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Gao SY, Liu YX, Dong Y, Fan LL, Ding Q, Liu L. Case report: A novel WASHC5 variant altering mRNA splicing causes spastic paraplegia in a patient. Front Genet 2023; 14:1205052. [PMID: 38028608 PMCID: PMC10644772 DOI: 10.3389/fgene.2023.1205052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Background: Hereditary spastic paraplegia (HSP) is a progressive upper-motor neurodegenerative disease. Mutations in the WASHC5 gene are associated with autosomal dominant HSP, spastic paraplegia 8 (SPG8). However, due to the small number of reported cases, the exact mechanism remains unclear. Method: We report a Chinese family with HSP. The proband was referred to our hospital due to restless leg syndrome and insomnia. The preliminary clinical diagnosis of the proband was spastic paraplegia. Whole-exome sequencing (WES) and RNA splicing analysis were conducted to evaluate the genetic cause of the disease in this family. Results: A novel splice-altering variant (c.712-2A>G) in the WASHC5 gene was detected and further verified by RNA splicing analysis and Sanger sequencing. Real-time qPCR analysis showed that the expression of genes involved in the Wiskott-Aldrich syndrome protein and SCAR homolog (WASH) complex and endosomal and lysosomal systems was altered due to this variant. Conclusion: A novel heterozygous splice-altering variant (c.712-2A>G) in the WASHC5 gene was detected in a Chinese family with HSP. Our study provided data for genetic counseling to this family and offered evidence that this splicing variant in the WASHC5 gene is significant in causing HSP.
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Affiliation(s)
- Shan-Yu Gao
- Department of Neurology, Changshu No. 2 People’s Hospital, Changshu, China
- Department of Cell Biology, School of Life Science, Central South University, Changsha, China
- Department of Pulmonary and Critical Care Medicine, Research Unit of Respiratory Disease, Hunan Diagnosis and Treatment Center of Respiratory Disease, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yu-Xing Liu
- Department of Cell Biology, School of Life Science, Central South University, Changsha, China
- Department of Nephrology, Xiangya Hospital Central South University, Changsha, China
| | - Yi Dong
- Department of Cell Biology, School of Life Science, Central South University, Changsha, China
| | - Liang-Liang Fan
- Department of Cell Biology, School of Life Science, Central South University, Changsha, China
| | - Qi Ding
- Department of Neurology, Changshu No. 2 People’s Hospital, Changshu, China
| | - Lv Liu
- Department of Pulmonary and Critical Care Medicine, Research Unit of Respiratory Disease, Hunan Diagnosis and Treatment Center of Respiratory Disease, The Second Xiangya Hospital, Central South University, Changsha, China
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Smith KM, Wirrell EC, Andrade DM, Choi H, Trenité DKN, Jones H, Knupp KG, Mugar J, Nordli DR, Riva A, Stern JM, Striano P, Thiele EA, Zawar I. Clinical presentation and evaluation of epilepsy with eyelid myoclonia: Results of an international expert consensus panel. Epilepsia 2023; 64:2330-2341. [PMID: 37329145 DOI: 10.1111/epi.17683] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/31/2023] [Accepted: 06/13/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The objective of this study was to determine areas of consensus among an international panel of experts for the clinical presentation and diagnosis of epilepsy with eyelid myoclonia (EEM; formerly known as Jeavons syndrome) to improve a timely diagnosis. METHODS An international steering committee was convened of physicians and patients/caregivers with expertise in EEM. This committee summarized the current literature and identified an international panel of experts (comprising 25 physicians and five patients/caregivers). This international expert panel participated in a modified Delphi process, including three rounds of surveys to determine areas of consensus for the diagnosis of EEM. RESULTS There was a strong consensus that EEM is a female predominant generalized epilepsy syndrome with onset between 3 and 12 years of age and that eyelid myoclonia must be present to make the diagnosis. There was a strong consensus that eyelid myoclonia may go unrecognized for years prior to an epilepsy diagnosis. There was consensus that generalized tonic-clonic and absence seizures are typically or occasionally seen in patients. There was a consensus that atonic or focal seizures should lead to the consideration of reclassification or alternate diagnoses. There was a strong consensus that electroencephalography is required, whereas magnetic resonance imaging is not required for diagnosis. There was a strong consensus to perform genetic testing (either epilepsy gene panel or whole exome sequencing) when one or a combination of factors was present: family history of epilepsy, intellectual disability, or drug-resistant epilepsy. SIGNIFICANCE This international expert panel identified multiple areas of consensus regarding the presentation and evaluation of EEM. These areas of consensus may be used to inform clinical practice to shorten the time to the appropriate diagnosis.
