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van Wijngaarden V, de Wilde H, Mink van der Molen D, Petter J, Stegeman I, Gerrits E, Smit AL, van den Boogaard MJ. Genetic outcomes in children with developmental language disorder: a systematic review. Front Pediatr 2024; 12:1315229. [PMID: 38298611 PMCID: PMC10828955 DOI: 10.3389/fped.2024.1315229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/02/2024] [Indexed: 02/02/2024] Open
Abstract
Introduction Developmental language disorder (DLD) is a common childhood condition negatively influencing communication and psychosocial development. An increasing number of pathogenic variants or chromosomal anomalies possibly related to DLD have been identified. To provide a base for accurate clinical genetic diagnostic work-up for DLD patients, understanding the specific genetic background is crucial. This study aims to give a systematic literature overview of pathogenic variants or chromosomal anomalies causative for DLD in children. Methods We conducted a systematic search in PubMed and Embase on available literature related to the genetic background of diagnosed DLD in children. Included papers were critically appraised before data extraction. An additional search in OMIM was performed to see if the described DLD genes are associated with a broader clinical spectrum. Results The search resulted in 15,842 papers. After assessing eligibility, 47 studies remained, of which 25 studies related to sex chromosome aneuploidies and 15 papers concerned other chromosomal anomalies (SCAs) and/or Copy Number Variants (CNVs), including del15q13.1-13.3 and del16p11.2. The remaining 7 studies displayed a variety of gene variants. 45 (candidate) genes related to language development, including FOXP2, GRIN2A, ERC1, and ATP2C2. After an additional search in the OMIM database, 22 of these genes were associated with a genetic disorder with a broader clinical spectrum, including intellectual disability, epilepsy, and/or autism. Conclusion Our study illustrates that DLD can be related to SCAs and specific CNV's. The reported (candidate) genes (n = 45) in the latter category reflect the genetic heterogeneity and support DLD without any comorbidities and syndromic language disorder have an overlapping genetic etiology.
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Affiliation(s)
| | - Hester de Wilde
- Department of Pediatric Otorhinolaryngology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Jildo Petter
- Faculty of Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands
- Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Ellen Gerrits
- Research Group Speech and Language Therapy, HU University of Applied Sciences Utrecht, Utrecht, Netherlands
- Department of Languages, Literature and Communication, Faculty of Humanities, Utrecht University, Utrecht, Netherlands
| | - Adriana L. Smit
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands
- Research Group Speech and Language Therapy, HU University of Applied Sciences Utrecht, Utrecht, Netherlands
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Samango-Sprouse CA, Hamzik MP, Gropman E, Brooks MR, Powell S, Taylor AM, Sadeghin T, Gropman AL. The behavioral profile of 49,XXXXY and the potential impact of testosterone replacement therapy. Genet Med 2023; 25:100847. [PMID: 37061875 DOI: 10.1016/j.gim.2023.100847] [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: 07/11/2022] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 04/17/2023] Open
Abstract
PURPOSE 49,XXXXY (1:85,000-100,000) is a rare sex chromosome aneuploidy that often presents with complex musculoskeletal abnormalities, decreased cognitive capabilities, speech and language dysfunction, and behavioral complications. Hormonal replacement therapy, or testosterone replacement therapy, is associated with improved neurodevelopmental and behavioral outcomes in males with 49,XXXXY. Two forms of testosterone replacement therapy, early hormonal treatment (EHT) and hormonal booster therapy (HBT), are associated with improved neurodevelopmental and behavioral outcomes in these boys. This study investigates the impact of EHT and HBT on behavioral symptoms in males with 49,XXXXY. METHODS A total of 59 individuals were divided into 4 groups: 19 no testosterone (no-T), 23 EHT, 6 HBT, and 11 EHT and HBT. An analysis of variance examined group differences on the Child Behavior Checklist and the Behavior Rating Inventory of Executive Function ranging from 5 to 18 years. RESULTS Although no differences were identified on the Behavior Rating Inventory of Executive Function, the 3 hormonal replacement therapy groups presented with decreased complications on numerous variables on the Child Behavior Checklist; these include somatic complaints (P = .0095), somatic problems (P = .041), internalizing problems (P = .034), externalizing problems (P = .0001), and withdrawn/depression (P = .025). CONCLUSION This study presents evidence that HBT may be a beneficial treatment for individuals with 49,XXXXY.
