-8. [PMID: 24327117 DOI: 10.1038/ejcn.2013.250] [Citation(s) in RCA: 5] [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] [Received: 05/21/2013] [Revised: 10/09/2013] [Accepted: 10/16/2013] [Indexed: 12/28/2022]
Abstract
BACKGROUND/OBJECTIVES Serum or tissue zinc concentrations are often used to assess body zinc status. However, all of these methods are relatively inaccurate. Thus, we investigated three different kinetic methods for the determination of zinc clearance to establish which of these could detect small changes in the body zinc status of children. SUBJECTS/METHODS Forty apparently healthy children were studied. Renal handling of zinc was investigated during intravenous zinc administration (0.06537 mg Zn/kg of body weight), both before and after oral zinc supplementation (5 mg Zn/day for 3 months). Three kinetic methods were used to determine zinc clearance: CZn-Formula A and CZn-Formula B were both used to calculate systemic clearance; the first is a general formula and the second is used for the specific analysis of a single-compartment model; CZn-Formula C is widely used in medical practices to analyze kinetic routine. RESULTS Basal serum zinc values, which were within the reference range for healthy children, increased significantly after oral zinc supplementation. The three formulas used gave different results for zinc clearance both before and after oral zinc supplementation. CZn-Formula B showed a positive correlation with basal serum zinc concentration after oral supplementation (R2=0.1172, P=0.0306). In addition, CZn-Formula B (P=0.0002) was more effective than CZn-Formula A (P=0.6028) and CZn-Formula C (P=0.0732) in detecting small variations in body zinc status. CONCLUSIONS All three of the formulas used are suitable for studying zinc kinetics; however, CZn-Formula B is particularly effective at detecting small changes in body zinc status in healthy children.
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Affiliation(s)
- S H L Vale
- Postgraduate Program in Health Sciences, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - L D Leite
- Department of Nutrition, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - C X Alves
- Postgraduate Program in Health Sciences, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - M M G Dantas
- Postgraduate Program in Health Sciences, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - J B S Costa
- Department of Chemical Engineering, Center for Industrial Technology, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - J S Marchini
- Department of Internal Medicine, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - M C França
- Department of Statistics, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - J Brandão-Neto
- Department of Internal Medicine, Universidade Federal do Rio Grande do Norte, Natal, Brazil
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França MC, Dogini DB, D'Abreu A, Teive HAG, Munhoz RP, Raskin S, Moro A, Melo CC, Gomes AP, Saute JAM, Jardim LB, Lopes-Cendes I. SPG4-related hereditary spastic paraplegia: frequency and mutation spectrum in Brazil. Clin Genet 2013; 86:194-6. [PMID: 24033003 DOI: 10.1111/cge.12252] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 08/06/2013] [Accepted: 08/09/2013] [Indexed: 11/28/2022]
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Abstract
BACKGROUND Autonomic dysfunction is a usual feature of several neurological conditions characterized by either extra-pyramidal and/or peripheral damage, such as those seen in Machado-Joseph disease (MJD). AIMS OF THE STUDY We used clinical evaluation and sympathetic skin responses (SSR) to assess autonomic function in a large series of patients with MJD. METHODS A total of 50 patients were enrolled in this study and all of them had the molecular confirmation of MJD by DNA genotyping. In addition, a group of 20 control subjects was included. RESULTS Overall, autonomic complaints were more frequent in patients than in control subjects, especially those related to the genitourinary and sudomotor systems. Eighteen patients (36%) presented abnormal SSR. Age at onset, duration of disease and length of expanded (CAG)(n) were not different between patients with and without dysautonomia. However, severe dysautonomia was significantly associated with polyneuropathic or parkinsonian phenotypes in patients with MJD. CONCLUSION Autonomic symptoms are common, but possibly under recognized in patients with MJD; therefore, we believe that autonomic complaints should be sought in patients with MJD, especially in those with parkinsonian or polyneuropathic phenotypes.
