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Journal of Medical Genetics logoLink to Journal of Medical Genetics
. 2005 Jan;42(1):1–7. doi: 10.1136/jmg.2004.027730

Rett syndrome: clinical review and genetic update

L Weaving 1, C Ellaway 1, J Gecz 1, J Christodoulou 1
PMCID: PMC1735910  PMID: 15635068

Abstract

Rett syndrome (RS) is a severe neurodevelopmental disorder that contributes significantly to severe intellectual disability in females worldwide. It is caused by mutations in MECP2 in the majority of cases, but a proportion of atypical cases may result from mutations in CDKL5, particularly the early onset seizure variant. The relationship between MECP2 and CDKL5, and whether they cause RS through the same or different mechanisms is unknown, but is worthy of investigation. Mutations in MECP2 appear to give a growth disadvantage to both neuronal and lymphoblast cells, often resulting in skewing of X inactivation that may contribute to the large degree of phenotypic variation. MeCP2 was originally thought to be a global transcriptional repressor, but recent evidence suggests that it may have a role in regulating neuronal activity dependent expression of specific genes such as Hairy2a in Xenopus and Bdnf in mouse and rat.

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Selected References

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  1. Aber K. M., Nori P., MacDonald S. M., Bibat G., Jarrar M. H., Kaufmann W. E. Methyl-CpG-binding protein 2 is localized in the postsynaptic compartment: an immunochemical study of subcellular fractions. Neuroscience. 2003;116(1):77–80. doi: 10.1016/s0306-4522(02)00586-9. [DOI] [PubMed] [Google Scholar]
  2. Adler D. A., Quaderi N. A., Brown S. D., Chapman V. M., Moore J., Tate P., Disteche C. M. The X-linked methylated DNA binding protein, Mecp2, is subject to X inactivation in the mouse. Mamm Genome. 1995 Aug;6(8):491–492. doi: 10.1007/BF00356163. [DOI] [PubMed] [Google Scholar]
  3. Akbarian S., Chen R. Z., Gribnau J., Rasmussen T. P., Fong H., Jaenisch R., Jones E. G. Expression pattern of the Rett syndrome gene MeCP2 in primate prefrontal cortex. Neurobiol Dis. 2001 Oct;8(5):784–791. doi: 10.1006/nbdi.2001.0420. [DOI] [PubMed] [Google Scholar]
  4. Amir R. E., Van den Veyver I. B., Schultz R., Malicki D. M., Tran C. Q., Dahle E. J., Philippi A., Timar L., Percy A. K., Motil K. J. Influence of mutation type and X chromosome inactivation on Rett syndrome phenotypes. Ann Neurol. 2000 May;47(5):670–679. [PubMed] [Google Scholar]
  5. Amir R. E., Zoghbi H. Y. Rett syndrome: methyl-CpG-binding protein 2 mutations and phenotype-genotype correlations. Am J Med Genet. 2000 Summer;97(2):147–152. doi: 10.1002/1096-8628(200022)97:2<147::aid-ajmg6>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
  6. Anvret M., Wahlström J. Rett syndrome: random X chromosome inactivation. Clin Genet. 1994 May;45(5):274–275. doi: 10.1111/j.1399-0004.1994.tb04157.x. [DOI] [PubMed] [Google Scholar]
  7. Ariani Francesca, Mari Francesca, Pescucci Chiara, Longo Ilaria, Bruttini Mirella, Meloni Ilaria, Hayek Giuseppe, Rocchi Raffaele, Zappella Michele, Renieri Alessandra. Real-time quantitative PCR as a routine method for screening large rearrangements in Rett syndrome: Report of one case of MECP2 deletion and one case of MECP2 duplication. Hum Mutat. 2004 Aug;24(2):172–177. doi: 10.1002/humu.20065. [DOI] [PubMed] [Google Scholar]
