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Additional rare variant analysis in Parkinson?s disease cases with and without known pathogenic mutations: evidence for oligogenic inheritance

Lubbe, Steven J., Escott-Price, Valentina ORCID:, Gibbs, J. Raphael, Nalls, Mike A., Bras, Jose, Price, T. Ryan, Nicolas, Aude, Jansen, Iris E., Mok, Kin Y., Pittman, Alan M., Tomkins, James E., Lewis, Patrick A., Noyce, Alastair J., Lesage, Suzanne, Sharma, Manu, Schiff, Elena R., Levine, Adam P., Brice, Alexis, Gasser, Thomas, Hardy, John, Heutink, Peter, Wood, Nicholas W., Singleton, Andrew B., Williams, Nigel ORCID: and Morris, Huw R. 2016. Additional rare variant analysis in Parkinson?s disease cases with and without known pathogenic mutations: evidence for oligogenic inheritance. Human Molecular Genetics 25 (24) , pp. 5483-5489. 10.1093/hmg/ddw348

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Oligogenic inheritance implies a role for several genetic factors in disease etiology. We studied oligogenic inheritance in Parkinson’s (PD) by assessing the potential burden of additional rare variants in established Mendelian genes and/or GBA, in individuals with and without a primary pathogenic genetic cause in two large independent cohorts totaling 7,900 PD cases and 6,166 controls. An excess (�30%) of cases with a recognised primary genetic cause had�1 additional rare variants in Mendelian PD genes, as compared with no known mutation PD cases (17%) and unaffected controls (16%), supporting our hypothesis. Carriers of additional Mendelian gene variants have younger ages at onset (AAO). The effect of additional Mendelian variants in LRRK2 G2019S mutation carriers, of which ATP13A2 variation is particularly common, may account for some of the variation in penetrance. About 10% of No Known Mutation-PD cases harbour a rare GBA variant compared to known pathogenic mutation PD cases (8%) and controls (5%), with carriers having earlier AAOs. Together, the data suggest that the oligogenic inheritance of rare Mendelian variants may be important in patient with a primary pathogenic cause, whereas GBA increases risk across all forms of PD. This study highlights the potential genetic complexity of Mendelian PD. The identification of potential modifying variants provides new insights into disease mechanisms by potentially separating relevant from benign variants and by the interaction between genes in specific pathways. In the future this may be relevant to genetic testing and counselling of patients with PD and their families.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: parkinson disease , mutation , genes , penetrance, genetic , genetics , genetic inheritance , lrrk2 gene , atp13a2 gene
Additional Information: C The Author 2016. Published by Oxford University Press. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (,
Publisher: Oxford University Press
ISSN: 0964-6906
Date of First Compliant Deposit: 22 February 2017
Date of Acceptance: 7 October 2016
Last Modified: 19 Nov 2023 15:59

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