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      <abstractText>Perrault syndrome is a genetically heterogenous, very rare disease, characterized clinically by sensorineural hearing loss, ovarian dysfunction and neurological symptoms. We present the case of a 33 years old female patient with TWNK-associated Perrault syndrome. The TWNK gene is coding the mitochondrial protein Twinkle and currently there are only two reports characterizing the phenotype of TWNK-associated Perrault syndrome. None of these publications reported about special brain MRI alterations and neuropathological changes in the muscle and peripheral nerves.Our patients with TWNK-dependent Perrault syndrome had severe bilateral hypoacusis, severe ataxia, polyneuropathy, lower limb spastic paraparesis with pyramidal signs, and gonadal dysgenesis. Psychiatric symptoms such as depression and paranoia were present as well. Brain MRI observed progressive cerebellar hyperintensive signs associated with cerebellar, medulla oblongata and cervical spinal cord atrophy. Light microscopy of the muscle biopsy detected severe neurogenic lesions. COX staining was centrally reduced in many muscle fibers. Both muscle and sural nerve electron microscopy detected slightly enlarged mitochondria with abnormal cristae surrounded by lipid vacuoles. In the sural nerve, dystrophic axons had focally uncompacted myelin lamellae present. Genetic investigation revealed multiple mtDNA deletion and compound heterozygous mutations of the TWNK gene (c.1196 A > G, c.1358 G > A).This study demonstrates that TWNK associated Perrault syndrome has a much broader phenotype as originally published. The coexistence of severe hypoacusis, spastic limb weakness, ataxia, polyneuropathy, gonadal dysgensia, hyperintense signals in the cerebellum and the presence of the mtDNA multiple deletion could indicate the impairment of the TWNK gene. This is the first report about pyramidal tract involvement and cerebellar MRI alteration associated with TWNK-related Perrault syndrome.</abstractText>
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&lt;span class=&quot;deleted-record&quot;&gt;Központi kezelésű&lt;/span&gt; &lt;span class=&quot;short-pub-mtid&quot;&gt; Közlemény:31032708 &lt;/span&gt; &lt;span class=&quot;status-holder&quot;&gt;&lt;span class=&quot;status-data status-VALIDATED&quot;&gt; Egyeztetett &lt;/span&gt;&lt;/span&gt; &lt;span class=&quot;pub-core&quot;&gt;Forrás Idéző &lt;/span&gt; &lt;span class=&quot;pub-type&quot;&gt;Folyóiratcikk (Szakcikk ) &lt;/span&gt; &lt;!-- &amp;&amp; !record.category.scientific --&gt; &lt;span class=&quot;pub-category&quot;&gt;Tudományos&lt;/span&gt; &lt;div class=&quot;publication-citation&quot; style=&quot;margin-left: 0.5cm;&quot;&gt; &lt;span title=&quot;Nyilvános idézőközlemények összesen, említések nélkül&quot; class=&quot;citingPub-count&quot;&gt;Nyilvános idéző összesen: 18&lt;/span&gt; | Független: 18 | Függő: 0 | Nem jelölt: 0 | WoS jelölt: 18 | Scopus jelölt:&amp;nbsp;17 | WoS/Scopus jelölt:&amp;nbsp;18 | DOI jelölt:&amp;nbsp;18 &lt;/div&gt; &lt;/div&gt; &lt;/div&gt; &lt;/div&gt;</template><template2>&lt;div class=&quot;JournalArticle Publication long-list&quot;&gt; &lt;div class=&quot;authors&quot;&gt; &lt;img