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Alcalá-Torres J, Pérez-de la Fuente R, Cárdenas-Del Carre A, Arteche-López A, Posada-Rodríguez IJ. [Episodic ataxia type 2: a clinical, genetic and radiological study of 10 patients]. Rev Neurol 2023; 76:321-325. [PMID: 37165528 PMCID: PMC10478108 DOI: 10.33588/rn.7610.2023117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVES To describe a series of patients with episodic ataxia type 2 (EA2), attending to epidemiological, clinical, radiological, and therapeutic variables. MATERIAL AND METHODS Retrospective revision of patients with molecular diagnosis of EA2 (CACNA1A mutations), between 1988 and 2022. Information achieved from the database of our Movement Disorders clinic. A descriptive statistical analysis was made. RESULTS Ten patients from five families were analyzed (six women). Median age at diagnosis was 37.5 years-old, with a median diagnostic delay of 20 years. 70% reported familial history of CACNA1A associated symptoms, although 50% presented migraine, epilepsy, dystonia, or neuropsychiatric alterations. Two heterozygous consanguineous patients had homozygotic descendance with infant mortality due to early-onset epileptic encephalopathy type 42. Five pathogenic/probably pathogenic CACNA1A variants were detected. 80% of patients had episodic triggers, being stress the most common. Episodes had a weekly frequency before treatment initiation. Six patients developed chronic ataxia (one patient demand gait support). 50% of patients with neuroimaging presented cerebellar atrophy. Acetazolamide were initiated in 80%, and 75% of them showed improvement of episodic symptoms. Nephrolithiasis was the most frequent side effect. CONCLUSIONS EA2 has a great intrafamilial and interfamilial phenotypic variability. The most frequent phenotype were weekly episodes of unsteadiness, several hours of length, stress as the main trigger, chronic ataxia and gaze-evoked nystagmus. Acetazolamide is effective, although complications are usual. Neurologist must be alert as diagnostic delay is constant.
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Arteche-López A, Álvarez-Mora MI, Sánchez Calvin MT, Lezana Rosales JM, Palma Milla C, Gómez Rodríguez MJ, Gomez Manjón I, Blázquez A, Juarez Rufián A, Ramos Gómez P, Sierra Tomillo O, Hidalgo Mayoral I, Pérez de la Fuente R, Posada Rodríguez IJ, González Granado LI, Martin MA, Quesada-Espinosa JF, Moreno-García M. Biallelic variants in genes previously associated with dominant inheritance: CACNA1A, RET and SLC20A2. Eur J Hum Genet 2021; 29:1520-1526. [PMID: 34267336 PMCID: PMC8484357 DOI: 10.1038/s41431-021-00919-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 05/12/2021] [Accepted: 05/26/2021] [Indexed: 02/07/2023] Open
Abstract
A subset of families with co-dominant or recessive inheritance has been described in several genes previously associated with dominant inheritance. Those recessive families displayed similar, more severe, or even completely different phenotypes to their dominant counterparts. We report the first patients harboring homozygous disease-related variants in three genes that were previously associated with dominant inheritance: a loss-of-function variant in the CACNA1A gene and two missense variants in the RET and SLC20A2 genes, respectively. All patients presented with a more severe clinical phenotype than the corresponding typical dominant form. We suggest that co-dominant or recessive inheritance for these three genes could explain the phenotypic differences from those documented in their cognate dominant phenotypes. Our results reinforce that geneticists should be aware of the possible different forms of inheritance in genes when WES variant interpretation is performed. We also evidence the need to refine phenotypes and inheritance patterns associated with genes in order to avoid failures during WES analysis and thus, raising the WES diagnostic capacity in the benefit of patients.
