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Ultra-Rare Genetic Variation in the Epilepsies: A Whole-Exome Sequencing Study of 17,606 Individuals
The American Journal of Human Genetics, Volume: 105, Issue: 2, Pages: 267 - 282
Swansea University Authors: Robert Powell, Owen Pickrell
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DOI (Published version): 10.1016/j.ajhg.2019.05.020
Abstract
Sequencing-based studies have identified novel risk genes for rare, severe epilepsies and revealed a role of rare deleterious variation in common epilepsies. To identify the shared and distinct ultra-rare genetic risk factors for rare and common epilepsies, we performed a whole-exome sequencing (WES...
Published in: | The American Journal of Human Genetics |
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ISSN: | 0002-9297 |
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Elsevier BV
2019
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URI: | https://cronfa.swan.ac.uk/Record/cronfa51398 |
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2019-08-15T15:30:43Z |
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2019-09-24T14:18:08Z |
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<?xml version="1.0"?><rfc1807><datestamp>2019-09-24T13:48:51.8763172</datestamp><bib-version>v2</bib-version><id>51398</id><entry>2019-08-15</entry><title>Ultra-Rare Genetic Variation in the Epilepsies: A Whole-Exome Sequencing Study of 17,606 Individuals</title><swanseaauthors><author><sid>7c8ac48bb6ae4281930e4138f94a51b6</sid><firstname>Robert</firstname><surname>Powell</surname><name>Robert Powell</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>1c3044b5ff7a6552ff5e8c9e3901c807</sid><ORCID>0000-0003-4396-5657</ORCID><firstname>Owen</firstname><surname>Pickrell</surname><name>Owen Pickrell</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2019-08-15</date><abstract>Sequencing-based studies have identified novel risk genes for rare, severe epilepsies and revealed a role of rare deleterious variation in common epilepsies. To identify the shared and distinct ultra-rare genetic risk factors for rare and common epilepsies, we performed a whole-exome sequencing (WES) analysis of 9,170 epilepsy-affected individuals and 8,364 controls of European ancestry. We focused on three phenotypic groups; the rare but severe developmental and epileptic encephalopathies (DEE), and the commoner phenotypes of genetic generalized epilepsy (GGE) and non-acquired focal epilepsy (NAFE). We observed that compared to controls, individuals with any type of epilepsy carried an excess of ultra-rare, deleterious variants in constrained genes and in genes previously associated with epilepsy, with the strongest enrichment seen in DEE and the least in NAFE. Moreover, we found that inhibitory GABAA receptor genes were enriched for missense burden across all three classes of epilepsy, while no enrichment was seen in excitatory receptor genes. The larger gene groups for the GABAergic pathway or cation channels also showed a significant mutational burden in DEE and GGE. Although no single gene surpassed exome-wide significance for individuals with GGE or NAFE, highly constrained genes and genes encoding ion channels were among the top associations, including CACNA1G, EEF1A2, and GABRG2 for GGE and LGI1, TRIM3, and GABRG2 for NAFE. Our study confirms a convergence in the genetics of common and rare epilepsies associated with ultra-rare coding variation and highlights a ubiquitous role of GABAergic inhibition in epilepsy etiology in the largest epilepsy WES study to date.