GhKNL1 controls fiber elongation and secondary cell wall synthesis by repressing its downstream genes in cotton (Gossypium hirsutum).

Cotton which produces natural fiber materials for the textile industry is one of the most important crops in the world. Class II KNOX proteins are often considered as transcription factors in regulating plant secondary cell wall (SCW) formation. However, the molecular mechanism of the KNOX transcription factor-regulated SCW synthesis in plants (especially in cotton) remains unclear in details so far. In this study, we show a cotton class II KNOX protein (GhKNL1) as a transcription repressor functioning in fiber development. The GhKNL1-silenced transgenic cotton produced longer fibers with thicker SCWs, whereas GhKNL1 dominant repression transgenic lines displayed the opposite fiber phenotype, compared with controls. Further experiments revealed that GhKNL1 could directly bind to promoters of GhCesA4-2/4-4/8-2 and GhMYB46 for modulating cellulose synthesis during fiber SCW development in cotton. On the other hand, GhKNL1 could also suppress expressions of GhEXPA2D/4A-1/4D-1/13A through binding to their promoters for regulating fiber elongation of cotton. Taken together, these data revealed GhKNL1 functions in fiber elongation and SCW formation by directly repressing expressions of its target genes related to cell elongation and cellulose synthesis. Thus, our data provide an effective clue for potentially improving fiber quality by genetic manipulation of GhKNL1 in cotton breeding.

Expansion of GGC repeat in the human-specific NOTCH2NLC gene is associated with essential tremor.

Essential tremor is one of the most common movement disorders. Despite its high prevalence and heritability, the genetic aetiology of essential tremor remains elusive. Up to now, only a few genes/loci have been identified, but these genes have not been replicated in other essential tremor families or cohorts. Here we report a genetic study in a cohort of 197 Chinese pedigrees clinically diagnosed with essential tremor. Using a comprehensive strategy combining linkage analysis, whole-exome sequencing, long-read whole-genome sequencing, repeat-primed polymerase chain reaction and GC-rich polymerase chain reaction, we identified an abnormal GGC repeat expansion in the 5' region of the NOTCH2NLC gene that co-segregated with disease in 11 essential tremor families (5.58%) from our cohort. Clinically, probands that had an abnormal GGC repeat expansion were found to have more severe tremor phenotypes, lower activities of daily living ability. Obvious genetic anticipation was also detected in these 11 essential tremor-positive families. These results indicate that abnormal GGC repeat expansion in the 5' region of NOTCH2NLC gene is associated with essential tremor, and provide strong evidence that essential tremor is a family of diseases with high clinical and genetic heterogeneities.

Drinking water temperature affects cognitive function and progression of Alzheimer's disease in a mouse model.

Lifestyle factors may affect mental health and play a critical role in the development of neurodegenerative diseases including Alzheimer's disease (AD). However, whether the temperatures of daily beverages have any impact on cognitive function and AD development has never been studied. In this study, we investigated the effects of daily drinking water temperatures on cognitive function and AD development and progression in mice and the underlying mechanisms. Cognitive function of mice was assessed using passive avoidance test, open field test, and Morris water maze. Wild-type Kunming mice receiving intragastric water (IW, 10 mL/kg, 2 times/day) at 0 °C for consecutive 15 days displayed significant cognitive defects accompanied by significant decrease in gain of body weight, gastric emptying rate, pepsin activity, and an increase in the energy charge in the cortex when compared with mice receiving the same amount of IW at 25 °C (a temperature mimicking most common drinking habits in human), suggesting the altered neuroenergetics may cause cognitive decline. Similarly, in the transgenic APPwse/PS1De9 familial AD mice and their age- and gender-matched wild-type C57BL/6 mice, receiving IW at 0 °C, but not at 25 °C, for 35 days caused a significant time-dependent decrease in body weight and cognitive function, accompanied by a decreased expression of PI3K, Akt, the glutamate/GABA ratio, as well as neuropathy with significant amyloid lesion in the cortex and hippocampus. All of these changes were significantly aggravated in the APPwse/PS1De9 mice than in the control C57BL/6 mice. These data demonstrate that daily beverage at 0 °C may alter brain insulin-mediated neuroenergetics, glutamate/GABA ratio, cause cognitive decline and neuropathy, and promote AD progression.

