4.7 Article

Preimplantation Genetic Testing for Adult-Onset Neurodegenerative Disease

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NEUROLOGY
卷 101, 期 19, 页码 836-841

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0000000000207736

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Preimplantation genetic testing for monogenic conditions (PGT-M) is a specialized assisted reproduction technique aimed at reducing the risk of inheritance of monogenic conditions. There are currently no guidelines, so it is important to consider genetic, practical, technical, and psychosocial and ethical factors.
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.

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