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Somatic mosaic deletions involving SCN1A cause Dravet syndrome
Authors:Tojo Nakayama  Atsushi Ishii  Takeshi Yoshida  Hirosato Nasu  Keiko Shimojima  Toshiyuki Yamamoto  Shigeo Kure  Shinichi Hirose
Affiliation:1. Department of Pediatrics, Tohoku University School of Medicine, Sendai, Japan;2. Department of Pediatrics, School of Medicine, Fukuoka University, Fukuoka, Japan;3. Central Research Institute for the Molecular Pathomechanisms of Epilepsy, Fukuoka University, Fukuoka, Japan;4. Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan;5. National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan;6. Tokyo Women's Medical University Institute for Integrated Medical Sciences, Tokyo, Japan
Abstract:
Somatic mosaicism in single nucleotide variants of SCN1A is known to occur in a subset of parents of children with Dravet syndrome (DS). Here, we report recurrent somatic mosaic microdeletions involving SCN1A in children diagnosed with DS. Through the evaluation of 237 affected individuals with DS who did not show SCN1A or PCHD19 mutations in prior sequencing analyzes, we identified two children with mosaic microdeletions covering the entire SCN1A region. The allele frequency of the mosaic deletions estimated by multiplex ligation‐dependent probe amplification and array comparative genomic hybridization was 25–40%, which was comparable to the mosaic ratio in lymphocytes and buccal mucosa cells observed by fluorescence in situ hybridization analysis. The minimal prevalence of SCN1A mosaic deletion is estimated to be 0.9% (95% confidence level: 0.11–3.11%) of DS with negative for SCN1A and PCDH19 mutations. This study reinforces the importance of somatic mosaicism caused by copy number variations in disease‐causing genes, and provides an alternative spectrum of SCN1A mutations causative of DS. Somatic deletions in SCN1A should be considered in cases with DS when standard screenings for SCN1A mutations are apparently negative for mutations.
Keywords:copy number variations  epileptic encephalopathy  microdeletion  somatic mosaicism
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