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Genetic Biomarkers in Epilepsy

Abstract

The identification of valid biomarkers for outcome prediction of diseases and improvement of drug response, as well as avoidance of side effects is an emerging field of interest in medicine. The concept of individualized therapy is becoming increasingly important in the treatment of patients with epilepsy, as predictive markers for disease prognosis and treatment outcome are still limited. Currently, the clinical decision process for selection of an antiepileptic drug (AED) is predominately based on the patient’s epileptic syndrome and side effect profiles of the AEDs, but not on effectiveness data. Although standard dosages of AEDs are used, supplemented, in part, by therapeutic monitoring, the response of an individual patient to a specific AED is generally unpredictable, and the standard care of patients in antiepileptic treatment is more or less based on trial and error. Therefore, there is an urgent need for valid predictive biomarkers to guide patient-tailored individualized treatment strategies in epilepsy, a research area that is still in its infancy. This review focuses on genomic factors as part of an individual concept for AED therapy summarizing examples that influence the prognosis of the disease and the response to AEDs, including side effects.

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Acknowledgments

This work was supported by the European Commission 530 (FP7 project EpiPGX, 279062), the Robert Bosch Foundation (Stuttgart, Germany), the IZEPHA project 18-0-0 (University of Tübingen, Germany), and the Federal Ministry for Education and Research (BMBF, Berlin, Germany) grant 03 IS 2061C.

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Correspondence to Yvonne G. Weber or Holger Lerche.

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Weber, Y.G., Nies, A.T., Schwab, M. et al. Genetic Biomarkers in Epilepsy. Neurotherapeutics 11, 324–333 (2014). https://doi.org/10.1007/s13311-014-0262-5

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Keywords

  • HLA
  • Sodium channels
  • Side effect
  • Prognosis
  • Pharmaco-resistance
  • Pharmaco-response