2019, Number 4
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MEDICC Review 2019; 21 (4)
Hereditary ataxias in cuba: Results and impact of a comprehensive, multidisciplinary project
Rodríguez-Labrada R, Medrano-Montero J, Velázquez-Pérez L
Language: English
References: 62
Page: 39-45
PDF size: 78.81 Kb.
ABSTRACT
Spinocerebellar ataxia type 2 is a degenerative disease that causes physical disability and, ultimately, prostration and death. Globally, reported prevalence is around 3 cases per 100,000 population and Cuba has the world’s highest rates of the disease, affecting both patients and their at-risk descendants. In Holguín Province, which has the country’s highest concentration of cases, incidence is 4.4 per 100,000 population and prevalence is 40.2 per 100,000 population. In 2000, a specialized research center was established in that province. Supplied with the necessary equipment and human resources, the center conducted national multidisciplinary studies involving molecular biology, clinical care, epidemiology, psychology, clinical neurophysiology, imaging, clinical genetics and community medicine, among others. A training and continuing education program also raised scientific capacity. Priority was given to developing international collaborations for academic exchange and training of Cuban researchers.
Multiple results from research involving clinical and epidemiologic characterization of the disease, identification of biomarkers and therapeutic targets, genetic association studies, clinical trials and characterization of the disease’s preclinical stages have been introduced in care of patients and their at-risk descendants. This has been accomplished through various programs including personalized rehabilitation, predictive diagnosis and social services. These results have also been published in high-impact scientific journals and received national and international awards. Such an experience in the context of Cuba’s national health system—which is universal, free, accessible, comprehensive, prevention-oriented and with a record of international cooperation—demonstrates the possibility of providing quality care to affected families. Incorporating research findings into medical practice, with the resulting impact on patients’ health and wellbeing, is a practical example of translational medicine in Cuba.
REFERENCES
Ashizawa T, Öz G, Paulson HL. Spinocerebellar ataxias: prospects and challenges for therapy development. Nat Rev Neurol. 2018;14(10):590605.
Coarelli G, Brice A, Durr A. Recent advances in understanding dominant spinocerebellar ataxias from clinical and genetic points of view. F1000Res. 2018;7. pii: F1000 Faculty Rev-1781.
Auburger GW. Spinocerebellar ataxia type 2. Handb Clin Neurol. 2012;103:42336.
Velázquez-Pérez LC, Rodríguez-Labrada R, Fernández-Ruiz J. Spinocerebellar ataxia type 2: clinicogenetic aspects, mechanistic insights, and management approaches. Front Neurol. 2017 Sep 11;8:472.
Velázquez-Pérez L, Rodríguez-Labrada R, García- Rodríguez JC, Almaguer- Mederos LE, Cruz- Mariño T, Laf ta-Mesa JM. A comprehensive review of spinocerebellar ataxia type 2 in Cuba. Cerebellum. 2011 Jun;10(2):18498.
Velázquez-Pérez L, Sánchez-Cruz G, Santos Falcón N, Almaguer Mederos LE, Escalona Batallan K, Rodríguez Labrada R, et al. Molecular epidemiology of spinocerebellar ataxias in Cuba: insights into SCA2 founder effect in Holguín. Neurosci Lett. 2009 Apr 24;454(2):15760.
Velázquez-Pérez L, Santos-Falcón N, García- Zaldívar R, Paneque-Herrera M, Hechavarría- Pupo R. Epidemiología de la ataxia hereditaria cubana. Rev Neurol. 2001;32(7):60611. Spanish.
Rojo Pérez N, Valenti Pérez C, Martínez Trujillo N, Morales Suárez I, Martínez Torres E, Fleitas Estévez I, et al. Ciencia e innovación tecnológica en la salud en Cuba: resultados en problemas seleccionados. Rev Panam Salud Pública [Internet]. 2018 Apr 24 [cited 2019 Apr 17];42:98108. Available from: https://www.scielosp.org/pdf/ rpsp/2018.v42/e32/es. Spanish.
Velázquez Pérez L, Rodríguez Labrada R, Sánchez Cruz G, Laf ta Mesa JM, Almaguer Mederos L, Aguilera Rodríguez R, et al. Caracterización integral de la ataxia espinocerebelosa 2 en Cuba y su aplicación en proyectos de intervención. Rev Cub Salud Pública. 2011;37(3):23044. Spanish.
