Hsu Shao-Lun, Lu Yi-Jiun, Tsai Yu-Shuen, Chao Hua-Chuan, Fuh Jong-Ling, Liao Yi-Chu, Lee Yi-Chung
Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Neurology, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
J Formos Med Assoc. 2022 Jan;121(1 Pt 1):126-133. doi: 10.1016/j.jfma.2021.02.005. Epub 2021 Feb 24.
BACKGROUND/PURPOSE: Hereditary spastic paraplegia (HSP) is a heterogeneous group of inherited neurodegenerative disorders characterized by slowly progressive lower limbs spasticity and weakness. HSP type 15 (SPG15) is an autosomal recessive subtype caused by ZFYVE26 mutations. The aim of this study was to investigate the frequency and clinical and genetic features of ZFYVE26 mutations in a Taiwanese HSP cohort.
Mutational analysis of the coding regions of ZFYVE26 was performed by targeted resequencing in the 195 unrelated Taiwanese patients with HSP. All of the patients were of Han Chinese ethnicity. Clinical, neuropsychological, electrophysiological evaluations and imaging studies were collected.
Among the 195 patients, only one SPG15 patient was identified. The patient had a novel recessive ZFYVE26 frameshift truncating mutation, p.R1806Gfs∗36 (c.5415delC), and presented with insidious onset spastic weakness of lower-extremities and cognitive impairment. Neuropsychological assessment revealed deficits in executive function, visual naming, category verbal fluency, and manual dexterity. Brain MRI showed thin corpus callosum and the "ears of lynx" sign.
SPG15 accounts for approximately 0.5% (1/195) of the Taiwanese HSP cohort. This study identified the first Taiwanese SPG15 case and delineated the clinical, genetic, neuropsychological, and neuroimaging features. These findings expand the mutational spectrum of ZFYVE26 and also broaden the knowledge of clinical and neuropsychological characteristics of SPG15.
背景/目的:遗传性痉挛性截瘫(HSP)是一组异质性的遗传性神经退行性疾病,其特征为下肢痉挛和无力进行性加重。15型遗传性痉挛性截瘫(SPG15)是由ZFYVE26基因突变引起的常染色体隐性遗传亚型。本研究旨在调查台湾遗传性痉挛性截瘫队列中ZFYVE26基因突变的频率以及临床和遗传特征。
对195例无亲缘关系的台湾遗传性痉挛性截瘫患者进行靶向重测序,以分析ZFYVE26编码区的突变情况。所有患者均为汉族。收集患者的临床、神经心理学、电生理评估及影像学研究资料。
在195例患者中,仅鉴定出一例SPG15患者。该患者存在一种新的隐性ZFYVE26移码截断突变,即p.R1806Gfs∗36(c.5415delC),表现为隐匿起病的下肢痉挛性无力和认知障碍。神经心理学评估显示其执行功能、视觉命名、类别言语流畅性及手部灵活性存在缺陷。脑部磁共振成像显示胼胝体变薄及“猞猁耳”征。
SPG15在台湾遗传性痉挛性截瘫队列中约占0.5%(1/195)。本研究鉴定出首例台湾SPG15病例,并描述了其临床、遗传、神经心理学及神经影像学特征。这些发现扩展了ZFYVE26的突变谱,也拓宽了对SPG15临床及神经心理学特征的认识。