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    Reversible vestibular neuropathy in adult Refsum disease.
    Neurology 2018 Apr 6. Epub 2018 Apr 6.
    From the Institute of Clinical Neurosciences (R.L.T., S.K.J., A.S.Y., G.M.H., M.S.W.) and Department of Clinical Biochemistry (D.S.), Royal Prince Alfred Hospital, and Faculty of Medicine (D.S.), Central Clinical School, University of Sydney; and The Balance Clinic and Laboratory (A.S.Y., M.S.W.), Sydney, Australia.

    Histologic and ultrastructural features in early and advanced phases of Zellweger spectrum disorder (infantile Refsum disease).
    Ultrastruct Pathol 2018 Feb 26:1-8. Epub 2018 Feb 26.
    c Genetics Division, Department of Pediatrics, Keck School of Medicine , University of Southern California , Los Angeles , California , USA.
    Zellweger spectrum disorders (ZSD) are rare autosomal recessive inherited metabolic disorders and include severe (Zellweger syndrome) and milder phenotypes [neonatal adrenoleukodystrophy and infantile Refsum disease (IRD)]. ZSD are characterized by impaired peroxisomal functions and lack of peroxisomes detected by electron microscopy (EM). ZSD are caused by mutations in any of the 14 PEX genes. Read More

    Homocysteine and Dementia: An International Consensus Statement.
    J Alzheimers Dis 2018 ;62(2):561-570
    Department of Clinical Chemistry and Laboratory Medicine, University Hospital of the Saarland, Germany.
    Identification of modifiable risk factors provides a crucial approach to the prevention of dementia. Nutritional or nutrient-dependent risk factors are especially important because dietary modifications or use of dietary supplements may lower the risk factor level. One such risk factor is a raised concentration of the biomarker plasma total homocysteine, which reflects the functional status of three B vitamins (folate, vitamins B12, B6). Read More

    Living-donor liver transplantation for mild Zellweger spectrum disorder: Up to 17 years follow-up.
    Pediatr Transplant 2018 May 16;22(3):e13112. Epub 2018 Feb 16.
    Service de Gastro-Entérologie et Hépatologie Pédiatrique, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
    Mild Zellweger spectrum disorder, also described as Infantile Refsum disease, is attributable to mutations in PEX genes. Its clinical course is characterized by progressive hearing and vision loss, and neurodevelopmental regression. Supportive management is currently considered the standard of care, as no treatment has shown clinical benefits. Read More

    Lipidomic Analysis: From Archaea to Mammals.
    Lipids 2018 Jan 15;53(1):5-25. Epub 2018 Feb 15.
    Institute of Microbiology, Academy of Sciences of the Czech Republic, Vídeňská 1083, Prague, 142 20, Czech Republic.
    Lipids are among the most important organic compounds found in all living cells, from primitive archaebacteria to flowering plants or mammalian cells. They form part of cell walls and constitute cell storage material. Their biosynthesis and metabolism play key roles in faraway topics such as biofuel production (third-generation biofuels produced by microorganisms, e. Read More

    Syndromic Hearing Loss: A Brief Review of Common Presentations and Genetics.
    J Pediatr Genet 2018 Mar 4;7(1):1-8. Epub 2018 Jan 4.
    Department of Otolaryngology - Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, United States.
    Congenital hearing loss is one of the most common birth defects worldwide, with around 1 in 500 people experiencing some form of severe hearing loss. While over 400 different syndromes involving hearing loss have been described, it is important to be familiar with a wide range of syndromes involving hearing loss so an early diagnosis can be made and early intervention can be pursued to maximize functional hearing and speech-language development in the setting of verbal communication. This review aims to describe the presentation and genetics for some of the most frequently occurring syndromes involving hearing loss, including neurofibromatosis type 2, branchio-oto-renal syndrome, Treacher Collins syndrome, Stickler syndrome, Waardenburg syndrome, Pendred syndrome, Jervell and Lange-Nielsen syndrome, Usher syndromes, Refsum disease, Alport syndrome, MELAS, and MERRF. Read More

    Cataract surgery outcomes and complications in retinal dystrophy patients.
    Can J Ophthalmol 2017 Dec 22;52(6):543-547. Epub 2017 Jul 22.
    Cornea and Refractive Surgery Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA.
    Objective: To investigate intraoperative complications, postoperative findings, and visual acuity outcomes in patients with retinal dystrophy after cataract surgery.

