Abstract

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social communication and restricted and repetitive behaviors and interests. Identifying the genetic background may be one of the key features for the future diagnosis and treatment of ASD. With the tremendous development in genetic diagnosis techniques, next-generation sequencing (NGS) can be used to analyze multiple genes simultaneously with a single test in laboratory and clinical settings and is well suited for investigating autism genetics. According to previous studies, there are two types of genetic variants in ASD, rare variants and common variants, and both are important in explaining pathogenesis. In this study, NGS data from 137 participants with ASD were reviewed retrospectively with consideration for comorbid epilepsy. Diagnostic yield was 17.51% (24/137), and pathogenic/likely pathogenic variants were seen more frequently in female participants. Fourteen participants were diagnosed with comorbid epilepsy, six of them had pathogenic/likely pathogenic variants (43%). Genes with variants of unknown significance (VOUS) which have one or more evidence of pathogenicity following the American College of Medical Genetics (ACMG) criteria were also reviewed in both ASD and ASD with comorbid epilepsy groups. We found that most frequently found VOUS genes have previously been reported as genes related to ASD or other developmental disorders. These results suggest that when interpreting the NGS results in the clinical setting, careful observation of VOUS with some pathological evidence might contribute to the discovery of genetic pathogenesis of neurodevelopmental disorders such as ASD and epilepsy.

Highlights

  • Autism spectrum disorder (ASD) is a neurodevelopmental disorder with core symptoms of persistent deficits in social communication and restricted, repetitive patterns of behavior, interests, or activities (APA, 2013)

  • Among 137 patients, only three patients showed no pathogenic/ likely pathogenic variants nor variants of unknown significance (VOUS) according to our next-generation sequencing (NGS) clinical reports

  • Seven cases were identified with pathogenic variants, and 17 participants had likely pathogenic variants

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Summary

Introduction

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with core symptoms of persistent deficits in social communication and restricted, repetitive patterns of behavior, interests, or activities (APA, 2013). Autism spectrum disorder is not a disorder but a significant social problem because the annual costs for ASD patients are tremendous (Lavelle et al, 2014). Studies of monozygotic twin concordance and sibling recurrence rates clearly reveal that genetic factors play important roles in the development of ASD (Geschwind, 2011; Sandin et al, 2014; Tick et al, 2016). In this context, identifying the genetic background of each ASD patient could be the ‘cornerstone’ of proper diagnosis and individualized treatment. Tools for genetic analyses are rapidly developing and the collection of genetic information is accelerating tremendously (Geschwind and State, 2015; Loth et al, 2016)

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