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CYP7B1: novel mutations and magnetic resonance spectroscopy abnormalities in hereditary spastic paraplegia type 5A

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UNLABELLED: The SPG5A subtype of Hereditary Spastic Paraplegia (HSP) is a rare autosomal recessive neurodegenerative disorder caused by mutations in the CYP7B1 gene, which encodes a steroid cytochrome P450 7α-hydroxylase. This enzyme provides the primary metabolic route for neurosteroids. Clinically, SPG5A has been characterized as a pure form of HSP with a variable age of onset, but recently a broader spectrum of phenotypes has been described.

OBJECTIVE: This study characterizes four unrelated SPG5A patients through clinical evaluation.

METHODS: The investigations included blood biochemistry, electrophysiology, brain MRI and MR spectroscopy.

RESULTS: One patient had saccadic pursuit eye movements in addition to a pure HSP phenotype. Motor evoked potential (MEP) examinations revealed prolonged central conduction time. MRI of the brain showed white matter hyperintensities (WMH) in one patient. MRS showed elevated mI/Cr ratio in white matter in two patients; in the one patient with WMH and in one patient with normal MRI. Four novel mutations were identified; one frameshift (c.509 delT p.L170fs), one premature stop codon (c.334 C>T p.R112X), one amino acid changing (c.440 G>A p.G147D) and one duplication (c.945_947 dupGGC p.A316AA).

CONCLUSION: SPG5A could be characterized as a predominantly pure HSP. MRS showing elevated mI/Cr ratio in the white matter may be indicative of SPG5A.

Original languageEnglish
JournalActa Neurologica Scandinavica
Volume129
Issue number5
Pages (from-to)330-4
Number of pages5
ISSN0001-6314
DOIs
Publication statusPublished - May 2014

    Research areas

  • Adolescent, Adult, Brain, Cohort Studies, DNA Mutational Analysis, Evoked Potentials, Motor, Evoked Potentials, Somatosensory, Female, Humans, Magnetic Resonance Imaging, Magnetic Resonance Spectroscopy, Middle Aged, Mutation, Nerve Fibers, Myelinated, Neural Conduction, Spastic Paraplegia, Hereditary, Steroid Hydroxylases, Young Adult

ID: 44892458