GRIA2-Related Syndrome
What is GRIA2-related syndrome?
GRIA2-related syndrome happens when there are changes in the GRIA2 gene. These changes can keep the gene from working as it should.
Key Role
The GRIA2 gene plays a key role in communication among brain cells. The GRIA2 gene codes for a unit of the AMPA receptor. The gene is called GRIA2, and the protein is called GluA2.
Symptoms
Because the GRIA2 gene is important for brain activity, many people who have GRIA2-related syndrome have:
- Intellectual disability
- Global developmental delay
- Speech delay or absent speech
- Delayed or absent walking
- Movement discoordination
- Seizures
- Autism spectrum disorder
What causes GRIA2-related syndrome?
GRIA2-related syndrome is a genetic condition, which means that it is caused by variants in genes. Our genes contain the instructions, or code, that tell our cells how to grow, develop, and work. Every child gets two copies of the GRIA2 gene: one copy from their mother’s egg, and one copy from their father’s sperm. In most cases, parents pass on exact copies of the gene to their child. But the process of creating the egg or sperm is not perfect. A change in the genetic code can lead to physical issues, developmental issues, or both.
Sometimes a spontaneous variant happens in the sperm, egg or after fertilization. When a brand new genetic variant happens in the genetic code is called a ‘de novo’ genetic variant. The child is usually the first in the family to have the genetic variant.
De novo variants can take place in any gene. We all have some de novo variants, most of which don’t affect our health. But because GRIA2 plays a key role in development, de novo variants in this gene can have a meaningful effect.
Research shows that GRIA2-related syndrome is often the result of a de novo variant in GRIA2. Many parents who have had their genes tested do not have the GRIA2 genetic variant found in their child who has the syndrome. In some cases, GRIA2-related syndrome happens because the genetic variant was passed down from a parent.
Autosomal dominant conditions
GRIA2-related syndrome is an autosomal dominant genetic condition. This means that when a person has the one damaging variant in GRIA2 they will likely have symptoms of GRIA2-related syndrome. For someone with an autosomal dominant genetic syndrome, every time they have a child there is a 50 percent chance they pass on the same genetic variant and a 50 percent chance they do not pass on the same genetic variant.
Autosomal Dominant Genetic Syndrome
Why does my child have a change in the GRIA2 gene?
No parent causes their child’s GRIA2-related syndrome. We know this because no parent has any control over the gene changes that they do or do not pass on to their children. Please keep in mind that nothing a parent does before or during the pregnancy causes this to happen. The gene change takes place on its own and cannot be predicted or stopped.
What are the chances that other family members of future children will have GRIA2-related syndrome?
Each family is different. A geneticist or genetic counselor can give you advice on the chance that this will happen again in your family.
The risk of having another child who has GRIA2-related syndrome depends on the genes of both biological parents.
- If neither biological parent has the same genetic variant found in their child, the chance of having another child who has the syndrome is on average 1 percent. This 1 percent chance is higher than the chance of the general population. The increase in risk is due to the very unlikely chance that more of the mother’s egg cells or the father’s sperm cells carry the same genetic variant.
- If one biological parent has the same genetic variant found in their child, the chance of having another child who has the syndrome is 50 percent.
For a symptom-free brother or sister of someone who has GRIA2-related syndrome, the sibling’s risk of having a child who has GRIA2-related syndrome depends on the sibling’s genes and their parents’ genes.
- If neither parent has the same genetic variant causing GRIA2-related syndrome, the symptom-free sibling has a nearly 0 percent chance of having a child who would inherit GRIA2-related syndrome.
- If one biological parent has the same genetic variant causing GENE-related syndrome, the symptom-free sibling has a 50 percent chance of also having the same genetic variant. If the symptom-free sibling has the same genetic variant, their chance of having a child who has the genetic variant is 50 percent.
For a person who has GRIA2-related syndrome, the risk of having a child who has the syndrome is about 50 percent.
How many people have GRIA2-related syndrome?
As of 2024, at least 39 people with GRIA2-related syndrome have been identified in the medical literature.
Do people who have GRIA2-related syndrome look different?
