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Ahlström S, Reiterä P, Jokela R, Olkkola KT, Kaunisto MA, Kalso E. Influence of Clinical and Genetic Factors on Propofol Dose Requirements: A Genome-wide Association Study. Anesthesiology 2024; 141:300-312. [PMID: 38700459 DOI: 10.1097/aln.0000000000005036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
BACKGROUND Propofol is a widely used intravenous hypnotic. Dosing is based mostly on weight, with great interindividual variation in consumption. Suggested factors affecting propofol requirements include age, sex, ethnicity, anxiety, alcohol consumption, smoking, and concomitant valproate use. Genetic factors have not been widely explored. METHODS This study considered 1,000 women undergoing breast cancer surgery under propofol and remifentanil anesthesia. Depth of anesthesia was monitored with State Entropy (GE Healthcare, Finland). Propofol requirements during surgery were recorded. DNA from blood was genotyped with a genome-wide array. A multivariable linear regression model was used to assess the relevance of clinical variables and select those to be used as covariates in a genome-wide association study. Imputed genotype data were used to explore selected loci further. In silico functional annotation was used to explore possible consequences of the discovered genetic variants. Additionally, previously reported genetic associations from candidate gene studies were tested. RESULTS Body mass index, smoking status, alcohol use, remifentanil dose (ln[mg · kg-1 · min-1]), and average State Entropy during surgery remained statistically significant in the multivariable model. Two loci reached genome-wide significance (P < 5 × 10-8). The most significant associations were for single-nucleotide polymorphisms rs997989 (30 kb from ROBO3), likely affecting expression of another nearby gene, FEZ1, and rs9518419, close to NALCN (sodium leak channel); rs10512538 near KCNJ2 encoding the Kir2.1 potassium channel showed suggestive association (P = 4.7 × 10-7). None of these single-nucleotide polymorphisms are coding variants but possibly affect the regulation of nearby genes. None of the single-nucleotide polymorphisms previously reported as affecting propofol pharmacokinetics or pharmacodynamics showed association in the data. CONCLUSIONS In this first genome-wide association study exploring propofol requirements, This study discovered novel genetic associations suggesting new biologically relevant pathways for propofol and general anesthesia. The roles of the gene products of ROBO3/FEZ1, NALCN, and KCNJ2 in propofol anesthesia warrant further studies. EDITOR’S PERSPECTIVE
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Affiliation(s)
- Sirkku Ahlström
- Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
| | - Paula Reiterä
- Department of Public Health, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
| | - Ritva Jokela
- HUS Shared Group Services, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
| | - Klaus T Olkkola
- Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland; INDIVIDRUG Research Program, Faculty of Medicine, University of Helsinki, Finland
| | - Mari A Kaunisto
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Eija Kalso
- Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland; Department of Pharmacology, Faculty of Medicine, University of Helsinki, Finland; SleepWell Research Program, Faculty of Medicine, University of Helsinki, Finland
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Günbey C, Çavdarlı B, Göçmen R, Yazıcı M, Temuçin ÇM, Özdemir Ö, Çırak S, Haliloğlu G. Horizontal gaze palsy with progressive scoliosis: Further expanding the ROBO3 spectrum. Ann Clin Transl Neurol 2024. [PMID: 39030736 DOI: 10.1002/acn3.52129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 06/03/2024] [Accepted: 06/03/2024] [Indexed: 07/22/2024] Open
Abstract
OBJECTIVE Horizontal gaze palsy with progressive scoliosis (HGPPS) is a rare, autosomal recessive disorder resulting from axonal midline crossing defect due to variants in ROBO3. METHODS We retrospectively evaluated demographics, clinical phenotype, course of spinal deformities, and neuroimaging findings of six Turkish patients with HGPPS. We performed targeted gene testing by next-generation sequencing. RESULTS The median age at symptom onset and diagnosis was 1.5 years (0.5-4), and 11 years (2-16), respectively. Oculomotor signs were the most common presenting symptom (n = 4), followed by scoliosis (n = 2). The course of scoliosis was progressive and accompanied by kyphosis, showed intrafamilial variability, and was corrected surgically in three of the patients. Intellectual disability (n = 4), hypergonadotropic hypogonadism (n = 2), hearing loss (n = 2), and tranisent movement disorders (n = 1) were additional features. Targeted gene sequencing revealed five distinct homozygous variants. Of the four novel variants, two of them were located in the acceptor site of the noncoding region of the gene, remaining two were missense and frameshift variants, located in immunoglobulin-like domain-2, and cytoplasmic signaling motif 2, respectively. Structural magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) showed the absence of decussation of superior cerebellar peduncle and dorsal transverse pontine fibers. INTERPRETATION Spectrum of HGPPS is further expanded with novel variants in the ROBO3 with clinical and radiological fingerprints. Spinal deformities require close orthopedic screening and individualized approach. Intellectual disability and hearing loss emerge as additional features. Hypogonadism and transient subtle movement disorders require further attention and confirmation from other series.
