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Leclert V, Laurencin C, Ameli R, Hermier M, Flaus A, Prange S, Lesca G, Thobois S. Globus Pallidus Lesion With Iron Deposition and Dopaminergic Denervation in a Patient With a Pathogenic SLC6A1 Variant: A Case Report. Neurol Genet 2024; 10:e200136. [PMID: 38515990 PMCID: PMC10955334 DOI: 10.1212/nxg.0000000000200136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/19/2024] [Indexed: 03/23/2024]
Abstract
Objectives SLC6A1-related disorders encompass heterogeneous neuropsychiatric manifestations through GABAergic dysregulation, without any specific abnormalities on brain MRI, nor evidence of dopaminergic cell loss on I123-FP-β-CIT SPECT. We report here a case of globus pallidus lesions and dopaminergic denervation in a patient with a pathogenic SLC6A1 variant. Methods A 26-year-old female patient with intellectual disability, behavioral, and psychiatric disorders treated by neuroleptics for many years developed a parkinsonian syndrome associated with mild hand dystonia and chorea. A 3T brain MRI and I123-FP-β-CIT SPECT were performed. Results MRI of the brain found bilateral pallidal lesions consistent with neurodegeneration with iron accumulation. The I123-FP-β-CIT SPECT showed bilateral striatal presynaptic dopaminergic denervation. Whole-genome sequencing revealed a pathogenic SLC6A1 de novo variant. No additional variant was found in any of the genes responsible for Neurodegeneration with Brain Iron Accumulation (NBIA). Discussion This is a description of dopaminergic denervation and globus pallidus lesions with iron accumulation related to a SLC6A1 pathogenic variant. These findings expand the phenotype of SLC6A1-related disorder and suggest that it could be considered as a differential diagnosis of NBIA.
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Affiliation(s)
- Victoire Leclert
- From the Department of Neurology C (V.L., C.L., S.P., S.T.), Expert Parkinson Center NS-PARK/FCRIN, Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital, Bron; Lyon Neuroscience Research Center (C.L., A.F.), UMR5292, INSERM U1028/CNRS; Department of Neuroradiology (R.A., M.H.); Nuclear Medicine Department (A.F.), Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital; Marc Jeannerod Cognitive Neuroscience Institute (S.P., S.T.), CNRS, UMR 5229, Bron; Faculté de Médecine et Maïeutique Lyon Sud Charles-Mérieux (S.P., G.L., S.T.), Université de Lyon, Université Claude-Bernard Lyon I; Department of Genetics (G.L.), Hospices Civils de Lyon, Mother Child Hospital, Bron; and Physiopathology and Genetics of Neurons and Muscles (G.L.), UMR5261, U1315, Institut NeuroMyoGène, Lyon, France
| | - Chloe Laurencin
- From the Department of Neurology C (V.L., C.L., S.P., S.T.), Expert Parkinson Center NS-PARK/FCRIN, Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital, Bron; Lyon Neuroscience Research Center (C.L., A.F.), UMR5292, INSERM U1028/CNRS; Department of Neuroradiology (R.A., M.H.); Nuclear Medicine Department (A.F.), Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital; Marc Jeannerod Cognitive Neuroscience Institute (S.P., S.T.), CNRS, UMR 5229, Bron; Faculté de Médecine et Maïeutique Lyon Sud Charles-Mérieux (S.P., G.L., S.T.), Université de Lyon, Université Claude-Bernard Lyon I; Department of Genetics (G.L.), Hospices Civils de Lyon, Mother Child Hospital, Bron; and Physiopathology and Genetics of Neurons and Muscles (G.L.), UMR5261, U1315, Institut NeuroMyoGène, Lyon, France
| | - Roxana Ameli
- From the Department of Neurology C (V.L., C.L., S.P., S.T.), Expert Parkinson Center NS-PARK/FCRIN, Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital, Bron; Lyon Neuroscience Research Center (C.L., A.F.), UMR5292, INSERM U1028/CNRS; Department of Neuroradiology (R.A., M.H.); Nuclear Medicine Department (A.F.), Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital; Marc Jeannerod Cognitive Neuroscience Institute (S.P., S.T.), CNRS, UMR 5229, Bron; Faculté de Médecine et Maïeutique Lyon Sud Charles-Mérieux (S.P., G.L., S.T.), Université de Lyon, Université Claude-Bernard Lyon I; Department of Genetics (G.L.), Hospices Civils de Lyon, Mother Child Hospital, Bron; and Physiopathology and Genetics of Neurons and Muscles (G.L.), UMR5261, U1315, Institut NeuroMyoGène, Lyon, France
| | - Marc Hermier
- From the Department of Neurology C (V.L., C.L., S.P., S.T.), Expert Parkinson Center NS-PARK/FCRIN, Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital, Bron; Lyon Neuroscience Research Center (C.L., A.F.), UMR5292, INSERM U1028/CNRS; Department of Neuroradiology (R.A., M.H.); Nuclear Medicine Department (A.F.), Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital; Marc Jeannerod Cognitive Neuroscience Institute (S.P., S.T.), CNRS, UMR 5229, Bron; Faculté de Médecine et Maïeutique Lyon Sud Charles-Mérieux (S.P., G.L., S.T.), Université de Lyon, Université Claude-Bernard Lyon I; Department of Genetics (G.L.), Hospices Civils de Lyon, Mother Child Hospital, Bron; and Physiopathology and Genetics of Neurons and Muscles (G.L.), UMR5261, U1315, Institut NeuroMyoGène, Lyon, France
