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1.
Ann Clin Transl Neurol ; 8(1): 252-258, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33231368

RESUMEN

SUCLA2 is a component of mitochondrial succinate-CoA ligase and nucleotide diphosphokinase activities. Its absence results in Krebs cycle failure, mitochondrial DNA depletion, and a childhood-fatal encephalomyopathy. We describe a purely neurologic allelic form of the disease consisting of deafness, putamenal hyperintensity on MRI and a myoclonic-dystonic movement disorder unchanging from childhood into, so far, the late fourth decade. We show that succinate supplementation circumvents the Krebs cycle block, but does not correct the neurologic disease. Our patients' Arg407Trp mutation has been reported in children with (yet) no MRI abnormalities. It remains possible that early succinate supplementation could impact the disease.


Asunto(s)
Sordera/genética , Trastornos del Movimiento/genética , Succinato-CoA Ligasas/genética , Sordera/tratamiento farmacológico , Femenino , Humanos , Masculino , Trastornos del Movimiento/tratamiento farmacológico , Mutación Missense , Linaje , Ácido Succínico/uso terapéutico
2.
Am J Med Genet A ; 182(9): 2129-2132, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32627382

RESUMEN

YY1 mutations cause Gabriele-de Vries syndrome, a recently described condition involving cognitive impairment, facial dysmorphism and intrauterine growth restriction. Movement disorders were reported in 5/10 cases of the original series, but no detailed description was provided. Here we present a 21-year-old woman with a mild intellectual deficit, facial dysmorphism and a complex movement disorder including an action tremor, cerebellar ataxia, dystonia, and partial ocular apraxia as the presenting and most striking feature. Whole-exome sequencing revealed a novel heterozygous de novo mutation in YY1 [NM: 003403.4 (YY1): c.907 T > C; p.(Cys303Arg)], classified as pathogenic according to the ACMG guidelines.


Asunto(s)
Trastornos del Movimiento/genética , Trastornos del Neurodesarrollo/genética , Factor de Transcripción YY1/genética , Niño , Preescolar , Exoma/genética , Femenino , Predisposición Genética a la Enfermedad , Heterocigoto , Humanos , Lactante , Recién Nacido , Discapacidad Intelectual/genética , Discapacidad Intelectual/patología , Trastornos del Movimiento/patología , Trastornos del Neurodesarrollo/patología , Fenotipo , Secuenciación del Exoma
3.
Lancet Child Adolesc Health ; 3(12): 917-928, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31653548

RESUMEN

The diagnosis and management of movement disorders in children can be improved by understanding the pathways, neurons, ion channels, and receptors involved in motor learning and control. In this Review, we use a localisation approach to examine the anatomy, physiology, and circuitry of the basal ganglia and highlight the mechanisms that underlie some of the major movement disorders in children. We review the connections between the basal ganglia and the thalamus and cortex, address the basic clinical definitions of movement disorders, and then place diseases within an anatomical or physiological framework that highlights basal ganglia function. We discuss how new pharmacological, behavioural, and electrophysiological approaches might benefit children with movement disorders by modifying synaptic function. A better understanding of the mechanisms underlying movement disorders allows improved diagnostic and treatment decisions.


Asunto(s)
Ganglios Basales/fisiología , Corteza Cerebral/fisiología , Dopamina/deficiencia , Trastornos del Movimiento/fisiopatología , Tálamo/fisiología , Adolescente , Ganglios Basales/anatomía & histología , Corteza Cerebral/anatomía & histología , Niño , Terapia Cognitivo-Conductual/métodos , Fenómenos Electrofisiológicos/fisiología , Humanos , Neuronas Motoras/fisiología , Trastornos del Movimiento/líquido cefalorraquídeo , Trastornos del Movimiento/genética , Trastornos del Movimiento/terapia , Sinapsis/fisiología , Tálamo/anatomía & histología , Adulto Joven
4.
J Parkinsons Dis ; 8(1): 17-32, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29480229

RESUMEN

Parkinson's disease (PD) is an adult onset neurodegenerative disease that is characterized by selective degeneration of neurons primarily in the substantia nigra. At present, the pathogenesis of PD is incompletely understood and there are no neuroprotective treatments available. Accurate animal models of PD provide the opportunity to elucidate disease mechanisms and identify therapeutic targets. This review focuses on C. elegans models of PD, including both genetic and toxicant models. This microscopic worm offers several advantages for the study of PD including ease of genetic manipulation, ability to complete experiments rapidly, low cost, and ability to perform large scale screens for disease modifiers. A number of C. elegans models of PD have been generated including transgenic worms that express α-synuclein or LRRK2, and worms with deletions in PRKN/pdr-1, PINK1/pink-1, DJ-1/djr-1.1/djr-1.2 and ATP13A2/catp-6. These worms have been shown to exhibit multiple phenotypic deficits including the loss of dopamine neurons, disruption of dopamine-dependent behaviors, increased sensitivity to stress, age-dependent aggregation, and deficits in movement. As a result, these phenotypes can be used as outcome measures to gain insight into disease pathogenesis and to identify disease modifiers. In this way, C. elegans can be used as an experimental tool to elucidate mechanisms involved in PD and to find novel therapeutic targets that can subsequently be validated in other models.


