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Chengyan L, Chupeng X, You W, Yinhui C, Binglong H, Dang A, Ling L, Chuan T. Identification of genetic causes in children with unexplained epilepsy based on trio-whole exome sequencing. Clin Genet 2024; 106:140-149. [PMID: 38468460 DOI: 10.1111/cge.14519] [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: 11/03/2023] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/13/2024]
Abstract
Genotype and clinical phenotype analyses of 128 children were performed based on whole exome sequencing (WES), providing a reference for the provision of genetic counseling and the precise diagnosis and treatment of epilepsy. A total of 128 children with unexplained epilepsy were included in this study, and all their clinical data were analyzed. The children's treatments, epilepsy control, and neurodevelopmental levels were regularly followed up every 3 months. The genetic diagnostic yield of the 128 children with epilepsy is 50.8%, with an SNV diagnostic yield of 39.8% and a CNV diagnostic yield of 12.5%. Among the 128 children with epilepsy, 57.0% had onset of epilepsy in infancy, 25.8% have more than two clinical seizure forms, 62.5% require two or more anti-epileptic drug treatments, and 72.7% of the children have varying degrees of psychomotor development retardation. There are significant differences between ages of onset, neurodevelopmental levels and the presence of drug resistance in the genetic diagnostic yield (all p < 0.05). The 52 pathogenic/likely pathogenic SNVs involve 31 genes, with genes encoding ion channels having the largest number of mutations (30.8%). There were 16 cases of pathogenic/possibly pathogenic CNVs, among which the main proportions of CNVs were located in chromosome 15 and chromosome 16. Trio-WES is an essential tool for the genetic diagnosis of unexplained epilepsy, with a genetic diagnostic yield of up to 50.8%. Early genetic testing can provide an initiate appropriate therapies and accurate molecular diagnosis.
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Affiliation(s)
- Li Chengyan
- Department of Pediatrics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, People's Republic of China
| | - Xue Chupeng
- Department of Pediatrics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, People's Republic of China
- Department of Pediatrics, Shantou Central Hospital, Shantou, People's Republic of China
| | - Wang You
- Department of Pediatrics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, People's Republic of China
| | - Chen Yinhui
- Department of Pediatrics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, People's Republic of China
| | - Huang Binglong
- Department of Pediatrics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, People's Republic of China
| | - Ao Dang
- Department of Pediatrics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, People's Republic of China
| | - Liu Ling
- Department of Pediatrics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, People's Republic of China
| | - Tian Chuan
- Department of Pediatrics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, People's Republic of China
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Liu Q, Zhao Q, Ji Q, Lv X, Huang X, Xu X, Zhan Y. Trends of mortality from epilepsy in the United States, 1979-2021. Seizure 2024; 120:83-88. [PMID: 38908145 DOI: 10.1016/j.seizure.2024.06.014] [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: 03/01/2024] [Revised: 06/17/2024] [Accepted: 06/19/2024] [Indexed: 06/24/2024] Open
Abstract
PURPOSE The analysis of long-term trends of mortality from epilepsy has not been conducted, which is crucial for estimating the future burden of epilepsy. We therefore aimed to investigate the long-term trends of mortality from epilepsy in the United States from 1979 to 2021. METHODS The cause-of-death and demographic data were from the National Center for Health Statistics (1979-2021) and population estimates were from the US Census Bureau. We used the joinpoint regression model to analyze secular trends in the mortality of epilepsy spanning from 1979 to 2021. Age-adjusted mortality from epilepsy was assessed based on the year 2000 U.S. population data, stratified by age, sex, and race. RESULTS The age-adjusted mortality from epilepsy increased from 0.78 per 100,000 population in 1979 to 1.01 per 100,000 population in 2021, with an average annual percent change (AAPC) of 0.58% (95% confidence interval [CI]: 0.45% - 0.72%). The overall age-adjusted mortality of epilepsy had been on the rise between 2011 and 2021. The mortality rate generally increases with age. The mortality of epilepsy was higher in the Afro-American people and men. The mortality of epilepsy in both sexes declined first and then increased, with AAPC 1.02% (95% CI: 0.88%, 1.23%) in women and 0.10% (95% CI: -0.002%, 0.21%) in men. Mortality in all races including White, Afro-American people, and other races individuals fell first and then rose. The AAPC of mortality in White, other races, and Afro-American people were 0.89% (95% CI: 0.79%, 1.02%), -0.87% (95% CI: -1.84%, 0.88%), and -0.31% (95% CI: -0.48%, -0.13%), respectively. CONCLUSION Although the mortality rate from epilepsy has experienced a period of decline, it is worth noting that the last decade has seen a rapid increase. A comprehensive assessment of long-term trends in mortality from epilepsy holds significance for healthcare prioritization.
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Affiliation(s)
- Qi Liu
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, PR China
| | - Qingya Zhao
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, PR China
| | - Qianqian Ji
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, PR China
| | - Xiaogang Lv
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, PR China
| | - Xiaoping Huang
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, PR China
| | - Xiaowei Xu
- Department of Neurology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, PR China.
| | - Yiqiang Zhan
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, PR China; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Li JB, Jiang J, Xue L, Zhao S, Liu HQ. Clinical efficacy of Baijin pills in the treatment of generalized tonic-clonic seizure epilepsy with cognitive impairment. World J Psychiatry 2024; 14:938-944. [PMID: 38984341 PMCID: PMC11230082 DOI: 10.5498/wjp.v14.i6.938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/22/2024] [Accepted: 04/25/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND The generalized tonic-clonic seizure (GTCS) is the most usual variety of epileptic seizure. It is mainly characterized by strong body muscle rigidity, loss of consciousness, a disorder of plant neurofunction, and significant damage to cognitive function. The effect of antiepileptic drugs on cognition should also be considered. At present, there is no effective treatment for patients with epilepsy, but traditional Chinese medicine has shown a significant effect on chronic disease with fewer harmful side effects and should, therefore, be considered for the therapy means of epilepsy with cognitive dysfunction. AIM To investigate the clinical efficacy of Baijin pills for treating GTCS patients with cognitive impairment. METHODS This prospective study enrolled patients diagnosed with GTCS between January 2020 and December 2023 and separate them into two groups (experimental and control) using random number table method. The control group was treated with sodium valproate, and the experimental group was Baijin pills and sodium valproate for three months. The frequency and duration of each seizure, the Montreal Cognitive Assessment Scale (MoCA), and the Quality of Life Rating Scale (QOLIE-31) were recorded before and after treatment. RESULTS There were 85 patients included (42 in the control group and 43 in the experimental group). After treatment, the seizure frequency in the experimental group was significantly reduced (P < 0.05), and seizure duration was shortened (P < 0.01). The total MoCA score in the experimental group significantly increased compared to before treatment (P < 0.01), and the sub-item scores, except naming and abstract generalization ability, significantly increased (P < 0.05), whereas the total MoCA score in the control group significantly decreased after treatment (P < 0.05). The QOLIE-31 score of the experimental group increased significantly after treatment compared to before treatment (P < 0.01). CONCLUSION Baijin pills have a good clinical effect on epilepsy with cognitive dysfunction.
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Affiliation(s)
- Jing-Bo Li
- Department of Neurology, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210000, Jiangsu Province, China
- Department of Neurology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing 210000, Jiangsu Province, China
| | - Jing Jiang
- Department of Neurology, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210000, Jiangsu Province, China
- Department of Neurology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing 210000, Jiangsu Province, China
| | - Lian Xue
- Department of Neurology, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210000, Jiangsu Province, China
- Department of Neurology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing 210000, Jiangsu Province, China
| | - Shuai Zhao
- Department of Neurology, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210000, Jiangsu Province, China
- Department of Neurology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing 210000, Jiangsu Province, China
| | - Hong-Quan Liu
- Department of Neurology, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210000, Jiangsu Province, China
- Department of Neurology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing 210000, Jiangsu Province, China
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Huang Y, Wang Q, Liu X, Du W, Hao Z, Wang Y. Transcriptional Signatures of a Dynamic Epilepsy Process Reveal Potential Immune Regulation. Mol Neurobiol 2024; 61:3384-3396. [PMID: 37989981 PMCID: PMC11087345 DOI: 10.1007/s12035-023-03786-x] [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: 11/18/2022] [Accepted: 11/09/2023] [Indexed: 11/23/2023]
Abstract
Epilepsy is a progression of development and advancement over time. However, the molecular features of epilepsy were poorly studied from a dynamic developmental perspective. We intend to investigate the key mechanisms in the process of epilepsy by exploring the roles of stage-specifically expressed genes. By using time-course transcriptomic data of epileptic samples, we first analyzed the molecular features of epilepsy in different stages and divided it into progression and remission stages based on their transcriptomic features. 34 stage-specifically expressed genes were then identified by the Tau index and verified in other epileptic datasets. These genes were then enriched for immune-related biological functions. Furthermore, we found that the level of immune infiltration and mechanisms at different stages were different, which may result from different types of immune cells playing leading roles in distinct stages. Our findings indicated an essential role of immune regulation as the potential mechanism of epilepsy development.
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Affiliation(s)
- Yanruo Huang
- Department of Anesthesiology, Huashan Hospital, Fudan University, 12 Middle Wulumuqi Road, Shanghai, 200040, People's Republic of China
| | - Qihang Wang
- State Key Laboratory of Molecular Biology, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, Shanghai, 200031, People's Republic of China
- University of Chinese Academy of Sciences, Beijing, 100049, People's Republic of China
| | - Xiaoyin Liu
- Department of Neurosurgery, West China Medical School, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Wenjie Du
- Department of Anesthesiology, Huashan Hospital, Fudan University, 12 Middle Wulumuqi Road, Shanghai, 200040, People's Republic of China
| | - Zijian Hao
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, 200433, People's Republic of China.
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200433, People's Republic of China.
| | - Yingwei Wang
- Department of Anesthesiology, Huashan Hospital, Fudan University, 12 Middle Wulumuqi Road, Shanghai, 200040, People's Republic of China.
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Han Y, Hao G, Wang Z, Wang C, Qi X, Liang G, Li X. Association between serum apolipoprotein E and cognitive function in Chinese patients with temporal lobe epilepsy. Epilepsy Behav 2024; 154:109750. [PMID: 38552413 DOI: 10.1016/j.yebeh.2024.109750] [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: 11/01/2023] [Revised: 03/14/2024] [Accepted: 03/21/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVE To investigate the effect of serum apolipoprotein E (APOE) levels on cognitive function in patients with temporal lobe epilepsy (TLE). METHODS Clinical data were collected from 190 subjects including 110 TLE patients and 80 healthy people. Cognitive function was assessed using the Addenbrooke's Cognitive Examination Revised (ACE-R) scale. Serum levels of APOE were measured using ELISA kits. Genotyping of APOE in peripheral blood was detected by microarray hybridization. RESULTS Patients with TLE had significantly lower ACE-R total score, memory and verbal fluency scores compared to the healthy group. Serum levels of APOE were significantly higher in TLE patients than in the healthy subjects. Serum APOE levels were significantly negatively correlated with ACE-R total score, memory and verbal fluency scores. The cognitive function score of TLE with APOE ε4 allele was lower than that of TLE without APOE ε4 allele. SIGNIFICANCE Our study showed that serum APOE levels were higher in TLE patients than in the healthy population. And serum APOE levels were associated with cognitive dysfunction in TLE patients. APOE ε4 allele carriers have poor cognitive function in TLE patients.
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Affiliation(s)
- Yuwei Han
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China
| | - Guangzhi Hao
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China
| | - Zhen Wang
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China
| | - Chenchen Wang
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China
| | - Xin Qi
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China
| | - Guobiao Liang
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China
| | - Xiaoming Li
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China.
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Alowaysi M, Al-Shehri M, Badkok A, Attas H, Aboalola D, Baadhaim M, Alzahrani H, Daghestani M, Zia A, Al-Ghamdi K, Al-Ghamdi A, Zakri S, Aouabdi S, Tegner J, Alsayegh K. Generation of iPSC lines (KAIMRCi003A, KAIMRCi003B) from a Saudi patient with Dravet syndrome carrying homozygous mutation in the CPLX1 gene and heterozygous mutation in SCN9A. Hum Cell 2024; 37:502-510. [PMID: 38110787 PMCID: PMC10890977 DOI: 10.1007/s13577-023-01016-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: 09/26/2023] [Accepted: 11/15/2023] [Indexed: 12/20/2023]
Abstract
The most prevalent form of epileptic encephalopathy is Dravet syndrome (DRVT), which is triggered by the pathogenic variant SCN1A in 80% of cases. iPSCs with different SCN1A mutations have been constructed by several groups to model DRVT syndrome. However, no studies involving DRVT-iPSCs with rare genetic variants have been conducted. Here, we established two DRVT-iPSC lines harboring a homozygous mutation in the CPLX1 gene and heterozygous mutation in SCN9A gene. Therefore, the derivation of these iPSC lines provides a unique cellular platform to dissect the molecular mechanisms underlying the cellular dysfunctions consequent to CPLX1 and SCN9A mutations.
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Affiliation(s)
- Maryam Alowaysi
- King Abdullah International Medical Research Center (KAIMRC), King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Mohammad Al-Shehri
- King Abdullah International Medical Research Center (KAIMRC), King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Amani Badkok
- King Abdullah International Medical Research Center (KAIMRC), King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Hanouf Attas
- King Abdullah International Medical Research Center (KAIMRC), King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Doaa Aboalola
- King Abdullah International Medical Research Center (KAIMRC), King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Moayad Baadhaim
- King Abdullah International Medical Research Center (KAIMRC), King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Hajar Alzahrani
- King Abdullah International Medical Research Center (KAIMRC), King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Mustafa Daghestani
- King Abdullah International Medical Research Center (KAIMRC), King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Department of Pathology and Laboratory Medicine, Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia
| | - Asima Zia
- Biological and Environmental Science and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
| | - Khalid Al-Ghamdi
- Forensic Laboratories, Criminal Evidence Department, Jeddah, Saudi Arabia
| | - Asayil Al-Ghamdi
- Forensic Laboratories, Criminal Evidence Department, Jeddah, Saudi Arabia
| | - Samer Zakri
- King Abdullah International Medical Research Center (KAIMRC), King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Sihem Aouabdi
- King Abdullah International Medical Research Center (KAIMRC), King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Jesper Tegner
- Biological and Environmental Science and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
- Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
| | - Khaled Alsayegh
- King Abdullah International Medical Research Center (KAIMRC), King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
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Türk BG, Yeni SN, Atalar AÇ, Ekizoğlu E, Gök DK, Baykan B, Özge A, Ayta S, Erdoğan FF, Taşdelen B, Velioğlu SK. Exploring shared triggers and potential etiopathogenesis between migraine and idiopathic/genetic epilepsy: Insights from a multicenter tertiary-based study. Clin Neurol Neurosurg 2024; 237:108146. [PMID: 38367542 DOI: 10.1016/j.clineuro.2024.108146] [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: 09/29/2023] [Revised: 01/23/2024] [Accepted: 01/27/2024] [Indexed: 02/19/2024]
Abstract
INTRODUCTION Migraine and epilepsy are two episodic disorders that share common pathophysiological mechanisms. The aim of our research was to assess the possible shared etiopathogenesis by analyzing the relations of headache, and seizure triggers, based on information obtained from a national cohort surveying the headache characteristics of 809 patients who had been diagnosed with idiopathic/genetic epilepsy. MATERIAL AND METHODS Our study utilized data from a multi-center, nationwide investigation of headaches in 809 patients with idiopathic/genetic epilepsy. Out of these, 508 patients reported complaints related to any type of headache (333 Migraines, 175 Headaches of other types). In the initial phase of the study encompassing the entire sample of 809 epilepsy patients, differences in seizure triggers were assessed between the migraine group (n = 333) and the non-migraine group (n = 476). Additionally, the subsequent part of the study pertains to a subgroup of the entire patient group, namely those affected by all types of headaches (n = 508), and differences in headache triggers were assessed among migraine patients (n = 333) and those with other types of headaches (n = 175). Similar differences were observed between epilepsy patients with and without a family history of epilepsy. RESULTS The most frequently reported seizure triggers in all I/GE group (n = 809) were stress (23%), sleep deprivation (22%) and fatigue (18%), respectively. The most frequently reported headache triggers in migraine patients were stress (31%), sleep deprivation (28%), and noise (26%). The occurrence of menstruation-triggered seizures in individuals with migraine and I/GE was found to be considerably higher than those without migraine. The most common triggers for seizure and headache among the individuals with a positive family history of epilepsy were determined to be light stimuli and sleep deprivation. CONCLUSION In conclusion, our study provides valuable insights into the overlapping triggers including sleep patterns, stress levels, and menstrual cycles, etc. and potential shared etiology of migraine and I/GE. Recognizing these connections may facilitate the development of more precise therapeutic strategies and underscore the significance of adopting a holistic, multidisciplinary approach to the management of these intricate neurological conditions. Further research is essential to explore in greater depth the shared mechanisms underpinning these associations and their implications for clinical practice.
