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1.
Am J Hum Genet ; 109(11): 2080-2087, 2022 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-36288729

RESUMO

Genetic epilepsy with febrile seizures plus (GEFS+) is an autosomal dominant familial epilepsy syndrome characterized by distinctive phenotypic heterogeneity within families. The SCN1B c.363C>G (p.Cys121Trp) variant has been identified in independent, multi-generational families with GEFS+. Although the variant is present in population databases (at very low frequency), there is strong clinical, genetic, and functional evidence to support pathogenicity. Recurrent variants may be due to a founder event in which the variant has been inherited from a common ancestor. Here, we report evidence of a single founder event giving rise to the SCN1B c.363C>G variant in 14 independent families with epilepsy. A common haplotype was observed in all families, and the age of the most recent common ancestor was estimated to be approximately 800 years ago. Analysis of UK Biobank whole-exome-sequencing data identified 74 individuals with the same variant. All individuals carried haplotypes matching the epilepsy-affected families, suggesting all instances of the variant derive from a single mutational event. This unusual finding of a variant causing an autosomal dominant, early-onset disease in an outbred population that has persisted over many generations can be attributed to the relatively mild phenotype in most carriers and incomplete penetrance. Founder events are well established in autosomal recessive and late-onset disorders but are rarely observed in early-onset, autosomal dominant diseases. These findings suggest variants present in the population at low frequencies should be considered potentially pathogenic in mild phenotypes with incomplete penetrance and may be more important contributors to the genetic landscape than previously thought.


Assuntos
Epilepsia , Convulsões Febris , Criança , Humanos , Linhagem , Eletroencefalografia , Convulsões Febris/genética , Fenótipo , Epilepsia/genética
2.
Am J Hum Genet ; 108(1): 176-185, 2021 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-33245860

RESUMO

Fibroblast growth factor homologous factors (FHFs) are intracellular proteins which regulate voltage-gated sodium (Nav) channels in the brain and other tissues. FHF dysfunction has been linked to neurological disorders including epilepsy. Here, we describe two sibling pairs and three unrelated males who presented in infancy with intractable focal seizures and severe developmental delay. Whole-exome sequencing identified hemi- and heterozygous variants in the N-terminal domain of the A isoform of FHF2 (FHF2A). The X-linked FHF2 gene (also known as FGF13) has alternative first exons which produce multiple protein isoforms that differ in their N-terminal sequence. The variants were located at highly conserved residues in the FHF2A inactivation particle that competes with the intrinsic fast inactivation mechanism of Nav channels. Functional characterization of mutant FHF2A co-expressed with wild-type Nav1.6 (SCN8A) revealed that mutant FHF2A proteins lost the ability to induce rapid-onset, long-term blockade of the channel while retaining pro-excitatory properties. These gain-of-function effects are likely to increase neuronal excitability consistent with the epileptic potential of FHF2 variants. Our findings demonstrate that FHF2 variants are a cause of infantile-onset developmental and epileptic encephalopathy and underline the critical role of the FHF2A isoform in regulating Nav channel function.


Assuntos
Encefalopatias/genética , Epilepsia/genética , Fatores de Crescimento de Fibroblastos/genética , Mutação de Sentido Incorreto/genética , Isoformas de Proteínas/genética , Adolescente , Sequência de Aminoácidos , Criança , Éxons/genética , Feminino , Mutação com Ganho de Função/genética , Genes Ligados ao Cromossomo X/genética , Heterozigoto , Humanos , Masculino , Canal de Sódio Disparado por Voltagem NAV1.6/genética , Neurônios/fisiologia , Convulsões/genética
3.
Epilepsia ; 64(11): 3099-3108, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37643892

RESUMO

OBJECTIVE: This study was undertaken to develop a novel pathway linking genetic data with routinely collected data for people with epilepsy, and to analyze the influence of rare, deleterious genetic variants on epilepsy outcomes. METHODS: We linked whole-exome sequencing (WES) data with routinely collected primary and secondary care data and natural language processing (NLP)-derived seizure frequency information for people with epilepsy within the Secure Anonymised Information Linkage Databank. The study participants were adults who had consented to participate in the Swansea Neurology Biobank, Wales, between 2016 and 2018. DNA sequencing was carried out as part of the Epi25 collaboration. For each individual, we calculated the total number and cumulative burden of rare and predicted deleterious genetic variants and the total of rare and deleterious variants in epilepsy and drug metabolism genes. We compared these measures with the following outcomes: (1) no unscheduled hospital admissions versus unscheduled admissions for epilepsy, (2) antiseizure medication (ASM) monotherapy versus polytherapy, and (3) at least 1 year of seizure freedom versus <1 year of seizure freedom. RESULTS: We linked genetic data for 107 individuals with epilepsy (52% female) to electronic health records. Twenty-six percent had unscheduled hospital admissions, and 70% were prescribed ASM polytherapy. Seizure frequency information was linked for 100 individuals, and 10 were seizure-free. There was no significant difference between the outcome groups in terms of the exome-wide and gene-based burden of rare and deleterious genetic variants. SIGNIFICANCE: We successfully uploaded, annotated, and linked genetic sequence data and NLP-derived seizure frequency data to anonymized health care records in this proof-of-concept study. We did not detect a genetic influence on real-world epilepsy outcomes, but our study was limited by a small sample size. Future studies will require larger (WES) data to establish genetic variant contribution to epilepsy outcomes.


