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Kasimoğlu N, Gürarslan Baş N. The relationship between parental attitude toward childhood epilepsy and spiritual orientation. Epilepsy Behav 2024; 158:109946. [PMID: 39002274 DOI: 10.1016/j.yebeh.2024.109946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/27/2024] [Accepted: 07/07/2024] [Indexed: 07/15/2024]
Abstract
AIM The aim of this study is to evaluate the relationship between parental attitudes toward childhood epilepsy and spiritual orientations. METHODS This descriptive study was conducted online between May and July 2022 with 417 parents residing in the eastern part of Turkey. Data were collected using a descriptive information form, the Social Attitudes Scale toward Childhood Epilepsies, and the Spiritual Orientation Scale. The obtained data were analyzed using the SPSS software package, employing descriptive statistics such as frequency, percentage, mean, standard deviation, as well as inferential statistics including independent samples t-test, ANOVA, multiple linear regression and correlation tests. RESULTS The Total Social Attitudes Scale Score toward Childhood Epilepsies was calculated as 45.10 ± 7.81, and the Spiritual Orientation Scale Score was 89.88 ± 30.30 for parents with an average age of 36.64 ± 8.26. It was found statistically significant and high (p > 0.05) for parents who are female, have a higher level of education, and have previously received education about epilepsy regarding both the Total Social Attitudes Scale Score toward Childhood Epilepsies and the Spiritual Orientation Scale Score. A statistically significant positive correlation was found between the Total Social Attitudes Scale Score toward Childhood Epilepsies and the Spiritual Orientation Scale Score. CONCLUSION According to the findings of the research, parents' attitudes towards childhood epilepsy are positive, and their spiritual orientation levels are high. As parents' spiritual orientation levels increase, their positive attitudes towards childhood epilepsy also increase.
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Affiliation(s)
- Necla Kasimoğlu
- Erzincan Binali Yıldırım University, Faculty of Health Sciences, Department of Child Health and Diseases Nursing, Erzincan, Turkey.
| | - Nazan Gürarslan Baş
- Munzur University, Faculty of Health Sciences, Nursing Department Tunceli, Turkey.
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Tong X, Wang Q, Yang J, Zhou J, Chen X, Gan J, Cai Q, Yu T, Luo R. Optimizing ketogenic diet therapy for childhood epilepsy: Identifying key factors for seizure control and psychomotor enhancement. Epilepsia 2024. [PMID: 39190400 DOI: 10.1111/epi.18098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 08/02/2024] [Accepted: 08/02/2024] [Indexed: 08/28/2024]
Abstract
OBJECTIVE To identify key factors influencing the therapeutic efficacy of the ketogenic diet (KD) for children with drug-resistant epilepsy and elucidate their interconnected relationships to optimize clinical practice. METHODS Participants were selected from children receiving KD treatment at West Second University Hospital of Sichuan University from September 2015 to October 2023. Clinical factors pre-KD and post-KD (at the third month) were analyzed systematically using an analytical framework. Descriptive analyses, univariate analyses, and multivariate regression analyses were performed for the entire cohort and subgroups of genetic and non-genetic (i.e., structural and unknown) etiologies. Thereby, the most significant predictors were identified for each relevant dependent variable. Path analysis diagrams were used for visual representation. RESULTS Of 156 patients, genetic etiology was prevalent (38.5%). In the genetic subgroup, channelopathies predicted lower baseline seizure frequency and increased chance of seizure freedom with KD. Frequent seizures and complex history of anti-seizure medications (ASMs) predicted severe baseline psychomotor abnormalities. Younger age at KD initiation benefited psychomotor improvement. In the non-genetic subgroup, lower baseline seizure frequency increased the likelihood of seizure freedom post-KD. Concurrent use of multiple ASMs helped achieve ≥50% seizure reduction. Boys were more likely to experience psychomotor improvement. A significant correlation was found between ≥50% seizure reduction and psychomotor improvement in both subgroups. Delayed KD initiation (longer epilepsy duration at KD start) was related to a greater number of ASMs used, infrequent seizures, and older age at epilepsy onset. In addition, patients with channelopathies had delayed initiation of KD. SIGNIFICANCE Children with genetic epilepsy display more pronounced characteristics of epileptic encephalopathy. Early KD intervention is crucial for channelopathies, notably SCN1A variants. For other drug-resistant epilepsy cases, KD alongside diverse ASMs may improve seizure control and developmental outcomes. However, the patient population benefiting most from early KD tends to start the treatment later, urging a re-evaluation of KD decision-making paradigms.
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Affiliation(s)
- Xin Tong
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, China
| | - Qian Wang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, China
| | - Jie Yang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, China
| | - Jielan Zhou
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, China
| | - Xiaolu Chen
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, China
| | - Jing Gan
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, China
| | - Qianyun Cai
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, China
| | - Tao Yu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, China
| | - Rong Luo
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, China
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Li L, Liu Z. SRF Facilitates Transcriptional Inhibition of Gem Expression by m6A Methyltransferase METTL3 to Suppress Neuronal Damage in Epilepsy. Mol Neurobiol 2024:10.1007/s12035-024-04396-x. [PMID: 39190265 DOI: 10.1007/s12035-024-04396-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 07/21/2024] [Indexed: 08/28/2024]
Abstract
A bioinformatics analysis was conducted to screen for relevant expression datasets of the transcription factor SRF knockout mice. The aim was to investigate the relationship between SRF and m6A-related genes, predict how SRF regulates the m6A modification of GEM genes mediated by METTL3, and explore potential molecular mechanisms associated with neurotrauma. Disease gene databases such as GeneCards, DisGeNET, and Phenolyzer, and transcription factor databases TFDB and TRRUST, were used to obtain epilepsy-related genes and transcription factors. The intersection was then selected. Expression data of SRF knockout epilepsy mice were obtained from the GEO database and used to filter differentially expressed genes. Important module genes related to the disease were selected through WGCNA co-expression analysis. The intersection between these genes and the differentially expressed genes was performed, followed by PPI network analysis and GO/KEGG enrichment analysis. Furthermore, the core genes were selected using the cytoHubba plugin of the Cytoscape software. Differential expression analysis was performed on m6A-related factors in the GEO dataset, and the relationship between SRF and m6A-related factors and core genes was analyzed. The m6A binding sites of SRF with the METTL3 promoter and target gene Gem were predicted using the AnimalTFDB and SRAMP websites, respectively. We found that the transcription factor SRF may be a key gene in epilepsy during neuronal development. Further WGCNA analysis showed that 129 module genes were associated with SRF knockout epilepsy, and these differentially expressed genes were mainly enriched in the neuroactive ligand-receptor interaction pathway. The final results indicate that knocking out SRF may inhibit the transcription of METTL3, thereby inhibiting the m6A modification of Gem and leading to upregulation of Gem expression, thereby playing an important role in neuronal damage. Knocking out the SRF gene may inhibit the transcription of m6A methyltransferase METTL3, thereby inhibiting the m6A modification of GEM genes mediated by METTL3, promoting GEM gene expression, and leading to the occurrence of epilepsy-related neuron injury. Further investigation revealed that SRF overexpression can potentially enhance the transcription of METTL3, thus promoting m6A modification of GEM, resulting in downregulation of GEM expression. This process regulates oxidative stress in epileptic mouse neurons, suppresses inflammatory responses, and mitigates associated damage. Additionally, an in vitro neuronal epileptic model was established, and experimental techniques such as qRT-PCR and WB were employed to assess the expression of SRF, METTL3, and GEM in hippocampal tissues and neurons. The experimental results were consistent with our predictions, demonstrating that overexpression of SRF can inhibit the development of epilepsy-related neuronal damage. This study reveals that knockout of the SRF gene may suppress the transcription of m6A methyltransferase METTL3, thereby inhibiting m6A modification of the GEM gene mediated by METTL3 and subsequently promoting the expression of the GEM gene, leading to the occurrence of epilepsy-related neuronal damage.
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Affiliation(s)
- Lianling Li
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan Province, P. R. China.
| | - Zhiguo Liu
- Department of Neurosurgery, Centtal Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250012, P. R. China
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Peng T, Xie Y, Zhao S, Wang X, Zhang W, Xie Y, Wang C, Xie N. TRPML1 ameliorates seizures-related neuronal injury by regulating autophagy and lysosomal biogenesis via Ca 2+/TFEB signaling pathway. Biochim Biophys Acta Mol Basis Dis 2024; 1870:167477. [PMID: 39173889 DOI: 10.1016/j.bbadis.2024.167477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 08/05/2024] [Accepted: 08/15/2024] [Indexed: 08/24/2024]
Abstract
Alterations in autophagy have been observed in epilepsy, although their exact etiopathogenesis remains elusive. Transient Receptor Potential Mucolipin Protein 1 (TRPML1) is an ion channel protein that regulates autophagy and lysosome biogenesis. To explore the role of TRPML1 in seizures-induced neuronal injury and the potential mechanisms involved, an hyperexcitable neuronal model induced by Mg2+-free solution was used for the study. Our results revealed that TRPML1 expression was upregulated after seizures, which was accompanied by intracellular ROS accumulation, mitochondrial damage, and neuronal apoptosis. Activation of TRPML1 by ML-SA1 diminished intracellular ROS, restored mitochondrial function, and subsequently alleviated neuronal apoptosis. Conversely, inhibition of TRPML1 had the opposite effect. Further examination revealed that the accumulation of ROS and damaged mitochondria was associated with interrupted mitophagy flux and enlarged defective lysosomes, which were attenuated by TRPML1 activation. Mechanistically, TRPML1 activation allows more Ca2+ to permeate from the lysosome into the cytoplasm, resulting in the dephosphorylation of TFEB and its nuclear translocation. This process further enhances autophagy initiation and lysosomal biogenesis. Additionally, the expression of TRPML1 is positively regulated by WTAP-mediated m6A modification. Our findings highlighted crucial roles of TRPML1 and autophagy in seizures-induced neuronal injury, which provides a new target for epilepsy treatment.
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Affiliation(s)
- Tingting Peng
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, 1 East Jianshe Road, Zhengzhou 450052, Henan Province, PR China; Academy of Medical Sciences of Zhengzhou University, Zhengzhou 450052, Henan Province, PR China
| | - Yinyin Xie
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, 1 East Jianshe Road, Zhengzhou 450052, Henan Province, PR China; Academy of Medical Sciences of Zhengzhou University, Zhengzhou 450052, Henan Province, PR China
| | - Senfeng Zhao
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, 1 East Jianshe Road, Zhengzhou 450052, Henan Province, PR China; Academy of Medical Sciences of Zhengzhou University, Zhengzhou 450052, Henan Province, PR China
| | - Xiaoyi Wang
- Institutes of Biological and Medical Sciences, Suzhou Medical College of Soochow University, Suzhou 215123, Jiangsu Province, PR China
| | - Wanwan Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, 1 East Jianshe Road, Zhengzhou 450052, Henan Province, PR China
| | - Yi Xie
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, 1 East Jianshe Road, Zhengzhou 450052, Henan Province, PR China
| | - Cui Wang
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Key Clinical Laboratory of Henan Province, 1 East Jianshe Road, Zhengzhou 450052, Henan Province, PR China.
| | - Nanchang Xie
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, 1 East Jianshe Road, Zhengzhou 450052, Henan Province, PR China.
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Jakubiec M, Abram M, Zagaja M, Socała K, Panic V, Latacz G, Mogilski S, Szafarz M, Szala-Rycaj J, Saunders J, West PJ, Nieoczym D, Przejczowska-Pomierny K, Szulczyk B, Krupa A, Wyska E, Wlaź P, Metcalf CS, Wilcox K, Andres-Mach M, Kamiński RM, Kamiński K. Discovery and Profiling of New Multimodal Phenylglycinamide Derivatives as Potent Antiseizure and Antinociceptive Drug Candidates. ACS Chem Neurosci 2024. [PMID: 39166702 DOI: 10.1021/acschemneuro.4c00438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024] Open
Abstract
We developed a focused series of original phenyl-glycinamide derivatives which showed potent activity across in vivo mouse seizure models, namely, maximal electroshock (MES) and 6 Hz (using both 32 and 44 mA current intensities) seizure models. Following intraperitoneal (i.p.) administration, compound (R)-32, which was identified as a lead molecule, demonstrated potent protection against all seizure models with ED50 values of 73.9 mg/kg (MES test), 18.8 mg/kg (6 Hz, 32 mA test), and 26.5 mg/kg (6 Hz, 44 mA test). Furthermore, (R)-32 demonstrated efficacy in both the PTZ-induced kindling paradigm and the ivPTZ seizure threshold test. The expression of neurotrophic factors, such as mature brain-derived neurotrophic factor (mBDNF) and nerve growth factor (NGF), in the hippocampus and/or cortex of mice, and the levels of glutamate and GABA were normalized after PTZ-induced kindling by (R)-32. Importantly, besides antiseizure activity, (R)-32 demonstrated potent antinociceptive efficacy in formalin-induced pain, capsaicin-induced pain, as well as oxaliplatin- and streptozotocin-induced peripheral neuropathy in mice (i.p.). No influence on muscular strength and body temperature in mice was observed. Pharmacokinetic studies and in vitro ADME-Tox data (i.e., high metabolic stability in human liver microsomes, a weak influence on CYPs, no hepatotoxicity, satisfactory passive transport, etc.) proved favorable drug-like properties of (R)-32. Thermal stability of (R)-32 shown in thermogravimetry and differential scanning calorimetry gives the opportunity to develop innovative oral solid dosage forms loaded with this compound. The in vitro binding and functional assays indicated its multimodal mechanism of action. (R)-32, beyond TRPV1 antagonism, inhibited calcium and sodium currents at a concentration of 10 μM. Therefore, the data obtained in the current studies justify a more detailed preclinical development of (R)-32 for epilepsy and pain indications.
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Affiliation(s)
- Marcin Jakubiec
- Department of Medicinal Chemistry, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, Cracow 30-688, Poland
| | - Michał Abram
- Department of Medicinal Chemistry, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, Cracow 30-688, Poland
| | - Mirosław Zagaja
- Department of Experimental Pharmacology, Institute of Rural Health, Jaczewskiego 2, Lublin 20-950, Poland
| | - Katarzyna Socała
- Department of Animal Physiology and Pharmacology, Institute of Biological Sciences, Faculty of Biology and Biotechnology, Maria Curie-Skłodowska University, Akademicka 19, Lublin 20-033, Poland
| | - Vanja Panic
- Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, Utah 84112, United States
| | - Gniewomir Latacz
- Department of Technology and Biotechnology of Drugs, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, Cracow 30-688, Poland
| | - Szczepan Mogilski
- Department Pharmacodynamics, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, Cracow 30-688, Poland
| | - Małgorzata Szafarz
- Department of Pharmacokinetics and Physical Pharmacy, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, Cracow 30-688, Poland
| | - Joanna Szala-Rycaj
- Department of Experimental Pharmacology, Institute of Rural Health, Jaczewskiego 2, Lublin 20-950, Poland
| | - Jerry Saunders
- Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, Utah 84112, United States
| | - Peter J West
- Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, Utah 84112, United States
| | - Dorota Nieoczym
- Department of Animal Physiology and Pharmacology, Institute of Biological Sciences, Faculty of Biology and Biotechnology, Maria Curie-Skłodowska University, Akademicka 19, Lublin 20-033, Poland
| | - Katarzyna Przejczowska-Pomierny
- Department of Pharmacokinetics and Physical Pharmacy, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, Cracow 30-688, Poland
| | - Bartłomiej Szulczyk
- Chair and Department of Pharmacotherapy and Pharmaceutical Care, Centre for Preclinical Research and Technology, Medical University of Warsaw, Banacha 1B, Warsaw 02-097, Poland
| | - Anna Krupa
- Department of Pharmaceutical Technology and Biopharmaceutics, Jagiellonian University Medical College, Medyczna 9, Cracow 30-688, Poland
| | - Elżbieta Wyska
- Department of Pharmacokinetics and Physical Pharmacy, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, Cracow 30-688, Poland
| | - Piotr Wlaź
- Department of Animal Physiology and Pharmacology, Institute of Biological Sciences, Faculty of Biology and Biotechnology, Maria Curie-Skłodowska University, Akademicka 19, Lublin 20-033, Poland
| | - Cameron S Metcalf
- Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, Utah 84112, United States
| | - Karen Wilcox
- Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, Utah 84112, United States
| | - Marta Andres-Mach
- Department of Experimental Pharmacology, Institute of Rural Health, Jaczewskiego 2, Lublin 20-950, Poland
| | - Rafał M Kamiński
- Department of Medicinal Chemistry, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, Cracow 30-688, Poland
| | - Krzysztof Kamiński
- Department of Medicinal Chemistry, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, Cracow 30-688, Poland
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Santana-Coelho D, Pranske ZJ, Nolan SO, Hodges SL, Binder MS, Womble PD, Narvaiz DA, Muhammad I, Lugo JN. Neonatal immune stimulation results in sex-specific changes in ultrasonic vocalizations but does not affect seizure susceptibility in neonatal mice. Int J Dev Neurosci 2024; 84:381-391. [PMID: 38712612 DOI: 10.1002/jdn.10333] [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: 10/12/2023] [Revised: 04/15/2024] [Accepted: 04/19/2024] [Indexed: 05/08/2024] Open
Abstract
Neuroinflammation during the neonatal period has been linked to disorders such as autism and epilepsy. In this study, we investigated the early life behavioral consequences of a single injection of lipopolysaccharide (LPS) at postnatal day 10 (PD10) in mice. To assess deficits in communication, we performed the isolation-induced ultrasonic vocalizations (USVs) test at PD12. To determine if early life immune stimulus could alter seizure susceptibility, latency to flurothyl-induced generalized seizures was measured at 4 hours (hrs), 2 days, or 5 days after LPS injections. LPS had a sex-dependent effect on USV number. LPS-treated male mice presented significantly fewer USVs than LPS-treated female mice. However, the number of calls did not significantly differ between control and LPS for either sex. In male mice, we found that downward, short, and composite calls were significantly more prevalent in the LPS treatment group, while upward, chevron, and complex calls were less prevalent than in controls (p < 0.05). Female mice that received LPS presented a significantly higher proportion of short, frequency steps, two-syllable, and composite calls in their repertoire when compared with female control mice (p < 0.05). Seizure latency was not altered by early-life inflammation at any of the time points measured. Our findings suggest that early-life immune stimulation at PD10 disrupts vocal development but does not alter the susceptibility to flurothyl-induced seizures during the neonatal period. Additionally, the effect of inflammation in the disruption of vocalization is sex-dependent.
