We identified 15q13.3 microdeletions encompassing the CHRNA7 gene in 12 of 1,223 individuals with idiopathic generalized epilepsy (IGE), which were not detected in 3,699 controls (joint P = 5.32 × 10 −8 ). Most deletion carriers showed common IGE syndromes without other features previously associated with 15q13.3 microdeletions, such as intellectual disability, autism or schizophrenia. Our results indicate that 15q13.3 microdeletions constitute the most prevalent risk factor for common epilepsies identified to date.Idiopathic generalized epilepsies (IGE) are common seizure disorders accounting for up to one-third of all epilepsies 1 . The vast majority of individuals with IGE have a complex genetic etiology2, for which the underlying genetic alterations remain largely unknown. Recently, a 15q13.3 microdeletion syndrome has been identified in 0.2-0.3% of individuals Correspondence should be addressed to T.S. (sandert@uni-koeln.de). Note: Supplementary information is available on the Nature Genetics website. AUTHOR CONTRIBUTIONST.S. and E.E.E. initiated and designed the study; I.H., H.M., S.v.S., I.S., A.A.K.-L., V.G., B.S., K.M.K., P.S.R., F.R., Y.W., H.L., F.Z., L.U., K.F., M. Feucht, F.V., G.-J.d.H., R.S.M., H.H., D. Luciano, C.R., D. Lindhout, C.E.E., U.S. and T.S. recruited and phenotyped the EPICURE sample; H.C.M., A.J.S., M.G., M. Fichera, C.B., P.G., P.T., A.M. and E.E.E. recruited and phenotyped the mixed IGE sample; A.F., M.W., M.N. and S.S. recruited and phenotyped the PopGen control sample; I.H., A.F., C.L., K.L.K., I.S., M.W., M.N., P.N. and T.S. performed the CNV analysis on SNP arrays; H.C.M., A.J.S., M. Fichera, C.B. and D. Luciano performed the qPCR screening; H.C.M., M. Fichera, C.B. and D. Luciano performed the screening using Illumina Genotyping BeadChips; H.C.M., A.J.S. and C.B. performed the confirmation using NimbleGen arrays; C.d.K., B.P.C.K. and D. Lindhout performed the confirmation using Illumina CNV BeadChips; I.H., H.C.M., A.J.S., M.G., M. Fichera, A.F., C.d.K., K.L.K., C.R., B.P.C.K., D. Lindhout, E.E.E. and T.S. coordinated the work and prepared the manuscript. Susceptibility loci for common idiopathic epilepsies, comprising benign epilepsy of childhood with centrotemporal spikes7 and common IGE syndromes8 ,9 , have also been mapped to the 15q13-q14 region. To test whether the 15q13.3 deletion increases risk of common epilepsies, we screened for structural variants within the 15q13.3 region in two independent samples of individuals with IGE and ancestrally matched controls. The first sample comprised 647 unrelated IGE cases of Western European ancestry (EPICURE sample) and 1,202 German controls (PopGen) genotyped using the Affymetrix GenomeWide Human SNP array 6.0. We identified the 15q13.3 microdeletion in 7 of 647 IGE cases ( Supplementary Fig. 1 online) with different IGE syndromes ( Supplementary Fig. 2 online). Thus, our results suggest that the 15q13.3 deletion only, and not the reciprocal duplication, represents a major risk factor for IGE. NIH Public AccessIn our stu...

