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This disorder has been reported in specific communities based on intra-community marriages where both parents of the child are carrying the same mutation. One of the communities reported is [[Agrawal]] (Agarwal) Community mainly based in Northern Part of India. The known mutation in Agarwal community is pathogenic mutation 1c.215_216insA in PANK2 gene. This is also coded as chr20:3870292-3870293insA by some labs. It results in a frameshift and premature truncation of the protein 47 amino acids downstream to codon 183 (p.Arg183GlufsTer47; ENST00000316562).
This disorder has been reported in specific communities based on intra-community marriages where both parents of the child are carrying the same mutation. One of the communities reported is [[Agrawal]] (Agarwal) Community mainly based in Northern Part of India. The known mutation in Agarwal community is pathogenic mutation 1c.215_216insA in PANK2 gene. This is also coded as chr20:3870292-3870293insA by some labs. It results in a frameshift and premature truncation of the protein 47 amino acids downstream to codon 183 (p.Arg183GlufsTer47; ENST00000316562).
<ref>https://www.scribd.com/doc/95164360/PANK2-Agarwal</ref>
<ref>{{Cite web | url=https://www.scribd.com/doc/95164360/PANK2-Agarwal |title = PANK2_Agarwal}}</ref>
<ref>http://www.britannica.com/bps/additionalcontent/18/27764296/Founder-mutation-in-the-PANK-gene-of-Agrawal-children-with-Neurodegeneration-with-Brain-Iron-accumulation-NBIA</ref>
<ref>http://www.britannica.com/bps/additionalcontent/18/27764296/Founder-mutation-in-the-PANK-gene-of-Agrawal-children-with-Neurodegeneration-with-Brain-Iron-accumulation-NBIA</ref>


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==Treatment==
==Treatment==
Phosphopantothenate has been shown to treat PKAN in a human, and also in a mouse model of the disease. [[Pantethine]] (a precursor of [[pantetheine]]) has been studied and shown to be effective in a mouse and in a [[Drosophila melanogaster|fruit fly]] model of the disease.<ref>{{cite journal| pmc=3891449 | pmid=24316510 | volume=137 | title=Pantethine treatment is effective in recovering the disease phenotype induced by ketogenic diet in a pantothenate kinase-associated neurodegeneration mouse model | year=2014 | author=Brunetti D, Dusi S, Giordano C, Lamperti C, Morbin M, Fugnanesi V, Marchet S, Fagiolari G, Sibon O, Moggio M, d'Amati G, Tiranti V | journal=Brain | pages=57–68 | doi=10.1093/brain/awt325}}</ref><ref>{{cite journal| pmc=2872433 | pmid=20351285 | doi=10.1073/pnas.0912105107 | volume=107 | title=Pantethine rescues a Drosophila model for pantothenate kinase-associated neurodegeneration | year=2010 | author=Rana A, Seinen E, Siudeja K, Muntendam R, Srinivasan B, van der Want JJ, Hayflick S, Reijngoud DJ, Kayser O, Sibon OC | journal=Proc Natl Acad Sci U S A | pages=6988–93}}</ref><ref name="Christou YP, Tanteles GA, Kkolou E, Ormiston A, Konstantopoulos K, Beconi M, Marshall RD, Plotkin H, Kleopa KA 2017 3247034">{{cite journal| pmc=5439260 | pmid=28567317 | doi=10.1155/2017/3247034 | volume=2017 | title=Open-Label Fosmetpantotenate, a Phosphopantothenate Replacement Therapy in a Single Patient with Atypical PKAN | year=2017 | author=Christou YP, Tanteles GA, Kkolou E, Ormiston A, Konstantopoulos K, Beconi M, Marshall RD, Plotkin H, Kleopa KA | journal=Case Rep Neurol Med | page=3247034}}</ref><ref>{{cite journal| pmc=4764103 | pmid=26549575 | doi=10.1016/j.ymgme.2015.10.011 | volume=116 | title=Correction of a genetic deficiency in pantothenate kinase 1 using phosphopantothenate replacement therapy | year=2015 | author=Zano SP, Pate C, Frank M, Rock CO, Jackowski S | journal=Mol Genet Metab | pages=281–8}}</ref>
Phosphopantothenate has been shown to treat PKAN in a human, and also in a mouse model of the disease. [[Pantethine]] (a precursor of [[pantetheine]]) has been studied and shown to be effective in a mouse and in a [[Drosophila melanogaster|fruit fly]] model of the disease.<ref>{{cite journal| pmc=3891449 | pmid=24316510 | volume=137 | issue=Pt 1 | title=Pantethine treatment is effective in recovering the disease phenotype induced by ketogenic diet in a pantothenate kinase-associated neurodegeneration mouse model | year=2014 | author=Brunetti D, Dusi S, Giordano C, Lamperti C, Morbin M, Fugnanesi V, Marchet S, Fagiolari G, Sibon O, Moggio M, d'Amati G, Tiranti V | journal=Brain | pages=57–68 | doi=10.1093/brain/awt325}}</ref><ref>{{cite journal| pmc=2872433 | pmid=20351285 | doi=10.1073/pnas.0912105107 | volume=107 | issue=15 | title=Pantethine rescues a Drosophila model for pantothenate kinase-associated neurodegeneration | year=2010 | author=Rana A, Seinen E, Siudeja K, Muntendam R, Srinivasan B, van der Want JJ, Hayflick S, Reijngoud DJ, Kayser O, Sibon OC | journal=Proc Natl Acad Sci U S A | pages=6988–93| bibcode=2010PNAS..107.6988R }}</ref><ref name="Christou YP, Tanteles GA, Kkolou E, Ormiston A, Konstantopoulos K, Beconi M, Marshall RD, Plotkin H, Kleopa KA 2017 3247034">{{cite journal| pmc=5439260 | pmid=28567317 | doi=10.1155/2017/3247034 | volume=2017 | title=Open-Label Fosmetpantotenate, a Phosphopantothenate Replacement Therapy in a Single Patient with Atypical PKAN | year=2017 | author=Christou YP, Tanteles GA, Kkolou E, Ormiston A, Konstantopoulos K, Beconi M, Marshall RD, Plotkin H, Kleopa KA | journal=Case Rep Neurol Med | page=3247034}}</ref><ref>{{cite journal| pmc=4764103 | pmid=26549575 | doi=10.1016/j.ymgme.2015.10.011 | volume=116 | issue=4 | title=Correction of a genetic deficiency in pantothenate kinase 1 using phosphopantothenate replacement therapy | year=2015 | author=Zano SP, Pate C, Frank M, Rock CO, Jackowski S | journal=Mol Genet Metab | pages=281–8}}</ref>


