• Title/Summary/Keyword: Spinocerebellar Ataxia(SCA)

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Case Report of a Type 3 Spinocerebellar Ataxia Patient Treated with Traditional Korean Medicine (제 3형 척수소뇌실조 환자의 한방 치험 1례)

  • Hur, Hee-soo;Lee, Myeong-hwa;Kim, Kyoung-min;Kim, Young-kyun
    • The Journal of Internal Korean Medicine
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    • v.37 no.2
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    • pp.322-329
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    • 2016
  • Objective: This study reports on one clinical case of type 3 spinocerebellar ataxia (SCA) to examine the effectiveness of herbal medicine and traditional Korean treatments.Methods: A patient with type 3 spinocerebellar ataxia was treated using traditional Korean medicine options such as acupuncture and Hyangsayukgunja-tang. The effects on type 3 spinocerebellar ataxia were measured using the numeric rating scale (NRS) and ambulatory status.Results: Improvements in NRS and ambulatory status were observed after treatment.Conclusion: According to this study, traditional Korean medicine may be effective in the treatment of type 3 spinocerebellar ataxia.

A Case of Spinocerebellar Ataxia Type 2 with Slowed Saccades (느린 홱보기를 동반한 척수소뇌실조 2형 1예)

  • Nam, Jungmoo;Kim, Byung-Kun;Koo, Ja-Seong;Park, Jongmoo;Lee, JungJu;Kwon, Ohyun
    • Annals of Clinical Neurophysiology
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    • v.9 no.2
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    • pp.102-104
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    • 2007
  • Spinocerebellar ataxia type 2 (SCA2) is characterized by progressive cerebellar ataxia and slow saccades. A 40-year-old woman presented with progressive gait disturbance and ataxia over 15 years. Neurologic examination revealed scanning speech, ataxia, and hyporeflexia. Brain CT showed diffuse atrophy of the cerebellum. Electronystagmography demonstrated slowed saccades with normal accuracy and delayed latency. The diagnosis of SCA2 was confirmed by the genetic test. Documentation of slow saccades may help differentiation among SCA subgroups.

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A Case Report on Spinocerebellar Ataxia Type 2 (제2형 척수소뇌실조 환자 치험 1례)

  • An, Da-young;Han, Seung-hee;Nam, Hyun-seo;Han, Su-zy;Kim, Mi-kyung;Sun, Seung-ho
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.784-792
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    • 2021
  • Objectives: The purpose of this study was to investigate a case of a patient with spinocerebellar ataxia (SCA) type 2 whose condition improved following treatment with Korean medicine. Methods: A 25-year-old man, diagnosed with SCA type 2, was treated with herbal medicine (Yukmijiwhang-tang-gami), acupuncture, and physical treatment. The therapeutic effect was evaluated using the Berg Balance Scale (BBS) and gait status. Results: Following treatment, the BBS score increased, and gait ataxia improved. Conclusions: This case study suggests that Korean medicine could be effective for relieving symptoms of SCA type 2.

Molecular Pathogenesis of Spinocerebellar Ataxia Type 1 Disease

  • Kang, Seongman;Hong, Sunghoi
    • Molecules and Cells
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    • v.27 no.6
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    • pp.621-627
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    • 2009
  • Spinocerebellar ataxia type 1 (SCA1) is an autosomal-dominant neurodegenerative disorder characterized by ataxia and progressive motor deterioration. SCA1 is associated with an elongated polyglutamine tract in ataxin-1, the SCA1 gene product. As summarized in this review, recent studies have clarified the molecular mechanisms of SCA1 pathogenesis and provided direction for future therapeutic approaches. The nucleus is the subcellular site where misfolded mutant ataxin-1 acts to cause SCA1 disease in the cerebellum. The role of these nuclear aggregates is the subject of intensive study. Additional proteins have been identified, whose conformational alterations occurring through interactions with the polyglutamine tract itself or non-polyglutamine regions in ataxin-1 are the cause of SCA-1 cytotoxicity. Therapeutic hope comes from the observations concerning the reduction of nuclear aggregation and alleviation of the pathogenic phenotype by the application of potent inhibitors and RNA interference.

Case report on Spinpcerebellar Ataxia(SCA) with cerebellar vermis artophy (Cerebellar vermis atrophy로 인한 Spinocerebellar Ataxia환자(患者) 치험(治驗) 1례(1例) 보고(報告))

  • Cho Hyun-Yeul;Bae Eun-Jeong;Lee Kyung-Min;Soe Jung-Chul;Han Sang-Won
    • Korean Journal of Acupuncture
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    • v.19 no.2
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    • pp.79-85
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    • 2002
  • Objective : In 1983 Autosomal dominent spinocerebellar ataxia(ADCA) has been classified to four types by a useful clinical features according to Harding. Since 1993 ADCA referred to as SCA by molecular genetic characteristics. We focused on the improvement of clinical symptoms in SCA patient through oriental medical treatment. Methods & Results : The assessment included neurophysiological examination and clinical symptoms. For example slow saccade, gaze limitation, upward and lateral, nystagmus, truncal and gait ataxia. The patient(M/30) was clinically charaterized by ocular abnormalities, trunkal and gait ataxia and the MRI showed atrophy of cerebellar vermis. The patient was taken both common acupuncture and Dong-Si venepuncture on Hwasan with herbal medicine. Before the treatment Rt. ocular movement were slowed and a significant eye fixation was observed always in abduction and intermittently presented trunkal and gait ataxia. During the treatment trunkal and gait ataxia has not been presented and ocular obnomalities changed to normal state. This case suggests the possibility of oriental medical treatment on SCA but further observation is needed on this patient.

