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Hereditary Spastic Paraplegia (hereditary + spastic_paraplegia)
Selected AbstractsHereditary spastic paraplegia or spinocerebellar ataxia?EUROPEAN JOURNAL OF NEUROLOGY, Issue 8 2009Not always as easy as it seems No abstract is available for this article. [source] Botulinum neurotoxin type A injections reduce spasticity in mild to moderate hereditary spastic paraplegia, Report of 19 casesMOVEMENT DISORDERS, Issue 2 2008Martin J. Hecht MD Abstract Hereditary spastic paraplegia (HSP) is characterized by lower extremity spasticity. Symptomatic therapy generally includes physical therapy and oral antispastic agents, in selected cases intrathecal baclofen. Because of the positive results in other treatments of spasticity, the use of botulinum neurotoxin type A (BoNT-A) might also be considered for patients with HSP. We report the effect of BoNT-A injections in 19 unselected patients with HSP treated by the members of the German Spasticity Education Group. In 17 patients, the modified Ashworth scale had improved by one point. In one patient, it improved by three points. Most of the patients reported reduction of spasticity. BoNT-A injections were continued in 11 of 19 patients (57.9%). All of the patients with continued injections had a good or very good global subjective improvement. Patients with less pronounced spasticity and patients with accompanying physical therapy tended to exhibit a better effect. Only four patients reported adverse effects which were increased weakness in three patients and pain in one patient. BoNT-A injections appear to reduce spasticity effectively and safely, especially in patients with mild to moderate spasticity. The preliminary results of our case series should encourage larger studies of BoNT-A injections in HSP. © 2007 Movement Disorder Society [source] Hereditary spastic paraplegia associated with dopa-responsive parkinsonismMOVEMENT DISORDERS, Issue 5 2006Federico Micheli MD Abstract A 47-year-old patient with hereditary spastic paraplegia and parkinsonian features is reported. Treatment with levodopa led to marked improvement in his neurological status and quality of life. However, several years later he developed motor fluctuations and dyskinesias. The latter promptly remitted with amantadine treatment. © 2006 Movement Disorder Society [source] The extent of axonal loss in the long tracts in hereditary spastic paraplegiaNEUROPATHOLOGY & APPLIED NEUROBIOLOGY, Issue 6 2004G. C. DeLuca Hereditary spastic paraplegia (HSP) comprises a group of inherited neurodegenerative disorders with the shared characteristics of progressive weakness and spasticity predominantly affecting the lower limbs. Limited pathological accounts have described a ,dying back' axonal degeneration in this disease. However, the distribution and extent of axonal loss has not been elucidated in a quantitative way. We have studied post-mortem material from six HSP patients and 32 controls in detail. The population of axons was examined quantitatively in the corticospinal tracts from the medulla to the lumbar spinal cord and the sensory tracts from the lumbar to upper cervical spinal cord. Myelin and axon-stained sections were employed to estimate the notional area and axonal density, respectively, of both tracts. Our results indicate that in the corticospinal tracts there is a significant reduction in area and axonal density at all levels investigated in HSP compared to controls. In the corticospinal tracts, the ratio of medulla and lumbar total axonal number was significantly greater in HSP cases compared to controls suggesting more pronounced axonal loss in the distal neuraxis in HSP than in controls. The sensory tracts in HSP, in contrast, showed a significant reduction in area and axonal density only in the upper regions of the spinal cord. Similar to the corticospinal tracts, the ratio of lumbar and upper cervical cord total axonal number in the sensory tracts was increased in HSP cases compared to controls. These findings are consistent with a length-dependent ,dying back' axonopathy. Nerve fibre loss was not size-selective with both small and large diameter fibres affected. In HSP, axonal loss is widespread and symmetrical and its extent tract-specific. The characterization of the nature of axonal loss in HSP, where this is a primary phenomenon, may help the interpretation of axonal loss in conditions such as multiple sclerosis where the sequence of events is less clear. [source] Human spastin has multiple microtubule-related functionsJOURNAL OF NEUROCHEMISTRY, Issue 5 2005Sara Salinas Abstract Hereditary spastic paraplegias (HSPs) are neurodegenerative diseases caused by mutations in more than 20 genes, which lead to progressive spasticity and weakness of the lower limbs. The most frequently mutated gene causing autosomal dominant HSP is SPG4, which encodes spastin, a protein that belongs to the family of ATPases associated with various cellular activities (AAAs). A number of studies have suggested that spastin regulates microtubule dynamics. We have studied the ATPase activity of recombinant human spastin and examined the effect of taxol-stabilized microtubules on this