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NEUROLOGY 1997;48:1244-1253
© 1997 American Academy of Neurology

Autosomal dominant progressive external ophthalmoplegia with multiple deletions of mtDNA

Clinical, biochemical, and molecular genetic features of the 1Oq-linked disease

A. Suomalainen, MD, PhD, A. Majander, MD, PhD, M. Wallin, MD, K. Setälä, MD, K. Kontula, MD, PhD, H. Leinonen, MD, PhD, T. Salmi, MD, A. Paetau, MD, PhD, M. Haltia, MD, PhD, L. Valanne, MD, J. Lonnqvist, MD, PhD, L. Peltonen, MD, PhD and H. Somer, MD, PhD

From the Departments of Human Molecular Genetics (Drs. Suomalainen and Peltonen) and Mental Health (Dr. Lonnqvist), National Public Health Institute; and the Departments of Medical Chemistry (Dr. Majander), Psychiatry (Dr. Wallin), Ophthalmology (Dr. Setala), First (Dr. Leinonen) and Second (Dr. Kontula) Departments of Medicine, Neurology (Drs. Salmi and Somer), Pathology (Drs. Paetau and Haltia), and Radiology (Dr. Valanne), University of Helsinki, Helsinki, Finland.

Autosomal dominant progressive external ophthalmoplegia (adPEO) is a mitochondrial disease characterized by accumulation of multiple large deletions of mtDNA in patients' tissues. We previously showed that the disease is genetically heterogeneous by assigning two nuclear loci predisposing to mtDNA deletions: one on chromosome 10q 23.3–24.3 in a Finnish family and one on 3p 14.1–21.2 in three Italian families. To reveal any locus-specific disease features, we report here the clinical, biochemical, and molecular genetic characteristics of the 10q-linked disease in the single family reported to date. All seven patients and four asymptomatic subjects had ragged-red fibers and multiple deletions of mtDNA in their muscle. Ptosis and external ophthalmoplegia were the major clinical findings, and depression or avoidant personality traits were frequently, but not consistently, present in the subjects carrying mutant mtDNA. In six of the subjects with mutant mtDNA, the activities of the respiratory chain complexes I or IV, or both, were below or within the low normal range. Two autopsy studies revealed the characteristic distribution of mutant mtDNA in these patients: highest proportion of mutant mtDNA is found in different parts of the brain, followed by the skeletal and ocular muscle, and the heart.




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