1
|
Wang H, Guan L, Wu X, Guan J, Li J, Li N, Wu K, Gao Y, Bing D, Zhang J, Lan L, Shi T, Li D, Wang W, Xie L, Xiong F, Shi W, Zhao L, Wang D, Yin Y, Wang Q. Clinical and genetic architecture of a large cohort with auditory neuropathy. Hum Genet 2024; 143:293-309. [PMID: 38456936 PMCID: PMC11043192 DOI: 10.1007/s00439-024-02652-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/25/2024] [Indexed: 03/09/2024]
Abstract
Auditory neuropathy (AN) is a unique type of language developmental disorder, with no precise rate of genetic contribution that has been deciphered in a large cohort. In a retrospective cohort of 311 patients with AN, pathogenic and likely pathogenic variants of 23 genes were identified in 98 patients (31.5% in 311 patients), and 14 genes were mutated in two or more patients. Among subgroups of patients with AN, the prevalence of pathogenic and likely pathogenic variants was 54.4% and 56.2% in trios and families, while 22.9% in the cases with proband-only; 45.7% and 25.6% in the infant and non-infant group; and 33.7% and 0% in the bilateral and unilateral AN cases. Most of the OTOF gene (96.6%, 28/29) could only be identified in the infant group, while the AIFM1 gene could only be identified in the non-infant group; other genes such as ATP1A3 and OPA1 were identified in both infant and non-infant groups. In conclusion, genes distribution of AN, with the most common genes being OTOF and AIFM1, is totally different from other sensorineural hearing loss. The subgroups with different onset ages showed different genetic spectrums, so did bilateral and unilateral groups and sporadic and familial or trio groups.
Collapse
Affiliation(s)
- Hongyang Wang
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Liping Guan
- Hebei Industrial Technology Research Institute of Genomics in Maternal and Child Health, Shijiazhuang, 050000, People's Republic of China
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, People's Republic of China
| | - Xiaonan Wu
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Jing Guan
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Jin Li
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Nan Li
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, People's Republic of China
| | - Kaili Wu
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Ya Gao
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, People's Republic of China
| | - Dan Bing
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Jianguo Zhang
- Hebei Industrial Technology Research Institute of Genomics in Maternal and Child Health, Shijiazhuang, 050000, People's Republic of China
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, People's Republic of China
| | - Lan Lan
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Tao Shi
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Danyang Li
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Wenjia Wang
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Linyi Xie
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Fen Xiong
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Wei Shi
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Lijian Zhao
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, People's Republic of China
- Medical Technology College, Hebei Medical University, Shijiazhuang, 050000, People's Republic of China
| | - Dayong Wang
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Ye Yin
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, People's Republic of China
| | - Qiuju Wang
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China.
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China.
| |
Collapse
|
2
|
Zhu YM, Li Q, Gao X, Li YF, Liu YL, Dai P, Li XP. Familial Temperature-Sensitive Auditory Neuropathy: Distinctive Clinical Courses Caused by Variants of the OTOF Gene. Front Cell Dev Biol 2021; 9:732930. [PMID: 34692690 PMCID: PMC8529165 DOI: 10.3389/fcell.2021.732930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate the clinical course and genetic etiology of familial temperature-sensitive auditory neuropathy (TSAN), which is a very rare subtype of auditory neuropathy (AN) that involves an elevation of hearing thresholds due to an increase in the core body temperature, and to evaluate the genotype-phenotype correlations in a family with TSAN. Methods: Six members of a non-consanguineous Chinese family, including four siblings complaining of communication difficulties when febrile, were enrolled in this study. The clinical and audiological profiles of the four siblings were fully evaluated during both febrile and afebrile episodes, and the genetic etiology of hearing loss (HL) was explored using next-generation sequencing (NGS) technology. Their parents, who had no complaints of fluctuating HL due to body temperature variation, were enrolled for the genetics portion only. Results: Audiological tests during the patients' febrile episodes met the classical diagnostic criteria for AN, including mild HL, poor speech discrimination, preserved cochlear microphonics (CMs), and absent auditory brainstem responses (ABRs). Importantly, unlike the pattern observed in previously reported cases of TSAN, the ABRs and electrocochleography (ECochG) signals of our patients improved to normal during afebrile periods. Genetic analysis identified a compound heterozygous variant of the OTOF gene (which encodes the otoferlin protein), including one previously reported pathogenic variant, c.5098G > C (p.Glu1700Gln), and one novel variant, c.4882C > A (p.Pro1628Thr). Neither of the identified variants affected the C2 domains related to the main function of otoferlin. Both variants faithfully cosegregated with TSAN within the pedigree, suggesting that OTOF is the causative gene of the autosomal recessive trait segregation in this family. Conclusion: The presence of CMs with absent (or markedly abnormal) ABRs is a reliable criterion for diagnosing AN. The severity of the phenotype caused by dysfunctional neurotransmitter release in TSAN may reflect variants that alter the C2 domains of otoferlin. The observations from this study enrich the current understanding of the phenotype and genotype of TSAN and may lay a foundation for further research on its pathogenesis.
Collapse
Affiliation(s)
- Yi-Ming Zhu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Otolaryngology-Head and Neck Surgery, Lanzhou University Second Hospital, Lanzhou, China
| | - Qi Li
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xue Gao
- Department of Otolaryngology, PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Yan-Fei Li
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - You-Li Liu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Pu Dai
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Otolaryngology-Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
| | - Xiang-Ping Li
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| |
Collapse
|
3
|
Song M, Li J, Lan L, Xie L, Xiong F, Yu L, Shi W, Wang D, Guan J, Wang H, Wang Q. Clinical characteristics of patients with unilateral auditory neuropathy. Am J Otolaryngol 2021; 42:103143. [PMID: 34175691 DOI: 10.1016/j.amjoto.2021.103143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 06/14/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To analyze the clinical characteristics of patients with unilateral auditory neuropathy (UAN), and to provide guidance for future clinical diagnosis and research. METHODS Patients who were clinically diagnosed with UAN from 2004 to 2019 were included. Clinical characteristics, audiological features, imaging findings, genetic test results and management effect were summarized and followed. RESULTS A total of 44 patients [mean age, 4.35 ± 4.39 years; 22 (50.00%) males and 22 (50.00%) females] were enrolled for analyses. Among the 38 patients who were tested by pure-tone or behavioral audiometry, the degree of hearing loss of the affected ear was characterized as mild in 2 ears (5.26%), moderate in 5 (13.16%), severe in 9 (23.68%) and profound in 22 (57.89%). For the 44 contralateral ears, 33 (75.00%) showed normal hearing and 11 (25.00%) presented with sensorineural hearing loss. Auditory brainstem responses were absent or abnormal in all 44 affected ears, while otoacoustic emissions and/or cochlear microphonics were present. Among the 18 patients who underwent magnetic resonance imaging (MRI), 7 (38.89%) presented cochlear nerve deficiency (CND). Nineteen candidate variants were found in 12 patients among the 15 UAN patients who were conducted targeted gene capture and next generation sequencing. Thirty patients were followed up by telephone to investigate their management effect. CONCLUSIONS Our study demonstrates comprehensive audiological features of patients with UAN to improve the clinical understanding and diagnosis. Some patients with UAN could show ipsilateral CND and MRI is essential to evaluate if the nerve is deficient. No pathogenic variants that directly related to the pathogenesis of UAN have been found in this study currently.
