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Pascual-Morena C, Martínez-Vizcaíno V, Cavero-Redondo I, Álvarez-Bueno C, Martínez-García I, Rodríguez-Gutiérrez E, Otero-Luis I, Del Saz-Lara A, Saz-Lara A. Prevalence and genotypic associations of epilepsy in Prader-Willi Syndrome: A systematic review and meta-analysis. Epilepsy Behav 2024; 155:109803. [PMID: 38663143 DOI: 10.1016/j.yebeh.2024.109803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 04/14/2024] [Accepted: 04/17/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVE To estimate the prevalence of epilepsy and febrile seizures and their association with genotype, i.e., 15q11-q13 deletions, uniparental chromosome 15 disomy (UPD) and other mutations, in the population with Prader-Willi syndrome (PWS). METHODS A systematic search of Medline, Scopus, Web of Science and the Cochrane Library was conducted. Studies estimating the prevalence of seizures, epilepsy and febrile seizures in the PWS population were included. Meta-analyses of the prevalence of epilepsy and febrile seizures and their association with genotype using the prevalence ratio (PR) were performed. RESULTS Fifteen studies were included. The prevalence of epilepsy was 0.11 (0.07, 0.15), similar to the prevalence of febrile seizures, with a prevalence of 0.09 (0.05, 0.13). The comparison "deletion vs. UPD" had a PR of 2.03 (0.90, 4.57) and 3.76 (1.54, 9.18) for epilepsy and febrile seizures. CONCLUSIONS The prevalence of seizure disorders in PWS is higher than in the general population. In addition, deletions in 15q11-q13 may be associated with a higher risk of seizure disorders. Therefore, active screening for seizure disorders in PWS should improve the lives of these people. In addition, genotype could be used to stratify risk, even for epilepsy, although more studies or larger sample sizes are needed.
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Affiliation(s)
- Carlos Pascual-Morena
- Health and Social Research Center, Universidad de Castilla - La Mancha, 16071 Cuenca, Spain; Faculty of Nursing, Universidad de Castilla-La Mancha, 02006 Albacete, Spain
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla - La Mancha, 16071 Cuenca, Spain; Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 3460000, Chile
| | - Iván Cavero-Redondo
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 3460000, Chile.
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla - La Mancha, 16071 Cuenca, Spain; Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Irene Martínez-García
- Health and Social Research Center, Universidad de Castilla - La Mancha, 16071 Cuenca, Spain
| | | | - Iris Otero-Luis
- Health and Social Research Center, Universidad de Castilla - La Mancha, 16071 Cuenca, Spain
| | - Andrea Del Saz-Lara
- Health and Social Research Center, Universidad de Castilla - La Mancha, 16071 Cuenca, Spain; Laboratory of Epigenetics of Lipid Metabolism, Madrid Institute for Advanced Studies (IMDEA)-Food, CEI UAM + CSIC, 28049 Madrid, Spain
| | - Alicia Saz-Lara
- Health and Social Research Center, Universidad de Castilla - La Mancha, 16071 Cuenca, Spain
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Mao S, Yang L, Gao Y, Zou C. Genotype-phenotype correlation in Prader-Willi syndrome: A large-sample analysis in China. Clin Genet 2024; 105:415-422. [PMID: 38258470 DOI: 10.1111/cge.14477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/14/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024]
Abstract
The genotype-phenotype relationship in PWS patients is important for a better understanding of the clinical phenotype and clinical characteristics of different genotypes of PWS in children. We aimed to explore the influence of specific gene changes on the clinical symptoms of PWS and the value of early screening and early intervention of the condition. All data in this study were extracted from the database of the XiaoPang Weili Rare Disease Care Center. The collected information included basic demographics, maternal pregnancy information, endocrine abnormalities, growth and development abnormalities, and other clinical phenotypes. The relationships between genotypes and phenotypes in the major categories of PWS were analyzed. A total of 586 PWS cases with confirmed molecular diagnosis and genotyping were included in this study. Among them, 83.8% belonged to the deletion type, 10.9% the uniparental disomy (UPD) type, and 5.3% the imprinting defect (ID) type. Age-wide comparison among the three groups: The rate of hypopigmentation in the deletion group was higher than that in the UPD group (88.8% vs. 60.9%; p < 0.05); A total of 62 patients (14.2%) had epilepsy; and no statistical significance was found among the three groups (p = 0.110). Age-wide comparison between the deletion and non-deletion types: the rate of skin hypopigmentation and epilepsy in the deletion group was significantly higher than that in the non-deletion group (88.8% vs. 68.4%, p < 0.001; 15.9% vs. 7.6%, p = 0.040). The intergroup comparison for the >2-year age group: there were significant intergroup differences in the language development delay among the three groups (p < 0.001). The incidence of delayed language development was the highest in the deletion group, followed by the UPD group, and the lowest in the ID group. The rates of obesity and hyperphagia in the deletion group were also higher than those in the non-deletion group (71.1% vs. 58.9%, p = 0.041; 75.7% vs. 62.0%, p = 0.016). There are significant differences in the rates of skin hypopigmentation and language developmental delay among the deletion, UPD, and ID genotypes. The patients with deletion type had significantly higher rates of lighter skin color, obesity, hyperphagia, language developmental delay, and epilepsy. The results of this study will help clinicians better understand the impact of different PWS molecular etiologies on specific phenotypes.