Assuntos
Epilepsia , Adulto , Humanos , Feminino , Masculino , Sequenciamento do Exoma , Epilepsia/tratamento farmacológico , Epilepsia/genética , Convulsões/tratamento farmacológico , Atenção à Saúde , Armazenamento e Recuperação da Informação , Anticonvulsivantes/uso terapêutico
4.
Proc Natl Acad Sci U S A ; 117(29): 17068-17073, 2020 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-32631995

RESUMO

Biotic interactions are central to both ecological and evolutionary dynamics. In the vast majority of empirical studies, the strength of intraspecific interactions is estimated by using simple measures of population size. Biologists have long known that these are crude metrics, with experiments and theory suggesting that interactions between individuals should depend on traits, such as body size. Despite this, it has been difficult to estimate the impact of traits on competitive ability from ecological field data, and this explains why the strength of biotic interactions has empirically been treated in a simplistic manner. Using long-term observational data from four different populations, we show that large Trinidadian guppies impose a significantly larger competitive pressure on conspecifics than individuals that are smaller; in other words, competition is asymmetric. When we incorporate this asymmetry into integral projection models, the predicted size structure is much closer to what we see in the field compared with models where competition is independent of body size. This difference in size structure translates into a twofold difference in reproductive output. This demonstrates how the nature of ecological interactions drives the size structure, which, in turn, will have important implications for both the ecological and evolutionary dynamics.


Assuntos
Evolução Biológica , Ecossistema , Densidade Demográfica , Dinâmica Populacional , Animais , Tamanho Corporal/fisiologia , Feminino , Masculino , Modelos Biológicos , Poecilia/fisiologia
5.
New Phytol ; 233(2): 995-1010, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34726792

RESUMO

Growth rates vary widely among plants with different strategies. For crops, evolution under predictable and high-resource environments might favour rapid resource acquisition and growth, but whether this strategy has consistently evolved during domestication and improvement remains unclear. Here we report a comprehensive study of the evolution of growth rates based on comparisons among wild, landrace, and improved accessions of 19 herbaceous crops grown under common conditions. We also examined the underlying growth components and the influence of crop origin and history on growth evolution. Domestication and improvement did not affect growth consistently, that is growth rates increased or decreased or remained unchanged in different crops. Crops selected for fruits increased the physiological component of growth (net assimilation rate), whereas leaf and seed crops showed larger domestication effects on morphology (leaf mass ratio and specific leaf area). Moreover, climate and phylogeny contributed to explaining the effects of domestication and changes in growth. Crop-specific responses to domestication and improvement suggest that selection for high yield has not consistently changed growth rates. The trade-offs between morpho-physiological traits and the distinct origins and histories of crops accounted for the variability in growth changes. These findings have far-reaching implications for our understanding of crop performance and adaptation.


Assuntos
Produtos Agrícolas , Domesticação , Produtos Agrícolas/fisiologia , Frutas , Fenótipo , Filogenia
6.
Epilepsia ; 62(7): 1604-1616, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34046890

RESUMO

OBJECTIVE: This study was undertaken to determine whether epilepsy and antiepileptic drugs (including enzyme-inducing and non-enzyme-inducing drugs) are associated with major cardiovascular events using population-level, routinely collected data. METHODS: Using anonymized, routinely collected, health care data in Wales, UK, we performed a retrospective matched cohort study (2003-2017) of adults with epilepsy prescribed an antiepileptic drug. Controls were matched with replacement on age, gender, deprivation quintile, and year of entry into the study. Participants were followed to the end of the study for the occurrence of a major cardiovascular event, and survival models were constructed to compare the time to a major cardiovascular event (cardiac arrest, myocardial infarction, stroke, ischemic heart disease, clinically significant arrhythmia, thromboembolism, onset of heart failure, or a cardiovascular death) for individuals in the case group versus the control group. RESULTS: There were 10 241 cases (mean age = 49.6 years, 52.2% male, mean follow-up = 6.1 years) matched to 35 145 controls. A total of 3180 (31.1%) cases received enzyme-inducing antiepileptic drugs, and 7061 (68.9%) received non-enzyme-inducing antiepileptic drugs. Cases had an increased risk of experiencing a major cardiovascular event compared to controls (adjusted hazard ratio = 1.58, 95% confidence interval [CI] = 1.51-1.63, p < .001). There was no notable difference in major cardiovascular events between those treated with enzyme-inducing antiepileptic drugs and those treated with non-enzyme-inducing antiepileptic drugs (adjusted hazard ratio = .95, 95% CI = .86-1.05, p = .300). SIGNIFICANCE: Individuals with epilepsy prescribed antiepileptic drugs are at an increased risk of major cardiovascular events compared with population controls. Being prescribed an enzyme-inducing antiepileptic drug is not associated with a greater risk of a major cardiovascular event compared to treatment with other antiepileptic drugs. Our data emphasize the importance of cardiovascular risk management in the clinical care of people with epilepsy.


