Early Onset Ataxia with Comorbid Dystonia: Clinical, Anatomical and Biological Pathway Analysis Expose Shared Pathophysiology

Research output: Contribution to journalArticle

Abstract

In degenerative adult onset ataxia (AOA), dystonic comorbidity is attributed to one disease continuum. However, in early adult onset ataxia (EOA), the prevalence and pathogenesis of dystonic comorbidity (EOAD+), are still unclear. In 80 EOA-patients, we determined the EOAD+-prevalence in association with MRI-abnormalities. Subsequently, we explored underlying biological pathways by genetic network and functional enrichment analysis. We checked pathway-outcomes in specific EOAD+-genotypes by comparing results with non-specifically (in-silico-determined) shared genes in up-to-date EOA, AOA and dystonia gene panels (that could concurrently cause ataxia and dystonia). In the majority (65%) of EOA-patients, mild EOAD+-features concurred with extra-cerebellar MRI abnormalities (at pons and/or basal-ganglia and/or thalamus (p = 0.001)). Genetic network and functional enrichment analysis in EOAD+-genotypes indicated an association with organelle- and cellular-component organization (important for energy production and signal transduction). In non-specifically, in-silico-determined shared EOA, AOA and dystonia genes, pathways were enriched for Krebs-cycle and fatty acid/lipid-metabolic processes. In frequently occurring EOAD+-phenotypes, clinical, anatomical and biological pathway analyses reveal shared pathophysiology between ataxia and dystonia, associated with cellular energy metabolism and network signal transduction. Insight in the underlying pathophysiology of heterogeneous EOAD+-phenotype-genotype relationships supports the rationale for testing with complete, up-to-date movement disorder gene lists, instead of single EOA gene-panels.

Details

Authors
  • Deborah A Sival
  • Martinica Garofalo
  • Rick Brandsma
  • Tom A Bokkers
  • Marloes van den Berg
  • Tom J de Koning
  • Marina A J Tijssen
  • Dineke S Verbeek
External organisations
  • Hanze University of Applied Sciences
  • Beatrix Children's Hospital
  • University Medical Center Groningen
  • Fox Chase Cancer Center
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Physiology
  • Medical and Health Sciences
Original languageEnglish
JournalDiagnostics
Volume10
Issue number12
Publication statusPublished - 2020 Nov 24
Publication categoryResearch
Peer-reviewedYes
Externally publishedYes