{Reference Type}: Journal Article {Title}: OMIXCARE: OMICS technologies solved about 33% of the patients with heterogeneous rare neuro-developmental disorders and negative exome sequencing results and identified 13% additional candidate variants. {Author}: Colin E;Duffourd Y;Tisserant E;Relator R;Bruel AL;Tran Mau-Them F;Denommé-Pichon AS;Safraou H;Delanne J;Jean-Marçais N;Keren B;Isidor B;Vincent M;Mignot C;Heron D;Afenjar A;Heide S;Faudet A;Charles P;Odent S;Herenger Y;Sorlin A;Moutton S;Kerkhof J;McConkey H;Chevarin M;Poë C;Couturier V;Bourgeois V;Callier P;Boland A;Olaso R;Philippe C;Sadikovic B;Thauvin-Robinet C;Faivre L;Deleuze JF;Vitobello A; {Journal}: Front Cell Dev Biol {Volume}: 10 {Issue}: 0 {Year}: 2022 {Factor}: 6.081 {DOI}: 10.3389/fcell.2022.1021785 {Abstract}: Purpose: Patients with rare or ultra-rare genetic diseases, which affect 350 million people worldwide, may experience a diagnostic odyssey. High-throughput sequencing leads to an etiological diagnosis in up to 50% of individuals with heterogeneous neurodevelopmental or malformation disorders. There is a growing interest in additional omics technologies in translational research settings to examine the remaining unsolved cases. Methods: We gathered 30 individuals with malformation syndromes and/or severe neurodevelopmental disorders with negative trio exome sequencing and array comparative genomic hybridization results through a multicenter project. We applied short-read genome sequencing, total RNA sequencing, and DNA methylation analysis, in that order, as complementary translational research tools for a molecular diagnosis. Results: The cohort was mainly composed of pediatric individuals with a median age of 13.7 years (4 years and 6 months to 35 years and 1 month). Genome sequencing alone identified at least one variant with a high level of evidence of pathogenicity in 8/30 individuals (26.7%) and at least a candidate disease-causing variant in 7/30 other individuals (23.3%). RNA-seq data in 23 individuals allowed two additional individuals (8.7%) to be diagnosed, confirming the implication of two pathogenic variants (8.7%), and excluding one candidate variant (4.3%). Finally, DNA methylation analysis confirmed one diagnosis identified by genome sequencing (Kabuki syndrome) and identified an episignature compatible with a BAFopathy in a patient with a clinical diagnosis of Coffin-Siris with negative genome and RNA-seq results in blood. Conclusion: Overall, our integrated genome, transcriptome, and DNA methylation analysis solved 10/30 (33.3%) cases and identified a strong candidate gene in 4/30 (13.3%) of the patients with rare neurodevelopmental disorders and negative exome sequencing results.