학술논문

The C9orf72 hexanucleotide repeat expansion presents a challenge for testing laboratories and genetic counseling.
Document Type
Article
Source
Amyotrophic Lateral Sclerosis & Frontotemporal Degeneration. Aug2019, Vol. 20 Issue 5/6, p310-316. 7p.
Subject
*FRONTOTEMPORAL lobar degeneration
*GENETIC counseling
*AMYOTROPHIC lateral sclerosis
*GENETIC testing
*TESTING laboratories
*FRONTOTEMPORAL dementia
Language
ISSN
2167-8421
Abstract
C9orf72 hexanucleotide repeat expansions are the most common known cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). Genetic testing for C9orf72 expansions in patients with ALS and/or FTD and their relatives has become increasingly available since hexanucleotide repeat expansions were first reported in 2011. The repeat number is highly variable and the threshold at which repeat size leads to neurodegeneration remains unknown. We present the case of an ALS patient who underwent genetic testing through our Motor Neurone Disease Clinic. We highlight current limitations to analysing and interpreting C9orf72 expansion test results and describe how this resulted in discordant reports of pathogenicity between testing laboratories that confounded the genetic counselling process. We conclude that patients with ALS or FTD and their at-risk family members, need to be adequately counselled about the limitations of current knowledge to ensure they are making informed decisions about genetic testing for C9orf72. Greater collaboration between clinicians, testing laboratories and researchers is required to ensure risks to patients and their families are minimised. [ABSTRACT FROM AUTHOR]