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<title>Mutations in VPS13D lead to a new recessive ataxia with spasticity and mitochondrial defects - PubMed</title>
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<meta name="description" content="Our study demonstrates that compound heterozygous mutations in VPS13D cause movement disorders along the ataxia-spasticity spectrum, making VPS13D the fourth VPS13 paralog involved in neurological disorders. Ann Neurol 2018."><meta name="keywords" content="pmid:29604224, PMC6105379, doi:10.1002/ana.25220, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov&#x27;t, Eunju Seong, Ryan Insolera, Margit Burmeister, Adult, Cerebellar Ataxia / genetics, Female, Genetic Linkage, Humans, Intellectual Disability / genetics*, Male, Middle Aged, Mitochondria / genetics*, Muscle Spasticity / genetics*, Mutation / genetics*, Optic Atrophy / genetics*, Pedigree, Proteins / genetics*, Spastic Paraplegia, Hereditary / genetics, Spinocerebellar Ataxias / genetics*, PubMed Abstract, NIH, NLM, NCBI, National Institutes of Health, National Center for Biotechnology Information, National Library of Medicine, MEDLINE"><meta name="robots" content="index,nofollow,noarchive"><meta property="og:title" content="Mutations in VPS13D lead to a new recessive ataxia with spasticity and mitochondrial defects - PubMed"><meta property="og:url" content="https://pubmed.ncbi.nlm.nih.gov/29604224/"><meta property="og:description" content="Our study demonstrates that compound heterozygous mutations in VPS13D cause movement disorders along the ataxia-spasticity spectrum, making VPS13D the fourth VPS13 paralog involved in neurological disorders. Ann Neurol 2018."><meta property="og:image" content="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/pubmed-meta-image-v2.jpg"><meta property="og:image:secure_url" content="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/pubmed-meta-image-v2.jpg"><meta property="og:type" content="website"><meta property="og:site_name" content="PubMed"><meta name="twitter:domain" content="pubmed.ncbi.nlm.nih.gov"><meta name="twitter:card" content="summary_large_image"><meta name="twitter:title" content="Mutations in VPS13D lead to a new recessive ataxia with spasticity and mitochondrial defects - PubMed"><meta name="twitter:url" content="https://pubmed.ncbi.nlm.nih.gov/29604224/"><meta name="twitter:description" content="Our study demonstrates that compound heterozygous mutations in VPS13D cause movement disorders along the ataxia-spasticity spectrum, making VPS13D the fourth VPS13 paralog involved in neurological disorders. Ann Neurol 2018."><meta name="twitter:image" content="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/pubmed-meta-image-v2.jpg">
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<input type="email" aria-label="Sender Email Address" placeholder="email@example.com" id="email-from" class="email-from" pattern="^[a-zA-Z0-9_.+-]+@[a-zA-Z0-9-]+\.[a-zA-Z0-9-.]+$" maxlength="256">
</div>
<div class="action-panel-control-wrap">
<label for="email-citation-format" class="action-panel-label">
Format:
</label>
<select id="email-citation-format" name="citation-format" class="action-panel-selector email-citation-format">
<option selected="selected" value="summary">Summary</option>
<option value="summary-text">Summary (text)</option>
<option value="abstract">Abstract</option>
<option value="abstract-text">Abstract (text)</option>
</select>
</div>
<div class="include-supplemental-container">
<input type="checkbox" aria-label="Include MeSH and other data" name="include-supplemental" id="email-include-supplemental" class="email-include-supplemental">
<label for="email-include-supplemental" class="email-include-supplemental-label">MeSH and other data</label>
</div>
<div class="form-field recaptcha ">
<div class="g-recaptcha" id="id-recaptcha" data-sitekey="6LfsWHMdAAAAAClKbtOpjQ2pMjgsGxvv7NdZW9uI"></div>
</div>
<div id="captcha-error-message" class="usa-input-error-message captcha-validation-message" role="alert"></div>
<div class="action-panel-actions">
<button class="action-panel-submit"
type="submit"
data-loading-label="Sending..."
