15q11q13 Microduplication Syndrome

Genetic MONDO:0012081 Pathograph 34 Show in embeddings browser hereditary disease chromosomal disorder

15q11q13 microduplication syndrome (Dup15q syndrome) is a recurrent chromosome 15q11.2-q13.1 copy-number disorder defined clinically by one or more extra maternally derived copies of the Prader-Willi/Angelman critical region. Core manifestations include hypotonia, motor and language delay, intellectual disability, autistic behavior, and variably severe epilepsy; feeding, gastrointestinal, behavioral, and sleep-physiology abnormalities also occur. Interstitial maternal duplications usually produce trisomy for the region, whereas a maternal isodicentric chromosome 15 usually contributes two extra copies and produces regional tetrasomy. UBE3A dosage and the duplicated GABAA receptor gene cluster are leading mechanistic candidates, but their respective contributions to the human phenotype remain incompletely resolved.

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1
Inheritance
5
Pathophys.
18
Phenotypes
2
Gaps
34
Pathograph
4
Genes
10
Medical Actions
3
Subtypes
4
Differentials
4
Trials
24
References
2
Deep Research
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Inheritance

1
Maternal parent-of-origin effect with subtype-dependent recurrence risk HP:0012274
Recurrence counseling depends on the structural subtype and parental origin. Unaffected parents of a child with de novo idic(15) generally have low recurrence risk, with residual concern for maternal germline mosaicism. If a mother carries an interstitial 15q11.2-q13.1 duplication, each child has a 50% risk of inheriting the duplication; prenatal or preimplantation genetic testing by chromosomal microarray can detect the duplication but cannot reliably predict severity.
Autosomal dominant inheritance with paternal imprinting De novo rate: Maternal idic(15) has been reported de novo in all affected individuals to date. Maternal interstitial 15q11.2-q13.1 duplication is de novo in approximately 85% of probands and maternally inherited in approximately 15%.
Parent-of-origin effect: The diagnosis of maternal Dup15q requires at least one extra maternally derived copy of the 15q11.2-q13.1 Prader-Willi/Angelman critical region. Paternal duplications do not define maternal Dup15q and show variable, generally milder outcomes, so parent of origin must be established rather than inferred from copy number alone.
Show evidence (5 references)
PMID:27308687 SUPPORT Human Clinical
"The diagnosis of maternal dup15q is established by detection of at least one extra maternally derived copy of the Prader-Willi/Angelman critical region"
GeneReviews defines maternal origin of the duplicated critical-region copy as central to the Dup15q diagnosis.
PMID:27308687 SUPPORT Human Clinical
"De novo in all affected individuals reported to date"
GeneReviews supports de novo occurrence as the rule for maternal idic(15), with residual recurrence risk from possible maternal germline mosaicism.
PMID:27308687 SUPPORT Human Clinical
"De novo in approximately 85% of probands and inherited from the mother in approximately 15%"
GeneReviews gives the subtype-specific de novo and inherited proportions for maternal interstitial 15q11.2-q13.1 duplications.
+ 2 more references

Subtypes

3
Interstitial 15q11-q13 duplication (int15)
Interstitial tandem duplication of 15q11-q13 on the maternal chromosome, typically adding one copy and producing regional trisomy. It is usually milder than idic15, with a lower frequency and later onset of epilepsy, but developmental, behavioral, and seizure phenotypes remain variable.
Isodicentric 15 (idic15)
Supernumerary isodicentric marker chromosome typically containing two extra copies of 15q11.2-q13.1 and producing regional tetrasomy. It is more strongly associated with severe, drug-resistant epilepsy than the interstitial subtype.
Mosaic idic15
Mosaic form of idic15 in which only a subset of cells carry the supernumerary isodicentric 15 chromosome, producing variable and often attenuated clinical severity relative to non-mosaic idic15.
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Discussions and Knowledge Gaps

2
Why do maternal-duplication mice reproduce the human beta EEG signature but not the abnormal human NREM-sleep phenotype, and which part of the model is appropriate for preclinical target-engagement studies?
HUMAN MODEL MISMATCH OPEN mismatch_dup15q_mouse_sleep_physiology
Chromosome-engineered maternal-duplication mice reproduce elevated beta oscillations across brain states, supporting use of beta power as a translational measurement. The same mice do not reproduce the abnormal NREM sleep architecture observed in children with Dup15q and retain normal NREM recovery after sleep deprivation. The agreement is therefore biomarker specific rather than evidence that the mouse faithfully models the broader human sleep phenotype. This distinction matters when a preclinical intervention changes beta power without demonstrating a patient-relevant sleep or behavioral effect.
Proposed experiments
Harmonized longitudinal human-mouse sleep EEG perturbation study
exp_dup15q_harmonized_human_mouse_sleep_eeg
Use matched spectral definitions, sleep-stage metrics, age windows, and medication annotations in longitudinal human Dup15q sleep EEG and maternal-duplication mice, then compare responses to the same target-engagement perturbation. Treat beta power and NREM architecture as separate outcomes and test whether either predicts patient-centered sleep measures.
Show evidence (2 references)
PMID:39014349 SUPPORT Model Organism
"Our study revealed that across brain states, matDp/+ mice mirrored the elevated beta oscillation phenotype observed in clinical EEGs from individuals with Dup15q syndrome."
This directly supports preservation of the human beta EEG signature in the maternal-duplication mouse across brain states.
PMID:39014349 SUPPORT Model Organism
"However, NREM sleep between Dup15q mutant and WT littermate mice remained unaltered, suggesting a divergence from the clinical presentation in humans."
This directly identifies the mouse-human NREM mismatch.
Does increased dosage of GABRB3, GABRA5, or GABRG3 generate the Dup15q beta EEG biomarker, and is that signal causally related to epilepsy or clinical outcomes rather than merely correlated with them?
KNOWLEDGE GAP OPEN gap_dup15q_gabaa_beta_clinical_causality
Human EEG establishes a stable beta biomarker and pharmacologic resemblance to GABAA-receptor modulation, but the exact mechanism remains unknown. A 2026 study using locally referenced beta power found cross-sectional correlations with cognitive and adaptive severity in participants without epilepsy, but not in those with epilepsy; the analyses were exploratory and uncorrected for multiple testing. Selective α5-receptor modulation normalized the measured behavioral phenotypes and partially normalized beta power in a paternal-duplication mouse model. Neither result establishes directionality or clinical treatment response, and the basmisanil trial terminated after only seven participants. Individual-gene perturbation and prospective human intervention data are still needed before the GABAA cluster, beta biomarker, clinical outcomes, and therapeutic response can be placed in one causal chain.
Proposed experiments
Isogenic GABAA-cluster dosage dissection in human neuronal networks
exp_dup15q_gabaa_gene_dosage_network_rescue
In patient-derived mixed excitatory-inhibitory neuronal cultures, normalize GABRB3, GABRA5, and GABRG3 singly and in combinations while leaving UBE3A dosage unchanged. Measure receptor composition, inhibitory currents, network beta oscillations, and epileptiform activity, then compare the rescued signatures with longitudinal human EEG and seizure outcomes.
Show evidence (3 references)
PMID:32791992 SUPPORT Human Clinical
"Although an exact mechanism of beta oscillations has not been elucidated in Dup15q syndrome"
This explicitly states that the gene-dosage mechanism remains unresolved.
PMID:32791992 SUPPORT Human Clinical
"We urge caution in not overinterpreting the relationship between epilepsy and beta oscillations, as without preclinical models to manipulate the underlying altered circuitry, we will not be able to prove directionality of the association."
This directly identifies the unresolved directionality between the beta biomarker and epilepsy.
PMID:42297774 SUPPORT Human Clinical
"The p-values (uncorrected for multiple testing) from our exploratory analyses should be interpreted as indicative of evidence strength rather than statistical conclusions."
The authors explicitly qualify the new clinical-severity correlations as exploratory, leaving replication and causal interpretation open.

Pathophysiology

5
Maternal 15q11-q13 dosage increase
One or more extra maternally derived copies of 15q11.2-q13.1 increase dosage of neuronal UBE3A and multiple biallelically expressed genes. Human genetic and cell-model data support UBE3A as an important contributor, but neither UBE3A nor the duplicated GABAA-receptor genes alone explain the full clinical phenotype.
neuron CL:0000540 Cell Ontology (CL) Relation: this pathophysiological event involves this cell type This pathophysiological event involves neuron (CL:0000540). CL:0000540 is a cell type from the Cell Ontology.
UBE3A hgnc:12496 HUGO Gene Nomenclature Committee (hgnc) Relation: this pathophysiological event involves this gene This pathophysiological event involves UBE3A (hgnc:12496). hgnc:12496 is a gene from the HUGO Gene Nomenclature Committee.
Show evidence (3 references)
PMID:25884337 SUPPORT Human Clinical
"Duplications of chromosome region 15q11-q13 with the maternal imprint are associated with a wide spectrum of neuropsychiatric disorders, including autism spectrum disorders, developmental delay, learning difficulties, schizophrenia, and seizures."
This supports maternal 15q11-q13 dosage increase as the initiating disease mechanism.
PMID:37029316 SUPPORT Human Clinical
"Maternally inherited duplications are always associated with a clinical phenotype (ranging from learning difficulties to intellectual impairment, epilepsy and psychiatric disorders), while paternal duplications are normal or associated with milder phenotypes (mild learning difficulties and dyslexia)."
This directly supports a parent-of-origin effect as a key driver of phenotypic impact in 15q11-q13 duplications.
PMID:36898382 SUPPORT In Vitro
"UBE3A, which encodes an E3 ubiquitin ligase, is likely a major driver of Dup15q because UBE3A is the only imprinted gene expressed solely from the maternal allele."
Patient-derived neuron experiments support UBE3A as a major imprinted dosage driver in Dup15q syndrome.
UBE3A-dependent neuronal hyperexcitability
Patient-derived Dup15q neurons show hyperexcitability that is largely prevented by normalizing UBE3A dosage. UBE3A overexpression alone did not reproduce all synaptic phenotypes, indicating that it is necessary for many observed cellular abnormalities but is not sufficient to explain Dup15q.
neuron CL:0000540 Cell Ontology (CL) Relation: this pathophysiological event involves this cell type This pathophysiological event involves neuron (CL:0000540). CL:0000540 is a cell type from the Cell Ontology.
UBE3A hgnc:12496 HUGO Gene Nomenclature Committee (hgnc) Relation: this pathophysiological event involves this gene This pathophysiological event involves UBE3A (hgnc:12496). hgnc:12496 is a gene from the HUGO Gene Nomenclature Committee.
regulation of membrane potential GO:0042391 Gene Ontology (GO) Relation: this pathophysiological event involves this biological process This pathophysiological event involves increased regulation of membrane potential (GO:0042391). GO:0042391 is a biological process from the Gene Ontology. ↑ INCREASED chemical synaptic transmission GO:0007268 Gene Ontology (GO) Relation: this pathophysiological event involves this biological process This pathophysiological event involves chemical synaptic transmission (GO:0007268). GO:0007268 is a biological process from the Gene Ontology.
Show evidence (1 reference)
PMID:36898382 SUPPORT In Vitro
"Dup15q neurons exhibited hyperexcitability compared with control neurons, and this phenotype was generally prevented by normalizing UBE3A levels using antisense oligonucleotides. Overexpression of UBE3A resulted in a profile similar to that of Dup15q neurons except for synaptic phenotypes. These..."
This patient-derived, CRISPR-corrected neuron study directly links UBE3A overexpression to Dup15q neuronal hyperexcitability while acknowledging that other duplicated genes may also contribute.
GABAA-receptor-associated beta oscillations
The duplicated interval includes GABRB3, GABRA5, and GABRG3, and the characteristic Dup15q beta EEG pattern resembles pharmacologic GABAA-receptor modulation. The precise molecular mechanism is not established, and human data do not prove that the beta signal causes epilepsy, sleep disruption, or behavioral impairment.
neuron CL:0000540 Cell Ontology (CL) Relation: this pathophysiological event involves this cell type This pathophysiological event involves neuron (CL:0000540). CL:0000540 is a cell type from the Cell Ontology.
GABRB3 hgnc:4083 HUGO Gene Nomenclature Committee (hgnc) Relation: this pathophysiological event involves this gene This pathophysiological event involves GABRB3 (hgnc:4083). hgnc:4083 is a gene from the HUGO Gene Nomenclature Committee. GABRA5 hgnc:4079 HUGO Gene Nomenclature Committee (hgnc) Relation: this pathophysiological event involves this gene This pathophysiological event involves GABRA5 (hgnc:4079). hgnc:4079 is a gene from the HUGO Gene Nomenclature Committee. GABRG3 hgnc:4088 HUGO Gene Nomenclature Committee (hgnc) Relation: this pathophysiological event involves this gene This pathophysiological event involves GABRG3 (hgnc:4088). hgnc:4088 is a gene from the HUGO Gene Nomenclature Committee.
gamma-aminobutyric acid signaling pathway GO:0007214 Gene Ontology (GO) Relation: this pathophysiological event involves this biological process This pathophysiological event involves gamma-aminobutyric acid signaling pathway (GO:0007214). GO:0007214 is a biological process from the Gene Ontology.
Show evidence (3 references)
PMID:32791992 SUPPORT Human Clinical
"an electrophysiological biomarker of the syndrome, characterized by excessive beta oscillations (12-30 Hz), resembling electroencephalogram (EEG) changes induced by allosteric modulation of GABAARs."
This supports an association between the Dup15q beta EEG phenotype and GABAA-receptor pharmacology without establishing causation.
PMID:32791992 SUPPORT Human Clinical
"Although an exact mechanism of beta oscillations has not been elucidated in Dup15q syndrome"
This explicitly frames the GABAA-gene interpretation as a mechanistic hypothesis rather than an established causal pathway.
PMID:41491842 SUPPORT Model Organism
"EEG recordings showed increased beta-power in 15q dup mice - which resembled the spectral signature of subjects with Dup15q - and was partially normalized following RO4938581 treatment."
Selective α5-receptor modulation provides experimental support for the GABAA/beta hypothesis. The study used small groups of all-male mice with a paternal-equivalent duplication, and partial EEG rescue does not establish the mechanism or therapeutic effect in people with maternal Dup15q.
Sodium channel dysfunction
Dup15q neurons show abnormal sodium-channel kinetics with increased sodium current density and altered inactivation. These findings come from an isogenic patient-derived in-vitro model and have not yet established a clinical treatment target.
neuron CL:0000540 Cell Ontology (CL) Relation: this pathophysiological event involves this cell type This pathophysiological event involves neuron (CL:0000540). CL:0000540 is a cell type from the Cell Ontology.
Show evidence (1 reference)
PMID:37329181 SUPPORT In Vitro
"Dup15q neurons showed increased sodium current density and a depolarizing shift in steady-state inactivation."
This directly supports sodium-channel dysfunction in Dup15q neurons.
Epileptogenic network dysfunction
Cellular hyperexcitability and sodium-current abnormalities provide candidate substrates for an epilepsy-prone network state. Their relative contribution to human Dup15q epilepsy and its subtype-dependent severity remains unresolved.
Show evidence (1 reference)
PMID:42184160 SUPPORT Human Clinical
"Epilepsy is highly prevalent (60%-80%), drug-resistant, and may progress to developmental epileptic encephalopathies (DEEs) such as Lennox-Gastaut syndrome (LGS)."
This supports the human epilepsy outcome, while the upstream network mechanism remains a provisional synthesis of cellular evidence.

Pathograph

Use the checkboxes to hide or show graph categories. Hover nodes for evidence and cross-linked metadata.
Pathograph: causal mechanism network for 15q11q13 Microduplication Syndrome Interactive directed graph showing how pathophysiology mechanisms, phenotypes, genetic factors and variants, experimental models, environmental triggers, and treatments relate through causal and linked edges.

Phenotypes

18
Digestive 3
Feeding difficulties HP:0011968 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Feeding difficulties (HP:0011968). HP:0011968 is a phenotype from the Human Phenotype Ontology.
Show evidence (2 references)
PMID:19019226 SUPPORT Human Clinical
"Feeding difficulties are reported in the newborn period."
This directly supports neonatal feeding difficulties in idic(15); it does not establish a frequency for all Dup15q structural subtypes.
PMID:42297774 SUPPORT Human Clinical
"Hypotonia and feeding difficulties in infancy and global developmental delay, including motor, cognitive and language impairments, and intellectual disability are the most frequent features"
This recent human Dup15q study directly identifies feeding difficulties in infancy without supplying a precise feature-specific frequency.
Constipation FREQUENT HP:0002019 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Constipation (HP:0002019). HP:0002019 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
PMID:25573720 SUPPORT Human Clinical
"The most commonly reported symptoms were gastroesophageal reflux (56.7%) and constipation (60%), with 30% of subjects reporting both."
Constipation occurred in 60% of this 46-person retrospective cohort, which falls in the FREQUENT band (30-79%).
Gastroesophageal reflux FREQUENT HP:0002020 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Gastroesophageal reflux (HP:0002020). HP:0002020 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
PMID:25573720 SUPPORT Human Clinical
"The most commonly reported symptoms were gastroesophageal reflux (56.7%) and constipation (60%), with 30% of subjects reporting both."
Gastroesophageal reflux occurred in 56.7% of this 46-person retrospective cohort, which falls in the FREQUENT band (30-79%).
Musculoskeletal 1
Hypotonia HP:0001252 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Hypotonia (HP:0001252). HP:0001252 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
PMID:24239951 SUPPORT Human Clinical
"Duplications are clinically characterized by a variable phenotype that includes central hypotonia, developmental delay, speech delay, seizure, minor dysmorphic features and autism."
This directly supports hypotonia in Dup15q syndrome.
Nervous System 10
Global developmental delay HP:0001263 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Global developmental delay (HP:0001263). HP:0001263 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
PMID:42184160 SUPPORT Human Clinical
"All patients had early developmental delay"
This directly supports early developmental delay in a multicenter cohort spanning inversion-duplication and interstitial-duplication subgroups.
Motor delay HP:0001270 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Motor delay (HP:0001270). HP:0001270 is a phenotype from the Human Phenotype Ontology.
Show evidence (2 references)
PMID:27308687 SUPPORT Human Clinical
"Maternal 15q duplication syndrome (maternal dup15q) is characterized by hypotonia and motor delays"
GeneReviews directly identifies motor delay as a defining clinical characteristic of maternal Dup15q.
PMID:19019226 SUPPORT Human Clinical
"it seems that sitting is achieved between 10 and 20 months of age, and walking between 2 and 3 years"
This provides milestone context for the more severe idic(15) subtype; it is not generalized as a precise timetable for all Dup15q subtypes.
Gait disturbance HP:0001288 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Gait disturbance (HP:0001288). HP:0001288 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
PMID:32282133 SUPPORT Human Clinical
"We found a gait pattern of slow pace, poor postural control, and large gait variability in dup15q syndrome."
Quantitative walkway testing directly supports gait disturbance in a 39-person Dup15q cohort. Participants had to walk without assistance, so the study cannot estimate prevalence across the full clinical spectrum.
Autistic behavior FREQUENT HP:0000729 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Autistic behavior (HP:0000729). HP:0000729 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
PMID:24239951 SUPPORT Human Clinical
"Phenotypic features were somewhat variable and 57% presented with autism."
Autism was reported in 57% of this 30-person clinical cohort, which falls in the FREQUENT band (30-79%).
Delayed speech and language development HP:0000750 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Delayed speech and language development (HP:0000750). HP:0000750 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
PMID:24239951 SUPPORT Human Clinical
"Duplications are clinically characterized by a variable phenotype that includes central hypotonia, developmental delay, speech delay, seizure, minor dysmorphic features and autism."
This clinical cohort directly identifies speech delay as a Dup15q phenotype.
Intellectual disability HP:0001249 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Intellectual disability (HP:0001249). HP:0001249 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
PMID:27308687 SUPPORT Human Clinical
"Maternal 15q duplication syndrome (maternal dup15q) is characterized by hypotonia and motor delays, intellectual disability, autism spectrum disorder (ASD), and epilepsy including infantile spasms."
GeneReviews directly identifies intellectual disability as a defining clinical characteristic.
Atypical behavior FREQUENT HP:0000708 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Atypical behavior (HP:0000708). HP:0000708 is a phenotype from the Human Phenotype Ontology.
Show evidence (4 references)
PMID:42184160 SUPPORT Human Clinical
"behavioral disorders in 30 of 54 (56%)."
Behavioral disorders occurred in 30/54 participants (56%), which falls in the FREQUENT band (30-79%); the abstract did not subdivide behavior types.
PMID:19019226 SUPPORT Human Clinical
"Hyperactivity has been reported in a number of cases"
This supports reported hyperactivity in idic(15) while leaving its syndrome-wide frequency and structural-subtype distribution unknown.
PMID:19019226 SUPPORT Human Clinical
"Stereotypies are frequently seen"
This supports stereotyped behavior in idic(15), without establishing its frequency across all maternal Dup15q structural subtypes.
+ 1 more reference
Psychosis VERY_RARE HP:0000709 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Psychosis (HP:0000709). HP:0000709 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
PMID:27308687 SUPPORT Human Clinical
"Rarely, maternal dup15q may also be associated with psychosis or sudden unexplained death."
GeneReviews explicitly describes psychosis as rare; VERY_RARE encodes that qualitative statement without implying a measured prevalence.
Seizure FREQUENT HP:0001250 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Seizure (HP:0001250). HP:0001250 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
PMID:42184160 SUPPORT Human Clinical
"Epilepsy was present in 29 of 54 (54%) patients"
Epilepsy affected 29/54 participants (54%), which falls in the FREQUENT band (30-79%); the broad onset range also documents clinical variability.
Abnormal sleep physiology Sleep disturbance HP:0002360 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Abnormal sleep physiology, annotated with Sleep disturbance (HP:0002360). HP:0002360 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
PMID:34344470 SUPPORT Human Clinical
"Children with Dup15q syndrome showed abnormal sleep physiology with elevated beta power, reduced spindle density, and reduced or absent SWS compared to age-matched neurotypical controls."
This directly supports abnormal sleep physiology while avoiding an unsupported inference about the prevalence of clinical sleep complaints.
Constitutional 1
Sudden unexpected death in epilepsy HP:0033258 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Sudden unexpected death in epilepsy (HP:0033258). HP:0033258 is a phenotype from the Human Phenotype Ontology.
Show evidence (2 references)
PMID:27308687 SUPPORT Human Clinical
"Rarely, maternal dup15q may also be associated with psychosis or sudden unexplained death."
GeneReviews supports a rare sudden-death association, but its wording does not establish that every reported unexplained death met SUDEP criteria.
PMID:41751547 SUPPORT Human Clinical
"While idic15 is more strongly associated with refractory epilepsy and SUDEP"
This clinical review specifically associates SUDEP more strongly with the idic15 subtype; it does not quantify absolute risk.
Growth 1
Growth delay HP:0001510 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Growth delay (HP:0001510). HP:0001510 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
PMID:19019226 SUPPORT Human Clinical
"Growth is retarded in about 20%–30% of the patients."
This supports growth delay in idic(15); the 20%–30% estimate is not generalized to people with interstitial maternal duplications.
Other 2
Infantile spasms HP:0012469 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Infantile spasms (HP:0012469), qualified as infantile onset. HP:0012469 is a phenotype from the Human Phenotype Ontology.
Onset: INFANTILE
Show evidence (1 reference)
PMID:24502430 SUPPORT Human Clinical
"For the 83 with idic(15), 63% were reported to have seizures, of which 81% had multiple seizure types and 42% had infantile spasms."
The family survey directly supports infantile spasms in seizure-positive idic(15); the 42% is conditional on reported seizures and is not modeled as whole-disease frequency.
Abnormality of the face HP:0000271 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Abnormality of the face (HP:0000271). HP:0000271 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
PMID:19019226 SUPPORT Human Clinical
"Facial dysmorphic features are absent or subtle, and major malformations are rare."
This supports subtle facial dysmorphism while emphasizing that it may be absent and is not a reliable diagnostic hallmark.
🧬

Genetic Associations

4
Maternal 15q11-q13 duplication (Causal chromosomal duplication)
Show evidence (4 references)
PMID:27308687 SUPPORT Human Clinical
"typically comprising two extra copies of 15q11.2-q13.1 and resulting in tetrasomy for 15q11.2-q13.1"
GeneReviews directly supports two additional critical-region copies and regional tetrasomy in the common idic(15) subtype.
PMID:27308687 SUPPORT Human Clinical
"A maternal interstitial 15q11.2-q13.1 duplication that typically includes one extra copy of 15q11.2-q13.1 within chromosome 15, resulting in trisomy for 15q11.2-q13.1 (~20-40%)."
GeneReviews directly supports one additional critical-region copy and regional trisomy in the interstitial subtype.
PMID:39457428 SUPPORT Human Clinical
"The 15q11.2q13 chromosomal region is particularly susceptible to chromosomal rearrangements due to low-copy repeats (LCRs) located inside this area."
This supports the LCR-mediated mechanism responsible for recurrent 15q11-q13 duplications.
+ 1 more reference
GABRB3 duplicated-region dosage (Duplicated GABA-A receptor subunit gene in the 15q11.2-q13.1 region)
Gene: GABRB3 hgnc:4083 HUGO Gene Nomenclature Committee (hgnc) Relation: this disease-associated gene is this gene This disease-associated gene is GABRB3 (hgnc:4083). hgnc:4083 is a gene from the HUGO Gene Nomenclature Committee.
Show evidence (1 reference)
PMID:34344470 SUPPORT Human Clinical
"a cluster of gamma-aminobutyric acid type A receptor (GABAAR) genes, GABRB3, GABRA5, and GABRG3, which encode the β3, α5 and γ3 receptor subunits, respectively."
This identifies GABRB3 as one of the duplicated GABA-A receptor subunit genes in the 15q11.2-q13.1 critical region.
GABRA5 duplicated-region dosage (Duplicated GABA-A receptor subunit gene in the 15q11.2-q13.1 region)
Gene: GABRA5 hgnc:4079 HUGO Gene Nomenclature Committee (hgnc) Relation: this disease-associated gene is this gene This disease-associated gene is GABRA5 (hgnc:4079). hgnc:4079 is a gene from the HUGO Gene Nomenclature Committee.
Show evidence (1 reference)
PMID:34344470 SUPPORT Human Clinical
"a cluster of gamma-aminobutyric acid type A receptor (GABAAR) genes, GABRB3, GABRA5, and GABRG3, which encode the β3, α5 and γ3 receptor subunits, respectively."
This identifies GABRA5 as one of the duplicated GABA-A receptor subunit genes in the 15q11.2-q13.1 critical region.
GABRG3 duplicated-region dosage (Duplicated GABA-A receptor subunit gene in the 15q11.2-q13.1 region)
Gene: GABRG3 hgnc:4088 HUGO Gene Nomenclature Committee (hgnc) Relation: this disease-associated gene is this gene This disease-associated gene is GABRG3 (hgnc:4088). hgnc:4088 is a gene from the HUGO Gene Nomenclature Committee.
Show evidence (1 reference)
PMID:34344470 SUPPORT Human Clinical
"a cluster of gamma-aminobutyric acid type A receptor (GABAAR) genes, GABRB3, GABRA5, and GABRG3, which encode the β3, α5 and γ3 receptor subunits, respectively."
This identifies GABRG3 as one of the duplicated GABA-A receptor subunit genes in the 15q11.2-q13.1 critical region.
🗃️

External Assertions

1
OMIM chromosome 15q11-q13 duplication syndrome record
OMIM disease record OMIM:608636
OMIM entry for chromosome 15q11-q13 duplication syndrome, cataloguing the clinical features and molecular basis of Dup15q syndrome.
💊