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Affiliation(s)
- Kelsey M Smith
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Danielle M Andrade
- Department of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Hyunmi Choi
- Department of Neurology, Columbia University, New York, New York, USA
| | | | | | - Kelly G Knupp
- Department of Pediatrics, University of Colorado, Aurora, Colorado, USA
| | | | - Douglas R Nordli
- Department of Neurology, University of Chicago, Chicago, Illinois, USA
| | - Antonella Riva
- Istituto di Ricovero e Cura a Carattere Scientifico Istituto Giannina Gaslini and Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - John M Stern
- Department of Neurology, University of California, Los Angeles, Los Angeles, California, USA
| | - Pasquale Striano
- Istituto di Ricovero e Cura a Carattere Scientifico Istituto Giannina Gaslini and Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Elizabeth A Thiele
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ifrah Zawar
- Department of Neurology, University of Virginia, Charlottesville, Virginia, USA
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3
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Smith KM, Wirrell EC, Andrade DM, Choi H, Trenité DKN, Knupp KG, Nordli DR, Riva A, Stern JM, Striano P, Thiele EA, Zawar I. A comprehensive narrative review of epilepsy with eyelid myoclonia. Epilepsy Res 2023; 193:107147. [PMID: 37121024 DOI: 10.1016/j.eplepsyres.2023.107147] [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: 03/15/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/02/2023]
Abstract
Epilepsy with eyelid myoclonia (EEM) is a generalized epilepsy syndrome with childhood-onset and 2:1 female predominance that consists of: 1. eyelid myoclonia with or without absence seizures, 2. eye closure induced seizures or EEG paroxysms, 3. clinical or EEG photosensitivity. While eyelid myoclonia is the disease hallmark, other seizure types, including absence seizures and generalized tonic-clonic seizures, may be present. It is thought to have a genetic etiology, and around one-third of patients may have a positive family history of epilepsy. Recently, specific genetic mutations have been recognized in a minority patients, including in SYNGAP1, NEXMIF, RORB, and CHD2 genes. There are no randomized controlled trials in EEM, and the management literature is largely restricted to small retrospective studies. Broad-spectrum antiseizure medications such as valproate, levetiracetam, lamotrigine, and benzodiazepines are typically used. Seizures typically persist into adulthood, and drug-resistant epilepsy is reported in over 50%.
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Affiliation(s)
- Kelsey M Smith
- Department of Neurology, Mayo Clinic, Rochester, MN, United States.
