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http://purl.uniprot.org/citations/32337771http://www.w3.org/1999/02/22-rdf-syntax-ns#typehttp://purl.uniprot.org/core/Journal_Citation
http://purl.uniprot.org/citations/32337771http://www.w3.org/2000/01/rdf-schema#comment"

Objective

To foster trial-readiness of coenzyme Q8A (COQ8A)-ataxia, we map the clinicogenetic, molecular, and neuroimaging spectrum of COQ8A-ataxia in a large worldwide cohort, and provide first progression data, including treatment response to coenzyme Q10 (CoQ10).

Methods

Cross-modal analysis of a multicenter cohort of 59 COQ8A patients, including genotype-phenotype correlations, 3D-protein modeling, in vitro mutation analyses, magnetic resonance imaging (MRI) markers, disease progression, and CoQ10 response data.

Results

Fifty-nine patients (39 novel) with 44 pathogenic COQ8A variants (18 novel) were identified. Missense variants demonstrated a pleiotropic range of detrimental effects upon protein modeling and in vitro analysis of purified variants. COQ8A-ataxia presented as variable multisystemic, early-onset cerebellar ataxia, with complicating features ranging from epilepsy (32%) and cognitive impairment (49%) to exercise intolerance (25%) and hyperkinetic movement disorders (41%), including dystonia and myoclonus as presenting symptoms. Multisystemic involvement was more prevalent in missense than biallelic loss-of-function variants (82-93% vs 53%; p = 0.029). Cerebellar atrophy was universal on MRI (100%), with cerebral atrophy or dentate and pontine T2 hyperintensities observed in 28%. Cross-sectional (n = 34) and longitudinal (n = 7) assessments consistently indicated mild-to-moderate progression of ataxia (SARA: 0.45/year). CoQ10 treatment led to improvement by clinical report in 14 of 30 patients, and by quantitative longitudinal assessments in 8 of 11 patients (SARA: -0.81/year). Explorative sample size calculations indicate that ≥48 patients per arm may suffice to demonstrate efficacy for interventions that reduce progression by 50%.

Interpretation

This study provides a deeper understanding of the disease, and paves the way toward large-scale natural history studies and treatment trials in COQ8A-ataxia. ANN NEUROL 2020;88:251-263."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.org/dc/terms/identifier"doi:10.1002/ana.25751"xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Bingman C.A."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Rougeot C."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Durr A."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Pagliarini D.J."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Bertini E."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Koenig M."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Santorelli F.M."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Klopstock T."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Horvath R."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Kern J."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Ganos C."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Baets J."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Laugwitz L."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Grasshoff U."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Magri S."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Synofzik M."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Taroni F."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Malandrini A."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Anheim M."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Reich S."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Puccio H."xsd:string
http://purl.uniprot.org/citations/32337771http://purl.uniprot.org/core/author"Distelmaier F."xsd:string
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