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                <title level="j">Genetics in Medicine</title>
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                  <publisher>Nature Publishing Group</publisher>
                  <biblScope unit="volume">22</biblScope>
                  <biblScope unit="issue">11</biblScope>
                  <biblScope unit="pp">1851-1862</biblScope>
                  <date type="datePub">2020-11</date>
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                <term xml:lang="en">SCA48</term>
                <term xml:lang="en">SCAR16</term>
                <term xml:lang="en">STUB1</term>
                <term xml:lang="en">cognitive impairment</term>
                <term xml:lang="en">spinocerebellar ataxia</term>
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              <classCode scheme="mesh">ATP-Dependent Proteases</classCode>
              <classCode scheme="mesh">ATPases Associated with Diverse Cellular Activities</classCode>
              <classCode scheme="mesh">Ataxia</classCode>
              <classCode scheme="mesh">Cerebellar Ataxia</classCode>
              <classCode scheme="mesh">Cognitive Dysfunction</classCode>
              <classCode scheme="mesh">Female</classCode>
              <classCode scheme="mesh">Humans</classCode>
              <classCode scheme="mesh">Male</classCode>
              <classCode scheme="mesh">Spinocerebellar Ataxias</classCode>
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              <p>Purpose: Pathogenic variants in STUB1 were initially described in autosomal recessive spinocerebellar ataxia type 16 and dominant cerebellar ataxia with cerebellar cognitive dysfunction (SCA48).Methods: We analyzed a large series of 440 index cerebellar ataxia cases, mostly with dominant inheritance.Results: STUB1 variants were detected in 50 patients. Age at onset and severity were remarkably variable. Cognitive impairment, predominantly frontal syndrome, was observed in 54% of STUB1 variant carriers, including five families with Huntington or frontotemporal dementia disease-like phenotypes associated with ataxia, while no STUB1 variant was found in 115 patients with frontotemporal dementia. We report neuropathological findings of a STUB1 heterozygous patient, showing massive loss of Purkinje cells in the vermis and major loss in the cerebellar hemispheres without atrophy of the pons, hippocampus, or cerebral cortex. This screening of STUB1 variants revealed new features: (1) the majority of patients were women (70%) and (2) "second hits" in AFG3L2, PRKCG, and TBP were detected in three families suggesting synergic effects.Conclusion: Our results reveal an unexpectedly frequent (7%) implication of STUB1 among dominantly inherited cerebellar ataxias, and suggest that the penetrance of STUB1 variants could be modulated by other factors, including sex and variants in other ataxia-related genes.</p>
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          <date type="end">2021-12-31</date>
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            <address>
              <addrLine>Place Eugène Bataillon 34095 Montpellier Cedex 5</addrLine>
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          <orgName>Centre Hospitalier Universitaire [Strasbourg]</orgName>
          <orgName type="acronym">CHU Strasbourg</orgName>
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            <address>
              <country key="FR"/>
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            <ref type="url">https://www.chru-strasbourg.fr/</ref>
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        <org type="laboratory" xml:id="struct-578709" status="VALID">
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            <address>
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              <addrLine>12 rue Dubernat 33400 Talence</addrLine>
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          <orgName>Universitätsklinikum Essen = University Hospital Essen [Universität Duisburg-Essen]</orgName>
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            <ref type="url">http://www.inserm.fr</ref>
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          <orgName>Sorbonne Université</orgName>
          <orgName type="acronym">SU</orgName>
          <date type="start">2018-01-01</date>
          <desc>
            <address>
              <addrLine>21 rue de l’École de médecine - 75006 Paris</addrLine>
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            <ref type="url">http://www.sorbonne-universite.fr/</ref>
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          <orgName>Centre National de la Recherche Scientifique</orgName>
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          <orgName>Université Paris Sciences et Lettres</orgName>
          <orgName type="acronym">PSL</orgName>
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              <addrLine>60 rue Mazarine 75006 Paris</addrLine>
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            <ref type="url">https://www.psl.eu/</ref>
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          <orgName>Université Montpellier 1</orgName>
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              <addrLine>5, boulevard Henri IV - CS 19044 - 34967 Montpellier cedex</addrLine>
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