==Prognosis==
==Prognosis==
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PKAN was first described by [[Julius Hallervorden|Hallervorden]] and [[Hugo Spatz|Spatz]] (1922). Their discovery was brought about by a diagnosis of a family of 12 in which five sisters exhibited progressively increasing dementia and dysarthria. [[Autopsy|Autopsies]] revealed brown discolorations in different areas of the brain (particularly of interest were the globus pallidus and substantia nigra regions). Further investigation and description was brought about by Meyer (1958) who diagnosed 30 separate cases of PKAN. Meyer(1958) was followed by Elejalde et al. (1978) who described 5 affected family members and hypothesized that the disorder originated in central [[Europe]], backing up his hypothesis with clinical and genetic analysis. Further investigation and insights were provided by Malmstrom-Groth and Kristensson (1982)<ref>{{cite journal |vauthors=Malmström-Groth AG, Kristensson K |title=Neuroaxonal dystrophy in childhood. Report of two second cousins with PKAN, and a case of Seitelberger's disease |journal=Acta Paediatrica Scandinavica |volume=71 |issue=6 |pages=1045–9 |year=1982|pmid=7158329 |doi=10.1111/j.1651-2227.1982.tb09574.x}}</ref> and Jankovic et al. (1985).<ref>{{cite journal |vauthors=Jankovic J, Kirkpatrick JB, Blomquist KA, Langlais PJ, Bird ED |title=Late-onset Hallervorden-Spatz disease presenting as familial parkinsonism |journal=Neurology |volume=35 |issue=2 |pages=227–34 |date=February 1985 |pmid=3969211 |doi= 10.1159/000153550|url=}}</ref>
PKAN was first described by [[Julius Hallervorden|Hallervorden]] and [[Hugo Spatz|Spatz]] (1922). Their discovery was brought about by a diagnosis of a family of 12 in which five sisters exhibited progressively increasing dementia and dysarthria. [[Autopsy|Autopsies]] revealed brown discolorations in different areas of the brain (particularly of interest were the globus pallidus and substantia nigra regions). Further investigation and description was brought about by Meyer (1958) who diagnosed 30 separate cases of PKAN. Meyer(1958) was followed by Elejalde et al. (1978) who described 5 affected family members and hypothesized that the disorder originated in central [[Europe]], backing up his hypothesis with clinical and genetic analysis. Further investigation and insights were provided by Malmstrom-Groth and Kristensson (1982)<ref>{{cite journal |vauthors=Malmström-Groth AG, Kristensson K |title=Neuroaxonal dystrophy in childhood. Report of two second cousins with PKAN, and a case of Seitelberger's disease |journal=Acta Paediatrica Scandinavica |volume=71 |issue=6 |pages=1045–9 |year=1982|pmid=7158329 |doi=10.1111/j.1651-2227.1982.tb09574.x}}</ref> and Jankovic et al. (1985).<ref>{{cite journal |vauthors=Jankovic J, Kirkpatrick JB, Blomquist KA, Langlais PJ, Bird ED |title=Late-onset Hallervorden-Spatz disease presenting as familial parkinsonism |journal=Neurology |volume=35 |issue=2 |pages=227–34 |date=February 1985 |pmid=3969211 |doi= 10.1159/000153550|url=}}</ref>