data-ga-category="save_share"
data-ga-action="email"
data-ga-label="send">
Send email
</button>
<button class="action-panel-cancel"
aria-label="Close 'Email citations' panel"
ref="linksrc=close_email_panel"
aria-controls="email-action-panel"
aria-expanded="false"
data-ga-category="save_share"
data-ga-action="email"
data-ga-label="cancel">
Cancel
</button>
</div>
<input type="hidden" name="email-search-details" value="" />
<input type="hidden" name="email-search-details-hash" value="0e42663a6c3bd85498fcb88798998fed7bfdc45d457db35281e41afe13cc0524" />
</form>
</div>
</div>
<div id="collections-action-panel"
class="collections-action-panel action-panel in-progress-dots-panel"
aria-hidden="true"
data-collections-open-panel-enabled="false"
data-collections-open-panel-url-hash="#open-collections-panel">
<div class="inner-wrap">
<h3 class="action-panel-heading">
Add to Collections
</h3>
<form id="collections-action-panel-form"
class="collections-action-panel-form action-panel-content action-form action-panel-smaller-selectors"
data-existing-collections-url="/list-existing-collections/"
data-add-to-existing-collection-url="/add-to-existing-collection/"
data-create-and-add-to-new-collection-url="/create-and-add-to-new-collection/"
data-get-article-ids-by-search-url="/get-article-ids-by-search/"
data-myncbi-max-collection-name-length="100"
data-add-to-collection-max-amount="1000"
data-collections-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/">
<input type="hidden" name="csrfmiddlewaretoken" value="ghgNvnIfHoGwzC3WOJbksSgHpqxu4Ehmx40S8dbBhZt0t39Mr2OmW0MlXufGXfPG">
<div class="choice-group" role="radiogroup">
<ul class="radio-group-items">
<li>
<input type="radio"
id="collections-action-panel-new"
class="collections-new"
name="collections"
value="new"
data-ga-category="save_share"
data-ga-action="collections"
data-ga-label="collections_radio_new">
<label for="collections-action-panel-new">Create a new collection</label>
</li>
<li>
<input type="radio"
id="collections-action-panel-existing"
class="collections-existing"
name="collections"
value="existing"
checked="true"
data-ga-category="save_share"
data-ga-action="collections"
data-ga-label="collections_radio_existing">
<label for="collections-action-panel-existing">Add to an existing collection</label>
</li>
</ul>
</div>
<div class="controls-wrapper">
<div class="action-panel-control-wrap new-collections-controls">
<label for="collections-action-panel-add-to-new" class="action-panel-label required-field-asterisk">
Name your collection:
</label>
<input
type="text"
name="add-to-new-collection"
id="collections-action-panel-add-to-new"
class="collections-action-add-to-new"
pattern="[^&quot;&amp;=&lt;&gt;\/]*" title="The following characters are not allowed in the Name field: &quot;&amp;=&lt;&gt;/"
maxlength="100"
data-ga-category="save_share"
data-ga-action="create_collection"
data-ga-label="non_favorties_collection">
<div class="collections-new-name-too-long usa-input-error-message selection-validation-message">
Name must be less than 100 characters
</div>
</div>
<div class="action-panel-control-wrap existing-collections-controls">
<label for="collections-action-panel-add-to-existing" class="action-panel-label">
Choose a collection:
</label>
<select id="collections-action-panel-add-to-existing"
class="action-panel-selector collections-action-add-to-existing"
data-ga-category="save_share"
data-ga-action="select_collection"
data-ga-label="($('#collections-action-add-to-existing').val() === 'Favorites') ? 'Favorites' : 'non_favorites_collection'">
</select>
<div class="collections-retry-load-on-error usa-input-error-message selection-validation-message">
Unable to load your collection due to an error<br>
<a href="#">Please try again</a>
</div>
</div>
</div>
<div class="action-panel-actions">
<button class="action-panel-submit"
type="submit"
data-loading-label="Adding..."
data-pinger-ignore
data-ga-category="save_share"
data-ga-action="collections"
data-ga-label="add">
Add
</button>
<button class="action-panel-cancel"
aria-label="Close 'Add to Collections' panel"
ref="linksrc=close_collections_panel"
aria-controls="collections-action-panel"
aria-expanded="false"
data-ga-category="save_share"
data-ga-action="collections"
data-ga-label="cancel">
Cancel
</button>
</div>
</form>
</div>
</div>
<div id="bibliography-action-panel"
class="bibliography-action-panel action-panel in-progress-dots-panel"
aria-hidden="true"
data-bibliography-open-panel-enabled="false"
data-bibliography-open-panel-url-hash="#open-bibliography-panel">
<div class="inner-wrap">
<h3 class="action-panel-heading">
Add to My Bibliography
</h3>
<form id="bibliography-action-panel-form"
class="bibliography-action-panel-form action-panel-content action-form action-panel-smaller-selectors"
data-add-to-bibliography-max-amount="100"
data-add-to-bibliography-batch-size="10"
data-bibliography-delegates-url="/list-bibliography-delegates/"
data-add-to-bibliography-url="/add-to-bibliography/"
data-get-article-ids-by-search-url="/get-article-ids-by-search/"
data-mybib-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/mybibliography/">
<input type="hidden" name="csrfmiddlewaretoken" value="ghgNvnIfHoGwzC3WOJbksSgHpqxu4Ehmx40S8dbBhZt0t39Mr2OmW0MlXufGXfPG">
<div class="action-panel-control-wrap bibliographies-controls">
<div class="choice-group">
<ul class="bibliographies-action-add radio-group-items">
<li>
<input name="bibliography" id="my-bibliography" class="my-bibliography" type="radio" checked/>
<label for="my-bibliography">My Bibliography</label>
</li>
</ul>
</div>
</div>
<div class="bibliographies-retry-load-on-error usa-input-error-message selection-validation-message">
Unable to load your delegates due to an error<br>
<a href="#">Please try again</a>
</div>
<div class="action-panel-actions">
<button class="action-panel-submit"
type="submit"
data-loading-label="Adding..."
data-pinger-ignore>
Add
</button>
<button class="action-panel-cancel"
aria-label="Close 'Add to bibliography' panel"
ref="linksrc=close_bibliography_panel"
aria-controls="bibliography-action-panel"
aria-expanded="false"
data-ga-category="save_share"
data-ga-action="mybib"
data-ga-label="cancel">
Cancel
</button>
</div>
</form>
</div>
</div>
<div id="saved-search-action-panel" class="saved-search-action-panel action-panel " aria-hidden="true"
data-saved-search-open-panel-enabled="false"
data-saved-search-open-panel-url-hash="#open-saved-search-panel">
<div class="inner-wrap">
<h2 class="action-panel-heading">
Your saved search
</h2>
<form id="saved-search-action-panel-form"
class="saved-search-action-panel-form action-panel-content action-form"
data-create-saved-search-url="/create-saved-search/"
data-try-search-terms-url="/try-search-term/"
data-saved-search-root-url="https://www.ncbi.nlm.nih.gov/myncbi/searches/">
<input type="hidden" name="csrfmiddlewaretoken" value="ghgNvnIfHoGwzC3WOJbksSgHpqxu4Ehmx40S8dbBhZt0t39Mr2OmW0MlXufGXfPG">
<div class="action-panel-control-wrap">
<label for="saved-search-name" class="action-panel-label saved-search-name-label required-field-asterisk">
Name of saved search:
</label>
<input maxlength="200"
type="text"
name="saved-search-name"
id="saved-search-name"
class="saved-search-name"
value=""
required
pattern="[^&quot;&amp;=&lt;&gt;\/]*" title="The following characters are not allowed in the Name field: &quot;&amp;=&lt;&gt;/">
</div>
<div class="action-panel-control-wrap">
<label for="saved-search-term" class="action-panel-label required-field-asterisk">
Search terms:
</label>
<textarea name="saved-search-term" id="saved-search-term" class="saved-search-term" required></textarea>
</div>
<div class="test-search-term-wrap">
<a href="#" class="try-search-term">Test search terms</a>
</div>
<div class="choice-group action-panel-extra-margin-top">
<span class="action-panel-label" id="fieldset-label">
Would you like email updates of new search results?
