CDKL5 gene status in female patients with epilepsy and Rett-like features: two new mutations in the catalytic domain

ABSTRACT: BACKGROUND: Mutations in the cyclin-dependent kinase-like 5 gene (CDKL5) located in the Xp22 region have been shown to cause a subset of atypical Rett syndrome with infantile spasms or early seizures starting in the first postnatal months. METHODS: We performed mutation screening of CDKL5 in 60 female patients who had been identified as negative for the methyl CpG-binding protein 2 gene (MECP2) mutations, but who had current or past epilepsy, regardless of the age of onset, type, and severity. All the exons in the CDKL5 gene and their neighbouring sequences were examined, and CDKL5 rearrangements were studied by multiplex ligation-dependent probe amplification (MLPA). RESULTS: Six previously unidentified DNA changes were detected, two of which were disease-causing mutations in the catalytic domain: a frameshift mutation (c.509_510insGT; p.Glu170GlyfsX36) and a complete deletion of exon 10. Both were found in patients with seizures that started in the first month of life. CONCLUSIONS: This study demonstrated the importance of CDKL5 mutations as etiological factors in neurodevelopmental disorders, and indicated that a thorough analysis of the CDKL5 gene sequence and its rearrangements should be considered in females with Rett syndrome-like phenotypes, severe encephalopathy and epilepsy with onset before 5 months of age. This study also confirmed the usefulness of MLPA as a diagnostic screening method for use in clinical practice.     

Evaluation of attitudes towards treatment in adolescents with attention deficit hyperactivity disorder (ADHD)

A substantial proportion of adolescents with attention deficit hyperactivity disorder (ADHD) do not appropriately adhere to prescribed treatments, especially to pharmacological treatments. It is important to disentangle the specific attitudes that contribute to treatment adherence. A 33-item questionnaire was applied to 120 adolescents diagnosed with ADHD and their respective parents. Reliability of the scale was explored using factor analysis, Cronbach's alpha, and test-retest. Validity was explored by face validity and the known-groups method. For the young people's version, three main dimensions (preoccupations, insight and self-concept) emerged. The parents' version showed six main dimensions (child's personal attitudes, worries, social stigma, insight, future side effects and knowledge). The potential of this questionnaire to explore the attitudes of patients and their families towards treatments and for clinicians to predict treatment adherence is discussed.     

Spatial compartmentalization of AMPA glutamate receptor subunits at the calyx of Held synapse

The mature calyx of Held ending on principal neurons of the medial nucleus of the trapezoid body (MNTB) has very specialized morphological and molecular features that make it possible to transmit auditory signals with high fidelity. In a previous work we described an increased localization of the ionotropic α‐amino‐3‐hydroxy‐5‐methyl‐4 isoxazolepropionic acid (AMPA) glutamate receptor (GluA) subunits at postsynaptic sites of the calyx of Held‐principal cell body synapses from postnatal development to adult. The aim of the present study was to investigate whether the pattern of the synaptic distribution of GluA2/3/4c and ‐4 in adult MNTB principal cell bodies correlated with preferential subcellular domains (stalks and swellings) of the calyx. We used a postembedding immunocytochemical method combined with specific antibodies to GluA2/3/4c and GluA4 subunits. We found that the density of GluA2/3/4c in calyceal swellings (19 ± 1.54 particles/μm) was higher than in stalks (10.93 ± 1.37 particles/μm); however, the differences for GluA4 were not statistically significant (swellings: 13.84 ± 1.39 particles/μm; stalks: 10.42 ± 1.24 particles/μm). Furthermore, GluA2/3/4c and GluA4 labeling co‐localized to some extent in calyceal stalks and swellings. Taking these data together, the distribution pattern of GluA subunits in postsynaptic specializations are indicative of a spatial compartmentalization of AMPA subunits in mature calyx‐principal neuron synapses that may support the temporally precise transmission required for sound localization in the auditory brainstem. J. Comp. Neurol. 518:163–174, 2010. © 2009 Wiley‐Liss, Inc.     

Functional characterization and haplotype analysis of polymorphisms in the human equilibrative nucleoside transporter, ENT2.

The equilibrative nucleoside transporter 2 (ENT2; SLC29A2) is a bidirectional transporter that is involved in the disposition of naturally occurring nucleosides as well as a variety of anticancer and antiviral nucleoside analogs. The goal of the current study was to evaluate the function of genetic variants in ENT2 in cellular assays and to determine the haplotype structure of the coding and flanking intronic region of the gene. As part of a large study focused on genetic variation in membrane transporters (Leabman et al., 2003), DNA samples from ethnically diverse populations (100 African-Americans, 100 European-Americans, 30 Asians, 10 Mexicans, and 7 Pacific Islanders) were screened for variants in membrane transporters, including SLC29A2. Fourteen polymorphic sites in SLC29A2 were found, including 11 in the coding region. Five protein-altering variants were identified: three nonsynonymous variants, and two deletions. Each of the protein-altering variants was found at a very low frequency, occurring only once in the sample population. The nonsynonymous variants and the deletions were constructed via site-directed mutagenesis and were subsequently characterized in Xenopus laevis oocytes. All variants were able to take up inosine with the exception of ENT2-Delta845-846, which resulted in a frameshift mutation that prematurely truncated the protein. ENT2 showed very infrequent variation compared with most other transporter proteins studied, and it was found that five haplotypes were sufficient to describe the entire sample set. The low overall genetic diversity in SLC29A2 makes it unlikely that variation in the coding region contributes significantly to clinically observed differences in drug response.     

Factors influencing primary care attendance in adolescents with high levels of depressive symptoms

Background  

Although depression is common amongst adolescents attending general practice, little is known about factors which influence consultation. This study aims to identify factors that contribute to GP attendance in adolescents with high levels of mood symptoms.