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Novelli M, Galosi S, Zorzi G, Martinelli S, Capuano A, Nardecchia F, Granata T, Pollini L, Di Rocco M, Marras CE, Nardocci N, Leuzzi V. GNAO1-related movement disorder: An update on phenomenology, clinical course, and response to treatments. Parkinsonism Relat Disord 2023:105405. [PMID: 37142469 DOI: 10.1016/j.parkreldis.2023.105405] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/09/2023] [Accepted: 04/16/2023] [Indexed: 05/06/2023]
Abstract
AIM To evaluate clinical phenotype and molecular findings of 157 cases with GNAO1 pathogenic or likely pathogenic variants delineating the clinical spectrum, course, and response to treatments. METHOD Clinical phenotype, genetic data, and pharmacological and surgical treatment history of 11 novel cases and 146 previously published patients were analyzed. RESULTS Complex hyperkinetic movement disorder (MD) characterizes 88% of GNAO1 patients. Severe hypotonia and prominent disturbance of postural control seem to be hallmarks in the early stages preceding the hyperkinetic MD. In a subgroup of patients, paroxysmal exacerbations became so severe as to require admission to intensive care units (ICU). Almost all patients had a good response to deep brain stimulation (DBS). Milder phenotypes with late-onset focal/segmental dystonia, mild to moderate intellectual disability, and other minor neurological signs (i.e., parkinsonism and myoclonus) are emerging. MRI, previously considered noncontributory to a diagnosis, can show recurrent findings (i.e., cerebral atrophy, myelination and/or basal ganglia abnormalities). Fifty-eight GNAO1 pathogenic variants, including missense changes and a few recurrent splice site defects, have been reported. Substitutions at residues Gly203, Arg209 and Glu246, together with the intronic c.724-8G > A change, account for more than 50% of cases. INTERPRETATION Infantile or childhood-onset complex hyperkinetic MD (chorea and/or dystonia) with or without paroxysmal exacerbations, associated hypotonia, and developmental disorders should prompt research for GNAO1 mutations. DBS effectively controls and prevents severe exacerbations and should be considered early in patients with specific GNAO1 variants and refractory MD. Prospective and natural history studies are necessary to define genotype-phenotype correlations further and clarify neurological outcomes.
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Affiliation(s)
- Maria Novelli
- Department of Human Neuroscience, Sapienza University of Rome, Italy
| | - Serena Galosi
- Department of Human Neuroscience, Sapienza University of Rome, Italy.
| | - Giovanna Zorzi
- Department of Pediatric Neuroscience, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Simone Martinelli
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | | | | | - Tiziana Granata
- Department of Pediatric Neuroscience, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Luca Pollini
- Department of Human Neuroscience, Sapienza University of Rome, Italy
| | - Martina Di Rocco
- Department of Human Neuroscience, Sapienza University of Rome, Italy; Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | | | - Nardo Nardocci
- Department of Pediatric Neuroscience, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Vincenzo Leuzzi
- Department of Human Neuroscience, Sapienza University of Rome, Italy
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Koval A, Larasati YA, Savitsky M, Solis GP, Good JM, Quinodoz M, Rivolta C, Superti-Furga A, Katanaev VL. In-depth molecular profiling of an intronic GNAO1 mutant as the basis for personalized high-throughput drug screening. MED 2023; 4:311-325.e7. [PMID: 37001522 DOI: 10.1016/j.medj.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND The GNAO1 gene, encoding the major neuronal G protein Gαo, is mutated in a subset of pediatric encephalopathies. Most such mutations consist of missense variants. METHODS In this study, we present a precision medicine workflow combining next-generation sequencing (NGS) diagnostics, molecular etiology analysis, and personalized drug discovery. FINDINGS We describe a patient carrying a de novo intronic mutation (NM_020988.3:c.724-8G>A), leading to epilepsy-negative encephalopathy with motor dysfunction from the second decade. Our data show that this mutation creates a novel splice acceptor site that in turn causes an in-frame insertion of two amino acid residues, Pro-Gln, within the regulatory switch III region of Gαo. This insertion misconfigures the switch III loop and creates novel interactions with the catalytic switch II region, resulting in increased GTP uptake, defective GTP hydrolysis, and aberrant interactions with effector proteins. In contrast, intracellular localization, Gβγ interactions, and G protein-coupled receptor (GPCR) coupling of the Gαo[insPQ] mutant protein remain unchanged. CONCLUSIONS This in-depth analysis characterizes the heterozygous c.724-8G>A mutation as partially dominant negative, providing clues to the molecular etiology of this specific pathology. Further, this analysis allows us to establish and validate a high-throughput screening platform aiming at identifying molecules that could correct the aberrant biochemical functions of the mutant Gαo. FUNDING This work was supported by the Joint Seed Money Funding scheme between the University of Geneva and the Hebrew University of Jerusalem.
