Tuberous Sclerosis Complex Clinical Trial
Official title:
The Cognitive Variability in Neurofibromatosis Type I and Tuberous Sclerosis Complex Monozygotic Twins
Both Neurofibromatosis type 1 (NF1) and Tuberous Sclerosis Complex (TSC) are highly
heterogeneous diseases. Cognitive features seem to vary widely even between family members
carrying the same mutation. This phenotypic variability is not well understood, but is
generally assumed to be caused by modifier genes which regulate the affected pathways.
However, recent studies brought forward an alternative explanation for the phenotypic
variability. Post-mortem studies showed that second hit mutations causing loss of the second
('healthy') allele are more widespread than previously believed. These loss of
heterozygosity (LOH) mutations cause bi-allelic loss of the disease-linked gene and are
known to cause the gross of somatic features in both diseases (like neurofibromas and
hamartomas). Hence, it could be the stochastic occurrence of second-hit mutations in the
brain are the cause of the variable cognitive phenotypes.
To investigate to what extent these LOH mutations in the brain contribute to the phenotype
and to what extent this variation is due to genetic modifiers factors is unknown. The
investigators therefore propose to elucidate this variability by comparing the correlation
of cognitive features of monozygotic twins with NF1 or TSC to healthy twins in the
population. If modifier genes are the cause of the variability of cognitive features in NF1
and TSC the investigators expect that the variability in cognitive tests in monozygotic
twins is the same as monozygotic twins in the healthy population. However, if the
variability is caused by the occurrence of LOH mutations, the investigators expect to have a
lower correlation in our monozygotic patients compared to the healthy twins.
n/a
Observational Model: Cohort, Time Perspective: Cross-Sectional
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