Asunto(s)
Caenorhabditis elegans , Modelos Animales de Enfermedad , Trastornos Parkinsonianos/genética , Animales , Animales Modificados Genéticamente , Antiparkinsonianos/farmacología , Caenorhabditis elegans/genética , Caenorhabditis elegans/fisiología , Proteínas de Caenorhabditis elegans/genética , Proteínas de Caenorhabditis elegans/fisiología , Neuronas Dopaminérgicas/efectos de los fármacos , Neuronas Dopaminérgicas/patología , Evaluación Preclínica de Medicamentos , Conducta Alimentaria , Interacción Gen-Ambiente , Genes Reporteros , Humanos , Mitocondrias/patología , Trastornos del Movimiento/genética , Degeneración Nerviosa/genética , Neurotoxinas/toxicidad , Fenotipo , Agregación Patológica de Proteínas , Interferencia de ARN , Proteínas Recombinantes de Fusión/genética , Proteínas Recombinantes de Fusión/metabolismo , Especificidad de la Especie , alfa-Sinucleína/química , alfa-Sinucleína/genética
5.
Exp Neurol ; 293: 101-114, 2017 07.
Artículo en Inglés | MEDLINE | ID: mdl-28373024

RESUMEN

Autism spectrum disorder (ASD) is the most common neurodevelopmental disorder with a constantly increasing prevalence. Model organisms may be tools to identify underlying cellular and molecular mechanisms, as well as aid the discovery and development of novel therapeutic approaches. A simple animal such as the nematode Caenorhabditis elegans may provide insights into the extreme complexity of ASD genetics. Despite its potential, using C. elegans in ASD research is a controversial approach and has not yet been used extensively in this context. In this study, we present a screening approach of potential C. elegans mutants as potential ASD models. We screened these mutants for motor-deficiency phenotypes, which can be exploited to study underlying mechanisms of the disorder. Selected motor-deficient mutants were then used in a comprehensive drug screen of over 3900 compounds, including many FDA-approved and natural molecules, that were analyzed for their ability to suppress motility defects caused by ASD-associated gene orthologues. This genetic-chemical approach, i.e. establishing C. elegans models for ASD and screening of a well-characterized compound library, might be a promising first step to understand the mechanisms of how gene variations cause neuronal dysfunction, leading to ASD and other neurological disorders. Positively acting compounds could also be promising candidates for preclinical studies.


Asunto(s)
Trastorno del Espectro Autista/complicaciones , Proteínas de Caenorhabditis elegans/genética , Evaluación Preclínica de Medicamentos/métodos , Pruebas Genéticas/métodos , Trastornos del Movimiento , Animales , Animales Modificados Genéticamente , Trastorno del Espectro Autista/genética , Caenorhabditis elegans , Proteínas de Caenorhabditis elegans/metabolismo , Modelos Animales de Enfermedad , Humanos , Proteínas Luminiscentes/genética , Proteínas Luminiscentes/metabolismo , Trastornos del Movimiento/diagnóstico , Trastornos del Movimiento/tratamiento farmacológico , Trastornos del Movimiento/etiología , Trastornos del Movimiento/genética , Mutación/genética , Fenotipo
6.
Behav Brain Res ; 305: 37-45, 2016 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-26892275

RESUMEN

Motor dysfunction has been found to be predictive of cognitive dysfunction in Alzheimer's disease and to occur earlier than cognitive impairments. While apolipoprotein (Apo) E4 has been associated with cognitive impairments, it remains unclear whether it also increases risk for motor dysfunction. Exercise and antioxidants are often recommended to reduce cognitive declines, however it is unclear whether they can successfully improve motor impairments. This study was designed to determine the extent of the impact of apolipoprotein genotype on motor function, and whether interventions such as exercise and antioxidant intake can improve motor function. This study is the first to identify the nature of the interaction between antioxidant intake and exercise using a mouse model expressing either the human ApoE3 or ApoE4 isoforms under glial fibrillary acid protein promoter (GFAP-ApoE3 and GFAP-ApoE4 mice). The mice were fed either a control diet or the control diet supplemented with vitamins E and C (1.12 IU/g diet α-tocopheryl acetate and 1.65mg/g ascorbic acid). Each genotype/diet group was further divided into a sedentary group or a group that followed a 6 days a week exercise regimen. After 8 weeks on their respective treatment, the mice were administered a battery of motor tests to measure reflexes, strength, coordination and balance. GFAP-ApoE4 mice exhibited impaired motor learning and diminished strength compared to the GFAP-ApoE3 mice. Exercise alone was more efficient at improving motor function and reversing ApoE4-associated impairments than antioxidants alone, even though improvements were rather subtle. Contrarily to expected outcomes, combination of antioxidants and exercise did not yield further improvements of motor function. Interestingly, antioxidants antagonized the beneficial effects of exercise on strength. These data suggest that environmental and genetic factors influence the outcome of interventions on motor function and should be investigated more thoroughly and taken into consideration when implementing changes in lifestyles.


Asunto(s)
Apolipoproteína E4/genética , Proteína Ácida Fibrilar de la Glía/genética , Trastornos del Movimiento/genética , Trastornos del Movimiento/rehabilitación , Análisis de Varianza , Animales , Antioxidantes/farmacología , Antioxidantes/uso terapéutico , Apolipoproteína E4/metabolismo , Peso Corporal/efectos de los fármacos , Peso Corporal/genética , Modelos Animales de Enfermedad , Ingestión de Alimentos/efectos de los fármacos , Ingestión de Alimentos/genética , Terapia por Ejercicio , Proteína Ácida Fibrilar de la Glía/metabolismo , Humanos , Locomoción/efectos de los fármacos , Locomoción/genética , Ratones , Ratones Transgénicos , Trastornos del Movimiento/tratamiento farmacológico , Trastornos del Movimiento/terapia , Músculo Esquelético/efectos de los fármacos , Músculo Esquelético/fisiología , Desempeño Psicomotor/efectos de los fármacos , Tiempo de Reacción/efectos de los fármacos , Tiempo de Reacción/genética , Reflejo/efectos de los fármacos
7.
Pak J Pharm Sci ; 28(6): 2207-11, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26639513

