Neurology-Genetics最新文献

{"title":"<i>SON</i>-Related Zhu-Tokita-Takenouchi-Kim Syndrome With Recurrent Hemiplegic Migraine: Putative Role of <i>PRRT2</i>.","authors":"Jordan Langford,&nbsp;Lana Vukadin,&nbsp;John C Carey,&nbsp;Lorenzo D Botto,&nbsp;Matt Velinder,&nbsp;Rong Mao,&nbsp;Christine E Miller,&nbsp;Francis Filloux,&nbsp;Eun-Young Erin Ahn","doi":"10.1212/NXG.0000000000200062","DOIUrl":"https://doi.org/10.1212/NXG.0000000000200062","url":null,"abstract":"<p><strong>Background and objectives: </strong>Zhu-Tokita-Takenouchi-Kim (ZTTK) syndrome (OMIM 617140) is a recently identified neurodevelopmental disorder caused by heterozygous loss-of-function (LoF) variants in <i>SON</i>. Because the SON protein functions as an RNA-splicing regulator, it has been shown that some clinical features of ZTTK syndrome can be attributed to abnormal RNA splicing. Several neurologic features have been observed in patients with ZTTK syndrome, including seizure/epilepsy and other EEG abnormalities. However, a relationship between <i>SON</i> LoF in ZTTK syndrome and hemiplegic migraine remains unknown.</p><p><strong>Methods: </strong>We identified a patient with a pathogenic variant in <i>SON</i> who shows typical clinical features of ZTTK syndrome and experienced recurrent episodes of hemiplegic migraine. To define clinical features, brain MRI and EEG during and after episodes of hemiplegic migraine were characterized. To identify molecular mechanisms for this clinical presentation, we investigated the impact of small interfering RNA (siRNA)-mediated <i>SON</i> knockdown on mRNA expression of the <i>CACNA1A</i>, <i>ATP1A2</i>, <i>SCN1A</i>, and <i>PRRT2</i> genes, known to be associated with hemiplegic migraine, by quantitative RT-PCR. Pre-mRNA splicing of <i>PRRT2</i> on <i>SON</i> knockdown was further examined by RT-PCR using primers targeting specific exons.</p><p><strong>Results: </strong>Recurrent episodes of hemiplegic migraine in our patient typically followed modest closed head injuries, and recurrent seizures occurred during the most severe of these episodes. Transient hemispheric cortical interstitial edema and asymmetric EEG slowing were identified during episodes. Our siRNA experiments revealed that <i>SON</i> knockdown significantly reduces <i>PRRT2</i> mRNA levels in U87MG and SH-SY5Y cell lines, although a reduction in <i>CACNA1A</i>, <i>ATP1A2</i>, and <i>SCN1A</i> mRNA expression was not observed. We further identified that <i>SON</i> knockdown leads to failure in intron 2 removal from <i>PRRT2</i> pre-mRNA, resulting in a premature termination codon that blocks the generation of functionally intact full-length PRRT2.</p><p><strong>Discussion: </strong>This report identifies recurrent hemiplegic migraine as a novel clinical manifestation of ZTTK syndrome, further characterizes this clinical feature, and provides evidence for downregulation of <i>PRRT2</i> caused by <i>SON</i> LoF as a mechanism causing hemiplegic migraine. Examination of the <i>SON</i> gene may be indicated in individuals with recurrent hemiplegic migraine.</p>","PeriodicalId":48613,"journal":{"name":"Neurology-Genetics","volume":"9 3","pages":"e200062"},"PeriodicalIF":3.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9c/0b/NXG-2023-000004.PMC10091367.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9736813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Stroke as a Clinical Manifestation of Zhu-Tokita-Takenouchi-Kim Syndrome: A Case Series.","authors":"Angie El-Said,&nbsp;Jorge Luis Morales,&nbsp;Gian Rossi,&nbsp;Neha Longani","doi":"10.1212/NXG.0000000000200072","DOIUrl":"https://doi.org/10.1212/NXG.0000000000200072","url":null,"abstract":"<p><strong>Objective: </strong>This study reports 2 unrelated individuals with Zhu-Tokita-Takenouchi-Kim (ZTTK) syndrome who presented with a metabolic stroke, which has not been commonly reported as a clinical manifestation of this syndrome.