  8. Balmer Damina, Arredondo Juan, Samaco Rodney C., LaSalle Janine M. MECP2 mutations in Rett syndrome adversely affect lymphocyte growth, but do not affect imprinted gene expression in blood or brain. Hum Genet. 2002 Apr 25;110(6):545–552. doi: 10.1007/s00439-002-0724-4. [DOI] [PubMed] [Google Scholar]
  9. Beyer Kim S., Blasi Francesca, Bacchelli Elena, Klauck Sabine M., Maestrini Elena, Poustka Annemarie, International Molecular Genetic Study of Autism Consortium (IMGSAC) Mutation analysis of the coding sequence of the MECP2 gene in infantile autism. Hum Genet. 2002 Aug 14;111(4-5):305–309. doi: 10.1007/s00439-002-0786-3. [DOI] [PubMed] [Google Scholar]
  10. Braunschweig Daniel, Simcox Thomas, Samaco Rodney C., LaSalle Janine M. X-Chromosome inactivation ratios affect wild-type MeCP2 expression within mosaic Rett syndrome and Mecp2-/+ mouse brain. Hum Mol Genet. 2004 Apr 28;13(12):1275–1286. doi: 10.1093/hmg/ddh142. [DOI] [PubMed] [Google Scholar]
  11. Brunner B., Todt T., Lenzner S., Stout K., Schulz U., Ropers H. H., Kalscheuer V. M. Genomic structure and comparative analysis of nine Fugu genes: conservation of synteny with human chromosome Xp22.2-p22.1. Genome Res. 1999 May;9(5):437–448. [PMC free article] [PubMed] [Google Scholar]
  12. Budden S. S. Management of Rett syndrome: a ten year experience. Neuropediatrics. 1995 Apr;26(2):75–77. doi: 10.1055/s-2007-979727. [DOI] [PubMed] [Google Scholar]
  13. Budden S. S. Rett syndrome: habilitation and management reviewed. Eur Child Adolesc Psychiatry. 1997;6 (Suppl 1):103–107. [PubMed] [Google Scholar]
  14. Buschdorf Jan P., Strätling Wolf H. A WW domain binding region in methyl-CpG-binding protein MeCP2: impact on Rett syndrome. J Mol Med (Berl) 2003 Nov 15;82(2):135–143. doi: 10.1007/s00109-003-0497-9. [DOI] [PubMed] [Google Scholar]
  15. Camus P., Abbadi N., Perrier M. C., Chéry M., Gilgenkrantz S. X chromosome inactivation in 30 girls with Rett syndrome: analysis using the probe. Hum Genet. 1996 Feb;97(2):247–250. doi: 10.1007/BF02265275. [DOI] [PubMed] [Google Scholar]
  16. Chen R. Z., Akbarian S., Tudor M., Jaenisch R. Deficiency of methyl-CpG binding protein-2 in CNS neurons results in a Rett-like phenotype in mice. Nat Genet. 2001 Mar;27(3):327–331. doi: 10.1038/85906. [DOI] [PubMed] [Google Scholar]
  17. Chen Wen G., Chang Qiang, Lin Yingxi, Meissner Alexander, West Anne E., Griffith Eric C., Jaenisch Rudolf, Greenberg Michael E. Derepression of BDNF transcription involves calcium-dependent phosphorylation of MeCP2. Science. 2003 Oct 31;302(5646):885–889. doi: 10.1126/science.1086446. [DOI] [PubMed] [Google Scholar]
  18. Christodoulou John, Grimm Andrew, Maher Tony, Bennetts Bruce. RettBASE: The IRSA MECP2 variation database-a new mutation database in evolution. Hum Mutat. 2003 May;21(5):466–472. doi: 10.1002/humu.10194. [DOI] [PubMed] [Google Scholar]
  19. Colantuoni C., Jeon O. H., Hyder K., Chenchik A., Khimani A. H., Narayanan V., Hoffman E. P., Kaufmann W. E., Naidu S., Pevsner J. Gene expression profiling in postmortem Rett Syndrome brain: differential gene expression and patient classification. Neurobiol Dis. 2001 Oct;8(5):847–865. doi: 10.1006/nbdi.2001.0428. [DOI] [PubMed] [Google Scholar]
