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A new model for prediction of the age of onset and penetrance for Huntington's disease based on CAG length
Author(s) -
Langbehn DR,
Brinkman RR,
Falush D,
Paulsen JS,
Hayden MR
Publication year - 2004
Publication title -
clinical genetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.543
H-Index - 102
eISSN - 1399-0004
pISSN - 0009-9163
DOI - 10.1111/j.1399-0004.2004.00241.x
Subject(s) - penetrance , age of onset , cohort , trinucleotide repeat expansion , confidence interval , disease , huntington's disease , medicine , predictive testing , pediatrics , psychology , genetics , biology , allele , phenotype , gene
Huntington's disease (HD) is a neurodegenerative disorder caused by an unstable CAG repeat. For patients at risk, participating in predictive testing and learning of having CAG expansion, a major unanswered question shifts from “Will I get HD?” to “When will it manifest?” Using the largest cohort of HD patients analyzed to date (2913 individuals from 40 centers worldwide), we developed a parametric survival model based on CAG repeat length to predict the probability of neurological disease onset (based on motor neurological symptoms rather than psychiatric onset) at different ages for individual patients. We provide estimated probabilities of onset associated with CAG repeats between 36 and 56 for individuals of any age with narrow confidence intervals. For example, our model predicts a 91% chance that a 40‐year‐old individual with 42 repeats will have onset by the age of 65, with a 95% confidence interval from 90 to 93%. This model also defines the variability in HD onset that is not attributable to CAG length and provides information concerning CAG‐related penetrance rates.