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Whispering dysphonia (DYT4 dystonia) is caused by a mutation in the TUBB4 gene

Identifieur interne : 007A10 ( Istex/Corpus ); précédent : 007A09; suivant : 007A11

Whispering dysphonia (DYT4 dystonia) is caused by a mutation in the TUBB4 gene

Auteurs : Katja Lohmann ; Robert A. Wilcox ; Susen Winkler ; Alfredo Ramirez ; Aleksandar Rakovic ; Jin-Sung Park ; Björn Arns ; Thora Lohnau ; Justus Groen ; Meike Kasten ; Norbert Brüggemann ; Johann Hagenah ; Alexander Schmidt ; Frank J. Kaiser ; Kishore R. Kumar ; Katja Zschiedrich ; Daniel Alvarez-Fischer ; Eckart Altenmüller ; Andreas Ferbert ; Anthony E. Lang ; Alexander Münchau ; Vladimir Kostic ; Kristina Simonyan ; Marc Agzarian ; Laurie J. Ozelius ; Antonius P. M. Langeveld ; Carolyn M. Sue ; Marina A. J. Tijssen ; Christine Klein

Source :

RBID : ISTEX:F6A00D29EF6786FF6A04D8706628D149643C161B

English descriptors

Abstract

A study was undertaken to identify the gene underlying DYT4 dystonia, a dominantly inherited form of spasmodic dysphonia combined with other focal or generalized dystonia and a characteristic facies and body habitus, in an Australian family.

