cima case study variants

Exam Resource

Full post exam materials may /august 2021 mcs and gateway.

This document contains the full post exam supporting materials for the May and August 2021 management case study and CIMA gateway exam containing:

pre-seen material
exam variants
suggested solutions
examiners report
marking guidance

How to Pass CIMA Case Study Exams: Detailed Guide to Success

This CIMA case study article shows you how to write an answer that puts you ahead of 90% of candidates, offers expert preparation tips, and increases your chances of obtaining your qualification.

1. How to Pass CIMA Case Study Exams: An Introduction to Our CIMA Exam Experience

In the last five years, we’ve helped over 10,000 CIMA students from 94 countries prepare for and pass their CIMA exams. In that time, VIVA’s tutors have seen every kind of exam answer you can imagine.

As an official CIMA tuition provider, we've seen everything; the good, the bad, and the downright baffling! But more importantly, we’ve also seen what works, and what definitely does not work.

In this article, we’ve compiled all of the key DOs and DON’Ts our CIMA tutors have gleaned from their years marking VIVA students’ CIMA mock exam answers. We see the same kinds of mistakes made over and over again. And the great news for you is — these mistakes can be very quickly rectified to help you pass your CIMA exams the first time around.

The Starting Point: What to Be Aware of before Learning More about CIMA Exam Strategies

The first step is being aware of what to avoid in CIMA exams.

This sets the foundation for you to go on refining and perfecting your approach. As in any other walk of life, perhaps the most important thing is to avoid doing foolish things rather than seeking perfection.

In the words of the very wise Charlie Munger: “It is remarkable how much long-term advantage people like us have gotten by trying to be consistently not stupid, instead of trying to be very intelligent.”

All the advice below comes directly from our CIMA case study professional tutors, who mark thousands of student scripts throughout the year.

If you wish to get your VIVA mock exam answers corrected, check out our CIMA course pages , where you can obtain professional marking services as part of the Elite Course.

2. What to Expect on Exam Day

Before we get into the meat of the matter, let’s just review what exactly you can expect to be presented with on exam day. (Feel free to skip on to the next section if you are already well acquainted with the Case Study exam format):

You will be faced with 1 of 3 CIMA exam variants during any specific exam window (that's a total of 6 variants per pre-seen document under the 2019 CIMA syllabus)
Each variant is broken down into timed sections (maximum of 5, minimum of 3)
Each section will include either emails, records of conversations, schedules of information or combinations of all 3
These give new information that leads on from the pre-seen document information
Within each section, there will be a task or tasks for the candidate to complete (e.g. write a report, write sections of a report, write an email)
These tasks might be embedded in the body of the email or conversation
The task or tasks might include several different elements that pull from different pillars and competencies
Candidates are NOT expected to perform any detailed calculations
Each section will move through time (you cannot go back to a previous section once you move on to a subsequent section)

Of course, the best way to familiarise yourself with the real-life experience of a CIMA case study exam is to practice as many different mock exams as possible.

VIVA's OCS, MCS and SCS courses come with up to 5 different professionally prepared CIMA mock exams based on the current pre-seen, which you can practice online under timed exam conditions.

You’ll also want to review past CIMA exam variants to familiarise yourself with the different question styles that can come up.

However, there’s no substitute for timed practice based on the current pre-seen material – and that’s what you’ll get with us.

Source: Pexels

3. Reading the Question: Establishing the Case Study Exam Tasks and Requirements

One common error that our tutors' report is that students do not answer all the requirements included in the task.

In some cases, of course, this is simply down to the student not knowing how to answer the particular requirement. However, we have seen many scenarios in which students have simply missed the requirement due to not having read the question carefully enough!

Consider the sample below taken from a case study exam:

Here we have examples of what is sometimes called “triggers”. These are the places in the question where the requirements are explicitly stated.

Triggers are sometimes in the form of questions, sometimes not. Look out for phrases like “I need you to”, “I would welcome your suggestions for”, “Please draft”, and “Can you please include in your report”.

These are the sections that you really need to pay close attention to because it is there that you will be presented with the requirements.

As you can see in the screenshot above, there is one “task”, i.e., the report that you must draft. But the task has two requirements.

One is a comparison of financial performance and the other deals with the introduction of the balanced scorecard.

However, notice that each requirement contains several sub-requirements.

In the case of the first requirement, notice the “and.” You have to both “compare” and “analyse the implications.” Too many students will simply read the “Compare” part and completely pass over the analysis of the implications:

Likewise, in the case of the second requirement. There’s even more going on here, so you must pay close attention as you read through these “triggers.”

Not only do you have to offer your “suggestions for the other three quadrants,” but you also have to “explain why we have chosen the measures for each quadrant” and “ how they will influence behaviours in the company.”

All of these elements must be addressed to gain full marks.

But too often, students only pay attention to the first one or two. It is not necessarily the case that the first thing asked is the most important or even carries the most weight in terms of marks!

So, it’s essential that you carefully read these trigger sections thoroughly, making a note of each requirement as you go.

Another crucial point: answer the questions that have been asked!

This might seem obvious, but you'd be surprised how many students fail to do this. There are two main reasons students fail to answer the question asked:

(i) because they answer a question they wish they had been asked instead;

(ii) They don't read the trigger verbs carefully enough and misinterpret what is being asked.

The first reason has to do with the fact that sometimes, students will carefully prepare for particular kinds of questions during their exam preparation or practice. They will feel much more confident about some particular question types than others and will have prepared very effectively for those question types.

So strong is their hope that this kind of question will come up on exam day that when they read a question that is superficially similar, they will "shoehorn" their prepared answer into that question.

The result is an answer that is either only partly relevant or, in the worst case, utterly irrelevant to the question being asked!

So remember: don't let your hopes/preferences/strengths influence the kind of answer that you give. Allow the question to dictate what kind of answer you write.

The second reason students fail to answer the question asked is that they misinterpret a key term or phrase or forget what they were asked after they start writing. Consider the example below: ‍

In this example, an incorrect interpretation of the question might be to think about identifying the "limitations" or "drawbacks" of TQM, instead of the "obstacles" that might be encountered when implementing TQM.

The second part of the requirement is about how to overcome those obstacles. An incorrect interpretation might be "what the benefits of TQM would be, after implementing."

You can see that these are "similar" kinds of questions, but strictly speaking, they are different. So be very careful when reading the requirements or trigger sections that you identify the key verbs and key terms so you are certain that you are answering what is being asked.

A final point: ensure that your answers are in alignment with the question asked.

This is essentially about ensuring that you do not go off task as you write your answer - that your answer tracks the requirement and corresponds to each part of the requirement.

Too often, students go off task, padding or filling out their answers with irrelevant information. While writing each new paragraph, the key is to briefly refer back to the question and quickly ask yourself: "Is this relevant and contributing to answering the question?".

This is a good "check" to ensure you align your answers with the question.

4. Good Structure and Planning Can Help You Pass Your CIMA Case Study Exam

We really can’t overemphasize the importance of proper structure for your answers when it comes to achieving the required CIMA pass rates.