activity. We used spastin translated from the second ATG and provide evidence that this is the physiologically relevant form. We showed that microtubules enhance the ATPase activity of the protein, a property also described for katanin, an AAA of the same spastin subgroup. Furthermore, we demonstrated that human spastin has a microtubule-destabilizing activity and can bundle microtubules in vitro, providing new insights into the molecular pathogenesis of HSP. [source] Genotype,phenotype correlation in some autosomal recessive hereditary spastic paraplegiasJOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 2 2004F Manganelli Hereditary spastic paraplegias (HSPs) are a group of clinically and genetically inherited disorders. Spastic paraparesis (SP), the main clinical feature of all HSPs can occur in relative isolation in the "pure" form or in combination with other neurological deficits in "complicated" forms. Autosomal dominant, autosomal recessive (AR) and X-linked recessive inheritance pattern of HSPs have been reported. At present, among AR-HSPs, three genes, paraplegin (SPG7), spartin (SPG20 , Troyer syndrome) and maspardin (SPG21) have been identified and six genetic loci have been mapped (SPG5, SPG11, SPG14, SPG15, SPG24, SPG25). We have evaluated 11 patients belonging to six AR-HSP families genetically identified as SPG5, SPG7, SPG11 and SPG15. In all patients electromyography, nerve conduction velocity studies, visual (VEPs), somatosensory (SSEPs), brainstem auditory (BAEPs) and magnetic motor (MMEPs) evoked potentials were performed. All 4 SPG5 patients, affected by a pure form of SP, showed abnormalities of both MMEPs and SSEPs, and two of them also VEP alterations. In the two SPG7 patients with complicated SP, MMEP abnormalities only were discovered. Among the three SPG11 patients affected by SP, complicated by mental retardation and thin corpus callosum, electrophysiological studies revealed MMEP abnormalities and signs of motor neuropathy in one of them. Finally, in the SPG15 family, presenting with SP associated with mental retardation and neurosensorial deafness, MMEP and BAEP alterations were found. [source] Long-term course and mutational spectrum of spatacsin -linked spastic paraplegiaANNALS OF NEUROLOGY, Issue 6 2007Ute Hehr MD Objective Hereditary spastic paraplegias (HSPs) comprise a heterogeneous group of neurodegenerative disorders resulting in progressive spasticity of the lower limbs. One form of autosomal recessive hereditary spastic paraplegia (ARHSP) with thin corpus callosum (TCC) was linked to chromosomal region 15q13-21 (SPG11) and associated with mutations in the spatacsin gene. We assessed the long-term course and the mutational spectrum of spatacsin -associated ARHSP with TCC. Methods Neurological examination, cerebral magnetic resonance imaging (MRI), 18fluorodeoxyglucose positron emission tomography (PET), nerve biopsy, linkage and mutation analysis are presented. Results Spastic paraplegia in patients with spatacsin mutations (n = 20) developed during the second decade of life. The Spastic Paraplegia Rating Scale (SPRS) showed severely compromised walking between the second and third decades of life (mean SPRS score, >30). Impaired cognitive function was associated with severe atrophy of the frontoparietal cortex, TCC, and bilateral periventricular white matter lesions. Progressive cortical and thalamic hypometabolism in the 18fluorodeoxyglucose PET was observed. Sural nerve biopsy showed a loss of unmyelinated nerve fibers and accumulation of intraaxonal pleomorphic membranous material. Mutational analysis of spatacsin demonstrated six novel and one previously reported frameshift mutation and two novel nonsense mutations. Furthermore, we report the first two splice mutations to be associated with SPG11. Interpretation We demonstrate that not only frameshift and nonsense mutations but also splice mutations result in SPG11. Mutations are distributed throughout the spatacsin gene and emerge as major cause for ARHSP with TCC associated with severe motor and cognitive impairment. The clinical phenotype and the ultrastructural analysis suggest a disturbed axonal transport of long projecting neurons. Ann Neurol 2007 [source] The role of mitochondria in inherited neurodegenerative diseasesJOURNAL OF NEUROCHEMISTRY, Issue 6 2006Jennifer Q. Kwong Abstract In the past decade, the genetic causes underlying familial forms of many neurodegenerative disorders, such as Huntington's disease, Parkinson's disease, Alzheimer's disease, amyotrophic lateral sclerosis, Friedreich ataxia, hereditary spastic paraplegia, dominant optic atrophy, Charcot-Marie-Tooth type 2A, neuropathy ataxia and retinitis pigmentosa, and Leber's hereditary optic atrophy have been elucidated. However, the common pathogenic mechanisms of neuronal death are still largely unknown. Recently, mitochondrial dysfunction has emerged as a potential ,lowest common denominator' linking these disorders. In this review, we discuss the body of evidence supporting the role of mitochondria in the pathogenesis of hereditary neurodegenerative diseases. We summarize the principal features of genetic diseases caused by abnormalities of mitochondrial