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Scorrano G, Dono F, Corniello C, Evangelista G, Chiarelli F, Sensi SL. Exploring epileptic phenotypes in PRRT2-related disorders: A report of two cases and literature appraisal. Seizure 2024; 119:3-11. [PMID: 38749256 DOI: 10.1016/j.seizure.2024.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 04/14/2024] [Accepted: 04/19/2024] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND The proline-rich transmembrane protein 2 (PRRT2) is a synaptic protein involved in neurotransmitter vesicle release. PRRT2 protein is highly expressed in the cerebellum, cerebral cortex, basal ganglia, and hippocampus. Variants in PRRT2 have been identified as a cause of several neurological disorders, including epilepsy, movement disorders, and headache. METHODS We report two families carrying two distinct PRRT2 mutations showing childhood onset of movement disorders, headache, and epilepsy. Demographics, clinical, EEG, neuroimaging, and genetic sequencing study data were collected. A systematic review of the literature was also performed to dissect the most frequently reported PRRT2-associated epileptic phenotypes. RESULTS two variants in PRRT2 gene (NM_145239.3:c718C>T, p.Arg240Ter; c.649dupC, p.Arg217Profs*8) were identified. The two variants altered the same extracellular domain of PRRT2. The de novo PRRT2 mutation (c718C>T, p.Arg240Ter) was related to multi-drug-resistant epilepsy. According to the literature, homozygous, biallelic variants and 16p11.2 deletions lead to PRRT2 haploinsufficiency and a more severe phenotype. CONCLUSIONS PRRT2 mutations can be associated with several epileptic phenotypes ranging from benign ASM-responsive form to more severe epileptic encephalopathies. Identifying PRRT2 variants in epilepsy patients may help achieve more personalized treatment approaches. However, phenotype-genotype correlations remain a challenge.
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Affiliation(s)
- Giovanna Scorrano
- Department of Pediatrics, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Fedele Dono
- Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy; Neurology Clinic, Epilepsy Center, "SS Annunziata" Hospital of Chieti, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST-, University G. d'Annunzio of Chieti-Pescara, Italy.
| | - Clarissa Corniello
- Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy; Neurology Clinic, Epilepsy Center, "SS Annunziata" Hospital of Chieti, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST-, University G. d'Annunzio of Chieti-Pescara, Italy
| | - Giacomo Evangelista
- Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy; Neurology Clinic, Epilepsy Center, "SS Annunziata" Hospital of Chieti, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST-, University G. d'Annunzio of Chieti-Pescara, Italy
| | - Francesco Chiarelli
- Department of Pediatrics, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Stefano L Sensi
- Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy; Neurology Clinic, Epilepsy Center, "SS Annunziata" Hospital of Chieti, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST-, University G. d'Annunzio of Chieti-Pescara, Italy
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2
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Zhang L, Wan ZX, Zhu JY, Liu HJ, Sun J, Zou XH, Zhang T, Li Y. A Girl with PRRT2 Mutation Presenting with Benign Familial Infantile Seizures Followed by Autistic Regression. Case Rep Pediatr 2024; 2024:5539799. [PMID: 38406554 PMCID: PMC10890899 DOI: 10.1155/2024/5539799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/10/2024] [Accepted: 01/24/2024] [Indexed: 02/27/2024] Open
Abstract
Benign familial infantile seizure (BFIS) is an autosomal dominant infantile-onset epilepsy syndrome with a typically benign prognosis. It is commonly associated with heterozygous mutations of the PRRT2 gene located on chromosome 16p11.2. The frameshift heterozygous mutation (c.649dupC, p.Arg217Profs∗8) in PRRT2 is responsible for the majority of BFIS cases. In this report, we present a rare case of a girl with a confirmed clinical and genetic diagnosis of BFIS due to a frameshift heterozygous mutation in PRRT2 (c.649dupC). She exhibited typical neurodevelopment until 15 months of age, followed by an unexpected severe autistic regression. In addition to BFIS, PRRT2 mutations are also associated with paroxysmal kinesigenic dyskinesia (PKD) and infantile convulsions and paroxysmal choreoathetosis (ICCA), indicating a complex genotype-phenotype heterogeneity in PRRT2 mutations. This clinical observation highlights the possibility that BFIS patients with PRRT2 mutations may not always have a benign neurodevelopmental prognosis, emphasizing the need for long-term clinical follow-up.
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Affiliation(s)
- Li Zhang
- Research Center for Child Health, Department of Child Health Care, Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China
| | - Zhen-Xia Wan
- Neonatal Intensive Care Unit, Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China
| | - Jin-Yi Zhu
- Affiliated Hospital of Weifang Medical University, School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Hui-Juan Liu
- Research Center for Child Health, Department of Child Health Care, Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China
| | - Jin Sun
- Department of Child Health Care, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Xiao-Hui Zou
- Department of Child Health Care, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Ting Zhang
- Research Center for Child Health, Department of Child Health Care, Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China
| | - Yan Li
- Research Center for Child Health, Department of Child Health Care, Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China
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3
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Millevert C, Weckhuysen S. ILAE Genetic Literacy Series: Self-limited familial epilepsy syndromes with onset in neonatal age and infancy. Epileptic Disord 2023; 25:445-453. [PMID: 36939707 DOI: 10.1002/epd2.20026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/13/2022] [Accepted: 12/22/2022] [Indexed: 03/21/2023]
Abstract
The self-limited (familial) epilepsies with onset in neonates or infants, formerly called benign familial neonatal and/or infantile epilepsies, are autosomal dominant disorders characterized by neonatal- or infantile-onset focal motor seizures and the absence of neurodevelopmental complications. Seizures tend to remit during infancy or early childhood and are therefore called "self-limited". A positive family history for epilepsy usually suggests the genetic etiology, but incomplete penetrance and de novo inheritance occur. Here, we review the phenotypic spectrum and the genetic architecture of self-limited (familial) epilepsies with onset in neonates or infants. Using an illustrative case study, we describe important clues in recognition of these syndromes, diagnostic steps including genetic testing, management, and genetic counseling.
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Affiliation(s)
- Charissa Millevert
- Applied & Translational Neurogenomics Group, VIB Center for Molecular Neurology, VIB, Antwerp, Belgium
- Department of Neurology, University Hospital, Antwerp, Belgium
| | - Sarah Weckhuysen
- Applied & Translational Neurogenomics Group, VIB Center for Molecular Neurology, VIB, Antwerp, Belgium
- Department of Neurology, University Hospital, Antwerp, Belgium
- μNEURO Research Centre of Excellence, University of Antwerp, Antwerp, Belgium
- Translational Neurosciences, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
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4
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Gu Y, Mei D, Wang X, Ma A, Kong J, Zhang Y. Clinical and genetic analysis of benign familial infantile epilepsy caused by PRRT2 gene variant. Front Neurol 2023; 14:1135044. [PMID: 37228410 PMCID: PMC10204721 DOI: 10.3389/fneur.2023.1135044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/18/2023] [Indexed: 05/27/2023] Open
Abstract
Objective This study presents the clinical phenotypes and genetic analysis of seven patients with benign familial infantile epilepsy (BFIE) diagnosed by whole-exome sequencing. Methods The clinical data of seven children with BFIE diagnosed at the Department of Neurology, Children's Hospital Affiliated to Zhengzhou University between December 2017 and April 2022 were retrospectively analyzed. Whole-exome sequencing was used to identify the genetic causes, and the variants were verified by Sanger sequencing in other family members. Results The seven patients with BFIE included two males and five females ranging in age between 3 and 7 months old. The main clinical phenotype of the seven affected children was the presence of focal or generalized tonic-clonic seizures, which was well controlled by anti-seizure medication. Cases 1 and 5 exhibited predominantly generalized tonic-clonic seizures accompanied by focal seizures while cases 2, 3, and 7 displayed generalized tonic-clonic seizures, and cases 4 and 6 had focal seizures. The grandmother and father of cases 2, 6, and 7 had histories of seizures. However, there was no family history of seizures in the remaining cases. Case 1 carried a de novo frameshift variant c.397delG (p.E133Nfs*43) in the proline-rich transmembrane protein 2 (PRRT2) gene while case 2 had a nonsense variant c.46G > T (p.Glu16*) inherited from the father, and cases 3-7 carried a heterozygous frameshift variant c.649dup (p.R217Pfs*8) in the same gene. In cases 3 and 4, the frameshift variant was de novo, while in cases 5-7, the variant was paternally inherited. The c.397delG (p.E133Nfs*43) variant is previously unreported. Conclusion This study demonstrated the effectiveness of whole-exome sequencing in the diagnosis of BFIE. Moreover, our findings revealed a novel pathogenic variant c.397delG (p.E133Nfs*43) in the PRRT2 gene that causes BFIE, expanding the mutation spectrum of PRRT2.
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Affiliation(s)
- Yu Gu
- Department of Pediatrics, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Daoqi Mei
- Department of Neurology, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Xiaona Wang
- Zhengzhou Key Laboratory of Pediatric Neurobehavioral, Henan Neural Development Engineering Research Center, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Ang Ma
- Department of Pediatrics, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Jinghui Kong
- Zhengzhou Key Laboratory of Pediatric Neurobehavioral, Henan Neural Development Engineering Research Center, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Yaodong Zhang
- Zhengzhou Key Laboratory of Pediatric Neurobehavioral, Henan Neural Development Engineering Research Center, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China
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5
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Lee YS, Lee GH, Kwon YS. Update on benign convulsions with mild gastroenteritis. Clin Exp Pediatr 2022; 65:469-475. [PMID: 34961297 PMCID: PMC9561189 DOI: 10.3345/cep.2021.00997] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 12/15/2021] [Indexed: 12/16/2022] Open
Abstract
Benign convulsions with mild gastroenteritis (CwG) are characterized by afebrile convulsions associated with viral gastroenteritis in previously healthy infants and children. The main causative pathogens are rotavirus and norovirus. CwG occurs frequently in both East Asian and Western countries. The prevalence of CwG was reportedly not decreased by the introduction of rotavirus vaccines, and the prevalence of norovirus-associated CwG has been increasing annually. Convulsions in CwG are usually clustered, do not last longer than 5 minutes, and are mostly generalized. Laboratory diagnostics, electroencephalography (EEG), and imaging findings are usually normal. There is a probability of mild, transient abnormal findings on EEG or imaging limited to the acute disease phase. Although several reports have suggested that pathogens that affect the central nervous system through direct or indirect mechanisms could be related to the pathophysiology of CwG, its mechanism is not fully understood. Several antiepileptic drugs are effective during convulsions; however, long-term antiepileptic treatment is not required as CwG usually has a good prognosis.
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Affiliation(s)
- Yeong Seok Lee
- Department of Pediatrics, School of Medicine, Inha University, Incheon, Korea
| | - Ga Hee Lee
- Department of Pediatrics, School of Medicine, Inha University, Incheon, Korea
| | - Young Se Kwon
- Department of Pediatrics, School of Medicine, Inha University, Incheon, Korea
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6
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Zhong L, Song Y, Marziali F, Uzbekov R, Nguyen XN, Journo C, Roingeard P, Cimarelli A. A novel domain within the CIL regulates egress of IFITM3 from the Golgi and reveals a regulatory role of IFITM3 on the secretory pathway. Life Sci Alliance 2022; 5:5/7/e202101174. [PMID: 35396335 PMCID: PMC8994042 DOI: 10.26508/lsa.202101174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 12/30/2022] Open
Abstract
The InterFeron-Induced TransMembrane proteins (IFITMs) are members of the dispanin/CD225 family that act as broad viral inhibitors by preventing viral-to-cellular membrane fusion. In this study, we uncover egress from the Golgi as an important step in the biology of IFITM3 by identifying the domain that regulates this process and that similarly controls the egress of the dispanins IFITM1 and PRRT2, protein linked to paroxysmal kinesigenic dyskinesia. In the case of IFITM3, high levels of expression of wild-type, or mutations in the Golgi egress domain, lead to accumulation of IFITM3 in the Golgi and drive generalized glycoprotein trafficking defects. These defects can be relieved upon incubation with Amphotericin B, compound known to relieve IFITM-driven membrane fusion defects, as well as by v-SNARE overexpression, suggesting that IFITM3 interferes with membrane fusion processes important for Golgi functionalities. The comparison of glycoprotein trafficking in WT versus IFITMs-KO cells indicates that the modulation of the secretory pathway is a novel feature of IFITM proteins. Overall, our study defines a novel domain that regulates the egress of several dispanin/CD225 members from the Golgi and identifies a novel modulatory function for IFITM3.
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Affiliation(s)
- Li Zhong
- Centre International de Recherche en Infectiologie (CIRI), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
| | - Yuxin Song
- Centre International de Recherche en Infectiologie (CIRI), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
| | - Federico Marziali
- Centre International de Recherche en Infectiologie (CIRI), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
| | - Rustem Uzbekov
- Plateforme IBiSA de Microscopie Electronique, Université de Tours et CHU de Tours, Tours, France,Faculty of Bioengineering and Bioinformatics, Moscow State University, Moscow, Russia
| | - Xuan-Nhi Nguyen
- Centre International de Recherche en Infectiologie (CIRI), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
| | - Chloé Journo
- Centre International de Recherche en Infectiologie (CIRI), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
| | - Philippe Roingeard
- Plateforme IBiSA de Microscopie Electronique, Université de Tours et CHU de Tours, Tours, France,INSERM U1259, Université de Tours et CHU de Tours, Tours, France
| | - Andrea Cimarelli
- Centre International de Recherche en Infectiologie (CIRI), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France,Correspondence:
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7
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I D, Aysina V. The coincidence of benign non-familial infantile seizures type 2 with osteogenesis imperfecta type 1. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:128-131. [DOI: 10.17116/jnevro2022122051128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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8
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Chen Y, Chen D, Zhao S, Liu G, Li H, Wu ZY. Penetrance estimation of PRRT2 variants in paroxysmal kinesigenic dyskinesia and infantile convulsions. Front Med 2021; 15:877-886. [PMID: 34825340 DOI: 10.1007/s11684-021-0863-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 04/25/2021] [Indexed: 11/30/2022]
Abstract
Proline-rich transmembrane protein 2 (PRRT2) is the leading cause of paroxysmal kinesigenic dyskinesia (PKD), benign familial infantile epilepsy (BFIE), and infantile convulsions with choreoathetosis (ICCA). Reduced penetrance of PRRT2 has been observed in previous studies, whereas the exact penetrance has not been evaluated well. The objective of this study was to estimate the penetrance of PRRT2 and determine its influencing factors. We screened 222 PKD index patients and their available relatives, identified 39 families with pathogenic or likely pathogenic (P/LP) PRRT2 variants via Sanger sequencing, and obtained 184 PKD/BFIE/ICCA families with P/LP PRRT2 variants from the literature. Penetrance was estimated as the proportion of affected variant carriers. PRRT2 penetrance estimate was 77.6% (95% confidence interval (CI) 74.5%-80.7%) in relatives and 74.5% (95% CI 70.2%-78.8%) in obligate carriers. In addition, we first observed that penetrance was higher in truncated than in non-truncated variants (75.8% versus 50.0%, P = 0.01), higher in Asian than in Caucasian carriers (81.5% versus 68.5%, P = 0.004), and exhibited no difference in gender or parental transmission. Our results are meaningful for genetic counseling, implying that approximately three-quarters of PRRT2 variant carriers will develop PRRT2-related disorders, with patients from Asia or carrying truncated variants at a higher risk.
