Autosomal dominant striatal neurodegeneration is an ultra-rare adult-onset movement disorder caused by heterozygous loss-of-function PDE8B variants. Reported families show a slowly progressive striatal movement disorder, usually with parkinsonism, bradykinesia, rigidity, dysarthria, and gait disturbance, together with characteristic signal abnormalities of the putamen and caudate. Ataxia, tremor without parkinsonism, and limb dystonia expand the phenotype in individual reports. The link from impaired PDE8B cyclic-nucleotide hydrolysis to selective striatal injury remains unresolved.
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Conditions with similar clinical presentations that must be differentiated from Autosomal dominant striatal neurodegeneration:
name: Autosomal dominant striatal neurodegeneration
creation_date: "2026-05-11T21:02:17Z"
description: >-
Autosomal dominant striatal neurodegeneration is an ultra-rare adult-onset
movement disorder caused by heterozygous loss-of-function PDE8B variants.
Reported families show a slowly progressive striatal movement disorder,
usually with parkinsonism, bradykinesia, rigidity, dysarthria, and gait
disturbance, together with characteristic signal abnormalities of the
putamen and caudate. Ataxia, tremor without parkinsonism, and limb dystonia
expand the phenotype in individual reports. The link from impaired PDE8B
cyclic-nucleotide hydrolysis to selective striatal injury remains unresolved.
category: Mendelian
disease_term:
preferred_term: striatal degeneration, autosomal dominant
term:
id: MONDO:0000211
label: striatal degeneration, autosomal dominant
parents:
- Neurodegenerative Disease
- Movement Disorder
synonyms:
- ADSD
inheritance:
- name: Autosomal dominant inheritance
inheritance_term:
preferred_term: Autosomal dominant inheritance
term:
id: HP:0000006
label: Autosomal dominant inheritance
description: >-
ADSN is inherited as an autosomal dominant disorder in the reported families.
evidence:
- reference: ORPHA:228169
reference_title: "Autosomal dominant striatal neurodegeneration"
supports: SUPPORT
evidence_source: OTHER
snippet: "Autosomal dominant"
explanation: Orphanet lists autosomal dominant inheritance.
- reference: PMID:15210883
reference_title: "Autosomal dominant striatal degeneration (ADSD): clinical description and mapping to 5q13-5q14."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "OBJECTIVE: To describe the clinical and neuroradiologic features and chromosomal mapping of a novel autosomal dominant disease affecting the basal ganglia."
explanation: The original family report describes ADSD as an autosomal dominant basal-ganglia disease.
prevalence:
- population: Worldwide
measure_type: POINT_PREVALENCE
prevalence_class: BELOW_1_IN_1000000
rate_high: 0.1
percentage: "<1 / 1,000,000"
notes: Orphanet records ADSN as an ultra-rare worldwide disorder.
evidence:
- reference: ORPHA:228169
reference_title: "Autosomal dominant striatal neurodegeneration"
supports: SUPPORT
evidence_source: OTHER
snippet: "<1 / 1 000 000 | Worldwide | Point prevalence | PMID:15210883,PMID:26769607,PMID:26475694"
explanation: Orphanet provides the worldwide point-prevalence class for ADSN.
progression:
- phase: Adult onset
age_range: Adult
notes: >-
Orphanet records adult onset, and the PDE8B family report describes slowly
progressive parkinsonism. The original kindred had no apparent reduction
in life expectancy, but the number of longitudinally observed individuals
remains too small to define survival or late-stage burden.
evidence:
- reference: ORPHA:228169
reference_title: "Autosomal dominant striatal neurodegeneration"
supports: SUPPORT
evidence_source: OTHER
snippet: "Age of onset: Adult"
explanation: Orphanet records adult onset.
- reference: PMID:26769607
reference_title: "A novel mutation of PDE8B Gene in a Japanese family with autosomal-dominant striatal degeneration."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "BACKGROUND: Autosomal-dominant striatal degeneration is a rare autosomal-dominant neurodegenerative movement disorder characterized by slowly progressive parkinsonism."
explanation: This human family report characterizes ADSN as slowly progressive.
