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DOI: 10.1055/a-2768-3351
Exploring Molecular Pathways Underlying Epilepsy Development in Intellectual Disability
Autor*innen
Abstract
Background
Intellectual disability (ID) and epilepsy are often comorbid, but the pathways that lead to epilepsy in individuals with ID remain unclear. This study aims to explore the molecular pathways linked to epilepsy development in ID, providing insights into shared genetic mechanisms.
Methods
Definitive ID-related genes were extracted from the SysNDD database, and their association with epilepsy pathways was assessed using gene set overrepresentation analysis. Enrichment was performed using Kyoto Encyclopedia of Genes and Genomes (KEGG), Gene Ontology (GO), and Disease Ontology (DO) terms. Pathways were classified based on their relevance to epilepsy, and the involvement of specific genes was analyzed.
Results
Approximately 75% of ID-related genes were associated with epilepsy. Enriched pathways in ID-related epilepsy genes included neurotransmitter signaling, ion channel regulation, and metabolic pathways such as “nicotine addiction” and “thermogenesis.” Key genes like GRIN2A, CACNA1A, and PIGB were found to be involved in multiple pathways, suggesting their potential as therapeutic targets. DO and GO terms indicated shared and distinct mechanisms between ID and epilepsy, with significant overlap in pathways such as “intellectual disability.”
Conclusion
We performed overrepresentation analyses on curated gene sets; the results are descriptive and hypothesis-generating rather than causal. These insights provide potential targets for therapeutic interventions and highlight the need for further research into the genetic underpinnings of epilepsy in this population.
Keywords
intellectual disability - epilepsy - overrepresentation analysis - neurotransmitter signaling - pathway analysisContributors' Statement
All authors have seen and approved the final version of the main text.
Ethical Approval
This study was approved by the Dokuz Eylul University Faculty of Medicine Ethics Committee.
Publikationsverlauf
Eingereicht: 17. August 2025
Angenommen: 04. Dezember 2025
Accepted Manuscript online:
11. Dezember 2025
Artikel online veröffentlicht:
24. Dezember 2025
© 2025. Thieme. All rights reserved.
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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References
- 1 Mir YR, Kuchay RAH. Advances in identification of genes involved in autosomal recessive intellectual disability: a brief review. J Med Genet 2019; 56 (09) 567-573
- 2 Löscher W, Potschka H, Sisodiya SM, Vezzani A. Drug resistance in epilepsy: clinical impact, potential mechanisms, and new innovative treatment options. Pharmacol Rev 2020; 72 (03) 606-638
- 3 Robertson J, Hatton C, Emerson E, Baines S. Prevalence of epilepsy among people with intellectual disabilities: a systematic review. Seizure 2015; 29: 46-62
- 4 Robertson J, Baines S, Emerson E, Hatton C. Service responses to people with intellectual disabilities and epilepsy: a systematic review. J Appl Res Intellect Disabil 2017; 30 (01) 1-32
- 5 Willemsen MH, Kleefstra T. Making headway with genetic diagnostics of intellectual disabilities. Clin Genet 2014; 85 (02) 101-110
- 6 Ruggiero SM, Xian J, Helbig I. The current landscape of epilepsy genetics: where are we, and where are we going?. Curr Opin Neurol 2023; 36 (02) 86-94
- 7 Subramanian A, Tamayo P, Mootha VK. et al. Gene set enrichment analysis: a knowledge-based approach for interpreting genome-wide expression profiles. Proc Natl Acad Sci U S A 2005; 102 (43) 15545-15550
