1
|
Friedman JM, van Essen P, van Karnebeek CDM. Cerebral palsy and related neuromotor disorders: Overview of genetic and genomic studies. Mol Genet Metab 2022; 137:399-419. [PMID: 34872807 DOI: 10.1016/j.ymgme.2021.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 12/14/2022]
Abstract
Cerebral palsy (CP) is a debilitating condition characterized by abnormal movement or posture, beginning early in development. Early family and twin studies and more recent genomic investigations clearly demonstrate that genetic factors of major effect contribute to the etiology of CP. Most copy number variants and small alterations of nucleotide sequence that cause CP arise as a result of de novo mutations, so studies that estimate heritability on basis of recurrence frequency within families substantially underestimate genetic contributions to the etiology. At least 4% of patients with typical CP have disease-causing CNVs, and at least 14% have disease-causing single nucleotide variants or indels. The rate of pathogenic genomic lesions is probably more than twice as high among patients who have atypical CP, i.e., neuromotor dysfunction with additional neurodevelopmental abnormalities or malformations, or with MRI findings and medical history that are not characteristic of a perinatal insult. Mutations of many different genetic loci can produce a CP-like phenotype. The importance of genetic variants of minor effect and of epigenetic modifications in producing a multifactorial predisposition to CP is less clear. Recognizing the specific cause of CP in an affected individual is essential to providing optimal clinical management. An etiological diagnosis provides families an "enhanced compass" that improves overall well-being, facilitates access to educational and social services, permits accurate genetic counseling, and, for a subset of patients such as those with underlying inherited metabolic disorders, may make precision therapy that targets the pathophysiology available. Trio exome sequencing with assessment of copy number or trio genome sequencing with bioinformatics analysis for single nucleotide variants, indels, and copy number variants is clinically indicated in the initial workup of CP patients, especially those with additional malformations or neurodevelopmental abnormalities.
Collapse
Affiliation(s)
- Jan M Friedman
- Department of Medical Genetics, University of British Columbia, Vancouver, Canada
| | - Peter van Essen
- Department of Pediatrics, Amalia Children's Hospital, Radboud Centre for Mitochondrial Diseases, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Clara D M van Karnebeek
- Department of Pediatrics, Amalia Children's Hospital, Radboud Centre for Mitochondrial Diseases, Radboud University Medical Center, Nijmegen, the Netherlands; Departments of Human Genetics and Pediatrics, Emma Children's Hospital, Amsterdam University Medical Centres, Amsterdam, the Netherlands; Department of Pediatrics, Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, Canada.
| |
Collapse
|
2
|
Holborn MA, Ford G, Turner S, Mellet J, van Rensburg J, Joubert F, Pepper MS. The NESHIE and CP Genetics Resource (NCGR): A database of genes and variants reported in neonatal encephalopathy with suspected hypoxic ischemic encephalopathy (NESHIE) and consequential cerebral palsy (CP). Genomics 2022; 114:110508. [PMID: 36270382 PMCID: PMC9726645 DOI: 10.1016/j.ygeno.2022.110508] [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: 08/30/2022] [Revised: 10/12/2022] [Accepted: 10/17/2022] [Indexed: 01/15/2023]
Abstract
Neonatal encephalopathy (NE) with suspected hypoxic ischaemic encephalopathy (HIE) (NESHIE) is a complex syndrome occurring in newborns, characterised by altered neurological function. It has been suggested that genetic variants may influence NESHIE susceptibility and outcomes. Unlike NESHIE, for which a limited number of genetic studies have been performed, many studies have identified genetic variants associated with cerebral palsy (CP), which can develop from severe NESHIE. Identifying variants in patients with CP, as a consequence of NESHIE, may provide a starting point for the identification of genetic variants associated with NESHIE outcomes. We have constructed NCGR (NESHIE and CP Genetics Resource), a database of genes and variants reported in patients with NESHIE and CP (where relevant to NESHIE), for the purpose of collating and comparing genetic findings between the two conditions. In this paper we describe the construction and functionality of NCGR. Furthermore, we demonstrate how NCGR can be used to prioritise genes and variants of potential clinical relevance that may underlie a genetic predisposition to NESHIE and contribute to an understanding of its pathogenesis.
Collapse
Affiliation(s)
- Megan A. Holborn
- Institute for Cellular and Molecular Medicine, Department of Immunology; SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Graeme Ford
- Institute for Cellular and Molecular Medicine, Department of Immunology; SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa,Centre for Bioinformatics and Computational Biology, Genomics Research Institute, Department of Biochemistry, Genetics and Microbiology, University of Pretoria, Pretoria, South Africa
| | - Sarah Turner
- Institute for Cellular and Molecular Medicine, Department of Immunology; SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa,Centre for Bioinformatics and Computational Biology, Genomics Research Institute, Department of Biochemistry, Genetics and Microbiology, University of Pretoria, Pretoria, South Africa
| | - Juanita Mellet
- Institute for Cellular and Molecular Medicine, Department of Immunology; SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Jeanne van Rensburg
- Institute for Cellular and Molecular Medicine, Department of Immunology; SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Fourie Joubert
- Centre for Bioinformatics and Computational Biology, Genomics Research Institute, Department of Biochemistry, Genetics and Microbiology, University of Pretoria, Pretoria, South Africa
| | - Michael S. Pepper
- Institute for Cellular and Molecular Medicine, Department of Immunology; SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa,Corresponding author.
