Stendel, C.* ; Neuhofer, C.* ; Floride, E.* ; Yuqing, S.* ; Ganetzky, R.D.* ; Park, J.* ; Freisinger, P.* ; Kornblum, C.* ; Kleinle, S.* ; Schöls, L.* ; Distelmaier, F.* ; Stettner, G.M.* ; Büchner, B.* ; Falk, M.J.* ; Mayr, J.A.* ; Synofzik, M.* ; Abicht, A.* ; Haack, T.B.* ; Prokisch, H. ; Wortmann, S.B. ; Murayama, K.* ; Fang, F.* ; Klopstock, T.*
     
 
    
        
Delineating MT-ATP6-associated disease.
    
    
        
    
    
        
        Neurol. Genet. 6:e393 (2020)
    
    
    
		
		
			
				ObjectiveTo delineate the phenotypic and genotypic spectrum in carriers of mitochondrial MT-ATP6 mutations in a large international cohort.MethodsWe analyzed in detail the clinical, genetical, and neuroimaging data from 132 mutation carriers from national registries and local databases from Europe, USA, Japan, and China.ResultsWe identified 113 clinically affected and 19 asymptomatic individuals with a known pathogenic MT-ATP6 mutation. The most frequent mutations were m.8993 T > G (53/132, 40%), m.8993 T > C (30/132, 23%), m.9176 T > C (30/132, 23%), and m.9185 T > C (12/132, 9%). The degree of heteroplasmy was high both in affected (mean 95%, range 20%-100%) and unaffected individuals (mean 73%, range 20%-100%). Age at onset ranged from prenatal to the age of 75 years, but almost half of the patients (49/103, 48%) became symptomatic before their first birthday. In 28 deceased patients, the median age of death was 14 months. The most frequent symptoms were ataxia (81%), cognitive dysfunction (49%), neuropathy (48%), seizures (37%), and retinopathy (14%). A diagnosis of Leigh syndrome was made in 55% of patients, whereas the classic syndrome of neuropathy, ataxia, and retinitis pigmentosa (NARP) was rare (8%).ConclusionsIn this currently largest series of patients with mitochondrial MT-ATP6 mutations, the phenotypic spectrum ranged from asymptomatic to early onset multisystemic neurodegeneration. The degree of mutation heteroplasmy did not reliably predict disease severity. Leigh syndrome was found in more than half of the patients, whereas classic NARP syndrome was rare. Oligosymptomatic presentations were rather frequent in adult-onset patients, indicating the need to include MT-ATP6 mutations in the differential diagnosis of both ataxias and neuropathies.
			
			
				
			
		 
		
			
				
					
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        Publikationstyp
        Artikel: Journalartikel
    
 
    
        Dokumenttyp
        Wissenschaftlicher Artikel
    
 
    
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        Herausgeber
        
    
    
        Schlagwörter
        Leigh-syndrome; Mitochondrial; Mutation; Ataxia; Neuropathy; Insights; Defects
    
 
    
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        Sprache
        englisch
    
 
    
        Veröffentlichungsjahr
        2020
    
 
    
        Prepublished im Jahr 
        
    
 
    
        HGF-Berichtsjahr
        2020
    
 
    
    
        ISSN (print) / ISBN
        2376-7839
    
 
    
        e-ISSN
        2376-7839
    
 
    
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	    Band: 6,  
	    Heft: 1,  
	    Seiten: ,  
	    Artikelnummer: e393 
	    Supplement: ,  
	
    
 
  
        
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            Verlag
            American Academy of Neurology
        
 
        
            Verlagsort
            Minneapolis, Minn.
        
 
	
        
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        Begutachtungsstatus
        Peer reviewed
    
 
     
    
        POF Topic(s)
        30501 - Systemic Analysis of Genetic and Environmental Factors that Impact Health
    
 
    
        Forschungsfeld(er)
        Genetics and Epidemiology
    
 
    
        PSP-Element(e)
        G-500700-001
    
 
    
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        Erfassungsdatum
        2020-05-19