Uner Tan Syndrome

Mendelian MONDO:0100144 Pathograph 7 Show in embeddings browser hereditary neurological disease congenital nervous system disorder

This entry is scoped to the MONDO:0100144 TUBB2B p.Arg390Gln-specific entity, not to every disorder historically described as Uner Tan syndrome. The defining report identified a biallelic p.Arg390Gln substitution in a consanguineous family with three affected individuals. All three had habitual quadrupedal locomotion and severe cerebellar hypoplasia, and none had the basal ganglia malformations reported in other TUBB2B-associated disease. Variant assays found intact beta-tubulin folding, alpha/beta-heterodimer assembly, and incorporation of variant-containing heterodimers into microtubule polymers. A homologous yeast TUB2-390Q model grew normally under basal conditions but was more sensitive to microtubule-depolymerizing drugs. These measurements support a mild perturbation of microtubule function but do not establish a specific functional-impact class in the developing human brain, exclude every possible dominant-negative effect, explain recessivity, or resolve the intermediates leading to cerebellar hypoplasia. The allele, inheritance, and anatomical pattern distinguish this entity from de novo TUBB2B-related complex cortical dysplasia and from the genetically heterogeneous CAMRQ disorders that can also include quadrupedal gait.

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1
Inheritance
2
Pathophys.
2
Phenotypes
1
Gaps
7
Pathograph
1
Genes
2
Differentials
2
Models
3
References
👪

Inheritance

1
Autosomal recessive inheritance HP:0000007
The reported consanguineous family carried a biallelic TUBB2B p.Arg390Gln substitution. This supports autosomal recessive inheritance for this allele-specific entity but does not by itself explain the molecular dosage mechanism.
Autosomal recessive inheritance
Show evidence (2 references)
PMID:28013290 SUPPORT Human Clinical
"Analysis of a consanguineous UTS family identified a biallelic TUBB2B mutation, resulting in a p.R390Q amino acid substitution."
Establishes the biallelic variant and family context.
PMID:28013290 SUPPORT Human Clinical
"The TUBB2B mutation described here represents an unusual recessive mode of inheritance for missense-mediated tubulinopathies"
The authors explicitly interpret the reported inheritance as recessive.
?

Discussions and Knowledge Gaps

1
Which of substitution chemistry, tubulin-isotype context, and zygosity explains the different observations for TUBB2B p.Arg390Gln and TUBB2A p.Arg391His?
KNOWLEDGE GAP OPEN gap_uner_tan_arg390_versus_tubb2a_arg391
TUBB2B p.Arg390Gln leaves the assayed folding, heterodimer-assembly, and polymer-incorporation steps intact and is reported in the biallelic state. The structurally corresponding TUBB2A p.Arg391His variant is heterozygous and computationally predicted to weaken heterodimer formation. These records do not isolate residue substitution, isotype background, or allele dosage. Reciprocal substitutions tested in the same experimental system could help separate those variables; the current comparison cannot establish an isotype-specific mechanism by analogy alone.
Show evidence (2 references)
PMID:28013290 SUPPORT In Vitro
"Functional analysis of the R390Q substitution revealed that it did not affect the ability of β-tubulin to fold or become assembled into the α/β-heterodimer, nor did it influence the incorporation of mutant-containing heterodimers into microtubule polymers."
Defines the directly assayed TUBB2B side of the comparison.
PMID:41080462 SUPPORT Computational
"Computational modeling demonstrated that the variant disrupts α/β-tubulin heterodimer formation, impairing binding stability at this critical interaction site."
Defines the computational TUBB2A side and prevents it from being presented as an experimentally demonstrated cellular effect.

