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Autosomal recessive form of periventricular heterotopia

From the Division of Neurogenetics (Drs. Sheen, Hill, and Walsh, A. Bodell, V.S. Ganesh, and T.J. Cherry), Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Institutes of Medicine, and Program in Biological and Biomedical Sciences (Dr. Walsh), Harvard Medical School, Boston, MA, and Department of Pediatric Epidemiology (Dr. Shugart), Johns Hopkins Medical School, Baltimore, MD; Department of Pediatric Neurology (Drs. Topçu and Yalnizoglu), Hacettepe University School of Medicine, Ihsan Dogramaci Children’s Hospital, Ankara, Turkey; Department of Neurology (Dr. Berkovic), University of Melbourne, Austin, and Repatriation Medical Centre, Heidelberg, Victoria, Australia; and Department of Neurology (Dr. Blatt), Chaim Sheba Medical Center, Ramat Gan, Israel.

Address correspondence and reprint requests to Dr. C. A. Walsh, Harvard Institutes of Medicine, 77 Ave. Louis Pasteur, Rm. 816, Boston, MA 02115; e-mail: cwalsh{at}caregroup.harvard.edu

Background: Familial periventricular heterotopia (PH) represents a disorder of neuronal migration resulting in multiple gray matter nodules along the lateral ventricular walls. Prior studies have shown that mutations in the filamin A (FLNA) gene can cause PH through an X-linked dominant inheritance pattern.

Objective: To classify cortical malformation syndromes associated with PH.

Methods: Analyses using microsatellite markers directed toward genomic regions of FLNA and to a highly homologous autosomal gene, FLNB, were performed on two pedigrees to evaluate for linkage with either filamin gene.

Results: Two consanguineous pedigrees with PH that suggest an autosomal recessive inheritance pattern are reported. MRI of the brain revealed periventricular nodules of cerebral gray matter intensity, typical for PH. Seizures or developmental delay appeared to be a common presenting feature. Microsatellite analysis suggested no linkage to FLNA or FLNB.

Conclusions: Autosomal recessive PH is another syndromic migrational disorder, distinct from X-linked dominant PH. Further classification of these different syndromes will provide an approach for genetic evaluation.

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