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IF 7.6 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-17 DOI: 10.1002/mds.29863

Prediction of pathological subthalamic nucleus beta burst occurrence in Parkinson's disease

帕金森病病理性丘脑下核β爆发的预测
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引用次数: 0
Movement Disorders: Volume 40, Number 12, December 2025 运动障碍:第40卷,第12期,2025年12月
IF 7.6 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-17 DOI: 10.1002/mds.70154
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引用次数: 0
Author Response to Comment on “Neuropsychological Tests of Memory, Visuospatial, and Language Function in Parkinson's Disease: Review, Critique, and Recommendations” 作者对“帕金森病中记忆、视觉空间和语言功能的神经心理学测试:回顾、批评和建议”评论的回应
IF 7.6 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-16 DOI: 10.1002/mds.70149
Ondrej Bezdicek PhD, Roberta Biundo PhD, Matej Skorvanek MD, PhD, Daniel Weintraub MD, Gert J. Geurtsen PhD
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引用次数: 0
Comment on “Neuropsychological Tests of Memory, Visuospatial, and Language Function in Parkinson's Disease: Review, Critique, and Recommendations” 《帕金森病患者的记忆、视觉空间和语言功能的神经心理学测试:综述、批评和建议》
IF 7.6 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-16 DOI: 10.1002/mds.70148
Joshua P. Woller MSc, Alireza Gharabaghi MD
<p>We commend Bezdicek and colleagues for a rigorous, consensus-based evaluation of neuropsychological tests for memory, language, visuospatial function, and premorbid intelligence in Parkinson's disease (PD).<span><sup>1</sup></span> Their tiered recommendations provide practical guidance for level-II assessment across Parkinson's Disease Mild Cognitive Impairment (PD-MCI) and PD dementia (PDD) and for outcome selection in trials.</p><p>The panel's core messages are clear. Word-list and story-recall measures show acceptable validity, reliability, and sensitivity to change in PD. The Boston Naming Test is a practical reference for language, matrix reasoning is the current visuospatial choice, and National adult reading test (NART) or NAART improves adjudication through premorbid-ability estimates. These points, including the stated limitations for early-stage sensitivity and motor confounds, provide a strong foundation for standardized workflows.</p><p>We suggest three additions that support the authors' framework.</p><p>First, reliability should also be treated as a design constraint of subsequent analyses. The maximum observable association between two variables is limited by their reliabilities. When studies compare or pool correlations across outcomes with unequal reliability, attenuation biases estimate toward zero and can be mistaken for weak construct associations.<span><sup>2</sup></span> Explicit reporting of reliability for each selected measure, and correction for attenuation in secondary analyses where justified, would reduce interpretive variability and improve cross-cohort comparability.</p><p>Second, sensitivity to change should use complementary thresholds. Minimal detectable change quantifies the smallest difference beyond measurement error, and minimal clinically important difference reflects patient-perceived benefit.<span><sup>3</sup></span> The latter is, therefore, often used when assessing outcomes of clinical trials.