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Onset and pre-onset studies to define the Huntington’s disease natural history

Identifieur interne : 002A25 ( Istex/Corpus ); précédent : 002A24; suivant : 002A26

Onset and pre-onset studies to define the Huntington’s disease natural history

Auteurs : F. Squitieri ; M. Cannella ; P. Giallonardo ; V. Maglione ; C. Mariotti ; M. R. Hayden

Source :

RBID : ISTEX:15F32D0387E2F0031C413C67C5CE17E6434C7AA5

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Abstract

Huntington’s disease’s (HD) clinical history has not been defined yet. However, many aspects of the most confusing clinical stages, i.e., the first and last disease phases, including the symptom progression and the disease duration, have been better approached after discovery of the responsible gene. The existence of accurate genetic tests, available for affected and pre-symptomatic subjects (i.e., mutation carriers) and the possibility to study transgenic in vivo models, are actually helping us to understand some of the aspects of HD clinical presentation. HD may present with motor symptoms other than chorea, the psychiatric manifestations may represent part of the clinical picture and cognitive deterioration may occur very early in the disease and depend on early cortical involvement. Pre-onset studies are of crucial importance in understanding the temporal sequence of the clinical events. This is also very important for future therapeutic strategies in those diseases initiating late in the life, such as HD.

Url:
DOI: 10.1016/S0361-9230(01)00648-7

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ISTEX:15F32D0387E2F0031C413C67C5CE17E6434C7AA5

