1
|
Baer S, Schalk A, Miguet M, Schaefer É, El Chehadeh S, Ginglinger E, de Saint Martin A, Abi Wardé MT, Laugel V, de Feraudy Y, Gauer L, Hirsch E, Boulay C, Bansept C, Bolocan A, Kitadinis I, Gouronc A, Gérard B, Piton A, Scheidecker S. Copy Number Variation and Epilepsy: State of the Art in the Era of High-Throughput Sequencing-A Multicenter Cohort Study. Pediatr Neurol 2024; 159:16-25. [PMID: 39094250 DOI: 10.1016/j.pediatrneurol.2024.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 06/12/2024] [Accepted: 07/09/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Genetic epilepsy diagnosis is increasing due to technological advancements. Although the use of molecular diagnosis is increasing, chromosomal microarray analysis (CMA) remains an important diagnostic tool for many patients. We aim to explore the role and indications of CMA in epilepsy, given the current genomic advances. METHODS We obtained data from 378 epileptic described patients, who underwent CMA between 2015 and 2021. Different types of syndromic or nonsyndromic epilepsy were represented. RESULTS After excluding patients who were undertreated or had missing data, we included 250 patients with treated epilepsy and relevant clinical information. These patients mostly had focal epilepsy or developmental and epileptic encephalopathy, with a median start age of 2 years. Ninety percent of the patients had intellectual disability, more than two thirds had normal head size, and 60% had an abnormal magnetic resonance imaging. We also included 10 patients with epilepsy without comorbidities. In our cohort, we identified 35 pathogenic copy number variations (CNVs) explaining epilepsy with nine recurrent CNVs enriched in patients with epilepsy, 12 CNVs related to neurodevelopmental disorder phenotype with possible epilepsy, five CNVs including a gene already known in epilepsy, and nine CNVs based on size combined with de novo occurrence. The diagnosis rate in our study reached 14% (35 of 250) with first-line CMA, as previously reported. Although targeted gene panel sequencing could potentially diagnose some of the reported epilepsy CNVs (34% [12 of 35]). CONCLUSIONS CMA remains a viable option as the first-line genetic test in cases where other genetic tests are not available and as a second-line diagnostic technique if gene panel or exome sequencing yields negative results.
Collapse
Affiliation(s)
- Sarah Baer
- Department of Neuropediatrics, ERN EpiCare, French Centre de référence des Épilepsies Rares (CréER), Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Institute for Genetics and Molecular and Cellular Biology (IGBMC), University of Strasbourg, CNRS UMR7104, INSERM U1258, Illkirch, France.
| | - Audrey Schalk
- Laboratories of Genetic Diagnosis, Institut de Génétique Médicale d'Alsace (IGMA), Strasbourg University Hospitals Strasbourg France, Strasbourg, France
| | | | - Élise Schaefer
- Clinical Genetics Unit, Institut de Génétique Médicale d'Alsace (IGMA), Strasbourg, France
| | - Salima El Chehadeh
- Clinical Genetics Unit, Institut de Génétique Médicale d'Alsace (IGMA), Strasbourg, France
| | | | - Anne de Saint Martin
- Department of Neuropediatrics, ERN EpiCare, French Centre de référence des Épilepsies Rares (CréER), Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Marie-Thérèse Abi Wardé
- Department of Neuropediatrics, ERN EpiCare, French Centre de référence des Épilepsies Rares (CréER), Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Vincent Laugel
- Department of Neuropediatrics, ERN EpiCare, French Centre de référence des Épilepsies Rares (CréER), Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Yvan de Feraudy
- Department of Neuropediatrics, ERN EpiCare, French Centre de référence des Épilepsies Rares (CréER), Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Lucas Gauer
- Epilepsy Unit "Francis Rohmer," ERN EpiCare, French Centre de référence des Épilepsies Rares (CréER), Neurology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Edouard Hirsch
- Epilepsy Unit "Francis Rohmer," ERN EpiCare, French Centre de référence des Épilepsies Rares (CréER), Neurology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Clotilde Boulay
- Epilepsy Unit "Francis Rohmer," ERN EpiCare, French Centre de référence des Épilepsies Rares (CréER), Neurology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Department of Pediatrics, Émile Muller Hospital, Mulhouse, France
| | - Claire Bansept
- Department of Pediatrics, Émile Muller Hospital, Mulhouse, France
| | - Anamaria Bolocan
- Department of Pediatrics, Émile Muller Hospital, Mulhouse, France
| | - Ismini Kitadinis
- Department of Pediatrics, Émile Muller Hospital, Mulhouse, France
| | - Aurélie Gouronc
- Laboratories of Genetic Diagnosis, Institut de Génétique Médicale d'Alsace (IGMA), Strasbourg University Hospitals Strasbourg France, Strasbourg, France
| | - Bénédicte Gérard
- Laboratories of Genetic Diagnosis, Institut de Génétique Médicale d'Alsace (IGMA), Strasbourg University Hospitals Strasbourg France, Strasbourg, France
| | - Amélie Piton
- Institute for Genetics and Molecular and Cellular Biology (IGBMC), University of Strasbourg, CNRS UMR7104, INSERM U1258, Illkirch, France; Laboratories of Genetic Diagnosis, Institut de Génétique Médicale d'Alsace (IGMA), Strasbourg University Hospitals Strasbourg France, Strasbourg, France
| | - Sophie Scheidecker
- Laboratories of Genetic Diagnosis, Institut de Génétique Médicale d'Alsace (IGMA), Strasbourg University Hospitals Strasbourg France, Strasbourg, France
| |
Collapse
|
2
|
Tong L, Wang X, Wang H, Yang R, Li X, Yin X. Functional analysis of a novel nonsense PPP1R12A variant in a Chinese family with infantile epilepsy. BMC Med Genomics 2024; 17:236. [PMID: 39334371 PMCID: PMC11429181 DOI: 10.1186/s12920-024-02009-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 09/10/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Defects in PPP1R12A can lead to genitourinary and/or brain malformation syndrome (GUBS). GUBS is primarily characterized by neurological or genitourinary system abnormalities, but a few reported cases are associated with neonatal seizures. Here, we report a case of a female newborn with neonatal seizures caused by a novel variant in PPP1R12A, aiming to enhance the clinical and variant data of genetic factors related to epilepsy in early life. METHODS Whole-exome and Sanger sequencing were used for familial variant assessment, and bioinformatics was employed to annotate the variant. A structural model of the mutant protein was simulated using molecular dynamics (MD), and the free binding energy between PPP1R12A and PPP1CB was analyzed. A mutant plasmid was constructed, and mutant protein expression was analyzed using western blotting (WB), and the interaction between the mutant and PPP1CB proteins using co-immunoprecipitation (Co-IP) experiments. RESULTS The patient experienced tonic-clonic seizures on the second day after birth. Genetic testing revealed a heterozygous variant in PPP1R12A, NM_002480.3:c.2533 C > T (p.Arg845Ter). Both parents had the wild-type gene. MD suggested that loss of the C-terminal structure in the mutant protein altered its structural stability and increased the binding energy with PPP1CB, indicating unstable protein-protein interactions. On WB, a low-molecular-weight band was observed, indicating that the protein was truncated. Co-IP indicated that the mutant protein no longer interacted with PPP1CB, indicating an effect on the structural stability of the myosin phase complex. CONCLUSION The PPP1R12A c.2533 C > T variant may explain the neonatal seizures in the present case. The findings of this study expand the spectrum of PPP1R12A variants and highlight the potential significance of truncated proteins in the pathogenesis of GUBS.
Collapse
Affiliation(s)
- Ling Tong
- Department of Neonatology, Anhui Women and Children's Medical Center, No. 15, Yimin Street, Hefei, 230001, Anhui, China
| | - Xinxin Wang
- Department of Neonatology, Anhui Women and Children's Medical Center, No. 15, Yimin Street, Hefei, 230001, Anhui, China
| | - Huiqin Wang
- Department of Neonatology, Anhui Women and Children's Medical Center, No. 15, Yimin Street, Hefei, 230001, Anhui, China
| | - Rong Yang
- Department of Neonatology, Anhui Women and Children's Medical Center, No. 15, Yimin Street, Hefei, 230001, Anhui, China
| | - Xiaoyan Li
- Department of Neonatology, Anhui Women and Children's Medical Center, No. 15, Yimin Street, Hefei, 230001, Anhui, China
| | - Xiaoguang Yin
- Department of Neonatology, Anhui Women and Children's Medical Center, No. 15, Yimin Street, Hefei, 230001, Anhui, China.
| |
Collapse
|
3
|
Garavaglia B, Nasca A, Mitola S, Ingrassia R. WDR45-dependent impairment of cell cycle in fibroblasts of patients with beta propeller protein-associated neurodegeneration (BPAN). BIOCHIMICA ET BIOPHYSICA ACTA. MOLECULAR CELL RESEARCH 2024; 1871:119842. [PMID: 39265886 DOI: 10.1016/j.bbamcr.2024.119842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 08/29/2024] [Accepted: 09/06/2024] [Indexed: 09/14/2024]
Abstract
De novo mutations in the WDR45 gene have been found in patients affected by Neurodegeneration with Brain Iron Accumulation type 5 (NBIA5 or BPAN), with Non-Transferrin Bound Iron (NTBI) accumulation in the basal ganglia and WDR45-dependent impairment of autophagy. Here we show the downregulation of TFEB and cell cycle impairment in BPAN primary fibroblasts. Noteworthy, TFEB overexpression rescued this impairment, depicting a novel WDR45-dependent cell cycle phenotype.
Collapse
Affiliation(s)
- Barbara Garavaglia
- Medical Genetics and Neurogenetics Unit - Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Alessia Nasca
- Medical Genetics and Neurogenetics Unit - Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Stefania Mitola
- Section of Biotechnologies, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Rosaria Ingrassia
- Section of Biotechnologies, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
| |
Collapse
|
4
|
Matsuoka T, Yoshida H, Kasai T, Tozawa T, Iehara T, Chiyonobu T. α-Synuclein pathology in Drosophila melanogaster is exacerbated by haploinsufficiency of Rop: connecting STXBP1 encephalopathy with α-synucleinopathies. Hum Mol Genet 2024; 33:1328-1338. [PMID: 38692286 DOI: 10.1093/hmg/ddae073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/21/2024] [Accepted: 04/19/2024] [Indexed: 05/03/2024] Open
Abstract
Syntaxin-binding protein 1 (STXBP1) is a presynaptic protein that plays important roles in synaptic vesicle docking and fusion. STXBP1 haploinsufficiency causes STXBP1 encephalopathy (STXBP1-E), which encompasses neurological disturbances including epilepsy, neurodevelopmental disorders, and movement disorders. Most patients with STXBP1-E present with regression and movement disorders in adulthood, highlighting the importance of a deeper understanding of the neurodegenerative aspects of STXBP1-E. An in vitro study proposed an interesting new role of STXBP1 as a molecular chaperone for α-Synuclein (αSyn), a key molecule in the pathogenesis of neurodegenerative disorders. However, no studies have shown αSyn pathology in model organisms or patients with STXBP1-E. In this study, we used Drosophila models to examine the effects of STXBP1 haploinsufficiency on αSyn-induced neurotoxicity in vivo. We demonstrated that haploinsufficiency of Ras opposite (Rop), the Drosophila ortholog of STXBP1, exacerbates compound eye degeneration, locomotor dysfunction, and dopaminergic neurodegeneration in αSyn-expressing flies. This phenotypic aggravation was associated with a significant increase in detergent-insoluble αSyn levels in the head. Furthermore, we tested whether trehalose, which has neuroprotective effects in various models of neurodegenerative disorders, mitigates αSyn-induced neurotoxicity exacerbated by Rop haploinsufficiency. In flies expressing αSyn and carrying a heterozygous Rop null variant, trehalose supplementation effectively alleviates neuronal phenotypes, accompanied by a decrease in detergent-insoluble αSyn in the head. In conclusion, this study revealed that Rop haploinsufficiency exacerbates αSyn-induced neurotoxicity by altering the αSyn aggregation propensity. This study not only contributes to understanding the mechanisms of neurodegeneration in STXBP1-E patients, but also provides new insights into the pathogenesis of α-synucleinopathies.
Collapse
Affiliation(s)
- Taro Matsuoka
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Hideki Yoshida
- Department of Applied Biology, Kyoto Institute of Technology, Matsugasaki, Sakyo-ku, Kyoto 606-8585, Japan
| | - Takashi Kasai
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Takenori Tozawa
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Tomoko Iehara
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Tomohiro Chiyonobu
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Molecular Diagnostics and Therapeutics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| |
Collapse
|
5
|
André T, van Berkel AA, Singh G, Abualrous ET, Diwan GD, Schmenger T, Braun L, Malsam J, Toonen RF, Freund C, Russell RB, Verhage M, Söllner TH. Reduced Protein Stability of 11 Pathogenic Missense STXBP1/MUNC18-1 Variants and Improved Disease Prediction. Biol Psychiatry 2024; 96:125-136. [PMID: 38490366 DOI: 10.1016/j.biopsych.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 03/04/2024] [Accepted: 03/05/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Pathogenic variants in STXBP1/MUNC18-1 cause severe encephalopathies that are among the most common in genetic neurodevelopmental disorders. Different molecular disease mechanisms have been proposed, and pathogenicity prediction is limited. In this study, we aimed to define a generalized disease concept for STXBP1-related disorders and improve prediction. METHODS A cohort of 11 disease-associated and 5 neutral variants (detected in healthy individuals) were tested in 3 cell-free assays and in heterologous cells and primary neurons. Protein aggregation was tested using gel filtration and Triton X-100 insolubility. PRESR (predicting STXBP1-related disorder), a machine learning algorithm that uses both sequence- and 3-dimensional structure-based features, was developed to improve pathogenicity prediction using 231 known disease-associated variants and comparison to our experimental data. RESULTS Disease-associated variants, but none of the neutral variants, produced reduced protein levels. Cell-free assays demonstrated directly that disease-associated variants have reduced thermostability, with most variants denaturing around body temperature. In addition, most disease-associated variants impaired SNARE-mediated membrane fusion in a reconstituted assay. Aggregation/insolubility was observed for none of the variants in vitro or in neurons. PRESR outperformed existing tools substantially: Matthews correlation coefficient = 0.71 versus <0.55. CONCLUSIONS These data establish intrinsic protein instability as the generalizable, primary cause for STXBP1-related disorders and show that protein-specific ortholog and 3-dimensional information improve disease prediction. PRESR is a publicly available diagnostic tool.
Collapse
Affiliation(s)
- Timon André
- Heidelberg University Biochemistry Centre, Heidelberg, Germany
| | - Annemiek A van Berkel
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit, Amsterdam, the Netherlands; Department of Clinical Genetics, Center for Neurogenomics and Cognitive Research (CNRC), University Medical Center Amsterdam; Amsterdam 1081 HV, the Netherlands
| | - Gurdeep Singh
- Heidelberg University Biochemistry Centre, Heidelberg, Germany; BioQuant, Heidelberg University, Heidelberg, Germany
| | - Esam T Abualrous
- Laboratory of Protein Biochemistry, Institute for Chemistry and Biochemistry, Freie Universität Berlin, Berlin, Germany; Department of Mathematics and Computer Science, Freie Universität Berlin, Berlin, Germany; Department of Physics, Faculty of Science, Ain Shams University, Cairo, Egypt
| | - Gaurav D Diwan
- Heidelberg University Biochemistry Centre, Heidelberg, Germany; BioQuant, Heidelberg University, Heidelberg, Germany
| | - Torsten Schmenger
- Heidelberg University Biochemistry Centre, Heidelberg, Germany; BioQuant, Heidelberg University, Heidelberg, Germany
| | - Lara Braun
- Heidelberg University Biochemistry Centre, Heidelberg, Germany
| | - Jörg Malsam
- Heidelberg University Biochemistry Centre, Heidelberg, Germany
| | - Ruud F Toonen
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit, Amsterdam, the Netherlands
| | - Christian Freund
- Laboratory of Protein Biochemistry, Institute for Chemistry and Biochemistry, Freie Universität Berlin, Berlin, Germany
| | - Robert B Russell
- Heidelberg University Biochemistry Centre, Heidelberg, Germany; BioQuant, Heidelberg University, Heidelberg, Germany
| | - Matthijs Verhage
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit, Amsterdam, the Netherlands; Department of Clinical Genetics, Center for Neurogenomics and Cognitive Research (CNRC), University Medical Center Amsterdam; Amsterdam 1081 HV, the Netherlands.
| | | |
Collapse
|
6
|
He MF, Liu LH, Luo S, Wang J, Guo JJ, Wang PY, Zhai QX, He SL, Zou DF, Liu XR, Li BM, Ma HY, Qiao JD, Zhou P, He N, Yi YH, Liao WP. ZFHX3 variants cause childhood partial epilepsy and infantile spasms with favourable outcomes. J Med Genet 2024; 61:652-660. [PMID: 38508705 PMCID: PMC11228202 DOI: 10.1136/jmg-2023-109725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/18/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND The ZFHX3 gene plays vital roles in embryonic development, cell proliferation, neuronal differentiation and neuronal death. This study aims to explore the relationship between ZFHX3 variants and epilepsy. METHODS Whole-exome sequencing was performed in a cohort of 378 patients with partial (focal) epilepsy. A Drosophila Zfh2 knockdown model was used to validate the association between ZFHX3 and epilepsy. RESULTS Compound heterozygous ZFHX3 variants were identified in eight unrelated cases. The burden of ZFHX3 variants was significantly higher in the case cohort, shown by multiple/specific statistical analyses. In Zfh2 knockdown flies, the incidence and duration of seizure-like behaviour were significantly greater than those in the controls. The Zfh2 knockdown flies exhibited more firing in excitatory neurons. All patients presented partial seizures. The five patients with variants in the C-terminus/N-terminus presented mild partial epilepsy. The other three patients included one who experienced frequent non-convulsive status epilepticus and two who had early spasms. These three patients had also neurodevelopmental abnormalities and were diagnosed as developmental epileptic encephalopathy (DEE), but achieved seizure-free after antiepileptic-drug treatment without adrenocorticotropic-hormone/steroids. The analyses of temporal expression (genetic dependent stages) indicated that ZFHX3 orthologous were highly expressed in the embryonic stage and decreased dramatically after birth. CONCLUSION ZFHX3 is a novel causative gene of childhood partial epilepsy and DEE. The patients of infantile spasms achieved seizure-free after treatment without adrenocorticotropic-hormone/steroids implies a significance of genetic diagnosis in precise treatment. The genetic dependent stage provided an insight into the underlying mechanism of the evolutional course of illness.