title=&quot;Forrásközlemény&quot; style=&quot;float: left&quot; src=&quot;/frontend/resources/grid/publication-core-icon.png&quot;&gt; &lt;img title=&quot;Idézőközlemény&quot; style=&quot;float: left&quot; src=&quot;/frontend/resources/grid/publication-citation-icon.png&quot;&gt; &lt;div class=&quot;autype autype0&quot;&gt; &lt;span class=&quot;author-name&quot; mtid=&quot;10052027&quot;&gt;&lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10052027&quot; target=&quot;_blank&quot;&gt;Fekete Bálint ✉ (&lt;span class=&quot;authorship-author-name&quot;&gt;Fekete Bálint András&lt;/span&gt; &lt;span class=&quot;authorAux-mtmt&quot;&gt; genetika&lt;/span&gt;) &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-affil&quot;&gt;&lt;span title=&quot;Semmelweis Egyetem&quot;&gt;SE&lt;/span&gt;/&lt;span title=&quot;Általános Orvostudományi Kar&quot;&gt;AOK&lt;/span&gt;/&lt;span title=&quot;Intézet&quot;&gt;I&lt;/span&gt;/Genomikai Medicina és Ritka Betegségek Intézete&lt;/span&gt; ;&amp;nbsp;&amp;nbsp;&amp;nbsp; &lt;span class=&quot;author-name&quot; mtid=&quot;10032402&quot;&gt;&lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10032402&quot; target=&quot;_blank&quot;&gt;Pentelényi Klára (&lt;span class=&quot;authorship-author-name&quot;&gt;Pentelényi Klára&lt;/span&gt; &lt;span class=&quot;authorAux-mtmt&quot;&gt; molekuláris biológia, genetika&lt;/span&gt;) &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-affil&quot;&gt;&lt;span title=&quot;Semmelweis Egyetem&quot;&gt;SE&lt;/span&gt;/&lt;span title=&quot;Általános Orvostudományi Kar&quot;&gt;AOK&lt;/span&gt;/&lt;span title=&quot;Intézet&quot;&gt;I&lt;/span&gt;/Genomikai Medicina és Ritka Betegségek Intézete&lt;/span&gt; ;&amp;nbsp;&amp;nbsp;&amp;nbsp; &lt;span class=&quot;author-name&quot; mtid=&quot;10022028&quot;&gt;&lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10022028&quot; target=&quot;_blank&quot;&gt;Rudas Gabor (&lt;span class=&quot;authorship-author-name&quot;&gt;Rudas Gábor&lt;/span&gt; &lt;span class=&quot;authorAux-mtmt&quot;&gt; MR kutatás&lt;/span&gt;) &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-affil&quot;&gt;&lt;span title=&quot;Semmelweis Egyetem&quot;&gt;SE&lt;/span&gt;/&lt;span title=&quot;Központi Szervezeti Egységek (beleértve az Egyéb Szervezeti Egységeket)&quot;&gt;KSZE&lt;/span&gt;/MR Kutatóközpont&lt;/span&gt; ;&amp;nbsp;&amp;nbsp;&amp;nbsp; &lt;span class=&quot;author-name&quot; mtid=&quot;10013908&quot;&gt;&lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10013908&quot; target=&quot;_blank&quot;&gt;Gál Anikó (&lt;span class=&quot;authorship-author-name&quot;&gt;Gál Anikó&lt;/span&gt; &lt;span class=&quot;authorAux-mtmt&quot;&gt; Molekuláris biológia-genetika&lt;/span&gt;) &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-affil&quot;&gt;&lt;span title=&quot;Semmelweis Egyetem&quot;&gt;SE&lt;/span&gt;/&lt;span title=&quot;Általános Orvostudományi Kar&quot;&gt;AOK&lt;/span&gt;/&lt;span title=&quot;Intézet&quot;&gt;I&lt;/span&gt;/Genomikai Medicina és Ritka Betegségek Intézete&lt;/span&gt; ;&amp;nbsp;&amp;nbsp;&amp;nbsp; &lt;span class=&quot;author-name&quot; mtid=&quot;10040725&quot;&gt;&lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10040725&quot; target=&quot;_blank&quot;&gt;Grosz