A Ataxia Espinocerebelar com Dismorfismo é marcada por características faciais específicas, associadas a dificuldades na fala (disartria), atraso no desenvolvimento psicomotor (das habilidades mentais e motoras), falta de coordenação (ataxia), curvatura da coluna (escoliose) e deformidades nos pés. Três casos foram descritos e a transmissão parece ser autossômica recessiva, o que significa que a criança precisa herdar um gene alterado de cada um dos pais para desenvolver a condição. Os pais, nesse caso, geralmente são apenas portadores e não apresentam a doença.
Introdução
O que você precisa saber de cara
A Ataxia Espinocerebelar com Dismorfismo é marcada por características faciais específicas, associadas a dificuldades na fala (disartria), atraso no desenvolvimento psicomotor (das habilidades mentais e motoras), falta de coordenação (ataxia), curvatura da coluna (escoliose) e deformidades nos pés. Três casos foram descritos e a transmissão parece ser autossômica recessiva, o que significa que a criança precisa herdar um gene alterado de cada um dos pais para desenvolver a condição. Os pais, nesse caso, geralmente são apenas portadores e não apresentam a doença.
Escala de raridade
<1/50kMuito rara
1/20kRara
1/10kPouco freq.
1/5kIncomum
1/2k
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Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Partes do corpo afetadas
+ 8 sintomas em outras categorias
Características mais comuns
Os sintomas variam de pessoa para pessoa. Abaixo estão as 26 características clínicas mais associadas, ordenadas por frequência.
Linha do tempo da pesquisa
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Genética e causas
O que está alterado no DNA e como passa nas famílias
Nenhum gene associado encontrado
Os dados genéticos desta condição ainda estão sendo catalogados.
Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
Remédios, cuidados de apoio e o que precisa acompanhar
Onde tratar no SUS
Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)
🇧🇷 Atendimento SUS — Síndrome de ataxia espinocerebelosa-dismorfia
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T2-FLAIR hyperintensities in the inferior cerebellar peduncles and their association with clinical symptoms, molecular and MRI markers in male FMR1 premutation carriers.
FMR1 premutation carriers (55-200 CGG repeats) are at risk of developing fragile X-associated tremor/ataxia syndrome (FXTAS), a neurodegenerative disorder associated with motor and cognitive impairment. Bilateral hyperintensities of the middle cerebellar peduncles (MCP sign) are the major radiological hallmarks of FXTAS. The inferior cerebellar peduncles (ICP) contain fibers related to proprioception and vestibular functions (such as the rostral and posterior spinocerebellar tracts and the juxta restiform body), which are clinically associated with cerebellar gait ataxia, a major clinical criterion for FXTAS diagnosis. However, the ICP hyperintensity has yet to be studied in FXTAS. We evaluated 588 MRI scans (mean 2.05 visits/participant) from 202 male premutation carriers (164 with FXTAS and 38 without FXTAS at last visits) and 85 controls. Two radiologists, independently, rated as absent or present the signal of the right and left ICP in T2-Fluid-attenuated inversion recovery (FLAIR) scans. Mixed-effects models were used for statistical analysis adjusting for age. Only carriers with FXTAS revealed ICP hyperintensities at last visits. Furthermore, ICP hyperintensity was associated with brain atrophy, increased white matter disease, the MCP sign, FXTAS stage, abnormal gait, lower cognitive functioning and faster age-related increase in anxiety and depression scores. Finally, carriers with ICP hyperintensities had significantly higher CGG repeat length than carriers without ICP hyperintensities. This study describes ICP hyperintensity as a new potential radiological finding in FXTAS, suggests involvement of the vestibulo-cerebellar, rostral, and posterior spinocerebellar tracts, and the vestibular system in FXTAS physiopathology, and reinforces the association of CGG expansion in the range of brain changes seen in FXTAS.
