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Horizontal gaze palsy with progressive scoliosis: Further expanding the ROBO3 spectrum.


ABSTRACT:

Objective

Horizontal gaze palsy with progressive scoliosis (HGPPS) is a rare, autosomal recessive disorder resulting from axonal midline crossing defect due to variants in ROBO3.

Methods

We retrospectively evaluated demographics, clinical phenotype, course of spinal deformities, and neuroimaging findings of six Turkish patients with HGPPS. We performed targeted gene testing by next-generation sequencing.

Results

The median age at symptom onset and diagnosis was 1.5 years (0.5-4), and 11 years (2-16), respectively. Oculomotor signs were the most common presenting symptom (n = 4), followed by scoliosis (n = 2). The course of scoliosis was progressive and accompanied by kyphosis, showed intrafamilial variability, and was corrected surgically in three of the patients. Intellectual disability (n = 4), hypergonadotropic hypogonadism (n = 2), hearing loss (n = 2), and tranisent movement disorders (n = 1) were additional features. Targeted gene sequencing revealed five distinct homozygous variants. Of the four novel variants, two of them were located in the acceptor site of the noncoding region of the gene, remaining two were missense and frameshift variants, located in immunoglobulin-like domain-2, and cytoplasmic signaling motif 2, respectively. Structural magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) showed the absence of decussation of superior cerebellar peduncle and dorsal transverse pontine fibers.

Interpretation

Spectrum of HGPPS is further expanded with novel variants in the ROBO3 with clinical and radiological fingerprints. Spinal deformities require close orthopedic screening and individualized approach. Intellectual disability and hearing loss emerge as additional features. Hypogonadism and transient subtle movement disorders require further attention and confirmation from other series.

SUBMITTER: Gunbey C 

PROVIDER: S-EPMC11330215 | biostudies-literature | 2024 Aug

REPOSITORIES: biostudies-literature

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Publications

Horizontal gaze palsy with progressive scoliosis: Further expanding the ROBO3 spectrum.

Günbey Ceren C   Çavdarlı Büşranur B   Göçmen Rahşan R   Yazıcı Muharrem M   Temuçin Çağrı Mesut ÇM   Özdemir Özkan Ö   Çırak Sebahattin S   Haliloğlu Göknur G  

Annals of clinical and translational neurology 20240621 8


<h4>Objective</h4>Horizontal gaze palsy with progressive scoliosis (HGPPS) is a rare, autosomal recessive disorder resulting from axonal midline crossing defect due to variants in ROBO3.<h4>Methods</h4>We retrospectively evaluated demographics, clinical phenotype, course of spinal deformities, and neuroimaging findings of six Turkish patients with HGPPS. We performed targeted gene testing by next-generation sequencing.<h4>Results</h4>The median age at symptom onset and diagnosis was 1.5 years (0  ...[more]

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