There are three main reasons why structure and careful planning is essential for getting your CIMA certificate:

1. It helps to ensure you have enough points raised to obtain top marks

2. It helps to prevent the duplication of content

3. It makes life easier for the marker – more precisely, it makes it easier for the marker to see that you have indeed addressed each requirement adequately, where you have done so, and how much you have written for each requirement. Consider good structure as being key to a more positive examiner experience.

If you clearly signal where each task starts and ends with headings and sub-headings and give each relevant point a full, separate paragraph, you will be making the examiner’s life easier (a happy examiner is likely to be more generous with marks!).

The post-exam reports ALWAYS mention the importance of structure. An orderly answer indicates an orderly and clear thought process behind your answer and shows evidence of planning.

5. Our Top Tips for CIMA Case Study Exam Structure and Planning

Firstly, a common question from students is: how do I know how many paragraphs to write for each task?

Now sometimes, we get lucky and a task or requirement will say something like: "Identify five risks..." or "Give three benefits...". In such questions, it's obvious how many paragraphs there should be!

For five risks, we will write five paragraphs, one for each risk. For the three benefits, we will write three paragraphs, one for each benefit.

Unfortunately, CIMA isn't always so generous! We are not always given the specific number of points explicitly. And so the question then becomes: how do we decide on the number of paragraphs to write?

The key is to look at the percentage of marks allocated for that particular task. CIMA now includes a percentage allocation for each task.

A good rule of thumb here is that for every 10% allocated to a particular task, you add one paragraph. So if a task is worth, say, 33%, you will write approximately three paragraphs. If a task is worth 60%, you will write about six paragraphs.

Note that this is a "rule of thumb." This, of course, isn't supposed to be a perfect formula, but rather a guideline to get you started.

There may be cases where four paragraphs are sufficient for a 60% task, if the paragraphs are long and substantial enough in terms of content . Nevertheless, this is a useful general guideline.

We recommend that you plan and structure your answers before you begin writing.

However, many people lose valuable time at the beginning of each section planning their answers elaborately on the separate whiteboard provided on exam day. Instead, we recommend planning your answer within the answer box itself, not on the whiteboard or outside of the answer box.

A great way to plan on the fly is to work up a structure and fill in the gaps as you proceed. This forces you to get writing immediately, and by the time your structure is "filled out" the answer pretty much writes itself as you just go back and flesh out each heading and sub-heading:

Requirement A (this would correspond to the first requirement, so use an appropriate title, e.g., “Financial Performance”)

- Paragraph 1 (relates to first major point): idea 1, idea 2, idea 3 (If you have time, it’s worth emphasising the title of this key point by underlining it or putting it in bold, for example)

- Paragraph 2 (relates to second major point): idea 1, idea 2, idea 3

- Paragraph 3 (relates to third major point) etc etc: idea 1, idea 2, idea 3

Requirement B (this would correspond to the second requirement, e.g., "Balanced Scorecard")

…repeat as per above

TASK 2…repeat as per above

Remember, get straight to the point.

Write a 1-2 line introduction at the beginning of your answer, restating briefly what you were asked and the order in which you will address each point in the body of your answer.

Too many students waste time in their opening remarks repeating information we already know or rehearsing irrelevant information.

(You will see in VIVA’s model answers how short the introductions are -> you want to give yourself as much time and space as possible to demonstrate your knowledge and understanding! No marks are given for pleasantries).

It's also a good idea to have a "time plan" for each section of the exam. Now some students worry when they hear this: "ANOTHER PLAN!? Isn't that just going to waste even more of my time!?"

But there is no need to worry here because a time plan is really very simple - but also crucially important! You need to know roughly how much time you can spend on each task so you don't run out of time!

The first thing to do is, note the length of time allocated per section. In the case of the OCS and MCS, that will typically be 45 minutes per section (with 4 sections in total).

In the case of the SCS, it will typically be 60 minutes per section (with 3 sections in total). The next thing to note is that not all of that time will be or can be spent literally answering the question.

Because, of course, some of that time will be needed for reading the question! So it's a good idea to deduct a short amount of time from the total allocated to a section and consider this your "reading time."

A good target is around 5 or 6 minutes maximum for reading the question. The amount left over after you deduct the reading time is the amount that you can allocate to actually writing your answer.

Now, remember: writing your answer should include the planning process. So you don't need to allocate a separate portion of time to the "planning." Consider planning and writing part of the whole answering process.

So after you deduct the reading time, you now need to decide how to allocate the "answer time."

And this is a relatively simple process. Note the percentages allocated to each task/subtask. Then use that to calculate that percentage of the answer time.

So, for example, let's say you have a section of 45 minutes. You deduct 5 minutes for reading time, which leaves 40 minutes.

Let's say there are two tasks: the first one is worth 60%, and the second one is worth 40%.

60% of 40 minutes is 24 minutes. 40% of 40 minutes is 16 minutes.

And there you have it! You would have 24 minutes to write your answer for the first task, and 16 minutes to write your answer for the second task.

7. A Quick Word on CIMA Case Study Answer Length

I'm sure you've all heard the cliche, "it's about quality, not quantity"!

Of course, there's a kernel of truth to that. But let's be realistic: you're not going to pass your exam if you write 2 lines of text, even if they're the best lines ever written by a CIMA student!

So the cliche only gets us so far. The reality is that markers consistently report that longer answers do tend to score higher marks. And that shouldn't be surprising.

Other things being equal, the longer an answer is, the more likely it will contain more points - or more detailed points.

When it comes to the OCS and MCS exams, you should be aiming for a minimum of 2 pages, but ideally, 3 pages in a typical 45-minute section would be best if you want to score well.

Each relevant point you make should get a separate paragraph and be supported by examples, reference to the pre-seen and perhaps the real-life industry if applicable, and relevant theories from the Enterprise, Performance and Financial pillars.

In the case of the SCS exam , you should aim for a minimum of 2.5 pages, but ideally, 3.5 pages + in a typical 60-minute section if you want to score well.

8. What about the Content of Your CIMA Exam Answers?

Of course, we can’t tell you exactly what to write – that depends on the questions asked on the day! But there are some fundamental rules of thumb and principles that you should bear in mind.

(i) Justify and Explain

One very simple but crucial point is the following: you have to justify all your arguments and should explain technical terms.

Now that might appear obvious. But you’d be surprised how frequently students fail to do these basic things. And our tutors believe they know why.

This is the error of assuming that the marker will already know what you are talking about. The thing is, they probably will! But that’s not the point.

The point of the exam is to demonstrate your understanding!

So even if you think your marker will probably know what you mean, you should act as if they might not. Show them that you understand, and leave no room for doubt.

A good tip here is to try to really adopt the role that you have been assigned - and correspondingly, speak to the character whom you are addressing in the scenario as if they really are that person!

That way, you are more likely to consider terms they may not fully understand and give more comprehensive explanations of your arguments and conclusions.