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Affiliation(s)
- Alexey Koval
- Translational Research Center in Oncohaematology, Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Yonika A Larasati
- Translational Research Center in Oncohaematology, Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Mikhail Savitsky
- Translational Research Center in Oncohaematology, Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Gonzalo P Solis
- Translational Research Center in Oncohaematology, Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Jean-Marc Good
- Division of Genetic Medicine, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland
| | - Mathieu Quinodoz
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), 4031 Basel, Switzerland; Department of Ophthalmology, University of Basel, 4031 Basel, Switzerland; Department of Genetics and Genome Biology, University of Leicester, Leicester LE1 7RH, UK
| | - Carlo Rivolta
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), 4031 Basel, Switzerland; Department of Ophthalmology, University of Basel, 4031 Basel, Switzerland; Department of Genetics and Genome Biology, University of Leicester, Leicester LE1 7RH, UK
| | - Andrea Superti-Furga
- Division of Genetic Medicine, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland
| | - Vladimir L Katanaev
- Translational Research Center in Oncohaematology, Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland; Institute of Life Sciences and Biomedicine, Far Eastern Federal University, 690090 Vladivostok, Russia.
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3
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Cnpy3 2xHA mice reveal neuronal expression of Cnpy3 in the brain. J Neurosci Methods 2023; 383:109730. [PMID: 36280087 DOI: 10.1016/j.jneumeth.2022.109730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/04/2022] [Accepted: 10/17/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Identification of biallelic CNPY3 mutations in patients with epileptic encephalopathy and abnormal electroencephalography findings of Cnpy3 knock-out mice have indicated that the loss of CNPY3 function causes neurological disorders such as epilepsy. However, the basic property of CNPY3 in the brain remains unclear. NEW METHOD We generated C-terminal 2xHA-tag knock-in Cnpy3 mice by i-GONAD in vivo genome editing system to investigate the expression and function of Cnpy3 in the mouse brain. RESULTS 2xHA-tagged Cnpy3 was confirmed by immunoblot analysis using anti-HA and CNPY3 antibodies, although HA tagging caused the decreased Cnpy3 protein level. Immunohistochemical analysis of Cnpy32xHA knock-in mice showed that Cnpy3-2xHA was predominantly expressed in the neuron. In addition, Cnpy3 and Cnpy3-2xHA were both localized in the endoplasmic reticulum and synaptosome and showed age-dependent expression changes in the brain. COMPARISON WITH EXISTING METHODS Conventional Cnpy3 antibodies could not allow us to investigate the distribution of Cnpy3 expression in the brain, while HA-tagging revealed the expression of CNPY3 in neuronal cells. CONCLUSIONS Taken together, we demonstrated that Cnpy32xHA knock-in mice would be useful to further elucidate the property of Cnpy3 in brain function and neurological disorders.
