Open Access Highly Accessed Research article

A missense founder mutation in VLDLR is associated with Dysequilibrium Syndrome without quadrupedal locomotion

Bassam R Ali1, Jennifer L Silhavy2, Matthew J Gleeson2, Joseph G Gleeson2 and Lihadh Al-Gazali3*

Author Affiliations

1 Department of Pathology, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates

2 Department of Neurosciences and Pediatrics, Howard Hughes Medical Institute, University of California, San Diego, USA

3 Department of Pediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al-Ain, United Arab Emirates

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BMC Medical Genetics 2012, 13:80  doi:10.1186/1471-2350-13-80

Published: 14 September 2012



Dysequilibrium syndrome is a genetically heterogeneous condition that combines autosomal recessive, nonprogressive cerebellar ataxia with mental retardation. The condition has been classified into cerebellar ataxia, mental retardation and disequilibrium syndrome types 1 (CAMRQ1), 2 (CAMRQ2) and 3 (CAMRQ3) and attributed to mutations in VLDLR, CA8 and WDR81 genes, respectively. Quadrupedal locomotion in this syndrome has been reported in association with mutations in all three genes.


SNP mapping and candidate gene sequencing in one consanguineous Omani family from the United Arab Emirates with cerebellar hypoplasia, moderate mental retardation, delayed ambulation and truncal ataxia was used to identify the mutation. In a second unrelated consanguineous Omani family, massively parallel exonic sequencing was used.


We identified a homozygous missense mutation (c.2117ā€‰Gā€‰>ā€‰T, p.C706F) in the VLDLR gene in both families on a shared affected haplotype block.This is the first reported homozygous missense mutation in VLDLR and it occurs in a highly conserved residue and predicted to be damaging to protein function.


We have delineated the phenotype associated with dysequilibrium syndrome in two Omani families and identified the first homozygous missense pathogenic mutation in VLDLR gene with likely founder effect in the southeastern part of the Arabian Peninsula.