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The spinocerebellar ataxia composite score (SCACOMS) comprises items from the functional Scale for the Assessment and Rating of Ataxia (f-SARA) and the Clinician Global Impression of Change (CGI-C). In the derivation of SCACOMS, weights reflecting 1-year responsiveness were assigned to each item using partial least squares (PLS) regression modeling. The current objective was to incorporate patient-feedback into the SCACOMS item weights, examine corresponding responsiveness of the composite scale, and discuss potential implications for future use. Item weights derived by PLS regression were compared to each item's relative importance as assigned by 16 patients with SCA during semi-structured interviews. SCACOMS item weights were adjusted using the following combinations: (1) 50/50 weighted combination of PLS and patient weights and (2) reducing the weight of CGI-C to 20% and averaging individual item weights obtained from each perspective. The 1-year mean to standard deviation ratios (MSDRs) for the resulting reweighted scales were compared, with larger MSDRs indicating greatest sensitivity to disease progression. The PLS-derived SCACOMS had the highest MSDR (0.99). When item weights were averaged across the two sources, the resulting MSDR was 0.91. When the weight of CGI-C was set to 20%, reflecting patient preferences for higher weights on the discrete symptoms, the MSDR was 0.79. This study took a novel approach to enhance the face validity of SCACOMS by incorporating patient feedback into the statistically optimized item weights. The result is the merging of objectively derived item weightings (reflecting optimal scale responsiveness) with patient-assigned relevance. While this update may increase the patient centricity of a composite measure, this comes at the expense of reduced sensitivity. This potential trade-off in sensitivity to detect change should be evaluated in the context of the composite measure's intended use.
Pearls & Oy-sters: SCA27B as an Elusive Genetic Cause of Episodic Neurologic Symptoms in Later Adulthood.
Spinocerebellar ataxia type 27B (SCA27B) is a recently identified autosomal dominant form of late-onset cerebellar ataxia (LOCA) caused by a guanine-adenine-adenine (GAA) > 250 intronic repeat expansion in the fibroblast growth factor 14 (FGF14) gene. Recent studies suggest that SCA27B may account for 10%-60% of undiagnosed patients with LOCA. Age at onset ranges from 40s to 70s, and clinical features include slowly progressive pancerebellar syndrome with prominent gait ataxia and cerebellar oculomotor abnormalities. Positive family history may be absent, particularly given the characteristically late onset of this condition. It is important to note that up to half of the patients with SCA27B report episodic symptoms, including imbalance, vertigo, visual disturbances, or dysarthria, which might initially manifest without clear interictal clinical or radiologic features of cerebellar ataxia. These features can result in the misdiagnosis of SCA27B. We present 2 patients with LOCA. Both patients initially received alternative working diagnoses, which were re-examined several years later only after symptoms and imaging findings progressed. First-line genetic testing for both patients was unrevealing because of the deep intronic location of the causative variant. Ultimately, whole-genome-based testing in one case and targeted FGF14 trinucleotide repeat analysis in the other revealed the diagnosis of SCA27B. These cases highlight SCA27B as a cause of episodic neurologic symptoms in an older adult population. Furthermore, these cases demonstrate the potential pitfalls of panel and exome-based genetic testing, given the important role of pathogenic intronic variants in the spectrum of neurogenetic disorders.
Functional and Epigenomic Consequences of DNMT1 Variants in Inherited Neurological Disorders.
DNMT1 variants are linked to complex neurodegenerative syndromes, yet their variant-specific functional and epigenomic consequences remain poorly defined. DNMT1 variants were identified in eight patients using gene-panel or whole-exome sequencing. Functional effects were assessed by site-directed mutagenesis and transient expression in HEK293T cells. Genome-wide methylation profiling of peripheral blood leukocyte DNA was performed using Nanopore sequencing, enabling direct quantification of 5-methylcytosine (5mC). CpG island-level differential methylation and gene set enrichment analysis (GSEA) were conducted. Variants in the replication foci targeting sequence (RFTS) domain (p.Y511H, p.Y540C, p.H569R) exhibited reduced DNMT1 protein expression, decreased enzymatic activity, and cytosolic aggregation. Variants in the C-terminal catalytic domain (p.A1334V and p.P1546S) showed reduced protein expression with relatively mild enzymatic impairment. Patients carrying the p.Y511H variant demonstrated a significant reduction in global 5mC levels compared with controls. Principal component analysis revealed distinct methylomic profiles separating most patients from controls, with marked intra- and inter-familial heterogeneity. CpG island-level analysis identified a single significantly hypomethylated region in p.Y511H carriers, and GSEA revealed differential enrichment of multiple Gene Ontology biological pathways. This study defines domain-dependent functional effects of DNMT1 variants and provides the first nanopore-based methylome analysis, revealing variant-specific and heterogeneous epigenomic alterations.