The cotton ß-galactosyltransferase 1 (GalT1) that galactosylates arabinogalactan proteins participates in controlling fiber development.

Arabinogalactan proteins (AGPs) are highly glycosylated proteins that play pivotal roles in diverse developmental processes in plants. Type-II AG glycans, mostly O-linked to the hydroxyproline residues of the protein backbone, account for up to 95% w/w of the AGP, but their functions are still largely unclear. Cotton fibers are extremely elongated single-cell trichomes on the seed epidermis; however, little is known of the molecular basis governing the regulation of fiber cell development. Here, we characterized the role of a CAZy glycosyltransferase 31 (GT31) family member, GhGalT1, in cotton fiber development. The fiber length of the transgenic cotton overexpressing GhGalT1 was shorter than that of the wild type, whereas in the GhGalT1-silenced lines there was a notable increase in fiber length compared with wild type. The carbohydrate moieties of AGPs were altered in fibers of GhGalT1 transgenic cotton. The galactose: arabinose ratio of AG glycans was higher in GhGalT1 overexpression fibers, but was lower in GhGalT1-silenced lines, compared with that in the wild type. Overexpression of GhGalT1 upregulates transcript levels of a broad range of cell wall-related genes, especially the fasciclin-like AGP (FLA) backbone genes. An enzyme activity assay demonstrated that GhGalT1 is a ß-1,3-galactosyltransferase (ß-1,3-GalT) involved in biosynthesis of the ß-1,3-galactan backbone of the type-II AG glycans of AGPs. We also show that GhGalT1 can form homo- and heterodimers with other cotton GT31 family members to facilitate AG glycan assembly of AGPs. Thus, our data demonstrate that GhGalT1 influences cotton fiber development via controlling the glycosylation of AGPs, especially FLAs.

Idiopathic hypertrophic spinal pachymeningitis: a case report and review of literature.

PURPOSE: To report an unusual case of idiopathic hypertrophic spinal pachymeningitis (IHSP) with a review of relevant literature and to discuss the etiology, clinical features, imaging, treatment and prognosis of IHSP. METHODS: The case of a 44-year-old woman is reported. MEDLINE was used to search relevant literatures written in English since 2004. RESULTS: The patient suffered from progressive mild thoracic backache followed by truncal and lower extremity weakness, numbness and urinary retention. The diagnosis was confirmed by magnetic resonance (MR) imaging and histopathologic examination. Although she received corticosteroid therapy and decompressive surgery, the patient suffered a rapid relapse probably because of the withdrawal of postoperative steroid therapy. CONCLUSIONS: IHSP is a rare disease characterized by inflammatory hypertrophy of the dura mater without identifiable cause and featured clinical progress of radiculalgia to myelopathy. It is a diagnosis of exclusion. In our view, surgical decompression with postoperative steroid therapy may be optimal. Furthermore,we speculated that increased levels of protein and cell count in cerebrospinal fluid (CSF) might be positively related to the disease progression. High inflammatory signs or CSF protein and cell levels before surgery or postoperative residual lesions are possible reasons of poor prognosis in patients with IHSP.

Arabidopsis drought-induced protein Di19-3 participates in plant response to drought and high salinity stresses.

Di19 (drought-induced protein19) family is a novel type of Cys2/His2 zinc-finger proteins. In this study, Arabidopsis Di19-3 was functionally characterized. The experimental results revealed that AtDi19-3 is a transcriptional activator, and could bind to the TACA(A/G)T sequence. AtDi19-3 expression in plants was remarkably induced by NaCl, mannitol and abscisic acid (ABA). T-DNA insertion mutation of AtDi19-3 results in an increase in plant tolerance to drought and high salinity stresses and ABA, whereas overexpression of AtDi19-3 leads to a drought-, salt- and ABA-sensitive phenotype of the transgenic plants. In the presence of NaCl, mannitol or ABA, rates of seed germination and cotyledon greening in Atdi19-3 mutant were higher, but in AtDi19-3 overexpression transgenic plants were lower than those in wild type. Roots of Atdi19-3 mutant seedlings were longer, but those of AtDi19-3 overexpression transgenic seedlings were shorter than those of wild type. Chlorophyll and proline contents in Atdi19-3 mutant were higher, but in AtDi19-3 overexpression seedlings were lower than those in wild type. Atdi19-3 mutant showed greater drought-tolerance, whereas AtDi19-3 overexpression transgenic plants exhibited more drought-sensitivity than wild type. Furthermore, expression of the genes related to ABA signaling pathway was altered in Atdi19-3 mutant and AtDi19-3 transgenic plants. These data suggest that AtDi19-3 may participate in plant response to drought and salt stresses in an ABA-dependent manner.

