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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1995 Aug;59(2):160–164. doi: 10.1136/jnnp.59.2.160

Leber's "plus": neurological abnormalities in patients with Leber's hereditary optic neuropathy.

E K Nikoskelainen 1, R J Marttila 1, K Huoponen 1, V Juvonen 1, T Lamminen 1, P Sonninen 1, M L Savontaus 1
PMCID: PMC485991  PMID: 7629530

Abstract

Previous studies suggest that Leber's hereditary optic neuropathy (LHON) may be a systemic disorder with manifestations in organs other than the optic nerves. To evaluate nervous system involvement 38 men and eight women with LHON were re-examined. The patients were divided into three groups according to mtDNA analysis--namely, patients with the 11778 or with the 3460 mutation and patients without these primary mutations. Fifty nine per cent of patients had neurological abnormalities but there was no significant difference between the three groups. Movement disorders were the most common finding; nine patients had constant postural tremor, one chronic motor tic disorder, and one parkinsonism with dystonia. Four patients had peripheral neuropathy with no other evident cause. Two patients had a multiple sclerosis-like syndrome; in both patients MRI showed changes in the periventricular white matter. Thoracic kyphosis occurred in seven patients, five of whom had the 3460 mutation. In one patient the 3460 mutation was associated with involvement of the brain stem. It is suggested that various movement disorders, multiple sclerosis-like illness, and deformities of the vertebral column may associate pathogenetically with LHON.

