De novo partial deletion in GRID2 presenting with complicated spastic paraplegia

Muscle Nerve. 2014 Feb;49(2):289-92. doi: 10.1002/mus.24096. Epub 2013 Dec 16.

Abstract

Introduction: Complex forms of spastic paraplegia (SPG) are rare and genetically heterogeneous. In apparently sporadic cases, analysis of known SPG genes often fails to reveal a mutation.

Methods: We report a 24-year-old patient with a syndrome of spastic paraplegia, ataxia, frontotemporal dementia, and lower motor neuron involvement.

Results: Screening of the patient's genome for copy number variation identified a novel 276 kb deletion spanning the first exon of the GRID2 gene. MRI scan showed atrophy of the cerebellum, and electromyography revealed a chronic disorder of motor neurons or their axons. A deletion in GRID2, coding for the glutamate receptor delta-2 subunit precursor protein, was excluded in either parent, suggesting that the deletion in the index patient occurred de novo.

Conclusions: We hypothesize that the deletion identified here is the cause of our patient's clinical presentation, due to the resemblance to the GRID2 mutation phenotype in mouse models.

Keywords: GRID2; array comparative genomic hybridization; ataxia; complicated spastic paraplegia; frontotemporal dementia; glutamate receptor delta-2 subunit precursor protein.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain / pathology
  • Cerebellar Ataxia / diagnosis
  • Cerebellar Ataxia / epidemiology
  • Cerebellar Ataxia / genetics*
  • Chromosomes, Human, Pair 4 / genetics
  • Comorbidity
  • Electromyography
  • Exons / genetics
  • Frontotemporal Dementia / diagnosis
  • Frontotemporal Dementia / epidemiology
  • Frontotemporal Dementia / genetics*
  • Gene Deletion*
  • Gene Dosage / genetics
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Muscular Atrophy / diagnosis
  • Muscular Atrophy / epidemiology
  • Muscular Atrophy / genetics*
  • Paraplegia / diagnosis
  • Paraplegia / epidemiology
  • Paraplegia / genetics*
  • Receptors, Glutamate / genetics*
  • Young Adult

Substances

  • Receptors, Glutamate
  • glutamate receptor delta 2