Pathophysiology

2
TUBB2B p.Arg390Gln-Associated Microtubule-Function Perturbation
The biallelic p.Arg390Gln substitution is the molecular trigger. Assays found no detectable defect in three measured steps: beta-tubulin folding, alpha/beta-heterodimer assembly, and incorporation into microtubule polymers. A homologous yeast model showed normal basal growth but increased sensitivity to microtubule-depolymerizing drugs. The human neural-cell consequence and precise functional class remain unresolved.
TUBB2B hgnc:30829 HUGO Gene Nomenclature Committee (hgnc) Relation: this pathophysiological event involves this gene This pathophysiological event involves TUBB2B (hgnc:30829). hgnc:30829 is a gene from the HUGO Gene Nomenclature Committee.
Genetic context allele_type: missense variant_origin: GERMLINE zygosity: HOMOZYGOUS functional_impact_category: UNKNOWN
Homozygous p.Arg390Gln. Intact performance in the assayed steps and a mild yeast challenge phenotype do not establish partial loss of function, prove haplosufficiency, or exclude unmeasured dominant-negative or other effects in human neurodevelopment.
microtubule cytoskeleton organization GO:0000226 Gene Ontology (GO) Relation: this pathophysiological event involves this biological process This pathophysiological event involves dysregulated microtubule cytoskeleton organization (GO:0000226). GO:0000226 is a biological process from the Gene Ontology. ↕ DYSREGULATED
Show evidence (2 references)
PMID:28013290 SUPPORT In Vitro
"Functional analysis of the R390Q substitution revealed that it did not affect the ability of β-tubulin to fold or become assembled into the α/β-heterodimer, nor did it influence the incorporation of mutant-containing heterodimers into microtubule polymers."
Directly reports intact performance in the three assayed biochemical and assembly steps; it does not test every possible variant effect.
PMID:28013290 SUPPORT Model Organism
"The 390Q mutation in S. cerevisiae TUB2 did not affect growth under basal conditions, but did result in increased sensitivity to microtubule-depolymerizing drugs, indicative of a mild impact of this mutation on microtubule function."
Shows a challenge-dependent phenotype in a homologous yeast model rather than a direct readout in developing human neural tissue.
Cerebellar Developmental Abnormality
Severe cerebellar hypoplasia was present in all three affected individuals. The source interprets this pattern as evidence that the developing cerebellum is sensitive to microtubule defects, but it does not identify a selectively affected cerebellar cell type or prove a tissue-specific threshold mechanism.
cerebellum development GO:0021549 Gene Ontology (GO) Relation: this pathophysiological event involves this biological process This pathophysiological event involves dysregulated cerebellum development (GO:0021549). GO:0021549 is a biological process from the Gene Ontology. ↕ DYSREGULATED
Show evidence (2 references)
PMID:28013290 SUPPORT Human Clinical
"In addition to the identifying quadrupedal locomotion, all three patients showed severe cerebellar hypoplasia."
Establishes the structural cerebellar finding in the complete reported affected set.
PMID:28013290 SUPPORT Other
"reinforces the sensitivity of the developing cerebellum to microtubule defects"
Records the authors' interpretation while preserving its inferential source type.

Pathograph

Use the checkboxes to hide or show graph categories. Hover nodes for evidence and cross-linked metadata.
Pathograph: causal mechanism network for Uner Tan 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

2
Nervous System 1
Cerebellar Hypoplasia 3/3 affected individuals in the reported family HP:0001321 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Cerebellar hypoplasia (HP:0001321). HP:0001321 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
PMID:28013290 SUPPORT Human Clinical
"all three patients showed severe cerebellar hypoplasia"
Reports the finding and severity in the complete affected set.
Other 1
Habitual Quadrupedal Locomotion 3/3 affected individuals in the reported family Cerebellar ataxia associated with quadrupedal gait HP:0009878 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Cerebellar ataxia associated with quadrupedal gait (HP:0009878). HP:0009878 is a phenotype from the Human Phenotype Ontology.
HP:0009878 is the exact HPO concept for cerebellar ataxia associated with quadrupedal gait. Neither this term nor the curated source supports evolutionary-hierarchy descriptions of affected people.
Show evidence (1 reference)
PMID:28013290 SUPPORT Human Clinical
"In addition to the identifying quadrupedal locomotion, all three patients showed severe cerebellar hypoplasia."
Names quadrupedal locomotion as the identifying feature in all three affected individuals.
🧬

Genetic Associations

1
TUBB2B (Causative)
Gene: TUBB2B (beta-tubulin 2B) hgnc:30829 HUGO Gene Nomenclature Committee (hgnc) Relation: this disease-associated gene is this gene This disease-associated gene is TUBB2B (beta-tubulin 2B), annotated with TUBB2B (hgnc:30829). hgnc:30829 is a gene from the HUGO Gene Nomenclature Committee.
Show evidence (1 reference)
PMID:28013290 SUPPORT Human Clinical
"Analysis of a consanguineous UTS family identified a biallelic TUBB2B mutation, resulting in a p.R390Q amino acid substitution."
Identifies TUBB2B and the specific biallelic substitution in the reported family.
🔬

Diagnosis

1
Molecular Identification of Biallelic TUBB2B p.Arg390Gln (Biallelic TUBB2B p.Arg390Gln in an individual with a compatible phenotype)
Quadrupedal gait and cerebellar hypoplasia are not gene-specific. Molecular identification of the biallelic TUBB2B p.Arg390Gln substitution distinguishes this entity from de novo TUBB2B cortical-malformation disease and from other genetic causes of a similar clinical pattern. Evidence is limited to one reported family, so this is a scope boundary rather than a validated diagnostic performance claim.
Results: Identification of the biallelic p.Arg390Gln substitution supports assignment to this allele-specific MONDO entity.
Show evidence (1 reference)
PMID:28013290 SUPPORT Human Clinical
"Analysis of a consanguineous UTS family identified a biallelic TUBB2B mutation, resulting in a p.R390Q amino acid substitution."
Supports molecular definition by the biallelic p.Arg390Gln finding.
🩻

Imaging Findings

1
Reported Absence of Basal Ganglia Malformation 3/3 affected individuals in the reported family
None of the three affected individuals had the basal ganglia malformations described as typical of other TUBB2B mutations. This is a negative structural finding, not a positive abnormal-basal-ganglia phenotype and not a validated pathognomonic test.
Other
Show evidence (1 reference)
PMID:28013290 SUPPORT Human Clinical
"None, however, displayed the basal ganglia malformations typically associated with TUBB2B mutations."
Directly supports the explicitly negative finding; SUPPORT applies to the absence statement itself.
🔀

