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Li Q, Chen C, Ren Y, Liu X. Recurrent Stroke-Like Symptoms After Cesarean Section Deliveries in a Female Patient With X-Linked Charcot-Marie-Tooth Type 1. Front Neurol 2020; 11:8. [PMID: 32047472 PMCID: PMC6997334 DOI: 10.3389/fneur.2020.00008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/07/2020] [Indexed: 01/12/2023] Open
Abstract
Background: X-linked Charcot-Marie-Tooth type 1 (CMTX1) is the second most frequent form of CMT, which is caused by mutations in the gap junction beta 1 gene (GJB1) coding for connexin 32 protein. In addition to typical peripheral neuropathy, central nervous system (CNS) involvement in patients with CMTX1 has been reported as a special feature, but female patients are rarely affected. Case presentation: We describe a 29-year-old female who had a history of two cesarean deliveries. After each delivery, she presented transient and recurrent slurred speech and limb weakness. Magnetic resonance imaging (MRI) showed diffuse abnormal signals in the corpus callosum, posterior limbs of bilateral internal capsule, and centrum semiovale. Electromyogram showed sensorimotor peripheral neuropathy with the characteristics of intermediate CMT. The C.622G>A mutation (p.Glu208Lys) in the GJB1 gene was detected by PCR-sequencing. Conclusion: The diagnosis of CMTX1 should be considered, even in female patients, when the disease presents with recurrent stroke-like symptoms and abnormal white matter signals on MRI. The puerperium after delivery may be one of the precipitating factors.
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Affiliation(s)
- Qu Li
- Department of Neurology, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Chen Chen
- Key Laboratory of Cell Biology, Ministry of Public Health, Key Laboratory of Medical Cell Biology, Ministry of Education, The Research Center for Medical Genomics, School of Life Sciences, China Medical University, Shenyang, China
| | - Yan Ren
- Department of Neurology, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xu Liu
- Department of Neurology, First Affiliated Hospital of China Medical University, Shenyang, China
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Martin PB, Hicks AN, Holbrook SE, Cox GA. Overlapping spectrums: The clinicogenetic commonalities between Charcot-Marie-Tooth and other neurodegenerative diseases. Brain Res 2020; 1727:146532. [PMID: 31678418 PMCID: PMC6939129 DOI: 10.1016/j.brainres.2019.146532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/20/2019] [Accepted: 10/22/2019] [Indexed: 12/11/2022]
Abstract
Charcot-Marie-Tooth (CMT) disease is a progressive and heterogeneous inherited peripheral neuropathy. A myriad of genetic factors have been identified that contribute to the degeneration of motor and sensory axons in a length-dependent manner. Emerging biological themes underlying disease include defects in axonal trafficking, dysfunction in RNA metabolism and protein homeostasis, as well deficits in the cellular stress response. Moreover, genetic contributions to CMT can have overlap with other neuropathies, motor neuron diseases (MNDs) and neurodegenerative disorders. Recent progress in understanding the molecular biology of CMT and overlapping syndromes aids in the search for necessary therapeutic targets.
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Affiliation(s)
- Paige B Martin
- The Jackson Laboratory, Bar Harbor, ME 04609, USA; Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, ME 04469, USA
| | - Amy N Hicks
- The Jackson Laboratory, Bar Harbor, ME 04609, USA
| | - Sarah E Holbrook
- The Jackson Laboratory, Bar Harbor, ME 04609, USA; Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, ME 04469, USA
| | - Gregory A Cox
- The Jackson Laboratory, Bar Harbor, ME 04609, USA; Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, ME 04469, USA.
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Whole exome sequencing reveals a broader variant spectrum of Charcot-Marie-Tooth disease type 2. Neurogenetics 2019; 21:79-86. [PMID: 31832804 DOI: 10.1007/s10048-019-00591-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 09/12/2019] [Indexed: 12/21/2022]
Abstract
Charcot-Marie-Tooth disease type 2 (CMT2) is a clinically and genetically heterogeneous inherited neuropathy. Although new causative and disease-associated genes have been identified for CMT2 in recent years, molecular diagnoses are still lacking for a majority of patients. We here studied a cohort of 35 CMT2 patients of Chinese descent, using whole exome sequencing to investigate gene mutations and then explored relationships among genotypes, clinical features, and mitochondrial DNA levels in blood as assessed by droplet digital PCR. We identified pathogenic variants in 57% of CMT2 patients. The most common genetic causes in the cohort were MFN2 mutations. Two patients with typical CMT phenotype and neuromyotonia were detected to harbor compound heterozygous variations in the HINT1 gene. In conclusion, our work supports that the molecular diagnostic rate of CMT2 patients can be increased via whole exome sequencing, and our data suggest that assessment of possible HINT1 mutations should be undertaken for CMT2 patients with neuromyotonia.
