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Capacci E, Bagnoli S, Giacomucci G, Rapillo CM, Govoni A, Bessi V, Polito C, Giotti I, Brogi A, Pelo E, Sorbi S, Nacmias B, Ferrari C. The Frequency of Intermediate Alleles in Patients with Cerebellar Phenotypes. CEREBELLUM (LONDON, ENGLAND) 2024; 23:1135-1145. [PMID: 37906407 PMCID: PMC11102406 DOI: 10.1007/s12311-023-01620-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 11/02/2023]
Abstract
Cerebellar syndromes are clinically and etiologically heterogeneous and can be classified as hereditary, neurodegenerative non-hereditary, or acquired. Few data are available on the frequency of each form in the clinical setting. Growing interest is emerging regarding the genetic forms caused by triplet repeat expansions. Alleles with repeat expansion lower than the pathological threshold, termed intermediate alleles (IAs), have been found to be associated with disease manifestation. In order to assess the relevance of IAs as a cause of cerebellar syndromes, we enrolled 66 unrelated Italian ataxic patients and described the distribution of the different etiology of their syndromes and the frequency of IAs. Each patient underwent complete clinical, hematological, and neurophysiological assessments, neuroimaging evaluations, and genetic tests for autosomal dominant cerebellar ataxia (SCA) and fragile X-associated tremor/ataxia syndrome (FXTAS). We identified the following diagnostic categories: 28% sporadic adult-onset ataxia, 18% cerebellar variant of multiple system atrophy, 9% acquired forms, 9% genetic forms with full-range expansion, and 12% cases with intermediate-range expansion. The IAs were six in the FMR1 gene, two in the gene responsible for SCA8, and one in the ATXN2 gene. The clinical phenotype of patients carrying the IAs resembles, in most of the cases, the one associated with full-range expansion. Our study provides an exhaustive description of the causes of cerebellar ataxia, estimating for the first time the frequency of IAs in SCAs- and FXTAS-associated genes. The high percentage of cases with IAs supports further screening among patients with cerebellar syndromes.
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Affiliation(s)
- Elena Capacci
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Silvia Bagnoli
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Giulia Giacomucci
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Costanza Maria Rapillo
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Alessandra Govoni
- Neuromuscular-Skeletal and Sensory Organs Department, AOU Careggi, Florence, Italy
| | - Valentina Bessi
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | | | - Irene Giotti
- SODc Diagnostica Genetica, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Alice Brogi
- SODc Diagnostica Genetica, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Elisabetta Pelo
- SODc Diagnostica Genetica, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Camilla Ferrari
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy.
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Perez BA, Shorrock HK, Banez‐Coronel M, Zu T, Romano LEL, Laboissonniere LA, Reid T, Ikeda Y, Reddy K, Gomez CM, Bird T, Ashizawa T, Schut LJ, Brusco A, Berglund JA, Hasholt LF, Nielsen JE, Subramony SH, Ranum LPW. CCG•CGG interruptions in high-penetrance SCA8 families increase RAN translation and protein toxicity. EMBO Mol Med 2021; 13:e14095. [PMID: 34632710 PMCID: PMC8573593 DOI: 10.15252/emmm.202114095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 12/28/2022] Open
Abstract
Spinocerebellar ataxia type 8 (SCA8), a dominantly inherited neurodegenerative disorder caused by a CTG•CAG expansion, is unusual because most individuals that carry the mutation do not develop ataxia. To understand the variable penetrance of SCA8, we studied the molecular differences between highly penetrant families and more common sporadic cases (82%) using a large cohort of SCA8 families (n = 77). We show that repeat expansion mutations from individuals with multiple affected family members have CCG•CGG interruptions at a higher frequency than sporadic SCA8 cases and that the number of CCG•CGG interruptions correlates with age at onset. At the molecular level, CCG•CGG interruptions increase RNA hairpin stability, and in cell culture experiments, increase p-eIF2α and polyAla and polySer RAN protein levels. Additionally, CCG•CGG interruptions, which encode arginine interruptions in the polyGln frame, increase toxicity of the resulting proteins. In summary, SCA8 CCG•CGG interruptions increase polyAla and polySer RAN protein levels, polyGln protein toxicity, and disease penetrance and provide novel insight into the molecular differences between SCA8 families with high vs. low disease penetrance.
