Cited by 205Neurological diseases and metabolismParkinson's Disease Mechanisms and TreatmentsGenetic Neurodegenerative Diseases

Clinical features and natural history of neuroferritinopathy caused by the FTL1 460InsA mutation

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Chinnery, P. F., Crompton, D. E., Birchall, D., Jackson, M. J., Coulthard, A., Lombes, A., Quinn, N., Wills, A. +6 more·2006·Brain

Abstract

Neuroferritinopathy is a progressive potentially treatable adult-onset movement disorder caused by mutations in the ferritin light chain gene (FTL1). Features overlap with common extrapyramidal disorders: idiopathic torsion dystonia, idiopathic Parkinson's disease and Huntington's disease, but the phenotype and natural history have not been defined. We studied a genetically homogeneous group of 41 subjects with the 460InsA mutation in FTL1, documenting the presentation, clinical course, biochemistry and neuroimaging. The mean age of onset was 39.4 years (SD = 13.3, range 13-63), beginning with chorea in 50%, focal lower limb dystonia in 42.5% and parkinsonism in 7.5%. The majority reported a family history of a movement disorder often misdiagnosed as Huntington's disease. The disease progressed relentlessly, becoming generalized over a 5-10 year period, eventually leading to aphonia, dysphagia and severe motor disability with subcortical/frontal cognitive dysfunction as a late feature. A characteristic action-specific facial dystonia was common (65%), and in 63% there was asymmetry throughout the disease course. Serum ferritin levels were low in the majority of males and post-menopausal females, but within normal limits for pre-menopausal females. MR brain imaging was abnormal on all affected individuals and one presymptomatic carrier. In conclusion, isolated parkinsonism is unusual in neuroferritinopathy, and unlike Huntington's disease, cognitive changes are absent or subtle in the early stages. Depressed serum ferritin is common and provides a useful screening test in routine practice, and gradient echo brain MRI will identify all symptomatic cases.

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  • Neuroferritinopathy is caused by mutations in light-chain-ferritin resulting in loss of function and accumulation of iron in the globus pallidus, putamen, and dentate nuclei of the cerebellum.

    “Neuroferritinopathy, a rare adult-onset condition presenting with a range of extrapyramidal movement disorders, is caused by mutations in light-chain–ferritin185 (the principal iron storage protein) resulting in loss of function and accumulation of iron in the globus pallidus, putamen, and dentate nuclei of the cerebellum.186”

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Research works printed but not linked: 1

  1. Fink JK, Filling-Katz MR, Sokol J, Cogan DG, Pikus A, Sonies B, et al. Clinical spectrumof Niemann-Pick diseasetype C. Neurology1989;39: 1040-9.

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Authors
Chinnery, P. F., Crompton, D. E., Birchall, D., Jackson, M. J., Coulthard, A., Lombes, A., Quinn, N., Wills, A., Fletcher, N., Mottershead, J. P., Cooper, P., Kellett, M., Bates, D., & Burn, J.
Affiliations
  • Newcastle University (GB)
  • Newcastle upon Tyne Hospitals NHS Foundation Trust (GB)
  • The University of Queensland (AU)
  • National Hospital for Neurology and Neurosurgery (GB)
  • Queen's Medical Centre (GB)
  • Walton Centre (GB)
  • Salford Royal Hospital (GB)
Corresponding author
Chinnery, P. F.
Venue
Brain
Published
2006-11-21
Volume
130
Issue
1
Pages
110-119
ISSN
  • 0006-8950 (ISSN-L)
  • 1460-2156
OpenAlex
W2147249791
Cited by
205
References
29
Citations by year
2026: 4 · 2025: 2 · 2024: 4 · 2023: 4 · 2022: 2 · 2021: 11 · 2020: 7 · 2019: 8 · 2018: 3 · 2017: 11 · 2016: 12 · 2015: 12 · 2014: 23 · 2013: 22 · 2012: 17
FWCI
5.92
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • Brain (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Newcastle University ePrints (Newcastle Univesity)
Funders
  • Wellcome Trust
  • Alzheimer's Research Trust
  • Ataxia UK
Topics
  • Life Sciences › Neuroscience › Neurology › Neurological diseases and metabolism
  • Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Genetic Neurodegenerative Diseases
Keywords
neuroferritinopathy, chorea, facial dystonia, parkinsonism, idiopathic torsion dystonia, serum ferritin, brain MRI abnormalities, natural history (disease), extrapyramidal disorders, cognitive impairment
MeSH terms
Adolescent, Adult, Apoferritins, Brain, Chorea, Dystonia, Family Health, Female, Ferritins, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Movement Disorders, Mutation, Parkinson Disease, Phenotype, Sex Factors, Age of Onset, Muscle, Skeletal

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