Cotton KNL1, encoding a class II KNOX transcription factor, is involved in regulation of fibre development.

In this study, the GhKNL1 (KNOTTED1-LIKE) gene, encoding a classical class II KNOX protein was identified in cotton (Gossypium hirsutum). GhKNL1 was preferentially expressed in developing fibres at the stage of secondary cell wall (SCW) biosynthesis. GhKNL1 was localized in the cell nucleus, and could interact with GhOFP4, as well as AtOFP1, AtOFP4, and AtMYB75. However, GhKNL1 lacked transcriptional activation activity. Dominant repression of GhKNL1 affected fibre development of cotton. The expression levels of genes related to fibre elongation and SCW biosynthesis were altered in transgenic fibres of cotton. As a result, transgenic cotton plants produced aberrant, shrunken, and collapsed fibre cells. Length and cell-wall thickness of fibres of transgenic cotton plants were significantly reduced compared with the wild type. Furthermore, overexpression and dominant repression of GhKNL1 in Arabidopsis resulted in a reduction in interfascicular fibre cell-wall thickening of basal stems of transgenic plants. Complementation revealed that GhKNL1 rescued the defective phenotype of Arabidopsis knat7 mutant in some extent. These data suggest that GhKNL1, as a transcription factor, participates in regulating fibre development of cotton.

Cotton PRP5 gene encoding a proline-rich protein is involved in fiber development.

Proline-rich proteins contribute to cell wall structure of specific cell types and are involved in plant growth and development. In this study, a fiber-specific gene, GhPRP5, encoding a proline-rich protein was functionally characterized in cotton. GhPRP5 promoter directed GUS expression only in trichomes of both transgenic Arabidopsis and tobacco plants. The transgenic Arabidopsis plants with overexpressing GhPRP5 displayed reduced cell growth, resulting in smaller cell size and consequently plant dwarfs, in comparison with wild type plants. In contrast, knock-down of GhPRP5 expression by RNA interference in cotton enhanced fiber development. The fiber length of transgenic cotton plants was longer than that of wild type. In addition, some genes involved in fiber elongation and wall biosynthesis of cotton were up-regulated or down-regulated in the transgenic cotton plants owing to suppression of GhPRP5. Collectively, these data suggested that GhPRP5 protein as a negative regulator participates in modulating fiber development of cotton.

Selective and sensitive detection of intracellular O2(•-) using Au NPs/cytochrome c as SERS nanosensors.

A novel surface-enhanced Raman scattering (SERS) nanosensor was developed by modifying oxidized cytochrome c (Cyt c) on gold nanoparticles (Au NPs) for the sensitive and selective determination of intracellular superoxide anion radical (O2(•-)). On the basis of the differences in the SERS spectra between the oxidized and reduced form of Cyt c, this nanosensor could be employed to investigate O2(•-) concentration by measuring the SERS spectra of the reduced Cyt c. Using this SERS nanosensor, a detection limit of 1.0 × 10(-8) M for O2(•-) could be attained. Additionally, the selectivity of the SERS nanosensor for O2(•-) was examined, showing that other reactive oxygen species (ROS) and biologically relevant species did not influence the detection of O2(•-). More importantly, the nanosensor could be delivered to the living HeLa and normal human liver cells and permitted the concentration of O2(•-) to be monitored in real time and in a noninvasive manner, which indicates that this nanosensor will be suitable for the qualitative and quantitative analysis of O2(•-) in biosystems, thus leading to a greater understanding of oxidative-stress-related diseases at a cellular level.

A wearable screen-printed SERS array sensor on fire-retardant fibre gloves for on-site environmental emergency monitoring.

