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Landais R, Sultan M, Thomas RH. The promise of AI Large Language Models for Epilepsy care. Epilepsy Behav 2024; 154:109747. [PMID: 38518673 DOI: 10.1016/j.yebeh.2024.109747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 03/24/2024]
Abstract
Artificial intelligence (AI) has been supporting our digital life for decades, but public interest in this has exploded with the recognition of large language models, such as GPT-4. We examine and evaluate the potential uses for generative AI technologies in epilepsy and neurological services. Generative AI could not only improve patient care and safety by refining communication and removing certain barriers to healthcare but may also extend to streamlining a doctor's practice through strategies such as automating paperwork. Challenges with the integration of generative AI in epilepsy services are also explored and include the risk of producing inaccurate and biased information. The impact generative AI could have on the provision of healthcare, both positive and negative, should be understood and considered carefully when deciding on the steps that need to be taken before AI is ready for use in hospitals and epilepsy services.
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Affiliation(s)
- Raphaëlle Landais
- Faculty of Medical Sciences, Newcastle University, Newcastle-Upon-Tyne NE1 7RU, United Kingdom
| | - Mustafa Sultan
- Manchester University NHS Foundation Trust, Manchester M13 9PT, United Kingdom
| | - Rhys H Thomas
- Department of Neurology, Royal Victoria Infirmary, Queen Victoria Rd, Newcastle-Upon-Tyne NE1 4LP, United Kingdom; Translational and Clinical Research Institute, Henry Wellcome Building, Framlington Place, Newcastle-Upon-Tyne NE2 4HH, United Kingdom.
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van Wamelen DJ, Rota S, Hartmann M, Martin NH, Alam AM, Thomas RH, Dodd KC, Jenkins T, Smith CJ, Zandi MS, Easton A, Carr G, Benjamin LA, Lilleker JB, Saucer D, Coles AJ, Wood N, Chaudhuri KR, Breen G, Michael BD. Addressing ethnic disparities in neurological research in the United Kingdom: an example from the prospective multicentre COVID-19 Clinical Neuroscience Study. Clin Med (Lond) 2024:100209. [PMID: 38642613 DOI: 10.1016/j.clinme.2024.100209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 03/24/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Minority ethnic groups have often been underrepresented in research, posing a problem in relation to external validity and extrapolation of findings. Here, we aimed to assess recruitment and retainment strategies in a large observational study assessing neurological complications following SARS-CoV-2 infection. METHODS Participants were recruited following confirmed infection with SARS-CoV-2 and hospitalisation. Self-reported ethnicity was recorded alongside other demographic data to identify potential barriers to recruitment. RESULTS 807 participants were recruited to COVID-CNS, and ethnicity data were available for 93.2%. We identified a proportionate representation of self-reported ethnicity categories, and distribution of broad ethnicity categories mirrored individual centres' catchment areas. White ethnicity within individual centres ranged between 44.5% and 89.1%, with highest percentage of participants with non-white ethnicity in London-based centres. Examples are provided how to reach potentially underrepresented minority ethnic groups. CONCLUSIONS Recruitment barriers in relation to potentially underrepresented ethnic groups may be overcome with strategies identified here.
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Affiliation(s)
- Daniel J van Wamelen
- Institute of Psychiatry, Psychology & Neuroscience; Department of Neuroimaging; King's College London; London, United Kingdom; Parkinson Foundation Centre of Excellence at King's College Hospital NHS Foundation Trust; and King's College London, United Kingdom; Radboud University Medical Center; Donders Institute for Brain, Cognition and Behaviour; Department of Neurology; Centre of Expertise for Parkinson & Movement Disorders; Nijmegen, the Netherlands; Institute of Psychiatry, Psychology & Neuroscience; Department of Basic & Clinical Neuroscience, Division of Neuroscience; King's College London; London, United Kingdom.
| | - Silvia Rota
- Institute of Psychiatry, Psychology & Neuroscience; Department of Neuroimaging; King's College London; London, United Kingdom; Parkinson Foundation Centre of Excellence at King's College Hospital NHS Foundation Trust; and King's College London, United Kingdom; Institute of Psychiatry, Psychology & Neuroscience; Department of Basic & Clinical Neuroscience, Division of Neuroscience; King's College London; London, United Kingdom
| | - Monika Hartmann
- Institute of Psychiatry, Psychology & Neuroscience; Department of Neuroimaging; King's College London; London, United Kingdom
| | - Naomi H Martin
- Institute of Psychiatry, Psychology & Neuroscience; Department of Neuroimaging; King's College London; London, United Kingdom
| | - Ali M Alam
- Institute of Infection, Veterinary and Ecological Science, University of Liverpool, NIHR HPRU for Emerging and Zoonotic Infection, Liverpool, United Kingdom
| | - Rhys H Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.; Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, United Kingdom
| | - Katherine C Dodd
- Lydia Becker Institute of Immunology and Inflammation, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; Manchester Centre for Clinical Neurosciences, Salford Royal Care Organisation, Northern Care Alliance NHS Foundation Trust, Salford, United Kingdom
| | - Thomas Jenkins
- Department of Neurology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom.; Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, United Kingdom.; Midland St John of God Hospital and Curtin University, Perth, Western Australia, Australia
| | - Craig J Smith
- Lydia Becker Institute of Immunology and Inflammation, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; Manchester Centre for Clinical Neurosciences, Salford Royal Care Organisation, Northern Care Alliance NHS Foundation Trust, Salford, United Kingdom; Division of Cardiovascular Sciences, School of Medical Sciences, The University of Manchester, Geoffrey Jefferson Brain Research Centre, Manchester, United Kingdom
| | - Michael S Zandi
- National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Ava Easton
- Institute of Infection, Veterinary and Ecological Science, University of Liverpool, NIHR HPRU for Emerging and Zoonotic Infection, Liverpool, United Kingdom; Encephalitis Society, Malton, United Kingdom
| | - Georgina Carr
- Neurological Alliance, London WD17 1EU, United Kingdom
| | - Laura A Benjamin
- National Hospital for Neurology and Neurosurgery, London, United Kingdom.; Stroke Research Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - James B Lilleker
- Manchester Centre for Clinical Neurosciences, Salford Royal Care Organisation, Northern Care Alliance NHS Foundation Trust, Salford, United Kingdom; Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - David Saucer
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Alasdair J Coles
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Nicholas Wood
- Department of Clinical and Movement Neurosciences, University College London, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - K Ray Chaudhuri
- Parkinson Foundation Centre of Excellence at King's College Hospital NHS Foundation Trust; and King's College London, United Kingdom; Institute of Psychiatry, Psychology & Neuroscience; Department of Basic & Clinical Neuroscience, Division of Neuroscience; King's College London; London, United Kingdom
| | - Gerome Breen
- Institute of Psychiatry, Psychology & Neuroscience; Social, Genetic & Developmental Psychiatry Centre; King's College London, London, United Kingdom
| | - Benedict Daniel Michael
- Institute of Infection, Veterinary and Ecological Science, University of Liverpool, NIHR HPRU for Emerging and Zoonotic Infection, Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust; Department of Neurology; Liverpool, United Kingdom
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Chen J, Ngo A, Rodríguez-Cruces R, Royer J, Caligiuri ME, Gambardella A, Concha L, Keller SS, Cendes F, Yasuda CL, Alvim MKM, Bonilha L, Gleichgerrcht E, Focke NK, Kreilkamp B, Domin M, von Podewils F, Langner S, Rummel C, Wiest R, Martin P, Kotikalapudi R, Bender B, O’Brien TJ, Sinclair B, Vivash L, Kwan P, Desmond PM, Lui E, Duma GM, Bonanni P, Ballerini A, Vaudano AE, Meletti S, Tondelli M, Alhusaini S, Doherty CP, Cavalleri GL, Delanty N, Kälviäinen R, Jackson GD, Kowalczyk M, Mascalchi M, Semmelroch M, Thomas RH, Soltanian-Zadeh H, Davoodi-Bojd E, Zhang J, Lenge M, Guerrini R, Bartolini E, Hamandi K, Foley S, Rüber T, Bauer T, Weber B, Caldairou B, Depondt C, Absil J, Carr SJA, Abela E, Richardson MP, Devinsky O, Pardoe H, Severino M, Striano P, Tortora D, Kaestner E, Hatton SN, Arienzo D, Vos SB, Ryten M, Taylor PN, Duncan JS, Whelan CD, Galovic M, Winston GP, Thomopoulos SI, Thompson PM, Sisodiya SM, Labate A, McDonald CR, Caciagli L, Bernasconi N, Bernasconi A, Larivière S, Schrader D, Bernhardt BC. A WORLDWIDE ENIGMA STUDY ON EPILEPSY-RELATED GRAY AND WHITE MATTER COMPROMISE ACROSS THE ADULT LIFESPAN. bioRxiv 2024:2024.03.02.583073. [PMID: 38496668 PMCID: PMC10942350 DOI: 10.1101/2024.03.02.583073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Objectives Temporal lobe epilepsy (TLE) is commonly associated with mesiotemporal pathology and widespread alterations of grey and white matter structures. Evidence supports a progressive condition although the temporal evolution of TLE is poorly defined. This ENIGMA-Epilepsy study utilized multimodal magnetic resonance imaging (MRI) data to investigate structural alterations in TLE patients across the adult lifespan. We charted both grey and white matter changes and explored the covariance of age-related alterations in both compartments. Methods We studied 769 TLE patients and 885 healthy controls across an age range of 17-73 years, from multiple international sites. To assess potentially non-linear lifespan changes in TLE, we harmonized data and combined median split assessments with cross-sectional sliding window analyses of grey and white matter age-related changes. Covariance analyses examined the coupling of grey and white matter lifespan curves. Results In TLE, age was associated with a robust grey matter thickness/volume decline across a broad cortico-subcortical territory, extending beyond the mesiotemporal disease epicentre. White matter changes were also widespread across multiple tracts with peak effects in temporo-limbic fibers. While changes spanned the adult time window, changes accelerated in cortical thickness, subcortical volume, and fractional anisotropy (all decreased), and mean diffusivity (increased) after age 55 years. Covariance analyses revealed strong limbic associations between white matter tracts and subcortical structures with cortical regions. Conclusions This study highlights the profound impact of TLE on lifespan changes in grey and white matter structures, with an acceleration of aging-related processes in later decades of life. Our findings motivate future longitudinal studies across the lifespan and emphasize the importance of prompt diagnosis as well as intervention in patients.
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Affiliation(s)
- Judy Chen
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Alexander Ngo
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Raúl Rodríguez-Cruces
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Jessica Royer
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | | | - Antonio Gambardella
- Neuroscience Research Center, University Magna Græcia, Catanzaro, CZ, Italy
- Institute of Neurology, University Magna Græcia, Catanzaro, CZ, Italy
| | - Luis Concha
- Institute of Neurobiology, Universidad Nacional Autónoma de México, Querétaro, México
| | - Simon S. Keller
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
- Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Fernando Cendes
- Department of Neurology, University of Campinas-–UNICAMP, Campinas, São Paulo, Brazil
| | - Clarissa L. Yasuda
- Department of Neurology, University of Campinas-–UNICAMP, Campinas, São Paulo, Brazil
| | - Marina K. M. Alvim
- Department of Neurology, University of Campinas-–UNICAMP, Campinas, São Paulo, Brazil
| | | | | | - Niels K. Focke
- Department of Neurology, University of Medicine Göttingen, Göttingen, Germany
| | - Barbara Kreilkamp
- Department of Neurology, University of Medicine Göttingen, Göttingen, Germany
| | - Martin Domin
- Institute of Diagnostic Radiology and Neuroradiology, Functional Imaging Unit, University Medicine Greifswald, Greifswald, Germany
| | - Felix von Podewils
- Department of Neurology, University Medicine Greifswald, Epilepsy Center, Greifswald, Germany
| | - Soenke Langner
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Christian Rummel
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Raviteja Kotikalapudi
- Department of Neurology, University of Medicine Göttingen, Göttingen, Germany
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Benjamin Bender
- Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Germany
| | - Terence J. O’Brien
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Patrick Kwan
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Patricia M. Desmond
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Elaine Lui
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Gian Marco Duma
- Scientific Institute IRCCS E.Medea, Epilepsy Unit, Conegliano (TV), Italy
| | - Paolo Bonanni
- Scientific Institute IRCCS E.Medea, Epilepsy Unit, Conegliano (TV), Italy
| | - Alice Ballerini
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Anna Elisabetta Vaudano
- Neurology Unit, OCB Hospital, Azienda Ospedaliera-Universitaria, Modena, Italy
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Meletti
- Neurology Unit, OCB Hospital, Azienda Ospedaliera-Universitaria, Modena, Italy
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Manuela Tondelli
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
- Primary Care Department, Azienda Sanitaria Locale di Modena, Modena, Italy
| | - Saud Alhusaini
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Neurology, Alpert Medical School of Brown University, Providence, RI, USA
| | - Colin P. Doherty
- Department of Neurology, St James’ Hospital, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Gianpiero L. Cavalleri
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Norman Delanty
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Reetta Kälviäinen
- Epilepsy Center, Neuro Center, Kuopio University Hospital, Member of the European Reference Network for Rare and Complex Epilepsies EpiCARE, Kuopio, Finland
- Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Graeme D. Jackson
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne VIC 3010, Australia
| | - Magdalena Kowalczyk
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne VIC 3010, Australia
| | - Mario Mascalchi
- Neuroradiology Research Program, Meyer Children Hospital of Florence, University of Florence, Florence, Italy
| | - Mira Semmelroch
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne VIC 3010, Australia
| | - Rhys H. Thomas
- Transitional and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Hamid Soltanian-Zadeh
- Contol and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
- Departments of Research Administration and Radiology, Henry Ford Health System, Detroit, MI, USA
| | | | - Junsong Zhang
- Cognitive Science Department, Xiamen University, Xiamen, China
| | - Matteo Lenge
- Child Neurology Unit and Laboratories, Neuroscience Department, Meyer Children’s Hospital IRCCS, Florence, Italy
| | - Renzo Guerrini
- Child Neurology Unit and Laboratories, Neuroscience Department, Meyer Children’s Hospital IRCCS, Florence, Italy
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Italy
| | | | - Khalid Hamandi
- Cardiff University Brain Research Imaging Centre (CUBRIC), College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
- The Welsh Epilepsy Unit, Department of Neurology, University Hospital of Wales, Cardiff, UK
| | - Sonya Foley
- Cardiff University Brain Research Imaging Centre (CUBRIC), College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Theodor Rüber
- Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
| | - Tobias Bauer
- Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University Hospital Bonn, Bonn, Germany
| | - Benoit Caldairou
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles, Brussels, Belgium
| | - Julie Absil
- Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Sarah J. A. Carr
- School of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Eugenio Abela
- School of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Mark P. Richardson
- School of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Orrin Devinsky
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, United States
| | - Heath Pardoe
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, United States
| | | | - Pasquale Striano
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Domenico Tortora
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Erik Kaestner
- Department of Radiation Medicine and Applied Sciences; Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, United States
| | - Sean N. Hatton
- Department of Neurosciences, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, United States
| | - Donatello Arienzo
- Department of Radiation Medicine and Applied Sciences; Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, United States
| | - Sjoerd B. Vos
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
- Centre for Medical Image Computing, University College London, London, UK
| | - Mina Ryten
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Bucks, UK
| | - Peter N. Taylor
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- CNNP Lab, ICOS group, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - John S. Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - Christopher D. Whelan
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Marian Galovic
- Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zürich, Zürich, Switzerland
| | - Gavin P. Winston
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
- Department of Medicine, Division of Neurology, Queen’s University, Kingston, ON, Canada
| | - Sophia I. Thomopoulos
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Paul M. Thompson
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Sanjay M. Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - Angelo Labate
- Neurophysiopathology and Movement Disorders Clinic, Regional Epilepsy Center, University of Messina, Italy
| | - Carrie R. McDonald
- Department of Radiation Medicine and Applied Sciences; Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, United States
| | - Lorenzo Caciagli
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Bucks, UK
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
- Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Harvard University, Boston, MA, USA
| | - Dewi Schrader
- BC Children’s Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Boris C. Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
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Thomas RH. Practical approach to anti seizure medications, an update. Clin Med (Lond) 2024; 24:100040. [PMID: 38570094 PMCID: PMC11046222 DOI: 10.1016/j.clinme.2024.100040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Affiliation(s)
- Rhys H Thomas
- Royal Victoria Infirmary, Newcastle-Upon-Tyne, United Kingdom and Translational and Clinical Research Institute, Henry Wellcome Building, Framlington Place, Newcastle-Upon-Tyne, United Kingdom.
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Norton AC, Smeaton M, Twohig-Bennett C, Thomas RH. What the Top Ten epilepsy research priorities mean for the UK research ecosystem. EBioMedicine 2024; 100:104919. [PMID: 38212159 PMCID: PMC10878987 DOI: 10.1016/j.ebiom.2023.104919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/01/2023] [Indexed: 01/13/2024] Open
Affiliation(s)
- Anna C Norton
- Epilepsy Research Institute UK, Churchill House, 35 Red Lion Square, London, WC1R 4SG, UK.
| | - Maxine Smeaton
- Epilepsy Research Institute UK, Churchill House, 35 Red Lion Square, London, WC1R 4SG, UK
| | - Caoimhe Twohig-Bennett
- Epilepsy Research Institute UK, Churchill House, 35 Red Lion Square, London, WC1R 4SG, UK
| | - Rhys H Thomas
- Translational and Clinical Research Institute, Newcastle University, NE2 4HH, UK; Neurosciences, Royal Victoria Infirmary, Victoria Road, Newcastle, NE1 4LP, UK
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Gargano MA, Matentzoglu N, Coleman B, Addo-Lartey EB, Anagnostopoulos A, Anderton J, Avillach P, Bagley AM, Bakštein E, Balhoff JP, Baynam G, Bello SM, Berk M, Bertram H, Bishop S, Blau H, Bodenstein DF, Botas P, Boztug K, Čady J, Callahan TJ, Cameron R, Carbon S, Castellanos F, Caufield JH, Chan LE, Chute C, Cruz-Rojo J, Dahan-Oliel N, Davids JR, de Dieuleveult M, de Souza V, de Vries BBA, de Vries E, DePaulo JR, Derfalvi B, Dhombres F, Diaz-Byrd C, Dingemans AJM, Donadille B, Duyzend M, Elfeky R, Essaid S, Fabrizzi C, Fico G, Firth HV, Freudenberg-Hua Y, Fullerton JM, Gabriel DL, Gilmour K, Giordano J, Goes FS, Moses RG, Green I, Griese M, Groza T, Gu W, Guthrie J, Gyori B, Hamosh A, Hanauer M, Hanušová K, He Y(O, Hegde H, Helbig I, Holasová K, Hoyt CT, Huang S, Hurwitz E, Jacobsen JOB, Jiang X, Joseph L, Keramatian K, King B, Knoflach K, Koolen DA, Kraus M, Kroll C, Kusters M, Ladewig MS, Lagorce D, Lai MC, Lapunzina P, Laraway B, Lewis-Smith D, Li X, Lucano C, Majd M, Marazita ML, Martinez-Glez V, McHenry TH, McInnis MG, McMurry JA, Mihulová M, Millett CE, Mitchell PB, Moslerová V, Narutomi K, Nematollahi S, Nevado J, Nierenberg AA, Čajbiková NN, Nurnberger JI, Ogishima S, Olson D, Ortiz A, Pachajoa H, Perez de Nanclares G, Peters A, Putman T, Rapp CK, Rath A, Reese J, Rekerle L, Roberts A, Roy S, Sanders SJ, Schuetz C, Schulte EC, Schulze TG, Schwarz M, Scott K, Seelow D, Seitz B, Shen Y, Similuk MN, Simon ES, Singh B, Smedley D, Smith CL, Smolinsky JT, Sperry S, Stafford E, Stefancsik R, Steinhaus R, Strawbridge R, Sundaramurthi JC, Talapova P, Tenorio Castano JA, Tesner P, Thomas RH, Thurm A, Turnovec M, van Gijn ME, Vasilevsky NA, Vlčková M, Walden A, Wang K, Wapner R, Ware JS, Wiafe AA, Wiafe SA, Wiggins LD, Williams AE, Wu C, Wyrwoll MJ, Xiong H, Yalin N, Yamamoto Y, Yatham LN, Yocum AK, Young AH, Yüksel Z, Zandi PP, Zankl A, Zarante I, Zvolský M, Toro S, Carmody LC, Harris NL, Munoz-Torres MC, Danis D, Mungall CJ, Köhler S, Haendel MA, Robinson PN. The Human Phenotype Ontology in 2024: phenotypes around the world. Nucleic Acids Res 2024; 52:D1333-D1346. [PMID: 37953324 PMCID: PMC10767975 DOI: 10.1093/nar/gkad1005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/12/2023] [Accepted: 10/19/2023] [Indexed: 11/14/2023] Open
Abstract
The Human Phenotype Ontology (HPO) is a widely used resource that comprehensively organizes and defines the phenotypic features of human disease, enabling computational inference and supporting genomic and phenotypic analyses through semantic similarity and machine learning algorithms. The HPO has widespread applications in clinical diagnostics and translational research, including genomic diagnostics, gene-disease discovery, and cohort analytics. In recent years, groups around the world have developed translations of the HPO from English to other languages, and the HPO browser has been internationalized, allowing users to view HPO term labels and in many cases synonyms and definitions in ten languages in addition to English. Since our last report, a total of 2239 new HPO terms and 49235 new HPO annotations were developed, many in collaboration with external groups in the fields of psychiatry, arthrogryposis, immunology and cardiology. The Medical Action Ontology (MAxO) is a new effort to model treatments and other measures taken for clinical management. Finally, the HPO consortium is contributing to efforts to integrate the HPO and the GA4GH Phenopacket Schema into electronic health records (EHRs) with the goal of more standardized and computable integration of rare disease data in EHRs.
