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Beloribi-Djefaflia S, Morales RJ, Fatehi F, Isapof A, Servais L, Leonard-Louis S, Michaud M, Verdure P, Gidaro T, Pouget J, Poinsignon V, Bonello-Palot N, Attarian S. Clinical and genetic features of patients suffering from CMT4J. J Neurol 2024; 271:1355-1365. [PMID: 37950760 DOI: 10.1007/s00415-023-12076-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 11/13/2023]
Abstract
Mutations in the FIG4 gene have been identified in various diseases, including amyotrophic lateral sclerosis, Parkinson's disease, and Charcot-Marie-Tooth 4 J (CMT4J), with a wide range of phenotypic manifestations. We present eight cases of CMT4J patients carrying the p.Ile41Thr mutation of FIG4. The patients were categorized according to their phenotype. Six patients had a pure CMT; whereas, two patients had a CMT associated with parkinsonism. Three patients had an early onset and exhibited more severe forms of the disease. Three others experienced symptoms in their teenage years and had milder forms. Two patients had a late onset in adulthood. Four patients showed electrophysiological evidence of conduction blocks, typically associated with acquired neuropathies. Consequently, two of them received intravenous immunoglobulin treatment without a significant objective response. Interestingly, two heterozygous patients with the same mutations exhibited contrasting phenotypes, one having a severe early-onset form and the other experiencing a slow disease progression starting at the age of 49. Notably, although 7 out of 8 patients in this study were compound heterozygous for the p.Ile41Thr mutation, only one individual was found to be homozygous for this genetic variant and exhibited an early-onset, severe form of the disease. Additionally, one patient who developed the disease in his youth was also diagnosed with hereditary neuropathy with pressure palsies. Our findings provide insights into the CMT4J subtype by reporting on eight heterogeneous patient cases and highlight the potential for misdiagnosis when conduction blocks or asymmetrical nerve conduction study results are observed in patients with FIG4 mutations.
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Affiliation(s)
- Sadia Beloribi-Djefaflia
- Reference Center for Neuromuscular Disorders and ALS, Timone University Hospital, Aix-Marseille University, 264 Rue Saint Pierre, 05 13385, Marseille, Cedex, France
- Filnemus, European Reference Network of Rare Diseases (ERN), Marseille, France
| | - Raul Juntas Morales
- Neuromuscular Unit. Neurology Department, Vall d'Hebron University Hospital. Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Farzad Fatehi
- Reference Center for Neuromuscular Disorders and ALS, Timone University Hospital, Aix-Marseille University, 264 Rue Saint Pierre, 05 13385, Marseille, Cedex, France
- Filnemus, European Reference Network of Rare Diseases (ERN), Marseille, France
| | - Arnaud Isapof
- Pediatric Neurology Department, Reference Centre for Neuromuscular Diseases, Armand Trousseau Hospital, APHP, Sorbonne University, 26, Avenue du Docteur Arnold Netter, 75012, Paris, France
| | - Laurent Servais
- MDUK Oxford Neuromuscular Centre and NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
- Neuromuscular Reference Center, Department of Paediatrics, University and University Hospital of Liege, Liege, Belgium
| | - Sarah Leonard-Louis
- Neuromyology, Reference Center of Neuromuscular Disorders, Pitié Salpétrière Hospital, APHP, 47-83 Boulevard de L'Hôpital, 75651, Paris Cedex 13, France
| | - Maud Michaud
- Reference Center for Neuromuscular Disorders, Central Nancy University Hospital, 29 Avenue Maréchal de Lattre de Tassigny, 54035, Nancy, France
| | | | - Teresa Gidaro
- I-Motion Institute, Hôpital Trousseau, Paris, France
| | - Jean Pouget
- Reference Center for Neuromuscular Disorders and ALS, Timone University Hospital, Aix-Marseille University, 264 Rue Saint Pierre, 05 13385, Marseille, Cedex, France
- Filnemus, European Reference Network of Rare Diseases (ERN), Marseille, France
- Aix Marseille Université-Inserm UMR 1251, Medical Genetics and Functional Genomics, Marseille, France
| | - Vianney Poinsignon
- Department of Molecular Genetics Pharmacogenomics and Hormonology, APHP, CHU de Bicêtre, 94276, Le Kremlin-Bicêtre, France
| | - Nathalie Bonello-Palot
- Aix Marseille Université-Inserm UMR 1251, Medical Genetics and Functional Genomics, Marseille, France
| | - Shahram Attarian
- Reference Center for Neuromuscular Disorders and ALS, Timone University Hospital, Aix-Marseille University, 264 Rue Saint Pierre, 05 13385, Marseille, Cedex, France.