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Affiliation(s)
- Ceren Günbey
- Division of Pediatric Neurology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Büşranur Çavdarlı
- Department of Medical Genetics, Bilkent City Hospital, Ankara, Turkey
| | - Rahşan Göçmen
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Muharrem Yazıcı
- Department of Orthopedics and Traumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Çağrı Mesut Temuçin
- Department of Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Özkan Özdemir
- Center for Molecular Medicine, University of Cologne, Cologne, Germany
| | - Sebahattin Çırak
- Center for Molecular Medicine, University of Cologne, Cologne, Germany
| | - Göknur Haliloğlu
- Division of Pediatric Neurology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Tsytsarev V, Plachez C, Zhao S, O'Connor DH, Erzurumlu RS. Bilateral Whisker Representations in the Primary Somatosensory Cortex in Robo3cKO Mice Are Reflected in the Primary Motor Cortex. Neuroscience 2024; 544:128-137. [PMID: 38447690 PMCID: PMC11146016 DOI: 10.1016/j.neuroscience.2024.02.031] [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: 02/09/2024] [Accepted: 02/28/2024] [Indexed: 03/08/2024]
Abstract
In Robo3cKO mice, midline crossing defects of the trigeminothalamic projections from the trigeminal principal sensory nucleus result in bilateral whisker maps in the somatosensory thalamus and consequently in the face representation area of the primary somatosensory (S1) cortex (Renier et al., 2017; Tsytsarev et al., 2017). We investigated whether this bilateral sensory representation in the whisker-barrel cortex is also reflected in the downstream projections from the S1 to the primary motor (M1) cortex. To label these projections, we injected anterograde viral axonal tracer in S1 cortex. Corticocortical projections from the S1 distribute to similar areas across the ipsilateral hemisphere in control and Robo3cKO mice. Namely, in both genotypes they extend to the M1, premotor/prefrontal cortex (PMPF), secondary somatosensory (S2) cortex. Next, we performed voltage-sensitive dye imaging (VSDi) in the left hemisphere following ipsilateral and contralateral single whisker stimulation. While controls showed only activation in the contralateral whisker barrel cortex and M1 cortex, the Robo3cKO mouse left hemisphere was activated bilaterally in both the barrel cortex and the M1 cortex. We conclude that the midline crossing defect of the trigeminothalamic projections leads to bilateral whisker representations not only in the thalamus and the S1 cortex but also downstream from the S1, in the M1 cortex.