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Affiliation(s)
- Bengi Gül Türk
- Istanbul University-Cerrahpasa, Faculty of Medicine, Department of Neurology and Clinical Neurophysiology, Istanbul, Turkey.
| | - Seher Naz Yeni
- Istanbul University-Cerrahpasa, Faculty of Medicine, Department of Neurology and Clinical Neurophysiology, Istanbul, Turkey
| | - Arife Çimen Atalar
- University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Department of Neurology, Istanbul, Turkey
| | - Esme Ekizoğlu
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology and Clinical Neurophysiology, Istanbul, Turkey
| | - Duygu Kurt Gök
- Erciyes University, Faculty of Medicine, Department of Neurology and Clinical Neurophysiology, Kayseri, Turkey
| | - Betül Baykan
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology and Clinical Neurophysiology, Istanbul, Turkey
| | - Aynur Özge
- Mersin University School of Medicine, Department of Neurology, Algology and Clinical Neurophysiology, Mersin, Turkey
| | - Semih Ayta
- University of Health Sciences, Haseki Training and Research Hospital, Department of Pediatrics, Child Neurology Unit, Istanbul, Turkey
| | - Füsun Ferda Erdoğan
- Erciyes University, Faculty of Medicine, Department of Neurology and Clinical Neurophysiology, Kayseri, Turkey
| | - Bahar Taşdelen
- Mersin University School of Medicine, Department of Biostatistics and Medical Informatics, Mersin University, Mersin, Turkey
| | - Sibel K Velioğlu
- Karadeniz Technical University Medical Faculty, Department of Neurology, Clinical Neurophysiology Unit, Trabzon, Turkey
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Boleti APDA, Cardoso PHDO, Frihling BEF, de Moraes LFRN, Nunes EAC, Mukoyama LTH, Nunes EAC, Carvalho CME, Macedo MLR, Migliolo L. Pathophysiology to Risk Factor and Therapeutics to Treatment Strategies on Epilepsy. Brain Sci 2024; 14:71. [PMID: 38248286 PMCID: PMC10813806 DOI: 10.3390/brainsci14010071] [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: 12/18/2023] [Revised: 12/30/2023] [Accepted: 01/06/2024] [Indexed: 01/23/2024] Open
Abstract
Epilepsy represents a condition in which abnormal neuronal discharges or the hyperexcitability of neurons occur with synchronicity, presenting a significant public health challenge. Prognostic factors, such as etiology, electroencephalogram (EEG) abnormalities, the type and number of seizures before treatment, as well as the initial unsatisfactory effects of medications, are important considerations. Although there are several third-generation antiepileptic drugs currently available, their multiple side effects can negatively affect patient quality of life. The inheritance and etiology of epilepsy are complex, involving multiple underlying genetic and epigenetic mechanisms. Different neurotransmitters play crucial roles in maintaining the normal physiology of different neurons. Dysregulations in neurotransmission, due to abnormal transmitter levels or changes in their receptors, can result in seizures. In this review, we address the roles played by various neurotransmitters and their receptors in the pathophysiology of epilepsy. Furthermore, we extensively explore the neurological mechanisms involved in the development and progression of epilepsy, along with its risk factors. Furthermore, we highlight the new therapeutic targets, along with pharmacological and non-pharmacological strategies currently employed in the treatment of epileptic syndromes, including drug interventions employed in clinical trials related to epilepsy.
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Affiliation(s)
- Ana Paula de Araújo Boleti
- S-Inova Biotech, Programa de Pós-Graduação em Biotecnologia, Universidade Católica Dom Bosco, Campo Grande 79117-900, Brazil; (A.P.d.A.B.); (P.H.d.O.C.); (B.E.F.F.); (L.F.R.N.d.M.); (E.A.C.N.); (L.T.H.M.); (E.A.C.N.); (C.M.E.C.)
- Laboratório de Purificação de Proteínas e Suas Funções Biológicas, Unidade de Tecnologia de Alimentos e da Saúde Pública, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Brazil;
| | - Pedro Henrique de Oliveira Cardoso
- S-Inova Biotech, Programa de Pós-Graduação em Biotecnologia, Universidade Católica Dom Bosco, Campo Grande 79117-900, Brazil; (A.P.d.A.B.); (P.H.d.O.C.); (B.E.F.F.); (L.F.R.N.d.M.); (E.A.C.N.); (L.T.H.M.); (E.A.C.N.); (C.M.E.C.)
| | - Breno Emanuel Farias Frihling
- S-Inova Biotech, Programa de Pós-Graduação em Biotecnologia, Universidade Católica Dom Bosco, Campo Grande 79117-900, Brazil; (A.P.d.A.B.); (P.H.d.O.C.); (B.E.F.F.); (L.F.R.N.d.M.); (E.A.C.N.); (L.T.H.M.); (E.A.C.N.); (C.M.E.C.)
| | - Luiz Filipe Ramalho Nunes de Moraes
- S-Inova Biotech, Programa de Pós-Graduação em Biotecnologia, Universidade Católica Dom Bosco, Campo Grande 79117-900, Brazil; (A.P.d.A.B.); (P.H.d.O.C.); (B.E.F.F.); (L.F.R.N.d.M.); (E.A.C.N.); (L.T.H.M.); (E.A.C.N.); (C.M.E.C.)
| | - Ellynes Amancio Correia Nunes
- S-Inova Biotech, Programa de Pós-Graduação em Biotecnologia, Universidade Católica Dom Bosco, Campo Grande 79117-900, Brazil; (A.P.d.A.B.); (P.H.d.O.C.); (B.E.F.F.); (L.F.R.N.d.M.); (E.A.C.N.); (L.T.H.M.); (E.A.C.N.); (C.M.E.C.)
- Programa de Pós-graduação em Bioquímica, Universidade Federal do Rio Grande do Norte, Natal 59078-970, Brazil
| | - Lincoln Takashi Hota Mukoyama
- S-Inova Biotech, Programa de Pós-Graduação em Biotecnologia, Universidade Católica Dom Bosco, Campo Grande 79117-900, Brazil; (A.P.d.A.B.); (P.H.d.O.C.); (B.E.F.F.); (L.F.R.N.d.M.); (E.A.C.N.); (L.T.H.M.); (E.A.C.N.); (C.M.E.C.)
| | - Ellydberto Amancio Correia Nunes
- S-Inova Biotech, Programa de Pós-Graduação em Biotecnologia, Universidade Católica Dom Bosco, Campo Grande 79117-900, Brazil; (A.P.d.A.B.); (P.H.d.O.C.); (B.E.F.F.); (L.F.R.N.d.M.); (E.A.C.N.); (L.T.H.M.); (E.A.C.N.); (C.M.E.C.)
- Programa de Pós-graduação em Bioquímica, Universidade Federal do Rio Grande do Norte, Natal 59078-970, Brazil
| | - Cristiano Marcelo Espinola Carvalho
- S-Inova Biotech, Programa de Pós-Graduação em Biotecnologia, Universidade Católica Dom Bosco, Campo Grande 79117-900, Brazil; (A.P.d.A.B.); (P.H.d.O.C.); (B.E.F.F.); (L.F.R.N.d.M.); (E.A.C.N.); (L.T.H.M.); (E.A.C.N.); (C.M.E.C.)
| | - Maria Lígia Rodrigues Macedo
- Laboratório de Purificação de Proteínas e Suas Funções Biológicas, Unidade de Tecnologia de Alimentos e da Saúde Pública, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Brazil;
| | - Ludovico Migliolo
- S-Inova Biotech, Programa de Pós-Graduação em Biotecnologia, Universidade Católica Dom Bosco, Campo Grande 79117-900, Brazil; (A.P.d.A.B.); (P.H.d.O.C.); (B.E.F.F.); (L.F.R.N.d.M.); (E.A.C.N.); (L.T.H.M.); (E.A.C.N.); (C.M.E.C.)
- Programa de Pós-graduação em Bioquímica, Universidade Federal do Rio Grande do Norte, Natal 59078-970, Brazil
- Programa de Pós-graduação em Biologia Celular e Molecular, Universidade Federal da Paraíba, João Pessoa 58051-900, Brazil
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9
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Abd-Allah WH, El-Mohsen Anwar MA, Mohammed ER, El Moghazy SM. Anticonvulsant Classes and Possible Mechanism of Actions. ACS Chem Neurosci 2023; 14:4076-4092. [PMID: 37948544 DOI: 10.1021/acschemneuro.3c00613] [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] [Indexed: 11/12/2023] Open
Abstract
Epilepsy is considered one of the most common neurological disorders worldwide; it needs long-term or life-long treatment. Despite the presence of several novel antiepileptic drugs, approximately 30% patients still suffer from drug-resistant epilepsy. Subsequently, searching for new anticonvulsants with lower toxicity and better efficacy is still in paramount demand. Using target-based studies in the discovery of novel antiepileptics is uncommon owing to the insufficient information on the molecular pathway of epilepsy and complex mode of action for most of known antiepileptic drugs. In this review, we investigated the properties of anticonvulsants, types of epileptic seizures, and mechanism of action for anticonvulsants.
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Affiliation(s)
- Walaa Hamada Abd-Allah
- Pharmaceutical Chemistry Department, Collage of Pharmaceutical Science and Drug Manufacturing, Misr University for Science and Technology, P.O. 77, 12568 6th of October City, Giza, Egypt
| | - Mostafa Abd El-Mohsen Anwar
- Pharmaceutical Chemistry Department, Collage of Pharmaceutical Science and Drug Manufacturing, Misr University for Science and Technology, P.O. 77, 12568 6th of October City, Giza, Egypt
| | - Eman R Mohammed
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Cairo University, 11562 Cairo, Egypt
| | - Samir M El Moghazy
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Cairo University, 11562 Cairo, Egypt
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10
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Xu D, Chu M, Chen Y, Fang Y, Wang J, Zhang X, Xu F. Identification and verification of ferroptosis-related genes in the pathology of epilepsy: insights from CIBERSORT algorithm analysis. Front Neurol 2023; 14:1275606. [PMID: 38020614 PMCID: PMC10644861 DOI: 10.3389/fneur.2023.1275606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/04/2023] [Indexed: 12/01/2023] Open
Abstract
Background Epilepsy is a neurological disorder characterized by recurrent seizures. A mechanism of cell death regulation, known as ferroptosis, which involves iron-dependent lipid peroxidation, has been implicated in various diseases, including epilepsy. Objective This study aimed to provide a comprehensive understanding of the relationship between ferroptosis and epilepsy through bioinformatics analysis. By identifying key genes, pathways, and potential therapeutic targets, we aimed to shed light on the underlying mechanisms involved in the pathogenesis of epilepsy. Materials and methods We conducted a comprehensive analysis by screening gene expression data from the Gene Expression Omnibus (GEO) database and identified the differentially expressed genes (DEGs) related to ferroptosis. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed to gain insights into the biological processes and pathways involved. Moreover, we constructed a protein-protein interaction (PPI) network to identify hub genes, which was further validated using the receiver operating characteristic (ROC) curve analysis. To explore the relationship between immune infiltration and genes, we employed the CIBERSORT algorithm. Furthermore, we visualized four distinct interaction networks-mRNA-miRNA, mRNA-transcription factor, mRNA-drug, and mRNA-compound-to investigate potential regulatory mechanisms. Results In this study, we identified a total of 33 differentially expressed genes (FDEGs) associated with epilepsy and presented them using a Venn diagram. Enrichment analysis revealed significant enrichment in the pathways related to reactive oxygen species, secondary lysosomes, and ubiquitin protein ligase binding. Furthermore, GSVA enrichment analysis highlighted significant differences between epilepsy and control groups in terms of the generation of precursor metabolites and energy, chaperone complex, and antioxidant activity in Gene Ontology (GO) analysis. Furthermore, during the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, we observed differential expression in pathways associated with amyotrophic lateral sclerosis (ALS) and acute myeloid leukemia (AML) between the two groups. To identify hub genes, we constructed a protein-protein interaction (PPI) network using 30 FDEGs and utilized algorithms. This analysis led to the identification of three hub genes, namely, HIF1A, TLR4, and CASP8. The application of the CIBERSORT algorithm allowed us to explore the immune infiltration patterns between epilepsy and control groups. We found that CD4-naïve T cells, gamma delta T cells, M1 macrophages, and neutrophils exhibited higher expression in the control group than in the epilepsy group. Conclusion This study identified three FDEGs and analyzed the immune cells in epilepsy. These findings pave the way for future research and the development of innovative therapeutic strategies for epilepsy.
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Affiliation(s)
- Dan Xu
- Department of Pediatric Neurology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - ManMan Chu
- Department of Pediatric Neurology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - YaoYao Chen
- Department of Pediatric Neurology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yang Fang
- Department of Laboratory Medicine, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - JingGuang Wang
- Department of Pediatrics, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - XiaoLi Zhang
- Department of Pediatric Neurology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - FaLin Xu
- Department of Pediatrics, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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11
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Rastin C, Schenkel LC, Sadikovic B. Complexity in Genetic Epilepsies: A Comprehensive Review. Int J Mol Sci 2023; 24:14606. [PMID: 37834053 PMCID: PMC10572646 DOI: 10.3390/ijms241914606] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Epilepsy is a highly prevalent neurological disorder, affecting between 5-8 per 1000 individuals and is associated with a lifetime risk of up to 3%. In addition to high incidence, epilepsy is a highly heterogeneous disorder, with variation including, but not limited to the following: severity, age of onset, type of seizure, developmental delay, drug responsiveness, and other comorbidities. Variable phenotypes are reflected in a range of etiologies including genetic, infectious, metabolic, immune, acquired/structural (resulting from, for example, a severe head injury or stroke), or idiopathic. This review will focus specifically on epilepsies with a genetic cause, genetic testing, and biomarkers in epilepsy.
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Affiliation(s)
- Cassandra Rastin
- Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, ON N6A 5W9, Canada
- Department of Pathology and Laboratory Medicine, Western University, London, ON N6A 3K7, Canada
| | - Laila C. Schenkel
- Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, ON N6A 5W9, Canada
- Department of Pathology and Laboratory Medicine, Western University, London, ON N6A 3K7, Canada
| | - Bekim Sadikovic
- Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, ON N6A 5W9, Canada
- Department of Pathology and Laboratory Medicine, Western University, London, ON N6A 3K7, Canada
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12
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Perucca E, Bialer M, White HS. New GABA-Targeting Therapies for the Treatment of Seizures and Epilepsy: I. Role of GABA as a Modulator of Seizure Activity and Recently Approved Medications Acting on the GABA System. CNS Drugs 2023; 37:755-779. [PMID: 37603262 PMCID: PMC10501955 DOI: 10.1007/s40263-023-01027-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 08/22/2023]
Abstract
γ-Aminobutyric acid (GABA) is the most prevalent inhibitory neurotransmitter in the mammalian brain and has been found to play an important role in the pathogenesis or the expression of many neurological diseases, including epilepsy. Although GABA can act on different receptor subtypes, the component of the GABA system that is most critical to modulation of seizure activity is the GABAA-receptor-chloride (Cl-) channel complex, which controls the movement of Cl- ions across the neuronal membrane. In the mature brain, binding of GABA to GABAA receptors evokes a hyperpolarising (anticonvulsant) response, which is mediated by influx of Cl- into the cell driven by its concentration gradient between extracellular and intracellular fluid. However, in the immature brain and under certain pathological conditions, GABA can exert a paradoxical depolarising (proconvulsant) effect as a result of an efflux of chloride from high intracellular to lower extracellular Cl- levels. Extensive preclinical and clinical evidence indicates that alterations in GABAergic inhibition caused by drugs, toxins, gene defects or other disease states (including seizures themselves) play a causative or contributing role in facilitating or maintaning seizure activity. Conversely, enhancement of GABAergic transmission through pharmacological modulation of the GABA system is a major mechanism by which different antiseizure medications exert their therapeutic effect. In this article, we review the pharmacology and function of the GABA system and its perturbation in seizure disorders, and highlight how improved understanding of this system offers opportunities to develop more efficacious and better tolerated antiseizure medications. We also review the available data for the two most recently approved antiseizure medications that act, at least in part, through GABAergic mechanisms, namely cenobamate and ganaxolone. Differences in the mode of drug discovery, pharmacological profile, pharmacokinetic properties, drug-drug interaction potential, and clinical efficacy and tolerability of these agents are discussed.
