Sleep-related hypermotor epilepsy (SHE): Contribution of known genes in 103 patients

On behalf of the Collaborative Group of Italian League Against Epilepsy (LICE) Genetic Study Group on SHE, L. Licchetta, T. Pippucci, S. Baldassari, R. Minardi, F. Provini, B. Mostacci, G. Plazzi, P. Tinuper, F. Bisulli, A. Bianchi, P. Striano, A. Gambardella, L. Giordano, M. Santucci, S. Meletti, G. Crichiutti, C. Marini, A. Vignoli, R. DilenaE. Briatore

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Genetics of Sleep-related Hypermotor Epilepsy (SHE) includes mutations in several genes that cumulatively account for 30 % of families. This approximate estimate comes from different case-series, each focused on the screening of a single gene. We systematically investigated a large cohort of SHE patients to estimate the frequency of pathogenic variants in the main genes thus far implicated in this epilepsy syndrome. Methods: We selected familial and isolated cases diagnosed with clinical/confirmed SHE who underwent genetic analysis by comparable next generation sequencing (NGS) techniques (WES/ multigene epilepsy panel). The identified heterozygous variants were classified according to the American College of Medical Genetics and Genomics guidelines. Results: We included 103 SHE patients (M/F:61/42) who underwent NGS. Sixteen (15.5 %) were familial cases, 16.5 % had focal cortical dysplasia (FCD). We identified three pathogenic variants in CHRNA4 (2.9 %, CI: 0.6–8.3 %), two of whom novel; one pathogenic variant in KCNT1 (1 %, CI: 0.02–5.29 %); four loss-of-function variants in DEPDC5 (3.9 %, CI: 1.1–9.7 %), one of whom never reported; finally, one missense change in NPRL2 (1 %, CI: 0.02–5.29 %), already reported as pathogenic. Three out of the four patients with DEPDC5 variants had FCD. Conclusions: The overall frequency of pathogenic variants in our SHE cohort was 8.7 %, 19 % and 7 % considering familial and sporadic cases, respectively. Pathogenic variants in the GATOR1-complex genes account for 5 % of the cases. DEPDC5 shows the highest variants frequency, especially in patients with genetic-structural etiology. From a practical perspective, analysis of this gene is recommended even in isolated cases, because of possible implications for patient management.

Original languageEnglish
Pages (from-to)60-64
Number of pages5
JournalSeizure
Volume74
DOIs
Publication statusPublished - 2020

Keywords

  • Genetics
  • Nocturnal frontal lobe epilepsy
  • Sleep-related hypermotor epilepsy
  • nicotinic receptor alpha4
  • Article
  • child
  • CHRNA4 gene
  • cohort analysis
  • controlled study
  • cortical dysplasia
  • DEPDC5 gene
  • epilepsy
  • familial disease
  • female
  • frameshift mutation
  • gene frequency
  • genetic variability
  • health care organization
  • heterozygosity
  • human
  • KCNT1 gene
  • loss of function mutation
  • major clinical study
  • male
  • missense mutation
  • multigene epilepsy panel
  • next generation sequencing
  • nonsense mutation
  • NPRL2 gene
  • practice guideline
  • priority journal
  • prognosis
  • sleep related hypermotor epilepsy
  • whole exome sequencing

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