{"id":71095,"date":"2024-04-02T15:43:23","date_gmt":"2024-04-02T13:43:23","guid":{"rendered":"https:\/\/cegat.com\/?p=71095"},"modified":"2025-02-07T10:10:45","modified_gmt":"2025-02-07T09:10:45","slug":"de-novo-variants-in-gabra4-are-associated-with-a-neurological-phenotype-including-developmental-delay-behavioral-abnormalities-and-epilepsy","status":"publish","type":"post","link":"https:\/\/cegat.com\/de\/de-novo-variants-in-gabra4-are-associated-with-a-neurological-phenotype-including-developmental-delay-behavioral-abnormalities-and-epilepsy\/","title":{"rendered":"De novo variants in GABRA4 are associated with a neurological phenotype including developmental delay, behavioral abnormalities and epilepsy"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\" style=\"--awb-font-size:24px;\"><p style=\"text-align: justify;\">Samin A Sajan <sup>#<\/sup> <sup>1<\/sup>, Ralph Gradisch <sup>#<\/sup> <sup>2<\/sup> <sup>3<\/sup>, Florian D Vogel <sup>4<\/sup>, Alison J Coffey <sup>5<\/sup>, Daria Salyakina <sup>6<\/sup>, Diana Soler <sup>6<\/sup>, Parul Jayakar <sup>7<\/sup>, Anuj Jayakar <sup>8<\/sup>, Simona E Bianconi <sup>9<\/sup>, Annina H Cooper <sup>9<\/sup>, Shuxi Liu <sup>10<\/sup>, Nancy William <sup>11<\/sup>, Ira Benkel-Herrenbr\u00fcck <sup>12<\/sup>, Robert Maiwald <sup>13<\/sup>, Corina Heller <sup>14<\/sup>, Saskia Biskup <sup>14<\/sup> <sup>15<\/sup>, Steffen Leiz <sup>16<\/sup>, Dominik S Westphal <sup>17<\/sup> <sup>18<\/sup>, Matias Wagner <sup>17<\/sup>, Amy Clarke <sup>2<\/sup>, Thomas Stockner <sup>2<\/sup>, Margot Ernst <sup>4<\/sup>, Akanchha Kesari <sup>5<\/sup>, Martin Krenn <sup>19<\/sup> <sup>20<\/sup><\/p>\n<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:60px;--awb-padding-bottom:60px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-1 fusion-sep-none fusion-title-text fusion-title-size-two\" style=\"--awb-text-color:var(--awb-custom_color_1);--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h2 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;text-transform:none;--fontSize:36;line-height:var(--awb-typography1-line-height);\">Abstract<\/h2><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-2\"><p style=\"text-align: justify;\">Nine out of 19 genes encoding GABA<sub>A<\/sub> receptor subunits have been linked to monogenic syndromes characterized by seizures and developmental disorders. Previously, we reported the de novo variant p.(Thr300Ile) in GABRA4 in a patient with epilepsy and neurodevelopmental abnormalities. However, no new cases have been reported since then. Through an international collaboration, we collected molecular and phenotype data of individuals carrying de novo variants in GABRA4. Patients and their parents were investigated either by exome or genome sequencing, followed by targeted Sanger sequencing in some cases. All variants within the transmembrane domain, including the previously reported p.(Thr300Ile) variant, were characterized in silico and analyzed by molecular dynamics (MD) simulation studies. We identified three novel de novo missense variants in GABRA4 (NM_000809.4): c.797 C &gt; T, p.(Pro266Leu), c.899 C &gt; A, p.(Thr300Asn), and c.634 G &gt; A, p.(Val212Ile). The p.(Thr300Asn) variant impacts the same codon as the previously reported variant p.(Thr300Ile) and likely arose post-zygotically as evidenced by sequencing oral mucosal cells. Overlapping phenotypes among affected individuals included developmental delay (4\/4), epileptiform EEG abnormalities (3\/4), attention deficits (3\/4), seizures (2\/4), autistic features (2\/4) and structural brain abnormalities (2\/4). MD simulations of the three variants within the transmembrane domain of the receptor indicate that sub-microsecond scale dynamics differ between wild-type and mutated subunits. Taken together, our findings further corroborate an association between GABRA4 and a neurological phenotype including variable neurodevelopmental, behavioral and epileptic abnormalities.