Chromosomal Microarray Analysis in Turkish Patients with Unexplained Developmental Delay and Intellectual Developmental Disorders

Hakan Gürkan; Emine İkbal Atli; Engin Atli; Leyla Bozatli; Mengühan Araz Altay; Sinem Yalçintepe; Yasemin Özen; Damla Eker; Çisem Akurut; Selma Demır; Işık Görker

doi:10.29399/npa.24890

Chromosomal Microarray Analysis in Turkish Patients with Unexplained Developmental Delay and Intellectual Developmental Disorders

Noro Psikiyatr Ars. 2020 May 5;57(3):177-191. doi: 10.29399/npa.24890. eCollection 2020 Sep.

Affiliations

¹ Faculty of Medicine, Department of Medical Genetics, Edirne, Trakya University, Edirne, Turkey.
² Faculty of Medicine, Department of Child and Adolescent Psychiatry, Trakya University, Edirne, Turkey.

Abstract

Introduction: Aneuploids, copy number variations (CNVs), and single nucleotide variants in specific genes are the main genetic causes of developmental delay (DD) and intellectual disability disorder (IDD). These genetic changes can be detected using chromosome analysis, chromosomal microarray (CMA), and next-generation DNA sequencing techniques. Therefore; In this study, we aimed to investigate the importance of CMA in determining the genomic etiology of unexplained DD and IDD in 123 patients.

Method: For 123 patients, chromosome analysis, DNA fragment analysis and microarray were performed. Conventional G-band karyotype analysis from peripheral blood was performed as part of the initial screening tests. FMR1 gene CGG repeat number and methylation analysis were carried out to exclude fragile X syndrome.

Results: CMA analysis was performed in 123 unexplained IDD/DD patients with normal karyotypes and fragile X screening, which were evaluated by conventional cytogenetics. Forty-four CNVs were detected in 39 (39/123=31.7%) patients. Twelve CNV variant of unknown significance (VUS) (9.75%) patients and 7 CNV benign (5.69%) patients were reported. In 6 patients, one or more pathogenic CNVs were determined. Therefore, the diagnostic efficiency of CMA was found to be 31.7% (39/123).

Conclusion: Today, genetic analysis is still not part of the routine in the evaluation of IDD patients who present to psychiatry clinics. A genetic diagnosis from CMA can eliminate genetic question marks and thus alter the clinical management of patients. Approximately one-third of the positive CMA findings are clinically intervenable. However, the emergence of CNVs as important risk factors for multiple disorders increases the need for individuals with comorbid neurodevelopmental conditions to be the priority where the CMA test is recommended.

Keywords: Copy number variations; chromosomal microarray; developmental delay; genetic testing; intellectual developmental disorder; mental retardation.