Neurodevelopmental disorders with periventricular nodular heterotopia (PNH) are etiologically heterogeneous, and their genetic causes remain in many cases unknown. Here we show that missense mutations in NEDD4L mapping to the HECT domain of the encoded E3 ubiquitin ligase lead to PNH associated with toe syndactyly, cleft palate and neurodevelopmental delay. Cellular and expression data showed sensitivity of PNH-associated mutants to proteasome degradation. Moreover, an in utero electroporation approach showed that PNH-related mutants and excess wild-type NEDD4L affect neurogenesis, neuronal positioning and terminal translocation. Further investigations, including rapamycin-based experiments, found differential deregulation of pathways involved. Excess wild-type NEDD4L leads to disruption of Dab1 and mTORC1 pathways, while PNH-related mutations are associated with deregulation of mTORC1 and AKT activities. Altogether, these data provide insights into the critical role of NEDD4L in the regulation of mTOR pathways and their contributions in cortical development.

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We are grateful to the patients and their families for their participation. We thank D. Rotin and C. Jiang (The Hospital for Sick Children) for kindly providing humanV5-tagged Nedd4-2 constructs (pcDNA3.1-nV5 wild type, CS and Y971A constructs) and L. Lindner, M. Ruff, M. Macias and F. Francis for their thoughtful comments and help. We thank investigators from the Epi4K Consortium and the Epilepsy Phenome/Genome Project for contributing NEDD4L-related genotype and phenotype data. This work was supported by funding from Strasbourg University and grant ANR-10-LABX-0030-INRT, a French State Fund managed by the Agence Nationale de la Recherche under the frame program Investissements d'Avenir ANR-10-IDEX-0002-02, the Fondation pour la Recherche Médicale (FRM funding within the framework of the program Equipe FRM; J.C–DEQ20130326477), the Fondation Maladies Rares, the Fondation NRJ–Institut de France, Agence National de Recherche (ANR Blanc 1103 01, project R11039KK; ANR E-Rare-012-01, project E10107KP; ANR-13-BSV-0009-01) and European Union FP7 project GENECODYS (grant 241995) and DESIRE (grant agreement 602531), and funding provided from the National Institute of Neurological Disorders and Stroke to the Epi4k Consortium and the Epilepsy Phenome/Genome Project (NS053998, NS077364, NS077274, NS077303 and NS077276). This study was also supported in part by the NIHR Biomedical Research Centre Oxford with funding from the UK Department of Health's NIHR Biomedical Research Centre funding scheme. The views expressed in this publication are those of the authors and not necessarily those of the UK Department of Health.

Author information

Author notes

    • Loïc Broix
    •  & Hélène Jagline

    These authors contributed equally to this work.


  1. Institut de Génétique et de Biologie Moléculaire et Cellulaire, Illkirch, France.

    • Loïc Broix
    • , Hélène Jagline
    • , Ekaterina L Ivanova
    • , Stéphane Schmucker
    • , Nathalie Drouot
    • , Peggy Tilly
    • , Tristan Stemmelen
    • , Gabrielle Rudolf
    • , Juliette Godin
    • , Izabela Sumara
    • , Maria-Victoria Hinckelmann
    •  & Jamel Chelly
  2. CNRS U7104, Illkirch, France.

    • Loïc Broix
    • , Hélène Jagline
    • , Ekaterina L Ivanova
    • , Stéphane Schmucker
    • , Nathalie Drouot
    • , Peggy Tilly
    • , Tristan Stemmelen
    • , Gabrielle Rudolf
    • , Juliette Godin
    • , Izabela Sumara
    • , Maria-Victoria Hinckelmann
    •  & Jamel Chelly
  3. INSERM U964, Illkirch, France.

    • Loïc Broix
    • , Hélène Jagline
    • , Ekaterina L Ivanova
    • , Stéphane Schmucker
    • , Nathalie Drouot
    • , Peggy Tilly
    • , Tristan Stemmelen
    • , Gabrielle Rudolf
    • , Juliette Godin
    • , Izabela Sumara
    • , Maria-Victoria Hinckelmann
    •  & Jamel Chelly
  4. Université de Strasbourg, Illkirch, France.