| | - Anthime Flaus
- From the Department of Neurology C (V.L., C.L., S.P., S.T.), Expert Parkinson Center NS-PARK/FCRIN, Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital, Bron; Lyon Neuroscience Research Center (C.L., A.F.), UMR5292, INSERM U1028/CNRS; Department of Neuroradiology (R.A., M.H.); Nuclear Medicine Department (A.F.), Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital; Marc Jeannerod Cognitive Neuroscience Institute (S.P., S.T.), CNRS, UMR 5229, Bron; Faculté de Médecine et Maïeutique Lyon Sud Charles-Mérieux (S.P., G.L., S.T.), Université de Lyon, Université Claude-Bernard Lyon I; Department of Genetics (G.L.), Hospices Civils de Lyon, Mother Child Hospital, Bron; and Physiopathology and Genetics of Neurons and Muscles (G.L.), UMR5261, U1315, Institut NeuroMyoGène, Lyon, France
| | - Stephane Prange
- From the Department of Neurology C (V.L., C.L., S.P., S.T.), Expert Parkinson Center NS-PARK/FCRIN, Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital, Bron; Lyon Neuroscience Research Center (C.L., A.F.), UMR5292, INSERM U1028/CNRS; Department of Neuroradiology (R.A., M.H.); Nuclear Medicine Department (A.F.), Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital; Marc Jeannerod Cognitive Neuroscience Institute (S.P., S.T.), CNRS, UMR 5229, Bron; Faculté de Médecine et Maïeutique Lyon Sud Charles-Mérieux (S.P., G.L., S.T.), Université de Lyon, Université Claude-Bernard Lyon I; Department of Genetics (G.L.), Hospices Civils de Lyon, Mother Child Hospital, Bron; and Physiopathology and Genetics of Neurons and Muscles (G.L.), UMR5261, U1315, Institut NeuroMyoGène, Lyon, France
| | - Gaetan Lesca
- From the Department of Neurology C (V.L., C.L., S.P., S.T.), Expert Parkinson Center NS-PARK/FCRIN, Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital, Bron; Lyon Neuroscience Research Center (C.L., A.F.), UMR5292, INSERM U1028/CNRS; Department of Neuroradiology (R.A., M.H.); Nuclear Medicine Department (A.F.), Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital; Marc Jeannerod Cognitive Neuroscience Institute (S.P., S.T.), CNRS, UMR 5229, Bron; Faculté de Médecine et Maïeutique Lyon Sud Charles-Mérieux (S.P., G.L., S.T.), Université de Lyon, Université Claude-Bernard Lyon I; Department of Genetics (G.L.), Hospices Civils de Lyon, Mother Child Hospital, Bron; and Physiopathology and Genetics of Neurons and Muscles (G.L.), UMR5261, U1315, Institut NeuroMyoGène, Lyon, France
| | - Stephane Thobois
- From the Department of Neurology C (V.L., C.L., S.P., S.T.), Expert Parkinson Center NS-PARK/FCRIN, Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital, Bron; Lyon Neuroscience Research Center (C.L., A.F.), UMR5292, INSERM U1028/CNRS; Department of Neuroradiology (R.A., M.H.); Nuclear Medicine Department (A.F.), Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital; Marc Jeannerod Cognitive Neuroscience Institute (S.P., S.T.), CNRS, UMR 5229, Bron; Faculté de Médecine et Maïeutique Lyon Sud Charles-Mérieux (S.P., G.L., S.T.), Université de Lyon, Université Claude-Bernard Lyon I; Department of Genetics (G.L.), Hospices Civils de Lyon, Mother Child Hospital, Bron; and Physiopathology and Genetics of Neurons and Muscles (G.L.), UMR5261, U1315, Institut NeuroMyoGène, Lyon, France
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Mori T, Sakamoto M, Tayama T, Goji A, Toda Y, Fujita A, Mizuguchi T, Urushihara M, Matsumoto N. A case of epilepsy with myoclonic atonic seizures caused by SLC6A1 gene mutation due to balanced chromosomal translocation. Brain Dev 2023:S0387-7604(23)00044-X. [PMID: 36966012 DOI: 10.1016/j.braindev.2023.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/02/2023] [Accepted: 03/05/2023] [Indexed: 03/27/2023]
Abstract
INTRODUCTION Epilepsy with myoclonic atonic seizures (EMAtS) was previously thought to occur in normally developing children. We report a female case of EMAtS and mild developmental delay before onset. Importantly, a de novo balanced chromosomal translocation was recognized in the patient. CASE PRESENTATION The patient was a 4-year-old girl. Mild developmental delay was observed during infancy. At the age of one and a half years, she developed atonic seizures once a month. At 4 years of age, her seizures increased to more than 10 times per hour. An ictal electroencephalogram (EEG) showed a 3-4-Hz spike-and-wave complex, which was consistent with atonic and myoclonic seizures of the trunk, eyelids, and lips. Therefore, EMAtS was