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Genetic Basis of Early-onset Developmental and Epileptic Encephalopathies

  • Hwang, Su-Kyeong (Department of Pediatrics, School of Medicine, Kyungpook National University)
  • Received : 2021.03.19
  • Accepted : 2021.03.30
  • Published : 2021.04.30

Abstract

Developmental and epileptic encephalopathies are the most devastating early-onset epilepsies, characterized by early-onset seizures that are often intractable, electroencephalographic abnormalities, developmental delay or regression, and various comorbidities. A large number of underlying genetic variants of developmental and epileptic encephalopathies have been identified over the past few decades. However, the most thorough sequencing studies leave 60-65% of patients without a molecular diagnosis. This review explores the genetic basis of developmental and epileptic encephalopathies that start within the first year of life, including Ohtahara syndrome, early myoclonic encephalopathy, epilepsy of infancy with migrating focal seizures, infantile spasms, and Dravet syndrome. The purpose of this review is to give an overview and encourage the clinicians to start considering genetic testing as an important investigation along with electroencephalogram for better understanding and management of developmental and epileptic encephalopathies.

Keywords

References

  1. Nieh SE, Sherr EH. Epileptic encephalopathies: new genes and new pathways. Neurotherapeutics 2014;11:796-806. https://doi.org/10.1007/s13311-014-0301-2
  2. Euro E-RESC, Epilepsy Phenome/Genome P, Epi KC. De novo mutations in synaptic transmission genes including DNM1 cause epileptic encephalopathies. Am J Hum Genet 2014;95:360-70. https://doi.org/10.1016/j.ajhg.2014.08.013
  3. Gursoy S, Ercal D. Diagnostic approach to genetic causes of early-onset epileptic encephalopathy. J Child Neurol 2016;31:523-32. https://doi.org/10.1177/0883073815599262
  4. Wirrell E, Wong-Kisiel L, Mandrekar J, Nickels K. Predictors and course of medically intractable epilepsy in young children presenting before 36 months of age: a retrospective, populationbased study. Epilepsia 2012;53:1563-9. https://doi.org/10.1111/j.1528-1167.2012.03562.x
  5. Eltze CM, Chong WK, Cox T, Whitney A, Cortina-Borja M, Chin RF, et al. A population-based study of newly diagnosed epilepsy in infants. Epilepsia 2013;54:437-45. https://doi.org/10.1111/epi.12046
  6. Morrison-Levy N, Borlot F, Jain P, Whitney R. Early-onset developmental and epileptic encephalopathies of infancy: an overview of the genetic basis and clinical features. Pediatr Neurol 2020;116:85-94. https://doi.org/10.1016/j.pediatrneurol.2020.12.001
  7. Scheffer IE, Berkovic S, Capovilla G, Connolly MB, French J, Guilhoto L, et al. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia 2017;58:512-21. https://doi.org/10.1111/epi.13709
  8. Deciphering Developmental Disorders S. Prevalence and architecture of de novo mutations in developmental disorders. Nature 2017;542:433-8. https://doi.org/10.1038/nature21062
  9. Steward CA, Roovers J, Suner MM, Gonzalez JM, Uszczynska-Ratajczak B, Pervouchine D, et al. Re-annotation of 191 developmental and epileptic encephalopathy-associated genes unmasks de novo variants in SCN1A. NPJ Genom Med 2019;4:31. https://doi.org/10.1038/s41525-019-0106-7
  10. Shellhaas RA, Wusthoff CJ, Tsuchida TN, Glass HC, Chu CJ, Massey SL, et al. Profile of neonatal epilepsies: Characteristics of a prospective US cohort. Neurology 2017;89:893-9. https://doi.org/10.1212/wnl.0000000000004284
  11. Ma X, Yang F, Hua Z. Genetic diagnosis of neonatal-onset seizures. Genes Dis 2019;6:441-7. https://doi.org/10.1016/j.gendis.2019.02.002
