Genome sequencing and comprehensive rare-variant analysis of 465 families with neurodevelopmental disorders
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Abstract
Despite significant progress in unraveling the genetic causes of neurodevelopmental disorders (NDDs), a substantial proportion of individuals with NDDs remain without a genetic diagnosis after microarray and/or exome sequencing. Here, we aimed to assess the power of short-read genome sequencing (GS), complemented with long-read GS, to identify causal variants in participants with NDD from the National Institute for Health and Care Research (NIHR) BioResource project. Short-read GS was conducted on 692 individuals (489 affected and 203 unaffected relatives) from 465 families. Additionally, long-read GS was performed on five affected individuals who had structural variants (SVs) in technically challenging regions, had complex SVs, or required distal variant phasing. Causal variants were identified in 36% of affected individuals (177/489), and a further 23% (112/489) had a variant of uncertain significance after multiple rounds of re-analysis. Among all reported variants, 88% (333/380) were coding nuclear SNVs or insertions and deletions (indels), and the remainder were SVs, non-coding variants, and mitochondrial variants. Furthermore, long-read GS facilitated the resolution of challenging SVs and invalidated variants of difficult interpretation from short-read GS. This study demonstrates the value of short-read GS, complemented with long-read GS, in investigating the genetic causes of NDDs. GS provides a comprehensive and unbiased method of identifying all types of variants throughout the nuclear and mitochondrial genomes in individuals with NDD.
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Another nonsense variant, p.Gln520Ter, has also been reported in one individual.
“Another nonsense variant, p.Gln520Ter, has also been reported in one individual98,99.”
From The WAVE complex in developmental and adulthood brain disorders (2025) · cites this paper as [98]
The cohort-results section reports variants in individuals, but the passages in our copy do not identify p.Gln520Ter. Searches for “p.Gln520Ter,” “Gln520*,” and “520Ter” found no passage establishing that this nonsense variant was reported in one individual. (LLM, conf=0.72)
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Richards, S., Aziz, N., Bale, S., Bick, D., Das, S., Gastier-Foster, J., Grody, W. W., Hegde, M., Lyon, E., Spector, E., et al. (2015) · Genetics in Medicine · doi:10.1038/gim.2015.30 · Cited by 32,594 · see citing works
ClinVar: improving access to variant interpretations and supporting evidence
Landrum, M. J., Lee, J. M., Benson, M., Brown, G. R., Chao, C., Chitipiralla, S., Gu, B., Hart, J., Hoffman, D., Jang, W., et al. (2018) · Nucleic Acids Research · doi:10.1093/nar/gkx1153 · Cited by 4,196 · see citing works
Clark, M. M., Stark, Z., Farnaes, L., Tan, T. Y., White, S. M., Dimmock, D., & Kingsmore, S. F. (2018) · npj Genomic Medicine · doi:10.1038/s41525-018-0053-8 · Cited by 619 · see citing works
The sequences of 150,119 genomes in the UK Biobank
Halldorsson, B. V., Eggertsson, H. P., Moore, K. H. S., Hauswedell, H., Eiriksson, O., Ulfarsson, M. O., Palsson, G., Hardarson, M. T., Oddsson, A., Jensson, B. O., et al. (2022) · Nature · doi:10.1038/s41586-022-04965-x · Cited by 448 · see citing works
