Unraveling the Mysteries of ATP1A3 Mutation in Rapid-Onset Dystonia Parkinsonism

Published on August 1, 2022

Welcome to the world of rapid-onset dystonia parkinsonism (RDP), a rare and puzzling disease caused by a tiny sly mutant known as ATP1A3. Think of RDP as a detective story, where scientists are on a mission to decode the culprit behind this condition. In this study, two brave patients from the same family offered their case to help scientists crack the code of a brand new ATP1A3 variant. By reviewing other similar stories, researchers discovered that ATP1A3 has specific mutation hotspots, like marked spots on a treasure map. Astonishingly, delays in diagnosing RDP were quite common, taking an average of 14 years! But fret not, for there is hope! If you find yourself or someone you know experiencing strange movements or slowing down, fear not, because gene screening on ATP1A3 might hold the key to unlocking answers for an early diagnosis and treatment. Step into the story yourself by exploring the full article!

BackgroundRapid-onset dystonia parkinsonism (RDP) is a rare disease caused by ATP1A3 mutation with considerable clinical heterogeneity. Increased knowledge of RDP could be beneficial in its early diagnosis and treatment.ObjectiveThis study aimed to summarize the gene mutation spectrum of ATP1A3 associated with RDP, and to explore the correlation of ATP1A3 variants with RDP clinical phenotypes.MethodsIn this study, we reported two RDP patients from a family with a novel inherited ATP1A3 variant. Then, we reviewed and analyzed the available literature in English focused on ATP1A3-causative RDP. A total of 35 articles covering 15 families (59 patients) and 36 sporadic RDP cases were included in our analysis.ResultsThe variant A813V (2438C>T) in ATP1A3 found in our cases was a novel mutant. Delays in diagnosis were common, with a mean delay time of 14 years. ATP1A3 had distinct RDP-related mutation hotspots, which consisted of exon8, 14, 17, and 18, and the most frequently occurring variants were T613M and I578S. Approximately 74.5% of patients have specific triggers before disease onset, and 82.1% of RDPs have stable symptoms within 1 month. The incidence rates of dystonia and bradykinesia are 100 and 88.1%, respectively. The onset site varied and exhibited a rostrocaudal gradient distribution pattern in 45% of patients with RDP. Approximately 63.6% of patients had mild improvement after receiving comprehensive interventions, especially in gait disturbance amelioration.ConclusionIn patients with acute and unexplained dystonia or bradykinesia, gene screening on ATP1A3 should be timely performed. When a diagnosis has been made, treatments that may be effective are to be attempted. Our study would be helpful for the early diagnosis and treatment of ATP1T3-related RDP.

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