Vallés L, Estrada GL, Bastecherrea SL. Algunas formas de heredoataxia en una región de Cuba. Rev Neurol. 1978;27:16376. Spanish.
Beguería R. Alteraciones de la Motilidad Ocular en las Enfermedades Heredodegenerativas Espinocerebelosas Tipo Pierre Marie en la región del Norte de Oriente. Estudio prospectivo de 30 enfermos [thesis]. [Havana]: Institute of Neurology and Neurosurgery (CU); 1977. 182 p. Spanish.
Cordovés SR. Estudio clínico epidemiológico de las enfermedades heredodegenerativas espinocerebelosas tipo Pierre Marie en un área de salud de la provincia de Holguín [thesis]. [Holguín]: “Vladimir Ilich Lenin” Provincial Teaching Hospital; 1981. Spanish.
Nodarse A, Orozco DG, Gutiérrez S, Coutin P. Clinical electrophysiological correlation in patients with hereditary ataxia and asymptomatic relatives. EEG Clin Neurophysiol. 1987;66:573.
Orozco G, Estrada R, Perry TL, Araña J, Fernández R, González-Quevedo A, et al. Dominantly inherited olivopontocerebellar atrophy from eastern Cuba. Clinical, neuropathological and biochemical ndings. J Neurol Sci. 1989 Oct;93(1):3750.
Auburger G, Díaz GO, Capote RF, Sánchez SG, Pérez MP, del Cueto ME, et al. Autosomal dominant ataxia: genetic evidence for locus heterogeneity from a Cuban founder-effect population. Am J Hum Genet. 1990 Jun;46(6):1163–77.
Pulst SM, Nechiporuk A, Nechiporuk T, Gispert S, Chen XN, Lopes-Cendes I, et al. Moderate expansion of a normally biallelic trinucleotide repeat in spinocerebellar ataxia type 2. Nature Genet. 1996 Nov;14(3):26976.
Sanpei K, Takano H, Igarashi S, Sato T, Oyake M, Sasaki H, et al. Identi cation of the spinocerebellar ataxia type 2 gene using a direct identi cation of repeat expansion and cloning technique, DIRECT. Nat Genet. 1996 Nov;14(3):27784.
Imbert G, Saudou F, Yvert G, Devys D, Trottier Y, Garnier JM, et al. Cloning of the gene for spinocerebellar ataxia 2 reveals a locus with high sensitivity to expaned CAG/ glutamine repeats. Nature Genet. 1996 Nov;14(3):28591.
Cruz-Mariño T, Velázquez- Pérez L, González- Zaldívar Y, Aguilera-Rodríguez R, Velázquez- Santos M, Vázquez-Mojena Y, et al. Cuban adolescents requesting presymptomatic testing for spinocerebellar ataxia type 2. ISRN Genetics [Internet]. 2013 [cited 2019 Apr 5];2013. Available from: https://www.hindawi.com/journals/ isrn/2013/837202/
Cruz-Mariño T, Velázquez-Pérez L, González- Zaldívar Y, Aguilera-Rodríguez R, Velázquez- Santos M, Vázquez-Mojena Y, et al. Couples at risk for spinocerebellar ataxia type 2: the Cuban prenatal diagnosis experience. J Community Genet. 2013 Oct;4(4):451–60.
Cruz-Mariño T, Vázquez-Mojena Y, Velázquez- Pérez L, González-Zaldívar Y, Aguilera-Rodríguez R, Vázquez-Santos M, et al. SCA2 predictive testing in Cuba: challenging concepts and protocol evolution. J Community Genet. 2015;6(3):26573.
Cruz Mariño T, Velázquez Pérez L, González Zaldívar Y, Aguilera-Rodríguez R, Velázquez- Santos M, Vázquez-Mojena Y, et al. The Cuban program for predictive testing of SCA2: 11 years and 768 individuals to learn from. Clin Genet. 2013 Jun;83(6):51824.
Paneque HM, Prieto AL, Reynaldo RR, Cruz MT, Santos FN, Almaguer ML, et al. Psychological aspects of presymptomatic diagnosis of spinocerebellar ataxia type 2 in Cuba. Community Genet. 2007;10(3):1329.
