Abstract
The KCNQ2 gene codifies a subunit of the voltage-gated potassium M channel underlying the neuronal M-current. Classically, mutations in this gene have been associated with benign familial neonatal seizures, however, in recent years KCNQ2 mutations have been reported associated to early-onset epileptic encephalopathy. In this work, detailed familiar, clinical and genetic data were collected for 13 KCNQ2-positive patients revealed among a cohort of 80 epileptic pediatric probands from Spain who were analyzed through a targeted next-generation sequencing assay for 155 epilepsy-associated genes. This work shows for the first time the association between KCNQ2 mutations and startle attacks in 38% of patients, which opens the possibility to define electroclinical phenotypes associated to KCNQ2 mutations. It also demonstrates that KCNQ2 mutations contribute to an important percentage of Spanish patients with epilepsy. The study confirm the high genetic heterogeneity of this gene with 13 different mutations found, 10 of them novel and the better outcome of patients treated with sodium channel blockers.
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References
Ottman, R., Hirose, S., Jain, S., Lerche, H., Lopes-Cendes, I., Noebels, J. L. et al. Genetic testing in the epilepsies—report of the ILAE Genetics Commission. Epilepsia 51, 655–670 (2010).
Thomas, R. H. & Berkovic, S. F. The hidden genetics of epilepsy—a clinically important new paradigm. Nat. Rev. Neurol. 10, 283–292 (2014).
Wang, H. S., Pan, Z., Shi, W., Brown, B. S., Wymore, R. S., Cohen, I. S. et al. KCNQ2 and KCNQ3 potassium channel subunits: molecular correlates of the M-channel. Science 282, 1890–1893 (1998).
Biervert, C., Schroeder, B. C., Kubisch, C., Berkovic, S. F., Propping, P., Jentsch, T. J. et al. A potassium channel mutation in neonatal human epilepsy. Science 279, 403–406 (1998).
Charlier, C., Singh, N. A., Ryan, S. G., Lewis, T. B., Reus, B. E., Leach, R. J. et al. A pore mutation in a novel KQT-like potassium channel gene in an idiopathic epilepsy family. Nat. Genet. 18, 53–55 (1998).
Singh, N. A., Charlier, C., Stauffer, D., DuPont, B. R., Leach, R. J., Melis, R. et al. A novel potassium channel gene, KCNQ2, is mutated an inherited epilepsy of newborns. Nat. Genet 18, 25–29 (1998).
Kato, M., Yamagata, T., Kubota, M., Arai, H., Yamashita, S., Nakagawa, T. et al. Clinical spectrum of early onset epileptic encephalopathies caused by KCNQ2 mutation. Epilepsia 54, 1282–1287 (2013).
Serino, D., Specchio, N., Pontrelli, G., Vigevano, F. & Fusco, L. Video/EEG findings in a KCNQ2 epileptic encephalopathy: a case report and revision of literature data. Epileptic Disord. 15, 158–165 (2013).
Saitsu, H., Kato, M., Koide, A., Goto, T., Fujita, T., Nishiyama, K. et al. Whole exome sequencing identifies KCNQ2 mutations in Ohtahara syndrome. Ann. Neurol. 72, 298–300 (2012).
Weckhuysen, S., Mandelstam, S., Suls, A., Audenaert, D., Deconinck, T., Claes, L. R. et al. KCNQ2 encephalopathy: emerging phenotype of a neonatal epileptic encephalopathy. Ann. Neurol. 71, 15–25 (2012).
Dedek, K., Fusco, L., Teloy, N. & Steinlein, O. K. Neonatal convulsions and epileptic encephalopathy in an Italian family with a missense mutation in the fifth transmembrane region of KCNQ2. Epilepsy Res. 54, 21–27 (2003).
Borgatti, R., Zucca, C., Cavallini, A., Ferrario, M., Panzeri, C., Castaldo, P. et al. A novel mutation in KCNQ2 associated with BFNC, drug resistant epilepsy, and mental retardation. Neurology 63, 57–65 (2004).
Dalen Meurs-van der Schoor, C., van Weissenbruch, M., van Kempen, M., Bugiani, M., Aronica, E., Ronner, H. et al. Severe neonatal epileptic encephalopathy and KCNQ2 mutation: neuropathological substrate? Front. Pediatr. 2, 136 (2014).
Allen, N. M., Mannion, M., Conroy, J., Lynch, S. A., Shahwan, A., Lynch, B. et al. The variable phenotypes of KCNQ-related epilepsy. Epilepsia 55, e99–e105 (2014).