- Filnemus, European Reference Network of Rare Diseases (ERN), Marseille, France.
- Aix Marseille Université-Inserm UMR 1251, Medical Genetics and Functional Genomics, Marseille, France.
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Brooks JK, Porter NC, Bisordi KA, Miclat CE, Greene CL. Review of general and head and neck/oral and maxillofacial features of Charcot-Marie-Tooth disease and dental management considerations. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 133:e170-e177. [PMID: 35305937 DOI: 10.1016/j.oooo.2021.12.125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/19/2021] [Indexed: 01/15/2023]
Abstract
Charcot-Marie-Tooth disease (CMTD) is an uncommon progressive neuromuscular disorder of the peripheral nervous system and primarily leads to distal extremity weakness and sensory deficits. Frequently, affected patients manifest pes cavus, drop foot, and digit contractures that may pose significant challenges in ambulation and grasping objects. Although there are numerous articles of this syndrome in the medical literature, there is a limited number of dental publications. The objective of this article is to review the general and head and neck/oral and maxillofacial features of CMTD. General guidelines for dental management are also provided.
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Affiliation(s)
- John K Brooks
- Clinical Professor, Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD, USA.
| | - Neil C Porter
- Assistant Professor, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Katharine A Bisordi
- Instructor and Genetic Counselor, Department of Pediatrics, Division of Human Genetics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Claire E Miclat
- Predoctoral student, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Carol L Greene
- Professor, Director of Clinical Genetics Service, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
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Shintaku M, Maeda K, Shiohara M, Namura T, Kushima R. Neuropathology of the spinal nerve roots, spinal cord, and brain in the first autopsied case of Charcot-Marie-Tooth disease 4F with a D651N mutation in the periaxin gene. Neuropathology 2021; 41:281-287. [PMID: 34002422 DOI: 10.1111/neup.12731] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/07/2021] [Accepted: 01/14/2021] [Indexed: 11/29/2022]
Abstract
Charcot-Marie-Tooth disease (CMT) 4F is an autosomal recessive, hereditary peripheral neuropathy, mostly caused by mutations in the periaxin gene (PRX). This article reports neuropathological findings of the spinal nerve roots, spinal cord, and brain of a patient with CMT4F and a D651N missense mutation in PRX. The patient was a 74-year-old woman who had a history of peripheral neuropathy with onset at the age of 30 years. She also had a history of infantile paralysis at the age of 18 months. The most pronounced autopsy finding was diffuse enlargement of anterior and posterior nerve roots, accentuated at the lumbo-sacral levels. On microscopy, the swollen nerve roots showed a loss of large-diameter myelinated fibers and formation of numerous onion bulbs. Most of the onion bulbs lacked the central, regenerating thin myelin sheaths, and in large-diameter nerve fibers whose axons had been lost, collagen fibers occupied the center of the onion bulbs. Some nerve roots formed glial bundles at the proximal end. The spinal cord showed degeneration of the gracile fascicles, and the lumbar segment anterior horn showed an asymmetric neuronal loss with rarefaction of the neuropil. The brain did not show any notable changes except for multiple foci of a radial microcolumnar arrangement of neurons in the cerebral cortex. Degeneration of the lumbar segment anterior horn is most likely secondary to the anterior radiculopathy, but a localized circulatory disturbance is another possibility.