Diagnosis of PKAN hit a milestone with the availability of MRIs, as well as the in-depth descriptions of those MRIs provided by Littrup and Gebarski (1985),<ref>{{cite journal|vauthors=Jankovic J, Kirkpatrick JB, Blomquist KA, Langlais PJ, Bird ED |title=Late-onset Hallervorden-Spatz disease presenting as familial parkinsonism |journal=Neurology |volume=35|issue=2 |pages=227–34 |year=1985 |pmid=3969211 |doi=10.1159/000153550}}</ref> Tanfani et al. (1987),<ref>{{cite journal |vauthors=Tanfani G, Mascalchi M, Dal Pozzo GC, Taverni N, Saia A, Trevisan C |title=MR imaging in a case of Hallervorden-Spatz disease |journal=Journal of computer assisted tomography |volume=11 |issue=6 |pages=1057–8 |year=1987|pmid=3680689 |doi=10.1097/00004728-198711000-00027}}</ref> Sethi et al. (1988),<ref>{{cite journal |vauthors=Sethi KD, Adams RJ, Loring DW, el Gammal T |title=Hallervorden-Spatz syndrome: clinical and magnetic resonance imaging correlations |journal=Ann. Neurol. |volume=24 |issue=5 |pages=692–4 |year=1988 |pmid=3202617 |doi=10.1002/ana.410240519}}</ref> Angelini et al. (1992),<ref>{{cite journal |vauthors=Angelini L, Nardocci N, Rumi V, Zorzi C, Strada L, Savoiardo M |title=Hallervorden-Spatz disease: clinical and MRI study of 11 cases diagnosed in life |journal=J. Neurol. |volume=239 |issue=8 |pages=417–25 |year=1992 |pmid=1447570 |doi=10.1007/BF00856805}}</ref> Casteels et al. (1994),<ref>{{cite journal |vauthors=Casteels I, Spileers W, Swinnen T, etal |title=Optic atrophy as the presenting sign in Hallervorden-Spatz syndrome |journal=Neuropediatrics |volume=25 |issue=5|pages=265–7 |year=1994 |pmid=7885538 |doi=10.1055/s-2008-1073034}}</ref> and Malandrini et al. (1995).<ref>{{cite journal |vauthors=Malandrini A, Bonuccelli U, Parrotta E, Ceravolo R, Berti G, Guazzi GC |title=Myopathic involvement in two cases of Hallervorden-Spatz disease |journal=Brain Dev. |volume=17 |issue=4 |pages=286–90 |year=1995 |pmid=7503394|doi=10.1016/0387-7604(95)00039-E}}</ref> The gene was localized to chromosome 20p by Taylor et al. (1996) <ref name="Taylor1996">{{cite journal |vauthors=Taylor TD, Litt M, Kramer P, Pandolfo M, Angelini L, Nardocci N, Davis S, Pineda M, Hattori H, Flett PJ, Cilio MR, Bertini E, Hayflick SJ |title=Homozygosity mapping of Hallervorden-Spatz syndrome to chromosome 20p12.3-p13 |journal=Nat. Genet. |volume=14 |issue=4 |pages=479–81 |year=1996 |pmid=8944032 |doi=10.1038/ng1296-479}}</ref> who suggested that this disorder should be referred to as neurodegeneration with brain iron accumulation (NBIA1) to avoid the objectionable eponym of Hallervorden-Spatz. The disease was named 'pantothenate kinase-associated neurodegeneration' or PKAN by Zhou et al. (2001)<ref name="Zhou2001">{{cite journal |vauthors=Zhou B, Westaway SK, Levinson B, Johnson MA, Gitschier J, Hayflick SJ |title=A novel pantothenate kinase gene (PANK2) is defective in Hallervorden-Spatz syndrome |journal=Nat. Genet. |volume=28 |issue=4 |pages=345–9 |year=2001 |pmid=11479594|doi=10.1038/ng572}}</ref> who suggested the name to avoid misinterpretation and to better reflect the true nature of the disorder. Most recently Pellecchia et al. (2005) published a report of 16 patients afflicted with PKAN, confirmed by genetic analysis.<ref>{{cite journal |vauthors=Pellecchia MT, Valente EM, Cif L, etal |title=The diverse phenotype and genotype of pantothenate kinase-associated neurodegeneration |journal=Neurology |volume=64 |issue=10 |pages=1810–2 |year=2005 |pmid=15911822|doi=10.1212/01.WNL.0000161843.52641.EC}}</ref>