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Affiliation(s)
| | - Zachary J Pranske
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
| | - Suzanne O Nolan
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
| | | | - Matthew S Binder
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
| | - Paige D Womble
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
| | - David A Narvaiz
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
| | - Ilyasah Muhammad
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
| | - Joaquin N Lugo
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
- Institute of Biomedical Studets, Waco, Texas, USA
- Department of Biology, Baylor University, Waco, Texas, USA
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Cui TY, Wu H, Tang CY, Wang XF, Li TF, Zhou J. Surgical outcomes of patients with genetically refractory epilepsy: A systematic review and meta-analysis. Seizure 2024; 120:124-134. [PMID: 38959583 DOI: 10.1016/j.seizure.2024.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/27/2024] [Accepted: 06/29/2024] [Indexed: 07/05/2024] Open
Abstract
OBJECTIVE To summarize the surgical outcomes of genetically refractory epilepsy and identify prognostic factors for these outcomes. METHODS A literature search of the PubMed, Web of Science, and Embase databases for relevant studies, published between January 1, 2002 and December 31, 2023, was performed using specific search terms. All studies addressing surgical outcomes and follow-up of genetically refractory epilepsy were included. All statistical analyses were performed using STATA software (StataCorp LLC, College Station, TX, USA). This review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, 2020 (i.e., "PRISMA") reporting guidelines. RESULTS Of the 3833 studies retrieved, 55 fulfilled the inclusion criteria. Eight studies were eligible for meta-analysis at the study level. Pooled outcomes revealed that 74 % of patients who underwent resective surgery (95 % confidence interval [CI] 0.55-0.89; z = 9.47, p < 0.05) achieved Engel I status at the last follow-up. In the study level analysis, pooled outcomes revealed that 9 % of patients who underwent vagus nerve stimulation achieved seizure-free status (95 % CI 0.00-0.31; z = 1.74, p < 0.05), and 61 % (95 % CI 0.55-0.89; z = 11.96, p < 0.05) achieved a 50 % reduction in seizure frequency at the last follow-up. Fifty-three studies comprising 249 patients were included in an individual-level analysis. Among patients who underwent lesion resection or lobectomy/multilobar resection, 65 % (100/153) achieved Engel I status at the last follow-up. Univariate analysis indicated that female sex, somatic mutations, and presenting with focal seizure symptoms were associated with better prognosis (p < 0.05). Additionally, 75 % (21/28) of patients who underwent hemispherectomy/hemispherotomy achieved Engel I status at the last follow-up. In the individual-level analysis, among patients treated with vagus nerve stimulation, 21 % (10/47) were seizure-free and 64 % (30/47) experienced >50 % reduction in seizure frequency compared with baseline. CONCLUSION Meticulous presurgical evaluation and selection of appropriate surgical procedures can, to a certain extent, effectively control seizures. Therefore, various surgical procedures should be considered when treating patients with genetically refractory epilepsy.
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Affiliation(s)
- Tian-Yi Cui
- Functional Neurosurgery Department, Sanbo Brain Hospital, Capital Medical University, Beijing, China; Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
| | - Han Wu
- Functional Neurosurgery Department, Sanbo Brain Hospital, Capital Medical University, Beijing, China; Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
| | - Chong-Yang Tang
- Functional Neurosurgery Department, Sanbo Brain Hospital, Capital Medical University, Beijing, China; Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
| | - Xiong-Fei Wang
- Functional Neurosurgery Department, Sanbo Brain Hospital, Capital Medical University, Beijing, China; Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
| | - Tian-Fu Li
- Department of Neurology, Sanbo Brain Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Clinical Research on Epilepsy, Beijing, China; Centre of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China; Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
| | - Jian Zhou
- Functional Neurosurgery Department, Sanbo Brain Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Clinical Research on Epilepsy, Beijing, China; Centre of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China; Laboratory for Clinical Medicine, Capital Medical University, Beijing, China.
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Gadhia A, Barker E, Morgan A, Barclay JW. Functional analysis of epilepsy-associated GABA A receptor mutations using Caenorhabditis elegans. Epilepsia Open 2024; 9:1458-1466. [PMID: 38813985 PMCID: PMC11296113 DOI: 10.1002/epi4.12982] [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: 01/24/2024] [Revised: 05/03/2024] [Accepted: 05/18/2024] [Indexed: 05/31/2024] Open
Abstract
OBJECTIVE GABAA receptor subunit mutations pose a significant risk for genetic generalized epilepsy; however, there are over 150 identified variants, many with unknown or unvalidated pathogenicity. We aimed to develop in vivo models for testing GABAA receptor variants using the model organism, Caenorhabditis elegans. METHODS CRISPR-Cas9 gene editing was used to create a complete deletion of unc-49, a C. elegans GABAA receptor, and to create homozygous epilepsy-associated mutations in the endogenous unc-49 gene. The unc-49 deletion strain was rescued with transgenes for either the C. elegans unc-49B subunit or the α1, β3, and γ2 subunits for the human GABAA receptor. All newly created strains were analyzed for phenotype and compared against existing unc-49 mutations. RESULTS Nematodes with a full genetic deletion of the entire unc-49 locus were compared with existing unc-49 mutations in three separate phenotypic assays-coordinated locomotion, shrinker frequency and seizure-like convulsions. The full unc-49 deletion exhibited reduced locomotion and increased shrinker frequency and PTZ-induced convulsions, but were not found to be phenotypically stronger than existing unc-49 mutations. Rescue with the unc-49B subunit or creation of humanized worms for the GABAA receptor both showed partial phenotypic rescue for all three phenotypes investigated. Finally, two epilepsy-associated variants were analyzed and deemed to be loss of function, thus validating their pathogenicity. SIGNIFICANCE These findings establish C. elegans as a genetic model to investigate GABAA receptor mutations and delineate a platform for validating associated variants in any epilepsy-associated gene. PLAIN LANGUAGE SUMMARY Epilepsy is a complex human disease that can be caused by mutations in specific genes. Many possible mutations have been identified, but it is unknown for most of them whether they cause the disease. We tested the role of mutations in one specific gene using a small microscopic worm as an animal model. Our results establish this worm as a model for epilepsy and confirm that the two unknown mutations are likely to cause the disease.
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Affiliation(s)
- Ami Gadhia
- Department of Biochemistry, Cell and Systems Biology, ISMIBUniversity of LiverpoolLiverpoolUK
| | - Eleanor Barker
- Department of Biochemistry, Cell and Systems Biology, ISMIBUniversity of LiverpoolLiverpoolUK
| | - Alan Morgan
- Department of Biochemistry, Cell and Systems Biology, ISMIBUniversity of LiverpoolLiverpoolUK
| | - Jeff W. Barclay
- Department of Biochemistry, Cell and Systems Biology, ISMIBUniversity of LiverpoolLiverpoolUK
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Neumann AM, Britsch S. Molecular Genetics of Acquired Temporal Lobe Epilepsy. Biomolecules 2024; 14:669. [PMID: 38927072 PMCID: PMC11202058 DOI: 10.3390/biom14060669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/02/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
An epilepsy diagnosis reduces a patient's quality of life tremendously, and it is a fate shared by over 50 million people worldwide. Temporal lobe epilepsy (TLE) is largely considered a nongenetic or acquired form of epilepsy that develops in consequence of neuronal trauma by injury, malformations, inflammation, or a prolonged (febrile) seizure. Although extensive research has been conducted to understand the process of epileptogenesis, a therapeutic approach to stop its manifestation or to reliably cure the disease has yet to be developed. In this review, we briefly summarize the current literature predominately based on data from excitotoxic rodent models on the cellular events proposed to drive epileptogenesis and thoroughly discuss the major molecular pathways involved, with a focus on neurogenesis-related processes and transcription factors. Furthermore, recent investigations emphasized the role of the genetic background for the acquisition of epilepsy, including variants of neurodevelopmental genes. Mutations in associated transcription factors may have the potential to innately increase the vulnerability of the hippocampus to develop epilepsy following an injury-an emerging perspective on the epileptogenic process in acquired forms of epilepsy.
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Affiliation(s)
| | - Stefan Britsch
- Institute of Molecular and Cellular Anatomy, Ulm University, 89081 Ulm, Germany;
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10
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Di Gennaro G, Lattanzi S, Mecarelli O, Saverio Mennini F, Vigevano F. Current challenges in focal epilepsy treatment: An Italian Delphi consensus. Epilepsy Behav 2024; 155:109796. [PMID: 38643659 DOI: 10.1016/j.yebeh.2024.109796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/18/2024] [Accepted: 04/14/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Epilepsy, a globally prevalent neurological condition, presents distinct challenges in management, particularly for focal-onset types. This study aimed at addressing the current challenges and perspectives in focal epilepsy management, with focus on the Italian reality. METHODS Using the Delphi methodology, this research collected and analyzed the level of consensus of a panel of Italian epilepsy experts on key aspects of focal epilepsy care. Areas of focus included patient flow, treatment pathways, controlled versus uncontrolled epilepsy, follow-up protocols, and the relevance of patient-reported outcomes (PROs). This method allowed for a comprehensive assessment of consensus and divergences in clinical opinions and practices. RESULTS The study achieved consensus on 23 out of 26 statements, with three items failing to reach a consensus. There was strong agreement on the importance of timely intervention, individualized treatment plans, regular follow-ups at Epilepsy Centers, and the role of PROs in clinical practice. In cases of uncontrolled focal epilepsy, there was a clear inclination to pursue alternative treatment options following the failure of two previous therapies. Divergent views were evident on the inclusion of epilepsy surgery in treatment for uncontrolled epilepsy and the routine necessity of EEG evaluations in follow-ups. Other key findings included concerns about the lack of pediatric-specific research limiting current therapeutic options in this patient population, insufficient attention to the transition from pediatric to adult care, and need for improved communication. The results highlighted the complexities in managing epilepsy, with broad consensus on patient care aspects, yet notable divergences in specific treatment and management approaches. CONCLUSION The study offered valuable insights into the current state and complexities of managing focal-onset epilepsy. It highlighted many deficiencies in the therapeutic pathway of focal-onset epilepsy in the Italian reality, while it also underscored the importance of patient-centric care, the necessity of early and appropriate intervention, and individualized treatment approaches. The findings also called for continued research, policy development, and healthcare system improvements to enhance epilepsy management, highlighting the ongoing need for tailored healthcare solutions in this evolving field.
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Affiliation(s)
| | - Simona Lattanzi
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | - Oriano Mecarelli
- Department of Human Neurosciences, Sapienza University, Rome (Retired) and Past President of LICE, Italian League Against Epilepsy, Rome, Italy
| | - Francesco Saverio Mennini
- Faculty of Economics, Economic Evaluation and HTA (EEHTA), CEIS, University of Rome "Tor Vergata", Rome, Italy; Institute for Leadership and Management in Health, Kingston University London, London, UK.
| | - Federico Vigevano
- Head of Paediatric Neurorehabilitation Department, IRCCS San Raffaele, Rome, Italy.
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11
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Sabnis G, Hession L, Mahoney JM, Mobley A, Santos M, Kumar V. Visual detection of seizures in mice using supervised machine learning. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.29.596520. [PMID: 38868170 PMCID: PMC11167691 DOI: 10.1101/2024.05.29.596520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
Seizures are caused by abnormally synchronous brain activity that can result in changes in muscle tone, such as twitching, stiffness, limpness, or rhythmic jerking. These behavioral manifestations are clear on visual inspection and the most widely used seizure scoring systems in preclinical models, such as the Racine scale in rodents, use these behavioral patterns in semiquantitative seizure intensity scores. However, visual inspection is time-consuming, low-throughput, and partially subjective, and there is a need for rigorously quantitative approaches that are scalable. In this study, we used supervised machine learning approaches to develop automated classifiers to predict seizure severity directly from noninvasive video data. Using the PTZ-induced seizure model in mice, we trained video-only classifiers to predict ictal events, combined these events to predict an univariate seizure intensity for a recording session, as well as time-varying seizure intensity scores. Our results show, for the first time, that seizure events and overall intensity can be rigorously quantified directly from overhead video of mice in a standard open field using supervised approaches. These results enable high-throughput, noninvasive, and standardized seizure scoring for downstream applications such as neurogenetics and therapeutic discovery.
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Affiliation(s)
| | | | | | | | | | - Vivek Kumar
- The Jackson Laboratory, Bar Harbor, ME USA
- School of Graduate Biomedical Sciences, Tufts University School of Medicine, Boston, MA USA
- Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, ME USA
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12
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Wang D, Cui Y, Gao F, Zheng W, Li J, Xian Z. Keap1/Nrf2 signaling pathway participating in the progression of epilepsy via regulation of oxidative stress and ferroptosis in neurons. Clinics (Sao Paulo) 2024; 79:100372. [PMID: 38733688 PMCID: PMC11103370 DOI: 10.1016/j.clinsp.2024.100372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 03/13/2024] [Accepted: 04/17/2024] [Indexed: 05/13/2024] Open
Abstract
OBJECTIVE This study aims to analyze the relationship between the Kelch-like ECH-associated protein 1 (Keap1)/Nuclear factor-erythroid 2-related factor 2 (Nrf2) and Epilepsy (EP), as well as its mechanism of action. METHODS Thirty Wistar rats were divided into a control group (without treatment), a model group (EP modeling), and an inhibition group (EP modeling + intervention by Keap1/Nrf2 signaling pathway inhibitor ATRA) and subject to Morris water maze experiment. Then, the expression of Oxidative Stress (OS) markers, ferroptosis-associated proteins and Keap1/Nrf2 pathway in rat hippocampus was measured. In addition, rat hippocampal neuronal cell HT22 was purchased and treated accordingly based on the results of grouping, and cell proliferation and apoptosis in the three groups were determined. RESULTS Compared with rats in the model group, those in the inhibition group showed shorter escape latency and an increased number of platform crossings (p < 0.05). Significant OS and neuron ferroptosis, increased apoptosis rate, elevated Keap1 expression, and decreased Nrf2 expression were observed in the model group compared to the control group (p < 0.05). The inhibition group exhibited notably improved OS and ferroptosis, as well as enhanced neuronal viability (p < 0.05). CONCLUSION Inhibition of the Keap1/Nrf2 pathway can reverse the OS and neuron viability in EP rats.
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Affiliation(s)
- Dandan Wang
- Department of Ultrasound Medicine, Affiliated Hospital of Yanbian University, Yanji, Jilin, China
| | - Yunmei Cui
- Department of Ultrasound Medicine, Affiliated Hospital of Yanbian University, Yanji, Jilin, China
| | - Fan Gao
- Department of Ultrasound Medicine, Affiliated Hospital of Yanbian University, Yanji, Jilin, China
| | - Weiwei Zheng
- Department of Ultrasound Medicine, Affiliated Hospital of Yanbian University, Yanji, Jilin, China
| | - Jinzi Li
- Department of Pediatrics, Affiliated Hospital of Yanbian University, Yanji, Jilin, China.
| | - Zhemin Xian
- Department of Pediatrics, Affiliated Hospital of Yanbian University, Yanji, Jilin, China.
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13
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Robertson AJ, Tran KA, Bennett C, Sullivan C, Stark Z, Vadlamudi L, Waddell N. Clinically significant changes in genes and variants associated with epilepsy over time: implications for re-analysis. Sci Rep 2024; 14:7717. [PMID: 38565608 PMCID: PMC10987647 DOI: 10.1038/s41598-024-57976-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/23/2024] [Indexed: 04/04/2024] Open
Abstract
Despite the significant advances in understanding the genetic architecture of epilepsy, many patients do not receive a molecular diagnosis after genomic testing. Re-analysing existing genomic data has emerged as a potent method to increase diagnostic yields-providing the benefits of genomic-enabled medicine to more individuals afflicted with a range of different conditions. The primary drivers for these new diagnoses are the discovery of novel gene-disease and variants-disease relationships; however, most decisions to trigger re-analysis are based on the passage of time rather than the accumulation of new knowledge. To explore how our understanding of a specific condition changes and how this impacts re-analysis of genomic data from epilepsy patients, we developed Vigelint. This approach combines the information from PanelApp and ClinVar to characterise how the clinically relevant genes and causative variants available to laboratories change over time, and this approach to five clinical-grade epilepsy panels. Applying the Vigelint pipeline to these panels revealed highly variable patterns in new, clinically relevant knowledge becoming publicly available. This variability indicates that a more dynamic approach to re-analysis may benefit the diagnosis and treatment of epilepsy patients. Moreover, this work suggests that Vigelint can provide empirical data to guide more nuanced, condition-specific approaches to re-analysis.
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Affiliation(s)
- Alan J Robertson
- Faculty of Medicine, University of Queensland, Brisbane, Australia.
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
- Queensland Digital Health Centre, University of Queensland, Brisbane, Australia.
- The Genomic Institute, Department of Health, Queensland Government, Brisbane, Australia.
| | - Khoa A Tran
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- School of Biomedical Sciences, Queensland University of Technology (QUT), Brisbane, Australia
| | - Carmen Bennett
- UQ Centre for Clinical Research, Herston, Brisbane, QLD, 4029, Australia
- Department of Neurology, Royal Brisbane & Women's Hospital, Herston, Brisbane, QLD, 4029, Australia
| | - Clair Sullivan
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Queensland Digital Health Centre, University of Queensland, Brisbane, Australia
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Woolloongabba, Australia
- Department of Health, Metro North Hospital and Health Service, Queensland Government, Brisbane, Australia
| | - Zornitza Stark
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Australian Genomics, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | - Lata Vadlamudi
- UQ Centre for Clinical Research, Herston, Brisbane, QLD, 4029, Australia
- Department of Neurology, Royal Brisbane & Women's Hospital, Herston, Brisbane, QLD, 4029, Australia
| | - Nicola Waddell
- Faculty of Medicine, University of Queensland, Brisbane, Australia.
