Michels Savannah, Foss Kimberly, Park Kaylee, Golden-Grant Katie, Saneto Russell, Lopez Jonathan, Mirzaa Ghayda M
Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, Washington.
Seattle University, Seattle, Washington.
Am J Med Genet A. 2017 Dec;173(12):3127-3131. doi: 10.1002/ajmg.a.38496. Epub 2017 Oct 19.
The clinical diagnosis of malformations of cortical development (MCDs) is often challenging due to the complexity of the brain malformation by neuroimaging, the rarity of individual malformation syndromes, and the rapidly evolving genetic landscape of these disorders facilitated with the use of Next Generation Sequencing (NGS) methods. While the clinical and molecular diagnosis of severe cortical malformations, such as classic lissencephaly, is often straightforward, the diagnosis of more subtle and complex types of cortical malformations, such as pachygyria and polymicrogyria (PMG), can be more challenging due to limited knowledge regarding their genetic etiologies. Here, we report two individuals with the same de novo KIF5C mutation who present with subtle MCDs, early onset epilepsy and significant neurodevelopmental and behavioral issues including absent language. Our data, combined with the limited literature on KIF5C mutations, to date, support that KIF5C mutations are associated with a neurodevelopmental disorder characterized by infantile onset epilepsy, and subtle but recognizable types of brain malformations. We also show that the spectrum of KIF5C mutations is narrow, as five out of the six identified individuals have mutations affecting amino acid Glu237. Therefore, the identification of the clinical and neuroimaging features of this disorder may strongly facilitate rapid and efficient molecular diagnosis.
由于神经影像学显示的脑畸形的复杂性、个体畸形综合征的罕见性以及借助下一代测序(NGS)方法这些疾病快速演变的遗传格局,皮质发育畸形(MCDs)的临床诊断往往具有挑战性。虽然严重皮质畸形(如经典型无脑回畸形)的临床和分子诊断通常较为直接,但对于更细微和复杂类型的皮质畸形(如巨脑回畸形和多小脑回畸形(PMG)),由于对其遗传病因的了解有限,诊断可能更具挑战性。在此,我们报告了两名具有相同新发KIF5C突变的个体,他们表现为细微的MCDs、早发性癫痫以及严重的神经发育和行为问题,包括语言缺失。我们的数据,结合迄今为止关于KIF5C突变的有限文献,支持KIF5C突变与一种以婴儿期癫痫发作以及细微但可识别的脑畸形类型为特征的神经发育障碍相关。我们还表明KIF5C突变谱较窄,因为在已鉴定的六名个体中,有五名的突变影响氨基酸Glu237。因此,识别该疾病的临床和神经影像学特征可能极大地促进快速有效的分子诊断。