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A Novel Homozygous Variant in the MCOLN1 Gene Associated With Severe Oromandibular Dystonia and Parkinsonism

Published online by Cambridge University Press:  27 March 2024

Aida Ghasemi
Affiliation:
Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Genetics research center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
Mahdieh Eslami Ardakani
Affiliation:
Neurology Ward, School of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Mansoureh Togha
Affiliation:
Neurology Ward, School of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Narges Yazdi
Affiliation:
Department of Neurology, School of Medicine, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
Anthony E. Lang
Affiliation:
Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada Edmond J. Safra Program in Parkinson’s Disease and the Morton and Gloria Shulman. Movement Disorders Clinic, Toronto Western Hospital and Division of Neurology, Toronto, ON, Canada Krembil Brain Institute, University Health Network, Toronto, ON, Canada
Elahe Amini
Affiliation:
Department of Neurology, School of Medicine, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Skull Base Research Center, The Five Senses Health Institute Iran University of Medical Sciences, Tehran, Iran
Mohammad Rohani
Affiliation:
Department of Neurology, School of Medicine, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
Afagh Alavi*
Affiliation:
Genetics research center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
*
Corresponding author: A. Alavi; Email: afaghalavi@gmail.com

Abstract

Background:

Mucolipidosis type IV (MLIV) is a rare, progressive lysosomal storage disorder characterized by severe intellectual disability, delayed motor milestones and ophthalmologic abnormalities. MLIV is an autosomal recessive disease caused by mutations in the MCOLN1 gene, encoding mucolipin-1 which is responsible for maintaining lysosomal function.

Objectives and Methods:

Here, we report a family of four Iranian siblings with cognitive decline, progressive visual and pyramidal disturbances, and abnormal movements manifested by severe oromandibular dystonia and parkinsonism. MRI scans of the brain demonstrated signal abnormalities in the white matter and thinning of the corpus callosum.

Results and Conclusions:

Whole-exome sequencing identified a novel homozygous variant, c.362C > T:p. Thr121Met in the MCOLN1 gene consistent with a diagnosis of MLIV. The presentation of MLIV may overlap with a variety of other neurological diseases, and genetic analysis is an important strategy to clarify the diagnosis. This is an important point that clinicians should be familiar with. The novel variant c.362C > T:p. Thr121Met herein described may be related to a comparatively older age at onset. Our study also expands the clinical spectrum of MLIV associated with the MCOLN1 variants and introduces a novel likely pathogenic variant for testing in MLIV cases that remain unresolved.

Résumé

RÉSUMÉ

Un tout nouveau variant homozygote du gène MCOLN1 associé à une dystonie oromandibulaire grave et au parkinsonisme

Contexte :

La mucolipidose de type IV (ML IV) est une maladie de surcharge lysosomale rare et évolutive, qui se caractérise par un déficit intellectuel grave, un retard des étapes du développement moteur et des anomalies oculaires. La ML IV est une maladie autosomique récessive, causée par des mutations du gène MCOLN1, qui code la mucolipine1, responsable du maintien de la fonction lysosomale.

Objectif et méthode :

Sera présentée, dans l’article, l’histoire d’une famille iranienne, comptant une fratrie de quatre membres atteints d’un déclin cognitif, de troubles visuels et pyramidaux progressifs et de mouvements anormaux qui se manifestent par une dystonie oromandibulaire grave et du parkinsonisme. Les examens par IRM du cerveau ont révélé des anomalies de la transmission des signaux dans la substance blanche et un amincissement du corps calleux.

Résultats et conclusion :

Grâce au séquençage de l’exome entier, l’équipe a découvert un tout nouveau variant homozygote, c.362C>T :p. Thr121Met, du gène MCOLN1, qui se montre compatible avec le diagnostic de la ML IV. Le tableau clinique de la ML IV peut coïncider avec celui de plusieurs autres maladies du système nerveux, et une analyse génétique représente une stratégie primordiale afin de clarifier le diagnostic. Il s’agit là d’un point important que devraient bien connaître les médecins. Le tout nouveau variant c.362C>T :p. Thr121Met ici décrit pourrait commencer à se manifester à un âge plus avancé que d’autres gènes du groupe. L’étude a aussi permis d’élargir le champ clinique de la ML IV associée aux variants MCOLN1 et présente un tout nouveau variant, probablement pathogène, à soumettre à des tests dans les cas non résolus de ML IV.

Type
Original Article
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation

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