Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
Department of Neurology, University of Lübeck, Lübeck, Germany.
Mov Disord. 2021 May;36(5):1086-1103. doi: 10.1002/mds.28485. Epub 2021 Jan 27.
This comprehensive MDSGene review is devoted to 7 genes - TOR1A, THAP1, GNAL, ANO3, PRKRA, KMT2B, and HPCA - mutations in which may cause isolated dystonia. It followed MDSGene's standardized data extraction protocol and screened a total of ~1200 citations. Phenotypic and genotypic data on ~1200 patients with 254 different mutations were curated and analyzed. There were differences regarding age at onset, site of onset, and distribution of symptoms across mutation carriers in all 7 genes. Although carriers of TOR1A, THAP1, PRKRA, KMT2B, or HPCA mutations mostly showed childhood and adolescent onset, patients with GNAL and ANO3 mutations often developed first symptoms in adulthood. GNAL and KMT2B mutation carriers frequently have 1 predominant site of onset, that is, the neck (GNAL) or the lower limbs (KMT2B), whereas site of onset in DYT-TOR1A, DYT-THAP1, DYT-ANO3, DYT-PRKRA, and DYT-HPCA was broader. However, in most DYT-THAP1 and DYT-ANO3 patients, dystonia first manifested in the upper half of the body (upper limb, neck, and craniofacial/laryngeal), whereas onset in DYT-TOR1A, DYT-PRKRA and DYT-HPCA was frequently observed in an extremity, including both upper and lower ones. For ANO3, a segmental/multifocal distribution was typical, whereas TOR1A, PRKRA, KMT2B, and HPCA mutation carriers commonly developed generalized dystonia. THAP1 mutation carriers presented with focal, segmental/multifocal, or generalized dystonia in almost equal proportions. GNAL mutation carriers rarely showed generalization. This review provides a comprehensive overview of the current knowledge of hereditary isolated dystonia. The data are also available in an online database (http://www.mdsgene.org), which additionally offers descriptive summary statistics. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
这篇全面的 MDSGene 综述专注于 7 个基因——TOR1A、THAP1、GNAL、ANO3、PRKRA、KMT2B 和 HPCA——这些基因突变可能导致孤立性肌张力障碍。它遵循 MDSGene 的标准化数据提取协议,共筛选了约 1200 篇参考文献。对约 1200 名患有 254 种不同突变的患者的表型和基因型数据进行了整理和分析。在所有 7 个基因中,突变携带者的发病年龄、发病部位和症状分布存在差异。虽然 TOR1A、THAP1、PRKRA、KMT2B 或 HPCA 突变携带者大多表现为儿童和青少年发病,但 GNAL 和 ANO3 突变携带者常于成年后出现首发症状。GNAL 和 KMT2B 突变携带者常以 1 个主要发病部位为首发,即颈部(GNAL)或下肢(KMT2B),而 DYT-TOR1A、DYT-THAP1、DYT-ANO3、DYT-PRKRA 和 DYT-HPCA 的发病部位更为广泛。然而,在大多数 DYT-THAP1 和 DYT-ANO3 患者中,肌张力障碍首先表现为上半身(上肢、颈部和颅面部/喉部),而 DYT-TOR1A、DYT-PRKRA 和 DYT-HPCA 的发病部位常发生在四肢,包括上下肢。ANO3 患者常表现为节段性/多灶性分布,而 TOR1A、PRKRA、KMT2B 和 HPCA 突变携带者常表现为全身性肌张力障碍。THAP1 突变携带者的局灶性、节段性/多灶性或全身性肌张力障碍的发病比例几乎相等。GNAL 突变携带者很少出现全身性表现。本综述全面概述了遗传性孤立性肌张力障碍的现有知识。这些数据也可在在线数据库(http://www.mdsgene.org)中获得,该数据库还提供描述性汇总统计信息。© 2021 作者。运动障碍由 Wiley 期刊出版公司代表国际帕金森病和运动障碍学会出版。