POLR3A-related disorders: From spastic ataxia to generalised dystonia and long-term efficacy of deep brain stimulation.

Wai Yan Yau; Catherine Ashton; Eoin Mulroy; Thomas Foltynie; Patricia Limousin; Jana Vandrovcova; Kunal P Verma; Rick Stell; Mark Davis; Phillipa Lamont
Abstract
While biallelic POLR3A loss-of-function variants are traditionally linked to hypomyelinating leukodystrophy, patients with a specific splice variant c.1909+22G>A manifest as adolescent-onset spastic ataxia without overt leukodystrophy. In this study, we reported eight new cases, POLR3A-related disorder with c.1909+22 variant. One of these patients showed expanded phenotypic spectrum of generalised dystonia and her sister remained asymptomatic except for hypodontia. Two patients with dystonic arm tremor responded to deep brain stimulation. In our systemic literature review, we found that POLR3A-related disorder with c.1909+22 variant has attenuated disease severity but frequency of dystonia and upper limb tremor did not differ among genotypes.
Journal ANNALS OF CLINICAL AND TRANSLATIONAL NEUROLOGY
ISSN 2328-9503
Published 03 May 2024
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Pages
DOI 10.1002/acn3.52064
Type Journal Article
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