Natural History of Adult Patients with GM2 Gangliosidosis.

Abstract:

OBJECTIVE:GM2 gangliosidoses are lysosomal diseases due to biallelic mutations in the HEXA (Tay-Sachs disease [TS]) or HEXB (Sandhoff disease [SD]) genes, with subsequent low hexosaminidase(s) activity. Most patients have childhood onset, but some experience the first symptoms during adolescence/adulthood. This study aims to clarify the natural history of adult patients with GM2 gangliosidosis. METHODS:We retrospectively described 12 patients from a French cohort and 45 patients from the literature. RESULTS:We observed 4 typical presentations: (1) lower motoneuron disorder responsible for proximal lower limb weakness that subsequently expanded to the upper limbs, (2) cerebellar ataxia, (3) psychosis and/or severe mood disorder (only in the TS patients), and (4) a complex phenotype mixing the above 3 manifestations. The psoas was the first and most affected muscle in the lower limbs, whereas the triceps and interosseous were predominantly involved in the upper limbs. A longitudinal study of compound motor action potentials showed a progressive decrease in all nerves, with different kinetics. Sensory potentials were sometimes abnormally low, mainly in the SD patients. The main brain magnetic resonance imaging feature was cerebellar atrophy, even in patients without cerebellar symptoms. The prognosis was mainly related to gait disorder, as we showed that beyond 20 years of disease evolution, half of the patients were wheelchair users. INTERPRETATION:Improved knowledge of GM2 gangliosidosis in adults will help clinicians achieve correct diagnoses and better inform patients on the evolution and prognosis. It may also contribute to defining proper outcome measures when testing emerging therapies. ANN NEUROL 2020;87:609-617.

journal_name

Ann Neurol

journal_title

Annals of neurology

authors

Masingue M,Dufour L,Lenglet T,Saleille L,Goizet C,Ayrignac X,Ory-Magne F,Barth M,Lamari F,Mandia D,Caillaud C,Nadjar Y

doi

10.1002/ana.25689

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

609-617

issue

4

eissn

0364-5134

issn

1531-8249

journal_volume

87

pub_type

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