  20. Colvin L., Leonard H., de Klerk N., Davis M., Weaving L., Williamson S., Christodoulou J. Refining the phenotype of common mutations in Rett syndrome. J Med Genet. 2004 Jan;41(1):25–30. doi: 10.1136/jmg.2003.011130. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Coy J. F., Sedlacek Z., Bächner D., Delius H., Poustka A. A complex pattern of evolutionary conservation and alternative polyadenylation within the long 3"-untranslated region of the methyl-CpG-binding protein 2 gene (MeCP2) suggests a regulatory role in gene expression. Hum Mol Genet. 1999 Jul;8(7):1253–1262. doi: 10.1093/hmg/8.7.1253. [DOI] [PubMed] [Google Scholar]
  22. D'Esposito M., Quaderi N. A., Ciccodicola A., Bruni P., Esposito T., D'Urso M., Brown S. D. Isolation, physical mapping, and northern analysis of the X-linked human gene encoding methyl CpG-binding protein, MECP2. Mamm Genome. 1996 Jul;7(7):533–535. doi: 10.1007/s003359900157. [DOI] [PubMed] [Google Scholar]
  23. Dotti M. T., Orrico A., De Stefano N., Battisti C., Sicurelli F., Severi S., Lam C. W., Galli L., Sorrentino V., Federico A. A Rett syndrome MECP2 mutation that causes mental retardation in men. Neurology. 2002 Jan 22;58(2):226–230. doi: 10.1212/wnl.58.2.226. [DOI] [PubMed] [Google Scholar]
  24. Egger J., Hofacker N., Schiel W., Holthausen H. Magnesium for hyperventilation in Rett's syndrome. Lancet. 1992 Sep 5;340(8819):621–622. doi: 10.1016/0140-6736(92)92166-d. [DOI] [PubMed] [Google Scholar]
  25. Ellaway C. J., Badawi N., Raffaele L., Christodoulou J., Leonard H. A case of multiple congenital anomalies in association with Rett syndrome confirmed by MECP2 mutation screening. Clin Dysmorphol. 2001 Jul;10(3):185–188. doi: 10.1097/00019605-200107000-00006. [DOI] [PubMed] [Google Scholar]
  26. Ellaway C. J., Peat J., Williams K., Leonard H., Christodoulou J. Medium-term open label trial of L-carnitine in Rett syndrome. Brain Dev. 2001 Dec;23 (Suppl 1):S85–S89. doi: 10.1016/s0387-7604(01)00346-1. [DOI] [PubMed] [Google Scholar]
  27. Ellaway C. J., Sholler G., Leonard H., Christodoulou J. Prolonged QT interval in Rett syndrome. Arch Dis Child. 1999 May;80(5):470–472. doi: 10.1136/adc.80.5.470. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Ellaway C., Williams K., Leonard H., Higgins G., Wilcken B., Christodoulou J. Rett syndrome: randomized controlled trial of L-carnitine. J Child Neurol. 1999 Mar;14(3):162–167. doi: 10.1177/088307389901400306. [DOI] [PubMed] [Google Scholar]
  29. Erlandson Anna, Samuelsson Lena, Hagberg Bengt, Kyllerman Mårten, Vujic Mihailo, Wahlström Jan. Multiplex ligation-dependent probe amplification (MLPA) detects large deletions in the MECP2 gene of Swedish Rett syndrome patients. Genet Test. 2003 Winter;7(4):329–332. doi: 10.1089/109065703322783707. [DOI] [PubMed] [Google Scholar]
  30. Giardina Emiliano, Capon Francesca, D'Apice M. Rosaria, Amati Francesca, Arturi Franco, Filetti Sebastiano, Bonifazi Emanuela, Pucci Sabina, Conte Chiara, Novelli Giuseppe. Mutational analysis of Peroxiredoxin IV: exclusion of a positional candidate for multinodular goitre. BMC Med Genet. 2002 Jul 23;3:5–5. doi: 10.1186/1471-2350-3-5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Girard M., Couvert P., Carrié A., Tardieu M., Chelly J., Beldjord C., Bienvenu T. Parental origin of de novo MECP2 mutations in Rett syndrome. Eur J Hum Genet. 2001 Mar;9(3):231–236. doi: 10.1038/sj.ejhg.5200618. [DOI] [PubMed] [Google Scholar]