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4
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Wirth T, Garone G, Kurian MA, Piton A, Millan F, Telegrafi A, Drouot N, Rudolf G, Chelly J, Marks W, Burglen L, Demailly D, Coubes P, Castro‐Jimenez M, Joriot S, Ghoumid J, Belin J, Faucheux J, Blumkin L, Hull M, Parnes M, Ravelli C, Poulen G, Calmels N, Nemeth AH, Smith M, Barnicoat A, Ewenczyk C, Méneret A, Roze E, Keren B, Mignot C, Beroud C, Acosta F, Nowak C, Wilson WG, Steel D, Capuano A, Vidailhet M, Lin J, Tranchant C, Cif L, Doummar D, Anheim M. Highlighting the Dystonic Phenotype Related to GNAO1. Mov Disord 2022; 37:1547-1554. [PMID: 35722775 PMCID: PMC9545634 DOI: 10.1002/mds.29074] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Most reported patients carrying GNAO1 mutations showed a severe phenotype characterized by early-onset epileptic encephalopathy and/or chorea. OBJECTIVE The aim was to characterize the clinical and genetic features of patients with mild GNAO1-related phenotype with prominent movement disorders. METHODS We included patients diagnosed with GNAO1-related movement disorders of delayed onset (>2 years). Patients experiencing either severe or profound intellectual disability or early-onset epileptic encephalopathy were excluded. RESULTS Twenty-four patients and 1 asymptomatic subject were included. All patients showed dystonia as prominent movement disorder. Dystonia was focal in 1, segmental in 6, multifocal in 4, and generalized in 13. Six patients showed adolescence or adulthood-onset dystonia. Seven patients presented with parkinsonism and 3 with myoclonus. Dysarthria was observed in 19 patients. Mild and moderate ID were present in 10 and 2 patients, respectively. CONCLUSION We highlighted a mild GNAO1-related phenotype, including adolescent-onset dystonia, broadening the clinical spectrum of this condition. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Thomas Wirth
- Département de Neurologie, Hôpital de HautepierreHôpitaux Universitaires de StrasbourgStrasbourg,Fédération de Médecine Translationnelle de Strasbourg (FMTS)Université de StrasbourgStrasbourgFrance,Institut de Génétique et de Biologie Moléculaire et CellulaireIllkirchFrance
| | - Giacomo Garone
- University Hospital Pediatric Department, IRCCS Bambino Gesù Children's HospitalUniversity of Rome Tor VergataRomeItaly,Movement Disorders Clinic, Department of NeurosciencesBambino Gesù Children's HospitalRomeItaly
| | - Manju A. Kurian
- Molecular Neurosciences, Developmental NeurosciencesUCL Great Ormond Street Institute of Child HealthLondonUnited Kingdom
| | - Amélie Piton
- Fédération de Médecine Translationnelle de Strasbourg (FMTS)Université de StrasbourgStrasbourgFrance,Institut de Génétique et de Biologie Moléculaire et CellulaireIllkirchFrance,Laboratoire de diagnostic génétique, Nouvel Hôpital CivilHôpitaux universitaires de StrasbourgStrasbourgFrance
| | | | | | - Nathalie Drouot
- Institut de Génétique et de Biologie Moléculaire et CellulaireIllkirchFrance
| | - Gabrielle Rudolf
- Département de Neurologie, Hôpital de HautepierreHôpitaux Universitaires de StrasbourgStrasbourg,Fédération de Médecine Translationnelle de Strasbourg (FMTS)Université de StrasbourgStrasbourgFrance,Institut de Génétique et de Biologie Moléculaire et CellulaireIllkirchFrance
| | - Jamel Chelly
- Fédération de Médecine Translationnelle de Strasbourg (FMTS)Université de StrasbourgStrasbourgFrance,Institut de Génétique et de Biologie Moléculaire et CellulaireIllkirchFrance,Laboratoire de diagnostic génétique, Nouvel Hôpital CivilHôpitaux universitaires de StrasbourgStrasbourgFrance
| | - Warren Marks
- Cook Children's Medical CentreFort WorthTexasUSA
| | - Lydie Burglen
- Centre de Référence des Malformations et Maladies Congénitales du Cervelet, Département de Génétique et Embryologie MédicaleAPHP, Hôpital TrousseauParisFrance