Collapse
|
4
|
Cai L, Liu Y, Xu Y, Yang H, Lv L, Li Y, Chen Q, Lin X, Yang Y, Hu G, Zheng G, Zhou J, Qian Q, Xu MA, Fang J, Ding J, Chen W, Gao J. Multi-Center in-Depth Screening of Neonatal Deafness Genes: Zhejiang, China. Front Genet 2021; 12:637096. [PMID: 34276761 PMCID: PMC8282931 DOI: 10.3389/fgene.2021.637096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 05/07/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose The conventional genetic screening for deafness involves 9-20 variants from four genes. This study expands screening to analyze the mutation types and frequency of hereditary deafness genes in Zhejiang, China, and explore the significance of in-depth deafness genetic screening in newborns. Methods This was a multi-centre study conducted in 5,120 newborns from 12 major hospitals in the East-West (including mountains and islands) of Zhejiang Province. Concurrent hearing and genetic screening was performed. For genetic testing, 159 variants of 22 genes were screened, including CDH23, COL11A1, DFNA5, DFNB59, DSPP, GJB2, GJB3, KCNJ10, MT-RNR1, MT-TL1, MT-TS1, MYO15A, MYO7A, OTOF, PCDH15, SLC26A4, SOX10, TCOF1, TMC1, USH1G, WFS1, and WHRN using next-generation sequencing. Newborns who failed to have genetic mutations or hearing screening were diagnosed audiologically at the age of 6 months. Results A total of 4,893 newborns (95.57%) have passed the initial hearing screening, and 7 (0.14%) have failed in repeated screening. Of these, 446 (8.71%) newborns carried at least one genetic deafness-associated variant. High-risk pathogenic variants were found in 11 newborns (0.21%) (nine homozygotes and two compound heterozygotes), and eight of these infants have passed the hearing screening. The frequency of mutations in GJB2, GJB3, SLC26A4, 12SrRNA, and TMC1 was 5.43%, 0.59%, 1.91%, 0.98%, and 0.02%, respectively. The positive rate of in-depth screening was significantly increased when compared with 20 variants in four genes of traditional testing, wherein GJB2 was increased by 97.2%, SLC26A4 by 21% and MT-RNR1 by 150%. The most common mutation variants were GJB2c.235delC and SLC26A4c.919-2A > G, followed by GJB2c.299_300delAT. Homoplasmic mutation in MT-RNR1 was the most common, including m.1555A > G, m.961T > C, m.1095T > C. All these infants have passed routine hearing screening. The positive rate of MT-RNR1 mutation was significantly higher in newborns with high-risk factors of maternal pregnancy. Conclusion The positive rate of deafness gene mutations in the Zhejiang region is higher than that of the database, mainly in GJB2c.235delC, SLC26A4 c.919-2A > G, and m.1555A > G variants. The expanded genetic screening in the detection rate of diseasecausing variants was significantly improved. It is helpful in identifying high-risk children for follow-up intervention.
Collapse
Affiliation(s)
- Luhang Cai
- Department of Otorhinolaryngology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ya Liu
- Department of Otorhinolaryngology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yaping Xu
- Department of Otorhinolaryngology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hang Yang
- Department of Otorhinolaryngology, Jiangshan People's Hospital, Quzhou, China
| | - Lihui Lv
- Department of Otorhinolaryngology, Fenghua People's Hospital, Ningbo, China
| | - Yang Li
- Department of Obstetrics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiongqiong Chen
- Department of Otorhinolaryngology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojiang Lin
- Department of Otorhinolaryngology, Kaihua People's Hospital, Quzhou, China
| | - Yihui Yang
- Department of Otorhinolaryngology, Ningbo Women and Children's Hospital, Ningbo, China
| | - Guangwei Hu
- Department of Otorhinolaryngology, Zhoushan Hospital, Zhoushan, China
| | - Guofeng Zheng
- Department of Otorhinolaryngology, Shaoxing Second Hospital, Shaoxing, China
| | - Jing Zhou
- Department of Otorhinolaryngology, Ruian People's Hospital, Wenzhou, China
| | - Qiyong Qian
- Department of Otorhinolaryngology, Shengzhou People's Hospital, Shaoxing, China
| | - Mei-Ai Xu
- Department of Otorhinolaryngology, Sanmen People's Hospital, Taizhou, China
| | - Jin Fang
- Department of Otorhinolaryngology, Zhejiang Xin'an International Hospital, Jiaxing, China
| | - Jianjun Ding
- Department of Otorhinolaryngology, Linhai First People's Hospital, Taizhou, China
| | - Wei Chen
- Department of Otorhinolaryngology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiong Gao
- Beijing Genomics Institute, Shenzhen, China
| |
Collapse
|
5
|
Vona B, Rad A, Reisinger E. The Many Faces of DFNB9: Relating OTOF Variants to Hearing Impairment. Genes (Basel) 2020; 11:genes11121411. [PMID: 33256196 PMCID: PMC7768390 DOI: 10.3390/genes11121411] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 01/05/2023] Open
Abstract
The OTOF gene encodes otoferlin, a critical protein at the synapse of auditory sensory cells, the inner hair cells (IHCs). In the absence of otoferlin, signal transmission of IHCs fails due to impaired release of synaptic vesicles at the IHC synapse. Biallelic pathogenic and likely pathogenic variants in OTOF predominantly cause autosomal recessive profound prelingual deafness, DFNB9. Due to the isolated defect of synaptic transmission and initially preserved otoacoustic emissions (OAEs), the clinical characteristics have been termed "auditory synaptopathy". We review the broad phenotypic spectrum reported in patients with variants in OTOF that includes milder hearing loss, as well as progressive and temperature-sensitive hearing loss. We highlight several challenges that must be addressed for rapid clinical and genetic diagnosis. Importantly, we call for changes in newborn hearing screening protocols, since OAE tests fail to diagnose deafness in this case. Continued research appears to be needed to complete otoferlin isoform expression characterization to enhance genetic diagnostics. This timely review is meant to sensitize the field to clinical characteristics of DFNB9 and current limitations in preparation for clinical trials for OTOF gene therapies that are projected to start in 2021.
Collapse
|
6
|
Deterioration in Distortion Product Otoacoustic Emissions in Auditory Neuropathy Patients With Distinct Clinical and Genetic Backgrounds. Ear Hear 2019; 40:184-191. [PMID: 29688962 DOI: 10.1097/aud.0000000000000586] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Auditory neuropathy (AN) is a clinical disorder characterized by the absence of auditory brainstem response and presence of otoacoustic emissions. A gradual loss of otoacoustic emissions has been reported for some cases of AN. Such cases could be diagnosed as cochlear hearing loss and lead to misunderstanding of the pathology when patients first visit clinics after the loss of otoacoustic emissions. The purpose of this study was to investigate the time course of changes in distortion product otoacoustic emissions (DPOAEs) in association with patients' genetic and clinical backgrounds, including the use of hearing aids. DESIGN DPOAE measurements from 31 patients with AN were assessed. Genetic analyses for GJB2, OTOF, and mitochondrial m.1555A> G and m.3243A> G mutations were conducted for all cases, and the analyses for CDH23 and OPA1 were conducted for the selected cases. Patients who were younger than 10 years of age at the time of AN diagnosis were designated as the pediatric AN group (22 cases), and those who were 18 years of age or older were designated as the adult AN group (9 cases). DPOAE was measured at least twice in all patients. The response rate for DPOAEs was defined and analyzed. RESULTS The pediatric AN group comprised 10 patients with OTOF mutations, 1 with GJB2 mutations, 1 with OPA1 mutation, and 10 with indefinite causes. Twelve ears (27%) showed no change in DPOAE, 20 ears (46%) showed a decrease in DPOAE, and 12 ears (27%) lost DPOAE. Loss of DPOAE occurred in one ear (2%) at 0 years of age and four ears (9%) at 1 year of age. The time courses of DPOAEs in patients with OTOF mutations were divided into those with early loss and those with no change, indicating that the mechanism for deterioration of DPOAEs includes not only the OTOF mutations but also other common modifier factors. Most, but not all, AN patients who used hearing aids showed deterioration of DPOAEs after the start of using hearing aids. A few AN patients also showed deterioration of DPOAEs before using hearing aids. The adult AN group comprised 2 patients with OPA1 mutations, 2 with OTOF mutations, and 5 with indefinite causes. Four ears (22%) showed no change in DPOAE, 13 ears (72%) showed a decrease, and one ear (6%) showed a loss of DPOAE. Although the ratio of DPOAE decrease was higher in the adult AN group than in the pediatric AN group, the ratio of DPOAE loss was lower in the adult AN group. DPOAE was not lost in all four ears with OPA1 mutations and in all four ears with OTOF mutations in the adult group. CONCLUSIONS DPOAE was decreased or lost in approximately 70% of pediatric and about 80% of adult AN patients. Eleven percent of pediatric AN patients lost DPOAEs by 1 year of age. Genetic factors were thought to have influenced the time course of DPOAEs in the pediatric AN group. In most adult AN patients, DPOAE was rarely lost regardless of the genetic cause.