| | - Elaine C Wirrell
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | | | - Hyunmi Choi
- Department of Neurology, Columbia University, New York, NY, United States
| | | | - Kelly G Knupp
- Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Douglas R Nordli
- Department of Neurology, University of Chicago, Chicago, IL, United States
| | - Antonella Riva
- IRCCS Istituto Giannina Gaslini", Genova, Italy and Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - John M Stern
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States
| | - Pasquale Striano
- IRCCS Istituto Giannina Gaslini", Genova, Italy and Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Elizabeth A Thiele
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
| | - Ifrah Zawar
- Department of Neurology, University of Virginia, Charlottesville, VA, United States
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4
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Soliani L, Alcalá San Martín A, Balsells S, Hernando‐Davalillo C, Ortigoza‐Escobar JD. Chromosome Microarray Analysis for the Investigation of Deletions in Pediatric Movement Disorders: A Systematic Review of the Literature. Mov Disord Clin Pract 2023; 10:547-557. [PMID: 37070051 PMCID: PMC10105116 DOI: 10.1002/mdc3.13711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/19/2023] [Accepted: 02/19/2023] [Indexed: 03/06/2023] Open
Abstract
Background Chromosome microarray analysis (CMA) can detect copy number variants (CNV) beyond the resolution of standard G-banded karyotyping. De novo or inherited microdeletions may cause autosomal dominant movement disorders. Objectives The purpose of this study was to analyze the clinical characteristics, associated features, and genetic information of children with deletions in known genes that cause movement disorders and to make recommendations regarding the diagnostic application of CMA. Methods Clinical cases published in English were identified in scientific databases (PubMed, ClinVar, and DECIPHER) from January 1998 to July 2019 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Cases with deletions or microdeletions greater than 300 kb were selected. Information collected included age, sex, movement disorders, associated features, and the size and location of the deletion. Duplications or microduplications were not included. Results A total of 18.097 records were reviewed, and 171 individuals were identified. Ataxia (30.4%), stereotypies (23.9%), and dystonia (21%) were the most common movement disorders. A total of 16% of the patients demonstrated more than one movement disorder. The most common associated features were intellectual disability or developmental delay (78.9%) and facial dysmorphism (57.8%). The majority (77.7%) of microdeletions were smaller than 5 Mb. We find no correlation between movement disorders, their associated features, and the size of microdeletions. Conclusions Our results support the use of CMA as an investigational test in children with movement disorders. As the majority of identified articles were case reports and small case series (low quality), future efforts should focus on larger prospective studies to examine the causation of microdeletions in pediatric movement disorders.
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Affiliation(s)
- Luca Soliani
- IRCCS Istituto delle Scienze Neurologiche di Bologna UOC Neuropsichiatria dell'età PediatricaBolognaItaly
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC) Università di BolognaBolognaItaly
| | - Adrián Alcalá San Martín
- Department of Genetic and Molecular Medicine and Pediatric Institute of Rare DiseasesHospital Sant Joan de Déu BarcelonaBarcelonaSpain
| | - Sol Balsells
- Department of StatisticsInstitut de Recerca Sant Joan de DéuBarcelonaSpain
| | - Cristina Hernando‐Davalillo
- Department of Genetic and Molecular Medicine and Pediatric Institute of Rare DiseasesHospital Sant Joan de Déu BarcelonaBarcelonaSpain
| | - Juan Darío Ortigoza‐Escobar
- U‐703 Centre for Biomedical Research on Rare Diseases (CIBER‐ER)Instituto de Salud Carlos IIIBarcelonaSpain
- Movement Disorders Unit, Pediatric Neurology Department, Institut de RecercaHospital Sant Joan de Déu BarcelonaBarcelonaSpain
- European Reference Network for Rare Neurological Diseases (ERN‐RND)BarcelonaSpain
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5
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Wang Y, Zhang X, Zhang W, Peng M, Tan G, Qaseem MF, Li H, Wu AM. Physiological and transcriptomic responses to magnesium deficiency in Neolamarckia Cadamba. PLANT PHYSIOLOGY AND BIOCHEMISTRY : PPB 2023; 197:107645. [PMID: 36963300 DOI: 10.1016/j.plaphy.2023.107645] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/23/2023] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
Magnesium (Mg2+) is a critical component of chlorophyll and enzymes involved in various physiological and biochemical processes essential for plant growth, biomass accumulation, and photosynthesis. Mg2+ deficiency (MgD) is common in hot and rainy subtropical areas due to its easy loss from soil. Neolamarckia cadamba, an important tropical tree in South Asia, faces severe effects of MgD, however, the responses of N. cadamba to MgD stress remain unclear. In here, effects of N. cadamba under MgD stress were investigated. The study revealed that MgD had lower plant biomass, fresh and dry weight, root length, root volume, and surface area compared to CK (normal Mg2+). As treatment time increased, the leaves began to yellow, and lesions appeared. Chlorophyll a, chlorophyll b, and total chlorophyll content, along with fluorescence-related parameters and leaf photosynthetic capacity, were significantly reduced in MgD stress compared to CK treatment. Transcriptome analysis showed that transporters as well as transcription factors (TFs) from MYC (v-myc avian myelocytomatosis viral oncogene homolog), MYB (v-myb avian myeloblastosis viral oncogene homolog), bHLH (basic helix-loop-helix) and WRKY families were upregulated in leaves at 10 d of MgD stress, indicating that magnesium signaling transduction might be activated to compensate MgD. In addition, genes including chlorophyll(ide) b reductase (NYC1/NOL) chlorophyll/bacteriochlorophyll synthase (G4) and 7-hydroxymethyl chlorophyll a reductase synthesizing (HCAR) chlorophyll a and chlorophyll b were down-regulated in leaves, while those scavenging reactive oxygen species (ROS) were mainly up-regulated at 10 d of MgD stress. These results shed light on underlying MgD in N. cadamba.
