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Korteling D, Musch JLI, Zinkstok JR, Boot E. Psychiatric and neurological manifestations in adults with Smith-Magenis syndrome: A scoping review. Am J Med Genet B Neuropsychiatr Genet 2024; 195:e32956. [PMID: 37584268 DOI: 10.1002/ajmg.b.32956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 05/20/2023] [Accepted: 07/11/2023] [Indexed: 08/17/2023]
Abstract
Smith-Magenis syndrome (SMS) is a neurodevelopmental disorder caused by a 17p11.2 deletion or a pathogenic variant of the RAI1 gene, which lies within the 17p11.2 region. Various psychiatric and neurological disorders have been reported in SMS, with most literature focusing on children and adolescents. To provide an overview of the current knowledge on this topic in adults with SMS, we performed a comprehensive scoping review of the relevant literature. Our findings suggest that many manifestations that are common in childhood persist into adulthood. Neuropsychiatric manifestations in adults with SMS include intellectual disability, autism spectrum- and attention deficit hyperactivity disorder-related features, self-injurious and physical aggressive behaviors, sleep-wake disorders, and seizures. Findings of this review may facilitate optimization of management strategies in adults with SMS, and may guide future studies exploring late-onset psychiatric and neurological comorbidities in SMS.
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Affiliation(s)
- Dorinde Korteling
- Child and Adolescent Psychiatry & Psychosocial Care, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Janneke R Zinkstok
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
- Department of Psychiatry and Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Erik Boot
- Advisium, 's Heeren Loo, Amersfoort, The Netherlands
- The Dalglish Family 22q Clinic, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, The Netherlands
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Rive Le Gouard N, Jacquinet A, Ruaud L, Deleersnyder H, Ageorges F, Gallard J, Lacombe D, Odent S, Mikaty M, Manouvrier-Hanu S, Ghoumid J, Geneviève D, Lehman N, Philip N, Edery P, Héron D, Rastel C, Chancenotte S, Thauvin-Robinet C, Faivre L, Perrin L, Verloes A. Smith-Magenis syndrome: Clinical and behavioral characteristics in a large retrospective cohort. Clin Genet 2021; 99:519-528. [PMID: 33368193 DOI: 10.1111/cge.13906] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/28/2020] [Accepted: 12/22/2020] [Indexed: 11/30/2022]
Abstract
Smith-Magenis syndrome (SMS), characterized by dysmorphic features, neurodevelopmental disorder, and sleep disturbance, is due to an interstitial deletion of chromosome 17p11.2 (90%) or to point mutations in the RAI1 gene. In this retrospective cohort, we studied the clinical, cognitive, and behavioral profile of 47 European patients with SMS caused by a 17p11.2 deletion. We update the clinical and neurobehavioral profile of SMS. Intrauterine growth was normal in most patients. Prenatal anomalies were reported in 15%. 60% of our patients older than 10 years were overweight. Prevalence of heart defects (6.5% tetralogy of Fallot, 6.5% pulmonary stenosis), ophthalmological problems (89%), scoliosis (43%), or deafness (32%) were consistent with previous reports. Epilepsy was uncommon (2%). We identified a high prevalence of obstipation (45%). All patients had learning difficulties and developmental delay, but ID range was wide and 10% of patients had IQ in the normal range. Behavioral problems included temper tantrums and other difficult behaviors (84%) and night-time awakenings (86%). Optimal care of SMS children is multidisciplinary and requires important parental involvement. In our series, half of patients were able to follow adapted schooling, but 70% of parents had to adapt their working time, illustrating the medical, social, educative, and familial impact of having a child with SMS.