Consider the following passage, which is taken verbatim from a past student’s mock exam answer for the Strategic Case Study of May 2018:

“Mr. Winston, however, may not understand the online streaming industry, where consumers just want to watch movies and tv series without interruptions of advertisements in between. His presence may also de-motivate other employees looking to grow within the business. The cultures may be different and it will take him a long time to get used to the streaming business.”

The student left it at that and then moved on to the following requirement. You should be able to see clearly what is wrong here, even without knowing what question was asked.

Each of the three sentences above could (and should have) been explained. Take the first. The obvious question is: why may Mr. Winston not understand the streaming industry?

Consider then the second sentence. The obvious question here is, why might his presence de-motivate other employees?

There’s a hint when he mentions other employees have been willing to “grow within the business,” but the student still fails to make his argument explicit.

What he might be trying to say is that, given that existing employees have grown with the business and have been loyal to the company for a long time, they might feel some resentment towards an external person being given a high-ranking position – instead of hiring from within the company.

But this is not what the student wrote. And so, he lost potential marks by not spelling it out. In the case of the final sentence, there are two more key points left undeveloped: in what way exactly may the cultures be different? And why might it take Mr. Winston a long time to get used to the business?

It’s clear that these points seemed obvious to the student, but he ultimately lost marks because he did not demonstrate understanding.

What you’ll often find is that, once you begin to explain something that seems to “go without saying,” you actually think of interesting points that you hadn’t considered before or that you had forgotten. You want to give yourself as much opportunity to make as many points as possible in support of your answer.

(ii) Give Specific Examples in Terms of the Pre-seen Company

It is not enough to simply define a theory or principle or even to explain a theory or principle in the abstract.

You have to apply it as well. What does that mean?

Basically, you have to be able to say why or how a particular theory/principle/method is relevant to the specifics of the unseen and pre-seen information.

Ask yourself: How can this theory be applied to the current case? What are some concrete examples of the abstract concepts I am using here in terms of the current company?

To follow my own advice, let’s look at another example from another real student’s answer. In this case, the student is asked to give examples for each category in a cost of quality report (OCS May 2018). The student’s answer to this requirement is as follows:

“A) Examples of costs to be included in each category of the report are as below:

1. Wastage of materials when errors are found.

2. Duplication of workload when errors are found

3. Damage to morale when work has to be repeated

1. Loss of consumer confidence

2. Damage to reputation

3. Cost of replacing the product

1. Invest in better-trained staff to ensure fewer errors in production.

2. Invest in higher quality materials to ensure the material doesn't fail.

3. investment in automating processes to reduce human error

1. Inspection of raw materials on arrival

2. Inspection of completed goods before they leave the factory

Notice that this segment of the answer is quite well-structured. The student uses headings and sub-headings and orders the answer logically.

However, the problem is that the student doesn’t actually give specific examples for each category that are derived from the company in question (a luxury bag manufacturer in this case).

Instead, she gives generic examples that could come from almost any company that manufactures any product. In this case, the student would need to provide specific examples.

So instead of simply saying “wastage of materials when errors are found,” the student should give concrete examples of errors that could occur in the context of this company, a luxury bag manufacturer. What kinds of materials are likely to be wasted? What kinds of errors might be found?

These are the kinds of questions you should be asking yourself when applying a particular theory or model to the current case. The marker needs to see that you can actually use the theories and models you have learned during your objective studies in a real-world scenario and in a realistic way.

This shows you’re ready for the real world as a management accountant! Simply giving generic examples that could equally well apply to any number of companies or scenarios is not sufficient to score full marks.

(iii) Avoid List-style Answers

Another common error is that students will give their answers in the form of bullet points.

Unfortunately, this is not what markers are looking for. It might seem neat and tidy and concise to you, but to a marker, it will simply give the impression of superficial engagement. Lists also give the impression that you are rushing through the answer.

Try to write your answers in prose style. It should be conversational but professional. You are trying to engage with and guide the fictional person who has asked for your assistance. Throwing a list of bullet points without elaboration will not be acceptable!

Now that’s not to say that you can’t use bullet points to structure your answers. But this is different from simply having a list of one-liners alongside bullet points.

You may organize your sub-headings in a bullet-point style, but what follows should be in prose style, with full sentences, explanations, examples and justifications.

9. Managing Technical CIMA Questions That Appear in Exams

Many students mistakenly believe that when it comes to more technical questions involving financial statements and “the numbers,” a different approach is necessary.

Students feel they need to spend much of their time performing calculations and showing off their ability to use various formulae from their objective studies.

However, this is not the case. In fact, you are not expected to perform lengthy calculations when it comes to technical components in the case study exam. Instead, the extent to which you will be expected to demonstrate your technical capacities corresponds to the following:

You will need to be able to:

- explain how the content of a schedule/table/financial statement has been prepared

- interpret the solution from a schedule/table/financial statement

- interpret the information within the schedule/table/financial statement

- explain the accounting treatment for a certain type of transaction and the impact on the financial statements

The occasional basic calculation can be made to illustrate a point or to support your interpretation, but that interpretation should be written in prose form.

Markers do not want to see long strings of calculations and formulae without any written explanation or justification. If you do include calculations, keep them short, and focus instead on demonstrating your understanding through written means.

When it comes to a general approach to technical components, we recommend that you follow the order of operations indicated in the diagram below:

We've already dealt with structure above.

In terms of content, it's a good idea to start with the general theoretical and technical concepts/principles that you are going to be using in the requirement. You don't need to spend too long on this phase - you're not expected to give a complete, exhaustive abstract explanation of a model or theory.

Rather, give a short but jargon-free summary of the model or theory that you are making use of. You want to spend as much time on the application phase as possible. This is where you will demonstrate your deep theoretical understanding.

Remember, markers want to see you applying your knowledge as if you were really working in this company, in the specified role, and charged with the tasks outlined in the exam .

Simply stating abstract principles would not be acceptable in the real world. Nor is it acceptable in the CIMA case study exam.

Finally, and ideally, you want to move beyond the narrow application of the relevant theory to the specifics of the case.

Markers like to see students adopt a wider perspective of the business and spell out some of the broader implications of your solution to the task/requirement.

It's a good idea here to stretch out your time horizon and consider second and third-order consequences of a particular action - positive or negative.

Markers also like to see students derive conclusions and recommendations in questions where students are asked to consider advantages and disadvantages/risks and benefits of particular courses of action. This shows deeper engagement with the case and wider business awareness.

10. How to Pass CIMA: Key Takeaways for Upcoming Case Study Exams

When it comes to case study success, there are three really key components:

1. Solid theoretical knowledge relating to objective subjects

2. Intimate knowledge of the pre-seen and some familiarity with industry trends

3. Excellent exam answer technique

Too many CIMA students get hung up on revising their objective test theory in the wrong way, i.e., committing theory to memory from their CIMA objective test textbook material. The result is less flexibility in producing answers to new problems.

A much better approach is to review key theories by applying each one to the specifics of the current pre-seen document.

In this way, you kill two birds with one stone, i.e., solid theoretical knowledge and intimate knowledge of the pre-seen.