RESUMEN

The creatine biosynthetic pathway is essential for cellular phosphate associated energy production and storage, particularly in tissues having higher metabolic demands. Guanidinoacetate N-Methyl transferase (GAMT) is an important enzyme in creatine endogenous biosynthetic pathway, with highest expression in liver and kidney. GAMT deficiency is an inherited autosomal recessive trait that was the first among creatine deficiency syndrome to be reported in 1994 having characteristic features of no comprehensible speech development, severe mental retardation, muscular hypotonia, involuntary movements and seizures that partly cannot be treated with anti-epileptic drugs. Due to problematic endogenous creatine biosynthesis, systemic depletion of creatine/phosphocreatine and accumulation of guanidinoacetate takes place that are the diagnostic features of this disease. Dietary creatine supplementation alone or along with arginine restriction has been reported to be beneficial for all treated patients, although to various extent. However, none of the GAMT deficient patient has been reported to return to complete normal developmental level.


Asunto(s)
Arginina/administración & dosificación , Creatina/uso terapéutico , Proteínas en la Dieta/administración & dosificación , Suplementos Dietéticos , Metabolismo Energético , Guanidinoacetato N-Metiltransferasa/deficiencia , Trastornos del Desarrollo del Lenguaje/terapia , Trastornos del Movimiento/congénito , Creatina/biosíntesis , Creatina/deficiencia , Predisposición Genética a la Enfermedad , Guanidinoacetato N-Metiltransferasa/genética , Humanos , Trastornos del Desarrollo del Lenguaje/diagnóstico , Trastornos del Desarrollo del Lenguaje/enzimología , Trastornos del Desarrollo del Lenguaje/genética , Trastornos del Movimiento/diagnóstico , Trastornos del Movimiento/enzimología , Trastornos del Movimiento/genética , Trastornos del Movimiento/terapia , Fenotipo , Resultado del Tratamiento
8.
Pediatr Neurol ; 51(1): 133-7, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24766785

RESUMEN

BACKGROUND: Guanidinoacetate methyltransferase deficiency is an autosomal recessively inherited disorder of creatine biosynthesis. We report a new patient with guanidinoacetate methyltransferase deficiency and her >3-year treatment outcome. PATIENT: This is a 6-year-old girl who was diagnosed with guanidinoacetate methyltransferase deficiency at the age of 28 months. She presented with moderate global developmental delay, one afebrile seizure, and hypotonia between 6 and 18 months of life. She was treated with creatine and ornithine supplementation and a strict arginine-restricted diet for 42 months. RESULTS: Mutation analysis (compound heterozygous mutations, a known c.327G>A and a novel c.58dupT [p.Trp20LeufsX65]) and enzyme studies in primary fibroblasts confirmed the diagnosis. After 33 months of therapy, her cerebrospinal fluid guanidinoacetate level decreased from 47 to 5.3 times the normal level. Brain creatine by proton magnetic resonance spectroscopy increased by >75% but did not normalize in the basal ganglia and white matter after 3 years of therapy. Additional treatment with sodium benzoate for 17 months did not further improve plasma guanidinoacetate levels, which questions the relevance of this therapy. CONCLUSION: Treatment did not improve moderate intellectual disability or normalize guanidinoacetate accumulation in the central nervous system.


Asunto(s)
Conservantes de Alimentos/efectos adversos , Guanidinoacetato N-Metiltransferasa/deficiencia , Trastornos del Desarrollo del Lenguaje/tratamiento farmacológico , Trastornos del Movimiento/congénito , Benzoato de Sodio/efectos adversos , Aminoácidos/sangre , Niño , Creatina/administración & dosificación , Suplementos Dietéticos , Femenino , Guanidinoacetato N-Metiltransferasa/líquido cefalorraquídeo , Guanidinoacetato N-Metiltransferasa/genética , Humanos , Trastornos del Desarrollo del Lenguaje/líquido cefalorraquídeo , Trastornos del Desarrollo del Lenguaje/genética , Espectroscopía de Resonancia Magnética , Trastornos del Movimiento/líquido cefalorraquídeo , Trastornos del Movimiento/tratamiento farmacológico , Trastornos del Movimiento/genética , Mutación/genética , Ornitina/administración & dosificación , Protones , Pruebas Psicológicas , Insuficiencia del Tratamiento , Resultado del Tratamiento
9.
Nat Genet ; 46(2): 188-93, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24336167

RESUMEN

Mitochondrial Ca(2+) uptake has key roles in cell life and death. Physiological Ca(2+) signaling regulates aerobic metabolism, whereas pathological Ca(2+) overload triggers cell death. Mitochondrial Ca(2+) uptake is mediated by the Ca(2+) uniporter complex in the inner mitochondrial membrane, which comprises MCU, a Ca(2+)-selective ion channel, and its regulator, MICU1. Here we report mutations of MICU1 in individuals with a disease phenotype characterized by proximal myopathy, learning difficulties and a progressive extrapyramidal movement disorder. In fibroblasts from subjects with MICU1 mutations, agonist-induced mitochondrial Ca(2+) uptake at low cytosolic Ca(2+) concentrations was increased, and cytosolic Ca(2+) signals were reduced. Although resting mitochondrial membrane potential was unchanged in MICU1-deficient cells, the mitochondrial network was severely fragmented. Whereas the pathophysiology of muscular dystrophy and the core myopathies involves abnormal mitochondrial Ca(2+) handling, the phenotype associated with MICU1 deficiency is caused by a primary defect in mitochondrial Ca(2+) signaling, demonstrating the crucial role of mitochondrial Ca(2+) uptake in humans.


