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Loss of Dp140 dystrophin isoform and intellectual impairment in Duchenne dystrophy

From the Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.) Eugenio Medea (Drs. Felisari, Bardoni, Sironi, Robotti, Turconi, Lai, and Bresolin), Bosisio Parini, Lecco; Dino Ferrari Centre, Institute of Clinical Neurology, University of Milan (Drs. Martinelli Boneschi, Comi, and Bresolin), I.R.C.C.S. Ospedale Maggiore Policlinico, Milan; and Statistical Department (Dr Corrao) University of Milan–Bicocca, Milan, Italy.

Address correspondence and reprint requests to Dr. Giorgio Felisari, I.R.C.C.S. E. Medea, Via Don Luigi Monza 20, 23842 Bosisio Parini (LC), Italy; e-mail: felisari{at}bp.lnf.it

BACKGROUND: Mental retardation is a clinical feature of Duchenne dystrophy (DD) and affects about one-third of patients. No clear association has been found between DNA mutations, protein expression, and IQ scores, although distal deletions in the dystrophin gene have been reported in association with intellectual impairment. A role for the brain distal dystrophin isoform Dp140 was suggested.

OBJECTIVE: To explore the possible association between cognitive impairment and DNA macrodeletions in the distal part of the gene, including Dp140 gene region.

METHODS: Sixty-six patients with DD received general intelligence assessment by Wechsler Intelligence Scales measuring full, verbal, and performance IQ. PCR analysis was performed to detect deletions in the dystrophin gene, and the Dp140 regulatory region was analyzed in a subgroup of 12 patients. Statistical analysis was performed by nonparametric Wilcoxon rank signed and rank sum tests.

RESULTS: Comparison of neuropsychological and genetic data revealed an association between distal macrodeletions and cognitive impairment (p < 0.001). Comparing deletions involving the Dp140 gene region with deletions presumably not altering Dp140 expression resulted in even greater significance.

CONCLUSIONS: These data suggest that in DD, distal dystrophin deletions are associated with intellectual impairment. This study highlights a possible role for the brain distal isoform Dp140 in normal cognitive development.

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