HSAN-8

PRDM12 | 2015

What Is HSAN-8?

HSAN-8 is a type of CMT caused by autosomal recessive mutations in the PRDM12 gene. This gene provides instructions for making a protein required for the development of pain-sensing nerve cells. Mutations in the PRDM12 gene disrupt this function, leading to impaired nerve signal transmission.

HSAN-8 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 HSAN-8 is variable, ranging from childhood to adulthood. The disease involves loss of sensation that begins in the hands and feet (glove-and-stocking distribution) and progresses over time towards the center of the body. Nerve conduction studies usually show somewhat slowed conduction velocities and reduced amplitudes, consistent with an axonal form of CMT.

HSAN-8 symptoms may include:

  • Progressive loss of sensation in the feet and hands
  • Loss of pain and temperature sensation
  • Reduced sweating and tear production
  • Reduced or absent reflexes
  • Foot deformities, including high arches, and hammertoes (clawed toes)
  • Distal weakness that develops as the disease progresses
  • Foot drop
  • Additional symptoms not listed here

Disease Course

HSAN-8 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
HSAN-8

Classification
HSAN

Neuropathy Type
Axonal

Inheritance Pattern
autosomal recessive

Genetic Context

HGNC-Approved Gene Symbol
PRDM12

Gene Full Name
PR/SET domain 12

Chromosome
9q34.12

Zygosity of Responsible Variant
Homozygous

Variant Mechanism

Loss of Function (LoF)

Details

Mechanistic basis:
Complete loss

Confidence:
High

Prediction:
The literature predicts a biallelic loss-of-function mechanism for HSAN-8: recessive PRDM12 changes, including truncating alleles, PR/SET-domain missense substitutions, and expansions of the C-terminal polyalanine tract, remove the transcriptional and chromatin-modifying activity required to specify and maintain nociceptive sensory neurons. Affected individuals are born without pain sensation because the nociceptor lineage never forms properly, and reinstating PRDM12 activity is predicted to correct the deficit.

Rationale:
Polyalanine expansions are the alleles that would most plausibly act by aggregation, yet they deplete PRDM12 from the nucleus rather than trapping the wild-type product with it, and expansion carriers are unaffected. Strict recessive segregation across consanguineous families completes the case for absent nociceptor-specifying activity.

ClinVar Pathogenic Variants

View PRDM12 ClinVar Variants

HSAN-8 OMIM Entry

HSAN-8 OMIM

PRDM12 OMIM Entry

PRDM12 OMIM

More Info

HSAN-8 Research Opportunity

CMT Natural History Study

Original Discovery Publication

Publication Title

Transcriptional Regulator PRDM12 is Essential for Human Pain Perception

Authors

Chen, Y. C., Auer-Grumbach, M., Matsukawa, S., Zitzelsberger, M., Themistocleous, A. C., Strom, T. M., Samara, C., Moore, A. W., Cho, L. T., Young, G. T., Weiss, C., Schabhüttl, M., Stucka, R., Schmid, A. B., Parman, Y., Graul-Neumann, L., Heinritz, W., Passarge, E., Watson, R. M., Hertz, J. M., … Senderek, J.

Publication Date
May 25, 2015

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

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