    Design: Retrospective chart review at an academic tertiary referral centre.

    Participants: Thirty eyes from 18 patients with retinitis pigmentosa and other retinal dystrophies (Usher syndrome, Refsum disease, and Leber congenital amaurosis) who underwent cataract surgery were identified by searching the electronic medical record system from January 2010 to September 2015 for all patients treated by a single physician with billing codes for retinal dystrophy and cataract surgery. Read More

    The relation of CUN-BAE index and BMI with body fat, cardiovascular events and diabetes during a 6-year follow-up: the Hordaland Health Study.
    Clin Epidemiol 2017 8;9:555-566. Epub 2017 Nov 8.
    Department of Pharmacology, University of Oxford, Oxford, UK.
    Objective: We compared Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) and body mass index (BMI) as correlates of body fat percent (BF%) and the association with future risk of cardiovascular disease (CVD) and type 2 diabetes in a Caucasian population.

    Methods: We used data from 6796 individuals (born 1925-27 and 1950-52) from the Hordaland Health Study, a prospective cohort study in Norway. The study was conducted in 1992-1993 and 1997-1999. Read More

    Phytyl fatty acid esters in vegetables pose a risk for patients suffering from Refsum's disease.
    PLoS One 2017 13;12(11):e0188035. Epub 2017 Nov 13.
    Institute of Food Chemistry, University of Hohenheim, Stuttgart, Germany.
    Patients suffering from Refsum's disease show mutations in the enzyme necessary for the degradation of phytanic acid. Accumulation of this tetramethyl-branched fatty acid in inner organs leads to severe neurological and cardiac dysfunctions which can even result in death. Thus, patients with Refsum's disease have to follow a specific diet resigning foods with high levels of phytanic acid and trans-phytol like products from ruminant animals with a tolerable daily intake (TDI) of ≤ 10 mg/d. Read More

    Kynurenine Pathway Metabolites in Alzheimer's Disease.
    J Alzheimers Dis 2017 ;60(2):495-504
    Department of Clinical Science, University of Bergen, Norway.
    Background: Metabolites of tryptophan, produced via the kynurenine pathway (kynurenines), have been linked to Alzheimer's disease (AD) in small cohorts with conflicting results.

    Objective: To compare differences in plasma kynurenine levels between AD and controls and identify potential associations with cognition.

    Methods: The study included 65 histopathologically-confirmed AD patients and 65 cognitively-screened controls from the Oxford Project to Investigate Memory and Ageing (OPTIMA) cohort. Read More

    Cardiovascular disease risk associated with serum apolipoprotein B is modified by serum vitamin A.
    Atherosclerosis 2017 Oct 21;265:325-330. Epub 2017 Jul 21.
    Department of Heart Disease, Haukeland University Hospital, 5021 Bergen, Norway; KG Jebsen Centre for Diabetes Research, University of Bergen, 5009 Bergen, Norway; Department of Clinical Science, Faculty of Medicine, University of Bergen, 5021 Bergen, Norway.
    Background And Aims: Apolipoproteins B (apoB) and A1 (apoA1) are major protein constituents of low-density and high-density lipoproteins, respectively, and serum concentrations of these apolipoproteins are associated with risk of atherosclerosis. Vitamin A (VA) has been implicated in lipoprotein metabolism. We evaluated the associations of serum apoB, apoA1 and their ratio (apoBAR) with risk of incident acute myocardial infarction (AMI) and the possible modification by serum VA. Read More

    Cochlear Implantation in Siblings With Refsum's Disease.
    Ann Otol Rhinol Laryngol 2017 Aug 6;126(8):611-614. Epub 2017 Jul 6.
    1 Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, Essen, Germany.
    Objectives: Whether the origin of severe hearing loss in Refsum's syndrome is caused by cochlear impairment or retrocochlear degeneration remains unclear. This case report aims to investigate hearing performance before and after cochlear implantation to shed light on this question. Also, identification of new mutations causing Refsum's syndrome would be helpful in generating additional means of diagnosis. Read More