| |
Collapse
|
3
|
Zhang W, Hu L, Huang X, Xie D, Wu J, Fu X, Liang D, Huang S. Whole-exome sequencing identified five novel de novo variants in patients with unexplained intellectual disability. J Clin Lab Anal 2022; 36:e24587. [PMID: 35837997 PMCID: PMC9459325 DOI: 10.1002/jcla.24587] [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: 03/10/2022] [Revised: 05/20/2022] [Accepted: 06/25/2022] [Indexed: 11/30/2022] Open
Abstract
Background Intellectual disability (ID) represents a neurodevelopmental disorder, which is characterized by marked defects in the intellectual function and adaptive behavior, with an onset during the developmental period. ID is mainly caused by genetic factors, and it is extremely genetically heterogeneous. This study aims to identify the genetic cause of ID using trio‐WES analysis. Methods We recruited four pediatric patients with unexplained ID from non‐consanguineous families, who presented at the Department of Pediatrics, Guizhou Provincial People's Hospital. Whole‐exome sequencing (WES) and Sanger sequencing validation were performed in the patients and their unaffected parents. Furthermore, conservative analysis and protein structural and functional prediction were performed on the identified pathogenic variants. Results We identified five novel de novo mutations from four known ID‐causing genes in the four included patients, namely COL4A1 (c.2786T>A, p.V929D and c.2797G>A, p.G933S), TBR1 (c.1639_1640insCCCGCAGTCC, p.Y553Sfs*124), CHD7 (c.7013A>T, p.Q2338L), and TUBA1A (c.1350del, p.E450Dfs*34). These mutations were all predicted to be deleterious and were located at highly conserved domains that might affect the structure and function of these proteins. Conclusion Our findings contribute to expanding the mutational spectrum of ID‐related genes and help to deepen the understanding of the genetic causes and heterogeneity of ID.
Collapse
Affiliation(s)
- Wenqiu Zhang
- School of Medicine, Guizhou University, Guiyang, China.,Prenatal Diagnosis Center, Guizhou Provincial People's hospital, Guiyang, China
| | - Li Hu
- Prenatal Diagnosis Center, Guizhou Provincial People's hospital, Guiyang, China
| | - Xinyi Huang
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dan Xie
- School of Medicine, Guizhou University, Guiyang, China.,Prenatal Diagnosis Center, Guizhou Provincial People's hospital, Guiyang, China
| | - Jiangfen Wu
- School of Medicine, Guizhou University, Guiyang, China.,Prenatal Diagnosis Center, Guizhou Provincial People's hospital, Guiyang, China
| | - Xiaoling Fu
- Department of Pediatrics, Guizhou Provincial People's hospital, Guiyang, China
| | - Daiyi Liang
- Department of Neurology, Guizhou Provincial People's hospital, Guiyang, China
| | - Shengwen Huang
- School of Medicine, Guizhou University, Guiyang, China.,Prenatal Diagnosis Center, Guizhou Provincial People's hospital, Guiyang, China.,NHC Key Laboratory of Pulmonary Immunological Diseases, Guizhou Provincial People's Hospital, Guiyang, China
| |
Collapse
|
4
|
McKnight D, Bristow SL, Truty RM, Morales A, Stetler M, Westbrook MJ, Robinson K, Riethmaier D, Borlot F, Kellogg M, Hwang ST, Berg A, Aradhya S. Multigene Panel Testing in a Large Cohort of Adults With Epilepsy: Diagnostic Yield and Clinically Actionable Genetic Findings. Neurol Genet 2022; 8:e650. [PMID: 34926809 PMCID: PMC8678910 DOI: 10.1212/nxg.0000000000000650] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/04/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Although genetic testing among children with epilepsy has demonstrated clinical utility and become a part of routine testing, studies in adults are limited. This study reports the diagnostic yield of genetic testing in adults with epilepsy. METHODS Unrelated individuals aged 18 years and older who underwent diagnostic genetic testing for epilepsy using a comprehensive, next-generation sequencing-based, targeted gene panel (range 89-189 genes) were included in this cross-sectional study. Clinical information, provided at the discretion of the ordering clinician, was reviewed and analyzed. Diagnostic yield was calculated for all individuals including by age at seizure onset and comorbidities based on clinician-reported information. The proportion of individuals with clinically actionable genetic findings, including instances when a specific treatment would be indicated or contraindicated due to a diagnostic finding, was calculated. RESULTS Among 2,008 individuals, a diagnostic finding was returned for 218 adults (10.9%), with clinically actionable findings in 55.5% of diagnoses. The highest diagnostic yield was in adults with seizure onset during infancy (29.6%, 0-1 year), followed by in early childhood (13.6%, 2-4 years), late childhood (7.0%, 5-10 years), adolescence (2.4%, 11-17 years), and adulthood (3.7%, ≥18 years). Comorbid intellectual disability (ID) or developmental delay resulted in a high diagnostic yield (16.0%), most notably for females (19.6% in females vs 12.3% in males). Among individuals with pharmacoresistant epilepsy, 13.5% had a diagnostic finding, and of these, 57.4% were clinically actionable genetic findings. DISCUSSION These data reinforce the utility of genetic testing for adults with epilepsy, particularly for those with childhood-onset seizures, ID, and pharmacoresistance. This is an important consideration due to longer survival and the complexity of the transition from pediatric to adult care. In addition, more than half of diagnostic findings in this study were considered clinically actionable, suggesting that genetic testing could have a direct impact on clinical management and outcomes.
