The 22q11.2 deletion syndrome (22q11.2DS) is a multisystem disorder with an estimated prevalence of 1:3000 live births. Manifestations show a marked variability in expression and include speech‐ and language delay, intellectual disability, and neuropsychiatric disorders. We aim to provide an overview of ocular findings in 22q11.2DS in order to optimize recommendations for ophthalmic screening. We combined results from a systematic literature review with results from a multicenter cross‐sectional study of patients with 22q11.2DS who were assessed by an ophthalmologist. Our systematic literature search yielded four articles, describing 270 patients. We included 132 patients in our cross‐sectional study (median age 8.9 [range 0–56] years). Most reported ocular findings were retinal vascular tortuosity (32%–78%), posterior embryotoxon (22%–50%), eye lid hooding (20%–67%), strabismus (12%–36%), amblyopia (2%–11%), ptosis (4%–6%), and refractive errors, of which hyperopia (6%–48%) and astigmatism (3%–23%) were most common. Visual acuity was (near) normal in most patients (91%–94%). Refractive errors, strabismus, and amblyopia are treatable conditions that are frequently present in patients with 22q11.2DS and should be corrected at an early stage. Therefore, in 22q11.2DS, we recommend ophthalmic and orthoptic screening at the age of 3 years or at diagnosis, and a low‐threshold referral in adults.

Background: Schizophrenia genetics is complex, and the contribution of common and rare variants are not fully understood. Several specific copy number variations (CNVs) confer increased risk for schizophrenia, and the study of their effects is central to molecular models of mental illness. However, these CNVs, microdeletions or duplications, are spread across the genome and differ in number of genes affected and classes of coded proteins. This suggests that, in order to fully understand the contribution of these genetic variants to mental illness, we need to look beyond the deleted or duplicated genes, to their interaction partners and involved molecular pathways. Methods: In this study, we developed machine readable interactive pathways to enable analysis of downstream effects of genes within CNV loci and identify common pathways between CNVs with high schizophrenia risk using the WikiPathways database, and schizophrenia risk gene collections from GWAS studies and a gene-disease association database. Results: For CNVs that are pathogenic for schizophrenia we found overlapping pathways, including BDNF signaling, cytoskeleton, cell cell connections, inflammation and MAPK3 signaling. Common schizophrenia risk genes identified by different studies are found in all CNV pathways but not enriched. Conclusions: Our findings suggest that specific pathways, such as BDNF signaling, may be critical contributors to schizophrenia risk conferred by rare CNVs, and common risk variants may operate through distinct mechanisms. Our approach highlights the importance of not only investigating deleted or duplicated genes within pathogenic CNV loci, but also their direct interaction partners, which may explain pleiotropic effects of CNVs on schizophrenia risk.

Background With advances in clinical genetic testing, associations between genetic neurodevelopmental disorders and parkinsonism are increasingly recognized. In this review, we aimed to provide a comprehensive overview of reports on parkinsonism in genetic neurodevelopmental disorders and summarize findings related to genetic diagnosis, clinical features and proposed disease mechanisms. Methods A systematic literature review was conducted in PubMed and Embase on June 15, 2021. Search terms for parkinsonism and genetic neurodevelopmental disorders, using generic terms and the Human Phenotype Ontology, were combined. Study characteristics and descriptive data were extracted from the articles using a modified version of the Cochrane Consumers and Communication Review Group's data extraction template. The protocol was registered in PROSPERO (CRD42020191035). Results The literature search yielded 208 reports for data‐extraction, describing 69 genetic disorders in 422 patients. The five most reported from most to least frequent were: 22q11.2 deletion syndrome, beta‐propeller protein‐associated neurodegeneration, Down syndrome, cerebrotendinous xanthomatosis, and Rett syndrome. Notable findings were an almost equal male to female ratio, an early median age of motor onset (26 years old) and rigidity being more common than rest tremor. Results of dopaminergic imaging and response to antiparkinsonian medication often supported the neurodegenerative nature of parkinsonism. Moreover, neuropathology results showed neuronal loss in the majority of cases. Proposed disease mechanisms included aberrant mitochondrial function and disruptions in neurotransmitter metabolism, endosomal trafficking, and the autophagic‐lysosomal and ubiquitin‐proteasome system. Conclusion Parkinsonism has been reported in many GNDs. Findings from this study may provide clues for further research and improve management of patients with GNDs and/or parkinsonism.