Glove-based wearable sensors can offer the potential ability to a fast and on-site environmental threat assessment, which is crucial for timely and informed incident management. In this study, an on-demand surface-enhanced Raman scattering (SERS) array sensor has been patterned on fire-retardant fibre gloves via the screen-printing technique in large batches. The screen-printed ink contains one-pot synthesized silver nanoparticle and molybdenum disulfide nanocomposite (Ag/MoS2), and polyanionic cellulose (PAC) as a new adhesive agent. Rhodamine 6G (R6G) was employed as an initial probe molecule to systematically evaluate the performance of the resulting sensor. The results suggest that the fabricated fire-retardant screen-printed SERS array sensor displays high reproducibility and stability at 250 °C, with the lower detection limit of 10-13 M for R6G. The spot-to-spot SERS signals show that the intensity variation was less than 10%. Besides, the SERS signals can be maintained over 7 weeks. Further investigation was then successfully carried out to detect polycyclic aromatic hydrocarbons (PAHs), which are commonly used as flammable chemicals. In our perception, this wearable fire-retardant screen-printed SERS array sensor would be an ideal candidate for practical on-site environmental emergency monitoring due to its fire-retardant capability and timely measurement on a portable carrier.

Coenzyme†Q functionalized CdTe/ZnS quantum dots for reactive oxygen species (ROS) imaging.

Quantum dots (QDs) have been widely used for fluorescent imaging in cells. In particular, surface functionalized QDs are of interest, since they possess the ability to recognize and detect the analytes in the surrounding nanoscale environment based on electron and hole transfer between the analytes and the QDs. Here we demonstrate that fluorescence enhancement/quenching in QDs can be switched by electrochemically modulating electron transfer between attached molecules and QDs. For this purpose, a number of redox-active coenzyme Q (CoQ) disulfide derivatives [CoQC(n)S](2) were synthesized with different alkyl chain lengths (n=1, 5, and 10). The system supremely sensitive to NADH (nicotinamide adenine dinucleotide) and superoxide radical (O(2)(.)(-)), and represents a biomimetic electron-transfer system, modeling part of the mitochondrial respiratory chain. The results of our in situ fluorescence spectroelectrochemical study demonstrate that the reduced state of [CoQC(n)S](2) significantly enhanced the fluorescence intensity of CdTe/ZnS QDs, while the oxidized state of the CoQ conjugates quench the fluorescence to varying degrees. Fluorescence imaging of cells loaded with the conjugate QD-[CoQC(n)S](2) displayed strikingly differences in the fluorescence depending on the redox state of the capping layer, thus introducing a handle for evaluating the status of the cellular redox potential status. Moreover, an MTT assay (MTT=3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) proved that the cytotoxicity of QDs was significantly reduced after immobilization by CoQ derivatives. Those unique features make CoQ derivatived QDs as a promising probe to image redox coenzyme function in vitro and in vivo.

Preliminary Study of hsa-mir-626 Change in the Cerebrospinal Fluid in Parkinson's Disease.

CONTEXT: A host of microRNAs have been reported to suppress tumor growth, invasion, and metastasis and play roles in neurodegeneration disorders. Moreover, microRNA changes are found in the peripheral blood, cerebrospinal fluid (CSF), and brain tissues of central nervous system diseases, including glioma, Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis, and depression. Compared with other body fluids, CSF can reflect the brain pathological processes more accurately. AIMS: To understand whether microRNA expression may be misregulated in patients with PD, and further discover potential diagnostic biomarkers and promising therapeutic targets for PD. MATERIALS AND METHODS: Here, through real-time reverse-transcription polymerase chain reaction (RT-PCR), we compared CSF microRNA from 15 PD patients, 11 AD patients, and 16 controls with other neurologic disorders, such as encephalitis and Guillain-Barre syndrome. RESULTS: Finally, we identified hsa-miR-626 changes in the CSF of PD patients. The mean expression level of hsa-miR-626 was significantly reduced in the CSF of PD patients compared with AD patients and controls. CONCLUSIONS: Our approach provides a preliminary research for identifying biomarkers in the CSF that could be used for the detection, diagnosis, and monitoring of PD.

