What is X-linked Dystonia-Parkinsonism (XDP)?

X-Linked Dystonia Parkinsonism, also called Lubag or DYT3 dystonia, primarily affects men with Filipino ancestry from the Island of Panay. XDP is an inherited neurodegenerative movement disorder that changes over the course of many years, resulting in significant disability. Beginning in adulthood, people with XDP experience movement problems, called dystonia or parkinsonism. Dystonia is a pattern of involuntary, continuous muscle cramping and spasm. Depending on which muscles are affected, dystonia can cause difficulty with speaking, swallowing, coordination, and walking. Parkinsonism is a group of movement difficulties including tremors, slow movements, stiffness, unsteadiness and a shuffling gait. The signs and symptoms of dystonia and/or parkinsonism vary widely between related and unrelated people.

What causes XDP?

XDP is caused by a genetic mutation that can be passed down from parent to child. Recent CCXDP-funded research studies have shown that XDP is most likely caused by a DNA insertion (retrotransposon) in a gene called TAF1. The DNA insertion contains a repetitive sequence, the length of which can vary among patients. The longer repeat sequences can lead to an earlier age of disease onset. One consequence of the insertion is a decrease in TAF1 gene expression.

Where is Panay Island?

Panay is one island in the Philippines, which is in southeast Asia. The Philippines has a population of roughly 100 million and is made up of over 7,000 islands. Panay is part of a group of islands called the Visayas in the central part of the Philippines. Panay is divided into five provinces; Aklan, Antique, Capiz, Iloilo and Guimaras (a small island off Panay).

There are more than 12 million people of Filipino descent who live overseas in many countries around the world, including the United States.

Is Genetic Testing Available?

Genetic testing for XDP is available, and the MGH Dystonia Clinic provides genetic counseling to patients who may be considering this option. Trisha Multhaupt-Buell, MS, LCGC, is a genetic counselor specializing in hereditary forms of dystonia, including XDP. She works with patients who may be contemplating genetic testing for XDP to explain the options and assist them in determining if testing is appropriate for them. Please contact Ms. Multhaupt-Buell at tmulthaupt-buell@mgh.harvard.edu for additional information.

What are Treatment Options for Patients?

Are there resources for patients in the Philippines?

group photo
The team from the Sunshine Care Foundation

The Center is dedicated to helping families in the Philippines by providing better access to medicines, clinical care and emotional support. We have employed a network of community advocates on Panay island to help us understand the daily struggles patients face and the barriers that often prevent access to medical care. Learn more about our work in the Philippines and our partner, The Sunshine Care Foundation.