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Sami L, Chipaux M, Ferrand-Sorbets S, Doladilhe M, Bulteau C, Raffo E, Rosenberg S, Dorfmuller G, Checri R, De Sainte Agathe JM, Leguern E, Adle-Biassette H, Baldassari S, Baulac S. Genetic Insights Into Hypothalamic Hamartoma: Unraveling Somatic Variants. Neurol Genet 2024; 10:e200180. [PMID: 39246740 PMCID: PMC11380500 DOI: 10.1212/nxg.0000000000200180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 06/12/2024] [Indexed: 09/10/2024]
Abstract
Objectives Hypothalamic hamartomas (HHs) are rare developmental brain lesions associated with drug-resistant epilepsy and often subjected to epilepsy surgery. Brain somatic variants in genes affecting the Sonic hedgehog (Shh) and primary cilia signaling pathways have been implicated in approximately 50% of nonsyndromic HH cases. This study aims to characterize a new cohort of 9 HH cases and elucidate their genetic etiology. Methods We recruited 9 HH cases including 8 nonsyndromic cases of which 4 were type IV HH. Genomic DNA was extracted from peripheral blood and surgical brain tissues, and somatic variants were investigated using high-depth whole-exome sequencing. Results Pathogenic somatic variants in known HH genes (GLI3, OFD1, and PRKACA) were identified in 7 of the 9 cases. In addition, a 2-hit mutational event comprising a germline variant (predicted to impair kinase activity) and a somatic loss-of-heterozygosity was identified in TNK2, a gene encoding a brain-expressed tyrosine kinase. Discussion Our findings reinforce the role of somatic variants in Shh and cilia genes in HH cases while also shedding light on TNK2 as a potential novel disease-causing gene. This study emphasizes the increasing importance of brain mosaicism in epilepsy disorders and underscores the critical role of genetic diagnosis derived from resected brain tissue.
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Affiliation(s)
- Lina Sami
- From the Institut du Cerveau-Paris Brain Institute-ICM (L.S., M.D., J.-M.D.S.A., E.L., Sara Baldassari, Stephanie Baulac), Sorbonne Université, Inserm, CNRS, Hôpital de la Pitié Salpêtrière; Department of Pediatric Neurosurgery (M.C., S.F.-S., C.B., E.R., S.R., G.D., R.C.), Rothschild Foundation Hospital EPICARE; Department of Medical Genetics (J.-M.D.S.A., E.L.), AP-HP, Sorbonne Université, Hôpital de la Pitié Salpêtrière; and Université de Paris Cité (H.A.-B.), service d'Anatomie Pathologique, AP-HP, Hôpital Lariboisière, DMU DREAM, Biobank BB-0033-00064, UMR 1141, INSERM, Paris, France
| | - Mathilde Chipaux
- From the Institut du Cerveau-Paris Brain Institute-ICM (L.S., M.D., J.-M.D.S.A., E.L., Sara Baldassari, Stephanie Baulac), Sorbonne Université, Inserm, CNRS, Hôpital de la Pitié Salpêtrière; Department of Pediatric Neurosurgery (M.C., S.F.-S., C.B., E.R., S.R., G.D., R.C.), Rothschild Foundation Hospital EPICARE; Department of Medical Genetics (J.-M.D.S.A., E.L.), AP-HP, Sorbonne Université, Hôpital de la Pitié Salpêtrière; and Université de Paris Cité (H.A.-B.), service d'Anatomie Pathologique, AP-HP, Hôpital Lariboisière, DMU DREAM, Biobank BB-0033-00064, UMR 1141, INSERM, Paris, France
| | - Sarah Ferrand-Sorbets
- From the Institut du Cerveau-Paris Brain Institute-ICM (L.S., M.D., J.-M.D.S.A., E.L., Sara Baldassari, Stephanie Baulac), Sorbonne Université, Inserm, CNRS, Hôpital de la Pitié Salpêtrière; Department of Pediatric Neurosurgery (M.C., S.F.-S., C.B., E.R., S.R., G.D., R.C.), Rothschild Foundation Hospital EPICARE; Department of Medical Genetics (J.-M.D.S.A., E.L.), AP-HP, Sorbonne Université, Hôpital de la Pitié Salpêtrière; and Université de Paris Cité (H.A.-B.), service d'Anatomie Pathologique, AP-HP, Hôpital Lariboisière, DMU DREAM, Biobank BB-0033-00064, UMR 1141, INSERM, Paris, France
| | - Marion Doladilhe
- From the Institut du Cerveau-Paris Brain Institute-ICM (L.S., M.D., J.-M.D.S.A., E.L., Sara Baldassari, Stephanie Baulac), Sorbonne Université, Inserm, CNRS, Hôpital de la Pitié Salpêtrière; Department of Pediatric Neurosurgery (M.C., S.F.-S., C.B., E.R., S.R., G.D., R.C.), Rothschild Foundation Hospital EPICARE; Department of Medical Genetics (J.-M.D.S.A., E.L.), AP-HP, Sorbonne Université, Hôpital de la Pitié Salpêtrière; and Université de Paris Cité (H.A.-B.), service d'Anatomie Pathologique, AP-HP, Hôpital Lariboisière, DMU DREAM, Biobank BB-0033-00064, UMR 1141, INSERM, Paris, France
| | - Christine Bulteau
- From the Institut du Cerveau-Paris Brain Institute-ICM (L.S., M.D., J.-M.D.S.A., E.L., Sara Baldassari, Stephanie Baulac), Sorbonne Université, Inserm, CNRS, Hôpital de la Pitié Salpêtrière; Department of Pediatric Neurosurgery (M.C., S.F.-S., C.B., E.R., S.R., G.D., R.C.), Rothschild Foundation Hospital EPICARE; Department of Medical Genetics (J.-M.D.S.A., E.L.), AP-HP, Sorbonne Université, Hôpital de la Pitié Salpêtrière; and Université de Paris Cité (H.A.-B.), service d'Anatomie Pathologique, AP-HP, Hôpital Lariboisière, DMU DREAM, Biobank BB-0033-00064, UMR 1141, INSERM, Paris, France
| | - Emmanuel Raffo
- From the Institut du Cerveau-Paris Brain Institute-ICM (L.S., M.D., J.-M.D.S.A., E.L., Sara Baldassari, Stephanie Baulac), Sorbonne Université, Inserm, CNRS, Hôpital de la Pitié Salpêtrière; Department of Pediatric Neurosurgery (M.C., S.F.-S., C.B., E.R., S.R., G.D., R.C.), Rothschild Foundation Hospital EPICARE; Department of Medical Genetics (J.-M.D.S.A., E.L.), AP-HP, Sorbonne Université, Hôpital de la Pitié Salpêtrière; and Université de Paris Cité (H.A.-B.), service d'Anatomie Pathologique, AP-HP, Hôpital Lariboisière, DMU DREAM, Biobank BB-0033-00064, UMR 1141, INSERM, Paris, France
| | - Sarah Rosenberg
- From the Institut du Cerveau-Paris Brain Institute-ICM (L.S., M.D., J.-M.D.S.A., E.L., Sara Baldassari, Stephanie Baulac), Sorbonne Université, Inserm, CNRS, Hôpital de la Pitié Salpêtrière; Department of Pediatric Neurosurgery (M.C., S.F.-S., C.B., E.R., S.R., G.D., R.C.), Rothschild Foundation Hospital EPICARE; Department of Medical Genetics (J.-M.D.S.A., E.L.), AP-HP, Sorbonne Université, Hôpital de la Pitié Salpêtrière; and Université de Paris Cité (H.A.-B.), service d'Anatomie Pathologique, AP-HP, Hôpital Lariboisière, DMU DREAM, Biobank BB-0033-00064, UMR 1141, INSERM, Paris, France
| | - Georg Dorfmuller
- From the Institut du Cerveau-Paris Brain Institute-ICM (L.S., M.D., J.-M.D.S.A., E.L., Sara Baldassari, Stephanie Baulac), Sorbonne Université, Inserm, CNRS, Hôpital de la Pitié Salpêtrière; Department of Pediatric Neurosurgery (M.C., S.F.-S., C.B., E.R., S.R., G.D., R.C.), Rothschild Foundation Hospital EPICARE; Department of Medical Genetics (J.-M.D.S.A., E.L.), AP-HP, Sorbonne Université, Hôpital de la Pitié Salpêtrière; and Université de Paris Cité (H.A.-B.), service d'Anatomie Pathologique, AP-HP, Hôpital Lariboisière, DMU DREAM, Biobank BB-0033-00064, UMR 1141, INSERM, Paris, France