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Affiliation(s)
- Vassiliy Tsytsarev
- Department of Neurobiology, University of Maryland School of Medicine, 20 Penn St, HSF-2, Baltimore, MD 21201, USA.
| | - Céline Plachez
- Department of Neurobiology, University of Maryland School of Medicine, 20 Penn St, HSF-2, Baltimore, MD 21201, USA.
| | - Shuxin Zhao
- Department of Neurobiology, University of Maryland School of Medicine, 20 Penn St, HSF-2, Baltimore, MD 21201, USA.
| | - Daniel H O'Connor
- The Zanvyl Krieger Mind/Brain Institute, The Johns Hopkins University, 3400 N. Charles Street, 338 Krieger Hall, Baltimore, MD 21218, USA.
| | - Reha S Erzurumlu
- Department of Neurobiology, University of Maryland School of Medicine, 20 Penn St, HSF-2, Baltimore, MD 21201, USA.
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Sim B, Ng JWZ, Sim DY, Goh J, Kam S, Teo JX, Lim WW, Lieviant J, Lim WK, Lim SA, Tang PH, Ling S, Ng SWL, Roca X, Jamuar SS. A novel intronic variant in ROBO3 associated with horizontal gaze palsy with progressive scoliosis: case report and literature review. J AAPOS 2023; 27:359-363. [PMID: 37931836 DOI: 10.1016/j.jaapos.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 11/08/2023]
Abstract
Horizontal gaze palsy with progressive scoliosis (HGPPS) is a rare, autosomal recessive inherited disorder caused by mutations in ROBO3 gene. The clinical features of HGPPS include horizontal gaze palsy, progressive scoliosis, other oculomotor abnormalities such as strabismus and nystagmus. Whole-exome sequencing (WES) is used to diagnose rare Mendelian disorders, when routine standard tests have failed to make a formal pathological diagnosis. However, WES may identify variants of uncertain significance (VUS) that may add further ambiguity to the diagnosis. We report the case of a 4-year-old boy with horizontal gaze palsy, progressive scoliosis, microcephaly, and mild developmental delay. WES identified an intronic VUS in ROBO3 gene. We performed minigene splicing functional analysis to confirm the pathogenicity of this VUS. This report illustrates that WES data analysis with supportive functional analysis provides an effective approach to improve the diagnostic yield for unsolved clinical cases. This case also highlights the phenotypic heterogeneity in patients with HGPPS.
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Affiliation(s)
- Bryan Sim
- Neuro-Ophthalmology Service, KKH Eye Centre, KK Women's and Children's Hospital, Singapore; Myopia Service, Singapore National Eye Centre (SNEC), Singapore
| | - Janice Wan Zhen Ng
- School of Biological Sciences, Nanyang Technological University Singapore
| | - Donald Yuhui Sim
- School of Biological Sciences, Nanyang Technological University Singapore
| | - Jeannette Goh
- Genetics Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore; SingHealth Duke-NUS Genomic Medicine Centre, Singapore
| | - Sylvia Kam
- Genetics Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore; SingHealth Duke-NUS Genomic Medicine Centre, Singapore
| | - Jing Xian Teo
- SingHealth Duke-NUS Institute of Precision Medicine, Singapore
| | - Wan Wan Lim
- Cancer & Stem Cell Biology Program, Duke-NUS Medical School, Singapore
| | - Jane Lieviant
- Cancer & Stem Cell Biology Program, Duke-NUS Medical School, Singapore
| | - Weng Khong Lim
- SingHealth Duke-NUS Genomic Medicine Centre, Singapore; SingHealth Duke-NUS Institute of Precision Medicine, Singapore; Cancer & Stem Cell Biology Program, Duke-NUS Medical School, Singapore; Laboratory of Genome Variation Analytics, Genome Institute of Singapore, Singapore
| | - Su Ann Lim
- Neuro-Ophthalmology Service, KKH Eye Centre, KK Women's and Children's Hospital, Singapore; Department of Ophthalmology, Tan Tock Seng Hospital, Singapore
| | - Phua Hwee Tang
- Department of Radiology, KK Women's and Children's Hospital, Singapore
| | - Simon Ling
- Neurology Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | - Stacy Wei Ling Ng
- Department of Orthopaedics, KK Women's and Children's Hospital, Singapore
| | - Xavier Roca
- School of Biological Sciences, Nanyang Technological University Singapore
| | - Saumya Shekhar Jamuar
- Genetics Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore; SingHealth Duke-NUS Genomic Medicine Centre, Singapore; SingHealth Duke-NUS Institute of Precision Medicine, Singapore.
