CMT-NDUFS6

NDUFS6 | 2024

What Is CMT-NDUFS6?

CMT-NDUFS6 is a type of CMT caused by autosomal recessive mutations in the NDUFS6 gene. This gene provides instructions for making a component of the mitochondrial enzyme complex responsible for producing cellular energy. Mutations in the NDUFS6 gene disrupt this function, leading to impaired nerve signal transmission.

CMT-NDUFS6 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-NDUFS6 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-NDUFS6 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-NDUFS6 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-NDUFS6

Classification
Unclassified Subtypes

Neuropathy Type
Axonal

Inheritance Pattern
autosomal recessive

Genetic Context

HGNC-Approved Gene Symbol
NDUFS6

Gene Full Name
NADH:ubiquinone oxidoreductase subunit S6

Chromosome
5p15.33

Zygosity of Responsible Variant
Homozygous

Mitochondrial Involvement
Yes

Variant Mechanism

Loss of Function (LoF)

Details

Mechanistic basis:
Hypomorphic

Confidence:
Low

Prediction:
The literature reads CMT-NDUFS6 as a biallelic loss-of-function disease: NDUFS6 encodes a small nuclear-encoded subunit of the N module of complex I, where NADH oxidation feeds the respiratory chain. Recessive variants reduce or abolish its incorporation, leaving complex I under-assembled and its catalytic activity low in tissues with high oxidative demand. Supplying intact subunit is predicted to restore assembly. Reports linking this gene to CMT date only from 2024 and remain few, so confidence sits at low.

Rationale:
A structural subunit that is missing or unstable fails to join the assembling complex; it does not occupy a position in the holoenzyme from which it could compromise the wild-type product, which is the specific reason interference is not the better reading here. Complete NDUFS6 loss produces severe infantile complex I deficiency, placing the CMT alleles at the hypomorphic end of one gradient.

ClinVar Pathogenic Variants

View NDUFS6 ClinVar Variants

NDUFS6 OMIM Entry

NDUFS6 OMIM

More Info

CMT-NDUFS6 Research Opportunity

CMT Natural History Study

Original Discovery Publication

Publication Title

Alternative Splicing Expands the Clinical Spectrum of NDUFS6-Related Mitochondrial Disorders.

Authors

Armirola-Ricaurte, C., Zonnekein, N., Koutsis, G., Amor-Barris, S., Pelayo-Negro, A. L., Atkinson, D., Efthymiou, S., Turchetti, V., Dinopoulos, A., Garcia, A., Karakaya, M., Moris, G., Polat, A. I., Yiş, U., Espinos, C., Van de Vondel, L., De Vriendt, E., Karadima, G., Wirth, B., Hanna, M., Houlden, H., Berciano, J., Jordanova, A.

Publication Date
June 1, 2024

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

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