J Clin Neurol.  2014 Jan;10(1):50-54.

Clinical Manifestations in Paroxysmal Kinesigenic Dyskinesia Patients with Proline-Rich Transmembrane Protein 2 Gene Mutation

Affiliations
  • 1Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jinwhan.cho@samsung.com changski@skku.edu
  • 2Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3Department of Neurology, Soonchunhyang University College of Medicine, Seoul, Korea.
  • 4Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jinwhan.cho@samsung.com changski@skku.edu

Abstract

BACKGROUND AND PURPOSE
Given the diverse phenotypes including combined non-dyskinetic symptoms in patients harboring mutations of the gene encoding proline-rich transmembrane protein 2 (PRRT2), the clinical significance of these mutations in paroxysmal kinesigenic dyskinesia (PKD) is questionable. In this study, we investigated the clinical characteristics of PKD patients with PRRT2 mutations.
METHODS
Familial and sporadic PKD patients were enrolled and PRRT2 gene sequencing was performed. Demographic and clinical data were compared between PKD patients with and without a PRRT2 mutation.
RESULTS
Among the enrolled PKD patients (8 patients from 5 PKD families and 19 sporadic patients), PRRT2 mutations were detected in 3 PKD families (60%) and 2 sporadic cases (10.5%). All familial patients with a PRRT2 gene mutation had the c.649dupC mutation, which is the most commonly reported mutation. Two uncommon mutations (c.649delC and c.629dupC) were detected only in the sporadic cases. PKD patients with PRRT2 mutation were younger at symptom onset and had more non-dyskinetic symptoms than those without PRRT2 mutation. However, the characteristics of dyskinetic movement did not differ between the two groups.
CONCLUSIONS
This is the first study of PRRT2 mutations in Korea. The presence of a PRRT2 mutation was more strongly related to familial PKD, and was clinically related with earlier age of onset and common non-dyskinetic symptoms in PKD patients.

Keyword

paroxysmal dyskinesia; paroxysmal; dyskinesia; chorea; dystonia; PRRT2

MeSH Terms

Age of Onset
Chorea
Dyskinesias*
Dystonia
Humans
Korea
Phenotype

Figure

  • Fig. 1 The pedigrees of five Korean PKD families. Filled and open symbols indicate relatives with and without PKD, respectively. *Subjects who underwent PRRT2 gene mutation analysis, #Subjects with PRRT2 gene mutation. PKD: Paroxysmal kinesigenic dyskinesia, PRRT2: proline-rich transmembrane protein 2.


Reference

1. Goodenough DJ, Fariello RG, Annis BL, Chun RW. Familial and acquired paroxysmal dyskinesias. A proposed classification with delineation of clinical features. Arch Neurol. 1978; 35:827–831.
2. Katschnig P, Schwingenschuh P, Chaudhary UJ, Edwards MJ, Lemieux L, Walker MC, et al. Paroxysmal limb dyskinesia induced by weight: an unusual case of cortical reflex seizures. Mov Disord. 2011; 26:2438–2439.
Article
3. Kertesz A. Paroxysmal kinesigenic choreoathetosis An entity within the paroxysmal choreoathetosis syndrome. Description of 10 cases, including 1 autopsied. Neurology. 1967; 17:680–690.
Article
4. Chen WJ, Lin Y, Xiong ZQ, Wei W, Ni W, Tan GH, et al. Exome sequencing identifies truncating mutations in PRRT2 that cause paroxysmal kinesigenic dyskinesia. Nat Genet. 2011; 43:1252–1255.
Article
5. Li J, Zhu X, Wang X, Sun W, Feng B, Du T, et al. Targeted genomic sequencing identifies PRRT2 mutations as a cause of paroxysmal kinesigenic choreoathetosis. J Med Genet. 2012; 49:76–78.
Article
6. Liu XR, Wu M, He N, Meng H, Wen L, Wang JL, et al. Novel PRRT2 mutations in paroxysmal dyskinesia patients with variant inheritance and phenotypes. Genes Brain Behav. 2013; 12:234–240.
Article
7. Méneret A, Grabli D, Depienne C, Gaudebout C, Picard F, Dürr A, et al. PRRT2 mutations: a major cause of paroxysmal kinesigenic dyskinesia in the European population. Neurology. 2012; 79:170–174.
Article
8. van Vliet R, Breedveld G, de Rijk-van Andel J, Brilstra E, Verbeek N, Verschuuren-Bemelmans C, et al. PRRT2 phenotypes and penetrance of paroxysmal kinesigenic dyskinesia and infantile convulsions. Neurology. 2012; 79:777–784.
Article
9. Liu Q, Qi Z, Wan XH, Li JY, Shi L, Lu Q, et al. Mutations in PRRT2 result in paroxysmal dyskinesias with marked variability in clinical expression. J Med Genet. 2012; 49:79–82.
Article
10. Lee YC, Lee MJ, Yu HY, Chen C, Hsu CH, Lin KP, et al. PRRT2 mutations in paroxysmal kinesigenic dyskinesia with infantile convulsions in a Taiwanese cohort. PLoS One. 2012; 7:e38543.
Article
11. Groffen AJ, Klapwijk T, van Rootselaar AF, Groen JL, Tijssen MA. Genetic and phenotypic heterogeneity in sporadic and familial forms of paroxysmal dyskinesia. J Neurol. 2013; 260:93–99.
Article
12. Bruno MK, Hallett M, Gwinn-Hardy K, Sorensen B, Considine E, Tucker S, et al. Clinical evaluation of idiopathic paroxysmal kinesigenic dyskinesia: new diagnostic criteria. Neurology. 2004; 63:2280–2287.
Article
13. Heron SE, Grinton BE, Kivity S, Afawi Z, Zuberi SM, Hughes JN, et al. PRRT2 mutations cause benign familial infantile epilepsy and infantile convulsions with choreoathetosis syndrome. Am J Hum Genet. 2012; 90:152–160.
Article
14. Gardiner AR, Bhatia KP, Stamelou M, Dale RC, Kurian MA, Schneider SA, et al. PRRT2 gene mutations: from paroxysmal dyskinesia to episodic ataxia and hemiplegic migraine. Neurology. 2012; 79:2115–2121.
Article
15. Sheerin UM, Stamelou M, Charlesworth G, Shiner T, Spacey S, Valente EM, et al. Migraine with aura as the predominant phenotype in a family with a PRRT2 mutation. J Neurol. 2013; 260:656–660.
Article
16. Tan LC, Methawasin K, Teng EW, Ng AR, Seah SH, Au WL, et al. Clinico-genetic comparisons of paroxysmal kinesigenic dyskinesia patients with and without PRRT2 mutations. Eur J Neurol. 2013; [Epub ahead of print].
Article
17. Li HF, Chen WJ, Ni W, Wang KY, Liu GL, Wang N, et al. PRRT2 mutation correlated with phenotype of paroxysmal kinesigenic dyskinesia and drug response. Neurology. 2013; 80:1534–1535.
Article
18. Houser MK, Soland VL, Bhatia KP, Quinn NP, Marsden CD. Paroxysmal kinesigenic choreoathetosis: a report of 26 patients. J Neurol. 1999; 246:120–126.
Article
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