<span><sup>4</sup></span> If responder classification is applied, minimally detectable change (MDC) and minimal clinically important difference (MCID) should shape that split. When MCID is smaller than MDC, individual change scores that exceed MCID but fall below MDC remain indeterminate and should not be interpreted as true change. This differentiation is especially relevant given the substantial day-to-day variability of PD symptoms, which may surpass MCID values.<span><sup>5</sup></span></p><p>Third, measurement invariance should be established before comparing groups, subtypes, therapy states, or time points.<span><sup>6</sup></span> Without item-level invariance, observed score differences may be driven by a subset of items that function differentially, which decouples scores from the intended construct. Given the paper's critique about uneven domain sensitivity and executive contamination of visuospatial measures, routine checks for differential item functioning and factorial stability would strengthen in
我们赞扬Bezdicek及其同事对帕金森病(PD)的记忆、语言、视觉空间功能和病前智力的神经心理学测试进行了严格的、基于共识的评估他们的分级建议为帕金森病轻度认知障碍(PD- mci)和PD痴呆(PDD)的ii级评估和试验结果选择提供了实用指导。该小组的核心信息是明确的。单词表和故事回忆测量显示出可接受的效度、信度和对PD变化的敏感性。波士顿命名测试是语言的实用参考,矩阵推理是当前的视觉空间选择,国家成人阅读测试(NART)或NAART通过预估发病能力来改善裁决。这些要点,包括对早期灵敏度和电机干扰的限制,为标准化工作流程提供了坚实的基础。我们建议增加三个部分来支持作者的框架。首先,可靠性也应被视为后续分析的设计约束。两个变量之间可观察到的最大关联受其信度的限制。当研究比较或汇总可靠性不相等的结果之间的相关性时,衰减偏差估计为零,并可能被误认为是弱结构关联明确报告每个选定测量的可靠性,并在合理的情况下对二次分析中的衰减进行校正,将减少解释的可变性并提高跨队列的可比性。其次,对变化的敏感性应使用互补阈值。最小可检测变化量化了测量误差之外的最小差异,最小临床重要差异反映了患者感知的益处因此,后者通常用于评估临床试验的结果如果应用应答者分类,最小可检测变化(MDC)和最小临床重要差异(MCID)应该形成这种划分。当MCID小于MDC时,超过MCID但低于MDC的个体变化得分仍然不确定,不应被解释为真正的变化。这种区分尤其重要,因为PD症状的日常变化可能超过MCID值。第三,在比较组、亚型、治疗状态或时间点之前,应建立测量不变性如果没有项目级别的不变性,观察到的分数差异可能是由功能不同的项目子集驱动的,这将分数与预期的结构解耦。鉴于本文对视觉空间测量的不均匀域敏感性和执行污染的批评,对差异项目功能和析因稳定性的常规检查将加强纵向和多中心研究的推论。这些补充与作者的未来方向一致,并进一步扩展了PD患者神经心理测试的需求我们支持验证控制学习记忆范式,如连续反应时间(SRT)或记忆绑定测试(MBT),以减少执行负荷。我们也支持在语言和视觉空间测试中限制运动混淆的努力,包括前驱队列的数字语音或语言分析。此外,发病前智商应纳入常规,因为它可以改变PD-MCI的分类和提高诊断的准确性。最后,实现方面的考虑也很重要。记录在案的法律和成本障碍主张采用标准化、可共享的核心电池,并采用经过验证的并行形式,以支持各中心的公平采用。总之,本文综述了PD认知表型标准化的研究进展。嵌入可靠性感知分析、双变化阈值和常规不变性测试将使这些建议更具可重复性和可试验性。(1)研究项目:a、构思、b、组织、c、执行;(2)统计分析:A.设计,B.执行,C.回顾与批判;(3)论文准备:A.初稿写作,B.评审与批评。j.p.w.: 1A, 1B, 1C, 3A, 3B.A.G。: 1a, 1b, 1c, 3a, 3b。数据共享不适用于本文,因为在当前研究期间没有生成或分析数据集。
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引用次数: 0
LRRK2 as a Potential Disease‐Modifying Target in Sporadic Parkinson's Disease LRRK2作为散发性帕金森病的潜在疾病修饰靶点
IF 8.6 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-13 DOI: 10.1002/mds.70100
Anthony E. Lang, Robert A. Hauser, Lorraine V. Kalia, Bonnie Hersh, Zdenek Berger, Roy Llorens Arenas, Coro Paisan‐Ruiz, Kyle Fraser, Danna Jennings, Jillian H. Kluss, Sarah Huntwork‐Rodriguez, Anastasia G. Henry, J. Timothy Greenamyre
