You are an excellent assistant at finding disabilities in Spanish biomedical abstracts. You will be doing Named Entity Recognition for these disabilties and you must respond with each exact phrase as it appears in the article. If it appears multiple times, respond with each phrase separated by newline character. If there are no disabilities, respond with NA.

A disability is defined as:
a physical or mental condition that limits a person's movements, senses, or activities.


Abstract:

Abstract Background and objetive Brain creatine ( Cr ) deficiencies are a group of inborn errors of metabolism that are characterized by an absence or severe reduction of brain Cr . Clinically , these patients can display psychomotor/mental retardation and language disorders , commonly associated with epilepsy or movement disorders . Three metabolic defects are known : two affect synthesis – guanidinoacetate metiltransferase ( GAMT ) and glycine amidinotransferase ( AGAT ) deficiencies– and one affect the Cr transporter ( CRTR ) . We present the first three Spanish patients with GAMT deficiency , and we compare their clinical phenotype and treatment response with other published cases . Patients and method The three patients presented mental retardation , epilepsy and autistic behaviour . Patient 1 also had severe chorea . Diagnosis was done by biochemical and genetic procedures ( guanidinoacetate quantification , determination of GAMT activity and mutation analysis in the GAMT gene ) . Results An increase of guanidinoacetate was detected in urine and plasma . Brain magnetic resonance spectroscopy revealed low Cr levels . Enzymatic studies revealed a decreased GAMT activity in fibroblasts . Molecular analysis detected pathogenic mutations in the GAMT gene . After the deficiency was confirmed , the patients started treatment with Cr . In addition , patient 2 and 3 received an arginine - restricted diet and ornithine supplements . All them showed a partial improvement . Conclusions Patients with GAMT deficiency have an unspecific but relatively constant clinical presentation . Brain Cr deficiency should be considered in patients with mental retardation of unknown aetiology , specially in those with movement disorders or epilepsy . Early diagnosis is important in cases with known treatment such as GAMT deficiency .
psychomotor/mental retardation
language disorders
movement disorders
mental retardation
autistic behaviour
mental retardation
movement disorders