Paneque M, Lemos C, Sousa A, Velázquez L, Fleming M, Sequeiros J. Role of the disease in the psychological impact of pre-symptomatic testing for SCA2 and FAP ATTRV30M: experience with the disease, kinship and gender of the transmitting parent. J Genet Couns. 2009 Oct;18(5);48393.
Cruz Mariño T, Armiñán RR, Cedeño HJ, Mesa JM, Zaldívar YG, Rodríguez RA, et al. Ethical dilemmas in genetic testing: examples from the Cuban program for predictive diagnosis of hereditary ataxias. J Genet Couns. 2011 Jun;20(3):2418.
Pérez-Ávila I, Fernández JA, Martínez-Góngora E, Ochoa Mastrapa R, Velázquez-Manresa MG. [Effects of a physical training program on quantitative neurological indices in mild stage type 2 spinocerebellar ataxia patients]. Rev Neurol. 2004 Nov 16–30;39(10):90710. Spanish.
Rodríguez JC, Velázquez L, Sánchez G, Almaguer L, Almaguer D, García JC, et al. Evaluación de la restauración neurológica en pacientes con ataxia SCA2 cubana. Plast & Rest Neurol. 2008 Jan–Dec;7(1–2):138. Spanish.
Rodríguez-Díaz JC, Velázquez-Pérez L, Rodríguez- Labrada R, Aguilera R, Laf ta D, Canales N, et al. Neurorehabilitation therapy in spinocerebellar ataxia type 2: a 24-week, rater-blinded, randomized, controlled trial. Mov Disord. 2018 Sep;33(9):14817.
Velázquez-Pérez L, Rodríguez-Díaz JC, Rodríguez- Labrada R, Medrano-Montero J, Aguilera Cruz AB, Reynaldo-Cejas L, et al. Neurorehabilitation improves the motor features in prodromal SCA2: a randomized, controlled trial. Mov Disord. 2019 Apr 8. DOI: 10.1002/mds.27676.
Velázquez-Pérez L, Seifried C, Santos-Falcón N, Abele M, Ziemann U, Almaguer LE, et al. Saccade velocity is controlled by polyglutamine size in spinocerebellar ataxia 2. Ann Neurol. 2004 Sep;56(3):4447.
Velázquez-Pérez L, Voss U, Rodríguez-Labrada R, Auburger G, Canales Ochoa N, Sánchez Cruz G, et al. Sleep disorders in spinocerebellar ataxia type 2 patients. Neurodegener Dis. 2011;8(6):44754.
Rodríguez-Labrada R, Velázquez-Pérez L, Aguilera-Rodríguez R, Seifried-Oberschmidt C, Seifried-Oberschmidt C, Peña-Acosta A, et al. Executive de cit in spinocerebellar ataxia type 2 is related to expanded CAG repeats: evidence from antisaccadic eye movements. Brain Cogn. 2014 Nov;91:2834.
Velázquez-Pérez L, Rodríguez-Labrada R, Canales- Ochoa N, Medrano-Montero J, Sánchez- Cruz G, Aguilera-Rodríguez R, et al. Progression of early features of spinocerebellar ataxia type 2 in individuals at risk: a longitudinal study. Lancet Neurol. 2014 May;13(5):4829.
Velázquez-Pérez L, Seifried C, Abele M, Wirjatijasa F, Rodríguez-Labrada R, Santos-Falcón N, et al. Saccade velocity is reduced in presymptomatic spinocerebellar ataxia type 2. Clin Neurophysiol. 2009 Mar;120(3):6325.
Rodríguez-Labrada R, Velázquez-Pérez L, Canales Ochoa N, Galicia Polo L, Haro Valencia R, Sánchez Cruz G, et al. Subtle rapid eye movement sleep abnormalities in presymptomatic spinocerebellar ataxia type 2 gene carriers. Mov Disord. 2011 Feb 1;26(2):34750.
Velázquez-Pérez L, Rodríguez-Labrada R, Torres-Vega R, Ortega-Sánchez R, Medrano- Montero J, González-Piña R, et al. Progression of corticospinal tract dysfunction in pre-ataxic spinocerebellar ataxia type 2: a two-years follow-up TMS study. Clin Neurophysiol. 2018 May;129(5):895900.
