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We describe a family with an autosomal dominant familial dyskinesia resembling myoclonus-dystonia associated with a novel missense mutation in ADCY5, found through whole-exome sequencing. A tiered analytical approach was used to analyse whole-exome sequencing data from an affected grandmother-granddaughter pair. Whole-exome sequencing identified 18,000 shared variants, of which 46 were non-synonymous changes not present in a local cohort of control exomes (n = 422). Further filtering based on predicted splicing effect, minor allele frequency in the 1000 Genomes Project and on phylogenetic conservation yielded 13 candidate variants, of which the heterozygous missense mutation c.3086T>G, p. M1029R in ADCY5 most closely matched the observed phenotype. This report illustrates the utility of whole-exome sequencing in cases of undiagnosed movement disorders with clear autosomal dominant inheritance. Moreover, ADCY5 mutations should be considered in cases with apparent myoclonus-dystonia, particularly where SCGE mutations have been excluded. ADCY5-related dyskinesia may manifest variable expressivity within a single family, and affected individuals may be initially diagnosed with differing neurological phenotypes.

Original publication

DOI

10.1007/s10048-017-0510-z

Type

Journal article

Journal

Neurogenetics

Publication Date

04/2017

Volume

18

Pages

111 - 117

Keywords

ADCY5, Exome sequencing, Familial dyskinesia, Myoclonus-dystonia, Adenylyl Cyclases, Adolescent, Adult, Child, Preschool, Dyskinesias, Dystonic Disorders, Family, Female, Humans, Middle Aged, Mutation, Missense, Pedigree, Phenotype