- reference: PMID:15210883
reference_title: "Autosomal dominant striatal degeneration (ADSD): clinical description and mapping to 5q13-5q14."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "RESULTS: The main clinical features of the disease are dysarthria and gait disturbance without any apparent reduction in life expectancy."
explanation: The original kindred provides the limited published evidence about long-term survival.
genetic:
- name: PDE8B pathogenic variants
gene_term:
preferred_term: PDE8B
term:
id: hgnc:8794
label: PDE8B
association: Heterozygous germline PDE8B pathogenic variants cause ADSN.
relationship_type: CAUSATIVE
variant_origin: GERMLINE
inheritance:
- name: Autosomal dominant inheritance
inheritance_term:
preferred_term: Autosomal dominant inheritance
term:
id: HP:0000006
label: Autosomal dominant inheritance
evidence:
- reference: PMID:15210883
reference_title: "Autosomal dominant striatal degeneration (ADSD): clinical description and mapping to 5q13-5q14."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "OBJECTIVE: To describe the clinical and neuroradiologic features and chromosomal mapping of a novel autosomal dominant disease affecting the basal ganglia."
explanation: The original pedigree establishes dominant transmission for the mapped disorder.
evidence:
- reference: ORPHA:228169
reference_title: "Autosomal dominant striatal neurodegeneration"
supports: SUPPORT
evidence_source: OTHER
snippet: "PDE8B | phosphodiesterase 8B | hgnc:8794 | Disease-causing germline mutation(s) in"
explanation: Orphanet records PDE8B as a disease-causing germline gene for ADSN.
- reference: PMID:26769607
reference_title: "A novel mutation of PDE8B Gene in a Japanese family with autosomal-dominant striatal degeneration."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "We found a heterozygous nonsense mutation in the first exon of cyclic nucleotide phosphodiesterase 8B gene, which is predicted to disrupt all important functional domains of the cyclic nucleotide phosphodiesterase 8B protein."
explanation: Human family sequencing identified a heterozygous PDE8B nonsense variant predicted to disrupt all important protein domains.
- reference: PMID:26769607
reference_title: "A novel mutation of PDE8B Gene in a Japanese family with autosomal-dominant striatal degeneration."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "CONCLUSIONS: This family is the second family with autosomal-dominant striatal degeneration after the first German family, confirming that cyclic nucleotide phosphodiesterase 8B gene is the causative gene for this disease."
explanation: The second-family report directly supports PDE8B as the causative gene.
- reference: PMID:20085714
reference_title: "Autosomal-dominant striatal degeneration is caused by a mutation in the phosphodiesterase 8B gene."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Here we show that ADSD is caused by a complex frameshift mutation (c.94G>C+c.95delT) in the phosphodiesterase 8B (PDE8B) gene, which results in a loss of enzymatic phosphodiesterase activity."
explanation: The original molecular study identified a PDE8B frameshift mutation and linked it to loss of enzyme activity.
- reference: PMID:38818539
reference_title: "A Novel PDE8B Gene Variant Associated with Autosomal Dominant Striatal Degeneration."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "A Novel PDE8B Gene Variant Associated with Autosomal Dominant Striatal Degeneration."
explanation: A later human case report adds another PDE8B variant associated with the same disease entity.
pathophysiology:
- name: PDE8B Cyclic Nucleotide Phosphodiesterase Loss
description: >-
ADSN-associated heterozygous PDE8B frameshift or nonsense variants abolish
or are predicted to abolish phosphodiesterase activity. PDE8B normally
degrades cyclic AMP, a second messenger involved in dopamine signaling and
movement control. Altered striatal cAMP/dopamine signaling is therefore a
plausible bridge to disease, but it has not been demonstrated directly in
patient-derived striatal neurons.
