MTOR and nervous system disorder: Tao et al. (2019) showed that miR-4465 significantly inhibited the expression of PTEN, upregulated phosphorylated AKT and ultimately inhibited autophagy by activating mTOR in HEK293, HeLa, and SH-SY5Y cells (Tao et al., 2019). Half dosage of hsa-mir-4465 in our patient is expected to cause upregulation of PTEN, contributing to postsynaptic impairment. MiRNAs are important regulators of brain development and neuronal function, and have been associated with a variety of nervous system diseases, including ASD (Cheng et al., 2018; Wu et al., 2020).