<\/p>\n<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-3 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--link_hover_color: var(--awb-color6);--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:60px;--awb-padding-bottom:60px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-tabs fusion-tabs-1 classic vertical-tabs icon-position-left mobile-mode-carousel\" style=\"--awb-title-border-radius-top-left:0px;--awb-title-border-radius-top-right:0px;--awb-title-border-radius-bottom-right:0px;--awb-title-border-radius-bottom-left:0px;--awb-title-padding-top:10px;--awb-title-padding-right:50px;--awb-title-padding-bottom:10px;--awb-title-padding-left:50px;--awb-alignment:start;--awb-inactive-color:var(--awb-color7);--awb-title-text-color:var(--awb-color5);--awb-title-active-text-color:var(--awb-custom_color_1);--awb-background-color:var(--awb-color5);--awb-border-color:rgba(0,0,0,0.05);--awb-active-border-color:var(--awb-custom_color_1);\"><div class=\"nav\"><ul class=\"nav-tabs\" role=\"tablist\" aria-orientation=\"vertical\"><li class=\"active\" role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-95820d84ac410f84290\" aria-selected=\"true\" tabindex=\"0\" id=\"fusion-tab-95820d84ac410f84290\" href=\"#tab-95820d84ac410f84290\"><h3 class=\"fusion-tab-heading\">Referenzen<\/h3><\/a><\/li><li  role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-fe04465cf4481488aef\" aria-selected=\"false\" tabindex=\"-1\" id=\"fusion-tab-fe04465cf4481488aef\" href=\"#tab-fe04465cf4481488aef\"><h3 class=\"fusion-tab-heading\">Autorinnen\/Autoren<\/h3><\/a><\/li><\/ul><\/div><div class=\"tab-content\"><div class=\"tab-pane fade fusion-clearfix in active\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-95820d84ac410f84290\" id=\"tab-95820d84ac410f84290\">\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38565639\/\" target=\"_blank\" rel=\"noopener\">Ver\u00f6ffentlichung auf NCBI anschauen<\/a><\/p>\n<p><a href=\"https:\/\/cegat.com\/de\/diagnostik\/seltene-erkrankungen\/epilepsie-und-hirnentwicklungsstoerungen\/\" target=\"_blank\" rel=\"noopener\"><span class=\"avia_iconbox_title\">Zu unserem Panel f\u00fcr Epilepsie &amp; Hirnentwicklungsst\u00f6rungen<\/span><\/a><\/p>\n<\/div><div class=\"tab-pane fade fusion-clearfix\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-fe04465cf4481488aef\" id=\"tab-fe04465cf4481488aef\">\n<ol>\n<li>Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.<\/li>\n<li>Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria.<\/li>\n<li>Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland.<\/li>\n<li>Department of Pathobiology of the Nervous System, Center for Brain Research, Medical University of Vienna, Vienna, Austria.<\/li>\n<li>lllumina Clinical Services Laboratory, Illumina Inc., San Diego, CA, USA.<\/li>\n<li>Personalized Medicine and Health Outcomes Research, Nicklaus Children&#8217;s Hospital, Miami, FL, USA.<\/li>\n<li>Division of Genetics and Metabolism, Nicklaus Children&#8217;s Hospital, Miami, FL, USA.<\/li>\n<li>Department of Neurology, Division of Epilepsy, Nicklaus Children&#8217;s Hospital, Miami, FL, USA.<\/li>\n<li>Kaiser Permanente, San Diego, CA, USA.<\/li>\n<li>GeneDx, Gaithersburg, MD, USA.<\/li>\n<li>Mayo Clinic, Rochester, MN, USA.<\/li>\n<li>Kinderneurologisches Zentrum, Sana Kliniken D\u00fcsseldorf, D\u00fcsseldorf, Germany.<\/li>\n<li>Medizinisches Versorgungszentrum f\u00fcr Gerinnungsdiagnostik und Medizinische Genetik K\u00f6ln, K\u00f6ln, Germany.<\/li>\n<li>Zentrum f\u00fcr Humangenetik, T\u00fcbingen, Germany.<\/li>\n<li>Center for Genomics and Transcriptomics (CeGaT), T\u00fcbingen, Germany.<\/li>\n<li>Division of Neuropediatrics, Klinikum Dritter Orden, Munich, Germany.<\/li>\n<li>Institute of Human Genetics, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.<\/li>\n<li>Department of Internal Medicine I, School of Medicine &amp; Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.<\/li>\n<li>Department of Neurology, Medical University of Vienna, Vienna, Austria. martin.krenn@meduniwien.ac.at.<\/li>\n<li>Comprehensive Center for Clinical Neurosciences &amp; Mental Health, Medical University of Vienna, Vienna, Austria. martin.krenn@meduniwien.ac.at.<\/li>\n<\/ol>\n<p># Contributed equally.<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":25,"featured_media":46347,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[53,278],"tags":[244],"class_list":["post-71095","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-veroeffentlichungen","category-publications-de","tag-epilepsie-und-hirnentwicklungsstoerungen"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.1.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>De novo variants in GABRA4 are associated with a neurological phenotype including developmental delay, behavioral abnormalities and 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