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Chanda G, Reddy N, Konanki R, Boltshauser E, Lingappa L. Teaching NeuroImage: ROBO3 Mutation Causing Horizontal Gaze Palsy and Brainstem Malformation. Neurology 2023; 100:840-841. [PMID: 36564212 PMCID: PMC10136014 DOI: 10.1212/wnl.0000000000206821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Geetha Chanda
- From the Department of Pediatric Neurology (G.C., R.K., L.L.), Rainbow Childrens Hospital; Rainbow Childrens Hospital (N.R.), Hyderabad, India; and Eugen Boltshauser (E.B.), Department of Pediatric Neurology, University Childrens Hospital, Zurich.
| | - Nihaal Reddy
- From the Department of Pediatric Neurology (G.C., R.K., L.L.), Rainbow Childrens Hospital; Rainbow Childrens Hospital (N.R.), Hyderabad, India; and Eugen Boltshauser (E.B.), Department of Pediatric Neurology, University Childrens Hospital, Zurich
| | - Ramesh Konanki
- From the Department of Pediatric Neurology (G.C., R.K., L.L.), Rainbow Childrens Hospital; Rainbow Childrens Hospital (N.R.), Hyderabad, India; and Eugen Boltshauser (E.B.), Department of Pediatric Neurology, University Childrens Hospital, Zurich
| | - Eugen Boltshauser
- From the Department of Pediatric Neurology (G.C., R.K., L.L.), Rainbow Childrens Hospital; Rainbow Childrens Hospital (N.R.), Hyderabad, India; and Eugen Boltshauser (E.B.), Department of Pediatric Neurology, University Childrens Hospital, Zurich
| | - Lokesh Lingappa
- From the Department of Pediatric Neurology (G.C., R.K., L.L.), Rainbow Childrens Hospital; Rainbow Childrens Hospital (N.R.), Hyderabad, India; and Eugen Boltshauser (E.B.), Department of Pediatric Neurology, University Childrens Hospital, Zurich
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Zhang Z, Zhang Z, Shu L, Meng Y, Ma J, Gao R, Zhou X. A Genetic Variant of the ROBO3 Gene is Associated With Adolescent Idiopathic Scoliosis in the Chinese Population. Spine (Phila Pa 1976) 2023; 48:E20-E24. [PMID: 36149840 DOI: 10.1097/brs.0000000000004484] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/05/2022] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A case-control association study. OBJECTIVES This study aimed to reveal whether mutations within roundabout receptor 3 ( ROBO3 ) gene were related to adolescent idiopathic scoliosis (AIS) in Chinese Han population and to investigate the functional role of ROBO3 in the pathogenesis and progression of AIS. SUMMARY OF BACKGROUND DATA ROBO3 is essential for the regulation of hindbrain axonal cell migration and midline crossing. Studies have demonstrated that ROBO3 homozygous mutations are associated with horizontal gaze palsy with progressive scoliosis. However, whether and how ROBO3 contributed to the development of scoliosis remains unclear. MATERIALS AND METHODS Whole exome sequencing was performed in 135 AIS patients and 267 healthy controls to evaluate the differences of single nucleotide polymorphism variants within ROBO3 . Then the identified variant of ROBO3 was genotyped in another cohort included 1140 AIS patients and 1580 controls. Moreover, paraspinal muscles were collected from 39 AIS patients and 45 lumbar disk herniation patients for the measurement of ROBO3 mRNA expression. The χ 2 test, Fisher exact test or the Student t test were used to compare intergroup data. Pearson correlation was used to determine the association between ROBO3 expression and clinical phenotypes. RESULTS A significant association was identified between the gene variant (rs74787566) of ROBO3 and the development of AIS through exome sequencing. The genotyping cohort demonstrated a higher frequency of allele A in AIS patients compared to controls (7.89% vs . 