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Moss KR, Höke A. Targeting the programmed axon degeneration pathway as a potential therapeutic for Charcot-Marie-Tooth disease. Brain Res 2019; 1727:146539. [PMID: 31689415 DOI: 10.1016/j.brainres.2019.146539] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/24/2019] [Accepted: 10/30/2019] [Indexed: 12/14/2022]
Abstract
The programmed axon degeneration pathway has emerged as an important process contributing to the pathogenesis of several neurological diseases. The most crucial events in this pathway include activation of the central executioner SARM1 and NAD+ depletion, which leads to an energetic failure and ultimately axon destruction. Given the prevalence of this pathway, it is not surprising that inhibitory therapies are currently being developed in order to treat multiple neurological diseases with the same therapy. Charcot-Marie-Tooth disease (CMT) is a heterogeneous group of neurological diseases that may also benefit from this therapeutic approach. To evaluate the appropriateness of this strategy, the contribution of the programmed axon degeneration pathway to the pathogenesis of different CMT subtypes is being actively investigated. The subtypes CMT1A, CMT1B and CMT2D are the first to have been examined. Based on the results from these studies and advances in developing therapies to block the programmed axon degeneration pathway, promising therapeutics for CMT are now on the horizon.
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Affiliation(s)
- Kathryn R Moss
- Department of Neurology, Neuromuscular Division, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Ahmet Höke
- Department of Neurology, Neuromuscular Division, Johns Hopkins School of Medicine, Baltimore, MD, United States.
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Pan Y, Kafaie J, Thomas FP. Longitudinal 16-year study of dominant intermediate CMT type C neuropathy. Muscle Nerve 2019; 61:111-115. [PMID: 31587308 DOI: 10.1002/mus.26724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 09/16/2019] [Accepted: 09/17/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Dominant-intermediate Charcot-Marie-Tooth neuropathy subtype C (DI-CMTC) is associated with mutations in the YARS gene. The aim of this study is to investigate the long-term natural history of the disease. METHODS In a 5-generation DI-CMTC family, we compared data from 2016 to that of 2000 in 13 of 21 original participants. RESULTS Five women and 8 men were examined. While most symptoms and signs progressed, only gait progression was statistically significant (P = .016). The median CMT Neuropathy Score was 6.08 in 2000 and 11 in 2016 (P = .001). Quality of life (QOL) deteriorated in mobility (P = .008), pain/discomfort (P = .011), and anxiety/depression (P = .014). Median and ulnar compound muscle action potential amplitudes decreased from 9.35 ± 2.90 mV to 6.0 ± 2.9 mV (P = .002), and from 9.24 ± 2.10 mV to 6.06 ± 1.81 mV (P = .004), respectively, whereas motor nerve conduction velocities remained unchanged. CONCLUSIONS DI-CMTC in this family is a slowly progressive disease with axonal degeneration, deteriorating mobility and QOL.
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Affiliation(s)
- Yi Pan
- Hereditary Neuropathy Foundation Center of Excellence, Department of Neurology, Saint Louis University, St. Louis, Missouri
| | - Jafar Kafaie
- Hereditary Neuropathy Foundation Center of Excellence, Department of Neurology, Saint Louis University, St. Louis, Missouri
| | - Florian P Thomas
- Hereditary Neuropathy Foundation Center of Excellence, Department of Neurology, Saint Louis University, St. Louis, Missouri.,Hereditary Neuropathy Foundation Center of Excellence, Neuroscience Institute, Department of Neurology, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, New Jersey
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Peretti A, Perie M, Vincent D, Bouhour F, Dieterich K, Mallaret M, Duval F, Goizet C, Juntas-Morales R, Magy L, Solé G, Nollet S, Not A, Léonard-Louis S, Francou B, Leguern E, Lia AS, Magdelaine C, Latour P, Stojkovic T. LRSAM1 variants and founder effect in French families with ataxic form of Charcot-Marie-Tooth type 2. Eur J Hum Genet 2019; 27:1406-1418. [PMID: 30996334 PMCID: PMC6777460 DOI: 10.1038/s41431-019-0403-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 03/17/2019] [Accepted: 03/26/2019] [Indexed: 11/08/2022] Open
Abstract
Currently only 25-30% of patients with axonal forms of Charcot-Marie-Tooth disease (CMT) receive a genetic diagnosis. We aimed to identify the causative gene of CMT type 2 in 8 non-related French families with a distinct clinical phenotype. We collected clinical, electrophysiological, and laboratory findings and performed genetic analyses in four different French laboratories. Seventy-two patients with autosomal dominant inheritance were identified. The disease usually started in the fourth decade and the clinical picture was dominated by sensory ataxia (80%), neuropathic pain (38%), and length-dependent sensory loss to all modalities. Electrophysiological studies showed a primarily axonal neuropathy, with possible isolated sensory involvement in milder phenotypes. Disease severity varied greatly but the clinical course was generally mild. We identified 2 novel variants in LRSAM1 gene: a deletion of 4 amino acids, p.(Gln698_Gln701del), was found in 7 families and a duplication of a neighboring region of 10 amino acids, p.(Pro702_Gln711dup), in the remaining family. A common haplotype of ~450 kb suggesting a founder effect was noted around LRSAM1 in 4 families carrying the first variant. LRSAM1 gene encodes for an E3 ubiquitin ligase important for neural functioning. Our results confirm the localization of variants in its catalytic C-terminal RING domain and broaden the phenotypic spectrum of LRSAM1-related neuropathies, including painful and predominantly sensory ataxic forms.