</span>
<fieldset id="saved-search-alert" aria-describedby="fieldset-label">
<legend class="usa-sr-only">Saved Search Alert Radio Buttons</legend>
<ul class="radio-group-items">
<li>
<input type="radio" id="saved-search-alert-yes" class="saved-search-alert-yes" name="saved-search-alert" value="yes" checked>
<label for="saved-search-alert-yes" class="action-panel-label">Yes</label>
</li>
<li>
<input aria-label="No radio input" type="radio" id="saved-search-alert-no" class="saved-search-alert-no" name="saved-search-alert" value="no">
<label for="saved-search-alert-no" class="action-panel-label">No</label>
</li>
</ul>
</fieldset>
</div>
<div class="alert-schedule-wrap">
<div class="action-panel-control-wrap">
<label class="action-panel-label">
Email:
</label>
<span aria-label="Email address" id="saved-search-email" class="action-panel-label"><span class="action-panel-label-bold"></span> (<a class="myncbi-account-settings" href="https://www.ncbi.nlm.nih.gov/account/settings/">change</a>)</span>
</div>
<div class="action-panel-control-wrap action-panel-extra-margin-top">
<label for="saved-search-frequency" class="action-panel-label">
Frequency:
</label>
<select id="saved-search-frequency" class="no-border-panel-selector saved-search-frequency">
<option value="monthly">Monthly</option>
<option value="weekly">Weekly</option>
<option value="daily">Daily</option>
</select>
</div>
<div class="action-panel-control-wrap saved-search-monthly-additional">
<label for="saved-search-monthly-on-day" class="action-panel-label">
Which day?
</label>
<select id="saved-search-monthly-on-day" class="no-border-panel-selector">
<option value="Sunday">The first Sunday</option>
<option value="Monday">The first Monday</option>
<option value="Tuesday">The first Tuesday</option>
<option value="Wednesday">The first Wednesday</option>
<option value="Thursday">The first Thursday</option>
<option value="Friday">The first Friday</option>
<option value="Saturday">The first Saturday</option>
<option value="day">The first day</option>
<option value="weekday">The first weekday</option>
</select>
</div>
<div class="action-panel-control-wrap saved-search-weekly-additional">
<label for="saved-search-weekly-on-day" class="action-panel-label">
Which day?
</label>
<select id="saved-search-weekly-on-day" class="no-border-panel-selector saved-search-weekly-on-day">
<option value="Sunday">Sunday</option>
<option value="Monday">Monday</option>
<option value="Tuesday">Tuesday</option>
<option value="Wednesday">Wednesday</option>
<option value="Thursday">Thursday</option>
<option value="Friday">Friday</option>
<option value="Saturday">Saturday</option>
</select>
</div>
<div class="action-panel-control-wrap">
<label for="saved-search-report" class="action-panel-label">
Report format:
</label>
<select id="saved-search-report" class="no-border-panel-selector saved-search-report">
<option value="DocSum">Summary</option>
<option value="DocSumText">Summary (text)</option>
<option value="Abstract">Abstract</option>
<option value="AbstractText">Abstract (text)</option>
<option value="MEDLINE">PubMed</option>
</select>
</div>
<div class="action-panel-control-wrap">
<label for="saved-search-amount" class="action-panel-label">
Send at most:
</label>
<select id="saved-search-amount" class="no-border-panel-selector saved-search-amount">
<option value="1">1 item</option>
<option value="5" selected>5 items</option>
<option value="10">10 items</option>
<option value="20">20 items</option>
<option value="50">50 items</option>
<option value="100">100 items</option>
<option value="200">200 items</option>
</select>
</div>
<div>
<input type="checkbox" id="saved-search-send-if-no-result" class="saved-search-send-if-no-result" name="saved-search-send-if-no-result">
<label for="saved-search-send-if-no-result" class="action-panel-label smaller-checkbox">
Send even when there aren't any new results
</label>
</div>
<div class="action-panel-control-wrap option-text-in-email-wrap">
<label for="saved-search-email-text" class="action-panel-label">
Optional text in email:
</label>
<textarea name="saved-search-email-text"
id="saved-search-email-text"
class="saved-search-email-text"></textarea>
</div>
</div>
<div class="action-panel-actions">
<button class="action-panel-submit"
type="submit"
data-loading-label="Saving..."
