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GM1 gangliosidosis in adults: Clinical and molecular analysis of 16 Japanese patients
Author(s) -
Yoshida Kunihiro,
Oshima Akihiro,
Sakuraba Hitoshi,
Nakano Takeshi,
Yanagisawa Nobuo,
Inui Koji,
Okada Shintaro,
Uyama Eiichiro,
Namba Reiko,
Kondo Kiyohiko,
Iwasaki Shinichi,
Takamiya Kiyoshi,
Suzuki Yoshiyuki
Publication year - 1992
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410310316
Subject(s) - gangliosidosis , compound heterozygosity , allele , medicine , dystonia , myoclonus , heterozygote advantage , age of onset , genetic counseling , choreoathetosis , gastroenterology , endocrinology , pediatrics , genetics , biology , gene , disease , psychiatry
Clinical findings were compared with the results of molecular analysis in 16 Japanes patients from 10 unrelated families with the adult/chronic form of GM1 gangliosidosis. Age of onset ranged from 3 to 30 years. Major clinical manifestations were gait and speech disturbances caused by persistent muscle hypertonia. Dystonic postures and movements, facial grimacing, and parkinsonian manifestations were commonly seen. Cerebellar signs, myoclonus, severe intellectual impairment, dysmorphism, or visceromegaly were not observed. A common single‐base substitution, 51 Ile(ATC)→Thr(ACC) , reported in a previous study of ours, was confirmed in 14 patients by the Bsu 361 restriction site analysis; one was a compound heterozygote with another mutation ( 457 Agr{CGA}→ Gln{CAA} ) and the others were homozygotes of this mutation. Clinically, the compound‐heterozygous patient showed more severe neurological manifestations and a more rapid clinical course than those of homozygotes. The homozygotes showed considerable variations in the age of onset and subsequent clinical course. The 51 Ile→Thr mutant allele expressed a significant amount of β‐galactosidase activity, whereas the 457 Arg→Gln mutant allele extremely low activity in human GM1 gangliosidosis fibroblasts. We conclude that these gene mutations causing different residual enzyme activities are related to the severity of clinical manifestations, but some other genetic or environmental factors contribute to clinical heterogeneity. The Bsu 361 retriction site analysis was performed in 7 families and provided clear results for the diagnosis of heterozygotes as well as homozygotes of this specific clinical form of GM1 gangliosidosis. The technique is applicable to prenatal diagnosis and genetic counseling.