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Affiliation(s)
- Yulan Chen
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, and Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Dianfu Chen
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, and Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Shaoyun Zhao
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, and Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Gonglu Liu
- Department of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
| | - Hongfu Li
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, and Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310009, China.
| | - Zhi-Ying Wu
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, and Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310009, China.
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Prabhakara S, Hanumantha Rao HM, Prashanth LK, Anbazhagan K, Jacques R, Reddy BK. PRRT2 Gene Mutations in Indian Paroxysmal Kinesigenic Dyskinesia Patients. Ann Indian Acad Neurol 2021; 24:425-429. [PMID: 34447013 PMCID: PMC8370144 DOI: 10.4103/aian.aian_417_20] [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: 05/08/2020] [Revised: 05/15/2020] [Accepted: 05/31/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- S Prabhakara
- Central Research Laboratory, RajaRajeswari Medical College and Hospital, Bangalore, Karnataka, India
| | - H M Hanumantha Rao
- Central Research Laboratory, RajaRajeswari Medical College and Hospital, Bangalore, Karnataka, India
| | - L K Prashanth
- Vikram Hospital, Vasanth Nagar, Bengaluru, Karnataka, India
| | - K Anbazhagan
- Central Research Laboratory, RajaRajeswari Medical College and Hospital, Bangalore, Karnataka, India
| | - Rochette Jacques
- UPJV, CURS - EA 4666, 1 Rue Du Prof. C. Cabrol, Amiens 80000, France
| | - Basanth Kumar Reddy
- Central Research Laboratory, RajaRajeswari Medical College and Hospital, Bangalore, Karnataka, India
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Ferrante D, Sterlini B, Prestigio C, Marte A, Corradi A, Onofri F, Tortarolo G, Vicidomini G, Petretto A, Muià J, Thalhammer A, Valente P, Cingolani LA, Benfenati F, Baldelli P. PRRT2 modulates presynaptic Ca 2+ influx by interacting with P/Q-type channels. Cell Rep 2021; 35:109248. [PMID: 34133925 PMCID: PMC8220258 DOI: 10.1016/j.celrep.2021.109248] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 04/07/2021] [Accepted: 05/24/2021] [Indexed: 12/28/2022] Open
Abstract
Loss-of-function mutations in proline-rich transmembrane protein-2 (PRRT2) cause paroxysmal disorders associated with defective Ca2+ dependence of glutamatergic transmission. We find that either acute or constitutive PRRT2 deletion induces a significant decrease in the amplitude of evoked excitatory postsynaptic currents (eEPSCs) that is insensitive to extracellular Ca2+ and associated with a reduced contribution of P/Q-type Ca2+ channels to the EPSC amplitude. This synaptic phenotype parallels a decrease in somatic P/Q-type Ca2+ currents due to a decreased membrane targeting of the channel with unchanged total expression levels. Co-immunoprecipitation, pull-down assays, and proteomics reveal a specific and direct interaction of PRRT2 with P/Q-type Ca2+ channels. At presynaptic terminals lacking PRRT2, P/Q-type Ca2+ channels reduce their clustering at the active zone, with a corresponding decrease in the P/Q-dependent presynaptic Ca2+ signal. The data highlight the central role of PRRT2 in ensuring the physiological Ca2+ sensitivity of the release machinery at glutamatergic synapses.
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Affiliation(s)
- Daniele Ferrante
- Department of Experimental Medicine, University of Genova, Viale Benedetto XV, 3, 16132 Genova, Italy
| | - Bruno Sterlini
- Department of Experimental Medicine, University of Genova, Viale Benedetto XV, 3, 16132 Genova, Italy; Center for Synaptic Neuroscience and Technology, Istituto Italiano di Tecnologia, Largo Rosanna Benzi 10, 16132 Genova, Italy
| | - Cosimo Prestigio
- Department of Experimental Medicine, University of Genova, Viale Benedetto XV, 3, 16132 Genova, Italy
| | - Antonella Marte
- Department of Experimental Medicine, University of Genova, Viale Benedetto XV, 3, 16132 Genova, Italy; IRCCS, Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genova, Italy
| | - Anna Corradi
- Department of Experimental Medicine, University of Genova, Viale Benedetto XV, 3, 16132 Genova, Italy; IRCCS, Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genova, Italy
| | - Franco Onofri
- Department of Experimental Medicine, University of Genova, Viale Benedetto XV, 3, 16132 Genova, Italy; IRCCS, Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genova, Italy
| | - Giorgio Tortarolo
- Molecular Microscopy and Spectroscopy, Istituto Italiano di Tecnologia, Via Enrico Melen, 83B, 16152, Genova, Italy
| | - Giuseppe Vicidomini
- Molecular Microscopy and Spectroscopy, Istituto Italiano di Tecnologia, Via Enrico Melen, 83B, 16152, Genova, Italy
| | - Andrea Petretto
- Core Facilities-Clinical Proteomics and Metabolomics, IRCCS, Istituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147 Genova, Italy
| | - Jessica Muià
- Department of Experimental Medicine, University of Genova, Viale Benedetto XV, 3, 16132 Genova, Italy; Center for Synaptic Neuroscience and Technology, Istituto Italiano di Tecnologia, Largo Rosanna Benzi 10, 16132 Genova, Italy
| | - Agnes Thalhammer
- Center for Synaptic Neuroscience and Technology, Istituto Italiano di Tecnologia, Largo Rosanna Benzi 10, 16132 Genova, Italy
| | - Pierluigi Valente
- Department of Experimental Medicine, University of Genova, Viale Benedetto XV, 3, 16132 Genova, Italy; IRCCS, Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genova, Italy
| | - Lorenzo A Cingolani
- Center for Synaptic Neuroscience and Technology, Istituto Italiano di Tecnologia, Largo Rosanna Benzi 10, 16132 Genova, Italy; Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Fabio Benfenati
- Center for Synaptic Neuroscience and Technology, Istituto Italiano di Tecnologia, Largo Rosanna Benzi 10, 16132 Genova, Italy; IRCCS, Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genova, Italy.
| | - Pietro Baldelli
- Department of Experimental Medicine, University of Genova, Viale Benedetto XV, 3, 16132 Genova, Italy; IRCCS, Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genova, Italy.
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11
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Harvey S, King MD, Gorman KM. Paroxysmal Movement Disorders. Front Neurol 2021; 12:659064. [PMID: 34177764 PMCID: PMC8232056 DOI: 10.3389/fneur.2021.659064] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/20/2021] [Indexed: 11/13/2022] Open
Abstract
Paroxysmal movement disorders (PxMDs) are a clinical and genetically heterogeneous group of movement disorders characterized by episodic involuntary movements (dystonia, dyskinesia, chorea and/or ataxia). Historically, PxMDs were classified clinically (triggers and characteristics of the movements) and this directed single-gene testing. With the advent of next-generation sequencing (NGS), how we classify and investigate PxMDs has been transformed. Next-generation sequencing has enabled new gene discovery (RHOBTB2, TBC1D24), expansion of phenotypes in known PxMDs genes and a better understanding of disease mechanisms. However, PxMDs exhibit phenotypic pleiotropy and genetic heterogeneity, making it challenging to predict genotype based on the clinical phenotype. For example, paroxysmal kinesigenic dyskinesia is most commonly associated with variants in PRRT2 but also variants identified in PNKD, SCN8A, and SCL2A1. There are no radiological or biochemical biomarkers to differentiate genetic causes. Even with NGS, diagnosis rates are variable, ranging from 11 to 51% depending on the cohort studied and technology employed. Thus, a large proportion of patients remain undiagnosed compared to other neurological disorders such as epilepsy, highlighting the need for further genomic research in PxMDs. Whole-genome sequencing, deep-sequencing, copy number variant analysis, detection of deep-intronic variants, mosaicism and repeat expansions, will improve diagnostic rates. Identifying the underlying genetic cause has a significant impact on patient care, modification of treatment, long-term prognostication and genetic counseling. This paper provides an update on the genetics of PxMDs, description of PxMDs classified according to causative gene rather than clinical phenotype, highlighting key clinical features and providing an algorithm for genetic testing of PxMDs.
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Affiliation(s)
- Susan Harvey
- Department of Paediatric Neurology and Clinical Neurophysiology, Children's Health Ireland at Temple Street, Dublin, Ireland
| | - Mary D King
- Department of Paediatric Neurology and Clinical Neurophysiology, Children's Health Ireland at Temple Street, Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Kathleen M Gorman
- Department of Paediatric Neurology and Clinical Neurophysiology, Children's Health Ireland at Temple Street, Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
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12
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Massimino CR, Portale L, Sapuppo A, Pizzo F, Sciuto L, Romano C, Salafia S, Falsaperla R. PRRT2 Related Epilepsies: A Gene Review. JOURNAL OF PEDIATRIC NEUROLOGY 2021. [DOI: 10.1055/s-0041-1728683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Abstract
PRRT2 encodes for proline-rich transmembrane protein 2 involved in synaptic vesicle fusion and presynaptic neurotransmitter release. Mutations in human PRRT2 have been related to paroxysmal kinesigenic dyskinesia (PKD), infantile convulsions with choreoathetosis, benign familial infantile epilepsies, and hemiplegic migraine. PRRT2 mutations cause neuronal hyperexcitability, which could be related to basal ganglia or cortical circuits dysfunction, leading to paroxysmal disorders. PRRT2 is expressed in the cerebral cortex, basal ganglia, and cerebellum. Approximately, 90% of pathogenic variants are inherited and 10% are de novo. Paroxysmal attacks in PKD are characterized by dystonia, choreoathetosis, and ballismus. In the benign familial infantile epilepsy (BFIE), seizures are usually focal with or without generalization, usually begin between 3 and 12 months of age and remit by 2 years of age. In 30% of cases of PRRT2-associated PKD, there is an association with BFIE, and this entity is referred to as PKD with infantile convulsions (PKD/IC). PRRT2 mutations are the cause of benign family childhood epilepsy and PKD/IC. On the other hand, PRRT2 mutations do not seem to correlate with other types of epilepsy. The increasing incidence of hemiplegic migraine in families with PRRT2-associated PKD or PKD/IC suggests a common disease pathway, and it is possible to assert that BFIE, paroxysmal kinesigenic dyskinesia, and PKD with IC belong to a continuous disease spectrum of PRRT2-associated diseases.
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Affiliation(s)
- Carmela Rita Massimino
- Pediatrics Postgraduate Residency Program, Section of Pediatrics and Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Laura Portale
- Pediatrics Postgraduate Residency Program, Section of Pediatrics and Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Annamaria Sapuppo
- Pediatrics Postgraduate Residency Program, Section of Pediatrics and Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Francesco Pizzo
- Pediatrics Postgraduate Residency Program, Section of Pediatrics and Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Laura Sciuto
- Pediatrics Postgraduate Residency Program, Section of Pediatrics and Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Catia Romano
- Italian Blind Union, Catania section, Catania, Italy
| | | | - Raffaele Falsaperla
- Unit of Pediatrics and Pediatric Emergency, University Hospital “Policlinico Rodolico-San Marco,” Catania, Italy
- Unit of Neonatal Intensive Care and Neonatology, University Hospital “Policlinico Rodolico-San Marco,” Catania, Italy
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13
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Li Y, Chen S, Wang C, Wang P, Li X, Zhou L. PRRT2 gene and protein in human: characteristics, evolution and function. ACTA EPILEPTOLOGICA 2021. [DOI: 10.1186/s42494-021-00042-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
This study was designed to characterize human PRRT2 gene and protein, in order to provide theoretical reference for research on regulation of PRRT2 expression and its involvement in the pathogenesis of paroxysmal kinesigenic dyskinesia and other related diseases.
Method
Biological softwares Protparam, Protscale, MHMM, SignalP 5.0, NetPhos 3.1, Swiss-Model, Promoter 2.0, AliBaba2.1 and EMBOSS were used to analyze the sequence characteristics, transcription factors of human PRRT2 and their binding sites in the promoter region of the gene, as well as the physicochemical properties, signal peptides, hydrophobicity property, transmembrane regions, protein structure, interacting proteins and functions of PRRT2 protein.
Results
(1) Evolutionary analysis of PRRT2 protein showed that the human PRRT2 had closest genetic distance from Pongo abelii. (2) The human PRRT2 protein was an unstable hydrophilic protein located on the plasma membrane. (3) The forms of random coil (67.65%) and alpha helix (23.24%) constituted the main secondary structure elements of PRRT2 protein. There were also multiple potential phosphorylation sites in the protein. (4) The results of ontology analysis showed that the cellular component of PRRT2 protein was located in the plasma membrane; the molecular function of PRRT2 included syntaxin-1 binding and SH3 domain binding; the PRRT2 protein is involved in biological processes of negative regulation of soluble NSF attachment protein receptor (SNARE) complex assembly and calcium-dependent activation of synaptic vesicle fusion. (5) String database analysis revealed 10 proteins with close interactions with the human PRRT2 protein. (6) There were at least two promoter regions in the PRRT2 gene within 2000 bp upstream the 5' flank, a 304-bp CpG island in the promoter region and four GC boxes in the 5' regulatory region of PRRT2 gene and we found 13 transcription factors that could bind the promoter region of the PRRT2 gene.
Conclusion
These results provide important information for further studies on the role of PRRT2 gene and identify their functions.
