Semin Neurol 2011; 31(5): 542-552
DOI: 10.1055/s-0031-1299792
© Thieme Medical Publishers

Genetic Testing for Neurologic Disorders

Susanne A. Schneider1 , Uwe H. Schneider2 , Christine Klein1
  • 1Schilling Section of Clinical and Molecular Neurogenetics, Department of Neurology, University of Lübeck, Lübeck
  • 2Center for German and International Law of Financial Services, Johannes Gutenberg University Mainz, Wallstraße 11, Mainz, and Schmitz & Partner Rechtsanwälte, Of Counsel, Frankfurt am Main, Germany
Further Information

Publication History

Publication Date:
21 January 2012 (online)

ABSTRACT

New technologies and more research in genetics have revealed an increasing amount of genetic data and identified new diseases. In parallel to the wider availability of genetic testing, efforts have been made to regulate the use of genetic technology and genetic information. The swift pace of developments, not surprisingly, may cause uncertainty among those confronted with genetics. The authors review the current state of genetic testing with a focus on movement disorders. They introduce terminology (inheritance patterns; penetrance; clinical and genetic heterogeneity and types of testing, including influences of direct-to-consumer testing) and discuss general aspects of genetics, including indication for testing, familial implications as well as social, ethical, and in particular legal implications (discrimination acts, insurance aspects, protection of data of deceased, etc.). They also cover recent developments with regard to new molecular techniques, economic issues, and the difficulties of data interpretation.