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Affiliation(s)
- Emilio Perucca
- Department of Medicine (Austin Health), The University of Melbourne, Melbourne, VIC, Australia.
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia.
- Melbourne Brain Centre, 245 Burgundy Street, Heidelberg, VIC, 3084, Australia.
| | - Meir Bialer
- Institute of Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- David R. Bloom Center for Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - H Steve White
- Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA, USA
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13
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Xie G, Chen H, He C, Hu S, Xiao X, Luo Q. The dysregulation of miRNAs in epilepsy and their regulatory role in inflammation and apoptosis. Funct Integr Genomics 2023; 23:287. [PMID: 37653173 PMCID: PMC10471759 DOI: 10.1007/s10142-023-01220-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 08/22/2023] [Accepted: 08/26/2023] [Indexed: 09/02/2023]
Abstract
Epilepsy is a neurological disorder that impacts millions of people worldwide, and it is characterized by the occurrence of recurrent seizures. The pathogenesis of epilepsy is complex, involving dysregulation of various genes and signaling pathways. MicroRNAs (miRNAs) are a group of small non-coding RNAs that play a vital role in the regulation of gene expression. They have been found to be involved in the pathogenesis of epilepsy, acting as key regulators of neuronal excitability and synaptic plasticity. In recent years, there has been a growing interest in exploring the miRNA regulatory network in epilepsy. This review summarizes the current knowledge of the regulatory miRNAs involved in inflammation and apoptosis in epilepsy and discusses its potential as a new avenue for developing targeted therapies for the treatment of epilepsy.
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Affiliation(s)
- Guoping Xie
- Department of Clinical Laboratory, The Second Staff Hospital of Wuhan Iron and Steel (Group) Corporation, Wuhan, Hubei, China
| | - Huan Chen
- Department of Clinical Laboratory, Wuhan Institute of Technology Hospital, Wuhan Institute of Technology, Wuhan, China
| | - Chan He
- Department of Clinical Laboratory, Maternal and Child Health Hospital in Wuchang District, Wuhan, Hubei, China
| | - Siheng Hu
- Department of Clinical Laboratory, Honggangcheng Street Community Health Service Center, Qingshan District, Wuhan, Hubei, China
| | - Xue Xiao
- Department of Clinical Laboratory, Gongrencun Street Community Health Service Center, Wuhan, China
| | - Qunying Luo
- Department of Neurology, Huarun Wuhan Iron and Steel General Hospital, Wuhan, Hubei, China.
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14
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Nimgampalle M, Chakravarthy H, Sharma S, Shree S, Bhat AR, Pradeepkiran JA, Devanathan V. Neurotransmitter systems in the etiology of major neurological disorders: Emerging insights and therapeutic implications. Ageing Res Rev 2023; 89:101994. [PMID: 37385351 DOI: 10.1016/j.arr.2023.101994] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/21/2023] [Accepted: 06/25/2023] [Indexed: 07/01/2023]
Abstract
Neurotransmitters serve as chemical messengers playing a crucial role in information processing throughout the nervous system, and are essential for healthy physiological and behavioural functions in the body. Neurotransmitter systems are classified as cholinergic, glutamatergic, GABAergic, dopaminergic, serotonergic, histaminergic, or aminergic systems, depending on the type of neurotransmitter secreted by the neuron, allowing effector organs to carry out specific functions by sending nerve impulses. Dysregulation of a neurotransmitter system is typically linked to a specific neurological disorder. However, more recent research points to a distinct pathogenic role for each neurotransmitter system in more than one neurological disorder of the central nervous system. In this context, the review provides recently updated information on each neurotransmitter system, including the pathways involved in their biochemical synthesis and regulation, their physiological functions, pathogenic roles in diseases, current diagnostics, new therapeutic targets, and the currently used drugs for associated neurological disorders. Finally, a brief overview of the recent developments in neurotransmitter-based therapeutics for selected neurological disorders is offered, followed by future perspectives in that area of research.
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Affiliation(s)
- Mallikarjuna Nimgampalle
- Department of Biology, Indian Institute of Science Education and Research Tirupati (IISER T), Transit campus, Karakambadi Road, Mangalam, Tirupati 517507, Andhra Pradesh, India
| | - Harshini Chakravarthy
- Department of Biology, Indian Institute of Science Education and Research Tirupati (IISER T), Transit campus, Karakambadi Road, Mangalam, Tirupati 517507, Andhra Pradesh, India.
| | - Sapana Sharma
- Department of Biology, Indian Institute of Science Education and Research Tirupati (IISER T), Transit campus, Karakambadi Road, Mangalam, Tirupati 517507, Andhra Pradesh, India
| | - Shruti Shree
- Department of Biology, Indian Institute of Science Education and Research Tirupati (IISER T), Transit campus, Karakambadi Road, Mangalam, Tirupati 517507, Andhra Pradesh, India
| | - Anoop Ramachandra Bhat
- Department of Biology, Indian Institute of Science Education and Research Tirupati (IISER T), Transit campus, Karakambadi Road, Mangalam, Tirupati 517507, Andhra Pradesh, India
| | | | - Vasudharani Devanathan
- Department of Biology, Indian Institute of Science Education and Research Tirupati (IISER T), Transit campus, Karakambadi Road, Mangalam, Tirupati 517507, Andhra Pradesh, India.
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15
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Bhoot N, Gohil AV, Usgaokar K, Ranpariya K, Yadav R, Nanda A. Epilepsy Videos on YouTube: A Cross-Sectional Observational Study. Cureus 2023; 15:e43916. [PMID: 37746477 PMCID: PMC10513475 DOI: 10.7759/cureus.43916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/26/2023] Open
Abstract
INTRODUCTION Epilepsy is defined as a disorder of the brain characterized by an enduring predisposition to epileptic seizures. Being the most common neurological condition in the world, information regarding epilepsy is gathered by people from different available sources. OBJECTIVES The objective of this study was to evaluate the reliability and quality of YouTube videos about epilepsy as a source of information for the general population and also for patients suffering from this illness and for their families. METHODOLOGY A cross-sectional observational study was conducted, utilizing a questionnaire prepared on Google Forms (Google LLC, Mountain View, California, United States) with predetermined criteria. Each of the six authors independently searched and evaluated 10 YouTube videos using specific keywords. The assessment included determining the global quality score and utilizing the DISCERN tool. The collected data was recorded in Microsoft Excel and subsequently analyzed. RESULTS A total of 60 videos were analyzed, revealing that 76.27% of them provided information on the available treatment options for epilepsy, 71.19% explained the cause and etiology of the condition, and only 3.39% of the videos mentioned support groups. CONCLUSIONS Our study highlights the importance of assessment of medical information on social media platforms in order to ensure availability of correct information with high quality and reliability for epilepsy patients. This will help in understanding their medical health issues and decision making.
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Affiliation(s)
- Netra Bhoot
- Internal Medicine, Jawaharlal Nehru Medical College, Belgavi, IND
| | - Aasvi V Gohil
- Pediatrics, Gujarat Medical Education and Research Society (GMERS) Medical College and Hospital, Vadodara, IND
| | - Kapil Usgaokar
- Hospital Medicine, Sussex Partnership National Health Service (NHS) Foundation Trust, Chichester, GBR
| | - Keyur Ranpariya
- Pediatrics and Neonatology, UNM Children's Hospital, Gujarat, IND
| | - Rakshit Yadav
- Internal Medicine, Ram Kishan Yadav (RKY) Memorial Hospital, Jaipur, IND
| | - Ankita Nanda
- Medicine and Surgery, Rangaraya Medical College, Kolkata, IND
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16
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Ruan Y, Deng X, Liu J, Xiao X, Yang Z. Identification of miRNAs in extracellular vesicles as potential diagnostic markers for pediatric epilepsy and drug-resistant epilepsy via bioinformatics analysis. Front Pediatr 2023; 11:1199780. [PMID: 37469680 PMCID: PMC10352456 DOI: 10.3389/fped.2023.1199780] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/22/2023] [Indexed: 07/21/2023] Open
Abstract
Background Pediatric epilepsy (PE) is a common neurological disease. However, many challenges regarding the clinical diagnosis and treatment of PE and drug-resistant epilepsy (DRE) remain unsettled. Our study aimed to identify potential miRNA biomarkers in children with epilepsy and drug-resistant epilepsy by scrutinizing differential miRNA expression profiles. Methods In this study, miRNA expression profiles in plasma extracellular vesicles (EV) of normal controls, children with drug-effective epilepsy (DEE), and children with DRE were obtained. In addition, differential analysis, transcription factor (TF) enrichment analysis, Gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses, and target gene prediction were used to identify specifically expressed miRNAs and their potential mechanisms of action. Potential diagnostic markers for DRE were identified using machine learning algorithms, and their diagnostic efficiency was assessed by the receiver operating characteristic curve (ROC). Results The hsa-miR-1307-3p, hsa-miR-196a-5p, hsa-miR-199a-3p, and hsa-miR-21-5p were identified as diagnostic markers for PE, with values of area under curve (AUC) 0.780, 0.840, 0.832, and 0.816, respectively. In addition, the logistic regression model incorporating these four miRNAs had an AUC value of 0.940, and its target gene enrichment analysis highlighted that these miRNAs were primarily enriched in the PI3K-Akt, MAPK signaling pathways, and cell cycle. Furthermore, hsa-miR-99a-5p, hsa-miR-532-5p, hsa-miR-181d-5p, and hsa-miR-181a-5p showed good performance in differentiating children with DRE from those with DEE, with AUC values of 0.737 (0.534-0.940), 0.737 (0.523-0.952), 0.788 (0.592-0.985), and 0.788 (0.603-0.974), respectively. Conclusion This study characterized the expression profile of miRNAs in plasma EVs of children with epilepsy and identified miRNAs that can be used for the diagnosis of DRE.
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Affiliation(s)
- Yucai Ruan
- Department of Pediatrics, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
| | - Xuhui Deng
- Department of Neurology, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
| | - Jun Liu
- Medical Research Center and Clinical Laboratory Medicine, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
| | - Xiaobing Xiao
- Department of Pediatrics, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
| | - Zhi Yang
- Department of Pediatrics, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
- Department of Neurology, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
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17
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Stöber TM, Batulin D, Triesch J, Narayanan R, Jedlicka P. Degeneracy in epilepsy: multiple routes to hyperexcitable brain circuits and their repair. Commun Biol 2023; 6:479. [PMID: 37137938 PMCID: PMC10156698 DOI: 10.1038/s42003-023-04823-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 04/06/2023] [Indexed: 05/05/2023] Open
Abstract
Due to its complex and multifaceted nature, developing effective treatments for epilepsy is still a major challenge. To deal with this complexity we introduce the concept of degeneracy to the field of epilepsy research: the ability of disparate elements to cause an analogous function or malfunction. Here, we review examples of epilepsy-related degeneracy at multiple levels of brain organisation, ranging from the cellular to the network and systems level. Based on these insights, we outline new multiscale and population modelling approaches to disentangle the complex web of interactions underlying epilepsy and to design personalised multitarget therapies.
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Affiliation(s)
- Tristan Manfred Stöber
- Frankfurt Institute for Advanced Studies, 60438, Frankfurt am Main, Germany
- Institute for Neural Computation, Faculty of Computer Science, Ruhr University Bochum, 44801, Bochum, Germany
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe University, 60590, Frankfurt, Germany
| | - Danylo Batulin
- Frankfurt Institute for Advanced Studies, 60438, Frankfurt am Main, Germany
- CePTER - Center for Personalized Translational Epilepsy Research, Goethe University, 60590, Frankfurt, Germany
- Faculty of Computer Science and Mathematics, Goethe University, 60486, Frankfurt, Germany
| | - Jochen Triesch
- Frankfurt Institute for Advanced Studies, 60438, Frankfurt am Main, Germany
| | - Rishikesh Narayanan
- Cellular Neurophysiology Laboratory, Molecular Biophysics Unit, Indian Institute of Science, Bangalore, 560012, India
| | - Peter Jedlicka
- ICAR3R - Interdisciplinary Centre for 3Rs in Animal Research, Faculty of Medicine, Justus Liebig University Giessen, 35390, Giessen, Germany.
- Institute of Clinical Neuroanatomy, Neuroscience Center, Goethe University, 60590, Frankfurt am Main, Germany.
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18
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Akünal Türel C, Yunusoğlu O. Oleanolic acid suppresses pentylenetetrazole-induced seizure in vivo. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:529-540. [PMID: 36812380 DOI: 10.1080/09603123.2023.2167947] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 01/07/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to investigate the protective effects of triterpene oleanolic acid on the brain tissue of mice with pentylenetetrazole (PTZ)-induced epileptic seizures. Male Swiss albino mice were randomly separated into five groups as the PTZ, control, and oleanolic acid (10, 30, and 100 mg/kg) groups. PTZ injection was seen to cause significant seizures compared with the control group. Oleanolic acid significantly prolonged the latency to onset of myoclonic jerks and the duration of clonic convulsions, and decreased mean seizure scores following PTZ administration. Pretreatment with oleanolic acid also led to an increase in antioxidant enzyme activity (CAT and AChE) and levels (GSH and SOD) in the brain. The data obtained from this study support oleanolic acid may have anticonvulsant potential in PTZ-induced seizures, prevent oxidative stress and protect against cognitive disturbances. These results may provide useful information for the inclusion of oleanolic acid in epilepsy treatment.
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Affiliation(s)
- Canan Akünal Türel
- Department of Neurology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Oruç Yunusoğlu
- Department of Pharmacology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
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19
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Zhao L, Mühleisen TW, Pelzer DI, Burger B, Beins EC, Forstner AJ, Herms S, Hoffmann P, Amunts K, Palomero-Gallagher N, Cichon S. Relationships between neurotransmitter receptor densities and expression levels of their corresponding genes in the human hippocampus. Neuroimage 2023; 273:120095. [PMID: 37030412 PMCID: PMC10167541 DOI: 10.1016/j.neuroimage.2023.120095] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/02/2023] [Accepted: 04/05/2023] [Indexed: 04/08/2023] Open
Abstract
Neurotransmitter receptors are key molecules in signal transmission, their alterations are associated with brain dysfunction. Relationships between receptors and their corresponding genes are poorly understood, especially in humans. We combined in vitro receptor autoradiography and RNA sequencing to quantify, in the same tissue samples (7 subjects), the densities of 14 receptors and expression levels of their corresponding 43 genes in the Cornu Ammonis (CA) and dentate gyrus (DG) of human hippocampus. Significant differences in receptor densities between both structures were found only for metabotropic receptors, whereas significant differences in RNA expression levels mostly pertained ionotropic receptors. Receptor fingerprints of CA and DG differ in shapes but have similar sizes; the opposite holds true for their "RNA fingerprints", which represent the expression levels of multiple genes in a single area. In addition, the correlation coefficients between receptor densities and corresponding gene expression levels vary widely and the mean correlation strength was weak-to-moderate. Our results suggest that receptor densities are not only controlled by corresponding RNA expression levels, but also by multiple regionally specific post-translational factors.
