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editorial
. 1996 Jul;59(1):1–6.

Huntington disease--another chapter rewritten.

M A Nance
PMCID: PMC1915085  PMID: 8659511

Abstract

To those of us who began life when humans had 48 chromosomes and who began working in genetics when the (by then 46) chromosomes had no bands and chromosome 4 could not reliably be distinguished from chromosome 5, the mere ability to diagnose and correlate the clinical phenotypes of genetic disorders with their molecular genotypes is a source of continuing astonishment and pleasure. Indeed, molecular genetic analysis of neurogenetic disorders such as Huntington disease (HD) has provided a steady stream of challenges and surprises to all who believe the genetic principles that they were taught about these disorders. The paper by Rubinsztein et al. in this issue of the journal highlights yet another surprise, which was adumbrated even in the initial paper announcing the discovery of the HD gene: incomplete penetrance of HD gene mutations.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andrew S. E., Goldberg Y. P., Kremer B., Telenius H., Theilmann J., Adam S., Starr E., Squitieri F., Lin B., Kalchman M. A. The relationship between trinucleotide (CAG) repeat length and clinical features of Huntington's disease. Nat Genet. 1993 Aug;4(4):398–403. doi: 10.1038/ng0893-398. [DOI] [PubMed] [Google Scholar]
  2. Andrew S. E., Goldberg Y. P., Theilmann J., Zeisler J., Hayden M. R. A CCG repeat polymorphism adjacent to the CAG repeat in the Huntington disease gene: implications for diagnostic accuracy and predictive testing. Hum Mol Genet. 1994 Jan;3(1):65–67. doi: 10.1093/hmg/3.1.65. [DOI] [PubMed] [Google Scholar]
  3. Ashizawa T., Wong L. J., Richards C. S., Caskey C. T., Jankovic J. CAG repeat size and clinical presentation in Huntington's disease. Neurology. 1994 Jun;44(6):1137–1143. doi: 10.1212/wnl.44.6.1137. [DOI] [PubMed] [Google Scholar]
  4. Barron L. H., Rae A., Holloway S., Brock D. J., Warner J. P. A single allele from the polymorphic CCG rich sequence immediately 3' to the unstable CAG trinucleotide in the IT15 cDNA shows almost complete disequilibrium with Huntington's disease chromosomes in the Scottish population. Hum Mol Genet. 1994 Jan;3(1):173–175. doi: 10.1093/hmg/3.1.173. [DOI] [PubMed] [Google Scholar]
  5. Barron L. H., Warner J. P., Porteous M., Holloway S., Simpson S., Davidson R., Brock D. J. A study of the Huntington's disease associated trinucleotide repeat in the Scottish population. J Med Genet. 1993 Dec;30(12):1003–1007. doi: 10.1136/jmg.30.12.1003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Beilby J., Chin C. Y., Porter I., Walpole I. R., Goldblatt J. Improving diagnosis of Huntington's disease by analysis of an intragenic trinucleotide repeat expansion. Med J Aust. 1994 Sep 19;161(6):356–360. doi: 10.5694/j.1326-5377.1994.tb127486.x. [DOI] [PubMed] [Google Scholar]
  7. Britton J. W., Uitti R. J., Ahlskog J. E., Robinson R. G., Kremer B., Hayden M. R. Hereditary late-onset chorea without significant dementia: genetic evidence for substantial phenotypic variation in Huntington's disease. Neurology. 1995 Mar;45(3 Pt 1):443–447. doi: 10.1212/wnl.45.3.443. [DOI] [PubMed] [Google Scholar]
  8. Campuzano V., Montermini L., Moltò M. D., Pianese L., Cossée M., Cavalcanti F., Monros E., Rodius F., Duclos F., Monticelli A. Friedreich's ataxia: autosomal recessive disease caused by an intronic GAA triplet repeat expansion. Science. 1996 Mar 8;271(5254):1423–1427. doi: 10.1126/science.271.5254.1423. [DOI] [PubMed] [Google Scholar]
  9. Craufurd D., Dodge A. Mutation size and age at onset in Huntington's disease. J Med Genet. 1993 Dec;30(12):1008–1011. doi: 10.1136/jmg.30.12.1008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Davis M. B., Bateman D., Quinn N. P., Marsden C. D., Harding A. E. Mutation analysis in patients with possible but apparently sporadic Huntington's disease. Lancet. 1994 Sep 10;344(8924):714–717. doi: 10.1016/s0140-6736(94)92208-x. [DOI] [PubMed] [Google Scholar]