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Miura S, Shimojo T, Morikawa T, Kamada T, Uchiyama Y, Kurata S, Fujioka R, Shibata H. Familial paroxysmal kinesigenic dyskinesia with a novel missense variant (Arg2866Trp) in NBEA. J Hum Genet 2021; 66:805-811. [PMID: 33692494 DOI: 10.1038/s10038-021-00914-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/17/2021] [Accepted: 02/20/2021] [Indexed: 11/10/2022]
Abstract
Paroxysmal kinesigenic dyskinesia (PKD) is a movement disorder characterized by episodic involuntary movement attacks triggered by sudden movements, acceleration, or intention to move. We ascertained two Japanese familial cases with PKD. The proband is a 22-year-old woman who had noted sudden brief (<30 s) of involuntary movements provoked by kinesigenic trigger such as starting to run, getting on a train, picking up a telephone receiver and so on at the age of 14. Interictal brain single photon emission computed tomography (SPECT) showed hyperperfusion in the left thalamus. A 46-year-old woman, the mother of the proband was also suffering from brief attacks triggered by starting to run in her high school days. On neurological examination, both showed no abnormality. Whole exome sequencing combined with rigorous filtering revealed two heterozygous nonsynonymous variants (NM_001447: c.8976G > C [p.Gln2992His] in FAT2 and NM_015678: c.8596C > T [p.Arg2866Trp] in NBEA). Real time quantitative PCR analysis of Nbea mRNA levels in the developing rat brain revealed peak at postnatal day 28 and decline at postnatal day 56. This result might match the most common clinical course of PKD from the point of view of the most common age at remission. NBEA has been reported to be responsible for neurodevelopmental disease accompanied by epilepsy. We concluded the variant in NBEA most likely to be responsible for our familial cases of PKD.
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Affiliation(s)
- Shiroh Miura
- Department of Neurology and Geriatric Medicine, Ehime University Graduate School of Medicine, Toon, 791-0295, Japan.,Division of Genomics, Medical Institute of Bioregulation, Kyushu University, Fukuoka, 812-8582, Japan
| | - Tomofumi Shimojo
- Division of Genomics, Medical Institute of Bioregulation, Kyushu University, Fukuoka, 812-8582, Japan
| | - Takuya Morikawa
- Division of Genomics, Medical Institute of Bioregulation, Kyushu University, Fukuoka, 812-8582, Japan
| | - Takashi Kamada
- Department of Neurology, Fukuoka Sanno Hospital, Fukuoka, 814-0001, Japan
| | - Yusuke Uchiyama
- Department of Radiology, Kurume University School of Medicine, Kurume, 830-0011, Japan
| | - Seiji Kurata
- Department of Radiology, Kurume University School of Medicine, Kurume, 830-0011, Japan
| | - Ryuta Fujioka
- Department of Food and Nutrition, Beppu University Junior College, Beppu, 874-8501, Japan
| | - Hiroki Shibata
- Division of Genomics, Medical Institute of Bioregulation, Kyushu University, Fukuoka, 812-8582, Japan.
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15
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Zhou Y, Zhang J, Wang X, Peng Q, Shang X. Paroxysmal kinesigenic dyskinesia associated with a novel POLG variant: A case report. Medicine (Baltimore) 2021; 100:e24395. [PMID: 33530235 PMCID: PMC7850660 DOI: 10.1097/md.0000000000024395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 12/29/2020] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Paroxysmal kinesigenic dyskinesia (PKD) is a rare neurological disease characterized by recurrent dyskinesia or choreoathetosis triggered by sudden movements. Pathogenic variants in PRRT2 are the main cause of PKD. However, only about half of clinically diagnosed PKD patients have PRRT2 mutations, indicating that additional undiscovered causative genes could be implicated. PKD associated with POLG variant has not been reported. PATIENT CONCERNS A 14-year-old boy presented with a 2-month history of involuntary dystonic movements triggered by sudden activities. He was conscious during the attacks. Neurological examination, laboratory tests, brain magnetic resonance imaging (MRI), electroencephalogram (EEG) were all normal. Genetic analysis showed a novel variant of POLG (c.440G>T, p.Ser147Ile), which was considered to be a likely pathogenic variant in this case. DIAGNOSES The patient was diagnosed with PKD. INTERVENTIONS Low dose carbamazepine was used orally for treatment. OUTCOMES The patient achieved complete resolution of symptoms without any dyskinesia during the 6-month follow up. CONCLUSION Our study identified the novel POLG variant (c.440G>T, p.Ser147Ile) to be a likely pathogenic variant in PKD.
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16
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Ahn H, Ko TS. The Genetic Relationship between Paroxysmal Movement Disorders and Epilepsy. ANNALS OF CHILD NEUROLOGY 2020. [DOI: 10.26815/acn.2020.00073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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17
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De Gusmao CM, Silveira-Moriyama L. Paroxysmal movement disorders - practical update on diagnosis and management. Expert Rev Neurother 2019; 19:807-822. [PMID: 31353980 DOI: 10.1080/14737175.2019.1648211] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Paroxysmal dyskinesias and episodic ataxias are often caused by mutations in genes related to cell membrane and synaptic function. Despite the exponential increase in publications of genetically confirmed cases, management remains largely clinical based on non-systematic evidence. Areas covered: The authors provide a historical and clinical review of the main types of paroxysmal dyskinesias and episodic ataxias, with recommendations for diagnosis and management of patients suffering from these conditions. Expert opinion: After secondary paroxysmal dyskinesias, the most common paroxysmal movement disorders are likely to be PRRT2-associated paroxysmal kinesigenic dyskinesias, which respond well to small doses of carbamazepine, and episodic ataxia type 2, which often responds to acetazolamide. Familial paroxysmal non-kinesigenic dyskinesias are largely caused by mutations in PNKD and have poor response to therapy but improve with age. Exercise-induced dyskinesias are genetically heterogeneous, caused by disorders of glucose transport, mitochondrial function, dopaminergic pathways or neurodegenerative conditions amongst others. GNAO1 and ADCY5 mutations can also cause paroxysmal movement disorders, often in the context of ongoing motor symptoms. Although a therapeutic trial is justified for classic cases and in limited resource settings, genetic testing may help direct initial or rescue therapy. Deep brain stimulation may be an option for severe cases.
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Affiliation(s)
- Claudio M De Gusmao
- Department of Neurology, Harvard Medical School, Boston Children's Hospital , Boston , MA , USA.,Department of Neurology, Universidade Estadual de Campinas (UNICAMP) , São Paulo , Brazil
| | - Laura Silveira-Moriyama
- Department of Neurology, Universidade Estadual de Campinas (UNICAMP) , São Paulo , Brazil.,Education Unit, UCL Institute of Neurology, University College London , London , UK.,Department of Neurology, Hospital Bairral, Fundação Espírita Américo Bairral , Itapira , Brazil
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18
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Tsai M, Nian F, Hsu M, Liu W, Liu Y, Liu C, Lin P, Hwang D, Chuang Y, Tsai J. PRRT
2
missense mutations cluster near C‐terminus and frequently lead to protein mislocalization. Epilepsia 2019; 60:807-817. [DOI: 10.1111/epi.14725] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 03/19/2019] [Indexed: 01/06/2023]
Affiliation(s)
- Meng‐Han Tsai
- Department of NeurologyCollege of MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University Kaohsiung Taiwan
| | - Fang‐Shin Nian
- Institute of Brain ScienceSchool of MedicineNational Yang‐Ming University Taipei Taiwan
- Program in Molecular MedicineNational Yang‐Ming University and Academia Sinica Taipei Taiwan
| | - Mei‐Hsin Hsu
- Department of PediatricsKaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan
| | - Wei‐Szu Liu
- Department of Life SciencesNational Yang‐Ming University Taipei Taiwan
| | - Yo‐Tsen Liu
- Institute of Brain ScienceSchool of MedicineNational Yang‐Ming University Taipei Taiwan
- Department of NeurologyNeurological InstituteTaipei Veterans General Hospital Taipei Taiwan
- Department of MedicineSchool of MedicineNational Yang‐Ming University Taipei Taiwan
- Brain Research CenterNational Yang‐Ming University Taipei Taiwan
| | - Chen Liu
- Institute of Brain ScienceSchool of MedicineNational Yang‐Ming University Taipei Taiwan
| | - Po‐Hsi Lin
- Department of MedicineSchool of MedicineNational Yang‐Ming University Taipei Taiwan
| | - Daw‐Yang Hwang
- Division of NephrologyKaohsiung Medical University HospitalKaohsiung Medical University Kaohsiung Taiwan
| | - Yao‐Chung Chuang
- Department of NeurologyCollege of MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University Kaohsiung Taiwan
| | - Jin‐Wu Tsai
- Institute of Brain ScienceSchool of MedicineNational Yang‐Ming University Taipei Taiwan
- Brain Research CenterNational Yang‐Ming University Taipei Taiwan
- Biophotonics and Molecular Imaging Research CenterNational Yang‐Ming University Taipei Taiwan
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19
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Mo J, Wang B, Zhu X, Wu X, Liu Y. PRRT2 deficiency induces paroxysmal kinesigenic dyskinesia by influencing synaptic function in the primary motor cortex of rats. Neurobiol Dis 2019; 121:274-285. [DOI: 10.1016/j.nbd.2018.10.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 01/26/2023] Open
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20
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Ma H, Feng S, Deng X, Wang L, Zeng S, Wang C, Ma X, Sun H, Chen R, Du S, Mao J, Zhang X, Ma C, Jiang H, Zhang L, Tang B, Liu JY. APRRT2variant in a Chinese family with paroxysmal kinesigenic dyskinesia and benign familial infantile seizures results in loss of interaction withSTX1B. Epilepsia 2018; 59:1621-1630. [DOI: 10.1111/epi.14511] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 06/14/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Hongying Ma
- Key Laboratory of Molecular Biophysics of the Ministry of Education; Center for Human Genome Research; College of Life Science and Technology; Huazhong University of Science and Technology; Wuhan China
| | - Shenglei Feng
- Key Laboratory of Molecular Biophysics of the Ministry of Education; Center for Human Genome Research; College of Life Science and Technology; Huazhong University of Science and Technology; Wuhan China
| | - Xuejun Deng
- Department of Neurology; Union Hospital of Huazhong University of Science and Technology; Wuhan China
| | - Li Wang
- Key Laboratory of Molecular Biophysics of the Ministry of Education; Center for Human Genome Research; College of Life Science and Technology; Huazhong University of Science and Technology; Wuhan China
| | - Sheng Zeng
- Department of Neurology, Xiangya Hospital; Key Laboratory of Hunan Province in Neurodegenerative Disorders; Central South University; Changsha China
| | - Cheng Wang
- Key Laboratory of Molecular Biophysics of the Ministry of Education; Center for Human Genome Research; College of Life Science and Technology; Huazhong University of Science and Technology; Wuhan China
| | - Xixiang Ma
- Key Laboratory of Molecular Biophysics of the Ministry of Education; Center for Human Genome Research; College of Life Science and Technology; Huazhong University of Science and Technology; Wuhan China
| | - Hao Sun
- Key Laboratory of Molecular Biophysics of the Ministry of Education; Center for Human Genome Research; College of Life Science and Technology; Huazhong University of Science and Technology; Wuhan China
| | - Rui Chen
- Key Laboratory of Molecular Biophysics of the Ministry of Education; Center for Human Genome Research; College of Life Science and Technology; Huazhong University of Science and Technology; Wuhan China
| | - Shiyue Du
- Key Laboratory of Molecular Biophysics of the Ministry of Education; Center for Human Genome Research; College of Life Science and Technology; Huazhong University of Science and Technology; Wuhan China
| | - Jinglin Mao
- Key Laboratory of Molecular Biophysics of the Ministry of Education; Center for Human Genome Research; College of Life Science and Technology; Huazhong University of Science and Technology; Wuhan China
| | - Xianwei Zhang
- Department of Anesthesiology; Tongji Hospital of Huazhong University of Science and Technology; Wuhan China
| | - Cong Ma
- Key Laboratory of Molecular Biophysics of the Ministry of Education; Center for Human Genome Research; College of Life Science and Technology; Huazhong University of Science and Technology; Wuhan China
| | - Hong Jiang
- Department of Neurology, Xiangya Hospital; Key Laboratory of Hunan Province in Neurodegenerative Disorders; Central South University; Changsha China
| | - Luoying Zhang
- Key Laboratory of Molecular Biophysics of the Ministry of Education; Center for Human Genome Research; College of Life Science and Technology; Huazhong University of Science and Technology; Wuhan China
| | - Beisha Tang
- Department of Neurology, Xiangya Hospital; Key Laboratory of Hunan Province in Neurodegenerative Disorders; Central South University; Changsha China
| | - Jing Yu Liu
- Key Laboratory of Molecular Biophysics of the Ministry of Education; Center for Human Genome Research; College of Life Science and Technology; Huazhong University of Science and Technology; Wuhan China
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21
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Tian WT, Huang XJ, Liu XL, Shen JY, Liang GL, Zhu CX, Tang WG, Chen SD, Song YY, Cao L. Depression, anxiety, and quality of life in paroxysmal kinesigenic dyskinesia patients. Chin Med J (Engl) 2018; 130:2088-2094. [PMID: 28836553 PMCID: PMC5586178 DOI: 10.4103/0366-6999.213431] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background: Paroxysmal kinesigenic dyskinesia (PKD) is a rare movement disorder characterized by recurrent dystonic or choreoathetoid attacks triggered by sudden voluntary movements. Under the condition of psychological burden, some patients’ attacks may get worsened with longer duration and higher frequency. This study aimed to assess nonmotor symptoms and quality of life of patients with PKD in a large population. Methods: We performed a cross-sectional survey in 165 primary PKD patients from August 2008 to October 2016 in Rui Jin Hospital, using Symptom Check List-90-Revised (SCL-90-R), World Health Organization Quality of Life-100 (WHOQoL-100), Self-Rating Depression Scale, and Self-Rating Anxiety Scale. We evaluated the differences of SCL-90-R and WHOQOL-100 scores in patients and Chinese normative data (taken from literature) by using the unpaired Student's t-test. We applied multivariate linear regression to analyze the relationships between motor manifestations, mental health, and quality of life among PKD patients. Results: Compared with Chinese normative data taken from literature, patients with PKD exhibited significantly higher (worse) scores across all SCL-90-R subscales (somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism; P = 0.000 for all) and significantly lower (worse) scores of five domains in WHOQoL-100 (physical domain, psychological domain, independence domain, social relationship domain, and general quality of life; P = 0.000 for all). Nonremission of dyskinesia episodes (P = 0.011) and higher depression score (P = 0.000) were significantly associated with lower levels of quality of life. The rates of depression and anxiety in patients with PKD were 41.2% (68/165) and 26.7% (44/165), respectively. Conclusions: Depression, anxiety, and low levels of quality of life were prevalent in patients with PKD. Co-occurrence of depression and anxiety was common among these patients. Regular mental health interventions could set depression and anxiety as intervention targets. Considering that the motor episodes could be elicited by voluntary movements and sometimes also by emotional stress, and that symptoms may get worsened with longer duration and higher frequency when patients are stressed out, intervention or treatment of depression and anxiety might improve the motor symptoms and overall quality of life in PKD patients.