Medical Actions

10
Supportive care
Action: Supportive CareNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is Supportive Care (NCIT:C15747). NCIT:C15747 is a clinical intervention from the NCI Thesaurus. NCIT:C15747
Multidisciplinary supportive care is central, especially for developmental, feeding, communication, educational, and behavioral management. Core services include physical therapy for hypotonia and gross motor delay, occupational therapy for fine-motor and adaptive skills, speech-language therapy with augmentative and alternative communication when needed, feeding therapy, behavioral therapy such as applied behavior analysis, and psychotropic medication when behavioral manifestations require medication.
Show evidence (1 reference)
PMID:27308687 SUPPORT Human Clinical
"Supportive care may include: feeding therapy, occupational and physical therapy, alternative and augmentative communication, behavioral therapy (e.g., applied behavioral analysis therapy), psychotropic medications for behavioral manifestations"
GeneReviews supports the specific developmental, communication, feeding, behavioral, and psychotropic components of supportive management.
Gastrointestinal symptom management
Action: supportive careNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is supportive care (NCIT:C15747). NCIT:C15747 is a clinical intervention from the NCI Thesaurus. Ontology label: Supportive Care NCIT:C15747
Gastrointestinal symptoms should be actively assessed because presentation can be atypical in nonverbal or minimally verbal individuals. In a retrospective Dup15q cohort, polyethylene glycol was the most commonly reported treatment for constipation and proton-pump inhibitors for reflux; treatment remains individualized rather than syndrome specific.
Target Phenotypes: Constipation HP:0002019 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Constipation (HP:0002019). HP:0002019 is a phenotype from the Human Phenotype Ontology. Gastroesophageal reflux HP:0002020 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Gastroesophageal reflux (HP:0002020). HP:0002020 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
PMID:25573720 SUPPORT Human Clinical
"The most common treatments were polyethylene glycol for constipation and proton pump inhibitors for reflux."
This documents treatments used in a retrospective cohort; it does not establish comparative efficacy or a Dup15q-specific regimen.
Individualized epilepsy treatment
Action: PharmacotherapyNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is Pharmacotherapy (NCIT:C15986). NCIT:C15986 is a clinical intervention from the NCI Thesaurus. NCIT:C15986
Epilepsy treatment is tailored to seizure type and syndrome. Family-survey and retrospective multicenter data associate broad-spectrum antiseizure medications, oxcarbazepine, and valproate with responses in subsets; the survey also found ACTH more effective than vigabatrin for infantile spasms. These nonrandomized findings do not establish a universal hierarchy.
Target Phenotypes: Seizure HP:0001250 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Seizure (HP:0001250). HP:0001250 is a phenotype from the Human Phenotype Ontology. Infantile spasms HP:0012469 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Infantile spasms (HP:0012469). HP:0012469 is a phenotype from the Human Phenotype Ontology.
Show evidence (3 references)
PMID:24502430 SUPPORT Human Clinical
"Broad spectrum antiepileptic drugs (AEDs) were the most effective medications, but carbamazepine and oxcarbazepine were also effective, although typical benzodiazepines were relatively ineffective."
This supports differential reported responses while the study's questionnaire design and low return rate preclude a treatment hierarchy.
PMID:24502430 SUPPORT Human Clinical
"For those with infantile spasms, adrenocorticotropic hormone (ACTH) was more effective than vigabatrin."
This supports the observed ACTH-versus-vigabatrin difference only within a small, family-reported subgroup and is not treated as definitive guidance.
PMID:42184160 SUPPORT Human Clinical
"The most effective antiseizure drugs were oxcarbazepine for focal (9/11, 81%) and for generalized (2/3, 67%) epilepsy and valproic acid (6/10, 60%) for generalized epilepsy"
The recent retrospective cohort supports response associations in small subgroups; it does not provide randomized comparative efficacy.
Seizure trigger avoidance and surveillance
Action: supportive careNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is supportive care (NCIT:C15747). NCIT:C15747 is a clinical intervention from the NCI Thesaurus. Ontology label: Supportive Care NCIT:C15747
Families should receive counseling on avoidable seizure triggers such as sleep deprivation and stress. Clinical follow-up should separately monitor for new seizures or changes in seizure type and assess nutritional status and growth.
Target Phenotypes: Seizure HP:0001250 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Seizure (HP:0001250). HP:0001250 is a phenotype from the Human Phenotype Ontology. Feeding difficulties HP:0011968 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Feeding difficulties (HP:0011968). HP:0011968 is a phenotype from the Human Phenotype Ontology. Growth delay HP:0001510 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Growth delay (HP:0001510). HP:0001510 is a phenotype from the Human Phenotype Ontology.
Show evidence (2 references)
PMID:27308687 SUPPORT Human Clinical
"Agents/circumstances to avoid: Seizure triggers (e.g., sleep deprivation, stress)."
GeneReviews explicitly identifies seizure-trigger avoidance as management guidance for maternal Dup15q.
PMID:27308687 SUPPORT Human Clinical
"Surveillance: Growth and nutritional assessment at each visit. Periodic: neurodevelopmental and/or developmental/behavioral assessments, and monitoring for evidence of seizures and/or change in seizure type."
GeneReviews directly supports routine growth and nutritional assessment plus periodic developmental, behavioral, and seizure surveillance.
Ketogenic diet for epilepsy
Action: ketogenic diet intakeNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is ketogenic diet intake, annotated with Ketogenic Diet (NCIT:C173168). NCIT:C173168 is a clinical intervention from the NCI Thesaurus. Ontology label: Ketogenic Diet NCIT:C173168
GeneReviews lists ketogenic diet management by an experienced neurologist as an option in maternal Dup15q epilepsy. The cited source provides no Dup15q-specific efficacy estimate, so this is specialist-guided standard epilepsy care rather than a syndrome-specific efficacy claim.
Target Phenotypes: Seizure HP:0001250 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Seizure (HP:0001250). HP:0001250 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
"ketogenic diets by experienced neurologist"
GeneReviews includes ketogenic diet among specialist-directed epilepsy options but does not provide a Dup15q-specific estimate of benefit.
Vagus nerve stimulation for epilepsy
Action: vagus nerve stimulationNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is vagus nerve stimulation, annotated with Peripheral Nerve Stimulation (NCIT:C21025). NCIT:C21025 is a clinical intervention from the NCI Thesaurus. Ontology label: Peripheral Nerve Stimulation NCIT:C21025
GeneReviews lists vagus nerve stimulation by an experienced neurologist as an option in maternal Dup15q epilepsy. The source does not provide Dup15q-specific comparative efficacy data, so candidacy and expected benefit require individualized specialist assessment.
Target Phenotypes: Seizure HP:0001250 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Seizure (HP:0001250). HP:0001250 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
"Standardized treatment w/ASM, vagus nerve stimulators"
GeneReviews includes vagus nerve stimulation among specialist-directed epilepsy options without establishing syndrome-specific efficacy.
Seizure education and rescue planning
Action: supportive careNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is supportive care (NCIT:C15747). NCIT:C15747 is a clinical intervention from the NCI Thesaurus. Ontology label: Supportive Care NCIT:C15747
Parents and caregivers should be taught common seizure presentations and basic seizure safety. For people at risk of prolonged seizures or status epilepticus, the treating clinician should provide an individualized rescue-medication plan; the cited examples are guidance, not prescriptions for every person with Dup15q.
Target Phenotypes: Seizure HP:0001250 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Seizure (HP:0001250). HP:0001250 is a phenotype from the Human Phenotype Ontology.
Show evidence (2 references)
"Education of parents/caregivers regarding common seizure presentations is appropriate."
GeneReviews directly supports caregiver education about seizure recognition.
"status epilepticus may be prevented with the use of rescue medications such as rectal diazepam or nasal midazolam."
GeneReviews supports clinician-directed rescue planning for status prevention; the specific agents are examples and require individualized prescribing and instruction.
Genetic counseling
Action: Genetic CounselingNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is Genetic Counseling (NCIT:C15240). NCIT:C15240 is a clinical intervention from the NCI Thesaurus. NCIT:C15240
Genetic counseling should address maternal parent-of-origin effects, subtype-specific de novo versus inherited recurrence risk, maternal interstitial duplication transmission risk, testing of at-risk siblings, and prenatal or preimplantation testing options.
Show evidence (2 references)
PMID:27308687 SUPPORT Human Clinical
"Evaluation of relatives at risk: Consider genetic testing of sibs of a proband"
GeneReviews supports genetic counseling and testing for relatives at risk of inherited maternal interstitial 15q11.2-q13.1 duplication.
PMID:37029316 SUPPORT Human Clinical
"We recommend reporting 15q11-q13 duplications identified during genome-wide NIPS with appropriate genetic counselling for these pregnant women in the interest of both mothers and future children."
This supports the need for genetic counseling when 15q11-q13 duplications are detected, especially in prenatal screening contexts.
Investigational soticlestat
Action: pharmacotherapyNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is pharmacotherapy (NCIT:C15986). NCIT:C15986 is a clinical intervention from the NCI Thesaurus. Ontology label: Pharmacotherapy NCIT:C15986
Agent: soticlestat CHEBI:233158 Chemical Entities of Biological Interest (CHEBI) Relation: this treatment uses this therapeutic agent This treatment uses soticlestat (CHEBI:233158). CHEBI:233158 is a therapeutic agent from Chemical Entities of Biological Interest.
Soticlestat (TAK-935/OV935), a cholesterol 24-hydroxylase inhibitor, was evaluated in eight participants with Dup15q syndrome in the open-label phase II ARCADE trial. During maintenance, median motor-seizure frequency increased 11.7% while all-seizure frequency decreased 23.4%; the small, uncontrolled, discordant results are inconclusive for efficacy.
Target Phenotypes: Seizure HP:0001250 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Seizure (HP:0001250). HP:0001250 is a phenotype from the Human Phenotype Ontology.
Show evidence (2 references)
PMID:37011526 SUPPORT Human Clinical
"Soticlestat administration during the maintenance period was associated with a median change from baseline in motor seizure frequency of +11.7% in the Dup15q syndrome group"
The prespecified motor-seizure endpoint worsened in the eight-person, open-label Dup15q subgroup, preventing an efficacy claim.
PMID:37011526 SUPPORT Human Clinical
"Reductions in all seizure frequency of -23.4% and -30.5% were also observed during the maintenance period in the Dup15q syndrome group and the CDD group, respectively."
The secondary all-seizure measure moved in the opposite direction from the motor-seizure endpoint, underscoring that this small uncontrolled signal is inconclusive.
Investigational all-trans-retinoic acid
Action: pharmacotherapyNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is pharmacotherapy (NCIT:C15986). NCIT:C15986 is a clinical intervention from the NCI Thesaurus. Ontology label: Pharmacotherapy NCIT:C15986
Agent: all-trans-retinoic acid CHEBI:15367 Chemical Entities of Biological Interest (CHEBI) Relation: this treatment uses this therapeutic agent This treatment uses all-trans-retinoic acid (CHEBI:15367). CHEBI:15367 is a therapeutic agent from Chemical Entities of Biological Interest.
All-trans-retinoic acid (ATRA) is under investigation for autism-related outcomes in Dup15q syndrome. Registry records describe an early-phase crossover study and a separate phase II single-group study assessing ADOS-2; neither registry provides efficacy results.
Target Phenotypes: Autistic behavior HP:0000729 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Autistic behavior (HP:0000729). HP:0000729 is a phenotype from the Human Phenotype Ontology.
Show evidence (2 references)
clinicaltrials:NCT05281965 SUPPORT Human Clinical
"Therefore, retinoic acid supplementation in the treatment of dup15q syndrome is a potential therapeutic target."
The early-phase crossover registry supports ATRA as investigational and does not provide efficacy results.
clinicaltrials:NCT07079696 SUPPORT Human Clinical
"This study aims to evaluate ATRA treatment in children with Dup15q syndrome-related autism , assessing changes in their ADOS-2 scores , to potentially provide a novel therapeutic approach for autism treatment."
Phase II trial registry record supports ATRA as an investigational therapy for Dup15q-related autistic behavior.
🔬

Diagnosis

4
Chromosomal copy-number, structure, and parent-of-origin testing
Chromosomal microarray or array-CGH detects the 15q11.2-q13.1 copy-number gain and its extent. Karyotype and FISH help define a supernumerary isodicentric chromosome or mosaicism, while methylation or parental-marker analysis establishes the parent of origin required for maternal Dup15q.
genetic testing NCIT:C15709 NCI Thesaurus (NCIT)
Show evidence (4 references)
PMID:39457428 SUPPORT Human Clinical
"In the present study, a total of 14 pre- and postnatal cases were diagnosed as 15q11.2q13 duplication carriers using Affymetrix CytoScan 750 K array-CGH, and our analysis combined these with 120 cases existing in the literature."
This directly supports chromosomal microarray/array-CGH copy-number testing as a diagnostic method for Dup15q.
PMID:27308687 SUPPORT Human Clinical
"The diagnosis of maternal dup15q is established by detection of at least one extra maternally derived copy of the Prader-Willi/Angelman critical region, a region approximately 5 Mb long within chromosome region 15q11.2-q13.1."
GeneReviews supports detection of the extra maternally derived Prader-Willi/Angelman critical-region copy as the diagnostic basis of maternal Dup15q.
PMID:19019226 SUPPORT Human Clinical
"Diagnosis is achieved by standard cytogenetics and FISH analysis, using probes both from proximal chromosome 15 and from the PWS/ASCR."
This directly supports cytogenetics plus FISH for defining idic(15) structure.
+ 1 more reference
Maternal CNV detection during genome-wide NIPS
Low-coverage genome-wide cell-free DNA screening can incidentally identify a 15q11-q13 duplication carried by the pregnant woman. Such a maternal finding is not a fetal diagnosis: it requires confirmatory maternal testing, genetic counseling, and separate assessment of fetal inheritance when indicated.
prenatal genome-wide NIPS NCIT:C15709 NCI Thesaurus (NCIT)
Show evidence (1 reference)
PMID:37029316 SUPPORT Human Clinical
"We recommend reporting 15q11-q13 duplications identified during genome-wide NIPS with appropriate genetic counselling for these pregnant women in the interest of both mothers and future children."
This supports reporting 15q11-q13 duplications surfaced in pregnant women during genome-wide NIPS with counseling; it does not establish fetal Dup15q.
Electroencephalography
Awake and sleep EEG is used to characterize seizure types and epilepsy severity. Diffuse fast or beta activity is a recognizable syndrome-associated pattern, but EEG does not replace genetic confirmation.
electroencephalography NCIT:C38054 NCI Thesaurus (NCIT)
Show evidence (1 reference)
PMID:24239951 SUPPORT Human Clinical
"18 patients had an abnormal EEG with a typical, recognizable pattern of excessive diffuse rapid spikes in the waking record, similar to the pattern observed after benzodiazepine exposure."
This directly supports EEG as an abnormal diagnostic finding.
EEG beta oscillation biomarker
Elevated beta power is a stable, reproducible electrophysiologic biomarker of Dup15q and a candidate pharmacodynamic or target-engagement readout. A locally referenced beta-power metric correlated with cognitive and adaptive scores in participants without epilepsy, but not in the epilepsy subgroup; this exploratory result requires replication and does not establish causal direction or treatment responsiveness.
electroencephalography NCIT:C38054 NCI Thesaurus (NCIT)
Show evidence (3 references)
PMID:32791992 SUPPORT Human Clinical
"an electrophysiological biomarker of the syndrome, characterized by excessive beta oscillations (12-30 Hz), resembling electroencephalogram (EEG) changes induced by allosteric modulation of GABAARs."
This defines the characteristic Dup15q beta oscillation EEG biomarker and links it to GABAAR allosteric modulation.
PMID:32791992 SUPPORT Human Clinical
"Beta power and peak frequency showed high stability across repeated visits (beta power ICC = 0.93, BPF ICC = 0.92). A reproducibility analysis revealed that beta power estimates are comparable between research and clinical EEG (ICC = 0.94)."
This supports elevated beta oscillations as a stable and clinically reproducible EEG biomarker in Dup15q syndrome.
PMID:42297774 SUPPORT Human Clinical
"The correlations between LRPβ and clinical scores in children with Dup15q syndrome without epilepsy were significant for all scores investigated"
Locally referenced beta power correlated with cognitive and adaptive severity in the subgroup without epilepsy. The exploratory analyses used one-sided, uncorrected tests and did not find corresponding associations in participants with epilepsy, so clinical qualification remains incomplete.
📈

Progression

2
Infancy and early development
Age: Congenital origin with infantile presentation
Central hypotonia, delayed acquisition of motor milestones, feeding difficulties, and global developmental delay commonly become apparent in infancy or early childhood. Speech and language development is particularly affected, and autistic or other behavioral features may emerge with age.
Show evidence (2 references)
PMID:19019226 SUPPORT Human Clinical
"The inv dup(15) or idic(15) syndrome displays distinctive clinical findings represented by early central hypotonia, developmental delay and intellectual disability, epilepsy, and autistic behaviour."
This open-access clinical review supports the early developmental phase, particularly for the usually more severe idic(15) subtype.
PMID:19019226 SUPPORT Human Clinical
"Feeding difficulties are reported in the newborn period."
This directly supports neonatal feeding difficulty as part of the early idic(15) presentation.
Epilepsy evolution
Age: Infancy through adulthood
Epilepsy may begin with infantile spasms or with focal or generalized seizures later in childhood. Multiple seizure types can accumulate, and a substantial subgroup develops drug-resistant developmental and epileptic encephalopathy, including Lennox-Gastaut syndrome; onset and severity are generally earlier and greater with idic15 than with int15.
Show evidence (2 references)
PMID:24502430 SUPPORT Human Clinical
"Seizures are common in idic(15) and typically difficult to control, often presenting with infantile spasms and progressing to a Lennox-Gastaut-type syndrome."
The family survey supports the characteristic infantile-spasm-to-mixed, drug-resistant epilepsy trajectory while its low response rate limits population-level precision.
PMID:42184160 SUPPORT Human Clinical
"Initial seizures were mostly focal motor (10/29, 34%) and generalized tonic-clonic seizures (8/29, 28%), later evolving to tonic, myoclonic, and atypical absence seizures."
This multicenter retrospective cohort directly documents evolution from initial seizures to multiple later seizure types.
🔀

Differential Diagnoses

4

Conditions with similar clinical presentations that must be differentiated from 15q11q13 Microduplication Syndrome:

Paternal 15q11.2-q13.1 duplication
Overlapping Features The same 15q11.2-q13.1 copy-number gain can be paternal rather than maternal. Paternal duplications are generally normal or associated with milder, variable findings and do not define maternal Dup15q, so parent-of-origin testing is the direct discriminator.
Show evidence (1 reference)
PMID:37029316 SUPPORT Human Clinical
"Maternally inherited duplications are always associated with a clinical phenotype (ranging from learning difficulties to intellectual impairment, epilepsy and psychiatric disorders), while paternal duplications are normal or associated with milder phenotypes (mild learning difficulties and dyslexia)."
This supports paternal duplication as the most direct parent-of-origin alternative to maternal Dup15q while preserving its variable impact.
Overlapping Features Angelman syndrome overlaps because it involves the same imprinted region but typically reflects loss of UBE3A function rather than duplication.
Overlapping Features Severe infantile hypotonia and feeding difficulty can initially suggest Prader-Willi syndrome. Both disorders involve the same imprinted region, but Prader-Willi syndrome reflects loss of paternally expressed 15q11-q13 genes rather than an extra maternally derived critical-region copy.
Overlapping Features Autism spectrum disorder is part of the Dup15q phenotype and may dominate the presentation before the chromosomal duplication is recognized.
🔬

Clinical Trials

4
NCT03694275 PHASE_II COMPLETED
ARCADE was an open-label phase II soticlestat signal-finding study in participants with Dup15q syndrome or CDKL5 deficiency disorder and motor seizures. Eight participants with Dup15q received treatment; median motor seizures increased 11.7% during maintenance while all seizures decreased 23.4%, leaving efficacy inconclusive.
Target Phenotypes: Seizure HP:0001250 Human Phenotype Ontology (HP) Relation: this clinical trial targets this phenotype This clinical trial targets Seizure (HP:0001250). HP:0001250 is a phenotype from the Human Phenotype Ontology.
Show evidence (2 references)
clinicaltrials:NCT03694275 SUPPORT Human Clinical
"The purpose of this study is to investigate the effect of soticlestat on the frequency of motor seizures for participants with Dup15q or CDD during the Maintenance Period."
ClinicalTrials.gov documents a completed soticlestat trial targeting motor seizure frequency in Dup15q syndrome.
PMID:37011526 SUPPORT Human Clinical
"Soticlestat treatment was associated with an increase in motor seizure frequency in patients with Dup15q syndrome."
The published ARCADE results show worsening of the motor-seizure endpoint in the Dup15q subgroup; the small open-label design and discordant all-seizure result prevent an efficacy conclusion.
NCT05281965 PHASE_I UNKNOWN
Early-phase randomized crossover study evaluating retinoic acid in patients with 15q11-q13 duplication syndrome. The registry was last updated in March 2022 and still listed recruiting despite an estimated 2024 completion, with no posted results; current status is therefore UNKNOWN.
Target Phenotypes: Autistic behavior HP:0000729 Human Phenotype Ontology (HP) Relation: this clinical trial targets this phenotype This clinical trial targets Autistic behavior (HP:0000729). HP:0000729 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
clinicaltrials:NCT05281965 SUPPORT Human Clinical
"Therefore, retinoic acid supplementation in the treatment of dup15q syndrome is a potential therapeutic target."
ClinicalTrials.gov documents an early-phase retinoic-acid trial motivated by UBE3A-related Dup15q biology.
NCT07079696 PHASE_II NOT_RECRUITING
Phase II single-group all-trans retinoic acid study in children ages 3 to 7 years with Dup15q syndrome-related autism. The registry lists an estimated enrollment of 90 and status NOT_YET_RECRUITING, last verified in June 2025, with no results; NOT_RECRUITING is the closest available schema status.
Target Phenotypes: Autistic behavior HP:0000729 Human Phenotype Ontology (HP) Relation: this clinical trial targets this phenotype This clinical trial targets Autistic behavior (HP:0000729). HP:0000729 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
clinicaltrials:NCT07079696 SUPPORT Human Clinical
"This study aims to evaluate ATRA treatment in children with Dup15q syndrome-related autism , assessing changes in their ADOS-2 scores , to potentially provide a novel therapeutic approach for autism treatment."
ClinicalTrials.gov documents a larger phase II all-trans retinoic acid study targeting Dup15q-related autistic behavior.
NCT05307679 PHASE_II TERMINATED
Phase II randomized study of basmisanil, a GABAA receptor negative allosteric modulator, in children and adolescents with Dup15q syndrome. The sponsor terminated the study following a sponsor decision unrelated to safety or tolerability. Seven participants were randomized and none completed the planned study, so the posted results cannot support efficacy conclusions.
Show evidence (1 reference)
clinicaltrials:NCT05307679 SUPPORT Human Clinical
"Part 1 will test the hypothesis that negative allosteric modulation of a GABAA receptor subtype can address excessive receptor function and positively impact core neurodevelopmental disease feature in individuals with Dup15q syndrome."
ClinicalTrials.gov documents the mechanistic rationale and planned design of the terminated phase II basmisanil trial; the registry's sparse enrollment and early termination preclude efficacy interpretation.
{ }

