Large-Scale Screening: Phenotypic and Mutational Spectrum in Isolated and Combined Dystonia Genes.

GCH1 GNAL KMT2B PRKRA SGCE THAP1 TOR1A dystonia monogenic primary dystonia

Journal

Movement disorders : official journal of the Movement Disorder Society
ISSN: 1531-8257
Titre abrégé: Mov Disord
Pays: United States
ID NLM: 8610688

Informations de publication

Date de publication:
12 Jan 2024
Historique:
revised: 16 11 2023
received: 02 10 2023
accepted: 01 12 2023
medline: 12 1 2024
pubmed: 12 1 2024
entrez: 12 1 2024
Statut: aheadofprint

Résumé

Pathogenic variants in several genes have been linked to genetic forms of isolated or combined dystonia. The phenotypic and genetic spectrum and the frequency of pathogenic variants in these genes have not yet been fully elucidated, neither in patients with dystonia nor with other, sometimes co-occurring movement disorders such as Parkinson's disease (PD). To screen >2000 patients with dystonia or PD for rare variants in known dystonia-causing genes. We screened 1207 dystonia patients from Germany (DysTract consortium), Spain, and South Korea, and 1036 PD patients from Germany for pathogenic variants using a next-generation sequencing gene panel. The impact on DNA methylation of KMT2B variants was evaluated by analyzing the gene's characteristic episignature. We identified 171 carriers (109 with dystonia [9.0%]; 62 with PD [6.0%]) of 131 rare variants (minor allele frequency <0.005). A total of 52 patients (48 dystonia [4.0%]; four PD [0.4%, all with GCH1 variants]) carried 33 different (likely) pathogenic variants, of which 17 were not previously reported. Pathogenic biallelic variants in PRKRA were not found. Episignature analysis of 48 KMT2B variants revealed that only two of these should be considered (likely) pathogenic. This study confirms pathogenic variants in GCH1, GNAL, KMT2B, SGCE, THAP1, and TOR1A as relevant causes in dystonia and expands the mutational spectrum. Of note, likely pathogenic variants only in GCH1 were also found among PD patients. For DYT-KMT2B, the recently described episignature served as a reliable readout to determine the functional effect of newly identified variants. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Sections du résumé

BACKGROUND BACKGROUND
Pathogenic variants in several genes have been linked to genetic forms of isolated or combined dystonia. The phenotypic and genetic spectrum and the frequency of pathogenic variants in these genes have not yet been fully elucidated, neither in patients with dystonia nor with other, sometimes co-occurring movement disorders such as Parkinson's disease (PD).
OBJECTIVES OBJECTIVE
To screen >2000 patients with dystonia or PD for rare variants in known dystonia-causing genes.
METHODS METHODS
We screened 1207 dystonia patients from Germany (DysTract consortium), Spain, and South Korea, and 1036 PD patients from Germany for pathogenic variants using a next-generation sequencing gene panel. The impact on DNA methylation of KMT2B variants was evaluated by analyzing the gene's characteristic episignature.
RESULTS RESULTS
We identified 171 carriers (109 with dystonia [9.0%]; 62 with PD [6.0%]) of 131 rare variants (minor allele frequency <0.005). A total of 52 patients (48 dystonia [4.0%]; four PD [0.4%, all with GCH1 variants]) carried 33 different (likely) pathogenic variants, of which 17 were not previously reported. Pathogenic biallelic variants in PRKRA were not found. Episignature analysis of 48 KMT2B variants revealed that only two of these should be considered (likely) pathogenic.
CONCLUSION CONCLUSIONS
This study confirms pathogenic variants in GCH1, GNAL, KMT2B, SGCE, THAP1, and TOR1A as relevant causes in dystonia and expands the mutational spectrum. Of note, likely pathogenic variants only in GCH1 were also found among PD patients. For DYT-KMT2B, the recently described episignature served as a reliable readout to determine the functional effect of newly identified variants. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Identifiants

pubmed: 38214203
doi: 10.1002/mds.29693
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Bundesministerium für Bildung und Forschung
ID : 01GM1514B
Organisme : Deutsche Forschungsgemeinschaft
ID : LO1555/10-1

