COXFA4L2 upregulation preserves residual cytochrome c oxidase activity in COXFA4-related Leigh-like encephalopathy
Falabella M, Lopez Calcerrada S, Aref J, Gao J, Macken WL, Pizzamiglio C, Kabiljo R, Francavilla AL, Gaignard P, Pouzet A, Levy J, Barcia G, Leighton JK, Chronopoulou E, Pierre G, Köksal Özgül R, Dursun A, Halligan R, Mundy H, Raza Alvi J, Sultan T, Craigen WJ, Emrick L, Rosenfeld JA, Elmakkawy G, Kim J, Gleeson JJ, Rad A, Oprea G, Hussain M, Rehman KU, Riaz S, Taylor RW, Procaccio V, Zaki MS, Fernandez-Vizarra E, Pierri CL, Hanna MG, Houlden H, Maroofian R, Ugalde C, Taanman JW, Pitceathly RDS.
Nat Commun. 2026 May 30. doi: 10.1038/s41467-026-73455-9. Online ahead of print.
ABSTRACT
Primary mitochondrial diseases (PMDs) affect approximately 1 in 4300 individuals and cause early-onset neuromuscular and multisystem dysfunction with reduced lifespan. They result from pathogenic variants in mitochondrial or nuclear DNA that impair oxidative phosphorylation. Cytochrome c oxidase (COX; complex IV) deficiency is a well-established cause of PMD, leading to a broad spectrum of phenotypes. COXFA4 (cytochrome c oxidase subunit FA4), formerly NDUFA4, is a nuclear-encoded COX subunit, but its role in disease remains poorly defined. We report the largest genetically confirmed cohort of COXFA4-related PMD to date, comprising 13 individuals from 12 families with biallelic pathogenic COXFA4 variants. All present with Leigh-like encephalopathy and complete loss of COXFA4 protein; however, patient-derived fibroblasts retain residual COX activity, with upregulation of COXFA4L2 (cytochrome c oxidase subunit FA4-like 2), a poorly characterised paralog. Here, we show that COXFA4 is a late-stage COX assembly subunit and identify a paralog-mediated compensatory mechanism with translational potential.
PMID:
42218136 | DOI:
10.1038/s41467-026-73455-9
May 30, 2026
Gene ExpressionGene OntologyNeurodevelopmentNeurogenomics
Essential genetic testing in movement disorders – results from a Delphi study
Carvalho V, Guedes LC, Gatto E, Rodriguez-Violante M, Klein C, Rodriguez-Porcel F, Morgante F, Rossi M, Miranda M, Ganos C, Riboldi GM, Cesarini M, Darling A, Skorvanek M, van de Warrenburg B, Shalash A, Cossu G, Friedman J, Albanese A, Cardozo A, Lohmann K, Thaler A, Stamelou M, Saunders-Pullman R, Marras C, Sarva H, Bhatia KP, Ferreira JJ.
Parkinsonism Relat Disord. 2026 May 22;148:108367. doi: 10.1016/j.parkreldis.2026.108367. Online ahead of print.
ABSTRACT
BACKGROUND: While genetic testing in Movement Disorders (MD) has expanded enormously, access to genetic testing and genetic counseling remains asymmetric at the global scale. Guidance on efficient testing strategies for clinicians, governments and stakeholders is crucial.
OBJECTIVES: Establish a list of genetic movement disorders considered essential as determined by a group of MD experts.
METHODS: All genes associated with MD were searched using the OMIM and MDS Gene database. We collected all additional tests available at 4 different laboratories from the EuroGentest database. The results were compiled in 6 questionnaires. A genetic test was considered essential if molecular testing had a direct impact in the management of the patient, including treatment of the disease or its comorbidities, or genetic counseling of the patient and family members. Two Delphi rounds were conducted asking MD experts which specific tests they considered essential in an adult MD clinic.
RESULTS: Fifty-nine disorders were considered essential to genetically identify by the MD experts. This included 25 genes associated with ataxia, 15 with parkinsonism, 14 with dystonia, eight with chorea, five with paroxysmal disorders, four with myoclonus, four with hereditary spastic paraparesis, and one with tremor. Sixteen disorders reached 100% consensus among experts: Huntington’s disease, PxMD-PPRT2, Wilson’s disease, DYT-SGCE, DYT-THAP1, DYT-TOR1A, DYT/PARK-GCH1, Fragile-X Tremor-ataxia syndrome, PARK-GBA, PARK-LRRK2, PARK-PINK1, PARK-PRKN, PARK-SNCA, Cerebrotendinous Xanthomatosis, Ataxia-Telangiectasia, and Niemann-Pick disease type C.
