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A review of quality of life after predictive testing for and earlier identification of neurodegenerative diseases
Open accessAbstract
The past decade has witnessed an explosion of evidence suggesting that many neurodegenerative diseases can be detected years, if not decades, earlier than previously thought. To date, these scientific advances have not provoked any parallel translational or clinical improvements. There is an urgency to capitalize on this momentum so earlier detection of disease can be more readily translated into improved health-related quality of life for families at risk for, or suffering with, neurodegenerative diseases. In this review, we discuss health-related quality of life (HRQOL) measurement in neurodegenerative diseases and the importance of these "patient reported outcomes" for all clinical research. Next, we address HRQOL following early identification or predictive genetic testing in some neurodegenerative diseases: Huntington disease, Alzheimer's disease, Parkinson's disease, Dementia with Lewy bodies, frontotemporal dementia, amyotrophic lateral sclerosis, prion diseases, hereditary ataxias, Dentatorubral-pallidoluysian atrophy and Wilson's disease. After a brief report of available direct-to-consumer genetic tests, we address the juxtaposition of earlier disease identification with assumed reluctance toward predictive genetic testing. Forty-one studies examining health-related outcomes following predictive genetic testing for neurodegenerative disease suggested that (a) extreme or catastrophic outcomes are rare; (b) consequences commonly include transiently increased anxiety and/or depression; (c) most participants report no regret; (d) many persons report extensive benefits to receiving genetic information; and (e) stigmatization and discrimination for genetic diseases are poorly understood and policy and laws are needed. Caution is appropriate for earlier identification of neurodegenerative diseases but findings suggest further progress is safe, feasible and likely to advance clinical care.
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Metadata
- Authors
- Paulsen, J. S., Nance, M., Kim, J.-I., Carlozzi, N. E., Panegyres, P. K., Erwin, C., Goh, A., McCusker, E., & Williams, J. K.
- Affiliations
- University of Iowa (US)
- Park Nicollet Methodist Hospital (US)
- University of Michigan (US)
- The University of Texas Health Science Center at Houston (US)
- The Royal Melbourne Hospital (AU)
- The University of Sydney (AU)
- Corresponding author
- Paulsen, Jane S.
- ORCID
- Venue
- Progress in Neurobiology
- Publisher
- Elsevier BV
- Published
- 2013-11
- Volume
- 110
- Pages
- 2-28
- ISSN
- 0301-0082 (ISSN-L)
- PMC
- PMC3833259
- OpenAlex
- W1980542254
- Cited by
- 168
- References
- 290
- Citations by year
- 2026: 8 · 2025: 16 · 2024: 18 · 2023: 10 · 2022: 18 · 2021: 21 · 2020: 10 · 2019: 14 · 2018: 9 · 2017: 14 · 2016: 8 · 2015: 11 · 2014: 10
- FWCI
- 0.98
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Progress in Neurobiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Iowa Research Online (The University of Iowa) (submittedVersion)
- Funders
- National Institutes of Health (UL1TR000442)
- U.S. Public Health Service (NGHG003330)
- National Human Genome Research Institute (R01HG003330)
- National Institute of Neurological Disorders and Stroke (R01NS040068, R01NS077946, NS040068, R01NS054893, NS054893, NS077946)
- National Center for Advancing Translational Sciences
- Topics
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Genetic Neurodegenerative Diseases
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- health-related quality of life, predictive genetic testing, early diagnosis, neurodegenerative diseases, patient-reported outcomes, Huntington's disease, Alzheimer's disease, Parkinson's disease, dementia with Lewy bodies, frontotemporal dementia, amyotrophic lateral sclerosis, prion disease, hereditary ataxia, dentatorubral-pallidoluysian atrophy, Wilson's disease, direct-to-consumer genetic testing, regret, genetic discrimination, stigmatization
- MeSH terms
- Brain, Genetic Testing, Humans, Quality of Life, Neurodegenerative Diseases, Early Diagnosis
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