data-ga-category="save_share"
data-ga-action="alert"
data-ga-label="save">
Save
</button>
<button class="action-panel-cancel"
aria-label="Close 'Your saved search' panel"
ref="linksrc=close_saved_search_panel"
aria-controls="saved-search-action-panel"
aria-expanded="false"
data-ga-category="save_share"
data-ga-action="alert"
data-ga-label="cancel">
Cancel
</button>
</div>
</form>
</div>
</div>
<div id="citation-manager-action-panel" class="citation-manager-action-panel action-panel" aria-hidden="true">
<div class="inner-wrap">
<h2 class="action-panel-heading">
Create a file for external citation management software
</h2>
<form id="citation-manager-action-panel-form"
class="action-panel-content action-form"
action="/results-export-ids/"
data-by-search-action="/results-export-search-data/"
data-by-ids-action="/results-export-ids/"
method="post"
data-by-search-method="post"
data-by-ids-method="post">
<input type="hidden" name="csrfmiddlewaretoken" value="ghgNvnIfHoGwzC3WOJbksSgHpqxu4Ehmx40S8dbBhZt0t39Mr2OmW0MlXufGXfPG">
<input name="results-format" type="hidden" value="pubmed"/>
<div class="action-panel-actions">
<button class="action-panel-submit"
type="submit"
data-loading-label="Sending..."
data-ga-category="save_share"
data-ga-action="citation_manager"
data-ga-label="save">
Create file
</button>
<button class="action-panel-cancel"
aria-label="Close 'Send citations to citation manager' panel"
ref="linksrc=close_citation_manager_panel"
aria-controls="citation-manager-action-panel"
aria-expanded="false"
data-ga-category="save_share"
data-ga-action="citation_manager"
data-ga-label="cancel">
Cancel
</button>
</div>
</form>
</div>
</div>
<div id="rss-action-panel" class="rss-action-panel action-panel " aria-hidden="true">
<div class="inner-wrap">
<h2 class="action-panel-heading">
Your RSS Feed
</h2>
<form id="rss-action-panel-form"
class="rss-action-panel-form action-panel-content action-form"
data-create-rss-feed-url="/create-rss-feed-url/"
data-search-form-term-value="">
<input type="hidden" name="csrfmiddlewaretoken" value="ghgNvnIfHoGwzC3WOJbksSgHpqxu4Ehmx40S8dbBhZt0t39Mr2OmW0MlXufGXfPG">
<div class="action-panel-control-wrap">
<label for="rss-name" class="action-panel-label required-field-asterisk">
Name of RSS Feed:
</label>
<input maxlength="200"
placeholder="Name"
type="text"
name="rss-name"
id="rss-name"
class="rss-name"
value=''
required
pattern="[^&quot;&amp;=&lt;&gt;\/]*" title="The following characters are not allowed in the Name field: &quot;&amp;=&lt;&gt;/">
</div>
<div class="rss-limit-wrap">
<div class="action-panel-control-wrap action-panel-extra-margin-top">
<label for="rss-limit" class="action-panel-label">
Number of items displayed:
</label>
<select id="rss-limit" class="no-border-panel-selector rss-limit">
<option value="5">5</option>
<option value="10">10</option>
<option value="15" selected="selected">15</option>
<option value="20">20</option>
<option value="50">50</option>
<option value="100">100</option>
</select>
</div>
</div>
<div class="action-panel-actions">
<button class="action-panel-submit"
type="submit"
data-loading-label="Creating..."
data-ga-category="save_share"
data-ga-action="alert"
data-ga-label="save">
Create RSS
</button>
<button class="action-panel-cancel"
aria-label="Close 'Your RSS' panel"
ref="linksrc=close_rss_panel"
aria-controls="rss-action-panel"
aria-expanded="false"
data-ga-category="save_share"
data-ga-action="alert"
data-ga-label="cancel">
Cancel
</button>
</div>
<div class="action-panel-control-wrap rss-link-copy-wrap">
<label for="rss-link" class="usa-sr-only">RSS Link</label>
<input placeholder="Your RSS Feed Link" type="text" name="rss-link" id="rss-link" class="rss-link" title="RSS Link">
<button
type="button"
disabled
class="rss-link-copy-button disabled"
data-ga-category="save_share"
data-ga-action="rss"
data-ga-label="copy">
Copy
</button>
</div>
</form>
</div>
</div>
</div>
</div>
<div class="article-page" id="article-page" data-article-pmid="29604224">
<aside class="page-sidebar">
<div class="inner-wrap">
<div class="full-text-links">
<div class="full-view">
<h3 class="title">
Full text links
</h3>
<div class="full-text-links-list">
<a class="link-item
dialog-focus"
href="https://doi.org/10.1002/ana.25220"
target="_blank"
rel="noopener"
ref="linksrc=fulltextorjournal_fulltext&amp;is_pmc=False&amp;PrId=3058&amp;itool=Abstract-def&amp;log$=linkouticon&amp;uid=29604224&amp;db=pubmed&amp;nlmid=7707449"
title="See full text options at Wiley"
data-ga-category="full_text"
data-ga-action="Wiley"
data-ga-label="29604224"
><img src="https://cdn.ncbi.nlm.nih.gov/corehtml/query/egifs/http:--media.wiley.com-assets-7388-69-wiley-full-text.png" alt="Wiley full text link"><span class="text">
Wiley
</span></a><a class="link-item
pmc
"
href="https://pmc.ncbi.nlm.nih.gov/articles/pmid/29604224/"
target="_blank"
rel="noopener"
ref="linksrc=fulltextorjournal_fulltext&amp;is_pmc=True&amp;PrId=3494&amp;itool=Abstract-def&amp;log$=linkouticon&amp;uid=29604224&amp;db=pubmed&amp;nlmid=7707449"
title="Free full text at PubMed Central"
data-ga-category="full_text"
data-ga-action="PMC"
data-ga-label="29604224"
><span class="text">
Free PMC article
</span></a>
</div>
</div>
<div class="short-view">
<a href="#" class="full-text-links-button full-text-links-dialog-trigger">
Full text links
</a>
</div>
</div>
<div class="actions-buttons sidebar"><h3 class="title">Actions</h3><div class="inner-wrap"><button class="citation-button citation-dialog-trigger"
aria-label="Open dialog with citation text in different styles"
data-ga-category="save_share"
data-ga-action="cite"
data-ga-label="open"
data-all-citations-url="/29604224/citations/"
data-citation-style="nlm"
data-pubmed-format-link="/29604224/export/"><span class="button-label">Cite</span></button><link type="text/css" href="ncbi-overlay-block/src/overlay-block.css"><div class="collections-button-container" data-article-id="29604224" data-article-db="pubmed"><button class="collections-button collections-dialog-trigger"
aria-label="Save article in MyNCBI collections."
