Publications
Expert review of molecular diagnosticsJan 2023 DOI:
10.1080/14737159.2023.2173578

Combined exome analysis and exome depth assessment achieves a high diagnostic yield in an epilepsy case series, revealing significant genomic heterogeneity and novel mechanisms

Veltra, Danai; Tilemis, Faidon-Nikolaos; Marinakis, Nikolaos M; Svingou, Maria; Mitrakos, Anastasios; Kosma, Konstantina; Tsoutsou, Irene; Makrythanasis, Periklis; Theodorou, Virginia; Katsalouli, Marina; Vorgia, Pelagia; Niotakis, Georgios; Vartzelis, Georgios; Dinopoulos, Argirios; Evangeliou, Athanasios; Mouskou, Stella; Korona, Anastasia; Mastroyianni, Sotiria; Papavasiliou, Antigone; Tzetis, Maria; Pons, Roser; Traeger-Synodinos, Joanne; Sofocleous, Christalena
Product Used
NGS
Abstract
The genetics of epilepsy are highly heterogenous and often complex. Lesions detected involve genes encoding various types of channels, transcription factors, and other proteins implicated in numerous cellular processes, such as synaptogenesis. Consequently, a wide spectrum of clinical presentations and overlapping phenotypes, hinders differential diagnosis and highlights the need for molecular investigations towards delineation of underlying mechanisms and final diagnosis. Characterization of defects may also contribute valuable data on genetic landscapes and networks implicated in epileptogenesis.This study reports on genetic findings from exome sequencing (ES) data of 107 patients with variable types of seizures, with or without additional symptoms, in the context of neurodevelopmental disorders.Multidisciplinary evaluation of ES, including ancillary detection of Copy Number Variants (CNVs) with the ExomeDepth tool, supported a definite diagnosis in 59.8% of the patients, reflecting one of the highest diagnostic yields in epilepsy.Emerging advances of next generation technologies and "in silico" analysis tools offer the possibility to simultaneously detect several types of variations. Wide assessment of variable findings, specifically those found to be novel and least expected, reflect the ever-evolving genetic landscape of seizure development, potentially beneficial for increased opportunities for trial recruitment and enrollment, and optimized, even personalized, medical management.
Product Used
NGS

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