diagnosed based on the symptoms and EEG findings. After administration of valproic acid (VPA), the epileptic seizures disappeared immediately. At the age of 5 years and 2 months, the seizures recurred but disappeared again when the dose of VPA was increased. Subsequently, no recurrence was observed until 6 years and 3 months of age on VPA and lamotrigine. Chromosome analysis of the patient disclosed 46,XX,t(3;11)(p25;q13.1)dn. Long-read sequencing of the the patient's genomic DNA revealed that the 3p25.3 translocation breakpoint disrupted the intron 7 of the SLC6A1 gene. CONCLUSION The SLC6A1 disruption by chromosome translocation well explains the clinical features of this patient. Long-read sequencing is a powerful technique to determine genomic abnormality at the nucleotide level for disease-associated chromosomal abnormality.
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Affiliation(s)
- Tatsuo Mori
- Department of Pediatrics, Graduate School of Biomedical Sciences, Tokushima University, Japan; Division of Epilepsy Center, Tokushima University Hospital, Japan.
| | - Masamune Sakamoto
- Department of Human Genetics, Yokohama City University, Graduate School of Medicine, Japan; Department of Pediatrics, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Takahiro Tayama
- Department of Pediatrics, Graduate School of Biomedical Sciences, Tokushima University, Japan; Division of Epilepsy Center, Tokushima University Hospital, Japan
| | - Aya Goji
- Department of Pediatrics, Graduate School of Biomedical Sciences, Tokushima University, Japan; Division of Epilepsy Center, Tokushima University Hospital, Japan
| | - Yoshihiro Toda
- Department of Pediatrics, Graduate School of Biomedical Sciences, Tokushima University, Japan; Division of Epilepsy Center, Tokushima University Hospital, Japan
| | - Atsushi Fujita
- Department of Human Genetics, Yokohama City University, Graduate School of Medicine, Japan
| | - Takeshi Mizuguchi
- Department of Human Genetics, Yokohama City University, Graduate School of Medicine, Japan
| | - Maki Urushihara
- Department of Pediatrics, Graduate School of Biomedical Sciences, Tokushima University, Japan
| | - Naomichi Matsumoto
- Department of Pediatrics, Graduate School of Biomedical Sciences, Tokushima University, Japan
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Goodspeed K, Mosca LR, Weitzel NC, Horning K, Simon EW, Pfalzer AC, Xia M, Langer K, Freed A, Bone M, Picone M, Bichell TJV. A draft conceptual model of SLC6A1 neurodevelopmental disorder. Front Neurosci 2023; 16:1026065. [PMID: 36741059 PMCID: PMC9893116 DOI: 10.3389/fnins.2022.1026065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 12/05/2022] [Indexed: 01/21/2023] Open
Abstract
Introduction SLC6A1 Neurodevelopmental Disorder (SLC6A1-NDD), first described in 2015, is a rare syndrome caused by a mutation in the SLC6A1 gene which encodes for the GABA Transporter 1 (GAT-1) protein. Epilepsy is one of the most common symptoms in patients and is often the primary treatment target, though the severity of epilepsy is variable. The impact of seizures and other symptoms of SLC6A1-NDD on patients and caregivers is wide-ranging and has not been described in a formal disease concept study. Methods A literature search was performed using the simple search term, "SLC6A1." Papers published before 2015, and those which did not describe the human neurodevelopmental disorder were removed from analysis. Open-ended interviews on lived experiences were conducted with two patient advocate key opinion leaders. An analysis of de-identified conversations between families of people with SLC6A1-NDD on social media was performed to quantify topics of concern. Results Published literature described symptoms in all of the following domains: neurological, visual, motor, cognitive, communication, behavior, gastrointestinal, sleep, musculo-skeletal, and emotional in addition to epilepsy. Key opinion leaders noted two unpublished features: altered hand use in infants, and developmental regression with onset of epilepsy. Analysis of social media interactions confirmed that the core symptoms of epilepsy and autistic traits were prominent concerns, but also demonstrated that other symptoms have a large impact on family life. Discussion For rare diseases, analysis of published literature is important, but may not be as comprehensive as that which can be gleaned from spontaneous interactions between families and through qualitative interviews. This report reflects our current understanding of the lived experience of SLC6A1-NDD. The discrepancy between the domains of disease reported in the literature and those discussed in patient conversations suggests that a formal qualitative interview-based disease concept study of SLC6A1-NDD is warranted.
