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                  <mods:namePart>Garone, Caterina</mods:namePart>
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                  <mods:namePart>Mootha, Vamsi K</mods:namePart>
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               <mods:identifier type="citation">Garone C, Donati MA, Sacchini M, et al. Mitochondrial Encephalomyopathy Due to a Novel Mutation in ACAD9. JAMA Neurol. 2013;70(9):1177–1179. doi:10.1001/jamaneurol.2013.3197</mods:identifier>
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               <mods:identifier type="doi">10.1001/jamaneurol.2013.3197</mods:identifier>
               <mods:abstract>Importance  Mendelian forms of complex I deficiency are usually associated with fatal infantile encephalomyopathy. Application of “MitoExome” sequencing (deep sequencing of the entire mitochondrial genome and the coding exons of >1000 nuclear genes encoding the mitochondrial proteome) allowed us to reveal an unusual clinical variant of complex I deficiency due to a novel homozygous mutation in ACAD9. The patient had an infantile-onset but slowly progressive encephalomyopathy and responded favorably to riboflavin therapy.&#xd;
&#xd;
Observation  A 13-year-old boy had exercise intolerance, weakness, and mild psychomotor delay. Muscle histochemistry showed mitochondrial proliferation, and biochemical analysis revealed severe complex I deficiency (15% of normal). The level of complex I holoprotein was reduced as determined by use of Western blot both in muscle (54%) and in fibroblasts (57%).&#xd;
&#xd;
Conclusions and Relevance  The clinical presentation of complex I deficiency due ACAD9 mutations spans from fatal infantile encephalocardiomyopathy to mild encephalomyopathy. Our data support the notion that ACAD9 functions as a complex I assembly protein. ACAD9 is a flavin adenine dinucleotide–containing flavoprotein, and treatment with riboflavin is advisable.</mods:abstract>
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                  <mods:title>Mitochondrial Encephalomyopathy Due to a Novel Mutation in ACAD9</mods:title>
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