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Affiliation(s)
| | - Kengo Maeda
- Department of Neurology, Vories Memorial Hospital, Omi-hachiman, Japan
| | - Masanori Shiohara
- Department of Clinical Laboratory Medicine and Diagnostic Pathology, Shiga University of Medical Science, Ohtsu, Japan
| | - Tomo Namura
- Department of Clinical Laboratory Medicine and Diagnostic Pathology, Shiga University of Medical Science, Ohtsu, Japan
| | - Ryoji Kushima
- Department of Clinical Laboratory Medicine and Diagnostic Pathology, Shiga University of Medical Science, Ohtsu, Japan
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Kacem I, Sghaier I, Bougatef S, Nasri A, Gargouri A, Ajroud-Driss S, Gouider R. Epidemiological and clinical features of amyotrophic lateral sclerosis in a Tunisian cohort. Amyotroph Lateral Scler Frontotemporal Degener 2019; 21:131-139. [DOI: 10.1080/21678421.2019.1704012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Imen Kacem
- Department of Neurology, LR18SP03, Razi Hospital, Tunis, Tunisia,
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,
| | - Ikram Sghaier
- Department of Neurology, LR18SP03, Razi Hospital, Tunis, Tunisia,
| | - Sabrine Bougatef
- Department of Neurology, LR18SP03, Razi Hospital, Tunis, Tunisia,
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,
| | - Amina Nasri
- Department of Neurology, LR18SP03, Razi Hospital, Tunis, Tunisia,
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,
| | - Amina Gargouri
- Department of Neurology, LR18SP03, Razi Hospital, Tunis, Tunisia,
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,
| | | | - Riadh Gouider
- Department of Neurology, LR18SP03, Razi Hospital, Tunis, Tunisia,
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,
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Kinesins: Motor Proteins as Novel Target for the Treatment of Chronic Pain. Mol Neurobiol 2018; 56:3854-3864. [DOI: 10.1007/s12035-018-1327-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 08/21/2018] [Indexed: 10/28/2022]
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Mathis S, Goizet C, Tazir M, Magdelaine C, Lia AS, Magy L, Vallat JM. Charcot-Marie-Tooth diseases: an update and some new proposals for the classification. J Med Genet 2015; 52:681-90. [PMID: 26246519 DOI: 10.1136/jmedgenet-2015-103272] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 07/13/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND Charcot-Marie-Tooth (CMT) disease, the most frequent form of inherited neuropathy, is a genetically heterogeneous group of disorders of the peripheral nervous system, but with a quite homogeneous clinical phenotype (progressive distal muscle weakness and atrophy, foot deformities, distal sensory loss and usually decreased tendon reflexes). Our aim was to review the various CMT subtypes identified at the present time. METHODS We have analysed the medical literature and performed a historical retrospective of the main steps from the individualisation of the disease (at the end of the nineteenth century) to the recent knowledge about CMT. RESULTS To date, >60 genes (expressed in Schwann cells and neurons) have been implicated in CMT and related syndromes. The recent advances in molecular genetic techniques (such as next-generation sequencing) are promising in CMT, but it is still useful to recognise some specific clinical or pathological signs that enable us to validate genetic results. In this review, we discuss the diagnostic approaches and the underlying molecular pathogenesis. CONCLUSIONS We suggest a modification of the current classification and explain why such a change is needed.
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Affiliation(s)
- Stéphane Mathis
- Department of Neurology, University Hospital, Poitiers, France Department of Neurology (National Reference Center "Neuropathies Périphériques Rares"), University Hospital Dupuytren, Limoges, France
| | - Cyril Goizet
- Department of Medical Genetics, University Hospital (CHU Pellegrin), Bordeaux, France
| | - Meriem Tazir
- Department of Neurology, University Hospital Mustapha Bacha, Algiers, Algeria
| | | | - Anne-Sophie Lia
- Department of Genetics, University Hospital, Limoges, France
| | - Laurent Magy
- Department of Neurology (National Reference Center "Neuropathies Périphériques Rares"), University Hospital Dupuytren, Limoges, France
| | - Jean-Michel Vallat
- Department of Neurology (National Reference Center "Neuropathies Périphériques Rares"), University Hospital Dupuytren, Limoges, France
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Mathis S, Magy L, Vallat JM. Therapeutic options in Charcot–Marie–Tooth diseases. Expert Rev Neurother 2015; 15:355-66. [DOI: 10.1586/14737175.2015.1017471] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Neuropathologic Characterization ofINF2-Related Charcot-Marie-Tooth Disease: Evidence for a Schwann Cell Actinopathy. J Neuropathol Exp Neurol 2014; 73:223-33. [DOI: 10.1097/nen.0000000000000047] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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9
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New mutation in periaxin gene causing Charcot Marie Tooth disease in a Puerto Rican young male. J Clin Neuromuscul Dis 2013; 15:63-8. [PMID: 24263033 DOI: 10.1097/cnd.0000000000000009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Charcot-Marie-Tooth (CMT) disease is an inherited peripheral neuropathy caused by mutations in more than 30 different genes. One of the genes encodes for periaxin (PRX) protein, which is required for the maintenance of peripheral nerve myelin. Individuals with PRX gene mutations have been described to present early-onset, autosomal recessive, demyelinating CMT disease or CMT4F subtype. Only 23 mutations involving the PRX gene have been reported in patients throughout the world. We describe a case of a Puerto Rican adolescent with history, neurologic examination, electromyographic data, and laboratory tests consistent with CMT4F. Genetic analysis of this individual showed a heterozygous transversion resulting in amino acid change from arginine to glycine in the PRX gene, suggesting CMT4F. We report this novel PRX mutation to expand the clinical spectrum of CMT disease.