  11. De Rooij K. E., De Koning Gans P. A., Skraastad M. I., Belfroid R. D., Vegter-Van Der Vlis M., Roos R. A., Bakker E., Van Ommen G. J., Den Dunnen J. T., Losekoot M. Dynamic mutation in Dutch Huntington's disease patients: increased paternal repeat instability extending to within the normal size range. J Med Genet. 1993 Dec;30(12):996–1002. doi: 10.1136/jmg.30.12.996. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Duyao M., Ambrose C., Myers R., Novelletto A., Persichetti F., Frontali M., Folstein S., Ross C., Franz M., Abbott M. Trinucleotide repeat length instability and age of onset in Huntington's disease. Nat Genet. 1993 Aug;4(4):387–392. doi: 10.1038/ng0893-387. [DOI] [PubMed] [Google Scholar]
  13. Dürr A., Dodé C., Hahn V., Pêcheux C., Pillon B., Feingold J., Kaplan J. C., Agid Y., Brice A. Diagnosis of "sporadic" Huntington's disease. J Neurol Sci. 1995 Mar;129(1):51–55. doi: 10.1016/0022-510x(94)00250-r. [DOI] [PubMed] [Google Scholar]
  14. Goldberg Y. P., Andrew S. E., Theilmann J., Kremer B., Squitieri F., Telenius H., Brown J. D., Hayden M. R. Familial predisposition to recurrent mutations causing Huntington's disease: genetic risk to sibs of sporadic cases. J Med Genet. 1993 Dec;30(12):987–990. doi: 10.1136/jmg.30.12.987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Goldberg Y. P., Kremer B., Andrew S. E., Theilmann J., Graham R. K., Squitieri F., Telenius H., Adam S., Sajoo A., Starr E. Molecular analysis of new mutations for Huntington's disease: intermediate alleles and sex of origin effects. Nat Genet. 1993 Oct;5(2):174–179. doi: 10.1038/ng1093-174. [DOI] [PubMed] [Google Scholar]
  16. Illarioshkin S. N., Igarashi S., Onodera O., Markova E. D., Nikolskaya N. N., Tanaka H., Chabrashwili T. Z., Insarova N. G., Endo K., Ivanova-Smolenskaya I. A. Trinucleotide repeat length and rate of progression of Huntington's disease. Ann Neurol. 1994 Oct;36(4):630–635. doi: 10.1002/ana.410360412. [DOI] [PubMed] [Google Scholar]
  17. Kieburtz K., MacDonald M., Shih C., Feigin A., Steinberg K., Bordwell K., Zimmerman C., Srinidhi J., Sotack J., Gusella J. Trinucleotide repeat length and progression of illness in Huntington's disease. J Med Genet. 1994 Nov;31(11):872–874. doi: 10.1136/jmg.31.11.872. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Kremer B., Almqvist E., Theilmann J., Spence N., Telenius H., Goldberg Y. P., Hayden M. R. Sex-dependent mechanisms for expansions and contractions of the CAG repeat on affected Huntington disease chromosomes. Am J Hum Genet. 1995 Aug;57(2):343–350. [PMC free article] [PubMed] [Google Scholar]
  19. Kremer B., Goldberg P., Andrew S. E., Theilmann J., Telenius H., Zeisler J., Squitieri F., Lin B., Bassett A., Almqvist E. A worldwide study of the Huntington's disease mutation. The sensitivity and specificity of measuring CAG repeats. N Engl J Med. 1994 May 19;330(20):1401–1406. doi: 10.1056/NEJM199405193302001. [DOI] [PubMed] [Google Scholar]
  20. Kremer B., Squitieri F., Telenius H., Andrew S. E., Theilmann J., Spence N., Goldberg Y. P., Hayden M. R. Molecular analysis of late onset Huntington's disease. J Med Genet. 1993 Dec;30(12):991–995. doi: 10.1136/jmg.30.12.991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Legius E., Cuppens H., Dierick H., Van Zandt K., Dom R., Fryns J. P., Evers-Kiebooms G., Decruyenaere M., Demyttenaere K., Marynen P. Limited expansion of the (CAG)n repeat of the Huntington gene: a premutation (?). Eur J Hum Genet. 1994;2(1):44–50. doi: 10.1159/000472340. [DOI] [PubMed] [Google Scholar]
  22. Lucotte G., Turpin J. C., Riess O., Epplen J. T., Siedlaczk I., Loirat F., Hazout S. Confidence intervals for predicted age of onset, given the size of (CAG)n repeat, in Huntington's disease. Hum Genet. 1995 Feb;95(2):231–232. doi: 10.1007/BF00209410. [DOI] [PubMed] [Google Scholar]
