Early-onset Parkinson disease
Gene: DDC
**New evidence**: PMID 35593933 adds a homozygous missense p.Pro330Leu variant with variant‑specific biochemical loss‑of‑function data and confirms parental carrier status; PMID 35829818 reports a novel frameshift null variant (p.Tyr37Thrfs*5) and provides detailed neurophysiological profiling of three affected individuals; PMID 36928758 expands the cohort to 15 families (16 patients) from the Middle East, describing eight distinct pathogenic variants—including recurrent c.1234C>T (5 families) and c.571‑3C>G (3 families) – and confirms loss‑of‑function by low plasma AADC activity and CSF neurotransmitter abnormalities; PMID 36054588 aggregates nine additional patients with biallelic loss‑of‑function DDC variants, reinforcing the association with early‑onset parkinsonism‑dystonia.
**Prior reviews**: Rated GREEN on PanelApp Australia (2022) for "aromatic L‑amino acid decarboxylase deficiency" (autosomal recessive) based on limited families and functional data; a prior AMBER rating (2022) noted phenotypic overlap concerns.
**Panel relevance**: Aromatic L‑amino acid decarboxylase deficiency manifests as early‑onset parkinsonism, dystonia, oculogyric crises and autonomic dysfunction – core features of the Early‑onset Parkinson disease panel (extrapyramidal motor dysfunction).
**Assessment**: The aggregated evidence now includes ≥3 independent families with qualifying loss‑of‑function variants (splice‑site founder, missense with functional loss, frameshift null) fulfilling Criterion A, a clear monogenic autosomal recessive inheritance (Criterion D) and no contradictory data (Criterion E); consequently DDC attains diagnostic‑grade (GREEN) status for early‑onset parkinsonism‑related phenotypes.Created: 20 Jun 2026, 8:17 p.m. | Last Modified: 20 Jun 2026, 8:17 p.m.
Panel Version: 3.18
Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal
Phenotypes
aromatic L-amino acid decarboxylase deficiency, MONDO:0012084
Publications
Limited phenotypic overlap: oculogyric crises are a rare feature of PD.Created: 20 Jul 2022, 12:33 p.m.
Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal
Phenotypes
Aromatic L-amino acid decarboxylase deficiency, MIM# 608643
Sources: LiteratureCreated: 18 Jul 2022, 7:27 a.m.
Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal
Phenotypes
Aromatic L-amino acid decarboxylase deficiency (DYT-DDC); Infantile-onset parkinsonism & dystonia; Bulbar dysfunction; Oculogyric crisis; Autonomic dysfunction; Intellectual disability; OMIM 608603
Publications
Publications for gene: DDC were set to PMID: 33983693
Gene: ddc has been classified as Green List (High Evidence).
Gene: ddc has been classified as Amber List (Moderate Evidence).
Phenotypes for gene: DDC were changed from Aromatic L-amino acid decarboxylase deficiency (DYT-DDC); Infantile-onset parkinsonism & dystonia; Bulbar dysfunction; Oculogyric crisis; Autonomic dysfunction; Intellectual disability; OMIM 608603 to Aromatic L-amino acid decarboxylase deficiency, MIM# 608643; Infantile-onset parkinsonism & dystonia; Bulbar dysfunction; Oculogyric crisis; Autonomic dysfunction; Intellectual disability
Gene: ddc has been classified as Amber List (Moderate Evidence).
gene: DDC was added gene: DDC was added to Early-onset Parkinson disease. Sources: Literature Mode of inheritance for gene: DDC was set to BIALLELIC, autosomal or pseudoautosomal Publications for gene: DDC were set to PMID: 33983693 Phenotypes for gene: DDC were set to Aromatic L-amino acid decarboxylase deficiency (DYT-DDC); Infantile-onset parkinsonism & dystonia; Bulbar dysfunction; Oculogyric crisis; Autonomic dysfunction; Intellectual disability; OMIM 608603 Review for gene: DDC was set to GREEN