Idiopathic generalized epilepsies account for 30% of all epilepsies. Despite a predominant genetic aetiology, the genetic factors predisposing to idiopathic generalized epilepsies remain elusive. Studies of structural genomic variations have revealed a significant excess of recurrent microdeletions at 1q21.1, 15q11.2, 15q13.3, 16p11.2, 16p13.11 and 22q11.2 in various neuropsychiatric disorders including autism, intellectual disability and schizophrenia. Microdeletions at 15q13.3 have recently been shown to constitute a strong genetic risk factor for common idiopathic generalized epilepsy syndromes, implicating that other recurrent microdeletions may also be involved in epileptogenesis. This study aimed to investigate the impact of five microdeletions at the genomic hotspot regions 1q21.1, 15q11.2, 16p11.2, 16p13.11 and 22q11.2 on the genetic risk to common idiopathic generalized epilepsy syndromes. The candidate microdeletions were assessed by high-density single nucleotide polymorphism arrays in 1234 patients with idiopathic generalized epilepsy from North-western Europe and 3022 controls from the German population. Microdeletions were validated by quantitative polymerase chain reaction and their breakpoints refined by array comparative genomic hybridization. In total, 22 patients with idiopathic generalized epilepsy (1.8%) carried one of the five novel microdeletions compared with nine controls (0.3%) (odds ratio = 6.1; 95% confidence interval 2.8-13.2; chi(2) = 26.7; 1 degree of freedom; P = 2.4 x 10(-7)). Microdeletions were observed at 1q21.1 [Idiopathic generalized epilepsy (IGE)/control: 1/1], 15q11.2 (IGE/control: 12/6), 16p11.2 IGE/control: 1/0, 16p13.11 (IGE/control: 6/2) and 22q11.2 (IGE/control: 2/0). Significant associations with IGEs were found for the microdeletions at 15q11.2 (odds ratio = 4.9; 95% confidence interval 1.8-13.2; P = 4.2 x 10(-4)) and 16p13.11 (odds ratio = 7.4; 95% confidence interval 1.3-74.7; P = 0.009). Including nine patients with idiopathic generalized epilepsy in this cohort with known 15q13.3 microdeletions (IGE/control: 9/0), parental transmission could be examined in 14 families. While 10 microdeletions were inherited (seven maternal and three paternal transmissions), four microdeletions occurred de novo at 15q13.3 (n = 1), 16p13.11 (n = 2) and 22q11.2 (n = 1). Eight of the transmitting parents were clinically unaffected, suggesting that the microdeletion itself is not sufficient to cause the epilepsy phenotype. Although the microdeletions investigated are individually rare (<1%) in patients with idiopathic generalized epilepsy, they collectively seem to account for a significant fraction of the genetic variance in common idiopathic generalized epilepsy syndromes. The present results indicate an involvement of microdeletions at 15q11.2 and 16p13.11 in epileptogenesis and strengthen the evidence that recurrent microdeletions at 15q11.2, 15q13.3 and 16p13.11 confer a pleiotropic susceptibility effect to a broad range of neuropsychiatric disorders.

GABA A receptors are ligand-gated chloride ion channels that are presumed to be pentamers composed of ␣, ␤, and ␥ subunits. The subunit stoichiometry, however, is controversial, and the subunit arrangement presently is not known. In this study the ratio of subunits in recombinant ␣1␤3␥2 receptors was determined in Western blots from the relative signal intensities of antibodies directed against the N terminus or the cytoplasmic loop of different subunits after the relative reactivity of these antibodies had been determined with GABA A receptor subunit chimeras composed of the N-terminal domain of one and the remaining part of the other subunit. Via this method a subunit stoichiometry of two ␣ subunits, two ␤ subunits, and one ␥ subunit was derived. Similar experiments investigating the composition of ␣1␤3 receptors expressed on the surface of human embryonic kidney (HEK) 293 cells cotransfected with ␣1 and ␤3 subunits resulted in a stoichiometry of two ␣ and three ␤ subunits. Density gradient centrifugation studies indicated that combinations of ␣1␤3␥2 or ␣1␤3 subunits expressed in HEK 293 cells are able to form pentamers, whereas combinations of ␣1␥2 or ␤3␥2 subunits predominantly form heterodimers. These results provide valuable information on the mechanism of GABA A receptor assembly and support the conclusion that GABA A receptors are pentamers in which a total of four alternating ␣ and ␤ subunits are connected by a ␥ subunit. Key words: GABA A receptor; stoichiometry; assembly; subunit arrangement; human embryonic kidney 293 cells; chimeric subunits; density gradient centrifugation; Western blotGABA, the major inhibitory transmitter in the CNS, mediates fast synaptic inhibition by opening the chloride ion channel intrinsic to the GABA A receptor. This receptor is a hetero-oligomeric protein and the site of action of a variety of pharmacologically and clinically important drugs, such as benzodiazepines, barbiturates, steroids, anesthetics, and convulsants (Sieghart, 1995). So far, six ␣, three ␤, three ␥, one ␦, and two subunits of these receptors, as well as several alternatively spliced isoforms of some of these subunits, have been identified in mammalian brain (Macdonald and Olsen, 1994;Sieghart, 1995). Expression studies have indicated that an ␣, a ␤, and a ␥ subunit have to combine to produce GABA A receptors with a pharmacology resembling that of receptors found in the brain and that, depending on the subunits used for transfection of cells, receptors with distinct pharmacological and electrophysiological properties do arise (Sieghart, 1995). Overall it is assumed, however, that a total of five subunits have to combine to form functional GABA A receptors (Nayeem et al., 1994).A variety of subunit-specific antibodies has been raised to investigate the subunit composition of GABA A receptors. Immunocytochemical studies demonstrating the colocalization of subunits in GABA A receptor clusters on neuronal membranes (Fritschy et al., 1992;Caruncho and Costa, 1994;Fritschy and Möhler, 1995;Somogyi et al., 199...