Pathogenic UNC13A variants cause a neurodevelopmental syndrome by impairing synaptic function

Asadollahi R, Ahmad A, Boonsawat P, Shahanoor Hinzen J, Lohse M, Bouazza-Arostegui B, Sun S, Utesch T, Sommer JD, Ilic D, Padmanarayana M, Fischermanns K, Ranjan M, Boll M, Ka C, Piton A, Mattioli F, Isidor B, Õunap K, Reinson K, Wojcik MH, Marshall CR, Mercimek-Andrews S, Matsumoto N, Miyake N, Stephan BdO, Honjo RS, Bertola DR, Kim CA, Yusupov R, Mefford HC, Christodoulou J, Lee J, Heath O, Brown NJ, Baker N, Stark Z, Delatycki M, Lake NJ, Zeidler S, Zuurbier L, Maas SM, de Kruiff CC, Rajabi F, Rodan LH, Coury SA, Platzer K, Oppermann H, Abou Jamra R, Beblo S, Maxton C, Śmigiel R, Underhill H, Dubbs H, Rosen A, Helbig KL, Helbig I, Ruggiero SMK, Fitzgerald MP, Kraemer D, Prada CE, Tenney J, Jayakar P, Redon S, Lefranc J, Uguen K, Race S, Efthymiou S, Maroofian R, Houlden H, Coppens S, Deconinck N, Ashokkumar B, Varalakshmi P, Gowda K VR, Eghbal F, Ghayoor Karimiani E, Heidari M, Neidhardt J, Owczarek-Lipska M, Korenke GC, Bamshad MJ, Campeau PM, Lehman A, Hendon LG, Wentzensen IM, Monaghan KG, Chen Y, Szuto A, Cohn RD, Au PYB, Hübner C, Boschann F, Manickam K, Koboldt DC, Rad A, Oprea G, Bachman KK, Seeley AH, Agolini E, Terracciano A, Carmelo P, Bupp C, Grysko B, Rein-Rothschild A, Ben Zeev B, Margolin A, Morrison J, Dagli A, Stolerman E, Louie RJ, Washington C, Stevens SJ, Heijligers M, Alkuraya FS, Lisfeld J, Neu A, Paoli Monteiro F, Santos Pessoa AL, Camelo-Filho AE, Kok F, Koeberl D, Riley K, Burglen L, Doummar D, Héron B, Mignot C, Keren B, Charles P, Nava C, Bernhard FP, Kühn AA, Thoms S, Morrie RD, Mekhoubad S, Green EM, Barmada SJ, Gitler AD, Jahn O, Rhee JS, Rosenmund C, Mitkovski M, Sticht H, Sun H, Le Gac G, Taschenberger H, Brose N, Dittman JS, Rauch A, Lipstein N (2025)


Publication Type: Journal article

Publication year: 2025

Journal

Book Volume: 57

Pages Range: 2691-2704

Journal Issue: 11

DOI: 10.1038/s41588-025-02361-5

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.

Authors with CRIS profile

Involved external institutions

University of Zurich / Universität Zürich (UZH) Freie Universität Berlin Wrocław Medical University / Uniwersytet Medyczny we Wrocławiu Max-Planck-Institut für Multidisziplinäre Naturwissenschaften / Max Planck Institute for Multidisciplinary Sciences Weill Cornell Medicine Leibniz-Forschungsinstitut für Molekulare Pharmakologie im Forschungsverbund Berlin e.V. (FMP) Murdoch Childrens Research Institute Tehran University of Medical Sciences (TUMS) / دانشگاه علوم پزشکی تهران Carl von Ossietzky Universität Oldenburg University of Washington Centre Hospitalier Universitaire Sainte-Justine, CHU Sainte-Justine University of British Columbia University of Mississippi Medical Center GeneDX The Hospital for Sick Children (SickKids) Alberta Children's Hospital Research Institute (ACHRI) Universitätsklinikum Carl Gustav Carus Dresden Erasmus University Medical Center (MC) Nationwide Children's Hospital University of Amsterdam Ohio State University Arcensus GmbH Academic Medical Centre / Academisch Medisch Centrum (AMC) Geisinger Medical Center Chaim Sheba Medical Center at Tel HaShomer / המרכז הרפואי עש חיים שיבא – תל השומר‎‎ Boston Children's Hospital Tel Aviv University Orlando Health Arnold Palmer Hospital for Children Universität Leipzig Greenwood Genetic Center Maastricht University King Faisal Specialist Hospital & Research Centre Universitätsklinikum Hamburg-Eppendorf (UKE) Mendelics Universidade Federal do Ceará (UCF) University of São Paulo / Universidade de São Paulo (USP) Duke University Hôpital Armand-Trousseau (AP-HP) Nicklaus Children's Hospital Université de Bretagne Occidentale Universitätsklinikum Leipzig Centre hospitalier universitaire de Brest (CHRU Brest) Philipps-Universität Marburg Charité - Universitätsmedizin Berlin British Columbia Children's Hospital (BC Children's Hospital) University of Utah University College London (UCL) Universität Bielefeld Children's Hospital of Philadelphia Trace Neuroscience Brussels University Hospital (H.U.B) / Hôpital Universitaire de Bruxelles University of Michigan Queen Fabiola Childrens Hospital / L'Hôpital universitaire des enfants Reine Fabiola Madurai Kamaraj University / மதுரை காமராசர் பல்கலைக்கழகம் Stanford University Indira Gandhi Institute of Child Health Ospedale Pediatrico Bambino Gesu Helen DeVos Children's Hospital University of Cincinnati Pitié-Salpêtrière University Hospital / Hôpital universitaire Pitié-Salpêtrière Institute of Genetics and Molecular and Cellular Biology / Institut de génétique et de biologie moléculaire et cellulaire (IGBMC) Nantes University Hospital / Centre hospitalier universitaire de Nantes (CHU) Tartu University Hospital Harvard University University of Alberta Yokohama City University Joe DiMaggio Children's Hospital St. Jude Children’s Research Hospital The Royal Children's Hospital Melbourne

How to cite

APA:

Asadollahi, R., Ahmad, A., Boonsawat, P., Shahanoor Hinzen, J., Lohse, M., Bouazza-Arostegui, B.,... Lipstein, N. (2025). Pathogenic UNC13A variants cause a neurodevelopmental syndrome by impairing synaptic function. Nature Genetics, 57(11), 2691-2704. https://doi.org/10.1038/s41588-025-02361-5

MLA:

Asadollahi, Reza, et al. "Pathogenic UNC13A variants cause a neurodevelopmental syndrome by impairing synaptic function." Nature Genetics 57.11 (2025): 2691-2704.

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