Regarding some functionality of these genes (TBC1D22A, CELSR1, and GRAMD4), we propose previously a region of 4.5 to 8 Mb from the telomere, strongly associated with macrocephaly in PMS [3], also supported by this study, and aligned with other works [21], suggesting to GRAMD4 associated with macrocephaly. The gene discussed is GRAMD4; the disease is Macrocephaly.