REFERENCES

  • 1 Morling N, Allen R W, Carracedo A Paternity Testing Commission of the International Society of Forensic Genetics et al. Paternity Testing Commission of the International Society of Forensic Genetics: recommendations on genetic investigations in paternity cases.  Forensic Sci Int. 2002;  129 (3) 148-157
  • 2 Budowle B, van Daal A. Extracting evidence from forensic DNA analyses: future molecular biology directions.  Biotechniques. 2009;  46 (5) 339-340, 342–350
  • 3 Godard B, Raeburn S, Pembrey M, Bobrow M, Farndon P, Aymé S. Genetic information and testing in insurance and employment: technical, social and ethical issues.  Eur J Hum Genet. 2003;  11 (Suppl 2) S123-S142
  • 4 Klein C, Lohmann-Hedrich K, Rogaeva E, Schlossmacher M G, Lang A E. Deciphering the role of heterozygous mutations in genes associated with parkinsonism.  Lancet Neurol. 2007;  6 (7) 652-662
  • 5 West A, Periquet M, Lincoln S French Parkinson's Disease Genetics Study Group and the European Consortium on Genetic Susceptibility on Parkinson's Disease et al. Complex relationship between Parkin mutations and Parkinson disease.  Am J Med Genet. 2002;  114 (5) 584-591
  • 6 Risch N J, Bressman S B, Senthil G, Ozelius L J. Intragenic cis and trans modification of genetic susceptibility in DYT1 torsion dystonia.  Am J Hum Genet. 2007;  80 (6) 1188-1193
  • 7 McConkie-Rosell A, Abrams L, Finucane B et al.. Recommendations from multi-disciplinary focus groups on cascade testing and genetic counseling for fragile X-associated disorders.  J Genet Couns. 2007;  16 (5) 593-606
  • 8 Schneider S A, Bhatia K P, Hardy J. Complicated recessive dystonia parkinsonism syndromes.  Mov Disord. 2009;  24 (4) 490-499
  • 9 Schneider S A, Bhatia K P. Three faces of the same gene: FA2H links neurodegeneration with brain iron accumulation, leukodystrophies, and hereditary spastic paraplegias.  Ann Neurol. 2010;  68 (5) 575-577
  • 10 Klein C, Schneider S A, Lang A E. Hereditary parkinsonism: Parkinson disease look-alikes—an algorithm for clinicians to “PARK” genes and beyond.  Mov Disord. 2009;  24 (14) 2042-2058
  • 11 Schneider S A, Walker R H, Bhatia K P. The Huntington's disease-like syndromes: what to consider in patients with a negative Huntington's disease gene test.  Nat Clin Pract Neurol. 2007;  3 (9) 517-525
  • 12 Convention for the protection of human rights and dignity of the human being with regard to the application of biology and medicine: Convention on Human Rights and Biomedicine. Available at: http://conventions coe int/treaty/en/treaties/html/164 htm Accessed Jan 2011
  • 13 Sermon K, Seneca S, De Rycke M et al.. PGD in the lab for triplet repeat diseases - myotonic dystrophy, Huntington's disease and Fragile-X syndrome.  Mol Cell Endocrinol. 2001;  183 (Suppl 1) S77-S85
  • 14 Sermon K, De Rijcke M, Lissens W et al.. Preimplantation genetic diagnosis for Huntington's disease with exclusion testing.  Eur J Hum Genet. 2002;  10 (10) 591-598
  • 15 Geraedts J P, De Wert G M. Preimplantation genetic diagnosis.  Clin Genet. 2009;  76 (4) 315-325
  • 16 Ross L F, Moon M R. Ethical issues in pediatric genetics. In: Genetics in the Clinic: Clinical, Ethical, and Social Implications for Primary Care. St Louis, MO: Mosby; 2010: 153-166
  • 17 Nelson R M, Botkin J R, Kodish E D Committee on Bioethics et al. Ethical issues with genetic testing in pediatrics.  Pediatrics. 2001;  107 (6) 1451-1455
  • 18 Borry P, Stultiens L, Nys H, Cassiman J J, Dierickx K. Presymptomatic and predictive genetic testing in minors: a systematic review of guidelines and position papers.  Clin Genet. 2006;  70 (5) 374-381
  • 19 Borry P, Evers-Kiebooms G, Cornel M C, Clarke A, Dierickx K. Public and Professional Policy Committee (PPPC) of the European Society of Human Genetics (ESHG) . Genetic testing in asymptomatic minors: background considerations towards ESHG Recommendations.  Eur J Hum Genet. 2009;  17 (6) 711-719
