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Royer-Bertrand, B; Jequier, Gygax, M; Cisarova, K; Rosenfeld, JA; Bassetti, JA; Moldovan, O; O'Heir, E; Burrage, LC; Allen, J; Emrick, LT; Eastman, E; Kumps, C; Abbas, S; Van, Winckel, G; Chabane, N; Zackai, EH; Lebon, S; Keena, B; Bhoj, EJ; Umair, M; Li, D; Donald, KA; Superti-Furga, A, , Undiagnosed, Diseases, Network.
De novo variants in CACNA1E found in patients with intellectual disability, developmental regression and social cognition deficit but no seizures.
Mol Autism. 2021; 12(1): 69 Doi: 10.1186/s13229-021-00473-3 [OPEN ACCESS]
Web of Science PubMed PUBMED Central FullText FullText_MUG

 

Führende Autor*innen der Med Uni Graz
Vizar Cisarova Katarina
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Abstract:
BACKGROUND: De novo variants in the voltage-gated calcium channel subunit α1 E gene (CACNA1E) have been described as causative of epileptic encephalopathy with contractures, macrocephaly and dyskinesias. METHODS: Following the observation of an index patient with developmental delay and autism spectrum disorder (ASD) without seizures who had a de novo deleterious CACNA1E variant, we screened GeneMatcher for other individuals with CACNA1E variants and neurodevelopmental phenotypes without epilepsy. The spectrum of pathogenic CACNA1E variants was compared to the mutational landscape of variants in the gnomAD control population database. RESULTS: We identified seven unrelated individuals with intellectual disability, developmental regression and ASD-like behavioral profile, and notably without epilepsy, who had de novo heterozygous putatively pathogenic variants in CACNA1E. Age of onset of clinical manifestation, presence or absence of regression and degree of severity were variable, and no clear-cut genotype-phenotype association could be recognized. The analysis of disease-associated variants and their comparison to benign variants from the control population allowed for the identification of regions in the CACNA1E protein that seem to be intolerant to substitutions and thus more likely to harbor pathogenic variants. As in a few reported cases with CACNA1E variants and epilepsy, one patient showed a positive clinical behavioral response to topiramate, a specific calcium channel modulator. LIMITATIONS: The significance of our study is limited by the absence of functional experiments of the effect of identified variants, the small sample size and the lack of systematic ASD assessment in all participants. Moreover, topiramate was given to one patient only and for a short period of time. CONCLUSIONS: Our results indicate that CACNA1E variants may result in neurodevelopmental disorders without epilepsy and expand the mutational and phenotypic spectrum of this gene. CACNA1E deserves to be included in gene panels for non-specific developmental disorders, including ASD, and not limited to patients with seizures, to improve diagnostic recognition and explore the possible efficacy of topiramate.
Find related publications in this database (using NLM MeSH Indexing)
Autism Spectrum Disorder - genetics
Calcium Channels, R-Type - genetics
Cation Transport Proteins - genetics
Child - administration & dosage
Developmental Disabilities - administration & dosage
Humans - administration & dosage
Intellectual Disability - genetics
Phenotype - administration & dosage
Seizures - genetics
Social Cognition - administration & dosage

Find related publications in this database (Keywords)
Autism spectrum disorder
CACNA1E
Developmental regression
Epilepsy
Exome sequencing
Global developmental delay
Intellectual disability
Neurodevelopmental disorders
Seizures
Topiramate
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