Neurotherapeutics

, Volume 10, Issue 2, pp 251–261

Molecular Genetic Testing for Mitochondrial Disease: From One Generation to the Next

Authors

  • Elizabeth McCormick
    • Divisions of Human Genetics and Child Development and Metabolic Disease, Department of PediatricsThe Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine
  • Emily Place
    • Divisions of Human Genetics and Child Development and Metabolic Disease, Department of PediatricsThe Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine
    • Department of Ophthalmology, Ocular Genomics Institute, Massachusetts Eye and Ear InfirmaryHarvard Medical School
    • Divisions of Human Genetics and Child Development and Metabolic Disease, Department of PediatricsThe Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine
Review

DOI: 10.1007/s13311-012-0174-1

Cite this article as:
McCormick, E., Place, E. & Falk, M.J. Neurotherapeutics (2013) 10: 251. doi:10.1007/s13311-012-0174-1

Abstract

Molecular genetic diagnostic testing for mitochondrial disease has evolved continually since the first genetic basis for a clinical mitochondrial disease syndrome was identified in the late 1980s. Owing to global limitations in both knowledge and technology, few individuals, even among those with strong clinical or biochemical evidence of mitochondrial respiratory chain dysfunction, ever received a definitive molecular diagnosis prior to 2005. Clinically available genetic diagnostic testing options improved by 2006 to include sequencing and deletion analysis of an increasing number of individual nuclear genes linked to mitochondrial disease, genome-wide microarray analysis for chromosomal copy number abnormalities, and mitochondrial DNA whole genome sequence analysis. To assess the collective effect of these tests on the genetic diagnosis of suspected mitochondrial disease, we report here results from a retrospective review of the diagnostic yield in patients evaluated from 2008 to 2011 in the Mitochondrial-Genetics Diagnostic Clinic at The Children’s Hospital of Philadelphia. Among 152 patients aged 6 weeks to 81 years referred for clinical evaluation of multisystem presentations concerning for suspected mitochondrial disease, a genetic etiology was established that confirmed definite mitochondrial disease in 16.4 % and excluded primary mitochondrial disease in 9.2 %. Substantial diagnostic challenges remain owing to the clinical difficulty and frank low yield of a priori selecting individual nuclear genes to sequence based on particular symptomatic or biochemical manifestations of suspected mitochondrial disease. These findings highlight the particular utility of massively parallel nuclear exome sequencing technologies, whose benefits and limitations are explored relative to the clinical genetic diagnostic evaluation of mitochondrial disease.

Key Words

Next generation sequencingmassively parallel sequencingwhole exome sequencingretrospective studymitochondrial disease diagnosis

Supplementary material

13311_2012_174_MOESM1_ESM.pdf (907 kb)
ESM 1(PDF 907 kb)

Copyright information

© The American Society for Experimental NeuroTherapeutics, Inc. 2012