JIMD Reports, Volume 30 pp 81-87 | Cite as
Biomarkers in a Taurine Trial for Succinic Semialdehyde Dehydrogenase Deficiency
Abstract
Aim: We tested the hypothesis that patients with succinic semialdehyde dehydrogenase (SSADH) deficiency on taurine would have decreased cortical excitability as measured by transcranial magnetic stimulation (TMS) and improved cognition, due to taurine’s partial GABA(A and B) receptor agonist effects and rescue in the null mouse model from status epilepticus and premature lethality.
Method: Biomarkers including neuropsychological testing, TMS, and CSF metabolites were studied in a cohort of patients on and off three months’ taurine treatment.
Results: Seven patients (5M/2F; age range 12–33 years) were enrolled in this open-label crossover study. Baseline average full-scale IQ (FSIQ) was 44.1 (range 34–55). Of six who returned at 6-month follow-up, five completed cognitive testing (3M/2F) on therapy; average FSIQ = 43.4 (range 33–51). CSF biomarkers (n = 4 subjects) revealed elevation in taurine levels but no change in free or total GABA. Baseline cortical excitability measured with TMS agreed with previous findings in this population, with a short cortical silent period and lack of long-interval intracortical inhibition. Patients on taurine showed a decrease in cortical silent period and short-interval intracortical inhibition compared to their off taurine study.
Interpretation: TMS demonstrated decreased inhibition in patients on taurine, in contrast to the study hypothesis, but consistent with its failure to produce clinical or cognitive improvement. TMS may be a useful biomarker for therapy in pediatric neurotransmitter disorders.
Keywords
Conditioning Stimulus Transcranial Magnetic Stimulation Motor Threshold First Dorsal Interosseous Cortical Silent PeriodReferences
- Belluzzi O, Puopolo M, Benedusi M, Kratskin I (2004) Selective neuroinhibitory effects of taurine in slices of rat main olfactory bulb. Neuroscience 124:929–944CrossRefPubMedGoogle Scholar
- Bidri M, Choay P (2003) Taurine: a particular aminoacid with multiple functions. Ann Pharm Fr 61:385–391PubMedGoogle Scholar
- Buzzi A, Wu Y, Frantseva MV et al (2006) Succinic semialdehyde dehydrogenase deficiency: GABAB receptor-mediated function. Brain Res 1090:15–22CrossRefPubMedGoogle Scholar
- Chan CY, Sun HS, Shah SM, Agovic MS, Friedman E, Banerjee SP (2014) Modes of direct modulation by taurine of the glutamate NMDA receptor in rat cortex. Eur J Pharmacol 728:167–175CrossRefPubMedGoogle Scholar
- Chen WQ, Jin H, Nguyen M et al (2001) Role of taurine in regulation of intracellular calcium level and neuroprotective function in cultured neurons. J Neurosci Res 66:612–619CrossRefPubMedGoogle Scholar
- Cherubini E, Gaiarsa JL, Ben-Ari Y (1991) GABA: an excitatory transmitter in early postnatal life. Trends Neurosci 14:515–519CrossRefPubMedGoogle Scholar
- Gupta M, Greven R, Jansen EE et al (2002) Therapeutic intervention in mice deficient for succinate semialdehyde dehydrogenase (gamma-hydroxybutyric aciduria). J Pharmacol Exp Ther 302:180–187CrossRefPubMedGoogle Scholar
- Han NL, Haddrill JL, Lynch JW (2001) Characterization of a glycine receptor domain that controls the binding and gating mechanisms of the beta-amino acid agonist, taurine. J Neurochem 79:636–647CrossRefPubMedGoogle Scholar
- Ilic TV, Meintzschel F, Cleff U, Ruge D, Kessler KR, Ziemann U (2002) Short-interval paired-pulse inhibition and facilitation of human motor cortex: the dimension of stimulus intensity. J Physiol 545:153–167CrossRefPubMedPubMedCentralGoogle Scholar