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Spinocerebellar ataxia 7 (SCA7) (척수소뇌성 운동실조증 제7형)

  • Seon-Yong, Jeong;Seok-Hun, Jang;Hyon-J., Kim
    • Journal of Genetic Medicine
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    • v.4 no.1
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    • pp.22-37
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    • 2007
  • The autosomal dominant spinocerebellar ataxias (SCAs) are a group of neurodegenerative diseases, clinically and genetically heterogeneous, characterized by degeneration of spinocerebellar pathways with variable involvement of other neural systems. At present, 27 distinct genetic forms of SCAs are known: SCA1-8, SCA10-21, SCA23, SCA25-28, DRPLA (dentatorubral-pallidoluysian atrophy), and 16q-liked ADCA (autosomal dominant cerebellar ataxia). Epidemiological data about the prevalence of SCAs are restricted to a few studies of isolated geographical regions, and most do not reflect the real occurrence of the disease. In general a prevalence of about 0.3-2 cases per 100,000 people is assumed. As SCA are highly heterogeneous, the prevalence of specific subtypes varies between different ethnic and continental populations. Most recent data suggest that SCA3 is the commonest subtype worldwide; SCA1, SCA2, SCA6, SCA7, and SCA8 have a prevalence of over 2%, and the remaining SCAs are thought to be rare (prevalence <1%). In this review, we highlight and discuss the SCA7. The hallmark of SCA7 is the association of hereditary ataxia and visual loss caused by pigmentary macular degeneration. Visual failure is progressive, bilateral and symmetrical, and leads irreversibly to blindness. This association represents a distinct disease entity classified as autosomal dominant cerebellar ataxia (ADCA) type II by Harding. The disease affectsprimarily the cerebellum and the retina by the moderate to severe neuronal loss and gliosis, but also many other central nervous system structures as the disease progresses. SCA7 is caused by expansion of an unstable trinucleotide CAG repeat in the ATXN7 gene encoding a polyglutamine (polyQ) tract in the corresponding protein, ataxin-7. Normal ATXN7 alleles contain 4-35 CAG repeats, whereas pathological alleles contain from 36->450 CAG repeats. Immunoblott analysis demonstrated that ataxin-7 is widely expressed but that expression levels vary among tissues. Instability of expanded repeats is more pronounced in SCA7 than in other SCA subtypes and can cause substantial lowering of age at onset in successive generations termed ‘anticipation’ so that children may become diseased even before their parents develop symptoms. The strong anticipation in SCA7 and the rarity of contractions should have led to its extinction within a few generations. There is no specific drug therapy for this neurodegenerative disorder. Currently, therapy remains purely symptomatic. Cellular models and SCA7 transgenic mice have been generated which constitute valuable resources for studying the disease mechanism. Understanding the pathogenetic mechanisms of neurodegeneration in SCAs should lead to the identification of potential therapeutic targets and ultimately facilitate drug discovery. Here we summarize the clinical, pathological, and genetic aspects of SCA7, and review the current understanding of the pathogenesis of this disorder. Further, we also review the potential therapeutic strategies that are currently being explored in polyglutamine diseases.

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Distribution of five common subtypes of spinocerebellar ataxia in the Korean population

  • Choi, In-Hee;Kim, Gu-Hwan;Lee, Beom-Hee;Choi, Jin-Ho;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • v.11 no.2
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    • pp.69-73
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    • 2014
  • Purpose: Spinocerebellar ataxia (SCA) is a genetically heterogeneous disease for which more than 30 subtypes have been identified. However, 5 subtypes, SCA1, SCA2, SCA3, SCA6, and SCA7, account for more than 60% of cases. In this study, we report the distribution of these 5 subtypes in Korean patients. Materials and Methods: Six hundred and thirty-eight unrelated patients with a presumptive diagnosis of SCA were included in this study. Trinucleotide (CAG) repeat number (TNR) repeat number was determined using fluorescently labeled primers and fragment analysis. Results: A total of 128 unrelated patients (20.1% of all individuals tested) tested positive for SCA subtypes, including SCA1 (5 patients, 3.9% of those testing positive), SCA2 (38 patients, 29.7%), SCA3 (30 patients, 23.4%), SCA6 (39 patients, 30.5%), and SCA7 (16 patients, 12.5%). The mean copy number of pathogenic TNR alleles was $45{\pm}8.5$ for SCA1, $42{\pm}3.1$ for SCA2, $72{\pm}5.4$ for SCA3, $23{\pm}1.5$ for SCA6, and $50{\pm}11.4$ for SCA7. TNR copy number was inversely correlated with onset age in SCA2, SCA6, and SCA7. Conclusion: SCA2, SCA3, and SCA6 are common SCA subtypes in Korean patients and could be screened as a first-line test. Expanded pathogenic allele size was associated with early onset age.