Asunto(s)
Señalización del Calcio/genética , Proteínas de Unión al Calcio/genética , Proteínas de Transporte de Catión/genética , Discapacidades para el Aprendizaje/genética , Mitocondrias/metabolismo , Proteínas de Transporte de Membrana Mitocondrial/genética , Trastornos del Movimiento/genética , Enfermedades Musculares/genética , Fenotipo , Análisis de Varianza , Secuencia de Bases , Canales de Calcio/metabolismo , Señalización del Calcio/fisiología , Proteínas de Unión al Calcio/metabolismo , Proteínas de Transporte de Catión/metabolismo , ADN Complementario/genética , Exoma/genética , Tractos Extrapiramidales/patología , Técnica del Anticuerpo Fluorescente , Técnicas Histológicas , Humanos , Inmunohistoquímica , Potencial de la Membrana Mitocondrial/genética , Proteínas de Transporte de Membrana Mitocondrial/metabolismo , Datos de Secuencia Molecular , Linaje , Polimorfismo de Nucleótido Simple/genética , Músculo Cuádriceps/patología , Reacción en Cadena en Tiempo Real de la Polimerasa , Análisis de Secuencia de ADN
10.
Curr Opin Neurol ; 26(4): 435-41, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23787769

RESUMEN

PURPOSE OF REVIEW: Recent advances in genetics, diagnosis, and management of disorders associated with brain manganese, copper, and iron brain accumulation are reviewed. RECENT FINDINGS: A genetic disorder leading to manganese accumulation in children and young adults has recently been identified and may be treated successfully with chelation. Neurodegeneration of the basal ganglia in chronic acquired hepatocerebral syndrome and ephedrone toxicity has been linked with acquired manganism. New mutations in genes linked with accumulation of iron and copper in the brain have also been identified. SUMMARY: Recent genetic findings have shed light on the role of iron, manganese, and copper in neurodegenerative disease. MRI is a helpful diagnostic tool in the investigation of basal ganglia disease when iron accumulation is suspected. Chelation therapy is effective for Wilson's disease and hereditary hypermanganesemia, but there is no proven effective treatment for toxic manganese exposure.


Asunto(s)
Metales/metabolismo , Trastornos del Movimiento/metabolismo , Enfermedades Neurodegenerativas/metabolismo , Encéfalo/metabolismo , Encéfalo/patología , Terapia por Quelación/métodos , Humanos , Imagen por Resonancia Magnética , Trastornos del Movimiento/tratamiento farmacológico , Trastornos del Movimiento/genética , Enfermedades Neurodegenerativas/tratamiento farmacológico , Enfermedades Neurodegenerativas/genética
11.
Brain Behav Immun ; 32: 164-72, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23624295

RESUMEN

Toll-like receptors (TLRs) mediate the induction of the innate immune system in response to pathogens, injury and disease. However, they also play non-immune roles and are expressed in the central nervous system (CNS) during prenatal and postnatal stages including adulthood. Little is known about their roles in the CNS in the absence of pathology. Several members of the TLR family have been implicated in the development of neural and cognitive function although the contribution of TLR9 to these processes has not been well defined. The current studies were undertaken to determine whether developmental TLR9 deficiency affects motor, sensory or cognitive functions. We report that TLR9 deficient (TLR9(-/-)) mice show a hyper-responsive sensory and motor phenotype compared to wild type (TLR9(+/+)) controls. This is indicated by hypersensitivity to thermal stimuli in the hot plate paw withdrawal test, enhanced motor-responsivity under anxious conditions in the open field test and greater sensorimotor reactivity in the acoustic startle response. Prepulse inhibition (PPI) of the acoustic startle response was also enhanced, which indicates abnormal sensorimotor gating. In addition, subtle, but significant, gait abnormalities were noted in the TLR9(-/-) mice on the horizontal balance beam test with higher foot slip numbers than TLR9(+/+) controls. In contrast, spatial learning and memory, assessed by the Morris water maze, was similar in the TLR9(-/-) and TLR9(+/+) mice. These findings support the notion that TLR9 is important for the appropriate development of sensory and motor behaviors.


Asunto(s)
Conducta Animal/fisiología , Actividad Motora/genética , Actividad Motora/fisiología , Sensación/genética , Sensación/fisiología , Receptor Toll-Like 9/deficiencia , Receptor Toll-Like 9/fisiología , Estimulación Acústica , Animales , Ansiedad/genética , Ansiedad/psicología , Femenino , Habituación Psicofisiológica/genética , Habituación Psicofisiológica/fisiología , Fuerza de la Mano/fisiología , Hipocampo/fisiología , Masculino , Aprendizaje por Laberinto/fisiología , Memoria/fisiología , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Trastornos del Movimiento/genética , Trastornos del Movimiento/psicología , Dolor/genética , Dolor/psicología , Fenotipo , Equilibrio Postural/genética , Equilibrio Postural/fisiología , Reflejo de Sobresalto/genética , Reflejo de Sobresalto/fisiología , Receptor Toll-Like 9/genética
12.
Neurobiol Aging ; 34(10): 2322-30, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23601674