proteins encoded by the mitochondrial or the nuclear genomes. We then address genetic diseases where mutant proteins are localized in multiple cell compartments, including mitochondria and where mitochondrial defects are likely to be directly caused by the mutant proteins. Finally, we describe examples of neurodegenerative disorders where mitochondrial dysfunction may be ,secondary' and probably concomitant with degenerative events in other cell organelles, but may still play an important role in the neuronal decay. Understanding the contribution of mitochondrial dysfunction to neurodegeneration and its pathophysiological basis will significantly impact our ability to develop more effective therapies for neurodegenerative diseases. [source] Botulinum neurotoxin type A injections reduce spasticity in mild to moderate hereditary spastic paraplegia, Report of 19 casesMOVEMENT DISORDERS, Issue 2 2008Martin J. Hecht MD Abstract Hereditary spastic paraplegia (HSP) is characterized by lower extremity spasticity. Symptomatic therapy generally includes physical therapy and oral antispastic agents, in selected cases intrathecal baclofen. Because of the positive results in other treatments of spasticity, the use of botulinum neurotoxin type A (BoNT-A) might also be considered for patients with HSP. We report the effect of BoNT-A injections in 19 unselected patients with HSP treated by the members of the German Spasticity Education Group. In 17 patients, the modified Ashworth scale had improved by one point. In one patient, it improved by three points. Most of the patients reported reduction of spasticity. BoNT-A injections were continued in 11 of 19 patients (57.9%). All of the patients with continued injections had a good or very good global subjective improvement. Patients with less pronounced spasticity and patients with accompanying physical therapy tended to exhibit a better effect. Only four patients reported adverse effects which were increased weakness in three patients and pain in one patient. BoNT-A injections appear to reduce spasticity effectively and safely, especially in patients with mild to moderate spasticity. The preliminary results of our case series should encourage larger studies of BoNT-A injections in HSP. © 2007 Movement Disorder Society [source] Hereditary spastic paraplegia associated with dopa-responsive parkinsonismMOVEMENT DISORDERS, Issue 5 2006Federico Micheli MD Abstract A 47-year-old patient with hereditary spastic paraplegia and parkinsonian features is reported. Treatment with levodopa led to marked improvement in his neurological status and quality of life. However, several years later he developed motor fluctuations and dyskinesias. The latter promptly remitted with amantadine treatment. © 2006 Movement Disorder Society [source] The extent of axonal loss in the long tracts in hereditary spastic paraplegiaNEUROPATHOLOGY & APPLIED NEUROBIOLOGY, Issue 6 2004G. C. DeLuca Hereditary spastic paraplegia (HSP) comprises a group of inherited neurodegenerative disorders with the shared characteristics of progressive weakness and spasticity predominantly affecting the lower limbs. Limited pathological accounts have described a ,dying back' axonal degeneration in this disease. However, the distribution and extent of axonal loss has not been elucidated in a quantitative way. We have studied post-mortem material from six HSP patients and 32 controls in detail. The population of axons was examined quantitatively in the corticospinal tracts from the medulla to the lumbar spinal cord and the sensory tracts from the lumbar to upper cervical spinal cord. Myelin and axon-stained sections were employed to estimate the notional area and axonal density, respectively, of both tracts. Our results indicate that in the corticospinal tracts there is a significant reduction in area and axonal density at all levels investigated in HSP compared to controls. In the corticospinal tracts, the ratio of medulla and lumbar total axonal number was significantly greater in HSP cases compared to controls suggesting more pronounced axonal loss in the distal neuraxis in HSP than in controls. The sensory tracts in HSP, in contrast, showed a significant reduction in area and axonal density only in the upper regions of the spinal cord. Similar to the corticospinal tracts, the ratio of lumbar and upper cervical cord total axonal number in the sensory tracts was increased in HSP cases compared to controls. These findings are consistent with a length-dependent ,dying back' axonopathy. Nerve fibre loss was not size-selective with both small and large diameter fibres affected. In HSP, axonal loss is widespread and symmetrical and its extent tract-specific. The characterization of the nature of axonal loss in HSP, where this is a primary phenomenon, may help the interpretation of axonal loss in conditions such as multiple sclerosis where the sequence of events is less clear. [source] Long-term course and mutational spectrum of spatacsin -linked spastic paraplegiaANNALS OF NEUROLOGY, Issue 6 2007Ute Hehr MD Objective Hereditary spastic paraplegias (HSPs) comprise a heterogeneous group of neurodegenerative disorders resulting in progressive spasticity of the