</p><p><strong>Methods: </strong>Two female children were identified after presenting to our institution with a metabolic stroke and carried a diagnosis of ZTTK syndrome because of their clinical characteristics and previous genetic testing demonstrating pathogenic variants in <i>SON</i>.</p><p><strong>Results: </strong>Both individuals presented with acute-onset left hemiplegia. They underwent workup, and corresponding metabolic stroke was identified on brain MRI. Both individuals recovered with good functional outcome. One individual was treated with l-arginine, ubiquinol, and levocarnitine. The other individual recovered without any intervention.</p><p><strong>Discussion: </strong>ZTTK syndrome is a rare condition caused by pathogenic variants in <i>SON</i>. This syndrome is characterized by global developmental delay, short stature, facial dysmorphisms, seizures, hypotonia, and brain abnormalities. A metabolic stroke has not been reported as a common manifestation. <i>SON</i> has been reported to play a role in mitochondrial function. This can explain why metabolic stroke can be seen in individuals with ZTTK syndrome. It is important to recognize that metabolic stroke can be a clinical manifestation of ZTTK syndrome because it carries clinical and therapeutic implications.</p>","PeriodicalId":48613,"journal":{"name":"Neurology-Genetics","volume":"9 3","pages":"e200072"},"PeriodicalIF":3.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/18/NXG-2023-000015.PMC10166595.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9507705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex 4q35 and 10q26 Rearrangements: A Challenge for Molecular Diagnosis of Patients With Facioscapulohumeral Dystrophy.","authors":"Megane Delourme,&nbsp;Chaix Charlene,&nbsp;Laurene Gerard,&nbsp;Benjamin Ganne,&nbsp;Pierre Perrin,&nbsp;Catherine Vovan,&nbsp;Karine Bertaux,&nbsp;Karine Nguyen,&nbsp;Rafaëlle Bernard,&nbsp;Frederique Magdinier","doi":"10.1212/NXG.0000000000200076","DOIUrl":"https://doi.org/10.1212/NXG.0000000000200076","url":null,"abstract":"<p><strong>Background and objectives: </strong>After clinical evaluation, the molecular diagnosis of type 1 facioscapulohumeral dystrophy (FSHD1) relies in most laboratories on the detection of a shortened D4Z4 array at the 4q35 locus by Southern blotting. In many instances, this molecular diagnosis remains inconclusive and requires additional experiments to determine the number of D4Z4 units or identify somatic mosaicism, 4q-10q translocations, and proximal p13E-11 deletions. These limitations highlight the need for alternative methodologies, illustrated by the recent emergence of novel technologies such as molecular combing (MC), single molecule optical mapping (SMOM), or Oxford Nanopore-based long-read sequencing providing a more comprehensive analysis of 4q and 10q loci. Over the last decade, MC revealed a further increasing complexity in the organization of the 4q and 10q distal regions in patients with FSHD with <i>cis</i>-duplication of D4Z4 arrays in approximately 1%-2% of cases.</p><p><strong>Methods: </strong>By using MC, we investigated in our center 2,363 cases for molecular diagnosis of FSHD. We also evaluated whether previously reported <i>cis</i>-duplications might be identified by SMOM using the Bionano EnFocus FSHD 1.0 algorithm.</p><p><strong>Results: </strong>In our cohort of 2,363 samples, we identified 147 individuals carrying an atypical organization of the 4q35 or 10q26 loci. Mosaicism is the most frequent category followed by <i>cis</i>-duplications of the D4Z4 array. We report here chromosomal abnormalities of the 4q35 or 10q26 loci in 54 patients clinically described as FSHD, which are not present in the healthy population. In one-third of the 54 patients, these rearrangements are the only genetic defect suggesting that they might be causative of the disease. By analyzing DNA samples from 3 patients carrying a complex rearrangement of the 4q35 region, we further showed that the SMOM direct assembly of the 4q and 10q alleles failed to reveal these abnormalities and lead to negative results for FSHD molecular diagnosis.