Collapse
Affiliation(s)
- Dianalee McKnight
- From the Invitae (D.M., S.L.B., R.M.T., A.M., M.S., M.J.W., K.R., D.R., S.A.), San Francisco, CA; Alberta Children's Hospital Research Institute, Cumming School of Medicine, (F.B.) University of Calgary, Canada; Oregon Health & Science University Comprehensive Epilepsy Center (M.K.); Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell (S.T.H); Epilepsy Center, Ann & Robert H. Lurie Children's Hospital of Chicago (A.B.); and Department of Neurology, Northwestern University-Feinberg School of Medicine (A.B.), Chicago, IL
| | - Sara L. Bristow
- From the Invitae (D.M., S.L.B., R.M.T., A.M., M.S., M.J.W., K.R., D.R., S.A.), San Francisco, CA; Alberta Children's Hospital Research Institute, Cumming School of Medicine, (F.B.) University of Calgary, Canada; Oregon Health & Science University Comprehensive Epilepsy Center (M.K.); Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell (S.T.H); Epilepsy Center, Ann & Robert H. Lurie Children's Hospital of Chicago (A.B.); and Department of Neurology, Northwestern University-Feinberg School of Medicine (A.B.), Chicago, IL
| | - Rebecca M. Truty
- From the Invitae (D.M., S.L.B., R.M.T., A.M., M.S., M.J.W., K.R., D.R., S.A.), San Francisco, CA; Alberta Children's Hospital Research Institute, Cumming School of Medicine, (F.B.) University of Calgary, Canada; Oregon Health & Science University Comprehensive Epilepsy Center (M.K.); Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell (S.T.H); Epilepsy Center, Ann & Robert H. Lurie Children's Hospital of Chicago (A.B.); and Department of Neurology, Northwestern University-Feinberg School of Medicine (A.B.), Chicago, IL
| | - Ana Morales
- From the Invitae (D.M., S.L.B., R.M.T., A.M., M.S., M.J.W., K.R., D.R., S.A.), San Francisco, CA; Alberta Children's Hospital Research Institute, Cumming School of Medicine, (F.B.) University of Calgary, Canada; Oregon Health & Science University Comprehensive Epilepsy Center (M.K.); Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell (S.T.H); Epilepsy Center, Ann & Robert H. Lurie Children's Hospital of Chicago (A.B.); and Department of Neurology, Northwestern University-Feinberg School of Medicine (A.B.), Chicago, IL
| | - Molly Stetler
- From the Invitae (D.M., S.L.B., R.M.T., A.M., M.S., M.J.W., K.R., D.R., S.A.), San Francisco, CA; Alberta Children's Hospital Research Institute, Cumming School of Medicine, (F.B.) University of Calgary, Canada; Oregon Health & Science University Comprehensive Epilepsy Center (M.K.); Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell (S.T.H); Epilepsy Center, Ann & Robert H. Lurie Children's Hospital of Chicago (A.B.); and Department of Neurology, Northwestern University-Feinberg School of Medicine (A.B.), Chicago, IL
| | - M. Jody Westbrook
- From the Invitae (D.M., S.L.B., R.M.T., A.M., M.S., M.J.W., K.R., D.R., S.A.), San Francisco, CA; Alberta Children's Hospital Research Institute, Cumming School of Medicine, (F.B.) University of Calgary, Canada; Oregon Health & Science University Comprehensive Epilepsy Center (M.K.); Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell (S.T.H); Epilepsy Center, Ann & Robert H. Lurie Children's Hospital of Chicago (A.B.); and Department of Neurology, Northwestern University-Feinberg School of Medicine (A.B.), Chicago, IL
| | - Kristina Robinson
- From the Invitae (D.M., S.L.B., R.M.T., A.M., M.S., M.J.W., K.R., D.R., S.A.), San Francisco, CA; Alberta Children's Hospital Research Institute, Cumming School of Medicine, (F.B.) University of Calgary, Canada; Oregon Health & Science University Comprehensive Epilepsy Center (M.K.); Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell (S.T.H); Epilepsy Center, Ann & Robert H. Lurie Children's Hospital of Chicago (A.B.); and Department of Neurology, Northwestern University-Feinberg School of Medicine (A.B.), Chicago, IL
| | - Darlene Riethmaier
- From the Invitae (D.M., S.L.B., R.M.T., A.M., M.S., M.J.W., K.R., D.R., S.A.), San Francisco, CA; Alberta Children's Hospital Research Institute, Cumming School of Medicine, (F.B.) University of Calgary, Canada; Oregon Health & Science University Comprehensive Epilepsy Center (M.K.); Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell (S.T.H); Epilepsy Center, Ann & Robert H. Lurie Children's Hospital of Chicago (A.B.); and Department of Neurology, Northwestern University-Feinberg School of Medicine (A.B.), Chicago, IL
| | - Felippe Borlot
