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Takasu M, Kubota T, Tsuji T, Kurahashi H, Numoto S, Watanabe K, Okumura A. The semiology of febrile seizures: Focal features are frequent. Epilepsy Behav 2017. [PMID: 28622546 DOI: 10.1016/j.yebeh.2017.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To clarify the semiology of febrile seizures (FS) and to determine the frequency of FS with symptoms suggestive of focal onset. METHODS FS symptoms in children were reported within 24h of seizure onset by the parents using a structured questionnaire consisting principally of closed-ended questions. We focused on events at seizure commencement, including changes in behavior and facial expression, and ocular and oral symptoms. We also investigated the autonomic and motor symptoms developing during seizures. The presence or absence of focal and limbic features was determined for each patient. The associations of certain focal and limbic features with patient characteristics were assessed. RESULTS Information was obtained on FS in 106 children. Various events were recorded at seizure commencement. Behavioral changes were observed in 35 children, changes in facial expression in 53, ocular symptoms in 78, and oral symptoms in 90. In terms of events during seizures, autonomic symptoms were recognized in 78, and convulsive motor symptoms were recognized in 68 children. Focal features were evident in 81 children; 38 children had two or more such features. Limbic features were observed in 44 children, 9 of whom had two or more such features. There was no significant relationship between any patient characteristic and the numbers of focal or limbic features. SIGNIFICANCE The semiology of FS varied widely among children, and symptoms suggestive of focal onset were frequent. FS of focal onset may be more common than is generally thought.
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Affiliation(s)
| | - Tetsuo Kubota
- Department of Pediatrics, Anjo Kosei Hospital, Japan
| | - Takeshi Tsuji
- Department of Pediatrics, Okazaki City Hospital, Japan
| | | | - Shingo Numoto
- Department of Pediatrics, Aichi Medical University, Japan
| | - Kazuyoshi Watanabe
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Japan
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Tobochnik S, Fahlstrom R, Shain C, Winawer MR. Familial aggregation of focal seizure semiology in the Epilepsy Phenome/Genome Project. Neurology 2017; 89:22-28. [PMID: 28566546 DOI: 10.1212/wnl.0000000000004052] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 03/10/2017] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To improve phenotype definition in genetic studies of epilepsy, we assessed the familial aggregation of focal seizure types and of specific seizure symptoms within the focal epilepsies in families from the Epilepsy Phenome/Genome Project. METHODS We studied 302 individuals with nonacquired focal epilepsy from 149 families. Familial aggregation was assessed by logistic regression analysis of relatives' traits (dependent variable) by probands' traits (independent variable), estimating the odds ratio for each symptom in a relative given presence vs absence of the symptom in the proband. RESULTS In families containing multiple individuals with nonacquired focal epilepsy, we found significant evidence for familial aggregation of ictal motor, autonomic, psychic, and aphasic symptoms. Within these categories, ictal whole body posturing, diaphoresis, dyspnea, fear/anxiety, and déjà vu/jamais vu showed significant familial aggregation. Focal seizure type aggregated as well, including complex partial, simple partial, and secondarily generalized tonic-clonic seizures. CONCLUSION Our results provide insight into genotype-phenotype correlation in the nonacquired focal epilepsies and a framework for identifying subgroups of patients likely to share susceptibility genes.
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Affiliation(s)
- Steven Tobochnik
- From the Department of Neurology and G.H. Sergievsky Center (S.T., M.R.W.), Columbia University, New York, NY; Department of Neurology (R.F.), University of California, San Francisco; and Department of Neurology (C.S.), Boston Children's Hospital, MA
| | - Robyn Fahlstrom
- From the Department of Neurology and G.H. Sergievsky Center (S.T., M.R.W.), Columbia University, New York, NY; Department of Neurology (R.F.), University of California, San Francisco; and Department of Neurology (C.S.), Boston Children's Hospital, MA
| | - Catherine Shain
- From the Department of Neurology and G.H. Sergievsky Center (S.T., M.R.W.), Columbia University, New York, NY; Department of Neurology (R.F.), University of California, San Francisco; and Department of Neurology (C.S.), Boston Children's Hospital, MA
| | - Melodie R Winawer
- From the Department of Neurology and G.H. Sergievsky Center (S.T., M.R.W.), Columbia University, New York, NY; Department of Neurology (R.F.), University of California, San Francisco; and Department of Neurology (C.S.), Boston Children's Hospital, MA.
