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Porras-García E, Mas-Nieto M, Delgado-García JM, Domínguez-Del-Toro E. Noradrenergic projections regulate the acquisition of classically conditioned eyelid responses in wild-type and are impaired in kreisler mice. Sci Rep 2023; 13:11458. [PMID: 37454229 PMCID: PMC10349844 DOI: 10.1038/s41598-023-38278-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023] Open
Abstract
During embryonic development, heterozygous mutant kreisler mice undergo ectopic expression of the Hoxa3 gene in the rostral hindbrain, affecting the opioid and noradrenergic systems. In this model, we have investigated behavioral and cognitive processes in their adulthood. We confirmed that pontine and locus coeruleus neuronal projections are impaired, by using startle and pain tests and by analyzing immunohistochemical localization of tyrosine hydroxylase. Our results showed that, even if kreisler mice are able to generate eyelid reflex responses, there are differences with wild-types in the first component of the response (R1), modulated by the noradrenergic system. The acquisition of conditioned motor responses is impaired in kreisler mice when using the trace but not the delay paradigm, suggesting a functional impairment in the hippocampus, subsequently confirmed by reduced quantification of alpha2a receptor mRNA expression in this area but not in the cerebellum. Moreover, we demonstrate the involvement of adrenergic projection in eyelid classical conditioning, as clonidine prevents the appearance of eyelid conditioned responses in wild-type mice. In addition, hippocampal motor learning ability was restored in kreisler mice by administration of adrenergic antagonist drugs, and a synergistic effect was observed following simultaneous administration of idazoxan and naloxone.
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Affiliation(s)
- Elena Porras-García
- Division of Neurosciences, University Pablo de Olavide, Ctra. de Utrera, Km. 1, 41013, Sevilla, Spain
| | - Magdalena Mas-Nieto
- Division of Neurosciences, University Pablo de Olavide, Ctra. de Utrera, Km. 1, 41013, Sevilla, Spain
| | - José María Delgado-García
- Division of Neurosciences, University Pablo de Olavide, Ctra. de Utrera, Km. 1, 41013, Sevilla, Spain
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Wang H, Nie W, Wang C, Wang Z, Zheng Y. Novel CPLANE1 c.8948dupT (p.P2984Tfs*7) variant in a child patient with Joubert syndrome. Open Life Sci 2023; 18:20220542. [PMID: 36789003 PMCID: PMC9896164 DOI: 10.1515/biol-2022-0542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/20/2022] [Accepted: 11/23/2022] [Indexed: 02/04/2023] Open
Abstract
Joubert syndrome (JBTS) is a class of heterogeneous ciliopathy genetically associated with CPLANE1 mutations. The characteristics of clinical phenotypes and CPLANE1 variants were analyzed in a 2-month-old patient. A 2-month-old patient with JBTS was diagnosed after clinical evaluation including family history, physical examination, cerebral MRI, ultrasonography imaging, VEGG, ocular fundus examination, and comprehensive blood and urine testing. Whole exome sequencing (WES) was performed to detect CPLANE1 variants, and Sanger sequencing was used to confirm the variants. This JBTS patient presented with oculomotor apraxia, dysregulation of breathing pattern, and ataxia. MRI revealed poor continuity of cerebelli, batwing appearance, and molar tooth sign. This patient was noted with abnormal hematology, dysregulation of hepatic function, thyroid function, immunity, and renal function, and encephalopathy. CPLANE1 (c.8948dupT (p.P2984Tfs*7) and c.247G > T (p.G83X)) variants were noticed in the patient as a pathogenic variant and caused autosomal recessive inheritance. The JBTS patient with mutations in CPLANE1 (c.8948dupT (p.P2984Tfs*7) and c.247G > T (p.G83X)) developed JBTS phenotypes. The novel CPLANE1 c.8948dupT (p.P2984Tfs*7) variant will assist clinicians and geneticists in reaching a precise diagnosis for JBTS.
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Affiliation(s)
- Huiping Wang
- Department of Neurology, Kunming Children’s Hospital, Kunming Children’s Hospital Affiliated with Kunming Medical University, No. 288, Qianxing Road, Xishan District, Kunming 650228, China
| | - Wensha Nie
- Department of Neurology, Kunming Children’s Hospital, Kunming Children’s Hospital Affiliated with Kunming Medical University, No. 288, Qianxing Road, Xishan District, Kunming 650228, China
| | - Chunxia Wang
- Department of Neurology, Kunming Children’s Hospital, Kunming Children’s Hospital Affiliated with Kunming Medical University, No. 288, Qianxing Road, Xishan District, Kunming 650228, China
| | - Zuohua Wang
- Department of Neurology, Kunming Children’s Hospital, Kunming Children’s Hospital Affiliated with Kunming Medical University, No. 288, Qianxing Road, Xishan District, Kunming 650228, China
| | - Yuxia Zheng
- Department of Neurology, Kunming Children’s Hospital, Kunming Children’s Hospital Affiliated with Kunming Medical University, No. 288, Qianxing Road, Xishan District, Kunming 650228, China
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Manti S, Gitto E, Ceravolo I, Mancuso A, Ceravolo A, Salpietro A, Farello G, Chimenz R, Iapadre G, Battaglia F, Cuppari C. A Brief Focus on Joubert Syndrome and Related Acute Complications. JOURNAL OF PEDIATRIC NEUROLOGY 2023. [DOI: 10.1055/s-0042-1760240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AbstractJoubert syndrome (JS) and related disorders are a group of congenital anomalies syndromes in which the obligatory hallmark is the molar tooth sign, a complex midbrain–hindbrain malformation. Moreover, JS may be associated with multiorgan involvement, mainly nephronophthisis, hepatic fibrosis, retinal dystrophy, and other abnormalities with both inter- and intra-familial variability. Therefore, these patients should be followed by both diagnostic protocol and multidisciplinary approach to assess multiorgan involvement. Here, we briefly summarize the possible complications in patients with JS.
