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X-linked protocadherin 19 mutations cause female-limited epilepsy and cognitive impairment.

Epilepsy and mental retardation limited to females (EFMR) is a disorder with an X-linked mode of inheritance and an unusual expression pattern. Disorders arising from mutations on the X chromosome are typically characterized by affected males and unaffected carrier females. In contrast, EFMR spares transmitting males and affects only carrier females. Aided by systematic resequencing of 737 X chromosome genes, we identified different protocadherin 19 (PCDH19) gene mutations in seven families with EFMR. Five mutations resulted in the introduction of a premature termination codon. Study of two of these demonstrated nonsense-mediated decay of PCDH19 mRNA. The two missense mutations were predicted to affect adhesiveness of PCDH19 through impaired calcium binding. PCDH19 is expressed in developing brains of human and mouse and is the first member of the cadherin superfamily to be directly implicated in epilepsy or mental retardation.

Pubmed ID: 18469813


  • Dibbens LM
  • Tarpey PS
  • Hynes K
  • Bayly MA
  • Scheffer IE
  • Smith R
  • Bomar J
  • Sutton E
  • Vandeleur L
  • Shoubridge C
  • Edkins S
  • Turner SJ
  • Stevens C
  • O'Meara S
  • Tofts C
  • Barthorpe S
  • Buck G
  • Cole J
  • Halliday K
  • Jones D
  • Lee R
  • Madison M
  • Mironenko T
  • Varian J
  • West S
  • Widaa S
  • Wray P
  • Teague J
  • Dicks E
  • Butler A
  • Menzies A
  • Jenkinson A
  • Shepherd R
  • Gusella JF
  • Afawi Z
  • Mazarib A
  • Neufeld MY
  • Kivity S
  • Lev D
  • Lerman-Sagie T
  • Korczyn AD
  • Derry CP
  • Sutherland GR
  • Friend K
  • Shaw M
  • Corbett M
  • Kim HG
  • Geschwind DH
  • Thomas P
  • Haan E
  • Ryan S
  • McKee S
  • Berkovic SF
  • Futreal PA
  • Stratton MR
  • Mulley JC
  • G├ęcz J


Nature genetics

Publication Data

June 29, 2008

Associated Grants

  • Agency: NIGMS NIH HHS, Id: GM061354
  • Agency: NICHD NIH HHS, Id: N01-HD-4-3368
  • Agency: NICHD NIH HHS, Id: N01-HD-4-3383
  • Agency: NIMH NIH HHS, Id: R01 MH 64547
  • Agency: NIMH NIH HHS, Id: R01 MH064547
  • Agency: NIMH NIH HHS, Id: R01 MH064547-01
  • Agency: NIMH NIH HHS, Id: R01 MH064547-01S1
  • Agency: NIMH NIH HHS, Id: R01 MH064547-02
  • Agency: NIMH NIH HHS, Id: R01 MH064547-02S1
  • Agency: NIMH NIH HHS, Id: R01 MH064547-03
  • Agency: NIMH NIH HHS, Id: R01 MH064547-04
  • Agency: NIMH NIH HHS, Id: R01 MH064547-05
  • Agency: Wellcome Trust, Id:

Mesh Terms

  • Animals
  • Brain
  • Cadherins
  • Case-Control Studies
  • Chromosomes, Human, X
  • Codon, Nonsense
  • Cognition Disorders
  • Epilepsy
  • Female
  • Fibroblasts
  • Gene Expression Regulation, Developmental
  • Genes, X-Linked
  • Genomic Imprinting
  • Humans
  • In Situ Hybridization
  • Male
  • Mental Retardation, X-Linked
  • Mice
  • Mutation, Missense
  • Pedigree
  • Phenotype
  • RNA, Messenger
  • Reverse Transcriptase Polymerase Chain Reaction
  • Skin