case_images: PMC7458500_01
case_images: Patient 1, homozygous for c.472insC (p.His158ProfsTer8). (a) Neurological examination of the patient shows bilateral optic atrophy, upper extremity amyotrophy, proximal and distal weakness and spastic tetraparesis. Pedigree of the family and Sanger sequencing show segregation of the TACO1 variant in family members. The proband is homozygous and his mother, father and unaffected siblings are heterozygous for the TACO1; c.472insC variant. (b) Cranial MR imaging demonstrate progressive cerebral atrophy and T2 hyperintense periventricular white matter lesions (arrows).
case_images: jnd-7-jnd200510-g001.jpg
case_images: PMC7458500_01_jnd-7-jnd200510-g001.jpg
case_images: jnd-7-jnd200510-g001
case_images: He had learning difficulties with dysarthria, delayed speech and language development (Fig. 1).
case_images: PMC7458500_02
case_images: Patient 2, homozygous for c.252_253delCT (p.Cys85PhefsTer15). (a) Pedigree of family and Sanger sequencing show that the prob and is homozygous and her mother and father are heterozygous for the TACO1c.252_253delCT variant. (b) Baseline MRI image at the age of 25 years (i + iv on the left) and follow-up 14 years later (ii/iii+v/vi) show white matter degeneration with white matter atrophy and sulcal widening (arrows in i and ii) as well as cystic lesions that demonstrate CSF like signal behavior in the FLAIR (iii). The infratentorial T2-weighted image (vi)demonstrates hyperintensities within the middle cerebellar peduncle (asterix) and within the cerbellar white matter (arrow). (c) Color fundus photography (i) shows severe paleness of the optic nerve head. OCT (ii+iii) reveals atrophy of the peripapillary retinal nerve fiber layer (RNFL) (ii). The foveal depression is flattened due to atrophy of the ganglion cell layer (GCL) and retinal nerve fiber layer (RNFL) (see * in (iii)). All other retinal layers are intact; in particular, there are no signs or chorioretinal atrophy. Best corrected visual acuity was 20/400 (right eye) and 20/250 (left eye), the subject was legally blind (according to WHO definition). Images for the left eye are shown; all changes were present in both eyes.
case_images: jnd-7-jnd200510-g002.jpg
case_images: PMC7458500_02_jnd-7-jnd200510-g002.jpg
case_images: jnd-7-jnd200510-g002
case_images: Ophthalmological examination confirmed an optic atrophy, progressive over time; no retinal changes were noted on fundoscopy (Fig. 2). No morphological or signal changes were noted in the area of the basal ganglia (Fig. 2).