title: Severity of manifestations in tuberous sclerosis complex in relation to genotype.
abstract: OBJECTIVE
  Patients with tuberous sclerosis complex (TSC) commonly present with significant neurologic deficits, including seizures, autism, and intellectual disability. Previous evidence suggests that the TSC2 mutation genotype may be associated with a more severe disease phenotype. This study evaluates the association of the TSC1 and TSC2 genotype with patient and disease characteristics in a retrospective review of a large TSC Natural History Database consisting of 919 patients with TSC.
  
  
  METHODS
  Univariate logistic regression was conducted to evaluate the association of the TSC1 and TSC2 gene mutations with patient and disease characteristics.
  
  
  RESULTS
  As compared to patients with the TSC1 mutation, patients with the TSC2 mutation were younger (p = 0.02), more likely to have partial epilepsy (odds ratio (OR) 1.74, p = 0.0015), complex partial seizures (OR 2.03, p = 0.02), infantile spasms (IS) (OR 1.67, p = 0.01), subependymal giant-cell astrocytomas (SEGAs) (OR 1.64, p = 0.01), and intellectual disability (OR 2.90, p = 0.0002).
  
  
  CONCLUSIONS
  The clinical presentation of TSC is highly variable and not well understood. Our findings confirm and supplement existing literature that TSC2 mutation is likely to be associated with a more severe, earlier presenting TSC phenotype, including infantile spasms.
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Center, New York University Langone Medical Center, New York, New York, U.S.A.
authors.forename: Sanjeev V
authors.initials: SV
authors.lastname: Kothare
authors.forename: Kanwaljit
authors.initials: K
authors.lastname: Singh
authors.forename: Jason R
authors.initials: JR
authors.lastname: Chalifoux
authors.forename: Brigid A
authors.initials: BA
authors.lastname: Staley
authors.forename: Howard L
authors.initials: HL
authors.lastname: Weiner
authors.forename: Kimberly
authors.initials: K
authors.lastname: Menzer
authors.forename: Orrin
authors.initials: O
authors.lastname: Devinsky
mesh_terms: D000293:Adolescent; D000328:Adult; D001530:Belgium / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual / Q000639:trends; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014402:Tuberous Sclerosis / Q000175:diagnosis* / Q000235:genetics*; D000077005:Tuberous Sclerosis Complex 2 Protein; D025521:Tumor Suppressor Proteins / Q000235:genetics*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: C000624653:TSC2 protein, human; D000077005:Tuberous Sclerosis Complex 2 Protein; D025521:Tumor Suppressor Proteins
keywords: Epilepsy; TSC mutations; Tuberous sclerosis complex