RESUMEN

More than 130 different mutations in the Cu/Zn superoxide dismutase (SOD1) gene have been associated with amyotrophic lateral sclerosis but the mechanism of this toxicity remains controversial. To gain insight into the importance of the zinc site in the pathogenesis of SOD1 in vivo, we generated a Drosophila model with transgenic expression of a zinc-deficient human SOD1. Expression of zinc-deficient SOD1 in Drosophila resulted in a progressive movement defect with associated mitochondrial cristae vacuolization and reductions in adenosine triphosphate (ATP) levels. Furthermore, these flies are sensitized to mitochondrial toxins, paraquat, and zinc. Importantly, we show that the zinc-deficient SOD1-induced motor defect can be ameliorated by supplementing the endogenous fly respiratory chain machinery with the single-subunit NADH-ubiquinone oxidoreductase from yeast (NADH is nicotinamide adenine dinucleotide, reduced form.). These results demonstrate that zinc-deficient SOD1 is neurotoxic in vivo and suggest that mitochondrial dysfunction plays a critical role in this toxicity. The robust behavioral, pathological, and biochemical phenotypes conferred by zinc-deficient SOD1 in Drosophila have general implications for the role of the zinc ion in familial and sporadic amyotrophic lateral sclerosis.


Asunto(s)
Esclerosis Amiotrófica Lateral/genética , Mitocondrias/patología , Enfermedades Mitocondriales/genética , Actividad Motora/genética , Superóxido Dismutasa/genética , Zinc/deficiencia , Zinc/fisiología , Adenosina Trifosfato/deficiencia , Animales , Modelos Animales de Enfermedad , Progresión de la Enfermedad , Drosophila , Femenino , Expresión Génica , Masculino , Mitocondrias/genética , Mitocondrias/metabolismo , Mitocondrias/ultraestructura , Enfermedades Mitocondriales/patología , Trastornos del Movimiento/genética , Mutación , Superóxido Dismutasa/toxicidad , Vacuolas/patología
13.
Rev. neurol. (Ed. impr.) ; 54(supl.5): s1-s8, 3 oct., 2012. tab, ilus
Artículo en Español | IBECS | ID: ibc-150359

RESUMEN

Introducción. Desde su aparición en la década de los noventa, la estimulación cerebral profunda se ha impuesto como una alternativa terapéutica segura y eficaz en la enfermedad de Parkinson, estando indicada cuando aparecen complicaciones motoras incontrolables con el tratamiento farmacológico. Objetivo. Realizar una revisión actualizada de la literatura médica sobre los aspectos más importantes de esta cirugía funcional. Desarrollo. Aunque su mecanismo de acción a día de hoy continúa siendo desconocido, se ha postulado que ejerce una acción inhibitoria sobre la actividad de los núcleos subtalámico y globo pálido interno, que se encuentra exaltada en enfermos parkinsonianos. La técnica quirúrgica de elección es la estimulación del núcleo subtalámico. Ha demostrado tener unos resultados favorables tanto desde el punto de vista motor, con una mejoría significativa de los síntomas cardinales de la enfermedad, como en la calidad de vida de estos pacientes. El éxito de la cirugía depende de tres pasos fundamentales: 1) La adecuada selección del candidato quirúrgico, teniendo en cuenta las recomendaciones de los principales grupos de estudio sobre factores pronóstico como son la edad, el tiempo de evolución y la presencia de síntomas resistentes a la levodopa. 2) La correcta posición del electrodo en la diana quirúrgica. 3) La programación del sistema de estimulación. Conclusión. La estimulación cerebral profunda del núcleo subtalámico es una opción terapéutica claramente establecida en la enfermedad de Parkinson avanzada, cuyo desarrollo en los últimos años, ha favorecido la obtención de unos resultados clínicos favorables cuando el tratamiento farmacológico fracasa (AU)


Introduction. Since its appearance in the nineties, deep brain stimulation has proved itself to be a safe, effective therapeutic alternative in Parkinson's disease, and is indicated when there are motor complications that pharmacological treatment fails to control. Aims. The purpose of this work is to conduct an updated review of the medical literature on the most important aspects of this functional surgery. Development. Although today its mechanism of action remains unknown, it has been suggested that it exerts an inhibitory action on the activity of the subthalamic nuclei and internal globus pallidus, which is found to be overexcited in patients with parkinsonism. The preferred surgical technique is subthalamic nucleus stimulation. This procedure has proved to yield favourable results both from the motor point of view, with a significant improvement in the cardinal symptoms of the disease, and as regards these patients’ quality of life. The success of the surgical procedure depends on three fundamental steps: 1) Selection of a suitable candidate for surgery, taking into account the recommendations of the main study groups on prognostic factors, such as age, time to progression and the presence of symptoms that are resistant to levodopa; 2) The correct position of the electrode on the surgical target; 3) The programming of the stimulation system. Conclusions. Deep brain stimulation of the subthalamic nucleus is a clearly established therapeutic option in advanced Parkinson's disease. Recent developments allow favourable clinical outcomes to be obtained when pharmacological treatment fails (AU)


Asunto(s)
Humanos , Masculino , Femenino , Enfermedad de Parkinson/genética , Estimulación Encefálica Profunda/métodos , Preparaciones Farmacéuticas/administración & dosificación , Terapéutica/métodos , Levodopa/administración & dosificación , Neurología/educación , Trastornos del Movimiento/genética , Trastornos de Deglución/diagnóstico , Anestesia Local/métodos , Electrodos/clasificación , Enfermedad de Parkinson/terapia , Estimulación Encefálica Profunda/instrumentación , Preparaciones Farmacéuticas/metabolismo , Terapéutica/clasificación , Levodopa , Neurología/métodos , Trastornos del Movimiento/patología , Trastornos de Deglución/complicaciones , Anestesia Local/clasificación , Electrodos
14.
Biol Psychiatry ; 72(8): 700-6, 2012 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-22695185

