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Manzoor U, Ali A, Ali SL, Abdelkarem O, Kanwal S, Alotaibi SS, Baazeem A, Baiduissenova A, Yktiyarov A, Hajar A, Olzhabay A. Mutational screening of GDAP1 in dysphonia associated with Charcot-Marie-Tooth disease: clinical insights and phenotypic effects. J Genet Eng Biotechnol 2023; 21:119. [PMID: 37966693 PMCID: PMC10651813 DOI: 10.1186/s43141-023-00568-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 10/26/2023] [Indexed: 11/16/2023]
Abstract
INTRODUCTION Mutations in GDAP1 (Ganglioside-induced differentiation-associated protein 1) gene are linked to Charcot-Marie-Tooth disease (CMT), a Heterogenous group of disorders with multiple phenotypes, characterized by peripheral nerve dysfunction that can lead to vocal cord paralysis and diaphragmatic dysfunction. MAIN BODY All three affected children of this chosen family have manifested the same clinical symptoms with progressive weakness, mild sensory impairment, and absent tendon reflexes in their early years. Electrodiagnostic analysis displayed an axonal type of neuropathy in affected patients. Sequencing of the GDAP1 gene was requested for all members of the family. Diagnostic assessments included pulmonary and vocal cord function tests, as well as phrenic and peripheral nerve conduction studies. Pathogenicity of GDAP1 variant p.Pro419Leu with axonal CMT2 and autosomal recessive inheritance was confirmed via in silico analysis. Patients with GDAP1 mutations showed dysphonia, speech difficulties, and the characteristic symptoms of CMT. The severity of symptoms correlated with the presence of a type of GDAP1 mutation. Patients with normal vocal cords and pulmonary function exhibited milder symptoms compared to those with GDAP1 mutations. Our study provides clinical insights into the phenotypic effects of GDAP1 mutations in CMT patients. The findings highlight the adverse clinical course and severe disability associated with GDAP1 mutations, including weak limb and laryngeal muscles. CONCLUSION Patients with GDAP1 mutations and autosomal recessive neuropathy present with dysphonia and require interventions such as surgery, braces, physical therapy, and exercise. Early diagnosis and comprehensive clinical evaluations are crucial for managing CMT patients with GDAP1 mutations.
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Affiliation(s)
- Uzma Manzoor
- Department of Clinical Biochemistry, COMSATS University Islamabad, Sahiwal Campus, Sahiwal, Pakistan.
| | - Awais Ali
- Department of Biochemistry, Abdul wali Khan University Mardan, Mardan, 23200, Pakistan
| | - S Luqman Ali
- Department of Biochemistry, Abdul wali Khan University Mardan, Mardan, 23200, Pakistan
| | - Omneya Abdelkarem
- Department of Chemical Pathology, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Sumaira Kanwal
- Department of Clinical Biochemistry, COMSATS University Islamabad, Sahiwal Campus, Sahiwal, Pakistan
| | - Saqer S Alotaibi
- Department of Biotechnology, College of Science, Taif University, P.O.Box 11099, 21944, Taif, Saudi Arabia
| | - Alaa Baazeem
- Department of Biology, College of Science, Taif University, P.O. Box 11099, 21944, Taif, Saudi Arabia
| | - Aliya Baiduissenova
- Department of Microbiology and Virology, Astana Medical University, Astana City, 010000, Kazakhstan
| | - Ayaz Yktiyarov
- Department of Microbiology and Virology, Astana Medical University, Astana City, 010000, Kazakhstan
| | - Azraida Hajar
- Department of Biology, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco
| | - Abay Olzhabay
- Department of Otorhinolaryngology, Astana Medical University, Astana City, 010000, Kazakhstan
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Pareyson D, Stojkovic T, Reilly MM, Leonard-Louis S, Laurà M, Blake J, Parman Y, Battaloglu E, Tazir M, Bellatache M, Bonello-Palot N, Lévy N, Sacconi S, Guimarães-Costa R, Attarian S, Latour P, Solé G, Megarbane A, Horvath R, Ricci G, Choi BO, Schenone A, Gemelli C, Geroldi A, Sabatelli M, Luigetti M, Santoro L, Manganelli F, Quattrone A, Valentino P, Murakami T, Scherer SS, Dankwa L, Shy ME, Bacon CJ, Herrmann DN, Zambon A, Tramacere I, Pisciotta C, Magri S, Previtali SC, Bolino A. A multicenter retrospective study of charcot-marie-tooth disease type 4B (CMT4B) associated with mutations in myotubularin-related proteins (MTMRs). Ann Neurol 2019; 86:55-67. [PMID: 31070812 DOI: 10.1002/ana.25500] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 04/23/2019] [Accepted: 05/05/2019] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Charcot-Marie-Tooth (CMT) disease 4B1 and 4B2 (CMT4B1/B2) are characterized by recessive inheritance, early onset, severe course, slowed nerve conduction, and myelin outfoldings. CMT4B3 