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Affiliation(s)
- Nicolas Rive Le Gouard
- Department of Genetics, APHP Nord-Université de Paris Robert Debré University Hospital and INSERM U1141 NeuroDiderot, Paris, France
| | - Adeline Jacquinet
- Department of Genetics, APHP Nord-Université de Paris Robert Debré University Hospital and INSERM U1141 NeuroDiderot, Paris, France.,Department of Genetics, Sart Tilman University Hospital, Liège, Belgium
| | - Lyse Ruaud
- Department of Genetics, APHP Nord-Université de Paris Robert Debré University Hospital and INSERM U1141 NeuroDiderot, Paris, France
| | - Hélène Deleersnyder
- Department of Genetics, APHP Nord-Université de Paris Robert Debré University Hospital and INSERM U1141 NeuroDiderot, Paris, France
| | - Faustine Ageorges
- Department of Genetics, APHP Nord-Université de Paris Robert Debré University Hospital and INSERM U1141 NeuroDiderot, Paris, France
| | - Jennifer Gallard
- Department of Genetics, APHP Nord-Université de Paris Robert Debré University Hospital and INSERM U1141 NeuroDiderot, Paris, France
| | - Didier Lacombe
- Department of Genetics, Bordeaux, Pellegrin University Hospital, Bordeaux, France
| | - Sylvie Odent
- Department of Genetics, Rennes University Hospital, Rennes, France
| | - Myriam Mikaty
- Department of Genetics, Rennes University Hospital, Rennes, France
| | | | - Jamal Ghoumid
- Department of Genetics, Lille Jeanne de Flandre, University Hospital, Lille, France
| | - David Geneviève
- Department of Genetics, Arnaud de Villeneuve University Hospital, Montpellier, France
| | - Natacha Lehman
- Department of Genetics, Arnaud de Villeneuve University Hospital, Montpellier, France
| | - Nicole Philip
- Department of Genetics, la Timone University Hospital, Marseille, France
| | - Patrick Edery
- Department of Genetics, Femme-Mère-Enfant University Hospital, Lyon, France
| | - Delphine Héron
- Department of Genetics, APHP Pitié-Salpêtrière University Hospital, Paris, France
| | - Coralie Rastel
- Department of Genetics, APHP Pitié-Salpêtrière University Hospital, Paris, France
| | | | | | - Laurence Faivre
- Department of Genetics, Dijon University Hospital, Dijon, France
| | - Laurence Perrin
- Department of Genetics, APHP Nord-Université de Paris Robert Debré University Hospital and INSERM U1141 NeuroDiderot, Paris, France
| | - Alain Verloes
- Department of Genetics, APHP Nord-Université de Paris Robert Debré University Hospital and INSERM U1141 NeuroDiderot, Paris, France
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Ciaccio C, Pantaleoni C, Milani D, Alfei E, Sciacca FL, Canafoglia L, Erbetta A, D'Arrigo S. Neurological phenotype of Potocki-Lupski syndrome. Am J Med Genet A 2020; 182:2317-2324. [PMID: 33043631 DOI: 10.1002/ajmg.a.61789] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/19/2020] [Accepted: 06/25/2020] [Indexed: 12/20/2022]
Abstract
Potocki-Lupski syndrome is a condition mainly characterized by infantile hypotonia, developmental delay/intellectual disability (DD/ID), and congenital anomalies, caused by duplications of the 17p11.2 region, encompassing RAI1 gene. Its clinical presentation is extremely variable, especially for what concerns the cognitive level and the behavioral phenotype. Such aspects, as well as the dysmorphic/malformative ones, have been covered by previous studies; otherwise neurological features have never been systematically described. In order to delineate the neurological phenotype of Potocki-Lupski Syndrome, we collect an 8-patients cohort. Developmental milestones are delayed and a mild to moderate cognitive impairment is present in all patients, variably associated with features of autism spectrum disorder, behavioral disturb, and sleep disturb. Hypotonia appears a less frequent finding than what previously reported, while motor clumsiness/coordination impairment is frequent. EGG registration demonstrated a common pattern with excess of diffuse rhythmic activity in sleep phases or while the patient is falling asleep. Brain MRI did not reveal common anomalies, although unspecific white matter changes may be present. We discuss such findings and compare them to literature data, offering an overview on the neurological and cognitive-behavioral presentation of the syndrome.
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Affiliation(s)
- Claudia Ciaccio
- Developmental Neurology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Chiara Pantaleoni
- Developmental Neurology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Donatella Milani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatria Alta Intensità di Cura, Milan, Italy
| | - Enrico Alfei
- Developmental Neurology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.,Pediatric Neurology Unit-Vittore Buzzi Children's Hospital-ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Francesca L Sciacca
- Laboratory of Cytogenetic, Neurological Biochemistry and Neuropharmacology Unit, Department of Diagnostic and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Laura Canafoglia
- Neurophysiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alessandra Erbetta
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Stefano D'Arrigo
- Developmental Neurology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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Abstract
Smith–Magenis syndrome (SMS; OMIM #182290) is a complex genetic disorder characterized by distinctive physical features, developmental delay, cognitive impairment, and a typical behavioral phenotype. SMS is caused by interstitial 17p11.2 deletions, encompassing multiple genes and including the retinoic acid-induced 1 gene (RAI1), or by mutations in RAI1 itself. About 10% of all the SMS patients, in fact, carry an RAI1 mutation responsible for the phenotype. RAI1 (OMIM *607642) is a dosage-sensitive gene expressed in many tissues and highly conserved among species. Over the years, several studies have demonstrated that RAI1 (or its homologs in animal models) acts as a transcriptional factor implicated in embryonic neurodevelopment, neuronal differentiation, cell growth and cell cycle regulation, bone and skeletal development, lipid and glucose metabolisms, behavioral functions, and circadian activity. Patients with RAI1 pathogenic variants show some phenotypic differences when compared to those carrying the typical deletion. They usually have lower incidence of hypotonia and less cognitive impairment than those with 17p11.2 deletions but more frequently show the behavioral characteristics of the syndrome and overeating issues. These differences reflect the primary pathogenetic role of RAI1 without the pathogenetic contribution of the other genes included in the typical 17p11.2 deletion. The better comprehension of physiological roles of RAI1, its molecular co-workers and interactors, and its contribution in determining the typical SMS phenotype will certainly open a new path for therapeutic interventions.
