ABSTRACT
Amyotrophic lateral sclerosis (ALS) is a devastating paralytic disorder caused by the death of motoneurons. Several mutations in the KIF5A gene have been identified in patients with ALS. Some mutations affect the splicing sites of exon 27 leading to its deletion (Δ27 mutation). KIF5A Δ27 is aggregation-prone and pathogenic for motoneurons due to a toxic gain of function. Another mutation found to be enriched in ALS patients is a proline/leucine substitution at position 986 (P986L mutation). Bioinformatic analyses strongly suggest that this variant is benign. Our study aims to conduct functional studies in Drosophila to classify the KIF5A P986L variant. When expressed in motoneurons, KIF5A P986L does not modify the morphology of larval NMJ or the synaptic transmission. In addition, KIF5A P986L is uniformly distributed in axons and does not disturb mitochondria distribution. Locomotion at larval and adult stages is not affected by KIF5A P986L. Finally, both KIF5A WT and P986L expression in adult motoneurons extend median lifespan compared to control flies. Altogether, our data show that the KIF5A P986L variant is not pathogenic for motoneurons and may represent a hypomorphic allele, although it is not causative for ALS.
Subject(s)
Amyotrophic Lateral Sclerosis , Kinesins , Motor Neurons , Animals , Kinesins/genetics , Kinesins/metabolism , Motor Neurons/metabolism , Motor Neurons/pathology , Amyotrophic Lateral Sclerosis/genetics , Amyotrophic Lateral Sclerosis/pathology , Amyotrophic Lateral Sclerosis/metabolism , Mutation , Humans , Drosophila Proteins/genetics , Drosophila Proteins/metabolism , Drosophila , Neuromuscular Junction/metabolism , Neuromuscular Junction/pathology , Drosophila melanogaster/genetics , Synaptic Transmission/genetics , Disease Models, Animal , Axons/metabolism , Axons/pathology , Larva/genetics , Larva/metabolismABSTRACT
The release of neurotransmitters (NTs) at central synapses is dependent on a cascade of protein interactions, specific to the presynaptic compartment. Among those dedicated molecules, the cytosolic complexins play an incompletely defined role as synaptic transmission regulators. Complexins are multidomain proteins that bind soluble N-ethylmaleimide sensitive factor attachment protein receptor complexes, conferring both inhibitory and stimulatory functions. Using systematic mutagenesis and comparing reconstituted in vitro membrane fusion assays with electrophysiology in cultured neurons from mice of either sex, we deciphered the function of the N-terminus of complexin (Cpx) II. The N-terminus (amino acid 1-27) starts with a region enriched in hydrophobic amino acids (1-12), which binds lipids. Mutants maintaining this hydrophobic character retained the stimulatory function of Cpx, whereas exchanges introducing charged residues perturbed both spontaneous and evoked exocytosis. Mutants in the more distal region of the N-terminal domain (amino acid 11-18) showed a spectrum of effects. On the one hand, mutation of residue A12 increased spontaneous release without affecting evoked release. On the other hand, replacing D15 with amino acids of different shapes or hydrophobic properties (but not charge) not only increased spontaneous release but also impaired evoked release. Most surprising, this substitution reduced the size of the readily releasable pool, a novel function for Cpx at mammalian synapses. Thus, the exact amino acid composition of the Cpx N-terminus fine-tunes the degree of spontaneous and evoked NT release.