Url:
DOI: 10.1002/ana.23829

Links to Exploration step

ISTEX:F6A00D29EF6786FF6A04D8706628D149643C161B

Le document en format XML

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<name sortKey="Winkler, Susen" sort="Winkler, Susen" uniqKey="Winkler S" first="Susen" last="Winkler">Susen Winkler</name>
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<mods:affiliation>Institute of Neurogenetics, University of Lübeck, Lübeck, Germany</mods:affiliation>
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<name sortKey="Ramirez, Alfredo" sort="Ramirez, Alfredo" uniqKey="Ramirez A" first="Alfredo" last="Ramirez">Alfredo Ramirez</name>
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<mods:affiliation>Institute of Neurogenetics, University of Lübeck, Lübeck, Germany</mods:affiliation>
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<mods:affiliation>Institute of Neurogenetics, University of Lübeck, Lübeck, Germany</mods:affiliation>
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<name sortKey="Groen, Justus" sort="Groen, Justus" uniqKey="Groen J" first="Justus" last="Groen">Justus Groen</name>
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</affiliation>
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<name sortKey="Kasten, Meike" sort="Kasten, Meike" uniqKey="Kasten M" first="Meike" last="Kasten">Meike Kasten</name>
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</affiliation>
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<name sortKey="Bruggemann, Norbert" sort="Bruggemann, Norbert" uniqKey="Bruggemann N" first="Norbert" last="Brüggemann">Norbert Brüggemann</name>
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<mods:affiliation>Institute of Neurogenetics, University of Lübeck, Lübeck, Germany</mods:affiliation>
</affiliation>
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<name sortKey="Hagenah, Johann" sort="Hagenah, Johann" uniqKey="Hagenah J" first="Johann" last="Hagenah">Johann Hagenah</name>
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<mods:affiliation>Institute of Neurogenetics, University of Lübeck, Lübeck, Germany</mods:affiliation>
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<name sortKey="Schmidt, Alexander" sort="Schmidt, Alexander" uniqKey="Schmidt A" first="Alexander" last="Schmidt">Alexander Schmidt</name>
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<name sortKey="Kaiser, Frank J" sort="Kaiser, Frank J" uniqKey="Kaiser F" first="Frank J." last="Kaiser">Frank J. Kaiser</name>
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</affiliation>
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<name sortKey="Kumar, Kishore R" sort="Kumar, Kishore R" uniqKey="Kumar K" first="Kishore R." last="Kumar">Kishore R. Kumar</name>
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<mods:affiliation>Institute of Neurogenetics, University of Lübeck, Lübeck, Germany</mods:affiliation>
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<affiliation>
<mods:affiliation>Departments of Neurology and Neurogenetics, Royal North Shore Hospital and Kolling Institute of Medical Research, University of Sydney, Sydney, Australia</mods:affiliation>
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<name sortKey="Zschiedrich, Katja" sort="Zschiedrich, Katja" uniqKey="Zschiedrich K" first="Katja" last="Zschiedrich">Katja Zschiedrich</name>
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<mods:affiliation>Institute of Neurogenetics, University of Lübeck, Lübeck, Germany</mods:affiliation>
</affiliation>
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<name sortKey="Alvarez Ischer, Daniel" sort="Alvarez Ischer, Daniel" uniqKey="Alvarez Ischer D" first="Daniel" last="Alvarez-Fischer">Daniel Alvarez-Fischer</name>
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<name sortKey="Altenmuller, Eckart" sort="Altenmuller, Eckart" uniqKey="Altenmuller E" first="Eckart" last="Altenmüller">Eckart Altenmüller</name>
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</affiliation>
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<name sortKey="Ferbert, Andreas" sort="Ferbert, Andreas" uniqKey="Ferbert A" first="Andreas" last="Ferbert">Andreas Ferbert</name>
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<author>
<name sortKey="Munchau, Alexander" sort="Munchau, Alexander" uniqKey="Munchau A" first="Alexander" last="Münchau">Alexander Münchau</name>
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<mods:affiliation>Department of Neurology, University Medical Center Eppendorf, Hamburg, Germany</mods:affiliation>
</affiliation>
</author>
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<name sortKey="Kostic, Vladimir" sort="Kostic, Vladimir" uniqKey="Kostic V" first="Vladimir" last="Kostic">Vladimir Kostic</name>
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</affiliation>
</author>
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<name sortKey="Simonyan, Kristina" sort="Simonyan, Kristina" uniqKey="Simonyan K" first="Kristina" last="Simonyan">Kristina Simonyan</name>
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<mods:affiliation>Departments of Neurology and Otolaryngology, Mount Sinai School of Medicine, NY, New York</mods:affiliation>
</affiliation>
</author>
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<name sortKey="Agzarian, Marc" sort="Agzarian, Marc" uniqKey="Agzarian M" first="Marc" last="Agzarian">Marc Agzarian</name>
