{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T14:17:21Z","timestamp":1788617841300,"version":"build-2803163510"},"reference-count":48,"publisher":"National Academy of Sciences","issue":"51","license":[{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000065","name":"HHS | NIH | National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["NIH R01 NS106985"],"award-info":[{"award-number":["NIH R01 NS106985"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"HHS | NIH | National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["NIH R01 NS106985"],"award-info":[{"award-number":["NIH R01 NS106985"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.pnas.org"],"crossmark-restriction":true},"short-container-title":["Proc. Natl. Acad. Sci. U.S.A."],"published-print":{"date-parts":[[2023,12,19]]},"abstract":"<jats:p>\n                    Idiopathic normal pressure hydrocephalus (iNPH) is an enigmatic neurological disorder that develops after age 60 and is characterized by gait difficulty, dementia, and incontinence. Recently, we reported that heterozygous\n                    <jats:italic>CWH43<\/jats:italic>\n                    deletions may cause iNPH. Here, we identify mutations affecting nine additional genes (\n                    <jats:italic>AK9<\/jats:italic>\n                    ,\n                    <jats:italic>RXFP2, PRKD1, HAVCR1, OTOG, MYO7A, NOTCH1, SPG11, and MYH13<\/jats:italic>\n                    ) that are statistically enriched among iNPH patients. The encoded proteins are all highly expressed in choroid plexus and ependymal cells, and most have been associated with cilia. Damaging mutations in\n                    <jats:italic>AK9<\/jats:italic>\n                    , which encodes an adenylate kinase, were detected in 9.6% of iNPH patients. Mice homozygous for an iNPH-associated\n                    <jats:italic>AK9<\/jats:italic>\n                    mutation displayed normal cilia structure and number, but decreased cilia motility and beat frequency, communicating hydrocephalus, and balance impairment.\n                    <jats:italic>AK9<\/jats:italic>\n                    +\/\u2212 mice displayed normal brain development and behavior until early adulthood, but subsequently developed communicating hydrocephalus. Together, our findings suggest that heterozygous mutations that impair ventricular epithelial function may contribute to iNPH.\n                  <\/jats:p>","DOI":"10.1073\/pnas.2300681120","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T13:31:56Z","timestamp":1702647116000},"update-policy":"https:\/\/doi.org\/10.1073\/pnas.cm10313","source":"Crossref","is-referenced-by-count":25,"title":["A role for mutations in\n                    <i>AK9<\/i>\n                    and other genes affecting ependymal cells in idiopathic normal pressure hydrocephalus"],"prefix":"10.1073","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2367-4692","authenticated-orcid":false,"given":"Hong Wei","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Massachusetts Chan Medical School, Worcester, MA 01655"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9015-6046","authenticated-orcid":false,"given":"Semin","family":"Lee","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Boston, MA 02115"},{"name":"Harvard Medical School, Boston, MA 02115"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethany C.","family":"Berry","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Massachusetts Chan Medical School, Worcester, MA 01655"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5118-0652","authenticated-orcid":false,"given":"Dejun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Massachusetts Chan Medical School, Worcester, MA 01655"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaokuan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Massachusetts Chan Medical School, Worcester, MA 01655"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6804-7177","authenticated-orcid":false,"given":"Rona S.","family":"Carroll","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Massachusetts Chan Medical School, Worcester, MA 01655"},{"name":"Brigham and Women\u2019s Hospital, Boston, MA 02115"},{"name":"Harvard Medical School, Boston, MA 02115"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9378-960X","authenticated-orcid":false,"given":"Peter J.","family":"Park","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Boston, MA 02115"},{"name":"Harvard Medical School, Boston, MA 02115"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Massachusetts Chan Medical School, Worcester, MA 01655"},{"name":"Department of Neurological Surgery, University of Massachusetts Memorial Health, Worcester, MA 01655"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"341","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"key":"e_1_3_4_1_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196507152730301"},{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3171\/2016.6.JNS16496"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1159\/000186501"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.2176\/nmc.48.197"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2015.07.005"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000342"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.3171\/foc.2007.22.5.2"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.40.4.331"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.27.1.24"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/2045-8118-11-19"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.60.3.282"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s007010200033"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000363408.69856.B8"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007505"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2012.07.062"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.31958"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2016.06.052"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2011.06.018"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0166615"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.15252\/emmm.202013249"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkw971"},{"key":"e_1_3_4_22_2","unstructured":"M. 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