- Inghilleri M, Berardelli A, Cruccu G, Manfredi M (1993) Silent period evoked by transcranial stimulation of the human cortex and cervicomedullary junction. J Physiol 466:521–534PubMedPubMedCentralGoogle Scholar
- Jansen EE, Struys E, Jakobs C, Hager E, Snead OC, Gibson KM (2008) Neurotransmitter alterations in embryonic succinate semialdehyde dehydrogenase (SSADH) deficiency suggest a heightened excitatory state during development. BMC Dev Biol 8:112CrossRefPubMedPubMedCentralGoogle Scholar
- Junyent F, Utrera J, Romero R et al (2009) Prevention of epilepsy by taurine treatments in mice experimental model. J Neurosci Res 87:1500–1508CrossRefPubMedGoogle Scholar
- Kimiskidis VK, Papagiannopoulos S, Kazis DA et al (2006) Lorazepam-induced effects on silent period and corticomotor excitability. Exp Brain Res 173:603–611CrossRefPubMedGoogle Scholar
- Kok RM, Howells DW, van den Heuvel CC, Guerand WS, Thompson GN, Jakobs C (1993) Stable isotope dilution analysis of GABA in CSF using simple solvent extraction and electron-capture negative-ion mass fragmentography. J Inherit Metab Dis 16:508–512CrossRefPubMedGoogle Scholar
- McDonnell MN, Orekhov Y, Ziemann U (2006) The role of GABA(B) receptors in intracortical inhibition in the human motor cortex. Exp Brain Res 173:86–93CrossRefPubMedGoogle Scholar
- Mody I, De Koninck Y, Otis TS, Soltesz I (1994) Bridging the cleft at GABA synapses in the brain. Trends Neurosci 17:517–525CrossRefPubMedGoogle Scholar
- Okamoto K, Kimura H, Sakai Y (1983) Evidence for taurine as an inhibitory neurotransmitter in cerebellar stellate interneurons: selective antagonism by TAG (6-aminomethyl-3-methyl-4H,1,2,4-benzothiadiazine-1,1-dioxide). Brain Res 265:163–168CrossRefPubMedGoogle Scholar
- Pearl PL, Gibson KM, Acosta MT et al (2003a) Clinical spectrum of succinic semialdehyde dehydrogenase deficiency. Neurology 60:1413–1417CrossRefPubMedGoogle Scholar
- Pearl PL, Novotny EJ, Acosta MT, Jakobs C, Gibson KM (2003b) Succinic semialdehyde dehydrogenase deficiency in children and adults. Ann Neurol 54(Suppl 6):S73–S80CrossRefPubMedGoogle Scholar
- Pearl PL, Gibson KM, Quezado Z et al (2009) Decreased GABA-A binding on FMZ-PET in succinic semialdehyde dehydrogenase deficiency. Neurology 73:423–429CrossRefPubMedPubMedCentralGoogle Scholar
- Pearl PL, Schreiber J, Theodore WH et al (2014) Taurine trial in succinic semialdehyde dehydrogenase deficiency and elevated CNS GABA. Neurology 82:940–944CrossRefPubMedPubMedCentralGoogle Scholar
- Reis J, Cohen LG, Pearl PL et al (2012) GABAB-ergic motor cortex dysfunction in SSADH deficiency. Neurology 79:47–54CrossRefPubMedPubMedCentralGoogle Scholar
- Saronwala A, Tournay A, Gargus J (2008) Taurine treatment of succinate semialdehyde dehydrogenase (SSADH) deficiency reverses MRI-documented globus lesions and clinical syndrome. Conference Taurine treatment of succinate semialdehyde dehydrogenase (SSADH) deficiency reverses MRI-documented globus lesions and clinical syndrome., Phoenix AZ, 2008, 103.Google Scholar
- Tang ZQ, Lu YG, Chen L (2008) Developmental stability of taurine’s activation on glycine receptors in cultured neurons of rat auditory cortex. Neurosci Lett 430:54–59CrossRefPubMedGoogle Scholar
- Wu Y, Buzzi A, Frantseva M et al (2006) Status epilepticus in mice deficient for succinate semialdehyde dehydrogenase: GABAA receptor-mediated mechanisms. Ann Neurol 59:42–52CrossRefPubMedGoogle Scholar