Department of Neurology, Peking University First Hospital, Beijing, China.
Department of Neurology, Ulm University, Ulm, Germany.
Brain Behav. 2020 Sep;10(9):e01765. doi: 10.1002/brb3.1765. Epub 2020 Jul 16.
Genetic mutations associated with early-onset Parkinson's disease (EOPD) vary widely among different ethnicities. We detected the genes associated with EOPD in a Chinese cohort using next-generation sequencing (NGS) combined with multiplex ligation-dependent probe amplification (MLPA) and analyzed the phenotypic characteristics of the mutation carriers.
Cohort of 23 sporadic EOPD patients (onset age ≤ 45 years) were recruited. Genetic causes were identified by a targeted NGS panel containing 136 known extrapyramidal disease-causative genes. Multiplications or deletions of PD-causing genes were detected using the MLPA method. Demographic and clinical data were obtained, analyzed, and compared between patients with and those without Parkin gene variants.
We identified 14 pathogenic or likely pathogenic variants (12 in Parkin, 1 in LRRK2, and 1 in VPS13C) in 10 patients (43.5%) and 8 rare variants of uncertain significance in 9 patients (39.1%). Parkin (34.8%) was the most common causative gene among our patients cohort, and exon deletion (62.5%) was the main type of variant. Patients with Parkin mutations had a younger age of onset, longer delay in diagnosis, slower disease progression, higher frequency of hyperreflexia, fatigue, and less hyposmia compared to patients without Parkin mutations.
Our results revealed a higher prevalence of Parkin mutations in Chinese sporadic EOPD patients, and notably, exon deletion was the most common type of mutation. EOPD patients with Parkin mutations showed unique clinical characteristics.
早发性帕金森病(EOPD)相关的遗传突变在不同种族之间差异很大。我们使用下一代测序(NGS)结合多重连接依赖性探针扩增(MLPA)在中国队列中检测与 EOPD 相关的基因,并分析了突变携带者的表型特征。
招募了 23 例散发性 EOPD 患者(发病年龄≤45 岁)。通过包含 136 个已知锥体外系疾病致病基因的靶向 NGS 面板确定遗传原因。使用 MLPA 方法检测 PD 致病基因的扩增或缺失。收集患者的人口统计学和临床数据,并对携带和不携带 Parkin 基因突变的患者进行分析和比较。
我们在 10 名患者(43.5%)中发现了 14 种致病性或可能致病性变异(12 种在 Parkin 中,1 种在 LRRK2 中,1 种在 VPS13C 中),在 9 名患者(39.1%)中发现了 8 种罕见的意义不明的变异。Parkin(34.8%)是我们患者队列中最常见的致病基因,缺失外显子(62.5%)是主要的变异类型。与不携带 Parkin 基因突变的患者相比,携带 Parkin 基因突变的患者发病年龄更早,诊断延迟更长,疾病进展更慢,反射亢进、疲劳的频率更高,嗅觉减退的程度更低。
我们的结果表明,中国散发性 EOPD 患者中 Parkin 基因突变的发生率较高,特别是缺失外显子是最常见的突变类型。携带 Parkin 基因突变的 EOPD 患者表现出独特的临床特征。