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Practical neurology
Published

Repeat expansion disorders

Authors

Zhongbo Chen, Huw R Morris, James Polke, Nicholas W Wood, Sonia Gandhi, Mina Ryten, Henry Houlden, Arianna Tucci

Abstract

Pract Neurol. 2024 Sep 30:pn-2023-003938. doi: 10.1136/pn-2023-003938. Online ahead of print.

ABSTRACT

An increasing number of repeat expansion disorders have been found to cause both rare and common neurological disease. This is exemplified in recent discoveries of novel repeat expansions underlying a significant proportion of several late-onset neurodegenerative disorders, such as CANVAS (cerebellar ataxia, neuropathy and vestibular areflexia syndrome) and spinocerebellar ataxia type 27B. Most of the 60 described repeat expansion disorders to date are associated with neurological disease, providing substantial challenges for diagnosis, but also opportunities for management in a clinical neurology setting. Commonalities in clinical presentation, overarching diagnostic features and similarities in the approach to genetic testing justify considering these disorders collectively based on their unifying causative mechanism. In this review, we discuss the characteristics and diagnostic challenges of repeat expansion disorders for the neurologist and provide examples to highlight their clinical heterogeneity. With the ready availability of clinical-grade whole-genome sequencing for molecular diagnosis, we discuss the current approaches to testing for repeat expansion disorders and application in clinical practice.

PMID:39349043 | DOI:10.1136/pn-2023-003938

UK DRI Authors

Sonia Gandhi

Prof Sonia Gandhi

Senior Group Leader and Assistant Research Director, The Francis Crick Institute

Prof Sonia Gandhi
Mina Ryten

Prof Mina Ryten

Centre Director

Leveraging brain transcriptomics to understand the pathophysiology of Lewy body diseases

Prof Mina Ryten
Arianna Tucci

Dr Arianna Tucci

Clinical Reader in Genomic Medicine, Queen Mary University of London

Dr Arianna Tucci