@article {694, title = {Infant mortality: the contribution of genetic disorders.}, journal = {J Perinatol}, volume = {39}, year = {2019}, month = {2019 Dec}, pages = {1611-1619}, abstract = {

OBJECTIVE: To determine the proportion of infant deaths occurring in the setting of a confirmed genetic disorder.

STUDY DESIGN: A retrospective analysis of the electronic medical records of infants born from 1 January, 2011 to 1 June, 2017, who died prior to 1 year of age.

RESULTS: Five hundred and seventy three deceased infants were identified. One hundred and seventeen were confirmed to have a molecular or cytogenetic diagnosis in a clinical diagnostic laboratory and an additional seven were diagnosed by research testing for a total of 124/573 (22\%) diagnosed infants. A total of 67/124 (54\%) had chromosomal disorders and 58/124 (47\%) had single gene disorders (one infant had both). The proportion of diagnoses made by sequencing technologies, such as exome sequencing, increased over the years.

CONCLUSIONS: The prevalence of confirmed genetic disorders within our cohort of infant deaths is higher than that previously reported. Increased efforts are needed to further understand the mortality burden of genetic disorders in infancy.

}, issn = {1476-5543}, doi = {10.1038/s41372-019-0451-5}, author = {Wojcik, Monica H and Schwartz, Talia S and Thiele, Katri E and Paterson, Heather and Stadelmaier, Rachel and Mullen, Thomas E and VanNoy, Grace E and Genetti, Casie A and Madden, Jill A and Gubbels, Cynthia S and Yu, Timothy W and Tan, Wen-Hann and Agrawal, Pankaj B} } @article {653, title = {Unique bioinformatic approach and comprehensive reanalysis improve diagnostic yield of clinical exomes.}, journal = {Eur J Hum Genet}, year = {2019}, month = {2019 Apr 12}, abstract = {

Clinical exome sequencing (CES) is increasingly being utilized; however, a large proportion of patients remain undiagnosed, creating a need for a systematic approach to increase the diagnostic yield. We have reanalyzed CES data for a clinically heterogeneous cohort of 102 probands with likely Mendelian conditions, including 74 negative cases and 28 cases with candidate variants, but reanalysis requested by clinicians. Reanalysis was performed by an interdisciplinary team using a validated custom-built pipeline, "Variant Explorer Pipeline" (VExP). This reanalysis approach and results were compared with existing literature. Reanalysis of candidate variants from CES in 28 cases revealed 1 interpretation that needed to be reclassified. A confirmed or potential genetic diagnosis was identified in 24 of 75 CES-negative/reclassified cases (32.0\%), including variants in known disease-causing genes (n = 6) or candidate genes (n = 18). This yield was higher compared with similar studies demonstrating the utility of this approach. In summary, reanalysis of negative CES in a research setting enhances diagnostic yield by about a third. This study suggests the need for comprehensive, continued reanalysis of exome data when molecular diagnosis is elusive.

}, issn = {1476-5438}, doi = {10.1038/s41431-019-0401-x}, author = {Schmitz-Abe, Klaus and Li, Qifei and Rosen, Samantha M and Nori, Neeharika and Madden, Jill A and Genetti, Casie A and Wojcik, Monica H and Ponnaluri, Sadhana and Gubbels, Cynthia S and Picker, Jonathan D and O{\textquoteright}Donnell-Luria, Anne H and Yu, Timothy W and Bodamer, Olaf and Brownstein, Catherine A and Beggs, Alan H and Agrawal, Pankaj B} } @article {17, title = {The sensitivity of exome sequencing in identifying pathogenic mutations for LGMD in the United States.}, journal = {J Hum Genet}, volume = {62}, year = {2017}, month = {2017 Feb}, pages = {243-252}, abstract = {

The current study characterizes a cohort of limb-girdle muscular dystrophy (LGMD) in the United States using whole-exome sequencing. Fifty-five families affected by LGMD were recruited using an institutionally approved protocol. Exome sequencing was performed on probands and selected parental samples. Pathogenic mutations and cosegregation patterns were confirmed by Sanger sequencing. Twenty-two families (40\%) had novel and previously reported pathogenic mutations, primarily in LGMD genes, and also in genes for Duchenne muscular dystrophy, facioscapulohumeral muscular dystrophy, congenital myopathy, myofibrillar myopathy, inclusion body myopathy and Pompe disease. One family was diagnosed via clinical testing. Dominant mutations were identified in COL6A1, COL6A3, FLNC, LMNA, RYR1, SMCHD1 and VCP, recessive mutations in ANO5, CAPN3, GAA, LAMA2, SGCA and SGCG, and X-linked mutations in DMD. A previously reported variant in DMD was confirmed to be benign. Exome sequencing is a powerful diagnostic tool for LGMD. Despite careful phenotypic screening, pathogenic mutations were found in other muscle disease genes, largely accounting for the increased sensitivity of exome sequencing. Our experience suggests that broad sequencing panels are useful for these analyses because of the phenotypic overlap of many neuromuscular conditions. The confirmation of a benign DMD variant illustrates the potential of exome sequencing to help determine pathogenicity.