  32. Glaze D. G., Schultz R. J., Frost J. D. Rett syndrome: characterization of seizures versus non-seizures. Electroencephalogr Clin Neurophysiol. 1998 Jan;106(1):79–83. doi: 10.1016/s0013-4694(97)00084-9. [DOI] [PubMed] [Google Scholar]
  33. Guy J., Hendrich B., Holmes M., Martin J. E., Bird A. A mouse Mecp2-null mutation causes neurological symptoms that mimic Rett syndrome. Nat Genet. 2001 Mar;27(3):322–326. doi: 10.1038/85899. [DOI] [PubMed] [Google Scholar]
  34. Hagberg B., Aicardi J., Dias K., Ramos O. A progressive syndrome of autism, dementia, ataxia, and loss of purposeful hand use in girls: Rett's syndrome: report of 35 cases. Ann Neurol. 1983 Oct;14(4):471–479. doi: 10.1002/ana.410140412. [DOI] [PubMed] [Google Scholar]
  35. Hagberg B., Hagberg G. Rett syndrome: epidemiology and geographical variability. Eur Child Adolesc Psychiatry. 1997;6 (Suppl 1):5–7. [PubMed] [Google Scholar]
  36. Hagberg B. Rett syndrome: clinical peculiarities and biological mysteries. Acta Paediatr. 1995 Sep;84(9):971–976. doi: 10.1111/j.1651-2227.1995.tb13809.x. [DOI] [PubMed] [Google Scholar]
  37. Hagberg B., Witt-Engerström I. Rett syndrome: a suggested staging system for describing impairment profile with increasing age towards adolescence. Am J Med Genet Suppl. 1986;1:47–59. doi: 10.1002/ajmg.1320250506. [DOI] [PubMed] [Google Scholar]
  38. Hagberg Bengt, Hanefeld Folker, Percy Alan, Skjeldal Ola. An update on clinically applicable diagnostic criteria in Rett syndrome. Comments to Rett Syndrome Clinical Criteria Consensus Panel Satellite to European Paediatric Neurology Society Meeting, Baden Baden, Germany, 11 September 2001. Eur J Paediatr Neurol. 2002;6(5):293–297. doi: 10.1053/ejpn.2002.0612. [DOI] [PubMed] [Google Scholar]
  39. Hanks S. B. Motor disabilities in the Rett syndrome and physical therapy strategies. Brain Dev. 1990;12(1):157–161. doi: 10.1016/s0387-7604(12)80201-4. [DOI] [PubMed] [Google Scholar]
  40. Hoffbuhr K. C., Moses L. M., Jerdonek M. A., Naidu S., Hoffman E. P. Associations between MeCP2 mutations, X-chromosome inactivation, and phenotype. Ment Retard Dev Disabil Res Rev. 2002;8(2):99–105. doi: 10.1002/mrdd.10026. [DOI] [PubMed] [Google Scholar]
  41. Hoffbuhr K., Devaney J. M., LaFleur B., Sirianni N., Scacheri C., Giron J., Schuette J., Innis J., Marino M., Philippart M. MeCP2 mutations in children with and without the phenotype of Rett syndrome. Neurology. 2001 Jun 12;56(11):1486–1495. doi: 10.1212/wnl.56.11.1486. [DOI] [PubMed] [Google Scholar]
  42. Huopaniemi L., Tyynismaa H., Rantala A., Rosenberg T., Alitalo T. Characterization of two unusual RS1 gene deletions segregating in Danish retinoschisis families. Hum Mutat. 2000 Oct;16(4):307–314. doi: 10.1002/1098-1004(200010)16:4<307::AID-HUMU3>3.0.CO;2-L. [DOI] [PubMed] [Google Scholar]
  43. Huppke P., Held M., Hanefeld F., Engel W., Laccone F. Influence of mutation type and location on phenotype in 123 patients with Rett syndrome. Neuropediatrics. 2002 Apr;33(2):63–68. doi: 10.1055/s-2002-32365. [DOI] [PubMed] [Google Scholar]
  44. Jones P. L., Veenstra G. J., Wade P. A., Vermaak D., Kass S. U., Landsberger N., Strouboulis J., Wolffe A. P. Methylated DNA and MeCP2 recruit histone deacetylase to repress transcription. Nat Genet. 1998 Jun;19(2):187–191. doi: 10.1038/561. [DOI] [PubMed] [Google Scholar]
