Abstract

GNAO1 encephalopathy characterized by a wide spectrum of neurological deficiencies in pediatric patients originates from de novo heterozygous mutations in the gene encoding Gαo, the major neuronal G protein. Efficient treatments and even the proper understanding of the underlying etiology are currently lacking for this dominant disease. Adequate animal models of GNAO1 encephalopathy are urgently needed. Here we describe establishment and characterization of mouse models of the disease based on two point mutations in GNAO1 with different clinical manifestations. One of them is G203R leading to the early-onset epileptic seizures, motor dysfunction, developmental delay and intellectual disability. The other is C215Y producing much milder clinical outcomes, mostly-late-onset hyperkinetic movement disorder. The resultant mouse models show distinct phenotypes: severe neonatal lethality in GNAO1[G203R]/ + mice vs. normal vitality in GNAO1[C215Y]/ + . The latter model further revealed strong hyperactivity and hyperlocomotion in a panel of behavioral assays, without signs of epilepsy, recapitulating the patients’ manifestations. Importantly, despite these differences the two models similarly revealed prenatal brain developmental anomalies, such as enlarged lateral ventricles and decreased numbers of neuronal precursor cells in the cortex. Thus, our work unveils GNAO1 encephalopathy as to a large extent neurodevelopmental malady. We expect that this understanding and the tools we established will be instrumental for future therapeutic developments.

Highlights

  • GNAO1 encephalopathy is a group of neurological disorders, manifesting in infants and children and caused by heterozygous and mainly de novo mutations in GNAO1the gene encoding the major neuronal G protein Gαo [1,2,3,4]

  • First reported in 2013, dominant mutations in GNAO1 cause a spectrum of early-onset neurological deficiencies in affected children, encompassing, depending on the exact mutation, severe motor disabilities, epileptic seizures, developmental delay, intellectual disability, and progressive brain atrophy [1,2,3,4]

  • No curative therapy exists for GNAO1 encephalopathy patients, with symptomatic treatments at best demonstrating partial and temporary effects [3, 10, 11]

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Summary

Introduction

GNAO1 encephalopathy is a group of neurological disorders, manifesting in infants and children and caused by heterozygous and mainly de novo mutations in GNAO1the gene encoding the major neuronal G protein Gαo [1,2,3,4]. One of the hotspots of mutations, c.607G > A producing the Gαo[G203R] protein variant, leads to the most severe manifestations of the disease: early onset (sometimes days after birth) epileptic seizures, severe motor dysfunctions, Silachev et al Acta Neuropathologica Communications (2022) 10:9 developmental and intellectual delay, and brain malformations (Table 1). This mutation has been clinically described in 7 patients [1, 2, 5,6,7] (Table 1); a recent survey reported 12 patients with the Gαo[G203R] substitution [3]. These models will be instrumental in the drug discovery/development targeting GNAO1 encephalopathies

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