A step toward essential tremor gene discovery: identification of extreme phenotype and screening of HTRA2 and ANO3
Identifieur interne : 000367 ( Main/Exploration ); précédent : 000366; suivant : 000368A step toward essential tremor gene discovery: identification of extreme phenotype and screening of HTRA2 and ANO3
Auteurs : Mathilde Renaud [France] ; Christophe Marcel [France] ; Gabrielle Rudolf [France] ; Mickaël Schaeffer [France] ; Ouhaïd Lagha-Boukbiza [France] ; Jean-Baptiste Chanson [France] ; Jamel Chelly [France] ; Mathieu Anheim [France] ; Christine Tranchant [France]Source :
- BMC Neurology [ 1471-2377 ] ; 2016.
Abstract
Essential tremor (ET) is characterized by a frequent family history. No monogenic form of ET has been identified. We aimed at exploring ET patients to identify distinct subgroups and facilitate the identification of ET genes. We tested for the presence of
Between June 2011 and November 2013, all consecutive patients suspected with ET were prospectively included in a prospective, monocentric study. Family history, age at onset (AAO), features of tremor, benefit of alcohol and drugs, electrophysiological recording findings were collected. Sanger sequencing was performed for
Sixty eight patients were investigated. Fourteen diagnosed with psychogenic (5) or dystonic tremor (9) were excluded. Regarding the 54 ET patients, mean AAO was 48 years (6–77), and mean disease duration 15 years (1–55). Bimodal distribution of AAO was consistent with phenotypic subgroups. In patients with AAO before 30 years, marked benefit of alcohol (
Our data support that distinct ET phenotypic subgroups may be encountered. We recommend to study separately extreme phenotypes of ET, particularly autosomal dominant families with early AAO (<30 years) and marked benefit of alcohol, to facilitate the identification of ET genes. Electromyographic recording remains a support to distinguish ET from differential diagnosis.
Url:
DOI: 10.1186/s12883-016-0748-3
PubMed: 27881096
PubMed Central: 5120508
Affiliations:
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<affiliation wicri:level="4"><nlm:aff id="Aff2">Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg</wicri:regionArea>
<placeName><region type="region">Grand Est</region>
<region type="old region">Alsace (région administrative)</region>
<settlement type="city">Strasbourg</settlement>
</placeName>
<orgName type="university">Université de Strasbourg</orgName>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="Aff3">Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67404 Illkirch, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67404 Illkirch</wicri:regionArea>
<placeName><region type="region" nuts="2">Grand Est</region>
<region type="old region" nuts="2">Alsace (région administrative)</region>
<settlement type="city">Illkirch</settlement>
</placeName>
<orgName type="university">Université de Strasbourg</orgName>
</affiliation>
</author>
<author><name sortKey="Schaeffer, Mickael" sort="Schaeffer, Mickael" uniqKey="Schaeffer M" first="Mickaël" last="Schaeffer">Mickaël Schaeffer</name>
<affiliation wicri:level="4"><nlm:aff id="Aff2">Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg</wicri:regionArea>
<placeName><region type="region">Grand Est</region>
<region type="old region">Alsace (région administrative)</region>
<settlement type="city">Strasbourg</settlement>
</placeName>
<orgName type="university">Université de Strasbourg</orgName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="Aff4">Département d’informations médicales, Hôpitaux universitaires de Strasbourg, Hôpital civil, 1 place de l’Hôpital, 67000 Strasbourg, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Département d’informations médicales, Hôpitaux universitaires de Strasbourg, Hôpital civil, 1 place de l’Hôpital, 67000 Strasbourg</wicri:regionArea>