Collapse
Affiliation(s)
- Ming-Feng He
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China
| | - Li-Hong Liu
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China
- Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Sheng Luo
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China
| | - Juan Wang
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China
| | - Jia-Jun Guo
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China
| | - Peng-Yu Wang
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China
| | - Qiong-Xiang Zhai
- Department of Pediatrics, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510120, China
| | - Su-Li He
- Department of Pediatrics, Shantou Chaonan Minsheng Hospital, Shantou 515000, China
| | - Dong-Fang Zou
- Epilepsy Center and Department of Neurology, Shenzhen Children's Hospital, Shenzhen 518029, China
| | - Xiao-Rong Liu
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China
| | - Bing-Mei Li
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China
| | - Hai-Yan Ma
- Department of Functional Neurosurgery, Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Jing-Da Qiao
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China
| | - Peng Zhou
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China
| | - Na He
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China
| | - Yong-Hong Yi
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China
| | - Wei-Ping Liao
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China
| |
Collapse
|
7
|
Guiberson NGL, Black LS, Haller JE, Brukner A, Abramov D, Ahmad S, Xie YX, Sharma M, Burré J. Disease-linked mutations in Munc18-1 deplete synaptic Doc2. Brain 2024; 147:2185-2202. [PMID: 38242640 PMCID: PMC11146428 DOI: 10.1093/brain/awae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 11/20/2023] [Accepted: 01/09/2024] [Indexed: 01/21/2024] Open
Abstract
Heterozygous de novo mutations in the neuronal protein Munc18-1/STXBP1 cause syndromic neurological symptoms, including severe epilepsy, intellectual disability, developmental delay, ataxia and tremor, summarized as STXBP1 encephalopathies. Although haploinsufficiency is the prevailing disease mechanism, it remains unclear how the reduction in Munc18-1 levels causes synaptic dysfunction in disease as well as how haploinsufficiency alone can account for the significant heterogeneity among patients in terms of the presence, onset and severity of different symptoms. Using biochemical and cell biological readouts on mouse brains, cultured mouse neurons and heterologous cells, we found that the synaptic Munc18-1 interactors Doc2A and Doc2B are unstable in the absence of Munc18-1 and aggregate in the presence of disease-causing Munc18-1 mutants. In haploinsufficiency-mimicking heterozygous knockout neurons, we found a reduction in Doc2A/B levels that is further aggravated by the presence of the disease-causing Munc18-1 mutation G544D as well as an impairment in Doc2A/B synaptic targeting in both genotypes. We also demonstrated that overexpression of Doc2A/B partially rescues synaptic dysfunction in heterozygous knockout neurons but not heterozygous knockout neurons expressing G544D Munc18-1. Our data demonstrate that STXBP1 encephalopathies are not only characterized by the dysfunction of Munc18-1 but also by the dysfunction of the Munc18-1 binding partners Doc2A and Doc2B, and that this dysfunction is exacerbated by the presence of a Munc18-1 missense mutant. These findings may offer a novel explanation for the significant heterogeneity in symptoms observed among STXBP1 encephalopathy patients.
Collapse
Affiliation(s)
- Noah Guy Lewis Guiberson
- Helen and Robert Appel Alzheimer’s Disease Research Institute, Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY 10021, USA
| | - Luca S Black
- Helen and Robert Appel Alzheimer’s Disease Research Institute, Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY 10021, USA
| | - Jillian E Haller
- Helen and Robert Appel Alzheimer’s Disease Research Institute, Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY 10021, USA
| | - Aniv Brukner
- Helen and Robert Appel Alzheimer’s Disease Research Institute, Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY 10021, USA
| | - Debra Abramov
- Helen and Robert Appel Alzheimer’s Disease Research Institute, Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY 10021, USA
| | - Saad Ahmad
- Helen and Robert Appel Alzheimer’s Disease Research Institute, Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY 10021, USA
| | - Yan Xin Xie
- Helen and Robert Appel Alzheimer’s Disease Research Institute, Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY 10021, USA
| | - Manu Sharma
- Helen and Robert Appel Alzheimer’s Disease Research Institute, Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY 10021, USA
| | - Jacqueline Burré
- Helen and Robert Appel Alzheimer’s Disease Research Institute, Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY 10021, USA
| |
Collapse
|
8
|
Öttl M, Toonen RF, Verhage M. Reduced synaptic depression in human neurons carrying homozygous disease-causing STXBP1 variant L446F. Hum Mol Genet 2024; 33:991-1000. [PMID: 38484778 PMCID: PMC11102591 DOI: 10.1093/hmg/ddae035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/02/2024] [Indexed: 05/20/2024] Open
Abstract
MUNC18-1 is an essential protein of the regulated secretion machinery. De novo, heterozygous mutations in STXBP1, the human gene encoding this protein, lead to a severe neurodevelopmental disorder. Here, we describe the electrophysiological characteristics of a unique case of STXBP1-related disorder caused by a homozygous mutation (L446F). We engineered this mutation in induced pluripotent stem cells from a healthy donor (STXBP1LF/LF) to establish isogenic cell models. We performed morphological and electrophysiological analyses on single neurons grown on glial micro-islands. Human STXBP1LF/LF neurons displayed normal morphology and normal basal synaptic transmission but increased paired-pulse ratios and charge released, and reduced synaptic depression compared to control neurons. Immunostainings revealed normal expression levels but impaired recognition by a mutation-specific MUNC18-1 antibody. The electrophysiological gain-of-function phenotype is in line with earlier overexpression studies in Stxbp1 null mouse neurons, with some potentially human-specific features. Therefore, the present study highlights important differences between mouse and human neurons critical for the translatability of pre-clinical studies.
Collapse
Affiliation(s)
- Miriam Öttl
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, De Boelelaan 1085, Amsterdam 1081HV, the Netherlands
| | - Ruud F Toonen
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, De Boelelaan 1085, Amsterdam 1081HV, the Netherlands
| | - Matthijs Verhage
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, De Boelelaan 1085, Amsterdam 1081HV, the Netherlands
- Department of Human Genetics, Center for Neurogenomics and Cognitive Research, University Medical Center, De Boelelaan 1117, Amsterdam 1081HV, the Netherlands
| |
Collapse
|
9
|
Jarosz ŁS, Socała K, Michalak K, Wiater A, Ciszewski A, Majewska M, Marek A, Grądzki Z, Wlaź P. The effect of psychoactive bacteria, Bifidobacterium longum Rosell®-175 and Lactobacillus rhamnosus JB-1, on brain proteome profiles in mice. Psychopharmacology (Berl) 2024; 241:925-945. [PMID: 38156998 PMCID: PMC11031467 DOI: 10.1007/s00213-023-06519-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024]
Abstract
RATIONALE The gut microbiota may play an important role in the development and functioning of the mammalian central nervous system. The assumption of the experiment was to prove that the use of probiotic bacterial strains in the diet of mice modifies the expression of brain proteins involved in metabolic and immunological processes. OBJECTIVES AND RESULTS Albino Swiss mice were administered with Bifidobacterium longum Rosell®-175 or Lactobacillus rhamnosus JB-1 every 24 h for 28 days. Protein maps were prepared from hippocampal homogenates of euthanized mice. Selected proteins that were statistically significant were purified and concentrated and identified using MALDI-TOF mass spectrometry. Among the analysed samples, 13 proteins were identified. The mean volumes of calcyon, secreted frizzled-associated protein 3, and catalase in the hippocampus of mice from both experimental groups were statistically significantly higher than in the control group. In mice supplemented with Lactobacillus rhamnosus JB-1, a lower mean volume of fragrance binding protein 2, shadow of prion protein, and glycine receptor α4 subunit was observed compared to the control. CONCLUSION The psychobiotics Bifidobacterium longum Rosell®-175 and Lactobacillus rhamnosus JB-1enhances expression of proteins involved in the activation and maturation of nerve cells, as well as myelination and homeostatic regulation of neurogenesis in mice. The tested psychobiotics cause a decrease in the expression of proteins associated with CNS development and in synaptic transmission, thereby reducing the capacity for communication between nerve cells. The results of the study indicate that psychobiotic bacteria can be used in auxiliary treatment of neurological disorders.
Collapse
Affiliation(s)
- Łukasz S Jarosz
- Department of Epizootiology and Clinic of Infectious Diseases, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, Głęboka 30, 20-612, Lublin, Poland.
| | - Katarzyna Socała
- Department of Animal Physiology and Pharmacology, Institute of Biological Sciences, Faculty of Biology and Biotechnology, Maria Curie-Skłodowska University, Akademicka 19, 20-033, Lublin, Poland
| | - Katarzyna Michalak
- Department of Epizootiology and Clinic of Infectious Diseases, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, Głęboka 30, 20-612, Lublin, Poland
| | - Adrian Wiater
- Department of Industrial and Environmental Microbiology, Institute of Biological Sciences, Faculty of Biology and Biotechnology, Maria Curie-Skłodowska University, Akademicka 19, 20-033, Lublin, Poland
| | - Artur Ciszewski
- Department of Epizootiology and Clinic of Infectious Diseases, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, Głęboka 30, 20-612, Lublin, Poland
| | - Małgorzata Majewska
- Department of Industrial and Environmental Microbiology, Institute of Biological Sciences, Faculty of Biology and Biotechnology, Maria Curie-Skłodowska University, Akademicka 19, 20-033, Lublin, Poland
| | - Agnieszka Marek
- Department of Preventive Veterinary and Avian Diseases, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, Głęboka 30, 20-612, Lublin, Poland
| | - Zbigniew Grądzki
- Department of Epizootiology and Clinic of Infectious Diseases, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, Głęboka 30, 20-612, Lublin, Poland
| | - Piotr Wlaź
- Department of Animal Physiology and Pharmacology, Institute of Biological Sciences, Faculty of Biology and Biotechnology, Maria Curie-Skłodowska University, Akademicka 19, 20-033, Lublin, Poland
| |
Collapse
|
10
|
Poliquin S, Nwosu G, Randhave K, Shen W, Flamm C, Kang JQ. Modulating Endoplasmic Reticulum Chaperones and Mutant Protein Degradation in GABRG2(Q390X) Associated with Genetic Epilepsy with Febrile Seizures Plus and Dravet Syndrome. Int J Mol Sci 2024; 25:4601. [PMID: 38731820 PMCID: PMC11083348 DOI: 10.3390/ijms25094601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/10/2024] [Accepted: 04/17/2024] [Indexed: 05/13/2024] Open
Abstract
A significant number of patients with genetic epilepsy do not obtain seizure freedom, despite developments in new antiseizure drugs, suggesting a need for novel therapeutic approaches. Many genetic epilepsies are associated with misfolded mutant proteins, including GABRG2(Q390X)-associated Dravet syndrome, which we have previously shown to result in intracellular accumulation of mutant GABAA receptor γ2(Q390X) subunit protein. Thus, a potentially promising therapeutic approach is modulation of proteostasis, such as increasing endoplasmic reticulum (ER)-associated degradation (ERAD). To that end, we have here identified an ERAD-associated E3 ubiquitin ligase, HRD1, among other ubiquitin ligases, as a strong modulator of wildtype and mutant γ2 subunit expression. Overexpressing HRD1 or knockdown of HRD1 dose-dependently reduced the γ2(Q390X) subunit. Additionally, we show that zonisamide (ZNS)-an antiseizure drug reported to upregulate HRD1-reduces seizures in the Gabrg2+/Q390X mouse. We propose that a possible mechanism for this effect is a partial rescue of surface trafficking of GABAA receptors, which are otherwise sequestered in the ER due to the dominant-negative effect of the γ2(Q390X) subunit. Furthermore, this partial rescue was not due to changes in ER chaperones BiP and calnexin, as total expression of these chaperones was unchanged in γ2(Q390X) models. Our results here suggest that leveraging the endogenous ERAD pathway may present a potential method to degrade neurotoxic mutant proteins like the γ2(Q390X) subunit. We also demonstrate a pharmacological means of regulating proteostasis, as ZNS alters protein trafficking, providing further support for the use of proteostasis regulators for the treatment of genetic epilepsies.
Collapse
Affiliation(s)
- Sarah Poliquin
- Neuroscience Graduate Program, Vanderbilt University, Nashville, TN 37232, USA;
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN 37232, USA;
| | - Gerald Nwosu
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN 37232, USA;
- Department of Neuroscience and Pharmacology, Meharry Medical College, Nashville, TN 37208, USA
- Department of Neurology, Vanderbilt University Medical Center, 465 21st Ave South, Nashville, TN 37232, USA; (K.R.); (W.S.); (C.F.)
| | - Karishma Randhave
- Department of Neurology, Vanderbilt University Medical Center, 465 21st Ave South, Nashville, TN 37232, USA; (K.R.); (W.S.); (C.F.)
| | - Wangzhen Shen
- Department of Neurology, Vanderbilt University Medical Center, 465 21st Ave South, Nashville, TN 37232, USA; (K.R.); (W.S.); (C.F.)
| | - Carson Flamm
- Department of Neurology, Vanderbilt University Medical Center, 465 21st Ave South, Nashville, TN 37232, USA; (K.R.); (W.S.); (C.F.)
| | - Jing-Qiong Kang
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN 37232, USA;
- Department of Neurology, Vanderbilt University Medical Center, 465 21st Ave South, Nashville, TN 37232, USA; (K.R.); (W.S.); (C.F.)
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA
- Vanderbilt Kennedy Center of Human Development, Vanderbilt University, Nashville, TN 37232, USA
| |
Collapse
|
11
|
Kádková A, Murach J, Østergaard M, Malsam A, Malsam J, Lolicato F, Nickel W, Söllner TH, Sørensen JB. SNAP25 disease mutations change the energy landscape for synaptic exocytosis due to aberrant SNARE interactions. eLife 2024; 12:RP88619. [PMID: 38411501 PMCID: PMC10911398 DOI: 10.7554/elife.88619] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Abstract
SNAP25 is one of three neuronal SNAREs driving synaptic vesicle exocytosis. We studied three mutations in SNAP25 that cause epileptic encephalopathy: V48F, and D166Y in the synaptotagmin-1 (Syt1)-binding interface, and I67N, which destabilizes the SNARE complex. All three mutations reduced Syt1-dependent vesicle docking to SNARE-carrying liposomes and Ca2+-stimulated membrane fusion in vitro and when expressed in mouse hippocampal neurons. The V48F and D166Y mutants (with potency D166Y > V48F) led to reduced readily releasable pool (RRP) size, due to increased spontaneous (miniature Excitatory Postsynaptic Current, mEPSC) release and decreased priming rates. These mutations lowered the energy barrier for fusion and increased the release probability, which are gain-of-function features not found in Syt1 knockout (KO) neurons; normalized mEPSC release rates were higher (potency D166Y > V48F) than in the Syt1 KO. These mutations (potency D166Y > V48F) increased spontaneous association to partner SNAREs, resulting in unregulated membrane fusion. In contrast, the I67N mutant decreased mEPSC frequency and evoked EPSC amplitudes due to an increase in the height of the energy barrier for fusion, whereas the RRP size was unaffected. This could be partly compensated by positive charges lowering the energy barrier. Overall, pathogenic mutations in SNAP25 cause complex changes in the energy landscape for priming and fusion.
Collapse
Affiliation(s)
- Anna Kádková
- Department of Neuroscience, University of CopenhagenCopenhagenDenmark
| | | | - Maiken Østergaard
- Department of Neuroscience, University of CopenhagenCopenhagenDenmark
| | - Andrea Malsam
- Heidelberg University Biochemistry CenterHeidelbergDenmark
| | - Jörg Malsam
- Heidelberg University Biochemistry CenterHeidelbergDenmark
| | - Fabio Lolicato
- Heidelberg University Biochemistry CenterHeidelbergDenmark
- Department of Physics, University of HelsinkiHelsinkiFinland
| | - Walter Nickel
- Heidelberg University Biochemistry CenterHeidelbergDenmark
| | | | | |
Collapse
|
12
|
Zaker E, Nouri N, Movahedinia M, Dadbinpour A, Vahidi Mehrjardi MY. Type 1 early infantile epileptic encephalopathy: A case report and literature review. Mol Genet Genomic Med 2024; 12:e2412. [PMID: 38400608 PMCID: PMC10891437 DOI: 10.1002/mgg3.2412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Variants in the Aristaless-related homeobox (ARX) gene lead to a variety of phenotypes, with intellectual disability being a steady feature. Other features can include severe epilepsy, spasticity, movement disorders, hydranencephaly, and ambiguous genitalia in males. X-linked Ohtahara syndrome or Type 1 early infantile epileptic encephalopathy (EIEE1) is a severe early-onset epileptic encephalopathy with arrested psychomotor development caused by hemizygous mutations in the ARX gene, which encodes a transcription factor in fundamental brain developmental processes. METHODS We presented a case report of a 2-year-old boy who exhibited symptoms such as microcephaly, seizures, and severe multifocal epileptic abnormalities, and genetic techniques such as autozygosity mapping, Sanger sequencing, and whole-exome sequencing. RESULTS We confirmed that the patient had the NM_139058.3:c.84C>A; p.(Cys28Ter) mutation in the ARX gene. CONCLUSION The patient with EIEE1 had physical symptoms and hypsarrhythmia on electroencephalogram. Genetic testing identified a causative mutation in the ARX gene, emphasizing the role of genetic testing in EIEE diagnosis.