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Affiliation(s)
- Shujiong Mao
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
- Department of Pediatrics, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, China
| | - Lili Yang
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Ying Gao
- Department of Pediatrics, Ningbo Medical Center Lihuili Hospital, Ningbo, China
| | - Chaochun Zou
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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Karunakaran S, Menon RN, Nair SS, Santhakumar S, Nair M, Sundaram S. Clinical and Genetic Profile of Autism Spectrum Disorder-Epilepsy (ASD-E) Phenotype: Two Sides of the Same Coin! Clin EEG Neurosci 2020; 51:390-398. [PMID: 32114799 DOI: 10.1177/1550059420909673] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The clinical phenotype of autism spectrum disorder and epilepsy (ASD-E) is a common neurological presentation in various genetic disorders, irrespective of the underlying pathophysiological mechanisms. Here we describe the demographic and clinical profiles, coexistent neurological conditions, type of seizures, epilepsy syndrome, and EEG findings in 11 patients with ASD-E phenotype with proven genetic etiology. The commonest genetic abnormality noted was CDKL5 mutation (3), MECP2 mutation (2), and 1p36 deletion (2). The median age of onset of clinical seizures was 6 months (range, 10 days to 11 years). The most common seizure type was focal onset seizures with impaired awareness, observed in 7 (63.6%) patients followed by epileptic spasms in 4 (30.8%), generalized tonic-clonic and atonic seizures in 3 (27.3%) patients each and tonic seizures in 2 (18.2%) patients and myoclonic seizures in 1 (9.1%) patient. Focal and multifocal interictal epileptiform abnormalities were seen in 6 (54.6%) and 5 (45.5%) patients, respectively. Epileptic encephalopathy and focal epilepsy were seen in 7 (63.6%) and 4 (36.4%) patients, respectively. The diagnostic yield of genetic testing was 44% (11 of 25 patients) and when variants of unknown significance and metabolic defects were included, the yield increased to 60% (15 of 25 patients). We conclude that in patients with ASD-E phenotype with an underlying genetic basis, the clinical seizure type, epilepsy syndrome, and EEG patterns are variable. Next-generation exome sequencing and chromosomal microarray need to be considered in clinical practice as part of evaluation of children with ASD-E phenotype.
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Affiliation(s)
- Sudhakar Karunakaran
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Ramshekhar N Menon
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Sruthi S Nair
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - S Santhakumar
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Muralidharan Nair
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Soumya Sundaram
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
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Budisteanu M, Jurca C, Papuc SM, Focsa I, Riga D, Riga S, Jurca A, Arghir A. Treatment of Epilepsy Associated with Common Chromosomal Developmental Diseases. Open Life Sci 2020; 15:21-29. [PMID: 33987468 PMCID: PMC8114617 DOI: 10.1515/biol-2020-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 10/22/2019] [Indexed: 11/15/2022] Open
Abstract
Chromosomal diseases are heterogeneous conditions with complex phenotypes, which include also epileptic seizures. Each chromosomal syndrome has a range of specific characteristics regarding the type of seizures, EEG findings and specific response to antiepileptic drugs, significant in the context of the respective genetic etiology. Therefore, it is very important to know these particularities, in order to avoid an exacerbation of seizures or some side effects. In this paper we will present a review of the epileptic seizures and antiepileptic treatment in some of the most common chromosomal syndromes.
