The Epilepsy Phenome/Genome Project

Background Epilepsy is a common neurological disorder that affects approximately 50 million people worldwide. Both risk of epilepsy and response to treatment partly depend on genetic factors, and gene identification is a promising approach to target new prediction, treatment, and prevention strategies. However, despite significant progress in the identification of genes causing epilepsy in families with a Mendelian inheritance pattern, there is relatively little known about the genetic factors responsible for common forms of epilepsy and so-called epileptic encephalopathies. Study design The Epilepsy Phenome/Genome Project (EPGP) is a multi-institutional, retrospective phenotype–genotype study designed to gather and analyze detailed phenotypic information and DNA samples on 5250 participants, including probands with specific forms of epilepsy and, in a subset, parents of probands who do not have epilepsy. Results EPGP is being executed in four phases: study initiation, pilot, study expansion/establishment, and close-out. This article discusses a number of key challenges and solutions encountered during the first three phases of the project, including those related to (1) study initiation and management, (2) recruitment and phenotyping, and (3) data validation. The study has now enrolled 4223 participants. Conclusions EPGP has demonstrated the value of organizing a large network into cores with specific roles, managed by a strong Administrative Core that utilizes frequent communication and a collaborative model with tools such as study timelines and performance-payment models. The study also highlights the critical importance of an effective informatics system, highly structured recruitment methods, and expert data review.

[1]  W. Hauser,et al.  The risks of seizure disorders among relatives of patients with childhood onset epilepsy , 1982, Neurology.

[2]  W. Nance,et al.  The occurrence of epilepsy and febrile seizures in Virginian and Norwegian twins , 1991, Neurology.

[3]  E. Lander The New Genomics: Global Views of Biology , 1996, Science.

[4]  N. Risch,et al.  Relations of genetic and environmental factors in the etiology of epilepsy , 1996, Annals of neurology.

[5]  E. Wirrell,et al.  Long-term psychosocial outcome in typical absence epilepsy. Sometimes a wolf in sheeps' clothing. , 1997, Archives of pediatrics & adolescent medicine.

[6]  S. Berkovic,et al.  Epilepsies in twins: Genetics of the major epilepsy syndromes , 1998, Annals of neurology.

[7]  E. So,et al.  The Cost of Epilepsy in the United States: An Estimate from Population‐Based Clinical and Survey Data , 2000, Epilepsia.

[8]  L. Lagae,et al.  De novo mutations in the sodium-channel gene SCN1A cause severe myoclonic epilepsy of infancy. , 2001, American journal of human genetics.

[9]  A. Chakravarti Single nucleotide polymorphisms: . . .to a future of genetic medicine , 2001, Nature.

[10]  C. Martin,et al.  A locus for bilateral perisylvian polymicrogyria maps to Xq28. , 2002, American journal of human genetics.

[11]  A. Bianchi,et al.  Family study of epilepsy in first degree relatives: data from the Italian Episcreen Study , 2003, Seizure.

[12]  Kaare Christensen,et al.  Epileptic seizures and syndromes in twins: the importance of genetic factors , 2003, Epilepsy Research.

[13]  E. Sherr,et al.  The ARX story (epilepsy, mental retardation, autism, and cerebral malformations): one gene leads to many phenotypes. , 2003, Current opinion in pediatrics.

[14]  J. Hopper,et al.  Epilepsy in twins , 2004, Neurology.

[15]  P. Genton,et al.  Severe epilepsy, retardation, and dysmorphic features with a 2q deletion including SCN1A and SCN2A , 2004, Neurology.

[16]  A. Berg Understanding the Delay Before Epilepsy Surgery: Who Develops Intractable Focal Epilepsy and When? , 2004, CNS Spectrums.

[17]  E. Andermann,et al.  Genetics of the polymicrogyria syndromes , 2005, Journal of Medical Genetics.

[18]  R. Ottman Analysis of Genetically Complex Epilepsies , 2005, Epilepsia.

[19]  U. Stephani,et al.  Recurrent de novo mutations of SCN1A in severe myoclonic epilepsy of infancy. , 2006, Pediatric neurology.

[20]  K. Hemminki,et al.  Familial Risks for Epilepsy among Siblings Based on Hospitalizations in Sweden , 2006, Neuroepidemiology.

[21]  I. Scheffer,et al.  Multicentre search for genetic susceptibility loci in sporadic epilepsy syndrome and seizure types: a case-control study , 2007, The Lancet Neurology.

[22]  N. Boddaert,et al.  The three stages of epilepsy in patients with CDKL5 mutations , 2008, Epilepsia.

[23]  I. Scheffer,et al.  Navigating the channels and beyond: unravelling the genetics of the epilepsies , 2008, The Lancet Neurology.

[24]  Naomichi Matsumoto,et al.  De novo mutations in the gene encoding STXBP1 (MUNC18-1) cause early infantile epileptic encephalopathy , 2008, Nature Genetics.

[25]  Judy H. Cho,et al.  Finding the missing heritability of complex diseases , 2009, Nature.

[26]  Christian E Elger,et al.  15q13.3 microdeletions increase risk of idiopathic generalized epilepsy , 2009, Nature Genetics.

[27]  D. Goldstein Common genetic variation and human traits. , 2009, The New England journal of medicine.

[28]  J. Armstrong,et al.  Novel FOXG1 mutations associated with the congenital variant of Rett syndrome , 2009, Journal of Medical Genetics.

[29]  Samuel F. Berkovic,et al.  Mechanisms of human inherited epilepsies , 2009, Progress in Neurobiology.

[30]  Michael R. Johnson,et al.  Rare deletions at 16p13.11 predispose to a diverse spectrum of sporadic epilepsy syndromes. , 2010, American journal of human genetics.

[31]  I. Scheffer,et al.  Genetic testing in the epilepsies—Report of the ILAE Genetics Commission , 2010, Epilepsia.

[32]  I. Scheffer,et al.  Copy number variants--an unexpected risk factor for the idiopathic generalized epilepsies. , 2010, Brain : a journal of neurology.

[33]  Michael R. Johnson,et al.  Common genetic variation and susceptibility to partial epilepsies: a genome-wide association study , 2010, Brain : a journal of neurology.

[34]  C. Baker,et al.  Recurrent microdeletions at 15q11.2 and 16p13.11 predispose to idiopathic generalized epilepsies. , 2010, Brain : a journal of neurology.

[35]  M. Kerr,et al.  Epidemiology of Epilepsies in Developed Countries , 2010 .

[36]  A. Singleton,et al.  Towards a complete resolution of the genetic architecture of disease. , 2010, Trends in genetics : TIG.

[37]  Epidemiology of Epilepsies in Resource-poor Countries , 2010 .

[38]  Ulrich Stephani,et al.  Genome-Wide Copy Number Variation in Epilepsy: Novel Susceptibility Loci in Idiopathic Generalized and Focal Epilepsies , 2010, PLoS genetics.

[39]  W. Hauser,et al.  Estimating risk for developing epilepsy , 2011, Neurology.

[40]  Gerry Nesbitt,et al.  The Epilepsy Phenome/Genome Project (EPGP) informatics platform , 2013, Int. J. Medical Informatics.