{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T21:01:02Z","timestamp":1782421262826,"version":"3.54.5"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,24]],"date-time":"2021-12-24T00:00:00Z","timestamp":1640304000000},"content-version":"vor","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Disruption of the <jats:italic>Neurobeachin<\/jats:italic> gene is a rare genetic mutation that has been implicated in the development of autism and enhanced long-term potentiation of the hippocampal CA1 region, causing a heightened conditioned fear response and impaired fear extinction. Prazosin, an alpha-1 receptor antagonist, has been used in patients with posttraumatic stress disorder to mitigate the increased alpha-1 activity involved in fear and startle responses. Here we report a case of a patient with a rare <jats:italic>Neurobeachin<\/jats:italic> gene deletion, who demonstrated marked and sustained improvement in paranoid behavior within days of prazosin initiation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>The patient is a 27-year-old White male with autism spectrum disorder, obsessive\u2013compulsive disorder, and schizophrenia, with a chromosome 13q12 deletion including deletion of the <jats:italic>Neurobeachin<\/jats:italic> gene, who presented to the emergency department due to worsening functional status and profound weight loss as a result of only eating prepackaged foods. He had not showered or changed clothes in several months prior to presentation. He was hospitalized in the inpatient psychiatric unit for 2\u00a0months before prazosin was initiated. During that time, he demonstrated paranoia as evidenced by heightened sensitivity to doors opening, guarded interactions, and limited communication with providers and other patients. He also exhibited poor grooming habits, with aversion to showering, shaving, and changing clothes. Since initiating prazosin, he has demonstrated a brighter affect, initiates and maintains conversations, showers and changes clothes on a regular basis, and eats a variety of foods. At the time of this report, the patient was discharged to live in an apartment with a caregiver after a 7-month inpatient hospitalization.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Low-dose prazosin shows rapid and sustained improvement in paranoid behavior in a patient with a rare <jats:italic>Neurobeachin<\/jats:italic> gene deletion. Prazosin has a relatively favorable side effect profile with once-daily dosing and low cost. Prazosin may provide clinical improvement in patients with <jats:italic>Neurobeachin<\/jats:italic> gene deletions due to its theoretical attenuation in fear response through alpha-1 antagonism.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-021-03209-2","type":"journal-article","created":{"date-parts":[[2021,12,24]],"date-time":"2021-12-24T00:05:56Z","timestamp":1640304356000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prazosin use in a patient with rare Neurobeachin gene deletion shows improvement in paranoid behavior: a case report"],"prefix":"10.1186","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2759-2539","authenticated-orcid":false,"given":"Christina Y.","family":"Cantwell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Fortman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Seegan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,24]]},"reference":[{"issue":"14","key":"3209_CR1","doi-asserted-by":"publisher","first-page":"3627","DOI":"10.1523\/JNEUROSCI.4644-03.2004","volume":"24","author":"Y Su","year":"2004","unstructured":"Su Y, Balice-Gordon RJ, Hess DM, Landsman DS, Minarcik J, Golden J, Hurwitz I, Liebhaber SA, Cooke NE. Neurobeachin is essential for neuromuscular synaptic transmission. J Neurosci. 2004;24(14):3627\u201336.","journal-title":"J Neurosci"},{"issue":"5","key":"3209_CR2","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1136\/jmg.40.5.352","volume":"40","author":"D Castermans","year":"2003","unstructured":"Castermans D, Wilquet V, Parthoens E, Huysmans C, Steyaert J, Swinnen L, et\u00a0al. The neurobeachin gene is disrupted by a translocation in a patient with idiopathic autism. J Med Genet. 2003;40(5):352\u20136.","journal-title":"J Med Genet"},{"issue":"23","key":"3209_CR3","doi-asserted-by":"publisher","first-page":"8551","DOI":"10.1523\/JNEUROSCI.20-23-08551.2000","volume":"20","author":"X Wang","year":"2000","unstructured":"Wang X, Herberg FW, Laue MM, Wullner C, Hu B, Petrasch-Parwez E, Kilimann MW. Neurobeachin: a protein kinase A-anchoring, beige\/Chediak-Higashi protein homolog implicated in neuronal membrane traffic. 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Haploinsufficiency of the autism candidate gene Neurobeachin induces autism-like behaviors and affects cellular and molecular processes of synaptic plasticity in mice. Neurobiol Dis. 2013;51:144\u201351.","journal-title":"Neurobiol Dis"},{"issue":"8","key":"3209_CR9","doi-asserted-by":"publisher","first-page":"13752","DOI":"10.1038\/s41598-018-30589-1","volume":"13","author":"B Lee","year":"2018","unstructured":"Lee B, Bang E, Yang WS, Paydar A, et\u00a0al. The possible role of neurobeachin in extinction of contextual fear memory. Sci Rep. 2018;13(8):13752.","journal-title":"Sci Rep"},{"issue":"1","key":"3209_CR10","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1097\/00004714-200202000-00013","volume":"22","author":"F Taylor","year":"2002","unstructured":"Taylor F, Raskind MA. The alpha-1-adrenergic antagonist prazosin improves sleep and nightmares in civilian trauma posttraumatic stress disorder. 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A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"612"}}