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Brain Calcification and Movement Disorders

  • Movement Disorders (SH Fox, Section Editor)
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Abstract

Brain calcifications may be an incidental finding on neuroimaging in normal, particularly older individuals, but can also indicate numerous hereditary and nonhereditary syndromes, and metabolic, environmental, infectious, autoimmune, mitochondrial, traumatic, or toxic disorders. Bilateral calcifications most commonly affecting the basal ganglia may often be found in idiopathic cases, and a new term, primary familial brain calcification (PFBC), has been proposed that recognizes the genetic causes of the disorder and that calcifications occurred well beyond the basal ganglia. PFBC, usually inherited in an autosomal dominant fashion, is both an intrafamilial and an interfamilial heterogeneous disorder, clinically characterized by an insidious and progressive development of movement disorders, cognitive decline, and psychiatric symptoms, but also cerebellar ataxia, pyramidal signs, and sometimes isolated seizures and headaches/migraines. Heterozygous mutations in four genes (SLC20A2, PDGFRB, PDGFB, XPR1) have recently proved to be the causes of the autosomal dominant forms of PFBC, also suggesting disrupted phosphate homeostasis as “an underlying and converging” pathophysiological mechanism. However, to date, it is not possible to anticipate with acceptable certainty any of known genetic causes of PFBC on the basis of the type, severity, pattern of distribution, or combination of movement disorders (mainly parkinsonism, with or without tremor, but also dystonia, chorea, paroxysmal kinesigenic dyskinesia, orofacial dyskinesia, and gait and speech disorders).

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Acknowledgements

This study was supported by the Ministry of Education, Science, and Technological Development of the Republic of Serbia (grant no. 175090).

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  1. Clinic of Neurology, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Dr Subotica 6, Belgrade, 11000, Serbia

    Vladimir S. Kostić & Igor N. Petrović

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Correspondence to Vladimir S. Kostić.

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Vladimir S. Kostić has received a grant from the Ministry of Education, Science, and Technological Development of the Republic of Serbia (no. 175090) and from the Serbian Academy of Arts and Sciences, as well as research grants from Stada, Valeant, Boehringer-Ingelheim, and Novartis. He has also received lecturing fees from Stada, Boehringer-Ingelheim, and Novartis. Igor N. Petrović has received a grant from the Ministry of Education, Science, and Technological Development of the Republic of Serbia (no. 175090) and from the Serbian Academy of Arts and Sciences, a travel grant from Novartis, and speaker honoraria from Boehringer-Ingelheim, ElPharma, and GlaxoSmithKlein.

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Video 1

Levodopa-responsive parkinsonism–dystonia syndrome in a patient with secondary (postoperative) hypoparathyroidism. Segment 1. Without levodopa. Bilateral (severer on the right) parkinsonism with hypokinesia, rest and postural tremor, and dystonic hand and foot postures. Shuffling gait and positive pull test. Segment 2. Levodopa-induced peak-dose dyskinesia (WMV 51010 kb)

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Kostić, V.S., Petrović, I.N. Brain Calcification and Movement Disorders. Curr Neurol Neurosci Rep 17, 2 (2017). https://doi.org/10.1007/s11910-017-0710-9

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