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Affiliation(s)
| | | | - Ben Coleman
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | | | | | - Joel Anderton
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Anita M Bagley
- Shriners Children's Northern California, Sacramento, CA, USA
| | - Eduard Bakštein
- National Institute of Mental Health, Klecany, Czech Republic
| | - James P Balhoff
- Renaissance Computing Institute, University of North Carolina, Chapel Hill, NC 27517, USA
| | - Gareth Baynam
- Rare Care Centre, Perth Children's Hospital, Perth, Australia
| | | | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Holli Bertram
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Somer Bishop
- Department of Psychiatry and Behavioral Sciences, UCSF Weil Institute for Neuroscience, San Francisco, CA, USA
| | - Hannah Blau
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - David F Bodenstein
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | | | - Kaan Boztug
- St. Anna Children's Cancer Research Institute (CCRI), Vienna, Austria
| | - Jolana Čady
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - Tiffany J Callahan
- Department of Biomedical Informatics, Columbia University Irving Medical Center, NY, NY, USA
| | | | - Seth J Carbon
- Division of Environmental Genomics and Systems Biology, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | | | - J Harry Caufield
- Division of Environmental Genomics and Systems Biology, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Lauren E Chan
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, USA
| | - Christopher G Chute
- Schools of Medicine, Public Health, and Nursing, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Jaime Cruz-Rojo
- UDISGEN (Dysmorphology and Genetics Unit), 12 de Octubre Hospital, Madrid, Spain
| | - Noémi Dahan-Oliel
- Department of Clinical Research, Shriners Hospitals for Children, Montreal, Quebec, Canada
| | - Jon R Davids
- Shriners Children's Northern California, Sacramento, CA, USA
| | - Maud de Dieuleveult
- Département I&D, AP-HP, Banque Nationale de Données Maladies Rares, Paris, France
| | - Vinicius de Souza
- European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton CB10 1SD, UK
| | - Bert B A de Vries
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - J Raymond DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Beata Derfalvi
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Ferdinand Dhombres
- Fetal Medicine Department, Armand Trousseau Hospital, Sorbonne University, GRC26, INSERM, Limics, Paris, France
| | - Claudia Diaz-Byrd
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Alexander J M Dingemans
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Bruno Donadille
- St Antoine Hospital, Reference Center for Rare Growth Endocrine Disorders, Sorbonne University, AP-HP, INSERM, US14 - Orphanet, Plateforme Maladies Rares, Paris, France
| | | | - Reem Elfeky
- Department of Immunology, GOS Hospital for Children NHS Foundation Trust, University College London, London, UK
| | - Shahim Essaid
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | | | - Giovanna Fico
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Helen V Firth
- Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK
| | - Yun Freudenberg-Hua
- Department of Psychiatry, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | | | - Davera L Gabriel
- School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA
| | | | - Jessica Giordano
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Rachel Gore Moses
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Ian Green
- SNOMED International, London W2 6BD, UK
| | - Matthias Griese
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, German center for Lung research (DZL), Munich, Germany
| | - Tudor Groza
- Rare Care Centre, Perth Children's Hospital, Perth, Australia
| | | | - Julia Guthrie
- Department of Structural and Computational Biology, University of Vienna; Max Perutz Labs, Vienna, Austria
| | - Benjamin Gyori
- Khoury College of Computer Sciences, Northeastern University, Boston, MA, USA
| | - Ada Hamosh
- Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Marc Hanauer
- INSERM, US14 - Orphanet, Plateforme Maladies Rares, Paris, France
| | - Kateřina Hanušová
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | | | - Harshad Hegde
- Division of Environmental Genomics and Systems Biology, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Ingo Helbig
- Neurology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Kateřina Holasová
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - Charles Tapley Hoyt
- Khoury College of Computer Sciences, Northeastern University, Boston, MA, USA
| | | | - Eric Hurwitz
- University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Julius O B Jacobsen
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | | | - Lisa Joseph
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, Bethesda, MD, USA
| | - Kamyar Keramatian
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Bryan King
- Department of Psychiatry and Behavioral Sciences, UCSF Weil Institute for Neuroscience, San Francisco, CA, USA
| | - Katrin Knoflach
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, German center for Lung research (DZL), Munich, Germany
| | - David A Koolen
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Megan L Kraus
- University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Carlo Kroll
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Maaike Kusters
- Immunology, NIHR Great Ormond Street Hospital BRC, London, UK
| | - Markus S Ladewig
- Department of Ophthalmology, University Clinic Marburg - Campus Fulda, Fulda, Germany
| | - David Lagorce
- INSERM, US14 - Orphanet, Plateforme Maladies Rares, Paris, France
| | - Meng-Chuan Lai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Pablo Lapunzina
- Institute of Medical and Molecular Genetics, Hospital Univ. La Paz, Madrid, Spain
| | - Bryan Laraway
- University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - David Lewis-Smith
- Translational and Clinical Research Institute, Henry Wellcome Building, Framlington Place, Newcastle University, Newcastle-Upon-Tyne NE14LP, UK
| | | | - Caterina Lucano
- INSERM, US14 - Orphanet, Plateforme Maladies Rares, Paris, France
| | - Marzieh Majd
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mary L Marazita
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Victor Martinez-Glez
- Center for Genomic Medicine, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain
| | - Toby H McHenry
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Julie A McMurry
- University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Michaela Mihulová
- Department of Biology and Medical Genetics, 2nd Medical Faculty of Charles University and University Hospital Motol, Prague, Czech Republic
| | - Caitlin E Millett
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Philip B Mitchell
- Discipline of Psychiatry & Mental Health, School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
| | - Veronika Moslerová
- Department of Biology and Medical Genetics, 2nd Medical Faculty of Charles University and University Hospital Motol, Prague, Czech Republic
| | - Kenji Narutomi
- Okinawa Prefectural Nanbu Medical Center & Children's Medical Center
| | - Shahrzad Nematollahi
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Julian Nevado
- Institute of Medical and Molecular Genetics, Hospital Univ. La Paz, Madrid, Spain
| | - Andrew A Nierenberg
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
| | - Nikola Novák Čajbiková
- Department of Biology and Medical Genetics, 2nd Medical Faculty of Charles University and University Hospital Motol, Prague, Czech Republic
| | - John I Nurnberger
- Stark Neurosciences Research Institute, Departments of Psychiatry and Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Daniel Olson
- Data Collaboration Center, Data Science, Critical Path Institute, Tucson, AZ, USA
| | - Abigail Ortiz
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Harry Pachajoa
- Centro de Investigaciones en Anomalías Congénitas y Enfermedades Raras (CIACER), Universidad Icesi, Cali, Colombia
| | - Guiomar Perez de Nanclares
- Molecular (epi) genetics lab, Bioaraba Health Research Institute, Araba University Hospital, Vitoria-Gasteiz, Spain
| | - Amy Peters
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Tim Putman
- University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Christina K Rapp
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, German center for Lung research (DZL), Munich, Germany
| | - Ana Rath
- INSERM, US14 - Orphanet, Plateforme Maladies Rares, Paris, France
| | - Justin Reese
- Division of Environmental Genomics and Systems Biology, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Lauren Rekerle
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - Angharad M Roberts
- National Heart & Lung Institute & MRC London Institute of Medical Sciences, Imperial College London, London W12 0HS, UK
| | - Suzy Roy
- SNOMED International, London W2 6BD, UK
| | - Stephan J Sanders
- Department of Paediatrics, Institute of Developmental and Regenerative Medicine, University of Oxford, Oxford, UK
| | - Catharina Schuetz
- Universitätsklinikum Carl Gustav Carus, Medizinische Fakultät, TU, Dresden, Germany
| | - Eva C Schulte
- Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Munich, Germany
| | - Thomas G Schulze
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Martin Schwarz
- Department of Biology and Medical Genetics, 2nd Medical Faculty of Charles University and University Hospital Motol, Prague, Czech Republic
| | - Katie Scott
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Dominik Seelow
- Exploratory Diagnostic Sciences, Berliner Institut für Gesundheitsforschung - Charité, Berlin, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center UKS, Homburg/Saar, Germany
| | | | - Morgan N Similuk
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Eric S Simon
- Eisenberg Family Depression Center, University of Michigan, Ann Arbor, MI, USA
| | - Balwinder Singh
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Damian Smedley
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | | | - Jake T Smolinsky
- Human Genetics Institute of New Jersey, Rutgers University, Piscataway, NJ, USA
| | - Sarah Sperry
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | - Ray Stefancsik
- European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton CB10 1SD, UK
| | - Robin Steinhaus
- Exploratory Diagnostic Sciences, Berliner Institut für Gesundheitsforschung - Charité, Berlin, Germany
| | - Rebecca Strawbridge
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Polina Talapova
- Institute for Research and Health Policy Studies, Tufts Medicine, Boston, MA 2111, USA
| | | | - Pavel Tesner
- Department of Biology and Medical Genetics, 2nd Medical Faculty of Charles University and University Hospital Motol, Prague, Czech Republic
| | - Rhys H Thomas
- Translational and Clinical Research Institute, Henry Wellcome Building, Framlington Place, Newcastle University, Newcastle-Upon-Tyne NE14LP, UK
| | - Audrey Thurm
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, Bethesda, MD, USA
| | - Marek Turnovec
- Department of Biology and Medical Genetics, 2nd Medical Faculty of Charles University and University Hospital Motol, Prague, Czech Republic
| | - Marielle E van Gijn
- Department of Genetics, University Medical Center Groningen, Groningen, Netherlands
| | | | - Markéta Vlčková
- Department of Biology and Medical Genetics, 2nd Medical Faculty of Charles University and University Hospital Motol, Prague, Czech Republic
| | - Anita Walden
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Kai Wang
- Chinese HPO Consortium, Beijing, China
| | - Ron Wapner
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA
| | - James S Ware
- National Heart & Lung Institute & MRC London Institute of Medical Sciences, Imperial College London, London W12 0HS, UK
| | | | | | - Lisa D Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Andrew E Williams
- Institute for Research and Health Policy Studies, Tufts Medicine, Boston, MA 2111, USA
| | - Chen Wu
- Chinese HPO Consortium, Beijing, China
| | - Margot J Wyrwoll
- Centre for Regenerative Medicine, Institute for Regeneration and Repair, Institute for Stem Cell Research, University of Edinburgh, Edinburgh, UK
| | - Hui Xiong
- Chinese HPO Consortium, Beijing, China
| | - Nefize Yalin
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Yasunori Yamamoto
- Database Center for Life Science, Joint Support-Center for Data Science Research, Research Organization of Information and Systems, Japan
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Anastasia K Yocum
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Allan H Young
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, London SE5 8AF, UK
| | - Zafer Yüksel
- Department of Human Genetics, Bioscientia Healthcare GmbH, Ingelheim, Germany
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Andreas Zankl
- Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Ignacio Zarante
- Institute of Human Genetics, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Miroslav Zvolský
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - Sabrina Toro
- University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Leigh C Carmody
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - Nomi L Harris
- Division of Environmental Genomics and Systems Biology, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Monica C Munoz-Torres
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Daniel Danis
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - Christopher J Mungall
- Division of Environmental Genomics and Systems Biology, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | | | - Melissa A Haendel
- University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Peter N Robinson
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
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Watkins LV, Dunstall H, Musicha C, Lawthom C, John K, Bright C, Richings C, Harding K, Moon S, Pape SE, Winterhalder R, Allgar V, Thomas RH, McLean B, Laugharne R, Shankar R. Rapid switching from levetiracetam to brivaracetam in pharmaco-resistant epilepsy in people with and without intellectual disabilities: a naturalistic case control study. J Neurol 2023; 270:5889-5902. [PMID: 37610448 DOI: 10.1007/s00415-023-11959-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Approximately one quarter of people with an intellectual disability (PwID) have epilepsy of whom nearly three-quarters are pharmaco-resistant. There are higher reported neuropsychiatric side-effects to anti-seizure medication (ASM) in this group. Levetiracetam (LEV) is a first-line ASM with a stronger association with neuropsychiatric symptoms for PwID than other ASMs. Brivaracetam (BRV) is a newer ASM. Recent studies suggest a beneficial effect of swapping people who experience neuropsychiatric events with LEV to BRV. However, there is limited evidence of this for PwID. This evaluation analyses real world outcomes of LEV to BRV swap for PwID compared to those without ID. METHODS We performed a multicentre, retrospective review of clinical records. Demographic, clinical characteristics and reported adverse events of patients switched from LEV to BRV (2016-2020) were recorded at 3 months pre and 6- and 12-month post-BRV initiation. Outcomes were compared between PwID and those without and summarised using cross-tabulations and logistic regression models. A Bonferroni correction was applied. RESULTS Of 77 participants, 46 had ID and 52% had a past psychiatric illness. 71% participants switched overnight from LEV to BRV. Seizure reduction of > 50% was seen in 40% patients. Psychiatric illness history was predictive of having neuropsychiatric side-effects with LEV but not BRV (p = 0.001). There was no significant difference for any primary outcomes between PwID versus without ID. CONCLUSIONS Switching from LEV to BRV appears as well tolerated and efficacious in PwID as those without ID with over 90% still on BRV after 12 months.
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Affiliation(s)
- L V Watkins
- Swansea Bay University Health Board, Port Talbot, UK
- University of South Wales, Aberdare, UK
- University of Plymouth, Plymouth, UK
| | - H Dunstall
- Swansea Bay University Health Board, Port Talbot, UK
| | - C Musicha
- University of Plymouth, Plymouth, UK
| | - C Lawthom
- Aneurin Bevan University Health Board, Newport, UK
- Swansea University, Swansea, UK
| | - K John
- Aneurin Bevan University Health Board, Newport, UK
| | - C Bright
- University of South Wales, Aberdare, UK
- Aneurin Bevan University Health Board, Newport, UK
| | - C Richings
- Aneurin Bevan University Health Board, Newport, UK
| | - K Harding
- Aneurin Bevan University Health Board, Newport, UK
| | - S Moon
- Swansea Bay University Health Board, Port Talbot, UK
| | - S E Pape
- Oxleas NHS Foundation Trust, Kent, UK
| | | | - V Allgar
- University of Plymouth, Plymouth, UK
| | - R H Thomas
- Newcastle University, Newcastle upon Tyne, UK
- The Newcastle Upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK
| | - B McLean
- University of Plymouth, Plymouth, UK
| | | | - Rohit Shankar
- University of Plymouth, Plymouth, UK.
- Cornwall Partnership NHS Foundation Trust, Threemilestone Industrial Estate, Truro, TR4 9LD, UK.
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8
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Horsley JJ, Thomas RH, Chowdhury FA, Diehl B, McEvoy AW, Miserocchi A, de Tisi J, Vos SB, Walker MC, Winston GP, Duncan JS, Wang Y, Taylor PN. Complementary structural and functional abnormalities to localise epileptogenic tissue. EBioMedicine 2023; 97:104848. [PMID: 37898096 PMCID: PMC10630610 DOI: 10.1016/j.ebiom.2023.104848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/11/2023] [Accepted: 10/11/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND When investigating suitability for epilepsy surgery, people with drug-refractory focal epilepsy may have intracranial EEG (iEEG) electrodes implanted to localise seizure onset. Diffusion-weighted magnetic resonance imaging (dMRI) may be acquired to identify key white matter tracts for surgical avoidance. Here, we investigate whether structural connectivity abnormalities, inferred from dMRI, may be used in conjunction with functional iEEG abnormalities to aid localisation of the epileptogenic zone (EZ), improving surgical outcomes in epilepsy. METHODS We retrospectively investigated data from 43 patients (42% female) with epilepsy who had surgery following iEEG. Twenty-five patients (58%) were free from disabling seizures (ILAE 1 or 2) at one year. Interictal iEEG functional, and dMRI structural connectivity abnormalities were quantified by comparison to a normative map and healthy controls. We explored whether the resection of maximal abnormalities related to improved surgical outcomes, in both modalities individually and concurrently. Additionally, we suggest how connectivity abnormalities may inform the placement of iEEG electrodes pre-surgically using a patient case study. FINDINGS Seizure freedom was 15 times more likely in patients with resection of maximal connectivity and iEEG abnormalities (p = 0.008). Both modalities separately distinguished patient surgical outcome groups and when used simultaneously, a decision tree correctly separated 36 of 43 (84%) patients. INTERPRETATION Our results suggest that both connectivity and iEEG abnormalities may localise epileptogenic tissue, and that these two modalities may provide complementary information in pre-surgical evaluations. FUNDING This research was funded by UKRI, CDT in Cloud Computing for Big Data, NIH, MRC, Wellcome Trust and Epilepsy Research UK.
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Affiliation(s)
- Jonathan J Horsley
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Rhys H Thomas
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Fahmida A Chowdhury
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Beate Diehl
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Andrew W McEvoy
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Anna Miserocchi
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Jane de Tisi
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Sjoerd B Vos
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Centre for Microscopy, Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia; Centre for Medical Image Computing, Computer Science Department, University College London, London, United Kingdom
| | - Matthew C Walker
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Gavin P Winston
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Division of Neurology, Department of Medicine, Queen's University, Kingston, Canada
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Yujiang Wang
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom; Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Peter N Taylor
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom; Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
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9
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Ben-Menachem E, Schmitz B, Kälviäinen R, Thomas RH, Klein P. The burden of chronic drug-refractory focal onset epilepsy: Can it be prevented? Epilepsy Behav 2023; 148:109435. [PMID: 37748414 DOI: 10.1016/j.yebeh.2023.109435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/28/2023] [Accepted: 08/31/2023] [Indexed: 09/27/2023]
Abstract
Despite the many therapeutic options for epilepsy available today, a third of patients still have poorly controlled epilepsy. Over the years, their transition through lines of treatment exposes them to increased risk of disease progression, mortality, morbidity, mental distress, and not least significantly impaired quality of life (QoL). The present review explores the multiple factors contributing to the impairment of health-related QoL in PWE-including both seizure-related and non seizure-related. The analysis aims to identify potential areas of intervention and strategies for a more holistic approach to epilepsy care and inform policy-makers and healthcare providers in their approach to this condition.
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Affiliation(s)
| | - Bettina Schmitz
- Neurology/Center for Epilepsy, Stroke Unit and Neurological Rehabilitation, Vivantes Humboldt Hospital, Berlin, Germany.
| | | | - Rhys H Thomas
- Department of Neurology, Royal Victoria Infirmary, Queen Victoria Rd, Newcastle-Upon-Tyne NE1 4LP, United Kingdom; Translational and Clinical Research Institute, Henry Wellcome Building, Framlington Place, Newcastle-Upon-Tyne NE2 4HH, United Kingdom.
| | - Pavel Klein
- Department of Neurology, George Washington University, Boston, United States.
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10
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Horsley JJ, Thomas RH, Chowdhury FA, Diehl B, McEvoy AW, Miserocchi A, de Tisi J, Vos SB, Walker MC, Winston GP, Duncan JS, Wang Y, Taylor PN. Complementary structural and functional abnormalities to localise epileptogenic tissue. ArXiv 2023:arXiv:2304.03192v3. [PMID: 37064531 PMCID: PMC10104180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Background When investigating suitability for epilepsy surgery, people with drug-refractory focal epilepsy may have intracranial EEG (iEEG) electrodes implanted to localise seizure onset. Diffusion-weighted magnetic resonance imaging (dMRI) may be acquired to identify key white matter tracts for surgical avoidance. Here, we investigate whether structural connectivity abnormalities, inferred from dMRI, may be used in conjunction with functional iEEG abnormalities to aid localisation of the epileptogenic zone (EZ), improving surgical outcomes in epilepsy. Methods We retrospectively investigated data from 43 patients with epilepsy who had surgery following iEEG. Twenty-five patients (58%) were free from disabling seizures (ILAE 1 or 2) at one year. Interictal iEEG functional, and dMRI structural connectivity abnormalities were quantified by comparison to a normative map and healthy controls. We explored whether the resection of maximal abnormalities related to improved surgical outcomes, in both modalities individually and concurrently. Additionally, we suggest how connectivity abnormalities may inform the placement of iEEG electrodes pre-surgically using a patient case study. Findings Seizure freedom was 15 times more likely in patients with resection of maximal connectivity and iEEG abnormalities (p=0.008). Both modalities separately distinguished patient surgical outcome groups and when used simultaneously, a decision tree correctly separated 36 of 43 (84%) patients. Interpretation Our results suggest that both connectivity and iEEG abnormalities may localise epileptogenic tissue, and that these two modalities may provide complementary information in pre-surgical evaluations. Funding This research was funded by UKRI, CDT in Cloud Computing for Big Data, NIH, MRC, Wellcome Trust and Epilepsy Research UK.
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Affiliation(s)
- Jonathan J. Horsley
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Rhys H. Thomas
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Fahmida A. Chowdhury
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Beate Diehl
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Andrew W. McEvoy
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Anna Miserocchi
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Jane de Tisi
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Sjoerd B. Vos
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Centre for Microscopy, Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
- Centre for Medical Image Computing, Computer Science Department, University College London, London, United Kingdom
| | - Matthew C. Walker
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Gavin P. Winston
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Division of Neurology, Department of Medicine, Queen’s University, Kingston, Canada
| | - John S. Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Yujiang Wang
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Peter N. Taylor
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
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11
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Roshandel D, Sanders EJ, Shakeshaft A, Panjwani N, Lin F, Collingwood A, Hall A, Keenan K, Deneubourg C, Mirabella F, Topp S, Zarubova J, Thomas RH, Talvik I, Syvertsen M, Striano P, Smith AB, Selmer KK, Rubboli G, Orsini A, Ng CC, Møller RS, Lim KS, Hamandi K, Greenberg DA, Gesche J, Gardella E, Fong CY, Beier CP, Andrade DM, Jungbluth H, Richardson MP, Pastore A, Fanto M, Pal DK, Strug LJ. SLCO5A1 and synaptic assembly genes contribute to impulsivity in juvenile myoclonic epilepsy. NPJ Genom Med 2023; 8:28. [PMID: 37770509 PMCID: PMC10539321 DOI: 10.1038/s41525-023-00370-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/29/2023] [Indexed: 09/30/2023] Open
Abstract
Elevated impulsivity is a key component of attention-deficit hyperactivity disorder (ADHD), bipolar disorder and juvenile myoclonic epilepsy (JME). We performed a genome-wide association, colocalization, polygenic risk score, and pathway analysis of impulsivity in JME (n = 381). Results were followed up with functional characterisation using a drosophila model. We identified genome-wide associated SNPs at 8q13.3 (P = 7.5 × 10-9) and 10p11.21 (P = 3.6 × 10-8). The 8q13.3 locus colocalizes with SLCO5A1 expression quantitative trait loci in cerebral cortex (P = 9.5 × 10-3). SLCO5A1 codes for an organic anion transporter and upregulates synapse assembly/organisation genes. Pathway analysis demonstrates 12.7-fold enrichment for presynaptic membrane assembly genes (P = 0.0005) and 14.3-fold enrichment for presynaptic organisation genes (P = 0.0005) including NLGN1 and PTPRD. RNAi knockdown of Oatp30B, the Drosophila polypeptide with the highest homology to SLCO5A1, causes over-reactive startling behaviour (P = 8.7 × 10-3) and increased seizure-like events (P = 6.8 × 10-7). Polygenic risk score for ADHD genetically correlates with impulsivity scores in JME (P = 1.60 × 10-3). SLCO5A1 loss-of-function represents an impulsivity and seizure mechanism. Synaptic assembly genes may inform the aetiology of impulsivity in health and disease.
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Affiliation(s)
- Delnaz Roshandel
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada
| | - Eric J Sanders
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, The University of Toronto, Toronto, Canada
| | - Amy Shakeshaft
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Naim Panjwani
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada
| | - Fan Lin
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada
| | - Amber Collingwood
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Anna Hall
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Katherine Keenan
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada
| | - Celine Deneubourg
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Filippo Mirabella
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Simon Topp
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jana Zarubova
- Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Rhys H Thomas
- Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | | | - Marte Syvertsen
- Department of Neurology, Drammen Hospital, Vestre Viken Health Trust, Oslo, Norway
| | - Pasquale Striano
- IRCCS Istituto 'G. Gaslini', Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Anna B Smith
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Kaja K Selmer
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
- National Centre for Epilepsy, Oslo University Hospital, Oslo, Norway
| | - Guido Rubboli
- Danish Epilepsy Centre, Dianalund, Denmark
- University of Copenhagen, Copenhagen, Denmark
| | - Alessandro Orsini
- Pediatric Neurology, Azienda Ospedaliero-Universitaria Pisana, Pisa University Hospital, Pisa, Italy
| | - Ching Ching Ng
- Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Rikke S Møller
- Danish Epilepsy Centre, Dianalund, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Kheng Seang Lim
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Khalid Hamandi
- The Welsh Epilepsy Unit, Department of Neurology Cardiff & Vale University Health Board, Cardiff, UK
- Department of Psychological Medicine and Clinical Neuroscience, Cardiff University, Cardiff, UK
| | | | | | - Elena Gardella
- Danish Epilepsy Centre, Dianalund, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Choong Yi Fong
- Division of Paediatric Neurology, Department of Pediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Danielle M Andrade
- Adult Epilepsy Genetics Program, Krembil Research Institute, University of Toronto, Toronto, Canada
| | - Heinz Jungbluth
- Randall Centre for Cell and Molecular Biophysics, Muscle Signalling Section, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Department of Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, UK
| | - Mark P Richardson
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- King's College Hospital, London, UK
| | - Annalisa Pastore
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Manolis Fanto
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Deb K Pal
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK.
- King's College Hospital, London, UK.
| | - Lisa J Strug
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada.
- Division of Biostatistics, Dalla Lana School of Public Health, The University of Toronto, Toronto, Canada.
- Departments of Statistical Sciences and Computer Science, The University of Toronto, Toronto, Canada.
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Canada.
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12
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Stevelink R, Campbell C, Chen S, Abou-Khalil B, Adesoji OM, Afawi Z, Amadori E, Anderson A, Anderson J, Andrade DM, Annesi G, Auce P, Avbersek A, Bahlo M, Baker MD, Balagura G, Balestrini S, Barba C, Barboza K, Bartolomei F, Bast T, Baum L, Baumgartner T, Baykan B, Bebek N, Becker AJ, Becker F, Bennett CA, Berghuis B, Berkovic SF, Beydoun A, Bianchini C, Bisulli F, Blatt I, Bobbili DR, Borggraefe I, Bosselmann C, Braatz V, Bradfield JP, Brockmann K, Brody LC, Buono RJ, Busch RM, Caglayan H, Campbell E, Canafoglia L, Canavati C, Cascino GD, Castellotti B, Catarino CB, Cavalleri GL, Cerrato F, Chassoux F, Cherny SS, Cheung CL, Chinthapalli K, Chou IJ, Chung SK, Churchhouse C, Clark PO, Cole AJ, Compston A, Coppola A, Cosico M, Cossette P, Craig JJ, Cusick C, Daly MJ, Davis LK, de Haan GJ, Delanty N, Depondt C, Derambure P, Devinsky O, Di Vito L, Dlugos DJ, Doccini V, Doherty CP, El-Naggar H, Elger CE, Ellis CA, Eriksson JG, Faucon A, Feng YCA, Ferguson L, Ferraro TN, Ferri L, Feucht M, Fitzgerald M, Fonferko-Shadrach B, Fortunato F, Franceschetti S, Franke A, French JA, Freri E, Gagliardi M, Gambardella A, Geller EB, Giangregorio T, Gjerstad L, Glauser T, Goldberg E, Goldman A, Granata T, Greenberg DA, Guerrini R, Gupta N, Haas KF, Hakonarson H, Hallmann K, Hassanin E, Hegde M, Heinzen EL, Helbig I, Hengsbach C, Heyne HO, Hirose S, Hirsch E, Hjalgrim H, Howrigan DP, Hucks D, Hung PC, Iacomino M, Imbach LL, Inoue Y, Ishii A, Jamnadas-Khoda J, Jehi L, Johnson MR, Kälviäinen R, Kamatani Y, Kanaan M, Kanai M, Kantanen AM, Kara B, Kariuki SM, Kasperavičiūte D, Kasteleijn-Nolst Trenite D, Kato M, Kegele J, Kesim Y, Khoueiry-Zgheib N, King C, Kirsch HE, Klein KM, Kluger G, Knake S, Knowlton RC, Koeleman BPC, Korczyn AD, Koupparis A, Kousiappa I, Krause R, Krenn M, Krestel H, Krey I, Kunz WS, Kurki MI, Kurlemann G, Kuzniecky R, Kwan P, Labate A, Lacey A, Lal D, Landoulsi Z, Lau YL, Lauxmann S, Leech SL, Lehesjoki AE, Lemke JR, Lerche H, Lesca G, Leu C, Lewin N, Lewis-Smith D, Li GHY, Li QS, Licchetta L, Lin KL, Lindhout D, Linnankivi T, Lopes-Cendes I, Lowenstein DH, Lui CHT, Madia F, Magnusson S, Marson AG, May P, McGraw CM, Mei D, Mills JL, Minardi R, Mirza N, Møller RS, Molloy AM, Montomoli M, Mostacci B, Muccioli L, Muhle H, Müller-Schlüter K, Najm IM, Nasreddine W, Neale BM, Neubauer B, Newton CRJC, Nöthen MM, Nothnagel M, Nürnberg P, O’Brien TJ, Okada Y, Ólafsson E, Oliver KL, Özkara C, Palotie A, Pangilinan F, Papacostas SS, Parrini E, Pato CN, Pato MT, Pendziwiat M, Petrovski S, Pickrell WO, Pinsky R, Pippucci T, Poduri A, Pondrelli F, Powell RHW, Privitera M, Rademacher A, Radtke R, Ragona F, Rau S, Rees MI, Regan BM, Reif PS, Rhelms S, Riva A, Rosenow F, Ryvlin P, Saarela A, Sadleir LG, Sander JW, Sander T, Scala M, Scattergood T, Schachter SC, Schankin CJ, Scheffer IE, Schmitz B, Schoch S, Schubert-Bast S, Schulze-Bonhage A, Scudieri P, Sham P, Sheidley BR, Shih JJ, Sills GJ, Sisodiya SM, Smith MC, Smith PE, Sonsma ACM, Speed D, Sperling MR, Stefansson H, Stefansson K, Steinhoff BJ, Stephani U, Stewart WC, Stipa C, Striano P, Stroink H, Strzelczyk A, Surges R, Suzuki T, Tan KM, Taneja RS, Tanteles GA, Taubøll E, Thio LL, Thomas GN, Thomas RH, Timonen O, Tinuper P, Todaro M, Topaloğlu P, Tozzi R, Tsai MH, Tumiene B, Turkdogan D, Unnsteinsdóttir U, Utkus A, Vaidiswaran P, Valton L, van Baalen A, Vetro A, Vining EPG, Visscher F, von Brauchitsch S, von Wrede R, Wagner RG, Weber YG, Weckhuysen S, Weisenberg J, Weller M, Widdess-Walsh P, Wolff M, Wolking S, Wu D, Yamakawa K, Yang W, Yapıcı Z, Yücesan E, Zagaglia S, Zahnert F, Zara F, Zhou W, Zimprich F, Zsurka G, Zulfiqar Ali Q. GWAS meta-analysis of over 29,000 people with epilepsy identifies 26 risk loci and subtype-specific genetic architecture. Nat Genet 2023; 55:1471-1482. [PMID: 37653029 PMCID: PMC10484785 DOI: 10.1038/s41588-023-01485-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/21/2023] [Indexed: 09/02/2023]
Abstract
Epilepsy is a highly heritable disorder affecting over 50 million people worldwide, of which about one-third are resistant to current treatments. Here we report a multi-ancestry genome-wide association study including 29,944 cases, stratified into three broad categories and seven subtypes of epilepsy, and 52,538 controls. We identify 26 genome-wide significant loci, 19 of which are specific to genetic generalized epilepsy (GGE). We implicate 29 likely causal genes underlying these 26 loci. SNP-based heritability analyses show that common variants explain between 39.6% and 90% of genetic risk for GGE and its subtypes. Subtype analysis revealed markedly different genetic architectures between focal and generalized epilepsies. Gene-set analyses of GGE signals implicate synaptic processes in both excitatory and inhibitory neurons in the brain. Prioritized candidate genes overlap with monogenic epilepsy genes and with targets of current antiseizure medications. Finally, we leverage our results to identify alternate drugs with predicted efficacy if repurposed for epilepsy treatment.