Diagnosis of PKAN hit a milestone with the availability of MRIs, as well as the in-depth descriptions of those MRIs provided by Littrup and Gebarski (1985),<ref>{{cite journal|vauthors=Jankovic J, Kirkpatrick JB, Blomquist KA, Langlais PJ, Bird ED |title=Late-onset Hallervorden-Spatz disease presenting as familial parkinsonism |journal=Neurology |volume=35|issue=2 |pages=227–34 |year=1985 |pmid=3969211 |doi=10.1159/000153550}}</ref> Tanfani et al. (1987),<ref>{{cite journal |vauthors=Tanfani G, Mascalchi M, Dal Pozzo GC, Taverni N, Saia A, Trevisan C |title=MR imaging in a case of Hallervorden-Spatz disease |journal=Journal of Computer Assisted Tomography |volume=11 |issue=6 |pages=1057–8 |year=1987|pmid=3680689 |doi=10.1097/00004728-198711000-00027}}</ref> Sethi et al. (1988),<ref>{{cite journal |vauthors=Sethi KD, Adams RJ, Loring DW, el Gammal T |title=Hallervorden-Spatz syndrome: clinical and magnetic resonance imaging correlations |journal=Ann. Neurol. |volume=24 |issue=5 |pages=692–4 |year=1988 |pmid=3202617 |doi=10.1002/ana.410240519}}</ref> Angelini et al. (1992),<ref>{{cite journal |vauthors=Angelini L, Nardocci N, Rumi V, Zorzi C, Strada L, Savoiardo M |title=Hallervorden-Spatz disease: clinical and MRI study of 11 cases diagnosed in life |journal=J. Neurol. |volume=239 |issue=8 |pages=417–25 |year=1992 |pmid=1447570 |doi=10.1007/BF00856805}}</ref> Casteels et al. (1994),<ref>{{cite journal |vauthors=Casteels I, Spileers W, Swinnen T, etal |title=Optic atrophy as the presenting sign in Hallervorden-Spatz syndrome |journal=Neuropediatrics |volume=25 |issue=5|pages=265–7 |year=1994 |pmid=7885538 |doi=10.1055/s-2008-1073034}}</ref> and Malandrini et al. (1995).<ref>{{cite journal |vauthors=Malandrini A, Bonuccelli U, Parrotta E, Ceravolo R, Berti G, Guazzi GC |title=Myopathic involvement in two cases of Hallervorden-Spatz disease |journal=Brain Dev. |volume=17 |issue=4 |pages=286–90 |year=1995 |pmid=7503394|doi=10.1016/0387-7604(95)00039-E}}</ref> The gene was localized to chromosome 20p by Taylor et al. (1996) <ref name="Taylor1996">{{cite journal |vauthors=Taylor TD, Litt M, Kramer P, Pandolfo M, Angelini L, Nardocci N, Davis S, Pineda M, Hattori H, Flett PJ, Cilio MR, Bertini E, Hayflick SJ |title=Homozygosity mapping of Hallervorden-Spatz syndrome to chromosome 20p12.3-p13 |journal=Nat. Genet. |volume=14 |issue=4 |pages=479–81 |year=1996 |pmid=8944032 |doi=10.1038/ng1296-479}}</ref> who suggested that this disorder should be referred to as neurodegeneration with brain iron accumulation (NBIA1) to avoid the objectionable eponym of Hallervorden-Spatz. The disease was named 'pantothenate kinase-associated neurodegeneration' or PKAN by Zhou et al. (2001)<ref name="Zhou2001">{{cite journal |vauthors=Zhou B, Westaway SK, Levinson B, Johnson MA, Gitschier J, Hayflick SJ |title=A novel pantothenate kinase gene (PANK2) is defective in Hallervorden-Spatz syndrome |journal=Nat. Genet. |volume=28 |issue=4 |pages=345–9 |year=2001 |pmid=11479594|doi=10.1038/ng572}}</ref> who suggested the name to avoid misinterpretation and to better reflect the true nature of the disorder. Most recently Pellecchia et al. (2005) published a report of 16 patients afflicted with PKAN, confirmed by genetic analysis.<ref>{{cite journal |vauthors=Pellecchia MT, Valente EM, Cif L, etal |title=The diverse phenotype and genotype of pantothenate kinase-associated neurodegeneration |journal=Neurology |volume=64 |issue=10 |pages=1810–2 |year=2005 |pmid=15911822|doi=10.1212/01.WNL.0000161843.52641.EC}}</ref>