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Affiliation(s)
- Barbara A Perez
- Center for NeuroGeneticsUniversity of FloridaGainesvilleFLUSA
- Department of Molecular Genetics and MicrobiologyUniversity of FloridaGainesvilleFLUSA
| | - Hannah K Shorrock
- Center for NeuroGeneticsUniversity of FloridaGainesvilleFLUSA
- Department of Molecular Genetics and MicrobiologyUniversity of FloridaGainesvilleFLUSA
| | - Monica Banez‐Coronel
- Center for NeuroGeneticsUniversity of FloridaGainesvilleFLUSA
- Department of Molecular Genetics and MicrobiologyUniversity of FloridaGainesvilleFLUSA
| | - Tao Zu
- Center for NeuroGeneticsUniversity of FloridaGainesvilleFLUSA
- Department of Molecular Genetics and MicrobiologyUniversity of FloridaGainesvilleFLUSA
| | - Lisa EL Romano
- Center for NeuroGeneticsUniversity of FloridaGainesvilleFLUSA
- Department of Molecular Genetics and MicrobiologyUniversity of FloridaGainesvilleFLUSA
| | - Lauren A Laboissonniere
- Center for NeuroGeneticsUniversity of FloridaGainesvilleFLUSA
- Department of Molecular Genetics and MicrobiologyUniversity of FloridaGainesvilleFLUSA
| | - Tammy Reid
- Center for NeuroGeneticsUniversity of FloridaGainesvilleFLUSA
- Department of Molecular Genetics and MicrobiologyUniversity of FloridaGainesvilleFLUSA
| | - Yoshio Ikeda
- Department of NeurologyGunma UniversityMaebashiJapan
| | - Kaalak Reddy
- RNA InstituteUniversity at Albany–SUNYAlbanyNYUSA
| | | | - Thomas Bird
- Department of NeurologyUniversity of WashingtonSeattleWAUSA
- Geriatrics Research SectionVA Puget Sound Health Care SystemSeattleWAUSA
| | - Tetsuo Ashizawa
- Department of NeurologyHouston Methodist Research InstituteHoustonTXUSA
| | | | - Alfredo Brusco
- Department of Medical SciencesUniversity of TorinoTorinoItaly
- Medical Genetics Units“Città della Salute e della Scienza” University HospitalTorinoItaly
| | - J Andrew Berglund
- Center for NeuroGeneticsUniversity of FloridaGainesvilleFLUSA
- RNA InstituteUniversity at Albany–SUNYAlbanyNYUSA
| | - Lis F Hasholt
- Institute of Cellular and Molecular MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Jorgen E Nielsen
- Department of NeurologyRigshospitaletUniversity of CopenhagenCopenhagenDenmark
| | - SH Subramony
- Center for NeuroGeneticsUniversity of FloridaGainesvilleFLUSA
- McKnight Brain InstituteUniversity of FloridaGainesvilleFLUSA
| | - Laura PW Ranum
- Center for NeuroGeneticsUniversity of FloridaGainesvilleFLUSA
- Department of Molecular Genetics and MicrobiologyUniversity of FloridaGainesvilleFLUSA
- McKnight Brain InstituteUniversity of FloridaGainesvilleFLUSA
- Genetics InstituteUniversity of FloridaGainesvilleFLUSA
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3
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Genetic and clinical analyses of spinocerebellar ataxia type 8 in mainland China. J Neurol 2019; 266:2979-2986. [DOI: 10.1007/s00415-019-09519-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/19/2019] [Accepted: 08/19/2019] [Indexed: 02/01/2023]
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Abstract
Spinocerebellar ataxia type 8 (SCA8) is a rare autosomal dominant neurodegenerative disease caused by expanded CTA/CTG repeats in the ATXN8OS gene. Many patients had pure cerebellar ataxia, while some had parkinsonism, both without causal explanation. We analyzed the ATXN8OS gene in 150 Japanese patients with ataxia and 76 patients with Parkinson's disease or related disorders. We systematically reassessed 123 patients with SCA8, both our patients and those reported in other studies. Two patients with progressive supranuclear palsy (PSP) had mutations in the ATXN8OS gene. Systematic analyses revealed that patients with parkinsonism had significantly shorter CTA/CTG repeat expansions and older age at onset than those with predominant ataxia. We show the imaging results of patients with and without parkinsonism. We also found a significant inverse relationship between repeat sizes and age at onset in all patients, which has not been detected previously. Our results may be useful to genetic counseling, improve understanding of the pathomechanism, and extend the clinical phenotype of SCA8.
