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Journal of Neurology
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Journal of Neurology
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Journal of Neurology
Article . 2021 . Peer-reviewed
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A de novo STUB1 variant associated with an early adult-onset multisystemic ataxia phenotype

Authors: David Mengel; Andreas Traschütz; Selina Reich; Alejandra Leyva-Gutiérrez; Friedemann Bender; Stefan Hauser; Tobias B. Haack; +1 Authors

A de novo STUB1 variant associated with an early adult-onset multisystemic ataxia phenotype

Abstract

Abstract Background Biallelic STUB1 variants are a well-established cause of autosomal-recessive early-onset multisystemic ataxia (SCAR16). Evidence for STUB1 variants causing autosomal-dominant ataxia (SCA48) so far largely relies on segregation data in larger families. Presenting the first de novo occurrence of a heterozygous STUB1 variant, we here present additional qualitative evidence for STUB1-disease as an autosomal-dominant disorder. Methods Whole exome sequencing on an index patient with sporadic early-onset ataxia, followed by Sanger sequencing in all family members, was used to identify causative variants as well as to rule out alternative genetic hits and intronic STUB1 variants. STUB1 mRNA and protein levels in PBMCs in all family members were analysed using qRT-PCR and Western Blot. Results A previously unreported start-lost loss-of-function variant c.3G>A in the start codon of STUB1 was identified in the index case, occurring de novo and without evidence for a second (potentially missed) variant (e.g., intronic or copy number) in STUB1. The patient showed an early adult-onset multisystemic ataxia complicated by spastic gait disorder, distal myoclonus and cognitive dysfunction, thus closely mirroring the systems affected in autosomal-recessive STUB1-associated disease. In line with the predicted start-lost effect of the variant, functional investigations demonstrated markedly reduced STUB1 protein expression in PBMCs, whereas mRNA levels were intact. Conclusion De novo occurrence of the loss-of-function STUB1 variant in our case with multisystemic ataxia provides a qualitatively additional line of evidence for STUB1-disease as an autosomal-dominant disorder, in which the same neurological systems are affected as in its autosomal-recessive counterpart. Moreover, this finding adds support for loss-of-function as a mechanism underlying autosomal-dominant STUB1-disease, thus mirroring its autosomal-recessive counterpart also in terms of the underlying mutational mechanism.

Countries
Germany, Germany
Keywords

SCA48 ; Ataxia ; Dominant ; Adult [MeSH] ; Humans [MeSH] ; Ataxia/genetics [MeSH] ; Spinocerebellar Ataxias [MeSH] ; Ubiquitin-Protein Ligases/genetics [MeSH] ; Cerebellar Ataxia [MeSH] ; CHIP ; Pedigree [MeSH] ; STUB1 ; Phenotype [MeSH] ; Early-onset ataxia ; Original Communication, genetics [Ubiquitin-Protein Ligases], Adult, Original Communication, Cerebellar Ataxia, CHIP, Ubiquitin-Protein Ligases, Early-onset ataxia, genetics [Ataxia], Pedigree, Phenotype, SCA48, Humans, Spinocerebellar Ataxias, Dominant, Ataxia, STUB1, ddc: ddc:610

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
12
Top 10%
Average
Top 10%
Green
hybrid