Weckhuysen, S., Ivanovic, V., Hendrickx, R., Van Coster, R., Hjalgrim, H., Møller, R. S. et al. Extending the KCNQ2 encephalopathy spectrum: clinical and neuroimaging findings in 17 patients. Neurology 81, 1697–1703 (2013).
Carvill, G. L., Heavin, S. B., Yendle, S. C., McMahon, J. M., O'Roak, B. J., Cook, J. et al. Targeted resequencing in epileptic encephalopathies identifies de novo mutations in CHD2 and SYNGAP1. Nat. Genet. 45, 825–830 (2013).
Milh, M., Boutry-Kryza, N., Sutera-Sardo, J., Mignot, C., Auvin, S., Lacoste, C. et al. Similar early characteristics but variable neurological outcome of patients with a de novo mutation of KCNQ2. Orphanet J. Rare Dis. 8, 80 (2013).
Orhan, G., Bock, M., Schepers, D., Ilina, E. I., Reichel, S. N., Löffler, H. et al. Dominant-negative effects of KCNQ2 mutations are associated with epileptic encephalopathy. Ann. Neurol. 75, 382–394 (2014).
Li, H. & Durbin, R. Fast and accurate short read alignment with Burrows-Wheeler transform. Bioinformatics 25, 1754–1760 (2009).
Koboldt, D. C., Chen, K., Wylie, T., Larson, D. E., McLellan, M. D., Mardis, E. R. et al. VarScan: variant detection in massively parallel sequencing of individual and pooled samples. Bioinformatics 25, 2283–2285 (2009).
Li, H., Handsaker, B., Wysoker, A., Fennell, T., Ruan, J., Homer, N. et al. The sequence alignment/map format and SAMtools. Bioinformatics 25, 2078–2079 (2009).
Wang, K., Li, M. & Hakonarson, H. ANNOVAR: functional annotation of genetic variants from high-throughput sequencing data. Nucleic Acids Res. 38, e164 (2010).
González-Pérez, A. & López-Bigas, N. Improving the assessment of the outcome of nonsynonymous SNVs with a consensus deleteriousness score, Condel. Am. J. Hum. Genet. 88, 440–449 (2011).
Numis, A. L., Angriman, M., Sullivan, J. E., Lewis, A. J., Striano, P., Nabbout, R. et al. KCNQ2 encephalopathy: delineation of the electroclinical phenotype and treatment response. Neurology 82, 368–370 (2014).
Jentsch, T. Neuronal KCNQ potassium channels: physiology and role in disease. Nat. Rev. Neurosci. 1, 21–30 (2000).
Singh, N. A., Otto, J. F., Dahle, E. J., Pappas, C., Leslie, J. D., Vilaythong, A. et al. Mouse models of human KCNQ2 and KCNQ3 mutations for benign familial neonatal convulsions show seizures and neuronal plasticity without synaptic reorganization. J. Physiol. 586, 3405–3423 (2008).
Miceli, F., Soldovieri, M. V., Ambrosino, P., Barrese, V., Migliore, M., Cilio, M. R. et al. Genotype-phenotype correlations in neonatal epilepsies caused by mutations in the voltage sensor of K(v)7.2 potassium channel subunits. Proc. Natl Acad. Sci. USA 110, 4386–4391 (2013).
Miceli, F., Soldovieri, M. V., Ambrosino, P., De Maria, M., Migliore, M., Migliore, R. et al. Early-onset epileptic encephalopathy caused by gain-of-function mutations in the voltage sensor of Kv7.2 and Kv7.3 potassium channel subunits. J. Neurosci. 35, 3782–3793 (2015).
Milh, M., Lacoste, C., Cacciagli, P., Abidi, A., Sutera-Sardo, J., Tzelepis, I. et al. Variable clinical expression in patients with mosaicism for KCNQ2 mutations. Am. J. Med. Genet. A 167, 2314–2318 (2015).
Depienne, C., Trouillard, O., Gourfinkel-An, I., Saint-Martin, C., Bouteiller, D., Graber, D. et al. Mechanisms for variable expressivity of inherited SCN1A mutations causing Dravet syndrome. J. Med. Genet. 47, 404–410 (2010).
Acknowledgements
This study was financially supported, in part, by a grant from the Spanish ministry of health (Instituto de Salud Carlos III (FIS), Grant No.PI13/2177).
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Hortigüela, M., Fernández-Marmiesse, A., Cantarín, V. et al. Clinical and genetic features of 13 Spanish patients with KCNQ2 mutations. J Hum Genet 62, 185–189 (2017). https://doi.org/10.1038/jhg.2016.104
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DOI: https://doi.org/10.1038/jhg.2016.104
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