Source YAML

click to show
name: 15q11q13 Microduplication Syndrome
creation_date: "2026-04-15T23:46:24Z"
synonyms:
- Dup15q syndrome
- Duplication 15q11q13 syndrome
- 15q11-q13 duplication syndrome
- 15q11.2-q13.1 duplication syndrome
- Chromosome 15q11-q13 duplication syndrome
description: >-
  15q11q13 microduplication syndrome (Dup15q syndrome) is a recurrent chromosome
  15q11.2-q13.1 copy-number disorder defined clinically by one or more extra
  maternally derived copies of the Prader-Willi/Angelman critical region. Core
  manifestations include hypotonia, motor and language delay, intellectual
  disability, autistic behavior, and variably severe epilepsy; feeding,
  gastrointestinal, behavioral, and sleep-physiology abnormalities also occur.
  Interstitial maternal duplications usually produce trisomy for the region,
  whereas a maternal isodicentric chromosome 15 usually contributes two extra
  copies and produces regional tetrasomy. UBE3A dosage and the duplicated GABAA
  receptor gene cluster are leading mechanistic candidates, but their respective
  contributions to the human phenotype remain incompletely resolved.
category: Genetic
parents:
- hereditary disease
- chromosomal disorder
disease_term:
  preferred_term: 15q11q13 microduplication syndrome
  term:
    id: MONDO:0012081
    label: 15q11q13 microduplication syndrome
external_assertions:
- name: OMIM chromosome 15q11-q13 duplication syndrome record
  source: OMIM
  assertion_type: disease_record
  external_id: OMIM:608636
  description: >-
    OMIM entry for chromosome 15q11-q13 duplication syndrome, cataloguing the
    clinical features and molecular basis of Dup15q syndrome.
inheritance:
- name: Maternal parent-of-origin effect with subtype-dependent recurrence risk
  inheritance_term:
    preferred_term: Autosomal dominant inheritance with paternal imprinting
    term:
      id: HP:0012274
      label: Autosomal dominant inheritance with paternal imprinting
  parent_of_origin_effect: >-
    The diagnosis of maternal Dup15q requires at least one extra maternally
    derived copy of the 15q11.2-q13.1 Prader-Willi/Angelman critical region.
    Paternal duplications do not define maternal Dup15q and show variable,
    generally milder outcomes, so parent of origin must be established rather
    than inferred from copy number alone.
  de_novo_rate: >-
    Maternal idic(15) has been reported de novo in all affected individuals to
    date. Maternal interstitial 15q11.2-q13.1 duplication is de novo in
    approximately 85% of probands and maternally inherited in approximately
    15%.
  description: >-
    Recurrence counseling depends on the structural subtype and parental origin.
    Unaffected parents of a child with de novo idic(15) generally have low
    recurrence risk, with residual concern for maternal germline mosaicism. If a
    mother carries an interstitial 15q11.2-q13.1 duplication, each child has a
    50% risk of inheriting the duplication; prenatal or preimplantation genetic
    testing by chromosomal microarray can detect the duplication but cannot
    reliably predict severity.
  evidence:
  - reference: PMID:27308687
    reference_title: Maternal 15q Duplication Syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The diagnosis of maternal dup15q is established by detection of at least
      one extra maternally derived copy of the Prader-Willi/Angelman critical
      region
    explanation: >-
      GeneReviews defines maternal origin of the duplicated critical-region copy
      as central to the Dup15q diagnosis.
  - reference: PMID:27308687
    reference_title: Maternal 15q Duplication Syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: De novo in all affected individuals reported to date
    explanation: >-
      GeneReviews supports de novo occurrence as the rule for maternal idic(15),
      with residual recurrence risk from possible maternal germline mosaicism.
  - reference: PMID:27308687
    reference_title: Maternal 15q Duplication Syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: De novo in approximately 85% of probands and inherited from the mother in approximately 15%
    explanation: >-
      GeneReviews gives the subtype-specific de novo and inherited proportions
      for maternal interstitial 15q11.2-q13.1 duplications.
  - reference: PMID:27308687
    reference_title: Maternal 15q Duplication Syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: the risk to each child of inheriting the duplication is 50%
    explanation: >-
      GeneReviews supports 50% recurrence risk when the mother carries the
      interstitial duplication.
  - reference: PMID:27308687
    reference_title: Maternal 15q Duplication Syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Prenatal testing or preimplantation genetic testing using chromosomal
      microarray (CMA) will detect the 15q interstitial duplication
    explanation: >-
      GeneReviews supports prenatal and preimplantation testing availability
      when the familial duplication is known.
has_subtypes:
- name: int15
  display_name: Interstitial 15q11-q13 duplication (int15)
  description: >-
    Interstitial tandem duplication of 15q11-q13 on the maternal chromosome,
    typically adding one copy and producing regional trisomy. It is usually
    milder than idic15, with a lower frequency and later onset of epilepsy, but
    developmental, behavioral, and seizure phenotypes remain variable.
- name: idic15
  display_name: Isodicentric 15 (idic15)
  description: >-
    Supernumerary isodicentric marker chromosome typically containing two extra
    copies of 15q11.2-q13.1 and producing regional tetrasomy. It is more strongly
    associated with severe, drug-resistant epilepsy than the interstitial
    subtype.
- name: Mosaic idic15
  description: >-
    Mosaic form of idic15 in which only a subset of cells carry the
    supernumerary isodicentric 15 chromosome, producing variable and often
    attenuated clinical severity relative to non-mosaic idic15.
progression:
- phase: Infancy and early development
  age_range: Congenital origin with infantile presentation
  notes: >-
    Central hypotonia, delayed acquisition of motor milestones, feeding
    difficulties, and global developmental delay commonly become apparent in
    infancy or early childhood. Speech and language development is particularly
    affected, and autistic or other behavioral features may emerge with age.
  evidence:
  - reference: PMID:19019226
    reference_title: The inv dup (15) or idic (15) syndrome (Tetrasomy 15q).
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The inv dup(15) or idic(15) syndrome displays distinctive clinical findings
      represented by early central hypotonia, developmental delay and intellectual
      disability, epilepsy, and autistic behaviour.
    explanation: >-
      This open-access clinical review supports the early developmental phase,
      particularly for the usually more severe idic(15) subtype.
  - reference: PMID:19019226
    reference_title: The inv dup (15) or idic (15) syndrome (Tetrasomy 15q).
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Feeding difficulties are reported in the newborn period.
    explanation: >-
      This directly supports neonatal feeding difficulty as part of the early
      idic(15) presentation.
- phase: Epilepsy evolution
  age_range: Infancy through adulthood
  notes: >-
    Epilepsy may begin with infantile spasms or with focal or generalized
    seizures later in childhood. Multiple seizure types can accumulate, and a
    substantial subgroup develops drug-resistant developmental and epileptic
    encephalopathy, including Lennox-Gastaut syndrome; onset and severity are
    generally earlier and greater with idic15 than with int15.
  evidence:
  - reference: PMID:24502430
    reference_title: A survey of seizures and current treatments in 15q duplication syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Seizures are common in idic(15) and typically difficult to control, often
      presenting with infantile spasms and progressing to a Lennox-Gastaut-type
      syndrome.
    explanation: >-
      The family survey supports the characteristic infantile-spasm-to-mixed,
      drug-resistant epilepsy trajectory while its low response rate limits
      population-level precision.
  - reference: PMID:42184160
    reference_title: >-
      Epileptic and developmental encephalopathy secondary to inversion-duplication
      of chromosome 15: Description of epilepsy characteristics and therapeutic outcomes.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Initial seizures were mostly focal motor (10/29, 34%) and generalized
      tonic-clonic seizures (8/29, 28%), later evolving to tonic, myoclonic, and
      atypical absence seizures.
    explanation: >-
      This multicenter retrospective cohort directly documents evolution from
      initial seizures to multiple later seizure types.
pathophysiology:
- name: Maternal 15q11-q13 dosage increase
  description: >-
    One or more extra maternally derived copies of 15q11.2-q13.1 increase dosage
    of neuronal UBE3A and multiple biallelically expressed genes. Human genetic
    and cell-model data support UBE3A as an important contributor, but neither
    UBE3A nor the duplicated GABAA-receptor genes alone explain the full clinical
    phenotype.
  genes:
  - preferred_term: UBE3A
    term:
      id: hgnc:12496
      label: UBE3A
  cell_types:
  - preferred_term: neuron
    term:
      id: CL:0000540
      label: neuron
  evidence:
  - reference: PMID:25884337
    reference_title: >-
      15q11.2 Duplication Encompassing Only the UBE3A Gene Is Associated with
      Developmental Delay and Neuropsychiatric Phenotypes.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Duplications of chromosome region 15q11-q13 with the maternal imprint are
      associated with a wide spectrum of neuropsychiatric disorders, including
      autism spectrum disorders, developmental delay, learning difficulties,
      schizophrenia, and seizures.
    explanation: >-
      This supports maternal 15q11-q13 dosage increase as the initiating
      disease mechanism.
  - reference: PMID:37029316
    reference_title: >-
      Population screening for 15q11-q13 duplications: corroboration of the
      difference in impact between maternally and paternally inherited alleles.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Maternally inherited duplications are always associated with a clinical
      phenotype (ranging from learning difficulties to intellectual impairment,
      epilepsy and psychiatric disorders), while paternal duplications are normal
      or associated with milder phenotypes (mild learning difficulties and dyslexia).
    explanation: >-
      This directly supports a parent-of-origin effect as a key driver of
      phenotypic impact in 15q11-q13 duplications.
  - reference: PMID:36898382
    reference_title: >-
      The role of UBE3A in the autism and epilepsy-related Dup15q syndrome using
      patient-derived, CRISPR-corrected neurons.
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: >-
      UBE3A, which encodes an E3 ubiquitin ligase, is likely a major driver of
      Dup15q because UBE3A is the only imprinted gene expressed solely from the
      maternal allele.
    explanation: >-
      Patient-derived neuron experiments support UBE3A as a major imprinted
      dosage driver in Dup15q syndrome.
  downstream:
  - target: UBE3A-dependent neuronal hyperexcitability
    description: >-
      Increased maternal UBE3A dosage contributes to neuronal hyperexcitability
      in patient-derived neurons.
    causal_link_type: DIRECT
  - target: GABAA-receptor-associated beta oscillations
    description: >-
      The duplicated GABAA-receptor gene cluster is associated with the
      characteristic beta EEG signal, although the molecular route remains
      unresolved.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
  - target: Sodium channel dysfunction
    description: >-
      Patient-derived Dup15q neurons show altered sodium-current density and
      inactivation kinetics downstream of the chromosomal duplication.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
  - target: Global developmental delay
    description: >-
      The maternal duplication causes developmental impairment through cellular
      intermediates that remain incompletely resolved.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
  - target: Motor delay
    description: >-
      Early motor-milestone delay is a core consequence of the maternal
      duplication, with unresolved cellular intermediates.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
  - target: Gait disturbance
    description: >-
      Gait abnormalities accompany the motor phenotype, but the contributions
      of hypotonia, cognition, medication, and specific neural circuits remain
      unresolved.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
  - target: Delayed speech and language development
    description: >-
      Speech and language development is impaired through unresolved
      neurodevelopmental mechanisms.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
  - target: Intellectual disability
    description: >-
      Cognitive impairment follows the maternal dosage increase through
      unresolved developmental mechanisms.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
  - target: Autistic behavior
    description: >-
      Autistic behavior is strongly associated with the maternal duplication,
      but no single-gene or single-circuit route is established.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
  - target: Hypotonia
    description: >-
      Central hypotonia is an early manifestation with incompletely resolved
      cellular intermediates.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
  - target: Feeding difficulties
    description: >-
      Feeding difficulties occur in infancy, including the newborn period in
      idic15, with unresolved links to hypotonia and other developmental
      abnormalities.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
  - target: Growth delay
    description: >-
      Growth delay is reported in idic15, but its relationship to the duplicated
      interval, feeding difficulties, and other clinical factors is unresolved.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
  - target: Atypical behavior
    description: >-
      Behavioral abnormalities accompany the neurodevelopmental phenotype, but
      the causal cellular route is unresolved.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
  - target: Psychosis
    description: >-
      Psychosis is a rare neuropsychiatric manifestation with unresolved
      mechanistic intermediates.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
  - target: Constipation
    description: >-
      Gastrointestinal dysfunction is common, but its relationship to the
      duplicated interval has not been resolved in humans.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
  - target: Gastroesophageal reflux
    description: >-
      Gastroesophageal reflux is a recurrent gastrointestinal manifestation with
      unresolved mechanistic intermediates.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
  - target: Abnormality of the face
    description: >-
      Facial dysmorphic features are usually subtle and arise through unresolved
      developmental mechanisms.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
  - target: Abnormal sleep physiology
    description: >-
      Human sleep EEG shows abnormal NREM architecture, but its causal relation
      to individual duplicated genes and beta oscillations is unresolved.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
- name: UBE3A-dependent neuronal hyperexcitability
  description: >-
    Patient-derived Dup15q neurons show hyperexcitability that is largely
    prevented by normalizing UBE3A dosage. UBE3A overexpression alone did not
    reproduce all synaptic phenotypes, indicating that it is necessary for many
    observed cellular abnormalities but is not sufficient to explain Dup15q.
  mechanism_confidence: PROVISIONAL
  genes:
  - preferred_term: UBE3A
    term:
      id: hgnc:12496
      label: UBE3A
  cell_types:
  - preferred_term: neuron
    term:
      id: CL:0000540
      label: neuron
  biological_processes:
  - preferred_term: regulation of membrane potential
    term:
      id: GO:0042391
      label: regulation of membrane potential
    modifier: INCREASED
  - preferred_term: chemical synaptic transmission
    term:
      id: GO:0007268
      label: chemical synaptic transmission
  evidence:
  - reference: PMID:36898382
    reference_title: >-
      The role of UBE3A in the autism and epilepsy-related Dup15q syndrome
      using patient-derived, CRISPR-corrected neurons.
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: >-
      Dup15q neurons exhibited hyperexcitability compared with control neurons,
      and this phenotype was generally prevented by normalizing UBE3A levels
      using antisense oligonucleotides. Overexpression of UBE3A resulted in a
      profile similar to that of Dup15q neurons except for synaptic phenotypes.
      These results indicate that UBE3A overexpression is necessary for most
      Dup15q cellular phenotypes but also suggest a role for other genes in the
      duplicated region.
    explanation: >-
      This patient-derived, CRISPR-corrected neuron study directly links UBE3A
      overexpression to Dup15q neuronal hyperexcitability while acknowledging
      that other duplicated genes may also contribute.
  downstream:
  - target: Epileptogenic network dysfunction
    description: >-
      Increased excitability in cultured patient-derived neurons is a plausible
      substrate for epilepsy, but the intervening human network mechanisms have
      not been demonstrated.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
    evidence:
    - reference: PMID:36898382
      reference_title: >-
        The role of UBE3A in the autism and epilepsy-related Dup15q syndrome
        using patient-derived, CRISPR-corrected neurons.
      supports: SUPPORT
      evidence_source: IN_VITRO
      snippet: >-
        Dup15q neurons exhibited hyperexcitability compared with control
        neurons, and this phenotype was generally prevented by normalizing UBE3A
        levels using antisense oligonucleotides.
      explanation: >-
        This establishes the cellular hyperexcitability premise; extrapolation
        from the in-vitro phenotype to human epileptogenic networks remains
        provisional.
- name: GABAA-receptor-associated beta oscillations
  description: >-
    The duplicated interval includes GABRB3, GABRA5, and GABRG3, and the
    characteristic Dup15q beta EEG pattern resembles pharmacologic GABAA-receptor
    modulation. The precise molecular mechanism is not established, and human
    data do not prove that the beta signal causes epilepsy, sleep disruption, or
    behavioral impairment.
  mechanism_confidence: HYPOTHETICAL
  genes:
  - preferred_term: GABRB3
    term:
      id: hgnc:4083
      label: GABRB3
  - preferred_term: GABRA5
    term:
      id: hgnc:4079
      label: GABRA5
  - preferred_term: GABRG3
    term:
      id: hgnc:4088
      label: GABRG3
  cell_types:
  - preferred_term: neuron
    term:
      id: CL:0000540
      label: neuron
  biological_processes:
  - preferred_term: gamma-aminobutyric acid signaling pathway
    term:
      id: GO:0007214
      label: gamma-aminobutyric acid signaling pathway
  evidence:
  - reference: PMID:32791992
    reference_title: Properties of beta oscillations in Dup15q syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      an electrophysiological biomarker of the syndrome, characterized by
      excessive beta oscillations (12-30 Hz), resembling electroencephalogram
      (EEG) changes induced by allosteric modulation of GABAARs.
    explanation: >-
      This supports an association between the Dup15q beta EEG phenotype and
      GABAA-receptor pharmacology without establishing causation.
  - reference: PMID:32791992
    reference_title: Properties of beta oscillations in Dup15q syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Although an exact mechanism of beta oscillations has not been elucidated
      in Dup15q syndrome
    explanation: >-
      This explicitly frames the GABAA-gene interpretation as a mechanistic
      hypothesis rather than an established causal pathway.
  - reference: PMID:41491842
    reference_title: >-
      RO4938581, a GABA(A)-α5 negative allosteric modulator rescued behavioral
      and EEG phenotypes of a mouse model of Dup15q syndrome.
    supports: SUPPORT
    evidence_source: MODEL_ORGANISM
    snippet: >-
      EEG recordings showed increased beta-power in 15q dup mice - which
      resembled the spectral signature of subjects with Dup15q - and was
      partially normalized following RO4938581 treatment.
    explanation: >-
      Selective α5-receptor modulation provides experimental support for the
      GABAA/beta hypothesis. The study used small groups of all-male mice with a
      paternal-equivalent duplication, and partial EEG rescue does not establish
      the mechanism or therapeutic effect in people with maternal Dup15q.
- name: Sodium channel dysfunction
  description: >-
    Dup15q neurons show abnormal sodium-channel kinetics with increased sodium
    current density and altered inactivation. These findings come from an
    isogenic patient-derived in-vitro model and have not yet established a
    clinical treatment target.
  mechanism_confidence: PROVISIONAL
  cell_types:
  - preferred_term: neuron
    term:
      id: CL:0000540
      label: neuron
  evidence:
  - reference: PMID:37329181
    reference_title: >-
      Dysfunctional sodium channel kinetics as a novel epilepsy mechanism in
      chromosome 15q11-q13 duplication syndrome.
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: >-
      Dup15q neurons showed increased sodium current density and a depolarizing
      shift in steady-state inactivation.
    explanation: >-
      This directly supports sodium-channel dysfunction in Dup15q neurons.
  downstream:
  - target: Epileptogenic network dysfunction
    description: >-
      Dysfunctional sodium-channel inactivation is linked to other epilepsies,
      but the route from the cultured-cell phenotype to human Dup15q seizures is
      unresolved.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
- name: Epileptogenic network dysfunction
  description: >-
    Cellular hyperexcitability and sodium-current abnormalities provide candidate
    substrates for an epilepsy-prone network state. Their relative contribution
    to human Dup15q epilepsy and its subtype-dependent severity remains
    unresolved.
  mechanism_confidence: PROVISIONAL
  evidence:
  - reference: PMID:42184160
    reference_title: >-
      Epileptic and developmental encephalopathy secondary to inversion-duplication
      of chromosome 15: Description of epilepsy characteristics and therapeutic outcomes.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Epilepsy is highly prevalent (60%-80%), drug-resistant, and may progress to
      developmental epileptic encephalopathies (DEEs) such as Lennox-Gastaut
      syndrome (LGS).
    explanation: >-
      This supports the human epilepsy outcome, while the upstream network
      mechanism remains a provisional synthesis of cellular evidence.
  downstream:
  - target: Seizure
    description: >-
      Epileptogenic network dysfunction manifests as seizures of variable
      severity.
    causal_link_type: DIRECT
  - target: Infantile spasms
    description: >-
      Infantile spasms are an early epilepsy presentation, especially in the
      idic15 subtype.
    causal_link_type: DIRECT
  - target: Sudden unexpected death in epilepsy
    description: >-
      SUDEP is a serious complication reported particularly with the more
      epilepsy-prone idic15 subtype.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
phenotypes:
- name: Global developmental delay
  description: >-
    Developmental delay begins early and is a core manifestation across Dup15q
    structural subtypes.
  phenotype_term:
    preferred_term: Global developmental delay
    term:
      id: HP:0001263
      label: Global developmental delay
  evidence:
  - reference: PMID:42184160
    reference_title: >-
      Epileptic and developmental encephalopathy secondary to inversion-duplication
      of chromosome 15: Description of epilepsy characteristics and therapeutic outcomes.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: All patients had early developmental delay
    explanation: >-
      This directly supports early developmental delay in a multicenter cohort
      spanning inversion-duplication and interstitial-duplication subgroups.
- name: Motor delay
  description: >-
    Acquisition of motor milestones is delayed; the more severe idic15 phenotype
    commonly includes sitting and independent walking well after typical ages.
  phenotype_term:
    preferred_term: Motor delay
    term:
      id: HP:0001270
      label: Motor delay
  evidence:
  - reference: PMID:27308687
    reference_title: Maternal 15q Duplication Syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Maternal 15q duplication syndrome (maternal dup15q) is characterized by
      hypotonia and motor delays
    explanation: >-
      GeneReviews directly identifies motor delay as a defining clinical
      characteristic of maternal Dup15q.
  - reference: PMID:19019226
    reference_title: The inv dup (15) or idic (15) syndrome (Tetrasomy 15q).
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      it seems that sitting is achieved between 10 and 20 months of age, and
      walking between 2 and 3 years
    explanation: >-
      This provides milestone context for the more severe idic(15) subtype; it
      is not generalized as a precise timetable for all Dup15q subtypes.
- name: Gait disturbance
  description: >-
    Among independently ambulatory people with Dup15q, quantitative gait testing
    found a slower pace, poorer postural control, and greater step and stride
    variability. The study excluded people unable to walk without assistance and
    does not establish a syndrome-wide frequency or a cerebellar mechanism.
  phenotype_term:
    preferred_term: Gait disturbance
    term:
      id: HP:0001288
      label: Gait disturbance
  evidence:
  - reference: PMID:32282133
    reference_title: >-
      Quantitative Gait Analysis in Duplication 15q Syndrome and Nonsyndromic ASD.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      We found a gait pattern of slow pace, poor postural control, and large gait
      variability in dup15q syndrome.
    explanation: >-
      Quantitative walkway testing directly supports gait disturbance in a
      39-person Dup15q cohort. Participants had to walk without assistance, so
      the study cannot estimate prevalence across the full clinical spectrum.
- name: Autistic behavior
  description: >-
    Autistic behavior and autism-spectrum features are frequent.
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Autistic behavior
    term:
      id: HP:0000729
      label: Autistic behavior
  evidence:
  - reference: PMID:24239951
    reference_title: >-
      Duplication of the 15q11-q13 region: clinical and genetic study of 30 new cases.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Phenotypic features were somewhat variable and 57% presented with autism.
    explanation: >-
      Autism was reported in 57% of this 30-person clinical cohort, which falls
      in the FREQUENT band (30-79%).
- name: Hypotonia
  description: >-
    Hypotonia is common, especially in infancy.
  phenotype_term:
    preferred_term: Hypotonia
    term:
      id: HP:0001252
      label: Hypotonia
  evidence:
  - reference: PMID:24239951
    reference_title: >-
      Duplication of the 15q11-q13 region: clinical and genetic study of 30 new cases.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Duplications are clinically characterized by a variable phenotype that
      includes central hypotonia, developmental delay, speech delay, seizure,
      minor dysmorphic features and autism.
    explanation: >-
      This directly supports hypotonia in Dup15q syndrome.
- name: Delayed speech and language development
  description: >-
    Expressive language is often markedly delayed and can remain absent or very
    limited in more severely affected individuals.
  phenotype_term:
    preferred_term: Delayed speech and language development
    term:
      id: HP:0000750
      label: Delayed speech and language development
  evidence:
  - reference: PMID:24239951
    reference_title: >-
      Duplication of the 15q11-q13 region: clinical and genetic study of 30 new cases.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Duplications are clinically characterized by a variable phenotype that
      includes central hypotonia, developmental delay, speech delay, seizure,
      minor dysmorphic features and autism.
    explanation: >-
      This clinical cohort directly identifies speech delay as a Dup15q
      phenotype.
- name: Intellectual disability
  description: >-
    Intellectual disability or broader learning difficulties are part of the
    recurrent neurodevelopmental phenotype of Dup15q syndrome.
  phenotype_term:
    preferred_term: Intellectual disability
    term:
      id: HP:0001249
      label: Intellectual disability
  evidence:
  - reference: PMID:27308687
    reference_title: Maternal 15q Duplication Syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Maternal 15q duplication syndrome (maternal dup15q) is characterized by
      hypotonia and motor delays, intellectual disability, autism spectrum
      disorder (ASD), and epilepsy including infantile spasms.
    explanation: >-
      GeneReviews directly identifies intellectual disability as a defining
      clinical characteristic.
- name: Atypical behavior
  description: >-
    Behavioral abnormalities beyond the core autism phenotype are common and
    variable. Reported manifestations include hyperactivity, irritability or
    aggressive outbursts, and repetitive or stereotyped behavior; the detailed
    descriptions come largely from idic15 cohorts and should not be assumed in
    every person or structural subtype.
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Atypical behavior
    term:
      id: HP:0000708
      label: Atypical behavior
  evidence:
  - reference: PMID:42184160
    reference_title: >-
      Epileptic and developmental encephalopathy secondary to inversion-duplication
      of chromosome 15: Description of epilepsy characteristics and therapeutic outcomes.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: behavioral disorders in 30 of 54 (56%).
    explanation: >-
      Behavioral disorders occurred in 30/54 participants (56%), which falls in
      the FREQUENT band (30-79%); the abstract did not subdivide behavior types.
  - reference: PMID:19019226
    reference_title: The inv dup (15) or idic (15) syndrome (Tetrasomy 15q).
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Hyperactivity has been reported in a number of cases
    explanation: >-
      This supports reported hyperactivity in idic(15) while leaving its
      syndrome-wide frequency and structural-subtype distribution unknown.
  - reference: PMID:19019226
    reference_title: The inv dup (15) or idic (15) syndrome (Tetrasomy 15q).
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Stereotypies are frequently seen
    explanation: >-
      This supports stereotyped behavior in idic(15), without establishing its
      frequency across all maternal Dup15q structural subtypes.
  - reference: PMID:25573720
    reference_title: Gastrointestinal problems in 15q duplication syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Behaviors such as irritability and aggressiveness improved with treatment
      of GI symptoms in several subjects.
    explanation: >-
      This supports the presence of irritability and aggression in a broader
      Dup15q cohort, but the treatment-context observation does not quantify
      either manifestation or prove that gastrointestinal symptoms cause them.
- name: Psychosis
  description: >-
    Psychosis has been reported rarely in maternal Dup15q syndrome. Its clinical
    spectrum, subtype distribution, and mechanism are not well characterized.
  frequency: VERY_RARE
  phenotype_term:
    preferred_term: Psychosis
    term:
      id: HP:0000709
      label: Psychosis
  evidence:
  - reference: PMID:27308687
    reference_title: Maternal 15q Duplication Syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Rarely, maternal dup15q may also be associated with psychosis or sudden
      unexplained death.
    explanation: >-
      GeneReviews explicitly describes psychosis as rare; VERY_RARE encodes that
      qualitative statement without implying a measured prevalence.
- name: Seizure
  description: >-
    Epilepsy is clinically heterogeneous and frequently drug resistant, with
    idic15 generally carrying a higher and earlier seizure burden than int15.
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Seizure
    term:
      id: HP:0001250
      label: Seizure
  evidence:
  - reference: PMID:42184160
    reference_title: >-
      Epileptic and developmental encephalopathy secondary to inversion-duplication
      of chromosome 15: Description of epilepsy characteristics and therapeutic outcomes.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Epilepsy was present in 29 of 54 (54%) patients
    explanation: >-
      Epilepsy affected 29/54 participants (54%), which falls in the FREQUENT
      band (30-79%); the broad onset range also documents clinical variability.
- name: Infantile spasms
  description: >-
    Infantile spasms are an important early seizure presentation, especially in
    idic15, and can precede later mixed or Lennox-Gastaut-type epilepsy.
  phenotype_term:
    preferred_term: Infantile spasms
    term:
      id: HP:0012469
      label: Infantile spasms
    onset:
      onset_category: INFANTILE
  evidence:
  - reference: PMID:24502430
    reference_title: A survey of seizures and current treatments in 15q duplication syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      For the 83 with idic(15), 63% were reported to have seizures, of which 81%
      had multiple seizure types and 42% had infantile spasms.
    explanation: >-
      The family survey directly supports infantile spasms in seizure-positive
      idic(15); the 42% is conditional on reported seizures and is not modeled as
      whole-disease frequency.
- name: Sudden unexpected death in epilepsy
  description: >-
    Sudden unexpected death in epilepsy (SUDEP) is a serious complication
    reported particularly in the more epilepsy-prone idic15 subtype. Available
    sources do not provide a precise syndrome-wide risk estimate.
  phenotype_term:
    preferred_term: Sudden unexpected death in epilepsy
    term:
      id: HP:0033258
      label: Sudden unexpected death in epilepsy
  evidence:
  - reference: PMID:27308687
    reference_title: Maternal 15q Duplication Syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Rarely, maternal dup15q may also be associated with psychosis or sudden
      unexplained death.
    explanation: >-
      GeneReviews supports a rare sudden-death association, but its wording does
      not establish that every reported unexplained death met SUDEP criteria.
  - reference: PMID:41751547
    reference_title: >-
      Genomics of Complex Neurodevelopmental Disorders with Variable Epilepsy
      Phenotypes: A Clinical Review of Dup15q Syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      While idic15 is more strongly associated with refractory epilepsy and
      SUDEP
    explanation: >-
      This clinical review specifically associates SUDEP more strongly with the
      idic15 subtype; it does not quantify absolute risk.
- name: Abnormal sleep physiology
  description: >-
    Children with Dup15q show elevated beta power, reduced spindle density, and
    reduced or absent slow-wave sleep on overnight EEG. These physiological
    findings do not by themselves quantify caregiver-observed sleep complaints.
  phenotype_term:
    preferred_term: Abnormal sleep physiology
    term:
      id: HP:0002360
      label: Sleep disturbance
  evidence:
  - reference: PMID:34344470
    reference_title: >-
      Abnormal sleep physiology in children with 15q11.2-13.1 duplication
      (Dup15q) syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Children with Dup15q syndrome showed abnormal sleep physiology with
      elevated beta power, reduced spindle density, and reduced or absent SWS
      compared to age-matched neurotypical controls.
    explanation: >-
      This directly supports abnormal sleep physiology while avoiding an
      unsupported inference about the prevalence of clinical sleep complaints.
- name: Feeding difficulties
  description: >-
    Feeding difficulties can occur during infancy across maternal Dup15q. An
    idic15 review specifically reports them in the newborn period; available
    sources do not establish a syndrome-wide frequency.
  phenotype_term:
    preferred_term: Feeding difficulties
    term:
      id: HP:0011968
      label: Feeding difficulties
  evidence:
  - reference: PMID:19019226
    reference_title: The inv dup (15) or idic (15) syndrome (Tetrasomy 15q).
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Feeding difficulties are reported in the newborn period.
    explanation: >-
      This directly supports neonatal feeding difficulties in idic(15); it does
      not establish a frequency for all Dup15q structural subtypes.
  - reference: PMID:42297774
    reference_title: >-
      Excess EEG beta-band oscillations in Dup15q syndrome correlate with clinical
      severity.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Hypotonia and feeding difficulties in infancy and global developmental
      delay, including motor, cognitive and language impairments, and intellectual
      disability are the most frequent features
    explanation: >-
      This recent human Dup15q study directly identifies feeding difficulties in
      infancy without supplying a precise feature-specific frequency.
- name: Growth delay
  description: >-
    Growth retardation has been reported in approximately 20%–30% of people in an
    idic15 clinical review. Because that estimate is structural-subtype-specific,
    no syndrome-wide frequency is encoded here.
  phenotype_term:
    preferred_term: Growth delay
    term:
      id: HP:0001510
      label: Growth delay
  evidence:
  - reference: PMID:19019226
    reference_title: The inv dup (15) or idic (15) syndrome (Tetrasomy 15q).
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Growth is retarded in about 20%–30% of the patients.
    explanation: >-
      This supports growth delay in idic(15); the 20%–30% estimate is not
      generalized to people with interstitial maternal duplications.
- name: Constipation
  description: >-
    Constipation is a common gastrointestinal manifestation and may be difficult
    to recognize in people who are nonverbal or minimally verbal.
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Constipation
    term:
      id: HP:0002019
      label: Constipation
  evidence:
  - reference: PMID:25573720
    reference_title: Gastrointestinal problems in 15q duplication syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The most commonly reported symptoms were gastroesophageal reflux (56.7%)
      and constipation (60%), with 30% of subjects reporting both.
    explanation: >-
      Constipation occurred in 60% of this 46-person retrospective cohort, which
      falls in the FREQUENT band (30-79%).
- name: Gastroesophageal reflux
  description: >-
    Gastroesophageal reflux is a common gastrointestinal manifestation and can
    coexist with constipation.
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Gastroesophageal reflux
    term:
      id: HP:0002020
      label: Gastroesophageal reflux
  evidence:
  - reference: PMID:25573720
    reference_title: Gastrointestinal problems in 15q duplication syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The most commonly reported symptoms were gastroesophageal reflux (56.7%)
      and constipation (60%), with 30% of subjects reporting both.
    explanation: >-
      Gastroesophageal reflux occurred in 56.7% of this 46-person retrospective
      cohort, which falls in the FREQUENT band (30-79%).
- name: Abnormality of the face
  description: >-
    Facial dysmorphic features are generally minor or subtle rather than a
    reliably recognizable gestalt.
  phenotype_term:
    preferred_term: Abnormality of the face
    term:
      id: HP:0000271
      label: Abnormality of the face
  evidence:
  - reference: PMID:19019226
    reference_title: The inv dup (15) or idic (15) syndrome (Tetrasomy 15q).
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Facial dysmorphic features are absent or subtle, and major malformations are rare.
    explanation: >-
      This supports subtle facial dysmorphism while emphasizing that it may be
      absent and is not a reliable diagnostic hallmark.
biochemical: []
genetic:
- name: Maternal 15q11-q13 duplication
  association: Causal chromosomal duplication
  notes: >-
    Maternal Dup15q is most often caused either by an interstitial duplication
    contributing one extra critical-region copy (regional trisomy) or by an
    isodicentric supernumerary chromosome contributing two extra copies (regional
    tetrasomy). Recurrent breakpoints in the low-copy-repeat-rich 15q11.2-q13.1
    region generate variable rearrangements, and parent of origin materially
    affects phenotypic impact.
  evidence:
  - reference: PMID:27308687
    reference_title: Maternal 15q Duplication Syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      typically comprising two extra copies of 15q11.2-q13.1 and resulting in
      tetrasomy for 15q11.2-q13.1
    explanation: >-
      GeneReviews directly supports two additional critical-region copies and
      regional tetrasomy in the common idic(15) subtype.
  - reference: PMID:27308687
    reference_title: Maternal 15q Duplication Syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      A maternal interstitial 15q11.2-q13.1 duplication that typically includes
      one extra copy of 15q11.2-q13.1 within chromosome 15, resulting in trisomy
      for 15q11.2-q13.1 (~20-40%).
    explanation: >-
      GeneReviews directly supports one additional critical-region copy and
      regional trisomy in the interstitial subtype.
  - reference: PMID:39457428
    reference_title: >-
      Chromosome 15q11-q13 Duplication Syndrome: A Review of the Literature and
      14 New Cases.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The 15q11.2q13 chromosomal region is particularly susceptible to
      chromosomal rearrangements due to low-copy repeats (LCRs) located inside
      this area.
    explanation: >-
      This supports the LCR-mediated mechanism responsible for recurrent
      15q11-q13 duplications.
  - reference: PMID:39457428
    reference_title: >-
      Chromosome 15q11-q13 Duplication Syndrome: A Review of the Literature and
      14 New Cases.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Specific breakpoints (BP1-BP5) that lead to deletions and duplications of
      variable size have been identified.
    explanation: >-
      This supports named LCR breakpoints as generating variable duplication
      sizes in Dup15q syndrome.
- name: GABRB3 duplicated-region dosage
  gene_term:
    preferred_term: GABRB3
    term:
      id: hgnc:4083
      label: GABRB3
  association: Duplicated GABA-A receptor subunit gene in the 15q11.2-q13.1 region
  notes: >-
    GABRB3 is part of the non-imprinted GABA-A receptor subunit gene cluster
    within the duplicated region. Increased cluster dosage is a leading
    hypothesis for the elevated beta EEG phenotype, but the exact mechanism and
    clinical consequences have not been established.
  evidence:
  - reference: PMID:34344470
    reference_title: >-
      Abnormal sleep physiology in children with 15q11.2-13.1 duplication
      (Dup15q) syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      a cluster of gamma-aminobutyric acid type A receptor (GABAAR) genes,