A growing understanding of the role that leucine‐rich repeat kinase 2 (LRRK2) plays in Parkinson's disease (PD) supports continued focus on this enzyme as a therapeutic target for PD. Accumulating evidence suggests that there are phenotypic, neuropathologic, and biological similarities between sporadic PD (sPD) and familial forms in which LRRK2 variants are inherited in an autosomal‐dominant pattern with variable penetrance (LRRK2‐PD). Further, genome‐wide association studies have found specific non‐coding variants that are risk factors for sPD. In this review, we describe the current state of knowledge as it relates to LRRK2's role in sPD, with a focus on comparing the physiology and pathology of sPD with LRRK2‐PD. As in LRRK2‐PD, LRRK2 activity may also be increased in sPD, possibly through interactions between genetics and the environment. Increased activity of LRRK2 and associated endolysosomal dysfunction have been observed in sPD patients, including evidence from postmortem brains of patients with sPD and animal models showing increased LRRK2 activity. Additionally, beneficial effects of LRRK2 inhibitors, such as improved lysosomal function, reduced α‐synuclein accumulation, and amelioration of neurodegeneration, have been demonstrated in animal models of sPD. Therefore, inhibition of LRRK2 kinase activity may be a promising approach to disease modification for sPD and LRRK2‐PD. Ongoing and future clinical studies examining LRRK2 kinase inhibitors will aim to elucidate their clinical efficacy in PD and to assess their potential effects on lysosomal function. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
随着对富含亮氨酸的重复激酶2 (LRRK2)在帕金森病(PD)中所起作用的日益了解,人们继续关注这种酶作为PD的治疗靶点。越来越多的证据表明,散发性PD (sPD)和家族性PD (LRRK2变异以常染色体显性模式遗传,具有可变外显率(LRRK2‐PD))之间存在表型、神经病理学和生物学上的相似性。此外,全基因组关联研究发现特定的非编码变异是sPD的危险因素。在这篇综述中,我们描述了与LRRK2在sPD中的作用相关的知识现状,重点比较了sPD与LRRK2‐PD的生理和病理。与LRRK2‐PD一样,sPD中LRRK2活性也可能增加,这可能是遗传和环境之间的相互作用。在sPD患者中观察到LRRK2活性增加和相关的内溶酶体功能障碍,包括来自sPD患者死后大脑和动物模型的证据显示LRRK2活性增加。此外,LRRK2抑制剂的有益作用,如改善溶酶体功能、减少α‐突触核蛋白积累和改善神经退行性变,已在sPD的动物模型中得到证实。因此,抑制LRRK2激酶活性可能是sPD和LRRK2‐PD疾病修饰的一种有希望的方法。正在进行和未来的临床研究检查LRRK2激酶抑制剂将旨在阐明其在PD中的临床疗效,并评估其对溶酶体功能的潜在影响。©2025作者。Wiley期刊有限责任公司代表国际帕金森和运动障碍学会出版的《运动障碍》。
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引用次数: 0
It Is Personal: What People with Parkinson's Disease Say Matters Most for Quality of Life 这是个人的:帕金森病患者说什么对生活质量最重要
IF 8.6 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-13 DOI: 10.1002/mds.70134
Samantha Dorrance, Richa Patel, Glenn T. Stebbins, Jamie Adams, Allison M. Allen, Tara Hastings, Soania Mathur, Onanong Phokaewvarangkul, Gary Rafaloff, Rajasumi Rajalingam, Anette Schrag, Christine Sun, Jennifer Mammen, Connie Marras
Background Little is known about what matters most for quality of life in people with Parkinson's disease and how much it varies between individuals. Objective The goal was to define the relative impact of quality of life determinants in people with Parkinson's disease, including variation across individuals and by disease severity, gender, age, and ethnicity. Methods Sixty‐one factors potentially associated with quality of life in people with Parkinson's disease were identified from the literature and nominated by participants with Parkinson's disease. Forty‐four participants then rated their degree of impact on quality of life from “a lot” to “not at all,” and identified their “top 3 most important” factors. Results At the individual level, determinants of utmost importance varied greatly, with 39 of 61 factors being reported at least once in the “top 3.” There were 17 factors that at least 50% of the sample agreed affected quality of life “a lot,” and only two were symptoms of the