title: Clinical features, DYT1 mutation screening and genotype-phenotype correlation in patients with dystonia from Iran.
abstract: OBJECTIVE
  To test Iranian patients with primary torsion dystonia to determine the frequency of 904-906 del GAG mutation in the DYT1 (TOR1A) gene and to investigate the genotype-phenotype association for this disease.
  
  
  METHODS
  Sixty-three patients with primary dystonia were investigated. DNA was extracted from peripheral blood and these samples were subjected to PCR-sequencing for exon 5 of the DYT1 gene.
  
  
  RESULTS
  Of the 63 patients, 10 (15.9%) carried the triplet GAG deletion mutation; this is a high DYT1-positive rate in comparison with other populations and the type of dystonia in this positive group was generalized in all except 1. In our patients, limbs were the most severely involved site at the time of onset and in most cases it developed to generalized form. The majority of DYT1-positive cases showed higher leg onset (5 patients, 62.5%) in comparison with higher arm onset in negative patients (20 patients, 50%). Also, the progression to generalized dystonia in DYT1-positive patients was significantly higher than in DYT1-negative patients. The mean age at onset was 8.6 ± 1.6 years (7-12 years) in DYT1-positive patients, while mean age at onset in patients with no GAG deletion mutation was higher (15.7 ± 11.5 years).
  
  
  CONCLUSIONS
  The DYT1 904-906 del GAG mutation is responsible for some of Iranian dystonia patients, and screening for the DYT1 deletion is significant in cases with the generalized type of primary dystonia. Also, patients with leg or arm onset at a younger age are more likely to be DYT1-positive among primary torsion dystonia cases.
authors.affiliation: Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
authors.forename: Mohammad Taghi
authors.initials: MT
authors.lastname: Akbari
authors.forename: Zahra
authors.initials: Z
authors.lastname: Zand
authors.forename: Gholam Ali
authors.initials: GA
authors.lastname: Shahidi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Hamid
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D004421:Dystonia / Q000145:classification / Q000453:epidemiology* / Q000235:genetics*; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease / Q000453:epidemiology; D005820:Genetic Testing; D005838:Genotype; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D018832:Molecular Chaperones / Q000235:genetics*; D010641:Phenotype; D016133:Polymerase Chain Reaction; D017384:Sequence Deletion
chemical_list: D018832:Molecular Chaperones; C108175:TOR1A protein, human