| | - Rayann Checri
- From the Institut du Cerveau-Paris Brain Institute-ICM (L.S., M.D., J.-M.D.S.A., E.L., Sara Baldassari, Stephanie Baulac), Sorbonne Université, Inserm, CNRS, Hôpital de la Pitié Salpêtrière; Department of Pediatric Neurosurgery (M.C., S.F.-S., C.B., E.R., S.R., G.D., R.C.), Rothschild Foundation Hospital EPICARE; Department of Medical Genetics (J.-M.D.S.A., E.L.), AP-HP, Sorbonne Université, Hôpital de la Pitié Salpêtrière; and Université de Paris Cité (H.A.-B.), service d'Anatomie Pathologique, AP-HP, Hôpital Lariboisière, DMU DREAM, Biobank BB-0033-00064, UMR 1141, INSERM, Paris, France
| | - Jean-Madeleine De Sainte Agathe
- From the Institut du Cerveau-Paris Brain Institute-ICM (L.S., M.D., J.-M.D.S.A., E.L., Sara Baldassari, Stephanie Baulac), Sorbonne Université, Inserm, CNRS, Hôpital de la Pitié Salpêtrière; Department of Pediatric Neurosurgery (M.C., S.F.-S., C.B., E.R., S.R., G.D., R.C.), Rothschild Foundation Hospital EPICARE; Department of Medical Genetics (J.-M.D.S.A., E.L.), AP-HP, Sorbonne Université, Hôpital de la Pitié Salpêtrière; and Université de Paris Cité (H.A.-B.), service d'Anatomie Pathologique, AP-HP, Hôpital Lariboisière, DMU DREAM, Biobank BB-0033-00064, UMR 1141, INSERM, Paris, France
| | - Eric Leguern
- From the Institut du Cerveau-Paris Brain Institute-ICM (L.S., M.D., J.-M.D.S.A., E.L., Sara Baldassari, Stephanie Baulac), Sorbonne Université, Inserm, CNRS, Hôpital de la Pitié Salpêtrière; Department of Pediatric Neurosurgery (M.C., S.F.-S., C.B., E.R., S.R., G.D., R.C.), Rothschild Foundation Hospital EPICARE; Department of Medical Genetics (J.-M.D.S.A., E.L.), AP-HP, Sorbonne Université, Hôpital de la Pitié Salpêtrière; and Université de Paris Cité (H.A.-B.), service d'Anatomie Pathologique, AP-HP, Hôpital Lariboisière, DMU DREAM, Biobank BB-0033-00064, UMR 1141, INSERM, Paris, France
| | - Homa Adle-Biassette
- From the Institut du Cerveau-Paris Brain Institute-ICM (L.S., M.D., J.-M.D.S.A., E.L., Sara Baldassari, Stephanie Baulac), Sorbonne Université, Inserm, CNRS, Hôpital de la Pitié Salpêtrière; Department of Pediatric Neurosurgery (M.C., S.F.-S., C.B., E.R., S.R., G.D., R.C.), Rothschild Foundation Hospital EPICARE; Department of Medical Genetics (J.-M.D.S.A., E.L.), AP-HP, Sorbonne Université, Hôpital de la Pitié Salpêtrière; and Université de Paris Cité (H.A.-B.), service d'Anatomie Pathologique, AP-HP, Hôpital Lariboisière, DMU DREAM, Biobank BB-0033-00064, UMR 1141, INSERM, Paris, France
| | - Sara Baldassari
- From the Institut du Cerveau-Paris Brain Institute-ICM (L.S., M.D., J.-M.D.S.A., E.L., Sara Baldassari, Stephanie Baulac), Sorbonne Université, Inserm, CNRS, Hôpital de la Pitié Salpêtrière; Department of Pediatric Neurosurgery (M.C., S.F.-S., C.B., E.R., S.R., G.D., R.C.), Rothschild Foundation Hospital EPICARE; Department of Medical Genetics (J.-M.D.S.A., E.L.), AP-HP, Sorbonne Université, Hôpital de la Pitié Salpêtrière; and Université de Paris Cité (H.A.-B.), service d'Anatomie Pathologique, AP-HP, Hôpital Lariboisière, DMU DREAM, Biobank BB-0033-00064, UMR 1141, INSERM, Paris, France
| | - Stephanie Baulac
- From the Institut du Cerveau-Paris Brain Institute-ICM (L.S., M.D., J.-M.D.S.A., E.L., Sara Baldassari, Stephanie Baulac), Sorbonne Université, Inserm, CNRS, Hôpital de la Pitié Salpêtrière; Department of Pediatric Neurosurgery (M.C., S.F.-S., C.B., E.R., S.R., G.D., R.C.), Rothschild Foundation Hospital EPICARE; Department of Medical Genetics (J.-M.D.S.A., E.L.), AP-HP, Sorbonne Université, Hôpital de la Pitié Salpêtrière; and Université de Paris Cité (H.A.-B.), service d'Anatomie Pathologique, AP-HP, Hôpital Lariboisière, DMU DREAM, Biobank BB-0033-00064, UMR 1141, INSERM, Paris, France
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Klein KM, Mascarenhas R, Merrikh D, Khanbabaei M, Maroilley T, Kaur N, Liu Y, Soule T, Manalo M, Tamura G, Jacobs J, Hader W, Pfeffer G, Tarailo-Graovac M. Identification of a mosaic MTOR variant in purified neuronal DNA in a patient with focal cortical dysplasia using a novel depth electrode harvesting technique. Epilepsia 2024; 65:1768-1776. [PMID: 38587282 DOI: 10.1111/epi.17980] [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: 01/20/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE Recent studies have identified brain somatic variants as a cause of focal epilepsy. These studies relied on resected tissue from epilepsy surgery, which is not available in most patients. The use of trace tissue adherent to depth electrodes used for stereo electroencephalography (EEG) has been proposed as an alternative but is hampered by the low cell quality and contamination by nonbrain cells. Here, we use our improved depth electrode harvesting technique that purifies neuronal nuclei to achieve molecular diagnosis in a patient with focal cortical dysplasia (FCD). METHODS Depth electrode tips were collected, pooled by brain region and seizure onset zone, and nuclei were isolated and sorted using fluorescence-activated nuclei sorting (FANS). Somatic DNA was amplified from neuronal and astrocyte nuclei using primary template amplification followed by exome sequencing of neuronal DNA from the affected pool, unaffected pool, and saliva. The identified variant was validated using droplet digital polymerase chain reaction (PCR). RESULTS An 11-year-old male with drug-resistant genetic-structural epilepsy due to left anterior insula FCD had seizures from age 3 years. Stereo EEG confirmed seizure onset in the left anterior insula. The two anterior insula electrodes were combined as the affected pool and three frontal electrodes as the unaffected pool. FANS isolated 140 neuronal nuclei from the affected and 245 neuronal nuclei from the unaffected pool. A novel somatic missense MTOR variant (p.Leu489Met, CADD score 23.7) was identified in the affected neuronal sample. Droplet digital PCR confirmed a mosaic gradient (variant allele frequency = .78% in affected neuronal sample; variant was absent in all other samples). SIGNIFICANCE Our findings confirm that harvesting neuronal DNA from depth electrodes followed by molecular analysis to identify brain somatic variants is feasible. Our novel method represents a significant improvement compared to the previous method by focusing the analysis on high-quality cells of the cell type of interest.