</p><p><strong>Discussion: </strong>This work further highlights the complexity of the 4q and 10q subtelomeric regions and the need of in-depth analyses in a significant number of cases. This work also highlights the complexity of the 4q35 region and interpretation issues with consequences on the molecular diagnosis of patients or genetic counseling.</p>","PeriodicalId":48613,"journal":{"name":"Neurology-Genetics","volume":"9 3","pages":"e200076"},"PeriodicalIF":3.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10188231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9483869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autosomal Recessive Spinocerebellar Ataxia Type 9 With a Response to Phosphate Repletion: A Case Report.","authors":"Shotaro Haji,&nbsp;Ryosuke Miyamoto,&nbsp;Hiroyuki Morino,&nbsp;Yusuke Osaki,&nbsp;Seijiro Tsuji,&nbsp;Ichizo Nishino,&nbsp;Masahiro Abe,&nbsp;Yuishin Izumi","doi":"10.1212/NXG.0000000000200070","DOIUrl":"https://doi.org/10.1212/NXG.0000000000200070","url":null,"abstract":"<p><strong>Objective: </strong>Autosomal recessive spinocerebellar ataxia type 9 (SCAR9) has received attention due to its potential response to coenzyme Q10 (CoQ10) supplementation; however, the response has so far been limited and variable.</p><p><strong>Methods: </strong>We report a SCAR9 patient with severe hypophosphatemia who responded well to CoQ10 and phosphate repletion.</p><p><strong>Results: </strong>A 70-year-old man (the offspring of a consanguineous marriage) presented with cerebellar ataxia and intense fatigue after exercise. Whole-exome sequencing identified a novel homozygous deletion mutation (NM_020247.5:c.1218_1219del) in <i>COQ8A</i>. We thus diagnosed him with SCAR9. Supplementation of CoQ10 alleviated his symptoms, with the Scale for the Assessment and Rating of Ataxia (SARA) dropping from 16 to 14. During the course of the disease, he demonstrated continuous hypophosphatemia caused by renal phosphate wasting. Gait dysfunction due to weakness and eye movement was partially alleviated, and SARA dropped from 17 to 13 after phosphate repletion.</p><p><strong>Discussion: </strong>Phosphate repletion should be considered for patients with severe hypophosphatemia without any apparent subjective symptoms. In this case, phosphate repletion could have improved myopathy leading to partial improvement in the patient's symptoms. Further analyses regarding the association between COQ8A mutation and phosphate wasting are required to elucidate the detailed pathogenesis.</p><p><strong>Classification of evidence: </strong>This provides Class IV evidence. This is a single observational study without controls.</p>","PeriodicalId":48613,"journal":{"name":"Neurology-Genetics","volume":"9 3","pages":"e200070"},"PeriodicalIF":3.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/85/96/NXG-2023-000013.PMC10389171.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9922896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Aging and Alzheimer Disease-Associated Somatic Variations in Excitatory Neurons From the Human Frontal Cortex.","authors":"Meng Zhang,&nbsp;Gerard A Bouland,&nbsp;Henne Holstege,&nbsp;Marcel J T Reinders","doi":"10.1212/NXG.0000000000200066","DOIUrl":"https://doi.org/10.1212/NXG.0000000000200066","url":null,"abstract":"<p><strong>Background and objectives: </strong>With age, somatic mutations accumulated in human brain cells can lead to various neurologic disorders and brain tumors. Because the incidence rate of Alzheimer disease (AD) increases exponentially with age, investigating the association between AD and the accumulation of somatic mutation can help understand the etiology of AD.</p><p><strong>Methods: </strong>We designed a somatic mutation detection workflow by contrasting genotypes derived from whole-genome sequencing (WGS) data with genotypes derived from scRNA-seq data and applied this workflow to 76 participants from the Religious Order Study and the Rush Memory and Aging Project (ROSMAP) cohort. We focused only on excitatory neurons, the dominant cell type in the scRNA-seq data.