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Jardim LB, Hasan A, Kuo SH, Magaña JJ, França M, Marques W, Camejo C, Santana-da-Silva LC, Leão EE, Espíndola G, Canals F, Miranda M, Salvatierra I, Cornejo-Olivas M, Fernandez-Ruiz J, Braga-Neto P, Dávila-Ortiz de Montellano DJ, Flores-Lagunes LL, Dupré N, Brais B, Vargas FR, Godeiro C, Coutinho L, Teive HG, Kaufmann M, Saffie P, Furtado GV, Saraiva-Pereira ML, Barsottini O, Pedroso JL, Rodríguez-Labrada R, Velázquez-Pérez L, Gomez C. An Exploratory Survey on the Care for Ataxic Patients in the American Continents and the Caribbean. Cerebellum 2023; 22:708-718. [PMID: 35796998 PMCID: PMC10461795 DOI: 10.1007/s12311-022-01442-z] [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] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
Little is known about access of rare disease carriers to health care. To increase this knowledge, the Pan American Hereditary Ataxia Network (PAHAN) conducted an exploratory survey about care for hereditary ataxias in American continents and the Caribbean. A questionnaire was sent to health professionals about the hereditary ataxias identified; access to care; and local teaching and research. The number of ataxics under current care per 100,000 inhabitants was subtracted from the expected overall prevalence of 6/100,000, to estimate the prevalence of uncovered ataxic patients. Local Human Development Indexes (HDI) were used to measure socio-economic factors. Twenty-six sites participated. Twelve sites had very high, 13 had high, and one site had medium HDI. Participants reported on 2239 and 602 patients with spinocerebellar ataxias and recessive forms under current care. The number of patients under current care per inhabitants varied between 0.14 and 12/100,000. The estimated prevalence of uncovered ataxic patients was inversely proportional to HDIs (rho = 0.665, p = 0.003). Access to diagnosis, pre-symptomatic tests, and rehabilitation were associated with HDIs. More and better molecular diagnostic tools, protocols and guidelines, and professional training for ataxia care were the top priorities common to all respondents. Evidence of inequalities was confirmed. Lower HDIs were associated with high potential numbers of uncovered ataxic subjects, and with lack of molecular diagnosis, pre-symptomatic testing, and rehabilitation. More and better diagnostic tools, guidelines, and professional training were priorities to all sites. PAHAN consortium might help with the last two tasks.
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Affiliation(s)
- Laura Bannach Jardim
- Serviço de Genética Médica e Centros de Pesquisa Clínica e Experimental, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2400, 90035-003, Porto Alegre, Brazil.
- Departamento de Medicina Interna, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, 90035-003, Brazil.
| | - Ali Hasan
- Departamento de Medicina Interna, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, 90035-003, Brazil
| | - Sheng-Han Kuo
- Columbia University, 710 West 168th Street, New York, NY, 10032, USA
| | - Jonathan Javier Magaña
- Instituto Nacional de Rehabilitación - LGII, Calz México-Xochimilco 289, Coapa, Guadalupe Tlalpan, Tlalpan, 14389, Ciudad de México, CDMX, México
| | - Marcondes França
- Universidade Estadual de Campinas, Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas, SP, 13083-970, Brazil
| | - Wilson Marques
- Faculdade de Medicina, Universidade de São Paulo, R. Ten. Catão Roxo, 3900 - Vila Monte Alegre, Ribeirão Preto, SP, 14015-010, Brazil
| | | | - Luiz Carlos Santana-da-Silva
- Instituto de Ciências Biológicas da Universidade Federal do Pará, Av. Perimetral, 2-224 - Guamá, Belém, 66077-830, Brazil
| | - Emília Embiruçu Leão
- Singular Medicina de Precisão, Rua Ewerton Visco, 290 - Sala 1301 - Caminho das Árvores, Salvador, 41820-022, Brazil
| | - Gisele Espíndola
- Hospital Universitário Polydoro Ernani de São Thiago da Universidade Federal de Santa Catarina, R. Profa. Maria Flora Pausewang - Trindade, Florianópolis, 88036-800, Brazil
| | - Francisca Canals
- Clinica Alemana, Av Vitacura 5951, Vitacura, Santiago, Región Metropolitana, Chile
| | - Marcelo Miranda
- Fundacion Diagnosis, Antonio Varas 175 of 32, Providencia, Santiago, Chile
| | - Igor Salvatierra
- Hospital Materno Infantil, Clinica Los Andes, GR46+9V7, El Alto, Bolívia
| | - Mario Cornejo-Olivas
- Instituto Nacional de Ciencias Neurologicas, Jr. Ancash 1271, Cercado de Lima 15003, Lima, Peru
| | - Juan Fernandez-Ruiz
- Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Circuito Interior de La Ciudad Universitaria, AV. Universidad 3000, 04510, Ciudad de México, México
| | - Pedro Braga-Neto
- Departamento de Medicina Clínica, Universidade Federal Do Ceará, Rua Pro. Costa Mendes, 1608 - Bloco Didático, 4° andar - Rodolfo Teófilo, Fortaleza, Brazil
| | | | - Luis Leonardo Flores-Lagunes
- Instituto Nacional de Medicina Genómica, Periférico Sur 4809, Arenal Tepepan, Tlalpan, 14610, Ciudad de México, Mexico
| | - Nicolas Dupré
- Department of Medicine, Faculty of Medicine, Université Laval, Ferdinand Vandry Pavillon, 1050 Av. de la Médecine, Quebec City, Quebec, G1V 0A6, Canada
| | - Bernard Brais
- Departments of Neurology and Neurosurgery and Human Genetics, Montreal Neurological Institute-Hospital, Faculty of Medicine, McGill University, University Street, Montreal, Quebec, 3801H3A 2B4, Canada
| | - Fernando Regla Vargas
- Laboratório de Epidemiologia de Malformações Congênitas, Fundação Oswaldo Cruz, Avenida Brasil 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil
| | - Clécio Godeiro
- Universidade Federal do Rio Grande do Norte, Campus Universitário - Lagoa Nova, Natal, 59078-970, Brazil