</abstract><type>Journal Article</type><journal>The American Journal of Human Genetics</journal><volume>105</volume><journalNumber>2</journalNumber><paginationStart>267</paginationStart><paginationEnd>282</paginationEnd><publisher>Elsevier BV</publisher><issnPrint>0002-9297</issnPrint><keywords>epilepsy; seizures; epileptic encephalopathy; exome; sequencing; burden analysis</keywords><publishedDay>1</publishedDay><publishedMonth>8</publishedMonth><publishedYear>2019</publishedYear><publishedDate>2019-08-01</publishedDate><doi>10.1016/j.ajhg.2019.05.020</doi><url/><notes/><college>COLLEGE NANME</college><CollegeCode>COLLEGE CODE</CollegeCode><institution>Swansea University</institution><apcterm/><lastEdited>2019-09-24T13:48:51.8763172</lastEdited><Created>2019-08-15T09:35:39.5785538</Created><authors><author><firstname>Robert</firstname><surname>Powell</surname><order>1</order></author><author><firstname>Yen-Chen Anne</firstname><surname>Feng</surname><order>2</order></author><author><firstname>Daniel P.</firstname><surname>Howrigan</surname><order>3</order></author><author><firstname>Liam E.</firstname><surname>Abbott</surname><order>4</order></author><author><firstname>Katherine</firstname><surname>Tashman</surname><order>5</order></author><author><firstname>Felecia</firstname><surname>Cerrato</surname><order>6</order></author><author><firstname>Tarjinder</firstname><surname>Singh</surname><order>7</order></author><author><firstname>Henrike</firstname><surname>Heyne</surname><order>8</order></author><author><firstname>Andrea</firstname><surname>Byrnes</surname><order>9</order></author><author><firstname>Claire</firstname><surname>Churchhouse</surname><order>10</order></author><author><firstname>Nick</firstname><surname>Watts</surname><order>11</order></author><author><firstname>Matthew</firstname><surname>Solomonson</surname><order>12</order></author><author><firstname>Dennis</firstname><surname>Lal</surname><order>13</order></author><author><firstname>Erin L.</firstname><surname>Heinzen</surname><order>14</order></author><author><firstname>Ryan S.</firstname><surname>Dhindsa</surname><order>15</order></author><author><firstname>Kate E.</firstname><surname>Stanley</surname><order>16</order></author><author><firstname>Gianpiero L.</firstname><surname>Cavalleri</surname><order>17</order></author><author><firstname>Hakon</firstname><surname>Hakonarson</surname><order>18</order></author><author><firstname>Ingo</firstname><surname>Helbig</surname><order>19</order></author><author><firstname>Roland</firstname><surname>Krause</surname><order>20</order></author><author><firstname>Patrick</firstname><surname>May</surname><order>21</order></author><author><firstname>Sarah</firstname><surname>Weckhuysen</surname><order>22</order></author><author><firstname>Slavé</firstname><surname>Petrovski</surname><order>23</order></author><author><firstname>Sitharthan</firstname><surname>Kamalakaran</surname><order>24</order></author><author><firstname>Sanjay 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A.