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The Journal of Headache and Pain

Official Journal of the "European Headache Federation" and of "Lifting The Burden - The Global Campaign against Headache"

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Volume 16 Supplement 1

1st Joint ANIRCEF-SISC Congress

Open Access

O056. Migraine as presenting symptom of SLC20A2gene mutations

  • Elisa Rubino1, 2Email author,
  • Elisa Giorgio3,
  • Innocenzo Rainero1,
  • Patrizia Ferrero1,
  • Salvatore Gallone4,
  • Flora Govone1,
  • Lorenzo Pinessi1, 4,
  • Laura Orsi4,
  • Sergio Duca2 and
  • Alfredo Brusco3, 5
The Journal of Headache and Pain201516(Suppl 1):A121

Published: 28 September 2015


MigraineGlobus PallidusFrameshift MutationDentate NucleusSLC20A2 Gene


Idiopathic basal ganglia calcifications (IBGC), also known as Fahr's disease, are neurological diseases characterized by symmetric calcium deposits in basal ganglia and other brain regions. Clinically, IBGC patients show high phenotypic heterogeneity, both in the clinical manifestations and neuroradiological findings. Recently, PDGFRB, PDGFB, XPR1 and SLC20A2 have been identified as causative genes for IBGC[1].

The aim of this study was to report on two Italian patients with idiopathic basal ganglia calcifications associated with novel mutations in the SLC20A2 gene who both presented with episodic migraine.

Materials and methods

Two 48-year-old unrelated women presented to the Headache Center, Department of Neuroscience “Rita Levi Montalcini”, University of Torino, with a long-lasting history of headache. The reported symptoms fulfilled ICHD-III beta version criteria for episodic migraine without aura (code 1.1). Computed tomography scans showed in both cases severe calcifications at the bilateral globus pallidus, caudate nuclei, putamen, and dentate nuclei. On the basis of neuroradiological findings, SLC20A2 gene was sequenced.


A novel missense mutation Gly63Asp (exon 1) and a frameshift mutation p.Val507Glufs*2 (c.1520_1521delTG, exon 8) in the isoform 1 of the SLC20A2 gene were identified. In silico analysis showed that the first substitution was predicted to have a damaging role. For the frameshift mutation, the genetic variant was found to change an aminoacid and insert a stop codon, likely leading to a degradation of the mutated messenger RNA.

Discussion and conclusions

The clinical manifestations in patients with IBGC range widely from neurological and psychiatric symptoms to asymptomatic status[2]. We suggest that migraine should be considered when evaluating patients with IBGC and first-degree relatives, in particular in young age, when other neurological symptoms are absent. The identification of new genetic variants further enlarge the spectrum of mutations in SLC20A2, helping to better elucidate the worldwide distribution and the different clinical features.

Written informed consent to publication was obtained from the patient(s).

Authors’ Affiliations

Department of Neuroscience “Rita Levi Montalcini”, University of Torino, Turin, Italy
Koelliker Hospital, Turin, Italy
Department of Medical Sciences, University of Torino, Turin, Italy
Department of Neuroscience and Mental Health, A.O.U. Città della Salute e della Scienza, Turin, Italy
Medical Genetics, A.O.U. Città della Salute e della Scienza, Turin, Italy


  1. Wang C, Li Y, Shi L, Ren J, et al: Mutations in SLC20A2 link familial idiopathic basal ganglia calcification with phosphate homeostasis. Nat Genet. 2012, 44: 254-256. 10.1038/ng.1077.View ArticlePubMedGoogle Scholar
  2. Nicolas G, Pottier C, Charbonnier C, et al: Phenotypic spectrum of probable and genetically-confirmed idiopathic basal ganglia calcification. Brain. 2013, 136: 3395-3407. 10.1093/brain/awt255.View ArticlePubMedGoogle Scholar


© Rubino et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.


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