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<mods:affiliation>MRI Unit, Department of Radiology, Flinders Medical Centre, Adelaide, Australia</mods:affiliation>
</affiliation>
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<name sortKey="Ozelius, Laurie J" sort="Ozelius, Laurie J" uniqKey="Ozelius L" first="Laurie J." last="Ozelius">Laurie J. Ozelius</name>
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</affiliation>
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<name sortKey="Langeveld, Antonius P M" sort="Langeveld, Antonius P M" uniqKey="Langeveld A" first="Antonius P. M." last="Langeveld">Antonius P. M. Langeveld</name>
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<mods:affiliation>Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands</mods:affiliation>
</affiliation>
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<name sortKey="Sue, Carolyn M" sort="Sue, Carolyn M" uniqKey="Sue C" first="Carolyn M." last="Sue">Carolyn M. Sue</name>
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</affiliation>
</author>
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<name sortKey="Tijssen, Marina A J" sort="Tijssen, Marina A J" uniqKey="Tijssen M" first="Marina A. J." last="Tijssen">Marina A. J. Tijssen</name>
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<mods:affiliation>Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands</mods:affiliation>
</affiliation>
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<name sortKey="Klein, Christine" sort="Klein, Christine" uniqKey="Klein C" first="Christine" last="Klein">Christine Klein</name>
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<mods:affiliation>Institute of Neurogenetics, University of Lübeck, Lübeck, Germany</mods:affiliation>
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<mods:affiliation>E-mail: christine.klein@neuro.uni-luebeck.de</mods:affiliation>
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<term>Abbott laboratories</term>
<term>Abnormal microtubule function</term>
<term>Australian dyt4 family</term>
<term>Australian family</term>
<term>Autoregulated instability</term>
<term>Axon guidance</term>
<term>Body habitus</term>
<term>Boehringer ingelheim</term>
<term>Brain development</term>
<term>Cervical dystonia</term>
<term>Characteristic facies</term>
<term>Control chromosomes</term>
<term>Different cell types</term>
<term>Disease controls</term>
<term>Dot1l</term>
<term>Dysphonia</term>
<term>Dystonia</term>
<term>Dyt4</term>
<term>Dyt4 dystonia</term>
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<div type="abstract">A study was undertaken to identify the gene underlying DYT4 dystonia, a dominantly inherited form of spasmodic dysphonia combined with other focal or generalized dystonia and a characteristic facies and body habitus, in an Australian family.</div>
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<affiliation>Address correspondence to Dr Klein, Institute of Neurogenetics, University of Lübeck; Ratzeburger Allee 160; 23538 Lübeck, Germany. E‐mail: christine.klein@neuro.uni-luebeck.de</affiliation>
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<abstract style="main"> Objective
<p>A study was undertaken to identify the gene underlying DYT4 dystonia, a dominantly inherited form of spasmodic dysphonia combined with other focal or generalized dystonia and a characteristic facies and body habitus, in an Australian family.</p>
Methods
<p>Genome‐wide linkage analysis was carried out in 14 family members followed by genome sequencing in 2 individuals. The index patient underwent a detailed neurological follow‐up examination, including electrophysiological studies and magnetic resonance imaging scanning. Biopsies of the skin and olfactory mucosa were obtained, and expression levels of
<hi rend="italic">TUBB4</hi>
mRNA were determined by quantitative real‐time polymerase chain reaction in 3 different cell types. All exons of TUBB4 were screened for mutations in 394 unrelated dystonia patients.</p>
Results
<p>The disease‐causing gene was mapped to a 23cM region on chromosome 19p13.3‐p13.2 with a maximum multipoint LOD score of 5.338 at markers D9S427 and D9S1034. Genome sequencing revealed a missense variant in the
<hi rend="italic">TUBB4</hi>
(tubulin beta‐4; Arg2Gly) gene as the likely cause of disease. Sequencing of
<hi rend="italic">TUBB4</hi>
in 394 unrelated dystonia patients revealed another missense variant (Ala271Thr) in a familial case of segmental dystonia with spasmodic dysphonia. mRNA expression studies demonstrated significantly reduced levels of mutant
<hi rend="italic">TUBB4</hi>
mRNA in different cell types from a heterozygous Arg2Gly mutation carrier compared to controls.</p>
Interpretation
<p>A mutation in
<hi rend="italic">TUBB4</hi>
causes DYT4 dystonia in this Australian family with so‐called whispering dysphonia, and other mutations in
<hi rend="italic">TUBB4</hi>
may contribute to spasmodic dysphonia. Given that TUBB4 is a neuronally expressed tubulin, our results imply abnormal microtubule function as a novel mechanism in the pathophysiology of dystonia. Ann Neurol 2013;73:537–545</p>
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<count type="pageTotal" number="9"></count>
</countGroup>
<titleGroup>
<title type="articleCategory">Original Article</title>
<title type="tocHeading1">Original Articles</title>
</titleGroup>
<copyright ownership="thirdParty">Copyright © 2012 American Neurological Association</copyright>
<eventGroup>
