An AKT3-FOXG1-reelin network underlies defective migration in human focal malformations of cortical development

ST Baek, B Copeland, EJ Yun, SK Kwon… - Nature medicine, 2015 - nature.com
ST Baek, B Copeland, EJ Yun, SK Kwon, A Guemez-Gamboa, AE Schaffer, S Kim, HC Kang…
Nature medicine, 2015nature.com
Focal malformations of cortical development (FMCDs) account for the majority of drug-
resistant pediatric epilepsy. Postzygotic somatic mutations activating the
phosphatidylinositol-4, 5-bisphosphate-3-kinase (PI3K)–protein kinase B (AKT)–mammalian
target of rapamycin (mTOR) pathway are found in a wide range of brain diseases, including
FMCDs. It remains unclear how a mutation in a small fraction of cells disrupts the
architecture of the entire hemisphere. Within human FMCD-affected brain, we found that …
Abstract
Focal malformations of cortical development (FMCDs) account for the majority of drug-resistant pediatric epilepsy. Postzygotic somatic mutations activating the phosphatidylinositol-4,5-bisphosphate-3-kinase (PI3K)–protein kinase B (AKT)–mammalian target of rapamycin (mTOR) pathway are found in a wide range of brain diseases, including FMCDs. It remains unclear how a mutation in a small fraction of cells disrupts the architecture of the entire hemisphere. Within human FMCD-affected brain, we found that cells showing activation of the PI3K-AKT-mTOR pathway were enriched for the AKT3E17K mutation. Introducing the FMCD-causing mutation into mouse brain resulted in electrographic seizures and impaired hemispheric architecture. Mutation-expressing neural progenitors showed misexpression of reelin, which led to a non–cell autonomous migration defect in neighboring cells, due at least in part to derepression of reelin transcription in a manner dependent on the forkhead box (FOX) transcription factor FOXG1. Treatments aimed at either blocking downstream AKT signaling or inactivating reelin restored migration. These findings suggest a central AKT-FOXG1-reelin signaling pathway in FMCD and support pathway inhibitors as potential treatments or therapies for some forms of focal epilepsy.
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