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Selected References

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  1. BEREDAY M., COBB S. Relation of hereditary optic atrophy (leber) to the other familial degenerative diseases of central nervous system. AMA Arch Ophthalmol. 1952 Dec;48(6):669–680. doi: 10.1001/archopht.1952.00920010681001. [DOI] [PubMed] [Google Scholar]
  2. BRUYN G. W., WENT L. N. A SEX-LINKED HEREDO-DEGENERATIVE NEUROLOGICAL DISORDER, ASSOCIATED WITH LEBER'S OPTIC ATROPHY. I. CLINICAL STUDIES. J Neurol Sci. 1964 Jan-Feb;1(1):59–80. doi: 10.1016/0022-510x(64)90054-1. [DOI] [PubMed] [Google Scholar]
  3. Bruyn G. W., Vielvoye G. J., Went L. N. Hereditary spastic dystonia: a new mitochondrial encephalopathy? Putaminal necrosis as a diagnostic sign. J Neurol Sci. 1991 Jun;103(2):195–202. doi: 10.1016/0022-510x(91)90164-3. [DOI] [PubMed] [Google Scholar]
  4. Cullom M. E., Heher K. L., Miller N. R., Savino P. J., Johns D. R. Leber's hereditary optic neuropathy masquerading as tobacco-alcohol amblyopia. Arch Ophthalmol. 1993 Nov;111(11):1482–1485. doi: 10.1001/archopht.1993.01090110048021. [DOI] [PubMed] [Google Scholar]
  5. Flanigan K. M., Johns D. R. Association of the 11778 mitochondrial DNA mutation and demyelinating disease. Neurology. 1993 Dec;43(12):2720–2722. doi: 10.1212/wnl.43.12.2720. [DOI] [PubMed] [Google Scholar]
  6. Harding A. E., Sweeney M. G., Miller D. H., Mumford C. J., Kellar-Wood H., Menard D., McDonald W. I., Compston D. A. Occurrence of a multiple sclerosis-like illness in women who have a Leber's hereditary optic neuropathy mitochondrial DNA mutation. Brain. 1992 Aug;115(Pt 4):979–989. doi: 10.1093/brain/115.4.979. [DOI] [PubMed] [Google Scholar]
  7. Hirano M., Ricci E., Koenigsberger M. R., Defendini R., Pavlakis S. G., DeVivo D. C., DiMauro S., Rowland L. P. Melas: an original case and clinical criteria for diagnosis. Neuromuscul Disord. 1992;2(2):125–135. doi: 10.1016/0960-8966(92)90045-8. [DOI] [PubMed] [Google Scholar]
  8. Howell N., Kubacka I., Halvorson S., Mackey D. Leber's hereditary optic neuropathy: the etiological role of a mutation in the mitochondrial cytochrome b gene. Genetics. 1993 Jan;133(1):133–136. doi: 10.1093/genetics/133.1.133. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Howell N., Kubacka I., Xu M., McCullough D. A. Leber hereditary optic neuropathy: involvement of the mitochondrial ND1 gene and evidence for an intragenic suppressor mutation. Am J Hum Genet. 1991 May;48(5):935–942. [PMC free article] [PubMed] [Google Scholar]
  10. Huoponen K., Lamminen T., Juvonen V., Aula P., Nikoskelainen E., Savontaus M. L. The spectrum of mitochondrial DNA mutations in families with Leber hereditary optic neuroretinopathy. Hum Genet. 1993 Oct;92(4):379–384. doi: 10.1007/BF01247339. [DOI] [PubMed] [Google Scholar]
  11. Johns D. R., Neufeld M. J. Cytochrome b mutations in Leber hereditary optic neuropathy. Biochem Biophys Res Commun. 1991 Dec 31;181(3):1358–1364. doi: 10.1016/0006-291x(91)92088-2. [DOI] [PubMed] [Google Scholar]
  12. Johns D. R., Neufeld M. J., Park R. D. An ND-6 mitochondrial DNA mutation associated with Leber hereditary optic neuropathy. Biochem Biophys Res Commun. 1992 Sep 30;187(3):1551–1557. doi: 10.1016/0006-291x(92)90479-5. [DOI] [PubMed] [Google Scholar]
  13. Johns D. R., Smith K. H., Miller N. R. Leber's hereditary optic neuropathy. Clinical manifestations of the 3460 mutation. Arch Ophthalmol. 1992 Nov;110(11):1577–1581. doi: 10.1001/archopht.1992.01080230077025. [DOI] [PubMed] [Google Scholar]
  14. Johns D. R., Smith K. H., Savino P. J., Miller N. R. Leber's hereditary optic neuropathy. Clinical manifestations of the 15257 mutation. Ophthalmology. 1993 Jul;100(7):981–986. doi: 10.1016/s0161-6420(93)31527-7. [DOI] [PubMed] [Google Scholar]
  15. Jun A. S., Brown M. D., Wallace D. C. A mitochondrial DNA mutation at nucleotide pair 14459 of the NADH dehydrogenase subunit 6 gene associated with maternally inherited Leber hereditary optic neuropathy and dystonia. Proc Natl Acad Sci U S A. 1994 Jun 21;91(13):6206–6210. doi: 10.1073/pnas.91.13.6206. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. LEES F., MACDONALD A. M., TURNER J. W. LEBER'S DISEASE WITH SYMPTOMS RESEMBLING DISSEMINATED SCLEROSIS. J Neurol Neurosurg Psychiatry. 1964 Oct;27:415–421. doi: 10.1136/jnnp.27.5.415. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Larsson N. G., Andersen O., Holme E., Oldfors A., Wahlström J. Leber's hereditary optic neuropathy and complex I deficiency in muscle. Ann Neurol. 1991 Nov;30(5):701–708. doi: 10.1002/ana.410300511. [DOI] [PubMed] [Google Scholar]