Differential Diagnoses

2

Conditions with similar clinical presentations that must be differentiated from Uner Tan Syndrome:

Overlapping Features The CAMRQ umbrella covers genetically heterogeneous autosomal recessive cerebellar disorders, including separately curated VLDLR-, WDR81-, CA8-, and ATP8A2-related subtypes. Some historical uses of the Uner Tan eponym overlap this broader clinical group; molecular diagnosis is needed to preserve the disease boundary.
Distinguishing Features
  • A causal finding in VLDLR, WDR81, CA8, or ATP8A2 favors the corresponding CAMRQ subtype.
  • Biallelic TUBB2B p.Arg390Gln favors the MONDO:0100144 entity curated here.
Show evidence (1 reference)
PMID:28013290 SUPPORT Human Clinical
"Analysis of a consanguineous UTS family identified a biallelic TUBB2B mutation, resulting in a p.R390Q amino acid substitution."
Supports the TUBB2B p.Arg390Gln side of the differential. The broader CAMRQ taxonomy is an ontology and cross-record assertion, as stated below.
🧫

Experimental Models

2
TUBB2B p.Arg390Gln Folding, Heterodimer-Assembly, and Polymer-Incorporation Assays OTHER
Variant-focused assays tested beta-tubulin folding, alpha/beta-heterodimer assembly, and incorporation of variant-containing heterodimers into microtubule polymers. All three measured steps were intact; the assays do not model developing neural tissue or establish that every microtubule function is normal.
TUBB2B p.Arg390Gln compared with wild-type protein in folding, heterodimer-assembly, and polymer-incorporation assays
Publication
Findings
p.Arg390Gln did not measurably impair folding, heterodimer assembly, or incorporation into microtubule polymers.
"Functional analysis of the R390Q substitution revealed that it did not affect the ability of β-tubulin to fold or become assembled into the α/β-heterodimer, nor did it influence the incorporation of mutant-containing heterodimers into microtubule polymers."
Show evidence (1 reference)
PMID:28013290 SUPPORT In Vitro
"Functional analysis of the R390Q substitution revealed that it did not affect the ability of β-tubulin to fold or become assembled into the α/β-heterodimer, nor did it influence the incorporation of mutant-containing heterodimers into microtubule polymers."
Supports the negative result for each of the three measured assay steps.
Show evidence (1 reference)
PMID:28013290 SUPPORT In Vitro
"Functional analysis of the R390Q substitution revealed that it did not affect the ability of β-tubulin to fold or become assembled into the α/β-heterodimer, nor did it influence the incorporation of mutant-containing heterodimers into microtubule polymers."
Defines the measured in-vitro system and its negative results.
Saccharomyces cerevisiae TUB2-390Q Drug-Sensitivity Model OTHER
A homologous 390Q substitution in yeast TUB2 produced normal basal growth but increased sensitivity to microtubule-depolymerizing drugs. This provides a model-organism challenge readout of microtubule function, not a human neural developmental model.
TUB2-390Q under basal growth conditions TUB2-390Q challenged with microtubule-depolymerizing drugs
Organism
Saccharomyces cerevisiae NCBITaxon:4932 NCBI Taxonomy (NCBITaxon) Relation: this experimental model is built in this organism This experimental model is built in Saccharomyces cerevisiae (NCBITaxon:4932). NCBITaxon:4932 is an organism from the NCBI Taxonomy.
Publication
Findings
TUB2-390Q preserved basal growth but increased sensitivity to microtubule-depolymerizing drugs.
"The 390Q mutation in S. cerevisiae TUB2 did not affect growth under basal conditions, but did result in increased sensitivity to microtubule-depolymerizing drugs, indicative of a mild impact of this mutation on microtubule function."
Show evidence (1 reference)
PMID:28013290 SUPPORT Model Organism
"The 390Q mutation in S. cerevisiae TUB2 did not affect growth under basal conditions, but did result in increased sensitivity to microtubule-depolymerizing drugs, indicative of a mild impact of this mutation on microtubule function."
Supports the stated basal-growth and drug-sensitivity finding.
Show evidence (1 reference)
PMID:28013290 SUPPORT Model Organism
"The 390Q mutation in S. cerevisiae TUB2 did not affect growth under basal conditions, but did result in increased sensitivity to microtubule-depolymerizing drugs, indicative of a mild impact of this mutation on microtubule function."
Directly reports the basal and challenged phenotypes of the yeast model.
{ }

Source YAML

click to show
name: Uner Tan Syndrome
creation_date: "2026-08-20T18:20:00Z"
category: Mendelian
synonyms:
- recessive quadrupedalism
disease_term:
  preferred_term: Uner Tan Syndrome
  term:
    id: MONDO:0100144
    label: Uner Tan Syndrome
description: >-
  This entry is scoped to the MONDO:0100144 TUBB2B p.Arg390Gln-specific entity,
  not to every disorder historically described as Uner Tan syndrome. The
  defining report identified a biallelic p.Arg390Gln substitution in a
  consanguineous family with three affected individuals. All three had habitual
  quadrupedal locomotion and severe cerebellar hypoplasia, and none had the basal
  ganglia malformations reported in other TUBB2B-associated disease.