Assuntos
Anticonvulsivantes/efeitos adversos , Anticonvulsivantes/uso terapêutico , Doenças Cardiovasculares/etiologia , Epilepsia/complicações , Epilepsia/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Estudos de Casos e Controles , Estudos de Coortes , Indução Enzimática/efeitos dos fármacos , Epilepsia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Análise de Sobrevida , Resultado do Tratamento , Reino Unido/epidemiologia , País de Gales , Adulto Jovem
7.
New Phytol ; 228(4): 1306-1315, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32841398

RESUMO

Growth rate represents a fundamental axis of life history variation. Faster growth associated with C4 photosynthesis and annual life history has evolved multiple times, and the resulting diversity in growth is typically explained via resource acquisition and allocation. However, the underlying changes in morphogenesis remain unknown. We conducted a phylogenetic comparative experiment with 74 grass species, conceptualising morphogenesis as the branching and growth of repeating modules. We aimed to establish whether faster growth in C4 and annual grasses, compared with C3 and perennial grasses, came from the faster growth of individual modules or higher rates of module initiation. Morphogenesis produces fast growth in different ways in grasses using C4 and C3 photosynthesis, and in annual compared with perennial species. C4 grasses grow faster than C3 species through a greater enlargement of shoot modules and quicker secondary branching of roots. However, leaf initiation is slower and there is no change in shoot branching. Conversely, faster growth in annuals than perennials is achieved through greater branching and enlargement of shoots, and possibly faster root branching. The morphogenesis of fast growth depends on ecological context, with C4 grasses tending to promote resource capture under competition, and annuals enhancing branching to increase reproductive potential.


Assuntos
Fotossíntese , Poaceae , Morfogênese , Filogenia , Folhas de Planta
8.
Epilepsy Behav ; 111: 107196, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32554230

RESUMO

OBJECTIVE: The objective of the study was to assess the long-term outcomes of epilepsy surgery between 1995 and 2015 in South Wales, UK, linking case note review, postal questionnaire, and routinely collected healthcare data. METHOD: We identified patients from a departmental database and collected outcome data from patient case notes, a postal questionnaire, and the QOLIE-31-P and linked with Welsh routinely collected data in the Secure Anonymised Information Linkage (SAIL) databank. RESULTS: Fifty-seven patients were included. Median age at surgery was 34 years (11-70), median: 24 years (2-56) after onset of habitual seizures. Median follow-up was 7 years (2-19). Twenty-eight (49%) patients were free from disabling seizures (Engel Class 1), 9 (16%) experienced rare disabling seizures (Class 2), 13 (23%) had worthwhile improvements (Class 3), and 7 (12%) had no improvement (Class 4). There was a 30% mean reduction in total antiepileptic drug (AED) load at five years postsurgery. Thirty-eight (66.7%) patients experienced tonic-clonic seizures presurgery verses 8 (14%) at last review. Seizure-free patients self-reported a greater overall quality of life (QOL; QOLIE-31-P) when compared with those not achieving seizure freedom. Seizure-free individuals scored a mean of 67.6/100 (100 is best), whereas those with continuing seizures scored 46.0/100 (p < 0.006). There was a significant decrease in the median rate of hospital admissions for any cause after epilepsy surgery (9.8 days per 1000 patient days before surgery compared with 3.9 after p < 0.005). SIGNIFICANCE: Epilepsy surgery was associated with significant improvements in seizures, a reduced AED load, and an improved QOL that closely correlated with seizure outcomes and reduced hospital admission rates following surgery. Despite this, there was a long delay from onset of habitual seizures to surgery. The importance of long-term follow-up is emphasized in terms of evolving medical needs and health and social care outcomes.


