Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Brief Communication
  • Published:

A novel variant in the transmembrane 4 domain of ANO3 identified in a two-year-old girl with developmental delay and tremor

Abstract

ANO3 encodes Anoctamin-3, also known as TMEM16C, a calcium-activated chloride channel. Heterozygous variants of ANO3 can cause dystonia 24, an adult-onset focal dystonia. Some pediatric cases have been reported, but most patients were intellectually normal with some exceptions. Here, we report a two-year-old girl who showed mild to moderate developmental delay, tremor, and ataxic gait, but no obvious dystonia. Trio exome sequencing identified a heterozygous de novo missense variant NM_031418.4:c.1809T>G, p.(Asn603Lys) in the ANO3 gene. Three cases with ANO3 variants and intellectual disability have been reported, including the present case. These variants were predicted to face in the same direction on the same alpha-helix (the transmembrane 4 domain), suggesting an association between these variants and childhood-onset movement disorder with intellectual disability. In pediatric cases with developmental delay and movement disorders such as tremor and ataxia, specific variants in the transmembrane 4 domain of ANO3 may be a cause, even in the absence of dystonia.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Variants in ANO3 in our case and previously reported pediatric cases.

References

  1. Picollo A, Malvezzi M, Accardi A. TMEM16 proteins: unknown structure and confusing functions. J Mol Biol. 2015;427:94–105.

    Article  CAS  Google Scholar 

  2. Pedemonte N, Galietta LJ. Structure and function of TMEM16 proteins (anoctamins). Physiol Rev. 2014;94:419–59.

    Article  CAS  Google Scholar 

  3. Charlesworth G, Plagnol V, Holmstrom KM, Bras J, Sheerin UM, Preza E, et al. Mutations in ANO3 cause dominant craniocervical dystonia: ion channel implicated in pathogenesis. Am J Hum Genet. 2012;91:1041–50.

    Article  CAS  Google Scholar 

  4. Nelin S, Hussey R, Faux BM, Rohena L. Youngest presenting patient with dystonia 24 and review of the literature. Clin Case Rep. 2018;6:2070–4.

    Article  Google Scholar 

  5. Jimenez de Domingo A, Lopez-Martin S, Albert J, Jimenez de la Pena M, Tirado P, Fernandez-Mayoralas DM, et al. ANO3 and early-onset dyskinetic encephalopathy. Eur J Med Genet. 2020;63:104085.

    Article  Google Scholar 

  6. Olschewski L, Jesus S, Kim HJ, Tunc S, Lons S, Junker J, et al. Role of ANO3 mutations in dystonia: a large-scale mutational screening study. Parkinsonism Relat Disord 2019;62:196–200.

    Article  Google Scholar 

  7. Tunc S, Denecke J, Olschewski L, Baumer T, Munchau A, Lessel D, et al. A recurrent de-novo ANO3 mutation causes early-onset generalized dystonia. J Neurol Sci. 2019;396:199–201.

    Article  CAS  Google Scholar 

  8. Yoo D, Kim HJ, Lee JS, Lee S, Kim SY, Choi M, et al. Early-onset generalized dystonia starting in the lower extremities in a patient with a novel ANO3 variant. Parkinsonism Relat Disord. 2018;50:124–5.

    Article  Google Scholar 

  9. Zech M, Boesch S, Jochim A, Weber S, Meindl T, Schormair B, et al. Clinical exome sequencing in early-onset generalized dystonia and large-scale resequencing follow-up. Mov Disord. 2017;32:549–59.

    Article  CAS  Google Scholar 

  10. Laurencin C, Broussolle E, Danaila T, Anheim M, Chelly J, Thobois S. A novel heterozygous ANO3 mutation responsible for myoclonic dystonia. J Neurol Sci. 2019;403:65–6.