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Affiliation(s)
- Yueyang Wang
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, Guangdong Key Laboratory for Innovative Development and Utilization of Forest Plant Germplasm, College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, 510642, China
| | - Xintong Zhang
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, Guangdong Key Laboratory for Innovative Development and Utilization of Forest Plant Germplasm, College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, 510642, China
| | - Wenjuan Zhang
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, Guangdong Key Laboratory for Innovative Development and Utilization of Forest Plant Germplasm, College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, 510642, China
| | - Mengxuan Peng
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, Guangdong Key Laboratory for Innovative Development and Utilization of Forest Plant Germplasm, College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, 510642, China
| | - Guoqing Tan
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, Guangdong Key Laboratory for Innovative Development and Utilization of Forest Plant Germplasm, College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, 510642, China
| | - Mirza Faisal Qaseem
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, Guangdong Key Laboratory for Innovative Development and Utilization of Forest Plant Germplasm, College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, 510642, China
| | - Huiling Li
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, Guangdong Key Laboratory for Innovative Development and Utilization of Forest Plant Germplasm, College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, 510642, China.
| | - Ai-Min Wu
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, Guangdong Key Laboratory for Innovative Development and Utilization of Forest Plant Germplasm, College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, 510642, China; Guangdong Laboratory of Lingnan Modern Agriculture, Guangzhou, 510642, China.
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6
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Fang SY, Chou YT, Hsu KC, Hsu SL, Yu KW, Tsai YS, Liao YC, Tsai PC, Lee YC. Clinical and genetic characterization of NIPA1 mutations in a Taiwanese cohort with hereditary spastic paraplegia. Ann Clin Transl Neurol 2023; 10:353-362. [PMID: 36607129 PMCID: PMC10014004 DOI: 10.1002/acn3.51724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 12/10/2022] [Accepted: 12/17/2022] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE NIPA1 mutations have been implicated in hereditary spastic paraplegia (HSP) as the cause of spastic paraplegia type 6 (SPG6). The aim of this study was to investigate the clinical and genetic features of SPG6 in a Taiwanese HSP cohort. METHODS We screened 242 unrelated Taiwanese patients with HSP for NIPA1 mutations. The clinical features of patients with a NIPA1 mutation were analyzed. Minigene-based splicing assay, RT-PCR analysis on the patients' RNA, and cell-based protein expression study were utilized to assess the effects of the mutations on splicing and protein expression. RESULTS Two patients were identified to carry a different heterozygous NIPA1 mutation. The two mutations, c.316G>A and c.316G>C, are located in the 3' end of NIPA1 exon 3 near the exon-intron boundary and putatively lead to the same amino acid substitution, p.G106R. The patient harboring NIPA1 c.316G>A manifested spastic paraplegia, epilepsy and schizophrenia since age 17 years, whereas the individual carrying NIPA1 c.316G>C had pure HSP since age 12 years. We reviewed literature and found that epilepsy was present in multiple individuals with NIPA1 c.316G>A but none with NIPA1 c.316G>C. Functional studies demonstrated that both mutations did not affect splicing, but only the c.316G>A mutation was associated with a significantly reduced NIPA1 protein expression. INTERPRETATION SPG6 accounted for 0.8% of HSP cases in the Taiwanese cohort. The NIPA1 c.316G>A and c.316G>C mutations are associated with adolescent-onset complex and pure form HSP, respectively. The different effects on protein expression of the two mutations may be associated with their phenotypic discrepancy.