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13
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Montanucci L, Lewis-Smith D, Collins RL, Niestroj LM, Parthasarathy S, Xian J, Ganesan S, Macnee M, Brünger T, Thomas RH, Talkowski M, Helbig I, Leu C, Lal D. Genome-wide identification and phenotypic characterization of seizure-associated copy number variations in 741,075 individuals. Nat Commun 2023; 14:4392. [PMID: 37474567 PMCID: PMC10359300 DOI: 10.1038/s41467-023-39539-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 06/16/2023] [Indexed: 07/22/2023] Open
Abstract
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.
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Affiliation(s)
- Ludovica Montanucci
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, USA
| | - David Lewis-Smith
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Clinical Neurosciences, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- The Epilepsy NeuroGenetics Initiative, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Biomedical and Health Informatics (DBHi), Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ryan L Collins
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, USA
- Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology (M.I.T.) and Harvard, Cambridge, USA
| | | | - Shridhar Parthasarathy
- The Epilepsy NeuroGenetics Initiative, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Biomedical and Health Informatics (DBHi), Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Julie Xian
- The Epilepsy NeuroGenetics Initiative, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Biomedical and Health Informatics (DBHi), Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Shiva Ganesan
- The Epilepsy NeuroGenetics Initiative, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Biomedical and Health Informatics (DBHi), Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Marie Macnee
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | - Tobias Brünger
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | - Rhys H Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Clinical Neurosciences, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Michael Talkowski
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, USA
- Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology (M.I.T.) and Harvard, Cambridge, USA
| | - Ingo Helbig
- The Epilepsy NeuroGenetics Initiative, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Biomedical and Health Informatics (DBHi), Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Costin Leu
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, USA.
- Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK.
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T, Cambridge, MA, USA.
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, US.
| | - Dennis Lal
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, USA.
- Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology (M.I.T.) and Harvard, Cambridge, USA.
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T, Cambridge, MA, USA.
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, US.
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14
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Rubboli G, Beier CP, Selmer KK, Syvertsen M, Shakeshaft A, Collingwood A, Hall A, Andrade DM, Fong CY, Gesche J, Greenberg DA, Hamandi K, Lim KS, Ng CC, Orsini A, Striano P, Thomas RH, Zarubova J, Richardson MP, Strug LJ, Pal DK. Variation in prognosis and treatment outcome in juvenile myoclonic epilepsy: a Biology of Juvenile Myoclonic Epilepsy Consortium proposal for a practical definition and stratified medicine classifications. Brain Commun 2023; 5:fcad182. [PMID: 37361715 PMCID: PMC10288558 DOI: 10.1093/braincomms/fcad182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 03/21/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023] Open
Abstract
Reliable definitions, classifications and prognostic models are the cornerstones of stratified medicine, but none of the current classifications systems in epilepsy address prognostic or outcome issues. Although heterogeneity is widely acknowledged within epilepsy syndromes, the significance of variation in electroclinical features, comorbidities and treatment response, as they relate to diagnostic and prognostic purposes, has not been explored. In this paper, we aim to provide an evidence-based definition of juvenile myoclonic epilepsy showing that with a predefined and limited set of mandatory features, variation in juvenile myoclonic epilepsy phenotype can be exploited for prognostic purposes. Our study is based on clinical data collected by the Biology of Juvenile Myoclonic Epilepsy Consortium augmented by literature data. We review prognosis research on mortality and seizure remission, predictors of antiseizure medication resistance and selected adverse drug events to valproate, levetiracetam and lamotrigine. Based on our analysis, a simplified set of diagnostic criteria for juvenile myoclonic epilepsy includes the following: (i) myoclonic jerks as mandatory seizure type; (ii) a circadian timing for myoclonia not mandatory for the diagnosis of juvenile myoclonic epilepsy; (iii) age of onset ranging from 6 to 40 years; (iv) generalized EEG abnormalities; and (v) intelligence conforming to population distribution. We find sufficient evidence to propose a predictive model of antiseizure medication resistance that emphasises (i) absence seizures as the strongest stratifying factor with regard to antiseizure medication resistance or seizure freedom for both sexes and (ii) sex as a major stratifying factor, revealing elevated odds of antiseizure medication resistance that correlates to self-report of catamenial and stress-related factors including sleep deprivation. In women, there are reduced odds of antiseizure medication resistance associated with EEG-measured or self-reported photosensitivity. In conclusion, by applying a simplified set of criteria to define phenotypic variations of juvenile myoclonic epilepsy, our paper proposes an evidence-based definition and prognostic stratification of juvenile myoclonic epilepsy. Further studies in existing data sets of individual patient data would be helpful to replicate our findings, and prospective studies in inception cohorts will contribute to validate them in real-world practice for juvenile myoclonic epilepsy management.
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Affiliation(s)
- Guido Rubboli
- Correspondence may also be addressed to: Guido Rubboli Danish Epilepsy Center, Filadelfia/University of Copenhagen Kolonivej 2A, Dianalund 4293, Denmark E-mail:
| | - Christoph P Beier
- Department of Neurology, Odense University Hospital, Odense 5000, Denmark
| | - Kaja K Selmer
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo 0372, Norway
- National Centre for Epilepsy, Oslo University Hospital, Oslo 1337, Norway
| | - Marte Syvertsen
- Department of Neurology, Drammen Hospital, Vestre Viken Health Trust, Oslo 3004, Norway
| | - Amy Shakeshaft
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
- MRC Centre for Neurodevelopmental Disorders, King’s College London, London SW1H 9NA, UK
| | - Amber Collingwood
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Anna Hall
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Danielle M Andrade
- Adult Epilepsy Genetics Program, Krembil Research Institute, University of Toronto, Toronto M5T 0S8, Canada
| | - Choong Yi Fong
- Division of Paediatric Neurology, Department of Pediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Joanna Gesche
- Department of Neurology, Odense University Hospital, Odense 5000, Denmark
| | - David A Greenberg
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus 43215, USA
| | - Khalid Hamandi
- Department of Neurology, Cardiff & Vale University Health Board, Cardiff CF14 4XW, UK
| | - Kheng Seang Lim
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Ching Ching Ng
- Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Alessandro Orsini
- Department of Clinical and Experimental Medicine, Pisa University Hospital, Pisa 56126, Italy
| | | | - Pasquale Striano
- Pediatric Neurology and Muscular Disease Unit, IRCCS Istituto ‘G. Gaslini’, Genova 16147, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova 16132, Italy
| | - Rhys H Thomas
- Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Jana Zarubova
- Department of Neurology, Second Faculty of Medicine, Charles University, Prague 150 06, Czech Republic
- Motol University Hospital, Prague 150 06, Czech Republic
| | - Mark P Richardson
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
- MRC Centre for Neurodevelopmental Disorders, King’s College London, London SW1H 9NA, UK
- School of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London SE5 8AF, UK
| | - Lisa J Strug
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto M5G 1X8, Canada
- Departments of Statistical Sciences and Computer Science and Division of Biostatistics, The University of Toronto, Toronto M5G 1Z5, Canada
| | - Deb K Pal
- Correspondence to: Deb K. Pal Maurice Wohl Clinical Neurosciences Institute Institute of Psychiatry, Psychology and Neuroscience, King’s College London 5 Cutcombe Road, London SE5 9RX, UK E-mail:
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15
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Gascoigne SJ, Waldmann L, Schroeder GM, Panagiotopoulou M, Blickwedel J, Chowdhury F, Cronie A, Diehl B, Duncan JS, Falconer J, Faulder R, Guan Y, Leach V, Livingstone S, Papasavvas C, Thomas RH, Wilson K, Taylor PN, Wang Y. A library of quantitative markers of seizure severity. Epilepsia 2023; 64:1074-1086. [PMID: 36727552 PMCID: PMC10952709 DOI: 10.1111/epi.17525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Understanding fluctuations in seizure severity within individuals is important for determining treatment outcomes and responses to therapy, as well as assessing novel treatments for epilepsy. Current methods for grading seizure severity rely on qualitative interpretations from patients and clinicians. Quantitative measures of seizure severity would complement existing approaches to electroencephalographic (EEG) monitoring, outcome monitoring, and seizure prediction. Therefore, we developed a library of quantitative EEG markers that assess the spread and intensity of abnormal electrical activity during and after seizures. METHODS We analyzed intracranial EEG (iEEG) recordings of 1009 seizures from 63 patients. For each seizure, we computed 16 markers of seizure severity that capture the signal magnitude, spread, duration, and postictal suppression of seizures. RESULTS Quantitative EEG markers of seizure severity distinguished focal versus subclinical seizures across patients. In individual patients, 53% had a moderate to large difference (rank sumr > .3 ,p < .05 ) between focal and subclinical seizures in three or more markers. Circadian and longer term changes in severity were found for the majority of patients. SIGNIFICANCE We demonstrate the feasibility of using quantitative iEEG markers to measure seizure severity. Our quantitative markers distinguish between seizure types and are therefore sensitive to established qualitative differences in seizure severity. Our results also suggest that seizure severity is modulated over different timescales. We envisage that our proposed seizure severity library will be expanded and updated in collaboration with the epilepsy research community to include more measures and modalities.
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Affiliation(s)
- Sarah J. Gascoigne
- Computational Neurology, Neuroscience & Psychiatry Lab, Interdisciplinary Computing and Complex BioSystems Group, School of ComputingNewcastle UniversityNewcastle Upon TyneUK
| | | | - Gabrielle M. Schroeder
- Computational Neurology, Neuroscience & Psychiatry Lab, Interdisciplinary Computing and Complex BioSystems Group, School of ComputingNewcastle UniversityNewcastle Upon TyneUK
| | - Mariella Panagiotopoulou
- Computational Neurology, Neuroscience & Psychiatry Lab, Interdisciplinary Computing and Complex BioSystems Group, School of ComputingNewcastle UniversityNewcastle Upon TyneUK
| | - Jess Blickwedel
- Computational Neurology, Neuroscience & Psychiatry Lab, Interdisciplinary Computing and Complex BioSystems Group, School of ComputingNewcastle UniversityNewcastle Upon TyneUK
| | | | | | - Beate Diehl
- UCL Queen Square Institute of NeurologyLondonUK
| | | | | | - Ryan Faulder
- Computational Neurology, Neuroscience & Psychiatry Lab, Interdisciplinary Computing and Complex BioSystems Group, School of ComputingNewcastle UniversityNewcastle Upon TyneUK
| | - Yu Guan
- Department of Computer ScienceUniversity of WarwickWarwickUK
| | | | | | - Christoforos Papasavvas
- Computational Neurology, Neuroscience & Psychiatry Lab, Interdisciplinary Computing and Complex BioSystems Group, School of ComputingNewcastle UniversityNewcastle Upon TyneUK
| | | | - Kevin Wilson
- School of Mathematics, Statistics, and PhysicsNewcastle UniversityNewcastle Upon TyneUK
| | - Peter N. Taylor
- Computational Neurology, Neuroscience & Psychiatry Lab, Interdisciplinary Computing and Complex BioSystems Group, School of ComputingNewcastle UniversityNewcastle Upon TyneUK
- UCL Queen Square Institute of NeurologyLondonUK
- Faculty of Medical SciencesNewcastle UniversityNewcastle Upon TyneUK
| | - Yujiang Wang
- Computational Neurology, Neuroscience & Psychiatry Lab, Interdisciplinary Computing and Complex BioSystems Group, School of ComputingNewcastle UniversityNewcastle Upon TyneUK
- UCL Queen Square Institute of NeurologyLondonUK
- Faculty of Medical SciencesNewcastle UniversityNewcastle Upon TyneUK
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16
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Donovan B, Ashby S, Hanna J, Cowdry T, Thorpe J, Hughes E, Kerr MP, Thomas RH. "Untold Distress" - How did the COVID-19 pandemic affect those who had previously experienced an epilepsy-related bereavement? Epilepsy Behav 2023; 139:109071. [PMID: 36640482 PMCID: PMC9835558 DOI: 10.1016/j.yebeh.2022.109071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 01/03/2023]
Abstract
PURPOSE This study explores the impact of the COVID-19 pandemic and lockdown on people with lived experience of sudden bereavement as a consequence of an epilepsy-related death. METHOD We developed an online survey with fixed choice and open-ended response formats to collect data on grief symptoms and well-being during the pandemic. A total of 275 people bereaved by epilepsy-related deaths between 1980-2020 participated in this study: with 79 participants providing free-text responses for inductive thematic analysis. RESULTS In total, 84% of participants reported a bereavement following a sudden death of a person aged under 40, with 22% aged 19 and under. The majority (77% of participants) reported they had been thinking more about the person who died compared to before the COVID-19 outbreak and 54% had experienced more distressing flashbacks to the time of death. Additionally, 61% reported more difficulties falling asleep and staying asleep and 88% of participants reported that the outbreak and response measures had negatively impacted upon their mental health. Medication was being taken for a diagnosed mental health condition by 33% of participants at the time of the study. We categorized these negative experiences during COVID in to four main-themes - 'Family', 'Lifestyle', 'Personal Well-being' and 'Health Services and Shielding Populations'. The 'Personal Well-being' theme was inextricably linked to grief symptoms including 'reflection on the death', 're-exposure to feeling', 'grief', 'salience of sudden deaths in the media' and 'inability to commemorate anniversaries and rituals'. These findings were consistent for bereaved people irrespective of the recency of the death. CONCLUSION This study highlights the impact of the disruption caused by the pandemic on the grief-management of those bereaved by epilepsy-related death. Grief is not static and its management is connected to the psychosocial and formal support structures that were disrupted during the pandemic. The removal of these supports had an adverse effect upon the mental health and well-being of many bereaved. There is an urgent need for a system-wide transformation of epilepsy and mental health services to be inclusive of the needs and experiences of people impacted by sudden deaths in epilepsy and the contribution of the specialist service developed by families and clinicians to meet this gap.
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Affiliation(s)
- Ben Donovan
- SUDEP Action, 18, Newbury St., Wantage OX12 8DA, United Kingdom.
| | - Samantha Ashby
- SUDEP Action, 18, Newbury St., Wantage OX12 8DA, United Kingdom
| | - Jane Hanna
- SUDEP Action, 18, Newbury St., Wantage OX12 8DA, United Kingdom
| | - Tracy Cowdry
- SUDEP Action, 18, Newbury St., Wantage OX12 8DA, United Kingdom
| | - Jennifer Thorpe
- SUDEP Action, 18, Newbury St., Wantage OX12 8DA, United Kingdom
| | - Elaine Hughes
- King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, United Kingdom; Evelina Children's Hospital, Westminster Bridge Rd, St Thomas' Hospital, London SE1 7EH, United Kingdom
| | - Mike P Kerr
- Psychological Medicine and Clinical Neurosciences, Hadyn Ellis Building, Maindy Road, Cardiff CF24 4HQ, United Kingdom
| | - Rhys H Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom; Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, United Kingdom
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17
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Laskier V, Agyei-Kyeremateng KK, Eddy AE, Patel D, Mulheron S, James S, Thomas RH, Sander JW. Cost-effectiveness of cenobamate for focal seizures in people with drug-resistant epilepsy. Epilepsia 2023; 64:843-856. [PMID: 36625423 DOI: 10.1111/epi.17506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/06/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This study was undertaken to estimate the cost-effectiveness of add-on cenobamate in the UK when used to treat drug-resistant focal seizures in adults who are not adequately controlled with at least two prior antiseizure medications, including at least one used adjunctively. METHODS We estimated the cost per quality-adjusted life-year (QALY) for cenobamate compared to brivaracetam, eslicarbazepine, lacosamide, and perampanel in the UK National Health Service over a lifetime time horizon. We used a Markov cohort structure to determine response to treatment, using pooled data from three long-term studies of cenobamate. A network meta-analysis informed the likelihood of response to therapy with brivaracetam, eslicarbazepine, lacosamide, and perampanel relative to cenobamate. Once individuals discontinued treatment, they transitioned to subsequent treatment health states, including other antiseizure medicines, surgery, and vagus nerve stimulation. Costs included treatment, administration, routine monitoring, event management, and adverse events. Published evidence and expert opinion informed the likelihood of response to subsequent treatments, associated adverse events, and costs. Utility data were based on Short-Form six-dimension form utility. Discounting was applied at 3.5% per annum as per National Institute for Health and Care Excellence guidance. Uncertainty was explored through deterministic and probabilistic sensitivity analyses. RESULTS In the base case, cenobamate led to cost savings of £51 967 (compared to brivaracetam), £21 080 (compared to eslicarbazepine), £33 619 (compared to lacosamide), and £28 296 (compared to perampanel) and increased QALYs of 1.047 (compared to brivaracetam), 0.598 (compared to eslicarbazepine), 0.776 (compared to lacosamide), and 0.703 (compared to perampanel) per individual over a lifetime time horizon. Cenobamate also dominated the four drugs across most sensitivity analyses. Differences were due to reduced seizure frequency with cenobamate relative to comparators. SIGNIFICANCE Cenobamate improved QALYs and was less costly than brivaracetam, eslicarbazepine, lacosamide, and perampanel. Therefore, cenobamate may be considered as a cost-effective adjunctive antiseizure medication for people with drug-resistant focal seizures.
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Affiliation(s)
| | | | | | | | | | | | - Rhys H Thomas
- Department of Neurology, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.,Translational and Clinical Research Institute, Newcastle, UK
| | - Josemir W Sander
- UCL Queen Square Institute of Neurology, London, UK.,Chalfont Centre for Epilepsy, Chalfont St Peter, UK.,Stichting Epilepsie Instellingen Nederland, Heemstede, The Netherlands.,Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
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18
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Grundmann A, Wu C, Hardwick M, Baillie JK, Openshaw PJM, Semple MG, Böhning D, Pett S, Michael BD, Thomas RH, Galea I. Fewer COVID-19 Neurological Complications with Dexamethasone and Remdesivir. Ann Neurol 2023; 93:88-102. [PMID: 36261315 PMCID: PMC9874556 DOI: 10.1002/ana.26536] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 10/17/2022] [Accepted: 10/17/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The objective of this study was to assess the impact of treatment with dexamethasone, remdesivir or both on neurological complications in acute coronavirus diease 2019 (COVID-19). METHODS We used observational data from the International Severe Acute and emerging Respiratory Infection Consortium World Health Organization (WHO) Clinical Characterization Protocol, United Kingdom. Hospital inpatients aged ≥18 years with laboratory-confirmed severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection admitted between January 31, 2020, and June 29, 2021, were included. Treatment allocation was non-blinded and performed by reporting clinicians. A propensity scoring methodology was used to minimize confounding. Treatment with remdesivir, dexamethasone, or both was assessed against the standard of care. The primary outcome was a neurological complication occurring at the point of death, discharge, or resolution of the COVID-19 clinical episode. RESULTS Out of 89,297 hospital inpatients, 64,088 had severe COVID-19 and 25,209 had non-hypoxic COVID-19. Neurological complications developed in 4.8% and 4.5%, respectively. In both groups, neurological complications were associated with increased mortality, intensive care unit (ICU) admission, worse self-care on discharge, and time to recovery. In patients with severe COVID-19, treatment with dexamethasone (n = 21,129), remdesivir (n = 1,428), and both combined (n = 10,846) were associated with a lower frequency of neurological complications: OR = 0.76 (95% confidence interval [CI] = 0.69-0.83), OR = 0.69 (95% CI = 0.51-0.90), and OR = 0.54 (95% CI = 0.47-0.61), respectively. In patients with non-hypoxic COVID-19, dexamethasone (n = 2,580) was associated with less neurological complications (OR = 0.78, 95% CI = 0.62-0.97), whereas the dexamethasone/remdesivir combination (n = 460) showed a similar trend (OR = 0.63, 95% CI = 0.31-1.15). INTERPRETATION Treatment with dexamethasone, remdesivir, or both in patients hospitalized with COVID-19 was associated with a lower frequency of neurological complications in an additive manner, such that the greatest benefit was observed in patients who received both drugs together. ANN NEUROL 2023;93:88-102.
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Affiliation(s)
- Alexander Grundmann
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
- Department of NeurologyWessex Neurological Centre, University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Chieh‐Hsi Wu
- Statistics, Mathematical Sciences, and Faculty of Social SciencesUniversity of SouthamptonSouthamptonUK
| | - Marc Hardwick
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
- Department of NeurologyWessex Neurological Centre, University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - J. Kenneth Baillie
- Roslin InstituteUniversity of Edinburgh, Easter BushEdinburghUK
- Intensive Care UnitRoyal Infirmary of EdinburghEdinburghUK
| | - Peter J M Openshaw
- National Heart and Lung InstituteImperial College LondonLondonUK
- Imperial College Healthcare NHS TrustLondonUK
| | - Malcolm G. Semple
- NIHR Health Protection Research Unit for Emerging and Zoonotic InfectionsInstitute of Infection, Veterinary and Ecological Sciences, University of LiverpoolLiverpoolUK
- Department of Respiratory MedicineAlder Hey Children's HospitalLiverpoolUK
| | - Dankmar Böhning
- Statistics, Mathematical Sciences, and Faculty of Social SciencesUniversity of SouthamptonSouthamptonUK
| | - Sarah Pett
- Medical Research Council Clinical Trials UnitInstitute of Clinical Trials and Methodology, University College LondonLondonUK
- Institute for Global HealthUniversity College LondonLondonUK
| | - Benedict D. Michael
- NIHR Health Protection Research Unit for Emerging and Zoonotic InfectionsInstitute of Infection, Veterinary and Ecological Sciences, University of LiverpoolLiverpoolUK
- Department of Clinical Infection Microbiology and ImmunologyInstitute of Infection, Veterinary, and Ecological Sciences, University of LiverpoolLiverpoolUK
- Department of NeurologyThe Walton Centre NHS Foundation TrustLiverpoolUK
| | - Rhys H. Thomas
- Translational and Clinical Research InstituteUniversity of NewcastleNewcastle upon TyneUK
- Department of NeurologyRoyal Victoria InfirmaryNewcastle upon TyneUK
| | - Ian Galea
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
- Department of NeurologyWessex Neurological Centre, University Hospital Southampton NHS Foundation TrustSouthamptonUK
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19
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Parenti I, Leitão E, Kuechler A, Villard L, Goizet C, Courdier C, Bayat A, Rossi A, Julia S, Bruel AL, Tran Mau-Them F, Nambot S, Lehalle D, Willems M, Lespinasse J, Ghoumid J, Caumes R, Smol T, El Chehadeh S, Schaefer E, Abi-Warde MT, Keren B, Afenjar A, Tabet AC, Levy J, Maruani A, Aledo-Serrano Á, Garming W, Milleret-Pignot C, Chassevent A, Koopmans M, Verbeek NE, Person R, Belles R, Bellus G, Salbert BA, Kaiser FJ, Mazzola L, Convers P, Perrin L, Piton A, Wiegand G, Accogli A, Brancati F, Benfenati F, Chatron N, Lewis-Smith D, Thomas RH, Zara F, Striano P, Lesca G, Depienne C. The different clinical facets of SYN1-related neurodevelopmental disorders. Front Cell Dev Biol 2022; 10:1019715. [PMID: 36568968 PMCID: PMC9773998 DOI: 10.3389/fcell.2022.1019715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/20/2022] [Indexed: 12/13/2022] Open
Abstract
Synapsin-I (SYN1) is a presynaptic phosphoprotein crucial for synaptogenesis and synaptic plasticity. Pathogenic SYN1 variants are associated with variable X-linked neurodevelopmental disorders mainly affecting males. In this study, we expand on the clinical and molecular spectrum of the SYN1-related neurodevelopmental disorders by describing 31 novel individuals harboring 22 different SYN1 variants. We analyzed newly identified as well as previously reported individuals in order to define the frequency of key features associated with these disorders. Specifically, behavioral disturbances such as autism spectrum disorder or attention deficit hyperactivity disorder are observed in 91% of the individuals, epilepsy in 82%, intellectual disability in 77%, and developmental delay in 70%. Seizure types mainly include tonic-clonic or focal seizures with impaired awareness. The presence of reflex seizures is one of the most representative clinical manifestations related to SYN1. In more than half of the cases, seizures are triggered by contact with water, but other triggers are also frequently reported, including rubbing with a towel, fever, toothbrushing, fingernail clipping, falling asleep, and watching others showering or bathing. We additionally describe hyperpnea, emotion, lighting, using a stroboscope, digestive troubles, and defecation as possible triggers in individuals with SYN1 variants. The molecular spectrum of SYN1 variants is broad and encompasses truncating variants (frameshift, nonsense, splicing and start-loss variants) as well as non-truncating variants (missense substitutions and in-frame duplications). Genotype-phenotype correlation revealed that epileptic phenotypes are enriched in individuals with truncating variants. Furthermore, we could show for the first time that individuals with early seizures onset tend to present with severe-to-profound intellectual disability, hence highlighting the existence of an association between early seizure onset and more severe impairment of cognitive functions. Altogether, we present a detailed clinical description of the largest series of individuals with SYN1 variants reported so far and provide the first genotype-phenotype correlations for this gene. A timely molecular diagnosis and genetic counseling are cardinal for appropriate patient management and treatment.