</firstname><surname>McCarroll</surname><order>233</order></author><author><firstname>Namrata</firstname><surname>Gupta</surname><order>234</order></author><author><firstname>Stacey B.</firstname><surname>Gabriel</surname><order>235</order></author><author><firstname>Mark J.</firstname><surname>Daly</surname><order>236</order></author><author><firstname>Eric S.</firstname><surname>Lander</surname><order>237</order></author><author><firstname>Daniel H.</firstname><surname>Lowenstein</surname><order>238</order></author><author><firstname>David B.</firstname><surname>Goldstein</surname><order>239</order></author><author><firstname>Holger</firstname><surname>Lerche</surname><order>240</order></author><author><firstname>Samuel F.</firstname><surname>Berkovic</surname><order>241</order></author><author><firstname>Benjamin M.</firstname><surname>Neale</surname><order>242</order></author><author><firstname>Owen</firstname><surname>Pickrell</surname><orcid>0000-0003-4396-5657</orcid><order>243</order></author></authors><documents><document><filename>51398__15710__c52ca83e489c49e7a8d471c1ab7659ff.pdf</filename><originalFilename>Epi25_Preprint.pdf</originalFilename><uploaded>2019-10-24T09:05:50.1806108</uploaded><type>Output</type><contentLength>489399</contentLength><contentType>application/pdf</contentType><version>Author's Original</version><cronfaStatus>true</cronfaStatus><documentNotes>Released under the terms of a Creative Commons Attribution Non-Commercial No Derivatives License (CC-BY-NC-ND).</documentNotes><copyrightCorrect>true</copyrightCorrect></document></documents><OutputDurs/></rfc1807> |
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2019-09-24T13:48:51.8763172 v2 51398 2019-08-15 Ultra-Rare Genetic Variation in the Epilepsies: A Whole-Exome Sequencing Study of 17,606 Individuals 7c8ac48bb6ae4281930e4138f94a51b6 Robert Powell Robert Powell true false 1c3044b5ff7a6552ff5e8c9e3901c807 0000-0003-4396-5657 Owen Pickrell Owen Pickrell true false 2019-08-15 Sequencing-based studies have identified novel risk genes for rare, severe epilepsies and revealed a role of rare deleterious variation in common epilepsies. To identify the shared and distinct ultra-rare genetic risk factors for rare and common epilepsies, we performed a whole-exome sequencing (WES) analysis of 9,170 epilepsy-affected individuals and 8,364 controls of European ancestry. We focused on three phenotypic groups; the rare but severe developmental and epileptic encephalopathies (DEE), and the commoner phenotypes of genetic generalized epilepsy (GGE) and non-acquired focal epilepsy (NAFE). We observed that compared to controls, individuals with any type of epilepsy carried an excess of ultra-rare, deleterious variants in constrained genes and in genes previously associated with epilepsy, with the strongest enrichment seen in DEE and the least in NAFE. Moreover, we found that inhibitory GABAA receptor genes were enriched for missense burden across all three classes of epilepsy, while no enrichment was seen in excitatory receptor genes. The larger gene groups for the GABAergic pathway or cation channels also showed a significant mutational burden in DEE and GGE. Although no single gene surpassed exome-wide