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Candelo E, Estrada-Mesa MA, Jaramillo A, Martinez-Cajas CH, Osorio JC, Pachajoa H. The Oral Health of Patients with DiGeorge Syndrome (22q11) Microdeletion: A Case Report. APPLICATION OF CLINICAL GENETICS 2021; 14:267-277. [PMID: 34103968 PMCID: PMC8179788 DOI: 10.2147/tacg.s280066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/20/2021] [Indexed: 11/23/2022]
Abstract
Background DiGeorge syndrome (DG) is a genetic disorder associated with 22q11 deletion. It involves various phenotypes, including craniofacial abnormalities, congenital heart disorders, endocrine dysfunction, cognitive deficits, and psychiatric disorders. Cases commonly involve multiple anomalies. However, little is known about the condition of the oral cavity in this disorder, although palate fissure, abnormal mandible, malocclusion, and tooth hypoplasia have been identified. We aimed to determine the odontological features of patients with 22q11.2 microdeletion, in relation to gingival health and oral hygiene. We report the systemic manifestations of nine patients and results of oral evaluation of two patients. In the oral examination, oral hygiene and gingivitis were evaluated. Case Presentation In terms of the systemic manifestations, we found high frequencies of low weight and height at birth. In terms of the oral manifestations, both examined patients presented malocclusion, enamel hypoplasia, dental crowding, anodontia, and healthy periodontium. Conclusion Although DG has been documented to involve periodontium disease, the patients in this study exhibited more dental manifestations such as enamel defects, misalignment between the teeth and the two dental arches, anodontia, and dental crowding. As such, a multidisciplinary approach combining dentistry and healthcare is recommended in this case.
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Affiliation(s)
- Estephania Candelo
- Congenital Abnormalities and Rare Disease Centre (CIACER), Cali, Colombia.,Genetics Department, Fundacion Valle del Lili, Cali, Colombia.,Centro de Investigaciones Clínicas, Fundacion Valle del Lili, Cali, Colombia
| | | | - Adriana Jaramillo
- Institución Universitaria Colegios de Colombia (UNICOC), Cali, Colombia
| | | | | | - Harry Pachajoa
- Congenital Abnormalities and Rare Disease Centre (CIACER), Cali, Colombia.,Genetics Department, Fundacion Valle del Lili, Cali, Colombia
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İnce B, Altinoz MA, Ayran AC, Cansız A, Altinbaş K, Guloksuz S, Kurt E. Minor Physical Anomalies in Bipolar Disorder. Compr Psychiatry 2020; 103:152206. [PMID: 33099105 DOI: 10.1016/j.comppsych.2020.152206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 06/07/2020] [Accepted: 09/01/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE High-arched palate is more frequent in schizophrenia and bipolar disorder (BD). Upto 40% of patients develop schizophrenia in 22q11.2 Deletion Syndrome manifested with cleft lip and palate, which originate from the first pharyngeal arch in embryo. The auricle also originates from the dorsal ends of the first and second pharyngeal arches; hence, we aimed to determine the associations between auricular anomalies and BD. METHODS We screened for 36 minor physical anomalies of the auricle in 146 patients with BD. RESULTS 7 out of the of 36 assessed anomalies highly differed between healthy subjects and BD patients. A regression model including the differing anomalies predicted healthy subjects and BD-patients by 78.8% and 68.5%, respectively. CONCLUSIONS Assessing minor anomalies in psychiatric disorders may help to discover novel pathogenesis pathways and even new endophenotypes.
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Affiliation(s)
- Bahri İnce
- Department of Psychiatry, Bakirkoy Research and Training Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Meric A Altinoz
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, the Netherlands; Department of Medical Biochemistry, Acibadem University, Istanbul, Turkey.
| | - Aylin Can Ayran
- Department of Psychiatry, Kilis State Hospital, Kilis, Turkey
| | - Alparslan Cansız
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Kürşat Altinbaş
- Department of Psychiatry, Faculty of Medicine, Selçuk University, Konya, Turkey
| | - Sinan Guloksuz
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, the Netherlands; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Erhan Kurt
- Department of Psychiatry, Bakirkoy Research and Training Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
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Dolleman-van der Weel MJ, Witter MP. The thalamic midline nucleus reuniens: potential relevance for schizophrenia and epilepsy. Neurosci Biobehav Rev 2020; 119:422-439. [PMID: 33031816 DOI: 10.1016/j.neubiorev.2020.09.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 09/03/2020] [Accepted: 09/28/2020] [Indexed: 01/08/2023]
Abstract
Anatomical, electrophysiological and behavioral studies in rodents have shown that the thalamic midline nucleus reuniens (RE) is a crucial link in the communication between hippocampal formation (HIP, i.e., CA1, subiculum) and medial prefrontal cortex (mPFC), important structures for cognitive and executive functions. A common feature in neurodevelopmental and neurodegenerative brain diseases is a dysfunctional connectivity/communication between HIP and mPFC, and disturbances in the cognitive domain. Therefore, it is assumed that aberrant functioning of RE may contribute to behavioral/cognitive impairments in brain diseases characterized by cortico-thalamo-hippocampal circuit dysfunctions. In the human brain the connections of RE are largely unknown. Yet, recent studies have found important similarities in the functional connectivity of HIP-mPFC-RE in humans and rodents, making cautious extrapolating experimental findings from animal models to humans justifiable. The focus of this review is on a potential involvement of RE in schizophrenia and epilepsy.