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Amorim S, Heise CO, Santos S, Macedo-Souza LI, Zatz M, Kok F. Nerve conduction studies in spastic paraplegia, optic atrophy, and neuropathy (SPOAN) syndrome. Muscle Nerve 2013; 49:131-3. [PMID: 24123118 DOI: 10.1002/mus.24087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2013] [Indexed: 01/07/2023]
Abstract
INTRODUCTION SPOAN (spastic paraplegia, optic atrophy, and neuropathy) syndrome is an autosomal recessive neurodegenerative disorder identified in a large consanguineous Brazilian family. METHODS Twenty-seven patients with SPOAN syndrome (20 women), aged 4-58 years, underwent nerve conduction studies (NCS) of the median, ulnar, tibial, and fibular nerves, and sensory NCS of the median, ulnar, radial, sural, and superficial fibular nerves. RESULTS Sensory nerve action potentials were absent in the lower limbs and absent in >80% of upper limbs. Motor NCS had reduced amplitudes and borderline velocities in the upper limbs and absent compound muscle action potentials (CMAPs) in the lower limbs. CONCLUSIONS The neuropathy in SPOAN syndrome is a severe, early-onset sensory-motor axonal polyneuropathy. Normal NCS seem to rule-out this condition.
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Affiliation(s)
- Simone Amorim
- Department of Neurology, University of São Paulo School of Medicine, São Paulo, Brazil
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12
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Tazir M, Bellatache M, Nouioua S, Vallat JM. Autosomal recessive Charcot-Marie-Tooth disease: from genes to phenotypes. J Peripher Nerv Syst 2013; 18:113-29. [DOI: 10.1111/jns5.12026] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 03/19/2013] [Accepted: 03/19/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Meriem Tazir
- Service de Neurologie; University Hospital Mustapha Bacha; Alger Algeria
- Laboratoire de NeuroSciences; Université d'Alger 1; Alger Algeria
| | - Mounia Bellatache
- Service de Neurologie; University Hospital Mustapha Bacha; Alger Algeria
- Laboratoire de NeuroSciences; Université d'Alger 1; Alger Algeria
| | - Sonia Nouioua
- Service de Neurologie; University Hospital Mustapha Bacha; Alger Algeria
- Laboratoire de NeuroSciences; Université d'Alger 1; Alger Algeria
| | - Jean-Michel Vallat
- Centre de Référence ⟨Neuropathies Périphériques Rares⟩, Service et Laboratoire de Neurologie; University Hospital; Limoges France
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Nouioua S, Hamadouche T, Funalot B, Bernard R, Bellatache N, Bouderba R, Grid D, Assami S, Benhassine T, Levy N, Vallat JM, Tazir M. Novel mutations in the PRX and the MTMR2 genes are responsible for unusual Charcot-Marie-Tooth disease phenotypes. Neuromuscul Disord 2011; 21:543-50. [PMID: 21741241 DOI: 10.1016/j.nmd.2011.04.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Revised: 04/19/2011] [Accepted: 04/27/2011] [Indexed: 11/30/2022]
Abstract
Autosomal recessive Charcot-Marie-Tooth diseases, relatively common in Algeria due to high prevalence of consanguineous marriages, are clinically and genetically heterogeneous. We report on two consanguineous families with demyelinating autosomal recessive Charcot-Marie-Tooth disease (CMT4) associated with novel homozygous mutations in the MTMR2 gene, c.331dupA (p.Arg111LysfsX24) and PRX gene, c.1090C>T (p.Arg364X) respectively, and peculiar clinical phenotypes. The three patients with MTMR2 mutations (CMT4B1 family) had a typical phenotype of severe early onset motor and sensory neuropathy with typical focally folded myelin on nerve biopsy. Associated clinical features included vocal cord paresis, prominent chest deformities and claw hands. Contrasting with the classical presentation of CMT4F (early-onset Dejerine-Sottas phenotype), the four patients with PRX mutations (CMT4F family) had essentially a late age of onset and a protracted and relatively benign evolution, although they presented marked spine deformities. These observations broaden the spectrum of clinical phenotypes associated with these two CMT4 forms.