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Affiliation(s)
- Wo-Tu Tian
- Department of Neurology and Institute of Neurology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xiao-Jun Huang
- Department of Neurology and Institute of Neurology, Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 201801, China
| | - Xiao-Li Liu
- Department of Neurology and Institute of Neurology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Jun-Yi Shen
- Department of Neurology and Institute of Neurology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Gui-Ling Liang
- Basic Medical Science College, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Chen-Xi Zhu
- Basic Medical Science College, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Wei-Guo Tang
- Department of Neurology, Zhoushan Hospital, Zhoushan, Zhejiang 316000, China
| | - Sheng-Di Chen
- Department of Neurology and Institute of Neurology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yan-Yan Song
- Department of Biostatistics, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Li Cao
- Department of Neurology and Institute of Neurology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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22
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Li C, Ma Y, Zhang K, Gu J, Tang F, Chen S, Cao L, Li S, Jin Y. Aberrant transcriptional networks in step-wise neurogenesis of paroxysmal kinesigenic dyskinesia-induced pluripotent stem cells. Oncotarget 2018; 7:53611-53627. [PMID: 27449084 PMCID: PMC5288209 DOI: 10.18632/oncotarget.10680] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 06/30/2016] [Indexed: 12/31/2022] Open
Abstract
Paroxysmal kinesigenic dyskinesia (PKD) is an episodic movement disorder with autosomal-dominant inheritance and marked variability in clinical manifestations. Proline-rich transmembrane protein 2 (PRRT2) has been identified as a causative gene of PKD, but the molecular mechanism underlying the pathogenesis of PKD still remains a mystery. The phenotypes and transcriptional patterns of the PKD disease need further clarification. Here, we report the generation and neural differentiation of iPSC lines from two familial PKD patients with c.487C>T (p. Gln163X) and c.573dupT (p. Gly192Trpfs*8) PRRT2 mutations, respectively. Notably, an extremely lower efficiency in neural conversion from PKD-iPSCs than control-iPSCs is observed by a step-wise neural differentiation method of dual inhibition of SMAD signaling. Moreover, we show the high expression level of PRRT2 throughout the human brain and the expression pattern of PRRT2 in other human tissues for the first time. To gain molecular insight into the development of the disease, we conduct global gene expression profiling of PKD cells at four different stages of neural induction and identify altered gene expression patterns, which peculiarly reflect dysregulated neural transcriptome signatures and a differentiation tendency to mesodermal development, in comparison to control-iPSCs. Additionally, functional and signaling pathway analyses indicate significantly different cell fate determination between PKD-iPSCs and control-iPSCs. Together, the establishment of PKD-specific in vitro models and the illustration of transcriptome features in PKD cells would certainly help us with better understanding of the defects in neural conversion as well as further investigations in the pathogenesis of the PKD disease.
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Affiliation(s)
- Chun Li
- Laboratory of Molecular Developmental Biology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yu Ma
- Laboratory of Molecular Developmental Biology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Kunshan Zhang
- Stem Cell Translational Research Center, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Junjie Gu
- Laboratory of Molecular Developmental Biology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Fan Tang
- Laboratory of Molecular Developmental Biology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Shengdi Chen
- Department of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.,Key Laboratory of Stem Cell Biology, Center for The Excellence in Molecular and Cell Sciences, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Li Cao
- Department of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Siguang Li
- Stem Cell Translational Research Center, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China.,Collaborative Innovation Center for Brain Science, Tongji University, Shanghai 200092, China
| | - Ying Jin
- Laboratory of Molecular Developmental Biology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.,Key Laboratory of Stem Cell Biology, Center for The Excellence in Molecular and Cell Sciences, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
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Zhao G, Liu X, Zhang Q, Wang K. PRRT2 mutations in a cohort of Chinese families with paroxysmal kinesigenic dyskinesia and genotype-phenotype correlation reanalysis in literatures. Int J Neurosci 2018; 128:751-760. [PMID: 29285950 DOI: 10.1080/00207454.2017.1418345] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE OF THE STUDY Though rare, children are susceptible to paroxysmal dyskinesias such as paroxysmal kinesigenic dyskinesia, and infantile convulsions and choreoathetosis. Recent studies showed that the cause of paroxysmal kinesigenic dyskinesia or infantile convulsions and choreoathetosis could be proline-rich transmembrane protein 2 (PRRT2) gene mutations. MATERIAL AND METHODS This study analysed PRRT2 gene mutations in 51 families with paroxysmal kinesigenic dyskinesia or infantile convulsions and choreoathetosis by direct sequencing. In particular, we characterize the genotype-phenotype correlation between age at onset and the types of PRRT2 mutations in all published cases. RESULTS Direct sequencing showed that 12 out of the 51 families had three different pathogenic mutations (c.649dupC, c.776dupG, c.649C>T) in the PRRT2 gene. No significant difference of age at onset between the patients with and without PRRT2 mutations was found in this cohort of patients. A total of 97 different PRRT2 mutations have been reported in 87 studies till now. The PRRT2 mutation classes are wide, and most mutations are frameshift mutations but the most common mutation remains c.649dupC. Comparisons of the age at onset in paroxysmal kinesigenic dyskinesia or infantile convulsions patients with different types of mutations showed no significant difference. CONCLUSIONS This study expands the clinical and genetic spectrums of Chinese patients with paroxysmal kinesigenic dyskinesia and infantile convulsions and choreoathetosis. No clear genotype-phenotype correlation between the age at onset and the types of mutations has been determined.
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Affiliation(s)
- Guohua Zhao
- a Department of Neurology, Second Affiliated Hospital, College of Medicine , Zhejiang University, Hangzhou, China
| | - Xiaomin Liu
- b Department of Neurology, Qianfoshan Hospital , Shandong University, Jinan, China
| | - Qiong Zhang
- c Department of Psychology and Behavioral Sciences , Zhejiang University, Hangzhou, China
| | - Kang Wang
- d Department of Neurology, First Affiliated Hospital, College of Medicine , Zhejiang University, Hangzhou, China
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24
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Genetic analysis of benign familial epilepsies in the first year of life in a Chinese cohort. J Hum Genet 2017; 63:9-18. [PMID: 29215089 PMCID: PMC8075886 DOI: 10.1038/s10038-017-0359-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 08/09/2017] [Accepted: 08/09/2017] [Indexed: 11/09/2022]
Abstract
Benign familial epilepsies that present themselves in the first year of life include benign familial neonatal epilepsy (BFNE), benign familial neonatal-infantile epilepsy (BFNIE) and benign familial infantile epilepsy (BFIE). We used Sanger sequencing and targeted next-generation sequencing to detect gene mutations in a Chinese cohort of patients with these three disorders. A total of 79 families were collected, including 4 BFNE, 7 BFNIE, and 68 BFIE. Genetic testing led to the identification of gene mutations in 60 families (60 out of 79, 75.9%). A total of 42 families had PRRT2 mutations, 9 had KCNQ2 mutations, 8 had SCN2A mutations, and 1 had a GABRA6 mutation. In total three of four BFNE families were detected with KCNQ2 mutations. Mutations were detected in all BFNIE families, including 3 KCNQ2 mutations, 3 SCN2A mutations, and 1 PRRT2 mutation. Gene mutations were identified in 50 out of 68 BFIE families (73.5%), including 41 PRRT2 mutations (41 out of 68, 60.3%), 5 SCN2A mutations, 3 KCNQ2 mutations, and 1 GABRA6 mutation. Our results confirmed that mutations in KCNQ2, SCN2A, and PRRT2 are major genetic causes of benign familial epilepsy in the first year of life in the Chinese population. KCNQ2 is the major gene related to BFNE. PRRT2 is the main gene responsible for BFIE.
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25
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Weber YG, Biskup S, Helbig KL, Von Spiczak S, Lerche H. The role of genetic testing in epilepsy diagnosis and management. Expert Rev Mol Diagn 2017; 17:739-750. [PMID: 28548558 DOI: 10.1080/14737159.2017.1335598] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Epilepsy is a common neurological disorder characterized by recurrent unprovoked seizures. More than 500 epilepsy-associated genes have been described in the literature. Most of these genes play an important role in neuronal excitability, cortical development or synaptic transmission. A growing number of genetic variations have implications on diagnosis and prognostic or therapeutic advice in terms of a personalized medicine. Area covered: The review presents the different forms of genetic epilepsies with respect to their underlying genetic and functional pathophysiology and aims to give advice for recommended genetic testing. Moreover, it discusses ethical and legal guidelines, costs and technical limitations which should be considered. Expert commentary: Genetic testing is an important component in the diagnosis and treatment of many forms of epilepsy.
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Affiliation(s)
- Yvonne G Weber
- a Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research , University of Tübingen , Tubingen , Germany
| | - Saskia Biskup
- b CeGaT GmbH , Center for Genomics and Transcriptomics , Tübingen , Germany
| | - Katherine L Helbig
- c Division of Clinical Genomics , Ambry Genetics , Aliso Viejo , CA , USA
| | - Sarah Von Spiczak
- d Department of Neuropediatrics , University Medical Center Schleswig-Holstein, Christian Albrechts University , Kiel , Germany.,e Northern German Epilepsy Center for Children and Adolescents , Schwentinental-Raisdorf , Germany
| | - Holger Lerche
- a Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research , University of Tübingen , Tubingen , Germany
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Erro R, Bhatia KP, Espay AJ, Striano P. The epileptic and nonepileptic spectrum of paroxysmal dyskinesias: Channelopathies, synaptopathies, and transportopathies. Mov Disord 2017; 32:310-318. [PMID: 28090678 DOI: 10.1002/mds.26901] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 11/28/2016] [Accepted: 12/01/2016] [Indexed: 12/12/2022] Open
Abstract
Historically, the syndrome of primary paroxysmal dyskinesias was considered a group of disorders as a result of ion channel dysfunction. This proposition was primarily based on the discovery of mutations in ion channels, which caused other episodic neurological disorders such as epilepsy and migraine and also supported by the frequent association between paroxysmal dyskinesias and epilepsy. However, the discovery of the genes responsible for the 3 classic forms of paroxysmal dyskinesias disproved this ion channel theory. On the other hand, novel gene mutations implicating ion channels have been recently reported to produce episodic movement disorders clinically similar to the classic paroxysmal dyskinesias. Here, we review the clinical and pathophysiological aspects of the paroxysmal dyskinesias, further proposing a pathophysiological framework according to which they can be classified as synaptopathies (proline-rich transmembrane protein 2 and myofibrillogenesis regulator gene), channelopathies (calcium-activated potassium channel subunit alpha-1 and voltage-gated sodium channel type 8), or transportopathies (solute carrier family 2 member 1). This proposal might serve to explain similarities and differences among the various paroxysmal dyskinesias in terms of clinical features, treatment response, and natural history. © 2017 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Roberto Erro
- Sobell Department of Motor Neuroscience and Movement Disorders, University College London, Institute of Neurology, London, UK.,Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy
| | - Kailash P Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders, University College London, Institute of Neurology, London, UK
| | - Alberto J Espay
- Gardner Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Ohio, USA
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, "G. Gaslini" Institute, Genova, Italy
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27
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PRRT2: from Paroxysmal Disorders to Regulation of Synaptic Function. Trends Neurosci 2016; 39:668-679. [DOI: 10.1016/j.tins.2016.08.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 08/19/2016] [Accepted: 08/22/2016] [Indexed: 12/19/2022]
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Igarashi A, Okumura A, Shimojima K, Abe S, Ikeno M, Shimizu T, Yamamoto T. Focal seizures and epileptic spasms in a child with Down syndrome from a family with a PRRT2 mutation. Brain Dev 2016; 38:597-600. [PMID: 26867511 DOI: 10.1016/j.braindev.2015.12.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 12/25/2015] [Accepted: 12/25/2015] [Indexed: 11/28/2022]
Abstract
We describe a girl with Down syndrome who experienced focal seizures and epileptic spasms during infancy. The patient was diagnosed as having trisomy 21 during the neonatal period. She had focal seizures at five months of age, which were controlled with phenobarbital. However, epileptic spasms appeared at seven months of age in association with hypsarrhythmia. Upon treatment with adrenocorticotropic hormone, her epileptic spasms disappeared. Her younger brother also had focal seizures at five months of age. His development and interictal electroencephalogram were normal. The patient's father had had infantile epilepsy and paroxysmal kinesigenic dyskinesia. We performed a mutation analysis of the PRRT2 gene and found a c.841T>C mutation in the present patient, her father, and in her younger brother. We hypothesized that the focal seizures in our patient were caused by the PRRT2 mutation, whereas the epileptic spasms were attributable to trisomy 21.
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Affiliation(s)
- Ayuko Igarashi
- Department of Pediatrics, Juntendo University, Faculty of Medicine, Japan.
| | | | - Keiko Shimojima
- Tokyo Women's Medical University, Institute for Integrated Medical Sciences, Japan
| | - Shinpei Abe
- Department of Pediatrics, Juntendo University, Faculty of Medicine, Japan
| | - Mitsuru Ikeno
- Department of Pediatrics, Juntendo University, Faculty of Medicine, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics, Juntendo University, Faculty of Medicine, Japan
| | - Toshiyuki Yamamoto
- Tokyo Women's Medical University, Institute for Integrated Medical Sciences, Japan
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Novel Locus for Paroxysmal Kinesigenic Dyskinesia Mapped to Chromosome 3q28-29. Sci Rep 2016; 6:25790. [PMID: 27173777 PMCID: PMC4865737 DOI: 10.1038/srep25790] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 04/20/2016] [Indexed: 11/09/2022] Open
Abstract
Paroxysmal kinesigenic dyskinesia (PKD) is characterized by recurrent and brief attacks of dystonia or chorea precipitated by sudden movements. It can be sporadic or familial. Proline-Rich Transmembrane Protein 2 (PRRT2) has been shown to be a common causative gene of PKD. However, less than 50% of patients with primary PKD harbor mutations in PRRT2. The aim of this study is to use eight families with PKD to identify the pathogenic PRRT2 mutations, or possible novel genetic cause of PKD phenotypes. After extensive clinical investigation, direct sequencing and mutation analysis of PRRT2 were performed on patients from eight PKD families. A genome-wide STR and SNP based linkage analysis was performed in one large family that is negative for pathogenic PRRT2 mutations. Using additional polymorphic markers, we identified a novel gene locus on chromosome 3q in this PRRT2-mutation-negative PKD family. The LOD score for the region between markers D3S1314 and D3S1256 is 3.02 and we proposed to designate this locus as Episodic Kinesigenic Dyskinesia (EKD3). Further studies are needed to identify the causative gene within this locus.