significance for individuals with GGE or NAFE, highly constrained genes and genes encoding ion channels were among the top associations, including CACNA1G, EEF1A2, and GABRG2 for GGE and LGI1, TRIM3, and GABRG2 for NAFE. Our study confirms a convergence in the genetics of common and rare epilepsies associated with ultra-rare coding variation and highlights a ubiquitous role of GABAergic inhibition in epilepsy etiology in the largest epilepsy WES study to date. Journal Article The American Journal of Human Genetics 105 2 267 282 Elsevier BV 0002-9297 epilepsy; seizures; epileptic encephalopathy; exome; sequencing; burden analysis 1 8 2019 2019-08-01 10.1016/j.ajhg.2019.05.020 COLLEGE NANME COLLEGE CODE Swansea University 2019-09-24T13:48:51.8763172 2019-08-15T09:35:39.5785538 Robert Powell 1 Yen-Chen Anne Feng 2 Daniel P. Howrigan 3 Liam E. Abbott 4 Katherine Tashman 5 Felecia Cerrato 6 Tarjinder Singh 7 Henrike Heyne 8 Andrea Byrnes 9 Claire Churchhouse 10 Nick Watts 11 Matthew Solomonson 12 Dennis Lal 13 Erin L. Heinzen 14 Ryan S. Dhindsa 15 Kate E. Stanley 16 Gianpiero L. Cavalleri 17 Hakon Hakonarson 18 Ingo Helbig 19 Roland Krause 20 Patrick May 21 Sarah Weckhuysen 22 Slavé Petrovski 23 Sitharthan Kamalakaran 24 Sanjay M. Sisodiya 25 Patrick Cossette 26 Chris Cotsapas 27 Peter De Jonghe 28 Tracy Dixon-Salazar 29 Renzo Guerrini 30 Patrick Kwan 31 Anthony G. Marson 32 Randy Stewart 33 Chantal Depondt 34 Dennis J. Dlugos 35 Ingrid E. Scheffer 36 Pasquale Striano 37 Catharine Freyer 38 Kevin McKenna 39 Brigid M. Regan 40 Susannah T. Bellows 41 Costin Leu 42 Caitlin A. Bennett 43 Esther M.C. Johns 44 Alexandra Macdonald 45 Hannah Shilling 46 Rosemary Burgess 47 Dorien Weckhuysen 48 Melanie Bahlo 49 Terence J. O’Brien 50 Marian Todaro 51 Hannah Stamberger 52 Danielle M. Andrade 53 Tara R. Sadoway 54 Kelly Mo 55 Heinz Krestel 56 Sabina Gallati 57 Savvas S. Papacostas 58 Ioanna Kousiappa 59 George A. Tanteles 60 Katalin Štěrbová 61 Markéta Vlčková 62 Lucie Sedláčková 63 Petra Laššuthová 64 Karl Martin Klein 65 Felix Rosenow 66 Philipp S. Reif 67 Susanne Knake 68 Wolfram S. Kunz 69 Gábor Zsurka 70 Christian E. Elger 71 Jürgen Bauer 72 Michael Rademacher 73 Manuela Pendziwiat 74 Hiltrud Muhle 75 Annika Rademacher 76 Andreas van Baalen 77 Sarah von Spiczak 78 Ulrich Stephani 79 Zaid Afawi 80 Amos D. Korczyn 81 Moien Kanaan 82 Christina Canavati 83 Gerhard Kurlemann 84 Karen Müller-Schlüter 85 Gerhard Kluger 86 Martin Häusler 87 Ilan Blatt 88 Johannes R. Lemke 89 Ilona Krey 90 Yvonne G. Weber 91 Stefan Wolking 92 Felicitas Becker 93 Christian Hengsbach 94 Sarah Rau 95 Ana F. Maisch 96 Bernhard J. Steinhoff 97 Andreas Schulze-Bonhage 98 Susanne Schubert-Bast 99 Herbert Schreiber 100 Ingo Borggräfe 101 Christoph J. Schankin 102 Thomas Mayer 103 Rudolf Korinthenberg 104 Knut Brockmann 105 Gerhard Kurlemann 106 Dieter Dennig 107 Rene Madeleyn 108 Reetta Kälviäinen 109 Pia Auvinen 110 Anni Saarela 111 Tarja Linnankivi 112 Anna-Elina Lehesjoki 113 Mark I. Rees 114 Seo-Kyung Chung 115 William O. Pickrell 116 Robert Powell 117 Natascha Schneider 118 Simona Balestrini 119 Sara Zagaglia 120 Vera Braatz 121 Michael R. Johnson 122 Pauls Auce 123 Graeme J. Sills 124 Larry W. Baum 125 Pak C. Sham 126 Stacey S. Cherny 127 Colin H.T. Lui 128 Nina Barišić 