Subject(s)
Nerve Tissue Proteins , Synaptic Vesicles , Animals , Synaptic Vesicles/metabolism , Synaptic Vesicles/genetics , Mice , Male , Female , Nerve Tissue Proteins/genetics , Nerve Tissue Proteins/metabolism , Nerve Tissue Proteins/chemistry , Mutation , Adaptor Proteins, Vesicular Transport/genetics , Adaptor Proteins, Vesicular Transport/metabolism , Adaptor Proteins, Vesicular Transport/chemistry , Membrane Fusion/physiology , Membrane Fusion/genetics , Cells, Cultured , Phenotype , Neurons/metabolism , Synaptic Transmission/genetics , Synaptic Transmission/physiology , Mice, Inbred C57BL , Exocytosis/physiology , Exocytosis/geneticsABSTRACT
The circular RNA (circRNA) Cdr1as is conserved across mammals and highly expressed in neurons, where it directly interacts with microRNA miR-7. However, the biological function of this interaction is unknown. Here, using primary cortical murine neurons, we demonstrate that stimulating neurons by sustained depolarization rapidly induces two-fold transcriptional upregulation of Cdr1as and strong post-transcriptional stabilization of miR-7. Cdr1as loss causes doubling of glutamate release from stimulated synapses and increased frequency and duration of local neuronal bursts. Moreover, the periodicity of neuronal networks increases, and synchronicity is impaired. Strikingly, these effects are reverted by sustained expression of miR-7, which also clears Cdr1as molecules from neuronal projections. Consistently, without Cdr1as, transcriptomic changes caused by miR-7 overexpression are stronger (including miR-7-targets downregulation) and enriched in secretion/synaptic plasticity pathways. Altogether, our results suggest that in cortical neurons Cdr1as buffers miR-7 activity to control glutamatergic excitatory transmission and neuronal connectivity important for long-lasting synaptic adaptations.
Subject(s)
Glutamic Acid , MicroRNAs , Neurons , Synaptic Transmission , MicroRNAs/genetics , MicroRNAs/metabolism , Animals , Neurons/metabolism , Mice , Glutamic Acid/metabolism , Synaptic Transmission/genetics , Neuronal Plasticity/genetics , RNA, Circular/genetics , RNA, Circular/metabolism , Synapses/metabolism , RNA, Long Noncoding/genetics , RNA, Long Noncoding/metabolism , Gene Expression Regulation , Cells, CulturedABSTRACT
BACKGROUND: Methylation of serotonin-related genes has been proposed as a plausible gene-by-environment link which may mediate environmental stress, depressive and anxiety symptoms. DNA methylation is often measured in blood cells, but little is known about the association between this peripheral epigenetic modification and brain serotonergic architecture. Here, we evaluated the association between whole-blood-derived methylation of four CpG sites in the serotonin transporter (SLC6A4) and six CpG sites of the tryptophan hydroxylase 2 (TPH2) gene and in-vivo brain levels of serotonin transporter (5-HTT) and serotonin 4 receptor (5-HT4) in a cohort of healthy individuals (N = 254) and, for 5-HT4, in a cohort of unmedicated patients with depression (N = 90). To do so, we quantified SLC6A4/TPH2 methylation using bisulfite pyrosequencing and estimated brain 5-HT4 and 5-HTT levels using positron emission tomography. In addition, we explored the association between SLC6A4 and TPH2 methylation and measures of early life and recent stress, depressive and anxiety symptoms on 297 healthy individuals. RESULTS: We found no statistically significant association between peripheral DNA methylation and brain markers of serotonergic neurotransmission in patients with depression or in healthy individuals. In addition, although SLC6A4 CpG2 (chr17:30,236,083) methylation was marginally associated with the parental bonding inventory overprotection score in the healthy cohort, statistical significance did not remain after accounting for blood cell heterogeneity. CONCLUSIONS: We suggest that findings on peripheral DNA methylation in the context of brain serotonin-related features should be interpreted with caution. More studies are needed to rule out a role of SLC6A4 and TPH2 methylation as biomarkers for environmental stress, depressive or anxiety symptoms.