CONCLUSION: This study provides a list of genetic MD that should be molecularly tested in adult centers with a compatible phenotype according to a group of MD experts.
PMID:
42202611 | DOI:
10.1016/j.parkreldis.2026.108367
May 22, 2026
Genetic DiagnosticsMovement DisordersNeurogenomicsPhenotyping
Long-read genome sequencing improves detection and functional interpretation of structural and repeat variants in autism
Mortazavi M, Guevara J, Diaz J, Tran S, Ziaei Jam H, Reeves C, Batalov S, Jepsen K, Bainbridge M, Besterman AD, Gymrek M, Palmer AA, Sebat J.
Cell Genom. 2026 Mar 9:101186. doi: 10.1016/j.xgen.2026.101186. Online ahead of print.
ABSTRACT
Long-read whole-genome sequencing (LR-WGS) technologies enhance the discovery of structural variants (SVs) and tandem repeats (TRs). We performed LR-WGS on 267 individuals from 63 autism spectrum disorder (ASD) families and generated an integrated call set combining long- and short-read data. LR-WGS increased detection of gene-disrupting SVs and TRs by 33% and 38%, respectively, and enabled identification of novel exonic de novo germline and somatic SVs. We observed complex SV patterns, including a class of nested duplication-deletion events. By joint analysis of phased genetic variation and DNA methylation, we identified deletions of imprinted genes and demonstrated the effect of intermediate TR expansions (35-54 CGG) on the methylation of FMR1 promoter. Rare SVs, TRs, and damaging SNVs together accounted for 7.4% (95% confidence interval [CI], 2.7%-17%) of the heritability of ASD. These findings demonstrate how LR-WGS can resolve complex genetic variation and its functional consequences and regulatory effects in a single assay.
PMID:
41806827 | DOI:
10.1016/j.xgen.2026.101186
May 13, 2026
Neurogenomics
Saturation editing of RNU4-2 reveals distinct dominant and recessive disorders
De Jonghe J, Kim HC, Adedeji A, Leitão E, Dawes R, Kajba CM, Cogné B, Chen Y, Blakes AJM, Simons C, Rius R, Alvi JR, Amblard F, Austin-Tse C, Baer S, Balton EV, Blanc P, Calame DG, Coutton C, Cunningham CA, Dargie N, Dipple KM, Du H, El Chehadeh S, Glass I, Gleeson JG, Grunewald O, Gueguen P, Harbuz R, Jacquemont ML, Leventer RJ, Marijon P, Messaoud O, Sultan T, Thauvin C, Vincent-Delorme C, Yilmaz Gulec E, Thevenon J, Mendez R, MacArthur DG, Depienne C, Nava C, Whiffin N, Findlay GM.
Nature. 2026 Apr 8. doi: 10.1038/s41586-026-10334-9. Online ahead of print.
ABSTRACT
Recently, de novo variants in an 18-nucleotide region in the centre of RNU4-2 were shown to cause ReNU syndrome, a syndromic neurodevelopmental disorder that is predicted to affect tens of thousands of individuals worldwide
1,2. RNU4-2 is a non-protein-coding gene that is transcribed into the U4 small nuclear RNA component of the major spliceosome
3. ReNU syndrome variants disrupt spliceosome function and alter 5′ splice site selection
1,4. Here we performed saturation genome editing (SGE) of RNU4-2 to identify the functional and clinical impact of variants across the entire gene. The resulting SGE function scores, derived from variants’ effects on cell fitness, discriminate ReNU syndrome variants from those observed in the population and markedly outperform in silico variant effect prediction. Using these data, we redefine the ReNU syndrome critical region at single-nucleotide resolution, resolve variant pathogenicity for variants of uncertain significance and show that SGE function scores delineate variants by phenotypic severity and the extent of observed splicing disruption. Furthermore, we identify variants affecting function in regions of RNU4-2 that are critical for interactions with other spliceosome components. We show that these variants cause a new recessive neurodevelopmental disorder that is distinct from ReNU syndrome. Together, this work defines the landscape of variant function across RNU4-2, providing critical insights for both diagnosis and therapeutic development.
PMID:
41951737 | DOI:
10.1038/s41586-026-10334-9
April 8, 2026
Neurogenomics
Disease insights from brain somatic mosaicism
Chung C, Nedunuri R, Gleeson JG.
Exp Mol Med. 2026 Apr 8. doi: 10.1038/s12276-024-01331-x. Online ahead of print.