- From the Invitae (D.M., S.L.B., R.M.T., A.M., M.S., M.J.W., K.R., D.R., S.A.), San Francisco, CA; Alberta Children's Hospital Research Institute, Cumming School of Medicine, (F.B.) University of Calgary, Canada; Oregon Health & Science University Comprehensive Epilepsy Center (M.K.); Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell (S.T.H); Epilepsy Center, Ann & Robert H. Lurie Children's Hospital of Chicago (A.B.); and Department of Neurology, Northwestern University-Feinberg School of Medicine (A.B.), Chicago, IL
| | - Marissa Kellogg
- From the Invitae (D.M., S.L.B., R.M.T., A.M., M.S., M.J.W., K.R., D.R., S.A.), San Francisco, CA; Alberta Children's Hospital Research Institute, Cumming School of Medicine, (F.B.) University of Calgary, Canada; Oregon Health & Science University Comprehensive Epilepsy Center (M.K.); Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell (S.T.H); Epilepsy Center, Ann & Robert H. Lurie Children's Hospital of Chicago (A.B.); and Department of Neurology, Northwestern University-Feinberg School of Medicine (A.B.), Chicago, IL
| | - Sean T. Hwang
- From the Invitae (D.M., S.L.B., R.M.T., A.M., M.S., M.J.W., K.R., D.R., S.A.), San Francisco, CA; Alberta Children's Hospital Research Institute, Cumming School of Medicine, (F.B.) University of Calgary, Canada; Oregon Health & Science University Comprehensive Epilepsy Center (M.K.); Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell (S.T.H); Epilepsy Center, Ann & Robert H. Lurie Children's Hospital of Chicago (A.B.); and Department of Neurology, Northwestern University-Feinberg School of Medicine (A.B.), Chicago, IL
| | - Anne Berg
- From the Invitae (D.M., S.L.B., R.M.T., A.M., M.S., M.J.W., K.R., D.R., S.A.), San Francisco, CA; Alberta Children's Hospital Research Institute, Cumming School of Medicine, (F.B.) University of Calgary, Canada; Oregon Health & Science University Comprehensive Epilepsy Center (M.K.); Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell (S.T.H); Epilepsy Center, Ann & Robert H. Lurie Children's Hospital of Chicago (A.B.); and Department of Neurology, Northwestern University-Feinberg School of Medicine (A.B.), Chicago, IL
| | - Swaroop Aradhya
- From the Invitae (D.M., S.L.B., R.M.T., A.M., M.S., M.J.W., K.R., D.R., S.A.), San Francisco, CA; Alberta Children's Hospital Research Institute, Cumming School of Medicine, (F.B.) University of Calgary, Canada; Oregon Health & Science University Comprehensive Epilepsy Center (M.K.); Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell (S.T.H); Epilepsy Center, Ann & Robert H. Lurie Children's Hospital of Chicago (A.B.); and Department of Neurology, Northwestern University-Feinberg School of Medicine (A.B.), Chicago, IL
| |
Collapse
|
5
|
May HJ, Fasheun JA, Bain JM, Baugh EH, Bier LE, Revah-Politi A, Roye DP, Goldstein DB, Carmel JB. Genetic testing in individuals with cerebral palsy. Dev Med Child Neurol 2021; 63:1448-1455. [PMID: 34114234 PMCID: PMC9277698 DOI: 10.1111/dmcn.14948] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/30/2021] [Indexed: 12/28/2022]
Abstract
AIM To determine which patients with cerebral palsy (CP) should undergo genetic testing, we compared the rate of likely causative genetic variants from whole-exome sequencing in individuals with and without environmental risk factors. METHOD Patients were part of a convenience and physician-referred cohort recruited from a single medical center, and research whole-exome sequencing was completed. Participants were evaluated for the following risk factors: extreme preterm birth, brain bleed or stroke, birth asphyxia, brain malformations, and intrauterine infection. RESULTS A total of 151 unrelated individuals with CP (81 females, 70 males; mean age 25y 7mo [SD 17y 5mo], range 3wks-72y) participated. Causative genetic variants were identified in 14 participants (9.3%). There was no significant difference in diagnostic rate between individuals with risk factors (10 out of 123; 8.1%) and those without (4 out of 28; 14.3%) (Fisher's exact p=0.3). INTERPRETATION While the rate of genetic diagnoses among individuals without risk factors was higher than those with risk factors, the difference was not statistically significant at this sample size. The identification of genetic diagnoses in over 8% of cases with risk factors suggests that these might confer susceptibility to environmental factors, and that further research should include individuals with risk factors. What this paper adds There is no significant difference in diagnostic rate between individuals with and without risk factors. Genetic variants may confer susceptibility to environmental risk factors. Six causative variants were identified in genes not previously associated with cerebral palsy. Global developmental delay/intellectual disability is positively associated with a genetic etiology. Extreme preterm birth, stroke/brain hemorrhage, and older age are negatively associated with a genetic etiology.
