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. 2011 Oct;34(5):1083-93.
doi: 10.1007/s10545-011-9323-7. Epub 2011 Apr 16.

Juvenile neuronal ceroid lipofuscinosis: clinical course and genetic studies in Spanish patients

María-Socorro Pérez-Poyato  1 , Montserrat Milà Recansens, Isidre Ferrer Abizanda, Raquel Montero Sánchez, Laia Rodríguez-Revenga, Victoria Cusí Sánchez, M Mar García González, Rosario Domingo Jiménez, Rafael Camino León, Ramón Velázquez Fragua, Antonio Martínez-Bermejo, Mercè Pineda Marfà
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Juvenile neuronal ceroid lipofuscinosis: clinical course and genetic studies in Spanish patients

María-Socorro Pérez-Poyato et al. J Inherit Metab Dis. 2011 Oct.

Abstract

Background: Juvenile neuronal ceroid lipofuscinosis (JNCL, NCL3, Batten disease) is usually caused by a 1.02-kb deletion in the CLN3 gene. Mutations in the CLN1 gene may be associated with a variant form of JNCL (vJNCL). We report the clinical course and molecular studies in 24 patients with JNCL collected from 1975 to 2010 with the aim of assessing the natural history of the disorder and phenotype/genotype correlations.

Patients and methods: Patients were classified into the groups of vJNCL with mutations in the CLN1 gene and/or granular osmiophilic deposit (GROD) inclusion bodies (n = 11) and classic JNCL (cJNCL) with mutations in the CLN3 gene and/or fingerprint (FP) profiles (n = 13). Psychomotor impairment included regression of acquired skills, cognitive decline, and clinical manifestations of the disease. We used Kaplan-Meier analyses to estimate the age of onset of psychomotor impairment.

Results: Patients with vJNCL showed learning delay at an earlier age (median 4 years, 95% confidence interval [CI] 3.1-4.8) than those in the cJNCL group (median 8 years, 95% CI 6.2-9.7) (P = 0.001) and regression of acquired skills at a younger age. Patients with vJNCL showed a more severe and progressive clinical course than those with cJNCL. There may be a Gypsy ancestry for V181L missense mutation in the CLN1 gene.

Conclusions: The rate of disease progression may be useful to diagnose vJNCL or cJNCL, which should be confirmed by molecular studies in CLN1/CLN3 genes. Further studies of genotype/phenotype correlation will be helpful for understanding the pathogenesis of this disease.

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