Assuntos
Gânglios da Base/fisiopatologia , Calcinose/fisiopatologia , Discinesia Induzida por Medicamentos/fisiopatologia , Distúrbios Distônicos/fisiopatologia , Transtornos da Motilidade Ocular/fisiopatologia , Transtornos Parkinsonianos/fisiopatologia , Idade de Início , Antiparkinsonianos/efeitos adversos , Apomorfina/farmacologia , Gânglios da Base/patologia , Calcinose/complicações , Calcinose/patologia , Distúrbios Distônicos/complicações , Distúrbios Distônicos/patologia , Feminino , Humanos , Levodopa/efeitos adversos , Pessoa de Meia-Idade , Transtornos da Motilidade Ocular/complicações , Transtornos da Motilidade Ocular/patologia , Músculos Oculomotores/fisiopatologia , Transtornos Parkinsonianos/complicações , Transtornos Parkinsonianos/patologiaRESUMO
BACKGROUND: Mutations in the Parkin gene (PARK2) are the most commonly identified cause of recessively inherited early-onset Parkinson disease (EOPD) but account for only a portion of cases. DJ-1 (PARK7) was recently reported as a second gene associated with recessively inherited PD with a homozygous exon deletion and a homozygous point mutation in two families. METHODS: To investigate the frequency of DJ-1 mutations, the authors performed mutational analysis of all six coding exons of DJ-1 in 100 EOPD patients. For the detection of exon rearrangements, the authors developed a quantitative duplex PCR assay. Denaturing high performance liquid chromatography analysis was used to screen for point mutations and small deletions. Further, Parkin analysis was performed as previously described. RESULTS: The authors identified two carriers of single heterozygous loss-of-function DJ-1 mutations, including a heterozygous deletion of exons 5 to 7 and an 11-base pair deletion, removing the invariant donor splice site in intron 5. Interestingly, both DJ-1 mutations identified in this study were found in the heterozygous state only. The authors also detected a polymorphism (R98Q) in 1.5% of the chromosomes in both the patient and control group. In the same patient sample, 17 cases were detected with mutations in the Parkin gene. CONCLUSIONS: Mutations in DJ-1 are less frequent than mutations in Parkin in EOPD patients but should be considered as a possible cause of EOPD. The effect of single heterozygous mutations in DJ-1 on the nigrostriatal system, as described for heterozygous changes in Parkin and PARK6, remains to be elucidated.