Patient-reported Vision Quality-of-life in Parkinsonian Syndromes and Ataxias and Association with Clinical Oculomotor Findings.
Oculomotor dysfunction is common in parkinsonian syndromes and ataxias, but its impact on patient-reported vision-related quality of life (VQoL) remains insufficiently understood. To characterize VQoL across parkinsonian syndromes and ataxias and assess the functional significance of specific oculomotor abnormalities in spinocerebellar ataxias. Participants were recruited at Massachusetts General Hospital ( n =231): 104 with Parkinson's disease (PD), 10 with progressive supranuclear palsy (PSP), 56 with genetically defined ataxias (SCA2, SCA3, SCA6, SCA27B, CANVAS), and 61 healthy controls. VQoL was assessed using a 13-item subset of the Visual Activities Questionnaire targeting depth perception, visual acuity/spatial vision, and visual processing speed. Clinical severity was assessed with the Brief Ataxia Rating Scale and Modified International Cooperative Ataxia Rating Scale, and subjective symptoms with PROM-Ataxia. Group comparisons, correlations, and regression analyses were performed. All disease groups reported significantly worse VQoL than controls, with the largest deficits in visual processing speed. PSP showed the greatest impairment across all domains, while PD was less affected. Individuals with SCA3 and SCA6 had significantly lower VQoL across all subcategories. In ataxias, VQoL correlated moderately with PROM-Ataxia and weakly with clinical oculomotor scores. Gaze-evoked nystagmus was the only oculomotor sign independently associated with reduced VQoL. Parkinsonian syndromes and ataxias are associated with substantial VQoL impairment, particularly in visual processing speed. Gaze-evoked nystagmus is a key predictor of reduced VQoL in ataxias, highlighting the functional relevance of fixation instability. Patient-reported outcomes and oculomotor assessments are essential for capturing visual disability in clinical care and trials.
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Neuroscience researchReactive Bergmann glia play a central role in spinocerebellar ataxia inflammation via the JNK pathway.
Journal of neuroinflammationThe Therapeutic Potential of Non-Invasive and Invasive Cerebellar Stimulation Techniques in Hereditary Ataxias.
CellsThe Y831C Mutation of the POLG Gene in Dementia.
BiomedicinesGAA-FGF14 ataxia (SCA27B): phenotypic profile, natural history progression and 4-aminopyridine treatment response.
Brain : a journal of neurologyExpansion of clinical and variant spectrum of EEF2-related neurodevelopmental disorder: Report of two additional cases.
American journal of medical genetics. Part AA novel de novo variant in CASK causes a severe neurodevelopmental disorder that masks the phenotype of a novel de novo variant in EEF2.
Journal of human genetics[Non-cerebellar ataxias: posterior column-like ataxia and cerebellar-like ataxia].
Rinsho shinkeigaku = Clinical neurologySynthesis and cloning of long repeat sequences using single-stranded circular DNA.
Frontiers in bioengineering and biotechnology[Multiple system atrophy].
Zhurnal nevrologii i psikhiatrii imeni S.S. KorsakovaThe Homogeneous Azorean Machado-Joseph Disease Cohort: Characterization and Contributions to Advances in Research.
BiomedicinesCase report: Variants in the ERCC4 gene as a rare cause of cerebellar ataxia with chorea.
Frontiers in geneticsBetween Order and Chaos: Understanding the Mechanism and Pathology of RAN Translation.
