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Mosaic human cortical organoids model mTOR-related focal cortical dysplasia through DEPDC5 deletion

Published inBrain, awag086
First online date2026-03-06
Abstract

Focal cortical dysplasia type II (FCDII), a major cause of pediatric drug-resistant focal epilepsy, results from brain somatic variants in mTOR pathway genes, including germline and somatic second-hit loss-of-function variants in the mTOR repressor DEPDC5. Here, we present a proof-of-concept model of DEPDC5 two-hit inactivation mosaicism using patient-derived human cortical organoids (hCOs). Mosaic hCOs displayed increased mTOR activity that was rescued by the mTOR inhibitor rapamycin. Mosaic hCOs also exhibited dysmorphic-like neurons and enhanced neuronal excitability, recapitulating key FCDII pathology hallmarks. Single-cell transcriptomics across three developmental stages revealed aberrant differentiation trajectories leading to premature upper-layer neuron generation, upregulated Notch and Wnt signaling pathways in neural progenitors, and altered expression of synaptic- and epilepsy-associated genes in excitatory neurons. In addition, we identified cell-autonomous alterations in metabolism and translation in mosaic DEPDC5 two-hit hCOs. This study provides novel insights into how DEPDC5 deficiency perturbs human corticogenesis, highlighting that mosaic biallelic inactivation of the gene is necessary for FCDII pathogenesis.

Keywords
  • Brain mosaicism
  • Epilepsy
  • Focal cortical dysplasia
  • MTOR signaling
  • Neurodevelopmental disorders
  • Somatic mutations
Funding
  • European Commission - NEUROBIOLOGY OF EPILEPSY GENES [682345]
  • ANR program "Investissements d'avenir" [ANR-10-IAIHU-06]
  • Fondation pour la Recherche Médicale [ECO20160736027]
  • ANR - ERANET-NEURON [ANR-21-NEU2-0002-01]
  • European Commission - Exploring new genetic causes and pathological mechanisms of epileptic focal cortical dysplasia [101026484]
  • European Commission - Lineage tracing of the human brain [101115984]
  • Fondation pour la Recherche Médicale [FDT201904008269]
Citation (ISO format)
MALETIC, Marina et al. Mosaic human cortical organoids model mTOR-related focal cortical dysplasia through DEPDC5 deletion. In: Brain, 2026, p. awag086. doi: 10.1093/brain/awag086
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Journal ISSN0006-8950
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Creation14/04/2026 10:26:01
First validation16/09/2026 13:02:52
Update16/09/2026 13:02:52
Status update16/09/2026 13:02:52
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