lunes, 25 de agosto de 2014

Somatic Mutations in Cerebral Cortical Malformations — NEJM

Somatic Mutations in Cerebral Cortical Malformations — NEJM



Somatic Mutations in Cerebral Cortical Malformations

Saumya S. Jamuar, M.R.C.P.C.H., Anh-Thu N. Lam, B.S., Martin Kircher, Ph.D., Alissa M. D’Gama, B.A., Jian Wang, Ph.D., Brenda J. Barry, M.S., Xiaochang Zhang, Ph.D., Robert Sean Hill, Ph.D., Jennifer N. Partlow, M.S., Aldo Rozzo, D.V.M., Ph.D., Sarah Servattalab, B.S., Bhaven K. Mehta, M.A., Meral Topcu, Ph.D., Dina Amrom, M.D., Eva Andermann, M.D., Ph.D., Bernard Dan, Ph.D., Elena Parrini, Ph.D., Renzo Guerrini, M.D., Ingrid E. Scheffer, M.B., B.S., Ph.D., Samuel F. Berkovic, M.D., Richard J. Leventer, M.B., B.S., Ph.D., Yiping Shen, Ph.D., Bai Lin Wu, Ph.D., A. James Barkovich, M.D., Mustafa Sahin, M.D., Ph.D., Bernard S. Chang, M.D., Michael Bamshad, M.D., Deborah A. Nickerson, Ph.D., Jay Shendure, M.D., Ph.D., Annapurna Poduri, M.D., M.P.H., Timothy W. Yu, M.D., Ph.D., and Christopher A. Walsh, M.D., Ph.D.
N Engl J Med 2014; 371:733-743August 21, 2014DOI: 10.1056/NEJMoa1314432
Abstract
Article
References

BACKGROUND

Although there is increasing recognition of the role of somatic mutations in genetic disorders, the prevalence of somatic mutations in neurodevelopmental disease and the optimal techniques to detect somatic mosaicism have not been systematically evaluated.

METHODS

Using a customized panel of known and candidate genes associated with brain malformations, we applied targeted high-coverage sequencing (depth, ≥200×) to leukocyte-derived DNA samples from 158 persons with brain malformations, including the double-cortex syndrome (subcortical band heterotopia, 30 persons), polymicrogyria with megalencephaly (20), periventricular nodular heterotopia (61), and pachygyria (47). We validated candidate mutations with the use of Sanger sequencing and, for variants present at unequal read depths, subcloning followed by colony sequencing.

RESULTS

Validated, causal mutations were found in 27 persons (17%; range, 10 to 30% for each phenotype). Mutations were somatic in 8 of the 27 (30%), predominantly in persons with the double-cortex syndrome (in whom we found mutations in DCX and LIS1), persons with periventricular nodular heterotopia (FLNA), and persons with pachygyria (TUBB2B). Of the somatic mutations we detected, 5 (63%) were undetectable with the use of traditional Sanger sequencing but were validated through subcloning and subsequent sequencing of the subcloned DNA. We found potentially causal mutations in the candidate genes DYNC1H1KIF5C, and other kinesin genes in persons with pachygyria.

CONCLUSIONS

Targeted sequencing was found to be useful for detecting somatic mutations in patients with brain malformations. High-coverage sequencing panels provide an important complement to whole-exome and whole-genome sequencing in the evaluation of somatic mutations in neuropsychiatric disease. (Funded by the National Institute of Neurological Disorders and Stroke and others.)

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