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Affiliation(s)
- Kimberly Goodspeed
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States,*Correspondence: Kimberly Goodspeed,
| | - Lindsay R. Mosca
- College of Arts and Sciences, Vanderbilt University, Nashville, TN, United States
| | - Nicole C. Weitzel
- College of Arts and Sciences, Vanderbilt University, Nashville, TN, United States
| | | | - Elijah W. Simon
- College of Arts and Sciences, Vanderbilt University, Nashville, TN, United States
| | | | - Maya Xia
- COMBINEDBrain, Brentwood, TN, United States
| | - Katherine Langer
- College of Arts and Sciences, Vanderbilt University, Nashville, TN, United States
| | | | - Megan Bone
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Maria Picone
- TREND Community, Philadelphia, PA, United States
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Maurer-Morelli CV, de Vasconcellos JF, Bruxel EM, Rocha CS, do Canto AM, Tedeschi H, Yasuda CL, Cendes F, Lopes-Cendes I. Gene expression profile suggests different mechanisms underlying sporadic and familial mesial temporal lobe epilepsy. Exp Biol Med (Maywood) 2022; 247:2233-2250. [PMID: 36259630 PMCID: PMC9899983 DOI: 10.1177/15353702221126666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Most patients with pharmacoresistant mesial temporal lobe epilepsy (MTLE) have hippocampal sclerosis on the postoperative histopathological examination. Although most patients with MTLE do not refer to a family history of the disease, familial forms of MTLE have been reported. We studied surgical specimens from patients with MTLE who had epilepsy surgery for medically intractable seizures. We assessed and compared gene expression profiles of the tissue lesion found in patients with familial MTLE (n = 3) and sporadic MTLE (n = 5). In addition, we used data from control hippocampi obtained from a public database (n = 7). We obtained expression profiles using the Human Genome U133 Plus 2.0 (Affymetrix) microarray platform. Overall, the molecular profile identified in familial MTLE differed from that in sporadic MTLE. In the tissue of patients with familial MTLE, we found an over-representation of the biological pathways related to protein response, mRNA processing, and synaptic plasticity and function. In sporadic MTLE, the gene expression profile suggests that the inflammatory response is highly activated. In addition, we found enrichment of gene sets involved in inflammatory cytokines and mediators and chemokine receptor pathways in both groups. However, in sporadic MTLE, we also found enrichment of epidermal growth factor signaling, prostaglandin synthesis and regulation, and microglia pathogen phagocytosis pathways. Furthermore, based on the gene expression signatures, we identified different potential compounds to treat patients with familial and sporadic MTLE. To our knowledge, this is the first study assessing the mRNA profile in surgical tissue obtained from patients with familial MTLE and comparing it with sporadic MTLE. Our results clearly show that, despite phenotypic similarities, both forms of MTLE present distinct molecular signatures, thus suggesting different underlying molecular mechanisms that may require distinct therapeutic approaches.