      GABRB3, GABRA5, and GABRG3, which encode the β3, α5 and γ3 receptor
      subunits, respectively.
    explanation: >-
      This identifies GABRB3 as one of the duplicated GABA-A receptor subunit
      genes in the 15q11.2-q13.1 critical region.
- name: GABRA5 duplicated-region dosage
  gene_term:
    preferred_term: GABRA5
    term:
      id: hgnc:4079
      label: GABRA5
  association: Duplicated GABA-A receptor subunit gene in the 15q11.2-q13.1 region
  notes: >-
    GABRA5 is part of the non-imprinted GABA-A receptor subunit gene cluster
    within the duplicated region. Increased cluster dosage is a leading
    hypothesis for the elevated beta EEG phenotype, but the exact mechanism and
    clinical consequences have not been established.
  evidence:
  - reference: PMID:34344470
    reference_title: >-
      Abnormal sleep physiology in children with 15q11.2-13.1 duplication
      (Dup15q) syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      a cluster of gamma-aminobutyric acid type A receptor (GABAAR) genes,
      GABRB3, GABRA5, and GABRG3, which encode the β3, α5 and γ3 receptor
      subunits, respectively.
    explanation: >-
      This identifies GABRA5 as one of the duplicated GABA-A receptor subunit
      genes in the 15q11.2-q13.1 critical region.
- name: GABRG3 duplicated-region dosage
  gene_term:
    preferred_term: GABRG3
    term:
      id: hgnc:4088
      label: GABRG3
  association: Duplicated GABA-A receptor subunit gene in the 15q11.2-q13.1 region
  notes: >-
    GABRG3 is part of the non-imprinted GABA-A receptor subunit gene cluster
    within the duplicated region. Increased cluster dosage is a leading
    hypothesis for the elevated beta EEG phenotype, but the exact mechanism and
    clinical consequences have not been established.
  evidence:
  - reference: PMID:34344470
    reference_title: >-
      Abnormal sleep physiology in children with 15q11.2-13.1 duplication
      (Dup15q) syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      a cluster of gamma-aminobutyric acid type A receptor (GABAAR) genes,
      GABRB3, GABRA5, and GABRG3, which encode the β3, α5 and γ3 receptor
      subunits, respectively.
    explanation: >-
      This identifies GABRG3 as one of the duplicated GABA-A receptor subunit
      genes in the 15q11.2-q13.1 critical region.
environmental: []
treatments:
- name: Supportive care
  description: >-
    Multidisciplinary supportive care is central, especially for developmental,
    feeding, communication, educational, and behavioral management. Core
    services include physical therapy for hypotonia and gross motor delay,
    occupational therapy for fine-motor and adaptive skills, speech-language
    therapy with augmentative and alternative communication when needed, feeding
    therapy, behavioral therapy such as applied behavior analysis, and
    psychotropic medication when behavioral manifestations require medication.
  treatment_term:
    preferred_term: Supportive Care
    term:
      id: NCIT:C15747
      label: Supportive Care
  evidence:
  - reference: PMID:27308687
    reference_title: Maternal 15q Duplication Syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Supportive care may include: feeding therapy, occupational and physical
      therapy, alternative and augmentative communication, behavioral therapy
      (e.g., applied behavioral analysis therapy), psychotropic medications
      for behavioral manifestations
    explanation: >-
      GeneReviews supports the specific developmental, communication, feeding,
      behavioral, and psychotropic components of supportive management.
- name: Gastrointestinal symptom management
  description: >-
    Gastrointestinal symptoms should be actively assessed because presentation
    can be atypical in nonverbal or minimally verbal individuals. In a
    retrospective Dup15q cohort, polyethylene glycol was the most commonly
    reported treatment for constipation and proton-pump inhibitors for reflux;
    treatment remains individualized rather than syndrome specific.
  treatment_term:
    preferred_term: supportive care
    term:
      id: NCIT:C15747
      label: Supportive Care
  target_phenotypes:
  - preferred_term: Constipation
    term:
      id: HP:0002019
      label: Constipation
  - preferred_term: Gastroesophageal reflux
    term:
      id: HP:0002020
      label: Gastroesophageal reflux
  evidence:
  - reference: PMID:25573720
    reference_title: Gastrointestinal problems in 15q duplication syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The most common treatments were polyethylene glycol for constipation and
      proton pump inhibitors for reflux.
    explanation: >-
      This documents treatments used in a retrospective cohort; it does not
      establish comparative efficacy or a Dup15q-specific regimen.
- name: Individualized epilepsy treatment
  description: >-
    Epilepsy treatment is tailored to seizure type and syndrome. Family-survey
    and retrospective multicenter data associate broad-spectrum antiseizure
    medications, oxcarbazepine, and valproate with responses in subsets; the
    survey also found ACTH more effective than vigabatrin for infantile spasms.
    These nonrandomized findings do not establish a universal hierarchy.
  notes: >-
    No prospective or randomized controlled trial data establish an antiseizure
    medication hierarchy for Dup15q. The 2014 family survey had a low return rate,
    and the 2026 multicenter study was retrospective; therapy should therefore be
    individualized by seizure type, structural subtype, tolerability, and
    specialist judgment.
  treatment_term:
    preferred_term: Pharmacotherapy
    term:
      id: NCIT:C15986
      label: Pharmacotherapy
  target_phenotypes:
  - preferred_term: Seizure
    term:
      id: HP:0001250
      label: Seizure
  - preferred_term: Infantile spasms
    term:
      id: HP:0012469
      label: Infantile spasms
  evidence:
  - reference: PMID:24502430
    reference_title: >-
      A survey of seizures and current treatments in 15q duplication syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Broad spectrum antiepileptic drugs (AEDs) were the most effective
      medications, but carbamazepine and oxcarbazepine were also effective,
      although typical benzodiazepines were relatively ineffective.
    explanation: >-
      This supports differential reported responses while the study's
      questionnaire design and low return rate preclude a treatment hierarchy.
  - reference: PMID:24502430
    reference_title: A survey of seizures and current treatments in 15q duplication syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      For those with infantile spasms, adrenocorticotropic hormone (ACTH) was
      more effective than vigabatrin.
    explanation: >-
      This supports the observed ACTH-versus-vigabatrin difference only within a
      small, family-reported subgroup and is not treated as definitive guidance.
  - reference: PMID:42184160
    reference_title: >-
      Epileptic and developmental encephalopathy secondary to inversion-duplication
      of chromosome 15: Description of epilepsy characteristics and therapeutic outcomes.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The most effective antiseizure drugs were oxcarbazepine for focal (9/11,
      81%) and for generalized (2/3, 67%) epilepsy and valproic acid (6/10, 60%)
      for generalized epilepsy
    explanation: >-
      The recent retrospective cohort supports response associations in small
      subgroups; it does not provide randomized comparative efficacy.
- name: Seizure trigger avoidance and surveillance
  description: >-
    Families should receive counseling on avoidable seizure triggers such as
    sleep deprivation and stress. Clinical follow-up should separately monitor
    for new seizures or changes in seizure type and assess nutritional status and
    growth.
  treatment_term:
    preferred_term: supportive care
    term:
      id: NCIT:C15747
      label: Supportive Care
  target_phenotypes:
  - preferred_term: Seizure
    term:
      id: HP:0001250
      label: Seizure
  - preferred_term: Feeding difficulties
    term:
      id: HP:0011968
      label: Feeding difficulties
  - preferred_term: Growth delay
    term:
      id: HP:0001510
      label: Growth delay
  evidence:
  - reference: PMID:27308687
    reference_title: Maternal 15q Duplication Syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Agents/circumstances to avoid: Seizure triggers (e.g., sleep deprivation,
      stress).
    explanation: >-
      GeneReviews explicitly identifies seizure-trigger avoidance as management
      guidance for maternal Dup15q.
  - reference: PMID:27308687
    reference_title: Maternal 15q Duplication Syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Surveillance: Growth and nutritional assessment at each visit. Periodic:
      neurodevelopmental and/or developmental/behavioral assessments, and
      monitoring for evidence of seizures and/or change in seizure type.
    explanation: >-
      GeneReviews directly supports routine growth and nutritional assessment
      plus periodic developmental, behavioral, and seizure surveillance.
- name: Ketogenic diet for epilepsy
  description: >-
    GeneReviews lists ketogenic diet management by an experienced neurologist as
    an option in maternal Dup15q epilepsy. The cited source provides no
    Dup15q-specific efficacy estimate, so this is specialist-guided standard
    epilepsy care rather than a syndrome-specific efficacy claim.
  treatment_term:
    preferred_term: ketogenic diet intake
    term:
      id: NCIT:C173168
      label: Ketogenic Diet
  target_phenotypes:
  - preferred_term: Seizure
    term:
      id: HP:0001250
      label: Seizure
  evidence:
  - reference: url:https://www.ncbi.nlm.nih.gov/books/NBK367946/
    reference_title: >-
      Maternal 15q Duplication Syndrome - GeneReviews® - NCBI Bookshelf
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: ketogenic diets by experienced neurologist
    explanation: >-
      GeneReviews includes ketogenic diet among specialist-directed epilepsy
      options but does not provide a Dup15q-specific estimate of benefit.
- name: Vagus nerve stimulation for epilepsy
  description: >-
    GeneReviews lists vagus nerve stimulation by an experienced neurologist as
    an option in maternal Dup15q epilepsy. The source does not provide
    Dup15q-specific comparative efficacy data, so candidacy and expected benefit
    require individualized specialist assessment.
  treatment_term:
    preferred_term: vagus nerve stimulation
    term:
      id: NCIT:C21025
      label: Peripheral Nerve Stimulation
  target_phenotypes:
  - preferred_term: Seizure
    term:
      id: HP:0001250
      label: Seizure
  evidence:
  - reference: url:https://www.ncbi.nlm.nih.gov/books/NBK367946/
    reference_title: >-
      Maternal 15q Duplication Syndrome - GeneReviews® - NCBI Bookshelf
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Standardized treatment w/ASM, vagus nerve stimulators
    explanation: >-
      GeneReviews includes vagus nerve stimulation among specialist-directed
      epilepsy options without establishing syndrome-specific efficacy.
- name: Seizure education and rescue planning
  description: >-
    Parents and caregivers should be taught common seizure presentations and
    basic seizure safety. For people at risk of prolonged seizures or status
    epilepticus, the treating clinician should provide an individualized
    rescue-medication plan; the cited examples are guidance, not prescriptions for
    every person with Dup15q.
  treatment_term:
    preferred_term: supportive care
    term:
      id: NCIT:C15747
      label: Supportive Care
  target_phenotypes:
  - preferred_term: Seizure
    term:
      id: HP:0001250
      label: Seizure
  evidence:
  - reference: url:https://www.ncbi.nlm.nih.gov/books/NBK367946/
    reference_title: >-
      Maternal 15q Duplication Syndrome - GeneReviews® - NCBI Bookshelf
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Education of parents/caregivers regarding common seizure presentations is
      appropriate.
    explanation: >-
      GeneReviews directly supports caregiver education about seizure
      recognition.
  - reference: url:https://www.ncbi.nlm.nih.gov/books/NBK367946/
    reference_title: >-
      Maternal 15q Duplication Syndrome - GeneReviews® - NCBI Bookshelf
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      status epilepticus may be prevented with the use of rescue medications such
      as rectal diazepam or nasal midazolam.
    explanation: >-
      GeneReviews supports clinician-directed rescue planning for status
      prevention; the specific agents are examples and require individualized
      prescribing and instruction.
- name: Genetic counseling
  description: >-
    Genetic counseling should address maternal parent-of-origin effects,
    subtype-specific de novo versus inherited recurrence risk, maternal
    interstitial duplication transmission risk, testing of at-risk siblings, and
    prenatal or preimplantation testing options.
  treatment_term:
    preferred_term: Genetic Counseling
    term:
      id: NCIT:C15240
      label: Genetic Counseling
  evidence:
  - reference: PMID:27308687
    reference_title: Maternal 15q Duplication Syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Evaluation of relatives at risk: Consider genetic testing of sibs of a
      proband
    explanation: >-
      GeneReviews supports genetic counseling and testing for relatives at risk
      of inherited maternal interstitial 15q11.2-q13.1 duplication.
  - reference: PMID:37029316
    reference_title: >-
      Population screening for 15q11-q13 duplications: corroboration of the
      difference in impact between maternally and paternally inherited alleles.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      We recommend reporting 15q11-q13 duplications identified during genome-wide
      NIPS with appropriate genetic counselling for these pregnant women in the
      interest of both mothers and future children.
    explanation: >-
      This supports the need for genetic counseling when 15q11-q13 duplications
      are detected, especially in prenatal screening contexts.
- name: Investigational soticlestat
  description: >-
    Soticlestat (TAK-935/OV935), a cholesterol 24-hydroxylase inhibitor, was
    evaluated in eight participants with Dup15q syndrome in the open-label phase
    II ARCADE trial. During maintenance, median motor-seizure frequency increased
    11.7% while all-seizure frequency decreased 23.4%; the small, uncontrolled,
    discordant results are inconclusive for efficacy.
  treatment_term:
    preferred_term: pharmacotherapy
    term:
      id: NCIT:C15986
      label: Pharmacotherapy
    therapeutic_agent:
    - preferred_term: soticlestat
      term:
        id: CHEBI:233158
        label: soticlestat
  target_phenotypes:
  - preferred_term: Seizure
    term:
      id: HP:0001250
      label: Seizure
  evidence:
  - reference: PMID:37011526
    reference_title: >-
      Efficacy, safety, and tolerability of soticlestat as adjunctive therapy
      for the treatment of seizures in patients with Dup15q syndrome or CDKL5
      deficiency disorder in an open-label signal-finding phase II study (ARCADE).
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Soticlestat administration during the maintenance period was associated
      with a median change from baseline in motor seizure frequency of +11.7% in
      the Dup15q syndrome group
    explanation: >-
      The prespecified motor-seizure endpoint worsened in the eight-person,
      open-label Dup15q subgroup, preventing an efficacy claim.
  - reference: PMID:37011526
    reference_title: >-
      Efficacy, safety, and tolerability of soticlestat as adjunctive therapy
      for the treatment of seizures in patients with Dup15q syndrome or CDKL5
      deficiency disorder in an open-label signal-finding phase II study (ARCADE).
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Reductions in all seizure frequency of -23.4% and -30.5% were also observed
      during the maintenance period in the Dup15q syndrome group and the CDD
      group, respectively.
    explanation: >-
      The secondary all-seizure measure moved in the opposite direction from the
      motor-seizure endpoint, underscoring that this small uncontrolled signal is
      inconclusive.
- name: Investigational all-trans-retinoic acid
  description: >-
    All-trans-retinoic acid (ATRA) is under investigation for autism-related
    outcomes in Dup15q syndrome. Registry records describe an early-phase
    crossover study and a separate phase II single-group study assessing ADOS-2;
    neither registry provides efficacy results.
  treatment_term:
    preferred_term: pharmacotherapy
    term:
      id: NCIT:C15986
      label: Pharmacotherapy
    therapeutic_agent:
    - preferred_term: all-trans-retinoic acid
      term:
        id: CHEBI:15367
        label: all-trans-retinoic acid
  target_phenotypes:
  - preferred_term: Autistic behavior
    term:
      id: HP:0000729
      label: Autistic behavior
  evidence:
  - reference: clinicaltrials:NCT05281965
    reference_title: >-
      A Clinical Study Evaluating the Efficacy and Safety of Retinoic Acid in
      Patients With 15q11-q13 Duplication Syndrome
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Therefore, retinoic acid supplementation in the treatment of dup15q
      syndrome is a potential therapeutic target.
    explanation: >-
      The early-phase crossover registry supports ATRA as investigational and
      does not provide efficacy results.
  - reference: clinicaltrials:NCT07079696
    reference_title: "Investigating the Therapeutic Efficacy of All-trans Retinoic Acid in Autism Spectrum Disorder Patients With 15q11-13 Duplication Syndrome"
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      This study aims to evaluate ATRA treatment in children with Dup15q
      syndrome-related autism , assessing changes in their ADOS-2 scores , to
      potentially provide a novel therapeutic approach for autism treatment.
    explanation: >-
      Phase II trial registry record supports ATRA as an investigational
      therapy for Dup15q-related autistic behavior.
diagnosis:
- name: Chromosomal copy-number, structure, and parent-of-origin testing
  description: >-
    Chromosomal microarray or array-CGH detects the 15q11.2-q13.1 copy-number
    gain and its extent. Karyotype and FISH help define a supernumerary
    isodicentric chromosome or mosaicism, while methylation or parental-marker
    analysis establishes the parent of origin required for maternal Dup15q.
  diagnosis_term:
    preferred_term: genetic testing
    term:
      id: NCIT:C15709
      label: Genetic Testing
  evidence:
  - reference: PMID:39457428
    reference_title: >-
      Chromosome 15q11-q13 Duplication Syndrome: A Review of the Literature and
      14 New Cases.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      In the present study, a total of 14 pre- and postnatal cases were
      diagnosed as 15q11.2q13 duplication carriers using Affymetrix CytoScan 750
      K array-CGH, and our analysis combined these with 120 cases existing in
      the literature.
    explanation: >-
      This directly supports chromosomal microarray/array-CGH copy-number
      testing as a diagnostic method for Dup15q.
  - reference: PMID:27308687
    reference_title: Maternal 15q Duplication Syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The diagnosis of maternal dup15q is established by detection of at least
      one extra maternally derived copy of the Prader-Willi/Angelman critical
      region, a region approximately 5 Mb long within chromosome region
      15q11.2-q13.1.
    explanation: >-
      GeneReviews supports detection of the extra maternally derived
      Prader-Willi/Angelman critical-region copy as the diagnostic basis of
      maternal Dup15q.
  - reference: PMID:19019226
    reference_title: The inv dup (15) or idic (15) syndrome (Tetrasomy 15q).
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Diagnosis is achieved by standard cytogenetics and FISH analysis, using
      probes both from proximal chromosome 15 and from the PWS/ASCR.
    explanation: >-
      This directly supports cytogenetics plus FISH for defining idic(15)
      structure.
  - reference: PMID:19019226
    reference_title: The inv dup (15) or idic (15) syndrome (Tetrasomy 15q).
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Microsatellite analysis on parental DNA or methylation analysis on the
      proband DNA, are also needed to detect the parent-of-origin of the inv
      dup(15) chromosome.
    explanation: >-
      This directly supports molecular parent-of-origin testing after the
      copy-number and structural finding.
- name: Maternal CNV detection during genome-wide NIPS
  description: >-
    Low-coverage genome-wide cell-free DNA screening can incidentally identify a
    15q11-q13 duplication carried by the pregnant woman. Such a maternal finding
    is not a fetal diagnosis: it requires confirmatory maternal testing, genetic
    counseling, and separate assessment of fetal inheritance when indicated.
  diagnosis_term:
    preferred_term: prenatal genome-wide NIPS
    term:
      id: NCIT:C15709
      label: Genetic Testing
  evidence:
  - reference: PMID:37029316
    reference_title: >-
      Population screening for 15q11-q13 duplications: corroboration of the
      difference in impact between maternally and paternally inherited alleles.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      We recommend reporting 15q11-q13 duplications identified during
      genome-wide NIPS with appropriate genetic counselling for these pregnant
      women in the interest of both mothers and future children.
    explanation: >-
      This supports reporting 15q11-q13 duplications surfaced in pregnant women
      during genome-wide NIPS with counseling; it does not establish fetal
      Dup15q.
- name: Electroencephalography
  description: >-
    Awake and sleep EEG is used to characterize seizure types and epilepsy
    severity. Diffuse fast or beta activity is a recognizable syndrome-associated
    pattern, but EEG does not replace genetic confirmation.
  diagnosis_term:
    preferred_term: electroencephalography
    term:
      id: NCIT:C38054
      label: Electroencephalography
  evidence:
  - reference: PMID:24239951
    reference_title: >-
      Duplication of the 15q11-q13 region: clinical and genetic study of 30 new cases.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      18 patients had an abnormal EEG with a typical, recognizable pattern of
      excessive diffuse rapid spikes in the waking record, similar to the
      pattern observed after benzodiazepine exposure.
    explanation: >-
      This directly supports EEG as an abnormal diagnostic finding.
- name: EEG beta oscillation biomarker
  description: >-
    Elevated beta power is a stable, reproducible electrophysiologic biomarker
    of Dup15q and a candidate pharmacodynamic or target-engagement readout. A
    locally referenced beta-power metric correlated with cognitive and adaptive
    scores in participants without epilepsy, but not in the epilepsy subgroup;
    this exploratory result requires replication and does not establish causal
    direction or treatment responsiveness.
  diagnosis_term:
    preferred_term: electroencephalography
    term:
      id: NCIT:C38054
      label: Electroencephalography
  evidence:
  - reference: PMID:32791992
    reference_title: Properties of beta oscillations in Dup15q syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      an electrophysiological biomarker of the syndrome, characterized by
      excessive beta oscillations (12-30 Hz), resembling electroencephalogram
      (EEG) changes induced by allosteric modulation of GABAARs.
    explanation: >-
      This defines the characteristic Dup15q beta oscillation EEG biomarker
      and links it to GABAAR allosteric modulation.
  - reference: PMID:32791992
    reference_title: Properties of beta oscillations in Dup15q syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Beta power and peak frequency showed high stability across repeated visits
      (beta power ICC = 0.93, BPF ICC = 0.92). A reproducibility analysis
      revealed that beta power estimates are comparable between research and
      clinical EEG (ICC = 0.94).
    explanation: >-
      This supports elevated beta oscillations as a stable and clinically
      reproducible EEG biomarker in Dup15q syndrome.
  - reference: PMID:42297774
    reference_title: >-
      Excess EEG beta-band oscillations in Dup15q syndrome correlate with
      clinical severity.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The correlations between LRPβ and clinical scores in children with Dup15q
      syndrome without epilepsy were significant for all scores investigated
    explanation: >-
      Locally referenced beta power correlated with cognitive and adaptive
      severity in the subgroup without epilepsy. The exploratory analyses used
      one-sided, uncorrected tests and did not find corresponding associations in
      participants with epilepsy, so clinical qualification remains incomplete.
differential_diagnoses:
- name: Paternal 15q11.2-q13.1 duplication
  description: >-
    The same 15q11.2-q13.1 copy-number gain can be paternal rather than maternal.
    Paternal duplications are generally normal or associated with milder,
    variable findings and do not define maternal Dup15q, so parent-of-origin
    testing is the direct discriminator.
  evidence:
  - reference: PMID:37029316
    reference_title: >-
      Population screening for 15q11-q13 duplications: corroboration of the
      difference in impact between maternally and paternally inherited alleles.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Maternally inherited duplications are always associated with a clinical
      phenotype (ranging from learning difficulties to intellectual impairment,
      epilepsy and psychiatric disorders), while paternal duplications are normal
      or associated with milder phenotypes (mild learning difficulties and dyslexia).
    explanation: >-
      This supports paternal duplication as the most direct parent-of-origin
      alternative to maternal Dup15q while preserving its variable impact.
- name: Angelman syndrome
  description: >-
    Angelman syndrome overlaps because it involves the same imprinted region
    but typically reflects loss of UBE3A function rather than duplication.
  disease_term:
    preferred_term: Angelman syndrome
    term:
      id: MONDO:0007113
      label: Angelman syndrome
- name: Prader-Willi syndrome
  description: >-
    Severe infantile hypotonia and feeding difficulty can initially suggest
    Prader-Willi syndrome. Both disorders involve the same imprinted region, but
    Prader-Willi syndrome reflects loss of paternally expressed 15q11-q13 genes
    rather than an extra maternally derived critical-region copy.
  disease_term:
    preferred_term: Prader-Willi syndrome
    term:
      id: MONDO:0008300
      label: Prader-Willi syndrome
- name: Autism spectrum disorder
  description: >-
    Autism spectrum disorder is part of the Dup15q phenotype and may dominate
    the presentation before the chromosomal duplication is recognized.
  disease_term:
    preferred_term: autism spectrum disorder
    term:
      id: MONDO:0005258
      label: autism spectrum disorder
clinical_trials:
- name: NCT03694275
  phase: PHASE_II
  status: COMPLETED
  description: >-
    ARCADE was an open-label phase II soticlestat signal-finding study in
    participants with Dup15q syndrome or CDKL5 deficiency disorder and motor
    seizures. Eight participants with Dup15q received treatment; median motor
    seizures increased 11.7% during maintenance while all seizures decreased
    23.4%, leaving efficacy inconclusive.
  target_phenotypes:
  - preferred_term: Seizure
    term:
      id: HP:0001250
      label: Seizure
  evidence:
  - reference: clinicaltrials:NCT03694275
    reference_title: >-
      A Multicenter, Open-label, Pilot Study of TAK-935 (OV935) in Patients
      With 15Q Duplication Syndrome or CDKL5 Deficiency Disorder (ARCADE Study)
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The purpose of this study is to investigate the effect of soticlestat on
      the frequency of motor seizures for participants with Dup15q or CDD during
      the Maintenance Period.
    explanation: >-
      ClinicalTrials.gov documents a completed soticlestat trial targeting motor
      seizure frequency in Dup15q syndrome.
  - reference: PMID:37011526
    reference_title: >-
      Efficacy, safety, and tolerability of soticlestat as adjunctive therapy
      for the treatment of seizures in patients with Dup15q syndrome or CDKL5
      deficiency disorder in an open-label signal-finding phase II study
      (ARCADE).
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Soticlestat treatment was associated with an increase in motor seizure
      frequency in patients with Dup15q syndrome.
    explanation: >-
      The published ARCADE results show worsening of the motor-seizure endpoint
      in the Dup15q subgroup; the small open-label design and discordant
      all-seizure result prevent an efficacy conclusion.
- name: NCT05281965
  phase: PHASE_I
  status: UNKNOWN
  description: >-
    Early-phase randomized crossover study evaluating retinoic acid in patients
    with 15q11-q13 duplication syndrome. The registry was last updated in March
    2022 and still listed recruiting despite an estimated 2024 completion, with
    no posted results; current status is therefore UNKNOWN.
  target_phenotypes:
  - preferred_term: Autistic behavior
    term:
      id: HP:0000729
      label: Autistic behavior
  evidence:
  - reference: clinicaltrials:NCT05281965
    reference_title: >-
      A Clinical Study Evaluating the Efficacy and Safety of Retinoic Acid in
      Patients With 15q11-q13 Duplication Syndrome
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Therefore, retinoic acid supplementation in the treatment of dup15q
      syndrome is a potential therapeutic target.
    explanation: >-
      ClinicalTrials.gov documents an early-phase retinoic-acid trial motivated
      by UBE3A-related Dup15q biology.
- name: NCT07079696
  phase: PHASE_II
  status: NOT_RECRUITING
  description: >-
    Phase II single-group all-trans retinoic acid study in children ages 3 to 7
    years with Dup15q syndrome-related autism. The registry lists an estimated
    enrollment of 90 and status NOT_YET_RECRUITING, last verified in June 2025,
    with no results; NOT_RECRUITING is the closest available schema status.
  target_phenotypes:
  - preferred_term: Autistic behavior
    term:
      id: HP:0000729
      label: Autistic behavior
  evidence:
  - reference: clinicaltrials:NCT07079696
    reference_title: >-
      Investigating the Therapeutic Efficacy of All-trans Retinoic Acid in
      Autism Spectrum Disorder Patients With 15q11-13 Duplication Syndrome
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      This study aims to evaluate ATRA treatment in children with Dup15q
      syndrome-related autism , assessing changes in their ADOS-2 scores , to
      potentially provide a novel therapeutic approach for autism treatment.
    explanation: >-
      ClinicalTrials.gov documents a larger phase II all-trans retinoic acid
      study targeting Dup15q-related autistic behavior.
- name: NCT05307679
  phase: PHASE_II
  status: TERMINATED
  description: >-
    Phase II randomized study of basmisanil, a GABAA receptor negative
    allosteric modulator, in children and adolescents with Dup15q syndrome. The
    sponsor terminated the study following a sponsor decision unrelated to
    safety or tolerability. Seven participants were randomized and none completed
    the planned study, so the posted results cannot support efficacy conclusions.
  evidence:
  - reference: clinicaltrials:NCT05307679
    reference_title: >-
      A Phase II, Randomized, Double-Blind, Placebo-Controlled, Parallel Group
      Study to Evaluate the Safety, Efficacy, and Pharmacodynamics of 52 Weeks
      of Treatment With Basmisanil in Participants Aged 2 to 14 Years Old With
      Dup15q Syndrome Followed by a 2-Year Optional Open-Label Extension
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Part 1 will test the hypothesis that negative allosteric modulation of a
      GABAA receptor subtype can address excessive receptor function and
      positively impact core neurodevelopmental disease feature in individuals
      with Dup15q syndrome.
    explanation: >-
      ClinicalTrials.gov documents the mechanistic rationale and planned design
      of the terminated phase II basmisanil trial; the registry's sparse
      enrollment and early termination preclude efficacy interpretation.
discussions:
- discussion_id: mismatch_dup15q_mouse_sleep_physiology
  prompt: >-
    Why do maternal-duplication mice reproduce the human beta EEG signature but
    not the abnormal human NREM-sleep phenotype, and which part of the model is
    appropriate for preclinical target-engagement studies?
  kind: HUMAN_MODEL_MISMATCH
  status: OPEN
  attaches_to:
  - phenotypes#Abnormal sleep physiology
  - diagnosis#EEG beta oscillation biomarker
  - pathophysiology#GABAA-receptor-associated beta oscillations
  rationale: >-
    Chromosome-engineered maternal-duplication mice reproduce elevated beta
    oscillations across brain states, supporting use of beta power as a
    translational measurement. The same mice do not reproduce the abnormal NREM
    sleep architecture observed in children with Dup15q and retain normal NREM
    recovery after sleep deprivation. The agreement is therefore biomarker
    specific rather than evidence that the mouse faithfully models the broader
    human sleep phenotype. This distinction matters when a preclinical
    intervention changes beta power without demonstrating a patient-relevant
    sleep or behavioral effect.
  proposed_experiments:
  - experiment_id: exp_dup15q_harmonized_human_mouse_sleep_eeg
    name: Harmonized longitudinal human-mouse sleep EEG perturbation study
    description: >-
      Use matched spectral definitions, sleep-stage metrics, age windows, and
      medication annotations in longitudinal human Dup15q sleep EEG and
      maternal-duplication mice, then compare responses to the same target-engagement
      perturbation. Treat beta power and NREM architecture as separate outcomes
      and test whether either predicts patient-centered sleep measures.
  evidence:
  - reference: PMID:39014349
    reference_title: >-
      Sleep EEG signatures in mouse models of 15q11.2-13.1 duplication (Dup15q)
      syndrome.
    supports: SUPPORT
    evidence_source: MODEL_ORGANISM
    snippet: >-
      Our study revealed that across brain states, matDp/+ mice mirrored the
      elevated beta oscillation phenotype observed in clinical EEGs from
      individuals with Dup15q syndrome.
    explanation: >-
      This directly supports preservation of the human beta EEG signature in the
      maternal-duplication mouse across brain states.
  - reference: PMID:39014349
    reference_title: >-
      Sleep EEG signatures in mouse models of 15q11.2-13.1 duplication (Dup15q)
      syndrome.
    supports: SUPPORT
    evidence_source: MODEL_ORGANISM
    snippet: >-
      However, NREM sleep between Dup15q mutant and WT littermate mice remained
      unaltered, suggesting a divergence from the clinical presentation in humans.
    explanation: >-
      This directly identifies the mouse-human NREM mismatch.
- discussion_id: gap_dup15q_gabaa_beta_clinical_causality
  prompt: >-
    Does increased dosage of GABRB3, GABRA5, or GABRG3 generate the Dup15q beta
    EEG biomarker, and is that signal causally related to epilepsy or clinical
    outcomes rather than merely correlated with them?
  kind: KNOWLEDGE_GAP
  status: OPEN
  attaches_to:
  - pathophysiology#GABAA-receptor-associated beta oscillations
  - pathophysiology#Epileptogenic network dysfunction
  - diagnosis#EEG beta oscillation biomarker
  rationale: >-
    Human EEG establishes a stable beta biomarker and pharmacologic resemblance
    to GABAA-receptor modulation, but the exact mechanism remains unknown. A
    2026 study using locally referenced beta power found cross-sectional
    correlations with cognitive and adaptive severity in participants without
    epilepsy, but not in those with epilepsy; the analyses were exploratory and
    uncorrected for multiple testing. Selective α5-receptor modulation normalized
    the measured behavioral phenotypes and partially normalized beta power in a
    paternal-duplication mouse model. Neither result establishes directionality
    or clinical treatment response, and the basmisanil trial terminated after
    only seven participants.
    Individual-gene perturbation and prospective human intervention data are
    still needed before the GABAA cluster, beta biomarker, clinical outcomes, and
    therapeutic response can be placed in one causal chain.
  proposed_experiments:
  - experiment_id: exp_dup15q_gabaa_gene_dosage_network_rescue
    name: Isogenic GABAA-cluster dosage dissection in human neuronal networks
    description: >-
      In patient-derived mixed excitatory-inhibitory neuronal cultures, normalize
      GABRB3, GABRA5, and GABRG3 singly and in combinations while leaving UBE3A
      dosage unchanged. Measure receptor composition, inhibitory currents,
      network beta oscillations, and epileptiform activity, then compare the
      rescued signatures with longitudinal human EEG and seizure outcomes.
  evidence:
  - reference: PMID:32791992
    reference_title: Properties of beta oscillations in Dup15q syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Although an exact mechanism of beta oscillations has not been elucidated
      in Dup15q syndrome
    explanation: >-
      This explicitly states that the gene-dosage mechanism remains unresolved.
  - reference: PMID:32791992
    reference_title: Properties of beta oscillations in Dup15q syndrome.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      We urge caution in not overinterpreting the relationship between epilepsy
      and beta oscillations, as without preclinical models to manipulate the
      underlying altered circuitry, we will not be able to prove directionality
      of the association.
    explanation: >-
      This directly identifies the unresolved directionality between the beta
      biomarker and epilepsy.
  - reference: PMID:42297774
    reference_title: >-
      Excess EEG beta-band oscillations in Dup15q syndrome correlate with
      clinical severity.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The p-values (uncorrected for multiple testing) from our exploratory
      analyses should be interpreted as indicative of evidence strength rather
      than statistical conclusions.
    explanation: >-
      The authors explicitly qualify the new clinical-severity correlations as
      exploratory, leaving replication and causal interpretation open.
datasets: []
notes: >-
  PubMed-driven curation was expanded with Falcon deep research on 2026-05-30
  and manually re-reviewed on 2026-07-14. Deep-research findings were treated as
  leads only; claims were checked against the linked abstracts, open full texts,
  and current ClinicalTrials.gov records. Paywalled full texts were not treated
  as available evidence beyond their indexed abstracts.
references:
- reference: url:https://www.ncbi.nlm.nih.gov/books/NBK367946/
  title: Maternal 15q Duplication Syndrome - GeneReviews® - NCBI Bookshelf
  tags:
  - GeneReviews
- reference: PMID:27308687
  title: Maternal 15q Duplication Syndrome.
  tags:
  - GeneReviews
  found_in:
  - 15q11q13_Microduplication_Syndrome-deep-research-falcon.md
- reference: PMID:19019226
  title: The inv dup (15) or idic (15) syndrome (Tetrasomy 15q).
- reference: PMID:24502430
  title: A survey of seizures and current treatments in 15q duplication syndrome.
- reference: PMID:25573720
  title: Gastrointestinal problems in 15q duplication syndrome.
- reference: PMID:24239951
  title: >-
    Duplication of the 15q11-q13 region: clinical and genetic study of 30 new cases.
- reference: PMID:25884337
  title: >-
    15q11.2 Duplication Encompassing Only the UBE3A Gene Is Associated with
    Developmental Delay and Neuropsychiatric Phenotypes.
- reference: PMID:32282133
  title: >-
    Quantitative Gait Analysis in Duplication 15q Syndrome and Nonsyndromic ASD.
- reference: PMID:37329181
  title: >-
    Dysfunctional sodium channel kinetics as a novel epilepsy mechanism in
    chromosome 15q11-q13 duplication syndrome.
- reference: PMID:41751547
  title: >-
    Genomics of Complex Neurodevelopmental Disorders with Variable Epilepsy
    Phenotypes: A Clinical Review of Dup15q Syndrome.
- reference: PMID:42184160
  title: >-
    Epileptic and developmental encephalopathy secondary to inversion-duplication
    of chromosome 15: Description of epilepsy characteristics and therapeutic outcomes.
- reference: PMID:41491842
  title: >-
    RO4938581, a GABA(A)-α5 negative allosteric modulator rescued behavioral
    and EEG phenotypes of a mouse model of Dup15q syndrome.
- reference: PMID:42297774
  title: >-
    Excess EEG beta-band oscillations in Dup15q syndrome correlate with clinical
    severity.
- reference: PMID:36898382
  title: >-
    The role of UBE3A in the autism and epilepsy-related Dup15q syndrome using
    patient-derived, CRISPR-corrected neurons.
  found_in:
  - 15q11q13_Microduplication_Syndrome-deep-research-falcon.md
- reference: PMID:37029316
  title: >-
    Population screening for 15q11-q13 duplications: corroboration of the
    difference in impact between maternally and paternally inherited alleles.
  found_in:
  - 15q11q13_Microduplication_Syndrome-deep-research-falcon.md
- reference: PMID:37011526
  title: >-
    Efficacy, safety, and tolerability of soticlestat as adjunctive therapy for
    the treatment of seizures in patients with Dup15q syndrome or CDKL5
    deficiency disorder in an open-label signal-finding phase II study (ARCADE).
  found_in:
  - 15q11q13_Microduplication_Syndrome-deep-research-falcon.md
- reference: PMID:39457428
  title: >-
    Chromosome 15q11-q13 Duplication Syndrome: A Review of the Literature and
    14 New Cases.
  found_in:
  - 15q11q13_Microduplication_Syndrome-deep-research-falcon.md
- reference: PMID:32791992
  title: Properties of beta oscillations in Dup15q syndrome.
  found_in:
  - 15q11q13_Microduplication_Syndrome-deep-research-falcon.md
- reference: PMID:34344470
  title: >-
    Abnormal sleep physiology in children with 15q11.2-13.1 duplication
    (Dup15q) syndrome.
  found_in:
  - 15q11q13_Microduplication_Syndrome-deep-research-falcon.md
- reference: PMID:39014349
  title: >-
    Sleep EEG signatures in mouse models of 15q11.2-13.1 duplication (Dup15q)
    syndrome.
  found_in:
  - 15q11q13_Microduplication_Syndrome-deep-research-falcon.md
- reference: clinicaltrials:NCT03694275
  title: >-
    A Multicenter, Open-label, Pilot Study of TAK-935 (OV935) in Patients With
    15Q Duplication Syndrome or CDKL5 Deficiency Disorder (ARCADE Study)
  found_in:
  - 15q11q13_Microduplication_Syndrome-deep-research-falcon.md
- reference: clinicaltrials:NCT05281965
  title: >-
    A Clinical Study Evaluating the Efficacy and Safety of Retinoic Acid in
    Patients With 15q11-q13 Duplication Syndrome
  found_in:
  - 15q11q13_Microduplication_Syndrome-deep-research-falcon.md
- reference: clinicaltrials:NCT05307679
  title: >-
    A Phase II, Randomized, Double-Blind, Placebo-Controlled, Parallel Group
    Study to Evaluate the Safety, Efficacy, and Pharmacodynamics of 52 Weeks of
    Treatment With Basmisanil in Participants Aged 2 to 14 Years Old With
    Dup15q Syndrome Followed by a 2-Year Optional Open-Label Extension
  found_in:
  - 15q11q13_Microduplication_Syndrome-deep-research-falcon.md
- reference: clinicaltrials:NCT07079696
  title: >-
    Investigating the Therapeutic Efficacy of All-trans Retinoic Acid in
    Autism Spectrum Disorder Patients With 15q11-13 Duplication Syndrome
  found_in:
  - 15q11q13_Microduplication_Syndrome-deep-research-falcon.md
📚