  45. Jung Benjamin P., Jugloff Denis G. M., Zhang Guangming, Logan Richard, Brown Stephanie, Eubanks James H. The expression of methyl CpG binding factor MeCP2 correlates with cellular differentiation in the developing rat brain and in cultured cells. J Neurobiol. 2003 Apr;55(1):86–96. doi: 10.1002/neu.10201. [DOI] [PubMed] [Google Scholar]
  46. Kalscheuer Vera M., Tao Jiong, Donnelly Andrew, Hollway Georgina, Schwinger Eberhard, Kübart Sabine, Menzel Corinna, Hoeltzenbein Maria, Tommerup Niels, Eyre Helen. Disruption of the serine/threonine kinase 9 gene causes severe X-linked infantile spasms and mental retardation. Am J Hum Genet. 2003 May 7;72(6):1401–1411. doi: 10.1086/375538. [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Kerr A. M., Nomura Y., Armstrong D., Anvret M., Belichenko P. V., Budden S., Cass H., Christodoulou J., Clarke A., Ellaway C. Guidelines for reporting clinical features in cases with MECP2 mutations. Brain Dev. 2001 Jul;23(4):208–211. doi: 10.1016/s0387-7604(01)00193-0. [DOI] [PubMed] [Google Scholar]
  48. Kerr A. M., Ravine D. Review article: breaking new ground with Rett syndrome. J Intellect Disabil Res. 2003 Nov;47(Pt 8):580–587. doi: 10.1046/j.1365-2788.2003.00506.x. [DOI] [PubMed] [Google Scholar]
  49. Klauck Sabine M., Lindsay Susan, Beyer Kim S., Splitt Miranda, Burn John, Poustka Annemarie. A mutation hot spot for nonspecific X-linked mental retardation in the MECP2 gene causes the PPM-X syndrome. Am J Hum Genet. 2002 Feb 15;70(4):1034–1037. doi: 10.1086/339553. [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Kleefstra T., Yntema H. G., Oudakker A. R., Romein T., Sistermans E., Nillessen W., van Bokhoven H., de Vries B. B. A., Hamel B. C. J. De novo MECP2 frameshift mutation in a boy with moderate mental retardation, obesity and gynaecomastia. Clin Genet. 2002 May;61(5):359–362. doi: 10.1034/j.1399-0004.2002.610507.x. [DOI] [PubMed] [Google Scholar]
  51. Kleefstra Tjitske, Yntema Helger G., Nillesen Willy M., Oudakker Astrid R., Mullaart Reinier A., Geerdink Niels, van Bokhoven Hans, de Vries Bert B. A., Sistermans Erik A., Hamel Ben C. J. MECP2 analysis in mentally retarded patients: implications for routine DNA diagnostics. Eur J Hum Genet. 2004 Jan;12(1):24–28. doi: 10.1038/sj.ejhg.5201080. [DOI] [PubMed] [Google Scholar]
  52. Klose Robert, Bird Adrian. Molecular biology. MeCP2 repression goes nonglobal. Science. 2003 Oct 31;302(5646):793–795. doi: 10.1126/science.1091762. [DOI] [PubMed] [Google Scholar]
  53. Kokura K., Kaul S. C., Wadhwa R., Nomura T., Khan M. M., Shinagawa T., Yasukawa T., Colmenares C., Ishii S. The Ski protein family is required for MeCP2-mediated transcriptional repression. J Biol Chem. 2001 Jul 5;276(36):34115–34121. doi: 10.1074/jbc.M105747200. [DOI] [PubMed] [Google Scholar]
  54. Krepischi A. C., Kok F., Otto P. G. X chromosome-inactivation patterns in patients with Rett syndrome. Hum Genet. 1998 Mar;102(3):319–321. doi: 10.1007/s004390050698. [DOI] [PubMed] [Google Scholar]
  55. Kriaucionis Skirmantas, Bird Adrian. The major form of MeCP2 has a novel N-terminus generated by alternative splicing. Nucleic Acids Res. 2004 Mar 19;32(5):1818–1823. doi: 10.1093/nar/gkh349. [DOI] [PMC free article] [PubMed] [Google Scholar]
