Volume : 12, Issue : 08, August- 2025

Title:

NEURONAL CEROID LIPOFUSCINOSES (BATTEN DISEASE)-COMPHRENSIVE REVIEW

Authors :

Mumtaj Begum A., Sandhiya R., Pradeep Kumar P., Vignesh S., Bharath A.,

Abstract :

Neuronal ceroid lipofuscinoses (NCLs) constitute a heterogeneous group of rare, inherited neurodegenerative lysosomal storage disorders marked by accumulation of autofluorescent lipopigments—lipofuscin and ceroid—in neurons and various body tissues. At least 13 NCL subtypes, each associated with distinct genetic mutations, have been identified, with classification based on age of onset, clinical features, and genetic profile. NCLs most commonly affect infants and children but can present from early infancy through adulthood. Typical symptoms include progressive vision impairment leading to blindness, seizures, cognitive and motor decline, dementia, behavioral changes, and decreased life expectancy. Onset and progression differ by subtype: infantile and juvenile forms exhibit rapid neurodegeneration, while adult forms may be slower, sometimes presenting primarily with dementia or movement disorders. Diagnosis relies on a combination of clinical evaluation, neuroimaging, enzyme assays, ultrastructural studies demonstrating intra lysosomal inclusions, and definitive genetic testing for mutations in CLN genes. Early diagnosis is crucial for optimal management and genetic counseling. Currently, there is no cure for most NCL forms. Treatments are largely symptomatic, focusing on seizure control, managing neuropsychiatric symptoms, and palliative care. Recent advances include enzyme replacement therapy (ERT) for CLN2 disease and ongoing investigation into gene therapy, small molecule drugs, and stem cell therapies, although these remain experimental for most subtypes. The aim of this review is to study the causes, symptoms, pathogenesis, modern therapeutic and diagnostic strategies to enable optimal supportive interventions and to expand eligibility for disease-modifying and experimental therapies, thereby striving to slow neurological decline and improve quality of life.
Keywords:
Neuronal Ceroid Lipofuscinosis, NCL, Batten disease, lysosomal storage disorder, CLN genes, neurodegeneration, lipopigment accumulation, progressive epilepsy, vision loss, cognitive decline, genetic disorder, pediatric neurodegenerative disease, enzyme deficiency, autofluorescent storage material.

Cite This Article:

Please cite this article in press Sandhiya R et al., Neuronal Ceroid Lipofuscinoses (Batten Disease)-Comphrensive Review., Indo Am. J. P. Sci, 2025; 12(08).

Number of Downloads : 10

References:

1. Simonati A, Williams RE. Neuronal Ceroid Lipofuscinosis: The Multifaceted Approach to the Clinical Issues, an Overview. Front Neurol. 2022 Mar 11;13:811686. doi: 10.3389/fneur.2022.811686. PMID: 35359645; PMCID: PMC8961688.
2. Johnson TB, Cain JT, White KA, Ramirez-Montealegre D, Pearce DA, Weimer JM. Therapeutic landscape for Batten disease: current treatments and future prospects. Nat Rev Neurol. 2019 Mar;15(3):161-178. doi: 10.1038/s41582-019-0138-8. PMID
: 30783219; PMCID: PMC6681450.
3. Geraets RD, Koh Sy, Hastings ML, Kielian T, Pearce DA, Weimer JM. Moving towards effective therapeutic strategies for Neuronal Ceroid Lipofuscinosis. Orphanet J Rare Dis. 2016 Apr 16;11:40. doi: 10.1186/s13023-016-0414-2. PMID: 27083890; PMCID: PMC4833901.
4. Zhang Y, Du B, Zou M, Peng B, Rao Y. Neuronal Ceroid Lipofuscinosis-Concepts, Classification, and Avenues for Therapy. CNS Neurosci Ther. 2025 Feb;31(2):e70261. doi: 10.1111/cns.70261. PMID: 39925015; PMCID: PMC11808193.
5. Kousi M, Lehesjoki AE, Mole SE. Update of the mutation spectrum and clinical correlations of over 360 mutations in eight genes that underlie the neuronal ceroid lipofuscinoses. Hum Mutat. 2012 Jan;33(1):42-63. doi: 10.1002/humu.21624. Epub 2011 Nov 16. PMID: 21990111.
6. Bose, A., & Tripathy, K. (2024). Batten Disease (Juvenile Neuronal Ceroid Lipofuscinosis). In StatPearls. StatPearls Publishing.
7. Carcel-Trullols, Jaime, et al. “Cell Biology of the NCL Proteins: What They Do and Don’t Do.” Biochimica et Biophysica Acta: Molecular Basis of Disease, vol. 1852, no. 10, 1 Oct. 2015, pp. 2242–2255, https://doi.org/10.1016/j.bbadis.2015.04.027. Accessed 17 Aug. 2023.
8. Krystyna E. Wisniewski, Elizabeth Kida, Adam A. Golabek, Wojciech Kaczmarski, Fred Connell, Nanbert Zhong, https://doi.org/10.1016/S0065-2660(01)45002-4.
9. Zhong N. (2001). Molecular genetic testing for neuronal ceroid lipofuscinoses. Advances in genetics, 45, 141–158. https://doi.org/10.1016/s0065-2660(01)45008-5
10. Lake BD, Young EP, Winchester BG. Prenatal diagnosis of lysosomal storage diseases. Brain Pathol. 1998 Jan;8(1):133-49. doi: 10.1111/j.1750-3639.1998.tb00141.x. PMID: 9458172; PMCID: PMC8098505.
11. Santavuori, P., Rapola, J., Raininko, R., Autti, T., Lappi, M., Nuutila, A., Launes, J., & Sainio, K. (1993). Early juvenile neuronal ceroid-lipofuscinosis or variant Jansky-Bielschowsky disease: diagnostic criteria and nomenclature. Journal of inherited metabolic disease, 16(2), 230–232. https://doi.org/10.1007/BF00710251
12. Sands M. S. (2013). Considerations for the treatment of infantile neuronal ceroid lipofuscinosis (infantile Batten disease). Journal of child neurology, 28(9), 1151–1158. https://doi.org/10.1177/0883073813495960
13. Kohlschütter, A., Schulz, A., Bartsch, U. et al. Current and Emerging Treatment Strategies for Neuronal Ceroid Lipofuscinoses. CNS Drugs 33, 315–325 (2019). https://doi.org/10.1007/s40263-019-00620-8
14. Hawkins-Salsbury, J. A., Cooper, J. D., & Sands, M. S. (2013). Pathogenesis and therapies for infantile neuronal ceroid lipofuscinosis (infantile CLN1 disease). Biochimica et biophysica acta, 1832(11), 1906–1909. https://doi.org/10.1016/j.bbadis.2013.05.026
15. Johnson, T. B., Cain, J. T., White, K. A., Ramirez-Montealegre, D., Pearce, D. A., & Weimer, J. M. (2019). Therapeutic landscape for Batten disease: current treatments and future prospects. Nature reviews. Neurology, 15(3), 161–178. https://doi.org/10.1038/s41582-019-0138-8
16. Kohlschütter, A., Schulz, A., Bartsch, U. et al. Current and Emerging Treatment Strategies for Neuronal Ceroid Lipofuscinoses. CNS Drugs 33, 315–325 (2019). https://doi.org/10.1007/s40263-019-00620-8
17. El-Sitt, S., Soueid, J., Maalouf, K., Makhoul, N., Al Ali, J., Makoukji, J., Asser, B., Daou, D., Harati, H., & Boustany, R. M. (2019). Exogenous Galactosylceramide as Potential Treatment for CLN3 Disease. Annals of neurology, 86(5), 729–742. https://doi.org/10.1002/ana.25573