Velázquez Pérez L, Sánchez Cruz G, Canales Ochoa N, Rodríguez Labrada R, Rodríguez Díaz J, Almaguer Mederos L, et al. Electrophysiological features in patients and presymptomatic relatives with spinocerebellar ataxia type 2. J Neurol Sci. 2007 Dec 15;263(12):15864.
Rodríguez-Labrada R, Velázquez-Pérez L, Auburger G, Ziemann U, Canales-Ochoa N, Medrano-Montero J, et al. Spinocerebellar ataxia type 2: measures of saccade changes improve power for clinical trials. Mov Disord. 2016 Apr;31(4):5708.
Rodríguez-Labrada R, Vázquez-Mojena Y, Canales- Ochoa N, Medrano-Montero J, Velázquez- Pérez L. Heritability of saccadic eye movements in spinocerebellar ataxia type 2: insights into an endophenotype marker. Cerebellum Ataxias. 2017 Dec 19;4:19.
Velázquez-Pérez L, Rodríguez-Labrada R, Laf ta-Mesa JM. Prodromal spinocerebellar ataxia type 2: prospects for early interventions and ethical challenges. Mov Disord. 2017 May;32(5):70818.
Velázquez-Pérez L, Rodríguez-Labrada R, Cruz- Rivas EM, Fernández-Ruiz J, Vaca-Palomares I, Lilia-Campins J, et al. Comprehensive study of early features in spinocerebellar ataxia 2: delineating the prodromal stage of the disease. Cerebellum. 2014 Oct;13(5):56879.
Rodríguez-Labrada R, Velázquez-Pérez L, Ortega- Sánchez R, Peña-Acosta A, Vázquez-Mojena Y, Canales-Ochoa N, et al. Insights into cognitive decline in spinocerebellar Ataxia type 2: a P300 event-related brain potential study. Cerebellum Ataxias. 2019 Mar 4;6:3.
Rodríguez-Labrada R, Velázquez-Pérez L, Seigfried C, Canales-Ochoa N, Auburger G, Medrano-Montero J, et al. Saccadic latency is prolonged in spinocerebellar ataxia type 2 and correlates with the frontal-executive dysfunctions. J Neurol Sci. 2011 Jul 15;306(1–2):1037.
Pulst SM, Santos N, Wang D, Yang H, Huynh D, Velázquez L, et al. Spinocerebellar ataxia type 2: polyQ repeat variation in the CACNA1A channel modi es age onset. Brain. 2005 Oct;128(Pt 10):2297303.
Almaguer-Mederos LE, Almaguer-Gotay D, Aguilera- Rodríguez R, González-Zaldívar Y, Cuello- Almarales D, Laf ta-Mesa J, et al. Association of glutathione S-transferase omega polymorphism and spinocerebellar ataxia type 2. J Neurol Sci. 2017 Jan 15;372:3248.
Simon DK, Zheng K, Velázquez L, Santos N, Almaguer L, Figueroa P, et al. Mitochondrial complex I gene variant associated with early age at onset in spinocerebellar ataxia type 2. Arch Neurol. 2007 Jul;64(7):10424.
Almaguer-Mederos LE, Aguilera-Rodríguez R, Cuello-Almarales D, Almaguer-Gotay D, González-Zaldívar Y, Vázquez-Mojena Y, et al. Normal ATXN2 alleles in uences on the age at onset in spinocerebellar ataxia type 2. Mov Disord. 2017 Sep;32(9):132930.
Laf ta-Mesa JM, Bauer PO, Kourí V, Peña Serrano L, Roskams J, Almaguer Gotay D, et al. Epigenetics DNA methylation in the core ataxin-2 gene promoter: novel physiological and pathological implications. Hum Genet. 2012 Apr;131(4):62538.
Laf ta-Mesa JM, Rodríguez Pupo JM, Moreno Sera R, Vázquez-Mojena Y, Kourí V, Laguna- Salvia L, et al. De novo mutations in ataxin-2 gene and ALS risk. PLoS One. 2013 Aug 6;8(8):e70560.
