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- Title
Marked variation in clinical presentation and age of onset in a family with a heterozygous parkin mutation.
- Authors
Tan, Louis C.; Tanner, Caroline M.; Chen, Rong; Chan, Piu; Farrer, Matthew; Hardy, John; Langston, J. William
- Abstract
Parkin gene mutations have been detected in families with early-onset autosomal recessive parkinsonism. We report a novel heterozygous 40 base pair deletion in exon 3 of the parkin gene that increases the susceptibility of carriers to develop parkinsonism/dystonia and manifests remarkable variability in regard to age of onset and phenotype in a single family. After identifying the new mutation in the proband of this kindred, family members were contacted and evaluated by a movement disorders specialist using standardized protocols and prospectively set diagnostic criteria. Importantly, examining physicians and family members were blinded to the genetic testing. Five affected members in two generations carried the parkin mutation. The proband and one of his brothers had disease onset at 24 years of age while another brother had disease at age 44. One exhibited multi-focal dystonia and parkinsonism of 17 years duration, another suffered a unilateral slowly progressive parkinsonism over 13 years while the third suffered dystonia-parkinsonism of recent onset. A sibling pair in the preceding generation had mild previously undiagnosed parkinsonism. Clinicians should be aware that patients carrying a parkin gene mutation may present with dystonia-parkinsonism or very subtle parkinsonism with a markedly varied age of onset.
- Subjects
DIAGNOSIS of dementia; PARKINSON'S disease diagnosis; DYSTONIA; AGE distribution; COMPARATIVE studies; DEMENTIA; DIFFERENTIAL diagnosis; DISEASE susceptibility; ENZYMES; GENEALOGY; GENES; GENETICS; GENETIC techniques; RESEARCH methodology; MEDICAL cooperation; MOLECULAR structure; GENETIC mutation; NEUROLOGIC examination; PARKINSON'S disease; RESEARCH; PHENOTYPES; GENETIC testing; EVALUATION research; DISEASE progression; SEQUENCE analysis; DIAGNOSIS
- Publication
Movement Disorders, 2003, Vol 18, Issue 7, p758
- ISSN
0885-3185
- Publication type
journal article
- DOI
10.1002/mds.10432