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Affiliation(s)
- Ilaria Parenti
- Institute of Human Genetics, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Elsa Leitão
- Institute of Human Genetics, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Alma Kuechler
- Institute of Human Genetics, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Laurent Villard
- INSERM, MMG, Faculté de Médecine, Aix-Marseille University, Marseille, France,Département de Génétique Médicale, APHM, Hôpital d'Enfants de La Timone, Marseille, France
| | - Cyril Goizet
- Service de Génétique Médicale, Bordeaux, France,Centre de Référence Maladies Rares Neurogénétique, Service de Génétique Médicale, Bordeaux, France,NRGEN Team, INCIA, CNRS UMR 5287, University of Bordeaux, Bordeaux, France
| | - Cécile Courdier
- Service de Génétique Médicale, Bordeaux, France,Centre de Référence Maladies Rares Neurogénétique, Service de Génétique Médicale, Bordeaux, France,NRGEN Team, INCIA, CNRS UMR 5287, University of Bordeaux, Bordeaux, France
| | - Allan Bayat
- Institute for Regional Health Services, University of Southern Denmark, Odense, Denmark,Department of Epilepsy Genetics and Personalized Medicine, Danish Epilepsy Center, Dianalund, Denmark,Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Alessandra Rossi
- Department of Epilepsy Genetics and Personalized Medicine, Danish Epilepsy Center, Dianalund, Denmark,Pediatric Clinic, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Sophie Julia
- Service de Génétique Médicale, Pôle de Biologie, CHU de Toulouse - Hôpital Purpan, Toulouse, France
| | - Ange-Line Bruel
- Unité Fonctionnelle Innovation en Diagnostic Génomique des Maladies Rares, FHU-TRANSLAD, CHU Dijon Bourgogne, Dijon, France,UMR1231 GAD, Inserm - Université Bourgogne-Franche Comté, Dijon, France
| | - Frédéric Tran Mau-Them
- Unité Fonctionnelle Innovation en Diagnostic Génomique des Maladies Rares, FHU-TRANSLAD, CHU Dijon Bourgogne, Dijon, France,UMR1231 GAD, Inserm - Université Bourgogne-Franche Comté, Dijon, France
| | - Sophie Nambot
- UMR1231 GAD, Inserm - Université Bourgogne-Franche Comté, Dijon, France
| | - Daphné Lehalle
- Unité Fonctionnelle Innovation en Diagnostic Génomique des Maladies Rares, FHU-TRANSLAD, CHU Dijon Bourgogne, Dijon, France,UMR1231 GAD, Inserm - Université Bourgogne-Franche Comté, Dijon, France
| | - Marjolaine Willems
- Department of Medical Genetics, Rare diseases and Personalized Medicine, CHU Montpellier, University of Montpellier, Montpellier, France,Inserm U1298, INM, CHU Montpellier, University of Montpellier, Montpellier, France
| | - James Lespinasse
- Service de Cytogenetique, Centre Hospitalier de Chambéry, Chambéry, France
| | - Jamal Ghoumid
- Univ. Lille, ULR7364 RADEME, Lille, France,CHU Lille, Clinique de Génétique, Guy Fontaine, Lille, France
| | - Roseline Caumes
- Univ. Lille, ULR7364 RADEME, Lille, France,CHU Lille, Clinique de Génétique, Guy Fontaine, Lille, France
| | - Thomas Smol
- Univ. Lille, ULR7364 RADEME, Lille, France,CHU Lille, Institut de Génétique Médicale, Lille, France
| | - Salima El Chehadeh
- Service de Génétique Médicale, Institut de Génétique Médicale d'Alsace (IGMA), Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg, France
| | - Elise Schaefer
- Service de Génétique Médicale, Institut de Génétique Médicale d'Alsace (IGMA), Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg, France
| | | | - Boris Keren
- APHP, Département de Génétique, UF de Génomique du Développement, Département de Génétique, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Alexandra Afenjar
- Département de Génétique, Centre de Référence déficiences Intellectuelles de Causes Rares, APHP, Hôpital Armand Trousseau, Sorbonne Université, Paris, France
| | | | - Jonathan Levy
- APHP, Département de Génétique, Hôpital Robert-Debré, Paris, France
| | - Anna Maruani
- Department of Child and Adolescent Psychiatry, Robert Debré Hospital, APHP, Paris, France
| | - Ángel Aledo-Serrano
- Epilepsy and Neurogenetics Program, Neurology Department, Ruber Internacional Hospital, Madrid, Spain
| | - Waltraud Garming
- Sozialpädiatrisches Zentrum, Kinder-und Jugendklinik Gelsenkirchen, Gelsenkirchen, Germany
| | | | - Anna Chassevent
- Department of Neurogenetics, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Marije Koopmans
- Department of Genetics, Utrecht University Medical Center, Utrecht, Netherlands
| | - Nienke E. Verbeek
- Department of Genetics, Utrecht University Medical Center, Utrecht, Netherlands
| | | | - Rebecca Belles
- Medical Genetics, Geisinger Medical Center, Danville, PA, United States
| | - Gary Bellus
- Medical Genetics, Geisinger Medical Center, Danville, PA, United States
| | - Bonnie A. Salbert
- Medical Genetics, Geisinger Medical Center, Danville, PA, United States
| | - Frank J. Kaiser
- Institute of Human Genetics, University Hospital Essen, University Duisburg-Essen, Essen, Germany,Essener Zentrum für Seltene Erkrankungen (EZSE), Universitätsklinikum Essen, Essen, Germany
| | - Laure Mazzola
- Department of Neurology, University Hospital, Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, Lyon, France,Department of Neurology, University Hospital, Saint-Etienne, France
| | - Philippe Convers
- Department of Neurology, University Hospital, Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, Lyon, France,Department of Neurology, University Hospital, Saint-Etienne, France
| | - Laurine Perrin
- Department of Paediatric Physical Medicine and Rehabilitation, CHU Saint-Étienne, Hôpital Bellevue, Rhône-Alpes Reference Centre for Neuromuscular Diseases, Saint-Étienne, France
| | - Amélie Piton
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, Illkirch, France,Centre National de la Recherche Scientifique, UMR7104, Illkirch, France,Institut National de la Santé et de la Recherche Médicale, U964, Illkirch, France,Université de Strasbourg, Illkirch, France
| | - Gert Wiegand
- Division of Pediatric Neurology, Department of Pediatrics, Asklepios Klinik Nord-Heidberg, Hamburg, Germany,Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics), University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - Andrea Accogli
- Department of Specialized Medicine, Division of Medical Genetics, McGill University Health Centre, Montreal, Qc, Canada,Department of Human Genetics, Faculty of Medicine, McGill University, Montreal, Qc, Canada
| | - Francesco Brancati
- Department of Life, Human Genetics, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy,IRCCS San Raffaele Roma, Rome, Italy
| | - Fabio Benfenati
- Center for Synaptic Neuroscience and Technology, Istituto Italiano di Tecnologia, Geneva, Italy,IRCCS Ospedale Policlinico San Martino, Geneva, Italy
| | - Nicolas Chatron
- Service de Genetique, Hospices Civils de Lyon, Bron, France,Institute NeuroMyoGène, Laboratoire Physiopathologie et Génétique du Neurone et du Muscle, CNRS UMR 5261 -INSERM U1315, Université de Lyon - Université Claude Bernard Lyon 1, Lyon, France
| | - David Lewis-Smith
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom,Department of Clinical Neurosciences, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | - Rhys H. Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom,Department of Clinical Neurosciences, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | - Federico Zara
- IRCCS G. Gaslini, Genova, Italy,Department of Neurology, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Pasquale Striano
- IRCCS G. Gaslini, Genova, Italy,Department of Neurology, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Gaetan Lesca
- Service de Genetique, Hospices Civils de Lyon, Bron, France,Institute NeuroMyoGène, Laboratoire Physiopathologie et Génétique du Neurone et du Muscle, CNRS UMR 5261 -INSERM U1315, Université de Lyon - Université Claude Bernard Lyon 1, Lyon, France
| | - Christel Depienne
- Institute of Human Genetics, University Hospital Essen, University Duisburg-Essen, Essen, Germany,*Correspondence: Christel Depienne,
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Alam AM, Chen JPK, Wood GK, Facer B, Bhojak M, Das K, Defres S, Marson A, Granerod J, Brown D, Thomas RH, Keller SS, Solomon T, Michael BD. Correction: Increased volume of cerebral oedema is associated with risk of acute seizure activity and adverse neurological outcomes in encephalitis - regional and volumetric analysis in a multi-centre cohort. BMC Neurol 2022; 22:451. [PMID: 36464705 PMCID: PMC9721044 DOI: 10.1186/s12883-022-02995-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Ali M. Alam
- grid.10025.360000 0004 1936 8470Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, UK ,The NIHR Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, UK
| | - Jian P. K. Chen
- grid.139534.90000 0001 0372 5777Barts Health NHS Trust, London, UK
| | - Greta K. Wood
- grid.10025.360000 0004 1936 8470Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, UK ,The NIHR Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, UK
| | - Bethany Facer
- grid.10025.360000 0004 1936 8470Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Maneesh Bhojak
- grid.416928.00000 0004 0496 3293Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Kumar Das
- grid.416928.00000 0004 0496 3293Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Sylviane Defres
- grid.10025.360000 0004 1936 8470Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, UK ,The NIHR Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, UK ,grid.10025.360000 0004 1936 8470Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Trust, Liverpool, UK
| | - Anthony Marson
- grid.10025.360000 0004 1936 8470Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK ,grid.416928.00000 0004 0496 3293Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Julia Granerod
- grid.271308.f0000 0004 5909 016XIndependent Scientific Consultant, formerly of Public Health England, London, UK
| | - David Brown
- UK Heath Security Agency, 61 Colindale Avenue, London, UK
| | - Rhys H. Thomas
- grid.1006.70000 0001 0462 7212Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Simon S. Keller
- grid.10025.360000 0004 1936 8470Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Tom Solomon
- grid.10025.360000 0004 1936 8470Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, UK ,The NIHR Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, UK ,grid.416928.00000 0004 0496 3293Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Benedict D. Michael
- grid.10025.360000 0004 1936 8470Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, UK ,The NIHR Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, UK ,grid.416928.00000 0004 0496 3293Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
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21
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Alam AM, Chen JPK, Wood GK, Facer B, Bhojak M, Das K, Defres S, Marson A, Granerod J, Brown D, Thomas RH, Keller SS, Solomon T, Michael BD. Increased volume of cerebral oedema is associated with risk of acute seizure activity and adverse neurological outcomes in encephalitis - regional and volumetric analysis in a multi-centre cohort. BMC Neurol 2022; 22:412. [PMID: 36344954 PMCID: PMC9639313 DOI: 10.1186/s12883-022-02926-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Seizures can occur unpredictably in patients with acute encephalitis syndrome (AES), and many suffer from poor long-term neurological sequelae. Establishing factors associated with acute seizures risk and poor outcomes could support clinical care. We aimed to conduct regional and volumetric analysis of cerebral oedema on magnetic resonance imaging (MRI) in patients with AES. We assessed the relationship of brain oedema with acute seizure activity and long-term neurological outcome. METHODS In a multi-centre cohort study, adults and children presenting with an AES were recruited in the UK. The clinical and brain MRI data were retrospectively reviewed. The outcomes variables were inpatient acute seizure activity and neurological disability at six-months post-discharge. A poor outcome was defined as a Glasgow outcome score (GOS) of 1-3. We quantified regional brain oedema on MRI through stereological examination of T2-weighted images using established methodology by independent and blinded assessors. Clinical and neuroimaging variables were analysed by multivariate logistic regression to assess for correlation with acute seizure activity and outcome. RESULTS The study cohort comprised 69 patients (mean age 31.8 years; 53.6% female), of whom 41 (59.4%) had acute seizures as inpatients. A higher Glasgow coma scale (GCS) score on admission was a negative predictor of seizures (OR 0.61 [0.46-0.83], p = 0.001). Even correcting for GCS on admission, the presence of cortical oedema was a significant risk factor for acute seizure activity (OR 5.48 [1.62-18.51], p = 0.006) and greater volume of cerebral oedema in these cortical structures increased the risk of acute seizures (OR 1.90 [1.12-3.21], p = 0.017). At six-month post-discharge, 21 (30.4%) had a poor neurological outcome. Herpes simplex virus encephalitis was associated with higher risk of poor outcomes in univariate analysis (OR 3.92 [1.08-14.20], p = 0.038). When controlling for aetiology, increased volume of cerebral oedema was an independent risk factor for adverse neurological outcome at 6 months (OR 1.73 [1.06-2.83], p = 0.027). CONCLUSIONS Both the presence and degree of cerebral oedema on MRIs of patients with AES may help identify patients at risk of acute seizure activity and subsequent long-term morbidity.
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Affiliation(s)
- Ali M Alam
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, UK
- The NIHR Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, UK
| | | | - Greta K Wood
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, UK
- The NIHR Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, UK
| | - Bethany Facer
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Maneesh Bhojak
- Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Kumar Das
- Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Sylviane Defres
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, UK
- The NIHR Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, UK
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Trust, Liverpool, UK
| | - Anthony Marson
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Julia Granerod
- Independent Scientific Consultant, formerly of Public Health England, London, UK
| | - David Brown
- UK Heath Security Agency, 61 Colindale Avenue, London, UK
| | - Rhys H Thomas
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Simon S Keller
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Tom Solomon
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, UK
- The NIHR Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, UK
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Benedict D Michael
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, UK.
- The NIHR Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, UK.
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK.
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22
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Lewis-Smith D, Parthasarathy S, Xian J, Kaufman MC, Ganesan S, Galer PD, Thomas RH, Helbig I. Computational analysis of neurodevelopmental phenotypes: Harmonization empowers clinical discovery. Hum Mutat 2022; 43:1642-1658. [PMID: 35460582 PMCID: PMC9560951 DOI: 10.1002/humu.24389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/23/2022] [Accepted: 04/21/2022] [Indexed: 11/09/2022]
Abstract
Making a specific diagnosis in neurodevelopmental disorders is traditionally based on recognizing clinical features of a distinct syndrome, which guides testing of its possible genetic etiologies. Scalable frameworks for genomic diagnostics, however, have struggled to integrate meaningful measurements of clinical phenotypic features. While standardization has enabled generation and interpretation of genomic data for clinical diagnostics at unprecedented scale, making the equivalent breakthrough for clinical data has proven challenging. However, increasingly clinical features are being recorded using controlled dictionaries with machine readable formats such as the Human Phenotype Ontology (HPO), which greatly facilitates their use in the diagnostic space. Improving the tractability of large-scale clinical information will present new opportunities to inform genomic research and diagnostics from a clinical perspective. Here, we describe novel approaches for computational phenotyping to harmonize clinical features, improve data translation through revising domain-specific dictionaries, quantify phenotypic features, and determine clinical relatedness. We demonstrate how these concepts can be applied to longitudinal phenotypic information, which represents a critical element of developmental disorders and pediatric conditions. Finally, we expand our discussion to clinical data derived from electronic medical records, a largely untapped resource of deep clinical information with distinct strengths and weaknesses.
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Affiliation(s)
- David Lewis-Smith
- Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, UK
- Department of Clinical Neurosciences, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Shridhar Parthasarathy
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Julie Xian
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Michael C. Kaufman
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Shiva Ganesan
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Peter D. Galer
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Center for Neuroengineering and Therapeutics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Rhys H. Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, UK
- Department of Clinical Neurosciences, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
| | - Ingo Helbig
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
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23
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Goldberg AJ, Chowdhury K, Molloy AP, Davies MB, Hepple S, Thomas RH, Siddique MS, Loveday DT, Dhar S, Bing AJ, Clough T, Bendall SP, Rogers M, Milner S, Mishra V, Butler M, Halliwell P, Townshend DN. 2022 Roger A. Mann Award Winner: Total Ankle Replacement vs Arthrodesis (TARVA) Randomized Controlled Trial: 2 Year Results. Foot & Ankle Orthopaedics 2022. [DOI: 10.1177/2473011421s00673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Category: Ankle Arthritis; Ankle; Hindfoot; Other Introduction/Purpose: End-stage ankle osteoarthritis (EOA) causes severe pain and chronic disability. Once non operative measures have been exhausted the two main surgical treatments include total ankle replacement (TAR) and ankle fusion (AF). Systematic reviews have confirmed that both procedures are effective but there has never been a robust randomised multicentre level I study comparing the two treatments. Our objective was to investigate and compare the clinical and cost effectiveness of TAR against AF in the treatment of end-stage ankle osteoarthritis in patients aged 50-85 years. Methods: TARVA is a multi-centre, parallel-group, open label randomised trial. Patients with EOA, aged 50-85, suitable for either procedure were recruited at 17 UK hospitals. Randomisation was carried out using a secure on-line service and was stratified by surgeon and the presence or absence of adjacent joint OA (based on an independently reviewed preoperative MRI scan). Participants were randomised 1:1 to either TAR or ankle arthrodesis. The primary outcome was the change in the Manchester Oxford Foot & Ankle Questionnaire (MOXFQ) walking/standing domain scores between pre-operation and 52 weeks post- operation. Secondary outcomes measures included FAAM; FAAM (ADL); and Sport subscale scores. Quality of life was measured using the EQ-5D-5L. Total range of tibia to floor motion was measured using a validated method. Health economic analysis used mean incremental cost per quality-adjusted life years (QALY) gained. Analysis was by intention to treat. The trial registration is ISRCTN60672307. Results: Of 933 eligible patients 303 were randomised. 282 underwent surgery. Mean age 68 (71% male). Aetiology was post- trauma in 55.3%, and inflammatory in 7.1%. Groups were well balanced at baseline on all parameters. 54% TARs were fixed bearing. 61% of fusions were performed arthroscopically. At 2 years the adjusted mean difference in the change in MOXFQ W/S between TAR & AF was -4.4(95% CI -11.38 to 2.68, p=0∙23). Post hoc analysis of the commonest implant type (fixed bearing TAR) did show a statistically significant improvement over AF (p=0∙04, -8.9, 95% CI -17.2 to -0.6). Secondary outcomes, EQ5D-VAS and FAAM were significant. Complications included wound healing issues (13.8% vs 5.5%); nerve injuries (4.3% vs 0.7%). 11.8% of AF patients had plain radiographic evidence of non-union but only 6.9% had symptoms. Reoperation rate was 7.2% for TAR vs 5.2% for AF; and revision rate was 0.7% for TAR vs 2.8% for AF. Conclusion: Patients improved in all outcomes in both arms. We did not show a significant difference in our primary outcome measure between TAR and AF overall(p=0.23), but did show significance when fixed bearing TAR alone was compared against AF(p=0.04). Secondary outcomes did show significance. Adjacent joint arthritis increases the size of effect noted between arms. There were more wound healing issues and nerve injuries in TAR group. The symptomatic non-union rate for AF is 6.9%. TAR is likely to be cost-effective compared to AF at the NICE cost-effectiveness threshold of £20,000 per Quality Adjusted Life Year gained over the patients' lifetime.
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24
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Larivière S, Royer J, Rodríguez-Cruces R, Paquola C, Caligiuri ME, Gambardella A, Concha L, Keller SS, Cendes F, Yasuda CL, Bonilha L, Gleichgerrcht E, Focke NK, Domin M, von Podewills F, Langner S, Rummel C, Wiest R, Martin P, Kotikalapudi R, O'Brien TJ, Sinclair B, Vivash L, Desmond PM, Lui E, Vaudano AE, Meletti S, Tondelli M, Alhusaini S, Doherty CP, Cavalleri GL, Delanty N, Kälviäinen R, Jackson GD, Kowalczyk M, Mascalchi M, Semmelroch M, Thomas RH, Soltanian-Zadeh H, Davoodi-Bojd E, Zhang J, Winston GP, Griffin A, Singh A, Tiwari VK, Kreilkamp BAK, Lenge M, Guerrini R, Hamandi K, Foley S, Rüber T, Weber B, Depondt C, Absil J, Carr SJA, Abela E, Richardson MP, Devinsky O, Severino M, Striano P, Tortora D, Kaestner E, Hatton SN, Vos SB, Caciagli L, Duncan JS, Whelan CD, Thompson PM, Sisodiya SM, Bernasconi A, Labate A, McDonald CR, Bernasconi N, Bernhardt BC. Structural network alterations in focal and generalized epilepsy assessed in a worldwide ENIGMA study follow axes of epilepsy risk gene expression. Nat Commun 2022; 13:4320. [PMID: 35896547 PMCID: PMC9329287 DOI: 10.1038/s41467-022-31730-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 06/30/2022] [Indexed: 12/12/2022] Open
Abstract
Epilepsy is associated with genetic risk factors and cortico-subcortical network alterations, but associations between neurobiological mechanisms and macroscale connectomics remain unclear. This multisite ENIGMA-Epilepsy study examined whole-brain structural covariance networks in patients with epilepsy and related findings to postmortem epilepsy risk gene expression patterns. Brain network analysis included 578 adults with temporal lobe epilepsy (TLE), 288 adults with idiopathic generalized epilepsy (IGE), and 1328 healthy controls from 18 centres worldwide. Graph theoretical analysis of structural covariance networks revealed increased clustering and path length in orbitofrontal and temporal regions in TLE, suggesting a shift towards network regularization. Conversely, people with IGE showed decreased clustering and path length in fronto-temporo-parietal cortices, indicating a random network configuration. Syndrome-specific topological alterations reflected expression patterns of risk genes for hippocampal sclerosis in TLE and for generalized epilepsy in IGE. These imaging-transcriptomic signatures could potentially guide diagnosis or tailor therapeutic approaches to specific epilepsy syndromes.
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Affiliation(s)
- Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada.
| | - Jessica Royer
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Raúl Rodríguez-Cruces
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Casey Paquola
- Institute for Neuroscience and Medicine (INM-1), Forschungszentrum Jülich, Jülich, Germany
| | | | - Antonio Gambardella
- Neuroscience Research Center, University Magna Græcia, Catanzaro, CZ, Italy
- Institute of Neurology, University Magna Græcia, Catanzaro, CZ, Italy
| | - Luis Concha
- Institute of Neurobiology, Universidad Nacional Autónoma de México, Querétaro, México
| | - Simon S Keller
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Fernando Cendes
- Department of Neurology, University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
| | - Clarissa L Yasuda
- Department of Neurology, University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
| | | | | | - Niels K Focke
- Department of Neurology, University of Medicine Göttingen, Göttingen, Germany
| | - Martin Domin
- Institute of Diagnostic Radiology and Neuroradiology, Functional Imaging Unit, University Medicine Greifswald, Greifswald, Germany
| | - Felix von Podewills
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Soenke Langner
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Christian Rummel
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Raviteja Kotikalapudi
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Terence J O'Brien
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Melbourne, VIC, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Melbourne, VIC, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Melbourne, VIC, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Patricia M Desmond
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Elaine Lui
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Anna Elisabetta Vaudano
- Neurology Unit, OCB Hospital, Azienda Ospedaliera-Universitaria, Modena, Italy
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Meletti
- Neurology Unit, OCB Hospital, Azienda Ospedaliera-Universitaria, Modena, Italy
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Manuela Tondelli
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
- Primary Care Department, Azienda Sanitaria Locale di Modena, Modena, Italy
| | - Saud Alhusaini
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Colin P Doherty
- Department of Neurology, St James' Hospital, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Gianpiero L Cavalleri
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Norman Delanty
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Reetta Kälviäinen
- Epilepsy Center, Neuro Center, Kuopio University Hospital, Member of the European Reference Network for Rare and Complex Epilepsies EpiCARE, Kuopio, Finland
- Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Graeme D Jackson
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Magdalena Kowalczyk
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Mario Mascalchi
- Neuroradiology Research Program, Meyer Children Hospital of Florence, University of Florence, Florence, Italy
| | - Mira Semmelroch
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Rhys H Thomas
- Transitional and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Hamid Soltanian-Zadeh
- Contol and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
- Departments of Research Administration and Radiology, Henry Ford Health System, Detroit, MI, USA
| | | | - Junsong Zhang
- Cognitive Science Department, Xiamen University, Xiamen, China
| | - Gavin P Winston
- Division of Neurology, Department of Medicine, Queen's University, Kingston, ON, Canada
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - Aoife Griffin
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Science, Queens University Belfast, Belfast, UK
| | - Aditi Singh
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Science, Queens University Belfast, Belfast, UK
| | - Vijay K Tiwari
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Science, Queens University Belfast, Belfast, UK
| | | | - Matteo Lenge
- Child Neurology Unit and Laboratories, Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Florence, Italy
- Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Renzo Guerrini
- Child Neurology Unit and Laboratories, Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Khalid Hamandi
- The Welsh Epilepsy Unit, Department of Neurology, University Hospital of Whales, Cardiff, UK
- Cardiff University Brain Research Imaging Centre (CUBRIC), College of Biomedical Sciences, Cardiff University, Cardiff, UK
| | - Sonya Foley
- Cardiff University Brain Research Imaging Centre (CUBRIC), College of Biomedical Sciences, Cardiff University, Cardiff, UK
| | - Theodor Rüber
- Department of Epileptology, University of Bonn Medical Center, Bonn, Germany
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany
- Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University Hospital Bonn, Bonn, Germany
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Julie Absil
- Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Sarah J A Carr
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Eugenio Abela
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mark P Richardson
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Orrin Devinsky
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, US
| | | | - Pasquale Striano
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Domenico Tortora
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Erik Kaestner
- Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, US
| | - Sean N Hatton
- Department of Neurosciences, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, US
| | - Sjoerd B Vos
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
- Centre for Medical Image Computing, University College London, London, UK
| | - Lorenzo Caciagli
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - Christopher D Whelan
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, US
| | - Sanjay M Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Angelo Labate
- Neurology, BIOMORF Dipartment, University of Messina, Messina, Italy
| | - Carrie R McDonald
- Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, US
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Boris C Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada.
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25
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Stamberger H, Crosiers D, Balagura G, Bonardi CM, Basu A, Cantalupo G, Chiesa V, Christensen J, Dalla Bernardina B, Ellis CA, Furia F, Gardiner F, Giron C, Guerrini R, Klein KM, Korff C, Krijtova H, Leffler M, Lerche H, Lesca G, Lewis-Smith D, Marini C, Marjanovic D, Mazzola L, McKeown Ruggiero S, Mochel F, Ramond F, Reif PS, Richard-Mornas A, Rosenow F, Schropp C, Thomas RH, Vignoli A, Weber Y, Palmer E, Helbig I, Scheffer IE, Striano P, Møller RS, Gardella E, Weckhuysen S. Natural History Study of STXBP1-Developmental and Epileptic Encephalopathy Into Adulthood. Neurology 2022; 99:e221-e233. [PMID: 35851549 PMCID: PMC9302932 DOI: 10.1212/wnl.0000000000200715] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 03/25/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Pathogenic STXBP1 variants cause a severe early-onset developmental and epileptic encephalopathy (STXBP1-DEE). We aimed to investigate the natural history of STXBP1-DEE in adults focusing on seizure evolution, the presence of movement disorders, and the level of functional (in)dependence. METHODS In this observational study, patients with a minimum age of 18 years carrying a (likely) pathogenic STXBP1 variant were recruited through medical genetics departments and epilepsy centers. Treating clinicians completed clinical questionnaires and performed semistructured video examinations while performing tasks from the (modified) Unified Parkinson Disease Rating Scale when possible. RESULTS Thirty adult patients were included for summary statistics, with video recordings available for 19 patients. The median age at last follow-up was 24 years (range 18-58 years). All patients had epilepsy, with a median onset age of 3.5 months. At last follow-up, 80% of adults had treatment-resistant seizures despite long periods of seizure freedom in 37%. Tonic-clonic, focal, and tonic seizures were most frequent in adults. Epileptic spasms, an unusual feature beyond infancy, were present in 3 adults. All individuals had developmental impairment. Periods of regression were present in 59% and did not always correlate with flare-ups in seizure activity. Eighty-seven percent had severe or profound intellectual disability, 42% had autistic features, and 65% had significant behavioral problems. Video examinations showed gait disorders in all 12 patients able to walk, including postural abnormalities with external rotation of the feet, broad-based gait, and asymmetric posture/dystonia. Tremor, present in 56%, was predominantly of the intention/action type. Stereotypies were seen in 63%. Functional outcome concerning mobility was variable ranging from independent walking (50%) to wheelchair dependence (39%). Seventy-one percent of adults were nonverbal, and all were dependent on caregivers for most activities of daily living. DISCUSSION STXBP1-DEE warrants continuous monitoring for seizures in adult life. Periods of regression are more frequent than previously established and can occur into adulthood. Movement disorders are often present and involve multiple systems. Although functional mobility is variable in adulthood, STXBP1-DEE frequently leads to severe cognitive impairments and a high level of functional dependence. Understanding the natural history of STXBP1-DEE is important for prognostication and will inform future therapeutic trials.
