Diagnostic yield of targeted sequential and massive panel approaches for inherited neuropathies

Clin Genet. 2020 Aug;98(2):185-190. doi: 10.1111/cge.13793. Epub 2020 Jun 29.

Abstract

Diagnostic yield of genetic studies for Charcot-Marie-Tooth disease (CMT) is little known, with a lack of epidemiological data to build better diagnostic strategies outside the United States and Europe. We aimed to evaluate the performance of two molecular diagnostic strategies for patients with CMT, and to characterize epidemiological findings of these conditions in southern Brazil. We performed a single-center cross-sectional study, in which 94 patients (55 families) with CMT suspicion were evaluated. Overall, the diagnostic yield of the combined strategy of Multiplex-ligation-dependent-probe-amplification (MLPA) of PMP22/GJB1/MPZ and GJB1/MPZ/PMP22 Sanger sequencing was 63.6% (28/44) for index cases with demyelinating/intermediate CMT suspicion (21 CMT1A-PMP22, 5 CMTX1-GJB1 and 2 with probably CMT1B-MPZ diagnosis). Five of the 11 index cases (45.4%) with axonal CMT had at least a possible diagnosis with next generation sequencing (NGS) panel of 104 inherited neuropathies-related genes (one each with CMT1A-PMP22, CMT2A-MFN2, CMT2K-GDAP1, CMT2U-MARS, CMT2W-HARS1). Detailed clinical, neurophysiological and molecular data of families are provided. Sequential molecular diagnosis strategies with MLPA plus target Sanger sequencing for demyelinating/intermediate CMT had high diagnostic yield, and almost half of axonal CMT families had at least a possible diagnosis with the comprehensive NGS panel. Most frequent subtypes of CMT in our region are CMT1A-PMP22 and CMTX1-GJB1.

Keywords: Charcot-Marie-Tooth disease; diagnosis; hereditary neuropathy with liability to pressure palsies; multiplex ligation-dependent probe amplification; next generation sequencing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brazil / epidemiology
  • Charcot-Marie-Tooth Disease / classification
  • Charcot-Marie-Tooth Disease / diagnosis*
  • Charcot-Marie-Tooth Disease / epidemiology
  • Charcot-Marie-Tooth Disease / genetics
  • Connexins / genetics*
  • Female
  • Gap Junction beta-1 Protein
  • Humans
  • Male
  • Multiplex Polymerase Chain Reaction / methods
  • Mutation
  • Myelin P0 Protein / genetics*
  • Myelin Proteins / genetics*
  • Pathology, Molecular / methods
  • Sequence Analysis, DNA

Substances

  • Connexins
  • MPZ protein, human
  • Myelin P0 Protein
  • Myelin Proteins
  • PMP22 protein, human

Supplementary concepts

  • Charcot-Marie-Tooth disease, Type 2A
  • Charcot-Marie-Tooth disease, Type 2K
  • Charcot-Marie-Tooth disease, X-linked, 1