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Cardoso F, Goetz CG, Mestre TA, Sampaio C, Adler CH, Berg D, Bloem BR, Burn DJ, Fitts MS, Gasser T, Klein C, de Tijssen MAJ, Lang AE, Lim SY, Litvan I, Meissner WG, Mollenhauer B, Okubadejo N, Okun MS, Postuma RB, Svenningsson P, Tan LCS, Tsunemi T, Wahlstrom-Helgren S, Gershanik OS, Fung VSC, Trenkwalder C. A Statement of the MDS on Biological Definition, Staging, and Classification of Parkinson's Disease. Mov Disord 2024; 39:259-266. [PMID: 38093469 DOI: 10.1002/mds.29683] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/16/2023] [Accepted: 11/20/2023] [Indexed: 12/27/2023] Open
Affiliation(s)
- Francisco Cardoso
- Movement Disorders Unit, Neurology Service, Internal Medicine Department, The Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Christopher G Goetz
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Tiago A Mestre
- Ottawa Hospital Research Institute; University of Ottawa Brain and Mind Research Institute; Division of Neurology, Department of Medicine, University of Ottawa, The Ottawa Hospital Ottawa, Ottawa, Ontario, Canada
| | - Cristina Sampaio
- CHDI Management/CHDI Foundation, Princeton, New Jersey, USA
- Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Charles H Adler
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Daniela Berg
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel and Christian Albrechts-University of Kiel, Kiel, Germany
| | - Bastiaan R Bloem
- Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behavior, Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Nijmegen, The Netherlands
| | - David J Burn
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Michael S Fitts
- UAB Libraries, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Thomas Gasser
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany. German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Marina A J de Tijssen
- Department of Neurology, Expertise Centre Movement Disorders, University Medical Centre Groningen, Groningen, The Netherlands
| | - Anthony E Lang
- Edmond J. Safra Program in Parkinson's Disease, University Health Network and the University of Toronto, Toronto, Ontario, Canada
| | - Shen-Yang Lim
- Division of Neurology, Department of Medicine, and the Mah Pooi Soo and Tan Chin Nam Centre for Parkinson's and Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Irene Litvan
- Parkinson and Other Movement Disorders Center, Department of Neurosciences, University of California San Diego, La Jolla, California, USA
| | - Wassilios G Meissner
- CHU Bordeaux, Service de Neurologie des Maladies Neurodégénératives, Bordeaux, France
- Univ. Bordeaux, CNRS, IMN, Bordeaux, France
- Department of Medicine, University of Otago, Christchurch, and New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Brit Mollenhauer
- Department of Neurology, University Medical Center, Kassel, Germany
| | - Njideka Okubadejo
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Michael S Okun
- Adelaide Lackner Professor of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainsville, Florida, USA
| | - Ronald B Postuma
- Department of Neurology, McGill University, Montreal Neurological Institute, Montreal, Quebec, Canada
| | | | | | - Taiji Tsunemi
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | | | - Oscar S Gershanik
- Movement Disorders Unit, Institute of Neuroscience, Favaloro Foundation University Hospital, Buenos Aires, Argentina
- Cognitive Neuroscience Laboratory, Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina
| | - Victor S C Fung
- Movement Disorders Unit, Department of Neurology, Westmead Hospital and Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Claudia Trenkwalder
- Paracelsus-Elena Klinik, Kassel, Germany
- Department of Neurosurgery, University Medical Center, Goettingen, Germany
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2
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Nogueira R, Couto CM, Oliveira PD, Martins BJAF, Montanaro VVA. Response to comments on the management and ethical implications of genetic testing in CADASIL. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:1025-1026. [PMID: 38035587 PMCID: PMC10689097 DOI: 10.1055/s-0043-1777067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 10/10/2023] [Indexed: 12/02/2023]
Affiliation(s)
- Renata Nogueira
- Rede Sarah de Hospitais de Reabilitação, Rio de Janeiro RJ, Brazil.
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3
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Jain V, Irving R, Williams A. Genomic testing in neurology. Pract Neurol 2023; 23:420-429. [PMID: 37468300 DOI: 10.1136/pn-2023-003735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2023] [Indexed: 07/21/2023]
Abstract
Genomic testing has been available for neurological conditions for decades. However, in recent years, there has been a significant change in its availability, range and cost, as well as improvements in the technology and knowledge that underpin how the genome is interrogated. Neurologists can encounter a wide range of genetic conditions, and so their understanding of genomic testing is fundamental to modern clinical practice.