Informations de copyright

© 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Références

Albanese A, Bhatia K, Bressman SB, et al. Phenomenology and classification of dystonia: a consensus update. Mov Disord 2013;28:863-873. https://doi.org/10.1002/mds.25475
Zech M, Jech R, Boesch S, et al. Monogenic variants in dystonia: an exome-wide sequencing study. Lancet Neurol 2020;19:908-918. https://doi.org/10.1016/S1474-4422(20)30312-4
Lange LM, Gonzalez-Latapi P, Rajalingam R, et al. Nomenclature of genetic movement disorders: recommendations of the International Parkinson and Movement Disorder Society Task Force - an update. Mov Disord 2022;37:905-935. https://doi.org/10.1002/mds.28982
Thomsen M, Lange LM, Klein C, Lohmann K. MDSGene: extending the list of isolated dystonia genes by VPS16, EIF2AK2, and AOPEP. Mov Disord 2023;38:507-508. https://doi.org/10.1002/mds.29327
Lange LM, Junker J, Loens S, et al. Genotype-phenotype relations for isolated dystonia genes: MDSGene systematic review. Mov Disord 2021;36:1086-1103. https://doi.org/10.1002/mds.28485
Pérez-Dueñas B, Gorman K, Marcé-Grau A, et al. The genetic landscape of complex childhood-onset hyperkinetic movement disorders. Mov Disord 2022;37:2197-2209. https://doi.org/10.1002/mds.29182
Mencacci NE, Isaias IU, Reich MM, et al. International Parkinson's disease genomics consortium and UCL-exomes consortium, Parkinson's disease in GTP cyclohydrolase 1 mutation carriers. Brain 2014;137:2480-2492. https://doi.org/10.1093/brain/awu179
Weissbach A, Pauly MG, Herzog R, et al. Relationship of genotype, phenotype, and treatment in dopa-responsive dystonia: MDSGene review. Mov Disord 2022;37:237-252. https://doi.org/10.1002/mds.28874
Richards S, Aziz N, Bale S, et al. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med 2015;17:405-424. https://doi.org/10.1038/gim.2015.30
Kasten M, Hartmann C, Hampf J, et al. Genotype-phenotype relations for the Parkinson's disease genes parkin, PINK1, DJ1: MDSGene systematic review. Mov Disord 2018;33:730-741. https://doi.org/10.1002/mds.27352
Rentzsch P, Witten D, Cooper GM, Shendure J, Kircher M. CADD: predicting the deleteriousness of variants throughout the human genome. Nucleic Acids Res 2019;47:D886-D894. https://doi.org/10.1093/nar/gky1016
Lohmann K, Uflacker N, Erogullari A, et al. Identification and functional analysis of novel THAP1 mutations. Eur J Hum Genet 2012;20:171-175. https://doi.org/10.1038/ejhg.2011.159
Fuchs T, Saunders-Pullman R, Masuho I, et al. Mutations in GNAL cause primary torsion dystonia. Nat Genet 2013;45:88-92. https://doi.org/10.1038/ng.2496
Mirza-Schreiber N, Zech M, Wilson R, et al. Blood DNA methylation provides an accurate biomarker of KMT2B-related dystonia and predicts onset. Brain 2022;145:644-654. https://doi.org/10.1093/brain/awab360
Almeida LS, Pereira C, Aanicai R, et al. An integrated multiomic approach as an excellent tool for the diagnosis of metabolic diseases: our first 3720 patients. Eur J Hum Genet 2022;30:1029-1035. https://doi.org/10.1038/s41431-022-01119-5
Olschewski L, Jesús S, Kim H-J, et al. Role of ANO3 mutations in dystonia: a large-scale mutational screening study. Parkinsonism Relat Disord 2019;62:196-200. https://doi.org/10.1016/j.parkreldis.2018.12.030
Agaoglu NB, Unal B, Akgun Dogan O, et al. Consistency of variant interpretations among bioinformaticians and clinical geneticists in hereditary cancer panels. Eur J Hum Genet 2022;30:378-383. https://doi.org/10.1038/s41431-022-01060-7
Liu N, Li LL, Ruan YF, et al. Performance of interpreting the variants of long QT syndrome according ACMG guidelines by four clinical gene screening agencies from Beijing. Zhonghua Xin Xue Guan Bing Za Zhi 2018;46:857-861. https://doi.org/10.3760/cma.j.issn.0253-3758.2018.11.008
Vulinovic F, Lohmann K, Rakovic A, et al. Unraveling cellular phenotypes of novel TorsinA/TOR1A mutations. Hum Mutat 2014;35:1114-1122. https://doi.org/10.1002/humu.22604