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Affiliation(s)
- Sara Manti
- Unit of Pediatric Emergency, Department of Human Pathology of the Adult and Developmental Age “Gaetano Barresi,” University of Messina, Messina, Italy
| | - Eloisa Gitto
- Neonatal and Pediatric Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age Gaetano Barresi, University of Messina, Messina, Italy
| | - Ida Ceravolo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Alessio Mancuso
- Unit of Pediatric Emergency, Department of Human Pathology of the Adult and Developmental Age “Gaetano Barresi,” University of Messina, Messina, Italy
| | | | | | - Giovanni Farello
- Department of Life, Health and Environmental Sciences, Pediatric Clinic, Coppito (AQ), Italy
| | - Roberto Chimenz
- Unit of Pediatric Nephrology and Rheumatology, Department of Human Pathology of the Adult and Developmental Age “Gaetano Barresi,” University of Messina, Messina, Italy
| | - Giulia Iapadre
- Department of Pediatrics, University of L'Aquila, L'Aquila, Italy
| | - Francesco Battaglia
- Department of Biomedical Sciences and Advanced Therapies, Orthopaedic Clinic, University of Ferrara, Ferrara, Italy
| | - Caterina Cuppari
- Unit of Pediatric Emergency, Department of Human Pathology of the Adult and Developmental Age “Gaetano Barresi,” University of Messina, Messina, Italy
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Kim JY, Jeong K, Han KS, Park JE, Kim MG, Jun MR. Anesthetic considerations of Joubert syndrome in patients with mitochondrial disease - A case report. Anesth Pain Med (Seoul) 2021; 16:158-162. [PMID: 33845552 PMCID: PMC8107256 DOI: 10.17085/apm.20091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 02/05/2021] [Indexed: 11/23/2022] Open
Abstract
Background Joubert syndrome and mitochondrial disease are rare congenital diseases in
which a wide range of symptoms affects multiple organs. Patients with these
diseases present characteristic symptoms related to the musculoskeletal,
respiratory, and neurological systems, which make it difficult for
anesthesiologists to manage the patient’s airway and choose
appropriate anesthetic drugs. Case A 13-year-old male patient with Joubert syndrome and mitochondrial disease
underwent elective surgery to insert a continuous ambulatory peritoneal
dialysis catheter. Anesthesia was induced and maintained with propofol,
remifentanil, and rocuronium. An I-gel was inserted to secure the airway;
however, the fitting did not work properly, so the patient was intubated.
The operation was completed without any major problems, and the intubated
patient was transferred to the intensive care unit. Conclusions Anesthesiologists should determine the method of anesthesia and prepare for
unintended complications based on a full understanding of these congenital
diseases.
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Affiliation(s)
- Jeong Yeon Kim
- Department of Anesthesiology and Pain Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Koun Jeong
- Department of Anesthesiology and Pain Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Ki Seob Han
- Department of Anesthesiology and Pain Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Ji Eun Park
- Department of Anesthesiology and Pain Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Mun Gyu Kim
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Mi Roung Jun
- Department of Anesthesiology and Pain Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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Hong H, Joo K, Park SM, Seo J, Kim MH, Shin E, Cheong HI, Lee JH, Kim J. Extraciliary roles of the ciliopathy protein JBTS17 in mitosis and neurogenesis. Ann Neurol 2019; 86:99-115. [PMID: 31004438 DOI: 10.1002/ana.25491] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 04/16/2019] [Accepted: 04/17/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE JBTS17 is a major gene mutated in ciliopathies such as Joubert syndrome and oral-facial-digital syndrome type VI. Most patients with loss of function mutations in JBTS17 exhibit cerebellar vermis hypoplasia and brainstem malformation. However, some patients with JBTS17 mutations show microcephaly and abnormal gyration. We examined potential roles of JBTS17 in neurogenesis to understand the pathological mechanism of JBTS17-related cortical abnormalities. METHODS We examined subcellular localization and cell-cycle-dependent expression of JBTS17 proteins using anti-JBTS17 antibodies and JBTS17 expression vectors. We also performed knockdown experiments to determined roles of JBTS17 in human cells, and demonstrated mitotic functions of JBTS17 using immunostaining and live imaging. We examined the involvement of JBTS17 in cortical neurogenesis using a mouse in utero electroporation technique. RESULTS We found that JBTS17 localizes to the kinetochore and the level of JBTS17 is regulated by cell-cycle-dependent proteolysis. Depletion of JBTS17 disrupts chromosome alignment and spindle pole orientation, resulting in mitotic delay. JBTS17 interacts with LIS1 and influences LIS1 localization. Depletion of Jbts17 in the developing mouse cortex interferes with the mitotic progression of neural progenitors and the migration of postmitotic neurons. INTERPRETATION LIS1 is implicated in lissencephaly, but altered dosage of LIS1 has been also associated with microcephaly syndromes. Our results suggest that JBTS17 contributes to mitotic progression by interacting with LIS1, and abnormal mitosis is an underlying mechanism of the microcephaly phenotype in JBTS17-related ciliopathies. We propose that understanding extraciliary roles of ciliopathy proteins is important to elucidate pathological mechanisms underlying diverse ciliopathy phenotypes. ANN NEUROL 2019.
