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Genetic testing for Parkinson disease: current practice, knowledge, and attitudes among US and Canadian movement
Roy N Alcalay1, Caitlin Kehoe2, Evan Shorr2
1Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA. rna2104@cumc.columbia.edu.
Purpose:
Genetic testing for Parkinson disease (PD) has not been widely used in clinical practice. In preparation for upcoming precision medicine-designed clinical trials for GBA and LRRK2, we evaluated movement disorders specialists' current practice, knowledge, attitudes, and barriers to genetic testing in PD.
Methods:
An anonymous questionnaire was sent to movement disorders specialists at 146 Parkinson Study Group (PSG) sites in the United States (n = 131) and Canada (n = 15) to assess their knowledge and attitudes about genetic testing for PD.
Results:
One hundred seventy-eight (47.6%) PSG clinicians completed the questionnaire. Forty-one percent of respondents had not referred any PD patients for genetic testing in the last year and >80% reported referring fewer than 11 patients over the same period. Most common reasons for not referring for genetic testing included lack of insurance coverage/cost to the patient and lack of perceived utility. On a scale of 0-100, the mean level of comfort in respondents' own ability to genetically counsel PD patients on GBA and LRRK2 was 52 (SD = 28). Sixty percent of clinicians correctly answered all questions about the inheritance and penetrance of GBA and LRRK2 variants.
Conclusions:
There is an urgent need to increase knowledge and reduce practical barriers to genetic counseling and testing in PD.
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