Subject(s)
Brain , DNA Methylation , Depression , Epigenesis, Genetic , Serotonin Plasma Membrane Transport Proteins , Serotonin , Synaptic Transmission , Tryptophan Hydroxylase , Humans , DNA Methylation/genetics , Serotonin Plasma Membrane Transport Proteins/genetics , Male , Female , Adult , Tryptophan Hydroxylase/genetics , Serotonin/metabolism , Serotonin/blood , Brain/metabolism , Depression/genetics , Depression/metabolism , Epigenesis, Genetic/genetics , Synaptic Transmission/genetics , CpG Islands/genetics , Middle Aged , Young Adult , Receptors, Serotonin, 5-HT4/genetics , Receptors, Serotonin, 5-HT4/metabolism , Positron-Emission Tomography , Cohort StudiesABSTRACT
Sex is a pivotal biological factor that significantly impacts tissue homeostasis and disease susceptibility. In the auditory system, sex differences have been observed in cochlear physiology and responses to pathological conditions. However, the underlying molecular mechanisms responsible for these differences remain elusive. The current research explores the differences in gene expression profiles in the cochlea between male and female mice, aiming to understand the functional implication of sex-biased gene expression in each sex. Using RNA-sequencing analysis on cochlear tissues obtained from male and female mice, we identified a significant number of genes exhibiting sex-biased expression differences. While some of these differentially expressed genes are located on sex chromosomes, most are found on autosomal chromosomes. Further bioinformatic analysis revealed that these genes are involved in several key cellular functions. In males, these genes are notably linked to oxidative phosphorylation and RNA synthesis and processing, suggesting their involvement in mitochondrial energy production and regulatory control of gene expression. In contrast, sex-biased genes are associated with mechano-transduction and synaptic transmission within female cochleae. Collectively, our study provides valuable insights into the molecular differences between the sexes and emphasizes the need for future research to uncover their functional implications and relevance to auditory health and disease development.
Subject(s)
Cochlea , Gene Expression Profiling , Transcriptome , Animals , Female , Cochlea/metabolism , Male , Sex Factors , Mice , RNA-Seq , Mechanotransduction, Cellular , Mice, Inbred C57BL , Synaptic Transmission/genetics , Sex Characteristics , Gene Expression Regulation , Sex Chromosomes/geneticsABSTRACT
Neurodevelopment is a highly organized and complex process involving lasting and often irreversible changes in the central nervous system. Inherited disorders of neurotransmission (IDNT) are a group of genetic disorders where neurotransmission is primarily affected, resulting in abnormal brain development from early life, manifest as neurodevelopmental disorders and other chronic conditions. In principle, IDNT (particularly those of monogenic causes) are amenable to gene replacement therapy via precise genetic correction. However, practical challenges for gene replacement therapy remain major hurdles for its translation from bench to bedside. We discuss key considerations for the development of gene replacement therapies for IDNT. As an example, we describe our ongoing work on gene replacement therapy for succinic semialdehyde dehydrogenase deficiency, a GABA catabolic disorder.
Subject(s)
Amino Acid Metabolism, Inborn Errors , Genetic Therapy , Succinate-Semialdehyde Dehydrogenase , Synaptic Transmission , Humans , Succinate-Semialdehyde Dehydrogenase/deficiency , Succinate-Semialdehyde Dehydrogenase/genetics , Genetic Therapy/methods , Amino Acid Metabolism, Inborn Errors/therapy , Amino Acid Metabolism, Inborn Errors/genetics , Synaptic Transmission/genetics , AnimalsABSTRACT
MUNC18-1 is an essential protein of the regulated secretion machinery. De novo, heterozygous mutations in STXBP1, the human gene encoding this protein, lead to a severe neurodevelopmental disorder. Here, we describe the electrophysiological characteristics of a unique case of STXBP1-related disorder caused by a homozygous mutation (L446F). We engineered this mutation in induced pluripotent stem cells from a healthy donor (STXBP1LF/LF) to establish isogenic cell models. We performed morphological and electrophysiological analyses on single neurons grown on glial micro-islands. Human STXBP1LF/LF neurons displayed normal morphology and normal basal synaptic transmission but increased paired-pulse ratios and charge released, and reduced synaptic depression compared to control neurons. Immunostainings revealed normal expression levels but impaired recognition by a mutation-specific MUNC18-1 antibody. The electrophysiological gain-of-function phenotype is in line with earlier overexpression studies in Stxbp1 null mouse neurons, with some potentially human-specific features. Therefore, the present study highlights important differences between mouse and human neurons critical for the translatability of pre-clinical studies.