Collapse
|
7
|
Xia H, Huang X, Xu H, Guo Y, Hu P, Deng X, Yang Z, Liu A, Deng H. An OTOF Frameshift Variant Associated with Auditory Neuropathy Spectrum Disorder. Curr Genomics 2018; 19:370-374. [PMID: 30065612 PMCID: PMC6030853 DOI: 10.2174/1389202919666171113152951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 06/13/2016] [Accepted: 06/18/2016] [Indexed: 11/28/2022] Open
Abstract
Background: Auditory Neuropathy Spectrum Disorder (ANSD) is manifested as impairment of auditory nerve activity but preservation of the outer hair cell function. Objective: This study was to detect the disease-causing gene and variant(s) in a Chinese ANSD family. Methods: A four-generation consanguineous Chinese ANSD family and 200 unrelated healthy controls were enrolled. Exome sequencing and Sanger sequencing were applied to identify the genetic basis for ANSD in this family. Results: Exome sequencing detected a c.1236delC variant of the otoferlin gene in an apparently homozygous state. Sanger sequencing confirmed that the variant co-segregating with the phenotype of hearing impairments in this family. The variant was not detected in 200 healthy controls. The c.1236delC alteration may result in a truncated otoferlin missing the C2C-C2F domains and the C-terminal transmembrane domain, and thus severely damages Ca2+-dependent synaptic vesicle fusion and targeting function of the otoferlin. Conclusion: Our study suggested that the c.1236delC alteration in the otoferlin gene may be the disease-causing variant in this family, and also shed new light on genetic counseling to this ANSD family.
Collapse
Affiliation(s)
- Hong Xia
- Center for Experimental Medicine and Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China.,Department of Emergency, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xiangjun Huang
- Department of General Surgery, The First Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Hongbo Xu
- Center for Experimental Medicine and Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yi Guo
- Center for Experimental Medicine and Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China.,Department of Medical Information, Information Security and Big Data Research Institute, Central South University, Changsha, China
| | - Pengzhi Hu
- Center for Experimental Medicine and Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China.,Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xiong Deng
- Center for Experimental Medicine and Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhijian Yang
- Center for Experimental Medicine and Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - An Liu
- Department of Otolaryngology-Head Neck Surgery, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Hao Deng
- Center for Experimental Medicine and Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
8
|
Han KH, Oh DY, Lee S, Lee C, Han JH, Kim MY, Park HR, Park MK, Kim NKD, Lee J, Yi E, Kim JM, Kim JW, Chae JH, Oh SH, Park WY, Choi BY. ATP1A3 mutations can cause progressive auditory neuropathy: a new gene of auditory synaptopathy. Sci Rep 2017; 7:16504. [PMID: 29184165 PMCID: PMC5705773 DOI: 10.1038/s41598-017-16676-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 11/16/2017] [Indexed: 12/21/2022] Open
Abstract
The etiologies and prevalence of sporadic, postlingual-onset, progressive auditory neuropathy spectrum disorder (ANSD) have rarely been documented. Thus, we aimed to evaluate the prevalence and molecular etiologies of these cases. Three out of 106 sporadic progressive hearing losses turned out to manifest ANSD. Through whole exome sequencing and subsequent bioinformatics analysis, two out of the three were found to share a de novo variant, p.E818K of ATP1A3, which had been reported to cause exclusively CAPOS (cerebellar ataxia, areflexia, pes cavus, optic atrophy, and sensorineural hearing loss) syndrome. However, hearing loss induced by CAPOS has never been characterized to date. Interestingly, the first proband did not manifest any features of CAPOS, except subclinical areflexia; however, the phenotypes of second proband was compatible with that of CAPOS, making this the first reported CAPOS allele in Koreans. This ANSD phenotype was compatible with known expression of ATP1A3 mainly in the synapse between afferent nerve and inner hair cells. Based on this, cochlear implantation (CI) was performed in the first proband, leading to remarkable benefits. Collectively, the de novo ATP1A3 variant can cause postlingual-onset auditory synaptopathy, making this gene a significant contributor to sporadic progressive ANSD and a biomarker ensuring favorable short-term CI outcomes.
Collapse
Affiliation(s)
- Kyu-Hee Han
- Department of Otorhinolaryngology, National Medical Center, Seoul, Korea
| | - Doo-Yi Oh
- Department of Otorhinolaryngology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seungmin Lee
- Department of Otorhinolaryngology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Chung Lee
- Samsung Genome Institute, Samsung Medical Center, Seoul, Korea.,Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
| | - Jin Hee Han
- Department of Otorhinolaryngology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Min Young Kim
- Department of Otorhinolaryngology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hye-Rim Park
- Department of Otorhinolaryngology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Moo Kyun Park
- Department of Otorhinolaryngology, Seoul National University Hospital, Seoul, Korea
| | - Nayoung K D Kim
- Samsung Genome Institute, Samsung Medical Center, Seoul, Korea
| | - Jaekwang Lee
- Division of Functional Food Research, Korea Food Research Institute (KFRI), Seongnam, Korea
| | - Eunyoung Yi
- College of Pharmacy and Natural Medicine Research Institute, Mokpo National University, Muan, Korea
| | - Jong-Min Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jeong-Whun Kim
- Department of Otorhinolaryngology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jong-Hee Chae
- Department of Pediatrics, Pediatric Clinical Neuroscience Center, Seoul National University Children's Hospital, Seoul, Korea
| | - Seung Ha Oh
- Department of Otorhinolaryngology, Seoul National University Hospital, Seoul, Korea
| | - Woong-Yang Park
- Samsung Genome Institute, Samsung Medical Center, Seoul, Korea.,Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea.,Department of Molecular Cell Biology, School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - Byung Yoon Choi
- Department of Otorhinolaryngology, Seoul National University Bundang Hospital, Seongnam, Korea.
