Category: Parkinsonism (Other)
Objective: To report the clinical and pathological features of CSF1R-RD associated with the c.2330G>A, p.R777Q variant, and to report a new family carrying this variant.
Background: Colony-stimulating factor-1 receptor (CSF1R)-related disorder (CSF1R-RD) is a rapidly progressive neurodegenerative disease with a median age of onset of 43 years. Most affected individuals develop rapidly progressive dementia and motor symptoms and eventually become bedridden; median disease duration is 6.8 years. More than 200 CSF1R pathogenic variants have been identified, but no genotype-phenotype correlation has been established. The c.2330G>A, p.R777Q variant has been reported previously as causative for CSF1R-RD; in silico analysis supports that this missense variant has a deleterious effect on protein structure/function
Method: We performed a literature search for CSF1R-RD associated with the c.2330G>A, p.R777Q variant and compared the collected data with data available from our new family.
Results: We identify 13 individuals from 8 families including ours affected by CSF1R-RD associated with the c.2330G>A, p.R777Q variant from Asia, Europe, and North America. The mean age of onset was 40.8±13.5 years (ranging from 22 to 63 years), and the mean survival was only 3.0±2.2 years. Brain autopsy of our index patient showed diffuse leukoencephalopathy with spheroids and pigmented glia, most severe in the frontal and parietal lobes; white matter was spared in the temporal and occipital lobes.
Conclusion: CSF1R-RD associated with the c.2330G>A, p.R777Q variant has a typical clinical and radiologic presentation of CSF1R-RD. Although the mean age of onset was close to that reported in the literature for all mutations, but it had a very wide range. In addition, the patients carrying this variant had a short survival, shorter than mean survival time for all mutations. Pathological abnormalities were like those observed on autopsies of other pathogenic variants.
References: Dulski K et al. CSF1R-related disorder: state of the art, challenges, and proposition of a new terminology. Parkinsonism Relat Disord. 2024;121:105894
Rademakers R, et al. Mutations in the colony stimulating factor 1 receptor (CSF1R) gene cause hereditary diffuse leukoencephalopathy with spheroids. Nat Genet. 2011 Dec 25;44(2):200-5.
Konno T et al. Clinical and genetic characterization of adult-onset leukoencephalopathy with axonal spheroids and pigmented glia associated with CSF1R mutation. Eur J Neurol. 2017 Jan;24(1):37-45.
Dulski J et al. Global Presence and Penetrance of CSF1R-Related Disorder. Neurol Genet. 2024 Sep 13;10(5):e200187.
Papapetropoulos S et al. Adult-Onset Leukoencephalopathy With Axonal Spheroids and Pigmented Glia: Review of Clinical Manifestations as Foundations for Therapeutic Development. Front Neurol. 2022 Feb 3;12:788168.
Papapetropoulos S et al. Clinical presentation and diagnosis of adult-onset leukoencephalopathy with axonal spheroids and pigmented glia: a literature analysis of case studies. Front Neurol. 2024 Mar 11;15:1320663
Schwarz JM, Rödelsperger C, Schuelke M, Seelow D. MutationTaster evaluates disease-causing potential of sequence alterations. Nat Methods. 2010;7(8):575-576
Hoffmann S, Murrell J, Harms L, et al. Enlarging the nosological spectrum of hereditary diffuse leukoencephalopathy with axonal spheroids (HDLS). Brain Pathol. 2014;24(5):452-458
Makary MS, Awan U, Kisanuki YY, Slone HW. Adult-onset leukoencephalopathy with axonal spheroids and pigmented glia: Clinical and imaging characteristics. Neuroradiol J. 2019;32(2):139-142. doi:10.1177/1971400918822136
Tsai PC, Fuh JL, Yang CC, et al. Clinical and genetic characterization of adult-onset leukoencephalopathy caused by CSF1R mutations. Ann Clin Transl Neurol. 2021;8(11):2121-2131
Ng PC, Henikoff S. Predicting deleterious amino acid substitutions. Genome Res. 2001;11(5):863-874.
Guerreiro R, Kara E, Le Ber I, et al. Genetic analysis of inherited leukodystrophies: genotype-phenotype correlations in the CSF1R gene. JAMA Neurol. 2013;70(7):875-882
Inui T, Kawarai T, Fujita K, et al. A new CSF1R mutation presenting with an extensive white matter lesion mimicking primary progressive multiple sclerosis. J Neurol Sci. 2013;334(1-2):192-195.
Karle KN, Biskup S, Schüle R, et al. De novo mutations in hereditary diffuse leukoencephalopathy with axonal spheroids (HDLS). Neurology. 2013;81(23):2039-2044
Chung B, Kim M, Kim SK, Kang H. A case of adult-onset leukoencephalopathy with axonal spheroids and pigmented glia presenting with alien hand syndrome. eNeurologicalSci. 2022;30:100441
To cite this abstract in AMA style:
T. Chmiela, A. Strongosky, D. Dickson, Z. Wszolek. Clinical and Pathological Features of CSF1R-Related Disorder Associated with the c.2330G>A, p.R777Q Pathogenic Variant [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/clinical-and-pathological-features-of-csf1r-related-disorder-associated-with-the-c-2330ga-p-r777q-pathogenic-variant/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-and-pathological-features-of-csf1r-related-disorder-associated-with-the-c-2330ga-p-r777q-pathogenic-variant/