==References==
==References==

Revision as of 17:57, 8 April 2019

Pantothenate kinase-associated neurodegeneration
Other namesNeurodegeneration with brain iron accumulation 1
Pantetheine
SpecialtyNeurology Edit this on Wikidata

Pantothenate kinase-associated neurodegeneration (PKAN), also called Hallervorden–Spatz syndrome,[1][2][3] is a degenerative disease of the brain that can lead to parkinsonism, dystonia, dementia, and ultimately death. Neurodegeneration in PKAN is accompanied by an excess of iron that progressively builds up in the brain.

Signs and symptoms

Symptoms typically begin in childhood and are progressive, often resulting in death by early adulthood. Symptoms of PKAN begin before middle childhood, and most often are noticed before ten years of age. Symptoms include:

25% of individuals experience an uncharacteristic form of PKAN that develops post-10 years of age and follows a slower, more gradual pace of deterioration than those pre-10 years of age. These individuals face significant speech deficits as well as psychiatric and behavioral disturbances.

Being a progressive, degenerative nerve illness, PKAN leads to early immobility and often death by early adulthood. Death occurs prematurely due to infections such as pneumonia, and the disease in itself is technically not life limiting.

Genetics

PKAN is an autosomal recessive disorder. The parents of an afflicted child must both be heterozygous carriers for the disease and therefore must carry one mutant allele. As it is an autosomal disorder, those heterozygous for the disorder may not display any atypical characteristics that are considered suggestive of the disorder, however there have been reported cases of compound heterozygosity in which heterozygous individuals do develop the classic form of the disease.[4][5]

The disorder is caused by a mutant PANK2 gene located at the chromosomal locus: 20p13-p12.3. PANK2 is responsible for coding the protein Pantothenate kinase 2. PANK2 encodes the enzyme pantothenate kinase, and mutations in the gene lead to an inborn error of vitamin B5 (pantothenate) metabolism. Vitamin B5 is required for the production of coenzyme A in cells. Disruption of this enzyme affects energy and lipid metabolism and may lead to accumulation of potentially harmful compounds in the brain, including iron.

PANK2 encodes a 1.85Kb transcript which is derived from seven exons covering a total distance of approximately 3.5Mb of genomic DNA. The PANK2 gene also encodes a 50.5-kDaprotein that is a functional pantothenate kinase, an essential regulatory enzyme in coenzyme A (CoA) biosynthesis, and catalyzing the phosphorylation of pantothenate (vitamin B5), N-pantothenoyl-cysteine, and pantetheine (OMIM).

