Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)

Legacy Department


Committee Chair/Advisor

Lawton-Rauh, Amy

Committee Member

DuPont , Barbara R

Committee Member

Chen , Chin-Fu

Committee Member

Feltus , Alex

Committee Member

Clark , Leigh Anne


Phelan-McDermid syndrome is a developmental disability syndrome associated with deletions of the terminal end of one copy of chromosome 22q13. The observed chromosomal aberrations include simple terminal deletions, interstitial deletions, deletions and duplications, and duplications without deletions. All patients have some degree of developmental disability and many also have hypotonia, autism, minor dysmorphic features, and seizures. I performed an epidemiological and cytogenetic investigation to better understand the etiology of Phelan-McDermid syndrome and to provide information to patients and their families, clinicians, and researchers investigating developmental disabilities. Deletions vary widely in size, from 60 kb to more than 9 Mb, but almost all cases are missing one copy of the subtelomeric gene SHANK3, a candidate gene for neurological features. The results of this study established that larger deletions are associated with more severe disability establishing the rationale to investigate the role of additional genes or genomic regions for clinical features. Statistical association analyses identified specific genomic regions as associated with 22 clinical features. In particular, speech is highly correlated with deletion size indicating that speech-related genes or genomic elements located in genomic bands 22q13.2q13.31 may be critical in determining a patient's ability to communicate verbally. The use of protein interaction networks identified candidate genes within these narrowed genomic regions. Also, a longitudinal assessment of phenotypes observed among individuals aged 0.4 to 64 years established significant variation of phenotypes by age, such that future investigations need to take age into account when conducting genotype-phenotype studies. In particular, we find that behavioral difficulties subside and low muscle tone becomes less prominent as children age, however seizures, autism, and some chronic diseases become more apparent in teens and adults.



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