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Affiliation(s)
- Vani Jain
- All Wales Medical Genomics Service, University Hospital of Wales Healthcare NHS Trust, Cardiff, UK
| | - Rachel Irving
- All Wales Medical Genomics Service, University Hospital of Wales Healthcare NHS Trust, Cardiff, UK
| | - Angharad Williams
- All Wales Medical Genomics Service, University Hospital of Wales Healthcare NHS Trust, Cardiff, UK
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4
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Chambers C, Lichten L, Crook A, Uhlmann WR, Dratch L. Incorporating Genetic Testing Into the Care of Patients With Amyotrophic Lateral Sclerosis/Frontotemporal Degeneration Spectrum Disorders. Neurol Clin Pract 2023; 13:e200201. [PMID: 37736067 PMCID: PMC10511270 DOI: 10.1212/cpj.0000000000200201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 08/14/2023] [Indexed: 09/23/2023]
Abstract
Purpose of Review Amyotrophic lateral sclerosis (ALS) and frontotemporal degeneration (FTD) spectrum disorders have a strong genetic component. Genetic counselors are a limited resource, and therefore, other providers must be prepared to integrate genetic testing into their practice. Recent Findings Recent ALS/FTD studies have demonstrated that lack of family history does not preclude a genetic etiology. The benefits of a genetic diagnosis have expanded to include the potential to treat; thus, genetic testing is increasingly recommended to be offered to all persons with ALS/FTD. Summary Offering genetic testing to persons with ALS/FTD spectrum disorders should be part of routine clinical neurologic care. All genetic testing should include discussion about the medical and psychosocial implications of testing for the patient and family members. Neurologists should be prepared to facilitate this process and recognize when referral to a genetic counselor is indicated.
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Affiliation(s)
- Chelsea Chambers
- Department of Neurology (CC), University of Virginia, Charlottesville; Emory University School of Medicine (LL), Atlanta, GA; Macquarie University (AC); University of Technology Syndey (AC), Australia; University of Michigan (WRU), Ann Arbor; University of Pennsylvania (LD), Philadelphia
| | - Lauren Lichten
- Department of Neurology (CC), University of Virginia, Charlottesville; Emory University School of Medicine (LL), Atlanta, GA; Macquarie University (AC); University of Technology Syndey (AC), Australia; University of Michigan (WRU), Ann Arbor; University of Pennsylvania (LD), Philadelphia
| | - Ashley Crook
- Department of Neurology (CC), University of Virginia, Charlottesville; Emory University School of Medicine (LL), Atlanta, GA; Macquarie University (AC); University of Technology Syndey (AC), Australia; University of Michigan (WRU), Ann Arbor; University of Pennsylvania (LD), Philadelphia
| | - Wendy R Uhlmann
- Department of Neurology (CC), University of Virginia, Charlottesville; Emory University School of Medicine (LL), Atlanta, GA; Macquarie University (AC); University of Technology Syndey (AC), Australia; University of Michigan (WRU), Ann Arbor; University of Pennsylvania (LD), Philadelphia
| | - Laynie Dratch
- Department of Neurology (CC), University of Virginia, Charlottesville; Emory University School of Medicine (LL), Atlanta, GA; Macquarie University (AC); University of Technology Syndey (AC), Australia; University of Michigan (WRU), Ann Arbor; University of Pennsylvania (LD), Philadelphia
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5
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Pal G, Cook L, Schulze J, Verbrugge J, Alcalay RN, Merello M, Sue CM, Bardien S, Bonifati V, Chung SJ, Foroud T, Gatto E, Hall A, Hattori N, Lynch T, Marder K, Mascalzoni D, Novaković I, Thaler A, Raymond D, Salari M, Shalash A, Suchowersky O, Mencacci NE, Simuni T, Saunders‐Pullman R, Klein C. Genetic Testing in Parkinson's Disease. Mov Disord 2023; 38:1384-1396. [PMID: 37365908 PMCID: PMC10946878 DOI: 10.1002/mds.29500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/28/2023] [Accepted: 05/24/2023] [Indexed: 06/28/2023] Open
Abstract
Genetic testing for persons with Parkinson's disease is becoming increasingly common. Significant gains have been made regarding genetic testing methods, and testing is becoming more readily available in clinical, research, and direct-to-consumer settings. Although the potential utility of clinical testing is expanding, there are currently no proven gene-targeted therapies, but clinical trials are underway. Furthermore, genetic testing practices vary widely, as do knowledge and attitudes of relevant stakeholders. The specter of testing mandates financial, ethical, and physician engagement, and there is a need for guidelines to help navigate the myriad of challenges. However, to develop guidelines, gaps and controversies need to be clearly identified and analyzed. To this end, we first reviewed recent literature and subsequently