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Affiliation(s)
- A. Arteche-López
- grid.144756.50000 0001 1945 5329Genetics Department, University Hospital 12 de Octubre, Madrid, Spain
| | - MI. Álvarez-Mora
- grid.144756.50000 0001 1945 5329Genetics Department, University Hospital 12 de Octubre, Madrid, Spain ,grid.428756.a0000 0004 0412 0974Biochemistry and Molecular Genetics Department, Hospital Clinic of Barcelona and Fundació Clínic per la Recerca Biomèdica, Barcelona, Spain
| | - MT. Sánchez Calvin
- grid.144756.50000 0001 1945 5329Genetics Department, University Hospital 12 de Octubre, Madrid, Spain
| | - JM. Lezana Rosales
- grid.144756.50000 0001 1945 5329Genetics Department, University Hospital 12 de Octubre, Madrid, Spain
| | - C. Palma Milla
- grid.144756.50000 0001 1945 5329Genetics Department, University Hospital 12 de Octubre, Madrid, Spain
| | - M. J. Gómez Rodríguez
- grid.144756.50000 0001 1945 5329Genetics Department, University Hospital 12 de Octubre, Madrid, Spain
| | - I. Gomez Manjón
- grid.144756.50000 0001 1945 5329Genetics Department, University Hospital 12 de Octubre, Madrid, Spain
| | - A. Blázquez
- Mitochondrial and Neurometabolic Diseases Lab. Biochemistry Department, ‘12 de Octubre’ Research Institute (imas12), Madrid, Spain ,grid.413448.e0000 0000 9314 1427Center for Biomedical Network Research on Rare Diseases (CIBERER), ISCIII, Madrid, Spain
| | - A. Juarez Rufián
- grid.144756.50000 0001 1945 5329Genetics Department, University Hospital 12 de Octubre, Madrid, Spain
| | - P. Ramos Gómez
- grid.144756.50000 0001 1945 5329Genetics Department, University Hospital 12 de Octubre, Madrid, Spain
| | - O. Sierra Tomillo
- grid.144756.50000 0001 1945 5329Genetics Department, University Hospital 12 de Octubre, Madrid, Spain
| | - I. Hidalgo Mayoral
- grid.144756.50000 0001 1945 5329Genetics Department, University Hospital 12 de Octubre, Madrid, Spain
| | - R. Pérez de la Fuente
- grid.144756.50000 0001 1945 5329Genetics Department, University Hospital 12 de Octubre, Madrid, Spain
| | - IJ. Posada Rodríguez
- grid.144756.50000 0001 1945 5329Neurology Department, University Hospital 12 de Octubre, Madrid, Spain
| | - LI. González Granado
- grid.144756.50000 0001 1945 5329Pediatrics Department, Immunodeficiency Unit, University Hospital 12 de Octubre, Madrid, Spain ,grid.4795.f0000 0001 2157 7667Complutense University School of Medicine. Madrid, Spain and ‘12 de Octubre’ Research Institute (imas12), Madrid, Spain
| | - Miguel A. Martin
- Mitochondrial and Neurometabolic Diseases Lab. Biochemistry Department, ‘12 de Octubre’ Research Institute (imas12), Madrid, Spain ,grid.413448.e0000 0000 9314 1427Center for Biomedical Network Research on Rare Diseases (CIBERER), ISCIII, Madrid, Spain
| | - JF. Quesada-Espinosa
- grid.144756.50000 0001 1945 5329Genetics Department, University Hospital 12 de Octubre, Madrid, Spain
| | - M. Moreno-García
- grid.144756.50000 0001 1945 5329Genetics Department, University Hospital 12 de Octubre, Madrid, Spain
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González-Mera L, Ravenscroft G, Cabrera-Serrano M, Ermolova N, Domínguez-González C, Arteche-López A, Soltanzadeh P, Evesson F, Navas C, Mavillard F, Clayton J, Rodrigo P, Servián-Morilla E, Cooper ST, Waddell L, Reardon K, Corbett A, Hernandez-Laín A, Sanchez A, Esteban Perez J, Paradas-Lopez C, Rivas-Infante E, Spencer M, Laing N, Olivé M. Heterozygous CAPN3 missense variants causing autosomal-dominant calpainopathy in seven unrelated families. Neuropathol Appl Neurobiol 2020; 47:283-296. [PMID: 32896923 DOI: 10.1111/nan.12663] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/03/2020] [Accepted: 08/22/2020] [Indexed: 01/05/2023]
Abstract
AIMS Recessive variants in CAPN3 gene are the cause of the commonest form of autosomal recessive limb girdle muscle dystrophy. However, two distinct in-frame deletions in CAPN3 (NM_000070.3:c.643_663del21 and c.598_621del15) and more recently, Gly445Arg and Arg572Pro substitutions have been linked to autosomal dominant (AD) forms of calpainopathy. We report 21 affected individuals from seven unrelated families presenting with an autosomal dominant form of muscular dystrophy associated with five different heterozygous missense variants in CAPN. METHODS We have used massively parallel gene sequencing (MPS) to determine the genetic basis of a dominant form of limb girdle muscular dystrophy in affected individuals from seven unrelated families. RESULTS The c.700G> A, [p.(Gly234Arg)], c.1327T> C [p.(Ser443Pro], c.1333G> A [p.(Gly445Arg)], c.1661A> C [p.(Tyr554Ser)] and c.1706T> C [p.(Phe569Ser)] CAPN3 variants were identified. Affected individuals presented in young adulthood with progressive proximal and axial weakness, waddling walking and scapular winging or with isolated hyperCKaemia. Muscle imaging showed fatty replacement of paraspinal muscles, variable degrees of involvement of the gluteal muscles, and the posterior compartment of the thigh and minor changes at the mid-leg level. Muscle biopsies revealed mild myopathic changes. Western blot analysis revealed a clear reduction in calpain 3 in skeletal muscle relative to controls. Protein modelling of these variants on the predicted structure of calpain 3 revealed that all variants are located in proximity to the calmodulin-binding site and are predicted to interfere with proteolytic activation. CONCLUSIONS We expand the genotypic spectrum of CAPN3-associated muscular dystrophy due to autosomal dominant missense variants.