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30
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Che XQ, Sun ZF, Mao X, Xia K, Yan XX, Jiang H, Shen L, Li N, Tang BS. Mutation screening of the PRRT2 gene for benign epilepsy with centrotemporal spikes in Chinese mainland population. Int J Neurosci 2016; 127:10-13. [PMID: 26954261 DOI: 10.3109/00207454.2015.1136886] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Proline-rich transmembrane protein 2 gene (PRRT2) mutations are reported to cause common paroxysmal neurological disorders and show a remarkable pleiotropy. Benign epilepsy with centrotemporal spikes (BECTS) is considered to be the most common epilepsy syndrome in childhood. It is placed among the idiopathic localization related epilepsies. Recently, it was reported that a girl with a PRRT2 mutation c.649_650insC developed infantile focal epilepsy with bilateral spikes which resembled the rolandic spikes. Hereby we performed a comprehensive genetic mutation screening of PRRT2 gene in a cohort of 53 sporadic BECTS patients. None of the 53 sporadic BECTS patients and other 250 controls carried mutations including c.649_650insC in PRRT2. Our data indicated that the PRRT2 mutations might most likely not be associated with BECTS in Chinese mainland population.
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Affiliation(s)
- Xiang-Qian Che
- a 1 The Department of Neurology, Xiangya Hospital , Central South University , Changsha , Hunan , People's Republic of China
| | - Zhan-Fang Sun
- a 1 The Department of Neurology, Xiangya Hospital , Central South University , Changsha , Hunan , People's Republic of China
| | - Xiao Mao
- a 1 The Department of Neurology, Xiangya Hospital , Central South University , Changsha , Hunan , People's Republic of China
| | - Kun Xia
- b 2 The Department of State Key Laboratory of Medical Genetics , Central South University , Changsha , Hunan , People's Republic of China
| | - Xin-Xiang Yan
- a 1 The Department of Neurology, Xiangya Hospital , Central South University , Changsha , Hunan , People's Republic of China.,b 2 The Department of State Key Laboratory of Medical Genetics , Central South University , Changsha , Hunan , People's Republic of China.,c 3 The Department of Neurodegenerative Disorders Research Center , Central South University , Changsha , Hunan , People's Republic of China
| | - Hong Jiang
- a 1 The Department of Neurology, Xiangya Hospital , Central South University , Changsha , Hunan , People's Republic of China.,b 2 The Department of State Key Laboratory of Medical Genetics , Central South University , Changsha , Hunan , People's Republic of China.,c 3 The Department of Neurodegenerative Disorders Research Center , Central South University , Changsha , Hunan , People's Republic of China
| | - Lu Shen
- a 1 The Department of Neurology, Xiangya Hospital , Central South University , Changsha , Hunan , People's Republic of China.,b 2 The Department of State Key Laboratory of Medical Genetics , Central South University , Changsha , Hunan , People's Republic of China.,c 3 The Department of Neurodegenerative Disorders Research Center , Central South University , Changsha , Hunan , People's Republic of China
| | - Nan Li
- a 1 The Department of Neurology, Xiangya Hospital , Central South University , Changsha , Hunan , People's Republic of China.,b 2 The Department of State Key Laboratory of Medical Genetics , Central South University , Changsha , Hunan , People's Republic of China.,c 3 The Department of Neurodegenerative Disorders Research Center , Central South University , Changsha , Hunan , People's Republic of China
| | - Bei-Sha Tang
- a 1 The Department of Neurology, Xiangya Hospital , Central South University , Changsha , Hunan , People's Republic of China.,b 2 The Department of State Key Laboratory of Medical Genetics , Central South University , Changsha , Hunan , People's Republic of China.,c 3 The Department of Neurodegenerative Disorders Research Center , Central South University , Changsha , Hunan , People's Republic of China
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Liu XR, Huang D, Wang J, Wang YF, Sun H, Tang B, Li W, Lai JX, He N, Wu M, Su T, Meng H, Shi YW, Li BM, Tang BS, Liao WP. Paroxysmal hypnogenic dyskinesia is associated with mutations in the PRRT2 gene. NEUROLOGY-GENETICS 2016; 2:e66. [PMID: 27123484 PMCID: PMC4830198 DOI: 10.1212/nxg.0000000000000066] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 02/01/2016] [Indexed: 11/26/2022]
Abstract
Objective: To explore the potential causative genes of paroxysmal hypnogenic dyskinesia (PHD), which was initially considered a subtype of paroxysmal dyskinesia and has been recently considered a form of nocturnal frontal lobe epilepsy (NFLE). Methods: Eleven patients with PHD were recruited. Mutations in proline-rich region transmembrane protein-2 (PRRT2), myofibrillogenesis regulator 1 (MR-1), solute carrier family 2, member 1 (SLC2A1), calcium-activated potassium channel alpha subunit (KCNMA1), cholinergic receptor, nicotinic, alpha 4 (CHRNA4), cholinergic receptor, nicotinic, beta 2 (CHRNB2), cholinergic receptor, nicotinic, alpha 2 (CHRNA2), and potassium channel subfamily T member 1 (KCNT1) were screened by direct sequencing. Results: Two PRRT2 mutations were identified in patients with typical PHD. A mutation of c.649dupC (p.Arg217ProfsX8) was identified in a patient with PHD and his father who was diagnosed with paroxysmal kinesigenic dyskinesia. An additional mutation of c.640G>C (p.Ala214Pro) was identified in a sporadic patient and his asymptomatic mother. No mutations were found in the other screened genes. Conclusions: The present study identified PRRT2 mutations in PHD, extending the phenotypic spectrum of PRRT2 and supporting the classification of PHD as a subtype of paroxysmal dyskinesia but not NFLE. Based on the results of this study, screening for the PRRT2 mutation is recommended in patients with PHD.
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Affiliation(s)
- Xiao-Rong Liu
- Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University and Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China (X.-R.L., D.H., J.W., Y.-F.W., H.S., B.T., W.L., J.-X.L., N.H., M.W., T.S., H.M., Y.-W.S., B.-M.L., W.-P.L.), Guangzhou, China; and Department of Neurology (B.-S.T.), Xiangya Hospital, Central South University, Changsha, China
| | - Dan Huang
- Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University and Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China (X.-R.L., D.H., J.W., Y.-F.W., H.S., B.T., W.L., J.-X.L., N.H., M.W., T.S., H.M., Y.-W.S., B.-M.L., W.-P.L.), Guangzhou, China; and Department of Neurology (B.-S.T.), Xiangya Hospital, Central South University, Changsha, China
| | - Jie Wang
- Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University and Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China (X.-R.L., D.H., J.W., Y.-F.W., H.S., B.T., W.L., J.-X.L., N.H., M.W., T.S., H.M., Y.-W.S., B.-M.L., W.-P.L.), Guangzhou, China; and Department of Neurology (B.-S.T.), Xiangya Hospital, Central South University, Changsha, China
| | - Yi-Fan Wang
- Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University and Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China (X.-R.L., D.H., J.W., Y.-F.W., H.S., B.T., W.L., J.-X.L., N.H., M.W., T.S., H.M., Y.-W.S., B.-M.L., W.-P.L.), Guangzhou, China; and Department of Neurology (B.-S.T.), Xiangya Hospital, Central South University, Changsha, China
| | - Hui Sun
- Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University and Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China (X.-R.L., D.H., J.W., Y.-F.W., H.S., B.T., W.L., J.-X.L., N.H., M.W., T.S., H.M., Y.-W.S., B.-M.L., W.-P.L.), Guangzhou, China; and Department of Neurology (B.-S.T.), Xiangya Hospital, Central South University, Changsha, China
| | - Bin Tang
- Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University and Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China (X.-R.L., D.H., J.W., Y.-F.W., H.S., B.T., W.L., J.-X.L., N.H., M.W., T.S., H.M., Y.-W.S., B.-M.L., W.-P.L.), Guangzhou, China; and Department of Neurology (B.-S.T.), Xiangya Hospital, Central South University, Changsha, China
| | - Wen Li
- Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University and Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China (X.-R.L., D.H., J.W., Y.-F.W., H.S., B.T., W.L., J.-X.L., N.H., M.W., T.S., H.M., Y.-W.S., B.-M.L., W.-P.L.), Guangzhou, China; and Department of Neurology (B.-S.T.), Xiangya Hospital, Central South University, Changsha, China
| | - Jin-Xing Lai
- Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University and Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China (X.-R.L., D.H., J.W., Y.-F.W., H.S., B.T., W.L., J.-X.L., N.H., M.W., T.S., H.M., Y.-W.S., B.-M.L., W.-P.L.), Guangzhou, China; and Department of Neurology (B.-S.T.), Xiangya Hospital, Central South University, Changsha, China
| | - Na He
- Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University and Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China (X.-R.L., D.H., J.W., Y.-F.W., H.S., B.T., W.L., J.-X.L., N.H., M.W., T.S., H.M., Y.-W.S., B.-M.L., W.-P.L.), Guangzhou, China; and Department of Neurology (B.-S.T.), Xiangya Hospital, Central South University, Changsha, China
| | - Mei Wu
- Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University and Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China (X.-R.L., D.H., J.W., Y.-F.W., H.S., B.T., W.L., J.-X.L., N.H., M.W., T.S., H.M., Y.-W.S., B.-M.L., W.-P.L.), Guangzhou, China; and Department of Neurology (B.-S.T.), Xiangya Hospital, Central South University, Changsha, China
| | - Tao Su
- Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University and Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China (X.-R.L., D.H., J.W., Y.-F.W., H.S., B.T., W.L., J.-X.L., N.H., M.W., T.S., H.M., Y.-W.S., B.-M.L., W.-P.L.), Guangzhou, China; and Department of Neurology (B.-S.T.), Xiangya Hospital, Central South University, Changsha, China
| | - Heng Meng
- Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University and Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China (X.-R.L., D.H., J.W., Y.-F.W., H.S., B.T., W.L., J.-X.L., N.H., M.W., T.S., H.M., Y.-W.S., B.-M.L., W.-P.L.), Guangzhou, China; and Department of Neurology (B.-S.T.), Xiangya Hospital, Central South University, Changsha, China
| | - Yi-Wu Shi
- Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University and Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China (X.-R.L., D.H., J.W., Y.-F.W., H.S., B.T., W.L., J.-X.L., N.H., M.W., T.S., H.M., Y.-W.S., B.-M.L., W.-P.L.), Guangzhou, China; and Department of Neurology (B.-S.T.), Xiangya Hospital, Central South University, Changsha, China
| | - Bing-Mei Li
- Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University and Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China (X.-R.L., D.H., J.W., Y.-F.W., H.S., B.T., W.L., J.-X.L., N.H., M.W., T.S., H.M., Y.-W.S., B.-M.L., W.-P.L.), Guangzhou, China; and Department of Neurology (B.-S.T.), Xiangya Hospital, Central South University, Changsha, China
| | - Bei-Sha Tang
- Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University and Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China (X.-R.L., D.H., J.W., Y.-F.W., H.S., B.T., W.L., J.-X.L., N.H., M.W., T.S., H.M., Y.-W.S., B.-M.L., W.-P.L.), Guangzhou, China; and Department of Neurology (B.-S.T.), Xiangya Hospital, Central South University, Changsha, China
| | - Wei-Ping Liao
- Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University and Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China (X.-R.L., D.H., J.W., Y.-F.W., H.S., B.T., W.L., J.-X.L., N.H., M.W., T.S., H.M., Y.-W.S., B.-M.L., W.-P.L.), Guangzhou, China; and Department of Neurology (B.-S.T.), Xiangya Hospital, Central South University, Changsha, China
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Miyagi T, Okuma M, Suwazono S, Kido M, Tashiro Y, Ishihara S, Nakachi R, Suehara M. [Clinical manifestations of 5 patients with idiopathic paroxysmal kinesigenic choreoathetosis]. Rinsho Shinkeigaku 2016; 56:165-73. [PMID: 26887836 DOI: 10.5692/clinicalneurol.cn-000816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Paroxysmal kinesigenic choreoathetosis (PKC) is a rare disorder characterized by recurrent and brief attacks of choreoathetoid and/or dystonic movements in trunk and limbs triggered by initiation of voluntary movement. Of 5 patients with idiopathic PKC in our hospital, four were men and one was with family history. Age of onset ranged from 8 to 15 years old. They were consistent with previous reports in the characteristics of involuntary movements, normal neurological findings, normal laboratory data, no abnormal findings of standard imaging studies, and good restraining effects on attacks with carbamazepine. Individual body parts where attacks often involved were different among 5 patients. Although previous reports which said the prognosis and outcome of PKC were good, neuropsychological examinations in our study revealed that 2 patients out of 5 had certain cortical dysfunction, one patient was with progressive deterioration, and the other was with underlying mild abnormalities. Detailed and serial neuropsychological examinations might be necessary for some PKC patients.
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Affiliation(s)
- Tetsuya Miyagi
- Department of Neurology, National Hospital Organization Okinawa Hospital
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Gardella E, Becker F, Møller RS, Schubert J, Lemke JR, Larsen LHG, Eiberg H, Nothnagel M, Thiele H, Altmüller J, Syrbe S, Merkenschlager A, Bast T, Steinhoff B, Nürnberg P, Mang Y, Bakke Møller L, Gellert P, Heron SE, Dibbens LM, Weckhuysen S, Dahl HA, Biskup S, Tommerup N, Hjalgrim H, Lerche H, Beniczky S, Weber YG. Benign infantile seizures and paroxysmal dyskinesia caused by an SCN8A mutation. Ann Neurol 2016; 79:428-36. [PMID: 26677014 DOI: 10.1002/ana.24580] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 12/02/2015] [Accepted: 12/13/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Benign familial infantile seizures (BFIS), paroxysmal kinesigenic dyskinesia (PKD), and their combination-known as infantile convulsions and paroxysmal choreoathetosis (ICCA)-are related autosomal dominant diseases. PRRT2 (proline-rich transmembrane protein 2 gene) has been identified as the major gene in all 3 conditions, found to be mutated in 80 to 90% of familial and 30 to 35% of sporadic cases. METHODS We searched for the genetic defect in PRRT2-negative, unrelated families with BFIS or ICCA using whole exome or targeted gene panel sequencing, and performed a detailed cliniconeurophysiological workup. RESULTS In 3 families with a total of 16 affected members, we identified the same, cosegregating heterozygous missense mutation (c.4447G>A; p.E1483K) in SCN8A, encoding a voltage-gated sodium channel. A founder effect was excluded by linkage analysis. All individuals except 1 had normal cognitive and motor milestones, neuroimaging, and interictal neurological status. Fifteen affected members presented with afebrile focal or generalized tonic-clonic seizures during the first to second year of life; 5 of them experienced single unprovoked seizures later on. One patient had seizures only at school age. All patients stayed otherwise seizure-free, most without medication. Interictal electroencephalogram (EEG) was normal in all cases but 2. Five of 16 patients developed additional brief paroxysmal episodes in puberty, either dystonic/dyskinetic or "shivering" attacks, triggered by stretching, motor initiation, or emotional stimuli. In 1 case, we recorded typical PKD spells by video-EEG-polygraphy, documenting a cortical involvement. INTERPRETATION Our study establishes SCN8A as a novel gene in which a recurrent mutation causes BFIS/ICCA, expanding the clinical-genetic spectrum of combined epileptic and dyskinetic syndromes.