| |
Collapse
|
9
|
Tang F, Ma D, Wang Y, Qiu Y, Liu F, Wang Q, Lu Q, Shi M, Xu L, Liu M, Liang J. Novel compound heterozygous mutations in the OTOF Gene identified by whole-exome sequencing in auditory neuropathy spectrum disorder. BMC MEDICAL GENETICS 2017; 18:35. [PMID: 28335750 PMCID: PMC5364697 DOI: 10.1186/s12881-017-0400-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 03/14/2017] [Indexed: 11/16/2022]
Abstract
Background Many hearing-loss diseases are demonstrated to have Mendelian inheritance caused by mutations in single gene. However, many deaf individuals have diseases that remain genetically unexplained. Auditory neuropathy is a sensorineural deafness in which sounds are able to be transferred into the inner ear normally but the transmission of the signals from inner ear to auditory nerve and brain is injured, also known as auditory neuropathy spectrum disorder (ANSD). The pathogenic mutations of the genes responsible for the Chinese ANSD population remain poorly understood. Methods A total of 127 patients with non-syndromic hearing loss (NSHL) were enrolled in Guangxi Zhuang Autonomous Region. A hereditary deafness gene mutation screening was performed to identify the mutation sites in four deafness-related genes (GJB2, GJB3, 12S rRNA, and SLC26A4). In addition, whole-exome sequencing (WES) was applied to explore unappreciated mutation sites in the cases with the singularity of its phenotype. Results Well-characterized mutations were found in only 8.7% (11/127) of the patients. Interestingly, two mutations in the OTOF gene were identified in two affected siblings with ANSD from a Chinese family, including one nonsense mutation c.1273C > T (p.R425X) and one missense mutation c.4994 T > C (p.L1665P). Furthermore, we employed Sanger sequencing to confirm the mutations in each subject. Two compound heterozygous mutations in the OTOF gene were observed in the two affected siblings, whereas the two parents and unaffected sister were heterozygous carriers of c.1273C > T (father and sister) and c.4994 T > C (mother). The nonsense mutation p.R425X, contributes to a premature stop codon, may result in a truncated polypeptide, which strongly suggests its pathogenicity for ANSD. The missense mutation p.L1665P results in a single amino acid substitution in a highly conserved region. Conclusions Two mutations in the OTOF gene in the Chinese deaf population were recognized for the first time. These findings not only extend the OTOF gene mutation spectrum for ANSD but also indicate that whole-exome sequencing is an effective approach to clarify the genetic characteristics in non-syndromic ANSD patients. Electronic supplementary material The online version of this article (doi:10.1186/s12881-017-0400-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Fengzhu Tang
- Department of Otolaryngology, The People's Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Road, Nanning, 530021, China
| | - Dengke Ma
- CapitalBio Technology Co., Ltd., Building C, Block 88 Kechuang 6th Street, Yizhuang Biomedical Park, Beijing Economic- Technological Development Area, Beijing, 101111, China
| | - Yulan Wang
- CapitalBio Technology Co., Ltd., Building C, Block 88 Kechuang 6th Street, Yizhuang Biomedical Park, Beijing Economic- Technological Development Area, Beijing, 101111, China
| | - Yuecai Qiu
- CapitalBio Technology Co., Ltd., Building C, Block 88 Kechuang 6th Street, Yizhuang Biomedical Park, Beijing Economic- Technological Development Area, Beijing, 101111, China
| | - Fei Liu
- Research Center of Medical Sciences, The People's Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Road, Nanning, 530021, China
| | - Qingqing Wang
- CapitalBio Technology Co., Ltd., Building C, Block 88 Kechuang 6th Street, Yizhuang Biomedical Park, Beijing Economic- Technological Development Area, Beijing, 101111, China
| | - Qiutian Lu
- Department of Otolaryngology, The People's Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Road, Nanning, 530021, China
| | - Min Shi
- Department of Otolaryngology, The People's Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Road, Nanning, 530021, China
| | - Liang Xu
- Department of Otolaryngology, The People's Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Road, Nanning, 530021, China
| | - Min Liu
- Department of Otolaryngology, The People's Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Road, Nanning, 530021, China
| | - Jianping Liang
- Department of Otolaryngology, The People's Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Road, Nanning, 530021, China.
| |
Collapse
|
10
|
de Carvalho GM, Z Ramos P, M Castilho A, C Guimarães A, L Sartorato E. Relationship Between Patients with Clinical Auditory Neuropathy Spectrum Disorder and Mutations in Gjb2 Gene. Open Neurol J 2016; 10:127-135. [PMID: 27843504 PMCID: PMC5080869 DOI: 10.2174/1874205x01610010127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 09/20/2015] [Accepted: 10/22/2015] [Indexed: 11/22/2022] Open
Abstract
The auditory neuropathy is a condition which there is a dyssynchrony in the nerve conduction of the auditory nerve fibers. There is no evidence
about the relationship between patients with clinical auditory neuropathy spectrum disorder and mutations in GJB2 gene. There are only two
studies about this topic in the medical literature. Connexin 26 (GJB2 gene) mutations are common causes of genetic deafness in many
populations and we also being reported in subjects with auditory neuropathy.
Collapse
Affiliation(s)
| | - Priscila Z Ramos
- Human Molecular Genetics Laboratory, Molecular Biology and Genetic Engineering Center, CBMEG, Unicamp, Sao Paulo, Brazil
| | - Arthur M Castilho
- Otologist, Otology, Audiology and Implantable Ear Prostheses, Unicamp, Sao Paulo, Brazil
| | - Alexandre C Guimarães
- Otologist, Otology, Audiology and Implantable Ear Prostheses, Unicamp, Sao Paulo, Brazil
| | - Edi L Sartorato
- Molecular Biology and Genetic Engineering Center, CBMEG, Unicamp, Sao Paulo, Brazil
| |
Collapse
|
11
|
Prabhu P. Evaluation of Depression, Anxiety, and Stress in Adolescents and Young Adults with Auditory Neuropathy Spectrum Disorder. SCIENTIFICA 2016; 2016:4378269. [PMID: 27579218 PMCID: PMC4992756 DOI: 10.1155/2016/4378269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 06/29/2016] [Accepted: 07/11/2016] [Indexed: 06/06/2023]
Abstract
The aim of the present study was to determine the severity of stress, anxiety, and depression using Depression Anxiety Stress Scales (DASS) in adolescents and young adults with auditory neuropathy spectrum disorder (ANSD). DASS was administered to 20 individuals with auditory neuropathy spectrum disorder. The effect of gender on severity of anxiety, stress, and depression on DASS scores was determined. It was attempted to determine the correlation of severity of anxiety, stress, and depression with the reported onset of the problem, degree of hearing loss, and speech identification scores. The results of the study showed that individuals with ANSD had a moderate degree of depression and anxiety. The results also showed that the symptoms were more seen in females than in males. Correlation analysis revealed that DASS scores correlated with the reported onset of condition and speech identification scores (SIS) and the degree of hearing loss showed no correlation. The study concludes that individuals with ANSD experience depression and anxiety and this could be because of the inadequate management options available for individuals with ANSD. Thus, there is a need to develop appropriate management strategies for individuals with ANSD and provide appropriate referral for management of psychological issues.
Collapse
Affiliation(s)
- Prashanth Prabhu
- All India Institute of Speech and Hearing, Mysore 570 006, India
| |
Collapse
|
12
|
Carvalho GMD, Ramos PZ, Castilho AM, Guimarães AC, Sartorato EL. Molecular study of patients with auditory neuropathy. Mol Med Rep 2016; 14:481-90. [PMID: 27177047 DOI: 10.3892/mmr.2016.5226] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 01/20/2016] [Indexed: 11/05/2022] Open
Abstract
Auditory neuropathy is a type of hearing loss that constitutes a change in the conduct of the auditory stimulus by the involvement of inner hair cells or auditory nerve synapses. It is characterized by the absence or alteration of waves in the examination of brainstem auditory evoked potentials, with otoacoustic and/or cochlear microphonic issues. At present, four loci associated with non‑syndromic auditory neuropathy have been mapped: Autosomal recessive deafness‑9 [DFNB9; the otoferlin (OTOF) gene] and autosomal recessive deafness‑59 [DFNB59; the pejvakin (PJVK) gene], associated with autosomal recessive inheritance; the autosomal dominant auditory neuropathy gene [AUNA1; the diaphanous‑3 (DIAPH3) gene]; and AUNX1, linked to chromosome X. Furthermore, mutations of connexin 26 [the gap junction β2 (GJB2) gene] have also been associated with the disease. OTOF gene mutations exert a significant role in auditory neuropathy. In excess of 80 pathogenic mutations have been identified in individuals with non‑syndromic deafness in populations of different origins, with an emphasis on the p.Q829X mutation, which was found in ~3% of cases of deafness in the Spanish population. The identification of genetic alterations responsible for auditory neuropathy is one of the challenges contributing to understand the molecular bases of the different phenotypes of hearing loss. Thus, the present study aimed to investigate molecular changes in the OTOF gene in patients with auditory neuropathy, and to develop a DNA chip for the molecular diagnosis of auditory neuropathy using mass spectrometry for genotyping. Genetic alterations were investigated in 47 patients with hearing loss and clinical diagnosis of auditory neuropathy, and the c.35delG mutation in the GJB2 gene was identified in three homozygous patients, and the heterozygous parents of one of these cases. Additionally, OTOF gene mutations were tracked by complete sequencing of 48 exons, although these results are still preliminary. Studying the genetic basis of auditory neuropathy is of utmost importance for obtaining a differential diagnosis, developing more specific treatments and more accurate genetic counseling.