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Affiliation(s)
- Mariateresa Falco
- Department of Molecular Medicine and Medical Biotechnology, University of Naples "Federico II", Naples, Italy
| | - Sonia Amabile
- Department of Molecular Medicine and Medical Biotechnology, University of Naples "Federico II", Naples, Italy
| | - Fabio Acquaviva
- Department of Translational Medical Sciences (DISMET), Section of Pediatric Clinical Genetics, University of Naples "Federico II", Naples, Italy
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Acquaviva F, Sana ME, Della Monica M, Pinelli M, Postorivo D, Fontana P, Falco MT, Nardone AM, Lonardo F, Iascone M, Scarano G. First evidence of Smith-Magenis syndrome in mother and daughter due to a novel RAI mutation. Am J Med Genet A 2016; 173:231-238. [PMID: 27683195 DOI: 10.1002/ajmg.a.37989] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 09/07/2016] [Indexed: 12/20/2022]
Abstract
Smith-Magenis syndrome (SMS) is a complex genetic disorder caused by interstitial 17p11.2 deletions encompassing multiple genes, including the retinoic acid induced 1 gene-RAI1-or mutations in RAI1 itself. The clinical spectrum includes developmental delay, cognitive impairment, and behavioral abnormalities, with distinctive physical features that become more evident with age. No patients have been reported to have had offspring. We here describe a girl with developmental delay, mainly compromising the speech area, and her mother with mild intellectual disabilities and minor dysmorphic features. Both had sleep disturbance and attention deficit disorder, but no other atypical behaviors have been reported. In both, CGH-array analysis detected a 15q13.3 interstitial duplication, encompassing CHRNA7. However, the same duplication has been observed in several, apparently healthy, maternal relatives. We, thus, performed a whole exome sequencing analysis, which detected a frameshift mutation in RAI1, de novo in the mother, and transmitted to her daughter. No other family members carried this mutation. This is the first report of an SMS patient having offspring. Our experience confirms the importance of searching for alternative causative genetic mechanisms in case of confounding/inconclusive findings such as a CGH-array result of uncertain significance. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Fabio Acquaviva
- U.O. di Genetica Medica, A.O.R.N. "G. Rummo", Benevento, Italy
| | - Maria Elena Sana
- U.S.S.D. Laboratorio di Genetica Medica, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Michele Pinelli
- Telethon Institute of Genetic Medicine (TIGEM), Pozzuoli, Napoli, Italy
| | - Diana Postorivo
- U.O.C. Laboratorio di Genetica Medica, Policlinico Tor Vergata, Roma, Italy
| | - Paolo Fontana
- Dipartimento di Medicine Molecolare e Biotecnologie Mediche, Università "Federico II", Napoli, Italy
| | - Maria Teresa Falco
- Dipartimento di Medicine Molecolare e Biotecnologie Mediche, Università "Federico II", Napoli, Italy
| | - Anna Maria Nardone
- U.O.C. Laboratorio di Genetica Medica, Policlinico Tor Vergata, Roma, Italy
| | | | - Maria Iascone
- U.S.S.D. Laboratorio di Genetica Medica, ASST Papa Giovanni XXIII, Bergamo, Italy
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Dubourg C, Bonnet-Brilhault F, Toutain A, Mignot C, Jacquette A, Dieux A, Gérard M, Beaumont-Epinette MP, Julia S, Isidor B, Rossi M, Odent S, Bendavid C, Barthélémy C, Verloes A, David V. Identification of Nine New RAI1-Truncating Mutations in Smith-Magenis Syndrome Patients without 17p11.2 Deletions. Mol Syndromol 2014; 5:57-64. [PMID: 24715852 DOI: 10.1159/000357359] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2013] [Indexed: 11/19/2022] Open
Abstract
Smith-Magenis syndrome (SMS) is an intellectual disability syndrome with sleep disturbance, self-injurious behaviors and dysmorphic features. It is estimated to occur in 1/25,000 births, and in 90% of cases it is associated with interstitial deletions of chromosome 17p11.2. RAI1 (retinoic acid induced 1; OMIM 607642) mutations are the second most frequent molecular etiology, with this gene being located in the SMS locus at 17p11.2. Here, we report 9 new RAI1-truncating mutations in nonrelated individuals referred for molecular analysis due to a possible SMS diagnosis. None of these patients carried a 17p11.2 deletion. The 9 mutations include 2 nonsense mutations and 7 heterozygous frameshift mutations leading to protein truncation. All mutations map in exon 3 of RAI1 which codes for more than 98% of the protein. RAI1 regulates gene transcription, and its targets are themselves involved in transcriptional regulation, cell growth and cell cycle regulation, bone and skeletal development, lipid and glucide metabolisms, neurological development, behavioral functions, and circadian activity. We report the clinical features of the patients carrying these deleterious mutations in comparison with those of patients carrying 17p11.2 deletions.