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Affiliation(s)
- Magdalena Budisteanu
- Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, BucharestRomania
- ”Victor Babes“ National Institute of Pathology, BucharestRomania
- ”Titu Maiorescu” University – Faculty of Medicine, BucharestRomania
| | - Claudia Jurca
- University of Oradea, Faculty of Medicine and Pharmacy, Preclinical Department, OradeaRomania
| | | | - Ina Focsa
- ”Carol Davila” University of Pharmacy and Medicine, BucharestRomania
| | - Dan Riga
- Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, BucharestRomania
| | - Sorin Riga
- Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, BucharestRomania
| | - Alexandru Jurca
- University of Oradea, Faculty of Medicine and Pharmacy, Preclinical Department, OradeaRomania
| | - Aurora Arghir
- ”Victor Babes“ National Institute of Pathology, BucharestRomania
- ”Carol Davila” University of Pharmacy and Medicine, BucharestRomania
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Ge MM, Gao YY, Wu BB, Yan K, Qin Q, Wang H, Zhou W, Yang L. Relationship between phenotype and genotype of 102 Chinese newborns with Prader-Willi syndrome. Mol Biol Rep 2019; 46:4717-4724. [PMID: 31270759 DOI: 10.1007/s11033-019-04916-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 06/13/2019] [Indexed: 12/14/2022]
Abstract
High rates of misdiagnosis and delayed intervention in neonatal PWS are leading to poor prognoses. To determine the clinical and image characteristics of newborns with Prader-Willi syndrome (PWS). A total of 102 cases of newborns definitively diagnosed with PWS at the Children's Hospital of Fudan University from 02/2014 to 12/2017 were retrospectively analyzed. We analyzed the modulated voxel-based morphology (VBM) of gray matter in PWS by T2 weighted imaging. Of 102 cases, 75 (73.5%) have paternal deletion of 15q11.2-q13, whereas 27 (26.5%) have maternal uniparental disomy (UPD). Of the 75 deletion cases, 75 (100%) week crying, 71 (94.7%) hypotonia, 70 (93.3%) poor feeding, 46 (61.3%) hypopigmentation, 43 (57.3%) male cryptorchidism, 10 (13.3%) female labia minora, 48 (64%) characteristic facial features. Of 27 UPD cases, 27 (100%) week crying and hypotonia, 25 (92.6%) hypophagia, 20 (74.1%) male cryptorchidism, 1 (3.7%) female labia minora, 19 (70.4%) characteristic facial features, 12 (44.4%) hypopigmentation. The modulated VBM analysis shows that the middle frontal gyrus, orbitofrontal cortex (middle), and inferior frontal gyrus are the most variable brain regions that determine the endo-phenotype difference between the two genotypes. Hypotonia, hypophagia, and maldevelopment of sexual organs are general characteristics of newborns with PWS in Chinese population. In UPD cases, the proportions of premature newborns, elderly parturient women and congenital malformations were higher than for paternal deletion cases. The differences in the gray matter volume of these three regions between the two genotypes may explain the differences in maladaptive behaviors and emotions.
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Affiliation(s)
- Meng-Meng Ge
- Department of Neonates, Children's Hospital, Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China
| | - Yan-Yan Gao
- Department of B Ultrasonography, Children's Hospital, Fudan University, Shanghai, China
| | - Bing-Bing Wu
- Clinical Genetic Center, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China
| | - Kai Yan
- Department of Neonates, Children's Hospital, Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China
| | - Qian Qin
- Clinical Genetic Center, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China
| | - HuiJun Wang
- Birth Defect Laboratory, Children's Hospital of Fudan University, Shanghai, China
| | - WenHao Zhou
- Department of Neonates, Children's Hospital, Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China.
- Birth Defect Laboratory, Children's Hospital of Fudan University, Shanghai, China.
| | - Lin Yang
- Clinical Genetic Center, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China.
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Clinical and Molecular Characterization of Prader-Willi Syndrome. Indian J Pediatr 2017; 84:815-821. [PMID: 28660389 DOI: 10.1007/s12098-017-2386-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 05/11/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To describe the clinical presentations and molecular diagnosis to aid the clinicians in early diagnosis and appropriate management of Prader-Willi syndrome (PWS). METHODS Thirty-four clinically diagnosed PWS cases were enrolled after obtaining informed consent/assent. Demographic details, clinical data and anthropometry were recorded using structured proforma. The facial dysmorphology was evaluated. Appropriate genetic testing was performed to confirm the diagnosis. RESULTS At diagnosis, the most common clinical features included obesity (59%) and short stature (53%). Distinct dysmorphic features were observed in 67%. Neonatal hypotonia with feeding difficulty, delayed development in infancy and childhood behavioral problems were reported in 94%, 94% and 74% respectively. Food seeking behavior and hyperphagia was reported in 67%. Seizures were reported in 47%. All children had underdeveloped external genitalia. Growth hormone (GH) deficiency and impaired glucose tolerance were found in 56% and 50% respectively. Sleep related problems were seen in 67%. Skin and rectal picking were reported in 67%. FISH confirmed micro-deletion was found in 64.7% and abnormal methylation in 35%, of which uniparental disomy was confirmed in 14.7%. CONCLUSIONS Clinical suspicion is vital for early detection of PWS. Confirmation of the diagnosis requires complex multi-tier molecular genetic testing.