Collapse
Affiliation(s)
- Erfan Zaker
- Department of Medical Genetics, Faculty of MedicineShahid Sadoughi University of Medical SciencesYazdIran
| | - Negar Nouri
- Department of Medical Genetics, Faculty of MedicineShahid Sadoughi University of Medical SciencesYazdIran
| | - Mojtaba Movahedinia
- Department of Children Growth Disorder Research CenterShahid Sadoughi University of Medical SciencesYazdIran
| | - Ali Dadbinpour
- Department of Medical GeneticsSchool of MedicineShahid Sadoughi University of Medical SciencesYazdIran
| | | |
Collapse
|
13
|
Goss JR, Prosser B, Helbig I, Son Rigby C. STXBP1: fast-forward to a brighter future - a patient organization perspective. THERAPEUTIC ADVANCES IN RARE DISEASE 2024; 5:26330040241257221. [PMID: 38898886 PMCID: PMC11186390 DOI: 10.1177/26330040241257221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/08/2024] [Indexed: 06/21/2024]
Abstract
Syntaxin-binding protein 1 related disorder (STXBP1-RD) is a rare neurologic disorder associated with global neurodevelopmental delay, intellectual disability, early-onset epilepsy, motor abnormalities, and autism. The underlying pathophysiology stems from a de novo mutation in the STXBP1 gene, which codes for the STXBP1 protein. The STXBP1 protein is involved in synaptic vesicle fusion and neurotransmitter release. Pathogenic variants in the STXBP1 gene generally result in haploinsufficiency, an impairment in neurotransmitter release, and subsequent dysfunction in neuronal communication. The STXBP1 Foundation was founded in 2017 to support families of children with STXBP1-RD and accelerate the development of effective therapies and, ultimately, a cure for the disorder. The Foundation initially supported research aimed at better understanding the complex phenotypic presentation of the disease as well as the development of animal and cellular models usable by the research community to more fully characterize STXBP1 function and disease pathogenicity. In 2023, the Foundation embarked on its STXBP1 Fast Forward Strategic Plan, which includes a prospective natural history study and substantive biomarker work to drive forward the development of new precision therapies for STXBP1-RD.
Collapse
Affiliation(s)
- James R. Goss
- STXBP1 Foundation, PO Box 1148, Holly Springs, NC 27540, USA
| | - Benjamin Prosser
- Department of Physiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Epilepsy and Neurodevelopmental Disorders (ENDD), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ingo Helbig
- Division of Neurology, Department of Biomedical and Health Informatics, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Center for Epilepsy and Neurodevelopmental Disorders (ENDD), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | |
Collapse
|
14
|
van Berkel AA, Lammertse HCA, Öttl M, Koopmans F, Misra-Isrie M, Meijer M, Dilena R, van Hasselt PM, Engelen M, van Haelst M, Smit AB, van der Sluis S, Toonen RF, Verhage M. Reduced MUNC18-1 Levels, Synaptic Proteome Changes, and Altered Network Activity in STXBP1-Related Disorder Patient Neurons. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:284-298. [PMID: 38298782 PMCID: PMC10829628 DOI: 10.1016/j.bpsgos.2023.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 05/06/2023] [Accepted: 05/14/2023] [Indexed: 02/02/2024] Open
Abstract
Background STXBP1-related disorder (STXBP1-RD) is a neurodevelopmental disorder caused by pathogenic variants in the STXBP1 gene. Its gene product MUNC18-1 organizes synaptic vesicle exocytosis and is essential for synaptic transmission. Patients present with developmental delay, intellectual disability, and/or epileptic seizures, with high clinical heterogeneity. To date, the cellular deficits of neurons of patients with STXBP1-RD are unknown. Methods We combined live-cell imaging, electrophysiology, confocal microscopy, and mass spectrometry proteomics to characterize cellular phenotypes of induced pluripotent stem cell-derived neurons from 6 patients with STXBP1-RD, capturing shared features as well as phenotypic diversity among patients. Results Neurons from all patients showed normal in vitro development, morphology, and synapse formation, but reduced MUNC18-1 RNA and protein levels. In addition, a proteome-wide screen identified dysregulation of proteins related to synapse function and RNA processes. Neuronal networks showed shared as well as patient-specific phenotypes in activity frequency, network irregularity, and synchronicity, especially when networks were challenged by increasing excitability. No shared effects were observed in synapse physiology of single neurons except for a few patient-specific phenotypes. Similarities between functional and proteome phenotypes suggested 2 patient clusters, not explained by gene variant type. Conclusions Together, these data show that decreased MUNC18-1 levels, dysregulation of synaptic proteins, and altered network activity are shared cellular phenotypes of STXBP1-RD. The 2 patient clusters suggest distinctive pathobiology among subgroups of patients, providing a plausible explanation for the clinical heterogeneity. This phenotypic spectrum provides a framework for future validation studies and therapy design for STXBP1-RD.
Collapse
Affiliation(s)
- Annemiek Arienne van Berkel
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Functional Genomics, Department of Human Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Universitair Medische Centra, Amsterdam, the Netherlands
| | - Hanna Charlotte Andrea Lammertse
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Functional Genomics, Department of Human Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Universitair Medische Centra, Amsterdam, the Netherlands
| | - Miriam Öttl
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Frank Koopmans
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Mala Misra-Isrie
- Functional Genomics, Department of Human Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Universitair Medische Centra, Amsterdam, the Netherlands
- Department of Human Genetics, Clinical Genetics Section, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Marieke Meijer
- Functional Genomics, Department of Human Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Universitair Medische Centra, Amsterdam, the Netherlands
| | - Robertino Dilena
- Clinical Neurophysiology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Peter Marin van Hasselt
- Department of Metabolic Diseases, Division of Pediatrics, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Marc Engelen
- Department of (Pediatric) Neurology, Amsterdam Universitair Medische Centra, Amsterdam, the Netherlands
| | - Mieke van Haelst
- Department of Human Genetics, Clinical Genetics Section, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - August Benjamin Smit
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Sophie van der Sluis
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Child and Adolescence Psychiatry, Section of Complex Trait Genetics, Amsterdam Universitair Medische Centra, Amsterdam, the Netherlands
| | - Ruud Franciscus Toonen
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Matthijs Verhage
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Functional Genomics, Department of Human Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Universitair Medische Centra, Amsterdam, the Netherlands
| |
Collapse
|
15
|
Freibauer A, Wohlleben M, Boelman C. STXBP1-Related Disorders: Clinical Presentation, Molecular Function, Treatment, and Future Directions. Genes (Basel) 2023; 14:2179. [PMID: 38137001 PMCID: PMC10742812 DOI: 10.3390/genes14122179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 11/27/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023] Open
Abstract
In recent years, the affordability and availability of genetic testing have led to its increased use in clinical care. The increased frequency of testing has led to STXBP1 variants being identified as one of the more common variants associated with neurological disorders. In this review, we aim to summarize the common clinical phenotypes associated with STXBP1 pathogenic variants, provide an overview of their known natural history, and discuss current research into the genotype to phenotype correlation. We will also provide an overview of the suspected normal function of the STXBP1-encoded Munc18-1 protein, animal models, and experimental techniques that have been developed to study its function and use this information to try to explain the diverse phenotypes associated with STXBP1-related disorders. Finally, we will explore current therapies for STXBP1 disorders, including an overview of treatment goals for STXBP1-related disorders, a discussion of the current evidence for therapies, and future directions of personalized medications for STXBP1-related disorders.
Collapse
Affiliation(s)
- Alexander Freibauer
- Division of Neurology, BC Children’s Hospital, Vancouver, BC V6H 3N1, Canada;
- Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Mikayla Wohlleben
- Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Cyrus Boelman
- Division of Neurology, BC Children’s Hospital, Vancouver, BC V6H 3N1, Canada;
- Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| |
Collapse
|
16
|
Desai NN, Guerrero C, Mesaros M, Schmitt SE, Campbell Z. Musicogenic seizures-STXBP1 encephalopathy with reflex seizures. Epileptic Disord 2023; 25:886-889. [PMID: 37861287 DOI: 10.1002/epd2.20157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/17/2023] [Accepted: 08/25/2023] [Indexed: 10/21/2023]
Abstract
Mutations in the gene encoding syntaxin binding protein 1 (STXBP1) have been implicated in a wide variety of epileptic encephalopathies. Although the recognized phenotypes of patients with STXBP1 encephalopathies have broadened in recent years, no case of reflex seizures, particularly musicogenic seizures, has been reported in the literature. We present an 18-year-old woman with STXBP1 encephalopathy and seizures that are stereotypically reproducible in response to a variety of audible stimuli. An 18-year-old woman with a history of profound intellectual disability, confirmed STXBP1 genetic defect via genetic testing, and seizures beginning as infantile spasms during childhood, who presented to the epilepsy monitoring unit for seizure characterization. Her mother reported reproducible seizures triggered by a particular cell phone ringtone, music from a certain automobile television commercial and certain beeping alarm sounds. In response, the patient had clinically stereotyped seizures associated with staring, behavioral arrest, followed by eye deviation to the left, tonic stiffening in upper and lower extremities, and labored breathing lasting between 30 s and 2 min. These seizures were reliably reproducible within a few seconds of exposure to the auditory stimulus. During hospitalization, mother played one of the cell phone ringtones known to trigger seizures for the patient, which resulted in induction of a seizure characterized by diffuse electrodecrement, subsequent emergence of frontal-predominant theta which was followed by progressive diffuse attenuation and semi-rhythmic slowing over the right posterior quadrant. This is the first case to describe musicogenic or other reflex seizures in a patient with STXBP1 encephalopathy.
Collapse
Affiliation(s)
- Nimit N Desai
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Carlos Guerrero
- AdventHealth Medical Group- Neurology, Altamonte Springs, Florida, USA
| | - Maysen Mesaros
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Sarah E Schmitt
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Zeke Campbell
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
| |
Collapse
|
17
|
Xian J, Thalwitzer KM, McKee J, Sullivan KR, Brimble E, Fitch E, Toib J, Kaufman MC, deCampo D, Cunningham K, Pierce SR, Goss J, Rigby CS, Syrbe S, Boland M, Prosser B, Fitter N, Ruggiero SM, Helbig I. Delineating clinical and developmental outcomes in STXBP1-related disorders. Brain 2023; 146:5182-5197. [PMID: 38015929 PMCID: PMC10689925 DOI: 10.1093/brain/awad287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/31/2023] [Accepted: 08/18/2023] [Indexed: 11/30/2023] Open
Abstract
STXBP1-related disorders are among the most common genetic epilepsies and neurodevelopmental disorders. However, the longitudinal epilepsy course and developmental end points, have not yet been described in detail, which is a critical prerequisite for clinical trial readiness. Here, we assessed 1281 cumulative patient-years of seizure and developmental histories in 162 individuals with STXBP1-related disorders and established a natural history framework. STXBP1-related disorders are characterized by a dynamic pattern of seizures in the first year of life and high variability in neurodevelopmental trajectories in early childhood. Epilepsy onset differed across seizure types, with 90% cumulative onset for infantile spasms by 6 months and focal-onset seizures by 27 months of life. Epilepsy histories diverged between variant subgroups in the first 2 years of life, when individuals with protein-truncating variants and deletions in STXBP1 (n = 39) were more likely to have infantile spasms between 5 and 6 months followed by seizure remission, while individuals with missense variants (n = 30) had an increased risk for focal seizures and ongoing seizures after the first year. Developmental outcomes were mapped using milestone acquisition data in addition to standardized assessments including the Gross Motor Function Measure-66 Item Set and the Grasping and Visual-Motor Integration subsets of the Peabody Developmental Motor Scales. Quantification of end points revealed high variability during the first 5 years of life, with emerging stratification between clinical subgroups. An earlier epilepsy onset was associated with lower developmental abilities, most prominently when assessing gross motor development and expressive communication. We found that individuals with neonatal seizures or early infantile seizures followed by seizure offset by 12 months of life had more predictable seizure trajectories in early to late childhood compared to individuals with more severe seizure presentations, including individuals with refractory epilepsy throughout the first year. Characterization of anti-seizure medication response revealed age-dependent response over time, with phenobarbital, levetiracetam, topiramate and adrenocorticotropic hormone effective in reducing seizures in the first year of life, while clobazam and the ketogenic diet were effective in long-term seizure management. Virtual clinical trials using seizure frequency as the primary outcome resulted in wide range of trial success probabilities across the age span, with the highest probability in early childhood between 1 year and 3.5 years. In summary, we delineated epilepsy and developmental trajectories in STXBP1-related disorders using standardized measures, providing a foundation to interpret future therapeutic strategies and inform rational trial design.
Collapse
Affiliation(s)
- Julie Xian
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Kim Marie Thalwitzer
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
- Division of Pediatric Epileptology, Centre for Pediatric and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Jillian McKee
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Katie Rose Sullivan
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Elise Brimble
- Ciitizen Natural History Registry, Invitae, San Francisco, CA 94017, USA
| | - Eryn Fitch
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Jonathan Toib
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Michael C Kaufman
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
| | - Danielle deCampo
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Kristin Cunningham
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Samuel R Pierce
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | | | | | - Steffen Syrbe
- Division of Pediatric Epileptology, Centre for Pediatric and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Michael Boland
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
- Institute for Genomic Medicine, Columbia University, New York, NY 10032, USA
| | - Benjamin Prosser
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
- Department of Physiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Nasha Fitter
- Ciitizen Natural History Registry, Invitae, San Francisco, CA 94017, USA
| | - Sarah M Ruggiero
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Ingo Helbig
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| |
Collapse
|
18
|
Al-Khfaji KMS, Zamani NK, Arefian E. HSV-1 latency-associated transcript miR-H3 and miR-H4 target STXBP1 and GABBR2 genes. J Neurovirol 2023; 29:669-677. [PMID: 37668872 DOI: 10.1007/s13365-023-01174-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/21/2023] [Accepted: 08/28/2023] [Indexed: 09/06/2023]
Abstract
During latent infection, the HSV-1 virus generates only a single transcript, LAT, which encodes six miRNAs. The GABAergic pathway signaling system is an essential cell signaling pathway influenced by various therapeutic targets and some brain disorders, such as epilepsy. This study found that miRNAs encoding LAT might target the STXBP1 and GABBR2 genes, which are among the significant genes in the GABAergic pathway. Bioinformatic analysis utilizing TargetScan version 5.2 and the RNA22 tools uncovered miRNAs encoding LAT that can influence STXBP1 and GABBR2 transcripts. To evaluate the targeting effect of candidate microRNAs encoding LAT, namely, miR-H3 and miR-H4, LAT constructs were transfected into HEK 293T cells. The expression levels of microRNAs encoding LAT, as well as STXBP1 and GABBR2, were assayed by real-time PCR. Finally, the targeting potential of STXBP1 and GABBR2 3'UTR by LAT-encoded microRNAs was evaluated by the luciferase assay. In the current study, the bioinformatic tool TargetScan demonstrated that miR-H3 has the potential to target the transcripts of the STXBP1 and GABBR2 genes, whereas miR-H4 solely targeted GABBR2. On the other hand, the bioinformatic tool RNA22 validated the potential targeting of STXBP1 and GABBR2 by miR-H3 and miR-H4. Our findings showed that overexpression of miR-H4, miR-H3, or LAT significantly decreased STXBP1 gene expression by an average of 0.0593-fold, 0.237-fold, and 0.84-fold, respectively. Similarly, overexpression of miR-H3 or miR-H4 decreased GABBR2 expression by an average of 0.055- or 0.687-fold, respectively. Notably, targeting the GABBR2 3'UTR with the LAT transcript had no detectable effect. The evaluation of the targeting potential of STXBP1 and GABBR2 3'UTR by microRNAs encoded by LAT was conducted with a luciferase assay. Our results showed that miR-H3 overexpression reduces Renilla expression in psiCHECK2 plasmids with STXBP1 or GABBR2 3'UTR genes by 0.62- and 0.55-fold, respectively. miR-H4 reduced Renilla gene expression regulated by GABBR2's 3'UTR plasmid but had no effect on the Renilla gene expression regulated by STXBP1's 3'UTR. When the LAT transcript was overexpressed, there was a decrease in Renilla expression by 0.44-fold because of the regulation of STXBP1's 3'UTR. However, there was no significant effect observed through the control of GABBR2's 3'UTR.
Collapse
Affiliation(s)
- Karrar Mahmood Shaker Al-Khfaji
- Molecular Virology Lab, Department of Microbiology, School of Biology, College of Sciences, University of Tehran, P.O. Box 14155-6455, Tehran, 1417614411, Iran
| | - Nika Kooshki Zamani
- Department of Biotechnology, College of Sciences, University of Tehran, Tehran, Iran
| | - Ehsan Arefian
- Molecular Virology Lab, Department of Microbiology, School of Biology, College of Sciences, University of Tehran, P.O. Box 14155-6455, Tehran, 1417614411, Iran.
- Paediatric Cell and Gene Therapy Research Center, Gene, Cell & Tissue Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
19
|
Vinci M, Costanza C, Galati Rando R, Treccarichi S, Saccone S, Carotenuto M, Roccella M, Calì F, Elia M, Vetri L. STXBP6 Gene Mutation: A New Form of SNAREopathy Leads to Developmental Epileptic Encephalopathy. Int J Mol Sci 2023; 24:16436. [PMID: 38003627 PMCID: PMC10670990 DOI: 10.3390/ijms242216436] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/13/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023] Open
Abstract
Syntaxin-binding protein 6 (STXBP6), also known as amysin, is an essential component of the SNAP receptor (SNARE) complex and plays a crucial role in neuronal vesicle trafficking. Mutations in genes encoding SNARE proteins are often associated with a broad spectrum of neurological conditions defined as "SNAREopathies", including epilepsy, intellectual disability, and neurodevelopmental disorders such as autism spectrum disorders. The present whole exome sequencing (WES) study describes, for the first time, the occurrence of developmental epileptic encephalopathy and autism spectrum disorders as a result of a de novo deletion within the STXBP6 gene. The truncated protein in the STXBP6 gene leading to a premature stop codon could negatively modulate the synaptic vesicles' exocytosis. Our research aimed to elucidate a plausible, robust correlation between STXBP6 gene deletion and the manifestation of developmental epileptic encephalopathy.
