Neuropediatrics 2018; 49(06): 357-362
DOI: 10.1055/s-0038-1675238
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Lafora Disease: A Review of Molecular Mechanisms and Pathology[*]

Brandy Verhalen
1   Division of Neurology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, United States
,
Susan Arnold
2   Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, United States
,
Berge A. Minassian
1   Division of Neurology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, United States
2   Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, United States
› Author Affiliations
Further Information

Publication History

17 May 2018

26 August 2018

Publication Date:
18 October 2018 (online)

Abstract

Lafora's disease is a neurodegenerative disorder caused by recessive loss-of-function mutations in the EPM2A (laforin glycogen phosphatase) or EPM2B (malin E3 ubiquitin ligase) genes. Neuropathology is characterized by malformed precipitated glycogen aggregates termed Lafora bodies. Asymptomatic until adolescence, patients undergo first insidious then rapid progressive myoclonus epilepsy toward a vegetative state and death within a decade. Laforin and malin interact to regulate glycogen phosphorylation and chain length pattern, the latter critical to glycogen's solubility. Significant gaps remain in precise mechanistic understanding. However, demonstration that partial reduction in brain glycogen synthesis near-completely prevents the disease in its genetic animal models opens a direct present path to therapy.

* This work has been presented during the 46th SENP (Société Européenne de Neurologie Pédiatrique) meeting, in Barcelona (April 27th–28th, 2018).


 
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