4.30%, P <0.001, odds ratio=1.87). In addition, the expression of ROBO3 in paraspinal muscles was inversely correlated with the Cobb angle ( P =0.043, r2 =0.1059). CONCLUSION A significant association was identified between the gene variant (rs74787566) of ROBO3 and the development of AIS. The reduced expression of ROBO3 could result in the progression of curve magnitude in patients with AIS. Further studies are needed to verify the functional role of ROBO3 in the development of AIS. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Zheng Zhang
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University (Naval Medical University), Shanghai
| | - Zhanrong Zhang
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University (Naval Medical University), Shanghai
| | - Lun Shu
- Department of Orthopedics, Hainan Hospital, Chinese PLA General Hospital, Hainan, People's Republic of China
| | - Yichen Meng
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University (Naval Medical University), Shanghai
| | - Jun Ma
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University (Naval Medical University), Shanghai
| | - Rui Gao
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University (Naval Medical University), Shanghai
| | - Xuhui Zhou
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University (Naval Medical University), Shanghai
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Pânzaru MC, Popa S, Lupu A, Gavrilovici C, Lupu VV, Gorduza EV. Genetic heterogeneity in corpus callosum agenesis. Front Genet 2022; 13:958570. [PMID: 36246626 PMCID: PMC9562966 DOI: 10.3389/fgene.2022.958570] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/05/2022] [Indexed: 11/18/2022] Open
Abstract
The corpus callosum is the largest white matter structure connecting the two cerebral hemispheres. Agenesis of the corpus callosum (ACC), complete or partial, is one of the most common cerebral malformations in humans with a reported incidence ranging between 1.8 per 10,000 livebirths to 230–600 per 10,000 in children and its presence is associated with neurodevelopmental disability. ACC may occur as an isolated anomaly or as a component of a complex disorder, caused by genetic changes, teratogenic exposures or vascular factors. Genetic causes are complex and include complete or partial chromosomal anomalies, autosomal dominant, autosomal recessive or X-linked monogenic disorders, which can be either de novo or inherited. The extreme genetic heterogeneity, illustrated by the large number of syndromes associated with ACC, highlight the underlying complexity of corpus callosum development. ACC is associated with a wide spectrum of clinical manifestations ranging from asymptomatic to neonatal death. The most common features are epilepsy, motor impairment and intellectual disability. The understanding of the genetic heterogeneity of ACC may be essential for the diagnosis, developing early intervention strategies, and informed family planning. This review summarizes our current understanding of the genetic heterogeneity in ACC and discusses latest discoveries.