De novo mutations in regulatory elements in neurodevelopmental disorders
Short, P. J., McRae, J. F., Gallone, G., Sifrim, A., Won, H., Geschwind, D. H., Wright, C. F., Firth, H. V., FitzPatrick, D. R., Barrett, J. C., et al. (2018) · Nature · doi:10.1038/nature25983 · Cited by 274 · see citing works
Decrease of 3243 A–>G mtDNA mutation from blood in MELAS syndrome: a longitudinal study
Rahman, S., Poulton, J., Marchington, D., & Suomalainen, A. (2001) · The American Journal of Human Genetics · doi:10.1086/316930 · Cited by 237 · see citing works
Flagged first, then by citations
Research works printed but not linked: 40
- Deciphering Developmental Disorders Study (2017). Preva- lence and architecture of de novo mutations in developmental disorders. Nature 542, 433-438. https://doi.org/10.1038/ nature21062. · DOI · Paper page
- 100000 Genomes Project Pilot Investigators, Smedley, D., Smith, K.R., Martin, A., Thomas, E.A., McDonagh, E.M., Ci- priani, V., Ellingford, J.M., Arno, G., Tucci, A., et al. (2021). 100,000 Genomes pilot on rare-disease diagnosis in health care -preliminary report. N. Engl. J. Med. 385, 1868-1880. https://doi.org/10.1056/NEJMoa2035790. · DOI · Paper page
- Belyeu, J.R., Brand, H., Wang, H., Zhao, X., Pedersen, B.S., Feusier, J., Gupta, M., Nicholas, T.J., Brown, J., Baird, L., et al. (2021). De novo structural mutation rates and gamete- of-origin biases revealed through genome sequencing of 2,396 families. Am. J. Hum. Genet. 108, 597-607. https:// doi.org/10.1016/j.ajhg.2021.02.012. · DOI
- Mitsuhashi, S., and Matsumoto, N. (2020). Long-read sequencing for rare human genetic diseases. J. Hum. Genet. 65, 11-19. https://doi.org/10.1038/s10038-019-0671-8. · DOI
- Turro, E., Astle, W.J., Megy, K., Gra ¨f, S., Greene, D., Shamar- dina, O., Allen, H.L., Sanchis-Juan, A., Frontini, M., Thys, C., et al. (2020). Whole-genome sequencing of patients with rare diseases in a national health system. Nature 583, 96- 102. https://doi.org/10.1038/s41586-020-2434-2. · DOI · Paper page
- Meyer, E., Carss, K.J., Rankin, J., Nichols, J.M.E., Grozeva, D., Joseph, A.P., Mencacci, N.E., Papandreou, A., Ng, J., Barral, S., et al. (2017). Mutations in the histone methyltransferase gene KMT2B cause complex early-onset dystonia. Nat. Genet. 49, 223-237. https://doi.org/10.1038/ng.3740. · DOI
- Helbig, K.L., Lauerer, R.J., Bahr, J.C., Souza, I.A., Myers, C.T., Uysal, B., Schwarz, N., Gandini, M.A., Huang, S., Keren, B., et al. (2018). De novo pathogenic variants in CACNA1E cause developmental and epileptic encephalopathy with contractures, macrocephaly, and dyskinesias. Am. J. Hum. Genet. 103, 666-678. https://doi.org/10.1016/j.ajhg.2018. 09.006. · DOI
- Ito, Y., Carss, K.J., Duarte, S.T., Hartley, T., Keren, B., Kurian, M.A., Marey, I., Charles, P., Mendonc ¸a, C., Nava, C., et al. (2018). De novo truncating mutations in WASF1 cause intel- lectual disability with seizures. Am. J. Hum. Genet. 103, 144-153. https://doi.org/10.1016/j.ajhg.2018.06.001. · DOI · Paper page
