Dong Yi, Wu Jian-Jun, Wu Zhi-Ying
Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Department of Neurology and Institute of Neurology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Parkinsonism Relat Disord. 2015 Apr;21(4):398-401. doi: 10.1016/j.parkreldis.2015.01.006. Epub 2015 Jan 17.
Spinocerebellar ataxia type 12 (SCA12) is predominantly characterized by action tremor, followed by slowly progressive cerebellar dysfunction. It is a very rare disorder and only identified in certain countries so far. The current appreciation for phenotypic and genotypic features of SCA12 is still limited.
We investigated CAG copies within PPP2R2B in 29 patients with spinocerebellar ataxia who are excluded from the most common SCA subtypes including SCA1, SCA2, SCA3 and SCA6. The medical data of patients carrying abnormal expanded PPP2R2B allele were reviewed and summarized.
We found that 3 patients carried 53, 46 and 54 CAG repeats respectively, while the other 26 cases harbored CAG repeats less than 30. The probably shortest pathogenic allele of 46 repeats was detected in one kindred typically experiencing action tremor. Additionally, compared to the prominent cerebellar ataxia, nystagmus and dysphagia seem to be rare in our SCA12 patients.
SCA12 might not be as rare in Chinese as previously assumed. The identification of the shortest pathogenic allele helps to define the minimal limit implicated in the disease onset. Moreover, the disease manifestations distinct from other SCA subtypes could help clinicians to provide timely genetic counseling.
12型脊髓小脑共济失调(SCA12)主要特征为动作性震颤,其次是缓慢进展的小脑功能障碍。它是一种非常罕见的疾病,迄今为止仅在某些国家被发现。目前对SCA12表型和基因型特征的认识仍然有限。
我们调查了29例脊髓小脑共济失调患者中PPP2R2B基因的CAG重复序列,这些患者被排除在包括SCA1、SCA2、SCA3和SCA6在内的最常见SCA亚型之外。对携带异常扩增的PPP2R2B等位基因患者的医学数据进行了回顾和总结。
我们发现3例患者分别携带53、46和54个CAG重复序列,而其他26例患者的CAG重复序列少于30个。在一个典型表现为动作性震颤的家系中检测到可能最短的致病等位基因46个重复序列。此外,与明显的小脑共济失调相比,眼球震颤和吞咽困难在我们的SCA12患者中似乎较少见。
SCA12在中国可能不像以前认为的那么罕见。最短致病等位基因的鉴定有助于确定疾病发病所涉及的最小限度。此外,与其他SCA亚型不同的疾病表现可以帮助临床医生提供及时的遗传咨询。