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Mandrile G, Di Gregorio E, Goel H, Giachino D, De Mercanti S, Iudicello M, Rolando M, Losa S, De Marchi M, Brusco A. Heterozygous Deletion of KLHL1/ATX8OS at the SCA8 Locus Is Unlikely Associated With Cerebellar Impairment in Humans. THE CEREBELLUM 2016; 15:208-12. [PMID: 25998497 DOI: 10.1007/s12311-015-0679-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Giorgia Mandrile
- Medical Genetics, San Luigi Gonzaga University Hospital, Orbassano, 10043, Italy
- Department of Clinical and Biological Sciences, University of Torino, Orbassano, 10043, Italy
| | - Eleonora Di Gregorio
- Department of Medical Sciences, University of Torino, via Santena 19, Torino, 10126, Italy
- Medical Genetics, Città della Salute e della Scienza di Torino University Hospital, Torino, 10126, Italy
| | - Himanshu Goel
- Faculty of Health and Medicine, Callaghan and Hunter Genetics, University of Newcastle, Waratah, NSW2308, Australia
| | - Daniela Giachino
- Medical Genetics, San Luigi Gonzaga University Hospital, Orbassano, 10043, Italy
- Department of Clinical and Biological Sciences, University of Torino, Orbassano, 10043, Italy
| | - Stefania De Mercanti
- Department of Clinical and Biological Sciences, University of Torino, Orbassano, 10043, Italy
- Neurology Division, San Luigi Gonzaga University Hospital, Orbassano, 10043, Italy
| | - Marco Iudicello
- Neurology Division, San Luigi Gonzaga University Hospital, Orbassano, 10043, Italy
| | - Marco Rolando
- Azienda Sanitaria Locale TO3 di Collegno e Pinerolo, Neuropsichiatria Infantile, Collegno, 10093, Italy
| | - Sabrina Losa
- Azienda Sanitaria Locale TO3 di Collegno e Pinerolo, Neuropsichiatria Infantile, Collegno, 10093, Italy
| | - Mario De Marchi
- Medical Genetics, San Luigi Gonzaga University Hospital, Orbassano, 10043, Italy
- Department of Clinical and Biological Sciences, University of Torino, Orbassano, 10043, Italy
| | - Alfredo Brusco
- Department of Medical Sciences, University of Torino, via Santena 19, Torino, 10126, Italy.
- Medical Genetics, Città della Salute e della Scienza di Torino University Hospital, Torino, 10126, Italy.
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Role of dynamic and mitochondrial mutations in neurodegenerative diseases with ataxia: lower repeats and LNAs at multiple loci as alternative pathogenesis. J Mol Neurosci 2014; 54:837-47. [PMID: 25303857 DOI: 10.1007/s12031-014-0431-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 09/24/2014] [Indexed: 10/24/2022]
Abstract
Spinocerebellar ataxia is a growing group of hereditary neurodegenerative diseases for which ≥30 different genetic loci have been identified. In this study, we assessed the repeats at eight spinocerebellar ataxia (SCA) loci in 188 clinical SCA patients and 100 individuals without any neurological signs. Results from the present study were able to identify 16/188 (8.5%) clinical ataxia patients with repeat expansions in the pathological range of SCA genes, with the majority having expansion at the SCA1, 2, and 3 loci. The present study further evaluated two mitochondrial mutations associated with ataxia, i.e., T8993G and A8344G. Six patients were identified with A8344G mutation and none had the mutation in ATPase 6 gene; however, G8994A variation was found in three cases. Overall, three cases had triplet repeat expansions as well as mitochondrial (mt) mutations, which indicates potential association of triplet repeat expansions and mitochondrial mutations. Both the molecular analysis of several SCA loci and two relevant mt mutations indicated that the majority of ataxia cases were still undiagnosed; hence, the following hypotheses were proposed and tested based on available data: (i) lower repeats than normal range and (ii) large normal alleles (LNAs) at multiple loci may be an alternative basis for disease pathogenesis.
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8
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Ikeda Y, Ranum LPW, Day JW. Clinical and genetic features of spinocerebellar ataxia type 8. HANDBOOK OF CLINICAL NEUROLOGY 2012; 103:493-505. [PMID: 21827909 DOI: 10.1016/b978-0-444-51892-7.00031-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Yoshio Ikeda
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN 55455, USA
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Ikeda Y, Daughters RS, Ranum LPW. Bidirectional expression of the SCA8 expansion mutation: one mutation, two genes. THE CEREBELLUM 2009; 7:150-8. [PMID: 18418692 DOI: 10.1007/s12311-008-0010-7] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Spinocerebellar ataxia type 8 (SCA8) is a dominantly inherited, slowly progressive neurodegenerative disorder caused by a CTG.CAG repeat expansion located on chromosome 13q21. The expansion mutation was isolated directly from the DNA of a single patient using RAPID cloning and subsequently shown to co-segregate with disease in additional ataxia families including a seven-generation kindred (the MN-A family). The size-dependent penetrance of the repeat found in the large MN-A kindred makes it appear as though some parts of the family have a dominant disorder while other parts of this same family have recessive or sporadic forms of ataxia. While the linkage and size-dependent penetrance of the SCA8 CTG.CAG expansion in the MN-A family argue that the SCA8 expansion causes ataxia, the reduced penetrance in other SCA8 families and the discovery of expansions in the general population have led to a controversy surrounding whether or not the SCA8 expansion is pathogenic. A recently reported mouse model in which SCA8 BAC-expansion but not BAC-control lines develop a progressive neurological phenotype now demonstrates the pathogenicity of the (CTG.CAG)(n) expansion. These mice show a loss of cerebellar GABAergic inhibition and, similar to human patients, have 1C2-positive intranuclear inclusions in Purkinje cells and other neurons. Additional studies demonstrate that the SCA8 expansion is expressed in both directions (CUG and CAG) and that a novel gene expressed in the CAG direction encodes a pure polyglutamine expansion protein (ataxin 8, ATXN8). Moreover, the expression of non-coding (CUG)(n) expansion transcripts (ataxin 8 opposite strand, ATXN8OS) and the discovery of intranuclear polyglutamine inclusions suggest SCA8 pathogenesis may involve toxic gain-of-function mechanisms at both the protein and RNA levels. Our data, combined with the recently reported antisense transcripts spanning the DM1 repeat expansion in the CAG direction and the growing number of reports of antisense transcripts expressed throughout the mammalian genome, raises the possibility that bidirectional expression across pathogenic microsatellite expansions may occur in other expansion disorders, and that potential pathogenic effects of mutations expressed from both strands should be considered.