- 8 Wu T, Hu E, Xu S. et al. clusterProfiler 4.0: a universal enrichment tool for interpreting omics data. Innovation (Camb) 2021; 2 (03) 100141
- 9 Kanehisa M, Goto S. KEGG: Kyoto Encyclopedia of Genes and Genomes. Nucleic Acids Res 2000; 28 (01) 27-30
- 10 Ashburner M, Ball CA, Blake JA. et al; The Gene Ontology Consortium. Gene ontology: tool for the unification of biology. Nat Genet 2000; 25 (01) 25-29
- 11 Schriml LM, Munro JB, Schor M. et al. The Human Disease Ontology 2022 update. Nucleic Acids Res 2022; 50 (D1): D1255-D1261
- 12 Günay Ç, Aykol D, Özsoy Ö. et al. Shared biological pathways and processes in patients with intellectual disability: a multicenter study. Neuropediatrics 2023; 54 (04) 225-238
- 13 Jin Y, Zhao C, Chen L. et al. Identification of novel gene and pathway targets for human epilepsy treatment. Biol Res 2016; 49 (01) 3
- 14 Zhang MW, Liang XY, Wang J. et al; China Epilepsy Gene 1.0 Project. Epilepsy-associated genes: an update. Seizure 2024; 116: 4-13
- 15 Sarlo GL, Holton KF. Brain concentrations of glutamate and GABA in human epilepsy: a review. Seizure 2021; 91: 213-227
- 16 Kaiser J, Risteska A, Muller AG. et al. Convergence on CaMK4: a key modulator of autism-associated signaling pathways in neurons. Biol Psychiatry 2025; 97 (05) 439-449
- 17 Yang K, Zhang T, Niu R. et al. Unveiling the role of IGF1R in autism spectrum disorder: a multi-omics approach to decipher common pathogenic mechanisms in the IGF signaling pathway. Front Genet 2024; 15: 1483574
- 18 Wang L, Park JY, Liu F. et al. A kinase-independent function of cyclin-dependent kinase 6 promotes outer radial glia expansion and neocortical folding. Proc Natl Acad Sci USA 2022; 119 (38) e2206147119
- 19 Safavi F, Calco B, Steiner J. et al. Neuroimmunology: PIK3R1 Ile571TyrfsTer31 plays an important role in neuronal function and survival. Clin Immunol 2023; 250: 109365
- 20 Kim YE, Baek ST. Neurodevelopmental aspects of RASopathies. Mol Cells 2019; 42 (06) 441-447
- 21 Yamamoto GL, Aguena M, Gos M. et al. Rare variants in SOS2 and LZTR1 are associated with Noonan syndrome. J Med Genet 2015; 52 (06) 413-421
- 22 Cordeddu V, Yin JC, Gunnarsson C. et al. Activating mutations affecting the Dbl homology domain of SOS2 cause Noonan syndrome. Hum Mutat 2015; 36 (11) 1080-1087
- 23 Akyuz E, Polat AK, Eroglu E, Kullu I, Angelopoulou E, Paudel YN. Revisiting the role of neurotransmitters in epilepsy: an updated review. Life Sci 2021; 265: 118826
- 24 Myers SJ, Yuan H, Kang JQ, Tan FCK, Traynelis SF, Low CM. Distinct roles of GRIN2A and GRIN2B variants in neurological conditions. F1000 Res 2019; 8: 8
- 25 Spires TL, Molnár Z, Kind PC. et al. Activity-dependent regulation of synapse and dendritic spine morphology in developing barrel cortex requires phospholipase C-β1 signalling. Cereb Cortex 2005; 15 (04) 385-393
- 26 Hommersom MP, Doorn N, Puvogel S. et al. CACNA1A haploinsufficiency leads to reduced synaptic function and increased intrinsic excitability. Brain 2025; 148 (04) 1286-1301
- 27 Akamine S, Okuzono S, Yamamoto H. et al. GNAO1 organizes the cytoskeletal remodeling and firing of developing neurons. FASEB J 2020; 34 (12) 16601-16621
- 28 Szabadics J, Varga C, Molnár G, Oláh S, Barzó P, Tamás G. Excitatory effect of GABAergic axo-axonic cells in cortical microcircuits. Science 2006; 311 (5758): 233-235
- 29 Mattison KA, Tossing G, Mulroe F. et al; Genomics England Research Consortium. ATP6V0C variants impair V-ATPase function causing a neurodevelopmental disorder often associated with epilepsy. Brain 2023; 146 (04) 1357-1372