Collapse
Affiliation(s)
- Mirella Vinci
- Oasi Research Institute-IRCCS, 94018 Troina, Italy; (M.V.); (R.G.R.); (S.T.); (M.E.); (L.V.)
| | - Carola Costanza
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90141 Palermo, Italy; (C.C.); (M.R.)
| | - Rosanna Galati Rando
- Oasi Research Institute-IRCCS, 94018 Troina, Italy; (M.V.); (R.G.R.); (S.T.); (M.E.); (L.V.)
| | - Simone Treccarichi
- Oasi Research Institute-IRCCS, 94018 Troina, Italy; (M.V.); (R.G.R.); (S.T.); (M.E.); (L.V.)
| | - Salvatore Saccone
- Department Biological, Geological and Environmental Sciences, University of Catania, Via Androne 81, 95124 Catania, Italy;
| | - Marco Carotenuto
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
| | - Michele Roccella
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90141 Palermo, Italy; (C.C.); (M.R.)
| | - Francesco Calì
- Oasi Research Institute-IRCCS, 94018 Troina, Italy; (M.V.); (R.G.R.); (S.T.); (M.E.); (L.V.)
| | - Maurizio Elia
- Oasi Research Institute-IRCCS, 94018 Troina, Italy; (M.V.); (R.G.R.); (S.T.); (M.E.); (L.V.)
| | - Luigi Vetri
- Oasi Research Institute-IRCCS, 94018 Troina, Italy; (M.V.); (R.G.R.); (S.T.); (M.E.); (L.V.)
| |
Collapse
|
20
|
Thalwitzer KM, Driedger JH, Xian J, Saffari A, Zacher P, Bölsterli BK, Ruggiero SM, Sullivan KR, Datta AN, Kellinghaus C, Althaus J, Wiemer-Kruel A, van Baalen A, Pampel A, Alber M, Braakman HMH, Debus OM, Denecke J, Hobbiebrunken E, Breitweg I, Diehl D, Eitel H, Gburek-Augustat J, Preisel M, Schlump JU, Laufs M, Mammadova D, Wurst C, Prager C, Löhr-Nilles C, Martin P, Garbade SF, Platzer K, Benkel-Herrenbrueck I, Egler K, Fazeli W, Lemke JR, Runkel E, Klein B, Linden T, Schröter J, Steffeck H, Thies B, von Deimling F, Illsinger S, Borggraefe I, Classen G, Wieczorek D, Ramantani G, Koelker S, Hoffmann GF, Ries M, Helbig I, Syrbe S. Natural History and Developmental Trajectories of Individuals With Disease-Causing Variants in STXBP1. Neurology 2023; 101:e879-e891. [PMID: 37407264 PMCID: PMC10501093 DOI: 10.1212/wnl.0000000000207550] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 05/08/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Pathogenic variants in STXBP1 are among the major genetic causes of neurodevelopmental disorders. Despite the increasing number of individuals diagnosed without a history of epilepsy, little is known about the natural history and developmental trajectories in this subgroup and endpoints for future therapeutic studies are limited to seizure control. METHODS We performed a cross-sectional retrospective study using standardized questionnaires for clinicians and caregivers of individuals with STXBP1-related disorders capturing medical histories, genetic findings, and developmental outcomes. Motor and language function were assessed using Gross Motor Function Classification System (GMFCS) scores and a speech impairment score and were compared within and across clinically defined subgroups. RESULTS We collected data of 71 individuals with STXBP1-related disorders, including 44 previously unreported individuals. Median age at inclusion was 5.3 years (interquartile range 3.5-9.3) with the oldest individual aged 43.8 years. Epilepsy was absent in 18/71 (25%) of individuals. The range of developmental outcomes was broad, including 2 individuals presenting with close to age-appropriate motor development. Twenty-nine of 61 individuals (48%) were able to walk unassisted, and 24/69 (35%) were able to speak single words. Individuals without epilepsy presented with a similar onset and spectrum of phenotypic features but had lower GMFCS scores (median 3 vs 4, p < 0.01) than individuals with epilepsy. Individuals with epileptic spasms were less likely to walk unassisted than individuals with other seizure types (6% vs 58%, p < 0.01). Individuals with early epilepsy onset had higher speech impairment scores (p = 0.02) than individuals with later epilepsy onset. DISCUSSION We expand the spectrum of STXBP1-related disorders and provide clinical features and developmental trajectories in individuals with and without a history of epilepsy. Individuals with epilepsy, in particular epileptic spasms, and neonatal or early-onset presented with less favorable motor and language functional outcomes compared with individuals without epilepsy. These findings identify children at risk for severe disease and can serve as comparator for future interventional studies in STXBP1-related disorders.
Collapse
Affiliation(s)
- Kim M Thalwitzer
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Jan H Driedger
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Julie Xian
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Afshin Saffari
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Pia Zacher
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Bigna K Bölsterli
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Sarah McKeown Ruggiero
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Katie Rose Sullivan
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Alexandre N Datta
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Christoph Kellinghaus
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Jürgen Althaus
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Adelheid Wiemer-Kruel
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Andreas van Baalen
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Armin Pampel
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Michael Alber
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Hilde M H Braakman
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Otfried M Debus
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Jonas Denecke
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Elke Hobbiebrunken
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Ina Breitweg
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Danielle Diehl
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Hans Eitel
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Janina Gburek-Augustat
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Martin Preisel
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Jan-Ulrich Schlump
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Mirjam Laufs
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Dilbar Mammadova
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Carsten Wurst
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Christine Prager
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Christa Löhr-Nilles
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Peter Martin
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Sven F Garbade
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Konrad Platzer
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Ira Benkel-Herrenbrueck
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Kerstin Egler
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Walid Fazeli
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Johannes R Lemke
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Eva Runkel
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Barbara Klein
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Tobias Linden
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Julian Schröter
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Heike Steffeck
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Bastian Thies
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Florian von Deimling
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Sabine Illsinger
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Ingo Borggraefe
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Georg Classen
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Dagmar Wieczorek
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Georgia Ramantani
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Stefan Koelker
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Georg F Hoffmann
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Markus Ries
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Ingo Helbig
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Steffen Syrbe
- From the Division of Pediatric Epileptology (K.M.T., J.H.D., A.S., J.S., S.S.), Pediatric Neurology and Metabolic Medicine (A.S., S.F.G., J.S., S.K., G.F.H., M.R.), Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Germany; The Epilepsy NeuroGenetics Initiative (ENGIN) (K.M.T., J.X., S.M.R., K.R.S., I.H.), Division of Neurology (J.X., S.M.R., K.R.S., I.H.), and Department of Biomedical and Health Informatics (DBHi) (J.X., I.H.), Children's Hospital of Philadelphia, PA; Epilepsy Center Kleinwachau (P.Z.), Radeberg, Germany; Department of Neuropediatrics and Children's Research Center (B.K.B., G.R.), University Children's Hospital Zurich, University of Zurich; Department of Pediatric Neurology (B.K.B.), Children's Hospital of Eastern Switzerland, Sankt Gallen; Department of Pediatric Neurology and Developmental Medicine (A.N.D.), University Children's Hospital Basel UKBB, Switzerland; Department of Neurology (C.K.), Klinikum Osnabrück; Epilepsy Center (C.K.), Münster-Osnabrück, Campus Osnabrück; Department of Pediatrics (J.A.), Christophorus Hospital Coesfeld; Epilepsy Center Kork (A.W.-K.), Clinic for Children and Adolescents, Kehl-Kork; Department of Neuropediatrics (A.v.B., M.L.), University Medical Center Schleswig-Holstein, Kiel University (CAU); Center for Social Pediatrics (A.P.), Johannes Wesling Klinikum Minden; Department of Pediatric Neurology and Developmental Medicine (M.A.), University Children's Hospital, Tübingen, Germany; Department of Pediatric Neurology (H.M.H.B.), Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatrics (O.M.D.), Clemenshospital Münster; Department of Pediatrics (J.D.), University Medical Center Hamburg-Eppendorf; Division of Pediatric Neurology (E.H.), Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen; Kinderärzte Ammersee (I. Breitweg), Neubruch 1, Inning an Ammersee; Department of Neuropediatrics (D.D.), University Hospital Giessen; Department of Neuropediatrics (H.E.), Klinikum Esslingen; Division of Neuropediatrics (J.G.-A.), Hospital for Children and Adolescents, University Hospital Leipzig, Germany; Department of Neuropediatrics (M.P.), Children University Hospital and Paracelsus Medical University, Salzburg, Austria; Department of Neuropediatrics (J.-U.S.), Gemeinschaftskrankenhaus Herdecke; Department of Pediatrics and Adolescent Medicine (D.M.), and Center for Social Pediatrics (D.M.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU); Department of Pediatric Neurology (C.W.), SRH Zentralklinikum Suhl; Department of Pediatric Neurology (C.P.), and Center for Chronically Sick Children (C.P.), Charité-Universitätsmedizin Berlin; Department of Pediatric Neurology (C.L.-N.), Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier; Séguin-Clinic for Persons with Severe Intellectual Disability (P.M.), Epilepsy Centre Kork; Medical Faculty (P.M.), University of Freiburg; Institute of Human Genetics (K.P., J.R.L.), University of Leipzig Medical Center; Sana-Krankenhaus Düsseldorf-Gerresheim (I.B.-H.), Academic Teaching Hospital der Heinrich-Heine-University Düsseldorf; Department of Neuropediatrics (K.E.), Sankt Elisabeth, KJF Klinik, Neuburg an der Donau; Department of Neuropediatrics (W.F.), Children's Hospital, University of Bonn; Center of Rare Diseases (J.R.L.), University of Leipzig Medical Center; Klinikum Aschaffenburg-Alzenau (E.R.); Department of Neuropediatrics (B.K.), Klinikum Frankfurt Höchst GmbH; Department of Neuropediatrics (T.L.), University Children's Hospital, Klinikum Oldenburg; Department of Neuropediatrics (H.S.), Klinikum Wolfsburg; Kinderneurologie Thies (B.T.), Lüneburg; Sozialpädiatrisches Zentrum Coburg (F.v.D.); Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases (S.I.), Hannover Medical School; Division of Pediatric Neurology and Developmental Medicine (I. Borggraefe), Department of Pediatrics, University Hospital of the Ludwig-Maximilians-University of Munich; Department of Pediatrics (G.C.), Evangelisches Klinikum Bethel, University Hospital Owl, University Bielefeld; Institute of Human Genetics (D.W.), Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany; and Department of Neurology (I.H.), University of Pennsylvania Perelman School of Medicine, Philadelphia.
| |
Collapse
|
21
|
Taura Y, Tozawa T, Fujimoto T, Ichise E, Chiyonobu T, Itoh K, Iehara T. Myosin Va, a novel interaction partner of STXBP1, is required to transport Syntaxin1A to the plasma membrane. Neuroscience 2023:S0306-4522(23)00251-8. [PMID: 37315734 DOI: 10.1016/j.neuroscience.2023.05.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/20/2023] [Accepted: 05/28/2023] [Indexed: 06/16/2023]
Abstract
Syntaxin-binding protein 1 (STXBP1, also known as Munc18-1) regulates exocytosis as a chaperone protein of Syntaxin1A. The haploinsufficiency of STXBP1 causes early infantile-onset developmental and epileptic encephalopathy, known as STXBP1 encephalopathy. Previously, we reported impaired cellular localization of Syntaxin1A in induced pluripotent stem cell-derived neurons from an STXBP1 encephalopathy patient harboring a nonsense mutation. However, the molecular mechanism of abnormal Syntaxin1A localization in the haploinsufficiency of STXBP1 remains unknown. This study aimed to identify the novel interacting partner of STXBP1 involved in transporting Syntaxin1A to the plasma membrane. Affinity purification coupled with mass spectrometry analysis identified a motor protein Myosin Va as a potential binding partner of STXBP1. Co-immunoprecipitation analysis of the synaptosomal fraction from the mouse and tag-fused recombinant proteins revealed that the STXBP1 short splice variant (STXBP1S) interacted with Myosin Va in addition to Syntaxin1A. These proteins colocalized at the tip of the growth cone and axons in primary cultured hippocampal neurons. Furthermore, RNAi-mediated gene silencing in Neuro2a cells showed that STXBP1 and Myosin Va were required for membrane trafficking of Syntaxin1A. In conclusion, this study proposes a potential role of STXBP1 in the trafficking of the presynaptic protein Syntaxin1A to the plasma membrane in conjunction with Myosin Va.
Collapse
Affiliation(s)
- Yoshihiro Taura
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takenori Tozawa
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Takahiro Fujimoto
- Department of Pathology and Applied Neurobiology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Eisuke Ichise
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tomohiro Chiyonobu
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Molecular Diagnostics and Therapeutics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kyoko Itoh
- Department of Pathology and Applied Neurobiology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Tomoko Iehara
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
22
|
Hopkins CE, McCormick K, Brock T, Wood M, Ruggiero S, Mcbride K, Kim C, Lawson JA, Helbig I, Bainbridge MN. Clinical variants in Caenorhabditis elegans expressing human STXBP1 reveal a novel class of pathogenic variants and classify variants of uncertain significance. GENETICS IN MEDICINE OPEN 2023; 1:100823. [PMID: 38827422 PMCID: PMC11141691 DOI: 10.1016/j.gimo.2023.100823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
Purpose Modeling disease variants in animals is useful for drug discovery, understanding disease pathology, and classifying variants of uncertain significance (VUS) as pathogenic or benign. Methods Using Clustered Regularly Interspaced Short Palindromic Repeats, we performed a Whole-gene Humanized Animal Model procedure to replace the coding sequence of the animal model's unc-18 ortholog with the coding sequence for the human STXBP1 gene. Next, we used Clustered Regularly Interspaced Short Palindromic Repeats to introduce precise point variants in the Whole-gene Humanized Animal Model-humanized STXBP1 locus from 3 clinical categories (benign, pathogenic, and VUS). Twenty-six phenotypic features extracted from video recordings were used to train machine learning classifiers on 25 pathogenic and 32 benign variants. Results Using multiple models, we were able to obtain a diagnostic sensitivity near 0.9. Twenty-three VUS were also interrogated and 8 of 23 (34.8%) were observed to be functionally abnormal. Interestingly, unsupervised clustering identified 2 distinct subsets of known pathogenic variants with distinct phenotypic features; both p.Tyr75Cys and p.Arg406Cys cluster away from other variants and show an increase in swim speed compared with hSTXBP1 worms. This leads to the hypothesis that the mechanism of disease for these 2 variants may differ from most STXBP1-mutated patients and may account for some of the clinical heterogeneity observed in the patient population. Conclusion We have demonstrated that automated analysis of a small animal system is an effective, scalable, and fast way to understand functional consequences of variants in STXBP1 and identify variant-specific intensities of aberrant activity suggesting a genotype-to-phenotype correlation is likely to occur in human clinical variations of STXBP1.
Collapse
Affiliation(s)
| | | | | | | | - Sarah Ruggiero
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA
- University of Pennsylvania, Neuroscience Program, Philadelphia, PA
| | | | | | | | - Ingo Helbig
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA
- University of Pennsylvania, Neuroscience Program, Philadelphia, PA
| | - Matthew N. Bainbridge
- Codified Genomics, LLC, Houston, TX
- Rady Children’s Institute for Genomic Medicine, San Diego, CA
| |
Collapse
|
23
|
Sullivan KR, Ruggiero SM, Xian J, Thalwitzer KM, Ali R, Stewart S, Cosico M, Steinberg J, Goss J, Pfalzer AC, Horning KJ, Weitzel N, Corey S, Conway L, Rigby CS, Bichell TJ, Helbig I. A disease concept model for STXBP1-related disorders. Epilepsia Open 2023; 8:320-333. [PMID: 36625631 PMCID: PMC10235567 DOI: 10.1002/epi4.12688] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/31/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE STXBP1-related disorders are rare genetic epilepsies and neurodevelopmental disorders, but the impact of symptoms across clinical domains is poorly understood. Disease concept models are formal frameworks to assess the lived experience of individuals and their families and provide a basis for generating outcome measures. METHODS We conducted semistructured, qualitative interviews with 19 caregivers of 16 individuals with STXBP1-related disorders and 7 healthcare professionals. We systematically coded themes using NVivo software and grouped concepts into the domains of symptoms, symptom impact, and caregiver impact. We quantified the frequency of concepts throughout the lifespan and across clinical subgroups stratified by seizure history and developmental trajectories. RESULTS Over 25 hours of interviews, we coded a total of 3626 references to 38 distinct concepts. In addition to well-recognized clinical features such as developmental delay (n = 240 references), behavior (n = 201), and seizures (n = 147), we identified previously underrepresented symptoms including gastrointestinal (n = 68) and respiratory symptoms (n = 24) and pain (n = 30). The most frequently referenced symptom impacts were autonomy (n = 96), socialization (n = 64), and schooling (n = 61). Emotional impact (n = 354), support (n = 200), and daily life & activities (n = 108) were highly cited caregiver impacts. We found that seizures were more commonly referenced in infancy than in other age groups, while behavior and socialization were more likely to be referred to in childhood. We found that caregivers of individuals with ongoing seizures were less likely to reference developmental delay, possibly due to the relatively high impact of seizures. SIGNIFICANCE STXBP1-related disorders are complex conditions affecting a wide range of clinical and social domains. We comprehensively mapped symptoms and their impact on families to generate a comprehensive disease model as a foundation for clinical endpoints in future trials.
Collapse
Affiliation(s)
- Katie R. Sullivan
- Division of NeurologyChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
- The Epilepsy NeuroGenetics Initiative (ENGIN)Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
| | - Sarah M. Ruggiero
- Division of NeurologyChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
- The Epilepsy NeuroGenetics Initiative (ENGIN)Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
| | - Julie Xian
- Division of NeurologyChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
- The Epilepsy NeuroGenetics Initiative (ENGIN)Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
- Department of Biomedical and Health Informatics (DBHi)Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
| | - Kim M. Thalwitzer
- The Epilepsy NeuroGenetics Initiative (ENGIN)Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
- Department of Biomedical and Health Informatics (DBHi)Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
| | - Rahma Ali
- Division of NeurologyChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
- The Epilepsy NeuroGenetics Initiative (ENGIN)Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
| | - Sydni Stewart
- Division of NeurologyChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
- The Epilepsy NeuroGenetics Initiative (ENGIN)Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
| | - Mahgenn Cosico
- Division of NeurologyChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
- The Epilepsy NeuroGenetics Initiative (ENGIN)Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
- Department of Biomedical and Health Informatics (DBHi)Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
| | | | - James Goss
- STXBP1 Foundation, ApexHolly SpringsNorth CarolinaUSA
| | | | - Kyle J. Horning
- Vanderbilt UniversityNashvilleTennesseeUSA
- COMBINEDBrainBrentwoodTennesseeUSA
| | | | | | - Laura Conway
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | | | - Terry Jo Bichell
- Vanderbilt UniversityNashvilleTennesseeUSA
- COMBINEDBrainBrentwoodTennesseeUSA
| | - Ingo Helbig
- Division of NeurologyChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
- The Epilepsy NeuroGenetics Initiative (ENGIN)Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
- Department of Biomedical and Health Informatics (DBHi)Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
- Department of NeurologyUniversity of Pennsylvania, Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
| |
Collapse
|
24
|
Kanduc D. Exposure to SARS-CoV-2 and Infantile Diseases. Glob Med Genet 2023; 10:72-78. [PMID: 37144240 PMCID: PMC10154082 DOI: 10.1055/s-0043-1768699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
Background and Aim Immune response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in newborns and children after prophylactic immunization is currently a relevant research topic. The present study analyzes the issue by examining the possibility that the anti-SARS-CoV-2 immune responses are not uniquely directed against the virus but can-via molecular mimicry and the consequent cross-reactivity-also hit human proteins involved in infantile diseases. Methods Human proteins that-if altered-associate with infantile disorders were searched for minimal immune pentapeptide determinants shared with SARS-CoV-2 spike glycoprotein (gp). Then, the shared pentapeptides were analyzed for immunologic potential and immunologic imprinting phenomena. Results Comparative sequence analysis shows that: (1) numerous pentapeptides (namely, 54) are common to SARS-CoV-2 spike gp and human proteins that, when altered, are linked to infantile diseases; (2) all the shared peptides have an immunologic potential since they are present in experimentally validated SARS-CoV-2 spike gp-derived epitopes; and (3) many of the shared peptides are also hosted in infectious pathogens to which children can have already been exposed, thus making immunologic imprint phenomena feasible. Conclusion Molecular mimicry and the consequent cross-reactivity can represent the mechanism that connects exposure to SARS-CoV-2 and various pediatric diseases, with a fundamental role of the immunologic memory and the history of the child's infections in determining and specifying the immune response and the pathologic autoimmune sequela.