Collapse
Affiliation(s)
- Halie J. May
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY
| | - Jennifer A. Fasheun
- Weinberg Family Cerebral Palsy Center, Department of Orthopedics, Columbia University Irving Medical Center, New York, NY
| | - Jennifer M. Bain
- Department of Neurology, Columbia University Irving Medical Center, New York, NY
| | - Evan H. Baugh
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY
| | - Louise E. Bier
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY
| | - Anya Revah-Politi
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY
| | - David P. Roye
- Weinberg Family Cerebral Palsy Center, Department of Orthopedics, Columbia University Irving Medical Center, New York, NY
| | - David B. Goldstein
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY
| | - Jason B. Carmel
- Weinberg Family Cerebral Palsy Center, Department of Orthopedics, Columbia University Irving Medical Center, New York, NY
- Department of Neurology, Columbia University Irving Medical Center, New York, NY
| | - NYP/CUIMC Genomics Team
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY
- Weinberg Family Cerebral Palsy Center, Department of Orthopedics, Columbia University Irving Medical Center, New York, NY
- Department of Neurology, Columbia University Irving Medical Center, New York, NY
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY
- Division of Clinical Genetics, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY
| |
Collapse
|
6
|
Yield of clinically reportable genetic variants in unselected cerebral palsy by whole genome sequencing. NPJ Genom Med 2021; 6:74. [PMID: 34531397 PMCID: PMC8445947 DOI: 10.1038/s41525-021-00238-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/26/2021] [Indexed: 12/24/2022] Open
Abstract
Cerebral palsy (CP) is the most common cause of childhood physical disability, with incidence between 1/500 and 1/700 births in the developed world. Despite increasing evidence for a major contribution of genetics to CP aetiology, genetic testing is currently not performed systematically. We assessed the diagnostic rate of genome sequencing (GS) in a clinically unselected cohort of 150 singleton CP patients, with CP confirmed at >4 years of age. Clinical grade GS was performed on the proband and variants were filtered, and classified according to American College of Medical Genetics and Genomics–Association for Molecular Pathology (ACMG-AMP) guidelines. Variants classified as pathogenic or likely pathogenic (P/LP) were further assessed for their contribution to CP. In total, 24.7% of individuals carried a P/LP variant(s) causing or increasing risk of CP, with 4.7% resolved by copy number variant analysis and 20% carrying single nucleotide or indel variants. A further 34.7% carried one or more rare, high impact variants of uncertain significance (VUS) in variation intolerant genes. Variants were identified in a heterogeneous group of genes, including genes associated with hereditary spastic paraplegia, clotting and thrombophilic disorders, small vessel disease, and other neurodevelopmental disorders. Approximately 1/2 of individuals were classified as likely to benefit from changed clinical management as a result of genetic findings. In addition, no significant association between genetic findings and clinical factors was detectable in this cohort, suggesting that systematic sequencing of CP will be required to avoid missed diagnoses.
Collapse
|
7
|
Are COL4A1 and COL4A2 gene polymorphisms associated with cerebral palsy? Turk J Phys Med Rehabil 2021; 67:242-249. [PMID: 34396076 PMCID: PMC8343154 DOI: 10.5606/tftrd.2021.5481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 04/16/2020] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to investigate the association of COL4A1 and COL4A2 gene polymorphisms with susceptibility to risk of developing cerebral palsy (CP) and severity of CP. Patients and methods Between December 2016 and June 2017, a total of 176 patients with CP (101 males, 75 females; mean age 71.8±37.9 months; range, 24 to 184 months) and age-, sex-, and ethnically-matched 178 (90 males, 88 females; mean age 69.3±55.2 months; range, 24 to 214 months) controls were included. Two polymorphisms of COL4A1 (rs1961495) and COL4A2 (rs9521733) genes were typed from genomic deoxyribonucleic acid. Genotype distributions and allelic frequencies were compared between the patient and control groups. Gross Motor Function Classification System, the use of medical drugs, type of involvement, number of affected limbs, accompanying conditions, birth weight, gestational age, and magnetic resonance imaging (MRI) findings were used to evaluate the disease severity and their relationships with the COL4A1 and COL4A2 gene polymorphisms. Results There was no statistically significant difference between the groups in terms of genotype distribution and allele frequency of COL4A1 and COL4A2 gene polymorphisms (p>0.05). In addition, there was no relationship between severity of CP and two gene polymorphisms (p>0.05). A significant association was detected between the COL4A2 polymorphism and growth retardation in CP. The TT genotype (57.1%) and T allele (76.2%) were higher, compared to CC (4.8%) and CT genotypes (38.1%) and C allele (23.8%) in patients with CP with growth retardation (p=0.03 for genotype and p=0.01 for allele frequency). Conclusion These findings suggest that COL4A1 and COL4A2 gene polymorphisms are not associated with susceptibility to CP in a group of Turkish populations, although COL4A2 gene polymorphism may be associated with growth retardation in patients with CP.
