CMT-NAMPT

NAMPT | 2025

What Is CMT-NAMPT?

CMT-NAMPT is a type of CMT caused by autosomal recessive mutations in the NAMPT gene. This gene provides instructions for making an enzyme central to the production of NAD, a molecule essential to cellular energy metabolism. Mutations in the NAMPT gene disrupt this function, leading to impaired nerve signal transmission.

CMT-NAMPT 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-NAMPT 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-NAMPT 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-NAMPT 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-NAMPT

Classification
Unclassified Subtypes

Neuropathy Type
Axonal

Inheritance Pattern
autosomal recessive

Genetic Context

HGNC-Approved Gene Symbol
NAMPT

Gene Full Name
Nicotinamide Phosphoribosyltransferase

HGNC Gene Alias(es)
PBEF1

Chromosome
7q22.3

Zygosity of Responsible Variant
Homozygous

Variant Mechanism

Loss of Function (LoF)

Details

Mechanistic basis:
Biallelic

Confidence:
Low

Prediction:
The literature predicts a biallelic loss-of-function mechanism for CMT-NAMPT: recessive homozygous NAMPT variants, in the rate-limiting enzyme of the NAD+ salvage pathway, reduce enzymatic activity and impair NAD+ biosynthesis in neurons. Because both copies must be affected and restored wild-type enzyme is predicted to rescue, this is loss of function, though the ultra-rare 2025 evidence holds confidence at low.

Rationale:
Biallelic NAMPT variants lose enzymatic function and reduce NAD+ salvage in axons, so restored wild-type is predicted to rescue: a recessive loss of function. The ultra-rare 2025 evidence holds confidence at low.

ClinVar Pathogenic Variants

View CMT-NAMPT ClinVar Variants

NAMPT OMIM Entry

NAMPT OMIM

More Info

CMT-NAMPT Research Opportunity

CMT Natural History Study

Original Discovery Publication

Publication Title

A Sensory and Motor Neuropathy Caused by a Genetic Variant of NAMPT

Authors

Zhang, Z., Pilch, J., Lundt, S., Zhang, N., Chang, Y., Singer, T., Śladowski, D., Hu, X. L., Zheng, L., Ge, W. P., Zhang, H., Li, D. P., Han, X., Ploski, R., & Ding, S

Publication Date
September 26, 2025

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

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