Multiple cases of parent-to-child transmission suggest that<unk>  exhibits autosomal dominant inheritance. Exome sequencing and expression studies have shown that BSS is caused by mutations in the TWIST2 gene that affect a highly conserved residue of TWIST2 (twist-related protein 2). TWIST2 is a basic helix-loop-helix transcription factor that binds to E-box DNA motifs (5'-CANNTG-3') as a heterodimer and inhibits transcriptional activation. Because TWIST2 mediates mesenchymal stem cell differentiation and prevents premature or ectopic osteoblast differentiation, mutations in TWIST2 that disrupt these functions by altering DNA-binding activity could explain many of the phenotypes of BSS.
Barber–Say syndrome
Cohen syndrome
Cohen-Gibson syndrome
Barakat syndrome
Catel–Manzke syndrome
Gleich's syndrome
Eiken syndrome
Neu–Laxova syndrome