Volume 62, Issue 2 pp. 121-127
Original Article

Phenotypic characterization of hypomyelination and congenital cataract

Roberta Biancheri MD, PhD

Corresponding Author

Roberta Biancheri MD, PhD

Muscular and Neurodegenerative Disease Unit, G. Gaslini Institute and University of Genova, Genova, Italy

Muscular and Neurodegenerative Disease Unit, G. Gaslini Institute and University of Genova, Largo Gaslini 5, 16147 Genova, ItalySearch for more papers by this author
Federico Zara PhD

Federico Zara PhD

Muscular and Neurodegenerative Disease Unit, G. Gaslini Institute and University of Genova, Genova, Italy

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Claudio Bruno MD

Claudio Bruno MD

Muscular and Neurodegenerative Disease Unit, G. Gaslini Institute and University of Genova, Genova, Italy

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Andrea Rossi MD

Andrea Rossi MD

Department of Pediatric Neuroradiology, G. Gaslini Institute, Genova, Italy

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Laura Bordo BSc

Laura Bordo BSc

Muscular and Neurodegenerative Disease Unit, G. Gaslini Institute and University of Genova, Genova, Italy

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Elisabetta Gazzerro MD

Elisabetta Gazzerro MD

Muscular and Neurodegenerative Disease Unit, G. Gaslini Institute and University of Genova, Genova, Italy

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Federica Sotgia PhD

Federica Sotgia PhD

Muscular and Neurodegenerative Disease Unit, G. Gaslini Institute and University of Genova, Genova, Italy

Departments of Cancer Biology and Biochemistry and Molecular Biology, Thomas Jefferson University, Kimmel Cancer Center, Philadelphia, PA

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Marina Pedemonte MD

Marina Pedemonte MD

Muscular and Neurodegenerative Disease Unit, G. Gaslini Institute and University of Genova, Genova, Italy

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Sara Scapolan MD

Sara Scapolan MD

Muscular and Neurodegenerative Disease Unit, G. Gaslini Institute and University of Genova, Genova, Italy

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Massimo Bado MD

Massimo Bado MD

Muscular and Neurodegenerative Disease Unit, G. Gaslini Institute and University of Genova, Genova, Italy

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Graziella Uziel MD

Graziella Uziel MD

Division of Child Neuropsychiatry, C. Besta Institute, Milan, Milan, Italy

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Marianna Bugiani MD

Marianna Bugiani MD

Division of Child Neuropsychiatry, C. Besta Institute, Milan, Milan, Italy

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Laura Doria Lamba MD

Laura Doria Lamba MD

Child Neuropsychiatry Unit, G. Gaslini Institute, Genova, Genova, Italy

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Valeria Costa MD

Valeria Costa MD

Child Neuropsychiatry Unit, Azienda Sanitaria Locale (ASL) 6, Palermo, Palermo, Italy

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Angelo Schenone MD

Angelo Schenone MD

Department of Neurosciences, Ophthalmology and Genetics, University of Genova, Genova, Italy

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Annemieke J. M. Rozemuller MD

Annemieke J. M. Rozemuller MD

Department of Neuropathology, VU University Medical Center, Amsterdam, the Netherlands

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Paolo Tortori-Donati MD

Paolo Tortori-Donati MD

Department of Pediatric Neuroradiology, G. Gaslini Institute, Genova, Italy

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Michael P. Lisanti MD

Michael P. Lisanti MD

Muscular and Neurodegenerative Disease Unit, G. Gaslini Institute and University of Genova, Genova, Italy

Departments of Cancer Biology and Biochemistry and Molecular Biology, Thomas Jefferson University, Kimmel Cancer Center, Philadelphia, PA

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Marjo S. van der Knaap MD, PhD

Marjo S. van der Knaap MD, PhD

Department of Child Neurology, VU University Medical Center, Amsterdam, the Netherlands

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Carlo Minetti MD

Carlo Minetti MD

Muscular and Neurodegenerative Disease Unit, G. Gaslini Institute and University of Genova, Genova, Italy

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First published: 19 September 2007
Citations: 42

Abstract

Objective

To define the clinical and laboratory findings in a novel autosomal recessive white matter disorder called hypomyelination and congenital cataract, recently found to be caused by a deficiency of a membrane protein, hyccin, encoded by the DRCTNNB1A gene located on chromosome 7p21.3-p15.3.

Methods

We performed neurological examination, neurophysiological, neuroimaging, and neuropathological studies on sural nerve biopsy in 10 hypomyelination and congenital cataract patients from 5 unrelated families.

Results

The clinical picture was characterized by bilateral congenital cataract, developmental delay, and slowly progressive neurological impairment with spasticity, cerebellar ataxia, and mild-to-moderate mental retardation. Neurophysiological studies showed a slightly to markedly slowed motor nerve conduction velocity in 9 of 10 patients, and multimodal evoked potentials indicated increased central conduction times. Neuroimaging studies demonstrated a diffuse supratentorial hypomyelination, with in some patients, additional areas of more prominent signal change in the frontal region. Sural nerve biopsy showed a slight-to-severe reduction in myelinated fiber density, with several axons surrounded by a thin myelin sheath or devoid of myelin.

Interpretation

Hypomyelination and congenital cataract is a novel autosomal recessive white matter disorder characterized by the unique association of congenital cataract and hypomyelination of the central and peripheral nervous system. Ann Neurol 2007

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