<event type="manuscriptReceived" date="2012-09-19"></event>
<event type="manuscriptRevised" date="2012-11-13"></event>
<event type="manuscriptAccepted" date="2012-11-30"></event>
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<event type="publishedOnlineAccepted" date="2012-12-13"></event>
<event type="publishedOnlineEarlyUnpaginated" date="2013-04-17"></event>
<event type="publishedOnlineFinalForm" date="2013-05-21"></event>
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<numberingGroup>
<numbering type="pageFirst">537</numbering>
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</numberingGroup>
<correspondenceTo>Address correspondence to Dr Klein, Institute of Neurogenetics, University of Lübeck; Ratzeburger Allee 160; 23538 Lübeck, Germany. E‐mail:
<email>christine.klein@neuro.uni-luebeck.de</email>
</correspondenceTo>
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<link type="toTypesetVersion" href="file:ANA.ANA23829.pdf"></link>
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<titleGroup>
<title type="main">Whispering dysphonia (DYT4 dystonia) is caused by a mutation in the
<i>TUBB4</i>
gene</title>
<title type="short">
<i>TUBB4</i>
and DYT4 Dystonia</title>
<title type="shortAuthors">Lohmann et al</title>
</titleGroup>
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<personName>
<givenNames>Frank J.</givenNames>
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<creator affiliationRef="#ana23829-aff-0001 #ana23829-aff-0005" creatorRole="author" xml:id="ana23829-cr-0015">
<personName>
<givenNames>Kishore R.</givenNames>
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<personName>
<givenNames>Eckart</givenNames>
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<personName>
<givenNames>Laurie J.</givenNames>
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<personName>
<givenNames>Antonius P. M.</givenNames>
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<personName>
<givenNames>Carolyn M.</givenNames>
<familyName>Sue</familyName>
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<givenNames>Marina A. J.</givenNames>
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<creator affiliationRef="#ana23829-aff-0001" corresponding="yes" creatorRole="author" xml:id="ana23829-cr-0029">
<personName>
<givenNames>Christine</givenNames>
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<affiliation countryCode="DE" type="organization" xml:id="ana23829-aff-0001">
<orgDiv>Institute of Neurogenetics</orgDiv>
<orgName>University of Lübeck</orgName>
<address>
<city>Lübeck</city>
<country>Germany</country>
</address>
</affiliation>
<affiliation countryCode="AU" type="organization" xml:id="ana23829-aff-0002">
<orgDiv>Department of Neurology</orgDiv>
<orgName>Flinders Medical Centre</orgName>
<address>
<city>Adelaide</city>
<country>Australia</country>
</address>
</affiliation>
<affiliation countryCode="DE" type="organization" xml:id="ana23829-aff-0003">
<orgDiv>Department of Psychiatry and Psychotherapy</orgDiv>
<orgName>University of Bonn</orgName>
<address>
<city>Bonn</city>
<country>Germany</country>
</address>
</affiliation>
<affiliation countryCode="DE" type="organization" xml:id="ana23829-aff-0004">
<orgName>Institute of Human Genetics, University of Bonn</orgName>
<address>
<city>Bonn</city>
<country>Germany</country>
</address>
</affiliation>
<affiliation countryCode="AU" type="organization" xml:id="ana23829-aff-0005">
<orgDiv>Departments of Neurology and Neurogenetics</orgDiv>
<orgName>Royal North Shore Hospital and Kolling Institute of Medical Research, University of Sydney</orgName>
<address>
<city>Sydney</city>
<country>Australia</country>
</address>
</affiliation>
<affiliation countryCode="NL" type="organization" xml:id="ana23829-aff-0006">
<orgDiv>Department of Neurology</orgDiv>
<orgName>Academic Medical Center</orgName>
<address>
<city>Amsterdam</city>
<country>the Netherlands</country>
</address>
</affiliation>
<affiliation countryCode="DE" type="organization" xml:id="ana23829-aff-0007">
<orgDiv>Institute of Human Genetics</orgDiv>
<orgName>University of Lübeck</orgName>
<address>
<city>Lübeck</city>
<country>Germany</country>
</address>
</affiliation>
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<orgDiv>Institute of Music Physiology and Musicians' Medicine</orgDiv>
<orgName>Hanover University of Music, Drama, and Media</orgName>
<address>
<city>Hanover</city>
<country>Germany</country>
</address>
</affiliation>
<affiliation countryCode="DE" type="organization" xml:id="ana23829-aff-0009">
<orgDiv>Clinic of Neurology</orgDiv>
<orgName>Kassel School of Medicine</orgName>
<address>
<city>Kassel</city>
<country>Germany</country>
</address>
</affiliation>
<affiliation countryCode="CA" type="organization" xml:id="ana23829-aff-0010">
<orgDiv>Morton and Gloria Shulman Movement Disorders Center and the Edmond J. Safra Program in Parkinson's Disease</orgDiv>
<orgName>Toronto Western Hospital, University of Toronto</orgName>
<address>
<city>Toronto</city>
<countryPart>Ontario</countryPart>
<country>Canada</country>
</address>
</affiliation>
<affiliation countryCode="DE" type="organization" xml:id="ana23829-aff-0011">
<orgDiv>Department of Neurology</orgDiv>
<orgName>University Medical Center Eppendorf</orgName>
<address>
<city>Hamburg</city>
<country>Germany</country>
</address>
</affiliation>
<affiliation countryCode="RS" type="organization" xml:id="ana23829-aff-0012">
<orgDiv>Department of Neurology</orgDiv>