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Affiliation(s)
- Karl Martin Klein
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Rumika Mascarenhas
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Daria Merrikh
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Maryam Khanbabaei
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Tatiana Maroilley
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Biochemistry and Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Navprabhjot Kaur
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Yiping Liu
- Flow Cytometry Core Facility, University of Calgary, Calgary, Alberta, Canada
| | - Tyler Soule
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Minette Manalo
- Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Goichiro Tamura
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Julia Jacobs
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Walter Hader
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Gerald Pfeffer
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Maja Tarailo-Graovac
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Biochemistry and Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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3
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Phillips HW, D'Gama AM, Wang Y, Chahine Y, Chiu M, Swanson AC, Ahtam B, Bolton JB, Madsen JR, Lee EA, Prabhu SP, Lidov HG, Papadakis J, Huang AY, Poduri A, Stone SS, Walsh CA. Somatic Mosaicism in PIK3CA Variant Correlates With Stereoelectroencephalography-Derived Electrophysiology. Neurol Genet 2024; 10:e200117. [PMID: 38149038 PMCID: PMC10751024 DOI: 10.1212/nxg.0000000000200117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/20/2023] [Indexed: 12/28/2023]
Abstract
Objectives Brain-limited pathogenic somatic variants are associated with focal pediatric epilepsy, but reliance on resected brain tissue samples has limited our ability to correlate epileptiform activity with abnormal molecular pathology. We aimed to identify the pathogenic variant and map variant allele fractions (VAFs) across an abnormal region of epileptogenic brain in a patient who underwent stereoelectroencephalography (sEEG) and subsequent motor-sparing left frontal disconnection. Methods We extracted genomic DNA from peripheral blood, brain tissue resected from peri-sEEG electrode regions, and microbulk brain tissue adherent to sEEG electrodes. Samples were mapped based on an anatomic relationship with the presumed seizure onset zone (SOZ). We performed deep panel sequencing of amplified and unamplified DNA to identify pathogenic variants with subsequent orthogonal validation. Results We detect a pathogenic somatic PIK3CA variant, c.1624G>A (p.E542K), in the brain tissue samples, with VAF inversely correlated with distance from the SOZ. In addition, we identify this variant in amplified electrode-derived samples, albeit with lower VAFs. Discussion We demonstrate regional mosaicism across epileptogenic tissue, suggesting a correlation between variant burden and SOZ. We also validate a pathogenic variant from individual amplified sEEG electrode-derived brain specimens, although further optimization of techniques is required.
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Affiliation(s)
- H Westley Phillips
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Alissa M D'Gama
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Yilan Wang
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Yasmine Chahine
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Michelle Chiu
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Amanda C Swanson
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Banu Ahtam
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Jeffrey B Bolton
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Joseph R Madsen
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Eunjung A Lee
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Sanjay P Prabhu
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Hart G Lidov
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Joanna Papadakis
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - August Y Huang
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Annapurna Poduri
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Scellig S Stone
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Christopher A Walsh
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
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4
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Gatesman TA, Hect JL, Phillips HW, Johnson BJ, Wald AI, McClung C, Nikiforova MN, Skaugen JM, Pollack IF, Abel TJ, Agnihotri S. Characterization of low-grade epilepsy-associated tumor from implanted stereoelectroencephalography electrodes. Epilepsia Open 2024; 9:409-416. [PMID: 37798921 PMCID: PMC10839351 DOI: 10.1002/epi4.12840] [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: 04/21/2023] [Accepted: 09/29/2023] [Indexed: 10/07/2023] Open
Abstract
Low-grade epilepsy-associated tumors (LEATs) are a common cause of drug-resistant epilepsy in children. Herein, we demonstrate the feasibility of using tumor tissue derived from stereoelectroencephalography (sEEG) electrodes upon removal to molecularly characterize tumors and aid in diagnosis. An 18-year-old male with focal epilepsy and MRI suggestive of a dysembryoplastic neuroepithelial tumor (DNET) in the left posterior temporal lobe underwent implantation of seven peri-tumoral sEEG electrodes for peri-operative language mapping and demarcation of the peri-tumoral ictal zone prior to DNET resection. Using electrodes that passed through tumor tissue, we show successful isolation of tumor DNA and subsequent analysis using standard methods for tumor classification by DNA, including Glioseq targeted sequencing and DNA methylation array analysis. This study provides preliminary evidence for the feasibility of molecular diagnosis of LEATs or other lesions using a minimally invasive method with microscopic tissue volumes. The implications of sEEG electrodes in tumor characterization are broad but would aid in diagnosis and subsequent targeted therapeutic strategies.
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Affiliation(s)
- Taylor A. Gatesman
- Department of Neurological SurgeryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
- Department of Cellular and Molecular PathologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
- John G. Rangos Sr. Research CenterChildren's Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - Jasmine L. Hect
- Department of Neurological SurgeryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
- John G. Rangos Sr. Research CenterChildren's Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - H. Westley Phillips
- Department of Neurological SurgeryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Brenden J. Johnson
- Department of Neurological SurgeryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
- John G. Rangos Sr. Research CenterChildren's Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - Abigail I. Wald
- Molecular and Genomic PathologyUniversity of Pittsburgh Medical Center Health SystemPittsburghPennsylvaniaUSA
| | - Colleen McClung
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Marina N. Nikiforova
- Molecular and Genomic PathologyUniversity of Pittsburgh Medical Center Health SystemPittsburghPennsylvaniaUSA
| | - John M. Skaugen
- Molecular and Genomic PathologyUniversity of Pittsburgh Medical Center Health SystemPittsburghPennsylvaniaUSA
| | - Ian F. Pollack
- Department of Neurological SurgeryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
- John G. Rangos Sr. Research CenterChildren's Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - Taylor J. Abel
- Department of Neurological SurgeryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Sameer Agnihotri
- Department of Neurological SurgeryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
- Department of Cellular and Molecular PathologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
- John G. Rangos Sr. Research CenterChildren's Hospital of PittsburghPittsburghPennsylvaniaUSA
- Department of NeurobiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
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5
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Green TE, Fujita A, Ghaderi N, Heinzen EL, Matsumoto N, Klein KM, Berkovic SF, Hildebrand MS. Brain mosaicism of hedgehog signalling and other cilia genes in hypothalamic hamartoma. Neurobiol Dis 2023; 185:106261. [PMID: 37579995 DOI: 10.1016/j.nbd.2023.106261] [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: 03/17/2023] [Revised: 08/02/2023] [Accepted: 08/11/2023] [Indexed: 08/16/2023] Open
Abstract
Hypothalamic hamartoma (HH) is a rare benign developmental brain lesion commonly associated with a well characterized epilepsy phenotype. Most individuals with HH are non-syndromic without additional developmental anomalies nor a family history of disease. Nonetheless, HH is a feature of Pallister-Hall (PHS) and Oro-Facial-Digital Type VI (OFD VI) syndromes, both characterized by additional developmental anomalies. Initial genetic of analysis HH began with syndromic HH, where germline inherited or de novo variants in GLI3, encoding a central transcription factor in the sonic hedgehog (Shh) signalling pathway, were identified in most individuals with PHS. Following these discoveries in syndromic HH, the hypothesis that post-zygotic mosaicism in related genes may underly non-syndromic HH was tested. We discuss the identified mosaic variants within individuals with non-syndromic HH, review the analytical methodologies and diagnostic yields, and explore understanding of the functional role of the implicated genes with respect to Shh signalling, and cilia development and function. We also outline future challenges in studying non-syndromic HH and suggest potential novel strategies to interrogate brain mosaicism in HH.
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Affiliation(s)
- Timothy E Green
- Epilepsy Research Centre, Department of Medicine, The University of Melbourne, Austin Health, Heidelberg, Victoria 3084, Australia
| | - Atsushi Fujita
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
| | - Navid Ghaderi
- Departments of Clinical Neurosciences, Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada
| | - Erin L Heinzen
- Eshelman School of Pharmacy, Division of Pharmacotherapy and Experimental Therapeutics, Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
| | - Karl Martin Klein
- Departments of Clinical Neurosciences, Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University and University Hospital Frankfurt, Frankfurt am Main, Germany; LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Samuel F Berkovic
- Epilepsy Research Centre, Department of Medicine, The University of Melbourne, Austin Health, Heidelberg, Victoria 3084, Australia
| | - Michael S Hildebrand
- Epilepsy Research Centre, Department of Medicine, The University of Melbourne, Austin Health, Heidelberg, Victoria 3084, Australia; Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia.
