Increased severity over generations of Charcot-Marie-Tooth disease type 1A

I. Steiner, M. Gotkine, B. Steiner-Birmanns, I. Biran, S. Silverstein, D. Abeliovich, Z. Argov, I. Wirguin

    Research output: Contribution to journalArticlepeer-review

    19 Scopus citations


    Background: Charcot-Marie-Tooth type 1A (CMT1A) is an autosomal dominant polyneuropathy due to a 1.5 Mb tandem duplication in chromosome 17p11.2, containing the PMP22 gene. This mutation is not modified during inheritance. Objectives: We set forth to test the hypothesis that in a subgroup of CMT1A patients there is clinical anticipation, namely an increase in disease severity over generations. Methods: Thirty-nine CMT1A mutation-positive patients in 16 families and 23 parent-offspring pairs were evaluated. This included 14 families with 2 generations and 2 families with 3 generations. Age of presentation was assessed by interviewing the patients and clinical severity was measured using the CMT neuropathy score (CMTNS). Results: In 21/23 parent-child pairs and 14/16 families, there was an earlier age of presentation in children of genetically affected parents. The mean age of onset in the progeny was 12.61 years compared to 41.22 years in the parent generation, (p < 0.001).Mean severity in the younger generation was slightly higher than that of the parent generation. When corrected for the age difference, the trend for a worse phenotype in the younger generation became statistically significant (p < 0.02, Wilcoxon signed rank test). Conclusions: Our findings suggest that in a subgroup of CMT1A patients there is an increase in clinical severity over generations. The mechanism responsible for this observation remains unknown. Our findings should be validated on a larger cohort of CMT1A families.

    Original languageEnglish
    Pages (from-to)813-819
    Number of pages7
    JournalJournal of Neurology
    Issue number6
    StatePublished - 1 Jun 2008


    • Age of symptom onset
    • Anticipation
    • CMT neuropathy score
    • Charcot-Marie-Tooth 1A
    • Hereditary neuropathy

    ASJC Scopus subject areas

    • Neurology
    • Clinical Neurology


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