Preliminary study of hsa-miR-626 change in the cerebrospinal fluid of Parkinson's disease patients.

microRNAs have been reported to suppress tumor growth, invasion, and metastasis and play roles in neurodegeneration disorders. Moreover, changes in microRNAs are found in the peripheral blood, cerebrospinal fluid (CSF), and brain tissues in patients of central nervous system diseases, including glioma, Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis and depression. Compared with other bodily fluids, CSF is the most accurate at representing the pathological processes of the brain. To understand whether microRNA expression may be dysregulated in the patients of PD, and to further discover potential diagnostic biomarkers and promising therapeutic targets for PD, we used real-time polymerase chain reaction (RT-PCR) to compare CSF microRNAs from 20 PD patients, 13 AD patients and 27 controls with other neurologic disorders such as encephalitis and Guillain-Barre syndrome. Finally, we found that the mean expression level of hsa-miR-626 was significantly reduced in the CSF of patients with PD compared with AD and controls. Our approach potentially identified a biomarker in CSF that upon further investigation, could be used for the detection, diagnosis, and monitoring of PD in combination with other PD biomarkers.

Binding of daunorubicin to human serum albumin using molecular modeling and its analytical application.

This study was designed to examine the interaction of daunorubicin with human serum albumin (HSA) for the first time by fluorescence spectroscopy in combination with UV absorption and molecular modeling under simulative physiological conditions. The quenching mechanism was suggested to be static quenching according to the fluorescence measurement and the linearity of Scatchard plot indicated that daunorubicin bound to a single class of binding sites on HSA. The thermodynamic parameters, enthalpy change (DeltaH) and entropy change (DeltaS) were calculated to be -16.13 kJ/mol and 27.86 J/(molK), according to the Vant'Hoff equation. These data suggested that hydrophobic interaction was the predominant intermolecular forces stabilizing the complex, which was in good agreement with the results of molecular modeling study. In addition, the effects of common ions on the binding constant of daunorubicin-HSA complex were also discussed at room temperature. Moreover, the synchronous fluorescence technique was successfully employed to determine the total proteins in serum, urine and saliva samples at room temperature under the optimum conditions with a wide linear range and satisfactory results.

[Studied on the determination of protein by probe of zinc 5-aminosalicylate].

Zinc 5- aminosalylicylate (5-ASZ), a new creative medicine, can react with serum albumin to form a complex. Based on this, a new method for the determination of proteins by synchronous fluorescence spectra under simulated physiological conditions was established using 5 - ASZ as a fluorescence probe. The spectral characterization and intensity of synchronous fluorescence were related to the value of deltalambda, reaction medium and reaction temperature, and so on. On basis of these, eperimental results show that, under the optimum conditions, the synchronous fluorescence intensity of the system is in proportion to the concentration of protein in the range of 1.66-496.8 microg x mL(-1) for human serum albumin (HSA). The detection limit was 0.88 microg x mL(-1) (n = 11) for HSA. On basis of these it had been applied to the determination of proteins in human serum, urine and spit samples with satisfactory results, the recovery was within the range of 98.0%-103.8%. Results suggested that the method possessed easy of implementation, rapidity, high sensitivity, broad linear range, and better RSD and recovery, and so on, and the method was employed directly to determine the total proteins in samples, which results were satisfactory.

BAG5 Interacts with DJ-1 and Inhibits the Neuroprotective Effects of DJ-1 to Combat Mitochondrial Oxidative Damage.

Loss-of-function mutations in gene encoding DJ-1 contribute to the pathogenesis of autosomal recessive early-onset familial forms of Parkinson's disease (PD). DJ-1 is a multifunctional protein and plays a protective role against oxidative stress-induced mitochondrial damage and cell death, but the exact mechanism underlying this is not yet clearly understood. Here, using coimmunoprecipitation (Co-IP) and immunofluorescence methods, we prove that Bcl-2-associated athanogene 5 (BAG5), a BAG family member, interacts with DJ-1 in mammalian cells. Moreover, we show that BAG5 could decrease stability of DJ-1 and weaken its role in mitochondrial protection probably by influencing dimerization in stress condition. Our study reveals the relationship of BAG5 and DJ-1 suggesting a potential role for BAG5 in the pathogenesis of PD through its functional interactions with DJ-1.

Phosphorylation of serine residue modulates cotton Di19-1 and Di19-2 activities for responding to high salinity stress and abscisic acid signaling.

