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Record W4394601075 · doi:10.1212/wnl.0000000000206383

Adult-onset Leigh Syndrome: An analysis of the North American Mitochondrial Disease Consortium Database (P3-11.017)

2024· article· en· W4394601075 on OpenAlexaboutno aff
Emanuele Barca, Adam Kroopnick, Alexander Houck, Kiran T. Thakur, Rachelle Dugue, Zarazuela Zolkipli‐Cunningham, Marni J. Falk, Amy Goldstein, Matthew M. Demczko, Ralitza H. Gavrilova, Austin Larson, Johan Van Hove, Russell P. Saneto, Richard Buchsbaum, John L.P. Thompson, Michio Hirano

Bibliographic record

VenueNeurology · 2024
Typearticle
Languageen
FieldBiochemistry, Genetics and Molecular Biology
TopicMitochondrial Function and Pathology
Canadian institutionsnot available
Fundersnot available
KeywordsProbandMedicinePediatricsLeigh diseaseDiseaseMitochondrial diseaseAge of onsetPathologicalCohortPathologyMitochondrial DNAInternal medicineBiologyGeneticsGeneMutation

Abstract

fetched live from OpenAlex

OBJECTIVE: This analysis of Adult-Onset Leigh Syndrome (LS) patients from the North American Mitochondrial Disease Consortium (NAMDC) Registry aims to enhance clinical insights, improve diagnoses, and uncover potential modifiers. BACKGROUND: LS is a rare syndrome linked to defects in more than one hundred genes. Most LS patients develop subacute neurological deterioration or regression before age two years. The pathological and radiological hallmarks are the subacute necrotizing degeneration of basal ganglia, cerebellum, brainstem, and/or cervical spinal cord, frequently triggered by metabolic stress. A small group of patients develop central nervous system involvement later in life. DESIGN/METHODS: This retrospective study stemmed from a case of a twenty-five-year-old man with mild developmental delay and sensory-motor neuropathy admitted for worsening weakness. During his hospital stay, he developed a rapidly progressive encephalopathy and classic LS radiological findings. Intrigued by this observation, we interrogated the NAMDC registry to retrieve data from other adult-onset LS individuals. The registry contains demographic, manifestation, genetic, imaging, and biochemistry data from more than 2100 subjects enrolled from 17 centers in North America and Canada. RESULTS: We identified six subjects with onset of CNS manifestations after age 18. Most of the subjects had been involved of other organ systems preceding the CNS lesions. Four probands had pathogenic variants in nuclear-encoded mitochondria metabolism genes, one in mitochondrial DNA-encoded ATP synthase subunit gene, and one patient remained genetically undefined. The disease progression varied among the cohort, with probands harboring nuclear variants experiencing a slower course compared to the individual with a mitochondrial DNA defect, who suffered a rapid, progressive, and fatal deterioration. CONCLUSIONS: Dr. Barca has nothing to disclose. Dr. Kroopnick has nothing to disclose. Dr. Houck has nothing to disclose. Dr. Thakur has received personal compensation for serving as an employee of World Health Organization. Dr. Thakur has received personal compensation for serving as an employee of Pan American Health Organization. Dr. Thakur has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Delve Bio. The institution of Dr. Thakur has received research support from Center for Disease Control and Prevention. The institution of Dr. Thakur has received research support from National Institute of Health. Dr. Dugue has nothing to disclose. Dr. Zolkipli-Cunningham has nothing to disclose. An immediate family member of Marni Falk has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lumiere. Marni Falk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mission Therapeutics. Marni Falk has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Primera Therapeutics. Marni Falk has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Imel Therapeutics. Marni Falk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MiMo Therapeutics. Marni Falk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GenoMind. Marni Falk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Autobahn. Marni Falk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Casma Therapeutics. Marni Falk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mayflower, Inc.. Marni Falk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Precision Biosciences. Marni Falk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Foresite Labs. Marni Falk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Stealth BioTherapeutics. Marni Falk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Taysha Gene Therapies. Marni Falk has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Larimar Therapeutics. Marni Falk has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Khondrion. Marni Falk has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for United MItochondrial Disease Foundation. Marni Falk has stock in Rarefy Therapeutics. Marni Falk has stock in RiboNova Inc. The institution of Marni Falk has received research support from Merck. The institution of Marni Falk has received research support from Saol Therapeutics. The institution of Marni Falk has received research support from Stealth Biotherapeutics. The institution of Marni Falk has received research support from Astellas. The institution of Marni Falk has received research support from UMDF. The institution of Marni Falk has received research support from CureARS Foundation. The institution of Marni Falk has received research support from Mission Therapeutics. The institution of Marni Falk has received research support from Cyclerion. The institution of Marni Falk has received research support from NIH. The institution of Marni Falk has received research support from DOD. The institution of Marni Falk has received research support from FDA. Marni Falk has received intellectual property interests from a discovery or technology relating to health care. Marni Falk has received publishing royalties from a publication relating to health care. Dr. Goldstein has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Reneo Pharmaceuticals . Dr. Demczko has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck Manuals. Dr. Gavrilova has nothing to disclose. Austin Larson has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Illumina. An immediate family member of Austin Larson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurocrine. An immediate family member of Austin Larson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ionis. Austin Larson has received personal compensation in the range of $0-$499 for serving as a Consultant for Tisento. Austin Larson has received personal compensation in the range of $0-$499 for serving as a Consultant for UCB. The institution of Austin Larson has received research support from Stealth Biotherapeutics. The institution of Austin Larson has received research support from Astellas. The institution of Austin Larson has received research support from Entrada. The institution of Austin Larson has received research support from Neuren. The institution of an immediate family member of Austin Larson has received research support from Neurocrine. Johan Van Hove has received intellectual property interests from a discovery or technology relating to health care. Dr. Saneto has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for REATA. Dr. Saneto has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for GW Pharmaceuticals. The institution of Dr. Saneto has received research support from NIH. The institution of Dr. Saneto has received research support from Zogenix. The institution of Dr. Saneto has received research support from GW Pharmaceuticals. The institution of Dr. Thompson has received research support from NIH. Dr. Hirano has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Modis Therapeutics (a subsidiary of Zogenix). Dr. Hirano has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Epirium Bio. Dr. Hirano has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Innovation Specialist. Dr. Hirano has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Platform Q Health. The institution of Dr. Hirano has received research support from Modis Therapeutics (a subsidiary of Zogenix). The institution of Dr. Hirano has received research support from Cyclerion. Dr. Hirano has received intellectual property interests from a discovery or technology relating to health care. Dr. Hirano has received personal compensation in the range of $0-$499 for serving as a Study Section Reviewer with NIH. Dr. Hirano has a non-compensated relationship as a Research Advisory Board member with Muscular Dystrophy Association that is relevant to AAN interests or activities. Dr. Hirano has a non-compensated relationship as a Scientific and Medical Advisory Board member with United Mitochondrial Disease Foundation that is relevant to AAN interests or activities. Dr. Hirano has a non-compensated relationship as a Scientific Advisory Board member with Barth Syndrome Foundation that is relevant to AAN interests or activities.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.002
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.023
Threshold uncertainty score0.046

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.002
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0020.004
Science and technology studies0.0000.000
Scholarly communication0.0010.000
Open science0.0000.001
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0020.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.009
GPT teacher head0.248
Teacher spread0.239 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations0
Published2024
Admission routes1
Has abstractyes

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