Zoltán (&lt;span class=&quot;authorship-author-name&quot;&gt;Grosz Zoltán&lt;/span&gt; &lt;span class=&quot;authorAux-mtmt&quot;&gt; Neurológia&lt;/span&gt;) &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-affil&quot;&gt;&lt;span title=&quot;Semmelweis Egyetem&quot;&gt;SE&lt;/span&gt;/&lt;span title=&quot;Általános Orvostudományi Kar&quot;&gt;AOK&lt;/span&gt;/&lt;span title=&quot;Intézet&quot;&gt;I&lt;/span&gt;/Genomikai Medicina és Ritka Betegségek Intézete&lt;/span&gt; ;&amp;nbsp;&amp;nbsp;&amp;nbsp; &lt;span class=&quot;author-name&quot; mtid=&quot;10048349&quot;&gt;&lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10048349&quot; target=&quot;_blank&quot;&gt;Illés Anett (&lt;span class=&quot;authorship-author-name&quot;&gt;Illés Anett&lt;/span&gt; &lt;span class=&quot;authorAux-mtmt&quot;&gt; Molekuláris biológia, Genetika&lt;/span&gt;) &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-affil&quot;&gt;&lt;span title=&quot;Semmelweis Egyetem&quot;&gt;SE&lt;/span&gt;/&lt;span title=&quot;Általános Orvostudományi Kar&quot;&gt;AOK&lt;/span&gt;/&lt;span title=&quot;Intézet&quot;&gt;I&lt;/span&gt;/Genomikai Medicina és Ritka Betegségek Intézete&lt;/span&gt; ;&amp;nbsp;&amp;nbsp;&amp;nbsp; &lt;span class=&quot;author-name&quot; mtid=&quot;10068012&quot;&gt;&lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10068012&quot; target=&quot;_blank&quot;&gt;Idris Jimoh (&lt;span class=&quot;authorship-author-name&quot;&gt;Jimoh Idris János&lt;/span&gt; &lt;span class=&quot;authorAux-mtmt&quot;&gt; Neurogenetika&lt;/span&gt;) &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-affil&quot;&gt;&lt;span title=&quot;Semmelweis Egyetem&quot;&gt;SE&lt;/span&gt;/&lt;span title=&quot;Általános Orvostudományi Kar&quot;&gt;AOK&lt;/span&gt;/&lt;span title=&quot;Intézet&quot;&gt;I&lt;/span&gt;/Genomikai Medicina és Ritka Betegségek Intézete&lt;/span&gt; ;&amp;nbsp;&amp;nbsp;&amp;nbsp; &lt;span class=&quot;author-name&quot; mtid=&quot;10023954&quot;&gt;&lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10023954&quot; target=&quot;_blank&quot;&gt;Csukly Gabor (&lt;span class=&quot;authorship-author-name&quot;&gt;Csukly Gábor&lt;/span&gt; &lt;span class=&quot;authorAux-mtmt&quot;&gt; Pszichiátria&lt;/span&gt;) &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-affil&quot;&gt;&lt;span title=&quot;Semmelweis Egyetem&quot;&gt;SE&lt;/span&gt;/&lt;span title=&quot;Általános Orvostudományi Kar&quot;&gt;AOK&lt;/span&gt;/&lt;span title=&quot;Klinikum&quot;&gt;K&lt;/span&gt;/Pszichiátriai és Pszichoterápiás Klinika&lt;/span&gt; ;&amp;nbsp;&amp;nbsp;&amp;nbsp; &lt;span class=&quot;author-name&quot; mtid=&quot;203&quot;&gt;&lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=203&quot; target=&quot;_blank&quot;&gt;Domonkos Andor (&lt;span class=&quot;authorship-author-name&quot;&gt;Domonkos Andor&lt;/span&gt; &lt;span class=&quot;authorAux-mtmt&quot;&gt; Neurobiológia&lt;/span&gt;) &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-affil&quot;&gt;&lt;span title=&quot;Kísérleti Orvostudományi Kutatóintézet&quot;&gt;KOKI&lt;/span&gt;/&lt;span title=&quot;Celluláris és Hálózat-neurobiológiai Osztály&quot;&gt;CHO&lt;/span&gt;/Agykéreg