Distinct pathogenic genes causing intellectual disability and autism exhibit overlapping effects on neuronal network development

Neuronal gene transcription through epigenetic modifications plays an important role in the etiology of intellectual disability (ID) and autism spectrum disorders (ASD). Haploinsufficiency of the Euchromatin Histone Methyltransferase 1 (EHMT1) gene causes Kleefstra syndrome, a neurodevelopmental disorder with the clinical features of both ID and ASD. Interestingly, patients with loss-of-function mutations in the functionally distinct epigenetic regulators MBD5, MLL3 or SMARCB1 also share the same core features, referred to as the Kleefstra syndrome spectrum (KSS). Currently, little is known about how variants in these different chromatin remodelers lead to the phenotypic convergence in KSS. To decipher the pathophysiology underlying KSS we here directly compared the effect of loss of function of four distinct KSS genes in developing rodent neuronal networks, using a combination of transcriptional analysis, immunocytochemistry, single-cell recordings and micro-electrode arrays. KSS gene-deficient neuronal networks all showed impaired neural network activity, resulting in hyperactive networks with altered network organization. At the single-cell level, we found genotype-specific changes in intrinsic excitability and in excitatory-inhibitory balance, all leading to increased excitability. These findings we could also recapitulate in a mouse model for Kleefstra syndrome. Transcriptional analysis further revealed distinct regulatory mechanisms. Nevertheless, KSS-target genes share similar functions in regulating neuronal excitability and synaptic function, several of which are associated with ID and ASD. Our results show that KSS genes mainly converge at the level of neuronal network development, providing new insights into the pathophysiology of KSS and to other phenotypically congruent disorders involving ID and autism.