Then it's all about honing your exam technique. The reality is, our markers report over and over again that the typical student's main problem often isn't so much their lack of theoretical knowledge (although that is sometimes definitely the case), as they cannot order their thoughts, apply their knowledge, and master their timing.

When it comes to timing, there's no substitute for practice (all of VIVA's mocks can be taken in our online CIMA exam simulator under timed conditions).

If you combine practice with careful attention to the points listed above, you will likely write an exam answer that puts you ahead of 90% of CIMA students.

11. Get Ahead with VIVA Financial Tuition

It doesn't matter what kind of business career you're after, CIMA qualifications can unlock a brighter future.

Whether you aim to be a Chief Financial Officer or business owner, our CIMA exam tips and advice can get you where you want to go faster, and for a fraction of the cost of traditional tuition providers. Start your journey today and discover our range of CIMA courses .

Check out our market-leading Study Packs for the current Case Study. The packs include hours of high-quality video tuition by some of the world's leading CIMA experts, alongside mock exams modelled closely on the official CIMA exams and a whole range of support materials. You might also want to read: Working through your CIMA Case Study Course .

Like to explore how VIVA can help you with your CIMA studies?

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Cracking the case study exams in 2024: The definitive guide to the CIMA case study exams

Find Your Astranti Case Study Course

We have OnDemand courses available for every case study student, whether you need lots of guidance and assistance along the way or you just need to get up to speed with the latest pre-seen. On our courses you will find study guides, recorded videos, mock exams & practice questions, live online classes, tutor/mentor support and much more.

Prices start at just £245 or £45 a month for 6 months.

Explore each of our case study courses below…

CIMA Case Studies: November 2019

It feels like the CIMA August case studies have just finished and here we are considering the next cycle of exams.

Having just sat the SCS exam a couple of weeks back myself, I felt that my preparation BEFORE the pre-seen analysis was released really helped me hit the ground running for the 6 week’s of work ahead.

The November pre-seen materials release dates are;

OCS – 20th September 2019
MCS – 27th September 2019
SCS – 4th October 2019

*at the time of posting this blog post, OCS students still have over two weeks to look back at the post exam kits and practice some questions.

Here is what I did and why;

CIMA Post Exam Kits

I had two weeks before my pre-seen materials were released and I spent this time looking back at previous exam kits and attempting some of the real exam questions students faced.

You might think, well why I do I want to learn and attempt questions on a scenario that I won’t be facing in November? IT’S ALL ABOUT PRACTICE! Honing your writing skills and being able to put together a balanced answer with enough depth.

The scenario is irrelevant at this stage.

You can find the all of the CIMA case study post exam kits on the CIMA connect site, for example here the kit for the 2015 Operational Case Study. (do a google search if you are struggling to find them for the MCS or SCS).

Read through the pre-seen materials of the scenario and make a few notes on it. Then throw yourself in at the deep end, attempt one or two of the questions from the actual exam and use the pre-seen as a reference.

In total you have five variants of the exam, so there are plenty of different questions available for you to practice on – all free materials!

Attempt one question each day before your pre-seen is released and you’ll see an immediate improvement in your technique, answer planning and ability to produce a balanced answer.

What’s more you have the examiners feedback document in these exam kits which tell you directly what the examiner is looking for and what mistakes to avoid.

November CIMA Case Study Planning

Each tuition provider will have a schedule or timetable that you are advised to follow, but nevertheless an efficient plan should look something like this.

This is based on the November 2019 operational case study with the yellow dates indicating when the pre-seen is released and the exam week starts, but the structure is the same for MCS and SCS (just one or two weeks ahead of the OCS).

You have six weeks from pre-seen release to prepare for your case study.

A plan is meant to be flexible, so some of these topics will be mixed together.

For example, your pre-seen and industry analysis is not meant just for Week 1, it’s more than likely you will also cover this during the later weeks when you are revising and reviewing feedback from your mock exam attempts.

November 2019 Case Study Courses

I have used the Astranti case study courses for all three of my case study exams to date.

2019-06-17 16_39_30-Astranti_ CIMA Operational Case Study Courses - Internet Explorer

Here is what you can expect from their course.

Complete pre-seen pack (pre-seen, strategic, industry analysis and top 10 issues) 3 x Full tuition videos 2 x Study texts 2 x Live Masterclasses (the keys to passing and revision masterclass) 3 x Full Mock Exams (based on Aug 19 scenario) Detailed marking and feedback Ethics Pack Pass Guarantee

Tips for mastering the CIMA Case Study Exams

The CIMA® Case Study exams are the final capstone exams of each level of the CIMA Professional Qualification, which students must pass to gain the CGMA® designation. We explore four tips to help you prepare for the exams.

1) Understand the three Case Study levels.

Each Case Study exam lasts three hours, with multiple tasks of equal lengths. There is a natural progression to the levels — Operational, Management and Strategic — that simulate how work as a management accountant progresses. To reach the Case Study level, you will have already passed the Objective Tests, which focus on ensuring that you have acquired the knowledge and skills for each pillar. Case Study exams are more about interpreting data and require practical answers to practical questions and simulate real-life business scenarios.

Operational Case Study (OCS)

Focus — The short-term role of the finance officer and the implementation of decisions
Skills you need to convey — How to work with others in the organisation and use appropriate data and technology to translate medium-term decisions into short-term actionable plans
Stats — Three-hour exam containing four tasks related to the enterprise, performance, and financial pillars; allotted 45 minutes per task, each task has two to three sub-tasks

Management Case Study (MCS)

Focus — The role of the finance manager involves translating long-term decisions into medium-term plans
Skills you need to convey — How to use data and relevant technology to manage organisational and individual performance; allocate resources to implement decisions; monitor and report the implementation of decisions; prepare and interpret financial statements to show performance

Strategic Case Study (SCS)

Focus — The role of the senior finance manager entails long-term strategic decision-making
Skills you need to convey — How to support organisational leaders to craft strategy and evaluate and manage risks that might prevent the successful implementation of strategy, including sourcing financial resources; value the organisations
Stats — Three-hour exam containing three tasks related to the enterprise, performance, and financial pillars; allotted 1-hour per task, each task has two to three sub-tasks

2) Understand the Case Study exam cycle.

Preseen — Released seven weeks before Exam 1
Exam 1 — Exam cycle is May and August . The same three to four exam variants are offered both months.
Results — Released seven weeks after the exam
Preseen — Released seven weeks before Exam 2
Exam 2 — Exam cycle is November and February . The same three to four exam variants are offered both months.

C opyright: BPP

3) Understand the pre-seen materials.

Pre-seen materials — known as ‘preseens’ — are background information about the fictitious organisation featured in the Case Study exam. This information forms the basis of the tasks you can expect to see in the exam. The preseen tells the story of the company, including the industry and context in which it operates, its financial statements, management accounts, markets and competitors. Preseens are usually 26 – 30 pages long. Key tips include:

Be ready — Familiarise yourself with the company, industry and current events.
Analyse — Perform an analysis such as strengths, weaknesses, opportunities and threats (SWOT) or political, economic, social and technological (PEST); review financial statements and reporting issues. The end of the preseen will contain live issues regarding what is happening in the industry. For instance, a new standard may have come out that will change reporting standards from the current year to the next and that the Case Study exam must address.
Cross-reference with the blueprint — Being able to know what you can do is critical. Can you discuss finance options, dividend policy or evaluate digital strategies?