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Affiliation(s)
- Carole A Samango-Sprouse
- Department of Research, The Focus Foundation, Davidsonville, MD; Department of Human and Molecular Genetics, Florida International University, Miami, FL; Department of Pediatrics, George Washington University, Washington, DC.
| | - Mary P Hamzik
- Department of Research, The Focus Foundation, Davidsonville, MD
| | - Eliana Gropman
- Department of Research, The Focus Foundation, Davidsonville, MD
| | | | - Sherida Powell
- Department of Economics, George Washington University, Washington, DC
| | - Alexa M Taylor
- Department of Research, The Focus Foundation, Davidsonville, MD
| | - Teresa Sadeghin
- Department of Research, The Focus Foundation, Davidsonville, MD
| | - Andrea L Gropman
- Division of Neurogenetics and Developments Pediatrics, Children's National Health System, Washington, DC; Department of Neurology, George Washington University, Washington, DC
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Ricciardi G, Cammisa L, Bove R, Picchiotti G, Spaziani M, Isidori AM, Aceti F, Giacchetti N, Romani M, Sogos C. Clinical, Cognitive and Neurodevelopmental Profile in Tetrasomies and Pentasomies: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1719. [PMID: 36360447 PMCID: PMC9688827 DOI: 10.3390/children9111719] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/28/2022] [Accepted: 11/05/2022] [Indexed: 10/23/2023]
Abstract
Background: Sex chromosome aneuploidies (SCAs) are a group of disorders characterised by an abnormal number of sex chromosomes. Collective prevalence rate of SCAs is estimated to be around 1 in 400-500 live births; sex chromosome trisomies (e.g., XXX, XXY, XYY) are most frequent, while tetra- and pentasomies (e.g., XXXX, XXXXX, XXXY, XXXXY) are rarer, and the most common is 48, XXYY syndrome. The presence of additional X and/or Y chromosomes is believed to cause neurodevelopmental differences, with increased risk for developmental delays, language-based learning disabilities, cognitive impairments, executive dysfunction, and behavioural and psychological disorders. Aim of the Study: Our review has the purpose of analysing the neurocognitive, linguistical and behavioural profile of patients affected by sex chromosomes supernumerary aneuploidies (tetrasomy and pentasomy) to better understand the specific areas of weakness, in order to provide specific rehabilitation therapy. Methods: The literature search was performed by two authors independently. We used MEDLINE, PubMed, and PsycINFO search engines to identify sources of interest, without year or language restrictions. At the end of an accurate selection, 16 articles fulfilled the inclusion and exclusion criteria. Results and Conclusions: International literature has described single aspects of the neuropsychological profile of 48, XXYY and 49, XXXXY patients. In 48, XXYY patients, various degrees of psychosocial/executive functioning issues have been reported and there is an increased frequency of behavioural problems in childhood. Developmental delay and behavioural problems are the most common presenting problems, even if anxiety, depression and oppositional defiant disorder are also reported. They also show generalized difficulties with socialization and communication. Cognitive abilities are lower in measures of verbal IQ than in measures of performance IQ. Visuospatial skills are a relative strength compared to verbal skills. In patients with 49, XXXXY, both intellectual and adaptive functioning skills fall into the disability range, with better non-verbal cognitive performance. Speech and language testing reveals more deficits in expressive language than receptive language and comprehension. Anxiety, thought problems, internalizing and externalizing problems, and deficits in social cognition and communication are reported. Behavioural symptoms lessen from school age to adolescence, with the exception of thought problems and anxiety. Individuals affected by sex chromosome aneuploidies show testosterone deficiency, microorchidism, lack of pubertal progression and infertility. Hormone replacement therapy (HRT) is usually recommended for these patients: different studies have found that testosterone-based HRT benefit a wide range of areas initiated in these disorders, affecting not only neuromotor, cognitive and behavioural profile but also structural anomalies of the brain (i.e., increase of volume of grey temporal lobe matter). In conclusion, further studies are needed to better understand the neuropsychological profile with a complete evaluation, including neurocognitive and psychosocial aspects and to establish the real impact of HRT on improving the cognitive and behavioural profile of these patients.