identified gaps and controversies, some of which were partially addressed in the literature, but many of which are not well delineated or researched. Key gaps and controversies include: (1) Is genetic testing appropriate in symptomatic and asymptomatic individuals without medical actionability? (2) How, if at all, should testing vary based on ethnicity? (3) What are the long-term outcomes of consumer- and research-based genetic testing in presymptomatic PD? (4) What resources are needed for clinical genetic testing, and how is this impacted by models of care and cost-benefit considerations? Addressing these issues will help facilitate the development of consensus and guidelines regarding the approach and access to genetic testing and counseling. This is also needed to guide a multidisciplinary approach that accounts for cultural, geographic, and socioeconomic factors in developing testing guidelines. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Gian Pal
- Department of NeurologyRutgers‐Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
| | - Lola Cook
- Department of Medical and Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Jeanine Schulze
- Department of Medical and Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Jennifer Verbrugge
- Department of Medical and Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Roy N. Alcalay
- Department of NeurologyColumbia University Irving Medical CenterNew YorkNew YorkUSA
- Movement Disorders Division, Neurological InstituteTel Aviv Sourasky Medical CenterTel AvivIsrael
| | - Marcelo Merello
- Neuroscience Department FleniCONICET, Catholic University of Buenos AiresBuenos AiresArgentina
| | - Carolyn M. Sue
- Department of NeurologyRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
- Department of Neurogenetics, Kolling Institute, Faculty of Medicine and HealthUniversity of SydneySt LeonardsNew South WalesAustralia
| | - Soraya Bardien
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health SciencesStellenbosch UniversityCape TownSouth Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research UnitStellenbosch UniversityCape TownSouth Africa
| | - Vincenzo Bonifati
- Department of Clinical Genetics, Erasmus MCUniversity Medical Center RotterdamRotterdamthe Netherlands
| | - Sun Ju Chung
- Department of Neurology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Tatiana Foroud
- Department of Medical and Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Emilia Gatto
- Instituto de Neurociencias Buenos AiresAffiliated Buenos Aires UniversityBuenos AiresArgentina
| | - Anne Hall
- Parkinson's FoundationNew YorkNew YorkUSA
| | - Nobutaka Hattori
- Research Institute of Disease of Old Age, Graduate School of MedicineJuntendo UniversityTokyoJapan
- Department of NeurologyJuntendo University School of MedicineTokyoJapan
- Neurodegenerative Disorders Collaborative LaboratoryRIKEN Center for Brain ScienceSaitamaJapan
| | - Tim Lynch
- Dublin Neurological Institute at the Mater Misericordiae University HospitalDublinIreland
| | - Karen Marder
- Department of NeurologyColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Deborah Mascalzoni
- Institute for Biomedicine, Eurac ResearchAffiliated Institute of the University of LübeckBolzanoItaly
- Center for Research Ethics and Bioethics, Department of Public Health and Caring SciencesUppsala UniversityUppsalaSweden
| | - Ivana Novaković
- Institute of Human Genetics, Faculty of MedicineUniversity of BelgradeBelgradeSerbia
| | - Avner Thaler
- Movement Disorders Unit, Neurological InstituteTel‐Aviv Medical CenterTel AvivIsrael
- Sackler School of MedicineTel‐Aviv UniversityTel AvivIsrael
- Sagol School of NeuroscienceTel‐Aviv UniversityTel AvivIsrael
- Laboratory of Early Markers of Neurodegeneration, Neurological InstituteTel‐Aviv Medical CenterTel AvivIsrael
| | - Deborah Raymond
- Department of NeurologyMount Sinai Beth Israel and Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Mehri Salari
- Functional Neurosurgery Research Center, Shohada‐e Tajrish Comprehensive Neurosurgical Center of ExcellenceShahid Beheshti University of Medical SciencesTehranIran
| | - Ali Shalash
- Department of Neurology, Faculty of MedicineAin Shams UniversityCairoEgypt
| | - Oksana Suchowersky
- Department of Medicine (Neurology), Medical Genetics and PediatricsUniversity of AlbertaEdmontonAlbertaCanada
| | - Niccolò E. Mencacci
- Ken and Ruth Davee Department of Neurology and Simpson Querrey Center for NeurogeneticsNorthwestern University, Feinberg School of MedicineChicagoIllinoisUSA
- Parkinson's Disease and Movement Disorders CenterNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Tanya Simuni
- Parkinson's Disease and Movement Disorders CenterNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Rachel Saunders‐Pullman
- Department of NeurologyMount Sinai Beth Israel and Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Christine Klein
- Institute of NeurogeneticsUniversity of Lübeck and University Hospital Schleswig‐HolsteinLübeckGermany