</p><p><strong>Results: </strong>We identified 196 sites that harbored at least 1 individual with an excitatory neuron-specific somatic mutation (ENSM), and these 196 sites were mapped to 127 genes. The single base substitution (SBS) pattern of the putative ENSMs was best explained by signature SBS5 from the Catalogue of Somatic Mutations in Cancer (COSMIC) mutational signatures, a clock-like pattern correlating with the age of the individual. The count of ENSMs per individual also showed an increasing trend with age. Among the mutated sites, we found 2 sites tend to have more mutations in older individuals (16:6899517 [<i>RBFOX1</i>], <i>p</i> = 0.04; 4:21788463 [<i>KCNIP4</i>], <i>p</i> < 0.05). In addition, 2 sites were found to have a higher odds ratio to detect a somatic mutation in AD samples (6:73374221 [<i>KCNQ5</i>], <i>p</i> = 0.01 and 13:36667102 [<i>DCLK1</i>], <i>p</i> = 0.02). Thirty-two genes that harbor somatic mutations unique to AD and the <i>KCNQ5</i> and <i>DCLK1</i> genes were used for gene ontology (GO)-term enrichment analysis. We found the AD-specific ENSMs enriched in the GO-term \"vocalization behavior\" and \"intraspecies interaction between organisms.\" Of interest we observed both age-specific and AD-specific ENSMs enriched in the K⁺ channel-associated genes.</p><p><strong>Discussion: </strong>Our results show that combining scRNA-seq and WGS data can successfully detect putative somatic mutations. The putative somatic mutations detected from ROSMAP data set have provided new insights into the association of AD and aging with brain somatic mutagenesis.</p>","PeriodicalId":48613,"journal":{"name":"Neurology-Genetics","volume":"9 3","pages":"e200066"},"PeriodicalIF":3.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ca/87/NXG-2023-000009.PMC10136684.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9450006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exome Sequencing and Multigene Panel Testing in 1,411 Patients With Adult-Onset Neurologic Disorders.","authors":"Nika Schuermans,&nbsp;Hannah Verdin,&nbsp;Jody Ghijsels,&nbsp;Madeleine Hellemans,&nbsp;Elke Debackere,&nbsp;Elke Bogaert,&nbsp;Sofie Symoens,&nbsp;Leslie Naesens,&nbsp;Elien Lecomte,&nbsp;David Crosiers,&nbsp;Bruno Bergmans,&nbsp;Kristof Verhoeven,&nbsp;Bruce Poppe,&nbsp;Guy Laureys,&nbsp;Sarah Herdewyn,&nbsp;Tim Van Langenhove,&nbsp;Patrick Santens,&nbsp;Jan L De Bleecker,&nbsp;Dimitri Hemelsoet,&nbsp;Bart Dermaut","doi":"10.1212/NXG.0000000000200071","DOIUrl":"https://doi.org/10.1212/NXG.0000000000200071","url":null,"abstract":"<p><strong>Background and objectives: </strong>Owing to their extensive clinical and molecular heterogeneity, hereditary neurologic diseases in adults are difficult to diagnose. The current knowledge about the diagnostic yield and clinical utility of exome sequencing (ES) for neurologic diseases in adults is limited. This observational study assesses the diagnostic value of ES and multigene panel analysis in adult-onset neurologic disorders.</p><p><strong>Methods: </strong>From January 2019 through April 2022, ES-based multigene panel testing was conducted in 1,411 patients with molecularly unexplained neurologic phenotypes at the Ghent University Hospital. Gene panels were developed for ataxia and spasticity, leukoencephalopathy, movement disorders, paroxysmal episodic disorders, neurodegeneration with brain iron accumulation, progressive myoclonic epilepsy, and amyotrophic lateral sclerosis. Single nucleotide variants, small indels, and copy number variants were analyzed. Across all panels, our analysis covered a total of 725 genes associated with Mendelian inheritance.