Clinical and Molecular Spectrum of Autosomal Recessive CA8-Related Cerebellar Ataxia.
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Kaiyrzhanov Rauan, Ortigoza-Escobar Juan Darío, Stringer Brett W, Ganieva Manizha, Gowda Vykuntaraju K, Srinivasan Varunvenkat M, Macaya Alfons, Laner Andreas, Onbool Enas, Al-Shammari Randa, Al-Owain Mohammed, Deconinck Nicolas, Vilain Catheline, Dontaine Pauline, Self Eleanor, Akram Rabia, Hussain Ghulam, Baig Shahid Mahmood, Iqbal Javed, Salpietro Vincenzo, Neshatdoust Maedeh, Kasiri Mahboubeh, Yesil Gozde, Uygur Turkan, Pysden Karen, Berry Ian R, Alves Cesar Augusto, Giacomotto Jean, Houlden Henry, Maroofian Reza
Аннотация
OBJECTIVES: We aim to comprehensively investigate CA8-related disorders (CA8-RD) by reviewing existing literature and exploring neurological, neuroradiological, and molecular observations in a cohort of newly identified patients.
METHODS: We analyzed the phenotype of 27 affected individuals from 14 families with biallelic CA8 variants (including data from 15 newly identified patients from eight families), ages 4 to 35 years. Clinical, genetic, and radiological assessments were performed, and zebrafish models with ca8 knockout were used for functional analysis.
RESULTS: Patients exhibited varying degrees of neurodevelopmental disorders (NDD), along with predominantly progressive cerebellar ataxia and pyramidal signs and variable bradykinesia, dystonia, and sensory impairment. Quadrupedal gait was present in only 10 of 27 patients. Progressive selective cerebellar atrophy, predominantly affecting the superior vermis, was a key diagnostic finding in all patients. Seven novel homozygous CA8 variants were identified. Zebrafish models demonstrated impaired early neurodevelopment and motor behavior on ca8 knockout.
CONCLUSION: Our comprehensive analysis of phenotypic features indicates that CA8-RD exhibits a wide range of clinical manifestations, setting it apart from other subtypes within the category of CAMRQ. CA8-RD is characterized by cerebellar atrophy and should be recognized as part of the autosomal-recessive cerebellar ataxias associated with NDD. Notably, the presence of progressive superior vermis atrophy serves as a valuable diagnostic indicator. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.