Tackling “I can” from each of the core activities in each of the sections is necessary for success. For instance:

I can identify relevant costs and benefits.
I can advise on the communication process.
I can recommend a dividend policy.
I can use appropriate technologies to gather data for costing purposes, from digital and other sources.

Have a broad syllabus knowledge and know your company intrinsically. You become the person when you role-play the exam. Avoid prefabricated answers, as the exam will have details not included in the preseens. Your answers have to be relevant to the question.

4) Plan your exam approach.

Manage your time — If you can complete a section early, that time does not get applied to the next section. We suggest spending all of your allotted time within the section.
Keep your answers real and relevant — Remember this is a role-based exam; identify one or more factors that might be relevant, then explain why that approach would be relevant. The more tangible details you provide, the higher you are likely to score. Do not offer irrelevant arguments for the sake of padding your answers. Aim for neat, discreet paragraphs.
Understand the scoring — People mark the exams, and the pass rate is 60%. Even though a scale is scored 80 out of 150, 60% is the pass rate. The sub-tasks will be weighted differently. Each case will contain tasks from all five of the core activities:

Evaluate opportunities to add value.

- Implement senior management decisions.

- Manage performance and costs to aid value creation.

- Measure performance.

- Manage internal and external stakeholder.

Scoring example

“For a 12-mark answer, it might be possible to identify, say, four issues. A candidate who aims to write about four topics only has to score three marks for each to obtain full marks.” – MCS Examiner

You have all the tools you need to do well on the CIMA Case Study exams. From all of us at the Association, we wish you the very best for your next Case Study exam.

The content of this article is based on a Case Study Masterclass webinar delivered by CIMA and BPP in November 2020.

MJ THE TUTOR

Cima exam support and preparation, how to prepare using cima past exam papers.

This is from the “Accounting Makes Cents” podcast episode #31 released on Monday, 16 January 2023.

In this episode, we’re going to discuss the value in using past exam papers for your CIMA case study preparation. Additionally, I’m going to try and show how you can use these past exam papers to practice questions and develop answers using the current CIMA case study pre-seen information.

Jump to show notes .

This is actually quite an interesting question I got asked by a student this past weekend while I was teaching one of my classes. The question was: “Is there value in going through past papers to prepare for the exams?” The simple answer to this is yes. Now this is not one of those questions where the simple answer is yes, but ultimately it’s a “no, you shouldn’t be doing it”. What I want to explore today is that the answer is yes, and explain why it’s a “definitely yes” answer.

Let’s get right into it.

Past paper questions have value in them in that there is a whole library of them available to students online, you just need to get your hands on them. They can normally be found on the CIMA website, if you just search for past papers, they should come up. Each session in the past always had 3 exam variants at a minimum. Each variant had 4 sections. And then each section had 2 requirements at the very least. So that would mean that for each exam session that you want to go through for the questions, you will have face 24 requirements or 12 questions and suggested answers. And you guys can imagine, CIMA has been running exams like these for a couple of years now so there is a lot of available questions and answers for you guys on the website. This is at minimum.

The general issue with using past paper questions is that the suggested answers that go with the past question do not always link back to the current pre-seen material and situation. This is a bigger issue especially if you can’t visualise how you can apply it to your current situation. Each session focuses on different pre-seen companies. The companies come with their own sets of background information, their strategies, strengths and weaknesses, etc. So with all this information available with regards to the companies, there will be no two companies that will be exactly alike or exactly the same. Hence, when you think about the answers for specific questions, the answers will not exactly be the same.

The trick is to read and face the questions on the past paper, but when you are thinking of the answers, you should use the current pre-seen backgrounder. You are actually, essentially putting your own suggested answers together for the past paper questions but just updating it to the company you are going to be examined on.

Now, in having done this, you may ask – well if we are just looking at the questions and not focusing too much on the suggested answers, then is it okay if we just disregard the suggested answers?

I’d say no, because there is still some value in those. Granted, like I said, they may not link back exactly with the pre-seen company that you have now, but you should still be able to follow the way CIMA suggests how you should put together your answers and just interchange some of the logic and reasoning behind those suggested answers. Another thing is that they give you points to consider, especially if you’re having trouble coming up with points for your current pre-seen. You may be able to use those suggested answers to come up with the points, or at least there is already pre-loaded points that you can think on and how you can relate it back to your pre-seen.

The example

For me to show this, I’m going to have to grab a question from a past paper exam and use that as an example. The question I’m using today is on the May and August 2021 CIMA Management Case Study (MCS) Exam Variant 5 Section 3 Requirement B. I repeat May and August 2021 MCS Variant 5 Section 3 Requirement B. The question refers to a discussion of the “characteristics of debt and equity as potential sources of finance as a result of a Board’s decision”.

So for that particular session, the pre-seen company was a company called Trayyner, which was an unquoted company offering executive training courses. When thinking about a discussion on funding sources, we know that there is a difference between what is available to quoted and unquoted companies, especially ones related to equity.

The suggested answer on this particular requirement started off looking at specifics of the funding required for the venture. There are specific numbers that were shared on the suggested answers, which we could also look at and switch, using the numbers on our current pre-seen, where applicable.

A few paragraphs then of the suggested answer dealt with debt and what the gearing ratio of Trayyner was. This was then used to gauge how much it would affect Trayyner’s gearing ratio once the borrowing has been provided or obtained. In practical terms, we should also be able to use the gearing ratio of our current pre-seen and determine how much effect that would have if additional borrowings were obtained.

Now onto the equity side of things, and here is where it gets interesting. Since this question asked for a discussion of funding sources,, it’s always a good idea to present sides to the discussion. In this case, since we’ve already done a few paragraphs on debt, we should do a few on equity as well.

Trayyner was an unlisted company so one of the main things that was not available to it as a funding source was to offer the shares on the stock exchange, which would be a good idea or good way for a listed company to raise equity funding. The next few paragraphs of the suggested answer dealt with how we could gain equity funding as an unlisted company, so things like offering a rights issue came up in the discussion.

I highlight this part because you could end up having a listed company as a current pre-seen and this is not uncommon. Actually, most pre-seen companies in general are listed companies. So in which case, you could then add the discussion of offering shares on the stock exchange, how quick and easy it is or how difficult and cumbersome it is, and whether it’s a good idea or not to use such a way to fund your investments.

The takeaway

So you see, even if the suggested answers do not totally link back to your current scenario, there are still ways for you to be able to use those answers to help you formulate good ones or good points for your current pre-seen.

Please note that although I’ve used a Management Case Study past paper, that this practice of going through the past papers can also be done with the Operational Case Study and Strategic Case Study levels.

