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Brain Advance Access published online on June 9, 2005
Brain, doi:10.1093/brain/awh576
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© The Author (2005). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received February 9, 2005
Revised April 27, 2005
Accepted May 20, 2005

Article

Myotilinopathy: refining the clinical and myopathological phenotype

Montse Olivé 1*, Lev G. Goldfarb 2, Alexey Shatunov 2, Dirk Fischer 3, and Isidro Ferrer 1

1 Institut de Neuropatologia, IDIBELL-Hospital de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
2 The National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892-1361, USA
3 Muskellabor, Department of Neurology, University of Bonn, 53105 Bonn, Germany

* To whom correspondence should be addressed.
Montse Olivé, E-mail: 25169mop{at}comb.es


  Abstract

Mutations in myotilin gene (MYOT) have been associated with variable syndromes including limb girdle muscular dystrophy type 1A (LGMD1A) and a subgroup of myofibrillar myopathy (MFM/MYOT). We studied six Spanish patients from three unrelated kindreds and seven patients without family history. Three previously reported and two novel disease-associated MYOT mutations were identified in this group of patients. The disease is characterized by the onset at the age of 42-77 years with muscle weakness initially in distal or proximal leg muscles, eventually spreading to other muscle groups of the lower and upper extremities. Associated signs of cardiomyopathy, respiratory failure and peripheral neuropathy are present in a fraction of patients. Myopathological features of focal myofibrillar destruction resulting in intracytoplasmic deposits, strongly immunoreactive to myotilin, multiple rimmed and centrally or subsarcolemmally located non-rimmed vacuoles and streaming Z-lines, were observed in each patient studied. The Spanish cohort, the largest group of patients studied so far, shares phenotypic features with both LGMD1A and MFM/MYOT variants thus establishing a continuum of phenotypic manifestations characteristic of myotilinopathy, an emerging neuromuscular disorder.

Keywords: LGMD1A; myofibrillar myopathy; myotilin; MYOT mutations; phenotype.
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