Collapse
Affiliation(s)
- Darja Kanduc
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
- Address for correspondence Darja Kanduc, PhD Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari70126 BariItaly
| |
Collapse
|
25
|
Xian J, Thalwitzer KM, McKee J, Sullivan KR, Brimble E, Fitch E, Toib J, Kaufman MC, deCampo D, Cunningham K, Pierce SR, Goss J, Rigby CS, Syrbe S, Boland M, Prosser B, Fitter N, Ruggiero SM, Helbig I. Delineating clinical and developmental outcomes in STXBP1-related disorders. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.10.23289776. [PMID: 37215006 PMCID: PMC10197795 DOI: 10.1101/2023.05.10.23289776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
STXBP1-related disorders are among the most common genetic epilepsies and neurodevelopmental disorders. However, the longitudinal epilepsy course and developmental endpoints have not yet been described in detail, which is a critical prerequisite for clinical trial readiness. Here, we assessed 1,281 cumulative patient-years of seizure and developmental histories in 162 individuals with STXBP1-related disorders and established a natural history framework. STXBP1-related disorders are characterized by a dynamic pattern of seizures in the first year of life and high variability in neurodevelopmental trajectories in early childhood. Epilepsy onset differed across seizure types, with 90% cumulative onset for infantile spasms by 6 months and focal-onset seizures by 27 months of life. Epilepsy histories diverged between variant subgroups in the first 2 years of life, when individuals with protein-truncating variants and deletions in STXBP1 (n=39) were more likely to have infantile spasms between 5 and 6 months followed by seizure remission, while individuals with missense variants (n=30) had an increased risk for focal seizures and ongoing seizures after the first year. Developmental outcomes were mapped using milestone acquisition data in addition to standardized assessments including the Gross Motor Function Measure-66 Item Set and the Grasping and Visual-Motor Integration subsets of the Peabody Developmental Motor Scales. Quantification of endpoints revealed high variability during the first five years of life, with emerging stratification between clinical subgroups, most prominently between individuals with and without infantile spasms. We found that individuals with neonatal seizures or early infantile seizures followed by seizure offset by 12 months of life had more predictable seizure trajectories in early to late childhood than compared to individuals with more severe seizure presentations, including individuals with refractory epilepsy throughout the first year. Characterization of anti-seizure medication response revealed age-dependent response over time, with phenobarbital, levetiracetam, topiramate, and adrenocorticotropic hormone effective in reducing seizures in the first year of life, while clobazam and the ketogenic diet were effective in long-term seizure management. Virtual clinical trials using seizure frequency as the primary outcome resulted in wide range of trial success probabilities across the age span, with the highest probability in early childhood between 1 year and 3.5 years. In summary, we delineated epilepsy and developmental trajectories in STXBP1-related disorders using standardized measures, providing a foundation to interpret future therapeutic strategies and inform rational trial design.
Collapse
Affiliation(s)
- Julie Xian
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Kim Marie Thalwitzer
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
- Division of Pediatric Epileptology, Centre for Pediatric and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Jillian McKee
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Katie Rose Sullivan
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | | | - Eryn Fitch
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Jonathan Toib
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Michael C. Kaufman
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
| | - Danielle deCampo
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Kristin Cunningham
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Samuel R. Pierce
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | | | | | - Steffen Syrbe
- Division of Pediatric Epileptology, Centre for Pediatric and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Michael Boland
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
- Institute for Genomic Medicine, Columbia University, New York, NY 10032, USA
| | - Ben Prosser
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
- Department of Physiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | | | - Sarah M. Ruggiero
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Ingo Helbig
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
- Epilepsy and Neurodevelopmental Disorders Center (ENDD), Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| |
Collapse
|
26
|
Liu RJY, Al-Molieh Y, Chen SZ, Drobac M, Urban D, Chen CH, Yao HHY, Geng RSQ, Li L, Pluthero FG, Benlekbir S, Rubinstein JL, Kahr WHA. The Sec1/Munc18 protein VPS33B forms a uniquely bidirectional complex with VPS16B. J Biol Chem 2023; 299:104718. [PMID: 37062417 DOI: 10.1016/j.jbc.2023.104718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 03/03/2023] [Accepted: 04/07/2023] [Indexed: 04/18/2023] Open
Abstract
Loss of function variants of VPS33B and VIPAS39 (encoding VPS16B) are causative for arthrogryposis, renal dysfunction and cholestasis (ARC) syndrome, where early lethality of patients indicates that VPS33B and VPS16B play essential cellular roles. VPS33B is a member of the Sec1/Munc18 (SM) protein family, and thus thought to facilitate vesicular fusion via interaction with SNARE complexes, as does its paralog VPS33A in the homotypic fusion and vacuole sorting (HOPS) complex. VPS33B and VPS16B have been shown to associate, but little is known about the composition, structure or function of the VPS33B/VPS16B complex. We show here that human VPS33B/VPS16B is a high molecular weight complex, which we expressed in yeast to obtain material for structural, composition and stability analysis. Circular dichroism data indicate VPS33B/VPS16B has a well-folded α-helical secondary structure, for which size exclusion chromatography-multi angle light scattering revealed a MW of ∼315 kDa. Quantitative immunoblotting indicated the complex has a VPS33B:VPS16B ratio of 2:3. Expression of ARC syndrome-causing VPS33B missense variants showed that L30P disrupts complex formation, but not S243F or H344D. Truncated VPS16B containing amino acids 143-316 was sufficient to form a complex with VPS33B. Small angle X-ray scattering and negative staining electron microscopy revealed a two-lobed shape for VPS33B/VPS16B. Avidin tagging indicated that each lobe contains a VPS33B molecule, and they are oriented in opposite directions. From this we propose a structure for VPS33B/VPS16B that allows the copies of VPS33B at each end to interact with separate SNARE bundles and/or SNAREpins, plus their associated membrane components. Thus our observations reveal the only known potentially bidirectional SM protein complex.
Collapse
Affiliation(s)
- Richard J Y Liu
- Department of Biochemistry, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Yusef Al-Molieh
- Department of Biochemistry, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Shao Z Chen
- Department of Biochemistry, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Marko Drobac
- Department of Biochemistry, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Denisa Urban
- Department of Biochemistry, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Chang H Chen
- Department of Biochemistry, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Helen H Y Yao
- Department of Biochemistry, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Ryan S Q Geng
- Department of Biochemistry, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Ling Li
- Cell Biology Program, Research Institute, Hospital for Sick Children, Toronto, ON, M5G 0A4, Canada
| | - Fred G Pluthero
- Cell Biology Program, Research Institute, Hospital for Sick Children, Toronto, ON, M5G 0A4, Canada
| | - Samir Benlekbir
- Molecular Medicine Program, Research Institute, Hospital for Sick Children, Toronto, ON, M5G 0A4, Canada
| | - John L Rubinstein
- Department of Biochemistry, University of Toronto, Toronto, ON, M5S 1A8, Canada; Molecular Medicine Program, Research Institute, Hospital for Sick Children, Toronto, ON, M5G 0A4, Canada
| | - Walter H A Kahr
- Department of Biochemistry, University of Toronto, Toronto, ON, M5S 1A8, Canada; Cell Biology Program, Research Institute, Hospital for Sick Children, Toronto, ON, M5G 0A4, Canada; Division of Haematology/Oncology, Department of Paediatrics, University of Toronto and The Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada.
| |
Collapse
|
27
|
Uzay B, Kavalali ET. Genetic disorders of neurotransmitter release machinery. Front Synaptic Neurosci 2023; 15:1148957. [PMID: 37066095 PMCID: PMC10102358 DOI: 10.3389/fnsyn.2023.1148957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/10/2023] [Indexed: 04/03/2023] Open
Abstract
Synaptic neurotransmitter release is an evolutionarily conserved process that mediates rapid information transfer between neurons as well as several peripheral tissues. Release of neurotransmitters are ensured by successive events such as synaptic vesicle docking and priming that prepare synaptic vesicles for rapid fusion. These events are orchestrated by interaction of different presynaptic proteins and are regulated by presynaptic calcium. Recent studies have identified various mutations in different components of neurotransmitter release machinery resulting in aberrant neurotransmitter release, which underlie a wide spectrum of psychiatric and neurological symptoms. Here, we review how these genetic alterations in different components of the core neurotransmitter release machinery affect the information transfer between neurons and how aberrant synaptic release affects nervous system function.
Collapse
Affiliation(s)
- Burak Uzay
- Vanderbilt Brain Institute, Nashville, TN, United States
- Department of Pharmacology, Vanderbilt University, Nashville, TN, United States
| | - Ege T. Kavalali
- Vanderbilt Brain Institute, Nashville, TN, United States
- Department of Pharmacology, Vanderbilt University, Nashville, TN, United States
| |
Collapse
|
28
|
Kaya Özçora GD, Söbü E, Gümüş U. Genetic and clinical variations of developmental epileptic encephalopathies. Neurol Res 2023; 45:226-233. [PMID: 36731496 DOI: 10.1080/01616412.2023.2170917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The concept of 'developmental and epileptic encephalopathy (DEE)' recognises that in infants presenting with severe early-onset epilepsy, neurodevelopmental comorbidity may be attributable to both the underlying cause and to adverse effects of uncontrolled epileptic activity. There is no direct genotype - phenotype correlation in DEEs. This study aimed to report the genetic and phenotypic differences in patients with DEE. METHODS Genetic evaluations of the patients were performed due to epilepsy combined with developmental delay, epileptic encephalopathy, motor deficits, autistic features, or cognitive impairment. Patients were assessed for demographic characteristics, medical history, family history, psychomotor development, seizure control interventions, electroencephalogram (EEG) and magnetic resonance imaging (MRI) findings. RESULTS This study included 20 children aged 0-16 years who were diagnosed as having DEE.The types of DEE detected in our study were DEE 2, 4, 6B, 7, 11, 26, 30, 33, 35, 42, 58, 62, and 67.Status epilepticus was recorded in only DEE7. The most common EEG abnormality was multifocal epileptic discharges (35%,) followed by burst-suppression patterns in patients with neonatal-onset seizures. Thirteen of the children were aged over 2 years, two (15%) were non-ambulatory and six (46%) were non-verbal. MRI scans were normal in 80% of the patients. Refractory epilepsy seen in 33% of cases.De-novo mutation, microcephaly and dysmorphic findings accompany resistant seizures and are associated with poor prognosis. DISCUSSION For patients with movement disorders, developmental delay, autism, and ID with or without epilepsy in any period of their life, next-generation sequencing is the only diagnostic technique available, with genetic analysis often being the only diagnostic method.
Collapse
Affiliation(s)
- Gül Demet Kaya Özçora
- Faculty of Medical Sciences Pediatric Neurology Dept, Gaziantep Hasan Kalyoncu University, Gaziantep, Turkey
| | - Elif Söbü
- Kartal Dr.Lütfi Kırdar City Hospital, Department of Pediatric Endocrinology, Istanbul, Turkey
| | - Uğur Gümüş
- Dr. Ersin Arslan Education and Research Hospital, Medical Genetics Department, Gaziantep, Turkey
| |
Collapse
|
29
|
Zhou Y, Hong Q, Xu W, Chen W, Xie X, Zhuang D, Lai M, Fu D, Xu Z, Wang M, Zhou W, Liu H. Differential expression profiling of tRNA-Derived small RNAs and their potential roles in methamphetamine self-administered rats. Front Genet 2023; 14:1088498. [PMID: 36845381 PMCID: PMC9945332 DOI: 10.3389/fgene.2023.1088498] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/18/2023] [Indexed: 02/05/2023] Open
Abstract
Transfer RNA-derived small RNAs (tsRNAs) are a novel class of short, non-coding RNAs that are closely associated with the pathogenesis of various diseases. Accumulating evidence has demonstrated their critical functional roles as regulatory factors in gene expression regulation, protein translation regulation, regulation of various cellular activities, immune mediation, and response to stress. However, the underlying mechanisms by which tRFs & tiRNAs affect methamphetamine-induced pathophysiological processes are largely unknown. In this study, we used a combination of small RNA sequencing, quantitative reverse transcription-polymerase chain reaction (qRT‒PCR), bioinformatics, and luciferase reporter assays to screen the expression profiles and identify the functional roles of tRFs and tiRNAs in the nucleus accumbens (NAc) of methamphetamine self-administration rat models. A total of 461 tRFs & tiRNAs were identified in the NAc of rats after 14 days of methamphetamine self-administration training. Of those, 132 tRFs & tiRNAs were significantly differentially expressed: 59 were significantly upregulated, whereas 73 were significantly downregulated in the rats with methamphetamine self-administration. Decreased expression levels of tiRNA-1-34-Lys-CTT-1 and tRF-1-32-Gly-GCC-2-M2, as well as increased expression levels of tRF-1-16-Ala-TGC-4 in the METH group compared with the saline control were validated by using RT‒PCR. Then, bioinformatic analysis was performed to analyse the possible biological functions of tRFs & tiRNAs in methamphetamine-induced pathogenesis. Furthermore, tRF-1-32-Gly-GCC-2-M2 was identified to target BDNF using the luciferase reporter assay. An altered tsRNA expression pattern was proven, and tRF-1-32-Gly-GCC-2-M2 was shown to be involved in methamphetamine-induced pathophysiologic processes by targeting BDNF. The current study provides new insights for future investigations to explore the mechanisms and therapeutic methods for methamphetamine addiction.
Collapse
Affiliation(s)
- Yun Zhou
- School of Medicine, Ningbo University, Laboratory of Behavioral Neuroscience, Ningbo Kangning Hospital, Ningbo, Zhejiang, China
| | - Qingxiao Hong
- School of Medicine, Ningbo University, Laboratory of Behavioral Neuroscience, Ningbo Kangning Hospital, Ningbo, Zhejiang, China,Key Laboratory of Addiction Research of Zhejiang Province, Ningbo, Zhejiang, China
| | - Wenjin Xu
- School of Medicine, Ningbo University, Laboratory of Behavioral Neuroscience, Ningbo Kangning Hospital, Ningbo, Zhejiang, China,Key Laboratory of Addiction Research of Zhejiang Province, Ningbo, Zhejiang, China
| | - Weisheng Chen
- School of Medicine, Ningbo University, Laboratory of Behavioral Neuroscience, Ningbo Kangning Hospital, Ningbo, Zhejiang, China,Key Laboratory of Addiction Research of Zhejiang Province, Ningbo, Zhejiang, China
| | - Xiaohu Xie
- School of Medicine, Ningbo University, Laboratory of Behavioral Neuroscience, Ningbo Kangning Hospital, Ningbo, Zhejiang, China,Key Laboratory of Addiction Research of Zhejiang Province, Ningbo, Zhejiang, China
| | - Dingding Zhuang
- School of Medicine, Ningbo University, Laboratory of Behavioral Neuroscience, Ningbo Kangning Hospital, Ningbo, Zhejiang, China,Key Laboratory of Addiction Research of Zhejiang Province, Ningbo, Zhejiang, China
| | - Miaojun Lai
- School of Medicine, Ningbo University, Laboratory of Behavioral Neuroscience, Ningbo Kangning Hospital, Ningbo, Zhejiang, China,Key Laboratory of Addiction Research of Zhejiang Province, Ningbo, Zhejiang, China
| | - Dan Fu
- School of Medicine, Ningbo University, Laboratory of Behavioral Neuroscience, Ningbo Kangning Hospital, Ningbo, Zhejiang, China,Key Laboratory of Addiction Research of Zhejiang Province, Ningbo, Zhejiang, China
| | - Zemin Xu
- School of Medicine, Ningbo University, Laboratory of Behavioral Neuroscience, Ningbo Kangning Hospital, Ningbo, Zhejiang, China,Key Laboratory of Addiction Research of Zhejiang Province, Ningbo, Zhejiang, China
| | - Majie Wang
- School of Medicine, Ningbo University, Laboratory of Behavioral Neuroscience, Ningbo Kangning Hospital, Ningbo, Zhejiang, China,Key Laboratory of Addiction Research of Zhejiang Province, Ningbo, Zhejiang, China
| | - Wenhua Zhou
- School of Medicine, Ningbo University, Laboratory of Behavioral Neuroscience, Ningbo Kangning Hospital, Ningbo, Zhejiang, China,Key Laboratory of Addiction Research of Zhejiang Province, Ningbo, Zhejiang, China,*Correspondence: Wenhua Zhou, ; Huifen Liu,
| | - Huifen Liu
- School of Medicine, Ningbo University, Laboratory of Behavioral Neuroscience, Ningbo Kangning Hospital, Ningbo, Zhejiang, China,Key Laboratory of Addiction Research of Zhejiang Province, Ningbo, Zhejiang, China,*Correspondence: Wenhua Zhou, ; Huifen Liu,
| |
Collapse
|
30
|
Bryson A, Reid C, Petrou S. Fundamental Neurochemistry Review: GABA A receptor neurotransmission and epilepsy: Principles, disease mechanisms and pharmacotherapy. J Neurochem 2023; 165:6-28. [PMID: 36681890 DOI: 10.1111/jnc.15769] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/12/2022] [Accepted: 01/04/2023] [Indexed: 01/23/2023]
Abstract
Epilepsy is a common neurological disorder associated with alterations of excitation-inhibition balance within brain neuronal networks. GABAA receptor neurotransmission is the most prevalent form of inhibitory neurotransmission and is strongly implicated in both the pathophysiology and treatment of epilepsy, serving as a primary target for antiseizure medications for over a century. It is now established that GABA exerts a multifaceted influence through an array of GABAA receptor subtypes that extends far beyond simply negating excitatory activity. As the role of GABAA neurotransmission within inhibitory circuits is elaborated, this will enable the development of precision therapies that correct the network dysfunction underlying epileptic pathology.