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Affiliation(s)
- Alessia Peretti
- AP-HP, G-H Pitié-Salpêtrière, Centre de Référence des Maladies neuromusculaires, Paris Nord/Est/Ile de france, Paris, France.
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Maud Perie
- Service de Neurologie CHU Gabriel Montpied, Clermont Ferrand, France
| | - Didier Vincent
- Service de Neurologie, Groupe Hospitalier La Rochelle-Ré-Aunis, La Rochelle, France
| | - Françoise Bouhour
- Hôpital Neurologique Pierre Wertheimer, Service d'ENMG-Pathologies Neuromusculaires, Lyon-Bron, France
| | - Klaus Dieterich
- Service de Génétique Clinique, Hôpital Couple Enfant, CHU Grenoble Alpes, Grenoble, France
| | - Martial Mallaret
- Centre de Compétences des Maladies Neuro Musculaires, CHU Grenoble Alpes, Grenoble, France
| | - Fanny Duval
- Département de Neurologie, CHU Bordeaux (Pellegrin Hospital), Bordeaux, France
| | - Cyril Goizet
- Centre de Référence neurogénétique, Hôpital Pellegrin, CHU Bordeaux, Bordeaux, France
- Laboratoire MRGM, INSERM U1211, Univ. Bordeaux, Bordeaux, France
| | | | - Laurent Magy
- Service et Laboratoire de Neurologie, Centre de Référence Neuropathies Périphériques rares, CHU Limoges, Limoges, France
| | - Guilhem Solé
- Département de Neurologie, CHU Bordeaux (Pellegrin Hospital), Bordeaux, France
| | - Sylvain Nollet
- Service Explorations et Pathologies Neuromusculaires, CHRU Besançon, Besançon, France
| | - Adeline Not
- AP-HP, Service de Neurologie, CHU Bicêtre, Le Kremlin-Bicêtre, France
- Centre de Référence national des Neuropathies amyloïdes familiales et Autres Neuropathies périphériques rares (NNERF), Le Kremlin-Bicêtre, France
| | - Sarah Léonard-Louis
- AP-HP, G-H Pitié-Salpêtrière, Centre de Référence des Maladies neuromusculaires, Paris Nord/Est/Ile de france, Paris, France
| | - Bruno Francou
- AP-HP, Bicêtre Paris Sud Hospital, Service Génétique moléculaire pharmacogénétique et Hormonologie, Le Kremlin-Bicêtre, France
| | - Eric Leguern
- Département de Génétique, AP-HP, Sorbonne Université, Paris, France
- Hôpital Pitié-Salpêtrière, Paris, France
| | | | | | - Philippe Latour
- Service de Biochimie et Biologie moléculaire Grand Est, Unité Médicale Pathologies neurologiques et cardiologiques, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Bron, France
| | - Tanya Stojkovic
- AP-HP, G-H Pitié-Salpêtrière, Centre de Référence des Maladies neuromusculaires, Paris Nord/Est/Ile de france, Paris, France
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He J, Guo L, Lin S, Chen W, Xu G, Cai B, Xu L, Hong J, Qiu L, Wang N, Chen W. ATP1A1mutations cause intermediate Charcot‐Marie‐Tooth disease. Hum Mutat 2019; 40:2334-2343. [DOI: 10.1002/humu.23886] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 06/18/2019] [Accepted: 07/30/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Jin He
- Department of Neurology and Institute of Neurology, First Affiliated HospitalFujian Medical University Fuzhou China
- Fujian Key Laboratory of Molecular NeurologyFujian Medical University Fuzhou China
| | - Lingling Guo
- Department of Neurology and Institute of Neurology, First Affiliated HospitalFujian Medical University Fuzhou China
| | - Shan Lin
- Department of Neurology and Institute of Neurology, First Affiliated HospitalFujian Medical University Fuzhou China
| | - Wenfeng Chen