Di19 (drought-induced protein 19) family is a novel type of Cys2/His2 zinc-finger proteins. In this study, we demonstrated that cotton Di19-1 and Di19-2 (GhDi19-1/-2) proteins could be phosphorylated in vitro by the calcium-dependent protein kinase (CDPK). Mutation of Ser to Ala in N-terminus of GhDi19-1/-2 led to the altered subcellular localization of the two proteins, but the constitutively activated form (Ser was mutated to Asp) of GhDi19-1/-2 still showed the nuclear localization. GhDi19-1/-2 overexpression transgenic Arabidopsis seedlings displayed the hypersensitivity to high salinity and abscisic acid (ABA). However, Ser site-mutated GhDi19-1(S116A) and GhDi19-2(S114A), and Ser and Thr double sites-mutated GhDi19-1(S/T-A/A) and GhDi19-2(S/T-A/A) transgenic Arabidopsis did not show the salt- and ABA-hypersensitive phenotypes. In contrast, overexpression of Thr site-mutated GhDi19-1(T114A) and GhDi19-2(T112A) in Arabidopsis still resulted in salt- and ABA-hypersensitivity phenotypes, like GhDi19-1/-2 transgenic lines. Overexpression of GhDi19-1/-2 and their constitutively activated forms in Atcpk11 background could recover the salt- and ABA-insensitive phenotype of the mutant. Thus, our results demonstrated that Ser phosphorylation (not Thr phosphorylation) is crucial for functionally activating GhDi19-1/-2 in response to salt stress and ABA signaling during early plant development, and GhDi19-1/-2 proteins may be downstream targets of CDPKs in ABA signal pathway.

GIT1 enhances neurite outgrowth by stimulating microtubule assembly.

GIT1, a G-protein-coupled receptor kinase interacting protein, has been reported to be involved in neurite outgrowth. However, the neurobiological functions of the protein remain unclear. In this study, we found that GIT1 was highly expressed in the nervous system, and its expression was maintained throughout all stages of neuritogenesis in the brain. In primary cultured mouse hippocampal neurons from GIT1 knockout mice, there was a significant reduction in total neurite length per neuron, as well as in the average length of axon-like structures, which could not be prevented by nerve growth factor treatment. Overexpression of GIT1 significantly promoted axon growth and fully rescued the axon outgrowth defect in the primary hippocampal neuron cultures from GIT1 knockout mice. The GIT1 N terminal region, including the ADP ribosylation factor-GTPase activating protein domain, the ankyrin domains and the Spa2 homology domain, were sufficient to enhance axonal extension. Importantly, GIT1 bound to many tubulin proteins and microtubule-associated proteins, and it accelerated microtubule assembly in vitro. Collectively, our findings suggest that GIT1 promotes neurite outgrowth, at least partially by stimulating microtubule assembly. This study provides new insight into the cellular and molecular pathogenesis of GIT1-associated neurological diseases.

Stroke-like Migraine Attacks after Radiation Therapy Syndrome.

OBJECTIVE: To summarize the clinical presentation, pathogenesis, neuroimaging, treatment, and outcome of stroke-like migraine attacks after radiation therapy (SMART) syndrome, and to propose diagnostic criteria for this disorder. DATA SOURCES: We searched the PubMed database for articles in English published from 1995 to 2015 using the terms of "stroke-like AND migraine AND radiation." Reference lists of the identified articles and reviews were used to retrieve additional articles. STUDY SELECTION: Data and articles related to late-onset effects of cerebral radiation were selected and reviewed. RESULTS: SMART is a rare condition that involves complex migraines with focal neurologic deficits following cranial irradiation for central nervous system malignancies. The recovery, which ranges from hours to days to weeks, can be partial or complete. We propose the following diagnostic criteria for SMART: (1) Remote history of therapeutic external beam cranial irradiation for malignancy; (2) prolonged, reversible clinical manifestations mostly years after irradiation, which may include migraine, seizures, hemiparesis, hemisensory deficits, visuospatial defect, aphasia, confusion and so on; (3) reversible, transient, unilateral cortical gadolinium enhancement correlative abnormal T2 and fluid-attenuated inversion recovery signal of the affected cerebral region; (4) eventual complete or partial recovery, the length of duration of recovery ranging from hours to days to weeks; (5) no evidence of residual or recurrent tumor; (6) not attributable to another disease. To date, no specific treatment has been identified for this syndrome. CONCLUSIONS: SMART is an extremely rare delayed complication of brain irradiation. However, improvements in cancer survival rates have resulted in a rise in its frequency. Hence, awareness and recognition of the syndrome is important to make a rapid diagnosis and avoid aggressive interventions such as brain biopsy and cerebral angiography.