Collapse
Affiliation(s)
- Guilherme Machado De Carvalho
- Otology, Audiology and Implantable Ear Prostheses, Ear, Nose, Throat and Head and Neck Surgery Department, State University of Campinas (UNICAMP), São Paulo 13081‑970, Brazil
| | - Priscila Zonzini Ramos
- Human Molecular Genetics Laboratory, Molecular Biology and Genetic Engineering Center‑CBMEG, State University of Campinas (UNICAMP), São Paulo 13081‑970, Brazil
| | - Arthur Menino Castilho
- Otology, Audiology and Implantable Ear Prostheses, Ear, Nose, Throat and Head and Neck Surgery Department, State University of Campinas (UNICAMP), São Paulo 13081‑970, Brazil
| | - Alexandre Caixeta Guimarães
- Otology, Audiology and Implantable Ear Prostheses, Ear, Nose, Throat and Head and Neck Surgery Department, State University of Campinas (UNICAMP), São Paulo 13081‑970, Brazil
| | - Edi Lúcia Sartorato
- Human Molecular Genetics Laboratory, Molecular Biology and Genetic Engineering Center‑CBMEG, State University of Campinas (UNICAMP), São Paulo 13081‑970, Brazil
| |
Collapse
|
13
|
Narne VK, Prabhu P, Chandan HS, Deepthi M. Audiological profiling of 198 individuals with auditory neuropathy spectrum disorder. HEARING, BALANCE AND COMMUNICATION 2014. [DOI: 10.3109/21695717.2014.938481] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
14
|
Pavone P, Briuglia S, Falsaperla R, Warm A, Pavone V, Bernardini L, Novelli A, Praticò AD, Salpietro V, Ruggieri M. Wide spectrum of congenital anomalies including choanal atresia, malformed extremities, and brain and spinal malformations in a girl with a de novo 5.6-Mb deletion of 13q12.11-13q12.13. Am J Med Genet A 2014; 164A:1734-43. [PMID: 24807585 DOI: 10.1002/ajmg.a.36391] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 11/07/2013] [Indexed: 01/31/2023]
Abstract
A 2 ½-year-old girl with multiple congenital anomalies and a de novo 5.6-Mb deletion on chromosome 13q12.11-13q12.13 is reported. She showed choanal atresia, scalp aplasia cutis, mild dysmorphic features, severe malformation of the hands and feet, Sylvian aqueductal stenosis, hydrocephalus, small cerebellum with pointed cerebellar tonsils, cervical, lumbar and sacral clefting, single central incisor and mild developmental delay. The girl's anomalies were compared with: (A) one boy reported by each of Der Kaloustian et al. [2011] and Tanteles et al. [2011] with similar, albeit smaller, 2.1 to 2.9 Mb deletions in which the abnormalities consisted of mild facial dysmorphism, mild malformations of the fingers and/or toes, and developmental delay; (B) one girl reported by Friedman et al. [2006] with similar, albeit larger, 5.7 Mb deletion with mild developmental delay and haematological abnormalities; (C) one girl reported by Slee et al. [1991] with a deletion of band q12.2 in chromosome 13, who had Moebius syndrome with facial dysmorphism, high arched palate, micrognathia, and small tongue with no abnormalities of the extremities; and (D) seven additional individuals recorded in the DECIPHER 6.0 database who all had dysmorphic features and developmental delay plus a spectrum of clinical manifestations including deafness, ataxia/oculomotor apraxia, spasticity, small testes, and mild fingers' anomalies. The deleted region hereby reported encompassed 34 known genes, including GJA3, GJB2, and GJB6, which are responsible for autosomal recessive deafness, FGF9, which plays crucial roles in embryonic neurological development, and ATP8A2, which causes a cerebellar ataxia and disequilibrium syndrome.
Collapse
Affiliation(s)
- Piero Pavone
- Unit of Pediatrics and Pediatric Emergency, University Hospital "Policlinico-Vittorio Emanuele", Catania, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Chan DK, Chang KW. GJB2-associated hearing loss: Systematic review of worldwide prevalence, genotype, and auditory phenotype. Laryngoscope 2013; 124:E34-53. [DOI: 10.1002/lary.24332] [Citation(s) in RCA: 183] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2013] [Indexed: 12/17/2022]
Affiliation(s)
- Dylan K. Chan
- Department of Otolaryngology-Head and Neck Surgery; University of California; San Francisco U.S.A
| | - Kay W. Chang
- Department of Otolaryngology-Head and Neck Surgery; Stanford University School of Medicine; Stanford California U.S.A
| |
Collapse
|
16
|
Kim AH, Nahm E, Sollas A, Mattiace L, Rozental R. Connexin 43 and hearing: possible implications for retrocochlear auditory processing. Laryngoscope 2013; 123:3185-93. [PMID: 23817980 DOI: 10.1002/lary.24249] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 05/10/2013] [Accepted: 05/22/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS To examine the relationship between hearing and connexin 43, a dominant gap junctional protein in the central nervous system. STUDY DESIGN Original research. METHODS Connexin 43 heterozygous mice are used to assess its mutational effect on hearing. Results are compared to controls consisting of connexin 43, wild type and CBA/J mice. Hearing is assessed using auditory brainstem response and distortion product otoacoustic emissions tests. Distribution of connexin 43 in the organ of Corti and the retrocochlear auditory centers (eight nerve, cochlear nucleus, olivary complex, lateral lemniscus, inferior colliculus, respectively) is examined. Fluorescent markers are used to elucidate cell types. RESULTS Mean click auditory brainstem response threshold for the young connexin 43 heterozygous mice (3-4 months) was 36.7 ± 12.6 dB compared to 25 ± 0 dB for control mice (P < 0.05). Mean threshold difference became more pronounced (68 ± 7.5 dB vs. 31 ± 2.2 dB) at 10 months (P < 0.05). Tonal auditory brainstem response testing showed elevated thresholds (>60 dB) at all frequencies (4-32 kHz) compared to the controls. Distortion product otoacoustic emissions (DPOAE) were present in all the mice, although the older connexin 43 heterozygous mice responded at higher thresholds. The pattern of connexin 43 immunoreactivity was distinctive from connexin 26 and 30, showing minimal presence in the organ of Corti but robustly present in the retrocochlear centers. CONCLUSION Connexin 43 heterozygous mice demonstrated greater degree of hearing loss compared to age-matched controls. It is abundantly found in the retrocochlear auditory centers. The mechanism of hearing loss in these mice does not appear to be related to hair cell loss.
Collapse
Affiliation(s)
- Ana H Kim
- Department of Otolaryngology, New York Eye and Ear Infirmary, New York; New York Medical College, Valhalla, New York
| | | | | | | | | |
Collapse
|
17
|
Matos TD, Simões-Teixeira H, Caria H, Gonçalves AC, Chora J, Correia MDC, Moura C, Rosa H, Monteiro L, O'Neill A, Dias Ó, Andrea M, Fialho G. Spectrum and frequency of GJB2 mutations in a cohort of 264 Portuguese nonsyndromic sensorineural hearing loss patients. Int J Audiol 2013; 52:466-71. [PMID: 23668481 DOI: 10.3109/14992027.2013.783719] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess the spectrum and prevalence of mutations in the GJB2 gene in Portuguese nonsyndromic sensorineural hearing loss (NSSHL) patients. DESIGN Sequencing of the coding region, basal promoter, exon 1, and donor splice site of the GJB2 gene; screening for the presence of the two common GJB6 deletions. STUDY SAMPLE A cohort of 264 Portuguese NSSHL patients. RESULTS At least one out of 21 different GJB2 variants was identified in 80 (30.2%) of the 264 patients analysed. Two mutant alleles were found in 53 (20%) of these probands, of which 83% (44/53) harboured at least one c.35delG allele. Twenty-seven (10.2%) of the probands harboured only one mutant allele. Subsequent analysis revealed that the GJB6 deletion del(GJB6-D13S1854) was present in at least 7.4% (2/27) of the patients carrying only one mutant GJB2 allele. Overall, one in five (55/264) of the patients were diagnosed as having DFNB1-related NSSHL, of which the vast majority (53/55) harboured only GJB2 mutations. CONCLUSIONS This study provides clear demonstration that mutations in the GJB2 gene are an important cause of NSSHL in Portugal, thus representing a valuable indicator as regards therapeutical and rehabilitation options, as well as genetic counseling of these patients and their families.
