title: Identification of ATP1A3 mutations by exome sequencing as the cause of alternating hemiplegia of childhood in Japanese patients.
abstract: BACKGROUND
  Alternating hemiplegia of childhood (AHC) is a rare disorder characterized by transient repeated attacks of paresis and cognitive impairment. Recent studies from the U.S. and Europe have described ATP1A3 mutations in AHC. However, the genotype-phenotype relationship remains unclear. The purpose of this study was to identify the genetic abnormality in a Japanese cohort of AHC using exome analysis.
  
  
  RESULTS
  A total of 712,558 genetic single nucleotide variations in 8 patients with sporadic AHC were found. After a series of exclusions, mutations of three genes were regarded as candidate causes of AHC. Each patient harbored a heterozygous missense mutation of ATP1A3, which included G755C, E815K, C927Y and D801N. All mutations were at highly conserved amino acid residues and deduced to affect ATPase activity of the corresponding ATP pump, the product of ATP1A3. They were de novo mutations and not identified in 96 healthy volunteers. Using Sanger sequencing, E815K was found in two other sporadic cases of AHC. In this study, E815K was found in 5 of 10 patients (50%), a prevalence higher than that reported in two recent studies [19 of 82 (23%) and 7 of 24 (29%)]. Furthermore, the clinical data of the affected individuals indicated that E815K resulted in a severer phenotype compared with other ATP1A3 mutations.
  
  
  CONCLUSIONS
  Heterozygous de novo mutations of ATP1A3 were identified in all Japanese patients with AHC examined in this study, confirming that ATP1A3 mutation is the cause of AHC.
authors: Department of Pediatrics, School of Medicine, Fukuoka University, Fukuoka, Japan.
authors: Atsushi
authors: A
authors: Ishii
authors: Yoshiaki
authors: Y
authors: Saito
authors: Jun
authors: J
authors: Mitsui
authors: Hiroyuki
authors: H
authors: Ishiura
authors: Jun
authors: J
authors: Yoshimura
authors: Hidee
authors: H
authors: Arai
authors: Sumimasa
authors: S
authors: Yamashita
authors: Sadami
authors: S
authors: Kimura
authors: Hirokazu
authors: H
authors: Oguni
authors: Shinichi
authors: S
authors: Morishita
authors: Shoji
authors: S
authors: Tsuji
authors: Masayuki
authors: M
authors: Sasaki
authors: Shinichi
authors: S
authors: Hirose
mesh_terms: D000595:Amino Acid Sequence; D000818:Animals; D044466:Asian People / Q000235:genetics*; D001483:Base Sequence; D004252:DNA Mutational Analysis; D059472:Exome / Q000235:genetics*; D005260:Female; D006429:Hemiplegia / Q000235:genetics*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008969:Molecular Sequence Data; D009154:Mutation; D000254:Sodium-Potassium-Exchanging ATPase / Q000737:chemistry / Q000235:genetics*
chemical_list: C488756:ATP1A3 protein, human; D000254:Sodium-Potassium-Exchanging ATPase