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Guo W, Shang DM, Cao JH, Feng K, He YC, Jiang Y, Wang S, Gao YF. Identifying and Analyzing Novel Epilepsy-Related Genes Using Random Walk with Restart Algorithm. BIOMED RESEARCH INTERNATIONAL 2017; 2017:6132436. [PMID: 28255556 PMCID: PMC5309434 DOI: 10.1155/2017/6132436] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 01/15/2017] [Indexed: 02/07/2023]
Abstract
As a pathological condition, epilepsy is caused by abnormal neuronal discharge in brain which will temporarily disrupt the cerebral functions. Epilepsy is a chronic disease which occurs in all ages and would seriously affect patients' personal lives. Thus, it is highly required to develop effective medicines or instruments to treat the disease. Identifying epilepsy-related genes is essential in order to understand and treat the disease because the corresponding proteins encoded by the epilepsy-related genes are candidates of the potential drug targets. In this study, a pioneering computational workflow was proposed to predict novel epilepsy-related genes using the random walk with restart (RWR) algorithm. As reported in the literature RWR algorithm often produces a number of false positive genes, and in this study a permutation test and functional association tests were implemented to filter the genes identified by RWR algorithm, which greatly reduce the number of suspected genes and result in only thirty-three novel epilepsy genes. Finally, these novel genes were analyzed based upon some recently published literatures. Our findings implicate that all novel genes were closely related to epilepsy. It is believed that the proposed workflow can also be applied to identify genes related to other diseases and deepen our understanding of the mechanisms of these diseases.
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Affiliation(s)
- Wei Guo
- Department of Outpatient, China-Japan Union Hospital of Jilin University, Changchun 130033, China
| | - Dong-Mei Shang
- Department of Outpatient, China-Japan Union Hospital of Jilin University, Changchun 130033, China
| | - Jing-Hui Cao
- Department of Neurosurgery, China-Japan Union Hospital of Jilin University, Changchun 130033, China
| | - Kaiyan Feng
- Department of Computer Science, Guangdong AIB Polytechnic, Guangzhou 510507, China
| | - Yi-Chun He
- Department of Neurosurgery, China-Japan Union Hospital of Jilin University, Changchun 130033, China
| | - Yang Jiang
- Department of Surgery, China-Japan Union Hospital of Jilin University, Changchun 130033, China
| | - ShaoPeng Wang
- School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Yu-Fei Gao
- Department of Neurosurgery, China-Japan Union Hospital of Jilin University, Changchun 130033, China
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Seneviratne U, Boston RC, Cook M, D'Souza W. EEG correlates of seizure freedom in genetic generalized epilepsies. Neurol Clin Pract 2016; 7:35-44. [PMID: 29849234 DOI: 10.1212/cpj.0000000000000323] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background We investigated the association between epileptiform EEG abnormalities and the preceding duration of seizure freedom in genetic generalized epilepsies (GGE). Methods We analyzed 24-hour ambulatory EEG recordings of patients with GGE diagnosed and classified according to the International League Against Epilepsy criteria. We quantified epileptiform EEG abnormalities into density scores (total duration of epileptiform discharges per hour) and estimated the preceding seizure-free duration at the time of EEG recording based on the last self-reported seizure. We then employed regression analysis to quantitate the relationship between the duration of seizure freedom and EEG variables. Results We analyzed 6,923 epileptiform discharges from 105 patients with abnormal 24-hour EEGs. In the regression analysis exploring the crude associations, we found significant correlations between 6 EEG variables and the duration of seizure freedom indicating that shorter duration of seizure freedom was associated with higher spike densities and longer paroxysms. These associations were not affected by confounders such as syndrome, age at EEG, age at epilepsy onset, sex, duration of epilepsy, or number of antiepileptic drugs. Conclusions Higher densities and longer durations of epileptiform discharges may be retrospectively associated with a shorter duration of self-reported seizure freedom. Hence, EEG can potentially be used as a biomarker of prognosis in GGE. These findings need to be validated in a prospective study in order to define EEG markers of future seizure freedom.
