Kisho is an information platform, not a medical provider. Nothing on this site constitutes medical advice, diagnosis, or treatment recommendations. All content is aggregated from publicly available sources (including ClinicalTrials.gov, PubMed, FDA.gov, and Orphanet) and is provided for informational purposes only. Clinical trial eligibility, treatment decisions, and any health-related actions should always be discussed with a qualified healthcare professional. Kisho does not endorse any specific therapy, organization, or clinical trial. Terms of use · Privacy policy
Features include always present findings: Microcephaly, Delayed ability to walk, and Global developmental delay; and very common findings: Short stature and Delayed speech and language development. 38 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Brain and nerves | 9 | Seizure, Cerebral visual impairment, Enlarged brain ventricles (ventriculomegaly) |
LMNB1 encodes lamin B1 (586 aa). Lamins are intermediate filament proteins that assemble into a filamentous meshwork, and which constitute the major components of the nuclear lamina, a fibrous layer on the nucleoplasmic side of the inner nuclear membrane. Highest expression in Cells EBV-transformed lymphocytes (160.4 TPM) and Whole Blood (37.7 TPM).
Microcephaly 26, primary, autosomal dominant is caused by mutations in the LMNB1 gene on chromosome 5.
The LMNB1 protein participates in p-S395, S405-LMNB1, p-S23, S395, S405-LMNB1, and Expression of Lamin-B1 pathways.
LMNB1 is classified as a druggable target with score 0.0.
No formal diagnostic criteria exist.
LMNB1-related autosomal dominant leukodystrophy (ADLD) should be suspected in adults with the following clinical, neuroimaging, and family history findings:
Clinical features
Onset in the fourth to fifth decade of signs and symptoms of autonomic dysfunction including bladder dysfunction, constipation, erectile dysfunction, and postural hypotension
No approved treatments are currently available for microcephaly 26, primary, autosomal dominant. The disease remains an area of unmet medical need.
No clinical practice guidelines for LMNB1-related autosomal dominant leukodystrophy (ADLD) have been published. Evaluations Following Initial Diagnosis To establish the extent of disease and needs in an individual diagnosed with LMNB1-related ADLD, the evaluations summarized (if not performed as part of the evaluation that led to the diagnosis) are recommended. Table 3. Recommended Evaluations Following Initial Diagnosis in Individuals with LMNB1-related Autosomal Dominant Leukodystrophy (ADLD)
Recommended surveillance:
Routine assessment of weight, nutrition, and feeding; pulmonary status (re possible recurrent pneumonia); bladder and erectile function; psychosocial well-being; and medications and dosage to avoid iatrogenic polypharmacy
At least annual assessment by multidisciplinary specialists including a neurologist for disease manifestations and progression; and by a physiatrist, orthopedist, physical therapist, and occupational therapist to address orthopedic, equipment, and functional needs
No clinical trials have been registered for microcephaly 26, primary, autosomal dominant.
2 publications have been identified in PubMed for microcephaly 26, primary, autosomal dominant. Research spans Basic Science / Preclinical (100%).
Sanz-Moreno A (2025). [PMID: 40215293](https://pubmed.ncbi.nlm.nih.gov/40215293/). *Sci Adv*. [Basic Science / Preclinical]
Vollmer LL (2025). [PMID: 40025114](https://pubmed.ncbi.nlm.nih.gov/40025114/). *Sci Rep*. [Basic Science / Preclinical]
Data assembled from 7 of 12 sources · Last updated Sep 19, 2026, 6:45 AM UTC
Online Mendelian Inheritance in Man
Genetic and Rare Diseases Info Center
Growth and development |
2 |
Short stature, Failure to thrive |
Digestive system | 2 | Chronic constipation, Feeding difficulties |
Eyes | 1 | Cerebral visual impairment |
Lungs and breathing | 1 | Recurrent pneumonia |
Arms and legs | 1 | Stereotypical hand wringing |
Muscles | 1 | Axial hypotonia |
Head and neck | 1 | Microcephaly |
Bones and joints | 1 | Sideways curvature of the spine (scoliosis) |
LMNB1-related autosomal dominant leukodystrophy (ADLD) is a slowly progressive neurologic disorder of central nervous system white matter. Adults show autonomic dysfunction, the first evidence of the disorder, in the fourth to fifth decade of life, followed by pyramidal and cerebellar abnormalities resulting in spasticity, ataxia, and tremor . To date, at least 33 families have been identified with a pathogenic variant in LMNB1 [, , , , , , , , , , , , , , ]. The following description of the phenotypic features associated with this condition is based on these reports. Autonomic dysfunction, a nearly universal feature , includes bladder dysfunction, constipation, postural hypotension, erectile dysfunction, and (less often) impaired sweating.