genes:
- preferred_term: PDE8B
term:
id: hgnc:8794
label: PDE8B
molecular_functions:
- preferred_term: 3',5'-cyclic-nucleotide phosphodiesterase activity
term:
id: GO:0004114
label: 3',5'-cyclic-nucleotide phosphodiesterase activity
modifier: DECREASED
biological_processes:
- preferred_term: cAMP catabolic process
term:
id: GO:0006198
label: cAMP catabolic process
modifier: DECREASED
evidence:
- reference: PMID:20085714
reference_title: "Autosomal-dominant striatal degeneration is caused by a mutation in the phosphodiesterase 8B gene."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Here we show that ADSD is caused by a complex frameshift mutation (c.94G>C+c.95delT) in the phosphodiesterase 8B (PDE8B) gene, which results in a loss of enzymatic phosphodiesterase activity."
explanation: The molecular study provides direct human genetic and functional support for loss of PDE8B phosphodiesterase activity.
- reference: PMID:20085714
reference_title: "Autosomal-dominant striatal degeneration is caused by a mutation in the phosphodiesterase 8B gene."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "PDE8B degrades cyclic AMP, a second messenger implied in dopamine signaling."
explanation: This supports cAMP degradation as the relevant PDE8B-linked signaling process.
- reference: PMID:26769607
reference_title: "A novel mutation of PDE8B Gene in a Japanese family with autosomal-dominant striatal degeneration."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "We found a heterozygous nonsense mutation in the first exon of cyclic nucleotide phosphodiesterase 8B gene, which is predicted to disrupt all important functional domains of the cyclic nucleotide phosphodiesterase 8B protein."
explanation: The reported nonsense variant is predicted to disrupt PDE8B functional domains, supporting reduced phosphodiesterase function.
- reference: PMID:34155691
reference_title: "The Emerging Role of Phosphodiesterases in Movement Disorders."
supports: SUPPORT
evidence_source: OTHER
snippet: "mutations in genes encoding different PDEs, including PDE2A, PDE8B, and PDE10A, are responsible for rare forms of monogenic parkinsonism and chorea."
explanation: A movement-disorder review independently places PDE8B among monogenic cyclic-nucleotide movement-disorder genes.
downstream:
- target: Degeneration of the striatum
description: PDE8B disruption is causative for a striatal neurodegenerative movement disorder.
causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
evidence:
- reference: PMID:20085714
reference_title: "Autosomal-dominant striatal degeneration is caused by a mutation in the phosphodiesterase 8B gene."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Autosomal-dominant striatal degeneration (ADSD) is an autosomal-dominant movement disorder affecting the striatal part of the basal ganglia."
explanation: The molecular study links PDE8B loss to a dominantly inherited striatal movement disorder.
- reference: PMID:26769607
reference_title: "A novel mutation of PDE8B Gene in a Japanese family with autosomal-dominant striatal degeneration."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Recently, a mutation of the cyclic nucleotide phosphodiesterase 8B gene was reported to be a causal gene mutation of this disease."
explanation: The family report links PDE8B mutation to ADSN but does not define the intervening cellular mechanism.
- name: Degeneration of the striatum
description: >-
ADSN primarily affects the basal ganglia/striatal system, with MRI lesions
restricted mainly to the putamen and caudate nucleus or high T2 signal in
the striatum. Published evidence localizes the lesion radiographically but
does not yet identify a selectively vulnerable striatal cell type.
locations:
- preferred_term: striatum
term:
id: UBERON:0002435
label: striatum
- preferred_term: putamen
term:
id: UBERON:0001874
label: putamen
- preferred_term: caudate nucleus
term:
id: UBERON:0001873
label: caudate nucleus
evidence:
- reference: PMID:20085714
reference_title: "Autosomal-dominant striatal degeneration is caused by a mutation in the phosphodiesterase 8B gene."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "PDE8B is highly expressed in the brain, especially in the putamen, which is affected by ADSD."
explanation: The causal PDE8B study supports putaminal involvement and links affected anatomy to PDE8B expression.
- reference: PMID:15210883
reference_title: "Autosomal dominant striatal degeneration (ADSD): clinical description and mapping to 5q13-5q14."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "MRI demonstrated a distinctive lesion pattern restricted mainly to the putamen and caudate nucleus."
explanation: The original clinical mapping study localizes ADSD lesions mainly to striatal structures.