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Affiliation(s)
- Elena Gardella
- Danish Epilepsy Center-Filadelfia, Dianalund, Denmark.,Institute of Regional Health Research, University of South Denmark, Odense, Denmark
| | - Felicitas Becker
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Rikke S Møller
- Danish Epilepsy Center-Filadelfia, Dianalund, Denmark.,Institute of Regional Health Research, University of South Denmark, Odense, Denmark
| | - Julian Schubert
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Johannes R Lemke
- Institute of Human Genetics, University Hospitals, University of Leipzig, Leipzig, Germany
| | | | - Hans Eiberg
- RC-LINK, Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Michael Nothnagel
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | - Holger Thiele
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | - Janine Altmüller
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | - Steffen Syrbe
- Department of Woman and Child Health, Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany
| | - Andreas Merkenschlager
- Department of Woman and Child Health, Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany
| | | | | | - Peter Nürnberg
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | - Yuan Mang
- Wilhelm Johannsen Center for Functional Genome Research, Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Pia Gellert
- Danish Epilepsy Center-Filadelfia, Dianalund, Denmark
| | - Sarah E Heron
- Epilepsy Research Program, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia.,Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Leanne M Dibbens
- Epilepsy Research Program, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia.,Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Sarah Weckhuysen
- Neurogenetics Group, VIB Department of Molecular Genetics, University of Antwerp, Antwerp, Belgium.,Laboratory of Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | | | - Saskia Biskup
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Niels Tommerup
- Wilhelm Johannsen Center for Functional Genome Research, Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Helle Hjalgrim
- Danish Epilepsy Center-Filadelfia, Dianalund, Denmark.,Institute of Regional Health Research, University of South Denmark, Odense, Denmark
| | - Holger Lerche
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Sándor Beniczky
- Danish Epilepsy Center-Filadelfia, Dianalund, Denmark.,Department of Clinical Neurophysiology, Aarhus University, Aarhus, Denmark
| | - Yvonne G Weber
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
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Rossi P, Sterlini B, Castroflorio E, Marte A, Onofri F, Valtorta F, Maragliano L, Corradi A, Benfenati F. A Novel Topology of Proline-rich Transmembrane Protein 2 (PRRT2): HINTS FOR AN INTRACELLULAR FUNCTION AT THE SYNAPSE. J Biol Chem 2016; 291:6111-23. [PMID: 26797119 PMCID: PMC4813553 DOI: 10.1074/jbc.m115.683888] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Indexed: 11/06/2022] Open
Abstract
Proline-rich transmembrane protein 2 (PRRT2) has been identified as the single causative gene for a group of paroxysmal syndromes of infancy, including epilepsy, paroxysmal movement disorders, and migraine. On the basis of topology predictions, PRRT2 has been assigned to the recently characterized family of Dispanins, whose members share the two-transmembrane domain topology with a large N terminus and short C terminus oriented toward the outside of the cell. Because PRRT2 plays a role at the synapse, it is important to confirm the exact orientation of its N and C termini with respect to the plasma membrane to get clues regarding its possible function. Using a combination of different experimental approaches, including live immunolabeling, immunogold electron microscopy, surface biotinylation and computational modeling, we demonstrate a novel topology for this protein. PRRT2 is a type II transmembrane protein in which only the second hydrophobic segment spans the plasma membrane, whereas the first one is associated with the internal surface of the membrane and forms a helix-loop-helix structure without crossing it. Most importantly, the large proline-rich N-terminal domain is not exposed to the extracellular space but is localized intracellularly, and only the short C terminus is extracellular (Ncyt/Cexo topology). Accordingly, we show that PRRT2 interacts with the Src homology 3 domain-bearing protein Intersectin 1, an intracellular protein involved in synaptic vesicle cycling. These findings will contribute to the clarification of the role of PRRT2 at the synapse and the understanding of pathogenic mechanisms on the basis of PRRT2-related neurological disorders.
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Affiliation(s)
- Pia Rossi
- From the Department of Experimental Medicine, University of Genova, Viale Benedetto XV, 3, 16132 Genova, Italy
| | - Bruno Sterlini
- the Center for Synaptic Neuroscience and Technology, Fondazione Istituto Italiano di Tecnologia, Largo Rosanna Benzi 10, 16132 Genoa, Italy, and
| | - Enrico Castroflorio
- the Center for Synaptic Neuroscience and Technology, Fondazione Istituto Italiano di Tecnologia, Largo Rosanna Benzi 10, 16132 Genoa, Italy, and
| | - Antonella Marte
- From the Department of Experimental Medicine, University of Genova, Viale Benedetto XV, 3, 16132 Genova, Italy
| | - Franco Onofri
- From the Department of Experimental Medicine, University of Genova, Viale Benedetto XV, 3, 16132 Genova, Italy
| | - Flavia Valtorta
- the San Raffaele Scientific Institute, Vita Salute University, Via Olgettina 58, 20132 Milan, Italy
| | - Luca Maragliano
- the Center for Synaptic Neuroscience and Technology, Fondazione Istituto Italiano di Tecnologia, Largo Rosanna Benzi 10, 16132 Genoa, Italy, and
| | - Anna Corradi
- From the Department of Experimental Medicine, University of Genova, Viale Benedetto XV, 3, 16132 Genova, Italy
| | - Fabio Benfenati
- From the Department of Experimental Medicine, University of Genova, Viale Benedetto XV, 3, 16132 Genova, Italy, the Center for Synaptic Neuroscience and Technology, Fondazione Istituto Italiano di Tecnologia, Largo Rosanna Benzi 10, 16132 Genoa, Italy, and
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Ebrahimi-Fakhari D, Saffari A, Westenberger A, Klein C. The evolving spectrum ofPRRT2-associated paroxysmal diseases. Brain 2015; 138:3476-95. [DOI: 10.1093/brain/awv317] [Citation(s) in RCA: 175] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 09/30/2015] [Indexed: 02/01/2023] Open
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Huang XJ, Wang T, Wang JL, Liu XL, Che XQ, Li J, Mao X, Zhang M, Bi GH, Wu L, Zhang Y, Wang JY, Shen JY, Tang BS, Cao L, Chen SD. Paroxysmal kinesigenic dyskinesia: Clinical and genetic analyses of 110 patients. Neurology 2015; 85:1546-53. [PMID: 26446061 DOI: 10.1212/wnl.0000000000002079] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 07/01/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We aimed to investigate the clinical and genetic features of paroxysmal kinesigenic dyskinesia (PKD) in a large population and to analyze the genotype-phenotype correlation of PKD. METHODS We analyzed clinical manifestations and conducted PRRT2 screening in 110 patients with PKD. Clinical data were compared between 91 probands with and without PRRT2 mutations. RESULTS Among the enrolled participants (45 from 26 families, 65 sporadic cases), 8 PRRT2 mutations were detected in 20 PKD families (76.9%) and 14 sporadic cases (21.5%), accounting for 37.4% (34/91) of the study population. Five mutations (c.649dupC, c.649delC, c.487C>T, c.573dupT, c.796C>T) were already reported, while 3 mutations (c.787C>T, c.797G>A, c.931C>T) were undocumented. A patient harboring a homozygous c.931C>T mutation was shown to have inherited the mutation via uniparental disomy. Compared with non-PRRT2 mutation carriers, the PRRT2 mutation carriers were younger at onset, experienced longer attacks, and tended to present with complicated PKD, combined phenotypes of dystonia and chorea, and a positive family history. A good response was shown in 98.4% of the patients prescribed with carbamazepine. CONCLUSIONS PRRT2 mutations are common in patients with PKD and are significantly associated with an earlier age at onset, longer duration of attacks, a complicated form of PKD, combined phenotypes of dystonia and chorea, and a tendency for a family history of PKD. A patient with uniparental disomy resulting in a homozygous c.931C>T mutation is identified in the present study. Carbamazepine is the first-choice drug for patients with PKD, but an individualized treatment regimen should be developed.
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Affiliation(s)
- Xiao-Jun Huang
- From the Department of Neurology and Institute of Neurology (X.-J.H., T.W., X.-L.L., L.W., Y.Z., J.-Y.W., J.-Y.S., L.C., S.-D.C.), Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine; Department of Neurology (J.-L.W., X.-Q.C., J.L., X.M., B.-S.T.), Xiangya Hospital, Central South University, Changsha, Hunan Province; Department of Neurology (M.Z.), Huainan First People's Hospital affiliated to Bengbu Medical College, Huainan, Anhui Province; and Department of Neurology (G.-H.B.), Dongying People's Hospital, Dongying, Shandong Province, China
| | - Tian Wang
- From the Department of Neurology and Institute of Neurology (X.-J.H., T.W., X.-L.L., L.W., Y.Z., J.-Y.W., J.-Y.S., L.C., S.-D.C.), Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine; Department of Neurology (J.-L.W., X.-Q.C., J.L., X.M., B.-S.T.), Xiangya Hospital, Central South University, Changsha, Hunan Province; Department of Neurology (M.Z.), Huainan First People's Hospital affiliated to Bengbu Medical College, Huainan, Anhui Province; and Department of Neurology (G.-H.B.), Dongying People's Hospital, Dongying, Shandong Province, China
| | - Jun-Ling Wang
- From the Department of Neurology and Institute of Neurology (X.-J.H., T.W., X.-L.L., L.W., Y.Z., J.-Y.W., J.-Y.S., L.C., S.-D.C.), Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine; Department of Neurology (J.-L.W., X.-Q.C., J.L., X.M., B.-S.T.), Xiangya Hospital, Central South University, Changsha, Hunan Province; Department of Neurology (M.Z.), Huainan First People's Hospital affiliated to Bengbu Medical College, Huainan, Anhui Province; and Department of Neurology (G.-H.B.), Dongying People's Hospital, Dongying, Shandong Province, China
| | - Xiao-Li Liu
- From the Department of Neurology and Institute of Neurology (X.-J.H., T.W., X.-L.L., L.W., Y.Z., J.-Y.W., J.-Y.S., L.C., S.-D.C.), Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine; Department of Neurology (J.-L.W., X.-Q.C., J.L., X.M., B.-S.T.), Xiangya Hospital, Central South University, Changsha, Hunan Province; Department of Neurology (M.Z.), Huainan First People's Hospital affiliated to Bengbu Medical College, Huainan, Anhui Province; and Department of Neurology (G.-H.B.), Dongying People's Hospital, Dongying, Shandong Province, China
| | - Xiang-Qian Che
- From the Department of Neurology and Institute of Neurology (X.-J.H., T.W., X.-L.L., L.W., Y.Z., J.-Y.W., J.-Y.S., L.C., S.-D.C.), Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine; Department of Neurology (J.-L.W., X.-Q.C., J.L., X.M., B.-S.T.), Xiangya Hospital, Central South University, Changsha, Hunan Province; Department of Neurology (M.Z.), Huainan First People's Hospital affiliated to Bengbu Medical College, Huainan, Anhui Province; and Department of Neurology (G.-H.B.), Dongying People's Hospital, Dongying, Shandong Province, China
| | - Jin Li
- From the Department of Neurology and Institute of Neurology (X.-J.H., T.W., X.-L.L., L.W., Y.Z., J.-Y.W., J.-Y.S., L.C., S.-D.C.), Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine; Department of Neurology (J.-L.W., X.-Q.C., J.L., X.M., B.-S.T.), Xiangya Hospital, Central South University, Changsha, Hunan Province; Department of Neurology (M.Z.), Huainan First People's Hospital affiliated to Bengbu Medical College, Huainan, Anhui Province; and Department of Neurology (G.-H.B.), Dongying People's Hospital, Dongying, Shandong Province, China
| | - Xiao Mao
- From the Department of Neurology and Institute of Neurology (X.-J.H., T.W., X.-L.L., L.W., Y.Z., J.-Y.W., J.-Y.S., L.C., S.-D.C.), Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine; Department of Neurology (J.-L.W., X.-Q.C., J.L., X.M., B.-S.T.), Xiangya Hospital, Central South University, Changsha, Hunan Province; Department of Neurology (M.Z.), Huainan First People's Hospital affiliated to Bengbu Medical College, Huainan, Anhui Province; and Department of Neurology (G.-H.B.), Dongying People's Hospital, Dongying, Shandong Province, China
| | - Mei Zhang
- From the Department of Neurology and Institute of Neurology (X.-J.H., T.W., X.-L.L., L.W., Y.Z., J.-Y.W., J.-Y.S., L.C., S.-D.C.), Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine; Department of Neurology (J.-L.W., X.-Q.C., J.L., X.M., B.-S.T.), Xiangya Hospital, Central South University, Changsha, Hunan Province; Department of Neurology (M.Z.), Huainan First People's Hospital affiliated to Bengbu Medical College, Huainan, Anhui Province; and Department of Neurology (G.-H.B.), Dongying People's Hospital, Dongying, Shandong Province, China
| | - Guang-Hui Bi
- From the Department of Neurology and Institute of Neurology (X.-J.H., T.W., X.-L.L., L.W., Y.Z., J.-Y.W., J.-Y.S., L.C., S.-D.C.), Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine; Department of Neurology (J.-L.W., X.-Q.C., J.L., X.M., B.-S.T.), Xiangya Hospital, Central South University, Changsha, Hunan Province; Department of Neurology (M.Z.), Huainan First People's Hospital affiliated to Bengbu Medical College, Huainan, Anhui Province; and Department of Neurology (G.-H.B.), Dongying People's Hospital, Dongying, Shandong Province, China
| | - Li Wu
- From the Department of Neurology and Institute of Neurology (X.-J.H., T.W., X.-L.L., L.W., Y.Z., J.-Y.W., J.-Y.S., L.C., S.-D.C.), Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine; Department of Neurology (J.-L.W., X.-Q.C., J.L., X.M., B.-S.T.), Xiangya Hospital, Central South University, Changsha, Hunan Province; Department of Neurology (M.Z.), Huainan First People's Hospital affiliated to Bengbu Medical College, Huainan, Anhui Province; and Department of Neurology (G.-H.B.), Dongying People's Hospital, Dongying, Shandong Province, China
| | - Yu Zhang
- From the Department of Neurology and Institute of Neurology (X.-J.H., T.W., X.-L.L., L.W., Y.Z., J.-Y.W., J.-Y.S., L.C., S.-D.C.), Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine; Department of Neurology (J.-L.W., X.-Q.C., J.L., X.M., B.-S.T.), Xiangya Hospital, Central South University, Changsha, Hunan Province; Department of Neurology (M.Z.), Huainan First People's Hospital affiliated to Bengbu Medical College, Huainan, Anhui Province; and Department of Neurology (G.-H.B.), Dongying People's Hospital, Dongying, Shandong Province, China
| | - Jing-Yi Wang
- From the Department of Neurology and Institute of Neurology (X.-J.H., T.W., X.-L.L., L.W., Y.Z., J.-Y.W., J.-Y.S., L.C., S.-D.C.), Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine; Department of Neurology (J.-L.W., X.-Q.C., J.L., X.M., B.-S.T.), Xiangya Hospital, Central South University, Changsha, Hunan Province; Department of Neurology (M.Z.), Huainan First People's Hospital affiliated to Bengbu Medical College, Huainan, Anhui Province; and Department of Neurology (G.-H.B.), Dongying People's Hospital, Dongying, Shandong Province, China
| | - Jun-Yi Shen
- From the Department of Neurology and Institute of Neurology (X.-J.H., T.W., X.-L.L., L.W., Y.Z., J.-Y.W., J.-Y.S., L.C., S.-D.C.), Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine; Department of Neurology (J.-L.W., X.-Q.C., J.L., X.M., B.-S.T.), Xiangya Hospital, Central South University, Changsha, Hunan Province; Department of Neurology (M.Z.), Huainan First People's Hospital affiliated to Bengbu Medical College, Huainan, Anhui Province; and Department of Neurology (G.-H.B.), Dongying People's Hospital, Dongying, Shandong Province, China
| | - Bei-Sha Tang
- From the Department of Neurology and Institute of Neurology (X.-J.H., T.W., X.-L.L., L.W., Y.Z., J.-Y.W., J.-Y.S., L.C., S.-D.C.), Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine; Department of Neurology (J.-L.W., X.-Q.C., J.L., X.M., B.-S.T.), Xiangya Hospital, Central South University, Changsha, Hunan Province; Department of Neurology (M.Z.), Huainan First People's Hospital affiliated to Bengbu Medical College, Huainan, Anhui Province; and Department of Neurology (G.-H.B.), Dongying People's Hospital, Dongying, Shandong Province, China.