  56. Laccone F., Huppke P., Hanefeld F., Meins M. Mutation spectrum in patients with Rett syndrome in the German population: Evidence of hot spot regions. Hum Mutat. 2001 Mar;17(3):183–190. doi: 10.1002/humu.3. [DOI] [PubMed] [Google Scholar]
  57. Laccone Franco, Jünemann Ivonne, Whatley Sharon, Morgan Rhian, Butler Rachel, Huppke Peter, Ravine David. Large deletions of the MECP2 gene detected by gene dosage analysis in patients with Rett syndrome. Hum Mutat. 2004 Mar;23(3):234–244. doi: 10.1002/humu.20004. [DOI] [PubMed] [Google Scholar]
  58. Leonard H., Bower C., English D. The prevalence and incidence of Rett syndrome in Australia. Eur Child Adolesc Psychiatry. 1997;6 (Suppl 1):8–10. [PubMed] [Google Scholar]
  59. Leonard H., Weaving L., Eastaugh P., Smith L., Delatycki M., Witt Engerström I., Christodoulou J. Trisomy 21 and Rett syndrome: a double burden. J Paediatr Child Health. 2004 Jul;40(7):406–409. doi: 10.1111/j.1440-1754.2004.00413.x. [DOI] [PubMed] [Google Scholar]
  60. Martinowich Keri, Hattori Daisuke, Wu Hao, Fouse Shaun, He Fei, Hu Yan, Fan Guoping, Sun Yi E. DNA methylation-related chromatin remodeling in activity-dependent BDNF gene regulation. Science. 2003 Oct 31;302(5646):890–893. doi: 10.1126/science.1090842. [DOI] [PubMed] [Google Scholar]
  61. McArthur A. J., Budden S. S. Sleep dysfunction in Rett syndrome: a trial of exogenous melatonin treatment. Dev Med Child Neurol. 1998 Mar;40(3):186–192. doi: 10.1111/j.1469-8749.1998.tb15445.x. [DOI] [PubMed] [Google Scholar]
  62. Meloni I., Bruttini M., Longo I., Mari F., Rizzolio F., D'Adamo P., Denvriendt K., Fryns J. P., Toniolo D., Renieri A. A mutation in the rett syndrome gene, MECP2, causes X-linked mental retardation and progressive spasticity in males. Am J Hum Genet. 2000 Sep 12;67(4):982–985. doi: 10.1086/303078. [DOI] [PMC free article] [PubMed] [Google Scholar]
  63. Migeon B. R., Dunn M. A., Thomas G., Schmeckpeper B. J., Naidu S. Studies of X inactivation and isodisomy in twins provide further evidence that the X chromosome is not involved in Rett syndrome. Am J Hum Genet. 1995 Mar;56(3):647–653. [PMC free article] [PubMed] [Google Scholar]
  64. Miltenberger-Miltenyi Gabriel, Laccone Franco. Mutations and polymorphisms in the human methyl CpG-binding protein MECP2. Hum Mutat. 2003 Aug;22(2):107–115. doi: 10.1002/humu.10243. [DOI] [PubMed] [Google Scholar]
  65. Montini E., Andolfi G., Caruso A., Buchner G., Walpole S. M., Mariani M., Consalez G., Trump D., Ballabio A., Franco B. Identification and characterization of a novel serine-threonine kinase gene from the Xp22 region. Genomics. 1998 Aug 1;51(3):427–433. doi: 10.1006/geno.1998.5391. [DOI] [PubMed] [Google Scholar]
  66. Moog Ute, Smeets Eric E. J., van Roozendaal Kees E. P., Schoenmakers Sam, Herbergs Jos, Schoonbrood-Lenssen Anneke M. J., Schrander-Stumpel Connie T. R. M. Neurodevelopmental disorders in males related to the gene causing Rett syndrome in females (MECP2). Eur J Paediatr Neurol. 2003;7(1):5–12. doi: 10.1016/s1090-3798(02)00134-4. [DOI] [PubMed] [Google Scholar]
  67. Nan X., Ng H. H., Johnson C. A., Laherty C. D., Turner B. M., Eisenman R. N., Bird A. Transcriptional repression by the methyl-CpG-binding protein MeCP2 involves a histone deacetylase complex. Nature. 1998 May 28;393(6683):386–389. doi: 10.1038/30764. [DOI] [PubMed] [Google Scholar]