Show notes simplified

In this episode, MJ the tutor discusses the value in using past paper exams for the CIMA case study preparation. Additionally, she shows how a student can use past paper exams to practice questions and develop answers for the current CIMA case study pre-seen information.

Resources and links from this episode: CIMA past paper example

Credits: “Ding Ding Small Bell” ( https://freesound.org/s/173932/ ) by JohnsonBrandEditing ( https://www.youtube.com/channel/UC1RImxnsbfngagfXd_GWCDQ ) licensed under CC0 Licence.

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CASE REPORT article

A novel variant of pla2g6 gene related early-onset parkinsonism: a case report and literature review.

$\r\nDapeng Cai$

Department of Neurology, Qujing First People's Hospital, Qujing, Yunnan, China

This study reported a case of early-onset parkinsonism associated with a novel variant of the PLA2G6 gene. The boy first started showing symptoms at the age of 11, with gait instability and frequent falls. As the disease progressed, his gait instability worsened, and he developed difficulties with swallowing and speaking, although there was no apparent decline in cognitive function. An MRI of the head revealed significant atrophy of the cerebellum. The initial diagnosis for the boy was early-onset parkinsonism, classified as Hoehn-Yahr grade 5.Genomic sequencing of the patient indicated that he had compound heterozygous variations in the PLA2G6 gene: c.1454G>A (p.Gly485Glu) and c.991G>T (p.Asp331Tyr). Pedigree analysis revealed that his younger brother also carried the same variant, albeit with milder symptoms. The patient's unaffected mother was found to be a carrier of the c.991G>T variant. Additionally, this study reviewed 62 unrelated families with PLA2G6 gene-related early-onset parkinsonism. The analysis showed a higher proportion of female probands, with a mean age of onset of ~23.0 years. Primary symptoms were predominantly bradykinesia and psychosis, with tremors being relatively rare. Cerebellar atrophy was observed in 41 patients (66.1%). Among the reported mutations, the most common mutation was c.991G>T, presenting in 21 families (33.9%), followed by c.2222G>A in eight families (12.9%). Other mutations were less common. Notably, the c.991G>T mutation was exclusive to Chinese families and was a prevalent mutation among this population. The initial symptoms varied significantly among patients with different mutations.

1 Introduction

Early-onset parkinsonism (EOP) is a neurodegenerative disease related to genetic factors. PLA2G6 gene mutation is considered to be one of the pathogenic genes involved in the development of EOP ( 1 ). Autosomal recessive EOP caused by mutations in the PLA2G6 gene is called PLA2G6-associated Neurodegeneration (PLAN) ( 2 , 3 ). These include Infantile neuroaxonal dystrophy (INAD), Atypical neuroaxonal dystrophy (ANAD), and EOP ( 4 ). In this study, a case of EOP caused by a novel PLA2G6 gene mutation was reported, and previous reports of EOP related to this gene were reviewed.

2 Case presentation

A 22-year-old male patient was admitted to the hospital due to gait abnormality and frequent falls. The patient developed the above symptoms at the age of 11, and his motor development was slightly worse than that of his peers. After that, the patient's gait instability was aggravated, dysphagia and dysarthria gradually appeared, without obvious cognitive decline, and no special diagnosis and treatment were given. The patient's anomalies of gait and weakness of extremities were further aggravated, manifested as frequent falls, requiring bed rest or wheelchair. The patient's articulation disorder and deglutition disorders were aggravated compared with the previous ones, and the cognitive decline was presented, but he could still communicate normally with his family members. The proband's father died of trauma. Prior to his death, he denied the anomalies of gait, muscle weakness and other symptoms. The proband's younger brother began to have gait instability at the age of 11, and his motor development since childhood was slightly worse than that of his peers. At the age of 20, he can still walk normally, live independently, but his muscle tension is symmetrically increased. The proband's mother had a head trembling a few months ago, without other special discomforts. The patient's cranial magnetic resonance imaging (MRI) examination in September 2022 revealed cerebellar atrophy. The diagnosis of Parkinson's syndrome was made, and the Hoehn-Yahr grade was 5.

The nervous system physical examination revealed that the patient had normal vital signs, clear mind, but had severe dysarthria. The orientation of time, character and place was normal, the calculation and comprehension were decreased. The cranial nerves examination did not reveal any abnormalities. The distal and proximal muscle strength of both upper limbs was grade 3, the distal and proximal muscle strength of both lower limbs was grade 2, the symmetry of muscle tension of both upper limbs was increased, the muscle tension of both lower limbs was decreased, the tendon reflex of both upper limbs was brisk, the tendon reflex of both lower limbs was absent, the Rossolimo's sign of both upper limbs was positive, the pathological sign of both lower limbs was negative, the meningeal irritation sign was negative, and the patient had no sensory abnormalities and ataxia signs in the physical examination. Wide base gait, slow movement, reduced swing arms of both hands, and unilateral assistance during walking. The patient could not cooperate to complete the bilateral finger-nose test, heel-knee-tibia test, and pull-back test.

The results of auxiliary examination suggest that: there were no abnormalities in hematuria, stool routine, biochemical indicators, homocysteine, ceruloplasmin, hepatitis, syphilis, HIV, coagulation function, autoimmune antibody spectrum, and cardiac ultrasound. MRI plain scan and contrast-enhancement of the head indicated brain atrophy, especially in the bilateral cerebellar hemispheres ( Figure 1C ).

Figure 1 . (A) Family diagram of the proband; (B) Another complex heterozygous variation of proband c.1454G>A with Sanger sequencing; (C) Cerebellar atrophy can be seen in the sagittal T1WI phase of the proband's head MRI; (D) The conservative analysis of this variant suggests that it is highly conservative.

The patient's whole genome sequencing suggested that the PLA2G6 gene compound heterozygous variants c.1454G > A (p.Gly485Glu), c.991G > T (p.Asp331Tyr) ( Figures 1A , B ). The results of pedigree verification suggested that the proband's brother was consistent with the proband's results. The proband's mother was a asymptomatic carrier of the variant of PLA2G6 gene c.991G > T. The proband's father failed to perform pedigree verification due to unexpected death, which was consistent with the role of family co-segregation. The variant of c.991G > T has been previously reported as a pathogenic variation ( 5 ), however, the variant of c.1454G > A has not been reported. The Mutation Taster software predicted it as a pathogenic variation, and the probability was 0.9999; this variant was not found in ExAC and Thousand Human Genome Database, and the conservation analysis suggested that it was highly conserved ( Figure 1D ).

The patient was finally diagnosed with PLA2G6 gene-related early-onset Parkinson's syndrome. The patient was treated with madopa 62.5 mg tid gradually increased to 125 mg tid orally. After 2 months of follow-up, the patient's gait abnormality was slightly improved compared with the previous one, and the disease did not progress significantly.

3 Literature review

In this study, the keywords “PLA2G6,” “parkinsonism,” and “Parkinson” were searched through “Pubmed,” “Wanfang Medicine,” and “China National Knowledge Infrastructure” databases. The literature of PLA2G6 gene-related EOP patients reported in Chinese and English was reviewed. A total of 62 families, including 30 Chinese families, were reviewed, and the clinical and genetic characteristics of the probands in all families were summarized ( Table 1 ).