Assuntos
Análise de Dados , Epilepsia/cirurgia , Aceitação pelo Paciente de Cuidados de Saúde , Medidas de Resultados Relatados pelo Paciente , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Criança , Estudos de Coortes , Epilepsia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , País de Gales/epidemiologia , Adulto Jovem
9.
Am Nat ; 194(1): E13-E29, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31251648

RESUMO

We use integral projection models (IPMs) and individual-based simulations to study the evolution of genetic variance in two monocarpic plant systems. Previous approaches combining IPMs with an adaptive dynamics-style invasion analysis predicted that genetic variability in the size threshold for flowering will not be maintained, which conflicts with empirical evidence. We ask whether this discrepancy can be resolved by making more realistic assumptions about the underlying genetic architecture, assuming a multilocus quantitative trait in an outcrossing diploid species. To do this, we embed the infinitesimal model of quantitative genetics into an IPM for a size-structured cosexual plant species. The resulting IPM describes the joint dynamics of individual size and breeding value of the evolving trait. We apply this general framework to the monocarpic perennials Oenothera glazioviana and Carlina vulgaris. The evolution of heritable variation in threshold size is explored in both individual-based models (IBMs) and IPMs, using a mutation rate modifier approach. In the Oenothera model, where the environment is constant, there is selection against producing genetically variable offspring. In the Carlina model, where the environment varies between years, genetically variable offspring provide a selective advantage, allowing the maintenance of genetic variability. The contrasting predictions of adaptive dynamics and quantitative genetics models for the same system suggest that fluctuating selection may be more effective at maintaining genetic variation than previously thought.


Assuntos
Flores/fisiologia , Variação Genética , Modelos Genéticos , Taxa de Mutação , Oenothera/genética , Seleção Genética , Evolução Biológica , Característica Quantitativa Herdável
10.
Ann Neurol ; 84(6): 829-842, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30362156

RESUMO

OBJECTIVE: Cortical gray matter (GM) pathology, involving demyelination and neurodegeneration, associated with meningeal inflammation, could be important in determining disability progression in multiple sclerosis (MS). However, we need to know more about how cortical demyelination, neurodegeneration, and meningeal inflammation contribute to pathology at early stages of MS to better predict long-term outcome. METHODS: Tissue blocks from short disease duration MS (n = 12, median disease duration = 2 years), progressive MS (n = 21, disease duration = 25 years), non-diseased controls (n = 11), and other neurological inflammatory disease controls (n = 6) were quantitatively analyzed by immunohistochemistry, immunofluorescence, and in situ hybridization. RESULTS: Cortical GM demyelination was extensive in some cases of acute MS (range = 1-48% of total cortical GM), and subpial lesions were the most common type (62%). The numbers of activated (CD68+ ) microglia/macrophages were increased in cases with subpial lesions, and the density of neurons was significantly reduced in acute MS normal appearing and lesion GM, compared to controls (p < 0.005). Significant meningeal inflammation and lymphoid-like structures were seen in 4 of 12 acute MS cases. The extent of meningeal inflammation correlated with microglial/macrophage activation (p < 0.05), but not the area of cortical demyelination, reflecting the finding that lymphoid-like structures were seen adjacent to GM lesions as well as areas of partially demyelinated/remyelinated, cortical GM. INTERPRETATION: Our findings demonstrate that cortical demyelination, neuronal loss, and meningeal inflammation are notable pathological hallmarks of acute MS and support the need to identify early biomarkers of this pathology to better predict outcome. Ann Neurol 2018;84:829-842.


Assuntos
Córtex Cerebral/patologia , Inflamação/complicações , Meninges/patologia , Esclerose Múltipla/complicações , Bainha de Mielina/patologia , Adulto , Idoso , Antígenos CD/metabolismo , Córtex Cerebral/metabolismo , Estudos de Coortes , Proteínas de Ligação a DNA/metabolismo , Progressão da Doença , Feminino , Substância Cinzenta/metabolismo , Substância Cinzenta/patologia , Humanos , Macrófagos/metabolismo , Macrófagos/patologia , Masculino , Meninges/metabolismo , Microglia/metabolismo , Microglia/patologia , Pessoa de Meia-Idade , Bainha de Mielina/metabolismo , Fatores de Transcrição/metabolismo , Adulto Jovem
11.
Brain ; 141(3): 651-661, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29390050