RESUMEN

BACKGROUND: Tardive dyskinesia (TD) has no well-accepted treatments or known pathophysiology, but low brain-derived neurotrophic factor (BDNF) may play an important role in its pathophysiology. Ginkgo biloba (EGb-761) is a potent antioxidant that has neuroprotective effects mediated through enhancing BDNF levels. We hypothesized that treatment with EGb-761 would increase serum BDNF levels and reduce TD, particularly among schizophrenia patients who have the BDNF valine 66 to methionine (Val66Met) genotype (Val/Val). METHODS: Serum BDNF levels and genotyping for the BDNF gene Val66Met polymorphism were assessed in Chinese schizophrenic patients with (n = 368) and without (n = 563) TD as well as healthy control subjects (n = 546). About half of the TD patients (n = 157) then participated in a double-blind, randomized, placebo-control 12-week treatment with 240 mg per day of EGb-761. Serum BDNF levels were measured again at posttreatment. Clinical efficacy was determined using the Abnormal Involuntary Movement Scale (AIMS). RESULTS: TD patients had lower BDNF levels than the non-TD patients and healthy controls. EGb-761 treatment improved symptoms of TD and increased BDNF levels compared with placebo treatment. Moreover, the improvement of AIMS total score correlated with the increase in BDNF levels. Furthermore, improvement in the AIMS score was greatest in those with the Val/Val allele and lowest with the Met/Met allele. CONCLUSIONS: The BDNF system may be implicated in the pathophysiology of TD and its improvement with antioxidant treatment. Furthermore, patients with the genetic potential for greater BDNF release (Val/Val at 66) may obtain a greater reduction in TD from EGb-761 treatment.


Asunto(s)
Factor Neurotrófico Derivado del Encéfalo/sangre , Factor Neurotrófico Derivado del Encéfalo/genética , Metionina/genética , Trastornos del Movimiento/tratamiento farmacológico , Trastornos del Movimiento/genética , Extractos Vegetales/uso terapéutico , Polimorfismo Genético/genética , Valina/genética , Adulto , Análisis de Varianza , Antipsicóticos/efectos adversos , China , Femenino , Genotipo , Ginkgo biloba , Humanos , Masculino , Persona de Mediana Edad , Trastornos del Movimiento/sangre , Trastornos del Movimiento/etiología , Farmacogenética , Valor Predictivo de las Pruebas , Análisis de Regresión , Esquizofrenia/tratamiento farmacológico , Índice de Severidad de la Enfermedad , Resultado del Tratamiento
15.
Brain Res ; 1448: 144-52, 2012 Apr 11.
Artículo en Inglés | MEDLINE | ID: mdl-22370144

RESUMEN

Severe disruption of brain iron homeostasis can cause fatal neurodegenerative disease, however debate surrounds the neurologic effects of milder, more common iron loading disorders such as hereditary hemochromatosis, which is usually caused by loss-of-function polymorphisms in the HFE gene. There is evidence from both human and animal studies that HFE gene variants may affect brain function and modify risks of brain disease. To investigate how disruption of HFE influences brain transcript levels, we used microarray and real-time reverse transcription polymerase chain reaction to assess the brain transcriptome in Hfe(-/-) mice relative to wildtype AKR controls (age 10 weeks, n≥4/group). The Hfe(-/-) mouse brain showed numerous significant changes in transcript levels (p<0.05) although few of these related to proteins directly involved in iron homeostasis. There were robust changes of at least 2-fold in levels of transcripts for prominent genes relating to transcriptional regulation (FBJ osteosarcoma oncogene Fos, early growth response genes), neurotransmission (glutamate NMDA receptor Grin1, GABA receptor Gabbr1) and synaptic plasticity and memory (calcium/calmodulin-dependent protein kinase IIα Camk2a). As previously reported for dietary iron-supplemented mice, there were altered levels of transcripts for genes linked to neuronal ceroid lipofuscinosis, a disease characterized by excessive lipofuscin deposition. Labile iron is known to enhance lipofuscin generation which may accelerate brain aging. The findings provide evidence that iron loading disorders can considerably perturb levels of transcripts for genes essential for normal brain function and may help explain some of the neurologic signs and symptoms reported in hemochromatosis patients.


Asunto(s)
Química Encefálica/genética , Antígenos de Histocompatibilidad Clase I/fisiología , Sobrecarga de Hierro/genética , Proteínas de la Membrana/fisiología , Transcriptoma/genética , Animales , Suplementos Dietéticos , Hemocromatosis/genética , Proteína de la Hemocromatosis , Antígenos de Histocompatibilidad Clase I/genética , Hierro/metabolismo , Hierro de la Dieta/farmacología , Hígado/metabolismo , Masculino , Proteínas de la Membrana/genética , Memoria/fisiología , Ratones , Ratones Noqueados , Análisis por Micromatrices , Trastornos del Movimiento/genética , Plasticidad Neuronal/genética , Proteínas de Hierro no Heme/sangre , ARN/genética , ARN/aislamiento & purificación , Reacción en Cadena en Tiempo Real de la Polimerasa , Elementos Reguladores de la Transcripción/genética , Transmisión Sináptica/genética
16.
Pediatr Neurol ; 42(3): 163-71, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20159424

