Dr D Falush was affiliated with the Max-Planck Institut für Infektionsbiologie, Berlin, Germany during the conduct of this Research.
A new model for prediction of the age of onset and penetrance for Huntington's disease based on CAG length
Article first published online: 12 MAR 2004
Volume 65, Issue 4, pages 267–277, April 2004
How to Cite
Langbehn, D., Brinkman, R., Falush, D., Paulsen, J., Hayden, M. and on behalf of an International Huntington's Disease Collaborative Group (2004), A new model for prediction of the age of onset and penetrance for Huntington's disease based on CAG length. Clinical Genetics, 65: 267–277. doi: 10.1111/j.1399-0004.2004.00241.x
- Issue published online: 12 MAR 2004
- Article first published online: 12 MAR 2004
- Received 15 December 2003, revised and accepted for publication 9 January 2004
- Huntington's Disease;
- onset age;
- statistical modeling;
- trinucleotide repeat
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.