Rare variants in γ-aminobutyric acid type A receptor genes in rolandic epilepsy and related syndromes
Eva M. Reinthaler PhD
Department of Neurology, Medical University of Vienna, Vienna, Austria
Search for more papers by this authorBorislav Dejanovic PhD
Institute of Biochemistry, Department of Chemistry, University of Cologne, Cologne, Germany
Search for more papers by this authorDennis 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
Search for more papers by this authorMarcus Semtner PhD
RNA Editing and Hyperexcitability Disorders Helmholtz Group, Max Delbrück Center for Molecular Medicine, Berlin, Germany
Search for more papers by this authorYvonne Merkler MSc
Institute of Biochemistry, Department of Chemistry, University of Cologne, Cologne, Germany
Search for more papers by this authorAnnika Reinhold
RNA Editing and Hyperexcitability Disorders Helmholtz Group, Max Delbrück Center for Molecular Medicine, Berlin, Germany
Search for more papers by this authorDorothea A. Pittrich BSc
Department of Neurology, Medical University of Vienna, Vienna, Austria
Search for more papers by this authorChristoph Hotzy BSc
Department of Neurology, Medical University of Vienna, Vienna, Austria
Search for more papers by this authorMartha Feucht MD
Department of Pediatrics, Medical University of Vienna, Vienna, Austria
Search for more papers by this authorHannelore Steinböck MD
Private Practice of Pediatrics, Vienna, Austria
Search for more papers by this authorUrsula Gruber-Sedlmayr MD
Department of Pediatrics, Medical University of Graz, Graz, Austria
Search for more papers by this authorGabriel M. Ronen MD
Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
Search for more papers by this authorBirgit Neophytou MD
Department of Neuropediatrics, St Anna Children's Hospital, Vienna, Austria
Search for more papers by this authorJulia Geldner MD
Department of Pediatrics, SMZ Süd - Kaiser-Franz-Josef-Hospital, Vienna, Austria
Search for more papers by this authorEdda Haberlandt MD
Department of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria
Search for more papers by this authorHiltrud Muhle MD
Department of Neuropediatrics, University Medical Center Schleswig-Holstein, Christian Albrechts University, Kiel, Germany
Search for more papers by this authorM. Arfan Ikram MD, PhD
Departments of Epidemiology, Neurology, and Radiology, Erasmus Medical Center, Rotterdam, the Netherlands
Search for more papers by this authorCornelia M. van Duijn PhD
Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
Search for more papers by this authorAndre G. Uitterlinden PhD
Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
Search for more papers by this authorAlbert Hofman MD, PhD
Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
Search for more papers by this authorJanine Altmüller MD
Cologne Center for Genomics, University of Cologne, Cologne, Germany
Institute of Human Genetics, University of Cologne, Cologne, Germany
Search for more papers by this authorAmit Kawalia MSc
Cologne Center for Genomics, University of Cologne, Cologne, Germany
Search for more papers by this authorMohammad R. Toliat PhD
Cologne Center for Genomics, University of Cologne, Cologne, Germany
Search for more papers by this authorEuroEPINOMICS Consortium
Search for more papers by this authorPeter 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
Search for more papers by this authorHolger Lerche MD
Department of Neurology and Epileptology, Hertie Institute of Clinical Brain Research, University of Tübingen, Tübingen, Germany
Search for more papers by this authorMichael Nothnagel PhD
Cologne Center for Genomics, University of Cologne, Cologne, Germany
Search for more papers by this authorHolger Thiele MD
Cologne Center for Genomics, University of Cologne, Cologne, Germany
Search for more papers by this authorThomas Sander MD
Cologne Center for Genomics, University of Cologne, Cologne, Germany
Search for more papers by this authorJochen 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
Search for more papers by this authorGünter 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
Search for more papers by this authorBernd A. Neubauer MD
Department of Neuropediatrics, University Medical Center Giessen and Marburg, Giessen, Germany
Search for more papers by this authorCorresponding 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 authorEva M. Reinthaler PhD
Department of Neurology, Medical University of Vienna, Vienna, Austria