  • 20 Borry P, Stultiens L, Goffin T, Nys H, Dierickx K. Minors and informed consent in carrier testing: a survey of European clinical geneticists.  J Med Ethics. 2008;  34 (5) 370-374
  • 21 Borry P, Goffin T, Nys H, Dierickx K. Predictive genetic testing in minors for adult-onset genetic diseases.  Mt Sinai J Med. 2008;  75 (3) 287-296
  • 22 McBride C M, Wade C H, Kaphingst K A. Consumers' views of direct-to-consumer genetic information.  Annu Rev Genomics Hum Genet. 2010;  11 427-446
  • 23 Jedermanns Gentest .Analysen von Erbinformation werden günstiger/Die Zahl der Anbieter steigt rasant, aber nicht alle sind serioes. Frankfurt am Main, Germany: Frankfurter Allgemeine Zeitung; 2011. p.16.06.06
  • 24 Boddington P. The ethics and regulation of direct-to-consumer genetic testing.  Genome Med. 2009;  1 (7) 71
  • 25 European Society of Human Genetics . Statement of the ESHG on direct-to-consumer genetic testing for health-related purposes.  Eur J Hum Genet. 2010;  18 (12) 1271-1273
  • 26 Tamir S. Direct-to-consumer genetic testing: ethical-legal perspectives and practical considerations.  Med Law Rev. 2010;  18 (2) 213-238
  • 27 Ensenauer R E, Michels V V, Reinke S S. Genetic testing: practical, ethical, and counseling considerations.  Mayo Clin Proc. 2005;  80 (1) 63-73
  • 28 International Huntington Association (IHA) and the World Federation of Neurology (WFN) Research Group on Huntington's Chorea . Guidelines for the molecular genetics predictive test in Huntington's disease.  Neurology. 1994;  44 (8) 1533-1536
  • 29 Bressman S B, Sabatti C, Raymond D et al.. The DYT1 phenotype and guidelines for diagnostic testing.  Neurology. 2000;  54 (9) 1746-1752
  • 30 Harbo H F, Finsterer J, Baets J EFNS et al. EFNS guidelines on the molecular diagnosis of neurogenetic disorders: general issues, Huntington's disease, Parkinson's disease and dystonias.  Eur J Neurol. 2009;  16 (7) 777-785
  • 31 Kuhlenbäumer G, Hullmann J, Appenzeller S. Novel genomic techniques open new avenues in the analysis of monogenic disorders.  Hum Mutat. 2011;  32 (2) 144-151
  • 32 The Genetic Information Nondiscrimination Act of 2008. Available at: http://www.govtrack.us/congress/billtext.xpd?bill=h110-493&show-changes=0&page-command=print Accessed Jan 2011
  • 33 Thiele F. Genetic tests in the insurance system: criteria for a moral evaluation.  Poiesis Prax. 2003;  3 (1) 185-195
  • 34 Regenauer A. Genetic testing and insurance – a global view. Munich, Germany: Munich Reinsurance Company; 2000
  • 35 Ziegler J, Ziegler A. Gendiagnostikgesetz und versicherung: Anspruch und Wirklichkeit.  Zeitschrift für die gesamte Versicherungswissenschaft. 2011;  100 29-53
  • 36 Brinkmann Th. Die Zulaessigkeit der Verwertung von genetischen Informationen im Deutschen und Amerikanischen Versicherungsrecht. Karlsruhe, Germany: Verlag Versicherungswirtschaft GmbH; 2006
  • 37 Simon J, Knoepffler N, Buyten R. Gendiagnostik und Versicherung–die internationale Lage im Vergleich. Baden Baden, Germany: Nomos; 2001
  • 38 Nicolás P. Ethical and juridical issues of genetic testing: a review of the international regulation.  Crit Rev Oncol Hematol. 2009;  69 (2) 98-107
  • 39 Präve P. Das Gendiagnostikgesetz aus Versicherungsrechtlicher Sicht.  Zeitschrift für versicherungsrecht, Haftungs–und Schadenrecht. 2009;  60 857-912
  • 40 Brand O. Grenzen der vorvertraglichen Anzeigepflicht des Versicherungsnehmers.  VersR. 2009;  16 715-721
  • 41 Mandich P, Jacopini G, Di Maria E et al.. Predictive testing for Huntington's disease: ten years' experience in two Italian centres.  Ital J Neurol Sci. 1998;  19 (2) 68-74
  • 42 Netzer C, Klein C, Kohlhase J, Kubisch C. New challenges for informed consent through whole genome array testing.  J Med Genet. 2009;  46 (7) 495-496
  • 43 Greendale K, Pyeritz R E. Empowering primary care health professionals in medical genetics: how soon? How fast? How far?.  Am J Med Genet. 2001;  106 (3) 223-232