Subject(s)
Homozygote , Induced Pluripotent Stem Cells , Munc18 Proteins , Neurons , Synaptic Transmission , Munc18 Proteins/genetics , Munc18 Proteins/metabolism , Humans , Neurons/metabolism , Neurons/pathology , Synaptic Transmission/genetics , Induced Pluripotent Stem Cells/metabolism , Animals , Mice , Mutation , Synapses/metabolism , Synapses/genetics , Synapses/pathologyABSTRACT
Temporal lobe epilepsy (TLE), the most common type of drug-resistant epilepsy, severely affects quality of life. However, the underlying mechanism of TLE remains unclear and deserves further exploration. Sorbs2, a key synaptic regulatory protein, plays an important role in the regulation of synaptic transmission in the mammalian brain. In this study, we aimed to investigate the expression pattern of Sorbs2 in a kainic acid (KA)-induced TLE mouse model and in patients with TLE to further determine whether Sorbs2 is involved in seizure activity and to explore the potential mechanism by which Sorbs2 affects seizures in this TLE mouse model. First, we found that the expression of Sorbs2 was obviously increased in the hippocampus and cortex of a TLE mouse model and in the temporal cortex of TLE patients, indicating an abnormal expression pattern of Sorbs2 in TLE. Importantly, subsequent behavioral analyses and local field potential (LFP) analyses of a TLE mouse model demonstrated that the downregulation of hippocampal Sorbs2 could prolong the latency to spontaneous recurrent seizures (SRSs) and protect against SRSs. We also found that the knockdown of Sorbs2 in the hippocampus could decrease excitatory synaptic transmission in pyramidal neurons (PNs) in the hippocampal CA1 region and reduce the expression levels of the AMPAR subunits GluA1 and GluA2. Thus, we speculated that Sorbs2 may promote epileptogenesis and the development of TLE by affecting AMPAR-mediated excitatory synaptic transmission in PNs in the CA1 region. Therefore, reducing the expression of hippocampal Sorbs2 could restrain epileptogenesis and the development of TLE.
Subject(s)
Epilepsy, Temporal Lobe , RNA-Binding Proteins , Receptors, AMPA , Seizures , Synaptic Transmission , Animals , Female , Humans , Male , Mice , Epilepsy, Temporal Lobe/metabolism , Epilepsy, Temporal Lobe/chemically induced , Excitatory Postsynaptic Potentials/drug effects , Excitatory Postsynaptic Potentials/physiology , Hippocampus/metabolism , Hippocampus/drug effects , Kainic Acid/pharmacology , Kainic Acid/toxicity , Mice, Inbred C57BL , Receptors, AMPA/metabolism , Seizures/metabolism , Seizures/chemically induced , Synaptic Transmission/drug effects , Synaptic Transmission/genetics , Synaptic Transmission/physiology , RNA-Binding Proteins/genetics , RNA-Binding Proteins/metabolism , Adaptor Proteins, Signal Transducing/genetics , Adaptor Proteins, Signal Transducing/metabolismABSTRACT
The essential metal manganese (Mn) induces neuromotor disease at elevated levels. The manganese efflux transporter SLC30A10 regulates brain Mn levels. Homozygous loss-of-function mutations in SLC30A10 induce hereditary Mn neurotoxicity in humans. Our prior characterization of Slc30a10 knockout mice recapitulated the high brain Mn levels and neuromotor deficits reported in humans. But, mechanisms of Mn-induced motor deficits due to SLC30A10 mutations or elevated Mn exposure are unclear. To gain insights into this issue, we characterized changes in gene expression in the basal ganglia, the main brain region targeted by Mn, of Slc30a10 knockout mice using unbiased transcriptomics. Compared with littermates, >1000 genes were upregulated or downregulated in the basal ganglia sub-regions (i.e. caudate putamen, globus pallidus, and substantia nigra) of the knockouts. Pathway analyses revealed notable changes in genes regulating synaptic transmission and neurotransmitter function in the knockouts that may contribute to the motor phenotype. Expression changes in the knockouts were essentially normalized by a reduced Mn chow, establishing that changes were Mn dependent. Upstream regulator analyses identified hypoxia-inducible factor (HIF) signaling, which we recently characterized to be a primary cellular response to elevated Mn, as a critical mediator of the transcriptomic changes in the basal ganglia of the knockout mice. HIF activation was also evident in the liver of the knockout mice. These results: (i) enhance understanding of the pathobiology of Mn-induced motor disease; (ii) identify specific target genes/pathways for future mechanistic analyses; and (iii) independently corroborate the importance of the HIF pathway in Mn homeostasis and toxicity.