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Affiliation(s)
- Hannah Stamberger
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia.
| | - David Crosiers
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Ganna Balagura
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Claudia M Bonardi
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Anna Basu
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Gaetano Cantalupo
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Valentina Chiesa
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Jakob Christensen
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Bernardo Dalla Bernardina
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Colin A Ellis
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Francesca Furia
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Fiona Gardiner
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Camille Giron
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Renzo Guerrini
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Karl Martin Klein
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Christian Korff
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Hana Krijtova
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Melanie Leffler
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Holger Lerche
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Gaetan Lesca
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - David Lewis-Smith
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Carla Marini
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Dragan Marjanovic
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Laure Mazzola
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Sarah McKeown Ruggiero
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Fanny Mochel
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Francis Ramond
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Philipp S Reif
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Aurélie Richard-Mornas
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Felix Rosenow
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Christian Schropp
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Rhys H Thomas
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Aglaia Vignoli
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Yvonne Weber
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Elizabeth Palmer
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Ingo Helbig
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Ingrid E Scheffer
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Pasquale Striano
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Rikke S Møller
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Elena Gardella
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
| | - Sarah Weckhuysen
- From the Applied and Translational Neurogenomics Group (H.S., S.W.), VIB Center for Molecular Neurology, University of Antwerp; Department of Neurology (H.S., D.C., S.W.), Antwerp University Hospital; Faculty of Medicine and Health Sciences (D.C., S.W.), Translational Neurosciences, Institute Born-Bunge (D.C.), and µNEURO Research Centre of Excellence (D.C., S.W.), University of Antwerp, Belgium; IRCCS Istituto Giannina Gaslini (G.B., P.S.), Genova; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.B., P.S.), University of Genova, Italy; Department of Epilepsy Genetics (C.M.B., F.F., R.S.M., E.G.), Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Woman's and Child's Health (C.M.B.), Padova University Hospital, Italy; Population Health Sciences Institute (A.B.), Newcastle University; Department of Paediatric Neurology (A.B.), Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neuropsychiatry Section (G.C.), Department of Surgical Sciences, Dentistry, Gynecology and Paediatrics, University of Verona; UOC Neuropsichiatria Infantile (G.C.), Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria Integrata, Verona; Center for Research on Epilepsies in Pediatric Age (CREP) (G.C., B.D.B.), Verona; Epilepsy Center (V.C.), ASST Santi Paolo Carlo, Milan, Italy; Department of Clinical Medicine (J.C.), Aarhus University; Department of Neurology (J.C.), Aarhus University Hospital, Denmark; Department of Neurology (C.A.E.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Institute for Regional Health Services Research (F.F., R.S.M., E.G.), University of Southern Denmark, Odense; University of Melbourne, Austin Health (F.G., I.E.S.), Victoria, Australia; AP-HP (C.G.), Pitié-Salpêtrière University Hospital, Department of Neurology, Paris, France; Child Neurology Unit and Laboratories (R.G.), Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy; Departments of Clinical Neurosciences (K.M.K.), Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute & Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Epilepsy Center Frankfurt Rhine-Main (K.M.K., P.S.R., F. Rosenow), Department of Neurology, Johann Wolfgang Goethe University; LOEWE Center for Personalized Translational Epilepsy Research (CePTER) (K.M.K., P.S.R., F. Rosenow), Goethe University Frankfurt, Frankfurt am Main, Germany; Pediatric Neurology Unit (C.K.), University Hospitals, Geneva, Switzerland; Department of Neurology (H.K.), Second Faculty of Medicine, Charles University and Motol University Hospital Prague, Czech Republic; The GOLD Service (M.L.), Waratah, New South Wales, Australia; Department of Neurology and Epileptology & Hertie Institute for Clinical Brain Research (H.L., Y.W.), University of Tubingen, Germany; Department of Medical Genetics (G.L.), Lyon University Hospital, Université de Lyon, INMG, France; Translational and Clinical Research Institute (D.L.-S., R.H.T.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T.), Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; Child Neurology and Psychiatric Unit (C.M.), G. Salesi Pediatric Hospital, United Hospitals of Ancona, Italy; Department of Adults with Handicap (D.M.), Danish Epilepsy Centre, Dianalund, Denmark; Department of Neurology (L.M.), University Hospital of St-Etienne; Team "Central Integration of Pain" (L.M.), Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR 5292, France; The Epilepsy NeuroGenetics Initiative (ENGIN) (S.M.R.), Children's Hospital of Philadelphia, PA; AP-HP (F.M.), Pitié-Salpêtrière University Hospital, Department of Genetics, Reference Centers for Adult Neurometabolic Diseases and Adult Leukodystrophies; INSERM U 1127 (F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris Brain Institute, ICM; Service de Génétique (F. Ramond), Centre Hospitalier Universitaire de Saint-Etienne, France; Department of Neurology (P.S.R.), Ortenau Klinikum Offenburg Kehl, Germany; Unit of Neurophysiology and Epileptology (A.R.-M.), Hospices Civils of Lyon, France; Kinderklinik Dritter Orden (C.S.), Passau, Germany; Child Neuropsychiatry Unit (A.V.), Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo Hospital, Università Degli Studi di Milano, Italy; Department of Epileptology and Neurology (Y.W.), University of Aachen, Germany; School of Women and Children's Health (E.P.), Faculty of Medicine, UNSW; Sydney Children's Hospital Network (E.P.), Randwick, Australia; Division of Neurology (I.H.), Children's Hospital of Philadelphia, PA; and Department of Paediatrics (I.E.S.), University of Melbourne, Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
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Horsley JJ, Schroeder GM, Thomas RH, de Tisi J, Vos SB, Winston GP, Duncan JS, Wang Y, Taylor PN. Volumetric and structural connectivity abnormalities co-localise in TLE. Neuroimage Clin 2022; 35:103105. [PMID: 35863179 PMCID: PMC9421455 DOI: 10.1016/j.nicl.2022.103105] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 05/17/2022] [Accepted: 06/29/2022] [Indexed: 12/02/2022]
Abstract
Patients with temporal lobe epilepsy (TLE) exhibit both volumetric and structural connectivity abnormalities relative to healthy controls. How these abnormalities inter-relate and their mechanisms are unclear. We computed grey matter volumetric changes and white matter structural connectivity abnormalities in 144 patients with unilateral TLE and 96 healthy controls. Regional volumes were calculated using T1-weighted MRI, while structural connectivity was derived using white matter fibre tractography from diffusion-weighted MRI. For each regional volume and each connection strength, we calculated the effect size between patient and control groups in a group-level analysis. We then applied hierarchical regression to investigate the relationship between volumetric and structural connectivity abnormalities in individuals. Additionally, we quantified whether abnormalities co-localised within individual patients by computing Dice similarity scores. In TLE, white matter connectivity abnormalities were greater when joining two grey matter regions with abnormal volumes. Similarly, grey matter volumetric abnormalities were greater when joined by abnormal white matter connections. The extent of volumetric and connectivity abnormalities related to epilepsy duration, but co-localisation did not. Co-localisation was primarily driven by neighbouring abnormalities in the ipsilateral hemisphere. Overall, volumetric and structural connectivity abnormalities were related in TLE. Our results suggest that shared mechanisms may underlie changes in both volume and connectivity alterations in patients with TLE.
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Affiliation(s)
- Jonathan J Horsley
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Gabrielle M Schroeder
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Rhys H Thomas
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Jane de Tisi
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Sjoerd B Vos
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Centre for Microscopy, Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia; Centre for Medical Image Computing, Computer Science Department, University College London, London, United Kingdom
| | - Gavin P Winston
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Division of Neurology, Department of Medicine, Queen's University, Kingston, Canada
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Yujiang Wang
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom; Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Peter N Taylor
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom; Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
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Thomas RH, Hunter A, Butterworth L, Feeney C, Graves TD, Holmes S, Hossain P, Lowndes J, Sharpe J, Upadhyaya S, Varhaug KN, Votruba M, Wheeler R, Staley K, Rahman S. Research priorities for mitochondrial disorders: Current landscape and patient and professional views. J Inherit Metab Dis 2022; 45:796-803. [PMID: 35543492 PMCID: PMC9429991 DOI: 10.1002/jimd.12521] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/16/2022] [Accepted: 04/27/2022] [Indexed: 11/15/2022]
Abstract
Primary mitochondrial disorders encompass a wide range of clinical presentations and a spectrum of severity. They currently lack effective disease-modifying therapies and have a high mortality and morbidity rate. It is therefore essential to know that competitively funded research designed by academics meets the core needs of people with mitochondrial disorders and their clinicians. Priority setting partnerships are an established collaborative methodology that brings patients, carers and families, charity representatives and clinicians together to try to establish the most pressing and unanswered research priorities for a particular disease. We developed a web-based questionnaire, requesting all patients affected by primary mitochondrial disease, their carers and clinicians to pose their research questions. This yielded 709 questions from 147 participants. These were grouped into overarching themes including basic biology, causation, health services, clinical management, social impacts, prognosis, prevention, symptoms, treatment and psychological impact. Following the removal of "answered questions", the process resulted in a list of 42 discrete, answerable questions. This was further refined by web-based ranking by the community to 24 questions. These were debated at a face-to-face workshop attended by a diverse range of patients, carers, charity representatives and clinicians to create a definitive "Top 10 of unanswered research questions for primary mitochondrial disorders". These Top 10 questions related to understanding biological processes, including triggers of disease onset, mechanisms underlying progression and reasons for differential symptoms between individuals with identical genetic mutations; new treatments; biomarker discovery; psychological support and optimal management of stroke-like episodes and fatigue.
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Affiliation(s)
- Rhys H. Thomas
- Translational and Clinical Research InstituteNewcastle UniversityNewcastleUK
| | | | | | - Catherine Feeney
- NHS Highly Specialised Service for Rare Mitochondrial Diseases, Newcastle Hospitals NHS Foundation TrustNewcastleUK
| | - Tracey D. Graves
- Hinchingbrooke HospitalHuntingdonUK
- The National Hospital for Neurology and NeurosurgeryLondonUK
| | - Sarah Holmes
- The National Hospital for Neurology and NeurosurgeryLondonUK
| | | | - Jo Lowndes
- Oxford University Hospitals NHS Foundation TrustOxfordUK
| | - Jenny Sharpe
- Centre for Innovation in Regulatory ScienceLondonUK
| | | | - Kristin N. Varhaug
- Translational and Clinical Research InstituteNewcastle UniversityNewcastleUK
| | - Marcela Votruba
- University Hospital Wales and School of Vision SciencesCardiff UniversityCardiffUK
| | | | | | - Shamima Rahman
- Mitochondrial Research Group, UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital for Children NHS Foundation TrustLondonUK
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Panagiotopoulou M, Papasavvas CA, Schroeder GM, Thomas RH, Taylor PN, Wang Y. Fluctuations in EEG band power at subject-specific timescales over minutes to days explain changes in seizure evolutions. Hum Brain Mapp 2022; 43:2460-2477. [PMID: 35119173 PMCID: PMC9057101 DOI: 10.1002/hbm.25796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 12/30/2021] [Accepted: 01/23/2022] [Indexed: 01/14/2023] Open
Abstract
Epilepsy is recognised as a dynamic disease, where both seizure susceptibility and seizure characteristics themselves change over time. Specifically, we recently quantified the variable electrographic spatio-temporal seizure evolutions that exist within individual patients. This variability appears to follow subject-specific circadian, or longer, timescale modulations. It is therefore important to know whether continuously recorded interictaliEEG features can capture signatures of these modulations over different timescales. In this study, we analyse continuous intracranial electroencephalographic (iEEG) recordings from video-telemetry units and find fluctuations in iEEG band power over timescales ranging from minutes up to 12 days. As expected and in agreement with previous studies, we find that all subjects show a circadian fluctuation in their iEEG band power. We additionally detect other fluctuations of similar magnitude on subject-specific timescales. Importantly, we find that a combination of these fluctuations on different timescales can explain changes in seizure evolutions in most subjects above chance level. These results suggest that subject-specific fluctuations in iEEG band power over timescales of minutes to days may serve as markers of seizure modulating processes. We hope that future study can link these detected fluctuations to their biological driver(s). There is a critical need to better understand seizure modulating processes, as this will enable the development of novel treatment strategies that could minimise the seizure spread, duration or severity and therefore the clinical impact of seizures.
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Affiliation(s)
- Mariella Panagiotopoulou
- CNNP Lab, Interdisciplinary Computing and Complex BioSystems GroupSchool of Computing, Newcastle UniversityNewcastle upon Tyne
| | - Christoforos A. Papasavvas
- CNNP Lab, Interdisciplinary Computing and Complex BioSystems GroupSchool of Computing, Newcastle UniversityNewcastle upon Tyne
| | - Gabrielle M. Schroeder
- CNNP Lab, Interdisciplinary Computing and Complex BioSystems GroupSchool of Computing, Newcastle UniversityNewcastle upon Tyne
| | - Rhys H. Thomas
- Faculty of Medical SciencesNewcastle UniversityNewcastle upon Tyne
| | - Peter N. Taylor
- CNNP Lab, Interdisciplinary Computing and Complex BioSystems GroupSchool of Computing, Newcastle UniversityNewcastle upon Tyne
- Faculty of Medical SciencesNewcastle UniversityNewcastle upon Tyne
- UCL Queen Square Institute of Neurology, Queen SquareLondon
| | - Yujiang Wang
- CNNP Lab, Interdisciplinary Computing and Complex BioSystems GroupSchool of Computing, Newcastle UniversityNewcastle upon Tyne
- Faculty of Medical SciencesNewcastle UniversityNewcastle upon Tyne
- UCL Queen Square Institute of Neurology, Queen SquareLondon
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Lewis-Smith D, Galer PD, Ganesan S, Ellis CA, Thomas RH, Helbig I. 140 How can we maximise discovery potential from sparse clinical information? J Neurol Neurosurg Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Collaborative studies exploit large data sets to discover new associations with diseases. However, analyses of clinical features struggle with big data. Beyond sheer volume, the challenge is in harmonisation of terminology and the level of detail of information provided for analysis by different sources; in epilepsy this is most pertinent to seizures.We applied two ontologies (representations of the relationship between different types of seizure) to the same sparse details from 82 individuals. We compared the amount of information imputed using the Human Phenotype Ontology (HPO, a reference of clinical phenotypes widely used by geneticists) and an ontology of seizures created by the Epilepsiome Task Force of the International League Against Epilepsy Genetics Commission (based upon ILAE classifications).We translated each individual’s seizure descriptions into 2 terms (median) from each ontology. Imputa- tion generated 2 additional terms per individual using the HPO and 4 using the Epilepsiome ontology. The Epilepsiome ontology was able to increase the amount of information available for analysis by two- thirds compared to the HPO.Well-designed ontologies can be used to impute descriptions of complex clinical features at multiple less specific levels of precision, addressing a major limiting step in harmonisation of data for collabora- tion or re-use.rhys.thomas@ncl.ac.uk
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Park BY, Larivière S, Rodríguez-Cruces R, Royer J, Tavakol S, Wang Y, Caciagli L, Caligiuri ME, Gambardella A, Concha L, Keller SS, Cendes F, Alvim MKM, Yasuda C, Bonilha L, Gleichgerrcht E, Focke NK, Kreilkamp BAK, Domin M, von Podewils F, Langner S, Rummel C, Rebsamen M, Wiest R, Martin P, Kotikalapudi R, Bender B, O’Brien TJ, Law M, Sinclair B, Vivash L, Kwan P, Desmond PM, Malpas CB, Lui E, Alhusaini S, Doherty CP, Cavalleri GL, Delanty N, Kälviäinen R, Jackson GD, Kowalczyk M, Mascalchi M, Semmelroch M, Thomas RH, Soltanian-Zadeh H, Davoodi-Bojd E, Zhang J, Lenge M, Guerrini R, Bartolini E, Hamandi K, Foley S, Weber B, Depondt C, Absil J, Carr SJA, Abela E, Richardson MP, Devinsky O, Severino M, Striano P, Parodi C, Tortora D, Hatton SN, Vos SB, Duncan JS, Galovic M, Whelan CD, Bargalló N, Pariente J, Conde-Blanco E, Vaudano AE, Tondelli M, Meletti S, Kong X, Francks C, Fisher SE, Caldairou B, Ryten M, Labate A, Sisodiya SM, Thompson PM, McDonald CR, Bernasconi A, Bernasconi N, Bernhardt BC. Topographic divergence of atypical cortical asymmetry and atrophy patterns in temporal lobe epilepsy. Brain 2022; 145:1285-1298. [PMID: 35333312 PMCID: PMC9128824 DOI: 10.1093/brain/awab417] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/15/2021] [Accepted: 08/14/2021] [Indexed: 12/20/2022] Open
Abstract
Temporal lobe epilepsy, a common drug-resistant epilepsy in adults, is primarily a limbic network disorder associated with predominant unilateral hippocampal pathology. Structural MRI has provided an in vivo window into whole-brain grey matter structural alterations in temporal lobe epilepsy relative to controls, by either mapping (i) atypical inter-hemispheric asymmetry; or (ii) regional atrophy. However, similarities and differences of both atypical asymmetry and regional atrophy measures have not been systematically investigated. Here, we addressed this gap using the multisite ENIGMA-Epilepsy dataset comprising MRI brain morphological measures in 732 temporal lobe epilepsy patients and 1418 healthy controls. We compared spatial distributions of grey matter asymmetry and atrophy in temporal lobe epilepsy, contextualized their topographies relative to spatial gradients in cortical microstructure and functional connectivity calculated using 207 healthy controls obtained from Human Connectome Project and an independent dataset containing 23 temporal lobe epilepsy patients and 53 healthy controls and examined clinical associations using machine learning. We identified a marked divergence in the spatial distribution of atypical inter-hemispheric asymmetry and regional atrophy mapping. The former revealed a temporo-limbic disease signature while the latter showed diffuse and bilateral patterns. Our findings were robust across individual sites and patients. Cortical atrophy was significantly correlated with disease duration and age at seizure onset, while degrees of asymmetry did not show a significant relationship to these clinical variables. Our findings highlight that the mapping of atypical inter-hemispheric asymmetry and regional atrophy tap into two complementary aspects of temporal lobe epilepsy-related pathology, with the former revealing primary substrates in ipsilateral limbic circuits and the latter capturing bilateral disease effects. These findings refine our notion of the neuropathology of temporal lobe epilepsy and may inform future discovery and validation of complementary MRI biomarkers in temporal lobe epilepsy.
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Affiliation(s)
- Bo-yong Park
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
- Department of Data Science, Inha University, Incheon, Republic of Korea
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Republic of Korea
| | - Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Raul Rodríguez-Cruces
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Jessica Royer
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Shahin Tavakol
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Yezhou Wang
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Lorenzo Caciagli
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Antonio Gambardella
- Neuroscience Research Center, University Magna Græcia, Catanzaro, CZ, Italy
- Institute of Neurology, University Magna Græcia, Catanzaro, CZ, Italy
| | - Luis Concha
- Institute of Neurobiology, Universidad Nacional Autónoma de México, Querétaro, México
| | - Simon S Keller
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Fernando Cendes
- Department of Neurology, University of Campinas–UNICAMP, Campinas, São Paulo, Brazil
| | - Marina K M Alvim
- Department of Neurology, University of Campinas–UNICAMP, Campinas, São Paulo, Brazil
| | - Clarissa Yasuda
- Department of Neurology, University of Campinas–UNICAMP, Campinas, São Paulo, Brazil
| | | | | | - Niels K Focke
- Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | | | - Martin Domin
- Institute of Diagnostic Radiology and Neuroradiology, Functional Imaging Unit, University Medicine Greifswald, Greifswald, Germany
| | - Felix von Podewils
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Soenke Langner
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Christian Rummel
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Michael Rebsamen
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Raviteja Kotikalapudi
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Department of Radiology, Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Benjamin Bender
- Department of Radiology, Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Terence J O’Brien
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Meng Law
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Patrick Kwan
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Patricia M Desmond
- Department of Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Charles B Malpas
- Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Elaine Lui
- Department of Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Saud Alhusaini
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Colin P Doherty
- Department of Neurology, St James’ Hospital, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Gianpiero L Cavalleri
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Norman Delanty
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Reetta Kälviäinen
- Epilepsy Center, Neuro Center, Kuopio University Hospital, Member of the European Reference Network for Rare and Complex Epilepsies EpiCARE, Kuopio, Finland
- Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Graeme D Jackson
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Magdalena Kowalczyk
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Mario Mascalchi
- Neuroradiology Research Program, Meyer Children Hospital of Florence, University of Florence, Florence, Italy
| | - Mira Semmelroch
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Rhys H Thomas
- Transitional and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Hamid Soltanian-Zadeh
- Control and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
- Departments of Research Administration and Radiology, Henry Ford Health System, Detroit, MI, USA
| | | | - Junsong Zhang
- Department of Artificial Intelligence, Xiamen University, Xiamen, China
| | - Matteo Lenge
- Child Neurology Unit and Laboratories, Neuroscience Department, Children’s Hospital A. Meyer-University of Florence, Florence, Italy
- Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, Children’s Hospital A. Meyer-University of Florence, Florence, Italy
| | - Renzo Guerrini
- Child Neurology Unit and Laboratories, Neuroscience Department, Children’s Hospital A. Meyer-University of Florence, Florence, Italy
| | - Emanuele Bartolini
- USL Centro Toscana, Neurology Unit, Nuovo Ospedale Santo Stefano, Prato, Italy
| | - Khalid Hamandi
- Cardiff University Brain Research Imaging Centre (CUBRIC), College of Biomedical Sciences, Cardiff University, Cardiff, UK
- The Welsh Epilepsy Unit, Department of Neurology, University Hospital of Wales, Cardiff, UK
| | - Sonya Foley
- Cardiff University Brain Research Imaging Centre (CUBRIC), College of Biomedical Sciences, Cardiff University, Cardiff, UK
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University Hospital Bonn, Bonn, Germany
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Julie Absil
- Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Sarah J A Carr
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Eugenio Abela
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Mark P Richardson
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Orrin Devinsky
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
| | - Mariasavina Severino
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Pasquale Striano
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Costanza Parodi
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Domenico Tortora
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Sean N Hatton
- Department of Neurosciences, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, USA
| | - Sjoerd B Vos
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK
- Centre for Medical Image Computing, University College London, London, UK
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK
| | - Marian Galovic
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK
- Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Christopher D Whelan
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Núria Bargalló
- Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Radiology CDIC, Hospital Clinic Barcelona, Barcelona, Spain
| | - Jose Pariente
- Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Anna Elisabetta Vaudano
- Neurology Unit, Azienda Ospedaliero-Universitaria of Modena, OCB Hospital, Modena, Italy
- Department of Biomedical, Metabolic, and Neural Sciences, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Manuela Tondelli
- Neurology Unit, Azienda Ospedaliero-Universitaria of Modena, OCB Hospital, Modena, Italy
- Department of Biomedical, Metabolic, and Neural Sciences, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Meletti
- Neurology Unit, Azienda Ospedaliero-Universitaria of Modena, OCB Hospital, Modena, Italy
- Department of Biomedical, Metabolic, and Neural Sciences, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Xiang‐Zhen Kong
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Clyde Francks
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Simon E Fisher
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Benoit Caldairou
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Mina Ryten
- Department of Neurodegenerative Disease, Queen Square Institute of Neurology, University College London, London, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, University College London, London, UK
- Department of Genetics and Genomic Medicine, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Angelo Labate
- Neurology, BIOMORF Department, University of Messina, Messina, Italy
| | - Sanjay M Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging and Informatics, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Carrie R McDonald
- Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, USA
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Boris C Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
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31
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Willison AG, Thomas RH. The neurodevelopmental spectrum seen with
CHD2
variants. Pediatr Investig 2022; 6:147-148. [PMID: 35774518 PMCID: PMC9218968 DOI: 10.1002/ped4.12323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 12/02/2022] Open
Affiliation(s)
- Alice G Willison
- Faculty of Medical Sciences Translational and Clinical Research Institute Newcastle University Newcastle UK
- Royal Victoria Infirmary Newcastle Upon Tyne NHS Foundation Trust Newcastle UK
| | - Rhys H Thomas
- Faculty of Medical Sciences Translational and Clinical Research Institute Newcastle University Newcastle UK
- Royal Victoria Infirmary Newcastle Upon Tyne NHS Foundation Trust Newcastle UK
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32
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Ng YS, Lax NZ, Blain AP, Erskine D, Baker MR, Polvikoski T, Thomas RH, Morris CM, Lai M, Whittaker RG, Gebbels A, Winder A, Hall J, Feeney C, Farrugia ME, Hirst C, Roberts M, Lawthom C, Chrysostomou A, Murphy K, Baird T, Maddison P, Duncan C, Poulton J, Nesbitt V, Hanna MG, Pitceathly RDS, Taylor RW, Blakely EL, Schaefer AM, Turnbull DM, McFarland R, Gorman GS. Forecasting stroke-like episodes and outcomes in mitochondrial disease. Brain 2022; 145:542-554. [PMID: 34927673 PMCID: PMC9014738 DOI: 10.1093/brain/awab353] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/16/2021] [Accepted: 08/06/2021] [Indexed: 12/03/2022] Open
Abstract
In this retrospective, multicentre, observational cohort study, we sought to determine the clinical, radiological, EEG, genetics and neuropathological characteristics of mitochondrial stroke-like episodes and to identify associated risk predictors. Between January 1998 and June 2018, we identified 111 patients with genetically determined mitochondrial disease who developed stroke-like episodes. Post-mortem cases of mitochondrial disease (n = 26) were identified from Newcastle Brain Tissue Resource. The primary outcome was to interrogate the clinico-radiopathological correlates and prognostic indicators of stroke-like episode in patients with mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes syndrome (MELAS). The secondary objective was to develop a multivariable prediction model to forecast stroke-like episode risk. The most common genetic cause of stroke-like episodes was the m.3243A>G variant in MT-TL1 (n = 66), followed by recessive pathogenic POLG variants (n = 22), and 11 other rarer pathogenic mitochondrial DNA variants (n = 23). The age of first stroke-like episode was available for 105 patients [mean (SD) age: 31.8 (16.1)]; a total of 35 patients (32%) presented with their first stroke-like episode ≥40 years of age. The median interval (interquartile range) between first and second stroke-like episodes was 1.33 (2.86) years; 43% of patients developed recurrent stroke-like episodes within 12 months. Clinico-radiological, electrophysiological and neuropathological findings of stroke-like episodes were consistent with the hallmarks of medically refractory epilepsy. Patients with POLG-related stroke-like episodes demonstrated more fulminant disease trajectories than cases of m.3243A>G and other mitochondrial DNA pathogenic variants, in terms of the frequency of refractory status epilepticus, rapidity of progression and overall mortality. In multivariate analysis, baseline factors of body mass index, age-adjusted blood m.3243A>G heteroplasmy, sensorineural hearing loss and serum lactate were significantly associated with risk of stroke-like episodes in patients with the m.3243A>G variant. These factors informed the development of a prediction model to assess the risk of developing stroke-like episodes that demonstrated good overall discrimination (area under the curve = 0.87, 95% CI 0.82-0.93; c-statistic = 0.89). Significant radiological and pathological features of neurodegeneration were more evident in patients harbouring pathogenic mtDNA variants compared with POLG: brain atrophy on cranial MRI (90% versus 44%, P < 0.001) and reduced mean brain weight (SD) [1044 g (148) versus 1304 g (142), P = 0.005]. Our findings highlight the often idiosyncratic clinical, radiological and EEG characteristics of mitochondrial stroke-like episodes. Early recognition of seizures and aggressive instigation of treatment may help circumvent or slow neuronal loss and abate increasing disease burden. The risk-prediction model for the m.3243A>G variant can help inform more tailored genetic counselling and prognostication in routine clinical practice.