- Institute of Life SciencesFuzhou University Fuzhou China
| | - Guorong Xu
- Department of Neurology and Institute of Neurology, First Affiliated HospitalFujian Medical University Fuzhou China
| | - Bin Cai
- Department of Neurology and Institute of Neurology, First Affiliated HospitalFujian Medical University Fuzhou China
- Fujian Key Laboratory of Molecular NeurologyFujian Medical University Fuzhou China
| | - Liuqing Xu
- Department of Neurology and Institute of Neurology, First Affiliated HospitalFujian Medical University Fuzhou China
| | - Jingmei Hong
- Department of Neurology and Institute of Neurology, First Affiliated HospitalFujian Medical University Fuzhou China
| | - Liangliang Qiu
- Department of Neurology and Institute of Neurology, First Affiliated HospitalFujian Medical University Fuzhou China
| | - Ning Wang
- Department of Neurology and Institute of Neurology, First Affiliated HospitalFujian Medical University Fuzhou China
- Fujian Key Laboratory of Molecular NeurologyFujian Medical University Fuzhou China
| | - Wanjin Chen
- Department of Neurology and Institute of Neurology, First Affiliated HospitalFujian Medical University Fuzhou China
- Fujian Key Laboratory of Molecular NeurologyFujian Medical University Fuzhou China
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Hsu Y, Lin K, Guo Y, Tsai Y, Liao Y, Lee Y. Mutation spectrum of Charcot-Marie-Tooth disease among the Han Chinese in Taiwan. Ann Clin Transl Neurol 2019; 6:1090-1101. [PMID: 31211173 PMCID: PMC6562034 DOI: 10.1002/acn3.50797] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 04/25/2019] [Accepted: 05/02/2019] [Indexed: 12/25/2022] Open
Abstract
Objective Charcot‐Marie‐Tooth disease (CMT) is a clinically and genetically heterogeneous group of inherited neuropathies. Mutations in more than 90 genes have been implicated in CMT; however, the mutational spectrum of CMT in Chinese population remains obscure. This study aims to provide a comprehensive overview of the frequency of mutations in Taiwanese patients with CMT and look for genotype‐phenotype correlations. Methods Mutational analyses were performed on 427 unrelated Taiwanese patients with CMT by polymorphic microsatellite markers analysis or real‐time fluorescent PCR for PMP22 duplication, Sanger sequencing for GJB1 mutations, and targeted sequencing covering 124 genes causing or relevant to inherited neuropathies. We also correlated the genotypes with the phenotypic features, such as age at disease onset and ulnar motor nerve conduction velocity. Results Pathogenic mutations were identified in 312 patients (73.1%; 312/427), including 208 patients with a PMP22 duplication, 40 patients with a GJB1 mutation, and 64 patients with a mutation in one of other 18 CMT genes. A confirmed molecular diagnosis was achieved in 84.4% (266/315) of the patients with demyelinating CMT and 41.1% (46/112) of the patients with axonal CMT. Mutations in MPZ, MFN2, or NEFL are the most frequent disease causes in patients with infantile‐onset CMT (≤2 years), while PMP22 duplications and mutations in GJB1, MFN2, or MPZ are the frequent causes among patients with childhood‐ or adolescence‐onset CMT (3–9 years). Interpretation This study provides a genotype‐phenotype landscape of CMT in Taiwan and highlights the unique spectrum of CMT genes frequencies among patients of Chinese origin.