- reference: PMID:26769607
reference_title: "A novel mutation of PDE8B Gene in a Japanese family with autosomal-dominant striatal degeneration."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "RESULTS: Clinical features of the patients are slowly progressive parkinsonism and brain MRI showing high signal intensity in T2-weighted images in the striatum."
explanation: The Japanese family report supports striatal neuroimaging involvement with progressive parkinsonism.
- reference: PMID:31726290
reference_title: "Clinical findings of autosomal-dominant striatal degeneration and PDE8B mutation screening in parkinsonism and related disorders."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Neuroimaging showed an inhomogeneous increased signal in the patient's striatum on T1-weighted images but a decreased signal in the presymptomatic carrier."
explanation: A later family report supports striatal imaging abnormalities in affected and presymptomatic PDE8B carriers.
downstream:
- target: Parkinsonism
description: Striatal degeneration produces slowly progressive parkinsonism.
causal_link_type: DIRECT
evidence:
- reference: PMID:26769607
reference_title: "A novel mutation of PDE8B Gene in a Japanese family with autosomal-dominant striatal degeneration."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "BACKGROUND: Autosomal-dominant striatal degeneration is a rare autosomal-dominant neurodegenerative movement disorder characterized by slowly progressive parkinsonism."
explanation: The second molecularly confirmed family directly links the striatal disorder to progressive parkinsonism.
- target: Bradykinesia
description: Basal ganglia dysfunction manifests as slowed movement.
causal_link_type: DIRECT
evidence:
- reference: PMID:20085714
reference_title: "Autosomal-dominant striatal degeneration is caused by a mutation in the phosphodiesterase 8B gene."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "ADSD is characterized by bradykinesia, dysarthria, and muscle rigidity."
explanation: Bradykinesia is part of the defining phenotype in the molecular report.
- target: Rigidity
description: Basal ganglia dysfunction manifests as rigidity.
causal_link_type: DIRECT
evidence:
- reference: PMID:20085714
reference_title: "Autosomal-dominant striatal degeneration is caused by a mutation in the phosphodiesterase 8B gene."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "ADSD is characterized by bradykinesia, dysarthria, and muscle rigidity."
explanation: Rigidity is part of the defining phenotype in the molecular report.
- target: Dysarthria
description: Striatal/basal-ganglia disease contributes to dysarthric speech.
causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
evidence:
- reference: PMID:20085714
reference_title: "Autosomal-dominant striatal degeneration is caused by a mutation in the phosphodiesterase 8B gene."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "ADSD is characterized by bradykinesia, dysarthria, and muscle rigidity."
explanation: Dysarthria is part of the defining phenotype in the molecular report.
- target: Gait disturbance
description: Striatal/basal-ganglia disease contributes to impaired gait.
causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
evidence:
- reference: PMID:15210883
reference_title: "Autosomal dominant striatal degeneration (ADSD): clinical description and mapping to 5q13-5q14."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "RESULTS: The main clinical features of the disease are dysarthria and gait disturbance without any apparent reduction in life expectancy."
explanation: Gait disturbance was a main feature in the original kindred.
- target: Dysphagia
description: Progressive motor dysfunction can include swallowing impairment.
causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
evidence:
- reference: ORPHA:228169
reference_title: "Autosomal dominant striatal neurodegeneration"
supports: SUPPORT
evidence_source: OTHER
snippet: "HP:0002015 | Dysphagia | Frequent (79-30%)"
explanation: Orphanet records dysphagia in the structured ADSN phenotype profile.
- target: Dysdiadochokinesis
description: Motor-circuit dysfunction can impair rapid alternating movements.
causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
evidence:
- reference: ORPHA:228169
reference_title: "Autosomal dominant striatal neurodegeneration"
supports: SUPPORT
evidence_source: OTHER
snippet: "HP:0002075 | Dysdiadochokinesis | Very frequent (99-80%)"
explanation: Orphanet records dysdiadochokinesis in the structured ADSN phenotype profile.