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Affiliation(s)
- Monica-Cristina Pânzaru
- Department of Medical Genetics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Setalia Popa
- Department of Medical Genetics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- *Correspondence: Setalia Popa, ; Vasile Valeriu Lupu,
| | - Ancuta Lupu
- Department of Pediatrics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Cristina Gavrilovici
- Department of Pediatrics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Vasile Valeriu Lupu
- Department of Pediatrics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- *Correspondence: Setalia Popa, ; Vasile Valeriu Lupu,
| | - Eusebiu Vlad Gorduza
- Department of Medical Genetics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
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Matera E, Petruzzelli MG, Tarantini M, Gabellone A, Marzulli L, Ficarella R, Orsini P, Margari L. Horizontal Gaze Palsy with Progressive Scoliosis with Overlapping Epilepsy and Learning Difficulties: A Case Report. Brain Sci 2022; 12:brainsci12050613. [PMID: 35625000 PMCID: PMC9139940 DOI: 10.3390/brainsci12050613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/27/2022] [Accepted: 05/07/2022] [Indexed: 12/10/2022] Open
Abstract
Horizontal gaze palsy with progressive scoliosis (HGPPS) is a rare congenital disease characterized by the absence of horizontal gaze movements, progressive scoliosis, and typical brain, cerebellum, and medullary malformations. Here we describe a pediatric HGPPS case with overlapping epilepsy and learning difficulties. A 6-year-old girl was admitted to the University Hospital of Bari for the onset of a tonic–clonic seizure. Electroencephalogram showed slow and sharp waves on the right side with the tendency to diffuse. Brain magnetic resonance imaging demonstrated malformations compatible with HGPPS. Ophthalmological and orthopedic evaluations confirmed conjugate horizontal gaze palsy and mild thoracolumbar scoliosis. Neuropsychological assessment attested normal intelligence but serious difficulties in reading and writing. In spite of neuroradiological malformations, visual difficulties, and spinal deformities, literature data are limited about any coexisting neurocognitive HGPPS symptoms. Literature data regarding such topics are very limited. If, on the one hand, the coexistence of such symptoms can be interpreted as occasional, it could support the idea that they could fall within a spectrum of HGPPS anomalies. In addition to the standard investigations, the activation of specific neuropsychological assessment programs could help interventions improve the specialist care and the quality of life of HGPPS patients.
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Affiliation(s)
- Emilia Matera
- Department of Biomedical Sciences and Human Oncology, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (E.M.); (M.T.); (A.G.); (L.M.); (L.M.)
| | - Maria Giuseppina Petruzzelli
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy
- Correspondence:
| | - Martina Tarantini
- Department of Biomedical Sciences and Human Oncology, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (E.M.); (M.T.); (A.G.); (L.M.); (L.M.)
| | - Alessandra Gabellone
- Department of Biomedical Sciences and Human Oncology, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (E.M.); (M.T.); (A.G.); (L.M.); (L.M.)
| | - Lucia Marzulli
- Department of Biomedical Sciences and Human Oncology, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (E.M.); (M.T.); (A.G.); (L.M.); (L.M.)
| | - Romina Ficarella
- Medical Genetics Unit, Department of Human Reproductive Medicine, ASL Bari, Via Ospedale Di Venere 1, 70012 Bari, Italy; (R.F.); (P.O.)
| | - Paola Orsini
- Medical Genetics Unit, Department of Human Reproductive Medicine, ASL Bari, Via Ospedale Di Venere 1, 70012 Bari, Italy; (R.F.); (P.O.)
| | - Lucia Margari
- Department of Biomedical Sciences and Human Oncology, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (E.M.); (M.T.); (A.G.); (L.M.); (L.M.)
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Huang L, Guo J, Xie Y, Zhou Y, Wu X, Li H, Peng Y, Li N. Clinical features and genotypes of six patients from four families with horizontal gaze palsy with progressive scoliosis. Front Pediatr 2022; 10:949565. [PMID: 36186627 PMCID: PMC9515397 DOI: 10.3389/fped.2022.949565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/15/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Horizontal gaze palsy with progressive scoliosis (HGPPS) is a rare disorder mainly involved in ocular movement and spinal development. It is caused by a roundabout guidance receptor 3 (ROBO3) gene mutation. This study aimed to describe the clinical features of six patients with HGPPS and investigate the corresponding ROBO3 gene mutations. METHODS Patients underwent detailed clinical and imaging examinations. Whole-exome sequencing was performed to detect nucleotide variations in the disease-causing genes of HGPPS. RESULTS Six pathogenic variants were detected in the ROBO3 gene from six patients with HGPPS, including two novel compound heterozygous mutations, c.1447C > T (p.R483X) and c.2462G > C (p.R821P); c.1033G > C (p.V345L) and c.3287G > T (p.C1096F); a novel homozygous indel mutation, c.565dupC (p.R191Pfs*61); and a known missense mutation, c.416G > T (p.G139V). Patients with HGPPS had horizontal conjugated eye movement defects and scoliosis with variable degrees, as well as flattened pontine tegmentum and uncrossed corticospinal tracts on magnetic resonance imaging. CONCLUSION Our genetic findings will expand the spectrum of ROBO3 mutations and help inform future research on the molecular mechanism of HGPPS.
