Royal College of Surgeons in Ireland
The role of common genetic variation in presumed monogenic epilepsies.pdf (677.74 kB)

The role of common genetic variation in presumed monogenic epilepsies.

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journal contribution
posted on 2022-10-28, 08:20 authored by Ciaran Campbell, Costin Leu, Yen-Chen Anne Feng, Stefan Wolking, Claudia Moreau, Colin Ellis, Shiva Ganesan, Helena Martins, Karen Oliver, Isabelle Boothman, Katherine Benson, Anne Molloy, Lawrence Brody, Epi4K Collaborative, Genomics England Research Consortium, Jacques L Michaud, Fadi F Hamdan, Berge A Minassian, Holger Lerche, Ingrid E Scheffer, Sanjay Sisodiya, Simon Girard, Patrick Cosette, Norman DelantyNorman Delanty, Dennis Lal, Gianpiero CavalleriGianpiero Cavalleri, Epi25 Collaborative

Background: The developmental and epileptic encephalopathies (DEEs) are the most severe group of epilepsies which co-present with developmental delay and intellectual disability (ID). DEEs usually occur in people without a family history of epilepsy and have emerged as primarily monogenic, with damaging rare mutations found in 50% of patients. Little is known about the genetic architecture of patients with DEEs in whom no pathogenic variant is identified. Polygenic risk scoring (PRS) is a method that measures a person's common genetic burden for a trait or condition. Here, we used PRS to test whether genetic burden for epilepsy is relevant in individuals with DEEs, and other forms of epilepsy with ID.

Methods: Genetic data on 2,759 cases with DEEs, or epilepsy with ID presumed to have a monogenic basis, and 447,760 population-matched controls were analysed. We compared PRS for 'all epilepsy', 'focal epilepsy', and 'genetic generalised epilepsy' (GGE) between cases and controls. We performed pairwise comparisons between cases stratified for identifiable rare deleterious genetic variants and controls.

Findings: Cases of presumed monogenic severe epilepsy had an increased PRS for 'all epilepsy' (p<0.0001), 'focal epilepsy' (p<0.0001), and 'GGE' (p=0.0002) relative to controls, which explain between 0.08% and 3.3% of phenotypic variance. PRS was increased in cases both with and without an identified deleterious variant of major effect, and there was no significant difference in PRS between the two groups.

Interpretation: We provide evidence that common genetic variation contributes to the aetiology of DEEs and other forms of epilepsy with ID, even when there is a known pathogenic variant of major effect. These results provide insight into the genetic underpinnings of the severe epilepsies and warrant a shift in our understanding of the aetiology of the DEEs as complex, rather than monogenic, disorders.


Science Foundation Ireland

Human Genome Research Institute

National Heart, Lung, and Blood Institute

German Research Foundation



The original article is available at

Published Citation

Campbell C. et al. The role of common genetic variation in presumed monogenic epilepsies. EBioMedicine. 2022;81:104098.

Publication Date

6 June 2022

PubMed ID



  • Beaumont Hospital
  • FutureNeuro Centre
  • School of Pharmacy and Biomolecular Sciences

Research Area

  • Neurological and Psychiatric Disorders
  • Vascular Biology


Elsevier BV


  • Published Version (Version of Record)