disease. Twelve (all positive experiences) retained at least 50% agreement across subgroups defined by disease severity, age, gender and ethnicity. Symptom‐related factors of high importance varied markedly in mild disease subgroup in particular. Conclusions Factors that are not direct consequences of the disease, but may be highly personal and interfere with what one finds meaningful, emerged as highly relevant. Symptoms also greatly impacted quality of life for most individuals, but specific symptoms varied across individuals. Quality of life determinants in people with Parkinson's disease appear highly individualized, and currently used measurement tools with fixed items may not be optimal. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
对于帕金森病患者的生活质量最重要的因素是什么,以及个体之间的差异有多大,我们知之甚少。目的:确定帕金森病患者生活质量决定因素的相对影响,包括个体差异、疾病严重程度、性别、年龄和种族差异。方法从文献中识别出61个可能与帕金森病患者生活质量相关的因素,并由帕金森病患者提出。然后,44名参与者将他们对生活质量的影响程度从“很多”到“根本没有”进行评级,并确定他们“最重要的3个”因素。结果在个体层面上,最重要的决定因素差异很大,61个因素中有39个至少在“前3名”中出现过一次。有17个因素至少有50%的样本同意影响生活质量“很大”,只有两个是疾病的症状。12例(均为积极经历)在按疾病严重程度、年龄、性别和种族定义的亚组中保持至少50%的一致性。在轻度疾病亚组中,高度重要的症状相关因素差异显著。结论:虽然不是疾病的直接后果,但可能是高度个人化的,并且会干扰人们发现有意义的事情,这些因素都是高度相关的。症状也极大地影响了大多数人的生活质量,但具体的症状因人而异。帕金森病患者的生活质量决定因素似乎高度个性化,目前使用的固定项目测量工具可能不是最佳的。©2025作者。Wiley期刊有限责任公司代表国际帕金森和运动障碍学会出版的《运动障碍》。©2025作者。Wiley期刊有限责任公司代表国际帕金森和运动障碍学会出版的《运动障碍》。
{"title":"It Is Personal: What People with Parkinson's Disease Say Matters Most for Quality of Life","authors":"Samantha Dorrance, Richa Patel, Glenn T. Stebbins, Jamie Adams, Allison M. Allen, Tara Hastings, Soania Mathur, Onanong Phokaewvarangkul, Gary Rafaloff, Rajasumi Rajalingam, Anette Schrag, Christine Sun, Jennifer Mammen, Connie Marras","doi":"10.1002/mds.70134","DOIUrl":"https://doi.org/10.1002/mds.70134","url":null,"abstract":"Background Little is known about what matters most for quality of life in people with Parkinson's disease and how much it varies between individuals. Objective The goal was to define the relative impact of quality of life determinants in people with Parkinson's disease, including variation across individuals and by disease severity, gender, age, and ethnicity. Methods Sixty‐one factors potentially associated with quality of life in people with Parkinson's disease were identified from the literature and nominated by participants with Parkinson's disease. Forty‐four participants then rated their degree of impact on quality of life from “a lot” to “not at all,” and identified their “top 3 most important” factors. Results At the individual level, determinants of utmost importance varied greatly, with 39 of 61 factors being reported at least once in the “top 3.” There were 17 factors that at least 50% of the sample agreed affected quality of life “a lot,” and only two were symptoms of the disease. Twelve (all positive experiences) retained at least 50% agreement across subgroups defined by disease severity, age, gender and ethnicity. Symptom‐related factors of high importance varied markedly in mild disease subgroup in particular. Conclusions Factors that are not direct consequences of the disease, but may be highly personal and interfere with what one finds meaningful, emerged as highly relevant. Symptoms also greatly impacted quality of life for most individuals, but