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Monfrini E, Avanzino L, Palermo G, Bonato G, Brescia G, Ceravolo R, Cantarella G, Mandich P, Prokisch H, Storm van's Gravesande K, Straccia G, Elia A, Reale C, Panteghini C, Zorzi G, Eleopra R, Erro R, Carecchio M, Garavaglia B, Zech M, Romito L, Di Fonzo A. Dominant VPS16 Pathogenic Variants: Not Only Isolated Dystonia. Mov Disord Clin Pract 2024; 11:87-93. [PMID: 38291845 PMCID: PMC10828607 DOI: 10.1002/mdc3.13927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND VPS16 pathogenic variants have been recently associated with inherited dystonia. Most patients affected by dominant VPS16-related disease display early-onset isolated dystonia with prominent oromandibular, bulbar, cervical, and upper limb involvement, followed by slowly progressive generalization. CASES We describe six newly reported dystonic patients carrying VPS16 mutations displaying unusual phenotypic features in addition to dystonia, such as myoclonus, choreoathetosis, pharyngospasm and freezing of gait. Response to bilateral Globus Pallidus Internus Deep Brain Stimulation (GPi-DBS) is reported in three of them, associated with significant improvement of dystonia but only minor effect on other hyperkinetic movements. Moreover, five novel pathogenic/likely pathogenic variants are described. CONCLUSIONS This case collection expands the genetic and clinical spectrum of VPS16-related disease, prompting movement disorder specialists to suspect mutations of this gene not only in patients with isolated dystonia.
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Affiliation(s)
- Edoardo Monfrini
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and TransplantationUniversity of MilanMilanItaly
- Foundation IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoNeurology UnitMilanItaly
| | - Laura Avanzino
- Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze MotorieUniversity of GenoaGenoaItaly
- IRCCS Ospedale Policlinico San MartinoGenoaItaly
| | - Giovanni Palermo
- Center for Neurodegenerative Diseases, Parkinson's Disease and Movement Disorders, Unit of Neurology, Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
| | - Giulia Bonato
- Parkinson and Movement Disorders Unit, Centre for Rare Neurological Diseases (ERN‐RND), Department of Neuroscience University of PaduaPaduaItaly
| | - Gloria Brescia
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and TransplantationUniversity of MilanMilanItaly
- Medical Genetics LaboratoryFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Roberto Ceravolo
- Center for Neurodegenerative Diseases, Parkinson's Disease and Movement Disorders, Unit of Neurology, Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
| | - Giovanna Cantarella
- Department of Clinical Sciences and Community HealthUniversity of MilanMilanItaly
- Department of OtolaryngologyFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Paola Mandich
- IRCCS Ospedale Policlinico San MartinoGenoaItaly
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal, and Child HealthUniversity of GenoaGenoaItaly
| | - Holger Prokisch
- Institute of Neurogenomics, Helmholtz MunichNeuherbergGermany
- Institute of Human Genetics, Technical University of Munich, School of MedicineMunichGermany
| | - Karin Storm van's Gravesande
- Department of Pediatrics, Child and Adolescent PsychosomaticsTechnical University MunichMunichGermany
- Department of Pediatric NeurologyUniversity Children's Hospital FreiburgFreiburgGermany
| | - Giulia Straccia
- Department of Clinical Neurosciences, Parkinson and Movement Disorders UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
| | - Antonio Elia
- Department of Clinical Neurosciences, Parkinson and Movement Disorders UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
| | - Chiara Reale
- Medical Genetics and Neurogenetics UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
| | - Celeste Panteghini
- Medical Genetics and Neurogenetics UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
| | - Giovanna Zorzi
- Department of Pediatric NeuroscienceFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
| | - Roberto Eleopra
- Department of Clinical Neurosciences, Parkinson and Movement Disorders UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana,” Neuroscience SectionUniversity of SalernoSalernoItaly
| | - Miryam Carecchio
- Center for Neurodegenerative Diseases, Parkinson's Disease and Movement Disorders, Unit of Neurology, Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
| | - Barbara Garavaglia
- Medical Genetics and Neurogenetics UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
| | - Michael Zech
- Institute of Neurogenomics, Helmholtz MunichNeuherbergGermany
- Institute of Human Genetics, Technical University of Munich, School of MedicineMunichGermany
- Institute for Advanced Study, Technical University of MunichGarchingGermany
| | - Luigi Romito
- Department of Clinical Neurosciences, Parkinson and Movement Disorders UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
| | - Alessio Di Fonzo
- Foundation IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoNeurology UnitMilanItaly
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Vimercati A, Tannorella P, Orlandini E, Calzari L, Moro M, Guzzetti S, Selicorni A, Crippa M, Larizza L, Bonati MT, Russo S. Case report: atypical Silver-Russell syndrome patient with hand dystonia: the valuable support of the consensus statement to the wide syndromic spectrum. Front Genet 2023; 14:1198821. [PMID: 37529781 PMCID: PMC10387531 DOI: 10.3389/fgene.2023.1198821] [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: 04/03/2023] [Accepted: 06/19/2023] [Indexed: 08/03/2023] Open
Abstract