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Affiliation(s)
- M C França
- Department of Neurology, University of Campinas, Brazil
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12
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Botelho MA, Martins JG, Ruela RS, I R, Santos JA, Soares JB, França MC, Montenegro D, Ruela WS, Barros LP, Queiroz DB, Araujo RS, Sampio FC. Protective effect of locally applied carvacrol gel on ligature-induced periodontitis in rats: a tapping mode AFM study. Phytother Res 2009; 23:1439-48. [DOI: 10.1002/ptr.2798] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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13
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Affiliation(s)
- M C França
- Department of Neurology, Faculty of Medical Sciences, Campinas State University (UNICAMP), São Paulo, Brazil.
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14
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Malveira GLS, Deus-Silva L, Ferreira CM, Pirani C, França MC, Zanardi VA, Faria AV, Li LM, Damasceno BP, Cendes F. Alternating hemisphere tumefactive demyelinating disorder. Eur J Neurol 2006; 12:737-8. [PMID: 16128880 DOI: 10.1111/j.1468-1331.2005.01046.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Abstract
Idiopathic stabbing headache (ISH) is defined as the occurrence of short-lasting, painful jabs, restricted to the ophthalmic division of the trigeminal nerve. It is closely related to other forms of headache (such as migraine and tension-type headache) and has been reported among all age groups, including children and adolescents. As pathogenic mechanisms of the disease remain unclear, management decisions are empirical and limited to few options. Classically, indomethacin has been considered the first option, but therapeutic failure occurs in up to 35% of cases. In this setting, we report four patients with young-onset indomethacin-resistant ISH which had good responses to gabapentin and discuss the use of this drug in the presenting situation.
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Affiliation(s)
- M C França
- Headache Clinic, Department of Neurology, Faculty of Medical Sciences, Campinas State University (UNICAMP), Sao Paulo, Brazil
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16
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Abstract
We report a 56-year old man with prolonged focal motor status epilepticus as the first clinical manifestation of paracoccidioidomycosis (PCM) and discuss this unusual presentation. We emphasize the need for a comprehensive work-up and increased awareness for central nervous system involvement in PCM, particularly in endemic areas.
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Affiliation(s)
- M C França
- Department of Neurology, Universidade Estadual de Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.
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17
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Cunha GM, Moraes RA, Moraes GA, França MC, Moraes MO, Viana GS. Nerve growth factor, ganglioside and vitamin E reverse glutamate cytotoxicity in hippocampal cells. Eur J Pharmacol 1999; 367:107-12. [PMID: 10082272 DOI: 10.1016/s0014-2999(98)00942-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [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: 11/20/2022]
Abstract
The present work showed that glutamate decreased hippocampal cell viability in a dose-dependent manner. While no significant effect was observed after cell exposure to 0.1 mM glutamate, cell incubation for 0.5 h caused a progressive decrease of cell viability, which at 5 mM concentration reached 68% as compared to controls. No further effect was observed in the presence of 10 mM glutamate. While nerve growth factor (NGF) at the dose of 0.5 ng/ml presented no effect, it significantly reduced glutamate cytotoxicity at a higher dose (1 ng/ml) increasing the cell viability to 66%. Similarly, cell viabilities in the presence of the ganglioside GM, (5 and 10 ng/ml) after glutamate exposure were 19 and 73%, respectively. A dose-response relationship was observed after cell incubation with vitamin E (0.5 and 1 mM) which resulted in cell viability of the order of 34 and 70%, respectively. Surprisingly, a potentiation of the effect was observed after the association of NGF (0.5 ng/ml) plus ganglioside GM1 (5 ng/ml) or vitamin E (0.5 mM) plus ganglioside GM1 (5 ng/ml), after pre-incubation with glutamate. In these conditions, significantly higher viabilities were demonstrated (66 and 71% for the two associations, respectively) as compared to each one of the compounds alone (NGF 0.5 ng/ml--29.5%; ganglioside GM1 5 ng/ml--19.4%). However, no potentiation was seen after the association of NGF plus vitamin E on glutamate pre-exposed cells. These results showed a cytoprotective effect of ganglioside GM1, NGF and vitamin E on the glutamate-induced cytotoxicity in rat hippocampal cells.
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Affiliation(s)
- G M Cunha
- Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
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