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20
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Functional investigation of SLC1A2 variants associated with epilepsy. Cell Death Dis 2022; 13:1063. [PMID: 36543780 PMCID: PMC9772344 DOI: 10.1038/s41419-022-05457-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/15/2022] [Accepted: 11/18/2022] [Indexed: 12/24/2022]
Abstract
Epilepsy is a common neurological disorder and glutamate excitotoxicity plays a key role in epileptic pathogenesis. Astrocytic glutamate transporter GLT-1 is responsible for preventing excitotoxicity via clearing extracellular accumulated glutamate. Previously, three variants (G82R, L85P, and P289R) in SLC1A2 (encoding GLT-1) have been clinically reported to be associated with epilepsy. However, the functional validation and underlying mechanism of these GLT-1 variants in epilepsy remain undetermined. In this study, we reported that these disease-linked mutants significantly decrease glutamate uptake, cell membrane expression of the glutamate transporter, and glutamate-elicited current. Additionally, we found that these variants may disturbed stromal-interacting molecule 1 (STIM1)/Orai1-mediated store-operated Ca2+ entry (SOCE) machinery in the endoplasmic reticulum (ER), in which GLT-1 may be a new partner of SOCE. Furthermore, knock-in mice with disease-associated variants showed a hyperactive phenotype accompanied by reduced glutamate transporter expression. Therefore, GLT-1 is a promising and reliable therapeutic target for epilepsy interventions.
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21
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McKnight D, Morales A, Hatchell KE, Bristow SL, Bonkowsky JL, Perry MS, Berg AT, Borlot F, Esplin ED, Moretz C, Angione K, Ríos-Pohl L, Nussbaum RL, Aradhya S, Levy RJ, Parachuri VG, Lay-Son G, de Montellano DJDO, Ramirez-Garcia MA, Benítez Alonso EO, Ziobro J, Chirita-Emandi A, Felix TM, Kulasa-Luke D, Megarbane A, Karkare S, Chagnon SL, Humberson JB, Assaf MJ, Silva S, Zarroli K, Boyarchuk O, Nelson GR, Palmquist R, Hammond KC, Hwang ST, Boutlier SB, Nolan M, Batley KY, Chavda D, Reyes-Silva CA, Miroshnikov O, Zuccarelli B, Amlie-Wolf L, Wheless JW, Seinfeld S, Kanhangad M, Freeman JL, Monroy-Santoyo S, Rodriguez-Vazquez N, Ryan MM, Machie M, Guerra P, Hassan MJ, Candee MS, Bupp CP, Park KL, Muller E, Lupo P, Pedersen RC, Arain AM, Murphy A, Schatz K, Mu W, Kalika PM, Plaza L, Kellogg MA, Lora EG, Carson RP, Svystilnyk V, Venegas V, Luke RR, Jiang H, Stetsenko T, Dueñas-Roque MM, Trasmonte J, Burke RJ, Hurst AC, Smith DM, Massingham LJ, Pisani L, Costin CE, Ostrander B, Filloux FM, Ananth AL, Mohamed IS, Nechai A, Dao JM, Fahey MC, Aliu E, Falchek S, Press CA, Treat L, Eschbach K, Starks A, Kammeyer R, Bear JJ, Jacobson M, Chernuha V, Meibos B, Wong K, Sweney MT, Espinoza AC, Van Orman CB, Weinstock A, Kumar A, Soler-Alfonso C, Nolan DA, Raza M, Rojas Carrion MD, Chari G, Marsh ED, Shiloh-Malawsky Y, Parikh S, Gonzalez-Giraldo E, Fulton S, Sogawa Y, Burns K, Malets M, Montiel Blanco JD, Habela CW, Wilson CA, Guzmán GG, Pavliuk M. Genetic Testing to Inform Epilepsy Treatment Management From an International Study of Clinical Practice. JAMA Neurol 2022; 79:1267-1276. [PMID: 36315135 PMCID: PMC9623482 DOI: 10.1001/jamaneurol.2022.3651] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Importance It is currently unknown how often and in which ways a genetic diagnosis given to a patient with epilepsy is associated with clinical management and outcomes. Objective To evaluate how genetic diagnoses in patients with epilepsy are associated with clinical management and outcomes. Design, Setting, and Participants This was a retrospective cross-sectional study of patients referred for multigene panel testing between March 18, 2016, and August 3, 2020, with outcomes reported between May and November 2020. The study setting included a commercial genetic testing laboratory and multicenter clinical practices. Patients with epilepsy, regardless of sociodemographic features, who received a pathogenic/likely pathogenic (P/LP) variant were included in the study. Case report forms were completed by all health care professionals. Exposures Genetic test results. Main Outcomes and Measures Clinical management changes after a genetic diagnosis (ie, 1 P/LP variant in autosomal dominant and X-linked diseases; 2 P/LP variants in autosomal recessive diseases) and subsequent patient outcomes as reported by health care professionals on case report forms. Results Among 418 patients, median (IQR) age at the time of testing was 4 (1-10) years, with an age range of 0 to 52 years, and 53.8% (n = 225) were female individuals. The mean (SD) time from a genetic test order to case report form completion was 595 (368) days (range, 27-1673 days). A genetic diagnosis was associated with changes in clinical management for 208 patients (49.8%) and usually (81.7% of the time) within 3 months of receiving the result. The most common clinical management changes were the addition of a new medication (78 [21.7%]), the initiation of medication (51 [14.2%]), the referral of a patient to a specialist (48 [13.4%]), vigilance for subclinical or extraneurological disease features (46 [12.8%]), and the cessation of a medication (42 [11.7%]). Among 167 patients with follow-up clinical information available (mean [SD] time, 584 [365] days), 125 (74.9%) reported positive outcomes, 108 (64.7%) reported reduction or elimination of seizures, 37 (22.2%) had decreases in the severity of other clinical signs, and 11 (6.6%) had reduced medication adverse effects. A few patients reported worsening of outcomes, including a decline in their condition (20 [12.0%]), increased seizure frequency (6 [3.6%]), and adverse medication effects (3 [1.8%]). No clinical management changes were reported for 178 patients (42.6%). Conclusions and Relevance Results of this cross-sectional study suggest that genetic testing of individuals with epilepsy may be materially associated with clinical decision-making and improved patient outcomes.
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Affiliation(s)
| | | | | | | | - Joshua L. Bonkowsky
- Division of Pediatric Neurology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City,Center for Personalized Medicine, Primary Children’s Hospital, Salt Lake City, Utah
| | - Michael Scott Perry
- Jane and John Justin Neuroscience Center, Cook Children’s Medical Center, Fort Worth, Texas
| | - Anne T. Berg
- Department of Neurology, Northwestern University—Feinberg School of Medicine, Chicago, Illinois,COMBINEDBrain, Brentwood, Tennessee
| | - Felippe Borlot
- Section of Neurology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada,Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | | | - Katie Angione
- Children’s Hospital Colorado, Aurora,Department of Pediatrics, University of Colorado School of Medicine, Aurora
| | - Loreto Ríos-Pohl
- Clinical Integral de Epilepsia, Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile
| | | | | | | | - Rebecca J. Levy
- Division of Medical Genetics, Lucile Packard Children’s Hospital at Stanford University, Stanford, California
- Division of Child Neurology, Lucile Packard Children’s Hospital at Stanford University, Stanford, California
| | | | - Guillermo Lay-Son
- Genetic Unit, Pediatrics Division, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Miguel Angel Ramirez-Garcia
- Genetics Department, National Institute of Neurology and Neurosurgery, “Manuel Velasco Suárez,” Mexico City, Mexico
| | - Edmar O. Benítez Alonso
- Genetics Department, National Institute of Neurology and Neurosurgery, “Manuel Velasco Suárez,” Mexico City, Mexico
| | - Julie Ziobro
- Department of Pediatrics, University of Michigan, Ann Arbor
| | - Adela Chirita-Emandi
- Genetic Discipline, Center of Genomic Medicine, University of Medicine and Pharmacy “Victor Babes” Timisoara, Timis, Romania
- Regional Center of Medical Genetics Timis, Clinical Emergency Hospital for Children “Louis Turcanu” Timisoara, Timis, Romania
| | - Temis M. Felix
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Dianne Kulasa-Luke
- NeuroDevelopmental Science Center, Akron Children’s Hospital, Akron, Ohio
| | - Andre Megarbane
- Department of Human Genetics, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- Institut Jerome Lejeune, Paris, France
| | | | | | | | | | - Sebastian Silva
- Child Neurology Service, Hospital de Puerto Montt, Puerto Montt, Chile
| | | | - Oksana Boyarchuk
- I.Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Gary R. Nelson
- Division of Pediatric Neurology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
| | - Rachel Palmquist
- Division of Pediatric Neurology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
| | - Katherine C. Hammond
- Department of Pediatric Neurology, University of Alabama at Birmingham, Birmingham
| | - Sean T. Hwang
- Zucker School of Medicine, Hofstra Northwell, Hempstead, New York
| | - Susan B. Boutlier
- ECU Physician Internal Medicine Pediatric Neurology, Greenville, North Carolina
| | | | - Kaitlin Y. Batley
- Department of Pediatrics and Neurology, UT Southwestern, Dallas, Texas
| | - Devraj Chavda
- SUNY Downstate Health Sciences University, Brooklyn, New York
| | | | | | | | | | - James W. Wheless
- Pediatric Neurology, University of Tennessee Health Science Center, Memphis
- Le Bonheur Comprehensive Epilepsy Program & Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, Tennessee
| | | | - Manoj Kanhangad
- Department of Paediatrics, Monash University, Clayton, Australia
| | | | | | | | - Monique M. Ryan
- The Royal Children’s Hospital Melbourne, Melbourne, Australia
- Murdoch Children’s Research Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | - Michelle Machie
- Department of Pediatrics and Neurology, UT Southwestern, Dallas, Texas
| | - Patricio Guerra
- Universidad San Sebastián, Department of Pediatrics, Medicine School, Patagonia Campus, Puerto Montt, Chile
| | - Muhammad Jawad Hassan
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Meghan S. Candee
- Division of Pediatric Neurology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
| | - Caleb P. Bupp
- Spectrum Health, West Michigan Helen DeVos Children’s Hospital, Grand Rapids, Michigan
| | - Kristen L. Park
- Children’s Hospital Colorado, Aurora
- Department of Pediatrics, University of Colorado School of Medicine, Aurora
- Department of Neurology, University of Colorado School of Medicine, Aurora
| | - Eric Muller
- Clinical Genetics, Stanford Children’s Health Specialty Services, San Francisco, California
| | - Pamela Lupo
- Division of Neurology, Department of Pediatrics, University of Texas Medical Branch, League City
| | | | - Amir M. Arain
- Division of Epilepsy, Department of Neurology, University of Utah School of Medicine, Salt Lake City
| | - Andrea Murphy
- Mary Bird Perkins Cancer Center, Baton Rouge, Louisiana
| | | | - Weiyi Mu
- Johns Hopkins University, Baltimore, Maryland
| | | | - Lautaro Plaza
- Hospital Materno Perinatal “Mónica Pretelini Sáenz,” Toluca, México
| | | | - Evelyn G. Lora
- Dominican Neurological and Neurosurgical Society, Santo Domingo, Dominican Republic
| | | | | | - Viviana Venegas
- Clínica Alemana de Santiago, Universidad del Desarrollo, Pediatric Neurology Unit, Santiago, Chile
| | - Rebecca R. Luke
- Jane and John Justin Neuroscience Center, Cook Children’s Medical Center, Fort Worth, Texas
| | | | | | | | | | - Rebecca J. Burke
- Division of Medical Genetics, Department of Pediatrics, West Virginia University School of Medicine, Morgantown
- Division of Neonatology, Department of Pediatrics, West Virginia University School of Medicine, Morgantown
| | - Anna C.E. Hurst
- Department of Genetics, University of Alabama at Birmingham, Birmingham
| | | | - Lauren J. Massingham
- Hasbro Children’s Hospital, Providence, Rhode Island
- Alpert Medical School, Brown University, Providence, Rhode Island
| | - Laura Pisani
- Zucker School of Medicine, Hofstra Northwell, Hempstead, New York
- Northwell Health, Medical Genetics, Great Neck, New York
| | | | - Betsy Ostrander
- Division of Pediatric Neurology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
| | - Francis M. Filloux
- Division of Pediatric Neurology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
| | - Amitha L. Ananth
- Department of Pediatric Neurology, University of Alabama at Birmingham, Birmingham
| | - Ismail S. Mohamed
- Department of Pediatric Neurology, University of Alabama at Birmingham, Birmingham
| | - Alla Nechai
- Neurology Department, Kiev City Children Clinical Hospital No. 1, Kyiv City, Ukraine
| | - Jasmin M. Dao
- Adult and Child Neurology Medical Associates, Long Beach, California
- Miller Children’s Hospital, Long Beach, California
| | - Michael C. Fahey
- Department of Paediatrics, Monash University, Clayton, Australia
| | - Ermal Aliu
- Department of Genetics, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Stephen Falchek
- Nemours Children’s Hospital, Wilmington, Delaware
- Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Craig A. Press
- Children’s Hospital Colorado, Aurora
- Department of Pediatrics, University of Colorado School of Medicine, Aurora
- Department of Neurology, University of Colorado School of Medicine, Aurora
| | - Lauren Treat
- Children’s Hospital Colorado, Aurora
- Department of Pediatrics, University of Colorado School of Medicine, Aurora
- Department of Neurology, University of Colorado School of Medicine, Aurora
| | - Krista Eschbach
- Children’s Hospital Colorado, Aurora
- Department of Pediatrics, University of Colorado School of Medicine, Aurora
- Department of Neurology, University of Colorado School of Medicine, Aurora
| | - Angela Starks
- Children’s Hospital Colorado, Aurora
- Department of Pediatrics, University of Colorado School of Medicine, Aurora
- Department of Neurology, University of Colorado School of Medicine, Aurora
| | - Ryan Kammeyer
- Children’s Hospital Colorado, Aurora
- Department of Pediatrics, University of Colorado School of Medicine, Aurora
- Department of Neurology, University of Colorado School of Medicine, Aurora
| | - Joshua J. Bear
- Children’s Hospital Colorado, Aurora
- Department of Pediatrics, University of Colorado School of Medicine, Aurora
- Department of Neurology, University of Colorado School of Medicine, Aurora
| | - Mona Jacobson
- Children’s Hospital Colorado, Aurora
- Department of Pediatrics, University of Colorado School of Medicine, Aurora
- Department of Neurology, University of Colorado School of Medicine, Aurora
| | - Veronika Chernuha
- Pediatric Neurology Institute, “Dana-Dwek” Children’s Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | - Kristen Wong
- Division of Pediatric Neurology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
| | - Matthew T. Sweney
- Division of Pediatric Neurology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
| | - A. Chris Espinoza
- Division of Pediatric Neurology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
| | - Colin B. Van Orman
- Division of Pediatric Neurology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
| | - Arie Weinstock
- Division of Child Neurology, Department of Neurology, University at Buffalo, Buffalo, New York
- Oishei Children’s Hospital, Buffalo, New York
| | - Ashutosh Kumar
- Department of Pediatrics and Neurology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Claudia Soler-Alfonso
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | | | - Muhammad Raza
- Nishtar Medical University, Multan, Punjab, Pakistan
| | | | - Geetha Chari
- SUNY Downstate Health Sciences University, Brooklyn, New York
- Kings County Hospital Center, Brooklyn, New York
| | - Eric D. Marsh
- Division of Child Neurology, Departments of Neurology and Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- University of Pennsylvania Perelman School of Medicine, Philadelphia
| | | | - Sumit Parikh
- Neurogenetics, Cleveland Clinic, Cleveland, Ohio
| | | | - Stephen Fulton
- Pediatric Neurology, University of Tennessee Health Science Center, Memphis
- Le Bonheur Comprehensive Epilepsy Program & Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, Tennessee
| | - Yoshimi Sogawa
- UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | | | | | | | | | - Carey A. Wilson
- Division of Pediatric Neurology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
| | - Guillermo G. Guzmán
- Servicio Neuropsiquiatria Infantil, Hospital San Borja Arriarán, Santiago, Chile
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22
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Variable Expression of GABAA Receptor Subunit Gamma 2 Mutation in a Nuclear Family Displaying Developmental and Encephalopathic Phenotype. Int J Mol Sci 2022; 23:ijms23179683. [PMID: 36077081 PMCID: PMC9456057 DOI: 10.3390/ijms23179683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/13/2022] [Accepted: 08/23/2022] [Indexed: 12/17/2022] Open
Abstract
Mutations in GABAA receptor subunit genes (GABRs) are a major etiology for developmental and epileptic encephalopathies (DEEs). This article reports a case of a genetic abnormality in GABRG2 and updates the pathophysiology and treatment development for mutations in DEEs based on recent advances. Mutations in GABRs, especially in GABRA1, GABRB2, GABRB3, and GABRG2, impair GABAergic signaling and are frequently associated with DEEs such as Dravet syndrome and Lennox-Gastaut syndrome, as GABAergic signaling is critical for early brain development. We here present a novel association of a microdeletion of GABRG2 with a diagnosed DEE phenotype. We characterized the clinical phenotype and underlying mechanisms, including molecular genetics, EEGs, and MRI. We then compiled an update of molecular mechanisms of GABR mutations, especially the mutations in GABRB3 and GABRG2 attributed to DEEs. Genetic therapy is also discussed as a new avenue for treatment of DEEs through employing antisense oligonucleotide techniques. There is an urgent need to define treatment targets and explore new treatment paradigms for the DEEs, as early deployment could alleviate long-term disabilities and improve quality of life for patients. This study highlights biomolecular targets for future therapeutic interventions, including via both pharmacological and genetic approaches.