  68. Orrico A., Lam C., Galli L., Dotti M. T., Hayek G., Tong S. F., Poon P. M., Zappella M., Federico A., Sorrentino V. MECP2 mutation in male patients with non-specific X-linked mental retardation. FEBS Lett. 2000 Sep 22;481(3):285–288. doi: 10.1016/s0014-5793(00)01994-3. [DOI] [PubMed] [Google Scholar]
  69. Plioplys A. V., Kasnicka I. L-carnitine as a treatment for Rett syndrome. South Med J. 1993 Dec;86(12):1411–1412. doi: 10.1097/00007611-199312000-00021. [DOI] [PubMed] [Google Scholar]
  70. Rett A. Uber ein eigenartiges hirnatrophisches Syndrom bei Hyperammonämie im Kindersalter. Wien Med Wochenschr. 1966 Sep 10;116(37):723–726. [PubMed] [Google Scholar]
  71. Schanen Carolyn, Houwink Elisa J. F., Dorrani Naghmeh, Lane Jane, Everett Ruth, Feng Alice, Cantor Rita M., Percy Alan. Phenotypic manifestations of MECP2 mutations in classical and atypical Rett syndrome. Am J Med Genet A. 2004 Apr 15;126A(2):129–140. doi: 10.1002/ajmg.a.20571. [DOI] [PubMed] [Google Scholar]
  72. Schollen E., Smeets E., Deflem E., Fryns J. P., Matthijs G. Gross rearrangements in the MECP2 gene in three patients with Rett syndrome: implications for routine diagnosis of Rett syndrome. Hum Mutat. 2003 Aug;22(2):116–120. doi: 10.1002/humu.10242. [DOI] [PubMed] [Google Scholar]
  73. Schwartzman J. S., Bernardino A., Nishimura A., Gomes R. R., Zatz M. Rett syndrome in a boy with a 47,XXY karyotype confirmed by a rare mutation in the MECP2 gene. Neuropediatrics. 2001 Jun;32(3):162–164. doi: 10.1055/s-2001-16620. [DOI] [PubMed] [Google Scholar]
  74. Sekul E. A., Moak J. P., Schultz R. J., Glaze D. G., Dunn J. K., Percy A. K. Electrocardiographic findings in Rett syndrome: an explanation for sudden death? J Pediatr. 1994 Jul;125(1):80–82. doi: 10.1016/s0022-3476(94)70128-8. [DOI] [PubMed] [Google Scholar]
  75. Shahbazian Mona D., Antalffy Barbara, Armstrong Dawna L., Zoghbi Huda Y. Insight into Rett syndrome: MeCP2 levels display tissue- and cell-specific differences and correlate with neuronal maturation. Hum Mol Genet. 2002 Jan 15;11(2):115–124. doi: 10.1093/hmg/11.2.115. [DOI] [PubMed] [Google Scholar]
  76. Shahbazian Mona D., Sun Yaling, Zoghbi Huda Y. Balanced X chromosome inactivation patterns in the Rett syndrome brain. Am J Med Genet. 2002 Aug 1;111(2):164–168. doi: 10.1002/ajmg.10557. [DOI] [PubMed] [Google Scholar]
  77. Stancheva Irina, Collins Anne L., Van den Veyver Ingatia B., Zoghbi Huda, Meehan Richard R. A mutant form of MeCP2 protein associated with human Rett syndrome cannot be displaced from methylated DNA by notch in Xenopus embryos. Mol Cell. 2003 Aug;12(2):425–435. doi: 10.1016/s1097-2765(03)00276-4. [DOI] [PubMed] [Google Scholar]
  78. Strømme Petter, Mangelsdorf Marie E., Shaw Marie A., Lower Karen M., Lewis Suzanne M. E., Bruyere Helene, Lütcherath Viggo, Gedeon Agi K., Wallace Robyn H., Scheffer Ingrid E. Mutations in the human ortholog of Aristaless cause X-linked mental retardation and epilepsy. Nat Genet. 2002 Mar 11;30(4):441–445. doi: 10.1038/ng862. [DOI] [PubMed] [Google Scholar]
  79. Thomas G. H. High male:female ratio of germ-line mutations: an alternative explanation for postulated gestational lethality in males in X-linked dominant disorders. Am J Hum Genet. 1996 Jun;58(6):1364–1368. [PMC free article] [PubMed] [Google Scholar]
  80. Topçu Meral, Akyerli Cemaliye, Sayi Ayça, Törüner Gökçe A., Koçoğlu Süha R., Cimbiş Mine, Ozçelik Tayfun. Somatic mosaicism for a MECP2 mutation associated with classic Rett syndrome in a boy. Eur J Hum Genet. 2002 Jan;10(1):77–81. doi: 10.1038/sj.ejhg.5200745. [DOI] [PubMed] [Google Scholar]
