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Velo-Cardio-Facial Syndrome. PRINCIPAL INVESTIGATOR: Marek Kubicki, MD, PhD INVESTIGATORS: Zora Kikinis, PhD Sylvain Bouix, PhD Marc Niethammer, PhD Martha Shenton, PhD Christine Finn, MD Raju Kucherlapati, MD RESEARCH ASSISTANT: Doug Markant, BA. Velo-Cardio-Facial Syndrome (VCFS).
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Velo-Cardio-Facial Syndrome PRINCIPAL INVESTIGATOR: Marek Kubicki, MD, PhD INVESTIGATORS: Zora Kikinis, PhD Sylvain Bouix, PhD Marc Niethammer, PhD Martha Shenton, PhD Christine Finn, MD Raju Kucherlapati, MD RESEARCH ASSISTANT: Doug Markant, BA
Velo-Cardio-Facial Syndrome (VCFS) • Condition defined by Sphrintzen in 1978 • Chromosome 22 q11.2 deletion. Deletion of 1.5 to 3 Mb (single copies of 30 to 45 genes missing) • Prevalence 1 in every 4000 newborns
VCFS Symptoms • "velum" latin meaning soft palate Cleft palate, small or aplastic tonsils, hypernasal speech • “kardia" greek meaning heart VSD , right sided aortic arch, tetralogy of Fallot, aberrant subclavian artery • "facial" latin having to do with the face maxillary excess, malar flatness, facial asymmetry, thin upper lip, prominent nasal root, large nasal tip, pinched, hypoplastic base
Common Cognitive Deficits in VCFS • Psychomotor and perceptual deficits • Learning and memorydisabilities • Emotional abnormalities (flat affect and poor social interaction). • High incidence for schizophrenia and/or bipolar disorder in adult(30%VCFS patients developschizophrenia)
Neuroimaging Findings in VCFS • MRI case reports (most) • - high frequency of nonspecific white matter hyperintensities (30% of cases) • - cavum septi pellucidi (in 45% of cases) • MRI quantitative reports (few) • - Reduced volumes of regions related to language and verbal memory (superior temporal gyrus, hippocampus, amygdala and parietal lobe). • - Increased volume and posterior displacement of the corpus callosum • DTI (two studies) • - Reduced anisotropy in frontal, parietal, and temporal white matter • - Reduced anisotropy in white matter tracts connecting frontal and temporal lobes • - Reduced anisotropy in inferior parietal lobule which is correlated with scores from the arithmetic subscale of the WISC/WAIS, after co-varying for IQ and age of subjects.
Neuroimaging Findings in VCFS Cases with Schizophrenia • MRI (3 studies, only one with IQ matched populations) • - Decreased total gray and white matter volumes • - Increased total and sulcal CSF volumes. • - Decreased frontal, temporal and parietal gray matter volumes • - Increased corpus callosum volume • Based on scarce findings, VCFS investigators proposed a model, in which a deficiency in frontal maturation leads to a vulnerability for schizophrenia among individuals with VCFS • DTI • - None
VCFS Schizophrenia Candidate Genes • COMT (controls dopamine degradation in prefrontal cortex, related to attention and memory) • RTN4R(also known as Nogo-66 Receptor, related toaxonal regeneration and plasticity as well as myelin) • PRODH (one of the enzymes to convert proline to glutamate) • ZDH8 • SNAP29 • TBX1
Project • Subject recruitment • Psychological interview • DNA analysis, genotyping of the 22q11.2 region • Brain imaging (MRI and DTI on 3T) • Analysis of imaging data, and genetic correlations
Aims • Etiology of schizophrenia and related diseases • Prognosis of mental health diseases in VCFS • Early intervention
Hypotheses • Regions that we want to study with MRI • DLPC (COMT) • Orbital Frontal Gyrus (emotion) • Cingulate Gyrus (attention, emotion) • Hippocampus (memory, learning) Tracts that we want to study with DTI • Fornix (memory) • Arcuate Fasciculus (language) • Cingulum Bundle (attention) • Uncinate Fasciculus (emotion, affective flattening)
Potential Challenges for Atlas Based Scripts • Brain atrophy • Congenital abnormalities • Brain asymmetry • White matter lesions
Velo-Cardio-Facial Syndrome (VCFS) as a Genetic Model for Schizophrenia. PRINCIPAL INVESTIGATOR: Marek Kubicki, MD, PhD INVESTIGATORS: Zora Kikinis, PhD Sylvain Bouix, PhD Marc Niethammer, PhD Christine Finn, MD Raju Kucherlapati, MD Martha Shenton, PhD RESEARCH ASSISTANT: Doug Markant, BA • BACKGROUND: • VCFS is a rare genetic syndrome (single copies of 30-45 genes on 22 chromosome are missing) • 30% of patients with VCFS develop schizophrenia • AIMS: • To characterize anatomical similarities and dissimilarities between VCFS and Schizophrenia • To find “schizophrenia” genes • DATA: • DTI, MRI, haplotypes, neuropsychology