129 Norman Delanty 130 Colin P. Doherty 131 Arif Shukralla 132 Mark McCormack 133 Hany El-Naggar 134 Laura Canafoglia 135 Silvana Franceschetti 136 Barbara Castellotti 137 Tiziana Granata 138 Federico Zara 139 Michele Iacomino 140 Francesca Madia 141 Maria Stella Vari 142 Maria Margherita Mancardi 143 Vincenzo Salpietro 144 Francesca Bisulli 145 Paolo Tinuper 146 Laura Licchetta 147 Tommaso Pippucci 148 Carlotta Stipa 149 Raffaella Minardi 150 Antonio Gambardella 151 Angelo Labate 152 Grazia Annesi 153 Lorella Manna 154 Monica Gagliardi 155 Elena Parrini 156 Davide Mei 157 Annalisa Vetro 158 Claudia Bianchini 159 Martino Montomoli 160 Viola Doccini 161 Carla Marini 162 Toshimitsu Suzuki 163 Yushi Inoue 164 Kazuhiro Yamakawa 165 Birute Tumiene 166 Lynette G. Sadleir 167 Chontelle King 168 Emily Mountier 169 S. Hande Caglayan 170 Mutluay Arslan 171 Zuhal Yapıcı 172 Uluc Yis 173 Pınar Topaloglu 174 Bulent Kara 175 Dilsad Turkdogan 176 Aslı Gundogdu-Eken 177 Nerses Bebek 178 Sibel Uğur-İşeri 179 Betül Baykan 180 Barış Salman 181 Garen Haryanyan 182 Emrah Yücesan 183 Yeşim Kesim 184 Çiğdem Özkara 185 Annapurna Poduri 186 Beth R. Shiedley 187 Catherine Shain 188 Russell J. Buono 189 Thomas N. Ferraro 190 Michael R. Sperling 191 Warren Lo 192 Michael Privitera 193 Jacqueline A. French 194 Steven Schachter 195 Ruben I. Kuzniecky 196 Orrin Devinsky 197 Manu Hegde 198 Pouya Khankhanian 199 Katherine L. Helbig 200 Colin A. Ellis 201 Gianfranco Spalletta 202 Fabrizio Piras 203 Federica Piras 204 Tommaso Gili 205 Valentina Ciullo 206 Andreas Reif 207 Andrew McQuillin 208 Nick Bass 209 Andrew McIntosh 210 Douglas Blackwood 211 Mandy Johnstone 212 Aarno Palotie 213 Michele T. Pato 214 Carlos N. Pato 215 Evelyn J. Bromet 216 Celia Barreto Carvalho 217 Eric D. Achtyes 218 Maria Helena Azevedo 219 Roman Kotov 220 Douglas S. Lehrer 221 Dolores Malaspina 222 Stephen R. Marder 223 Helena Medeiros 224 Christopher P. Morley 225 Diana O. Perkins 226 Janet L. Sobell 227 Peter F. Buckley 228 Fabio Macciardi 229 Mark H. Rapaport 230 James A. Knowles 231 Ayman H. Fanous 232 Steven A. McCarroll 233 Namrata Gupta 234 Stacey B. Gabriel 235 Mark J. Daly 236 Eric S. Lander 237 Daniel H. Lowenstein 238 David B. Goldstein 239 Holger Lerche 240 Samuel F. Berkovic 241 Benjamin M. Neale 242 Owen Pickrell 0000-0003-4396-5657 243 51398__15710__c52ca83e489c49e7a8d471c1ab7659ff.pdf Epi25_Preprint.pdf 2019-10-24T09:05:50.1806108 Output 489399 application/pdf Author's Original true Released under the terms of a Creative Commons Attribution Non-Commercial No Derivatives License (CC-BY-NC-ND). true |
title |
Ultra-Rare Genetic Variation in the Epilepsies: A Whole-Exome Sequencing Study of 17,606 Individuals |
spellingShingle |
Ultra-Rare Genetic Variation in the Epilepsies: A Whole-Exome Sequencing Study of 17,606 Individuals Robert Powell Owen Pickrell |
title_short |
Ultra-Rare Genetic Variation in the Epilepsies: A Whole-Exome Sequencing Study of 17,606 Individuals |
title_full |
Ultra-Rare Genetic Variation in the Epilepsies: A Whole-Exome Sequencing Study of 17,606 Individuals |
title_fullStr |
Ultra-Rare Genetic Variation in the Epilepsies: A Whole-Exome Sequencing Study of 17,606 Individuals |
title_full_unstemmed |
Ultra-Rare Genetic Variation in the Epilepsies: A Whole-Exome Sequencing Study of 17,606 Individuals |
