A total of approximately 80 patients with each of three specific diagnoses and 40 participants with an overlap disorder have been seen in the NIH Clinical Center. Natural history data have been collected on all 280 participants, including ophthalmologic, otolaryngologic, echocardiography and rehabilitation medicine consultations. Our studies have documented newly recognized gastrointestinal complications of these disorders, and that chronic musculoskeletal pain is a significant complication of both EDS and Stickler syndrome. Echocardiography analysis of patients with Ehlers-Danlos syndrome demonstrated a 30% incidence of aortic root dilation in this group of patients. We have compared the Berlin and Gent nosologies for the Marfan syndrome in our population and examined the efficacy of screening for dural ectasia in the diagnosis of the Marfan syndrome. We have analyzed the prevalence of spinal and hip abnormlities in Stickler syndrome and their relationship to chronic pain. Our studies documented an increased risk of femoral head failure in children with Stickler syndrome. We have developed proposed diagnostic criteria for Stickler syndrome based on our clinical and molecular studies in this population. We have identified a previously undescribed connective tissue disorder with features resembling Marfan syndrome, Stickler syndrome and the Ehlers-Danlos syndrome. Chronic musculoskeletal pain is a serious complication of many of the hereditary disorders of connective tissue. We have performed a pilot study of the Mindfulness-Based Stress Reduction program to examine its efficacy in the relief of chronic pain in this population. We plan to pursue the mechanism of chronic musculoskeletal pain in this population and continue to explore alternative means of ameliorating the pain.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Intramural Research (Z01)
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Milhorat, Thomas H; Bolognese, Paolo A; Nishikawa, Misao et al. (2007) Syndrome of occipitoatlantoaxial hypermobility, cranial settling, and chiari malformation type I in patients with hereditary disorders of connective tissue. J Neurosurg Spine 7:601-9
Liberfarb, Ruth M; Levy, Howard P; Rose, Peter S et al. (2003) The Stickler syndrome: genotype/phenotype correlation in 10 families with Stickler syndrome resulting from seven mutations in the type II collagen gene locus COL2A1. Genet Med 5:21-7
Wenstrup, Richard J; Meyer, Richard A; Lyle, Jennifer S et al. (2002) Prevalence of aortic root dilation in the Ehlers-Danlos syndrome. Genet Med 4:112-7
Ho, Nicola C; Hadley, Donald W; Jain, Pawan K et al. (2002) Case 47: dural ectasia associated with Marfan syndrome. Radiology 223:767-71
Rose, P S; Ahn, N U; Levy, H P et al. (2001) Thoracolumbar spinal abnormalities in Stickler syndrome. Spine (Phila Pa 1976) 26:403-9
Szymko-Bennett, Y M; Mastroianni, M A; Shotland, L I et al. (2001) Auditory dysfunction in Stickler syndrome. Arch Otolaryngol Head Neck Surg 127:1061-8
Peters, K F; Kong, F; Horne, R et al. (2001) Living with Marfan syndrome I. Perceptions of the condition. Clin Genet 60:273-82
Peters, K F; Horne, R; Kong, F et al. (2001) Living with Marfan syndrome II. Medication adherence and physical activity modification. Clin Genet 60:283-92
Rose, P S; Ahn, N U; Levy, H P et al. (2001) The hip in Stickler syndrome. J Pediatr Orthop 21:657-63