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Lieto M, Riso V, Galatolo D, De Michele G, Rossi S, Barghigiani M, Cocozza S, Pontillo G, Trovato R, Saccà F, Salvatore E, Tessa A, Filla A, Santorelli FM, De Michele G, Silvestri G. The complex phenotype of spinocerebellar ataxia type 48 in eight unrelated Italian families. Eur J Neurol 2019; 27:498-505. [PMID: 31571321 DOI: 10.1111/ene.14094] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 09/27/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE Heterozygous mutations in the STUB1 gene have recently been associated with an autosomal dominant form of spinocerebellar ataxia (SCA) associated with cerebellar cognitive-affective syndrome (CCAS), named SCA48. METHODS Molecular screening was performed in a cohort of 235 unrelated patients with adult-onset, autosomal dominant (17) or sporadic (218) cerebellar ataxia, negative for pathological trinucleotide expansions in the common SCAs, FRDA and FXTAS loci, by using targeted multigene panels or whole-exome sequencing. Bioinformatics analyses, detailed neurological phenotyping and family segregation studies corroborated the pathogenicity of the novel STUB1 mutations. Clinico-diagnostic findings were reviewed to define the phenotypic spectrum. RESULTS Eight heterozygous STUB1 mutations were identified, six of which were novel in 11 patients from eight index families, giving an estimated overall frequency of 3.4% (8/235) for SCA48 in our study cohort, rising to 23.5% (4/17) when considering only familial cases. All our SCA48 patients had cerebellar ataxia and dysarthria associated with cerebellar atrophy on brain magnetic resonance imaging; of note, many cases were also associated with parkinsonism, chorea and dystonia. CCAS also occurred frequently, whereas definite signs of pyramidal tract dysfunction and peripheral nervous system involvement were absent. One SCA48 patient presented with hypogonadism, associated with other autoimmune endocrine dysfunctions. CONCLUSIONS Our results support SCA48 as a significant cause of adult-onset SCA. Besides CCAS, our SCA48 patients often showed movement disorders and other clinical manifestations previously described in SCAR16, linked to biallelic variants in the same gene, thus suggesting a continuous clinical spectrum and significant overlap amongst recessive and dominantly inherited mutations in STUB1.
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Affiliation(s)
- M Lieto
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | - V Riso
- Area of Neuroscience, Institute of Neurology, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
| | - D Galatolo
- IRCCS Fondazione Stella Maris, Pisa, Italy
| | - G De Michele
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | - S Rossi
- Area of Neuroscience, Institute of Neurology, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
| | | | - S Cocozza
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - G Pontillo
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - R Trovato
- IRCCS Fondazione Stella Maris, Pisa, Italy
| | - F Saccà
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | - E Salvatore
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | - A Tessa
- IRCCS Fondazione Stella Maris, Pisa, Italy
| | - A Filla
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | | | - G De Michele
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | - G Silvestri
- Area of Neuroscience, Institute of Neurology, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
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Mancini C, Giorgio E, Rubegni A, Pradotto L, Bagnoli S, Rubino E, Prontera P, Cavalieri S, Di Gregorio E, Ferrero M, Pozzi E, Riberi E, Ferrero P, Nigro P, Mauro A, Zibetti M, Tessa A, Barghigiani M, Antenora A, Sirchia F, Piacentini S, Silvestri G, De Michele G, Filla A, Orsi L, Santorelli FM, Brusco A. Prevalence and phenotype of the c.1529C>T SPG7 variant in adult-onset cerebellar ataxia in Italy. Eur J Neurol 2018; 26:80-86. [PMID: 30098094 DOI: 10.1111/ene.13768] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 08/07/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE Hereditary ataxias are heterogeneous groups of neurodegenerative disorders, characterized by cerebellar syndromes associated with dysarthria, oculomotor and corticospinal signs, neuropathy and cognitive impairment. Recent reports have suggested mutations in the SPG7 gene, causing the most common form of autosomal recessive spastic paraplegia (MIM#607259), as a main cause of ataxias. The majority of described patients were homozygotes or compound heterozygotes for the c.1529C>T (p.Ala510Val) change. We screened a cohort of 895 Italian patients with ataxia for p.Ala510Val in order to define the prevalence and genotype-phenotype correlation of this variant. METHODS We set up a rapid assay for c.1529C>T using restriction enzyme analysis after polymerase chain reaction amplification. We confirmed the diagnosis with Sanger sequencing. RESULTS We identified eight homozygotes and 13 compound heterozygotes, including two novel variants affecting splicing. Mutated patients showed a pure cerebellar ataxia at onset, evolving in mild spastic ataxia (alternatively) associated with dysarthria (~80% of patients), urinary urgency (~30%) and pyramidal signs (~70%). Comparing homozygotes and compound heterozygotes, we noted a difference in age at onset and Scale for the Assessment and Rating of Ataxia score between the two groups, supporting an earlier and more severe phenotype in compound heterozygotes versus homozygotes. CONCLUSIONS The SPG7 c.1529C>T (p.Ala510Val) mutants accounted for 2.3% of cerebellar ataxia cases in Italy, suggesting that this variant should be considered as a priority test in the presence of late-onset pure ataxia. Moreover, the heterozygous/homozygous genotype appeared to predict the onset of clinical manifestation and disease progression.
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Affiliation(s)
- C Mancini
- Department of Medical Sciences, University of Torino, Turin, Italy
| | - E Giorgio
- Department of Medical Sciences, University of Torino, Turin, Italy
| | - A Rubegni
- Molecular Medicine, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - L Pradotto
- Division of Neurology and Neurorehabilitation, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, Piancavallo, Italy
| | - S Bagnoli
- Department of Neuroscience, Psychology, Drug Research and Child's Health, University of Florence, Florence, Italy
| | - E Rubino
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - P Prontera
- Medical Genetics Unit, Hospital S. Maria della Misericordia, Perugia, Italy
| | - S Cavalieri
- Department of Medical Sciences, University of Torino, Turin, Italy
| | - E Di Gregorio
- Department of Medical Sciences, University of Torino, Turin, Italy
| | - M Ferrero
- Department of Medical Sciences, University of Torino, Turin, Italy
| | - E Pozzi
- Department of Medical Sciences, University of Torino, Turin, Italy
| | - E Riberi
- Department of Medical Sciences, University of Torino, Turin, Italy
| | - P Ferrero
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - P Nigro
- Clinica Neurologica, Azienda Ospedaliera - Università di Perugia, Perugia, Italy
| | - A Mauro
- Department of Neurosciences, University of Torino, Turin, Italy
| | - M Zibetti
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - A Tessa
- Molecular Medicine, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - M Barghigiani
- Molecular Medicine, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - A Antenora
- Department of Neurosciences, Federico II University, Naples, Italy
| | - F Sirchia
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - S Piacentini
- Department of Neuroscience, Psychology, Drug Research and Child's Health, University of Florence, Florence, Italy
| | - G Silvestri
- Fondazione Policlinico Universitario IRCCS, A. Gemelli, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - G De Michele
- Department of Neurosciences, Federico II University, Naples, Italy
| | - A Filla
- Department of Neurosciences, Federico II University, Naples, Italy
| | - L Orsi
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - F M Santorelli
- Molecular Medicine, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - A Brusco
- Department of Medical Sciences, University of Torino, Turin, Italy.,Medical Genetics Unit, Città della Salute e della Scienza Hospital, Turin, Italy
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