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Affiliation(s)
- Yoshio Ikeda
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN 55455, USA
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10
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Munhoz RP, Teive HA, Raskin S, Werneck LC. CTA/CTG expansions at the SCA 8 locus in multiple system atrophy. Clin Neurol Neurosurg 2008; 111:208-10. [PMID: 18980793 DOI: 10.1016/j.clineuro.2008.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2008] [Revised: 08/29/2008] [Accepted: 09/05/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Spinocerebellar ataxia type 8 (SCA 8) is an autosomal dominant disorder characterized by cerebellar ataxia with additional features, such as upper motor neuron signs, urinary incontinence and dysphagia. From a clinical standpoint, SCA 8 and the cerebellar form of multiple system atrophy (MSA-C) share several common features. METHODS We studied the presence of expanded SCA 8 alleles in 10 sporadic patients with probable MSA-C. RESULTS We found 1 patient with a heterozygous CTA/CTG repeat expansion in the pathological range. Clinically this subject presented no features that differed from the other subjects carrying smaller repeat sizes. CONCLUSIONS We believe that the association of SCA 8 repeat expansions with sporadic, atypical and heterogeneous phenotypes is debatable and should be interpreted with caution. Our personal conclusion is that testing in such patients may become a source of diagnostic confusion.
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Affiliation(s)
- Renato P Munhoz
- Department of Neurology, Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil.
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11
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Abstract
Myotonic dystrophy type 1 (DM1) is caused by a CTG expansion mutation located in the 3' untranslated portion of the dystrophica myotonin protein kinase gene. The identification and characterization of RNA-binding proteins that interact with expanded CUG repeats and the discovery that a similar transcribed but untranslated CCTG expansion in an intron causes myotonic dystrophy type 2 (DM2) have uncovered a new type of mechanism in which microsatellite expansion mutations cause disease through an RNA gain-of-function mechanism. This review discusses RNA pathogenesis in DM1 and DM2 and evidence that similar mechanisms may play a role in a growing number of dominant noncoding expansion disorders, including fragile X tremor ataxia syndrome (FXTAS), spinocerebellar ataxia type 8 (SCA8), SCA10, SCA12, and Huntington's disease-like 2 (HDL2).
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Affiliation(s)
- Laura P W Ranum
- Institute of Human Genetics and Department of Genetics, Cell Biology & Development, University of Minnesota, Minneapolis, Minnesota 55455, USA.
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12
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Maschke M, Oehlert G, Xie TD, Perlman S, Subramony SH, Kumar N, Ptacek LJ, Gomez CM. Clinical feature profile of spinocerebellar ataxia type 1-8 predicts genetically defined subtypes. Mov Disord 2006; 20:1405-12. [PMID: 16037936 DOI: 10.1002/mds.20533] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
An increasing number of genetically defined types of spinocerebellar ataxia (SCA) have been reported in the past decade. Phenotype--genotype correlation studies have suggested a broad overlap between SCA types. The aim of the present study was to identify patterns of clinical features that were likely to distinguish between SCA types and to test the specificity and sensitivity of these signs and symptoms using a Bayesian classifier. In total, 127 patients from 50 families with SCA types 1 to 8 were examined using a worksheet with a panel of 33 symptoms and signs. By computing the probabilities of each trait for each SCA type, we rated the predictive value of each feature for each form of ataxia and then combined the probabilities for the entire panel of traits to construct a Bayesian classifier. Results of this analysis were summarized in a simpler, more operator-based algorithm. Patients with SCA5, SCA6, and SCA8 demonstrated a predominant cerebellar syndrome, whereas patients with SCA1, SCA2, SCA3, SCA4, and SCA7 frequently had clinical features indicating an extracerebellar involvement. The Bayesian classifier predicted the SCA type in 78% of patients with sensitivities between 60 and 100% and specificities between 94 and 98.2%. The highest sensitivity to correctly predict the true SCA type was found for SCA5, SCA7, and SCA8. Sensitivities and specificities found in the present study validate the use of algorithms to help to prioritize specific SCA gene testing, which will help to reduce costs for gene testing.