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Affiliation(s)
- Shih-Yu Fang
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Neurology, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan
| | - Ying-Tsen Chou
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kuo-Chou Hsu
- Department of Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yuanshan, Taiwan
| | - Shao-Lun Hsu
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Neurology, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan
| | - Kai-Wei Yu
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Shuen Tsai
- Center for Systems and Synthetic Biology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Chu Liao
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Neurology, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Pei-Chien Tsai
- Department of Life Sciences, National Chung Hsing University, Taichung, Taiwan
| | - Yi-Chung Lee
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Neurology, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Prader-Willi Syndrome and Chromosome 15q11.2 BP1-BP2 Region: A Review. Int J Mol Sci 2023; 24:ijms24054271. [PMID: 36901699 PMCID: PMC10002205 DOI: 10.3390/ijms24054271] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/13/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
Prader-Willi syndrome (PWS) is a complex genetic disorder with three PWS molecular genetic classes and presents as severe hypotonia, failure to thrive, hypogonadism/hypogenitalism and developmental delay during infancy. Hyperphagia, obesity, learning and behavioral problems, short stature with growth and other hormone deficiencies are identified during childhood. Those with the larger 15q11-q13 Type I deletion with the absence of four non-imprinted genes (NIPA1, NIPA2, CYFIP1, TUBGCP5) from the 15q11.2 BP1-BP2 region are more severely affected compared with those with PWS having a smaller Type II deletion. NIPA1 and NIPA2 genes encode magnesium and cation transporters, supporting brain and muscle development and function, glucose and insulin metabolism and neurobehavioral outcomes. Lower magnesium levels are reported in those with Type I deletions. The CYFIP1 gene encodes a protein associated with fragile X syndrome. The TUBGCP5 gene is associated with attention-deficit hyperactivity disorder (ADHD) and compulsions, more commonly seen in PWS with the Type I deletion. When the 15q11.2 BP1-BP2 region alone is deleted, neurodevelopment, motor, learning and behavioral problems including seizures, ADHD, obsessive-compulsive disorder (OCD) and autism may occur with other clinical findings recognized as Burnside-Butler syndrome. The genes in the 15q11.2 BP1-BP2 region may contribute to more clinical involvement and comorbidities in those with PWS and Type I deletions.
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Panwala TF, Garcia-Santibanez R, Vizcarra JA, Garcia AG, Verma S. Childhood-Onset Hereditary Spastic Paraplegia (HSP): A Case Series and Review of Literature. Pediatr Neurol 2022; 130:7-13. [PMID: 35303589 DOI: 10.1016/j.pediatrneurol.2022.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/30/2022] [Accepted: 02/25/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Hereditary spastic paraplegia (HSP) encompasses several rare genetic disorders characterized by progressive lower extremity spasticity and weakness caused by corticospinal tract degeneration. Published literature on genetically confirmed pediatric HSP cases is limited. METHODS We conducted a retrospective review of childhood-onset HSP cases followed in the neuromuscular clinics at Children's and Emory Healthcare in Atlanta. Clinical presentation, family history, examination, electrodiagnostic data, neuroimaging, genetic test results, comorbidities, and treatment were recorded. RESULTS Sixteen patients with HSP (eight males, eight females) with a mean age 19 years ± 15.7 years were included. Ten patients (66%) presented with gait difficulty. Seven (44%) were ambulatory at the last clinic follow-up visit with an average disease duration of 7.4 years. Genetically confirmed etiologies included SPAST (3 patients), MARS (2), KIF1A (2), KIF5A (1), SACS (1), SPG7 (1), REEP1 (1), PNPT1 (1), MT-ATP6 (1), and ATL1 (1). Symptom onset to genetic confirmation on an average was 8.2 years. Sensory motor axonal polyneuropathy was found in seven patients, and two exhibited cerebellar atrophy on magnetic resonance imaging (MRI) of the brain. Neurological comorbidities included developmental delay (n = 9), autism (n = 5), epilepsy (n = 3), and attention-deficit/hyperactivity disorder (n = 2). CONCLUSIONS In our study, a significant proportion (70%) of subjects with childhood-onset HSP had comorbid neurocognitive deficits, polyneuropathy with or without neuroimaging abnormalities, and rare genetic etiology. Genetic diagnosis was established either through inherited genetic neuropathy panel or whole-exome sequencing, which supports the utility of whole-exome sequencing in aiding in HSP diagnosis.