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6
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Checri R, Chipaux M, Ferrand-Sorbets S, Raffo E, Bulteau C, Rosenberg SD, Doladilhe M, Dorfmüller G, Adle-Biassette H, Baldassari S, Baulac S. Detection of brain somatic mutations in focal cortical dysplasia during epilepsy presurgical workup. Brain Commun 2023; 5:fcad174. [PMID: 37324239 PMCID: PMC10261848 DOI: 10.1093/braincomms/fcad174] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/01/2023] [Accepted: 05/31/2023] [Indexed: 06/17/2023] Open
Abstract
Brain-restricted somatic variants in genes of the mechanistic target of rapamycin signalling pathway cause focal epilepsies associated with focal cortical dysplasia type II. We hypothesized that somatic variants could be identified from trace tissue adherent to explanted stereoelectroencephalography electrodes used in the presurgical epilepsy workup to localize the epileptogenic zone. We investigated three paediatric patients with drug-resistant focal epilepsy subjected to neurosurgery. In the resected brain tissue, we identified low-level mosaic somatic mutations in AKT3 and DEPDC5 genes. We collected stereoelectroencephalography depth electrodes in the context of a second presurgical evaluation and identified 4/33 mutation-positive electrodes that were either located in the epileptogenic zone or at the border of the dysplasia. We provide the proof-of-concept that somatic mutations with low levels of mosaicism can be detected from individual stereoelectroencephalography electrodes and support a link between the mutation load and the epileptic activity. Our findings emphasize future opportunities for integrating genetic testing from stereoelectroencephalography electrodes into the presurgical evaluation of refractory epilepsy patients with focal cortical dysplasia type II to improve the patients' diagnostic journey and guide towards precision medicine.
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Affiliation(s)
| | | | - Sarah Ferrand-Sorbets
- Department of Pediatric Neurosurgery, Rothschild Foundation Hospital EpiCARE, 75019, Paris, France
| | - Emmanuel Raffo
- Department of Pediatric Neurosurgery, Rothschild Foundation Hospital EpiCARE, 75019, Paris, France
- Unité de recherche 3450 DevAH, Développement, Adaptation et Handicap, Campus Brabois-Santé, Université de Lorraine, 54505, Vandoeuvre-lès-Nancy, France
| | - Christine Bulteau
- Department of Pediatric Neurosurgery, Rothschild Foundation Hospital EpiCARE, 75019, Paris, France
- Université de Paris Cité, MC2Lab, Institut de Psychologie, F-92100 Boulogne-Billancourt, France
| | | | - Marion Doladilhe
- Sorbonne Université, Institut du Cerveau—Paris Brain Institute—ICM, Inserm, CNRS, Hôpital de la Pitié Salpêtrière, 75013, Paris, France
| | - Georg Dorfmüller
- Department of Pediatric Neurosurgery, Rothschild Foundation Hospital EpiCARE, 75019, Paris, France
| | - Homa Adle-Biassette
- Université de Paris Cité, service d’Anatomie Pathologique, APHP, Hôpital Lariboisière, DMU DREAM, UMR 1141, INSERM, 75010, Paris, France
| | | | - Stéphanie Baulac
- Correspondence to: Stéphanie Baulac Institut du Cerveau, 47 bd de l’hôpital, 75013, Paris, France E-mail:
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7
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Gerasimenko A, Baldassari S, Baulac S. mTOR pathway: Insights into an established pathway for brain mosaicism in epilepsy. Neurobiol Dis 2023; 182:106144. [PMID: 37149062 DOI: 10.1016/j.nbd.2023.106144] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/08/2023] Open
Abstract
The mechanistic target of rapamycin (mTOR) signaling pathway is an essential regulator of numerous cellular activities such as metabolism, growth, proliferation, and survival. The mTOR cascade recently emerged as a critical player in the pathogenesis of focal epilepsies and cortical malformations. The 'mTORopathies' comprise a spectrum of cortical malformations that range from whole brain (megalencephaly) and hemispheric (hemimegalencephaly) abnormalities to focal abnormalities, such as focal cortical dysplasia type II (FCDII), which manifest with drug-resistant epilepsies. The spectrum of cortical dysplasia results from somatic brain mutations in the mTOR pathway activators AKT3, MTOR, PIK3CA, and RHEB and from germline and somatic mutations in mTOR pathway repressors, DEPDC5, NPRL2, NPRL3, TSC1 and TSC2. The mTORopathies are characterized by excessive mTOR pathway activation, leading to a broad range of structural and functional impairments. Here, we provide a comprehensive literature review of somatic mTOR-activating mutations linked to epilepsy and cortical malformations in 292 patients and discuss the perspectives of targeted therapeutics for personalized medicine.
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Affiliation(s)
- Anna Gerasimenko
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Hôpital de la Pitié Salpêtrière, 75013 Paris, France; APHP Sorbonne Université, GH Pitié Salpêtrière et Trousseau, Département de Génétique, Centre de référence "déficiences intellectuelles de causes rares", Paris, France
| | - Sara Baldassari
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Hôpital de la Pitié Salpêtrière, 75013 Paris, France
| | - Stéphanie Baulac
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Hôpital de la Pitié Salpêtrière, 75013 Paris, France.
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D'Gama AM, Poduri A. Brain somatic mosaicism in epilepsy: Bringing results Back to the clinic. Neurobiol Dis 2023; 181:106104. [PMID: 36972791 DOI: 10.1016/j.nbd.2023.106104] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 03/28/2023] Open
Abstract
Over the past decade, there has been tremendous progress in understanding brain somatic mosaicism in epilepsy in the research setting. Access to resected brain tissue samples from patients with medically refractory epilepsy undergoing epilepsy surgery has been key to making these discoveries. In this review, we discuss the gap between making discoveries in the research setting and bringing results back to the clinical setting. Current clinical genetic testing mainly uses clinically accessible tissue samples, like blood and saliva, and can detect inherited and de novo germline variants and potentially non-brain-limited mosaic variants that have resulted from post-zygotic mutation (also called "somatic mutations"). Methods developed in the research setting to detect brain-limited mosaic variants using brain tissue samples need to be further translated and validated in the clinical setting, which will allow post-resection brain tissue genetic diagnoses. However, obtaining a genetic diagnosis after surgery for refractory focal epilepsy, when brain tissue samples are available, is arguably "too late" to guide precision management. Emerging methods using cerebrospinal fluid (CSF) and subdural electroencephalogram (SEEG) depth electrodes hold promise for establishing genetic diagnoses pre-resection without the need for actual brain tissue. In parallel, development of curation rules for interpreting the pathogenicity of mosaic variants, which have unique considerations compared to germline variants, will assist clinically accredited laboratories and epilepsy geneticists in making genetic diagnoses. Returning results of brain-limited mosaic variants to patients and their families will end their diagnostic odyssey and advance epilepsy precision management.
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Ye Z, Bennett MF, Neal A, Laing JA, Hunn MK, Wittayacharoenpong T, Todaro M, Patel SK, Bahlo M, Kwan P, O'Brien TJ, Scheffer IE, Berkovic SF, Perucca P, Hildebrand MS. Somatic Mosaic Pathogenic Variant Gradient Detected in Trace Brain Tissue From Stereo-EEG Depth Electrodes. Neurology 2022; 99:1036-1041. [PMID: 36192176 DOI: 10.1212/wnl.0000000000201469] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 09/09/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Mosaic pathogenic variants restricted to the brain are increasingly recognized as a cause of focal epilepsies. We aimed to identify a mosaic pathogenic variant and its anatomical gradient in brain DNA derived from trace tissue on explanted stereoelectroencephalography (SEEG) electrodes. METHODS We studied a patient with nonlesional multifocal epilepsy undergoing presurgical evaluation with SEEG. After explantation, the electrodes were divided into 3 pools based on their brain location (right posterior quadrant, left posterior quadrant, hippocampus/temporal neocortex). Tissue from each pool was processed for trace DNA that was whole genome amplified prior to high-depth exome sequencing. Droplet digital PCR was performed to quantify mosaicism. A brain-specific glial fibrillary acidic protein (GFAP) assay enabled cell-of-origin analysis. RESULTS We demonstrated a mosaic gradient for a novel pathogenic KCNT1 loss-of-function variant (c.530G>A, p.W177X) predicted to lead to nonsense-mediated decay. Strikingly, the mosaic gradient correlated strongly with the SEEG findings because the highest variant allele frequency was in the right posterior quadrant, reflecting the most epileptogenic region on EEG studies. An elevated GFAP level indicated enrichment of brain-derived cells in SEEG cell suspension. DISCUSSION This study demonstrates a proof of concept that mosaic gradients of pathogenic variants can be established using trace tissue from explanted SEEG electrodes.