Laf ta-Mesa JM, Velázquez-Pérez LC, Santos Falcón N, Cruz-Mariño T, González-Saldívar Y, Vázquez-Mojena Y, et al. Unexpanded and intermediate CAG polymorphisms at the SCA2 locus (ATXN2) in the Cuban population: evidence about the origin of expanded SCA2 alleles. Eur J Hum Genet. 2012 Jan;20(1):419.
Almaguer-Mederos LE, Mesa JML, González- Zaldívar Y, Almaguer-Gotay D, Cuello-Almarales D, Aguilera-Rodríguez R, et al. Factors associated with ATXN2 CAG/CAA repeat intergenerational instability in spinocerebellar ataxia type 2. Clin Genet. 2018 Oct;94(34):34650.
Vázquez-Mojena Y, Laguna-Salvia L, Laf ta-Mesa JM, González-Zaldívar Y, Almaguer-Mederos LE, Rodríguez-Labrada R, et al. Genetic features of Huntington disease in Cuban population: implications for phenotype, epidemiology and predictive testing. J Neurol Sci. 2013 Dec 15;335(1–2):1014.
González-Zaldívar Y, Vázquez-Mojena Y, Laf ta-Mesa JM, Almaguer-Mederos LE, Rodríguez-Labrada R, Sánchez-Cruz G, et al. Epidemiological, clinical, and molecular characterization of Cuban families with spinocerebellar ataxia type 3/Machado-Joseph disease. Cerebellum Ataxias. 2015 Feb 21;2:1.
Almaguer-Mederos LE, Proenza CL, Almira YR, Batallán KE, Falcón NS, Góngora EM, et al. Age-dependent risks in genetics counseling for spinocerebellar ataxia type 2. Clin Genet. 2008 Dec;74(6):571–3.
Almaguer-Mederos LE, Falcón NS, Almira YR, Zaldívar YG, Almarales DC, Góngora EM, et al. Estimation of the age at onset in spinocerebellar ataxia type 2 Cuban patients by survival analysis. Clin Genet. 2010 Aug;78(2):16974.
Almaguer-Mederos LE, Aguilera Rodríguez R, González Zaldívar Y, Almaguer Gotay D, Cuello Almarales D, Laf ta Mesa J, et al. Estimation of survival in spinocerebellar ataxia type 2 Cuban patients. Clin Genet. 2013 Mar;83(3):2934.
Aguiar J, Fernández J, Aguilar A, Mendoza Y, Vázquez M, Suárez J, et al. Characterization of a new transgenic mouse model of the spinocerebellar ataxia type 2. Biotecnol Aplicada. 2006;23(1):549.
Almaguer-Gotay D, Almaguer-Mederos LE, Aguilera-Rodríguez R, Estupiñán-Rodríguez A, González-Zaldívar Y, Cuello-Almarales D, et al. Role of glutathione S-transferases in the spinocerebellar ataxia type 2 clinical phenotype. J Neurol Sci. 2014 Jun 15;341(12):415.
Almaguer-Gotay D, Almaguer-Mederos L, Aguilera-Rodríguez R, Rodríguez-Labrada R, Cuello-Almarales D, Estupiñán-Domínguez A, et al. Spinocerebellar ataxia type 2 is associated to the extracellular loss of superoxide dismutase but not catalase activity. Front Neurol. 2017 Jun 13;8:276.
Velázquez-Pérez L, Rodríguez-Chanfrau J, García- Rodríguez JC, Sánchez-Cruz G, Aguilera- Rodríguez R, Rodríguez-Labrada R, et al. Oral zinc sulphate supplementation for six months in SCA2 patients: a randomized, double-blind, placebo-controlled trial. Neurochem Res. 2011 Oct;36(10):1793–800.
Velázquez-Pérez L, Rodríguez-Labrada R, Álvarez- González L, Aguilera-Rodríguez R, Álvarez Sánchez M, Canales-Ochoa N, et al. Lisuride reduces involuntary periodic leg movements in spinocerebellar ataxia type 2 patients. Cerebellum. 2012 Dec;11(4):10516.
Rodríguez-Labrada R, González Gay OT, Velázquez- Pérez L, Aguilera Rodríguez R, Canales Ochoa N, Coira Moreno Y, et al. Preliminary evaluation of the effect of Compvit-B on memory and learning processes in patients with SCA2. Rev Cubana Invest Bioméd. 2014;33(2):1409.