Glioma genetic profiles associated with electrophysiologic hyperexcitability

Published by Oxford University Press on behalf of the Society for Neuro-Oncology 2023..

BACKGROUND: Distinct genetic alterations determine glioma aggressiveness, however, the diversity of somatic mutations contributing to peritumoral hyperexcitability and seizures over the course of the disease is uncertain. This study aimed to identify tumor somatic mutation profiles associated with clinically significant hyperexcitability.

METHODS: A single center cohort of adults with WHO grades 1-4 glioma and targeted exome sequencing (n = 1716) was analyzed and cross-referenced with a validated EEG database to identify the subset of individuals who underwent continuous EEG monitoring (n = 206). Hyperexcitability was defined by the presence of lateralized periodic discharges and/or electrographic seizures. Cross-validated discriminant analysis models trained exclusively on recurrent somatic mutations were used to identify variants associated with hyperexcitability.

RESULTS: The distribution of WHO grades and tumor mutational burdens were similar between patients with and without hyperexcitability. Discriminant analysis models classified the presence or absence of EEG hyperexcitability with an overall accuracy of 70.9%, regardless of IDH1 R132H inclusion. Predictive variants included nonsense mutations in ATRX and TP53, indel mutations in RBBP8 and CREBBP, and nonsynonymous missense mutations with predicted damaging consequences in EGFR, KRAS, PIK3CA, TP53, and USP28. This profile improved estimates of hyperexcitability in a multivariate analysis controlling for age, sex, tumor location, integrated pathologic diagnosis, recurrence status, and preoperative epilepsy. Predicted somatic mutation variants were over-represented in patients with hyperexcitability compared to individuals without hyperexcitability and those who did not undergo continuous EEG.

CONCLUSION: These findings implicate diverse glioma somatic mutations in cancer genes associated with peritumoral hyperexcitability. Tumor genetic profiling may facilitate glioma-related epilepsy prognostication and management.

Errataetall:

UpdateOf: medRxiv. 2023 Feb 24;:. - PMID 36865325

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:26

Enthalten in:

Neuro-oncology - 26(2024), 2 vom: 02. Feb., Seite 323-334

Sprache:

Englisch

Beteiligte Personen:

Tobochnik, Steven [VerfasserIn]
Dorotan, Maria Kristina C [VerfasserIn]
Ghosh, Hia S [VerfasserIn]
Lapinskas, Emily [VerfasserIn]
Vogelzang, Jayne [VerfasserIn]
Reardon, David A [VerfasserIn]
Ligon, Keith L [VerfasserIn]
Bi, Wenya Linda [VerfasserIn]
Smirnakis, Stelios M [VerfasserIn]
Lee, Jong Woo [VerfasserIn]

Links:

Volltext

Themen:

Brain tumor
EC 3.4.19.12
Electroencephalography
Epilepsy
Glioma
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.
Somatic mutation
USP28 protein, human
Ubiquitin Thiolesterase

Anmerkungen:

Date Completed 05.02.2024

Date Revised 22.04.2024

published: Print

UpdateOf: medRxiv. 2023 Feb 24;:. - PMID 36865325

Citation Status MEDLINE

doi:

10.1093/neuonc/noad176

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM362106118