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Affiliation(s)
- Claudia V Maurer-Morelli
- Department of Translational Medicine,
School of Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-888,
Brazil,Brazilian Institute of Neuroscience and
Neurotechnology (BRAINN), Campinas 13083-888, Brazil
| | - Jaira F de Vasconcellos
- Department of Translational Medicine,
School of Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-888,
Brazil,Department of Biology, James Madison
University, Harrisonburg, VA 22807, USA
| | - Estela M Bruxel
- Department of Translational Medicine,
School of Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-888,
Brazil,Brazilian Institute of Neuroscience and
Neurotechnology (BRAINN), Campinas 13083-888, Brazil
| | - Cristiane S Rocha
- Department of Translational Medicine,
School of Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-888,
Brazil,Brazilian Institute of Neuroscience and
Neurotechnology (BRAINN), Campinas 13083-888, Brazil
| | - Amanda M do Canto
- Department of Translational Medicine,
School of Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-888,
Brazil,Brazilian Institute of Neuroscience and
Neurotechnology (BRAINN), Campinas 13083-888, Brazil
| | - Helder Tedeschi
- Department of Neurology, School of
Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-887, Brazil
| | - Clarissa L Yasuda
- Brazilian Institute of Neuroscience and
Neurotechnology (BRAINN), Campinas 13083-888, Brazil,Department of Neurology, School of
Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-887, Brazil
| | - Fernando Cendes
- Brazilian Institute of Neuroscience and
Neurotechnology (BRAINN), Campinas 13083-888, Brazil,Department of Neurology, School of
Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-887, Brazil
| | - Iscia Lopes-Cendes
- Department of Translational Medicine,
School of Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-888,
Brazil,Brazilian Institute of Neuroscience and
Neurotechnology (BRAINN), Campinas 13083-888, Brazil,Iscia Lopes-Cendes.
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Lie MEK, Kickinger S, Skovgaard-Petersen J, Ecker GF, Clausen RP, Schousboe A, White HS, Wellendorph P. Pharmacological Characterization of a Betaine/GABA Transporter 1 (BGT1) Inhibitor Displaying an Unusual Biphasic Inhibition Profile and Anti-seizure Effects. Neurochem Res 2020; 45:1551-1565. [PMID: 32248400 PMCID: PMC7297817 DOI: 10.1007/s11064-020-03017-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/09/2020] [Accepted: 03/18/2020] [Indexed: 12/01/2022]
Abstract
Focal epileptic seizures can in some patients be managed by inhibiting γ-aminobutyric acid (GABA) uptake via the GABA transporter 1 (GAT1) using tiagabine (Gabitril®). Synergistic anti-seizure effects achieved by inhibition of both GAT1 and the betaine/GABA transporter (BGT1) by tiagabine and EF1502, compared to tiagabine alone, suggest BGT1 as a target in epilepsy. Yet, selective BGT1 inhibitors are needed for validation of this hypothesis. In that search, a series of BGT1 inhibitors typified by (1R,2S)-2-((4,4-bis(3-methylthiophen-2-yl)but-3-en-yl)(methyl)amino)cyclohexanecarboxylic acid (SBV2-114) was developed. A thorough pharmacological characterization of SBV2-114 using a cell-based [3H]GABA uptake assay at heterologously expressed BGT1, revealed an elusive biphasic inhibition profile with two IC50 values (4.7 and 556 μM). The biphasic profile was common for this structural class of compounds, including EF1502, and was confirmed in the MDCK II cell line endogenously expressing BGT1. The possibility of two binding sites for SBV2-114 at BGT1 was assessed by computational docking studies and examined by mutational studies. These investigations confirmed that the conserved residue Q299 in BGT1 is involved in, but not solely responsible for the biphasic inhibition profile of SBV2-114. Animal studies revealed anti-seizure effects of SBV2-114 in two mouse models, supporting a function of BGT1 in epilepsy. However, as SBV2-114 is apparent to be rather non-selective for BGT1, the translational relevance of this observation is unknown. Nevertheless, SBV2-114 constitutes a valuable tool compound to study the molecular mechanism of an emerging biphasic profile of BGT1-mediated GABA transport and the putative involvement of two binding sites for this class of compounds.
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Affiliation(s)
- Maria E K Lie
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.
