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Living with Neurodegeneration with brain iron accumulation 6

A very rare, slowly worsening nervous system condition (CoPAN) with movement problems that starts in childhood.

Understanding Neurodegeneration with brain iron accumulation 6

Neurodegeneration with brain iron accumulation 6, or CoPAN (COASY protein-associated neurodegeneration), is a very rare, slowly worsening nervous system condition.

It has the classic features of NBIA. These include early-onset stiffness and muscle spasms in the legs, muscle spasms around the mouth and jaw, slurred speech, Parkinson-like signs, nerve problems, progressive thinking problems, complex tics, and obsessive-compulsive disorder. GARD lists onset in childhood.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Changes in walking
  • Slurred speech (dysarthria)
  • Muscle spasms around the mouth and jaw
  • Parkinson-like symptoms
  • Memory and thinking problems
  • Obsessive-compulsive behaviors

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include brain and nervous system specialists and genetic specialists.

  3. Consider genetic testing

    Changes in COASY are linked to this condition. Genetic testing and counseling can help confirm a diagnosis and explain what it means for your family.

Care & treatment

Care team
Brain and nervous system specialists (neurologists); Genetic specialists (geneticists)
Expert care
Ask about multidisciplinary care centers for rare conditions
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with NBIA Disorders Association and other patient organizations
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Should we have genetic testing for the COASY gene?
Which treatments can help with muscle spasms and movement?
Who can help with tics or obsessive-compulsive behaviors?

Quick facts

Symptoms usually startChild
InheritanceAutosomal Recessive
GenesCOASY

GARD lists changes in the COASY gene. A child inherits a changed copy of the gene from each parent (autosomal recessive).

GeneticNeurological

Also known as: coasy neurodegeneration with brain iron accumulation; coasy protein-associated neurodegeneration; coenzyme a synthase protein associated neurodegeneration; copan; copan - coenzyme a synthase protein associated neurodegeneration; nbia6

Patient organizations

Source: NIH GARD · Neurodegeneration with brain iron accumulation 6GARD ID 12571 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

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