- Sanchis-Juan, A., Hasenahuer, M.A., Baker, J.A., McTague, A., Barwick, K., Kurian, M.A., Duarte, S.T., NIHR BioResource, Carss, K.J., Thornton, J., and Raymond, F.L. (2020). Structural analysis of pathogenic missense mutations in GABRA2 and identification of a novel de novo variant in the desensitization gate. Mol. Genet. Genomic Med. 8, e1106. https://doi.org/10. 1002/mgg3.1106. · DOI
- Sobreira, N., Schiettecatte, F., Valle, D., and Hamosh, A. (2015). GeneMatcher: a matching tool for connecting investi- gators with an interest in the same gene. Hum. Mutat. 36, 928-930. https://doi.org/10.1002/humu.22844. · DOI · Paper page
- Martin, A.R., Williams, E., Foulger, R.E., Leigh, S., Daugherty, L.C., Niblock, O., Leong, I.U.S., Smith, K.R., Gerasimenko, O., Haraldsdottir, E., et al. (2019). PanelApp crowdsources expert knowledge to establish consensus diagnostic gene panels. Nat. Genet. 51, 1560-1565. https://doi.org/10.1038/ s41588-019-0528-2. · DOI · Paper page
- Wright, C.F., Fitzgerald, T.W., Jones, W.D., Clayton, S., McRae, J.F., van Kogelenberg, M., King, D.A., Ambridge, K., Barrett, D.M., Bayzetinova, T., et al. (2015). Genetic diagnosis of devel- opmental disorders in the DDD study: a scalable analysis of genome-wide research data. Lancet 385, 1305-1314. https:// doi.org/10.1016/S0140-6736(14)61705-0. · DOI
- Stenson, P.D., Ball, E.V., Mort, M., Phillips, A.D., Shiel, J.A., Thomas, N.S.T., Abeysinghe, S., Krawczak, M., and Cooper, D.N. (2003). Human Gene Mutation Database (HGMDâ): 2003 update. Hum. Mutat. 21, 577-581. https://doi.org/10. 1002/humu.10212. · DOI
- Robinson, J.T., Thorvaldsdo ´ttir, H., Wenger, A.M., Zehir, A., and Mesirov, J.P. (2017). Variant review with the Integrative Genomics Viewer. Cancer Res. 77, e31-e34. https://doi.org/ 10.1158/0008-5472.CAN-17-0337. · DOI
- Rimmer, A., Phan, H., Mathieson, I., Iqbal, Z., Twigg, S.R.F., WGS500 Consortium, Wilkie, A.O.M., McVean, G., and Lunter, G. (2014). Integrating mapping-assembly-and haplo- type-based approaches for calling variants in clinical sequencing applications. Nat. Genet. 46, 912-918. https:// doi.org/10.1038/ng.3036. · DOI
- French, C.E., Delon, I., Dolling, H., Sanchis-Juan, A., Shamardina, O., Me ´gy, K., Abbs, S., Austin, T., Bowdin, S., Branco, R.G., et al. (2019). Whole genome sequencing reveals that genetic condi- tions are frequent in intensively ill children. Intensive Care Med. 45, 627-636. https://doi.org/10.1007/s00134-019-05552-x. · DOI
- de la Morena-Barrio, B., Stephens, J., de la Morena-Barrio, M.E., Stefanucci, L., Padilla, J., Min ˜ano, A., Gleadall, N., Garcı ´a, J.L., Lo ´pez-Ferna ´ndez, M.F., Morange, P.E., et al. (2022). Long-read sequencing identifies the first retrotranspo- son insertion and resolves structural variants causing anti- thrombin deficiency. Thromb. Haemost. 122, 1369-1378. https://doi.org/10.1055/s-0042-1749345. · DOI
- Sanchis-Juan, A., Bitsara, C., Low, K.Y., Carss, K.J., French, C.E., Spasic-Boskovic, O., Jarvis, J., Field, M., Raymond, F.L., and Grozeva, D. (2019). Rare genetic variation in 135 families with family history suggestive of X-linked intellectual disability. Front. Genet. 10, 578. https://doi.org/10.3389/ fgene.2019.00578. · DOI
- Carss, K.J., Arno, G., Erwood, M., Stephens, J., Sanchis-Juan, A., Hull, S., Megy, K., Grozeva, D., Dewhurst, E., Malka, S., et al. (2017). Comprehensive rare variant analysis via whole- genome sequencing to determine the molecular pathology of inherited retinal disease. Am. J. Hum. Genet. 100, 75-90. https://doi.org/10.1016/j.ajhg.2016.12.003. · DOI