Kutatócsoport&lt;/span&gt; ;&amp;nbsp;&amp;nbsp;&amp;nbsp; &lt;span class=&quot;author-name&quot; mtid=&quot;10002781&quot;&gt;&lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10002781&quot; target=&quot;_blank&quot;&gt;Molnar Maria Judit (&lt;span class=&quot;authorship-author-name&quot;&gt;Molnár Mária Judit&lt;/span&gt; &lt;span class=&quot;authorAux-mtmt&quot;&gt; Neurológia&lt;/span&gt;) &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-affil&quot;&gt;&lt;span title=&quot;Semmelweis Egyetem&quot;&gt;SE&lt;/span&gt;/&lt;span title=&quot;Általános Orvostudományi Kar&quot;&gt;AOK&lt;/span&gt;/&lt;span title=&quot;Intézet&quot;&gt;I&lt;/span&gt;/Genomikai Medicina és Ritka Betegségek Intézete&lt;/span&gt; &lt;/div&gt; &lt;/div&gt; &lt;div class=&quot;title&quot;&gt;&lt;a href=&quot;/gui2/?mode=browse&amp;params=publication;31032708&quot; target=&quot;_blank&quot;&gt;Broadening the phenotype of the TWNK gene associated Perrault syndrome&lt;/a&gt;&lt;/div&gt; &lt;div&gt; &lt;span class=&quot;journal-title&quot;&gt;BMC MEDICAL GENETICS&lt;/span&gt; &lt;span class=&quot;journal-issn&quot;&gt;(&lt;a target=&quot;_blank&quot; href=&quot;https://portal.issn.org/resource/ISSN/1471-2350&quot;&gt;1471-2350&lt;/a&gt; &lt;a target=&quot;_blank&quot; href=&quot;https://portal.issn.org/resource/ISSN/1471-2350&quot;&gt;1471-2350&lt;/a&gt;)&lt;/span&gt;: &lt;span class=&quot;journal-volume&quot;&gt;20&lt;/span&gt; &lt;span class=&quot;journal-issue&quot;&gt;1&lt;/span&gt; &lt;span class=&quot;page&quot;&gt; Paper 198. 8 p. &lt;/span&gt; &lt;span class=&quot;year&quot;&gt;(2019)&lt;/span&gt; &lt;/div&gt; &lt;div class=&quot;pub-footer&quot;&gt;  &lt;span class=&quot;language&quot; xmlns=&quot;http://www.w3.org/1999/html&quot;&gt;Nyelv: Angol | &lt;/span&gt; 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target=&quot;_blank&quot; href=&quot;http://www.scopus.com/record/display.url?origin=inward&amp;eid=2-s2.0-85076971426&quot;&gt; Scopus &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;id identifier oa_none&quot; title=&quot;none&quot;&gt; &lt;a style=&quot;color:blue&quot; title=&quot;31852434&quot; target=&quot;_blank&quot; href=&quot;http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;list_uids=31852434&amp;dopt=Abstract&quot;&gt; PubMed &lt;/a&gt; &lt;/span&gt; &lt;/span&gt; &lt;OnlyViewableByAuthor&gt;&lt;div class=&quot;ratings&quot;&gt; &lt;div class=&quot;journal-subject&quot;&gt;Folyóirat szakterülete: Scopus - Genetics (clinical)&amp;nbsp;&amp;nbsp;&amp;nbsp;SJR indikátor:&amp;nbsp;Q3&lt;/div&gt; &lt;div class=&quot;journal-subject&quot;&gt;Folyóirat szakterülete: Scopus - Genetics&amp;nbsp;&amp;nbsp;&amp;nbsp;SJR indikátor:&amp;nbsp;Q3&lt;/div&gt; &lt;/div&gt;&lt;/OnlyViewableByAuthor&gt; &lt;div class=&quot;publication-citation&quot; style=&quot;margin-left: 0.5cm;&quot;&gt; 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&lt;/div&gt; &lt;div class=&quot;lastModified&quot;&gt;Utolsó módosítás: 2023.01.23. 15:31 Csajbók Edit (SE_KK_Admin5_CSE, admin) &lt;/div&gt; &lt;div class=&quot;lockedBy&quot;&gt;Központi kezelésű 2026.01.20. 16:16 Tokai Tamás (Központi 2-3, admin) &lt;/div&gt; &lt;/div&gt;&lt;/div&gt;</template2>
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