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Distal hereditary motor neuronopathy as a new phenotype associated with variants in BAG3
Ist Teil von
Journal of neurology, 2024-02, Vol.271 (2), p.986-994
Ort / Verlag
Berlin/Heidelberg: Springer Berlin Heidelberg
Erscheinungsjahr
2024
Quelle
Springer Online Journals
Beschreibungen/Notizen
Objective
To describe a new phenotype associated with a novel variant in
BAG3
: autosomal dominant adult-onset distal hereditary motor neuronopathy.
Methods
This study enrolled eight affected individuals from a single family and included a comprehensive evaluation of the clinical phenotype, neurophysiologic testing, muscle MRI, muscle biopsy and western blot of BAG3 protein in skeletal muscle. Genetic workup included whole exome sequencing and segregation analysis of the detected variant in
BAG3
.
Results
Seven patients developed slowly progressive and symmetric distal weakness and atrophy of lower limb muscles, along with absent Achilles reflexes. The mean age of onset was 46 years. The neurophysiological examination was consistent with the diagnosis of distal motor neuronopathy. One 57-year-old female patient was minimally symptomatic. The pattern of inheritance was autosomal dominant, with one caveat: one female patient who was an obligate carrier of the variant died at the age of 73 years without exhibiting any muscle weakness. The muscle biopsies revealed neurogenic changes. A novel heterozygous truncating variant c.1513_1514insGGAC (p.Val505GlyfsTer6) in the gene
BAG3
was identified in all affected family members.
Conclusions
We report an autosomal dominant adult-onset distal hereditary motor neuronopathy with incomplete penetrance in women as a new phenotype related to a truncating variant in the
BAG3
gene. Our findings expand the phenotypic spectrum of
BAG3
-related disorders, which previously included dilated cardiomyopathy, myofibrillar myopathy and adult-onset Charcot-Marie-Tooth type 2 neuropathy. Variants in
BAG3
should be considered in the differential diagnosis of distal hereditary motor neuronopathies.