Klein C, Baumann H, Olschewski L, et al. De-novo KMT2B mutation in a consanguineous family: 15-year follow-up of an Afghan dystonia patient. Parkinsonism Relat Disord 2019;64:337-339. https://doi.org/10.1016/j.parkreldis.2019.03.018
Dos Santos CO, da Silva-Júnior FP, Puga RD, et al. The prevalence of PRKRA mutations in idiopathic dystonia. Parkinsonism Relat Disord 2018;48:93-96. https://doi.org/10.1016/j.parkreldis.2017.12.015
Zech M, Jech R, Boesch S, et al. Scoring algorithm-based genomic testing in dystonia: a prospective validation study. Mov Disord 2021;36:1959-1964. https://doi.org/10.1002/mds.28614
Gorcenco S, Ilinca A, Almasoudi W, Kafantari E, Lindgren AG, Puschmann A. New generation genetic testing entering the clinic. Parkinsonism Relat Disord 2020;73:72-84. https://doi.org/10.1016/j.parkreldis.2020.02.015
Hettich J, Ryan SD, de Souza ON, et al. Biochemical and cellular analysis of human variants of the DYT1 dystonia protein, TorsinA/TOR1A. Hum Mutat 2014;35:1101-1113. https://doi.org/10.1002/humu.22602
da Silva-Junior FP, dos Santos CO, Silva SMCA, et al. Novel THAP1 variants in Brazilian patients with idiopathic isolated dystonia. J Neurol Sci 2014;344:190-192. https://doi.org/10.1016/j.jns.2014.06.012
Camargo CHF, Camargos ST, Raskin S, Cardoso FEC, Teive HAG. DYT6 in Brazil: genetic assessment and clinical characteristics of patients. Tremor Other Hyperkinet Mov 2014;4:226. https://doi.org/10.7916/D83776RC
Paudel R, Li A, Hardy J, Bhatia KP, Houlden H, Holton J. DYT6 dystonia: a neuropathological study. Neurodegener Dis 2016;16:273-278. https://doi.org/10.1159/000440863
Meyer E, Carss KJ, Rankin J, et al. Mutations in the histone methyltransferase gene KMT2B cause complex early-onset dystonia. Nat Genet 2017;49:223-237. https://doi.org/10.1038/ng.3740
Zech M, Boesch S, Maier EM, et al. Haploinsufficiency of KMT2B, encoding the lysine-specific histone methyltransferase 2B, results in early-onset generalized dystonia. Am J Hum Genet 2016;99:1377-1387. https://doi.org/10.1016/j.ajhg.2016.10.010
Pott H, Brüggemann N, Reese R, et al. Truncating VPS16 mutations are rare in early onset dystonia. Ann Neurol 2021;89:625-626. https://doi.org/10.1002/ana.25990
Kuipers DJS, Mandemakers W, Lu C-S, et al. EIF2AK2 missense variants associated with early onset generalized dystonia. Ann Neurol 2021;89:485-497. https://doi.org/10.1002/ana.25973
Zech M, Kumar KR, Reining S, et al. Biallelic AOPEP loss-of-function variants cause progressive dystonia with prominent limb involvement. Mov Disord 2022;37:137-147. https://doi.org/10.1002/mds.28804
Harrer P, Škorvánek M, Kittke V, et al. Dystonia linked to EIF4A2 haploinsufficiency: a disorder of protein translation dysfunction. Mov Disord 2023;38(10):1914-1924. https://doi.org/10.1002/mds.29562
Mencacci NE, Rubio-Agusti I, Zdebik A, et al. A missense mutation in KCTD17 causes autosomal dominant myoclonus-dystonia. Am J Hum Genet 2015;96:938-947. https://doi.org/10.1016/j.ajhg.2015.04.008
Keller Sarmiento IJ, Mencacci NE. Genetic Dystonias: update on classification and new genetic discoveries. Curr Neurol Neurosci Rep 2021;21:8. https://doi.org/10.1007/s11910-021-01095-1
Schmidt A, Altenmüller E, Jabusch H-C, Lee A, Wiegers K, Klein C, Lohmann K. The GAG deletion in Tor1A (DYT1) is a rare cause of complex musician's dystonia. Parkinsonism Relat Disord 2012;18:690-691. https://doi.org/10.1016/j.parkreldis.2011.12.008
Djarmati A, Schneider SA, Lohmann K, et al. Mutations in THAP1 (DYT6) and generalised dystonia with prominent spasmodic dysphonia: a genetic screening study. Lancet Neurol 2009;8:447-452. https://doi.org/10.1016/S1474-4422(09)70083-3
Hagenah J, Saunders-Pullman R, Hedrich K, et al. High mutation rate in dopa-responsive dystonia: detection with comprehensive GCHI screening. Neurology 2005;64:908-911. https://doi.org/10.1212/01.WNL.0000152839.50258.A2
Grünewald A, Djarmati A, Lohmann-Hedrich K, et al. Myoclonus-dystonia: significance of large SGCE deletions. Hum Mutat 2008;29:331-332. https://doi.org/10.1002/humu.9521