<placeName><region type="region" nuts="2">Grand Est</region>
<region type="old region" nuts="2">Alsace (région administrative)</region>
<settlement type="city">Strasbourg</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lagha Boukbiza, Ouhaid" sort="Lagha Boukbiza, Ouhaid" uniqKey="Lagha Boukbiza O" first="Ouhaïd" last="Lagha-Boukbiza">Ouhaïd Lagha-Boukbiza</name>
<affiliation wicri:level="3"><nlm:aff id="Aff1">Service of Neurology, University Hospital of Strasbourg, Hospital of Hautepierre, 1 avenue Molière, 67098 Strasbourg Cedex, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service of Neurology, University Hospital of Strasbourg, Hospital of Hautepierre, 1 avenue Molière, 67098 Strasbourg Cedex</wicri:regionArea>
<placeName><region type="region" nuts="2">Grand Est</region>
<region type="old region" nuts="2">Alsace (région administrative)</region>
<settlement type="city">Strasbourg</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="Aff2">Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg</wicri:regionArea>
<placeName><region type="region">Grand Est</region>
<region type="old region">Alsace (région administrative)</region>
<settlement type="city">Strasbourg</settlement>
</placeName>
<orgName type="university">Université de Strasbourg</orgName>
</affiliation>
</author>
<author><name sortKey="Chanson, Jean Baptiste" sort="Chanson, Jean Baptiste" uniqKey="Chanson J" first="Jean-Baptiste" last="Chanson">Jean-Baptiste Chanson</name>
<affiliation wicri:level="3"><nlm:aff id="Aff1">Service of Neurology, University Hospital of Strasbourg, Hospital of Hautepierre, 1 avenue Molière, 67098 Strasbourg Cedex, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service of Neurology, University Hospital of Strasbourg, Hospital of Hautepierre, 1 avenue Molière, 67098 Strasbourg Cedex</wicri:regionArea>
<placeName><region type="region" nuts="2">Grand Est</region>
<region type="old region" nuts="2">Alsace (région administrative)</region>
<settlement type="city">Strasbourg</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="Aff2">Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg</wicri:regionArea>
<placeName><region type="region">Grand Est</region>
<region type="old region">Alsace (région administrative)</region>
<settlement type="city">Strasbourg</settlement>
</placeName>
<orgName type="university">Université de Strasbourg</orgName>
</affiliation>
</author>
<author><name sortKey="Chelly, Jamel" sort="Chelly, Jamel" uniqKey="Chelly J" first="Jamel" last="Chelly">Jamel Chelly</name>
<affiliation wicri:level="4"><nlm:aff id="Aff2">Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg</wicri:regionArea>
<placeName><region type="region">Grand Est</region>
<region type="old region">Alsace (région administrative)</region>
<settlement type="city">Strasbourg</settlement>
</placeName>
<orgName type="university">Université de Strasbourg</orgName>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="Aff3">Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67404 Illkirch, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67404 Illkirch</wicri:regionArea>
<placeName><region type="region" nuts="2">Grand Est</region>
<region type="old region" nuts="2">Alsace (région administrative)</region>
<settlement type="city">Illkirch</settlement>
</placeName>
<orgName type="university">Université de Strasbourg</orgName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="Aff5">Service de Diagnostic génétique, Nouvel hôpital civil, 67000 Strasbourg Cedex, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service de Diagnostic génétique, Nouvel hôpital civil, 67000 Strasbourg Cedex</wicri:regionArea>
<placeName><region type="region" nuts="2">Grand Est</region>
<region type="old region" nuts="2">Alsace (région administrative)</region>
