Unstable TTTTA/TTTCA expansions in MARCH6 are associated with Familial Adult Myoclonic Epilepsy type 3.

Florian, Rahel T.; Kraft, Florian ORCID; Leitão, Elsa ORCID; Kaya, Sabine; Klebe, Stephan GND; Magnin, Eloi; van Rootselaar, Anne-Fleur ORCID; Buratti, Julien ORCID; Kühnel, Theresa; Schröder, Christopher; Giesselmann, Sebastian; Tschernoster, Nikolai; Altmueller, Janine; Lamiral, Anaide ORCID; Keren, Boris; Nava, Caroline; Bouteiller, Delphine; Forlani, Sylvie; Jornea, Ludmila; Kubica, Regina; Ye, Tao ORCID; Plassard, Damien ORCID; Jost, Bernard; Meyer, Vincent; Deleuze, Jean-François; Delpu, Yannick; Avarello, Mario D. M.; Vijfhuizen, Lisanne S.; Rudolf, Gabrielle ORCID; Hirsch, Edouard; Kroes, Thessa; Reif, Philipp S.; Rosenow, Felix; Ganos, Christos; Vidailhet, Marie; Thivard, Lionel; Mathieu, Alexandre; Bourgeron, Thomas; Kurth, Ingo ORCID; Rafehi, Haloom; Steenpaß, Laura; Horsthemke, Bernhard GND; LeGuern, Eric; Klein, Karl Martin ORCID; Labauge, Pierre ORCID; Bennett, Mark F. ORCID; Bahlo, Melanie ORCID; Gecz, Jozef ORCID; Corbett, Mark A. ORCID; Tijssen, Marina A. J. ORCID; van den Maagdenberg, Arn M. J. M.; Depienne, Christel ORCID

Familial Adult Myoclonic Epilepsy (FAME) is a genetically heterogeneous disorder characterized by cortical tremor and seizures. Intronic TTTTA/TTTCA repeat expansions in SAMD12 (FAME1) are the main cause of FAME in Asia. Using genome sequencing and repeat-primed PCR, we identify another site of this repeat expansion, in MARCH6 (FAME3) in four European families. Analysis of single DNA molecules with nanopore sequencing and molecular combing show that expansions range from 3.3 to 14 kb on average. However, we observe considerable variability in expansion length and structure, supporting the existence of multiple expansion configurations in blood cells and fibroblasts of the same individual. Moreover, the largest expansions are associated with micro-rearrangements occurring near the expansion in 20% of cells. This study provides further evidence that FAME is caused by intronic TTTTA/TTTCA expansions in distinct genes and reveals that expansions exhibit an unexpectedly high somatic instability that can ultimately result in genomic rearrangements.

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Florian, Rahel / Kraft, Florian / Leitão, Elsa / et al: Unstable TTTTA/TTTCA expansions in MARCH6 are associated with Familial Adult Myoclonic Epilepsy type 3.. 2019.

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