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Affiliation(s)
- Yi Shiau Ng
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute; NIHR Newcastle Biomedical Research Centre and Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
- Directorate of Neurosciences, Royal Victoria Infirmary, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK
- Department of Neurosciences, NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne NE2 4HH, UK
| | - Nichola Z Lax
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute; NIHR Newcastle Biomedical Research Centre and Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Alasdair P Blain
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute; NIHR Newcastle Biomedical Research Centre and Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Daniel Erskine
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute; NIHR Newcastle Biomedical Research Centre and Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Mark R Baker
- Directorate of Neurosciences, Royal Victoria Infirmary, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK
- Campus for Ageing and Vitality, Newcastle Brain Tissue Resource, Newcastle University, Edwardson Building, Newcastle upon Tyne NE4 5PL, UK
| | - Tuomo Polvikoski
- Campus for Ageing and Vitality, Newcastle Brain Tissue Resource, Newcastle University, Edwardson Building, Newcastle upon Tyne NE4 5PL, UK
| | - Rhys H Thomas
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute; NIHR Newcastle Biomedical Research Centre and Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
- Directorate of Neurosciences, Royal Victoria Infirmary, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK
- Department of Neurosciences, NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne NE2 4HH, UK
| | - Christopher M Morris
- Campus for Ageing and Vitality, Newcastle Brain Tissue Resource, Newcastle University, Edwardson Building, Newcastle upon Tyne NE4 5PL, UK
| | - Ming Lai
- Directorate of Neurosciences, Royal Victoria Infirmary, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK
| | - Roger G Whittaker
- Directorate of Neurosciences, Royal Victoria Infirmary, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Alasdair Gebbels
- Directorate of Neurosciences, Royal Victoria Infirmary, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK
| | - Amy Winder
- Directorate of Neurosciences, Royal Victoria Infirmary, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK
| | - Julie Hall
- Directorate of Neurosciences, Royal Victoria Infirmary, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK
| | - Catherine Feeney
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute; NIHR Newcastle Biomedical Research Centre and Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
- Directorate of Neurosciences, Royal Victoria Infirmary, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK
- Department of Neurosciences, NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne NE2 4HH, UK
| | - Maria Elena Farrugia
- Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK
| | - Claire Hirst
- Trust Headquarters, One Talbot Gateway, Baglan Energy Park, Baglan, Port Talbot SA12 7BR, UK
| | - Mark Roberts
- Greater Manchester Neuroscience Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Salford M6 8HD, UK
| | - Charlotte Lawthom
- Aneurin Bevan Epilepsy Specialist Team, Aneurin Bevan University Health Board, Newport, NP20 2UB, UK
| | - Alexia Chrysostomou
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute; NIHR Newcastle Biomedical Research Centre and Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Kevin Murphy
- Department of Neurology, Sligo University Hospital, Sligo F91 H684, Ireland
| | - Tracey Baird
- Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK
| | - Paul Maddison
- Department of Neurology, Queen’s Medical Centre, Nottingham NG7 2UH, UK
| | - Callum Duncan
- Department of Neurology, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen AB25 2ZN, UK
| | - Joanna Poulton
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford OX3 9DU, UK
| | - Victoria Nesbitt
- Department of Paediatrics, Medical Sciences Division, Oxford University, Oxford OX3 9DU, UK
- Department of Paediatrics, The Children's Hospital, Oxford, OX3 9DU, UK
| | - Michael G Hanna
- Department of Neuromuscular Diseases, University College London Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK
| | - Robert D S Pitceathly
- Department of Neuromuscular Diseases, University College London Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK
| | - Robert W Taylor
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute; NIHR Newcastle Biomedical Research Centre and Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
- Department of Neurosciences, NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne NE2 4HH, UK
| | - Emma L Blakely
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute; NIHR Newcastle Biomedical Research Centre and Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
- Department of Neurosciences, NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne NE2 4HH, UK
| | - Andrew M Schaefer
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute; NIHR Newcastle Biomedical Research Centre and Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
- Directorate of Neurosciences, Royal Victoria Infirmary, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK
- Department of Neurosciences, NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne NE2 4HH, UK
| | - Doug M Turnbull
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute; NIHR Newcastle Biomedical Research Centre and Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
- Department of Neurosciences, NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne NE2 4HH, UK
| | - Robert McFarland
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute; NIHR Newcastle Biomedical Research Centre and Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
- Department of Neurosciences, NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne NE2 4HH, UK
| | - Gráinne S Gorman
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute; NIHR Newcastle Biomedical Research Centre and Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
- Directorate of Neurosciences, Royal Victoria Infirmary, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK
- Department of Neurosciences, NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne NE2 4HH, UK
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33
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Pizzamiglio C, Machado PM, Thomas RH, Gorman GS, McFarland R, Hanna MG, Pitceathly RDS. COVID-19-Related Outcomes in Primary Mitochondrial Diseases: An International Study. Neurology 2022; 98:576-582. [PMID: 35190464 PMCID: PMC8992603 DOI: 10.1212/wnl.0000000000200240] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/03/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To identify factors associated with severe coronavirus disease 2019 (COVID-19), defined by hospitalization status, in patients with primary mitochondrial diseases (PMDs), thereby enabling future risk stratification and informed management decisions. METHODS We undertook a cross-sectional, international, registry-based study. Data were extracted from the International Neuromuscular COVID-19 Database and collected between May 1, 2020, and May 31, 2021. The database included subjects with (1) PMD diagnosis (any age), clinically/histopathologically suspected and/or genetically confirmed; and (2) COVID-19 diagnosis classified as "confirmed", "probable", or "suspected" based on World Health Organization definitions. The primary outcome was hospitalization because of COVID-19. We collected demographic information, smoking status, coexisting comorbidities, outcomes after COVID-19 infection, and PMD genotype-phenotype. Baseline status was assessed using the modified Rankin scale (mRS) and the Newcastle Mitochondrial Disease Adult Scale (NMDAS). RESULTS Seventy-nine subjects with PMDs from 10 countries were included (mean age 41.5 ± 18 years): 25 (32%) were hospitalized, 48 (61%) recovered fully, 28 (35%) improved with sequelae, and 3 (4%) died. Statistically significant differences in hospitalization status were observed in baseline status, including the NMDAS score (p = 0.003) and mRS (p = 0.001), presence of respiratory dysfunction (p < 0.001), neurologic involvement (p = 0.003), and more than 4 comorbidities (p = 0.002). In multivariable analysis, respiratory dysfunction was independently associated with COVID-19 hospitalization (odds ratio, 7.66; 95% CI, 2-28; p = 0.002). DISCUSSION Respiratory dysfunction is an independent risk factor for severe COVID-19 in PMDs while high disease burden and coexisting comorbidities contribute toward COVID-19-related hospitalization. These findings will enable risk stratification and informed management decisions for this vulnerable population.
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Affiliation(s)
- Chiara Pizzamiglio
- From the Department of Neuromuscular Diseases (C.P., P.M.M., M.G.H., R.D.S.P.), UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London; and Wellcome Centre for Mitochondrial Research (R.H.T., G.S.G., R.M.), Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Pedro M Machado
- From the Department of Neuromuscular Diseases (C.P., P.M.M., M.G.H., R.D.S.P.), UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London; and Wellcome Centre for Mitochondrial Research (R.H.T., G.S.G., R.M.), Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Rhys H Thomas
- From the Department of Neuromuscular Diseases (C.P., P.M.M., M.G.H., R.D.S.P.), UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London; and Wellcome Centre for Mitochondrial Research (R.H.T., G.S.G., R.M.), Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Gráinne S Gorman
- From the Department of Neuromuscular Diseases (C.P., P.M.M., M.G.H., R.D.S.P.), UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London; and Wellcome Centre for Mitochondrial Research (R.H.T., G.S.G., R.M.), Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Robert McFarland
- From the Department of Neuromuscular Diseases (C.P., P.M.M., M.G.H., R.D.S.P.), UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London; and Wellcome Centre for Mitochondrial Research (R.H.T., G.S.G., R.M.), Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Michael G Hanna
- From the Department of Neuromuscular Diseases (C.P., P.M.M., M.G.H., R.D.S.P.), UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London; and Wellcome Centre for Mitochondrial Research (R.H.T., G.S.G., R.M.), Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Robert D S Pitceathly
- From the Department of Neuromuscular Diseases (C.P., P.M.M., M.G.H., R.D.S.P.), UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London; and Wellcome Centre for Mitochondrial Research (R.H.T., G.S.G., R.M.), Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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34
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Shakeshaft A, Panjwani N, Collingwood A, Crudgington H, Hall A, Andrade DM, Beier CP, Fong CY, Gardella E, Gesche J, Greenberg DA, Hamandi K, Koht J, Lim KS, Møller RS, Ng CC, Orsini A, Rees MI, Rubboli G, Selmer KK, Striano P, Syvertsen M, Thomas RH, Zarubova J, Richardson MP, Strug LJ, Pal DK. Sex-specific disease modifiers in juvenile myoclonic epilepsy. Sci Rep 2022; 12:2785. [PMID: 35190554 PMCID: PMC8861057 DOI: 10.1038/s41598-022-06324-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/25/2021] [Indexed: 11/22/2022] Open
Abstract
Juvenile myoclonic epilepsy (JME) is a common idiopathic generalised epilepsy with variable seizure prognosis and sex differences in disease presentation. Here, we investigate the combined epidemiology of sex, seizure types and precipitants, and their influence on prognosis in JME, through cross-sectional data collected by The Biology of Juvenile Myoclonic Epilepsy (BIOJUME) consortium. 765 individuals met strict inclusion criteria for JME (female:male, 1.8:1). 59% of females and 50% of males reported triggered seizures, and in females only, this was associated with experiencing absence seizures (OR = 2.0, p < 0.001). Absence seizures significantly predicted drug resistance in both males (OR = 3.0, p = 0.001) and females (OR = 3.0, p < 0.001) in univariate analysis. In multivariable analysis in females, catamenial seizures (OR = 14.7, p = 0.001), absence seizures (OR = 6.0, p < 0.001) and stress-precipitated seizures (OR = 5.3, p = 0.02) were associated with drug resistance, while a photoparoxysmal response predicted seizure freedom (OR = 0.47, p = 0.03). Females with both absence seizures and stress-related precipitants constitute the prognostic subgroup in JME with the highest prevalence of drug resistance (49%) compared to females with neither (15%) and males (29%), highlighting the unmet need for effective, targeted interventions for this subgroup. We propose a new prognostic stratification for JME and suggest a role for circuit-based risk of seizure control as an avenue for further investigation.
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Affiliation(s)
- Amy Shakeshaft
- Department of Basic and Clinical Neurosciences, Maurice Wohl Clinical Neurosciences Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Road, London, SE5 9RX, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Naim Panjwani
- Program in Genetics and Genome Biology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada
| | - Amber Collingwood
- Department of Basic and Clinical Neurosciences, Maurice Wohl Clinical Neurosciences Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Road, London, SE5 9RX, UK
| | - Holly Crudgington
- Department of Basic and Clinical Neurosciences, Maurice Wohl Clinical Neurosciences Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Road, London, SE5 9RX, UK
| | - Anna Hall
- Department of Basic and Clinical Neurosciences, Maurice Wohl Clinical Neurosciences Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Road, London, SE5 9RX, UK
| | - Danielle M Andrade
- Adult Epilepsy Genetics Program, Krembil Research Institute, University of Toronto, Toronto, Canada
| | | | - Choong Yi Fong
- Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | | | | | - Jeanette Koht
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Kheng Seang Lim
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rikke S Møller
- Danish Epilepsy Centre, Dianalund, Denmark
- Department of Regional Health Services, University of Southern Denmark, Odense, Denmark
| | - Ching Ching Ng
- Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Alessandro Orsini
- Department of Clinical and Experimental Medicine, Pisa University Hospital, Pisa, Italy
| | - Mark I Rees
- Neurology Research Group, Swansea University Medical School, Swansea, UK
| | - Guido Rubboli
- Danish Epilepsy Centre, Dianalund, Denmark
- University of Copenhagen, Copenhagen, Denmark
| | - Kaja K Selmer
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
- National Centre for Epilepsy, Oslo University Hospital, Oslo, Norway
| | - Pasquale Striano
- IRCCS Istituto 'G. Gaslini', Genoa, Italy
- University of Genova, Genoa, Italy
| | - Marte Syvertsen
- Department of Neurology, Drammen Hospital, Vestre Viken Health Trust, Oslo, Norway
| | - Rhys H Thomas
- Newcastle Upon Tyne NHS Foundation Trust, Newcastle, UK
- Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, Newcastle, UK
| | - Jana Zarubova
- Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Mark P Richardson
- Department of Basic and Clinical Neurosciences, Maurice Wohl Clinical Neurosciences Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Road, London, SE5 9RX, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
- King's College Hospital, London, UK
| | - Lisa J Strug
- Program in Genetics and Genome Biology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada.
- Departments of Statistical Sciences and Computer Science and Division of Biostatistics, The University of Toronto, Toronto, Canada.
| | - Deb K Pal
- Department of Basic and Clinical Neurosciences, Maurice Wohl Clinical Neurosciences Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Road, London, SE5 9RX, UK.
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK.
- King's College Hospital, London, UK.
- Evelina London Children's Hospital, London, UK.
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35
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Altmann A, Ryten M, Di Nunzio M, Ravizza T, Tolomeo D, Reynolds RH, Somani A, Bacigaluppi M, Iori V, Micotti E, Di Sapia R, Cerovic M, Palma E, Ruffolo G, Botía JA, Absil J, Alhusaini S, Alvim MKM, Auvinen P, Bargallo N, Bartolini E, Bender B, Bergo FPG, Bernardes T, Bernasconi A, Bernasconi N, Bernhardt BC, Blackmon K, Braga B, Caligiuri ME, Calvo A, Carlson C, Carr SJ, Cavalleri GL, Cendes F, Chen J, Chen S, Cherubini A, Concha L, David P, Delanty N, Depondt C, Devinsky O, Doherty CP, Domin M, Focke NK, Foley S, Franca W, Gambardella A, Guerrini R, Hamandi K, Hibar DP, Isaev D, Jackson GD, Jahanshad N, Kalviainen R, Keller SS, Kochunov P, Kotikalapudi R, Kowalczyk MA, Kuzniecky R, Kwan P, Labate A, Langner S, Lenge M, Liu M, Martin P, Mascalchi M, Meletti S, Morita-Sherman ME, O’Brien TJ, Pariente JC, Richardson MP, Rodriguez-Cruces R, Rummel C, Saavalainen T, Semmelroch MK, Severino M, Striano P, Thesen T, Thomas RH, Tondelli M, Tortora D, Vaudano AE, Vivash L, von Podewils F, Wagner J, Weber B, Wiest R, Yasuda CL, Zhang G, Zhang J, Leu C, Avbersek A, Thom M, Whelan CD, Thompson P, McDonald CR, Vezzani A, Sisodiya SM. A systems-level analysis highlights microglial activation as a modifying factor in common epilepsies. Neuropathol Appl Neurobiol 2022; 48:e12758. [PMID: 34388852 PMCID: PMC8983060 DOI: 10.1111/nan.12758] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/15/2021] [Indexed: 02/03/2023]
Abstract
AIMS The causes of distinct patterns of reduced cortical thickness in the common human epilepsies, detectable on neuroimaging and with important clinical consequences, are unknown. We investigated the underlying mechanisms of cortical thinning using a systems-level analysis. METHODS Imaging-based cortical structural maps from a large-scale epilepsy neuroimaging study were overlaid with highly spatially resolved human brain gene expression data from the Allen Human Brain Atlas. Cell-type deconvolution, differential expression analysis and cell-type enrichment analyses were used to identify differences in cell-type distribution. These differences were followed up in post-mortem brain tissue from humans with epilepsy using Iba1 immunolabelling. Furthermore, to investigate a causal effect in cortical thinning, cell-type-specific depletion was used in a murine model of acquired epilepsy. RESULTS We identified elevated fractions of microglia and endothelial cells in regions of reduced cortical thickness. Differentially expressed genes showed enrichment for microglial markers and, in particular, activated microglial states. Analysis of post-mortem brain tissue from humans with epilepsy confirmed excess activated microglia. In the murine model, transient depletion of activated microglia during the early phase of the disease development prevented cortical thinning and neuronal cell loss in the temporal cortex. Although the development of chronic seizures was unaffected, the epileptic mice with early depletion of activated microglia did not develop deficits in a non-spatial memory test seen in epileptic mice not depleted of microglia. CONCLUSIONS These convergent data strongly implicate activated microglia in cortical thinning, representing a new dimension for concern and disease modification in the epilepsies, potentially distinct from seizure control.
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Affiliation(s)
- Andre Altmann
- Centre for Medical Image Computing, University College London, London, UK
| | - Mina Ryten
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Martina Di Nunzio
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Teresa Ravizza
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Daniele Tolomeo
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Regina H Reynolds
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Alyma Somani
- Division of Neuropathology, UCL Queen Square Institute of Neurology, London, UK
| | - Marco Bacigaluppi
- Department of Neurology, San Raffaele Scientific Institute and Vita Salute San Raffaele University, Milan, Italy
| | - Valentina Iori
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Edoardo Micotti
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Rossella Di Sapia
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Milica Cerovic
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Eleonora Palma
- Department of Physiology and Pharmacology, University of Rome, Sapienza
| | - Gabriele Ruffolo
- Department of Physiology and Pharmacology, University of Rome, Sapienza
| | - Juan A. Botía
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK.,Departamento de Ingeniería de la Información y las Comunicaciones. Universidad de Murcia, Murcia, Spain
| | - Julie Absil
- Department of Radiology, Hôpital Erasme, Universite Libre de Bruxelles, Brussels 1070, Belgium
| | - Saud Alhusaini
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | | | - Pia Auvinen
- Epilepsy Center, Department of Neurology, Kuopio University, Kuopio, Finland.,Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
| | - Nuria Bargallo
- Magnetic Resonance Image Core Facility, IDIBAPS, Barcelona, Spain.,Centre de Diagnostic Per la Imatge (CDIC), Hospital Clinic, Barcelona, Spain
| | - Emanuele Bartolini
- Pediatric Neurology Unit, Children’s Hospital A. Meyer-University of Florence, Italy.,IRCCS Stella Maris Foundation, Pisa, Italy
| | - Benjamin Bender
- Department of Diagnostic and Interventional Neuroradiology, University of Tübingen, Tübingen, Germany
| | | | - Tauana Bernardes
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Boris C. Bernhardt
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.,Multimodal Imaging and Connectome Analysis Lab, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Karen Blackmon
- Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York, USA.,Department of Physiology, Neuroscience and Behavioral Science, St. George’s University, Grenada, West Indies
| | - Barbara Braga
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Maria Eugenia Caligiuri
- Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy
| | - Anna Calvo
- Magnetic Resonance Image Core Facility, IDIBAPS, Barcelona, Spain
| | - Chad Carlson
- Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York, USA.,Medical College of Wisconsin, Department of Neurology, Milwaukee, WI, USA
| | - Sarah J. Carr
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Gianpiero L. Cavalleri
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.,FutureNeuro Research Centre, RCSI, Dublin, Ireland
| | - Fernando Cendes
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Jian Chen
- Department of Computer Science and Engineering, The Ohio State University, USA
| | - Shuai Chen
- Cognitive Science Department, Xiamen University, Xiamen, China.,Fujian Key Laboratory of the Brain-like Intelligent Systems, China
| | - Andrea Cherubini
- Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy
| | - Luis Concha
- Instituto de Neurobiología, Universidad Nacional Autónoma de México. Querétaro, Querétaro, México
| | - Philippe David
- Department of Radiology, Hôpital Erasme, Universite Libre de Bruxelles, Brussels 1070, Belgium
| | - Norman Delanty
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.,FutureNeuro Research Centre, RCSI, Dublin, Ireland.,Division of Neurology, Beaumont Hospital, Dublin 9, Ireland
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme, Universite Libre de Bruxelles, Brussels 1070, Belgium
| | - Orrin Devinsky
- Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York, USA
| | - Colin P. Doherty
- FutureNeuro Research Centre, RCSI, Dublin, Ireland.,Neurology Department, St. James’s Hospital, Dublin 8, Ireland
| | - Martin Domin
- Functional Imaging Unit, Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Niels K. Focke
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,Department of Clinical Neurophysiology, University Medicine Göttingen, Göttingen, Germany
| | - Sonya Foley
- Cardiff University Brain Research Imaging Centre, School of Psychology, Wales, UK
| | - Wendy Franca
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Antonio Gambardella
- Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy.,Institute of Neurology, University ‚ “Magna Græcia”, Catanzaro, Italy
| | - Renzo Guerrini
- Pediatric Neurology Unit, Children’s Hospital A. Meyer-University of Florence, Italy.,IRCCS Stella Maris Foundation, Pisa, Italy
| | - Khalid Hamandi
- Institute of Psychological Medicine and Clinical Neurosciences, Hadyn Ellis Building, Maindy Road, Cardiff, UK.,Department of Neurology, University Hospital of Wales, Cardiff, UK
| | - Derrek P. Hibar
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California, USA
| | - Dmitry Isaev
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California, USA
| | - Graeme D. Jackson
- The Florey Institute of Neuroscience and Mental Health, Austin Campus, Melbourne, VIC, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California, USA
| | - Reetta Kalviainen
- Epilepsy Center, Department of Neurology, Kuopio University, Kuopio, Finland.,Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
| | - Simon S. Keller
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, UK
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Maryland, USA
| | - Raviteja Kotikalapudi
- Department of Diagnostic and Interventional Neuroradiology, University of Tübingen, Tübingen, Germany.,Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Magdalena A. Kowalczyk
- The Florey Institute of Neuroscience and Mental Health, Austin Campus, Melbourne, VIC, Australia
| | - Ruben Kuzniecky
- Department of Neurology, Zucker Hofstra School of Medicine, New York, NY 10075, USA
| | - Patrick Kwan
- Department of Neurology, Royal Melbourne Hospital, Parkville, 3050, Australia
| | - Angelo Labate
- Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy.,Institute of Neurology, University ‚ “Magna Græcia”, Catanzaro, Italy
| | - Soenke Langner
- Functional Imaging Unit, Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Matteo Lenge
- Pediatric Neurology Unit, Children’s Hospital A. Meyer-University of Florence, Italy
| | - Min Liu
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Mario Mascalchi
- Neuroradiology Unit, Children’s Hospital A. Meyer, Florence, Italy.,“Mario Serio” Department of Experimental and Clinical Biomedical Sciences, University of Florence, Italy
| | - Stefano Meletti
- Department of Biomedical, Metabolic, and Neural Science, University of Modena and Reggio Emilia, NOCSE Hospital, Modena, Italy
| | | | - Terence J. O’Brien
- Department of Neurology, Royal Melbourne Hospital, Parkville, 3050, Australia.,Department of Medicine, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Jose C. Pariente
- Magnetic Resonance Image Core Facility, IDIBAPS, Barcelona, Spain
| | - Mark P. Richardson
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK.,Department of Neurology, King’s College Hospital, London, UK
| | - Raul Rodriguez-Cruces
- Instituto de Neurobiología, Universidad Nacional Autónoma de México. Querétaro, Querétaro, México
| | - Christian Rummel
- Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland
| | - Taavi Saavalainen
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland.,Central Finland Central Hospital, Medical Imaging Unit, Jyväskylä, Finland
| | - Mira K. Semmelroch
- The Florey Institute of Neuroscience and Mental Health, Austin Campus, Melbourne, VIC, Australia
| | - Mariasavina Severino
- Neuroradiology Unit, Department of Head and Neck and Neurosciences, Istituto Giannina Gaslini, Genova, Italy
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genova, Italy
| | - Thomas Thesen
- Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York, USA.,Department of Physiology, Neuroscience and Behavioral Science, St. George’s University, Grenada, West Indies
| | - Rhys H. Thomas
- Institute of Psychological Medicine and Clinical Neurosciences, Hadyn Ellis Building, Maindy Road, Cardiff, UK.,Department of Neurology, University Hospital of Wales, Cardiff, UK
| | - Manuela Tondelli
- Department of Biomedical, Metabolic, and Neural Science, University of Modena and Reggio Emilia, NOCSE Hospital, Modena, Italy
| | - Domenico Tortora
- Neuroradiology Unit, Department of Head and Neck and Neurosciences, Istituto Giannina Gaslini, Genova, Italy
| | - Anna Elisabetta Vaudano
- Department of Biomedical, Metabolic, and Neural Science, University of Modena and Reggio Emilia, NOCSE Hospital, Modena, Italy
| | - Lucy Vivash
- Department of Neurology, Royal Melbourne Hospital, Parkville, 3050, Australia.,Melbourne Brain Centre, Department of Medicine, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Felix von Podewils
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Jan Wagner
- Department of Neurology, University of Ulm and Universitäts- and Rehabilitationskliniken Ulm, Germany
| | - Bernd Weber
- Department of Epileptology, University Hospital Bonn, Bonn, Germany.,Department of Neurocognition / Imaging, Life & Brain Research Centre, Bonn, Germany
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland
| | | | - Guohao Zhang
- Department of Computer Science and Electrical Engineering, University of Maryland, Baltimore County, USA
| | - Junsong Zhang
- Cognitive Science Department, Xiamen University, Xiamen, China.,Fujian Key Laboratory of the Brain-like Intelligent Systems, China
| | | | - Costin Leu
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.,Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA.,Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Andreja Avbersek
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | | | - Maria Thom
- Division of Neuropathology, UCL Queen Square Institute of Neurology, London, UK.,Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Christopher D Whelan
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.,Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California, USA
| | - Paul Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California, USA
| | - Carrie R McDonald
- Multimodal Imaging Laboratory, University of California San Diego, San Diego, California, USA.,Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Annamaria Vezzani
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy.,To whom correspondence may be addressed
| | - Sanjay M Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.,Chalfont Centre for Epilepsy, Bucks, UK.,To whom correspondence may be addressed
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36
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Elwan M, Fowkes R, Lewis-Smith D, Winder A, Baker MR, Thomas RH. Late-onset cluster seizures and intellectual disability associated with a novel truncation variant in SMC1A. Epilepsy Behav Rep 2022; 19:100556. [PMID: 35712061 PMCID: PMC9194849 DOI: 10.1016/j.ebr.2022.100556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 05/08/2022] [Accepted: 05/31/2022] [Indexed: 11/25/2022] Open
Abstract
Epilepsy due to truncating SMC1A variants can present with onset in later childhood. People with to truncating SMC1A variants can have normal development prior to presentation. Seizures occur periodically in clusters and are poorly responsive to antiseizure medications.