RESUMO

Members of the AAA+ superfamily of ATPases are involved in the unfolding of proteins and disassembly of protein complexes and aggregates. ATAD1 encoding the ATPase family, AAA+ domain containing 1-protein Thorase plays an important role in the function and integrity of mitochondria and peroxisomes. Postsynaptically, Thorase controls the internalization of excitatory, glutamatergic AMPA receptors by disassembling complexes between the AMPA receptor-binding protein, GRIP1, and the AMPA receptor subunit GluA2. Using whole-exome sequencing, we identified a homozygous frameshift mutation in the last exon of ATAD1 [c.1070_1071delAT; p.(His357Argfs*15)] in three siblings who presented with a severe, lethal encephalopathy associated with stiffness and arthrogryposis. Biochemical and cellular analyses show that the C-terminal end of Thorase mutant gained a novel function that strongly impacts its oligomeric state, reduces stability or expression of a set of Golgi, peroxisomal and mitochondrial proteins and affects disassembly of GluA2 and Thorase oligomer complexes. Atad1-/- neurons expressing Thorase mutantHis357Argfs*15 display reduced amount of GluA2 at the cell surface suggesting that the Thorase mutant may inhibit the recycling back and/or reinsertion of AMPA receptors to the plasma membrane. Taken together, our molecular and functional analyses identify an activating ATAD1 mutation as a new cause of severe encephalopathy and congenital stiffness.


Assuntos
ATPases Associadas a Diversas Atividades Celulares/genética , Encefalopatias/genética , Regulação da Expressão Gênica/genética , Mutação/genética , Neurônios/patologia , Receptores de AMPA/metabolismo , Adenosina Trifosfatases/metabolismo , Encefalopatias/diagnóstico por imagem , Encefalopatias/patologia , Proteínas de Transporte/metabolismo , Análise Mutacional de DNA , Saúde da Família , Feminino , Homozigoto , Humanos , Lactente , Imageamento por Ressonância Magnética , Masculino , Mitocôndrias/genética , Mitocôndrias/patologia , Modelos Moleculares , Complexos Multiproteicos/genética , Complexos Multiproteicos/metabolismo , Proteínas do Tecido Nervoso/metabolismo , Neurônios/metabolismo , Neurônios/ultraestrutura , Consumo de Oxigênio/genética , Transporte Proteico/genética , RNA Mensageiro/metabolismo
12.
Brain ; 141(3): 698-712, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29365063

RESUMO

Polymicrogyria is a malformation of cortical development. The aetiology of polymicrogyria remains poorly understood. Using whole-exome sequencing we found de novo heterozygous missense GRIN1 mutations in 2 of 57 parent-offspring trios with polymicrogyria. We found nine further de novo missense GRIN1 mutations in additional cortical malformation patients. Shared features in the patients were extensive bilateral polymicrogyria associated with severe developmental delay, postnatal microcephaly, cortical visual impairment and intractable epilepsy. GRIN1 encodes GluN1, the essential subunit of the N-methyl-d-aspartate receptor. The polymicrogyria-associated GRIN1 mutations tended to cluster in the S2 region (part of the ligand-binding domain of GluN1) or the adjacent M3 helix. These regions are rarely mutated in the normal population or in GRIN1 patients without polymicrogyria. Using two-electrode and whole-cell voltage-clamp analysis, we showed that the polymicrogyria-associated GRIN1 mutations significantly alter the in vitro activity of the receptor. Three of the mutations increased agonist potency while one reduced proton inhibition of the receptor. These results are striking because previous GRIN1 mutations have generally caused loss of function, and because N-methyl-d-aspartate receptor agonists have been used for many years to generate animal models of polymicrogyria. Overall, our results expand the phenotypic spectrum associated with GRIN1 mutations and highlight the important role of N-methyl-d-aspartate receptor signalling in the pathogenesis of polymicrogyria.


Assuntos
Mutação/genética , Proteínas do Tecido Nervoso/genética , Polimicrogiria/genética , Receptores de N-Metil-D-Aspartato/genética , Animais , Criança , Pré-Escolar , Análise Mutacional de DNA , Agonistas de Aminoácidos Excitatórios/farmacologia , Saúde da Família , Feminino , Ácido Glutâmico/farmacologia , Glicina/metabolismo , Glicina/farmacologia , Células HEK293 , Humanos , Lactente , Imageamento por Ressonância Magnética , Masculino , Potenciais da Membrana/genética , Modelos Moleculares , Mutagênese/genética , N-Metilaspartato/farmacologia , Técnicas de Patch-Clamp , Polimicrogiria/diagnóstico por imagem , Ratos , Transfecção
13.
Ecol Lett ; 21(12): 1845-1852, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30276980

RESUMO

The impact of species loss from competitive communities partly depends on how populations of the surviving species respond. Predicting the response should be straightforward using models that describe population growth as a function of competitor densities; but these models require accurate estimates of interaction strengths. Here, we quantified how well we could predict responses to competitor removal in a community of annual plants, using a combination of observation and experiment. It was straightforward to fit models to multi-species communities, which passed standard diagnostic tests and provided apparently sensible estimates of interaction strengths. However, the models consistently underpredicted the response to competitor removal, by a factor of at least 50%. We argue that this poor predictive ability is likely to be general in plant communities due to 'the ghost of competition present' that confines species to parts of the environment in which they compete best.