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Affiliation(s)
- Udaya Seneviratne
- St. Vincent's Hospital (US, RCB, MC, WD), University of Melbourne; Monash Medical Centre (US); and Monash University (US), Melbourne, Australia
| | - Ray C Boston
- St. Vincent's Hospital (US, RCB, MC, WD), University of Melbourne; Monash Medical Centre (US); and Monash University (US), Melbourne, Australia
| | - Mark Cook
- St. Vincent's Hospital (US, RCB, MC, WD), University of Melbourne; Monash Medical Centre (US); and Monash University (US), Melbourne, Australia
| | - Wendyl D'Souza
- St. Vincent's Hospital (US, RCB, MC, WD), University of Melbourne; Monash Medical Centre (US); and Monash University (US), Melbourne, Australia
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Sethi NK, Seneviratne U, Cook M, D'Souza W. Focal seizure symptoms in idiopathic generalized epilepsiesAuthor Response. Neurology 2016; 86:792. [DOI: 10.1212/wnl.0000000000002429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Seneviratne U, Woo JJ, Boston RC, Cook M, D'Souza W. Focal seizure symptoms in idiopathic generalized epilepsies. Neurology 2015; 85:589-95. [DOI: 10.1212/wnl.0000000000001841] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 03/27/2015] [Indexed: 11/15/2022] Open
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Dazzo E, Santulli L, Posar A, Fattouch J, Conti S, Lodén-van Straaten M, Mijalkovic J, De Bortoli M, Rosa M, Millino C, Pacchioni B, Di Bonaventura C, Giallonardo AT, Striano S, Striano P, Parmeggiani A, Nobile C. Autosomal dominant lateral temporal epilepsy (ADLTE): novel structural and single-nucleotide LGI1 mutations in families with predominant visual auras. Epilepsy Res 2014; 110:132-8. [PMID: 25616465 DOI: 10.1016/j.eplepsyres.2014.12.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 11/11/2014] [Accepted: 12/01/2014] [Indexed: 01/05/2023]
Abstract
PURPOSE Autosomal dominant lateral temporal epilepsy (ADLTE) is a genetic focal epilepsy syndrome characterized by prominent auditory or aphasic symptoms. Mutations in LGI1 account for less than 50% of ADLTE families. We assessed the impact of LGI1 microrearrangements in a collection of ADLTE families and sporadic lateral temporal epilepsy (LTE) patients, and investigated novel ADLTE and LTE patients. METHODS Twenty-four ADLTE families and 140 sporadic LTE patients with no evidence of point mutations in LGI1 were screened for copy number alterations using multiplex ligation-dependent probe amplification (MLPA). Newly ascertained familial and sporadic LTE patients were clinically investigated, and interictal EEG and MRI findings were obtained; probands were tested for LGI1 mutations by direct exon sequencing or denaturing high performance liquid chromatography. RESULTS We identified a novel microdeletion spanning LGI1 exon 2 in a family with two affected members, both presenting focal seizures with visual symptoms. Also, we identified a novel LGI1 missense mutation (c.1118T > C; p.L373S) in a newly ascertained family with focal seizures with prominent visual auras, and another missense mutation (c.856T > C; p.C286R) in a sporadic patient with auditory seizures. CONCLUSIONS We describe two novel ADLTE families with predominant visual auras segregating pathogenic LGI1 mutations. These findings support the notion that, in addition to auditory symptoms, other types of auras can be found in patients carrying LGI1 mutations. The identification of a novel microdeletion in LGI1, the second so far identified, suggests that LGI1 microrearrangements may not be exceptional.
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Affiliation(s)
- Emanuela Dazzo
- CNR-Neuroscience Institute, Section of Padua, Padova, Italy
| | - Lia Santulli
- Department of Neurological Sciences, Federico II University, Napoli, Italy
| | - Annio Posar
- IRCCS-Neurological Sciences, Bellaria Hospital, Bologna, Italy
| | - Jinane Fattouch
- Department of Neurological Sciences, La Sapienza University, Roma, Italy
| | - Sara Conti
- IRCCS-Neurological Sciences, Bellaria Hospital, Bologna, Italy
| | | | | | | | - Maurizio Rosa
- Department of Biology, University of Padova, Padova, Italy
| | | | | | | | | | - Salvatore Striano
- Department of Neurological Sciences, Federico II University, Napoli, Italy
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Institute "G. Gaslini", University of Genova, Genova, Italy
| | | | - Carlo Nobile
- CNR-Neuroscience Institute, Section of Padua, Padova, Italy.
