Homozygosity for CAG mutation in Huntington disease is associated with a more severe clinical course
Identifieur interne : 00AF21 ( Main/Exploration ); précédent : 00AF20; suivant : 00AF22Homozygosity for CAG mutation in Huntington disease is associated with a more severe clinical course
Auteurs : Ferdinando Squitieri ; Cinzia Gellera ; Milena Cannella ; Caterina Mariotti ; Giuliana Cislaghi ; David C. Rubinsztein ; Elisabeth W. Almqvist ; David Turner ; Anne-Catherine Bachoud-Le Vi [France] ; Sheila A. Simpson ; Martin Delatycki ; Vittorio Maglione ; Michael R. Hayden ; Stefano Di DonatoSource :
- Brain [ 0006-8950 ] ; 2003-04.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Adulte.
English descriptors
- KwdEn :
- Abbreviations: UHDRS = Unified Huntington’s Disease Rating Scale; TFC = total functional capacity, Adult, Age of onset, Aggressive behaviour, Allele, Atrophy, Behavioural, Behavioural changes, Brain atrophy, Chorea, Clinical assessment, Clinical course, Clinical data, Clinical picture, Complete dominance, Disability, Disability score, Disability scores, Disease chromosomes, Disease duration, Disease onset, Disease progression, Disease rating scale, Disease severity, Disease stage, Disease stages, Disease years, Early stages, Expansion mutation, Female, Functional decline, Generalized brain atrophy, Genet, Genetic analysis, Genetic data, Genetic determinism, Gusella, Heterozygote, Heterozygote sibling, Heterozygous patients, Heterozygous subjects, Homozygosity, Homozygote, Homozygous patients, Huntingtin, Huntington, Huntington disease, Huntington disease homozygosity, Huntington disease homozygotes, Huntington disease mutation, Huntington disease patients, Huntington disease stage, Huntington study group, Keywords: CAG expansion; CAG mutation homozygosity; disease progression; age at onset; brain atrophy; UHDRS, Kremer, Last assessment, Lower scores, Male, Medical genetics, Motor manifestations, Motor symptoms, Mouse model, Movement disorders, Multicentre study, Mutant alleles, Mutant protein, Mutation, Neurological, Neurological institute irccs, Neuronal survival, Neuropathological report, Neuropsychological testing, Normal huntingtin, Onset ages, Other diseases, Phenotype, Predictive factor, Prognosis, Progression, Range years, Repeated sequence, Research group, Score change, Severe behavioural changes, Squitieri, State examination, Symptom, Toxic gain, Trends neurosci, Trinucleotide, Uhdrs, Wechsler adult intelligence scale.
- Teeft :
- Aggressive behaviour, Allele, Atrophy, Behavioural, Behavioural changes, Brain atrophy, Chorea, Clinical assessment, Clinical course, Clinical data, Clinical picture, Complete dominance, Disability, Disability score, Disability scores, Disease chromosomes, Disease duration, Disease onset, Disease progression, Disease rating scale, Disease severity, Disease stage, Disease stages, Disease years, Early stages, Expansion mutation, Functional decline, Generalized brain atrophy, Genet, Genetic analysis, Genetic data, Gusella, Heterozygote, Heterozygote sibling, Heterozygous patients, Heterozygous subjects, Homozygosity, Homozygote, Homozygous patients, Huntingtin, Huntington, Huntington disease, Huntington disease homozygosity, Huntington disease homozygotes, Huntington disease mutation, Huntington disease patients, Huntington disease stage, Huntington study group, Kremer, Last assessment, Lower scores, Medical genetics, Motor manifestations, Motor symptoms, Mouse model, Movement disorders, Multicentre study, Mutant alleles, Mutant protein, Mutation, Neurological, Neurological institute irccs, Neuronal survival, Neuropathological report, Neuropsychological testing, Normal huntingtin, Onset ages, Other diseases, Progression, Range years, Research group, Score change, Severe behavioural changes, Squitieri, State examination, Symptom, Toxic gain, Trends neurosci, Uhdrs, Wechsler adult intelligence scale.
Abstract
Huntington disease is caused by a dominantly transmitted CAG repeat expansion mutation that is believed to confer a toxic gain of function on the mutant protein. Huntington disease patients with two mutant alleles are very rare. In other poly(CAG) diseases such as the dominant ataxias, inheritance of two mutant alleles causes a phenotype more severe than in heterozygotes. In this multicentre study, we sought differences in the disease features between eight homozygotes and 75 heterozygotes for the Huntington disease mutation. We identified subjects homozygous for the Huntington disease mutation by DNA testing and compared their clinical features (age at onset, symptom presentation, disease severity and disease progression) with those of a group of heterozygotes, who were assessed longitudinally. The age at onset of symptoms in the homozygote cases was within the range expected for heterozygotes with the same CAG repeat lengths, whereas homozygotes had a more severe clinical course. The observation of a more rapid decline in motor, cognitive and behavioural symptoms in homozygotes was consistent with the extent of neurodegeneration as available at imaging in three patients, and at the post‐mortem neuropathological report in one case. Our analysis suggests that although homozygosity for the Huntington disease mutation does not lower the age at onset of symptoms, it affects the phenotype and the rate of disease progression. These data, once confirmed in a larger series of patients, point to the possibility that the mechanisms underlying age at onset and disease progression in Huntington disease may differ.
