Abstract

BackgroundX-linked Charcot-Marie Tooth (CMT) is caused by mutations in the connexin32 gene that encodes a polypeptide which is arranged in hexameric array and form gap junctions.MethodsWe describe two novel mutations in the connexin32 gene in two Norwegian families.ResultsFamily 1 had a c.225delG (R75fsX83) which causes a frameshift and premature stop codon at position 247. This probably results in a shorter non-functional protein structure. Affected individuals had an early age at onset usually in the first decade. The symptoms were more severe in men than women. All had severe muscle weakness in the legs. Several abortions were observed in this family. Family 2 had a c.536 G>A (C179Y) transition which causes a change of the highly conserved cysteine residue, i.e. disruption of at least one of three disulfide bridges. The mean age at onset was in the first decade. Muscle wasting was severe and correlated with muscle weakness in legs. The men and one woman also had symptom from their hands.The neuropathy is demyelinating and the nerve conduction velocities were in the intermediate range (25–49 m/s). Affected individuals had symmetrical clinical findings, while the neurophysiology revealed minor asymmetrical findings in nerve conduction velocity in 6 of 10 affected individuals.ConclusionThe two novel mutations in the connexin32 gene are more severe than the majority of previously described mutations possibly due to the severe structural change of the gap junction they encode.

Highlights

  • X-linked Charcot-Marie Tooth (CMT) is caused by mutations in the connexin32 gene that encodes a polypeptide which is arranged in hexameric array and form gap junctions

  • The two novel mutations in the connexin32 gene are more severe than the majority of previously described mutations possibly due to the severe structural change of the gap junction they encode

  • The majority of CMT cases are caused by a duplication of peripheral myelin protein 22 (PMP22), which is carried by 71% of those with CMT 1 [7]

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Summary

Introduction

X-linked Charcot-Marie Tooth (CMT) is caused by mutations in the connexin gene that encodes a polypeptide which is arranged in hexameric array and form gap junctions. Charcot-Marie-Tooth (CMT) disease is the most common inherited disorder of the peripheral nervous system with an estimated prevalence of 1 in 2,500 [1] It is clinically, neurophysiologically and genetically a heterogeneous disorder. Connexin is expressed in both the peripheral and central nervous system (PNS and CNS) It is expressed in the paranodal region and incisures of myelinating Schwann cells, and in cell bodies and processes of oligodendrocytes, while it is not expressed in the compact myelin layer [18]. This is interesting since some patients with mutations in the connexin gene have hearing loss, subclinical CNS symptoms, acute or chronic clinical CNS manifestations as well as CNS involvement on brain MRI [19,20,21,22]

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