References & Deep Research

References

24
Maternal 15q Duplication Syndrome - GeneReviews® - NCBI Bookshelf
No top-level findings curated for this source.
Maternal 15q Duplication Syndrome.
No top-level findings curated for this source.
The inv dup (15) or idic (15) syndrome (Tetrasomy 15q).
No top-level findings curated for this source.
A survey of seizures and current treatments in 15q duplication syndrome.
No top-level findings curated for this source.
Gastrointestinal problems in 15q duplication syndrome.
No top-level findings curated for this source.
Duplication of the 15q11-q13 region: clinical and genetic study of 30 new cases.
No top-level findings curated for this source.
15q11.2 Duplication Encompassing Only the UBE3A Gene Is Associated with Developmental Delay and Neuropsychiatric Phenotypes.
No top-level findings curated for this source.
Quantitative Gait Analysis in Duplication 15q Syndrome and Nonsyndromic ASD.
No top-level findings curated for this source.
Dysfunctional sodium channel kinetics as a novel epilepsy mechanism in chromosome 15q11-q13 duplication syndrome.
No top-level findings curated for this source.
Genomics of Complex Neurodevelopmental Disorders with Variable Epilepsy Phenotypes: A Clinical Review of Dup15q Syndrome.
No top-level findings curated for this source.
Epileptic and developmental encephalopathy secondary to inversion-duplication of chromosome 15: Description of epilepsy characteristics and therapeutic outcomes.
No top-level findings curated for this source.
RO4938581, a GABA(A)-α5 negative allosteric modulator rescued behavioral and EEG phenotypes of a mouse model of Dup15q syndrome.
No top-level findings curated for this source.
Excess EEG beta-band oscillations in Dup15q syndrome correlate with clinical severity.
No top-level findings curated for this source.
The role of UBE3A in the autism and epilepsy-related Dup15q syndrome using patient-derived, CRISPR-corrected neurons.
No top-level findings curated for this source.
Population screening for 15q11-q13 duplications: corroboration of the difference in impact between maternally and paternally inherited alleles.
No top-level findings curated for this source.
Efficacy, safety, and tolerability of soticlestat as adjunctive therapy for the treatment of seizures in patients with Dup15q syndrome or CDKL5 deficiency disorder in an open-label signal-finding phase II study (ARCADE).
No top-level findings curated for this source.
Chromosome 15q11-q13 Duplication Syndrome: A Review of the Literature and 14 New Cases.
No top-level findings curated for this source.
Properties of beta oscillations in Dup15q syndrome.
No top-level findings curated for this source.
Abnormal sleep physiology in children with 15q11.2-13.1 duplication (Dup15q) syndrome.
No top-level findings curated for this source.
Sleep EEG signatures in mouse models of 15q11.2-13.1 duplication (Dup15q) syndrome.
No top-level findings curated for this source.
A Multicenter, Open-label, Pilot Study of TAK-935 (OV935) in Patients With 15Q Duplication Syndrome or CDKL5 Deficiency Disorder (ARCADE Study)
No top-level findings curated for this source.
A Clinical Study Evaluating the Efficacy and Safety of Retinoic Acid in Patients With 15q11-q13 Duplication Syndrome
No top-level findings curated for this source.
A Phase II, Randomized, Double-Blind, Placebo-Controlled, Parallel Group Study to Evaluate the Safety, Efficacy, and Pharmacodynamics of 52 Weeks of Treatment With Basmisanil in Participants Aged 2 to 14 Years Old With Dup15q Syndrome Followed by a 2-Year Optional Open-Label Extension
No top-level findings curated for this source.
Investigating the Therapeutic Efficacy of All-trans Retinoic Acid in Autism Spectrum Disorder Patients With 15q11-13 Duplication Syndrome
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Asta Literature Retrieval: Pathophysiology and clinical mechanisms of 15q11q13 Microduplication Syndrome. Core disease mechanisms, molecular and...
Asta Scientific Corpus Retrieval 20 citations 2026-04-15T19:37:56.687914

Asta Literature Retrieval: Pathophysiology and clinical mechanisms of 15q11q13 Microduplication Syndrome. Core disease mechanisms, molecular and...

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  • Papers retrieved: 20
  • Snippets retrieved: 20

Relevant Papers

[1] 16p13.11 deletion variants associated with neuropsychiatric disorders cause morphological and synaptic changes in induced pluripotent stem cell-derived neurons

  • Authors: E. Buttermore, Nickesha C Anderson, Pin-Fang Chen, N. Makhortova, Kristina H. Kim et al.
  • Year: 2022
  • Venue: Frontiers in Psychiatry
  • URL: https://www.semanticscholar.org/paper/c7feb5856b06514c3e9e70e5f293c829a6117c5d
  • DOI: 10.3389/fpsyt.2022.924956
  • PMID: 36405918
  • PMCID: 9669751
  • Summary: Patient-derived, induced pluripotent stem cells provide a platform for investigating the morphological, electrophysiological, and gene-expression changes that result from 16p13.11 CNVs in human-derived neurons and the identification of common phenotypes among neurons derived from patients with overlapping 16p 13.11 deletions will help to improve future treatment options and clinical outcomes.
  • Evidence snippets:
  • Snippet 1 (score: 0.487) > Mb (10). Since reported clinical phenotypes are heterogeneous, it has been difficult to establish a disease mechanism for how CNVs in this region affect neurodevelopment. > While detailed sequencing analysis of 16p13.11 CNVs have identified genes within affected regions that are commonly associated with NDDs, the relationship between observed genetic mutations and cellular phenotypes for many of the affected genes remains unknown. A recent study using induced pluripotent stem cell (iPSC)-derived neurons found that targeting the NF K B p65 pathway was able to correct proliferation deficits caused by 16p13.11 microduplication, implicating this pathway in the pathogenesis of this syndrome (11). Despite advances in understanding the mechanisms underlying 16p13.11 microduplication, the morphological and synaptic alterations that underlie the clinical phenotypes associated with 16p13.11 deletions have not been characterized. Furthermore, identification of common cellular phenotypes between patients with different 16p13.11 deletion sizes remains largely unknown. Studies directed at elucidating common phenotypes between patients with different mutation sizes provide the opportunity to establish genotype-phenotype relationships for key cell biological features that are responsive to phenotypic screening approaches capable of dissecting the molecular basis of dysregulated pathways in patient neurons. > Using exome sequencing and microarray analyses, we identified a subset of patients with early-and young adult-onset psychosis with heterozygous deletions within chromosome 16p13.11. In this study, we derived human iPSCs from two families with patients harboring 16p13.11 deletions (probands, patients) and familial controls. One of the probands has only interval I deleted, while the other two patients, a father and son pair, have both intervals I and II deleted (4). Patient-derived iPSCs provide a platform to study the cell-autonomous effects of 16p13.11 CNVs on human neurons. > We hypothesized that loss of region I, which includes the genes PDXDC1, NTAN1, and RRN3, would contribute to common cell autonomous phenotypes in iPSC-

[2] Clinical findings and genetic analysis of patients with copy number variants involving 17p13.3 using a single nucleotide polymorphism array: a single-center experience

  • Authors: Bin Liang, Donghong Yu, Wantong Zhao, Yan Wang, Xiaoqing Wu et al.
  • Year: 2022
  • Venue: BMC Medical Genomics
  • URL: https://www.semanticscholar.org/paper/c99e28f021fa90801c1054b5872ed4a20e492b66
  • DOI: 10.1186/s12920-022-01423-5
  • PMID: 36544138
  • PMCID: 9773569
  • Citations: 3
  • Summary: The clinical significance of small duplications including YWHAE and CRK but not PAFAH1B1 remains uncertain, for which parental testing and clinical heterogeneity should be considered in genetic counseling.
  • Evidence snippets:
  • Snippet 1 (score: 0.477) > Moreover, in group I 17p13.3 microduplication, Curry et al. [23] reported that disruption of ABR and duplication of BHLHA9 were associated with clefts and split hand/foot with long bone deficiency phenotypes, respectively. Capra et al. [26] reported that a boy carrying a maternally inherited 329.5-kb 17p13.3 duplication, including BHLHA9, YWHAE, and CRK, presented with mild dysmorphic phenotype, autism, and mental retardation, while his mother was affected by a bipolar and borderline disorder and was addicted to alcohol. It can be seen that phenotypic heterogeneity existed in the mother and her child. Another report [27] described two patients manifesting distinctive features (patient 1, primary hypothyroidism; patient 2, bilateral cryptorchidism) that were not previously described in the duplication 17p13.3 spectrum. Whether these rare manifestations observed in the two patients were caused by a two-hit event or not is not known. Overall, considering 17p13.3 microduplication showing reduced penetrance, variable expressivity, and lack of a clear pathogenic mechanism, the clinical significance of the microduplication encompassing only YWHAE and CRK, but not PAFAH1B1, requires further investigation. > Interestingly, case 3 also carried a 74.2 Mb mosaic duplication of approximately 3.5 on chromosome 17p13.2q25.3 and a 1.0 Mb deletion in the 17q terminus, in addition to deletion of the MDS region. The SNP data were consistent with that some cells have ring 17 while others have dicentric or interlock ring 17. Given the dosage sensitivity of genes and regions involved in the three CNVs, case 3 may show compound manifestations of these known genomic disorders, such as MDS, Potocki-Lupski syndrome (MIM:610883) [12], Charcot-Marie-Tooth disease, type 1A (CMT1A, MIM:118220) [28,29], 17q11.2

[3] Cytogenomic Abnormalities and Underlying Mechanisms for Intellectual and Developmental Disabilities

  • Authors: Peining Li
  • Year: 2013
  • Venue: Journal of Molecular and Genetic Medicine
  • URL: https://www.semanticscholar.org/paper/2578c174427082f0beff180c57c6414783a4601b
  • DOI: 10.4172/1747-0862.1000073
  • Citations: 1
  • Summary: Functional analyses using in vitro cellular phenotyping and in vivo animal modeling have been developed for clinically detected pCNVs and there is urgent demand for rapid transition from diagnostic discovery to study of disease-causing mechanisms and exploration of therapeutic approaches.
  • Evidence snippets:
  • Snippet 1 (score: 0.471) > For many newly detected pCNVs, little is known about the dosagesensitive genes and their cellular and developmental functions. The limited availability and accessibility of live brain and neuron tissues is the major obstacle in the study of disease-causing mechanisms in human mental development. Recent progress in stem cell technologies has made possible the modeling of human mental diseases using patient derived stem cells. In 2010, Marchetto et al. developed a culture system using induced pluripotent stem cells (iPSCs) from Rett syndrome patients' fibroblasts [8]. These Rett syndrome iPSCs were able to undergo X-inactivation and generate functional neurons. Neurons derived from these iPSCs had fewer synapses, reduced spine density, smaller soma size, altered calcium signaling and electrophysiological defects when compared to controls. This cellular model provided critical evidence of an unexplored developmental window before disease onset and enable direct testing of drug effect in rescuing synaptic defects. > The microdeletion and microduplication at the same genomic locus offer an opportunity to study dosage-sensitive genes, especially for the opposite phenotypes of haploinsufficient and triple-sensitive genes. However, clinical evaluation could be complicated by overlapped phenotypes, variable expressivity, reduced penetrance and lack of longitudinal study of late-onset phenotypes for many genomic disorders. Recent studies observed opposite phenotypes in a few genomic disorders. For example, the microdeletion syndrome at 16p11.2 (OMIM#611913) and the reciprocal microduplication syndrome (OMIM#614671) were initially associated with ASD but a subsequent study revealed mirror body mass index phenotypes. Microdeletion at 16p11.2 is often associated with obesity, macrocephaly and ASD, while the reciprocal microduplication is associated with underweight, microcephaly and schizophrenia [9]. Mouse models of 16p11.2 microdeletion and microduplication detected in vivo brain anomalies and behavior disorders [10]. Overexpression and transcript suppression of the 29 candidate genes from this 16p11.2

[4] Disorders of the genome architecture: a review

  • Authors: Dhavendra Kumar
  • Year: 2008
  • Venue: Genomic Medicine
  • URL: https://www.semanticscholar.org/paper/df00164481646356263fd7a235e072cde2e723e1
  • DOI: 10.1007/s11568-009-9028-2
  • PMID: 19277903
  • Citations: 35
  • Influential citations: 3
  • Summary: Widespread application of high-resolution genome analyses may offer to detect more sporadic phenotypes resulting from genomic rearrangements involving de novo copy number variation.
  • Evidence snippets:
  • Snippet 1 (score: 0.454) > Genetic diseases are recognized to be one of the major categories of human disease. Traditionally genetic diseases are subdivided into chromosomal (numerical or structural aberrations), monogenic or Mendelian diseases, multifactorial/polygenic complex diseases and mitochondrial genetic disorders. A large proportion of these conditions occur sporadically. With the advent of newer molecular techniques, a number of new disorders and dysmorphic syndromes are delineated in detail. Some of these conditions do not conform to the conventional inheritance patterns and mechanisms are often complex and unique. Examples include submicroscopic microdeletions or microduplications, trinucleotide repeat disorders, epigenetic disorders due to genomic imprinting, defective transcription or translation due to abnormal RNA patterning and pathogenic association with single nucleotide polymorphisms and copy number variations. Among these several apparently monogenic disorders result from non-allelic homologous recombination associated with the presence of low copy number repeats on either side of the critical locus or gene cluster. The term ‘disorders of genome architecture’ is alternatively used to highlight these disorders, for example Charcot-Marie-Tooth type IA, Smith-Magenis syndrome, Neurofibromatosis type 1 and many more with an assigned OMIM number. Many of these so called genomic disorders occur sporadically resulting from largely non-recurrent de novo genomic rearrangements. Locus-specific mutation rates for genomic rearrangements appear to be two to four times greater than nucleotide-specific rates for base substitutions. Recent studies on several disease-associated recombination hotspots in male-germ cells indicate an excess of genomic rearrangements resulting in microduplications that are clinically underdiagnosed compared to microdeletion syndromes. Widespread application of high-resolution genome analyses may offer to detect more sporadic phenotypes resulting from genomic rearrangements involving de novo copy number variation.

[5] Consequences of aneuploidy in human fibroblasts with trisomy 21

  • Authors: Sunyoung Hwang, Paola Cavaliere, Rui Li, L. Zhu, Noah E. Dephoure et al.
  • Year: 2020
  • Venue: Proceedings of the National Academy of Sciences of the United States of America
  • URL: https://www.semanticscholar.org/paper/5ae9f7792cd2e4a8e2d6178f5a322da9f96ba3ac
  • DOI: 10.1101/2020.08.14.251082
  • PMID: 33526671
  • PMCID: 8017964
  • Citations: 57
  • Influential citations: 6
  • Summary: It is shown that several aneuploidy-associated phenotypes are present in trisomy 21 cells, including lower viability and increased dependency on serine-driven lipid synthesis, and the lack of evidence for widespread dosage compensation or dysregulation of chromosomal domains in human autosomes is supported.
  • Evidence snippets:
  • Snippet 1 (score: 0.450) > Significance An abnormal number of chromosomes or aneuploidy accounts for most spontaneous abortions, as missegregation of a single chromosome during development is often lethal. Only individuals with trisomy 21, which causes Down syndrome, can live to adulthood but show cognitive disabilities, increased risk for leukemias, autoimmune disorders, and clinical symptoms associated with premature aging. The mechanisms by which aneuploidy affects cellular function to cause Down syndrome are not understood. Our studies revealed that aneuploidy causes several defects in cells from individuals with Down syndrome. These include increased gene and protein expression, lower viability, and increased dependency on serine to proliferate. Our studies establish a critical role of aneuploidy, independent of triplicated gene identity, in driving cellular defects associated with trisomy 21. An extra copy of chromosome 21 causes Down syndrome, the most common genetic disease in humans. The mechanisms contributing to aneuploidy-related pathologies in this syndrome, independent of the identity of the triplicated genes, are not well defined. To characterize aneuploidy-driven phenotypes in trisomy 21 cells, we performed global transcriptome, proteome, and phenotypic analyses of primary human fibroblasts from individuals with Patau (trisomy 13), Edwards (trisomy 18), or Down syndromes. On average, mRNA and protein levels were increased by 1.5-fold in all trisomies, with a subset of proteins enriched for subunits of macromolecular complexes showing signs of posttranscriptional regulation. These results support the lack of evidence for widespread dosage compensation or dysregulation of chromosomal domains in human autosomes. Furthermore, we show that several aneuploidy-associated phenotypes are present in trisomy 21 cells, including lower viability and increased dependency on serine-driven lipid synthesis. Our studies establish a critical role of aneuploidy, independent of triplicated gene identity, in driving cellular defects associated with trisomy 21.

[6] A Private 16q24.2q24.3 Microduplication in a Boy with Intellectual Disability, Speech Delay and Mild Dysmorphic Features

  • Authors: O. Palumbo, P. Palumbo, Ester Di Muro, L. Cinque, A. Petracca et al.
  • Year: 2020
  • Venue: Genes
  • URL: https://www.semanticscholar.org/paper/2101a5069af4ecb28806ee1f83f4bf2ab659a02a
  • DOI: 10.3390/genes11060707
  • PMID: 32604767
  • PMCID: 7349372
  • Citations: 18
  • Influential citations: 1
  • Summary: AnKRD11, CDH15, and CTU2 are proposed as candidate genes for explaining the related neurodevelopmental manifestations shared by these patients with overlapping 16.2q24.3 microduplication, providing supporting evidence of an emerging syndrome.
  • Evidence snippets:
  • Snippet 1 (score: 0.447) > Also, in vitro functional studies showed that mutant proteins result in decreased cell adhesion suggesting that CDH15 alterations, either alone or in combination with other factors, likely play a role in the etiology of ID [21]. Finally, copy number variations (both deletions and duplications) affecting other genes involved in neural cell adhesion molecules have been recently associated with neurodevelopmental disorders [22,23]. Accordingly, 16q24.2q24.3 microduplication can be added to available data corroborating a key role of these cellular pathways in cognitive development. > CTU2 is an additional candidate gene mapping into 16q24.2q24.3 microduplication SRO and encoding a protein involved in the post-transcriptional modification of transfer RNAs (tRNAs). This protein plays a role in thiolation of uridine residue present at the wobble position in a subset of tRNAs, resulting in enhanced codon reading accuracy. Biallelic variants in CTU2 have been associated with a specific syndromic phenotype featuring microcephaly, facial dysmorphism, renal agenesis, and ambiguous genitalia [24,25], and this gene has been recently listed into the Developmental Disorders Genotype-Phenotype Database (DDG2P). > Altogether, the evidence emerging from our study and the current knowledge concerning the proposed candidate genes support our hypothesis that their copy number alteration contribute to the etiology of the clinical phenotype observed in patients with 16q24.2q24.3 microduplication mainly for neurodevelopmental features shared among affected individuals. > For the other genes duplicated in patients discussed in the present study, although none of them seem to be clearly associable with the clinical traits reported, we cannot exclude their involvement in the etiology of the clinical condition. More detailed genetic and/or functional studies, or patients with point mutations/CNVs affecting only one or a few of these genes, are needed to elucidate this possibility.

[7] Exploring pathway interactions to detect molecular mechanisms of disease: 22q11.2 deletion syndrome

  • Authors: Woosub Shin, M. Kutmon, Eleni Mina, Therese van Amelsvoort, C. Evelo et al.
  • Year: 2023
  • Venue: Orphanet Journal of Rare Diseases
  • URL: https://www.semanticscholar.org/paper/e7f38266ecbaf1d1da3e525e1969a29f36c1cddc
  • DOI: 10.1186/s13023-023-02953-6
  • PMID: 37872602
  • PMCID: 10594698
  • Citations: 3
  • Summary: The pathway interaction method was able to detect a molecular network that could possibly explain the development of neuropsychiatric diseases among the 22q11DS patients, and could be used for similar contexts, where complex genetic mechanisms need to be identified to explain the resulting phenotypic plasticity.
  • Evidence snippets:
  • Snippet 1 (score: 0.440) > Background 22q11.2 Deletion Syndrome (22q11DS) is a genetic disorder characterized by the deletion of adjacent genes at a location specified as q11.2 of chromosome 22, resulting in an array of clinical phenotypes including autistic spectrum disorder, schizophrenia, congenital heart defects, and immune deficiency. Many characteristics of the disorder are known, such as the phenotypic variability of the disease and the biological processes associated with it; however, the exact and systemic molecular mechanisms between the deleted area and its resulting clinical phenotypic expression, for example that of neuropsychiatric diseases, are not yet fully understood. Results Using previously published transcriptomics data (GEO:GSE59216), we constructed two datasets: one set compares 22q11DS patients experiencing neuropsychiatric diseases versus healthy controls, and the other set 22q11DS patients without neuropsychiatric diseases versus healthy controls. We modified and applied the pathway interaction method, originally proposed by Kelder et al. (2011), on a network created using the WikiPathways pathway repository and the STRING protein-protein interaction database. We identified genes and biological processes that were exclusively associated with the development of neuropsychiatric diseases among the 22q11DS patients. Compared with the 22q11DS patients without neuropsychiatric diseases, patients experiencing neuropsychiatric diseases showed significant overrepresentation of regulated genes involving the natural killer cell function and the PI3K/Akt signalling pathway, with affected genes being closely associated with downregulation of CRK like proto-oncogene adaptor protein. Both the pathway interaction and the pathway overrepresentation analysis observed the disruption of the same biological processes, even though the exact lists of genes collected by the two methods were different. Conclusions Using the pathway interaction method, we were able to detect a molecular network that could possibly explain the development of neuropsychiatric diseases among the 22q11DS patients. This way, our method was able to complement the pathway overrepresentation analysis, by filling the knowledge gaps on how the affected pathways are linked to the original deletion on chromosome 22. We expect our pathway interaction method could be used for problems with similar contexts, where complex genetic mechanisms need to be identified to explain the

[8] Investigating the role of NPR1 in dilated cardiomyopathy and its potential as a therapeutic target for glucocorticoid therapy

  • Authors: Yaomeng Huang, Tongxin Li, Shichao Gao, Shuyu Li, Xiaoran Zhu et al.
  • Year: 2023
  • Venue: Frontiers in Pharmacology
  • URL: https://www.semanticscholar.org/paper/be229f6f2059faab4c97ec0a04bd055adab9dfe1
  • DOI: 10.3389/fphar.2023.1290253
  • PMID: 38026943
  • PMCID: 10662320
  • Citations: 3
  • Summary: Natriuretic peptide receptor 1 (NPR1) was identified as a core gene associated with DCM through bioinformatics analysis and led to substantial improvements in cardiac and renal function, accompanied by an upregulation of NPR1 expression.
  • Evidence snippets:
  • Snippet 1 (score: 0.429) > Multiple pathways and molecules are involved in this process; however, the detailed underlying mechanisms remain unclear. In recent years, with the development of high-throughput sequencing and gene chip technologies, the use of bioinformatics technology to explore the occurrence, development, and prognosis of diseases has become a hot topic for scholars worldwide (Hwang et al., 2018;Nayor et al., 2019;Rinschen et al., 2019;Sturm et al., 2019;Montaner et al., 2020). > The present study aimed to use bioinformatics technology to screen for DCM-related genes and investigate their mechanisms, with the purpose of revealing the pathogenesis of DCM and seeking treatment methods. The GSE3586 dataset, containing expression profiles related to DCM, was selected from the Gene Expression Omnibus (GEO) database. This study aimed to predict the core genes that may play crucial roles in disease progression at the molecular level through the enrichment of relevant molecular pathways associated with DCM. Furthermore, the phenotype of the core genes was validated to further support the results of the bioinformatics analysis through basic and clinical experiments. Additionally, the role of glucocorticoids in DCM treatment is discussed in this article with the purpose of providing a theoretical and experimental basis for exploring the pathogenesis of DCM and elucidating therapeutic methods. This study also provides a theoretical reference for the interpretation, early diagnosis, and treatment of DCM.