    Phytol-induced pathology in 2-hydroxyacyl-CoA lyase (HACL1) deficient mice. Evidence for a second non-HACL1-related lyase.
    Biochim Biophys Acta 2017 09 17;1862(9):972-990. Epub 2017 Jun 17.
    LIPIT, Department of Cellular and Molecular Medicine, KU Leuven, Belgium. Electronic address:
    2-Hydroxyacyl-CoA lyase (HACL1) is a key enzyme of the peroxisomal α-oxidation of phytanic acid. To better understand its role in health and disease, a mouse model lacking HACL1 was investigated. Under normal conditions, these mice did not display a particular phenotype. Read More

    Identification and diagnostic value of phytanoyl- and pristanoyl-carnitine in plasma from patients with peroxisomal disorders.
    Mol Genet Metab 2017 Jul 6;121(3):279-282. Epub 2017 May 6.
    Laboratory Genetic Metabolic Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, 1105, AZ, The Netherlands.
    Phytanic acid is a branched-chain fatty acid, the level of which is elevated in patients with a variety of peroxisomal disorders, including Refsum disease, and Rhizomelic chondrodysplasia punctata type 1 and 5. Elevated levels of both phytanic and pristanic acid are found in patients with Zellweger Spectrum Disorders, and pristanic acid is elevated in patients with α-methylacyl-CoA racemase deficiency. For the diagnosis of peroxisomal disorders, a variety of metabolites can be measured in blood samples from suspected patients, including very long-chain fatty acids, phytanic and pristanic acid. Read More

    Clinical and Laboratory Diagnosis of Peroxisomal Disorders.
    Methods Mol Biol 2017 ;1595:329-342
    Department Paediatric Neurology, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, AZ, 1105, The Netherlands.
    The peroxisomal disorders (PDs) are a heterogeneous group of genetic diseases in man caused by an impairment in peroxisome biogenesis or one of the metabolic functions of peroxisomes. Thanks to the revolutionary technical developments in gene sequencing methods and their increased use in patient diagnosis, the field of genetic diseases in general and peroxisomal disorders in particular has dramatically changed in the last few years. Indeed, several novel peroxisomal disorders have been identified recently and in addition it has been realized that the phenotypic spectrum of patients affected by a PD keeps widening, which makes clinical recognition of peroxisomal patients increasingly difficult. Read More

    HMSN Lom in 12 Czech patients, with one unusual case due to uniparental isodisomy of chromosome 8.
    J Hum Genet 2017 Mar 22;62(3):431-435. Epub 2016 Dec 22.
    Department of Paediatric Neurology, DNA Laboratory, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic.
    Hereditary motor and sensory neuropathy-type Lom (HMSNL), also known as CMT4D, a demyelinating neuropathy with late-onset deafness is an autosomal recessive disorder threatening Roma population worldwide. The clinical phenotype was reported in several case reports before the gene discovery. HMSNL is caused by a homozygous founder mutation p. Read More

    A novel NDRG1 mutation in a non-Romani patient with CMT4D/HMSN-Lom.
    J Peripher Nerv Syst 2017 Mar;22(1):47-50
    Unit of Rare Neurological Diseases of Adulthood, Department of Clinical Neurosciences, IRCCS Foundation, "C. Besta" Neurological Institute, Milan, Italy.
    Charcot-Marie-Tooth disease type 4D (CMT4D), also known as hereditary motor and sensory neuropathy Lom type (HMSNL), is an autosomal recessive, early onset, severe demyelinating neuropathy with hearing loss, caused by N-Myc downstream-regulated gene 1 (NDRG1) mutations. CMT4D is rare with only three known mutations, one of which (p.Arg148Ter) is found in patients of Romani ancestry and accounts for the vast majority of cases. Read More

