CHD8-related disorders redefined: an expanding spectrum of dystonic phenotypes.

CHD8 CHD8-NDD Autism Dystonia Exome sequencing Movement disorders

Journal

Journal of neurology
ISSN: 1432-1459
Titre abrégé: J Neurol
Pays: Germany
ID NLM: 0423161

Informations de publication

Date de publication:
05 Mar 2024
Historique:
received: 08 01 2024
accepted: 19 02 2024
revised: 17 02 2024
medline: 5 3 2024
pubmed: 5 3 2024
entrez: 5 3 2024
Statut: aheadofprint

Résumé

Heterozygous loss-of-function variants in CHD8 have been associated with a syndromic neurodevelopmental-disease spectrum, collectively referred to as CHD8-related neurodevelopmental disorders. Several different clinical manifestations, affecting neurodevelopmental and systemic domains, have been described, presenting with highly variable expressivity. Some expressions are well established and comprise autism spectrum disorders, psychomotor delay with cognitive impairment, postnatal overgrowth with macrocephaly, structural brain abnormalities, gastrointestinal disturbances, and behavioral and sleep-pattern problems. However, the complete phenotypic spectrum of CHD8-related disorders is still undefined. In 2021, our group described two singular female patients with CHD8-related neurodevelopmental disorder and striking dystonic manifestations, prompting the suggestion that dystonia should be considered a possible component of this condition. We describe three additional unrelated female individuals, each carrying a different CHD8 frameshift variant and whose clinical presentations were primarily characterized by young-onset dystonia. Their dystonic manifestations were remarkably heterogeneous and ranged from focal, exercise-dependent, apparently isolated forms to generalized permanent phenotypes accompanied by spasticity and tremor. Neurocognitive impairment and autistic behaviors, typical of CHD8-related disorders, were virtually absent or at the mild end of the spectrum. This work validates our previous observation that dystonia is part of the phenotypic spectrum of CHD8-related neurodevelopmental disorders with potential female preponderance, raising new challenges and opportunities in the diagnosis and management of this condition. It also highlights the importance of in-depth neurologic phenotyping of patients carrying variants associated with neurodevelopmental disorders, as the connection between neurodevelopmental and movement disorders is proving closer than previously appreciated.

Sections du résumé

BACKGROUND BACKGROUND
Heterozygous loss-of-function variants in CHD8 have been associated with a syndromic neurodevelopmental-disease spectrum, collectively referred to as CHD8-related neurodevelopmental disorders. Several different clinical manifestations, affecting neurodevelopmental and systemic domains, have been described, presenting with highly variable expressivity. Some expressions are well established and comprise autism spectrum disorders, psychomotor delay with cognitive impairment, postnatal overgrowth with macrocephaly, structural brain abnormalities, gastrointestinal disturbances, and behavioral and sleep-pattern problems. However, the complete phenotypic spectrum of CHD8-related disorders is still undefined. In 2021, our group described two singular female patients with CHD8-related neurodevelopmental disorder and striking dystonic manifestations, prompting the suggestion that dystonia should be considered a possible component of this condition.
CASE SERIES PRESENTATION UNASSIGNED
We describe three additional unrelated female individuals, each carrying a different CHD8 frameshift variant and whose clinical presentations were primarily characterized by young-onset dystonia. Their dystonic manifestations were remarkably heterogeneous and ranged from focal, exercise-dependent, apparently isolated forms to generalized permanent phenotypes accompanied by spasticity and tremor. Neurocognitive impairment and autistic behaviors, typical of CHD8-related disorders, were virtually absent or at the mild end of the spectrum.
CONCLUSIONS CONCLUSIONS
This work validates our previous observation that dystonia is part of the phenotypic spectrum of CHD8-related neurodevelopmental disorders with potential female preponderance, raising new challenges and opportunities in the diagnosis and management of this condition. It also highlights the importance of in-depth neurologic phenotyping of patients carrying variants associated with neurodevelopmental disorders, as the connection between neurodevelopmental and movement disorders is proving closer than previously appreciated.

Identifiants

pubmed: 38441608
doi: 10.1007/s00415-024-12271-x
pii: 10.1007/s00415-024-12271-x
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s).

Références

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Auteurs

Ugo Sorrentino (U)

Institute of Human Genetics, School of Medicine, Technical University of Munich, Munich, Germany. ugo.sorrentino@unipd.it.
Institute of Neurogenomics, Helmholtz Munich, Neuherberg, Germany. ugo.sorrentino@unipd.it.
Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Padua, Italy. ugo.sorrentino@unipd.it.

Sylvia Boesch (S)

Center for Rare Movement Disorders Innsbruck, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.

Diane Doummar (D)

Sorbonne Université, Service de Neuropédiatrie-Pathologie du Développement, Centre de Référence Neurogénétique, Hôpital Trousseau AP-HP.SU, HU I2D2, Paris, France.

Claudia Ravelli (C)

Sorbonne Université, Service de Neuropédiatrie-Pathologie du Développement, Centre de Référence Neurogénétique, Hôpital Trousseau AP-HP.SU, HU I2D2, Paris, France.

Tereza Serranova (T)

Department of Neurology and Centre of Clinical Neuroscience, General University Hospital and First Faculty of Medicine, Charles University, Kateřinská 30, 12 800, Prague, Czech Republic.

Elisabetta Indelicato (E)

Center for Rare Movement Disorders Innsbruck, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.

Juliane Winkelmann (J)

Institute of Human Genetics, School of Medicine, Technical University of Munich, Munich, Germany.
Institute of Neurogenomics, Helmholtz Munich, Neuherberg, Germany.
DZPG, Deutsches Zentrum Für Psychische Gesundheit, Munich, Germany.
Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.

Lydie Burglen (L)

Cerebellar Malformations and Congenital Diseases Reference Center and Neurogenetics Lab, Department of Genetics, Armand Trousseau Hospital, AP-HP. Sorbonne Université, Paris, France.
Developmental Brain Disorders Laboratory, Imagine Institute, INSERM UMR 1163, Paris, France.

Robert Jech (R)

Department of Neurology and Centre of Clinical Neuroscience, General University Hospital and First Faculty of Medicine, Charles University, Kateřinská 30, 12 800, Prague, Czech Republic.

Michael Zech (M)

Institute of Human Genetics, School of Medicine, Technical University of Munich, Munich, Germany.
Institute of Neurogenomics, Helmholtz Munich, Neuherberg, Germany.
Institute for Advanced Study, Technical University of Munich, Garching, Germany.

Classifications MeSH