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De novo and inherited TCF20 pathogenic variants are associated with intellectual disability, dysmorphic features, hypotonia, and neurological impairments with similarities to Smith-Magenis syndrome.


ABSTRACT:

Background

Neurodevelopmental disorders are genetically and phenotypically heterogeneous encompassing developmental delay (DD), intellectual disability (ID), autism spectrum disorders (ASDs), structural brain abnormalities, and neurological manifestations with variants in a large number of genes (hundreds) associated. To date, a few de novo mutations potentially disrupting TCF20 function in patients with ID, ASD, and hypotonia have been reported. TCF20 encodes a transcriptional co-regulator structurally related to RAI1, the dosage-sensitive gene responsible for Smith-Magenis syndrome (deletion/haploinsufficiency) and Potocki-Lupski syndrome (duplication/triplosensitivity).

Methods

Genome-wide analyses by exome sequencing (ES) and chromosomal microarray analysis (CMA) identified individuals with heterozygous, likely damaging, loss-of-function alleles in TCF20. We implemented further molecular and clinical analyses to determine the inheritance of the pathogenic variant alleles and studied the spectrum of phenotypes.

Results

We report 25 unique inactivating single nucleotide variants/indels (1 missense, 1 canonical splice-site variant, 18 frameshift, and 5 nonsense) and 4 deletions of TCF20. The pathogenic variants were detected in 32 patients and 4 affected parents from 31 unrelated families. Among cases with available parental samples, the variants were de novo in 20 instances and inherited from 4 symptomatic parents in 5, including in one set of monozygotic twins. Two pathogenic loss-of-function variants were recurrent in unrelated families. Patients presented with a phenotype characterized by developmental delay, intellectual disability, hypotonia, variable dysmorphic features, movement disorders, and sleep disturbances.

Conclusions

TCF20 pathogenic variants are associated with a novel syndrome manifesting clinical characteristics similar to those observed in Smith-Magenis syndrome. Together with previously described cases, the clinical entity of TCF20-associated neurodevelopmental disorders (TAND) emerges from a genotype-driven perspective.

SUBMITTER: Vetrini F 

PROVIDER: S-EPMC6393995 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Publications

De novo and inherited TCF20 pathogenic variants are associated with intellectual disability, dysmorphic features, hypotonia, and neurological impairments with similarities to Smith-Magenis syndrome.

Vetrini Francesco F   McKee Shane S   Rosenfeld Jill A JA   Suri Mohnish M   Lewis Andrea M AM   Nugent Kimberly Margaret KM   Roeder Elizabeth E   Littlejohn Rebecca O RO   Holder Sue S   Zhu Wenmiao W   Alaimo Joseph T JT   Graham Brett B   Harris Jill M JM   Gibson James B JB   Pastore Matthew M   McBride Kim L KL   Komara Makanko M   Al-Gazali Lihadh L   Al Shamsi Aisha A   Fanning Elizabeth A EA   Wierenga Klaas J KJ   Scott Daryl A DA   Ben-Neriah Ziva Z   Meiner Vardiella V   Cassuto Hanoch H   Elpeleg Orly O   Holder J Lloyd JL   Burrage Lindsay C LC   Seaver Laurie H LH   Van Maldergem Lionel L   Mahida Sonal S   Soul Janet S JS   Marlatt Margaret M   Matyakhina Ludmila L   Vogt Julie J   Gold June-Anne JA   Park Soo-Mi SM   Varghese Vinod V   Lampe Anne K AK   Kumar Ajith A   Lees Melissa M   Holder-Espinasse Muriel M   McConnell Vivienne V   Bernhard Birgitta B   Blair Ed E   Harrison Victoria V   Muzny Donna M DM   Gibbs Richard A RA   Elsea Sarah H SH   Posey Jennifer E JE   Bi Weimin W   Lalani Seema S   Xia Fan F   Yang Yaping Y   Eng Christine M CM   Lupski James R JR   Liu Pengfei P  

Genome medicine 20190228 1


<h4>Background</h4>Neurodevelopmental disorders are genetically and phenotypically heterogeneous encompassing developmental delay (DD), intellectual disability (ID), autism spectrum disorders (ASDs), structural brain abnormalities, and neurological manifestations with variants in a large number of genes (hundreds) associated. To date, a few de novo mutations potentially disrupting TCF20 function in patients with ID, ASD, and hypotonia have been reported. TCF20 encodes a transcriptional co-regula  ...[more]

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