Source: GeneReviews — "LMNB1-Related Autosomal Dominant Leukodystrophy"
Differences in clinical findings and MRI features have been noted between individuals with LMNB1 duplications and those with deletions upstream of LMNB1. Those with the upstream deletions have been found to have earlier age of onset and a lack of early dysautonomia, with less brain stem and cerebellar involvement and spinal cord narrowing .
Source: GeneReviews — "LMNB1-Related Autosomal Dominant Leukodystrophy"
The disease presents in the fourth to fifth decade of adulthood, with equal frequency in males and females. Penetrance is not known but is thought to be 100%.
Source: GeneReviews — "LMNB1-Related Autosomal Dominant Leukodystrophy"
Subsequent onset of motor and cerebellar impairment resulting in spasticity, ataxia, and tremor
MRI findings. Brain and spinal cord MRI findings can precede clinical manifestations by decades. Specific brain and spine MRI findings suggestive of LMNB1-related ADLD [, , , )] include the following:
Source: GeneReviews — "LMNB1-Related Autosomal Dominant Leukodystrophy"
The differential diagnosis of LMNB1-related autosomal dominant leukodystrophy (ADLD) includes other leukodystrophies with adult onset as well as acquired demyelinating disorders such as multiple sclerosis.
Multiple sclerosis (MS) is an inflammatory disease that affects central nervous system white matter. The age of presentation and combination of motor, cerebellar, and autonomic manifestations make this disorder in some instances similar to LMNB1-related ADLD . Unlike the brain MRI in LMNB1-related ADLD, the brain MRI in MS is characterized by multifocal lesions mainly around the periventricular area, brain stem, cerebellum, and spinal cord . CSF contains high IgG and oligoclonal bands .
Source: GeneReviews — "LMNB1-Related Autosomal Dominant Leukodystrophy"
Genetic testing for LMNB1 is available. Testing is considered confirmatory for diagnosis.
System/Concern | Evaluation | Comment |
|---|---|---|
Neurologic | Neurologist | For evidence of autonomic dysfunction (e.g., orthostatic hypotension), abnormal tone, /or tremor Urogenital |
dysfunction | Urologic eval | For urinary dysfunction, recurrent urinary tract infection, erectile dysfunction |
Bowel dysfunction | Gastroenterology assessment | Upper motor |
neuron dysfunction | Assessment by rehab specialists | To incl equipment needs |
Cognitive function | Neuropsychological assessment | Jaw tremor |
pseudobulbar palsy | Eval of chewing, speech, swallowing | — |
Hearing loss | Audiologic assessment | — |
Genetic counseling | By genetics professionals1 | To inform patients their families re nature, MOI, implications of ADLD in order to facilitate medical personal decision making Family support resources |
Treatment of Manifestations in Individuals with LMNB1-related Autosomal Dominant Leukodystrophy (ADLD) Manifestation/Concern | Treatment | Considerations/Other |
Constipation | Good hydration dietary fiber | Stool softeners (e.g., docusate) or a laxative may be needed. Orthostatic hypotension |
Erectile dysfunction | Medical treatment w/sildenafil | — |
Anhidrosis | Avoid overheating. | Can use cooling vests, fans, air conditioning; Intensive mgmt of infections should incl adequate antipyretic treatment. |
Feeding difficulties assoc w/pseudobulbar palsy | Speech therapy appropriate feeding interventions to assure adequate nutrition while preventing aspiration pneumonia | Work w/social worker financial planner to help anticipate issues of guardianship that may accompany progressive decline.; Family patient support/advocacy groups to help address progressive psychosocial consequences of ADLD |
Source: GeneReviews — "LMNB1-Related Autosomal Dominant Leukodystrophy"
Because disease manifestations may be exacerbated with fever and infection, care should be taken to avoid whenever possible exposure to those with infections.
Source: GeneReviews — "LMNB1-Related Autosomal Dominant Leukodystrophy"
Search ClinicalTrials.gov in the US and EU Clinical Trials Register in Europe for access to information on clinical studies for a wide range of diseases and conditions. Note: There may not be clinical trials for this disorder.
Source: GeneReviews — "LMNB1-Related Autosomal Dominant Leukodystrophy"
View trials for microcephaly 26, primary, autosomal dominant
Source: GeneReviews — "LMNB1-Related Autosomal Dominant Leukodystrophy"
Phenotype severity distribution: 3 always present features, 2 very common features, 10 common features.