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23
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Blazekovic A, Gotovac Jercic K, Meglaj S, Duranovic V, Prpic I, Lozic B, Malenica M, Markovic S, Lujic L, Petelin Gadze Z, Juraski RG, Barišic N, Baric I, Borovecki F. Genetics of Pediatric Epilepsy: Next-Generation Sequencing in Clinical Practice. Genes (Basel) 2022; 13:genes13081466. [PMID: 36011376 PMCID: PMC9407986 DOI: 10.3390/genes13081466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 11/16/2022] Open
Abstract
Epilepsy is one of the most common neurological disorders with diverse phenotypic characteristics and high genetic heterogeneity. Epilepsy often occurs in childhood, so timely diagnosis and adequate therapy are crucial for preserving quality of life and unhindered development of a child. Next-generation-sequencing (NGS)-based tools have shown potential in increasing diagnostic yield. The primary objective of this study was to evaluate the impact of genetic testing and to investigate the diagnostic utility of targeted gene panel sequencing. This retrospective cohort study included 277 patients aged 6 months to 17 years undergoing NGS with an epilepsy panel covering 142 genes. Of 118 variants detected, 38 (32.2%) were not described in the literature. We identified 64 pathogenic or likely pathogenic variants with an overall diagnostic yield of 23.1%. We showed a significantly higher diagnostic yield in patients with developmental delay (28.9%). Furthermore, we showed that patients with variants reported as pathogenic presented with seizures at a younger age, which led to the conclusion that such children should be included in genomic diagnostic procedures as soon as possible to achieve a correct diagnosis in a timely manner, potentially leading to better treatment and avoidance of unnecessary procedures. Describing and discovering the genetic background of the disease not only leads to a better understanding of the mechanisms of the disorder but also opens the possibility of more precise and individualized treatment based on stratified medicine.
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Affiliation(s)
- Antonela Blazekovic
- Department for Functional Genomics, Center for Translational and Clinical Research, University Hospital Center Zagreb, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
- Department for Anatomy and Clinical Anatomy, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
- Correspondence:
| | - Kristina Gotovac Jercic
- Department for Functional Genomics, Center for Translational and Clinical Research, University Hospital Center Zagreb, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
- Department of Neurology, University Hospital Center Zagreb, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
| | - Sarah Meglaj
- Department for Functional Genomics, Center for Translational and Clinical Research, University Hospital Center Zagreb, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
| | - Vlasta Duranovic
- Department of Neuropediatrics, Children’s Hospital Zagreb, 10000 Zagreb, Croatia
- Department of Pediatrics, Clinical Hospital Center Rijeka, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Igor Prpic
- Department of Pediatrics, Clinical Hospital Center Rijeka, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Bernarda Lozic
- Department of Pediatrics, University Hospital of Split, University of Split School of Medicine, 21000 Split, Croatia
| | - Masa Malenica
- Department of Pediatrics, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Silvana Markovic
- Dr. Tomislav Bardek General Hospital Koprivnica, 48000 Koprivnica, Croatia
| | - Lucija Lujic
- Department of Neuropediatrics, Children’s Hospital Zagreb, 10000 Zagreb, Croatia
| | - Zeljka Petelin Gadze
- Department of Neurology, University Hospital Center Zagreb, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
- Referral Centre of the Ministry of Health of the Republic of Croatia for Epilepsy, Affiliated to ERN EpiCARE, 10000 Zagreb, Croatia
| | | | - Nina Barišic
- Department of Pediatrics, University Hospital Center Zagreb, 10000 Zagreb, Croatia
| | - Ivo Baric
- Department of Pediatrics, University Hospital Center Zagreb, 10000 Zagreb, Croatia
| | - Fran Borovecki
- Department for Functional Genomics, Center for Translational and Clinical Research, University Hospital Center Zagreb, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
- Department of Neurology, University Hospital Center Zagreb, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
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24
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Chen TS, Lai MC, Huang HYI, Wu SN, Huang CW. Immunity, Ion Channels and Epilepsy. Int J Mol Sci 2022; 23:ijms23126446. [PMID: 35742889 PMCID: PMC9224225 DOI: 10.3390/ijms23126446] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 12/10/2022] Open
Abstract
Epilepsy is a common chronic neurological disorder in modern society. One of the major unmet challenges is that current antiseizure medications are basically not disease-modifying. Among the multifaceted etiologies of epilepsy, the role of the immune system has attracted considerable attention in recent years. It is known that both innate and adaptive immunity can be activated in response to insults to the central nervous system, leading to seizures. Moreover, the interaction between ion channels, which have a well-established role in epileptogenesis and epilepsy, and the immune system is complex and is being actively investigated. Some examples, including the interaction between ion channels and mTOR pathways, will be discussed in this paper. Furthermore, there has been substantial progress in our understanding of the pathophysiology of epilepsy associated with autoimmune encephalitis, and numerous neural-specific autoantibodies have been found and documented. Early recognition of immune-mediated epilepsy is important, especially in cases of pharmacoresistant epilepsy and in the presence of signs of autoimmune encephalitis, as early intervention with immunotherapy shows promise.
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Affiliation(s)
- Tsang-Shan Chen
- Department of Neurology, Tainan Sin-Lau Hospital, Tainan 701002, Taiwan;
| | - Ming-Chi Lai
- Department of Pediatrics, Chi-Mei Medical Center, Tainan 71004, Taiwan;
| | | | - Sheng-Nan Wu
- Department of Physiology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
- Institute of Basic Medical Sciences, National Cheng Kung University Medical College, Tainan 70101, Taiwan
| | - Chin-Wei Huang
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Correspondence: ; Tel.: +886-6-2353535 (ext. 5485)
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25
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Exome sequencing allows detection of relevant pharmacogenetic variants in epileptic patients. THE PHARMACOGENOMICS JOURNAL 2022; 22:258-263. [PMID: 35590072 DOI: 10.1038/s41397-022-00280-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 04/28/2022] [Accepted: 05/09/2022] [Indexed: 01/08/2023]
Abstract
Beyond the identification of causal genetic variants in the diagnosis of Mendelian disorders, exome sequencing can detect numerous variants with potential relevance for clinical care. Clinical interventions can thus be conducted to improve future health outcomes for patients and their at-risk relatives, such as predicting late-onset genetic disorders accessible to prevention, treatment or identifying differential drug efficacy and safety. To evaluate the interest of such pharmacogenetic information, we designed an "in house" pipeline to determine the status of 122 PharmGKB (Pharmacogenomics Knowledgebase) variant-drug combinations in 31 genes. This pipeline was applied to a cohort of 90 epileptic patients who had previously an exome sequencing (ES) analysis, to determine the frequency of pharmacogenetic variants. We performed a retrospective analysis of drug plasma concentrations and treatment efficacy in patients bearing at least one relevant PharmGKB variant. For PharmGKB level 1A variants, CYP2C9 status for phenytoin prescription was the only relevant information. Nineteen patients were treated with phenytoin, among phenytoin-treated patients, none were poor metabolizers and four were intermediate metabolizers. While being treated with a standard protocol (10-23 mg/kg/30 min loading dose followed by 5 mg/kg/8 h maintenance dose), all identified intermediate metabolizers had toxic plasma concentrations (20 mg/L). In epileptic patients, pangenomic sequencing can provide information about common pharmacogenetic variants likely to be useful to guide therapeutic drug monitoring, and in the case of phenytoin, to prevent clinical toxicity caused by high plasma levels.
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26
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Demarest S, Calhoun J, Eschbach K, Yu HC, Mirsky D, Angione K, Shaikh TH, Carvill GL, Benke TA, Gunti J, Vanderveen G. Whole-exome sequencing and adrenocorticotropic hormone therapy in individuals with infantile spasms. Dev Med Child Neurol 2022; 64:633-640. [PMID: 35830182 DOI: 10.1111/dmcn.15109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 12/20/2022]
Abstract
AIM To identify additional genes associated with infantile spasms using a cohort with defined infantile spasms. METHOD Whole-exome sequencing (WES) was performed on 21 consented individuals with infantile spasms and their unaffected parents (a trio-based study). Clinical history and imaging were reviewed. Potentially deleterious exonic variants were identified and segregated. To refine potential candidates, variants were further prioritized on the basis of evidence for relevance to disease phenotype or known associations with infantile spasms, epilepsy, or neurological disease. RESULTS Likely pathogenic de novo variants were identified in NR2F1, GNB1, NEUROD2, GABRA2, and NDUFAF5. Suggestive dominant and recessive candidate variants were identified in PEMT, DYNC1I1, ASXL1, RALGAPB, and STRADA; further confirmation is required to support their relevance to disease etiology. INTERPRETATION This study supports the utility of WES in uncovering the genetic etiology in undiagnosed individuals with infantile spasms with an overall yield of five out of 21. High-priority candidates were identified in an additional five individuals. WES provides additional support for previously described disease-associated genes and expands their already broad mutational and phenotypic spectrum.
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Affiliation(s)
- Scott Demarest
- Children's Hospital Colorado, Aurora, CO, USA.,Department of Pediatrics, University of Colorado, School of Medicine, Aurora, CO, USA
| | - Jeff Calhoun
- Ken and Ruth Davee Department of Neurology, Northwestern University, School of Medicine, Chicago, IL, USA
| | - Krista Eschbach
- Children's Hospital Colorado, Aurora, CO, USA.,Department of Pediatrics, University of Colorado, School of Medicine, Aurora, CO, USA
| | - Hung-Chun Yu
- Department of Pediatrics, University of Colorado, School of Medicine, Aurora, CO, USA
| | - David Mirsky
- Children's Hospital Colorado, Aurora, CO, USA.,Department of Radiology, University of Colorado, School of Medicine, Aurora, CO, USA
| | - Katie Angione
- Children's Hospital Colorado, Aurora, CO, USA.,Department of Pediatrics, University of Colorado, School of Medicine, Aurora, CO, USA
| | - Tamim H Shaikh
- Department of Pediatrics, University of Colorado, School of Medicine, Aurora, CO, USA
| | - Gemma L Carvill
- Ken and Ruth Davee Department of Neurology, Northwestern University, School of Medicine, Chicago, IL, USA.,Department of Pharmacology, Northwestern University, School of Medicine, Chicago, IL, USA.,Department of Pediatrics, Northwestern University, School of Medicine, Chicago, IL, USA
| | - Tim A Benke
- Children's Hospital Colorado, Aurora, CO, USA.,Department of Pediatrics, University of Colorado, School of Medicine, Aurora, CO, USA.,Department of Pharmacology, University of Colorado, School of Medicine, Aurora, CO, USA.,Department of Neurology, University of Colorado, School of Medicine, Aurora, CO, USA.,Department of Otolaryngology, University of Colorado, School of Medicine, Aurora, CO, USA
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27
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Wang M, Cotter E, Wang YJ, Fu X, Whittsette AL, Lynch JW, Wiseman RL, Kelly JW, Keramidas A, Mu TW. Pharmacological activation of ATF6 remodels the proteostasis network to rescue pathogenic GABA A receptors. Cell Biosci 2022; 12:48. [PMID: 35477478 PMCID: PMC9044816 DOI: 10.1186/s13578-022-00783-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Genetic variants in the subunits of the gamma-aminobutyric acid type A (GABAA) receptors are implicated in the onset of multiple pathologic conditions including genetic epilepsy. Previous work showed that pathogenic GABAA subunits promote misfolding and inefficient assembly of the GABAA receptors, limiting receptor expression and activity at the plasma membrane. However, GABAA receptors containing variant subunits can retain activity, indicating that enhancing the folding, assembly, and trafficking of these variant receptors offers a potential opportunity to mitigate pathology associated with genetic epilepsy. RESULTS Here, we demonstrate that pharmacologically enhancing endoplasmic reticulum (ER) proteostasis using small molecule activators of the ATF6 (Activating Transcription Factor 6) signaling arm of the unfolded protein response (UPR) increases the assembly, trafficking, and surface expression of variant GABAA receptors. These improvements are attributed to ATF6-dependent remodeling of the ER proteostasis environment, which increases protein levels of pro-folding ER proteostasis factors including the ER chaperone BiP (Immunoglobulin Binding Protein) and trafficking receptors, such as LMAN1 (Lectin Mannose-Binding 1) and enhances their interactions with GABAA receptors. Importantly, we further show that pharmacologic ATF6 activators increase the activity of GABAA receptors at the cell surface, revealing the potential for this strategy to restore receptor activity to levels that could mitigate disease pathogenesis. CONCLUSIONS These results indicate that pharmacologic ATF6 activators offer an opportunity to restore GABAA receptor activity in diseases including genetic epilepsy and point to the potential for similar pharmacologic enhancement of ER proteostasis to improve trafficking of other disease-associated variant ion channels implicated in etiologically-diverse diseases.
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Affiliation(s)
- Meng Wang
- Department of Physiology and Biophysics, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, 44106, USA
| | - Edmund Cotter
- Queensland Brain Institute, the University of Queensland, Brisbane, QLD, 4072, Australia
| | - Ya-Juan Wang
- Department of Physiology and Biophysics, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, 44106, USA
| | - Xu Fu
- Department of Physiology and Biophysics, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, 44106, USA
| | - Angela L Whittsette
- Department of Physiology and Biophysics, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, 44106, USA
| | - Joseph W Lynch
- Queensland Brain Institute, the University of Queensland, Brisbane, QLD, 4072, Australia
| | - R Luke Wiseman
- Department of Molecular Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA, 92037, USA
| | - Jeffery W Kelly
- Department of Molecular Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA, 92037, USA
| | - Angelo Keramidas
- Queensland Brain Institute, the University of Queensland, Brisbane, QLD, 4072, Australia.
| | - Ting-Wei Mu
- Department of Physiology and Biophysics, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, 44106, USA.
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28
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Yang L. Nano-Hydrogel for the Treatment of Depression and Epilepsy. J Biomed Nanotechnol 2022; 18:1097-1105. [PMID: 35854439 DOI: 10.1166/jbn.2022.3318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This article first combines nano-carrier technology, the electrophysiological mechanism of seizures, and brain targeting technology to prepare new nano-hydrogels. Secondly, through the discharge information generated during the seizure and the electric field responsiveness of the nano-hydrogel, the free drug concentration in the brain area related to the seizure is increased, thereby, limiting the abnormal discharge of the focus to the local area and suppressing it in time. Finally, this article examines the impact of nano-hydrogel on the epilepsy and depression using relevant studies. The experimental observations revealed that the yield of the nano-hydrogel synthesized after 24 h of sapon-free emulsion polymerization was 50 to 70%, the swelling rate was 400 to 1700%, and the viscosity of the 20 mg/mL nano-hydrogel dispersion was 3.9 to 17.0 mPa· s. Furthermore, because the total efficiency was 0.952, the nano-hydrogels have a reduced recurrence rate and a better effect on the depression improvement.
