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Mutations in PRRT2 result in paroxysmal dyskinesias with marked variability in clinical expression
  1. Qing Liu1,
  2. Zhan Qi2,
  3. Xin-Hua Wan1,
  4. Jing-Yun Li2,
  5. Lei Shi2,
  6. Qiang Lu1,
  7. Xiang-Qin Zhou1,
  8. Lei Qiao1,
  9. Li-Wen Wu1,
  10. Xiu-Qin Liu1,
  11. Wei Yang2,
  12. Ying Liu2,
  13. Li-Ying Cui1,
  14. Xue Zhang1,2
  1. 1Department of Neurology and Center for Translational Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, China
  2. 2State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, CAMS & PUMC, Beijing, China
  1. Correspondence to Professor Xue Zhang, State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, 5 Dong Dan San Tiao, Beijing, China; xuezhang{at}pumc.edu.cn Professor Li-Ying Cui, Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 1 Shuaifuyuan, Beijing, China; pumchcly{at}yahoo.com.cn

Abstract

Background Paroxysmal dyskinesias (PDs), a clinically and genetically heterogeneous group of episodic movement disorders, include kinesigenic PD (PKD), exercise-induced PD (PED) and non-kinesigenic PD (PNKD). These disorders are all transmitted as autosomal dominant traits with incomplete penetrance. Several PD-related genetic disorders, including PKD and familial infantile convulsions with paroxysmal choreoathetosis (ICCA), mapped to the same region on chromosome 16. Independent genetic studies have recently revealed that PKD can be caused by loss-of-function mutations in the proline-rich transmembrane protein 2 gene (PRRT2). We tested the hypothesis that other forms of PDs are also due to PRRT2 mutations.

Methods/results The whole genomic region of PRRT2 was sequenced in six Han Chinese families and 15 sporadic cases of PD-related phenotypes. The previously reported mutation, c.649dupC (p.R217Pfs*7), was found in two families with PKD, one family with ICCA, one family with PNKD-like phenotype, and two sporadic cases with PED. In an additional ICCA family, a novel frameshift mutation, c.904dupG (p.D302Gfs*38), was identified. A missense mutation, c.913G→A (p.G305R), and a synonymous substitution, c.1011C→T (p.G337G), were also detected in two sporadic PKD cases.

Conclusion This study shows that PKD, ICCA and some other PD-related phenotypes are part of the same phenotypic spectrum, caused by mutations in PRRT2. This underscores the complexity of the phenotypic consequences of PRRT2 mutations.

  • Paroxysmal dyskinesia
  • paroxysmal kinesigenic dyskinesia
  • familial infantile convulsions with paroxysmal choreoathetosis
  • PRRT2
  • mutations
  • molecular genetics
  • genetic screening/counselling
  • dermatology
  • genetics
  • movement disorders (other than Parkinsons)
  • neurology
  • complex traits
  • epilepsy and seizures
  • genetics
  • linkage

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Footnotes

  • Funding This work was supported by the National Natural Science Foundation of China to QLiu (grant number 81100969), the Program for Changjiang Scholars and Innovative Research Team in University (PCSIRT) to XZ (grant number IRT1006) and a PUMCH fund to QLiu.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was approved by the ethics committee of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Primer sequences not given in the text are available upon request.

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