Stevanin Giovanni, Hahn Valérie, Lohmann Ebba, Bouslam Naima, Gouttard Michel, Soumphonphakdy Caroline, Welter Marie-Laure, Ollagnon-Roman Elisabeth, Lemainque Arnaud, Ruberg Merle, Brice Alexis, Durr Alexandra
INSERM U289, Institut Fédératif de Recherche en Neuroscience, Assistance Publique Hôpitaux de Paris, Hôpital de al Salpêtrière, Paris, France.
Arch Neurol. 2004 Aug;61(8):1242-8. doi: 10.1001/archneur.61.8.1242.
Autosomal dominant cerebellar ataxias comprise a clinically, neuropathologically, and genetically heterogeneous group of neurodegenerative disorders. The vast majority of cases are caused by trinucleotide or pentanucleotide repeat expansions in 9 different genes. Spinocerebellar ataxia type 14 (SCA14) is a relatively pure form of autosomal dominant cerebellar ataxia mapped to chromosome 19q and caused by missense mutations in the gene encoding protein kinase C gamma (PRKCG), which are all located in the regulatory domain.
To identify new SCA14 families and to describe the associated phenotype.
We describe a new SCA14 family of French ancestry with 14 patients and 4 probably affected individuals. Linkage to the SCA14 locus was evaluated according to standard procedures using 5 markers covering the SCA14 candidate interval. All 18 exons of the PRKCG gene and splice junctions were screened with direct sequencing in the index patient.
Linkage to the SCA14 locus was established with lod scores greater than 3 in the interval between DNA segments D19S571 and D19S926. Direct sequencing of the PRKCG gene revealed a T-to-C transition in exon 18 responsible for a novel missense mutation, F643L, which mapped to a highly conserved amino acid of the catalytic domain of protein kinase C gamma. The mutation showed complete segregation with the disease phenotype, was present in all affected and probably affected individuals, and was not observed on 410 control chromosomes from healthy white subjects. Age at onset, assessed in 14 affected individuals, was broader than in previous reports and ranged from childhood to age 60 years. All affected patients had slowly progressive cerebellar ataxia frequently associated with brisk reflexes. Cognitive impairment was also a striking feature in this family and has not been reported previously. Interestingly, there was no axial myoclonus as reported in a Japanese SCA14 family, but electrophysiological recordings in a single patient showed diffuse myoclonus in the arms and legs.
We have identified a new SCA14 family with the first mutation (F643L) located in the catalytic domain of the enzyme. The wide range of ages at onset, the presence of myoclonus in the limbs, and the presence of cognitive impairment extend the phenotype associated with this genetic entity.
常染色体显性遗传性小脑共济失调是一组临床、神经病理学和遗传学上均具有异质性的神经退行性疾病。绝大多数病例由9个不同基因中的三核苷酸或五核苷酸重复扩增引起。14型脊髓小脑共济失调(SCA14)是常染色体显性遗传性小脑共济失调的一种相对单纯的类型,定位于19号染色体长臂,由编码蛋白激酶Cγ(PRKCG)的基因中的错义突变所致,这些突变均位于调节域。
鉴定新的SCA14家系并描述相关表型。
我们描述了一个有法国血统的新SCA14家系,其中有14例患者和4例可能受累个体。根据标准程序,使用覆盖SCA14候选区间的5个标记评估与SCA14位点的连锁关系。对先证者的PRKCG基因的所有18个外显子和剪接位点进行直接测序。
在DNA片段D19S571和D19S926之间的区间内,与SCA14位点的连锁关系得以确立,对数优势分数大于3。PRKCG基因的直接测序显示外显子18中有一个T到C的转换,导致一个新的错义突变F643L,该突变定位于蛋白激酶Cγ催化域的一个高度保守的氨基酸上。该突变与疾病表型完全共分离,存在于所有受累和可能受累个体中,在410条来自健康白人受试者的对照染色体上未观察到。对14例受累个体评估的发病年龄比以前的报告范围更广,从儿童期到60岁。所有受累患者均有缓慢进展的小脑共济失调,常伴有活跃的反射。认知障碍也是这个家系的一个显著特征,以前未见报道。有趣的是,该家系中没有像日本一个SCA14家系中报道的轴性肌阵挛,但对一名患者的电生理记录显示其手臂和腿部有弥漫性肌阵挛。
我们鉴定了一个新的SCA14家系,其首个突变(F643L)位于该酶的催化域。发病年龄范围广、肢体存在肌阵挛以及存在认知障碍扩展了与该遗传实体相关的表型。