Search for more papers by this authorBorislav Dejanovic PhD
Institute of Biochemistry, Department of Chemistry, University of Cologne, Cologne, Germany
Search for more papers by this authorDennis 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
Search for more papers by this authorMarcus Semtner PhD
RNA Editing and Hyperexcitability Disorders Helmholtz Group, Max Delbrück Center for Molecular Medicine, Berlin, Germany
Search for more papers by this authorYvonne Merkler MSc
Institute of Biochemistry, Department of Chemistry, University of Cologne, Cologne, Germany
Search for more papers by this authorAnnika Reinhold
RNA Editing and Hyperexcitability Disorders Helmholtz Group, Max Delbrück Center for Molecular Medicine, Berlin, Germany
Search for more papers by this authorDorothea A. Pittrich BSc
Department of Neurology, Medical University of Vienna, Vienna, Austria
Search for more papers by this authorChristoph Hotzy BSc
Department of Neurology, Medical University of Vienna, Vienna, Austria
Search for more papers by this authorMartha Feucht MD
Department of Pediatrics, Medical University of Vienna, Vienna, Austria
Search for more papers by this authorHannelore Steinböck MD
Private Practice of Pediatrics, Vienna, Austria
Search for more papers by this authorUrsula Gruber-Sedlmayr MD
Department of Pediatrics, Medical University of Graz, Graz, Austria
Search for more papers by this authorGabriel M. Ronen MD
Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
Search for more papers by this authorBirgit Neophytou MD
Department of Neuropediatrics, St Anna Children's Hospital, Vienna, Austria
Search for more papers by this authorJulia Geldner MD
Department of Pediatrics, SMZ Süd - Kaiser-Franz-Josef-Hospital, Vienna, Austria
Search for more papers by this authorEdda Haberlandt MD
Department of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria
Search for more papers by this authorHiltrud Muhle MD
Department of Neuropediatrics, University Medical Center Schleswig-Holstein, Christian Albrechts University, Kiel, Germany
Search for more papers by this authorM. Arfan Ikram MD, PhD
Departments of Epidemiology, Neurology, and Radiology, Erasmus Medical Center, Rotterdam, the Netherlands
Search for more papers by this authorCornelia M. van Duijn PhD
Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
Search for more papers by this authorAndre G. Uitterlinden PhD
Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
Search for more papers by this authorAlbert Hofman MD, PhD
Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
Search for more papers by this authorJanine Altmüller MD
Cologne Center for Genomics, University of Cologne, Cologne, Germany
Institute of Human Genetics, University of Cologne, Cologne, Germany
Search for more papers by this authorAmit Kawalia MSc
Cologne Center for Genomics, University of Cologne, Cologne, Germany
Search for more papers by this authorMohammad R. Toliat PhD
Cologne Center for Genomics, University of Cologne, Cologne, Germany
Search for more papers by this authorEuroEPINOMICS Consortium
Search for more papers by this authorPeter 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
Search for more papers by this authorHolger Lerche MD
Department of Neurology and Epileptology, Hertie Institute of Clinical Brain Research, University of Tübingen, Tübingen, Germany
Search for more papers by this authorMichael Nothnagel PhD
Cologne Center for Genomics, University of Cologne, Cologne, Germany
Search for more papers by this authorHolger Thiele MD
Cologne Center for Genomics, University of Cologne, Cologne, Germany
Search for more papers by this authorThomas Sander MD
Cologne Center for Genomics, University of Cologne, Cologne, Germany
Search for more papers by this authorJochen 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
Search for more papers by this authorGünter 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
Search for more papers by this authorBernd A. Neubauer MD
Department of Neuropediatrics, University Medical Center Giessen and Marburg, Giessen, Germany
Search for more papers by this authorCorresponding 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 authorMembers 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
Supporting Information
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References
- 1Gobbi G, Boni A, Filippini M. The spectrum of idiopathic Rolandic epilepsy syndromes and idiopathic occipital epilepsies: from the benign to the disabling. Epilepsia 2006; 47(suppl 2): 62–66.
