Sensory neuronopathies: new genes, new antibodies and new concepts

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Main idea: Mechanisms of neural ganglia degeneration that leads to sensory neuronopathies development. Among the most crucial genes for risk diagnostics of sensory neuronopathies are RFC-1, FGFR3.

Abstract: Degeneration of dorsal root ganglia (DRG) and its central and peripheral projections provokes sensory neuronopathy (SN), a rare disorder with multiple genetic and acquired causes. Clinically, patients with SN are usually present with proprioceptive ataxia, patchy and asymmetric sensory abnormalities, widespread areflexia, and no weakness. Classic causes of SN include cancer, Sj√∂gren’s syndrome, vitamin deficiency, chemotherapy, mitochondrial disorders, and Friedreich ataxia. More recently, new genetic and dysimmune disorders associated with SN have been described, including RFC1 gene-linked cerebellar ataxia, neuropathy, and vestibular areflexia syndrome (CANVAS), and anti-FGFR3 antibodies. In this review, we detail the pathophysiology of DRG degeneration, and the genetic and acquired causes of SN, with a special focus on the recently described CANVAS and anti-FGFR3 antibodies. We also propose a user-friendly and easily implemented SN diagnostic strategy.

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