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Affiliation(s)
- Yun‐Hsin Hsu
- Division of Neurology, Department of Internal MedicineTaipei Veterans General Hospital Su‐Ao BranchYilanTaiwan
- Neurological Institute, Taichung Veterans General HospitalTaichungTaiwan
| | - Kon‐Ping Lin
- Neurological Institute, Taipei Veterans General HospitalTaipeiTaiwan
- Department of NeurologyNational Yang‐Ming University School of MedicineTaipeiTaiwan
| | - Yuh‐Cherng Guo
- Institute of Clinical MedicineNational Yang‐Ming UniversityTaipeiTaiwan
- Department of NeurologyChina Medical University HospitalTaichungTaiwan
- School of Medicine, College of MedicineChina Medical UniversityTaichungTaiwan
| | - Yu‐Shuen Tsai
- Institute of Biomedical InformaticsNational Yang‐Ming UniversityTaipeiTaiwan
- Center for Systems and Synthetic BiologyNational Yang‐Ming UniversityTaipeiTaiwan
| | - Yi‐Chu Liao
- Neurological Institute, Taipei Veterans General HospitalTaipeiTaiwan
- Department of NeurologyNational Yang‐Ming University School of MedicineTaipeiTaiwan
- Brain Research CenterNational Yang‐Ming University School of MedicineTaipeiTaiwan
| | - Yi‐Chung Lee
- Neurological Institute, Taipei Veterans General HospitalTaipeiTaiwan
- Department of NeurologyNational Yang‐Ming University School of MedicineTaipeiTaiwan
- Brain Research CenterNational Yang‐Ming University School of MedicineTaipeiTaiwan
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Ikenberg E, Reilich P, Abicht A, Heller C, Schoser B, Walter MC. Charcot-Marie-Tooth disease type 2CC due to a frameshift mutation of the neurofilament heavy polypeptide gene in an Austrian family. Neuromuscul Disord 2019; 29:392-397. [PMID: 30992180 DOI: 10.1016/j.nmd.2019.02.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 02/04/2019] [Accepted: 02/14/2019] [Indexed: 12/12/2022]
Abstract
Neurofilaments are structural components of motor axons. Recently different variants resulting in translation of a cryptic amyloidogenic element of the neurofilament-heavy polypeptide (NEFH) gene have been described to cause Charcot-Marie-Tooth disease type 2CC (CMT2CC) by forming amyloidogenic toxic protein aggregation. Until now only few CMT2CC patients have been described. Clinical features include progressive muscle weakness and atrophy mainly affecting the lower limbs, hyporeflexia and distal sensory impairment. In addition to classic CMT features, some patients were reported to have increased serum creatine kinase levels, an electrophysiologic pattern suggestive for myopathies, and pyramidal signs. Ambulation is progressively impaired, most patients are non-ambulant in the 5th decade. Nerve conduction testing shows a symmetrical, distal and proximal sensorimotor axonal neuropathy. Here we describe the first Austrian pedigree suffering from CMT2CC and give an overview on the phenotype of CMT2CC described so far.
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Affiliation(s)
- Elena Ikenberg
- Friedrich-Baur-Institute, Dep. of Neurology, Ludwig-Maximilians-University of Munich, Ziemssenstraße 1A, 80336 Munich, Germany
| | - Peter Reilich
- Friedrich-Baur-Institute, Dep. of Neurology, Ludwig-Maximilians-University of Munich, Ziemssenstraße 1A, 80336 Munich, Germany
| | - Angela Abicht
- Friedrich-Baur-Institute, Dep. of Neurology, Ludwig-Maximilians-University of Munich, Ziemssenstraße 1A, 80336 Munich, Germany; Medical Genetics Centre - MGZ, Bayerstraße 3, 80335 Munich, Germany
| | - Corina Heller
- CeGaT GmbH und Praxis für Humangenetik, Paul Ehrlich Straße 23, 72076, Tübingen, Germany
| | - Benedikt Schoser
- Friedrich-Baur-Institute, Dep. of Neurology, Ludwig-Maximilians-University of Munich, Ziemssenstraße 1A, 80336 Munich, Germany
| | - Maggie C Walter
- Friedrich-Baur-Institute, Dep. of Neurology, Ludwig-Maximilians-University of Munich, Ziemssenstraße 1A, 80336 Munich, Germany.
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Gonorazky HD, Dowling JJ, Volpatti JR, Vajsar J. Signs and Symptoms in Congenital Myopathies. Semin Pediatr Neurol 2019; 29:3-11. [PMID: 31060723 DOI: 10.1016/j.spen.2019.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Congenital myopathies (CM) represent a continuously growing group of disorders with a wide range of clinical and histopathologic presentations. The refinement and application of new technologies for genetic diagnosis have broadened our understanding of the genetic causes of CM. Our growing knowledge has revealed that there are no clear limits between each subgroup of CM, and thus the clinical overlap between genes has become more evident. The implementation of next generation sequencing has produced vast amounts of genomic data that may be difficult to interpret. With an increasing number of reports revealing variants of unknown significance, it is essential to support the genetic diagnosis with a well characterized clinical description of the patient. Phenotype-genotype correlation should be a priority at the moment of disclosing the genetic results. Thus, a detailed physical examination can provide us with subtle differences that are not only key in order to arrive at a correct diagnosis, but also in the characterization of new myopathies and candidate genes.
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Affiliation(s)
- Hernan D Gonorazky
- Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - James J Dowling
- Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Molecular Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jonathan R Volpatti
- Department of Molecular Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jiri Vajsar
- Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada.