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
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14
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Kilic MA, Yildiz EP, Kurekci F, Coskun O, Cura M, Avci R, Genc HM. Association of epilepsy with neuroimaging patterns in children with cerebral palsy. Acta Neurol Belg 2024; 124:567-572. [PMID: 37777694 DOI: 10.1007/s13760-023-02385-w] [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: 06/08/2023] [Accepted: 09/07/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVES In this study, we examined whether epilepsy and drug-resistant epilepsy are associated with neuroimaging findings in children with cerebral palsy (CP). METHODS Magnetic resonance imaging classification system (MRICS) proposed by Surveillance of Cerebral Palsy in Europe (SCPE) was used for classification of different MRI patterns in patients with cerebral palsy. We reviewed the brain MRI scans and medical records of children with CP who were followed-up in our clinic between 2019 and 2023. Patients were divided into three categories: CP without epilepsy, CP with controlled epilepsy and CP with DRE. MRI patterns were grouped as maldevelopments, predominant white matter injury, predominant gray matter injury, miscellaneous (delayed myelination, cerebral atrophy, cerebellar atrophy, brainstem lesions and calcifications, lesions that were not classified under any other group) and normal according to MRICS of the SCPE. RESULTS There were 325 CP patients. The most common MRI patterns were predominant white matter injury (47.6%) and gray matter injury (23.8%). There was a 1.5-fold reduction in the risk of epilepsy in patients with predominant white matter injury (OR = 1.54, 95% CI 1.23-1.94). In contrast, children in the miscellaneous group had significantly higher risks of epilepsy (p < 0.001), and we were able to determine that miscellaneous findings increased the risk by 1.8 times (OR = 1.77, 95% CI 1.47-2.12). CONCLUSION In conclusion, more than half of the children with CP had epilepsy, 40.7% of whom had DRE. On MRI, miscellaneous findings may indicate a poor prognosis for epilepsy, while predominant white matter injury may indicate a good outcome. Children with CP, especially those with miscellaneous findings on MRI, should be closely monitored for epilepsy development.
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Affiliation(s)
- Mehmet Akif Kilic
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
| | - Edibe Pembegul Yildiz
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Fulya Kurekci
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Orhan Coskun
- Department of Pediatric Neurology, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey
| | - Meryem Cura
- Department of Pediatrics, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Ridvan Avci
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Hulya Maras Genc
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
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15
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Leem E, Kim S, Sharma C, Nam Y, Kim TY, Shin M, Lee SG, Kim J, Kim SR. Inhibition of Granule Cell Dispersion and Seizure Development by Astrocyte Elevated Gene-1 in a Mouse Model of Temporal Lobe Epilepsy. Biomolecules 2024; 14:380. [PMID: 38540798 PMCID: PMC10968595 DOI: 10.3390/biom14030380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/15/2024] [Accepted: 03/15/2024] [Indexed: 04/04/2024] Open
Abstract
Although granule cell dispersion (GCD) in the hippocampus is known to be an important feature associated with epileptic seizures in temporal lobe epilepsy (TLE), the endogenous molecules that regulate GCD are largely unknown. In the present study, we have examined whether there is any change in AEG-1 expression in the hippocampus of a kainic acid (KA)-induced mouse model of TLE. In addition, we have investigated whether the modulation of astrocyte elevated gene-1 (AEG-1) expression in the dentate gyrus (DG) by intracranial injection of adeno-associated virus 1 (AAV1) influences pathological phenotypes such as GCD formation and seizure susceptibility in a KA-treated mouse. We have identified that the protein expression of AEG-1 is upregulated in the DG of a KA-induced mouse model of TLE. We further demonstrated that AEG-1 upregulation by AAV1 delivery in the DG-induced anticonvulsant activities such as the delay of seizure onset and inhibition of spontaneous recurrent seizures (SRS) through GCD suppression in the mouse model of TLE, while the inhibition of AEG-1 expression increased susceptibility to seizures. The present observations suggest that AEG-1 is a potent regulator of GCD formation and seizure development associated with TLE, and the significant induction of AEG-1 in the DG may have therapeutic potential against epilepsy.
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Affiliation(s)
- Eunju Leem
- BK21 FOUR KNU Creative BioResearch Group, School of Life Science, Kyungpook National University, Daegu 41566, Republic of Korea; (E.L.); (S.K.); (C.S.); (T.Y.K.)
- Dementia Research Group, Korea Brain Research Institute, Daegu 41062, Republic of Korea
- Efficacy Evaluation Department, New Drug Development Center, Daegu-Gyeongbuk Medical Innovation Foundation (K-MEDI Hub), Daegu 41061, Republic of Korea
| | - Sehwan Kim
- BK21 FOUR KNU Creative BioResearch Group, School of Life Science, Kyungpook National University, Daegu 41566, Republic of Korea; (E.L.); (S.K.); (C.S.); (T.Y.K.)
- Brain Science and Engineering Institute, Kyungpook National University, Daegu 41944, Republic of Korea;
| | - Chanchal Sharma
- BK21 FOUR KNU Creative BioResearch Group, School of Life Science, Kyungpook National University, Daegu 41566, Republic of Korea; (E.L.); (S.K.); (C.S.); (T.Y.K.)
| | - Youngpyo Nam
- Brain Science and Engineering Institute, Kyungpook National University, Daegu 41944, Republic of Korea;
| | - Tae Yeon Kim
- BK21 FOUR KNU Creative BioResearch Group, School of Life Science, Kyungpook National University, Daegu 41566, Republic of Korea; (E.L.); (S.K.); (C.S.); (T.Y.K.)
| | - Minsang Shin
- Department of Microbiology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea;
| | - Seok-Geun Lee
- Department of Biomedical Science & Technology and BioNanocomposite Research Center, Kyung Hee University, Seoul 02447, Republic of Korea;
| | - Jaekwang Kim
- Dementia Research Group, Korea Brain Research Institute, Daegu 41062, Republic of Korea
| | - Sang Ryong Kim
- BK21 FOUR KNU Creative BioResearch Group, School of Life Science, Kyungpook National University, Daegu 41566, Republic of Korea; (E.L.); (S.K.); (C.S.); (T.Y.K.)
- Brain Science and Engineering Institute, Kyungpook National University, Daegu 41944, Republic of Korea;
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16
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Li J, Qi H, Chen Y, Zhu X. Epilepsy and demyelination: Towards a bidirectional relationship. Prog Neurobiol 2024; 234:102588. [PMID: 38378072 DOI: 10.1016/j.pneurobio.2024.102588] [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: 01/14/2024] [Accepted: 02/13/2024] [Indexed: 02/22/2024]
Abstract
Demyelination stands out as a prominent feature in individuals with specific types of epilepsy. Concurrently, individuals with demyelinating diseases, such as multiple sclerosis (MS) are at a greater risk of developing epilepsy compared to non-MS individuals. These bidirectional connections raise the question of whether both pathological conditions share common pathogenic mechanisms. This review focuses on the reciprocal relationship between epilepsy and demyelination diseases. We commence with an overview of the neurological basis of epilepsy and demyelination diseases, followed by an exploration of how our comprehension of these two disorders has evolved in tandem. Additionally, we discuss the potential pathogenic mechanisms contributing to the interactive relationship between these two diseases. A more nuanced understanding of the interplay between epilepsy and demyelination diseases has the potential to unveiling the molecular intricacies of their pathological relationships, paving the way for innovative directions in future clinical management and treatment strategies for these diseases.
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Affiliation(s)
- Jiayi Li
- Department of Pharmacology, Medical School of Southeast University, Nanjing, China; Clinical Medicine, Medical School of Southeast University, Nanjing, China
| | - Honggang Qi
- Department of Pharmacology, Medical School of Southeast University, Nanjing, China
| | - Yuzhou Chen
- Department of Pharmacology, Medical School of Southeast University, Nanjing, China; Clinical Medicine, Medical School of Southeast University, Nanjing, China
| | - Xinjian Zhu
- Department of Pharmacology, Medical School of Southeast University, Nanjing, China.
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Holguin-Garcia SA, Guevara-Navarro E, Daza-Chica AE, Patiño-Claro MA, Arteaga-Arteaga HB, Ruz GA, Tabares-Soto R, Bravo-Ortiz MA. A comparative study of CNN-capsule-net, CNN-transformer encoder, and Traditional machine learning algorithms to classify epileptic seizure. BMC Med Inform Decis Mak 2024; 24:60. [PMID: 38429718 PMCID: PMC10908140 DOI: 10.1186/s12911-024-02460-z] [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: 08/09/2023] [Accepted: 02/13/2024] [Indexed: 03/03/2024] Open
Abstract
INTRODUCTION Epilepsy is a disease characterized by an excessive discharge in neurons generally provoked without any external stimulus, known as convulsions. About 2 million people are diagnosed each year in the world. This process is carried out by a neurological doctor using an electroencephalogram (EEG), which is lengthy. METHOD To optimize these processes and make them more efficient, we have resorted to innovative artificial intelligence methods essential in classifying EEG signals. For this, comparing traditional models, such as machine learning or deep learning, with cutting-edge models, in this case, using Capsule-Net architectures and Transformer Encoder, has a crucial role in finding the most accurate model and helping the doctor to have a faster diagnosis. RESULT In this paper, a comparison was made between different models for binary and multiclass classification of the epileptic seizure detection database, achieving a binary accuracy of 99.92% with the Capsule-Net model and a multiclass accuracy with the Transformer Encoder model of 87.30%. CONCLUSION Artificial intelligence is essential in diagnosing pathology. The comparison between models is helpful as it helps to discard those that are not efficient. State-of-the-art models overshadow conventional models, but data processing also plays an essential role in evaluating the higher accuracy of the models.
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Affiliation(s)
| | - Ernesto Guevara-Navarro
- Departamento de Electrónica y Automatización, Universidad Autónoma de Manizales, Manizales, 170001, Caldas, Colombia
| | - Alvaro Eduardo Daza-Chica
- Departamento de Electrónica y Automatización, Universidad Autónoma de Manizales, Manizales, 170001, Caldas, Colombia
| | - Maria Alejandra Patiño-Claro
- Departamento de Electrónica y Automatización, Universidad Autónoma de Manizales, Manizales, 170001, Caldas, Colombia
| | - Harold Brayan Arteaga-Arteaga
- Departamento de Electrónica y Automatización, Universidad Autónoma de Manizales, Manizales, 170001, Caldas, Colombia
| | - Gonzalo A Ruz
- Facultad de Ingeniería y Ciencias, Universidad Adolfo Ibáñez, Santiago, 7941169, Chile
- Center of Applied Ecology and Sustainability (CAPES), Santiago, 8331150, Chile
- Data Observatory Foundation, Santiago, 7510277, Chile
| | - Reinel Tabares-Soto
- Departamento de Electrónica y Automatización, Universidad Autónoma de Manizales, Manizales, 170001, Caldas, Colombia
- Departamento de Sistemas e Informática, Universidad de Caldas, Manizales, 170004, Caldas, Colombia
- Facultad de Ingeniería y Ciencias, Universidad Adolfo Ibáñez, Santiago, 7941169, Chile
| | - Mario Alejandro Bravo-Ortiz
- Departamento de Electrónica y Automatización, Universidad Autónoma de Manizales, Manizales, 170001, Caldas, Colombia.
- Centro de Bioinformática y Biología Computacional (BIOS), Manizales, 170001, Colombia.
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18
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Li Q, Qu Z, Jia L, Wang W. Expression and correlation of the NOD-like receptor family, pyrin domain-containing 3 inflammasome and the silent information regulator 1 in patients with drug-resistant epilepsy. Epilepsy Res 2024; 201:107338. [PMID: 38447234 DOI: 10.1016/j.eplepsyres.2024.107338] [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: 10/16/2023] [Revised: 02/07/2024] [Accepted: 02/29/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND The NOD-like receptor family, pyrin domain-containing 3 (NLRP3) inflammatory pathway is implicated in the development of epilepsy and can be suppressed by the activation of the silent information regulator 1 (SIRT1). However, the expression and correlation of the NLRP3 pathway and SIRT1 in drug-resistant epilepsy (DRE) remain unknown. METHODS This study evaluated the histopathology of the cerebral cortex from nine patients with DRE and eight patients with cavernous haemangioma undergoing surgical treatment. It analysed the expression of the NLRP3, interleukin-1β (IL-1β), caspase-1 and SIRT1 using immunohistochemistry. Additionally, the contents of NLRP3, caspase-1, IL-1β and SIRT1 in the serum samples of the included study participants were determined using ELISA method. The correlation between the NLRP3 pathway and the SIRT1 was assessed using Spearman's correlation analysis. RESULTS The expression of NLRP3, caspase-1 and IL-1β in the cerebral cortex of patients with DRE was elevated, with the NLRP3 expression being negatively correlated with the SIRT1 expression. Furthermore, IL-1β in serum was upregulated in patients with DRE. The correlation between the content of serum SIRT1 and NLRP3, caspase-1 and IL-1β in patients with DRE was not significant. Notably, serum caspase-1 levels were obviously higher in patients with bilateral hippocampal sclerosis than in patients with unilateral hippocampal sclerosis. CONCLUSIONS The current results indicate that the expression of the NLRP3/caspase-1/IL-1β pathway is significantly upregulated in patients with DRE and that it is partially correlated with the SIRT1 expression. This study is important for understanding the pathophysiology of DRE and developing new treatment strategies for it.
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Affiliation(s)
- Qing Li
- Department of Neurology, Key Laboratory of Neurology of Hebei Province, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, People's Republic of China
| | - Zhenzhen Qu
- Department of Neurology, Key Laboratory of Neurology of Hebei Province, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, People's Republic of China
| | - Lijing Jia
- Department of Neurology, Key Laboratory of Neurology of Hebei Province, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, People's Republic of China
| | - Weiping Wang
- Department of Neurology, Key Laboratory of Neurology of Hebei Province, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, People's Republic of China.
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19
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Chi W, Kiskinis E. Integrative analysis of epilepsy-associated genes reveals expression-phenotype correlations. Sci Rep 2024; 14:3587. [PMID: 38351047 PMCID: PMC10864290 DOI: 10.1038/s41598-024-53494-2] [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: 07/28/2023] [Accepted: 02/01/2024] [Indexed: 02/16/2024] Open
Abstract
Epilepsy is a highly prevalent neurological disorder characterized by recurrent seizures. Patients exhibit broad genetic, molecular, and clinical diversity involving mild to severe comorbidities. The factors that contribute to this phenotypic diversity remain unclear. Here we used publicly available datasets to systematically interrogate the expression pattern of 230 epilepsy-associated genes across human tissues, developmental stages, and central nervous system (CNS) cellular subtypes. We grouped genes based on their curated phenotypes into 3 broad classes: core epilepsy genes (CEG), where seizures are the dominant phenotype, developmental and epileptic encephalopathy genes (DEEG) that are associated with developmental and epileptic encephalopathy, and seizure-related genes (SRG), which are characterized by the presence of seizures and gross brain malformations. We find that compared to the other two groups of genes, DEEGs are highly expressed within the adult CNS, exhibit the highest and most dynamic expression in various brain regions across development, and are significantly enriched in GABAergic neurons. Our analysis provides an overview of the expression pattern of epilepsy-associated genes with spatiotemporal resolution and establishes a broad expression-phenotype correlation in epilepsy.
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Affiliation(s)
- Wanhao Chi
- The Ken & Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA.
| | - Evangelos Kiskinis
- The Ken & Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA.
- Simpson Querrey Institute, Northwestern University, Chicago, IL, 60611, USA.
- Department of Neuroscience, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA.
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20
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Wang W, Ren Y, Xu F, Zhang X, Wang F, Wang T, Zhong H, Wang X, Yao Y. Identification of hub genes significantly linked to temporal lobe epilepsy and apoptosis via bioinformatics analysis. Front Mol Neurosci 2024; 17:1300348. [PMID: 38384278 PMCID: PMC10879302 DOI: 10.3389/fnmol.2024.1300348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 01/23/2024] [Indexed: 02/23/2024] Open
Abstract
Background Epilepsy stands as an intricate disorder of the central nervous system, subject to the influence of diverse risk factors and a significant genetic predisposition. Within the pathogenesis of temporal lobe epilepsy (TLE), the apoptosis of neurons and glial cells in the brain assumes pivotal importance. The identification of differentially expressed apoptosis-related genes (DEARGs) emerges as a critical imperative, providing essential guidance for informed treatment decisions. Methods We obtained datasets related to epilepsy, specifically GSE168375 and GSE186334. Utilizing differential expression analysis, we identified a set of 249 genes exhibiting significant variations. Subsequently, through an intersection with apoptosis-related genes, we pinpointed 16 genes designated as differentially expressed apoptosis-related genes (DEARGs). These DEARGs underwent a comprehensive array of analyses, including enrichment analyses, biomarker selection, disease classification modeling, immune infiltration analysis, prediction of miRNA and transcription factors, and molecular docking analysis. Results In the epilepsy datasets examined, we successfully identified 16 differentially expressed apoptosis-related genes (DEARGs). Subsequent validation in the external dataset GSE140393 revealed the diagnostic potential of five biomarkers (CD38, FAIM2, IL1B, PAWR, S100A8) with remarkable accuracy, exhibiting an impressive area under curve (AUC) (The overall AUC of the model constructed by the five key genes was 0.916, and the validation set was 0.722). Furthermore, a statistically significant variance (p < 0.05) was observed in T cell CD4 naive and eosinophil cells across different diagnostic groups. Exploring interaction networks uncovered intricate connections, including gene-miRNA interactions (164 interactions involving 148 miRNAs), gene-transcription factor (TF) interactions (22 interactions with 20 TFs), and gene-drug small molecule interactions (15 interactions involving 15 drugs). Notably, IL1B and S100A8 demonstrated interactions with specific drugs. Conclusion In the realm of TLE, we have successfully pinpointed noteworthy differentially expressed apoptosis-related genes (DEARGs), including CD38, FAIM2, IL1B, PAWR, and S100A8. A comprehensive understanding of the implications associated with these identified genes not only opens avenues for advancing our comprehension of the underlying pathophysiology but also bears considerable potential in guiding the development of innovative diagnostic methodologies and therapeutic interventions for the effective management of epilepsy in the future.