| | - Léo Coutinho
- Hospital das Clínicas da Universidade Federal do Paraná, R. Gen. Carneiro, 181 - Alto da Glória, Curitiba, 80060-900, Brazil
| | - Helio G Teive
- Hospital das Clínicas da Universidade Federal do Paraná, R. Gen. Carneiro, 181 - Alto da Glória, Curitiba, 80060-900, Brazil
| | - Marcelo Kaufmann
- Neurogenetics Unit, Hospital Jose Ramos Mejia, Gral. Urquiza 609, C1221 ADC, Buenos Aires, Argentina
| | - Paula Saffie
- Centro de Estudios de Trastornos del Movimiento, Avenida José Joaquín Prieto Vial #7271, Santiago, Chile
| | - Gabriel Vasata Furtado
- Serviço de Genética Médica e Centros de Pesquisa Clínica e Experimental, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2400, 90035-003, Porto Alegre, Brazil
| | - Maria Luiza Saraiva-Pereira
- Serviço de Genética Médica e Centros de Pesquisa Clínica e Experimental, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2400, 90035-003, Porto Alegre, Brazil
- Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2600-Prédio Anexo, Porto Alegre, 90035-003, Brazil
| | - Orlando Barsottini
- Universidade Federal do Estado de São Paulo, R. Napoleão de Barros, 715 - Vila Clementino, São Paulo, São Paulo, Brasil
| | - José Luiz Pedroso
- Universidade Federal do Estado de São Paulo, R. Napoleão de Barros, 715 - Vila Clementino, São Paulo, São Paulo, Brasil
| | - Roberto Rodríguez-Labrada
- Cuban Centre for Neurosciences, 190st number 19818 between 27th and 27th, 11600, Playa, Havana, Cuba
- Centro para la Investigación y Rehabilitación de las Ataxias Hereditarias, Libertad Street number 26, between 12th and 16th, 80100, Holguin, Cuba
| | - Luis Velázquez-Pérez
- Centro para la Investigación y Rehabilitación de las Ataxias Hereditarias, Libertad Street number 26, between 12th and 16th, 80100, Holguin, Cuba
- Cuban Academy of Sciences, Cuba St Number 460 Between Teniente Rey and Amargura. Habana Vieja, 10100, Havana, Cuba
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Cornejo-Olivas M, Inca-Martinez M, Castilhos RM, Furtado GV, Mattos EP, Bampi GB, Leistner-Segal S, Marca V, Mazzetti P, Saraiva-Pereira ML, Jardim LB. Genetic Analysis of Hereditary Ataxias in Peru Identifies SCA10 Families with Incomplete Penetrance. Cerebellum 2020; 19:208-215. [PMID: 31900855 DOI: 10.1007/s12311-019-01098-2] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Relative frequency of hereditary ataxias remains unknown in many regions of Latin America. We described the relative frequency in spinocerebellar ataxias (SCA) due to (CAG)n and to (ATTCT)n expansions, as well as Friedreich ataxia (FRDA), among cases series of ataxic individuals from Peru. Among ataxic index cases from 104 families (38 of them with and 66 without autosomal dominant pattern of inheritance), we identified 22 SCA10, 8 SCA2, 3 SCA6, 2 SCA3, 2 SCA7, 1 SCA1, and 9 FRDA cases (or families). SCA10 was by far the most frequent one. Findings in SCA10 and FRDA families were of note. Affected genitors were not detected in 7 out of 22 SCA10 nuclear families; then overall maximal penetrance of SCA10 was estimated as 85%; in multiplex families, penetrance was 94%. Two out of nine FRDA cases carried only one allele with a GAA expansion. SCA10 was the most frequent hereditary ataxia in Peru. Our data suggested that ATTCT expansions at ATXN10 might not be fully penetrant and/or instability between generations might frequently cross the limits between non-penetrant and penetrant lengths. A unique distribution of inherited ataxias in Peru requires specific screening panels, considering SCA10 as first line of local diagnosis guidelines.
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Affiliation(s)
- Mario Cornejo-Olivas
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, 1271 Ancash St, Barrios Altos, 15003, Lima, Peru. .,Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Miguel Inca-Martinez
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, 1271 Ancash St, Barrios Altos, 15003, Lima, Peru.,Lerner Research Institute, Genomic Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Raphael Machado Castilhos
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Serviço de Neurologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Gabriel Vasata Furtado
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Laboratório de Identificação Genética, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Eduardo Preusser Mattos
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Laboratório de Identificação Genética, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Giovana Bavia Bampi
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Laboratório de Identificação Genética, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Sandra Leistner-Segal
- Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Victoria Marca
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, 1271 Ancash St, Barrios Altos, 15003, Lima, Peru
| | - Pilar Mazzetti
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, 1271 Ancash St, Barrios Altos, 15003, Lima, Peru
| | - Maria Luiza Saraiva-Pereira
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Laboratório de Identificação Genética, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Instituto de Genética Médica Populacional (INAGEMP), Porto Alegre, Brazil
| | - Laura Bannach Jardim
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Laboratório de Identificação Genética, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Departamento de Medicina Interna, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Instituto de Genética Médica Populacional (INAGEMP), Porto Alegre, Brazil
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