• Annals of Clinical Neurophysiology
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• 제9권2호
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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.

• 대한한방내과학회지
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• 제37권2호
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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.

• 대한한방내과학회지
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• 제42권5호
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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.

• Korean Journal of Acupuncture
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• 제19권2호
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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.

• Journal of Genetic Medicine
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• 제11권2호
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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.

• Clinical and Experimental Pediatrics
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• 제48권4호
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• pp.425-432
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• 2005

목 적 : 폴리글루타민 질환은 해당 발현단백질의 연속되는 글루타민 아미노산 서열이 신장되기 때문에 일어나는 질환군이다. 현 연구는 폴리글루타민 질환 형질전환 초파리 모델들이 환자들 에서와 유사한 장애를 나타내는지 확인하기 위해 수행되었다. 방 법 : 폴리글루타민 질환 (SCA3) 형질전환 초파리를 대상으로 벽을 기어오르는 운동 능력을 검사하였다. 또한 유전학적인 방법을 통해서 아폽토시스를 억제하는 bcl-2 유전자와 화학적 샤페론이 뇌신경의 퇴행에 어떤 영향을 미치는지 확인하였으며 향후의 연구를 위해 척수소뇌 운동실조증 타입 2 (SCA2) 질환을 발현하는 형질전환 초파리를 생산하였다. 결 과 : SCA3 형질전환 초파리에서 신장된 폴리글루타민 배열을 지니는 질환성 초파리의 경우 신경계에서 해당 단백질을 발현하였을 경우 전형적인 운동 능력 상실을 나타냈다. 아폽토시스를 억제하는 유전자인 bcl-2를 함께 발현했을 경우, 신장된 단백질의 유독한 영향을 약화시키지 못했지만, 화학적 샤페론인글리세롤의 경우 적어도 눈에서의 유독한 영향은 억제하는 것으로 보인다. 본 연구진에 의해 개발된 SCA2 형질전환 초파리의 경우 유해 단백질의 발현 정도가 낮아서 정확한 분석이 어려웠다. 결 론 : SCA3 형질전환 초파리는 환자들에서 발견되는 운동실조증을 보였다. 글리세롤과 같은 화학적 샤페론이 현재 치료가 전무한 이 종류의 질환군의 치료에 효과적일 것으로 사료된다.

• Journal of Genetic Medicine
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• 제4권1호
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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.

• Journal of Genetic Medicine
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• 제12권1호
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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.

• 대한소아신경학회지
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• 제25권3호
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• pp.200-203
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• 2017

척수소뇌실조는 임상적으로 다양하게 나타나는 보통염색체 우성신경변성 (혹은 퇴행성) 질환군으로서, 소뇌의 들과 날의 경로를 분열시켜 소뇌 실조를 일으키는 것으로 알려져 있다. 전형적인 임상증상은 30에서 40대에 발현되기 시작하고, 보행실조, 불분명 발음, 시력 이상, 사지의 조화운동 불능, 안구 움직임 제한, 인지 장애 등 다양한 증상의 조합을 특징으로 한다. 본 증례의 환아에서는 exome sequencing을 통하여 SPTBN2 (p.Glu1251Gln)의 새로운 이형접합 돌연변이를 발견하였으며 이것이 SCA5의 원인으로 밝혀졌다. 증례의 환아는 3년 5개월 때 발달지연을 주소로 본원에 내원하였다. 발달지연을 평가하기 위해 베일리 발달 검사에서 모든 영역에서 현저한 지연이 확인되었다. 본원 내원 1년 전 시행한 뇌자기공명영상에서 백샐질형성장애와 약간의 소뇌 위축이 보였다. 잠재적인 유전질환을 의심하여 진단 목적으로 전체엑솜염기서열분석을 시행하였고 결과적으로 SPTBN2의 새로운 이형접합 돌연변이 (p.Glu1251Gln) 가 SCA5의 원인 돌연변이로 사료된다. 척수소뇌실조에서 유전자의 역할을 명확하게 규명하기 위해서는 전체엑솜염기서열 분석을 포함한 다양한 방법을 통한 유전자 연구가 필요할 것으로 사료된다.

• 대한한방소아과학회지
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• 제19권2호
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• pp.41-50
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• 2005

저자는 Brain MRI 상 Cerebellar atrophy로 인한 척수소뇌성 운동실조증으로 진단받은 6세 환아의 Ataxia, Dysarthria, 두부진전증(頭部振顫症), 안진(眼振) 등에 대해 한방적 치료 후 호전도가 있었기에 이에 증례보고(證例報告)하는 바이다. 특히 두진(頭振), 안진(眼振)과 같은 진전(振顫)질환과 실조증에 대하여 두침(頭鍼)시술이 유효성이 컸으며, 오지(五遲) 오연증(五軟證)에 대하여서 간(肝), 신정격(腎正格)과 육미지황탕(六味地黃湯)의 장기 투여가 효과가 있었다. 일반적인 SCA, ADCA가 청, 장년기 이후에 발생하고 유전적인 경향이 큰 것에 반해 재태(在胎)시 큰 이상없이 생후 특발적으로 발생한 척수 소뇌성 운동실조에 대하여서는 한방적으로 증례보고(證例報告) 된 바가 드문 실정으로 유, 소아의 이러한 질환에 대한 진일보된 연구과 함께 평가척도나 치료방법적인 면에서의 고찰(考察)이 더욱 필요하리라 사료된다.