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Affiliation(s)
- Hyowon Hong
- Biomedical Science and Engineering Interdisciplinary Program, Korea Advanced Institute of Science and Technology, Daejeon
| | - Kwangsic Joo
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam
| | - Sang Min Park
- Biomedical Science and Engineering Interdisciplinary Program, Korea Advanced Institute of Science and Technology, Daejeon
| | - Jimyung Seo
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon
| | - Min Hwan Kim
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon
| | - EunBie Shin
- Biomedical Science and Engineering Interdisciplinary Program, Korea Advanced Institute of Science and Technology, Daejeon
| | - Hae Il Cheong
- Department Pediatrics, Seoul National University Children's Hospital, Seoul; and 5Research Coordination Center for Rare Disease, Seoul National University Hospital, Seoul, Korea
| | - Jeong Ho Lee
- Biomedical Science and Engineering Interdisciplinary Program, Korea Advanced Institute of Science and Technology, Daejeon.,Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon
| | - Joon Kim
- Biomedical Science and Engineering Interdisciplinary Program, Korea Advanced Institute of Science and Technology, Daejeon.,Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon
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Bulgheroni S, D'Arrigo S, Signorini S, Briguglio M, Di Sabato ML, Casarano M, Mancini F, Romani M, Alfieri P, Battini R, Zoppello M, Tortorella G, Bertini E, Leuzzi V, Valente EM, Riva D. Cognitive, adaptive, and behavioral features in Joubert syndrome. Am J Med Genet A 2016; 170:3115-3124. [DOI: 10.1002/ajmg.a.37938] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 08/03/2016] [Indexed: 11/12/2022]
Affiliation(s)
- Sara Bulgheroni
- Developmental Neurology Division; IRCCS Fondazione Istituto Neurologico C. Besta; Milan Italy
| | - Stefano D'Arrigo
- Developmental Neurology Division; IRCCS Fondazione Istituto Neurologico C. Besta; Milan Italy
| | - Sabrina Signorini
- Unit of Child Neurology and Psychiatry; IRCCS Fondazione Istituto Neurologico Nazionale C. Mondino; Pavia Italy
| | - Marilena Briguglio
- Department of Pediatric, Gynecological, Microbiological and Biomedical Sciences; Unit of Infantile Neuropsychiatry, University of Messina; Messina Italy
| | - Maria Lucia Di Sabato
- Department of Pediatrics and Child Neurology and Psychiatry; Sapienza University of Rome; Rome Italy
| | - Manuela Casarano
- Department of Developmental Neuroscience; IRCCS Fondazione Stella Maris; Pisa Italy
| | - Francesca Mancini
- Neurogenetics Unit, Mendel Laboratory; IRCCS Casa Sollievo Della Sofferenza; San Giovanni Rotondo Italy
| | - Marta Romani
- Neurogenetics Unit, Mendel Laboratory; IRCCS Casa Sollievo Della Sofferenza; San Giovanni Rotondo Italy
| | - Paolo Alfieri
- Unit of Child Neuropsichiatry; IRCCS Bambino Gesù Children's Hospital; Rome Italy
| | - Roberta Battini
- Department of Developmental Neuroscience; IRCCS Fondazione Stella Maris; Pisa Italy
| | - Marina Zoppello
- Unit of Child Neurology and Psychiatry; IRCCS Fondazione Istituto Neurologico Nazionale C. Mondino; Pavia Italy
| | - Gaetano Tortorella
- Department of Pediatric, Gynecological, Microbiological and Biomedical Sciences; Unit of Infantile Neuropsychiatry, University of Messina; Messina Italy
| | - Enrico Bertini
- Laboratory of Molecular Medicine, Unit of Neuromuscular and Neurodegenerative Disorders; IRCCS Bambino Gesù Pediatric Hospital; Rome Italy
| | - Vincenzo Leuzzi
- Department of Pediatrics and Child Neurology and Psychiatry; Sapienza University of Rome; Rome Italy
| | - Enza Maria Valente
- Department of Medicine and Surgery, Section of Neurosciences; University of Salerno; Salerno Italy
- Neurogenetics Unit; IRCCS Santa Lucia Foundation; Rome Italy
| | - Daria Riva
- Developmental Neurology Division; IRCCS Fondazione Istituto Neurologico C. Besta; Milan Italy
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7
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Tian Y, Voineagu I, Paşca SP, Won H, Chandran V, Horvath S, Dolmetsch RE, Geschwind DH. Alteration in basal and depolarization induced transcriptional network in iPSC derived neurons from Timothy syndrome. Genome Med 2014; 6:75. [PMID: 25360157 PMCID: PMC4213483 DOI: 10.1186/s13073-014-0075-5] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 09/15/2014] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Common genetic variation and rare mutations in genes encoding calcium channel subunits have pleiotropic effects on risk for multiple neuropsychiatric disorders, including autism spectrum disorder (ASD) and schizophrenia. To gain further mechanistic insights by extending previous gene expression data, we constructed co-expression networks in Timothy syndrome (TS), a monogenic condition with high penetrance for ASD, caused by mutations in the L-type calcium channel, Cav1.2. METHODS To identify patient-specific alterations in transcriptome organization, we conducted a genome-wide weighted co-expression network analysis (WGCNA) on neural progenitors and neurons from multiple lines of induced pluripotent stem cells (iPSC) derived from normal