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6
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Pérez‐Carbonell L, Simonet C, Chohan H, Gill A, Leschziner G, Schrag A, Noyce AJ. The Views of Patients with Isolated Rapid Eye Movement Sleep Behavior Disorder on Risk Disclosure. Mov Disord 2023; 38:1089-1093. [PMID: 37046409 PMCID: PMC10947281 DOI: 10.1002/mds.29403] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/20/2023] [Accepted: 03/22/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Isolated rapid eye movement sleep behavior disorder (iRBD) is associated with an increased risk of Parkinson's disease and other synucleinopathies. There is no consensus about disclosure of this risk to patients with iRBD. OBJECTIVE The objective of our study was to assess the experiences of risk disclosure in a group of patients with iRBD and their views on what, when, and how this should be done. METHODS A survey was administered to patients with iRBD to explore their experiences and views on risk disclosure. RESULTS Thirty-one patients with iRBD (28 males; mean age, 70 [SD 8.7] years; mean disease duration, 8.7 [SD 6.4] years) were included. A third reported they had not been informed about the link between iRBD and other conditions by clinicians at diagnosis, but 90% would have liked to have received prognostic information, and 60% indicated that this should happen at the point that iRBD was diagnosed. Most participants wanted this information to come from the clinician diagnosing and treating iRBD (90.3%). Almost three-quarters (72.2%) had searched for this information online. CONCLUSIONS Patients with iRBD mostly wished to have received information regarding the potential implications of iRBD when the diagnosis was made. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Laura Pérez‐Carbonell
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation TrustLondonUnited Kingdom
| | - Cristina Simonet
- Preventive Neurology Unit, Wolfson Institute of Population HealthQueen Mary University of LondonLondonUnited Kingdom
| | - Harneek Chohan
- Preventive Neurology Unit, Wolfson Institute of Population HealthQueen Mary University of LondonLondonUnited Kingdom
| | - Aneet Gill
- Preventive Neurology Unit, Wolfson Institute of Population HealthQueen Mary University of LondonLondonUnited Kingdom
| | - Guy Leschziner
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation TrustLondonUnited Kingdom
| | - Anette Schrag
- Department of Clinical and Movement NeuroscienceUCL Institute of NeurologyLondonUnited Kingdom
| | - Alastair J. Noyce
- Preventive Neurology Unit, Wolfson Institute of Population HealthQueen Mary University of LondonLondonUnited Kingdom
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Papadopoulou E, Pepe G, Konitsiotis S, Chondrogiorgi M, Grigoriadis N, Kimiskidis VK, Tsivgoulis G, Mitsikostas DD, Chroni E, Domouzoglou E, Tsaousis G, Nasioulas G. The evolution of comprehensive genetic analysis in neurology: Implications for precision medicine. J Neurol Sci 2023; 447:120609. [PMID: 36905813 DOI: 10.1016/j.jns.2023.120609] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/07/2023]
Abstract
Technological advancements have facilitated the availability of reliable and thorough genetic analysis in many medical fields, including neurology. In this review, we focus on the importance of selecting the appropriate genetic test to aid in the accurate identification of disease utilizing currently employed technologies for analyzing monogenic neurological disorders. Moreover, the applicability of comprehensive analysis via NGS for various genetically heterogeneous neurological disorders is reviewed, revealing its efficiency in clarifying a frequently cloudy diagnostic picture and delivering a conclusive and solid diagnosis that is essential for the proper management of the patient. The feasibility and effectiveness of medical genetics in neurology require interdisciplinary cooperation among several medical specialties and geneticists, to select and perform the most relevant test according to each patient's medical history, using the most appropriate technological tools. The prerequisites for a comprehensive genetic analysis are discussed, highlighting the utility of appropriate gene selection, variant annotation, and classification. Moreover, genetic counseling and interdisciplinary collaboration could improve diagnostic yield further. Additionally, a sub-analysis is conducted on the 1,502,769 variation records with submitted interpretations in the Clinical Variation (ClinVar) database, with a focus on neurology-related genes, to clarify the value of suitable variant categorization. Finally, we review the current applications of genetic analysis in the diagnosis and personalized management of neurological patients and the advances in the research and scientific knowledge of hereditary neurological disorders that are evolving the utility of genetic analysis towards the individualization of the treatment strategy.