Mutant PANK2 gene coded proteins are often caused by null or missense mutations most notably a 7bp deletion in the PANK2 gene coding sequence.

This disorder has been reported in specific communities based on intra-community marriages where both parents of the child are carrying the same mutation. One of the communities reported is Agrawal (Agarwal) Community mainly based in Northern Part of India. The known mutation in Agarwal community is pathogenic mutation 1c.215_216insA in PANK2 gene. This is also coded as chr20:3870292-3870293insA by some labs. It results in a frameshift and premature truncation of the protein 47 amino acids downstream to codon 183 (p.Arg183GlufsTer47; ENST00000316562). [6] [7]

Diagnosis

MRI image shows iron deposits in the basal ganglia, the so-called eye-of-the-tiger sign (T2w GRASE sequence).

A neurological examination would show evidence of muscle rigidity; weakness; and abnormal postures, movements, and tremors. If other family members are also affected, this may help determine the diagnosis. Genetic tests can confirm an abnormal gene causing the disease. However, this test is not yet widely available. Other movement disorders and diseases must be ruled out. Individuals exhibiting any of the above listed symptoms are often tested using MRI (Magnetic Resonance Imaging) for a number of neuro-related disorders. An MRI usually shows iron deposits in the basal ganglia. Development of diagnostic criteria continues in the hope of further separating PKAN from other forms of neurodegenerative diseases featuring NBIA.

Neuropathology

Microscopic features of PKAN include:

Treatment

Phosphopantothenate has been shown to treat PKAN in a human, and also in a mouse model of the disease. Pantethine (a precursor of pantetheine) has been studied and shown to be effective in a mouse and in a fruit fly model of the disease.[8][9][10][11]

Prognosis

Survival rates for those diagnosed with typical PKAN, and left untreated is 11.18 years with a standard deviation of 7.8 years. A study reporting good outcomes in a single patient with late onset PKAN has been performed.[10]

Epidemiology

Prevalence data regarding this disorder remains incomplete, however it is estimated that anywhere between 1 in 1,000,000 to 3 in 1,000,000 individuals will be afflicted with this disorder (based upon observed cases in a population), but once again this is only an estimate as the disease is so rare it is difficult to statistically and accurately ascertain.

History

PKAN was first described by Hallervorden and Spatz (1922). Their discovery was brought about by a diagnosis of a family of 12 in which five sisters exhibited progressively increasing dementia and dysarthria. Autopsies revealed brown discolorations in different areas of the brain (particularly of interest were the globus pallidus and substantia nigra regions). Further investigation and description was brought about by Meyer (1958) who diagnosed 30 separate cases of PKAN. Meyer(1958) was followed by Elejalde et al. (1978) who described 5 affected family members and hypothesized that the disorder originated in central Europe, backing up his hypothesis with clinical and genetic analysis. Further investigation and insights were provided by Malmstrom-Groth and Kristensson (1982)[12] and Jankovic et al. (1985).[13]

Diagnosis of PKAN hit a milestone with the availability of MRIs, as well as the in-depth descriptions of those MRIs provided by Littrup and Gebarski (1985),[14] Tanfani et al. (1987),[15] Sethi et al. (1988),[16] Angelini et al. (1992),[17] Casteels et al. (1994),[18] and Malandrini et al. (1995).[19] The gene was localized to chromosome 20p by Taylor et al. (1996) [20] who suggested that this disorder should be referred to as neurodegeneration with brain iron accumulation (NBIA1) to avoid the objectionable eponym of Hallervorden-Spatz. The disease was named 'pantothenate kinase-associated neurodegeneration' or PKAN by Zhou et al. (2001)[4] who suggested the name to avoid misinterpretation and to better reflect the true nature of the disorder. Most recently Pellecchia et al. (2005) published a report of 16 patients afflicted with PKAN, confirmed by genetic analysis.[21]