  23. MacDonald M. E., Barnes G., Srinidhi J., Duyao M. P., Ambrose C. M., Myers R. H., Gray J., Conneally P. M., Young A., Penney J. Gametic but not somatic instability of CAG repeat length in Huntington's disease. J Med Genet. 1993 Dec;30(12):982–986. doi: 10.1136/jmg.30.12.982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. MacDonald M. E., Novelletto A., Lin C., Tagle D., Barnes G., Bates G., Taylor S., Allitto B., Altherr M., Myers R. The Huntington's disease candidate region exhibits many different haplotypes. Nat Genet. 1992 May;1(2):99–103. doi: 10.1038/ng0592-99. [DOI] [PubMed] [Google Scholar]
  25. MacMillan J. C., Morrison P. J., Nevin N. C., Shaw D. J., Harper P. S., Quarrell O. W., Snell R. G. Identification of an expanded CAG repeat in the Huntington's disease gene (IT15) in a family reported to have benign hereditary chorea. J Med Genet. 1993 Dec;30(12):1012–1013. doi: 10.1136/jmg.30.12.1012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. MacMillan J. C., Snell R. G., Tyler A., Houlihan G. D., Fenton I., Cheadle J. P., Lazarou L. P., Shaw D. J., Harper P. S. Molecular analysis and clinical correlations of the Huntington's disease mutation. Lancet. 1993 Oct 16;342(8877):954–958. doi: 10.1016/0140-6736(93)92002-b. [DOI] [PubMed] [Google Scholar]
  27. Martin J. B., Gusella J. F. Huntington's disease. Pathogenesis and management. N Engl J Med. 1986 Nov 13;315(20):1267–1276. doi: 10.1056/NEJM198611133152006. [DOI] [PubMed] [Google Scholar]
  28. Myers R. H., MacDonald M. E., Koroshetz W. J., Duyao M. P., Ambrose C. M., Taylor S. A., Barnes G., Srinidhi J., Lin C. S., Whaley W. L. De novo expansion of a (CAG)n repeat in sporadic Huntington's disease. Nat Genet. 1993 Oct;5(2):168–173. doi: 10.1038/ng1093-168. [DOI] [PubMed] [Google Scholar]
  29. Novelletto A., Persichetti F., Sabbadini G., Mandich P., Bellone E., Ajmar F., Pergola M., Del Senno L., MacDonald M. E., Gusella J. F. Analysis of the trinucleotide repeat expansion in Italian families affected with Huntington disease. Hum Mol Genet. 1994 Jan;3(1):93–98. doi: 10.1093/hmg/3.1.93. [DOI] [PubMed] [Google Scholar]
  30. Nørremølle A., Riess O., Epplen J. T., Fenger K., Hasholt L., Sørensen S. A. Trinucleotide repeat elongation in the Huntingtin gene in Huntington disease patients from 71 Danish families. Hum Mol Genet. 1993 Sep;2(9):1475–1476. doi: 10.1093/hmg/2.9.1475. [DOI] [PubMed] [Google Scholar]
  31. Rubinsztein D. C., Barton D. E., Davison B. C., Ferguson-Smith M. A. Analysis of the huntingtin gene reveals a trinucleotide-length polymorphism in the region of the gene that contains two CCG-rich stretches and a correlation between decreased age of onset of Huntington's disease and CAG repeat number. Hum Mol Genet. 1993 Oct;2(10):1713–1715. doi: 10.1093/hmg/2.10.1713. [DOI] [PubMed] [Google Scholar]
  32. Rubinsztein D. C., Leggo J., Coles R., Almqvist E., Biancalana V., Cassiman J. J., Chotai K., Connarty M., Crauford D., Curtis A. Phenotypic characterization of individuals with 30-40 CAG repeats in the Huntington disease (HD) gene reveals HD cases with 36 repeats and apparently normal elderly individuals with 36-39 repeats. Am J Hum Genet. 1996 Jul;59(1):16–22. [PMC free article] [PubMed] [Google Scholar]
  33. Rubinsztein D. C., Leggo J., Goodburn S., Crow T. J., Lofthouse R., DeLisi L. E., Barton D. E., Ferguson-Smith M. A. Study of the Huntington's disease (HD) gene CAG repeats in schizophrenic patients shows overlap of the normal and HD affected ranges but absence of correlation with schizophrenia. J Med Genet. 1994 Sep;31(9):690–693. doi: 10.1136/jmg.31.9.690. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Simpson S. A., Davidson M. J., Barron L. H. Huntington's disease in Grampian region: correlation of the CAG repeat number and the age of onset of the disease. J Med Genet. 1993 Dec;30(12):1014–1017. doi: 10.1136/jmg.30.12.1014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Snell R. G., MacMillan J. C., Cheadle J. P., Fenton I., Lazarou L. P., Davies P., MacDonald M. E., Gusella J. F., Harper P. S., Shaw D. J. Relationship between trinucleotide repeat expansion and phenotypic variation in Huntington's disease. Nat Genet. 1993 Aug;4(4):393–397. doi: 10.1038/ng0893-393. [DOI] [PubMed] [Google Scholar]