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Affiliation(s)
- Zimeng Ye
- From the Department of Medicine (Austin Health) (Z.Y., M.F.B., S.K.P., I.E.S., S.F.B., P.P., M.S.H.), University of Melbourne, Heidelberg; Population Health and Immunity Division (M.F.B., M.B.), The Walter and Eliza Hall Institute of Medical Research, Parkville; Department of Medical Biology (M.F.B., M.B.), The University of Melbourne, Parkville; Department of Neurology (A.N., P.K., T.J.O.B., P.P.), Royal Melbourne Hospital, Parkville; Department of Neurology (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), Alfred Hospital, Melbourne; Department of Medicine (A.N., P.K., T.J.O.B.), Royal Melbourne Hospital, University of Melbourne, Parkville; Department of Neurosciences (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), The Central Clinical School, Monash University, Melbourne; Department of Neurology (A.N.), St Vincent's Hospital, Fitzroy; Department of Neurosurgery (M.K.H.), The Alfred Hospital, Melbourne; Florey Institute of Neuroscience and Mental Health (S.K.P., I.E.S.), Heidelberg; Murdoch Children's Research Institute (I.E.S., M.S.H.), Parkville; Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Parkville; and Bladin-Berkovic Comprehensive Epilepsy Program (S.F.B., P.P.), Department of Neurology, Austin Health, Heidelberg, Australia
| | - Mark F Bennett
- From the Department of Medicine (Austin Health) (Z.Y., M.F.B., S.K.P., I.E.S., S.F.B., P.P., M.S.H.), University of Melbourne, Heidelberg; Population Health and Immunity Division (M.F.B., M.B.), The Walter and Eliza Hall Institute of Medical Research, Parkville; Department of Medical Biology (M.F.B., M.B.), The University of Melbourne, Parkville; Department of Neurology (A.N., P.K., T.J.O.B., P.P.), Royal Melbourne Hospital, Parkville; Department of Neurology (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), Alfred Hospital, Melbourne; Department of Medicine (A.N., P.K., T.J.O.B.), Royal Melbourne Hospital, University of Melbourne, Parkville; Department of Neurosciences (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), The Central Clinical School, Monash University, Melbourne; Department of Neurology (A.N.), St Vincent's Hospital, Fitzroy; Department of Neurosurgery (M.K.H.), The Alfred Hospital, Melbourne; Florey Institute of Neuroscience and Mental Health (S.K.P., I.E.S.), Heidelberg; Murdoch Children's Research Institute (I.E.S., M.S.H.), Parkville; Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Parkville; and Bladin-Berkovic Comprehensive Epilepsy Program (S.F.B., P.P.), Department of Neurology, Austin Health, Heidelberg, Australia
| | - Andrew Neal
- From the Department of Medicine (Austin Health) (Z.Y., M.F.B., S.K.P., I.E.S., S.F.B., P.P., M.S.H.), University of Melbourne, Heidelberg; Population Health and Immunity Division (M.F.B., M.B.), The Walter and Eliza Hall Institute of Medical Research, Parkville; Department of Medical Biology (M.F.B., M.B.), The University of Melbourne, Parkville; Department of Neurology (A.N., P.K., T.J.O.B., P.P.), Royal Melbourne Hospital, Parkville; Department of Neurology (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), Alfred Hospital, Melbourne; Department of Medicine (A.N., P.K., T.J.O.B.), Royal Melbourne Hospital, University of Melbourne, Parkville; Department of Neurosciences (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), The Central Clinical School, Monash University, Melbourne; Department of Neurology (A.N.), St Vincent's Hospital, Fitzroy; Department of Neurosurgery (M.K.H.), The Alfred Hospital, Melbourne; Florey Institute of Neuroscience and Mental Health (S.K.P., I.E.S.), Heidelberg; Murdoch Children's Research Institute (I.E.S., M.S.H.), Parkville; Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Parkville; and Bladin-Berkovic Comprehensive Epilepsy Program (S.F.B., P.P.), Department of Neurology, Austin Health, Heidelberg, Australia
| | - Joshua A Laing
- From the Department of Medicine (Austin Health) (Z.Y., M.F.B., S.K.P., I.E.S., S.F.B., P.P., M.S.H.), University of Melbourne, Heidelberg; Population Health and Immunity Division (M.F.B., M.B.), The Walter and Eliza Hall Institute of Medical Research, Parkville; Department of Medical Biology (M.F.B., M.B.), The University of Melbourne, Parkville; Department of Neurology (A.N., P.K., T.J.O.B., P.P.), Royal Melbourne Hospital, Parkville; Department of Neurology (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), Alfred Hospital, Melbourne; Department of Medicine (A.N., P.K., T.J.O.B.), Royal Melbourne Hospital, University of Melbourne, Parkville; Department of Neurosciences (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), The Central Clinical School, Monash University, Melbourne; Department of Neurology (A.N.), St Vincent's Hospital, Fitzroy; Department of Neurosurgery (M.K.H.), The Alfred Hospital, Melbourne; Florey Institute of Neuroscience and Mental Health (S.K.P., I.E.S.), Heidelberg; Murdoch Children's Research Institute (I.E.S., M.S.H.), Parkville; Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Parkville; and Bladin-Berkovic Comprehensive Epilepsy Program (S.F.B., P.P.), Department of Neurology, Austin Health, Heidelberg, Australia
| | - Martin K Hunn
- From the Department of Medicine (Austin Health) (Z.Y., M.F.B., S.K.P., I.E.S., S.F.B., P.P., M.S.H.), University of Melbourne, Heidelberg; Population Health and Immunity Division (M.F.B., M.B.), The Walter and Eliza Hall Institute of Medical Research, Parkville; Department of Medical Biology (M.F.B., M.B.), The University of Melbourne, Parkville; Department of Neurology (A.N., P.K., T.J.O.B., P.P.), Royal Melbourne Hospital, Parkville; Department of Neurology (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), Alfred Hospital, Melbourne; Department of Medicine (A.N., P.K., T.J.O.B.), Royal Melbourne Hospital, University of Melbourne, Parkville; Department of Neurosciences (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), The Central Clinical School, Monash University, Melbourne; Department of Neurology (A.N.), St Vincent's Hospital, Fitzroy; Department of Neurosurgery (M.K.H.), The Alfred Hospital, Melbourne; Florey Institute of Neuroscience and Mental Health (S.K.P., I.E.S.), Heidelberg; Murdoch Children's Research Institute (I.E.S., M.S.H.), Parkville; Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Parkville; and Bladin-Berkovic Comprehensive Epilepsy Program (S.F.B., P.P.), Department of Neurology, Austin Health, Heidelberg, Australia
| | - Thanomporn Wittayacharoenpong
- From the Department of Medicine (Austin Health) (Z.Y., M.F.B., S.K.P., I.E.S., S.F.B., P.P., M.S.H.), University of Melbourne, Heidelberg; Population Health and Immunity Division (M.F.B., M.B.), The Walter and Eliza Hall Institute of Medical Research, Parkville; Department of Medical Biology (M.F.B., M.B.), The University of Melbourne, Parkville; Department of Neurology (A.N., P.K., T.J.O.B., P.P.), Royal Melbourne Hospital, Parkville; Department of Neurology (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), Alfred Hospital, Melbourne; Department of Medicine (A.N., P.K., T.J.O.B.), Royal Melbourne Hospital, University of Melbourne, Parkville; Department of Neurosciences (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), The Central Clinical School, Monash University, Melbourne; Department of Neurology (A.N.), St Vincent's Hospital, Fitzroy; Department of Neurosurgery (M.K.H.), The Alfred Hospital, Melbourne; Florey Institute of Neuroscience and Mental Health (S.K.P., I.E.S.), Heidelberg; Murdoch Children's Research Institute (I.E.S., M.S.H.), Parkville; Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Parkville; and Bladin-Berkovic Comprehensive Epilepsy Program (S.F.B., P.P.), Department of Neurology, Austin Health, Heidelberg, Australia