  81. Trappe R., Laccone F., Cobilanschi J., Meins M., Huppke P., Hanefeld F., Engel W. MECP2 mutations in sporadic cases of Rett syndrome are almost exclusively of paternal origin. Am J Hum Genet. 2001 Apr 17;68(5):1093–1101. doi: 10.1086/320109. [DOI] [PMC free article] [PubMed] [Google Scholar]
  82. Tudor Matthew, Akbarian Schahram, Chen Richard Z., Jaenisch Rudolf. Transcriptional profiling of a mouse model for Rett syndrome reveals subtle transcriptional changes in the brain. Proc Natl Acad Sci U S A. 2002 Nov 13;99(24):15536–15541. doi: 10.1073/pnas.242566899. [DOI] [PMC free article] [PubMed] [Google Scholar]
  83. Wan M., Lee S. S., Zhang X., Houwink-Manville I., Song H. R., Amir R. E., Budden S., Naidu S., Pereira J. L., Lo I. F. Rett syndrome and beyond: recurrent spontaneous and familial MECP2 mutations at CpG hotspots. Am J Hum Genet. 1999 Dec;65(6):1520–1529. doi: 10.1086/302690. [DOI] [PMC free article] [PubMed] [Google Scholar]
  84. Watson P., Black G., Ramsden S., Barrow M., Super M., Kerr B., Clayton-Smith J. Angelman syndrome phenotype associated with mutations in MECP2, a gene encoding a methyl CpG binding protein. J Med Genet. 2001 Apr;38(4):224–228. doi: 10.1136/jmg.38.4.224. [DOI] [PMC free article] [PubMed] [Google Scholar]
  85. Weaving Linda S., Williamson Sarah L., Bennetts Bruce, Davis Mark, Ellaway Carolyn J., Leonard Helen, Thong Meow-Keong, Delatycki Martin, Thompson Elizabeth M., Laing Nigel. Effects of MECP2 mutation type, location and X-inactivation in modulating Rett syndrome phenotype. Am J Med Genet A. 2003 Apr 15;118A(2):103–114. doi: 10.1002/ajmg.a.10053. [DOI] [PubMed] [Google Scholar]
  86. Webb T., Watkiss E. A comparative study of X-inactivation in Rett syndrome probands and control subjects. Clin Genet. 1996 Apr;49(4):189–195. doi: 10.1111/j.1399-0004.1996.tb03285.x. [DOI] [PubMed] [Google Scholar]
  87. Webb T., Watkiss E., Woods C. G. Neither uniparental disomy nor skewed X-inactivation explains Rett syndrome. Clin Genet. 1993 Nov;44(5):236–240. doi: 10.1111/j.1399-0004.1993.tb03889.x. [DOI] [PubMed] [Google Scholar]
  88. Yntema Helger G., Kleefstra Tjitske, Oudakker Astrid R., Romein Tom, de Vries Bert B. A., Nillesen Willy, Sistermans Erik A., Brunner Han G., Hamel Ben C. J., van Bokhoven Hans. Low frequency of MECP2 mutations in mentally retarded males. Eur J Hum Genet. 2002 Aug;10(8):487–490. doi: 10.1038/sj.ejhg.5200836. [DOI] [PubMed] [Google Scholar]
  89. Young Juan I., Zoghbi Huda Y. X-chromosome inactivation patterns are unbalanced and affect the phenotypic outcome in a mouse model of rett syndrome. Am J Hum Genet. 2004 Feb 17;74(3):511–520. doi: 10.1086/382228. [DOI] [PMC free article] [PubMed] [Google Scholar]
  90. Yu F., Thiesen J., Strätling W. H. Histone deacetylase-independent transcriptional repression by methyl-CpG-binding protein 2. Nucleic Acids Res. 2000 May 15;28(10):2201–2206. doi: 10.1093/nar/28.10.2201. [DOI] [PMC free article] [PubMed] [Google Scholar]
  91. Zoghbi H. Y., Percy A. K., Schultz R. J., Fill C. Patterns of X chromosome inactivation in the Rett syndrome. Brain Dev. 1990;12(1):131–135. doi: 10.1016/s0387-7604(12)80194-x. [DOI] [PubMed] [Google Scholar]

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