and TS (G406R in CACNA1C) individuals. We employed transcription factor binding site enrichment analysis to assess whether TS associated co-expression changes reflect calcium-dependent co-regulation. RESULTS We identified reproducible developmental and activity-dependent gene co-expression modules conserved in patient and control cell lines. By comparing cell lines from case and control subjects, we also identified co-expression modules reflecting distinct aspects of TS, including intellectual disability and ASD-related phenotypes. Moreover, by integrating co-expression with transcription factor binding analysis, we showed the TS-associated transcriptional changes were predicted to be co-regulated by calcium-dependent transcriptional regulators, including NFAT, MEF2, CREB, and FOXO, thus providing a mechanism by which altered Ca(2+) signaling in TS patients leads to the observed molecular dysregulation. CONCLUSIONS We applied WGCNA to construct co-expression networks related to neural development and depolarization in iPSC-derived neural cells from TS and control individuals for the first time. These analyses illustrate how a systems biology approach based on gene networks can yield insights into the molecular mechanisms of neural development and function, and provide clues as to the functional impact of the downstream effects of Ca(2+) signaling dysregulation on transcription.
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Affiliation(s)
- Yuan Tian
- />Neurogenetics Program, Department of Neurology, Center for Autism Research and Treatment, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, CA 90095 USA
- />Interdepartmental Ph.D. Program in Bioinformatics, University of California, Los Angeles, CA 90095 USA
| | - Irina Voineagu
- />School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW 2052 Australia
| | - Sergiu P Paşca
- />Department of Psychiatry & Behavioral Sciences, Center for Sleep Sciences and Medicine, Stanford University School of Medicine, Stanford, CA 94305 USA
| | - Hyejung Won
- />Neurogenetics Program, Department of Neurology, Center for Autism Research and Treatment, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, CA 90095 USA
| | - Vijayendran Chandran
- />Neurogenetics Program, Department of Neurology, Center for Autism Research and Treatment, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, CA 90095 USA
| | - Steve Horvath
- />Department of Human Genetics, David Geffen Sch. of Medicine, UCLA, Los Angeles, CA USA
| | - Ricardo E Dolmetsch
- />Department of Neurobiology, Stanford University, Stanford, CA 94305-5345 USA
- />Novartis Institutes for Biomedical Research, Cambridge, MA 02139 USA
| | - Daniel H Geschwind
- />Neurogenetics Program, Department of Neurology, Center for Autism Research and Treatment, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, CA 90095 USA
- />Interdepartmental Ph.D. Program in Bioinformatics, University of California, Los Angeles, CA 90095 USA
- />Department of Human Genetics, David Geffen Sch. of Medicine, UCLA, Los Angeles, CA USA
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Zafeiriou DI, Ververi A, Dafoulis V, Kalyva E, Vargiami E. Autism spectrum disorders: the quest for genetic syndromes. Am J Med Genet B Neuropsychiatr Genet 2013; 162B:327-66. [PMID: 23650212 DOI: 10.1002/ajmg.b.32152] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Accepted: 03/01/2013] [Indexed: 11/10/2022]
Abstract
Autism spectrum disorders (ASD) are a heterogeneous group of neurodevelopmental disabilities with various etiologies, but with a heritability estimate of more than 90%. Although the strong correlation between autism and genetic factors has been long established, the exact genetic background of ASD remains unclear. A number of genetic syndromes manifest ASD at higher than expected frequencies compared to the general population. These syndromes account for more than 10% of all ASD cases and include tuberous sclerosis, fragile X, Down, neurofibromatosis, Angelman, Prader-Willi, Williams, Duchenne, etc. Clinicians are increasingly required to recognize genetic disorders in individuals with ASD, in terms of providing proper care and prognosis to the patient, as well as genetic counseling to the family. Vice versa, it is equally essential to identify ASD in patients with genetic syndromes, in order to ensure correct management and appropriate educational placement. During investigation of genetic syndromes, a number of issues emerge: impact of intellectual disability in ASD diagnoses, identification of autistic subphenotypes and differences from idiopathic autism, validity of assessment tools designed for idiopathic autism, possible mechanisms for the association with ASD, etc. Findings from the study of genetic syndromes are incorporated into the ongoing research on autism etiology and pathogenesis; different syndromes converge upon common biological backgrounds (such as disrupted molecular pathways and brain circuitries), which probably account for their comorbidity with autism. This review paper critically examines the prevalence and characteristics of the main genetic syndromes, as well as the possible mechanisms for their association with ASD.