Subject(s)
Cation Transport Proteins , Manganese , Humans , Animals , Mice , Manganese/metabolism , Cation Transport Proteins/genetics , Cation Transport Proteins/metabolism , Synaptic Transmission/genetics , Mice, Knockout , HypoxiaABSTRACT
BACKGROUND: SHANK3 gene is a highly replicated causative gene for autism spectrum disorder and has been well characterized in multiple Shank3 mutant rodent models. When compared to rodents, domestic dogs are excellent animal models in which to study social cognition as they closely interact with humans and exhibit similar social behaviors. Using CRISPR/Cas9 editing, we recently generated a dog model carrying Shank3 mutations, which displayed a spectrum of autism-like behaviors, such as social impairment and heightened anxiety. However, the neural mechanism underlying these abnormal behaviors remains to be identified. METHODS: We used Shank3 mutant dog models to examine possible relationships between Shank3 mutations and neuronal dysfunction. We studied electrophysiological properties and the synaptic transmission of pyramidal neurons from acute brain slices of the prefrontal cortex (PFC). We also examined dendrite elaboration and dendritic spine morphology in the PFC using biocytin staining and Golgi staining. We analyzed the postsynaptic density using electron microscopy. RESULTS: We established a protocol for the electrophysiological recording of canine brain slices and revealed that excitatory synaptic transmission onto PFC layer 2/3 pyramidal neurons in Shank3 heterozygote dogs was impaired, and this was accompanied by reduced dendrite complexity and spine density when compared to wild-type dogs. Postsynaptic density structures were also impaired in Shank3 mutants; however, pyramidal neurons exhibited hyperexcitability. LIMITATIONS: Causal links between impaired PFC pyramidal neuron function and behavioral alterations remain unclear. Further experiments such as manipulating PFC neuronal activity or restoring synaptic transmission in Shank3 mutant dogs are required to assess PFC roles in altered social behaviors. CONCLUSIONS: Our study demonstrated the feasibility of using canine brain slices as a model system to study neuronal circuitry and disease. Shank3 haploinsufficiency causes morphological and functional abnormalities in PFC pyramidal neurons, supporting the notion that Shank3 mutant dogs are new and valid animal models for autism research.
