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was up to 3 mg/250 ml. Cox also observed decline in fruit bat consumption matching the decline in lytico-bodig. Support for the BMAA theory of the Guam disease came from the finding reported in 2016 that chronic dietary exposure of vervet monkeys homozygous for the APOE4 gene (which in humans increases risk of
Alzheimer's disease) to the cyanobacterial toxin BMAA produces dense neurofibrillary tangles and sparse amyloid plaques similar to that found in the brains of Chamorro villagers in Guam who died from lytico-bodig.
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and some non-Chamorro who moved to the island and followed the culture did develop it. Targeted high-throughput sequencing in a relatively small sample demonstrates that disease in many patients can be explained by pathogenic mutations in known genes for neurodegeneration. This includes parkinsonism-dementia due to PINK1 homozygous mutations, a DCTN1 mutation that may be causal for Perry syndrome, Huntington's disease due to HTT expansions, and FUS and ALS2 mutations.
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383:(beta-Methylamino-L-alanine). Initial laboratory results found low levels of free BMAA in cycad flour. The cycad hypothesis was abandoned a second time, because the acute toxicity shown by Spencer and Nunn was due to BMAA concentrations orders of magnitude higher. Further laboratory analysis, which included protein-bound BMAA, found significant levels in
368:, was a potent toxin; it was discovered in the 1950s. As toxic as it was, it was incapable of causing of the symptoms of lytico-bodig. Not only that, after nearly two decades of NIH-funded research, animal models failed to reproduce chronic Lytico-Bodig, and the hypothesis was rejected for the first time.
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The doctor visited a patient who had just suddenly come down with a virulent form. His symptoms had begun 18 months before, starting with a strange immobility and a loss of initiative and spontaneity; he found he had to make a huge effort to walk, to stand, and to make the least movement—his body was
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Genetics was first hypothesized due to the situation on Guam. Lytico-bodig was found in great numbers among members of the
Chamorro community, so genetic factors were possible. The disease was shown to be familial but not genetic. Chamorro who grew up outside of Guam had not developed the disease,
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was given to patients to alleviate some of the symptoms of bodig, but this only gave the patients one or two hours of freedom from the complete paralysis and rigidity of limbs. It seems in the case of the
Chamorros, family members are the primary caregivers, and they have accepted those who are ill
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BMAA in their fat, and eating even a few bats would cause a dose of BMAA similar to levels that produced disease symptoms in the earlier animal models. The content of free BMAA in fruit bats was up to 3 mg/g (approximately 30 mM), while that in the broth in which the fruit bats had been cooked
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While neurofibrillary degeneration is a potential cause of lytico-bodig, much is still undiscovered as to what causes the symptoms, what governs the severity, and how the onset of symptoms progresses. Similar symptoms of
Postencephalitic Parkinsonism patients and Alzheimer's patients could account
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are viewed under microscope. "Many of the cells are pale and depigmented. There's a lot of glial reaction, and bits of loose pigment. Shifting to a higher power, he saw a huge number of neurofibrillary tangles, densely staining, convoluted masses, harshly evident within the destroyed nerve cells."
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Age of onset seems to be increasing with no more teenage cases and almost no patients in their twenties. Presentation also varies between years. One form of the disease will present itself chiefly in one decade and then another form predominates in the next.
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The advanced progression presents as profound motionlessness, or catatonia, accompanied with tremors or rigidity. Except in cases with concurrent dementia, most patients are capable of lucid thought and speech throughout the disease's physical progression.
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Patients in the most virulent stage present with mouths hanging open, with excessive salivation; their tongues hang motionless, rendering speech and swallowing impossible. The patient's arms and legs become severely spastic and bent in immovable tension.
168:, in their body fat. The hypothesis suggests that consumption of the bats by the Chamorro exposed them to BMAA, contributing to or causing their condition. Decline in consumption of the bats has been linked to a decline in the incidence of the disease.
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Looking at other samples of hypothalamus, spinal cord, and cortex, all were full of neurofibrillary tangles. Neurofibrillary degeneration was everywhere. These slides were similar in appearance to those taken from postencephalitic parkinsonism.
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Diaphragm and respiratory accessory muscles can become paralyzed necessitating mechanical ventilation to facilitate breathing. Saliva must be suctioned from the mouth to prevent aspiration. This form of lytico-bodig is fatal in all cases.
129:. The frequency of cases grew amongst the Chamorro until it was the leading cause of adult death between 1945 and 1956. The incidence rate was 200 per 100,000 per year and it was 100 times more prevalent than in the rest of the world.
364:, and the flour is then used to make flatbread and dumplings. The flour is soaked and washed several times, as the seed in its natural form is extremely toxic. Ample research on the cycad hypothesis found a component of the seeds,
379:, Marjorie Whiting, a nutritional anthropologist, asked Arthur Bell, a plant biochemist, to test cycad seeds for their chemical constituents. Bell and his colleagues discovered another toxic substance in the seeds,
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Steele JC, Guella I, Szu-Tu C, Lin MK, Thompson C, Evans DM, Sherman HE, Vilariño-Güell C, Gwinn K, Morris H, Dickson DW, Farrer MJ (2015). "Defining neurodegeneration on Guam by targeted genomic sequencing".
