Hyperkinetic Movement Disorder Caused by the Recurrent c.892C>T NACC1 Variant

Mov Disord Clin Pract. 2024 Jun;11(6):708-715. doi: 10.1002/mdc3.14051. Epub 2024 May 2.

Abstract

Background: Genetic syndromes of hyperkinetic movement disorders associated with epileptic encephalopathy and intellectual disability are becoming increasingly recognized. Recently, a de novo heterozygous NACC1 (nucleus accumbens-associated 1) missense variant was described in a patient cohort including one patient with a combined mitochondrial oxidative phosphorylation (OXPHOS) deficiency.

Objectives: The objective is to characterize the movement disorder in affected patients with the recurrent c.892C>T NACC1 variant and study the NACC1 protein and mitochondrial function at the cellular level.

Methods: The movement disorder was analyzed on four patients with the NACC1 c.892C>T (p.Arg298Trp) variant. Studies on NACC1 protein and mitochondrial function were performed on patient-derived fibroblasts.

Results: All patients had a generalized hyperkinetic movement disorder with chorea and dystonia, which occurred cyclically and during sleep. Complex I was found altered, whereas the other OXPHOS enzymes and the mitochondria network seemed intact in one patient.

Conclusions: The movement disorder is a prominent feature of NACC1-related disease.

Keywords: NACC1; cyclic; hyperkinetic; movement disorder.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Female
  • Humans
  • Hyperkinesis* / genetics
  • Male
  • Mitochondria / genetics
  • Mitochondria / pathology
  • Mutation, Missense
  • Oxidative Phosphorylation
  • Repressor Proteins / genetics

Substances

  • Repressor Proteins
  • NACC1 protein, human