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Perry syndrome is a rare inherited neurodegenerative disorder characterized by rapidly progressive early-onset parkinsonism, central hypoventilation, weight loss, insomnia and depression.
Features include always present findings: Muscle stiffness (rigidity), Primitive reflex, Parkinsonism, and Akinesia; and very common findings: Lack of interest or motivation (apathy). 27 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Brain and nerves | 15 | Slowness of movement (bradykinesia), Frontotemporal dementia, Dystonia |
DCTN1 encodes dynactin subunit 1 (1,278 aa). Part of the dynactin complex that activates the molecular motor dynein for ultra-processive transport along microtubules. Highest expression in Brain Cerebellar Hemisphere (212.6 TPM) and Brain Cerebellum (206.3 TPM).
Perry syndrome is associated with mutations in the DCTN1 gene on chromosome 2.
The DCTN1 protein participates in DCTN1(1-1177)-ALK(1058-1620) fusion, DCTN1(1-599)-ALK(1058-1620) fusion, and DCTN1(1-1065)-ALK(1058-1620) fusion pathways.
DCTN1 is classified as a druggable target with score 4.4.
DCTN1-related neurodegeneration should be suspected in individuals with any combination of the following clinical features, family history of the following features, or neuroimaging findings.
Clinical findings
Parkinsonism
Mood/personality/cognitive changes (depression, apathy, withdrawal, disinhibition, dementia)
No approved treatments are currently available for Perry syndrome. The disease remains an area of unmet medical need.
Evaluations Following Initial Diagnosis To establish the extent of disease and needs in an individual diagnosed with DCTN1-related neurodegeneration, the evaluations summarized (if not performed as part of the evaluation that led to the diagnosis) are recommended. Table 3. Recommended Evaluations Following Initial Diagnosis in Individuals with DCTN1-Related Neurodegeneration
Evaluate weight and calorie intake, respiratory function (particularly at night or during sleep), motor function, and mood/personality changes annually or more frequently as needed.
Source: GeneReviews — "DCTN1-Related Neurodegeneration"
Phenotype severity distribution: 4 always present features, 1 very common feature, 7 common features.
No clinical trials have been registered for Perry syndrome.
10 publications have been identified in PubMed for Perry syndrome. Research spans Case Report / Case Series (30%), Other (20%), and Basic Science / Preclinical (20%).
Research Type | Count | % of Total |
|---|---|---|
Patient case studies | 3 | 30% |
Data assembled from 7 of 12 sources · Last updated Sep 19, 2026, 11:33 AM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center
Common questions about Perry syndrome
Lungs and breathing |
4 |
Respiratory arrest, Hypoventilation, Difficulty breathing (respiratory insufficiency) |
Growth and development | 1 | Weight loss |
The spectrum of DCTN1-related neurodegeneration includes Perry syndrome, distal hereditary motor neuronopathy type 7B (dHMN7B), frontotemporal dementia (FTD), motor neuron disease / amyotrophic lateral sclerosis (ALS), and progressive supranuclear palsy. Some individuals present with overlapping phenotypes (e.g., FTD-ALS, Perry syndrome-dHMN7B) . In most families, the phenotype is consistent among affected family members. However, not infrequently, the same DCTN1 pathogenic variant may manifest with a different clinical phenotype even within the same family.
The cardinal signs of Perry syndrome are parkinsonism, neuropsychiatric symptoms, hypoventilation, and weight loss . The mean age of onset is 49 years (range: 35-70 years); the mean disease duration is five years (range: 2...
Source: GeneReviews — "DCTN1-Related Neurodegeneration"
No clear genotype-phenotype correlations have been identified. While affected family members often share the same phenotype, intrafamilial variability has also been reported. For example, individuals from one Chinese family with the same DCTN1 pathogenic variant presented with dHMN7B, Perry syndrome, or overlapping features of dHMN7B-Perry syndrome .
Source: GeneReviews — "DCTN1-Related Neurodegeneration"
Although precise estimates have not been calculated given the limited number of families reported, penetrance is age related and high, with all asymptomatic heterozygotes being younger than or within the range of age of onset.
