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. Author manuscript; available in PMC: 2026 Aug 4.
Published in final edited form as: Handb Clin Neurol. 2018;148:441–464. doi: 10.1016/B978-0-444-64076-5.00029-6

Table 29.2.

Octapeptide repeat insertions and deletions

PRNP mutation Codon 129 polymorphism # of cases in literature Clinical phenotypes Age at onset (range)c (years) Disease duration (range)c (months or years) Positive FHxa CSF marker sensitivity
EEG PSWC MRI c/w JCDb Neuropathology Neuropathology pheno-type References
14-3-3 Total taud
2-OPRD MM (1) Unknown (1) 2 RPD RPD, Sz, Myo (62–86) (18–23) months 0% (0/2) N/A N/A N/A N/A JCD Beck et al., (2001); Capellari et al. (2002)
2-OPRI MM (1) MV (1) VV (1) Unknown (1) 4 RPD D Cbr Atx Mean 63.3 ± 7.9 (58–75) Mean 6.8 ± 6.4 (0.25–13) years 50% (2/4) N/A N/A N/A 0% (0/1) JCD Goldfarbe et al. (1993); Croes et al. (2004); van Harten et al.(2000)
3-OPRI VV (1) MM(1) 2 RPD (68–69) (4 months–3 years) 0% (0/1) 50% (1/2) N/A 50% (1/2) 100% (1/1) JCD Grasbon-Frodl et al. (2004) ; Nishida et al.(2004)
4-OPRI MM(9) VV (1) MV (Cis V, 1) 11 MM: RPD, Myo, Cbr, Atx VV: Dep, Behav MV: RPD MM: Mean 60 ± 13.6 (39–85) VV: 82 MV: 38 MM: mean 33.8 ± 32.7 (2–76) months VV: 4 months MV 8 months MM: 12.5% (1/8) VV: 0% (0/1) MV: 100% (1/1) MM: 100% (4/4) VV: N/A MV: 100% (1/1) N/A MM:22% (2/9) VV: 100% (1/1) MV: 0% (0/1) MM: 20%(1/5) VV: N/A MV: 100% (1/1) MM: JCD (7/7) VV: N/A MV: JCD (1/1) Laplanche et al. (1995); Kaski et al. (2011); Sanchez-Valle et al. (2012)
5-OPRI MM (6) MV (Cis M, 3) Unknown (8) 17 Cog, motor Mean 45.7±11.0 (26–63), Mean 76 ± 51.8 (10months–14.5 years) 100% (15/15) 100% (1/1) N/A 25%(2/8) 0% (0/8) V, Neu loss, kuru-like PrPSc Goldfarb et al. (1991); Cochran et al. (1996); Skworc et al. (1999); Beck et al. (2005); Mead et al. (2007)
5-OPRI* MM (1) 1 Visuosp 39 19Y FHx score 2 N/A N/A 0% 0% N/A Takada et al. (2017)
6-OPRI 63 Cog D, Front, Cbr Atx MM (30) 31.4 MV (10) 41.7 MM (19) 11.4Y, MV (8) 8.9Y N/A N/A 0% 0% Mead et al. (2006)
6-OPRI* Cis M (3) Cis V (2) 5 Cog, Cbr Atx Cis M 35±2.6 (32–37) Cis V (47–51) Cis M 5.9±3(3–9) years Cis V (5–10) months FHx score 2(n = 5) 0% (0/2) 0% (0/2) 0% (0/2) 0% (0/5) JCD (4/4) Takada et al. (2017)
7-OPRI Cis M/Cis V 16 Cog, Behav Motor 35 ±12.4 (18–59) 8.4 ±4.9, (0.6–17) 86% (6/7) N/A N/A 33.3% (1/3) 50% (1/2) Cis M no PrP-Plqs Cis V Uni-, multicentric PrP-Plqs Goldfarb et al. (1991); Tateishi et al. (1991); Brown et al. (1992); Dermaut et al. (2000) Lewis et al. (2003); Cannella et al. (2007) Wang et al. (2007); Guo et al. (2008); Mauro et al. (2008); Jansen et al. (2011)
8-OPRI Cis M (4) 11 Psy, D Mean 28 (21–34) Mean 3.8 (1–7) years 100% (11/11) N/A N/A 0% (0/3) 0% (0/2) Kuru, multicentric PrP-Plqs GSS Laplanche et al. (1999)
8-OPRI* MM 1 Dep, Cbr Atx 22 >5 yearse FHx score 0 N/A N/A N/A 0% N/A Takada et al. (2017)
9-OPRI Cis M (2) Unknown (1) 3 Cbr Atx Fall, Cog Behav, Cog 47±13 (32–55) (7 months–2.5 years) N/A N/A N/A 0% (0/1) 0% (0/1) Numerous small PrP plaqs Owen et al. (1992); Duchen et al. (1993); Krasemann et al.(1995)
9-OPRI* VV (1) 1 Visuosp, Cog 47 21 months FHx score 0 N/A 100% (1/1) 100% (1/1) 100% (1/1) JCD+ GSS Takada et al. (2017)
12-OPRI N/A 3 Cog, Behav, Cbr Atx, Sz 44 ± 1 (43–45) 8±1.7 (7–10) 100% (3/3) 0% (0/1) 100% (1/1) 0% (0/1) 0% (0/1) Multicentric PrP-Plqs GSS Kumar et al. (2011)
a

Positive family history of dementia with similar clinical features (as of the proband) or prion disease (PrD). For UCSF family history (FHx) score scale: 0 when there was no positive family medical history suspicious for or known PrD; 1 when there was at least one first-degree relative with dementia, encephalopathy, or movement disorder; or 2 in patients who were part of families with known PRNP mutations, or had positive history for clinical or path-proven PrDs.

b

According to most commonly used European 2009 and UCSF 2011 criteria (Zerr et al., 2009; Vitali et al., 2011).

c

Data on age at onset and duration of disease are shown as mean ± sd (range), unless otherwise indicated.

d

Positive if > total tau 1200 pg/mL.

e

Some patients still alive, so duration at last follow-up.

If there are differences between data published in the literature from the more recently published University of California, San Francisco (UCSF) cohort, this information is provided in the table separately for that mutation. Atx, ataxia; Cbr, cerebellar; c/w, consistent with; Behav, behavioral changes; Cog, cognitive; CSF, cerebrospinal fluid; D, dementia; Dep, depression; EEG, electroencephalogram; FHx, family history; Front, frontal-lobe dysfunction; GSS, Gerstmann–Sträussler–Scheinker; JCD, Jakob–Creutzfeldt disease; MRI, magnetic resonance imaging; Myo, myoclonus; N/A, not available; Neu, neuronal; OPRD, octapeptide repeat deletion; OPRI, octapeptide repeat insertion mutation; PrP-Plqs, PrP-amyloid plaques; PSWC, periodic sharp-wave complexes; Psy, psychiatric changes; RPD, rapidly progressive dementia; Sz, seizures; Visuosp, visuospatial.