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Dugan P, Carlson C, Bluvstein J, Chong DJ, Friedman D, Kirsch HE. Auras in generalized epilepsy. Neurology 2014; 83:1444-9. [PMID: 25230998 DOI: 10.1212/wnl.0000000000000877] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We studied the frequency of auras in generalized epilepsy (GE) using a detailed semistructured diagnostic interview. METHODS In this cross-sectional study, participants with GE were drawn from the Epilepsy Phenome/Genome Project (EPGP). Responses to the standardized diagnostic interview regarding tonic-clonic (grand mal) seizures were then examined. This questionnaire initially required participants to provide their own description of any subjective phenomena before their "grand mal seizures." Participants who provided answers to these questions were considered to have an aura. All participants were then systematically queried regarding a list of specific symptoms occurring before grand mal seizures, using structured (closed-ended) questions. RESULTS Seven hundred ninety-eight participants with GE were identified, of whom 530 reported grand mal seizures. Of these, 112 (21.3%) reported auras in response to the open-ended question. Analysis of responses to the closed-ended questions suggested that 341 participants (64.3%) experienced at least one form of aura. CONCLUSIONS Auras typically associated with focal epilepsy were reported by a substantial proportion of EPGP subjects with GE. This finding may support existing theories of cortical and subcortical generators of GE with variable spread patterns. Differences between responses to the open-ended question and closed-ended questions may also reflect clinically relevant variation in patient responses to history-taking and surveys. Open-ended questions may underestimate the prevalence of specific types of auras and may be in part responsible for the underrecognition of auras in GE. In addition, structured questions may influence participants, possibly leading to a greater representation of symptoms.
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Affiliation(s)
- Patricia Dugan
- From the Department of Neurology (P.D., J.B., D.J.C., D.F.), New York University Langone Medical Center, New York; Department of Neurology (C.C.), Medical College of Wisconsin, Milwaukee; and Department of Neurology (H.E.K.), University of California, San Francisco.
| | - Chad Carlson
- From the Department of Neurology (P.D., J.B., D.J.C., D.F.), New York University Langone Medical Center, New York; Department of Neurology (C.C.), Medical College of Wisconsin, Milwaukee; and Department of Neurology (H.E.K.), University of California, San Francisco
| | - Judith Bluvstein
- From the Department of Neurology (P.D., J.B., D.J.C., D.F.), New York University Langone Medical Center, New York; Department of Neurology (C.C.), Medical College of Wisconsin, Milwaukee; and Department of Neurology (H.E.K.), University of California, San Francisco
| | - Derek J Chong
- From the Department of Neurology (P.D., J.B., D.J.C., D.F.), New York University Langone Medical Center, New York; Department of Neurology (C.C.), Medical College of Wisconsin, Milwaukee; and Department of Neurology (H.E.K.), University of California, San Francisco
| | - Daniel Friedman
- From the Department of Neurology (P.D., J.B., D.J.C., D.F.), New York University Langone Medical Center, New York; Department of Neurology (C.C.), Medical College of Wisconsin, Milwaukee; and Department of Neurology (H.E.K.), University of California, San Francisco
| | - Heidi E Kirsch
- From the Department of Neurology (P.D., J.B., D.J.C., D.F.), New York University Langone Medical Center, New York; Department of Neurology (C.C.), Medical College of Wisconsin, Milwaukee; and Department of Neurology (H.E.K.), University of California, San Francisco
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Fanciulli M, Di Bonaventura C, Egeo G, Fattouch J, Dazzo E, Radovic S, Spadotto A, Giallonardo AT, Nobile C. Suggestive linkage of familial mesial temporal lobe epilepsy to chromosome 3q26. Epilepsy Res 2013; 108:232-40. [PMID: 24315020 DOI: 10.1016/j.eplepsyres.2013.11.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 09/26/2013] [Accepted: 11/03/2013] [Indexed: 12/01/2022]
Abstract
PURPOSE To describe the clinical findings in a family with a benign form of mesial temporal lobe epilepsy and to identify the causative genetic factors. METHODS All participants were personally interviewed and underwent neurologic examination. The affected subjects underwent EEG and most of them neuroradiological examinations (MRI). All family members were genotyped with the HumanCytoSNP-12 v1.0 beadchip and linkage analysis was performed with Merlin and Simwalk2 programs. Exome sequencing was performed on HiSeq2000, after exome capture with SureSelect 50 Mb kit v2.0. RESULTS The family had 6 members with temporal lobe epilepsy. Age at seizure onset ranged from 8 to 13 years. Five patients had epigastric auras often associated to oro-alimentary automatic activity, 3 patients presented loss of contact, and 2 experienced secondary generalizations. Febrile seizures occurred in 2 family members, 1 of whom also had temporal lobe epilepsy. EEG showed focal slow waves and epileptic abnormalities on temporal regions in 1 patient and was normal in the other affected individuals. MRI was normal in all temporal lobe epilepsy patients. We performed single nucleotide polymorphism-array linkage analysis of the family and found suggestive evidence of linkage (LOD score=2.106) to a region on chromosome 3q26. Haplotype reconstruction supported the linkage data and showed that the majority of unaffected family members carried the haplotype at risk. Whole exome sequencing failed to identify pathogenic mutations in genes of the candidate region. CONCLUSIONS Our data suggest the existence of a novel locus for benign familial mesial temporal lobe epilepsy on chromosome 3q26. Our failure to identify pathogenic mutations in genes of this region may be due to limitations of the exome sequencing technology.