Collapse
Affiliation(s)
- Tiago Daniel Matos
- Centre for Biodiversity, Functional, and Integrative Genomics BioFIG, Faculty of Science, University of Lisbon, Lisboa, Portugal
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
|
19
|
Yao J, Lu Y, Wei Q, Cao X, Xing G. A systematic review and meta-analysis of 235delC mutation of GJB2 gene. J Transl Med 2012; 10:136. [PMID: 22747691 PMCID: PMC3443034 DOI: 10.1186/1479-5876-10-136] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2011] [Accepted: 06/15/2012] [Indexed: 12/17/2022] Open
Abstract
Background The 235delC mutation of GJB2 gene is considered as a risk factor for the non-syndromic hearing loss (NSHL), and a significant difference in the frequency and distribution of the 235delC mutation has been described world widely. Methods A systematic review was performed by means of a meta-analysis to evaluate the influence of the 235delC mutation on the risk of NSHL. A literature search in electronic databases using keywords “235delC”, “GJB2” associated with “carrier frequency” was conducted to include all papers from January 1999 to June 2011. A total of 36 papers were included and there contained 13217 cases and 6521 controls derived from Oceania, American, Europe and Asian. Results A remarkable heterogeneity between these studies was observed. The combined results of meta-analysis showed that the 235delC mutant increased the risk of NSHL (OR = 7.9, 95%CI 4.77 ~ 13.11, P <0.00001). Meanwhile, heterogeneity of genetic effect was also observed due to the ethnic specificity and regional disparity. Therefore, the stratified meta-analysis was subsequently conducted and the results indicated that the 235delC mutation was significantly correlated with the risk of NHSL in the East Asian and South-east Asian populations (OR = 12.05, 95%CI 8.33~17.44, P <0.00001), but not significantly in the Oceania and European populations (OR = 10.36, 95%CI: 4.68~22.96, Z = 1.68, P >0.05). Conclusions The 235delC mutation of GJB2 gene increased the risk of NHSL in the East Asian and South-east Asian populations, but non-significantly associated with the NSHL susceptibility in Oceania and European populations, suggesting a significant ethnic specificity of this NSHL-associated mutation.
Collapse
Affiliation(s)
- Jun Yao
- Department of Biotechnology, School of Basic Medical Science, Nanjing Medical University, Nanjing 210029, People’s Republic of China
| | | | | | | | | |
Collapse
|
20
|
Matsunaga T, Mutai H, Kunishima S, Namba K, Morimoto N, Shinjo Y, Arimoto Y, Kataoka Y, Shintani T, Morita N, Sugiuchi T, Masuda S, Nakano A, Taiji H, Kaga K. A prevalent founder mutation and genotype-phenotype correlations ofOTOFin Japanese patients with auditory neuropathy. Clin Genet 2012; 82:425-32. [DOI: 10.1111/j.1399-0004.2012.01897.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
21
|
Nachman AJ. Retrocochlear hearing loss in infants: A case study of juvenile pilocytic astrocytoma. Int J Audiol 2012; 51:640-4. [DOI: 10.3109/14992027.2012.684404] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
22
|
Zhang QJ, Lan L, Shi W, Wang DY, Qi Y, Zong L, Li Q, Wang H, Ding HN, Li N, Han B, Wang QJ. Unilateral auditory neuropathy spectrum disorder. Acta Otolaryngol 2012; 132:72-9. [PMID: 22073929 DOI: 10.3109/00016489.2011.629630] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS The majority of the patients with unilateral auditory neuropathy spectrum disorder (UANSD) were pediatric and mostly showed a great degree of hearing loss when diagnosed. Abnormal auditory brainstem response (ABR) and preserved otoacoustic emissions (OAEs) and/or cochlear microphonics (CM) were important features to differentiate it from common sensorineural deafness and central nerve hearing loss. OBJECTIVE To identify the clinical characteristics of patients with UANSD. METHODS This was a retrospective study involving 14 patients diagnosed as having UANSD between 2004 and 2010 in the Chinese PLA Hospital. RESULTS In all, 50% of the cases were males (1:1 sex ratio) and the average age of onset was 4.1 years. Of the 14 affected ears with UANSD in these cases, 6 were left-sided, while 8 were right-sided. Of the 14 contralateral ears, 4 presented with sensorineural hearing loss, while the other 10 showed normal hearing. The degree of hearing loss in the 14 affected ears varied, including moderate in 1, moderately severe in 4, severe in 5, and profound in 4. ABRs were absent in the 14 affected ears, while the OAEs, and/or CM were present.
Collapse
Affiliation(s)
- Qiu-Jing Zhang
- Department of Otolaryngology/Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Beijing, China
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Jian W, Ying-ying F, Shu-juan W, Peng-Fei L, Jin-ling W, Jian-hua Q. Variants of OTOF and PJVK genes in Chinese patients with auditory neuropathy spectrum disorder. PLoS One 2011; 6:e24000. [PMID: 21935370 PMCID: PMC3174136 DOI: 10.1371/journal.pone.0024000] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Accepted: 07/27/2011] [Indexed: 12/21/2022] Open
Abstract
Background Mutations in OTOF and PJVK genes cause DFNB9 and DFNB59 types of hearing loss, respectively. The patients carrying pathogenic mutations in either of these genes may show the typical phenotype of auditory neuropathy spectrum disorder (ANSD). The aim of the present study was to identify OTOF and PJVK mutations in sporadic ANSD patients. Methods and Findings A total of 76 unrelated Chinese non-syndromic ANSD patients were sequenced on the gene OTOF and PJVK exon by exon. Variants were valued in 105 controls with normal hearing to verify the carrying rate. We identified one pathogenic mutation (c.1194T>A) and three novel, possibly pathogenic, variants (c.3570+2T>C, c.4023+1 G>A, and c.1102G>A) in the OTOF gene, and one novel, possibly pathogenic, variant (c.548G>A) in PJVK. Moreover, we found three novel missense mutations within the exons of OTOF. Conclusions As we identified 4 and 1 possible pathogenic variants of the OTOF gene and the PJVK gene, respectively, we believe that screening in these genes are important in sporadic ANSD patients. The pathogenicity of these novel mutations needs further study because of their single heterozygous nature. Knowledge on the mutation spectra of these genes in Chinese would be beneficial in understanding the genetic character of this worldwide disease.