title_sort |
Ultra-Rare Genetic Variation in the Epilepsies: A Whole-Exome Sequencing Study of 17,606 Individuals |
author_id_str_mv |
7c8ac48bb6ae4281930e4138f94a51b6 1c3044b5ff7a6552ff5e8c9e3901c807 |
author_id_fullname_str_mv |
7c8ac48bb6ae4281930e4138f94a51b6_***_Robert Powell 1c3044b5ff7a6552ff5e8c9e3901c807_***_Owen Pickrell |
author |
Robert Powell Owen Pickrell |
author2 |
Robert Powell Yen-Chen Anne Feng Daniel P. Howrigan Liam E. Abbott Katherine Tashman Felecia Cerrato Tarjinder Singh Henrike Heyne Andrea Byrnes Claire Churchhouse Nick Watts Matthew Solomonson Dennis Lal Erin L. Heinzen Ryan S. Dhindsa Kate E. Stanley Gianpiero L. Cavalleri Hakon Hakonarson Ingo Helbig Roland Krause Patrick May Sarah Weckhuysen Slavé Petrovski Sitharthan Kamalakaran Sanjay M. Sisodiya Patrick Cossette Chris Cotsapas Peter De Jonghe Tracy Dixon-Salazar Renzo Guerrini Patrick Kwan Anthony G. Marson Randy Stewart Chantal Depondt Dennis J. Dlugos Ingrid E. Scheffer Pasquale Striano Catharine Freyer Kevin McKenna Brigid M. Regan Susannah T. Bellows Costin Leu Caitlin A. Bennett Esther M.C. Johns Alexandra Macdonald Hannah Shilling Rosemary Burgess Dorien Weckhuysen Melanie Bahlo Terence J. O’Brien Marian Todaro Hannah Stamberger Danielle M. Andrade Tara R. Sadoway Kelly Mo Heinz Krestel Sabina Gallati Savvas S. Papacostas Ioanna Kousiappa George A. Tanteles Katalin Štěrbová Markéta Vlčková Lucie Sedláčková Petra Laššuthová Karl Martin Klein Felix Rosenow Philipp S. Reif Susanne Knake Wolfram S. Kunz Gábor Zsurka Christian E. Elger Jürgen Bauer Michael Rademacher Manuela Pendziwiat Hiltrud Muhle Annika Rademacher Andreas van Baalen Sarah von Spiczak Ulrich Stephani Zaid Afawi Amos D. Korczyn Moien Kanaan Christina Canavati Gerhard Kurlemann Karen Müller-Schlüter Gerhard Kluger Martin Häusler Ilan Blatt Johannes R. Lemke Ilona Krey Yvonne G. Weber Stefan Wolking Felicitas Becker Christian Hengsbach Sarah Rau Ana F. Maisch Bernhard J. Steinhoff Andreas Schulze-Bonhage Susanne Schubert-Bast Herbert Schreiber Ingo Borggräfe Christoph J. Schankin Thomas Mayer Rudolf Korinthenberg Knut Brockmann Gerhard Kurlemann Dieter Dennig Rene Madeleyn Reetta Kälviäinen Pia Auvinen Anni Saarela Tarja Linnankivi Anna-Elina Lehesjoki Mark I. Rees Seo-Kyung Chung William O. Pickrell Robert Powell Natascha Schneider Simona Balestrini Sara Zagaglia Vera Braatz Michael R. Johnson Pauls Auce Graeme J. Sills Larry W. Baum Pak C. Sham Stacey S. Cherny Colin H.T. Lui Nina Barišić Norman Delanty Colin P. Doherty Arif Shukralla Mark McCormack Hany El-Naggar Laura Canafoglia Silvana Franceschetti Barbara Castellotti Tiziana Granata Federico Zara Michele Iacomino Francesca Madia Maria Stella Vari Maria Margherita Mancardi Vincenzo Salpietro Francesca Bisulli Paolo Tinuper Laura Licchetta Tommaso Pippucci Carlotta Stipa Raffaella Minardi Antonio Gambardella Angelo Labate Grazia Annesi Lorella Manna Monica Gagliardi Elena Parrini Davide Mei Annalisa Vetro Claudia Bianchini Martino Montomoli Viola Doccini Carla Marini Toshimitsu Suzuki Yushi Inoue Kazuhiro Yamakawa Birute Tumiene Lynette G. Sadleir Chontelle King Emily Mountier S. Hande Caglayan Mutluay Arslan Zuhal Yapıcı Uluc Yis Pınar Topaloglu Bulent Kara Dilsad Turkdogan Aslı