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Affiliation(s)
- Giacomina Ricciardi
- Section of Child and Adolescents Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Luca Cammisa
- Section of Child and Adolescents Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Rossella Bove
- Section of Child and Adolescents Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Giorgia Picchiotti
- Section of Child and Adolescents Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Matteo Spaziani
- Advanced Endocrine Diagnostics Unit, Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy
| | - Andrea M. Isidori
- Advanced Endocrine Diagnostics Unit, Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy
| | - Franca Aceti
- Post-Partum Disorders Unit, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Nicoletta Giacchetti
- Post-Partum Disorders Unit, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Maria Romani
- Section of Child and Adolescents Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Carla Sogos
- Section of Child and Adolescents Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
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Lee RS, Song SQ, Garrison-Desany HM, Carey JL, Lasutschinkow P, Zabel A, Bressler J, Gropman A, Samango-Sprouse C. DNA methylation and behavioral dysfunction in males with 47,XXY and 49,XXXXY: a pilot study. Clin Epigenetics 2021; 13:136. [PMID: 34210361 PMCID: PMC8252231 DOI: 10.1186/s13148-021-01123-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/27/2021] [Indexed: 11/29/2022] Open
Abstract
Background Equal dosage of X-linked genes between males and females is maintained by the X-inactivation of the second X chromosome in females through epigenetic mechanisms. Boys with aneuploidy of the X chromosome exhibit a host of symptoms such as low fertility, musculoskeletal anomalies, and cognitive and behavioral deficits that are presumed to be caused by the abnormal dosage of these genes. The objective of this pilot study is to assess the relationship between CpG methylation, an epigenetic modification, at several genes on the X chromosome and behavioral dysfunction in boys with supernumerary X chromosomes. Results Two parental questionnaires, the Behavior Rating Inventory of Executive Function (BRIEF) and Child Behavior Checklist (CBCL), were analyzed, and they showed expected differences in both internal and external behaviors between neurotypical (46,XY) boys and boys with 49,XXXXY. There were several CpGs in AR and MAOA of boys with 49,XXXXY whose methylation levels were skewed from levels predicted from having one active (Xa) and three inactive (Xi) X chromosomes. Further, methylation levels of multiple CpGs in MAOA showed nominally significant association with externalizing behavior on the CBCL, and the methylation level of one CpG in AR showed nominally significant association with the BRIEF Regulation Index. Conclusions Boys with 49,XXXXY displayed higher levels of CpG methylation at regulatory intronic regions in X-linked genes encoding the androgen receptor (AR) and monoamine oxidase A (MAOA), compared to that in boys with 47,XXY and neurotypical boys. Our pilot study results suggest a link between CpG methylation levels and behavior in boys with 49,XXXXY. Supplementary Information The online version contains supplementary material available at 10.1186/s13148-021-01123-4.
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Affiliation(s)
- Richard S Lee
- The Mood Disorders Center, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sophia Q Song
- Department of Research, The Focus Foundation, Davidsonville, MD, USA
| | - Henri M Garrison-Desany
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jenny L Carey
- The Mood Disorders Center, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | | | - Andrea Gropman
- Department of Neurology, George Washington University, Washington, DC, USA.,Division of Neurogenetics and Developmental Pediatrics, Children's National Health System, Washington, DC, USA
| | - Carole Samango-Sprouse
- Department of Research, The Focus Foundation, Davidsonville, MD, USA. .,Department of Pediatrics, George Washington University, Washington, DC, USA. .,Department of Human and Molecular Genetics, Florida International University, Miami, FL, USA.
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Chekhlabi N, Haoudar A, Hamdaoui H, Dini N. Report of a New Case of Pentasomy X Revealed by Status Epilepticus. Cureus 2021; 13:e16062. [PMID: 34367739 PMCID: PMC8330396 DOI: 10.7759/cureus.16062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2021] [Indexed: 11/10/2022] Open
Abstract
This report describes an exceptional case of X (49, XXXXX) pentasomy in a girl aged three years and five months. She was admitted for recurrent seizures revealing epilepsy. She has growth failure and psychomotor retardation with a deformed face. The malformative assessment did not show any malformation apart from cerebral leukodystrophy. Pentasomy X is a very rare abnormality of the sex chromosomes. It only affects females, in whom three additional X chromosomes are added to the two X normally present. The pathogenesis of pentasomy X is not exactly clear, but it is probably caused by successive maternal nondisjunctions. Epilepsy and cerebral leukodystrophy are a new mode of revelation of this syndrome, never described in the literature.
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Affiliation(s)
- Nabila Chekhlabi
- Pediatrics, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences, Casablanca, MAR
| | - Amal Haoudar
- Anesthesia and Critical Care, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences, Casablanca, MAR
| | - Hasna Hamdaoui
- Genetics, Mohammed VI University of Health Sciences, Casablanca, MAR
| | - Nezha Dini
- Pediatrics, The International University Hospital Cheikh Khalifa Ibn Zaid, Casablanca, MAR.,Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, MAR
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Samango-Sprouse CA, Gropman AL. Introduction: Comprehensive investigation into an international cohort of boys with 49,XXXXY. Am J Med Genet A 2020; 185:3554-3556. [PMID: 32656873 DOI: 10.1002/ajmg.a.61739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 06/06/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Carole A Samango-Sprouse
- Research Department, The Focus Foundation, Davidsonville, Maryland, USA.,Department of Pediatrics, George Washington University, Washington, District of Columbia, USA.,Department of Human and Molecular Genetics, Florida International University, Miami, Florida, USA
| | - Andrea L Gropman
- Division of Neurogenetics and Developments Pediatrics, Children's National Health System, Washington, District of Columbia, USA.,Department of Neurology, George Washington University, Washington, District of Columbia, USA
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