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Neurological outcome in WDR62 primary microcephaly
Lyse Ruaud1, Séverine Drunat1, Monique Elmaleh-Bergès2
1Département de Génétique, UMR 1141 NEURODIDEROT, INSERM, APHP, Hôpital Universitaire Robert Debré, Université de Paris, Paris, France.
Insights
Patients with WD repeat domain 62 (WDR62)-related microcephaly show varied cognitive outcomes, with some retaining daily living autonomy. Long-term monitoring is advised due to potential progressive ataxia.
Area of Science:
- Neuroscience
- Genetics
- Developmental Biology
Background:
- Primary microcephaly is a rare neurological disorder characterized by reduced head circumference.
- Mutations in the WD repeat domain 62 (WDR62) gene are a known cause of primary microcephaly.
- Understanding the full spectrum of WDR62-related phenotypes is crucial for diagnosis and management.
Purpose of the Study:
- To characterize the cortical structure, developmental, and cognitive profiles of patients with WDR62-related primary microcephaly.
- To identify novel WDR62 variants and analyze genotype-phenotype correlations.
- To assess the long-term developmental trajectory and potential for autonomy in affected individuals.
Main Methods:
- Observational study of 17 patients with WDR62-related microcephaly.
- Clinical assessment of developmental, neurological, and cognitive status.
- Brain imaging (MRI) to evaluate cortical structure and malformations.
- Genetic analysis to identify WDR62 variants.
- Analysis of previously reported WDR62-related phenotypes.
Main Results:
- Brain malformations (pachygyria, heterotopia, schizencephaly, microlissencephaly) were observed in 11/15 patients.
- Mean full-scale IQ was 51.8, with intellectual disability ranging from mild to severe.
- Adaptive behavior scores indicated challenges in communication and motor skills, but socialization was relatively preserved.
- One patient developed progressive ataxia in their second decade of life.
Conclusions:
- WDR62-related microcephaly presents with significant brain malformations and intellectual disability.
- Cognitive consequences may be less severe than anticipated in some cases, with preserved autonomy.
- Progressive ataxia can occur, necessitating long-term clinical follow-up.
Aim:
To characterize the cortical structure, developmental, and cognitive profiles of patients with WD repeat domain 62 (WDR62)-related primary microcephaly.
Method:
In this observational study, we describe the developmental, neurological, cognitive, and brain imaging characteristics of 17 patients (six males, 11 females; mean age 12y 3mo standard deviation [SD] 5y 8mo, range 5y-24y 6mo) and identify 14 new variants of WDR62. We similarly analyse the phenotypes and genotypes of the 59 previously reported families.
Results:
Brain malformations, including pachygyria, neuronal heterotopia, schizencephaly, and microlissencephaly, were present in 11 out of 15 patients. The mean full-scale IQ of the 11 assessed patients was 51.8 (standard deviation [SD] 12.6, range 40-70). Intellectual disability was severe in four patients, moderate in four, and mild in three. Scores on the Vineland Adaptive Behavior Scales obtained from 10 patients were low for communication and motor skills (mean 38.29, SD 7.74, and 37.71, SD 5.74 respectively). The socialization score was higher (mean 47.14, SD 12.39). We found a significant difference between scores for communication and daily living skills (mean 54.43, SD 11.6; p=0.001, one-way analysis of variance). One patient displayed progressive ataxia.
Interpretation:
WDR62-related cognitive consequences may be less severe than expected because 3 out of 11 of the assessed patients had only mild intellectual disability and relatively preserved abilities of autonomy in daily life. We identified progressive ataxia in the second decade of life in one patient, which should encourage clinicians to follow up patients in the long term.
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