data-ga-category="collections_button"
data-ga-action="click"
data-ga-label="collections_button"
data-collections-open-dialog-enabled="false"
data-collections-open-dialog-url="https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F29604224%2F%23open-collections-dialog"
data-in-collections="false"><span class="button-label">Collections</span></button><div class="overlay" role="dialog"><div id="collections-action-dialog"
class="dialog collections-dialog"
aria-hidden="true"><div class="title">Add to Collections</div><div class="collections-action-panel action-panel"><form id="collections-action-dialog-form"
class="collections-action-panel-form action-panel-content action-form action-panel-smaller-selectors"
data-existing-collections-url="/list-existing-collections/"
data-add-to-existing-collection-url="/add-to-existing-collection/"
data-create-and-add-to-new-collection-url="/create-and-add-to-new-collection/"
data-myncbi-max-collection-name-length="100"
data-collections-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/"><input type="hidden" name="csrfmiddlewaretoken" value="ghgNvnIfHoGwzC3WOJbksSgHpqxu4Ehmx40S8dbBhZt0t39Mr2OmW0MlXufGXfPG"><div class="choice-group" role="radiogroup"><ul class="radio-group-items"><li><input type="radio"
id="collections-action-dialog-new"
class="collections-new"
name="collections"
value="new"
data-ga-category="collections_button"
data-ga-action="click"
data-ga-label="collections_radio_new"><label for="collections-action-dialog-new">Create a new collection</label></li><li><input type="radio"
id="collections-action-dialog-existing"
class="collections-existing"
name="collections"
value="existing"
checked="true"
data-ga-category="collections_button"
data-ga-action="click"
data-ga-label="collections_radio_existing"><label for="collections-action-dialog-existing">Add to an existing collection</label></li></ul></div><div class="controls-wrapper"><div class="action-panel-control-wrap new-collections-controls"><label for="collections-action-dialog-add-to-new" class="action-panel-label required-field-asterisk">
Name your collection:
</label><input
type="text"
name="add-to-new-collection"
id="collections-action-dialog-add-to-new"
class="collections-action-add-to-new"
pattern="[^&quot;&amp;=&lt;&gt;\/]*" title="The following characters are not allowed in the Name field: &quot;&amp;=&lt;&gt;/"
maxlength="100"
data-ga-category="collections_button"
data-ga-action="create_collection"
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<h1 class="heading-title">
Mutations in VPS13D lead to a new recessive ataxia with spasticity and mitochondrial defects
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><sup class="key">6</sup> Department of Human Genetics, University of Michigan, Ann Arbor, MI.</li>
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><sup class="key">7</sup> Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI.</li>
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><sup class="key">8</sup> Department of Pediatrics, Section on Medical Genetics, Wake Forest School of Medicine, Winston-Salem, NC.</li>
<li data-affiliation-id="full-view-affiliation-9"
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><sup class="key">9</sup> Department of Clinical Genetics, Erasmus MC, Rotterdam, the Netherlands.</li>
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><sup class="key">10</sup> Departments of Neurology and Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI.</li>
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><sup class="key">11</sup> Department of Neurology, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Centre, Nijmegen, the Netherlands.</li>
<li data-affiliation-id="full-view-affiliation-12"
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><sup class="key">12</sup> Department of Psychiatry, University of Michigan, Ann Arbor, MI.</li>
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Mutations in VPS13D lead to a new recessive ataxia with spasticity and mitochondrial defects
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<span class="authors-list-item "><span class="full-name">Eunju Seong</span><span class="citation-separator">&nbsp;et al.</span></span>
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</a></sup><span class="comma">,&nbsp;</span></span><span class="authors-list-item "><a class="full-name"
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</a></sup><span class="comma">,&nbsp;</span></span><span class="authors-list-item "><a class="full-name"
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</a></sup><span class="comma">,&nbsp;</span></span><span class="authors-list-item "><a class="full-name"
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><sup class="key">1</sup> Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI.</li>
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><sup class="key">2</sup> Department of Molecular, Cellular, and Developmental Biology, University of Michigan, Ann Arbor, MI.</li>
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><sup class="key">3</sup> Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.</li>
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><sup class="key">4</sup> Department of Human Genetics, Radboud University Medical Centre, Nijmegen, the Netherlands.</li>
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><sup class="key">5</sup> Department of Neurology, University of Lübeck, Lübeck, Germany.</li>
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><sup class="key">6</sup> Department of Human Genetics, University of Michigan, Ann Arbor, MI.</li>
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><sup class="key">7</sup> Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI.</li>
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><sup class="key">8</sup> Department of Pediatrics, Section on Medical Genetics, Wake Forest School of Medicine, Winston-Salem, NC.</li>
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><sup class="key">9</sup> Department of Clinical Genetics, Erasmus MC, Rotterdam, the Netherlands.</li>
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><sup class="key">10</sup> Departments of Neurology and Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI.</li>
<li data-affiliation-id="short-view-affiliation-11"
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><sup class="key">11</sup> Department of Neurology, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Centre, Nijmegen, the Netherlands.</li>
<li data-affiliation-id="short-view-affiliation-12"
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><sup class="key">12</sup> Department of Psychiatry, University of Michigan, Ann Arbor, MI.</li>
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Objective:
</strong>
To identify novel causes of recessive ataxias, including spinocerebellar ataxia with saccadic intrusions, spastic ataxias, and spastic paraplegia.