ABSTRACT
Brain somatic mosaicism (BSM) refers to genome variation within brain cells that results from accumulated postzygotic mutations. These mutations can be used to understand cell lineage, molecular dynamics and disease processes. Unlike most other organs, brain cells are mostly fixed in position and not replaced throughout life. Thus, assessing mosaic variants (MVs) within the brain, including their spread and cell type-specific distributions and correlations with aging and cellular health, can reveal insights into neurodevelopmental, neuropsychiatric and neurodegenerative diseases. Extracting genetic material from human surgical brain resections, pregnancy remnants, or postmortem samples can reveal the origins of brain cells and uncover the effects of aging and disease on genomic integrity. Technological advances combining high-read-depth bulk sequencing, isolation of specific brain cell types, and single-cell multiomics can both detect and quantify MVs with good precision and recall. Research exploiting brain MVs is revolutionizing the understanding of the origins, mechanisms and potential treatments for brain conditions.
PMID:
41951903 | DOI:
10.1038/s12276-024-01331-x
April 8, 2026
Genetic Neurologic DiseaseNeurogenomics
Systematic analysis of snRNA genes reveals frequent RNU2-2 variants in dominant and recessive developmental and epileptic encephalopathies
Leitão E, Santini A, Cogne B, Essid M, Athanasiadou M, LaFlamme CW, Marijon P, Bernard V, Jousselin K, Chatron N, Barcia G, Keren B, Mignot C, Charles P, Besnard T, Paluch R, de Sainte Agathe JM, Almanza Fuerte EP, Sengupta S, Milh M, Ramond F, Allan T, An I, Araujo C, Arpin S, Austin-Tse C, Auvin S, Baer S, Bahi-Buisson N, Bak M, Barth M, Baulac S, Bednarek-Weirauch N, Begemann M, Bennett MF, Bensabath U, Bézieau S, Bhouri R, Biehler M, Hammer TB, Bogoin J, Bonanno E, Boussion S, Bris C, Brosseau-Beauvir A, Bruel AL, Briand-Suleau A, Buratti J, Celse T, Chambon P, Chemaly N, Chesneau B, Colin E, Colmard M, Colson C, Conrad S, Courtin T, Creveaux I, Cullier AC, Dang LT, de Saint Martin A, de Vanssay de Blavous Legendre C, Demeer B, Denommé-Pichon AS, Diekhoff P, DiTroia S, Doco-Fenzy M, Dubourg C, Dubucs C, Ducreux S, Dufour L, Duquet R, Durand B, El Chehadeh S, Elbracht M, Faivre L, Faoucher M, Faudet A, Forlani S, Fradin M, Gaignard P, Ganne B, Garde A, Géraud J, Gill D, Goldenberg A, Grabli D, Grisel C, Gueden S, Gueguen P, Guerrot AM, Guichet A, Haack TB, Härting N, Häusler MG, Heide S, Herget T, Héron B, Héron D, Herwig J, Heulin M, Holling T, Houdayer C, Isidor B, Jacquette A, Januel L, Jean-Marçais N, Kaiser FJ, Kaya S, King C, Konyukh M, Kraft F, Krause J, Kirstetter R, Kuechler A, Kurth I, Kutsche K, Labalme A, Laloy JS, Laugel V, Le Bricquir F, Lèbre AS, Lebrun M, Leguern E, Levy J, Lieffering N, Lyonnet S, Lüthy K, Macdonald SMW, Mansour-Hendili L, Maraval J, Marquardt I, Mattausch C, Mercier S, Messaoud O, Morel G, Mortreux J, Munnich A, Nabbout R, Nambot S, Navarro V, Neale A, Nguyen L, Nizon M, Nowak F, O’Leary MC, Odent S, Ojeda NM, Olin V, Olivieri S, Õunap K, Pais LS, Panagiotakaki E, Patat O, Perrin-Sabourin L, Petit F, Philippe C, Piton A, Planes M, Poirsier C, Pouzet A, Prouteau C, Quéméner-Redon S, Renaud M, Richard AC, Rio M, Rivier C, Robin-Renaldo F, Rollier P, Rossi M, Roubertie A, Ruault V, Rupin-Mas M, Saugier-Veber P, Saunier A, Saneto R, Sarrazin E, Sarret C, Schaefer E, Schluth-Bolard C, Schneider A, Schumann I, Seplyarskiy VB, Spranger S, Smol T, Sturm M, Sunyaev SR, Sperelakis-Beedham B, Stenton SL, Stock F, Tharreau M, Torun D, Toulouse J, Thiyagarajah H, Valence S, Valleix S, Van-Gils J, Villard L, Ville D, Villeneuve N, Vitobello A, Waernessyckle A, Wagner J, Weber Y, Wieczorek D, Witkowski T, Yadavilli M, Yammine T, Zaafrane-Khachnaoui K, Zaki MS, Ziegler A, Bramswig NC, Lermine A, Nicolas G, Gleeson JG, Sadleir LG, Hildebrand MS, Scheffer IE, Whiffin N, O’Donnell-Luria A, Mefford HC, Blanc P, Thevenon J, Charbonnier C, Charenton C, Depienne C, Lesca G, Nava C.
