Neurodegeneration with brain iron accumulation

Handb Clin Neurol. 2018:147:293-305. doi: 10.1016/B978-0-444-63233-3.00019-1.


Neurodegeneration with brain iron accumulation (NBIA) comprises a clinically and genetically heterogeneous group of disorders affecting children and adults. These rare disorders are often first suspected when increased basal ganglia iron is observed on brain magnetic resonance imaging. For the majority of NBIA disorders the genetic basis has been delineated, and clinical testing is available. The four most common NBIA disorders include pantothenate kinase-associated neurodegeneration (PKAN) due to mutations in PANK2, phospholipase A2-associated neurodegeneration caused by mutation in PLA2G6, mitochondrial membrane protein-associated neurodegeneration from mutations in C19orf12, and beta-propeller protein-associated neurodegeneration due to mutations in WDR45. The ultrarare NBIA disorders are caused by mutations in CoASY, ATP13A2, and FA2H (causing CoA synthase protein-associated neurodegeneration, Kufor-Rakeb disease, and fatty acid hydroxylase-associated neurodegeneration, respectively). Together, these genes account for disease in approximately 85% of patients diagnosed with an NBIA disorder. New NBIA genes are being recognized with increasing frequency as a result of whole-exome sequencing, which is also facilitating early ascertainment of patients whose phenotype is often nonspecific.

Keywords: BPAN; INAD; MPAN; NBIA; PKAN; PLAN; infantile neuroaxonal dystrophy; neurodegeneration with brain iron accumulation; pantothenate kinase.

Publication types

  • Review

MeSH terms

  • Brain / metabolism*
  • Carrier Proteins / genetics
  • Group VI Phospholipases A2 / genetics
  • Humans
  • Iron / metabolism*
  • Iron Metabolism Disorders / complications*
  • Iron Metabolism Disorders / genetics
  • Mitochondrial Proteins / genetics
  • Mutation / genetics
  • Neurodegenerative Diseases / complications
  • Neurodegenerative Diseases / genetics
  • Neurodegenerative Diseases / pathology*
  • Phosphotransferases (Alcohol Group Acceptor) / genetics


  • C19orf12 protein, human
  • Carrier Proteins
  • Mitochondrial Proteins
  • WDR45 protein, human
  • Iron
  • Phosphotransferases (Alcohol Group Acceptor)
  • pantothenate kinase
  • Group VI Phospholipases A2
  • PLA2G6 protein, human