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Affiliation(s)
| | | | - Gabriella Egeo
- Department of Neurological Sciences, University of Rome "Sapienza", Roma, Italy; IRCCS San Raffaele Pisana, Roma, Italy
| | - Jinane Fattouch
- Department of Neurological Sciences, University of Rome "Sapienza", Roma, Italy
| | - Emanuela Dazzo
- CNR - Institute of Neurosciences, Section of Padua, Padova, Italy
| | | | | | | | - Carlo Nobile
- CNR - Institute of Neurosciences, Section of Padua, Padova, Italy.
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Narration and Neuroscience: Encountering the Social on the “Last Frontier of Medicine”. ACTA ACUST UNITED AC 2011. [DOI: 10.1108/s1057-6290(2011)0000013007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Shostak S, Zarhin D, Ottman R. What's at stake? Genetic information from the perspective of people with epilepsy and their family members. Soc Sci Med 2011; 73:645-54. [PMID: 21831495 PMCID: PMC3163050 DOI: 10.1016/j.socscimed.2011.06.043] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Revised: 06/20/2011] [Accepted: 06/23/2011] [Indexed: 02/04/2023]
Abstract
Substantial progress has been made in identifying genes that raise risk for epilepsy, and genetic testing for some of these genes is increasingly being used in clinical practice. However, almost no empirical data are available from the perspective of people with epilepsy and their family members about the impact of genetic information and potential benefits and harms of genetic testing. To address this gap we conducted in-depth qualitative interviews with 40 individuals (22 with epilepsy, 18 unaffected) in the USA from families containing multiple affected individuals who had participated in epilepsy genetics research. The interviews were coded and analyzed using the principles of grounded theory. Several major themes emerged from these interviews. Participants expressed "personal theories of inheritance" that emphasized commonalities among relatives and the idea that disease risk is most shared by family members who share physical or personality traits. Most participants said they would have genetic testing if it were offered. They cited many potential benefits, including learning what caused epilepsy in their family, being better able to care and advocate for children at risk, reducing guilt and blame, providing an increased sense of control, and relieving anxiety in unaffected individuals who test negative. The influence of genetic information on reproduction was a particularly salient theme. Although respondents believed genetic testing would be useful for informing their reproductive choices, they also expressed fear that it could lead to external pressures to modify these choices. Other concerns about the potential negative impact of genetic information included increased blame and guilt, increased stigma and discrimination in employment and insurance, self-imposed limitations on life goals, and alterations in fundamental conceptions of "what epilepsy is." Consideration of the perspectives of people with epilepsy and their family members is critical to understanding the implications of contemporary epilepsy genetic research and testing.
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Affiliation(s)
- Sara Shostak
- Brandeis University, Department of Sociology, MS 071, Waltham, MA 02454-9110, USA.