Assuntos
Ecossistema , Plantas , Modelos Biológicos , Dinâmica Populacional
14.
J Neurol Neurosurg Psychiatry ; 89(7): 736-740, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29588327

RESUMO

OBJECTIVE: Small prospective studies have identified that children exposed to valproate in utero have poorer scores on cognitive testing. We wanted to identify whether children exposed to antiepileptic drugs (AEDs) in utero have poorer school performance. METHODS: We used anonymised, linked, routinely collected healthcare records to identify children born to mothers with epilepsy. We linked these children to their national attainment Key Stage 1 (KS1) tests in mathematics, language and science at the age of 7 and compared them with matched children born to mothers without epilepsy, and with the national KS1 results. We used the core subject indicator (CSI) as an outcome measure (the proportion of children achieving a minimum standard in all subjects) and the results in individual subjects. RESULTS: We identified 440 children born to mothers with epilepsy with available KS1 results. Compared with a matched control group, fewer children with mothers being prescribed sodium valproate during pregnancy achieved the national minimum standard in CSI (-12.7% less than the control group), mathematics (-12.1%), language (-10.4%) and in science (-12.2%). Even fewer children with mothers being prescribed multiple AEDs during pregnancy achieved a national minimum standard: CSI (by -20.7% less than the control group), mathematics (-21.9%), language (-19.3%) and science (-19.4%). We did not observe any significant difference in children whose mothers were prescribed carbamazepine or were not taking an AED when compared with the control group. CONCLUSIONS: In utero exposure to AEDs in combination, or sodium valproate alone, is associated with a significant decrease in attainment in national educational tests for 7-year-old children compared with both a matched control group and the all-Wales national average. These results give further support to the cognitive and developmental effects of in utero exposure to sodium valproate as well as multiple AEDs, which should be balanced against the need for effective seizure control for women during pregnancy.


Assuntos
Anticonvulsivantes/uso terapêutico , Filho de Pais com Deficiência/psicologia , Escolaridade , Epilepsia/tratamento farmacológico , Complicações na Gravidez/tratamento farmacológico , Efeitos Tardios da Exposição Pré-Natal/psicologia , Estudos de Casos e Controles , Criança , Desenvolvimento Infantil , Feminino , Humanos , Masculino , Gravidez , Reino Unido
15.
Epilepsia ; 59(7): 1410-1420, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29901232

RESUMO

OBJECTIVE: There is little detailed phenotypic characterization of bilateral hippocampal sclerosis (HS). We therefore conducted a multicenter review of people with pharmacoresistant epilepsy and bilateral HS to better determine their clinical characteristics. METHODS: Databases from 11 EPIGEN centers were searched. For identified cases, clinicians reviewed the medical notes, imaging, and electroencephalographic (EEG), video-EEG, and neuropsychometric data. Data were irretrievably anonymized, and a single database was populated to capture all phenotypic information. These data were compared with phenotyped cases of unilateral HS from the same centers. RESULTS: In total, 96 patients with pharmacoresistant epilepsy and bilateral HS were identified (43 female, 53 male; age range = 8-80 years). Twenty-five percent had experienced febrile convulsions, and 27% of patients had experienced status epilepticus. The mean number of previously tried antiepileptic drugs was 5.32, and the average number of currently prescribed medications was 2.99; 44.8% of patients had cognitive difficulties, and 47.9% had psychiatric comorbidity; 35.4% (34/96) of patients continued with long-term medical therapy alone, another 4 being seizure-free on medication. Sixteen patients proceeded to, or were awaiting, neurostimulation, and 11 underwent surgical resection. One patient was rendered seizure-free postresection, with an improvement in seizures for 3 other cases. By comparison, of 201 patients with unilateral HS, a significantly higher number (44.3%) had febrile convulsions and only 11.4% had experienced status epilepticus. Importantly, 41.8% (84/201) of patients with unilateral HS had focal aware seizures, whereas such seizures were less frequently observed in people with bilateral HS, and were never observed exclusively (P = .002; Fisher's exact test). SIGNIFICANCE: The current work describes the phenotypic spectrum of people with pharmacoresistant epilepsy and bilateral HS, highlights salient clinical differences from patients with unilateral HS, and provides a large platform from which to develop further studies, both epidemiological and genomic, to better understand etiopathogenesis and optimal treatment regimes in this condition.


