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August 18, 2023Contemporary Issues in Practice, Education, & Research

Preimplantation Genetic Testing for Adult-Onset Neurodegenerative Disease: Considerations for Access, Utilization, and Counseling

Rachel A Paul, Aaron Baldwin, Kelsey Johnson, Sara Manning Peskin, View ORCID ProfileThomas F Tropea, Meron Azage, Tanya Bardakjian, Laynie Dratch
First published August 18, 2023, DOI: https://doi.org/10.1212/WNL.0000000000207736
Rachel A Paul
1Department of Neurology, University of Pennsylvania, Philadelphia PA
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  • For correspondence: rachel.paul3@pennmedicine.upenn.edu
Aaron Baldwin
1Department of Neurology, University of Pennsylvania, Philadelphia PA
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Kelsey Johnson
1Department of Neurology, University of Pennsylvania, Philadelphia PA
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Sara Manning Peskin
1Department of Neurology, University of Pennsylvania, Philadelphia PA
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Thomas F Tropea
1Department of Neurology, University of Pennsylvania, Philadelphia PA
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  • ORCID record for Thomas F Tropea
Meron Azage
1Department of Neurology, University of Pennsylvania, Philadelphia PA
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Tanya Bardakjian
2. Current: Sarepta Therapeutics, Cambridge, MA
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Laynie Dratch
1Department of Neurology, University of Pennsylvania, Philadelphia PA
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Citation
Preimplantation Genetic Testing for Adult-Onset Neurodegenerative Disease: Considerations for Access, Utilization, and Counseling
Rachel A Paul, Aaron Baldwin, Kelsey Johnson, Sara Manning Peskin, Thomas F Tropea, Meron Azage, Tanya Bardakjian, Laynie Dratch
Neurology Aug 2023, 10.1212/WNL.0000000000207736; DOI: 10.1212/WNL.0000000000207736

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Abstract

Preimplantation genetic testing for monogenic conditions (PGT-M), formerly called preimplantation genetic diagnosis, is a specialized assisted reproduction technique that aims to reduce the risk of a pregnancy inheriting a monogenic condition. Despite calls to increase awareness and prepare neurologists for discussing PGT-M with patients and their families, no guidelines currently exist. When introducing PGT-M to those who may be interested in using it, there are major factors for discussion, including (1) genetic considerations (e.g., requirement for a confirmed genetic diagnosis; timing of genetic test results); (2) practical considerations (e.g., access to PGT-M and genetic services); (3) technical considerations (e.g., factors that can affect the success rate of PGT-M); and (4) psychosocial and ethical considerations (e.g., predictive testing for asymptomatic family members; family dynamics and values). Here, our team of neurologists and specialized genetic counselors discusses the current state of genetic characterization in adult-onset neurodegenerative conditions and highlights the major factors that should be considered when discussing PGT-M with families.

  • Received January 10, 2023.
  • Accepted in final form June 20, 2023.
  • Copyright © 2023 American Academy of Neurology. Unauthorized reproduction of this article is prohibited

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