</p><p><strong>Results: </strong>A molecular diagnosis was established in 10% of the cases (144 of 1,411) representing 71 different monogenic disorders. The diagnostic yield depended significantly on the presenting phenotype with the highest yield seen in patients with ataxia or spastic paraparesis (19%). Most of the established diagnoses comprised disorders with an autosomal dominant inheritance (62%), and the most frequently mutated genes were <i>NOTCH3</i> (13 patients), <i>SPG7</i> (11 patients), and <i>RFC1</i> (8 patients). 34% of the disease-causing variants were novel, including a unique likely pathogenic variant in <i>APP</i> (Ghent mutation, p.[Asn698Asp]) in a family presenting with stroke and severe cerebral white matter disease. 7% of the pathogenic variants comprised copy number variants detected in the ES data and confirmed by an independent technique.</p><p><strong>Discussion: </strong>ES and multigene panel testing is a powerful and efficient tool to diagnose patients with unexplained, adult-onset neurologic disorders.</p>","PeriodicalId":48613,"journal":{"name":"Neurology-Genetics","volume":"9 3","pages":"e200071"},"PeriodicalIF":3.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9f/97/NXG-2023-000014.PMC10160959.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9763297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative Genetic Score and <i>C9orf72</i> Repeat Status Independently Contribute to Amyotrophic Lateral Sclerosis Risk in 2 Case-Control Studies.","authors":"John Dou, Kelly Bakulski, Kai Guo, Junguk Hur, Lili Zhao, Sara Saez-Atienzar, Ali Stark, Ruth Chia, Alberto García-Redondo, Ricardo Rojas-Garcia, Juan Francisco Vázquez Costa, Ruben Fernandez Santiago, Sara Bandres-Ciga, Pilar Gómez-Garre, Maria Teresa Periñán, Pablo Mir, Jordi Pérez-Tur, Fernando Cardona, Manuel Menendez-Gonzalez, Javier Riancho, Daniel Borrego-Hernández, Lucia Galán-Dávila, Jon Infante Ceberio, Pau Pastor, Carmen Paradas, Oriol Dols-Icardo, Bryan J Traynor, Eva L Feldman, Stephen A Goutman","doi":"10.1212/NXG.0000000000200079","DOIUrl":"10.1212/NXG.0000000000200079","url":null,"abstract":"<p><strong>Background and objectives: </strong>Most patients with amyotrophic lateral sclerosis (ALS) lack a monogenic mutation. This study evaluates ALS cumulative genetic risk in an independent Michigan and Spanish replication cohort using polygenic scores.</p><p><strong>Methods: </strong>Participant samples from University of Michigan were genotyped and assayed for the chromosome 9 open reading frame 72 hexanucleotide expansion. Final cohort size was 219 ALS and 223 healthy controls after genotyping and participant filtering. Polygenic scores excluding the C9 region were generated using an independent ALS genome-wide association study (20,806 cases, 59,804 controls). Adjusted logistic regression and receiver operating characteristic curves evaluated the association and classification between polygenic scores and ALS status, respectively. Population attributable fractions and pathway analyses were conducted. An independent Spanish study sample (548 cases, 2,756 controls) was used for replication.</p><p><strong>Results: </strong>Polygenic scores constructed from 275 single-nucleotide variation (SNV) had the best model fit in the Michigan cohort. An SD increase in ALS polygenic score associated with 1.28 (95% CI 1.04-1.57) times higher odds of ALS with area under the curve of 0.663 vs a model without the ALS polygenic score (<i>p</i> value = 1 × 10^-6). The population attributable fraction of the highest 20th percentile of ALS polygenic scores, relative to the lowest 80th percentile, was 4.1% of ALS cases. Genes annotated to this polygenic score enriched for important ALS pathomechanisms. Meta-analysis with the Spanish study, using a harmonized 132 single nucleotide variation polygenic score, yielded similar logistic regression findings (odds ratio: 1.13, 95% CI 1.04-1.23).</p><p><strong>Discussion: </strong>ALS polygenic scores can account for cumulative genetic risk in populations and reflect disease-relevant pathways. If further validated, this polygenic score will inform future ALS risk models.