The majority of epilepsies are focal in origin, with seizures emanating from one brain region. Although focal epilepsies often arise from structural brain lesions, many affected individuals have normal brain imaging. The etiology is unknown in the majority of individuals, although genetic factors are increasingly recognized. Autosomal dominant familial focal epilepsy with variable foci (FFEVF) is notable because family members have seizures originating from different cortical regions1. Using exome sequencing, we detected DEPDC5 mutations in two affected families. We subsequently identified mutations in five of six additional published large families with FFEVF. Study of families with focal epilepsy that were too small for conventional clinical diagnosis with FFEVF identified DEPDC5 mutations in approximately 12% of families (10/82). This high frequency establishes DEPDC5 mutations as a common cause of familial focal epilepsies. Shared homology with G protein signaling molecules and localization in human neurons suggest a role of DEPDC5 in neuronal signal transduction.
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NCBI Reference Sequence
We thank the individuals with epilepsy and their families for participating in our research. We thank B. Johns and R. Schultz for technical assistance and M. Broli, F. Provini, S. Foote and K. Praveen for assistance with family studies. We thank the Leiden Genome Technology Centre (LGTC) for exome sequencing of family D1. This work was supported by the National Health and Medical Research Council of Australia (Program grant 628952 to S.F.B., I.E.S., L.M.D., P.Q.T. and J.G., Australia Fellowship 466671 to S.F.B., Senior Research Fellowship 508043 to J.G., Practitioner Fellowship 1006110 to I.E.S., Training Fellowship 1016715 to S.E.H. and Career Development Fellowship 1032603 to L.M.D.) and by the Center of Medical System Biology (CMSB) established by the Netherlands Genomics Initiative/Netherlands Organisation for Scientific Research (NGI/NWO) to A.M.J.M.v.d.M., the Netherlands Organization for Scientific Research (NWO, 940-33-030) and the Dutch National Epilepsy Fund (98-14). P.M.C.C. received an unrestricted research grant from UCB Pharma (The Netherlands). J.S. received financial support from the Spanish government (grants EUI-EURC-2011-4325 within the EuroEPINOMICS-RES network and grant SAF2010-18586). D.E.C. received an unrestricted educational grant from UCB Pharma. P.Q.T. is a Pfizer Australia Research Fellow. K.M.K. was supported by a research fellowship from the Deutsche Forschungsgemeinschaft (KL 2254/1-1) and a scholarship from The University of Melbourne. This study makes use of data generated by the DECIPHER Consortium. A full list of centers who contributed to the generation of the data is available from the consortium website and via e-mail (email@example.com). Funding for the project was provided by the Wellcome Trust.
Supplementary Tables 1 and 2 and Supplementary Figures 1–3
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Expert Review of Molecular Diagnostics (2019)