Neurológia pre prax 2/2024
The growing importance of genetics and the concept of genetic testing in Alzheimer's disease and related dementias. Experience from one center
The scientific community is gradually unraveling the etiological factors and pathogenetic mechanisms of neurodegenerative diseases. From year to year there is the robust evidence of the increasing power of the genetic background as an etiological factor. In our paper, we integrate two levels of insight into the genetics of Alzheimer’s disease and related dementias. In the first part of the article, we summarize current knowledge about the genetic background of neurodegenerative dementias, with the main focus on Alzheimer’s disease. In addition to “classic” causal genes and susceptibility genes, we provide an overview of selected “new” genes whose polymorphisms can increase susceptibility to Alzheimer’s disease. In the second part – Experience from one center – we present an insight into the development and current concept of genetic testing at the I. Neurological Clinic. We present a dementia gene panel that currently includes 45 genes involved in the pathogenesis of Alzheimer’s disease, Frontotemporal dementia, Parkinson’s disease and rare dementias. In the near future, we plan to expand it to a 150 gene panel and gradually update it continuously. The scope of genetic testing that we present in this manuscript mainly applies to dementia clinics and dementia centers. We outline the concept of how testing should proceed in the future using the example of the testing concept at our I. Neurological Clinic. In any case, we are trying to bring this issue closer to other neurological clinics, departments and outpatient clinics, which can also join this system if they have suitable patients. We conclude the article with a chapter on the relativity of current knowledge, which reflects the turbulent topic of the genetics of Alzheimer’s disease, which is constantly changing, expanding and updating, and may bring answers to a number of currently unanswered questions.
Keywords: Alzheimer’s disease, apolipoprotein E4, genetic testing, gene panel