Url:
DOI: 10.1093/brain/awg077
Affiliations:
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Le document en format XML
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Abbreviations: UHDRS = Unified Huntington’s Disease Rating Scale; TFC = total functional capacity</term>
<term>Adult</term>
<term>Age of onset</term>
<term>Aggressive behaviour</term>
<term>Allele</term>
<term>Atrophy</term>
<term>Behavioural</term>
<term>Behavioural changes</term>
<term>Brain atrophy</term>
<term>Chorea</term>
<term>Clinical assessment</term>
<term>Clinical course</term>
<term>Clinical data</term>
<term>Clinical picture</term>
<term>Complete dominance</term>
<term>Disability</term>
<term>Disability score</term>
<term>Disability scores</term>
<term>Disease chromosomes</term>
<term>Disease duration</term>
<term>Disease onset</term>
<term>Disease progression</term>
<term>Disease rating scale</term>
<term>Disease severity</term>
<term>Disease stage</term>
<term>Disease stages</term>
<term>Disease years</term>
<term>Early stages</term>
<term>Expansion mutation</term>
<term>Female</term>
<term>Functional decline</term>
<term>Generalized brain atrophy</term>
<term>Genet</term>
<term>Genetic analysis</term>
<term>Genetic data</term>
<term>Genetic determinism</term>
<term>Gusella</term>
<term>Heterozygote</term>
<term>Heterozygote sibling</term>
<term>Heterozygous patients</term>
<term>Heterozygous subjects</term>
<term>Homozygosity</term>
<term>Homozygote</term>
<term>Homozygous patients</term>
<term>Huntingtin</term>
<term>Huntington</term>
<term>Huntington disease</term>
<term>Huntington disease homozygosity</term>
<term>Huntington disease homozygotes</term>
<term>Huntington disease mutation</term>
<term>Huntington disease patients</term>
<term>Huntington disease stage</term>
<term>Huntington study group</term>
<term>Keywords: CAG expansion; CAG mutation homozygosity; disease progression; age at onset; brain atrophy; UHDRS</term>
<term>Kremer</term>
<term>Last assessment</term>
<term>Lower scores</term>
<term>Male</term>
<term>Medical genetics</term>
<term>Motor manifestations</term>
<term>Motor symptoms</term>
<term>Mouse model</term>
<term>Movement disorders</term>
<term>Multicentre study</term>
<term>Mutant alleles</term>
<term>Mutant protein</term>
<term>Mutation</term>
<term>Neurological</term>
<term>Neurological institute irccs</term>
<term>Neuronal survival</term>
<term>Neuropathological report</term>
<term>Neuropsychological testing</term>
<term>Normal huntingtin</term>
<term>Onset ages</term>
<term>Other diseases</term>
<term>Phenotype</term>
<term>Predictive factor</term>
<term>Prognosis</term>
<term>Progression</term>
<term>Range years</term>
<term>Repeated sequence</term>
<term>Research group</term>
<term>Score change</term>
<term>Severe behavioural changes</term>
<term>Squitieri</term>
<term>State examination</term>
<term>Symptom</term>
<term>Toxic gain</term>
<term>Trends neurosci</term>
<term>Trinucleotide</term>
<term>Uhdrs</term>
<term>Wechsler adult intelligence scale</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Adulte</term>
<term>Age apparition</term>
<term>Chorée Huntington</term>
<term>Déterminisme génétique</term>
<term>Facteur prédictif</term>
<term>Femelle</term>
<term>Homozygotie</term>
<term>Mutation</term>
<term>Mâle</term>
<term>Phénotype</term>
<term>Pronostic</term>
<term>Séquence répétée</term>
<term>Trinucléotide</term>
</keywords>
<keywords scheme="Teeft" xml:lang="en"><term>Aggressive behaviour</term>
<term>Allele</term>
<term>Atrophy</term>
<term>Behavioural</term>
<term>Behavioural changes</term>
<term>Brain atrophy</term>
<term>Chorea</term>
<term>Clinical assessment</term>
<term>Clinical course</term>
<term>Clinical data</term>
<term>Clinical picture</term>
<term>Complete dominance</term>
<term>Disability</term>
<term>Disability score</term>
<term>Disability scores</term>
<term>Disease chromosomes</term>
<term>Disease duration</term>
<term>Disease onset</term>
<term>Disease progression</term>
<term>Disease rating scale</term>
<term>Disease severity</term>
<term>Disease stage</term>
<term>Disease stages</term>
<term>Disease years</term>
<term>Early stages</term>
<term>Expansion mutation</term>
<term>Functional decline</term>
<term>Generalized brain atrophy</term>
<term>Genet</term>
<term>Genetic analysis</term>
<term>Genetic data</term>
<term>Gusella</term>
<term>Heterozygote</term>
<term>Heterozygote sibling</term>
