Ultra-rare biallelic <i>THAP12</i> variants cause loss of function and underlie severe epileptic encephalopathy

Developmental and epileptic encephalopathies (DEEs) are a group of severe childhood-onset neurological disorders, often caused by rare genetic variants affecting brain development and excitability. Despite advances in genomic sequencing, a substantial proportion of DEE cases remain unsolved. Here, we identify <i>THAP12</i> as a novel disease-causing gene associated with autosomal recessive DEE. Whole-genome sequencing in two siblings who presented with infantile spasms and progressed to Lennox-Gastaut syndrome revealed compound heterozygous variants in <i>THAP12</i> , leading to a reduction in protein abundance, consistent with a loss-of-function mechanism. To confirm this mechanism <i>in vivo</i> , we generated mouse models carrying either of the two patient-specific alleles. Both homozygous and compound heterozygous animals exhibited embryonic lethality, confirming the essential and dosage-sensitive role of <i>Thap12</i> during early development. Zebrafish loss-of-function models recapitulated major aspects of the human phenotype, including microcephaly, brain hypoplasia, abnormal neuronal activity, and increased seizure sensitivity. Transcriptomic profiling of larval zebrafish brains revealed dysregulation of cell cycle and apoptotic pathways, in line with increased cell death and reduced proliferation observed in mutant embryos. Notably, overexpression of wild-type human <i>THAP12</i> mRNA rescued these <i>in vivo</i> phenotypes, while the patient-derived variants allele failed to do so. Altogether, our findings demonstrate that <i>THAP12</i> is essential for early brain development and neuronal survival, and that biallelic loss-of-function variants in this gene underlie a previously unrecognized etiology of autosomal recessive DEE. These results provide a mechanistic framework linking, for the first time, <i>THAP12</i> dysfunction to neurodevelopmental pathology and open new avenues for diagnosis in undiagnosed DEE cases.

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Journal
medRxiv
Published
2026-03-03
DOI
https://doi.org/10.64898/2026.02.27.26347078
Primary Topic
Epilepsy research and treatment
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article
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article

Ultra-rare biallelic THAP12 variants cause loss of function and underlie severe epileptic encephalopathy

Valérie Triassi, Éric Samarut, Guillaume Bernas, Jean-François Schmouth et al.
medRxiv
Epilepsy research and treatment
article

Ultra-rare biallelic THAP12 variants cause loss of function and underlie severe epileptic encephalopathy

Valérie Triassi, Éric Samarut, Guillaume Bernas, Jean-François Schmouth, Alexandre Brisson, Nicole Leclerc, Katarzyna Ochenkowska, Julie Pilliod, Diana Walleigh, Laurent Cappadocia, Sébastien Audet, M.H. Tetreault, Grace VanNoy, Alexandra da Silva Babinet, B Rampal, Lynn Pais, Mariah Gillaspie, Antoine Légaré, Anne O'Donnell-Luria, Patrick Desrosiers, Paul De Koninck
article en

Abstract

Developmental and epileptic encephalopathies (DEEs) are a group of severe childhood-onset neurological disorders, often caused by rare genetic variants affecting brain development and excitability. Despite advances in genomic sequencing, a substantial proportion of DEE cases remain unsolved. Here, we identify <i>THAP12</i> as a novel disease-causing gene associated with autosomal recessive DEE. Whole-genome sequencing in two siblings who presented with infantile spasms and progressed to Lennox-Gastaut syndrome revealed compound heterozygous variants in <i>THAP12</i> , leading to a reduction in protein abundance, consistent with a loss-of-function mechanism. To confirm this mechanism <i>in vivo</i> , we generated mouse models carrying either of the two patient-specific alleles. Both homozygous and compound heterozygous animals exhibited embryonic lethality, confirming the essential and dosage-sensitive role of <i>Thap12</i> during early development. Zebrafish loss-of-function models recapitulated major aspects of the human phenotype, including microcephaly, brain hypoplasia, abnormal neuronal activity, and increased seizure sensitivity. Transcriptomic profiling of larval zebrafish brains revealed dysregulation of cell cycle and apoptotic pathways, in line with increased cell death and reduced proliferation observed in mutant embryos. Notably, overexpression of wild-type human <i>THAP12</i> mRNA rescued these <i>in vivo</i> phenotypes, while the patient-derived variants allele failed to do so. Altogether, our findings demonstrate that <i>THAP12</i> is essential for early brain development and neuronal survival, and that biallelic loss-of-function variants in this gene underlie a previously unrecognized etiology of autosomal recessive DEE. These results provide a mechanistic framework linking, for the first time, <i>THAP12</i> dysfunction to neurodevelopmental pathology and open new avenues for diagnosis in undiagnosed DEE cases.

medRxiv
Broad Institute (US), Boston Children's Hospital (US), Harvard University (US), Université du Québec à Montréal (CA), Massachusetts General Hospital (US), PROTEO (CA), Lightning Packs (United States) (US), Université Laval (CA), University of Colorado Anschutz Medical Campus (US), Université de Montréal (CA), University of Colorado Denver (US)
Good health and well-being
Openalex Percentile: Top 43%
Epilepsy research and treatment
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