Dataset Information

Prognostic value of pathogenic variants in Lafora Disease: systematic review and meta-analysis of patient-level data.

ABSTRACT:

Background

Lafora disease (LD) is a fatal form of progressive myoclonic epilepsy caused by biallelic pathogenic variants in EPM2A or NHLRC1. With a few exceptions, the influence of genetic factors on disease progression has yet to be confirmed. We present a systematic review and meta-analysis of the known pathogenic variants to identify genotype-phenotype correlations.

Methods

We collected all reported cases with genetically-confirmed LD containing data on disease history. Pathogenic variants were classified into missense (MS) and protein-truncating (PT). Three genotype classes were defined according to the combination of the variants: MS/MS, MS/PT, and PT/PT. Time-to-event analysis was performed to evaluate survival and loss of autonomy.

Results

250 cases described in 70 articles were included. The mutated gene was NHLRC1 in 56% and EPM2A in 44% of cases. 114 pathogenic variants (67 EPM2A; 47 NHLRC1) were identified. The NHLRC1 genotype PT/PT was associated with shorter survival [HR 2.88; 95% CI 1.23-6.78] and a trend of higher probability of loss of autonomy [HR 2.03, 95% CI 0.75-5.56] at the multivariable Cox regression analysis. The population carrying the homozygous p.Asp146Asn variant of NHLRC1 genotype was confirmed to have a more favourable prognosis in terms of disease duration.

Conclusions

This study demonstrates the existence of prognostic genetic factors in LD, namely the genotype defined according to the functional impact of the pathogenic variants. Although the reasons why NHLRC1 genotype PT/PT is associated with a poorer prognosis have yet to be fully elucidated, it may be speculated that malin plays a pivotal role in LD pathogenesis.

SUBMITTER: Pondrelli F

PROVIDER: S-EPMC10474773 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Publications

Prognostic value of pathogenic variants in Lafora Disease: systematic review and meta-analysis of patient-level data.

Pondrelli Federica F Minardi Raffaella R Muccioli Lorenzo L Zenesini Corrado C Vignatelli Luca L Licchetta Laura L Mostacci Barbara B Tinuper Paolo P Vander Kooi Craig W CW Gentry Matthew S MS Bisulli Francesca F

Orphanet journal of rare diseases 20230902 1

<h4>Background</h4>Lafora disease (LD) is a fatal form of progressive myoclonic epilepsy caused by biallelic pathogenic variants in EPM2A or NHLRC1. With a few exceptions, the influence of genetic factors on disease progression has yet to be confirmed. We present a systematic review and meta-analysis of the known pathogenic variants to identify genotype-phenotype correlations.<h4>Methods</h4>We collected all reported cases with genetically-confirmed LD containing data on disease history. Pathoge ...[more]

PMID: 37658439

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Dataset Information

Prognostic value of pathogenic variants in Lafora Disease: systematic review and meta-analysis of patient-level data.

Background

Methods

Results

Conclusions

Publications

Prognostic value of pathogenic variants in Lafora Disease: systematic review and meta-analysis of patient-level data.

Similar Datasets

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