Assuntos
Dominância Cerebral/fisiologia , Epilepsia Resistente a Medicamentos/fisiopatologia , Epilepsias Parciais/fisiopatologia , Hipocampo/patologia , Fenótipo , Estado Epiléptico/fisiopatologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Epilepsia Resistente a Medicamentos/diagnóstico , Epilepsias Parciais/diagnóstico , Epilepsias Parciais/cirurgia , Feminino , Hipocampo/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco , Esclerose , Estado Epiléptico/diagnóstico , Estado Epiléptico/cirurgia , Adulto Jovem
16.
Proc Natl Acad Sci U S A ; 112(13): 4021-5, 2015 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-25775600

RESUMO

A nongenetic, transgenerational effect of parental age on offspring fitness has been described in many taxa in the laboratory. Such a transgenerational fitness effect will have important influences on population dynamics, population age structure, and the evolution of aging and lifespan. However, effects of parental age on offspring lifetime fitness have never been demonstrated in a natural population. We show that parental age has sex-specific negative effects on lifetime fitness, using data from a pedigreed insular population of wild house sparrows. Birds whose parents were older produced fewer recruits annually than birds with younger parents, and the reduced number of recruits translated into a lifetime fitness difference. Using a long-term cross-fostering experiment, we demonstrate that this parental age effect is unlikely to be the result of changes in the environment but that it potentially is epigenetically inherited. Our study reveals the hidden consequences of late-life reproduction that persist into the next generation.


Assuntos
Fatores Etários , Pardais/fisiologia , Animais , Evolução Biológica , Meio Ambiente , Epigênese Genética , Feminino , Aptidão Genética , Masculino , Modelos Estatísticos , Dinâmica Populacional , Reprodução
17.
Hum Mol Genet ; 24(18): 5313-25, 2015 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-26130693

RESUMO

Mutations in alpha- and beta-tubulins are increasingly recognized as a major cause of malformations of cortical development (MCD), typically lissencephaly, pachygyria and polymicrogyria; however, sequencing tubulin genes in large cohorts of MCD patients has detected tubulin mutations in only 1-13%. We identified patients with a highly characteristic cerebellar dysplasia but without lissencephaly, pachygyria and polymicrogyria typically associated with tubulin mutations. Remarkably, in seven of nine patients (78%), targeted sequencing revealed mutations in three different tubulin genes (TUBA1A, TUBB2B and TUBB3), occurring de novo or inherited from a mosaic parent. Careful re-review of the cortical phenotype on brain imaging revealed only an irregular pattern of gyri and sulci, for which we propose the term tubulinopathy-related dysgyria. Basal ganglia (100%) and brainstem dysplasia (80%) were common features. On the basis of in silico structural predictions, the mutations affect amino acids in diverse regions of the alpha-/beta-tubulin heterodimer, including the nucleotide binding pocket. Cell-based assays of tubulin dynamics reveal various effects of the mutations on incorporation into microtubules: TUBB3 p.Glu288Lys and p.Pro357Leu do not incorporate into microtubules at all, whereas TUBB2B p.Gly13Ala shows reduced incorporation and TUBA1A p.Arg214His incorporates fully, but at a slower rate than wild-type. The broad range of effects on microtubule incorporation is at odds with the highly stereotypical clinical phenotype, supporting differential roles for the three tubulin genes involved. Identifying this highly characteristic phenotype is important due to the low recurrence risk compared with the other (recessive) cerebellar dysplasias and the apparent lack of non-neurological medical issues.


Assuntos
Cerebelo/patologia , Mutação , Malformações do Sistema Nervoso/genética , Malformações do Sistema Nervoso/patologia , Tubulina (Proteína)/genética , Alelos , Encéfalo/patologia , Linhagem Celular , Vermis Cerebelar/patologia , Estudos de Coortes , Feminino , Genótipo , Humanos , Imageamento por Ressonância Magnética , Masculino , Microtúbulos/química , Microtúbulos/metabolismo , Modelos Moleculares , Malformações do Sistema Nervoso/diagnóstico , Fenótipo , Conformação Proteica , Multimerização Proteica , Relação Estrutura-Atividade , Tubulina (Proteína)/química
18.
Am J Hum Genet ; 94(4): 634-41, 2014 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-24702957