  12. Claes L, Del-Favero J, Ceulemans B, Lagae L, Van Broeckhoven C, De Jonghe P. De novo mutations in the sodium-channel gene SCN1A cause severe myoclonic epilepsy of infancy. Am J Hum Genet 2001;68:1327-32. https://doi.org/10.1086/320609
  13. Jain P, Andrade D, Donner E, Dyment D, Prasad AN, Goobie S, et al. Development of criteria for epilepsy genetic testing in Ontario, Canada. Can J Neurol Sci 2019;46:7-13. https://doi.org/10.1017/cjn.2018.341
  14. Myers KA, Johnstone DL, Dyment DA. Epilepsy genetics: Current knowledge, applications, and future directions. Clin Genet 2019;95:95-111. https://doi.org/10.1111/cge.13414
  15. Mefford HC, Yendle SC, Hsu C, Cook J, Geraghty E, McMahon JM, et al. Rare copy number variants are an important cause of epileptic encephalopathies. Ann Neurol 2011;70:974-85. https://doi.org/10.1002/ana.22645
  16. Olson H, Shen Y, Avallone J, Sheidley BR, Pinsky R, Bergin AM, et al. Copy number variation plays an important role in clinical epilepsy. Ann Neurol 2014;75:943-58. https://doi.org/10.1002/ana.24178
  17. Borlot F, Regan BM, Bassett AS, Stavropoulos DJ, Andrade DM. Prevalence of pathogenic copy number variation in adults with pediatric-onset epilepsy and intellectual disability. JAMA Neurol 2017;74:1301-11. https://doi.org/10.1001/jamaneurol.2017.1775
  18. Borlot F, de Almeida BI, Combe SL, Andrade DM, Filloux FM, Myers KA. Clinical utility of multigene panel testing in adults with epilepsy and intellectual disability. Epilepsia 2019;60:1661-9. https://doi.org/10.1111/epi.16273
  19. Perry MS. Genetic testing in epileptic encephalopathy: rosetta stone or just an expensive rock? Epilepsy Curr 2016;16:12-3. https://doi.org/10.5698/1535-7597-16.1.12
  20. Zupanc ML. Clinical evaluation and diagnosis of severe epilepsy syndromes of early childhood. J Child Neurol 2009;24(8 Suppl):6S-14S. https://doi.org/10.1177/0883073809338151
  21. Galanopoulou AS, Moshe SL. The epileptic hypothesis: developmentally related arguments based on animal models. Epilepsia. 2009;50(Suppl 7):37-42. https://doi.org/10.1111/j.1528-1167.2009.02217.x
  22. Na JH, Shin S, Yang D, Kim B, Kim HD, Kim S, et al. Targeted gene panel sequencing in early infantile onset developmental and epileptic encephalopathy. Brain Dev 2020;42:438-48. https://doi.org/10.1016/j.braindev.2020.02.004
  23. Kothur K, Holman K, Farnsworth E, Ho G, Lorentzos M, Troedson C, et al. Diagnostic yield of targeted massively parallel sequencing in children with epileptic encephalopathy. Seizure 2018;59:132-40. https://doi.org/10.1016/j.seizure.2018.05.005
  24. Arafat A, Jing P, Ma Y, Pu M, Nan G, Fang H, et al. Unexplained early infantile epileptic encephalopathy in han chinese children: next-generation sequencing and phenotype enriching. Sci Rep 2017;7:46227. https://doi.org/10.1038/srep46227
  25. Ohtahara S, Yamatogi Y. Ohtahara syndrome: with special reference to its developmental aspects for differentiating from early myoclonic encephalopathy. Epilepsy Res 2006;70(Suppl 1):S58-67.
  26. Murakami N, Ohtsuka Y, Ohtahara S. Early infantile epileptic syndromes with suppression-bursts: early myoclonic encephalopathy vs. Ohtahara syndrome. Jpn J Psychiatry Neurol 1993;47:197-200.
  27. Ohtahara S, Yamatogi Y. Epileptic encephalopathies in early infancy with suppression-burst. J Clin Neurophysiol 2003;20:398-407. https://doi.org/10.1097/00004691-200311000-00003
  28. Yamatogi Y, Ohtahara S. Early-infantile epileptic encephalopathy with suppression-bursts, Ohtahara syndrome; its overview referring to our 16 cases. Brain Dev 2002;24:13-23. https://doi.org/10.1016/S0387-7604(01)00392-8
  29. Hwang SK, Kwon S. Early-onset epileptic encephalopathies and the diagnostic approach to underlying causes. Korean J Pediatr 2015;58:407-14. https://doi.org/10.3345/kjp.2015.58.11.407
  30. McTague A, Howell KB, Cross JH, Kurian MA, Scheffer IE. The genetic landscape of the epileptic encephalopathies of infancy and childhood. Lancet Neurol 2016;15:304-16. https://doi.org/10.1016/S1474-4422(15)00250-1
