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Our aim was to characterize the clinical and genetic spectrum, in addition to the natural history of BAG3-NMDs in Europe.In this multicentre retrospective study, we collected clinical, ancillary and genetic data of patients with NMD and BAG3 variants, identified from European paediatric and adult neuromuscular reference centres from May to December 2023 following a call circulated through the European Reference Network EURO-NMD and other partners. Responses were received from 35 centres in 17 countries. Twenty-six patients (65.4% males, 34.6% females) with BAG3-NMD from 18 different families were included in Keywords: BAG3; neuromyopathy; cardiomyopathy; autophagy Author: Gorka Fernández-Eulate Creator: Servigistics Arbortext Advanced Print Publisher 11.1.4546/W-x64 Producer: PDFlib+PDI 9.0.7p3 (C++/Win64) CreationDate: Tue Dec 2 19:32:49 2025 CET ModDate: Thu Dec 4 12:47:24 2025 CET Custom Metadata: yes Metadata Stream: yes Tagged: yes UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 612.283 x 790.866 pts Page rot: 0 File size: 1048357 bytes Optimized: yes PDF version: 1.6 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- IAATOD+CaeciliaLTStd-Roman Type 1C Custom yes yes yes 1369 0 FLFWUV+CaeciliaLTStd-Bold Type 1C Custom yes yes yes 1372 0 ZWJDUZ+CaeciliaLTStd-BoldItalic Type 1C Custom yes yes yes 1375 0 KTJHQA+CaeciliaLTStd-Italic Type 1C Custom yes yes yes 1378 0 DNEGRY+STIXGeneral-Regular Type 1C Custom yes yes yes 1381 0 GONIWG+CaeciliaLTStd-Heavy Type 1C Custom yes yes yes 135 0 NTYLWZ+TimesNewRomanPSMT CID TrueType Identity-H yes yes yes 132 0 KIBYBR+STIXGeneral-Bold Type 1C Custom yes yes yes 173 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-10-15 04:26:04 CEST RepresentationInformation: 337105.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-10-14 18:13:30 CEST Size: 1048357 Format: PDF Version: 1.6 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf Profile: Linearized PDF, Tagged PDF PDFMetadata: Objects: 0 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: false CenterWindow: false DisplayDocTitle: true NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: OneColumn PageMode: UseOutlines Language: en Outlines: Item: Title: Disease spectrum and long-term prognosisof patients with BAG3-associatedneuromuscular diseases in Europe Children: Item: Title: Introduction Destination: secawaf223-s1 Item: Title: Materials and methods Destination: secawaf223-s2 Children: Item: Title: Study design and population Destination: secawaf223-s2.1 Item: Title: Clinical and ancillary data Destination: secawaf223-s2.2 Item: Title: Genetics Destination: secawaf223-s2.3 Item: Title: Statistical analysis Destination: secawaf223-s2.4 Item: Title: Results Destination: secawaf223-s3 Children: Item: Title: Patient series and genetics Destination: secawaf223-s3.1 Item: Title: Baseline characteristics Destination: secawaf223-s3.2 Children: Item: Title: Patient group carrying the p.(Pro209Leu) variant&italic/; Destination: secawaf223-s3.2.1 Item: Title: Patient group carrying other BAG3-NMD variants&italic/; Destination: secawaf223-s3.2.2 Item: Title: Long-term outcomes Destination: secawaf223-s3.3 Item: Title: Other genotype phenotype considerations Destination: secawaf223-s3.4 Item: Title: Discussion Destination: secawaf223-s4 Children: Item: Title: BAG3-NMD is a rare disease with two distinct genetic subgroups Destination: secawaf223-s4.1 Item: Title: The cardiomyopathy in p.(Pro209Leu) patients is restrictive and severe Destination: secawaf223-s4.2 Item: Title: Fast disease progression in p.(Pro209Leu) patients argues in favour of proactive and anticipatory management Destination: secawaf223-s4.3 Item: Title: Conclusion Destination: secawaf223-s5 Item: Title: Data availability Destination: secawaf223-s6 Item: Title: Acknowledgements Destination: acknow Item: Title: Funding Destination: secawaf223-s7 Item: Title: Competing interests Destination: secawaf223-s8 Item: Title: Supplementary material Destination: secawaf223-s9 Item: Title: References Destination: reflist Filters: FilterPipeline: FlateDecode FilterPipeline: DCTDecode Images: Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 2236 ImageHeight: 254 BitsPerSample: 8 BitsPerSampleUnit: integer Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 1350 ImageHeight: 774 BitsPerSample: 8 BitsPerSampleUnit: integer Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 1350 ImageHeight: 1335 BitsPerSample: 8 BitsPerSampleUnit: integer Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 1350 ImageHeight: 1307 BitsPerSample: 8 BitsPerSampleUnit: integer Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 1350 ImageHeight: 791 BitsPerSample: 8 BitsPerSampleUnit: integer Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 1350 ImageHeight: 722 ColorSpace: RGB BitsPerSample: 8 BitsPerSampleUnit: integer Fonts: Type0: Font: BaseFont: NTYLWZ+TimesNewRomanPSMT Encoding: Identity-H ToUnicode: true Type1: Font: BaseFont: KTJHQA+CaeciliaLTStd-Italic