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Abstract
Objective: To investigate the clinical, genetic, and neuroradiologic presentations of idiopathic basal ganglia calcification (IBGC) in a nationwide study in Japan.
Methods: We documented clinical and neuroimaging data of a total of 69 subjects including 23 subjects from 10 families and 46 subjects in sporadic cases of IBGC in Japan. Mutational analysis of SLC20A2 was performed.
Results: Six new mutations in SLC20A2 were found in patients with IBGC: 4 missense mutations, 1 nonsense mutation, and 1 frameshift mutation. Four of them were familial cases and 2 were sporadic cases in our survey. The frequency of families with mutations in SLC20A2 in Japan was 50%, which was as high as in a previous report on other regions. The clinical features varied widely among the patients with SLC20A2 mutations. However, 2 distinct families have the same mutation of S637R in SLC20A2 and they have similar characteristics in the clinical course, symptoms, neurologic findings, and neuroimaging. In our study, all the patients with SLC20A2 mutations showed calcification. In familial cases, there were symptomatic and asymptomatic patients in the same family.
Conclusion: SLC20A2 mutations are a major cause of familial IBGC in Japan. The members in the families with the same mutation had similar patterns of calcification in the brain and the affected members showed similar clinical manifestations.
GLOSSARY
- DNTC=
- diffuse neurofibrillary tangles with calcification;
- FIBGC=
- familial idiopathic basal ganglia calcification;
- IBGC=
- idiopathic basal ganglia calcification;
- MMSE=
- Mini-Mental State Examination;
- PDGF=
- platelet-derived growth factor;
- PDGFRB=
- platelet-derived growth factor receptor-β;
- Pi=
- inorganic phosphate;
- PiB=
- Pittsburgh compound B;
- PiT=
- type III sodium-dependent phosphate transporter;
- PKC=
- paroxysmal kinesigenic choreoathetosis
Footnotes
↵* These authors contributed equally to this work.
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at www.neurology.org
- Received May 18, 2013.
- Accepted in final form November 15, 2013.
- © 2014 American Academy of Neurology
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