- target: Ataxia
description: Striatal/basal-ganglia involvement can manifest with ataxia in reported ADSD.
causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
evidence:
- reference: PMID:31726290
reference_title: "Clinical findings of autosomal-dominant striatal degeneration and PDE8B mutation screening in parkinsonism and related disorders."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "For the first time, we described the typical ataxia phenotype in ADSD."
explanation: A molecularly confirmed family expands the phenotype to ataxia.
- target: Abnormality of movement
description: ADSN is classified clinically as a movement disorder.
causal_link_type: DIRECT
evidence:
- reference: PMID:20085714
reference_title: "Autosomal-dominant striatal degeneration is caused by a mutation in the phosphodiesterase 8B gene."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Autosomal-dominant striatal degeneration (ADSD) is an autosomal-dominant movement disorder affecting the striatal part of the basal ganglia."
explanation: The molecular report directly defines ADSD as a striatal movement disorder.
- target: Tremor
description: Tremor without parkinsonism has been reported as an expanded phenotype.
causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
evidence:
- reference: PMID:34022587
reference_title: "Tremor without parkinsonism: A new phenotype of autosomal-dominant striatal degeneration."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Tremor without parkinsonism: A new phenotype of autosomal-dominant striatal degeneration."
explanation: The case-report title directly identifies tremor without parkinsonism as an expanded ADSD phenotype.
phenotypes:
- category: Neurologic
name: Degeneration of the striatum
description: >-
Autosomal dominant striatal neurodegeneration is defined by degeneration
affecting the striatal part of the basal ganglia.
phenotype_term:
preferred_term: Degeneration of the striatum
term:
id: HP:0040140
label: Degeneration of the striatum
evidence:
- reference: PMID:20085714
reference_title: "Autosomal-dominant striatal degeneration is caused by a mutation in the phosphodiesterase 8B gene."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Autosomal-dominant striatal degeneration (ADSD) is an autosomal-dominant movement disorder affecting the striatal part of the basal ganglia."
explanation: >-
The molecular report directly supports striatal degeneration as the
defining anatomic phenotype.
- category: Neurologic
name: Dysarthria
phenotype_term:
preferred_term: Dysarthria
term:
id: HP:0001260
label: Dysarthria
frequency: VERY_FREQUENT
evidence:
- reference: ORPHA:228169
reference_title: "Autosomal dominant striatal neurodegeneration"
supports: SUPPORT
evidence_source: OTHER
snippet: "HP:0001260 | Dysarthria | Very frequent (99-80%)"
explanation: Orphanet lists dysarthria as very frequent in ADSN.
- reference: PMID:15210883
reference_title: "Autosomal dominant striatal degeneration (ADSD): clinical description and mapping to 5q13-5q14."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "RESULTS: The main clinical features of the disease are dysarthria and gait disturbance without any apparent reduction in life expectancy."
explanation: The original ADSD family report names dysarthria as a main clinical feature.
- category: Neurologic
name: Gait disturbance
phenotype_term:
preferred_term: Gait disturbance
term:
id: HP:0001288
label: Gait disturbance
frequency: FREQUENT
evidence:
- reference: ORPHA:228169
reference_title: "Autosomal dominant striatal neurodegeneration"
supports: SUPPORT
evidence_source: OTHER
snippet: "HP:0001288 | Gait disturbance | Frequent (79-30%)"
explanation: Orphanet lists gait disturbance as frequent in ADSN.
- reference: PMID:15210883
reference_title: "Autosomal dominant striatal degeneration (ADSD): clinical description and mapping to 5q13-5q14."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "RESULTS: The main clinical features of the disease are dysarthria and gait disturbance without any apparent reduction in life expectancy."
explanation: The original ADSD family report names gait disturbance as a main clinical feature.
- category: Neurologic
name: Dysphagia
phenotype_term:
preferred_term: Dysphagia
term:
id: HP:0002015
label: Dysphagia
frequency: FREQUENT
evidence:
- reference: ORPHA:228169
reference_title: "Autosomal dominant striatal neurodegeneration"
supports: SUPPORT
evidence_source: OTHER
snippet: "HP:0002015 | Dysphagia | Frequent (79-30%)"
explanation: Orphanet lists dysphagia as frequent in ADSN.