    Phytanic acid consumption and human health, risks, benefits and future trends: A review.
    Food Chem 2017 Apr 18;221:237-247. Epub 2016 Oct 18.
    Departamento de Quimica Analitica, Nutricion y Bromatologia, Facultad de Veterinaria, Universidade de Santiago de Compostela, Pabellón 4, Planta Baja, 27002 Lugo, Spain.
    Phytanic acid is a methyl-branched fatty acid present in the human diet, derived from the enzymatic degradation of phytol and subsequently oxidized by the rumenal microbiota and certain marine organisms. Consequently, phytanic acid is carried into the human body by means of food ingestion, mostly via red meat, dairy products and fatty marine foods. This fatty acid accumulates in people with some peroxisomal disorders and is traditionally related to neurological damage. Read More

    Phytanic acid attenuates insulin-like growth factor-1 activity via nitric oxide-mediated γ-secretase activation in rat aortic smooth muscle cells: possible implications for pathogenesis of infantile Refsum disease.
    Pediatr Res 2017 Mar 25;81(3):531-536. Epub 2016 Nov 25.
    Department of Pharmacology and Toxicology, Faculty of Medicine, Kuwait University, Kuwait.
    Background: Infantile Refsum disease (IRD), a peroxisomal disease with defective phytanic acid oxidation, causes neurological impairment and development delay. Insulin-like growth factor-1 (IGF-1) regulates child development and to understand molecular mechanism(s) of IRD, we examined the effect of phytanic acid (PA) on IGF-1 activity.

    Methods: Bromodeoxyuridine (BrdU) incorporation was measured in rat aortic smooth muscle cell (SMC) cultures following treatment with fetal bovine serum (FBS), basic fibroblast growth factor (bFGF), platelet-derived growth factor (PDGF) or IGF-1 in the absence or presence of PA. Read More

    Lipid profiles in schizophrenia associated with clinical traits: a five year follow-up study.
    BMC Psychiatry 2016 08 25;16:299. Epub 2016 Aug 25.
    NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
    Background: Alterations in serum and membrane lipids may be involved in schizophrenia pathophysiology. It is not known whether lipid profiles are associated with disease severity or current symptom level.

    Methods: Clinical and lipid data were gathered from 55 patients with schizophrenia admitted to psychiatric emergency wards in an acute stage of the disease (T1). Read More

    Understanding the Relationship Between Teacher Behavior and Motivation in Students with Acquired Deafblindness.
    Am Ann Deaf 2016 ;161(3):314-26
    Because little is known about teacher-student relationships that involve students with acquired deafblindness, the authors performed a multiple case study with a multiple-method design to investigate the relationship between need-supportive teaching behaviors and student engagement. Using self-determination theory (Deci & Ryan, 2000), they analyzed video observations of interactions. It was found that teachers' provision of structure, autonomy support, and involvement often cooccurs with higher levels of student engagement. Read More

    Keys to overcoming the challenge of diagnosing autosomal recessive spinocerebellar ataxia.
    Neurologia 2016 Jul 23. Epub 2016 Jul 23.
    Servicio de Neurología, Complexo Hospitalario Universitario, Santiago de Compostela, España. Electronic address:
    Introduction: Autosomal recessive spinocerebellar ataxia refers to a large group of diseases affecting the cerebellum and/or its connections, although they may also involve other regions of the nervous system. These diseases are accompanied by a wide range of systemic manifestations (cardiopathies, endocrinopathies, skeletal deformities, and skin abnormalities).

    Development: This study reviews current knowledge of the most common forms of autosomal recessive spinocerebellar ataxia in order to provide tips that may facilitate diagnosis. Read More

    Homocysteine, B Vitamins, and Cognitive Impairment.
    Annu Rev Nutr 2016 07;36:211-39
    OPTIMA, Department of Pharmacology, University of Oxford, Oxford OX1 3QT, United Kingdom; email:
    Moderately elevated plasma total homocysteine (tHcy) is a strong modifiable risk factor for vascular dementia and Alzheimer's disease. Prospectively, elevated tHcy is associated with cognitive decline, white matter damage, brain atrophy, neurofibrillary tangles, and dementia. Most homocysteine-lowering trials with folate and vitamins B6 and/or B12 tested as protective agents against cognitive decline were poorly designed by including subjects unlikely to benefit during the trial period. Read More

    Phytanic acid activates NADPH oxidase through transactivation of epidermal growth factor receptor in vascular smooth muscle cells.
    Lipids Health Dis 2016 Jun 10;15:105. Epub 2016 Jun 10.
    Pharmacology and Toxicology, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
    Background: Phytanic acid (PA) has been implicated in development of cancer and its defective metabolism is known to cause life-threatening conditions, such as Refsum disease, in children. To explore molecular mechanisms of phytanic acid-induced cellular pathology, we investigated its effect on NADPH oxidase (NOX) and epidermal growth factor receptor (EGFR) in rat aortic smooth muscle cells (RASMC).