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Affiliation(s)
- Libai Yang
- Department of Neurology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, 030032, Shanxi, P. R. China
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29
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Niu D, Sun P, Zhang F, Song F. Metabonomic analysis of cerebrospinal fluid in epilepsy. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:449. [PMID: 35571432 PMCID: PMC9096421 DOI: 10.21037/atm-22-1219] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/02/2022] [Indexed: 11/25/2022]
Abstract
Background We sought to explore the relationship between epilepsy and cerebrospinal fluid metabolomics and identify biomarkers for the diagnosis, treatment, and prognosis of epilepsy. Methods In total, 23 epileptic patients treated at The First Affiliated Hospital of Dalian Medical University from April 2019 to September 2019 were selected for the disease group and 13 non-epileptic patients were selected for the control group. Cerebrospinal fluid samples were collected from both groups, and the metabolites were analyzed by gas chromatography–mass spectrometry. The metabolites differentially expressed in the cerebrospinal fluid samples were identified. A differential metabolite enrichment analysis was performed to determine the metabolic pathways. Results Using a variable importance in the projection value >1 and a P value <0.05 as the screening criteria, we found that 3 metabolites (i.e., alpha-ketoisocaproic acid 1, xylose 1, and glycine 2) were differentially expressed in the cerebrospinal fluid of the 23 epileptic patients compared to the 13 non-epileptic patients. Alpha-ketoisocaproic acid 1 and xylose 1 were highly expressed in the epileptic cerebrospinal fluid samples, while glycine 2 was lowly expressed in the epileptic cerebrospinal fluid samples. Additionally, the 3 metabolites were significantly enriched in the 5 metabolic pathways of primary bile acid biosynthesis, valine, leucine, and isoleucine degradation, glutathione metabolism, glyoxylate and dicarboxylate metabolism, and glycine, serine, and threonine metabolism. Conclusions The present study examined the metabolites of the cerebrospinal fluid of epileptic patients and non-epileptic patients. Our findings provide insights that may inform the discovery of therapeutic targets and diagnostic markers for epilepsy.
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Affiliation(s)
- Di Niu
- College of Laboratory Medicine, Dalian Medical University, Dalian, China
| | - Pin Sun
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Fenghua Zhang
- College of Laboratory Medicine, Dalian Medical University, Dalian, China.,Department of Laboratory Medicine, Zhoupu Hospital Affiliated of Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Fan Song
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
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30
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Fusco F, Perottoni S, Giordano C, Riva A, Iannone LF, De Caro C, Russo E, Albani D, Striano P. The microbiota‐gut‐brain axis and epilepsy from a multidisciplinary perspective: clinical evidence and technological solutions for improvement of
in vitro
preclinical models. Bioeng Transl Med 2022; 7:e10296. [PMID: 35600638 PMCID: PMC9115712 DOI: 10.1002/btm2.10296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/10/2022] [Accepted: 01/15/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Federica Fusco
- Dipartimento di Chimica, materiali e ingegneria chimica "Giulio Natta" Politecnico di Milano Milan Italy
| | - Simone Perottoni
- Dipartimento di Chimica, materiali e ingegneria chimica "Giulio Natta" Politecnico di Milano Milan Italy
| | - Carmen Giordano
- Dipartimento di Chimica, materiali e ingegneria chimica "Giulio Natta" Politecnico di Milano Milan Italy
| | - Antonella Riva
- Paediatric Neurology and Muscular Disease Unit, IRCCS Istituto Giannina Gaslini Genova Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health Università degli Studi di Genova Genova Italy
| | | | - Carmen De Caro
- Science of Health Department Magna Graecia University Catanzaro Italy
| | - Emilio Russo
- Science of Health Department Magna Graecia University Catanzaro Italy
| | - Diego Albani
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS Milan Italy
| | - Pasquale Striano
- Paediatric Neurology and Muscular Disease Unit, IRCCS Istituto Giannina Gaslini Genova Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health Università degli Studi di Genova Genova Italy
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31
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Generative adversarial network and convolutional neural network-based EEG imbalanced classification model for seizure detection. Biocybern Biomed Eng 2022. [DOI: 10.1016/j.bbe.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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32
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Gao J, Dai N, Liu Z, Chen D, Zhen J, Wang J. Electroencephalogram Image under Complex Domain Analysis Algorithm to Analyze Neurological Status Epilepticus and Poor Prognostic Factors of Children. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:3109061. [PMID: 34956567 PMCID: PMC8694998 DOI: 10.1155/2021/3109061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022]
Abstract
This study was to adopt the electroencephalogram (EEG) image to analyze the neurological status epilepticus (SE) and adverse prognostic factors of children using the complex domain analysis algorithm, aiming at providing a theoretical basis for the clinical treatment of children with SE. 24-hour EEG was adopted to diagnose 197 children with SE. The patients were divided into an experimental group (100 cases) and a control group (97 cases) using a random number table method. The EEGs of children in the experimental group were analyzed using the compound domain analysis algorithm, and those in the control group were diagnosed by a professional doctor. The indicators of children in two groups were compared to analyze the effect of the compound domain analysis algorithm in diagnosing diseases through EEG. The prognostic scores of 197 children were scored one month after they were diagnosed, treated, and discharged, and the adverse prognostic factors were analyzed. As a result, EEG can accurately and effectively analyze the brain diseases in children. The sensitivity and specificity of the complex domain analysis algorithm for the detection of epilepsy EEG were much higher than those of the EEG automatic detection algorithm based on time-domain waveform similarity and the EEG automatic detection algorithm based on convolutional neural network (CNN), and the average running time was opposite, showing obvious difference (P < 0.05).The average accuracy, sensitivity, and specificity of children in the experimental group were 96.11%, 97.10%, and 95.19%, respectively; and those in the control group were 88.83%, 90.14%, and 87.82%, respectively, so there was an obvious difference in accuracy between two groups (P < 0.05). There were 57 cases with good prognosis and 140 cases with poor prognosis; there were 70 males with good prognosis and 19 poor prognoses and 69 women with good prognosis and 19 poor prognoses. Among 121 patients with infections, 84 cases had good prognosis and 37 cases had poor prognosis; 39 cases of irregular medication had good prognosis in 31 cases and a poor prognosis in 8 cases; and 37 cases had no obvious cause, including 25 cases with good prognosis and 12 cases with poor prognosis. In short, the EEG diagnosis and treatment effect of the compound domain analysis algorithm were better than those of professional doctors; the gender of the patient had no effect on the poor prognosis, and the pathogenic factors had an impact on the poor prognosis of the patient.
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Affiliation(s)
- Jiyong Gao
- Department of Pediatrics, Jinan Maternity and Child Care Hospital, Jinan 250001, Shandong, China
| | - Na Dai
- Department of Pediatrics, Jinan Maternity and Child Care Hospital, Jinan 250001, Shandong, China
| | - Zhigang Liu
- Department of Pediatrics, Jinan Maternity and Child Care Hospital, Jinan 250001, Shandong, China
| | - Dehong Chen
- Department of Pediatrics, Jinan Maternity and Child Care Hospital, Jinan 250001, Shandong, China
| | - Junqing Zhen
- Department of Pediatrics, Jinan Maternity and Child Care Hospital, Jinan 250001, Shandong, China
| | - Jin Wang
- Department of Pediatrics, Jinan Maternity and Child Care Hospital, Jinan 250001, Shandong, China
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33
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Benke TA, Park K, Krey I, Camp CR, Song R, Ramsey AJ, Yuan H, Traynelis SF, Lemke J. Clinical and therapeutic significance of genetic variation in the GRIN gene family encoding NMDARs. Neuropharmacology 2021; 199:108805. [PMID: 34560056 PMCID: PMC8525401 DOI: 10.1016/j.neuropharm.2021.108805] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/18/2021] [Accepted: 09/20/2021] [Indexed: 02/03/2023]
Abstract
Considerable genetic variation of N-methyl-d-aspartate receptors (NMDARs) has recently become apparent, with many hundreds of de novo variants identified through widely available clinical genetic testing. Individuals with GRIN variants present with neurological conditions such as epilepsy, autism, intellectual disability (ID), movement disorders, schizophrenia and behavioral disorders. Determination of the functional consequence of genetic variation for NMDARs should lead to precision therapeutics. Furthermore, genetic animal models harboring human variants have the potential to reveal mechanisms that are shared among different neurological conditions, providing strategies that may allow treatment of individuals who are refractory to therapy. Preclinical studies in animal models and small open label trials in humans support this idea. However, additional functional data for variants and animal models corresponding to multiple individuals with the same genotype are needed to validate this approach and to lead to thoughtfully designed, randomized, placebo-controlled clinical trials, which could provide data in order to determine safety and efficacy of potential precision therapeutics.
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Affiliation(s)
- Tim A Benke
- Departments of Pediatrics, Pharmacology, Neurology, and Otolaryngology, University of Colorado, School of Medicine and Children's Hospital Colorado, United States.
| | - Kristen Park
- Departments of Pediatrics and Neurology, University of Colorado School of Medicine and Children's Hospital Colorado, United States
| | - Ilona Krey
- Institute of Human Genetics, Leipzig Medical Center, Leipzig, Germany
| | - Chad R Camp
- Department of Pharmacology and Chemical Biology and the Center for Functional Evaluation of Rare Variants, Emory University School of Medicine, Atlanta, GA, United States
| | - Rui Song
- Department of Pharmacology and Chemical Biology and the Center for Functional Evaluation of Rare Variants, Emory University School of Medicine, Atlanta, GA, United States
| | - Amy J Ramsey
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
| | - Hongjie Yuan
- Department of Pharmacology and Chemical Biology and the Center for Functional Evaluation of Rare Variants, Emory University School of Medicine, Atlanta, GA, United States
| | - Stephen F Traynelis
- Department of Pharmacology and Chemical Biology and the Center for Functional Evaluation of Rare Variants, Emory University School of Medicine, Atlanta, GA, United States
| | - Johannes Lemke
- Institute of Human Genetics, Leipzig Medical Center, Leipzig, Germany
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34
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Moon JU, Han JY. Comparative Efficacy of Levetiracetam for Epilepsy in School-Aged Children with Intellectual Disability and Normal Intelligence. Brain Sci 2021; 11:brainsci11111452. [PMID: 34827451 PMCID: PMC8615484 DOI: 10.3390/brainsci11111452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 11/16/2022] Open
Abstract
Choosing optimal anti-seizure medication (ASM) is very important in pediatric patients with epilepsy who attend school, especially children with an intellectual disability (ID). Levetiracetam (LEV) has proven to be an effective, safe, generally well-tolerated, broad-spectrum ASM in children. In the context of increasing use of LEV in school-aged children with epilepsy and ID, we evaluate relevant clinical data, including efficacy, safety, and tolerability in children with epilepsy and an intellectual disability (ID) or normal intelligence (NI). We performed a retrospective chart review of children and included 298 pediatric patients with epilepsy who were treated with LEV with NI (147) and ID (151). After 6 months, 96% of NI and 83% of ID subjects had a seizure reduction rate greater than 50% (p = 0.031). The tolerability of LEV was generally good, with 75% retention rates at 2 years in both groups and only minor side effects (under 15%). The retention rates of patients with NI and ID were 76% and 74%, respectively (p = 0.597). Thus, LEV showed considerable efficacy with minimal side effects and high retention rates and is an easily maintained and safe treatment option for pediatric epilepsy with ID. However, better-designed research studies are needed to clearly elucidate the efficacy and safety of LEV in children with epilepsy and ID.
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Affiliation(s)
- Ja Un Moon
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
- Department of Pediatrics, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul 06591, Korea
| | - Ji Yoon Han
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
- Department of Pediatrics, Daejeon St. Mary’s Hospital, The Catholic University of Korea, Daejeon 34943, Korea
- Correspondence: ; Tel.: +82-42-220-9246
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35
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Zhang L, Wang Y. Gene therapy in epilepsy. Biomed Pharmacother 2021; 143:112075. [PMID: 34488082 DOI: 10.1016/j.biopha.2021.112075] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/11/2021] [Accepted: 08/17/2021] [Indexed: 01/15/2023] Open
Abstract
Gene therapy may constitute a promising alternative to conventional pharmacological tools and surgeries for epilepsy. For primary epilepsy, a single variant leading to a significant effect is relatively rare, while other forms are considered complex in inheritances with multiple susceptible mutations and impacts from the environment. Gene therapy in preclinical models of epilepsy has attempted to perform antiepileptogenic, anticonvulsant, or disease-modifying effects during epileptogenesis or after establishing the disease. Creating gene vectors tailored for different situations is the key to expanding gene therapy, and choosing the appropriate therapeutic target remains another fundamental problem. A variety of treatment strategies, from overexpressing inhibitory neuropeptides to modulating the expression of neurotransmitters or ion channels, have been tested in animal models. Additionally, emerging new approaches of optogenetics and chemogenetics, as well as genome-editing tools will further boost the prosperity of gene therapy. This review summarizes the experience obtained to date and discusses the challenges and opportunities in clinical translations.
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Affiliation(s)
- Lu Zhang
- Department of Neurology at Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Yuping Wang
- Beijing Key Laboratory of Neuromodulation, Capital Medical University, Beijing, China; Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China.
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36
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Rahman MM, Fatema K. Genetic Diagnosis in Children with Epilepsy and Developmental Disorders by Targeted Gene Panel Analysis in a Developing Country. J Epilepsy Res 2021; 11:22-31. [PMID: 34395220 PMCID: PMC8357555 DOI: 10.14581/jer.21004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/16/2021] [Accepted: 06/20/2021] [Indexed: 12/12/2022] Open
Abstract
Background and Purpose In childhood epilepsy, genetic etiology is increasingly recognized in recent years with the advent of next generation sequencing. This has broadened the scope of precision medicine in intractable epilepsy, particularly epileptic encephalopathy (EE). Developmental disorder (DD) is an integral part of childhood uncontrolled epilepsy. This study was performed to investigate the genetic etiology of childhood epilepsy and DD. Methods In this study, 40 children with epilepsy and DD with positive genetic mutation were included retrospectively. It was done in a tertiary care referral hospital of Bangladesh from January 2019 to December 2020. Genetic study was done by next generation sequencing. In all cases electroencephalography, neuroimaging was done and reviewed. Results In total, 40 children were enrolled and the average age was 41.4±35.850 months with a male predominance (67.5%). Generalized seizure was the predominant type of seizure. Regarding the association, intellectual disability and attention deficit hyperactivity disorder was common. Seventeen cases had genetically identified early infantile EE and common mutations observed were SCN1A (3), SCN8A (2), SLC1A2 (2), KCNT1 (2), and etc. Five patients of progressive myoclonic epilepsy were diagnosed and the mutations identified were in KCTD7, MFSD8, and CLN6 genes. Three cases had mitochondrial gene mutation (MT-ND5, MT-CYB). Some rare syndromes like Gibbs syndrome, Kohlschütter-Tönz syndrome, Cockayne syndrome, Pitt-Hopkins syndrome and cerebral creatine deficiency were diagnosed. Conclusions This is the first study from Bangladesh on genetics of epilepsy and DD. This will help to improve the understanding of genetics epilepsy of this region as well as contribute in administering precision medicine in these patients.
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Affiliation(s)
- Md Mizanur Rahman
- Department of Pediatric Neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Kanij Fatema
- Department of Pediatric Neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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37
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Ahmad MA, Pottoo FH, Akbar M. Gene Therapy Repairs for the Epileptic Brain: Potential for Treatment and Future Directions. Curr Gene Ther 2021; 19:367-375. [PMID: 32003688 DOI: 10.2174/1566523220666200131142423] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 01/01/2020] [Accepted: 01/15/2020] [Indexed: 01/19/2023]
Abstract
Epilepsy is a syndrome specified by frequent seizures and is one of the most prevalent neurological conditions, and that one-third of people of epilepsy are resistant to available drugs. Surgery is supposed to be the main treatment for the remedy of multiple drug-resistant epilepsy, but it is a drastic procedure. Advancement in genomic technologies indicates that gene therapy can make such surgery unnecessary. The considerable number of new studies show the significance of mutation in mammalian target of rapamycin pathway, NMDA receptors, GABA receptors, potassium channels and G-protein coupled receptors. Illustration of the meticulous drug in epilepsy targeting new expression of mutations in SCN8A, GRIN2A, GRIN2D and KCNT1 are conferred. Various methods are utilized to express a gene in a precise area of the brain; Transplantation of cells in an ex vivo approach (fetal cells, fibroblasts, immortalized cells), nonviral vector delivery and viral vector delivery like retrovirus, herpes simplex virus adenovirus and adeno-related virus. Gene therapy has thus been explored to generate anti-epileptogenic, anti-seizure and disease-modifying effects. Specific targeting of the epileptogenic region is facilitated by gene therapy, hence sparing the adjacent healthy tissue and decreasing the adverse effects that frequently go hand in hand with antiepileptic medication.