References

  1. ^ The use of this eponym is somewhat discouraged due to Hallervorden and Spatz's affiliation with the Nazi regime and the ethically questionable manner in which they acted. Bazelon, Emily (November 6, 2013). "The Nazi Anatomists". Slate Magazine. Web-based: The Washington Post Company. Retrieved November 7, 2013.
  2. ^ doctor/535 at Who Named It?
  3. ^ doctor/1063 at Who Named It?
  4. ^ a b Zhou B, Westaway SK, Levinson B, Johnson MA, Gitschier J, Hayflick SJ (2001). "A novel pantothenate kinase gene (PANK2) is defective in Hallervorden-Spatz syndrome". Nat. Genet. 28 (4): 345–9. doi:10.1038/ng572. PMID 11479594.
  5. ^ Bei-sha, Tang; et al. (2005). "Novel compound heterozygous mutations in the PANK2 gene in a Chinese patient with atypical pantothenate kinase-associated neurodegeneration". Movement Disorders. 20 (7): 819–21. doi:10.1002/mds.20408. PMC 2105744. PMID 15747360.
  6. ^ "PANK2_Agarwal".
  7. ^ http://www.britannica.com/bps/additionalcontent/18/27764296/Founder-mutation-in-the-PANK-gene-of-Agrawal-children-with-Neurodegeneration-with-Brain-Iron-accumulation-NBIA
  8. ^ Brunetti D, Dusi S, Giordano C, Lamperti C, Morbin M, Fugnanesi V, Marchet S, Fagiolari G, Sibon O, Moggio M, d'Amati G, Tiranti V (2014). "Pantethine treatment is effective in recovering the disease phenotype induced by ketogenic diet in a pantothenate kinase-associated neurodegeneration mouse model". Brain. 137 (Pt 1): 57–68. doi:10.1093/brain/awt325. PMC 3891449. PMID 24316510.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  9. ^ Rana A, Seinen E, Siudeja K, Muntendam R, Srinivasan B, van der Want JJ, Hayflick S, Reijngoud DJ, Kayser O, Sibon OC (2010). "Pantethine rescues a Drosophila model for pantothenate kinase-associated neurodegeneration". Proc Natl Acad Sci U S A. 107 (15): 6988–93. Bibcode:2010PNAS..107.6988R. doi:10.1073/pnas.0912105107. PMC 2872433. PMID 20351285.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  10. ^ a b Christou YP, Tanteles GA, Kkolou E, Ormiston A, Konstantopoulos K, Beconi M, Marshall RD, Plotkin H, Kleopa KA (2017). "Open-Label Fosmetpantotenate, a Phosphopantothenate Replacement Therapy in a Single Patient with Atypical PKAN". Case Rep Neurol Med. 2017: 3247034. doi:10.1155/2017/3247034. PMC 5439260. PMID 28567317.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: unflagged free DOI (link)
  11. ^ Zano SP, Pate C, Frank M, Rock CO, Jackowski S (2015). "Correction of a genetic deficiency in pantothenate kinase 1 using phosphopantothenate replacement therapy". Mol Genet Metab. 116 (4): 281–8. doi:10.1016/j.ymgme.2015.10.011. PMC 4764103. PMID 26549575.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  12. ^ Malmström-Groth AG, Kristensson K (1982). "Neuroaxonal dystrophy in childhood. Report of two second cousins with PKAN, and a case of Seitelberger's disease". Acta Paediatrica Scandinavica. 71 (6): 1045–9. doi:10.1111/j.1651-2227.1982.tb09574.x. PMID 7158329.
  13. ^ Jankovic J, Kirkpatrick JB, Blomquist KA, Langlais PJ, Bird ED (February 1985). "Late-onset Hallervorden-Spatz disease presenting as familial parkinsonism". Neurology. 35 (2): 227–34. doi:10.1159/000153550. PMID 3969211.
  14. ^ Jankovic J, Kirkpatrick JB, Blomquist KA, Langlais PJ, Bird ED (1985). "Late-onset Hallervorden-Spatz disease presenting as familial parkinsonism". Neurology. 35 (2): 227–34. doi:10.1159/000153550. PMID 3969211.
  15. ^ Tanfani G, Mascalchi M, Dal Pozzo GC, Taverni N, Saia A, Trevisan C (1987). "MR imaging in a case of Hallervorden-Spatz disease". Journal of Computer Assisted Tomography. 11 (6): 1057–8. doi:10.1097/00004728-198711000-00027. PMID 3680689.
  16. ^ Sethi KD, Adams RJ, Loring DW, el Gammal T (1988). "Hallervorden-Spatz syndrome: clinical and magnetic resonance imaging correlations". Ann. Neurol. 24 (5): 692–4. doi:10.1002/ana.410240519. PMID 3202617.
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