Auteurs

Mirja Thomsen (M)

Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.

Katrin Marth (K)

Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
Department of Neurology, University Hospital Rostock, Rostock, Germany.

Sebastian Loens (S)

Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
Institute of Systems Motor Science, CBBM, University of Lübeck, Lübeck, Germany.

Judith Everding (J)

Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Johanna Junker (J)

Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.

Friederike Borngräber (F)

Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Fabian Ott (F)

Medical Systems Biology Group, Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.

Silvia Jesús (S)

Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.

Mathias Gelderblom (M)

Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Thorsten Odorfer (T)

Department of Neurology, University Hospital Würzburg, Würzburg, Germany.

Gregor Kuhlenbäumer (G)

Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Han-Joon Kim (HJ)

Department of Neurology, Seoul National University Hospital, Seoul, South Korea.

Eva Schaeffer (E)

Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Jos Becktepe (J)

Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Meike Kasten (M)

Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
Department of Psychiatry, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.

Norbert Brüggemann (N)

Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.

Robert Pfister (R)

Neurological Practice, Neusäß, Germany.

Katja Kollewe (K)

Department of Neurology, Hannover Medical School, Hannover, Germany.

Joachim K Krauss (JK)

Department of Neurosurgery, Hannover Medical School, Hannover, Germany.

Ebba Lohmann (E)

Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
German Center for Neurodegenerative Diseases (DZNE)-Tübingen, Tübingen, Germany.

Frauke Hinrichs (F)

Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.

Daniela Berg (D)

Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Beomseok Jeon (B)

Department of Neurology, Seoul National University Hospital, Seoul, South Korea.

Hauke Busch (H)

Medical Systems Biology Group, Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.

Eckart Altenmüller (E)

Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Hanover, Germany.

Pablo Mir (P)

Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.
Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain.

Christoph Kamm (C)

Department of Neurology, University Hospital Rostock, Rostock, Germany.

Jens Volkmann (J)

Department of Neurology, University Hospital Würzburg, Würzburg, Germany.

Simone Zittel (S)

Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Andreas Ferbert (A)

Department of Neurology, Klinikum Kassel, Kassel, Germany.

Kirsten E Zeuner (KE)

Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Arndt Rolfs (A)

Medical Faculty, University of Rostock, Rostock, Germany.
Agyany Pharmaceuticals, Jerusalem, Israel.

Peter Bauer (P)

Centogene AG, Rostock, Germany.

Andrea A Kühn (AA)

Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Tobias Bäumer (T)

Institute of Systems Motor Science, CBBM, University of Lübeck, Lübeck, Germany.
Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
Center of Rare Diseases, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.

Christine Klein (C)

Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.

Katja Lohmann (K)

Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.

Classifications MeSH