Multiple Rare Variants in Typical and Atypical Rolandic Epilepsy – a Genetic Analysis

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Multiple Rare Variants in Typical and Atypical Rolandic Epilepsy – a Genetic Analysis MULTIPLE RARE VARIANTS IN TYPICAL AND ATYPICAL ROLANDIC EPILEPSY – A GENETIC ANALYSIS Doctoral thesis at the Medical University of Vienna for obtaining the academic degree Doctor of Philosophy Submitted by Mag. rer. nat Eva Maria Reinthaler Supervisor Fritz Zimprich, MD, PhD Department of Neurology Medical University of Vienna Währinger Gürtel 18-20 1090 Vienna, Austria Vienna, August 2014 ii DECLARATION I, Eva Maria Reinthaler, hereby declare that this thesis is my own work accomplished for obtaining the academic degree Doctor of Philosophy at the Medical University of Vienna and has not been submitted to any other University before. The thesis was compiled in a cumulative format using four manuscripts. For all included publications I am a first-shared author. The work was carried out at the Department of Neurology, Medical University of Vienna, Austria in tight collaboration with the Cologne Center for Genomics, University of Cologne, and Department of Neuropediatrics, University Medical Faculty Giessen, Germany. The generation of whole exome sequences and Illumina SNP-array genotyping data was done at the Cologne Center for Genomics with the latter being performed by myself. My main work, however, consisted in the curation of the sample database (DNA isolation, sample preparation), analyzing the data in a candidate gene or genome-wide approach and subsequent validation and segregation experiments (Sanger sequencing, SNP genotyping, quantitative realtime PCR). To increase the power of the analyses the datasets collected at the Department of Neurology, Medical University of Vienna and Department of Neuropediatrics, University Medical Faculty Giessen were merged and published together. Publication 1: published in Nature Genetics Lemke JR*, Lal D*, Reinthaler EM*, et al. Mutations in GRIN2A cause idiopathic focal epilepsy with rolandic spikes. Nat Genet. 2013 Sep;45(9):1067-72. doi: 10.1038/ng.2728. Epub 2013 Aug11. PubMed PMID: 23933819. Reprinted with permission. Publication 2: published in Annals of Neurology Lal D*, Reinthaler EM*, Schubert J*, et al. DEPDC5 mutations in genetic focal epilepsies of childhood. Ann Neurol 2014. 2014 May;75(5):788-92. doi: 10.1002/ana.24127. Epub 2014 Apr 14. PubMed PMID: 24591017. Reprinted with permission via RightsLink. Publication 3: published in Human Molecular Genetics Reinthaler EM*, Lal D,* et al. 16p11.2 600 kb Duplications Confer Risk for Typical and Atypical Rolandic Epilepsy. Hum Mol Genet. 2014 Jun16. pii: ddu306. [Epub ahead of print] PubMed PMID: 24939913. Pre-copyedited version reprinted with permission. iii The included manuscript is a pre-copyedited, author-produced PDF of an article accepted for publication in Human Molecular Genetics following peer review. The version of record [Reinthaler EM et al. 16p11.2 600 kb Duplications confer risk for typical and atypical Rolandic epilepsy. Hum Mol Genet. 2014 Jun 16. pii: ddu306.] is available online at: http://hmg.oxfordjournals.org/content/early/2014/06/27/hmg.ddu306.long. Publication 4: published in Epilepsia Reinthaler EM*, Lal D,* et al. Analysis of ELP4, SRPX2 and interacting genes in typical and atypical Rolandic epilepsy. Epilepsia. 2014 Jul 3. doi: 10.1111/epi.12712. [Epub ahead of print] PubMed PMID: 24995671. Reprinted with permission via RightsLink. * authors contributed equally to the work iv ACKNOWLEDGEMENTS Many people have directly or indirectly contributed to this thesis in a way they probably didn’t even notice. I cannot thank everyone but I am grateful for all the people, who surrounded me, supported me and with whom I had the pleasure to collaborate. My special and greatest thanks belong to my supervisor Prof. Fritz Zimprich for giving me the opportunity to work on such a collaborative, international research project. I thank him for his assistance, support, patience and belief in me. Many thanks to Dennis, he was my working counterpart and important for long discussions on all the pitfalls of the genetic data we were confronted with. I think we had great fun in studying the genetics of rolandic epilepsy. Still a lot to do! Special thanks also to Prof. Bernd Neubauer of the University Medical Faculty Giessen for his trust in Dennis and me for analyzing some of his more than 25 years old treasure. I specifically want to thank Dr. Thomas Sander from the Cologne Center for Genomics for his contribution to every manuscript and especially for giving me the opportunity for the 2- months exchange at the beginning of my PhD. I think without that I wouldn’t have come so far as this introduction into genome-wide genetics provided me with extremely helpful skills. Of course I would like to thank all the rest of the Cologne Center for Genomics. Further, I