- 2Guerrini R, Pellacani S. Benign childhood focal epilepsies. Epilepsia 2012; 53(suppl 4): 9–18.
- 3Fejerman N. Atypical rolandic epilepsy. Epilepsia 2009; 50(suppl 7): 9–12.
- 4Clarke T, Strug LJ, Murphy PL, et al. High risk of reading disability and speech sound disorder in rolandic epilepsy families: case-control study. Epilepsia 2007; 48: 2258–2265.
- 5Tovia E, Goldberg-Stern H, Ben Zeev B, et al. The prevalence of atypical presentations and comorbidities of benign childhood epilepsy with centrotemporal spikes. Epilepsia 2011; 52: 1483–1488.
- 6Kavros PM, Clarke T, Strug LJ, et al. Attention impairment in rolandic epilepsy: systematic review. Epilepsia 2008; 49: 1570–1580.
- 7Vears DF, Tsai MH, Sadleir LG, et al. Clinical genetic studies in benign childhood epilepsy with centrotemporal spikes. Epilepsia 2012; 53: 319–324.
- 8Lemke JR, Lal D, Reinthaler EM, et al. Mutations in GRIN2A cause idiopathic focal epilepsy with rolandic spikes. Nat Genet 2013; 45: 1067–1072.
- 9Lesca G, Rudolf G, Bruneau N, et al. GRIN2A mutations in acquired epileptic aphasia and related childhood focal epilepsies and encephalopathies with speech and language dysfunction. Nat Genet 2013; 45: 1061–1066.
- 10Carvill GL, Regan BM, Yendle SC, et al. GRIN2A mutations cause epilepsy-aphasia spectrum disorders. Nat Genet 2013; 45: 1073–1076.
- 11Lal D, Reinthaler EM, Schubert J, et al. DEPDC5 mutations in genetic focal epilepsies of childhood. Ann Neurol 2014; 75: 788–792.
- 12Lal D, Reinthaler EM, Altmuller J, et al. RBFOX1 and RBFOX3 mutations in rolandic epilepsy. PLoS One 2013; 8: e73323.
- 13Reinthaler EM, Lal D, Lebon S, et al. 16p11.2 600 kb duplications confer risk for typical and atypical rolandic epilepsy. Hum Mol Genet 2014; 23: 6069–6080.
- 14Winkelmann A, Maggio N, Eller J, et al. Changes in neural network homeostasis trigger neuropsychiatric symptoms. J Clin Invest 2014; 124: 696–711.
- 15Meier JC, Semtner M, Winkelmann A, Wolfart J. Presynaptic mechanisms of neuronal plasticity and their role in epilepsy. Front Cell Neurosci 2014; 8: 164.
- 16Luscher B, Fuchs T, Kilpatrick CL. GABAA receptor trafficking-mediated plasticity of inhibitory synapses. Neuron 2011; 70: 385–409.
- 17Galanopoulou AS. GABA(A) receptors in normal development and seizures: friends or foes? Curr Neuropharmacol 2008; 6: 1–20.
- 18Olsen RW, DeLorey TM, Gordey M, Kang MH. GABA receptor function and epilepsy. Adv Neurol 1999; 79: 499–510.
- 19De Deyn PP, Marescau B, MacDonald RL. Epilepsy and the GABA-hypothesis: a brief review and some examples. Acta Neurol Belg 1990; 90: 65–81.
- 20Macdonald RL, Kang JQ, Gallagher MJ. GABAA receptor subunit mutations and genetic epilepsies. In: JL Noebels, M Avoli, MA Rogawski, et al, eds. Jasper's basic mechanisms of the epilepsies. 4th ed. Bethesda, MD: National Center for Biotechnology Information, 2012.
10.1093/med/9780199746545.003.0057 Google Scholar
- 21Allen AS, Berkovic SF, Cossette P, et al. De novo mutations in epileptic encephalopathies. Nature 2013; 501: 217–221.
- 22Schweizer C, Balsiger S, Bluethmann H, et al. The gamma 2 subunit of GABA(A) receptors is required for maintenance of receptors at mature synapses. Mol Cell Neurosci 2003; 24: 442–450.
