A study of X-linked mental retardation in British Columbia
Creators: name: Herbst, Diana Shawn
Publisher: name: University of British Columbia
Year: 2010

description: An excess of males among the mentally retarded has been noted in practically all surveys of a mentally retarded population. It has been hypothesized that X-linked genes may account for this excess. The main purpose of this study was to test the hypothesis using data on the mentally retarded in British Columbia. A second purpose was to calculate the frequency of non-specific X-linked mental retardation in the population. In addition, an attempt was made to delineate clinical types of X-linked mental retardation. Data on the mentally retarded in British Columbia were obtained from the B.C. Health Surveillance Registry. The Registry also provided information on sibships with two or more sibs affected with non-specific mental retardation. Family histories on sibships with two or more affected males were obtained from the Department of Medical Genetics, institutions for the mentally retarded, namely Woodlands School and Tranquille, and in some cases personal interviews. The number of mothers in British Columbia giving birth to two or more sons in a defined birth cohort was retrieved from the linked family records of the B.C. Record Linkage Project. Families with a pattern of X-linked inheritance for non-specific mental retardation were ascertained while family histories on sibships with two or more affected males were being recorded and by reviewing files of other non-specific mentally retarded males in the Department of Medical Genetics, Woodlands School and Tranquille. Clinical and psychological characteristics of the mental retardation in males from these families were obtained from medical files from the same sources. Among the mentally retarded in British Columbia, there is an overall 28.2% excess of males. The extent of this excess is similar to that observed in other studies. This excess of males is seen at all levels of retardation except at the profound level. Mental retardation of known causes does not significantly contribute to the excess, which is due primarily to nonspecific mental retardation. Non-specific mental retardation in two or more sibs may be genetic in origin. Data from sibships with both males and females affected do not support an hypothesis of multifactorial inheritance with specific sex thresholds accounting for the excess of mentally retarded males. A ratio of 3.1:1 of sibships with two or more affected males to sibships with two or more affected females suggests that X-linked inheritance may account for the excess of male affected sibships. Family history data on sibships with two or more affected males provide evidence that X-linked genes can account for the excess of male affected sibships. A minimum frequency of 1.83 per 1,000 males for X-linked mental retardation in the population of British Columbia was calculated using sibship data. This frequency can account for the entire excess of non-specific mentally retarded males in the province. Mental retardation inherited in an X-linked pattern may be due to either single genes on the X chromosome or autosomal dominant genes with sex-limited expression. Distinguishing between the two types of genes was not possible in the present study. Specific clinical subtypes of X-linked mental retardation could not be differentiated due to a large amount of variability which was found not only in the level of retardation but also in associated psychological, neurological and physical characteristics. Although further clinical, biochemical and cytogenetic investigations of affected males in families with X-linked mental retardation may elucidate subtypes of non-specific mental retardation, variabiliy in phenotypic expression has been identified as an important feature of X-linked mental retardation.