  Variant assays found intact beta-tubulin folding, alpha/beta-heterodimer
  assembly, and incorporation of variant-containing heterodimers into
  microtubule polymers. A homologous yeast TUB2-390Q model grew normally under
  basal conditions but was more sensitive to microtubule-depolymerizing drugs.
  These measurements support a mild perturbation of microtubule function but do
  not establish a specific functional-impact class in the developing human
  brain, exclude every possible dominant-negative effect, explain recessivity,
  or resolve the intermediates leading to cerebellar hypoplasia.

  The allele, inheritance, and anatomical pattern distinguish this entity from
  de novo TUBB2B-related complex cortical dysplasia and from the genetically
  heterogeneous CAMRQ disorders that can also include quadrupedal gait.
parents:
- hereditary neurological disease
- congenital nervous system disorder
references:
- reference: PMID:28013290
  title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
- reference: PMID:19465910
  title: Mutations in the beta-tubulin gene TUBB2B result in asymmetrical polymicrogyria.
- reference: PMID:41080462
  title: A mutational hotspot in TUBB2A associated with impaired heterodimer formation and severe brain developmental disorders.
inheritance:
- name: Autosomal recessive inheritance
  inheritance_term:
    preferred_term: Autosomal recessive inheritance
    term:
      id: HP:0000007
      label: Autosomal recessive inheritance
  description: >-
    The reported consanguineous family carried a biallelic TUBB2B p.Arg390Gln
    substitution. This supports autosomal recessive inheritance for this
    allele-specific entity but does not by itself explain the molecular dosage
    mechanism.
  evidence:
  - reference: PMID:28013290
    reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Analysis of a consanguineous UTS family identified a biallelic TUBB2B
      mutation, resulting in a p.R390Q amino acid substitution.
    explanation: >-
      Establishes the biallelic variant and family context.
  - reference: PMID:28013290
    reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The TUBB2B mutation described here represents an unusual recessive mode of
      inheritance for missense-mediated tubulinopathies
    explanation: >-
      The authors explicitly interpret the reported inheritance as recessive.
pathophysiology:
- name: TUBB2B p.Arg390Gln-Associated Microtubule-Function Perturbation
  role: TRIGGER
  biological_scale: MOLECULAR
  description: >-
    The biallelic p.Arg390Gln substitution is the molecular trigger. Assays found
    no detectable defect in three measured steps: beta-tubulin folding,
    alpha/beta-heterodimer assembly, and incorporation into microtubule polymers.
    A homologous yeast model showed normal basal growth but increased sensitivity
    to microtubule-depolymerizing drugs. The human neural-cell consequence and
    precise functional class remain unresolved.
  genetic_context:
    functional_impact_category: UNKNOWN
    variant_origin: GERMLINE
    zygosity: HOMOZYGOUS
    allele_type: missense
    description: >-
      Homozygous p.Arg390Gln. Intact performance in the assayed steps and a mild
      yeast challenge phenotype do not establish partial loss of function, prove
      haplosufficiency, or exclude unmeasured dominant-negative or other effects
      in human neurodevelopment.
  genes:
  - preferred_term: TUBB2B
    term:
      id: hgnc:30829
      label: TUBB2B
  biological_processes:
  - preferred_term: microtubule cytoskeleton organization
    term:
      id: GO:0000226
      label: microtubule cytoskeleton organization
    modifier: DYSREGULATED
  evidence:
  - reference: PMID:28013290
    reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: >-
      Functional analysis of the R390Q substitution revealed that it did not
      affect the ability of β-tubulin to fold or become assembled into the
      α/β-heterodimer, nor did it influence the incorporation of
      mutant-containing heterodimers into microtubule polymers.
    explanation: >-
      Directly reports intact performance in the three assayed biochemical and
      assembly steps; it does not test every possible variant effect.
  - reference: PMID:28013290
    reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
    supports: SUPPORT
    evidence_source: MODEL_ORGANISM
    snippet: >-
      The 390Q mutation in S. cerevisiae TUB2 did not affect growth under basal
      conditions, but did result in increased sensitivity to
      microtubule-depolymerizing drugs, indicative of a mild impact of this
      mutation on microtubule function.
    explanation: >-
      Shows a challenge-dependent phenotype in a homologous yeast model rather
      than a direct readout in developing human neural tissue.
  downstream:
  - target: Cerebellar Developmental Abnormality
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
    description: >-
      The report links the tubulin variant to cerebellar hypoplasia, but the
      intervening neural cell types, developmental stages, and cellular events
      were not resolved.
    evidence:
    - reference: PMID:28013290
      reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
      supports: SUPPORT
      evidence_source: OTHER
      snippet: >-
        The TUBB2B mutation described here represents an unusual recessive mode
        of inheritance for missense-mediated tubulinopathies and reinforces the
        sensitivity of the developing cerebellum to microtubule defects.
      explanation: >-
        This is the authors' disease-level inference, not a directly mapped
        cellular pathway from the variant to the anatomical finding.
- name: Cerebellar Developmental Abnormality
  biological_scale: TISSUE
  description: >-
    Severe cerebellar hypoplasia was present in all three affected individuals.
    The source interprets this pattern as evidence that the developing
    cerebellum is sensitive to microtubule defects, but it does not identify a
    selectively affected cerebellar cell type or prove a tissue-specific
    threshold mechanism.
  biological_processes:
  - preferred_term: cerebellum development
    term:
      id: GO:0021549
      label: cerebellum development
    modifier: DYSREGULATED
  evidence:
  - reference: PMID:28013290
    reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      In addition to the identifying quadrupedal locomotion, all three patients
      showed severe cerebellar hypoplasia.
    explanation: >-
      Establishes the structural cerebellar finding in the complete reported
      affected set.
  - reference: PMID:28013290
    reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
    supports: SUPPORT
    evidence_source: OTHER
    snippet: >-
      reinforces the sensitivity of the developing cerebellum to microtubule
      defects
    explanation: >-
      Records the authors' interpretation while preserving its inferential
      source type.
  downstream:
  - target: Cerebellar Hypoplasia
    description: >-
      The developmental abnormality is observed structurally as cerebellar
      hypoplasia.
    evidence:
    - reference: PMID:28013290
      reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        all three patients showed severe cerebellar hypoplasia
      explanation: >-
        Directly connects the cerebellar developmental node to the reported
        anatomical phenotype.
  - target: Habitual Quadrupedal Locomotion
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
    description: >-
      The co-occurrence of quadrupedal locomotion and severe cerebellar
      hypoplasia motivates an emerging hypothesis that cerebellar developmental
      abnormality contributes to the locomotor phenotype through unresolved
      intermediates. This edge does not assert that cerebellar hypoplasia
      directly causes the gait pattern or identify a single causal route.
    evidence:
    - reference: PMID:28013290
      reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
      supports: SUPPORT
      evidence_source: OTHER
      snippet: >-
        In addition to the identifying quadrupedal locomotion, all three patients