Analysis of trinucleotide repetitive sequences for Korean patients with spinocerebellar ataxia types 8, 12, and 17

  • Kim, Gu-Hwan;Chung, Sun Ju;Ryu, Ho-Sung;Kim, Jaemin;Lee, Jin-Joo;Choi, Seoung Hoon;Lee, Juyeon;Lee, Beom Hee;Choi, Jin-Ho;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • v.12 no.1
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    • pp.38-43
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    • 2015
  • Purpose: Spinocerebellar ataxias (SCAs) are progressive neurodegenerative disorders with diverse modes of inheritance. There are several subtypes of SCAs. SCA 8, SCA 12, and SCA 17 are the less common forms of SCAs with limited information available on their epidemiological profiles in Korea. The purpose of this study was to investigate the prevalence of SCA8, SCA12, and SCA17 in Korea. Materials and Methods: Ninety-six unrelated Korean patients were enrolled and showed normal trinucleotide repeats through polymerase-chain reaction (PCR) for the genes ATXN1, ATXN2, ATXN3, CACNA1A, and ATXN7, which correspond to SCA1, SCA2, SCA3, SCA6, and SCA7, respectively. PCR products from patients were further analyzed by capillary electrophoresis using fluorescence labeled primers for the genes ATXN8OS, PPP2R2B, and TBP, which correspond to SCA8, SCA12, and SCA17. Results: Three patients had 104, 97, and 75 abnormal expanded repeats in the ATXN8OS gene, the causative gene for SCA8. None of the patients exhibited abnormal repeats in SCA12 and SCA17. Normal trinucleotide repeat ranges of the cohort in this study were estimated to be 17-34 copies (average, $24{\pm}4copies$) for SCA8, 7-18 copies (average, $13{\pm}3copies$) for SCA12, and 26-43 copies (average, $35{\pm}2copies$) for SCA17. Conclusion: This study demonstrated that SCA8, SCA12, and SCA17 are rare in Korean patients with SCA, and further genetic studies are warranted to enhance the mutation detection rate in the Korean SCA population.

Expression of Expanded Polyglutamine Disease Proteins in Drosophila (Drosophila Polyglutamine Disease Models) (증가된 글루타민에 의해 초래되는 뇌신경질환의 초파리 모델에 대한 연구)

  • Shin, Sang Min;Paik, Kyung Hoon;Jin, Dong Kyu
    • Clinical and Experimental Pediatrics
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    • v.48 no.4
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    • pp.425-432
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    • 2005
  • Purpose : Polyglutamine diseases are a group of diseases caused by the expansion of a polyglutamine tract in the protein. The present study was performed to verify if polyglutamine disease transgenic Drosophila models show similar dysfunctions as are seen in human patients. Methods : Polyglutamine disease transgenic Drosophila were tested for their climbing ability. And using genetic methods, the effects of anti-apoptotic gene bcl-2 and chemical chaperones on neurodegeneration were observed. Also, spinocerebellar ataxia 2 (SCA2) transgenic Drosophila lines were generated for future studies. Results : Expanded forms of spinocerebellar ataxia 3 (SCA3) transgenic protein causes characteristic locomotor dysfunction when expressed in the nervous system of Drosophila but the anti-apoptotic gene bcl-2 shows no evidence of ameliorating the deleterious effect of the expanded protein. However, Glycerol, a chemical chaperone, seemed to reduce the toxicity, at least in the eyes of the transgenic flies. The level SCA2 expression is too weak in the transgenic SCA2 Drosophila for evaluation. Conclusion : SCA3 transgenic Drosophila show ataxic behavior as observed in human patients. Chemical chaperones such as glycerol may prove beneficial in this class of genetic disease, which has no current method of cure.

Clinical Case Report of Spinocerebellar Ataxia Type 1 (제 1형 척수소뇌실조 환자의 증례보고)

  • Sun, Yung Chen;Jung, Woo Seok;Moon, Byung Soon;Yun, Jong Min
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.6
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    • pp.842-846
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    • 2013
  • The purpose of this study was to report one clinical case of spinocerebellar ataxia(SCA) type 1 improved by herbal medicine and oriental medical treatment. As a treatment, Yukmijihwang-tang(Liuweidihuangtang)-gamibang, acupuncture, and moxa were tried upon the patient for 21 days in order to relieve the symptoms. In terms of observing the changes of symptoms, the progress of patient's condition was evaluated periodically by using the Korean-mini mental state examination(K-MMSE), Modified Barthel Index(MBI), Functional Independence Measure(FIM). In accordance with the observation under K-MMSE, MBI, FIM, the patient's symptoms had gradually improved throughout the treatment. Therefore, this report suggests that Yukmijihwang-tang(Liuweidihuangtang)-gamibang, acupuncture and moxa were probably effective in the treatment of SCA type 1.