<orgName>School of Medicine, University of Belgrade</orgName>
<address>
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<country>Serbia</country>
</address>
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<countryPart>NY</countryPart>
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</affiliation>
<affiliation countryCode="AU" type="organization" xml:id="ana23829-aff-0014">
<orgDiv>MRI Unit</orgDiv>
<orgDiv>Department of Radiology</orgDiv>
<orgName>Flinders Medical Centre</orgName>
<address>
<city>Adelaide</city>
<country>Australia</country>
</address>
</affiliation>
<affiliation countryCode="US" type="organization" xml:id="ana23829-aff-0015">
<orgDiv>Department of Genetics and Genomic Sciences</orgDiv>
<orgName>Mount Sinai School of Medicine</orgName>
<address>
<city>New York</city>
<countryPart>NY</countryPart>
</address>
</affiliation>
<affiliation countryCode="NL" type="organization" xml:id="ana23829-aff-0016">
<orgDiv>Department of Otorhinolaryngology</orgDiv>
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<address>
<city>Leiden</city>
<country>the Netherlands</country>
</address>
</affiliation>
<affiliation countryCode="NL" type="organization" xml:id="ana23829-aff-0017">
<orgDiv>Department of Neurology</orgDiv>
<orgName>University Medical Center Groningen, University of Groningen</orgName>
<address>
<city>Groningen</city>
<country>the Netherlands</country>
</address>
</affiliation>
</affiliationGroup>
<supportingInformation>
<p>Additional Supporting Information may be found in the online version of this article.</p>
<supportingInfoItem>
<mediaResource alt="application/pdf" href="urn-x:wiley:03645134:media:ana23829:ana23829-sup-0001-suppinfo"></mediaResource>
<caption>Supplementary Information</caption>
</supportingInfoItem>
</supportingInformation>
<abstractGroup>
<abstract type="main">
<section xml:id="ana23829-sec-0001">
<title type="main">Objective</title>
<p>A study was undertaken to identify the gene underlying DYT4 dystonia, a dominantly inherited form of spasmodic dysphonia combined with other focal or generalized dystonia and a characteristic facies and body habitus, in an Australian family.</p>
</section>
<section xml:id="ana23829-sec-0002">
<title type="main">Methods</title>
<p>Genome‐wide linkage analysis was carried out in 14 family members followed by genome sequencing in 2 individuals. The index patient underwent a detailed neurological follow‐up examination, including electrophysiological studies and magnetic resonance imaging scanning. Biopsies of the skin and olfactory mucosa were obtained, and expression levels of
<i>TUBB4</i>
mRNA were determined by quantitative real‐time polymerase chain reaction in 3 different cell types. All exons of TUBB4 were screened for mutations in 394 unrelated dystonia patients.</p>
</section>
<section xml:id="ana23829-sec-0003">
<title type="main">Results</title>
<p>The disease‐causing gene was mapped to a 23cM region on chromosome 19p13.3‐p13.2 with a maximum multipoint LOD score of 5.338 at markers D9S427 and D9S1034. Genome sequencing revealed a missense variant in the
<i>TUBB4</i>
(tubulin beta‐4; Arg2Gly) gene as the likely cause of disease. Sequencing of
<i>TUBB4</i>
in 394 unrelated dystonia patients revealed another missense variant (Ala271Thr) in a familial case of segmental dystonia with spasmodic dysphonia. mRNA expression studies demonstrated significantly reduced levels of mutant
<i>TUBB4</i>
mRNA in different cell types from a heterozygous Arg2Gly mutation carrier compared to controls.</p>
</section>
<section xml:id="ana23829-sec-0004">
<title type="main">Interpretation</title>
<p>A mutation in
<i>TUBB4</i>
causes DYT4 dystonia in this Australian family with so‐called whispering dysphonia, and other mutations in
<i>TUBB4</i>
may contribute to spasmodic dysphonia. Given that TUBB4 is a neuronally expressed tubulin, our results imply abnormal microtubule function as a novel mechanism in the pathophysiology of dystonia. Ann Neurol 2013;73:537–545</p>
</section>
</abstract>
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<title>TUBB4 and DYT4 Dystonia</title>
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<title>Whispering dysphonia (DYT4 dystonia) is caused by a mutation in the TUBB4 gene</title>
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<affiliation>Morton and Gloria Shulman Movement Disorders Center and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University of Toronto, Ontario, Toronto, Canada</affiliation>
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<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">Alexander</namePart>
<namePart type="family">Münchau</namePart>
<namePart type="termsOfAddress">MD</namePart>
<affiliation>Department of Neurology, University Medical Center Eppendorf, Hamburg, Germany</affiliation>
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</name>
<name type="personal">
<namePart type="given">Vladimir</namePart>
<namePart type="family">Kostic</namePart>
<namePart type="termsOfAddress">MD</namePart>
<affiliation>Department of Neurology, School of Medicine, University of Belgrade, Belgrade, Serbia</affiliation>
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</name>
<name type="personal">
<namePart type="given">Kristina</namePart>
<namePart type="family">Simonyan</namePart>
<namePart type="termsOfAddress">MD, PhD</namePart>
<affiliation>Departments of Neurology and Otolaryngology, Mount Sinai School of Medicine, NY, New York</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">Marc</namePart>
