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      Electroencephalographic (EEG) Biomarkers in Genetic Neurodevelopmental Disorders

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          Abstract

          Collectively, neurodevelopmental disorders are highly prevalent, but more than a third of neurodevelopmental disorders have an identifiable genetic etiology, each of which is individually rare. The genes associated with neurodevelopmental disorders are often involved in early brain development, neuronal signaling, or synaptic plasticity. Novel treatments for many genetic neurodevelopmental disorders are being developed, but disease-relevant clinical outcome assessments and biomarkers are limited. Electroencephalography (EEG) is a promising noninvasive potential biomarker of brain function. It has been used extensively in epileptic disorders, but its application in neurodevelopmental disorders needs further investigation. In this review, we explore the use of EEG in 3 of the most prevalent genetic neurodevelopmental disorders—Angelman syndrome, Rett syndrome, and fragile X syndrome. Quantitative analyses of EEGs, such as power spectral analysis or measures of connectivity, can quantify EEG signatures seen on qualitative review and potentially correlate with phenotypes. In both Angelman syndrome and Rett syndrome, increased delta power on spectral analysis has correlated with clinical markers of disease severity including developmental disability and seizure burden, whereas spectral power analysis on EEG in fragile X syndrome tends to demonstrate abnormalities in gamma power. Further studies are needed to establish reliable relationships between quantitative EEG biomarkers and clinical phenotypes in rare genetic neurodevelopmental disorders.

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          Most cited references84

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          Large-Scale Exome Sequencing Study Implicates Both Developmental and Functional Changes in the Neurobiology of Autism

          We present the largest exome sequencing study of autism spectrum disorder (ASD) to date (n = 35,584 total samples, 11,986 with ASD). Using an enhanced analytical framework to integrate de novo and case-control rare variation, we identify 102 risk genes at a false discovery rate of 0.1 or less. Of these genes, 49 show higher frequencies of disruptive de novo variants in individuals ascertained to have severe neurodevelopmental delay, whereas 53 show higher frequencies in individuals ascertained to have ASD; comparing ASD cases with mutations in these groups reveals phenotypic differences. Expressed early in brain development, most risk genes have roles in regulation of gene expression or neuronal communication (i.e., mutations effect neurodevelopmental and neurophysiological changes), and 13 fall within loci recurrently hit by copy number variants. In cells from the human cortex, expression of risk genes is enriched in excitatory and inhibitory neuronal lineages, consistent with multiple paths to an excitatory-inhibitory imbalance underlying ASD.
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            Rett syndrome: revised diagnostic criteria and nomenclature.

            Rett syndrome (RTT) is a severe neurodevelopmental disease that affects approximately 1 in 10,000 live female births and is often caused by mutations in Methyl-CpG-binding protein 2 (MECP2). Despite distinct clinical features, the accumulation of clinical and molecular information in recent years has generated considerable confusion regarding the diagnosis of RTT. The purpose of this work was to revise and clarify 2002 consensus criteria for the diagnosis of RTT in anticipation of treatment trials. RettSearch members, representing the majority of the international clinical RTT specialists, participated in an iterative process to come to a consensus on a revised and simplified clinical diagnostic criteria for RTT. The clinical criteria required for the diagnosis of classic and atypical RTT were clarified and simplified. Guidelines for the diagnosis and molecular evaluation of specific variant forms of RTT were developed. These revised criteria provide clarity regarding the key features required for the diagnosis of RTT and reinforce the concept that RTT is a clinical diagnosis based on distinct clinical criteria, independent of molecular findings. We recommend that these criteria and guidelines be utilized in any proposed clinical research.
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              Prevalence and Trends of Developmental Disabilities among Children in the United States: 2009–2017

              To study the national prevalence of ten developmental disabilities in US children aged 3–17 years and explore changes over time by associated demographic and socioeconomic characteristics using the 2009–2017 National Health Interview Survey (NHIS). Data come from the NHIS, a nationally-representative survey of the civilian noninstitutionalized population. Parents reported physician or other health care professional diagnoses of attention-deficit/hyperactivity disorder (ADHD); autism spectrum disorder (ASD); blindness; cerebral palsy; moderate to profound hearing loss; learning disability (LD); intellectual disability (ID); seizures; stuttering or stammering; and other developmental delays. Weighted percentages for each of the selected developmental disabilities and any developmental disability were calculated between 2009–2017 and stratified by selected demographic/socioeconomic characteristics. From 2009–2011 to 2015–2017, there were overall significant increases in the prevalence of any developmental disability (16.2% to 17.8%, p<.001), ADHD (8.5% to 9.5%, p <.01), ASD (1.1% to 2.5%, p <.001), and ID (0.9% to 1.2%, p <.05), but a significant decrease for any other developmental delay (4.7% to 4.1% , p <.05). The prevalence of any developmental disability increased among boys, children ages 12–17, non-Hispanic white and Hispanic children, children with private insurance only, and children with birthweights ≥2,500 grams. An increase in prevalence of any developmental disability was also seen for children living in urban areas and with less educated mothers. The prevalence of developmental disability among US children aged 3–17 years increased between 2009–2017. Changes by demographic and socioeconomic subgroups may be related to improvements in awareness and access to health care. From the 2009–2017 NHIS, there was a 9.5% increase in the prevalence of developmental disabilities among children aged 3–17.
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                Author and article information

                Journal
                J Child Neurol
                J Child Neurol
                JCN
                spjcn
                Journal of Child Neurology
                SAGE Publications (Sage CA: Los Angeles, CA )
                0883-0738
                1708-8283
                1 June 2023
                May 2023
                : 38
                : 6-7
                : 466-477
                Affiliations
                [1 ]Department of Pediatrics, Division of Neurology, Ringgold 12334, universityUniversity of Texas Southwestern Medical Center; , Dallas, TX, USA
                [2 ]Department of Neurology, Ringgold 12334, universityUniversity of Texas Southwestern Medical Center; , Dallas, TX, USA
                [3 ]Department of Psychiatry, Ringgold 12334, universityUniversity of Texas Southwestern Medical Center; , Dallas, TX, USA
                [4 ]Department of Neuroscience, University of Texas Southwestern Medical Center, Dallas, TX, USA
                Author notes
                [*]Kimberly Goodspeed, MD, University of Texas Southwestern Medical Center, Department of Pediatrics, Division of Neurology, Dallas, TX, USA. Email: kimberly.goodspeed@ 123456utsouthwestern.edu
                Author information
                https://orcid.org/0000-0002-8823-2839
                https://orcid.org/0000-0002-0729-9688
                Article
                10.1177_08830738231177386
                10.1177/08830738231177386
                10644693
                37264615
                fc770f2e-ba2c-4505-893f-e99153bf3216
                © The Author(s) 2023

                This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 7 July 2022
                : 17 October 2022
                : 28 April 2023
                Funding
                Funded by: Dedman Family Endowment;
                Categories
                Topical Review Articles
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