Gundogdu-Eken Nerses Bebek Sibel Uğur-İşeri Betül Baykan Barış Salman Garen Haryanyan Emrah Yücesan Yeşim Kesim Çiğdem Özkara Annapurna Poduri Beth R. Shiedley Catherine Shain Russell J. Buono Thomas N. Ferraro Michael R. Sperling Warren Lo Michael Privitera Jacqueline A. French Steven Schachter Ruben I. Kuzniecky Orrin Devinsky Manu Hegde Pouya Khankhanian Katherine L. Helbig Colin A. Ellis Gianfranco Spalletta Fabrizio Piras Federica Piras Tommaso Gili Valentina Ciullo Andreas Reif Andrew McQuillin Nick Bass Andrew McIntosh Douglas Blackwood Mandy Johnstone Aarno Palotie Michele T. Pato Carlos N. Pato Evelyn J. Bromet Celia Barreto Carvalho Eric D. Achtyes Maria Helena Azevedo Roman Kotov Douglas S. Lehrer Dolores Malaspina Stephen R. Marder Helena Medeiros Christopher P. Morley Diana O. Perkins Janet L. Sobell Peter F. Buckley Fabio Macciardi Mark H. Rapaport James A. Knowles Ayman H. Fanous Steven A. McCarroll Namrata Gupta Stacey B. Gabriel Mark J. Daly Eric S. Lander Daniel H. Lowenstein David B. Goldstein Holger Lerche Samuel F. Berkovic Benjamin M. Neale Owen Pickrell |
format |
Journal article |
container_title |
The American Journal of Human Genetics |
container_volume |
105 |
container_issue |
2 |
container_start_page |
267 |
publishDate |
2019 |
institution |
Swansea University |
issn |
0002-9297 |
doi_str_mv |
10.1016/j.ajhg.2019.05.020 |
publisher |
Elsevier BV |
document_store_str |
1 |
active_str |
0 |
description |
Sequencing-based studies have identified novel risk genes for rare, severe epilepsies and revealed a role of rare deleterious variation in common epilepsies. To identify the shared and distinct ultra-rare genetic risk factors for rare and common epilepsies, we performed a whole-exome sequencing (WES) analysis of 9,170 epilepsy-affected individuals and 8,364 controls of European ancestry. We focused on three phenotypic groups; the rare but severe developmental and epileptic encephalopathies (DEE), and the commoner phenotypes of genetic generalized epilepsy (GGE) and non-acquired focal epilepsy (NAFE). We observed that compared to controls, individuals with any type of epilepsy carried an excess of ultra-rare, deleterious variants in constrained genes and in genes previously associated with epilepsy, with the strongest enrichment seen in DEE and the least in NAFE. Moreover, we found that inhibitory GABAA receptor genes were enriched for missense burden across all three classes of epilepsy, while no enrichment was seen in excitatory receptor genes. The larger gene groups for the GABAergic pathway or cation channels also showed a significant mutational burden in DEE and GGE. Although no single gene surpassed exome-wide significance for individuals with GGE or NAFE, highly constrained genes and genes encoding ion channels were among the top associations, including CACNA1G, EEF1A2, and GABRG2 for GGE and LGI1, TRIM3, and GABRG2 for NAFE. Our study confirms a convergence in the genetics of common and rare epilepsies associated with ultra-rare coding variation and highlights a ubiquitous role of GABAergic inhibition in epilepsy etiology in the largest epilepsy WES study to date. |
published_date |
2019-08-01T13:44:56Z |
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1821956895370379264 |
score |
11.048149 |