        showed severe cerebellar hypoplasia.
      explanation: >-
        The source establishes co-occurrence in three affected individuals, not
        causation. OTHER records that the proposed link is an explicit
        disease-level inference rather than a demonstrated mechanistic route.
phenotypes:
- name: Habitual Quadrupedal Locomotion
  category: Neurologic
  frequency: 3/3 affected individuals in the reported family
  description: >-
    Quadrupedal locomotion was the identifying locomotor phenotype in all three
    reported affected individuals. It is recorded descriptively; the available
    evidence does not establish a single causal path from cerebellar hypoplasia
    to this locomotor strategy.
  phenotype_term:
    preferred_term: Cerebellar ataxia associated with quadrupedal gait
    term:
      id: HP:0009878
      label: Cerebellar ataxia associated with quadrupedal gait
  notes: >-
    HP:0009878 is the exact HPO concept for cerebellar ataxia associated with
    quadrupedal gait. Neither this term nor the curated source supports
    evolutionary-hierarchy descriptions of affected people.
  evidence:
  - reference: PMID:28013290
    reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      In addition to the identifying quadrupedal locomotion, all three patients
      showed severe cerebellar hypoplasia.
    explanation: >-
      Names quadrupedal locomotion as the identifying feature in all three
      affected individuals.
- name: Cerebellar Hypoplasia
  category: Neurologic
  frequency: 3/3 affected individuals in the reported family
  severity: SEVERE
  description: >-
    Severe cerebellar hypoplasia was reported in all three affected individuals.
    The denominator describes the single reported family and must not be treated
    as a population frequency estimate.
  phenotype_term:
    preferred_term: Cerebellar hypoplasia
    term:
      id: HP:0001321
      label: Cerebellar hypoplasia
  evidence:
  - reference: PMID:28013290
    reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      all three patients showed severe cerebellar hypoplasia
    explanation: >-
      Reports the finding and severity in the complete affected set.
imaging_findings:
- name: Reported Absence of Basal Ganglia Malformation
  modality: OTHER
  frequency: 3/3 affected individuals in the reported family
  description: >-
    None of the three affected individuals had the basal ganglia malformations
    described as typical of other TUBB2B mutations. This is a negative structural
    finding, not a positive abnormal-basal-ganglia phenotype and not a validated
    pathognomonic test.
  evidence:
  - reference: PMID:28013290
    reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      None, however, displayed the basal ganglia malformations typically
      associated with TUBB2B mutations.
    explanation: >-
      Directly supports the explicitly negative finding; SUPPORT applies to the
      absence statement itself.
genetic:
- name: TUBB2B
  association: Causative
  gene_term:
    preferred_term: TUBB2B (beta-tubulin 2B)
    term:
      id: hgnc:30829
      label: TUBB2B
  notes: >-
    This association is variant- and inheritance-specific: the curated entity is
    anchored to biallelic p.Arg390Gln. It should not be generalized to every
    biallelic TUBB2B finding or merged with de novo TUBB2B
    cortical-malformation disease without separate evidence.
  evidence:
  - reference: PMID:28013290
    reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Analysis of a consanguineous UTS family identified a biallelic TUBB2B
      mutation, resulting in a p.R390Q amino acid substitution.
    explanation: >-
      Identifies TUBB2B and the specific biallelic substitution in the reported
      family.
diagnosis:
- name: Molecular Identification of Biallelic TUBB2B p.Arg390Gln
  presence: Biallelic TUBB2B p.Arg390Gln in an individual with a compatible phenotype
  results: >-
    Identification of the biallelic p.Arg390Gln substitution supports assignment
    to this allele-specific MONDO entity.
  description: >-
    Quadrupedal gait and cerebellar hypoplasia are not gene-specific. Molecular
    identification of the biallelic TUBB2B p.Arg390Gln substitution distinguishes
    this entity from de novo TUBB2B cortical-malformation disease and from
    other genetic causes of a similar clinical pattern. Evidence is limited to
    one reported family, so this is a scope boundary rather than a validated
    diagnostic performance claim.
  evidence:
  - reference: PMID:28013290
    reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Analysis of a consanguineous UTS family identified a biallelic TUBB2B
      mutation, resulting in a p.R390Q amino acid substitution.
    explanation: >-
      Supports molecular definition by the biallelic p.Arg390Gln finding.
differential_diagnoses:
- name: TUBB2B-Related Complex Cortical Dysplasia with Other Brain Malformations 7
  disease_term:
    preferred_term: complex cortical dysplasia with other brain malformations 7
    term:
      id: MONDO:0012399
      label: complex cortical dysplasia with other brain malformations 7
  description: >-
    This differential shares TUBB2B but is associated with de novo variants and
    a cortical-malformation pattern rather than the biallelic
    p.Arg390Gln-specific entity curated here.
  distinguishing_features:
  - De novo TUBB2B variants with bilateral asymmetrical polymicrogyria favor complex cortical dysplasia with other brain malformations 7.
  - Biallelic p.Arg390Gln with severe cerebellar hypoplasia and no reported basal ganglia malformation favors this entry.
  evidence:
  - reference: PMID:19465910
    reference_title: Mutations in the beta-tubulin gene TUBB2B result in asymmetrical polymicrogyria.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Here we report de novo mutations in a beta-tubulin gene, TUBB2B, in four
      individuals and a 27-gestational-week fetus with bilateral asymmetrical
      polymicrogyria.
    explanation: >-
      Establishes the de novo inheritance and cortical-malformation pattern of
      the same-gene differential.
  - reference: PMID:28013290
    reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      None, however, displayed the basal ganglia malformations typically
      associated with TUBB2B mutations.
    explanation: >-
      Supports the reported anatomical distinction from typical TUBB2B disease.
- name: Cerebellar Ataxia, Intellectual Disability, and Dysequilibrium Syndromes
  disease_term:
    preferred_term: cerebellar ataxia, intellectual disability, and dysequilibrium
    term:
      id: MONDO:0009133
      label: cerebellar ataxia, intellectual disability, and dysequilibrium
  description: >-
    The CAMRQ umbrella covers genetically heterogeneous autosomal recessive
    cerebellar disorders, including separately curated VLDLR-, WDR81-, CA8-, and
    ATP8A2-related subtypes. Some historical uses of the Uner Tan eponym overlap
    this broader clinical group; molecular diagnosis is needed to preserve the
    disease boundary.
  distinguishing_features:
  - A causal finding in VLDLR, WDR81, CA8, or ATP8A2 favors the corresponding CAMRQ subtype.
  - Biallelic TUBB2B p.Arg390Gln favors the MONDO:0100144 entity curated here.
  evidence:
  - reference: PMID:28013290
    reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Analysis of a consanguineous UTS family identified a biallelic TUBB2B
      mutation, resulting in a p.R390Q amino acid substitution.
    explanation: >-
      Supports the TUBB2B p.Arg390Gln side of the differential. The broader CAMRQ
      taxonomy is an ontology and cross-record assertion, as stated below.
  notes: >-
    This is an ontology and cross-record scope assertion. Source-level evidence
    for the four CAMRQ subtypes remains in the separately curated
    Cerebellar_Ataxia_Intellectual_Disability_and_Dysequilibrium record and is not
    duplicated here.
treatments: []
experimental_models:
- name: TUBB2B p.Arg390Gln Folding, Heterodimer-Assembly, and Polymer-Incorporation Assays
  description: >-
    Variant-focused assays tested beta-tubulin folding, alpha/beta-heterodimer
    assembly, and incorporation of variant-containing heterodimers into
