Heterozygous reelin mutations cause autosomal-dominant lateral temporal epilepsy

  • Am J Hum Genet. 2015 Jun 4;96(6):992-1000. doi: 10.1016/j.ajhg.2015.04.020.
Emanuela Dazzo  1 ,  Manuela Fanciulli  2 ,  Elena Serioli  1 ,  Giovanni Minervini  3 ,  Patrizia Pulitano  4 ,  Simona Binelli  5 ,  Carlo Di Bonaventura  4 ,  Concetta Luisi  6 ,  Elena Pasini  7 ,  Salvatore Striano  8 ,  Pasquale Striano  9 ,  Giangennaro Coppola  10 ,  Angela Chiavegato  1 ,  Slobodanka Radovic  11 ,  Alessandro Spadotto  11 ,  Sergio Uzzau  2 ,  Angela La Neve  6 ,  Anna Teresa Giallonardo  4 ,  Oriano Mecarelli  4 ,  Silvio C E Tosatto  12 ,  Ruth Ottman  13 ,  Roberto Michelucci  7 ,  Carlo Nobile  14
Affiliations
  • 1. Section of Padua, Institute of Neuroscience, Consiglio Nazionale delle Ricerche, 35121 Padova, Italy.
  • 2. Porto Conte Ricerche, 07041 Alghero, Sassari, Italy.
  • 3. Department of Biomedical Sciences, University of Padua, 35121 Padova, Italy.
  • 4. Department of Neurology and Psychiatry, Sapienza University of Rome, 00185 Roma, Italy.
  • 5. Carlo Besta Foundation Neurological Institute, 20133 Milano, Italy.
  • 6. Neurology Clinic, University of Bari, 70124 Bari, Italy.
  • 7. IRCCS-Institute of Neurological Sciences, Bellaria Hospital, 40139 Bologna, Italy.
  • 8. Department of Neurosciences and Reproductive and Odontostomatological Sciences, School of Medicine, University of Naples Federico II, 80131 Napoli, Italy.
  • 9. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa and Giannina Gaslini Institute, 16148 Genova, Italy.
  • 10. Child and Adolescent Psychiatry, Faculty of Medicine and Surgery, University of Salerno, 84100 Salerno, Italy.
  • 11. IGA Technology Services, 33100 Udine, Italy.
  • 12. Section of Padua, Institute of Neuroscience, Consiglio Nazionale delle Ricerche, 35121 Padova, Italy; Department of Biomedical Sciences, University of Padua, 35121 Padova, Italy.
  • 13. Departments of Epidemiology and Neurology and the Gertrude H. Sergievsky Center, Columbia University, New York, NY 10032, USA; Division of Epidemiology, New York State Psychiatric Institute, New York, NY 10032, USA.
  • 14. Section of Padua, Institute of Neuroscience, Consiglio Nazionale delle Ricerche, 35121 Padova, Italy; Department of Biomedical Sciences, University of Padua, 35121 Padova, Italy. Electronic address: [email protected].
Abstract

Autosomal-dominant lateral temporal Epilepsy (ADLTE) is a genetic Epilepsy syndrome clinically characterized by focal seizures with prominent auditory symptoms. ADLTE is genetically heterogeneous, and mutations in LGI1 account for fewer than 50% of affected families. Here, we report the identification of causal mutations in reelin (RELN) in seven ADLTE-affected families without LGI1 mutations. We initially investigated 13 ADLTE-affected families by performing SNP-array linkage analysis and whole-exome Sequencing and identified three heterozygous missense mutations co-segregating with the syndrome. Subsequent analysis of 15 small ADLTE-affected families revealed four additional missense mutations. 3D modeling predicted that all mutations have structural effects on protein-domain folding. Overall, RELN mutations occurred in 7/40 (17.5%) ADLTE-affected families. RELN encodes a secreted protein, Reelin, which has important functions in both the developing and adult brain and is also found in the blood serum. We show that ADLTE-related mutations significantly decrease serum levels of Reelin, suggesting an inhibitory effect of mutations on protein secretion. We also show that Reelin and LGI1 co-localize in a subset of rat brain neurons, supporting an involvement of both proteins in a common molecular pathway underlying ADLTE. Homozygous RELN mutations are known to cause lissencephaly with cerebellar hypoplasia. Our findings extend the spectrum of neurological disorders associated with RELN mutations and establish a link between RELN and LGI1, which play key regulatory roles in both the developing and adult brain.