{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:13:55Z","timestamp":1792059235201,"version":"4.4.0"},"reference-count":45,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["K08NS123552"],"award-info":[{"award-number":["K08NS123552"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["1U54NS148312"],"award-info":[{"award-number":["1U54NS148312"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001595","name":"Dystonia Medical Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001595","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2026,5]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n ATP1A3<\/jats:italic>\n \u2010related disorders are characterized by genetic heterogeneity and phenotypic pleiotropy, posing significant challenges for classification. Although canonical phenotypes have traditionally guided decision\u2010making, increasing evidence highlights their limitations in capturing the clinical complexity.\n <\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The aims of this study were to characterize movement disorders, paroxysmal features, and genotype\u2013phenotype relationships; to build a curated video archive; and to assess alignment with canonical phenotypes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This is an observational study of 88 individuals with pathogenic or likely pathogenic variants in\n ATP1A3<\/jats:italic>\n who were evaluated in specialized movement disorders programs.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Age at last clinical follow\u2010up ranged from 0.1 to 63\u2009years; 80.7% were pediatric patients. Chronic movement disorders were present in 68 of 88 individuals (75%); most had two or more coexisting phenomenologies. Dystonia was most common (47\/88, 53%), followed by spasticity (28\/88, 32%) and ataxia (28\/92, 32%). Paroxysmal events occurred in 78 of 88 (88%) patients, including dystonic spells (45\/78, 58%), abnormal eye movements (39\/78, 50%), and hemiplegic episodes (37\/78, 47%). Common comorbidities included epilepsy (21\/88, 24%), cognitive impairment (41\/88, 47%), and neuropsychiatric disorders. Only 22 of 88 (25%) fulfilled criteria for a single canonical phenotype; 28 of 88 (32%) met canonical criteria plus additional features, 18 of 88 (20%) satisfied criteria for \u22652 canonical phenotypes, and 20 of 88 (23%) fit no canonical category. We identified 43 distinct\n ATP1A3<\/jats:italic>\n variants; recurrent variants (eg, p.Arg756His, p.Asp801Asn, p.Glu818Lys) showed variable expressivity across categories.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The extensive clinical heterogeneity in\n ATP1A3<\/jats:italic>\n \u2010related disorders challenges rigid phenotypic classifications. The predominance of patients with overlapping or atypical features supports a shift toward flexible, symptom\u2010based clinical approaches rather than strict reliance on canonical phenotype recognition. \u00a9 2026 International Parkinson and Movement Disorder Society.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/mds.70227","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T02:40:33Z","timestamp":1773888033000},"page":"1268-1284","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Movement Disorder Spectrum of\n ATP1A3<\/i>\n \u2010Related Disorders: Cross\u2010Sectional Analysis and Video Archive of 88 Patients"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3387-7623","authenticated-orcid":false,"given":"Katerina","family":"Bernardi","sequence":"first","affiliation":[{"name":"Movement Disorders Program, Department of Neurology & F.M. 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