Collapse
Affiliation(s)
- Wang Jian
- Deafness Gene Diagnosis, PLA Otolaryngology-Head and Neck Surgery Center, Xijing Hospital, Fourth Military Medical University, Xi'an, Shannxi, China
| | - Fan Ying-ying
- Department of Anesthesiology, Stomatological College, Fourth Military Medical University, Xi'an, Shannxi, China
| | - Wang Shu-juan
- Deafness Gene Diagnosis, PLA Otolaryngology-Head and Neck Surgery Center, Xijing Hospital, Fourth Military Medical University, Xi'an, Shannxi, China
| | - Liang Peng-Fei
- Deafness Gene Diagnosis, PLA Otolaryngology-Head and Neck Surgery Center, Xijing Hospital, Fourth Military Medical University, Xi'an, Shannxi, China
| | - Wang Jin-ling
- PLA Otolaryngology-Head and Neck Surgery Center, Xijing Hospital, Fourth Military Medical University, Xi'an, Shannxi, China
| | - Qiu Jian-hua
- Deafness Gene Diagnosis, PLA Otolaryngology-Head and Neck Surgery Center, Xijing Hospital, Fourth Military Medical University, Xi'an, Shannxi, China
- PLA Otolaryngology-Head and Neck Surgery Center, Xijing Hospital, Fourth Military Medical University, Xi'an, Shannxi, China
- * E-mail:
| |
Collapse
|
24
|
The genetic basis of auditory neuropathy spectrum disorder (ANSD). Int J Pediatr Otorhinolaryngol 2011; 75:151-8. [PMID: 21176974 DOI: 10.1016/j.ijporl.2010.11.023] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Revised: 11/24/2010] [Accepted: 11/24/2010] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Auditory neuropathy is a hearing disorder where outer hair cell function within the cochlea is normal, but inner hair cell and/or the auditory nerve function is disrupted. It is a heterogeneous disorder which can have either congenital or acquired causes. Furthermore, the aetiology of auditory neuropathy is vast, which may include prematurity, hyperbilirubinaemia, anoxia, hypoxia, congenital brain anomalies, ototoxic drug exposure, and genetic factors. It is estimated that approximately 40% of cases have an underlying genetic basis, which can be inherited in both syndromic and non syndromic conditions. This review paper provides an overview of the genetic conditions associated with auditory neuropathy spectrum disorders (ANSDs) and highlights some of the defective genes that have been found to be linked to the pathological auditory changes. METHOD Literature search was conducted using a number of resources including textbooks, professional journals and the relevant websites. RESULTS The largest proportion of auditory neuropathy spectrum disorders (ANSDs) is due to genetic factors which can be syndromic, non-syndromic or mitochondrial related. The inheritance pattern can include all the four main types of inheritances such as autosomal dominant, autosomal recessive, X-linked and mitochondrial. CONCLUSION This paper has provided an overview of mutation with some of the genes and/or loci discovered to be the cause for auditory neuropathy spectrum disorders (ANSDs). It has been noted that different gene mutations may trigger different pathological changes in patients with this disorder. These discoveries have provided us with vital information as to the sites of pathology in auditory neuropathy spectrum disorders (ANSDs), and the results highlight the heterogeneity of the disorder.
Collapse
|
25
|
Reduced electromotility of outer hair cells associated with connexin-related forms of deafness: an in silico study of a cochlear network mechanism. J Assoc Res Otolaryngol 2010; 11:559-71. [PMID: 20635191 DOI: 10.1007/s10162-010-0226-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Accepted: 06/23/2010] [Indexed: 10/19/2022] Open
Abstract
Mutations in the GJB2 gene encoding for the connexin 26 (Cx26) protein are the most common source of nonsyndromic forms of deafness. Cx26 is a building block of gap junctions (GJs) which establish electrical connectivity in distinct cochlear compartments by allowing intercellular ionic (and metabolic) exchange. Animal models of the Cx26 deficiency in the organ of Corti seem to suggest that the hearing loss and the degeneration of outer hair cells (OHCs) and inner hair cells is due to failed K(+) and metabolite homeostasis. However, OHCs can develop normally in some mutants, suggesting that the hair cells death is not the universal mechanism. In search for alternatives, we have developed an in silico large scale three-dimensional model of electrical current flow in the cochlea in the small signal, linearised, regime. The effect of mutations was analysed by varying the magnitude of resistive components representing the GJ network in the organ of Corti. The simulations indeed show that reduced GJ conductivity increases the attenuation of the OHC transmembrane potential at frequencies above 5 kHz from 6.1 dB/decade in the wild-type to 14.2 dB/decade. As a consequence of increased GJ electrical filtering, the OHC transmembrane potential is reduced by up to 35 dB at frequencies >10 kHz. OHC electromotility, driven by this potential, is crucial for sound amplification, cochlear sensitivity and frequency selectivity. Therefore, we conclude that reduced OHC electromotility may represent an additional mechanism underlying deafness in the presence of Cx26 mutations and may explain lowered OHC functionality in particular reported Cx26 mutants.
Collapse
|
26
|
Berlin CI, Hood LJ, Morlet T, Wilensky D, Li L, Mattingly KR, Taylor-Jeanfreau J, Keats BJB, John PS, Montgomery E, Shallop JK, Russell BA, Frisch SA. Multi-site diagnosis and management of 260 patients with auditory neuropathy/dys-synchrony (auditory neuropathy spectrum disorder). Int J Audiol 2010; 49:30-43. [PMID: 20053155 DOI: 10.3109/14992020903160892] [Citation(s) in RCA: 184] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Test results and management data are summarized for 260 patients with diagnoses of Auditory Neuropathy Spectrum Disorder (ANSD). Hearing aids were tried in 85 of these patients, and 49 patients tried cochlear implants. Approximately 15% reported some benefit from hearing aids for language learning, while improvement in speech comprehension and language acquisition was reported in 85% of patients who were implanted. Approximately 5% (13/260) of the total population developed normal speech and language without intervention. Patients were diagnosed at our laboratory (n=66) or referred from other sites (n=194), and all showed absent/grossly abnormal auditory brainstem responses (ABR), often 'ringing' cochlear microphonics, and the presence or history of otoacoustic emissions. Etiologies and co-existing conditions included genetic (n=41), peripheral neuropathies (n=20), perinatal jaundice and/or anoxia and/or prematurity (n=74). These patients comprise 10% or more of hearing impaired patients; their language acquisition trajectories are generally unpredictable from their audiograms.
Collapse
Affiliation(s)
- Charles I Berlin
- Kresge Hearing Research Laboratory, LSUHSC, New Orleans, Louisiana, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Primignani P, Trotta L, Castorina P, Lalatta F, Sironi F, Radaelli C, Degiorgio D, Curcio C, Travi M, Ambrosetti U, Cesarani A, Garavelli L, Formigoni P, Milani D, Murri A, Cuda D, Coviello DA. Analysis of the GJB2 and GJB6 genes in Italian patients with nonsyndromic hearing loss: frequencies, novel mutations, genotypes, and degree of hearing loss. Genet Test Mol Biomarkers 2009; 13:209-17. [PMID: 19371219 DOI: 10.1089/gtmb.2008.0086] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Mutations in the GJB2 gene, which encodes the gap-junction protein connexin 26, are the most common cause of nonsyndromic hearing loss (NSHL) and account for about 32% of cases. We analyzed 734 patients and identified mutations in 474/1468 chromosomes. Thirty-six different mutations and five polymorphisms were found in 269 NSHL subjects. Our data confirm 35delG as the most frequent GJB2 mutation in the Italian population, accounting for about 68% of all the mutated GJB2 alleles analyzed. We also identified two novel variants: the V156I mutation and the C>A change at nucleotide 684 in the 3'UTR of the gene. The GJB6 gene deletion, del(GJB6-D13S1830), which can cause HL in combination with GJB2 mutations in trans, was identified in three patients, while the del(GJB6-D13S1854) was not observed in our cohort of patients. We collected audiometric data from 200 patients with biallelic DFNB1 mutations or with dominant mutation in GJB2 to determine the degree of HL to correlate the genotypes with the audiological phenotypes.
Collapse
Affiliation(s)
- Paola Primignani
- Laboratorio di Genetica Medica, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena-Milano, Milan, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Sanyelbhaa Talaat H, Kabel AH, Samy H, Elbadry M. Prevalence of auditory neuropathy (AN) among infants and young children with severe to profound hearing loss. Int J Pediatr Otorhinolaryngol 2009; 73:937-9. [PMID: 19409623 DOI: 10.1016/j.ijporl.2009.03.009] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2008] [Revised: 03/11/2009] [Accepted: 03/11/2009] [Indexed: 11/17/2022]
Abstract
UNLABELLED Auditory neuropathy is a challenging disorder and needs special habilitative/rehabilitative approach. This study aimed to detect its prevalence among infants and young children with severe to profound hearing loss. 112 infants and young children with age ranged 6-32 months were examined and diagnosed as having severe to profound hearing loss and were referred for hearing aid fitting. Those infants were reassessed in our centers for detecting cases with auditory neuropathy. The study group was subjected to immittancemetry, behavioral observation audiometry, ABR and cochlear microphonics. RESULTS 15 patients were found to have auditory neuropathy according to our criteria for diagnosis. CONCLUSIONS The prevalence of AN in the study group was 13.4%. CM were recommended to be tested routinely during ABR assessment whenever abnormal results are obtained.