Le document en format XML

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<note type="content">FIG. 1: Linear correlation obtained by simple regression analysis plotting the age at onset (y-axis) with the CAG repeat expansion (x-axis; n = 464, r2 = 0.54, p = 0.0001). Subjects, clinical and genetic data is included in the Italian Huntington’s disease databank (Table 1 and [54]). The logarithm transformation of data improved the linear correlation between x-y variables. The age at onset was calculated considering the first motor symptom appearance. The CAG repeat number beyond 35 was considered abnormal according to the published data [2].</note>
<note type="content">FIG. 2: Linear correlation obtained by simple regression analysis plotting the age of first severe psychiatric manifestations (y-axis) with the CAG repeat expansion (x-axis; n = 35; r2 = 0.31; p = 0.0005). Clinical and genetic data is included in the Italian Huntington’s disease databank (Table 1 and [54]). We considered as severe psychiatric symptoms those clinical manifestations altering the normal life state (mean age = 37.3 ± 11.7 years; range, 15–60) [61]. Severe behavioural changes anticipating of one or more years the motor onset symptoms (range, 1–28 years; mean = 7.6 ± 7 years), were considered.</note>
<note type="content">TABLE 1: Age-of-onset predictability according to the lower and upper 95% confidence intervals (CI) per fixed number of CAG expanded repeats</note>
<note type="content">TABLE 2: Effect of the affected parent’s gender on intergenerational year-of-onset and CAG repeat changes and influence of the normal allele length on age at onset</note>
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<ce:textfn>Division of Biochemistry and Genetics, Neurological Institute “C. Besta”, Milan, Italy</ce:textfn>
</ce:affiliation>
<ce:affiliation id="AFF3">
<ce:label>3</ce:label>
<ce:textfn>Centre for Molecular Medicine and Therapeutics, Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada</ce:textfn>
</ce:affiliation>
<ce:correspondence id="COR1">
<ce:label></ce:label>
<ce:text>Address for correspondence: Ferdinando Squitieri, M.D., Ph.D., Neurogenetics Unit, IRCCS Neuromed, Loc. Camerelle - 86077, Pozzilli (IS), Italy. Fax: +390865-927575</ce:text>
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<ce:abstract>
<ce:section-title>Abstract</ce:section-title>
<ce:abstract-sec>
<ce:simple-para>Huntington’s disease’s (HD) clinical history has not been defined yet. However, many aspects of the most confusing clinical stages, i.e., the first and last disease phases, including the symptom progression and the disease duration, have been better approached after discovery of the responsible gene. The existence of accurate genetic tests, available for affected and pre-symptomatic subjects (i.e., mutation carriers) and the possibility to study transgenic
<ce:italic>in vivo</ce:italic>
models, are actually helping us to understand some of the aspects of HD clinical presentation. HD may present with motor symptoms other than chorea, the psychiatric manifestations may represent part of the clinical picture and cognitive deterioration may occur very early in the disease and depend on early cortical involvement. Pre-onset studies are of crucial importance in understanding the temporal sequence of the clinical events. This is also very important for future therapeutic strategies in those diseases initiating late in the life, such as HD.</ce:simple-para>
</ce:abstract-sec>
</ce:abstract>
<ce:keywords class="keyword">
<ce:section-title>Keywords</ce:section-title>
<ce:keyword>
<ce:text>Predictive diagnosis</ce:text>
</ce:keyword>
<ce:keyword>
<ce:text>Clinical history</ce:text>
</ce:keyword>
<ce:keyword>
<ce:text>Onset symptoms</ce:text>
</ce:keyword>
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<namePart type="family">Squitieri</namePart>
<affiliation>E-mail: neurogen@neuromed.it</affiliation>
<affiliation>Neurogenetics Unit, Neurological Institute IRCCS “Neuromed”, Pozzilli (IS), Italy</affiliation>
<description>Address for correspondence: Ferdinando Squitieri, M.D., Ph.D., Neurogenetics Unit, IRCCS Neuromed, Loc. Camerelle - 86077, Pozzilli (IS), Italy. Fax: +390865-927575</description>
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<namePart type="given">M.</namePart>
<namePart type="family">Cannella</namePart>
<affiliation>Neurogenetics Unit, Neurological Institute IRCCS “Neuromed”, Pozzilli (IS), Italy</affiliation>
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<name type="personal">
<namePart type="given">P.</namePart>
<namePart type="family">Giallonardo</namePart>
<affiliation>Neurogenetics Unit, Neurological Institute IRCCS “Neuromed”, Pozzilli (IS), Italy</affiliation>
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<roleTerm type="text">author</roleTerm>
</role>
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<name type="personal">
<namePart type="given">V.</namePart>
<namePart type="family">Maglione</namePart>
<affiliation>Neurogenetics Unit, Neurological Institute IRCCS “Neuromed”, Pozzilli (IS), Italy</affiliation>
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<name type="personal">
<namePart type="given">C.</namePart>
<namePart type="family">Mariotti</namePart>
<affiliation>Division of Biochemistry and Genetics, Neurological Institute “C. Besta”, Milan, Italy</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">M.R.</namePart>
<namePart type="family">Hayden</namePart>
<affiliation>Centre for Molecular Medicine and Therapeutics, Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada</affiliation>
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<abstract lang="en">Huntington’s disease’s (HD) clinical history has not been defined yet. However, many aspects of the most confusing clinical stages, i.e., the first and last disease phases, including the symptom progression and the disease duration, have been better approached after discovery of the responsible gene. The existence of accurate genetic tests, available for affected and pre-symptomatic subjects (i.e., mutation carriers) and the possibility to study transgenic in vivo models, are actually helping us to understand some of the aspects of HD clinical presentation. HD may present with motor symptoms other than chorea, the psychiatric manifestations may represent part of the clinical picture and cognitive deterioration may occur very early in the disease and depend on early cortical involvement. Pre-onset studies are of crucial importance in understanding the temporal sequence of the clinical events. This is also very important for future therapeutic strategies in those diseases initiating late in the life, such as HD.</abstract>
<note type="content">FIG. 1: Linear correlation obtained by simple regression analysis plotting the age at onset (y-axis) with the CAG repeat expansion (x-axis; n = 464, r2 = 0.54, p = 0.0001). Subjects, clinical and genetic data is included in the Italian Huntington’s disease databank (Table 1 and [54]). The logarithm transformation of data improved the linear correlation between x-y variables. The age at onset was calculated considering the first motor symptom appearance. The CAG repeat number beyond 35 was considered abnormal according to the published data [2].</note>
<note type="content">FIG. 2: Linear correlation obtained by simple regression analysis plotting the age of first severe psychiatric manifestations (y-axis) with the CAG repeat expansion (x-axis; n = 35; r2 = 0.31; p = 0.0005). Clinical and genetic data is included in the Italian Huntington’s disease databank (Table 1 and [54]). We considered as severe psychiatric symptoms those clinical manifestations altering the normal life state (mean age = 37.3 ± 11.7 years; range, 15–60) [61]. Severe behavioural changes anticipating of one or more years the motor onset symptoms (range, 1–28 years; mean = 7.6 ± 7 years), were considered.</note>
<note type="content">TABLE 1: Age-of-onset predictability according to the lower and upper 95% confidence intervals (CI) per fixed number of CAG expanded repeats</note>
<note type="content">TABLE 2: Effect of the affected parent’s gender on intergenerational year-of-onset and CAG repeat changes and influence of the normal allele length on age at onset</note>
<subject lang="en">
<genre>Keywords</genre>
<topic>Predictive diagnosis</topic>
<topic>Clinical history</topic>
<topic>Onset symptoms</topic>
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<titleInfo>
<title>Brain Research Bulletin</title>
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<name type="conference">
<namePart>Triplet Repeat Diseases</namePart>
<namePart>Triplet Repeat Diseases</namePart>
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<name type="personal">
<namePart>A. Poletti</namePart>
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<name type="personal">
<namePart>A. Servadio</namePart>
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<name type="personal">
<namePart>F. Taroni</namePart>
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<dateIssued encoding="w3cdtf">20011101</dateIssued>
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<identifier type="ISSN">0361-9230</identifier>
<identifier type="PII">S0361-9230(00)X0116-5</identifier>
<part>
<date>20011101</date>
<detail type="issue">
<title>Triplet Repeat Diseases</title>
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<detail type="volume">
<number>56</number>
<caption>vol.</caption>
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<detail type="issue">
<number>3–4</number>
<caption>no.</caption>
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<extent unit="issue pages">
<start>159</start>
<end>410</end>
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<identifier type="DOI">10.1016/S0361-9230(01)00648-7</identifier>
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