CMT-DARS2

DARS2 | 2025

What Is CMT-DARS2?

CMT-DARS2 is a type of CMT caused by autosomal recessive mutations in the DARS2 gene. This gene provides instructions for making the mitochondrial aspartyl-tRNA synthetase, an enzyme required for building proteins inside mitochondria. Mutations in the DARS2 gene disrupt mitochondrial protein synthesis, leading to impaired nerve signal transmission.

CMT-DARS2 is autosomal recessive, meaning that both copies of the gene must have a mutation to cause this subtype.

Clinical Features

The age of symptom onset in CMT-DARS2 is variable, ranging from childhood to adulthood. Symptoms typically begin in the lower extremities and progress over time to involve the upper limbs. Nerve conduction studies usually show somewhat slowed conduction velocities and reduced amplitudes, consistent with an axonal form of CMT.

CMT-DARS2 symptoms may include:

  • Weakness in the feet and lower legs
  • Muscle atrophy
  • Foot drop
  • Reduced or absent reflexes
  • Reduced sensation
  • A steppage-style walking pattern
  • Foot deformities, including high arches, and hammertoes (clawed toes)
  • Progressive involvement of the hands and forearms
  • Difficulty with fine motor skills and manual dexterity
  • Additional symptoms not listed here

Disease Course

CMT-DARS2 shows wide variability in severity and progression. Some individuals are mildly affected, while others develop a more severe disease. Disease progression is generally slow, and life expectancy is not reduced.

Clinical Basics

Subtype
CMT-DARS2

Classification
Unclassified Subtypes

Neuropathy Type
Axonal

Inheritance Pattern
autosomal recessive

Genetic Context

HGNC-Approved Gene Symbol
DARS2

Gene Full Name
aspartyl-tRNA synthetase 2, mitochondrial

HGNC Gene Alias(es)
FLJ10514

Chromosome
1q25.1

Zygosity of Responsible Variant
Compound Heterozygous

Mitochondrial Involvement
Yes

Variant Mechanism

Loss of Function (LoF)

Details

Mechanistic basis:
Hypomorphic

Confidence:
High

Prediction:
Evidence from the reported genotypes supports biallelic loss of function in CMT-DARS2: a leaky intron-2 splice variant causing partial skipping of exon 3 sits in trans with a severe or null allele in nearly every patient, leaving reduced but non-zero mitochondrial aspartyl-tRNA synthetase and impairing mitochondrial translation. Two null alleles have not been observed, and the residual activity the leaky allele preserves appears to be what makes the genotype survivable.

Rationale:
The leaky splice allele carries the phenotype, and its tissue-variable exon 3 skipping explains the range from leukoencephalopathy with brainstem and spinal cord involvement to a predominantly peripheral presentation. A hypomorphic enzyme deficiency of this shape answers to added functional synthetase, and nothing in the genotypes indicates a mutant enzyme acting against its wild-type partner.

ClinVar Pathogenic Variants

View DARS2 ClinVar Variants

DARS2 OMIM Entry

DARS2 OMIM

More Info

CMT-DARS2 Research Opportunity

CMT Natural History Study

Original Discovery Publication

Publication Title

Biallelic Variants in the DARS2 Gene as a Novel Cause of Axonal Charcot-Marie-Tooth Disease

Authors

Estévez-Arias, B., Sarv, S., Bonello-Palot, N., Carrera-García, L., Ortez, C., Expósito-Escudero, J., Yubero, D., Muchart, J., Delmont, E., Õiglane-Shlik, E., Meren, T., Puusepp, S., Murumets, Ü., Salomons, G. S., Udd, B., Väli, L., Cantarero, L., Bönnemann, C. G., Nascimento, A., Ramón-Maiques, S., Õunap, K., Hoenicka, J., Natera-de Benito, D., Palau, F.

Publication Date
August 15, 2025

Updated: July 18, 2026 | By: K. Raymond

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