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Affiliation(s)
- M J Dolleman-van der Weel
- Kavli Institute for Systems Neuroscience and Centre for Neural Computation, NTNU Norwegian University of Science and Technology, Trondheim NO-7491, Norway.
| | - M P Witter
- Kavli Institute for Systems Neuroscience and Centre for Neural Computation, NTNU Norwegian University of Science and Technology, Trondheim NO-7491, Norway.
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Favorable effects of omega-3 polyunsaturated fatty acids in attentional control and conversion rate to psychosis in 22q11.2 deletion syndrome. Neuropharmacology 2020; 168:107995. [PMID: 32057798 DOI: 10.1016/j.neuropharm.2020.107995] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 12/13/2022]
Abstract
Omega-3-polyunsaturated-fatty-acids were suggested against cognitive dysfunctions and conversion to psychosis. However, a recent multicenter trial found no effect in reducing conversion rates in individuals at risk of developing schizophrenia. Patients' genetic heterogeneity and the timing of treatment might influence omega-3 efficacy. Here, we addressed the impact of omega-3 early treatment in both mice and human subjects with a 22q11.2 genetic hemi-deletion (22q11DS), characterized by cognitive dysfunctions and high penetrance of schizophrenia. We first tested the behavioural and cognitive consequences of adolescent exposure to normal or omega-3-enriched diets in wild-type and 22q11DS (LgDel/+) mice. We then contrasted mouse data with those gathered from sixty-two patients with 22q11DS exposed to a normal diet or supplemented with omega-3 during pre-adolescence/adolescence. Adolescent omega-3 exposure had no effects in wild-type mice. However, this treatment ameliorated distractibility deficits revealed in LgDel/+ mice by the Five Choice Serial Reaction Time Task (5CSRTT). The omega-3 improvement in LgDel/+ mice was selective, as no other generalized cognitive and non-cognitive effects were evident. Similarly, omega-3-exposed 22q11DS patients showed long-lasting improvements on distractibility as revealed by the continuous performance test (CPT). Moreover, omega-3-exposed 22q11DS patients showed less risk of developing an Ultra High Risk status and lower conversion rate to psychosis. Our convergent mouse-human findings represent a first analysis on the effects of omega-3 early treatment in 22q11DS. The beneficial effects in attentional control and transition to psychosis could support the early use of omega-3 supplementation in the 22q11DS population.
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Van Den Heuvel E, ReuterskiöLd C, Solot C, Manders E, Swillen A, Zink I. Referential communication abilities in children with 22q11.2 deletion syndrome. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 19:490-502. [PMID: 27690637 DOI: 10.1080/17549507.2016.1221456] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 07/20/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE This study describes the performance on a perspective- and role-taking task in 27 children, ages 6-13 years, with 22q11.2 deletion syndrome (22q11.2DS). A cross-cultural design comparing Dutch- and English-speaking children with 22q11.2DS explored the possibility of cultural differences. METHOD Chronologically age-matched and younger typically developing (TD) children matched for receptive vocabulary served as control groups to identify challenges in referential communication. RESULTS The utterances of children with 22q11.2DS were characterised as short and simple in lexical and grammatical terms. However, from a language use perspective, their utterances were verbose, ambiguous and irrelevant given the pictured scenes. They tended to elaborate on visual details and conveyed off-topic, extraneous information when participating in a barrier-game procedure. Both types of aberrant utterances forced a listener to consistently infer the intended message. Moreover, children with 22q11.2DS demonstrated difficulty selecting correct speech acts in accordance with contextual cues during a role-taking task. CONCLUSION Both English- and Dutch-speaking children with 22q11.2DS showed impoverished information transfer and an increased number of elaborations, suggesting a cross-cultural syndrome-specific feature.