Collapse
|
8
|
Pham R, Mol BW, Gecz J, MacLennan AH, MacLennan SC, Corbett MA, van Eyk CL, Webber DL, Palmer LJ, Berry JG. Definition and diagnosis of cerebral palsy in genetic studies: a systematic review. Dev Med Child Neurol 2020; 62:1024-1030. [PMID: 32542675 DOI: 10.1111/dmcn.14585] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2020] [Indexed: 01/01/2023]
Abstract
AIM To conduct a systematic review of phenotypic definition and case ascertainment in published genetic studies of cerebral palsy (CP) to inform guidelines for the reporting of such studies. METHOD Inclusion criteria comprised genetic studies of candidate genes, with CP as the outcome, published between 1990 and 2019 in the PubMed, Embase, and BIOSIS Citation Index databases. RESULTS Fifty-seven studies met the inclusion criteria. We appraised how CP was defined, the quality of information on case ascertainment, and compliance with international consensus guidelines. Seven studies (12%) were poorly described, 33 studies (58%) gave incomplete information, and 17 studies (30%) were well described. Missing key information precluded determining how many studies complied with the definition by Rosenbaum et al. Only 18 out of 57 studies (32%) were compliant with the Surveillance of Cerebral Palsy in Europe (SCPE) international guidelines on defining CP. INTERPRETATION Limited compliance with international consensus guidelines on phenotypic definition and mediocre reporting of CP case ascertainment hinders the comparison of results among genetic studies of CP (including meta-analyses), thereby limiting the quality, interpretability, and generalizability of study findings. Compliance with the SCPE guidelines is important for ongoing gene discovery efforts in CP, given the potential for misclassification of unrelated neurological conditions as CP.
Collapse
Affiliation(s)
- Ryan Pham
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Ben W Mol
- Discipline of Obstetrics & Gynaecology, University of Adelaide, Adelaide, South Australia, Australia.,Discipline of Obstetrics & Gynaecology, Monash University, Clayton, Victoria, Australia
| | - Jozef Gecz
- Robinson Research Institute & Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.,South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Alastair H MacLennan
- Discipline of Obstetrics & Gynaecology, University of Adelaide, Adelaide, South Australia, Australia.,Robinson Research Institute & Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Suzanna C MacLennan
- Neurology Department, Women's and Children's Hospital, North Adelaide, South Australia, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Mark A Corbett
- Robinson Research Institute & Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Clare L van Eyk
- Robinson Research Institute & Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Dani L Webber
- Robinson Research Institute & Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Lyle J Palmer
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Jesia G Berry
- Discipline of Obstetrics & Gynaecology, University of Adelaide, Adelaide, South Australia, Australia.,Robinson Research Institute & Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
9
|
Hakami WS, Hundallah KJ, Tabarki BM. Metabolic and genetic disorders mimicking cerebral palsy. NEUROSCIENCES (RIYADH, SAUDI ARABIA) 2019; 24:155-163. [PMID: 31380813 PMCID: PMC8015517 DOI: 10.17712/nsj.2019.3.20190045] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 06/27/2019] [Indexed: 11/20/2022]
Abstract
Cerebral palsy is a syndrome that encompasses a large group of childhood movement and posture disorders that result from a lesion occurring in the developing brain. The clinical presentation of many metabolic and genetic conditions, particularly in highly consanguineous populations, can mimic cerebral palsy particularly at early age. The aim of this review article is to identify the clinical features that should alert the physician to the possibility of disorders that resemble cerebral palsy, the clinical and neuroimaging red flags, and highlight some metabolic and genetic conditions which may present with spasticity, ataxia and dyskinesia. In the case of metabolic or genetic disorder, making a precise diagnosis is particularly important for the possibility of treatment, accurate prognosis and genetic counseling.