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Vasudevan C, McKechnie L, Levene M. Long-term outcome of antenatally diagnosed agenesis of corpus callosum and cerebellar malformations. Semin Fetal Neonatal Med 2012; 17:295-300. [PMID: 22840681 DOI: 10.1016/j.siny.2012.07.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Recent advancements in fetal imaging and antenatal care have enabled identification of numerous anomalies including agenesis of corpus callosum and posterior fossa abnormalities. One of the important determinants of long-term prognosis in these conditions is the presence of central nervous system (CNS) and extra-CNS anomalies. The difficulty in confirming the isolated nature of these conditions antenatally and the lack of clear information regarding long-term prognoses makes it difficult for the clinician to provide accurate information to the parents antenatally. Caring for these families would require input from a multidisciplinary team involving obstetricians, geneticists, neurologists, radiologists and neonatologists.
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Affiliation(s)
- C Vasudevan
- University of Leeds, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
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10
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de Oliveira AKP, Hamerschmidt R, Mocelin M, Rezende RK. Cochlear implantation in patient with Dandy-walker syndrome. Int Arch Otorhinolaryngol 2012; 16:406-9. [PMID: 25991966 PMCID: PMC4435434 DOI: 10.7162/s1809-97772012000300018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 08/01/2010] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Dandy Walker Syndrome is a congenital abnormality in the central nervous system, characterized by a deficiency in the development of middle cerebelar structures, cystic dilatation of the posterior pit communicating with the fourth ventricle and upward shift of the transverse sinuses, tentorium and dyes. Among the clinical signs are occipital protuberances, a progressive increase of the skull, bowing before the fontanels, papilledema, ataxia, gait disturbances, nystagmus, and intellectual impairment. OBJECTIVES To describe a case of female patient, 13 years old with a diagnosis of this syndrome and bilateral hearing loss underwent cochlear implant surgery under local anesthesia and sedation. CASE REPORT CGS, 13 years old female was referred to the Otolaryngological Department of Otolaryngology Institute of Parana with a diagnosis of "Dandy-Walker syndrome" for Otolaryngological evaluation for bilateral hearing loss with no response to the use of hearing aids. Final Comments: The field of cochlear implants is growing rapidly. We believe that the presence of Dandy-Walker syndrome cannot be considered a contraindication to the performance of cochlear implant surgery, and there were no surgical complications due to neurological disorders with very favorable results for the patient who exhibits excellent discrimination. It has less need for lip reading with improvement in speech quality.
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Affiliation(s)
| | - Rogerio Hamerschmidt
- Professor of Otolaryngology, Federal University of Parana. Otolaryngologist Doctor at, Hospital of Parana of Otolaryngology.
| | - Marcos Mocelin
- Head of the Department of Otolaryngology, Clinics Hospital, Federal University of Parana. Head of the Department of Otolaryngology, Clinics Hospital, Federal University of Parana.
| | - Rodrigo K. Rezende
- Resident of Otolaryngology at the Clinics Hospital, Federal University of Parana.
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Joubert syndrome: brain and spinal cord malformations in genotyped cases and implications for neurodevelopmental functions of primary cilia. Acta Neuropathol 2012; 123:695-709. [PMID: 22331178 DOI: 10.1007/s00401-012-0951-2] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 01/25/2012] [Accepted: 01/27/2012] [Indexed: 12/12/2022]
Abstract
Joubert syndrome (JS) is an autosomal recessive ciliopathy characterized by hypotonia, ataxia, abnormal eye movements, and intellectual disability. The brain is malformed, with severe vermian hypoplasia, fourth ventriculomegaly, and "molar tooth" appearance of the cerebral and superior cerebellar peduncles visible as consistent features on neuroimaging. Neuropathological studies, though few, suggest that several other brain and spinal cord structures, such as the dorsal cervicomedullary junction, may also be affected in at least some patients. Genetically, JS is heterogeneous, with mutations in 13 genes accounting for approximately 50% of patients. Here, we compare neuropathologic findings in five subjects with JS, including four with defined mutations in OFD1 (2 siblings), RPGRIP1L, or TCTN2. Characteristic findings in all JS genotypes included vermian hypoplasia, fragmented dentate and spinal trigeminal nuclei, hypoplastic pontine and inferior olivary nuclei, and nondecussation of corticospinal tracts. Other common findings, seen in multiple genotypes but not all subjects, were dorsal cervicomedullary heterotopia, nondecussation of superior cerebellar peduncles, enlarged arcuate nuclei, hypoplastic reticular formation, hypoplastic medial lemnisci, and dorsal spinal cord disorganization. Thus, while JS exhibits significant neuropathologic as well as genetic heterogeneity, no genotype-phenotype correlations are apparent as yet. Our findings suggest that primary cilia are important for neural patterning, progenitor proliferation, cell migration, and axon guidance in the developing human brain and spinal cord.
