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Gilles de la Tourette syndrome (GTS) is a neurodevelopmental disorder characterized by motor and vocal tics. The etiology of the disorder is unknown, although the predominant role of genetic factors has been established. Variants of the BTBD9 gene (rs4714156, rs9296249 and rs9357271) have been reported to be associated with GTS in French Canadian and Chinese Han populations. Therefore, we decided to test the association between GTS and polymorphisms of the BTBD9 gene in Polish patients. Our cohort of GTS cases comprised 162 patients aged 4-54 years (mean age: 19.9±8.7 years; 131 males, 80.9%). The control group consisted of 180 healthy persons aged 14-55 years (mean age: 23.1±2.1 years; 149 males, 82.8%). The rs4714156, rs9296249 and rs9357271 variants of the BTBD9 gene were genotyped. No significant differences were found in minor allele frequencies (MAFs) of the SNPs tested between the two groups. The frequency of MAFs of the genotyped SNPs was lower in GTS patients with Attention Deficit Hyperactivity Disorder (for rs9357271 and rs9296249, P=0.039 and rs4714156, P=0.040) and higher in GTS patients without comorbidities (for rs9357271 and rs9296249 P=0.021 and rs4714156 P=0.025). There was a trend toward an association between the minor allele of the SNPs and mild tics (P=0.089 for rs9357271 and rs9296249, P=0.057 for rs4714156). Despite limitations of the study, including the small number of cases and analyzed SNPs, our results suggest that the examined BTBD9 variants are not associated with GTS risk, but may be associated with comorbidity and tic severity in the Polish population.
INTRODUCTION: Myofibrillar myopathies (MFMs) are hereditary muscle diseases characterized by distinctive histopathology of myofibrillar disintegration and abnormal protein aggregation. Seven genes: DES, CRYAB, MYOT, FLNC, LDB3, BAG3, PLEC encoding proteins associated with Z disc are considered responsible for MFMs. However in about half of patients, the gene defect is still unknown. AIM(S): The aim of this study was to describe the clinical and histopathological features of genetically confirmed MFM. METHOD(S): 13 patients from 4 families with MFM were systematically identified and clinically studied. The families were not known to be related. In all suspected MFM patients (one proband from each family) disintegration of myofibrils and accumulation of degradation products into inclusions containing desmin were detected in muscle biopsy. However differentiation between MFM subtypes on the basis of clinical/ pathological phenotype alone was impossible. Therefore, subtype identification was performed using molecular studies. RESULTS: All patients presented with progressive muscle weakness with distal-proximal distribution in the lower limbs. CK was normal or slightly elevated. Finally three mutations were identified: two in DES: (Q348P) and (A357_E359del) and one in CRYAB (D109A). In two families with desminopathy caused by A357_E359del mutation cardiac arrhythmias was observed (paternal uncle with similar symptoms died due to cardiac arrhythmia). Dilated cardiomyopathy was confirmed by echocardiography in family with CRYAB D109A. In this family respiratory insufficiency as well as early cataract were diagnosed. CONCLUSIONS: Molecular identification of MFM is crucial for final diagnosis. The awareness of MFM type could be life-saving by means of appropriate treatment such as 1) inserting of a pacemaker in case of significant heart conduction defects and arrhythmia or 2) initiation of noninvasive ventilation in case of chronic respiratory failure.
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