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Affiliation(s)
- Ellen Van Den Heuvel
- a Department of Neurosciences, Research Group Experimental Oto-Rhino-Laryngology (ExpORL) , KU Leuven - University of Leuven , Leuven , Belgium
| | - Christina ReuterskiöLd
- b Department of Communicative Sciences and Disorders , New York University , New York , NY , USA
| | - Cynthia Solot
- c Center for Childhood Communication , The Children's Hospital of Philadelphia , Philadelphia , PA , USA
| | - Eric Manders
- a Department of Neurosciences, Research Group Experimental Oto-Rhino-Laryngology (ExpORL) , KU Leuven - University of Leuven , Leuven , Belgium
| | - Ann Swillen
- d Department of Human Genetics , KU Leuven - University of Leuven , Leuven , Belgium
- e Center for Human Genetics , University Hospital Leuven , Leuven , Belgium , and
| | - Inge Zink
- a Department of Neurosciences, Research Group Experimental Oto-Rhino-Laryngology (ExpORL) , KU Leuven - University of Leuven , Leuven , Belgium
- f Department of Oto-Rhino-Laryngology, Head & Neck Surgery, MUCLA , University Hospital Leuven , Leuven , Belgium
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Ingrao T, Lambert L, Valduga M, Bosser G, Albuisson E, Leheup B. [22q11.2 microdeletion syndrome: Analysis of the care pathway before the genetic diagnosis]. Arch Pediatr 2017; 24:1067-1075. [PMID: 28967605 DOI: 10.1016/j.arcped.2017.08.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 08/15/2017] [Accepted: 08/28/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND 22q11.2 deletion syndrome (22q11.2DS) is a very broad phenotypic spectrum disorder. It can affect many organs or systems. 22q11.2DS is the most common microdeletion syndrome in humans, with a prevalence ranging from one in every 2000 to one in 4000 newborns. It seems to be more prevalent than reported and under-recognized or undiagnosed because of its inherent clinical variability and heterogeneity. In France, 15,000 patients may be affected by this disease, more than half without knowing it. The aim of this study was to analyze the care pathway before the genetic diagnosis of 22q11.2DS. METHODS We conducted a single-center, retrospective analysis of postnatally diagnosed patients recruited by the cytogenetic laboratory of Nancy (France) from January 2000 to December 2015. Clinical data were first collected by consulting the medical files of patients and then by calling them directly. Written informed consent was obtained and the study was approved by local research ethics boards. Data concerned only clinical features before the diagnosis. RESULTS The cohort consisted of 32 individuals with 22q11.2DS. The average age at diagnosis was 9 years and 2 months and the median age was 2 years and 11 months. Fetal echography was abnormal in 15 pregnancies. During the neonatal period, the most important features were eating difficulties and congenital malformations (n=20), with a majority of complex heart diseases (n=16), dominated by conotruncal malformations (n=6). In case of malformation, the average age at diagnosis decreased to 2 years and 6 months. A congenital heart disease brought the average age of diagnosis down to 2 years and 6 months. Hypocalcemia and dysmorphism were also classical features (n=14). Before the age of 3 years, speech delay occurred in nine patients. After 3 years of age, rhinolalia was predominant (n=11). Academic disabilities were present in all subjects. At least 14 patients had a de novo deletion. Five patients were diagnosed within genetic counseling, with the deletion was inherited from the mother in three out of four cases. One was the monozygotic twin of a patient. Seven patients were diagnosed as adults. Four of them were diagnosed only because of the clinical presentation of their children or fetuses. Retrospectively, all adult patients had clinical signs suggesting the 22q11.2DS diagnosis. Relational disorders affected eight patients. None of them had been referred to the geneticist for this reason. In most cases, the pediatric cardiologist referred patients to the geneticist (n=9). Physiotherapists (n=15) and speech-language pathologists (n=12) were frequently requested but did not participate in the diagnosis. CONCLUSION The present study highlights the difficulty of establishing the diagnosis when the major features of the 22q11.2DS are absent during the 1st months of life. This is particularly true when there is no congenital defect. Special attention must be given to speech disorders in childhood and neuropsychological disorders later in life. The association between 22q11.2DS and early-onset parkinson disease implies that adult neurologists should be aware of this diagnosis. For adult patients, familial occurrence is the most frequent cause of diagnosis in spite of clinical signs suggestive of 22q11.2DS. The management of these patients involves better information of medical and paramedical staff in order to refer them to the geneticist earlier in life.
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Affiliation(s)
- T Ingrao
- Service de génétique clinique, CHRU de Nancy, rue du Morvan, 54511 Vandœuvre-Lès-Nancy, France.
| | - L Lambert
- Service de génétique clinique, CHRU de Nancy, rue du Morvan, 54511 Vandœuvre-Lès-Nancy, France
| | - M Valduga
- Service de cytogénétique et génétique moléculaire, laboratoire de génétique médicale, CHRU de Nancy, rue du Morvan, 54511 Vandœuvre-Lès-Nancy, France
| | - G Bosser
- Service de cardiologie infantile, CHRU de Nancy, rue du Morvan, 54511 Vandœuvre-Lès-Nancy, France
| | - E Albuisson
- Unité ESPRI-BioBase-méthodologie-réglementation-biostatistiques, plateforme d'aide à la recherche clinique (PARC), CHRU de Nancy, rue du Morvan, 54511 Vandœuvre-Lès-Nancy, France
| | - B Leheup
- Service de génétique clinique et pédiatrie, CHRU de Nancy, rue du Morvan, 54511 Vandœuvre-Lès-Nancy, France
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