  36. Soong B. W., Wang J. T. A study on Huntington's disease associated trinucleotide repeat within the Chinese population. Proc Natl Sci Counc Repub China B. 1995 Jul;19(3):137–142. [PubMed] [Google Scholar]
  37. Squitieri F., Andrew S. E., Goldberg Y. P., Kremer B., Spence N., Zeisler J., Nichol K., Theilmann J., Greenberg J., Goto J. DNA haplotype analysis of Huntington disease reveals clues to the origins and mechanisms of CAG expansion and reasons for geographic variations of prevalence. Hum Mol Genet. 1994 Dec;3(12):2103–2114. doi: 10.1093/hmg/3.12.2103. [DOI] [PubMed] [Google Scholar]
  38. St Clair D. Expanded CAG trinucleotide repeat of Huntington's disease gene in a patient with schizophrenia and normal striatal histology. J Med Genet. 1994 Aug;31(8):658–659. doi: 10.1136/jmg.31.8.658. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Stevens D., Parsonage M. Mutation in Huntington's chorea. J Neurol Neurosurg Psychiatry. 1969 Apr;32(2):140–143. doi: 10.1136/jnnp.32.2.140. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Stine O. C., Pleasant N., Franz M. L., Abbott M. H., Folstein S. E., Ross C. A. Correlation between the onset age of Huntington's disease and length of the trinucleotide repeat in IT-15. Hum Mol Genet. 1993 Oct;2(10):1547–1549. doi: 10.1093/hmg/2.10.1547. [DOI] [PubMed] [Google Scholar]
  41. Telenius H., Kremer B., Goldberg Y. P., Theilmann J., Andrew S. E., Zeisler J., Adam S., Greenberg C., Ives E. J., Clarke L. A. Somatic and gonadal mosaicism of the Huntington disease gene CAG repeat in brain and sperm. Nat Genet. 1994 Apr;6(4):409–414. doi: 10.1038/ng0494-409. [DOI] [PubMed] [Google Scholar]
  42. Telenius H., Kremer H. P., Theilmann J., Andrew S. E., Almqvist E., Anvret M., Greenberg C., Greenberg J., Lucotte G., Squitieri F. Molecular analysis of juvenile Huntington disease: the major influence on (CAG)n repeat length is the sex of the affected parent. Hum Mol Genet. 1993 Oct;2(10):1535–1540. doi: 10.1093/hmg/2.10.1535. [DOI] [PubMed] [Google Scholar]
  43. Trottier Y., Biancalana V., Mandel J. L. Instability of CAG repeats in Huntington's disease: relation to parental transmission and age of onset. J Med Genet. 1994 May;31(5):377–382. doi: 10.1136/jmg.31.5.377. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Tzagournissakis M., Fesdjian C. O., Shashidharan P., Plaitakis A. Stability of the Huntington disease (CAG)n repeat in a late onset form occuring on the Island of Crete. Hum Mol Genet. 1995 Dec;4(12):2239–2243. doi: 10.1093/hmg/4.12.2239. [DOI] [PubMed] [Google Scholar]
  45. Warner J. P., Barron L. H., Brock D. J. A new polymerase chain reaction (PCR) assay for the trinucleotide repeat that is unstable and expanded on Huntington's disease chromosomes. Mol Cell Probes. 1993 Jun;7(3):235–239. doi: 10.1006/mcpr.1993.1034. [DOI] [PubMed] [Google Scholar]
  46. Zühlke C., Riess O., Bockel B., Lange H., Thies U. Mitotic stability and meiotic variability of the (CAG)n repeat in the Huntington disease gene. Hum Mol Genet. 1993 Dec;2(12):2063–2067. doi: 10.1093/hmg/2.12.2063. [DOI] [PubMed] [Google Scholar]
  47. Zühlke C., Riess O., Schröder K., Siedlaczck I., Epplen J. T., Engel W., Thies U. Expansion of the (CAG)n repeat causing Huntington's disease in 352 patients of German origin. Hum Mol Genet. 1993 Sep;2(9):1467–1469. doi: 10.1093/hmg/2.9.1467. [DOI] [PubMed] [Google Scholar]
  48. de Rooij K. E., de Koning Gans P. A., Losekoot M., Bakker E., den Dunnen J. T., Vegter-van der Vlis M., Roos R. A., van Ommen G. J. Borderline repeat expansion in Huntington's disease. Lancet. 1993 Dec 11;342(8885):1491–1492. doi: 10.1016/0140-6736(93)92974-x. [DOI] [PubMed] [Google Scholar]

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