    Methods: Smooth muscle cells were isolated from rat aortae using enzymic digestion with collagenase and elastase. Read More

    Living-Donor Liver Transplantation From a Heterozygous Parent for Infantile Refsum Disease.
    Pediatrics 2016 Jun;137(6)
    Organ Transplantation Center, and.
    Infantile Refsum disease (IRD) is a rare autosomal recessive disorder of peroxisome biogenesis characterized by generalized peroxisomal metabolic dysfunction, including accumulation of very long-chain fatty acids (VLCFAs) and phytanic acid (PA), as well as decreased plasmalogen contents (PL). An effective therapy for this intractable disease has not been established, and only supportive management with docosahexaenoic acid supplementation and low PA diet has been reported so far. A boy of 3 years and 8 months presented with facial dysmorphism, transaminitis, and psychomotor retardation. Read More

    Association of Vitamin B12, Folate, and Sulfur Amino Acids With Brain Magnetic Resonance Imaging Measures in Older Adults: A Longitudinal Population-Based Study.
    JAMA Psychiatry 2016 Jun;73(6):606-13
    Center for Alzheimer Research-Aging Research Center, Karolinska Institutet, Stockholm University, Stockholm, Sweden.
    Importance: Vitamin B12, folate, and sulfur amino acids may be modifiable risk factors for structural brain changes that precede clinical dementia.

    Objective: To investigate the association of circulating levels of vitamin B12, red blood cell folate, and sulfur amino acids with the rate of total brain volume loss and the change in white matter hyperintensity volume as measured by fluid-attenuated inversion recovery in older adults.

    Design, Setting, And Participants: The magnetic resonance imaging subsample of the Swedish National Study on Aging and Care in Kungsholmen, a population-based longitudinal study in Stockholm, Sweden, was conducted in 501 participants aged 60 years or older who were free of dementia at baseline. Read More

    Brain Lipotoxicity of Phytanic Acid and Very Long-chain Fatty Acids. Harmful Cellular/Mitochondrial Activities in Refsum Disease and X-Linked Adrenoleukodystrophy.
    Aging Dis 2016 Mar 15;7(2):136-49. Epub 2016 Mar 15.
    Institut für Neurobiochemie (Institut für Inflammation und Neurodegeneration), Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg, Magdeburg, Germany.
    It is increasingly understood that in the aging brain, especially in the case of patients suffering from neurodegenerative diseases, some fatty acids at pathologically high concentrations exert detrimental activities. To study such activities, we here analyze genetic diseases, which are due to compromised metabolism of specific fatty acids, either the branched-chain phytanic acid or very long-chain fatty acids (VLCFAs). Micromolar concentrations of phytanic acid or of VLCFAs disturb the integrity of neural cells by impairing Ca(2+) homeostasis, enhancing oxidative stress or de-energizing mitochondria. Read More

    Zellweger syndrome with severe malnutrition, immunocompromised state and opportunistic infections.
    BMJ Case Rep 2016 Apr 18;2016:10.1136/bcr-2015-214283. Epub 2016 Apr 18.
    Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
    Peroxisome biogenesis disorders are related to a spectrum of genetic diseases that range from severe Zellweger syndrome to milder infantile Refsum disease. Zellweger syndrome is characterised by dysmorphic features, severe hypotonia, seizures, failure to thrive, liver dysfunction and skeletal defects. Increased levels of very long chain fatty acids are the biochemical hallmark and the most common mutations found in the PEX1 gene. Read More