| | - Li Cao
- From the Department of Neurology and Institute of Neurology (X.-J.H., T.W., X.-L.L., L.W., Y.Z., J.-Y.W., J.-Y.S., L.C., S.-D.C.), Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine; Department of Neurology (J.-L.W., X.-Q.C., J.L., X.M., B.-S.T.), Xiangya Hospital, Central South University, Changsha, Hunan Province; Department of Neurology (M.Z.), Huainan First People's Hospital affiliated to Bengbu Medical College, Huainan, Anhui Province; and Department of Neurology (G.-H.B.), Dongying People's Hospital, Dongying, Shandong Province, China.
| | - Sheng-Di Chen
- From the Department of Neurology and Institute of Neurology (X.-J.H., T.W., X.-L.L., L.W., Y.Z., J.-Y.W., J.-Y.S., L.C., S.-D.C.), Rui Jin Hospital & Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine; Department of Neurology (J.-L.W., X.-Q.C., J.L., X.M., B.-S.T.), Xiangya Hospital, Central South University, Changsha, Hunan Province; Department of Neurology (M.Z.), Huainan First People's Hospital affiliated to Bengbu Medical College, Huainan, Anhui Province; and Department of Neurology (G.-H.B.), Dongying People's Hospital, Dongying, Shandong Province, China.
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Kim JH, Kim D, Kim JB, Suh S, Koh S. Thalamic involvement in paroxysmal kinesigenic dyskinesia: a combined structural and diffusion tensor MRI analysis. Hum Brain Mapp 2015; 36:1429-41. [PMID: 25504906 PMCID: PMC6869556 DOI: 10.1002/hbm.22713] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 11/14/2014] [Accepted: 11/30/2014] [Indexed: 11/08/2022] Open
Abstract
Alteration of basal ganglia-thalamocortical circuit has been hypothesized to play a role in the pathophysiology underlying paroxysmal kinesigenic dyskinesia (PKD). We investigated macrostructural and microstructural changes in PKD patients using structural and diffusion tensor magnetic resonance imaging (MRI) analyses. Twenty-five patients with idiopathic PKD and 25 control subjects were prospectively studied on a 3T magnetic resonance (MR) scanner. Cortical thickness analysis was used to evaluate cortical gray matter (GM) changes, and automated volumetry and shape analysis were used to assess volume changes and shape deformation of the subcortical GM structures, respectively. Tract-based spatial statistics (TBSS) was used to evaluate white matter integrity changes in a whole-brain manner, and region-of-interest (ROI) analysis of diffusion tensor metrics was performed in subcortical GM structures. Compared to controls, PKD patients exhibited a reduction in volume of bilateral thalami and regional shape deformation mainly localized to the anterior and medial aspects of bilateral thalami. TBSS revealed an increase in fractional anisotropy (FA) of bilateral thalami and right anterior thalamic radiation in patients relative to controls. ROI analysis also showed an increase in FA of bilateral thalami in patients compared to controls. We have shown evidence for thalamic abnormalities of volume reduction, regional shape deformation, and increased FA in patients with PKD. Our novel findings of concomitant macrostructural and microstructural abnormalities in the thalamus lend further support to previous observations indicating causal relationship between a preferential lesion in the thalamus and development of PKD, thus providing neuroanatomical basis for the involvement of thalamus within the basal ganglia-thalamocortical pathway in PKD.
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Affiliation(s)
- Ji Hyun Kim
- Department of NeurologyKorea University Guro Hospital, Korea University College of MedicineSeoulKorea
| | - Dong‐Wook Kim
- Department of NeurologyKonkuk University Hospital, Konkuk University College of MedicineSeoulKorea
| | - Jung Bin Kim
- Department of NeurologyKorea University Guro Hospital, Korea University College of MedicineSeoulKorea
| | - Sang‐il Suh
- Department of RadiologyKorea University Guro Hospital, Korea University College of MedicineSeoulKorea
| | - Seong‐Beom Koh
- Department of NeurologyKorea University Guro Hospital, Korea University College of MedicineSeoulKorea
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38
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Ren J, Lei D, Yang T, An D, Xiao F, Li L, Huang X, Gong Q, Zhou D. Increased interhemispheric resting-state functional connectivity in paroxysmal kinesigenic dyskinesia: a resting-state fMRI study. J Neurol Sci 2015; 351:93-98. [PMID: 25783010 DOI: 10.1016/j.jns.2015.02.046] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 02/06/2015] [Accepted: 02/26/2015] [Indexed: 02/05/2023]
Abstract
PURPOSE Paroxysmal kinesigenic dyskinesia (PKD) is a rare movement disorder. The underlying neural mechanisms have not been fully understood. This study aimed to examine the alteration of resting-state functional connectivity (RSFC) between interhemispheric homotopic regions in PKD using a technique called "voxel-mirrored homotopic connectivity" (VMHC). METHODS The VMHC analysis was performed on resting-state functional MRI data from 11 PKD patients and 17 age and gender matched healthy subjects. Comparison between the two groups was conducted. The correlation relationship between VMHC and illness duration was analyzed. RESULTS Compared with healthy subjects, PKD patients showed increased interhemispheric RSFC in bilateral putamen, primary motor cortex, supplementary motor area, dorsal lateral prefrontal cortex, primary somatosensory cortex, superior and middle occipital gyri, as well as cerebellar tonsil. Besides, negative correlation was detected between illness duration and VMHC in bilateral putamen and the insular cortex. CONCLUSION The present study provided preliminary evidence of increased interhemispheric RSFC in PKD mainly in the basal ganglia-thalamo-cortical circuitry and cerebellum. A negative correlation between VMHC and illness duration was also detected. These findings could further enhance our understandings of the pathophysiology of PKD.
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Affiliation(s)
- Jiechuan Ren
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Du Lei
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Tianhua Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Dongmei An
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Fenglai Xiao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Lei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
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Extreia J, Monteiro I, Ferreira A, Rocha S. Discinesia paroxística cinesigénica familiar: descripción de una familia. An Pediatr (Barc) 2015; 82:e154-7. [DOI: 10.1016/j.anpedi.2014.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Revised: 06/30/2014] [Accepted: 07/30/2014] [Indexed: 10/24/2022] Open
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Schubert J, Siekierska A, Langlois M, May P, Huneau C, Becker F, Muhle H, Suls A, Lemke JR, de Kovel CGF, Thiele H, Konrad K, Kawalia A, Toliat MR, Sander T, Rüschendorf F, Caliebe A, Nagel I, Kohl B, Kecskés A, Jacmin M, Hardies K, Weckhuysen S, Riesch E, Dorn T, Brilstra EH, Baulac S, Møller RS, Hjalgrim H, Koeleman BPC, Jurkat-Rott K, Lehmann-Horn F, Roach JC, Glusman G, Hood L, Galas DJ, Martin B, de Witte PAM, Biskup S, De Jonghe P, Helbig I, Balling R, Nürnberg P, Crawford AD, Esguerra CV, Weber YG, Lerche H. Mutations in STX1B, encoding a presynaptic protein, cause fever-associated epilepsy syndromes. Nat Genet 2014; 46:1327-32. [DOI: 10.1038/ng.3130] [Citation(s) in RCA: 144] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 10/06/2014] [Indexed: 01/12/2023]
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Ji Z, Su Q, Hu L, Yang Q, Liu C, Xiong J, Xiong F. Novel loss-of-function PRRT2 mutation causes paroxysmal kinesigenic dyskinesia in a Han Chinese family. BMC Neurol 2014; 14:146. [PMID: 25027704 PMCID: PMC4107729 DOI: 10.1186/1471-2377-14-146] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 07/07/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mutations in proline-rich transmembrane protein 2 (PRRT2) are a cause of paroxysmal kinesigenic dyskinesia (PKD). In this study, we investigated the PRRT2 gene mutation in a Chinese Han family with PKD and study the pathogenesis of the mutation with PRRT2 gene. METHODS Peripheral venous blood was taken from the family members. Sanger sequencing was used for novel mutation sequencing. For the pathogenesis with the novel mutation was analyzed by bioinformatics, real-time PCR, subcellular localization and Western blot. RESULTS The Sanger sequencing showed a novel mutation, c.186-187delGC, a deletion mutation, in exon 2 of the PRRT2 gene, the frameshift mutation generated a truncated protein that was stably expressed in transfected Human embryonic kidney (HEK) 293 cells. A subcellular localization assay in COS-7 cells with GFP-tagged protein showed nuclear localization for the mutant protein while the wild-type protein was localized in membranes. Co-transfection of HEK293 cells with wild-type and mutant expression plasmids cells did not influence mRNA or protein expression from the wild-type plasmid. CONCLUSIONS Our findings demonstrated that the c.186-187delGC mutation resulted in a truncated protein from the PRRT2 gene to involve in PKD pathogenesis with haploinsufficiency. The results extend the mutation spectrum of the PRRT2 gene and provide a new example for studying the pathogenesis of the mutated PRRT2 gene.
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Affiliation(s)
| | | | | | | | | | | | - Fu Xiong
- Deparment of Medical Genetics, School of Basic Medicine Sciences, Southern Medical University, Guangzhou, China.
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Erro R, Sheerin UM, Bhatia KP. Paroxysmal dyskinesias revisited: a review of 500 genetically proven cases and a new classification. Mov Disord 2014; 29:1108-16. [PMID: 24963779 DOI: 10.1002/mds.25933] [Citation(s) in RCA: 137] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 04/30/2014] [Accepted: 05/13/2014] [Indexed: 12/31/2022] Open
Abstract
Paroxysmal movement disorders are a heterogeneous group of conditions manifesting as episodic dyskinesia with sudden onset and lasting a variable duration. Based on the difference of precipitating factors, three forms are clearly recognized, namely, paroxysmal kinesigenic (PKD), non-kinesigenic (PNKD), and exercise induced (PED). The elucidation of the genetic cause of various forms of paroxysmal dyskinesia has led to better clinical definitions based on genotype-phenotype correlations in the familial forms. However, it has been increasingly recognized that (1) there is a marked pleiotropy of mutations in such genes with still expanding clinical spectra; and (2) not all patients clinically presenting with either PKD, PNKD, or PED have mutations in these genes. We aimed to review the clinical features of 500 genetically proven cases published to date. Based on our results, it is clear that there is not a complete phenotypic-genotypic correlation, and therefore we suggest an algorithm to lead the genetic analyses. Given the fact that the reliability of current clinical categorization is not entirely valid, we further propose a novel classification for paroxysmal dyskinesias, which takes into account the recent genetic discoveries in this field.
