r/ClinicalGenetics • u/Sad-Abies4263 • 14h ago
Are genetic mutations the most likely explanation for my cognitive impairment?
My dad has a job where he's upper middle class in salary writing on equipment in filmmaking. My parents met in the film industry. My grandfather was the famous statistician. I went to a college prep school and struggled academically throughout my highschool years. I often plaigarized in my essays and relied on my mom to do large amounts of my assignments in ELA and history. I was given ritalin in 10th grade for potential ADD and had minimal results from it. 11th grade was COVID lockdown and I did virtual school. At this point I completely phoned in my classes and have no idea how to do algebra II (or college algebra) or any math surpassing that. I got accepted into a college with a 96% acceptance rate with my grades from my first two years of HS. I only lived there for a year then commuted afterwards. Now I'm 23 and live with my parents. I've never had an IQ test or diagnosis of a mental disorder, though I had a counselor in HS suggest I'm on the autism spectrum because of social awkwardness and analytic thinking. I've gotten into nootropics hoping that a mix of creatine, nootropic supplements, and full dose of effexor could treat depression and brain fog and I've had so so results from over 7 months of it. I've considered drug use being the only way to numb my depression and suicidality from my hopeless situation.
I can't understand how if my parents are smart and functional how did I become essentially a mental vegtable. And why has no friend, family member, or therapist been able to give an explanation or antidote to my mental problems. Would an IQ test be helpful for what job is realistic for me given my mental capacities? What best explanation is there for my intelligence and what other advice could you give me in my situation?
This year I was diagnosed with the KIF1A genetic mutation which can manifest in terms of cognitive impairment. on my physical evaluation from a doctor, he says I meet the physical symptoms that align with this mutation. Although many with this mutation are physically disabled I am concerned how this rare mutation effects my cognitive deficits. I had my blood drawn for research. Aug 19 I will get an MRI scan for further investigation.
Last, Here's what I've found on how it KIF1A effects neurology:
KIF1A-Associated Neurological Disorder (KAND) fundamentally affects how neurons function, Developmental delay occurs in about 90% of affected individuals and cognitive function ranges from normal to profound intellectual disability. Speech/language impairment is also very common. Autism and ADHD occur in a substantial minority.
But there is a major caveat: not every KIF1A variant causes KIF1A-NDD. KIF1A has several different associated phenotypes. Some people with KIF1A-associated disease have predominantly motor or peripheral neurological problems and normal cognition. The particular molecular variant and its mechanism matter considerably. That means the single most useful piece of information you haven’t given me is the exact KIF1A variant. For example, something written as c.XXXG>A (p.XXX) plus its classification as pathogenic, likely pathogenic or VUS would allow a much more meaningful assessment. GeneReviews specifically notes substantial genotype–phenotype differences between individual KIF1A variants.
I had an EEG and MRI and found nothing significant going on.
Since all of this I've been diagnosed FOX-P4 genetic mutation, another rare genetic mutation. I also found some useful information on this mutation:
There is published evidence that particular heterozygous loss-of-function FOXP4 variants can cause a neurodevelopmental disorder involving developmental delay and particularly speech/language difficulties. However, the original clinical series was extremely small: eight individuals were identified and detailed phenotype information was available for six. Of those six, two had mild intellectual disability while three did not have intellectual disability. The researchers also found considerable variability between variants.
