151. Consensus Paper: Pathological Mechanisms Underlying Neurodegeneration in Spinocerebellar Ataxias
- Author
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Olaf Riess, S Magri, Daniel R. Scoles, Jaime J. Schmidt, Alexis Brice, B R Underwood, Giovanni Stevanin, Antoni Matilla-Dueñas, Franco Taroni, Massimo Pandolfo, Karen N. McFarland, Thomas Schmidt, Ivelisse Sánchez, Tetsuo Ashizawa, David C. Rubinsztein, and Stefan M. Pulst
- Subjects
medicine.medical_specialty ,Neurology ,Ataxia ,Transcription, Genetic ,Calcium handling ,Biology ,Bioinformatics ,Ion Channels ,Article ,03 medical and health sciences ,0302 clinical medicine ,Autophagy ,medicine ,Animals ,Humans ,Spinocerebellar Ataxias ,Pathological ,030304 developmental biology ,0303 health sciences ,Neurodegeneration ,medicine.disease ,Phenotype ,Mitochondria ,3. Good health ,Nerve Degeneration ,Spinocerebellar ataxia ,RNA ,Neurology (clinical) ,medicine.symptom ,Neuroscience ,030217 neurology & neurosurgery - Abstract
Intensive scientific research devoted in the recent years to understand the molecular mechanisms or neurodegeneration in spinocerebellar ataxias (SCAs) are identifying new pathways and targets providing new insights and a better understanding of the molecular pathogenesis in these diseases. In this consensus manuscript, the authors discuss their current views on the identified molecular processes causing or modulating the neurodegenerative phenotype in spinocerebellar ataxias with the common opinion of translating the new knowledge acquired into candidate targets for therapy. The following topics are discussed: transcription dysregulation, protein aggregation, autophagy, ion channels, the role of mitochondria, RNA toxicity, modulators of neurodegeneration and current therapeutic approaches. Overall point of consensus includes the common vision of neurodegeneration in SCAs as a multifactorial, progressive and reversible process, at least in early stages. Specific points of consensus include the role of the dysregulation of protein folding, transcription, bioenergetics, calcium handling and eventual cell death with apoptotic features of neurons during SCA disease progression. Unresolved questions include how the dysregulation of these pathways triggers the onset of symptoms and mediates disease progression since this understanding may allow effective treatments of SCAs within the window of reversibility to prevent early neuronal damage. Common opinions also include the need for clinical detection of early neuronal dysfunction, for more basic research to decipher the early neurodegenerative process in SCAs in order to give rise to new concepts for treatment strategies and for the translation of the results to preclinical studies and, thereafter, in clinical practice.
- Published
- 2013