    microtubule polymers. All three measured steps were intact; the assays do not
    model developing neural tissue or establish that every microtubule function
    is normal.
  experimental_model_type: OTHER
  conditions:
  - TUBB2B p.Arg390Gln compared with wild-type protein in folding, heterodimer-assembly, and polymer-incorporation assays
  publication: PMID:28013290
  modeled_mechanisms:
  - target: TUBB2B p.Arg390Gln-Associated Microtubule-Function Perturbation
    description: >-
      Tests three candidate molecular failure points and finds no detectable
      impairment in those specific readouts.
    evidence:
    - reference: PMID:28013290
      reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
      supports: SUPPORT
      evidence_source: IN_VITRO
      snippet: >-
        Functional analysis of the R390Q substitution revealed that it did not
        affect the ability of β-tubulin to fold or become assembled into the
        α/β-heterodimer, nor did it influence the incorporation of
        mutant-containing heterodimers into microtubule polymers.
      explanation: >-
        Connects the assay model to the specific measured aspects of the trigger
        node.
  findings:
  - statement: >-
      p.Arg390Gln did not measurably impair folding, heterodimer assembly, or
      incorporation into microtubule polymers.
    supporting_text: >-
      Functional analysis of the R390Q substitution revealed that it did not
      affect the ability of β-tubulin to fold or become assembled into the
      α/β-heterodimer, nor did it influence the incorporation of
      mutant-containing heterodimers into microtubule polymers.
    evidence:
    - reference: PMID:28013290
      reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
      supports: SUPPORT
      evidence_source: IN_VITRO
      snippet: >-
        Functional analysis of the R390Q substitution revealed that it did not
        affect the ability of β-tubulin to fold or become assembled into the
        α/β-heterodimer, nor did it influence the incorporation of
        mutant-containing heterodimers into microtubule polymers.
      explanation: >-
        Supports the negative result for each of the three measured assay steps.
  evidence:
  - reference: PMID:28013290
    reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: >-
      Functional analysis of the R390Q substitution revealed that it did not
      affect the ability of β-tubulin to fold or become assembled into the
      α/β-heterodimer, nor did it influence the incorporation of
      mutant-containing heterodimers into microtubule polymers.
    explanation: >-
      Defines the measured in-vitro system and its negative results.
- name: Saccharomyces cerevisiae TUB2-390Q Drug-Sensitivity Model
  description: >-
    A homologous 390Q substitution in yeast TUB2 produced normal basal growth but
    increased sensitivity to microtubule-depolymerizing drugs. This provides a
    model-organism challenge readout of microtubule function, not a human neural
    developmental model.
  experimental_model_type: OTHER
  organism:
    preferred_term: Saccharomyces cerevisiae
    term:
      id: NCBITaxon:4932
      label: Saccharomyces cerevisiae
  conditions:
  - TUB2-390Q under basal growth conditions
  - TUB2-390Q challenged with microtubule-depolymerizing drugs
  publication: PMID:28013290
  modeled_mechanisms:
  - target: TUBB2B p.Arg390Gln-Associated Microtubule-Function Perturbation
    description: >-
      Models the homologous substitution and reveals a phenotype only under a
      microtubule-destabilizing challenge.
    evidence:
    - reference: PMID:28013290
      reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
      supports: SUPPORT
      evidence_source: MODEL_ORGANISM
      snippet: >-
        The 390Q mutation in S. cerevisiae TUB2 did not affect growth under basal
        conditions, but did result in increased sensitivity to
        microtubule-depolymerizing drugs, indicative of a mild impact of this
        mutation on microtubule function.
      explanation: >-
        Connects the homologous yeast challenge phenotype to the molecular
        perturbation node.
  findings:
  - statement: >-
      TUB2-390Q preserved basal growth but increased sensitivity to
      microtubule-depolymerizing drugs.
    supporting_text: >-
      The 390Q mutation in S. cerevisiae TUB2 did not affect growth under basal
      conditions, but did result in increased sensitivity to
      microtubule-depolymerizing drugs, indicative of a mild impact of this
      mutation on microtubule function.
    evidence:
    - reference: PMID:28013290
      reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
      supports: SUPPORT
      evidence_source: MODEL_ORGANISM
      snippet: >-
        The 390Q mutation in S. cerevisiae TUB2 did not affect growth under basal
        conditions, but did result in increased sensitivity to
        microtubule-depolymerizing drugs, indicative of a mild impact of this
        mutation on microtubule function.
      explanation: >-
        Supports the stated basal-growth and drug-sensitivity finding.
  evidence:
  - reference: PMID:28013290
    reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
    supports: SUPPORT
    evidence_source: MODEL_ORGANISM
    snippet: >-
      The 390Q mutation in S. cerevisiae TUB2 did not affect growth under basal
      conditions, but did result in increased sensitivity to
      microtubule-depolymerizing drugs, indicative of a mild impact of this
      mutation on microtubule function.
    explanation: >-
      Directly reports the basal and challenged phenotypes of the yeast model.
datasets: []
clinical_trials: []
discussions:
- discussion_id: gap_uner_tan_arg390_versus_tubb2a_arg391
  prompt: >-
    Which of substitution chemistry, tubulin-isotype context, and zygosity
    explains the different observations for TUBB2B p.Arg390Gln and TUBB2A
    p.Arg391His?
  kind: KNOWLEDGE_GAP
  status: OPEN
  attaches_to:
  - pathophysiology#TUBB2B p.Arg390Gln-Associated Microtubule-Function Perturbation
  rationale: >-
    TUBB2B p.Arg390Gln leaves the assayed folding, heterodimer-assembly, and
    polymer-incorporation steps intact and is reported in the biallelic state.
    The structurally corresponding TUBB2A p.Arg391His variant is heterozygous and
    computationally predicted to weaken heterodimer formation. These records do
    not isolate residue substitution, isotype background, or allele dosage.
    Reciprocal substitutions tested in the same experimental system could help
    separate those variables; the current comparison cannot establish an
    isotype-specific mechanism by analogy alone.
  evidence:
  - reference: PMID:28013290
    reference_title: Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: >-
      Functional analysis of the R390Q substitution revealed that it did not
      affect the ability of β-tubulin to fold or become assembled into the
      α/β-heterodimer, nor did it influence the incorporation of
      mutant-containing heterodimers into microtubule polymers.
    explanation: >-
      Defines the directly assayed TUBB2B side of the comparison.
  - reference: PMID:41080462
    reference_title: A mutational hotspot in TUBB2A associated with impaired heterodimer formation and severe brain developmental disorders.
    supports: SUPPORT
    evidence_source: COMPUTATIONAL
    snippet: >-
      Computational modeling demonstrated that the variant disrupts α/β-tubulin
      heterodimer formation, impairing binding stability at this critical
      interaction site.
    explanation: >-
      Defines the computational TUBB2A side and prevents it from being presented
      as an experimentally demonstrated cellular effect.
notes: >-
  This entry remains separate from TUBB2A/TUBB2B-related Cortical Malformation.
  That record maps MONDO:0100144 as skos:relatedMatch, reflecting a reviewed
  same-gene boundary rather than a subtype assertion. The existing CAMRQ umbrella
  record separately curates CAMRQ1 (VLDLR), CAMRQ2 (WDR81), CAMRQ3 (CA8), and
  CAMRQ4 (ATP8A2), correcting the earlier statement that these entities were
  uncurated.