| | - Marian Todaro
- From the Department of Medicine (Austin Health) (Z.Y., M.F.B., S.K.P., I.E.S., S.F.B., P.P., M.S.H.), University of Melbourne, Heidelberg; Population Health and Immunity Division (M.F.B., M.B.), The Walter and Eliza Hall Institute of Medical Research, Parkville; Department of Medical Biology (M.F.B., M.B.), The University of Melbourne, Parkville; Department of Neurology (A.N., P.K., T.J.O.B., P.P.), Royal Melbourne Hospital, Parkville; Department of Neurology (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), Alfred Hospital, Melbourne; Department of Medicine (A.N., P.K., T.J.O.B.), Royal Melbourne Hospital, University of Melbourne, Parkville; Department of Neurosciences (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), The Central Clinical School, Monash University, Melbourne; Department of Neurology (A.N.), St Vincent's Hospital, Fitzroy; Department of Neurosurgery (M.K.H.), The Alfred Hospital, Melbourne; Florey Institute of Neuroscience and Mental Health (S.K.P., I.E.S.), Heidelberg; Murdoch Children's Research Institute (I.E.S., M.S.H.), Parkville; Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Parkville; and Bladin-Berkovic Comprehensive Epilepsy Program (S.F.B., P.P.), Department of Neurology, Austin Health, Heidelberg, Australia
| | - Sheila K Patel
- From the Department of Medicine (Austin Health) (Z.Y., M.F.B., S.K.P., I.E.S., S.F.B., P.P., M.S.H.), University of Melbourne, Heidelberg; Population Health and Immunity Division (M.F.B., M.B.), The Walter and Eliza Hall Institute of Medical Research, Parkville; Department of Medical Biology (M.F.B., M.B.), The University of Melbourne, Parkville; Department of Neurology (A.N., P.K., T.J.O.B., P.P.), Royal Melbourne Hospital, Parkville; Department of Neurology (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), Alfred Hospital, Melbourne; Department of Medicine (A.N., P.K., T.J.O.B.), Royal Melbourne Hospital, University of Melbourne, Parkville; Department of Neurosciences (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), The Central Clinical School, Monash University, Melbourne; Department of Neurology (A.N.), St Vincent's Hospital, Fitzroy; Department of Neurosurgery (M.K.H.), The Alfred Hospital, Melbourne; Florey Institute of Neuroscience and Mental Health (S.K.P., I.E.S.), Heidelberg; Murdoch Children's Research Institute (I.E.S., M.S.H.), Parkville; Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Parkville; and Bladin-Berkovic Comprehensive Epilepsy Program (S.F.B., P.P.), Department of Neurology, Austin Health, Heidelberg, Australia
| | - Melanie Bahlo
- From the Department of Medicine (Austin Health) (Z.Y., M.F.B., S.K.P., I.E.S., S.F.B., P.P., M.S.H.), University of Melbourne, Heidelberg; Population Health and Immunity Division (M.F.B., M.B.), The Walter and Eliza Hall Institute of Medical Research, Parkville; Department of Medical Biology (M.F.B., M.B.), The University of Melbourne, Parkville; Department of Neurology (A.N., P.K., T.J.O.B., P.P.), Royal Melbourne Hospital, Parkville; Department of Neurology (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), Alfred Hospital, Melbourne; Department of Medicine (A.N., P.K., T.J.O.B.), Royal Melbourne Hospital, University of Melbourne, Parkville; Department of Neurosciences (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), The Central Clinical School, Monash University, Melbourne; Department of Neurology (A.N.), St Vincent's Hospital, Fitzroy; Department of Neurosurgery (M.K.H.), The Alfred Hospital, Melbourne; Florey Institute of Neuroscience and Mental Health (S.K.P., I.E.S.), Heidelberg; Murdoch Children's Research Institute (I.E.S., M.S.H.), Parkville; Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Parkville; and Bladin-Berkovic Comprehensive Epilepsy Program (S.F.B., P.P.), Department of Neurology, Austin Health, Heidelberg, Australia
| | - Patrick Kwan
- From the Department of Medicine (Austin Health) (Z.Y., M.F.B., S.K.P., I.E.S., S.F.B., P.P., M.S.H.), University of Melbourne, Heidelberg; Population Health and Immunity Division (M.F.B., M.B.), The Walter and Eliza Hall Institute of Medical Research, Parkville; Department of Medical Biology (M.F.B., M.B.), The University of Melbourne, Parkville; Department of Neurology (A.N., P.K., T.J.O.B., P.P.), Royal Melbourne Hospital, Parkville; Department of Neurology (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), Alfred Hospital, Melbourne; Department of Medicine (A.N., P.K., T.J.O.B.), Royal Melbourne Hospital, University of Melbourne, Parkville; Department of Neurosciences (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), The Central Clinical School, Monash University, Melbourne; Department of Neurology (A.N.), St Vincent's Hospital, Fitzroy; Department of Neurosurgery (M.K.H.), The Alfred Hospital, Melbourne; Florey Institute of Neuroscience and Mental Health (S.K.P., I.E.S.), Heidelberg; Murdoch Children's Research Institute (I.E.S., M.S.H.), Parkville; Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Parkville; and Bladin-Berkovic Comprehensive Epilepsy Program (S.F.B., P.P.), Department of Neurology, Austin Health, Heidelberg, Australia
| | - Terence J O'Brien
- From the Department of Medicine (Austin Health) (Z.Y., M.F.B., S.K.P., I.E.S., S.F.B., P.P., M.S.H.), University of Melbourne, Heidelberg; Population Health and Immunity Division (M.F.B., M.B.), The Walter and Eliza Hall Institute of Medical Research, Parkville; Department of Medical Biology (M.F.B., M.B.), The University of Melbourne, Parkville; Department of Neurology (A.N., P.K., T.J.O.B., P.P.), Royal Melbourne Hospital, Parkville; Department of Neurology (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), Alfred Hospital, Melbourne; Department of Medicine (A.N., P.K., T.J.O.B.), Royal Melbourne Hospital, University of Melbourne, Parkville; Department of Neurosciences (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), The Central Clinical School, Monash University, Melbourne; Department of Neurology (A.N.), St Vincent's Hospital, Fitzroy; Department of Neurosurgery (M.K.H.), The Alfred Hospital, Melbourne; Florey Institute of Neuroscience and Mental Health (S.K.P., I.E.S.), Heidelberg; Murdoch Children's Research Institute (I.E.S., M.S.H.), Parkville; Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Parkville; and Bladin-Berkovic Comprehensive Epilepsy Program (S.F.B., P.P.), Department of Neurology, Austin Health, Heidelberg, Australia
| | - Ingrid E Scheffer
- From the Department of Medicine (Austin Health) (Z.Y., M.F.B., S.K.P., I.E.S., S.F.B., P.P., M.S.H.), University of Melbourne, Heidelberg; Population Health and Immunity Division (M.F.B., M.B.), The Walter and Eliza Hall Institute of Medical Research, Parkville; Department of Medical Biology (M.F.B., M.B.), The University of Melbourne, Parkville; Department of Neurology (A.N., P.K., T.J.O.B., P.P.), Royal Melbourne Hospital, Parkville; Department of Neurology (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), Alfred Hospital, Melbourne; Department of Medicine (A.N., P.K., T.J.O.B.), Royal Melbourne Hospital, University of Melbourne, Parkville; Department of Neurosciences (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), The Central Clinical School, Monash University, Melbourne; Department of Neurology (A.N.), St Vincent's Hospital, Fitzroy; Department of Neurosurgery (M.K.H.), The Alfred Hospital, Melbourne; Florey Institute of Neuroscience and Mental Health (S.K.P., I.E.S.), Heidelberg; Murdoch Children's Research Institute (I.E.S., M.S.H.), Parkville; Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Parkville; and Bladin-Berkovic Comprehensive Epilepsy Program (S.F.B., P.P.), Department of Neurology, Austin Health, Heidelberg, Australia