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Affiliation(s)
- Sonia Nouioua
- Service de Neurologie, CHU Mustapha Bacha, Algiers, Algeria
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Vallat JM, Funalot B, Magy L. Nerve biopsy: requirements for diagnosis and clinical value. Acta Neuropathol 2011; 121:313-26. [PMID: 21293868 DOI: 10.1007/s00401-011-0804-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2010] [Revised: 01/14/2011] [Accepted: 01/20/2011] [Indexed: 12/27/2022]
Abstract
In many instances, nerve biopsy is not necessary in the diagnostic work-up of a peripheral neuropathy. However, histological examination of a tissue sample is still mandatory to show specific lesions in various conditions involving peripheral nerves. As there are fewer laboratories that examine human nerve samples, practitioners including neurologists and general pathologists may not be completely aware of the technical issues and data that are provided by nerve biopsy. Nerve biopsy is considered an invasive diagnostic method, although, its complications are by far less disabling than most of the disorders that lead to its indications. Nevertheless, the decision to perform a nerve biopsy has to be made on a case-by-case basis, and its results must be discussed between the pathologist and the clinician who is in charge of the patient's care. In this paper, we review the minimal technical requirements for proper peripheral nerve tissue analysis. Moreover, we provide data on the usefulness of nerve biopsy in various situations including abnormal deposits, cell infiltrates, link between peripheral neuropathy and monoclonal gammopathy, and numerous hereditary disorders.
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Affiliation(s)
- Jean-Michel Vallat
- Service et Laboratoire de Neurologie, Centre de Référence des Neuropathies Périphériques Rares, CHU de Limoges, Limoges, France.
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Pareyson D, Marchesi C. Diagnosis, natural history, and management of Charcot–Marie–Tooth disease. Lancet Neurol 2009; 8:654-67. [PMID: 19539237 DOI: 10.1016/s1474-4422(09)70110-3] [Citation(s) in RCA: 385] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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16
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Houlden H, Laura M, Ginsberg L, Jungbluth H, Robb SA, Blake J, Robinson S, King RH, Reilly MM. The phenotype of Charcot–Marie–Tooth disease type 4C due to SH3TC2 mutations and possible predisposition to an inflammatory neuropathy. Neuromuscul Disord 2009; 19:264-9. [DOI: 10.1016/j.nmd.2009.01.006] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2008] [Revised: 01/09/2009] [Accepted: 01/13/2009] [Indexed: 11/27/2022]
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17
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[Hereditary peripheral neuropathies]. Presse Med 2009; 38:1325-34. [PMID: 19327944 DOI: 10.1016/j.lpm.2009.01.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2008] [Revised: 12/28/2008] [Accepted: 01/14/2009] [Indexed: 12/13/2022] Open
Abstract
Currently more than 30 genes are known to be responsible for genetically determined neuropathies. Charcot-Marie-Tooth (CMT) disease is the most frequent of these hereditary neuropathies, with a prevalence of 4.7 to 36 per 100 000. In its demyelinating forms (CMT1), approximately 70% of cases are associated with a duplication of the PMP22gene. In its axonal forms (CMT2), 10-20% of the cases may be associated with a mutation of the MFN2gene. For North African patients with recessive transmission, a mutation of the LMNA gene must be sought. It is essential to stress the great variability of the phenotype--clinical, electrophysiological, and histologic--between and within families. A detailed analysis of these criteria, together with consideration of ethnic origin, may guide the search for the causal mutation. Whether the case involves certainly hereditary transmission or a sporadic form, it is desirable to be able to examine the maximum number of the patient's kin, both clinically and electrophysiologically. The forms with recessive transmission usually have a very early onset and are more serious than the dominant forms. The early- and very early-onset forms of CMT are increasingly better distinguished: congenital hypomyelination neuropathy (mutations of PMP22, MPZ or EGR2), or more axonal forms, including SMARD1 (Spinal muscle atrophy with respiratory distress; mutations of IGHMBP2) and EOHMSN (Early-onset hereditary motor and sensory neuropathy; mutations of MFN2). The prevention of cutaneous (ulcerations), bone, and amputation complications is very important in patients with hereditary sensory and autonomic neuropathies, because of the severity of the sensory disorders.