shows a more heterogeneous phenotype. All are associated with myotubularin-related protein (MTMR) mutations. We conducted a multicenter, retrospective study to better characterize CMT4B. METHODS We collected clinical and genetic data from CMT4B subjects in 18 centers using a predefined minimal data set including Medical Research Council (MRC) scores of nine muscle pairs and CMT Neuropathy Score. RESULTS There were 50 patients, 21 of whom never reported before, carrying 44 mutations, of which 21 were novel and six representing novel disease associations of known rare variants. CMT4B1 patients had significantly more-severe disease than CMT4B2, with earlier onset, more-frequent motor milestones delay, wheelchair use, and respiratory involvement as well as worse MRC scores and motor CMT Examination Score components despite younger age at examination. Vocal cord involvement was common in both subtypes, whereas glaucoma occurred in CMT4B2 only. Nerve conduction velocities were similarly slowed in both subtypes. Regression analyses showed that disease severity is significantly associated with age in CMT4B1. Slopes are steeper for CMT4B1, indicating faster disease progression. Almost none of the mutations in the MTMR2 and MTMR13 genes, responsible for CMT4B1 and B2, respectively, influence the correlation between disease severity and age, in agreement with the hypothesis of a complete loss of function of MTMR2/13 proteins for such mutations. INTERPRETATION This is the largest CMT4B series ever reported, demonstrating that CMT4B1 is significantly more severe than CMT4B2, and allowing an estimate of prognosis. ANN NEUROL 2019.
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Affiliation(s)
- Davide Pareyson
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Tanya Stojkovic
- Hôpital Pitié-Salpêtrière, AP-HP, Centre de référence des maladies neuromusculaires Nord/Est/Ile de France, Paris, France
| | - Mary M Reilly
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Sarah Leonard-Louis
- Hôpital Pitié-Salpêtrière, AP-HP, Centre de référence des maladies neuromusculaires Nord/Est/Ile de France, Paris, France
| | - Matilde Laurà
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Julian Blake
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, United Kingdom.,Department of Clinical Neurophysiology, Norfolk and Norwich University Hospital, Norfolk, United Kingdom
| | - Yesim Parman
- Istanbul University, Istanbul Faculty of Medicine, Neurology Dep. Istanbul, Turkey
| | - Esra Battaloglu
- Bogazici University, Department of Molecular Biology and Genetics, Istanbul, Turkey
| | - Meriem Tazir
- Laboratoire de Recherche en Neurosciences Service de Neurologie, CHU, Alger, Algeria
| | - Mounia Bellatache
- Laboratoire de Recherche en Neurosciences Service de Neurologie, CHU, Alger, Algeria
| | - Nathalie Bonello-Palot
- Department of Medical Genetics, Timone Hospital, Marseille, France.2, Aix-Marseille University, INSERM, MMG, U1251, Marseille, France
| | - Nicolas Lévy
- Department of Medical Genetics, Timone Hospital, Marseille, France.2, Aix-Marseille University, INSERM, MMG, U1251, Marseille, France
| | - Sabrina Sacconi
- Université Côte d'Azur, Service Système Nerveux Périphérique, Muscle et SLA, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Raquel Guimarães-Costa
- Hôpital Pitié-Salpêtrière, AP-HP, Centre de référence des maladies neuromusculaires Nord/Est/Ile de France, Paris, France
| | - Sharham Attarian
- Reference center for neuromuscular disorders and ALS, CHU La Timone, Aix-Marseille University, Marseille, France
| | - Philippe Latour
- Center of Biology and Pathology Laboratory of Molecular Neurogenetics, Hospices Civils, Lyon, France
| | - Guilhem Solé
- Reference center for neuromuscular disorders AOC (Atlantique Occitanie Caraibes), CHU de Bordeaux, Bordeaux, France
| | - André Megarbane
- Institut Jérôme Lejeune, Paris, France.,INOVIE, Beirut, Lebanon
| | - Rita Horvath
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom.,Institute of Genetic Medicine, Newcastle University, Newcastle, United Kingdom
| | - Giulia Ricci
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Byung-Ok Choi
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Angelo Schenone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and MATERNAL Infantile Sciences, University of Genoa, and IRCCS Policlinico San Martino, Genoa, Italy
| | - Chiara Gemelli
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and MATERNAL Infantile Sciences, University of Genoa, and IRCCS Policlinico San Martino, Genoa, Italy
| | - Alessandro Geroldi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and MATERNAL Infantile Sciences, University of Genoa, and IRCCS Policlinico San Martino, Genoa, Italy
