J Mov Disord.  2017 Sep;10(3):116-122. 10.14802/jmd.17011.

Genetic Screening for Spinocerebellar Ataxia Genes in a Japanese Single-Hospital Cohort

Affiliations
  • 1Deparment of Neurology and Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan. sakakibara@sakura.med.toho-u.ac.jp
  • 2Deparment of Radiology, Sakura Medical Center, Toho University, Sakura, Japan.
  • 3Deparment of Gene Analysis, Chiba University, Chiba, Japan.
  • 4Deparment of Neurology, Chiba University, Chiba, Japan.

Abstract


OBJECTIVE
Diagnosis of sporadic cerebellar ataxia is a challenge for neurologists. A wide range of potential causes exist, including chronic alcohol use, multiple system atrophy of cerebellar type (MSA-C), and sporadic late cortical cerebellar atrophy. Recently, an autosomal-dominant spinocerebellar ataxia (SCA) mutation was identified in a cohort of patients with non-MSA-C sporadic cerebellar ataxia. The aim of this study is to genetically screen genes involved in SCA in a Japanese single-hospital cohort.
METHODS
Over an 8-year period, 140 patients with cerebellar ataxia were observed. There were 109 patients with sporadic cerebellar ataxia (no family history for at least four generations, 73 patients with MSA-C, and 36 patients with non-MSA-C sporadic cerebellar ataxia) and 31 patients with familial cerebellar ataxia. We performed gene analysis comprising SCA1, 2, 3, 6, 7, 8, 12, 17, 31, and dentatorubro-pallidoluysian atrophy (DRPLA) in 28 of 31 non-MSA-C sporadic patients who requested the test. Familial patients served as a control.
RESULTS
Gene abnormalities were found in 57% of non-MSA-C sporadic cerebellar ataxia cases. Among patients with sporadic cerebellar ataxia, abnormalities in SCA6 were the most common (36%), followed by abnormalities in SCA1 (7.1%), SCA2 (3.6%), SCA3 (3.6%), SCA8 (3.6%), and DRPLA (3.6%). In contrast, gene abnormalities were found in 75% of familial cerebellar ataxia cases, with abnormalities in SCA6 being the most common (29%). For sporadic versus familial cases for those with SCA6 abnormalities, the age of onset was older (69 years vs. 59 years, respectively), and CAG repeat length was shorter (23 vs. 25, respectively) in the former than in the latter (not statistically significant).
CONCLUSION
Autosomal-dominant mutations in SCA genes, particularly in SCA6, are not rare in sporadic cerebellar ataxia. The reason for the frequency of mutations in SCA6 remains unclear; however, the reason may reflect a higher age at onset and variable penetrance of SCA6 mutations.

Keyword

Sporadic; cerebellar ataxia; spinocerebellar ataxia type 6; heredity

MeSH Terms

Age of Onset
Asian Continental Ancestry Group*
Atrophy
Cerebellar Ataxia
Cohort Studies*
Diagnosis
Family Characteristics
Genetic Testing*
Heredity
Humans
Multiple System Atrophy
Penetrance
Spinocerebellar Ataxias*
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