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Natural History and Treatment of Peripheral Inherited Neuropathies. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2009; 652:207-24. [DOI: 10.1007/978-90-481-2813-6_14] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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Abstract
The past 15 years have witnessed the identification of more than 25 genes responsible for inherited neuropathies in humans, many associated with primary alterations of the myelin sheath. A remarkable body of work in patients, as well as animal and cellular models, has defined the clinical and molecular genetics of these illnesses and shed light on how mutations in associated genes produce the heterogeneity of dysmyelinating and demyelinating phenotypes. Here, we review selected recent developments from work on the molecular mechanisms of these disorders and their implications for treatment strategies.
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Affiliation(s)
- Steven S Scherer
- The University of Pennsylvania Medical School, Philadelphia, Pennsylvania
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20
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Gosselin I, Thiffault I, Tétreault M, Chau V, Dicaire MJ, Loisel L, Emond M, Senderek J, Mathieu J, Dupré N, Vanasse M, Puymirat J, Brais B. Founder SH3TC2 mutations are responsible for a CMT4C French-Canadians cluster. Neuromuscul Disord 2008; 18:483-92. [PMID: 18511281 DOI: 10.1016/j.nmd.2008.04.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Revised: 03/31/2008] [Accepted: 04/08/2008] [Indexed: 11/24/2022]
Abstract
Charcot-Marie-Tooth polyneuropathies (CMT) are clinically and genetically heterogeneous. We describe a French-Canadian cluster of 17 recessive CMT cases belonging to 10 families with variable early-onset CMT and scoliosis. The patients demonstrate great intra- and inter-familial variability. Linkage analysis confirmed that all families are linked to CMT4C locus on chromosome 5q32 (multipoint LOD score of 9.06). Haplotype analysis suggests that two SH3TC2 mutations are present in this cohort. The majority of carrier chromosomes, 26 of 34 (76%), carry the c.2860C-->T mutation. Despite extensive sequencing, the other mutation is not yet uncovered. This study demonstrates that the clinical variability observed in CMT4C is due to other factors than the nature of the mutation and that further work is needed to better define the SH3TC2 gene to ensure the identification of all CMT4C mutations.
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Affiliation(s)
- Isabelle Gosselin
- Laboratoire de neurogénétique de la motricité, Centre d'Excellence en Neuromique de l'Université de Montréal, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame-CHUM, Montréal, Que., Canada
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21
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Affiliation(s)
- C N de Leeuw
- Centre for Molecular Medicine and Therapeutics, University of British Columbia, 950 West 28th Avenue, Vancouver, BC, Canada V5Z 4H4.