Collapse
Affiliation(s)
- Alexander Bryson
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia.,Department of Neurology, Austin Health, Heidelberg, Victoria, Australia
| | - Christopher Reid
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Steven Petrou
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia.,Praxis Precision Medicines, Inc., Cambridge, Massachusetts, USA
| |
Collapse
|
31
|
Li W, Xing Y, Wang Y, Xu T, Song E, Feng W. A non-canonical target-binding site in Munc18-1 domain 3b for assembling the Mint1-Munc18-1-syntaxin-1 complex. Structure 2023; 31:68-77.e5. [PMID: 36608665 DOI: 10.1016/j.str.2022.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/10/2022] [Accepted: 11/04/2022] [Indexed: 01/07/2023]
Abstract
As the prototype of Sec1/Munc18 (SM) family proteins, Munc18-1 can manipulate the distinct conformations of syntaxin-1 for controlling intracellular membrane fusion. The Munc18-1-interacting domain of Mint1 (Mint1-MID) binds to Munc18-1 together with syntaxin-1 to form a Mint1-Munc18-1-syntaxin-1 complex, but the mechanism underlying the complex assembly remains unclear. Here, we determine the structure of the Mint1-MID-Munc18-1-syntaxin-1 complex. Unexpectedly, Munc18-1 recognizes Mint1-MID and syntaxin-1 simultaneously via two opposite sites. The canonical central cavity between domains 1 and 3a of Munc18-1 embraces closed syntaxin-1, whereas the non-canonical basic pocket in domain 3b captures the acidic Mint1-MID helix. The domain 3b-mediated recognition of an acidic-helical motif is distinct from other target-recognition modes of Munc18-1. Mutations in the interface between domain 3b and Mint1-MID disrupt the assembly of the Mint1-Munc18-1-syntaxin-1 complex. This work reveals a non-canonical target-binding site in Munc18-1 domain 3b for assembling the Mint1-Munc18-1-syntaxin-1 complex.
Collapse
Affiliation(s)
- Wei Li
- National Laboratory of Biomacromolecules, CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, 15 Datun Road, Beijing 100101, China
| | - Ying Xing
- National Laboratory of Biomacromolecules, CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, 15 Datun Road, Beijing 100101, China; College of Life Sciences, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yue Wang
- National Laboratory of Biomacromolecules, CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, 15 Datun Road, Beijing 100101, China; College of Life Sciences, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Tao Xu
- National Laboratory of Biomacromolecules, CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, 15 Datun Road, Beijing 100101, China; College of Life Sciences, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Eli Song
- National Laboratory of Biomacromolecules, CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, 15 Datun Road, Beijing 100101, China.
| | - Wei Feng
- National Laboratory of Biomacromolecules, CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, 15 Datun Road, Beijing 100101, China; College of Life Sciences, University of Chinese Academy of Sciences, Beijing 100049, China.
| |
Collapse
|
32
|
Cnpy3 2xHA mice reveal neuronal expression of Cnpy3 in the brain. J Neurosci Methods 2023; 383:109730. [PMID: 36280087 DOI: 10.1016/j.jneumeth.2022.109730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/04/2022] [Accepted: 10/17/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Identification of biallelic CNPY3 mutations in patients with epileptic encephalopathy and abnormal electroencephalography findings of Cnpy3 knock-out mice have indicated that the loss of CNPY3 function causes neurological disorders such as epilepsy. However, the basic property of CNPY3 in the brain remains unclear. NEW METHOD We generated C-terminal 2xHA-tag knock-in Cnpy3 mice by i-GONAD in vivo genome editing system to investigate the expression and function of Cnpy3 in the mouse brain. RESULTS 2xHA-tagged Cnpy3 was confirmed by immunoblot analysis using anti-HA and CNPY3 antibodies, although HA tagging caused the decreased Cnpy3 protein level. Immunohistochemical analysis of Cnpy32xHA knock-in mice showed that Cnpy3-2xHA was predominantly expressed in the neuron. In addition, Cnpy3 and Cnpy3-2xHA were both localized in the endoplasmic reticulum and synaptosome and showed age-dependent expression changes in the brain. COMPARISON WITH EXISTING METHODS Conventional Cnpy3 antibodies could not allow us to investigate the distribution of Cnpy3 expression in the brain, while HA-tagging revealed the expression of CNPY3 in neuronal cells. CONCLUSIONS Taken together, we demonstrated that Cnpy32xHA knock-in mice would be useful to further elucidate the property of Cnpy3 in brain function and neurological disorders.
Collapse
|
33
|
Banerjee D, Girirajan S. Pathogenic Variants and Ascertainment: Neuropsychiatric Disease Risk in a Health System Cohort. Am J Psychiatry 2023; 180:11-13. [PMID: 36587271 PMCID: PMC9995216 DOI: 10.1176/appi.ajp.20220934] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Deepro Banerjee
- Bioinformatics and Genomics Program, Huck Institutes of Life Sciences, University Park, Pa. (Banerjee, Girirajan); Department of Biochemistry and Molecular Biology and Department of Anthropology, Pennsylvania State University, University Park, Pa. (Girirajan)
| | - Santhosh Girirajan
- Bioinformatics and Genomics Program, Huck Institutes of Life Sciences, University Park, Pa. (Banerjee, Girirajan); Department of Biochemistry and Molecular Biology and Department of Anthropology, Pennsylvania State University, University Park, Pa. (Girirajan)
| |
Collapse
|
34
|
Joshi C. Responding to the Need of the Hour: Natural History Studies. Epilepsy Curr 2023; 23:20-22. [PMID: 36923343 PMCID: PMC10009117 DOI: 10.1177/15357597221135963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Natural History Study of STXBP1-Developmental and Epileptic Encephalopathy Into Adulthood Stamberger H, Crosiers D, Balagura G, Bonardi CM, Basu A, Cantalupo G, Chiesa V, Christensen J, Bernardina BD, Ellis CA, Furia F, Gardiner F, Giron C, Guerrini R, Klein KM, Korff C, Krijtova H, Leffner M, Lerche H, Lesca G, Lewis-Smith D, Marini C, Marjanovic D, Mazzola L, Ruggiero SM, Mochel F, Ramond F, Reif PS, Richard-Mornas A, Rosenow F, Schropp C, Thomas RH, Vignoli A, Weber Y, Palmer E, Helbig I, Scheffer IE, Striano P, Møller RS, Gardella E, Weckhuysen S. Neurology. 2022;99(3):e221-e233. doi:10.1212/WNL.0000000000200715 Background and objectives: Pathogenic STXBP1 variants cause a severe early-onset developmental and epileptic encephalopathy (STXBP1-DEE). We aimed to investigate the natural history of STXBP1-DEE in adults focusing on seizure evolution, the presence of movement disorders, and the level of functional (in)dependence. Methods: In this observational study, patients with a minimum age of 18 years carrying a (likely) pathogenic STXBP1 variant were recruited through medical genetics departments and epilepsy centers. Treating clinicians completed clinical questionnaires and performed semistructured video examinations while performing tasks from the (modified) Unified Parkinson Disease Rating Scale when possible. Results: Thirty adult patients were included for summary statistics, with video recordings available for 19 patients. The median age at last follow-up was 24 years (range 18-58 years). All patients had epilepsy, with a median onset age of 3.5 months. At last follow-up, 80% of adults had treatment-resistant seizures despite long periods of seizure freedom in 37%. Tonic-clonic, focal, and tonic seizures were most frequent in adults. Epileptic spasms, an unusual feature beyond infancy, were present in 3 adults. All individuals had developmental impairment. Periods of regression were present in 59% and did not always correlate with flare-ups in seizure activity. Eighty-seven percent had severe or profound intellectual disability, 42% had autistic features, and 65% had significant behavioral problems. Video examinations showed gait disorders in all 12 patients able to walk, including postural abnormalities with external rotation of the feet, broad-based gait, and asymmetric posture/dystonia. Tremor, present in 56%, was predominantly of the intention/action type. Stereotypies were seen in 63%. Functional outcome concerning mobility was variable ranging from independent walking (50%) to wheelchair dependence (39%). Seventy-one percent of adults were nonverbal, and all were dependent on caregivers for most activities of daily living. Discussion: STXBP1-DEE warrants continuous monitoring for seizures in adult life. Periods of regression are more frequent than previously established and can occur into adulthood. Movement disorders are often present and involve multiple systems. Although functional mobility is variable in adulthood, STXBP1-DEE frequently leads to severe cognitive impairments and a high level of functional dependence. Understanding the natural history of STXBP1-DEE is important for prognostication and will inform future therapeutic trials.
Collapse
Affiliation(s)
- Charuta Joshi
- Department of Pediatrics, The University of Texas Southwestern Medical Center
| |
Collapse
|
35
|
Exploring the Genetic Causality of Discordant Phenotypes in Familial Apparently Balanced Translocation Cases Using Whole Exome Sequencing. Genes (Basel) 2022; 14:genes14010082. [PMID: 36672823 PMCID: PMC9859009 DOI: 10.3390/genes14010082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/23/2022] [Accepted: 12/24/2022] [Indexed: 12/29/2022] Open
Abstract
Familial apparently balanced translocations (ABTs) are usually not associated with a phenotype; however, rarely, ABTs segregate with discordant phenotypes in family members carrying identical rearrangements. The current study was a follow-up investigation of four familial ABTs, where whole exome sequencing (WES) was implemented as a diagnostic tool to identify the underlying genetic aetiology of the patients' phenotypes. Data were analysed using an in-house bioinformatics pipeline alongside VarSome Clinical. WES findings were validated with Sanger sequencing, while the impact of splicing and missense variants was assessed by reverse-transcription PCR and in silico tools, respectively. Novel candidate variants were identified in three families. In family 1, it was shown that the de novo pathogenic STXBP1 variant (NM_003165.6:c.1110+2T>G) affected splicing and segregated with the patient's phenotype. In family 2, a likely pathogenic TUBA1A variant (NM_006009.4:c.875C>T, NP_006000.2:p.(Thr292Ile)) could explain the patient's symptoms. In family 3, an SCN1A variant of uncertain significance (NM_006920.6:c.5060A>G, NP_008851.3:p.(Glu1687Gly)) required additional evidence to sufficiently support causality. This first report of WES application in familial ABT carriers with discordant phenotypes supported our previous findings describing such rearrangements as coincidental. Thus, WES can be recommended as a complementary test to find the monogenic cause of aberrant phenotypes in familial ABT carriers.
Collapse
|
36
|
Michetti C, Falace A, Benfenati F, Fassio A. Synaptic genes and neurodevelopmental disorders: From molecular mechanisms to developmental strategies of behavioral testing. Neurobiol Dis 2022; 173:105856. [PMID: 36070836 DOI: 10.1016/j.nbd.2022.105856] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 10/14/2022] Open
Abstract
Synaptopathies are a class of neurodevelopmental disorders caused by modification in genes coding for synaptic proteins. These proteins oversee the process of neurotransmission, mainly controlling the fusion and recycling of synaptic vesicles at the presynaptic terminal, the expression and localization of receptors at the postsynapse and the coupling between the pre- and the postsynaptic compartments. Murine models, with homozygous or heterozygous deletion for several synaptic genes or knock-in for specific pathogenic mutations, have been developed. They have proved to be extremely informative for understanding synaptic physiology, as well as for clarifying the patho-mechanisms leading to developmental delay, epilepsy and motor, cognitive and social impairments that are the most common clinical manifestations of neurodevelopmental disorders. However, the onset of these disorders emerges during infancy and adolescence while the behavioral phenotyping is often conducted in adult mice, missing important information about the impact of synaptic development and maturation on the manifestation of the behavioral phenotype. Here, we review the main achievements obtained by behavioral testing in murine models of synaptopathies and propose a battery of behavioral tests to improve classification, diagnosis and efficacy of potential therapeutic treatments. Our aim is to underlie the importance of studying behavioral development and better focusing on disease onset and phenotypes.
Collapse
Affiliation(s)
- Caterina Michetti
- Department of Experimental Medicine, University of Genoa, Genoa, Italy; Center for Synaptic Neuroscience, Istituto Italiano di Tecnologia, Genoa, Italy.
| | - Antonio Falace
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Fabio Benfenati
- Center for Synaptic Neuroscience, Istituto Italiano di Tecnologia, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Anna Fassio
- Department of Experimental Medicine, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| |
Collapse
|
37
|
Knowles JK, Helbig I, Metcalf CS, Lubbers LS, Isom LL, Demarest S, Goldberg EM, George AL, Lerche H, Weckhuysen S, Whittemore V, Berkovic SF, Lowenstein DH. Precision medicine for genetic epilepsy on the horizon: Recent advances, present challenges, and suggestions for continued progress. Epilepsia 2022; 63:2461-2475. [PMID: 35716052 PMCID: PMC9561034 DOI: 10.1111/epi.17332] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/14/2022] [Accepted: 06/14/2022] [Indexed: 01/18/2023]
Abstract
The genetic basis of many epilepsies is increasingly understood, giving rise to the possibility of precision treatments tailored to specific genetic etiologies. Despite this, current medical therapy for most epilepsies remains imprecise, aimed primarily at empirical seizure reduction rather than targeting specific disease processes. Intellectual and technological leaps in diagnosis over the past 10 years have not yet translated to routine changes in clinical practice. However, the epilepsy community is poised to make impressive gains in precision therapy, with continued innovation in gene discovery, diagnostic ability, and bioinformatics; increased access to genetic testing and counseling; fuller understanding of natural histories; agility and rigor in preclinical research, including strategic use of emerging model systems; and engagement of an evolving group of stakeholders (including patient advocates, governmental resources, and clinicians and scientists in academia and industry). In each of these areas, we highlight notable examples of recent progress, new or persistent challenges, and future directions. The future of precision medicine for genetic epilepsy looks bright if key opportunities on the horizon can be pursued with strategic and coordinated effort.
Collapse
Affiliation(s)
- Juliet K. Knowles
- Department of Neurology, Division of Child Neurology, Stanford University School of Medicine, Stanford, California, USA
| | - Ingo Helbig
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Epilepsy NeuroGenetics Initiative, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Neurology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Institute of Clinical Molecular Biology, University of Kiel, Kiel, Germany
- Department of Neuropediatrics, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Cameron S. Metcalf
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City, Utah, USA
| | - Laura S. Lubbers
- Citizens United for Research in Epilepsy, Chicago, Illinois, USA
| | - Lori L. Isom
- Department of Pharmacology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Scott Demarest
- Department of Pediatrics and Neurology, University of Colorado, School of Medicine, Aurora, Colorado, USA
| | - Ethan M. Goldberg
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Epilepsy NeuroGenetics Initiative, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Neurology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Alfred L. George
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Holger Lerche
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Sarah Weckhuysen
- Division of Neurology, University Hospital Antwerp, Antwerp, Belgium
- Applied and Translational Neurogenomics Group, Vlaams Instituut voor Biotechnologie Center for Molecular Neurology, Antwerp, Belgium
- Translational Neurosciences, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
- μNEURO Research Center of Excellence, University of Antwerp, Antwerp, Belgium
| | - Vicky Whittemore
- Division of Neuroscience, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Rockville, Maryland, USA
| | - Samuel F. Berkovic
- Epilepsy Research Centre, Department of Medicine, Austin Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Daniel H. Lowenstein
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| |
Collapse
|
38
|
Yan J, Kothur K, Innes EA, Han VX, Jones HF, Patel S, Tsang E, Webster R, Gupta S, Troedson C, Menezes MP, Antony J, Ardern-Holmes S, Tantsis E, Mohammad S, Wienholt L, Pires AS, Heng B, Guillemin GJ, Guller A, Gill D, Bandodkar S, Dale RC. Decreased cerebrospinal fluid kynurenic acid in epileptic spasms: A biomarker of response to corticosteroids. EBioMedicine 2022; 84:104280. [PMID: 36174397 PMCID: PMC9515432 DOI: 10.1016/j.ebiom.2022.104280] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/15/2022] Open
Abstract
Background Epileptic (previously infantile) spasms is the most common epileptic encephalopathy occurring during infancy and is frequently associated with abnormal neurodevelopmental outcomes. Epileptic spasms have a diverse range of known (genetic, structural) and unknown aetiologies. High dose corticosteroid treatment for 4 weeks often induces remission of spasms, although the mechanism of action of corticosteroid is unclear. Animal models of epileptic spasms have shown decreased brain kynurenic acid, which is increased after treatment with the ketogenic diet. We quantified kynurenine pathway metabolites in the cerebrospinal fluid (CSF) of infants with epileptic spasms and explored clinical correlations. Methods A panel of nine metabolites in the kynurenine pathway (tryptophan, kynurenine, kynurenic acid, 3-hydroxykynurenine, xanthurenic acid, anthranilic acid, 3-hydroxyanthranilic acid, quinolinic acid, and picolinic acid) were measured using liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). CSF collected from paediatric patients less than 3 years of age with epileptic spasms (n=34, 19 males, mean age 0.85, median 0.6, range 0.3–3 yrs) were compared with other epilepsy syndromes (n=26, 9 males, mean age 1.44, median 1.45, range 0.3–3 yrs), other non-inflammatory neurological diseases (OND) (n=29, 18 males, mean age 1.47, median 1.6, range 0.1–2.9 yrs) and inflammatory neurological controls (n=12, 4 males, mean age 1.80, median 1.80, range 0.8–2.5 yrs). Findings There was a statistically significant decrease of CSF kynurenic acid in patients with epileptic spasms compared to OND (p<0.0001). In addition, the kynurenic acid/kynurenine (KYNA/KYN) ratio was lower in the epileptic spasms subgroup compared to OND (p<0.0001). Epileptic spasms patients who were steroid responders or partial steroid responders had lower KYNA/KYN ratio compared to patients who were refractory to steroids (p<0.005, p<0.05 respectively). Interpretation This study demonstrates decreased CSF kynurenic acid and KYNA/KYN in epileptic spasms, which may also represent a biomarker for steroid responsiveness. Given the anti-inflammatory and neuroprotective properties of kynurenic acid, further therapeutics able to increase kynurenic acid should be explored. Funding Financial support for the study was granted by Dale NHMRC Investigator grant APP1193648, Petre Foundation, Cerebral Palsy Alliance and Department of Biochemistry at the Children's Hospital at Westmead. Prof Guillemin is funded by NHMRC Investigator grant APP1176660 and Macquarie University.
