Gavaz Meral, Aslan Elif S, Tekeş Selahattin
Department of Molecular and Medical Genetics, Biruni University, Istanbul, Turkey.
Faculty of Medicine, Department of Medical Genetics, Dicle University, Diyarbakir, Turkey.
J Neurogenet. 2024 Dec;38(4):187-194. doi: 10.1080/01677063.2024.2434869. Epub 2024 Dec 9.
The swift updates of public databases and advancements in next-generation sequencing (NGS) technologies have enhanced the genetic identification capacities of epilepsy clinics. This study aimed to evaluate the diagnostic efficacy of NGS in pediatric epilepsy patients as a whole and to present the data obtained in the whole exome sequence analysis. We enrolled 40 children with suspected childhood epilepsy in this study. All patients underwent evaluation by a clinical geneticist or pediatric neurologist and the molecular genetic analysis of those children was performed by whole-exome sequencing (WES). Out of the 40 patients, 12 (30%) received a genetic diagnosis, involving 14 mutations across 13 genes. The cumulative positive diagnostic yield was 30%. Twelve of these patients were identified to have 5 variants previously documented as pathogenic, 9 variants classified as likely pathogenic, and 5 novel variants that have not been reported before. The outcomes indicate that whole-exome sequencing offers great benefits in clinical patient diagnosis, particularly in terms of detecting diagnostic variants. This study underscored the significance of whole exome sequencing (WES) studies, where only a broad gene set is examined in epilepsy patients. This approach has the potential to establish gene-specific phenotypic profiles, particularly by uncovering novel candidate genes in epilepsy patients with well-defined phenotypes. Additionally, conducting validation studies on variants of uncertain clinical significance could enhance the outcome yield.
公共数据库的迅速更新以及新一代测序(NGS)技术的进步提高了癫痫诊所的基因识别能力。本研究旨在评估NGS对小儿癫痫患者的整体诊断效果,并展示全外显子组序列分析所获得的数据。我们在本研究中纳入了40名疑似儿童癫痫的患儿。所有患者均接受了临床遗传学家或儿科神经科医生的评估,这些儿童的分子遗传学分析通过全外显子组测序(WES)进行。在这40例患者中,12例(30%)获得了基因诊断,涉及13个基因中的14个突变。累积阳性诊断率为30%。其中12例患者被鉴定出有5个先前记录为致病性的变异、9个被分类为可能致病性的变异以及5个以前未报道过的新变异。结果表明,全外显子组测序在临床患者诊断中具有很大益处,特别是在检测诊断性变异方面。本研究强调了全外显子组测序(WES)研究的重要性,在癫痫患者中仅检测一组广泛的基因。这种方法有可能建立基因特异性的表型谱,特别是通过在具有明确表型的癫痫患者中发现新的候选基因。此外,对临床意义不明确的变异进行验证研究可以提高诊断率。