| | - Diane Demailly
- Département de Neurochirurgie, Unité des Pathologies Cérébrales Résistantes, Unité de Recherche sur les Comportements et Mouvements AnormauxHôpital Gui de Chauliac, Centre Hospitalier Régional MontpellierMontpellierFrance
| | - Phillipe Coubes
- Département de Neurochirurgie, Unité des Pathologies Cérébrales Résistantes, Unité de Recherche sur les Comportements et Mouvements AnormauxHôpital Gui de Chauliac, Centre Hospitalier Régional MontpellierMontpellierFrance
| | - Mayte Castro‐Jimenez
- Service de Neurologie, Department of Clinical NeurosciencesLausanne University Hospital (CHUV) and University of Lausanne (UNIL)LausanneSwitzerland
| | - Sylvie Joriot
- Department of Paediatric NeurologyUniversity Hospital of LilleLilleFrance
| | - Jamal Ghoumid
- Univ. Lille, ULR7364 RADEME, CHU Lille, Clinique de Génétique Guy FontaineLilleFrance
| | | | | | - Lubov Blumkin
- Pediatric Movement Disorders Clinic, Pediatric Neurology Unit, Wolfson Medical Center, Holon, Sackler School of MedicineTel‐Aviv UniversityTel‐AvivIsrael
| | - Mariam Hull
- Pediatric Movement Disorders Clinic, Blue Bird Circle Clinic for Pediatric Neurology, Section of Pediatric Neurology and Developmental NeuroscienceTexas Children's HospitalHoustonTexasUSA
| | - Mered Parnes
- Pediatric Movement Disorders Clinic, Blue Bird Circle Clinic for Pediatric Neurology, Section of Pediatric Neurology and Developmental NeuroscienceTexas Children's HospitalHoustonTexasUSA
| | - Claudia Ravelli
- Sorbonne Université, Service de Neuropédiatrie‐Pathologie du développement, centre de référence neurogénétiqueHôpital Trousseau AP‐HP.SU, FHU I2D2ParisFrance
| | - Gaëtan Poulen
- Département de Neurochirurgie, Unité des Pathologies Cérébrales Résistantes, Unité de Recherche sur les Comportements et Mouvements AnormauxHôpital Gui de Chauliac, Centre Hospitalier Régional MontpellierMontpellierFrance
| | - Nadège Calmels
- Fédération de Médecine Translationnelle de Strasbourg (FMTS)Université de StrasbourgStrasbourgFrance,Institut de Génétique et de Biologie Moléculaire et CellulaireIllkirchFrance,Laboratoire de diagnostic génétique, Nouvel Hôpital CivilHôpitaux universitaires de StrasbourgStrasbourgFrance
| | - Andrea H. Nemeth
- Oxford University Hospitals National Health Service Foundation Trust and University of OxfordOxfordUnited Kingdom
| | - Martin Smith
- Oxford University Hospitals National Health Service Foundation Trust and University of OxfordOxfordUnited Kingdom
| | - Angela Barnicoat
- Department of Clinical GeneticsGreat Ormond Street HospitalLondonUnited Kingdom
| | - Claire Ewenczyk
- Sorbonne Université/Inserm U1127/CNRS UMR 7225/Institut du CerveauParisFrance,Service de neurologie, Hôpital la Pitié SalpêtrièreSorbonne UniversitéParisFrance
| | - Aurélie Méneret
- Sorbonne Université/Inserm U1127/CNRS UMR 7225/Institut du CerveauParisFrance,Service de neurologie, Hôpital la Pitié SalpêtrièreSorbonne UniversitéParisFrance
| | - Emmanuel Roze
- Sorbonne Université/Inserm U1127/CNRS UMR 7225/Institut du CerveauParisFrance,Service de neurologie, Hôpital la Pitié SalpêtrièreSorbonne UniversitéParisFrance
| | - Boris Keren
- Sorbonne Université/Inserm U1127/CNRS UMR 7225/Institut du CerveauParisFrance,Service de neurologie, Hôpital la Pitié SalpêtrièreSorbonne UniversitéParisFrance
| | - Cyril Mignot
- Sorbonne Université/Inserm U1127/CNRS UMR 7225/Institut du CerveauParisFrance,Service de neurologie, Hôpital la Pitié SalpêtrièreSorbonne UniversitéParisFrance
| | - Christophe Beroud
- Aix Marseille Université, INSERM, MMG, Bioinformatics & GeneticsMarseilleFrance
| | | | - Catherine Nowak
- The Feingold Center for Children, Division of Genetics and GenomicsBoston Children's HospitalBostonMassachusettsUSA
| | - William G. Wilson
- Department of PediatricsUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Dora Steel