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Affiliation(s)
- Md A Ahmad
- Department of Pharmacology, Faculty of Pharmacy, Integral University, Lucknow, India
| | - Faheem H Pottoo
- Department of Pharmacology, College of Clinical Pharmacy, Imam Abdul Rahman Bin Faisal University, P.O. Box 1982, Dammam, 31441, Saudi Arabia
| | - Md Akbar
- Department of Pharmacology, School of Pharmaceutical, Education and Research, Jamia Hamdard, New Delhi- 110062, India
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38
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Treating of focal epilepsy: a patent review. Pharm Pat Anal 2021; 10:165-173. [PMID: 34076528 DOI: 10.4155/ppa-2021-0008] [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: 11/17/2022]
Abstract
Focal epilepsy is one of the most frequent specific type of epilepsies, with 30% treatment-resistant patients. There are several directions researchers can follow to improve existing treatment of focal epilepsy: synthesis of new compounds with anticonvulsant activity, repurposing drugs approved for other indications, finding drugs targeted to specific genetic and biochemical defects that underlie focal epilepsy syndromes, development of viral vectors for specific gene therapy, creation of devices and methods for suppression of seizures by electrostimulation and development of methods to increase safety of epilepsy surgery. Improvement of efficacy and safety of current therapies is necessary, as well as developing targeted treatment of genetic epilepsy syndromes that will not only suppress seizures, but stop further epileptogenesis.
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39
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Wang S, Wang D, Cai X, Wu Q, Han Y. Identification of the ZEB2 gene as a potential target for epilepsy therapy and the association between rs10496964 and ZEB2 expression. J Int Med Res 2021; 48:300060520980527. [PMID: 33870748 PMCID: PMC8061191 DOI: 10.1177/0300060520980527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective An association between the rs10496964 polymorphism and the
ZEB2 gene has not yet been reported, and the role of
ZEB2 in epilepsy therapy is also unclear. The aims of
this research were to evaluate the role of ZEB2 in the
therapy of epilepsy and to explore the association between rs10496964 and
ZEB2 expression. Methods We used the expression quantitative trait loci (eQTL) dataset resource from
the Brain eQTL Almanac to evaluate the association between rs10496964 and
ZEB2 expression in human brain tissue. Pathway and
process enrichment analysis, protein–protein interaction analysis, and
PhosphoSitePlus® analysis were then performed to further evaluate the role
of ZEB2 in the therapy of epilepsy. Results The rs10496964 polymorphism was found to regulate the expression of
ZEB2 in human brain tissue. The ZEB2 protein interacts
with the targets of approved antiepileptic drugs, and a post-translational
acetylation modification of ZEB2 was associated with an epilepsy drug
therapy. Conclusion Our findings suggest that ZEB2 may be involved in the
therapy of epilepsy, and rs10496964 regulates ZEB2
expression in human brain tissue.
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Affiliation(s)
- Shitao Wang
- Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Dan Wang
- Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xuemei Cai
- Department of Clinical Laboratory, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qian Wu
- Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yanbing Han
- Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, China
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40
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Praticò AD, Falsaperla R, Polizzi A, Ruggieri M. Monogenic Epilepsies: Channelopathies, Synaptopathies, mTorpathies, and Otheropathies. JOURNAL OF PEDIATRIC NEUROLOGY 2021. [DOI: 10.1055/s-0041-1727098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AbstractEpilepsy has been historically defined as the recurrence of two or more seizures, together with typical electroencephalogram (EEG) changes, and significant comorbidities, including cardiac and autonomic changes, injuries, intellectual disability, permanent brain damage, and higher mortality risk. Epilepsy may be the consequence of several causes, including genetic anomalies, structural brain malformations, hypoxic–ischemic encephalopathy, brain tumors, drugs, and all contributing factors to the imbalance between excitatory and inhibitory neurons and modulatory interneurons which in turn provoke abnormal, simultaneous electric discharge(s) involving part, or all the brain. In the pregenetic, pregenomic era, in most cases, the exact cause of such neuronal/interneuronal disequilibrium remained unknown and the term “idiopathic epilepsy” was used to define all the epilepsies without cause. At the same time, some specific epileptic syndromes were indicated by the eponym of the first physician who originally described the condition (e.g., the West syndrome, Dravet syndrome, Ohtahara syndrome, and Lennox–Gastaut syndrome) or by some characteristic clinical features (e.g., nocturnal frontal lobe epilepsy, absence epilepsy, and epilepsy and mental retardation limited to females). In many of these occurrences, the distinct epileptic syndrome was defined mainly by its most relevant clinical feature (e.g., seizure semiology), associated comorbidities, and EEGs patterns. Since the identification of the first epilepsy-associated gene (i.e., CHRNA4 gene: cholinergic receptor neuronal nicotinic α polypeptide 4), one of the genes responsible for autosomal dominant nocturnal frontal lobe epilepsy (currently known as sleep-related hypermotor epilepsy) in 1995, the field of epilepsy and the history of epilepsy gene discoveries have gone through at least three different stages as follows: (1) an early stage of relentless gene discovery in monogenic familial epilepsy syndromes; (2) a relatively quiescent and disappointing period characterized by largely negative genome-wide association candidate gene studies; and (3) a genome-wide era in which large-scale molecular genetic studies have led to the identification of several novel epilepsy genes, especially in sporadic forms of epilepsy. As of 2021, more than 150 epilepsy-associated genes or loci are listed in the Online Mendelian Inheritance in Man database.
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Affiliation(s)
- Andrea D. Praticò
- Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Catania, Italy
| | - Raffaele Falsaperla
- Unit of Pediatrics and Pediatric Emergency, University Hospital “Policlinico Rodolico-San Marco,” Catania, Italy
- Unit of Neonatal Intensive Care and Neonatology, University Hospital “Policlinico Rodolico-San Marco,” Catania, Italy
| | - Agata Polizzi
- Chair of Pediatrics, Department of Educational Sciences, University of Catania, Catania, Italy
| | - Martino Ruggieri
- Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Catania, Italy
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Wang J, Zhao J. MicroRNA Dysregulation in Epilepsy: From Pathogenetic Involvement to Diagnostic Biomarker and Therapeutic Agent Development. Front Mol Neurosci 2021; 14:650372. [PMID: 33776649 PMCID: PMC7994516 DOI: 10.3389/fnmol.2021.650372] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 02/23/2021] [Indexed: 12/21/2022] Open
Abstract
Epilepsy is the result of a group of transient abnormalities in brain function caused by an abnormal, highly synchronized discharge of brain neurons. MicroRNA (miRNA) is a class of endogenous non-coding single-stranded RNA molecules that participate in a series of important biological processes. Recent studies demonstrated that miRNAs are involved in a variety of central nervous system diseases, including epilepsy. Although the exact mechanism underlying the role of miRNAs in epilepsy pathogenesis is still unclear, these miRNAs may be involved in the inflammatory response in the nervous system, neuronal necrosis and apoptosis, dendritic growth, synaptic remodeling, glial cell proliferation, epileptic circuit formation, impairment of neurotransmitter and receptor function, and other processes. Here, we discuss miRNA metabolism and the roles of miRNA in epilepsy pathogenesis and evaluate miRNA as a potential new biomarker for the diagnosis of epilepsy, which enhances our understanding of disease processes.
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Affiliation(s)
- Jialu Wang
- Department of Neurology, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jiuhan Zhao
- Department of Neurology, First Affiliated Hospital of China Medical University, Shenyang, China
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Zhang L, Gao J, Liu H, Tian Y, Zhang X, Lei W, Li Y, Guo Y, Yu H, Yuan E, Liang L, Cui S, Zhang X. Pathogenic variants identified by whole-exome sequencing in 43 patients with epilepsy. Hum Genomics 2020; 14:44. [PMID: 33287870 PMCID: PMC7720389 DOI: 10.1186/s40246-020-00294-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 11/25/2020] [Indexed: 12/30/2022] Open
Abstract
Background Epilepsy is a group of neurological disorders characterized by recurrent epileptic seizures. Epilepsy is affected by many factors, approximately 20–30% of cases are caused by acquired conditions, but in the remaining cases, genetic factors play an important role. Early establishment of a specific diagnosis is important to treat and manage this disease. Methods In this study, we have recruited 43 epileptic encephalopathy patients and the molecular genetic analysis of those children was performed by whole-exome sequencing (WES). Results Fourteen patients (32.6%, 14/43) had positive genetic diagnoses, including fifteen mutations in fourteen genes. The overall diagnostic yield was 32.6%. A total of 9 patients were diagnosed as pathogenic mutations, including 4 variants had been reported as pathogenic previously and 6 novel variants that had not been reported previously. Therefore, WES heralds promise as a tool for clinical diagnosis of patients with genetic disease. Conclusion Early establishment of a specific diagnosis, on the one hand, is necessary for providing an accurate prognosis and recurrence risk as well as optimizing management and treatment options. On the other hand, to unveil the genetic architecture of epilepsy, it is of vital importance to investigate the phenotypic and genetic complexity of epilepsy.
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Affiliation(s)
- Linlin Zhang
- Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China.,Henan Academician Workstation of Genetic Diagnosis and Precision Medicine, Zhengzhou, Henan, People's Republic of China
| | - Jinshuang Gao
- Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China.,Henan Academician Workstation of Genetic Diagnosis and Precision Medicine, Zhengzhou, Henan, People's Republic of China
| | - Hailiang Liu
- Henan Academician Workstation of Genetic Diagnosis and Precision Medicine, Zhengzhou, Henan, People's Republic of China.,CapitalBio Genomics Co., Ltd., Dongguan, 532808, Guangdong, People's Republic of China
| | - Yuan Tian
- Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China.,Henan Academician Workstation of Genetic Diagnosis and Precision Medicine, Zhengzhou, Henan, People's Republic of China
| | - Xiaoli Zhang
- Henan Academician Workstation of Genetic Diagnosis and Precision Medicine, Zhengzhou, Henan, People's Republic of China.,Department of Neurologic Medicine, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China
| | - Wei Lei
- CapitalBio Genomics Co., Ltd., Dongguan, 532808, Guangdong, People's Republic of China
| | - Ying Li
- Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China.,Henan Academician Workstation of Genetic Diagnosis and Precision Medicine, Zhengzhou, Henan, People's Republic of China
| | - Yaqing Guo
- Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China.,Henan Academician Workstation of Genetic Diagnosis and Precision Medicine, Zhengzhou, Henan, People's Republic of China
| | - Haiyang Yu
- Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China.,Henan Academician Workstation of Genetic Diagnosis and Precision Medicine, Zhengzhou, Henan, People's Republic of China
| | - Erfeng Yuan
- Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China.,Henan Academician Workstation of Genetic Diagnosis and Precision Medicine, Zhengzhou, Henan, People's Republic of China
| | - Lisi Liang
- CapitalBio Genomics Co., Ltd., Dongguan, 532808, Guangdong, People's Republic of China
| | - Shihong Cui
- Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China. .,Henan Academician Workstation of Genetic Diagnosis and Precision Medicine, Zhengzhou, Henan, People's Republic of China. .,Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, 7 Front Kangfu Street, Zhengzhou, Henan, 450052, People's Republic of China. .,Department of Obstetrics, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China.
| | - Xiaoan Zhang
- Henan Academician Workstation of Genetic Diagnosis and Precision Medicine, Zhengzhou, Henan, People's Republic of China. .,Department of Imaging, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China. .,Department of Imaging and Gynecologic Oncology, The Third Affiliated Hospital of Zhengzhou University, 7 Front Kangfu Street, Zhengzhou, Henan, 450052, People's Republic of China.
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Berg AT, Gaebler-Spira D, Wilkening G, Zelko F, Knupp K, Dixon-Salazar T, Villas N, Meskis MA, Harwell V, Thompson T, Sims S, Nesbitt G. Nonseizure consequences of Dravet syndrome, KCNQ2-DEE, KCNB1-DEE, Lennox-Gastaut syndrome, ESES: A functional framework. Epilepsy Behav 2020; 111:107287. [PMID: 32759067 DOI: 10.1016/j.yebeh.2020.107287] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/19/2020] [Accepted: 06/21/2020] [Indexed: 11/28/2022]
Abstract
RATIONALE Developmental epilepsies and encephalopathies (DEEs) are characterized by many severe developmental impairments, which are not well-described. A functional framework could facilitate understanding of their nature and severity and guide the selection instruments to measure improvements in therapeutic trials. METHODS An online survey administered through several parent-organized foundations utilized accepted functional classifications and questionnaires derived from common instruments to determine levels of mobility, fine motor, communication, and feeding functions. Statistical analyses focused on overall levels of function and across-group comparisons adjusted for age. RESULTS From 6/2018 to 2/2020, 252 parents provided information for one or more functional domains. Median age was 7.2 years (interquartile range (IQR): 3.9 to 11.8), and 128 (51%) were females. DEE groups were Dravet syndrome (N = 72), KCNQ2-DEE (N = 80), KCNB1-DEE, (N = 33), Lennox-Gastaut syndrome (LGS; N = 26), electrographic status epilepticus in sleep (ESES; N = 15), and others (N = 26). Overall, functional hand grasp was absent in 48 (20%). Of children ≥2 years old, 60/214 (28%) could not walk independently, 85 (40%) were dependent on someone else for feeding, and 153 (73%) did not effectively communicate with unfamiliar people. Impairments entailing absence or near absence of independent function (profound impairment) were observed in 0, 1, 2, 3, and 4 domains for 58 (25%), 78 (34%), 40 (17%), 33 (14%), and 22 (10%) children, respectively. After adjustment for age, impairment levels varied substantially across DEE group for mobility (p < 0.0001), feeding (p < 0.0001), communication (p < 0.0001), hand grasp (p < 0.0001), and number of profoundly impaired domains (p < 0.0001). Three or four profoundly affected domains were reported in 44% of KCNQ2-DEE participants, followed by LGS (29%), KCNB1-DEE (27%), ESES (7%), and Dravet syndrome (6%). CONCLUSIONS Many children with DEEs experience severe functional impairments, and few children have typical function. As precision therapies will emphasize nonseizures consequences of DEEs, understanding the nature of abilities and impairments will be critical to selecting appropriate outcome measures in therapeutic trials.
