ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2025
Neuropsychological profile of POLR3A-related spastic ataxia.
Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND AND
objectivesPOLR3-related disorders are a group of autosomal recessive neurodegenerative diseases that usually cause leukodystrophy and can lead to cognitive dysfunction. Literature reporting comprehensive neuropsychological assessment in POLR3A-related diseases is sparse. Here we describe the neuropsychological profile of a case of childhood-onset POLR3A-related spastic ataxia without leukodystrophy.
methodsExtensive neuropsychological assessment covering the domains of attention, executive function, memory, language, visuospatial processing and social cognition in a patient with a compound heterozygous POLR3Amutation (c.2000T>A (p.Leu667*) / c.1909+22G>A) and a spastic ataxic phenotype.
resultsNeuropsychological testing showed a marked slowing of basic information processing (reading, colour naming on Stroop test), executive deficits (alternating attention through Letter-Digit Substitution Test and semantic word fluency) and social cognition impairment (facial emotion recognition via Facial Expressive Action Stimulus Test, intention and emotion attribution via Story-based Empathy Task). DISCUSSION: While originally described as a typical hypomyelination disorder, leukodystrophy nor striatal lesions seem pivotal to cognitive dysfunction in POLR3-related disease, as demonstrated in this patient. Further investigation of a larger cohort of (c.1909 + 22G>A) heterozygous patients is warranted to reveal which neuropsychological features correspond to this less aggressive phenotype.
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