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Patient presentations include muscle atrophy, maxillofacial paralysis, inability to speak or swallow and subsequent choking. Some patients retain mental lucidity throughout the illness until death, much like
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Morris HR, Al-Sarraj S, Schwab C, Gwinn-Hardy K, Perez-Tur J, Wood NW, Hardy J, Lees AJ, McGeer PL, Daniel SE, Steele JC (November 2001). "A clinical and pathological study of motor neurone disease on Guam".
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Kisby GE, Ellison M, Spencer PS (July 1992). "Content of the neurotoxins cycasin (methylazoxymethanol beta-D-glucoside) and BMAA (beta-N-methylamino-L-alanine) in cycad flour prepared by Guam
Chamorros".
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Duncan MW, Steele JC, Kopin IJ, Markey SP (May 1990). "2-Amino-3-(methylamino)-propanoic acid (BMAA) in cycad flour: an unlikely cause of amyotrophic lateral sclerosis and parkinsonism-dementia of Guam".
402:, after re-examining aspects of the Chamorro diet. Cox and his colleagues found that BMAA is produced by symbiotic cyanobacteria found in the coralloid roots of cycads. Other than that, fruit bats or
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Monson CS, Banack SA, Cox PA (2003). "Conservation implications of
Chamorro consumption of flying foxes as a possible cause of amyotrophic lateral sclerosis-parkinsonism dementia complex in Guam".
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and restless, and demonstrate irrational behavior, such as violence, and deep emotions at odd intervals. Patients experience manic highs and lows, giggling one minute and screaming the next.
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for the similarities in symptoms of lytico and bodig. Lytico-bodig, postencephalitis, and
Alzheimer's could possibly be the same disease taking three different forms.
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disobedient. The immobility attacked with frightening speed, and within a year, he was unable to stand alone and could not control his posture (2006).
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No standard form of bodig has been reported and the documented cases of the disease manifested in many different clinical presentations.
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Bradley WG, Mash DC (2009). "Beyond Guam: the cyanobacteria/BMAA hypothesis of the cause of ALS and other neurodegenerative diseases".
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Banack SA, Murch SJ, Cox PA (June 2006). "Neurotoxic flying foxes as dietary items for the
Chamorro people, Marianas Islands".
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Brody JA, Chen K (1969). "Changing epidemiologic patterns of
Amyotrophic Lateral Sclerosis and Parkinsonism-Dementia on Guam".
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Vega A, Bell EA (1967). "Alpha-amino-beta-methylaminopropionic acid, a new amino acid from seeds of cycas circinalis".
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800:"Biomagnification of cyanobacterial neurotoxins and neurodegenerative disease among the Chamorro people of Guam"
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As with bodig, the symptoms and forms of lytico present themselves differently from patient to patient.
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Miller G (July 2006). "Neurodegenerative disease. Guam's deadly stalker: on the loose worldwide?".
686:""A Batty Hypothesis on the Origins of Neurodegenerative Disease Resurfaces," Scientific American"
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Cheng R, Banack SA (2009). "Previous studies underestimate BMAA concentrations in cycad flour".
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seeds is consumed in the traditional
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Progressive dementia is also characteristic of bodig. Those who experience dementia are often
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Banack SA, Cox PA (2003). "Biomagnification of cycad neurotoxins in flying foxes".
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Golbe LI (September 2000). "Progressive supranuclear palsy in the molecular age".
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No treatment has been found to cure lytico-bodig. In some cases, the drug
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Guam disease, amyotrophic lateral sclerosis-parkinsonism-dementia, ALS-PDC
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feed on cycad seeds, and were a common food for the Chamorros. The bats
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Steele JC (August 2005). "Parkinsonism-dementia complex of Guam".
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The mechanism is complex and poorly understood. During autopsies,
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Cox PA, Davis DA, Mash DC, Metcalf JS, Banack SA (January 2016).
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and provide home care for all those inflicted with lytico-bodig.
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Some hypotheses as to the cause of the disease include genetics,
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are found in the brain which are congruent to the brain of an
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words for two different manifestations of the same condition.
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made at settlements with a higher incidence of lytico-bodig.
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Motor Neuron Diseases Research on ALS and Related Disorders
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and colleagues in 1961, reflects its resemblance to
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amyotrophic lateral sclerosis-parkinsonism-dementia
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242:Lytico-bodig disease presents itself in two ways:
246:Lytico is a cortical degeneration that resembles
256:Bodig is a subcortical degeneration resembling
121:First reports of the disease surfaced in three
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798:Cox PA, Banack SA, Murch SJ (November 2003).
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453:. Unsourced material may be challenged and
337:(BMAA) from the consumption of fruit bats.
