Congruently, the expanding spectrum of dominant and recessive mutations affecting the OPA1 protein has been reflected into a progressively larger landscape of clinical phenotypes linked to OPA1 dysfunction, including the vast catalog of the so-called DOA plus syndromes (14, 15) dominated by neurodegeneration and multisystem involvement (24), including multiple sclerosis (25, 26), Parkinsonism and dementia (18, 27), infantile Leigh syndrome (28), and cardiomyopathy (17). The gene discussed is OPA1; the disease is Parkinsonism.