RESUMEN

Creatine deficiency syndromes, which have only recently been described, represent a group of inborn errors of creatine synthesis (L-arginine-glycine amidinotransferase deficiency and guanidinoacetate methyltransferase deficiency) and transport (creatine transporter deficiency). Patients with creatine deficiency syndromes present with mental retardation expressive speech and language delay, and epilepsy. Patients with guanidinoacetate methyltransferase deficiency or creatine transporter deficiency may exhibit autistic behavior. The common denominator of these disorders is the depletion of the brain creatine pool, as demonstrated by in vivo proton magnetic resonance spectroscopy. For diagnosis, laboratory investigations start with analysis of guanidinoacetate, creatine, and creatinine in plasma and urine. Based on these findings, enzyme assays or DNA mutation analysis may be performed. The creatine deficiency syndromes are underdiagnosed, so the possibility should be considered in all children affected by unexplained mental retardation, seizures, and speech delay. Guanidinoacetate methyltransferase deficiency and arginine-glycine amidinotransferase deficiency are treatable by oral creatine supplementation, but patients with creatine transporter deficiency do not respond to this type of treatment.


Asunto(s)
Errores Innatos del Metabolismo de los Aminoácidos/diagnóstico , Creatina/deficiencia , Proteínas de Transporte de Membrana/genética , Amidinotransferasas/deficiencia , Trastorno Autístico/genética , Niño , Creatina/sangre , Creatina/orina , Epilepsia/genética , Guanidinoacetato N-Metiltransferasa/genética , Guanidinoacetato N-Metiltransferasa/metabolismo , Humanos , Discapacidad Intelectual/genética , Trastornos del Movimiento/genética , Mutación Puntual/genética
17.
J Neurochem ; 106(5): 1991-7, 2008 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-18466340

RESUMEN

The zebrafish, long recognized as a model organism for the analysis of basic developmental processes, is now also emerging as an alternative animal model for human diseases. This review will first provide an overview of the particular characteristics of zebrafish in general and their dopaminergic nervous system in particular. We will then summarize all work undertaken so far to establish zebrafish as a new animal model for movement disorders and will finally emphasize its particular strength - amenability to high throughput in vivo drug screening.


Asunto(s)
Antiparkinsonianos/farmacología , Modelos Animales de Enfermedad , Enfermedad de Huntington/genética , Trastornos del Movimiento/genética , Enfermedad de Parkinson/genética , Pez Cebra/genética , Animales , Evaluación Preclínica de Medicamentos , Predisposición Genética a la Enfermedad/genética , Enfermedad de Huntington/tratamiento farmacológico , Enfermedad de Huntington/fisiopatología , Trastornos del Movimiento/tratamiento farmacológico , Trastornos del Movimiento/fisiopatología , Mutación/genética , Enfermedad de Parkinson/tratamiento farmacológico , Enfermedad de Parkinson/fisiopatología , Pez Cebra/metabolismo
18.
Exp Neurol ; 212(1): 29-43, 2008 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-18455159

RESUMEN

Spinal muscular atrophy (SMA) is characterized by selective loss of alpha-motor neurons and is caused by homozygous loss or mutation in the survival motor neuron (SMN1) gene. Loss of SMN1 is partially compensated by the copy gene, SMN2. Currently, there are no specific treatments for SMA. Key features of SMA are modeled in mice by deletion of murine Smn, and insertion of both full length human SMN2 gene and the major aberrant splice isoform of the SMN2 gene (SMNDelta7; [Le, T.T., Pham, L.T., Butchbach, M.E., Zhang, H.L., Monani, U.R., Coovert, D.D., Gavrilina, T.O., Xing, L., Bassell, G.J., and Burghes, A.H. 2005. SMNDelta7, the major product of the centromeric survival motor neuron (SMN2) gene, extends survival in mice with spinal muscular atrophy and associates with full-length SMN. Hum Mol Genet 14: 845-857]). The present study identified moderate-throughput, quantitative behavioral tests in neonatal SMN2(+/+);SMNDelta7(+/+);Smn(-/-) mice. It also addresses methodological approaches and common interpretational challenges in a neonatal model with motor deficiencies and frequent deaths. Animals were assessed daily for body weight and survival, and every other day for neonatal well-being indices and tests of motor function such as performance on the hind-limb suspension test (a.k.a. tube test) and geotaxis. The tube test is a novel non-invasive motor function test specifically designed for neonatal rodents. We found progressive deterioration in SMA model mice for most measures studied particularly body weight, survival, body temperature and motor function with differences appearing as early as P3. Power analysis showed that body weight, survival, righting reflex, geotaxis and tube test had highest predictive power for drug efficacy studies. This multi-functional component battery of tests provides a rapid and efficient means to identify, evaluate and develop candidate therapies as a prelude to human clinical trials.