- Nellist, M., Brouwer, R.W.W., Kockx, C.E.M., van Veghel- Plandsoen, M., Withagen-Hermans, C., Prins-Bakker, L., Hoo- geveen-Westerveld, M., Mrsic, A., van den Berg, M.M.P., Koop- mans, A.E., et al. (2015). Targeted next generation sequencing reveals previously unidentified TSC1 and TSC2 mutations. BMC Med. Genet. 16, 10. https://doi.org/10.1186/s12881- 015-0155-4. · DOI
- Lo ´pez-Gallardo, E., Emperador, S., Solano, A., Llobet, L., Martı ´n-Navarro, A., Lo ´pez-Pe ´rez, M.J., Briones, P., Pineda, M., Artuch, R., Barraquer, E., et al. (2014). Expanding the clinical phenotypes of MT-ATP6 mutations. Hum. Mol. Genet. 23, 6191-6200. https://doi.org/10.1093/hmg/ ddu339. · DOI
- Yu-Wai-Man, P., and Chinnery, P.F. (1993). Leber hereditary optic neuropathy. In GeneReviews((R)), M.P. Adam, H.H. Ar- dinger, R.A. Pagon, S.E. Wallace, L.J.H. Bean, K.W. Gripp, G.M. Mirzaa, and A. Amemiya, eds. 28. Murakami, T., Mita, S., Tokunaga, M., Maeda, H., Ueyama, H., Kumamoto, T., Uchino, M., and Ando, M. (1996). Hered- itary cerebellar ataxia with Leber's hereditary optic neuropathy mitochondrial DNA 11778 mutation. J. Neurol. Sci. 142, 111-113. https://doi.org/10.1016/0022- 510x(96)00165-7. · DOI
- Grazina, M.M., Diogo, L.M., Garcia, P.C., Silva, E.D., Garcia, T.D., Robalo, C.B., and Oliveira, C.R. (2007). Atypical presen- tation of Leber's hereditary optic neuropathy associated to mtDNA 11778G>A point mutation-a case report. Eur. J. Pae- diatr. Neurol. 11, 115-118. https://doi.org/10.1016/j.ejpn. 2006.11.015. · DOI
- Beyter, D., Ingimundardottir, H., Oddsson, A., Eggertsson, H.P., Bjornsson, E., Jonsson, H., Atlason, B.A., Kristmundsdot- tir, S., Mehringer, S., Hardarson, M.T., et al. (2021). Long-read sequencing of 3,622 Icelanders provides insight into the role of structural variants in human diseases and other traits. Nat. Genet. 53, 779-786. https://doi.org/10.1038/s41588- 021-00865-4. · DOI
- Krzywinski, M., Schein, J., Birol, I., Connors, J., Gascoyne, R., Horsman, D., Jones, S.J., and Marra, M.A. (2009). Circos: an in- formation aesthetic for comparative genomics. Genome Res. 19, 1639-1645. https://doi.org/10.1101/gr.092759.109. · DOI
- Acuna-Hidalgo, R., Veltman, J.A., and Hoischen, A. (2016). New insights into the generation and role of de novo muta- tions in health and disease. Genome Biol. 17, 241. https:// doi.org/10.1186/s13059-016-1110-1. · DOI
- Kaer, K., and Speek, M. (2013). Retroelements in human dis- ease. Gene 518, 231-241. https://doi.org/10.1016/j.gene. 2013.01.008. · DOI
- Wright, C.F., Campbell, P., Eberhardt, R.Y., Aitken, S., Perrett, D., Brent, S., Danecek, P., Gardner, E.J., Chundru, V.K., Lind- say, S.J., et al. (2022). Optimising diagnostic yield in highly penetrant genomic disease. Preprint at medRxiv. https://doi. org/10.1101/2022.07.25.22278008. · DOI
- Grozeva, D., Carss, K., Spasic-Boskovic, O., Tejada, M.I., Gecz, J., Shaw, M., Corbett, M., Haan, E., Thompson, E., Friend, K., et al. (2015). Targeted next-generation sequencing analysis of 1,000 individuals with intellectual disability. Hum. Mutat. 36, 1197-1204. https://doi.org/10.1002/humu.22901. · DOI
