Back

Rare loss-of-function variants in POLD1, PMS1 and FAN1 modify age at onset of motor symptoms in Huntington's disease

Gelfman, S.; Wang, R.; Campos, A. I.; Sul, J.-H.; Li, Q. S.; Alvarez, S.; Pounjara, V. K.; Wang, C.; Ali, T.; Zou, Y.; Marcketta, A.; Ghosh, A.; Watanabe, K.; Lachmann, A.; Adhikari, K.; Ziyatdinov, A.; Yu, S.; Averitt, A.; Paynter, A.; LeBlanc, M.; Jones, M.; Marchini, J.; Abecasis, G. R.; Lotta, L. A.; Baras, A.; Kwak, S.; Rosinski, J.; Vogt, T. F.; Ferreira, M. A. R.; Stahl, E. A.; Coppola, G.

2026-06-22 genetic and genomic medicine
10.64898/2026.06.16.26354747 medRxiv
Show abstract

Huntington's disease is a rare neurodegenerative disease whose primary risk factors are inherited expansions of a CAG repeat tract in the HTT gene. Somatic expansion of these tracts leads to neuronal toxicity, neuronal death and clinical disease progression. To identify genetic factors with a major impact on disease onset and progression, we genome sequenced 18,825 individuals for the ENROLL-HD study. Our results show rare inactivating mutations in three genes, all involved in DNA damage repair, are major determinants of age of onset for motor symptoms (n=10,610) and other clinical manifestations. Heterozygote carriers of predicted loss-of-function (pLoF) variants in POLD1 and PMS1 developed motor symptoms an average 20 years (n=3; P=1x10-5) and 7 years (n=6; P=2x10-3) later than non-carriers, respectively. Conversely, heterozygote carriers of pLoF variants in FAN1 (n=30) developed symptoms 10 years earlier (P=2x10-10). Our findings highlight therapeutic strategies and help predict age of onset for at-risk individuals.

Matching journals

The top 3 journals account for 50% of the predicted probability mass.

50% of probability mass above

"Similar papers" are the closest papers from that journal in the model's embedding space. They show what the match is built on, but the ranking comes mostly from a classifier over the whole training set, not from these examples alone.