| | - Samuel F Berkovic
- From the Department of Medicine (Austin Health) (Z.Y., M.F.B., S.K.P., I.E.S., S.F.B., P.P., M.S.H.), University of Melbourne, Heidelberg; Population Health and Immunity Division (M.F.B., M.B.), The Walter and Eliza Hall Institute of Medical Research, Parkville; Department of Medical Biology (M.F.B., M.B.), The University of Melbourne, Parkville; Department of Neurology (A.N., P.K., T.J.O.B., P.P.), Royal Melbourne Hospital, Parkville; Department of Neurology (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), Alfred Hospital, Melbourne; Department of Medicine (A.N., P.K., T.J.O.B.), Royal Melbourne Hospital, University of Melbourne, Parkville; Department of Neurosciences (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), The Central Clinical School, Monash University, Melbourne; Department of Neurology (A.N.), St Vincent's Hospital, Fitzroy; Department of Neurosurgery (M.K.H.), The Alfred Hospital, Melbourne; Florey Institute of Neuroscience and Mental Health (S.K.P., I.E.S.), Heidelberg; Murdoch Children's Research Institute (I.E.S., M.S.H.), Parkville; Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Parkville; and Bladin-Berkovic Comprehensive Epilepsy Program (S.F.B., P.P.), Department of Neurology, Austin Health, Heidelberg, Australia
| | - Piero Perucca
- From the Department of Medicine (Austin Health) (Z.Y., M.F.B., S.K.P., I.E.S., S.F.B., P.P., M.S.H.), University of Melbourne, Heidelberg; Population Health and Immunity Division (M.F.B., M.B.), The Walter and Eliza Hall Institute of Medical Research, Parkville; Department of Medical Biology (M.F.B., M.B.), The University of Melbourne, Parkville; Department of Neurology (A.N., P.K., T.J.O.B., P.P.), Royal Melbourne Hospital, Parkville; Department of Neurology (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), Alfred Hospital, Melbourne; Department of Medicine (A.N., P.K., T.J.O.B.), Royal Melbourne Hospital, University of Melbourne, Parkville; Department of Neurosciences (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), The Central Clinical School, Monash University, Melbourne; Department of Neurology (A.N.), St Vincent's Hospital, Fitzroy; Department of Neurosurgery (M.K.H.), The Alfred Hospital, Melbourne; Florey Institute of Neuroscience and Mental Health (S.K.P., I.E.S.), Heidelberg; Murdoch Children's Research Institute (I.E.S., M.S.H.), Parkville; Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Parkville; and Bladin-Berkovic Comprehensive Epilepsy Program (S.F.B., P.P.), Department of Neurology, Austin Health, Heidelberg, Australia
| | - Michael S Hildebrand
- From the Department of Medicine (Austin Health) (Z.Y., M.F.B., S.K.P., I.E.S., S.F.B., P.P., M.S.H.), University of Melbourne, Heidelberg; Population Health and Immunity Division (M.F.B., M.B.), The Walter and Eliza Hall Institute of Medical Research, Parkville; Department of Medical Biology (M.F.B., M.B.), The University of Melbourne, Parkville; Department of Neurology (A.N., P.K., T.J.O.B., P.P.), Royal Melbourne Hospital, Parkville; Department of Neurology (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), Alfred Hospital, Melbourne; Department of Medicine (A.N., P.K., T.J.O.B.), Royal Melbourne Hospital, University of Melbourne, Parkville; Department of Neurosciences (A.N., J.A.L., T.W., M.T., P.K., T.J.O.B., P.P.), The Central Clinical School, Monash University, Melbourne; Department of Neurology (A.N.), St Vincent's Hospital, Fitzroy; Department of Neurosurgery (M.K.H.), The Alfred Hospital, Melbourne; Florey Institute of Neuroscience and Mental Health (S.K.P., I.E.S.), Heidelberg; Murdoch Children's Research Institute (I.E.S., M.S.H.), Parkville; Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Parkville; and Bladin-Berkovic Comprehensive Epilepsy Program (S.F.B., P.P.), Department of Neurology, Austin Health, Heidelberg, Australia.
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Ossola C, Kalebic N. Roots of the Malformations of Cortical Development in the Cell Biology of Neural Progenitor Cells. Front Neurosci 2022; 15:817218. [PMID: 35069108 PMCID: PMC8766818 DOI: 10.3389/fnins.2021.817218] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/14/2021] [Indexed: 12/13/2022] Open
Abstract
The cerebral cortex is a structure that underlies various brain functions, including cognition and language. Mammalian cerebral cortex starts developing during the embryonic period with the neural progenitor cells generating neurons. Newborn neurons migrate along progenitors’ radial processes from the site of their origin in the germinal zones to the cortical plate, where they mature and integrate in the forming circuitry. Cell biological features of neural progenitors, such as the location and timing of their mitoses, together with their characteristic morphologies, can directly or indirectly regulate the abundance and the identity of their neuronal progeny. Alterations in the complex and delicate process of cerebral cortex development can lead to malformations of cortical development (MCDs). They include various structural abnormalities that affect the size, thickness and/or folding pattern of the developing cortex. Their clinical manifestations can entail a neurodevelopmental disorder, such as epilepsy, developmental delay, intellectual disability, or autism spectrum disorder. The recent advancements of molecular and neuroimaging techniques, along with the development of appropriate in vitro and in vivo model systems, have enabled the assessment of the genetic and environmental causes of MCDs. Here we broadly review the cell biological characteristics of neural progenitor cells and focus on those features whose perturbations have been linked to MCDs.
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Ye Z, Bennett MF, Bahlo M, Scheffer IE, Berkovic SF, Perucca P, Hildebrand MS. Cutting edge approaches to detecting brain mosaicism associated with common focal epilepsies: implications for diagnosis and potential therapies. Expert Rev Neurother 2021; 21:1309-1316. [PMID: 34519595 DOI: 10.1080/14737175.2021.1981288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Mosaic variants arising in brain tissue are increasingly being recognized as a hidden cause of focal epilepsy. This knowledge gain has been driven by new, highly sensitive genetic technologies and genome-wide analysis of brain tissue from surgical resection or autopsy in a small proportion of patients with focal epilepsy. Recently reported novel strategies to detect mosaic variants limited to brain have exploited trace brain DNA obtained from cerebrospinal fluid liquid biopsies or stereo-electroencephalography electrodes. AREAS COVERED The authors review the data on these innovative approaches published in PubMed before 12 June 2021, discuss the challenges associated with their application, and describe how they are likely to improve detection of mosaic variants to provide new molecular diagnoses and therapeutic targets for focal epilepsy, with potential utility in other nonmalignant neurological disorders. EXPERT OPINION These cutting-edge approaches may reveal the hidden genetic etiology of focal epilepsies and provide guidance for precision medicine.