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Affiliation(s)
- Weiliang Wang
- Epilepsy Center, Xiamen Humanity Hospital, Fujian Medical University, Xiamen, Fujian, China
| | - Yinghao Ren
- Department of Dermatology, Xiamen Humanity Hospital, Fujian Medical University, Xiamen, Fujian, China
| | - Fei Xu
- Department of Pharmacogenomics, College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Xiaobin Zhang
- Epilepsy Center, Xiamen Humanity Hospital, Fujian Medical University, Xiamen, Fujian, China
| | - Fengpeng Wang
- Epilepsy Center, Xiamen Humanity Hospital, Fujian Medical University, Xiamen, Fujian, China
| | - Tianyu Wang
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Huijuan Zhong
- Epilepsy Center, Xiamen Humanity Hospital, Fujian Medical University, Xiamen, Fujian, China
| | - Xin Wang
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yi Yao
- Epilepsy Center, Xiamen Humanity Hospital, Fujian Medical University, Xiamen, Fujian, China
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21
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Dreier JW, Trabjerg BB, Plana-Ripoll O, Skipper N, Agerbo E, Cotsapas C, Berg AT, Christensen J. Epilepsy in childhood and school performance: a nation-wide cohort study. Brain 2024; 147:532-541. [PMID: 38102964 DOI: 10.1093/brain/awad382] [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: 08/15/2023] [Accepted: 10/26/2023] [Indexed: 12/17/2023] Open
Abstract
Childhood epilepsy has been linked to poor academic performance, but large-scale studies are lacking. In this nation-wide study of school-aged children, we examined the association between childhood epilepsy and school performance in standardized tests according to phenotypic and treatment-related characteristics. We performed a matched register-based cohort study of children born in Denmark (1997-2009) who participated in the Danish National School Test Programme between 2010 and 2019. We used population and health registers to identify children with epilepsy and a randomly sampled sex- and age-matched reference cohort without epilepsy (ratio 1:10). Norm-based test scores from language and mathematics reflecting performance as a percentile of the nation-wide distribution of scores (scale 1-100) were used to assess academic performance. Adjusted differences in mean standardized scores between children with and without epilepsy were estimated using linear regression models. Among 582 840 children participating in the School Test Programme, we identified 4659 (0.8%) children with epilepsy (52.8% males) and 46 590 matched reference children. Median age at epilepsy onset was 7.5 years (interquartile range: 4.0-10.6). Childhood epilepsy was associated with poorer school performance overall (mean score = 48.2 versus references = 56.7; adjusted difference = -6.7, 95% CI: -7.4 to -6.0), and worse performance was found in all epilepsy subgroups, including in 3534 children with uncomplicated epilepsy (i.e. no other pre-existing neurologic or intellectual disabilities and no identified possible cause for epilepsy; adjusted difference = -6.0, 95% CI: -6.8 to -5.2). No major variation by sex, age or subject was observed, but larger score differences were seen in children using antiseizure medication at time of testing (e.g. valproate monotherapy, adjusted difference = -9.3, 95% CI: -11.5 to -7.0 and lamotrigine monotherapy, adjusted difference = -13.1, 95% CI: -15.0 to -11.3) and in children with psychiatric comorbidity, especially epilepsy with comorbid intellectual disability (adjusted difference = -27.0, 95% CI: -30.0 to -23.9) and epilepsy with comorbid attention deficit/hyperactivity disorder (adjusted difference = -15.7, 95% CI: -19.0 to -12.4). Children with epilepsy scored significantly lower than their unaffected siblings (adjusted difference = -6.2, 95% CI: -7.1 to -5.4). In conclusion, childhood epilepsy was associated with impaired academic performance throughout schooling, which suggest that there is a widespread need for educational support of children with epilepsy, even when the child has no other comorbidities and when the epilepsy appears well-managed.
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Affiliation(s)
- Julie W Dreier
- National Centre for Register-Based Research, Business and Social Sciences, Aarhus University, 8210 Aarhus V, Denmark
- Centre for Integrated Register-based Research (CIRRAU), Business and Social Sciences, Aarhus University, 8210 Aarhus V, Denmark
- Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway
| | - Betina B Trabjerg
- National Centre for Register-Based Research, Business and Social Sciences, Aarhus University, 8210 Aarhus V, Denmark
- Centre for Integrated Register-based Research (CIRRAU), Business and Social Sciences, Aarhus University, 8210 Aarhus V, Denmark
| | - Oleguer Plana-Ripoll
- National Centre for Register-Based Research, Business and Social Sciences, Aarhus University, 8210 Aarhus V, Denmark
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Niels Skipper
- Department of Economics and Business Economics, Business and Social Sciences, Aarhus University, 8210 Aarhus V, Denmark
| | - Esben Agerbo
- National Centre for Register-Based Research, Business and Social Sciences, Aarhus University, 8210 Aarhus V, Denmark
- Centre for Integrated Register-based Research (CIRRAU), Business and Social Sciences, Aarhus University, 8210 Aarhus V, Denmark
| | - Chris Cotsapas
- Department of Neurology, Yale, New Haven, CT 06510, USA
- Department of Genetics, Yale, New Haven, CT 06510, USA
| | - Anne T Berg
- Department of Neurology, Northwestern University - Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Jakob Christensen
- Department of Neurology, Affiliated Member of the European Reference Network EpiCARE, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus N, Denmark
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22
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Cavirani B, Spagnoli C, Caraffi SG, Cavalli A, Cesaroni CA, Cutillo G, De Giorgis V, Frattini D, Marchetti GB, Masnada S, Peron A, Rizzi S, Varesio C, Spaccini L, Vignoli A, Canevini MP, Veggiotti P, Garavelli L, Fusco C. Genetic Epilepsies and Developmental Epileptic Encephalopathies with Early Onset: A Multicenter Study. Int J Mol Sci 2024; 25:1248. [PMID: 38279250 PMCID: PMC10816990 DOI: 10.3390/ijms25021248] [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: 12/30/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 01/28/2024] Open
Abstract
The genetic causes of epilepsies and developmental and epileptic encephalopathies (DEE) with onset in early childhood are increasingly recognized. Their outcomes vary from benign to severe disability. In this paper, we wished to retrospectively review the clinical, genetic, EEG, neuroimaging, and outcome data of patients experiencing the onset of epilepsy in the first three years of life, diagnosed and followed up in four Italian epilepsy centres (Epilepsy Centre of San Paolo University Hospital in Milan, Child Neurology and Psychiatry Unit of AUSL-IRCCS di Reggio Emilia, Pediatric Neurology Unit of Vittore Buzzi Children's Hospital, Milan, and Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia). We included 168 patients (104 with monogenic conditions, 45 with copy number variations (CNVs) or chromosomal abnormalities, and 19 with variants of unknown significance), who had been followed up for a mean of 14.75 years. We found a high occurrence of generalized seizures at onset, drug resistance, abnormal neurological examination, global developmental delay and intellectual disability, and behavioural and psychiatric comorbidities. We also documented differing presentations between monogenic issues versus CNVs and chromosomal conditions, as well as atypical/rare phenotypes. Genetic early-childhood-onset epilepsies and DEE show a very wide phenotypic and genotypic spectrum, with a high risk of complex neurological and neuropsychiatric phenotypes.
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Affiliation(s)
- Benedetta Cavirani
- Child Neuropsychiatry Unit, Azienda USL di Parma, 43121 Parma, Italy;
- Child Neurology and Psychiatry Unit, Department of Pediatrics, Presidio Ospedaliero Santa Maria Nuova, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (A.C.); (C.A.C.); (D.F.); (S.R.); (C.F.)
| | - Carlotta Spagnoli
- Child Neurology and Psychiatry Unit, Department of Pediatrics, Presidio Ospedaliero Santa Maria Nuova, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (A.C.); (C.A.C.); (D.F.); (S.R.); (C.F.)
| | - Stefano Giuseppe Caraffi
- Medical Genetics Unit, Presidio Ospedaliero Santa Maria Nuova, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy (L.G.)
| | - Anna Cavalli
- Child Neurology and Psychiatry Unit, Department of Pediatrics, Presidio Ospedaliero Santa Maria Nuova, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (A.C.); (C.A.C.); (D.F.); (S.R.); (C.F.)
| | - Carlo Alberto Cesaroni
- Child Neurology and Psychiatry Unit, Department of Pediatrics, Presidio Ospedaliero Santa Maria Nuova, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (A.C.); (C.A.C.); (D.F.); (S.R.); (C.F.)
| | - Gianni Cutillo
- Pediatric Neurology Unit, Department of Pediatric Neurology, Buzzi Children’s Hospital, 20154 Milan, Italy; (G.C.); (S.M.); (P.V.)
| | - Valentina De Giorgis
- Department of Brain and Behavioural Sciences, University of Pavia, 27100 Pavia, Italy; (V.D.G.); (C.V.)
- Department of Child Neurology and Psychiatriy, IRCCS Mondino Foundation, ERN-Epicare, 27100 Pavia, Italy
| | - Daniele Frattini
- Child Neurology and Psychiatry Unit, Department of Pediatrics, Presidio Ospedaliero Santa Maria Nuova, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (A.C.); (C.A.C.); (D.F.); (S.R.); (C.F.)
| | - Giulia Bruna Marchetti
- Medical Genetics Unit, Woman-Child-Newborn Department, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Silvia Masnada
- Pediatric Neurology Unit, Department of Pediatric Neurology, Buzzi Children’s Hospital, 20154 Milan, Italy; (G.C.); (S.M.); (P.V.)
| | - Angela Peron
- Medical Genetics, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy;
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, Università degli Studi di Firenze, 50121 Florence, Italy
- Medical Genetics, ASST Santi Paolo e Carlo, San Paolo Hospital, 20142 Milan, Italy
| | - Susanna Rizzi
- Child Neurology and Psychiatry Unit, Department of Pediatrics, Presidio Ospedaliero Santa Maria Nuova, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (A.C.); (C.A.C.); (D.F.); (S.R.); (C.F.)
| | - Costanza Varesio
- Department of Brain and Behavioural Sciences, University of Pavia, 27100 Pavia, Italy; (V.D.G.); (C.V.)
- Department of Child Neurology and Psychiatriy, IRCCS Mondino Foundation, ERN-Epicare, 27100 Pavia, Italy
| | - Luigina Spaccini
- Clinical Genetics Unit, Department of Obstetrics and Gynecology, V. Buzzi Children’s Hospital, University of Milan, 20157 Milan, Italy;
| | - Aglaia Vignoli
- Child Neuropsychiatry Unit-Epilepsy Center, ASST Santi Paolo e Carlo, San Paolo Hospital, 20142 Milan, Italy; (A.V.); (M.P.C.)
- Department of Health Sciences, University of Milan, 20157 Milan, Italy
| | - Maria Paola Canevini
- Child Neuropsychiatry Unit-Epilepsy Center, ASST Santi Paolo e Carlo, San Paolo Hospital, 20142 Milan, Italy; (A.V.); (M.P.C.)
- Department of Health Sciences, University of Milan, 20157 Milan, Italy
| | - Pierangelo Veggiotti
- Pediatric Neurology Unit, Department of Pediatric Neurology, Buzzi Children’s Hospital, 20154 Milan, Italy; (G.C.); (S.M.); (P.V.)
- Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, Italy
| | - Livia Garavelli
- Medical Genetics Unit, Presidio Ospedaliero Santa Maria Nuova, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy (L.G.)
| | - Carlo Fusco
- Child Neurology and Psychiatry Unit, Department of Pediatrics, Presidio Ospedaliero Santa Maria Nuova, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (A.C.); (C.A.C.); (D.F.); (S.R.); (C.F.)
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23
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Li X, Quan P, Si Y, Liu F, Fan Y, Ding F, Sun L, Liu H, Huang S, Sun L, Yang F, Yao L. The microRNA-211-5p/P2RX7/ERK/GPX4 axis regulates epilepsy-associated neuronal ferroptosis and oxidative stress. J Neuroinflammation 2024; 21:13. [PMID: 38191407 PMCID: PMC10773122 DOI: 10.1186/s12974-023-03009-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 12/28/2023] [Indexed: 01/10/2024] Open
Abstract
Ferroptosis is an iron-dependent cell death mechanism involving the accumulation of lipid peroxides. As a critical regulator, glutathione peroxidase 4 (GPX4) has been demonstrated to be downregulated in epilepsy. However, the mechanism of ferroptosis in epilepsy remains unclear. In this study, bioinformatics analysis, analysis of epilepsy patient blood samples and cell and mouse experiments revealed strong associations among epilepsy, ferroptosis, microRNA-211-5p and purinergic receptor P2X 7 (P2RX7). P2RX7 is a nonselective ligand-gated homotrimeric cation channel, and its activation mainly increases neuronal activity during epileptic seizures. In our study, the upregulation of P2RX7 in epilepsy was attributed to the downregulation of microRNA (miR)-211-5p. Furthermore, P2RX7 has been found to regulate GPX4/HO-1 by alleviating lipid peroxidation induced by suppression of the MAPK/ERK signaling pathway in murine models. The dynamic decrease in miR-211-5p expression induces hypersynchronization and both nonconvulsive and convulsive seizures, and forebrain miR-211-5p suppression exacerbates long-lasting pentylenetetrazole-induced seizures. Additionally, in this study, induction of miR-211-5p expression or genetic-silencing of P2RX7 significantly reduced the seizure score and duration in murine models through the abovementioned pathways. These results suggest that the miR-211-5p/P2RX7 axis is a novel target for suppressing both ferroptosis and epilepsy.
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Affiliation(s)
- Xueying Li
- Department of Neurology, The First Affiliated Hospital, Harbin Medical University, Harbin, 150081, China
| | - Pusheng Quan
- Department of Neurology, The First Affiliated Hospital, Harbin Medical University, Harbin, 150081, China
- Department of Neurology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China
| | - Yao Si
- Department of Neurology, The First Affiliated Hospital, Harbin Medical University, Harbin, 150081, China
| | - Fei Liu
- Department of Neurology, The First Affiliated Hospital, Harbin Medical University, Harbin, 150081, China
| | - Yuwei Fan
- Department of Neurology, The First Affiliated Hospital, Harbin Medical University, Harbin, 150081, China
| | - Feifan Ding
- Department of Neurology, The First Affiliated Hospital, Harbin Medical University, Harbin, 150081, China
| | - Lina Sun
- Department of Neurology, The First Affiliated Hospital, Harbin Medical University, Harbin, 150081, China
| | - Han Liu
- Department of Neurology, The First Affiliated Hospital, Harbin Medical University, Harbin, 150081, China
| | - Shuo Huang
- Department of Neurology, The First Affiliated Hospital, Harbin Medical University, Harbin, 150081, China
| | - Linlin Sun
- Department of Neurology, The First Affiliated Hospital, Harbin Medical University, Harbin, 150081, China.
| | - Fan Yang
- Department of Neurology, The First Affiliated Hospital, Harbin Medical University, Harbin, 150081, China.
| | - Lifen Yao
- Department of Neurology, The First Affiliated Hospital, Harbin Medical University, Harbin, 150081, China.
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24
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Samir S. Human DNA Mutations and their Impact on Genetic Disorders. Recent Pat Biotechnol 2024; 18:288-315. [PMID: 37936448 DOI: 10.2174/0118722083255081231020055309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 07/25/2023] [Accepted: 09/18/2023] [Indexed: 11/09/2023]
Abstract
DNA is a remarkably precise medium for copying and storing biological information. It serves as a design for cellular machinery that permits cells, organs, and even whole organisms to work. The fidelity of DNA replication results from the action of hundreds of genes involved in proofreading and damage repair. All human cells can acquire genetic changes in their DNA all over life. Genetic mutations are changes to the DNA sequence that happen during cell division when the cells make copies of themselves. Mutations in the DNA can cause genetic illnesses such as cancer, or they could help humans better adapt to their environment over time. The endogenous reactive metabolites, therapeutic medicines, and an excess of environmental mutagens, such as UV rays all continuously damage DNA, compromising its integrity. One or more chromosomal alterations and point mutations at a single site (monogenic mutation) including deletions, duplications, and inversions illustrate such DNA mutations. Genetic conditions can occur when an altered gene is inherited from parents, which increases the risk of developing that particular condition, or some gene alterations can happen randomly. Moreover, symptoms of genetic conditions depend on which gene has a mutation. There are many different diseases and conditions caused by mutations. Some of the most common genetic conditions are Alzheimer's disease, some cancers, cystic fibrosis, Down syndrome, and sickle cell disease. Interestingly, scientists find that DNA mutations are more common than formerly thought. This review outlines the main DNA mutations that occur along the human genome and their influence on human health. The subject of patents pertaining to DNA mutations and genetic disorders has been brought up.
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Affiliation(s)
- Safia Samir
- Department of Biochemistry and Molecular Biology, Theodor Bilharz Research Institute, Giza, Egypt
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25
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Cui X, Jia R, Zhao R, Ma N, Jiang F. Silencing PKM2 Attenuates Brain Injury Induced by Status Epilepticus by Inhibiting the AKT/mTOR Pathway and the NLRP3 Inflammasome. Neurochem Res 2024; 49:212-221. [PMID: 37702892 DOI: 10.1007/s11064-023-04023-6] [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: 07/14/2023] [Revised: 08/14/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023]
Abstract
PKM2 is a glycolytic pyruvate kinase isoenzyme, and its role in neurological diseases has been published. However, the role and mechanism of PKM2 in the process of status epilepticus have not been reported. The purpose of this study is to explore the role and mechanism of PKM2 in epilepsy. Quantitative real-time polymerase chain reaction (qRT-PCR) and western blotting were used to explore the expression of PKM2 in cells. Enzyme-linked immunosorbent assay kits were used to evaluate the level of inflammatory factors. An epilepsy model was established by intraperitoneal injection of lithium chloride in rats. Various behavioural assays were conducted to explore the learning ability and cognitive level of rats. PKM2 expression was upregulated in Mg2+-induced hippocampal neurons. PKM2 inhibition ameliorated Mg2+-induced hippocampal neuronal inflammation and reduced neuronal apoptosis. In addition, PKM2 silencing inhibited the metabolic dysfunction of Mg2+-induced hippocampal neurons. Subsequent experiments showed that the Akt/mTOR pathway and NLRP3 inflammasome are involved in PKM2-mediated neuronal regulation. More importantly, PKM2 inhibition could alleviate status epilepticus in rats. PKM2 inhibition attenuates Mg2+-induced hippocampal neuronal inflammation, apoptosis and metabolic dysfunction and improves the cognitive ability of rats. Therefore, PKM2 may be an important target for epilepsy treatment.