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Tozza S, Magri S, Pennisi EM, Schirinzi E, Pisciotta C, Balistreri F, Severi D, Ricci G, Siciliano G, Taroni F, Santoro L, Manganelli F. A novel family with axonal Charcot-Marie-Tooth disease caused by a mutation in the EGR2 gene. J Peripher Nerv Syst 2019; 24:219-223. [PMID: 30843326 DOI: 10.1111/jns.12314] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 02/17/2019] [Accepted: 03/04/2019] [Indexed: 11/30/2022]
Abstract
EGR2 (Early Growth Response 2) is one of the most important transcription factors involved in myelination in the peripheral nervous system. EGR2 mutations typically cause different forms of demyelinating neuropathy, that is, Charcot-Marie-Tooth type 1D (CMT1D), Dejerine-Sottas Syndrome (DSS), and Congenital Hypomyelinating Neuropathy (CHN). However, the EGR2 gene has been recently associated with an axonal phenotype (CMT2) in a large CMT family. Here, we report another CMT family exhibiting an axonal phenotype associated with a missense change (c.1235A>G, p.E412G) in the EGR2 gene. Neurological evaluation of five affected members of the family showed a classical CMT phenotype including distal muscle atrophy and weakness, absence of deep tendon reflexes, pes cavus, and scoliosis. Electrophysiological examination was consistent with a motor-sensory axonal neuropathy. Sural nerve biopsy performed in one patient showed a loss of myelinated and unmyelinated nerve fibers without de-remyelinating signs and onion bulbs. This study confirms the phenotypical heterogeneity of EGR2-related neuropathy, indicating a role for EGR2 in primary axonal degeneration.
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Affiliation(s)
- Stefano Tozza
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Stefania Magri
- Department of Diagnostics and Technology, Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Erika Schirinzi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Chiara Pisciotta
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Francesca Balistreri
- Department of Diagnostics and Technology, Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Daniele Severi
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Giulia Ricci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Franco Taroni
- Department of Diagnostics and Technology, Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Lucio Santoro
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
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Berciano J, García A. Novel GARS mutation presenting as autosomal dominant intermediate Charcot-Marie-Tooth disease: Intermediate or axonal? J Peripher Nerv Syst 2019; 24:161. [PMID: 30873681 DOI: 10.1111/jns.12300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 12/27/2018] [Indexed: 11/30/2022]
Affiliation(s)
- José Berciano
- Service of Neurology, University Hospital "Marqués de Valdecilla (IDIVAL)", University of Cantabria, "Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED)", Santander, Spain
| | - Antonio García
- Service of Clinical Neurophysiology, University Hospital "Marqués de Valdecilla (IDIVAL)", "Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED)", Santander, Spain
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Bacquet J, Stojkovic T, Boyer A, Martini N, Audic F, Chabrol B, Salort-Campana E, Delmont E, Desvignes JP, Verschueren A, Attarian S, Chaussenot A, Delague V, Levy N, Bonello-Palot N. Molecular diagnosis of inherited peripheral neuropathies by targeted next-generation sequencing: molecular spectrum delineation. BMJ Open 2018; 8:e021632. [PMID: 30373780 PMCID: PMC6224714 DOI: 10.1136/bmjopen-2018-021632] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
PURPOSE Inherited peripheral neuropathies (IPN) represent a large heterogenous group of hereditary diseases with more than 100 causative genes reported to date. In this context, targeted next-generation sequencing (NGS) offers the opportunity to screen all these genes with high efficiency in order to unravel the genetic basis of the disease. Here, we compare the diagnostic yield of targeted NGS with our previous gene by gene Sanger sequencing strategy. We also describe several novel likely pathogenic variants. DESIGN AND PARTICIPANTS We have completed the targeted NGS of 81 IPN genes in a cohort of 123 unrelated patients affected with diverse forms of IPNs, mostly Charcot-Marie-Tooth disease (CMT): 23% CMT1, 52% CMT2, 9% distal hereditary motor neuropathy, 7% hereditary sensory and autonomic neuropathy and 6.5% intermediate CMT. RESULTS We have solved the molecular diagnosis in 49 of 123 patients (~40%). Among the identified variants, 26 variants were already reported in the literature. In our cohort, the most frequently mutated genes are respectively: MFN2, SH3TC2, GDAP1, NEFL, GAN, KIF5A and AARS. Panel-based NGS was more efficient in familial cases than in sporadic cases (diagnostic yield 49%vs19%, respectively). NGS-based search for copy number variations, allowed the identification of three duplications in three patients and raised the diagnostic yield to 41%. This yield is two times higher than the one obtained previously by gene Sanger sequencing screening. The impact of panel-based NGS screening is particularly important for demyelinating CMT (CMT1) subtypes, for which the success rate reached 87% (36% only for axonal CMT2). CONCLUSION NGS allowed to identify causal mutations in a shorter and cost-effective time. Actually, targeted NGS is a well-suited strategy for efficient molecular diagnosis of IPNs. However, NGS leads to the identification of numerous variants of unknown significance, which interpretation requires interdisciplinary collaborations between molecular geneticists, clinicians and (neuro)pathologists.