  18. Leuzzi V., Bertini E., De Negri A. M., Gallucci M., Garavaglia B. Bilateral striatal necrosis, dystonia and optic atrophy in two siblings. J Neurol Neurosurg Psychiatry. 1992 Jan;55(1):16–19. doi: 10.1136/jnnp.55.1.16. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Mackey D., Howell N. A variant of Leber hereditary optic neuropathy characterized by recovery of vision and by an unusual mitochondrial genetic etiology. Am J Hum Genet. 1992 Dec;51(6):1218–1228. [PMC free article] [PubMed] [Google Scholar]
  20. Marsden C. D., Lang A. E., Quinn N. P., McDonald W. I., Abdallat A., Nimri S. Familial dystonia and visual failure with striatal CT lucencies. J Neurol Neurosurg Psychiatry. 1986 May;49(5):500–509. doi: 10.1136/jnnp.49.5.500. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. McCluskey D. J., O'Connor P. S., Sheehy J. T. Leber's optic neuropathy and Charcot-Marie-Tooth disease. Report of a case. J Clin Neuroophthalmol. 1986 Jun;6(2):76–81. [PubMed] [Google Scholar]
  22. McLeod J. G., Low P. A., Morgan J. A. Charcot-Marie-Tooth disease with Leber optic atrophy. Neurology. 1978 Feb;28(2):179–184. doi: 10.1212/wnl.28.2.179. [DOI] [PubMed] [Google Scholar]
  23. Mondelli M., Rossi A., Scarpini C., Dotti M. T., Federico A. BAEP changes in Leber's hereditary optic atrophy: further confirmation of multisystem involvement. Acta Neurol Scand. 1990 Apr;81(4):349–353. doi: 10.1111/j.1600-0404.1990.tb01569.x. [DOI] [PubMed] [Google Scholar]
  24. Newman N. J. Leber's hereditary optic neuropathy. New genetic considerations. Arch Neurol. 1993 May;50(5):540–548. doi: 10.1001/archneur.1993.00540050082021. [DOI] [PubMed] [Google Scholar]
  25. Nikoskelainen E. K., Savontaus M. L., Wanne O. P., Katila M. J., Nummelin K. U. Leber's hereditary optic neuroretinopathy, a maternally inherited disease. A genealogic study in four pedigrees. Arch Ophthalmol. 1987 May;105(5):665–671. doi: 10.1001/archopht.1987.01060050083043. [DOI] [PubMed] [Google Scholar]
  26. Nikoskelainen E., Nummelin K., Savontaus M. L. Does sporadic Leber's disease exist? J Clin Neuroophthalmol. 1988 Dec;8(4):225–229. [PubMed] [Google Scholar]
  27. Novotny E. J., Jr, Singh G., Wallace D. C., Dorfman L. J., Louis A., Sogg R. L., Steinman L. Leber's disease and dystonia: a mitochondrial disease. Neurology. 1986 Aug;36(8):1053–1060. doi: 10.1212/wnl.36.8.1053. [DOI] [PubMed] [Google Scholar]
  28. Ohama E., Ohara S., Ikuta F., Tanaka K., Nishizawa M., Miyatake T. Mitochondrial angiopathy in cerebral blood vessels of mitochondrial encephalomyopathy. Acta Neuropathol. 1987;74(3):226–233. doi: 10.1007/BF00688185. [DOI] [PubMed] [Google Scholar]
  29. Palan A., Stehouwer A., Went L. N. Studies on Leber's optic neuropathy III. Doc Ophthalmol. 1989 Jan;71(1):77–87. doi: 10.1007/BF00155135. [DOI] [PubMed] [Google Scholar]
  30. Paulus W., Straube A., Bauer W., Harding A. E. Central nervous system involvement in Leber's optic neuropathy. J Neurol. 1993;240(4):251–253. doi: 10.1007/BF00818714. [DOI] [PubMed] [Google Scholar]
  31. Rajput A. H., Rozdilsky B., Ang L., Rajput A. Clinicopathologic observations in essential tremor: report of six cases. Neurology. 1991 Sep;41(9):1422–1424. doi: 10.1212/wnl.41.9.1422. [DOI] [PubMed] [Google Scholar]
  32. Rautakorpi I., Takala J., Marttila R. J., Sievers K., Rinne U. K. Essential tremor in a Finnish population. Acta Neurol Scand. 1982 Jul;66(1):58–67. doi: 10.1111/j.1600-0404.1982.tb03129.x. [DOI] [PubMed] [Google Scholar]
  33. Sakuta R., Nonaka I. Vascular involvement in mitochondrial myopathy. Ann Neurol. 1989 Jun;25(6):594–601. doi: 10.1002/ana.410250611. [DOI] [PubMed] [Google Scholar]
  34. WILSON J. Leber's hereditary optic atrophy: some clinical and aetiological considerations. Brain. 1963 Jun;86:347–362. doi: 10.1093/brain/86.2.347. [DOI] [PubMed] [Google Scholar]
  35. Wallace D. C. A new manifestation of Leber's disease and a new explanation for the agency responsible for its unusual pattern of inheritance. Brain. 1970;93(1):121–132. doi: 10.1093/brain/93.1.121. [DOI] [PubMed] [Google Scholar]

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