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Affiliation(s)
- Lijuan Huang
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Jianlin Guo
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Yan Xie
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Yunyu Zhou
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Xiaofei Wu
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Hui Li
- Department of Ophthalmology, Changchun Children's Hospital, Changchun, China
| | - Yun Peng
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Ningdong Li
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China.,Department of Ophthalmology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
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10
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Deniz A, Çomu S, Güngör M, Anık Y, Kara B. Compound Heterozygous ROBO3 Mutation in Two Siblings Presenting with Horizontal Gaze Palsy without Scoliosis: Case-Based Review. J Pediatr Genet 2021. [DOI: 10.1055/s-0041-1739387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AbstractHorizontal gaze palsy with progressive scoliosis (HGPPS) is a rare, autosomal recessively inherited disorder characterized by a congenital absence of conjugated horizontal eye movements with progressive scoliosis developing in childhood and adolescence. HGPPS is caused by mutations of the ROBO3 gene that disrupts the midline crossing of the descending corticospinal and ascending lemniscal sensory tracts in the medulla. We present two siblings, 5-year-old and 2-year-old boys with HGPPS, from non-consanguineous parents. The older brother was brought for the evaluation of moderate psychomotor retardation. He had bilateral horizontal gaze palsy with preserved vertical gaze and convergence. Scoliosis was absent. Cranial MRI showed brainstem abnormalities, and diffusion tensor imaging showed absent decussation of cortico-spinal tracts in the medulla. Clinical diagnosis of HGPPS was confirmed by sequencing of ROBO3 gene, IVS4–1G > A (c.767–1G > A) and c.328_329delinsCCC (p.Asp110Profs*57) compound heterozygous variations were found, and segregated in parents. The younger boy was first reported at 16 months of age and had the same clinical and neuroradiological findings, unlike mild psychomotor retardation. ROBO3 gene analysis showed the same variants in his brother. Our cases show the importance of evaluating eye movements in children with neurodevelopmental abnormalities and looking for brainstem abnormalities in children with bilateral horizontal gaze palsy.
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Affiliation(s)
- Adnan Deniz
- Department of Pediatrics, Division of Child Neurology, Kocaeli Universitesi, Kocaeli, Turkey
| | - Sinan Çomu
- Department of Pediatrics, Division of Child Neurology, Anadolu Health Center, Kocaeli, Turkey
| | - Mesut Güngör
- Department of Pediatrics, Division of Child Neurology, Kocaeli Universitesi, Kocaeli, Turkey
| | - Yonca Anık
- Deparment of Radiology, Kocaeli University, Kocaeli, Turkey
| | - Bülent Kara
- Department of Pediatrics, Division of Child Neurology, Kocaeli Universitesi, Kocaeli, Turkey
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Borba FCD, Campos BMD, Gonçalves JPN, Martins Junior CR, França Junior MC. Functional magnetic resonance imaging and diffusion tensor imaging findings in a patient with ROBO3-related horizontal gaze palsy with progressive scoliosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2021; 79:1153-1154. [PMID: 34614068 DOI: 10.1590/0004-282x-anp-2021-0213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/18/2021] [Indexed: 11/22/2022]
Affiliation(s)
- Fabrício Castro de Borba
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Neurologia, Campinas SP, Brazil
| | - Brunno Machado de Campos
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Laboratório de Neuroimagem, Campinas SP, Brazil
| | - João Pedro Nunes Gonçalves
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Genética Médica, Campinas SP, Brazil
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