Neuropsychological and neurophysiological features of WAGR syndrome: Detailed comprehensive evaluation of a patient with severe intellectual disability and autism spectrum disorder.


Journal

Brain & development
ISSN: 1872-7131
Titre abrégé: Brain Dev
Pays: Netherlands
ID NLM: 7909235

Informations de publication

Date de publication:
Mar 2022
Historique:
received: 27 07 2021
revised: 01 11 2021
accepted: 18 11 2021
pubmed: 9 12 2021
medline: 22 3 2022
entrez: 8 12 2021
Statut: ppublish

Résumé

Wilms' tumor, aniridia, genitourinary anomalies, and mental retardation (WAGR) syndrome is a contiguous gene deletion syndrome caused by a de novo deletion including the 11p13 region. Although autism spectrum disorder (ASD) is frequently observed in patients with WAGR syndrome, few reports have comprehensively described its characteristics. We herein present the detailed neuropsychological and neurophysiological findings of a patient with WAGR syndrome complicated with severe psychomotor developmental delay and ASD. The patient is presently a 6-year-old boy. Microarray analysis revealed a 7.1 Mb loss at 11p14.3-p13 and a 9.3 Mb loss at 11p13-p12, which encompassed the PAX6, WT1, and PRRG4 genes. His behavioral features were characteristic even among the ASD population: severe hypoesthesia to touch, pain, and temperature in addition to remarkable sensory seeking posing a high risk of serious accident. Sensory Profile analysis objectively identified a strong preference for sensory stimulation. Furthermore, his somatosensory evoked potential (SSEP) showed a mild delay in central conduction time, suggesting partial brain stem dysfunction-induced hypoalgesia. This first attempt to characterize sensory dysfunction using Sensory Profile and SSEP in WAGR syndrome may contribute to understanding its neuropsychological features and improve the quality of rehabilitation and socioeducational support in affected children.

Sections du résumé

BACKGROUND BACKGROUND
Wilms' tumor, aniridia, genitourinary anomalies, and mental retardation (WAGR) syndrome is a contiguous gene deletion syndrome caused by a de novo deletion including the 11p13 region. Although autism spectrum disorder (ASD) is frequently observed in patients with WAGR syndrome, few reports have comprehensively described its characteristics. We herein present the detailed neuropsychological and neurophysiological findings of a patient with WAGR syndrome complicated with severe psychomotor developmental delay and ASD.
CASE PRESENTATION METHODS
The patient is presently a 6-year-old boy. Microarray analysis revealed a 7.1 Mb loss at 11p14.3-p13 and a 9.3 Mb loss at 11p13-p12, which encompassed the PAX6, WT1, and PRRG4 genes. His behavioral features were characteristic even among the ASD population: severe hypoesthesia to touch, pain, and temperature in addition to remarkable sensory seeking posing a high risk of serious accident. Sensory Profile analysis objectively identified a strong preference for sensory stimulation. Furthermore, his somatosensory evoked potential (SSEP) showed a mild delay in central conduction time, suggesting partial brain stem dysfunction-induced hypoalgesia.
DISCUSSION CONCLUSIONS
This first attempt to characterize sensory dysfunction using Sensory Profile and SSEP in WAGR syndrome may contribute to understanding its neuropsychological features and improve the quality of rehabilitation and socioeducational support in affected children.

Identifiants

pubmed: 34876316
pii: S0387-7604(21)00211-4
doi: 10.1016/j.braindev.2021.11.006
pii:
doi:

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

229-233

Informations de copyright

Copyright © 2021 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Hitomi Nishizawa (H)

Faculty of Health Sciences, Department of Medicine, Shinshu University, Matsumoto, Japan.

Mitsuo Motobayashi (M)

Department of Neurology, Nagano Children's Hospital, Azumino, Japan; Life Science Research Center, Nagano Children's Hospital, Azumino, Japan; Neuro-Care Center, Nagano Children's Hospital, Azumino, Japan; Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan. Electronic address: s001072@shinshu-u.ac.jp.

Miwa Akahane (M)

Faculty of Health Sciences, Department of Medicine, Shinshu University, Matsumoto, Japan.

Keiko Wakui (K)

Department of Medical Genetics, Shinshu University School of Medicine, Matsumoto, Japan; Center for Medical Genetics, Shinshu University Hospital, Matsumoto, Japan.

Noritaka Kitazawa (N)

Department of Ophthalmology, Nagano Children's Hospital, Azumino, Japan.

Yuji Inaba (Y)

Department of Neurology, Nagano Children's Hospital, Azumino, Japan; Life Science Research Center, Nagano Children's Hospital, Azumino, Japan; Neuro-Care Center, Nagano Children's Hospital, Azumino, Japan.

Yoshimitsu Fukushima (Y)

Department of Medical Genetics, Shinshu University School of Medicine, Matsumoto, Japan; Center for Medical Genetics, Shinshu University Hospital, Matsumoto, Japan.

Tomoki Kosho (T)

Department of Medical Genetics, Shinshu University School of Medicine, Matsumoto, Japan; Center for Medical Genetics, Shinshu University Hospital, Matsumoto, Japan; Research Center for Supports to Advanced Science, Shinshu University, Matsumoto, Japan; Division of Clinical Sequencing, Shinshu University School of Medicine, Matsumoto, Japan. Electronic address: ktomoki@shinshu-u.ac.jp.

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Classifications MeSH