PT - JOURNAL ARTICLE AU - Jack A. Kosmicki AU - Kaitlin E. Samocha AU - Daniel P. Howrigan AU - Stephan J. Sanders AU - Kamil Slowikowski AU - Monkol Lek AU - Konrad J. Karczewski AU - David J. Cutler AU - Bernie Devlin AU - Kathryn Roeder AU - Joseph D. Buxbaum AU - Benjamin M. Neale AU - Daniel G. MacArthur AU - Dennis P. Wall AU - Elise B. Robinson AU - Mark J. Daly TI - Refining the role of <em>de novo</em> protein truncating variants in neurodevelopmental disorders using population reference samples AID - 10.1101/052886 DP - 2017 Jan 01 TA - bioRxiv PG - 052886 4099 - http://biorxiv.org/content/early/2017/02/08/052886.short 4100 - http://biorxiv.org/content/early/2017/02/08/052886.full AB - Recent research has uncovered an important role for de novo variation in neurodevelopmental disorders. Using aggregated data from 9246 families with autism spectrum disorder, intellectual disability, or developmental delay, we show ~1/3 of de novo variants are independently observed as standing variation in the Exome Aggregation Consortium’s cohort of 60,706 adults, and these de novo variants do not contribute to neurodevelopmental risk. We further use a loss-of-function (LoF)-intolerance metric, pLI, to identify a subset of LoF-intolerant genes that contain the observed signal of associated de novo protein truncating variants (PTVs) in neurodevelopmental disorders. LoF-intolerant genes also carry a modest excess of inherited PTVs; though the strongest de novo impacted genes contribute little to this, suggesting the excess of inherited risk resides lower-penetrant genes. These findings illustrate the importance of population-based reference cohorts for the interpretation of candidate pathogenic variants, even for analyses of complex diseases and de novo variation.