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Shi C, Shang D, Sun S, Mao C, Qin J, Luo H, Shao M, Chen Z, Liu Y, Liu X, Song B, Xu Y. MMACHC gene mutation in familial hypogonadism with neurological symptoms. Gene 2015; 574:380-4. [PMID: 26283149 DOI: 10.1016/j.gene.2015.08.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 08/12/2015] [Accepted: 08/13/2015] [Indexed: 10/23/2022]
Abstract
Recent studies have convincingly documented that hypogonadism is a component of various hereditary disorders and is often recognized as an important clinical feature in combination with various neurological symptoms, yet, the causative genes in a few related families are still unknown. High-throughput sequencing has become an efficient method to identify causative genes in related complex hereditary disorders. In this study, we performed exome sequencing in a family presenting hypergonadotropic hypogonadism with neurological presentations of mental retardation, epilepsy, ataxia, and leukodystrophy. After bioinformatic analysis and Sanger sequencing validation, we identified compound heterozygous mutations: c.482G>A (p.R161Q) and c.609G>A (p.W203X) in MMACHC gene in this pedigree. MMACHC was previously confirmed to be responsible for methylmalonic aciduria (MMA) combined with homocystinuria, cblC type (cblC disease), a hereditary vitamin B12 metabolic disorder. Biochemical and gas chromatography-mass spectrometry (GC-MS) examinations in this pedigree further supported the cblC disease diagnosis. These results indicated that hypergonadotropic hypogonadism may be a novel clinical manifestation of cblC disease, but more reports on additional patients are needed to support this hypothesis.
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Affiliation(s)
- Changhe Shi
- Department of Neurology, The first affiliated Hospital of Zhengzhou University, Zhengzhou University. 1 Jian-she East Road, Zhengzhou 450000, Henan, China
| | - Dandan Shang
- Department of Neurology, The first affiliated Hospital of Zhengzhou University, Zhengzhou University. 1 Jian-she East Road, Zhengzhou 450000, Henan, China
| | - Shilei Sun
- Department of Neurology, The first affiliated Hospital of Zhengzhou University, Zhengzhou University. 1 Jian-she East Road, Zhengzhou 450000, Henan, China
| | - Chengyuan Mao
- Department of Neurology, The first affiliated Hospital of Zhengzhou University, Zhengzhou University. 1 Jian-she East Road, Zhengzhou 450000, Henan, China
| | - Jie Qin
- Department of Neurology, The first affiliated Hospital of Zhengzhou University, Zhengzhou University. 1 Jian-she East Road, Zhengzhou 450000, Henan, China
| | - Haiyang Luo
- Department of Neurology, The first affiliated Hospital of Zhengzhou University, Zhengzhou University. 1 Jian-she East Road, Zhengzhou 450000, Henan, China
| | - Mingwei Shao
- Department of Endocrinology, The first affiliated Hospital of Zhengzhou University, Zhengzhou University. 1 Jian-she East Road, Zhengzhou 450000, Henan, China
| | - Zhengguang Chen
- Department of Ultrasound, The first affiliated Hospital of Zhengzhou University, Zhengzhou University. 1 Jian-she East Road, Zhengzhou 450000, Henan, China
| | - Yutao Liu
- Department of Neurology, The first affiliated Hospital of Zhengzhou University, Zhengzhou University. 1 Jian-she East Road, Zhengzhou 450000, Henan, China
| | - Xinjing Liu
- Department of Neurology, The first affiliated Hospital of Zhengzhou University, Zhengzhou University. 1 Jian-she East Road, Zhengzhou 450000, Henan, China
| | - Bo Song
- Department of Neurology, The first affiliated Hospital of Zhengzhou University, Zhengzhou University. 1 Jian-she East Road, Zhengzhou 450000, Henan, China
| | - Yuming Xu
- Department of Neurology, The first affiliated Hospital of Zhengzhou University, Zhengzhou University. 1 Jian-she East Road, Zhengzhou 450000, Henan, China.
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