Summary
Objective
Copy number variations (
CNV
s) represent a significant genetic risk for several neurodevelopmental disorders including epilepsy. As knowledge increases, reanalysis of existing data is essential. Reliable estimates of the contribution of
CNV
s to epilepsies from sizeable populations are not available.
Methods
We assembled a cohort of 1255 patients with preexisting array comparative genomic hybridization or single nucleotide polymorphism array based
CNV
data. All patients had “epilepsy plus,” defined as epilepsy with comorbid features, including intellectual disability, psychiatric symptoms, and other neurological and nonneurological features.
CNV
classification was conducted using a systematic filtering workflow adapted to epilepsy.
Results
Of 1097 patients remaining after genetic data quality control, 120 individuals (10.9%) carried at least one autosomal
CNV
classified as pathogenic; 19 individuals (1.7%) carried at least one autosomal
CNV
classified as possibly pathogenic. Eleven patients (1%) carried more than one (possibly) pathogenic
CNV
. We identified
CNV
s covering recently reported (
HNRNPU
)
or emerging (
RORB
) epilepsy genes, and further delineated the phenotype associated with mutations of these genes. Additional novel epilepsy candidate genes emerge from our study. Comparing phenotypic features of pathogenic
CNV
carriers to those of noncarriers of pathogenic
CNV
s, we show that patients with nonneurological comorbidities, especially dysmorphism, were more likely to carry pathogenic
CNV
s (odds ratio = 4.09, confidence interval = 2.51‐6.68;
P
= 2.34 × 10
−9
). Meta‐analysis including data from published control groups showed that the presence or absence of epilepsy did not affect the detected frequency of
CNV
s.
Significance
The use of a specifically adapted workflow enabled identification of pathogenic autosomal
CNV
s in 10.9% of patients with epilepsy plus, which rose to 12.7% when we also considered possibly pathogenic
CNV
s. Our data indicate that epilepsy with comorbid features should be considered an indication for patients to be selected for a diagnostic algorithm including
CNV
detection. Collaborative large‐scale
CNV
reanalysis leads to novel declaration of pathogenicity in unexplained cases and can promote discovery of promising candidate epilepsy genes.