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CACNA1A Mutations Causing Early Onset Ataxia: Profiling Clinical, Dysmorphic and Structural-Functional Findings.


ABSTRACT: The CACNA1A gene encodes the pore-forming α1A subunit of the voltage-gated CaV2.1 Ca2+ channel, essential in neurotransmission, especially in Purkinje cells. Mutations in CACNA1A result in great clinical heterogeneity with progressive symptoms, paroxysmal events or both. During infancy, clinical and neuroimaging findings may be unspecific, and no dysmorphic features have been reported. We present the clinical, radiological and evolutionary features of three patients with congenital ataxia, one of them carrying a new variant. We report the structural localization of variants and their expected functional consequences. There was an improvement in cerebellar syndrome over time despite a cerebellar atrophy progression, inconsistent response to acetazolamide and positive response to methylphenidate. The patients shared distinctive facial gestalt: oval face, prominent forehead, hypertelorism, downslanting palpebral fissures and narrow nasal bridge. The two α1A affected residues are fully conserved throughout evolution and among the whole human CaV channel family. They contribute to the channel pore and the voltage sensor segment. According to structural data analysis and available functional characterization, they are expected to exert gain- (F1394L) and loss-of-function (R1664Q/R1669Q) effect, respectively. Among the CACNA1A-related phenotypes, our results suggest that non-progressive congenital ataxia is associated with developmental delay and dysmorphic features, constituting a recognizable syndromic neurodevelopmental disorder.

SUBMITTER: Martinez-Monseny AF 

PROVIDER: S-EPMC8153625 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

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<i>CACNA1A</i> Mutations Causing Early Onset Ataxia: Profiling Clinical, Dysmorphic and Structural-Functional Findings.

Martínez-Monseny Antonio F AF   Edo Albert A   Casas-Alba Dídac D   Izquierdo-Serra Mercè M   Bolasell Mercè M   Conejo David D   Martorell Loreto L   Muchart Jordi J   Carrera Laura L   Ortez Carlos I CI   Nascimento Andrés A   Oliva Baldo B   Fernández-Fernández José M JM   Serrano Mercedes M  

International journal of molecular sciences 20210513 10


The <i>CACNA1A</i> gene encodes the pore-forming α<sub>1A</sub> subunit of the voltage-gated Ca<sub>V</sub>2.1 Ca<sup>2+</sup> channel, essential in neurotransmission, especially in Purkinje cells. Mutations in <i>CACNA1A</i> result in great clinical heterogeneity with progressive symptoms, paroxysmal events or both. During infancy, clinical and neuroimaging findings may be unspecific, and no dysmorphic features have been reported. We present the clinical, radiological and evolutionary features  ...[more]

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