People who have GRIA2-related syndrome might not look very different. Some people have a smaller than average head size.
How is GRIA2-related syndrome treated?
Scientists and doctors have only just begun to study GRIA2-related syndrome. At this point, there are no medicines designed to treat the syndrome. A genetic diagnosis can help people decide on the best way to track the condition and manage therapies. Doctors can refer people to specialists for:
- Physical exams and brain studies
- Genetics consults
- Development and behavior studies
- Other issues, as needed
A developmental pediatrician, neurologist, or psychologist can follow progress over time and can help:
- Suggest the right therapies. This can include physical, occupational, speech, or behavioral therapy.
- Guide individualized education plans (IEPs).
Specialists advise that therapies for GRIA2-related syndrome should begin as early as possible, ideally before a child begins school.
If seizures happen, consult a neurologist. There are many types of seizures, and not all types are easy to spot. To learn more, you can refer to resources such as the Epilepsy Foundation’s website: epilepsy.com/…t-is-epilepsy/seizure-types
This section includes a summary of information from major published articles on GRIA2. To learn more about the articles, see the Sources and references section of this guide.
Behavior and development concerns linked to GRIA2-related syndrome
There are few research publications on people with GRIA2-related syndrome. The information below includes 33 people. The oldest person included was 31 years old.
All people had intellectual disability or developmental delay ranging from mild to severe, 24 people had moderate intellectual disability, and 9 people had severe intellectual disability. Many people had autism, and one-half had seizures. Seizure control through medication was difficult.
- 33 out of 33 people had intellectual disability (100 percent)
- 15 out of 33 people had seizures (45 percent)
- 2 out of 12 people took medication that controlled their seizures (17 percent)
Many people had autism, and 5 people had obsessive-compulsive disorder or repetitive traits. One person with GRIA2-related syndrome had self-harming behavior.
- 17 out of 21 people had autism (81 percent)
Speech was a problem for most people and regression of language abilities was reported. Some people had brain changes observed on magnetic resonance imaging (MRI). Most people had a head size that was smaller than average (18 out of 21, 86 percent). Only a few people had the clinical diagnosis of microcephaly.
- 25 out of 33 people had delayed or absent speech (76 percent)
- 8 out of 23 people had findings on MRI (35 percent)
- 4 out of 29 people had a clinical diagnosis of microcephaly (14 percent)
Some people had movement issues: 4 people were unable to walk and 3 people had movement issues, such as ataxia, dystonia, or spasticity.
- 6 out of 33 people had movement issues (18 percent)
Where can I find support and resources?
CureGRIN Foundation
CureGRIN Foundation is dedicated to improving the lives of people around the world with GRI Disorders (GRIA, GRID, GRIK, and GRIN) and their families through research, education, and support. We work closely with scientists and the medical community to drive patient-centered research that will lead to treatments and cures.
- Learn more: www.curegrin.org
Simons Searchlight
Simons Searchlight is an online international research program, building an ever growing natural history database, biorepository, and resource network of over 175 rare genetic neurodevelopmental disorders. By joining their community and sharing your experiences, you contribute to a growing database used by scientists worldwide to advance the understanding of your genetic condition. Through online surveys and optional blood sample collection, they gather valuable information to improve lives and drive scientific progress. Families like yours are the key to making meaningful progress. To register for Simons Searchlight, go to the Simons Searchlight website at www.simonssearchlight.org and click “Join Us.
- Learn more about Simons Searchlight:
- Simons Searchlight webpage with more information on GRIA2
Sources and References
The content in this guide comes from published studies about GRIA2-related syndrome. Below you can find details about each study, as well as links to summaries or, in some cases, the full article.
- Efthymiou, S., Rumbos Siurana, E., Salpietro, V., Bayat, A., & Houlden, H. GRIA2-related neurodevelopmental disorder. 2024 Jan 11. In: Adam MP, Feldman J, Mirzaa GM, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK599285/
- Salpietro, V., … Houlden, H. (2019). AMPA receptor GluA2 subunit defects are a cause of neurodevelopmental disorders. Nature Communications, 10(1), 3094. https://pubmed.ncbi.nlm.nih.gov/31300657/