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Samenvatting Neurogenetics

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This document contains all 10 lessons of the Neurogenetics elective course, with the last 5 “Disease focus” lessons. Each lesson is written according to the professor's words and is part of the given powerpoints. The slide titles are written in the document as titles with a line at the bottom.

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  • June 3, 2024
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Neurogenetics
Exam: written exam with part multiple choice and open questions.

28/02

Neurological disorders

Classification system

 These are all valid ways to define the diseases
 No good or bad way to do classification but helps to keep track for all the diseases discussed
here

Movement disorders

 Parkinson disease is the most common of these
 Many others and they are all caused by the defected cerebellum
o Can have diseases with a too fast or a too slow movement
o Hypokinetic = too slow, hyperkinetic = too fast
 Ataxia
o Has different types, where people have difficulties with moving and speaking
o Some are genetic and others can happen by alcohol or for example gluten intolerance
o Can cause heart problems, is different within every person
o Took over a decade to diagnose

Dementias

 Frontotemporal and Prion see next classes

Diseases of the white matter

 Myelin is normally formed and afterwards distructed
 It is formed from the beginning as a problem, or destructed later (like in MS)
 Multiple sclerosis

Neuromuscular disorders

 the upper and the lower
 ALS is an example of this
o Is a deadly disease that affects the motor nerve cells
o People become independent on others for help
o Frontotemporal dementia can happen same time with ALS

Paroxysmal disorders

 These occur unexpectedly and in episodes

Neurodevelopmental disorders

 Things like fragile X

Neurocutaneous disorders

 Neurofibromatosis type 1 (NF1)
 Tuber sclerosis complex

1

,  These tumors are in the brain and these cause epilepsy, they do not die but have other
effects and disabilities

Cerebrovascular diseases

 Genetic form of the disease is known as CADASIL
o Causes a lot of blood vessels in the brain

Major adult psychiatric disorders

Factors suggesting a neurogenetic disorders

 How to recognize if it is genetic?
o If it is inside a family
 It can be genetic but not in a family and vice versa
o Neurologists have combinations of symptoms for certain diseases and certain genetic
factors can be the sign of a disorder
o Subtle onset with a chronic, progressive cause
o Consanguinity
 When the parents are related to one another
o Increased frequency in a certain ethnic group
 Why would somebody have multiple individuals with the disorder in the family but is not
genetic?
o Environmental factors
o Age (Alzheimer for example because also common disease) = sporadic cases
o It can skip a generation, can be because there is a recessive gene
 Genetic but not in the family?
o De novo mutations
o Early death in the family
o Non paternity
 When the dad is not the dad

Inheritance patterns

 Examples
o First one is recessive because the parents are not affected
o Second example is dominant
 You expect 50% to be affected, here not the case because lot of people have
died already
o Third example is recessive because the parents are not affected
 You only see males that are affected (so might be X-linked)

Most patients/families affected by neurological disorders

 Not everyone that has the mutations presents symptoms = reduced penetrance
 A disease may not always be mono genetic but mutations can come together and you might
need 2 mutations or more to have a disorder and thus have a disease

From monogenic to complex diseases

 If you add more genes  oligogenic or complex where multiple genes play a role
 A single disorder can present in many different ways

2

, o The same disease can need one, or 2 or more genes
 The more genes come together, the more different the phenotypes get of the person
o Every time there is a slightly different phenotype, whilst the different persons have
the same disease
o Is because different genes that play a role in the disease

Impact of gene discovery

Gene identification methods

 Linkage analysis
o Based on the sharing of pieces of DNA between persons, measured by a LOD score
o You use STR markers, need 400-1000 markers for the genome
o You find a locus and do sequencing analysis in that reason, to find the gene that has
the mutation
o The challenge is that you need large families to do this
o Phenocopies and reduced penetrance will mess up the analysis
 Phenocopy is somebody who has the exact same phenotype as everyone else
in the family but does not carry the gene
 Population genetics
o Use unaffected individuals
 A person that is unrelated and a control needed
o Have to be careful that the cases and the control are well matched
o When people did association studies, people would take one gene at a time
 Did work sometimes
o Genome-wide association study
 The standard now for common variants in the population to use
 Manhattan plot are the different chromosomes and every dot is a different
variant
 The higher the variant, the more significant the p-value
 P < 5x10^-8
o Needed to say it is significantly associated with the disease
 Anything above the line means this variant is a risk factor for the
disease
 Polygenic risk scores
o You need the effect size
o Apply information to an individual and calculate the persons risk
 So information from the population that you apply on individual level
 Exam!
 You need a large population to come up with the effect size of a specific
variant and then you pull the variants together
 You take a single individual one at a time and then calculates its
personal risk score
 Based on that individuals data but with the effect size of the
population
o Considerations
 You have to decide which variants to include

Burden analysis

3

,  Let’s say you look for blue variants
 We should group all coding variants in gene X
 All loss-of-function variants in gene X
 it shows if you choose carefully and combine them in a burden analysis, you can also find rare
variants
o common variants GWAS

common vs rare

 in burden analysis the variants have a weaker effect like risk factors
 common variants with GWA
 common variants with strong effects are different to identify
 need to be able to place the studies in the wright part of the figure for the exam

example of ALS (Amyotrophic lateral sclerosis)

 many different genes can be present
 familial
o SOD1
o ALS2
o C9orf72 (see later)
 More than 20 different genes known, found in families and in sporadic individuals
 Oligogenic basis of ALS
o Often families where there is reduced penetrance, oligogenic disease and phenotypic
heterogeneity
 They often come together in the families
 Gene x Environmental interaction in ALS
o Interaction between genetics and environments, also in ALS
 ALS risk genes identified through GWAS
o 15 different risk loci found
 Polygenic risk score
o Overlap between the risk for ALS and the risk for schizophrenia is shown
 Exome sequencing study in ALS
o Type of analysis if we want to go beyond families = Burden analysis  is done here

Mutations affecting the coding sequence

 A gene can be coding in one sequence but not in another, there are multiple transcripts and
can have different effects

Nonsense-mediated decay

 Is an mRNA surveillance mechanism
 If a mutation is introduced before the stop codon, better to get rid of the entire transcript
 Exon junctions complexes that are usually around the exons
 By the premature stop, degradation is triggered because the exon junction complexes are still
sitting there
 However when there is a mutation in the last exon or 55nt before, NMD does not work and
the exon junctions stay
o This can play a role in neurologic diseases



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