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Affiliation(s)
- Juliette Bacquet
- Département de génétique médicale, Hôpital Timone enfants, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Tanya Stojkovic
- Centre de référence des maladies neuromusculaires, Hôpital Pitié-Salpétrière, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Amandine Boyer
- Département de génétique médicale, Hôpital Timone enfants, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Nathalie Martini
- Département de génétique médicale, Hôpital Timone enfants, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Frédérique Audic
- Centre de référence des maladies neuromusculaires, Hôpital Timone enfants, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Brigitte Chabrol
- Centre de référence des maladies neuromusculaires, Hôpital Timone enfants, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Emmanuelle Salort-Campana
- Centre de référence des maladies neuromusculaires, Hôpital Timone Adultes, Assistance Publique Hôpitaux de Marseille, Marseille, France
- INSERM, MMG, UMR 1251, Aix Marseille Univ, Marseille, France
| | - Emilien Delmont
- Centre de référence des maladies neuromusculaires, Hôpital Timone Adultes, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | | | - Annie Verschueren
- Centre de référence des maladies neuromusculaires, Hôpital Timone Adultes, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Shahram Attarian
- Centre de référence des maladies neuromusculaires, Hôpital Timone Adultes, Assistance Publique Hôpitaux de Marseille, Marseille, France
- INSERM, MMG, UMR 1251, Aix Marseille Univ, Marseille, France
| | | | - Valérie Delague
- INSERM, MMG, UMR 1251, Aix Marseille Univ, Marseille, France
| | - Nicolas Levy
- Département de génétique médicale, Hôpital Timone enfants, Assistance Publique Hôpitaux de Marseille, Marseille, France
- INSERM, MMG, UMR 1251, Aix Marseille Univ, Marseille, France
| | - Nathalie Bonello-Palot
- Département de génétique médicale, Hôpital Timone enfants, Assistance Publique Hôpitaux de Marseille, Marseille, France
- INSERM, MMG, UMR 1251, Aix Marseille Univ, Marseille, France
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Quadros Santos Monteiro Fonseca AT, Zanoteli E. Charcot-Marie-Tooth disease. REVISTA MÉDICA CLÍNICA LAS CONDES 2018. [DOI: 10.1016/j.rmclc.2018.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Wen Q, Cao L, Yang C, Xie Y. The Electrophysiological Features in X-Linked Charcot-Marie-Tooth Disease With Transient Central Nervous System Deficits. Front Neurol 2018; 9:461. [PMID: 30013503 PMCID: PMC6036262 DOI: 10.3389/fneur.2018.00461] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 05/30/2018] [Indexed: 11/17/2022] Open
Abstract
Background: Electrophysiological examination plays an important role in the diagnosis of X-linked Charcot-Marie-Tooth disease (CMTX1) with transient central nervous system deficits. However, the electrophysiological features are seldom reported. Methods: We reviewed and analyzed published reports to determine the electrophysiological features of CMTX1 patients with transient central nervous system deficits. Results: A total of 21 CMTX1 patients with transient central nervous system deficits were found in 17 published case reports/series. The age of onset ranged from 0.5 to 18 years (mean 12.02 ± 0.78 years). All patients were male. Recurrent episodes of central nervous system deficits were reported in all 21 cases and resolved in periods ranging from several minutes to 3 days. All 20 patients who had MRIs at presentation had bilaterally symmetrical abnormal T2/Diffusion signals in the white matter without enhancement of gadolinium. All subsequent MRIs showed improvement or were within normal limits. The median motor nerve conduction velocity (MNCV), motor latencies, and compound muscle action potential (CMAP) amplitude were the most commonly measurable electrophysiological parameters (85.7%). All cases that had MNCV at presentation had slower and significantly decreased MNCV compared with the normal value (34.1 ± 1.10 m/s vs. 46.8±2.05 m/s, P < 0.0001; 95% CI, −17.4 to −7.92). The average variations of MNCV in median nerve, ulnar nerve, peroneal nerve, and tibial nerve were 22.0 ± 5.96%, 27.6 ± 11.9%, 25.9 ± 4.36%, and 27.3 ± 4.30%, respectively. All cases with measured sensory nerve conduction velocity (SNCV) at presentation had slower and significantly decreased SNCV compared with the normal value (35.3 ± 1.33 m/s vs. 47.7 ± 2.40 m/s, P < 0.001; 95% CI −18.2 to −6.46). The average variations of SNCV in median nerve, ulnar nerve, and sural nerve were 19.9 ± 8.24%, 25.2 ± 7.75%, and 23.2 ± 3.95%, respectively. Conclusion: This case series serves as a reminder that electrophysiological examination should be included in the diagnosis of recurrent and episodic neurological deficit with white matter lesions. Median MNCV is a sensitive and valuable parameter to support the diagnosis of CMTX1 with transient central nervous system deficits.