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ADAM23, a Gene Related to LGI1, Is Not Linked to Autosomal Dominant Lateral Temporal Epilepsy. EPILEPSY RESEARCH AND TREATMENT 2011; 2011:258365. [PMID: 22937229 PMCID: PMC3428609 DOI: 10.1155/2011/258365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Accepted: 12/01/2010] [Indexed: 11/18/2022]
Abstract
Autosomal dominant lateral temporal epilepsy (ADTLE) is an inherited epileptic syndrome characterized by ictal auditory symptoms or aphasia, negative MRI findings, and relatively benign evolution. Mutations responsible for ADLTE have been found in the LGI1 gene. The functions of the Lgi1 protein apparently are mediated by interactions with members of the ADAM protein family: it binds the postsynaptic receptor ADAM22 to regulate glutamate-AMPA currents at excitatory synapses and also the ADAM23 receptor to promote neurite outgrowth in vitro and dendritic arborization in vivo. Because alteration of each of these neuronal mechanisms may underlie ADLTE, ADAM22 and ADAM23 are candidate genes for this syndrome. In a previous work, we excluded a major role of ADAM22 in the aetiology of ADLTE. Here, we performed linkage analysis between microsatellite markers within or flanking the ADAM23 gene and ADLTE in 13 Italian families. The results exclude ADAM23 as major causative gene for ADLTE.
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Striano P, Nobile C. Idiopathic mesial temporal lobe epilepsy: don't sow the tares with the wheat! Epilepsy Behav 2010; 18:500-1. [PMID: 20542741 DOI: 10.1016/j.yebeh.2010.04.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Accepted: 04/29/2010] [Indexed: 10/19/2022]
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Heiman GA, Kamberakis K, Gill R, Kalachikov S, Pedley TA, Hauser WA, Ottman R. Evaluation of depression risk in LGI1 mutation carriers. Epilepsia 2010; 51:1685-90. [PMID: 20659151 DOI: 10.1111/j.1528-1167.2010.02677.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
PURPOSE Depression is the most common comorbid condition in epilepsy. The cause of this comorbidity is unknown, and could involve psychosocial consequences of epilepsy, treatment side effects, seizure manifestations, or common neurobiologic mechanisms. One hypothesis of particular interest is a shared genetic susceptibility to epilepsy and depression. We tested this hypothesis by studying depressive symptoms in families with an identified genetic form of epilepsy: autosomal dominant partial epilepsy with auditory features caused by mutations in the leucine-rich, glioma inactivated 1 gene (LGI1). METHODS A standardized depression screen was administered to 94 individuals from 11 families with mutations in LGI1, including 38 mutation carriers with epilepsy (AC), 11 clinically unaffected mutation carriers (UC), and 45 noncarriers (NC). RESULTS Current depressive symptom scores were significantly higher in AC than in NC, an association that remained after excluding depressive symptoms that appeared likely to be caused by antiepileptic medication use. However, scores did not differ between UC and NC. DISCUSSION Although LGI1 mutation carriers who were clinically affected with epilepsy had increased depressive symptoms, mutation carriers without epilepsy did not. These findings suggest that the increase in depressive symptoms in affected individuals from these families is related to epilepsy or its treatment rather than to LGI1 mutations per se.
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Affiliation(s)
- Gary A Heiman
- Department of Genetics, Rutgers University, Piscataway, New Jersey, USA
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Poduri A, Wang Y, Gordon D, Barral-Rodriguez S, Barker-Cummings C, Ulgen A, Chitsazzadeh V, Hill RS, Risch N, Hauser WA, Pedley TA, Walsh CA, Ottman R. Novel susceptibility locus at chromosome 6q16.3-22.31 in a family with GEFS+. Neurology 2009; 73:1264-72. [PMID: 19841378 DOI: 10.1212/wnl.0b013e3181bd10d3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Genetic epilepsy with febrile seizures plus (GEFS+) is a familial epilepsy syndrome with extremely variable expressivity. Mutations in 5 genes that raise susceptibility to GEFS+ have been discovered, but they account for only a small proportion of families. METHODS We identified a 4-generation family containing 15 affected individuals with a range of phenotypes in the GEFS+ spectrum, including febrile seizures, febrile seizures plus, epilepsy, and severe epilepsy with developmental delay. We performed a genome-wide linkage analysis using microsatellite markers and then saturated the potential linkage region identified by this screen with more markers. We evaluated the evidence for linkage using both model-based and model-free (posterior probability of linkage [PPL]) analyses. We sequenced 16 candidate genes and screened for copy number abnormalities in the minimal genetic region. RESULTS All 15 affected subjects and 1 obligate carrier shared a haplotype of markers at chromosome 6q16.3-22.31, an 18.1-megabase region flanked by markers D6S962 and D6S287. The maximum multipoint lod score in this region was 4.68. PPL analysis indicated an 89% probability of linkage. Sequencing of 16 candidate genes did not reveal a causative mutation. No deletions or duplications were identified. CONCLUSIONS We report a novel susceptibility locus for genetic epilepsy with febrile seizures plus at 6q16.3-22.31, in which there are no known genes associated with ion channels or neurotransmitter receptors. The identification of the responsible gene in this region is likely to lead to the discovery of novel mechanisms of febrile seizures and epilepsy.