<settlement type="city">Strasbourg</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Anheim, Mathieu" sort="Anheim, Mathieu" uniqKey="Anheim M" first="Mathieu" last="Anheim">Mathieu Anheim</name>
<affiliation wicri:level="3"><nlm:aff id="Aff1">Service of Neurology, University Hospital of Strasbourg, Hospital of Hautepierre, 1 avenue Molière, 67098 Strasbourg Cedex, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service of Neurology, University Hospital of Strasbourg, Hospital of Hautepierre, 1 avenue Molière, 67098 Strasbourg Cedex</wicri:regionArea>
<placeName><region type="region" nuts="2">Grand Est</region>
<region type="old region" nuts="2">Alsace (région administrative)</region>
<settlement type="city">Strasbourg</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="Aff2">Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg</wicri:regionArea>
<placeName><region type="region">Grand Est</region>
<region type="old region">Alsace (région administrative)</region>
<settlement type="city">Strasbourg</settlement>
</placeName>
<orgName type="university">Université de Strasbourg</orgName>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="Aff3">Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67404 Illkirch, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67404 Illkirch</wicri:regionArea>
<placeName><region type="region" nuts="2">Grand Est</region>
<region type="old region" nuts="2">Alsace (région administrative)</region>
<settlement type="city">Illkirch</settlement>
</placeName>
<orgName type="university">Université de Strasbourg</orgName>
</affiliation>
</author>
<author><name sortKey="Tranchant, Christine" sort="Tranchant, Christine" uniqKey="Tranchant C" first="Christine" last="Tranchant">Christine Tranchant</name>
<affiliation wicri:level="3"><nlm:aff id="Aff1">Service of Neurology, University Hospital of Strasbourg, Hospital of Hautepierre, 1 avenue Molière, 67098 Strasbourg Cedex, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service of Neurology, University Hospital of Strasbourg, Hospital of Hautepierre, 1 avenue Molière, 67098 Strasbourg Cedex</wicri:regionArea>
<placeName><region type="region" nuts="2">Grand Est</region>
<region type="old region" nuts="2">Alsace (région administrative)</region>
<settlement type="city">Strasbourg</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="Aff2">Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg</wicri:regionArea>
<placeName><region type="region">Grand Est</region>
<region type="old region">Alsace (région administrative)</region>
<settlement type="city">Strasbourg</settlement>
</placeName>
<orgName type="university">Université de Strasbourg</orgName>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="Aff3">Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67404 Illkirch, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67404 Illkirch</wicri:regionArea>
<placeName><region type="region" nuts="2">Grand Est</region>
<region type="old region" nuts="2">Alsace (région administrative)</region>
<settlement type="city">Illkirch</settlement>
</placeName>
<orgName type="university">Université de Strasbourg</orgName>
</affiliation>
</author>
</analytic>
<series><title level="j">BMC Neurology</title>
<idno type="eISSN">1471-2377</idno>
<imprint><date when="2016">2016</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Essential tremor (ET) is characterized by a frequent family history. No monogenic form of ET has been identified. We aimed at exploring ET patients to identify distinct subgroups and facilitate the identification of ET genes. We tested for the presence of <italic>HTRA2</italic>
p.G399S, and <italic>ANO3</italic>
p. W490C, p. R484 W and p. S685G mutations.</p>
</sec>
<sec><title>Methods</title>