Collapse
Affiliation(s)
- Wejdan S. Hakami
- Division of Pediatric Neurology, Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Khaled J. Hundallah
- Division of Pediatric Neurology, Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Brahim M. Tabarki
- Division of Pediatric Neurology, Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
| |
Collapse
|
10
|
Pingel J, Andersen JD, Christiansen SL, Børsting C, Morling N, Lorentzen J, Kirk H, Doessing S, Wong C, Nielsen JB. Sequence variants in muscle tissue-related genes may determine the severity of muscle contractures in cerebral palsy. Am J Med Genet B Neuropsychiatr Genet 2019; 180:12-24. [PMID: 30467950 DOI: 10.1002/ajmg.b.32693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 07/20/2018] [Accepted: 09/20/2018] [Indexed: 12/30/2022]
Abstract
Muscle contractures are a common complication to cerebral palsy (CP). The purpose of this study was to evaluate whether individuals with CP carry specific gene variants of important structural genes that might explain the severity of muscle contractures. Next-generation-sequencing (NGS) of 96 candidate genes associated with muscle structure and metabolism were analyzed in 43 individuals with CP (Gross Motor Function classification system [GMFCS] I, n=10; GMFCS II, n=14; GMFCS III, n=19) and four control participants. In silico analysis of the identified variants was performed. The variants were classified into four categories ranging from likely benign (VUS0) to highly likely functional effect (VUS3). All individuals with CP were classified and grouped according to their GMFCS level: Statistical comparisons were made between GMFCS groups. Kruskal-Wallis tests showed significantly more VUS2 variants in the genes COL4 (GMFCS I-III; 1, 1, 5, respectively [p < .04]), COL5 (GMFCS I-III; 1, 1, 5 [p < .04]), COL6 (GMFCS I-III; 0, 4, 7 [p < .003]), and COL9 (GMFCS I-III; 1, 1, 5 [p < .04]), in individuals with CP within GMFCS Level III when compared to the other GMFCS levels. Furthermore, significantly more VUS3 variants in COL6 (GMFCS I-III; 0, 5, 2 [p < .01]) and COL7 (GMFCS I-III; 0, 3, 0 [p < .04]) were identified in the GMFCS II level when compared to the other GMFCS levels. The present results highlight several candidate gene variants in different collagen types with likely functional effects in individuals with CP.
Collapse
Affiliation(s)
- Jessica Pingel
- Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jeppe Dyrberg Andersen
- Department of Forensic Medicine, Section of Forensic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sofie Lindgren Christiansen
- Department of Forensic Medicine, Section of Forensic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Claus Børsting
- Department of Forensic Medicine, Section of Forensic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Morling
- Department of Forensic Medicine, Section of Forensic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Lorentzen
- Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Helene Elsass Center, Charlottenlund, Denmark
| | - Henrik Kirk
- Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Helene Elsass Center, Charlottenlund, Denmark
| | - Simon Doessing
- Department of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Christian Wong
- Department of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Jens Bo Nielsen
- Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Helene Elsass Center, Charlottenlund, Denmark
| |
Collapse
|
11
|
Qiu J, Huang G, Na N, Chen L. MicroRNA-214-5p/TGF-β/Smad2 signaling alters adipogenic differentiation of bone marrow stem cells in postmenopausal osteoporosis. Mol Med Rep 2018. [PMID: 29532880 PMCID: PMC5928609 DOI: 10.3892/mmr.2018.8713] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Postmenopausal osteoporosis (OPM) is a common type of osteoporosis in females. It is a systemic, chronic bone disease that presents as microstructure degradation of osseous tissue, decreased bone mineral density and increased osteopsathyrosis caused by hypoovarianism and reduced estrogen levels in the body following menopause. In the present study, the role of microRNA (miR)-214-5p in the regulation of the expression of bone marrow stem cells (BMSCs) was investigated, and its molecular mechanism of osteogenic induction in vitro was assessed. When dexamethasone-induced adipogenic differentiation was performed, miR-214-5p expression was increased compared with the control group, as determined by RT-qPCR. Furthermore, oil red O staining, RT-qPCR and western blot analysis demonstrated that overexpression of miR-214-5p promoted adipogenic differentiation, inhibited alkaline phosphatase (ALP), runt-related transcription factor 2 (Runx2), osteocalcin (OC) and collagen α-1 (I) chain (COL1A1) mRNA expression, and suppressed transforming growth factor (TGF)-β, phosphorylated (p)-Smad2 and collagen type IV α1 chain (COL4A1) protein expression in BMSCs. Additionally, downregulation of miR-214-5p increased the ALP, Runx2, OC and COL1 mRNA expression and increased TGF-β, Smad2 and COL4A1 protein expression in BMSCs. Furthermore, a TGF-β inhibitor was employed to inhibit TGF-β expression in BMSCs following miR-214-5p downregulation, which led to reduced Smad2, TGF-β and COL4A1 protein expression, and ALP, Runx2, OC and COL1 mRNA expression was also reduced, compared with the miR-214-5p downregulation only group. It was demonstrated that miR-214-5p may weaken osteogenic differentiation of BMSCs through regulating COL4A1. In conclusion, the results of the present study indicated that miR-214-5p may promote the adipogenic differentiation of BMSCs through regulation of the TGF-β/Smad2/COL4A1 signaling pathway, and potentially may be used to develop a novel drug for postmenopausal osteoporosis.