The amount of Insulin Growth Factor 2 (IGF2) controls the rate of embryonal and postnatal growth. The IGF2 and adjacent H19 are the imprinted genes of the telomeric cluster in the 11p15 chromosomal region regulated by differentially methylated regions (DMRs) or imprinting centers (ICs): H19/IGF2:IG-DMR (IC1). Dysregulation due to IC1 Loss-of-Methylation (LoM) or Gain-of-Methyaltion (GoM) causes Silver-Russell syndrome (SRS) or Beckwith-Wiedemann syndrome (BWS) disorders associated with growth retardation or overgrowth, respectively. Specific features define each of the two syndromes, but isolated asymmetry is a common cardinal feature, which is considered sufficient for a diagnosis in the BWS spectrum. Here, we report the case of a girl with right body asymmetry, which suggested BWS spectrum. Later, BWS/SRS molecular analysis identified IC1_LoM revealing the discrepant diagnosis of SRS. A clinical re-evaluation identified a relative macrocephaly and previously unidentified growth rate at lower limits of normal at birth, feeding difficulties, and asymmetry. Interestingly, and never previously described in IC1_LoM SRS patients, since the age of 16, she has developed hand-writer's cramps, depression, and bipolar disorder. Trio-WES identified a VPS16 heterozygous variant [NM_022575.4:c.2185C>G:p.Leu729Val] inherited from her healthy mother. VPS16 is involved in the endolysosomal system, and its dysregulation is linked to autosomal dominant dystonia with incomplete penetrance and variable expressivity. IGF2 involvement in the lysosomal pathway led us to speculate that the neurological phenotype of the proband might be triggered by the concurrent IGF2 deficit and VPS16 alteration.
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Affiliation(s)
- Alessandro Vimercati
- Research Laboratory of Medical Cytogenetics and Molecular Genetics, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Pierpaola Tannorella
- Research Laboratory of Medical Cytogenetics and Molecular Genetics, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Eleonora Orlandini
- Specialty School of Pediatrics, Alma Mater University of Bologna, Bologna, Italy
| | - Luciano Calzari
- Bioinformatics and Statistical Genomics Unit, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Mirella Moro
- Department of Endocrine and Metabolic Diseases and Lab of Endocrine and Metabolic Research, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Sara Guzzetti
- Research Laboratory of Medical Cytogenetics and Molecular Genetics, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | | | - Milena Crippa
- Research Laboratory of Medical Cytogenetics and Molecular Genetics, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Lidia Larizza
- Research Laboratory of Medical Cytogenetics and Molecular Genetics, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Maria Teresa Bonati
- Unit of Medical Genetics, Institute for Maternal and Child Health Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Burlo Garofalo, Trieste, Italy
| | - Silvia Russo
- Research Laboratory of Medical Cytogenetics and Molecular Genetics, IRCCS Istituto Auxologico Italiano, Milano, Italy
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Shashi S, Nashi S, Arunachal G, Venkatachalam N, Padmanabha H, Mailankody P, Menon D, Arshad F, Alladi S, Mathuranath P, Mahale RR. DYT30 due to VPS16 Mutation: An Etiology of Childhood-Onset Generalized Dystonia. Ann Indian Acad Neurol 2023; 26:286-288. [PMID: 37538408 PMCID: PMC10394456 DOI: 10.4103/aian.aian_59_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/10/2023] [Accepted: 03/11/2023] [Indexed: 08/05/2023] Open
Affiliation(s)
- Sridhar Shashi
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Saraswati Nashi
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Gautham Arunachal
- Department of Human Genetics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - N Venkatachalam
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Hansashree Padmanabha
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Pooja Mailankody
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Deepak Menon
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Faheem Arshad
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Suvarna Alladi
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Pavagada Mathuranath
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Rohan R. Mahale
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Stephen CD, Dy-Hollins M, Gusmao CMD, Qahtani XA, Sharma N. Dystonias: Clinical Recognition and the Role of Additional Diagnostic Testing. Semin Neurol 2023; 43:17-34. [PMID: 36972613 DOI: 10.1055/s-0043-1764292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Dystonia is the third most common movement disorder, characterized by abnormal, frequently twisting postures related to co-contraction of agonist and antagonist muscles. Diagnosis is challenging. We provide a comprehensive appraisal of the epidemiology and an approach to the phenomenology and classification of dystonia, based on the clinical characteristics and underlying etiology of dystonia syndromes. We discuss the features of common idiopathic and genetic forms of dystonia, diagnostic challenges, and dystonia mimics. Appropriate workup is based on the age of symptom onset, rate of progression, whether dystonia is isolated or combined with another movement disorder or complex neurological and other organ system eatures. Based on these features, we discuss when imaging and genetic should be considered. We discuss the multidisciplinary treatment of dystonia, including rehabilitation and treatment principles according to the etiology, including when pathogenesis-direct treatment is available, oral pharmacological therapy, chemodenervation with botulinum toxin injections, deep brain stimulation and other surgical therapies, and future directions.
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Affiliation(s)
| | - Marisela Dy-Hollins
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Xena Al Qahtani
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | - Nutan Sharma
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
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