TY - JOUR
T1 - Revisiting mitochondrial ocular myopathies
T2 - a study from the Italian Network
AU - Orsucci, D.
AU - Angelini, C.
AU - Bertini, E.
AU - Carelli, V.
AU - Comi, G. P.
AU - Federico, A.
AU - Minetti, C.
AU - Moggio, M.
AU - Mongini, T.
AU - Santorelli, F. M.
AU - Servidei, S.
AU - Tonin, P.
AU - Ardissone, A.
AU - Bello, L.
AU - Bruno, C.
AU - Ienco, E. Caldarazzo
AU - Diodato, D.
AU - Filosto, M.
AU - Lamperti, C.
AU - Moroni, I.
AU - Musumeci, O.
AU - Pegoraro, E.
AU - Primiano, G.
AU - Ronchi, D.
AU - Rubegni, A.
AU - Salvatore, S.
AU - Sciacco, M.
AU - Valentino, M. L.
AU - Vercelli, L.
AU - Toscano, A.
AU - Zeviani, M.
AU - Siciliano, G.
AU - Mancuso, M.
PY - 2017/7/10
Y1 - 2017/7/10
N2 - Ocular myopathy, typically manifesting as progressive external ophthalmoplegia (PEO), is among the most common mitochondrial phenotypes. The purpose of this study is to better define the clinical phenotypes associated with ocular myopathy. This is a retrospective study on a large cohort from the database of the “Nation-wide Italian Collaborative Network of Mitochondrial Diseases”. We distinguished patients with ocular myopathy as part of a multisystem mitochondrial encephalomyopathy (PEO-encephalomyopathy), and then PEO with isolated ocular myopathy from PEO-plus when PEO was associated with additional features of multisystemic involvement. Ocular myopathy was the most common feature in our cohort of mitochondrial patients. Among the 722 patients with a definite genetic diagnosis, ocular myopathy was observed in 399 subjects (55.3%) and was positively associated with mtDNA single deletions and POLG mutations. Ocular myopathy as manifestation of a multisystem mitochondrial encephalomyopathy (PEO-encephalomyopathy, n = 131) was linked to the m.3243A>G mutation, whereas the other “PEO” patients (n = 268) were associated with mtDNA single deletion and Twinkle mutations. Increased lactate was associated with central neurological involvement. We then defined, among the PEO group, as “pure PEO” the patients with isolated ocular myopathy and “PEO-plus” those with ocular myopathy and other features of neuromuscular and multisystem involvement, excluding central nervous system. The male proportion was significantly lower in pure PEO than PEO-plus. This study reinforces the need for research on the role of gender in mitochondrial diseases. The phenotype definitions here revisited may contribute to a more homogeneous patient categorization, useful in future studies and clinical trials.
AB - Ocular myopathy, typically manifesting as progressive external ophthalmoplegia (PEO), is among the most common mitochondrial phenotypes. The purpose of this study is to better define the clinical phenotypes associated with ocular myopathy. This is a retrospective study on a large cohort from the database of the “Nation-wide Italian Collaborative Network of Mitochondrial Diseases”. We distinguished patients with ocular myopathy as part of a multisystem mitochondrial encephalomyopathy (PEO-encephalomyopathy), and then PEO with isolated ocular myopathy from PEO-plus when PEO was associated with additional features of multisystemic involvement. Ocular myopathy was the most common feature in our cohort of mitochondrial patients. Among the 722 patients with a definite genetic diagnosis, ocular myopathy was observed in 399 subjects (55.3%) and was positively associated with mtDNA single deletions and POLG mutations. Ocular myopathy as manifestation of a multisystem mitochondrial encephalomyopathy (PEO-encephalomyopathy, n = 131) was linked to the m.3243A>G mutation, whereas the other “PEO” patients (n = 268) were associated with mtDNA single deletion and Twinkle mutations. Increased lactate was associated with central neurological involvement. We then defined, among the PEO group, as “pure PEO” the patients with isolated ocular myopathy and “PEO-plus” those with ocular myopathy and other features of neuromuscular and multisystem involvement, excluding central nervous system. The male proportion was significantly lower in pure PEO than PEO-plus. This study reinforces the need for research on the role of gender in mitochondrial diseases. The phenotype definitions here revisited may contribute to a more homogeneous patient categorization, useful in future studies and clinical trials.
KW - CPEO
KW - Mitochondrial disorders
KW - Mitochondrial myopathy
KW - mtDNA
KW - PEO
UR - http://www.scopus.com/inward/record.url?scp=85022225612&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85022225612&partnerID=8YFLogxK
U2 - 10.1007/s00415-017-8567-z
DO - 10.1007/s00415-017-8567-z
M3 - Article
AN - SCOPUS:85022225612
SP - 1
EP - 8
JO - Journal of Neurology
JF - Journal of Neurology
SN - 0340-5354
ER -