  The entry is intentionally not a member of the Tubulinopathies grouping. That
  grouping currently requires evidence for microtubule-dependent neuronal
  migration failure; the cached evidence for this entity supports cerebellar
  developmental involvement but does not establish cortical migration failure.
  It is likewise not mapped to the cerebellar Purkinje-cell degeneration module:
  the documented lesion is developmental hypoplasia, not demonstrated
  degeneration.

  Curated prose uses affected individuals, intellectual disability where
  source-supported, and habitual quadrupedal locomotion. Terms such as primitive,
  devolution, reverse evolution, and atavism are not used: the curated evidence
  supports a locomotor phenotype and neurodevelopmental disorder, not an
  evolutionary hierarchy. The gait is not presented as proof of a single causal
  route from cerebellar hypoplasia.
review_notes: >-
  Evidence review completed 2026-08-24. The cache for PMID:28013290 remained
  content_type abstract_only after sanctioned regeneration, so clinical details
  available only in the full article were not promoted into structured or
  snippet-backed claims. The modality of the reported structural brain findings
  is consequently left unspecified. PMID:19465910 is also abstract-only;
  PMID:41080462 is cached as full_text_xml. Every evidence snippet is exact text
  from the corresponding cache and its evidence_source reflects human clinical,
  in-vitro, model-organism, computational, or author-inference provenance.