Subject(s)
Autism Spectrum Disorder , Autistic Disorder , Humans , Dogs , Animals , Autistic Disorder/genetics , Nerve Tissue Proteins/genetics , Nerve Tissue Proteins/metabolism , Pyramidal Cells/metabolism , Synaptic Transmission/genetics , Prefrontal Cortex , Anxiety , Disease Models, AnimalABSTRACT
O colapso induzido pelo exercício (EIC) é considerado uma síndrome autossômica recessiva que afeta principalmente cães da raça Labrador Retriever. A doença é caracterizada por fraqueza muscular e colapso após exercício intenso. Usualmente, ocorre recuperação clínica após o episódio, mas alguns animais podem vir a óbito. Os sinais clínicos são decorrentes do polimorfismo de base única (SNP) c.767G>T no gene Dynamin 1 (DNM1). O objetivo deste trabalho foi determinar a ocorrência deste SNP em 321 cães da raça Labrador Retriever do Estado de São Paulo. Primers específicos para a amplificação de todo o exon 6 do gene DNM1 foram usados nas PCRs utilizando DNA a partir de amostras de sangue ou swab bucal, a avaliação final foi realizada com sequenciamento direto dos produtos da PCR. Dentre os 321 animais estudados, 3,4 % (11/321) eram homozigotos para o SNP c.767G>T no gene DNM1 e 24,6% (79/321) eram heterozigotos. Somente um dos 11 animais homozigotos apresentavam sinais clínicos compatíveis com a EIC. Este é o primeiro estudo sobre a ocorrência deste SNP no Brasil e considerando que quase 25% dos animais estudados eram heterozigotos, a genotipagem dos animais para este SNP pode ser importante antes dos acasalamentos para cães desta raça. A EIC deve ser considerada nos diagnósticos diferenciais de enfermidades neuromusculares em cães da raça Labrador Retriever.
The exercise-induced collapse (EIC) is considered an autosomal recessive syndrome that mainly affects Labrador Retriever dogs. The disease is characterized by muscle weakness and collapse after intense exercise. Recovery usually occurs after exercise but some animals may die. The clinical signs occurs due to the single-nucleotide polymorphism (SNP) c.767G>T in Dynamin 1 (DNM1) gene. The aim of this study was to evaluate the occurrence of this SNP in 321 Labrador Retriever dogs from São Paulo state. Specific primers for amplification of the entire exon 6 of the DNM1 gene were used in a PCR performed with DNA from blood or buccal swab samples, direct sequencing was performed for the final evaluation. Among 321 animals studied, 3.4% (11/321) of animals were homozygous for the DNM1 SNP (c.767G>T) and 24.6% (79/321) were heterozygous. Only one of the 11 homozygous animals in this study had previous clinical signs compatible with this disease. This is the first study that evaluated the occurrence of DNM1 SNP (c.767G>T) gene in Brazil and considering that almost 25% of the studied animals were heterozygous, the routinely evaluation of this SNP may be important before this breed mating The EIC should be include in the differential diagnosis of neuromuscular diseases in Labrador Retriever dogs.
Subject(s)
Animals , Dogs , Muscle Weakness/genetics , Muscle Weakness/veterinary , Heat Exhaustion/genetics , Heat Exhaustion/veterinary , Polymorphism, Single Nucleotide/genetics , Genotyping Techniques/veterinary , Alkalosis, Respiratory/genetics , Alkalosis, Respiratory/veterinary , Sequence Analysis, DNA/veterinary , Neuromuscular Diseases/genetics , Neuromuscular Diseases/veterinary , DNA Primers , Polymerase Chain Reaction/veterinary , Synaptic Transmission/geneticsABSTRACT
El Trastorno por Déficit de Atención con Hiperactividad (TDAH) es una patología frecuente de la infancia con una fuerte contribución genética. Tras unos años dedicados al estudio de los genes específicos que explicaban la sintomatología nuclear del trastorno (inatención, hiperactividad e impulsividad), en la actualidad el interés de los investigadores se ha ampliado, considerando la repercusión neuropsicológica que estas alteraciones genéticas tienen en los sujetos afectos de esta patología. En este trabajo revisamos la literatura existente sobre los correlatos genéticos de los déficits cognitivos del TDAH. Estas nuevas estrategias de investigación, necesariamente multidisciplinares, pretenden conseguir, además del incremento en la caracterización neurobiológica de esta patología, líneas de tratamiento alternativas a las existentes que respondan a la relación comentada entre genes y cognición en el TDAH