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Affiliation(s)
- Matthias Maschke
- Department of Neurology, University of Duisburg-Essen, Essen, Germany
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Felling RJ, Barron TF. Early onset of ataxia in a child with a pathogenic SCA8 allele. Pediatr Neurol 2005; 33:136-8. [PMID: 16087061 DOI: 10.1016/j.pediatrneurol.2005.02.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2004] [Revised: 01/08/2005] [Accepted: 02/14/2005] [Indexed: 10/25/2022]
Abstract
This case report describes a child with an expanded CTA/CTG repeat in one allele of the spinocerebellar ataxia 8 gene. This patient presented with ataxia at a much earlier age than is typical for patients with this condition. This unique patient further highlights the complexity of the role that this molecular defect plays in the onset and course of the disease.
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Affiliation(s)
- Ryan J Felling
- Penn State University College of Medicine, Neural and Behavioral Sciences, Hershey, Pennsylvania 17033, USA
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Baba Y, Uitti RJ, Farrer MJ, Wszolek ZK. Sporadic SCA8 mutation resembling corticobasal degeneration. Parkinsonism Relat Disord 2005; 11:147-50. [PMID: 15823478 DOI: 10.1016/j.parkreldis.2004.10.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2004] [Revised: 09/30/2004] [Accepted: 10/04/2004] [Indexed: 11/18/2022]
Abstract
Spinocerebellar ataxia type 8 (SCA8) is caused by the expansion of CTA/CTG triplet repeats on 13q21. Cases can be familial or sporadic. The clinical findings include cerebellar ataxia with upper motor neuron dysfunction, dysphagia, peripheral sensory disturbances, or cognitive and psychiatric impairments, indicating phenotypic variability in SCA8. We report on a patient with rapidly progressive parkinsonism-plus syndrome resembling corticobasal degeneration and triplet expansions in the SCA8 locus. The relationship between clinical phenotype and triplet expansions in the SCA8 locus requires further study.
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Affiliation(s)
- Yasuhiko Baba
- Department of Neurology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
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15
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Viau M, Boulanger Y. Characterization of ataxias with magnetic resonance imaging and spectroscopy. Parkinsonism Relat Disord 2004; 10:335-51. [PMID: 15261875 DOI: 10.1016/j.parkreldis.2004.02.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2003] [Revised: 02/17/2004] [Accepted: 02/26/2004] [Indexed: 11/19/2022]
Abstract
A wide variety of autosomal transmitted ataxias exist and their ultimate characterization requires genetic testing. Common clinical characteristics among different ataxia types complicate the choice of the appropriate genetic test. Magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) generally show cerebellar or cerebral atrophy and perturbed metabolite levels which differ between ataxias. In order to help the clinician accurately identify the ataxia type, reported MRI and MRS data in different brain regions are summarized for more than 60 different types of autosomal inherited and sporadic ataxias.
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Affiliation(s)
- Martin Viau
- Département de Radiologie, Hôpital Saint-Luc, Centre Hospitalier de l'Université de Montréal, 1058 St-Denis, Montréal, Québec, Canada H2X 3J4
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16
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Tsai HF, Liu CS, Leu TM, Wen FC, Lin SJ, Liu CC, Yang DK, Li C, Hsieh M. Analysis of trinucleotide repeats in different SCA loci in spinocerebellar ataxia patients and in normal population of Taiwan. Acta Neurol Scand 2004; 109:355-60. [PMID: 15080863 DOI: 10.1046/j.1600-0404.2003.00229.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To identify various subtypes of spinocerebellar ataxias (SCAs) among autosomal dominant cerebellar ataxia (ADCA) patients referred to our research center, SCA1, SCA2, SCA3/MJD (Machado-Joseph disease), SCA6, SCA7, SCA8 and SCA12 loci were assessed for expansion of trinucleotide repeats. PATIENTS AND METHODS A total of 211 ADCA patients, including 202 patients with dominantly inherited ataxia from 81 Taiwanese families and nine patients with sporadic ataxia, were included in this study and subjected to polymerase chain reaction (PCR) analysis. The amplified products of all loci were analyzed on both 3% agarose gels and 6% denaturing urea-polyacrylamide gels. PCR-based Southern blots were also applied for the detection of SCA7 locus. RESULTS The SCA1 mutation was detected in six affected individuals from one family (1.2%) with expanded alleles of 50-53 CAG repeats. Fourteen individuals from nine families (11%) had a CAG trinucleotide repeat expansion at the SCA2 locus, while affected SCA2 alleles have 34-49 CAG repeats. The SCA3/MJD CAG trinucleotide repeat expansion in 60 affected individuals from 26 families (32%) was expanded to 71-85 CAG repeats. As for the SCA7 locus, there were two affected individuals from one family (1.2%) possessed 41 and 100 CAG repeats, respectively. However, we did not detect expansion in the SCA6, SCA8 and SCA12 loci in any patient. CONCLUSIONS The SCA3/MJD CAG expansion was the most frequent mutation among the SCA patients. The relative prevalence of SCA3/MJD in Taiwan was higher than that of SCA2, SCA1 and SCA7.