Nat Genet. 2026 Mar 30. doi: 10.1038/s41588-026-02547-5. Online ahead of print.
ABSTRACT
Small nuclear RNAs (snRNAs) are essential components of the spliceosome. De novo variants in snRNA genes RNU4-2 (ReNU syndrome), RNU5B-1 and RNU2-2 have been linked to dominant neurodevelopmental disorders (NDDs), revealing a large unexpected contribution of noncoding RNA genes to genetic diseases. Here, through international collaborations, we analyze systematically 200 potentially functional snRNA genes in a French cohort of 34,329 people with rare disorders. We report RNU2-2 variants in 141 individuals, including 35 with recurrent dominant pathogenic variants and 91 affected members from 73 families with biallelic variants. Recessive RNU2-2 NDD is at least twice as frequent as the dominant form and often involves a de novo variant in trans with an inherited allele, consistent with the high mutability of snRNA genes. Dominant and recessive RNU2-2 NDDs share overlapping clinical features, with frequent epilepsy. Blood transcriptomics and DNA methylation analyses revealed subtle, variant-specific effects on splicing and episignatures. Our results support a gradient-of-impact model bridging dominant and recessive inheritance, and establish RNU2-2 variants as a principal contributor to NDDs, nearly as prevalent as ReNU syndrome.
PMID:
41912934 | DOI:
10.1038/s41588-026-02547-5
April 5, 2026
Gene DiscoveryGenetic Neurologic DiseaseNeurogenomics
Developmental organization of sensory and sympathetic ganglia
Vong KI, Alvarez YD, Zhang Q, Weng J, Noel G, Barton ST, Chung C, Howarth R, Meave N, Jiwani F, Patarlapalli SB, Yao F, Zhu F, Barrows C, Patel A, Wang JX, Chi NC, Kingsmore SF, White MD, Yang X, Gleeson JG.
Nature. 2026 Apr 1. doi: 10.1038/s41586-026-10313-0. Online ahead of print.
ABSTRACT
The neural crest generates a broad spectrum of cell types that migrate across the body plan to populate multiple tissues
1. However, the relationship between lineages of neural crest derivatives remains unclear, and the extent to which neural crest cells delaminated from the neural tube have specified fates remains debated. Here, leveraging CRISPR barcoding in mice and mosaic variant barcode analysis in humans, we demonstrate robust bilateral progenitor clonal spread of neural crest progenitors along the rostrocaudal axis but limited clonal overlap between sensory and sympathetic lineages. Computational modelling of mosaic variants suggests that most neural crest cells show strong fate restriction before delamination. Real-time imaging of quail embryos further shows a fibroblast-growth-factor-dependent rostrocaudal dispersion of neural crest cells across multiple axial levels. These findings support a model in which neural crest fate bias predominantly emerges within the neural tube, with only a minor subset of delaminated progenitors retaining multipotency to generate both sensory and sympathetic derivatives.
PMID:
41922758 | DOI:
10.1038/s41586-026-10313-0
April 1, 2026
Neurogenomics
When loss is gain: truncating mutations in additional sex combs (ASXL) gene family in cancer and neurodevelopment
Nakamura Y, Nguyen T, Mor N, Torio CJ, Thulaseedharan H, Dominissini D, Gleeson JG.
Trends Genet. 2026 Mar 31:S0168-9525(26)00038-7. doi: 10.1016/j.tig.2026.02.003. Online ahead of print.
ABSTRACT
The human ASXL gene family consists of ASXL1, ASXL2, and ASXL3, first described as the additional sex combs (Asx) in Drosophila. The encoded proteins scaffold BAP1-mediated histone H2A deubiquitination. ASXL genes are implicated in pre-cancerous, cancerous, and neurodevelopmental conditions. Truncating mutations predominate and were originally predicted to result in protein loss of function (LOF); however, mounting evidence from population genetics and in vitro studies supports gain-of-function (GOF) mechanisms. Sequence analysis suggests that such mechanisms require both escape from nonsense-mediated mRNA decay and removal of a putative C-terminal degron signal within ASXL proteins. We propose GOF as a generalized mechanism for ASXL mutations, resulting in increased protein stability and altered histone modifications, with implications for diagnosis and therapy for these medical conditions.
