Genetic heterogeneity of motor neuropathies.

TitleGenetic heterogeneity of motor neuropathies.
Publication TypeJournal Article
Year of Publication2017
AuthorsBansagi, B, Griffin, H, Whittaker, RG, Antoniadi, T, Evangelista, T, Miller, J, Greenslade, M, Forester, N, Duff, J, Bradshaw, A, Kleinle, S, Boczonadi, V, Steele, H, Ramesh, V, Franko, E, Pyle, A, Lochmüller, H, Chinnery, PF, Horvath, R
JournalNeurology
Volume88
Issue13
Pagination1226-1234
Date Published2017 Mar 28
ISSN1526-632X
KeywordsAdolescent, Adult, Aged, Analysis of Variance, Charcot-Marie-Tooth Disease, Cohort Studies, Connexins, DNA Mutational Analysis, Electromyography, England, Family Health, Female, Genetic Heterogeneity, GTP Phosphohydrolases, Hereditary Sensory and Motor Neuropathy, Humans, Male, Middle Aged, Mitochondrial Proteins, Mutation, Myelin Proteins, Neural Conduction, Young Adult
Abstract

OBJECTIVE: To study the prevalence, molecular cause, and clinical presentation of hereditary motor neuropathies in a large cohort of patients from the North of England.

METHODS: Detailed neurologic and electrophysiologic assessments and next-generation panel testing or whole exome sequencing were performed in 105 patients with clinical symptoms of distal hereditary motor neuropathy (dHMN, 64 patients), axonal motor neuropathy (motor Charcot-Marie-Tooth disease [CMT2], 16 patients), or complex neurologic disease predominantly affecting the motor nerves (hereditary motor neuropathy plus, 25 patients).

RESULTS: The prevalence of dHMN is 2.14 affected individuals per 100,000 inhabitants (95% confidence interval 1.62-2.66) in the North of England. Causative mutations were identified in 26 out of 73 index patients (35.6%). The diagnostic rate in the dHMN subgroup was 32.5%, which is higher than previously reported (20%). We detected a significant defect of neuromuscular transmission in 7 cases and identified potentially causative mutations in 4 patients with multifocal demyelinating motor neuropathy.

CONCLUSIONS: Many of the genes were shared between dHMN and motor CMT2, indicating identical disease mechanisms; therefore, we suggest changing the classification and including dHMN also as a subcategory of Charcot-Marie-Tooth disease. Abnormal neuromuscular transmission in some genetic forms provides a treatable target to develop therapies.

DOI10.1212/WNL.0000000000003772
Alternate JournalNeurology
Citation Key10.1212/WNL.0000000000003772
PubMed ID28251916
PubMed Central IDPMC5373778
Grant List309548 / / European Research Council / International