A comparison of genomic diagnostics in adults and children with epilepsy and comorbid intellectual disability

Eur J Hum Genet. 2020 Aug;28(8):1066-1077. doi: 10.1038/s41431-020-0610-3. Epub 2020 Apr 1.

Abstract

Next generation sequencing provides an important opportunity for improved diagnosis in epilepsy. To date, the majority of diagnostic genetic testing is conducted in the paediatric arena, while the utility of such testing is less well understood in adults with epilepsy. We conducted whole exome sequencing (WES) and copy number variant analyses in an Irish cohort of 101 people with epilepsy and co-morbid intellectual disability to compare the diagnostic yield of genomic testing between adult and paediatric patients. Variant interpretation followed American College of Medical Genetics and Genomics (ACMG) guidelines. We demonstrate that WES, in combination with array-comparative genomic hybridisation, provides a diagnostic rate of 27% in unrelated adult epilepsy patients and 42% in unrelated paediatric patients. We observe a 2.7% rate of ACMG-defined incidental findings. Our findings indicate that WES has similar utility in both adult and paediatric cohorts and is appropriate for diagnostic testing in both epilepsy patient groups.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Comorbidity
  • Comparative Genomic Hybridization / methods
  • Comparative Genomic Hybridization / standards
  • Epilepsy / diagnosis
  • Epilepsy / epidemiology
  • Epilepsy / genetics*
  • Exome Sequencing / methods
  • Exome Sequencing / standards
  • Female
  • Genetic Testing / methods*
  • Genetic Testing / standards
  • Humans
  • Infant
  • Intellectual Disability / diagnosis
  • Intellectual Disability / epidemiology
  • Intellectual Disability / genetics*
  • Male
  • Middle Aged
  • Mutation
  • Sensitivity and Specificity