@article {208, title = {Brain malformations associated with Knobloch syndrome--review of literature, expanding clinical spectrum, and identification of novel mutations.}, journal = {Pediatr Neurol}, volume = {51}, year = {2014}, month = {2014 Dec}, pages = {806-813.e8}, abstract = {

BACKGROUND: Knobloch syndrome is a rare, autosomal recessive, developmental disorder characterized by stereotyped ocular abnormalities with or without occipital skull deformities (encephalocele, bone defects, and cutis aplasia). Although there is clear heterogeneity in clinical presentation, central nervous system malformations, aside from the characteristic encephalocele, have not typically been considered a component of the disease phenotype.

METHODS: Four patients originally presented for genetic evaluation of symptomatic structural brain malformations. Whole-genome genotyping, whole-exome sequencing, and confirmatory Sanger sequencing were performed. Using immunohistochemical analysis, we investigated the protein expression pattern of COL18A1 in the mid-fetal and adult human cerebral cortex and then analyzed the spatial and temporal changes in the expression pattern of COL18A1 during human cortical development using the Human Brain Transcriptome database.

RESULTS: We identified two novel homozygous deleterious frame-shift mutations in the COL18A1 gene. On further investigation of these patients and their families, we found that many exhibited certain characteristics of Knobloch syndrome, including pronounced ocular defects. Our data strongly support an important role for COL18A1 in brain development, and this report contributes to an enhanced characterization of the brain malformations that can result from deficiencies of collagen XVIII.

CONCLUSIONS: This case series highlights the diagnostic power and clinical utility of whole-exome sequencing technology-allowing clinicians and physician scientists to better understand the pathophysiology and presentations of rare diseases. We suggest that patients who are clinically diagnosed with Knobloch syndrome and/or found to have COL18A1 mutations via genetic screening should be investigated for potential structural brain abnormalities even in the absence of an encephalocele.

}, keywords = {Adolescent, Adult, Cerebral Cortex, Collagen Type XVIII, Consanguinity, Encephalocele, Exome, Female, Fetus, Humans, Male, Mutation, Retinal Degeneration, Retinal Detachment, Young Adult}, issn = {1873-5150}, doi = {10.1016/j.pediatrneurol.2014.08.025}, author = {{\c C}a{\u g}layan, Ahmet Okay and Baranoski, Jacob F and Aktar, Fesih and Han, Wengi and Tuysuz, Beyhan and Guzel, Aslan and Guclu, Bulent and Kaymak{\c c}alan, Hande and Aktekin, Berrin and Akg{\"u}m{\"u}{\c s}, G{\"o}zde Tu{\u g}ce and Murray, Phillip B and Erson-Omay, Emine Z and Caglar, Caner and Bakircioglu, Mehmet and Sakalar, Yildirim Bayezit and Guzel, Ebru and Demir, Nihat and Tuncer, Oguz and Senturk, Senem and Ekici, Bar{\i}{\c s} and Minja, Frank J and {\v S}estan, Nenad and Yasuno, Katsuhito and Bilguvar, Kaya and Caksen, Huseyin and G{\"u}nel, Murat} } @article {309, title = {Mutations in LAMB1 cause cobblestone brain malformation without muscular or ocular abnormalities.}, journal = {Am J Hum Genet}, volume = {92}, year = {2013}, month = {2013 Mar 07}, pages = {468-74}, abstract = {

Cobblestone brain malformation (COB) is a neuronal migration disorder characterized by protrusions of neurons beyond the first cortical layer at the pial surface of the brain. It is usually seen in association with dystroglycanopathy types of congenital muscular dystrophies (CMDs) and ocular abnormalities termed muscle-eye-brain disease. Here we report homozygous deleterious mutations in LAMB1, encoding laminin subunit beta-1, in two families with autosomal-recessive COB. Affected individuals displayed a constellation of brain malformations including cortical gyral and white-matter signal abnormalities, severe cerebellar dysplasia, brainstem hypoplasia, and occipital encephalocele, but they had less apparent ocular or muscular abnormalities than are typically observed in COB. LAMB1 is localized to the pial basement membrane, suggesting that defective connection between radial glial cells and the pial surface mediated by LAMB1 leads to this malformation.

}, keywords = {Basement Membrane, Brain, Cerebellum, Cerebral Cortex, Encephalocele, Female, Genetic Predisposition to Disease, Homozygote, Humans, Laminin, Male, Muscular Dystrophies, Nervous System Malformations, Neuroglia, Neurons, Sequence Deletion, Walker-Warburg Syndrome}, issn = {1537-6605}, doi = {10.1016/j.ajhg.2013.02.005}, author = {Radmanesh, Farid and {\c C}a{\u g}layan, Ahmet Okay and Silhavy, Jennifer L and Yilmaz, Cahide and Cantagrel, Vincent and Omar, Tarek and Rosti, Basak and Kaymak{\c c}alan, Hande and Gabriel, Stacey and Li, Mingfeng and {\v S}estan, Nenad and Bilguvar, Kaya and Dobyns, William B and Zaki, Maha S and G{\"u}nel, Murat and Gleeson, Joseph G} }