Iannuzzelli K, Shi R, Carter R, Huynh R, Morgan O, Kuo SH, Bang J, Mills KA, Baranano K, Zee DS, Moukheiber E, Roda R, Butala A, Marvel C, Joyce M, Li X, Wang J, Rosenthal LS. The association between educational attainment and SCA 3 age of onset and disease course.
Parkinsonism Relat Disord 2022;
98:99-102. [PMID:
35635856 PMCID:
PMC10498785 DOI:
10.1016/j.parkreldis.2022.02.025]
[Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 02/15/2022] [Accepted: 02/27/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND
The number of trinucleotide CAG repeats is inversely correlated with the age at onset (AAO) of motor symptoms in individuals with Spinocerebellar Ataxia type 3 (SCA 3) and may be responsible for 50%-60% of the variability in AAO. Drawing from a social determinants of health model, we sought to determine if educational attainment further contributes to the AAO and motor symptom progression of SCA 3.
METHODS
We performed a retrospective chart review in which twenty individuals met criteria for inclusion and had been seen by an ataxia specialist at our hospital between January 2005 and July 2019. AAO of motor symptoms and Scale for Assessment and Rating of Ataxia (SARA) scores were used as primary outcome measures.
RESULTS
Using a linear regression, we found that having greater CAG repeat length and greater than 16 years of education results in an earlier AAO. The importance of the CAG repeat length on AAO, however, is greater amongst individuals with lower education. Using a linear mixed model evaluating SARA score over time with AAO, we found that less than 16 years of education is associated with faster progression of the disease.
CONCLUSION
In our group of SCA 3 patients, level of education correlated with both the AAO and SARA scores. Though our findings need to be confirmed with a larger cohort, our study suggests that level of education can have a strong influence on health outcomes in SCA 3 and possibly other groups of patients with ataxia.
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