The wide spectrum of tubulinopathies: what are the key features for the diagnosis?
- PMID: 24860126
- DOI: 10.1093/brain/awu082
The wide spectrum of tubulinopathies: what are the key features for the diagnosis?
Abstract
Complex cortical malformations associated with mutations in tubulin genes: TUBA1A, TUBA8, TUBB2B, TUBB3, TUBB5 and TUBG1 commonly referred to as tubulinopathies, are a heterogeneous group of conditions with a wide spectrum of clinical severity. Among the 106 patients selected as having complex cortical malformations, 45 were found to carry mutations in TUBA1A (42.5%), 18 in TUBB2B (16.9%), 11 in TUBB3 (10.4%), three in TUBB5 (2.8%), and three in TUBG1 (2.8%). No mutations were identified in TUBA8. Systematic review of patients' neuroimaging and neuropathological data allowed us to distinguish at least five cortical malformation syndromes: (i) microlissencephaly (n = 12); (ii) lissencephaly (n = 19); (iii) central pachygyria and polymicrogyria-like cortical dysplasia (n = 24); (iv) generalized polymicrogyria-like cortical dysplasia (n = 6); and (v) a 'simplified' gyral pattern with area of focal polymicrogyria (n = 19). Dysmorphic basal ganglia are the hallmark of tubulinopathies (found in 75% of cases) and are present in 100% of central pachygyria and polymicrogyria-like cortical dysplasia and simplified gyral malformation syndromes. Tubulinopathies are also characterized by a high prevalence of corpus callosum agenesis (32/80; 40%), and mild to severe cerebellar hypoplasia and dysplasia (63/80; 78.7%). Foetal cases (n = 25) represent the severe end of the spectrum and show specific abnormalities that provide insights into the underlying pathophysiology. The overall complexity of tubulinopathies reflects the pleiotropic effects of tubulins and their specific spatio-temporal profiles of expression. In line with previous reports, this large cohort further clarifies overlapping phenotypes between tubulinopathies and although current structural data do not allow prediction of mutation-related phenotypes, within each mutated gene there is an associated predominant pattern of cortical dysgenesis allowing some phenotype-genotype correlation. The core phenotype of TUBA1A and TUBG1 tubulinopathies are lissencephalies and microlissencephalies, whereas TUBB2B tubulinopathies show in the majority, centrally predominant polymicrogyria-like cortical dysplasia. By contrast, TUBB3 and TUBB5 mutations cause milder malformations with focal or multifocal polymicrogyria-like cortical dysplasia with abnormal and simplified gyral pattern.
Keywords: lissencephaly; microcephaly; microlissencephaly; pachygyria; polymicrogyria; tubulin.
© The Author (2014). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Similar articles
-
Overlapping cortical malformations and mutations in TUBB2B and TUBA1A.Brain. 2013 Feb;136(Pt 2):536-48. doi: 10.1093/brain/aws338. Epub 2013 Jan 29. Brain. 2013. PMID: 23361065
-
Mutations in tubulin genes are frequent causes of various foetal malformations of cortical development including microlissencephaly.Acta Neuropathol Commun. 2014 Jul 25;2:69. doi: 10.1186/2051-5960-2-69. Acta Neuropathol Commun. 2014. PMID: 25059107 Free PMC article.
-
Tubulin genes and malformations of cortical development.Eur J Med Genet. 2018 Dec;61(12):744-754. doi: 10.1016/j.ejmg.2018.07.012. Epub 2018 Jul 17. Eur J Med Genet. 2018. PMID: 30016746 Review.
-
Broadening the phenotypic spectrum of TUBA1A tubulinopathy to syndromic arthrogryposis multiplex congenita.Am J Med Genet A. 2022 Aug;188(8):2331-2338. doi: 10.1002/ajmg.a.62866. Epub 2022 Jun 10. Am J Med Genet A. 2022. PMID: 35686685
-
Tubulin mutations in human neurodevelopmental disorders.Semin Cell Dev Biol. 2023 Mar 15;137:87-95. doi: 10.1016/j.semcdb.2022.07.009. Epub 2022 Jul 30. Semin Cell Dev Biol. 2023. PMID: 35915025 Review.
Cited by
-
Sending Mixed Signals: The Expanding Role of Molecular Cascade Mutations in Malformations of Cortical Development and Epilepsy.Epilepsy Curr. 2016 May-Jun;16(3):158-63. doi: 10.5698/1535-7511-16.3.158. Epilepsy Curr. 2016. PMID: 27330441 Free PMC article.
-
Nosological delineation of congenital ocular motor apraxia type Cogan: an observational study.Orphanet J Rare Dis. 2016 Jul 29;11(1):104. doi: 10.1186/s13023-016-0486-z. Orphanet J Rare Dis. 2016. PMID: 27473762 Free PMC article.
-
In silico analysis of TUBA4A mutations in Amyotrophic Lateral Sclerosis to define mechanisms of microtubule disintegration.Sci Rep. 2023 Feb 6;13(1):2096. doi: 10.1038/s41598-023-28381-x. Sci Rep. 2023. PMID: 36747013 Free PMC article.
-
Comprehensive genotype-phenotype correlation in lissencephaly.Quant Imaging Med Surg. 2018 Aug;8(7):673-693. doi: 10.21037/qims.2018.08.08. Quant Imaging Med Surg. 2018. PMID: 30211035 Free PMC article. Review.
-
The spectrum of brainstem malformations associated to mutations of the tubulin genes family: MRI and DTI analysis.Eur Radiol. 2019 Feb;29(2):770-782. doi: 10.1007/s00330-018-5610-0. Epub 2018 Jul 31. Eur Radiol. 2019. PMID: 30066250
Publication types
MeSH terms
Substances
Supplementary concepts
LinkOut - more resources
Full Text Sources
Other Literature Sources
Research Materials
Miscellaneous