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From the Departments of Human Genetics (Drs. Dobyns, Matsumoto, Pilz, and Ledbetter), Neurology and Pediatrics (Dr. Dobyns), The University of Chicago, IL; Departments of Neurology (Drs. Truwit and Ross) and Radiology (Dr. Truwit), University of Minnesota, Minneapolis, MN; Department of Neurology (Dr. Gleeson), Childrens Hospital, Boston, MA; Division of Neurogenetics (Drs. Gleeson and Walsh), Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA; Programs in Neurosciences and Biological and Biomedical Sciences (Dr. Walsh), Harvard Medical School, Boston, MA; and the Departments of Radiology (Neuroradiology), Neurology, and Pediatrics (Dr. Barkovich), University of California, San Francisco, CA.
Address correspondence and reprint requests to Dr. W.B. Dobyns, Department of Human Genetics, The University of Chicago, 5841 S. Maryland Ave., Rm. L041, M/C 2050, Chicago, IL 60637.
BACKGROUND: Classical lissencephaly or "smooth brain" is a human brain malformation that consists of diffuse agyria and pachygyria. Two genes associated with classical lissencephaly have recently been clonedLIS1 from chromosome 17p13.3 and XLIS (also called DCX) from Xq22.3-q23.
OBJECTIVE: We performed genotype-phenotype analysis in children with lissencephaly associated with mutations of different genes.
METHODS: We compared the phenotype, especially brain imaging studies, in a series of 48 children with lissencephaly, including 12 with Miller-Dieker syndrome (MDS), which is associated with large deletions of LIS1 and other genes in the region, 24 with isolated lissencephaly sequence caused by smaller LIS1 deletions or mutations, and 12 with isolated lissencephaly sequence caused by XLIS mutations.
RESULTS: We found consistent differences in the gyral patterns, with the malformation more severe posteriorly in individuals with LIS1 mutations and more severe anteriorly in individuals with XLIS mutations. Thus, mutations of LIS1 are associated with a posterior-to-anterior gradient of lissencephaly, whereas mutations of XLIS are associated with an anterior-to-posterior gradient. We also confirmed differences in severity between MDS and ILS17. Hypoplasia of the cerebellar vermis proved to be more common with XLIS mutations.
CONCLUSION: It is often possible to predict the gene mutation from careful review of brain imaging studies.
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