91 research outputs found

    Polygenic burden in focal and generalized epilepsies

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    Rare genetic variants can cause epilepsy, and genetic testing has been widely adopted for severe, paediatric-onset epilepsies. The phenotypic consequences of common genetic risk burden for epilepsies and their potential future clinical applications have not yet been determined. Using polygenic risk scores (PRS) from a European-ancestry genome-wide association study in generalized and focal epilepsy, we quantified common genetic burden in patients with generalized epilepsy (GE-PRS) or focal epilepsy (FE-PRS) from two independent non-Finnish European cohorts (Epi25 Consortium, n = 5705; Cleveland Clinic Epilepsy Center, n = 620; both compared to 20 435 controls). One Finnish-ancestry population isolate (Finnish-ancestry Epi25, n = 449; compared to 1559 controls), two European-ancestry biobanks (UK Biobank, n = 383 656; Vanderbilt biorepository, n = 49 494), and one Japaneseancestry biobank (BioBank Japan, n = 168 680) were used for additional replications. Across 8386 patients with epilepsy and 622 212 population controls, we found and replicated significantly higher GE-PRS in patients with generalized epilepsy of European-ancestry compared to patients with focal epilepsy (Epi25: P = 1.64 710-15; Cleveland: P = 2.85 710-4; Finnish-ancestry Epi25: P = 1.80 710-4) or population controls (Epi25: P = 2.35 710-70; Cleveland: P = 1.43 710-7; Finnish-ancestry Epi25: P = 3.11 710-4; UK Biobank and Vanderbilt biorepository meta-analysis: P = 7.99 710-4). FE-PRS were significantly higher in patients with focal epilepsy compared to controls in the non-Finnish, non-biobank cohorts (Epi25: P = 5.74 710-19; Cleveland: P = 1.69 710-6). European ancestry-derived PRS did not predict generalized epilepsy or focal epilepsy in Japanese-ancestry individuals. Finally, we observed a significant 4.6-fold and a 4.5-fold enrichment of patients with generalized epilepsy compared to controls in the top 0.5% highest GE-PRS of the two non-Finnish European cohorts (Epi25: P = 2.60 710-15; Cleveland: P = 1.39 710-2). We conclude that common variant risk associated with epilepsy is significantly enriched in multiple cohorts of patients with epilepsy compared to controls-in particular for generalized epilepsy. As sample sizes and PRS accuracy continue to increase with further common variant discovery, PRS could complement established clinical biomarkers and augment genetic testing for patient classification, comorbidity research, and potentially targeted treatment

    Magnesium nebulization utilization in management of pediatric asthma (MagNUM PA) trial: study protocol for a randomized controlled trial

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    Genome-wide identification and phenotypic characterization of seizure-associated copy number variations in 741,075 individuals

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    Copy number variants (CNV) are established risk factors for neurodevelopmental disorders with seizures or epilepsy. With the hypothesis that seizure disorders share genetic risk factors, we pooled CNV data from 10,590 individuals with seizure disorders, 16,109 individuals with clinically validated epilepsy, and 492,324 population controls and identified 25 genome-wide significant loci, 22 of which are novel for seizure disorders, such as deletions at 1p36.33, 1q44, 2p21-p16.3, 3q29, 8p23.3-p23.2, 9p24.3, 10q26.3, 15q11.2, 15q12-q13.1, 16p12.2, 17q21.31, duplications at 2q13, 9q34.3, 16p13.3, 17q12, 19p13.3, 20q13.33, and reciprocal CNVs at 16p11.2, and 22q11.21. Using genetic data from additional 248,751 individuals with 23 neuropsychiatric phenotypes, we explored the pleiotropy of these 25 loci. Finally, in a subset of individuals with epilepsy and detailed clinical data available, we performed phenome-wide association analyses between individual CNVs and clinical annotations categorized through the Human Phenotype Ontology (HPO). For six CNVs, we identified 19 significant associations with specific HPO terms and generated, for all CNVs, phenotype signatures across 17 clinical categories relevant for epileptologists. This is the most comprehensive investigation of CNVs in epilepsy and related seizure disorders, with potential implications for clinical practice

    Biomechanical effects of rapid maxillary expansion on the craniofacial skeleton, studied by the finite element method

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    The aim of this study was to evaluate the biomechanical effect of rapid maxillary expansion (RME) on the craniofacial complex by using a three-dimensional finite element model (FEM) of the craniofacial skeleton. The construction of the three-dimensional FEM was based on computer tomography (CT) scans of the skull of a 12-year-old male subject. The CT pictures were digitized and converted to the finite element model by means of a procedure developed for the present study. The final mesh consisted of 2270 thick shell elements with 2120 nodes. The mechanical response in terms of displacement and von Mises stresses was determined by expanding the maxilla up to 5 mm on both sides. Viewed occlusally, the two halves of the maxilla were separated almost in a parallel manner during 1-, 3-, and 5-mm expansions. The greatest widening was observed in the dento-alveolar areas, and gradually decreased through the superior structures. The width of the nasal cavity at the floor of the nose increased markedly. However, the postero-superior part of the nasal cavity was moved slightly medially. No displacement was observed in the parietal, frontal and occipital bones. High stress levels were observed in the canine and molar regions of the maxilla, lateral wall of the inferior nasal cavity, zygomatic and nasal bones, with the highest stress concentration at the pterygoid plates of the sphenoid bone in the region close to the cranial base

    Identifying SNP targeted pathways in partial epilepsies with genome-wide association study data

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    Purpose: In a recent genome-wide association study for partial epilepsies in the European population, a common genetic variation has been reported to affect partial epilepsy only modestly. However, in complex diseases such as partial epilepsy, multiple factors (e.g. single nucleotide polymorphisms, microRNAs, metabolic and epigenetic factors) may target different sets of genes in the same pathway, affecting its function and thus causing the disease development. In this regard, we hypothesize that the pathways are critical for elucidating the mechanisms underlying partial epilepsy

    Differential Diagnosis of Bithalamic and Pallidal Hypointensity - a Case of HEXB Mutation

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    Sandhoff disease (SD) is a fatal, autosomal recessive lysosomal storage disease. Mutations in HEXB gene cause neuronal damage and SD due to accumulation of GM2 ganglioside. As ganglioside accumulates in the basal ganglia and white matter abnormalities occur, the T2 hypointensities of the basal ganglia, especially those of the thalamus, become observable on the magnetic resonance imaging (MRI). This is what leads to differential diagnosis. T2 hypointensities of the basal ganglia may be due to heterogeneous etiologies. Herein, we present an 18-month-old male patient who had progressive decline of motor functions, seizures, and bilateral thalamic hypointensity on T2-weighted MRI. Whole exome sequencing of the patient revealed homozygous c.1538T>C; p.Leu513Pro (RefSeq. NM_000521, GRCh38) HEXB mutation. Of note, our clinical findings were similar to those seen in patients with HEXB mutation. Exome sequencing allowed us to exclude genetic disorders with basal ganglia involvement
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