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Affiliation(s)
- H-F Tsai
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC
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Zeman A, Stone J, Porteous M, Burns E, Barron L, Warner J. Spinocerebellar ataxia type 8 in Scotland: genetic and clinical features in seven unrelated cases and a review of published reports. J Neurol Neurosurg Psychiatry 2004; 75:459-65. [PMID: 14966165 PMCID: PMC1738991 DOI: 10.1136/jnnp.2003.018895] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To establish whether the DNA expansion linked to spinocerebellar ataxia type 8 (SCA 8) is associated with ataxia in Scotland; to clarify the range of associated clinical phenotypes; and to compare the findings with previous reports. METHODS DNA was screened from 1190 anonymised controls, 137 subjects who had tested negative for Huntington's disease, 176 with schizophrenia, and 173 with undiagnosed ataxia. Five unrelated ataxic patients with the SCA 8 expansion and a sixth identified subsequently had clinical and psychometric assessment; the clinical features were available in a seventh. A systematic search for other reports of SCA 8 was undertaken. RESULTS Over 98% of SCA 8 CTA/CTG repeat lengths fell between 14 and 40. Repeat lengths over 91 were observed in three healthy controls (0.12%), two patients with suspected Huntington's disease (0.73%), and six ataxic subjects (1.74%; p<0.0005 v healthy controls). Repeat lengths over 100 occurred in five ataxic subjects but in only one control. All seven symptomatic subjects with the SCA 8 expansion had a cerebellar syndrome; four had upper motor neurone signs; and 5/6 assessed had cognitive complaints. There was personality change in two and mood disturbance in three. In published reports, SCA 8 repeat lengths over 91 occurred in approximately 0.5% of the healthy population but were over-represented among ataxic patients (3.4%; p<0.0001). The predominant clinical phenotype was cerebellar, with pyramidal signs in 50%, and neuropsychiatric features in some cases. CONCLUSIONS SCA 8 expansion is a risk factor for a cerebellar syndrome, often associated with upper motor neurone and neuropsychiatric features. The expansion occurs unexpectedly often in the general population.
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Affiliation(s)
- A Zeman
- Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, UK.
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Wu YR, Lin HY, Chen CM, Gwinn-Hardy K, Ro LS, Wang YC, Li SH, Hwang JC, Fang K, Hsieh-Li HM, Li ML, Tung LC, Su MT, Lu KT, Lee-Chen GJ. Genetic testing in spinocerebellar ataxia in Taiwan: expansions of trinucleotide repeats in SCA8 and SCA17 are associated with typical Parkinson's disease. Clin Genet 2004; 65:209-14. [PMID: 14756671 DOI: 10.1111/j.0009-9163.2004.00213.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
DNA tests in normal subjects and patients with ataxia and Parkinson's disease (PD) were carried out to assess the frequency of spinocerebellar ataxia (SCA) and to document the distribution of SCA mutations underlying ethnic Chinese in Taiwan. MJD/SCA3 (46%) was the most common autosomal dominant SCA in the Taiwanese cohort, followed by SCA6 (18%) and SCA1 (3%). No expansions of SCA types 2, 10, 12, or dentatorubropallidoluysian atrophy (DRPLA) were detected. The clinical phenotypes of these affected SCA patients were very heterogeneous. All of them showed clinical symptoms of cerebellar ataxia, with or without other associated features. The frequencies of large normal alleles are closely associated with the prevalence of SCA1, SCA2, MJD/SCA3, SCA6, and DRPLA among Taiwanese, Japanese, and Caucasians. Interestingly, abnormal expansions of SCA8 and SCA17 genes were detected in patients with PD. The clinical presentation for these patients is typical of idiopathic PD with the following characteristics: late onset of disease, resting tremor in the limbs, rigidity, bradykinesia, and a good response to levodopa. This study appears to be the first report describing the PD phenotype in association with an expanded allele in the TATA-binding protein gene and suggests that SCA8 may also be a cause of typical PD.
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Affiliation(s)
- Y R Wu
- Second Department of Neurology, Chang Gung Memorial Hospital, Taipei, Taiwan
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Mosemiller AK, Dalton JC, Day JW, Ranum LPW. Molecular genetics of spinocerebellar ataxia type 8 (SCA8). Cytogenet Genome Res 2003; 100:175-83. [PMID: 14526178 DOI: 10.1159/000072852] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2002] [Accepted: 03/06/2003] [Indexed: 11/19/2022] Open
Abstract
We previously reported that a transcribed but untranslated CTG expansion causes a novel form of ataxia, spinocerebellar ataxia type 8 (SCA8) (Koob et al., 1999). SCA8 was the first example of a dominant spinocerebellar ataxia that is not caused by the expansion of a CAG repeat translated into a polyglutamine tract. This slowly progressive form of ataxia is characterized by dramatic repeat instability and a high degree of reduced penetrance. The clinical and genetic features of the disease are discussed below.