specific symptoms varied across individuals. Quality of life determinants in people with Parkinson's disease appear highly individualized, and currently used measurement tools with fixed items may not be optimal. © 2025 The Author(s). <jats:italic>Movement Disorders</jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. © 2025 The Author(s). <jats:italic>Movement Disorders</jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"35 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145730689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Impact of Calcitriol on Frataxin Levels in Friedreich's Ataxia Patients: Insights and Future Directions 骨化三醇对共济失调患者Frataxin水平的影响:见解和未来方向
IF 8.6 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-12 DOI: 10.1002/mds.29933
Nie Zhang, Yahui Xu
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引用次数: 0
Longitudinal Dynamics of Plasma Neurofilament Light Chain in Hereditary Spastic Paraplegia Type 11 (HSP-SPG11) and Type 15 (HSP-ZFYVE26). 遗传性痉挛性截瘫11型(HSP-SPG11)和15型(HSP-ZFYVE26)血浆神经丝轻链的纵向动力学。
IF 8.6 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-09 DOI: 10.1002/mds.70142
Habibah A P Agianda,Julian E Alecu,Amy Tam,Hyo-Min Kim,Joshua Rong,Nicole Battaglia,Kaitlyn Warren,Rebekah Mannix,Nunzio Setola,Melissa Barghigiani,Grace Yoon,Yoshihisa Takiyama,Jangsup Moon,Katerina Bernardi,Kathryn Yang,Luca Schierbaum,Filippo Maria Santorelli,Darius Ebrahimi-Fakhari
BACKGROUNDHSP-SPG11 and HSP-ZFYVE26 are autosomal-recessive forms of hereditary spastic paraplegias (HSPs). As therapeutic trials emerge, validated biomarkers are critically needed.OBJECTIVESTo evaluate plasma neurofilament light chain (pNfL) as a biomarker for neurodegeneration and disease progression.METHODSWe analyzed pNfL levels in 57 patients (36 HSP-SPG11, 21 HSP-ZFYVE26) and matched controls using single-molecule array technology. Longitudinal clinical and biomarker data were collected over 5 years.RESULTSBaseline pNfL levels were significantly elevated in patients: 33.85 pg/mL (IQR 25.15-47.38) in HSP-SPG11, 46.70 pg/mL (IQR 29.95-54.84) in HSP-ZFYVE26, and 4.90 pg/mL (IQR 3.48-6.90) in controls (P < 0.001). No significant difference was observed between HSP-SPG11 and HSP-ZFYVE26. In matched pair analysis, pNfL showed inverse correlation with age (ρ = -0.463, P < 0.001). Baseline pNfL did not predict future clinical progression.CONCLUSIONSElevated pNfL reflects early neuroaxonal injury in HSP-SPG11 and HSP-ZFYVE26; however, it could not be used as a surrogate for disease progression. © 2025 International Parkinson and Movement Disorder Society.
背景:dhsp - spg11和HSP-ZFYVE26是遗传性痉挛性截瘫(HSPs)的常染色体隐性形式。随着治疗试验的出现,迫切需要经过验证的生物标志物。目的评价血浆神经丝轻链(pNfL)作为神经变性和疾病进展的生物标志物。方法采用单分子阵列技术分析57例患者(36例HSP-SPG11, 21例HSP-ZFYVE26)和匹配对照组的pNfL水平。纵向临床和生物标志物数据收集超过5年。结果患者pNfL基线水平显著升高:HSP-SPG11组为33.85 pg/mL (IQR 25.15 ~ 47.38), HSP-ZFYVE26组为46.70 pg/mL (IQR 29.95 ~ 54.84),对照组为4.90 pg/mL (IQR 3.48 ~ 6.90) (P < 0.001)。HSP-SPG11与HSP-ZFYVE26之间无显著性差异。配对分析中,pNfL与年龄呈负相关(ρ = -0.463, P < 0.001)。基线pNfL不能预测未来的临床进展。结论pNfL升高反映了HSP-SPG11和HSP-ZFYVE26的早期神经轴索损伤;然而,它不能作为疾病进展的替代品。©2025国际帕金森和运动障碍学会。