Biological & pharmaceutical bulletinElectrophysiological and neuropsychological assessment of cognition in spinocerebellar ataxia type 1 patients: a pilot study.
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical NeurophysiologySpinocerebellar ataxia type 31: A clinical and radiological literature review.
Journal of the neurological sciencesScreening for the FMR1 premutation in Greek patients with late-onset movement disorders.
Parkinsonism & related disordersA de novo hexokinase 1 (HK1) variant presenting as Boucher-Neuhäuser syndrome.
American journal of medical genetics. Part ACoexistence of spinocerebellar ataxia autosomal recessive type 21 and Ehlers-Danlos syndrome spondylodysplastic type 3 in a patient.
Clinical dysmorphologyAutosomal Recessive Spastic Ataxia of Charlevoix-Saguenay due to Novel Mutations in the SACS Gene.
Journal of investigative medicine high impact case reportsEpisodic ataxias in children and adolescents: Clinical findings and suggested diagnostic criteria.
Frontiers in neurologyThe frequency of non-motor symptoms in SCA3 and their association with disease severity and lifestyle factors.
Journal of neurologyAccidental Falls in Patients with Hyperkinetic Movement Disorders: A Systematic Review.
Tremor and other hyperkinetic movements (New York, N.Y.)Isolated axial lateropulsion caused by an acute lateral medullary infarction involving the dorsal spinocerebellar tract: A case report.
Brain circulationPharmacotherapy for the management of the symptoms of Machado-Joseph Disease.
Expert opinion on pharmacotherapyMutation analysis of the TATA box-binding protein (TBP) gene in Russian patients with spinocerebellar ataxia and Huntington disease-like phenotype.
Clinical neurology and neurosurgeryMoyamoya associated with Turner syndrome in a patient with type 2 spinocerebellar ataxia-Occam's razor or Hickam's dictum: a case report.
BMC neurologyThe inherited cerebellar ataxias: an update.
Journal of neurologyPearls & Oy-sters: Deep Phenotyping of Abnormal Eye Movements Advances the Detection of Gerstmann-Sträussler-Scheinker Syndrome.
NeurologyPearls & Oy-sters: SCA21 Due to TMEM240 Variation Presenting as Myoclonus Dystonia Syndrome.
NeurologyCIC missense variants contribute to susceptibility for spina bifida.
Human mutationThe Emerging Key Role of the mGluR1-PKCγ Signaling Pathway in the Pathogenesis of Spinocerebellar Ataxias: A Neurodevelopmental Viewpoint.
International journal of molecular sciencesThe S-Factor, a New Measure of Disease Severity in Spinocerebellar Ataxia: Findings and Implications.
Cerebellum (London, England)A PNPLA8 frameshift variant in Australian shepherd dogs with hereditary ataxia.
Animal geneticsPotpourri of retinopathies in rare eye disease - A case series.
Indian journal of ophthalmologySuperior Cerebellar Atrophy: An Imaging Clue to Diagnose ITPR1-Related Disorders.
International journal of molecular sciencesOn Spinocerebellar Ataxia 21 as a Mimicker of Cerebral Palsy.
Neurology. GeneticsCerebellar transcranial direct current stimulation modulates timing but not acquisition of conditioned eyeblink responses in SCA3 patients.
Brain stimulationAutosomal recessive spinocerebellar ataxia SCAR8/ARCA1: first families detected in Spain.
NeurologiaGenetic and Epigenetic Interplay Define Disease Onset and Severity in Repeat Diseases.
Frontiers in aging neuroscienceSleep disorders among Aboriginal Australians with Machado-Joseph Disease: Quantitative results from a multiple methods study to assess the experience of people living with the disease and their caregivers.
Neurobiology of sleep and circadian rhythmsCerebellar Transcranial Direct Current Stimulation in Spinocerebellar Ataxia Type 3: a Randomized, Double-Blind, Sham-Controlled Trial.
Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeuticsA Severe Dementia Syndrome Caused by Intron Retention and Cryptic Splice Site Activation in STUB1 and Exacerbated by TBP Repeat Expansions.