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Affiliation(s)
- C Dubourg
- Laboratoire de Génétique Moléculaire, CHU Pontchaillou, France ; CNRS UMR 6290, IFR140, Université de Rennes 1, France
| | | | - A Toutain
- Génétique, CHRU Bretonneau, Tours, France
| | - C Mignot
- Service de Génétique Clinique, CHU La Pitié Salpêtrière, France ; Service de Neuropédiatrie, APHP, Hôpital Armand Trousseau, France
| | - A Jacquette
- Service de Génétique Clinique, CHU La Pitié Salpêtrière, France
| | - A Dieux
- Service de Génétique Clinique, CHU, Lille, France
| | - M Gérard
- Service de Génétique, CHR Clémenceau, Caen, France
| | | | - S Julia
- Service de Génétique Médicale, CHU Purpan, Toulouse, France
| | - B Isidor
- Service de Génétique Médicale, CHU, Nantes, France
| | - M Rossi
- Service de Génétique Clinique, CHU, Lyon-Bron, France
| | - S Odent
- CNRS UMR 6290, IFR140, Université de Rennes 1, France ; Service de Génétique Médicale, CHU Hôpital Sud, Rennes, Services de, France
| | - C Bendavid
- CNRS UMR 6290, IFR140, Université de Rennes 1, France
| | | | - A Verloes
- Service de Génétique Clinique, CHU Robert Debré, Paris, France
| | - V David
- Laboratoire de Génétique Moléculaire, CHU Pontchaillou, France ; CNRS UMR 6290, IFR140, Université de Rennes 1, France
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Lee CG, Park SJ, Yun JN, Yim SY, Sohn YB. Reciprocal deletion and duplication of 17p11.2-11.2: Korean patients with Smith-Magenis syndrome and Potocki-Lupski syndrome. J Korean Med Sci 2012; 27:1586-90. [PMID: 23255863 PMCID: PMC3524443 DOI: 10.3346/jkms.2012.27.12.1586] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 08/14/2012] [Indexed: 11/24/2022] Open
Abstract
Deletion and duplication of the -3.7-Mb region in 17p11.2 result in two reciprocal syndrome, Smith-Magenis syndrome and Potocki-Lupski syndrome. Smith-Magenis syndrome is a well-known developmental disorder. Potocki-Lupski syndrome has recently been recognized as a microduplication syndrome that is a reciprocal disease of Smith-Magenis syndrome. In this paper, we report on the clinical and cytogenetic features of two Korean patients with Smith-Magenis syndrome and Potocki-Lupski syndrome. Patient 1 (Smith-Magenis syndrome) was a 2.9-yr-old boy who showed mild dysmorphic features, aggressive behavioral problems, and developmental delay. Patient 2 (Potocki-Lupski syndrome), a 17-yr-old boy, had only intellectual disabilities and language developmental delay. We used array comparative genomic hybridization (array CGH) and found a 2.6 Mb-sized deletion and a reciprocal 2.1 Mb-sized duplication involving the 17p11.2. These regions overlapped in a 2.1 Mb size containing 11 common genes, including RAI1 and SREBF.
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Affiliation(s)
- Cha Gon Lee
- Department of Pediatrics, Eulji General Hospital, Seoul, Korea
| | | | - Jun-No Yun
- Department of Medical Genetics, Ajou University School of Medicine, Suwon, Korea
| | - Shin-Young Yim
- Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Korea
| | - Young Bae Sohn
- Department of Medical Genetics, Ajou University School of Medicine, Suwon, Korea
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