Collapse
|
29
|
Feldmann D, Le Maréchal C, Jonard L, Thierry P, Czajka C, Couderc R, Ferec C, Denoyelle F, Marlin S, Fellmann F. A new large deletion in the DFNB1 locus causes nonsyndromic hearing loss. Eur J Med Genet 2008; 52:195-200. [PMID: 19101659 DOI: 10.1016/j.ejmg.2008.11.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Accepted: 11/30/2008] [Indexed: 10/21/2022]
Abstract
Mutations in the GJB2 gene encoding the gap junction protein connexin 26 are responsible for up to 30% of all cases of autosomal recessive nonsyndromic hearing impairment (HI) with prelingual onset in most populations. The corresponding locus DFNB1, located on chromosome 13q11-q12, is also affected by three distinct deletions. These deletions extended distally to GJB2, which remains intact. We report a novel large deletion in DFNB1 observed in a patient presenting profound prelingual HI. This deletion was observed in trans to a GJB2 mutated allele carrying the p.Val84Met (V84M) mutation and was shown to be associated with hearing loss. The deletion caused a false homozygosity of V84M in the proband. Quantification of alleles by quantitative fluorescent multiplex PCR (QFM-PCR) enabled us to study the breakpoints of the deletion. The deleted segment extended through at least 920kb and removed the three connexin genes GJA3, GJB2 and GJB6. The distal breakpoint inside intron 2 of CRYL1 gene differed from the breakpoints of the known DFNB1 deletions. This case highlights the importance of screening for large deletions in molecular studies of GJB2.
Collapse
Affiliation(s)
- Delphine Feldmann
- Laboratoire de Biochimie, INSERM, U587, Centre de Référence des Surdités Génétiques, AP-HP, Hôpital Armand-Trousseau, 26 Avenue du Docteur-Arnold-Netter, 75012 Paris, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Kirkim G, Serbetcioglu B, Erdag TK, Ceryan K. The frequency of auditory neuropathy detected by universal newborn hearing screening program. Int J Pediatr Otorhinolaryngol 2008; 72:1461-9. [PMID: 18674822 DOI: 10.1016/j.ijporl.2008.06.010] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2008] [Revised: 05/29/2008] [Accepted: 06/05/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Auditory neuropathy/auditory dyssynchrony (AN/AD) has become a well-accepted clinical entity. The combined use of oto-acoustic emissions (OAEs) and auditory brainstem response (ABR) testing in the universal newborn hearing screening (UNHS) has led to the easy recognition of this disorder. Although, we are now able to diagnose AN/AD reliably, little is known about its epidemiology, etiology, and especially the frequency of its occurrence. The primary goal of this study was to determine the frequency of AN/AD in the Western Anatolian region of Turkey. The secondary goal was to compare the detection rate of AN/AD before and after the implementation of the UNHS in the audiology department of Dokuz Eylul University Hospital. METHOD Between 2005 and 2007, among the 23,786 newborns who were screened by automated click evoked oto-acoustic emissions (a-CEOAE) and automated auditory brainstem responses (a-ABRs), 2236 were referred to our department. All necessary audiological tests were performed for all the referred newborns. Among them, babies with deficient or abnormal ABR in combination with normal OAEs were considered as having AN/AD. These babies were evaluated with additional diagnostic audiological tests. Furthermore, comparison of the incidence of children diagnosed with AN/AD before and after the implementation of UNHS in our audiology department was also performed. RESULTS Among the referred newborns, 65 had abnormal or deficient ABR test results. Ten of these 65 newborn babies (mean diagnostic age: 5.7 months) with hearing impairment showed electrophysiological test results that were consistent with AN/AD. The frequency of AN/AD in these 65 children with hearing loss was 15.38%. Moreover, the frequency of AN/AD within UNHS was found to be 0.044%. Seven of the 10 babies with AN/AD had hyperbilirubinemia as a risk factor, which is a high rate to be emphasized. On the other hand, the retrospective investigation of children diagnosed with AN/AD in the same audiology department between 1999 and 2005 (i.e. before the implementation of UNHS) revealed only 7 children, with an average diagnostic age of 34 months. CONCLUSION After implementing the UNHS, the incidence of AN/AD in the audiology department increased from 1.16 to 4.13. Furthermore, the age of diagnosis of AN/AD decreased from 34 months to 5.7 months. This study shows that AN/AD, when screened, is a comparatively common disorder in the population of hearing-impaired infants. While newborn hearing screening provides early detection of babies with hearing loss, it also helps to differentiate AN/AD cases when the screening is performed with both a-ABR and automated oto-acoustic emission (a-OAE) tests. Thus, the routine combined use of a-ABR and a-OAE tests in UNHS programs, especially for the high-risk infants, can provide better detection of newborns with AN/AD. Furthermore, hyperbilirubinemia is merely an association and maybe etiologically linked.
Collapse
Affiliation(s)
- Gunay Kirkim
- Dokuz Eylul Universitesi Tip Fakultesi KBB AD, Inciralti-Izmir 35340, Turkey.
| | | | | | | |
Collapse
|
31
|
Matos TD, Caria H, Simões-Teixeira H, Aasen T, Nickel R, Jagger DJ, O'Neill A, Kelsell DP, Fialho G. A novel hearing-loss-related mutation occurring in the GJB2 basal promoter. J Med Genet 2007; 44:721-5. [PMID: 17660464 PMCID: PMC2752183 DOI: 10.1136/jmg.2007.050682] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2007] [Revised: 06/25/2007] [Accepted: 07/11/2007] [Indexed: 11/04/2022]
Abstract
Mutations in the GJB2 gene are a major cause of non-syndromic recessive hearing loss in many countries. In a significant fraction of patients, only monoallelic GJB2 mutations known to be either recessive or of unclear pathogenicity are identified. This paper reports a novel GJB2 mutation, -3438C-->T, found in the basal promoter of the gene, in trans with V84M, in a patient with profound hearing impairment. This novel mutation can abolish the basal promoter activity of GJB2. These results highlight the importance of extending the mutational screening to regions outside the coding region of GJB2.
Collapse
|
32
|
Harvey EK, Stanton S, Garrett J, Neils-Strunjas J, Warren NS. A case for genetics education: collaborating with speech-language pathologists and audiologists. Am J Med Genet A 2007; 143A:1554-9. [PMID: 17542007 DOI: 10.1002/ajmg.a.31743] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Because speech-language pathologists (SLPs) and audiologists (AUDs) are among the first referrals for parents of children exhibiting feeding, speech, language, hearing, and balance difficulties, it is important for SLP and AUD professionals to recognize genetic causes of and contributions to complex and Mendelian communication disorders. We review genetics in the curricula of speech-language pathology and audiology programs and obstacles to its integration throughout curricula. We present suggestions about how SLPs and AUDs can aid in diagnosis and contribute their clinical expertise in characterizing phenotypes, followed with a review of a new genetics-education website developed by the National Coalition for Health Professional Education in Genetics (NCHPEG), the University of Cincinnati, and the National Society of Genetic Counselors. The need to integrate genetics content into curricula and continuing education across disciplines is clear, as is the need for and benefit of multidisciplinary collaboration in patient care. The NCHPEG site for speech-language pathology and audiology begins to address those needs and may serve as a practical model for future multidisciplinary collaborations between genetics professionals and other health professions.
Collapse
Affiliation(s)
- Erin K Harvey
- National Coalition for Health Professional Education in Genetics (NCHPEG), Lutherville, MD 21093, USA.
| | | | | | | | | |
Collapse
|
33
|
Schlade-Bartusiak K, Macintyre G, Zunich J, Cox DW. A child with deletion (14)(q24.3q32.13) and auditory neuropathy. Am J Med Genet A 2007; 146A:117-23. [DOI: 10.1002/ajmg.a.32064] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|