    • Loïc Broix
    • , Hélène Jagline
    • , Ekaterina L Ivanova
    • , Stéphane Schmucker
    • , Nathalie Drouot
    • , Peggy Tilly
    • , Tristan Stemmelen
    • , Gabrielle Rudolf
    • , Juliette Godin
    • , Izabela Sumara
    • , Maria-Victoria Hinckelmann
    •  & Jamel Chelly
  5. Institut Cochin, INSERM U1016, CNRS U8104, Paris Descartes University, Paris, France.

    • Loïc Broix
    • , Karine Poirier
    • , Yoann Saillour
    • , Nicolas Lebrun
    • , Giuseppe Muraca
    • , Benjamin Saintpierre
    •  & Adrienne Elmorjani
  6. Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Trust, Manchester Academic Health Science Centre, Manchester, UK.

    • Jill Clayton-Smith
    •  & Kay A Metcalfe
  7. NIHR Biomedical Research Centre, Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.

    • Alistair T Pagnamenta
    •  & Jenny C Taylor
  8. Service de Génétique Médicale, University Hospital of Nantes, Nantes, France.

    • Bertrand Isidor
  9. Unité de Neuropédiatrie et d'Epileptologie Infantile, University Hospital of Montpellier, Montpellier, France.

    • Ulrike Walther Louvier
  10. Epilepsy Genetics Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA.

    • Annapurna Poduri
  11. Grappe Interdisciplinaire de Génoprotéomique Appliquée-Neurosciences, University of Liège, Liège, Belgium.

    • Martin Moïse
    •  & Laurent Nguyen
  12. Hôpital Maison Blanche, University Hospital of Reims, Reims, France.

    • Nathalie Bednarek Weirauch
  13. Paediatric Neurology Unit, A. Meyer Children's Hospital, University of Florence, Florence, Italy.

    • Renzo Guerrini
  14. Centre National de Génotypage, Institut de Génomique, CEA, Evry, France.

    • Anne Boland
    • , Robert Olaso
    •  & Jean-François Deleuze
  15. Institut Imagine, Bioinformatics Platform, Paris Descartes University, Paris, France.

    • Cecile Masson
    •  & Patrick Nischké
  16. Institute of Molecular Pathology, Vienna, Austria.

    • Ratna Tripathy
    •  & David Keays
  17. Laboratoire de Biochimie et Génétique Moléculaire, Hôpital Cochin, Paris, France.

    • Cherif Beldjord
  18. Department of Clinical Genetics, Oxford University Hospitals NHS Trust, Oxford, UK.

    • Usha Kini
  19. Institut Imagine, INSERM U1163, Paris Descartes University, Hôpital Necker–Enfants Malades, Paris, France.

    • Nadia Bahi-Buisson
  20. Service de Diagnostic Génétique, Hôpital Civil de Strasbourg, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.

    • Jamel Chelly


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L.B., H.J., E.L.I. and M.-V.H. conceived and designed the experiments, performed the experiments, performed statistical analysis and analyzed the data related to cellular, IUEP and functional studies. S.S. provided technical assistance and performed ubiquitination experiments. N.D. provided technical assistance, performed expression and genetic studies, and prepared reagents. J.C.-S., K.A.M., B.I., U.W.L., A.P., N.B.W., R.G., D.K., C.B., the DDD study, U.K. and N.B.-B. contributed clinical and imaging data and follow-up of patients and families. P.T. and G.M. provided assistance for IUEP studies. A.T.P., J.C.T., K.P., Y.S., N.L., G.R., B.S., A.E. and R.T. contributed to genetic studies and analysis of variants in candidate genes and screened DNA from subjects. M.M. and J.G. performed expression studies during brain development. L.N. and J.G. contributed reagents and material, as well as critical suggestions for functional studies. T.S., the DDD study, A.B., R.O., C.M., P.N. and J.-F.D. contributed to the generation of whole-exome sequencing, bioinformatics tools and analysis of sequencing data. I.S. conceived and designed ubiquitination experiments. J.C. conceived, coordinated and supervised the study, designed experiments, analyzed data and wrote the manuscript.

Competing interests

The authors declare no competing financial interests.

Corresponding author

Correspondence to Jamel Chelly.

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