Stxbp1, also known as syntaxin-binding protein 1 or Munc18-1, is an essential protein for presynaptic vesicle release. It is involved in synaptic vesicle fusion and neurotransmitter release, playing a crucial role in neuronal communication [3]. Mutations in Stxbp1 have been associated with a series of (epileptic) neurodevelopmental disorders collectively referred to as Stxbp1-encephalopathy (Stxbp1-E) [4].

De novo Stxbp1 mutations are among the most frequent causes of epilepsy and encephalopathy. Most patients with Stxbp1-E have severe to profound intellectual disability, and 95% have epilepsy. Seizure severity and intellectual disability seem to be two independent dimensions of the phenotype. Neurologic comorbidities like autistic features and movement disorders are common [1]. In a study of 534 individuals with Stxbp1-related disorders, neurodevelopmental abnormalities were seen in 95% and seizures in 89%, with focal-onset seizures being the most common. Over 88% had seizure onset in the first year of life [2].

In conclusion, Stxbp1 is vital for presynaptic function and neurotransmitter release, with its disruption leading to various neurodevelopmental and epileptic disorders. The study of Stxbp1-related disorders through patient-based research has provided insights into the complex phenotypes associated with its mutations, which is crucial for understanding the disease mechanisms and developing potential therapeutic strategies for these severe conditions.