Collapse
Affiliation(s)
- Jingya Yan
- Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Department of Biochemistry, The Children's Hospital at Westmead, NSW, Australia; Clinical School, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Kavitha Kothur
- Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia; TY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, The University of Sydney, Westmead, New South Wales, Australia
| | - Emily A Innes
- TY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, The University of Sydney, Westmead, New South Wales, Australia
| | - Velda X Han
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Hannah F Jones
- Starship Hospital, Centre for Brain Research, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Shrujna Patel
- Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Clinical School, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Erica Tsang
- Clinical School, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Richard Webster
- TY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, The University of Sydney, Westmead, New South Wales, Australia
| | - Sachin Gupta
- TY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, The University of Sydney, Westmead, New South Wales, Australia
| | - Christopher Troedson
- TY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, The University of Sydney, Westmead, New South Wales, Australia; Clinical School, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Manoj P Menezes
- TY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, The University of Sydney, Westmead, New South Wales, Australia; Clinical School, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Jayne Antony
- TY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, The University of Sydney, Westmead, New South Wales, Australia
| | - Simone Ardern-Holmes
- TY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, The University of Sydney, Westmead, New South Wales, Australia
| | - Esther Tantsis
- Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Clinical School, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Shekeeb Mohammad
- Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia; TY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, The University of Sydney, Westmead, New South Wales, Australia; Clinical School, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Louise Wienholt
- Department of Clinical Immunology and Allergy, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Ananda S Pires
- Neuroinflammation Group, Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW, Australia
| | - Benjamin Heng
- Neuroinflammation Group, Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW, Australia
| | - Gilles J Guillemin
- Neuroinflammation Group, Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW, Australia
| | - Anna Guller
- Computational NeuroSurgery Lab, Macquarie University, Sydney, NSW, Australia
| | - Deepak Gill
- TY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, The University of Sydney, Westmead, New South Wales, Australia
| | - Sushil Bandodkar
- Department of Biochemistry, The Children's Hospital at Westmead, NSW, Australia; Clinical School, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Russell C Dale
- Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Clinical School, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia.
| |
Collapse
|
39
|
Mutation in the STXBP1 Gene Associated with Early Onset West Syndrome: A Case Report and Literature Review. Pediatr Rep 2022; 14:386-395. [PMID: 36278550 PMCID: PMC9589999 DOI: 10.3390/pediatric14040046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/05/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022] Open
Abstract
Syntaxin-binding protein1 (STXBP1) is a member of the Sec1/Munc18-1 protein family, which comprises important regulators of the secretory and synaptic vesicle fusion machinery underlying hormonal and neuronal transmission, respectively. STXBP1 pathogenic variants are associated with multiple neurological disorders. Herein, we present the case of a Japanese girl with a mutation in the STXBP1 gene, who was born at 40 weeks without neonatal asphyxia. At 15 days old, she developed epilepsy and generalized seizures. Around 88 days old, she presented with a series of nodding spasms, with the seizure frequency gradually increasing. Interictal EEG indicated hypsarrhythmia and she presented with developmental regression. At 1.5 years old, genetic testing was performed and mutational analysis revealed an STXBP1 gene mutation (c.875G > A: p.Arg292His). Accordingly, she was diagnosed with developmental and epileptic encephalopathy, presenting West syndrome’s clinical characteristics caused by the STXBP1 gene mutation. Although drug treatment has reduced the frequency of epileptic seizures, her development has remained regressive. The relationship between the location and type of genetic abnormality and the phenotype remains unclear. Future studies should investigate the genotype−phenotype correlation and the underlying pathophysiology to elucidate the causal relationships among the multiple phenotype-determining factors.
Collapse
|
40
|
Qi C, Luo LD, Feng I, Ma S. Molecular mechanisms of synaptogenesis. Front Synaptic Neurosci 2022; 14:939793. [PMID: 36176941 PMCID: PMC9513053 DOI: 10.3389/fnsyn.2022.939793] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022] Open
Abstract
Synapses are the basic units for information processing and storage in the nervous system. It is only when the synaptic connection is established, that it becomes meaningful to discuss the structure and function of a circuit. In humans, our unparalleled cognitive abilities are correlated with an increase in the number of synapses. Additionally, genes involved in synaptogenesis are also frequently associated with neurological or psychiatric disorders, suggesting a relationship between synaptogenesis and brain physiology and pathology. Thus, understanding the molecular mechanisms of synaptogenesis is the key to the mystery of circuit assembly and neural computation. Furthermore, it would provide therapeutic insights for the treatment of neurological and psychiatric disorders. Multiple molecular events must be precisely coordinated to generate a synapse. To understand the molecular mechanisms underlying synaptogenesis, we need to know the molecular components of synapses, how these molecular components are held together, and how the molecular networks are refined in response to neural activity to generate new synapses. Thanks to the intensive investigations in this field, our understanding of the process of synaptogenesis has progressed significantly. Here, we will review the molecular mechanisms of synaptogenesis by going over the studies on the identification of molecular components in synapses and their functions in synaptogenesis, how cell adhesion molecules connect these synaptic molecules together, and how neural activity mobilizes these molecules to generate new synapses. Finally, we will summarize the human-specific regulatory mechanisms in synaptogenesis and results from human genetics studies on synaptogenesis and brain disorders.
Collapse
Affiliation(s)
- Cai Qi
- Department of Neuroscience, Yale School of Medicine, New Haven, CT, United States
- *Correspondence: Cai Qi,
| | - Li-Da Luo
- Department of Neuroscience, Yale School of Medicine, New Haven, CT, United States
- Department of Cellular and Molecular Physiology, Program in Cellular Neuroscience, Neurodegeneration and Repair, Yale University School of Medicine, New Haven, CT, United States
| | - Irena Feng
- Boston University School of Medicine, Boston, MA, United States
| | - Shaojie Ma
- Department of Neuroscience, Yale School of Medicine, New Haven, CT, United States
| |
Collapse
|
41
|
Stamberger H, Crosiers D, Balagura G, Bonardi CM, Basu A, Cantalupo G, Chiesa V, Christensen J, Dalla Bernardina B, Ellis CA, Furia F, Gardiner F, Giron C, Guerrini R, Klein KM, Korff C, Krijtova H, Leffler M, Lerche H, Lesca G, Lewis-Smith D, Marini C, Marjanovic D, Mazzola L, McKeown Ruggiero S, Mochel F, Ramond F, Reif PS, Richard-Mornas A, Rosenow F, Schropp C, Thomas RH, Vignoli A, Weber Y, Palmer E, Helbig I, Scheffer IE, Striano P, Møller RS, Gardella E, Weckhuysen S. Natural History Study of STXBP1-Developmental and Epileptic Encephalopathy Into Adulthood. Neurology 2022; 99:e221-e233. [PMID: 35851549 PMCID: PMC9302932 DOI: 10.1212/wnl.0000000000200715] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 03/25/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Pathogenic STXBP1 variants cause a severe early-onset developmental and epileptic encephalopathy (STXBP1-DEE). We aimed to investigate the natural history of STXBP1-DEE in adults focusing on seizure evolution, the presence of movement disorders, and the level of functional (in)dependence. METHODS In this observational study, patients with a minimum age of 18 years carrying a (likely) pathogenic STXBP1 variant were recruited through medical genetics departments and epilepsy centers. Treating clinicians completed clinical questionnaires and performed semistructured video examinations while performing tasks from the (modified) Unified Parkinson Disease Rating Scale when possible. RESULTS Thirty adult patients were included for summary statistics, with video recordings available for 19 patients. The median age at last follow-up was 24 years (range 18-58 years). All patients had epilepsy, with a median onset age of 3.5 months. At last follow-up, 80% of adults had treatment-resistant seizures despite long periods of seizure freedom in 37%. Tonic-clonic, focal, and tonic seizures were most frequent in adults. Epileptic spasms, an unusual feature beyond infancy, were present in 3 adults. All individuals had developmental impairment. Periods of regression were present in 59% and did not always correlate with flare-ups in seizure activity. Eighty-seven percent had severe or profound intellectual disability, 42% had autistic features, and 65% had significant behavioral problems. Video examinations showed gait disorders in all 12 patients able to walk, including postural abnormalities with external rotation of the feet, broad-based gait, and asymmetric posture/dystonia. Tremor, present in 56%, was predominantly of the intention/action type. Stereotypies were seen in 63%. Functional outcome concerning mobility was variable ranging from independent walking (50%) to wheelchair dependence (39%). Seventy-one percent of adults were nonverbal, and all were dependent on caregivers for most activities of daily living. DISCUSSION STXBP1-DEE warrants continuous monitoring for seizures in adult life. Periods of regression are more frequent than previously established and can occur into adulthood. Movement disorders are often present and involve multiple systems. Although functional mobility is variable in adulthood, STXBP1-DEE frequently leads to severe cognitive impairments and a high level of functional dependence. Understanding the natural history of STXBP1-DEE is important for prognostication and will inform future therapeutic trials.
Collapse
Affiliation(s)
- Hannah Stamberger
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia.
| | - David Crosiers
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Ganna Balagura
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Claudia M Bonardi
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Anna Basu
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Gaetano Cantalupo
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Valentina Chiesa
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Jakob Christensen
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Bernardo Dalla Bernardina
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Colin A Ellis
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Francesca Furia
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Fiona Gardiner
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Camille Giron
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Renzo Guerrini
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Karl Martin Klein
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Christian Korff
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Hana Krijtova
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Melanie Leffler
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Holger Lerche
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Gaetan Lesca
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - David Lewis-Smith
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Carla Marini
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Dragan Marjanovic
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Laure Mazzola
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Sarah McKeown Ruggiero
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Fanny Mochel
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Francis Ramond
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Philipp S Reif
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Aurélie Richard-Mornas
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Felix Rosenow
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Christian Schropp
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Rhys H Thomas
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Aglaia Vignoli
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Yvonne Weber
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Elizabeth Palmer
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Ingo Helbig
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Ingrid E Scheffer
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Pasquale Striano
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Rikke S Møller
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Elena Gardella
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Sarah Weckhuysen
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| |
Collapse
|
42
|
Lesca G, Baumgartner T, Monin P, De Dominicis A, Kunz WS, Specchio N. Genetic causes of rare and common epilepsies: What should the epileptologist know? Eur J Med Genet 2022; 65:104570. [PMID: 35850153 DOI: 10.1016/j.ejmg.2022.104570] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 07/04/2022] [Accepted: 07/10/2022] [Indexed: 11/03/2022]
Abstract
In past decades, the identification of genes involved in epileptic disorders has grown exponentially. The pace of gene identification in epileptic disorders began to accelerate in the late 2000s, driven by new technologies such as molecular cytogenetics and next-generation sequencing (NGS). These technologies have also been applied to genetic diagnostics, with different configurations, such as gene panels, whole-exome sequencing and whole-genome sequencing. The clinician must be aware that any technology has its limitations and complementary techniques must still be used to establish a diagnosis for specific diseases. In addition, increasing the amount of genetic information available in a larger patient sample also increases the need for rigorous interpretation steps, when taking into account the clinical, electroclinical, and when available, functional data. Local, multidisciplinary discussions have proven valuable in difficult diagnostic situations, especially in cases where precision medicine is being considered. They also serve to improve genetic counseling in complex situations. In this article, we will briefly review the genetic basis of rare and common epilepsies, the current strategies used for molecular diagnosis, including their limitations, and some pitfalls for data interpretation, in the context of etiological diagnosis and genetic counseling.
Collapse
Affiliation(s)
- Gaetan Lesca
- Department of Medical Genetics and Department of Paedaitric Clinical Epileptology, Member of the ERN EpiCARE, University Hospitals of Lyon (HCL), Lyon, France; University Claude Bernard Lyon 1, Lyon, France.
| | - Tobias Baumgartner
- Department of Epileptology, University Hospital Bonn, Member of the ERN EpiCARE, Bonn, Germany
| | - Pauline Monin
- Department of Medical Genetics and Department of Paedaitric Clinical Epileptology, Member of the ERN EpiCARE, University Hospitals of Lyon (HCL), Lyon, France; University Claude Bernard Lyon 1, Lyon, France
| | - Angela De Dominicis
- Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Wolfram S Kunz
- Department of Epileptology, University Hospital Bonn, Member of the ERN EpiCARE, Bonn, Germany
| | - Nicola Specchio
- Rare and Complex Epilepsy Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Full Member of European Reference Network EpiCARE, Rome, Italy
| |
Collapse
|
43
|
Spaull R, Steel D, Barwick K, Prabhakar P, Wakeling E, Kurian MA. STXBP1
stop‐loss mutation associated with complex early onset movement disorder without epilepsy. Mov Disord Clin Pract 2022; 9:837-840. [PMID: 35937496 PMCID: PMC9346254 DOI: 10.1002/mdc3.13509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/01/2022] [Accepted: 06/10/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Robert Spaull
- Molecular Neurosciences, Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children UCL Great Ormond Street Institute of Child Health, UCL London UK
- Department of Neurology Great Ormond Street Hospital London UK
| | - Dora Steel
- Molecular Neurosciences, Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children UCL Great Ormond Street Institute of Child Health, UCL London UK
- Department of Neurology Great Ormond Street Hospital London UK
| | - Katy Barwick
- Molecular Neurosciences, Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children UCL Great Ormond Street Institute of Child Health, UCL London UK
| | - Prab Prabhakar
- Department of Neurology Great Ormond Street Hospital London UK
| | - Emma Wakeling
- North East Thames Regional Genetic Service Great Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Manju A. Kurian
- Molecular Neurosciences, Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children UCL Great Ormond Street Institute of Child Health, UCL London UK
- Department of Neurology Great Ormond Street Hospital London UK
| |
Collapse
|
44
|
Gorodetsky C, Fasano A. Developmental and Epileptic Encephalopathies in Adults: An Evolving Field. Neurology 2022; 99:89-91. [DOI: 10.1212/wnl.0000000000200190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 01/25/2022] [Indexed: 11/15/2022] Open
|
45
|
Xian J, Parthasarathy S, Ruggiero SM, Balagura G, Fitch E, Helbig K, Gan J, Ganesan S, Kaufman MC, Ellis CA, Lewis-Smith D, Galer P, Cunningham K, O’Brien M, Cosico M, Baker K, Darling A, Veiga de Goes F, El Achkar CM, Doering JH, Furia F, García-Cazorla Á, Gardella E, Geertjens L, Klein C, Kolesnik-Taylor A, Lammertse H, Lee J, Mackie A, Misra-Isrie M, Olson H, Sexton E, Sheidley B, Smith L, Sotero L, Stamberger H, Syrbe S, Thalwitzer KM, van Berkel A, van Haelst M, Yuskaitis C, Weckhuysen S, Prosser B, Son Rigby C, Demarest S, Pierce S, Zhang Y, Møller RS, Bruining H, Poduri A, Zara F, Verhage M, Striano P, Helbig I. Assessing the landscape of STXBP1-related disorders in 534 individuals. Brain 2022; 145:1668-1683. [PMID: 35190816 PMCID: PMC9166568 DOI: 10.1093/brain/awab327] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/30/2021] [Accepted: 08/10/2021] [Indexed: 01/18/2023] Open
Abstract
Disease-causing variants in STXBP1 are among the most common genetic causes of neurodevelopmental disorders. However, the phenotypic spectrum in STXBP1-related disorders is wide and clear correlations between variant type and clinical features have not been observed so far. Here, we harmonized clinical data across 534 individuals with STXBP1-related disorders and analysed 19 973 derived phenotypic terms, including phenotypes of 253 individuals previously unreported in the scientific literature. The overall phenotypic landscape in STXBP1-related disorders is characterized by neurodevelopmental abnormalities in 95% and seizures in 89% of individuals, including focal-onset seizures as the most common seizure type (47%). More than 88% of individuals with STXBP1-related disorders have seizure onset in the first year of life, including neonatal seizure onset in 47%. Individuals with protein-truncating variants and deletions in STXBP1 (n = 261) were almost twice as likely to present with West syndrome and were more phenotypically similar than expected by chance. Five genetic hotspots with recurrent variants were identified in more than 10 individuals, including p.Arg406Cys/His (n = 40), p.Arg292Cys/His/Leu/Pro (n = 30), p.Arg551Cys/Gly/His/Leu (n = 24), p.Pro139Leu (n = 12), and p.Arg190Trp (n = 11). None of the recurrent variants were significantly associated with distinct electroclinical syndromes, single phenotypic features, or showed overall clinical similarity, indicating that the baseline variability in STXBP1-related disorders is too high for discrete phenotypic subgroups to emerge. We then reconstructed the seizure history in 62 individuals with STXBP1-related disorders in detail, retrospectively assigning seizure type and seizure frequency monthly across 4433 time intervals, and retrieved 251 anti-seizure medication prescriptions from the electronic medical records. We demonstrate a dynamic pattern of seizure control and complex interplay with response to specific medications particularly in the first year of life when seizures in STXBP1-related disorders are the most prominent. Adrenocorticotropic hormone and phenobarbital were more likely to initially reduce seizure frequency in infantile spasms and focal seizures compared to other treatment options, while the ketogenic diet was most effective in maintaining seizure freedom. In summary, we demonstrate how the multidimensional spectrum of phenotypic features in STXBP1-related disorders can be assessed using a computational phenotype framework to facilitate the development of future precision-medicine approaches.