- Riggs, E.R., Andersen, E.F., Cherry, A.M., Kantarci, S., Kearney, H., Patel, A., Raca, G., Ritter, D.I., South, S.T., Thorland, E.C., et al. (2020). Technical standards for the interpretation and re- porting of constitutional copy-number variants: a joint consensus recommendation of the American College of Med- ical Genetics and Genomics (ACMG) and the Clinical Genome Resource (ClinGen). Genet. Med. 22, 245-257. https://doi.org/10.1038/s41436-019-0686-8. · DOI
- The All of Us Research Program Investigators, Denny, J.C., Rutter, J.L., Goldstein, D.B., Philippakis, A., Smoller, J.W., Jen- kins, G., and Dishman, E. (2019). The "All of Us" research pro- gram. N. Engl. J. Med. 381, 668-676. https://doi.org/10.1056/ NEJMsr1809937. · DOI · Paper page
- Dafsari, H.S., Sprute, R., Wunderlich, G., Daimagu ¨ler, H.S., Karaca, E., Contreras, A., Becker, K., Schulze-Rhonhof, M., Ki- ening, K., Karakulak, T., et al. (2019). Novel mutations in KMT2B offer pathophysiological insights into childhood- onset progressive dystonia. J. Hum. Genet. 64, 803-813. https://doi.org/10.1038/s10038-019-0625-1. · DOI
- Ziobro, J., Eschbach, K., Sullivan, J.E., and Knupp, K.G. (2018). Current treatment strategies and future treatment options for Dravet syndrome. Curr. Treat. Options Neurol. 20, 52. https:// doi.org/10.1007/s11940-018-0537-y. · DOI
- Lowther, C., Valkanas, E., Giordano, J.L., Wang, H.Z., Currall, B.B., O'Keefe, K., Pierce-Hoffman, E., Kurtas, N.E., Whelan, C.W., Hao, S.P., et al. (2022). Systematic evaluation of genome sequencing for the assessment of fetal structural anomalies. Preprint at bioRxiv. https://doi.org/10.1101/2020.08.12. 248526. · DOI
- Lavelle, T.A., Feng, X., Keisler, M., Cohen, J.T., Neumann, P.J., Prichard, D., Schroeder, B.E., Salyakina, D., Espinal, P.S., Weid- ner, S.B., and Maron, J.L. (2022). Cost-effectiveness of exome and genome sequencing for children with rare and undiag- nosed conditions. Genet. Med. 24, 2415-2417. https://doi. org/10.1016/j.gim.2022.03.005. · DOI
- Logsdon, G.A., Vollger, M.R., and Eichler, E.E. (2020). Long- read human genome sequencing and its applications. Nat. Rev. Genet. 21, 597-614. https://doi.org/10.1038/s41576- 020-0236-x. · DOI
- Collins, R.L., Brand, H., Karczewski, K.J., Zhao, X., Alfo ¨ldi, J., Francioli, L.C., Khera, A.V., Lowther, C., Gauthier, L.D., Wang, H., et al. (2020). A structural variation reference for medical and population genetics. Nature 581, 444-451. https://doi.org/10.1038/s41586-020-2287-8. · DOI · Paper page
- Sanchis-Juan, A., Stephens, J., French, C.E., Gleadall, N., Me ´gy, K., Penkett, C., Shamardina, O., Stirrups, K., Delon, I., Dewhurst, E., et al. (2018). Complex structural variants in Mendelian disorders: identification and breakpoint resolution using short-and long-read genome sequencing. Genome Med. 10, 95. https://doi.org/10.1186/s13073-018-0606-6. · DOI
- Thibodeau, M.L., O'Neill, K., Dixon, K., Reisle, C., Mungall, K.L., Krzywinski, M., Shen, Y., Lim, H.J., Cheng, D., Tse, K., et al. (2020). Improved structural variant interpretation for he- reditary cancer susceptibility using long-read sequencing. Genet. Med. 22, 1892-1897. https://doi.org/10.1038/ s41436-020-0880-8. · DOI
- Jain, M., Koren, S., Miga, K.H., Quick, J., Rand, A.C., Sasani, T.A., Tyson, J.R., Beggs, A.D., Dilthey, A.T., Fiddes, I.T., et al. (2018). Nanopore sequencing and assembly of a human genome with ultra-long reads. Nat. Biotechnol. 36, 338-345. https://doi.org/10.1038/nbt.4060. · DOI · Paper page