</p>
<p>
<strong class="sub-title">
Methods:
</strong>
In an international collaboration, we independently performed exome sequencing in 7 families with recessive ataxia and/or spastic paraplegia. To evaluate the role of VPS13D mutations, we evaluated a Drosophila knockout model and investigated mitochondrial function in patient-derived fibroblast cultures.
</p>
<p>
<strong class="sub-title">
Results:
</strong>
Exome sequencing identified compound heterozygous mutations in VPS13D on chromosome 1p36 in all 7 families. This included a large family with 5 affected siblings with spinocerebellar ataxia with saccadic intrusions (SCASI), or spinocerebellar ataxia, recessive, type 4 (SCAR4). Linkage to chromosome 1p36 was found in this family with a logarithm of odds score of 3.1. The phenotypic spectrum in our 12 patients was broad. Although most presented with ataxia, additional or predominant spasticity was present in 5 patients. Disease onset ranged from infancy to 39 years, and symptoms were slowly progressive and included loss of independent ambulation in 5. All but 2 patients carried a loss-of-function (nonsense or splice site) mutation on one and a missense mutation on the other allele. Knockdown or removal of Vps13D in Drosophila neurons led to changes in mitochondrial morphology and impairment in mitochondrial distribution along axons. Patient fibroblasts showed altered morphology and functionality including reduced energy production.
</p>
<p>
<strong class="sub-title">
Interpretation:
</strong>
Our study demonstrates that compound heterozygous mutations in VPS13D cause movement disorders along the ataxia-spasticity spectrum, making VPS13D the fourth VPS13 paralog involved in neurological disorders. Ann Neurol 2018.
</p>
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© 2018 American Neurological Association.
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<p xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:p1="http://pubmed.gov/pub-one">Potential Conflicts of Interests:</p>
<p xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:p1="http://pubmed.gov/pub-one">None of the authors report COI relevant to the reported work. See disclosures for other detailed COI</p>
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itemprop="contentUrl"
aria-describedby="figure-caption-0"
role="button"
data-image-width="800"
data-image-height="437"
data-image-alt="Figure 1"
data-pmc-id="PMC6105379"
data-figure-id="F1">
<img class="figure-thumb" itemprop="thumbnail"
id="article-image-0"
src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b73/6105379/26fe29cc94e1/nihms955732f1.gif"
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<strong class="figure-label">
<p> Figure 1. Multiplex ataxia families with compound… </p>
</strong>
</div>
</div>
<div class="figure-caption-medium figure-caption-text" aria-hidden="true">
<strong class="figure-label">
<p> Figure 1. Multiplex ataxia families with compound heterozygous mutations in <i> VPS13D </i> </p>
</strong>
<div class="figure-caption-contents"><b> A. </b> Pedigree of Family…</div>
</div>
<figcaption id="figure-caption-0" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description">
<strong class="figure-label">
Figure 1. Multiplex ataxia families with compound heterozygous mutations in <i>VPS13D</i>
</strong>
<div class="figure-caption-contents"><b>A.</b> Pedigree of Family UM1. Affected siblings are indicated by black
filled symbols while unaffected individuals are marked by unfilled symbols. The
nine unaffected siblings are shown in an open diamond. Mutational status is
given below each individual together with the respective laboratory ID.
<b>B.</b> Pedigree of Family LUB1 with mutations in the two affected
sisters, shown by black filled symbols. <b>C.</b> cDNA sequences of the
c.5409C&gt;A mutation before (top panel) and after (lower panel) treatment with
cycloheximide. The traces are representative of 2 sequencing runs. The
nonsense-mutated allele got stabilized and showed similar expression levels upon
treatment. <b>D.</b> Predicted domain maps of VPS13D protein (<ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://www.ebi.ac.uk/interpro/protein/Q5THJ4">http://www.ebi.ac.uk/interpro/protein/Q5THJ4</ext-link>) with the
identified missense mutations marked: N1: VPS13 1st N-terminal domain (aa
2-115), N2: VPS13 2nd N-terminal domain (aa 137-356), U: UBA
(Ubiquitin-associated)-like domain (aa 2627-2679), SHR: VPS13 SHORT ROOT
transcription factor-binding domain (aa 3276-3558), C: VPS13 C-terminal domain
(aa 3983-4129). The five different missense mutations appear to cluster in two
regions, one in the middle and the other near the C domain. <b>E</b>.
