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Pathogenic variants in NUS1 cause a complex neurological disorder with epilepsy and movement issues. Most affected individuals experience developmental delays and significant disability from movement disorders.

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Area of Science:

  • Genetics
  • Neurology
  • Rare Diseases

Background:

  • Growing evidence links genetic factors in developmental and epileptic encephalopathies (DEEs) with movement disorders.
  • De novo loss-of-function variants in NUS1 have been recently identified in DEE cases.

Purpose of the Study:

  • To report a large cohort of cases with pathogenic NUS1 variants.
  • To describe the clinical presentation, epilepsy, and movement disorders associated with NUS1 variants.

Main Methods:

  • Multicentric international collaboration using the GeneMatcher platform.
  • Retrospective review of clinical case notes for affected subjects.

Main Results:

  • Identified 41 subjects with 38 distinct pathogenic NUS1 variants.
  • Majority presented with developmental delays and intellectual disability.
  • Epilepsy occurred in 68.3% of cases; movement disorders in 87.8%, often without epilepsy.
  • Complex movement disorder phenomenology included myoclonus, dystonia, ataxia, and parkinsonism.

Conclusions:

  • Heterozygous NUS1 pathogenic variants lead to a complex neurological disorder.
  • Features include DEEs and a wide spectrum of movement disorders.
  • Movement disorders are a primary source of neurological disability in most cases.