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Affiliation(s)
| | - Georgia Pepe
- GeneKor Medical SA, Spaton 52, Gerakas 15344, Greece
| | - Spiridon Konitsiotis
- Department of Neurology, University of Ioannina, Stavrou Niarchou Avenue, Ioannina 45500, Greece
| | - Maria Chondrogiorgi
- Department of Neurology, University of Ioannina, Stavrou Niarchou Avenue, Ioannina 45500, Greece
| | - Nikolaos Grigoriadis
- Second Department of Neurology, "AHEPA" University Hospital, Aristotle University of Thessaloniki, St. Kiriakidis 1, Thessaloniki 54636, Greece
| | - Vasilios K Kimiskidis
- First Department of Neurology, "AHEPA" University hospital, Aristotle University of Thessaloniki, St. Kiriakidis 1, Thessaloniki 54636, Greece
| | - Georgios Tsivgoulis
- Second Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimos D Mitsikostas
- First Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Elisabeth Chroni
- Department of Neurology, School of Medicine, University of Patras, Rio-Patras, Greece
| | - Eleni Domouzoglou
- Department of Pediatrics, University Hospital of Ioannina, Stavrou Niarchou Avenue, Ioannina 45500, Greece
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8
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Galluzzi S, Mega A, Di Fede G, Muscio C, Fascendini S, Benussi L, Tagliavini F, Frisoni GB, Di Maria E. Psychological Impact of Predictive Genetic Testing for Inherited Alzheimer Disease and Frontotemporal Dementia: The IT-DIAfN Protocol. Alzheimer Dis Assoc Disord 2022; 36:118-124. [PMID: 35293381 PMCID: PMC9132242 DOI: 10.1097/wad.0000000000000494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/22/2021] [Indexed: 11/26/2022]
Abstract
AIM Our aim was to evaluate the psychological impact of predictive genetic testing in individuals at-risk for inherited dementia who underwent a structured counseling and testing protocol. METHODS Participants were healthy at-risk relatives from families with at least one affected patient, in whom a disease-associated genetic variant had been ascertained. A comprehensive psychological assessment (personality, anxiety and depression, quality of life, coping strategies, resilience and health-related beliefs) was administered at baseline, at 6 months and 12 months follow-up. RESULTS Twenty-four participants from 13 families were included. Sixteen participants underwent blood sampling and genetic analysis; 6 resulted to be carriers of pathogenic variants (1 in PSEN1, 1 in PSEN2, 4 in GRN). Carriers showed higher score on the Resilience Scale for Adults (RSA) - social competence, and on Multidimensional Health Locus of Control - internal, than noncarriers (P=0.03 for both). Ten at-risk relatives who completed the follow-up showed improvement in RSA - planned future (P=0.01) with respect to baseline. DISCUSSION Our case series showed that at-risk individuals undergoing predictive testing showed benefit on personal life and no detrimental impact on a broad range of psychological outcomes. Higher social skills and lower internal health locus of control in carriers may be an early psychological correlate of preclinical dementia.
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Affiliation(s)
| | - Anna Mega
- Laboratory Alzheimer’s Neuroimaging and Epidemiology
| | - Giuseppe Di Fede
- Neurology V – Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano
| | - Cristina Muscio
- Neurology V – Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano
| | | | - Luisa Benussi
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia
| | - Fabrizio Tagliavini
- Scientific Directorate, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano
| | | | - Giovanni B. Frisoni
- Laboratory Alzheimer’s Neuroimaging and Epidemiology
- Memory Clinic, Department of Rehabilitation and Geriatrics, University Hospitals and University of Geneva, Genève, Switzerland
| | - Emilio Di Maria
- Department of Health Sciences, University of Genoa
- Unit of Medical Genetics, Galliera Hospital, Genoa
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9
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Crook A, McEwen A. Genetic counselling and testing for neurodegenerative disorders using a proposed standard of practice for ALS/MND: diagnostic testing comes first. Eur J Hum Genet 2022; 30:394-395. [PMID: 34983943 PMCID: PMC8990066 DOI: 10.1038/s41431-021-01036-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- Ashley Crook
- Graduate School of Health, University of Technology Sydney, Chippendale, NSW, Australia.
