De novo mutations in epileptic encephalopathies

Nature. 2013 Sep 12;501(7466):217-21. doi: 10.1038/nature12439. Epub 2013 Aug 11.

Abstract

Epileptic encephalopathies are a devastating group of severe childhood epilepsy disorders for which the cause is often unknown. Here we report a screen for de novo mutations in patients with two classical epileptic encephalopathies: infantile spasms (n = 149) and Lennox-Gastaut syndrome (n = 115). We sequenced the exomes of 264 probands, and their parents, and confirmed 329 de novo mutations. A likelihood analysis showed a significant excess of de novo mutations in the ∼4,000 genes that are the most intolerant to functional genetic variation in the human population (P = 2.9 × 10(-3)). Among these are GABRB3, with de novo mutations in four patients, and ALG13, with the same de novo mutation in two patients; both genes show clear statistical evidence of association with epileptic encephalopathy. Given the relevant site-specific mutation rates, the probabilities of these outcomes occurring by chance are P = 4.1 × 10(-10) and P = 7.8 × 10(-12), respectively. Other genes with de novo mutations in this cohort include CACNA1A, CHD2, FLNA, GABRA1, GRIN1, GRIN2B, HNRNPU, IQSEC2, MTOR and NEDD4L. Finally, we show that the de novo mutations observed are enriched in specific gene sets including genes regulated by the fragile X protein (P < 10(-8)), as has been reported previously for autism spectrum disorders.

Publication types

  • Research Support, American Recovery and Reinvestment Act
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child Development Disorders, Pervasive
  • Cohort Studies
  • Exome / genetics
  • Female
  • Fragile X Mental Retardation Protein / metabolism
  • Genetic Predisposition to Disease / genetics
  • Humans
  • Infant
  • Intellectual Disability / genetics*
  • Intellectual Disability / physiopathology
  • Lennox Gastaut Syndrome
  • Male
  • Mutation / genetics*
  • Mutation Rate
  • N-Acetylglucosaminyltransferases / genetics
  • Probability
  • Receptors, GABA-A / genetics
  • Spasms, Infantile / genetics*
  • Spasms, Infantile / physiopathology

Substances

  • FMR1 protein, human
  • GABRB3 protein, human
  • Receptors, GABA-A
  • Fragile X Mental Retardation Protein
  • ALG13 protein, human
  • N-Acetylglucosaminyltransferases

Supplementary concepts

  • Epileptic encephalopathy, Lennox-Gastaut type