Volume 77, Issue 6 pp. 972-986
Research Article

Rare variants in γ-aminobutyric acid type A receptor genes in rolandic epilepsy and related syndromes

Eva M. Reinthaler PhD

Eva M. Reinthaler PhD

Department of Neurology, Medical University of Vienna, Vienna, Austria

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Borislav Dejanovic PhD

Borislav Dejanovic PhD

Institute of Biochemistry, Department of Chemistry, University of Cologne, Cologne, Germany

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Dennis Lal PhD

Dennis Lal PhD

Department of Neuropediatrics, University Medical Center Giessen and Marburg, Giessen, Germany

Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany

Cologne Center for Genomics, University of Cologne, Cologne, Germany

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Marcus Semtner PhD

Marcus Semtner PhD

RNA Editing and Hyperexcitability Disorders Helmholtz Group, Max Delbrück Center for Molecular Medicine, Berlin, Germany

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Yvonne Merkler MSc

Yvonne Merkler MSc

Institute of Biochemistry, Department of Chemistry, University of Cologne, Cologne, Germany

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Annika Reinhold

Annika Reinhold

RNA Editing and Hyperexcitability Disorders Helmholtz Group, Max Delbrück Center for Molecular Medicine, Berlin, Germany

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Dorothea A. Pittrich BSc

Dorothea A. Pittrich BSc

Department of Neurology, Medical University of Vienna, Vienna, Austria

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Christoph Hotzy BSc

Christoph Hotzy BSc

Department of Neurology, Medical University of Vienna, Vienna, Austria

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Martha Feucht MD

Martha Feucht MD

Department of Pediatrics, Medical University of Vienna, Vienna, Austria

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Hannelore Steinböck MD

Hannelore Steinböck MD

Private Practice of Pediatrics, Vienna, Austria

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Ursula Gruber-Sedlmayr MD

Ursula Gruber-Sedlmayr MD

Department of Pediatrics, Medical University of Graz, Graz, Austria

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Gabriel M. Ronen MD

Gabriel M. Ronen MD

Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada

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Birgit Neophytou MD

Birgit Neophytou MD

Department of Neuropediatrics, St Anna Children's Hospital, Vienna, Austria

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Julia Geldner MD

Julia Geldner MD

Department of Pediatrics, SMZ Süd - Kaiser-Franz-Josef-Hospital, Vienna, Austria

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Edda Haberlandt MD

Edda Haberlandt MD

Department of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria

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Hiltrud Muhle MD

Hiltrud Muhle MD

Department of Neuropediatrics, University Medical Center Schleswig-Holstein, Christian Albrechts University, Kiel, Germany

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M. Arfan Ikram MD, PhD

M. Arfan Ikram MD, PhD

Departments of Epidemiology, Neurology, and Radiology, Erasmus Medical Center, Rotterdam, the Netherlands

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Cornelia M. van Duijn PhD

Cornelia M. van Duijn PhD

Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands

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Andre G. Uitterlinden PhD

Andre G. Uitterlinden PhD

Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands

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Albert Hofman MD, PhD

Albert Hofman MD, PhD

Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands

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Janine Altmüller MD

Janine Altmüller MD

Cologne Center for Genomics, University of Cologne, Cologne, Germany

Institute of Human Genetics, University of Cologne, Cologne, Germany

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Amit Kawalia MSc

Amit Kawalia MSc

Cologne Center for Genomics, University of Cologne, Cologne, Germany

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Mohammad R. Toliat PhD

Mohammad R. Toliat PhD

Cologne Center for Genomics, University of Cologne, Cologne, Germany

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EuroEPINOMICS Consortium

EuroEPINOMICS Consortium

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Peter Nürnberg PhD

Peter Nürnberg PhD

Cologne Center for Genomics, University of Cologne, Cologne, Germany

Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany

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Holger Lerche MD

Holger Lerche MD

Department of Neurology and Epileptology, Hertie Institute of Clinical Brain Research, University of Tübingen, Tübingen, Germany

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Michael Nothnagel PhD

Michael Nothnagel PhD

Cologne Center for Genomics, University of Cologne, Cologne, Germany

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Holger Thiele MD

Holger Thiele MD

Cologne Center for Genomics, University of Cologne, Cologne, Germany

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Thomas Sander MD

Thomas Sander MD

Cologne Center for Genomics, University of Cologne, Cologne, Germany

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Jochen C. Meier PhD

Jochen C. Meier PhD

RNA Editing and Hyperexcitability Disorders Helmholtz Group, Max Delbrück Center for Molecular Medicine, Berlin, Germany

Braunschweig University of Technology, Zoological Institute, Division of Cell Physiology, Braunschweig, Germany

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Günter Schwarz PhD

Günter Schwarz PhD

Institute of Biochemistry, Department of Chemistry, University of Cologne, Cologne, Germany

Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany

Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany

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Bernd A. Neubauer MD

Bernd A. Neubauer MD

Department of Neuropediatrics, University Medical Center Giessen and Marburg, Giessen, Germany

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Fritz Zimprich MD, PhD

Corresponding Author

Fritz Zimprich MD, PhD

Department of Neurology, Medical University of Vienna, Vienna, Austria

Address correspondence to Dr Zimprich, Department of Neurology, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria. E-mail: [email protected]Search for more papers by this author
First published: 27 February 2015
Citations: 56

Members of the EuroEPINOMICS Consortium are listed in the Appendix on page 985.

Abstract

Objective

To test whether mutations in γ-aminobutyric acid type A receptor (GABAA-R) subunit genes contribute to the etiology of rolandic epilepsy (RE) or its atypical variants (ARE).

Methods

We performed exome sequencing to compare the frequency of variants in 18 GABAA-R genes in 204 European patients with RE/ARE versus 728 platform-matched controls. Identified GABRG2 variants were functionally assessed for protein stability, trafficking, postsynaptic clustering, and receptor function.

Results

Of 18 screened GABAA-R genes, we detected an enrichment of rare variants in the GABRG2 gene in RE/ARE patients (5 of 204, 2.45%) in comparison to controls (1 of 723, 0.14%; odds ratio = 18.07, 95% confidence interval = 2.01–855.07, p = 0.0024, pcorr = 0.043). We identified a GABRG2 splice variant (c.549-3T>G) in 2 unrelated patients as well as 3 nonsynonymous variations in this gene (p.G257R, p.R323Q, p.I389V). Functional assessment showed reduced surface expression of p.G257R and decreased GABA-evoked currents for p.R323Q. The p.G257R mutation displayed diminished levels of palmitoylation, a post-translational modification crucial for trafficking of proteins to the cell membrane. Enzymatically raised palmitoylation levels restored the surface expression of the p.G257R variant γ2 subunit.

Interpretation

The statistical association and the functional evidence suggest that mutations of the GABRG2 gene may increase the risk of RE/ARE. Restoring the impaired membrane trafficking of some GABRG2 mutations by enhancing palmitoylation might be an interesting therapeutic approach to reverse the pathogenic effect of such mutants. Ann Neurol 2015;77:972–986

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