{"title":"Longitudinal Dynamics of Plasma Neurofilament Light Chain in Hereditary Spastic Paraplegia Type 11 (HSP-SPG11) and Type 15 (HSP-ZFYVE26).","authors":"Habibah A P Agianda,Julian E Alecu,Amy Tam,Hyo-Min Kim,Joshua Rong,Nicole Battaglia,Kaitlyn Warren,Rebekah Mannix,Nunzio Setola,Melissa Barghigiani,Grace Yoon,Yoshihisa Takiyama,Jangsup Moon,Katerina Bernardi,Kathryn Yang,Luca Schierbaum,Filippo Maria Santorelli,Darius Ebrahimi-Fakhari","doi":"10.1002/mds.70142","DOIUrl":"https://doi.org/10.1002/mds.70142","url":null,"abstract":"BACKGROUNDHSP-SPG11 and HSP-ZFYVE26 are autosomal-recessive forms of hereditary spastic paraplegias (HSPs). As therapeutic trials emerge, validated biomarkers are critically needed.OBJECTIVESTo evaluate plasma neurofilament light chain (pNfL) as a biomarker for neurodegeneration and disease progression.METHODSWe analyzed pNfL levels in 57 patients (36 HSP-SPG11, 21 HSP-ZFYVE26) and matched controls using single-molecule array technology. Longitudinal clinical and biomarker data were collected over 5 years.RESULTSBaseline pNfL levels were significantly elevated in patients: 33.85 pg/mL (IQR 25.15-47.38) in HSP-SPG11, 46.70 pg/mL (IQR 29.95-54.84) in HSP-ZFYVE26, and 4.90 pg/mL (IQR 3.48-6.90) in controls (P < 0.001). No significant difference was observed between HSP-SPG11 and HSP-ZFYVE26. In matched pair analysis, pNfL showed inverse correlation with age (ρ = -0.463, P < 0.001). Baseline pNfL did not predict future clinical progression.CONCLUSIONSElevated pNfL reflects early neuroaxonal injury in HSP-SPG11 and HSP-ZFYVE26; however, it could not be used as a surrogate for disease progression. © 2025 International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"5 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Oligodendrocyte Inclusion Pathology in Fragile X‐Associated Tremor/Ataxia Syndrome 脆性X相关震颤/共济失调综合征的少突胶质细胞包涵病理
IF 8.6 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-06 DOI: 10.1002/mds.70145
Yingratana McLennan, Hassan Aliashrafzadeh, Faith Zirkelbach‐Ngai, Forrest McKenzie, Brett D. Dufour, Lina V. Becerra‐Hernández, Adolfo Sanchez Escobar, Flora Tassone, Paul Hagerman, Randi Hagerman, Veronica Martínez‐Cerdeño
Background Fragile X‐associated tremor/ataxia syndrome (FXTAS) is a neurodegenerative disorder marked by white matter degeneration and intranuclear inclusions. While astrocytic and neuronal inclusions are well‐documented, oligodendrocytes were previously thought to lack such pathology. Objective To demonstrate that oligodendrocytes in the prefrontal cortex of FXTAS patients do harbor intranuclear inclusions, with significantly higher burden in white matter than gray matter. Methods Ubiquitin and p62 immunofluorescence and enzymatic staining were employed to confirm the presence of intranuclear inclusions in oligodendrocytes across multiple brain regions. Results Oligodendrocytes contain inclusions and inclusion burden is correlated with FMR1 CGG repeat length ( ρ = 0.97, P < 0.001) in white matter. Conclusions These findings implicate oligodendrocyte dysfunction in FXTAS pathogenesis which may contribute to demyelination and white matter degeneration. Our data emphasize the need to consider cell type‐specific mechanisms in FXTAS and support future therapeutic efforts aimed at restoring glial proteostasis. © 2025 International Parkinson and Movement Disorder Society.