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Affiliation(s)
- Zimeng Ye
- Department of Medicine (Austin Health), Epilepsy Research Centre, University of Melbourne, Heidelberg, Australia
| | - Mark F Bennett
- Department of Medicine (Austin Health), Epilepsy Research Centre, University of Melbourne, Heidelberg, Australia.,Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.,Department of Medical Biology, The University of Melbourne, Parkville, Australia
| | - Melanie Bahlo
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.,Department of Medical Biology, The University of Melbourne, Parkville, Australia
| | - Ingrid E Scheffer
- Department of Medicine (Austin Health), Epilepsy Research Centre, University of Melbourne, Heidelberg, Australia.,Neuroscience Research Group, Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Parkville, Australia.,Department of Neurology, Comprehensive Epilepsy Program, Austin Health, Heidelberg, Australia
| | - Samuel F Berkovic
- Department of Medicine (Austin Health), Epilepsy Research Centre, University of Melbourne, Heidelberg, Australia.,Department of Neurology, Comprehensive Epilepsy Program, Austin Health, Heidelberg, Australia
| | - Piero Perucca
- Department of Medicine (Austin Health), Epilepsy Research Centre, University of Melbourne, Heidelberg, Australia.,Department of Neurology, Comprehensive Epilepsy Program, Austin Health, Heidelberg, Australia.,Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia.,Department of Neurology, Alfred Health, Melbourne, Australia.,Department of Neurology, The Royal Melbourne Hospital, Parkville, Australia
| | - Michael S Hildebrand
- Department of Medicine (Austin Health), Epilepsy Research Centre, University of Melbourne, Heidelberg, Australia.,Neuroscience Research Group, Murdoch Children's Research Institute, Parkville, Australia
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12
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Massey CA, Thompson SJ, Ostrom RW, Drabek J, Sveinsson OA, Tomson T, Haas EA, Mena OJ, Goldman AM, Noebels JL. X-linked serotonin 2C receptor is associated with a non-canonical pathway for sudden unexpected death in epilepsy. Brain Commun 2021; 3:fcab149. [PMID: 34396109 PMCID: PMC8361391 DOI: 10.1093/braincomms/fcab149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/14/2021] [Accepted: 05/07/2021] [Indexed: 11/13/2022] Open
Abstract
Sudden Unexpected Death in Epilepsy is a leading cause of epilepsy-related mortality, and the analysis of mouse Sudden Unexpected Death in Epilepsy models is steadily revealing a spectrum of inherited risk phenotypes based on distinct genetic mechanisms. Serotonin (5-HT) signalling enhances post-ictal cardiorespiratory drive and, when elevated in the brain, reduces death following evoked audiogenic brainstem seizures in inbred mouse models. However, no gene in this pathway has yet been linked to a spontaneous epilepsy phenotype, the defining criterion of Sudden Unexpected Death in Epilepsy. Most monogenic models of Sudden Unexpected Death in Epilepsy invoke a failure of inhibitory synaptic drive as a critical pathogenic step. Accordingly, the G protein-coupled, membrane serotonin receptor 5-HT2C inhibits forebrain and brainstem networks by exciting GABAergic interneurons, and deletion of this gene lowers the threshold for lethal evoked audiogenic seizures. Here, we characterize epileptogenesis throughout the lifespan of mice lacking X-linked, 5-HT2C receptors (loxTB Htr2c). We find that loss of Htr2c generates a complex, adult-onset spontaneous epileptic phenotype with a novel progressive hyperexcitability pattern of absences, non-convulsive, and convulsive behavioural seizures culminating in late onset sudden mortality predominantly in male mice. RNAscope localized Htr2c mRNA in subsets of Gad2+ GABAergic neurons in forebrain and brainstem regions. To evaluate the contribution of 5-HT2C receptor-mediated inhibitory drive, we selectively spared their deletion in GAD2+ GABAergic neurons of pan-deleted loxTB Htr2c mice, yet unexpectedly found no amelioration of survival or epileptic phenotype, indicating that expression of 5-HT2C receptors in GAD2+ inhibitory neurons was not sufficient to prevent hyperexcitability and lethal seizures. Analysis of human Sudden Unexpected Death in Epilepsy and epilepsy genetic databases identified an enrichment of HTR2C non-synonymous variants in Sudden Unexpected Death in Epilepsy cases. Interestingly, while early lethality is not reflected in the mouse model, we also identified variants mainly among male Sudden Infant Death Syndrome patients. Our findings validate HTR2C as a novel, sex-linked candidate gene modifying Sudden Unexpected Death in Epilepsy risk, and demonstrate that the complex epilepsy phenotype does not arise solely from 5-HT2C-mediated synaptic disinhibition. These results strengthen the evidence for the serotonin hypothesis of Sudden Unexpected Death in Epilepsy risk in humans, and advance current efforts to develop gene-guided interventions to mitigate premature mortality in epilepsy.
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Affiliation(s)
- Cory A Massey
- Developmental Neurogenetics Laboratory, Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Samantha J Thompson
- Developmental Neurogenetics Laboratory, Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Ryan W Ostrom
- Developmental Neurogenetics Laboratory, Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Janice Drabek
- Developmental Neurogenetics Laboratory, Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Olafur A Sveinsson
- Department of Neurology, National University Hospital of Iceland, 101 Reykjavik, Iceland
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm 171 76, Sweden
| | - Torbjörn Tomson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm 171 76, Sweden
| | - Elisabeth A Haas
- Department of Pathology, Rady Children’s Hospital-San Diego, San Diego, CA 92123, USA
| | - Othon J Mena
- Medical Examiner Office, Ventura County Health Care Agency, Ventura, CA 93003, USA
| | - Alica M Goldman
- Developmental Neurogenetics Laboratory, Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Jeffrey L Noebels
- Developmental Neurogenetics Laboratory, Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Neuroscience, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Human and Molecular Genetics, Baylor College of Medicine, Houston, TX 77030, USA
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13
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Lu YT, Hsu CY, Liu YT, Chan CK, Chuang YC, Lin CH, Chang KP, Ho CJ, Ng CC, Lim KS, Tsai MH. The clinical and imaging features of FLNA positive and negative periventricular nodular heterotopia. Biomed J 2021; 45:542-548. [PMID: 35660364 PMCID: PMC9421925 DOI: 10.1016/j.bj.2021.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 04/10/2021] [Accepted: 05/13/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Yan-Ting Lu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chung-Yao Hsu
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yo-Tsen Liu
- Division of Epilepsy, Department of Neurology Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Neurology, National Yang-Ming University School of Medicine, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Chung-Kin Chan
- Genetics and Molecular Biology, Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Yao-Chung Chuang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chih-Hsiang Lin
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Kai-Ping Chang
- Department of Pediatric, Wei-Gong Memorial Hospital, Miaoli, Taiwan; Department of Pediatric, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Chen-Jui Ho
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Ching-Ching Ng
- Genetics and Molecular Biology, Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Kheng-Seang Lim
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Meng-Han Tsai
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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14
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Montier L, Haneef Z, Gavvala J, Yoshor D, North R, Verla T, Van Ness PC, Drabek J, Goldman AM. A somatic mutation in MEN1 gene detected in periventricular nodular heterotopia tissue obtained from depth electrodes. Epilepsia 2019; 60:e104-e109. [PMID: 31489630 PMCID: PMC6852559 DOI: 10.1111/epi.16328] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 02/06/2023]
Abstract
Periventricular nodular heterotopia (PNH) is a common structural malformation of cortical development. Mutations in the filamin A gene are frequent in familial cases with X‐linked PNH. However, many cases with sporadic PNH remain genetically unexplained. Although medically refractory epilepsy often brings attention to the underlying PNH, patients are often not candidates for surgical resection. This limits access to neuronal tissue harboring causal mutations. We evaluated a patient with PNH and medically refractory focal epilepsy who underwent a presurgical evaluation with stereotactically placed electroencephalographic (SEEG) depth electrodes. Following SEEG explantation, we collected trace tissue adherent to the electrodes and extracted the DNA. Whole‐exome sequencing performed in a Clinical Laboratory Improvement Amendments–approved genetic diagnostic laboratory uncovered a de novo heterozygous pathogenic variant in novel candidate PNH gene MEN1 (multiple endocrine neoplasia type 1; c.1546dupC, p.R516PfsX15). The variant was absent in an earlier exome profiling of the venous blood–derived DNA. The MEN1 gene encodes the ubiquitously expressed, nuclear scaffold protein menin, a known tumor suppressor gene with an established role in the regulation of transcription, proliferation, differentiation, and genomic integrity. Our study contributes a novel candidate gene in PNH generation and a novel practical approach that integrates electrophysiological and genetic explorations of epilepsy.
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Affiliation(s)
- Laura Montier
- Department of Neurology, Baylor College of Medicine, Houston, Texas
| | - Zulfi Haneef
- Department of Neurology, Baylor College of Medicine, Houston, Texas
| | - Jay Gavvala
- Department of Neurology, Baylor College of Medicine, Houston, Texas
| | - Daniel Yoshor
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
| | - Robert North
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
| | - Terence Verla
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
| | - Paul C Van Ness
- Department of Neurology, Baylor College of Medicine, Houston, Texas
| | - Janice Drabek
- Department of Neurology, Baylor College of Medicine, Houston, Texas
| | - Alica M Goldman
- Department of Neurology, Baylor College of Medicine, Houston, Texas
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