The SPID-GBA study: Sex distribution, Penetrance, Incidence, and Dementia in GBA-PD

Letizia Straniero; Rosanna Asselta; Salvatore Bonvegna; Valeria Rimoldi; Giada Melistaccio; Giulia Soldà; Massimo Aureli; Matteo Della Porta; Ugo Lucca; Alessio Di Fonzo; Anna Zecchinelli; Gianni Pezzoli; Roberto Cilia; Stefano Duga

doi:10.1212/NXG.0000000000000523

The SPID-GBA study: Sex distribution, Penetrance, Incidence, and Dementia in GBA-PD

Neurol Genet. 2020 Oct 20;6(6):e523. doi: 10.1212/NXG.0000000000000523. eCollection 2020 Dec.

Affiliation

¹ Department of Biomedical Sciences (L.S., R.A., V.R., G.M., G.S., M.D.P., S.D.), Humanitas University; Humanitas Clinical and Research Center (R.A., V.R., G.S., M.D.P., S.D.), IRCCS, Rozzano; Fondazione Grigioni per il Morbo di Parkinson (S.B., A.Z., G.P.); Parkinson Institute (S.B., A.Z., G.P., R.C.), ASST "Gaetano Pini-CTO"; Department of Medical Biotechnology and Translational Medicine (M.A.), University of Milan; Laboratory of Geriatric Neuropsychiatry (U.L.), Istituto di Ricerche Farmacologiche Mario Negri IRCCS; IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico (A.D.F.), Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan; and Fondazione IRCCS Istituto Neurologico "Carlo Besta" (R.C.), Milan, Italy.

Abstract

Objective: To provide a variant-specific estimate of incidence, penetrance, sex distribution, and association with dementia of the 4 most common Parkinson disease (PD)-associated GBA variants, we analyzed a large cohort of 4,923 Italian unrelated patients with primary degenerative parkinsonism (including 3,832 PD) enrolled in a single tertiary care center and 7,757 ethnically matched controls.

Methods: The p.E326K, p.T369M, p.N370S, and p.L444P variants were screened using an allele-specific multiplexed PCR approach. All statistical procedures were performed using R or Plink v1.07.

Results: Among the 4 analyzed variants, the p.L444P confirmed to be the most strongly associated with disease risk for PD, PD dementia (PDD), and dementia with Lewy bodies (DLB) (odds ratio [OR] for PD 15.63, 95% confidence interval [CI] = 8.04-30.37, p = 4.97*10^-16; OR for PDD 29.57, 95% CI = 14.07-62.13, p = 3.86*10^-19; OR for DLB 102.7, 95% CI = 31.38-336.1, p = 1.91*10^-14). However, an unexpectedly high risk for dementia was conferred by p.E326K (OR for PDD 4.80, 95% CI = 2.87-8.02, p = 2.12*10^-9; OR for DLB 12.24, 95% CI = 4.95-30.24, p = 5.71*10^-8), which, on the basis of the impact on glucocerebrosidase activity, would be expected to be mild. The 1.5-2:1 male sex bias described in sporadic PD was lost in p.T369M carriers. We also showed that PD penetrance for p.L444P could reach the 15% at age 75 years.

Conclusions: We report a large monocentric study on GBA-PD assessing mutation-specific data on the sex distribution, penetrance, incidence, and association with dementia of the 4 most frequent deleterious variants in GBA.