210:. Unsourced material may be challenged and
125:on Guam in 1904 which made some mention of
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473:Learn how and when to remove this message
230:Learn how and when to remove this message
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394:The cycad hypothesis was resurrected by
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371:In 1967, following studies that linked
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451:adding citations to reliable sources
208:adding citations to reliable sources
150:had been feeding on Federico nuts (
1289:10.1212/01.wnl.0000078320.18564.9f
136:detailed this disease in his book
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496:The following is an excerpt from
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262:progressive supranuclear palsy
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1100:10.1016/s0031-9422(00)86018-5
613:10.1016/S0140-6736(00)02672-6
248:amyotrophic lateral sclerosis
108:amyotrophic lateral sclerosis
923:10.1126/science.313.5786.428
804:Proc. Natl. Acad. Sci. U.S.A
772:The Island of the Colorblind
684:Moisse, Katie (2013-09-24).
387:; the levels were higher in
303:The Island of the Colorblind
139:The Island of the Colorblind
354:The starch from indigenous
252:frontotemporal degeneration
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774:. New York: Random House.
335:beta-Methylamino-L-alanine
1254:10.1016/j.jep.2005.12.032
1211:10.3109/17482960903273528
1013:10.1093/brain/124.11.2215
860:Holtcamp W (March 2012).
738:10.3109/17482960903286009
649:. 20 Suppl 12: S99–S107.
72:neurodegenerative disease
866:Environ. Health Perspect
688:. Scientificamerican.com
498:Island of the Colorblind
146:subsequently wrote that
1203:Amyotroph Lateral Scler
825:10.1073/pnas.2235808100
730:Amyotroph Lateral Scler
487:neurofibrillary tangles
1443:Neurological disorders
1336:10.1098/rspb.2015.2397
770:Sacks, Oliver (2006).
541:This section is empty.
500:, in which samples of
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1438:Corticobasal syndrome
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1205:. 10 Suppl 2: 41–3.
1128:10.1212/wnl.40.5.767
957:Conservation Biology
878:10.1289/ehp.120-a110
732:. 10 Suppl 2: 7–20.
447:improve this section
333:seeds, and ingested
204:improve this section
156:) and concentrating
33:Lytico-bodig disease
18:Lytico-Bodig disease
1092:1967PChem...6..759V
1037:Annals of Neurology
969:2003ConBi..17..678M
816:2003PNAS..10013380C
116:Alzheimer's disease
112:Parkinson's disease
102:, a term coined by
1402:External resources
1007:(Pt 11): 2215–22.
341:Genetic hypothesis
172:Symptoms and signs
123:death certificates
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400:Oliver Sacks
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258:parkinsonism
241:
226:
220:October 2021
217:
202:Please help
190:
151:
142:. Sacks and
137:
134:Oliver Sacks
120:
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91:
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63:
60:Guam disease
59:
55:
52:Lytigo-bodig
51:
47:
46:
647:Mov. Disord
552:August 2021
491:Alzheimer's
131:Neurologist
104:Asao Hirano
38:Other names
1432:Categories
692:2013-09-28
586:References
281:patients.
250:(ALS) and
166:neurotoxin
1277:Neurology
1160:Neurology
1116:Neurology
525:Diagnosis
493:patient.
434:does not
415:Mechanism
373:lathyrism
191:does not
127:paralysis
1411:Orphanet
1354:26791617
1330:(1823).
1305:38943437
1297:12913204
1262:16457975
1227:40589338
1219:19929730
1188:71620280
1144:25006038
1065:20492783
1057:25558820
1021:11673323
985:84948326
939:34147464
931:16873621
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844:14612559
754:41622254
746:19929726
710:: 61–79.
671:28721189
663:16092098
629:44344682
621:11036887
574:-alanine
564:See also
162:-alanine
76:etiology
1345:4795023
1180:1620343
1136:2330104
1088:Bibcode
965:Bibcode
911:Science
887:3295368
812:Bibcode
455:removed
440:sources
366:cycasin
311:aphasic
212:removed
197:sources
110:(ALS),
100:ALS-PDC
70:) is a
68:ALS-PDC
56:disease
1392:105500
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619:
601:Lancet
576:(BMAA)
518:L-DOPA
389:fadang
385:fadang
362:fadang
269:Lytico
114:, and
88:Lytigo
50:(also
1416:90020
1301:S2CID
1223:S2CID
1184:S2CID
1140:S2CID
1061:S2CID
1001:Brain
981:S2CID
935:S2CID
750:S2CID
667:S2CID
625:S2CID
331:cycad
325:Cause
289:Bodig
92:bodig
62:, or
1387:OMIM
1350:PMID
1293:PMID
1258:PMID
1215:PMID
1176:PMID
1132:PMID
1053:PMID
1017:PMID
927:PMID
892:PMID
840:PMID
776:ISBN
742:PMID
659:PMID
617:PMID
438:any
436:cite
398:and
381:BMAA
377:ODAP
260:and
195:any
193:cite
148:bats
94:are
90:and
84:Guam
1340:PMC
1332:doi
1328:283
1285:doi
1250:doi
1246:106
1207:doi
1168:doi
1124:doi
1096:doi
1045:doi
1009:doi
1005:124
973:doi
919:doi
915:313
882:PMC
874:doi
870:120
830:PMC
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