| | - Stefanie Kickinger
- Department of Pharmaceutical Chemistry, University of Vienna, Vienna, Austria
| | | | - Gerhard F Ecker
- Department of Pharmaceutical Chemistry, University of Vienna, Vienna, Austria
| | - Rasmus P Clausen
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Arne Schousboe
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - H Steve White
- Department of Pharmacy, University of Washington, Washington, USA
| | - Petrine Wellendorph
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
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Zaręba P, Gryzło B, Malawska K, Sałat K, Höfner GC, Nowaczyk A, Fijałkowski Ł, Rapacz A, Podkowa A, Furgała A, Żmudzki P, Wanner KT, Malawska B, Kulig K. Novel mouse GABA uptake inhibitors with enhanced inhibitory activity toward mGAT3/4 and their effect on pain threshold in mice. Eur J Med Chem 2020; 188:111920. [DOI: 10.1016/j.ejmech.2019.111920] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 11/16/2019] [Accepted: 11/27/2019] [Indexed: 12/12/2022]
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Kessi M, Peng J, Yang L, Xiong J, Duan H, Pang N, Yin F. Genetic etiologies of the electrical status epilepticus during slow wave sleep: systematic review. BMC Genet 2018; 19:40. [PMID: 29976148 PMCID: PMC6034250 DOI: 10.1186/s12863-018-0628-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 06/19/2018] [Indexed: 12/25/2022] Open
Abstract
Background Electrical status epilepticus during slow-wave sleep (ESESS) which is also known as continuous spike-wave of slow sleep (CSWSS) is type of electroencephalographic (EEG) pattern which is seen in ESESS/CSWSS/epilepsy aphasia spectrum. This EEG pattern can occur alone or with other syndromes. Its etiology is not clear, however, brain malformations, immune disorders, and genetic etiologies are suspected to contribute. We aimed to perform a systematic review of all genetic etiologies which have been reported to associate with ESESS/CSWSS/epilepsy-aphasia spectrum. We further aimed to identify the common underlying pathway which can explain it. To our knowledge, there is no available systematic review of genetic etiologies of ESESS/CSWSS/epilepsy-aphasia spectrum. MEDLINE, EMBASE, PubMed and Cochrane review database were searched, using terms specific to electrical status epilepticus during sleep or continuous spike–wave discharges during slow sleep or epilepsy-aphasia spectrum and of studies of genetic etiologies. These included monogenic mutations and copy number variations (CNVs). For each suspected dosage-sensitive gene, further studies were performed through OMIM and PubMed database. Results Twenty-six studies out of the 136 identified studies satisfied our inclusion criteria. I51 cases were identified among those 26 studies. 16 studies reported 11 monogenic mutations: SCN2A (N = 6), NHE6/SLC9A6 (N = 1), DRPLA/ ATN1 (N = 1), Neuroserpin/SRPX2 (N = 1), OPA3 (N = 1), KCNQ2 (N = 2), KCNA2 (N = 5), GRIN2A (N = 34), CNKSR2 (N = 2), SLC6A1 (N = 2) and KCNB1 (N = 5). 10 studies reported 89 CNVs including 9 recurrent ones: Xp22.12 deletion encompassing CNKSR2 (N = 6), 16p13 deletion encompassing GRIN2A (N = 4), 15q11.2–13.1 duplication (N = 15), 3q29 duplication (N = 11), 11p13 duplication (N = 2), 10q21.3 deletion (N = 2), 3q25 deletion (N = 2), 8p23.3 deletion (N = 2) and 9p24.2 (N = 2). 68 of the reported genetic etiologies including monogenic mutations and CNVs were detected in patients with ESESS/CSWSS/epilepsy aphasia spectrum solely. The most common underlying pathway was channelopathy (N = 56). Conclusions Our review suggests that genetic etiologies have a role to play in the occurrence of ESESS/CSWSS/epilepsy-aphasia spectrum. The common underlying pathway is channelopathy. Therefore we propose more genetic studies to be done for more discoveries which can pave a way for proper drug identification. We also suggest development of common cut-off value for spike-wave index to ensure common language among clinicians and researchers. Electronic supplementary material The online version of this article (10.1186/s12863-018-0628-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Miriam Kessi
- Department of Pediatrics, Xiangya Hospital, Central South University, 87 Xiang Ya Road, Changsha, 410008, Hunan Province, China. .,Kilimanjaro Christian Medical University College, 2240, Moshi, Tanzania.
| | - Jing Peng
- Department of Pediatrics, Xiangya Hospital, Central South University, 87 Xiang Ya Road, Changsha, 410008, Hunan Province, China
| | - Lifen Yang
- Department of Pediatrics, Xiangya Hospital, Central South University, 87 Xiang Ya Road, Changsha, 410008, Hunan Province, China
| | - Juan Xiong
- Department of Pediatrics, Xiangya Hospital, Central South University, 87 Xiang Ya Road, Changsha, 410008, Hunan Province, China
| | - Haolin Duan
- Department of Pediatrics, Xiangya Hospital, Central South University, 87 Xiang Ya Road, Changsha, 410008, Hunan Province, China
| | - Nan Pang
- Department of Pediatrics, Xiangya Hospital, Central South University, 87 Xiang Ya Road, Changsha, 410008, Hunan Province, China
| | - Fei Yin
- Department of Pediatrics, Xiangya Hospital, Central South University, 87 Xiang Ya Road, Changsha, 410008, Hunan Province, China.