Source: GeneReviews — "DCTN1-Related Neurodegeneration"
Weight loss
Breathing disturbances (in particular central hypoventilation)
Muscle atrophy
Autonomic dysfunction
Vocal fold paralysis
Facial weakness
Family history is consistent with autosomal dominant inheritance (e.g., affected males and females in multiple generations). Absence of a known family history does not preclude the diagnosis. Neuroimaging and other studies [, , , , , , , , , , , , ]
Source: GeneReviews — "DCTN1-Related Neurodegeneration"
Table 2. Disorders of Interest in the Differential Diagnosis of DCTN1-Related Neurodegeneration
Phenotype | Gene | Disorder | MOI | Comment |
|---|---|---|---|---|
DNAJC6 | PARK-DNAJC6(OMIM 615528) | AR | Findings of personality changes, weight loss, hypoventilation in Perry syndrome tend to distinguish it from other forms of early-onset PD. Also, response to standard doses of levodopa is usually poorer or of shorter duration in Perry syndrome than in other forms of early-onset PD. | — |
FBXO7 | PARK-FBXO7(OMIM 260300) | AR LRRK2 | PARK-LRRK2 | — |
AD PARK7(DJ-1) | PARK-DJ1(OMIM 606324) | AR PINK1 | PARK-PINK1 | AR PRKN |
SYNJ1 | PARK-SYNJ1(OMIM 615530) | AR | — | — |
VPS13C | PARK-VPS13C(OMIM 616840) | AR Frontotemporal dementia | C9orf72 | — |
C9orf72-FTD/ALS | AD | DCTN1-related FTD other causes of FTD may share mood/ personality changes, similar age of onset, levodopa-resistant parkinsonism. Weight loss, breathing disturbances, muscle atrophy, dysautonomia suggest DCTN1-related disorder. GRN | GRN-FTD | AD MAPT1 |
MAPT | Progressive supranuclear palsy 1 (See MAPT-FTD.) | AD | MAPT- DCTN1-related PSP may share features of bvFTD. Weight loss, breathing disturbances, muscle atrophy, dysautonomia suggest DCTN1-related disorder. | — |
Source: GeneReviews — "DCTN1-Related Neurodegeneration"
Genetic testing for DCTN1 is available. Testing is considered confirmatory for diagnosis.
Biomarker and diagnostic research for Perry syndrome has been reported in the published literature.
System/Concern | Evaluation | Comment |
|---|
Neurologic | Neurologic eval of motor non-motor function | Pulmonary |
nutrition | Assessment of swallowing caloric intake | Genetic |
counseling | By genetics professionals1 | To inform affected persons their families re nature, MOI, implications of DCTN1-related neurodegeneration to facilitate medical personal decision making Family support resources |
Source: GeneReviews — "DCTN1-Related Neurodegeneration"
Use of central respiratory depressants (e.g., benzodiazepines, alcohol, narcotics) should be minimized.
Source: GeneReviews — "DCTN1-Related Neurodegeneration"
Search ClinicalTrials.gov in the US and EU Clinical Trials Register in Europe for access to information on clinical studies for a wide range of diseases and conditions. Note: There may not be clinical trials for this disorder.
Source: GeneReviews — "DCTN1-Related Neurodegeneration"
View trials for Perry syndrome
Estimated prevalence: <1 in 1,000,000 (VERY_RARE).
2 |
20% |
Laboratory research | 2 | 20% |
Testing and diagnosis research | 1 | 10% |
Research summaries | 1 | 10% |
Disease patterns and progression | 1 | 10% |
Lorenzo-Barreto P (2026). [PMID: 41921430](https://pubmed.ncbi.nlm.nih.gov/41921430/). *Parkinsonism Relat Disord*. [Other]
Chmiela T (2026). [PMID: 41378835](https://pubmed.ncbi.nlm.nih.gov/41378835/). *Expert Rev Neurother*. [Review / Meta-Analysis]
Alster P (2026). [PMID: 41898177](https://pubmed.ncbi.nlm.nih.gov/41898177/). *Biomedicines*. [Diagnostic / Biomarker]
Takezaki Y (2026). [PMID: 41864034](https://pubmed.ncbi.nlm.nih.gov/41864034/). *Parkinsonism Relat Disord*. [Other]
Xie V (2025). [PMID: 41463293](https://pubmed.ncbi.nlm.nih.gov/41463293/). *Biomolecules*. [Basic Science / Preclinical]
Hou X (2025). [PMID: 41271780](https://pubmed.ncbi.nlm.nih.gov/41271780/). *NPJ Genom Med*. [Epidemiology / Natural History]
Take Y (2025). [PMID: 39864870](https://pubmed.ncbi.nlm.nih.gov/39864870/). *Rinsho Shinkeigaku*. [Case Report / Case Series]
Pickles SR (2025). [PMID: 39788898](https://pubmed.ncbi.nlm.nih.gov/39788898/). *Mov Disord*. [Basic Science / Preclinical]
Lee B (2025). [PMID: 40665686](https://pubmed.ncbi.nlm.nih.gov/40665686/). *J Neuromuscul Dis*. [Case Report / Case Series]
Flores-Lagunes L (2024). [PMID: 38978535](https://pubmed.ncbi.nlm.nih.gov/38978535/). *Biomed Rep*. [Case Report / Case Series]