RT Journal Article SR Electronic T1 Identification of a new SYT2 variant validates an unusual distal motor neuropathy phenotype JF Neurology Genetics JO Neurol Genet FD Lippincott Williams & Wilkins SP e282 DO 10.1212/NXG.0000000000000282 VO 4 IS 6 A1 Nataly I. Montes-Chinea A1 Zhuo Guan A1 Marcella Coutts A1 Cecilia Vidal A1 Steve Courel A1 Adriana P. Rebelo A1 Lisa Abreu A1 Stephan Zuchner A1 J. Troy Littleton A1 Mario A. Saporta YR 2018 UL http://ng.neurology.org/content/4/6/e282.abstract AB Objective To report a new SYT2 missense mutation causing distal hereditary motor neuropathy and presynaptic neuromuscular junction (NMJ) transmission dysfunction.Methods We report a multigenerational family with a new missense mutation, c. 1112T>A (p. Ile371Lys), in the C2B domain of SYT2, describe the clinical and electrophysiologic phenotype associated with this variant, and validate its pathogenicity in a Drosophila model.Results Both proband and her mother present a similar clinical phenotype characterized by a slowly progressive, predominantly motor neuropathy and clear evidence of presynaptic NMJ dysfunction on nerve conduction studies. Validation of this new variant was accomplished by characterization of the mutation homologous to the human c. 1112T>A variant in Drosophila, confirming its dominant-negative effect on neurotransmitter release.Conclusions This report provides further confirmation of the role of SYT2 in human disease and corroborates the resultant unique clinical phenotype consistent with heriditary distal motor neuropathy. SYT2-related motor neuropathy is a rare disease but should be suspected in patients presenting with a combination of presynaptic NMJ dysfunction (resembling Lambert-Eaton myasthenic syndrome) and a predominantly motor neuropathy, especially in the context of a positive family history.ADM=abductor digiti minimi; AH=abductor hallucis; ANOVA=analysis of variance; APB=abductor pollicis brevis; CMT=Charcot-Marie-Tooth; CMTNS=Charcot-Marie-Tooth Neuropathy Score; dHMN=Hereditary distal motor neuropathy; eEJC=excitatory evoked junctional current; NMJ=neuromuscular junction; RNS=repetitive nerve stimulation; WT=wildtype