Amino acid sequence alignments of the regions surrounding each missense mutation
across various species. While Gly1190Asp, Asn4107Ile, and Gly4149Ser are
conserved in all VPS13D orthologs, Met1307Leu and Ala4210Val are conserved in
mammals and chicken but not in zebrafish and/or fruitfly.</div>
</figcaption>
</figure>
<figure class="figure-item "
itemscope itemtype="http://schema.org/ImageObject"
itemprop="associatedMedia"
data-slide-index="1"
data-label-slug="figure-2">
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itemprop="contentUrl"
aria-describedby="figure-caption-1"
role="button"
data-image-width="400"
data-image-height="1125"
data-image-alt="Figure 2"
data-pmc-id="PMC6105379"
data-figure-id="F2">
<img class="figure-thumb" itemprop="thumbnail"
id="article-image-1"
src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b73/6105379/5cf12528462e/nihms955732f2.gif"
alt="Figure 2" />
</a>
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<meta itemprop="height" itemtype="http://schema.org/ImageObject" content="1125">
<div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true">
<div class="caption-wrap">
<strong class="figure-label">
<p> Figure 2. Disruption of <i> Vps13D </i> in the… </p>
</strong>
</div>
</div>
<div class="figure-caption-medium figure-caption-text" aria-hidden="true">
<strong class="figure-label">
<p> Figure 2. Disruption of <i> Vps13D </i> in the <i> Drosophila </i> central nervous system affects mitochondrial morphology </p>
</strong>
<div class="figure-caption-contents"><b> A… </b></div>
</div>
<figcaption id="figure-caption-1" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description">
<strong class="figure-label">
Figure 2. Disruption of <i>Vps13D</i> in the <i>Drosophila</i> central nervous system affects mitochondrial morphology
</strong>
<div class="figure-caption-contents"><b>A</b>. Ventral nerve cord (VNC), stained for mitochondrial marker ATP5A,
of control (<i>w<sup>1118</sup>,</i> right panel) and
<i>Vps13D</i> mutant
(<i>Vps13D</i><sup>11101/11101</sup>, left panel)
<i>Drosophila</i> larvae. Bottom: High magnification single
confocal Z-planes of areas indicated by the dashed boxes, highlighting
mitochondrial morphology in neuronal cell bodies. Scale Bars: 50μm (top)
and 5μm (bottom) <b>B</b>. Representative images of motoneurons
(via D42-Gal4) with simultaneous expression of fluorescent mitochondrial marker
mitoGFP (green) along with control (left panel) and <i>Vps13D</i>
(right panel) RNAi expression. Bottom: High magnification single confocal
Z-planes of areas indicated by the dashed boxes, highlighting mitochondrial
morphology in motoneuron cell bodies. <b>C.</b> Quantification of form
factor analysis of the mitochondrial network (based on mitoGFP) in neuronal
cells bodies expressing control RNAi (white) vs. <i>Vps13D</i> RNAi
(grey). n=50 neurons per condition (from 5 different animals). Error
bars represent standard error. *** indicates p&lt;0.001
(Students T-test).</div>
</figcaption>
</figure>
<figure class="figure-item "
itemscope itemtype="http://schema.org/ImageObject"
itemprop="associatedMedia"
data-slide-index="2"
data-label-slug="figure-3">
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itemprop="contentUrl"
aria-describedby="figure-caption-2"
role="button"
data-image-width="800"
data-image-height="617"
data-image-alt="Figure 3"
data-pmc-id="PMC6105379"
data-figure-id="F3">
<img class="figure-thumb" itemprop="thumbnail"
id="article-image-2"
src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b73/6105379/70ed89a4d1a2/nihms955732f3.gif"
alt="Figure 3" />
</a>
<meta itemprop="width" itemtype="http://schema.org/ImageObject" content="800">
<meta itemprop="height" itemtype="http://schema.org/ImageObject" content="617">
<div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true">
<div class="caption-wrap">
<strong class="figure-label">
<p> Figure 3. Knockdown of <i> Vps13D </i> in <i> Drosophila… </i> </p>
</strong>
</div>
</div>
<div class="figure-caption-medium figure-caption-text" aria-hidden="true">
<strong class="figure-label">
<p> Figure 3. Knockdown of <i> Vps13D </i> in <i> Drosophila </i> motoneurons disrupts the distribution of mitochondria to distal… </p>
</strong>
</div>
<figcaption id="figure-caption-2" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description">
<strong class="figure-label">
Figure 3. Knockdown of <i>Vps13D</i> in <i>Drosophila</i> motoneurons disrupts the distribution of mitochondria to distal axons
</strong>
<div class="figure-caption-contents"><b>A</b>. Segmental nerves (HRP, red) containing motoneuron axons
expressing fluorescent mitochondrial marker mitoGFP (green) of control RNAi and
Vps13D RNAi knockdown (RNAi) animals. Nerves near the VNC (proximal, top) and
distant from the VNC (distal, bottom) are shown. Scale Bar: 10μm.
<b>B</b>. Quantification of the mitochondrial content per area within
segmental nerves in proximal and distal regions of motoneurons expressing
control RNAi (white) vs. <i>Vps13D</i> RNAi (grey). Data is normalized
to Control RNAi Proximal Region condition. N≥10 individual nerves from 5
different animals. Error bars represent standard error.
**** indicates p&lt;0.0001 (Students T-test).
<b>C</b>. Larval NMJ synapses from motoneuron axons expressing
fluorescent mitochondrial marker mitoGFP (green) of control and Vps13D RNAi
knockdown animals. HRP (red) labels neuronal membrane, while DLG (blue) labels
NMJ postsynaptic region. High magnification images of the synaptic region
(indicated by the dashed box) are shown (right panels) to highlight mitochondria
occupying the synaptic region. Scale Bar: 20μm (left) and 2.5μm
(right). <b>D</b>. Quantification of the mitochondrial content in the NMJ
synapse per area of motoneurons expressing control RNAi (white) vs.