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Affiliation(s)
- Qingxian Wen
- Department of Neurology, Jining No. 1 People's Hospital, Jining, China
| | - Longqiao Cao
- Department of Reproductive Medicine, Jining No. 1 People's Hospital, Jining, China
| | - Cun Yang
- Department of Pediatrics, Jinning No. 1 People's Hospital, Jining, China
| | - Yanchen Xie
- Department of Neurology, Washington Institute of Clinical Research, Vienna, VA, United States
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Chen DH, Ma M, Scavina M, Blue E, Wolff J, Karna P, Dorschner MO, Raskind WH, Bird TD. An 8-generation family with X-linked Charcot-Marie-Tooth: Confirmation Of the pathogenicity Of a 3' untranslated region mutation in GJB1 and its clinical features. Muscle Nerve 2018; 57:859-862. [PMID: 29236290 PMCID: PMC5910283 DOI: 10.1002/mus.26037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 12/07/2017] [Accepted: 12/09/2017] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Mutations in gap junction protein beta 1 (GJB1) on the X chromosome represent one of the most common causes of hereditary neuropathy. We assessed manifestations associated with a rare 3' untranslated region mutation (UTR) of GJB1 in a large family with X-linked Charcot-Marie-Tooth disease (CMTX). METHODS Clinical, electrophysiological, and molecular genetic analyses were performed on an 8-generation family with CMTX. RESULTS There were 22 affected males and 19 symptomatic females, including an 83-year-old woman followed for 40 years. Electrophysiological studies showed a primarily axonal neuropathy. The c.*15C>T mutation in the GJB1 3' UTR was identified in 4 branches of the family with a log of odds (LOD) of 4.91. This created a BstE II enzyme recognition site that enabled detection by restriction digestion. DISCUSSION The c.*15C>T mutation in the GJB1 3' UTR segregates with CMTX1 in 8 generations. Penetrance in males and females is essentially complete. A straightforward genetic method to detect this mutation is described. Muscle Nerve 57: 859-862, 2018.
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Affiliation(s)
- Dong-Hui Chen
- Department of Neurology, University of Washington, Seattle, WA
| | - Maxwell Ma
- Department of Neurology, University of Washington, Seattle, WA
- Neurology Section, VA Puget Sound Health Care System, Seattle, WA
| | - Mena Scavina
- Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE
| | - Elizabeth Blue
- Department of Medicine (Medical Genetics), University of Washington, Seattle, WA
| | - John Wolff
- Department of Medicine (Medical Genetics), University of Washington, Seattle, WA
- Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle, WA
| | - Prasanthi Karna
- Department of Medicine (Medical Genetics), University of Washington, Seattle, WA
| | - Michael O. Dorschner
- Center for Precision Diagnostics, University of Washington, Seattle, WA
- Department of Pathology, University of Washington, Seattle, WA
| | - Wendy H. Raskind
- Department of Medicine (Medical Genetics), University of Washington, Seattle, WA
- Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle, WA
| | - Thomas D. Bird
- Department of Neurology, University of Washington, Seattle, WA
- Department of Medicine (Medical Genetics), University of Washington, Seattle, WA
- Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle, WA
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Berciano J, García A. Letter regarding the article: "A novel missense variant (Gln220Arg) of GNB4 encoding guanine nucleotide-binding protein, subunit beta-4 in a Japanese family with autosomal dominant motor and sensory neuropathy". Eur J Med Genet 2017; 61:43-44. [PMID: 28705522 DOI: 10.1016/j.ejmg.2017.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 07/07/2017] [Indexed: 10/19/2022]
Affiliation(s)
- José Berciano
- Service of Neurology, University Hospital "Marqués de Valdecilla (IDIVAL)", University of Cantabria (UC), Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Santander, Spain.
| | - Antonio García
- Service of Clinical Neurophysiology, University Hospital "Marqués de Valdecilla (IDIVAL)", CIBERNED, Santander, Spain
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