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The genetics of Charcot–Marie–Tooth disease: current trends and future implications for diagnosis and management

Charcot–Marie–Tooth (CMT) disease is the most common hereditary polyneuropathy and is classically associated with an insidious onset of distal predominant motor and sensory loss, muscle wasting, and pes cavus. Other forms of hereditary neuropathy, including sensory predominant or motor predominant f...

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Autores principales: Hoyle, J Chad, Isfort, Michael C, Roggenbuck, Jennifer, Arnold, W David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4621202/
https://www.ncbi.nlm.nih.gov/pubmed/26527893
http://dx.doi.org/10.2147/TACG.S69969
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author Hoyle, J Chad
Isfort, Michael C
Roggenbuck, Jennifer
Arnold, W David
author_facet Hoyle, J Chad
Isfort, Michael C
Roggenbuck, Jennifer
Arnold, W David
author_sort Hoyle, J Chad
collection PubMed
description Charcot–Marie–Tooth (CMT) disease is the most common hereditary polyneuropathy and is classically associated with an insidious onset of distal predominant motor and sensory loss, muscle wasting, and pes cavus. Other forms of hereditary neuropathy, including sensory predominant or motor predominant forms, are sometimes included in the general classification of CMT, but for the purpose of this review, we will focus primarily on the forms associated with both sensory and motor deficits. CMT has a great deal of genetic heterogeneity, leading to diagnostic considerations that are still rapidly evolving for this disorder. Clinical features, inheritance pattern, gene mutation frequencies, and electrodiagnostic features all are helpful in formulating targeted testing algorithms in practical clinical settings, but these still have shortcomings. Next-generation sequencing (NGS), combined with multigene testing panels, is increasing the sensitivity and efficiency of genetic testing and is quickly overtaking targeted testing strategies. Currently, multigene panel testing and NGS can be considered first-line in many circumstances, although obtaining initial targeted testing for the PMP22 duplication in CMT patients with demyelinating conduction velocities is still a reasonable strategy. As technology improves and cost continues to fall, targeted testing will be completely replaced by multigene NGS panels that can detect the full spectrum of CMT mutations. Nevertheless, clinical acumen is still necessary given the variants of uncertain significance encountered with NGS. Despite the current limitations, the genetic diagnosis of CMT is critical for accurate prognostication, genetic counseling, and in the future, specific targeted therapies. Although whole exome and whole genome sequencing strategies have the power to further elucidate the genetics of CMT, continued technological advances are needed.
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spelling pubmed-46212022015-11-02 The genetics of Charcot–Marie–Tooth disease: current trends and future implications for diagnosis and management Hoyle, J Chad Isfort, Michael C Roggenbuck, Jennifer Arnold, W David Appl Clin Genet Review Charcot–Marie–Tooth (CMT) disease is the most common hereditary polyneuropathy and is classically associated with an insidious onset of distal predominant motor and sensory loss, muscle wasting, and pes cavus. Other forms of hereditary neuropathy, including sensory predominant or motor predominant forms, are sometimes included in the general classification of CMT, but for the purpose of this review, we will focus primarily on the forms associated with both sensory and motor deficits. CMT has a great deal of genetic heterogeneity, leading to diagnostic considerations that are still rapidly evolving for this disorder. Clinical features, inheritance pattern, gene mutation frequencies, and electrodiagnostic features all are helpful in formulating targeted testing algorithms in practical clinical settings, but these still have shortcomings. Next-generation sequencing (NGS), combined with multigene testing panels, is increasing the sensitivity and efficiency of genetic testing and is quickly overtaking targeted testing strategies. Currently, multigene panel testing and NGS can be considered first-line in many circumstances, although obtaining initial targeted testing for the PMP22 duplication in CMT patients with demyelinating conduction velocities is still a reasonable strategy. As technology improves and cost continues to fall, targeted testing will be completely replaced by multigene NGS panels that can detect the full spectrum of CMT mutations. Nevertheless, clinical acumen is still necessary given the variants of uncertain significance encountered with NGS. Despite the current limitations, the genetic diagnosis of CMT is critical for accurate prognostication, genetic counseling, and in the future, specific targeted therapies. Although whole exome and whole genome sequencing strategies have the power to further elucidate the genetics of CMT, continued technological advances are needed. Dove Medical Press 2015-10-19 /pmc/articles/PMC4621202/ /pubmed/26527893 http://dx.doi.org/10.2147/TACG.S69969 Text en © 2015 Hoyle et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Hoyle, J Chad
Isfort, Michael C
Roggenbuck, Jennifer
Arnold, W David
The genetics of Charcot–Marie–Tooth disease: current trends and future implications for diagnosis and management
title The genetics of Charcot–Marie–Tooth disease: current trends and future implications for diagnosis and management
title_full The genetics of Charcot–Marie–Tooth disease: current trends and future implications for diagnosis and management
title_fullStr The genetics of Charcot–Marie–Tooth disease: current trends and future implications for diagnosis and management
title_full_unstemmed The genetics of Charcot–Marie–Tooth disease: current trends and future implications for diagnosis and management
title_short The genetics of Charcot–Marie–Tooth disease: current trends and future implications for diagnosis and management
title_sort genetics of charcot–marie–tooth disease: current trends and future implications for diagnosis and management
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4621202/
https://www.ncbi.nlm.nih.gov/pubmed/26527893
http://dx.doi.org/10.2147/TACG.S69969
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