SMC1A variants are known to cause Cornelia de Lange Syndrome (CdLS) which encompasses a clinical spectrum of intellectual disability, dysmorphic features (long or thick eyebrows, a hypomorphic philtrum and small nose) and, in some cases, epilepsy. More recently, SMC1A truncating variants have been described as the cause of a neurodevelopmental disorder with early-childhood onset drug-resistant epilepsy with seizures that occur in clusters, similar to that seen in PCDH19-related epilepsy, but without the classical features of CdLS. Here, we report the case of a 28-year-old woman with a de novo heterozygous truncating variant in SMC1A who unusually presented with seizures at the late age of 12 years and had normal development into adulthood.
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Affiliation(s)
- Menatalla Elwan
- Department of Neurology, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, United Kingdom
| | - Ross Fowkes
- Department of Neurology, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, United Kingdom
| | - David Lewis-Smith
- Department of Neurology, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, United Kingdom
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - Amy Winder
- Department of Clinical Neurophysiology, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, United Kingdom
| | - Mark R. Baker
- Department of Neurology, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, United Kingdom
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
- Department of Clinical Neurophysiology, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, United Kingdom
| | - Rhys H. Thomas
- Department of Neurology, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, United Kingdom
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
- Wellcome Centre for Mitochondrial Research, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
- Corresponding author at: Intermediate Clinical Lecturer and Honorary Consultant in Epilepsy, Translational and Clinical Research Institute, Newcastle University, Henry Wellcome Building, Framlington Place, Newcastle upon Tyne NE2 4HH.
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37
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Butler M, Tamborska A, Wood GK, Ellul M, Thomas RH, Galea I, Pett S, Singh B, Solomon T, Pollak TA, Michael BD, Nicholson TR. Considerations for causality assessment of neurological and neuropsychiatric complications of SARS-CoV-2 vaccines: from cerebral venous sinus thrombosis to functional neurological disorder. J Neurol Neurosurg Psychiatry 2021; 92:1144-1151. [PMID: 34362855 DOI: 10.1136/jnnp-2021-326924] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/21/2021] [Indexed: 12/26/2022]
Affiliation(s)
- Matt Butler
- Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Arina Tamborska
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK.,University of Liverpool, Liverpool, UK
| | - Greta K Wood
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK.,University of Liverpool, Liverpool, UK
| | - Mark Ellul
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - Rhys H Thomas
- Department of Neuroscience, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK.,Translational and Clinical Research Institute, Newcastle upon Tyne, UK
| | - Ian Galea
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Sarah Pett
- MRC CTU at UCL, Institute for Global Health and Institute for Clinical Trials Methodology, University College London, London, UK
| | | | - Tom Solomon
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - Thomas Arthur Pollak
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK
| | - Benedict D Michael
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK.,University of Liverpool, Liverpool, UK
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38
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Gleichgerrcht E, Munsell BC, Alhusaini S, Alvim MKM, Bargalló N, Bender B, Bernasconi A, Bernasconi N, Bernhardt B, Blackmon K, Caligiuri ME, Cendes F, Concha L, Desmond PM, Devinsky O, Doherty CP, Domin M, Duncan JS, Focke NK, Gambardella A, Gong B, Guerrini R, Hatton SN, Kälviäinen R, Keller SS, Kochunov P, Kotikalapudi R, Kreilkamp BAK, Labate A, Langner S, Larivière S, Lenge M, Lui E, Martin P, Mascalchi M, Meletti S, O'Brien TJ, Pardoe HR, Pariente JC, Xian Rao J, Richardson MP, Rodríguez-Cruces R, Rüber T, Sinclair B, Soltanian-Zadeh H, Stein DJ, Striano P, Taylor PN, Thomas RH, Elisabetta Vaudano A, Vivash L, von Podewills F, Vos SB, Weber B, Yao Y, Lin Yasuda C, Zhang J, Thompson PM, Sisodiya SM, McDonald CR, Bonilha L. Artificial intelligence for classification of temporal lobe epilepsy with ROI-level MRI data: A worldwide ENIGMA-Epilepsy study. Neuroimage Clin 2021; 31:102765. [PMID: 34339947 PMCID: PMC8346685 DOI: 10.1016/j.nicl.2021.102765] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 07/15/2021] [Accepted: 07/17/2021] [Indexed: 01/22/2023]
Abstract
Artificial intelligence has recently gained popularity across different medical fields to aid in the detection of diseases based on pathology samples or medical imaging findings. Brain magnetic resonance imaging (MRI) is a key assessment tool for patients with temporal lobe epilepsy (TLE). The role of machine learning and artificial intelligence to increase detection of brain abnormalities in TLE remains inconclusive. We used support vector machine (SV) and deep learning (DL) models based on region of interest (ROI-based) structural (n = 336) and diffusion (n = 863) brain MRI data from patients with TLE with ("lesional") and without ("non-lesional") radiographic features suggestive of underlying hippocampal sclerosis from the multinational (multi-center) ENIGMA-Epilepsy consortium. Our data showed that models to identify TLE performed better or similar (68-75%) compared to models to lateralize the side of TLE (56-73%, except structural-based) based on diffusion data with the opposite pattern seen for structural data (67-75% to diagnose vs. 83% to lateralize). In other aspects, structural and diffusion-based models showed similar classification accuracies. Our classification models for patients with hippocampal sclerosis were more accurate (68-76%) than models that stratified non-lesional patients (53-62%). Overall, SV and DL models performed similarly with several instances in which SV mildly outperformed DL. We discuss the relative performance of these models with ROI-level data and the implications for future applications of machine learning and artificial intelligence in epilepsy care.
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Affiliation(s)
| | - Brent C Munsell
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC, USA; Department of Computer Science, University of North Carolina at Chapel Hill, NC, USA
| | - Saud Alhusaini
- Neurology Department, Yale University School of Medicine, New Haven, CT, USA; Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Marina K M Alvim
- Department of Neurology and Neuroimaging Laboratory, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Núria Bargalló
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain; Department of Radiology of Center of Image Diagnosis (CDIC), Hospital Clinic de Barcelona, Barcelona, Spain
| | - Benjamin Bender
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Boris Bernhardt
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Karen Blackmon
- Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | - Maria Eugenia Caligiuri
- Neuroscience Research Center, Department of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Fernando Cendes
- Department of Neurology and Neuroimaging Laboratory, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Luis Concha
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico
| | - Patricia M Desmond
- Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Orrin Devinsky
- Department of Neurology, Langone School of Medicine, New York University, New York, NY, USA
| | - Colin P Doherty
- Trinity College Dublin, School of Medicine, Dublin, Ireland; FutureNeuro SFI Research Centre for Rare and Chronic Neurological Diseases, Dublin, Ireland
| | - Martin Domin
- Functional Imaging Unit, Department of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Niels K Focke
- University Medicine Göttingen, Clinical Neurophysiology, Göttingen, Germany
| | - Antonio Gambardella
- Neuroscience Research Center, Department of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy; Institute of Neurology, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Bo Gong
- Department of Radiology, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Renzo Guerrini
- Neuroscience Department, University of Florence, Florence, Italy
| | - Sean N Hatton
- Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, USA
| | - Reetta Kälviäinen
- Kuopio University Hospital, Member of EpiCARE ERN, Kuopio, Finland; Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
| | - Simon S Keller
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK; The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Peter Kochunov
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Raviteja Kotikalapudi
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany; Department of Clinical Neurophysiology, University Hospital Göttingen, Goettingen, Germany; Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University Hospital Tübingen, Tübingen, Germany
| | - Barbara A K Kreilkamp
- University Medicine Göttingen, Clinical Neurophysiology, Göttingen, Germany; Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Angelo Labate
- Neuroscience Research Center, Department of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy; Institute of Neurology, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Soenke Langner
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany; Institute for Diagnostic and Interventional Radiology, Pediatric and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Sara Larivière
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Matteo Lenge
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Children's Hospital A. Meyer-University of Florence, Florence, Italy; Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Elaine Lui
- Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University Hospital Tübingen, Tübingen, Germany
| | - Mario Mascalchi
- 'Mario Serio' Department of Clinical and Experimental Medica Sciences, University of Florence, Florence, Italy
| | - Stefano Meletti
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Neurology Unit, OCB Hospital, AOU Modena, Modena, Italy
| | - Terence J O'Brien
- Department of Neuroscience, Monash University, Melbourne, VIC, Australia; The Department of Medicine (The Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia
| | - Heath R Pardoe
- Department of Neurology, Langone School of Medicine, New York University, New York, NY, USA
| | - Jose C Pariente
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Jun Xian Rao
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | | | - Raúl Rodríguez-Cruces
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico; Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Theodor Rüber
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
| | - Ben Sinclair
- Department of Neuroscience, Monash University, Melbourne, VIC, Australia; The Department of Medicine (The Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia
| | - Hamid Soltanian-Zadeh
- Radiology and Research Administration, Henry Ford Health System, Detroit, MI, USA; School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Dan J Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Pasquale Striano
- IRCCS Istituto 'G. Gaslini', Genova, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Peter N Taylor
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy; School of Computing, Newcastle University, Newcastle Upon Tyne, UK
| | - Rhys H Thomas
- Institute of Translational and Clinical Research, Newcastle University, Newcastle Upon Tyne, UK
| | - Anna Elisabetta Vaudano
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Neurology Unit, OCB Hospital, AOU Modena, Modena, Italy
| | - Lucy Vivash
- Department of Neuroscience, Monash University, Melbourne, VIC, Australia; The Department of Medicine (The Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia
| | - Felix von Podewills
- Department of Neurology, Epilepsy Center, University Medicine Greifswald, Greifswald, Germany
| | - Sjoerd B Vos
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK; Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University of Bonn, Bonn, Germany
| | - Yi Yao
- Institute of Experimental Epileptology and Cognition Research, University of Bonn, Bonn, Germany
| | - Clarissa Lin Yasuda
- Department of Neurology and Neuroimaging Laboratory, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Junsong Zhang
- Cognitive Science Department, School of Informatics, Xiamen University, Xiamen, China
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Sanjay M Sisodiya
- UCL Queen Square Institute of Neurology, London, UK; Chalfont Centre for Epilepsy, Bucks, UK
| | - Carrie R McDonald
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
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39
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Ross Russell AL, Hardwick M, Jeyanantham A, White LM, Deb S, Burnside G, Joy HM, Smith CJ, Pollak TA, Nicholson TR, Davies NWS, Manji H, Easton A, Ray S, Zandi MS, Coles JP, Menon DK, Varatharaj A, McCausland B, Ellul MA, Thomas N, Breen G, Keddie S, Lunn MP, Burn JPS, Quattrocchi G, Dixon L, Rice CM, Pengas G, Al-Shahi Salman R, Carson A, Joyce EM, Turner MR, Benjamin LA, Solomon T, Kneen R, Pett S, Thomas RH, Michael BD, Galea I. Spectrum, risk factors and outcomes of neurological and psychiatric complications of COVID-19: a UK-wide cross-sectional surveillance study. Brain Commun 2021; 3:fcab168. [PMID: 34409289 PMCID: PMC8364668 DOI: 10.1093/braincomms/fcab168] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2021] [Indexed: 01/06/2023] Open
Abstract
SARS-CoV-2 is associated with new-onset neurological and psychiatric conditions. Detailed clinical data, including factors associated with recovery, are lacking, hampering prediction modelling and targeted therapeutic interventions. In a UK-wide cross-sectional surveillance study of adult hospitalized patients during the first COVID-19 wave, with multi-professional input from general and sub-specialty neurologists, psychiatrists, stroke physicians, and intensivists, we captured detailed data on demographics, risk factors, pre-COVID-19 Rockwood frailty score, comorbidities, neurological presentation and outcome. A priori clinical case definitions were used, with cross-specialty independent adjudication for discrepant cases. Multivariable logistic regression was performed using demographic and clinical variables, to determine the factors associated with outcome. A total of 267 cases were included. Cerebrovascular events were most frequently reported (131, 49%), followed by other central disorders (95, 36%) including delirium (28, 11%), central inflammatory (25, 9%), psychiatric (25, 9%), and other encephalopathies (17, 7%), including a severe encephalopathy (n = 13) not meeting delirium criteria; and peripheral nerve disorders (41, 15%). Those with the severe encephalopathy, in comparison to delirium, were younger, had higher rates of admission to intensive care and a longer duration of ventilation. Compared to normative data during the equivalent time period prior to the pandemic, cases of stroke in association with COVID-19 were younger and had a greater number of conventional, modifiable cerebrovascular risk factors. Twenty-seven per cent of strokes occurred in patients <60 years. Relative to those >60 years old, the younger stroke patients presented with delayed onset from respiratory symptoms, higher rates of multi-vessel occlusion (31%) and systemic thrombotic events. Clinical outcomes varied between disease groups, with cerebrovascular disease conferring the worst prognosis, but this effect was less marked than the pre-morbid factors of older age and a higher pre-COVID-19 frailty score, and a high admission white cell count, which were independently associated with a poor outcome. In summary, this study describes the spectrum of neurological and psychiatric conditions associated with COVID-19. In addition, we identify a severe COVID-19 encephalopathy atypical for delirium, and a phenotype of COVID-19 associated stroke in younger adults with a tendency for multiple infarcts and systemic thromboses. These clinical data will be useful to inform mechanistic studies and stratification of patients in clinical trials.
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Affiliation(s)
- Amy L Ross Russell
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- Department of Neurology, Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Marc Hardwick
- Department of Neurology, Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Athavan Jeyanantham
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Laura M White
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, L9 7AL, UK
| | - Saumitro Deb
- Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, L3 5TR, UK
| | - Girvan Burnside
- Department of Health Data Science, University of Liverpool, Liverpool, L69 3BX, UK
| | - Harriet M Joy
- Neuroradiology Department, Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
| | - Craig J Smith
- Manchester Centre for Clinical Neurosciences, Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Salford Royal Foundation Trust, Salford, M6 8HD, UK
- Division of Cardiovascular Sciences, Lydia Becker Institute for Immunology and Inflammation, University of Manchester, Manchester, M13 9PL, UK
| | - Thomas A Pollak
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, SE5 8AF, UK
| | - Timothy R Nicholson
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, SE5 8AF, UK
| | | | - Hadi Manji
- MRC Centre for Neuromuscular Diseases, National Hospital for Neurology, London, WC1N 3BG, UK
- UCL Queen Square Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - Ava Easton
- Encephalitis Society, Malton, Malton, YO17 7DT, UK
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Sciences, University of Liverpool, Liverpool, L7 3EA, UK
| | - Stephen Ray
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Sciences, University of Liverpool, Liverpool, L7 3EA, UK
- The National Institute for Health Research Health Protection Research Unit for Emerging and Zoonotic Infections, University of Liverpool, Liverpool, L69 7BE, UK
| | - Michael S Zandi
- UCL Queen Square Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - Jonathan P Coles
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, CB2 0SP, UK
| | - David K Menon
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, CB2 0SP, UK
| | - Aravinthan Varatharaj
- Department of Neurology, Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Beth McCausland
- Department of Neurology, Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- Memory Assessment and Research Centre, Moorgreen Hospital, Southern Health Foundation Trust, Southampton, SO40 2RZ, UK
| | - Mark A Ellul
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Sciences, University of Liverpool, Liverpool, L7 3EA, UK
- The National Institute for Health Research Health Protection Research Unit for Emerging and Zoonotic Infections, University of Liverpool, Liverpool, L69 7BE, UK
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, L9 7LJ, UK
| | - Naomi Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle, NE1 7RU, UK
- Wellcome Centre for Mitochondrial Research, Newcastle University, Newcastle, NE2 4HH, UK
| | - Gerome Breen
- Department of Social Genetic and Developmental Psychiatry, King’s College London, London, SE5 8AF, UK
| | - Stephen Keddie
- Department of Neuromuscular Diseases, University College London, London, WC1N 3BG, UK
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, WC1N 3BG, UK
| | - Michael P Lunn
- MRC Centre for Neuromuscular Diseases, National Hospital for Neurology, London, WC1N 3BG, UK
- UCL Queen Square Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - John P S Burn
- Rehabilitation Department, Poole Hospital, University Hospitals Dorset NHS Foundation Trust, Poole, BH15 2JB, UK
| | - Graziella Quattrocchi
- Department of Neurology, North Middlesex University Hospital NHS Trust, London, N18 1QX, UK
| | - Luke Dixon
- Department of Neuroradiology, Imperial College NHS Healthcare Trust, London, W2 1NY, UK
| | - Claire M Rice
- Department of Neurology, Southmead Hospital, North Bristol NHS Trust, Bristol, S10 5NB, UK
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1TH, UK
| | - George Pengas
- Department of Neurology, Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | | | - Alan Carson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4SB, UK
| | - Eileen M Joyce
- UCL Queen Square Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - Martin R Turner
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK
| | - Laura A Benjamin
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Sciences, University of Liverpool, Liverpool, L7 3EA, UK
- The National Institute for Health Research Health Protection Research Unit for Emerging and Zoonotic Infections, University of Liverpool, Liverpool, L69 7BE, UK
- Laboratory of Molecular and Cell Biology, UCL, Gower St, King’s Cross, London, London, WC1E 6BT, UK
| | - Tom Solomon
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Sciences, University of Liverpool, Liverpool, L7 3EA, UK
- The National Institute for Health Research Health Protection Research Unit for Emerging and Zoonotic Infections, University of Liverpool, Liverpool, L69 7BE, UK
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, L9 7LJ, UK
| | - Rachel Kneen
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Sciences, University of Liverpool, Liverpool, L7 3EA, UK
- Department of Neurology, Alder Hey Children’s NHS Foundation Trust, Liverpool, Liverpool, L14 5AB, UK
| | - Sarah Pett
- Medical Research Council Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, WC1V 6LJ, UK
- Institute for Global Health, University College London, London, WC1N 1EH, UK
| | - Rhys H Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle, NE1 7RU, UK
- Wellcome Centre for Mitochondrial Research, Newcastle University, Newcastle, NE2 4HH, UK
- Department of Neurology, Royal Victoria Infirmary, Newcastle, NE1 4LP, UK
| | - Benedict D Michael
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Sciences, University of Liverpool, Liverpool, L7 3EA, UK
- The National Institute for Health Research Health Protection Research Unit for Emerging and Zoonotic Infections, University of Liverpool, Liverpool, L69 7BE, UK
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, L9 7LJ, UK
| | - Ian Galea
- Department of Neurology, Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
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Accogli A, Wiegand G, Scala M, Cerminara C, Iacomino M, Riva A, Carlini B, Camerota L, Belcastro V, Prontera P, Fernández-Jaén A, Bebek N, Scudieri P, Baldassari S, Salpietro V, Novelli G, De Luca C, von Stülpnagel C, Kluger F, Kluger GJ, Wohlrab GC, Ramantani G, Lewis-Smith D, Thomas RH, Lai M, Verrotti A, Striano S, Depienne C, Minetti C, Benfenati F, Brancati F, Zara F, Striano P. Clinical and Genetic Features in Patients With Reflex Bathing Epilepsy. Neurology 2021; 97:e577-e586. [PMID: 34078716 PMCID: PMC8424500 DOI: 10.1212/wnl.0000000000012298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/05/2021] [Indexed: 12/02/2022] Open
Abstract
Objective To describe the clinical and genetic findings in a cohort of individuals with bathing epilepsy, a rare form of reflex epilepsy. Methods We investigated by Sanger and targeted resequencing the SYN1 gene in 12 individuals from 10 different families presenting with seizures triggered primarily by bathing or showering. An additional 12 individuals with hot-water epilepsy were also screened. Results In all families with bathing epilepsy, we identified 8 distinct pathogenic or likely pathogenic variants and 2 variants of unknown significance in SYN1, 9 of which are novel. Conversely, none of the individuals with hot-water epilepsy displayed SYN1 variants. In mutated individuals, seizures were typically triggered by showering or bathing regardless of the water temperature. Additional triggers included fingernail clipping, haircutting, or watching someone take a shower. Unprovoked seizures and a variable degree of developmental delay were also common. Conclusion Bathing epilepsy is genetically distinct reflex epilepsy caused mainly by SYN1 mutations.
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Affiliation(s)
- Andrea Accogli
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Gert Wiegand
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Marcello Scala
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Caterina Cerminara
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Michele Iacomino
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Antonella Riva
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Barbara Carlini
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Letizia Camerota
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Vincenzo Belcastro
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Paolo Prontera
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Alberto Fernández-Jaén
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Nerses Bebek
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Paolo Scudieri
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Simona Baldassari
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Vincenzo Salpietro
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Giuseppe Novelli
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Chiara De Luca
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Celina von Stülpnagel
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Felicitas Kluger
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Gerhard Josef Kluger
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Gabriele Christine Wohlrab
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Georgia Ramantani
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - David Lewis-Smith
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Rhys H Thomas
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Ming Lai
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Alberto Verrotti
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Salvatore Striano
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Christel Depienne
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Carlo Minetti
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Fabio Benfenati
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Francesco Brancati
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Federico Zara
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
| | - Pasquale Striano
- From IRCCS Istituto Giannina Gaslini (A.A., M.S., M.I., A.R., B.C., P.S., S.B., V.D.S., C.M., F.Z., P.S.); Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) (A.A., M.S., P.S., V.D.S., C.M., F.Z., P.S.), University of Genoa, Italy; Neuropediatrics Section of the Department of Pediatrics (G.W.), Asklepios Clinic Hamburg Nord-Heidberg, Hamburg; Department of Pediatric and Adolescent Medicine II (Neuropediatrics, Social Pediatrics) (G.W.), University Medical Centre Schleswig-Holstein, Kiel, Germany; Department of Neurosciences (C.C., C.D.L.), Pediatric Neurology Unit, Tor Vergata University, Roma; Human Genetics (L.C., F. Brancati), Department of Life, Health, and Environmental Sciences, and Department of Pediatrics (A.V.), University of L'Aquila; Child Neuropsychiatry Unit (V.B.), Department of Mental Health, ASST-LARIANA, Como; Medical Genetics Unit (P.P.), "S. Maria della Misericordia" Hospital, Perugia, Italy; Department of Pediatric Neurology (A.F.-J.), Hospital Universitario Quirónsalud and Universidad Europea de Madrid, Madrid, Spain; Istanbul University Istanbul Faculty of Medicine (N.B.), Department of Neurology, Turkey; Department of Biomedicine and Prevention (G.N.), Tor Vergata University of Rome; IRCCS Neuromed (G.N.), Pozzilli, Italy; Department of Pharmacology (G.N.), School of Medicine, University of Nevada, Reno; Department of Pediatrics (C.v.S.), University Hospital Munich, Germany; Paracelsus Medical University (C.v.S.), Salzburg, Austria; Epilepsy Center for Children and Adolescents (F.K., G.J.K.), Vogtareuth, Germany; Department of Neuropediatrics (G.C.W., G.R.), University Children's Hospital Zurich, Switzerland; Translational and Clinical Research Institute (D.L.-S., R.H.T., M.L.), Newcastle University; Department of Clinical Neurosciences (D.L.-S., R.H.T., M.L.), Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, UK; Epilepsy Center (S.S.), Federico II University, Napoli, Italy; Institute of Human Genetics (C.D.), University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Institut du Cerveau et de la Moelle épinière (ICM) (C.D.), Sorbonne Université, UMR S 1127, Inserm U1127, CNRS UMR 7225, Paris, France; Center for Synaptic Neuroscience and Technology (F.Benfenati), Istituto Italiano di Tecnologia; IRCCS Ospedale Policlinico San Martino (F. Benfenati), Genoa; and Human Functional Genomics (F. Brancati), IRCCS San Raffaele Pisana, Rome, Italy
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Lewis-Smith D, Galer PD, Balagura G, Kearney H, Ganesan S, Cosico M, O'Brien M, Vaidiswaran P, Krause R, Ellis CA, Thomas RH, Robinson PN, Helbig I. Modeling seizures in the Human Phenotype Ontology according to contemporary ILAE concepts makes big phenotypic data tractable. Epilepsia 2021; 62:1293-1305. [PMID: 33949685 PMCID: PMC8272408 DOI: 10.1111/epi.16908] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/19/2021] [Accepted: 04/01/2021] [Indexed: 01/08/2023]
Abstract
Objective: The clinical features of epilepsy determine how it is defined, which in turn guides management. Therefore, consideration of the fundamental clinical entities that comprise an epilepsy is essential in the study of causes, trajectories, and treatment responses. The Human Phenotype Ontology (HPO) is used widely in clinical and research genetics for concise communication and modeling of clinical features, allowing extracted data to be harmonized using logical inference. We sought to redesign the HPO seizure subontology to improve its consistency with current epileptological concepts, supporting the use of large clinical data sets in high-throughput clinical and research genomics. Methods: We created a new HPO seizure subontology based on the 2017 International League Against Epilepsy (ILAE) Operational Classification of Seizure Types, and integrated concepts of status epilepticus, febrile, reflex, and neonatal seizures at different levels of detail. We compared the HPO seizure subontology prior to, and following, our revision, according to the information that could be inferred about the seizures of 791 individuals from three independent cohorts: 2 previously published and 150 newly recruited individuals. Each cohort’s data were provided in a different format and harmonized using the two versions of the HPO. Results: The new seizure subontology increased the number of descriptive concepts for seizures 5-fold. The number of seizure descriptors that could be annotated to the cohort increased by 40% and the total amount of information about individuals’ seizures increased by 38%. The most important qualitative difference was the relationship of focal to bilateral tonic-clonic seizure to generalized-onset and focal-onset seizures.
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Affiliation(s)
- David Lewis-Smith
- Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, UK.,Department of Clinical Neurosciences, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
| | - Peter D Galer
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Biomedical and Health Informatics (DBHi), Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Ganna Balagura
- Medical Genetics Unit, IRCSS Giannina Gaslini Institute, Genoa, Italy
| | - Hugh Kearney
- FutureNeuro the SFI Research Centre for Chronic and Rare Neurological Diseases, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - Shiva Ganesan
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Biomedical and Health Informatics (DBHi), Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Mahgenn Cosico
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Margaret O'Brien
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Priya Vaidiswaran
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Roland Krause
- Luxembourg Centre for Systems Biomedicine, Université du Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Colin A Ellis
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Rhys H Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, UK.,Department of Clinical Neurosciences, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
| | - Peter N Robinson
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA.,Institute for Systems Genomics, University of Connecticut, Farmington, CT, USA
| | - Ingo Helbig
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Biomedical and Health Informatics (DBHi), Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
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Craig DP, Choi YY, Hughes E, Osland K, Hanna J, Kerr MP, Thomas RH. Paediatric sudden unexpected death in epilepsy: A parental report cohort. Acta Neurol Scand 2021; 143:509-513. [PMID: 33210735 DOI: 10.1111/ane.13378] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/01/2020] [Accepted: 11/12/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Sudden unexpected death in epilepsy (SUDEP) accounts for a large percentage of deaths in children with epilepsy. Contributing factors to paediatric SUDEP are incompletely understood. AIMS OF STUDY The Epilepsy Deaths Register (EDR) is an anonymized register that compiles information on deaths related to epilepsy, across all ages and epilepsy classifications. Using the EDR, we sought to identify key risk factors for SUDEP in children to assist the development of preventive measures. METHODS All registrations between the ages of 1 and 16 years were reviewed to identify definite or probable SUDEP. These cases were analysed to identify common demographics, comorbidities, monitoring, treatments and circumstances near to the deaths. RESULTS We identified forty-six cases (27 males) of definite or probable SUDEP. Paediatric SUDEP is more common in a 12- to 16-year age group and in those with neuro-disability. Most paediatric SUDEP occurs during apparent sleep. There were four cases with a vagus nerve stimulator. SUDEP can occur early after the onset of seizures. CONCLUSIONS This is the largest single cohort of SUDEP reported in children. Reports from caregivers can augment population data. Surveillance in sleep is a priority area of development.