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Previtali SC, Quattrini A, Bolino A. Charcot-Marie-Tooth type 4B demyelinating neuropathy: deciphering the role of MTMR phosphatases. Expert Rev Mol Med 2007; 9:1-16. [PMID: 17880751 DOI: 10.1017/s1462399407000439] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Charcot-Marie-Tooth type 4B (CMT4B) is a severe autosomal recessive neuropathy with demyelination and myelin outfoldings of the nerve. This disorder is genetically heterogeneous, but thus far, mutations in myotubularin-related 2 (MTMR2) and MTMR13 genes have been shown to underlie CMT4B1 and CMT4B2, respectively. MTMR2 and MTMR13 belong to a family of ubiquitously expressed proteins sharing homology with protein tyrosine phosphatases (PTPs). The MTMR family, which has 14 members in humans, comprises catalytically active proteins, such as MTMR2, and catalytically inactive proteins, such as MTMR13. Despite their homology with PTPs, catalytically active MTMR phosphatases dephosphorylate both PtdIns3P and PtdIns(3,5)P2 phosphoinositides. Thus, MTMR2 and MTMR13 may regulate vesicular trafficking in Schwann cells. Loss of these proteins could lead to uncontrolled folding of myelin and, ultimately, to CMT4B. In this review, we discuss recent findings on this interesting protein family with the main focus on MTMR2 and MTMR13 and their involvement in the biology of Schwann cell and CMT4B neuropathies.
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Affiliation(s)
- Stefano C Previtali
- Neuropathology Unit, Department of Neurology, San Raffaele Scientific Institute, Milan, Italy
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Vallat JM, Magy L, Lagrange E, Sturtz F, Magdelaine C, Grid D, Tazir M. Diagnostic value of ultrastructural nerve examination in Charcot-Marie-Tooth disease: two CMT 1B cases with pseudo-recessive inheritance. Acta Neuropathol 2007; 113:443-9. [PMID: 17294201 DOI: 10.1007/s00401-007-0196-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2006] [Revised: 01/11/2007] [Accepted: 01/11/2007] [Indexed: 12/31/2022]
Abstract
We report two sporadic patients of CMT disease in different consanguineous families. The electrophysiological examination led to the diagnosis of a severe demyelinating neuropathy. The nerve biopsies exhibited numerous outfoldings of the myelin sheaths and onion-bulb proliferations. The consanguinity and the histological findings pointed to a diagnosis of CMT 4B. However, the detection of abnormal and regular widenings between the major dense lines of the myelin lamellae by electron microscopy led us to search for a P0 gene mutation. Two heterozygous mutations of this gene were identified: S63F and N131Y. Different aspects of uncompacted myelin lamellae have been described in some cases of P0 mutations and a few now appear to be quite specific to it. More than 30 genes are implicated in CMT and as mutation search is time- and money-consuming, we believe that in some selected patients ultrastructural examination of nerves, among other criteria, helps orientate the molecular diagnosis of CMT.
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Affiliation(s)
- Jean-Michel Vallat
- Department of Neurology et Centre National de Référence des Neuropathies Périphériques Rares, University Hospital, 2 Avenue Martin Luther King, 87042, Limoges Cedex, France.
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Bernard R, De Sandre-Giovannoli A, Delague V, Lévy N. Molecular genetics of autosomal-recessive axonal Charcot-Marie-Tooth neuropathies. Neuromolecular Med 2007; 8:87-106. [PMID: 16775369 DOI: 10.1385/nmm:8:1-2:87] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2005] [Revised: 12/13/2005] [Accepted: 12/21/2005] [Indexed: 12/16/2022]
Abstract
Autosomal-recessive forms of Charcot-Marie-Tooth (ARCMT) account for less than 10% of the families with CMT. On the other hand, in countries with a high prevalence of consanguinity this mode of inheritance accounts, likely, for the vast majority of CMT phenotypes. Like dominant forms, autosomal-recessive forms are generally subdivided into demyelinating forms (autosomal-recessive CMT1: ARCMT1 or CMT4) and axonal forms (ARCMT2). Until now, demyelinating ARCMT were more extensively studied at the genetic level than the axonal forms. Although the latter are undoubtedly the rarest forms among the heterogeneous group of CMT, three distinct forms have been genetically mapped and recent studies in the past 4 yr provided evidence that their respective causing genes have been characterized. Indeed, gene defects in encoding A-type lamins (LMNA), encoding Ganglioside-induced Differentiation-Associated Protein-1 (GDAP1) and encoding the mediator of RNA polymerase II transcription, subunit 25 homolog (MED25) have been identified in ARCMT2 subtypes. Given the clinical, electrophysiological and histological heterogeneity of CMT2, it is likely that unreported forms of ARCMT2, related to novel genes, remain to be discovered, leading to an even more complex classification. However, our goal in this review is to provide the reader with a clear view on the known genes and mechanisms involved in ARCMT2 and their associated phenotypes.