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12
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Gulkilik G, Erdenoz S, Oba EM. A case of Joubert syndrome with features of ocular neovascularization. J Pediatr Ophthalmol Strabismus 2010; 47 Online:e1-3. [PMID: 21214151 DOI: 10.3928/01913913-20100507-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Accepted: 11/19/2009] [Indexed: 11/20/2022]
Abstract
A 12-year-old boy with a diagnosis of Joubert syndrome with bilateral horizontal nystagmus was evaluated. Neovascularization over the iris and the pupillary border was observed on biomicroscopy. There was pigmentary retinal dystrophy in both eyes. Fundus fluorescein angiography revealed ischemic areas and fluorescein leakage due to retinal neovascularization in both eyes.
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Affiliation(s)
- Gokhan Gulkilik
- Sisli Etfal Education and Research Hospital, Eye Clinic, Istanbul, Turkey
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13
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Bolduc ME, Limperopoulos C. Neurodevelopmental outcomes in children with cerebellar malformations: a systematic review. Dev Med Child Neurol 2009; 51:256-67. [PMID: 19191827 DOI: 10.1111/j.1469-8749.2008.03224.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Cerebellar malformations are increasingly diagnosed in the fetal period. Consequently, their consideration requires stressful and often critical decisions from both clinicians and families. This has resulted in an emergent need to understand better the impact of these early life lesions on child development. We performed a comprehensive literature search of studies describing neurodevelopmental outcomes of cerebellar malformations between January 1997 and December 2007. Overall, the data suggested that children with isolated inferior vermis hypoplasia (IVH) and mega cisterna magna (MCM) have a good developmental outcome, whereas children with molar tooth sign/Joubert syndrome, vermis hypoplasia, pontocerebellar hypoplasia (PCH) type II, and cerebellar agenesis experience moderate to severe global developmental delays. Reports for Dandy-Walker malformation (DWM) were conflicting; however, the presence of a normally lobulated vermis and the absence of associated brain anomalies were associated with a more favourable outcome. Finally, children with isolated cerebellar hypoplasia experienced fewer impairments. Important methodological limitations highlighted include a lack of standardized outcome measure use in 79% of studies and the predominant use of retrospective study designs (85%), with 40% limited to case reports or case-series. In summary, rigorous outcome studies describing the spectrum of disabilities in survivors are urgently needed to accurately delineate the long-term neurodevelopmental consequences of cerebellar malformations.
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Affiliation(s)
- Marie-Eve Bolduc
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
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Ploeger A, van der Maas HLJ, Raijmakers MEJ, Galis F. Why did the savant syndrome not spread in the population? A psychiatric example of a developmental constraint. Psychiatry Res 2009; 166:85-90. [PMID: 19195716 DOI: 10.1016/j.psychres.2007.11.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Revised: 05/29/2007] [Accepted: 11/09/2007] [Indexed: 11/17/2022]
Abstract
A developmental constraint is a mechanism that limits the possibility of a phenotype to evolve. There is growing evidence for the existence of developmental constraints in the biological literature. We hypothesize that a developmental constraint prevents the savant syndrome, despite its positive aspects, from spreading in the population. Here, the developmental constraint is the result of the high interactivity among body parts in an early stage in embryological development, namely early organogenesis or the phylotypic stage. The interactivity during this stage involves all components of the embryo, and as a result mutations that affect one part of the embryo also affect other parts. We hypothesize that a mutation, which gives rise to the development of the positive aspects of the savant syndrome (e.g., an impressive memory capacity), will virtually always have a deleterious effect on the development of other phenotypic traits (e.g., resulting in autism and/or impaired motor coordination). Thus, our hypothesis states that the savant syndrome cannot spread in the population because of this developmental constraint. The finding that children with savant syndrome often have autism and physical anomalies, which are known to be established during early organogenesis, supports our hypothesis.
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Affiliation(s)
- Annemie Ploeger
- Department of Psychology, University of Amsterdam, Roetersstraat 15, 1018 WB Amsterdam, The Netherlands.
