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CNTNAP1 Gene Curation

CNTNAP1 Gene Curation

Gene-disease assertions not curated here (add link or write note):

Disease

CNTNAP1-related complex neurodevelopmental syndrome.

(Used a dyadic nomenclature used for disease name, similar to how the ID GCEP names these syndromes. Lumped the 2 OMIM phenotypes Hypomyelinating neuropathy, congenital, 3 and Lethal congenital contracture syndrome 7).

Disease

CNTNAP1-related complex neurodevelopmental syndrome.

(Used a dyadic nomenclature used for disease name, similar to how the ID GCEP names these syndromes. Lumped the 2 OMIM phenotypes Hypomyelinating neuropathy, congenital, 3 and Lethal congenital contracture syndrome 7).

Inheritance

Autosomal recessive

Prevalence

 RARE

Source:

Rapid or full curation?

Rapid
Full

ClinGen / GenCC / BabySeq / HGMD / OMIM

ClinGen - none. GenCC - Strong for lethal congenital contracture syndrome 7 by Invitae. babyseq - none. Curating HGMD variants below

Clinical Validity Scoring Notes and points

 

PMID: 29511323 (2018)

  • CASE SERIES: Severe congenital hypomyelinating neuropathy. Common clinical features: Polyhydramnios resulting in prematurity, hypotonia, respiratory distress at birth, demyelinating/hypomyelinating neuropathy, reduced white matter bulk and cerebral atrophy, facial features including myopathic facies.

  • Patient 2: c.1677G>A p.W559* - 9 alleles gnomAD v4, low enough for AR disease. NMD+. comp het with Leu212Pro (5 alleles total gnomAD v4, REVEL: 0.802). Phenotype - growth deficiency (low weight, height, OFC centiles), profound ID, central hypotonia, orobulbar dysfunction, peripheral myopathy, abnormal brain MRI (lack of myelination, reduced white matter, atrophic cerebellum), SNHL, pectus excavatum, neonatal respiratory distress, trach, scoliosis, hip subluxation, myopathic faces, cathedral palate. SEGREGATES IN AFFECTED SIB (1 AR SEG) 2.5 VARIANT POINTS

  • Patient 4: HOM for Arg782Ter (13/1179948 Euro alleles gAD v4, low enough for AR disease), similar pheno to proband 2. 4 VARIANT POINTS

  • Patient 5: Cmp het for 1735+1G>A (5 alleles total gAD v4) and Arg782Ter. Similar phenotype. 4 VARIANT POINTS

  • Patient 6: Comp het for c.149C>A p.Pro50Gln (1 allele total gAD v4) ;, c.2600del Asp867fs (5 alleles total, NMD+. 2.5 VARIANT POINTS

PMID: 27159321 (2016) - Curating for replication and phenotype (didn’t score variants).

  • LD_0158 HOM for p.Arg388Pro, per supplement case summary, respiratory failure, bilateral HL, cleft palate, hypomyelinating neuropathy, delayed myelination and cerebral atrophy.

  • LD_0333 Cmp het c.319C>T p.Arg107* c.967T>C p.Cys323Arg. Phenotype - hypotonia, feeding issues, developmental arrest, opisthotonic posturing, bilateral hydronephrosis, HL, GERD, demyelinating polyneuropathy, diffuse progressive white matter volume loss, persistent hypomelination.

  • Both of these individuals also reported in 29882456 (2018) where phenotype includes arthrogryposis (indicating the arthrogryposis and hypomyelinating phenotypes should be lumped (both LOF variants reported). Additional features included arthrogryposis multiplex congenita, cortical vision loss, neurogenic bladder, seizures,

PMID: 33820833 (2022)

  • Patients 37-42 in supplement with variants in CNTNAP1. Arthrogryposis multiplex congenita cohort. Phenotype: identified prenatally, postnatal death <1 month for 5/6 individuals, hypotonia,

Clinical Validity Points Total

13

 

Clinical Validity Classification

Definitive (12pts)

Strong (12pts)

Moderate (7-11pts)

Limited (0.1-6pts)

No genetic evidence

Refuted

Disputed

Definitive

Source:

Molecular Mechanism

Loss of function

Gain of function

Dominant negative

Unknown

Other

Loss of function

See clinical validity scoring, >3 LOF variants

 

Penetrance

Complete (100%)

High (≥80%)

Moderate  (<80% and >20%)

Low (≤20%)

(list source/PMID)

 

Source:

Age of Onset

Congenital

Pediatric

Adolescent

Adulthood

Late adulthood

(list source/PMID)

Congenital

Severity

Embryonic lethal - presence of a pathogenic variant or variants is not compatible with life. The penetrance must be complete.
Severe - presence of a pathogenic variant or variant(s) results in significantly reduced fitness. The penetrance must be complete or high.
Moderate - significant morbidity or mortality due to clinical features, but fitness may not be reduced, or penetrance is reduced.
Mild - Presence of a variant or variant(s) is not associated with reduced fitness, no significant morbidity or mortality, and/or penetrance is low.
None - presence of a variant results in no phenotype. An example is recessive disorders in which no phenotype is reported in carriers.

 

Clinical Features

  • Polyhydramnios resulting in prematurity, significant hypotonia, neonatal respiratory insufficiency, demyelinating/hypomyelinating neuropathy, abnormal brain MRI (delayed myelination, reduced white matter, cerebellar atrophy, cerebral atrophy), arthrogryposis multiplex congenita or contractures, feeding difficulties, facial features including myopathic facies, hearing loss, and intellectual disability (PMID: 29511323, 27159321, 33820833.

Sources:

HPO Terms

https://hpo.jax.org/app/

 

Gene SOPs & Notes

 

Curation Summary

- The @GENE@ is associated with @inheritance pattern@ @condition@, which is characterized by @clinical features@ (PMIDs).

- Variable expression or severity:
The severity and expressivity of the disorder is highly variable, even within families.
- If multiple conditions associated with the gene:
It has also been associated with @inheritance pattern@ @condition@, which is characterized by @clinical features@ (PMIDs).

- Limited evidence gene: The PCNA gene has been reported in individuals with early onset autosomal recessive ataxia (PMID: 33426167, 24911150), however, evidence supporting this gene-dIsease relationship is limited

The CNTNAP1 gene is associated with autosomal recessive CNTNAP1-related complex neurodevelopmental syndrome. This is a complex syndrome with many clinical features. Commonly observed features include polyhydramnios resulting in prematurity, significant hypotonia, neonatal respiratory insufficiency, demyelinating/hypomyelinating neuropathy, abnormal brain MRI (delayed myelination, reduced white matter, cerebellar atrophy, cerebral atrophy), arthrogryposis multiplex congenita or contractures, feeding difficulties, facial features including myopathic facies, hearing loss, and intellectual disability (PMID: 29511323, 27159321, 33820833).

Case ID, Curator name, Date, Jira ticket link

56752403082302, AO 03/06/2025