Collapse
Affiliation(s)
- Jiang Qiu
- Division of Organ Transplantation, The First Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Gang Huang
- Division of Organ Transplantation, The First Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Ning Na
- Division of Organ Transplantation, The Third Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510630, P.R. China
| | - Lizhong Chen
- Division of Organ Transplantation, The First Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| |
Collapse
|
12
|
Xu J, Xia L, Shang Q, Du J, Zhu D, Wang Y, Bi D, Song J, Ma C, Gao C, Zhang X, Sun Y, Zhu L, Wang X, Zhu C, Xing Q. A Variant of the Autophagy-Related 5 Gene Is Associated with Child Cerebral Palsy. Front Cell Neurosci 2017; 11:407. [PMID: 29326554 PMCID: PMC5741640 DOI: 10.3389/fncel.2017.00407] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/04/2017] [Indexed: 12/19/2022] Open
Abstract
Cerebral palsy (CP) is a major cause of childhood disability in developed and developing countries, but the pathogenic mechanisms of CP development remain largely unknown. Autophagy is a highly conserved cellular self-digestion of damaged organelles and dysfunctional macromolecules. Growing evidence suggests that autophagy-related gene 5 (ATG5)-dependent autophagy is involved in neural development, neuronal differentiation, and neurological degenerative diseases. The aim of this study was to analyze ATG5 protein expression and gene polymorphisms in Chinese patients with CP and to evaluate the importance of ATG5 in the development of CP. Five polymorphisms from different regions of the ATG5 gene (rs510432, rs3804338, rs573775, rs2299863, and rs6568431) were analyzed in 715 CP patients and 658 controls using MassARRAY. Of these, 58 patients and 56 controls were selected for measurement of plasma ATG5 level using ELISA. The relevance of disease-associated SNPs was evaluated using the SHEsis program. We identified a significant association between rs6568431 and CP (OR = 1.388, 95% CI = 1.173~1.643, Pallele = 0.0005, Pgenotype = 0.0015). Subgroup analysis showed a highly significant association of rs6568431 with spastic CP (n = 468, OR = 1.511, 95% CI = 1.251~1.824, Pallele = 8.50e-005, Pgenotype = 1.57e-004) and spastic quadriplegia (OR = 1.927, 95% CI = 1.533~2.421, Pallele = 7.35e-008, Pgenotype = 3.24e-009). Furthermore, mean plasma ATG5 levels were lower in CP patients than in controls, and individuals carrying the AA genotype of rs6568431 that was positively associated with CP had lower plasma ATG5 levels (P < 0.05). This study demonstrated an association of an ATG5 gene variant and low level of ATG5 protein with CP, and stronger associations with severe clinical manifestations were identified. Our results provide novel evidence for a role of ATG5 in CP and shed light on the molecular mechanisms underlying this neurodevelopmental disorder.
Collapse
Affiliation(s)
- Jianhua Xu
- Institute of Biomedical Science and Children's Hospital, and Key Laboratory of Reproduction Regulation of the National Population and Family Planning Commission (NPFPC), Shanghai Institute of Planned Parenthood Research (SIPPR), IRD, Fudan University, Shanghai, China
| | - Lei Xia
- Henan Key Laboratory of Child Brain Injury, Department of Pediatrics, The 3rd Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qing Shang
- Department of Pediatrics, Henan Children's Hospital, Zhengzhou, China
| | - Jing Du
- Institute of Biomedical Science and Children's Hospital, and Key Laboratory of Reproduction Regulation of the National Population and Family Planning Commission (NPFPC), Shanghai Institute of Planned Parenthood Research (SIPPR), IRD, Fudan University, Shanghai, China
| | - Dengna Zhu
- Henan Key Laboratory of Child Brain Injury, Department of Pediatrics, The 3rd Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Child Rehabilitation Center, The 3rd Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yangong Wang
- Institute of Biomedical Science and Children's Hospital, and Key Laboratory of Reproduction Regulation of the National Population and Family Planning Commission (NPFPC), Shanghai Institute of Planned Parenthood Research (SIPPR), IRD, Fudan University, Shanghai, China
| | - Dan Bi
- Henan Key Laboratory of Child Brain Injury, Department of Pediatrics, The 3rd Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Juan Song
- Henan Key Laboratory of Child Brain Injury, Department of Pediatrics, The 3rd Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Caiyun Ma
- Department of Pediatrics, Henan Children's Hospital, Zhengzhou, China
| | - Chao Gao
- Department of Pediatrics, Henan Children's Hospital, Zhengzhou, China
| | - Xiaoli Zhang
- Henan Key Laboratory of Child Brain Injury, Department of Pediatrics, The 3rd Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanyan Sun
- Henan Key Laboratory of Child Brain Injury, Department of Pediatrics, The 3rd Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Liping Zhu
- Shanghai Center for Women and Children's Health, Shanghai, China
| | - Xiaoyang Wang
- Perinatal Center, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Changlian Zhu
- Henan Key Laboratory of Child Brain Injury, Department of Pediatrics, The 3rd Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Center for Brain Repair and Rehabilitation, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Qinghe Xing
- Institute of Biomedical Science and Children's Hospital, and Key Laboratory of Reproduction Regulation of the National Population and Family Planning Commission (NPFPC), Shanghai Institute of Planned Parenthood Research (SIPPR), IRD, Fudan University, Shanghai, China.,Shanghai Center for Women and Children's Health, Shanghai, China
| |
Collapse
|