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Background: Myofibrillar myopathies (MFM) are a group of phenotypically and genetically heterogeneous neuromuscular disorders, which are characterized by protein aggregations in muscle fibres and can be associated with multisystemic involvement.
Methods: We screened a large cohort of 38 index patients with MFM for mutations in the nine thus far known causative genes using Sanger and next generation sequencing (NGS). We studied the clinical and histopathological characteristics in 38 index patients and five additional relatives (n = 43) and particularly focused on the associated multisystemic symptoms.
Results: We identified 14 heterozygous mutations (diagnostic yield of 37%), among them the novel p. Pro209Gln mutation in the BAG3 gene, which was associated with onset in adulthood, a mild phenotype and an axonal sensorimotor polyneuropathy, in the absence of giant axons at the nerve biopsy. We revealed several novel clinical phenotypes and unusual multisystemic presentations with previously described mutations: hearing impairment with a FLNC mutation, dysphonia with a mutation in DES and the first patient with a FLNC mutation presenting respiratory insufficiency as the initial symptom. Moreover, we described for the first time respiratory insufficiency occurring in a patient with the p. Gly154Ser mutation in CRYAB. Interestingly, we detected a polyneuropathy in 28% of the MFM patients, including a BAG3 and a MYOT case, and hearing impairment in 13%, including one patient with a FLNC mutation and two with mutations in the DES gene. In four index patients with a mutation in one of the MFM genes, typical histological findings were only identified at the ultrastructural level (29%).
Conclusions: We conclude that extraskeletal symptoms frequently occur in MFM, particularly cardiac and respiratory involvement, polyneuropathy and/or deafness. BAG3 mutations should be considered even in cases with a mild phenotype or an adult onset. We identified a genetic defect in one of the known genes in less than half of the MFM patients, indicating that more causative genes are still to be found. Next generation sequencing techniques should be helpful in achieving this aim.
In this work heterostructures based on the half-Heusler alloy NiMnSb have been fabricated and characterized. NiMnSb is a member of the half-metallic ferromagnets, which exhibit an electron spin-polarization of 100% at the Fermi-level. For fabrication of these structures InP substrates with surface orientations of (001),(111)A and (111)B have been used. The small lattice mismatch of NiMnSb to InP allows for pseudomorphic layers, the (111) orientation additionally makes the formation of a half-metallic interface possible. For the growth on InP(001), procedures for the substrate preparation, growth of the lattice matched (In,Ga)As buffer layer and of the NiMnSb layer have been developed. The effect of flux-ratios and substrate temperatures on the MBE growth of the buffer as well as of the NiMnSb layer have been investigated and the optimum conditions have been pointed out. NiMnSb grows in the layer-by-layer Frank-van der Merwe growth mode, which can be seen by the intensity oscillations of the RHEED specular spot during growth. RHEED and LEED measurements show a flat surface and a well-defined surface reconstruction. High resolution x-ray measurements support this statement, additionally they show a high crystalline quality. Measurements of the lateral and the vertical lattice constant of NiMnSb films on (001) oriented substrates show that layers above a thickness of 20nm exhibit a pseudomorphic as well as a relaxed part in the same layer. Whereas layers around 40nm show partly relaxed partitions, these partitions are totally relaxed for layers above 100nm. However, even these layers still have a pseudomorphic part. Depth-dependent x-ray diffraction experiments prove that the relaxed part of the samples is always on top of the pseudomorphic part. The formation and propagation of defects in these layers has been investigated by TEM. The defects nucleate early during growth and spread until they form a defect network at a thickness of about 40nm. These defects are not typical misfit dislocations but rather antiphase boundaries which evolve in the Mn/Sb sublattice of the NiMnSb system. Dependent on the thickness of the NiMnSb films different magnetic anisotropies can be found. For layers up to 15nm and above 25nm a clear uniaxial anisotropy can be determined, while the layers with thicknesses in between show a fourfold anisotropy. Notably the easy axis for the thin layers is perpendicular to the easy axis observed for the thick layers. Thin NiMnSb layers show a very good magnetic homogeneity, as can be seen by the very small FMR linewidth of 20Oe at 24GHz. However, the increase of the linewidth with increasing thickness shows that the extrinsic damping gets larger for thicker samples which is a clear indication for magnetic inhomogeneities introduced by crystalline defects. Also, the magnetic moment of thick NiMnSb is reduced compared to the theoretically expected value. If a antiferromagnetic material is deposited on top of the NiMnSb, a clear exchange biasing of the NiMnSb layer can be observed. In a further step the epitaxial layers of the semiconductor ZnTe have been grown on these NiMnSb layers, which enables the fabrication of NiMnSb/ZnTe/NiMnSb TMR structures. These heterostructures are single crystalline and exhibit a low surface and interface roughness as measured by x-ray reflectivity. Magnetic measurements of the hysteresis curves prove that both NiMnSb layers in these heterostructures can switch separately, which is a necessary requirement for TMR applications. If a NiMn antiferromagnet is deposited on top of this structure, the upper NiMnSb layer is exchange biased by the antiferromagnet, while the lower one is left unaffected. Furthermore the growth of NiMnSb on (111) oriented substrates has been investigated. For these experiments, InP substrates with a surface orientation of (111)A and (111)B were used, which were miscut by 1 to 2° from the exact orientation to allow for smoother surfaces during growth. Both the (In, Ga)As buffer as well as the NiMnSb layer show well defined surface reconstructions during growth. X-ray diffraction experiments prove the single crystalline structure of the samples. However, neither for the growth on (111)A nor on (111)B a perfectly smooth surface could be obtained during growth, which can be attributed to the formation of pyramid-like facets evolving as a result of the atomic configuration at the surface. A similar relaxation behavior as NiMnSb layers on (001) oriented InP could not be observed. RHEED and x-ray diffraction measurements show that above a thickness of about 10nm the NiMnSb layer begins to relax, but remnants of pseudomorphic parts could not be found. Magnetic measurements show that the misorientation of the substrate crystal has a strong influence on the magnetic anisotropies of NiMnSb(111) samples. In all cases a uniaxial anisotropy could be observed. The easy axis is always aligned parallel to the direction of the miscut of the substrate.