Epilepsy Phenome/Genome Project

The Epilepsy Phenome/Genome Project (EPGP) is a government-funded study to identify genes that influence the development of epilepsy and genes that affect the response to treatment. The study involves 13 major epilepsy centers and more than 150 scientists and clinical staff around the United States. The goal is to create a repository of clinical and genetic information on a select group of patients with epilepsy. The hope is that this information will reveal new insights and improve diagnosis and treatment.

EPGP is funded by the National Institutes of Health via [http://www.ninds.nih.gov/ The National Institute for Neurological Disorders and Stroke (NINDS)] .

The long-term goal of EPGP is to identify potential molecular targets that could be the basis of much more specific and effective treatments for patients who have epilepsy, and the prevention of epilepsy in those at risk.

Background on Genes and Epilepsy

Although heredity has been known since antiquity to cause epilepsy, the progress to date in identifying the genetic basis of epilepsy has been limited primarily to the discovery of single gene mutations that cause epilepsy in relatively rare families. For the more common types of epilepsy, heredity plays a subtler role, and it is thought that a combination of mutations in multiple genes likely determine an individual’s susceptibility to seizures, as well as the responsiveness to antiepileptic medications.

EPGP Phenotyping

The approach to teasing apart the more complicated genetic factors in epilepsy requires a very large number of patients whose epilepsy has been extremely well-characterized. EPGP investigators will be enrolling 3,750 patients and 3,000 controls over the course of the study.

Details about seizure types, EEGs, imaging studies, and effects of treatment will be collected and archived in a central data repository, and all participants will be asked to submit a sample of blood as a source of their DNA. Once this first phase of the study is completed, genomic analyses will be used to identify potential connections between patterns of DNA sequences and specific characteristics of epilepsy in the study population.

EPGP Genotyping

Aim 1: Identify Genetic Variants of Common Forms of Epilepsy

We hypothesize that a substantial portion of the inherited risk of epilepsy and pharmacoresistance is due to a small to moderate number of common frequency (frequency > 1%) allelic variants with modest to moderate relative risks.

SubAim 1.1 will identify loci contributing to the occurrence and type of epilepsy.

SubAim 1.2 will identify loci associated with pharmacoresponse to AEDs.

Aim 2: Determine Genetic Influence in Rare, Severe Epilepsy

We will determine the role of de novo copy number polymorphisms (CNPs) in Infantile Spasms (IS) (West syndrome), Lennox Gastaut Syndrome (LGS) (Lennox-Gastaut syndrome), and Polymicrogyria (PMG) (Polymicrogyria)/ Bilateral Periventricular Nodular Heterotopia (PVNH). We will evaluate the role of inherited CNPs in IS, LGS, and PMG/PVNH.

EPGP Clinical Centers

13 clinical centers around the US will enroll patients for EPGP. They are:
* Baylor College of Medicine (Houston, TX) [http://www.bcm.edu/]
* Children's Hospital of Philadelphia (Philadelphia, PA) [http://www.chop.edu/]
* Cincinnati Children's Hospital Medical Center (Cincinnati, OH) [http://www.cincinnatichildrens.org/]
* The Albert Einstein College of Medicine (Bronx, NY) [http://www.aecom.yu.edu/]
* Emory School of Medicine (Atlanta, GA) [http://www.med.emory.edu/]
* Johns Hopkins School of Medicine (Baltimore, MD) [http://www.hopkinsmedicine.org/]
* Mayo Clinic College of Medicine (Rochester, MN) [http://www.mayoclinic.com/]
* New York University School of Medicine (New York, NY) [http://www.med.nyu.edu/]
* Rush University Medical Center (Chicago, IL) [http://www.rush.edu/]
* St. Barnabas Medical Center (West Orange, NJ) [http://www.saintbarnabas.com/services/neuro/index.html]
* University of Alabama at Birmingham School of Medicine (Birmingham, AL) [http://www.uabhealth.org/]
* University of California, San Francisco (San Francisco, CA) [http://www.ucsf.edu/]

EPGP Investigators

EPGP is a collaboration of many of the leaders in epilepsy, epidemiology, and genetics research and informatics.

EPGP investigators include:
* Daniel Lowenstein, MD (UCSF)
* Dennis Dlugos, MD, MCSE (CHOP)
* Eileen Vining, MD (Johns Hopkins)
* Eli Mizrahi, MD (Baylor)
* Gregory Cascino, MD (Mayo)
* Jacqueline French, MD (NYU)
* Lawrence Hudson, MD (University of Michigan)
* Michael Smith, MD (Rush)
* Neil Risch, PhD (UCSF)
* Orrin Devinsky, MD (NYU)
* Peter Widdess-Walsh, MD (St. Barnabas)
* Robert Knowlton, MD (UAB)
* Ruben Kuzniecky, MD (NYU)
* Ruth Ottman, PhD (Columbia)
* Sandra Helmers, MD (Emory)
* Sheryl Haut, MD, MS (Einstein)
* Tracy Glauser, MD (Cincinnati Children's Hospital)

References

* Winawer, M.R., Phenotype definition in epilepsy. Epilepsy Behav, 2006.
* Andermann, F., E. Kobayashi, and E. Andermann, Genetic focal epilepsies: state of the art and paths to the future. Epilepsia, 2005. 46 Suppl 10: p. 61-7.
* Gardiner, M., Genetics of idiopathic generalized epilepsies. Epilepsia, 2005. 46 Suppl 9: p. 15-20.
* Crino, P.B., H. Miyata, and H.V. Vinters, Neurodevelopmental disorders as a cause of seizures: neuropathologic, genetic, and mechanistic considerations. Brain Pathol, 2002. 12(2): p. 212-33.
* Szoeke, C.E., et al., Update on pharmacogenetics in epilepsy: a brief review. Lancet Neurol, 2006. 5(2): p. 189-96.
* Choi H, Winawer MR, Kalachikov S, Pedley TA, Hauser WA, Ottman R. Classification of partial seizure symptoms in genetic studies of the epilepsies. Neurology. 2006 Jun 13;66(11):1648-53.
* Freimer N, Sabatti C. The human phenome project. Nat Genet. 2003 May;34(1):15-21

External links

* [http://www.epgp.org Official web site]