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Record W4388750229 · doi:10.1212/nxg.0000000000200105

Adult Phenotype of <i>SYNGAP1</i> -DEE

2023· article· fa· W4388750229 on OpenAlex

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.
fundA Canadian funder is recorded on the work.

Bibliographic record

VenueNeurology Genetics · 2023
Typearticle
Languagefa
FieldBiochemistry, Genetics and Molecular Biology
TopicGenomics and Rare Diseases
Canadian institutionsToronto Western HospitalCentre for Addiction and Mental HealthUniversity Health Network
FundersNational Institute on Deafness and Other Communication DisordersNational Institute of Mental HealthNational Institute on AgingUniversity Health Network FoundationCenters for Disease Control and PreventionMultidisciplinary University Research InitiativeNational Institute of Neurological Disorders and StrokeNovo NordiskInternational Rett Syndrome FoundationEisaiNovo Nordisk FondenDravet Syndrome FoundationNational Science FoundationGW PharmaceuticalsUniversity of Toronto
KeywordsPhenotypeVirologyBiologyGeneticsGene

Abstract

fetched live from OpenAlex

<h3>Background and Objectives</h3> <i>SYNGAP1</i> variants are associated with rare developmental and epileptic encephalopathies (DEEs). Although <i>SYNGAP1</i>-related childhood phenotypes are well characterized, the adult phenotype remains ill-defined. We sought to investigate phenotypes and outcomes in adults with <i>SYNGAP1</i> variants and epilepsy. <h3>Methods</h3> Patients 18 years or older with DEE carrying likely pathogenic and pathogenic (LP/P) <i>SYNGAP1</i> variants were recruited through physicians9 practices and patient organization groups. We used standardized questionnaires to evaluate current seizures, medication use, sleep, gastrointestinal symptoms, pain response, gait, social communication disorder and adaptive skills of patients. We also assessed caregiver burden. <h3>Results</h3> Fourteen unrelated adult patients (median: 21 years, range: 18–65 years) with <i>SYNGAP1</i>-DEE were identified, 11 with novel and 3 with known LP/P <i>SYNGAP1</i> de novo variants. One patient with a partial exon 3 deletion had greater daily living skills and social skills than others with single-nucleotide variants. Ten of 14 (71%) patients had drug-resistant seizures, treated with a median of 2 antiseizure medications. All patients (100%) had abnormal pain processing. Sleep disturbances, social communication disorders, and aggressive/self-injurious behaviors were each reported in 86% of patients. Only half of adults could walk with minimal or no assistance. Toileting was normal in 29%, and 71% had constipation. No adult patients could read or understand verbal material at a sixth-grade level or higher. Aggressive/self-injurious behaviors were leading cause of caregiver burden. The oldest patient was aged 65 years; although nonambulant, she had walked independently when younger. <h3>Discussion</h3> Seventy-one percent of patients with <i>SYNGAP1</i>-DEEs continue to have seizures when adults. Nonseizure comorbidities, especially aggression and self-injurious behaviors, are major management challenges in adults with <i>SYNGAP1</i>-DEE. Only 50% of adults can ambulate with minimal or no assistance. Almost all adult patients depend on caregivers for many activities of daily living. Prompt diagnostic genetic testing of adults with DEE can inform clinical care and guide outcomes of precision therapies.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Bench or experimental · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.576
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0010.001
Research integrity0.0010.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.008
GPT teacher head0.232
Teacher spread0.224 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it