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2016 ; 7
(4
): 220-233
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Genetic Basis of Brain Malformations
#MMPMID27781032
Parrini E
; Conti V
; Dobyns WB
; Guerrini R
Mol Syndromol
2016[Sep]; 7
(4
): 220-233
PMID27781032
show ga
Malformations of cortical development (MCD) represent a major cause of
developmental disabilities, severe epilepsy, and reproductive disadvantage. Genes
that have been associated to MCD are mainly involved in cell proliferation and
specification, neuronal migration, and late cortical organization.
Lissencephaly-pachygyria-severe band heterotopia are diffuse neuronal migration
disorders causing severe global neurological impairment. Abnormalities of the
LIS1, DCX, ARX, RELN, VLDLR, ACTB, ACTG1, TUBG1, KIF5C, KIF2A, and CDK5 genes
have been associated with these malformations. More recent studies have also
established a relationship between lissencephaly, with or without associated
microcephaly, corpus callosum dysgenesis as well as cerebellar hypoplasia, and at
times, a morphological pattern consistent with polymicrogyria with mutations of
several genes (TUBA1A, TUBA8, TUBB, TUBB2B, TUBB3, and DYNC1H1), regulating the
synthesis and function of microtubule and centrosome key components and hence
defined as tubulinopathies. MCD only affecting subsets of neurons, such as mild
subcortical band heterotopia and periventricular heterotopia, have been
associated with abnormalities of the DCX, FLN1A, and ARFGEF2 genes and cause
neurological and cognitive impairment that vary from severe to mild deficits.
Polymicrogyria results from abnormal late cortical organization and is
inconstantly associated with abnormal neuronal migration. Localized
polymicrogyria has been associated with anatomo-specific deficits, including
disorders of language and higher cognition. Polymicrogyria is genetically
heterogeneous, and only in a small minority of patients, a definite genetic cause
has been identified. Megalencephaly with normal cortex or polymicrogyria by MRI
imaging, hemimegalencephaly and focal cortical dysplasia can all result from
mutations in genes of the PI3K-AKT-mTOR pathway. Postzygotic mutations have been
described for most MCD and can be limited to the dysplastic tissue in the less
diffuse forms.