    Clinical and Biochemical Pitfalls in the Diagnosis of Peroxisomal Disorders.
    Neuropediatrics 2016 Aug 18;47(4):205-20. Epub 2016 Apr 18.
    Department of Pediatric Neurology, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
    Peroxisomal disorders are a heterogeneous group of genetic metabolic disorders, caused by a defect in peroxisome biogenesis or a deficiency of a single peroxisomal enzyme. The peroxisomal disorders include the Zellweger spectrum disorders, the rhizomelic chondrodysplasia punctata spectrum disorders, X-linked adrenoleukodystrophy, and multiple single enzyme deficiencies. There are several core phenotypes caused by peroxisomal dysfunction that clinicians can recognize. Read More

    Inherited ichthyosis: Syndromic forms.
    J Dermatol 2016 Mar;43(3):252-63
    Department of Dermatology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
    Among diseases that cause ichthyosis as one of the symptoms, there are some diseases that induce abnormalities in organs other than the skin. Of these, diseases with characteristic signs are regarded as syndromes. Although these syndromes are very rare, Netherton syndrome, Sjögren-Larsson syndrome, Conradi-Hünermann-Happle syndrome, Dorfman-Chanarin syndrome, ichthyosis follicularis, atrichia and photophobia (IFAP) syndrome, and Refsum syndrome have been described in texts as representative ones. Read More

    Ocular manifestations of genetic skin disorders.
    Clin Dermatol 2016 Mar-Apr;34(2):242-75. Epub 2015 Dec 2.
    The Vision Center, Children's Hospital Los Angeles; Department of Ophthalmology, Keck School of Medicine, University of Southern California, 4650 Sunset Blvd, MS #88, Los Angeles, CA, 90027.
    Genetic skin diseases, or genodermatoses, often have extracutaneous manifestations. Ocular manifestations in particular can have significant clinical implications, like blindness. Other manifestations, such as the corneal opacities that occur in X-linked ichthyosis, are asymptomatic but characteristic of a particular genodermatosis. Read More

    HSMNR belongs to the most frequent types of hereditary neuropathy in the Czech Republic and is twice more frequent than HMSNL.
    Clin Genet 2016 Aug 4;90(2):161-5. Epub 2016 Mar 4.
    DNA laboratory, Department of Paediatric Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic.
    Hereditary motor and sensory neuropathy type Russe (HMSNR), also called CMT4G, is an autosomal recessive inherited peripheral neuropathy (IPN) caused by a founder mutation in the HK1 gene. HMSNR affects only patients with Roma origin, similar to the better known HMSN type Lom clarified earlier. By testing IPN patients with Roma origin, we realized that HMSNR affects surprisingly many patients in the Czech Republic. Read More

    Safety of long-term restrictive diets for peroxisomal disorders: vitamin and trace element status of patients treated for Adult Refsum Disease.
    Int J Clin Pract 2016 Mar 22;70(3):229-35. Epub 2016 Jan 22.
    Adult Refsum Disease Clinic, Chelsea & Westminster Hospital, London, UK.
    Background: Adult Refsum's Disease (ARD) is caused by defects in the pathway for alpha-oxidation of phytanic acid (PA). Treatment involves restricting the dietary intake of phytanic acid by reducing the intake of dairy-derived fat. The adequacy of micronutrient intake in patients with ARD is unknown. Read More

    Omega-3 Fatty Acid Status Enhances the Prevention of Cognitive Decline by B Vitamins in Mild Cognitive Impairment.
    J Alzheimers Dis 2016 ;50(2):547-57
    Division of Geriatric Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
    A randomized trial (VITACOG) in people with mild cognitive impairment (MCI) found that B vitamin treatment to lower homocysteine slowed the rate of cognitive and clinical decline. We have used data from this trial to see whether baseline omega-3 fatty acid status interacts with the effects of B vitamin treatment. 266 participants with MCI aged ≥70 years were randomized to B vitamins (folic acid, vitamins B6 and B12) or placebo for 2 years. Read More

    Conventional and advanced MR imaging in infantile Refsum disease.
    Turk J Pediatr 2015 May-Jun;57(3):294-9
    Divisions of Pediatric Nutrition and Metabolism, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
    We report magnetic resonance (MR) imaging findings including diffusion-weighted imaging and proton MR spectroscopy findings in a patient with infantile Refsum disease. The initial diagnosis was made on the basis of history, clinical findings and biochemical studies. Bilateral and symmetrical involvement of the peritrigonal white matter, centrum semiovale, thalami, corpus callosum and corticospinal tracts as assessed by increased T2 signal was highly suggestive of a peroxisomal disorder. Read More

