Table 1 Clinical phenotypes of patients with heterozygous de novo and putative de novo NR4A2 variants.

From: De novo variants of NR4A2 are associated with neurodevelopmental disorder and epilepsy

Patient

Variant (NM_006186.3)

Inheritance

Protein domain/region

Seizures

Age, years/sex/age at seizure onset

Developmental delay

Speech and language impairment

Motor delay

Intellectual disability

Behavioral problems

MRI findings

Neurologic examination findings

Other

1

c.839G>A, p.C280Y

De novo

ZnF_C4 domain, DNA binding domain

Yes

15/F/6.5 years

Global

NA

NA

Severe

Autism

Normal

Normal

Sleeping difficulties

2

c.865-1_865delGCinsAAAAAGGAGT, p.?

De novo

ZnF_C4 domain, DNA binding domain

Yes

12/M/10 years

Global

Yes

Yes

Mild

Hyperactivity, anxiety

Normal

Mild hypotonia

EDS hypermobility

3

c.914G>A, p.C305Y

De novo

ZnF_C4 domain, DNA binding domain

Yes

9/F/NA

Moderate

NA

NA

Mild to moderate

NA

Gliosis

Choreoathetoid movements, dystonia, ataxic gait

NA

4

c.1175A>G, p.D392G

De novo

Hinge region

Yes

3/F/5 months

Global

NA

NA

Severe

No

Moderate cerebellar atrophy

Severe hypotonia, feeding difficulties, dystonia

None

5

c.1576G>T, p.E526*

NA

HOLI, ligand binding domain

No

5/M/Never

Global

Yes

Yes

Mild

Attachment disorder, hyposensitivity

NA

Mild hypotonia, no movement disorder

No

6

c.325dupC, p.Q109Pfs*3

De novo

N-terminal regulatory domain

Yes

2/M/6 months

Global

Yes

Yes

NA

Sensory sensitivity

Pontine hypoplasia, ventriculomegaly

Severe hypotonia, feeding difficulties

Facial dysmorphism, sleep disordered breathing

7

c.857T>C, p.F286S

De novo

ZnF_C4 domain, DNA binding domain

No

4/F/Never

Global

Yes

Yes

Moderate

No

Normal

Hypotonia

Mild joint hypermobility, shagreen spot and hypopigmented spot

8

c.968G>T, p.C323F

De novo

ZnF_C4 domain, DNA binding domain

No

19/F/Never

Global

Yes

Yes

Moderate to severe

No

Normal

Mild generalized hypotonia

Facial dysmorphism, joint hypermobility

9

arr[GRCh37]2q23.3q24.1(154790212_158488241)x1

De novo

NA

yes

43/M/13 years

Moderate

NA

NA

Moderate to severe

Hyperactivity, aggression

Enlarged cerebrospinal fluid spaces

Progressive ataxia in adulthood

No

  1. AED antiepileptic drug, EDS Ehlers–Danlos syndrome, EEG electroencephalogram, F female, M male, MRI magnetic resonance image, NA not assessed.