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Affiliation(s)
- L González-Mera
- Neuropathology Unit, Department of Pathology, IDIBELL-Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain.,Neuromuscular Unit, Department of Neurology, IDIBELL-Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - G Ravenscroft
- Centre for Medical Research, University of Western Australia, Harry Perkins Institute of Medical Research, Perth, WA, Australia
| | - M Cabrera-Serrano
- Centre for Medical Research, University of Western Australia, Harry Perkins Institute of Medical Research, Perth, WA, Australia.,Neurology Department, Hospital Universitario Virgen del Rocío, Seville, Spain.,Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocıo/CSIC, Universidad de Sevilla, Sevilla, Spain.,Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - N Ermolova
- Department of Physiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - C Domínguez-González
- Neuromuscular Unit, Department of Neurology, Hospital Universitario 12 de Octubre, Research Institute imas12, Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - A Arteche-López
- Department of Genetic, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - P Soltanzadeh
- Departments of Neurology and Physiology, David Geffen School of Medicine, UCLA, University of California, Los Angeles, CA, USA
| | - F Evesson
- Kids Neuroscience Centre, Kids Research, Children's Hospital at Westmead, Westmead, NSW, Australia.,The Children's Medical Research Institute, Westmead, NSW, Australia
| | - C Navas
- Neuropathology Unit, Department of Pathology, IDIBELL-Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - F Mavillard
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocıo/CSIC, Universidad de Sevilla, Sevilla, Spain.,Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - J Clayton
- Centre for Medical Research, University of Western Australia, Harry Perkins Institute of Medical Research, Perth, WA, Australia
| | - P Rodrigo
- Neuropathology Unit, Department of Pathology, IDIBELL-Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain.,Neuromuscular Unit, Department of Neurology, IDIBELL-Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - E Servián-Morilla
- Neurology Department, Hospital Universitario Virgen del Rocío, Seville, Spain.,Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocıo/CSIC, Universidad de Sevilla, Sevilla, Spain.,Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - S T Cooper
- Kids Neuroscience Centre, Kids Research, Children's Hospital at Westmead, Westmead, NSW, Australia.,The Children's Medical Research Institute, Westmead, NSW, Australia.,Discipline of Child and Adolescent Health, Faculty of Health and Medicine, University of Sydney, Westmead, NSW, Australia
| | - L Waddell
- Kids Neuroscience Centre, Kids Research, Children's Hospital at Westmead, Westmead, NSW, Australia.,Discipline of Child and Adolescent Health, Faculty of Health and Medicine, University of Sydney, Westmead, NSW, Australia
| | - K Reardon
- St. Vincent's Melbourne Neuromuscular Diagnostic Laboratory, Department of Clinical Neurosciences and Neurological Research, St Vincent's Hospital, Melbourne, VIC, Australia
| | - A Corbett
- Department of Neurology, Concord General Repatriation Hospital, Sydney, NSW, Australia
| | - A Hernandez-Laín
- Department of Pathology, Neuropathology Unit. Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A Sanchez
- Institut de Diagnòstic per la imatge (IDI), IDIBELL-Hospital de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - J Esteban Perez
- Neuromuscular Unit, Department of Neurology, Hospital Universitario 12 de Octubre, Research Institute imas12, Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - C Paradas-Lopez
- Neurology Department, Hospital Universitario Virgen del Rocío, Seville, Spain.,Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocıo/CSIC, Universidad de Sevilla, Sevilla, Spain.,Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - E Rivas-Infante
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Department of Neuropathology, Hospital U. Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain
| | - M Spencer
- Department of Neurology, Neuromuscular Program, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - N Laing
- Centre for Medical Research, University of Western Australia, Harry Perkins Institute of Medical Research, Perth, WA, Australia
| | - M Olivé
- Neuropathology Unit, Department of Pathology, IDIBELL-Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain.,Neuromuscular Unit, Department of Neurology, IDIBELL-Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
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