    Article  CAS  Google Scholar 

  11. Delamarre A, Chelly J, Guehl D, Drouot N, Tranchant C, Anheim M, et al. Novel anoctamin-3 missense mutation responsible for early-onset myoclonic dystonia. Parkinsonism Relat Disord. 2019;64:346–48.

    Article  CAS  Google Scholar 

  12. Stamelou M, Charlesworth G, Cordivari C, Schneider SA, Kagi G, Sheerin UM, et al. The phenotypic spectrum of DYT24 due to ANO3 mutations. Mov Disord. 2014;29:928–34.

    Article  CAS  Google Scholar 

  13. Carvalho V, Martins J, Correia F, Costa M, Massano J, Temudo T. Another twist in the tale: intrafamilial phenotypic heterogeneity in ANO3-related dystonia. Mov Disord Clin Pract. 2021;8:758–62.

    Article  Google Scholar 

  14. Li S, Wang L, Yang Y, Ma J, Wan X. ANO3 mutations in Chinese dystonia: a genetic screening study using next-generation sequencing. Front Neurol. 2019;10:1351.

    Article  Google Scholar 

  15. Lek M, Karczewski KJ, Minikel EV, Samocha KE, Banks E, Fennell T, et al. Analysis of protein-coding genetic variation in 60,706 humans. Nature. 2016;536:285–91.

    Article  CAS  Google Scholar 

  16. Tadaka S, Hishinuma E, Komaki S, Motoike IN, Kawashima J, Saigusa D, et al. jMorp updates in 2020: large enhancement of multi-omics data resources on the general Japanese population. Nucleic acids Res. 2021;49:D536–44.

    Article  CAS  Google Scholar 

  17. Richards S, Aziz N, Bale S, Bick D, Das S, Gastier-Foster J, et al. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med. 2015;17:405–24.

    Article  Google Scholar 

  18. Domingo A, Yadav R, Ozelius LJ. Isolated dystonia: clinical and genetic updates. J Neural Transm. 2021;128:405–16.

    Article  Google Scholar 

  19. Lange LM, Junker J, Loens S, Baumann H, Olschewski L, Schaake S, et al. Genotype-phenotype relations for isolated dystonia genes: MDSgene systematic review. Mov Disord. 2021;36:1086–103.

    Article  CAS  Google Scholar 

  20. Jiang LT, Li LX, Liu Y, Zhang XL, Pan YG, Wang L, et al. The expanding clinical and genetic spectrum of ANO3 dystonia. Neurosci Lett. 2021;746:135590.

    Article  CAS  Google Scholar 

  21. Jumper J, Evans R, Pritzel A, Green T, Figurnov M, Ronneberger O, et al. Highly accurate protein structure prediction with AlphaFold. Nature. 2021;596:583–9.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors would like to thank the patient and her family for their participation in this study. We thank Yoko Chiba and Kumi Ito for the technical assistance. We also acknowledge the support obtained from the Biomedical Research Core of the Tohoku University Graduate School of Medicine and the Biomedical Research Unit of Tohoku University Hospital. This research was supported by the Japanese Agency for Medical Research and Development (AMED) to SK (No. JP17ek0109151).

Author information

Authors and Affiliations

Authors

Contributions

YuA, MS and AK performed data analyses and wrote the manuscript, YuA and YK performed case examination and evaluation, TN, MS, RF, KN, and YoA performed exome sequencing and data collection, and SK designed and supervised the study.

Corresponding author

Correspondence to Atsuo Kikuchi.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethics approval

This study was approved by the ethics committee of Tohoku University School of Medicine. Written informed consent was obtained from the parents of the patient for the publication of this case report.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Aihara, Y., Shirota, M., Kikuchi, A. et al. A novel variant in the transmembrane 4 domain of ANO3 identified in a two-year-old girl with developmental delay and tremor. J Hum Genet 68, 51–54 (2023). https://doi.org/10.1038/s10038-022-01082-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s10038-022-01082-5

Search

Quick links