- category: Neurologic
name: Rigidity
phenotype_term:
preferred_term: Rigidity
term:
id: HP:0002063
label: Rigidity
frequency: VERY_FREQUENT
evidence:
- reference: ORPHA:228169
reference_title: "Autosomal dominant striatal neurodegeneration"
supports: SUPPORT
evidence_source: OTHER
snippet: "HP:0002063 | Rigidity | Very frequent (99-80%)"
explanation: Orphanet lists rigidity as very frequent in ADSN.
- category: Neurologic
name: Bradykinesia
phenotype_term:
preferred_term: Bradykinesia
term:
id: HP:0002067
label: Bradykinesia
frequency: VERY_FREQUENT
evidence:
- reference: ORPHA:228169
reference_title: "Autosomal dominant striatal neurodegeneration"
supports: SUPPORT
evidence_source: OTHER
snippet: "HP:0002067 | Bradykinesia | Very frequent (99-80%)"
explanation: Orphanet lists bradykinesia as very frequent in ADSN.
- category: Neurologic
name: Dysdiadochokinesis
phenotype_term:
preferred_term: Dysdiadochokinesis
term:
id: HP:0002075
label: Dysdiadochokinesis
frequency: VERY_FREQUENT
evidence:
- reference: ORPHA:228169
reference_title: "Autosomal dominant striatal neurodegeneration"
supports: SUPPORT
evidence_source: OTHER
snippet: "HP:0002075 | Dysdiadochokinesis | Very frequent (99-80%)"
explanation: Orphanet lists dysdiadochokinesis as very frequent in ADSN.
- category: Neurologic
name: Ataxia
phenotype_term:
preferred_term: Ataxia
term:
id: HP:0001251
label: Ataxia
description: Ataxia is reported in a PDE8B-confirmed ADSN family.
evidence:
- reference: PMID:31726290
reference_title: "Clinical findings of autosomal-dominant striatal degeneration and PDE8B mutation screening in parkinsonism and related disorders."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "For the first time, we described the typical ataxia phenotype in ADSD."
explanation: The Chinese family report explicitly identifies ataxia as an ADSD phenotype.
- category: Neurologic
name: Abnormality of movement
phenotype_term:
preferred_term: Abnormality of movement
term:
id: HP:0100022
label: Abnormality of movement
frequency: VERY_FREQUENT
evidence:
- reference: ORPHA:228169
reference_title: "Autosomal dominant striatal neurodegeneration"
supports: SUPPORT
evidence_source: OTHER
snippet: "HP:0100022 | Abnormality of movement | Very frequent (99-80%)"
explanation: Orphanet lists abnormality of movement as very frequent in ADSN.
- category: Neurologic
name: Parkinsonism
phenotype_term:
preferred_term: Parkinsonism
term:
id: HP:0001300
label: Parkinsonism
clinical_course: PROGRESSIVE
description: Slowly progressive parkinsonism is a reported core clinical presentation.
evidence:
- reference: PMID:26769607
reference_title: "A novel mutation of PDE8B Gene in a Japanese family with autosomal-dominant striatal degeneration."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "BACKGROUND: Autosomal-dominant striatal degeneration is a rare autosomal-dominant neurodegenerative movement disorder characterized by slowly progressive parkinsonism."
explanation: The Japanese family report describes slowly progressive parkinsonism as characteristic of ADSN.
- reference: PMID:31726290
reference_title: "Clinical findings of autosomal-dominant striatal degeneration and PDE8B mutation screening in parkinsonism and related disorders."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Clinically, the patient exhibited progressive parkinsonism without tremor and ataxia phenotype."
explanation: The Chinese family report supports progressive parkinsonism as an ADSN phenotype.