<term>Heterozygous patients</term>
<term>Heterozygous subjects</term>
<term>Homozygosity</term>
<term>Homozygote</term>
<term>Homozygous patients</term>
<term>Huntingtin</term>
<term>Huntington</term>
<term>Huntington disease</term>
<term>Huntington disease homozygosity</term>
<term>Huntington disease homozygotes</term>
<term>Huntington disease mutation</term>
<term>Huntington disease patients</term>
<term>Huntington disease stage</term>
<term>Huntington study group</term>
<term>Kremer</term>
<term>Last assessment</term>
<term>Lower scores</term>
<term>Medical genetics</term>
<term>Motor manifestations</term>
<term>Motor symptoms</term>
<term>Mouse model</term>
<term>Movement disorders</term>
<term>Multicentre study</term>
<term>Mutant alleles</term>
<term>Mutant protein</term>
<term>Mutation</term>
<term>Neurological</term>
<term>Neurological institute irccs</term>
<term>Neuronal survival</term>
<term>Neuropathological report</term>
<term>Neuropsychological testing</term>
<term>Normal huntingtin</term>
<term>Onset ages</term>
<term>Other diseases</term>
<term>Progression</term>
<term>Range years</term>
<term>Research group</term>
<term>Score change</term>
<term>Severe behavioural changes</term>
<term>Squitieri</term>
<term>State examination</term>
<term>Symptom</term>
<term>Toxic gain</term>
<term>Trends neurosci</term>
<term>Uhdrs</term>
<term>Wechsler adult intelligence scale</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Adulte</term>
</keywords>
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<front><div type="abstract" xml:lang="en">Huntington disease is caused by a dominantly transmitted CAG repeat expansion mutation that is believed to confer a toxic gain of function on the mutant protein. Huntington disease patients with two mutant alleles are very rare. In other poly(CAG) diseases such as the dominant ataxias, inheritance of two mutant alleles causes a phenotype more severe than in heterozygotes. In this multicentre study, we sought differences in the disease features between eight homozygotes and 75 heterozygotes for the Huntington disease mutation. We identified subjects homozygous for the Huntington disease mutation by DNA testing and compared their clinical features (age at onset, symptom presentation, disease severity and disease progression) with those of a group of heterozygotes, who were assessed longitudinally. The age at onset of symptoms in the homozygote cases was within the range expected for heterozygotes with the same CAG repeat lengths, whereas homozygotes had a more severe clinical course. The observation of a more rapid decline in motor, cognitive and behavioural symptoms in homozygotes was consistent with the extent of neurodegeneration as available at imaging in three patients, and at the post‐mortem neuropathological report in one case. Our analysis suggests that although homozygosity for the Huntington disease mutation does not lower the age at onset of symptoms, it affects the phenotype and the rate of disease progression. These data, once confirmed in a larger series of patients, point to the possibility that the mechanisms underlying age at onset and disease progression in Huntington disease may differ.</div>
</front>
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<name sortKey="Cislaghi, Giuliana" sort="Cislaghi, Giuliana" uniqKey="Cislaghi G" first="Giuliana" last="Cislaghi">Giuliana Cislaghi</name>
<name sortKey="Delatycki, Martin" sort="Delatycki, Martin" uniqKey="Delatycki M" first="Martin" last="Delatycki">Martin Delatycki</name>
<name sortKey="Donato, Stefano Di" sort="Donato, Stefano Di" uniqKey="Donato S" first="Stefano Di" last="Donato">Stefano Di Donato</name>
<name sortKey="Gellera, Cinzia" sort="Gellera, Cinzia" uniqKey="Gellera C" first="Cinzia" last="Gellera">Cinzia Gellera</name>
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<country name="France"><region name="Île-de-France"><name sortKey="Bachoud E Vi, Anne Atherine" sort="Bachoud E Vi, Anne Atherine" uniqKey="Bachoud E Vi A" first="Anne-Catherine" last="Bachoud-Le Vi">Anne-Catherine Bachoud-Le Vi</name>
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<name sortKey="Bachoud E Vi, Anne Atherine" sort="Bachoud E Vi, Anne Atherine" uniqKey="Bachoud E Vi A" first="Anne-Catherine" last="Bachoud-Le Vi">Anne-Catherine Bachoud-Le Vi</name>
</country>
</tree>
</affiliations>
</record>
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