- Molecular Neurosciences, Developmental NeurosciencesUCL Great Ormond Street Institute of Child HealthLondonUnited Kingdom
| | - Alessandro Capuano
- Movement Disorders Clinic, Department of NeurosciencesBambino Gesù Children's HospitalRomeItaly
| | - Marie Vidailhet
- Sorbonne Université/Inserm U1127/CNRS UMR 7225/Institut du CerveauParisFrance,Service de neurologie, Hôpital la Pitié SalpêtrièreSorbonne UniversitéParisFrance
| | - Jean‐Pierre Lin
- Children's Neurosciences Department, Evelina London Children's HospitalGuy's and St Thomas NHS Foundation TrustLondonUnited Kingdom
| | - Christine Tranchant
- Département de Neurologie, Hôpital de HautepierreHôpitaux Universitaires de StrasbourgStrasbourg,Fédération de Médecine Translationnelle de Strasbourg (FMTS)Université de StrasbourgStrasbourgFrance,Institut de Génétique et de Biologie Moléculaire et CellulaireIllkirchFrance
| | - Laura Cif
- Département de Neurochirurgie, Unité des Pathologies Cérébrales Résistantes, Unité de Recherche sur les Comportements et Mouvements AnormauxHôpital Gui de Chauliac, Centre Hospitalier Régional MontpellierMontpellierFrance
| | - Diane Doummar
- Sorbonne Université, Service de Neuropédiatrie‐Pathologie du développement, centre de référence neurogénétiqueHôpital Trousseau AP‐HP.SU, FHU I2D2ParisFrance
| | - Mathieu Anheim
- Département de Neurologie, Hôpital de HautepierreHôpitaux Universitaires de StrasbourgStrasbourg,Fédération de Médecine Translationnelle de Strasbourg (FMTS)Université de StrasbourgStrasbourgFrance,Institut de Génétique et de Biologie Moléculaire et CellulaireIllkirchFrance
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Al Masseri Z, AlSayed M. Gonadal mosaicism in GNAO1 causing neurodevelopmental disorder with involuntary movements; two additional variants. Mol Genet Metab Rep 2022; 31:100864. [PMID: 35782616 PMCID: PMC9248221 DOI: 10.1016/j.ymgmr.2022.100864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/19/2022] [Accepted: 03/20/2022] [Indexed: 11/25/2022] Open
Abstract
Background GNAO1 encodes an alpha subunit of the heterotrimeric guanine nucleotide-binding proteins (G proteins). Mutations in GNAO1 result in two clinical phenotypes: Early infantile epileptic encephalopathy 17 (EEIE17-OMIM #615473) and Neurodevelopmental disorder with involuntary movements (NEDIM-OMIM #617493). Both are inherited as autosomal dominant disorders and originate mainly as de novo. Only a few are reported as gonadal mosaicism. Materials and methods We recruited and retrospectively reviewed five patients from two families seen at King Faisal Specialist Hospital and Research Centre in Riyadh (KFSHRC). Results All patients presented with severe neurodevelopmental disorder, followed by progressive dystonia and hyperkinetic movements. In addition, none of the patients had seizures which was consistent with NEDIM phenotype. The specific diagnosis was not clinically entertained and was only found on whole exome sequencing (WES), which identified two variants (c.724-8G > A & c.709G > A). Both variants were previously reported as pathogenic de novo in patients with NEDIM, and one was reported as parental gonadal mosaicism. Conclusion We report these variants as additional variants in GNAO1 gene that may be inherited as parental gonadal mosaicism. Both variants resulted in NEDIM with no observed clinical differences in the severity than the reported cases. This noticeable reported association between GNAO1 gene associated disorders and gonadal mosaicism should be considered in reproductive genetic counselling of affected families. Furthermore, in view of these reports, more studies with prospective data collection to explore the association between GNAO1 and gonadal mosaicism and the underlying mechanisms will be necessary.
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