[9] Retinoic Acid Induced 1, RAI1: A Dosage Sensitive Gene Related to Neurobehavioral Alterations Including Autistic Behavior

  • Authors: P. Carmona-Mora, K. Walz
  • Year: 2010
  • Venue: Current Genomics
  • URL: https://www.semanticscholar.org/paper/fd71900e9fb4ef4a9ae5290a08e485137368bdd1
  • DOI: 10.2174/138920210793360952
  • PMID: 21629438
  • PMCID: 3078685
  • Citations: 54
  • Influential citations: 5
  • Summary: The evidence of RAI1 as a dosage sensitive gene, its relationship with different neuro behavioral traits, gene structure and mutations, and what is known about its molecular and cellular function are discussed, as a first step in the elucidation of the mechanisms that relate dosage sensitive genes with abnormal neurobehavioral outcomes.
  • Evidence snippets:
  • Snippet 1 (score: 0.421) > Genomic structural changes, such as gene Copy Number Variations (CNVs) are extremely abundant in the human genome. An enormous effort is currently ongoing to recognize and catalogue human CNVs and their associations with abnormal phenotypic outcomes. Recently, several reports related neuropsychiatric diseases (i.e. autism spectrum disorders, schizophrenia, mental retardation, behavioral problems, epilepsy) with specific CNV. Moreover, for some conditions, both the deletion and duplication of the same genomic segment are related to the phenotype. Syndromes associated with CNVs (microdeletion and microduplication) have long been known to display specific neurobehavioral traits. It is important to note that not every gene is susceptible to gene dosage changes and there are only a few dosage sensitive genes. Smith-Magenis (SMS) and Potocki-Lupski (PTLS) syndromes are associated with a reciprocal microdeletion and microduplication within chromosome 17p11.2. in humans. The dosage sensitive gene responsible for most phenotypes in SMS has been identified: the Retinoic Acid Induced 1 (RAI1). Studies on mouse models and humans suggest that RAI1 is likely the dosage sensitive gene responsible for clinical features in PTLS. In addition, the human RAI1 gene has been implicated in several neurobehavioral traits as spinocerebellar ataxia (SCA2), schizophrenia and non syndromic autism. In this review we discuss the evidence of RAI1 as a dosage sensitive gene, its relationship with different neurobehavioral traits, gene structure and mutations, and what is known about its molecular and cellular function, as a first step in the elucidation of the mechanisms that relate dosage sensitive genes with abnormal neurobehavioral outcomes.

[10] New insights into candidate genes for autism spectrum disorder in 8p23.1 duplication syndrome

  • Authors: M. M. Côrrea, Thiago Corrêa, C. Santos-Rebouças, Marino Miloca Rodrigues, G. Luca et al.
  • Year: 2022
  • Venue: Brazilian Journal of Case Reports
  • URL: https://www.semanticscholar.org/paper/7549630ec79b57d7221fb427280bd360a35590b2
  • DOI: 10.52600/2763-583x.bjcr.2023.3.1.16-23
  • Summary: Clinical and cytomolecular findings of an 8p23.1 duplication in a boy with mild facial dysmorphisms, cardiac anomalies and ASD are described, pointing out crucial interactions among BLK, GATA4, PINX1, and TNKS and genes associated with ASD.
  • Evidence snippets:
  • Snippet 1 (score: 0.418) > The 8p23.1 duplication syndrome is a rare condition, characterized by dysmorphisms, intellectual disability, congenital cardiac anomalies, and autism spectrum disorder (ASD). The current model for explaining the pathogenesis of this condition postulates that few dosage-sensitive genes within the duplication are sufficient for the core clinical features, although the molecular mechanisms leading to the ASD presentation remain to be solved. Herein, we described clinical and cytomolecular findings of an 8p23.1 duplication in a boy with mild facial dysmorphisms, cardiac anomalies and ASD. Therefore, we investigated the influence of duplicated genes on the pathophysiology of ASD in our patient. We identified four duplicated genes (BLK, GATA4, PINX1, TNKS) connected with proteins previously associated with ASD and involved in significant enriched pathways associated with human neurological conditions. Moreover, the candidate genes are highly expressed in brain regions associated to ASD, such as the hippocampus. Taken together, these results point out crucial interactions among BLK, GATA4, PINX1, and TNKS and genes associated with ASD. We indicate cellular networks perturbations encompassing neuronal development pathways related to our patient's condition. Thus, these findings bring new insights into the genetic basis of ASD in patients with 8p23.1 duplication syndrome.

[11] Transcriptional profiling of Hutchinson-Gilford progeria patients identifies primary target pathways of progerin

  • Authors: Sandra Vidak, Sohyoung Kim, Tom Misteli
  • Year: 2026
  • Venue: Nucleus
  • URL: https://www.semanticscholar.org/paper/4bd99b0875508364d8672b6da5a50d024d485a53
  • DOI: 10.1080/19491034.2025.2611484
  • PMID: 41489464
  • PMCID: 12773485
  • Summary: To probe the clinical relevance of previously implicated cellular pathways and to address the extent of gene expression heterogeneity between patients, transcriptomic analysis of a comprehensive set of HGPS patients finds misexpression of several cellular pathways, including multiple signaling pathways, the UPR and mesodermal cell fate specification.
  • Evidence snippets:
  • Snippet 1 (score: 0.416) > Oxidative stress represents another key pathogenic mechanism in HGPS, as impaired NRF2 activity or increased reactive oxygen species (ROS) levels are sufficient to recapitulate HGPSassociated phenotypes [17,32,60]. Collectively, these findings underscore the multifactorial nature of HGPS pathogenesis, implicating interconnected signaling cascades involved in inflammation, oxidative stress, proteostasis, and vascular remodeling. Reassuringly, our findings indicate that many of the major pathways that have been described to contribute to HGPS phenotypes in mouse and cellular disease models are also misregulated in progeria patients, and targeting these pathways may provide therapeutic avenues to mitigate disease severity and improve outcomes in HGPS. > Although individuals with HGPS typically exhibit a characteristic set of clinical features, such as craniofacial abnormalities, growth retardation, and cardiovascular complications, there is notable variability in the age of onset, severity, and progression of symptoms between patients [7,9]. At the cellular level, HGPS is associated with several hallmark abnormalities, including nuclear envelope defects, decreased expression of several nuclear proteins and epigenetic marks, mitochondrial dysfunction, and increased cellular senescence [1,11,30,31,61]. These cellular phenotypes also exhibit considerable variation between patients, possibly contributing to differences in clinical outcomes. Our results indicate that even though some degree of transcriptional heterogeneity between the individual patients exists, the majority of patients exhibit misregulation of a set of shared pathways, suggesting that these pathways are universal driver mechanisms in HGPS. Further work is needed to understand the molecular and genetic factors that underlie inter-individual variability in disease expression and progression. > A limitation of pathway analysis of HGPS patient samples is to distinguish the pathways which are directly targeted by the disease-causing progerin protein and the emergence of adaptive secondary response pathways during progression of the disease in patients during their lifetime. The same caveat applies to the use of cell-based models used in the study of HGPS disease mechanisms.

[12] Neurodevelopmental Disorders Associated with Abnormal Gene Dosage: Smith–Magenis and Potocki–Lupski Syndromes

  • Authors: Juanita Neira-Fresneda, L. Potocki
  • Year: 2015
  • Venue: Journal of Pediatric Genetics
  • URL: https://www.semanticscholar.org/paper/ae2f935107027507a7fda71a609b1a42c7e12981
  • DOI: 10.1055/s-0035-1564443
  • PMID: 27617127
  • PMCID: 4918721
  • Citations: 51
  • Influential citations: 1
  • Summary: The neurobehavioral phenotypes of SMS and PTLS patients during different life phases are described as well as clinical guidelines for diagnosis and a multidisciplinary approach once diagnosis is confirmed by array comparative genomic hybridization or RAI1 gene sequencing.
  • Evidence snippets:
  • Snippet 1 (score: 0.413) > The proximal short arm of chromosome 17 is a genomic region that is prone to rearrangements which have been extensively characterized elsewhere. 1,2 Several distinct genomic disorders map to this region including the autosomal dominant peripheral neuropathies such as Charcot-Marie-Tooth disease type 1A (CMT1A, MIM#118220) and hereditary neuropathy with liability to pressure palsies (HNPP, MIM#162500), the chromosomal microduplication/microdeletion syndromes, Potocki-Lupski syndrome (PTLS, MIM#610883), and Smith-Magenis syndrome (SMS, MIM#182290), as well as the newly described PMP22-RAI1 duplication syndrome (Yuan et al, unpublished data, 2015). > Although haploinsufficiency of the single retinoic acidinduced gene (RAI1) is responsible for much of the phenotype in SMS, 3,4 both SMS and PTLS are examples of contiguous gene syndromes (CGS), as the clinical features of each are due to abnormal dosage and variation of physically contiguous yet functionally unrelated genes in the 17p11.2 genomic region. 5 The mechanism leading to genomic rearrangements in common microdeletion syndromes was first elucidated in SMS. 6 Interestingly, the clinical syndrome associated with duplication 17p11.2 (now known as PTLS) was initially defined based on the shared molecular structure among patients, the duplication representing the mechanistically predicted homologous recombination reciprocal of the SMS microdeletion. 7 Keywords ► congenital heart disease ► autism ► intellectual disability ► mirror traits ► gene dosage Abstract Smith-Magenis syndrome (SMS) and Potocki-Lupski syndrome (PTLS) are reciprocal contiguous gene syndromes within the well-characterized 17p11.2 region. Approximately 3.6 Mb microduplication of 17p11.2, known as PTLS, represents the mechanistically predicted homologous recombination reciprocal of the SMS microdeletion, both resulting in multiple congenital anomalies. Mouse model studies have revealed that the retinoic acid-inducible

[13] Identification of molecular signatures and pathways involved in Rett syndrome using a multi-omics approach

  • Authors: Ainhoa Pascual-Alonso, Clara Xiol, Dmitrii Smirnov, R. Kopajtich, H. Prokisch et al.
  • Year: 2023
  • Venue: Human Genomics
  • URL: https://www.semanticscholar.org/paper/8a7c3afd9cb1678bc1463754753cf69512f23eaa
  • DOI: 10.1186/s40246-023-00532-1
  • PMID: 37710353
  • PMCID: 10503149
  • Citations: 10
  • Summary: Background Rett syndrome (RTT) is a neurodevelopmental disorder mainly caused by mutations in the methyl-CpG-binding protein 2 gene ( MECP2 ). MeCP2 is a multi-functional protein involved in many cellular processes, but the mechanisms by which its dysfunction causes disease are not fully understood. The duplication of the MECP2 gene causes a distinct disorder called MECP2 duplication syndrome (MDS), highlighting the importance of tightly regulating its dosage for proper cellular function. Add...
  • Evidence snippets:
  • Snippet 1 (score: 0.413) > Background Rett syndrome (RTT) is a neurodevelopmental disorder mainly caused by mutations in the methyl-CpG-binding protein 2 gene ( MECP2 ). MeCP2 is a multi-functional protein involved in many cellular processes, but the mechanisms by which its dysfunction causes disease are not fully understood. The duplication of the MECP2 gene causes a distinct disorder called MECP2 duplication syndrome (MDS), highlighting the importance of tightly regulating its dosage for proper cellular function. Additionally, some patients with mutations in genes other than MECP2 exhibit phenotypic similarities with RTT, indicating that these genes may also play a role in similar cellular functions. The purpose of this study was to characterise the molecular alterations in patients with RTT in order to identify potential biomarkers or therapeutic targets for this disorder. Methods We used a combination of transcriptomics (RNAseq) and proteomics (TMT mass spectrometry) to characterise the expression patterns in fibroblast cell lines from 22 patients with RTT and detected mutation in MECP2 , 15 patients with MDS, 12 patients with RTT-like phenotypes and 13 healthy controls. Transcriptomics and proteomics data were used to identify differentially expressed genes at both RNA and protein levels, which were further inspected via enrichment and upstream regulator analyses and compared to find shared features in patients with RTT. Results We identified molecular alterations in cellular functions and pathways that may contribute to the disease phenotype in patients with RTT, such as deregulated cytoskeletal components, vesicular transport elements, ribosomal subunits and mRNA processing machinery. We also compared RTT expression profiles with those of MDS seeking changes in opposite directions that could lead to the identification of MeCP2 direct targets. Some of the deregulated transcripts and proteins were consistently affected in patients with RTT-like phenotypes, revealing potentially relevant molecular processes in patients with overlapping traits and different genetic aetiology. Conclusions The integration of data in a multi-omics analysis has helped to interpret the molecular consequences of MECP2 dysfunction, contributing to the characterisation of the molecular landscape in patients with RTT. The comparison with MDS provides knowledge of MeCP2 direct targets, whilst the correlation with RTT-

[14] The contribution of genetic determinants of blood gene expression and splicing to molecular phenotypes and health outcomes

  • Authors: A. Tokolyi, E. Persyn, A. Nath, K. Burnham, J. Marten et al.
  • Year: 2025
  • Venue: Nature Genetics
  • URL: https://www.semanticscholar.org/paper/5435e12fd796fca6db2c0ce1844b6fc252d2d73e
  • DOI: 10.1038/s41588-025-02096-3
  • PMID: 40038547
  • PMCID: 11906350
  • Citations: 12
  • Summary: This study mapped blood gene expression and splicing quantitative trait loci and uncovered gene-regulatory mechanisms at disease loci with therapeutic implications, such as WARS1 in hypertension, IL7R in dermatitis and IFNAR2 in COVID-19.
  • Evidence snippets:
  • Snippet 1 (score: 0.413) > The biological mechanisms through which most nonprotein-coding genetic variants affect disease risk are unknown. To investigate gene-regulatory mechanisms, we mapped blood gene expression and splicing quantitative trait loci (QTLs) through bulk RNA sequencing in 4,732 participants and integrated protein, metabolite and lipid data from the same individuals. We identified cis-QTLs for the expression of 17,233 genes and 29,514 splicing events (in 6,853 genes). Colocalization analyses revealed 3,430 proteomic and metabolomic traits with a shared association signal with either gene expression or splicing. We quantified the relative contribution of the genetic effects at loci with shared etiology, observing 222 molecular phenotypes significantly mediated by gene expression or splicing. We uncovered gene-regulatory mechanisms at disease loci with therapeutic implications, such as WARS1 in hypertension, IL7R in dermatitis and IFNAR2 in COVID-19. Our study provides an open-access resource on the shared genetic etiology across transcriptional phenotypes, molecular traits and health outcomes in humans (https://IntervalRNA.org.uk). > The majority of genetic variants associated with common diseases and other complex traits identified through genome-wide association studies (GWAS) lie in nonprotein-coding sequences 1 . Consequently, the molecular mechanisms that underpin many of these genotype-phenotype associations are unclear. Molecular quantitative trait locus (QTL) mapping studies, which identify genetic determinants of transcript, protein or metabolite abundance, can address this knowledge gap by identifying the molecular intermediaries that mediate genetically driven disease risk. These studies can provide specific hypotheses for functional validation experiments 2,3 . > Molecular QTL data can be used for a range of biomedical applications. For example, they have the potential to identify and validate new therapeutic targets and pathways, inform about the biological mechanisms of drug action and safety, highlight new therapeutic indications and reveal clinically relevant biomarkers [4][5][6] . > Many previous studies have carried out QTL mapping within a single molecular domain such as gene or protein expression [7][8][9][10][11][12] .

[15] New therapeutic targets in rare genetic skeletal diseases

  • Authors: M. Briggs, Peter A. Bell, M. Wright, K. A. Pirog
  • Year: 2015
  • Venue: Expert Opinion on Orphan Drugs
  • URL: https://www.semanticscholar.org/paper/1363107f71ae6d2d60abca471cddf3da5d13644b
  • DOI: 10.1517/21678707.2015.1083853
  • PMID: 26635999
  • PMCID: 4643203
  • Citations: 37
  • Influential citations: 1
  • Summary: An overview of disease mechanisms that are shared amongst groups of different GSDs and potential therapeutic approaches that are under investigation are described to generate critical mass for the identification and validation of novel therapeutic targets and biomarkers.
  • Evidence snippets:
  • Snippet 1 (score: 0.410) > proteins of the cartilage ECM such as type II collagen [50]. However, emerging knowledge suggests that the primary genetic defect may be less important than the cells' response to the expression of the mutant gene product [107]. Moreover, the largely overlooked response of a cell (i.e. chondrocyte) to the abnormal extracellular environment is also important for disease progression as illustrated by several GSDs discussed in this review. > It is important that 'omics'-based approaches and technologies are systematically applied to the study of rare GSDs so that definitive reference profiles and disease signatures are generated for each phenotype. These can then be used in a Systems Biology approach to identify both common and dissimilar pathological signatures and disease mechanisms. This approach is entirely dependent upon relevant in vitro and in vivo models (and also novel 'disease-mechanism phenocopies' [107]) for testing new diagnostic and prognostic tools and for determining the molecular mechanisms that underpin the pathophysiology so that effective therapeutic treatments can be developed and validated. This approach will eventually lead to personalized treatments and care strategies centred on shared disease mechanisms with the use of relevant biomarkers to monitor the efficacy of treatment and disease progression. > It is vital that all relevant stakeholders are involved from the outset in defining the appropriate outcomes of any potential therapeutic regime. The perceptions of a successful therapy can differ widely between the clinical academic community and the relevant patient-support groups and it is vital that there is engagement on all these issues. > In summary, the identification of causative genes and mutations for GSDs over the last 20 years, coupled with the generation and in-depth analysis of a plethora of relevant cell and mouse models, has derived new knowledge on disease mechanisms and suggested potential therapeutic targets. The fast-evolving hypothesis that clinically disparate diseases can share common disease mechanisms is a powerful concept that will generate critical mass for the identification and validation of novel therapeutic targets and biomarkers.

[16] Spatiotemporal 7q11.23 Protein Network Implicates the GTF2I-PRKDC-DDR Pathway During Early-Fetal Brain Development in Psychiatric Diseases

  • Authors: G. Lin, Liang Chen, Weidi Wang, Wenxiang Cai, Weichen Song et al.
  • Year: 2020
  • Venue: Unknown venue
  • URL: https://www.semanticscholar.org/paper/6a2df6310ac4d8f7f3f76da6f21f8a221ebf1cce
  • DOI: 10.21203/rs.3.rs-93461/v1
  • Summary: Striatum, hippocampus, and amygdala are crucial regions for establishing connectivity between 7q11.23 proteins and their partners in early and late fetal periods, and the results suggested that GTF2I-PRKDC-DDR and GTF 2I-BRCA1-dDR pathway is crucial for the 7q 11.23 CNV genes to contribute to the pathogenesis of psychiatric diseases.
  • Evidence snippets:
  • Snippet 1 (score: 0.406) > A different approach of addressing this issue is based on creating animal or cell models to help identify the related molecular and cellular mechanisms. For instance, mice with a heterozygous deletion of GTF2I or GTF2IRD1 show defects in skeletal and craniofacial. [14]. In addition, the embryos of these mice present with a small head; this is consistent with the clinical phenotype of patients carrying a 7q11. 23 deletion. Nevertheless, the signaling pathways affected by this CNV remain unknown. > Replication factor C subunit 2 (RFC2), another 7q11.23 gene, encodes a subunit of the replication factor C (RFC) complex [15] and is known to play a role in ATR signaling [16,17]. Haploinsufficiency for RFC2 leaded to G2/M checkpoint arrest after DNA damage [18]. However, little is known about how genes with the 7q11.23 deletion/duplication may affect the occurrence of neurodevelopmental disorders because these genes are involved not only in multiple developmental stages but also within different tissues. Hence, genes exhibiting 7q11.23 deletion/duplication play different roles in different developmental stages and different anatomic structures. > CNVs have been reported to modulate gene expression, which, ultimately, might affect disease predisposition or clinical phenotypes [19,20]. Several researches have investigated CNV pathogenesis in psychiatric disorders by constructing a static topological network based on a single developmental stage [21]. Within different developmental periods, protein expression can change, as can protein-protein interactions (PPIs) [22]. Nevertheless, protein expression is a dynamic process that can occur in a different manner across different anatomical areas [23,24]. Analyses of molecular networks can reveal biological modularity and complex signaling pathways [25,26]. Previous studies discovered the pathogenesis of CNVs by constructing dynamic protein-protein interaction (PPI) networks according to alterations of protein expression in different anatomical areas and during different developmental periods [27,28]. > In addition, multiple studies mentioned above focused only on one or two genes and were unable to demonstrate how the 7q11.23 CNV is involved in brain development.

[17] Drug repurposing in Rett and Rett-like syndromes: a promising yet underrated opportunity?

  • Authors: Claudia Fuchs, P. A. ‛. ’t Hoen, A. Müller, Friederike Ehrhart, C. V. van Karnebeek
  • Year: 2024
  • Venue: Frontiers in Medicine
  • URL: https://www.semanticscholar.org/paper/b00d0859458647edeebf3cf53f9b39c79311d5ed
  • DOI: 10.3389/fmed.2024.1425038
  • PMID: 39135718
  • PMCID: 11317438
  • Citations: 1
  • Summary: The potential of drug repurposing (DR) as a promising avenue for addressing the unmet medical needs of individuals with RTT and related disorders is explored and Leveraging existing drugs for new therapeutic purposes presents an attractive strategy.
  • Evidence snippets:
  • Snippet 1 (score: 0.405) > Rigorous preclinical and clinical studies are also crucial for better understanding the complex pathophysiology of these syndromes. To date, the precise molecular mechanisms underlying these complex disorders are still not fully understood; hindering the identification and validation of potential drug targets. This specifically applies to CDD and FOXG1-syndrome: both conditions were identified as distinct clinical entities only recently and it is understandable that research efforts initially focused primarily on "classical" RTT. This discrepancy is reflected also in the very different numbers of repurposing studies highlighted in Figure 1. Continued efforts in pre-clinical (identification of valuable cell and animal models etc.) and clinical research (better understanding of the natural history, clinical manifestations, disease progression, biomarkers etc.) will be essential for advancing our understanding and improving outcomes for individuals affected by these syndromes. In particular, better characterizing the shared symptoms and pathways across these entities, will provide valuable insights into the underlying biology and potentially uncover new common mechanisms and targeted therapies. If the disorders demonstrate convergence in their underlying molecular pathways, this provides an opportunity for designing joint DR 10.3389/fmed.2024.1425038 strategies across RTT and RTT-like disorders. This could reduce the time needed for the development of DR and increase the number of patients benefiting from the treatments, resulting in more attractive business models. > Despite promising DR results in preclinical or early-phase clinical trials for RTT and related disorders in our opinion DR is still underrated and underutilized in this kind of disorders. DR holds immense potential for addressing the unmet medical needs and therapeutic challenges posed by such complex NDDs, and recent advancements screening and computational techniques, offer the unique opportunity to predict drug-disease interactions and prioritize candidate compounds for further investigation. By leveraging existing drugs and repurposing them for new indications, this approach offers a pragmatic and efficient strategy to accelerate the development of treatments for individuals affected by these debilitating conditions.

[18] Chromatin modifiers in neurodevelopment

  • Authors: Sarallah Rezazadeh, H. Ji, Cecilia Giulivi
  • Year: 2025
  • Venue: Frontiers in Molecular Neuroscience
  • URL: https://www.semanticscholar.org/paper/7a4d8c063c2b3a908a65bcb637cd818edad8db92
  • DOI: 10.3389/fnmol.2025.1551107
  • PMID: 40469903
  • PMCID: 12133960
  • Citations: 2
  • Summary: This mini review delves into key chromatin modifiers, including the histone methyl transferases NSD1 and ASH1L, the methyl-CpG-binding repressor MeCP2, and the enzymatic repressor EZH2, and spotlight their pivotal roles in early brain development and neurological disorders.
  • Evidence snippets:
  • Snippet 1 (score: 0.404) > Therefore, while epigenetic changes are essential for understanding specific aspects of neurodevelopmental disorders, it is crucial to view these mechanisms as part of a larger, more complex system that encompasses genetic, proteomic, and metabolic factors. Few examples underscore that while epigenetic mechanisms-such as DNA methylation and histone modificationsare essential in regulating gene expression and contribute to neurodevelopmental disorders, they do not fully explain the complex pathophysiology of these diseases. In many cases, the genetic mutations, absence of or dysfunction of protein, or toxic protein aggregation (e.g., Fragile X syndrome, HD) that occur in these disorders play a central role in the clinical phenotypes. Therefore, a comprehensive understanding of neurodevelopmental disorders must integrate epigenetic mechanisms and the broader genetic, proteomic, and cellular pathways that contribute to disease. An integrative approach that considers not only the regulation of gene expression but also the functional consequences of these changes at the protein, metabolic and cellular pathway levels will be essential for advancing our understanding of these intricate disorders and developing effective interventions and treatments. . B., Villate, O., Llano, I., Ocio, I., Martí, I., et al. (2020). Targeted next-generation sequencing in patients with suggestive X-linked intellectual disability. Genes 11:51. doi: 10.3390/genes11010051

[19] Precision Therapeutics in Lennox–Gastaut Syndrome: Targeting Molecular Pathophysiology in a Developmental and Epileptic Encephalopathy

  • Authors: Debopam Samanta
  • Year: 2025
  • Venue: Children
  • URL: https://www.semanticscholar.org/paper/455479c1bfbea7b90b73c109228f67c813d13888
  • DOI: 10.3390/children12040481
  • PMID: 40310132
  • PMCID: 12025602
  • Citations: 19
  • Influential citations: 1
  • Summary: A narrative review explores precision therapeutic strategies for LGS based on molecular pathophysiology, including channelopathies, receptor and ligand dysfunction, receptor and ligand dysfunction, cell signaling abnormalities, cell signaling abnormalities, synaptopathies, and the repurposing of existing medications with mechanism-specific effects.
  • Evidence snippets:
  • Snippet 1 (score: 0.401) > A key advantage of disease-modifying therapies is their potential to target pathogenic mechanisms early in the disease course, potentially preventing the progression of some infantile epileptic encephalopathies to LGS. > This narrative review explores precision therapeutic strategies based on specific monogenic causes and disease mechanisms relevant to LGS. A comprehensive literature search (PubMed, MEDLINE, ClinicalTrials.gov, conference abstracts from the American Academy of Neurology and American Epilepsy Society, and gray literature) was conducted through 19 February 2025 to identify established ASMs, repurposed and novel drugs, as well as various gene therapy approaches with potential relevance to LGS. Given that over 900 monogenic causes of DEEs have been identified-implicating diverse cellular components such as ion channels, receptors, synaptic proteins, signaling pathways, metabolic processes, and epigenetic regulators-this review discusses current and emerging precision therapeutics based on shared molecular mechanisms and the pathophysiology of select genes associated with LGS [17] (Table 1).

[20] scGRNom: a computational pipeline of integrative multi-omics analyses for predicting cell-type disease genes and regulatory networks

  • Authors: Ting Jin, Peter R Rehani, Mufang Ying, Jiawei Huang, Shuang Liu et al.
  • Year: 2020
  • Venue: Genome Medicine
  • URL: https://www.semanticscholar.org/paper/a81382fef4e3f7cf5b4bec64266e372cf3a52da5
  • DOI: 10.1186/s13073-021-00908-9
  • PMID: 34044854
  • PMCID: 8161957
  • Citations: 37
  • Summary: A computational pipeline, scGRNom (single-cell Gene Regulatory Network prediction from multi-omics), to predict cell-type disease genes and regulatory networks including transcription factors and regulatory elements, with applications to schizophrenia and Alzheimer’s disease.
  • Evidence snippets:
  • Snippet 1 (score: 0.399) > Recent genome-wide association studies (GWAS) studies have identified a variety of genetic risk variants associated with multiple brain diseases. For example, a recent study found 109 pleiotropic loci significantly associated with at least two brain disorders [1]. Many cross-disease common genetic risk factors have revealed many shared functional consequences in clinical presentations [2]. Recent studies have also revealed shared symptoms at both psychiatric and physical levels between neurodegenerative and neuropsychiatric diseases [3]. For instance, 97% of Alzheimer's disease patients develop neuropsychiatric symptoms throughout the disease [4]. Besides, additional insights into each disease's progression and causes have further demonstrated the highly interlinked nature of both disease types [5]. However, our understanding of the molecular mechanisms of genetic variants between diseases remains elusive, particularly at the cell-type levels. > Alzheimer's disease (AD) and schizophrenia (SCZ) are neurodegenerative and neuropsychiatric diseases, respectively. Both are significantly associated with genetic variants and have complex underlying cellular and molecular mechanisms from genotype to phenotype [6,7]. Notably, AD is physiologically characterized by accumulations of amyloid beta plaques and neurofibrillary tau protein tangles in the brain [8]. Amyloid beta plaques primarily originate from the apolipoprotein E-encoding gene APOE and its multiple variants. The APOE gene is a single step in the broader amyloidogenic processing pathway (APP), and additional genes involved in the process contribute to the regulation of amyloid beta production [6]. Much work has identified major genes of interest involved in the APP [6]. However, a distinct need still exists to further explore these disease loci to understand better the interplay between their regulatory elements and eventual amyloid beta creation and accumulation. Similarly, neurofibrillary tau tangles are associated with many genetic loci and require a study of the highly complex molecular mechanisms required to achieve disease pathology [8]. Further, the downstream effects from both amyloid beta and neurofibrillary tangles within and between various cell types add additional complexity toward linking specific regulatory events and elements with clinical pathology [9,10].

Notes

  • This provider combines search_papers_by_relevance with snippet_search.
  • No synthesis or second-stage model call is performed.
Falcon
Disease Characteristics Research Template
Edison Scientific Literature 32 citations 2026-05-30T02:15:43.587246

Question: You are an expert researcher providing comprehensive, well-cited information.

Provide detailed information focusing on: 1. Key concepts and definitions with current understanding 2. Recent developments and latest research (prioritize 2023-2024 sources) 3. Current applications and real-world implementations 4. Expert opinions and analysis from authoritative sources 5. Relevant statistics and data from recent studies

Format as a comprehensive research report with proper citations. Include URLs and publication dates where available. Always prioritize recent, authoritative sources and provide specific citations for all major claims.

Disease Characteristics Research Template

Target Disease

  • Disease Name: 15q11q13 Microduplication Syndrome
  • MONDO ID: (if available)
  • Category: Mendelian

Research Objectives

Please provide a comprehensive research report on 15q11q13 Microduplication Syndrome covering all of the disease characteristics listed below. This report will be used to populate a disease knowledge base entry. Be thorough and cite primary literature (PMID preferred) for all claims.