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Affiliation(s)
- Xiaoli Cui
- Department of Neurology, Shaanxi Provincial People's Hospital, No. 256 West Friendship Road, Xi'an, 710068, Shaanxi, China
| | - Ruihua Jia
- Department of Neurology, Shaanxi Provincial People's Hospital, No. 256 West Friendship Road, Xi'an, 710068, Shaanxi, China
| | - Rui Zhao
- Department of Neurology, Shaanxi Provincial People's Hospital, No. 256 West Friendship Road, Xi'an, 710068, Shaanxi, China
| | - Ni Ma
- Department of Neurology, Shaanxi Provincial People's Hospital, No. 256 West Friendship Road, Xi'an, 710068, Shaanxi, China
| | - Feng Jiang
- Department of Neurology, Shaanxi Provincial People's Hospital, No. 256 West Friendship Road, Xi'an, 710068, Shaanxi, China.
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26
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Gao X, Zhang W, Dong Z, Ren J, Song B, Zhang R, Yuan J. FRET Luminescent Probe for the Ratiometric Imaging of Peroxynitrite in Rat Brain Models of Epilepsy-Based on Organic Dye-Conjugated Iridium(III) Complex. Anal Chem 2023; 95:18530-18539. [PMID: 38048161 DOI: 10.1021/acs.analchem.3c03908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
Epilepsy is a chronic neurological disorder characterized by recurrent seizures globally, imposing a substantial burden on patients and their families. The pathological role of peroxynitrite (ONOO-), which can trigger oxidative stress, inflammation, and neuronal hyperexcitability, is critical in epilepsy. However, the development of reliable, in situ, and real-time optical imaging tools to detect ONOO- in the brain encounters some challenges related to the depth of tissue penetration, background interference, optical bleaching, and spectral overlapping. To address these limitations, we present Ir-CBM, a new one-photon and two-photon excitable and long-lived ratiometric luminescent probe designed specifically for precise detection of ONOO- in epilepsy-based on the Förster resonance energy transfer mechanism by combining an iridium(III) complex with an organic fluorophore. Ir-CBM possesses the advantages of rapid response, one-/two-photon excitation, and ratiometric luminescent imaging for monitoring the cellular levels of ONOO- and evaluating the effects of different therapeutic drugs on ONOO- in the brain of an epilepsy model rat. The development and utilization of Ir-CBM offer valuable insights into the design of ratiometric luminescent probes. Furthermore, Ir-CBM serves as a rapid imaging and screening tool for antiepileptic drugs, thereby accelerating the exploration of novel antiepileptic drug screening and improving preventive and therapeutic strategies in epilepsy research.
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Affiliation(s)
- Xiaona Gao
- School of Chemistry, Dalian University of Technology, Dalian 116024, China
| | - Wenzhu Zhang
- School of Chemistry, Dalian University of Technology, Dalian 116024, China
| | - Zhiyuan Dong
- School of Chemistry, Dalian University of Technology, Dalian 116024, China
| | - Junyu Ren
- School of Chemistry, Dalian University of Technology, Dalian 116024, China
| | - Bo Song
- School of Chemistry, Dalian University of Technology, Dalian 116024, China
| | - Run Zhang
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Jingli Yuan
- School of Chemistry, Dalian University of Technology, Dalian 116024, China
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27
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Johannesen KM, Tümer Z, Weckhuysen S, Barakat TS, Bayat A. Solving the unsolved genetic epilepsies: Current and future perspectives. Epilepsia 2023; 64:3143-3154. [PMID: 37750451 DOI: 10.1111/epi.17780] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 09/27/2023]
Abstract
Many patients with epilepsy undergo exome or genome sequencing as part of a diagnostic workup; however, many remain genetically unsolved. There are various factors that account for negative results in exome/genome sequencing for patients with epilepsy: (1) the underlying cause is not genetic; (2) there is a complex polygenic explanation; (3) the illness is monogenic but the causative gene remains to be linked to a human disorder; (4) family segregation with reduced penetrance; (5) somatic mosaicism or the complexity of, for example, a structural rearrangement; or (6) limited knowledge or diagnostic tools that hinder the proper classification of a variant, resulting in its designation as a variant of unknown significance. The objective of this review is to outline some of the diagnostic options that lie beyond the exome/genome, and that might become clinically relevant within the foreseeable future. These options include: (1) re-analysis of older exome/genome data as knowledge increases or symptoms change; (2) looking for somatic mosaicism or long-read sequencing to detect low-complexity repeat variants or specific structural variants missed by traditional exome/genome sequencing; (3) exploration of the non-coding genome including disruption of topologically associated domains, long range non-coding RNA, or other regulatory elements; and finally (4) transcriptomics, DNA methylation signatures, and metabolomics as complementary diagnostic methods that may be used in the assessment of variants of unknown significance. Some of these tools are currently not integrated into standard diagnostic workup. However, it is reasonable to expect that they will become increasingly available and improve current diagnostic capabilities, thereby enabling precision diagnosis in patients who are currently undiagnosed.
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Affiliation(s)
- Katrine M Johannesen
- Department of Genetics, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Epilepsy Genetics and Personalized Medicine, The Danish Epilepsy Center, Dianalund, Denmark
| | - Zeynep Tümer
- Department of Genetics, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sarah Weckhuysen
- Applied and Translational Neurogenomics Group, VIB Centre for Molecular Neurology, Antwerp, Belgium
- Translational Neurosciences, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
- Department of Neurology, University Hospital Antwerp, Antwerp, Belgium
- μNEURO Research Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Tahsin Stefan Barakat
- Department of Clinical Genetics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Discovery Unit, Department of Clinical Genetics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Allan Bayat
- Department of Epilepsy Genetics and Personalized Medicine, The Danish Epilepsy Center, Dianalund, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
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Wang YJ, Vu GH, Mu TW. Pathogenicity Prediction of GABA A Receptor Missense Variants. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.14.567135. [PMID: 38014242 PMCID: PMC10680766 DOI: 10.1101/2023.11.14.567135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Variants in the genes encoding the subunits of gamma-aminobutyric acid type A (GABA A ) receptors are associated with epilepsy. To date, over 1000 clinical variants have been identified in these genes. However, the majority of these variants lack functional studies and their clinical significance is uncertain although accumulating evidence indicates that proteostasis deficiency is the major disease-causing mechanism for GABA A receptor variants. Here, we apply two state-of-the-art modeling tools, namely AlphaMissense, which uses an artificial intelligence-based approach based on AlphaFold structures, and Rhapsody, which integrates sequence evolution and known structure-based data, to predict the pathogenicity of saturating missense variants in genes that encode the major subunits of GABA A receptors in the central nervous system, including GABRA1 , GABRB2 , GABRB3 , and GABRG2 . Our results demonstrate that the predicted pathogenicity correlates well between AlphaMissense and Rhapsody although AlphaMissense tends to generate higher pathogenic probability. Furthermore, almost all annotated pathogenic variants in the ClinVar clinical database are successfully identified from the prediction, whereas uncertain variants from ClinVar partially due to the lack of experimental data are differentiated into different pathogenicity groups. The pathogenicity prediction of GABA A receptor missense variants provides a resource to the community as well as guidance for future experimental and clinical investigations.
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Zhou Z, Wu S, Zou X, Gu S. Association between SCN1A polymorphism and risk of epilepsy in children: A systematic review and meta-analysis. Seizure 2023; 112:40-47. [PMID: 37741152 DOI: 10.1016/j.seizure.2023.09.012] [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: 07/03/2023] [Revised: 08/28/2023] [Accepted: 09/14/2023] [Indexed: 09/25/2023] Open
Abstract
Epilepsy is a common neurological disorder in children. Numerous studies have demonstrated the association between SCN1A polymorphisms and risk of epilepsy in adults, but their role in epilepsy in children has just gained traction and results have remained inconsistent. In this work, we performed a systematic review and meta-analysis to assess the association between SCN1A polymorphisms and risk for epilepsy in children. A systematic literature search was performed in PubMed, Scopus, Web of Science, China National Knowledge Internet, Wanfang and VIP databases to identify eligible studies up to June 2023. Quantitative data synthesis was then performed under five genetic models: dominant, recessive, homozygous, heterozygous, and allele. Five studies involving 1380 subjects were included in the meta-analysis. Among many SCN1A polymorphisms reported, only rs2298771 was repeatedly studied in these reports. Pooled analysis demonstrated that there was no significant association between the polymorphism and risk of epilepsy in children (P>0.05). In conclusion, SCN1A rs2298771 polymorphism was not significantly associated with the risk of epilepsy in children.
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Affiliation(s)
- Zhihong Zhou
- School of Nursing, Hebi Polytechnic, Hebi, 458030, China; SeHan University, Yeongam-gun, Jeollanam-do, 58447, Republic of Korea.
| | - Shuihua Wu
- Department of Neurosurgery, Hunan Children's Hospital, Changsha City, 410006, China
| | - Xin Zou
- Department of Neurosurgery, Hunan Children's Hospital, Changsha City, 410006, China
| | - Shuo Gu
- Department of Neurosurgery, The First Affiliated Hospital of Hainan Medical College, Haikou City, 570102, China
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30
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Paavola JT, Jokimäki J, Huttunen TJ, Fraunberg MVUZ, Koivisto T, Kämäräinen OP, Lång M, Jääskeläinen JE, Kälviäinen R, Lindgren AE, Huttunen J. Long-term Risk of Epilepsy in Subarachnoid Hemorrhage Survivors With Positive Family History: A Population-Based Follow-up Study. Neurology 2023; 101:e1623-e1632. [PMID: 37643884 PMCID: PMC10585675 DOI: 10.1212/wnl.0000000000207737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 06/20/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating form of stroke affecting the working-age population, where epilepsy is a common complication and major prognostic factor for increased morbidity in aSAH survivors. The objective of this analysis was to assess whether epilepsy in first-degree relatives is a risk of developing epilepsy after aSAH. METHODS We used a region-specific database that includes all cases of unruptured and ruptured saccular intracranial aneurysm admitted to Kuopio University Hospital from its defined Eastern Finnish catchment population. We also retrieved data from Finnish national health registries for prescription drug purchases and reimbursement, hospital discharge, and cause of death and linked them to patients with aSAH, their first-degree relatives, and population controls matched 3:1 by age, sex, and birth municipality. Cox regression modeling and Kaplan-Meier survival curves were used for analysis. RESULTS We examined data for 760 consecutive 12-month survivors of aSAH, born in 1950 or after, with a first aSAH from January 1, 1995, to December 31, 2018. Of the 760 patients (median age, 47 years; 53% female; median follow-up, 11 years), 111 (15%) developed epilepsy at a median of 7 months (interquartile range, 2-14 months) after admission for aSAH. Of the 2,240 population controls and 4,653 first-degree relatives of patients with aSAH, 23 (0.9%) and 80 (1.7%), respectively, developed epilepsy during the follow-up period. Among 79 patients with epilepsy in first-degree relatives, 22 (28%) developed epilepsy after aSAH; by contrast, among 683 patients with no epilepsy in first-degree relatives, 89 (13%) developed epilepsy after aSAH. Having at least 1 relative with epilepsy was an independent risk factor of epilepsy after aSAH (hazard ratio, 2.44; 95% CI 1.51-3.95). Cumulative 1-year rates by first-degree relationship were 40% with 1 or more children with epilepsy, 38% with 1 or more affected parents, 5% with 1 or more affected siblings, and 10% with no relatives with epilepsy. DISCUSSION Patients who developed epilepsy after aSAH were significantly more likely to have first-degree relatives with epilepsy than those who did not develop epilepsy after the aSAH.
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Affiliation(s)
- Juho Tapio Paavola
- From the Neurosurgery of NeuroCenter (J.T.P., T.J.H., T.K., O.-P.K., J.E.J., R.K., A.E.L., J.H.), Kuopio University Hospital; Institute of Clinical Medicine (J.T.P., J.J., T.J.H., T.K., O.-P.K., M.L., J.E.J., A.E.L., J.H.), Faculty of Health Sciences, University of Eastern Finland, Kuopio; Department of Neurosurgery (M.U.Z.F.), Oulu University Hospital; Research Unit of Clinical Medicine (M.U.Z.F.), University of Oulu; Neurointensive Care Unit (M.L.), Kuopio University Hospital; Epilepsy Center (R.K.), Neuro Center, Kuopio University Hospital, Member of the European Reference Network EpiCARE; and Department of Clinical Radiology (A.E.L.), Kuopio University Hospital, Finland.
| | - Jenna Jokimäki
- From the Neurosurgery of NeuroCenter (J.T.P., T.J.H., T.K., O.-P.K., J.E.J., R.K., A.E.L., J.H.), Kuopio University Hospital; Institute of Clinical Medicine (J.T.P., J.J., T.J.H., T.K., O.-P.K., M.L., J.E.J., A.E.L., J.H.), Faculty of Health Sciences, University of Eastern Finland, Kuopio; Department of Neurosurgery (M.U.Z.F.), Oulu University Hospital; Research Unit of Clinical Medicine (M.U.Z.F.), University of Oulu; Neurointensive Care Unit (M.L.), Kuopio University Hospital; Epilepsy Center (R.K.), Neuro Center, Kuopio University Hospital, Member of the European Reference Network EpiCARE; and Department of Clinical Radiology (A.E.L.), Kuopio University Hospital, Finland
| | - Terhi Johanna Huttunen
- From the Neurosurgery of NeuroCenter (J.T.P., T.J.H., T.K., O.-P.K., J.E.J., R.K., A.E.L., J.H.), Kuopio University Hospital; Institute of Clinical Medicine (J.T.P., J.J., T.J.H., T.K., O.-P.K., M.L., J.E.J., A.E.L., J.H.), Faculty of Health Sciences, University of Eastern Finland, Kuopio; Department of Neurosurgery (M.U.Z.F.), Oulu University Hospital; Research Unit of Clinical Medicine (M.U.Z.F.), University of Oulu; Neurointensive Care Unit (M.L.), Kuopio University Hospital; Epilepsy Center (R.K.), Neuro Center, Kuopio University Hospital, Member of the European Reference Network EpiCARE; and Department of Clinical Radiology (A.E.L.), Kuopio University Hospital, Finland
| | - Mikael von Und Zu Fraunberg
- From the Neurosurgery of NeuroCenter (J.T.P., T.J.H., T.K., O.-P.K., J.E.J., R.K., A.E.L., J.H.), Kuopio University Hospital; Institute of Clinical Medicine (J.T.P., J.J., T.J.H., T.K., O.-P.K., M.L., J.E.J., A.E.L., J.H.), Faculty of Health Sciences, University of Eastern Finland, Kuopio; Department of Neurosurgery (M.U.Z.F.), Oulu University Hospital; Research Unit of Clinical Medicine (M.U.Z.F.), University of Oulu; Neurointensive Care Unit (M.L.), Kuopio University Hospital; Epilepsy Center (R.K.), Neuro Center, Kuopio University Hospital, Member of the European Reference Network EpiCARE; and Department of Clinical Radiology (A.E.L.), Kuopio University Hospital, Finland
| | - Timo Koivisto
- From the Neurosurgery of NeuroCenter (J.T.P., T.J.H., T.K., O.-P.K., J.E.J., R.K., A.E.L., J.H.), Kuopio University Hospital; Institute of Clinical Medicine (J.T.P., J.J., T.J.H., T.K., O.-P.K., M.L., J.E.J., A.E.L., J.H.), Faculty of Health Sciences, University of Eastern Finland, Kuopio; Department of Neurosurgery (M.U.Z.F.), Oulu University Hospital; Research Unit of Clinical Medicine (M.U.Z.F.), University of Oulu; Neurointensive Care Unit (M.L.), Kuopio University Hospital; Epilepsy Center (R.K.), Neuro Center, Kuopio University Hospital, Member of the European Reference Network EpiCARE; and Department of Clinical Radiology (A.E.L.), Kuopio University Hospital, Finland
| | - Olli-Pekka Kämäräinen
- From the Neurosurgery of NeuroCenter (J.T.P., T.J.H., T.K., O.-P.K., J.E.J., R.K., A.E.L., J.H.), Kuopio University Hospital; Institute of Clinical Medicine (J.T.P., J.J., T.J.H., T.K., O.-P.K., M.L., J.E.J., A.E.L., J.H.), Faculty of Health Sciences, University of Eastern Finland, Kuopio; Department of Neurosurgery (M.U.Z.F.), Oulu University Hospital; Research Unit of Clinical Medicine (M.U.Z.F.), University of Oulu; Neurointensive Care Unit (M.L.), Kuopio University Hospital; Epilepsy Center (R.K.), Neuro Center, Kuopio University Hospital, Member of the European Reference Network EpiCARE; and Department of Clinical Radiology (A.E.L.), Kuopio University Hospital, Finland
| | - Maarit Lång
- From the Neurosurgery of NeuroCenter (J.T.P., T.J.H., T.K., O.-P.K., J.E.J., R.K., A.E.L., J.H.), Kuopio University Hospital; Institute of Clinical Medicine (J.T.P., J.J., T.J.H., T.K., O.-P.K., M.L., J.E.J., A.E.L., J.H.), Faculty of Health Sciences, University of Eastern Finland, Kuopio; Department of Neurosurgery (M.U.Z.F.), Oulu University Hospital; Research Unit of Clinical Medicine (M.U.Z.F.), University of Oulu; Neurointensive Care Unit (M.L.), Kuopio University Hospital; Epilepsy Center (R.K.), Neuro Center, Kuopio University Hospital, Member of the European Reference Network EpiCARE; and Department of Clinical Radiology (A.E.L.), Kuopio University Hospital, Finland
| | - Juha Eerik Jääskeläinen
- From the Neurosurgery of NeuroCenter (J.T.P., T.J.H., T.K., O.-P.K., J.E.J., R.K., A.E.L., J.H.), Kuopio University Hospital; Institute of Clinical Medicine (J.T.P., J.J., T.J.H., T.K., O.-P.K., M.L., J.E.J., A.E.L., J.H.), Faculty of Health Sciences, University of Eastern Finland, Kuopio; Department of Neurosurgery (M.U.Z.F.), Oulu University Hospital; Research Unit of Clinical Medicine (M.U.Z.F.), University of Oulu; Neurointensive Care Unit (M.L.), Kuopio University Hospital; Epilepsy Center (R.K.), Neuro Center, Kuopio University Hospital, Member of the European Reference Network EpiCARE; and Department of Clinical Radiology (A.E.L.), Kuopio University Hospital, Finland
| | - Reetta Kälviäinen
- From the Neurosurgery of NeuroCenter (J.T.P., T.J.H., T.K., O.-P.K., J.E.J., R.K., A.E.L., J.H.), Kuopio University Hospital; Institute of Clinical Medicine (J.T.P., J.J., T.J.H., T.K., O.-P.K., M.L., J.E.J., A.E.L., J.H.), Faculty of Health Sciences, University of Eastern Finland, Kuopio; Department of Neurosurgery (M.U.Z.F.), Oulu University Hospital; Research Unit of Clinical Medicine (M.U.Z.F.), University of Oulu; Neurointensive Care Unit (M.L.), Kuopio University Hospital; Epilepsy Center (R.K.), Neuro Center, Kuopio University Hospital, Member of the European Reference Network EpiCARE; and Department of Clinical Radiology (A.E.L.), Kuopio University Hospital, Finland
| | - Antti Elias Lindgren
- From the Neurosurgery of NeuroCenter (J.T.P., T.J.H., T.K., O.-P.K., J.E.J., R.K., A.E.L., J.H.), Kuopio University Hospital; Institute of Clinical Medicine (J.T.P., J.J., T.J.H., T.K., O.-P.K., M.L., J.E.J., A.E.L., J.H.), Faculty of Health Sciences, University of Eastern Finland, Kuopio; Department of Neurosurgery (M.U.Z.F.), Oulu University Hospital; Research Unit of Clinical Medicine (M.U.Z.F.), University of Oulu; Neurointensive Care Unit (M.L.), Kuopio University Hospital; Epilepsy Center (R.K.), Neuro Center, Kuopio University Hospital, Member of the European Reference Network EpiCARE; and Department of Clinical Radiology (A.E.L.), Kuopio University Hospital, Finland
| | - Jukka Huttunen
- From the Neurosurgery of NeuroCenter (J.T.P., T.J.H., T.K., O.-P.K., J.E.J., R.K., A.E.L., J.H.), Kuopio University Hospital; Institute of Clinical Medicine (J.T.P., J.J., T.J.H., T.K., O.-P.K., M.L., J.E.J., A.E.L., J.H.), Faculty of Health Sciences, University of Eastern Finland, Kuopio; Department of Neurosurgery (M.U.Z.F.), Oulu University Hospital; Research Unit of Clinical Medicine (M.U.Z.F.), University of Oulu; Neurointensive Care Unit (M.L.), Kuopio University Hospital; Epilepsy Center (R.K.), Neuro Center, Kuopio University Hospital, Member of the European Reference Network EpiCARE; and Department of Clinical Radiology (A.E.L.), Kuopio University Hospital, Finland
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Skoczylas S, Jakiel P, Płoszaj T, Gadzalska K, Borowiec M, Pastorczak A, Moczulska H, Malarska M, Eckersdorf-Mastalerz A, Budzyńska E, Zmysłowska A. Novel potentially pathogenic variants detected in genes causing intellectual disability and epilepsy in Polish families. Neurogenetics 2023; 24:221-229. [PMID: 37405542 PMCID: PMC10545623 DOI: 10.1007/s10048-023-00724-w] [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: 05/25/2023] [Accepted: 06/27/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Intellectual disability (ID) affects 1-3% of the world population. The number of genes whose dysfunctions cause intellectual disability is increasing. In addition, new gene associations are constantly being discovered, as well as specific phenotypic features for already identified genetic alterations are being described. The aim of our study was to search for pathogenic variants in genes responsible for moderate to severe intellectual disability and epilepsy, using a panel of targeted next-generation sequencing (tNGS) for diagnosis. METHODS The group of 73 patients (ID, n=32; epilepsy, n=21; ID and epilepsy, n=18) was enrolled in the nucleus DNA (nuDNA) study using a tNGS panel (Agilent Technologies, USA). In addition, high coverage mitochondrial DNA (mtDNA) was extracted from the tNGS data for 54 patients. RESULTS Fifty-two rare nuDNA variants, as well as 10 rare and 1 novel mtDNA variants, were found in patients in the study group. The 10 most damaging nuDNA variants were subjected to a detailed clinical analysis. Finally, 7 nuDNA and 1 mtDNA were found to be the cause of the disease. CONCLUSIONS This shows that still a very large proportion of patients remain undiagnosed and may require further testing. The reason for the negative results of our analysis may be a non-genetic cause of the observed phenotypes or failure to detect the causative variant in the genome. In addition, the study clearly shows that analysis of the mtDNA genome is clinically relevant, as approximately 1% of patients with ID may have pathogenic variant in mitochondrial DNA.