PMID:
41925445 | DOI:
10.1016/j.tig.2026.02.003
March 31, 2026
CancerNeurodevelopmentNeurogenomics
De novo mutations and environmental modifiers: lessons from neural tube defects
Li HY, Shen Y, Vong KI, Kahle KT, Gleeson JG.
Trends Genet. 2026 Mar 18:S0168-9525(26)00030-2. doi: 10.1016/j.tig.2026.01.011. Online ahead of print.
ABSTRACT
Spina bifida is a clinically and etiologically heterogeneous group of neural tube defects (NTDs) that includes meningomyelocele. While folic acid (FA) supplementation has reduced the incidence by 30-50%, genetic contributors remain only partially understood. New trio sequencing technology has identified de novo mutations (DNMs) in 20-25% of patients. Two recent large-scale genomic studies identified DNMs in 187 candidate genes and a recurrent 22q11.2 deletion as risk factors. Partial penetrance and variable expressivity are frequent, suggesting that risk is dependent upon FA and other modifiers. The Spina Bifida Sequencing Consortium supports large-scale data sharing for multidisciplinary approaches, emphasizing high-confidence NTD genes and moving the results toward clinical testing.
PMID:
41850968 | DOI:
10.1016/j.tig.2026.01.011
March 18, 2026
Genetic Neurologic DiseaseNeurogenomics
Recessive Loss of DIAPH1 Function Causes a Progressive Neurodevelopmental Syndrome with Variable Immunological Involvement
Galassi Deforie V, Maroofian R, Karagoz I, Godwin A, Al Sheikh E, Gestri G, Zaki MS, Woodward BL, Ghorab RM, Alvi JR, Alabdi L, Damseh N, Elshafie RM, Scardamaglia A, Alves C, Shaikh M, Özcan GG, Sadek AA, Issa MY, Striano P, Suri M, Murphy D, Ashhab M, de la Fuente RP, Arteche-López A, Hashem MO, Abdulwahab F, Aboelanine AH, Alkhawaja IA, Ibrahim S, van der Burg M, Berghuis D, Santen GW, Toosi MB, Alerasool M, Eslahi A, Srinivasan VM, Gowda VK, Trollmann R, Vasileiou G, Pauly M, Hashemi-Gorji F, Miryounesi M, Salpietro V, Al-Herz W, Carter SP, Briggs TA, Hussell T, Ruuska-Loewald T, Komulainen-Ebrahim J, Uusimaa J, Hautala T, Potluri S, Shackley F, Mojarrad M, Chung WK, Wilson SW, Sultan T, Gleeson JG, Marafi D, Alkuraya FS, Stewart GS, Efthymiou S, Guille M, Arkwright PD, Houlden H.
Genet Med. 2026 Mar 16:102551. doi: 10.1016/j.gim.2026.102551. Online ahead of print.
ABSTRACT
PURPOSE: Biallelic DIAPH1 pathogenic variants cause a neurodevelopmental syndrome occasionally associated with immunodeficiency. This study aims to define the clinical and immunological spectrum of DIAPH1-related neuroimmunological syndrome and explore the gene’s developmental role using vertebrate models.
METHODS: 53 individuals with biallelic DIAPH1 variants, including 33 previously unreported patients were studied. Clinical features were analysed and functional studies were conducted using knockout models in Danio rerio and Xenopus tropicalis.
RESULTS: Clinical features included developmental delay, intellectual disability, progressive microcephaly, cortical visual impairment or blindness, epilepsy, and frequent occipital-predominant brain abnormalities. Almost half suffered from infections, mainly affecting their respiratory tract related to epilepsy and aspiration. Although the majority had normal lymphocyte subsets and serum immunoglobulins, T-cell receptor excision circles and naïve T-lymphocyte counts were consistently low. The Xenopus model mirrored growth and eye defects seen in humans, while zebrafish exhibited no overt malformations but showed seizure-like behaviour in Phenothiazine assays.
CONCLUSIONS: DIAPH1 is critical for neurodevelopment, immune regulation, and DNA repair. The DNA repair defect may influence susceptibility to infection, lymphoma, or treatment-related toxicity. Although absolute T-cell numbers are not consistent with SCID, impaired T-cell maturation suggests these patients could be identified by TREC newborn screening before neurological symptoms develop.
PMID:
41860019 | DOI:
10.1016/j.gim.2026.102551
March 16, 2026
NeurodevelopmentNeurogenomics