</p>","PeriodicalId":48613,"journal":{"name":"Neurology-Genetics","volume":"9 4","pages":"e200079"},"PeriodicalIF":3.1,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10245939/pdf/NXG-2023-000022.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9882357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acknowledgment to Reviewers","authors":"Stefan M. Pulst","doi":"10.1212/nxg.0000000000200080","DOIUrl":"https://doi.org/10.1212/nxg.0000000000200080","url":null,"abstract":"On behalf of all handling editors we wish to acknowledge the individuals who have completed reviews for the journal from January 2022 until February 28, 2023. The thoughtful comments and insights are essential for scientific publishing, highly appreciated, and imperative for excellence in the field of neurogenetics. We are also grateful for your cooperation in returning reviews in a timely manner. Please find the guidelines for reviewing articles on the Neurology® Genetics website at [ng.neurology.org/][1]. This page provides information on expectations of reviewers regarding confidentiality, timeliness, and reviewer conflicts of interest; it also provides instructions for formatting the comments to editors and authors to enable the most effective communication with authors. [1]: https://ng.neurology.org/","PeriodicalId":48613,"journal":{"name":"Neurology-Genetics","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136380714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parent-of-Origin Effect on the Age at Symptom Onset in Myotonic Dystrophy Type 2.","authors":"Paloma Gonzalez-Perez,&nbsp;Eleonora S D'Ambrosio,&nbsp;Vincent Picher-Martel,&nbsp;Kathy Chuang,&nbsp;William S David,&nbsp;Anthony A Amato","doi":"10.1212/NXG.0000000000200073","DOIUrl":"10.1212/NXG.0000000000200073","url":null,"abstract":"<p><strong>Background and objectives: </strong>The existence of clinical anticipation, congenital form, and parent-of-origin effect in myotonic dystrophy type 2 (DM2) remains uncertain. Here, we aimed at investigating whether there is a parent-of-origin effect on the age at the first DM2-related clinical manifestation.</p><p><strong>Methods: </strong>We identified patients with genetically confirmed DM2 with known parental inheritance from (1) the electronic medical records of our institutions and (2) a systematic review of the literature following the PRISMA 2020 guidelines and recorded their age at and type of first disease-related symptom. We also interrogated the Myotonic Dystrophy Foundation Family Registry (MDFFR) for patients with DM2 who completed a survey including questions about parental inheritance and age at the first medical problem which they related to their DM2 diagnosis.</p><p><strong>Results: </strong>A total of 26 patients with DM2 from 18 families were identified at our institutions as having maternal (n = 14) or paternal (n = 12) inheritance of the disease, whereas our systematic review of the literature rendered a total of 61 patients with DM2 from 41 families reported by 24 eligible articles as having maternal (n = 40) or paternal (n = 21) inheritance of the disease. Both cohorts were combined for downstream analyses. Up to 61% and 58% of patients had muscle-related symptoms as the first disease manifestation in maternally and paternally inherited DM2 subgroups, respectively. Four patients developed hypotonia at birth and/or delayed motor milestones early in life, and 7 had nonmuscular presentations (2 had cardiac events within the second decade of life and 5 had cataracts), all of them with maternal inheritance. A maternal inheritance was associated with an earlier (within the first 3 decades of life) age at symptom onset relative to a paternal inheritance in this combined cohort, and this association was independent of the patient's sex (OR [95% CI] = 4.245 [1.429-13.820], <i>p</i> = 0.0117). However, this association was not observed in the MDFFR DM2 cohort (n = 127), possibly because age at onset was self-reported, and the information about the type of first symptom or medical problem that patients related to DM2 was lacking.