title: Familial multisystem degeneration with parkinsonism associated with the 11778 mitochondrial DNA mutation.
abstract: OBJECTIVE
  To investigate a family with maternally inherited, adult-onset multisystem degeneration including prominent parkinsonism to determine whether clinical features can result from a mitochondrial DNA (mtDNA) mutation. The parkinsonism was levodopa responsive and was associated with the loss of pigmented neurons in the substantia nigra in at least one patient.
  
  
  BACKGROUND
  Mitochondrial dysfunction is hypothesized to play a role in late-onset neurodegenerative diseases including PD and AD. Mitochondrial genetic mutations are hypothesized to account for these defects, but attempts to identify specific mtDNA mutations have been inconclusive.
  
  
  METHODS
  Clinical examinations, DNA sequencing, and restriction digestion and biochemical analyses were performed.
  
  
  RESULTS
  Maternal relatives harbor a G-to-A missense mutation, heteroplasmic in some patients, at nucleotide position 11778 of the mitochondrial ND4 gene of complex I that converts a highly conserved arginine to a histidine. Sequencing of the entire mitochondrial genome in an affected family member reveals no other mutations likely to be pathogenic. This mutation has been identified previously only in families with Leber's hereditary optic neuropathy-a disorder also linked to complex I dysfunction but usually limited clinically to optic atrophy.
  
  
  CONCLUSIONS
  These data reveal previously unsuspected clinical heterogeneity of the G11778A mutation, and suggest that an inherited mtDNA mutation can contribute to the development of adult-onset parkinsonism and multisystem degeneration.
authors.affiliation: Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02115, USA.
authors.forename: D K
authors.initials: DK
authors.lastname: Simon
authors.forename: S M
authors.initials: SM
authors.lastname: Pulst
authors.forename: J P
authors.initials: JP
authors.lastname: Sutton
authors.forename: S E
authors.initials: SE
authors.lastname: Browne
authors.forename: M F
authors.initials: MF
authors.lastname: Beal
authors.forename: D R
authors.initials: DR
authors.lastname: Johns
mesh_terms: D001483:Base Sequence / Q000235:genetics; D001921:Brain / Q000473:pathology; D004272:DNA, Mitochondrial / Q000235:genetics*; D005260:Female; D016678:Genome; D006801:Humans; D008297:Male; D008875:Middle Aged; D020734:Parkinsonian Disorders / Q000235:genetics* / Q000473:pathology; D010375:Pedigree; D017354:Point Mutation / Q000235:genetics*
chemical_list: D004272:DNA, Mitochondrial