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Affiliation(s)
- Rafaëlle Bernard
- Departement de Genetique Medicale Hopital d'enfants de la Timone, Marseille, France
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Ouvrier R, Geevasingha N, Ryan MM. Autosomal-recessive and X-linked forms of hereditary motor and sensory neuropathy in childhood. Muscle Nerve 2007; 36:131-43. [PMID: 17410579 DOI: 10.1002/mus.20776] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The hereditary motor and sensory neuropathies (HMSNs, Charcot-Marie-Tooth neuropathies) are the most common degenerative disorders of the peripheral nervous system. In recent years a dramatic expansion has occurred in our understanding of the molecular basis and cell biology of the recessively inherited demyelinating and axonal neuropathies, with delineation of a number of new neuropathies. Mutations in some genes cause a wide variety of clinical, neurophysiologic, and pathologic phenotypes, rendering diagnosis difficult. The X-linked forms of HMSN represent at least 10%-15% of all HMSNs and have an expanded disease spectrum including demyelinating, intermediate, and axonal neuropathies, transient central nervous system (CNS) dysfunction, mental retardation, and hearing loss. This review presents an overview of the recessive and X-linked forms of HMSN observed in childhood, with particular reference to disease phenotype and neurophysiologic and pathologic abnormalities suggestive of specific diagnoses. These findings can be used by the clinician to formulate a differential diagnosis and guide targeted genetic testing.
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Affiliation(s)
- Robert Ouvrier
- TY Nelson Department of Neurology and Neurosurgery, Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia.
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Pareyson D, Scaioli V, Laurà M. Clinical and electrophysiological aspects of Charcot-Marie-Tooth disease. Neuromolecular Med 2006; 8:3-22. [PMID: 16775364 DOI: 10.1385/nmm:8:1-2:3] [Citation(s) in RCA: 115] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2005] [Revised: 12/06/2005] [Accepted: 12/15/2005] [Indexed: 11/11/2022]
Abstract
Charcot-Marie-Tooth disease (CMT) is a genetically heterogeneous group of disorders sharing the same clinical phenotype, characterized by distal limb muscle wasting and weakness, usually with skeletal deformities, distal sensory loss, and abnormalities of deep tendon reflexes. Mutations of genes involved in different functions eventually lead to a length-dependent axonal degeneration, which is the likely basis of the distal predominance of the CMT phenotype. Nerve conduction studies are important for classification, diagnosis, and understanding of pathophysiology. The subdivision into demyelinating CMT1 and axonal CMT2 types was a milestone and is still valid for the majority of patients. However, exceptions to this partition are increasing. Intermediate conduction velocities are often found in males with X-linked CMT (CMTX), and different intermediate CMT types have been identified. Moreover, for some genes, different mutations may result either in demyelinating CMT with slow conduction, or in axonal CMT. Nerve conduction slowing is uniform and diffuse in the most common CMT1A associated with the 17p12 duplication, whereas it is often asymmetric and nonhomogeneous in CMTX, sometimes rendering difficult the differential diagnosis with acquired inflammatory neuropathies. The demyelinating recessive forms, termed CMT4, usually have early onset and run a more severe course than the dominant types. Pure motor CMT types are now classified as distal hereditary motor neuronopathy. The diagnostic approach to the identification of the CMT subtype is complex and cannot be based on the clinical phenotype alone, as different forms are often clinically indistinguishable. However, there are features that may be of help in addressing molecular investigation in a single patient. Late onset, prominent or peculiar sensory manifestations, autonomic nervous system dysfunction, cranial nerve involvement, upper limb predominance, subclinical central nervous system abnormalities, severe scoliosis, early-onset glaucoma, neutropenia are findings helpful for diagnosis.
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Affiliation(s)
- D Pareyson
- Division of Biochemistry and Genetics, Carlo Besta National Neurological Institute, via Celoria, 11, 20133, Milan, Italy.
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