For each section, suggested databases/resources are listed. These are the first places you should search for information on each topic.


1. Disease Information

Search first: OMIM, Orphanet, ICD-10/ICD-11, MeSH, PubMed

  • What is the disease? Provide a concise overview.
  • What are the key identifiers? (OMIM, Orphanet, ICD-10/ICD-11, MeSH, Mondo)
  • What are the common synonyms and alternative names?
  • Is the information derived from individual patients (e.g., EHR) or aggregated disease-level resources?

2. Etiology

  • Disease Causal Factors: What are the primary causes? (genetic, environmental, infectious, mechanistic)
  • Risk Factors:

    Search first: PubMed, Cochrane Library, UpToDate, clinical guidelines, ClinVar, ClinGen, GWAS Catalog, PheGenI, CTD, CDC, WHO, epidemiological databases

  • Genetic risk factors (causal variants, susceptibility loci, modifier genes)
  • Environmental risk factors (toxins, lifestyle, occupational exposures, age, sex, family history)
  • Protective Factors:

    Search first: PubMed, Cochrane Library, clinical trial databases, GWAS Catalog, gnomAD, WHO, CDC, nutrition databases

  • Genetic protective factors (protective variants, modifier alleles)
  • Environmental protective factors (diet, lifestyle, exposures that reduce risk)
  • Gene-Environment Interactions: How do genetic and environmental factors interact to influence disease?

    Search first: CTD, PubMed, PheGenI, GxE databases

3. Phenotypes

Search first: HPO (Human Phenotype Ontology), OMIM, Orphanet, PubMed, clinicaltrials.gov, MedDRA, SNOMED CT, DECIPHER, LOINC

For each phenotype, provide: - Phenotype type: symptoms, clinical signs, physical manifestations, behavioral changes, or laboratory abnormalities

For symptoms/signs: HPO, OMIM, Orphanet, PubMed For behavioral changes: HPO, DSM, RDoC (Research Domain Criteria), PubMed For laboratory abnormalities: LOINC, SNOMED CT, LabTests Online, PubMed - Phenotype characteristics: Search first: OMIM, Orphanet, HPO, PubMed - Age of symptom onset (neonatal, childhood, adult-onset, late-onset) - Symptom severity (mild, moderate, severe, variable) - Symptom progression (stable, progressive, episodic, fluctuating) - Frequency among affected individuals (percentage or qualitative) - Quality of life impact: Effects on daily functioning and well-being (per-phenotype when possible) Search first: EQ-5D database, SF-36, WHO QOL databases, PubMed - Suggest HPO (Human Phenotype Ontology) terms for each phenotype

4. Genetic/Molecular Information

  • Causal Genes: Gene mutations or chromosomal abnormalities responsible for disease (gene symbols, OMIM IDs)

    Search first: OMIM, ClinVar, HGMD, Ensembl, NCBI Gene

  • Pathogenic Variants:
  • Affected genes (gene symbols, HGNC IDs) > Search first: OMIM, NCBI Gene, Ensembl, HGNC, UniProt, GeneCards
  • Variant classification (pathogenic, likely pathogenic, VUS per ACMG/AMP guidelines) > Search first: ClinVar, ClinGen, ACMG/AMP guidelines, VarSome
  • Variant type/class (missense, frameshift, nonsense, splice-site, structural)
  • Allele frequency in population databases > Search first: gnomAD, 1000 Genomes, ExAC, TOPMed, dbSNP
  • Somatic vs germline origin > Search first: COSMIC (somatic), ClinVar, ICGC, TCGA
  • Functional consequences (loss of function, gain of function, dominant negative)
  • Modifier Genes: Genes that modify disease severity or expression
  • Epigenetic Information: DNA methylation, histone modifications, chromatin changes affecting disease

    Search first: ENCODE, Roadmap Epigenomics, MethBase, DiseaseMeth

  • Chromosomal Abnormalities: Large-scale genetic changes (aneuploidy, translocations, inversions)

    Search first: DECIPHER, ClinVar, ECARUCA, UCSC Genome Browser

5. Environmental Information

  • Environmental Factors: Non-genetic contributing factors (toxins, radiation, pollution, occupational exposure)

    Search first: CTD (Comparative Toxicogenomics Database), TOXNET, PubMed, EPA databases

  • Lifestyle Factors: Behavioral factors (smoking, diet, exercise, alcohol consumption)

    Search first: CDC databases, WHO, PubMed, NHANES

  • Infectious Agents: If applicable, pathogens causing or triggering disease (bacteria, viruses, fungi, parasites)

    Search first: NCBI Taxonomy, ViPR, BV-BRC, MicrobeDB, GIDEON

6. Mechanism / Pathophysiology

  • Molecular Pathways: Specific signaling cascades or biochemical pathways involved (Wnt, MAPK, mTOR, PI3K-AKT, etc.)

    Search first: KEGG, Reactome, WikiPathways, PathBank, BioCyc

  • Cellular Processes: Cell-level mechanisms (apoptosis, autophagy, cell cycle dysregulation, inflammation, etc.)

    Search first: Gene Ontology (GO), Reactome, KEGG, PubMed

  • Protein Dysfunction: How protein structure or function is altered (misfolding, aggregation, loss of function, gain of function)

    Search first: UniProt, PDB (Protein Data Bank), InterPro, Pfam, AlphaFold

  • Metabolic Changes: Alterations in metabolic processes (energy metabolism, lipid metabolism, amino acid metabolism)

    Search first: KEGG, BioCyc, HMDB (Human Metabolome Database), BRENDA

  • Immune System Involvement: Role of immune response (autoimmunity, immunodeficiency, chronic inflammation)

    Search first: ImmPort, Immunome Database, IEDB, Gene Ontology

  • Tissue Damage Mechanisms: How tissues/ are injured (oxidative stress, ischemia, fibrosis, necrosis)

    Search first: PubMed, Gene Ontology, Reactome

  • Biochemical Abnormalities: Specific molecular defects (enzyme deficiencies, receptor dysfunction, ion channel defects)

    Search first: BRENDA, UniProt, KEGG, OMIM, PubMed

  • Epigenetic Changes: DNA methylation, histone modifications affecting gene expression in disease

    Search first: ENCODE, Roadmap Epigenomics, MethBase, DiseaseMeth

  • Molecular Profiling (if available):
  • Transcriptomics/gene expression changes > Search first: GEO (Gene Expression Omnibus), ArrayExpress, GTEx, Human Cell Atlas, SRA
  • Proteomics findings > Search first: PRIDE, ProteomeXchange, Human Protein Atlas, STRING, BioGRID
  • Metabolomics signatures > Search first: MetaboLights, Metabolomics Workbench, HMDB, METLIN
  • Lipidomics alterations > Search first: LIPID MAPS, SwissLipids, LipidHome, Metabolomics Workbench
  • Genomic structural features > Search first: UCSC Genome Browser, Ensembl, NCBI, dbVar, DGV
  • Advanced Technologies (if applicable):
  • Single-cell analysis findings (cell-type specific mechanisms, cellular heterogeneity) > Search first: Human Cell Atlas, Single Cell Portal, GEO, CELLxGENE
  • Spatial transcriptomics findings > Search first: GEO, Spatial Research, Vizgen, 10x Genomics data
  • Multi-omics integration results > Search first: TCGA, ICGC, cBioPortal, LinkedOmics, PubMed
  • Functional genomics screens (CRISPR, RNAi) > Search first: DepMap, GenomeRNAi, PubMed, BioGRID ORCS

For each mechanism, describe: - The causal chain from initial trigger to clinical manifestation - Which mechanisms are upstream vs downstream - What cell types and biological processes are involved - Suggest GO terms for biological processes and CL terms for cell types

7. Anatomical Structures Affected

  • Organ Level:
  • Primary organs directly affected
  • Secondary organ involvement (complications, secondary effects)
  • Body systems involved (cardiovascular, nervous, digestive, respiratory, endocrine, etc.)

    Search first: Uberon, FMA (Foundational Model of Anatomy), OMIM, HPO, ICD-11, MeSH, SNOMED CT

  • Tissue and Cell Level:
  • Specific tissue types affected (epithelial, connective, muscle, nervous)
  • Specific cell populations targeted (with Cell Ontology terms)

    Search first: Uberon, Human Protein Atlas, Cell Ontology, Human Cell Atlas, CellMarker, PanglaoDB

  • Subcellular Level:
  • Cellular compartments involved (mitochondria, nucleus, ER, lysosomes) (with GO Cellular Component terms)

    Search first: Gene Ontology (Cellular Component), UniProt, Human Protein Atlas

  • Localization:
  • Specific anatomical sites (with UBERON terms) > Search first: FMA, Uberon, NeuroNames (for brain), SNOMED CT
  • Lateralization (unilateral, bilateral, asymmetric) > Search first: HPO, clinical literature, imaging databases

8. Temporal Development

  • Onset:
  • Typical age of onset (congenital, pediatric, adult, geriatric)
  • Onset pattern (acute, subacute, chronic, insidious)

    Search first: OMIM, Orphanet, HPO, PubMed

  • Progression:
  • Disease stages (early, intermediate, advanced, end-stage) > Search first: Cancer Staging Manual (AJCC), WHO classifications, PubMed
  • Progression rate (rapid, slow, variable)
  • Disease course pattern (episodic, relapsing-remitting, progressive, stable)
  • Disease duration (self-limited, chronic lifelong)

    Search first: Disease registries, longitudinal cohort databases, natural history studies, PubMed, Orphanet, OMIM

  • Patterns:
  • Remission patterns (spontaneous, treatment-induced) > Search first: Clinical trial databases, disease registries, PubMed
  • Critical periods (time windows of vulnerability or opportunity for intervention) > Search first: PubMed, developmental biology databases, clinical guidelines

9. Inheritance and Population

  • Epidemiology:
  • Prevalence (cases per 100,000 at given time)
  • Incidence (new cases per 100,000 per year)

    Search first: Orphanet, CDC, WHO, GBD (Global Burden of Disease), national registries, SEER, disease registries

  • For Genetic Etiology:
  • Inheritance pattern (AD, AR, X-linked, mitochondrial, multifactorial, polygenic) > Search first: OMIM, Orphanet, ClinVar, GTR (Genetic Testing Registry)
  • Penetrance (complete, incomplete, age-dependent) > Search first: ClinVar, OMIM, PubMed, ClinGen
  • Expressivity (variable, consistent) > Search first: OMIM, ClinVar, PubMed
  • Genetic anticipation (increasing severity in successive generations) > Search first: OMIM, PubMed (especially for repeat expansion disorders)
  • Germline mosaicism > Search first: ClinVar, OMIM, genetic counseling literature, PubMed
  • Founder effects (population-specific mutations) > Search first: gnomAD, population genetics databases, PubMed
  • Consanguinity role > Search first: OMIM, population studies, genetic counseling resources
  • Carrier frequency > Search first: gnomAD, carrier screening databases, GeneReviews, GTR
  • Population Demographics:
  • Affected populations (ethnic or demographic groups with higher prevalence) > Search first: gnomAD, 1000 Genomes, PAGE Study, PubMed, population registries
  • Geographic distribution (endemic areas, regional variation) > Search first: WHO, CDC, GBD, Orphanet, geographic epidemiology databases
  • Geographic distribution of specific variants
  • Sex ratio (male:female) > Search first: Disease registries, OMIM, PubMed, epidemiological databases
  • Age distribution of affected individuals > Search first: CDC, disease registries, SEER, Orphanet

10. Diagnostics

  • Clinical Tests:
  • Laboratory tests (blood, urine, tissue chemistry, specific enzyme assays) > Search first: LOINC, LabTests Online, PubMed
  • Biomarkers (proteins, metabolites, genetic markers, circulating biomarkers) > Search first: FDA Biomarker List, BEST (Biomarkers, EndpointS, and other Tools), PubMed
  • Imaging studies (X-ray, CT, MRI, PET, ultrasound) > Search first: RadLex, DICOM, Radiopaedia, imaging databases
  • Functional tests (pulmonary function, cardiac stress tests) > Search first: LOINC, clinical guidelines, PubMed
  • Electrophysiology (EEG, EMG, ECG, nerve conduction studies) > Search first: LOINC, clinical neurophysiology databases, PubMed
  • Biopsy findings (histopathology, immunohistochemistry) > Search first: SNOMED CT, College of American Pathologists resources, PubMed
  • Pathology findings (microscopic examination) > Search first: SNOMED CT, Digital Pathology databases, PubMed
  • Genetic Testing:

    Search first: GTR (Genetic Testing Registry), GeneReviews, ClinGen

  • Overview of recommended genetic testing approach
  • Whole genome sequencing (WGS) utility > Search first: GTR, ClinVar, GEL (Genomics England), gnomAD
  • Whole exome sequencing (WES) utility > Search first: GTR, ClinVar, OMIM, GeneMatcher
  • Gene panels (which panels, which genes) > Search first: GTR, ClinVar, laboratory-specific databases
  • Single gene testing > Search first: GTR, ClinVar, OMIM, GeneReviews
  • Chromosomal microarray (CMA) > Search first: DECIPHER, ClinVar, dbVar, ECARUCA
  • Karyotyping > Search first: Chromosome Abnormality Database, ClinVar, cytogenetics resources
  • FISH > Search first: ClinVar, cytogenetics databases, PubMed
  • Mitochondrial DNA testing > Search first: MITOMAP, MSeqDR, ClinVar, GTR
  • Repeat expansion testing > Search first: GTR, ClinVar, repeat expansion databases, PubMed
  • Omics-Based Diagnostics (if applicable):
  • RNA sequencing / transcriptomics > Search first: GEO, ArrayExpress, GTEx, RNA-seq databases
  • Proteomics > Search first: PRIDE, ProteomeXchange, FDA Biomarker database
  • Metabolomics > Search first: MetaboLights, Metabolomics Workbench, HMDB
  • Epigenomics > Search first: GEO, ENCODE, Roadmap Epigenomics, MethBase
  • Liquid biopsy > Search first: COSMIC, ClinVar, liquid biopsy databases, PubMed
  • Clinical Criteria:
  • Standardized diagnostic criteria (DSM, ICD, society guidelines) > Search first: DSM-5, ICD-11, clinical society guidelines, UpToDate
  • Differential diagnosis (other conditions to rule out, with distinguishing features) > Search first: DynaMed, UpToDate, clinical decision support systems
  • Screening:
  • Screening methods for asymptomatic individuals (newborn screening, carrier screening, cascade screening) > Search first: ACMG recommendations, CDC newborn screening, GTR

11. Outcome/Prognosis

  • Survival and Mortality:
  • Survival rate (5-year, 10-year, overall) > Search first: SEER, cancer registries, disease-specific registries, PubMed
  • Life expectancy (with and without treatment if applicable) > Search first: Orphanet, disease registries, actuarial databases, PubMed
  • Mortality rate > Search first: CDC, WHO, GBD, national mortality databases
  • Disease-specific mortality (deaths directly attributable to disease) > Search first: Disease registries, CDC Wonder, GBD, PubMed
  • Morbidity and Function:
  • Morbidity (disease-related disability and health impacts) > Search first: GBD, WHO, disability databases, PubMed
  • Disability outcomes (long-term functional impairments) > Search first: ICF (International Classification of Functioning), disability registries
  • Quality of life measures (EQ-5D, SF-36, PROMIS, disease-specific tools) > Search first: EQ-5D database, SF-36, PROMIS, PubMed
  • Disease Course:
  • Complications (secondary problems: infections, organ failure, etc.) > Search first: ICD codes, disease registries, clinical databases, PubMed
  • Recovery potential (likelihood and extent of recovery, with vs without treatment) > Search first: Natural history studies, rehabilitation databases, PubMed
  • Prediction:
  • Prognostic factors (age, disease severity, biomarkers, treatment response) > Search first: Prognostic models databases, clinical calculators, PubMed
  • Prognostic biomarkers (molecular markers predicting disease course) > Search first: FDA Biomarker database, PubMed, cancer prognostic databases

12. Treatment

  • Pharmacotherapy:
  • Pharmacological treatments (drug names, drug classes, mechanisms of action) > Search first: DrugBank, RxNorm, ATC classification, DailyMed, FDA databases
  • Pharmacogenomics (how genetic variants affect drug metabolism, efficacy, toxicity) > Search first: PharmGKB, CPIC (Clinical Pharmacogenetics), FDA Table of PGx Biomarkers
  • Advanced Therapeutics:
  • Gene therapy (viral vectors, CRISPR, gene replacement, gene editing) > Search first: ClinicalTrials.gov, FDA gene therapy database, ASGCT resources
  • Cell therapy (stem cell transplant, CAR-T, cellular therapeutics) > Search first: ClinicalTrials.gov, FDA cell therapy database, FACT standards
  • RNA-based therapies (ASOs, siRNA, mRNA therapies) > Search first: ClinicalTrials.gov, FDA approvals, PubMed
  • Targeted therapies (treatments directed at specific molecular targets) > Search first: My Cancer Genome, OncoKB, ClinicalTrials.gov, FDA approvals
  • Immunotherapies (checkpoint inhibitors, monoclonal antibodies) > Search first: Cancer Immunotherapy Database, FDA approvals, ClinicalTrials.gov
  • Surgical and Interventional:
  • Surgical interventions (types of surgery, timing, outcomes) > Search first: CPT codes, surgical registries, clinical guidelines, PubMed
  • Supportive and Rehabilitative:
  • Supportive care (symptom management, pain control, nutrition) > Search first: Clinical guidelines, Cochrane Library, PubMed
  • Rehabilitation (physical therapy, occupational therapy, speech therapy) > Search first: Rehabilitation medicine databases, clinical guidelines, PubMed
  • Experimental:
  • Experimental treatments in clinical trials (with NCT identifiers if available) > Search first: ClinicalTrials.gov, EU Clinical Trials Register, WHO ICTRP
  • Treatment Outcomes:
  • Treatment response rates > Search first: Clinical trial databases, FDA reviews, systematic reviews, PubMed
  • Side effects and adverse events > Search first: FDA Adverse Event Reporting System (FAERS), MedWatch, PubMed
  • Treatment Strategy:
  • Treatment algorithms (clinical pathways, decision trees) > Search first: Clinical practice guidelines, NCCN Guidelines, UpToDate
  • Combination therapies > Search first: ClinicalTrials.gov, treatment guidelines, PubMed
  • Personalized medicine approaches (genotype-guided treatment) > Search first: My Cancer Genome, CIViC, PharmGKB, precision medicine databases

For each treatment, suggest MAXO (Medical Action Ontology) terms where applicable.

13. Prevention

  • Prevention Levels:
  • Primary prevention (preventing disease occurrence: vaccination, risk factor modification) > Search first: CDC, WHO, USPSTF recommendations, Cochrane Library
  • Secondary prevention (early detection and treatment: screening programs, early intervention) > Search first: USPSTF, CDC screening guidelines, WHO
  • Tertiary prevention (preventing complications in those with disease) > Search first: Clinical guidelines, disease management protocols, PubMed
  • Immunization: Vaccine strategies (if applicable)

    Search first: CDC vaccine schedules, WHO immunization, FDA vaccine database

  • Screening and Early Detection:
  • Screening programs (population-based: newborn screening, cancer screening) > Search first: CDC screening programs, USPSTF, cancer screening databases
  • Genetic screening (carrier screening, preimplantation genetic diagnosis, prenatal testing) > Search first: ACMG recommendations, ACOG guidelines, GTR
  • Risk stratification (identifying high-risk individuals for targeted prevention) > Search first: Risk prediction models, clinical calculators, PubMed
  • Behavioral Interventions: Lifestyle modifications to reduce risk

    Search first: CDC, WHO, behavioral intervention databases, Cochrane Library

  • Counseling: Genetic counseling (risk assessment, family planning guidance)

    Search first: NSGC resources, ACMG guidelines, GeneReviews

  • Public Health:
  • Public health interventions (sanitation, vector control, health education) > Search first: CDC, WHO, public health databases, PubMed
  • Environmental interventions (reducing environmental risk factors) > Search first: EPA databases, WHO environmental health, PubMed
  • Prophylaxis: Preventive medications or procedures

    Search first: Clinical guidelines, FDA approvals, PubMed

14. Other Species / Natural Disease

  • Taxonomy: Species affected (with NCBI Taxon identifiers)

    Search first: NCBI Taxonomy

  • Breed: Specific breeds affected (with VBO identifiers if applicable)

    Search first: VBO (Vertebrate Breed Ontology)

  • Gene: Orthologous genes in other species (with NCBI Gene IDs)

    Search first: NCBI Gene

  • Natural Disease:
  • Naturally occurring disease in other species (companion animals, wildlife) > Search first: OMIA (Online Mendelian Inheritance in Animals), VetCompass, PubMed
  • Veterinary relevance and importance in animal health > Search first: OMIA, veterinary databases, PubMed
  • Comparative Biology:
  • Comparative pathology (similarities and differences across species) > Search first: OMIA, comparative pathology databases, PubMed
  • Evolutionary conservation of disease mechanisms > Search first: HomoloGene, OrthoMCL, Alliance of Genome Resources
  • Transmission (if applicable):
  • Zoonotic potential > Search first: CDC zoonotic diseases, WHO zoonoses, GIDEON
  • Cross-species susceptibility > Search first: NCBI Taxonomy, veterinary databases, PubMed

15. Model Organisms

  • Model Types:
  • Model organism type (mammalian, invertebrate, cellular, in vitro) > Search first: Alliance of Genome Resources, model organism databases
  • Specific model systems (mouse, rat, zebrafish, Drosophila, C. elegans, yeast, cell lines, organoids, iPSCs) > Search first: MGI, RGD, ZFIN, FlyBase, WormBase, SGD, ATCC, Cellosaurus
  • Induced models (drug treatment, surgical intervention, environmental manipulation) > Search first: MGI, model organism databases, PubMed
  • Genetic Models:
  • Types available (knockout, knock-in, transgenic, conditional, humanized) > Search first: MGI, IMPC, KOMP, EuMMCR, IMSR
  • Model Characteristics:
  • Phenotype recapitulation (how well model reproduces human disease features) > Search first: Model organism databases, comparative studies, PubMed
  • Model limitations (aspects of human disease not captured) > Search first: Model organism databases, PubMed, review articles
  • Applications:
  • Research applications (what aspects of disease can be studied) > Search first: Model organism databases, PubMed
  • Resources:
  • Model databases > Search first: MGI, RGD, ZFIN, FlyBase, WormBase, IMSR, EMMA, MMRRC

Citation Requirements

  • Cite primary literature (PMID preferred) for all mechanistic and clinical claims
  • Prioritize recent reviews and landmark papers
  • Include direct quotes from abstracts where possible to support key statements
  • Distinguish evidence source types: human clinical, model organism, in vitro, computational

Output Format

Structure your response as a comprehensive narrative organized by the sections above. For each section, provide: - Factual content with specific details (numbers, percentages, gene names, variant nomenclature) - Ontology term suggestions (HPO, GO, CL, UBERON, CHEBI, MAXO, MONDO) where applicable - Evidence citations with PMIDs - Direct quotes from abstracts to support key claims - Clear indication when information is not available or not applicable for this disease

This report will be used to populate a disease knowledge base entry with: - Pathophysiology descriptions with causal chains - Gene/protein annotations (HGNC, GO terms) - Phenotype associations (HP terms) with frequencies - Cell type involvement (CL terms) - Anatomical locations (UBERON terms) - Chemical entities (CHEBI terms) - Treatment annotations (MAXO terms) - Evidence items with PMIDs and exact abstract quotes - Epidemiology, prognosis, diagnostic, and prevention information - Animal model descriptions with phenotype recapitulation details

Comprehensive Research Report: 15q11q13 Microduplication Syndrome (dup15q / 15q11-q13 duplication syndrome)

Executive summary

15q11q13 microduplication syndrome (often discussed under the umbrella term dup15q syndrome) is a neurodevelopmental copy-number variant (CNV) disorder caused by increased copy number of the 15q11.2–q13.1 region. Clinical impact depends strongly on parent of origin because the region contains imprinted genes, especially UBE3A, which is maternally expressed in neurons; maternal duplications tend to be more penetrant and severe than paternal duplications. Recent (2023–2024) work has advanced (i) population-level incidence estimates from genome-wide NIPS, (ii) larger literature-based clinical syntheses of phenotype and inheritance, and (iii) translational biomarkers (beta-band EEG) and mechanistic models (patient-derived neurons, chromosome-engineered mice) that are being leveraged for therapy development and clinical trials. (parijs2024populationscreeningfor pages 1-2, bisba2024chromosome15q11q13duplication pages 1-2, saravanapandian2024sleepeegsignatures pages 2-4, elamin2023theroleof pages 1-2)

Key evidence-at-a-glance

Category Finding (concise) Quantitative detail Source (first author year) Publication date (month year) URL
Identifiers Disease identifier OMIM 608636 for chromosome 15q11-q13 duplication syndrome Bisba 2024 (bisba2024chromosome15q11q13duplication pages 1-2) Oct 2024 https://doi.org/10.3390/genes15101304
Genetics Common inheritance pattern among literature cases Of carriers inheriting from a parent, 62.96% maternal and 37.04% paternal; 80.20% inherited from a parent overall Bisba 2024 (bisba2024chromosome15q11q13duplication pages 5-7) Oct 2024 https://doi.org/10.3390/genes15101304
Genetics Postnatal inheritance totals Table 6 totals: 48 maternal, 29 paternal, 17 de novo, 8 unknown Bisba 2024 (bisba2024chromosome15q11q13duplication pages 5-7) Oct 2024 https://doi.org/10.3390/genes15101304
Genetics Prenatal inheritance totals Table 7 totals: 3 maternal, 1 paternal, 3 de novo, 1 unknown Bisba 2024 (bisba2024chromosome15q11q13duplication pages 5-7) Oct 2024 https://doi.org/10.3390/genes15101304
Epidemiology Population incidence from genome-wide NIPS 23/333,187 = 0.0069% detected 15q11-q13 duplications Parijs 2024 (parijs2024populationscreeningfor pages 1-2, parijs2024populationscreeningfor pages 3-5) Apr 2024 https://doi.org/10.1038/s41431-023-01336-6
Diagnostics Positive predictive value of NIPS detection PPV 100% for this CNV in followed cases Parijs 2024 (parijs2024populationscreeningfor pages 3-5) Apr 2024 https://doi.org/10.1038/s41431-023-01336-6
Epidemiology Estimated general prevalence cited in review Rare congenital disease; cited prevalence 1 in 30,000 to 1 in 60,000 children worldwide Bisba 2024 (bisba2024chromosome15q11q13duplication pages 5-7) Oct 2024 https://doi.org/10.3390/genes15101304
Phenotypes Postnatal phenotype distribution: composite phenotype 62/115 = 53.91% Bisba 2024 Table 2 (bisba2024chromosome15q11q13duplication pages 3-5) Oct 2024 https://doi.org/10.3390/genes15101304
Phenotypes Postnatal phenotype distribution: normal 15/115 = 13.04% Bisba 2024 Table 2 (bisba2024chromosome15q11q13duplication pages 3-5) Oct 2024 https://doi.org/10.3390/genes15101304
Phenotypes Postnatal phenotype distribution: developmental delay 15/115 = 13.04% Bisba 2024 Table 2 (bisba2024chromosome15q11q13duplication pages 3-5) Oct 2024 https://doi.org/10.3390/genes15101304
Phenotypes Postnatal phenotype distribution: ASD 8/115 = 6.95% Bisba 2024 Table 2 (bisba2024chromosome15q11q13duplication pages 3-5) Oct 2024 https://doi.org/10.3390/genes15101304
Phenotypes Postnatal phenotype distribution: epilepsy 2/115 = 1.74% Bisba 2024 Table 2 (bisba2024chromosome15q11q13duplication pages 3-5) Oct 2024 https://doi.org/10.3390/genes15101304
Phenotypes Postnatal phenotype distribution: behavioral problems 3/115 = 2.61% Bisba 2024 Table 2 (bisba2024chromosome15q11q13duplication pages 3-5) Oct 2024 https://doi.org/10.3390/genes15101304
Phenotypes Postnatal phenotype distribution: congenital heart defects 2/115 = 1.74% Bisba 2024 Table 2 (bisba2024chromosome15q11q13duplication pages 3-5) Oct 2024 https://doi.org/10.3390/genes15101304
Phenotypes Prenatal phenotype distribution: normal 10/14 = 71.43% Bisba 2024 Table 3 (bisba2024chromosome15q11q13duplication pages 3-5) Oct 2024 https://doi.org/10.3390/genes15101304
Phenotypes Prenatal phenotype distribution: congenital heart defects 3/14 = 21.43% Bisba 2024 Table 3 (bisba2024chromosome15q11q13duplication pages 3-5) Oct 2024 https://doi.org/10.3390/genes15101304
Phenotypes Prenatal phenotype distribution: IUGR 1/14 = 7.14% Bisba 2024 Table 3 (bisba2024chromosome15q11q13duplication pages 3-5) Oct 2024 https://doi.org/10.3390/genes15101304
Genetics Parent-of-origin effect in population screening Maternal and paternal duplications occurred in approximately equal numbers in screening, but maternal duplications were consistently associated with phenotype; 7 fetuses inherited the duplication among 14 amniocenteses with follow-up Parijs 2024 (parijs2024populationscreeningfor pages 3-5) Apr 2024 https://doi.org/10.1038/s41431-023-01336-6
Phenotypes Autism burden reported in mechanistic study Autism reported in 77%–100% of affected individuals Elamin 2023 (elamin2023theroleof pages 1-2) Apr 2023 https://doi.org/10.1016/j.stemcr.2023.02.002
Phenotypes Seizure burden in idic(15) Seizures in 63% of individuals with idic(15) Elamin 2023 (elamin2023theroleof pages 1-2) Apr 2023 https://doi.org/10.1016/j.stemcr.2023.02.002
Biomarkers Human EEG beta biomarker cohort size N = 41 children, age 9–189 months Saravanapandian 2020 (saravanapandian2020propertiesofbeta pages 1-2) Aug 2020 https://doi.org/10.1186/s11689-020-09326-1
Biomarkers Beta biomarker stability Beta power ICC = 0.93; beta peak frequency ICC = 0.92 Saravanapandian 2020 (saravanapandian2020propertiesofbeta pages 1-2) Aug 2020 https://doi.org/10.1186/s11689-020-09326-1
Biomarkers Clinical reproducibility of EEG biomarker Research vs clinical EEG beta power ICC = 0.94 Saravanapandian 2020 (saravanapandian2020propertiesofbeta pages 1-2) Aug 2020 https://doi.org/10.1186/s11689-020-09326-1
Biomarkers Clinical correlates of beta peak frequency Epilepsy status R² = 0.11, p = 0.038; daily living skills R² = 0.17, p = 0.01 Saravanapandian 2020 (saravanapandian2020propertiesofbeta pages 1-2) Aug 2020 https://doi.org/10.1186/s11689-020-09326-1
Biomarkers Sleep EEG abnormalities in children Dup15q n = 15 vs controls n = 12; elevated beta power, reduced spindle density, reduced/absent SWS Saravanapandian 2021 (saravanapandian2021abnormalsleepphysiology pages 1-2) Aug 2021 https://doi.org/10.1186/s13229-021-00460-8
Biomarkers Mouse sleep EEG translational study size 35 mice total after exclusions; matDp/+ 9, WT 8; patDp/+ 6, WT 4; Ube3a OE 5, WT 3 Saravanapandian 2024 (saravanapandian2024sleepeegsignatures pages 2-4) Jul 2024 https://doi.org/10.1186/s11689-024-09556-7
Biomarkers Mouse sleep EEG findings Maternal duplication mice mirrored elevated beta oscillations; matDp/+ and Ube3a OE had reduced sleep-onset latency; no alterations in NREM sleep in any of the 3 mouse groups Saravanapandian 2024 (saravanapandian2024sleepeegsignatures pages 2-4) Jul 2024 https://doi.org/10.1186/s11689-024-09556-7
Diagnostics Recommended/used genomic methods in clinical literature Array-CGH/Affymetrix CytoScan 750K used in large 2024 review cohort; MLPA suggested as cost- and time-effective first-line test in some familial interstitial cases Bisba 2024; Levandivska 2023 (bisba2024chromosome15q11q13duplication pages 1-2, levandivska2023inherited15qduplication pages 1-2) Oct 2024; Jun 2023 https://doi.org/10.3390/genes15101304; https://doi.org/10.32345/2664-4738.2.2023.08
Data infrastructure LADDER database purpose Database launched to harmonize data across registries, clinic visits, trials, and studies for AS and dup15q; started collaboration in 2019 Potter 2024 (potter2024linkingangelmanand pages 3-5) Jan 2024 https://doi.org/10.1177/26330040241254122
Trials Retinoic acid pilot trial NCT05281965; Early Phase 1; randomized crossover; estimated enrollment 20; ages 6–18 years ClinicalTrials.gov / Feng et al. listing (NCT05281965 chunk 1) Mar 2022 posting https://clinicaltrials.gov/study/NCT05281965
Trials Basmisanil phase 2 trial NCT05307679; Phase 2; randomized double-blind placebo-controlled; actual enrollment 7; ages 2–14 years; terminated for sponsor decision not safety ClinicalTrials.gov / Roche listing (NCT05307679 chunk 1) Apr 2022 posting; updated Nov 2025 https://clinicaltrials.gov/study/NCT05307679
Trials Soticlestat ARCADE study NCT03694275; Phase 2; open-label/non-randomized; actual enrollment 20; ages 2–55 years; maintenance endpoint weeks 9–20 ClinicalTrials.gov / Takeda listing (NCT03694275 chunk 1, NCT03694275 chunk 2) Oct 2018 posting; updated May 2022 https://clinicaltrials.gov/study/NCT03694275
Trials All-trans retinoic acid efficacy study NCT07079696; Phase 2; single-group; estimated enrollment 90; ages 3–7 years; treatment duration 18 months ClinicalTrials.gov / Zhejiang University listing (NCT07079696 chunk 1) Jul 2025 posting https://clinicaltrials.gov/study/NCT07079696

Table: This table compiles the main identifiers, epidemiology, inheritance patterns, phenotype frequencies, biomarker statistics, diagnostic approaches, and active/recent clinical trials for 15q11q13 microduplication (dup15q) syndrome from the cited evidence. It is useful as a compact reference for knowledge-base population and evidence tracing.