  • 44 Harvey E K, Fogel C E, Peyrot M, Christensen K D, Terry S F, McInerney J D. Providers' knowledge of genetics: A survey of 5915 individuals and families with genetic conditions.  Genet Med. 2007;  9 (5) 259-267
  • 45 Tomatir A G, Sorkun H C, Demirhan H, Akdağ B. Genetics and genetic counseling: practices and opinions of primary care physicians in Turkey.  Genet Med. 2007;  9 (2) 130-135
  • 46 Meiser B, Dunn S. Psychological impact of genetic testing for Huntington's disease: an update of the literature.  J Neurol Neurosurg Psychiatry. 2000;  69 (5) 574-578
  • 47 Falcone D C, Wood E M, Xie S X, Siderowf A, Van Deerlin V M. Genetic testing and Parkinson disease: assessment of patient knowledge, attitudes, and interest.  J Genet Couns. 2011;  20 (4) 384-395
  • 48 Mastromauro C, Myers R H, Berkman B. Attitudes toward presymptomatic testing in Huntington disease.  Am J Med Genet. 1987;  26 (2) 271-282
  • 49 Jacopini G A, D'Amico R, Frontali M, Vivona G. Attitudes of persons at risk and their partners toward predictive testing.  Birth Defects Orig Artic Ser. 1992;  28 (1) 113-117
  • 50 Jacobs H, Latza U, Vieregge A, Vieregge P. Attitudes of young patients with Parkinson's disease towards possible presymptomatic and prenatal genetic testing.  Genet Couns. 2001;  12 (1) 55-67
  • 51 Bombard Y, Veenstra G, Friedman J M Canadian Respond-HD Collaborative Research Group et al. Perceptions of genetic discrimination among people at risk for Huntington's disease: a cross sectional survey.  BMJ. 2009;  338 b2175
  • 52 Tan E K, Lee J, Hunter C, Shinawi L, Fook-Chong S, Jankovic J. Comparing knowledge and attitudes towards genetic testing in Parkinson's disease in an American and Asian population.  J Neurol Sci. 2007;  252 (2) 113-120
  • 53 Williams J K, Schutte D L, Evers C, Holkup P A. Redefinition: coping with normal results from predictive gene testing for neurodegenerative disorders.  Res Nurs Health. 2000;  23 (4) 260-269
  • 54 Almqvist E W, Bloch M, Brinkman R, Craufurd D, Hayden M R. A worldwide assessment of the frequency of suicide, suicide attempts, or psychiatric hospitalization after predictive testing for Huntington disease.  Am J Hum Genet. 1999;  64 (5) 1293-1304
  • 55 Coustasse A, Pekar A, Sikula A, Lurie S. Ethical considerations of genetic presymptomatic testing for Huntington's disease.  J Hosp Mark Public Relations. 2009;  19 (2) 129-141
  • 56 Craufurd D, Tyler A. Predictive testing for Huntington's disease: protocol of the UK Huntington's Prediction Consortium.  J Med Genet. 1992;  29 (12) 915-918
  • 57 Rantanen E, Hietala M, Kristoffersson U et al.. What is ideal genetic counselling? A survey of current international guidelines.  Eur J Hum Genet. 2008;  16 (4) 445-452
  • 58 Robins Wahlin T B. To know or not to know: a review of behaviour and suicidal ideation in preclinical Huntington's disease.  Patient Educ Couns. 2007;  65 (3) 279-287
  • 59 ACMG Laboratory Practice Committee Working Group . ACMG recommendations for standards for interpretation of sequence variations.  Genet Med. 2000;  2 302-303
  • 60 Petrucelli N, Lazebnik N, Huelsman K M, Lazebnik R S. Clinical interpretation and recommendations for patients with a variant of uncertain significance in BRCA1 or BRCA2: a survey of genetic counseling practice.  Genet Test. 2002;  6 (2) 107-113
  • 61 Durbin R M, Abecasis G R, Altshuler D L 1000 Genomes Project Consortium et al. A map of human genome variation from population-scale sequencing.  Nature. 2010;  467 (7319) 1061-1073
  • 62 McInerney-Leo A, Hadley D W, Gwinn-Hardy K, Hardy J. Genetic testing in Parkinson's disease.  Mov Disord. 2005;  20 (1) 1-10
  • 63 Schneider S A, Klein C. What is the role of genetic testing in movement disorders practice?.  Curr Neurol Neurosci Rep. 2011;  11 (4) 351-361

Privatdozentin Dr. Susanne A. SchneiderM.D. Ph.D. 

Section of Clinical and Molecular Neurogenetics, Department of Neurology

University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany

Email: susanne.schneider@neuro.uni-luebeck.de

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