- 23Dejanovic B, Schwarz G. Neuronal nitric oxide synthase-dependent S-nitrosylation of gephyrin regulates gephyrin clustering at GABAergic synapses. J Neurosci 2014; 34: 7763–7768.
- 24Berg AT, Berkovic SF, Brodie MJ, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005–2009. Epilepsia 2010; 51: 676–685.
- 25Aicardi J, Chevrie JJ. Atypical benign partial epilepsy of childhood. Dev Med Child Neurol 1982; 24: 281–292.
- 26Doose H, Hahn A, Neubauer BA, et al. Atypical "benign" partial epilepsy of childhood or pseudo-Lennox syndrome. Part II: family study. Neuropediatrics 2001; 32: 9–13.
- 27Hahn A, Pistohl J, Neubauer BA, Stephani U. Atypical "benign" partial epilepsy or pseudo-Lennox syndrome. Part I: symptomatology and long-term prognosis. Neuropediatrics 2001; 32: 1–8.
- 28Hofman A, van Duijn CM, Franco OH, et al. The Rotterdam Study: 2012 objectives and design update. Eur J Epidemiol 2011; 26: 657–686.
- 29Purcell SM, Moran JL, Fromer M, et al. A polygenic burden of rare disruptive mutations in schizophrenia. Nature 2014; 506: 185–190.
- 30Yeo G, Burge CB. Maximum entropy modeling of short sequence motifs with applications to RNA splicing signals. J Comput Biol 2004; 11: 377–394.
- 31Liu X, Jian X, Boerwinkle E. dbNSFP v2.0: a database of human non-synonymous SNVs and their functional predictions and annotations. Hum Mutat 2013; 34: E2393–E2402.
- 32Jacob TC, Bogdanov YD, Magnus C, et al. Gephyrin regulates the cell surface dynamics of synaptic GABAA receptors. J Neurosci 2005; 25: 10469–10478.
- 33Dejanovic B, Semtner M, Ebert S, et al. Palmitoylation of gephyrin controls receptor clustering and plasticity of GABAergic synapses. PLoS Biol 2014; 12: e1001908.
- 34Fukata M, Fukata Y, Adesnik H, et al. Identification of PSD-95 palmitoylating enzymes. Neuron 2004; 44: 987–996.
- 35Dejanovic B, Lal D, Catarino CB, et al. Exonic microdeletions of the gephyrin gene impair GABAergic synaptic inhibition in patients with idiopathic generalized epilepsy. Neurobiol Dis 2014; 67: 88–96.
- 36Tanaka M, Olsen RW, Medina MT, et al. Hyperglycosylation and reduced GABA currents of mutated GABRB3 polypeptide in remitting childhood absence epilepsy. Am J Hum Genet 2008; 82: 1249–1261.
- 37Dibbens LM, Feng HJ, Richards MC, et al. GABRD encoding a protein for extra- or peri-synaptic GABAA receptors is a susceptibility locus for generalized epilepsies. Hum Mol Genet 2004; 13: 1315–1319.
- 38Miller PS, Aricescu AR. Crystal structure of a human GABAA receptor. Nature 2014; 512: 270–275.
- 39Kang JQ, Macdonald RL. The GABAA receptor gamma2 subunit R43Q mutation linked to childhood absence epilepsy and febrile seizures causes retention of alpha1beta2gamma2S receptors in the endoplasmic reticulum. J Neurosci 2004; 24: 8672–8677.
- 40Keller CA, Yuan X, Panzanelli P, et al. The gamma2 subunit of GABA(A) receptors is a substrate for palmitoylation by GODZ. J Neurosci 2004; 24: 5881–5891.
- 41Fang C, Deng L, Keller CA, et al. GODZ-mediated palmitoylation of GABA(A) receptors is required for normal assembly and function of GABAergic inhibitory synapses. J Neurosci 2006; 26: 12758–12768.
- 42De Rubeis S, He X, Goldberg AP, et al. Synaptic, transcriptional and chromatin genes disrupted in autism. Nature 2014; 515: 209–215.