- Centre for MND research and Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.
| | - Alison McEwen
- Graduate School of Health, University of Technology Sydney, Chippendale, NSW, Australia
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10
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Crook A, Jacobs C, Newton-John T, McEwen A. Toward genetic counseling practice standards for diagnostic testing in amyotrophic lateral sclerosis and frontotemporal dementia. Amyotroph Lateral Scler Frontotemporal Degener 2022; 23:562-574. [PMID: 35343344 DOI: 10.1080/21678421.2022.2051553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objective: Genetic counseling and diagnostic genetic testing are considered part of the multidisciplinary care of individuals with amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). We aimed to investigate the ideal components of genetic counseling for ALS/FTD diagnostic testing amongst various stakeholders using an online, modified Delphi survey. Methods: Experts in genetic counseling and testing for ALS/FTD were purposively then snowball recruited and included genetic health professionals, health professionals outside of genetics and consumer experts (patients, relatives, and staff representatives from ALS/FTD support organizations). First-round items were informed by two systematic literature reviews and qualitative interviews with patients and families who had experienced diagnostic testing. Analysis of each round informed the development of the subsequent round and the final results. Results: Forty-six experts participated in the study, 95.65% completed both rounds. After round one, items were updated based on participant responses and were presented again for consensus in round two. After round two, a high level of consensus (≥80% agreement) was achieved on 16 items covering various topics related to genetic counseling service delivery, before and after diagnostic testing is facilitated. Conclusions: Genetic counseling for individuals with ALS/FTD and their families should include the provision of client-centered counseling, education and support throughout. The items developed are adaptable to varied healthcare settings and may inform a standard of genetic counseling practice for health professionals who facilitate testing and counseling discussions. This area of work is timely, given demand for testing is likely to increase as more genotype-driven clinical trials become available.
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Affiliation(s)
- Ashley Crook
- Graduate School of Health, University of Technology Sydney, Chippendale, NSW, Australia.,Centre for MND research, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Chris Jacobs
- Graduate School of Health, University of Technology Sydney, Chippendale, NSW, Australia
| | - Toby Newton-John
- Graduate School of Health, University of Technology Sydney, Chippendale, NSW, Australia
| | - Alison McEwen
- Graduate School of Health, University of Technology Sydney, Chippendale, NSW, Australia
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11
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Elsayed I, Martinez-Carrasco A, Cornejo-Olivas M, Bandres-Ciga S. Mapping the Diverse and Inclusive Future of Parkinson's Disease Genetics and Its Widespread Impact. Genes (Basel) 2021; 12:1681. [PMID: 34828286 PMCID: PMC8624537 DOI: 10.3390/genes12111681] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 12/27/2022] Open
Abstract
Over the last decades, genetics has been the engine that has pushed us along on our voyage to understand the etiology of Parkinson's disease (PD). Although a large number of risk loci and causative mutations for PD have been identified, it is clear that much more needs to be done to solve the missing heritability mystery. Despite remarkable efforts, as a field, we have failed in terms of diversity and inclusivity. The vast majority of genetic studies in PD have focused on individuals of European ancestry, leading to a gap of knowledge on the existing genetic differences across populations and PD as a whole. As we move forward, shedding light on the genetic architecture contributing to PD in non-European populations is essential, and will provide novel insight into the generalized genetic map of the disease. In this review, we discuss how better representation of understudied ancestral groups in PD genetics research requires addressing and resolving all the challenges that hinder the inclusion of these populations. We further provide an overview of PD genetics in the clinics, covering the current challenges and limitations of genetic testing and counseling. Finally, we describe the impact of worldwide collaborative initiatives in the field, shaping the future of the new era of PD genetics as we advance in our understanding of the genetic architecture of PD.
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Affiliation(s)
- Inas Elsayed
- Faculty of Pharmacy, University of Gezira, Wad Medani P.O. Box 20, Sudan;
- International Parkinson Disease Genomics Consortium (IPDGC)-Africa, University of Gezira, Wad Medani P.O. Box 20, Sudan
| | | | - Mario Cornejo-Olivas
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, Lima 15003, Peru;
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima 15103, Peru
| | - Sara Bandres-Ciga
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, NIH, Bethesda, MD 20892, USA
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