Collapse
Affiliation(s)
- Julie Xian
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
- Neuroscience Program, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Shridhar Parthasarathy
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
- Department of Biology, The College of New Jersey, Ewing Township, NJ 08618, USA
| | - Sarah M Ruggiero
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Ganna Balagura
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, University of Genoa, Genoa, Italy
- Pediatric Neurology and Muscular Diseases Unit, IRCCS ‘G. Gaslini’ Institute, Genoa, Italy
| | - Eryn Fitch
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Katherine Helbig
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
| | - Jing Gan
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Shiva Ganesan
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
| | - Michael C Kaufman
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
| | - Colin A Ellis
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - David Lewis-Smith
- Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne NE2 4HH, UK
- Royal Victoria Infirmary, Newcastle-upon-Tyne NE1 4LP, UK
| | - Peter Galer
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
- Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kristin Cunningham
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Margaret O’Brien
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
| | - Mahgenn Cosico
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Kate Baker
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Alejandra Darling
- Pediatric Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Fernanda Veiga de Goes
- Department of Pediatrics and Pediatric Neurology Laboratory, Instituto Fernandes Figueira, Rio de Janeiro 22250-020, Brazil
| | - Christelle M El Achkar
- Division of Epilepsy and Clinical Neurophysiology and Epilepsy Genetics Program, Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Jan Henje Doering
- Division of Pediatric Epileptology, Centre for Pediatric and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Francesca Furia
- Department of Clinical Neurophysiology, Danish Epilepsy Center Filadelfia, Dianalund 4293, Denmark
| | - Ángeles García-Cazorla
- Pediatric Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Elena Gardella
- Department of Clinical Neurophysiology, Danish Epilepsy Center Filadelfia, Dianalund 4293, Denmark
| | - Lisa Geertjens
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Courtney Klein
- Departments of Pediatrics and Neurology, Children's Hospital Colorado, Aurora, CO 80045, USA
| | | | - Hanna Lammertse
- Department of Human Genetics, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam University Medical Center, de Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Jeehun Lee
- Department of Pediatrics, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Alexandra Mackie
- Departments of Pediatrics and Neurology, Children's Hospital Colorado, Aurora, CO 80045, USA
| | - Mala Misra-Isrie
- Department of Human Genetics, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam University Medical Center, de Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Heather Olson
- Division of Epilepsy and Clinical Neurophysiology and Epilepsy Genetics Program, Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Emma Sexton
- Division of Epilepsy and Clinical Neurophysiology and Epilepsy Genetics Program, Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Beth Sheidley
- Division of Epilepsy and Clinical Neurophysiology and Epilepsy Genetics Program, Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Lacey Smith
- Division of Epilepsy and Clinical Neurophysiology and Epilepsy Genetics Program, Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Luiza Sotero
- Department of Pediatrics and Pediatric Neurology Laboratory, Instituto Fernandes Figueira, Rio de Janeiro 22250-020, Brazil
| | - Hannah Stamberger
- Division of Neurology, University Hospital Antwerp, Antwerp, Belgium
- Applied & Translational Neurogenomics Group, VIB Center for Molecular Neurology, VIB, Antwerp, Belgium
| | - Steffen Syrbe
- Division of Pediatric Epileptology, Centre for Pediatric and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Kim Marie Thalwitzer
- Division of Pediatric Epileptology, Centre for Pediatric and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Annemiek van Berkel
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research (CNCR), VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Mieke van Haelst
- Department of Human Genetics, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam University Medical Center, de Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Christopher Yuskaitis
- Division of Epilepsy and Clinical Neurophysiology and Epilepsy Genetics Program, Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Sarah Weckhuysen
- Division of Neurology, University Hospital Antwerp, Antwerp, Belgium
- Applied & Translational Neurogenomics Group, VIB Center for Molecular Neurology, VIB, Antwerp, Belgium
- Translational Neurosciences, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
| | - Ben Prosser
- Department of Physiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | | | - Scott Demarest
- Departments of Pediatrics and Neurology, Children's Hospital Colorado, Aurora, CO 80045, USA
| | - Samuel Pierce
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Yuehua Zhang
- Department of Pediatrics, Beijing University First Hospital, Beijing, China
| | - Rikke S Møller
- Department of Clinical Neurophysiology, Danish Epilepsy Center Filadelfia, Dianalund 4293, Denmark
| | - Hilgo Bruining
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Annapurna Poduri
- Division of Epilepsy and Clinical Neurophysiology and Epilepsy Genetics Program, Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Federico Zara
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, University of Genoa, Genoa, Italy
- Unit of Medical Genetics, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Matthijs Verhage
- Department of Human Genetics, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam University Medical Center, de Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research (CNCR), VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Pasquale Striano
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, University of Genoa, Genoa, Italy
- Pediatric Neurology and Muscular Diseases Unit, IRCCS ‘G. Gaslini’ Institute, Genoa, Italy
| | - Ingo Helbig
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| |
Collapse
|
46
|
Balagura G, Xian J, Riva A, Marchese F, Ben Zeev B, Rios L, Sirsi D, Accorsi P, Amadori E, Astrea G, Baldassari S, Beccaria F, Boni A, Budetta M, Cantalupo G, Capovilla G, Cesaroni E, Chiesa V, Coppola A, Dilena R, Faggioli R, Ferrari A, Fiorini E, Madia F, Gennaro E, Giacomini T, Giordano L, Iacomino M, Lattanzi S, Marini C, Mancardi MM, Mastrangelo M, Messana T, Minetti C, Nobili L, Papa A, Parmeggiani A, Pisano T, Russo A, Salpietro V, Savasta S, Scala M, Accogli A, Scelsa B, Scudieri P, Spalice A, Specchio N, Trivisano M, Tzadok M, Valeriani M, Vari MS, Verrotti A, Vigevano F, Vignoli A, Toonen R, Zara F, Helbig I, Striano P. Epilepsy Course and Developmental Trajectories in STXBP1-DEE. Neurol Genet 2022; 8:e676. [PMID: 35655584 PMCID: PMC9157582 DOI: 10.1212/nxg.0000000000000676] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 03/14/2022] [Indexed: 01/18/2023]
Abstract
Background and Objectives Clinical manifestations in STXBP1 developmental and epileptic encephalopathy (DEE) vary in severity and outcome, and the genotypic spectrum is diverse. We aim to trace the neurodevelopmental trajectories in individuals with STXBP1-DEE and dissect the relationship between neurodevelopment and epilepsy. Methods Retrospective standardized clinical data were collected through international collaboration. A composite neurodevelopmental score system compared the developmental trajectories in STXBP1-DEE. Results Forty-eight patients with de novo STXBP1 variants and a history of epilepsy were included (age range at the time of the study: 10 months to 35 years, mean 8.5 years). At the time of inclusion, 65% of individuals (31/48) had active epilepsy, whereas 35% (17/48) were seizure free, and 76% of those (13/17) achieved remission within the first year of life. Twenty-two individuals (46%) showed signs of developmental impairment and/or neurologic abnormalities before epilepsy onset. Age at seizure onset correlated with severity of developmental outcome and the developmental milestones achieved, with a later seizure onset associated with better developmental outcome. In contrast, age at seizure remission and epilepsy duration did not affect neurodevelopmental outcomes. Overall, we did not observe a clear genotype-phenotype correlation, but monozygotic twins with de novo STXBP1 variant showed similar phenotype and parallel disease course. Discussion The disease course in STXBP1-DEE presents with 2 main trajectories, with either early seizure remission or drug-resistant epilepsy, and a range of neurodevelopmental outcomes from mild to profound intellectual disability. Age at seizure onset is the only epilepsy-related feature associated with neurodevelopment outcome. These findings can inform future dedicated natural history studies and trial design.
Collapse
|
47
|
Clinical whole exome sequencing revealed de novo Heterozygous Stop-Gain and Missense variants in the STXBP1 gene associated with Epilepsy in Saudi Families. Saudi J Biol Sci 2022; 29:103309. [PMID: 35663845 PMCID: PMC9160351 DOI: 10.1016/j.sjbs.2022.103309] [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: 02/08/2022] [Revised: 03/06/2022] [Accepted: 05/15/2022] [Indexed: 11/21/2022] Open
Abstract
Intellectual disability and developmental encephalopathies are mostly linked with infant epilepsy. Epileptic encephalopathy is a term that is used to define association between developmental delay and epilepsy. Mutations in the STXBP1 (Syntaxin-binding protein 1) gene have been previously reported in association with multiple severe early epileptic encephalopathies along with many neurodevelopmental disorders. Among the disorders produced due to any mutations in the STXBP1 gene is developmental and epileptic encephalopathy 4 (OMIM: 612164), is an autosomal dominant neurologic disorder categorized by the onset of tonic seizures in early infancy (usually in the first months of life). In this article, we report two Saudi families one with de novo heterozygous stop-gain mutation c.364C > T and a novel missense c. 305C > A p.Ala102Glu in exon 5 of the STXBP1 gene (OMIM: 602926) lead to development of epileptic encephalopathy 4. The variants identified in the current study broadened the genetic spectrum of STXBP1 gene related with diseases, which will help to add in the literature and benefit to the studies addressing this disease in the future.
Collapse
|
48
|
Perl E, Ravisankar P, Beerens ME, Mulahasanovic L, Smallwood K, Sasso MB, Wenzel C, Ryan TD, Komár M, Bove KE, MacRae CA, Weaver KN, Prada CE, Waxman JS. Stx4 is required to regulate cardiomyocyte Ca 2+ handling during vertebrate cardiac development. HGG ADVANCES 2022; 3:100115. [PMID: 35599850 PMCID: PMC9114686 DOI: 10.1016/j.xhgg.2022.100115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/22/2022] [Indexed: 12/16/2022] Open
Abstract
Requirements for vesicle fusion within the heart remain poorly understood, despite the multitude of processes that necessitate proper intracellular trafficking within cardiomyocytes. Here, we show that Syntaxin 4 (STX4), a target-Soluble N-ethylmaleimide sensitive factor attachment receptor (t-SNARE) protein, is required for normal vertebrate cardiac conduction and vesicular transport. Two patients were identified with damaging variants in STX4. A patient with a homozygous R240W missense variant displayed biventricular dilated cardiomyopathy, ectopy, and runs of non-sustained ventricular tachycardia, sensorineural hearing loss, global developmental delay, and hypotonia, while a second patient displayed severe pleiotropic abnormalities and perinatal lethality. CRISPR/Cas9-generated stx4 mutant zebrafish exhibited defects reminiscent of these patients' clinical presentations, including linearized hearts, bradycardia, otic vesicle dysgenesis, neuronal atrophy, and touch insensitivity by 3 days post fertilization. Imaging of Vamp2+ vesicles within stx4 mutant zebrafish hearts showed reduced docking to the cardiomyocyte sarcolemma. Optical mapping of the embryonic hearts coupled with pharmacological modulation of Ca2+ handling together support that zebrafish stx4 mutants have a reduction in L-type Ca2+ channel modulation. Transgenic overexpression of zebrafish Stx4R241W, analogous to the first patient's STX4R240W variant, indicated that the variant is hypomorphic. Thus, these data show an in vivo requirement for SNAREs in regulating normal embryonic cardiac function and that variants in STX4 are associated with pleiotropic human disease, including cardiomyopathy.
Collapse
Affiliation(s)
- Eliyahu Perl
- Medical Scientist Training Program, University of Cincinnati College of Medicine, Cincinnati, OH, USA,Molecular and Developmental Biology Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH, USA,Division of Molecular Cardiovascular Biology, The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Padmapriyadarshini Ravisankar
- Division of Molecular Cardiovascular Biology, The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Manu E. Beerens
- Cardiovascular Medicine Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Lejla Mulahasanovic
- Praxis für Humangenetik, Tübingen, Baden-Württemberg, Germany,CeGaT GmbH, Tübingen, Baden-Württemberg, Germany
| | - Kelly Smallwood
- Division of Human Genetics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Marion Bermúdez Sasso
- Institute for Clinical Genetics, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Saxony, Germany
| | - Carina Wenzel
- Institute of Pathology, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
| | - Thomas D. Ryan
- Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH, USA,Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Matej Komár
- Department of Gynecology and Obstetrics, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Saxony, Germany
| | - Kevin E. Bove
- Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH, USA,Division of Pathology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA,Department of Pathology and Laboratory Medicine, University of Cincinnati, College of Medicine, Cincinnati, OH, USA
| | - Calum A. MacRae
- Cardiovascular Medicine Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Genetics and Network Medicine Divisions, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Harvard Stem Cell Institute, Boston, MA, USA
| | - K. Nicole Weaver
- Division of Human Genetics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA,Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH, USA
| | - Carlos E. Prada
- Division of Human Genetics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA,Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH, USA
| | - Joshua S. Waxman
- Division of Molecular Cardiovascular Biology, The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA,Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH, USA,Division of Developmental Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA,Corresponding author
| |
Collapse
|
49
|
Hamanaka K, Miyake N, Mizuguchi T, Miyatake S, Uchiyama Y, Tsuchida N, Sekiguchi F, Mitsuhashi S, Tsurusaki Y, Nakashima M, Saitsu H, Yamada K, Sakamoto M, Fukuda H, Ohori S, Saida K, Itai T, Azuma Y, Koshimizu E, Fujita A, Erturk B, Hiraki Y, Ch'ng GS, Kato M, Okamoto N, Takata A, Matsumoto N. Large-scale discovery of novel neurodevelopmental disorder-related genes through a unified analysis of single-nucleotide and copy number variants. Genome Med 2022; 14:40. [PMID: 35468861 PMCID: PMC9040275 DOI: 10.1186/s13073-022-01042-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/25/2022] [Indexed: 12/12/2022] Open
Abstract
Background Previous large-scale studies of de novo variants identified a number of genes associated with neurodevelopmental disorders (NDDs); however, it was also predicted that many NDD-associated genes await discovery. Such genes can be discovered by integrating copy number variants (CNVs), which have not been fully considered in previous studies, and increasing the sample size. Methods We first constructed a model estimating the rates of de novo CNVs per gene from several factors such as gene length and number of exons. Second, we compiled a comprehensive list of de novo single-nucleotide variants (SNVs) in 41,165 individuals and de novo CNVs in 3675 individuals with NDDs by aggregating our own and publicly available datasets, including denovo-db and the Deciphering Developmental Disorders study data. Third, summing up the de novo CNV rates that we estimated and SNV rates previously established, gene-based enrichment of de novo deleterious SNVs and CNVs were assessed in the 41,165 cases. Significantly enriched genes were further prioritized according to their similarity to known NDD genes using a deep learning model that considers functional characteristics (e.g., gene ontology and expression patterns). Results We identified a total of 380 genes achieving statistical significance (5% false discovery rate), including 31 genes affected by de novo CNVs. Of the 380 genes, 52 have not previously been reported as NDD genes, and the data of de novo CNVs contributed to the significance of three genes (GLTSCR1, MARK2, and UBR3). Among the 52 genes, we reasonably excluded 18 genes [a number almost identical to the theoretically expected false positives (i.e., 380 × 0.05 = 19)] given their constraints against deleterious variants and extracted 34 “plausible” candidate genes. Their validity as NDD genes was consistently supported by their similarity in function and gene expression patterns to known NDD genes. Quantifying the overall similarity using deep learning, we identified 11 high-confidence (> 90% true-positive probabilities) candidate genes: HDAC2, SUPT16H, HECTD4, CHD5, XPO1, GSK3B, NLGN2, ADGRB1, CTR9, BRD3, and MARK2. Conclusions We identified dozens of new candidates for NDD genes. Both the methods and the resources developed here will contribute to the further identification of novel NDD-associated genes. Supplementary Information The online version contains supplementary material available at 10.1186/s13073-022-01042-w.
Collapse
Affiliation(s)
- Kohei Hamanaka
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
| | - Noriko Miyake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Takeshi Mizuguchi
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Satoko Miyatake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Clinical Genetics Department, Yokohama City University Hospital, Yokohama, Japan
| | - Yuri Uchiyama
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Department of Rare Disease Genomics, Yokohama City University Hospital, Yokohama, Japan
| | - Naomi Tsuchida
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Department of Rare Disease Genomics, Yokohama City University Hospital, Yokohama, Japan
| | - Futoshi Sekiguchi
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Satomi Mitsuhashi
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yoshinori Tsurusaki
- Faculty of Nutritional Science, Sagami Women's University, Sagamihara, Japan
| | - Mitsuko Nakashima
- Department of Biochemistry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hirotomo Saitsu
- Department of Biochemistry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kohei Yamada
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masamune Sakamoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiromi Fukuda
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Sachiko Ohori
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ken Saida
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Toshiyuki Itai
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yoshiteru Azuma
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Department of Pediatrics, Aichi Medical University, Nagakute, Japan
| | - Eriko Koshimizu
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Atsushi Fujita
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Biray Erturk
- Department of Medical Genetics, Ege University Faculty of Medicine, Izmir, Turkey.,Current affiliation: Department of Medical Genetics, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Yoko Hiraki
- Hiroshima Municipal Center for Child Health and Development, Hiroshima, Japan
| | | | - Mitsuhiro Kato
- Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan
| | - Nobuhiko Okamoto
- Department of Medical Genetics, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Atsushi Takata
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan. .,Laboratory for Molecular Pathology of Psychiatric Disorders, RIKEN Center for Brain Science, Wako, Japan.
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
| |
Collapse
|
50
|
Moog M, Baraban SC. Clemizole and Trazodone are Effective Antiseizure Treatments in a Zebrafish Model of STXBP1 Disorder. Epilepsia Open 2022; 7:504-511. [PMID: 35451230 PMCID: PMC9436285 DOI: 10.1002/epi4.12604] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/19/2022] [Indexed: 11/07/2022] Open
Abstract
CRISPR-Cas9-generated zebrafish carrying a 12 base-pair deletion in stxbpb1b, a paralog sharing 79% amino acid sequence identity with human, exhibit spontaneous electrographic seizures during larval stages of development. Zebrafish stxbp1b mutants provide an efficient preclinical platform to test antiseizure therapeutics. The present study was designed to test antiseizure medications approved for clinical use and two recently identified repurposed drugs with antiseizure activity. Larval homozygous stxbp1b zebrafish (4 days post-fertilization) were agarose-embedded and monitored for electrographic seizure activity using a local field recording electrode placed in midbrain. Frequency of ictal-like events was evaluated at baseline and following 45 min of continuous drug exposure (1 mM, bath application). Analysis was performed on coded files by an experimenter blinded to drug treatment and genotype. Phenytoin, valproate, ethosuximide, levetiracetam, and diazepam had no effect on ictal-like event frequency in stxbp1b mutant zebrafish. Clemizole and trazodone decreased ictal-like event frequency in stxbp1b mutant zebrafish by 80% and 83%, respectively. These results suggest that repurposed drugs with serotonin receptor binding affinities could be effective antiseizure treatments. Clemizole and trazodone were previously identified in a larval zebrafish model for Dravet syndrome. Based primarily on these preclinical zebrafish studies, compassionate-use and double-blind clinical trials with both drugs have progressed. The present study extends this approach to a preclinical zebrafish model representing STXBP1-related disorders, and suggests that future clinical studies may be warranted.
Collapse
Affiliation(s)
- Maia Moog
- Department of Neurological Surgery & Weill Institute for NeuroscienceUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Scott C. Baraban
- Department of Neurological Surgery & Weill Institute for NeuroscienceUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Helen Wills Neuroscience InstituteUniversity of CaliforniaBerkeleyCaliforniaUSA
| |
Collapse
|