Mutations in KCNT1 cause a spectrum of focal epilepsies

Rikke S. Møller, Sarah E. Heron, Line H G Larsen, Chiao Xin Lim, Michael G. Ricos, Marta A. Bayly, Marjan J A Van Kempen, Sylvia Klinkenberg, Ian Andrews, Kent Kelley, Gabriel M. Ronen, David Callen, Jacinta M. McMahon, Simone C. Yendle, Gemma L. Carvill, Heather C. Mefford, Rima Nabbout, Annapurna Poduri, Pasquale Striano, Maria G. BagliettoFederico Zara, Nicholas J. Smith, Clair Pridmore, Elena Gardella, Marina Nikanorova, Hans Atli Dahl, Pia Gellert, Ingrid E. Scheffer, Boudewijn Gunning, Bente Kragh-Olsen, Leanne M. Dibbens

Research output: Contribution to journalArticle

Abstract

Summary Autosomal dominant mutations in the sodium-gated potassium channel subunit gene KCNT1 have been associated with two distinct seizure syndromes, nocturnal frontal lobe epilepsy (NFLE) and malignant migrating focal seizures of infancy (MMFSI). To further explore the phenotypic spectrum associated with KCNT1, we examined individuals affected with focal epilepsy or an epileptic encephalopathy for mutations in the gene. We identified KCNT1 mutations in 12 previously unreported patients with focal epilepsy, multifocal epilepsy, cardiac arrhythmia, and in a family with sudden unexpected death in epilepsy (SUDEP), in addition to patients with NFLE and MMFSI. In contrast to the 100% penetrance so far reported for KCNT1 mutations, we observed incomplete penetrance. It is notable that we report that the one KCNT1 mutation, p.Arg398Gln, can lead to either of the two distinct phenotypes, ADNFLE or MMFSI, even within the same family. This indicates that genotype-phenotype relationships for KCNT1 mutations are not straightforward. We demonstrate that KCNT1 mutations are highly pleiotropic and are associated with phenotypes other than ADNFLE and MMFSI. KCNT1 mutations are now associated with Ohtahara syndrome, MMFSI, and nocturnal focal epilepsy. They may also be associated with multifocal epilepsy and cardiac disturbances.

Original languageEnglish
Pages (from-to)e114-e120
JournalEpilepsia
Volume56
Issue number9
DOIs
Publication statusPublished - Sep 1 2015

Keywords

  • Autosomal dominant nocturnal frontal lobe epilepsy
  • Cardiac arrhythmia
  • Epileptic encephalopathy
  • KCNT1
  • Sudden unexpected death in epilepsy

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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  • Cite this

    Møller, R. S., Heron, S. E., Larsen, L. H. G., Lim, C. X., Ricos, M. G., Bayly, M. A., Van Kempen, M. J. A., Klinkenberg, S., Andrews, I., Kelley, K., Ronen, G. M., Callen, D., McMahon, J. M., Yendle, S. C., Carvill, G. L., Mefford, H. C., Nabbout, R., Poduri, A., Striano, P., ... Dibbens, L. M. (2015). Mutations in KCNT1 cause a spectrum of focal epilepsies. Epilepsia, 56(9), e114-e120. https://doi.org/10.1111/epi.13071