- category: Neurologic
name: Tremor
phenotype_term:
preferred_term: Tremor
term:
id: HP:0001337
label: Tremor
description: >-
Tremor without parkinsonism has been reported, so absence of tremor should
not be treated as an invariant diagnostic criterion.
evidence:
- reference: PMID:34022587
reference_title: "Tremor without parkinsonism: A new phenotype of autosomal-dominant striatal degeneration."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Tremor without parkinsonism: A new phenotype of autosomal-dominant striatal degeneration."
explanation: The report directly identifies a tremor-only expansion of the ADSD phenotype.
diagnosis:
- name: Brain MRI striatal lesions
diagnosis_term:
preferred_term: MRI of the brain
term:
id: NCIT:C16809
label: Magnetic Resonance Imaging
results: >-
Distinctive lesions in putamen and caudate nucleus, or high T2 signal in
the striatum, support ADSN diagnosis in the appropriate clinical and genetic
context.
evidence:
- reference: PMID:15210883
reference_title: "Autosomal dominant striatal degeneration (ADSD): clinical description and mapping to 5q13-5q14."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "MRI demonstrated a distinctive lesion pattern restricted mainly to the putamen and caudate nucleus."
explanation: The original ADSD study reports a characteristic putamen/caudate MRI pattern.
- reference: PMID:26769607
reference_title: "A novel mutation of PDE8B Gene in a Japanese family with autosomal-dominant striatal degeneration."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "RESULTS: Clinical features of the patients are slowly progressive parkinsonism and brain MRI showing high signal intensity in T2-weighted images in the striatum."
explanation: The second family report describes striatal high T2 MRI signal.
- reference: PMID:31726290
reference_title: "Clinical findings of autosomal-dominant striatal degeneration and PDE8B mutation screening in parkinsonism and related disorders."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Neuroimaging showed an inhomogeneous increased signal in the patient's striatum on T1-weighted images but a decreased signal in the presymptomatic carrier."
explanation: The later family report supports striatal MRI signal abnormalities across symptomatic and presymptomatic PDE8B carriers.
- name: PDE8B molecular genetic testing
diagnosis_term:
preferred_term: molecular genetic testing
term:
id: NCIT:C19770
label: Molecular Analysis
results: Identification of a heterozygous pathogenic PDE8B variant supports molecular confirmation.
evidence:
- reference: PMID:26769607
reference_title: "A novel mutation of PDE8B Gene in a Japanese family with autosomal-dominant striatal degeneration."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "METHODS: We report on the clinical characteristics of 2 patients of a Japanese family with autosomal-dominant striatal degeneration and the result of gene mutation analysis of this family."
explanation: The report used family mutation analysis to establish the PDE8B variant.
- reference: PMID:26769607
reference_title: "A novel mutation of PDE8B Gene in a Japanese family with autosomal-dominant striatal degeneration."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "We found a heterozygous nonsense mutation in the first exon of cyclic nucleotide phosphodiesterase 8B gene, which is predicted to disrupt all important functional domains of the cyclic nucleotide phosphodiesterase 8B protein."
explanation: Molecular testing identified the heterozygous PDE8B nonsense variant.
- reference: PMID:31726290
reference_title: "Clinical findings of autosomal-dominant striatal degeneration and PDE8B mutation screening in parkinsonism and related disorders."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "An ADSD diagnosis was confirmed by a nonsense mutation in PDE8B (p.E102X) in a patient and a presymptomatic carrier."
explanation: The Chinese family report supports PDE8B mutation testing for molecular confirmation.
differential_diagnoses:
- name: Parkinson disease
disease_term:
preferred_term: Parkinson disease
term:
id: MONDO:0005180
label: Parkinson disease
description: >-
ADSD can resemble idiopathic Parkinson disease clinically. A dominant
pedigree, a truncating PDE8B variant, and the characteristic bilateral
striatal MRI pattern support ADSD; rare tremor presentations mean that
tremor alone cannot reliably distinguish the two.
distinguishing_features:
- Characteristic putamen and caudate signal abnormalities in ADSD
- Heterozygous loss-of-function PDE8B variant segregating with disease
- Familial dominant transmission rather than a typical sporadic presentation
evidence:
- reference: PMID:20085714
reference_title: "Autosomal-dominant striatal degeneration is caused by a mutation in the phosphodiesterase 8B gene."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "These symptoms resemble idiopathic Parkinson disease, but tremor is not present."
explanation: The original molecular report explicitly identifies idiopathic Parkinson disease as a clinical mimic.