like to thank Prof. Alexander Zimprich for providing and supporting me with additional research projects in the field of neurogenetics and keeping me updated with daily news from outside of the PhD-world during lunchtime. I thank my lab colleagues, Christoph, Dora and Gerrit and Chantal from the neighbor lab. I like to thank the founders of the website “what should we call gradschool” for giving me hilarious laughs while the code was (NOT) running. Many thanks to all my friends and my family for being (trying to be) interested and still smiling and nodding although they had no idea what I was talking about in the majority of the time. And finally, a lot of thanks to Jörg, who accompanied and encouraged me through all the years. v TABLE OF CONTENTS DECLARATION iii ACKNOWLEDGEMENTS .................................................................................................v TABLE OF CONTENTS...................................................................................................vi ABSTRACT ....................................................................................................................vii ZUSAMMENFASSUNG ...................................................................................................ix 1 INTRODUCTION........................................................................................................1 1.1 The classification of epilepsies................................................................................1 1.1.1 The spectrum of Idiopathic focal childhood epilepsies .....................................2 1.1.2 Clinical symptomatology of typical and atypical rolandic epilepsy ....................4 1.2 The genetic architecture of complex diseases ........................................................7 1.2.1 Structural genomic variation ..........................................................................11 1.2.2 Overview of Epilepsy Genetics ......................................................................12 1.2.2.1 The genetics of typical and atypical Rolandic Epilepsy................................ 14 1.3 Aim & Objectives ..................................................................................................18 2 RESULTS ................................................................................................................20 2.1 Publication 1: Mutations in GRIN2A cause idiopathic focal epilepsy with rolandic spikes ..................................................................................................................20 2.2 Publication 2: DEPDC5 mutations in genetic focal epilepsies of childhood ...........50 2.3 Publication 3: 16p11.2 600 kb Duplications Confer Risk for Typical and Atypical Rolandic epilepsy..................................................................................................58 2.4 Publication 4: Analysis of ELP4, SRPX2 and interacting genes in typical and atypical Rolandic epilepsy...................................................................................105 3 DISCUSSION.........................................................................................................120 3.1 GRIN2A ..............................................................................................................121 3.2 Copy number variations (16p11.2 microduplication) ...........................................123 3.3 DEPDC5.............................................................................................................126 3.4 Multiple hits in typical and atypical rolandic epilepsy...........................................128 3.5 ELP4 & SRPX2...................................................................................................128 3.6 Summary and Outlook ........................................................................................130 4 SUMMARIZED METHODS ....................................................................................132 4.1 Subjects..............................................................................................................132 4.2 Whole Exome Sequencing..................................................................................132 4.3 Array-Genotyping and CNV calling .....................................................................133 4.4 Sanger Sequencing ............................................................................................134 4.5 Real Time Copy Number Detection.....................................................................134 REFERENCES..............................................................................................................136 ABBREVIATIONS.........................................................................................................146 CURRICULUM VITAE...................................................................................................148
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