Behavioral signs of CHARGE syndrome and CHD7 mutational spectrum

Introduction CHARGE syndrome is a genetic entity caused by mutations in the chromodomain helicase DNA-binding protein 7 gene (CHD7) at 8q12.1. There are pleiotropic signs among individuals with this disorder. Diagnosis is clinical using medical criteria. CHD7 gene mutations are usually found in 90%...

Full description

Bibliographic Details
Main Authors: N. Bouayed Abdelmoula, B. Abdelmoula
Format: Article
Language:English
Published: Cambridge University Press 2023-03-01
Series:European Psychiatry
Online Access:https://www.cambridge.org/core/product/identifier/S0924933823007678/type/journal_article
_version_ 1797616026781745152
author N. Bouayed Abdelmoula
B. Abdelmoula
author_facet N. Bouayed Abdelmoula
B. Abdelmoula
author_sort N. Bouayed Abdelmoula
collection DOAJ
description Introduction CHARGE syndrome is a genetic entity caused by mutations in the chromodomain helicase DNA-binding protein 7 gene (CHD7) at 8q12.1. There are pleiotropic signs among individuals with this disorder. Diagnosis is clinical using medical criteria. CHD7 gene mutations are usually found in 90% of affected patients. Objectives The aim of this study was to report behavioral signs of CHARGE syndrome and their phenotype-genotype correlations. Methods Four Tunisian males from Sfax (Tunisia) with clinical features suggestive of CHARGE syndrome were examined at our genetic counselling at the medical University of Sfax. Assessment of facial dysmorphic and behavioral features, karyotyping using RHG banding and molecular screening of CHD7 mutations were performed. Molecular analysis was made using direct Sanger sequencing of the entire CHD7 gene. Results Molecular genetic analysis revealed two deletions of the CHD7 gene at exon 3 for the first patient and at exon 8 for the second. The two genetic alterations were associated to retarded growth development and genital hypoplasia. Sensory impairments included for the first visual defects and for the second auditory and olfactory defects. Besides constant delayed psychomotor development, the two patients shared receptive and expressive communication disorders, anxiety, attention deficit, cognitive impairment and intellectual disability. There were no aggressive traits nor major autistic features. Learning disabilities were also present for the two patients. Conclusions The CHD7 gene controls the developmental pathways as a transcriptional regulator in the nucleoplasm through chromatin organization. Mutational alterations lead according to the affected domains, and the structure of the nonfunctional CHD7 protein, to the perturbation of the regulation of the developmental pathways’ genes expression. CHD7 is demonstrated as an important component of neurogenesis through two neuronal determination factors: Sox4 and Sox11. While nonsense, frameshift and missense mutations are most common, deletions and duplications are less frequent. Moreover, while exon 3 is commonly altered, mutations of exon 8, which is related to the CHD7 protein chromodomain, are very rare. Phenotype-genotype correlations according to the type of genomic alteration of CHD7 gene are rarely published, particularly concerning behavioral and psychological features of CHARGE association. Here, physical disorders of our two patients seem to be different but behavioral features seem to be common. Multidisciplinary care is thus required for CHARGE syndrome and molecular analysis must be indicated because the type of the genomic alterations may be a key step for a more accurate management of physical and behavioral disorders. Disclosure of Interest None Declared
first_indexed 2024-03-11T07:35:20Z
format Article
id doaj.art-de204b0b9be34877ae6d45015659fe23
institution Directory Open Access Journal
issn 0924-9338
1778-3585
language English
last_indexed 2024-03-11T07:35:20Z
publishDate 2023-03-01
publisher Cambridge University Press
record_format Article
series European Psychiatry
spelling doaj.art-de204b0b9be34877ae6d45015659fe232023-11-17T05:10:20ZengCambridge University PressEuropean Psychiatry0924-93381778-35852023-03-0166S352S35210.1192/j.eurpsy.2023.767Behavioral signs of CHARGE syndrome and CHD7 mutational spectrumN. Bouayed Abdelmoula0B. Abdelmoula1Genomics of Signalopathies at the service of Medicine, Medical University of Sfax, Sfax, TunisiaGenomics of Signalopathies at the service of Medicine, Medical University of Sfax, Sfax, Tunisia Introduction CHARGE syndrome is a genetic entity caused by mutations in the chromodomain helicase DNA-binding protein 7 gene (CHD7) at 8q12.1. There are pleiotropic signs among individuals with this disorder. Diagnosis is clinical using medical criteria. CHD7 gene mutations are usually found in 90% of affected patients. Objectives The aim of this study was to report behavioral signs of CHARGE syndrome and their phenotype-genotype correlations. Methods Four Tunisian males from Sfax (Tunisia) with clinical features suggestive of CHARGE syndrome were examined at our genetic counselling at the medical University of Sfax. Assessment of facial dysmorphic and behavioral features, karyotyping using RHG banding and molecular screening of CHD7 mutations were performed. Molecular analysis was made using direct Sanger sequencing of the entire CHD7 gene. Results Molecular genetic analysis revealed two deletions of the CHD7 gene at exon 3 for the first patient and at exon 8 for the second. The two genetic alterations were associated to retarded growth development and genital hypoplasia. Sensory impairments included for the first visual defects and for the second auditory and olfactory defects. Besides constant delayed psychomotor development, the two patients shared receptive and expressive communication disorders, anxiety, attention deficit, cognitive impairment and intellectual disability. There were no aggressive traits nor major autistic features. Learning disabilities were also present for the two patients. Conclusions The CHD7 gene controls the developmental pathways as a transcriptional regulator in the nucleoplasm through chromatin organization. Mutational alterations lead according to the affected domains, and the structure of the nonfunctional CHD7 protein, to the perturbation of the regulation of the developmental pathways’ genes expression. CHD7 is demonstrated as an important component of neurogenesis through two neuronal determination factors: Sox4 and Sox11. While nonsense, frameshift and missense mutations are most common, deletions and duplications are less frequent. Moreover, while exon 3 is commonly altered, mutations of exon 8, which is related to the CHD7 protein chromodomain, are very rare. Phenotype-genotype correlations according to the type of genomic alteration of CHD7 gene are rarely published, particularly concerning behavioral and psychological features of CHARGE association. Here, physical disorders of our two patients seem to be different but behavioral features seem to be common. Multidisciplinary care is thus required for CHARGE syndrome and molecular analysis must be indicated because the type of the genomic alterations may be a key step for a more accurate management of physical and behavioral disorders. Disclosure of Interest None Declaredhttps://www.cambridge.org/core/product/identifier/S0924933823007678/type/journal_article
spellingShingle N. Bouayed Abdelmoula
B. Abdelmoula
Behavioral signs of CHARGE syndrome and CHD7 mutational spectrum
European Psychiatry
title Behavioral signs of CHARGE syndrome and CHD7 mutational spectrum
title_full Behavioral signs of CHARGE syndrome and CHD7 mutational spectrum
title_fullStr Behavioral signs of CHARGE syndrome and CHD7 mutational spectrum
title_full_unstemmed Behavioral signs of CHARGE syndrome and CHD7 mutational spectrum
title_short Behavioral signs of CHARGE syndrome and CHD7 mutational spectrum
title_sort behavioral signs of charge syndrome and chd7 mutational spectrum
url https://www.cambridge.org/core/product/identifier/S0924933823007678/type/journal_article
work_keys_str_mv AT nbouayedabdelmoula behavioralsignsofchargesyndromeandchd7mutationalspectrum
AT babdelmoula behavioralsignsofchargesyndromeandchd7mutationalspectrum