CMT2FF

CADM3 | 2021

What Is CMT2FF?

CMT2FF is a type of CMT caused by mutations in the CADM3 gene. This gene provides instructions for producing cell adhesion molecule 3, a protein involved in cell-to-cell interactions that support normal nerve structure and signaling. Mutations in the CADM3 gene disrupt normal interactions between nerve cells, leading to impaired axonal function and nerve signal transmission.

CMT2FF is autosomal dominant, meaning that just one of the gene’s two copies must have a CMT-causing mutation to cause this subtype.

Clinical Features

The age of symptom onset in CMT2FF is variable, ranging from early childhood to adulthood. Symptoms typically begin in the lower extremities and progress over time to involve the upper limbs. An earlier onset isn’t necessarily associated with a more severe disease course. Nerve conduction studies usually show somewhat slowed conduction velocities and reduced amplitudes, consistent with an axonal form of CMT.

CMT2FF symptoms may include:

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

Disease Course

CMT2FF 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
CMT2FF

Classification
CMT2

Neuropathy Type
Axonal

Inheritance Pattern
autosomal dominant

Genetic Context

HGNC-Approved Gene Symbol
CADM3

Gene Full Name
cell adhesion molecule 3

HGNC Gene Alias(es)
IGSF4B, BIgR, FLJ10698, TSLL1, NECL1, SynCAM3, Necl-1

Chromosome
1q23.2

Zygosity of Responsible Variant
Heterozygous

Mitochondrial Involvement
No

Variant Mechanism

Dominant-Negative

Details

Confidence:
Medium

Prediction:
The literature predicts a dominant-negative mechanism for CMT2FF: the recurrent heterozygous CADM3 p.Tyr172Cys substitution introduces an unpaired cysteine that forms an aberrant disulfide bond, leaving the mutant adhesion molecule retained in the endoplasmic reticulum and the CADM3CADM4 axon-glia adhesion complex disrupted. The variant confers no independent overactive function, so the lesion is the mutant protein's effect on the partner it can no longer present correctly at the membrane rather than any new activity of its own.

Rationale:
Absence of any reported CADM3 null or haploinsufficiency CMT argues against halved dosage as the lesion, while the recurrent allele is characterized as a mistrafficked product that pulls its binding partner out of service at the axon-glia interface. Characterization rests on one recurrent variant and a single group's functional work, which caps confidence at medium.

ClinVar Pathogenic Variants

View CADM3 ClinVar Variants

CMT2FF OMIM Entry

CMT2FF OMIM

CADM3 OMIM Entry

CADM3 OMIM

More Info

CMT2FF Research Opportunity

CMT Natural History Study

Original Discovery Publication

Publication Title

A CADM3 Variant Causes Charcot-Marie-Tooth Disease with Marked Upper Limb Involvement

Authors

Rebelo, A. P., Cortese, A., Abraham, A., Eshed-Eisenbach, Y., Shner, G., Vainshtein, A., Buglo, E., Camarena, V., Gaidosh, G., Shiekhattar, R., Abreu, L., Courel, S., Burns, D. K., Bai, Y., Bacon, C., Feely, S., Castro, D., Peles, E., Reilly, M. M., Shy, M. E., & Züchner, S.

Publication Date
April 23, 2021

Updated: May 9, 2026 | By: K. Raymond

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