  31. Khan S, Al Baradie R. Epileptic encephalopathies: an overview. Epilepsy Res Treat 2012;2012:403592. https://doi.org/10.1155/2012/403592
  32. Lombroso CT. Early myoclonic encephalopathy, early infantile epileptic encephalopathy, and benign and severe infantile myoclonic epilepsies: a critical review and personal contributions. J Clin Neurophysiol 1990;7:380-408. https://doi.org/10.1097/00004691-199007000-00005
  33. Nabbout R, Desguerre I, Sabbagh S, Depienne C, Plouin P, Dulac O, et al. An unexpected EEG course in Dravet syndrome. Epilepsy Res 2008;81:90-5. https://doi.org/10.1016/j.eplepsyres.2008.04.015
  34. Coppola G, Plouin P, Chiron C, Robain O, Dulac O. Migrating partial seizures in infancy: a malignant disorder with developmental arrest. Epilepsia 1995;36:1017-24. https://doi.org/10.1111/j.1528-1157.1995.tb00961.x
  35. Barcia G, Fleming MR, Deligniere A, Gazula VR, Brown MR, Langouet M, et al. De novo gain-of-function KCNT1 channel mutations cause malignant migrating partial seizures of infancy. Nat Genet 2012;44:1255-9. https://doi.org/10.1038/ng.2441
  36. McTague A, Appleton R, Avula S, Cross JH, King MD, Jacques TS, et al. Migrating partial seizures of infancy: expansion of the electroclinical, radiological and pathological disease spectrum. Brain 2013;136(Pt 5):1578-91. https://doi.org/10.1093/brain/awt073
  37. Ohba C, Kato M, Takahashi N, Osaka H, Shiihara T, Tohyama J, et al. De novo KCNT1 mutations in early-onset epileptic encephalopathy. Epilepsia 2015;56:e121-8. https://doi.org/10.1111/epi.13072
  38. Alam S, Lux AL. Epilepsies in infancy. Arch Dis Child 2012;97:985-92. https://doi.org/10.1136/archdischild-2011-301119
  39. Mackay MT, Weiss SK, Adams-Webber T, Ashwal S, Stephens D, Ballaban-Gill K, et al. Practice parameter: medical treatment of infantile spasms: report of the American Academy of Neurology and the Child Neurology Society. Neurology 2004;62:1668-81. https://doi.org/10.1212/01.WNL.0000127773.72699.C8
  40. Wong M, Trevathan E. Infantile spasms. Pediatr Neurol 2001;24:89-98. https://doi.org/10.1016/S0887-8994(00)00238-1
  41. Trevathan E, Murphy CC, Yeargin-Allsopp M. The descriptive epidemiology of infantile spasms among Atlanta children. Epilepsia 1999;40:748-51. https://doi.org/10.1111/j.1528-1157.1999.tb00773.x
  42. Fusco L, Vigevano F. Ictal clinical electroencephalographic findings of spasms in West syndrome. Epilepsia 1993;34:671-8. https://doi.org/10.1111/j.1528-1157.1993.tb00445.x
  43. Vigevano F, Fusco L, Pachatz C. Neurophysiology of spasms. Brain Dev 2001;23:467-72. https://doi.org/10.1016/S0387-7604(01)00284-4
  44. Shbarou R. Current treatment options for early-onset pediatric epileptic encephalopathies. Curr Treat Options Neurol. 2016;18:44. https://doi.org/10.1007/s11940-016-0428-z
  45. Epi KC, Epilepsy Phenome/Genome P, Allen AS, Berkovic SF, Cossette P, Delanty N, et al. De novo mutations in epileptic encephalopathies. Nature 2013;501:217-21. https://doi.org/10.1038/nature12439
  46. Covanis A. Update on dravet syndrome. Dev Med Child Neurol 2011;53(Suppl 2):v-vi. https://doi.org/10.1111/j.1469-8749.2011.03963.x
  47. Specchio N, Balestri M, Trivisano M, Japaridze N, Striano P, Carotenuto A, et al. Electroencephalographic features in dravet syndrome: five-year follow-up study in 22 patients. J Child Neurol 2012;27:439-44. https://doi.org/10.1177/0883073811419262
  48. Caraballo RH, Fejerman N. Dravet syndrome: a study of 53 patients. Epilepsy Res 2006;70(Suppl 1):S231-8.
  49. Nabbout R, Gennaro E, Dalla Bernardina B, Dulac O, Madia F, Bertini E, et al. Spectrum of SCN1A mutations in severe myoclonic epilepsy of infancy. Neurology 2003;60:1961-7. https://doi.org/10.1212/01.WNL.0000069463.41870.2F