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Johannesen KM, Gardella E, Linnankivi T, Courage C, de Saint Martin A, Lehesjoki AE, Mignot C, Afenjar A, Lesca G, Abi-Warde MT, Chelly J, Piton A, Merritt JL, Rodan LH, Tan WH, Bird LM, Nespeca M, Gleeson JG, Yoo Y, Choi M, Chae JH, Czapansky-Beilman D, Reichert SC, Pendziwiat M, Verhoeven JS, Schelhaas HJ, Devinsky O, Christensen J, Specchio N, Trivisano M, Weber YG, Nava C, Keren B, Doummar D, Schaefer E, Hopkins S, Dubbs H, Shaw JE, Pisani L, Myers CT, Tang S, Tang S, Pal DK, Millichap JJ, Carvill GL, Helbig KL, Mecarelli O, Striano P, Helbig I, Rubboli G, Mefford HC, Møller RS. Defining the phenotypic spectrum of SLC6A1 mutations. Epilepsia 2018; 59:389-402. [PMID: 29315614 DOI: 10.1111/epi.13986] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Pathogenic SLC6A1 variants were recently described in patients with myoclonic atonic epilepsy (MAE) and intellectual disability (ID). We set out to define the phenotypic spectrum in a larger cohort of SCL6A1-mutated patients. METHODS We collected 24 SLC6A1 probands and 6 affected family members. Four previously published cases were included for further electroclinical description. In total, we reviewed the electroclinical data of 34 subjects. RESULTS Cognitive development was impaired in 33/34 (97%) subjects; 28/34 had mild to moderate ID, with language impairment being the most common feature. Epilepsy was diagnosed in 31/34 cases with mean onset at 3.7 years. Cognitive assessment before epilepsy onset was available in 24/31 subjects and was normal in 25% (6/24), and consistent with mild ID in 46% (11/24) or moderate ID in 17% (4/24). Two patients had speech delay only, and 1 had severe ID. After epilepsy onset, cognition deteriorated in 46% (11/24) of cases. The most common seizure types were absence, myoclonic, and atonic seizures. Sixteen cases fulfilled the diagnostic criteria for MAE. Seven further patients had different forms of generalized epilepsy and 2 had focal epilepsy. Twenty of 31 patients became seizure-free, with valproic acid being the most effective drug. There was no clear-cut correlation between seizure control and cognitive outcome. Electroencephalography (EEG) findings were available in 27/31 patients showing irregular bursts of diffuse 2.5-3.5 Hz spikes/polyspikes-and-slow waves in 25/31. Two patients developed an EEG pattern resembling electrical status epilepticus during sleep. Ataxia was observed in 7/34 cases. We describe 7 truncating and 18 missense variants, including 4 recurrent variants (Gly232Val, Ala288Val, Val342Met, and Gly362Arg). SIGNIFICANCE Most patients carrying pathogenic SLC6A1 variants have an MAE phenotype with language delay and mild/moderate ID before epilepsy onset. However, ID alone or associated with focal epilepsy can also be observed.
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Affiliation(s)
- Katrine M Johannesen
- The Danish Epilepsy Center Filadelfia, Dianalund, Denmark.,Institute for Regional Health Services Research, University of Southern Denmark, Odense, Denmark
| | - Elena Gardella
- The Danish Epilepsy Center Filadelfia, Dianalund, Denmark.,Institute for Regional Health Services Research, University of Southern Denmark, Odense, Denmark
| | - Tarja Linnankivi
- Department of Child Neurology, Children's Hospital, Helsinki University Hospital Helsinki, University of Helsinki, Helsinki, Finland
| | - Carolina Courage
- The Folkhälsan Institute of Genetics, University of Helsinki, Helsinki, Finland.,Research Programs Unit, Molecular Neurology and Neuroscience Center, Helsinki, Finland
| | - Anne de Saint Martin
- Department of Pediatrics, Pediatric Neurology, University Hospital of Strasbourg, Strasbourg, France.,Reference Center for Rare Epilepsies, Strasbourg, France
| | - Anna-Elina Lehesjoki
- The Folkhälsan Institute of Genetics, University of Helsinki, Helsinki, Finland.,Research Programs Unit, Molecular Neurology and Neuroscience Center, Helsinki, Finland
| | - Cyril Mignot
- Department of Genetics, Center for Rare causes of Intellectual Disabilities and UPMC Research Group "Intellectual Disabilities and Autism", Paris, France
| | | | - Gaetan Lesca
- Departments of Genetics, Lyon University Hospitals, Lyon, France.,Claude Bernard Lyon I University, Lyon, France.,Lyon Neuroscience Research Center, CNRS UMRS5292, INSERM U1028, Lyon, France
| | - Marie-Thérèse Abi-Warde
- Department of Pediatrics, Pediatric Neurology, University Hospital of Strasbourg, Strasbourg, France.,Reference Center for Rare Epilepsies, Strasbourg, France
| | - Jamel Chelly
- Department of Translational Medicine and Neurogenetics, Institut Génétique Biologie Moléculaire Cellulaire (IGBMC), Illkirch, France.,Laboratory of Genetic Diagnosis, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Amélie Piton
- Department of Translational Medicine and Neurogenetics, Institut Génétique Biologie Moléculaire Cellulaire (IGBMC), Illkirch, France.,Laboratory of Genetic Diagnosis, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - J Lawrence Merritt
- Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Lance H Rodan
- Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Wen-Hann Tan
- Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Lynne M Bird
- Division of Genetics, Department of Pediatrics, Rady Children's Hospital San Diego, University of California San Diego, San Diego, CA, USA
| | - Mark Nespeca
- Division of Neurology, Rady Children's Hospital, University of California, San Diego, CA, USA
| | - Joseph G Gleeson
- Rady Children's Institute for Genomic Medicine, Howard Hughes Medical Institute, University of California, San Diego, CA, USA
| | - Yongjin Yoo
- Department of Biomedical Sciences, Seoul National University School of Medicine, Seoul, South Korea
| | - Murim Choi
- Department of Biomedical Sciences, Seoul National University School of Medicine, Seoul, South Korea
| | - Jong-Hee Chae
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University School of Medicine, Seoul, South Korea
| | | | | | - Manuela Pendziwiat
- Department of Neuropediatrics, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Judith S Verhoeven
- Department of Neurology, Academic Center for Epileptology, Heeze, The Netherlands
| | - Helenius J Schelhaas
- Department of Neurology, Academic Center for Epileptology, Heeze, The Netherlands
| | | | - Jakob Christensen
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - Nicola Specchio
- Neurology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Marina Trivisano
- Neurology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Yvonne G Weber
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tüebingen, Tüebingen, Germany
| | - Caroline Nava
- Department of Genetics, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Sorbonne Universities, UPMC Univ Paris 06, UMR S 1127, Inserm U 1127, CNRS UMR 7225, ICM, Paris, France
| | - Boris Keren
- Department of Genetics, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Sorbonne Universities, UPMC Univ Paris 06, UMR S 1127, Inserm U 1127, CNRS UMR 7225, ICM, Paris, France
| | - Diane Doummar
- Assistance Publique-Hôpitaux de Paris, Neuropediatric Services, Hospital Armand Trousseau, Paris, France
| | - Elise Schaefer
- Medical Genetics, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Sarah Hopkins
- Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Holly Dubbs
- Division of Clinical Genetics, Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - Jessica E Shaw
- Division of Clinical Genetics, Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - Laura Pisani
- Division of Clinical Genetics, Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - Candace T Myers
- Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Sha Tang
- Division of Clinical Genomics, Ambry Genetics, Aliso Viejo, CA, USA
| | - Shan Tang
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Deb K Pal
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - John J Millichap
- Epilepsy Center and Division of Neurology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Gemma L Carvill
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Oriano Mecarelli
- Department of Neurology and Psychiatry, Neurophysiopathology and Neuromuscular Diseases, University of Sapeinza, Rome, Italy
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, University of Genoa 'G. Gaslini" Institute, Genova, Italy
| | - Ingo Helbig
- Department of Neuropediatrics, University Medical Center Schleswig-Holstein, Kiel, Germany.,Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Guido Rubboli
- The Danish Epilepsy Center Filadelfia, Dianalund, Denmark.,University of Copenhagen, Copenhagen, Denmark
| | - Heather C Mefford
- Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Rikke S Møller
- The Danish Epilepsy Center Filadelfia, Dianalund, Denmark.,Institute for Regional Health Services Research, University of Southern Denmark, Odense, Denmark
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Astrocytic GABA Transporters: Pharmacological Properties and Targets for Antiepileptic Drugs. ADVANCES IN NEUROBIOLOGY 2017; 16:283-296. [PMID: 28828616 DOI: 10.1007/978-3-319-55769-4_14] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Inactivation of GABA-mediated neurotransmission is achieved by high-affinity transporters located at both GABAergic neurons and the surrounding astrocytes. Early studies of the pharmacological properties of neuronal and glial GABA transporters suggested that different types of transporters might be expressed in the two cell types, and such a scenario was confirmed by the cloning of four distinctly different GABA transporters from a number of different species. These GABA-transport entities have been extensively characterized using a large number of GABA analogues of restricted conformation, and several of these compounds have been shown to exhibit pronounced anticonvulsant activity in a variety of animal seizure models. As proof of concept of the validity of this drug development approach, one GABA-transport inhibitor, tiagabine, has been developed as a clinically active antiepileptic drug. This review provides a detailed account of efforts to design new subtype-selective GABA-transport inhibitors aiming at identifying novel antiepileptic drug candidates.
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