<i>Vps13D</i> RNAi (grey). Data is normalized to Control RNAi
condition. n=5 animals (each n represents the avg. mitochondrial content
of ≥6 NMJ synapses/animal). Error bars represent standard error.
**** indicates p&lt;0.0001 (Students
T-test).</div>
</figcaption>
</figure>
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data-slide-index="3"
data-label-slug="figure-4">
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itemprop="contentUrl"
aria-describedby="figure-caption-3"
role="button"
data-image-width="800"
data-image-height="551"
data-image-alt="Figure 4"
data-pmc-id="PMC6105379"
data-figure-id="F4">
<img class="figure-thumb" itemprop="thumbnail"
id="article-image-3"
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<strong class="figure-label">
<p> Figure 4. Patient fibroblasts contain abnormal spherical… </p>
</strong>
</div>
</div>
<div class="figure-caption-medium figure-caption-text" aria-hidden="true">
<strong class="figure-label">
<p> Figure 4. Patient fibroblasts contain abnormal spherical mitochondria </p>
</strong>
<div class="figure-caption-contents"><b> AD </b> : Comparison of mitochondria in 4…</div>
</div>
<figcaption id="figure-caption-3" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description">
<strong class="figure-label">
Figure 4. Patient fibroblasts contain abnormal spherical mitochondria
</strong>
<div class="figure-caption-contents"><b>AD</b>: Comparison of mitochondria in 4 fibroblast lines of
Family UM1 stained with MitoTracker: A, UMCtrl1: wild type for
<i>VPS13D</i>; B, UM1.17: asymptomatic heterozygous carrier of the
Gly1190Asp missense mutation; C and D, UM1.2 and UM1.4: VPS13D compound
heterozygous patients. Note that while the majority of the mitochondria in the
control cells are elongated and of similar intensity, the patient cells are
loaded with particularly bright, circular mitochondrial objects mostly localized
in perinuclear region. <b>E</b>: Intensity histogram of MitoTracker
images. The X-axis represents the intensity, the numbers of pixels are plotted
on the Y-axis (the black plots in natural number scale and the gray plot in
log-scale). Note that both patients have many more pixels with higher intensity,
indicative of the increase in bright MitoTracker-stained objects. <b>F</b>
and <b>G</b>: Perinuclear mitochondria at higher magnification (60X lens,
4X zoom). Control mitochondria (F, UMCtrl1) are elongated, tubular, and
interconnected while the patient mitochondria (G, UM1.2) are often donut-shaped.
Here, brightness was individually optimized to reveal the structural details and
is not comparable. Scale Bars: 20 μm (A<b></b>D) and 2
μm (F and G). <b>H</b>: Average number of circular mitochondria
(MT) objects identified by image processing. Such circular objects are present
in the control cell lines at low frequencies but become much more abundant in
the affected cell lines (~6-fold increase). <b>I</b>: Percentage of cells
with at least 3 perinuclear circular MT objects. The patient fibroblast cultures
have higher number of cells with perinuclear circular MT objects than control
(6- and 9-fold increase). <b>J.</b> Form factor analysis of the
mitochondrial network stained by MitoTracker. In H to J, error bars represent
standard error. *, **, and ***
indicate p&lt;10<sup>4</sup>, p&lt;10<sup>5</sup>, and
p&lt;10<sup>6</sup> respectively (Students T-test).</div>
</figcaption>
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itemprop="contentUrl"
aria-describedby="figure-caption-4"
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data-image-width="800"
data-image-height="455"
data-image-alt="Figure 5"
data-pmc-id="PMC6105379"
data-figure-id="F5">
<img class="figure-thumb" itemprop="thumbnail"
id="article-image-4"
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<strong class="figure-label">
<p> Figure 5. Altered mitochondrial morphology and decreased… </p>
</strong>
</div>
</div>
<div class="figure-caption-medium figure-caption-text" aria-hidden="true">
<strong class="figure-label">
<p> Figure 5. Altered mitochondrial morphology and decreased ATP in <i> VPS13D </i> mutant fibroblasts </p>
</strong>
<div class="figure-caption-contents"><b> A. </b> Western blot…</div>
</div>
<figcaption id="figure-caption-4" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description">
<strong class="figure-label">
Figure 5. Altered mitochondrial morphology and decreased ATP in <i>VPS13D</i> mutant fibroblasts
</strong>
<div class="figure-caption-contents"><b>A.</b> Western blot analysis shows mitochondrial GRP75 protein levels in
the <i>VPS13D</i>-mutant fibroblasts (LUB1.1), patients
parents (LUB1.3 and LUB1.4), and healthy control fibroblasts (LUBCtrl2) with
β-actin as loading control. <b>B.</b> Quantification of the above
GRP75 Western blot using ImageJ. <b>C.</b> The mitochondrial network was
investigated under basal conditions by confocal microscopy in fixed cells
immunostained with anti-GRP75. Scale Bar: 20 μm. <b>D.</b> Form
factor as a measure for mitochondrial interconnectivity (GRP75 immunostaining)
was calculated for two control fibroblast lines (LUBCtrl1, LUBCrtl2) and one
patient line (LUB1.1) (n=20). Each dot represents measurement in a
single cell. The mean values, and the standard deviations of the investigated
individuals are shown. <b>E.</b> ATP production was determined based on
luminescence. ATP concentration (μmoles) was calculated per minute per
milligram of protein (n=3 independent experiments). In B and E, the
error bars indicate SEM of n≥3 independent experiments.</div>
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<span class="docsum-journal-citation full-journal-citation">Ann Neurol. 2018 Jun;83(6):1072-1074. doi: 10.1002/ana.25262.</span>
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