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Affiliation(s)
- Roberto Erro
- Sobell Department of Motor Neuroscience and Movement Disorders, University College London, Institute of Neurology, London, United Kingdom
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Olson H, Shen Y, Avallone J, Sheidley BR, Pinsky R, Bergin AM, Berry GT, Duffy FH, Eksioglu Y, Harris DJ, Hisama FM, Ho E, Irons M, Jacobsen CM, James P, Kothare S, Khwaja O, Lipton J, Loddenkemper T, Markowitz J, Maski K, Megerian JT, Neilan E, Raffalli PC, Robbins M, Roberts A, Roe E, Rollins C, Sahin M, Sarco D, Schonwald A, Smith SE, Soul J, Stoler JM, Takeoka M, Tan WH, Torres AR, Tsai P, Urion DK, Weissman L, Wolff R, Wu BL, Miller DT, Poduri A. Copy number variation plays an important role in clinical epilepsy. Ann Neurol 2014; 75:943-58. [PMID: 24811917 DOI: 10.1002/ana.24178] [Citation(s) in RCA: 120] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 05/07/2014] [Accepted: 05/07/2014] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To evaluate the role of copy number abnormalities detectable using chromosomal microarray (CMA) testing in patients with epilepsy at a tertiary care center. METHODS We identified patients with International Classification of Diseases, ninth revision (ICD-9) codes for epilepsy or seizures and clinical CMA testing performed between October 2006 and February 2011 at Boston Children's Hospital. We reviewed medical records and included patients who met criteria for epilepsy. We phenotypically characterized patients with epilepsy-associated abnormalities on CMA. RESULTS Of 973 patients who had CMA and ICD-9 codes for epilepsy or seizures, 805 patients satisfied criteria for epilepsy. We observed 437 copy number variants (CNVs) in 323 patients (1-4 per patient), including 185 (42%) deletions and 252 (58%) duplications. Forty (9%) were confirmed de novo, 186 (43%) were inherited, and parental data were unavailable for 211 (48%). Excluding full chromosome trisomies, CNV size ranged from 18kb to 142Mb, and 34% were >500kb. In at least 40 cases (5%), the epilepsy phenotype was explained by a CNV, including 29 patients with epilepsy-associated syndromes and 11 with likely disease-associated CNVs involving epilepsy genes or "hotspots." We observed numerous recurrent CNVs including 10 involving loss or gain of Xp22.31, a region described in patients with and without epilepsy. INTERPRETATION Copy number abnormalities play an important role in patients with epilepsy. Because the diagnostic yield of CMA for epilepsy patients is similar to the yield in autism spectrum disorders and in prenatal diagnosis, for which published guidelines recommend testing with CMA, we recommend the implementation of CMA in the evaluation of unexplained epilepsy.
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Affiliation(s)
- Heather Olson
- Epilepsy Genetics Program, Division of Epilepsy and Clinical Neurophysiology and Neurogenetics Program, Department of Neurology, Boston Children's Hospital, and Harvard Medical School, Boston, MA
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Abstract
The identification of valid biomarkers for outcome prediction of diseases and improvement of drug response, as well as avoidance of side effects is an emerging field of interest in medicine. The concept of individualized therapy is becoming increasingly important in the treatment of patients with epilepsy, as predictive markers for disease prognosis and treatment outcome are still limited. Currently, the clinical decision process for selection of an antiepileptic drug (AED) is predominately based on the patient's epileptic syndrome and side effect profiles of the AEDs, but not on effectiveness data. Although standard dosages of AEDs are used, supplemented, in part, by therapeutic monitoring, the response of an individual patient to a specific AED is generally unpredictable, and the standard care of patients in antiepileptic treatment is more or less based on trial and error. Therefore, there is an urgent need for valid predictive biomarkers to guide patient-tailored individualized treatment strategies in epilepsy, a research area that is still in its infancy. This review focuses on genomic factors as part of an individual concept for AED therapy summarizing examples that influence the prognosis of the disease and the response to AEDs, including side effects.
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Affiliation(s)
- Yvonne G. Weber
- />Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Anne T. Nies
- />Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Matthias Schwab
- />Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
- />Department of Clinical Pharmacology, University Hospital, Tübingen, Germany
| | - Holger Lerche
- />Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
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Kovac S, Walker MC. Recent advances in epilepsy. J Neurol 2014; 261:837-41. [PMID: 24590406 DOI: 10.1007/s00415-014-7294-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 02/20/2014] [Indexed: 12/27/2022]
Abstract
We have reviewed some of the important studies published within the last 18 months that have advanced our understanding of the epilepsies, their aetiology and treatment. Clinical studies have revealed new insights into old themes including seizure prediction, mortality in epilepsy, febrile seizures and the pathophysiology of focal cortical dysplasias. The rapid advances in genetics and particularly whole exome sequencing have had an impact on our understanding of epileptic encephalopathies, and the aetiology of hippocampal sclerosis. Experimental research techniques such as viral vector gene delivery, optogenetics and cell based transplantation techniques have set the framework for novel approaches to the treatment of pharmacoresistant epilepsy. These few examples are indicative of the great strides that have recently been made in epilepsy research.
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Affiliation(s)
- Stjepana Kovac
- Institute of Neurology, University College London, London, UK,
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Huguet G, Nava C, Lemière N, Patin E, Laval G, Ey E, Brice A, Leboyer M, Szepetowski P, Gillberg C, Depienne C, Delorme R, Bourgeron T. Heterogeneous pattern of selective pressure for PRRT2 in human populations, but no association with autism spectrum disorders. PLoS One 2014; 9:e88600. [PMID: 24594579 PMCID: PMC3940422 DOI: 10.1371/journal.pone.0088600] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 01/11/2014] [Indexed: 11/22/2022] Open
Abstract
Inherited and de novo genomic imbalances at chromosome 16p11.2 are associated with autism spectrum disorders (ASD), but the causative genes remain unknown. Among the genes located in this region, PRRT2 codes for a member of the synaptic SNARE complex that allows the release of synaptic vesicles. PRRT2 is a candidate gene for ASD since homozygote mutations are associated with intellectual disability and heterozygote mutations cause benign infantile seizures, paroxysmal dyskinesia, or hemiplegic migraine. Here, we explored the contribution of PRRT2 mutations in ASD by screening its coding part in a large sample of 1578 individuals including 431 individuals with ASD, 186 controls and 961 individuals from the human genome Diversity Panel. We detected 24 nonsynonymous variants, 1 frameshift (A217PfsX8) and 1 in-frame deletion of 6 bp (p.A361_P362del). The frameshift mutation was observed in a control with no history of neurological or psychiatric disorders. The p.A361_P362del was observed in two individuals with autism from sub-Saharan African origin. Overall, the frequency of PRRT2 deleterious variants was not different between individuals with ASD and controls. Remarkably, PRRT2 displays a highly significant excess of nonsynonymous (pN) vs synonymous (pS) mutations in Asia (pN/pS = 4.85) and Europe (pN/pS = 1.62) compared with Africa (pN/pS = 0.26; Asia vs Africa: P = 0.000087; Europe vs Africa P = 0.00035; Europe vs Asia P = P = 0.084). We also showed that whole genome amplification performed through rolling cycle amplification could artificially introduce the A217PfsX8 mutation indicating that this technology should not be performed prior to PRRT2 mutation screening. In summary, our results do not support a role for PRRT2 coding sequence variants in ASD, but provide an ascertainment of its genetic variability in worldwide populations that should help researchers and clinicians to better investigate the role of PRRT2 in human diseases.
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Affiliation(s)
- Guillaume Huguet
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
- CNRS URA 2182 ‘Genes, synapses and cognition’, Institut Pasteur, Paris, France
- University Denis Diderot Paris 7, Paris, France
| | - Caroline Nava
- INSERM, U975—CRICM, Institut du cerveau et de la moelle épinière (ICM), Hôpital Pitié-Salpêtrière, Paris, France
- CNRS 7225—CRICM, Hôpital Pitié-Salpêtrière, Paris, France
- Université Pierre et Marie Curie-Paris-6 (UPMC), UMR_S 975, Paris, France
- Département de Génétique et de Cytogénétique, Unité fonctionnelle de génétique clinique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Nathalie Lemière
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
- CNRS URA 2182 ‘Genes, synapses and cognition’, Institut Pasteur, Paris, France
- University Denis Diderot Paris 7, Paris, France
| | - Etienne Patin
- Unit of Human Evolutionary Genetics, Institut Pasteur, Paris, France
| | - Guillaume Laval
- Unit of Human Evolutionary Genetics, Institut Pasteur, Paris, France
| | - Elodie Ey
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
- CNRS URA 2182 ‘Genes, synapses and cognition’, Institut Pasteur, Paris, France
- University Denis Diderot Paris 7, Paris, France
| | - Alexis Brice
- INSERM, U975—CRICM, Institut du cerveau et de la moelle épinière (ICM), Hôpital Pitié-Salpêtrière, Paris, France
- CNRS 7225—CRICM, Hôpital Pitié-Salpêtrière, Paris, France
- Université Pierre et Marie Curie-Paris-6 (UPMC), UMR_S 975, Paris, France
- Département de Génétique et de Cytogénétique, Unité fonctionnelle de neurogénétique moléculaire et cellulaire, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Marion Leboyer
- INSERM, U955, Psychiatry Genetic team, Creteil, France
- Fondation FondaMental, Créteil, France
| | - Pierre Szepetowski
- INSERM, UMR_S901, Marseille, France
- Aix-Marseille University, Marseille, France
- Mediterranean Institute of Neurobiology (INMED), Marseille, France
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Göteborg, Sweden
- Institute of Neuroscience and Physiology, Department of Pharmacology, Gothenburg University, Gothenburg, Sweden
- Institute of Child Health, University College London, London, United Kingdom
| | - Christel Depienne
- INSERM, U975—CRICM, Institut du cerveau et de la moelle épinière (ICM), Hôpital Pitié-Salpêtrière, Paris, France
- CNRS 7225—CRICM, Hôpital Pitié-Salpêtrière, Paris, France
- Université Pierre et Marie Curie-Paris-6 (UPMC), UMR_S 975, Paris, France
- Département de Génétique et de Cytogénétique, Unité fonctionnelle de neurogénétique moléculaire et cellulaire, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Richard Delorme
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
- CNRS URA 2182 ‘Genes, synapses and cognition’, Institut Pasteur, Paris, France
- Fondation FondaMental, Créteil, France
- Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Department of Child and Adolescent Psychiatry, Paris, France
| | - Thomas Bourgeron
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
- CNRS URA 2182 ‘Genes, synapses and cognition’, Institut Pasteur, Paris, France
- University Denis Diderot Paris 7, Paris, France
- Fondation FondaMental, Créteil, France
- * E-mail:
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Nobile C, Striano P. PRRT2: A major cause of infantile epilepsy and other paroxysmal disorders of childhood. PROGRESS IN BRAIN RESEARCH 2014; 213:141-58. [DOI: 10.1016/b978-0-444-63326-2.00008-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Yang X, Zhang Y, Xu X, Wang S, Yang Z, Wu Y, Liu X, Wu X. Phenotypes and PRRT2 mutations in Chinese families with benign familial infantile epilepsy and infantile convulsions with paroxysmal choreoathetosis. BMC Neurol 2013; 13:209. [PMID: 24370076 PMCID: PMC3897939 DOI: 10.1186/1471-2377-13-209] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 12/17/2013] [Indexed: 01/09/2023] Open
Abstract
Background Mutations in the PRRT2 gene have been identified as the major cause of benign familial infantile epilepsy (BFIE), paroxysmal kinesigenic dyskinesia (PKD) and infantile convulsions with paroxysmal choreoathetosis/dyskinesias (ICCA). Here, we analyzed the phenotypes and PRRT2 mutations in Chinese families with BFIE and ICCA. Methods Clinical data were collected from 22 families with BFIE and eight families with ICCA. PRRT2 mutations were screened using PCR and direct sequencing. Results Ninety-five family members were clinically affected in the 22 BFIE families. During follow-up, two probands had one seizure induced by diarrhea at the age of two years. Thirty-one family members were affected in the eight ICCA families, including 11 individuals with benign infantile epilepsy, nine with PKD, and 11 with benign infantile epilepsy followed by PKD. Two individuals in one ICCA family had PKD or ICCA co-existing with migraine. One affected member in another ICCA family had experienced a fever-induced seizure at 7 years old. PRRT2 mutations were detected in 13 of the 22 BFIE families. The mutation c.649_650insC (p.R217PfsX8) was found in nine families. The mutations c.649delC (p.R217EfsX12) and c.904_905insG (p.D302GfsX39) were identified in three families and one family, respectively. PRRT2 mutations were identified in all eight ICCA families, including c.649_650insC (p.R217PfsX8), c.649delC (p.R217EfsX12), c.514_517delTCTG (p.S172RfsX3) and c.1023A > T (X341C). c.1023A > T is a novel mutation predicted to elongate the C-terminus of the protein by 28 residues. Conclusions Our data demonstrated that PRRT2 is the major causative gene of BFIE and ICCA in Chinese families. Site c.649 is a mutation hotspot: c.649_650insC is the most common mutation, and c.649delC is the second most common mutation in Chinese families with BFIE and ICCA. As far as we know, c.1023A > T is the first reported mutation in exon 4 of PRRT2. c.649delC was previously reported in PKD, ICCA and hemiplegic migraine families, but we further detected it in BFIE-only families. c.904_905insG was reported in an ICCA family, but we identified it in a BFIE family. c.514_517delTCTG was previously reported in a PKD family, but we identified it in an ICCA family. Migraine and febrile seizures plus could co-exist in ICCA families.
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Affiliation(s)
| | - Yuehua Zhang
- Department of Pediatrics, Peking University First Hospital, No, 1 of Xian Men Street, , Beijing, Xicheng District 100034, China.
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Wang JL, Mao X, Hu ZM, Li JD, Li N, Guo JF, Jiang H, Shen L, Li J, Shi YT, Xia K, Liu JY, Liao WP, Tang BS. Mutation analysis of PRRT2 in two Chinese BFIS families and nomenclature of PRRT2 related paroxysmal diseases. Neurosci Lett 2013; 552:40-5. [PMID: 23896529 DOI: 10.1016/j.neulet.2013.07.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 07/15/2013] [Indexed: 11/26/2022]
Abstract
Benign familial infantile seizure (BFIS) and paroxysmal kinesigenic dyskinesia (PKD) are autosomal-dominant inherited self-limited neurological disorders. BFIS is characterized by clusters of epileptic seizures in infancy while, in some cases, infantile seizures and adolescent-onset paroxysmal kinesigenic choreoathetosis co-occurred, which is called infantile convulsions and choreoathetosis (ICCA) syndrome. We and other researchers have reported the proline-rich transmembrane protein 2 (PRRT2) as the causative gene of PKD. We and our collaborators also identified PRRT2 mutations in ICCA and other phenotypes. Here we collected two BFIS families of Chinese Han origin. The linkage analysis has mapped the BFIS-causing locus to 16p12.1-q12.2, where PRRT2 is located. We then performed mutation analysis of PRRT2 by direct sequencing and identified c.649-650insC mutation in all BFIS patients. We also noticed that paroxysmal diseases (such as BFIS, PKD and ICCA) with PRRT2 mutations, instead of other forms, share some characteristics like being responded well to anti-epiletic treatment, we thus suggest to name them as PRRT2-related paroxysmal diseases (PRPDs) in order to assist clinical diagnosis and treatment.
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Affiliation(s)
- Jun-Ling Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan Province 410008, China
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