Table 1 . A retrospective analysis of PLA2G6 gene-related EOP literature has been reported.

By reviewing the literature, it was found that among the 62 probands, the male to female ratio was 2: 3, and the average onset age of male patients was 22.9 ± 8.7 years old. The average age of onset in women was 23.0 ± 8.5 years. There were 51 cases (82.2%) with movement disorder as the initial symptom, including 27 cases (43.5%) with gait disorder, 10 cases (16.1%) with gait instability, and 11 cases (17.7%) with limb trembling. There were 14 cases (22.6%) with depression, dysphoria, and other emotional instability as the initial symptoms. All probands were examined by cranial MRI, and 41 (66.1%) patients had cerebellar atrophy.

Among the 30 cases of national probands, the male to female ratio was 3:2, and the average onset age of male patients was 22.9 ± 8.9 years. The average age of onset in women was 22.9 ± 8.8 years. The most common mutation was c.991 G > T mutation in 21 families (70%), followed by c.967 G > A mutation in three families (10 %), c.1077 G > A mutation in three families (10%), and other mutations were rare. The most common clinical manifestations were movement disorder in 30 cases (100%), including gait disorder in 17 cases (56.7%), limb trembling in 19 cases (63.3%), and mental and behavioral disorders in 24 cases (80%). Among them, movement disorder was the most common symptom, with 28 cases (93.3%).

Among the 15 European and American probands, the ratio of male to female was 1:14. The most common clinical manifestations were movement disorder in 15 cases (100 %) and mental and behavioral disorders in 14 cases (93.3 %). Among them, mental and behavioral disorders were the most common symptoms, a total of 14 cases (93.3 %).

Of the 14 probands from the Middle East and western Asia, the ratio of male to female was 5: 9. The most common clinical symptoms were movement disorder (10 cases, 71.4%) and mental and behavioral disorders (13 cases, 92.9%). The most common symptoms were movement disorder (nine cases, 64.3%) and mental and behavioral disorders (seven cases, 50%).

Among the reported mutations, the most common mutation was c.991G > T in 21 families (33.9%), followed by c.2222G > A in eight families (12.9%), and other mutation types were rare. Among them, the c.991 G > T mutation only was found in Chinese, and the c.2222 G > A mutation was mainly distributed in the Middle East, western Asia and other countries. Among them, the ratio of male to female in the proband with c.991G > T mutation was 13:8. There were 15 cases (71%) of compound heterozygous mutations and six cases (29%) of homozygous mutations. The average age of onset of patients with compound heterozygous mutations was 23.1 ± 9.2 years old, and the most common initial symptom was movement disorder in seven cases (46.7%). There were 14 cases (93.3%) with dystonia and 10 cases (66.7%) with mental and behavioral disorders. The average age of patients with homozygous mutations was 32.5 ± 4.5 years old, and the initial symptoms were atypical, including one case of gait disorder (16.7%) and one case of movement disorder (16.7%). There were six cases (100%) of dystonia and three cases (50%) of mental and behavioral disorders. Among the probands with compound heterozygous mutations, there were 14 cases (93%) of cerebellar atrophy, and no cerebellar atrophy was found in the probands with homozygous mutations. The male to female ratio of the proband with c.2222G > A mutation was 1:7, all of which were homozygous mutations. The average age of onset was 23.3 ± 7.6 years. The most common initial symptoms were mental and behavioral disorders in seven cases (87.5%), including dysphoria, depression and other symptoms in 6 cases (75.0%). There were five cases (62.5%) of dystonia and eight cases (100%) of mental and behavioral disorders. A total of four probands had cerebellar atrophy (50%).

In addition, among all the probands, 9 (33%) patients with homozygous mutations had cerebellar atrophy, and 36 (85%) patients with compound heterozygous mutations had cerebellar atrophy.

4 Discussion

PLA2G6 gene is located in 22q13.1 region, about 6.0 Mb, containing 17 exons, encoding 85 ku cytosolic Ca2 + independent phospholipids A2 (iPLA2). There are two forms of iPLA2-A and iPLA2-β. The iPLA2-β enzyme is closely related to neurodegenerative diseases, and different mutation sites can lead to different degrees of changes in iPLA2-β enzyme. This leads to different clinical phenotypes of PLAN ( 31 ). The mutation types of this gene include missense mutation, truncation mutation and copy number variation, but the specific mechanism of this mutation is not clear ( 31 ). Previous studies have shown that the pathogenesis of EOP caused by PLA2G6 gene may be the loss of iPLA2 enzyme protein function caused by PLA2G6 gene mutation, which in turn causes phospholipid metabolism disorder of nerve cell membrane, intracellular iron deposition, lipid peroxidation, mitochondrial inner membrane damage, and Golgi morphological changes, eventually leading to a large number of apoptosis of dopaminergic neurons, decreased dopamine secretion, and the presence of Lewy bodies formed by misfolding and aggregation of α-synuclein in surviving neurons, leading to the occurrence of EOP ( 34 , 35 ).

After reviewing the literature, this study showed that there were slightly more female patients with PLA2G6 gene-related EOP than male patients, and all of them had similar age of onset. The average age of onset was about 22 years old. The patients of EOP usually had gait disorder and movement disorder as the initial symptoms, but the resting tremor was relatively rare. As the disease progressed, it might be accompanied by symptoms such as rigidity, cognitive decline, mental and behavioral disorders ( 36 – 38 ). The majority of patients responded well to levodopa preparations, but the incidence of dyskinesia and symptom fluctuations reported in the literature was high and occurred earlier ( 34 ).

Based on retrospective analysis, it was found that the most common mutation in Chinese people was c.991G > T. One of the mutations reported in this study was also this variant. The mutation accounted for more than half of the Chinese pedigrees reported. It was further confirmed that the c.991G > T was the hot spot mutation of the PLA2G6 gene in China ( 2 , 27 ), suggesting that this mutation had a founder effect in Chinese patients. The most common mutation reported abroad was c.2222G > A, which was mainly found in the Middle East and western Asia, including Arab, Saudi Arabia, India, Pakistan and other countries. The most common symptoms of c.991G > T mutation-related patients were movement disorder and gait disorder. Patients with c.2222G > A mutation usually had cognitive impairment, anxiety, depression, dysphoria, and other mental disorders, accompanied by a small amount of movement disorders. It was found that among the EOP probands caused by PLA2G6 gene, the probands with mental and behavioral disorders in Europe and America, western Asia and the Middle East were significantly higher than those in Chinese probands, which further confirmed the correlation between the clinical phenotype of EOP and different genotypes ( 29 ). However, Cheng et al. suggested that it might also be due to the complex phenotypic characteristics of Chinese patients, which could easily cover up symptoms such as myoclonus, cognitive decline and mental and behavioral disorders ( 2 ), suggesting that the evaluation of cognitive and mental disorders in EOP patients should be strengthened in clinical work.

In this study, 21 probands with c.991G > T mutation reported previously were further analyzed. It was found that patients with c.991G > T mutation usually had movement disorder, gait disorder and other symptoms as the first symptoms, followed by aggravation of symptoms and dystonia, resting tremor and other motor symptoms and non-motor symptoms. Among them, patients with c.991 G > T homozygous mutation occurred about 10 years later than those with compound heterozygous mutation. Furthermore, the initial symptoms were atypical and the clinical manifestations were milder. All of them were sensitive to levodopa treatment, which was consistent with previous studies ( 3 , 11 , 16 ). In addition, this study found that almost all of the probands with compound heterozygous mutations at this variant had cerebellar atrophy, while no cerebellar atrophy occurred in the six homozygous mutant probands, further suggesting that the clinical manifestations of patients with homozygous mutations at this variant were relatively mild. Previous in vitro cell experiments showed that c.991G > T mutant cells still retained 30% iPLA2β enzyme activity compared with wild-type cells, but the iPLA2β enzyme activity in H597fx69 cells expressing frameshift mutations only retained 6% ( 39 ). Because different mutation sites have different effects on iPLA2β enzyme activity, the reason for the difference between the two may be that another heterozygous mutation site outside the c.991 G > T mutation site has a greater effect on iPLA2β enzyme activity. The PLA2G6 protease activity of patients is higher than that of patients with heterozygous mutations, but more in vitro experiments of non-frameshift mutations are needed for further verification in the future. Therefore, we hypothesize that heterozygous and homozygous mutations in the PLA2G6 gene have different effects on the activity of iPLA2β enzyme, and the proportion of iPLA2β enzyme activity loss can partially explain that homozygous mutation probands have relatively benign clinical and neuroimaging phenotypes compared with heterozygous mutation probands ( 16 ).

This study also found that 64.8% of the probands showed brain atrophy on head MRI, but most studies showed that only a small number of EOP probands showed iron deposition on head MRI ( 31 , 37 , 40 ). From a pathological point of view, PLAN is characterized by the depletion of neurons in the cerebellar cortex, accompanied by astrocyte proliferation, axonal spheroids in the central and peripheral nervous system, and progressive brain iron deposition ( 2 ), cerebellar atrophy is the earliest sign on head MRI, while the signs of brain iron deposition in the basal ganglia often appear later. This may be the reason why MRI cerebellar atrophy signs are common and iron deposition signs are rare in EOP probands ( 2 ). Some researchers found that pro-inflammatory cytokines were significantly up-regulated, microglial activation, and reactive astrocyte proliferation were found in the pathological tissues of patients. Therefore, it is believed that inflammatory response is involved in the pathological process of cerebellar atrophy, and it is speculated that early anti-inflammatory treatment may help to delay the progression of cerebellar atrophy in patients with Parkinson's syndrome ( 41 ).

Another compound heterozygous mutation c.1454G > A in the PLA2G6 gene of the proband in this study has not been reported. Like most other EOP patients with PLA2G6 compound heterozygous mutations, the symptoms of PLA2G6 gene-related EOP in this patient were basically similar. The onset of the disease was 11 years old, with gait disorder, and the clinical manifestation was dystonia-Parkinson syndrome. The genetic test results of the proband's younger brother were consistent with those of the proband, and the age of onset was 11 years old. However, the clinical symptoms of the proband's younger brother were significantly lighter than those of the proband. The initial symptoms were anomalies of gait, and he could walk normally and take care of himself with the progression of the disease, and were not accompanied by symptoms such as dysphonia and dysphagia. It was speculated whether the proband had more susceptible genes than his younger brother, such as GBA, MAPT, SNCA, etc., leading to more severe clinical symptoms ( 42 ). In addition, different hormone levels could also affect the progression of Parkinson's disease ( 29 ). Considering that the living environment and habits of the proband and the proband's brother were roughly the same, this might also be one of the reasons for the clinical differences between the two.

Although the incidence of EOP is not high, the morbidity and mortality are very high ( 38 ), and most patients have a good response to treatment such as madopar 5–10 years after onset ( 3 ). This study also found that the vast majority of PLA2G6 gene-related EOP responds to levodopa treatment, but the delayed use of levodopa will increase the incidence of dyskinesia, and the switching period fluctuation is more obvious ( 33 ). Therefore, early diagnosis is of great significance for early initiation of anti-Parkinson therapy.

Because the sample size of most studies on PLA2G6 gene-related EOP in Chinese population is relatively small ( 3 , 16 , 27 ), this leads to limitations in the clinical and phenotypic comparison of different PLA2G6 gene mutation reviews in this study. The clinical and genetic characteristics of PLA2G6 gene-related EOP patients in China will be more clear in future multicenter large sample studies.

5 Conclusion

In conclusion, this study reported a case of early-onset parkinsonism caused by a novel variant of PLA2G6 gene and reviewed previous reports. This expands the genetic pedigree of the disease and increased clinicians' understanding of the clinical and genetic characteristics of early-onset parkinsonism.

Data availability statement

The datasets presented in this article are not readily available because of ethical and privacy restrictions. Requests to access the datasets should be directed to the corresponding author.

Ethics statement

The studies involving humans were approved by the Ethics Committee of Qujing First People's Hospital. The studies were conducted in accordance with the local legislation and institutional requirements. Written informed consent for participation in this study was provided by the participants' legal guardians/next of kin. Written informed consent was obtained from the individual(s), and minor(s)' legal guardian/next of kin, for the publication of any potentially identifiable images or data included in this article.

Author contributions

DC: Conceptualization, Data curation, Formal analysis, Writing – original draft. HW: Conceptualization, Methodology, Supervision, Writing – review & editing. BH: Conceptualization, Methodology, Supervision, Writing – review & editing. WX: Data curation, Methodology, Writing – review & editing. KD: Conceptualization, Formal analysis, Funding acquisition, Investigation, Methodology, Software, Supervision, Validation, Writing – review & editing.

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the Yunnan Provincial Department of Education Science Research Funding (No. 2023Y0702).

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Keywords: PLA2G6 , early-onset parkinsonism, cerebellar atrophy, hot spot mutation, heterogeneity

Citation: Cai D, Wu H, Huang B, Xiao W and Du K (2024) A novel variant of PLA2G6 gene related early-onset parkinsonism: a case report and literature review. Front. Neurol. 15:1349861. doi: 10.3389/fneur.2024.1349861

Received: 07 December 2023; Accepted: 18 March 2024; Published: 18 April 2024.

Reviewed by:

Copyright © 2024 Cai, Wu, Huang, Xiao and Du. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Kang Du, dukangyn@126.com

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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A novel variant of PLA2G6 gene related early-onset parkinsonism: a case
Department of Neurology, Qujing First People's Hospital, Qujing, Yunnan, China This study reported a case of early-onset parkinsonism associated with a novel variant of the PLA2G6 gene. The boy first started showing symptoms at the age of 11, with gait instability and frequent falls. As the disease ...