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- MR, mental retardation
- CGH, comparative genomic hybridisation
- M-FISH, multipaint FISH
- M-TEL, multiplex FISH telomere assay
- WHCR, Wolf-Hirschhorn critical region
- WBCR, Williams-Beuren critical region
- PAC, P1 derived artificial chromosome
- YAC, yeast artificial chromosome
- BAC, bacterial artificial chromosome
Mental retardation (MR), defined as an intelligence quotient (IQ) of less than 70, affects 2-3% of the population and its aetiology and pathogenesis are still poorly understood. The aetiology can be established in only ¬64% of cases with moderate to profound MR and in ¬24% of cases with mild MR.1 Available data indicate that chromosome aberrations are found in 4-28% of affected subjects. However, the yield of these abnormalities is increased when the severity of mental retardation and the presence of congenital anomalies are taken into account.
In the past decade, molecular-cytogenetic methods have documented a number of submicroscopic chromosomal rearrangements involving telomeric regions of chromosomes. They have been implicated in α thalassaemia with MR,2–4 Wolf-Hirschhorn syndrome,4–8, cri du chat syndrome,4,9,10 and Miller-Dieker syndrome.4,11 Their presence has also been reported in patients with 18p−, 18q−, 22q−, and 1p− deletion syndromes.12–25 These observations suggest that the telomeric regions of chromosomes might be more prone to cryptic rearrangements and thus might be responsible for mental retardation. As telomeric regions of chromosomes have the highest gene concentration in the human genome, rearrangements involving these regions may have severe phenotypic consequences. Moreover, the molecular structure of telomeric regions and high frequency of recombination are predisposing factors to the occurrence of such rearrangements.26,27
At present, there is still no single, useful cytogenetic method for screening the entire genome, regardless of the size of suspected chromosomal abnormality. Classical cytogenetic analysis, even with the use of high resolution banding, enables the detection of abnormalities >3-10 Mb in size. Thus, the resolution of the method is not sensitive enough to identify subtle submicroscopic rearrangements. They are not detected by G banding not only because of their small size but also because of …