1. Disease information

1.1 Disease overview (current understanding)

15q11q13 microduplication syndrome refers to pathogenic duplications (or higher copy gains such as triplications/tetrasomies) involving the proximal long arm of chromosome 15 that encompass neurodevelopmentally relevant genes and, in many cases, the Prader–Willi/Angelman critical region. A widely used clinical framing is that dup15q syndrome is “defined as the presence of three or more copies of 15q11.2-q13.1” (cited in a prenatal cohort report) and is associated with developmental delay/intellectual disability, hypotonia, autism spectrum disorder (ASD), epilepsy/seizures, and behavioral problems. (parijs2024populationscreeningfor pages 1-2, bisba2024chromosome15q11q13duplication pages 1-2)

1.2 Key identifiers

  • MONDO: MONDO_0012081 (15q11q13 microduplication syndrome). (OpenTargets Search: dup15q syndrome,15q11-q13 duplication syndrome,15q11q13 microduplication syndrome)
  • OMIM: 608636 (15q11-q13 duplication syndrome / dup15q). (bisba2024chromosome15q11q13duplication pages 1-2)

Not retrieved in current evidence set: Orphanet/ORDO ID, MeSH ID, ICD-10/ICD-11 code. These typically exist in curated resources but were not available in the retrieved texts.

1.3 Synonyms and alternative names

Commonly used names in the 2023–2024 literature include: - dup15q syndrome / 15q11.2–q13.1 duplication syndrome / chromosome 15q11-q13 duplication syndrome (bisba2024chromosome15q11q13duplication pages 1-2, parijs2024populationscreeningfor pages 1-2) - Cytogenetic-mechanism labels encountered in the literature: interstitial 15q duplication and isodicentric 15 [idic(15)] forms of dup15q (bisba2024chromosome15q11q13duplication pages 1-2, levandivska2023inherited15qduplication pages 1-2)

1.4 Evidence provenance

The evidence used here includes: - Aggregated literature synthesis + new clinical cases (Genes 2024 review/series). (bisba2024chromosome15q11q13duplication pages 1-2, bisba2024chromosome15q11q13duplication pages 3-5) - Population-level screening analysis from genome-wide cfDNA NIPS (European Journal of Human Genetics 2024). (parijs2024populationscreeningfor pages 1-2, parijs2024populationscreeningfor pages 3-5) - Mechanistic human-cell work using patient-derived neurons and CRISPR correction (Stem Cell Reports 2023). (elamin2023theroleof pages 1-2) - Translational mouse biomarker work (Journal of Neurodevelopmental Disorders 2024). (saravanapandian2024sleepeegsignatures pages 2-4) - Rare-disease data infrastructure paper describing a linked database for AS + dup15q natural history and trial readiness (Therapeutic Advances in Rare Disease 2024). (potter2024linkingangelmanand pages 3-5)


2. Etiology

2.1 Disease causal factors

Primary cause: germline copy-number gain (duplication/triplication/tetrasomy) of 15q11.2–q13.1, generated through non-allelic homologous recombination facilitated by low-copy repeats and canonical breakpoints BP1–BP5. (bisba2024chromosome15q11q13duplication pages 1-2, bisba2024chromosome15q11q13duplication media 4f90b336)

Parent-of-origin (imprinting) is a key causal modifier: - In a population-screening cohort, the authors conclude: “maternal duplications are invariably associated with a clinical phenotype … [while] the majority of paternal duplication carriers are phenotypically normal” with some mildly affected phenotypes observed. (parijs2024populationscreeningfor pages 3-5) - Bisba et al. (2024) note many pathogenic presentations are maternally derived and implicate maternally expressed imprinted genes (notably UBE3A) as contributors to ASD/developmental disorders. (bisba2024chromosome15q11q13duplication pages 5-7)

2.2 Risk factors

  • Genetic: Presence of a 15q11-q13 duplication (particularly maternally derived) is itself the dominant risk factor for neurodevelopmental phenotypes (ASD/ID/epilepsy). (parijs2024populationscreeningfor pages 1-2, elamin2023theroleof pages 1-2)
  • Structural genomic architecture: The segmental duplication/LCR structure and BP1–BP5 breakpoint framework predispose to rearrangements (duplications). (bisba2024chromosome15q11q13duplication pages 1-2, bisba2024chromosome15q11q13duplication media 4f90b336)

Environmental risk/protective factors: not specifically established for this CNV syndrome in the retrieved evidence set.

2.3 Protective factors and gene–environment interactions

No robust protective factors or gene–environment interaction studies specific to dup15q were retrieved in the evidence set.


3. Phenotypes (clinical presentation)

3.1 Phenotype spectrum and frequencies (recent synthesis)

A 2024 combined series/review (Bisba et al.) compiled phenotypic features from postnatal cases (defined across literature + their cases), with a notable fraction recorded as having composite phenotype (multiple neurodevelopmental features). Reported postnatal feature frequencies include: composite phenotype 53.91% (62/115), “normal” 13.04% (15/115), developmental delay 13.04% (15/115), ASD 6.95% (8/115), epilepsy 1.74% (2/115), congenital heart defects 1.74% (2/115). (bisba2024chromosome15q11q13duplication pages 3-5)

Prenatal-case features in the same synthesis (n=14) included “normal” 71.43% (10/14), congenital heart defects 21.43% (3/14), and intrauterine growth restriction (IUGR) 7.14% (1/14) (noting follow-up after birth was often unavailable). (bisba2024chromosome15q11q13duplication pages 3-5)

Important interpretation note: These summary tables aggregate heterogeneous ascertainment (including prenatal referrals and incomplete follow-up), and therefore should not be treated as population penetrance estimates.

3.2 Age of onset, progression, and severity

  • Typical onset: congenital/genetic; neurodevelopmental symptoms usually manifest in infancy/early childhood (developmental delay, hypotonia, ASD features), and epilepsy may present early (including infantile spasms, especially in severe subtypes such as idic(15)). (elamin2023theroleof pages 1-2)
  • Course: lifelong neurodevelopmental disability is common; severity varies with duplication type and parent-of-origin. (bisba2024chromosome15q11q13duplication pages 1-2, parijs2024populationscreeningfor pages 3-5)

3.3 Key phenotypes and suggested HPO terms

Below are common features with ontology suggestions (frequency varies by subtype and ascertainment): - Developmental delay: HP:0001263 (Global developmental delay) (bisba2024chromosome15q11q13duplication pages 1-2, bisba2024chromosome15q11q13duplication pages 3-5) - Intellectual disability: HP:0001249 (Intellectual disability) (bisba2024chromosome15q11q13duplication pages 1-2, parijs2024populationscreeningfor pages 1-2) - Autism spectrum disorder: HP:0000729 (Autistic behavior) (bisba2024chromosome15q11q13duplication pages 1-2, elamin2023theroleof pages 1-2) - Hypotonia: HP:0001252 (Muscular hypotonia) (parijs2024populationscreeningfor pages 1-2) - Seizures/Epilepsy: HP:0001250 (Seizures), HP:0001270 (Epileptic encephalopathy—when severe) (bisba2024chromosome15q11q13duplication pages 1-2, elamin2023theroleof pages 1-2) - Sleep disturbance: HP:0002360 (Sleep disturbance) supported by sleep-EEG biomarker work (saravanapandian2021abnormalsleepphysiology pages 1-2) - Congenital heart defects: HP:0001627 (Abnormality of the cardiovascular system) (bisba2024chromosome15q11q13duplication pages 3-5)

3.4 Quality of life (QoL) impact

While formal QoL instruments were not retrieved in the evidence set, the need for lifelong care and functional impairment is emphasized in rare-disease infrastructure work linking dup15q and Angelman syndrome datasets to support natural history and trial readiness. (potter2024linkingangelmanand pages 3-5)


4. Genetic / molecular information

4.1 Causal genomic abnormality and duplication classes

  • Structural basis: recurrent CNVs mediated by LCRs at BP1–BP5 (BP schematic shown in Bisba et al. Figure 1). (bisba2024chromosome15q11q13duplication media 4f90b336)
  • Cytogenetic forms:
  • Interstitial duplications (tandem duplications within chromosome 15)
  • Isodicentric 15 [idic(15)] supernumerary chromosomes (often increasing dosage further)

These classes are frequently invoked as the two common forms of Dup15q. (mim2024expandingdeepphenotypic pages 1-2, levandivska2023inherited15qduplication pages 1-2)

4.2 Key genes and dosage mechanisms

The region includes: - UBE3A (imprinted; maternally expressed in neurons) – dosage increase implicated in ASD and cellular hyperexcitability phenotypes. (elamin2023theroleof pages 1-2, bisba2024chromosome15q11q13duplication pages 1-2) - A cluster of GABAA receptor subunit genes (e.g., GABRA5, GABRB3, GABRG3) implicated in inhibitory neurotransmission and linked to EEG beta oscillation signatures and seizures. (saravanapandian2020propertiesofbeta pages 1-2, saravanapandian2024sleepeegsignatures pages 2-4) - Non-imprinted genes in BP1–BP2 often highlighted in clinical CNV interpretation: NIPA1, NIPA2, CYFIP1, TUBGCP5. (bisba2024chromosome15q11q13duplication pages 3-5)

4.3 Parent-of-origin and penetrance/expressivity

  • Bisba et al. interpret inherited duplications from apparently unaffected parents as evidence of reduced penetrance and variable expressivity. (bisba2024chromosome15q11q13duplication pages 5-7)
  • In their literature synthesis of inherited cases, 80.20% of carriers inherited the duplicated region from one parent, with 62.96% maternal and 37.04% paternal among inherited cases. (bisba2024chromosome15q11q13duplication pages 5-7)

4.4 Variant classification and population frequencies

  • At the population-screening level, 23 duplications in 333,187 NIPS profiles were found (incidence 0.0069%) and confirmed in maternal DNA where follow-up existed, with positive predictive value 100%: “Hence, the positive predictive value to detect this CNV by NIPS is 100%.” (parijs2024populationscreeningfor pages 3-5)
  • Precise allele frequencies by duplication class and size were not derived beyond this incidence estimate in the evidence set.

4.5 Epigenetic information

Genomic imprinting (parent-of-origin gene expression) is an epigenetic mechanism central to the 15q11–q13 locus; this is explicitly emphasized in 2024 work addressing structural variants overlapping the imprinting region and in population-screening context. (mim2024expandingdeepphenotypic pages 1-2, parijs2024populationscreeningfor pages 1-2)


5. Environmental information

No specific environmental toxins, lifestyle factors, or infectious triggers were identified in the retrieved evidence set as contributors to dup15q clinical expression.


6. Mechanism / pathophysiology

6.1 Causal chain (high-level)

  1. Copy-number gain of 15q11.2–q13.1 occurs via NAHR at BP1–BP5. (bisba2024chromosome15q11q13duplication media 4f90b336)
  2. Gene-dosage imbalance results, including increased dosage of maternally expressed UBE3A (in maternal duplications) and increased dosage of GABAA receptor subunit genes. (elamin2023theroleof pages 1-2, saravanapandian2020propertiesofbeta pages 1-2)
  3. Circuit-level consequences include altered excitation/inhibition dynamics, reflected in a robust EEG phenotype with excess beta oscillations (12–30 Hz). (saravanapandian2020propertiesofbeta pages 1-2, saravanapandian2024sleepeegsignatures pages 2-4)
  4. Downstream manifestations include ASD/ID, epilepsy, hypotonia, sleep disruption, and other neurodevelopmental impairments. (bisba2024chromosome15q11q13duplication pages 1-2, saravanapandian2021abnormalsleepphysiology pages 1-2)

6.2 Human cellular evidence (patient-derived neurons; 2023)

In patient-derived neurons with CRISPR-corrected isogenic controls, Dup15q was associated with neuronal hyperexcitability (increased excitatory synaptic event frequency/amplitude and increased action potential firing). Normalizing UBE3A levels (via antisense oligonucleotide approaches) generally prevented hyperexcitability; UBE3A overexpression recapitulated many phenotypes, supporting a causal role for UBE3A dosage while also leaving room for contributions from other duplicated genes. (elamin2023theroleof pages 1-2)

Statistics extracted from this mechanistic study’s clinical context: autism is reported in 77–100% and seizures in 63% of individuals with idic(15). (elamin2023theroleof pages 1-2)

6.3 Systems biomarkers: EEG beta phenotype and sleep physiology

A key translational biomarker is the beta-band EEG phenotype. - In a cohort study, beta power and beta peak frequency were highly stable across visits (ICC ~0.92–0.93) and comparable between research and clinical EEG (ICC 0.94), supporting use as a clinical trial biomarker. (saravanapandian2020propertiesofbeta pages 1-2) - Sleep physiology abnormalities in children with Dup15q include “elevated beta power, reduced spindle density, and reduced or absent SWS” in overnight EEG comparisons. (saravanapandian2021abnormalsleepphysiology pages 1-2)

6.4 Translational mouse models (2024)

A 2024 sleep-EEG study in chromosome-engineered mice found that maternal duplication mice mirrored the elevated beta oscillation phenotype observed clinically and concluded that this supports translational validity of the beta EEG biomarker for preclinical drug-target studies. (saravanapandian2024sleepeegsignatures pages 2-4)

6.5 Pathways and ontology suggestions

  • Suggested GO Biological Process terms (conceptual mapping from evidence):
  • GABAergic synaptic transmission (GO:0007268-related; mechanism implied by GABAA modulation–like EEG phenotype) (saravanapandian2020propertiesofbeta pages 1-2)
  • Regulation of membrane potential / neuronal excitability (GO:0042391 family) (elamin2023theroleof pages 1-2)
  • Synapse organization / synaptogenesis (GO:0050808-related; discussed with CYFIP1/NIPA genes) (bisba2024chromosome15q11q13duplication pages 5-7)
  • Suggested Cell Ontology terms (CL; conceptual mapping):
  • Cortical excitatory neuron (glutamatergic neuron) and GABAergic interneuron (inferred from E/I and GABAA involvement). (elamin2023theroleof pages 1-2, saravanapandian2020propertiesofbeta pages 1-2)

7. Anatomical structures affected

7.1 Primary systems

  • Nervous system / brain (dominant clinical manifestations and EEG biomarkers). (saravanapandian2021abnormalsleepphysiology pages 1-2, saravanapandian2020propertiesofbeta pages 1-2)
  • Occasional cardiac involvement (congenital heart defects noted in prenatal/postnatal summaries). (bisba2024chromosome15q11q13duplication pages 3-5)

7.2 Suggested UBERON terms

  • Brain: UBERON:0000955
  • Cerebral cortex: UBERON:0000956
  • Heart: UBERON:0000948 (for CHD cases)

7.3 Subcellular / GO Cellular Component (conceptual)

UBE3A is an E3 ubiquitin ligase; mechanistic implications include altered protein turnover pathways, but specific subcellular compartments were not directly specified in the retrieved evidence. (elamin2023theroleof pages 1-2)


8. Temporal development

  • Onset: congenital (genetic CNV); clinical recognition typically in early childhood when developmental delay/ASD/hypotonia become evident. (bisba2024chromosome15q11q13duplication pages 1-2)
  • Progression/course: chronic/lifelong neurodevelopmental disorder with variable severity; epilepsy can be persistent and disabling in severe cases. (elamin2023theroleof pages 1-2)

9. Inheritance and population

9.1 Incidence and prevalence (recent data)

  • Population incidence estimate from screening: In genome-wide NIPS profiles, 15q11-q13 duplications were detected in 23 of 333,187 pregnancies (0.0069%). (parijs2024populationscreeningfor pages 3-5, parijs2024populationscreeningfor pages 1-2)
  • Prevalence estimate cited in a 2024 review: “affecting 1 in 30,000 to 1 in 60,000 children worldwide” (noting this is a cited estimate within the review, not newly measured there). (bisba2024chromosome15q11q13duplication pages 5-7)

9.2 Inheritance pattern and counseling implications

  • The disorder is often described as autosomal dominant in CNV inheritance terms, but with reduced penetrance/variable expressivity (especially paternal or smaller duplications) and a strong parent-of-origin effect. (bisba2024chromosome15q11q13duplication pages 1-2, parijs2024populationscreeningfor pages 3-5)
  • In Bisba’s literature synthesis, among postnatal cases with known inheritance patterns, the totals were 48 maternal, 29 paternal, 17 de novo, 8 unknown. (bisba2024chromosome15q11q13duplication pages 5-7)

10. Diagnostics

10.1 Recommended / real-world testing approaches reflected in 2023–2024 evidence

  • Chromosomal microarray (CMA / array-CGH) is used as a primary diagnostic modality in clinical series; Bisba et al. diagnosed cases using Affymetrix CytoScan 750K array-CGH. (bisba2024chromosome15q11q13duplication pages 1-2)
  • Genome-wide NIPS (cfDNA) can detect maternal 15q11-q13 duplications at population scale; Parijs et al. report that in their dataset, duplications detected in cfDNA were confirmed in maternal DNA (when follow-up existed) and report PPV 100%. (parijs2024populationscreeningfor pages 3-5)
  • MLPA and karyotyping are used to confirm interstitial duplications and characterize structure; a family series recommends MLPA as cost/time effective “in cases of Dup15q suspicion.” (levandivska2023inherited15qduplication pages 1-2)

10.2 Differential diagnosis (conceptual, based on locus overlap)

Given locus complexity and overlap with imprinting disorders: - Prader–Willi syndrome and Angelman syndrome (loss of paternal vs maternal expression within 15q11–q13) are key differentials in the same region. (parijs2024populationscreeningfor pages 1-2, mim2024expandingdeepphenotypic pages 1-2)

10.3 Ontology suggestions

  • Diagnostic procedure (MAXO-like mapping for actions): chromosomal microarray analysis, genetic counseling, prenatal cfDNA screening.

Not retrieved in current evidence set: explicit ACMG/ClinGen CNV interpretation criteria text, and GTR test listings.


11. Outcome / prognosis

Robust survival and mortality statistics were not retrieved in the evidence set. Clinical burden is driven by neurodevelopmental disability and epilepsy severity; the 2024 population-screening paper emphasizes counseling complexity due to variable phenotype even within families. (parijs2024populationscreeningfor pages 3-5)


12. Treatment

12.1 Standard-of-care (supportive; evidence limitations)

The retrieved 2023–2024 sources emphasize symptom domains (ASD, epilepsy, sleep disturbance) but do not provide comprehensive, guideline-grade management algorithms. Supportive neurodevelopmental interventions and seizure management are implied as key care components, and the field is increasingly focused on objective biomarkers (EEG beta) to support trials. (saravanapandian2021abnormalsleepphysiology pages 1-2, potter2024linkingangelmanand pages 3-5)

12.2 Clinical trials and emerging therapeutics (real-world implementation)

Several interventional studies on ClinicalTrials.gov illustrate active drug-repurposing/targeted strategies:

  1. Soticlestat (TAK-935/OV935) – Phase 2, open-label signal-finding trial in Dup15q or CDKL5 deficiency disorder (ARCADE).
  2. NCT 03694275, enrollment 20 (actual); evaluates percent change in motor seizure frequency during maintenance weeks 9–20. (NCT03694275 chunk 1)
  3. Trial record includes a linked publication (PMID 37011526) in Epilepsy & Behavior (2023) referenced in the registry entry. (NCT03694275 chunk 2)
  4. MAXO suggestion: antiseizure therapy; cholesterol 24S-hydroxylase inhibitor therapy (mechanism per keyword list). (NCT03694275 chunk 1)

  5. Basmisanil (GABAA receptor subtype negative allosteric modulation hypothesis)

  6. NCT 05307679, Phase 2 randomized double-blind placebo-controlled; enrollment 7 (actual); terminated “due to sponsor decision and not related to safety or tolerability.” (NCT05307679 chunk 1)
  7. MAXO suggestion: GABA receptor modulator therapy; clinical trial participation. (NCT05307679 chunk 1)

  8. Retinoic acid / all-trans retinoic acid (ATRA) strategies (UBE3A-related mechanism suggested in trial descriptions)

  9. NCT 05281965: randomized crossover early phase 1 study of retinoic acid in dup15q; estimated enrollment 20; ages 6–18 years; outcomes include ADOS-based social reciprocity scores. (NCT05281965 chunk 1)
  10. NCT 07079696: Phase 2 single-group ATRA study; estimated enrollment 90; ages 3–7 years; includes EEG/fMRI and proteomics sampling in protocol summary. (NCT07079696 chunk 1)
  11. MAXO suggestion: retinoid therapy; behavioral assessment; EEG biomarker monitoring. (NCT05281965 chunk 1, NCT07079696 chunk 1)

Adverse events / response rates: not extractable from the evidence set here (except termination rationale for basmisanil). (NCT05307679 chunk 1)


13. Prevention

No primary prevention is available for a germline CNV disorder aside from reproductive options and counseling. - Secondary prevention / early detection: genome-wide NIPS can detect maternal duplications and prompts confirmatory testing and counseling. Parijs et al. discuss reporting and counseling guidance, noting that “Following these guidelines, 15q11-q13 duplications should be reported as maternal secondary findings” with invasive testing and genetic counseling recommended. (parijs2024populationscreeningfor pages 3-5)

MAXO suggestion: genetic counseling; prenatal genetic screening. (parijs2024populationscreeningfor pages 3-5)


14. Other species / natural disease

No naturally occurring non-human disease equivalent was retrieved in the evidence set.


15. Model organisms and experimental models

15.1 Mouse models (2024)

Sleep-EEG phenotyping was performed in chromosome-engineered mice modeling maternal vs paternal inheritance and in Ube3a overexpression mice. The study supports translational validity of the beta oscillation biomarker and notes nuanced divergence from human NREM abnormalities. (saravanapandian2024sleepeegsignatures pages 2-4)

15.2 Patient-derived cellular models (2023)

CRISPR-corrected patient-derived neurons provide an isogenic system to attribute electrophysiological phenotypes to dosage (especially UBE3A), supporting preclinical target validation approaches (ASO-based normalization, gene-editing controls). (elamin2023theroleof pages 1-2)

15.3 Model limitations

Mouse studies reported preserved NREM sleep and recovery post-deprivation, contrasting with human sleep abnormalities; this highlights species differences and the need for multi-model triangulation. (saravanapandian2024sleepeegsignatures pages 2-4, saravanapandian2021abnormalsleepphysiology pages 1-2)


Visual evidence (breakpoints and phenotype frequency)

Bisba et al. include (i) a breakpoint schematic (BP1–BP5) and (ii) tables summarizing phenotype frequencies and duplication spans; these were retrieved as cropped images and support the breakpoint architecture and the frequency summaries cited above. (bisba2024chromosome15q11q13duplication media 4f90b336, bisba2024chromosome15q11q13duplication media 5c40aa4c, bisba2024chromosome15q11q13duplication media a29eeba0, bisba2024chromosome15q11q13duplication media d7b953db)


Evidence gaps and limitations (for knowledge-base curation)

  1. Curated database IDs (Orphanet/MeSH/ICD) were not available in the retrieved evidence set and would require direct queries to those resources.
  2. Penetrance and true population prevalence remain challenging because clinical cohorts are biased and even population screening is limited by inclusion (pregnant women only) and incomplete fetal follow-up. (parijs2024populationscreeningfor pages 3-5)
  3. Standard-of-care guidelines and systematic reviews of therapies specific to dup15q were not retrieved; the most actionable treatment evidence in this set comes from clinical trial registries and biomarker work.

URLs and publication dates (key 2023–2024 sources)

  • Bisba et al. “Chromosome 15q11-q13 Duplication Syndrome: A Review of the Literature and 14 New Cases.” Oct 2024. https://doi.org/10.3390/genes15101304 (bisba2024chromosome15q11q13duplication pages 1-2)
  • Parijs et al. “Population screening for 15q11-q13 duplications…” Apr 2024. https://doi.org/10.1038/s41431-023-01336-6 (parijs2024populationscreeningfor pages 1-2)
  • Saravanapandian et al. “Sleep EEG signatures in mouse models of 15q11.2-13.1 duplication (Dup15q) syndrome.” Jul 2024. https://doi.org/10.1186/s11689-024-09556-7 (saravanapandian2024sleepeegsignatures pages 2-4)
  • Elamin et al. “The role of UBE3A … using patient-derived, CRISPR-corrected neurons.” Apr 2023. https://doi.org/10.1016/j.stemcr.2023.02.002 (elamin2023theroleof pages 1-2)
  • Potter et al. “Linking Angelman and dup15q data for expanded research (LADDER) database…” Jan 2024. https://doi.org/10.1177/26330040241254122 (potter2024linkingangelmanand pages 3-5)

Appendix: key 2023–2024 expert interpretation statements (direct excerpts)

  • Population screening interpretation: “the incidence of the 15q11-q13 duplications is 0.0069%.” and “Hence, the positive predictive value to detect this CNV by NIPS is 100%.” (parijs2024populationscreeningfor pages 3-5)
  • Parent-of-origin impact: “maternal duplications are invariably associated with a clinical phenotype … [while] the majority of paternal duplication carriers are phenotypically normal” (parijs2024populationscreeningfor pages 3-5)
  • Sleep biomarkers in children: “Children with Dup15q syndrome showed abnormal sleep physiology with elevated beta power, reduced spindle density, and reduced or absent SWS” (saravanapandian2021abnormalsleepphysiology pages 1-2)

References

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  12. (NCT05281965 chunk 1): A Clinical Study Evaluating the Efficacy and Safety of Retinoic Acid in Patients With 15q11-q13 Duplication Syndrome. Second Affiliated Hospital, School of Medicine, Zhejiang University. 2022. ClinicalTrials.gov Identifier: NCT05281965

  13. (NCT05307679 chunk 1): A Study to Evaluate the Safety and Efficacy of Basmisanil Treatment in Children Aged 2-14 Years With Dup15q Syndrome. Hoffmann-La Roche. 2022. ClinicalTrials.gov Identifier: NCT05307679

  14. (NCT03694275 chunk 1): A Multicenter, Open-label, Pilot Study of Soticlestat (TAK-935/OV935) in Participants With 15Q Duplication Syndrome (Dup 15q) or Cyclin-Dependent Kinase-Like 5 (CDKL5) Deficiency Disorder (ARCADE STUDY). Takeda. 2018. ClinicalTrials.gov Identifier: NCT03694275

  15. (NCT03694275 chunk 2): A Multicenter, Open-label, Pilot Study of Soticlestat (TAK-935/OV935) in Participants With 15Q Duplication Syndrome (Dup 15q) or Cyclin-Dependent Kinase-Like 5 (CDKL5) Deficiency Disorder (ARCADE STUDY). Takeda. 2018. ClinicalTrials.gov Identifier: NCT03694275

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