Genomics of human congenital hydrocephalus

Adam J. Kundishora, Amrita K. Singh, Garrett Allington, Phan Q. Duy, Jian Ryou, Seth L. Alper, Sheng Chih Jin, Kristopher T. Kahle

Research output: Contribution to journalArticlepeer-review

Abstract

Congenital hydrocephalus (CH), characterized by enlarged brain ventricles, is considered a disease of pathological cerebrospinal fluid (CSF) accumulation and, therefore, treated largely by neurosurgical CSF diversion. The persistence of ventriculomegaly and poor neurodevelopmental outcomes in some post-surgical patients highlights our limited knowledge of disease mechanisms. Recent whole-exome sequencing (WES) studies have shown that rare, damaging de novo and inherited mutations with large effect contribute to ~ 25% of sporadic CH. Interestingly, multiple CH genes are key regulators of neural stem cell growth and differentiation and converge in human transcriptional networks and cell types pertinent to fetal neurogliogenesis. These data implicate genetic disruption of early brain development as the primary pathomechanism in a substantial minority of patients with sporadic CH, shedding new light on human brain development and the pathogenesis of hydrocephalus. These data further suggest WES as a clinical tool with potential to re-classify CH according to a molecular nomenclature of increased precision and utility for genetic counseling, outcome prognostication, and treatment stratification.

Original languageEnglish
Pages (from-to)3325-3340
Number of pages16
JournalChild's Nervous System
Volume37
Issue number11
DOIs
StatePublished - Nov 2021

Keywords

  • Clinical diagnosis
  • Congenital hydrocephalus
  • Neurodevelopmental disorders

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