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- W4246635062 abstract "Michael Rawlins (Oct 23, p 1372)1Rawlins M Huntington's disease out of the closet?.Lancet. 2010; 376: 1372-1373Summary Full Text Full Text PDF PubMed Scopus (31) Google Scholar comments that the prevalence of Huntington's disease is rising. We would like to suggest several additional explanations for this finding.First, the baby-boomers are now in their 50s–60s. Typically Huntington's disease begins in the 30s–40s, but given the duration of illness, peak prevalence actually occurs in the 50s–60s. We explored the effect of this large baby-boomer birth cohort on Huntington's disease prevalence, using age-specific data from our 1996 study.2McCusker EA Casse RF Graham SJ Williams DB Lazarus R Prevalence of Huntington disease in New South Wales in 1996.Med J Aust. 2000; 173: 187-190PubMed Google Scholar Prevalence of Huntington's disease in New South Wales, Australia, would have increased from 6·3 per 100 000 in 1996 to 6·8 per 100 000 in 2009 on the basis of changes in population structure alone.Second, we continue to meet new patients with no family history. 6% of the general population carries an intermediate allele (27–35 CAG repeats) for Huntington's disease.3Sequeiros J Ramos EM Cerqueira J et al.Large normal and reduced penetrance alleles in Huntington disease: instability in families and frequency at the laboratory, at the clinic and in the population.Clin Genet. 2010; 78: 381-387Crossref PubMed Scopus (52) Google Scholar Although the frequency of intermediate alleles expanding to new mutations is unclear,4Semaka A Collins JA Hayden MR Unstable familial transmissions of Huntington disease alleles with 27–35 CAG repeats (intermediate alleles).Am J Med Genet B Neuropsychiatr Genet. 2010; 153B: 314-320PubMed Google Scholar new mutations do occur and can account for up to 4% of cases.5Ramos-Arroyo MA Moreno S Valiente A Incidence and mutation rates of Huntington's disease in Spain: experience of 9 years of direct genetic testing.J Neurol Neurosurg Psychiatry. 2005; 76: 337-342Crossref PubMed Scopus (57) Google ScholarAnecdotally we too have seen an increase in prevalence of Huntington's disease, albeit not to the same extent as Rawlins. We care for about 71% of people with Huntington's disease in the state of New South Wales. In 2010, after adjusting for population growth, our service is still supporting 5·5% more patients than our 1996 prevalence would have predicted. There are potential biases in extrapolating our data on service use to prevalence, and a repeat prevalence study is required for a definitive answer. Nonetheless, this observation would support Rawlins'. Thus we applaud his effort in highlighting this problem, and in establishing the All Party Parliamentary Group on Huntington's Disease.We declare that we have no conflicts of interest. Michael Rawlins (Oct 23, p 1372)1Rawlins M Huntington's disease out of the closet?.Lancet. 2010; 376: 1372-1373Summary Full Text Full Text PDF PubMed Scopus (31) Google Scholar comments that the prevalence of Huntington's disease is rising. We would like to suggest several additional explanations for this finding. First, the baby-boomers are now in their 50s–60s. Typically Huntington's disease begins in the 30s–40s, but given the duration of illness, peak prevalence actually occurs in the 50s–60s. We explored the effect of this large baby-boomer birth cohort on Huntington's disease prevalence, using age-specific data from our 1996 study.2McCusker EA Casse RF Graham SJ Williams DB Lazarus R Prevalence of Huntington disease in New South Wales in 1996.Med J Aust. 2000; 173: 187-190PubMed Google Scholar Prevalence of Huntington's disease in New South Wales, Australia, would have increased from 6·3 per 100 000 in 1996 to 6·8 per 100 000 in 2009 on the basis of changes in population structure alone. Second, we continue to meet new patients with no family history. 6% of the general population carries an intermediate allele (27–35 CAG repeats) for Huntington's disease.3Sequeiros J Ramos EM Cerqueira J et al.Large normal and reduced penetrance alleles in Huntington disease: instability in families and frequency at the laboratory, at the clinic and in the population.Clin Genet. 2010; 78: 381-387Crossref PubMed Scopus (52) Google Scholar Although the frequency of intermediate alleles expanding to new mutations is unclear,4Semaka A Collins JA Hayden MR Unstable familial transmissions of Huntington disease alleles with 27–35 CAG repeats (intermediate alleles).Am J Med Genet B Neuropsychiatr Genet. 2010; 153B: 314-320PubMed Google Scholar new mutations do occur and can account for up to 4% of cases.5Ramos-Arroyo MA Moreno S Valiente A Incidence and mutation rates of Huntington's disease in Spain: experience of 9 years of direct genetic testing.J Neurol Neurosurg Psychiatry. 2005; 76: 337-342Crossref PubMed Scopus (57) Google Scholar Anecdotally we too have seen an increase in prevalence of Huntington's disease, albeit not to the same extent as Rawlins. We care for about 71% of people with Huntington's disease in the state of New South Wales. In 2010, after adjusting for population growth, our service is still supporting 5·5% more patients than our 1996 prevalence would have predicted. There are potential biases in extrapolating our data on service use to prevalence, and a repeat prevalence study is required for a definitive answer. Nonetheless, this observation would support Rawlins'. Thus we applaud his effort in highlighting this problem, and in establishing the All Party Parliamentary Group on Huntington's Disease. We declare that we have no conflicts of interest." @default.
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- W4246635062 date "2010-10-01" @default.
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- W4246635062 title "Huntington's disease" @default.
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