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Affiliation(s)
| | - Yun Young Choi
- Wonju College of Medicine Yonsei University Wonju South Korea
| | - Elaine Hughes
- Paediatric Neurosciences Evelina London Children’s Hospital London UK
| | | | | | - Mike P. Kerr
- Psychological Medicine and Clinical Neurosciences Cardiff University Cardiff UK
| | - Rhys H. Thomas
- Royal Victoria Infirmary Newcastle‐upon‐Tyne UK
- Translational and Clinical Research Institute Newcastle University Newcastle UK
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Abstract
The bedrock of clinical medicine is effective communication. A generation ago, this was primarily the clinical consultation, the letter to the general practitioner, and the occasional scientific paper. In 2019, the avenues and opportunities for communication have exploded and include a pantheon of new and social media. We review the current state of how doctors use social media, and what can be gained by doing so. We provide strategies about how best to utilize these tools, depending on what you wish to gain. We discuss why every clinician needs a 'social media strategy' even if this is one of increasing your privacy levels and removing incorrect information from the web. We discuss the risks and harms of these newer forms of communication and how best to avoid embarrassment or censure. Social media fills an information vacuum, and in many ways, patients have embraced the opportunities with greater enthusiasm than have clinicians. To 'speak their language', we need to know how best to engage in social media.
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Affiliation(s)
- Mustafa Sultan
- Newcastle University, United Kingdom of Great Britain and Northern Ireland.
| | - Elen M Brown
- Nestlé UK, United Kingdom of Great Britain and Northern Ireland.
| | - Rhys H Thomas
- Institute of Neuroscience, Newcastle University, United Kingdom of Great Britain and Northern Ireland; Royal Victoria Infirmary, Newcastle-upon-Tyne, United Kingdom of Great Britain and Northern Ireland.
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44
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Crow YJ, Marshall H, Rice GI, Seabra L, Jenkinson EM, Baranano K, Battini R, Berger A, Blair E, Blauwblomme T, Bolduc F, Boddaert N, Buckard J, Burnett H, Calvert S, Caumes R, Ng ACH, Chiang D, Clifford DB, Cordelli DM, de Burca A, Demic N, Desguerre I, De Waele L, Di Fonzo A, Dunham SR, Dyack S, Elmslie F, Ferrand M, Fisher G, Karimiani EG, Ghoumid J, Gibbon F, Goel H, Hilmarsen HT, Hughes I, Jacob A, Jones EA, Kumar R, Leventer RJ, MacDonald S, Maroofian R, Mehta SG, Metz I, Monfrini E, Neumann D, Noetzel M, O'Driscoll M, Õunap K, Panzer A, Parikh S, Prabhakar P, Ramond F, Sandford R, Saneto R, Soh C, Stutterd CA, Subramanian GM, Talbot K, Thomas RH, Toro C, Touraine R, Wakeling E, Wassmer E, Whitney A, Livingston JH, O'Keefe RT, Badrock AP. Leukoencephalopathy with calcifications and cysts: Genetic and phenotypic spectrum. Am J Med Genet A 2021; 185:15-25. [PMID: 33029936 DOI: 10.1002/ajmg.a.61907] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/03/2020] [Accepted: 09/16/2020] [Indexed: 12/19/2022]
Abstract
Biallelic mutations in SNORD118, encoding the small nucleolar RNA U8, cause leukoencephalopathy with calcifications and cysts (LCC). Given the difficulty in interpreting the functional consequences of variants in nonprotein encoding genes, and the high allelic polymorphism across SNORD118 in controls, we set out to provide a description of the molecular pathology and clinical spectrum observed in a cohort of patients with LCC. We identified 64 affected individuals from 56 families. Age at presentation varied from 3 weeks to 67 years, with disease onset after age 40 years in eight patients. Ten patients had died. We recorded 44 distinct, likely pathogenic, variants in SNORD118. Fifty two of 56 probands were compound heterozygotes, with parental consanguinity reported in only three families. Forty nine of 56 probands were either heterozygous (46) or homozygous (three) for a mutation involving one of seven nucleotides that facilitate a novel intramolecular interaction between the 5' end and 3' extension of precursor-U8. There was no obvious genotype-phenotype correlation to explain the marked variability in age at onset. Complementing recently published functional analyses in a zebrafish model, these data suggest that LCC most often occurs due to combinatorial severe and milder mutations, with the latter mostly affecting 3' end processing of precursor-U8.
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Affiliation(s)
- Yanick J Crow
- Centre for Genomic and Experimental Medicine, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
- Laboratory of Neurogenetics and Neuroinflammation, Institut Imagine, Université de Paris, Paris, France
| | - Heather Marshall
- Centre for Genomic and Experimental Medicine, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Gillian I Rice
- Division of Evolution and Genomic Sciences, Faculty of Biology, Medicine and Health, School of Biological Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Luis Seabra
- Laboratory of Neurogenetics and Neuroinflammation, Institut Imagine, Université de Paris, Paris, France
| | - Emma M Jenkinson
- Division of Evolution and Genomic Sciences, Faculty of Biology, Medicine and Health, School of Biological Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Kristin Baranano
- Department of Neurology and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Roberta Battini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Andrea Berger
- Department of Neuropediatrics, Kliniken Nordoberpfalz AG, Germany
| | - Edward Blair
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Thomas Blauwblomme
- Paediatric Neurosurgery Department, Necker-Enfants Malades Hospital, APHP, Université de Paris, Paris, France
| | - Francois Bolduc
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Natalie Boddaert
- Paediatric Radiology Department, Hôpital Necker Enfants Malades, AP-HP, University de Paris, INSERM U1163, Institut Imagine, Paris, France
| | - Johannes Buckard
- Department of Neuropediatrics, Sozialpädiatrisches Zentrum am EVK Düsseldorf, Düsseldorf, Germany
| | | | - Sophie Calvert
- Neurosciences Department, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Roseline Caumes
- Clinique de Génétique Guy Fontaine, CHU Lille, Lille, France
| | - Andy Cheuk-Him Ng
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Diana Chiang
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - David B Clifford
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Duccio M Cordelli
- Child Neurology and Psychiatry Unit, Department of Medical and Surgical Sciences (DIMEC), S. Orsola Hospital, University of Bologna, Italy
| | - Anna de Burca
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Natasha Demic
- Department of Neurology, Vestfold Hospital, Tønsberg, Norway
| | - Isabelle Desguerre
- Department of Paediatric Neurology, Université de Paris, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Liesbeth De Waele
- Department of Paediatric Neurology, University Hospitals Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Alessio Di Fonzo
- Foundation IRCCS Ca 'Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - S Richard Dunham
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sarah Dyack
- Division of Medical Genetics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Frances Elmslie
- South West Thames Regional Genetics Service, St George's, University of London, London, UK
| | | | - Gemma Fisher
- Department of Paediatric Neurology, University Hospital of Wales, Cardiff, UK
| | - Ehsan Ghayoor Karimiani
- Molecular and Clinical Sciences Institute, St. George's University of London, London, UK
- Innovative Medical Research Center, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Jamal Ghoumid
- Clinique de Génétique Guy Fontaine, CHU Lille, Lille, France
| | - Frances Gibbon
- Department of Paediatric Neurology, University Hospital of Wales, Cardiff, UK
| | - Himanshu Goel
- Hunter Genetics, Hunter New England Local Health District, Waratah, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Hilde T Hilmarsen
- Department of Medical Genetics, Telemark Hospital Trust, Skien, Norway
| | - Imelda Hughes
- Department of Paediatric Neurology, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Anu Jacob
- Department of Neurology, The Walton Centre NHS Trust, Liverpool, UK
- Department of Neurology, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Elizabeth A Jones
- Division of Evolution and Genomic Sciences, Faculty of Biology, Medicine and Health, School of Biological Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- Clinical Genetic Service, Manchester Centre for Genomic Medicine, Saint Mary's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Ram Kumar
- Department of Paediatric Neurology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Richard J Leventer
- Department of Neurology Royal Children's Hospital, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Shelley MacDonald
- Maritime Medical Genetics, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Reza Maroofian
- Department of Neuromuscular Disorders, University College London Queen Square Institute of Neurology, London, UK
| | - Sarju G Mehta
- East Anglian Regional Genetics Service, Addenbrookes Hospital, Cambridge, UK
| | - Imke Metz
- Department of Neuropathology, University Medical Center, Georg August University, Göttingen, Germany
| | - Edoardo Monfrini
- Foundation IRCCS Ca 'Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Daniela Neumann
- Klinikum Wilhelmshaven, Department of Neuropediatrics, Germany
| | - Michael Noetzel
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Washington, USA
| | - Mary O'Driscoll
- West Midlands Regional Clinical Genetics Service, Birmingham Health Partners, Birmingham Women's Hospital NHS Foundation Trust, Birmingham, UK
| | - Katrin Õunap
- Department of Clinical Genetics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Department of Clinical Genetics, United Laboratories, Tartu University Hospital, Tartu, Estonia
| | - Axel Panzer
- Paediatric Neurology, DRK Kliniken Berlin-Westend, Berlin, Germany
| | - Sumit Parikh
- Neurogenetics Program, Center for Pediatric Neurology, Neurosciences Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Prab Prabhakar
- Department of Paediatric Neurology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Francis Ramond
- Service de Génétique, CHU-Hôpital Nord, Saint Etienne, France
| | - Richard Sandford
- Academic Department of Medical Genetics, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Russell Saneto
- Neuroscience Institute, Division of Paediatric Neurology, Seattle Children's Hospital and University of Washington, Seattle, Washington, USA
- Department of Neurology, Seattle Children's Hospital and University of Washington, Seattle, Washington, USA
| | - Calvin Soh
- Radiology Department, Manchester University Foundation NHS Trust, Manchester, UK
| | | | - Gopinath M Subramanian
- Department of Paediatric Neurology, John Hunter Children's Hospital, New Lambton Heights, New South Wales, Australia
| | - Kevin Talbot
- Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK
| | - Rhys H Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Camilo Toro
- NIH Undiagnosed Diseases Program (UDP), National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Renaud Touraine
- Neuroscience Institute, Division of Paediatric Neurology, Seattle Children's Hospital and University of Washington, Seattle, Washington, USA
| | - Emma Wakeling
- North East Thames Regional Genetics Service, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Evangeline Wassmer
- Department of Paediatric Neurology, Birmingham Children's Hospital, Birmingham, UK
| | - Andrea Whitney
- University Hospital Southampton NHS Foundation Trust, Department of Paediatric Neurology, Southampton, UK
| | - John H Livingston
- Department of Paediatric Neurology, Leeds General Infirmary, Leeds, UK
| | - Raymond T O'Keefe
- Division of Evolution and Genomic Sciences, Faculty of Biology, Medicine and Health, School of Biological Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Andrew P Badrock
- Centre for Genomic and Experimental Medicine, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
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45
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Shakeshaft A, Panjwani N, McDowall R, Crudgington H, Peña Ceballos J, Andrade DM, Beier CP, Fong CY, Gesche J, Greenberg DA, Hamandi K, Koht J, Lim KS, Orsini A, Rees MI, Rubboli G, Selmer KK, Smith AB, Striano P, Syvertsen M, Talvik I, Thomas RH, Zarubova J, Richardson MP, Strug LJ, Pal DK. Trait impulsivity in Juvenile Myoclonic Epilepsy. Ann Clin Transl Neurol 2020; 8:138-152. [PMID: 33264519 PMCID: PMC7818143 DOI: 10.1002/acn3.51255] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 01/22/2023] Open
Abstract
Objective Impulsivity is a multidimensional construct that can predispose to psychopathology. Meta‐analysis demonstrates an association between response impulsivity and Juvenile Myoclonic Epilepsy (JME), a common genetic generalized epilepsy. Here, we test the hypotheses that trait impulsivity is (i) elevated in JME compared to controls; (ii) moderated by specific seizure characteristics; and (iii) associated with psychiatric adverse effects of antiepileptic drugs (AEDs). Methods 322 participants with JME and 126 age and gender‐matched controls completed the Barratt’s Impulsiveness Scale (BIS‐brief) alongside information on seizure history and AED use. We compared group BIS‐brief scores and assessed associations of JME BIS‐brief scores with seizure characteristics and AED adverse effects. Results The mean BIS‐brief score in JME was 18.1 ± 4.4 compared with 16.2 ± 4.1 in controls (P = 0.0007). Elevated impulsivity was associated with male gender (P = 0.027), frequent absence seizures (P = 0.0004) and lack of morning predominance of myoclonus (P = 0.008). High impulsivity significantly increased the odds of a psychiatric adverse event on levetiracetam (P = 0.036), but not any other psychiatric or somatic adverse effects. Interpretation Trait impulsivity is elevated in JME and comparable to scores in personality and neurotic disorders. Increased seizure frequency and absence of circadian seizure pattern moderate BIS score, suggesting disruption of both cortico‐striatal and thalamocortical networks as a shared mechanism between seizures and impulsivity in JME. These findings warrant consideration of impulsivity as a distinct target of intervention, and as a stratifying factor for AED treatment in JME, and perhaps other types of epilepsy. The role of impulsivity in treatment adherence and psychosocial outcome requires further investigation.
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Affiliation(s)
- Amy Shakeshaft
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.,MRC Centre for Neurodevelopmental Disorders, King's College London, UK
| | | | - Robert McDowall
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Holly Crudgington
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Javier Peña Ceballos
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | | | | | - Choong Yi Fong
- Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | | | - Jeanette Koht
- Department of Neurology, Drammen Hospital, Vestre Viken Health Trust, Oslo, Norway.,University of Oslo, Oslo, Norway
| | - Kheng Seang Lim
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Alessandro Orsini
- Department of Clinical & Experimental Medicine, Pisa University Hospital, Italy
| | - Mark I Rees
- Neurology Research Group, Swansea University Medical School, UK
| | - Guido Rubboli
- Danish Epilepsy Centre, Dianalund, Denmark.,University of Copenhagen, Denmark
| | - Kaja K Selmer
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Norway.,National Centre for Epilepsy, Oslo University Hospital, Norway
| | - Anna B Smith
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Pasquale Striano
- IRCCS Istituto 'G. Gaslini', Genova, Italy.,University of Genova, Genova, Italy
| | - Marte Syvertsen
- Department of Neurology, Drammen Hospital, Vestre Viken Health Trust, Oslo, Norway
| | | | - Rhys H Thomas
- Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - Jana Zarubova
- Department of Neurology, Motol University Hospital, Prague, Czech Republic.,Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Mark P Richardson
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.,MRC Centre for Neurodevelopmental Disorders, King's College London, UK.,King's College Hospital, London, UK
| | | | - Deb K Pal
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.,MRC Centre for Neurodevelopmental Disorders, King's College London, UK.,King's College Hospital, London, UK.,Evelina London Children's Hospital, London, UK
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46
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Shankar R, Perera B, Thomas RH. Epilepsy, an orphan disorder within the neurodevelopmental family. J Neurol Neurosurg Psychiatry 2020; 91:1245-1247. [PMID: 32928935 DOI: 10.1136/jnnp-2020-324660] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/13/2020] [Accepted: 08/16/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Rohit Shankar
- Intellectual Disability Neuropsychiatry, Cornwall Partnership NHS Foundation Trust, Truro, UK .,Psychiatry and Neuroscience, University of Exeter Medical School, Truro, UK
| | - Bhathika Perera
- Learning Disability Services, Barnet Enfield and Haringey Mental Health NHS Trust, London, UK
| | - Rhys H Thomas
- Department of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.,Neurology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
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47
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Watson CJ, Thomas RH, Solomon T, Michael BD, Nicholson TR, Pollak TA. COVID-19 and psychosis risk: Real or delusional concern? Neurosci Lett 2020; 741:135491. [PMID: 33220366 DOI: 10.1016/j.neulet.2020.135491] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 11/03/2020] [Indexed: 02/07/2023]
Abstract
Historical epidemiological perspectives from past pandemics and recent neurobiological evidence link infections and psychoses, leading to concerns that COVID-19 will present a significant risk for the development of psychosis. But are these concerns justified, or mere sensationalism? In this article we review the historical associations between viral infection and the immune system more broadly in the development of psychosis, before critically evaluating the current evidence pertaining to SARS-CoV-2 and risk of psychosis as an acute or post-infectious manifestation of COVID-19. We review the 42 cases of psychosis reported in infected patients to date, and discuss the potential implications of in utero infection on subsequent neurodevelopment and psychiatric risk. Finally, in the context of the wider neurological and psychiatric manifestations of COVID-19 and our current understanding of the aetiology of psychotic disorders, we evaluate possible neurobiological and psychosocial mechanisms as well as the numerous challenges in ascribing a causal pathogenic role to the infection.
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Affiliation(s)
- Cameron J Watson
- Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London, UK.
| | - Rhys H Thomas
- Translational and Clinical Research Institute, University of Newcastle, UK; Royal Victoria Infirmary, Newcastle, UK
| | - Tom Solomon
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK; National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infection, University of Liverpool, UK; Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Zoological Science, University of Liverpool, UK
| | - Benedict Daniel Michael
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK; National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infection, University of Liverpool, UK; Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Zoological Science, University of Liverpool, UK
| | - Timothy R Nicholson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Thomas A Pollak
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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48
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Varatharaj A, Pollak TA, Nicholson TR, Coles JP, Benjamin LA, Carson A, Thomas RH, Michael BD. Characterising neuropsychiatric disorders in patients with COVID-19 - Authors' reply. Lancet Psychiatry 2020; 7:934-935. [PMID: 33069310 PMCID: PMC7561324 DOI: 10.1016/s2215-0366(20)30420-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Aravinthan Varatharaj
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Thomas A Pollak
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Timothy R Nicholson
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | | | - Laura A Benjamin
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Alan Carson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Rhys H Thomas
- Department of Neurology, Royal Victoria Infirmary, Newcastle, UK; Translational and Clinical Research Institute, University of Newcastle, Newcastle, UK
| | - Benedict D Michael
- The National Institute for Health Research Health Protection Research Unit for Emerging and Zoonotic Infections, Liverpool, UK; Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Sciences, University of Liverpool, Liverpool, UK; The Walton Centre NHS Foundation Trust, Liverpool, UK.
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49
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Larivière S, Rodríguez-Cruces R, Royer J, Caligiuri ME, Gambardella A, Concha L, Keller SS, Cendes F, Yasuda C, Bonilha L, Gleichgerrcht E, Focke NK, Domin M, von Podewills F, Langner S, Rummel C, Wiest R, Martin P, Kotikalapudi R, O'Brien TJ, Sinclair B, Vivash L, Desmond PM, Alhusaini S, Doherty CP, Cavalleri GL, Delanty N, Kälviäinen R, Jackson GD, Kowalczyk M, Mascalchi M, Semmelroch M, Thomas RH, Soltanian-Zadeh H, Davoodi-Bojd E, Zhang J, Lenge M, Guerrini R, Bartolini E, Hamandi K, Foley S, Weber B, Depondt C, Absil J, Carr SJA, Abela E, Richardson MP, Devinsky O, Severino M, Striano P, Tortora D, Hatton SN, Vos SB, Duncan JS, Whelan CD, Thompson PM, Sisodiya SM, Bernasconi A, Labate A, McDonald CR, Bernasconi N, Bernhardt BC. Network-based atrophy modeling in the common epilepsies: A worldwide ENIGMA study. Sci Adv 2020; 6:6/47/eabc6457. [PMID: 33208365 PMCID: PMC7673818 DOI: 10.1126/sciadv.abc6457] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 10/05/2020] [Indexed: 06/10/2023]
Abstract
Epilepsy is increasingly conceptualized as a network disorder. In this cross-sectional mega-analysis, we integrated neuroimaging and connectome analysis to identify network associations with atrophy patterns in 1021 adults with epilepsy compared to 1564 healthy controls from 19 international sites. In temporal lobe epilepsy, areas of atrophy colocalized with highly interconnected cortical hub regions, whereas idiopathic generalized epilepsy showed preferential subcortical hub involvement. These morphological abnormalities were anchored to the connectivity profiles of distinct disease epicenters, pointing to temporo-limbic cortices in temporal lobe epilepsy and fronto-central cortices in idiopathic generalized epilepsy. Negative effects of age on atrophy further revealed a strong influence of connectome architecture in temporal lobe, but not idiopathic generalized, epilepsy. Our findings were reproduced across individual sites and single patients and were robust across different analytical methods. Through worldwide collaboration in ENIGMA-Epilepsy, we provided deeper insights into the macroscale features that shape the pathophysiology of common epilepsies.
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Affiliation(s)
- Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Raúl Rodríguez-Cruces
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Jessica Royer
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | | | - Antonio Gambardella
- Neuroscience Research Center, University Magna Græcia, Catanzaro, CZ, Italy
- Institute of Neurology, University Magna Græcia, Catanzaro, CZ, Italy
| | - Luis Concha
- Institute of Neurobiology, Universidad Nacional Autónoma de México, Querétaro, México
| | - Simon S Keller
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Fernando Cendes
- Department of Neurology, University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
| | - Clarissa Yasuda
- Department of Neurology, University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
| | | | - Niels K Focke
- Department of Clinical Neurophysiology, University of Medicine Göttingen, Göttingen, Germany
| | - Martin Domin
- Institute of Diagnostic Radiology and Neuroradiology, Functional Imaging Unit, University Medicine Greifswald, Greifswald, Germany
| | - Felix von Podewills
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Soenke Langner
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Christian Rummel
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Raviteja Kotikalapudi
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Terence J O'Brien
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Patricia M Desmond
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Saud Alhusaini
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Colin P Doherty
- Department of Neurology, St. James' Hospital, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Gianpiero L Cavalleri
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Norman Delanty
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Reetta Kälviäinen
- Epilepsy Center, Neuro Center, Kuopio University Hospital, European Reference Network for Rare and Complex Epilepsies EpiCARE, Kuopio, Finland
- Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Graeme D Jackson
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Magdalena Kowalczyk
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Mario Mascalchi
- Neuroradiology Research Program, Meyer Children Hospital of Florence, University of Florence, Florence, Italy
| | - Mira Semmelroch
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Rhys H Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Hamid Soltanian-Zadeh
- Control and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
- Departments of Research Administration and Radiology, Henry Ford Health System, Detroit, MI, USA
| | | | - Junsong Zhang
- Cognitive Science Department, Xiamen University, Xiamen, China
| | - Matteo Lenge
- Child Neurology Unit and Laboratories, Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy
- Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, Children's Hospital A. Meyer-University of Florence, Italy
| | - Renzo Guerrini
- Child Neurology Unit and Laboratories, Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy
| | - Emanuele Bartolini
- USL Centro Toscana, Neurology Unit, Nuovo Ospedale Santo Stefano, Prato, Italy
| | - Khalid Hamandi
- Cardiff University Brain Research Imaging Centre (CUBRIC), College of Biomedical Sciences, Cardiff University, Cardiff, UK
- Welsh Epilepsy Unit, Department of Neurology, University Hospital of Wales, Cardiff, UK
| | - Sonya Foley
- Welsh Epilepsy Unit, Department of Neurology, University Hospital of Wales, Cardiff, UK
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University Hospital Bonn, Bonn, Germany
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Julie Absil
- Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Sarah J A Carr
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Eugenio Abela
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mark P Richardson
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Orrin Devinsky
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
| | | | | | | | - Sean N Hatton
- Department of Neurosciences, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, USA
| | - Sjoerd B Vos
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
- Centre for Medical Image Computing, University College London, London, UK
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - Christopher D Whelan
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Sanjay M Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Angelo Labate
- Neuroscience Research Center, University Magna Græcia, Catanzaro, CZ, Italy
- Institute of Neurology, University Magna Græcia, Catanzaro, CZ, Italy
| | - Carrie R McDonald
- Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, USA
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Boris C Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada.
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Galer PD, Ganesan S, Lewis-Smith D, McKeown SE, Pendziwiat M, Helbig KL, Ellis CA, Rademacher A, Smith L, Poduri A, Seiffert S, von Spiczak S, Muhle H, van Baalen A, Thomas RH, Krause R, Weber Y, Helbig I, Thomas RH, Krause R, Weber Y, Helbig I. Semantic Similarity Analysis Reveals Robust Gene-Disease Relationships in Developmental and Epileptic Encephalopathies. Am J Hum Genet 2020; 107:683-697. [PMID: 32853554 PMCID: PMC7536581 DOI: 10.1016/j.ajhg.2020.08.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 07/31/2020] [Indexed: 12/21/2022] Open
Abstract
More than 100 genetic etiologies have been identified in developmental and epileptic encephalopathies (DEEs), but correlating genetic findings with clinical features at scale has remained a hurdle because of a lack of frameworks for analyzing heterogenous clinical data. Here, we analyzed 31,742 Human Phenotype Ontology (HPO) terms in 846 individuals with existing whole-exome trio data and assessed associated clinical features and phenotypic relatedness by using HPO-based semantic similarity analysis for individuals with de novo variants in the same gene. Gene-specific phenotypic signatures included associations of SCN1A with “complex febrile seizures” (HP: 0011172; p = 2.1 × 10−5) and “focal clonic seizures” (HP: 0002266; p = 8.9 × 10−6), STXBP1 with “absent speech” (HP: 0001344; p = 1.3 × 10−11), and SLC6A1 with “EEG with generalized slow activity” (HP: 0010845; p = 0.018). Of 41 genes with de novo variants in two or more individuals, 11 genes showed significant phenotypic similarity, including SCN1A (n = 16, p < 0.0001), STXBP1 (n = 14, p = 0.0021), and KCNB1 (n = 6, p = 0.011). Including genetic and phenotypic data of control subjects increased phenotypic similarity for all genetic etiologies, whereas the probability of observing de novo variants decreased, emphasizing the conceptual differences between semantic similarity analysis and approaches based on the expected number of de novo events. We demonstrate that HPO-based phenotype analysis captures unique profiles for distinct genetic etiologies, reflecting the breadth of the phenotypic spectrum in genetic epilepsies. Semantic similarity can be used to generate statistical evidence for disease causation analogous to the traditional approach of primarily defining disease entities through similar clinical features.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Rhys H Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne NE1 7RU, UK; Royal Victoria Infirmary, Newcastle-upon-Tyne NE1 4LP, UK
| | - Roland Krause
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, 4367 Belvaux, Luxembourg
| | - Yvonne Weber
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany; Department of Epileptology and Neurology, University of Aachen, 52074 Aachen, Germany
| | - Ingo Helbig
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Department of Biomedical and Health Informatics (DBHi), Children's Hospital of Philadelphia, Philadelphia, PA 19146, USA; Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA.
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