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We describe a woman in her early twenties with childhood\u2010onset learning difficulties, progressive dysarthria, tremor, and generalized dystonia with marked cervical predominance, associated with a\n                    <jats:italic>de novo<\/jats:italic>\n                    <jats:italic>TCF20<\/jats:italic>\n                    frameshift variant identified by whole genome sequencing. Quantitative brain MRI demonstrated numerically increased globus pallidus susceptibility and reduced volume compared with controls, without clear evidence of iron accumulation. This case further supports generalized dystonia as a recognizable manifestation of\n                    <jats:italic>TCF20<\/jats:italic>\n                    \u2010related disorders and suggests a possible link between\n                    <jats:italic>TCF20<\/jats:italic>\n                    dysfunction and globus pallidus involvement in dystonia pathophysiology.\n                  <\/jats:p>","DOI":"10.1002\/acn3.70534","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T03:21:40Z","timestamp":1791602500000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Generalized Dystonia With Cervical Predominance in a Patient With a\n                    <i>\n                      De Novo\n                      <scp>TCF20<\/scp>\n                    <\/i>\n                    Variant"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9633-7190","authenticated-orcid":false,"given":"Melisa","family":"Kilic","sequence":"first","affiliation":[{"name":"Department of Genetics Aziz Sancar Institute of Experimental Medicine, Istanbul University  Istanbul T\u00fcrkiye"},{"name":"Institute of Graduate Studies in Health Sciences Istanbul University  Istanbul T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4877-9642","authenticated-orcid":false,"given":"Petr","family":"Dusek","sequence":"additional","affiliation":[{"name":"Department of Neurology Charles University 1st Faculty of Medicine  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8489-8095","authenticated-orcid":false,"given":"Ibrahim","family":"Kamaci","sequence":"additional","affiliation":[{"name":"Department of Neurology Istanbul University Faculty of Medicine  Istanbul T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4014-4079","authenticated-orcid":false,"given":"Bahar","family":"Gulmez","sequence":"additional","affiliation":[{"name":"Department of Neurology Hacettepe University Faculty of Medicine  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8545-7939","authenticated-orcid":false,"given":"Gul Yalcin","family":"Cakmakli","sequence":"additional","affiliation":[{"name":"Department of Neurology Hacettepe University Faculty of Medicine  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8418-2961","authenticated-orcid":false,"given":"Ersin","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Neurology Hacettepe University Faculty of Medicine  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5790-6853","authenticated-orcid":false,"given":"Sibel","family":"Ugur Iseri","sequence":"additional","affiliation":[{"name":"Department of Genetics Aziz Sancar Institute of Experimental Medicine, Istanbul University  Istanbul T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9349-565X","authenticated-orcid":false,"given":"Zuhal","family":"Yapici","sequence":"additional","affiliation":[{"name":"Department of Neurology Istanbul University Faculty of Medicine  Istanbul T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1042\/BJ20111230"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jnc.16297"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41436\u2010019\u20100454\u20109"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2022.07.026"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.14802\/jmd.24007"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2019.02.016"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2119078119"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13073\u2010019\u20100623\u20100"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.14241"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2018.07.065"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.70161"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010024\u201003420\u2010w"}],"container-title":["Annals 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