<namePart type="family">Agzarian</namePart>
<namePart type="termsOfAddress">MD</namePart>
<affiliation>MRI Unit, Department of Radiology, Flinders Medical Centre, Adelaide, Australia</affiliation>
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</role>
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<name type="personal">
<namePart type="given">Laurie J.</namePart>
<namePart type="family">Ozelius</namePart>
<namePart type="termsOfAddress">PhD</namePart>
<affiliation>Department of Genetics and Genomic Sciences, Mount Sinai School of Medicine, NY, New York</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">Antonius P. M.</namePart>
<namePart type="family">Langeveld</namePart>
<namePart type="termsOfAddress">MD, PhD</namePart>
<affiliation>Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands</affiliation>
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<name type="personal">
<namePart type="given">Carolyn M.</namePart>
<namePart type="family">Sue</namePart>
<namePart type="termsOfAddress">MBBS, FRACP, PhD</namePart>
<affiliation>Departments of Neurology and Neurogenetics, Royal North Shore Hospital and Kolling Institute of Medical Research, University of Sydney, Sydney, Australia</affiliation>
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<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">Marina A. J.</namePart>
<namePart type="family">Tijssen</namePart>
<namePart type="termsOfAddress">MD, PhD</namePart>
<affiliation>Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
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</name>
<name type="personal">
<namePart type="given">Christine</namePart>
<namePart type="family">Klein</namePart>
<namePart type="termsOfAddress">MD</namePart>
<affiliation>Institute of Neurogenetics, University of Lübeck, Lübeck, Germany</affiliation>
<affiliation>E-mail: christine.klein@neuro.uni-luebeck.de</affiliation>
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<dateIssued encoding="w3cdtf">2013-04</dateIssued>
<dateCreated encoding="w3cdtf">2012-12-26</dateCreated>
<dateCaptured encoding="w3cdtf">2012-09-19</dateCaptured>
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<abstract>A study was undertaken to identify the gene underlying DYT4 dystonia, a dominantly inherited form of spasmodic dysphonia combined with other focal or generalized dystonia and a characteristic facies and body habitus, in an Australian family.</abstract>
<abstract>Genome‐wide linkage analysis was carried out in 14 family members followed by genome sequencing in 2 individuals. The index patient underwent a detailed neurological follow‐up examination, including electrophysiological studies and magnetic resonance imaging scanning. Biopsies of the skin and olfactory mucosa were obtained, and expression levels of TUBB4 mRNA were determined by quantitative real‐time polymerase chain reaction in 3 different cell types. All exons of TUBB4 were screened for mutations in 394 unrelated dystonia patients.</abstract>
<abstract>The disease‐causing gene was mapped to a 23cM region on chromosome 19p13.3‐p13.2 with a maximum multipoint LOD score of 5.338 at markers D9S427 and D9S1034. Genome sequencing revealed a missense variant in the TUBB4 (tubulin beta‐4; Arg2Gly) gene as the likely cause of disease. Sequencing of TUBB4 in 394 unrelated dystonia patients revealed another missense variant (Ala271Thr) in a familial case of segmental dystonia with spasmodic dysphonia. mRNA expression studies demonstrated significantly reduced levels of mutant TUBB4 mRNA in different cell types from a heterozygous Arg2Gly mutation carrier compared to controls.</abstract>
<abstract>A mutation in TUBB4 causes DYT4 dystonia in this Australian family with so‐called whispering dysphonia, and other mutations in TUBB4 may contribute to spasmodic dysphonia. Given that TUBB4 is a neuronally expressed tubulin, our results imply abnormal microtubule function as a novel mechanism in the pathophysiology of dystonia. Ann Neurol 2013;73:537–545</abstract>
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<title>Ann Neurol.</title>
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<note type="content"> Additional Supporting Information may be found in the online version of this article.Supporting Info Item: Supplementary Information - </note>
<subject>
<genre>article-category</genre>
<topic>Original Article</topic>
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<identifier type="ISSN">0364-5134</identifier>
<identifier type="eISSN">1531-8249</identifier>
<identifier type="DOI">10.1002/(ISSN)1531-8249</identifier>
<identifier type="PublisherID">ANA</identifier>
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<date>2013</date>
<detail type="volume">
<caption>vol.</caption>
<number>73</number>
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<detail type="issue">
<caption>no.</caption>
<number>4</number>
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<extent unit="pages">
<start>537</start>
<end>545</end>
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<identifier type="DOI">10.1002/ana.23829</identifier>
<identifier type="ArticleID">ANA23829</identifier>
<accessCondition type="use and reproduction" contentType="copyright">Copyright © 2012 American Neurological AssociationCopyright © 2012 American Neurological Association</accessCondition>
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