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Affiliation(s)
- A K Mosemiller
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN 55455, USA
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Abstract
PURPOSE OF REVIEW The present review covers recent developments in inherited ataxias. The discovery of new loci and genes has led to improved understanding of the breadth and epidemiology of inherited ataxias. This has resulted also in more rational classification schemes. Research on identified loci has begun to yield insights into the pathogenesis of neuronal dysfunction and neurodegeneration in these diseases. RECENT FINDINGS There are a plethora of inherited ataxias due to a variety of mutational mechanisms involving numerous loci. While ataxia and other aspects of cerebellar dysfunction are the core features of these diseases, rational classification has been impeded by the simultaneous variety of associated clinical features and considerable overlap in clinical features among diseases involving different loci. Inherited ataxias can be classified according to mode of inheritance and mechanism of mutations. Dominantly inherited ataxias (spinocerebellar ataxias) are one major group of ataxias. Spinocerebellar ataxias can be subdivided into expanded exonic CAG repeat (polyglutamine; polyQ) disorders, dominantly inherited ataxias with mutations in non-coding regions, and dominantly inherited ataxias with chromosomal localizations but unidentified loci. Another group of dominantly inherited ataxias are episodic ataxias due to ion channel mutations. Recessive ataxias constitute a more heterogeneous group due to loss-of-function effects in numerous loci. A number of these loci have now been identified. Progress has been made in investigating the pathogenesis of neuronal dysfunction/neurodegeneration in several inherited ataxias. Convergent evidence suggests that transcriptional dysregulation is an important component of neurodegeneration in polyQ disorders. Mitochondrial dysfunction is central to pathogenesis of the most common recessive ataxia, Friedreich ataxia. SUMMARY Mapping of additional ataxia loci and identification of novel ataxia genes continues unabated. Genetic classification enables typology of inherited ataxias. Identification of the affected loci and the mutational mechanisms has allowed the first glimmers of understanding of the pathogenesis of several inherited ataxias.
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Affiliation(s)
- Roger L Albin
- Department of Neurology, University of Michigan, Ann Arbor, MI 48109, USA.
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Izumi Y, Maruyama H, Oda M, Morino H, Okada T, Ito H, Sasaki I, Tanaka H, Komure O, Udaka F, Nakamura S, Kawakami H. SCA8 repeat expansion: large CTA/CTG repeat alleles are more common in ataxic patients, including those with SCA6. Am J Hum Genet 2003; 72:704-9. [PMID: 12545428 PMCID: PMC1180244 DOI: 10.1086/367775] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2002] [Accepted: 11/25/2002] [Indexed: 11/03/2022] Open
Abstract
We analyzed the SCA8 CTA/CTG repeat in a large group of Japanese subjects. The frequency of large alleles (85-399 CTA/CTG repeats) was 1.9% in spinocerebellar ataxia (SCA), 0.4% in Parkinson disease, 0.3% in Alzheimer disease, and 0% in a healthy control group; the frequency was significantly higher in the group with SCA than in the control group. Homozygotes for large alleles were observed only in the group with SCA. In five patients with SCA from two families, a large SCA8 CTA/CTG repeat and a large SCA6 CAG repeat coexisted. Age at onset was correlated with SCA8 repeats rather than SCA6 repeats in these five patients. In one of these families, at least one patient showed only a large SCA8 CTA/CTG repeat allele, with no large SCA6 CAG repeat allele. We speculate that the presence of a large SCA8 CTA/CTG repeat allele influences the function of channels such as alpha(1A)-voltage-dependent calcium channel through changing or aberrant splicing, resulting in the development of cerebellar ataxia, especially in homozygous patients.