<p>Between June 2011 and November 2013, all consecutive patients suspected with ET were prospectively included in a prospective, monocentric study. Family history, age at onset (AAO), features of tremor, benefit of alcohol and drugs, electrophysiological recording findings were collected. Sanger sequencing was performed for <italic>HTRA2</italic>
and <italic>ANO3</italic>
mutations screening.</p>
</sec>
<sec><title>Results</title>
<p>Sixty eight patients were investigated. Fourteen diagnosed with psychogenic (5) or dystonic tremor (9) were excluded. Regarding the 54 ET patients, mean AAO was 48 years (6–77), and mean disease duration 15 years (1–55). Bimodal distribution of AAO was consistent with phenotypic subgroups. In patients with AAO before 30 years, marked benefit of alcohol (<italic>p</italic>
< 0.01) and ET family history (<italic>p</italic>
< 0.01) were more frequent and the disease progression less severe (<italic>p</italic>
< 0.0001). Neither <italic>HTRA2</italic>
nor <italic>ANO3</italic>
mutation were identified in our patients.</p>
</sec>
<sec><title>Conclusions</title>
<p>Our data support that distinct ET phenotypic subgroups may be encountered. We recommend to study separately extreme phenotypes of ET, particularly autosomal dominant families with early AAO (<30 years) and marked benefit of alcohol, to facilitate the identification of ET genes. Electromyographic recording remains a support to distinguish ET from differential diagnosis. <italic>HTRA2</italic>
and <italic>ANO3</italic>
mutations are not common causes of ET.</p>
</sec>
</div>
</front>
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</author>
<author><name sortKey="Zeuner, Ke" uniqKey="Zeuner K">KE Zeuner</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Elble, Rj" uniqKey="Elble R">RJ Elble</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Chuang, W L" uniqKey="Chuang W">W-L Chuang</name>
</author>
<author><name sortKey="Lu, C S" uniqKey="Lu C">C-S Lu</name>
</author>
<author><name sortKey="Huang, Y Z" uniqKey="Huang Y">Y-Z Huang</name>
</author>
<author><name sortKey="Chen, R S" uniqKey="Chen R">R-S Chen</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Cohen, O" uniqKey="Cohen O">O Cohen</name>
</author>
<author><name sortKey="Pullman, S" uniqKey="Pullman S">S Pullman</name>
</author>
<author><name sortKey="Jurewicz, E" uniqKey="Jurewicz E">E Jurewicz</name>
</author>
<author><name sortKey="Watner, D" uniqKey="Watner D">D Watner</name>
</author>
<author><name sortKey="Louis, Ed" uniqKey="Louis E">ED Louis</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Minen, Mt" uniqKey="Minen M">MT Minen</name>
</author>
<author><name sortKey="Louis, Ed" uniqKey="Louis E">ED Louis</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Hopfner, F" uniqKey="Hopfner F">F Hopfner</name>
</author>
<author><name sortKey="Muller, Sh" uniqKey="Muller S">SH Müller</name>
</author>
<author><name sortKey="Lorenz, D" uniqKey="Lorenz D">D Lorenz</name>
</author>
<author><name sortKey="Appenzeller, S" uniqKey="Appenzeller S">S Appenzeller</name>
</author>
<author><name sortKey="Klebe, S" uniqKey="Klebe S">S Klebe</name>
</author>
<author><name sortKey="Deuschl, G" uniqKey="Deuschl G">G Deuschl</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Tzoulis, C" uniqKey="Tzoulis C">C Tzoulis</name>
</author>
<author><name sortKey="Zayats, T" uniqKey="Zayats T">T Zayats</name>
</author>
<author><name sortKey="Knappskog, Pm" uniqKey="Knappskog P">PM Knappskog</name>
</author>
<author><name sortKey="Muller, B" uniqKey="Muller B">B Müller</name>
</author>
<author><name sortKey="Larsen, Jp" uniqKey="Larsen J">JP Larsen</name>
</author>
<author><name sortKey="Tysnes, O B" uniqKey="Tysnes O">O-B Tysnes</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Deuschl, G" uniqKey="Deuschl G">G Deuschl</name>
</author>
<author><name sortKey="Raethjen, J" uniqKey="Raethjen J">J Raethjen</name>