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Affiliation(s)
- S Skoczylas
- 1Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland.
| | - P Jakiel
- 1Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland
| | - T Płoszaj
- 1Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland
| | - K Gadzalska
- 1Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland
| | - M Borowiec
- 1Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland
| | - A Pastorczak
- 1Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland
| | - H Moczulska
- 1Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland
| | - M Malarska
- 1Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland
| | | | - E Budzyńska
- 1Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland
| | - A Zmysłowska
- 1Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland
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32
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Rastin C, Schenkel LC, Sadikovic B. Complexity in Genetic Epilepsies: A Comprehensive Review. Int J Mol Sci 2023; 24:14606. [PMID: 37834053 PMCID: PMC10572646 DOI: 10.3390/ijms241914606] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Epilepsy is a highly prevalent neurological disorder, affecting between 5-8 per 1000 individuals and is associated with a lifetime risk of up to 3%. In addition to high incidence, epilepsy is a highly heterogeneous disorder, with variation including, but not limited to the following: severity, age of onset, type of seizure, developmental delay, drug responsiveness, and other comorbidities. Variable phenotypes are reflected in a range of etiologies including genetic, infectious, metabolic, immune, acquired/structural (resulting from, for example, a severe head injury or stroke), or idiopathic. This review will focus specifically on epilepsies with a genetic cause, genetic testing, and biomarkers in epilepsy.
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Affiliation(s)
- Cassandra Rastin
- Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, ON N6A 5W9, Canada
- Department of Pathology and Laboratory Medicine, Western University, London, ON N6A 3K7, Canada
| | - Laila C. Schenkel
- Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, ON N6A 5W9, Canada
- Department of Pathology and Laboratory Medicine, Western University, London, ON N6A 3K7, Canada
| | - Bekim Sadikovic
- Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, ON N6A 5W9, Canada
- Department of Pathology and Laboratory Medicine, Western University, London, ON N6A 3K7, Canada
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Zeibich R, Kwan P, J. O’Brien T, Perucca P, Ge Z, Anderson A. Applications for Deep Learning in Epilepsy Genetic Research. Int J Mol Sci 2023; 24:14645. [PMID: 37834093 PMCID: PMC10572791 DOI: 10.3390/ijms241914645] [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: 08/23/2023] [Revised: 09/11/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
Epilepsy is a group of brain disorders characterised by an enduring predisposition to generate unprovoked seizures. Fuelled by advances in sequencing technologies and computational approaches, more than 900 genes have now been implicated in epilepsy. The development and optimisation of tools and methods for analysing the vast quantity of genomic data is a rapidly evolving area of research. Deep learning (DL) is a subset of machine learning (ML) that brings opportunity for novel investigative strategies that can be harnessed to gain new insights into the genomic risk of people with epilepsy. DL is being harnessed to address limitations in accuracy of long-read sequencing technologies, which improve on short-read methods. Tools that predict the functional consequence of genetic variation can represent breaking ground in addressing critical knowledge gaps, while methods that integrate independent but complimentary data enhance the predictive power of genetic data. We provide an overview of these DL tools and discuss how they may be applied to the analysis of genetic data for epilepsy research.
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Affiliation(s)
- Robert Zeibich
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC 3800, Australia; (R.Z.); (P.K.); (T.J.O.); (P.P.)
| | - Patrick Kwan
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC 3800, Australia; (R.Z.); (P.K.); (T.J.O.); (P.P.)
- Department of Neurology, Alfred Health, Melbourne, VIC 3004, Australia
- Department of Neurology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC 3052, Australia
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Terence J. O’Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC 3800, Australia; (R.Z.); (P.K.); (T.J.O.); (P.P.)
- Department of Neurology, Alfred Health, Melbourne, VIC 3004, Australia
- Department of Neurology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC 3052, Australia
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Piero Perucca
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC 3800, Australia; (R.Z.); (P.K.); (T.J.O.); (P.P.)
- Department of Neurology, Alfred Health, Melbourne, VIC 3004, Australia
- Department of Neurology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC 3052, Australia
- Epilepsy Research Centre, Department of Medicine, Austin Health, The University of Melbourne, Melbourne, VIC 3084, Australia
- Bladin-Berkovic Comprehensive Epilepsy Program, Department of Neurology, Austin Health, The University of Melbourne, Melbourne, VIC 3084, Australia
| | - Zongyuan Ge
- Faculty of Engineering, Monash University, Melbourne, VIC 3800, Australia;
- Monash-Airdoc Research, Monash University, Melbourne, VIC 3800, Australia
| | - Alison Anderson
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC 3800, Australia; (R.Z.); (P.K.); (T.J.O.); (P.P.)
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC 3052, Australia
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Girard A, Moreau C, Michaud JL, Minassian B, Cossette P, Girard SL. Unraveling the role of non-coding rare variants in epilepsy. PLoS One 2023; 18:e0291935. [PMID: 37756314 PMCID: PMC10529579 DOI: 10.1371/journal.pone.0291935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/10/2023] [Indexed: 09/29/2023] Open
Abstract
The discovery of new variants has leveled off in recent years in epilepsy studies, despite the use of very large cohorts. Consequently, most of the heritability is still unexplained. Rare non-coding variants have been largely ignored in studies on epilepsy, although non-coding single nucleotide variants can have a significant impact on gene expression. We had access to whole genome sequencing (WGS) from 247 epilepsy patients and 377 controls. To assess the functional impact of non-coding variants, ExPecto, a deep learning algorithm was used to predict expression change in brain tissues. We compared the burden of rare non-coding deleterious variants between cases and controls. Rare non-coding highly deleterious variants were significantly enriched in Genetic Generalized Epilepsy (GGE), but not in Non-Acquired Focal Epilepsy (NAFE) or all epilepsy cases when compared with controls. In this study we showed that rare non-coding deleterious variants are associated with epilepsy, specifically with GGE. Larger WGS epilepsy cohort will be needed to investigate those effects at a greater resolution. Nevertheless, we demonstrated the importance of studying non-coding regions in epilepsy, a disease where new discoveries are scarce.
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Affiliation(s)
- Alexandre Girard
- Centre Intersectoriel en Santé Durable, University of Quebec in Chicoutimi, Saguenay, Canada
| | - Claudia Moreau
- Centre Intersectoriel en Santé Durable, University of Quebec in Chicoutimi, Saguenay, Canada
| | - Jacques L. Michaud
- CHU Sainte-Justine, Montréal, Canada
- Department of Neurosciences and Department of Pediatrics, University of Montreal, Montréal, Canada
| | - Berge Minassian
- The Hospital for Sick Children, Department of Pediatrics, Toronto, Canada
- Department of Pediatrics, University of Texas Southwestern Medical School, Dallas, Texas, United States of America
| | - Patrick Cossette
- CHUM Research Center, Montréal, Canada
- Department of Neurosciences, University of Montreal, Montréal, Canada
| | - Simon L. Girard
- Centre Intersectoriel en Santé Durable, University of Quebec in Chicoutimi, Saguenay, Canada
- CERVO Research Center, Laval University, Québec, Canada
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35
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Trujillo S, Wetmore JB, Camarillo IA, Misiewicz S, May H, Choi H, Siegel K, Chung WK, Phelan JC, Yang LH, Leu CS, Bergner AL, Ottman R. Knowledge and beliefs about epilepsy genetics among Hispanic and non-Hispanic patients. Epilepsia 2023; 64:2443-2453. [PMID: 37353999 PMCID: PMC10529985 DOI: 10.1111/epi.17701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/02/2023] [Accepted: 06/22/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE Hispanics continue to face challenges when trying to access health care, including epilepsy care and genetic-related health care services. This study examined epilepsy genetic knowledge and beliefs in this historically underserved population. METHODS Questionnaires were completed by 641 adults with epilepsy without identified cause, of whom 122 self-identified as Hispanic or Latino and 519 as non-Hispanic. Participants were asked about their views on the contribution of genetics to the cause of their epilepsy ("genetic attribution"), optimism for advancements in epilepsy genetic research ("genetic optimism"), basic genetic knowledge, and epilepsy-specific genetic knowledge. Generalized linear models were used to compare the two groups in the means of quantitative measures and percents answered correctly for individual genetic knowledge items. Analyses were adjusted for age, sex, education, religion, family history of epilepsy, and time since last seizure. RESULTS Hispanics did not differ from non-Hispanics in genetic attribution, genetic optimism, or number of six basic genetic knowledge items answered correctly. The number of nine epilepsy-specific genetic knowledge items answered correctly was significantly lower for Hispanics than non-Hispanics (adjusted mean = 6.0 vs. 6.7, p < .001). After adjustment for education and other potential mediators, the proportion answered correctly was significantly lower for Hispanics than non-Hispanics for only two items related to family history and penetrance of epilepsy-related genes. Only 54% of Hispanics and 61% of non-Hispanics answered correctly that "If a person has epilepsy, his or her relatives have an increased chance of getting epilepsy." SIGNIFICANCE Despite large differences in sociodemographic variables including education, most attitudes and beliefs about genetics were similar in Hispanics and non-Hispanics. Epilepsy-specific genetic knowledge was lower among Hispanics than non-Hispanics, and this difference was mostly mediated by differences in demographic variables. Genetic counseling should address key concepts related to epilepsy genetics to ensure they are well understood by both Hispanic and non-Hispanic patients.
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Affiliation(s)
- Shannon Trujillo
- Rutgers-Robert Wood Johnson Medical School, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, New Brunswick, NJ, USA
| | - John B. Wetmore
- Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Itzel A. Camarillo
- Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY
| | - Sylwia Misiewicz
- Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY
| | - Halie May
- Departments of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Hyunmi Choi
- Departments of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Karolynn Siegel
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA , Departments of Medicine
| | - Wendy K. Chung
- Departments of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Departments of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Jo C. Phelan
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA , Departments of Medicine
| | - Lawrence H. Yang
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- School of Global Public Health, New York University, New York, NY
| | - Cheng-Shiun Leu
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Amanda L. Bergner
- Departments of Genetics and Development, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Genetic Counseling Graduate Program, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Ruth Ottman
- Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Departments of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Division of Translational Epidemiology and Mental Health Equity, New York State Psychiatric Institute, New York, NY, USA
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Miguel Sanz C, Martinez Navarro M, Caballero Diaz D, Sanchez-Elexpuru G, Di Donato V. Toward the use of novel alternative methods in epilepsy modeling and drug discovery. Front Neurol 2023; 14:1213969. [PMID: 37719765 PMCID: PMC10501616 DOI: 10.3389/fneur.2023.1213969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Epilepsy is a chronic brain disease and, considering the amount of people affected of all ages worldwide, one of the most common neurological disorders. Over 20 novel antiseizure medications (ASMs) have been released since 1993, yet despite substantial advancements in our understanding of the molecular mechanisms behind epileptogenesis, over one-third of patients continue to be resistant to available therapies. This is partially explained by the fact that the majority of existing medicines only address seizure suppression rather than underlying processes. Understanding the origin of this neurological illness requires conducting human neurological and genetic studies. However, the limitation of sample sizes, ethical concerns, and the requirement for appropriate controls (many patients have already had anti-epileptic medication exposure) in human clinical trials underscore the requirement for supplemental models. So far, mammalian models of epilepsy have helped to shed light on the underlying causes of the condition, but the high costs related to breeding of the animals, low throughput, and regulatory restrictions on their research limit their usefulness in drug screening. Here, we present an overview of the state of art in epilepsy modeling describing gold standard animal models used up to date and review the possible alternatives for this research field. Our focus will be mainly on ex vivo, in vitro, and in vivo larval zebrafish models contributing to the 3R in epilepsy modeling and drug screening. We provide a description of pharmacological and genetic methods currently available but also on the possibilities offered by the continued development in gene editing methodologies, especially CRISPR/Cas9-based, for high-throughput disease modeling and anti-epileptic drugs testing.
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Zhang G, Gao Y, Jiang L, Zhang Y. LncRNA FTX Inhibits Ferroptosis of Hippocampal Neurons Displaying Epileptiform Discharges In vitro Through the miR-142-5p/GABPB1 Axis. Neuroscience 2023; 526:48-60. [PMID: 37121382 DOI: 10.1016/j.neuroscience.2023.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/24/2023] [Accepted: 04/03/2023] [Indexed: 05/02/2023]
Abstract
Epilepsy is a disabling and drug-refractory neurological disorder. Long non-coding RNAs (lncRNAs) play a vital role in neuronal function and central nervous system development. This study aimed to explore the regulatory mechanism of lncRNA five prime to Xist (FTX) in cell ferroptosis following epilepsy to provide a theoretical foundation for epilepsy management. Hippocampal neurons were isolated from brain tissues of healthy male SD rats, and an in vitro cell model of epilepsy was established using magnesium-free (MGF) induction. Patch-clamp technique was used to determine the action potentials of neurons. Neuronal viability and apoptosis were assessed by CCK-8 assay and flow cytometry. Levels of FTX, miR-142-5p, and GABPB1 were determined by RT-qPCR and Western blot, respectively. The cellular location of FTX was predicted and validated by RNA immunoprecipitation. Dual-luciferase assay verified targeting relationships among FTX, miR-142-5p, and GAPBP1. Levels of ferroptosis indicators and ferroptosis-related proteins were measured using Western blot and corresponding kits. Neuronal ferroptosis and apoptosis increased after MGF induction, and FTX was weakly-expressed in MGF-induced neurons. FTX overexpression attenuated ferroptosis and apoptosis of MGF-induced neurons. miR-142-5p was upregulated after MGF induction and downregulated after FTX overexpression, and FTX targeted miR-142-5p. miR-142-5p overexpression partially negated the inhibitory action of FTX overexpression on ferroptosis of MGF-induced neurons. FTX regulated GABPB1 expression by targeting miR-142-5p. In conclusion, FTX overexpression mitigated ferroptosis of MGF-induced neurons through the miR-142-5p/GABPB1 axis. In conclusion, lncRNA FTX inhibited ferroptosis of MGF-induced rat hippocampal neurons via the miR-142-5p/GABPB1 axis.
