Clinical Features of Machado-Joseph Disease

  • Nuno Mendonça
  • Marcondes C. FrançaJr.
  • António Freire Gonçalves
  • Cristina Januário
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1049)

Abstract

Machado-Joseph disease (MJD) also known as Spinocerebellar ataxia type 3, is a hereditary neurodegenerative disease associated with severe clinical manifestations and premature death. Although rare, it is the most common autosomal dominant spinocerebellar ataxia worldwide and has a distinct geographic distribution, reaching peak prevalence in certain regions of Brazil, Portugal and China. Due to its clinical heterogeneity, it was initially described as several different entities and as had many designations over the last decades. An accurate diagnosis become possible in 1994, after the identification of the MJD1 gene. Among its wide clinical spectrum, progressive cerebellar ataxia is normally present. Other symptoms include pyramidal syndrome, peripheral neuropathy, oculomotor abnormalities, extrapyramidal signs and sleep disorders. On the basis of the presence/absence of important extra-pyramidal signs, and the presence/absence of peripheral signs, five clinical types have been defined. Neuroimaging studies like MRI, DTI and MRS, can be useful as they can characterize structural and functional differences in specific subgroups of patients with MJD. There is no effective treatment for MJD. Symptomatic therapies are used to relieve some of the clinical symptoms and physiotherapy is also helpful in improving quality of live. Several clinical trials have been carried out using different molecules like sulfamethoxazole-trimethoprim, varenicline and lithium carbonate, but the results of these trials were negative or showed little benefit. Future studies sufficiently powered and adequately designed are warranted.

Keywords

Machado-Joseph disease Spinocerebellar ataxia type 3 Polyglutamine diseases Natural history Pharmacological treatment 

Notes

Conflict of Interest:

Nuno Mendonça is a full time AbbVie Deutschland GmbH & Co. KG employee and may hold AbbVie stock and/or stock options.

The content of this work is not associated with the author responsibilities as an AbbVie employee.

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Nuno Mendonça
    • 1
    • 2
  • Marcondes C. FrançaJr.
    • 3
  • António Freire Gonçalves
    • 2
    • 4
  • Cristina Januário
    • 2
    • 4
  1. 1.CNC—Center for Neuroscience and Cell BiologyCoimbraPortugal
  2. 2.Faculty of MedicineUniversity of CoimbraCoimbraPortugal
  3. 3.Department of NeurologyUniversity of Campinas (UNICAMP)CampinasBrazil
  4. 4.Neurology DepartmentCoimbra University Hospital CenterCoimbraPortugal

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