PT  - JOURNAL ARTICLE
AU  - L. Saint-Val
AU  - T. Courtin
AU  - P. Charles
AU  - C. Verny
AU  - M. Catala
AU  - R. Schiffmann
AU  - O. Boespflug-Tanguy
AU  - F. Mochel
TI  - <em>GJA1</em> Variants Cause Spastic Paraplegia Associated with Cerebral Hypomyelination
AID  - 10.3174/ajnr.A6036
DP  - 2019 May 01
TA  - American Journal of Neuroradiology
PG  - 788--791
VI  - 40
IP  - 5
4099  - http://www.ajnr.org/content/40/5/788.short
4100  - http://www.ajnr.org/content/40/5/788.full
SO  - Am. J. Neuroradiol.2019 May 01; 40
AB  - SUMMARY: Oculodentodigital dysplasia is an autosomal dominant disorder due to GJA1 variants characterized by dysmorphic features. Neurologic symptoms have been described in some patients but without a clear neuroimaging pattern. To understand the pathophysiology underlying neurologic deficits in oculodentodigital dysplasia, we studied 8 consecutive patients presenting with hereditary spastic paraplegia due to GJA1 variants. Clinical disease severity was highly variable. Cerebral MR imaging revealed variable white matter abnormalities, consistent with a hypomyelination pattern, and bilateral hypointense signal of the basal ganglia on T2-weighted images and/or magnetic susceptibility sequences, as seen in neurodegeneration with brain iron accumulation diseases. Patients with the more prominent basal ganglia abnormalities were the most disabled ones. This study suggests that GJA1-related hereditary spastic paraplegia is a complex neurodegenerative disease affecting both the myelin and the basal ganglia. GJA1 variants should be considered in patients with hereditary spastic paraplegia presenting with brain hypomyelination, especially if associated with neurodegeneration and a brain iron accumulation pattern.Cx43connexin 43Cx47connexin 47ODDDoculodentodigital dysplasia