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Affiliation(s)
- Anne T Berg
- Division of Neurology, Epilepsy Center, Ann & Robert H. Lurie Children's Hospital of Chicago and Department of Pediatrics, Northwestern Feinberg School of Medicine, United States of America.
| | - Deborah Gaebler-Spira
- Shirley Ryan Ability Laboratory, Chicago, IL and Departments Physical Medicine and Rehabilitation and Pediatrics, Northwestern Feinberg School of Medicine, Chicago, IL, United States of America
| | - Greta Wilkening
- Depts. Pediatrics and Neurology, University of Colorado - Anschutz Campus, Aurora, CO, United States of America
| | - Frank Zelko
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States of America
| | - Kelly Knupp
- Depts. Pediatrics and Neurology, University of Colorado - Anschutz Campus, Aurora, CO, United States of America
| | | | - Nicole Villas
- Dravet Syndrome Foundation, Cherry Hill, NJ, United States of America
| | - Mary Anne Meskis
- Dravet Syndrome Foundation, Cherry Hill, NJ, United States of America
| | - Vinez Harwell
- ESES/CSWS/LKS Group, Williamsburg, VA, United States of America
| | - Tina Thompson
- KCNQ2 parent, West Des Moines, IA, United States of America
| | - Scotty Sims
- KCNQ2 Cure Alliance, Denver, CO, United States of America
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Markus F, Angelini C, Trimouille A, Rudolf G, Lesca G, Goizet C, Lasseaux E, Arveiler B, van Slegtenhorst M, Brooks AS, Abou Jamra R, Korenke GC, Neidhardt J, Owczarek-Lipska M. Rare variants in the GABA A receptor subunit ε identified in patients with a wide spectrum of epileptic phenotypes. Mol Genet Genomic Med 2020; 8:e1388. [PMID: 32588540 PMCID: PMC7507344 DOI: 10.1002/mgg3.1388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/29/2020] [Accepted: 05/31/2020] [Indexed: 01/08/2023] Open
Abstract
Background Epilepsy belongs to a group of chronic and highly heterogeneous brain disorders. Many types of epilepsy and epileptic syndromes are caused by genetic factors. The neural amino acid y‐aminobutyric acid (GABA) is a major inhibitory neurotransmitter in the mammalian central nervous system. It regulates activity of channel pores by binding to transmembrane GABA‐receptors (GABRs). The GABRs are heteropentamers assembled from different receptor subunits (α1‐6, β1‐3, γ1‐3, δ, ε, θ, π, and ρ1‐3). Several epileptic disorders are caused by mutations in genes encoding single GABRs. Methods We applied trio‐ and single‐whole exome sequencing to search for genetic sequence variants associated with a wide range of epileptic phenotypes accompanied by intellectual disability and/or global developmental delay in the investigated patients. Results We identified four hemizygous sequence variants in the GABAA receptor subunit ε gene (GABRE), including one nonsense (NM_004961.3: c.399C>A, p.Tyr133*), two missense variants (NM_004961.3: c.664G>A, p.Glu222Lys; NM_004961.3: c.1045G>A, p.Val349Ile), and one variant affecting the translation initiation codon (NM_004961.3: c.1A>G, p.Met1?) in four unrelated families. Conclusion Our clinical and molecular genetic findings suggest that GABRE is a likely candidate gene for epilepsy. Nevertheless, functional studies are necessary to better understand pathogenicity of the GABRE‐mutations and their associations with epileptic phenotypes.
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Affiliation(s)
- Fenja Markus
- Junior Research Group, Genetics of Childhood Brain Malformations, Faculty VI-School of Medicine and Health Sciences, University of Oldenburg, Oldenburg, Germany.,Human Genetics, Faculty VI-School of Medicine and Health Sciences, University of Oldenburg, Oldenburg, Germany
| | - Chloé Angelini
- Service de Génétique médicale, CHU de Bordeaux, Bordeaux, France
| | | | - Gabrielle Rudolf
- CNRS U7104, INSERM U1258, Institut de Génétique et de Biologie Moléculaire et Cellulaire, Illkirch, France.,Service de Neurologie, Centre de Références des Maladies Neurogénétique Rares, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Gaetan Lesca
- Genetics department, Lyon University Hospital and University of Lyon, Lyon, France
| | - Cyril Goizet
- Service de Génétique médicale, CHU de Bordeaux, Bordeaux, France.,CNRS U7104, INSERM U1258, Institut de Génétique et de Biologie Moléculaire et Cellulaire, Illkirch, France
| | - Eulalie Lasseaux
- Service de Génétique médicale, CHU de Bordeaux, Bordeaux, France
| | - Benoit Arveiler
- Service de Génétique médicale, CHU de Bordeaux, Bordeaux, France
| | - Marjon van Slegtenhorst
- Department of Clinical Genetics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Alice S Brooks
- Department of Clinical Genetics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Rami Abou Jamra
- Institute of Human Genetics, University Medical Center Leipzig, Leipzig, Germany
| | | | - John Neidhardt
- Human Genetics, Faculty VI-School of Medicine and Health Sciences, University of Oldenburg, Oldenburg, Germany.,Research Center Neurosensory Science, University of Oldenburg, Oldenburg, Germany
| | - Marta Owczarek-Lipska
- Junior Research Group, Genetics of Childhood Brain Malformations, Faculty VI-School of Medicine and Health Sciences, University of Oldenburg, Oldenburg, Germany.,Human Genetics, Faculty VI-School of Medicine and Health Sciences, University of Oldenburg, Oldenburg, Germany
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Abstract
Epilepsy includes a number of medical conditions with recurrent seizures as common denominator. The large number of different syndromes and seizure types as well as the highly variable inter-individual response to the therapies makes management of this condition often challenging. In the last two decades, a genetic etiology has been revealed in more than half of all epilepsies and single gene defects in ion channels or neurotransmitter receptors have been associated with most inherited forms of epilepsy, including some focal and lesional forms as well as specific epileptic developmental encephalopathies. Several genetic tests are now available, including targeted assays up to revolutionary tools that have made sequencing of all coding (whole exome) and non-coding (whole genome) regions of the human genome possible. These recent technological advances have also driven genetic discovery in epilepsy and increased our understanding of the molecular mechanisms of many epileptic disorders, eventually providing targets for precision medicine in some syndromes, such as Dravet syndrome, pyroxidine-dependent epilepsy, and glucose transporter 1 deficiency. However, these examples represent a relatively small subset of all types of epilepsy, and to date, precision medicine in epilepsy has primarily focused on seizure control, and other clinical aspects, such as neurodevelopmental and neuropsychiatric comorbidities, have yet been possible to address. We herein summarize the most recent advances in genetic testing and provide up-to-date approaches for the choice of the correct test for some epileptic disorders and tailored treatments that are already applicable in some monogenic epilepsies. In the next years, the most probably scenario is that epilepsy treatment will be very different from the currently almost empirical approach, eventually with a "precision medicine" approach applicable on a large scale.
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Affiliation(s)
- Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit, IRCCS Istituto "G. Gaslini", Genoa, Italy.
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Via Gaslini 5, 16148, Genoa, Italy.
| | - Berge A Minassian
- Department of Pediatrics Division of Neurology, University of Texas Southwestern, Dallas, Texas, USA
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Zhao F, Rouzbeh N, Hansen KB, Clausen RP. Improved synthetic route for the GluN2-specific NMDA receptor glycine site agonist AICP. Tetrahedron Lett 2020. [DOI: 10.1016/j.tetlet.2020.151653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Zhu L, Chen L, Xu P, Lu D, Dai S, Zhong L, Han Y, Zhang M, Xiao B, Chang L, Wu Q. Genetic and molecular basis of epilepsy-related cognitive dysfunction. Epilepsy Behav 2020; 104:106848. [PMID: 32028124 DOI: 10.1016/j.yebeh.2019.106848] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/06/2019] [Accepted: 12/06/2019] [Indexed: 02/02/2023]
Abstract
Epilepsy is a common neurological disease characterized by recurrent seizures. About 70 million people were affected by epilepsy or epileptic seizures. Epilepsy is a complicated complex or symptomatic syndromes induced by structural, functional, and genetic causes. Meanwhile, several comorbidities are accompanied by epileptic seizures. Cognitive dysfunction is a long-standing complication associated with epileptic seizures, which severely impairs quality of life. Although the definitive pathogenic mechanisms underlying epilepsy-related cognitive dysfunction remain unclear, accumulating evidence indicates that multiple risk factors are probably involved in the development and progression of cognitive dysfunction in patients with epilepsy. These factors include the underlying etiology, recurrent seizures or status epilepticus, structural damage that induced secondary epilepsy, genetic variants, and molecular alterations. In this review, we summarize several theories that may explain the genetic and molecular basis of epilepsy-related cognitive dysfunction.
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Affiliation(s)
- Lin Zhu
- Department of Neurology, First Affiliated Hospital, Kunming Medical University, 295 Xi Chang Road, Kunming, Yunnan 650032, PR China
| | - Lu Chen
- Department of Neurology, First Affiliated Hospital, Kunming Medical University, 295 Xi Chang Road, Kunming, Yunnan 650032, PR China
| | - Puying Xu
- Department of Neurology, First Affiliated Hospital, Kunming Medical University, 295 Xi Chang Road, Kunming, Yunnan 650032, PR China
| | - Di Lu
- Biomedicine Engineering Research Center, Kunming Medical University, 1168 Chun Rong West Road, Kunming, Yunnan 650500, PR China
| | - Shujuan Dai
- Department of Neurology, First Affiliated Hospital, Kunming Medical University, 295 Xi Chang Road, Kunming, Yunnan 650032, PR China
| | - Lianmei Zhong
- Department of Neurology, First Affiliated Hospital, Kunming Medical University, 295 Xi Chang Road, Kunming, Yunnan 650032, PR China
| | - Yanbing Han
- Department of Neurology, First Affiliated Hospital, Kunming Medical University, 295 Xi Chang Road, Kunming, Yunnan 650032, PR China
| | - Mengqi Zhang
- Department of Neurology, Xiangya Hospital, Central South University, 87 Xiang Ya Road, Changsha, Hunan 410008, PR China
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital, Central South University, 87 Xiang Ya Road, Changsha, Hunan 410008, PR China
| | - Lvhua Chang
- Department of Neurology, First Affiliated Hospital, Kunming Medical University, 295 Xi Chang Road, Kunming, Yunnan 650032, PR China.
| | - Qian Wu
- Department of Neurology, First Affiliated Hospital, Kunming Medical University, 295 Xi Chang Road, Kunming, Yunnan 650032, PR China.
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Scala M, Bianchi A, Bisulli F, Coppola A, Elia M, Trivisano M, Pruna D, Pippucci T, Canafoglia L, Lattanzi S, Franceschetti S, Nobile C, Gambardella A, Michelucci R, Zara F, Striano P. Advances in genetic testing and optimization of clinical management in children and adults with epilepsy. Expert Rev Neurother 2020; 20:251-269. [PMID: 31941393 DOI: 10.1080/14737175.2020.1713101] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Epileptic disorders are a heterogeneous group of medical conditions with epilepsy as the common denominator. Genetic causes, electro-clinical features, and management significantly vary according to the specific condition.Areas covered: Relevant diagnostic advances have been achieved thanks to the advent of Next Generation Sequencing (NGS)-based molecular techniques. These revolutionary tools allow to sequence all coding (whole exome sequencing, WES) and non-coding (whole genome sequencing, WGS) regions of human genome, with a potentially huge impact on patient care and scientific research.Expert opinion: The application of these tests in children and adults with epilepsy has led to the identification of new causative genes, widening the knowledge on the pathophysiology of epilepsy and resulting in therapeutic implications. This review will explore the most recent advancements in genetic testing and provide up-to-date approaches for the choice of the correct test in patients with epilepsy.
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Affiliation(s)
- Marcello Scala
- Pediatric Neurology and Muscular Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Amedeo Bianchi
- Division of Neurology, Hospital San Donato Arezzo, Arezzo, Italy
| | - Francesca Bisulli
- IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Antonietta Coppola
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | - Maurizio Elia
- Unit of Neurology and Clinical Neurophysiopathology, IRCCS Oasi Research Institute, Troina, Italy
| | - Marina Trivisano
- Neurology Unit, Department of Neuroscience, IRCCS Bambino Gesù Children's Hospital, Rome, Italy.,Clinic of Nervous System Diseases, University of Foggia, Foggia, Italy
| | - Dario Pruna
- Epilepsy Unit, A. Cao Hospital, Cagliari, Italy
| | - Tommaso Pippucci
- Medical Genetics Unit, Polyclinic Sant' Orsola-Malpighi University Hospital, Bologna, Italy
| | | | - Simona Lattanzi
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | | | - Carlo Nobile
- CNR-Neuroscience Institute and Department of Biomedical Sciences (C.N.), University of Padua, Padua, Italy
| | - Antonio Gambardella
- Dipartimento Di Scienze Mediche E Chirurgiche, Università Della Magna Graecia, Catanzaro, Istituto Di Scienze Neurologiche CNR Mangone, Cosenza, Italy
| | - Roberto Michelucci
- IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Ospedale Bellaria, Bologna, Italy
| | - Federico Zara
- Laboratory of Neurogenetics and Neuroscience, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
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Chang BS, Krishnan V, Dulla CG, Jette N, Marsh ED, Dacks PA, Whittemore V, Poduri A. Epilepsy Benchmarks Area I: Understanding the Causes of the Epilepsies and Epilepsy-Related Neurologic, Psychiatric, and Somatic Conditions. Epilepsy Curr 2020; 20:5S-13S. [PMID: 31965828 PMCID: PMC7031801 DOI: 10.1177/1535759719895280] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The 2014 NINDS Benchmarks for Epilepsy Research included area I: Understand the causes of the epilepsies and epilepsy-related neurologic, psychiatric, and somatic conditions. In preparation for the 2020 Curing Epilepsies Conference, where the Benchmarks will be revised, this review will cover scientific progress toward that Benchmark, with emphasize on studies since 2016.
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Affiliation(s)
- Bernard S Chang
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Vaishnav Krishnan
- Departments of Neurology, Neuroscience and Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Chris G Dulla
- Department of Neuroscience, Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, MA, USA
| | - Nathalie Jette
- Department of Neurology, Icahn School of Medicine at Mt. Sinai, New York, NY, USA.,Department of Population Health Science and Policy, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - Eric D Marsh
- Department of Neurology, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Vicky Whittemore
- Division of Neuroscience, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MA, USA
| | - Annapurna Poduri
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
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Liu YP, Wu X, Meng JH, Yao J, Wang BJ. Functional Analysis of the 3' Untranslated Region of the Human GRIN1 Gene in Regulating Gene Expression in vitro. Neuropsychiatr Dis Treat 2020; 16:2361-2370. [PMID: 33116535 PMCID: PMC7567549 DOI: 10.2147/ndt.s268753] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 09/12/2020] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Abnormal expression of the NR1 subunit of the N-methyl-d-aspartate (NMDA) receptor may potentially increase the susceptibility to neuropsychiatric diseases. The purpose of this study was to investigate the functional sequence of the 3'UTR of the human GRIN1 gene, which encodes the GluN1 receptor to determine the effect on the expression of GluN1 receptor. METHODS We transferred seven recombinant pmirGLO recombinant vectors containing the 3'UTR truncated fragment of the GRIN1 gene into HEK-293, SK-N-SH, and U87 cell lines and compared the relative fluorescence intensity of adjacent length fragments. The TargetScan database was used to predict miRNAs. Then, miRNA mimics/inhibitors were co-transfected into the three cell lines with the 3'UTR of GRIN1 (pmirGLO - GRIN1), to investigate their influence on GRIN1 gene expression. RESULTS Compared with the pmirGLo-Basic vector, the relative fluorescence intensity of the complete GRIN1 gene 3'UTR recombinant sequence -27 bp - +1284 bp (the next base of the stop codon is +1) was significantly decreased in all three cell lines. The relative fluorescence intensities were significantly different between -27 bp - +294 bp and -27 bp - +497 bp regions, and between -27 bp - +708 bp and -27 bp - +907 bp regions. According to the prediction of the TargetScan database and analysis, miR-212-5p, miR-324-3p and miR-326 may bind to +295 bp - +497 bp, while miR-491-5p may bind to +798 bp - +907 bp. After co-transfection of miRNA mimic/inhibitor or mimic/inhibitor NC with a recombinant vector in the 3'UTR region of GRIN1 gene, we found that has-miR-491-5p inhibited GRIN1 expression significantly in all three cell lines, while has-miR-326 inhibitor upregulated GRIN1 expression in HEK-293 and U87 cells. CONCLUSION miR-491-5p may bind to the 3'UTR of the GRIN1 gene (+799 bp - +805 bp, the next base of the stop codon is +1) and down-regulate gene expression in HEK-293, SK-N-SH, and U87 cell lines, which implicates a potential role of miR-491-5p in central nervous system diseases.
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Affiliation(s)
- Yong-Ping Liu
- School of Forensic Medicine, China Medical University, Shenyang 110122, People's Republic of China
| | - Xue Wu
- School of Forensic Medicine, China Medical University, Shenyang 110122, People's Republic of China
| | - Jing-Hua Meng
- School of Forensic Medicine, China Medical University, Shenyang 110122, People's Republic of China
| | - Jun Yao
- School of Forensic Medicine, China Medical University, Shenyang 110122, People's Republic of China
| | - Bao-Jie Wang
- School of Forensic Medicine, China Medical University, Shenyang 110122, People's Republic of China
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