DNA methylation-based classification of malformations of cortical development in the human brain.

Journal: Acta neuropathologica
PMID:

Abstract

Malformations of cortical development (MCD) comprise a broad spectrum of structural brain lesions frequently associated with epilepsy. Disease definition and diagnosis remain challenging and are often prone to arbitrary judgment. Molecular classification of histopathological entities may help rationalize the diagnostic process. We present a retrospective, multi-center analysis of genome-wide DNA methylation from human brain specimens obtained from epilepsy surgery using EPIC 850 K BeadChip arrays. A total of 308 samples were included in the study. In the reference cohort, 239 formalin-fixed and paraffin-embedded (FFPE) tissue samples were histopathologically classified as MCD, including 12 major subtype pathologies. They were compared to 15 FFPE samples from surgical non-MCD cortices and 11 FFPE samples from post-mortem non-epilepsy controls. We applied three different statistical approaches to decipher the DNA methylation pattern of histopathological MCD entities, i.e., pairwise comparison, machine learning, and deep learning algorithms. Our deep learning model, which represented a shallow neuronal network, achieved the highest level of accuracy. A test cohort of 43 independent surgical samples from different epilepsy centers was used to test the precision of our DNA methylation-based MCD classifier. All samples from the test cohort were accurately assigned to their disease classes by the algorithm. These data demonstrate DNA methylation-based MCD classification suitability across major histopathological entities amenable to epilepsy surgery and age groups and will help establish an integrated diagnostic classification scheme for epilepsy-associated MCD.

Authors

  • Samir Jabari
    Institute of Neuropathology, University Hospitals, Erlangen, Germany.
  • Katja Kobow
    Institute of Neuropathology, University Hospitals, Erlangen, Germany.
  • Tom Pieper
    Center for Pediatric Neurology, Neurorehabilitation and Epileptology, Vogtareuth, Germany.
  • Till Hartlieb
    Center for Pediatric Neurology, Neurorehabilitation and Epileptology, Vogtareuth, Germany.
  • Manfred Kudernatsch
    Center for Neurosurgery and Epilepsy Surgery, Schön Klinik Vogtareuth, Vogtareuth, Germany.
  • Tilman Polster
    Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, Germany.
  • Christian G Bien
    Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, Germany.
  • Thilo Kalbhenn
    Department of Neurosurgery - Epilepsy Surgery, Evangelisches Klinikum Bethel, Universitätsklinikum OWL, Bielefeld University, Bielefeld, Germany.
  • Matthias Simon
    Department of Neurosurgery - Epilepsy Surgery, Evangelisches Klinikum Bethel, Universitätsklinikum OWL, Bielefeld University, Bielefeld, Germany.
  • Hajo Hamer
    Department of Neurology, Epilepsy Center, Universitätsklinikum Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
  • Karl Rössler
    Department of Neurosurgery, Universitätsklinikum Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
  • Martha Feucht
  • Angelika Mühlebner
    Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Imad Najm
    Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA.
  • José Eduardo Peixoto-Santos
    Department of Neurology and Neurosurgery, Paulista Medical School, UNIFESP, Sao Paulo, Brazil.
  • Antonio Gil-Nagel
    Epilepsy Program, Hospital Ruber Internacional, Madrid, Spain.
  • Rafael Toledano Delgado
    Epilepsy Program, Hospital Ruber Internacional, Madrid, Spain.
  • Angel Aledo-Serrano
    Epilepsy Program, Hospital Ruber Internacional, Madrid, Spain.
  • Yanghao Hou
    Department of Neuropathology, German Cancer Research Center (DKFZ), Universitätsklinikum Heidelberg, and CCU Neuropathology, Heidelberg, Germany.
  • Roland Coras
    Institute of Neuropathology, University Hospitals, Erlangen, Germany.
  • Andreas von Deimling
    Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
  • Ingmar Blumcke
    Institute of Neuropathology, University Hospitals, Erlangen, Germany.