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Ophthalmic features of Joubert syndrome. Ophthalmology 2008; 115:2286-9. [PMID: 19041481 DOI: 10.1016/j.ophtha.2008.08.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2008] [Revised: 05/31/2008] [Accepted: 08/01/2008] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Joubert syndrome (Online Mendelian Inheritance in Man 213300) is a rare autosomal recessive congenital malformation of the brainstem and cerebellar vermis. Diagnosis is based on characteristic clinical features (e.g., hypotonia, episodic hyperpnea, developmental delay, progressive ataxia) and is confirmed by distinctive neuroradiologic findings (e.g., the "molar tooth" sign). Variable ophthalmic features have been mentioned in prior reports; however, most do not detail eye findings and the few that do were before the publication of suggested diagnostic criteria. The objective of the current study is to describe the ophthalmic phenotype in a cohort of patients with Joubert syndrome for whom the diagnosis was made using current diagnostic criteria. DESIGN Prospective case series. PARTICIPANTS Eight children diagnosed clinically with radiologic confirmation. METHODS Ophthalmic examination and visual electrophysiology. MAIN OUTCOME MEASURES Ocular and oculomotor examination (as allowed by patient cooperation), electroretinography, flash visual-evoked potential (fVEP). RESULTS Patients' ages ranged from 7 months to 10 years. Saccadic dysfunction was observed in all cooperative patients (6/6); compensatory head thrusts or turns were present in all except the youngest patient (7 months of age). Most patients (5/8) had primary-position nystagmus (see-saw in 3/5). Abnormal pursuit (3/7) and a dystrophic retinal appearance (3/8) were also seen. One patient had bilateral asymmetric ptosis with unilateral lid elevation during ipsilateral abduction. Electroretinography findings were normal for all 8 patients. Seven patients underwent fVEP; 6 were abnormal (asymmetric) and one was not interpretable because of study artifact. CONCLUSIONS Ophthalmologists should be aware that saccadic dysfunction (typically with head thrusts) and primary position nystagmus (typically see-saw) in a developmentally delayed child suggest the diagnosis of Joubert syndrome, especially if a dystrophic retinal appearance is also present. Our findings of asymmetric fVEPs and see-saw nystagmus suggest an abnormality in optic nerve decussation, consistent with the concept that impaired axonal guidance occurs in patients with Joubert syndrome. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Alvarez Retuerto AI, Cantor RM, Gleeson JG, Ustaszewska A, Schackwitz WS, Pennacchio LA, Geschwind DH. Association of common variants in the Joubert syndrome gene (AHI1) with autism. Hum Mol Genet 2008; 17:3887-96. [PMID: 18782849 DOI: 10.1093/hmg/ddn291] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
It has been suggested that autism, like other complex genetic disorders, may benefit from the study of rare or Mendelian variants associated with syndromic or non-syndromic forms of the disease. However, there are few examples in which common variation in genes causing a Mendelian neuropsychiatric disorder has been shown to contribute to disease susceptibility in an allied common condition. Joubert syndrome (JS) is a rare recessively inherited disorder, with mutations reported at several loci including the gene Abelson's Helper Integration 1 (AHI1). A significant proportion of patients with JS, in some studies up to 40%, have been diagnosed with autism spectrum disorder (ASD) and several linkage studies in ASD have nominally implicated the region on 6q where AHI1 resides. To evaluate AHI1 in ASD, we performed a three-stage analysis of AHI1 as an a priori candidate gene for autism. Re-sequencing was first used to screen AHI1, followed by two subsequent association studies, one limited and one covering the gene more completely, in Autism Genetic Resource Exchange (AGRE) families. In stage 3, we found evidence of an associated haplotype in AHI1 with ASD after correction for multiple comparisons, in a region of the gene that had been previously associated with schizophrenia. These data suggest a role for AHI1 in common disorders affecting human cognition and behavior.
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Affiliation(s)
- Ana I Alvarez Retuerto
- Center for Autism Research and Treatment Semel Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
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Zafeiriou DI, Ververi A, Vargiami E. Childhood autism and associated comorbidities. Brain Dev 2007; 29:257-72. [PMID: 17084999 DOI: 10.1016/j.braindev.2006.09.003] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2006] [Revised: 08/25/2006] [Accepted: 09/06/2006] [Indexed: 12/11/2022]
Abstract
Autism is a heterogeneous neurodevelopmental disorder with a variety of different etiologies, but with a heritability estimate of more than 90%. Although the strong correlation between autism and genetic factors has been long established, the exact genetic background of autism is still unclear. This review refers to all the genetic syndromes that have been described in children with pervasive developmental disorders (tuberous sclerosis, fragile X, Down, neurofibromatosis, Angelman, Prader-Willi, Gilles de la Tourette, Williams, etc.). Issues covered include prevalence and main characteristics of each syndrome, as well as the possible base of its association with autism in terms of contribution to the current knowledge on the etiology and genetic base of pervasive developmental disorders.
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Affiliation(s)
- Dimitrios I Zafeiriou
- 1st Department of Pediatrics, Aristotle University of Thessaloniki, Egnatia St. 106, 54622 Thessaloniki, Greece.