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Affiliation(s)
- A Poduri
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Children's Hospital Boston, MA, USA
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Sung H, Ji F, Levy DL, Matthysse S, Mendell NR. The power of linkage analysis of a disease-related endophenotype using asymmetrically ascertained sib pairs. Comput Stat Data Anal 2009; 53:1829-1842. [PMID: 20160849 DOI: 10.1016/j.csda.2008.08.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
A linkage study of a qualitative disease endophenotype in a sample of sib pairs, consisting of one disease affected proband and one sibling is considered. The linkage statistic compares marker allele sharing with the proband in siblings with an abnormal endophenotype to siblings with the normal endophenotype. Expressions for the distribution of this linkage statistic, in terms of the recombination fraction are derived and (1) the genetic parameter values (allele frequency and endophenotype and disease penetrance) and (2) the abnormal endophenotype rates in the population and in classes of relatives of disease affected probands. It is then shown that when either the disease or the abnormal endophenotype has additive penetrance, the expressions simplify to a monotonic function of the difference between abnormal endophenotype rates in siblings and in the population. Thought disorder is considered as a putative schizophrenia endophenotype. Forty sets of genetic parameter values that correspond to the known prevalence values for thought disorder in schizophrenic patients, siblings of schizophrenics and the general population are evaluated. For these genetic parameter values, numerical results show that the test statistic has>70% power (α = 0.0001) in general with a sample of 200 or more proband-sibling pairs to detect the linkage between a marker (θ = 0.01), and a locus pleiotropic for schizophrenia and thought disorder.
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Affiliation(s)
- Heejong Sung
- Genometric Section, IDRB, NHGRI, NIH, Baltimore, MD, USA
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Kalimo H, Miao Q, Tikka S, Mykkänen K, Junna M, Roine S, Viitanen M, Pöyhönen M, Baumann M. CADASIL: the most common hereditary subcortical vascular dementia. FUTURE NEUROLOGY 2008. [DOI: 10.2217/14796708.3.6.683] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Cerebral autosomal dominant arteriopathy with subcortical infarct and leukoencephalopathy (CADASIL) is the most common hereditary subcortical vascular dementia. It is caused by the defective NOTCH3 gene, which encodes a transmembrane receptor; over 170 different mutations are known. The main clinical features are migraine with aura (often atypical or isolated), strokes, cognitive decline/dementia and psychiatric symptoms. Executive and organizing cognitive functions are impaired first, memory is affected late. Typical MRI findings are T2 weighted hyperintensities in temporopolar white matter and the capsula externa. Smooth muscle cells in small arteries throughout the body degenerate and vessel walls become fibrotic. In the brain, this results in circulatory disturbances and lacunar infarcts, mainly in cerebral white matter and deep gray matter. The exact pathogenesis is still open: a dominant-negative toxic effect is suggested, possibly related to Notch3 misfolding. Diagnosis is reached either by identifying a pathogenic NOTCH3 mutation or by electron microscopic demonstration of granular osmiophilic material in a (skin) biopsy. Only symptomatic treatment is available at present.