lower limbs. One form of autosomal recessive hereditary spastic paraplegia (ARHSP) with thin corpus callosum (TCC) was linked to chromosomal region 15q13-21 (SPG11) and associated with mutations in the spatacsin gene. We assessed the long-term course and the mutational spectrum of spatacsin -associated ARHSP with TCC. Methods Neurological examination, cerebral magnetic resonance imaging (MRI), 18fluorodeoxyglucose positron emission tomography (PET), nerve biopsy, linkage and mutation analysis are presented. Results Spastic paraplegia in patients with spatacsin mutations (n = 20) developed during the second decade of life. The Spastic Paraplegia Rating Scale (SPRS) showed severely compromised walking between the second and third decades of life (mean SPRS score, >30). Impaired cognitive function was associated with severe atrophy of the frontoparietal cortex, TCC, and bilateral periventricular white matter lesions. Progressive cortical and thalamic hypometabolism in the 18fluorodeoxyglucose PET was observed. Sural nerve biopsy showed a loss of unmyelinated nerve fibers and accumulation of intraaxonal pleomorphic membranous material. Mutational analysis of spatacsin demonstrated six novel and one previously reported frameshift mutation and two novel nonsense mutations. Furthermore, we report the first two splice mutations to be associated with SPG11. Interpretation We demonstrate that not only frameshift and nonsense mutations but also splice mutations result in SPG11. Mutations are distributed throughout the spatacsin gene and emerge as major cause for ARHSP with TCC associated with severe motor and cognitive impairment. The clinical phenotype and the ultrastructural analysis suggest a disturbed axonal transport of long projecting neurons. Ann Neurol 2007 [source] Genotype,phenotype correlation in some autosomal recessive hereditary spastic paraplegiasJOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 2 2004F Manganelli Hereditary spastic paraplegias (HSPs) are a group of clinically and genetically inherited disorders. Spastic paraparesis (SP), the main clinical feature of all HSPs can occur in relative isolation in the "pure" form or in combination with other neurological deficits in "complicated" forms. Autosomal dominant, autosomal recessive (AR) and X-linked recessive inheritance pattern of HSPs have been reported. At present, among AR-HSPs, three genes, paraplegin (SPG7), spartin (SPG20 , Troyer syndrome) and maspardin (SPG21) have been identified and six genetic loci have been mapped (SPG5, SPG11, SPG14, SPG15, SPG24, SPG25). We have evaluated 11 patients belonging to six AR-HSP families genetically identified as SPG5, SPG7, SPG11 and SPG15. In all patients electromyography, nerve conduction velocity studies, visual (VEPs), somatosensory (SSEPs), brainstem auditory (BAEPs) and magnetic motor (MMEPs) evoked potentials were performed. All 4 SPG5 patients, affected by a pure form of SP, showed abnormalities of both MMEPs and SSEPs, and two of them also VEP alterations. In the two SPG7 patients with complicated SP, MMEP abnormalities only were discovered. Among the three SPG11 patients affected by SP, complicated by mental retardation and thin corpus callosum, electrophysiological studies revealed MMEP abnormalities and signs of motor neuropathy in one of them. Finally, in the SPG15 family, presenting with SP associated with mental retardation and neurosensorial deafness, MMEP and BAEP alterations were found. [source] Developmental and degenerative features in a complicated spastic paraplegiaANNALS OF NEUROLOGY, Issue 4 2010M. Chiara Manzini PhD Objective We sought to explore the genetic and molecular causes of Troyer syndrome, one of several complicated hereditary spastic paraplegias (HSPs). Troyer syndrome had been thought to be restricted to the Amish; however, we identified 2 Omani families with HSP, short stature, dysarthria and developmental delay,core features of Troyer syndrome,and a novel mutation in the SPG20 gene, which is also mutated in the Amish. In addition, we analyzed SPG20 expression throughout development to infer how disruption of this gene might generate the constellation of developmental and degenerative Troyer syndrome phenotypes. Methods Clinical characterization of 2 non-Amish families with Troyer syndrome was followed by linkage and sequencing analysis. Quantitative polymerase chain reaction and in situ hybridization analysis of SPG20 expression were carried out in embryonic and adult human and mouse tissue. Results Two Omani families carrying a novel SPG20 mutation displayed clinical features remarkably similar to the Amish patients with Troyer syndrome. SPG20 mRNA is expressed broadly but at low relative levels in the adult brain; however, it is robustly and specifically expressed in the limbs, face, and brain during early morphogenesis. Interpretation Null mutations in SPG20 cause Troyer syndrome, a specific clinical entity with developmental and degenerative features. Maximal expression of SPG20 in the limb buds and forebrain during embryogenesis may explain the developmental origin of the skeletal and cognitive defects observed in this disorder. ANN NEUROL 2010;67:516,525 [source] | ||||||||||