  Functional-impact classification was changed from PARTIAL_LOSS_OF_FUNCTION to
  UNKNOWN. Intact performance in selected assays and mild yeast drug sensitivity
  do not prove hypomorphic loss of function, explain recessivity, or exclude
  unmeasured mechanisms. The variant-to-cerebellar link is therefore explicitly
  INDIRECT_UNKNOWN_INTERMEDIATES, and cerebellar hypoplasia is not asserted to
  cause habitual quadrupedal locomotion.

  Frequencies are reported only as 3/3 affected individuals in the single family,
  not as population estimates. The negative basal-ganglia observation is modeled
  as a supported negative structural finding rather than a positive HPO
  abnormality with REFUTE evidence. HP:0009878 replaces the nonspecific
  gait-ataxia binding because it is the exact HPO term for cerebellar ataxia
  associated with quadrupedal gait.

  No disorder-specific therapeutic study or management guideline was present in
  the reviewed evidence, so unsupported treatment-effect entries were removed.
  Exact-name and gene/variant ClinicalTrials.gov searches returned no registered
  studies on 2026-08-24; clinical_trials is therefore empty. Disease- and
  variant-specific NCBI GDS, SRA, and BioProject searches returned no dedicated
  dataset. The full article's dbGaP accession belongs to a broader
  controlled-access exome initiative rather than a Uner Tan syndrome-specific
  dataset, so datasets is empty and no dbGaP cache was created. A current literature scan did
  not provide adequate evidence to expand MONDO:0100144 beyond p.Arg390Gln; a
  later biallelic TUBB2B report involved a dual molecular diagnosis and was not
  used to lump entities.
📚

References & Deep Research

References

3
Uner Tan syndrome caused by a homozygous TUBB2B mutation affecting microtubule stability.
No top-level findings curated for this source.
Mutations in the beta-tubulin gene TUBB2B result in asymmetrical polymicrogyria.
No top-level findings curated for this source.
A mutational hotspot in TUBB2A associated with impaired heterodimer formation and severe brain developmental disorders.
No top-level findings curated for this source.