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- Neurodegeneration with brain iron accumulation
- eye-of-the-tiger sign
- movement disorders
Neurodegeneration with brain iron accumulation (NBIA) is a heterogenous group of degenerative diseases presenting with movement disorders. Causative mutations have been identified, first in PANK2, encoding pantothenate kinase 2, and later in PLA2G6, a calcium independent phospholipase A2 enzyme.1 2 NBIA types 1 and 2 are the denominations used to label these two entities. The clinical picture includes pyramidal syndrome, movement disorders, cerebellar dysfunction, opthalmoparesis and ocular disturbance. A neuroradiological hallmark of NBIA type 1 is the “eye-of-the-tiger” sign, characterised by bilateral areas of hyperintensity surrounded by a ring of hypointensity in the medial globus pallidus on T2-weighted MRI. Radiological findings in NBIA type 2 comprise cortical atrophy in the cerebellum, increased iron deposition in globus pallidi and substantia nigra seen as reduced signal on T2 FLAIR and T2* gradient and diffusion weighted MRI sequences, reduced volume of the optic chiasm and optic nerves and cerebral white matter changes. In this paper, we report clinical, neurological and molecular findings …
Funding This work was supported in part by the Intramural Research Program of the National Institute on Aging, National Institutes of Health, Department of Health and Human Services; project Z01 AG000957-05.
Competing interests None.
Patient consent Obtained.
Ethics approval This study was conducted with the approval of the Ethics Committee of the Federal University of Minas Gerais.
Provenance and peer review Not commissioned; externally peer reviewed.