</p><p><strong>Discussion: </strong>A maternal inheritance may increase the risk of an early DM2 onset and of cataracts and cardiovascular events as first DM2 manifestations.</p>","PeriodicalId":48613,"journal":{"name":"Neurology-Genetics","volume":"9 3","pages":"e200073"},"PeriodicalIF":3.1,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/f8/NXG-2023-000016.PMC10136683.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9746637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Features and Classification of Neuronal Intranuclear Inclusion Disease.","authors":"Hongfei Tai,&nbsp;An Wang,&nbsp;Yumei Zhang,&nbsp;Shaocheng Liu,&nbsp;Yunzhu Pan,&nbsp;Kai Li,&nbsp;Guixian Zhao,&nbsp;Mengwen Wang,&nbsp;Guode Wu,&nbsp;Songtao Niu,&nbsp;Hua Pan,&nbsp;Bin Chen,&nbsp;Wei Li,&nbsp;Xingao Wang,&nbsp;Gehong Dong,&nbsp;Wei Li,&nbsp;Ying Zhang,&nbsp;Sheng Guo,&nbsp;Xiaoyun Liu,&nbsp;Mingxia Li,&nbsp;Hui Liang,&nbsp;Ming Huang,&nbsp;Wei'an Chen,&nbsp;Zaiqiang Zhang","doi":"10.1212/NXG.0000000000200057","DOIUrl":"https://doi.org/10.1212/NXG.0000000000200057","url":null,"abstract":"<p><strong>Background and objectives: </strong>Neuronal intranuclear inclusion body disease (NIID) is a neurodegenerative disease with highly heterogeneous clinical manifestations. The present study aimed to characterize clinical features and propose a classification system based on a large cohort of NIID in China.</p><p><strong>Methods: </strong>The Chinese NIID registry was launched from 2017, and participants' demographics and clinical features were recorded. Brain MRI, skin pathologies, and the number of GGC repeat expansions in the 5' untranslated region of the <i>NOTCH2NLC</i> gene were evaluated in all patients.</p><p><strong>Results: </strong>In total, 223 patients (64.6% female) were recruited; the mean (SD) onset age was 56.7 (10.3) years. The most common manifestations were cognitive impairment (78.5%) and autonomic dysfunction (70.9%), followed by episodic symptoms (51.1%), movement disorders (50.7%), and muscle weakness (25.6%). Imaging markers included hyperintensity signals along the corticomedullary junction on diffusion-weighted imaging (96.6%), white matter lesions (98.1%), paravermis (55.0%), and focal cortical lesions (10.1%). The median size of the expanded GGC repeats in these patients was 115 (range, 70-525), with 2 patients carrying >300 GGC repeats. A larger number of GGC repeats was associated with younger age at onset (<i>r</i> = -0.329, <i>p</i> < 0.0001). According to the proposed clinical classification based on the most prominent manifestations, the patients were designated into 5 distinct types: cognitive impairment-dominant type (34.1%, n = 76), episodic neurogenic event-dominant type (32.3%, n = 72), movement disorder-dominant type (17.5%, n = 39), autonomic dysfunction-dominant type (8.5%, n = 19), and neuromuscular disease-dominant type (7.6%, n = 17). Notably, 32.3% of the episodic neurogenic event-dominant type of NIID has characteristic focal cortical lesions on brain MRI presenting localized cortical edema or atrophy. The mean onset age of the neuromuscular disease-dominant type was 47.2 (17.6) years, younger than the other types (<i>p</i> < 0.001). There was no significant difference in the sizes of GGC repeats among the patients in the 5 types (<i>p</i> = 0.547, Kruskal-Wallis test).</p><p><strong>Discussion: </strong>This observational study of NIID establishes an overall picture of the disease regarding clinical, imaging, and genetic characteristics. The proposed clinical classification of NIID based on the most prominent manifestation divides patients into 5 types.</p>","PeriodicalId":48613,"journal":{"name":"Neurology-Genetics","volume":"9 2","pages":"e200057"},"PeriodicalIF":3.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/86/00/NXG-2022-200061.PMC10117695.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9393051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}