- 43Johnston AJ, Kang JQ, Shen W, et al. A novel GABRG2 mutation, p.R136*, in a family with GEFS+ and extended phenotypes. Neurobiol Dis 2014; 64: 131–141.
- 44de Kovel CG, Trucks H, Helbig I, et al. Recurrent microdeletions at 15q11.2 and 16p13.11 predispose to idiopathic generalized epilepsies. Brain 2010; 133(pt 1): 23–32.
- 45Lal D, Trucks H, Moller RS, et al. Rare exonic deletions of the RBFOX1 gene increase risk of idiopathic generalized epilepsy. Epilepsia 2013; 54: 265–271.
- 46Moller RS, Weber YG, Klitten LL, et al. Exon-disrupting deletions of NRXN1 in idiopathic generalized epilepsy. Epilepsia 2013; 54: 256–264.
- 47Ottman R. Analysis of genetically complex epilepsies. Epilepsia 2005; 46(suppl 10): 7–14.
- 48Audenaert D, Schwartz E, Claeys KG, et al. A novel GABRG2 mutation associated with febrile seizures. Neurology 2006; 67: 687–690.
- 49Huang X, Hernandez CC, Hu N, Macdonald RL. Three epilepsy-associated GABRG2 missense mutations at the gamma+/beta- interface disrupt GABAA receptor assembly and trafficking by similar mechanisms but to different extents. Neurobiol Dis 2014; 68: 167–179.
- 50Fisher JL, Macdonald RL. Single channel properties of recombinant GABAA receptors containing gamma 2 or delta subtypes expressed with alpha 1 and beta 3 subtypes in mouse L929 cells. J Physiol 1997; 505(pt 2): 283–297.
- 51Angelotti TP, Macdonald RL. Assembly of GABAA receptor subunits: alpha 1 beta 1 and alpha 1 beta 1 gamma 2S subunits produce unique ion channels with dissimilar single-channel properties. J Neurosci 1993; 13: 1429–1440.
- 52Essrich C, Lorez M, Benson JA, et al. Postsynaptic clustering of major GABAA receptor subtypes requires the gamma 2 subunit and gephyrin. Nat Neurosci 1998; 1: 563–571.
- 53Li RW, Yu W, Christie S, et al. Disruption of postsynaptic GABA receptor clusters leads to decreased GABAergic innervation of pyramidal neurons. J Neurochem 2005; 95: 756–770.
- 54Rathenberg J, Kittler JT, Moss SJ. Palmitoylation regulates the clustering and cell surface stability of GABAA receptors. Mol Cell Neurosci 2004; 26: 251–257.
- 55Todd E, Gurba KN, Botzolakis EJ, et al. GABAA receptor biogenesis is impaired by the gamma2 subunit febrile seizure-associated mutation, GABRG2(R177G). Neurobiol Dis 2014; 69: 215–224.
- 56Mody I, Pearce RA. Diversity of inhibitory neurotransmission through GABA(A) receptors. Trends Neurosci 2004; 27: 569–575.
- 57Reid CA, Kim T, Phillips AM, et al. Multiple molecular mechanisms for a single GABAA mutation in epilepsy. Neurology 2013; 80: 1003–1008.
- 58Luscher B, Shen Q, Sahir N. The GABAergic deficit hypothesis of major depressive disorder. Mol Psychiatry 2011; 16: 383–406.
- 59Shen Q, Fuchs T, Sahir N, Luscher B. GABAergic control of critical developmental periods for anxiety- and depression-related behavior in mice. PloS One 2012; 7: e47441.
- 60Laurie DJ, Wisden W, Seeburg PH. The distribution of thirteen GABAA receptor subunit mRNAs in the rat brain. III. Embryonic and postnatal development. J Neurosci 1992; 12: 4151–4172.
- 61Noebels JL. The biology of epilepsy genes. Annu Rev Neurosci 2003; 26: 599–625.
- 62Goldberg EM, Coulter DA. Mechanisms of epileptogenesis: a convergence on neural circuit dysfunction. Nat Rev Neurosci 2013; 14: 337–349.