- reference: PMID:31726290
reference_title: "Clinical findings of autosomal-dominant striatal degeneration and PDE8B mutation screening in parkinsonism and related disorders."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "No causative PDE8B mutation was discovered in our cohort of PD or Parkinsonism patients."
explanation: A large screening cohort argues against treating rare PDE8B ADSD as a common cause of Parkinson disease or parkinsonism.
treatments: []
clinical_trials: []
datasets: []
discussions:
- discussion_id: pde8b_to_selective_striatal_injury
prompt: >-
How does loss of PDE8B-mediated cAMP hydrolysis produce selective,
progressive striatal injury?
kind: KNOWLEDGE_GAP
status: OPEN
attaches_to:
- pathophysiology#PDE8B Cyclic Nucleotide Phosphodiesterase Loss
- pathophysiology#Degeneration of the striatum
rationale: >-
Human genetics and enzyme activity establish PDE8B loss of function, and
PDE8B expression plus its role in cAMP metabolism nominate altered dopamine
signaling. Published patient evidence does not resolve the relevant
striatal cell type, the direction and compartment of cyclic-nucleotide
dysregulation in vivo, or the intervening injury pathway.
evidence:
- reference: PMID:20085714
reference_title: "Autosomal-dominant striatal degeneration is caused by a mutation in the phosphodiesterase 8B gene."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "We believe that the functional analysis of PDE8B will help to further elucidate the pathomechanism of ADSD as well as contribute to a better understanding of movement disorders."
explanation: The causal-gene report explicitly leaves the downstream disease mechanism for future functional analysis.
- discussion_id: adsd_phenotypic_boundaries
prompt: >-
Which manifestations belong to the reproducible PDE8B-ADSD spectrum rather
than isolated case-level expansions?
kind: KNOWLEDGE_GAP
status: OPEN
attaches_to:
- phenotypes#Parkinsonism
- phenotypes#Ataxia
- phenotypes#Tremor
rationale: >-
Core bradykinetic-rigid, dysarthric, and gait manifestations recur across
families, whereas ataxia and tremor without parkinsonism are supported by
individual reports. Larger genotype-first cohorts and standardized
longitudinal imaging are needed before frequencies or prognostic claims
can be assigned to these expanded features.
evidence:
- reference: PMID:31726290
reference_title: "Clinical findings of autosomal-dominant striatal degeneration and PDE8B mutation screening in parkinsonism and related disorders."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "For the first time, we described the typical ataxia phenotype in ADSD."
explanation: The authors identify ataxia as a newly described case-level expansion.
- reference: PMID:34022587
reference_title: "Tremor without parkinsonism: A new phenotype of autosomal-dominant striatal degeneration."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Tremor without parkinsonism: A new phenotype of autosomal-dominant striatal degeneration."
explanation: The report identifies tremor without parkinsonism as another phenotypic expansion.
notes: >-
Evidence was re-audited through 2026-07-21. A fully paginated
ClinicalTrials.gov search for the disease name or PDE8B returned no studies,
and the corresponding NCBI GEO/DataSets search returned no disease-specific
datasets. No disease-modifying therapy or validated disease-specific
experimental model was identified. Symptomatic treatment evidence is limited
to individual reports and is therefore not promoted to a general treatment
recommendation here. Orphanet frequency labels derive from very small
reported families and should be interpreted cautiously.
mappings:
mondo_mappings:
- term:
id: MONDO:0000211
label: striatal degeneration, autosomal dominant
mapping_predicate: skos:exactMatch
mapping_source: MONDO
mapping_justification: MONDO provides the exact disease term used by this record.
This report is retrieval-only and is generated directly from Asta results.
search_papers_by_relevance with snippet_search.