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2015 ; 8
(ä): 235-43
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gab.com Text
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English Wikipedia
The genetics of Charcot-Marie-Tooth disease: current trends and future
implications for diagnosis and management
#MMPMID26527893
Hoyle JC
; Isfort MC
; Roggenbuck J
; Arnold WD
Appl Clin Genet
2015[]; 8
(ä): 235-43
PMID26527893
show ga
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.