</author>
<author><name sortKey="Hellriegel, H" uniqKey="Hellriegel H">H Hellriegel</name>
</author>
<author><name sortKey="Elble, R" uniqKey="Elble R">R Elble</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<affiliations><list><country><li>France</li>
</country>
<region><li>Alsace (région administrative)</li>
<li>Grand Est</li>
</region>
<settlement><li>Illkirch</li>
<li>Strasbourg</li>
</settlement>
<orgName><li>Université de Strasbourg</li>
</orgName>
</list>
<tree><country name="France"><region name="Grand Est"><name sortKey="Renaud, Mathilde" sort="Renaud, Mathilde" uniqKey="Renaud M" first="Mathilde" last="Renaud">Mathilde Renaud</name>
</region>
<name sortKey="Anheim, Mathieu" sort="Anheim, Mathieu" uniqKey="Anheim M" first="Mathieu" last="Anheim">Mathieu Anheim</name>
<name sortKey="Anheim, Mathieu" sort="Anheim, Mathieu" uniqKey="Anheim M" first="Mathieu" last="Anheim">Mathieu Anheim</name>
<name sortKey="Anheim, Mathieu" sort="Anheim, Mathieu" uniqKey="Anheim M" first="Mathieu" last="Anheim">Mathieu Anheim</name>
<name sortKey="Chanson, Jean Baptiste" sort="Chanson, Jean Baptiste" uniqKey="Chanson J" first="Jean-Baptiste" last="Chanson">Jean-Baptiste Chanson</name>
<name sortKey="Chanson, Jean Baptiste" sort="Chanson, Jean Baptiste" uniqKey="Chanson J" first="Jean-Baptiste" last="Chanson">Jean-Baptiste Chanson</name>
<name sortKey="Chelly, Jamel" sort="Chelly, Jamel" uniqKey="Chelly J" first="Jamel" last="Chelly">Jamel Chelly</name>
<name sortKey="Chelly, Jamel" sort="Chelly, Jamel" uniqKey="Chelly J" first="Jamel" last="Chelly">Jamel Chelly</name>
<name sortKey="Chelly, Jamel" sort="Chelly, Jamel" uniqKey="Chelly J" first="Jamel" last="Chelly">Jamel Chelly</name>
<name sortKey="Lagha Boukbiza, Ouhaid" sort="Lagha Boukbiza, Ouhaid" uniqKey="Lagha Boukbiza O" first="Ouhaïd" last="Lagha-Boukbiza">Ouhaïd Lagha-Boukbiza</name>
<name sortKey="Lagha Boukbiza, Ouhaid" sort="Lagha Boukbiza, Ouhaid" uniqKey="Lagha Boukbiza O" first="Ouhaïd" last="Lagha-Boukbiza">Ouhaïd Lagha-Boukbiza</name>
<name sortKey="Marcel, Christophe" sort="Marcel, Christophe" uniqKey="Marcel C" first="Christophe" last="Marcel">Christophe Marcel</name>
<name sortKey="Marcel, Christophe" sort="Marcel, Christophe" uniqKey="Marcel C" first="Christophe" last="Marcel">Christophe Marcel</name>
<name sortKey="Renaud, Mathilde" sort="Renaud, Mathilde" uniqKey="Renaud M" first="Mathilde" last="Renaud">Mathilde Renaud</name>
<name sortKey="Renaud, Mathilde" sort="Renaud, Mathilde" uniqKey="Renaud M" first="Mathilde" last="Renaud">Mathilde Renaud</name>
<name sortKey="Rudolf, Gabrielle" sort="Rudolf, Gabrielle" uniqKey="Rudolf G" first="Gabrielle" last="Rudolf">Gabrielle Rudolf</name>
<name sortKey="Rudolf, Gabrielle" sort="Rudolf, Gabrielle" uniqKey="Rudolf G" first="Gabrielle" last="Rudolf">Gabrielle Rudolf</name>
<name sortKey="Rudolf, Gabrielle" sort="Rudolf, Gabrielle" uniqKey="Rudolf G" first="Gabrielle" last="Rudolf">Gabrielle Rudolf</name>
<name sortKey="Schaeffer, Mickael" sort="Schaeffer, Mickael" uniqKey="Schaeffer M" first="Mickaël" last="Schaeffer">Mickaël Schaeffer</name>
<name sortKey="Schaeffer, Mickael" sort="Schaeffer, Mickael" uniqKey="Schaeffer M" first="Mickaël" last="Schaeffer">Mickaël Schaeffer</name>
<name sortKey="Tranchant, Christine" sort="Tranchant, Christine" uniqKey="Tranchant C" first="Christine" last="Tranchant">Christine Tranchant</name>
<name sortKey="Tranchant, Christine" sort="Tranchant, Christine" uniqKey="Tranchant C" first="Christine" last="Tranchant">Christine Tranchant</name>
<name sortKey="Tranchant, Christine" sort="Tranchant, Christine" uniqKey="Tranchant C" first="Christine" last="Tranchant">Christine Tranchant</name>
</country>
</tree>
</affiliations>
</record>
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