    Infantile Refsum Disease: Influence of Dietary Treatment on Plasma Phytanic Acid Levels.
    JIMD Rep 2016 25;26:53-60. Epub 2015 Aug 25.
    Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar/Universidade do Porto, Porto, Portugal.
    Infantile Refsum disease (IRD) is one of the less severe of Zellweger spectrum disorders (ZSDs), a group of peroxisomal biogenesis disorders resulting from a generalized peroxisomal function impairment. Increased plasma levels of very long chain fatty acids (VLCFA) and phytanic acid are biomarkers used in IRD diagnosis. Furthermore, an increased plasma level of phytanic acid is known to be associated with neurologic damage. Read More

    Phytol is lethal for Amacr-deficient mice.
    Biochim Biophys Acta 2015 Oct 4;1851(10):1394-405. Epub 2015 Aug 4.
    Faculty of Biochemistry and Molecular Medicine, University of Oulu, P.O. Box 5400, FI-90014, Finland; Biocenter Oulu, University of Oulu, Finland. Electronic address:
    α-Methylacyl-CoA racemase (Amacr) catalyzes the racemization of the 25-methyl group in C27-intermediates in bile acid synthesis and in methyl-branched fatty acids such as pristanic acid, a metabolite derived from phytol. Consequently, patients with Amacr deficiency accumulate C27-bile acid intermediates, pristanic and phytanic acid and display sensorimotor neuropathy, seizures and relapsing encephalopathy. In contrast to humans, Amacr-deficient mice are clinically symptomless on a standard laboratory diet, but failed to thrive when fed phytol-enriched chow. Read More

    Reactive nitrogen species mediate oxidative stress and astrogliosis provoked by in vivo administration of phytanic acid in cerebellum of adolescent rats: A potential contributing pathomechanism of cerebellar injury in peroxisomal disorders.
    Neuroscience 2015 Sep 15;304:122-32. Epub 2015 Jul 15.
    Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil. Electronic address:
    Phytanic acid (Phyt) accumulates in various peroxisomal diseases including Refsum disease (RD) and Zellweger syndrome (ZS). Since the pathogenesis of the neurological symptoms and especially the cerebellar abnormalities in these disorders are poorly known, we investigated the effects of in vivo intracerebral administration of Phyt on a large spectrum of redox homeostasis parameters in the cerebellum of young rats. Malondialdehyde (MDA) levels, sulfhydryl oxidation, carbonyl content, nitrite and nitrate concentrations, 2',7'-dichlorofluorescein (DCFH) oxidation, total (tGS) and reduced glutathione (GSH) levels and the activities of important antioxidant enzymes were determined at different periods after Phyt administration. Read More

    Audiological findings in Infantile Refsum disease.
    Int J Pediatr Otorhinolaryngol 2015 Aug 30;79(8):1366-9. Epub 2015 May 30.
    Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India. Electronic address:
    Audiological manifestations in a four-year-old child with Infantile Refsum disease are reported. He was born to non-consanguineous parents and had normal birth history and mildly delayed milestones prior to presentation. Clinical features were characterized by neuroregression, retinitis pigmentosa, hearing loss, peripheral neuropathy and white matter signal changes on magnetic resonance imaging. Read More

    Neurological associations in auditory neuropathy spectrum disorder: Results from a tertiary hospital in South India.
    Ann Indian Acad Neurol 2015 Apr-Jun;18(2):171-80
    Department of Ear, Nose and Throat, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
    Aims: To find out the prevalence and types of neurological abnormalities associated in auditory neuropathy spectrum disorder in a large tertiary referral center.

