Publications
medRxiv : the preprint server for health sciencesFeb 2025 DOI:
10.1101/2025.02.10.25321755

Variants in BSN , encoding the presynaptic protein Bassoon, result in a novel neurodevelopmental disorder with a broad phenotypic range

Guzman, Stacy G; Ruggiero, Sarah M; Ganesan, Shiva; Ellis, Colin A; Harrison, Alicia G; Sullivan, Katie R; Stark, Zornitza; Brown, Natasha J; Kana, Sajel L; Tuttle, Anabelle; Tenorio, Jair; Lapunzina, Pablo; Nevado, Julián; McDonald, Marie T; Jensen, Courtney; Wheeler, Patricia G; Stange, Lila; Morrison, Jennifer; Keren, Boris; Heide, Solveig; Keating, Meg W; Butler, Kameryn M; Lyons, Mike A; Jain, Shailly; Yeganeh, Mehdi; Thompson, Michelle L; Schroeder, Molly; Nguyen, Hoanh; Granadillo, Jorge; Johnston, Kari M; Murali, Chaya N; Bosanko, Katie; Burrow, T Andrew; CHOP Birth Defects Biorepository, ; Penn Medicine Biobank, ; Morgan, Syreeta; Watson, Deborah J; Hakonarson, Hakon; Helbig, Ingo
Product Used
Genes
Abstract
Disease-causing variants in synaptic function genes are a common cause of neurodevelopmental disorders and epilepsy. Here, we describe 14 individuals with de novo disruptive variants in BSN , which encodes the presynaptic protein Bassoon. To expand the phenotypic spectrum, we identified 15 additional individuals with protein-truncating variants (PTVs) from large biobanks. Clinical features were standardized using the Human Phenotype Ontology (HPO) across all 29 individuals, which revealed common clinical characteristics including epilepsy (13/29 45%), febrile seizures (7/29 25%), generalized tonic-clonic seizures (5/29 17%), and focal onset seizures (3/29 10%). Behavioral phenotypes were present in almost half of all individuals (14/29 48%), which comprised ADHD (7/29 25%) and autistic behavior (5/29 17%). Additional common features included developmental delay (11/29 38%), obesity (10/29 34%), and delayed speech (8/29 28%). In adults with BSN PTVs, milder features were common, suggesting phenotypic variability including a range of individuals without obvious neurodevelopmental features (7/29 24%). To detect gene-specific signatures, we performed association analysis in a cohort of 14,895 individuals with neurodevelopmental disorders (NDDs). A total of 66 clinical features were associated with BSN , including febrile seizures (p=1.26e-06) and behavioral disinhibition (p = 3.39e-17). Furthermore, individuals carrying BSN variants were phenotypically more similar than expected by chance (p=0.00014), exceeding phenotypic relatedness in 179/256 NDD-related conditions. In summary, integrating information derived from community-based gene matching and large data repositories through computational phenotyping approaches, we identify BSN variants as the cause of a new class of synaptic disorder with a broad phenotypic range across the age spectrum.
Product Used
Genes

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