脆性X相关震颤/共济失调综合征(FXTAS)是一种以白质变性和核内包涵体为特征的神经退行性疾病。虽然星形细胞和神经元包涵体已被充分证明,但少突胶质细胞以前被认为缺乏这种病理。目的探讨FXTAS患者前额叶皮层少突胶质细胞确实存在核内包涵体,其白质负荷明显高于灰质负荷。方法采用泛素、p62免疫荧光和酶促染色方法,证实脑多区少突胶质细胞核内包涵体的存在。结果少突胶质细胞中含有包涵体,包涵体负荷与白质中FMR1 CGG重复长度相关(ρ = 0.97, P < 0.001)。结论少突胶质细胞功能障碍可能参与FXTAS的发病机制,并可能导致脱髓鞘和白质变性。我们的数据强调需要考虑FXTAS的细胞类型特异性机制,并支持未来旨在恢复胶质蛋白平衡的治疗努力。©2025国际帕金森和运动障碍学会。
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引用次数: 0
Primary Brain Calcification: An International Consensus on Nomenclature, Diagnosis, Evaluation, and Management 原发性脑钙化:关于命名、诊断、评估和管理的国际共识
IF 8.6 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-05 DOI: 10.1002/mds.70140
Wei Luo, Zhidong Cen, Huiberdina Koek, Miryam Carecchio, Isao Hozumi, Wan‐Jin Chen, Amit Batla, Alexander Balck, Francesca Magrinelli, Dehao Yang, Xuewen Cheng, Ana Westenberger, Akiyoshi Kakita, Liam Chen, Christian Lambert, Jing‐Yu Liu, Annika Keller, João Ricardo Mendes de Oliveira, Zhi‐Qi Xiong, Henry Houlden, Kailash P. Bhatia, Christine Klein, Gaël Nicolas
Our understanding of primary brain calcification (PBC) has accelerated with the identification of seven causative genes over the past 13 years, vastly expanding knowledge of the molecular underpinnings of this disorder. Despite this progress, a lack of standardized clinical definitions, variable presentations, and heterogeneous calcification patterns has perpetuated inconsistencies in diagnosis and patient care. To address these challenges, an international expert panel undertook a comprehensive process—combining systematic literature review, virtual and in‐person expert discussions, and iterative Delphi consensus questionnaires—to develop unified recommendations. These consensus guidelines encompass terminology, diagnostic criteria, neuroimaging protocols, clinical evaluation standards, genetic testing approaches, and management strategies. Notably, PBC is recommended as the clinical standard, with new diagnostic criteria, including the use of a computed tomography–based total calcification score and a three‐tiered diagnostic algorithm (possible, probable, definite PBC). A systematic review of 27 symptoms and signs identified 19 as most closely linked with PBC, guiding more focused clinical assessment. Recommendations strongly support comprehensive next‐generation sequencing for genetic testing, favoring whole genome over exome or targeted panels to maximize diagnostic yield. Multidisciplinary management priorities are outlined in four key principles centering on individualized care, symptom relief, genetic counseling, and ongoing monitoring. Widespread adoption of these unified guidelines will facilitate consistent diagnosis, enable comparative international data collection, and lay the groundwork for large‐scale collaborative research—including future randomized controlled trials of symptomatic and disease‐modifying PBC therapies. This consensus fosters clarity and consistency, creating a framework for improved patient care and scientific discovery. © 2025 International Parkinson and Movement Disorder Society.
在过去的13年里,我们对原发性脑钙化(PBC)的理解随着7种致病基因的鉴定而加速,极大地扩展了对这种疾病分子基础的认识。尽管取得了这些进展,但缺乏标准化的临床定义、可变的表现和异质的钙化模式,导致了诊断和患者护理的不一致。为了应对这些挑战,一个国际专家小组进行了一个全面的过程,结合了系统的文献综述,虚拟和面对面的专家讨论,以及迭代的德尔菲共识问卷,以制定统一的建议。这些共识指南包括术语、诊断标准、神经影像学协议、临床评估标准、基因检测方法和管理策略。值得注意的是,PBC被推荐为临床标准,具有新的诊断标准,包括使用基于计算机断层扫描的总钙化评分和三层诊断算法(可能的、可能的、确定的PBC)。对27种症状和体征进行系统回顾,确定了19种与PBC最密切相关的症状和体征,指导更有针对性的临床评估。建议强烈支持全面的下一代基因检测测序,支持全基因组测序,而不是外显子组或靶向组,以最大限度地提高诊断产量。多学科管理的重点概述了四个关键原则,即个体化护理、症状缓解、遗传咨询和持续监测。这些统一指南的广泛采用将促进一致的诊断,使比较国际数据收集成为可能,并为大规模合作研究奠定基础,包括未来对症状性和疾病改变性PBC治疗的随机对照试验。这种共识促进了清晰度和一致性,为改善患者护理和科学发现创造了框架。©2025国际帕金森和运动障碍学会。
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引用次数: 0
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