    Settings And Design: A prospective clinical study was conducted on all patients diagnosed with auditory neuropathy spectrum disorder in the ear, nose, and throat (ENT) and neurology departments during a 17-month period. Patients with neurological abnormalities on history and examination were further assessed by a neurologist to determine the type of disorder present. Read More

    Brain atrophy in cognitively impaired elderly: the importance of long-chain ω-3 fatty acids and B vitamin status in a randomized controlled trial.
    Am J Clin Nutr 2015 Jul 15;102(1):215-21. Epub 2015 Apr 15.
    From the Oxford Project to Investigate Memory and Ageing (OPTIMA), Department of Pharmacology, University of Oxford, Oxford, United Kingdom;
    Background: Increased brain atrophy rates are common in older people with cognitive impairment, particularly in those who eventually convert to Alzheimer disease. Plasma concentrations of omega-3 (ω-3) fatty acids and homocysteine are associated with the development of brain atrophy and dementia.

    Objective: We investigated whether plasma ω-3 fatty acid concentrations (eicosapentaenoic acid and docosahexaenoic acid) modify the treatment effect of homocysteine-lowering B vitamins on brain atrophy rates in a placebo-controlled trial (VITACOG). Read More

    Phytanic acid induces Neuro2a cell death via histone deacetylase activation and mitochondrial dysfunction.
    Neurotoxicol Teratol 2015 Mar-Apr;48:33-9. Epub 2015 Jan 22.
    Department of Epigenetic Medicine, University of Yamanashi, Yamanashi 409-3898, Japan. Electronic address:
    Phytanic acid is a branched fatty acid that is a metabolic intermediate of chlorophyll. In this study, the effects of phytanic acid on Histone deacetylase (Hdac) activity were examined in an in vitro enzyme assay and in neuronal Neuro2a cells. Several fatty acids have been shown to be Hdac inhibitors, but phytanic acid enhanced the enzyme activity in vitro. Read More

    Cerebellar transcriptional alterations with Purkinje cell dysfunction and loss in mice lacking PGC-1α.
    Front Cell Neurosci 2014 6;8:441. Epub 2015 Jan 6.
    Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham Birmingham, AL, USA.
    Alterations in the expression and activity of the transcriptional coactivator peroxisome proliferator-activated receptor γ coactivator-1α (ppargc1a or PGC-1α) have been reported in multiple movement disorders, yet it is unclear how a lack of PGC-1α impacts transcription and function of the cerebellum, a region with high PGC-1α expression. We show here that mice lacking PGC-1α exhibit ataxia in addition to the previously described deficits in motor coordination. Using q-RT-PCR in cerebellar homogenates from PGC-1α(-/-) mice, we measured expression of 37 microarray-identified transcripts upregulated by PGC-1α in SH-SY5Y neuroblastoma cells with neuroanatomical overlap with PGC-1α or parvalbumin (PV), a calcium buffer highly expressed by Purkinje cells. Read More

    Peroxisomes in cardiomyocytes and the peroxisome / peroxisome proliferator-activated receptor-loop.
    Thromb Haemost 2015 Mar 22;113(3):452-63. Epub 2015 Jan 22.
    Eveline Baumgart-Vogt, Institute for Anatomy and Cell Biology II, Division of Medical Cell Biology, University of Giessen, 35392 Giessen, Germany, E-mail:
    It is well established that the heart is strongly dependent on fatty acid metabolism. In cardiomyocytes there are two distinct sites for the β-oxidisation of fatty acids: the mitochondrion and the peroxisome. Although the metabolism of these two organelles is believed to be tightly coupled, the nature of this relationship has not been fully investigated. Read More

    Refsum Disease Presenting with a Late-Onset Leukodystrophy.
    JIMD Rep 2015 21;19:7-10. Epub 2015 Jan 21.
    Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France,
    Adult Refsum disease is an autosomal recessive peroxisomal disorder characterized by phytanic acid storage. Clinical symptoms usually begin in late childhood before the age of 20. Typical clinical presentation includes nyctalopia caused by retinitis pigmentosa, and anosmia. Read More

    Infantile Refsum disease in a young adult: case presentation and brief review.
    Retin Cases Brief Rep 2014 ;8(1):56-9
    Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
    Purpose: To review and describe findings, pathophysiology, and management of infantile Refsum disease in a young adult, and to compare with those of classic Refsum Disease.

    Methods: Retrospective chart and digital photography review.

    Results: A 25-year-old woman with a diagnosis of infantile Refsum disease presented with progressively decreasing vision. Read More

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