Asunto(s)
Evaluación Preclínica de Medicamentos/métodos , Atrofias Musculares Espinales de la Infancia/tratamiento farmacológico , Animales , Animales Recién Nacidos , Peso Corporal/efectos de los fármacos , Peso Corporal/genética , Proteína de Unión a Elemento de Respuesta al AMP Cíclico/genética , Modelos Animales de Enfermedad , Femenino , Humanos , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Ratones Transgénicos , Trastornos del Movimiento/diagnóstico , Trastornos del Movimiento/tratamiento farmacológico , Trastornos del Movimiento/genética , Proteínas del Tejido Nervioso/genética , Fenotipo , Valor Predictivo de las Pruebas , Proteínas de Unión al ARN/genética , Proyectos de Investigación , Proteínas del Complejo SMN , Atrofias Musculares Espinales de la Infancia/genética , Tasa de Supervivencia , Proteína 1 para la Supervivencia de la Neurona Motora , Proteína 2 para la Supervivencia de la Neurona Motora , Resultado del Tratamiento
19.
Synapse ; 58(2): 95-101, 2005 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-16088950

RESUMEN

In 1989, we described a new autosomic-recessive myelin-mutant rat that develops a progressive motor syndrome characterized by tremor, ataxia, immobility episodes (IEs), epilepsy, and paralysis. taiep is the acronym of these symptoms. The rat developed a hypomyelination, followed by demyelination. At an age of 7-8 months, taiep rats developed IEs, characterized electroencephalographically by REM sleep-like cortical activity. In our study, we analyzed the ontogeny of gripping-induced IEs between 5 and 18 months, their dependence to light-dark changes, sexual dimorphism, and susceptibility to mild stress. Our results showed that IEs start at an age of 6.5 months, with a peak frequency between 8.5 and 9.5 months. IEs have two peaks, one in the morning (0800-1000 h) and a second peak in the middle of the night (2300-0100 h). Spontaneous IEs showed an even distribution with a mean of 3 IEs every 2 h. IEs are sexually dimorphic being more common in male rats. The IEs can be induced by gripping the rat by the tail or the thorax, but most of the IEs were produced by gripping the tail. Mild stress produced by i.p. injection of physiological saline significantly decreased IEs. These results suggested that IEs are dependent on several biological variables, which are caused by hypomyelination, followed by demyelization, which causes alterations in the brainstem and hypothalamic mechanisms responsible for the sleep-wake cycle regulation, producing emergence of REM sleep-like behavior during awake periods.


Asunto(s)
Enfermedades Desmielinizantes del Sistema Nervioso Central Hereditarias/fisiopatología , Trastornos del Movimiento/fisiopatología , Trastornos del Sueño-Vigilia/fisiopatología , Factores de Edad , Animales , Tronco Encefálico/patología , Tronco Encefálico/fisiopatología , Cataplejía/genética , Cataplejía/patología , Cataplejía/fisiopatología , Corteza Cerebral/fisiopatología , Trastornos de la Conciencia/genética , Trastornos de la Conciencia/patología , Trastornos de la Conciencia/fisiopatología , Epilepsia/genética , Epilepsia/patología , Epilepsia/fisiopatología , Femenino , Predisposición Genética a la Enfermedad/genética , Enfermedades Desmielinizantes del Sistema Nervioso Central Hereditarias/genética , Enfermedades Desmielinizantes del Sistema Nervioso Central Hereditarias/patología , Hipotálamo/patología , Hipotálamo/fisiopatología , Masculino , Trastornos del Movimiento/genética , Trastornos del Movimiento/patología , Narcolepsia/genética , Narcolepsia/patología , Narcolepsia/fisiopatología , Ratas , Ratas Mutantes , Caracteres Sexuales , Parálisis del Sueño/genética , Parálisis del Sueño/patología , Parálisis del Sueño/fisiopatología , Trastornos del Sueño-Vigilia/genética , Trastornos del Sueño-Vigilia/patología , Estrés Psicológico/genética , Estrés Psicológico/patología , Estrés Psicológico/fisiopatología , Temblor/genética , Temblor/patología , Temblor/fisiopatología
20.
Neuroscience ; 127(3): 785-96, 2004.
Artículo en Inglés | MEDLINE | ID: mdl-15283975

RESUMEN

In stargazer mutant mice, a mutation in the gene encoding stargazin results in absence epilepsy, cerebellar ataxia, and a characteristic abnormal motor syndrome. The main goal of the current studies was to characterize the nature and source of the abnormal motor behavior. Because the stargazer motor syndrome resembles that of other rodents with vestibular dysfunction, the motor abnormalities were compared with those of normal mice treated with toxins known to damage the vestibular system. Quantitative open field assessments revealed that the stargazer mice display a motor syndrome very similar to that exhibited by mice with toxin-induced vestibulopathy. However, stargazer mice also displayed several additional behaviors, such as ataxic gait and sustained extensor movements of the neck. In addition, stargazer mice performed worse than mice with toxin-induced vestibulopathy in most standard tests of motor function. Motor function was also impaired on each of four behavioral tests sensitive to vestibular function. Because of the close associations between the vestibular and auditory systems, tests of auditory function were also employed. The stargazer mutants exhibited relatively normal auditory brainstem evoked responses but no apparent acoustic startle reflex. Histological examination of vestibular sensory epithelium at the light and electron microscopic levels confirmed the existence of abnormalities in the stargazer mutants. These results imply a previously unrecognized role for stargazin in the normal functions of the vestibular system and indicate that some, but not all, of the abnormal motor syndrome of stargazer mice can be attributed to vestibular dysfunction.


Asunto(s)
Canales de Calcio/genética , Trastornos del Movimiento/fisiopatología , Vestíbulo del Laberinto/fisiopatología , Estimulación Acústica , Animales , Discinesias/genética , Discinesias/patología , Discinesias/fisiopatología , Electroencefalografía , Ratones , Ratones Endogámicos C57BL , Ratones Mutantes Neurológicos , Actividad Motora , Trastornos del Movimiento/genética , Trastornos del Movimiento/patología , Reflejo de Sobresalto , Vestíbulo del Laberinto/patología
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