Ultra-rare genetic variation in the epilepsies: A whole-exome sequencing study of 17,606 individuals
File(s)FINAL_PROOF_EPI25_WES_ms_text.docx (291.12 KB)
Accepted version
Author(s)
Type
Journal Article
Abstract
Sequencing-based studies have identified novel risk genes associated with severe epilepsies and revealed an excess of rare deleterious variation in less-severe forms of epilepsy. To identify the shared and distinct ultra-rare genetic risk factors for different types of epilepsies, we performed a whole-exome sequencing (WES) analysis of 9,170 epilepsy-affected individuals and 8,436 controls of European ancestry. We focused on three phenotypic groups: severe developmental and epileptic encephalopathies (DEEs), 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; we saw the strongest enrichment in individuals with DEEs and the least strong in individuals with NAFE. Moreover, we found that inhibitory GABAA receptor genes were enriched for missense variants across all three classes of epilepsy, whereas 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 DEEs and GGE. Although no single gene surpassed exome-wide significance among individuals with GGE or NAFE, highly constrained genes and genes encoding ion channels were among the lead associations; such genes included CACNA1G, EEF1A2, and GABRG2 for GGE and LGI1, TRIM3, and GABRG2 for NAFE. Our study, the largest epilepsy WES study to date, confirms a convergence in the genetics of severe and less-severe epilepsies associated with ultra-rare coding variation, and it highlights a ubiquitous role for GABAergic inhibition in epilepsy etiology.
Date Issued
2019-08-01
Date Acceptance
2019-05-29
Citation
The American Journal of Human Genetics, 2019, 105 (2), pp.267-282
ISSN
0002-9297
Publisher
Elsevier
Start Page
267
End Page
282
Journal / Book Title
The American Journal of Human Genetics
Volume
105
Issue
2
Copyright Statement
© 2019 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/.
Sponsor
Wellcome Trust
Department of Health
Institute of Neurology, UCL
Imperial College Healthcare NHS Trust- BRC Funding
Imperial College Healthcare NHS Trust- BRC Funding
Commission of the European Communities
Medical Research Council (MRC)
Imperial College Healthcare NHS Trust- BRC Funding
Grant Number
066056/Z/01/Z
PHGX16A
N/A
RDA03
RD610
279062
P35076
RDA03
Subjects
Genetics & Heredity
06 Biological Sciences
11 Medical and Health Sciences
Publication Status
Published
Date Publish Online
2019-07-18