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Affiliation(s)
- Guoli Zhang
- Department of Pediatrics, The Sixth Affiliated Hospital of Harbin Medical University, No.998, Aiying street, Songbei district, Harbin city, Heilongjiang Province 150023, PR China.
| | - Ying Gao
- Department of Pediatrics, The Sixth Affiliated Hospital of Harbin Medical University, No.998, Aiying street, Songbei district, Harbin city, Heilongjiang Province 150023, PR China
| | - Lixin Jiang
- Department of Clinical Laboratory, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, PR China
| | - Yuhang Zhang
- Department of Pediatrics, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, PR China
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Zabrodskaya Y, Paramonova N, Litovchenko A, Bazhanova E, Gerasimov A, Sitovskaya D, Nezdorovina V, Kravtsova S, Malyshev S, Skiteva E, Samochernykh K. Neuroinflammatory Dysfunction of the Blood-Brain Barrier and Basement Membrane Dysplasia Play a Role in the Development of Drug-Resistant Epilepsy. Int J Mol Sci 2023; 24:12689. [PMID: 37628870 PMCID: PMC10454729 DOI: 10.3390/ijms241612689] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/31/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
Drug-resistance epilepsy (DRE) is a key problem in neurology. It is possible that damage to the blood-brain barrier (BBB) may affect resistance in DRE. The aim of this work was to assess the damage and dysfunction in the BBB in the area of epileptic foci in patients with DRE under conditions of neuroinflammation. The changes to the BBB in temporal lobe epilepsy (by immunohistochemistry and transmission electron microscopy), levels of neuroinflammatory proteins, and cytokine levels in the blood (by multiplex analysis) were studied. Increased levels of vascular endothelial growth factor (VEGF) and growth-regulated protein (GRO), and decreased levels of epidermal growth factor (EGF) in plasma, combined with overexpression of the VEGF-A receptor by endotheliocytes were detected. Malformation-like growths of the basement membrane of the capillaries of the brain complicate the delivery of antiepileptic drugs (AEDs). Dysplasia of the basement membrane is the result of inadequate reparative processes in chronic inflammation. In conclusion, it should be noted that damage to the microcirculatory network of the brain should be considered one of the leading factors contributing to DRE.
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Affiliation(s)
- Yulia Zabrodskaya
- Polenov Neurosurgical Institute—Branch of the Almazov National Medical Research Centre, 197341 St. Petersburg, Russia; (A.G.); (D.S.); (V.N.); (S.K.); (S.M.); (E.S.); (K.S.)
| | - Natalia Paramonova
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, 194223 St. Petersburg, Russia; (N.P.); (A.L.); (E.B.)
- State Research Testing Institute of Military Medicine of the Ministry of Defense of the Russian Federation, 195043 St. Petersburg, Russia
| | - Anastasia Litovchenko
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, 194223 St. Petersburg, Russia; (N.P.); (A.L.); (E.B.)
| | - Elena Bazhanova
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, 194223 St. Petersburg, Russia; (N.P.); (A.L.); (E.B.)
- Golikov Research Center of Toxicology, 192019 St. Petersburg, Russia
| | - Aleksandr Gerasimov
- Polenov Neurosurgical Institute—Branch of the Almazov National Medical Research Centre, 197341 St. Petersburg, Russia; (A.G.); (D.S.); (V.N.); (S.K.); (S.M.); (E.S.); (K.S.)
| | - Darya Sitovskaya
- Polenov Neurosurgical Institute—Branch of the Almazov National Medical Research Centre, 197341 St. Petersburg, Russia; (A.G.); (D.S.); (V.N.); (S.K.); (S.M.); (E.S.); (K.S.)
| | - Victoria Nezdorovina
- Polenov Neurosurgical Institute—Branch of the Almazov National Medical Research Centre, 197341 St. Petersburg, Russia; (A.G.); (D.S.); (V.N.); (S.K.); (S.M.); (E.S.); (K.S.)
| | - Svetlana Kravtsova
- Polenov Neurosurgical Institute—Branch of the Almazov National Medical Research Centre, 197341 St. Petersburg, Russia; (A.G.); (D.S.); (V.N.); (S.K.); (S.M.); (E.S.); (K.S.)
| | - Stanislav Malyshev
- Polenov Neurosurgical Institute—Branch of the Almazov National Medical Research Centre, 197341 St. Petersburg, Russia; (A.G.); (D.S.); (V.N.); (S.K.); (S.M.); (E.S.); (K.S.)
| | - Ekaterina Skiteva
- Polenov Neurosurgical Institute—Branch of the Almazov National Medical Research Centre, 197341 St. Petersburg, Russia; (A.G.); (D.S.); (V.N.); (S.K.); (S.M.); (E.S.); (K.S.)
- State Scientific Center of the Russian Federation, Institute of Biomedical Problems of the Russian Academy of Sciences, 123007 Moscow, Russia
| | - Konstantin Samochernykh
- Polenov Neurosurgical Institute—Branch of the Almazov National Medical Research Centre, 197341 St. Petersburg, Russia; (A.G.); (D.S.); (V.N.); (S.K.); (S.M.); (E.S.); (K.S.)
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Vallés AS, Barrantes FJ. Nicotinic Acetylcholine Receptor Dysfunction in Addiction and in Some Neurodegenerative and Neuropsychiatric Diseases. Cells 2023; 12:2051. [PMID: 37626860 PMCID: PMC10453526 DOI: 10.3390/cells12162051] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/20/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
The cholinergic system plays an essential role in brain development, physiology, and pathophysiology. Herein, we review how specific alterations in this system, through genetic mutations or abnormal receptor function, can lead to aberrant neural circuitry that triggers disease. The review focuses on the nicotinic acetylcholine receptor (nAChR) and its role in addiction and in neurodegenerative and neuropsychiatric diseases and epilepsy. Cholinergic dysfunction is associated with inflammatory processes mainly through the involvement of α7 nAChRs expressed in brain and in peripheral immune cells. Evidence suggests that these neuroinflammatory processes trigger and aggravate pathological states. We discuss the preclinical evidence demonstrating the therapeutic potential of nAChR ligands in Alzheimer disease, Parkinson disease, schizophrenia spectrum disorders, and in autosomal dominant sleep-related hypermotor epilepsy. PubMed and Google Scholar bibliographic databases were searched with the keywords indicated below.
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Affiliation(s)
- Ana Sofía Vallés
- Bahía Blanca Institute of Biochemical Research (UNS-CONICET), Bahía Blanca 8000, Argentina;
| | - Francisco J. Barrantes
- Biomedical Research Institute (BIOMED), Faculty of Medical Sciences, Pontifical Catholic University of Argentina—National Scientific and Technical Research Council, Av. Alicia Moreau de Justo 1600, Buenos Aires C1107AFF, Argentina
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Rousseau J, Tene Tadoum SB, Lavertu Jolin M, Nguyen TTM, Ajeawung NF, Flenniken AM, Nutter LMJ, Vukobradovic I, Rossignol E, Campeau PM. The ATP6V1B2 DDOD/DOORS-Associated p.Arg506* Variant Causes Hyperactivity and Seizures in Mice. Genes (Basel) 2023; 14:1538. [PMID: 37628590 PMCID: PMC10454733 DOI: 10.3390/genes14081538] [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: 06/26/2023] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
The vacuolar H+-ATPase is a multisubunit enzyme which plays an essential role in the acidification and functions of lysosomes, endosomes, and synaptic vesicles. Many genes encoding subunits of V-ATPases, namely ATP6V0C, ATP6V1A, ATP6V0A1, and ATP6V1B2, have been associated with neurodevelopmental disorders and epilepsy. The autosomal dominant ATP6V1B2 p.Arg506* variant can cause both congenital deafness with onychodystrophy, autosomal dominant (DDOD) and deafness, onychodystrophy, osteodystrophy, mental retardation, and seizures syndromes (DOORS). Some but not all individuals with this truncating variant have intellectual disability and/or epilepsy, suggesting incomplete penetrance and/or variable expressivity. To further explore the impact of the p.Arg506* variant in neurodevelopment and epilepsy, we generated Atp6v1b2emR506* mutant mice and performed standardized phenotyping using the International Mouse Phenotyping Consortium (IMPC) pipeline. In addition, we assessed the EEG profile and seizure susceptibility of Atp6v1b2emR506* mice. Behavioral tests revealed that the mice present locomotor hyperactivity and show less anxiety-associated behaviors. Moreover, EEG analyses indicate that Atp6v1b2emR506* mutant mice have interictal epileptic activity and that both heterozygous (like patients) and homozygous mice have reduced seizure thresholds to pentylenetetrazol. Our results confirm that variants in ATP6V1B2 can cause seizures and that the Atp6v1b2emR506* heterozygous mouse model is a valuable tool to further explore the pathophysiology and potential treatments for vacuolar ATPases-associated epilepsy and disorders.
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Affiliation(s)
- Justine Rousseau
- CHU Sainte-Justine Research Centre, University of Montreal, Montreal, QC H3T 1C5, Canada (N.F.A.); (E.R.)
| | - Samuel Boris Tene Tadoum
- CHU Sainte-Justine Research Centre, University of Montreal, Montreal, QC H3T 1C5, Canada (N.F.A.); (E.R.)
| | - Marisol Lavertu Jolin
- CHU Sainte-Justine Research Centre, University of Montreal, Montreal, QC H3T 1C5, Canada (N.F.A.); (E.R.)
| | - Thi Tuyet Mai Nguyen
- CHU Sainte-Justine Research Centre, University of Montreal, Montreal, QC H3T 1C5, Canada (N.F.A.); (E.R.)
| | - Norbert Fonya Ajeawung
- CHU Sainte-Justine Research Centre, University of Montreal, Montreal, QC H3T 1C5, Canada (N.F.A.); (E.R.)
| | - Ann M. Flenniken
- Lunenfeld-Tanenbaum Research Institute, The Centre for Phenogenomics, Toronto, ON M5T 3H7, Canada
| | - Lauryl M. J. Nutter
- The Hospital for Sick Children, The Centre for Phenogenomics, Toronto, ON M5T 3H7, Canada
| | - Igor Vukobradovic
- Lunenfeld-Tanenbaum Research Institute, The Centre for Phenogenomics, Toronto, ON M5T 3H7, Canada
| | - Elsa Rossignol
- CHU Sainte-Justine Research Centre, University of Montreal, Montreal, QC H3T 1C5, Canada (N.F.A.); (E.R.)
| | - Philippe M. Campeau
- CHU Sainte-Justine Research Centre, University of Montreal, Montreal, QC H3T 1C5, Canada (N.F.A.); (E.R.)
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Sobregrau P, Baillès E, Carreño M, Donaire A, Boget T, Setoain X, Bargalló N, Rumià J, V Sánchez Vives M, Pintor L. Psychiatric and psychological assessment of patients with drug-resistant epilepsy and psychogenic nonepileptic seizures (PNES) with no response to previous treatments. Epilepsy Behav 2023; 145:109329. [PMID: 37453292 DOI: 10.1016/j.yebeh.2023.109329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/12/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE Psychogenic nonepileptic seizures (PNES) are common imitators of epileptic seizures. Refractoriness to antiseizure medication hinders the differential diagnosis between ES and PNES, carrying deleterious consequences in patients with PNES. Psychiatric and psychological characteristics may assist in the differential diagnosis between drug-resistant epilepsy (DRE) and PNES. Nevertheless, current comprehensive psychiatric and psychological descriptive studies on both patient groups are scarce and with several study limitations. This study provides a comprehensive psychiatric and psychological characterization of Spanish patients with DRE and PNES. METHOD A cross-sectional and comparative study was completed with 104 patients with DRE and 21 with PNES. Psychiatric and psychological characteristics were assessed with the HADS, SCL-90-R, NEO-FFI-R, PDQ-4+, COPE, and QOLIE-31 tests. Parametric and non-parametric tests were used, and regression models were fit to further explore factors affecting patients' life quality. RESULTS Patients with PNES had greater levels of somatization and extraversion and were associated with benzodiazepine intake. Patients with DRE showed greater narcissistic personality disorder symptoms than those with PNES. In patients with DRE, difficulty in performing basic needs-related tasks and greater psychological distress severity and seizure frequency were associated with poorer life quality. In contrast, being a woman, having a psychiatric disorder history, and greater psychiatric symptoms' intensity were associated with poorer life quality in patients with PNES. CONCLUSION Patients with DRE and PNES share similar psychiatric and psychological characteristics, with only very few being significantly different.
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Affiliation(s)
- Pau Sobregrau
- Faculty of Psychology, University of Barcelona (UB), Barcelona 08007, Spain; Department of Psychiatry, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain.
| | - Eva Baillès
- Health Psychology Unit, Psychiatry Department, Vall d'Hebron, Barcelona 08035, Spain
| | - Mar Carreño
- Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | - Antonio Donaire
- Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | - Teresa Boget
- Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain
| | - Xavier Setoain
- Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | - Núria Bargalló
- Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | - Jordi Rumià
- Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain
| | - María V Sánchez Vives
- Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University Hospital Clinic of Barcelona, Barcelona 08036, Spain; Department of Cognition, Development and Educational Psychology, Faculty of Psychology, University of Barcelona (UB), Barcelona 08007, Spain
| | - Luís Pintor
- Department of Psychiatry, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University Hospital Clinic of Barcelona, Barcelona 08036, Spain
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Bundalian L, Su YY, Chen S, Velluva A, Kirstein AS, Garten A, Biskup S, Battke F, Lal D, Heyne HO, Platzer K, Lin CC, Lemke JR, Le Duc D. Epilepsies of presumed genetic etiology show enrichment of rare variants that occur in the general population. Am J Hum Genet 2023; 110:1110-1122. [PMID: 37369202 PMCID: PMC10357498 DOI: 10.1016/j.ajhg.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Previous studies suggested that severe epilepsies, e.g., developmental and epileptic encephalopathies (DEEs), are mainly caused by ultra-rare de novo genetic variants. For milder disease, rare genetic variants could contribute to the phenotype. To determine the importance of rare variants for different epilepsy types, we analyzed a whole-exome sequencing cohort of 9,170 epilepsy-affected individuals and 8,436 control individuals. Here, we separately analyzed three different groups of epilepsies: severe DEEs, genetic generalized epilepsy (GGE), and non-acquired focal epilepsy (NAFE). We required qualifying rare variants (QRVs) to occur in control individuals with an allele count ≥ 1 and a minor allele frequency ≤ 1:1,000, to be predicted as deleterious (CADD ≥ 20), and to have an odds ratio in individuals with epilepsy ≥ 2. We identified genes enriched with QRVs primarily in NAFE (n = 72), followed by GGE (n = 32) and DEE (n = 21). This suggests that rare variants may play a more important role for causality of NAFE than for DEE. Moreover, we found that genes harboring QRVs, e.g., HSGP2, FLNA, or TNC, encode proteins that are involved in structuring the brain extracellular matrix. The present study confirms an involvement of rare variants for NAFE that occur also in the general population, while in DEE and GGE, the contribution of such variants appears more limited.
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Affiliation(s)
- Linnaeus Bundalian
- Institute of Human Genetics, University of Leipzig Medical Center, 04103 Leipzig, Germany.
| | - Yin-Yuan Su
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Siwei Chen
- Analytic and Translational Genetics Unit, Department of Medicine, Boston, MA, USA; Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Akhil Velluva
- Division of General Biochemistry, Rudolf Schönheimer Institute of Biochemistry, Medical Faculty, Leipzig University, 04103 Leipzig, Germany; Department of Evolutionary Genetics, Max Planck Institute for Evolutionary Anthropology, 04103 Leipzig, Germany
| | - Anna Sophia Kirstein
- Pediatric Research Center, University Hospital for Children and Adolescents, Leipzig University, 04103 Leipzig, Germany
| | - Antje Garten
- Pediatric Research Center, University Hospital for Children and Adolescents, Leipzig University, 04103 Leipzig, Germany
| | - Saskia Biskup
- CeGaT GmbH, 72076 Tuebingen, Germany; Hertie-Institute for Clinical Brain Research, 72070 Tubingen, Germany
| | | | - Dennis Lal
- Analytic and Translational Genetics Unit, Department of Medicine, Boston, MA, USA; Massachusetts General Hospital, Boston, MA 02114, USA; Cologne Center for Genomics, University of Cologne, 50937 Cologne, Germany
| | - Henrike O Heyne
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA; Hasso-Plattner-Institut for Digital Engineering, University of Potsdam, Potsdam, Germany; Hasso Plattner Institute at Mount Sinai, Mount Sinai School of Medicine, New York, NY, USA; Institute for Molecular Medicine Finland: FIMM, University of Helsinki, Helsinki, Finland
| | - Konrad Platzer
- Institute of Human Genetics, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Chen-Ching Lin
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Johannes R Lemke
- Institute of Human Genetics, University of Leipzig Medical Center, 04103 Leipzig, Germany; Center for Rare Diseases, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Diana Le Duc
- Institute of Human Genetics, University of Leipzig Medical Center, 04103 Leipzig, Germany; Department of Evolutionary Genetics, Max Planck Institute for Evolutionary Anthropology, 04103 Leipzig, Germany.
