Pathogenic UNC13A variants cause a neurodevelopmental syndrome by impairing synaptic function.

Authors

Reza Asadollahi
Aisha Ahmad
Paranchai Boonsawat
Jasmine Shahanoor Hinzen
Mareike Lohse
Boris Bouazza-Arostegui
Siqi Sun
Tillmann Utesch
Jonas D Sommer
Dragana Ilic
Murugesh Padmanarayana
Kati Fischermanns
Mrinalini Ranjan
Moritz Boll
Chandran Ka
Amélie Piton
Francesca Mattioli
Bertrand Isidor
Katrin Õunap
Karit Reinson
Monica H Wojcik
Christian R Marshall
Saadet Mercimek-Andrews
Naomichi Matsumoto
Noriko Miyake
Bruno de Oliveira Stephan
Rachel Sayuri Honjo
Debora R Bertola
Chong Ae Kim
Roman Yusupov
Heather C Mefford
John Christodoulou
Joy Lee
Oliver Heath
Natasha J Brown
Naomi Baker
Zornitza Stark
Martin Delatycki
Nicole J Lake
Shimriet Zeidler
Linda Zuurbier
Saskia M Maas
Chris C de Kruiff
Farrah Rajabi
Lance H Rodan
Stephanie A Coury
Konrad Platzer
Henry Oppermann
Rami Abou Jamra
Skadi Beblo
Caroline Maxton
Robert Śmigiel
Hunter Underhill
Holly Dubbs
Alyssa Rosen
Katherine L Helbig
Ingo Helbig
Sarah McKeown Ruggiero
Mark P Fitzgerald
Dennis Kraemer
Carlos E Prada
Jeffrey Tenney
Parul Jayakar
Sylvia Redon
Jérémie Lefranc
Kevin Uguen
Simone Race
Stephanie Efthymiou
Reza Maroofian
Henry Houlden
Sandra Coppens
Nicolas Deconinck
Balasubramaniem Ashokkumar
Perumal Varalakshmi
Vykunta Raju Gowda K
Fatemeh Eghbal
Ehsan Ghayoor Karimiani
Morteza Heidari
John Neidhardt
Marta Owczarek-Lipska
G Christoph Korenke
Michael J Bamshad
Philippe M Campeau
Anna Lehman
Laura G Hendon
Ingrid M Wentzensen
Kristin G Monaghan
Yanmin Chen
Anna Szuto
Ronald D Cohn
Ping Yee Billie Au
Christoph Hübner
Felix Boschann
Kandamurugu Manickam
Daniel C Koboldt
Aboulfazl Rad
Gabriela Oprea
Kristine K Bachman
Andrea H Seeley
Emanuele Agolini
Alessandra Terracciano
Piscopo Carmelo
Caleb Bupp
Bethany Grysko
Annick Rein-Rothschild
Bruria Ben Zeev
Amy Margolin
Jennifer Morrison
Aditi Dagli
Elliot Stolerman
Raymond J Louie
Camerun Washington
Servi J C Stevens
Malou Heijligers
Fowzan S Alkuraya
Jasmin Lisfeld
Axel Neu
Fabíola Paoli Monteiro
André Luiz Santos Pessoa
Antonio Edvan Camelo-Filho
Fernando Kok
Dwight Koeberl
Kacie Riley
Lydie Burglen
Diane Doummar
Bénédicte Héron
Cyril Mignot
Boris Keren
Perrine Charles
Caroline Nava
Felix P Bernhard
Andrea A Kühn
Sven Thoms
Ryan D Morrie
Shila Mekhoubad
Eric M Green
Sami J Barmada
Aaron D Gitler
Olaf Jahn
Jeong Seop Rhee
Christian Rosenmund
Mišo Mitkovski
Heinrich Sticht
Han Sun
Gerald Le Gac
Holger Taschenberger
Nils Brose
Jeremy S Dittman
Anita Rauch
Noa Lipstein

Publication/Presentation Date

10-22-2025

Abstract

The UNC13A gene encodes a presynaptic protein that is crucial for setting the strength and dynamics of information transfer between neurons. Here we describe a neurodevelopmental syndrome caused by germline coding or splice-site variants in UNC13A. The syndrome presents with variable degrees of developmental delay and intellectual disability, seizures of different types, tremor and dyskinetic movements and, in some cases, death in early childhood. Using assays with expression of UNC13A variants in mouse hippocampal neurons and in Caenorhabditis elegans, we identify three mechanisms of pathogenicity, including reduction in synaptic strength caused by reduced UNC13A protein expression, increased neurotransmission caused by UNC13A gain-of-function and impaired regulation of neurotransmission by second messenger signalling. Based on a strong genotype-phenotype-functional correlation, we classify three UNC13A syndrome subtypes (types A-C). We conclude that the precise regulation of neurotransmitter release by UNC13A is critical for human nervous system function.

ISSN

1546-1718

Disciplines

Medicine and Health Sciences | Pediatrics

PubMedID

41125872

Department(s)

Department of Pediatrics

Document Type

Article

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