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Affiliation(s)
- Hannu Kalimo
- Department of Pathology, University & University Hospital of Helsinki, Helsinki, Finland and, Uppsala University, Uppsala, Sweden and, Departments of Pathology & Forensic Medicine, Turku University & University Hospital, Turku, Finland
| | - Qing Miao
- Department of Pathology, Turku University, Turku, Finland
| | - Saara Tikka
- Protein Chemistry Unit, Institute of Biomedicine/Anatomy, University of Helsinki, Helsinki, Finland and, Department of Pathology, Helsinki University, Helsinki, Finland
| | - Kati Mykkänen
- Department of Medical Biochemistry & Genetics, University of Turku, Turku, Finland
| | - Maija Junna
- Department of Medical Biochemistry & Genetics, University of Turku, Turku, Finland
| | - Susanna Roine
- Department of Neurology, University Hospital of Turku, Turku, Finland
| | - Matti Viitanen
- Division of Clinical Geriatrics, Karolinska Institutet & Karolinska University Hospital, Stockholm, Sweden and, Department of Geriatric Medicine, University of Turku, Turku, Finland
| | - Minna Pöyhönen
- Department of Medical Genetics, University of Helsinki, Helsinki, Finland and, Department of Clinical Genetics, Helsinki University Hospital, Helsinki, Finland
| | - Marc Baumann
- Protein Chemistry Unit, Institute of Biomedicine/Anatomy, University of Helsinki, Helsinki, Finland
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Familial mesial temporal lobe epilepsy (FMTLE) : a clinical and genetic study of 15 Italian families. J Neurol 2007; 255:16-23. [PMID: 18004642 DOI: 10.1007/s00415-007-0653-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2007] [Revised: 04/12/2007] [Accepted: 05/04/2007] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Familial mesial temporal lobe epilepsy (FMTLE) is characterized by prominent psychic and autonomic seizures, often without hippocampal sclerosis (HS) or a previous history of febrile seizures (FS), and good prognosis. The genetics of this condition is largely unknown.We present the electroclinical and genetic findings of 15 MTLE Italian families. PATIENTS AND METHODS FMTLE was defined when two or more first-degree relatives had epilepsy suggesting a mesial temporal lobe origin. The occurrence of seizures with auditory auras was considered an exclusion criterion. Patients underwent video-EEG recordings, 1.5-Tesla MRI particularly focused on hippocampal analysis, and neuropsychological evaluation. Genetic study included genotyping and linkage analysis of candidate loci at 4q, 18q, 1q, and 12q as well as screening for LGI1/Epitempin mutations. RESULTS Most of the families showed an autosomal dominant inheritance pattern with incomplete penetrance. Fifty-four (32 F) affected individuals were investigated. Twenty-one (38.8 %) individuals experienced early FS. Forty-eight individuals fulfilled the criteria for MTLE. Epigastric/visceral sensation (72.9 %) was the most common type of aura, followed by psychic symptoms (35.4 %), and déjà vu (31.2 %). HS occurred in 13.8% of individuals, three of whom belonged to the same family. Prognosis of epilepsy was generally good. Genetic study failed to show LGI1/Epitempin mutations or significative linkage to the investigated loci. DISCUSSION FMTLE may be a more common than expected condition, clinically and genetically heterogeneous. Some of the reported families, grouped on the basis of a specific aura, may represent an interesting subgroup on whom to focus future linkage studies.
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Beghi E. Epilepsy. Curr Opin Neurol 2007; 20:169-74. [PMID: 17351487 DOI: 10.1097/wco.0b013e3280d646e4] [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: 11/26/2022]
Abstract
PURPOSE OF REVIEW To provide a critical review of studies published between December 2005 and November 2006, and detect the advances of basic and clinical research in epilepsy. RECENT FINDINGS The complexity of the mechanisms underlying epileptogenesis and drug resistance was repeatedly highlighted. Seizure diagnosis and classification are still difficult, despite the use of valid and reliable instruments. Even well defined epilepsy syndromes may exhibit complex genetic patterns and atypical electroencephalogram features. Low prevalence rates of active epilepsy have been reported from several countries, suggesting underreporting for sociocultural reasons. Several pregnancy and neonatal factors can be found to increase the risk of epilepsy when accurate data are available from well defined populations. Early remission of seizures does not always predict terminal remission after prolonged follow-up. Cognitive regression may be associated with the presence of interictal electroencephalographic epileptiform abnormalities. A Cochrane review showed lamotrigine to be less frequently withdrawn than carbamazepine. However, these findings are contrasted by clinical practice, which showed no individual drug to be more likely to confer seizure freedom than any other. SUMMARY Recent research highlights the complexity of the mechanisms of epileptogenesis and drug response, and the difficulties with the classification of epilepsy into separate phenotypic categories.
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Affiliation(s)
- Ettore Beghi
- Epilepsy Center, Ospedale San Gerardo, Monza, Italy.
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