{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T22:38:44Z","timestamp":1792708724902,"version":"4.5.0"},"reference-count":46,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:sec id=\"ab-noi230051-4\"><jats:title>Importance<\/jats:title><jats:p>Polymicrogyria is the most commonly diagnosed cortical malformation and is associated with neurodevelopmental sequelae including epilepsy, motor abnormalities, and cognitive deficits. Polymicrogyria frequently co-occurs with other brain malformations or as part of syndromic diseases. Past studies of polymicrogyria have defined heterogeneous genetic and nongenetic causes but have explained only a small fraction of cases.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi230051-5\"><jats:title>Objective<\/jats:title><jats:p>To survey germline genetic causes of polymicrogyria in a large cohort and to consider novel polymicrogyria gene associations.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi230051-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This genetic association study analyzed panel sequencing and exome sequencing of accrued DNA samples from a retrospective cohort of families with members with polymicrogyria. Samples were accrued over more than 20 years (1994 to 2020), and sequencing occurred in 2 stages: panel sequencing (June 2015 to January 2016) and whole-exome sequencing (September 2019 to March 2020). Individuals seen at multiple clinical sites for neurological complaints found to have polymicrogyria on neuroimaging, then referred to the research team by evaluating clinicians, were included in the study. Targeted next-generation sequencing and\/or exome sequencing were performed on probands (and available parents and siblings) from 284 families with individuals who had isolated polymicrogyria or polymicrogyria as part of a clinical syndrome and no genetic diagnosis at time of referral from clinic, with sequencing from 275 families passing quality control.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi230051-7\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The number of families in whom genetic sequencing yielded a molecular diagnosis that explained the polymicrogyria in the family. Secondarily, the relative frequency of different genetic causes of polymicrogyria and whether specific genetic causes were associated with co-occurring head size changes were also analyzed.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi230051-8\"><jats:title>Results<\/jats:title><jats:p>In 32.7% (90 of 275) of polymicrogyria-affected families, genetic variants were identified that provided satisfactory molecular explanations. Known genes most frequently implicated by polymicrogyria-associated variants in this cohort were <jats:italic>PIK3R2, TUBB2B, COL4A1,<\/jats:italic> and <jats:italic>SCN3A<\/jats:italic>. Six candidate novel polymicrogyria genes were identified or confirmed: de novo missense variants in <jats:italic>PANX1<\/jats:italic>, <jats:italic>QRICH1<\/jats:italic>, and <jats:italic>SCN2A<\/jats:italic> and compound heterozygous variants in <jats:italic>TMEM161B<\/jats:italic>, <jats:italic>KIF26A,<\/jats:italic> and <jats:italic>MAN2C1,<\/jats:italic> each with consistent genotype-phenotype relationships in multiple families.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi230051-9\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>This study\u2019s findings reveal a higher than previously recognized rate of identifiable genetic causes, specifically of channelopathies, in individuals with polymicrogyria and support the utility of exome sequencing for families affected with polymicrogyria.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaneurol.2023.2363","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T15:33:28Z","timestamp":1690212808000},"page":"980","source":"Crossref","is-referenced-by-count":35,"title":["Exome Sequencing and the Identification of New Genes and Shared Mechanisms in Polymicrogyria"],"prefix":"10.1001","volume":"80","author":[{"given":"Shyam K.","family":"Akula","sequence":"first","affiliation":[{"name":"Division of Genetics and Genomics, Department of Pediatrics, Boston Children\u2019s Hospital, and Allen Discovery Center for Human Brain Evolution, Boston, Massachusetts"},{"name":"Howard Hughes Medical Institute, Boston Children\u2019s Hospital, Boston, Massachusetts"},{"name":"Harvard-MIT MD\/PhD Program, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen Y.","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Genetics and Genomics, Department of Pediatrics, Boston Children\u2019s Hospital, and Allen Discovery Center for Human Brain Evolution, Boston, Massachusetts"},{"name":"Division of Rheumatology, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer E.","family":"Neil","sequence":"additional","affiliation":[{"name":"Division of Genetics and Genomics, Department of Pediatrics, Boston Children\u2019s Hospital, and Allen Discovery Center for Human Brain Evolution, Boston, Massachusetts"},{"name":"Howard Hughes Medical Institute, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane D.","family":"Shao","sequence":"additional","affiliation":[{"name":"Division of Genetics and Genomics, Department of Pediatrics, Boston Children\u2019s Hospital, and Allen Discovery Center for Human Brain Evolution, Boston, Massachusetts"},{"name":"Department of Neurology, 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