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Affiliation(s)
- Tanya F Panwala
- Florida Atlantic University, Charles E. Schmidt College of Medicine, Boca Raton, Florida
| | | | - Joaquin A Vizcarra
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
| | - Aixa Gonzalez Garcia
- Department of Pediatrics, Genetics Section, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Arkansas
| | - Sumit Verma
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia; Division of Pediatric Neurology, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia.
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Fu J, Ma M, Li G, Zhang J. Clinical and Genetic Features of Chinese Patients With NIPA1-Related Hereditary Spastic Paraplegia Type 6. Front Genet 2022; 13:859688. [PMID: 35464835 PMCID: PMC9024055 DOI: 10.3389/fgene.2022.859688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/22/2022] [Indexed: 12/03/2022] Open
Abstract
Background: Mutations in the NIPA1 gene cause hereditary spastic paraplegia (HSP) type 6 (SPG6), which is a rare type of HSP with a frequency of less than 1% in Europe. To date, less than 30 SPG6 families and limited NIPA1 mutations have been reported in different ethnic regions. The clinical features are variable. Methods: We screened for NIPA1 mutations by whole exome sequencing or next generation sequencing in 35 unrelated Chinese families with HSP. The clinical manifestations were evaluated. Results: Two variants of NIPA1 were identified in three index patients (3/35, 8.6%), two of whom carried a previously reported common variant c.316G > A (p.G106R), and the third patient harbored a novel likely pathogenic variant c.126C > G (p.N42K). Both variants were de novo in the three index patients. The phenotype was pure HSP in two patients and complicated HSP with epilepsy in the third one. Conclusion:NIPA1-related HSP is more common in China than it in Europe. Both pure and complicated form of HSP can be found. The variant c.316G > A is a hotspot mutation, and the novel variant c.126C > G expands the mutational spectrum. The phenomenon of de novo mutations in NIPA1 emphasizes the need to consider autosomal dominant HSP-related genes in sporadic patients.
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Affiliation(s)
- Jun Fu
- Department of Neurological Diseases, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China.,Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Mingming Ma
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Gang Li
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Jiewen Zhang
- Department of Neurological Diseases, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China.,Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China.,Center of Neurological Rare Diseases of Henan Province, Zhengzhou, China
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10
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Boysen S, Elumalai V, ElSheikh RH, Aravindhan A, Veerapandiyan A. Epilepsy in hereditary spastic paraplegia associated with NIPA1 gene. J Clin Neurosci 2022; 100:212-213. [PMID: 35181192 DOI: 10.1016/j.jocn.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 10/19/2022]
Affiliation(s)
- Sebastian Boysen
- Division of Neurology, Department of Pediatrics, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Vimala Elumalai
- Division of Neurology, Department of Pediatrics, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Reem H ElSheikh
- Division of Neurology, Department of Pediatrics, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Akilandeswari Aravindhan
- Division of Neurology, Department of Pediatrics, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Aravindhan Veerapandiyan
- Division of Neurology, Department of Pediatrics, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
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