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Affiliation(s)
- Yuishin Izumi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Science, Hiroshima; Department of Neurology, Kitano Hospital, Department of Neurology, Kansai Medical University, and Department of Neurology, Sumitomo Hospital, Osaka; Third Department of Internal Medicine, Kagawa Medical University, Kagawa, Japan; Third Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan; Department of Neurology, Utano National Hospital, Kyoto
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Science, Hiroshima; Department of Neurology, Kitano Hospital, Department of Neurology, Kansai Medical University, and Department of Neurology, Sumitomo Hospital, Osaka; Third Department of Internal Medicine, Kagawa Medical University, Kagawa, Japan; Third Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan; Department of Neurology, Utano National Hospital, Kyoto
| | - Masaya Oda
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Science, Hiroshima; Department of Neurology, Kitano Hospital, Department of Neurology, Kansai Medical University, and Department of Neurology, Sumitomo Hospital, Osaka; Third Department of Internal Medicine, Kagawa Medical University, Kagawa, Japan; Third Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan; Department of Neurology, Utano National Hospital, Kyoto
| | - Hiroyuki Morino
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Science, Hiroshima; Department of Neurology, Kitano Hospital, Department of Neurology, Kansai Medical University, and Department of Neurology, Sumitomo Hospital, Osaka; Third Department of Internal Medicine, Kagawa Medical University, Kagawa, Japan; Third Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan; Department of Neurology, Utano National Hospital, Kyoto
| | - Takayuki Okada
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Science, Hiroshima; Department of Neurology, Kitano Hospital, Department of Neurology, Kansai Medical University, and Department of Neurology, Sumitomo Hospital, Osaka; Third Department of Internal Medicine, Kagawa Medical University, Kagawa, Japan; Third Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan; Department of Neurology, Utano National Hospital, Kyoto
| | - Hidefumi Ito
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Science, Hiroshima; Department of Neurology, Kitano Hospital, Department of Neurology, Kansai Medical University, and Department of Neurology, Sumitomo Hospital, Osaka; Third Department of Internal Medicine, Kagawa Medical University, Kagawa, Japan; Third Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan; Department of Neurology, Utano National Hospital, Kyoto
| | - Iwao Sasaki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Science, Hiroshima; Department of Neurology, Kitano Hospital, Department of Neurology, Kansai Medical University, and Department of Neurology, Sumitomo Hospital, Osaka; Third Department of Internal Medicine, Kagawa Medical University, Kagawa, Japan; Third Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan; Department of Neurology, Utano National Hospital, Kyoto
| | - Hiroyasu Tanaka
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Science, Hiroshima; Department of Neurology, Kitano Hospital, Department of Neurology, Kansai Medical University, and Department of Neurology, Sumitomo Hospital, Osaka; Third Department of Internal Medicine, Kagawa Medical University, Kagawa, Japan; Third Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan; Department of Neurology, Utano National Hospital, Kyoto
| | - Osamu Komure
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Science, Hiroshima; Department of Neurology, Kitano Hospital, Department of Neurology, Kansai Medical University, and Department of Neurology, Sumitomo Hospital, Osaka; Third Department of Internal Medicine, Kagawa Medical University, Kagawa, Japan; Third Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan; Department of Neurology, Utano National Hospital, Kyoto
| | - Fukashi Udaka
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Science, Hiroshima; Department of Neurology, Kitano Hospital, Department of Neurology, Kansai Medical University, and Department of Neurology, Sumitomo Hospital, Osaka; Third Department of Internal Medicine, Kagawa Medical University, Kagawa, Japan; Third Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan; Department of Neurology, Utano National Hospital, Kyoto
| | - Shigenobu Nakamura
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Science, Hiroshima; Department of Neurology, Kitano Hospital, Department of Neurology, Kansai Medical University, and Department of Neurology, Sumitomo Hospital, Osaka; Third Department of Internal Medicine, Kagawa Medical University, Kagawa, Japan; Third Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan; Department of Neurology, Utano National Hospital, Kyoto
| | - Hideshi Kawakami
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Science, Hiroshima; Department of Neurology, Kitano Hospital, Department of Neurology, Kansai Medical University, and Department of Neurology, Sumitomo Hospital, Osaka; Third Department of Internal Medicine, Kagawa Medical University, Kagawa, Japan; Third Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan; Department of Neurology, Utano National Hospital, Kyoto
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Topisirovic I, Dragasevic N, Savic D, Ristic A, Keckarevic M, Keckarevic D, Culjkovic B, Petrovic I, Romac S, Kostic VS. Genetic and clinical analysis of spinocerebellar ataxia type 8 repeat expansion in Yugoslavia. Clin Genet 2002; 62:321-4. [PMID: 12372061 DOI: 10.1034/j.1399-0004.2002.620412.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Spinocerebellar ataxia type 8 (SCA8) is a slowly progressive ataxia causally associated with untranslated CTG repeat expansion on chromosome 13q21. However, the role of the CTG repeat in SCA8 pathology is not yet well understood. Therefore, we studied the length of the SCA8 CTA/CTG expansions (combined repeats, CRs) in 115 patients with ataxia, 64 unrelated individuals with non-triplet neuromuscular diseases, 70 unrelated patients with schizophrenia, and 125 healthy controls. Only one patient with apparently sporadic ataxia was identified with an expansion of 100 CRs. He had inherited the expansion from his asymptomatic father (140 CRs) and transmitted the mutation to his son (92 CRs). Paternal transmission in this family produced contractions of 40 and 8 CRs, respectively. None of the subjects from other studied groups had an expansion at the SCA8 locus. In the control group the number of CRs at the SCA8 locus ranged from 14 to 34. Our findings support the notion that allelic variants of the expansion mutation at the SCA8 locus can predispose to ataxia.
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Affiliation(s)
- I Topisirovic
- PCR Center, Faculty for Biology, Institute of Neurology CCS, School of Medicine, University of Belgrade, Serbia
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