Mental deficiency in three families with SPG4 spastic paraplegia.
Mutations and deletions in the SPG4 gene are responsible for up to 40% of autosomal dominant hereditary spastic paraplegia (HSP). Patients have pyramidal signs in the lower limbs and some present additional features including cognitive impairment such as executive dysfunction or subcortical dementia. We report 13 patients from three SPG4 families, who had spastic paraplegia associated with mental retardation (n=1), extensive social dependence (n=10), or isolated psychomotor delay (n=2). In family FSP-698, 10 affected individuals had both HSP and mental deficiency leading to social dependence in 9 and institutionalization in 5. The mean age at onset of spastic paraplegia was 11+/-20 years, ranging from 1 to 51 years. This phenotype segregated either with a novel p.Glu442Lys mutation or the two previously described p.Arg459Thr and p.Arg499Cys substitutions in the SPG4 gene. Since two of these mutations were previously reported in families with a pure form of the disease, another genetic factor linked to SPG4 could be responsible for this complex phenotype.
Ribaï
Pascale
P
Department of Genetics and Cytogenetics, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Depienne
Christel
C
Fedirko
Estelle
E
Jothy
Anne-Catherine
AC
Viveweger
Caterine
C
Hahn-Barma
Valérie
V
Brice
Alexis
A
Durr
Alexandra
A
D000251:Adenosine Triphosphatases / Q000235:genetics*; D000328:Adult; D019943:Amino Acid Substitution; D005260:Female; D005799:Genes, Dominant; D006239:Haplotypes; D006801:Humans; D008607:Intellectual Disability / Q000150:complications / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D020125:Mutation, Missense; D010375:Pedigree; D010641:Phenotype; D017354:Point Mutation; D015419:Spastic Paraplegia, Hereditary / Q000150:complications / Q000235:genetics* / Q000503:physiopathology / Q000523:psychology; D000074181:Spastin
D000251:Adenosine Triphosphatases; D000074181:Spastin; C400283:SPAST protein, human