Cited by
Sorted by citations
The WAVE complex in developmental and adulthood brain disorders
Kim, H.-G., Berdasco, C., Nairn, A. C., & Kim, Y. (2025) · Experimental & Molecular Medicine · doi:10.1038/s12276-024-01386-w · Cited by 8 · see citing works
- Authors
- Sanchis-Juan, A., Megy, K., Stephens, J., Armirola Ricaurte, C., Dewhurst, E., Low, K., French, C. E., Grozeva, D., Stirrups, K., Erwood, M., McTague, A., Penkett, C. J., Shamardina, O., Tuna, S., Daugherty, L. C., Gleadall, N., Duarte, S. T., Hedrera-Fernández, A., Vogt, J., Ambegaonkar, G., Chitre, M., Josifova, D., Kurian, M. A., Parker, A., Rankin, J., Reid, E., Wakeling, E., Wassmer, E., Woods, C. G., Raymond, F. L., & Carss, K. J.
- Affiliations
- University of Cambridge (GB)
- National Health Service (GB)
- Unidade Local de Saúde de São José (PT)
- Hospital Universitario Central de Asturias (ES)
- Birmingham Women's Hospital (GB)
- Cambridge University Hospitals NHS Foundation Trust (GB)
- Guy's Hospital (GB)
- Great Ormond Street Hospital for Children NHS Foundation Trust (GB)
- Royal Devon University Healthcare NHS Foundation Trust (GB)
- AstraZeneca (United Kingdom) (GB)
- Corresponding author
- Raymond, F. Lucy
- Carss, Keren J.
- ORCID
- Sanchis-Juan, Alba
- Megy, Karyn
- Stephens, Jonathan
- Armirola Ricaurte, Camila
- French, Courtney E.
- Grozeva, Detelina
- Stirrups, Kathleen
- McTague, Amy
- Penkett, Christopher J.
- Shamardina, Olga
- Tuna, Salih
- Daugherty, Louise C.
- Gleadall, Nicholas
- Duarte, Sofia T.
- Hedrera-Fernández, Antonio
- Vogt, Julie
- Ambegaonkar, Gautam
- Josifova, Dragana
- Kurian, Manju A.
- Parker, Alasdair
- Reid, Evan
- Wakeling, Emma
- Wassmer, Evangeline
- Woods, C. Geoffrey
- Raymond, F. Lucy
- Carss, Keren J.
- Venue
- The American Journal of Human Genetics
- Publisher
- Elsevier BV
- Published
- 2023-08
- Volume
- 110
- Issue
- 8
- Pages
- 1343-1355
- ISSN
- 0002-9297 (ISSN-L)
- PMC
- PMC10432178
- OpenAlex
- W4385546089
- Cited by
- 24
- References
- 6
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 8
- FWCI
- 3.97
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- The American Journal of Human Genetics (publishedVersion)
- medRxiv (acceptedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Royal Devon and Exeter Research Repository (Royal Devon and Exeter) (submittedVersion)
- Funders
- NIHR Cambridge Biomedical Research Centre (BRC-1215-20014)
- AstraZeneca
- NIHR Great Ormond Street Hospital Biomedical Research Centre
- NIHR BioResource (RG65966)
- National Institute for Health and Care Research
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genomics and Rare Diseases
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genomic variations and chromosomal abnormalities
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
- Keywords
- neurodevelopmental disorders, rare variants, long-read genome sequencing, structural variants, variant phasing, variants of uncertain significance, causal variant identification, mitochondrial DNA variants
- MeSH terms
- Base Sequence, Chromosome Mapping, Humans, Genome, Human, INDEL Mutation, Neurodevelopmental Disorders
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