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Elvidge KL, Christodoulou J, Farrar MA, Tilden D, Maack M, Valeri M, Ellis M, Smith NJC. The collective burden of childhood dementia: a scoping review. Brain 2023; 146:4446-4455. [PMID: 37471493 PMCID: PMC10629766 DOI: 10.1093/brain/awad242] [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: 04/11/2023] [Revised: 06/16/2023] [Accepted: 06/25/2023] [Indexed: 07/22/2023] Open
Abstract
Childhood dementia is a devastating and under-recognized group of disorders with a high level of unmet need. Typically monogenic in origin, this collective of individual neurodegenerative conditions are defined by a progressive impairment of neurocognitive function, presenting in childhood and adolescence. This scoping review aims to clarify definitions and conceptual boundaries of childhood dementia and quantify the collective disease burden. A literature review identified conditions that met the case definition. An expert clinical working group reviewed and ratified inclusion. Epidemiological data were extracted from published literature and collective burden modelled. One hundred and seventy genetic childhood dementia disorders were identified. Of these, 25 were analysed separately as treatable conditions. Collectively, currently untreatable childhood dementia was estimated to have an incidence of 34.5 per 100 000 (1 in 2900 births), median life expectancy of 9 years and prevalence of 5.3 per 100 000 persons. The estimated number of premature deaths per year is similar to childhood cancer (0-14 years) and approximately 70% of those deaths will be prior to adulthood. An additional 49.8 per 100 000 births are attributable to treatable conditions that would cause childhood dementia if not diagnosed early and stringently treated. A relational database of the childhood dementia disorders has been created and will be continually updated as new disorders are identified (https://knowledgebase.childhooddementia.org/). We present the first comprehensive overview of monogenic childhood dementia conditions and their collective epidemiology. Unifying these conditions, with consistent language and definitions, reinforces motivation to advance therapeutic development and health service supports for this significantly disadvantaged group of children and their families.
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Affiliation(s)
| | - John Christodoulou
- Brain and Mitochondrial Research Group, Murdoch Children’s Research Institute, Royal Children's Hospital, Parkville, Victoria 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Michelle A Farrar
- Department of Neurology, Sydney Children's Hospital Network, Randwick, NSW 2031, Australia
- Discipline of Paediatrics, School of Clinical Medicine, UNSW Medicine and Health, Sydney, NSW 2052, Australia
| | | | - Megan Maack
- Childhood Dementia Initiative, Brookvale, NSW 2100, Australia
| | | | - Magda Ellis
- THEMA Consulting Pty Ltd, Pyrmont, NSW 2009, Australia
| | - Nicholas J C Smith
- Discipline of Paediatrics, University of Adelaide, Women's and Children's Hospital, North Adelaide, South Australia 5006, Australia
- Department of Neurology and Clinical Neurophysiology, Women’s and Children’s Health Network, North Adelaide, South Australia 5006, Australia
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Delvecchio M, Ortolani F, Palumbo O, Aloi C, Salina A, Susca FC, Palumbo P, Carella M, Resta N, Piccinno E. A Novel Genetic Variant in the WFS1 Gene in a Patient with Partial Uniparental Mero-Isodisomy of Chromosome 4. Int J Mol Sci 2021; 22:ijms22158082. [PMID: 34360843 PMCID: PMC8348440 DOI: 10.3390/ijms22158082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/23/2021] [Accepted: 07/25/2021] [Indexed: 11/16/2022] Open
Abstract
Wolfram syndrome is a rare autosomal recessive disorder characterized by optic atrophy and diabetes mellitus. Wolfram syndrome type 1 (WFS1) is caused by bi-allelic pathogenic variations in the wolframin gene. We described the first case of WFS1 due to a maternal inherited mutation with uniparental mero-isodisomy of chromosome 4. Diabetes mellitus was diagnosed at 11 years of age, with negative anti-beta cells antibodies. Blood glucose control was optimal with low insulin requirement. No pathogenic variations in the most frequent gene causative of maturity-onset diabetes of the young subtypes were detected. At 17.8 years old, a rapid reduction in visual acuity occurred. Genetic testing revealed the novel homozygous variant c.1369A>G; p.Arg457Gly in the exon 8 of wolframin gene. It was detected in a heterozygous state only in the mother while the father showed a wild type sequence. In silico disease causing predictions performed by Polyphen2 classified it as “likely damaging”, while Mutation Tester and Sift suggested it was “polymorphism” and “tolerated”, respectively. High resolution SNP-array analysis was suggestive of segmental uniparental disomy on chromosome 4. In conclusion, to the best of our knowledge, we describe the first patient with partial uniparental mero-isodisomy of chromosome 4 carrying a novel mutation in the wolframin gene. The clinical phenotype observed in the patient and the analysis performed suggest that the genetic variant detected is pathogenetic.
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Affiliation(s)
- Maurizio Delvecchio
- Metabolic Disease and Genetics Disorders Unit, Giovanni XXIII Children’s Hospital, 70126 Bari, Italy; (F.O.); (E.P.)
- Correspondence: ; Tel.: +39-08-0559-6771
| | - Federica Ortolani
- Metabolic Disease and Genetics Disorders Unit, Giovanni XXIII Children’s Hospital, 70126 Bari, Italy; (F.O.); (E.P.)
| | - Orazio Palumbo
- Medical Genetics Unit, IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo (FG), Italy; (O.P.); (P.P.); (M.C.)
| | - Concetta Aloi
- Clinica Pediatrica, LABSIEM, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy; (C.A.); (A.S.)
| | - Alessandro Salina
- Clinica Pediatrica, LABSIEM, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy; (C.A.); (A.S.)
| | - Francesco Claudio Susca
- Department of Biomedical Sciences and Human Oncology (DIMO), Division of Medical Genetics, University of Bari “Aldo Moro”, 70125 Bari, Italy; (F.C.S.); (N.R.)
| | - Pietro Palumbo
- Medical Genetics Unit, IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo (FG), Italy; (O.P.); (P.P.); (M.C.)
| | - Massimo Carella
- Medical Genetics Unit, IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo (FG), Italy; (O.P.); (P.P.); (M.C.)
| | - Nicoletta Resta
- Department of Biomedical Sciences and Human Oncology (DIMO), Division of Medical Genetics, University of Bari “Aldo Moro”, 70125 Bari, Italy; (F.C.S.); (N.R.)
| | - Elvira Piccinno
- Metabolic Disease and Genetics Disorders Unit, Giovanni XXIII Children’s Hospital, 70126 Bari, Italy; (F.O.); (E.P.)
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