Treatment‐resistant schizophrenia with 22q11.2 deletion and additional genetic defects

Abstract We report a case of a 61‐year‐old female with 22q11.2 deletion syndrome (22q11.2DS) and a novel heterozygous nonsense variant in MAP1A, identified through whole‐genome sequencing (WGS). The patient presented with intellectual developmental disorder, treatment‐resistant schizophrenia (SCZ),...

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Main Authors: Sawako Furukawa, Shusei Arafuka, Hidekazu Kato, Tomoo Ogi, Norio Ozaki, Masashi Ikeda, Itaru Kushima
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:Neuropsychopharmacology Reports
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Online Access:https://doi.org/10.1002/npr2.12477
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author Sawako Furukawa
Shusei Arafuka
Hidekazu Kato
Tomoo Ogi
Norio Ozaki
Masashi Ikeda
Itaru Kushima
author_facet Sawako Furukawa
Shusei Arafuka
Hidekazu Kato
Tomoo Ogi
Norio Ozaki
Masashi Ikeda
Itaru Kushima
author_sort Sawako Furukawa
collection DOAJ
description Abstract We report a case of a 61‐year‐old female with 22q11.2 deletion syndrome (22q11.2DS) and a novel heterozygous nonsense variant in MAP1A, identified through whole‐genome sequencing (WGS). The patient presented with intellectual developmental disorder, treatment‐resistant schizophrenia (SCZ), and multiple congenital anomalies. Despite aggressive pharmacotherapy, she experienced persistent auditory hallucinations and negative symptoms. WGS revealed a 3 Mb deletion at 22q11.2 and a nonsense variant in MAP1A (c.4652T>G, p.Leu1551*). MAP1A, encoding microtubule‐associated protein 1A, is crucial for axon and dendrite development and has been implicated in autism spectrum disorder and SCZ. The MAP1A variant may contribute to the severe psychiatric phenotype, as it is thought to influence synaptic plasticity, a process also affected by 22q11.2 deletion. This case highlights the importance of WGS in identifying additional pathogenic variants that may explain phenotypic variability in 22q11.2DS. Thus, WGS can lead to a better understanding of the genetic architecture of 22q11.2DS. However, further studies are needed to elucidate the role of secondary genetic contributors in the diverse clinical presentations of 22q11.2DS.
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publishDate 2024-12-01
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series Neuropsychopharmacology Reports
spelling doaj-art-532c69a43b0c45068c05cf77d6eb5bfa2025-08-20T01:57:27ZengWileyNeuropsychopharmacology Reports2574-173X2024-12-0144484785110.1002/npr2.12477Treatment‐resistant schizophrenia with 22q11.2 deletion and additional genetic defectsSawako Furukawa0Shusei Arafuka1Hidekazu Kato2Tomoo Ogi3Norio Ozaki4Masashi Ikeda5Itaru Kushima6Department of Psychiatry Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Psychiatry Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Psychiatry Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Genetics Research Institute of Environmental Medicine (RIeM), Nagoya University Nagoya JapanPathophysiology of Mental Disorders Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Psychiatry Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Psychiatry Nagoya University Graduate School of Medicine Nagoya JapanAbstract We report a case of a 61‐year‐old female with 22q11.2 deletion syndrome (22q11.2DS) and a novel heterozygous nonsense variant in MAP1A, identified through whole‐genome sequencing (WGS). The patient presented with intellectual developmental disorder, treatment‐resistant schizophrenia (SCZ), and multiple congenital anomalies. Despite aggressive pharmacotherapy, she experienced persistent auditory hallucinations and negative symptoms. WGS revealed a 3 Mb deletion at 22q11.2 and a nonsense variant in MAP1A (c.4652T>G, p.Leu1551*). MAP1A, encoding microtubule‐associated protein 1A, is crucial for axon and dendrite development and has been implicated in autism spectrum disorder and SCZ. The MAP1A variant may contribute to the severe psychiatric phenotype, as it is thought to influence synaptic plasticity, a process also affected by 22q11.2 deletion. This case highlights the importance of WGS in identifying additional pathogenic variants that may explain phenotypic variability in 22q11.2DS. Thus, WGS can lead to a better understanding of the genetic architecture of 22q11.2DS. However, further studies are needed to elucidate the role of secondary genetic contributors in the diverse clinical presentations of 22q11.2DS.https://doi.org/10.1002/npr2.1247722q11.2 deletion syndromegenetics: Humanschizophrenia: Clinicaltreatment‐resistant schizophreniawhole‐genome sequencing
spellingShingle Sawako Furukawa
Shusei Arafuka
Hidekazu Kato
Tomoo Ogi
Norio Ozaki
Masashi Ikeda
Itaru Kushima
Treatment‐resistant schizophrenia with 22q11.2 deletion and additional genetic defects
Neuropsychopharmacology Reports
22q11.2 deletion syndrome
genetics: Human
schizophrenia: Clinical
treatment‐resistant schizophrenia
whole‐genome sequencing
title Treatment‐resistant schizophrenia with 22q11.2 deletion and additional genetic defects
title_full Treatment‐resistant schizophrenia with 22q11.2 deletion and additional genetic defects
title_fullStr Treatment‐resistant schizophrenia with 22q11.2 deletion and additional genetic defects
title_full_unstemmed Treatment‐resistant schizophrenia with 22q11.2 deletion and additional genetic defects
title_short Treatment‐resistant schizophrenia with 22q11.2 deletion and additional genetic defects
title_sort treatment resistant schizophrenia with 22q11 2 deletion and additional genetic defects
topic 22q11.2 deletion syndrome
genetics: Human
schizophrenia: Clinical
treatment‐resistant schizophrenia
whole‐genome sequencing
url https://doi.org/10.1002/npr2.12477
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