| | - Mario Sabatelli
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS. Centro Clinico Nemo Adulti Rome, Rome, Italy.,Università Cattolica del Sacro Cuore. Sede di Roma, Rome, Italy
| | - Marco Luigetti
- Università Cattolica del Sacro Cuore. Sede di Roma, Rome, Italy.,UOC Neurologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Lucio Santoro
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Naples, Italy
| | - Fiore Manganelli
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Naples, Italy
| | - Aldo Quattrone
- Department of Neurology, Università Magna Graecia di Catanzaro, Catanzaro, Italy
| | - Paola Valentino
- Department of Neurology, Università Magna Graecia di Catanzaro, Catanzaro, Italy
| | | | - Steven S Scherer
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Lois Dankwa
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Michael E Shy
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa, IA
| | - Chelsea J Bacon
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa, IA
| | | | - Alberto Zambon
- Institute of Experimental Neurology (InSpe), Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Irene Tramacere
- Department of Research and Clinical Development, Scientific Directorate, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Chiara Pisciotta
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Stefania Magri
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Stefano C Previtali
- Institute of Experimental Neurology (InSpe), Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Alessandra Bolino
- Institute of Experimental Neurology (InSpe), Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy
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Zambon AA, Natali Sora MG, Cantarella G, Cerri F, Quattrini A, Comi G, Previtali SC, Bolino A. Vocal cord paralysis in Charcot-Marie-Tooth type 4b1 disease associated with a novel mutation in the myotubularin-related protein 2 gene: A case report and review of the literature. Neuromuscul Disord 2017; 27:487-491. [PMID: 28190646 PMCID: PMC5425401 DOI: 10.1016/j.nmd.2017.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 11/21/2016] [Accepted: 01/09/2017] [Indexed: 12/05/2022]
Abstract
Vocal cord paralysis is a relevant symptom of Charcot–Marie–Tooth type 4B1. Patients harboring MTMR2 mutations should be investigated for laryngeal function. A new mutation in the MTMR2 gene is described. The frequency of vocal cord paralysis in early-onset CMT subtypes is explored.
Charcot–Marie–Tooth type 4B1 (CMT4B1) is an autosomal recessive motor and sensory demyelinating neuropathy characterized by the association of early-onset neurological symptoms and typical histological findings. The natural history and the clinical variability of the disease are still poorly known, thus further clarification of the different phenotypes is needed. We report on the case of a Pakistani girl born to consanguineous parents harboring a novel mutation in the MTMR2 gene. When aged 18 months, reduced limb tone, muscle wasting associated with proximal and distal weakness prevalent in lower limbs, absence of tendon reflexes, hoarseness and inspiratory stridor were detected. Vocal cord palsy was diagnosed shortly after. We suggest that laryngeal involvement might be a relevant and initial feature of early-onset CMT4B1 neuropathy. Thus, affected patients should undergo early laryngological evaluation in order to prompt an appropriate management.
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Affiliation(s)
- Alberto Andrea Zambon
- Department of Neurology, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy.
| | - Maria Grazia Natali Sora
- Department of Neurology, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy
| | - Giovanna Cantarella
- Otolaryngology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan, Italy
| | - Federica Cerri
- Department of Neurology, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy; Experimental Neuropathology Unit, INSPE and Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy
| | - Angelo Quattrini
- Department of Neurology, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy; Experimental Neuropathology Unit, INSPE and Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy
| | - Giancarlo Comi
- Department of Neurology, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy
| | - Stefano Carlo Previtali
- Department of Neurology, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy; Neuromuscular Repair Unit, INSPE and Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy
| | - Alessandra Bolino
- Human Inherited Neuropathies Unit, INSPE and Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy
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