}, keywords = {Base Sequence, Distal Myopathies, Exome, Female, Genetic Testing, Glycogen Storage Disease Type II, Humans, Male, Muscular Dystrophies, Limb-Girdle, Muscular Dystrophy, Duchenne, Muscular Dystrophy, Facioscapulohumeral, Mutation, Myopathies, Structural, Congenital, Sequence Analysis, DNA, United States}, issn = {1435-232X}, doi = {10.1038/jhg.2016.116}, author = {Reddy, Hemakumar M and Cho, Kyung-Ah and Lek, Monkol and Estrella, Elicia and Valkanas, Elise and Jones, Michael D and Mitsuhashi, Satomi and Darras, Basil T and Amato, Anthony A and Lidov, Hart Gw and Brownstein, Catherine A and Margulies, David M and Yu, Timothy W and Salih, Mustafa A and Kunkel, Louis M and MacArthur, Daniel G and Kang, Peter B} } @article {82, title = {Overlapping 16p13.11 deletion and gain of copies variations associated with childhood onset psychosis include genes with mechanistic implications for autism associated pathways: Two case reports.}, journal = {Am J Med Genet A}, volume = {170A}, year = {2016}, month = {2016 May}, pages = {1165-73}, abstract = {

Copy number variability at 16p13.11 has been associated with intellectual disability, autism, schizophrenia, epilepsy, and attention-deficit hyperactivity disorder. Adolescent/adult- onset psychosis has been reported in a subset of these cases. Here, we report on two children with CNVs in 16p13.11 that developed psychosis before the age of 7. The genotype and neuropsychiatric abnormalities of these patients highlight several overlapping genes that have possible mechanistic relevance to pathways previously implicated in Autism Spectrum Disorders, including the mTOR signaling and the ubiquitin-proteasome cascades. A careful screening of the 16p13.11 region is warranted in patients with childhood onset psychosis.

}, keywords = {Autistic Disorder, Child, Child, Preschool, Chromosome Deletion, Chromosomes, Human, Pair 16, Comparative Genomic Hybridization, Developmental Disabilities, DNA Copy Number Variations, Female, Genetic Association Studies, Humans, Male, Psychotic Disorders, Schizophrenia, Signal Transduction}, issn = {1552-4833}, doi = {10.1002/ajmg.a.37595}, author = {Brownstein, Catherine A and Kleiman, Robin J and Engle, Elizabeth C and Towne, Meghan C and D{\textquoteright}Angelo, Eugene J and Yu, Timothy W and Beggs, Alan H and Picker, Jonathan and Fogler, Jason M and Carroll, Devon and Schmitt, Rachel C O and Wolff, Robert R and Shen, Yiping and Lip, Va and Bilguvar, Kaya and Kim, April and Tembulkar, Sahil and O{\textquoteright}Donnell, Kyle and Gonzalez-Heydrich, Joseph} } @article {226, title = {Somatic mutations in cerebral cortical malformations.}, journal = {N Engl J Med}, volume = {371}, year = {2014}, month = {2014 Aug 21}, pages = {733-43}, abstract = {

BACKGROUND: Although there is increasing recognition of the role of somatic mutations in genetic disorders, the prevalence of somatic mutations in neurodevelopmental disease and the optimal techniques to detect somatic mosaicism have not been systematically evaluated.

METHODS: Using a customized panel of known and candidate genes associated with brain malformations, we applied targeted high-coverage sequencing (depth, >=200{\texttimes}) to leukocyte-derived DNA samples from 158 persons with brain malformations, including the double-cortex syndrome (subcortical band heterotopia, 30 persons), polymicrogyria with megalencephaly (20), periventricular nodular heterotopia (61), and pachygyria (47). We validated candidate mutations with the use of Sanger sequencing and, for variants present at unequal read depths, subcloning followed by colony sequencing.

RESULTS: Validated, causal mutations were found in 27 persons (17\%; range, 10 to 30\% for each phenotype). Mutations were somatic in 8 of the 27 (30\%), predominantly in persons with the double-cortex syndrome (in whom we found mutations in DCX and LIS1), persons with periventricular nodular heterotopia (FLNA), and persons with pachygyria (TUBB2B). Of the somatic mutations we detected, 5 (63\%) were undetectable with the use of traditional Sanger sequencing but were validated through subcloning and subsequent sequencing of the subcloned DNA. We found potentially causal mutations in the candidate genes DYNC1H1, KIF5C, and other kinesin genes in persons with pachygyria.

CONCLUSIONS: Targeted sequencing was found to be useful for detecting somatic mutations in patients with brain malformations. High-coverage sequencing panels provide an important complement to whole-exome and whole-genome sequencing in the evaluation of somatic mutations in neuropsychiatric disease. (Funded by the National Institute of Neurological Disorders and Stroke and others.).

}, keywords = {Cerebral Cortex, Classical Lissencephalies and Subcortical Band Heterotopias, DNA Mutational Analysis, Humans, Lissencephaly, Magnetic Resonance Imaging, Malformations of Cortical Development, Mutation, Periventricular Nodular Heterotopia}, issn = {1533-4406}, doi = {10.1056/NEJMoa1314432}, author = {Jamuar, Saumya S and Lam, Anh-Thu N and Kircher, Martin and D{\textquoteright}Gama, Alissa M and Wang, Jian and Barry, Brenda J and Zhang, Xiaochang and Hill, Robert Sean and Partlow, Jennifer N and Rozzo, Aldo and Servattalab, Sarah and Mehta, Bhaven K and Topcu, Meral and Amrom, Dina and Andermann, Eva and Dan, Bernard and Parrini, Elena and Guerrini, Renzo and Scheffer, Ingrid E and Berkovic, Samuel F and Leventer, Richard J and Shen, Yiping and Wu, Bai Lin and Barkovich, A James and Sahin, Mustafa and Chang, Bernard S and Bamshad, Michael and Nickerson, Deborah A and Shendure, Jay and Poduri, Annapurna and Yu, Timothy W and Walsh, Christopher A} }