Whole-exome sequencing with targeted analysis and epilepsy after acute symptomatic neonatal seizures

Adam L Numis; Gilberto da Gente; Elliott H Sherr; Hannah C Glass

doi:10.1038/s41390-021-01509-3

Whole-exome sequencing with targeted analysis and epilepsy after acute symptomatic neonatal seizures

Pediatr Res. 2022 Mar;91(4):896-902. doi: 10.1038/s41390-021-01509-3. Epub 2021 Apr 12.

Authors

Adam L Numis^{1

2}, Gilberto da Gente³, Elliott H Sherr^{3

4}, Hannah C Glass^{3

4

5}

Affiliations

¹ Department of Neurology, University of California San Francisco, San Francisco, CA, USA. Adam.numis@ucsf.edu.
² Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA, USA. Adam.numis@ucsf.edu.
³ Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
⁴ Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA, USA.
⁵ Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA.

Abstract

Background: The contribution of pathogenic gene variants with development of epilepsy after acute symptomatic neonatal seizures is not known.

Methods: Case-control study of 20 trios in children with a history of acute symptomatic neonatal seizures: 10 with and 10 without post-neonatal epilepsy. We performed whole-exome sequencing (WES) and identified pathogenic de novo, transmitted, and non-transmitted variants from established and candidate epilepsy association genes and correlated prevalence of these variants with epilepsy outcomes. We performed a sensitivity analysis with genes associated with coronary artery disease (CAD). We analyzed variants throughout the exome to evaluate for differential enrichment of functional properties using exploratory KEGG searches.

Results: Querying 200 established and candidate epilepsy genes, pathogenic variants were identified in 5 children with post-neonatal epilepsy yet in only 1 child without subsequent epilepsy. There was no difference in the number of trios with non-transmitted pathogenic variants in epilepsy or CAD genes. An exploratory KEGG analysis demonstrated a relative enrichment in cell death pathways in children without subsequent epilepsy.

Conclusions: In this pilot study, children with epilepsy after acute symptomatic neonatal seizures had a higher prevalence of coding variants with a targeted epilepsy gene sequencing analysis compared to those patients without subsequent epilepsy.

Impact: We performed whole-exome sequencing (WES) in 20 trios, including 10 children with epilepsy and 10 without epilepsy, both after acute symptomatic neonatal seizures. Children with post-neonatal epilepsy had a higher burden of pathogenic variants in epilepsy-associated genes compared to those without post-neonatal epilepsy. Future studies evaluating this association may lead to a better understanding of the risk of epilepsy after acute symptomatic neonatal seizures and elucidate molecular pathways that are dysregulated after brain injury and implicated in epileptogenesis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Case-Control Studies
Child
Epilepsy* / genetics
Exome Sequencing
Humans
Infant, Newborn
Infant, Newborn, Diseases* / genetics
Mutation
Pilot Projects
Seizures / epidemiology
Seizures / genetics

Grants and funding

K23 NS105918/NS/NINDS NIH HHS/United States