Frontiers in molecular neuroscienceCognitive Dysfunction in Repeat Expansion Diseases: A Review.
Frontiers in aging neuroscienceSpinocerebellar ataxia in a cohort of patients from Rio de Janeiro.
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical NeurophysiologyRamsay Hunt syndrome: New impressions in the era of molecular genetics.
Parkinsonism & related disordersClinical and Genetic Characterization of Brazilian Patients with Ataxia and Oculomotor Apraxia.
Movement disorders : official journal of the Movement Disorder SocietyThe CCAS-scale in hereditary ataxias: helpful on the group level, particularly in SCA3, but limited in individual patients.
Journal of neurologyMolecular Characterization of Portuguese Patients with Hereditary Cerebellar Ataxia.
CellsThe Clinical Concept of LTDpathy: Is Dysregulated LTD Responsible for Prodromal Cerebellar Symptoms?
Brain sciencesA study on non-invasive prenatal screening for the detection of aneuploidy.
Ginekologia polskaEffectiveness of functional trunk training on trunk control and upper limb functions in patients with autosomal recessive hereditary ataxia.
NeuroRehabilitationTranslation, Cross-Cultural Adaptation, and Validation to Brazilian Portuguese of the Cerebellar Cognitive Affective/Schmahmann Syndrome Scale.
Cerebellum (London, England)Case Report: Late-Onset Autosomal Recessive Cerebellar Ataxia Associated With SYNE1 Mutation in a Chinese Family.
Frontiers in geneticsEpilepsia Partialis Continua a Clinical Feature of a Missense Variant in the ADCK3 Gene and Poor Response to Therapy.
Journal of molecular neuroscience : MNSpinocerebellar ataxia type 3: response to levodopa infusion in two cases.
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical NeurophysiologyRetrocollis as the cardinal feature in a de novo ITRP1 variant.
Brain & developmentEarly-onset Parkinson's disease with atypical molecular imaging abnormalities in a patient carrying the de novo PRKCG mutation.
Parkinsonism & related disordersThymidine Kinase 2 and Mitochondrial Protein COX I in the Cerebellum of Patients with Spinocerebellar Ataxia Type 31 Caused by Penta-nucleotide Repeats (TTCCA)n.
Cerebellum (London, England)Multifaceted and Age-Dependent Phenotypes Associated With Biallelic PNPLA6 Gene Variants: Eight Novel Cases and Review of the Literature.
Frontiers in neurologyAssociações
Organizações que acompanham esta doença — pra ter apoio e orientação
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- T2-FLAIR hyperintensities in the inferior cerebellar peduncles and their association with clinical symptoms, molecular and MRI markers in male FMR1 premutation carriers.
- Incorporating Patient Perspectives into a Composite Score for Measuring Disease Progression in Spinocerebellar Ataxia (SCA).
- Pearls & Oy-sters: SCA27B as an Elusive Genetic Cause of Episodic Neurologic Symptoms in Later Adulthood.
- Functional and Epigenomic Consequences of DNMT1 Variants in Inherited Neurological Disorders.
- Patient-reported Vision Quality-of-life in Parkinsonian Syndromes and Ataxias and Association with Clinical Oculomotor Findings.
- Systematic literature review of the somatic comorbidities experienced by adults with phenylketonuria.
- Advancing Transthyretin Amyloidosis Drug Development in an Evolving Treatment Landscape: Amyloidosis Forum Meeting Proceedings.
- Targeted-Capture Next-Generation Sequencing in Diagnosis Approach of Pediatric Cholestasis.
- Genotype-phenotype correlation and natural history analyses in a Chinese cohort with pelizaeus-merzbacher disease.
- Cost-effectiveness analysis of using the TBX6-associated congenital scoliosis risk score (TACScore) in genetic diagnosis of congenital scoliosis.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:1185(Orphanet)
- OMIM OMIM:271270(OMIM)
- MONDO:0010062(MONDO)
- GARD:4958(GARD (NIH))
- Busca completa no PubMed(PubMed)
- Q55782323(Wikidata)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar