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Kim JT, Kim SJ, Joo CU, Cho SC, Lee DY. Joubert syndrome with peripheral dysostosis - A case report of long term follow-up -. KOREAN JOURNAL OF PEDIATRICS 2007. [DOI: 10.3345/kjp.2007.50.3.315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jung Tae Kim
- Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Jeonbuk, Korea
| | - Sun Jun Kim
- Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Jeonbuk, Korea
- Institute for Medical Science, Chonbuk National University Medical School, Jeonju, Jeonbuk, Korea
| | - Chan-Uhng Joo
- Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Jeonbuk, Korea
- Institute for Medical Science, Chonbuk National University Medical School, Jeonju, Jeonbuk, Korea
| | - Soo Chul Cho
- Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Jeonbuk, Korea
- Institute for Medical Science, Chonbuk National University Medical School, Jeonju, Jeonbuk, Korea
| | - Dae-Youl Lee
- Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Jeonbuk, Korea
- Institute for Medical Science, Chonbuk National University Medical School, Jeonju, Jeonbuk, Korea
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Colombani M, Chouchane M, Pitelet G, Morales L, Callier P, Pinard JP, Lion-François L, Thauvin-Robinet C, Mugneret F, Huet F, Guibaud L, Faivre L. A new case of megalencephaly and perisylvian polymicrogyria with post-axial polydactyly and hydrocephalus: MPPH syndrome. Eur J Med Genet 2006; 49:466-71. [PMID: 16807158 DOI: 10.1016/j.ejmg.2006.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2006] [Accepted: 05/21/2006] [Indexed: 10/24/2022]
Abstract
We report a new case of megalencephaly and polymicrogyria with post-axial polydactyly and hydrocephalus (MPPH syndrome) in an 18-month-old girl. She was the first child of healthy non-consanguineous parents and measurements at birth were +3 standard deviations (S.D.) for weight, +2 S.D. for length and +4 S.D. for OFC. Ultrasound scan at 24 weeks of gestation (WG) showed mild ventriculomagaly with unique umbilical artery and dacryocystocele. Clinical examination at birth revealed macrosomia with macrocephaly, facial dysmorphism, post-axial polydactyly at the right hand and both feet, and axial hypotonia with hypertonic arms and legs. At 18 months of age, weight was +2 S.D., length was +2 S.D. and OFC was +4 S.D. She remained hypertonic, could not sit and had no hand use. Cerebral magnetic resonance imaging showed stable ventriculomegaly and polymicrogyria located on the frontal and perisylvian region with white matter hypersignal on T2-weighted images. There was no associated visceral malformation. Standard and high-resolution cytogenetic examination, telomeric FISH and array-CGH studies were normal. This case represents the sixth observation of MPPH syndrome as described by Mirzaa et al. in 2004. We provide further neurological follow-up since three out of five index patients were aged 6 months or less. We postulate that macrosomia at birth might be a major feature (five/six cases), with advanced bone age in the two/two investigated cases. White matter abnormalities might be an occasional feature of this syndrome (three/six cases), as well as dacryocystocele, if not coincidental (one/six case). The mode of inheritance of this syndrome remains unknown since there was no significant family history in all reported cases. The search for infracytogenetic chromosomal imbalance was unsuccessful.
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Affiliation(s)
- Marina Colombani
- Département de Génétique, Hôpital d'Enfants, 10, bd Maréchal de Lattre de Tassigny, 21034 Dijon cedex, France
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Alexiev BA, Lin X, Sun CC, Brenner DS. Meckel-Gruber syndrome: pathologic manifestations, minimal diagnostic criteria, and differential diagnosis. Arch Pathol Lab Med 2006; 130:1236-8. [PMID: 16879033 DOI: 10.5858/2006-130-1236-ms] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This article provides an overview of the major pathologic manifestations of Meckel-Gruber syndrome, current knowledge about its pathogenesis, minimal diagnostic criteria, and differential diagnosis. Typical sonographic findings (occipital encephalocele, postaxial polydactyly, and cystic enlargement of the kidneys) allow for diagnosis of most cases before the 14th week of gestation, but the pathologist may encounter clinically unsuspected or atypical cases that require morphologic confirmation. In these cases, a meticulous autopsy is necessary to establish the diagnosis of Meckel-Gruber syndrome.
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Affiliation(s)
- Borislav A Alexiev
- Department of Pathology, University of Maryland Medical System, Baltimore, Maryland 21201, USA.
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Yönem O, Ozkayar N, Balkanci F, Harmanci O, Sökmensüer C, Ersoy O, Bayraktar Y. Is congenital hepatic fibrosis a pure liver disease? Am J Gastroenterol 2006; 101:1253-9. [PMID: 16771946 DOI: 10.1111/j.1572-0241.2006.00642.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES An association between congenital hepatic fibrosis (CHF) and several different conditions is being increasingly recognized. We aimed to investigate, prospectively, these associated disorders and the clinical consequences for patients with CHF. MATERIALS AND METHODS CHF was diagnosed using liver biopsy, abdominal ultrasound (US), Doppler US, upper endoscopy, and abdominal computed tomography (CT) in 19 patients (13 women, 6 men). CT portography and splenoportography with digital subtraction angiography were performed if indicated. Endoscopic retrograde cholangiopancreatography (ERCP) was performed to investigate the extent of portal vein involvement of the common bile duct if it existed, to remove a stone located in the common bile duct when documented, and to confirm the diagnosis of Caroli's syndrome. Cranial MRI was done when clinical findings suggested brain involvement. RESULTS The mean age of the patients was 29.47+/-12.06, ranging from 13 to 57. CHF-associated diseases were Caroli's syndrome, polycystic kidney disease, cavernous transformation of the portal vein, Joubert's syndrome, von Meyenburg complex, polydactyly, medullary sponge kidney, and pancreatic duct atrophy. In two cases, cholangiocarcinoma had developed. There was only one case with pure CHF. Portosystemic shunt, TIPS, or splenectomy were performed in some cases to control bleeding from esophageal varices. Papillotomy and stone extraction from the common bile duct were performed in four patients with Caroli's syndrome complicated by cholangitis. Three patients died of complications of CHF. Two patients with Caroli's syndrome underwent liver transplantation. CONCLUSION In this prospective study, it seems that CHF is not a pure liver disease but rather a multiorgan disorder involving the brain, portal vein, kidneys, and bile ducts. In most cases, the clinical picture includes other organ involvement, rather than purely the liver parenchyma.
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Affiliation(s)
- Ozlem Yönem
- Department of Gastroenterology, Hacettepe University, Ankara, Turkey
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