RESUMO

Tubulins, and microtubule polymers into which they incorporate, play critical mechanical roles in neuronal function during cell proliferation, neuronal migration, and postmigrational development: the three major overlapping events of mammalian cerebral cortex development. A number of neuronally expressed tubulin genes are associated with a spectrum of disorders affecting cerebral cortex formation. Such "tubulinopathies" include lissencephaly/pachygyria, polymicrogyria-like malformations, and simplified gyral patterns, in addition to characteristic extracortical features, such as corpus callosal, basal ganglia, and cerebellar abnormalities. Epilepsy is a common finding in these related disorders. Here we describe two unrelated individuals with infantile-onset epilepsy and abnormalities of brain morphology, harboring de novo variants that affect adjacent amino acids in a beta-tubulin gene TUBB2A. Located in a highly conserved loop, we demonstrate impaired tubulin and microtubule function resulting from each variant in vitro and by using in silico predictive modeling. We propose that the affected functional loop directly associates with the alpha-tubulin-bound guanosine triphosphate (GTP) molecule, impairing the intradimer interface and correct formation of the alpha/beta-tubulin heterodimer. This study associates mutations in TUBB2A with the spectrum of "tubulinopathy" phenotypes. As a consequence, genetic variations affecting all beta-tubulin genes expressed at high levels in the brain (TUBB2B, TUBB3, TUBB, TUBB4A, and TUBB2A) have been linked with malformations of cortical development.


Assuntos
Giro Denteado/patologia , Epilepsia/genética , Mutação de Sentido Incorreto , Tubulina (Proteína)/genética , Sequência de Aminoácidos , Epilepsia/patologia , Células HEK293 , Humanos , Lactente , Imageamento por Ressonância Magnética , Modelos Moleculares , Dados de Sequência Molecular , Homologia de Sequência de Aminoácidos , Tubulina (Proteína)/química
19.
Ecol Lett ; 19(3): 268-78, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26843397

RESUMO

The effects of asymmetric interactions on population dynamics has been widely investigated, but there has been little work aimed at understanding how life history parameters like generation time, life expectancy and the variance in lifetime reproductive success are impacted by different types of competition. We develop a new framework for incorporating trait-mediated density-dependence into size-structured models and use Trinidadian guppies to show how different types of competitive interactions impact life history parameters. Our results show the degree of symmetry in competitive interactions can have dramatic effects on the speed of the life history. For some vital rates, shifting the competitive superiority from small to large individuals resulted in a doubling of the generation time. Such large influences of competitive symmetry on the timescale of demographic processes, and hence evolution, highlights the interwoven nature of ecological and evolutionary processes and the importance of density-dependence in understanding eco-evolutionary dynamics.


Assuntos
Comportamento Competitivo , Poecilia/fisiologia , Animais , Feminino , Modelos Biológicos , Dinâmica Populacional
20.
J Neuroinflammation ; 13(1): 161, 2016 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-27333900

RESUMO

BACKGROUND: The symptoms of multiple sclerosis (MS) are caused by damage to myelin and nerve cells in the brain and spinal cord. Inflammation is tightly linked with neurodegeneration, and it is the accumulation of neurodegeneration that underlies increasing neurological disability in progressive MS. Determining pathological mechanisms at play in MS grey matter is therefore a key to our understanding of disease progression. METHODS: We analysed complement expression and activation by immunocytochemistry and in situ hybridisation in frozen or formalin-fixed paraffin-embedded post-mortem tissue blocks from 22 progressive MS cases and made comparisons to inflammatory central nervous system disease and non-neurological disease controls. RESULTS: Expression of the transcript for C1qA was noted in neurons and the activation fragment and opsonin C3b-labelled neurons and glia in the MS cortical and deep grey matter. The density of immunostained cells positive for the classical complement pathway protein C1q and the alternative complement pathway activation fragment Bb was significantly increased in cortical grey matter lesions in comparison to control grey matter. The number of cells immunostained for the membrane attack complex was elevated in cortical lesions, indicating complement activation to completion. The numbers of classical (C1-inhibitor) and alternative (factor H) pathway regulator-positive cells were unchanged between MS and controls, whilst complement anaphylatoxin receptor-bearing microglia in the MS cortex were found closely apposed to cortical neurons. Complement immunopositive neurons displayed an altered nuclear morphology, indicative of cell stress/damage, supporting our finding of significant neurodegeneration in cortical grey matter lesions. CONCLUSIONS: Complement is activated in the MS cortical grey matter lesions in areas of elevated numbers of complement receptor-positive microglia and suggests that complement over-activation may contribute to the worsening pathology that underlies the irreversible progression of MS.


Assuntos
Sistema Nervoso Central/patologia , Proteínas do Sistema Complemento/metabolismo , Encefalite/patologia , Substância Cinzenta/patologia , Esclerose Múltipla/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Clusterina/metabolismo , Estudos de Coortes , Proteínas Inativadoras do Complemento 1/metabolismo , Proteína Inibidora do Complemento C1 , Proteínas do Sistema Complemento/genética , Feminino , Antígenos HLA-D/genética , Antígenos HLA-D/metabolismo , Humanos , Masculino , Microglia/patologia , Pessoa de Meia-Idade , Glicoproteína Mielina-Oligodendrócito/metabolismo , Adulto Jovem
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