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Shafique A, Sultan T, Alzahrani F, Hun Seo G, Alkuraya FS, Naz S. Genomic Analysis of Multiplex Consanguineous Families Reveals Causes of Neurodevelopmental Disorders with Epilepsy. Gene 2023:147599. [PMID: 37393059 DOI: 10.1016/j.gene.2023.147599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/12/2023] [Accepted: 06/28/2023] [Indexed: 07/03/2023]
Abstract
INTRODUCTION Neurodevelopmental disorders (NDD) are a diverse group of disorders that affect the development of the nervous system. Epilepsy is a common phenotypic aspect of NDD. METHODS We recruited eight consanguineous families from Pakistan which segregated recessively inherited NDD with epilepsy. Magnetic Resonance imaging (MRI) and Electroencephalogram (EEG) were completed. Exome sequencing was carried out for selected participants from each family. The exome data were analyzed for exonic and splice-site variants that had allele frequencies of less than 0.01 in public databases. RESULTS Clinical investigations determined that developmental delay, intellectual disability and seizures were manifested by most patients in early childhood. EEG findings were abnormal in the participants of four families. MRI revealed demyelination orcerebral atrophic changes in multiple participants. We identified four novel homozygous variants including nonsense andmissense variants in OCLN, ALDH7A1, IQSEC2 and COL3A1, segregating with the phenotypes in the participants of four families. Previously reported homozygous variants of CNTNAP2, TRIT1 and NARS1 were found in individuals from three families. Clinical utility was observed in directing treatment in case of patients with an ALDH7A1 variant which included pyridoxine administration and enabling accurate counseling about the natural history and recurrence risk. CONCLUSION Our results add to the clinical and molecular delineation of very rare NDD with epilepsy. The high success rate of exome sequencing is likely attributable to the expectation of homozygous variants in patients of consanguineous families, and in one case, the availability of positional mapping data that greatly aided the variant prioritization.
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Affiliation(s)
- Anum Shafique
- School of Biological Sciences, University of the Punjab, Lahore, Pakistan.
| | - Tipu Sultan
- Children's Hospital & the Institute of Child Health, Lahore, Pakistan.
| | - Fatema Alzahrani
- Center for Genomic Medicine, Department of Translational Genomics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
| | | | - Fowzan S Alkuraya
- Center for Genomic Medicine, Department of Translational Genomics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
| | - Sadaf Naz
- School of Biological Sciences, University of the Punjab, Lahore, Pakistan.
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Feria-Romero IA, Reyes-Cuayahuitl A, Sosa-Maldonado J, Montes-Aparicio AV, Rayo-Mares D, Pérez-Pérez D, Grijalva-Otero I, Orozco-Suarez S. Study of genetic variants and their clinical significance in Mexican pediatric patients with epilepsy. Gene 2023:147565. [PMID: 37315635 DOI: 10.1016/j.gene.2023.147565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/06/2023] [Accepted: 06/09/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND The use of novel and accurate techniques to identify genetic variants (with or without a record in the National Center for Biotechnology Information (NCBI) database) improves diagnosis, prognosis, and therapeutics for patients with epilepsy, especially in populations for whom such techniques exist. The aim of this study was to find a genetic profile in Mexican pediatric epilepsy patients by focusing on ten genes associated with drug-resistant epilepsy (DRE). METHODS This was a prospective, analytical, cross-sectional study of pediatric patients with epilepsy. Informed consent was granted by the patients' guardians or parents. Genomic DNA from the patients was sequenced using next-generation sequencing (NGS). For statistical analysis, Fisher's exact, Chi-square or Mann-Whitney U, and OR (95% CI) tests were performed, with significance values of p<0.05. RESULTS Fifty-five patients met the inclusion criteria (female 58.2%, ages 1-16 years); 32 patients had controlled epilepsy (CTR), and 23 had DRE. Four hundred twenty-two genetic variants were identified (71.3% with a known SNP registered in the NCBI database). A dominant genetic profile consisting of four haplotypes of the SCN1A, CYP2C9, and CYP2C19 genes was identified in most of the patients studied. When comparing the results between patients with DRE and CTR, the prevalence of polymorphisms in the SCN1A (rs10497275, rs10198801, and rs67636132), CYP2D6 (rs1065852), and CYP3A4 (rs2242480) genes showed statistical significance (p = 0.021). Finally, the number of missense genetic variants in patients in the nonstructural subgroup was significantly higher in DRE than in CTR (1 [0-2] vs. 3 [2-4]; p=0.014). CONCLUSIONS The Mexican pediatric epilepsy patients included in this cohort presented a characteristic genetic profile infrequent in the Mexican population. SNP rs1065852 (CYP2D6*10) is associated with DRE, especially with nonstructural damage. The presence of three genetic alterations affecting the CYP2B6, CYP2C9, and CYP2D6 cytochrome genes is associated with nonstructural DRE.
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Affiliation(s)
- Iris A Feria-Romero
- Unidad de Investigación Médica en Enfermedades Neurológicas, Hospital de Especialidades, "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Aracely Reyes-Cuayahuitl
- Servicio de Neurología Pediátrica, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | | | - Alexia V Montes-Aparicio
- Programa de Maestría, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México, México
| | - Darío Rayo-Mares
- Servicio de Neurología Pediátrica, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Daniel Pérez-Pérez
- Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilian University, Munich, Germany
| | - Israel Grijalva-Otero
- Unidad de Investigación Médica en Enfermedades Neurológicas, Hospital de Especialidades, "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Sandra Orozco-Suarez
- Servicio de Neurología Pediátrica, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
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Chi W, Kiskinis E. Integrative Analysis of Epilepsy-Associated Genes Reveals Expression-Phenotype Correlations. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.09.544142. [PMID: 37333355 PMCID: PMC10274872 DOI: 10.1101/2023.06.09.544142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Epilepsy is a highly prevalent neurological disorder characterized by recurrent seizures. Patients exhibit broad genetic, molecular, and clinical diversity involving mild to severe comorbidities. The factors that contribute to this phenotypic diversity remain unclear. We used publicly available datasets to systematically interrogate the expression pattern of 247 epilepsy-associated genes across human tissues, developmental stages, and central nervous system (CNS) cellular subtypes. We grouped genes based on their curated phenotypes into 3 broad classes: core epilepsy genes (CEG), where seizures are the core syndrome, developmental and epileptic encephalopathy genes (DEEG) that are associated with developmental delay, and seizure-related genes (SRG), which are characterized by developmental delay and gross brain malformations. We find that DEEGs are highly expressed within the CNS, while SRGs are most abundant in non-CNS tissues. DEEGs and CEGs exhibit highly dynamic expression in various brain regions across development, spiking during the prenatal to infancy transition. Lastly, the abundance of CEGs and SRGs is comparable within cellular subtypes in the brain, while the average expression level of DEEGs is significantly higher in GABAergic neurons and non-neuronal cells. Our analysis provides an overview of the expression pattern of epilepsy-associated genes with spatiotemporal resolution and establishes a broad expression-phenotype correlation in epilepsy.
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Affiliation(s)
- Wanhao Chi
- The Ken & Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Evangelos Kiskinis
- The Ken & Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Simpson Querrey Institute, Northwestern University, Chicago, IL 60611, USA
- Department of Neuroscience, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
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Zhao K, Bai X, Wang X, Cao Y, Zhang L, Li W, Wang S. Insight on the hub gene associated signatures and potential therapeutic agents in epilepsy and glioma. Brain Res Bull 2023; 199:110666. [PMID: 37192718 DOI: 10.1016/j.brainresbull.2023.110666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 04/04/2023] [Accepted: 05/13/2023] [Indexed: 05/18/2023]
Abstract
OBJECTIVE The relationship between epilepsy and glioma has long been widely recognized, but the mechanisms of interaction remain unclear. This study aimed to investigate the shared genetic signature and treatment strategies between epilepsy and glioma. METHODS We subjected hippocampal tissue samples from patients with epilepsy and glioma to transcriptomic analysis to identify differential genes and associated pathways, respectively. Weight gene co-expression network (WGCNA) analysis was performed to identify conserved modules in epilepsy and glioma and to obtain differentially expressed conserved genes. Prognostic and diagnostic models were built using lasso regression. We also focused on building transcription factor-gene interaction networks and assessing the proportion of immune invading cells in epilepsy patients. Finally, drug compounds were inferred using a drug signature database (DSigDB) based on core targets. RESULTS We discovered 88 differently conserved genes, most of which are involved in synaptic signaling and calcium ion pathways. We used lasso regression model to reduce 88 characteristic genes, and finally screened out 14 genes (EIF4A2, CEP170B, SNPH, EPHA4, KLK7, GNG3, MYOP, ANKRD29, RASD2, PRRT3, EFR3A, SGIP1, RAB6B, CNNM1) as the features of glioma prognosis model whose ROC curve is 0.9. Then, we developed a diagnosis model for epilepsy patients using 8 genes (PRRT3, RASD2, MYPOP, CNNM1, ANKRD29, GNG3, SGIP1, KLK7) with area under ROC curve (AUC) values near 1. According to the ssGSEA method, we observed an increase in activated B cells, eosinophils, follicular helper T cells and type 2T helper cells, and a decrease in monocytes in patients with epilepsy. Notably, the great majority of these immune cells showed a negative correlation with hub genes. To reveal the transcriptional-level regulation mechanism, we also built a TF-gene network. In addition, we discovered that patients with glioma-related epilepsy may benefit more from gabapentin and pregabalin. CONCLUSION This study reveals the modular conserved phenotypes of epilepsy and glioma and constructs effective diagnostic and prognostic markers. It provides new biological targets and ideas for the early diagnosis and effective treatment of epilepsy.
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Affiliation(s)
- Kai Zhao
- Institute of Brain Trauma and Neurology, Pingjin Hospital, Characteristic Medical Center of the Chinese People's Armed Police Force, Tianjin, 300000, China
| | - Xuexue Bai
- Department of Neurosurgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510630, China
| | - Xiao Wang
- Department of Neurosurgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510630, China
| | - Yiyao Cao
- Department of Neurosurgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510630, China
| | - Liu Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510630, China
| | - Wei Li
- Department of Neurosurgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510630, China
| | - Shiyong Wang
- Department of Neurosurgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510630, China.
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Oliver KL, Scheffer IE, Bennett MF, Grinton BE, Bahlo M, Berkovic SF. Genes4Epilepsy: An epilepsy gene resource. Epilepsia 2023; 64:1368-1375. [PMID: 36808730 PMCID: PMC10952165 DOI: 10.1111/epi.17547] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 02/23/2023]
Abstract
OBJECTIVE "How many epilepsy genes are there?" is a frequently asked question. We sought to (1) provide a curated list of genes that cause monogenic epilepsies, and (2) compare and contrast epilepsy gene panels from multiple sources. METHODS We compared genes included on the epilepsy panels (as of July 29, 2022) of four clinical diagnostic providers: Invitae, GeneDx, Fulgent Genetics, and Blueprint Genetics; and two research resources: PanelApp Australia and ClinGen. A master list of all unique genes was supplemented by additional genes identified via PubMed searches up until August 15, 2022, using the search terms "genetics" AND/OR "epilepsy" AND/OR "seizures". Evidence supporting a monogenic role for all genes was manually reviewed; those with limited or disputed evidence were excluded. All genes were annotated according to inheritance pattern and broad epilepsy phenotype. RESULTS The comparison of genes included on epilepsy clinical panels revealed high heterogeneity in both number of genes (range: 144-511) and content. Just 111 genes (15.5%) were included on all four clinical panels. Subsequent manual curation of all "epilepsy genes" identified >900 monogenic etiologies. Almost 90% of genes were associated with developmental and epileptic encephalopathies. By comparison only 5% of genes were associated with monogenic causes of "common epilepsies" (i.e., generalized and focal epilepsy syndromes). Autosomal recessive genes were most frequent (56% of genes); however, this varied according to the associated epilepsy phenotype(s). Genes associated with common epilepsy syndromes were more likely to be dominantly inherited and associated with multiple epilepsy types. SIGNIFICANCE Our curated list of monogenic epilepsy genes is publicly available: github.com/bahlolab/genes4epilepsy and will be regularly updated. This gene resource can be utilized to target genes beyond those included on clinical gene panels, for gene enrichment methods and candidate gene prioritization. We invite ongoing feedback and contributions from the scientific community via genes4-epilepsy@unimelb.edu.au.
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Affiliation(s)
- Karen L. Oliver
- Department of Medicine, Epilepsy Research CentreUniversity of Melbourne, Austin HealthMelbourneVictoriaAustralia
- Population Health and Immunity DivisionThe Walter and Eliza Hall Institute of Medical ResearchParkvilleVictoriaAustralia
- Department of Medical BiologyThe University of MelbourneParkvilleVictoriaAustralia
| | - Ingrid E. Scheffer
- Department of Medicine, Epilepsy Research CentreUniversity of Melbourne, Austin HealthMelbourneVictoriaAustralia
- Florey Institute of Neuroscience and Mental HealthHeidelbergVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
- Murdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - Mark F. Bennett
- Department of Medicine, Epilepsy Research CentreUniversity of Melbourne, Austin HealthMelbourneVictoriaAustralia
- Population Health and Immunity DivisionThe Walter and Eliza Hall Institute of Medical ResearchParkvilleVictoriaAustralia
- Department of Medical BiologyThe University of MelbourneParkvilleVictoriaAustralia
| | - Bronwyn E. Grinton
- Department of Medicine, Epilepsy Research CentreUniversity of Melbourne, Austin HealthMelbourneVictoriaAustralia
| | - Melanie Bahlo
- Population Health and Immunity DivisionThe Walter and Eliza Hall Institute of Medical ResearchParkvilleVictoriaAustralia
- Department of Medical BiologyThe University of MelbourneParkvilleVictoriaAustralia
| | - Samuel F. Berkovic
- Department of Medicine, Epilepsy Research CentreUniversity of Melbourne, Austin HealthMelbourneVictoriaAustralia
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Tartibzadeh G, Feizollahzadeh H, Shabanloei R, Mwamba B. Epilepsy risk awareness and background factors in patients with epilepsy and family caregivers. Epilepsy Res 2023; 193:107146. [PMID: 37121025 DOI: 10.1016/j.eplepsyres.2023.107146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 05/02/2023]
Abstract
OBJECTIVES Patients with epilepsy are at risk of various injuries throughout their lives. Awareness of patients and family caregivers about risk factors and self-care prevents potential injuries. This study aimed to investigate epilepsy risk awareness and background factors in patients with epilepsy and family caregivers. METHODS This descriptive study was conducted with the recruitment of 120 patients with epilepsy and 120 family caregivers who were referred to the Neurological Clinic of Tabriz Razi Hospital in Iran. Data was collected using Persian version of the epilepsy risk awareness questionnaires for patients (3rd Edition) and family caregivers. RESULTS The average age of the patients (65.8% women) was 29.2 and of the family caregivers (58.3% women) 41.5 years. The average score of risk awareness in family caregivers was 82.6 ± 8.8 and higher than that in patients with epilepsy 84.9 ± 8.5 (obtainable score: 0-120). Compared to the maximum score, the average scores of both groups in all domains including epilepsy, personal security, physical health, and mental health were low. A statistically significant relationship was observed between the mean scores of risk awareness and some background variables. CONCLUSION The results showed that epilepsy risk awareness in patients and family caregivers is low and there is a need for education and support. By developing education programs for the patient and their family and increasing epilepsy risk awareness, patients can be protected from potential risks and their safety and quality of life can be improved.
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Affiliation(s)
- Golzar Tartibzadeh
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Feizollahzadeh
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Reza Shabanloei
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bupe Mwamba
- Midwifery and Neonatal Nursing Science, RM, RM, Lecturer, Clinical and Health Sciences, University of South Australia, Adelaide. Australia
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Pickrell WO, Fry AE. Epilepsy genetics: a practical guide for adult neurologists. Pract Neurol 2023; 23:111-119. [PMID: 36639246 DOI: 10.1136/pn-2022-003623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2022] [Indexed: 01/15/2023]
Abstract
An understanding of epilepsy genetics is important for adult neurologists, as making a genetic diagnosis gives clinical benefit. In this review, we describe the key features of different groups of genetic epilepsies. We describe the common available genetic tests for epilepsy, and how to interpret them.
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Affiliation(s)
- William Owen Pickrell
- Department of Neurology, Morriston Hospital, Swansea Bay University Health Board, Swansea, UK
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Andrew E Fry
- All Wales Medical Genomics Service, University Hospital of Wales, Cardiff, UK
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Cardiff, UK
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Domínguez-Oliva A, Hernández-Ávalos I, Martínez-Burnes J, Olmos-Hernández A, Verduzco-Mendoza A, Mota-Rojas D. The Importance of Animal Models in Biomedical Research: Current Insights and Applications. Animals (Basel) 2023; 13:ani13071223. [PMID: 37048478 PMCID: PMC10093480 DOI: 10.3390/ani13071223] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/19/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023] Open
Abstract
Animal research is considered a key element in advance of biomedical science. Although its use is controversial and raises ethical challenges, the contribution of animal models in medicine is essential for understanding the physiopathology and novel treatment alternatives for several animal and human diseases. Current pandemics’ pathology, such as the 2019 Coronavirus disease, has been studied in primate, rodent, and porcine models to recognize infection routes and develop therapeutic protocols. Worldwide issues such as diabetes, obesity, neurological disorders, pain, rehabilitation medicine, and surgical techniques require studying the process in different animal species before testing them on humans. Due to their relevance, this article aims to discuss the importance of animal models in diverse lines of biomedical research by analyzing the contributions of the various species utilized in science over the past five years about key topics concerning human and animal health.
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Affiliation(s)
- Adriana Domínguez-Oliva
- Master’s Program in Agricultural and Livestock Sciences [Maestría en Ciencias Agropecuarias], Xochimilco Campus, Universidad Autónoma Metropolitana (UAM), Mexico City 04960, Mexico
| | - Ismael Hernández-Ávalos
- Clinical Pharmacology and Veterinary Anesthesia, Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de México (UNAM), Cuautitlán 54714, Mexico
| | - Julio Martínez-Burnes
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Tamaulipas, Victoria City 87000, Mexico
| | - Adriana Olmos-Hernández
- Division of Biotechnology—Bioterio and Experimental Surgery, Instituto Nacional de Rehabilitación-Luis, Guillermo Ibarra Ibarra (INR-LGII), Mexico City 14389, Mexico
| | - Antonio Verduzco-Mendoza
- Division of Biotechnology—Bioterio and Experimental Surgery, Instituto Nacional de Rehabilitación-Luis, Guillermo Ibarra Ibarra (INR-LGII), Mexico City 14389, Mexico
| | - Daniel Mota-Rojas
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana (UAM), Mexico City 04960, Mexico
- Correspondence:
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