Attention Deficit/Hyperactivity Disorder (ADHD) is a frequent disorder in childhood with a strong genetic contribution. After a few years studying the specific genes that could explain the nuclear symptomatology of the disorder (inattention, hyperactivity, and impulsivity), actual research has been extended considering the neuropsychological repercussion that these genetic alterations have in subjects with ADHD. In this work we review the existing literature on the genetic basis of the cognitive deficits in ADHD. These new research strategies, necessarily multidisciplinary, try to explain a better neurobiological characterization of this pathology, plus alternative new lines of treatment based on the relationship between genes and cognition in ADHD
Subject(s)
Humans , Attention Deficit Disorder with Hyperactivity/genetics , Neurodevelopmental Disorders/genetics , Neuropsychological Tests/statistics & numerical data , Synaptic Transmission/genetics , Neurotransmitter Agents/genetics , Genetic Markers , Endophenotypes/analysis , Cognitive Dysfunction/geneticsABSTRACT
RESUMEN: Aunque la plasticidad neural muestra la capacidad del sistema nervioso para cambiar su estructura y función, lo cual es un hecho bien documentado, pocos estudios han mostrado la variación regional, dentro de la estructura del sistema nervioso central para sufrir cambios plásticos. A través de disecciones parasagitales, secuenciadas de medial a lateral, se estudió el grosor de la capa molecular, en el límite de la cisura primaria de hemisferio izquierdo del cerebelo, de ratas, con el propósito de evaluar las diferencias regionales en plasticidad. A pesar de la homogeneidad de la histología cerebelar, el estudio mostró que hay una diferencia interlobular significativa entre el grosor de la capa molecular en el límite de la fisura prima. Agregado a ello, fue revelado que los cambios de grosor tienen una tendencia significativa dentro de cada límite. La heterogeneidad cuantitativa de la arquitectura cerebelar, tal como la variación en el grosor cortical, puede proveer algunas evidencias que muestran que regiones diferentes de un corte homogéneo, aún de límites y áreas adyacentes dentro del mismo, pueden tener diferentes potenciales para plasticidad.
Subject(s)
Animals , Male , Rats , Cerebellum/anatomy & histology , Cerebellum/growth & development , Neuronal Plasticity/genetics , Rats, Wistar/anatomy & histology , Synaptic Transmission/geneticsABSTRACT
Los estudios del Síndrome de Charcot-Marie-Tooth (CMT) presenta heterogeneidad genética. Los estudios de conducción nerviosa y la práctica de biopsia de nervio periférico han permitido establecer dos tipos: CMT1: es hipertrófica, desmielinizante con descenso de las velocidades de conducción nerviosa motora. CMT2: velocidades de conducción nerviosa periférica normales o mínimamente descendidas y atrofia axonal primaria con mínima afectación de la mielina. Prevalencia entre 15 a 20 casos por 100.000 habitantes. Afecta a ambos sexos con ligera preferencia por los varones. Las características clínicas de CMT1 incluyen debilidad distal, atrofia de inicio en musculatura peroneal con extensión a dedos de las manos, hipo o arreflexia, pies cavos, engrosamiento de los nervios y alteraciones sensitivas distales. CMT2 es semejante al CMT1 aunque su inicio suele ser algo más tardío. Paciente escolar masculino de doce años, quien inicia cuadro clínico a los tres años caracterizado por tropiezos caídas frecuentes, dificultad para subir y bajar escaleras, y debilidad muscular de miembros inferiores de forma progresiva hasta la actualidad. Examen físico: marcha de estepaje, pie caído, hipotrofia de músculos intrapatelares bilaterales a predominio izquierdo, hiporreflexia y arreflexia en algunos grupos musculares y disminución de la fuerza muscular. Se realizó electromiografía y velocidad de conducción nerviosa siendo alteradas compatible junto a la clínica con CMT1. En conclusión es una patología que amerita el suficiente conocimiento por parte de los médicos en general para su correcto diagnóstico y manejo.