- 30 Zoncu R, Bar-Peled L, Efeyan A, Wang S, Sancak Y, Sabatini DM. mTORC1 senses lysosomal amino acids through an inside-out mechanism that requires the vacuolar H(+)-ATPase. Science 2011; 334 (6056): 678-683
- 31 Tang J, Maximov A, Shin OH, Dai H, Rizo J, Südhof TCA. A complexin/synaptotagmin 1 switch controls fast synaptic vesicle exocytosis. Cell 2006; 126 (06) 1175-1187
- 32 Maximov A, Tang J, Yang X, Pang ZP, Südhof TC. Complexin controls the force transfer from SNARE complexes to membranes in fusion. Science 2009; 323 (5913): 516-521
- 33 Reim K, Mansour M, Varoqueaux F. et al. Complexins regulate a late step in Ca2+-dependent neurotransmitter release. Cell 2001; 104 (01) 71-81
- 34 Vardar G, Gerth F, Schmitt XJ. et al. Epilepsy-causing STX1B mutations translate altered protein functions into distinct phenotypes in mouse neurons. Brain 2020; 143 (07) 2119-2138
- 35 Wolff M, Johannesen KM, Hedrich UBS. et al. Genetic and phenotypic heterogeneity suggest therapeutic implications in SCN2A-related disorders. Brain 2017; 140 (05) 1316-1336
- 36 Ma C, Su L, Seven AB, Xu Y, Rizo J. Reconstitution of the vital functions of Munc18 and Munc13 in neurotransmitter release. Science 2013; 339 (6118): 421-425
- 37 Murakami Y, Kanzawa N, Saito K. et al. Mechanism for release of alkaline phosphatase caused by glycosylphosphatidylinositol deficiency in patients with hyperphosphatasia mental retardation syndrome. J Biol Chem 2012; 287 (09) 6318-6325
- 38 Johnstone DL, Nguyen TTM, Murakami Y. et al; Care4Rare Canada Consortium. Compound heterozygous mutations in the gene PIGP are associated with early infantile epileptic encephalopathy. Hum Mol Genet 2017; 26 (09) 1706-1715
- 39 Santoro B, Liu DT, Yao H. et al. Identification of a gene encoding a hyperpolarization-activated pacemaker channel of brain. Cell 1998; 93 (05) 717-729
- 40 Simmer JP, Kelly RE, Rinker Jr AG. et al. Mammalian dihydroorotase: nucleotide sequence, peptide sequences, and evolution of the dihydroorotase domain of the multifunctional protein CAD. Proc Natl Acad Sci U S A 1990; 87 (01) 174-178
- 41 van Karnebeek CDM, Ramos RJ, Wen XY. et al. Bi-allelic GOT2 mutations cause a treatable malate-aspartate shuttle-related encephalopathy. Am J Hum Genet 2019; 105 (03) 534-548
- 42 Nguyen VTT, Vu VV, Pham PV. Brown adipocyte and browning thermogenesis: metabolic crosstalk beyond mitochondrial limits and physiological impacts. Adipocyte 2023; 12 (01) 2237164
- 43 Solmonson A, DeBerardinis RJ. Lipoic acid metabolism and mitochondrial redox regulation. J Biol Chem 2018; 293 (20) 7522-7530
- 44 Murakami Y, Nguyen TTM, Baratang N. et al. Mutations in PIGB cause an inherited GPI biosynthesis defect with an axonal neuropathy and metabolic abnormality in severe cases. Am J Hum Genet 2019; 105 (02) 384-394
- 45 Krenn M, Knaus A, Westphal DS. et al. Biallelic mutations in PIGP cause developmental and epileptic encephalopathy. Ann Clin Transl Neurol 2019; 6 (05) 968-973
- 46 Efthymiou S, Dutra-Clarke M, Maroofian R. et al. Expanding the phenotype of PIGS-associated early onset epileptic developmental encephalopathy. Epilepsia 2021; 62 (02) e35-e41
- 47 Martín-Grau C, Orellana Alonso C, Roselló Piera M. et al. Expanding the phenotype of PIGP deficiency to multiple congenital anomalies-hypotonia-seizures syndrome. Clin Genet 2023; 104 (02) 245-250
- 48 Schiavoni S, Spagnoli C, Rizzi S. et al. Further delineation of PIGB-related early infantile epileptic encephalopathy. Eur J Med Genet 2021; 64 (10) 104268
