The role of mutations in COL6A3 in isolated dystonia

Katja Lohmann, Felix Schlicht, Marina Svetel, Frauke Hinrichs, Simone Zittel, Julia Graf, Thora Lohnau, Alexander Schmidt, Pablo Mir, Patricia Krause, Antony E. Lang, Hans-Christian Jabusch, Alexander Wolters, Christoph Kamm, Kirsten E. Zeuner, Eckart Altenmüller, Sadaf Naz, Sun Ju Chung, Vladimir S. Kostic, Alexander Münchau, Andrea A. Kühn, Norbert Brüggemann, Christine Klein

Specific mutations in COL6A3 have recently been reported as the cause of isolated recessive dystonia, which is a rare movement disorder. In all patients, at least one mutation was located in Exons 41 and 42. In an attempt to replicate these findings, we assessed by direct sequencing the frequency of rare variants in Exons 41 and 42 of COL6A3 in 955 patients with isolated or combined dystonia or with another movement disorder with dystonic features. We identified nine heterozygous carriers of rare variants including five different missense mutations and an extremely rare synonymous variant. In these nine patients, we sequenced the remaining 41 coding exons of COL6A3 to test for a second mutation in the compound heterozygous state. In only one of them, a second rare variant was identified (Thr732Met + Pro3082Arg). Of note, this patient had been diagnosed with Parkinson´s disease (with dystonic posturing) due to homozygous PINK1 mutations. The COL6A3 mutations clearly did not segregate with the disease in the four affected siblings of this family. Further, there was no indication for a disease-modifying effect of the COL6A3 mutations since disease severity or age at onset did not correlate with the number of COL6A3 mutated alleles in this family. In conjunction with the relatively high frequency of homozygous carriers of reported mutations in publically available databases, our data call a causal role for variants in COL6A3 in isolated dystonia into question.