Nóbrega Paulo R, R B de Paiva Anderson, Souza Katiane S, de Souza Jorge Luiz B, G S B Lima Pedro Lucas, da Silva Delson José, Pitombeira Milena Sales, Borges Viviennee K, Dias Daniel A, Bispo Luciana M, Santos Carolina F, Freua Fernando, Silva Paulo Diego S, Alves Isabela S, Portella Leonardo B, Cunha Paulina R, Salomao Rubens Paulo A, Pedroso José Luiz, Miyajima Veridiana P, Miyajima Fábio, Cali Elisa, Wade Charles, Sudarsanam Annapurna, O'Driscoll Mary, Hayton Tom, Barsottini Orlando G P, Klebe Stephan, Kok Fernando, Lucato Leandro Tavares, Houlden Henry, Depienne Christel, Lynch David S, Braga-Neto Pedro
Division of Neurology, Department of Clinical Medicine, Federal University of Ceara, Fortaleza, Ceara 60430-160, Brazil.
Neurogenetics Unit, Department of Neurology, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo 05403-000, Brazil.
Brain Commun. 2023 Oct 17;6(1):fcad273. doi: 10.1093/braincomms/fcad273. eCollection 2024.
Mutations in are a rare cause of autosomal recessive leucoencephalopathy with ataxia and specific imaging abnormalities. Very few cases have been reported to date. Here, we describe the clinical and imaging phenotype of 12 additional patients and expand the known phenotypic spectrum of this disorder. Informed consent was obtained for all patients. Patients underwent either whole-exome sequencing or focused/panel-based sequencing to identify variants. Twelve patients with biallelic variants are described. This includes three novel likely pathogenic missense variants. All patients demonstrated typical MRI changes, including hyperintensity on T-weighted images in the posterior limbs of the internal capsules, midbrain cerebral peduncles, middle cerebellar peduncles and cerebral white matter. Clinical features included a variable combination of ataxia, headache, spasticity, seizures and other symptoms with a broad range of age of onset. This report is now the largest case series of patients with -related leucoencephalopathy and reinforces the finding that, although the imaging appearance is uniform, the phenotypic expression of this disorder is highly heterogeneous. Our findings expand the phenotypic spectrum of -related leucoencephalopathy by adding prominent seizures, severe spastic paraplegia and developmental delay.
[基因名称]突变是常染色体隐性遗传性白质脑病伴共济失调及特定影像学异常的罕见病因。迄今为止,报道的病例极少。在此,我们描述了另外12例[基因名称]患者的临床及影像学表型,扩展了该疾病已知的表型谱。所有患者均获得了知情同意。患者接受了全外显子测序或基于靶向/基因 panel 的测序以鉴定变异。本文描述了12例具有双等位基因[基因名称]变异的患者。其中包括3个新的可能致病的错义变异。所有患者均表现出典型的磁共振成像(MRI)改变,包括内囊后肢、中脑大脑脚、小脑中脚及脑白质在 T2加权像上呈高信号。临床特征包括共济失调、头痛、痉挛、癫痫发作及其他症状的不同组合,发病年龄范围广泛。本报告是目前关于[基因名称]相关白质脑病最大的病例系列,强化了以下发现:尽管影像学表现一致,但该疾病的表型表达高度异质性。我们的研究结果通过增加显著的癫痫发作、严重的痉挛性截瘫及发育迟缓,扩展了[基因名称]相关白质脑病的表型谱。