Ataxia
Gene: MT-CO1
DEFINITIVE by ClinGen for mitochondrial disease.
At least eight variants (m.5920G>A, m.6328C>T, m.6579G>A, m.6597C>A, m.6698del, m.6708G>A, m.6930G>A, m.7402del) have been reported in eight individuals across multiple publications. Single fiber testing and cybrid analyses supported the pathogenicity of several of these variants. Age of onset in affected individuals ranged from infancy to adolescence. Clinical features included Leigh syndrome, cognitive decline, exercise intolerance, myoglobinuria, stroke-like episodes, myoclonic epilepsy, cerebellar ataxia, muscle weakness and atrophy, cataracts, optic atrophy, sensorineural hearing loss, and left ventricular hypertrophy. Brain imaging was variable and ranged from normal to findings consistent with LSS, cerebellar atrophy, and cortical atrophy. Muscle biopsies showed ragged red fibers, COX-deficient fibers, and complex IV deficiency. Metabolic laboratory investigations revealed normal to elevated lactate and creatine kinase (CK). Heteroplasmy levels in affected individuals were highest in muscle when multiple tissues were assessed (61-95% in muscle, undetectable to 30% in blood, undetectable to 40% in skin fibroblasts, undetectable in hair follicles when tested, and 15-70% in urine).
The mechanism of pathogenicity appears to be loss of function resulting in specific loss of complex IV activity. This gene-disease relationship is also supported by known biochemical function, in vitro functional assays, and a mouse model, all of which demonstrate altered mitochondrial function as a result of variants in MT-CO1.Created: 4 Dec 2025, 8:56 a.m. | Last Modified: 4 Dec 2025, 8:56 a.m.
Panel Version: 0.1102
Sources: Expert listCreated: 19 Apr 2020, 12:55 p.m.
Mode of inheritance
MITOCHONDRIAL
Phenotypes
Mitochondrial respiratory chain complex deficiency, MONDO:0000066, MT-CO1-related
Publications
Gene: mt-co1 has been classified as Green List (High Evidence).
gene: MT-CO1 was added gene: MT-CO1 was added to Ataxia. Sources: Expert Review Green,Expert list mtDNA tags were added to gene: MT-CO1. Mode of inheritance for gene gene: MT-CO1 was set to MITOCHONDRIAL Publications for gene: MT-CO1 were set to 30743023; 39460813; 24956508; 10441567; 10980727; 15751226; 16284789; 18977334; 22832341; 18276892; 30030519 Phenotypes for gene: MT-CO1 were set to Mitochondrial respiratory chain complex deficiency, MONDO:0000066, MT-CO1-related