UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Overlap between age-at-onset and disease-progression determinants in Huntington disease

Aziz, NA; van der Burg, JMM; Tabrizi, SJ; Landwehrmeyer, GB; (2018) Overlap between age-at-onset and disease-progression determinants in Huntington disease. Neurology , 90 (24) e2099-e2106. 10.1212/WNL.0000000000005690. Green open access

[thumbnail of Tabrizi_Overlap between age-at-onset and disease-progression determinants in Huntington disease_VoR.pdf]
Preview
Text
Tabrizi_Overlap between age-at-onset and disease-progression determinants in Huntington disease_VoR.pdf - Published Version

Download (484kB) | Preview

Abstract

OBJECTIVE: A fundamental but still unresolved issue regarding Huntington disease (HD) pathogenesis is whether the factors that determine age at onset are the same as those that govern disease progression. Because elucidation of this issue is crucial for the development as well as optimal timing of administration of novel disease-modifying therapies, we aimed to assess the extent of overlap between age-at-onset and disease-progression determinants in HD. METHODS: Using observational data from Enroll-HD, the largest cohort of patients with HD worldwide, in this study we present, validate, and apply an intuitive method based on linear mixed-effect models to quantify the variability in the rate of disease progression in HD. RESULTS: A total of 3,411 patients with HD met inclusion criteria. We found that (1) about two-thirds of the rate of functional, motor, and cognitive progression in HD is determined by the same factors that also determine age at onset, with CAG repeat–dependent mechanisms having by far the largest effect; (2) although expanded HTT CAG repeat size had a large influence on average body weight, the rate of weight loss was largely independent of factors that determine age at onset in HD; and (3) about one-third of the factors that determine the rate of functional, motor, and cognitive progression are different from those that govern age at onset and need further elucidation. CONCLUSION: Our findings imply that targeting of CAG repeat–dependent mechanisms, for example through gene-silencing approaches, is likely to affect the rate of functional, motor, and cognitive impairment, but not weight loss, in manifest HD mutation carriers.

Type: Article
Title: Overlap between age-at-onset and disease-progression determinants in Huntington disease
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1212/WNL.0000000000005690
Publisher version: https://doi.org/10.1212/WNL.0000000000005690
Language: English
Additional information: © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial NoDerivatives License 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/).
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neurodegenerative Diseases
URI: https://discovery.ucl.ac.uk/id/eprint/10051261
Downloads since deposit
185Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item