FontSubset: true FirstChar: 1 LastChar: 46 FontDescriptor: FontName: KTJHQA+CaeciliaLTStd-Italic Flags: Nonsymbolic, Italic FontBBox: -166, -270, 1053, 915 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: DNEGRY+STIXGeneral-Regular FontSubset: true FirstChar: 1 LastChar: 7 FontDescriptor: FontName: DNEGRY+STIXGeneral-Regular Flags: Nonsymbolic FontBBox: -995, -455, 2000, 1055 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: GONIWG+CaeciliaLTStd-Heavy FontSubset: true FirstChar: 1 LastChar: 31 FontDescriptor: FontName: GONIWG+CaeciliaLTStd-Heavy Flags: Nonsymbolic, ForceBold FontBBox: -170, -277, 1146, 970 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: IAATOD+CaeciliaLTStd-Roman FontSubset: true FirstChar: 1 LastChar: 104 FontDescriptor: FontName: IAATOD+CaeciliaLTStd-Roman Flags: Nonsymbolic FontBBox: -167, -270, 1136, 926 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: FLFWUV+CaeciliaLTStd-Bold FontSubset: true FirstChar: 1 LastChar: 70 FontDescriptor: FontName: FLFWUV+CaeciliaLTStd-Bold Flags: Nonsymbolic, ForceBold FontBBox: -166, -273, 1141, 938 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: KIBYBR+STIXGeneral-Bold FontSubset: true FirstChar: 1 LastChar: 3 FontDescriptor: FontName: KIBYBR+STIXGeneral-Bold Flags: Nonsymbolic, ForceBold FontBBox: -1030, -455, 2000, 1055 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: ZWJDUZ+CaeciliaLTStd-BoldItalic FontSubset: true FirstChar: 1 LastChar: 7 FontDescriptor: FontName: ZWJDUZ+CaeciliaLTStd-BoldItalic Flags: Nonsymbolic, Italic, ForceBold FontBBox: -169, -273, 1082, 932 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true CIDFontType2: Font: BaseFont: NTYLWZ+TimesNewRomanPSMT CIDSystemInfo: Registry: Adobe Registry: Identity Supplement: 0 FontDescriptor: FontName: NTYLWZ+TimesNewRomanPSMT Flags: Nonsymbolic FontBBox: -568, -307, 2046, 1040 FontFile2: true XMP: uuid:bc35eab6-6f97-48b9-b35a-ae66574776fc uuid:A4B214D5-AE1D-A113-B71F-039877E687CB True BAG3; neuromyopathy; cardiomyopathy; autophagy PDFlib+PDI 9.0.7p3 (C++/Win64) application/pdf 10.1093/brain/awaf223 en Oxford University Press Disease spectrum and long-term prognosis of patients with BAG3-associated neuromuscular diseases in Europe Gorka Fernández-Eulate Cyril Gitiaux Simone Thiele Heinz Jungbluth Anna Potulska-Chromik Chiara Marini-Bettolo Jean Baptiste Davion Germán Morís Eduard Gallardo Montse Olivé Carlos Pablo de Fuenmayor-Fernández de la Hoz Frederique Audic Arnaud Isapof Maggie C. Walter Corrado Angelini Enrico Bertini Ulrike Schara-Schmidt Kristl G. Claeys Maike F. Dohrn Mohamed Dembele Frédéric Fer Guy Brochier Teresinha Evangelista Anna Kostera-Pruszczyk Shahram Attarian Volker Straub Cristina Domínguez-González John Vissing Pascale Richard Corinne Metay Diala Khraiche Karim Wahbi Tanya Stojkovic DOI: 10.1093/brain/awaf223; Brain, 148, 12, 2025-06-10.; Abstract: De novo or autosomal dominant BAG3 gene variants cause a wide range of skeletal and cardiac muscle diseases encompassing Charcot–Marie–Tooth disease, myofibrillar myopathy, cardiomyopathy or a combination of them. Given the severity and rarity of BAG3-neuromuscular diseases (NMDs), series of patients are lacking. Our aim was to characterize the clinical and genetic spectrum, in addition to the natural history of BAG3-NMDs in Europe.In this multicentre retrospective study, we collected clinical, ancillary and genetic data of patients with NMD and BAG3 variants, identified from European paediatric and adult neuromuscular reference centres from May to December 2023 following a call circulated through the European Reference Network EURO-NMD and other partners. Responses were received from 35 centres in 17 countries. Twenty-six patients (65.4% males, 34.6% females) with BAG3-NMD from 18 different families were included in © The Author(s) 2025. Published by Oxford University Press on behalf of the Guarantors of Brain. BAG3 neuromyopathy cardiomyopathy autophagy Journal Brain © The Author(s) 2025. 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320, 475, 329, 483 Flags: Print Destination: 21 Annotation: Subtype: Link Rect: 320, 433, 329, 441 Flags: Print Destination: 21 Annotation: Subtype: Link Rect: 320, 391, 329, 399 Flags: Print Destination: 21 Annotation: Subtype: Link Rect: 320, 360, 329, 367 Flags: Print Destination: 21 Annotation: Subtype: Link Rect: 320, 318, 329, 325 Flags: Print Destination: 21 Annotation: Subtype: Link Rect: 320, 286, 329, 294 Flags: Print Destination: 24 Annotation: Subtype: Link Rect: 320, 244, 329, 252 Flags: Print Destination: 28 Annotation: Subtype: Link Rect: 320, 213, 329, 220 Flags: Print Destination: 32 Annotation: Subtype: Link Rect: 320, 181, 329, 189 Flags: Print Destination: 32 Annotation: Subtype: Link Rect: 320, 139, 329, 147 Flags: Print Destination: 32 Checksum: 84b16f90 Type: CRC32 Checksum: 78dc72db5f942f0f5540e414ea7fe03c Type: MD5 Checksum: 4d7e802e971b8ea3429d83c6efff65510ddbfed6 Type: SHA-1 Checksum: 781ab459dedadd7137a45f33d2193be7ed5ab0e6b96c0ed0cc3e580c7d50e737 Type: SHA-256